Author Interviews, Brain Injury, Gender Differences, JAMA, Pediatrics / 05.11.2018
Girls Recover From Concussions More Slowly Than Boys
MedicalResearch.com Interview with:
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Dr. Ledoux[/caption]
Andrée-Anne Ledoux, PhD
Children’s Hospital of Eastern Ontario Research Institute
Ottawa, Ontario, Canada
MedicalResearch.com: What is the background for this study?
Response: The natural recovery processes from a pediatric concussion remains poorly characterized throughout childhood. Children’s brains go through many phases of growth during development and sex differences exist. Therefore a 6-year-old child may not have the same recovery trajectory as an adolescent because of biopsychosocial differences. Thus, this study explored symptom improvement after concussion while considering these two key demographic factors. Understanding symptom improvement at different stages of development is important in order to provide the best possible care.
The study examined data from 2,716 children and adolescents who had presented at nine emergency departments across Canada and were diagnosed with concussion. We examined the natural progression of self-reported symptom recovery following pediatric concussion over the initial three months after injury. Participants in the study were aged 5 to 18 years old with acute concussion, enrolled from August 1, 2013, to May 31, 2015. We examined different age cohorts – 5 to 7 years of age, 8 to 12 years of age, and 13 to 18 years of age, and investigated how sex is associated with recovery.
Our study represents the largest study to evaluate symptom improvement trajectories in concussed pediatric population.
Dr. Ledoux[/caption]
Andrée-Anne Ledoux, PhD
Children’s Hospital of Eastern Ontario Research Institute
Ottawa, Ontario, Canada
MedicalResearch.com: What is the background for this study?
Response: The natural recovery processes from a pediatric concussion remains poorly characterized throughout childhood. Children’s brains go through many phases of growth during development and sex differences exist. Therefore a 6-year-old child may not have the same recovery trajectory as an adolescent because of biopsychosocial differences. Thus, this study explored symptom improvement after concussion while considering these two key demographic factors. Understanding symptom improvement at different stages of development is important in order to provide the best possible care.
The study examined data from 2,716 children and adolescents who had presented at nine emergency departments across Canada and were diagnosed with concussion. We examined the natural progression of self-reported symptom recovery following pediatric concussion over the initial three months after injury. Participants in the study were aged 5 to 18 years old with acute concussion, enrolled from August 1, 2013, to May 31, 2015. We examined different age cohorts – 5 to 7 years of age, 8 to 12 years of age, and 13 to 18 years of age, and investigated how sex is associated with recovery.
Our study represents the largest study to evaluate symptom improvement trajectories in concussed pediatric population.
Dr. Michael Snape[/caption]
Michael Snape, Ph.D.
Chief executive officer
Chief scientific officer
AMO Pharma
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This is a further analysis of the Phase II Proof of Concept study that was described in March. We have extended the findings from that study by performing further analyses of the data obtained and also commencing an analysis of the relationship between the levels of AMO-02 involved and the clinical response seen.
The main finding is a confirmation that our previously reported conclusions are supported. The concordant trend analysis revealed a clear dose-response relationship that favored the 1000 mg over 400 mg dose for four of the 10 response variables differed in favor of 1000 mg over 400 mg dose on key clinician and caregiver measures, autism scores and grip strength.
Sean C. Rose, MD
Pediatric sports neurologist and co-director
Complex Concussion Clinic
Nationwide Children’s Hospital
Assistant professor of Pediatrics
The Ohio State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The link between sub-concussive head impacts and declines in neurocognitive function has been reported by some studies, yet refuted by others. There is very little evidence that has been collected in children as they are sustaining these head impacts.
We initiated a multi-year study of youth football players to provide a more in-depth look at the question. We measured head impacts using helmet sensors during the 2016 football season. 112 players age 9-18 completed a battery of neurocognitive tests before and after the football season.
We found that neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance from pre to post-season.
Dr. Smith[/caption]
Gary A. Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH
MedicalResearch.com: What is the background for this study?
Response: When residential fires happen at night while people are sleeping, deaths are more likely to occur. Smoke alarms are important for preventing these deaths, yet many young children don’t wake up to traditional high-pitch tone alarms. Children sleep longer and deeper than adults and require louder sounds to awaken than adults. For these reasons, children are less likely to awaken and escape a nighttime home fire.
Dr. Janey Pratt, MD
Clinical Associate Professor, Surgery
Stanford University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In 2013 obesity became recognized as a disease. The rate of pediatric obesity continues to rise. Severe pediatric obesity is rising at a even faster rate than obesity in pediatrics. Despite this Metabolic and Bariatric Surgery (MBS) remains underutilized in the treatment of severe pediatric obesity. There is a significant amount of adult data and now pediatric data about effective treatments for severe obesity. These support the use of MBS as a primary treatment for severe obesity in children. (BMI > 120% of 95th percentile with a comorbidity or BMI > 140% of 95th percentile).
Kathryn M. Edwards, M.D.
Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics
Professor of Pediatrics
Vanderbilt University School of Medicine
Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year. This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age. The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received. The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted. Overall 15, 333 children had their immunization records reviewed.
When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered.
First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage. Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%).
There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates. In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine.








