Author Interviews, Duke, JAMA, Mental Health Research, Pediatrics, Toxin Research / 23.01.2019

MedicalResearch.com Interview with: Aaron Reuben, MEM Department of Psychology and Neuroscience Duke University, Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? (1)  Study members with greater lead exposure in childhood tended to endorse more psychiatric symptoms when assessed for psychiatric disorders in adulthood (between 18 and 38 years of age).
  1. These individuals tended to report more internalizing (e.g., depression, anxiety) and thought disorder (e.g., OCD, schizophrenia, mania) symptoms.
  2. Compared to other findings from this sample, the associations reported in this article are similar to those reported for lead and IQ, and are stronger than those reported for lead and criminal offending.
    1. Informants who knew Study members well reported higher levels of difficult adult personality traits among Study members with greater lead exposure in childhood.
    2. Specifically, Study members with greater blood lead levels at age 11 were rated as more neurotic, less agreeable, and less conscientious by 38 years of age.
    3. These personality traits have been previously linked to a number of poor life outcomes, including greater psychopathology, worse physical health, less job satisfaction, and troubled interpersonal relationships
  3. Psychiatric problems related to lead exposure could be detected as early as 11 years of age. In the 1980’s, parents and teachers of children with higher blood-lead levels had described them as displaying more antisocial behavior, hyperactivity, and negative emotions (e.g., sadness, anxiety).
(more…)
Author Interviews, Diabetes, Infections, JAMA, Pediatrics, Vaccine Studies / 22.01.2019

MedicalResearch.com Interview with: Dr Kirsten Perrett MBBS FRACP PhD Team Leader / Clinician-Scientist Fellow, Population Allergy, Murdoch Children's Research Institute Consultant Paediatrician, Department of Allergy and Immunology and General Medicine The Royal Children's Hospital Fellow, School of Population and Global Health The University of Melbourne Parkville, Victoria  Australia MedicalResearch.com: What is the background for this study? Response: Before rotavirus vaccines were available, rotavirus infection was the most common cause of severe gastroenteritis in infants and young children. Because it is so contagious, infection in childhood is thought to be universal in unvaccinated children. Previous studies indicated that rotavirus infection of infants might be an environmental promoter of type 1 diabetes. Therefore, we anticipated that the introduction of the rotavirus vaccine might alter the disease incidence in young children.  (more…)
Author Interviews, Brain Injury, Orthopedics, Pediatrics, PNAS / 21.01.2019

MedicalResearch.com Interview with: Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba MedicalResearch.com: What is the background for this study? Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life.  HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion.  Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician.  We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery. We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury.  We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion. (more…)
Author Interviews, Global Health, JAMA, Mental Health Research, Pediatrics, UCLA, Zika / 21.01.2019

MedicalResearch.com Interview with: Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age. We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months. We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early. (more…)
Author Interviews, CDC, Infections, Pediatrics, Vaccine Studies / 18.01.2019

MedicalResearch.com Interview with: Sarah Anne Mbaeyi MD MPH Division of Bacterial Diseases CDC  MedicalResearch.com: What is the background for this study? Response: College freshman living in residence halls, though not college students overall, have previously been identified as being at increased risk for meningococcal disease. However, these evaluations were conducted in the 1990s when rates of disease were higher, serogroup C was the predominant cause of disease, and before the availability of quadrivalent meningococcal conjugate (MenACWY) or serogroup B meningococcal (MenB) vaccines. MenACWY vaccine is routinely recommended for all adolescents at age 11 years and 16 years, as well as unvaccinated or undervaccinated college freshmen living in residence halls. MenB vaccine is not routinely recommended for all adolescents or college students, but may be administered to persons aged 16-23 years, with the preferred age of 16-18 years, based on clinical decision-making. Meningococcal vaccines are also recommended during an outbreak, and in recent years MenB vaccines have been used during multiple outbreaks on college campuses. In this evaluation, we aimed to describe the current epidemiology of meningococcal disease among college-aged young adults in the United States. (more…)
Author Interviews, JAMA, Pediatrics, Transplantation, Vaccine Studies / 15.01.2019

MedicalResearch.com Interview with: Amy G. Feldman, MD, MSCS Assistant Professor, Pediatrics-Gastroenterology, Hepatology and Nutrition Program Director, Liver Transplant Fellowship Children's Hospital Colorado University of Colorado Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pediatric solid organ transplant recipients are at increased risk for vaccine preventable infections due to life-long immunosuppressive medications.  The objectives of this study were to 1) evaluate in pediatric    solid organ transplant recipients the number of hospitalizations for vaccine-preventable infections in the first five years post-transplantation and 2) determine the associated morbidity, mortality and costs. In this multicenter cohort study of 6980 children who underwent solid organ transplantation from January 1, 2004, to December 31, 2011, at a center participating in Pediatric Health Information System (PHIS), 15% of individuals had at least 1 hospitalization for a vaccine-preventable infection in the first 5 years after transplant.  Children who received transplants when they were younger than 2 years and recipients of lung, intestine, heart, and multi-visceral organs were at increased risk for hospitalization with a vaccine-preventable infection.  Transplant hospitalizations complicated by a vaccine-preventable infection were $120,498 more expensive (median cost) and were on average 39 days longer than transplant hospitalizations not complicated by vaccine-preventable infections (more…)
Author Interviews, CDC, Infections, JAMA, Pediatrics / 15.01.2019

MedicalResearch.com Interview with: Dr. Srinivas Acharya Nanduri, MBBS, MD, MPH Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases Centers for Disease Control and Prevention Roybal Campus Atlanta, GA 3033 MedicalResearch.com: What is the background for this study? Response: Group B Streptococcus (GBS) is a leading cause of serious illness such as meningitis and sepsis in infants. Among infants, there are two main types of GBS disease. Early-onset GBS disease occurs during the first week of life and late-onset GBS disease occurs from the first week through three months of life. Rates of early-onset disease in the United States have decreased significantly since the 1990s through widespread implementation of intrapartum antibiotic prophylaxis (IAP) guidelines. However, IAP does not prevent late-onset disease. Maternal immunization represents a nonantibiotic strategy to prevent both early and late-onset disease. Multivalent polysaccharide-protein conjugate vaccines are under development against GBS capsular types, with candidate vaccines in phase I and II trials. Active Bacterial Core surveillance (ABCs) conducts active surveillance for early and late-onset GBS disease among infants in select counties of 10 states, covering about 10% of live births across the United States. We analyzed data from early and late-onset GBS cases identified from ABCs between 2006 and 2015 to describe their epidemiology, incidence trends, and associated strain characteristics. (more…)
Annals Internal Medicine, Author Interviews, Diabetes, Pediatrics / 15.01.2019

MedicalResearch.com Interview with: Juliana CN Chan MD Chair Professor of Medicine and Therapeutics Head, Division of Clinical Pharmacology, Department of Medicine and Therapeutics Director, Hong Kong Institute of Diabetes and Obesity Director, Clinical Research Management Office Faculty of Medicine The Chinese University of Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of young onset diabetes (YOD) is increasing world-wide with doubling of its prevalence in the last 10 years in many developed nations. Using the Hong Kong Diabetes Register established since 1995, we first reported that 1 in 5 Chinese adults with diabetes were diagnosed before the age of 40 years. These young patients had poor control of multiple risk factors with 1.5 fold higher risk of premature death and cardiovascular-renal complications compared to patients with usual onset of diabetes after the age of 40 (Chan JC et al AJM 2014, Luk A et al Diabetes Care 2014). Due to the multisystem nature of diabetes, we asked the question whether these young patients might have recurrent hospitalizations during their 3-4 decades of complex clinical course. Using a territory-wide diabetes database involving 0.42 million people followed up between 2002 and 2014, we compared the hospitalization rates accrued till the age of 75 years and found that patients with young onset diabetes had the highest hospitalization rates by attained age. Compared to patients with usual onset of diabetes, patients with YOD had 1.8- 6.7 higher risk of hospitalizations due to all-causes, notably renal disease compared to those with usual onset of disease. Amongst patients with young onset diabetes, over one-third of the bed-days were due to mental illness before the age of 40 years. We used mathematical modeling and estimated that intensified risk factor control in YOD can reduce the cumulative bed-days by 30% which can be further reduced by delaying the onset of diabetes. These original data is a wakening call to the community regarding the complex nature of YOD involving interactions amongst environment, lifestyles and personal factors (e.g. genetics, education and socioeconomic status) and the biomedical-psychological-behavioral needs of these high risk population, which if undiagnosed, untreated or suboptimally managed, can have huge economic impacts on health care system and loss of societal productivity, leaving personal suffering aside. (more…)
Author Interviews, JACC, Karolinski Institute, OBGYNE, Pediatrics, Weight Research / 12.01.2019

MedicalResearch.com Interview with: Martina Persson, M.D, PhD Karolinska Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that maternal obesity increases risks of adverse fetal outcomes, including congenital malformations of the heart. However, it is unclear if maternal overweight and obesity associate with risks of specific and more complex congenital heart defects. We conducted a population-based cohort study in Sweden using data from several health registries. The study included more than 2 million live, singletons born between 1992-2012. Risks (prevalence rate ratios) of complex heart defects (Tetralogy of Fallot, transposition of the great arteries (TGA), atrial septal defects (ASD), aortic arch defects, and single ventricle heart) and several specific heart defects were estimated in infants to mothers with overweight and increasing degree of obesity. We found that risks of aortic arch defects, ASD and patent ductus arteriosus (in term infants) increased with maternal obesity severity. On the other hand, we found no clear associations between maternal BMI and risks of several other complex and specific heart defects.  (more…)
Author Interviews, Global Health, Pediatrics, Pulmonary Disease, Weight Research / 12.01.2019

MedicalResearch.com Interview with: Judith Garcia Aymerich Head of the Non-Communicable Diseases and Environment Programme ISGlobal  MedicalResearch.com: What is the background for this study? Response: Several studies have assessed the associations of overweight and obesity with lung function in children and adolescents, but they have found contradictory results. An important limitation of these studies is that most of them considered only overall body weight and did not take into account for the different contribution of lean body mass and fat mass, and their relative proportions that vary by age and sex. (more…)
Author Interviews, Pediatrics / 10.01.2019

MedicalResearch.com Interview with: PHILIPPE P. HUJOEL PhD, DDS, MSD, MS Professor, Oral Health Sciences Adjunct Professor, Epidemiology Adjunct Professor, Periodontics Dental Public Health Sciences, School of Dentistry University of Washington MedicalResearch.com: What is the background for this study? Response: In 2012, an economist, Kevin Denny, identified an association between breastfeeding and handedness.  The newly published study attempted to refute this association in a larger population, and with more control for potential confounding variables. (more…)
Author Interviews, JAMA, Pediatrics, Smoking, Tobacco, Tobacco Research / 07.01.2019

MedicalResearch.com Interview with: Dr. Hongying Dai, PhD Associate Professor at the College of Public Health University of Nebraska Medical Center. MedicalResearch.com: What is the background for this study? Response: The 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) banned cigarettes with characterizing flavors (e.g., candy, fruit, clove) except menthol. However, there are no restrictions on the marketing and sales of flavored non-cigarette tobacco products. This has led to a proliferation of flavored tobacco products in the marketplace. Flavoring has become one of the leading reasons for current tobacco use among youth. It is reported that 81% of e-cigarette users, 79% of hookah users, 74% of cigar users, 69% of smokeless tobacco users, and 67% of snus users attributed the availability of appealing flavors for their tobacco use in 2013–2014 among teenagers aged 12 to 17 years. In November 2018, the FDA proposed new restrictions on flavored tobacco products. (more…)
Author Interviews, NEJM, Pediatrics, Smoking, Tobacco, Tobacco Research, University of Michigan / 30.12.2018

MedicalResearch.com Interview with: Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Every year Monitoring the Future conducts a survey to examine trends in adolescent substance use.  We draw a random sample of schools from a list of all schools in the United States and conduct our survey in ~400 schools.  Our survey is representative of U.S. 8th, 10th, and 12th grade students.  In other words, our results are what you would find if you surveyed every single 8th, 10th, and 12th graders in the United States, within the bounds of a small sampling error of a few percentage points. An increase in vaping is the big news for 2018.  In 10th and 12th grade the increase in nicotine vaping was the largest we've ever seen for any substance in the past 43 years.  As a result of this increase in nicotine vaping, overall use of nicotine increased as well, which suggests that vaping is drawing youth into nicotine use.  We also saw a significant increase in marijuana vaping. (more…)
Author Interviews, JAMA, Pediatrics, Social Issues / 28.12.2018

MedicalResearch.com Interview with: Dr. Richard E. Tremblay, PhD, Professor Department of Pediatrics and Department of Psychology University of Montreal, Montreal, Quebec, Canada School of Public Health, University College Dublin, Dublin, Ireland MedicalResearch.com: What is the background for this study?   Response: Adolescent who have frequently use physical aggression are at high risk of school failure, criminal behavior, as well as physical and mental health problems. A major limit to preventive interventions is our ability to trace the developmental trajectories of physical aggression from infancy to adolescence using a uniform source of information. (more…)
Author Interviews, Education, JAMA, OBGYNE, Pediatrics, Social Issues / 21.12.2018

MedicalResearch.com Interview with "Pregnancy 1" by operalynn is licensed under CC BY 2.0Josephine Funck Bilsteen, MSc Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period. In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation.  (more…)
Author Interviews, Orthopedics, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Dana L. Duren, PhD Professor, Director of Orthopaedic Research Director of Skeletal Morphology Laboratory Thompson Laboratory for Regenerative Orthopaedics Department of Orthopaedic Surgery Missouri Orthopaedic Institute, University of Missouri Columbia, MO 6521 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The motivation for this study is the apparent accelerated maturity in children in the United States.   We previously demonstrated that skeletal maturity (bone age) is more advanced in today’s children compared to children born in the first half of the 20thCentury (Duren et al., 2015). n the current study (Boeyer et al., 2018) we show that a significant component of this advanced maturity status is the timing of epiphyseal fusion. In our study, nearly half of the epiphyses of the hand and wrist began or completed fusion significantly earlier in children born after 1995 than those born in the early part of the century, with differences as great as six to ten months for some bones, and mean differences on the order of 4 months in boys and 6 months in girls.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Associate Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Pregnant women often experience nausea and vomiting, particularly during the first trimester.  Early treatment is recommended to relieve symptoms and prevent progression to hyperemesis gravidarum.  Although not formally approved for this indication, ondansetron is the most frequently prescribed treatment for nausea and vomiting in pregnancy in the US: 22% of pregnant women reportedly used ondansetron in the US in 2014. Despite this common use, the available evidence on the fetal safety of ondansetron is limited and conflicting, and the possibility of a doubling in risk of cleft palate and cardiac malformations has been raised. We therefore evaluated the association between ondansetron exposure during the first trimester of pregnancy, the period of organogenesis, and the risk of congenital malformations in a cohort of 1,816,414,publicly insured pregnancies using the nationwide Medicaid Analytic eXtract data for 2000-2013.  A total of 88,467 women (4.9%) were exposed to ondansetron during the first trimester.  After adjusting for a broad range of potential confounding variables, we found no association with cardiac malformations (RR = 0.99; 95% CI, 0.93 – 1.06)  and congenital malformations overall (RR = 1.01; 95% CI, 0.98 – 1.05). For oral clefts, we found a 24% increase in risk (RR=1.24; 95% CI, 1.03 – 1.48), which corresponds to an absolute risk of 2.7 per 10,000 births (95% CI, 0.2 – 5.2 per 10,000 births).  These findings were consistent across sensitivity analyses, conducted to address potential misclassification and confounding bias.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cannabis, JAMA, Mental Health Research, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Sharon Levy, MD, MPH Director, Adolescent Substance Use and Addiction Program Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​For this study we analyzed data that were collected as part of a larger survey study that recruited a sample of adolescents who were coming to the doctor's office for routine medical care.  We asked them a lot of questions about their health, school, extracurricular activities, plans for the future, substance use patterns and problems associated with use among other things. The main finding was that among the participants who reported marijuana use in the past year, many of them, more than 40%, said that they had experienced either an hallucination, or paranoia/anxiety related to their use. Kids who used more frequently and those who met criteria for a substance use disorder were more likely to experience these symptoms, as were those who had symptoms of depression (more…)
Allergies, Author Interviews, OBGYNE, Pediatrics / 18.12.2018

MedicalResearch.com Interview with:  Karen Robbins, M.D. Allergist at Children’s National Health System  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that mothers are often concerned that something they did contributed to their children developing food allergies. Many will relate that they ate a lot of one specific food allergen while pregnant, and question how this could have impacted their unborn child. We realized that we hear a lot of anecdotal stories in clinic, but were not sure how frequently mothers try to alter their diet in the hopes of preventing food allergy in their children. We also were not sure where families get information or guidance on this topic. (more…)
ADHD, Author Interviews, Autism, JAMA, Pediatrics, UC Davis / 10.12.2018

MedicalResearch.com Interview with: Meghan Miller, Ph.D. Assistant Professor Department of Psychiatry & Behavioral Sciences UC Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study evaluated within-diagnosis sibling recurrence and sibling cross-aggregation of ADHD and autism spectrum disorder among later-born siblings of diagnosed children. We specifically chose to include only families who had at least one subsequent child after the diagnosis of an older child because failing to do so could bias recurrence risk estimates. We found that, compared to later-born siblings of non-diagnosed children, later-born siblings of children with autism were more likely to be diagnosed with autism or with ADHD. Likewise, compared to later-born siblings of non-diagnosed children, later-born siblings of children with ADHD were more likely to be diagnosed with ADHD or with autism. (more…)
Author Interviews, Hematology, Leukemia, Pediatrics / 05.12.2018

MedicalResearch.com Interview with: Charles G. Mullighan, MBBS (Hons), MSc, MD Member, St. Jude Faculty Co-Leader, Hematological Malignancies Program Medical Director, St. Jude Biorepository William E. Evans Endowed Chair St. Judes Children’s Research Hospital Memphis, TN MedicalResearch.com: What is the background for this study?   Response: B-lineage acute lymphoblastic leukemia (B-ALL) is the commonest form of ALL, and the commonest childhood tumor. It is a leading cause of childhood cancer death. It consists of multiple subtypes defined by genetic alterations. These are often chromosomal translocations that deregulate oncogenes or form fusion proteins. These alterations are disease initiating events and are associated with distinct patterns of leukemic cell gene expression. Most subtypes also have additional mutations that are important for cells to become fully leukemic. Identifying these initiating genetic changes is very important to identify patients that are likely to respond or do poorly with conventional therapy (multiagent chemotherapy). Also, some identify new opportunities for targeted therapy. However, using standard genetic testing approaches such as chromosomal cytogenetics, about 30% of B-ALL patients don’t have a subtype classifying alteration. (more…)
ADHD, Author Interviews, Pediatrics, Race/Ethnic Diversity / 05.12.2018

MedicalResearch.com Interview with: George J. DuPaul, PhD Department of Education and Human Services Lehigh University   Charles Barrett. Ph.D. School Psychologist Loudon County Virginia Public Schools   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD).  However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females.  For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys.  Few empirical studies have examined differences between Black and White boys. The present study sought to address several limitations in the field.  Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children.  Next, maternal figures, rather than teachers, were included as the informants. The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of ADHD).  Notably, although the boys’ behaviors were the same, maternal ratings were not identical. Specifically, using the ADHD Rating Scale, Fourth Edition (ARS-4), Black mothers assigned higher ratings to both Black and White boys. (more…)
Author Interviews, Autism, Pediatrics / 05.12.2018

MedicalResearch.com Interview with: Michael Kogan, Ph.D. Director of the office of Epidemiology and Research Health Resources and Services Administration’s Maternal and Child Health Bureau MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a study led by the Health Resources and Services Administration’s Maternal and Child Health Bureau, along with researchers from the Centers from Disease Control and Prevention, Harvard, Drexel, and George Washington Universities.  We used the 2016 National Survey of Children’s Health, a nationally representative survey of over 50,000 children that examines the health and well-being of US children, to examine the prevalence, treatment, and health care experiences of children with Autism Spectrum Disorder (ASD). We found that 1 out of 40 children in the US were reported by their parents to have been diagnosed with Autism Spectrum Disorder.  We also found that children with ASD were significantly less likely to receive services like needed care coordination, referrals to other services, and mental health counseling – even compared to children with other emotional, behavioral or developmental disorders (EBDs).  Parents of children with ASD were also significantly more likely to report being usually or always frustrated in their attempts to get services, again compared to families of children with other EBDs. Finally, we looked at treatment patterns for children with ASD and found that 64% had received behavioral therapy in the year before the interview, and 27% had received medications to treat symptoms of irritability.  (more…)
Author Interviews, Dental Research, JAMA, Opiods, Pediatrics / 03.12.2018

MedicalResearch.com Interview with: Alan Schroeder MD Associate Chief for Research Division of pediatric hospital medicine Lucile Packard Children’s Hospital Stanford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Third molar “wisdom teeth” extractions are one of the most common surgeries performed in adolescents and young adults, but an adequate appraisal of risks and benefits is lacking. Most patients who undergo this procedure are exposed to opioids post-operatively. We demonstrate that, for privately-insured opioid-naïve patients 16-25 years of age, exposure to opioids from a dental provider is associated with persistent use at 90-365 days in 7% of patients and a subsequent diagnosis relating to abuse in 6% of patients. In contrast persistent use and abuse were significantly lower in control patients not exposed to dental opioids (0.1% and 0.4%, respectively). The median number of pills dispensed for the initial prescriptions was 20. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics, USPSTF / 28.11.2018

MedicalResearch.com Interview with: Alex Kemper, M.D., M.P.H., M.S.  Dr. Kemper is a board-certified pediatrician and chief of the Division of Ambulatory Pediatrics at Nationwide Children’s Hospital. He is also the deputy editor of Pediatrics. MedicalResearch.com: What is the background for this recommendation statement? What are the main findings and recommendations?  Response: Child maltreatment, which includes abuse and neglect, is a serious health problem that affects too many children in the United States.  Abuse and neglect can have devastating health consequences, including long-term disabilities, depression, physical injury, and even death. In 2016, approximately 676,000 children were subjected to maltreatment, and more than 1,700 children died as a result. Because this is such an important public health issue, the U.S. Preventive Services Task Force looked at the most recent evidence on whether primary care clinicians can help prevent child maltreatment and its negative consequences. We found that, unfortunately, there is not enough evidence to recommend for or against these interventions. The Task Force is calling for more research on this important subject so that we can help prevent children from being abused and neglected.    (more…)
Author Interviews, Autism, Nature, Pediatrics / 27.11.2018

MedicalResearch.com Interview with: Michael Lombardo, PhD Assistant professor of Psychology the University of Cyprus  MedicalResearch.com: What is the background for this study? Response: Autism is a diagnostic label we give to children with difficulties in the areas of social-communication and restricted, repetitive stereotyped behaviors and interests. The diagnosis is made based on observations about behavior and is a consensus label, meaning that clinicians can show high degrees of agreement that a given set of behaviors is ‘autism’. But aside from the diagnostic label, there is a fair degree of heterogeneity within patients that have the diagnosis. One way in which patients are heterogeneous is with regard to early language development. Some toddlers with autism are minimally verbal, while at the other end, many toddlers with autism develop language typically. An important question to answer is whether that kind of difference in language development indicates a subtype with different underlying biology. To examine this question, we first split toddlers with autism into two subtypes defined by their language outcome at 4 years of age. Some toddlers were classified as poor language outcome, because their language performance was 1 standard deviation below typical norms. Other toddlers with autism had relatively good language outcome, as their language performance by 4 years of age was within 1 standard deviation of typical norms. We also measured the biology behind these two autism subtypes. First we used functional magnetic resonance imaging (fMRI), which is a non-invasive method to look at blood oxygenation response that changes according to a task. Blood oxygenation changes are an indirect measure of neural activity. We used fMRI during natural sleep at around 29 months of age while the toddlers were played language stimuli through headphones to elicit neural responses to speech. Second, we measured molecular aspects of biology, by taking blood samples, isolating leukocyte cells, and then quantifying gene expression for all protein coding genes in the genome, at around the same time as the fMRI scan. (more…)
Author Interviews, Gastrointestinal Disease, Microbiome, NEJM, Pediatrics, Probiotics / 22.11.2018

MedicalResearch.com Interview with: Stephen Freedman MDCM, MSc Alberta Children's Hospital Foundation Professor in Child Health and Wellness Sections of Pediatric Emergency Medicine and Gastroenterology Alberta Children's Hospital & Research Institute University of Calgary Calgary, AB  MedicalResearch.com: What is the background for this study? Response: Vomiting and diarrhea remain extremely common diseases in children and are the most common reason children are brought for emergency department care in North America.  While we have options to reduce vomiting there historically has been little physicians can offer to reduce the severity of the diarrhea. Probiotics have recently emerged as an option with some early evidence of benefit in clinical trials but the studies performed to date have been small and few little research has been conducted in North America in outpatient or emergency department children. The one study to date that was performed in a US emergency department did not find probiotic use to be beneficial.  Given the increasing importance of clarifying this issue we undertook this study. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 20.11.2018

MedicalResearch.com Interview with: "Pondering a firearm" by Dan Foy is licensed under CC BY 2.0Erin Morgan PhD Student | Department of Epidemiology University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: Going into this study we were interested in looking at youth exposure to unsafely stored firearms. Unsafely stored firearms in the household, especially those that are stored unlocked, are a known risk factor for adolescent suicide. We were also interested in looking into a population of children and teens who are at particularly heightened risk for suicide and unintentional injury—those living with an adult who misuses alcohol. Overall, we found that about 30% of those under the age of 18 live in a firearm owning home and among those youth, around 55% lived with a firearm stored in a way other than locked and unloaded. Among those in firearm owning household, we also found that when compared to youth living with a survey respondent that did not report alcohol misuse, those living with an adult that did misuse alcohol were 20% more likely to reside in a home where the firearm was stored unsafely; children were 27% more likely to live in a home reporting unlocked storage, specifically. (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics / 19.11.2018

MedicalResearch.com Interview with: "i have a lazy eye but it's a good thing" by jessica mullen is licensed under CC BY 2.0Eileen E. Birch, PhD Director, Crystal Charity Ball Pediatric Vision Evaluation Center Retina Foundation of the Southwest Adjunct Professor of Ophthalmology UT Southwestern Medical Center   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We previously reported that amblyopia, but not nonamblyopic strabismus or anisometropia, is associated with slower reading speed (Kelly et al  Journal of AAPOS 2015) and that this is related to abnormal eye movements and unstable fixation associated with amblyopia (Kelly et al 2017).  We have also shown that amblyopic children are slower at completing Scantron answer sheets (JAMA Ophthalmology 2018).  We thought that these difficulties experiences in school-age children with amblyopia might affect their self-perception. (more…)