Teens: Nonmedical Prescription Opioid Use Associated With Subsequent Heroin Use

MedicalResearch.com Interview with:

Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC

Dr. Kelley-Quon

Lorraine Kelley-Quon, MD, MSHS, FAAP
Assistant Professor | Division of Pediatric Surgery
Children’s Hospital Los Angeles
Department of Surgery & Preventive Medicine
Keck School of Medicine of USC 

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

Response: Prescription opioids are pharmacologically similar to heroin, and previous research has shown an association between nonmedical opioid use and heroin use.

This is the first study to follow a group of teenagers through all 4 years of high school and identify an association between nonmedical prescription opioid use and later heroin use.

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Preterm Babies Less Likely To Have Romantic Relationships as Adults

MedicalResearch.com Interview with:

Dr. Marina Mendonca PhD RECAP project (Research on European Children and Adults Born Preterm) Department of Psychology University of Warwick, UK

Dr. Mendonca

Dr. Marina Mendonca PhD
RECAP project (Research on European Children and Adults Born Preterm)
Department of Psychology
University of Warwick, UK

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

Response: Previous research on the social lives of adults born preterm (under 37 weeks gestation) was inconsistent. This meta-analysis brought together data from up to 4.4m adult participants and has shown that those who were born preterm are less likely to form romantic relationships, to have had sexual relations or experience parenthood than full terms. For example, those born preterm were 28% less likely to form romantic relationships and 22% less likely to become parents, when compared to those born full term. When looking at sexual relations, preterm born adults were 2.3 times (or 57%) less likely to ever have a sexual partner.

These associations were found for both men and women, and were stronger the lower gestational age. This means that the chances of finding a romantic partner or having children were lower for those born very (<28 weeks gestation) or extremely preterm (<28 weeks gestation), with the extremely pre-term born adults being for example 3.2 times (78%) less likely to ever having had sexual relations when compared to their full term peers.

Despite having fewer relationships, we found that when adults who were born preterm had friends or a partner, the quality of these relationships was at least as good as those born full term. 

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No Cognitive Deterioration Found After Two Years of Youth Football

MedicalResearch.com Interview with:

Sean C. Rose, MD Pediatric sports neurologist and co-director of the Complex Concussion Clinic Nationwide Children’s Hospital 

Dr. Rose

Sean C. Rose, MD
Pediatric sports neurologist and co-director of the
Complex Concussion Clinic
Nationwide Children’s Hospital 

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

Response: Very limited data has been collected in children while they are playing contact sports to study the relationship between repetitive head impacts and neurocognitive outcomes.  We previously published a 1-year analysis of youth tackle football players and found no association between the number or severity of head impacts and performance on neurocognitive testing before to after the football season.  We are now reporting the results from the 2nd year of our study, tracking children through two seasons of football participation.

We measured head impacts using helmet sensors during the 2016 and 2017 football seasons.  In the total group of 166 players age 9-18, one outcome measure (processing speed), out of the 23 outcome measures studied, declined over time.  However, several other measures that also assessed processing speed did not decline.  Neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance over the course of the two seasons.

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Type 1 Diabetes in Children Alters Brain Growth and Function

MedicalResearch.com Interview with:

Nelly Mauras, MD Chief, Division of Pediatric Endocrinology, Nemours Children’s Health System Professor of Pediatrics Mayo College of Medicine

Dr. Mauras

Nelly Mauras, MD
Chief, Division of Pediatric Endocrinology,
Nemours Children’s Health System
Professor of Pediatrics
Mayo College of Medicine

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

Response: Keeping blood sugars close to normal in young children with diabetes is often limited by parental fears of the risks of low blood sugars and impaired cognitive development. Dr. Nelly Mauras, at the Nemours Children’s Health System in Jacksonville FL, along with Dr. Allan Reiss at Stanford University are co-principal investigators of the Diabetes Research in Children Network, a 5-center consortium performing studies in children with diabetes, also including the University of Iowa, Washington University St Louis and Yale University.

The investigators recruited 144 children with type 1 diabetes who were 4-7 years old and performed brain imaging (MRIs), did special cognitive tests, and monitored blood sugars using continuous glucose monitors. These studies were repeated after 18 months, approximately 54 months and 74 months, to examine changes in the brain and compare the results with those of 70 children the same age who do not have diabetes.

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Do New Medical Marijuana Laws Increase Teen Use of Cannabis?

MedicalResearch.com Interview with:

D. Mark Anderson, Ph.D. Associate Professor Department of Agricultural Economics and Economics Montana State University, IZA, and NBER

Dr. Anderson

D. Mark Anderson, Ph.D.
Associate Professor
Department of Agricultural Economics and Economics
Montana State University, IZA, and NBER

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

Response: Using data from the Youth Risk Behavior Surveys for the period 1993-2017, we explore the effect medical and recreational marijuana laws have on teen use.

We find that medical marijuana laws (MMLs) are not associated with teen marijuana consumption, but recreational marijuana laws (RMLs) are actually negatively associated with teen use. 

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Zero-Calorie Sweeteners During Pregnancy Can Impact Offspring’s Microbiome

Dr. Hanover

Dr. Hanover

MedicalResearch.com Interview with:
John A. Hanover, Ph.D

Chief: Laboratory of Cell and Molecular Biology
Section Chief: 
Cell Biochemistry Section, Laboratory of Cell and Molecular Biology
Director: Genomics Core, Cores and Support Services
The National Institute of Diabetes and Digestive and Kidney Diseases

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

Response: We are interested in the impact of early nutrition on metabolic reprogramming in mammals.  In particular, we are interested in how the nutritional information may be transferred from mother to offspring. 

 To this end, we have exposed mice to high sugar and high fat diets.  One arm of these studies was to examine the effects of exposure of pregnant mice to artificial sweeteners and the subsequent changes in her offspring.  This has not been examined and was important control for the studies outlined above.

How Well Did California’s Interventions to Improve Vaccination Rates Work?

MedicalResearch.com Interview with:
Ms. Cassandra Pingali

Ms. Pingali worked on this paper while a a graduate student at Emory University, and completed it post-graduation.
She is currently an ORISE fellow at Centers for Disease Control and Prevention
Immunization Services Division

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

Response: Despite high overall immunization coverage in the United States, we are currently experiencing the largest measles outbreak since measles was declared eliminated in 2000. In 2014, California grappled with a very large measles outbreak known as the “Disneyland” outbreak. Later investigation revealed that most of the affected children were unvaccinated against measles despite the availability of a safe and effective vaccine.

In order to prevent future outbreaks, California officials wanted to improve their declining childhood vaccination coverage. California passed two laws and implemented an educational program for school staff to increase vaccination rates in the state. We felt it was important to take a systematic look at these interventions and examine if public health initiatives such as these are working to improve vaccination rates.

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Atomwise Launches AI-Powered Virtual Drug Screening Program for Pediatric Cancers

MedicalResearch.com Interview with:
atomwiseAbraham Heifets, PhD
Department of Computer Science
University of Toronto 

MedicalResearch.com: What is the background for this announcement? How many children and adolescents are affected by pediatric cancer?

Response: Cancer is diagnosed in more than 15,000 children and adolescents each year. Many cancers, including pediatric cancer, do not have effective treatments and for those that do, it is estimated that 80% have serious adverse effects that impact long-term health. 

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Childhood Abuse More Likely With Male Caregiver, especially Mother’s Boyfriend

MedicalResearch.com Interview with:

Amanda Fingarson, DO  Attending Physician, Child Abuse Pediatrics  Ann and Robert H. Lurie Children’s Hospital of Chicago  Assistant Professor of Pediatrics  Feinberg Northwestern School of Medicine      

Dr. Fingarson

Amanda Fingarson, DO
Attending Physician, Child Abuse Pediatrics
Ann and Robert H. Lurie Children’s Hospital of Chicago
Assistant Professor of Pediatrics
Feinberg Northwestern School of Medicine 

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

Response: Child physical abuse is a substantial pediatric public health issue, with significant morbidity and mortality. Studies have found that men, particularly children’s fathers and mothers’ boyfriends are common perpetrators of physical abuse. There is still a lack of knowledge, however, about the specific caregiver features that increase a child’s risk for physical abuse.

Our study design was unique, in that it was a multi-center study that compared young children with abusive and accidental injuries.

Our primary finding was that abuse was much more likely when a male caregiver was present, and the resulting injuries were more likely to be severe or fatal. The presence of the mother’s boyfriend was the riskiest scenario, with the highest likelihood of abuse. Similarly, we found that caregiver relationships of less than 1 year increased the odds of abuse. Overall, the likelihood of abuse with female caregivers was much lower, with the exception of female babysitters.  A final important finding of our study was that caregiving arrangements that were different than usual at the time of injury were at increased risk of abuse, suggesting that a stable and consistent caregiver is also important.  Continue reading

Sexting Linked to Increased Sexual Activity and Substance Abuse Among Teenagers

MedicalResearch.com Interview with:
texting, sextingCamille Mori, B.A. (hons)
M.Sc. candidate
Clinical Psychology Program
Determinants of Child Development Lab
University of Calgary 

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

Response: Sexting, which is the sharing of sexual messages, images, or videos over technological devices, has recently become a cause for concern among parents, teachers, and policy makers. However, the research on sexting among youth is still in early stages, and evidence of the risks associated with sexting is inconsistent. One way to resolve discrepancies in the field is to conduct a meta-analysis, which statistically summarizes existing research. We conducted a meta-analysis in order to examine the association between sexting and sexual activity (having sex, multiple sexual partners, and lack of contraception use). The associations between sexting and mental health related variables, including delinquent behaviour, substance use, and depression/anxiety were also examined.

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Drug Disposal Bags After Hospitalizations Can Get Rid of Some Leftover Opioids

MedicalResearch.com Interview with:

Jennifer N. Cooper, PhD Principal Investigator Center for Innovation in Pediatric Practice The Research Institute at Nationwide Children's Hospital, Research Assistant Professor of Pediatrics The Ohio State University College of Medicine

Dr. Cooper

Jennifer N. Cooper, PhD
Principal Investigator
Center for Innovation in Pediatric Practice
The Research Institute at Nationwide Children’s Hospital,
Research Assistant Professor of Pediatrics
The Ohio State University College of Medicine

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

Response: Although postoperative opioid prescribing has decreased in recent years due to an increased awareness of the risks of excess opioid prescribing, many patients are still prescribed more opioids than they need after surgery. In the pediatric population, most opioids are prescribed after surgical and dental procedures.

Although patients are often prescribed more opioids than they need after surgery, previous studies have found that excess opioids left unused after surgery are rarely properly disposed. These leftover opioids can be misused or accidentally ingested by young children. Previous studies have targeted the problem of non-disposal of opioids leftover after surgery by providing patients and families with educational materials describing proper methods of postoperative opioid disposal. However, these studies have had mixed results with some finding an increase in opioid disposal after education and others finding no effect of such education. In addition to education, another means of facilitating postoperative opioid disposal is the provision of drug disposal products. These products contain compounds that irreversible adsorb or oxidize medications, enabling them to be safely disposed of in the home garbage.

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Children with Birth and Chromosomal Defects More Likely to Develop Cancer

MedicalResearch.com Interview with:

Philip J. Lupo, PhD, MPH Co-Director, Childhood Cancer Epidemiology and Prevention Program, Texas Children's Cancer Center Associate Professor, Department of Pediatrics Section of Hematology-Oncology, Member, Dan L. Duncan Comprehensive Cancer Center Baylor College of Medicine Adjunct Associate Professor, Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences University of Texas School of Public Health

Dr. Lupo

Philip J. Lupo, PhD, MPH
Co-Director, Childhood Cancer Epidemiology and Prevention Program, Texas Children’s Cancer Center
Associate Professor, Department of Pediatrics
Section of Hematology-Oncology,
Member, Dan L. Duncan Comprehensive Cancer Center
Baylor College of Medicine
Adjunct Associate Professor, Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences
University of Texas School of Public Health
 

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

Response: While cancer risk in children with certain chromosomal defects like Down syndrome is well established, much less is known for children with birth defects where there is no known genetic cause, sometimes called non-chromosomal defects. Non-chromosomal defects, as a group, affect more children, but one of the primary challenges of understanding risk among these children is that limited sample sizes make studying specific defects, like spina bifida, more difficult.

Because of that, we gathered data from birth, birth defect, and cancer registries across Texas, Arkansas, Michigan, and North Carolina to generate a birth cohort of more than 10 million children born between 1992 and 2013. We looked at diagnoses of cancer until 18 years of age to determine differences in cancer risk between those with and without birth defects.

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Decrease in Obesity Among Young US Children Enrolled in Special Supplemental Nutrition Program 2010-2016

MedicalResearch.com Interview with:

Liping Pan, MD, MPH Epidemiologist Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention

Dr. Pan

Liping Pan, MD, MPH
Epidemiologist
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

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

Response: Children with severe obesity face significant health and social challenges. Children with obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease such as high blood pressure, impaired glucose tolerance, and high cholesterol than their healthyweight peers. Children with obesity can be bullied and teased more than their healthyweight peers. They are also more likely to suffer from social isolation, depression, and lower self-esteem. Children with obesity are also more likely to have obesity as adults. This can lead to lifelong physical and mental health problems. Adult obesity is associated with a higher risk of type 2 diabetes, heart disease, and many types of cancers. 

Childhood obesity is more common among children from lower-income families, as many lack access to healthy, affordable foods and beverages and opportunities for low-cost physical activity.

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Cognitive Brain Circuits Altered in Youth With Significant Cannabis Use

MedicalResearch.com Interview with:

Marilyn Cyr, Ph.D., Psy.D. Postdoctoral Research Scientist Division of Child and Adolescent Psychiatry New York State Psychiatric Institute Columbia University Medical Center New York, NY 10032

Dr. Cyr

Marilyn Cyr, Ph.D., Psy.D.
Postdoctoral Research Scientist
Division of Child and Adolescent Psychiatry
New York State Psychiatric Institute
Columbia University Medical Center
New York, NY 10032

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

Response: A hallmark feature of problematic substance use is compulsive drug-seeking long after the drug is no longer experienced as pleasurable and despite the associated adverse consequences of this behavior. Disturbances in cognitive control—an ensemble of processes by which the mind governs behaviors, regulates impulses and guides decisions based on goals—are believed to be involved in the initiation and maintenance of the compulsive drug-seeking that characterizes problematic substance use. Most adults with problematic substance use began having problems with drugs and alcohol in adolescence, a developmental period during which the neural circuits underlying cognitive control processes continue to mature.

As such, the adolescent brain may be particularly vulnerable to the effects of substance use, and particularly cannabis, the most commonly used recreational drug by teenagers worldwide.

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Type 2 Diabetes More Aggressive in Youth

MedicalResearch.com Interview with:
Dr. Ellen Leschek MD
Program Director: Division of Diabetes, Endocrinology, and Metabolic Diseases
The National Institute of Diabetes and Digestive and Kidney Diseases
Health Information Center

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

Response: Type 2 diabetes (T2D) is thought to be characterized by a progressive loss of pancreatic beta cell (insulin producing/releasing cell) function. For this reason, T2D medications eventually stop working and individuals with T2D require treatment with insulin.

The Restoring Insulin Secretion (RISE) Consortium was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to evaluate the effects of treatment and treatment withdrawal on the loss of pancreatic beta cell function. In the RISE Study, progression of disease was assessed by the measurement of pancreatic beta cell function in youth and adults who had either impaired glucose tolerance (IGT; prediabetes) or recently diagnosed Type 2 diabetes before, during and after treatment with study medications. Importantly, the RISE Pediatric Medication Study and the RISE Adult Medication Study were designed in tandem to allow direct comparison of the effects of two pharmacologic treatment regimens (the only two FDA-approved medications for Type 2 diabetes in youth) on disease progression in youth and adults. For more information about the RISE Study, please visit https://rise.bsc.gwu.edu/web/rise.

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Keep Your Up Cosmetics and Out of Sight of of Kids

MedicalResearch.com Interview with:

Rebecca McAdams, MA, MPH CHES Senior research associate Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH

Rebecca McAdams

Rebecca McAdams, MA, MPH CHES
Senior research associate
Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH 

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

Response: Cosmetic or personal care products are found in nearly every US home and include items such as nail, hair and skin care products. Many of us use these products daily. Although a cosmetic product may not be harmful when used according to the directions, it is important for parents and caregivers to know that a young child could be seriously injured by these products.

This study found that 64,686 children younger than five years of age were treated in U.S. emergency departments for injuries related to personal care products from 2002 through 2016 – that’s an average of about one child every two hours. 

MedicalResearch.com: What are the main findings?

Response: The study found that most injuries from these products occurred when a child swallowed the product (75.7%) or the product made contact with a child’s skin or eyes (19.3%). These ingestions and exposures most often led to poisonings (86.2%) or chemical burns (13.8%).

The study found that the top products that led to injuries were nail care products (28.3%), hair care products (27.0%), skin care products (25.0%), and fragrance products (12.7%). When we looked at specific cosmetic products, nail polish remover was the single product which most frequently caused injuries (17.3%). For all products, children younger than 2 years of age were most commonly injured (59.3%), and they were more than twice as likely to be injured by a cosmetic product compared to children 2-4 years of age. 

As the first comprehensive examination of cosmetic-related injuries in children younger than 5 years of age using NEISS data, these results indicate a steady and persistent number of cosmetic-related injuries for children. Children younger than 2 years demonstrated different patterns and injury rates, relative to children aged 2 to 4 years. These findings demonstrate the need for increased efforts and prevention messaging to reduce the burden of cosmetic injuries. Particularly, prevention efforts need to be age-specific to couple developmental milestones with corresponding cosmetic product exposures.

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

Response: It’s important for parents and caregivers with young children in the home to store all personal care products safely – up, away, and out of sight – in a locked cabinet is best. There are many products on the market to assist with safe storage. A variety of cabinet and drawer locks and latches are on the market which enable most spaces to be made more secure. These products can typically be purchased at grocery stores, mass retailers, drug stores, home improvement stores, hardware stores, and online.

It’s best to store personal care products up (in a cabinet children cannot reach), away (not just sitting on a shelf), and out of sight (in an opaque container or behind an opaque door or drawer). Remember that using child safety products like locks and latches will make storage safer and child-resistant, but no product will make your home completely child-proof.

Parents and child caregivers can help children stay safer by following these tips:

  • Up, away and out of sight. Store all personal care products safely: up, away and out of sight – in a cabinet that can be locked or latched is best. Never leave personal care products out unattended and put them away immediately after use.
  • Store safely now. It is never too soon to start practicing safe storage. Almost 60% of the injuries in this study were to children younger than 2 years of age.
  • Original containers. Keep all personal care products in their original containers.
  • Know how to get help. Save the national Poison Help Line (1-800-222-1222) in your cell phone and post it near your home phones.

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

Response: The persistence of cosmetic-related morbidity highlights the need to apply injury prevention strategies to this domain of consumer products. New emphasis needs to be placed on the safe storage recommendations put forward by the American Academy of Pediatrics on bathroom safety, and considerations need to be taken to store these items safely in the bedroom and common areas as well. Of particular relevance is the notion that cosmetic products need to be stored in the same manner as medications: in locked cabinets that are high and out of reach of young hands. Furthermore, not to be underestimated is the role of health care providers in advocating for safe storage of these common products through education at well-child appointments.

I have no financial relationships or potential conflicts of interest relevant to this article to disclose.

Citation:

Cosmetic-Related Injuries Treated in US Emergency Departments: 2002 to 2016

Jordan VajdaMA, MDivRebecca J. McAdamsMA, MPHKristin J. RobertsMS, MPHMotao ZhuMD, MS, PhDLara B. McKenziePhD, MA

https://doi.org/10.1177/0009922819850492 |
First Published June 16, 2019

 

[last-modified]

 

 

 

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Could Breast Milk from Overweight Moms Play a Role in Childhood Obesity?

MedicalResearch.com Interview with:

Henry J. Nuss, Ph.D. Assistant Professor Louisiana State University Health Sciences Center School of Public Health New Orleans, LA

Dr. Nuss

Henry J. Nuss, Ph.D.
Assistant Professor
Louisiana State University Health Sciences Center
School of Public Health
New Orleans, LA 

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

Response: Childhood obesity rates in the U.S. have been increasing within the past 30 years. We can point to things like sedentary lifestyle, energy-dense, nutrient-poor foods and savvy marketing techniques of large food corporations that target kids and their parents to buy food items that aren’t healthy. That said, we do know that women who have an unhealthy weight status (as measured by BMI ≥ 25) tend to have offspring that eventually attain an unhealthy weight status themselves. Aside from environmental factors, could this be due to maternal programming or perhaps something in the breastmilk? Or both? We saw some interesting research that showed breastfed infants/toddlers born to asthmatic moms were more likely to develop asthma. Furthermore, this association became stronger the longer the infants/toddlers were breastfed. The conclusion here is that it must be something in the breastmilk.

We knew that asthma and obesity are both inflammatory in nature and that there are specific pro- and anti-inflammatory and obesogenic bioactive compounds in human breastmilk. Some have been studied before but there were no studies at the time that tied all of the pieces together. If we could target specific compounds in the milk that were associated with unhealthy growth patterns in infants then we could perhaps be more specific in how we fight this problem.

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More Scooters Means More Head and Face Injuries

MedicalResearch.com Interview with:

Amishav Bresler MD Department of Otolaryngology - Head and Neck Surgery Rutgers - New Jersey Medical School

Dr. Bresler

Amishav Bresler MD
Department of Otolaryngology – Head and Neck Surgery
Rutgers – New Jersey Medical School 

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

Response: This study was inspired by a personal experience with the rental scooters.

The most recent American Academy of Otolaryngology-Head and Neck Surgery annual conference was in Atlanta this year. At the time of the conference, the scooter rental industry had recently entered the region. A friend of mine, another ENT resident, was encouraging others to use these scooters for transportation for both the novelty and convenience. However, he didn’t even have a helmet!

Here was a well-educated doctor who takes call for craniofacial injuries, who was about to get on a scooter without a helmet. This experience made me wonder if scooters were dangerous scooters and their overall impact on public health.

In terms of the backgroud, the personal transportation industry is undergoing a revolution. The search for efficient and environmentally-friendly urban transportation ignited an ongoing debate in the United States regarding the role of motorized scooters. Although known to be a popular method of transportation in Europe and Asia, motorized scooters have only recently begun to make inroads in the United States. The gradual rise in popularity has been attributed to their convenience, affordability, and status as a “green” alternative to vehicles with combustion engines. These advantages combined with the fact electric scooters enable users to travel longer distances than conventional scooters present an attractive method of transportation to school, work, and leisure.

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Are Some Dog Breeds More Likely to Bite?

MedicalResearch.com Interview with:

Dr. Garth Essig, MD Otolaryngologist The Ohio State University Wexner Medical Center. 

Dr. Essig

Dr. Garth Essig, MD
Otolaryngologist
The Ohio State University Wexner Medical Center. 

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

Response: Dog bites are a significant yet modifiable public health concern, but the true magnitude is difficult to estimate with such wide ranges in reporting, severity of injury and varieties of breeds that bite.  We reviewed bites from reports in the literature and from two regionally distinct medical centers.

We concluded that bite frequency and severity could be attributed to certain breeds in this sample, if the breed is known. Our study also acknowledged the significant risk of biting with the mixed breed population, which creates a dilemma with identification.

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Children with High Risk AML: Intensification of Induction II Chemotherapy and Liberalization of Stem Cell Donor Source does not Improve Outcomes

MedicalResearch.com Interview with:
Joseph Germino, M.D., PhD
Vice President US Medical Affairs Oncology
Bayer Healthcare Pharmaceuticals
Whippany, N.J. 07981

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

Response: Sorafenib (Nexavar®) is an oral anticancer therapy approved in more than 100 countries worldwide. It is approved for the treatment of patients with advanced hepatocellular carcinoma (HCC); advanced renal cell carcinoma (RCC) who have failed prior interferon-alpha or interleukin-2 based therapy or are considered unsuitable for such therapy; progressive, locally advanced or metastatic differentiated thyroid carcinoma (papillary/follicular/Hürthle cell), that is refractory to radioactive iodine (RAI).

The AAML 1031 is a recently completed Phase III clinical trial evaluating the use of bortezomib and sorafenib in patients 30 years or younger with newly diagnosed acute myeloid leukemia (AML).

At the 2019 ASCO Annual meeting, results of a report from the AAML1031 trial, which assessed whether intensification of Induction II chemotherapy (ADE or AraC/ Mitoxantrone) and liberalized stem cell transplant (SCT) donor source criteria improved clinical outcomes in patients with residual AML.  Continue reading

Many Teens Do Not Fill Their Prescriptions for STDs

MedicalResearch.com Interview with:

Monika K. Goyal, M.D., MSCE Assistant chief of Children’s Division Emergency Medicine and Trauma Services

Dr. Goyal

Monika K. Goyal, M.D., MSCE
Assistant chief of Children’s Division
Emergency Medicine and Trauma Services 

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

Response: Adolescents are disproportionately affected by sexually transmitted infections (STIs) and often present to the emergency department for care. I have devoted almost 15 years of my career trying to improve the sexual health of teens through advocacy and the development of novel interventions in the emergency department to increase access to sexual health services for youths.

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Canadian ERs Use Less Pediatric Diagnostic Imaging Than US

MedicalResearch.com Interview with:

Eyal Cohen, MD, M.Sc, FRCP(C)Professor, PediatricsUniversity of TorontoCo-Founder, Complex Care ProgramThe Hospital for Sick Children

Dr. Cohen

Eyal Cohen, MD, M.Sc, FRCP(C)
Professor, Pediatrics
University of Toronto
Co-Founder, Complex Care Program
The Hospital for Sick Children
 

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

Response: Minimizing care that provides little benefit to patients has become an important focus to decrease health care costs and improve the quality of care delivery.  Diagnostic imaging in children is a common focus for campaigns designed to reduce overuse both in Canada and the US. There are some suggestions that there may be more overuse of care in the United States than Canada, but there has been little study in children.

We compared the use of low-value diagnostic imaging rates from four pediatric emergency departments in Ontario to 26 in the United States from 2006 to 2016.  We defined low-value imaging as situations where children are discharged from an emergency department with a diagnosis for which routine use of diagnostic imaging may not be necessary, like asthma or constipation.  Continue reading

Larotrectinib (VITRAKVI® ): Efficacy and Safety in Pediatric TRK Fusion Cancer Patients

MedicalResearch.com Interview with:

Douglas S. Hawkins, M.D. Hematology/Oncology Division Chief and Professor Pediatrics at Seattle Children's Hospital University of Washington School of Medicine

Dr. Hawkins

Douglas S. Hawkins, M.D.
Hematology/Oncology Division Chief and Professor
Pediatrics at Seattle Children’s Hospital
University of Washington School of Medicine

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

Response: TRK fusion cancer is caused by a rare genomic alteration called a neurotrophic receptor tyrosine kinase (NTRK) gene fusion.

Larotrectinib is a central nervous system (CNS) active, oral and highly selective TRK inhibitor used for the treatment of adult and pediatric patients with solid tumors that have a rare genomic alteration called an NTRK gene fusion. Larotrectinib was approved at the end of 2018 in the U.S. under the brand name VITRAKVI®, with European and worldwide regulatory submissions underway.

At ASCO 2019, we will be presenting results from a new analysis specifically looking at the efficacy and safety of larotrectinib in pediatric patients (n=34) included in the expanded dataset from both adults and children across 24 tumor types, which was presented first at the European Society for Medical Oncology (ESMO) 2019 Annual Meeting.  Continue reading

Laundry Detergent Packets Still Poison Kids, Despite Tougher Standards

MedicalResearch.com Interview with:

Dr-Gary A. Smith

Dr. Gary Smith

Dr. Gary Smith, MD MPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH

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

Response: Our 2016 study (https://pediatrics.aappublications.org/content/137/5/e20154529) investigated calls to US poison control centers related to laundry and dishwasher detergent exposures among children younger than 6 years old from 2013 through 2014 and found that poison control centers received more than 30 calls a day about children who had been exposed to a laundry detergent packet, which is about one call every 45 minutes.

The current study investigated trends in calls to poison control centers across the country for exposure to liquid laundry detergent packets in order to evaluate the impact of the voluntary safety standard for this product with a focus on young children. The study found only a modest decrease (18%) in calls for children younger than 6 years of age following adoption of a 2015 product safety standard as well as an increase in calls for older children and adults. Exposures to the eyes also continued to climb.

The observed decrease in exposures among young children is considerably less than the 40% to 55% decrease in toxic ingestions seen after passage of the Poison Prevention Packaging Act. This demonstrates that the current liquid laundry detergent safety standard is inadequate and needs to be strengthened. Continue reading

Team Sports Benefits Teens With a Troubled Childhood

MedicalResearch.com Interview with:
Molly C. Easterlin, MD

Fellow, UCLA National Clinician Scholars Program
Clinical Instructor, Pediatrics, Cedars-Sinai Medical Center 

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

Response: Adverse childhood experiences or ACEs (including physical or emotional neglect or abuse, sexual abuse, domestic abuse, exposure to household substance misuse or mental illness, parental separation or divorce, and parental incarceration) are common with about half of children experiencing 1 and one-quarter of children experiencing 2 or more.

Children exposed to adverse childhood experiences have worse mental health throughout life, including higher rates of depression and anxiety. However, little is known about what factors improve long-term mental health in those exposed to ACEs. Additionally, as far as we are aware, no studies have looked at team sports participation as a potential factor that may be associated with improved mental health among those with adverse childhood experiences.

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Prenatal Exposure to Nicotine May Increase Risk of Nicotine Susceptibility Later in Life

MedicalResearch.com Interview with:

Davide Dulcis, PhDAssociate ProfessorDepartment of Psychiatry, UCSD School of MedicineUniversity of California, San DiegoLa Jolla, CA 92093-0603

Dr. Dulcis

Davide Dulcis, PhD
Associate Professor
Department of Psychiatry, UCSD School of Medicine
University of California, San Diego
La Jolla, CA 92093-0603

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

Response: Previous studies in humans have shown that pre-natal and early life exposure to nicotine can lead to altered children behavior and propensity for drug abuse, but the precise mechanisms involved are still unclear.

In this pre-clinical study we showed how nicotine “primes” neurons of the mouse brain’s reward center for a fate they normally would not have taken, making them more susceptible to the effects of nicotine when the animals are again exposed to nicotine later in life, said Dr. Benedetto Romoli, first author of the research article.   Continue reading

Cholesterol Levels in American Youth Improving, But Only Half Have Ideal Lipid Levels

MedicalResearch.com Interview with:

Amanda Marma Perak, MD, MSAssistant Professor of Pediatrics (Cardiology) and Preventive Medicine

Dr. Marma Perak

Amanda Marma Perak, MD, MS
Assistant Professor of Pediatrics (Cardiology) and
Preventive Medicine

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

Response: Blood cholesterol is a critical initiator of atherosclerotic plaques in the arteries that can lead to heart attack in adulthood. It is well established that these changes in the blood vessels occur already in childhood. Thus, it is important to know the status of cholesterol levels in youth to inform public health efforts aimed at preventing cardiovascular disease in the population.

In the US there have been changes in childhood obesity prevalence (which may worsen cholesterol levels), the food supply (such as reduction of trans fats which may improve cholesterol levels), and other factors in recent years.

We therefore designed a study to examine trends in cholesterol levels among youth in recent years.

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Few Teen Moms Protect Themselves with Condoms and Long Acting Contraceptives

MedicalResearch.com Interview with:
Lee Warner, PhD

Chief of the Women’s Health and Fertility Branch
Division of Reproductive Health
CDC

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

Response: Previous research has found lower prevalence of condom use combined with the most effective reversible contraceptive methods among teens, but this is the first study to our knowledge to confirm the finding among sexually active teen mothers in the postpartum period.

Our new paper finds that only 3 in 10 postpartum teen mothers report using condoms combined with a more effective contraceptive method (either long-acting reversible contraception or LARC or a non-LARC hormonal method). Dual use was 50 percent lower among LARC users compared with users of non-LARC hormonal methods.

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Sudden Infant Death Can Occur in Child Seats, esp When Not In Car and Adult Asleep

MedicalResearch.com Interview with:

Jeffrey Colvin, MD, JDDepartment of PediatricsChildren's Mercy HospitalKansas City, MO 64111

Dr. Colvin

Jeffrey Colvin, MD, JD
Department of Pediatrics
Children’s Mercy Hospital
Kansas City, MO 64111 

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

Response: Prior studies have found that infants spend an average of 5-6 hours a day in sitting devices. Sitting devices include car seats, swings, infant seats, and strollers.

Given how much time infants are spending in sitting devices, we wanted to know if sleep-related infant deaths (such as Sudden Infant Death Syndrome or “SIDS”) was occurring in those devices. We examined over 10,000 infant sleep-related deaths from 45 states. We found that 3% (or 348) of the deaths occurred in sitting devices. Two-thirds of the deaths in sitting devices were in car seats. What was most surprising was that less than 10% of the deaths in car seats occurred in cars. Instead, the great majority occurred in the child’s home or the home of a relative, friend, or babysitter. In 1/3 of the deaths in car seats, the supervising adult was asleep.  Continue reading

Mortality Rate Increases With Each Sugary Drink

MedicalResearch.com Interview with:
Jean A. Welsh, RN, MPH, PhD
Departments of Epidemiology and Pediatrics
Emory University
Wellness Department, Children’s Healthcare of Atlanta
Atlanta, Georgia

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

Response: As the evidence has accumulated regarding the health risks associated with sugar-sweetened beverages, I’ve wondered about fruit juices.  Though they have a kind of healthy halo, their main ingredients are the same as sugar-sweetened beverages, sugar and water.  We know that young children drink a lot of fruit juice, and I’ve wondered if older children and adults might switch to drinking more as concern grows about soft drinks and other sugar-sweetened beverages.

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