Almost 2 Million Children Suffer Traumatic Brain Injury Each Year

MedicalResearch.com Interview with:

Juliet Haarbauer-Krupa, PhD Senior Health Scientist Division of Unintentional Injury Prevention CDC

Dr. Haarbauer-Krupa

Juliet Haarbauer-Krupa, PhD
Senior Health Scientist
Division of Unintentional Injury Prevention
CDC

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

  • Traumatic brain injury in children results in a large number of emergency department visits each year and can result in long term difficulties
  • The purpose of this study was to estimate lifetime prevalence of TBI in children based on a nationally representative sample of U.S. parents/adults and to describe the association between TBI and other childhood health conditions.
  • CDC researchers examined the National Survey of Children’s Health, a cross-sectional telephone survey of U.S. households, to provide a national estimate of TBI in children.

Continue reading

“Head CT Choice” Educates Parents of Children with Mild Head Injury

MedicalResearch.com Interview with:

Erik P. Hess MD MSc Professor and Vice Chair for Research Department of Emergency Medicine UAB Medicine | The University of Alabama at Birmingham Birmingham Alabama 35249

Dr. Hess

Erik P. Hess MD MSc
Professor and Vice Chair for Research
Department of Emergency Medicine
UAB Medicine
he University of Alabama at Birmingham
Birmingham Alabama 35249

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

Response: 450,000 children present to U.S emergency departments each year for evaluation of head trauma.  Physicians obtain head computed tomography (CT) scans in 37%-50% of these patients, with less than 10% showing evidence of traumatic brain injury and only 0.2% that require neurosurgical treatment.

In order to avoid unnecessary CT scans and to limit radiation exposure, the Pediatric Emergency Care Applied Research Network (PECARN) developed clinical prediction rules that consist of 6 readily available factors that can be assessed from the history and physical examination.  If none of these risk factors are present, a CT scan is not indicated.

If either of 2 high risk factors such as signs of a skull fracture are present, CT scanning is indicated.

If 1 or 2 non-high risk factors are present, then either CT scanning or observation are recommended, depending on considerations such as parental preference, clinician experience and/or symptom progression.

In this study we designed a parent decision aid, “Head CT Choice” to educate the parent about the difference between a concussion – which does not show up on a CT scan – and a more serious brain injury causing bleeding in or around the brain.  The decision aid also shows parents their child’s risk for a serious brain injury – less than 1% risk in the majority of patients in our trial – what to observe their child at home for should they opt not to obtain a CT scan, and the advantages and disadvantages of CT scanning versus home observation.

In our trial, we did not observe a difference in the rate of head CT scans obtained in the ED but did find that parents who were engaged in shared decision-making using Head CT Choice were more knowledgeable about their child’s risk for serious brain injury, has less difficulty making the decision because they were clearer about the advantages and disadvantages of the diagnostic options, and were more involved in decision-making by their physician.  Parents also less frequently sought additional testing for their child within 1 week of the emergency department visit.

Continue reading

Could a Low-Gluten Diet During Pregnancy Protect Offspring from Diabetes?

MedicalResearch.com Interview with:
Knud Josefsen, senior researcher
Bartholin Institute, Rigshospitalet,
Copenhagen K, Denmark

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

Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31.

It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust Continue reading

Mouth Microbiome Linked to Childhood Obesity

MedicalResearch.com Interview with:

Dr. Sarah J.Carnahan Craig PhD

Dr. Carnahan Craig

Dr. Sarah J.Carnahan Craig PhD
Postdoctoral Scholar
Makova Lab
Biology Department
Center for Medical Genomics
Penn State University

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

Response: This study stems from a long standing collaboration with pediatrician, Ian Paul at Penn State Hershey Medical School (and a co-author on this paper). Ian is very interested in understanding and preventing childhood obesity. It also is part of a much larger, collaborative study objective, lead by Ian and Leann Birch (another co-author), to understand social/behavioral contributors to childhood obesity, how a responsive parenting intervention can prevent childhood overweight/obesity, and the biological factors that contribute to the disease. This is an important research area as childhood obesity is a public health problem — one in three children are overweight or obese. A fuller understanding of factors that contribute to childhood obesity, how to identify children who are at risk for developing childhood obesity, and methods to prevent childhood obesity are of critical importance.

MedicalResearch.com: What are the main findings?

Response: The main finding from this paper is that the oral microbiota (the collection of bacteria that live in the mouth) are significantly related to young child growth patterns. The surprising part of this finding was that we observed this result with the oral microbiota and not the gut microbiota. The oral microbiota (in comparison to the gut microbiota, which has been associated with obesity in many previous studies) are largely understudied, especially in young children. The gut microbiome we found to be strongly influenced by diet; when the two are considered together, there is a significant relationship with child growth patterns.

Additionally, our team developed novel statistical methods to use child growth curves as a more comprehensive outcome rather than an outcome of weight at a single time point (i.e. it uses more of the information about how a child is growing). These methods allow us to better detect the relationship between child growth and the microbiota; they increase our power. 

MedicalResearch.com: What should readers take away from your report?

Response: Readers should take away that there are many factors that contribute to obesity and obesity prevention – along with a healthy diet and exercise, biological factors, such as the microbiota for instance, could potentially be an important consideration. Additionally, we’re in the early stages of truly understanding how these microbes influence health. Importantly, we are unable to make any kind of causal conclusions – meaning we don’t know if the microbes are influencing the growth patterns, is health/environment influencing the microbes, or is it both directions.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: One of the limitations of this study is that it looks at the microbiota at a single time point, at two years after birth –  this is a dynamic community, so we are really only seeing a snapshot of what is happening. Additionally, the study is retrospective in that the microbiota is sampled at two years and the growth trajectory is made of measurements from birth through two years. Because of this, we might be missing important dynamics happening earlier in life. A more comprehensive study would be to sample the microbiota at all the time points you are sampling growth, health, and other information — this is a study we are currently doing. We hope that by building on this study and examining the microbiota (both oral and gut) longitudinally and in concert with the social, environmental, and health data that we will be closer to a fuller understanding, which could potentially identify children who are most at risk of developing childhood obesity and be prime candidates for obesity intervention programs.  

Citation: 

Sarah J. C. Craig, Daniel Blankenberg, Alice Carla Luisa Parodi, Ian M. Paul, Leann L. Birch, Jennifer S. Savage, Michele E. Marini, Jennifer L. Stokes, Anton Nekrutenko, Matthew Reimherr, Francesca Chiaromonte, Kateryna D. Makova. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-31866-9

Sep 19, 2018 @ 9:27 pm

 

 

 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Steep Increase in Adversity-Related Hospital Admissions for Teenage Girls

MedicalResearch.com Interview with:

Dr Ruth Blackburn PhD  UKRI Innovation Fellow UCL Institute of Health Informatics

Dr Ruth Blackburn PhD 
UKRI Innovation Fellow
UCL Institute of Health Informatics 

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

Response: In England one child in every classroom is admitted to hospital with an adversity related injury (i.e. violence, intentional self-injury, or drug or alcohol misuse) between the ages of 10 and 19 years. These young people are more likely than their classmates to be re-admitted to hospital or to die within 10 years.

We investigated how the rate of hospital admissions with an adversity related injury has changed over time among young people aged 10-24 years, using administrative data for National Health Service hospitals in England.

We found that between 2012 and 2016, rates of admission with an adversity related injury (including intentional self-injury) increased steeply for girls, with the biggest increase (6% per year) among 15-19 year olds. During the same time period, rates of admission with an adversity related injury decreased in boys aged 15-24 years (4-5% per year) but increased slightly for 10-14 year olds (3% per year).  Continue reading

CDC Identifies Risk Factors for Adverse Childhood Experiences

MedicalResearch.com Interview with:

Melissa T. Merrick, PhD Behavioral Scientist,  Surveillance Branch, Division of Violence Prevention CDC

Dr. Merrick

Melissa T. Merrick, PhD
Behavioral Scientist,
Surveillance Branch, Division of Violence Prevention
CDC

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

Response: Childhood experiences build the foundation for health throughout a person’s life. Adverse childhood experiences (ACEs) are potentially traumatic experiences, which occur in childhood. Exposure to ACEs, especially for young people without access to safe, stable, nurturing relationships and environments, can impact health in many ways, including increased risk of chronic disease, engagement in risky behaviors, limited life opportunities, and premature death.

Continue reading

Prenatal Exposure to Air Pollution May Affect Newborn’s Thyroid Function

MedicalResearch.com Interview with:

Carrie Breton ScD Associate Professor and Director of the MADRES Center  Division of Environmental Health Los Angeles, CA 90032

Dr. Breton

Carrie Breton ScD
Associate Professor and Director of the MADRES Center
Division of Environmental Health
Los Angeles, CA 90032

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

Response: I am interested in how the environment can influence our very early development, starting in the womb. I have studied the health effects of air pollutants on children for several years and wanted to focus now on the earliest windows of susceptibility.  Thyroid hormones play a critical role in fetal growth and development. We knew we could get information on newborn thyroid levels from the California Department of Public Health’s newborn screening program therefore look at this question in our study population.

We found that exposure to high levels of PM2.5 and PM10 throughout most of pregnancy affected TT4 levels in newborns. Continue reading

More Than 2 Million High School Students Have Used Marijuana in an E-Cigarette

MedicalResearch.com Interview with:

Katrina Trivers, PhD, MSP Lead author and lead epidemiologist Office on Smoking and Health CDC

Dr. Trivers

Katrina Trivers, PhD, MSP
Lead author and lead epidemiologist
Office on Smoking and Health
CDC

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

Response: Although we’ve seen considerable declines in the use of regular cigarettes among U.S. youth over the past several decades, the tobacco product landscape is evolving, and the use of other tobacco products have become increasingly popular. For example, as of 2014, e-cigarettes have become the most commonly used tobacco product among US youth. During 2011-2015, e-cigarette use increased 900% among U.S. high school students before declining in 2016. No change was observed in 2017, with about 2 million youth, including 12% of high school students and 3% of middle school students, reporting they had used e-cigarettes in the past 30 days.

This is a public health concern because the use of any form of tobacco product is unsafe among youth, irrespective of whether it’s smoked, smokeless, or electronic. The U.S. Surgeon General has concluded that the aerosol emitted from e-cigarettes is not harmless. It can contain harmful ingredients, including nicotine, carbonyl compounds, and volatile organic compounds known to have adverse health effects. The nicotine in these products is of particular concern given that nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.

In recent years, many youth have also been using other psychoactive substances in e-cigarettes, including cannabinoids and other illicit drugs. This could have been fueled, in part, by shifts in the social acceptability and access to cannabis as several states have or are considering legalized cannabis sales for adults. A previous CDC study found that in 2015, almost 1 in 3 students reported using e-cigarettes with non-nicotine substances. However, it wasn’t possible to identify what exactly those substances were based on the question. Given the high concurrent use of tobacco and other substances, including cannabis, a more detailed question was added to a future survey to assess the use of cannabis in e-cigarettes among U.S. youth. This study presents the findings from that question.

Continue reading

When Should Children in Pediatric Intensive Care Receive Parenteral Nutrition?

MedicalResearch.com Interview with:

Sascha Verbruggen, MD, PhD Pediatric intensivist Erasmus MC-Sophia Children's Hospital

Dr. Verbruggen

Sascha Verbruggen, MD, PhD
Pediatric intensivist
Erasmus MC-Sophia Children’s Hospital

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

Response: In critically ill children treated in the pediatric intensive care unit (PICU) are often difficult to feed. The subsequent macronutrient deficit was found to be associated with impaired outcomes in the PICU. Furthermore, being undernourished in the PICU has also been associated with poor outcome of critical illness in children.

These associations formed the basis for guidelines recommending initiation of parenteral nutritional support early when enteral feeding is insufficient. However, the multicenter randomised controlled trial (RCT) ‘Pediatric Early versus Late Parenteral Nutrition in Critical Illness’ (PEPaNIC), including 1440 critically ill children, showed that withholding PN for one week (Late-PN) resulted in fewer new infections and reduced the duration of PICU stay as compared to initiating PN at day 1 (Early-PN). However, withholding PN for one week in critically ill children, who are already undernourished upon admission to the PICU, raised concerns among experts.

Therefore we set out to investigate the impact of withholding supplemental PN in a subgroup of critically ill children who were acutely undernourished upon admission to the PICU.  Continue reading

Vaccines Against Rotavirus Gastroenteritis Decreased Infections Even in Unvaccinated Kids

MedicalResearch.com Interview with:

Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics

Dr. Chuanxi Fu

Chuanxi Fu, MD.PhD.
Professor of Epidemiology, School of Public Health
Zhejiang Chinese Medical University
Associate editor, Human Vaccines & Immunotherapeutics 

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

Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated.

In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage.  Continue reading

10% of US Kids Diagnosed with ADHD

MedicalResearch.com Interview with:

Wei Bao, MD, PhD Assistant Professor, Epidemiology College of Public Health University of Iowa

Dr. Wei Bao

Wei Bao, MD, PhD
Assistant Professor, Epidemiology
College of Public Health
University of Iowa

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

Response: ADHD is common in children, with the rate of 5% as said in the American Psychiatric Association states in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

In this study, we showed that the rate of diagnosed ADHD in US children and adolescents aged 4 to 17 years was 10.2% in 2015-2016, up from 6.1% in 1997-1998. 

MedicalResearch.com: What should readers take away from your report? 

Response:  Simply saying, a common condition becomes even common. Now, one in ten US kids have ADHD.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

  • First, continue to monitor the trend through health survey and surveillance program.
  • Second, figure out the reasons for the increase, especially, identify potentially modifiable environmental risk factors for ADHD, because that may lead to an effective prevention.
  • Third, provide adequate resources for the diagnosis and treatment of affected individuals in the future.

No disclosures 

Citation:

Xu G, Strathearn L, Liu B, Yang B, Bao W. Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016. JAMA Network Open. 2018;1(4):e181471. doi:10.1001/jamanetworkopen.2018.1471

Sep 5, 2018 @ 12:55 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

No Premature Menopause Found in Adolescents Who Receive HPV Vaccine

MedicalResearch.com Interview with:

Allison L. Naleway, PhD Senior Investigator Associate Director, Science Programs Center for Health Research Kaiser Permanente

Dr. Naleway

Allison L. Naleway, PhD
Senior Investigator
Associate Director, Science Programs
Center for Health Research
Kaiser Permanente

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

Response: Reports of premature menopause after human papillomavirus (HPV) vaccination have received a lot of media attention, including on social media, but these reports were based on a small number of isolated cases. Large studies have demonstrated the safety of HPV vaccination, but parental safety concerns—including potential impact on future fertility—are often cited as one reason for lower HPV coverage.

Rates of HPV vaccination have lagged behind coverage rates for other recommended adolescent vaccinations, such as tetanus-diphtheria-acellular pertussis and meningococcal conjugate. (Based on national coverage estimates from 2016, 65% of 13–17 year-old females received at least one HPV vaccination and only 49.5% were up to date with the series, compared to about 88% of adolescents who received Tdap.)

We conducted a study of nearly 200,000 young women to determine whether there was any elevated risk of primary ovarian insufficiency (POI) after HPV or other recommended vaccinations.  Continue reading

Interventions Reduced Childhood Lead Levels, But Did Not Improve Neurobehavioral Outcomes

MedicalResearch.com Interview with:

Joseph M. Braun, MSPH, PhD  Associate Professor of Epidemiology Epidemiology Master's Program Director  Brown University School of Public Health

Dr. Braun

Joseph M. Braun, MSPH, PhD
Associate Professor of Epidemiology
Epidemiology Master’s Program Director
Brown University School of Public Health

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

Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented.

Continue reading

Breast Milk Can Contain THC From Cannabis For Almost a Week

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

cannabis

Christina Chambers, PhD, MPH
Principal investigator
Professor in the Department of Pediatrics
UC San Diego School of Medicine
Drector of clinical research at Rady Children’s Hospital
San Diego 

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

Response: Although cannabis is one of the most common recreational drugs used by pregnant and breastfeeding women, there is little current research regarding potential exposure of the breastfed infant.  As a result, pediatricians are lacking concrete evidence to help support advice to breastfeeding mothers who use cannabis.  This is particularly important as cannabis products available today are substantially more potent than products available in years past.

Our group in the Department of Pediatrics at the University of California San Diego (UCSD) Center for Better Beginnings was interested in first determining how much if any of the ingredients in cannabis actually transfer into breastmilk and how long these metabolites might stay in the milk after the mom’s last use.  We invited mothers who are participating in our UCSD Human Milk Research Biorepository from across the U.S. and Canada to respond to questions about use of cannabis products over the previous 14 days and to provide a breast milk sample.

Fifty mothers participated in the study.  Samples were analyzed by investigators from the UCSD Skaggs School of Pharmacy.

Our major finding was that low, but measurable levels of THC, the main psychoactive ingredient in cannabis, were found in about 2/3 of the samples.  Although the number of hours after mother’s last use of cannabis that THC was still measurable varied widely, the longest time since mother’s last use that THC was still present was about 6 days.  Continue reading

Low Birth Weight Associated With More Diabetes and Hypertension in Adulthood

MedicalResearch.com Interview with:
“Chinese baby laying on a bed” by simpleinsomnia is licensed under CC BY 2.0Wanghong Xu, MD, PhD

Professor of Epidemiology
School of Public Health
Fudan University

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

Response: The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that cardiovascular diseases and other chronic conditions in adulthood may be a consequence of an unfavorable intrauterine life, a relationship that is further modified by patterns of postnatal growth, environment, and lifestyle.

Based on the two large-scale cohort studies, the Shanghai Women’s Health Study and the Shanghai Men’s Health Study, we observed nonlinear associations for birth weight with baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and low birth weight was linked with lower BMI, smaller WC, but larger WHR and WHtR.

An excess risk of T2DM and hypertension was observed for low birth weight (<2500 g) versus birth weight of 2500-3499 g since baseline and since birth. The results support the DoHad hypothesis, and indicate the importance of nutrition in early life on health in Chinese population.  Continue reading

Antibiotics Leading Cause of Pediatric Adverse Drug Events in ER

MedicalResearch.com Interview with:
Maribeth C. Lovegrove, MPH
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
Atlanta, GA 30333).

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

Response: There has been a lot of recent attention on reducing unnecessary antibiotic prescribing in order to reduce antibiotic resistance (a longer-term harm).  However, antibiotic use also can lead to shorter-term harms like allergic reactions and other side effects.  With this analysis, we wanted to focus on the acute harms to individual pediatric patients from antibiotic use in order to help target prevention efforts.  Specifically, we used data from two national data sources to identify the antibiotics with the highest numbers of emergency department visits for adverse drug events and the highest rates of emergency department visits for adverse drug events (accounting for amount of antibiotic prescriptions dispensed) and to identify the pediatric patients with the highest risks.

Continue reading

Bridge Symptoms in Adolescence Linked To Adult Anxiety Disorders

MedicalResearch.com Interview with:

Dr Alexandra Rouquette MD PhD Center for Research in Epidemiology and Population... French Institute of Health and Medical Research Paris

Dr. Rouquette

Dr Alexandra Rouquette MD PhD
Center for Research in Epidemiology and Population…
French Institute of Health and Medical Research
Paris

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

 Response: There is a growing number of clues in the literature that suggest that the onset of adult psychopathologic disorders can be traced back to behavioral or emotional symptoms observed in childhood or adolescence. Targeting early childhood symptoms might thus be effective in preventing future mental disorders. However, these interventions are challenging to implement because we lack knowledge on which specific childhood symptoms have predictive associations with adult psychopathologic disorders. In our study, we used a novel methodologic approach, the network perspective, in which symptoms are conceptualized as distinct entities that can causally influence each other, be self-reinforcing and are thus part of causal chains which can culminate in disorders.

We investigated longitudinally the network structure among a broad range of emotional and behavioral symptoms (symptoms of attention deficit, symptoms of hyperactivity, disruptive symptoms, internalizing symptoms, prosocial symptoms) collected in elementary school girls (6-10 years) included in the Quebec Longitudinal Study of Kindergarten Children. We showed that symptoms “irritable”, “blames others”, “not liked by other children”, “often cries”, and “solitary” retained a distinctive position in the network because most of the direct relationships between the disruptive and internalizing symptom clusters transited through them. These symptoms have been termed bridge symptoms in the network perspective, as they constitute pathways that can connect different disorders.

We then investigated the relationships between this emotional and behavioral symptoms network in childhood and the occurrence of anxiety disorders at age 15 and 22 years. Importantly, the bridge symptoms (particularly “not liked by other children” and “irritable”) exhibited the strongest relationships with future anxiety disorders. Continue reading

Children Need Both Naps and Overnight Sleep to Process Emotional Memories

MedicalResearch.com Interview with:

Dr. Rebecca Spencer PhD Associate Professor Department of Psychological and Brain Sciences University of Massachusetts

Dr. Rebecca Spencer

Dr. Rebecca Spencer PhD
Associate Professor
Department of Psychological and Brain Sciences
University of Massachusetts

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

Response: We know that in young adults, sleep contributes to emotion processing. We wondered if naps work similarly for preschool children.  To look at this, we had children learn an emotional memory task and then either take a nap or stay awake.  We then tested their memory after that interval and again the next day.

We found that when children napped, they had better memory for those items the next day than if they did not nap.  That the naps seem to support memory (even if in a delayed fashion) seems consistent with the observation of parents and preschool teachers that children are often emotionally dysregulated if they do not nap.

Continue reading

Complex Racial and Ethnic Disparities in Childhood Cancer Survival

MedicalResearch.com Interview with:
Rebecca D. Kehm, PhD
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis, MN  

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

Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer.

Continue reading

PITS Gene Linked To Rare Neurologic Disorders

MedicalResearch.com Interview with: 

Paul C Marcogliese, Ph.D. Postdoctoral Associate, Laboratory of Dr. Hugo Bellen Department of Molecular and Human Genetics Baylor College of Medicine Houston, Texas 77030

Dr. Marcogliese

Paul C Marcogliese, Ph.D.
Postdoctoral Associate,
Laboratory of Dr. Hugo Bellen
Department of Molecular and Human Genetics
Baylor College of Medicine
Houston, Texas 77030

Loren D. Pena, MD PhD Pediatric Medical Genetics Specialist Division of Medical Genetics, Department of Pediatrics Duke University School of Medicine, Durham, NC

Dr. Peña


Loren D. Pena, MD PhD
Division of Human Genetics
Cincinnati Children’s Hospital Medical Center
Department of Pediatrics
University of Cincinnati
Cincinnati, OH 45229


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

Response: The Undiagnosed Diseases Network (UDN) is a multi-site collaboration across the US that seeks to help diagnose patients with rare disorders that are ill-defined.

Dr. Loren D.M. Pena and Dr. Vandana Shashi at the Duke-Columbia clinical site of the UDN had seen a patient with a severe neurological disorder. While the patient had no symptoms at birth, the patient began falling at about 3 years of age, eventually losing motor coordination and developing seizures. In the interim, the regression has progressed to a severely debilitating state. Re-analysis of the participant’s exome data by our site bioinformatician at Columbia (Nicholas Stong) in Dr. David Goldstein’s laboratory revealed a truncating variant in the single exon gene IRF2BPL that could be the candidate disease-causing gene. The UDN clinicians at Duke then contacted the UDN Model Organism Screening Center (MOSC) led by Dr. Hugo Bellen at Baylor College of Medicine and the Howard Hughes Medical Institute for functional analysis. In parallel, four more patients were found with truncating mutations causing a similar disorder though the UDN and GeneMatcher.org. Additionally, two patients with missense variants in IRF2BPL were identified that displayed seizures and some developmental delay or autism spectrum disorder but no motor regression.

Work in MOSC by Dr. Paul Marcogliese using fruit flies revealed that the IRF2BPL truncating variants are severe loss of function mutations and one of the missense variants was a partial loss of function. Additionally, it was found that the fruit fly IRF2BPL gene, called pits, is expressed in the neurons of the adult fly brain. Lowering the levels of pits by about 50% in fly neurons leads to progressive behavioural abnormalities and neurodegeneration. By combining the human genetics, bioinformatics and model organism data, IRF2BPL was found to be a novel disease-causing gene in humans.

Continue reading

Most Young People Not Against Guns in the Home

MedicalResearch.com Interview with:
“GUNS” by Jessica Spengler is licensed under CC BY 2.0Kendrin R. Sonneville, ScD, RD

Assistant Professor
Department of Nutritional Sciences
University of Michigan School of Public Health

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

Response: The results from this come out of MyVoice, a text message cohort of youth ages 14-24 representing every state in the country (http://hearmyvoicenow.org/). Each week we ask the youth in our cohort a series of open-ended to questions, with the goal of gathering the real-time opinions and experiences of youth across the U.S. This study reports the results of questions we asked MyVoice paritpatns between 07/2017 and 01/2018 about guns and gun control. 

(1) What are your thoughts about having guns in your home?

(2) Do you think gun control laws would affect mass shootings? Why?

(3) Who, if anyone, should NOT be allowed to own guns?

We found that about one-third of youth in our diverse sample were “against” guns in the home, and the remaining two-thirds were either “pro” or “conditionally pro” guns in the home, stating that gun ownership is acceptable under certain conditions, such as proper storage, or kept away from children. Youth in our sample largely believed that gun control laws could decrease mass shootings, but one-third felt that gun control laws would not be enough to impact mass shootings. Continue reading

Specific Microbial Signatures Differentiate Chronic Coughs in Children

MedicalResearch.com Interview with:

Dr. Mikhail Kazachkov MD Director of Pediatric Pulmonology Hassenfeld Children’s Hospital NYU Langone Medical Center

Dr. Kazachkov

Dr. Mikhail Kazachkov MD
Director of Pediatric Pulmonology
Hassenfeld Children’s Hospital
NYU Langone Medical Center 

MedicalResearch.com: What is the background for this study? How common is the problem of chronic cough in children?  Is it more common in children with allergies, asthma or reflux?

Response: Chronic cough is one of the leading causes of pediatric referrals to subspecialty physicians.  Its prevalence in the general pediatric population may approach 3% (Galassi et al, Epidemiol. Prev. 2005;29,Suppl.:9–13).

It is important to recognize that the main causes of chronic cough in children are completely different for those in adults.  Specifically, gastroesophageal reflux and postnasal drip are not considered to be important causes of cough in children.  Cough variant asthma, although is a common cause of cough in adults, does not seem to be frequently diagnosed and a cause of chronic cough in children.

The main cause of chronic wet cough in children is protracted bacterial bronchitis (Chang et al, Chest. 2017 Apr;151:884-890).  It is important to recognize that neurologically impaired children have completely different pathogenesis of chronic cough, which is mostly related to aspiration into the lower airway and development of aspiration-related lung disease.

Continue reading

“Rory’s Regulations” Improves Pediatric Sepsis Care

MedicalResearch.com Interview with:

Idris V.R. Evans, M.D.,MA Assistant Professor Department of Critical Care Medicine University of Pittsburgh

Dr. Evans

Idris V.R. Evans, M.D.,MA
Assistant Professor
Department of Critical Care Medicine
University of Pittsburgh

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

Response: New York State issued a state-wide mandate in 2013 for all hospitals to develop protocols for sepsis recognition and treatment. This mandate was called “Rory’s Regulations” in honor of Rory Staunton, a boy who died from sepsis in 2012.

Pediatric protocols involved a bundle of care that included blood cultures, antibiotics, and an intravenous fluid bolus within 1–hour. We analyzed data collected by the NYS Department of Health on 1,179 patients from 54 hospitals and found that the completion of the pediatric bundle within 1 hour was associated with a 40% decrease in the odds of mortality.  Continue reading

Girls with PID Underscreened For Syphilis and HIV in ERs

MedicalResearch.com Interview with:

Monika K. Goyal, M.D., M.S.C.E., senior study author Assistant professor of Pediatrics and Emergency Medicine Children’s National Health System Washington, DC

Dr. Goyal

Monika K. Goyal, M.D., M.S.C.E., senior study author
Assistant professor of Pediatrics and Emergency Medicine
Children’s National Health System
Washington, DC 

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

Response: Patients with pelvic inflammatory disease (PID) are at an increased risk for syphilis and HIV. We know that adolescents account for 20 percent of the 1 million cases of PID that are diagnosed each year. We also know that an estimated one in four sexually active adolescent females has a sexually transmitted infection (STI). While screening for syphilis and HIV is recommended when diagnosing PID, actual screening rates among adolescents have been understudied.

This multi-center study aimed to quantify rates of HIV and syphilis screening in young women diagnosed with . pelvic inflammatory disease in pediatric emergency departments and to explore patient- and hospital-specific characteristics associated with screening for these two sexually transmitted infections.

Continue reading

Most Pediatricians are Women, But Men’s Opinions are Valued More

MedicalResearch.com Interview with:

Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals

Dr. Silver

Julie Silver, MD
Associate Professor and Associate Chair
Department of Physical Medicine and Rehabilitation at Harvard Medical School and
Staff physician at Massachusetts General
Brigham and Women’s and Spaulding Rehabilitation Hospitals 

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

Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish.

For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine.

Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process.

In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]).

We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%).  Continue reading