MedicalResearch.com Interview with:
Joseph Leigh Simpson, MD FACOG, FACMG
President at International Federation of Fertility Societies
March of Dimes Foundation
White Plains, NY
MedicalResearch.com: What is the background for this study?Response: Preterm birth (PTB) is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. A total of 1.1 million infants die each year. Preterm births and their complications are the leading cause of deaths in children under age 5.
The biological basis of preterm birth remains poorly understood, and for that reason, preventive interventions are often empiric and have only limited benefit. Large differences exist in preterm birth rates across high income countries: 5.5 percent in Sweden and at present 9.6 percent in the U.S. The International Federation of Gynecologists and Obstetricians (FIGO)/March of Dimes Working Group on Preterm Birth Prevention hypothesized that identifying the risk factors underlying these wide variations could lead to interventions that reduce preterm birth in countries having high rates.
MedicalResearch.com Interview with: Johanna M. Uitti, MD
Department of Paediatrics and Adolescent Medicine
Turku University Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?Response: According to several national guidelines, close follow-up is required if initial observation without antimicrobial agents is chosen for the management of acute otitis media (AOM) in children. The aim of this study was to examine whether close follow-up with reexamination is needed for children with AOM initially managed without antimicrobial agents who have symptomatic improvement during the first week after diagnosis, as assessed by their parents.
Of the 104 children with symptomatic improvement, 3 (2.9%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy. In contrast, of the 54 children with symptomatic failure, 16 (29.6%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy.
MedicalResearch.com Interview with:Pooja Rao, MD, MSCE
Division of Pediatric Hematology/Oncology
Milton S. Hershey Medical Center
Penn State College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment.
Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.
MedicalResearch.com Interview with:Jesus Pujol, MD
Director of the MRI Research Unit.
Department of Radiology. Hospital del Mar
MedicalResearch.com: What is the background for this study?Response: The pros and cons of video gaming in children have been extensively debated. There are relevant amounts of data indicating both the positive and negative effects of video games. Nevertheless, a key question for many parents remains unanswered: How long should children play? To provide some clarity, we have investigated the relationship between weekly video game use and certain cognitive abilities and conduct-related problems.
MedicalResearch.com Interview with: Laura M. Gottlieb, MD, MPH
Department of Family and Community Medicine,
2Center for Health and Community
University of California, San Francisco
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Numerous studies have demonstrated that childhood exposures to social adversities, like family financial insecurity, food insecurity, and housing instability, lead to poorer health outcomes across the life course. These social adversities disproportionately affect low-income and racial minority populations. In response to this evidence there have been calls to address social needs in pediatric clinical care settings. For example, recently the American Academy of Pediatrics’ Task Force on Childhood Poverty endorsed the promotion of evidenced-based strategies to reduce the negative health effects of poverty on low-income children, including by increasing the availability of clinic-based interventions addressing social risks.
In response to these calls to action, a growing number of pediatric health care organizations are screening for and address families’ social needs. There is a critical need for more evidence on the effectiveness of these types of interventions. Many of the studies conducted so far have focused primarily on assessing program process outcomes or impacts on families’ social needs, but have not evaluated actual health outcomes resulting from program participation.
To our knowledge, this study was the first randomized clinical trial evaluating the impacts of a pediatric social needs navigation program on child health.
The reported number of social needs identified at baseline ranged from 0 to 11 out of 14 possible items, with a mean [SD] of 2.7[2.2] needs identified by participating families. Family participation in the navigation program intervention significantly decreased families’ reports of social needs by a mean (SE) of .39(0.13) vs. an increase of a mean (SE) of .22(0.13) in the active control arm. Participation in the navigation program also significantly improved parent-reported overall child health, with a mean (SE) change of -.036(0.05), compared to the active control arm with a mean (SE) change of -0.12(0.05). At 4 months post enrollment, the number of social needs reported by those that participated in the navigation program decreased by a mean (SE) of .39(0.13).
MedicalResearch.com Interview with: Olga Gorlanova
Paediatric Pneumology Research Group
Universitäts-Kinderspital beider Base
MedicalResearch.com: What is the background for this study?Response: Previous research has investigated how childhood asthma and early wheeze can develop as the result of a complex interaction between environmental exposures, such as tobacco exposure, older siblings and an individual’s genetic profile. Genes associated with childhood asthma risk are located on chromosome 17, called 17q21. Our study asked the question: could the effect of 17q21 on respiratory symptoms in infants be modified by breastfeeding? (more…)
MedicalResearch.com Interview with:Bryan L. Love, PharmD, BCPS-AQ ID
Department of Clinical Pharmacy & Outcomes Sciences
South Carolina College of Pharmacy
University of South Carolina
Columbia, South Carolina 29208-0001
MedicalResearch.com: What is the background for this study?Response: In the US, food allergy has become one of the more common childhood medical conditions diagnosed in young children. Antibiotics are frequently prescribed in young children, and research continues to reveal that as many as 30% of antibiotic prescriptions are not appropriate.* We sought to examine if there was an association between antibiotic prescription and food allergy diagnosis.
MedicalResearch.com Interview with:
William Ryan B.V.Sc.Ryan Mitchell Associates LLC
Westfield, NJ and
Bernard Cohen, MD
Professor Dermatology and
Ellen Koch, MD
Division of Pediatric Dermatology
Johns Hopkins Medicine, Baltimore, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As a group we were concerned about the misinformation that continues to be promulgated on the internet and through other sites. Importantly, the group consisted of experts with specific experience in the management of head louse infestations, from pediatric dermatology, pediatrics, school nursing and head louse research fields. Even information sources that we would have expected to be credible are outdated, unreliable or both, often continuing myths about head louse infestations and how they can be controlled. We wanted to provide a balanced and informed perspective that would help physicians and parents recognize that head louse infestations do not present a serious problem, and can be well managed with an informed approach to treatment.
The main findings are that over the counder products (permethrin/pyrethrins) are unlikely to be effective, and that that there are safe and effective products that are available by prescription.
Interestingly, head lice do affect Indian and African children in their home countries, but virtually nonexistent in African Americans in North America. There has been speculation about hair grooming regimen or structure of African American hair but the cause is unknown. In a study we performed assessing resistance to over the counter pediculicide components over a decade ago in Baltimore, we were not able to find a single African American child with head lice. We were not able to recruit any patients from the Baltimore City Schools.
MedicalResearch.com Interview with:Prof. Alan Irvine DSc
Consultant Dermatologist Our Lady’s Children’s Hospital
Associate Professor of Dermatology
Trinity College Dublin
MedicalResearch.com: What is the background for this study? What are the main findings?Response: The background is that atopic dermatitis (AD) has a close relationship with staphylococcus aureus (SA) colonisation, and this is known to drive flares or exacerbations of AD but before our report it was not known which came first-AD colonisation or atopic dermatitis?
By following a cohort pf patients very carefully over a 1 year period and regularly sampling their skin microbiome we were able to show that SA colonisation did not precede development of AD and in fact that several non SA species of staphylococcus actually appeared to be protective for developing atopic dermatitis.
This is an important new finding in the complex relationship between the microbiome and skin inflammation, suggesting that some commensal bacterial are anti-inflammatory or protective.
MedicalResearch.com Interview with: Professor Charlotte Suppli Ulrik MD DMSc et al.
Dept. of Respiratory Medicine
MedicalResearch.com: What is the background for this study?Response: Obesity is a risk factor for new-onset asthma, but the association is incompletely understood. Our aim was, therefore, to investigate the association between body mass index (BMI) BMI in childhood and asthma admissions in early adulthood (until age 45 years).
We used data on BMI measured annually (age 7-13 years) in 321,830 children enrolled in the Copenhagen School Health Records Registry. During the 36-years of follow-up, a total of 2,059 first-time ever hospital admissions for asthma were observed.
MedicalResearch.com Interview with:Dr Steve Turner MD MBBS
Lead investigator of the study team and
Royal Aberdeen Children’s Hospital
MedicalResearch.com: What is the background for this study?Response: For almost thirty years there has been evidence that we are all born with a certain predisposition to what are called non communicable diseases (NCD) such as high blood pressure, type II diabetes and heart disease.
The evidence comes from studies which have linked reduced birth weight with increased risk for these NCDs in later life. The question which arises, and which has been more difficult to answer, is “when during pregnancy is the predisposition to for NCDs first seen?”
This is important to any attempt to reduce the unborn baby’s risk for NCD. We and other researchers have used fetal ultrasound data to link size before birth to non communicable diseases outcomes. In childhood, NCDs include asthma.
MedicalResearch.com Interview with:David Osborn MB BS MM PhD FRACP
Clinical Associate Professor, University of Sydney
Senior Neonatologist, Royal Prince Alfred Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?Response: In an analysis of trials of placental transfusion at delivery by either delayed umbilical cord clamping or cord milking in infants born before 30 weeks gestation, placental transfusion was associated with short term benefits including increased hemoglobin, fewer blood transfusions, improved blood pressure and reduced late onset sepsis, with no significant effect on other outcomes. There were insufficient data regarding effects of placental transfusion on survival and long term disability.
The Australian Placental Transfusion Study (APTS) is a randomised controlled trial that aims to determine if delayed cord clamping (≥ 60 seconds) compared to early cord clamping (≤10 seconds) in 1600 infants born before 30 weeks gestation results in improved newborn outcomes and disability free survival.
In this echocardiographic sub study, the aim was to determine the effect of placental transfusion on systemic blood flow in the first day after birth in 266 infants randomly allocated to delayed versus early cord clamping (133 infants in each group). The primary outcome was superior vena cava (SVC) flow (cardiac input) which overcomes the problem of shunts across the adapting heart which affect the usefulness of measuring ventricular outputs in the first days after birth.
In infants born <30 weeks gestation, delayed cord clamping had no effect on the principle measure of systemic blood flow (SVC flow) during the first 24 hours compared to immediate cord clamping. However, right ventricular output (RVO) was lower in the delayed cord clamping group. This was not predicted and may be a chance finding. Further analysis suggests the effect of cord clamping on RVO could be mediated by its effect on hemoglobin. This may be a positive or negative adaptive change. There was no evidence of an increase in right to left ductal shunting suggestive of high pulmonary blood pressure to explain the difference in RVO. Delayed cord clamping resulted in a 8.9g/L greater increase in hemoglobin to 6 hours but had no effect on ductus arteriosus size, shunt direction or treatment, no effect on blood pressure or its treatment, and no effect on blood gas parameters and other cardiovascular variables in the first 24 hours.
MedicalResearch.com Interview with:Steven E. Lipshultz, MD, FAAP, FAHA
Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology /Professor in the Center for Molecular Medicine and Genetics
Wayne State University School of Medicine
President, University Pediatricians & Interim Director, Children’s Research Center of Michigan
Pediatrician-in-Chief, Children’s Hospital of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Surviving childhood cancer has dramatically and increasing improved to the point where more than 80% will achieve a 5-year event free survival. Many of these survivors look forward to decades of active productive life.
More than half of these survivors have been treated with therapies know to be associated with late cardiotoxicity that can be pervasive, persistent, and progressive and associated with cardiovascular morbidity and mortality. In this article we review both the course and prevention of this cardiotoxicity. We focus in part on anthracycline chemotherapy that is widely used and known to be cardiotoxicity.
We further review studies we and others have conducted to examine the effectiveness of dexrazoxane, an iron chelator, that when given before each anthracycline dose results in anthracycline cardioprotection for long term survivors. In some reported studies this has allowed for higher cumulative anthracycline doses to be safely given. In other cases this has allowed for simultaneously being able to safely treat children with malignancies that would be refractory to conventional therapy more potent therapies that would normally have additive cardiotoxicity.
MedicalResearch.com Interview with:Francine M. Ducharme, MD, FRCPC
Professor, Departments of Paediatrics and Social and Preventive Medicine
University of Montreal
Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine
MedicalResearch.com: What is the background for this study? What are the main findings?Response: The management of asthma attacks in preschoolers has been the subject of much recent debate. The results of a study published in 2009 had shaken the pediatric world. The study reported that preschool children with viral-triggered flare-ups did not respond to standard treatment and, suggesting that this was due to their young age. Such finding was particularly worrisome as the majority of asthma-related emergency room visits and hospitalizations involve preschool children.
We conducted this large cohort study in which children aged 1 to 17 years with a moderate or severe asthma attack were treated using the established evidence-based therapy adjusted to the severity of exacerbation assessed by the Pediatric Respiratory Assessment Measure (PRAM), administered rapidly. We explored the determinants of the failure of emergency therapy. Age was not a factor. Instead, in addition to attack severity and symptoms between attacks, it was rather the presence of respiratory viral infection or fever triggering the attack that was more often associated with treatment failure, i.e., higher hospitalization rates, more returns to the emergency room, and reduced speed of recovery over the 10 days after discharge. Viral detection occurred more frequently in preschoolers (67%) than in older children (46%) with asthma.
Nevertheless, the results confirm the overall effectiveness of standard treatment, adjusted to the severity of the attack and administered early, in the vast majority of children, regardless of age and viral detection. Indeed, although a failure rate of nearly 40% was expected in this group of children with moderate to severe attack, only 17% of the participants did not respond to standard treatment. This rate was significantly higher (19%) in children with viral infection compared to uninfected children (13%).
MedicalResearch.com Interview with: David A Stempel, MD
Medical Affairs Lead
US Medical Affairs
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children.
It is unknown whether the concomitant use of inhaled glucocorticoids
with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children.
MedicalResearch.com Interview with:Dr. Ben Wheeler MB ChB(Otago) DCH CCE FRACP
Senior Lecturer / Paediatrician / Paediatric Endocrinologist
Department of Women’s & Children’s Health : Te Tari Hauora Wāhine me te Tamariki
Dunedin School of Medicine
MedicalResearch.com: What is the background for this study?Response: Vitamin D is essential for calcium and bone metabolism. It is unique among vitamins in that it is mainly derived from synthesis in the
skin after exposure to UV-B radiation. In the absence of fortification, few foods are rich in vitamin D, including human milk, which contains very low amounts. Breastfeeding infants in higher latitude countries such as New Zealand, much of North America and
Central/Northern Europe are at risk of vitamin D deficiency.
The most profound manifestation of vitamin D deficiency in growing children is rickets, characterized by bone deformities, impaired growth, biochemical abnormalities, and depending on the severity of deficiency, seizures. Studies also identified a number of common factors that potentially affect the risk of rickets, including darker pigmented skin, maternal vitamin D deficiency during pregnancy, season of birth, and age.
A potential alternative strategy to improve the vitamin D status of breastfed infants is high-dose vitamin D supplementation to pregnant and lactating women. This would be attractive from a compliance perspective, promote exclusive breastfeeding, and treat both the mother and her infant.
Thus, the primary aim of this randomized, placebo-controlled study was to determine the effect of two different monthly doses of maternal vitamin D supplementation on the vitamin D status of non–vitamin D–supplemented breastfed infants and their mothers.
MedicalResearch.com Interview with:Kai Ling Kong, PhD, MS
Division of Behavioral Medicine
Department of Pediatrics
School of Medicine and Biomedical Sciences
State University of New York at Buffalo
MedicalResearch.com: What is the background for this study?Response: Infant temperament, or individual behavior styles, can be reliably measured and is related to weight status. However, we know very little about the association of infants’ temperament and their motivation to eat versus engage in other activities (relative food reinforcement). Examining such associations is an important step given the need to use behavioral strategies in obesity prevention in early life. The purpose of our study was to determine if infant temperament, specifically the factors that have been linked with obesity risk, are associated with infant relative food reinforcement.
MedicalResearch.com Interview with: Marc Auerbach, MD, FAAP, MSc
Associate Professor of Pediatrics (Emergency Medicine) and of Emergency Medicine
Co-chair INSPIRE (International Network for Simulation Based Pediatric Innovation Research and Education)
Director, Pediatric Simulation
Yale Center for Medical Simulation;
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Severely ill infants and children present to any of over 5000 United States Emergency Departments every day. A direct comparison of the quality of resuscitative care across EDs is challenging due to the low frequency of these high stakes events in individual EDs. This study utilized in-situ simulation-based measurement to compare the quality of resuscitative care delivered to two infants and one child by 58 distinct interprofessional teams across 30 EDs. Composite quality scores correlated with annual pediatric patient volume, with higher volume departments demonstrating higher scores.
The pediatric readiness score measures compliance with guidelines created by the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association. The pediatric readiness score correlated with composite quality scores measured by simulation.
MedicalResearch.com Interview with:
Dr. Cohen Regev, M.D
Head of the infectious diseases and infection control units
Sanz Medical Center, Laniado hospital
MedicalResearch.com: What is the background for this study?
Response: During 3 months in 2012 we had a number of clinical isolates of Pseudomonas aeruginosa (PA) in our neonatal intensive care unit (NICU) and a high incidence of colonization among ventilated patients in our medical-surgical intensive care unit (MSICU). The origin of PA may be from various environmental sources (‘exogenous’), from the patients’ own microbiome (‘endogenous’), or from both. Since in NICUs the origin is usually exogenous, we investigated the sources of the bacteria, focusing on the faucets of these units, as they were previously incriminated as causes of outbreaks in ICUs.
The study was conducted in Sanz medical center, a 400-bed community hospital located in central Israel. In the NICU we obtained several environmental cultures from faucets using a bacterial swab by rubbing the tip into the distal part of the faucet. Aerators were dismantled from all faucets, cultured from their inner part using a swab and were not repositioned. Contaminated faucets were occasionally replaced or treated with enzymatic fluid and sterilization by Ethylene Oxide. During the intervention and since, neonates were bathed only with warmed sterile water, and tap water was allowed only for hand hygiene practices.
In the MSICU tap water was used only for bathing the patients. All other uses of tap water, such as drinking, moistening and mouth treatments, were allowed using only sterile water. The units' faucets were sampled on two different days concurrently with surveillance cultures of pharyngeal, sputum and urine from the patients.
Bacteria were identified with VITEK 2 (Biomerieux®) and typing was done by Enterobacterial Repetitive Intergenic Consensus (ERIC) PCR.
MedicalResearch.com Interview with: David A. Hill, M.D., Ph.D.
Division of Allergy and Immunology
The Children's Hospital of Philadelphia
Philadelphia, PA 19104-3375
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Eczema, asthma, allergic rhinitis, and food allergies are among the most common childhood medical conditions in the United States. Importantly, disease rates for these conditions are thought to be changing, prompting the need for continued surveillance.
In our study, we examined electronic medical record data of over 1 million children to measure incidence and prevalence rates of these conditions in our community. We found that 1 in 5 children seen in our network are diagnosed with asthma, a rate that is among the highest in the nation. Additionally, the large size of our study allowed us to measure the extent to which food allergies are associated with asthma or allergic rhinitis. In this analysis, we found that children with food allergies are 2 to 3 times more likely to develop asthma or allergic rhinitis, as compared with children without food allergy.
MedicalResearch.com Interview with:
Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois
MedicalResearch.com: What is the background for this study?Response: Some children with atopic dermatitis may have disease activity persist into adolescence and adulthood, although most children are thought to “grow out of it.” There have been a number of studies with varied results about how commonly atopic dermatitis actually persists later in life. Moreover, the risk factors for persistence of atopic dermatitis are unclear. We sought to systematically analyze the extant literature of research studies to determine the rates and predictors of atopic dermatitis persistence over time.
MedicalResearch.com Interview with:Dr. Gang Hu, Associate Professor
LSU’s Pennington Biomedical Research Center & Director
Chronic Disease Epidemiology Lab
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Some studies have found that maternal gestational diabetes mellitus (GDM) places offspring at increased risk of long-term adverse outcomes, including obesity. However, most of studies are from high income countries, with limited data from low to middle income countries. The present study, conducted at urban and suburban sites in 12 countries, found that the increased risk for children of GDM mothers compared with non-gestational diabetes mellitus mothers was 53% for obesity, 73% for central obesity, and 42% for high body fat.
MedicalResearch.com Interview with: Kristi Roberts, MS, MPH
Center for Injury Research and Policy
Nationwide Children’s Hospital.
MedicalResearch.com: What is the background for this study?Response: Strollers (such as these luxury strollers) and carriers are used regularly by caregivers and are intended to provide a safe and secure way to transport young children during everyday activities. However, parents and caregivers should be aware that injuries do occur while using these products.
MedicalResearch.com Interview with:Wanda Phipatanakul, MD, MS
Associate Professor of Pediatrics
Harvard Medical School
Director, Asthma Clinical Research Center
Boston Children's Hospital
Asthma, Allergy and Immunology
Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Acetaminophen (e.g., Tylenol, Panadol) and ibuprofen (e.g., Advil, Motrin) are the only available treatments for pain and fever in toddlers and the most commonly utilized medications worldwide. Recently there has been controversy and even alarm with suggestive observational data that acetaminophen makes asthma worse. This has led some experts to recommend the avoidance of acetaminophen in children with asthma. We sought to find the answer to this burning question through the first prospective, double-blind, randomized clinical trial comparing acetaminophen versus ibuprofen head to head for use when clinically indicated for fever or pain. Is there a difference in asthma morbidity (exacerbations) in young children between the age of 12-59 months, who have asthma?
MedicalResearch.com Interview with:
Dr. Mark Loeb
BSc (McGill), MD (McGill), MSc (McMaster), FRCPC
Professor, Department of Pathology and Molecular Medicine
Joint Member, Dept of Clinical Epidemiology & Biostatistics
Division Director, Infectious Diseases, McMaster University
MedicalResearch.com: What is the background for this study? What are the main findings?Response: The background for this study is that in the U.S, the Advisory Committee on Immunization Practices (ACIP), the committee that advises the CDC on vaccination policy, decided this June not to recommend LAIV (nasal live vaccine) for children. This is because of non-randomized studies conducted in the U.S suggesting that the vaccine was ineffective. This was an unprecedented decision in influenza vaccine policy making for children.
Our study, a randomized, blinded, controlled trial, which is the most rigorous type of study design, conducted over 3 years (2012-13, 2013-2014, 2014-2015 influenza seasons), showed in fact very similar protection for children and their communities for the live and inactivated vaccines. We conducted the study in the Hutterite community of Western Canada which allowed us to compare the effect of the vaccines in entire communities. That is, we were able to study the direct effect and the indirect effect of these vaccines.
MedicalResearch.com Interview with:Dr Evie Stergiakouli
Lecturer in Genetic Epidemiology and Statistical Genetics
MRC Integrative Epidemiology Unit
University of Bristol
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Acetaminophen is considered safe to use during pregnancy. However, research suggests that acetaminophen use in pregnancy is associated with abnormal neurodevelopment. It is possible that this association might be confounded by unmeasured behavioural factors linked to acetaminophen use. We compared acetaminophen use during pregnancy to postnatal acetaminophen use and partner's acetaminophen use. Only acetaminophen use during pregnancy has the potential to cause behavioural problems in the offspring. Any associations with postnatal acetaminophen use and partner's acetaminophen use would be due to confounding. Behavioural problems in the offspring were only associated with acetaminophen use during pregnancy.
MedicalResearch.com Interview with:Amy Baxter MD
CEO MMJ Labs LLC
MedicalResearch.com: Would you tell us a little about your background? How did you develop an interest in pain management and prevention?
Response: As a pediatric emergency doctor, I found it interesting that doctors could prevent pain but sometimes couldn't be bothered to do so. The lack of empathy and impatience is built into emergency training - we learn to diagnose and fix things quickly, not comfort and support. I decided to research how pain management would make procedures more successful, or faster, to convince doctors to use pain management for THEIR benefit.
MedicalResearch.com: What is the background for the Buzzy(r) device? How does it impact pain sensation?Response: When my 4 year old had a horrible vaccination experience, I realized that a fast effective parent-controlled option for pain relief was needed. I knew that cold running water could eliminate the pain from a burned finger using physiology called gate control. Basically, the small pain nerves run alongside big motion nerves, so if you heavily stimulate motion you scramble the pain sensation. Rubbing a bumped elbow is another good example. Vibration alone didn't work enough for needles, but when I added ice the two sensations of cold and motion eliminated pain in 84% of seniors getting a flu shot. We got a grant from the NIH to develop and study Buzzy - it's a palm sized vibration unit with a place on the back to attach ice "wings", that freeze solid. You put them both where an injection will go for a minute or less, then move them "between the brain and the pain" while doing a needle procedure. There are about 14 studies on IV access or blood draws and 6 on injections, showing between 50 and 88% pain reduction.
Several studies have demonstrated that Buzzy is truly a physiologic intervention, not a distraction: it didn't work for injections when only used for 10 seconds, too little time to block the pain nerves. But it worked really well for blood draws in severely cognitively impaired children for whom distraction wasn't an option.
MedicalResearch.com Interview with:
Marieke de Hoog
Julius Centrum voor Gezondheidswetenschappen en Eerstelijnsgeneeskunde
The NetherlandsMedicalResearch.com: What is the background for this study?
Response: Acute otitis media (AOM) is a prime reason for doctor consultations and antibiotic use in children. Although symptoms of AOM may resolve spontaneously, these infections have a significant impact on child and family life and carry a considerable health care and economic burden. Acute otitis media occurring early in life, also called early-onset AOM, has been suggested as a risk factor for subsequent Acute otitis media episodes during childhood and could therefore also impact health care resource use. Identifying the critical age-period and quantifying the long-term consequences of early-onset AOM is important to guide future management and prevention programs aiming to reduce the burden of AOM.
MedicalResearch.com Interview with:
Paula Lozano, MD MPH
Associate Medical Director, Research and Translation
Group Health Physicians
Group Health Research Institute
Metropolitan Park East
Seattle, WA 98101
MedicalResearch.com: What is the background for this study?Response: This wasn’t a study, but rather a study of studies, to support the US Preventive Services Task Force in updating its previous recommendation of
I: insufficient to assess the balance of benefits and harms. We conducted two systematic evidence reviews of screening children and adolescents:
1. for familial hypercholesterolemia (FH, a genetic disorder that interferes with the body’s ability to metabolize cholesterol and can result in early coronary heart disease); and
2. for multifactorial dyslipidemia—which we defined as elevated LDL cholesterol or total cholesterol, not caused by familial hypercholesterolemia. LDL and total cholesterol were of interest because they are considered atherogenic.
One of the challenges of lipid screening in youth is that blood levels of these atherogenic lipids are known to fluctuate during the course of childhood and adolescence. It’s sort of a W-shaped curve, with a peak at age 9-11 years. So for a given child, the definition of what’s an elevated LDL or total cholesterol level will change with age. Also, two-thirds of kids identified as having high cholesterol through universal screening would not go on to have high cholesterol as adults.
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