Author Interviews, Pediatrics, Sleep Disorders / 09.05.2016

MedicalResearch.com Interview with: Jean-Philippe Chaput, Ph.D. Assistant Professor of Pediatrics, University of Ottawa Research Scientist, Healthy Active Living and Obesity Research Group Children’s Hospital of Eastern Ontario Research Institute Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chaput: Folklore has associated behaviors of animals and humans, and even werewolves, to moon phases of the lunar cycle. However, the empirical evidence that the moon exerts an influence on behaviors is weak and very limited. In order to verify if the full moon is associated with sleep and physical activity of children (and possibly debunk this myth), we used a 12-country study involving 5,812 participants and providing 33,710 24-hour accelerometer recordings of sleep and activity behaviors. Overall, we observed that sleep duration was 5 minutes (1%) shorter at full moon compared to new moon, while activity behaviors were not significantly associated with the lunar cycle in this global sample of children drawn from all inhabited continents. However, the magnitude of this effect on sleep duration is unlikely to be clinically significant from a public health standpoint and people should stop worrying about the full moon. (more…)
Author Interviews, Flu - Influenza, OBGYNE, Pediatrics, Vaccine Studies / 09.05.2016

MedicalResearch.com Interview with: Julie H. Shakib, DO, MS, MPH Assistant Professor of Pediatrics | University of Utah Medical Director | Well Baby and Intermediate Nursery Salt Lake City  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Shakib: Immunization against influenza in the first six months of life is ineffective  due to an immature immune response. Passive protection via maternal immunization offers an alternative but only a few studies have evaluated the efficacy of this immunization strategy. We found that in infants born to women immunized against influenza during pregnancy, the risk of laboratory-confirmed influenza and influenza-related hospitalization were reduced by 70% and 81% in their first 6 months of life, respectively.This large study provides more evidence that when women are immunized against influenza during pregnancy, their infants are much less likely to be diagnosed with influenza in their first 6 months. (more…)
Author Interviews, Columbia, Pediatrics, Vaccine Studies / 06.05.2016

MedicalResearch.com Interview with: Melissa Stockwell, MD, MPH, FAAP Florence Irving Associate Professor of Pediatrics and Population and Family Health Columbia University - College of Physicians & Surgeons and Mailman School of Public Health Medical Director, New York-Presbyterian Hospital Immunization Registry (EzVac) Co-Director, Primary Care Clinician Research Fellowship in Community Health New York, NY 10032  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Stockwell: Fragmentation of immunization records place children at risk for underimmunization and overimmunization. Nearly all 50 states, 5 cities, and the District of Columbia operate an immunization information system, which is a system that collects and centralizes immunization data for children and adolescents from immunization providers at a regional or state level. More than 75% of US office-based physicians have adopted an electronic health record (EHR), but until recently, clinicians wanting to access patient immunization information in an IIS generally had to manually look up the patient data on a state or local IIS website, that data was not available to them within their own EHR. In this study, we demonstrated that exchange of immunization information between an immunization information system (IIS) and an EHR at point of care had a significant impact on up-to-date rates, overimmunization, and immunization record completeness for low-income, urban children and adolescents. (more…)
Author Interviews, Microbiome, Nutrition, Pediatrics, Weight Research / 05.05.2016

MedicalResearch.com Interview with: Jacob (Jed) E. Friedman, Professor, Ph.D. Department of Pediatrics, Biochemistry & Molecular Genetics Director, NIH Center for Human Nutrition Research Metabolism Core Laboratory University of Colorado Anschutz MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scientists have long established that children who are breastfed are less likely to be obese as adults, though they have yet to identify precisely how breastfeeding protects children against obesity. One likely reason is that children who are breastfed have different bacteria in their intestines than those who are formula fed. The study, published Monday in the American Journal of Clinical Nutrition examines the role of human milk hormones in the development of infants’ microbiome, a bacterial ecosystem in the digestive system that contributes to multiple facets of health. “This is the first study of its kind to suggest that hormones in human milk may play an important role in shaping a healthy infant microbiome,” said Bridget Young, co-first author and assistant professor of pediatric nutrition at CU Anschutz. “We’ve known for a long time that breast milk contributes to infant intestinal maturation and healthy growth. This study suggests that hormones in milk may be partly responsible for this positive impact through interactions with the infant’s developing microbiome.” Researchers found that levels of insulin and leptin in the breastmilk were positively associated with greater microbial diversity and families of bacteria in the infants’ stool. Insulin and leptin were associated with bacterial functions that help the intestine develop as a barrier against harmful toxins, which help prevent intestinal inflammation. By promoting a stronger intestinal barrier early in life, these hormones also may protect children from chronic low-grade inflammation, which can lead to a host of additional digestive problems and diseases. In addition, researchers found significant differences in the intestinal microbiome of breastfed infants who are born to mothers with obesity compared to those born to mothers of normal weight. Infants born to mothers with obesity showed a significant reduction in gammaproteobacteria, a pioneer species that aids in normal intestinal development and microbiome maturation. Gammaproteobacteria have been shown in mice and newborn infants to cause a healthy amount inflammation in their intestines, protecting them from inflammatory and autoimmune disorders later in life. The 2-week-old infants born to obese mothers in this study had a reduced number of gammaproteobacteria in the infant gut microbiome. (more…)
Author Interviews, Pediatrics, Vitamin D / 02.05.2016

MedicalResearch.com Interview with: Hope Weiler, RD (CDO), PhD Associate Professor Canada Research Chair tier I, Nutrition and Health Across the Lifespan, Director, Mary Emily Clinical Nutrition Research Unit School of Dietetics and Human Nutrition McGill University Macdonald Campus Ste Anne de Bellevue, QC  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Weiler: Vitamin D is a fat soluble with important functions in growth during infancy and childhood, especially for the skeleton. It is for this reason that many policy recommendations for infants stipulate that newborn infants receive a supplemental form of vitamin D. In Canada, it is recommended by Health Canada (www.hc-sc.gc.ca) that newborn infants receive 400 international units of vitamin D from birth to a year of age or until that amount can be obtained from diet. In Canada, older children and adults can make vitamin D when their skin is exposed to direct sunlight between April and October; however, parents are advised to avoid placing their infants in direct sunlight. Thus supplemental vitamin D is particularly important in infancy. Often newborn infants begin life with low body stores of vitamin D (Weiler and colleagues, CMAJ 2005). This prompted Dr. Weiler’s research group at McGill University to test how much vitamin D is needed by newborn infants in Canada. They learned that 400 to 1200 international units of vitamin D given daily to healthy term born infants is enough to support healthy bone growth and mineral deposition (Gallo and colleagues, JAMA 2013). In conducting tests of bone health, they also learned that the amount of muscle was enhanced and fat reduced when infants had very good vitamin D stores. Vitamin D stores are reflected in the blood. Blood concentrations of a vitamin D form called 25-hydroxyvitamin D are used to establish if stores are in a healthy range. In the recent study published in Pediatric Obesity by Hazell et al, values above 75 nanomoles per litre of blood plasma were linked to lower amounts of body fat (~450 g) at 3 years of age. The 450 g difference is almost a pound of fat. This is a meaningful amount to young children where typical amounts of body fat are 10-times that equating to 4.5 kg (almost 10 pounds). Thus the lower fat is still in a healthy range. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 02.05.2016

MedicalResearch.com Interview with: Zachary Y. Kerr, PhD, MPH Sports Injury Epidemiologist Director, NCAA Injury Surveillance Program Datalys Center for Sports Injury Research and Prevention Indianapolis, IN 46202 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kerr: A 2013 Institutes of Medicine report called for more research on concussion in athletes aged 5-21 years.  Although there is much research on the incidence of concussion across this age span, there is less related to outcomes such as symptoms and return to play time, let along comparisons by age. In examining sport-related concussions that occurred in youth, high school, and college football, we found differences in the symptomatology and return to play time of concussed players.  For example, the odds of return to play time being under 24 hours was higher in youth than in college.  Also, over 40% of all concussions were returned to play in 2 weeks or more. (more…)
Author Interviews, Depression, Mental Health Research, OBGYNE, Pediatrics, Pharmacology / 02.05.2016

MedicalResearch.com Interview with: Heli Malm, MD, PhD Specialist in Obstetrics and Gynecology Teratology Information Service Helsinki University and Helsinki University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Malm: Animal studies have demonstrated that exposure to SSRIs during early brain development can result in depression-like behavior in adolescence. Today 6% of pregnant women in the US and 4% in Finland are on selective serotonin reuptake inhibitors (SSRIs) at some stage of pregnancy. SSRIs pass the placenta but no prior studies have followed children beyond childhood to monitor the development of depressive disorders, which typically emerge after puberty onset. Results on autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorders (ADHD) have been conflicting. The study material is based on national register data from Finland. We investigated offspring psychiatric diagnoses, including depression, anxiety, ASD, and ADHD, of nearly 16,000 mothers who had used SSRIs during pregnancy between 1996 and 2010. Children in this cohort ranged in age from 0 to 15 years old. Because maternal psychiatric illness can affect offspring neurodevelopment in the absence of SSRIs, primary comparisons were made between offspring of the SSRI group and offspring of mothers with a psychiatric disorder diagnosis but no antidepressant use. Children exposed to SSRIs during gestation were diagnosed with depression at an increasing rate after age 12, reaching a cumulative incidence of 8.2% by age 15, compared to 1.9% in the group of children exposed to maternal psychiatric illness but no antidepressants. Rates of anxiety, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) diagnoses did not differ significantly between the two groups. (more…)
Author Interviews, JAMA, Nutrition, Pediatrics / 01.05.2016

MedicalResearch.com Interview with: Stephen B. Freedman MDCM, MSc, Associate Professor Department of Paediatrics, Sections of Emergency Medicine and Gastroenterology; ACHRI Healthy Outcomes Theme Group Leader Alberta Children’s Hospital, and Alberta Children’s Hospital Research Institute University of Calgary, Calgary, Canada MedicalResearch.com: What is the background for this study? Dr. Freedman: As a pediatric emergency medicine physician I continue to see large numbers of children who are brought for emergency care because of vomiting and diarrhea. In speaking with their caregivers it is clear that many of them try to administer electrolyte maintenance solutions at home but the children either refuse to drink them or they continue to vomit. As a researcher I have noticed that many children continue to receive intravenous rehydration despite not being significantly dehydrated and it appeared that this was often a physician’s response to a failed oral rehydration challenge in the emergency department, either due to refusal to consume the electrolyte maintenance solution supplied or because the children became more nauseous due to the poor palatability of the solution. It appeared that perhaps a less dogmatic approach aimed at providing fluids that children actually like, might overcome these problems leading to improved outcomes. MedicalResearch.com: What are the main findings? Dr. Freedman: Children with mild gastroenteritis and minimal dehydration experienced fewer treatment failures when offered dilute apple juice followed by their preferred fluid choice compared with those instructed to drink electrolyte maintenance solution to replace fluid losses. We found the benefit was greatest in those 24 to 60 months of age. The group provided and instructed to take their preferred fluids were administered intravenous rehydration less frequently. (more…)
Author Interviews, Autism, Pediatrics, Toxin Research / 01.05.2016

MedicalResearch.com Interview with: Steven Daniel Hicks, M.D., Ph.D. Penn State Hershey Medical Group Hope Drive, Pediatrics Hershey, PA 17033  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Hicks:  This research was inspired by results of the CHARGE study (examining environmental influences on autism) which showed that specific pesticides (including pyrethroids) increased the risk of autism and developmental delay, particularly when mothers were exposed in the 3rdtrimester. We recognized that the department of health sprayed pyrethroids from airplanes in a specific area near our regional medical center every summer to combat mosquito borne illnesses. We asked whether children from those areas had increased rates of autism and developmental delay. We found that they were about 25% more likely to be diagnosed with a developmental disorder at our medical center than children from control regions without aerial spraying of pyrethroids. (more…)
Author Interviews, Education, Pediatrics, Pediatrics / 29.04.2016

MedicalResearch.com Interview with: Jorijn Hornman, BSc (MD PhD student) Departments of Health Sciences University Medical Center Groningen University of Groningen, Netherlands MedicalResearch.com: What is the background for this study? Response: Preterm children are at increased risk of emotional and behavioral problems compared to full-term children. Prevalences vary with degree of prematurity and assessment age. Unknown was whether stability of these problems upon school entry differs between preterm and full-term children. MedicalResearch.com: What are the main findings? Response: We found that preterm children had higher rates than full-term children of persistent (7.2% versus 3.6%), emerging (4.3% versus 2.3%), and resolving (7.5% versus 3.6%) emotional and behavioral problems. Early preterm children –born at <32 weeks gestation- had the highest rates of persistent (8.2%) and emerging (5.2%) problems, and moderately preterm children –born at 32-35 weeks gestation- the highest rates of resolving problems (8.7%). (more…)
Author Interviews, Pediatrics, Pharmacology / 29.04.2016

MedicalResearch.com Interview with: Jonathan Slaughter, MD, MPH Assistant Professor of Pediatrics Center for Perinatal Research Nationwide Children's Hospital/The Ohio State University Columbus, OH 43205  MedicalResearch.com: What is the background for this study? Dr. Slaughter:   Increasing data has emerged over the last decade showing potential harm following acid suppression use in newborns, older children, and adults.  There are virtually no published data that show acid suppression via histamine-2-receptor antagonists (H2RAs) or proton-pump inhibitors (PPIs) is effective for gastroesophageal reflux disease (GERD) treatment or for other indications (stress ulcer prophylaxis, post-operative acid suppression) in healthy or sick newborns. Given the potentially limited effectiveness of these medications and increasing safety concerns following H2RA/PPI use in infants, we wanted to evaluate the frequency and duration of H2RA/PPI use among infants hospitalized within US children's hospital neonatal intensive care units (NICUs) to determine if these drugs appeared to be overused and if use appears to have changed over time.  We also evaluated neonatal diagnoses associated with acid suppression to identify targets for future studies that may evaluate the usefulness of acid suppression in neonates following a given diagnosis. (more…)
Author Interviews, Pediatrics, Weight Research / 29.04.2016

MedicalResearch.com Interview with: Ashley Wendell Kranjac, PhD Department of Sociology and Kinder Institute for Urban Research Rice University Houston, Texas and Robert L. Wagmiller, Jr. Associate Professor Department of Sociology Temple University Philadelphia, PA 19122 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Center for Disease Control recently reported a decline in child obesity amongst 2-to5-year old children between 2003/4 and 2011/12 (see, Ogden et al. 2014). We aimed to identify the sources of this decline because this change occurred in a relatively short period of time. What we found is that the decline in obesity did not occur due to the things that you might expect like changes in physical activity or dietary practices (although there were some differences in these factors across years). But, rather, what we found is that because there were differences in obesity rates for the youngest and oldest children in this age range in 2003/4, but not in 2011/12, that the decline in obesity exists. In other words, because the oldest children in 2003/4 had significantly higher obesity rates than the youngest children in this time period, but this effect is not observable in 2011/12, we see a decline in obesity. (more…)
Accidents & Violence, Author Interviews, Global Health, Pediatrics / 27.04.2016

MedicalResearch.com Interview with: Prof Naeemah Abrahams South African Medical Research Council Chief  Specialist Scientist:  Gender & Health Research Unit Cape Town | Western Cape MedicalResearch.com: What is the background for this study? What are the main findings? Prof Abrahams: Violence is a common feature of the South African social landscape and the murder of children is the most severe form of violence against children.  A national child homicide study reflecting 2009 murdered was done. Information was collected from mortuaries and police detectives. We identified the demographic detail of the child, the perpetrator information (if available) and the motive of the killings. In this manuscript we look in greater detail at children under the age of 5 years as this group represent the 2nd largest group of children killed. We also have a focus on neonaticides. We estimated that 454 children under the age of 5 years were killed in South Africa in 2009. This means more than 1 young child killed per day. The study showed the first 6 days of life are the time point of highest risk for being killed among children under 5 years with more than half (53.2%) of the children killed within the 1st month of their lives and nearly two thirds of the children (74.4%)  killed as infants.  This is amongst the highest reported rates for neonaticide and infanticide. Parents, in particular mothers, were the most common perpetrator of the younger children – this is most likely due to them being responsible for the care of young children. (more…)
Author Interviews, Education, Pediatrics, PNAS, Social Issues / 26.04.2016

MedicalResearch.com Interview with:

Joan L. Luby, MD Samuel and Mae S. Ludwig Professor of Child Psychiatry Director, Early Emotional Development Program Washington University School of Medicine St. Louis, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Luby: The study was designed to investigate brain development in early onset mental disorders. The main findings validate depression in preschoolers with brain change evident this young similar to that known in adults. We also found effects of maternal support on brain development in this process which is what the current paper focuses on . (more…)
Accidents & Violence, Author Interviews, Pediatrics, Toxin Research / 25.04.2016

MedicalResearch.com Interview with: Dr. Gary Smith, MD PhD Director, Center for Injury Research and Policy Nationwide Children's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Smith: Laundry detergent packets are relatively new to the U.S. market (introduced in 2012). As their popularity has increased, so have calls to poison centers for detergent packet exposures. The study analyzed calls to poison centers and compared exposures to young children from dishwasher and laundry detergent packets as well as traditional (liquid and powder) dishwasher and laundry detergents. Incidents related to laundry detergent packets saw the biggest rise - increasing 17% over the two-year study period. Poison control centers received more than 30 calls a day on average about a child who had been exposed to a laundry detergent packet, which is about one call about every 45 minutes. Claims made by others that the rate of exposures is decreasing are misleading – these claims are based on an inappropriate use of numbers. Children exposed to laundry detergent packets were significantly more likely to be admitted to a healthcare facility or have a serious medical outcome than those exposed to other types of detergent. They were also more likely to have serious clinical effects. Coma, pulmonary edema, respiratory arrest, and death were only observed among children exposed to laundry detergent packets. (more…)
AACR, Author Interviews, Breast Cancer, Cancer Research, Pediatrics, Radiation Therapy / 25.04.2016

MedicalResearch.com Interview with: Lindsay M. Morton, PhD Senior investigator in the Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetic National Cancer Institute Bethesda, Maryland MedicalResearch.com: What is the background for this study? Dr. Morton: We know that childhood cancer survivors, particularly those who received radiotherapy to the chest, have strongly increased risk of developing breast cancer. We studied about 3,000 female survivors of childhood cancer to identify whether inherited genetic susceptibility may influence which survivors go on to develop breast cancer. MedicalResearch.com: What are the main findings? Dr. Morton: In this discovery study, we found that specific variants in two regions of the genome were associated with increased risk of breast cancer after childhood cancer among survivors who received 10 or more gray of chest radiotherapy. A variant at position q41 on chromosome 1 was associated with nearly two-fold increased risk and one at position q23 on chromosome 11 was associated with a more than three-fold increased risk for each copy of the risk alleles. However, the variant alleles didn’t appear to have an effect among survivors who did not receive chest radiotherapy. (more…)
Author Interviews, BMJ, Heart Disease, Pediatrics / 25.04.2016

MedicalResearch.com Interview with: Hans Van Brabandt, M.D. Brussel, Belgium MedicalResearch.com: What is the background for this study? Dr. Van Brabandt: We have been asked by the Belgian government to assess the benefits and harms of pre-participation screening of young athletes. A number of Belgian cardiologists and screening physicians are intensely promoting such screening through mass media and were asking governmental support. MedicalResearch.com: What are the main findings? Dr. Van Brabandt:  There is no solid evidence on the benefit of cardiovascular pre-participation screening, and certainty of harms it induces through numerous false-positives, making that such screening in young athletes cannot be defended. -          Italian investigators assert they have provided evidence for the benefit of screening. The single study on which they base their claim however is far from convincing. Unfortunately, more than 10 years after their first paper, they still did not make the majority of their data publicly available. (more…)
Author Interviews, Global Health, Pediatrics / 23.04.2016

MedicalResearch.com Interview with: Janet Currie Henry Putnam Professor of Economics and Policy Affairs Chair, Department of Economics Director, Center for Health and Wellbeing Princeton University Princeton NJ 08544 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many recent studies point to increasing inequality in mortality in the United States over the past 20 years. These studies often use mortality rates in middle and old age. This is the first study to examine mortality trends for younger ages.  We find that for infants, children and young adults below age 20, however, there have been strong mortality improvements that were most pronounced in poorer counties, implying a strong decrease in mortality inequality. There is a great deal of evidence from past studies that healthier children grow up to be healthier adults.  These current young people will form the future adult U.S. population, so this research suggests that inequality in middle and old-age mortality may have peaked and is likely to decline as these cohorts become older. (more…)
Author Interviews, Nutrition, Pediatrics / 21.04.2016

MedicalResearch.com Interview with: Juliana F.W. Cohen, ScD, ScM Merrimack College, Department of Health Sciences North Andover MA 01845 Adjunct Assistant Professor of Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Dr. Cohen: Back in 2012, Massachusetts enacted both the updated USDA standards for school meals and healthier standards for snacks in schools that were similar to the upcoming, fully implemented national "Smart Snacks" standards.  We examined the impact of these standards on school food revenues and school meal participation. MedicalResearch.com: What are the main findings? Dr. Cohen: After schools had time to acclimate to the changes, schools revenues remained high. While students spent less money on snacks, more children were now participating in the lunch program so school food revenues were not impacted long-term. (more…)
Author Interviews, Diabetes, Metabolic Syndrome, OBGYNE, Pediatrics, University Texas, Weight Research / 21.04.2016

MedicalResearch.com Interview with: Antonio Saad, MD Fellow in Maternal Fetal Medicine & Critical Care Medicine University of Texas Medical Branch at Galveston MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Saad: Recently the WHO announced an alarming news, the prevalence of diabetes has increased four fold in the past quarter-century. The major factors attributed for this increase included excessive weight, and obesity. In the US alone, two thirds of people are either overweight or obese. There are shocking numbers that should alert physicians, patients and government officials for awareness and interventions that we can alter the path away from this drastic epidemic. In light of recent events, our group strongly believes that poor diet during pregnancy predisposes offspring in adult life to develop obesity and diabetes through fetal programming. High fructose introduction into our food chain has coincided with the obesity and diabetes epidemics. Hence, we designed an animal study where we fed pregnant mice with either regular diet or high fructose diet until delivery. Then we looked at the offspring, at 12 months of age. We looked at  their blood pressure, glucose tolerance tests, insulin resistance,  and weights. We also tested for serum marker of metabolic dysfunction and used computed tomography imaging to assess for liver fat infiltration and percent visceral adipose tissue. To our surprise, these offspring (mothers were fed high fructose diet) developed several features of metabolic syndrome.  Female offspring’s cardiovascular and metabolic function at one year of age (adulthood) had increased weight, blood pressure, visceral adiposity, liver fat infiltrates and  insulin resistance with impaired glucose tolerance).  The  male counterparts were limited to high blood pressure  and glucose intolerance. Keeping in mind that the amount of fructose given to these animals were equivalent to daily soda cans consumption in humans. (more…)
Author Interviews, JAMA, Pediatrics, Surgical Research / 18.04.2016

MedicalResearch.com Interview with: Thomas J. Sandora, M.D., M.P.H. Senior Associate Physician in Medicine; Hospital Epidemiologist; Medical Director, Infection Control Boston Children’s Hospital Associate Professor of Pediatrics, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sandora: Giving antibiotics before certain types of operations results in lower rates of surgical site infections. However, there are limited data about which pediatric operations require antibiotic prophylaxis. We examined national variability in antibiotic prophylaxis for the 45 most commonly performed pediatric operations at children's hospitals in the U.S. We found that antibiotic use was considered appropriate for only 64.6% of cases, with a high degree of variability within procedures and between hospitals. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 18.04.2016

MedicalResearch.com Interview with: Dr. Lara B. McKenzie PhD MA Principal Investigator Center for Injury Research and Policy The Research Institute Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. McKenzie: Skateboarding is a popular recreational sport and participation has increased the last several decades, faster than any other sport or recreation activity between 1998 and 2007 (National Sporting Goods Association Sports Participation in 2007). With growing participation, has come an increasing rate of injuries from skateboarding. The study examined data for youth and adolescents 5-19 years of age who were treated in U.S. emergency departments (EDs) for skateboarding-related injuries from 1990-2008. It found that nationally, over the 19-year period, there was an average of 64,572 children and adolescents treated each year for skateboarding-related injuries – about 176 a day. Most patients were male (89 percent), and were injured either at home (38 percent) or in the street and/or highway (30 percent). The most commonly injured body regions were the upper (45 percent) and lower (32 percent) extremities. The most common diagnoses were fractures or dislocations (33 percent), sprains and strains (25 percent) and bruises (20 percent). Children and adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age. (more…)
Author Interviews, Fertility, OBGYNE, Pediatrics / 15.04.2016

MedicalResearch.com Interview with: Dr. Kieron Barclay PhD Department of Social Policy London School of Economics MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Barclay: Mean age at childbearing has been increasing in most countries in the OECD since the early 1970s. A wealth of research has shown that childbearing at advanced ages is associated with greater difficulty in terms of getting pregnant, higher rates of miscarriage, stillbirth, and increased risk of poor peri-natal outcomes such as pre-term birth and low birth weight. Studies also indicate that the offspring of older mothers have a greater risk of Alzheimer’s disease, diabetes, and mortality in adulthood. However, from the perspective of any individual woman, delaying childbearing to an older age necessarily also means that she will give birth in a later birth year. The last 40 to 50 years have seen substantial improvements in educational opportunities, and better public health conditions and medical knowledge. As a result, these positive secular trends may outweigh or counterbalance the negative effects of reproductive aging for the child. (more…)
Allergies, Author Interviews, JAMA, Pediatrics / 08.04.2016

MedicalResearch.com Interview with: Moshe Ben-Shoshan, MD, M.Sc. Assistant Professor Division of Pediatric Allergy and Clinical Immunology Department of Pediatrics McGill University Health Center Montreal, Quebec, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ben-Shoshan: Given that up to 10% of children treated with amoxicillin are tagged as allergic usually with no confirmatory tests (given high waiting times to see an allergist and controversy regarding confirmatory tests) we aimed to assess the accuracy of the graded provocation challenge (PC) . Unlike previous studies we challenged ALL 818 children presenting with rashes on amoxicillin treatment . We were able to show that almost 95% tolerated the challenge while 17 had immediate reactions (within 1 hour ) and 31 had non immediate reactions . We found that although it is suggested to do skin tests ( with PrePen and pen G ) to diagnose immediate amoxicillin allergy only 1 of 17 had a positive skin test indicating poor sensitivity of this test. In addition among all those with negative challenge that we followed over 3 years 10% had mild skin reactions when they received subsequent full treatment . (more…)
Accidents & Violence, Author Interviews, CDC, Pediatrics, Sleep Disorders / 07.04.2016

MedicalResearch.com Interview with: Anne G. Wheaton, Ph.D. Epidemiologist Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Population Health Epidemiology and Surveillance Branch Atlanta, GA  30341-3717  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Wheaton: Unintentional injury, mostly from motor vehicle crashes, is the leading cause of death for adolescents. Adolescents who do not get enough sleep are at an increased risk for motor vehicle crashes and other unintentional injury, such as sports injuries and occupational injuries. We evaluated the association between self-reported sleep duration on an average school night and several injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) among more than 50 thousand US high school students. The likelihood of each of five injury-related risk behaviors (infrequent bicycle helmet use, infrequent seatbelt use, riding with a driver who had been drinking, drinking and driving, and texting while driving) was significantly higher for students sleeping ≤7 hours on an average school night compared with 9 hours. Infrequent seatbelt use, riding with a drinking driver, and drinking and driving were also more likely for students sleeping ≥10 hours compared to 9 hours on an average school night. Although short and long sleep may simply be associated with other adolescent risk behaviors, insufficient sleep may cause individuals to take more risks and disregard the possibility of negative consequences. However, the study was cross-sectional, meaning the students were asked questions at one time point, so it is not possible to determine if there is a cause and effect association between sleep and these risk behaviors. Insufficient sleep may contribute to injury risk directly by slowing reaction time, impairing ability to pay attention, or causing a driver to fall asleep, but these results provide evidence that some of the increased risk associated with insufficient sleep might be due to engaging in injury-related risk behaviors. (more…)
Author Interviews, BMJ, Cannabis, OBGYNE, Pediatrics / 06.04.2016

MedicalResearch.com Interview with: Cara Christ, M.D., M.S. Director of the Arizona Department of Health Services MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Christ: This study was a systematic review. The purpose of a systematic review is to critically assess and summarize the best available research evidence on a specific issue. This usually involves a critical synthesis of the results of several high quality studies on the issue under review. Overall, this review found that infants exposed to cannabis during pregnancy had a 77% higher likelihood of being underweight (<2500grams) at birth, compared to infants whose mothers did not use cannabis. Also, if the mother used cannabis during pregnancy, the likelihood of her infant needing to be placed in a neonatal intensive care unit was two times higher compared to those infants whose mothers did not use cannabis during pregnancy. (more…)
Author Interviews, CDC, Fertility, OBGYNE, Pediatrics / 06.04.2016

MedicalResearch.com Interview with: Sheree L. Boulet, DrPH, MPH Division of Reproductive Health Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? Dr. Boulet: Findings from some studies have suggested that children conceived with assisted reproductive technology (ART) have increased risks of birth defects compared with spontaneously conceived children. Many of these studies were limited by a small sample size and were unable to assess risks associated with specific ART procedures. MedicalResearch.com: What are the main findings? Dr. Boulet: We found that singleton infants conceived using assisted reproductive technology were 1.4 times more likely to have a non-chromosomal birth defect compared with other infants, and the risks were highest for gastrointestinal and musculoskeletal defects. However, when our study was restricted to only ART-conceived infants, no single procedure substantially increased the risk for birth defects. This suggests that the higher risk of birth defects may be due to underlying issues related to infertility, rather than to ART itself. (more…)
Author Interviews, JAMA, Pediatrics, Social Issues / 05.04.2016

MedicalResearch.com Interview with: Paula Braitstein, PhD Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis Regenstrief Institute Inc, Indianapolis, Indiana MedicalResearch.com: What is the background for this study? Dr. Braitstein: There are vast numbers of children and youth in the world who find themselves in street circumstances. Yet, there is an absence of consensus among academics, policymakers, stakeholders, and international organizations regarding the causes of child and youth street-involvement around the world. Without data concerning these reasons, policies are developed or implemented to mitigate street-involvement without taking these causes into account. Often, the prevailing paradigm assumes that children and youth on the street are juvenile delinquents and the government response is often characterized by social exclusion, criminalization, and oppression by police and civic authorities. Therefore we wanted to find out what reasons do children and youth self-report for their street-involvement globally. MedicalResearch.com: What are the main findings?  Dr. Braitstein: We systematically reviewed the literature and compiled data from 49 studies representing 24 countries globally. Street-connected children and youth most frequently reported poverty, family conflict, and abuse as their reasons for street-involvement. They infrequently identified delinquent behaviours for their circumstances. There were no significant differences between males and females reported reasons, with the exception of females in developed regions who were more likely to report abuse. (more…)
Author Interviews, Pediatrics, Respiratory, Vaccine Studies / 28.03.2016

MedicalResearch.com Interview with: Tasnee Chonmaitree, M.D. Professor, Pediatrics and Pathology Division of Pediatric Infectious Diseases Department of Pediatrics University of Texas Medical Branch Galveston, TX 77555-0371 MedicalResearch.com: What is the background for this study? Dr. Chonmaitree: Respiratory infections are common in infants and young children; they are caused by viruses and/or bacteria. Viral upper respiratory tract infection or the common cold is exceedingly common and leads to bacterial complications such as ear infection, which the leading cause of antibiotic prescription in the US and the most common reason children undergo surgery (ear tube placement). In the past few decades, some bacterial and viral vaccines have become available aiming to reduce respiratory infections in children. MedicalResearch.com: What are the main findings? Dr. Chonmaitree: Our study looked to update information on how often infants in the first year of life acquired the common cold, and ear infection in the new vaccine era. The study was performed between 2009 and 2014 and included 367 infants followed closely from near birth up to one year of age. We found that on average, an infant had about 3 colds in the first year of life, and almost half of infants had ear infection by age 1 year. This was less than what happened in the past few decades. The reduction of ear infection may have been the result of many factors from bacterial and viral vaccine use, to increased breastfeeding rate and reduction in household smoking. Risk factors for ear infection included carriage of bacteria in the nose, frequencies of common cold and lack of breastfeeding. (more…)