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Objective: Given the complicated relationship between body composition and mortality, changes in fat mass (FM) and fat-free mass (FFM) would be important parameters. Body compositions measurement may provide prognostic information. The primary aim was to observe the nature of body composition changes with weight reduction by lifestyle therapy. Materials and Methods: Obese patients who visited in Obesity Clinic, Srinagarind Hospital were enrolled in this retrospective observational study. Body composition changes during lifestyle therapy was measured by bioelectrical impedance analysis (BIA). Fat mass index (FMI) and fat-free mass index (FFMI) were calculated and used as normalization for FM and FFM, respectively. Results: Mean body weight of 121 patients was 113.8 kg and mean body mass index was 42.3 kg/m2. At 3-month, 49.6% of patients achieved 3% weight loss. At 6-month, 54.1% of the patients could achieve 5% weight reduction. There was a significant reduction in FMI afterward weight reduction at 6-month (mean difference 4.03 kg/m2; 95% CI 1.39 to 6.68) while FFMI had non-significant change (mean difference 0.50 kg/m2; 95% CI -1.25 to 2.25). At 6-month, patients who achieved 5% weight reduction had significant loss of FMI compared with who did not achieve (4.12 kg/m2 ±0.47 vs. 0.42 kg/m2 ±0.25; p-value <0.001). Conclusion: Lifestyle therapy could maintain FFM and lose FM in those who achieved weight reduction. Application of body composition analysis for daily practice will provide information of changes in the two distinct major body compartments. Maintenance of FFM with persistent FM reduction will be beneficial for long-term clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: The objectives are to explore the characteristics of organ failure and support in the medical intensive care units and exam the effect of organ failure on mortality. Materials and Methods: This was a prospective cohort study of critically ill medical patients. All consecutive patients were collected for one year. Demographic data, organ failure characteristics, and support were recorded. Outcomes were mortality at day 28,90, and year one. Results: A total of446 patients were included. The median age was 60 years (IQR 46,73], and the male was 58.3%. Median Charlson comorbidities index was 4 points (IQR 2,4). Median APACHE II and SOFA scores were 23 (IQR 18, 30] and 8 points (IQR 5,11]. Acute respiratory failure (ARF] developed 69.1% (95% CI 61.7 to 70.2], Mechanical ventilation duration was 6 days (95% CI 4 to 6], whereas the ventilator-free day on day 28 was 22 days (95% CI 16 to 23], Ventilator associated pneumonia rate was 9.4 events per 1,000 ventilator-days (95% CI 6.1 to 13.8]. Acute kidney injury (AKI] developed 71.5% (95% CI 66.8 to 75.7]: 25.2%, 20.5%, and 54.3% had stage I, II, III AKI. Patients developed shock 66.8%. Septic shock was the most common type. The median time to start nutrition support was 1 day (IQR 1.0, 2.0]. Mortality at day 28, day 90, and 1 year were 30.7% (95% CI 26.6 to 35.1], 42.4% (95% CI 37.9 to 47], and 53.8% (95% CI 49.2 to 58.4], ARF had a constant effect on death at day 28 (HR 3.68,95% CI 1.96 to 6.91]. Shock had a peak effect on mortality since day 1 of ICU admission (HR 120.3,95% CI 4.76 to 3,040.7] and still had a significant impact on day 28 (HR 2.07, 95% CI 1.14 to 3.74]. Development of stage III AKI had an earlier effect than stage II AKI on mortality and a peak effect at day 28. Conclusion: AKI and ARF were common in ICU. Shock had the highest effect on mortality, followed by ARF and AKI. [ABSTRACT FROM AUTHOR]