We found abnormal values in NBP and in NRS in a significant number of patients with SCI and PU of both III and IV. Both laboratory examinations and nutritional assessments at admission can help to detect and correct the nutritional deficits in patients at risk. Neither the grade of the PUs, nor the NBP or the NRS can replace one another.
An 81-year-old woman was taken to the hospital because of the suspected diagnosis of community-acquired pneumonia. She had a respiratory rate of 35/min and an O 2 saturation of 68% on room air. She had been taking amiodarone 200 mg/d for two years because of tachycardic atrial fibrillation, and her chest x-ray revealed an unusual opacification, leading us to suspect amiodarone-induced pneumonitis. High-resolution computed tomography of the chest showed the typical so-called crazy paving pattern (alveolar ground-glass opacification with a superimposed irregular reticular pattern). Cytological examination of a bronchial lavage specimen confirmed our working diagnosis (CD8+ lymphocytic alveolitis with foam-cell macrophages and mild alveolar hemorrhagic syndrome). The most common presentation of amiodarone-induced pneumopathy is interstitial pneumonitis, with an incidence of 1-5%. Risk factors include a daily amiodarone dose above 400 mg, advanced age, treatment for more than 2 months, and a pre-existing pneumopathy. The clinical presentation includes dry cough and dyspnea in 75% of cases, fever and weight loss in 33%. Our patient was treated with methylprednisolone 60 mg/d for two weeks, discontinuation of amiodarone, and empirical antibiotic therapy, and her condition rapidly improved.
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