Preventing lung injuries in very premature babies: Current therapies less effective than expected

Main Category: Pediatrics / Children's Health
Also Included In: Respiratory / Asthma;  Pregnancy / Obstetrics
Article Date: 17 Aug 2013 - 0:00 PDT Current ratings for:
Preventing lung injuries in very premature babies: Current therapies less effective than expected

A neonatologist at The Children's Hospital of Philadelphia is the senior author of a large new study that found that current non-invasive techniques for respiratory support are less effective than widely assumed, in reducing the incidence of severe lung injury in very premature infants. Neonatologists commonly use non-invasive nasal ventilation instead of mechanical ventilation via a breathing tube, in hopes of avoiding bronchopulmonary dysplasia (BPD).

Frequently a by-product of intubation, BPD - scarring and inflammation of the lungs - is a leading cause of death or neurological injury in extremely-low-birth-weight infants.

Haresh Kirpalani, M.D., of the Division of Neonatology at Children's Hospital, is the senior author of a study published in the New England Journal of Medicine.

This multinational, randomized trial compared two common forms of non-invasive ventilation used in extremely-low-birth-weight premature infants. Both techniques make breathing easier for the infant by stopping the lungs from collapsing, which over time causes lung inflammation and injury.

The current standard of care, nasal continuous positive airway pressure (CPAP), delivers slightly pressurized air throughout the breathing cycle. In contrast, nasal intermittent positive-pressure ventilation (IPPV), which has become widespread, provides an additional spike of positive pressure when the infant inhales. While more complicated, the hope had been that it was more effective than standard CPAP. Researchers tested the hypothesis that this extra pressure delivered in IPPV would be more beneficial than CPAP in preventing BPD.

The study team randomly assigned 1009 infants with a birth weight under 1000 grams (2.2 pounds) and gestational age under 30 weeks to either nasal CPAP or nasal IPPV. The infants were from 34 neonatal intensive care units in 10 countries. The researchers found no significant difference in the primary outcome of either death or survival with BPD at 36 weeks. They also found no significant difference in rates of other neonatal complications between the two treatment groups.

"Although somewhat discouraging, this research is significant as it refutes the common assumption that the non-invasive therapies being used are reducing severe lung injury in these tiny babies," said Kirpalani. "The study alerts us that we still need to develop new therapies for babies to avoid lung injury and BPD."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pediatrics / children's health section for the latest news on this subject.

The Canadian Institutes of Health Research supported this study.

"A Trial Comparing Noninvasive Ventilation Strategies in Preterm Infants," New England Journal of Medicine, Aug. 15, 2013. doi.org/10.1056/NEJMoa1214533

Children's Hospital of Philadelphia

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Beer industry's self-regulation ineffective at preventing advertising code violations

Main Category: Alcohol / Addiction / Illegal Drugs
Article Date: 15 Aug 2013 - 13:00 PDT Current ratings for:
Beer industry's self-regulation ineffective at preventing advertising code violations

In an evaluation of beer advertising code regulations aimed to encourage responsible advertising practices, new research from the American Journal of Public Health finds that content violations still occur and the current U.S. Beer Institute's self-regulation process may be ineffective.

Researchers reviewed all alcohol advertisements that aired during the men's and women's NCAA basketball tournament games from 1999 to 2008. Current alcohol advertising is self-regulated by the alcohol industry in which the U.S. Beer Institute develops, updates and enforces the regulation codes. This study employed academic and public health professionals to rate the ads using both the 1997 and 2006 versions of the U.S. Beer Institute's guidelines.

Results showed that when experts reviewed the advertisements, code violations were prevalent. Between 35 percent and 74 percent of the ads had violations, depending on the version of regulation codes used and the scoring method applied. Furthermore, ads with content violations were broadcast more often than those without. Ads that violated the codes most often included content that appealed to young people and content in which beer drinking was associated with social success and sexual attractiveness.

"The findings of this study are consistent with evidence from other research showing that alcohol industry self-regulation programs are ineffective at preventing content violations," the study's authors explain.

"Unless the alcohol industry insists on the use of standardized rating procedure by trained panels consisting of public health experts and members of vulnerable groups, it is unlikely that the high prevalence of content violations will be reduced," the study's authors suggest.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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“An Empirical Evaluation of the U.S. Beer Institute’s Self-Regulation Code Governing the Content of Beer Advertising.”

Thomas Babor, PhD, MPH, University of Connecticut Health Center

American Journal of Public Health

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Preventing the 'Freshman 15' via the Web

Main Category: Obesity / Weight Loss / Fitness
Also Included In: IT / Internet / E-mail
Article Date: 02 Aug 2013 - 2:00 PDT Current ratings for:
Preventing the 'Freshman 15' via the Web

A new study published in the July/August 2013 issue of the Journal of Nutrition Education and Behavior evaluated the motivational effects of Project WebHealth, a web-based health promotion intervention developed to prevent excessive weight gain in college students. Researchers found that specific procedures and components of Project WebHealth successfully motivated students to improve their weight-related health behaviors and that the level of motivation differed by gender.

The college years are frequently associated with risky health behaviors such as poor diet quality, reduced physical activity, and inadequate weight loss practices, often resulting in the "Freshman 15." Studies have suggested that web-based health promotional programs could make a difference. Project WebHealth online lessons are designed to help motivate students to engage in more healthful behaviors like increasing fruit and vegetable consumption and levels of maintained physical activity. This nondiet approach included lessons about body size and healthy weight, hunger/fullness, physical activity, skills to fuel the body, enhancing food variety, and eating enjoyment.

A multi-institutional study team investigated the overall impact of Project WebHealth and evaluated the underlying procedures that could help change dietary and exercise behavior among college students, including physical assessments and monetary incentives, as well as intervention components (eg, online lessons, goal setting). The study included 653 Project WebHealth participants from 8 geographically diverse institutions across the United States.

About half of the participants completed the Project WebHealth online lessons and filled out an instructional materials motivation survey, which gathered feedback about the lessons and lesson components. All participants completed an additional survey which gathered feedback on the participation process, including the online study surveys and physical assessments, feedback about the assessments, interaction with the research staff, and compensation.

The study found that women were generally more motivated than men. Among those who improved their health behaviors, the most effective lessons/lesson components for men included those on fueling the body, goal setting, and research snippets. Their female counterparts found significantly more motivation from lessons on body size and eating enjoyment, and by the suggested weekly activities.

Lead investigator Colleen Dour, MS, RD, Department of Public Health, Food Studies and Nutrition, Syracuse University, explains, "These findings suggest implementing a nondiet approach could be effective in gender-tailored interventions, but content relative to nondiet themes might need modification to improve its motivational influence. Such improvements might include adding video or audio clips within the lessons or even sending a tailored email to participants with a health message. Because many young adults still focus on dieting, further exploration on how best to communicate a nondiet approach is needed. Rather than college students falling into inappropriate diet habits that are common during the college years, we want to teach them how to prevent these behaviors from developing."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Sciences, Elsevier Health. "Preventing the 'Freshman 15' via the Web." Medical News Today. MediLexicon, Intl., 2 Aug. 2013. Web.
3 Aug. 2013. APA

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'Preventing the 'Freshman 15' via the Web'

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Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve

Main Category: Ear, Nose and Throat
Also Included In: Endocrinology;  Neurology / Neuroscience
Article Date: 25 Jul 2013 - 1:00 PDT Current ratings for:
Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve

Recurrent laryngeal nerve injury is the most common serious complication of thyroid surgery. Therefore, preventing recurrent laryngeal nerve injury is an important goal in thyroid surgery.

A retrospective clinical controlled study from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine demonstrates that dissecting the recurrent laryngeal nerve during thyroid surgery is clinically significant for preventing nerve injury.

To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, this study retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries.

Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark.

Among the 548 cases, seven of the 442 cases (1.6%) with the inferior parathyroid gland as a landmark for locating recurrent laryngeal nerves showed recurrent laryngeal nerve injury; two of the 79 cases (2.5%) with the middle thyroid vein as a landmark were injured; and three of the 27 cases (11.1%) with the recurrent laryngeal nerve into the larynx as the landmark showed recurrent laryngeal nerve injury.

These findings were published in Neural Regeneration Research (Vol. 8, No. 17, 2013).

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Article: " Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury " by Chenling Shen, Mingliang Xiang, Hao Wu, Yan Ma, Li Chen, Lan Cheng (Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China)

Shen CL, Xiang ML, Wu H, Ma Y, Chen L, Cheng L. Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury. Neural Regen Res. 2013;8(17):1568-1575.

Full text: http://www.sjzsyj.org:8080/Jweb_sjzs/CN/article/downloadArticleFile.do?attachType=PDF&id=625

Neural Regeneration Research

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'Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve'

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