Air Pollution Linked To Increased Respiratory Infections in Kids

MedicalResearch.com Interview with:

Benjamin D. Horne, PhD Director of Cardiovascular and Genetic Epidemiology Intermountain Heart Institute Intermountain Medical Center Salt Lake City, Utah 

Dr. Horne

Benjamin D. Horne, PhD
Director of Cardiovascular and Genetic Epidemiology
Intermountain Heart Institute
Intermountain Medical Center
Salt Lake City, Utah 

MedicalResearch.com: What is the background for this study?

Response: Evidence suggests that short-term elevations (even for just a few days) of fine particulate matter air pollution (PM2.5, which is particulate matter less than 2.5 um or about one-thirtieth the diameter of a human hair) is associated with various poor health outcomes among adults, including myocardial infarction, heart failure exacerbation, and worsening of chronic obstructive pulmonary disease symptoms. Studies of long-term exposure to moderately elevated levels of PM2.5 indicate that chronic daily air pollution exposure may contribute to death due to pneumonia and influenza.

Research regarding the association of short-term elevations in PM2.5 has provided some limited evidence of a possible association between short-term PM2.5 increases and infection with respiratory syncytial virus (RSV) or bronchiolitis in children, but scientifically these reports have been weak and unreliable, probably because they have only looked at a period of a few days to a week after short-term PM2.5 elevations. An evaluation of a very large population in a geographic location that provides a wide variation in PM2.5 levels from lowest to highest levels and that examines longer periods of time after the PM2.5 elevations is needed to determine whether a PM2.5 association with lower respiratory infection exists.

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PCPs Need More Training In Assessing and Treating Irritability in Children

MedicalResearch.com Interview with:
Anna Scandinaro
Medical student
Penn State College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called “What is irritability?” which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5.

The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations.

In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful.  Continue reading

Eating Disorders Raise Risk of Being Bullied

MedicalResearch.com Interview with:

Tracy Vaillancourt, Ph.D. Full Professor and Canada Research Chair Children’s Mental Health and Violence Prevention Counselling Psychology, Faculty of Education  School of Psychology, Faculty of Social Sciences  University of Ottawa

Dr. Vaillancourt

Tracy Vaillancourt, Ph.D.
Full Professor and Canada Research Chair
Children’s Mental Health and Violence Prevention
Counselling Psychology, Faculty of Education
School of Psychology, Faculty of Social Sciences
University of Ottawa

MedicalResearch.com: What is the background for this study?

Response: Although there have been a few studies that have looked at the relation between being bullied and disordered eating, most studies have looked at it from the perspective of does being bullied lead to disordered eating and does depressive symptoms mediate (i.e., explain) the link. We wanted to look more closely at how bullying, disordered eating, and depression were related over time among teenagers by examining all possible pathways.

Another novel aspect of our study was the focus on disordered eating behaviour only (e.g., vomiting, using diet pills, binge eating). Most previous work has examined behaviour and thoughts together, but because disordered eating thoughts are so common (termed normative discontent; e.g., fear of fat, dissatisfaction with body shape or size), particularly among girls and women, we wanted to focus on behaviour, which is more problematic in terms of physical and psychiatric health.

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Prenatal Exposure to SSRIs May Be Linked to Changes in Infant Brain Development

MedicalResearch.com Interview with:

Jiook Cha, PhD Assistant Professor Division of Child and Adolescent Psychiatry  Columbia University Medical Center  New York, NY 10032

Dr. Jiook Cha

Jiook Cha, PhD
Assistant Professor
Division of Child and Adolescent Psychiatry
Columbia University Medical Center
New York, NY 10032

MedicalResearch.com: What did we already know about the connection between maternal SSRI use during pregnancy and infant brain development, and how do the current study findings add to our understanding? What’s new/surprising here and why does it matter for mothers and babies?

Response: Prior studies have shown mixed results in terms of the associations between maternal SRI use during pregnancy and offspring’s brain and cognitive development. Neurobiological studies with animal models suggest that SSRI use perturbs serotonin signaling and that this has important effects on cognitive development (a study conducted an author of this paper, Jay Gingrich, MD, PhD: Ansorge et al., 2004, Science). The human literature has been more mixed in terms of the associations of prenatal exposure to SSRI with brain and cognitive development.

In our study, we used neonatal brain imaging because this is a direct, non-invasive method to test associations between SSRI use and brain development at an early developmental stage, limiting the effects of the post-natal environment. In our study, we had two different control groups, that is, a non-depressed SSRI-free group (healthy controls), and depressed but SSRI-free (SSRI controls) group. Also, in our study we used rigorous imaging analytics that significantly improve the quantitative nature of MR-derived signals from the brain structure using two of the nation’s fastest supercomputers (Argonne National Laboratory and Texas Advanced Computing Center) and allows robust reconstruction of brain’s grey and white matter structure in the infants’ brains.

We report a significant association of prenatal exposure to SSRI with a volume increases within many brain areas, including the amygdala and insula cortex, and an increase in white matter connection strength between the amygdala and insular cortex. We were surprised by the magnitude of the effects (or the statistical effect size), compared with other brain imaging studies in psychiatry with children or adults’ brains. Importantly, it should be noted that our estimates of brain structure are still experimental and for research-purpose only. This means that our data need to be replicated and rigorously tested against confounders in order to make a firm conclusion. While our study suggests a “potential” association between prenatal exposure to SSRI and a change in fetal or infant brain development, we still need more research. 

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Trained Rats Detect TB Better Than Microscopy

MedicalResearch.com Interview with:

Howard Burditt / Reuters The rats have been used to to detect land mines in Africa.

Howard Burditt / Reuters
The rats have been used to to detect land mines in Africa.

Georgies Mgode PhD
Sokoine University of Agriculture
Pest Management Centre
African Centre of Excellence for Innovative Rodent Pest Management and Biosensor Technology Development
Morogoro, Tanzania

MedicalResearch.com: What is the background for this study?

Response: The background of this study is the APOPO and Sokoine University of Agriculture together with NIMR and NTLP interest to explore a cheap, reliable and sustainable means of addressing TB problem in high-burden countries with limited access to advanced sensitive tests. This refers to countries where to-date TB diagnosis is mainly by microscopy that is less sensitive leaving majority of patients undetected. We were driven to explore how these rats can contribute to diagnosis of TB in children that is known to be difficult and rats are known to have a better and advanced sense of smell. According to WHO ” an estimated 1 million children became ill with TB and 250 000 children died of TB in 2016 and the actual burden of TB in children is likely higher given the challenge in diagnosing childhood TB.  Continue reading

Do Rear-Facing Car Seats Protect Children From Rear Crashes?

MedicalResearch.com Interview with:

Julie Mansfield straps a doll into a car seat. Rear-facing car seats are known to protect children in front and side impact crashes, but are rarely discussed in terms of rear-impact collisions. In a new study, researchers at The Ohio State University Wexner Medical Center explored the effectiveness of rear-facing car seats in rear-impact accidents by conducting crash tests with different car seat types and features.

Julie Mansfield straps a doll into a car seat. Rear-facing car seats are known to protect children in front and side impact crashes, but are rarely discussed in terms of rear-impact collisions. In a new study, researchers at The Ohio State University Wexner Medical Center explored the effectiveness of rear-facing car seats in rear-impact accidents by conducting crash tests with different car seat types and features.

Julie Mansfield, Lead author
Research engineer
Injury Biomechanics Research Center
Ohio State College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Parents and caregivers often understand that a rear-facing car seat will support the head, neck, and spine during frontal impacts. In frontal impacts, the child will simply be cradled and supported by the shell of the car seat as crash forces “pull” the child toward the front of the vehicle. However, caregivers often ask how a rear-facing car seat would work if the vehicle is struck from behind. In that case, crash forces might “pull” the occupant toward the rear of the vehicle. In this case, they wonder whether the head and neck of the rear-facing child would be supported.

Injuries to children in rear impact crashes are fairly rare. However, we wanted to run some crash tests so we could see exactly what was happening in these scenarios. With these data, we can better explain to caregivers how rear-facing car seats work in this type of crash.

We exposed four different models of rear-facing car seats to a moderate severity rear-impact crash pulse. All were installed on a recent model year vehicle seat. We used crash test dummies representing a one-year-old child and a three-year-old child.

We found that the rear-facing car seats protected the crash test dummy well when exposed to a typical rear impact. The car seats supported the child throughout the crash and still did their job to keep the head, neck, and spine aligned. A lot of the crash energy was absorbed through the car seat interacting with the vehicle seat, so that reduced the amount of energy transferred into the occupant. This is important in preventing injuries.  Continue reading

Current Lead Levels in Flint Michigan Children at Historic Lows

MedicalResearch.com Interview with:

Dr. Hernan F. Gomez MD Department of Emergency Medicine, Hurley Medical Center, Flint, MI Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 

Dr. Gomez

Dr. Hernan F. Gomez MD
Department of Emergency Medicine, Hurley Medical Center
Flint, MI
Department of Emergency Medicine, University of Michigan
Ann Arbor, MI 

MedicalResearch.com: Why did you decide to do this study?

Response: Although the Flint water crisis drew recent, national attention to childhood lead exposure, environmental lead exposure has been a longtime, widespread problem in the United States.

I have recollections of far higher blood lead levels in children during my training as a young pediatrician in an economically challenged city with roughly the same population as Flint. As a medical toxicologist I have not seen any children with lead levels requiring medical treatment in years. The last time a child required inpatient chelation treatment for elevated lead levels in Flint was during the 1980s.

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Study Finds Opportunities for Improvement to Pediatric Healthcare in Australia

MedicalResearch.com Interview with:

Professor Jeffrey Braithwaite, PhD Dr. Braithwaite is founding director of the Australian Institute of Health Innovation at Macquarie University and Chief Investigator of the just-published CareTrack Kids Study the largest study of the quality of care to children ever undertaken.

Prof. Braithwaite

Professor Jeffrey Braithwaite, PhD
Dr. Braithwaite is founding director of the Australian Institute of Health Innovation at Macquarie University and Chief Investigator of the just-published CareTrack Kids Study the largest study of the quality of care to children ever undertaken.

MedicalResearch.com: What is the background for this study?  

Response: While seeking to improve health outcomes for patients, there has been substantial investment in developing clinical practice guidelines, to support the delivery of evidence-based healthcare. Prior to the CareTrack Kids study, little was known about the level of adherence to clinical practice guidelines for the care of Australian children.

Our study examined care provided to children under 16 years of age treated for 17 important clinical conditions, such as asthma or fever, to assess adherence to these guidelines. We surveyed over 6500 medical records in four clinical settings (general practices; paediatricians offices; hospital emergency departments; and hospital inpatient wards) in South Australia, New South Wales and Queensland, and assessed visits during 2012 and 2013.  Continue reading

Full-Term Infant Deaths in US Remain High, Many From Suffocation

MedicalResearch.com Interview with:

Neha Bairoliya, Ph.D. Harvard Center for Population and Development Studies Cambridge, MA 02138

Dr. Bairoliya

Neha Bairoliya, Ph.D.
Harvard Center for Population and Development Studies
Cambridge, MA 02138

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: While the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates.

In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births. We show that infants born full-term in the US face 50%-200% higher risks of infant mortality compared to leading European countries.

The two main drivers of these high relative risks are increased risk of mortality due to congenital malformations, which patients cannot really do much about other than ensuring adequate screening during pregnancy, and high risk of sudden unexpected deaths in infancy, which should largely be preventable through appropriate sleeping arrangements. While we do not have data on actual sleeping arrangements from our study, other data sources suggest that a substantial number of babies continue to sleep on their tummy; we also found a shockingly large number of babies dying from suffocation, which suggests that parents either use covers that are not safe, or let children sleep in their own beds.

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TBI Predisposes Kids To Attention Deficit Problems, Even Years After Injury

MedicalResearch.com Interview with:
Dr. Megan E. Narad, PhD

Division of Behavioral Medicine and Clinical Psychology
Cincinnati Children’s Hospital Medical Center | CCHMC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has shown that children with a history of traumatic brain injury (TBI) demonstrate difficulties with attention following injury; however, most studies only follow children 2-3 years after injury. Our study followed a group of children with a history of TBI 7-10 years after injury.

The main finding is that those with severe TBI were at greater risk for developing secondary attention deficit hyperactivity disorder (SADHD) than those with orthopedic injury; however, it should also be noted that kids with less severe injuries were also at risk of developing SADHD. In addition to injury severity, environmental factors (maternal education and family functioning) also played a role in SADHD development. It should also be noted that a number of kids developed SADHD >3.5 years after injury suggesting that these difficulties may not surface until many years after injury.

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