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

Posted on May 22, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

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.

Continue reading →

Few Teen Moms Protect Themselves with Condoms and Long Acting Contraceptives

Posted on May 21, 2019 by Marie Benz MD FAAD

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.

Continue reading →

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

Posted on May 20, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

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

Posted on May 19, 2019 by Marie Benz MD FAAD

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.

Continue reading →

Are Kids Who Own Tobacco Promotional Materials More Likely To Start Products Like Juul?

Posted on May 19, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Bonnie Halpern-Felsher, PhD, FSAHM

Professor of Pediatrics
Director of Fellowship Research
Department of Pediatrics
Director of Research, Division of Adolescent Medicine
Associate Director, Adolescent Medicine Fellowship Program
Co-leader, Scholarly Concentrations,
Pediatrics Residency Program
Stanford University

Hoda S. Abdel Magid, MHS, PhD
Postdoctoral Scholar
Department of Health Research & Policy
Stanford University

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

Response: Dr. Hoda Magid, my former graduate student, and I wanted to examine whether owning promotional items for e-cigarettes and other non-cigarette products predicted youth use of those products. Other studies have examined whether ownership of coupons, samples, and other promotional materials influenced cigarette use, but no longitudinal study examined other tobacco products.

Our findings show that non-tobacco using youth who own items to promote e-cigarettes and other alternative tobacco products are twice as likely to use alternative tobacco products a year later.

Continue reading →

Pre-Visit Electronic Screening Helps Doctors Counsel Their Adolescent Patients

Posted on May 7, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. McCarty

Cari McCarty, PhD
Research Professor, UW
Investigator, Seattle Children’s Research Institute

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

Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents. The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician. We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care.

Continue reading →

Collaboration and Teamwork Allowed Reduction in Unintended Extubations in Neonatal ICU

Posted on May 6, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Galiote

John P. Galiote, M.D.
Neonatologist at Children’s National-Virginia Hospital Center NICU

Ms. Ridoré

Michelande Ridoré, MS, NICU
Quality improvement lead at Children’s National

Dr. Soghier

Lamia Soghier, M.D., MEd, Children’s National NICU Medical Director

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

Response: Our study emphasizes the importance of team work and real-time communication in a quality-improvement project within the neonatal intensive care unit (NICU) setting.

Through bedside huddles, weekly reviews of apparent cause analysis reports reducing the frequency of X-rays and the creation of an Airway Safety Protection Team, we were able to focus not only on reducing unintended extubations, but also on the quality-improvement project’s effect on our staff. Adhering to simple quality principles enabled us to ensure that all members of our staff were heard and had a positive effect on the progress of our project. This allowed us to implement and sustain a series of simple changes that standardized steps associated with securing and maintaining an endotracheal tube (ET). Unintended extubations are the fourth-most common adverse event in the nation’s NICUs. Continual monitoring via this quality-improvement project allowed us to intervene when our rates increased and further pushed our unintended extubation rate downward. Continue reading →

E-Cigs: New Source of Second-Hand Smoke for Children

Posted on May 6, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:Jenny L. Carwile, ScD, MPH
Department of Medicine
Maine Medical Center
Portland

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

Response: Although e-cigarette aerosols are commonly perceived to be “harmless water vapors” they contain numerous potentially harmful chemicals including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates. Non-users can be exposed to these chemicals through secondhand exposure.

We found that in the US 4.9% of adults who lived in a household with children were current e-cigarette users. Continue reading →

Microbiome in Early Adolescent Acne Changes Over Time

Posted on April 30, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Ahluwalia

Dr. Jusleen Ahluwalia MD
Second-year Dermatology resident
University of California, San Diego

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

Response: Preadolescence is an interesting stage during which changes in microbial diversity can coincide with the development of acne. This study is the largest assessment of preadolescent acne microbiome in the literature to date.

In this study, we found that early acne in preadolescent females is characterized by an abundance of Streptococcus mitis, while later stages are characterized by a predominance of Cutibacterium acnes (formerly known as Propionibacterium acnes).

Continue reading →

Cannabis and Tobacco/Nicotine Co-Use Common Among Young Adults

Posted on April 30, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Tucker

Joan S. Tucker, Ph.D.
Senior Behavioral Scientist
RAND Corporation
Santa Monica, CA

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

Response: In light of young adults’ expanding access to cannabis through legalization for recreational use, there has been growing interest in the co-use of cannabis with tobacco/nicotine products. Although existing data show that young adults who use cannabis products also tend to use tobacco/nicotine products, little is known about how these products are typically used together.

Existing research on co-use has mostly focused on combustible products, not accounting for the recent proliferation in cannabis and tobacco/nicotine product types and methods of use (e.g., vaping). Further, not much is known about whether there are important differences between types of co-use (e.g., using both products on the same occasion, one right after another, but not mixing them vs. using both products by mixing them in the same delivery device) in terms of heaviness of use, consequences from use, or associations with young adult functioning.

This study was designed as an important first step toward understanding cannabis and tobacco/nicotine co-use behavior among young adults and addressing these gaps in the research literature.

Continue reading →

Fetal and Early Infant Growth Linked to Persistent Body Fat Patterns

Posted on April 26, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Jaddoe

Vincent W. V. Jaddoe, MD, PhD
Adjunct Professor of Epidemiology
Department of Epidemiology

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

Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life.

We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat. Continue reading →

How Long Does Protection from DTaP Vaccination Last?

Posted on April 26, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Domenech de Cellès

Dr. Matthieu Domenech de Cellès PhD
Biostatistics, Biomathematics, Pharmacoepidemiology, and
Infectious Diseases Unit, Institut Pasteur, Inserm U1181,
University of Versailles St-Quentin-en-Yvelines,
Versailles, France

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

Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination.

Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex.

In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect. Continue reading →

Early Childhood Infections Associated With Eating Disorders In Adolescence

Posted on April 25, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Breithaupt

Lauren Breithaupt, PhD
Department of Psychology
George Mason University
Fairfax, Virginia

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

Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders.

We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk. Continue reading →

To Reduce Crib Deaths, Get Rid of Blankets, Pillows, Bumpers and Soft Objects

Posted on April 25, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Hauck

Fern R. Hauck, MD, MS
Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine
Professor of Public Health Sciences
Director, International Family Medicine Clinic
University of Virginia Department of Family Medicine

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

Response: Unintentional suffocation is the leading cause of injury deaths among infants under one year of age in the US. 82% of these deaths are attributed to accidental suffocation and strangulation in bed. The Sudden Unexpected Infant Death Case Registry was established by the Centers for Disease Control and Prevention (CDC) in 2009 to collect data on sudden unexpected infant deaths (SUID) to better understand trends and characteristics associated with these deaths. Data from 10 states, which account for about one-third of all US SUID cases, are captured in the Registry.

The CDC developed the Case Registry classification system in 2014 to differentiate SUID cases into several groups; explained suffocations with unsafe sleep factors is one of those categories, and the subject of this study. We analyzed infant deaths (children under one year of age) that occurred from 2011-2014 among states participating in the registry at the time of the study (Arizona, Colorado, Georgia, Louisiana, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, and Wisconsin). Among the 1812 cases in the Registry from 2011-2014, 250 (14%) were classified as suffocation. The remaining cases were classified as unexplained SUID.

Continue reading →

How Did Medicaid Expansion Affect Low Birth Weights and Preterm Births?

Posted on April 24, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Brown

Clare Brown, PhD
Health Systems and Services Research
University of Arkansas for Medical Sciences

Dr. Tilford

J. Mick Tilford, PhD,
Professor and Chair
Department of Health Policy and Management
Fay W. Boozman College of Public Health
University of Arkansas for Medical Science

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

Response: Prematurity and low birthweight are associated with increased risk of infant mortality as well as increased risk of chronic conditions throughout infancy and into adulthood. Non-Hispanic black infants are twice as likely to be born low birthweight (13.9% vs 7.0%) and 1.5 times as likely to be born prematurely (13.9% vs 9.1%) compared to non-Hispanic white infants.

Under the Affordable Care Act (ACA), states may expand Medicaid to adults with household income levels at or below 138% of the federal poverty level, thus extending coverage to childless adults and improving continuity. Insurance gain may ultimately improve maternal health, increased use and earlier initiation of prenatal care services, and improved access to pregnancy planning resources.

Our study aimed to evaluate whether there were changes in rates of low birthweight and preterm birth outcomes among states that expanded Medicaid versus states that did not expand Medicaid. Continue reading →

Changes in WIC Program Linked to Decreased Obesity in Children

Posted on April 23, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Chaparro

M. Pia Chaparro, MS, PhD
Assistant Professor
Department of Global Community Health and Behavioral Sciences
School of Public Health and Tropical Medicine
Tulane University
New Orleans, LA 70112

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

Response: In 2009, the WIC program changed the food packages participants receive to better align them with federal dietary guidelines. These changes included the addition of fruits, vegetables, and whole grains; a reduction in the amount of dairy and juice; and a calibration in formula amounts to match infants’ age and needs.

We found that this change in the food package was associated with a 10-12% lower obesity risk at age 4 years among children who participated in WIC in Los Angeles County continuously from birth until age 4. Continue reading →

USPSTF: More Research Needed to Determine What Primary Care Providers Can Do to Detect and Treat Lead Poisoning

Posted on April 23, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Krist

Alex H. Krist, MD, MPH
Vice-Chairperson, U.S. Preventive Services Task Force
Professor of family medicine and population healt
Virginia Commonwealth University

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

Response: Exposure to lead can have serious lifelong effects on the health and wellbeing of children. There is no safe level of lead exposure, so finding and removing any source of lead exposure is essential.

In its review of the evidence, the Task Force found that more research is needed to determine what primary care clinicians can do to help prevent and treat the health problems that can result from lead exposure in childhood and pregnancy.

Continue reading →

Kids Who Don’t Drink Water, More Likely To Drink Sugar-Sweetened Beverages

Posted on April 23, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Rosinger

Asher Y Rosinger, PhD, MPH
Assistant Professor of Biobehavioral Health and Anthropology
Director of the Water, Health, and Nutrition Laboratory
Pennsylvania State University

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

Response: Sugar-sweetened beverage consumption has been linked to many negative health conditions, such as weight gain, dental caries, and type 2 diabetes. Previous research found that when you replace sugar-sweetened beverages (SSBs) with water intake then total energy intake goes down. We wanted to know how many calories from SSBs children consume when they drink water or not since sugar-sweetened beverages are often used as a replacement for water. SSB intake has been falling among children over the last 15 years, but there are still pockets and sub-populations that have high consumption levels. It is critical to identify which kids are particularly at risk for high SSB intake since this can lead to these negative health effects.

Overall we found that kids that did not consume any plain water (from tap or bottled water) consumed almost twice as many calories and percent of total calories from sugar-sweetened beverages than kids that consumed water. And for the sample overall that translated to nearly 100 extra calories on a given day. Continue reading →

High Lead Levels in Refugee Children Resettled in US

Posted on April 20, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Bhatta

Madhav P. Bhatta, PhD, MPH
Associate Professor, Epidemiology & Global Health
College of Public Health
Kent State University
Kent, OH 44242

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

Response: Lead exposure, especially in children, in any amount is harmful. Lead poisoning is a growing global environmental health problem with increasing lead-related diseases, disabilities, and deaths. While exposure to lead in US children, in general, has significantly declined in the last three to four decades certain sub-groups of US children such as African Americans, immigrants and resettled refugees, and those from lower socioeconomic backgrounds are still vulnerable to environmental lead exposure.

Previous studies among resettled refugee children in the United States had found 4- to 5-times higher prevalence of elevated blood lead level (EBLL) when compared to US-born children. However, most of the studies were conducted when EBLL was defined as blood lead level ≥ 10 µg/dL. In 2012, the US Centers for Disease Control and Prevention changed the reference value for EBLL to ≥ 5 µg/dL. Moreover, because the countries of origin for US resettled refugees change over time, it is important to have epidemiologic studies that provide the current information on EBLL among these vulnerable new US immigrant children.

Using blood lead level data from the post-resettlement medical screening, our study examined the prevalence of elevated blood lead level at the time of resettlement among former refugee children who were settled in the state of Ohio from 2009-2016. We had a large and diverse sample (5,661 children from 46 countries of origin) of children for the study, which allowed us to assess EBLL in children from several countries of origin that had not been previously studied. Continue reading →

Pediatric Blood Lead Levels in Public vs Private New York Housing

Posted on April 20, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Lead paint can crack and form flakes, which can contaminate the surrounding environment.
Source: Wikipedia

Ms. Jacqueline Chiofalo, MPA
Director of Policy Research & Analysis
The Institute for Family Health
Astoria, New York

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

Response: Exposure to lead is dangerous and has been banned from use in residential dwellings. However, residual sources of lead still exist. Few studies have examined pediatric lead poisoning between public (NYCHA) and private housing units, and no recent studies performed in New York City. Our study used retrospective chart analysis of routine child lead testing to examine the difference in blood lead levels between the two housing types.

Our data showed that children seen in our health centers who lived in New York City public housing had significantly lower mean blood lead levels and fewer children were found with levels over the CDC reference range of 5 μg/dL compared to children who lived in private housing. Continue reading →

Pediatric Melanoma Risk Increasing in Adolescents & Young Adults, Including in Non-Whites

Posted on April 18, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Swetter

Susan M. Swetter, MD
Professor of Dermatology
Director, Pigmented Lesion & Melanoma Program
Physician Leader, Cancer Care Program in Cutaneous Oncology
Stanford University Medical Center and Cancer Institute

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

Response: The Stanford Pigmented Lesion and Melanoma and Program and Pediatric Dermatology Division participated in the long-term management of children, adolescents and young adults (<25 years of age) with melanoma and atypical melanocytic neoplasms, including atypical Spitz tumors (ASTs) that may be histopathologically challenging to differentiate from true melanoma.

Over a 23-year period, we have observed increased racial-ethnic diversity in young patients with these diagnoses, especially in the presentation of young individuals with darker skin phenotypes and more clinically amelanotic (nonpigmented) lesions compared to patients with lighter skin. Continue reading →

Oral Peanut Immunotherapy Evaluated for Preschool Children

Posted on April 18, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Soller

Lianne Soller, PhD
Allergy Research Manager
University of British Columbia
Vancouver, BC, Canada

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

Response: In 2017, a clinical trial of 37 subjects demonstrated that preschool peanut oral immunotherapy was safe, with predominantly mild symptoms reported and only one moderate reaction requiring epinephrine. Our study aimed to examine whether these findings would be applicable in a real-world setting (i.e., outside of research).

We found that peanut oral immunotherapy is safe in the vast majority of preschoolers, with only 0.4% of patients experiencing a severe reaction, and only 12 out of ~40,000 peanut doses needed epinephrine (0.03%). Continue reading →

Children Swallow Jewelry, Coins, Toys and Button Batteries, Leading to 99 ER Visits a Day

Posted on April 15, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Danielle Orsagh-Yentis, MD
Pediatric GI Motility Fellow
Department of Gastroenterology, Hepatology and Nutrition
Nationwide Children’s Hospital
Columbus, Ohio

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

Response: Foreign body ingestions are quite common in young children. Much of the literature and advocacy to date has focused on the harms of button battery and magnet ingestions.

We found that foreign body ingestions in children younger than 6 years of age have been increasing over the past 2 decades. This overall increase is mirrored by the rise in coin, toy, and jewelry ingestions, as well as batteries, which, when swallowed, have the potential to cause considerable harm. Continue reading →

Epilepsy: Genetic Testing Should Include Parental Sampling

Posted on April 12, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Abou Tayoun

Dr. Ahmad Abou Tayoun, PhD
Clinical Molecular Geneticist
Director of the Genetics Laboratory
Al Jalila Children’s
United Arab Emirates

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

Response: In this study, we provide data in favor of using an exome-based testing approach, where parental samples can be readily accessible, for early onset epilepsy patients. The exome test includes all coding genes in the human genome. Although we perform exome sequencing on those patients, we demonstrate that a first tier analysis should include targeted interpretation of ~100 genes strongly associated with the disease. This analysis provides diagnoses in ~11% of the patients. Follow up parental testing on a limited number of patients (n=15) that had inconclusive results, revealed de novo (new mutations) variant status, leading to upgrade to positive reports in 7 patients and adding ~5% to the overall diagnostic yield.

Continue reading →

TRAP: Traffic Related Air Pollution Linked to Millions of Pediatric Asthma Cases Worldwide

Posted on April 12, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Ploy Pattanun Achakulwisut, PhD
Postdoctoral Scientist in Climate change, Air pollution, and Public Health
Milken Institute School of Public Health (Anenberg Group
The George Washington University, D.C

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

Response: Dozens of epidemiological studies have found positive and generally statistically significant associations between long-term exposure to traffic-related air pollution (TRAP) and asthma development in children. The evidence is most robust for nitrogen dioxide (NO₂), a major component of and commonly used surrogate for the complex TRAP mixture. Recent reviews conducted by the US Environmental Protection Agency and Health Canada concluded that there is “likely a causal relationship” between long-term NO₂ exposure and pediatric asthma development.

Using NO₂ as a proxy for TRAP, our study provides the first global estimate of the number of new asthma cases among children that are attributable to traffic pollution, using fine spatial-scale global datasets that can resolve within-city and near-roadway NO₂ exposures.

Continue reading →

Lead in Topsoil Linked to Cognitive Difficulties in 5 Year Old Boys

Posted on April 12, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Severnini

Edson R. Severnini PhD
Assistant Professor Of Economics And Public Policy
Carnegie Mellon University

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

Response: Although lead has been banned from gasoline, paint, and other substances in the United States and many other countries around the world, the legacy of lead use is a critical environmental and public health issue. Surface soil contamination, in particular, has been long recognized as an important pathway of human lead exposure, and is now a worldwide health concern.

This study estimates the causal effects of exposure to lead in topsoil on cognitive ability among 5-year-old children. We draw on individual level data from the 2000 U.S. Census, and USGS data on lead in topsoil covering a broad set of counties across the United States.

We find that higher lead in topsoil increases considerably the probability of 5-year-old boys experiencing cognitive difficulties such as learning, remembering, concentrating, or making decisions. Living in counties with topsoil lead concentration above the national median roughly doubles the probability of 5-year-old boys having cognitive difficulties. This harmful effect does not seem to extend to 5-year-old girls, potentially due to the natural protection of estrogen. Continue reading →

Is There a Link Between Benzodiazepines During Pregnancy and Childhood ADHD?

Posted on April 8, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Lupattelli

Dr. Angela Lupattelli, PhD
School of Pharmacy
University of Oslo

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

Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women.

However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks. Continue reading →

Is There a Risk of Bleeding With Ibuprofen After Tonsillectomy ?

Posted on April 5, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Diercks

Gillian R. Diercks, MD, MPH
Instructor in Otolaryngology, Harvard Medical School
Department of Otolaryngology
Massachusetts Eye and Ear Infirmary
Boston, Massachusetts

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

Response: Pediatric tonsillectomy is a commonly performed procedure, representing the second most common ambulatory surgery performed on children in the United States, with over half a million children undergoing the surgery annually. A major concern for surgeons, patients, and their families is the issue of postoperative pain control as pain can last up to 10-14 days after surgery, be quite severe, and result in readmission to the hospital or ED visits for medications and dehydration.

In young children and children with sleep apnea we cannot safely administer narcotic pain medications at home. This leaves limited options for pain control, including acetaminophen and ibuprofen. However, there are concerns that ibuprofen could potentially increase bleeding risk after surgery because of its effects on platelet function in the blood. At baseline, the risk of postoperative hemorrhage within the first two weeks after tonsillectomy is around 4.5%, with about 1-1.5% of children requiring a return to the operating room to control severe bleeding. Our study set out to show that the risk of severe postoperative bleeding when ibuprofen is given for 9 days after tonsillectomy was not increased compared with the bleeding risk when acetaminophen was administered instead.

Our study could not conclude that the risk of bleeding is no different when ibuprofen is used, and was suggestive that the bleeding risk may actually be higher. Continue reading →

Fetal Haptoglobin as Potential Biomaker for Increased Risk of Cerebral Palsy

Posted on April 1, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Buhimschi

Catalin S. Buhimschi MD, MMS, MBA
Professor of Obstetrics and Gynecology
Division of Maternal Fetal Medicine
Director of Obstetrics
Department of Obstetrics and Gynecology
Chicago, IL, 60612

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

Response: In 2008, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal–Fetal Medicine Units Network published the results of a randomized controlled trial of magnesium sulfate for the prevention of cerebral palsy (CP). The results of this trial suggested that fetal exposure to magnesium sulfate before anticipated early preterm delivery did not reduce the combined risk of moderate to severe cerebral palsy or death, although the rate of cerebral palsy was reduced among survivors. As such, the search for a biomarker or a therapeutic solution to prevent CP had to continue.

We are grateful to the NICHD for giving us access to the umbilical cord blood samples retrieved at the time of birth for the infants enrolled, who were also followed for 2 years postnatally. We discovered that fetus’s ability to switch-on haptoglobin (Hp) expression in response to inflammation was associated with reduction of intra-ventricular hemorrhage (IVH) and/or death, and cerebral palsy and/or death. Fetuses unable to mount such a response in-utero had an increased risk of adverse outcomes.

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Almost No Increase is Childhood Cancers Among Children Conceived by IVF

Posted on April 1, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Spector

Logan G. Spector, Ph.D.
Professor
Suzanne Holmes Hodder Chair in Pediatric Cancer Research
Director, Division of Epidemiology/Clinical Research
Department of Pediatrics
University of Minnesota

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

Response: Since IVF has become commonplace in the last three decades there has been concern about its potential for affecting the health of children conceived this way. We know, for instance, that pregnancies enabled by IVF have more difficulties, and there are more birth defects among offspring. So for this study we wished to see if children conceived by IVF have a different risk of childhoood cancer.

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

Response: There is not an increased risk of most childhood cancers among children conceived by IVF. A class of especially rare childhood cancers known as embryonal tumors, especially embryonal liver tumors, appeared slightly more likely among children conceived by IVF. For these few cancers, even among children conceived by IVF, they remained very rare. Overall these results should be reassuring to parents who have used IVF.

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

Response: For the few, rare cancers that seemed to be associated with IVF it would be helpful to see if these childrens’ tumors differ from other childrens’ tumors. It will also be necessary to continue to follow cohorts of children conceived by IVF to see if their cancer experience differs at older ages.

MedicalResearch.com: Is there anything else you would like to add?

Response: This research took the cooperation of the Society for Assisted Reproductive Technology and over a dozen state departments of health over many years, for which we are thankful. No disclosures.

Citation:

Spector LG, Brown MB, Wantman E, et al. Association of In Vitro Fertilization With Childhood Cancer in the United States. JAMA Pediatr. Published online April 01, 2019. doi:10.1001/jamapediatrics.2019.0392

Apr 1, 2019 @ 4:24 pm

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