Premature babies at higher risk of sleep apnea from narrowed upper airways

Agencies
December 25, 2017

Dec 25: A premature infant, born more than 3 weeks before the due date, has narrowed upper airways as compared to newborn peers carried to full term.

Premature birth leaves these children more susceptible to disordered breathing while sleeping, including obstructive sleep apnea (OSA), an ailment characterized by increased upper-airway resistance that narrows airways.

"In addition to finding some airway volumes were smaller in preterm infants, our results indicated both sets of newborns had similar hypopharyngeal volumes. This suggests that risk factors that lead to OSA are confined to the uppermost airway and do not appear to be explained by enlarged adenoids and tonsils," says Anilawan Smitthimedhin, lead author of the paper.

In order to diagnose OSA, clinicians now use bronchoscopy, but the method has limitations, including the need to insert a lighted instrument into the airway, which can affect pressure and resistance within the airway.

The Children's National research team theorized that magnetic resonance imaging (MRI) could offer a non-invasive way to evaluate the upper airway, determine its anatomy and dynamic function, while shielding infants from radiation exposure that can accompany other imaging techniques.

They enrolled 96 infants who had undergone brain MRIs as part of an unrelated study about neonatal brain development. The newborns had a range of medical conditions, including suspected hypoxic ischemic encephalopathy, cardiac disease and seizures/movement disorders.

Forty-nine of the infants were born preterm; at the time of the MRI, their corrected mean gestational age was 38.4 weeks. Forty-seven of the newborns were born full term; they received MRIs at 1.7 weeks of age.

The airway structures of interest included the nasopharynx (the upper part of the pharynx), oropharynx (located at the back of the mouth behind the oral cavity), hypopharynx (the entrance into the esophagus), adenoids and tonsils. The team displayed the volumetric imaging in three perpendicular planes and a three-dimensional model.

"Nasopharyngeal volume of full-term infants was 495.6 mm, compared with 221.1 mm in preterm infants. Oropharyngeal volume of full-term infants was 313.6 mm, compared with 179.3 mm in preterm infants," Smitthimedhin says.

Aided by volumetric 3D data that more accurately measures airway and lymphoid tissue, the team proposes to study a larger group of infants to determine whether narrowing of the uppermost airways predisposes very young children to experiencing OSA later in life.

"Ultimately, our goal is to incorporate dedicated, dynamic MR imaging of the airway while children sleep, which would provide real-time, detailed information about the changes associated with sleep. This innovation holds the promise of leading to more accurate, non-invasive diagnosis of OSA in infants," says Dorothy Bulas, M.D., chief of Diagnostic Imaging and Radiology at Children's National.

The findings have been published in the journal Clinical Imaging.

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Agencies
February 6,2020

Researchers have found the rates of lung cancer are higher in young women than men.

The study, published in the journal Pediatrics, examined lung cancer rates in young adults in 40 countries across five continents and uncovered a trend of higher lung cancer rates in women compared with men in recent years.

The emerging trend was widespread, affecting countries across varied geographic locations and income levels.

The changes appeared to be driven by a rising rate of adenocarcinoma lung cancer among women, said the study researchers from University of Calgary in Canada.

Lung cancer rates have been higher among men than women because men started smoking in large numbers earlier and smoked at higher rates; however, recent studies have reported converging lung cancer incidence rates between sexes.

Among men, age specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men.

For the findings, lung and bronchial cancer cases between 30-64 age group from 1993-2012 were extracted from cancer incidence in five continents.

The study found the higher emerging rates of lung cancer in young women compared to young men.

According to the researchers, future studies are needed to identify reasons for the elevated incidence of lung cancer among young women.

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Agencies
July 14,2020

UN, Jul 14: There will be no return to the "old normal" for the foreseeable future as a result of the ongoing COVID-19 pandemic, and too many countries were still headed in the wrong direction, the chief of the World Health Organization (WHO) warned.

"The virus remains public enemy number one, but the actions of many governments and people do not reflect this," Xinhua news agency quoted WHO Director-General Tedros Adhanom Ghebreyesus at as saying a regular briefing on Monday.

He noted that mixed messages from leaders are undermining trust, which is the most critical ingredient of any response, while the only aim of the virus is to find people to infect.

Things are going to "get worse and worse and worse", he warned, unless governments communicate clearly with their citizens and roll out a comprehensive strategy focused on suppressing transmission and saving lives, while populations follow the basic public health principles of physical distancing, hand washing, wearing masks, coughing etiquette and staying home when sick.

COVID-19 has been gaining its momentum lately.

According to Tedros, Sunday saw a record of 230,000 cases reported to WHO, of which almost 80% were from just 10 countries and about half from just two countries.

"But it does not have to be this way," he said, asking every single leader, government and individual "to do their bit to break the chains of COVID-19 transmission and end the collective suffering".

To control the disease and get on with people's lives, Tedros said, three things are required. The first is to focus on reducing mortality and suppressing transmission; the second is to focus on an empowered, engaged community that takes individual behaviour measures in the interest of each other.

And the third is a strong government leadership and coordination of comprehensive strategies that are communicated clearly and consistently.

"We weren't prepared collectively, but we must use all the tools we have to bring this pandemic under control. And we need to do it right now," he added.

At the WHO briefing on Monday, health experts also said there was evidence to suggest that children under the age of 10 were only very mildly affected by Covid-19, while those over 10 seemed to suffer similar mild symptoms to young adults.

To what extent children can transmit the virus, while it appears to be low, remains unknown.

On Tuesday, the number of global coronavirus cases cross the 13 million mark, according to the Johns Hopkins University.

The total number of cases currently stood at 13,070,097, while the fatalities rose to 572,411, the University's Center for Systems Science and Engineering (CSSE) revealed in its latest update.

The US accounted for the world's highest number of infections and fatalities at 3,363,056 and 135,605, respectively, according to the CSSE.

Brazil came in the second place with 1,884,967 infections and 72,833 deaths.

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Agencies
July 25,2020

The COVID-19 pandemic and the subsequent lockdown saw many people turning chefs overnight, but those who could not turned to online delivery of food. And not just any food, as per a new report, Indians "craved the most for Biryani" during the lockdown.

The "StatEATistics report: The Quarantine Edition" from food delivery platform Swiggy found that Indians ordered biryani over "5.5 lakh times" from their favourite restaurants.

The new normal might have opened a pandora's box of behavioral changes, but some old habits die hard like the love for Biryani, which took the top spot for overall orders. It was followed by butter naan and masala dosa at 3,35,185 and 3,31,423, respectively.

Biryani has topped the list of most ordered dishes for the fourth year in a row, the food delivery platform noted.

Indians didn't forget to indulge their sweet tooth in the uncertain months of lockdown. Their favourite comfort food during the lockdown period was the moist and decadent Choco Lava cake, ordered around 1,29,000 times.

"The humble Gulab Jamun (84,558) and chic Butterscotch Mousse cake (27,317) followed suit," said the report derived from Swiggy's order analysis in the past few months across cities that it is present in.

Also, as birthday parties moved to video calls, and virtual cake cutting sessions, according to the food delivery platform, it delivered nearly "1,20,000 cakes" to complete these celebrations.

According to the report, on average, "65,000 meal orders" were placed by 8 pm each day to make sure food arrived in time for dinner.

"It was the busiest hour for Swiggy delivery partners and restaurants. On average, they (customers) chose to tip Rs.23.65, with one particularly generous customer tipping Rs. 2500!," it added.

For those who only relied on home-made food during the quarantine, Swiggy delivered a whooping 323 million kgs of onions and 56 million kgs of bananas through its grocery section and hence ensured that its consumers were all stocked up.

That said, it also took care of the 'quick-fix meal' tribe -- consumers who resort to the evergreen college hacks of living on instant noodles.

"Around 3,50,000 packets of this ideal easy to cook meal were ordered during the lockdown," it said.

In all, Swiggy delivered 40 million orders across food, groceries, medicines and other household items during India's lockdowns. It also delivered over 73,000 bottles of sanitizers and hand wash along with 47,000 face masks as the definition of essentials' changed during these uncertain times.

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