Introduction
Obesity is an increasing problem in the United States, and research into the association between obesity and pneumonia has yielded conflicting results.
Methods
Using Department of Veterans Affairs administrative data between fiscal years 2002-2006, we examined a cohort of patients hospitalized with a discharge diagnosis of pneumonia. Body Mass Index was categorized as underweight (< 18.5), normal (18.5-24.9, reference group), overweight (25-29.9), obese (30-39.9), and morbidly obese (≥40). Our primary analyses were multi-level regression models with the outcomes of 90-day mortality, intensive care unit (ICU) admission, need for mechanical ventilation and vasopressor utilization.
Results
The cohort comprised of 18,746 subjects. Three percent were underweight, 30% were normal, 35% were overweight, 26% were obese, and 4% were morbidly obese. In the regression models, after adjusting for potential confounders, morbid obesity was not associated with mortality (odds ratio 0.96, 95% confidence interval 0.72-1.28), but obesity was associated with decreased mortality (0.86, 95% 0.74-0.99). Neither obesity nor morbid obesity were associated with ICU admission, use of mechanical ventilation or vasopressor utilization. Underweight patients had increased 90-day mortality (1.40, 1.14-1.73).
Conclusions
Although obesity is a growing health epidemic, it appears to have little impact on clinical outcomes and may reduce mortality for veterans hospitalized with pneumonia.
Intraduct papillomas of the salivary glands are rare solitary tumours. Most of the reported cases have occurred in minor salivary glands. A case which occurred in the parotid gland is reported. Fine needle aspiration was performed on this tumour, and the cytological appearances of the aspirate were suggestive of an adenoid cystic carcinoma. This is an important potential diagnostic pitfall which should be borne in mind when interpreting aspirates from salivary gland tumours.
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