Oral occlusion pressure, a neuro-muscular index of the activity of the respiratory centers, was measured in 2 groups of children: one of 43 "healthy" children, in order to establish a predictive equation according to age (Y = 1.23 + 8.30 X A-1) and another of children presenting with respiratory failure, either due to an impairment of the thoracic cavity (10 dorsal scoliosis) or to an impairment of the respiratory muscles (29 children with muscular dystrophy or spinal muscular atrophy). The occlusion pressure increases with the degree of the ventilation deficiency in children with scoliosis. It remains paradoxically normal in children with neuro-muscular disease, irrespective of the ventilation deficiency. In the latter, the respiratory centers activity being considered as normal, this situation would indicate their muscular incapacity to correctly express this activity. It would show a severe muscular deficiency with a high risk of occurrence of respiratory distress accidents.
Introduction: The “obesity paradox” has been a controversial topic in health outcome research. Age has been a significant cofounder and a new study is needed. Purpose: To determine the relationship between obesity and in-hospital mortality, morbidity, and health care resource utilization in patients admitted to the hospital in the United States with acute pulmonary embolism (PE). Method: A retrospective study was conducted using the AHRQ-HCUP National Inpatient Sample for the year 2014. Adults (≥ 18 years) with a principal diagnosis of acute PE and a secondary diagnosis of obesity were identified using ICD-9 codes as described in the literature. The primary outcome was in-hospital mortality. Secondary outcomes were length of hospital stay (LOS), and total hospitalization costs. Propensity score (PS) using the next neighbor method without replacement with 1:1 matching was utilized to adjust for confounders. Results: In total, 171,233 hospital admissions with a primary diagnosis of acute PE were identified, of which 16.4% were obese. The index inhospital moralities were not statistically different between obese and non-obese patients (1.9 vs 7.1%, p=0.24). The 30-day readmission rate among were similar between the obese and non-obese patients (p=0.14). The most common reason for readmission was DVT (12%). Obesity and non-obese patients have similar LOS (p=0.46) and total hospital cost (p=0.52). Conclusion: In this study, the mortality difference between obese and non-obese patients was not statistically significant. This clarifies that among acute PE patient, obesity paradox may not hold true.
