This is the first report to quantify volumetric changes in the upper airway in obese children with OSAS after adenotonsillectomy showing significant residual adenoid tissue and an increase in the volume of the tongue and soft palate. These findings could explain the low success rate of AT reported in obese children with OSAS and are important considerations for clinicians treating these children.

Sleep-disordered breathing (SDB), a condition associated with abnormalities in respiratory gas exchange during sleep (particularly intermittent oxyhemoglobin desaturation), has been implicated as a possible risk factor for deleterious cerebrovascular complications in children with sickle cell disease (SCD). [1][2][3] Although the prevalence of SDB in these children has not been well established, estimates range from 5% to 79% 4-10 and are far greater than the prevalence of 1% to 4% in children without SCD. 11 In addition, the pathophysiology of SDB in these children is not well understood. Possible mechanisms include hypoven tilation due to chronic lung disease, 12,13 obstructive sleep apnea syndrome (OSAS) 6 (a disorder characterized by recurrent events of partial or complete Background: The prevalence of obstructive sleep apnea syndrome (OSAS) is higher in children with sickle cell disease (SCD) as compared with the general pediatric population. It has been speculated that overgrowth of the adenoid and tonsils is an important contributor. Methods: The current study used MRI to evaluate such an association. We studied 36 subjects with SCD (aged 6.9 Ϯ 4.3 years) and 36 control subjects (aged 6.6 Ϯ 3.4 years). Results: Compared with control subjects, children with SCD had a signifi cantly smaller upper airway (2.8 Ϯ 1.2 cm 3 vs 3.7 Ϯ 1.6 cm 3 , P , .01), and signifi cantly larger adenoid (8.4 Ϯ 4.1 cm 3 vs 6.0 Ϯ 2.2 cm 3 , P , .01), tonsils (7.0 Ϯ 4.3 cm 3 vs 5.1 Ϯ 1.9 cm 3 , P , .01), retropharyngeal nodes

Objective To compare the polysomnography findings and cardiometabolic function among adolescent girls with PCOS and matched female and male controls. Method Retrospective chart review of electronic medical records of 28 girls with PCOS (age: 16.8±1.9 yrs, BMI Z-score 2.4±0.4), 28 control females (age: 17.1±1.8, BMI Z-score 2.4±0.3) and 28 control males (age: 16.6±1.6, BMI Z-score 2.5±0.5) in a tertiary care center. Results The prevalence of obstructive sleep apnea (OSA) was higher in girls with PCOS compared to control females (16/28 (57%) vs. 4/28(14.3%), p<0.01), however, was comparable to that of the control males (16/28(57%) vs. 21/28(75%), p=0.4). Girls with PCOS had a significantly higher prevalence of insulin resistance compared to control females and control males (20/28 (71.4%) vs. 9/22 (41.0%) (p=0.04) vs. 8/23 (34.8%) (p=0.01). Among girls with PCOS, those with OSA had significantly higher proportions of metabolic syndrome (9/16 (56.3% ) vs. 1/12 (8.3%) p=0.03), higher insulin resistance (13/16 (81.3%) vs. 5/12 (41.6%), p=0.03), elevated daytime systolic blood pressure (128.4±12.8 vs. 115.6±11.4, p<0.01), lower HDL (38.6±8.7 vs. 49±10.9, p=0.01) and elevated triglycerides (149.7±87.7 vs. 93.3±25.8, p=0.03) compared to those without OSA. Conclusions We report a higher prevalence of OSA and metabolic dysfunction in a selected group of obese girls with PCOS referred with sleep related complaints compared to BMI matched control girls without PCOS. We also report higher prevalence of cardiometabolic dysfunction in girls with PCOS and OSA compared to girls with PCOS without OSA.

Both early EEG and neuro-imaging findings are predictive of outcome in infants with HIE. The predictive value of EEG is strengthened by neuro-imaging.