Dr. Nwosu[/caption]
Benjamin Udoka Nwosu, MD, FAAP
Associate Professor of Pediatrics
Division of Endocrinology
University of Massachusetts Medical School
Worcester, Massachusetts
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Vitamin D deficiency has been reported in various gastrointestinal disorders but the vitamin D status of children and adolescents with irritable bowel syndrome (IBS) has not been previously characterized.
Secondly, the vitamin D status in IBS has not been compared to those of other malabsorption syndromes such as irritable bowel syndrome, lactose intolerance, and celiac disease.
Prof. Baud[/caption]
Prof. Olivier Baud MD
Chef de Service, Réanimation et Pédiatrie Néonatales
Team leader, INSERM U1141
Université Paris-Diderot, Sorbonne Paris Cité
Département Hospitalo-Universitaire "PROTECT"
Hôpital Robert Debré, Paris, France
MedicalResearch.com: What is the background for this study?
Response: Preterm birth is frequently associated with perinatal inflammation, a major risk factor for bronchopulmonary dysplasia (BPD). Because glucocorticoids alleviate systemic inflammation, they have been proposed as a therapeutic option in very preterm infants. Early dexamethasone therapy led to short-term benefits but was associated with cerebral palsy and other adverse neurodevelopmental events. Early treatment with low-dose hydrocortisone has been reported to improve short-term outcomes in extremely preterm infants. However, its safety remains to be assessed with regard to the long-term neurodevelopmental outcomes.
Emily Dennis[/caption]
Emily Dennis PhD
Postdoctoral Scholar
Imaging Genetics Center
Mark and Mary Stevens Neuroimaging and Informatics Institute
USC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that there is heterogeneity in outcome post-traumatic brain injury (TBI), but we generally think of this as a continuous variable - with most patients falling in the middle and only a few at the extremes in terms of recovery process and outcome.
Our main finding was that interhemispheric transfer time (IHTT - the time it takes for information to move from one hemisphere of the brain to the other) identified 2 subgroups of TBI patients - those with slow IHTT and those with normal IHTT. These two groups show differences in cognitive function and brain structure, with the IHTT slow group showing structural disruptions that become progressively worse while the IHTT normal group seems to be recovering from the injury.
Dr. Jing Liu[/caption]
Jing Liu, Ph.D.
Associate Professor
College of Environmental & Resource Sciences
Zhejiang University
Hangzhou, China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In addition to consistent observations of earlier pubertal onset in female since late 19th century, acceleration in male pubertal development also has been reported in more recent studies. Improved nutrition, health and living conditions may contribute to the secular trend towards an earlier pubertal onset. However, the potential role of environmental agents, specifically endocrine-disrupting chemicals (EDCs), also has been emphasized.
Pyrethroids are among the currently used pesticide classes placed on the list of the US Environmental Protection Agency (EPA) as potential EDCs. Pyrethroids are one of the top 10 classes of pesticides and account for greater than 30% of global insecticide usage. Increased human exposure to pyrethroids is thought to occur mainly via residues in diets and indoor residential use. The metabolites of pyrethroids have been widely identified in urine samples of adults, children and adolescents worldwide and the detection rate is usually more than 60% in human populations.
Here, we recognize pyrethroids as a new environmental contributor to the observed secular trend toward earlier male sexual maturity. For the first time to our knowledge, this work reveal a significant and positive association between pyrethroids exposure and gonadotropins levels in 463 Chinese boys, in which a 10% increase in 3-PBA (a common urinary metabolite of pyrethroids) is associated with more than 2% increase in both LH and FSH. Boys with increased urinary levels of 3-PBA have a significantly increased risk of earlier pubertal development, in which the odds of being in an advanced testicular volume and genitalia stage are increase by 113% and 268%, respectively.
Because it is difficult to test the direct causality of environmental risk factors in humans, we further sought to identify in animals how pyrethroids alter the timing of puberty. Postnatal exposure to a widely used pyrethroid pesticide, cypermethrin, can accelerate pubertal timing and induce circulating levels of gonadotropins and testosterone in male mice. Our findings reveal the activation of voltage-gated calcium channels pathway in pituitary gonadotropes and testicular Leydig cells as a newly discovered mechanism of pyrethroid-induced early pubertal development in the male.
Dr. McIntosh[/caption]
James McIntosh PhD
Economics Department
Concordia University
Montreal, Quebec, Canada.
MedicalResearch.com: What is the background for this study
Response: Marijuana is about to become legal in Canada. Consequently, an analysis of its effects on users is a high priority. This issue has been explored by Canadian researchers to some extent but there are gaps in what is known about the effects of using marijuana. Most of the Canadian studies focus on youth or adolescent use. This is clearly important but adult use is as well. Establishing the link between early usage and the effects of use over an individual’s lifetime was a major objective of the study.
Dr. Debra Palmer[/caption]
Dr. Debra Palmer (BSc, BND, PhD)
on behalf of my fellow co-authors on this publication
Childhood Allergy and Immunology Research
University of Western Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We conducted a multicentre trial, Starting Time of Egg Protein (STEP) involving 820 infants, and found a 25% risk reduction in egg allergy with early regular egg intake from 4-6.5 months compared with egg avoidance to 10 months of age, although this did not achieve statistical significance.
So we also investigated in exploratory analyses whether the effect of regular egg introduction in solid foods was modified by any maternal, family or infant characteristics. Our results found that infants from families of higher socioeconomic status and those families who consume few eggs per week could benefit by less egg allergy at 12 months of age from regular egg intake once they start eating solid foods.
Dr. Neilan[/caption]
Anne M Neilan, MD,MPH
Assistant in Medicine and Pediatrics
Massachusetts General Hospital
Instructor at Harvard Medical School
Department: Medicine Service
Division: Infectious Disease
Department: Pediatric Service
Massachusetts General Hospital
Boston, MA 02114
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Adolescents infected with HIV – either at birth or later in life – experience poorer health outcomes compared to adults with HIV in nearly every respect. This study found that U.S. youth infected with HIV around the time of their birth are at higher risk throughout their adolescence and young adulthood for experiencing serious health problems, poor control of the HIV virus (having high levels of HIV virus in their bodies and fewer CD4 immune cells which protect the body from infection), or death. The study also found that among those with good HIV control, serious health problems are rare.
By combining data from two large, long-term U.S. studies – the Pediatric HIV/AIDS Cohort Study (PHACS, www.phacsstudy.org) and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT, www.impaactnetwork.org) Network – we were able to study the health of more than 1,400 perinatally HIV-infected children, adolescents and young adults ages 7 to 30 years between 2007 and 2015. The study found that youth ages 13 to 30 were most likely to have poor HIV control AIDS-related illnesses, and death compared to younger participants. Among 18 – 30 year-olds, the study found that poor control of the HIV virus – meaning higher levels of HIV virus and lower levels of CD4 immune cells which protect the body from infection –35 percent of the time, increasing the risk that these youth would stop responding to certain HIV medications and could transmit HIV to others. These findings are consistent with other U.S. and European reports. Despite being engaged in health care, the number of deaths among youth born with HIV in the U.S. is 6 to12 times higher than for youth without HIV of the same age, sex and race.
Along with HIV-related health problems, the most commonly reported health conditions concerned mental health and brain and nervous system development. Many women in the study also had sexually transmitted infections, which was found to be associated with lower CD4 immune cell counts. This may suggest a biological mechanism or may reflect that patients who have difficulty with their medications are also engaging in more frequent risky sexual behaviors.
Dr. Nichols[/caption]
Hazel B. Nichols, PhD, UNC
Assistant professor
Lineberger Comprehensive Cancer Center member
UNC Gillings School of Global Public Health.
MedicalResearch.com: What is the background for this study?
Response: Each year more than 45,000 adolescent and young adult women (AYA, ages 15-39 years) are diagnosed with cancer in the United States. While many of these women may wish to have children in the years following diagnosis, there is currently little information available to address their concerns about the impact of cancer diagnosis and treatment on future pregnancy.
We identified >2,500 women who had a child after their cancer diagnosis using data from the North Carolina Central Cancer registry and statewide birth certificate files. We investigated whether adverse birth outcomes, such as preterm birth and low birth weight, were more common among AYA cancer survivors compared to women without cancer. We also looked at infant Apgar scores, which measure newborn health, and a calculation called small-for-gestational age, which can indicate restricted growth during pregnancy.
Dr. Jonathan Silverberg[/caption]
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: Stevens-Johnson syndrome and Toxic Epidermal Necrolysis (SJS/TEN) are relatively rare and potentially life-threatening disorders. There have been some recent advances in our understanding of the epidemiology and risk factors of SJS/TEN in adults.
However, little is known about the epidemiology of pediatric SJS/TEN.
MedicalResearch.com Interview with: [caption id="attachment_33404" align="alignleft" width="107"] Dr. Guodong Liu[/caption] Guodong Liu, PhD Assistant Professor Division of Health Services and Behavioral Research Department of Public Health Sciences, A210 Penn State University College of Medicine Hershey, PA 17033 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adolescents with autism spectrum disorder (ASD) use emergency...
Dr. Auerbach[/caption]
Brandon Auerbach, MD, MPH
Acting Instructor
Division of General Internal Medicine
University of Washington
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The question of whether 100% fruit juice causes poor health outcomes in children, such as weight gain, has been a subject of controversy. On one hand, 100% fruit juice contains vitamins and nutrients that many children lack, is often cheaper than whole fruit, and may help kids with limited access to healthy food meet their daily fruit requirements.
On the other hand, leading nutrition experts have expressed concern that fruit juice contains amounts of sugar equal to or greater than those of sugary drinks like regular soda. Guidelines from the American Academy of Pediatrics warn that 100% juice can be a significant source of calories and contribute to obesity if consumed excessively.
Our main finding was that consuming 1 serving/day of 100% fruit juice was not associated with weight gain in children. Children ages 1 to 6 years gained a small amount of weight, but not enough to negatively impact health. Children ages 7 and older gained no weight. We did not study amounts of 100% fruit juice higher than 1 serving/day.
Dr. Michael Ciccotti[/caption]
Michael G. Ciccotti, MD
Professor of Orthopaedic Surgery
Rothman Institute
Chief of Sports Medicine, and
Director of the Sports Medicine Fellowship
Thomas Jefferson University
MedicalResearch.com: What is the background for this study?
Response: No doubt sports plays a huge role in the United States and all over world with millions of young people between the ages 6 and 18 participating in an organized sport on a regular basis.
Over the past decade, there has been a tremendous focus on youth single sport specialization (SSS), with pressure from coaches, parents and the athletes themselves to participate in one sport year round. Many participants, coaches and parents believe that early specialization may allow the young athlete to become better and progress more quickly in their sport, perhaps allowing them a greater chance of becoming a professional athlete. This drive toward early specialization has been fueled by popular icons i.e. Tiger Woods (golf) and Lionel “Leo” Messi (soccer) as well as by media hits such as Friday Night Tykes (young football players) and The Short Game (7-year old golfers). The pop-psych writer, Malcolm Gladwell, whose The 10,000 Hour Rule (in his book Outliers) holds that 10,000 hours of "deliberate practice" are needed to become world-class in any field may have also encouraged the specialization trend.
There is little doubt that youth sports may encourage a lifelong interest in a healthy lifestyle as well as improved self-esteem and social relationships. The flip side is that extreme training and singular focus on a sport can lead to stress on the developing musculo-skeletal system, a pressure to succeed at all costs, reduced fun, burnout and sometimes social isolation.
The dilemma we are beginning to scratch the surface of is does single sport specialization enhance the likelihood of getting to an elite level and does it increase the risk of injury? There is a growing sense in the medical community that SSS raises injury risk without enhancing progression to a higher level.
Dr. Upadhya[/caption]
Krishna K. Upadhya, M.D., M.P.H.
Division of General Pediatrics & Adolescent Medicine
Department of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD 21287
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product. Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age.
Dr. Panagiotopoulos[/caption]
Constadina Panagiotopoulos, MD, FRCPC
Department of Pediatrics, Endocrinology & Diabetes Unit
British Columbia Children’s Hospital
Vancouver, British Columbia, Canada
MedicalResearch.com: What is the background for this study?
Response: I decided to conduct this study after observing a few cases of severe acute kidney injury (AKI) in children hospitalized with diabetic ketoacidosis (DKA) (with two patients requiring dialysis) while on call in the 18 months prior to initiating the study. While caring for these patients, I scanned the literature and realized that aside from 2 published case reports, there had been no large-scale systematic studies assessing AKI in children with DKA. It immediately became apparent to me that managing patients with AKI and DKA was more challenging. On presentation to hospital, many of these children with DKA present quite volume depleted but fluid management is conservative because of the risk for cerebral edema.
One of the most important management strategies for acute kidney injury in patients with DKA is early detection and correcting volume depletion in a timely manner to prevent further injury. I discussed my observations and these clinical cases with pediatric nephrologist and co-investigator Dr. Cherry Mammen, a pediatric AKI expert, and he confirmed my initial literature review findings. Thus, we decided to conduct this study to better understand the scope of the problem and any associated risk factors.
Dr. Saskia Trump[/caption]
Dr. Saskia Trump PhD
Helmholtz-Centre for Environmental Research – UFZ
Department of Environmental Immunology
Leipzig, Germany
MedicalResearch.com: What is the background for this study?
Response: Environmental chemicals have long been discussed to contribute to the exacerbation or even the development of allergic diseases. In our study we were particularly interested in the effect of tobacco smoke exposure, which is the main source for indoor benzene exposure, on regulatory T cell (Treg) function and its relation to the development of childhood atopic dermatitis (AD). Tregs play a critical in controlling T effector cell activity by avoiding overexpression. A deficiency in this T cell subset increases the risk for allergic inflammation.
We have previously described that exposure to tobacco smoke during pregnancy can decrease the number of regulatory T cells (Treg) in the cord blood and predispose the child to the development of AD (1). In this subsequent study we were interested in the underlying mechanism involved.
Benzene itself is not considered to be toxic, however its metabolization leads to the formation of highly reactive molecules. In humans for example the metabolite 1,4-benzochinone (1,4-BQ) can be found in the blood as a consequence of benzene exposure.
To further assess the effect of benzene on Treg and the development of AD we combined in vitro studies, evaluating the impact of 1,4-BQ on human expanded Treg, with data from our prospective mother-child cohort LINA. The LINA study, recruited in Leipzig, Germany, is a longitudinal evaluation of mother-child pairs with respect to lifestyle and environmental factors that might contribute to disease development in the child. Based on this deeply phenotyped cohort we were able to translate our in vitro findings to the in vivo scenario.
MedicalResearch.com Interview with: Professor John J Reilly University of Strathclyde Glasgow Physical Activity for Health Group Scotland, UK MedicalResearch.com: What is the background for this study? Response: There is Concern that levels of physical activity among modern children are typically very low, well below the amounts recommended for their physical & mental health, well-being, and academic...
Dr. Taveras[/caption]
Dr. Elsie M. Taveras, MD MPH
Chief, Division of General Pediatrics
Director, Pediatric Population Health Management
Director, Raising Healthy Hearts Clinic
MassGeneral Hospital for Children
MedicalResearch.com: What are the primary findings of this study and why are they important?
Response: The primary findings of this study are that children who get an insufficient amount of sleep in their preschool and early school age years have a higher risk of poor neurobehavioral functioning as reported by their mothers and independently by their teachers at age 7. These behaviors included poorer executive function and more hyperactivity/inattention, emotional symptoms, conduct problems, and peer relationship problems.
Dr. Matsui[/caption]
Elizabeth C. Matsui, MD MHS
Professor of Pediatrics, Epidemiology, and Environmental Health Sciences
Johns Hopkins University
Baltimore, MD 21287
MedicalResearch.com: What is the background for this study?
Response: We designed this study after our previous work indicated that mouse allergy was common among low-income children living in some urban neighborhoods in the US, that these children also had high levels of mouse allergen exposure in their homes, and that children who are both allergic to mice and exposed to high levels of mouse allergen are at greater risk of asthma symptoms, emergency room visits and hospitalization. Given this background, we designed a randomized clinical trial to determine if an intensive professionally delivered mouse intervention was better than education about mouse control in reducing asthma symptoms and lowering home mouse allergen levels.
Dr. Sullivan[/caption]
Patrick W. Sullivan, Ph.D.
Professor
Regis University School of Pharmacy
Denver, CO 80221
MedicalResearch.com: What is the background for this study?
Response: Asthma is one of the most common chronic disorders among children. It affects 7.1 million children in the U.S. Of these, 4.1 million children suffered an asthma attack in 2011. An asthma attack is an acute period of extreme difficulty breathing. It can be life threatening and is always very frightening for children. Because asthma can be dangerous and frightening, it ends up costing a lot because patients need to go the doctor, hospital or take medications to try to control it.
Asthma also has a negative effect on the patient’s health and outlook about their health – both mentally and physically. Previous studies have focused on adults with asthma and have found that it is very expensive – it costs $18 billion in the U.S. to manage adults with asthma. Those studies also showed that adults with asthma have lower quality of life. However, there is not a lot of good evidence on the burden of asthma in children. This study was designed to quantify the cost and mental and physical health of children with asthma in the U.S.
Dr. Kyrgiou[/caption]
Dr Maria Kyrgiou MSc, PhD, MRCOG
Clinical Senior Lecturer & Consultant in Gynaecologic Oncology
IRDB - Department of Surgery and Cancer, Imperial College London
West London Gynaecological Cancer Centre, Queen Charlotte's & Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Obesity has become a major public health challenge and it's prevalence worldwide has more than doubled amongst women n the last four decades. Excess body weight has been associated with an increased risk of developing and dying from numerous cancers. Although the reported associations may be potentially causal, some of the associations may be flawed due to inherent study biases such as residual confounding and selective reporting of positive results.
We included 204 meta-analyses investigating associations between adiposity and the development or death from 36 primary cancers and their sub-types. Adiposity was associated with a higher risk of developing esophageal adenocarcinoma, gastric cardia, colon and rectal cancer in men, biliary tract system, pancreatic, postmenopausal breast among HRT non-users, endometrial, ovarian, and kidney cancer and multiple myeloma.
Dr. Graner[/caption]
Dr. Sophie Graner
Department of Women's and Childrens Health
Karolinska Institute, Stockholm, Sweden
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Pregnant women are at increased risks of severe disease and death due to influensa infection, as well as hospitalization. Also influenza and fever increase the risk of adverse pregnancy outcomes for their infants such as intrauterine death and preterm birth. Due to this, the regulatory agencies in Europe and the US recommended post exposure prophylaxis and treatment for pregnant women with neuraminidase inhibitors during the last influenza pandemic 2009-10. Despite the recommendations, the knowledge on the effect of neuraminidase inhibitors on the infant has been limited. Previously published studies have not shown any increased risk, but they have had limited power to assess specific neonatal outcomes such as stillbirth, neonatal mortality, preterm birth, low Agar score, neonatal morbidity and congenital malformations.