Author Interviews, Hematology, Memory, Pediatrics, Technology / 09.12.2016

MedicalResearch.com Interview with: Steven J. Hardy, Phd Licensed Clinical Psychologist Divisions of Hematology and Oncology Children’s National Health System Assistant Professor of Pediatrics and Psychiatry & Behavioral Sciences George Washington School of Medicine and Health Sciences Washington, DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children with sickle cell disease exhibit neurocognitive deficits as a consequence of either silent or overt cerebral infarction or disease-related non-infarct central nervous system effects (likely resulting from chronic anemia and hypoxic events). These complications often lead to impairment in executive functioning (e.g., working memory, attention, inhibition, cognitive flexibility), which can make it difficult to focus in class, plan for long-term school projects, remember and carry out multi-step tasks or assignments, and stay organized. The literature on interventions to reduce neurocognitive sequelae of sickle cell disease is extremely limited. Our research team investigated a promising home-based, computerized cognitive training program (Cogmed) involving repeated practice on performance-adapted exercises targeting working memory with a sample of youth (ages 7 – 16) with sickle cell disease. Of the participants who have enrolled in the study (n = 70), 49% exhibited working memory deficits (<25% in the general population have a working memory deficit) and were randomized to an eight-week waitlist or to begin Cogmed immediately. Participants who used Cogmed demonstrated significant improvements on multiple measures of working memory, while those randomized to the waitlist group only exhibited such improvements after receiving Cogmed. Approximately 25% of participants completed the recommended number of Cogmed sessions (20 – 25 sessions). However, analyses revealed that participants who completed at least 10 sessions (about 50% of the participants) showed comparable levels of working memory improvement. (more…)
Author Interviews, Brain Injury, MRI, Pediatrics / 09.12.2016

MedicalResearch.com Interview with: Eman S. Mahdi, MD, MBChB Pediatric Radiology Fellow Catherine Limperopoulos, PhD Director, Developing Brain Research Laboratory Co-Director of Research, Division of Neonatology Diagnostic Imaging and Radiology Children’s National Health System Washington, DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Premature birth is a major public health concern in the United States affecting 1 in 10 infants each year. Prematurity-related brain injury is very common and associated with a high prevalence of brain injury and accompanying lifelong neurodevelopmental morbidities. Early disturbances in systemic and cerebral hemodynamics are thought to mediate prematurity-related brain injury. The extent to which cerebral blood flow (CBF) is disturbed in preterm birth is poorly understood, in large part because of the lack of monitoring techniques that can directly and non-invasively measure cerebral blood flow. We report for the first time early disturbances in global and regional cerebral blood flow in preterm infants following brain injury on conventional magnetic resonance imaging (MRI) over the third trimester of ex-uterine life using arterial spin labelling images. In terms of regional differences, we saw a marked decrease in blood flow to the thalamus and the pons, regions known to be metabolically active during this time. (more…)
Author Interviews, OBGYNE, Pediatrics, Social Issues / 09.12.2016

MedicalResearch.com Interview with: Jonathan Y. Bernard, PhD Inserm UMRS 1153 – Centre for research in Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS) Team ORCHAD: early Origin of the Child Health And Development Hôpital Paul Brousse MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the World Health Organization’s recommendations promoting breast feeding, wide variations in breast feeding initiation rates are observed among Western countries: some reach >95%, while others remain <80%. Many individual-level determinants of breast feeding are known, including maternal age, education, ethnicity, smoking and employment status. Less is known regarding cultural determinants, such as religion, which could be underlying and explain rate differences between and within countries. We aimed at comparing countries’ breast feeding rates with the proportions of Catholics and Protestants. We thus carried out an ecological study by collating publicly available online data for 135 countries. We additionally gathered within-country data for 5 Western nations: France, Ireland, the UK, Canada and the USA. We found that, in Western countries, the proportion of Catholics was negatively correlated with the rate of breast feeding. This was also observed within countries in France, Ireland, the UK and Canada. In the USA, where breast feeding rates vary hugely between states, race was an important confounder. Interestingly, we also found the correlation in non-Hispanic whites. All our findings hold even when we account for wealth indicators, such as gross domestic product per capita. (more…)
Author Interviews, Dermatology, JAMA, Pediatrics / 07.12.2016

MedicalResearch.com Interview with: Steve Xu MD, MSc Resident Physician Department of Dermatology Northwestern Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Given the limited data on the effectiveness or safety of the different moisturizers examined in the study, how much do you think parents should decide what to use on their babies based on the "cost-effectiveness" determined in this study? Would you just say cheapest is best since we don't know how well these things work? Or what's the message? Price. Petrolatum is an extremely effective moisturizer. It also happens to be one of the most affordable. Unlike adults, I don't suspect newborns will complain too much about the greasiness of petrolatum. They're less concerned that their work clothes will get ruined. They are less likely to care about cosmetic elegance. I also will say that petrolatum is less likely to include any artificial fragrances, preservatives that could serve as irritants or allergens in the future. That's an added bonus. (more…)
Author Interviews, Biomarkers, Pediatrics, Pulmonary Disease / 02.12.2016

MedicalResearch.com Interview with: Prof. Henrik Verder Department of Pediatrics Holbaek University Hospital Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Respiratory Distress Syndrome (RDS) is a major cause of mortality and morbidity in premature infants. It can be effectively treated with surfactant, a therapy which reduces the effort needed to expand the lungs during inspiration and allow gas exchange to take place. Early surfactant treatment can help prevent the onset and impact of RDS, however, prophylactic treatment has been shown to be harmful and only necessary in half of all pre-term infants. This study provided data validating the efficacy of a lung maturity test (LMT) in identifying infants at risk of respiratory distress syndrome (RDS) who could benefit from early surfactant treatment. (more…)
Author Interviews, Education, Pediatrics, Technology / 01.12.2016

MedicalResearch.com Interview with: Dr Katie (Katherine) Twomey ESRC Future Research Leaders Fellow, Lancaster University Senior Research Associate, ESRC International Centre for Language and Communicative Development (LuCiD)   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although we know that toddlers can quickly work out what new words mean, it's not yet clear exactly how they do it. For example, when they see a new object alongside their favorite toy truck and hear a new word "block", we know that they will link "block" to the new object. They could do this by thinking in detail about what they already know, for example "if my toy is called "truck", then "block" must be the name of the new object". Equally, however, they could quickly link the new word to the new object without thinking about it in-depth. We tested this second possibility using iCub, a humanoid robot which learns by making quick associations between what it sees and what it hears, without the ability to think in detail about what it already knows. We replicated two studies of toddlers' early word learning with iCub and found that even though it can only learn through making simple links between words and objects, it behaved exactly as children did in the original experiments. (more…)
Author Interviews, Flu - Influenza, Pediatrics, Science, UCLA / 28.11.2016

MedicalResearch.com Interview with: Katelyn M. Gostic and Monique Ambrose Department of Ecology and Evolutionary Biology University of California Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Monique Ambrose: Influenza pandemics pose a serious, recurrent threat to human public health. One of the most probable sources of future pandemic influenza viruses is the pool of influenza A virus (IAV) subtypes that currently circulate in non-human animals. It has traditionally been thought that the human population is immunologically naïve and unprotected against these unfamiliar subtypes. However, our work suggests that an individual ‘imprints’ to the influenza A virus (IAV) encountered in early childhood in such a way that they retain protection against severe disease if they later encounter a novel IAV subtype that belongs to the same genetic group as their first exposure. Our research looked at human cases of H5N1 and H7N9, two avian IAV subtypes of global concern, to investigate what factors most strongly predicted risk of severe disease. The most striking explanatory factor was childhood IAV imprinting: our results suggest that individuals who had childhood imprinting on an IAV in the same genetic group as the avian IAV they encountered later in life experienced 75% protection against severe disease and 80% protection against death. (more…)
Author Interviews, Autism, Emory, Pediatrics / 25.11.2016

MedicalResearch.com Interview with: Warren Jones, PhD Director of Research, Marcus Autism Center Children's Healthcare of Atlanta CHOA Distinguished Chair in Autism Asst. Professor, Dept. of Pediatrics Emory University School of Medicine Atlanta, Georgia 30329 MedicalResearch.com: What is the background for this study? What are the main findings? Response: These results help clarify an important and longstanding question in autism: why do children with autism look less at other people’s eyes? Two ideas for reduced eye contact in autism have been proposed: - One idea is that children with autism avoid eye contact because they find it stressful and negative. - The other idea is that children with autism look less at other people’s eyes because the social cues from the eyes are not perceived as particularly meaningful or important. This study is important because each idea reflects a very different understanding of what autism is. And maybe even more importantly, each idea reflects a very different view about the right treatment approach to autism and to reduced eye contact in autism. To answer this question, we used eye-tracking technology to study how 86 children with and without autism paid attention to other people’s eyes. Children were tested when they were just two years old, at their time of initial diagnosis. (more…)
Author Interviews, Neurological Disorders, Ophthalmology, Pediatrics / 23.11.2016

MedicalResearch.com Interview with: Marius George Linguraru, DPhil, MA, MB Principal Investigator Associate Professor of Pediatrics and Radiology George Washington University School of Medicine and Health Sciences Children’s National Health System Washington, DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Neurofibromatosis type 1 (NF1) is the most common cancer predisposition syndrome affecting the central nervous with an incidence of one in 3,000 births. Nearly one in five children with NF1 develops an optic pathway glioma (OPG), a low-grade tumor of the anterior visual pathway (i.e., optic nerves, chiasm and tracts). These tumors are not amenable to surgical resection and can cause permanent vision loss ranging from a mild decline in visual acuity to complete blindness. Only half of children with NF1-OPGs will experience vision loss, typically between 1 to 6 years of age. The other half will never lose vision or require treatment. All previous studies have consistently demonstrated that the change in NF1-OPG size is not related to the clinical outcome. For example, the optic pathway glioma size may be stable or even decrease, yet the vision will decline. Alternatively, the OPG size may increase, yet the clinical outcome remains stable or even improves. As no imaging or clinical features can identify which children with NF1-OPGs will ultimately lose vision, clinicians struggle to follow these children and decide when to intervene. We used quantitative imaging technology to accurately assess in magnetic resonance imaging (MRI) the total volume of OPGs in NF1. We also determined the retinal nerve fiber layer thickness in these children, a measure of axonal degeneration and an established biomarker of visual impairment. The results were outstanding, as we showed for the first time that the volume of an optic pathway glioma is indeed correlated with the likelihood of vision loss in children with Neurofibromatosis type 1. (more…)
Author Interviews, BMJ, Pediatrics, Social Issues / 22.11.2016

MedicalResearch.com Interview with: Charles Opondo, BPharm MSc PhD. Researcher in Statistics and Epidemiology National Perinatal Epidemiology Unit Nuffield Department of Population Health University of Oxford Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study measured fathers’ involvement in their child’s upbringing in infancy by looking at their emotional response to their child (e.g. feeling confident with the child, making a strong bond with the child), how involved they were in childcare (e.g. changing nappies, playing, night feeding, and also general care tasks around the house such as meal preparation) and their feelings of being a secure in their role as a parent (e.g. feeling included by mother in childcare, not feeling inexperienced with children). We found that the children of fathers who scored highly in terms of their emotional response and feeling like a secure parent were less likely to have symptoms of behavioural problems when they were 9 or 11 years. However, fathers being more involved in direct childcare did not seem to affect the child’s risk of having later behavioural problems. (more…)
Author Interviews, CDC, Pediatrics, Weight Research / 21.11.2016

MedicalResearch.com Interview with: Liping Pan, MD MPH Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: This CDC report is the first to use the WIC Participant Characteristic (WIC PC) data from the USDA to monitor trends in obesity among young children aged 2 to 4 years in the WIC program. The main findings of the study are: • 34 of 56 (61%) WIC state agencies reported modest decreases in obesity among young children from 2010 to 2014. • From 2000 to 2010, the prevalence of obesity among 2-4 year olds increased from 14.0% to 15.9%, then dropped to 14.5% from 2010 to 2014. • Obesity prevalence varied by state, ranging from 8.2 percent in Utah to 20.0 percent in Virginia. • From 2010 to 2014, obesity prevalence decreased among all major racial/ethnic groups, including non-Hispanic whites, non-Hispanic blacks, Hispanics, American Indians/Alaska Natives, and Asians/Pacific Islanders. • From 2000 to 2014, obesity prevalence decreased significantly among Asian/Pacific Islanders, from 13.9 percent to 11.1 percent. (more…)
Author Interviews, Autism, JAMA, Pediatrics / 20.11.2016

MedicalResearch.com Interview with: Dr. Melanie Penner, MD FRCP (C) Clinician investigator and developmental pediatrician Holland Bloorview Kids Rehabilitation Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have shown that accessing intensive behavioral intervention (IBI) services at younger ages is associated with improved outcomes for children with autism spectrum disorder (ASD). In Ontario, Canada, children wait years to access publicly-funded IBI. This analysis estimated costs and projected adult independence for three IBI wait time scenarios: the current wait time, a wait time reduced by half, and an eliminated wait time. The model inputs came from published literature. The main findings showed that eliminating the wait time generated the most independence and cost the least amount of money to both the government and society. With no wait time for intensive behavioral intervention, the government would save $53,000 (2015 Canadian dollars per person) with autism spectrum disorder over their lifetime, and society would save $267,000 (2015 Canadian dollars). (more…)
Author Interviews, Pediatrics, Toxin Research / 20.11.2016

MedicalResearch.com Interview with: Toby Litovitz, MD Executive & Medical Director, National Capital Poison Center Professor of Emergency Medicine, Georgetown University Clinical Professor of Emergency Medicine The George Washington University Washington DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past decade, a dramatic and persistent rise in the severity of swallowed batteries has been attributed to increased use of 20 mm diameter lithium coin cell batteries. With its larger diameter compared to traditional button cells, these cells get stuck in the esophagus of small children. There the greater voltage (3 V for lithium coin cells rather than 1.5 V for traditional button batteries), causes these cells to rapidly generate an external current that hydrolyzes tissue fluids, generating hydroxide and causing severe burns, injury and even death. Severe or fatal complications include perforations of the esophagus, tracheoesophageal fistulas, recurrent laryngeal nerve damage leading to vocal cord paralysis, spondylodiscitis, strictures and aortoesophageal fistulas – the latter nearly always fatal. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Kidney Disease, NEJM, Pediatrics / 18.11.2016

MedicalResearch.com Interview with: Stuart L. Goldstein, MD, FAAP, FNKF Clark D. West Endowed Chair Professor of Pediatrics University of Cincinnati College of Medicine Director, Center for Acute Care Nephrology | Associate Director, Division of Nephrology Medical Director, Pheresis Service | Co-Medical Director, Heart Institute Research Core Division of Nephrology and Hypertension | The Heart Institute Cincinnati Children’s Hospital Medical Center Cincinnati, OH 45229 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a prospective international multi-center assessment of the epidemiology of acute kidney injury in children in young adults. Over 5,000 children were enrolled from 32 pediatric ICUs in 9 countries on 4 continents. The main findings are: 1) Severe AKI, defined by either Stage 2 or 3 KDIGO serum creatinine and urine output criteria carried an incremental risk of death after adjusting for 16 co-variates. 2) Patients with AKI by low urine output would have been misclassified as not having AKI by serum creatinine criteria and patients with AKI by urine output criteria have worse outcomes than patients with AKI by creatinine crtieria. 3) Severe AKI was also associated with increased and prolonged mechanical ventilation use, increased receipt of dialysis or ECMO (more…)
Author Interviews, Brigham & Women's - Harvard, OBGYNE, Pediatrics / 18.11.2016

MedicalResearch.com Interview with: Melissa C. Bartick, MD, MSc Department of Medicine Cambridge Health Alliance Harvard Medical School Cambridge, MA MedicalResearch.com: What is the background for this study? Response: This is the first study ever to combine maternal and pediatric health outcomes from breastfeeding into a single model. We had published a cost analysis of suboptimal breastfeeding for pediatric disease in 2010, which found that suboptimal breastfeeding cost the US $13 billion in costs of premature death costs and medical expenses, and 911 excess deaths. We followed that up with a maternal cost analysis which found about $18 billion in premature death costs and medical expenses. In both these studies, most of the costs were from premature death. We were unable to combine the results of these two studies because their methodologies were different, and both of them, especially the pediatric portion needed to be updated. (more…)
Author Interviews, Cancer Research, Immunotherapy, Pediatrics, Rheumatology / 16.11.2016

MedicalResearch.com Interview with: Timothy Beukelman, MD, MSCE Associate Professor of Pediatrics Division of Rheumatology and Division of Clinical Immunology & Rheumatology University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? Response: In 2009 the US FDA issued a boxed warning about malignancies reported in children treated with TNF inhibitors but their analysis did not account for a possible malignancy risk from other medications of from the Juvenile idiopathic arthritis (JIA) disease process itself. (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 15.11.2016

MedicalResearch.com Interview with: Katherine P. Theall, PhD Associate Professor Global Community Health and Behavioral Services Tulane University School of Public Health and Tropical Medicine New Orleans, Louisiana MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are stark health disparities in the U.S. by socioeconomic position as well as between racial and ethnic groups. Many of these health disparities may have a root cause in childhood and be driven by social risk factors. The authors report each neighborhood stressor was associated with biological stress as measured by shortened telomere length and cortisol functioning. Many children are exposed to violence and a greater understanding of the effect on children’s health is critical because social environmental conditions likely contribute to health disparities. Socioeconomically disadvantaged communities have a higher exposure to violence. Limitations of the study include its lack of applicability to other demographic groups. The study also cannot establish causality. (more…)
Asthma, Author Interviews, Education, Pediatrics / 14.11.2016

MedicalResearch.com Interview with: Manoj Warrier, M.D. Allergy, Asthma & Sinus Care Center Adjunct Associate Professor of Pediatrics Saint Louis University and Cardinal Glennon Children's Medical Center St. Louis, MO 63127 MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2012, Missouri House Bill 1188 was passed, which allowed trained employees in Missouri schools to administer asthma related rescue medications at their discretion to students experiencing an asthma exacerbation, even if the individual student did not have their own supply of the medication. The Asthma and Allergy Foundation of America St. Louis Chapter (AAFA-STL) was instrumental in facilitating passage of this bill and also created the RESCUE (Resources for Every School Confronting Unexpected Emergencies) program, which provides equipment and access to free medications to treat acute asthma symptoms, mainly supporting schools with lower income populations. AAFA-STL tracked how often RESCUE supplies were used and found that equipment was used 1357 individual times in 2013-2014 school year, with students going back to class 86.07%, sent home 10.83%, and sent to emergency department (ED) only 1.33% of the time. In the 2014-2015, they found similar results with equipment used 1720 individual times, with students going back to class 84.48%, sent home 10.81%, and sent to ED 3.14% of the time. (more…)
Allergies, Asthma, Author Interviews, Flu - Influenza, Pediatrics, Vaccine Studies / 14.11.2016

MedicalResearch.com Interview with: Deepa Patadia, MD Wexner Medical Center The Ohio State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Influenza vaccination is recommended every autumn for all children 6 months of age and older. It is particularly important for children with asthma, who are at high risk of hospitalization or severe illness if they contract influenza infection. The rates of influenza vaccination in children with asthma have not previously been well studied, but Healthy People 2020 has set a target goal to vaccinate 70% of all children for influenza. We found that rates of vaccination in our large primary care population was much lower than the target rate, with less than 50% of all children receiving the vaccine each year over a 5 year period; however rates were higher in children with asthma, albeit still only at 55%. (more…)
Author Interviews, Heart Disease, Pediatrics, University of Pennsylvania / 14.11.2016

MedicalResearch.com Interview with: Maryam Y. Naim, MD Pediatric Cardiac Intensive Care Physician The Cardiac Center The Children’s Hospital of Philadelphia Perelman School of Medicine The University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study?  Response: In adults bystander compression only CPR has similar outcomes to bystander conventional COR therefore the The American Heart Association recommends untrained lay rescuers perform compression only CPR in adults that have an out of hospital cardiac arrest. In children respiratory arrests are more common therefore conventional CPR with chest compressions and rescue breaths are recommended for out of hospital cardiac arrest. (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics, Technology / 11.11.2016

MedicalResearch.com Interview with: Krista Kelly, PhD Postdoctoral Fellow Crystal Charity Ball Pediatric Vision Evaluation Center Retina Foundation of the Southwest Dallas, TX 75231 MedicalResearch.com: What is the background for this study? Response: Amblyopia is one of the most common causes of monocular impairment in children, affecting 1 or 2 children in every US classroom. Patching of the fellow eye has been used for decades to improve visual acuity in the amblyopic eye. But patching does not always restore normal vision and does not teach the two eyes to work together. A novel technique originally designed by Drs Robert Hess and Ben Thompson at McGill University that works to reduce interocular suppression by rebalancing the contrast between the eyes has shown promising results in amblyopic adults. Dr Eileen Birch at the Retina Foundation of the Southwest worked with Dr Hess to adapt this contrast re-balancing approach to an iPad game platform suitable for children. Her research showed that the games were successful in improving visual acuity in amblyopic children as well. However, these initial games were rudimentary and resulted in low compliance. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 09.11.2016

MedicalResearch.com Interview with: Dr. Sharon Unger BSc, MD, FRCP Staff Neonatologist at Mount Sinai Hospital Associate Staff Neonatologist at The Hospital for Sick Children (SickKids) Associate Professor in the Department of Paediatrics at the University of Toronto. Medical Director of the Rogers Hixon Ontario Human Milk Bank and Dr. Deborah L. O’Connor PhD, RD Senior Associate Scientist in Physiology & Experimental Medicine SickKids and Professor Department of Nutritional Sciences at the University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Babies who are born very early (before 32 weeks’ gestation) and/or at very low weights (less than 1,500 grams) are among the most fragile of all paediatric patients, typically facing serious medical issues and requiring care in a Neonatal Intensive Care Unit (NICU). In addition to underdeveloped organs and risk of neurodevelopmental issues, preterm and very low birth weight babies are at risk of a severe bowel emergency called necrotizing enterocolitis, which involves the damage and potential destruction of the intestinal tissue. This disease affects approximately six per cent of very low birth weight infants each year, making it one of the most common causes of death and long-term complications in this population. As a neonatologist and a PhD-trained dietitian, we have spent our careers working to improve outcomes for babies and supporting breastfeeding. While there is already strong evidence to suggest that breastfeeding is associated with a variety of benefits including reduced risk of childhood infections and may play a role in the prevention of overweight and diabetes, in healthy, full-term infants, we launched a research program a decade ago to figure out how to ensure the same advantage could be provided to vulnerable hospitalized infants, specifically very low birth weight infants. Breastfeeding initiation rates in Canada are now at all-time high for healthy newborns, but for many reasons related to preterm birth, up to two thirds of mothers of very low birth weight infants are unable to provide a sufficient volume of breast milk to their infant. A variety of factors may limit breast milk production in these cases, including immaturity of the breast cells that make milk, maternal illness, breast pump dependency, and stress. In addition to the health benefits attributed to mother’s milk for full-term, healthy infants, previous studies have shown that use of mother’s milk in very low birth weight infants is associated with a reduction in necrotizing enterocolitis. It is also associated with a reduction in severe infection, improved feeding tolerance and more rapid hospital discharge. Ten years ago, along with our inter-professional colleagues at 21 NICUs in the Greater Toronto and Hamilton areas, we began to examine whether using donor breast milk as a supplement to mother’s milk would improve health outcomes of very low birth weight infants when mother’s milk was not available. (more…)
Author Interviews, CDC, Pediatrics, Salt-Sodium / 08.11.2016

MedicalResearch.com Interview with: Zerleen S. Quader, MPH CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sodium reduction is considered a key public health strategy to reduce cardiovascular disease nationwide, and this study is the latest in ongoing CDC efforts to monitor U.S. sodium intake. Eating habits and taste for salt are established early in life by what children eat. Eating too much sodium can set them up for high blood pressure now and health problems later. Previous evidence suggests that one in nine children already has blood pressure above the normal range, and strong evidence has shown that reducing sodium intake reduces blood pressure – and lowering blood pressure lowers the risk of cardiovascular disease among adults. With voluntary efforts already underway by some manufacturers to lower the sodium and added sugar content in some of their products, these findings help provide a baseline to monitor changes in the food industry, as well as sodium intake among U.S. youth. We examined data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to determine sodium intake by major food category, place and eating occasion. We found that average sodium intake among participants was 3,256 mg, and that doesn’t include salt added at the table. On the day of assessment, nearly 90 percent exceeded the upper level of sodium recommended for a healthy diet. • There were some variations based on age and gender. For example: o Average intake was highest among high school-aged children o Girls had significantly lower daily intake than boys (for example, 2,919 mg versus 3,584 mg) • In addition, we found that ten types of food make up nearly half of youth sodium intake nationwide, including pizza, bread, lunch meats and snack foods. We also analyzed where the foods were obtained and found that approximately 58 percent of sodium comes from store foods, 16 percent from fast food and pizza restaurants and 10 percent from school cafeteria foods. And when we looked at occasion, we discovered that 39 percent of sodium intake was consumed at dinner, 31 percent at lunch, 16 percent from snacks and 14 percent from breakfast. (more…)
Author Interviews, Pediatrics / 08.11.2016

MedicalResearch.com Interview with: Lisa Bailey-Davis, DEd, RD Assistant Professor, Department of Epidemiology and Health Services Research Associate Director, Obesity Institute Geisinger Health Systems Danville, PA 17822 MedicalResearch.com: What is the background for this study? What are the main findings? Response: National data from CDC suggest that 3.1% of 12-17 year olds self-reported using an antidepressant in 2005-2010, however we examined electronic health record orders at a large health system and found that antidepressants are ordered more frequently. Antidepressants were ordered for 7.2% of 13 year olds and 16.6% of 18 year olds in our population-representative data. Five or more cumulative months of antidepressant use was strongly associated with increased body mass index, particularly among older youths. At age 18 years, youth treated with 12 or more months of antidepressants were likely to be 2.1 kg heavier than youth without antidepressants. Depression diagnosis, independent, of antidepressants was also associated with higher body mass index. At age 12 years, youth with at least 1 depression diagnosis had a higher average BMI than youth without such diagnosis. (more…)
Author Interviews, Pediatrics / 08.11.2016

MedicalResearch.com Interview with: Barbara Voigtman, MSN, RN Baby and Child Care Clinical Nurse Specialist, Study Manager Kimberly-Clark Neenah, WI MedicalResearch.com: What is the background for this developmental diapering guide? Response: Changing an infant’s diaper currently is seen as a repetitive, routine task. The Huggies Nursing Advisory Council - a Kimberly Clark-sponsored consulting group made up of experts in neonatal and perinatal nursing, education, occupational therapy, as well as a NICU parent advocate - discovered an unseized opportunity for nurses to integrate, model and educate parents and other caregivers about a broad approach to diapering. This approach incorporates the developmental care model to foster infant/parent bonding as well as support psychological, neuorobiological and psychoemotional needs of the infant in addition to attending to the more commonly addressed physiological needs of the infant related to skin care. Together, the Council undertook an extensive literature review, analyzing more than 500 articles, and found that the majority of existing research focuses on prevention, diagnosis and resolution of diaper dermatitis, but there was no comprehensive resource that addresses all aspects of diapering. As a result, the Council co-authored Every Change Matters™: A Guide to Developmental Diapering Care, the first review to consider diapering care within a comprehensive approach—including skin care, physical development, sensory elements and bonding. (more…)
Author Interviews, End of Life Care, HIV, Pediatrics, Pediatrics / 03.11.2016

MedicalResearch.com Interview with: Maureen E. Lyon PhD Division of Adolescent and Young Adult Medicine, Center for Translational Science/Children’s Research Institute, Children’s National The George Washington University School of Medicine and Health Sciences Washington, District of Columbia MedicalResearch.com: What is the background for this study? Response: Despite policy recommendations to include adolescents with chronic and life-limiting conditions in decision-making about their own end-of-life care, barriers continue in clinical practice, including fear of distressing vulnerable adolescents and providers’ beliefs that these conversations are potentially harmful. (more…)
Allergies, Author Interviews, Pediatrics / 03.11.2016

MedicalResearch.com Interview with: Dr. Daniela Posa, MD Department of Paediatric Pneumology & Immunology Charité–Universitätsmedizin Berlin Berlin, Germany MedicalResearch.com: What is the background for this study? Response: Allergy to house dust mites contributes to chronic rhinitis and asthma in hundreds million children and adults worldwide, causing tremendous health and economic burden in high- and middle-income countries. The disease is caused by antibodies called immunoglobulin E (IgE), it starts in childhood and can be controlled with drugs and allergen avoidance. However, there is no cure, hence primary and secondary prevention of mite allergy is a global research priority. We wanted to discover how allergy to mites starts and evolves and why some children develop more severe sensitization and symptoms than others. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics, Vaccine Studies / 02.11.2016

MedicalResearch.com Interview with: Malini B. DeSilva, MD, MPH Clinician Investigator HealthPartners Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is a retrospective study of more than 324,000 live births at seven Vaccine Safety Datalink sites between 2007 and 2013 which showed that the Tdap vaccine in pregnant mothers was not associated with increased risk for microcephaly or other major birth defects in their offspring. (more…)
Author Interviews, Pediatrics, Race/Ethnic Diversity / 01.11.2016

MedicalResearch.com Interview with: Jennifer Howse, Ph.D. President of the March of Dimes Foundation MedicalResearch.com: What is the background for this study? What are the main findings? Response: The March of Dimes Premature Birth Report Card was created in 2007 to raise awareness of the unfair burden of preterm birth in certain communities and geographic areas in the United States. We also want to monitor progress, or lack of it, towards our goal to lower the national preterm birth rate to 8.1 percent by 2020 and to 5.5 percent by 2030. This year’s Report Card finds that, for the first time in eight years, the nation’s preterm birth rate did not decline – it worsened from 9.57 percent of all live births in 2014 to 9.63 percent in 2015, earning the nation a “C” grade. Seven states -- Arkansas, Connecticut, Idaho, Nebraska, New Mexico, Utah, and Wisconsin – received worse grades this year than last year on the Report Card. The March of Dimes strives for a world where every baby has a fair chance for a full-term pregnancy and a healthy birth, yet this is not the reality for many mothers and babies. The 2016 Report Card shows that babies in this country have different chances of surviving and thriving simply based on the circumstances of their birth. (more…)