Port Wine Stain Birthmarks in Infants Safely Treated Without Need for General Anesthesia

Posted on March 14, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Geronemus

Roy G. Geronemus, M.D.
Director, Laser & Skin Surgery Center of New York
Clinical Professor of Dermatology
New York University Medical Center
New York, NY 10016

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We made the observation in clinical practice that port wine stain birthmarks can be safely and effectively treated in early infancy without the need for general anesthesia. This observation is particularly important because of the FDA warnings regarding multiple exposures to general anesthesia under the age of 3 and the potential impact on neurocognitive development as these patients require multiple treatments.
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High-Dose Vitamin D During Pregnancy Did Not Reduce Risk of Childhood Asthma

Posted on March 12, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Chawes

Bo Chawes, MD, PhD, DMSc
Associate Professor
C‌openhagen Prospective Studies on Asthma in Childhood
H‌erlev and G‌entofte H‌ospital
U‌niversity of C‌openhagen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been a global surge in vitamin D deficiency happening in parallel with an increase in prevalence of childhood asthma, which suggests that low maternal vitamin D levels during pregnancy may increase asthma risk in the child.

Due to that we conducted a randomized double-blinded controlled trial within the Danish COPSAC2010 cohort (www.copsac.com) of 7-fold (2,800 IU/d) vs. standard dose (400 IU/d) of vitamin D supplementation from pregnancy week 24 aiming to reduce offspring asthma risk. At age 3, we observed a non-significant 24% reduced risk of recurrent asthma-like symptoms, ie. recurrent wheeze, in the high-dose vitamin D group. In the current study, we followed 545 of the 581 children in the study till age 6, where an asthma diagnosis can be established and observed no effect of the high-dose vitamin D supplement on the child’s risk of asthma.

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Steroids for Risk of Late Preterm Delivery Help Babies and Reduce Costs

Posted on March 12, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Gyamfi-Bannerman

Cynthia Gyamfi-Bannerman, MD, MSc
Ellen Jacobson Levine and Eugene Jacobson
Professor of Women’s Health in Obstetrics and Gynecology
Director, Maternal-Fetal Medicine Fellowship Program
Co-Director, CUMC Preterm Birth Prevention Center
Columbia University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In 2016 our group published the findings of the Antenatal Late Preterm Steroids (ALPS) trial in the NEJM. We found that administration of antenatal corticosteroids to women at high risk for delivery from 34-36 weeks decreased breathing problems in their neonates. This treatment had been traditionally only given at less than 34 weeks.

The current paper is a cost analysis of that trial. We found that the treatment was also cost effective. From a cost perspective treatment was both low cost and highly effective (the options are low cost, low effect/low cost/high effect, high cost/low effect, high cost/high effect). Continue reading →

Childhood Speech Disorder Apraxia: Underlying Brain Pathway Identified

Posted on March 8, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Prof. Morgan

Prof. Angela Morgan PhD
NHMRC Practitioner Fellow and
Leads the Speech and Language Group
Murdoch Children’s Research Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Approximately 5% of school-aged children have a communication impairment that affects speech, language, or both. There are many subtypes of speech sound disorders, but the most severe is (CAS), which impacts sequencing of speech movements. Childhood apraxia of speech occurs in around 1 in 1000 children. In persistent cases of CAS, speech cannot easily be understood throughout life. Although CAS is rare, unravelling its neurobiological causes is likely to identify brain networks crucial to more common and less severe forms of speech disorders.

Here we provide comprehensive speech and neuroimaging data on a large novel family where one parent and 11 children presented with features of childhood apraxia of speech. Brain MRI scanning revealed changes in core parts of the brain responsible for speech production. Even though CAS manifests as a problem with talking, we found disruptions in an underlying pathway of the brain normally associated with language (the meaning and grammar of what we say), rather than speech production. Our findings identify disruption of the dorsal language stream as a novel finding in developmental speech disorders. Overall, our data confirm the early role of this stream in auditory-to-articulation transformations. Continue reading →

Viaskin Peanut May Offer First Epicutaneous Treatment for Peanut Allergy

Posted on March 4, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Green

Todd Green MD
Vice President, Medical Affairs North America
DBV Technologies
Associate Professor of Pediatrics
University of Pittsburgh School of Medicine

MedicalResearch.com: What is the background for this announcement? What is Viaskin Peanut?

Response: Peanut allergy is one of the most common food allergies and can cause severe, potentially life-threatening allergic reactions, including anaphylaxis. Unfortunately, there are no FDA-approved treatment options for peanut or other food allergies – leaving patients with avoidance and readiness to manage reactions to accidental exposures as their only option.

Viaskin Peanut uses epicutaneous immunotherapy or EPIT, a method of delivering biologically active compounds to the immune system through the skin. Patients receive about 1/1,000th of a peanut with each daily dose of peanut protein – the equivalent of one peanut every three years – which activates the immune system with very minimal exposure.

In February 2019, DBV announced that its planned resubmission of the Biologics License Application (BLA) to the U.S. Food and Drug Administration (FDA) for Viaskin Peanut in the treatment of peanut-allergic children 4 to 11 years of age is anticipated in the third quarter of 2019.

DBV is working diligently on its resubmission package, bringing us one step closer to providing an FDA-approved treatment for peanut-allergic children and their families. Viaskin Peanut previously received Breakthrough and Fast Track designations for the treatment of peanut-allergic children from the FDA in 2015 and 2012, respectively.

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Childhood Onset of Puberty and Parental Height Linked

Posted on March 3, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Limony

Yehuda Limony, MD, MSc
Pediatric Endocrinology Unit
Faculty of Health Sciences
Ben-Gurion University of the Negev
Clalit Health Services
Beer-Sheva, Israel

MedicalResearch.com: What is the background for this study?

Response: The variability of the onset age of puberty is the subject of many studies in numerous disciplines; nonetheless, the timing of puberty remains an enigma. The conventional paradigm is that the time of onset of puberty is genetically determined even though genome-wide association studies explain only a very low percentage of the physiologic variability. It is commonly believed, therefore, that many environmental factors interfere with the genetics of timing of puberty.

On the other hand, children grow toward an adult height that is the standardized average of parents’ height called “target height”. That is why children are usually similar in height to parents. This targeted growth process is evident especially in children whose height percentile in childhood is different from their target height percentile (we called this difference the “height gap”). It is known that the timing of puberty is associated with adult height: earlier puberty causes shorter adult height and vice versa. We hypothesized that the targeted process of growth involves adaptation of the age of onset of puberty in accordance with the height gap. Continue reading →

Viaskin Peanut: Convenient Potential Treatment Option for Peanut Allergy

Posted on March 1, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Greenhawt

Dr. Matthew Greenhawt
Director, Food Challenge and Research Unit
Children’s Hospital Colorado

MedicalResearch.com: What is the background for this study?

Response: In the US, nearly one million children suffer from a peanut allergy and severe reactions to food allergens are not uncommon – yet there is significant unmet need in the food allergy immunotherapy space, as there are no currently approved treatment options. That being said, we are encouraged by the efficacy and safety data, which support Viaskin Peanut as a convenient and well-tolerated potential treatment option for the peanut allergy.

In the pivotal Phase III clinical trial (PEPITES) just published in The Journal of the American Medical Association (JAMA), Viaskin Peanut – the first epicutaneous immunotherapy (EPIT) in development that leverages the skin to activate the immune system – provided statistically significant desensitization in peanut-allergic children ages 4-11 years old. Patients who were treated with active therapy were more likely to have increased their eliciting dose to peanut (the amount of peanut protein ingested before an objective allergic reaction was seen during a double-blind, placebo-controlled food challenge) by a required amount as compared to patients treated with a placebo patch. The improvement suggests a reduced risk of allergic reaction to accidental peanut ingestion in the group treated with Viaskin Peanut, with no change seen in the placebo group.

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Parents Still Losing Sleep 6 Years After New Baby

Posted on March 1, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

“Baby K – Mother’s Kiss” by D.Clow

Dr. Sakari Lemola
Associate Professor
Department of Psychology
University of Warwick
Coventry, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sufficient sleep of good quality is important for physical and mental health. Therefore, we are studying factors in people’s lives that may affect their sleep.

In the present study we examined in particular how the birth of a child affects parents’ sleep. In detail, we used data on sleep of more than 4,600 parents in Germany who had a child between 2008 and 2015. During these years parents reported on their sleep in yearly interviews. We found that the birth of a child had quite drastic short-term effects on new mothers’ sleep, particularly during the first three months after birth. This is not a new finding; previous studies reported similar effects. What is new in the current study is that we compared sleep before pregnancy with sleep until up to 6 years after birth.

We were surprised to see that sleep duration and sleep satisfaction were still decreased up to six years after birth. Six years after birth mothers and father still slept around 15-20 minutes less. Continue reading →

Sport-Related Concussion: Sub-threshold Exercise May Speed Recory

Posted on February 7, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Leddy

John J. Leddy, MD
Clinical Professor
Department of Orthopaedics
Jacobs School of Medicine & Biomedical Sciences
University of Buffalo

MedicalResearch.com: What is the background for this study?

Response: Sport-related concussion (SRC) is a significant public health problem without an effective treatment. Recent International Guidelines have questioned the efficacy of recommending complete rest to treat concussion and have called for prospective studies to evaluate early active treatments for sport-related concussion. Continue reading →

Adverse Outcomes More Likely in Infants Born to Mothers Who Get the Flu

Posted on February 7, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Kim Newsome

Kim Newsome, MPH
National Center on Birth Defects and Developmental Disabilities
CDC

MedicalResearch.com: What is the background for this study?

Response: This study supports data from previous studies that have shown increased risks for infants born to pregnant women who are severely ill with flu.

MedicalResearch.com: What are the main findings?

Response: Our study found that severely ill women with 2009 H1N1 influenza during pregnancy were more likely to have adverse birth outcomes (such as their baby being born preterm or of low birth weight) than women without influenza.

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Study Find No Difference in Standardized Test Scores in Children With/Without Diabetes

Posted on February 6, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Skipper

Niels Skipper PhD
Associate Professor, Department of Economics and Business Economics
Aarhus University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is unclear if there is an association between type 1 diabetes and school performance in children. Some studies have found type 1 diabetes to be associated with worse performance, while others have found no differences. However, most of the existing literature are based on smaller, non-random samples of children with diabetes. In this study we used data on all public school children in the country of Denmark, involving more than 600,000 schoolchildren where approximately 2,000 had a confirmed diagnosis of type 1 diabetes. The children were tested in math and reading using a nationally standardized testing procedure, and we found no difference in the obtain test scores between children with diabetes compared to children without diabetes. Continue reading →

USPSTF Recommends Antibiotic Prophylaxis to Prevent Gonorrheal Eye Disease in Newborns

Posted on February 5, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Silverstein

Michael Silverstein, M.D., M.P.H.
Professor of Pediatrics
Director of the Division of General Academic Pediatrics
Vice chair of research for the Department of Pediatrics
Boston University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Gonococcal ophthalmia neonatorum, or GON, is a severe infection of the eye that can occur in babies born to women who have gonorrhea. If left untreated, GON can cause serious problems, including blindness, that can appear as soon as 24 hours after delivery.

Fortunately, there are effective treatments available that can prevent GON in newborns. The U.S. Preventive Services Task Force reviewed the most current research on the benefits and harms of ocular prophylaxis—which is applying antibiotic ointment to the babies’ eyes at birth—to prevent GON.

We found that, if applied within 24 hours after birth, the ointment is very effective at preventing gonococcal ophthalmia neonatorum and the problems it causes. Therefore, we are recommending that clinicians provide this preventive service for all newborns. Continue reading →

Screen Time Effects on Child Development

Posted on February 3, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Madigan

Sheri Madigan, Ph.D, R.Psych
Canada Research Chair in Determinants of Child Development
Assistant Professor, Department of Psychology
Alberta Children’s Hospital Research Institute
University of Calgary

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Parents are reporting that screen time is one of their major concerns, so we wanted to find out more about how large of a role screen time was playing on children’s developmental outcomes. We were especially interested in the long-term impact of screens, which is why we followed children over time, from ages 2 to 5 and repeatedly assessed both screen time use and children’s achievement of developmental milestones.

There are three main findings:

Our study revealed that on average children were viewing screens for 2.4, 3.6 and 1.6 hours per day at two, three and five years of age, respectively. This means that the majority of the participants in our sample are exceeding the American Academy of Pediatrics’ guideline of no more than one-hour of high quality programming per day, for children aged 2-5 years.
We found statistically significant, albeit small effects suggesting that greater amounts of screen time at two and three years predict poorer child outcomes at three and five years, respectively. Thus, screen time has a lasting influence on children’s development.
The opposite pattern was not observed. That is, we did not find evidence that children showing poor performance in terms of achieving developmental milestones were more likely to be place in front of screens to help cope with their potentially challenging behaviors.

MedicalResearch.com: What should readers take away from your report?

Response: When used in excess, screen time can have consequences for children’s development. We should think of screens like we do junk food, in small doses it’s ok, but in excess, it is problematic. But it’s never too late to make a change to the way digital technology is used in the home. Media plans can be developed as a family to manage media in the home and determine how often devices will be used, as well as when and where they will be used.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In this study, we asked about total hours of screen time and, as a result, we can’t determine if context matters (i.e., screens viewed with caregivers or not), or if there are certain types of digital mediums or devices that are worse than others (e.g., interactive screens, gaming consoles, or streaming media). Thus, it will be important to decipher in future research whether co-viewing screens with a caregiver, for example, dampens associations between screen time and delays in children’s development and whether certain types of screens are more or less detrimental for children’s development.

No disclosures

Citation:

Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr. Published online January 28, 2019. doi:10.1001/jamapediatrics.2018.5056

Feb 3, 2019 @ 1:12 pm

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Polygenic Risk Scores Linked to Intelligence, ADHD and Brain Findings

Posted on January 31, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Alemany

Silvia Alemany, PhD first author
Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa”.

In collaboration with co-authors:
Philip Jansen,MD, MSc and
Tonya White, MD, PhD
Erasmus University Medical Center, Rotterdam

MedicalResearch.com: What is the background for this study?

Response: Individuals affected by psychiatric disorders can demonstrate morphological brain abnormalities when compared to healthy controls. Although both genetic and environmental factors can account for these brain abnormalities, we expect that genetic susceptibility for psychiatric disorders has the greatest influence on the development of the brain.

Genetic susceptibility for psychiatric disorders can be estimated at the individual level by generating polygenic risk scores. Using this methodology, genetic susceptibility to psychiatric disorders and cognition has been associated with behavior problems in childhood. These findings suggest that heritable neurobiological mechanisms are at play in very early in the course of the illnesses.

Continue reading →

Venezuela: Rapid Rise in Infant Mortality Linked to Health Care System Collapse

Posted on January 29, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Ms Jenny García, PhD candidate
Institut National d’Études Démographiques INED
Institut de Démographie de l’université Paris 1 Panthéon Sorbonne IDUP
Paris, France

Prof Gerardo Correa, MSc
Instituto de Investigaciones Económicas y Sociales IIES
Universidad Católica Andrés Bello UCAB
Caracas, Venezuela

Prof Brenda Rousset, PhD
Departamento de Estadística, Escuela de Sociología (FaCES)
Universidad Central de Venezuela UCV
Caracas, Venezuela

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Venezuela, as many countries in Latin America, showed substantial improvements in infant mortality rates during the last 60 years. However, the decreasing pattern might be reversing. Recent socioeconomic and political events have led to a collapse in living standards, along with a breakdown of the health system. At the same time, a strict secrecy policy has ruled public institutions, and since 2013 the Venezuelan government stopped publishing mortality statistics.

This study attempts to fill this gap and estimate infant mortality using hospital and census data after 2013.

The main finding is that infant mortality rates in Venezuela may have stopped decreasing and started increasing in 2009 – around the time funding for the Venezuelan health system started to be substantially reduced. By 2016, the infant mortality rate was 21.1 deaths per 1000 live births, which is 1.4 times the rate in 2008 (15.0 deaths per 1000 live births), and equivalent to the rate recorded in the late 1990s, meaning 18 years of progress may have been lost. Continue reading →

Psychiatric Problems Related to Lead Exposure Detected As Early As Age 11

Posted on January 23, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Aaron Reuben, MEM
Department of Psychology and Neuroscience
Duke University, Durham, North Carolina

MedicalResearch.com: What is the background for this study? What are the main findings?

(1) Study members with greater lead exposure in childhood tended to endorse more psychiatric symptoms when assessed for psychiatric disorders in adulthood (between 18 and 38 years of age).

These individuals tended to report more internalizing (e.g., depression, anxiety) and thought disorder (e.g., OCD, schizophrenia, mania) symptoms.
Compared to other findings from this sample, the associations reported in this article are similar to those reported for lead and IQ, and are stronger than those reported for lead and criminal offending.
1. Informants who knew Study members well reported higher levels of difficult adult personality traits among Study members with greater lead exposure in childhood.
2. Specifically, Study members with greater blood lead levels at age 11 were rated as more neurotic, less agreeable, and less conscientious by 38 years of age.
3. These personality traits have been previously linked to a number of poor life outcomes, including greater psychopathology, worse physical health, less job satisfaction, and troubled interpersonal relationships
Psychiatric problems related to lead exposure could be detected as early as 11 years of age. In the 1980’s, parents and teachers of children with higher blood-lead levels had described them as displaying more antisocial behavior, hyperactivity, and negative emotions (e.g., sadness, anxiety).

Continue reading →

Type 1 Diabetes Cases Drop After Rotavirus Vaccine Introduced

Posted on January 22, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Kirsten Perrett

Dr Kirsten Perrett MBBS FRACP PhD
Team Leader / Clinician-Scientist Fellow, Population Allergy, Murdoch Children’s Research Institute
Consultant Paediatrician, Department of Allergy and Immunology and General Medicine
The Royal Children’s Hospital
Fellow, School of Population and Global Health
The University of Melbourne
Parkville, Victoria Australia

MedicalResearch.com: What is the background for this study?

Response: Before rotavirus vaccines were available, rotavirus infection was the most common cause of severe gastroenteritis in infants and young children. Because it is so contagious, infection in childhood is thought to be universal in unvaccinated children.

Previous studies indicated that rotavirus infection of infants might be an environmental promoter of type 1 diabetes. Therefore, we anticipated that the introduction of the rotavirus vaccine might alter the disease incidence in young children.

Continue reading →

Adolescents: Comparison of Recovery from Concussions vs Fractures

Posted on January 21, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Russell

Kelly Russell PhD
Department of Pediatrics and Child Health
University of Manitoba

MedicalResearch.com: What is the background for this study?

Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life. HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion. Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician. We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery.

We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury. We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion.

Continue reading →

Program Addresses Racial Inequities in Breastfeeding in Southern US

Posted on January 21, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Merewood

Anne Merewood PhD MPH
Director, Center for Health Equity, Education, and Research
Associate Professor of Pediatrics, Boston University School of Medicine
Associate Professor of Community Health Sciences
Boston University School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: CHAMPS (Communities and Hospitals Advancing Maternity Practices) worked with hospitals and communities across the southern US to implement the Baby-Friendly Hospital Initiative and decrease racial inequities in breastfeeding rates.

We found that indeed this program significantly reduced the gap between Black and White breastfeeding initiation rates in the 31 hospitals studied, by almost 10%.

MedicalResearch.com: What should readers take away from your report?

Response: Hospitals and communities can work together in areas where racial disparities are extreme and breastfeeding rates are low, to improve hospital practices around the time of birth. These changes will have an impact on racial gaps in breastfeeding, and will bring more humane and evidence-based care to thousands of women, now and in the future, as the changes are solidified. Improved practices level the playing field for underprivileged groups.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should assess the implementation model to see if it can be applied in other settings. Also, future research needs to examine how well these changes can be sustained.

Citation:

Addressing Racial Inequities in Breastfeeding in the Southern United States

Anne Merewood, Kimarie Bugg, Laura Burnham, Kirsten Krane, Nathan Nickel, Sarah Broom, Roger Edwards, Lori Feldman-Winter
Pediatrics Jan 2019, e20181897; DOI: 10.1542/peds.2018-1897

Jan 21, 2019 @ 1:31 pm

Zika: Simple General Movement Assessment Tool Can Predict Babies at Risk of Developmental Problems

Posted on January 21, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Nielsen

Karin Nielsen-Saines, MD, MPH
Professor of Clinical Pediatrics
Division of Pediatric Infectious Diseases
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study?

Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age.

We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months and then tested them through standard neurodevelopmental tests at the age of 12 months.

We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies. This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early.

Continue reading →

College Students at Increased Risk of Meningitis

Posted on January 18, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Mbaeyi

Sarah Anne Mbaeyi MD MPH
Division of Bacterial Diseases
CDC

MedicalResearch.com: What is the background for this study?

Response: College freshman living in residence halls, though not college students overall, have previously been identified as being at increased risk for meningococcal disease. However, these evaluations were conducted in the 1990s when rates of disease were higher, serogroup C was the predominant cause of disease, and before the availability of quadrivalent meningococcal conjugate (MenACWY) or serogroup B meningococcal (MenB) vaccines.

MenACWY vaccine is routinely recommended for all adolescents at age 11 years and 16 years, as well as unvaccinated or undervaccinated college freshmen living in residence halls. MenB vaccine is not routinely recommended for all adolescents or college students, but may be administered to persons aged 16-23 years, with the preferred age of 16-18 years, based on clinical decision-making. Meningococcal vaccines are also recommended during an outbreak, and in recent years MenB vaccines have been used during multiple outbreaks on college campuses.

In this evaluation, we aimed to describe the current epidemiology of meningococcal disease among college-aged young adults in the United States.

Continue reading →

Vaccine Preventable Infections Common After Pediatric Organ Transplantation

Posted on January 15, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Feldman

Amy G. Feldman, MD, MSCS
Assistant Professor, Pediatrics-Gastroenterology, Hepatology and Nutrition
Program Director, Liver Transplant Fellowship
Children’s Hospital Colorado
University of Colorado Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Pediatric solid organ transplant recipients are at increased risk for vaccine preventable infections due to life-long immunosuppressive medications. The objectives of this study were to 1) evaluate in pediatric solid organ transplant recipients the number of hospitalizations for vaccine-preventable infections in the first five years post-transplantation and 2) determine the associated morbidity, mortality and costs.

In this multicenter cohort study of 6980 children who underwent solid organ transplantation from January 1, 2004, to December 31, 2011, at a center participating in Pediatric Health Information System (PHIS), 15% of individuals had at least 1 hospitalization for a vaccine-preventable infection in the first 5 years after transplant. Children who received transplants when they were younger than 2 years and recipients of lung, intestine, heart, and multi-visceral organs were at increased risk for hospitalization with a vaccine-preventable infection. Transplant hospitalizations complicated by a vaccine-preventable infection were $120,498 more expensive (median cost) and were on average 39 days longer than transplant hospitalizations not complicated by vaccine-preventable infections Continue reading →

Group B Streptococcus Remain Significant Threat to US Infants

Posted on January 15, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Nanduri

Dr. Srinivas Acharya Nanduri, MBBS, MD, MPH
Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases
Centers for Disease Control and Prevention
Roybal Campus
Atlanta, GA 3033

MedicalResearch.com: What is the background for this study?

Response: Group B Streptococcus (GBS) is a leading cause of serious illness such as meningitis and sepsis in infants. Among infants, there are two main types of GBS disease. Early-onset GBS disease occurs during the first week of life and late-onset GBS disease occurs from the first week through three months of life. Rates of early-onset disease in the United States have decreased significantly since the 1990s through widespread implementation of intrapartum antibiotic prophylaxis (IAP) guidelines. However, IAP does not prevent late-onset disease. Maternal immunization represents a nonantibiotic strategy to prevent both early and late-onset disease. Multivalent polysaccharide-protein conjugate vaccines are under development against GBS capsular types, with candidate vaccines in phase I and II trials.

Active Bacterial Core surveillance (ABCs) conducts active surveillance for early and late-onset GBS disease among infants in select counties of 10 states, covering about 10% of live births across the United States. We analyzed data from early and late-onset GBS cases identified from ABCs between 2006 and 2015 to describe their epidemiology, incidence trends, and associated strain characteristics. Continue reading →

Mental Illness Risk Increased in Young Onset Diabetes

Posted on January 15, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Chan

Juliana CN Chan MD
Chair Professor of Medicine and Therapeutics
Head, Division of Clinical Pharmacology, Department of Medicine and Therapeutics
Director, Hong Kong Institute of Diabetes and Obesity
Director, Clinical Research Management Office
Faculty of Medicine
The Chinese University of Hong Kong

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The prevalence of young onset diabetes (YOD) is increasing world-wide with doubling of its prevalence in the last 10 years in many developed nations. Using the Hong Kong Diabetes Register established since 1995, we first reported that 1 in 5 Chinese adults with diabetes were diagnosed before the age of 40 years. These young patients had poor control of multiple risk factors with 1.5 fold higher risk of premature death and cardiovascular-renal complications compared to patients with usual onset of diabetes after the age of 40 (Chan JC et al AJM 2014, Luk A et al Diabetes Care 2014). Due to the multisystem nature of diabetes, we asked the question whether these young patients might have recurrent hospitalizations during their 3-4 decades of complex clinical course.

Using a territory-wide diabetes database involving 0.42 million people followed up between 2002 and 2014, we compared the hospitalization rates accrued till the age of 75 years and found that patients with young onset diabetes had the highest hospitalization rates by attained age. Compared to patients with usual onset of diabetes, patients with YOD had 1.8- 6.7 higher risk of hospitalizations due to all-causes, notably renal disease compared to those with usual onset of disease.

Amongst patients with young onset diabetes, over one-third of the bed-days were due to mental illness before the age of 40 years. We used mathematical modeling and estimated that intensified risk factor control in YOD can reduce the cumulative bed-days by 30% which can be further reduced by delaying the onset of diabetes. These original data is a wakening call to the community regarding the complex nature of YOD involving interactions amongst environment, lifestyles and personal factors (e.g. genetics, education and socioeconomic status) and the biomedical-psychological-behavioral needs of these high risk population, which if undiagnosed, untreated or suboptimally managed, can have huge economic impacts on health care system and loss of societal productivity, leaving personal suffering aside. Continue reading →

Maternal Obesity Raises Risk of Congenital Heart Defects

Posted on January 12, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Persson

Martina Persson, M.D, PhD
Karolinska Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is well known that maternal obesity increases risks of adverse fetal outcomes, including congenital malformations of the heart. However, it is unclear if maternal overweight and obesity associate with risks of specific and more complex congenital heart defects. We conducted a population-based cohort study in Sweden using data from several health registries. The study included more than 2 million live, singletons born between 1992-2012. Risks (prevalence rate ratios) of complex heart defects (Tetralogy of Fallot, transposition of the great arteries (TGA), atrial septal defects (ASD), aortic arch defects, and single ventricle heart) and several specific heart defects were estimated in infants to mothers with overweight and increasing degree of obesity.

We found that risks of aortic arch defects, ASD and patent ductus arteriosus (in term infants) increased with maternal obesity severity. On the other hand, we found no clear associations between maternal BMI and risks of several other complex and specific heart defects. Continue reading →

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