Category Archives: Pediatrics

Starting School Before 8:30 AM Associated With More Anxiety and Depression in Adolescents

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MedicalResearch.com Interview with:
Jack Peltz, Ph.D.
Clinical assistant professor in Psychiatry
Rochester Medical Center

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

Response: Approximately 90% of high-school aged adolescents get either
insufficient sleep during school nights or barely meet the required
amount of sleep (ie, 8–10 hours) expected for healthy functioning.(1)

In fact, sleep problems and insufficient sleep are so pervasive for
adolescents that they could be considered an epidemic due to their
adverse impact on adolescent mental and physical health.(2–5)

As a result,addressing insufficient adolescent sleep represents a critical
point of study and intervention. The growing body of evidence suggests
that later school start times (SST), 8:30 AM or later as recommended
by the American Academy of Pediatricians,6 convey
multiple benefits on adolescents, including improved sleep, better
mental and physical health, and improved academic outcomes.(7–10)

This research, however, has focused on the direct effects of delaying
school start times, or specifically how moving SST back directly predicts changes
in an outcome (eg, mental health, academic achievement). This
type of analysis precludes examining the important role that SST
might play as a condition or context under which other sleeprelated
processes take place. For instance, earlier school start times might exacerbate
the impact of sleep-related processes on adolescent behavioral
health outcomes. Thus, incorporating school start times as a larger contextual variable
that might moderate models of sleep and adolescent functioning
represents a gap in the literature and a unique opportunity to advance
conceptual models. Accordingly, the current study examines
the moderating role of school start times on the associations between sleep hygiene,
sleep quality, and mental health.

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Employer Health Plans Spend At Least $6 Billion Per Year On Preterm Infant Care

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MedicalResearch.com Interview with:

Scott D. Grosse, PhD National Center on Birth Defects and Developmental Disabilities CDC 

Dr. Scott Grosse

Scott D. Grosse, PhD
National Center on Birth Defects and Developmental Disabilities
CDC 

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

Response: The U.S. Institute of Medicine (IOM) in 2007 published estimates of the economic costs associated with preterm birth. That report is publicly available: https://www.ncbi.nlm.nih.gov/pubmed/20669423. The total societal cost over a lifetime of a single year’s cohort of infants born preterm was estimated as $26 billion in 2005 US dollars. The study in Pediatrics sought to provide more current estimates of one component of those costs: medical care between birth and 12 months and to answer two additional questions:

  1. What costs are specifically incurred by employer-sponsored private health plans?
  2. How much of the overall cost burden of prematurity is attributable to infants born preterm with major birth defects (congenital malformations and chromosome abnormalities)?

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How Do Viruses Trigger Cough In Asthmatic Children, Even Without Allergies

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MedicalResearch.com Interview with:

Giovanni Piedimonte, MD Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education Professor & Chair of Pediatrics Cleveland Clinic Lerner College of Medicine Case Western Reserve University

Dr. Piedimonte

Giovanni Piedimonte, MD
Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education
Professor & Chair of Pediatrics
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University

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

Response: This study proves that asthmatic children already have a hyperactive calcium channel that’s extremely sensitive to environmental triggers.

If these children contract a virus, such as RSV, the hyperactive channel causes more severe symptoms that may require care in a hospital setting.

When a child developed asthma or bronchitis in the past, doctors thought these conditions could only be triggered by environmental allergens. There was no explanation why two out of three children ages five and under who wheeze and cough – and still test negative for allergies.

We needed to explore the mechanisms of the calcium molecule and the epithelial cells, which seem to trigger these symptoms without an allergic reaction. If the molecule’s behavior is producing the cough, we just need to figure out how to control the molecule to properly deactivate the cough mechanism in the asthmatic child

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Treating Iron Deficiency In Infants Has Beneficial Brain and Behavioral Effects In Children

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MedicalResearch.com Interview with:

Staffan Berglund MD PhD Umeå University Sweden

Dr. Berglund

Staffan Berglund MD PhD
Umeå University
Sweden 

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

Response: Iron deficiency has been associated with impaired neurodevelopment and iron supplementation is recommended to those at risk. While it is well known that very low birth weight infants are at risk of iron deficiency, less has been known regarding the large subgroup of children born with only marginally low birth weight (2000-2500g). In the present study, we previously showed that this relatively common group of otherwise healthy children is at risk of iron deficiency during infancy (Berglund Pediatrics 2010;126).

In the study published this week, we now also found that supplementation during the first six months of life had long term positive effects on their behavioral profile, with significant reduction of externalizing behavioral problems.

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TDAP Vaccine During Pregnancy Prevents Whooping Cough In Young Babies

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MedicalResearch.com Interview with:
Tami H Skoff Centers for Disease Control and Prevention Atlanta, GeorgiaTami H Skoff
Centers for Disease Control and Prevention
Atlanta, Georgia

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

Response: Infants are at greatest risk for severe pertussis (whooping cough) morbidity and mortality, especially during the first months of life before infant immunizations begin.  CDC and the Advisory Committee on Immunization Practices (ACIP) currently recommend that women receive a dose of Tdap during the third trimester of each pregnancy.  This recommendation has been in place since 2012.  By getting Tdap, pregnant women pass critical short-term protection to their unborn babies. This helps protect babies until they are old enough to start getting their own whooping cough vaccines at 2 months of age.

The purpose of our study was to evaluate the effectiveness of maternal Tdap during pregnancy at preventing whooping cough in infants <2 months of age.

In our evaluation, Tdap administration during the third trimester of pregnancy prevented more than 3 in 4 (78%) infant cases.  Additionally, Tdap vaccination during pregnancy was even more effective (90%) at preventing whooping cough serious enough that the baby had to get treatment in a hospital.

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Asthma Improvement Collaborative Reduced ER Visits and Hospitalizations in Medicaid Population

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MedicalResearch.com Interview with:

Dr. Carolyn M. Kercsmar, MD Co-Director, Division of Pulmonary Medicine Director, Asthma Center Cincinnati Children’s Hospital Medical Center Department of Pediatrics, University of Cincinnati, College of Medicine Cincinnati, Ohio

Dr. Kercsmar

Dr. Carolyn M. Kercsmar, MD
Co-Director, Division of Pulmonary Medicine
Director, Asthma Center
Cincinnati Children’s Hospital Medical Center
Department of Pediatrics, University of Cincinnati, College of Medicine
Cincinnati, Ohio 

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

Response: Asthma is the most common chronic condition of childhood and is responsible for substantial morbidity and health care costs, in large portion as a result of emergency room visits and hospitalizations. Moreover, children who live in poverty and are members of minority groups are disproportionately affected.

Our paper reports the results of a quality improvement project that spanned the inpatient, outpatient and community settings and resulted in significant reduction in emergency department visits and hospitalizations for asthma in urban children insured by Medicaid.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Broad based interventions that are based on the chronic care model and involve changes in health care systems across multiple setting and disciplines can improve asthma outcomes.

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

Response: Future work should focus on replicating these findings in other settings and with other personnel, such as community health workers as interventionalists and a formal economic evaluation of the cost-effectiveness of the program. 

Disclosures: This work was supported by Cincinnati Children’s Hospital Medical Center and in part by a grant from Health Information Technology Beacon Program to the Cincinnati Children’s Hospital Medical Center and grant 90BC00116/01 for development of web-based asthma registry and health care use alerts. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Kercsmar CM, Beck AF, Sauers-Ford H, Simmons J, Wiener B, Crosby L, Wade-Murphy S, Schoettker PJ, Chundi PK, Samaan Z, Mansour M. Association of an Asthma Improvement Collaborative With Health Care Utilization in Medicaid-Insured Pediatric Patients in an Urban Community. JAMA Pediatr. Published online September 18, 2017. doi:10.1001/jamapediatrics.2017.2600

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

 

 

Maternal Blood Pressure Rise During Pregnancy Linked To Increased Risk Of Childhood Obesity

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MedicalResearch.com Interview with:

Duo Li, PhD Chief professor of Nutrition Institute of Nutrition and Health Qingdao University, China. 

Dr. Duo Li

Duo Li, PhD
Chief professor of Nutrition
Institute of Nutrition and Health
Qingdao University, China. 

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

Response: Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes and cardiovascular diseases. Identification of prenatal and early life risk factors is key for curbing the epidemic of the childhood obesity.

Main finding of the present study is that among pregnant women, elevated blood pressure is associated with a greater risk of overweight and obesity for their children.

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Chronic Hives In Children Resolve Slowly

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MedicalResearch.com Interview with:

Hives-Urticaria Wikipedia image

Hives-Urticaria
Wikipedia image

Elena Netchiporouk, MD, FRCPC, MSc
Dermatology Resident – PGY5 and
Dr. Moshe Ben-Shoshan, MD, FRCPC, MSc
McGill University

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

Response: We have followed a pediatric cohort of 139 patients with chronic urticaria (CU) (hives) between 2013 and 2015 in a single tertiary care center and assessed the comorbidities, the rate of resolution and determined predictors of resolution.

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Large Trial Evaluates Inhaled Nitric oxide on Survival Without Pulmonary Dysplasia in Preterm Infants

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MedicalResearch.com Interview with:

Shabih U. Hasan, MD, DCH, FRCPC Professor and Staff Neonatologist, Alberta Health Services Department of Pediatrics, Cumming School of Medicine University of Calgary

Dr. Hasan

Shabih U. Hasan, MD, DCH, FRCPC
Professor and Staff Neonatologist, Alberta Health Services
Department of Pediatrics, Cumming School of Medicine
University of Calgary

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

Response: Approximately 8% of all infants are born prematurely (preterm birth <37 weeks postmenstrual age). Preterm infants have many challenges including establishment of adequate pulmonary gas exchange. Due to not yet fully developed lungs, preterm infants require respiratory support consisting of respirators and other forms of non-invasive ventilation modalities and supplemental oxygen.  Bronchopulmonary dysplasia (BPD) is the commonest morbidity among very low birth weight infants as 40% of survivors at postmenstrual age <30 weeks develop BPD. This is a serious condition as it can lead to short- and long-term pulmonary complications, increased hospital visits and neurodevelopmental impairment. BPD is defined where preterm infants require respiratory support and/or supplemental oxygen at 36 weeks postmenstrual age.

A number of therapeutic and non-therapeutic modalities have been used to prevent BPD including inhaled nitric oxide (iNO).  In 2006, the NO CLD trial demonstrated that iNO prevented BPD (Relative benefit 1.81; CI 1.27-2.59, P = 0.006) if used according to the NO CLD Protocol (Ballard et al., New England Journal of Medicine, 355:343-353, 2006). Our study (NEWNO; Newborns treated with Nitric Oxide) was designed to replicate the NO CLD study.
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More Teenage Boys Becoming Fathers

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MedicalResearch.com Interview with:

Maureen Pirog PhD Rudy Professor of Policy Analysis School of Public and Environmental Affairs Indiana University

Dr. Pirog

Maureen Pirog PhD
Rudy Professor of Policy Analysis
School of Public and Environmental Affairs
Indiana University 

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

Response: We analyzed parenthood, education and income statistics over a long time span from two groups of about 10,000 people — those born in 1962-64 and those born in 1980-82.

  • Teen fathers and mothers came increasingly from single-mother families with disadvantaged backgrounds.
  • The proportion of teen mothers or fathers living with their partners didn’t change, but far fewer were married.
  • The birth rates to teenage girls across the two groups didn’t change, but the reported rate of teenage fatherhood increased, a seemingly contradictory conclusion. For example, 1.7 percent of the men in the older group were fathers by the time they were 17, while in the younger group, nearly double that number were dads. About 8 percent of the 17-year-old females in both groups were mothers.

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