pediatrics Tag
27 Sep Isolated Cleft Palate, But Not Cleft Lip, Linked to Increased Health Risks
MedicalResearch.com Interview with: Erik Berg, MD Department of Global Public Health and Primary Care University of Bergen Bergen, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parents regularly express concern about long term health outcomes for children born with oral cleft. In this study we used population-based long-term follow-up data from multiple national registries to focus on the future health outcomes of cleft cases without additional chronic medical conditions or congenital anomalies. The study cohort consisted of all individuals born in Norway between 1967 and 1992. All patients treated for clefts in Norway during the study period were invited to participate. 2 337 cases with isolated clefts and 1 413 819 unaffected individuals were followed until 2010. The main outcome variables were conditions diagnosed in childhood or early adulthood, need for social security benefits, and risk of death.25 Sep Early Immune Intervention May Prevent Atopic March of Eczema and Allergies
MedicalResearch.com Interview with: Emma Guttman-Yassky, MD, PhD Professor of Dermatology and Immunology Vice Chair of the Department of Dermatology at the Icahn School of Medicine and Amy S. Paller, MD Walter J. Hamlin Professor Chair of the Department of Dermatology at Northwestern MedicalResearch.com: What is the background for this study? Response: Researchers for the first time have identified the skin phenotype of pediatric eczema or atopic dermatitis (AD) in infants, opening the door for personalized treatment approaches for young children with eczema. The study, led by researchers at the Icahn School of Medicine at Mount Sinai and Northwestern University’s Feinberg School of Medicine, was published online today in the Journal of Allergy and Clinical Immunology. Emma Guttman-Yassky, MD, PhD, Professor of Dermatology and Immunology, and Vice Chair of the Department of Dermatology at the Icahn School of Medicine, and Amy S. Paller, MD, Walter J. Hamlin Professor and Chair of the Department of Dermatology at Northwestern, investigated lesional and non-lesional skin biopsies from 19 AD infants under the age of five, and compared them to age-matched pediatric controls, in addition to adult AD biopsies. The researchers found that the non-lesional, or normal-appearing, skin of young children with early eczema is already highly abnormal with significant immune activation, simulating that of lesional skin of adults with many years of active disease.21 Sep Collaborative Care is Effective and Cost-Effective For Adolescent Depression
MedicalResearch.com Interview with: [caption id="attachment_28010" align="alignleft" width="173"]
Dr. Laura Richardson[/caption]
Laura P. Richardson, MD, MPH
Interim Chief | Division of Adolescent Medicine
Director | UW Leadership Education in Adolescent Health (LEAH) Program
Professor | UW Department of Pediatrics
Seattle Children's | University of Washington
MedicalResearch.com: What is the background for this study?
Response: Adolescent depression is one of the most common mental health conditions during adolescence. Up to one in five adolescents experience an episode of major depression by age 18. Depressed youth are at greater risk of suicide, dropping out of school and poor long-term health. Treatments, including medications and psychotherapy, have been proven to be effective but most depressed teens don’t receive any treatment.
Two years ago, we showed that the Reaching Out to Adolescents in Distress (ROAD) collaborative care model (a.k.a. Reach Out 4 Teens) designed to increase support and the delivery of evidence-based treatments in primary care was effective in treating depression in teens, significantly improving outcomes. We ran a randomized clinical trial at nine of Group Health’s primary care clinics and reported effectiveness results in JAMA.
The current paper represents the next step in this work, examining the cost-effectiveness of collaborative care for adolescent depression in our intervention sample of 101 adolescents with depression, ages 13-17 years.
21 Sep Early Introduction May Reduce Peanut and Egg, But Not Gluten, Allergies in Children
MedicalResearch.com Interview with: [caption id="attachment_28127" align="alignleft" width="200"]
Dr. Robert Boyle[/caption]
Dr Robert Boyle
Senior lecturer in paediatric allergy
honorary consultant, Paediatric allergist
Imperial College Healthcare NHS Trust
MedicalResearch.com: What is the background for this study? What are the main findings?
Editors' note: Please discuss food introduction with your child's pediatrician before embarking on any new foods.
Response: Food allergy is a common problem which may be getting more common.
We have known for over 100 years that feeding egg to animals such as guinea pigs can prevent egg allergy. However randomised trials of allergenic food introduction for preventing food allergy in human infants have not been done until the past 5 years, and have so far yielded mixed results. One trial for peanut allergy was positive, with less peanut allergy in infants who were fed the food from early in life compared with infants who avoided it for 5 years. Other trials have yielded null findings, but may have been too small to yield a conclusive result. We used a technique called meta-analysis to combine the results of all previous trials of timing of allergenic food introduction and risk of food allergy. We also evaluated other allergic and autoimmune diseases.
Our analysis yielded conclusive results for both egg and peanut – that early introduction of these foods into an infant’s diet might reduce their risk of egg and peanut allergy by around 40-70%. We were surprised to see null findings in our meta-analysis of timing of gluten or wheat introduction and risk of coeliac disease (gluten intolerance) which is a different type of allergy to egg and peanut allergy. This suggests that early introduction of allergenic foods does not reduce risk of all types of food allergy.
21 Sep Intestinal Microbiome Linked to Obesity and Fat Storage in Children
MedicalResearch.com Interview with: [caption id="attachment_28185" align="alignleft" width="133"]
Dr. Nicola Santoro[/caption]
Nicola Santoro, MD, PhD
Associate Research Scientist in Pediatrics (Endocrinology)
Yale University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The study start from previous observations showing an association between the gut microbiota and obesity.
Similarly to what previously described in adults and in children, we found an association between the gut microbiota and obesity. We took a step further and also observed that the gut flora is associated to body fat partitioning (amount of fat in the abdomen). Moreover, we observed that the effect of microbiota could be mediated by the short chain fatty acids a product of gut flora.
17 Sep Healthy Eating in Adolescence Sets Pattern For Less Weight Gain As Young Adult
MedicalResearch.com Interview with: [caption id="attachment_28058" align="alignleft" width="133"]
Dr. David R. Jacobs, Jr.[/caption]
David R. Jacobs, Jr., PhD
Mayo Professor of Public Health
Division of Epidemiology and Community Health, School of Public Health
University of Minnesota
Minneapolis MN 55454-1075
MedicalResearch.com: What is the background for this study?
Response: Project EAT (Eating and Activity in Teens and Young Adults) is on ongoing longitudinal study which began by screening middle and secondary school students in the Minneapolis and St Paul Metropolitan are. Students were the 11-18 years old (average age 15), then followed up at average ages 20 and 25. We had devised an eating pattern in about 2006, which
a) predicts a lot of things in several different studies (including total mortality in the Iowa Women's Health Study) and b) looks a great deal like the recently released 2015 Dietary Guidelines for Americans (DGA).
We call our diet pattern A Priori Diet Quality Score (APDQS) and think of it as close to or in the style of a Mediterranean/prudent/healthy diet.
We hypothesized that this pattern would be associated with lower weight (in general with better long term health, but the focus in Project EAT was weight and BMI), probably least so at age 15. The minimal hypothesized effect in adolescence relates to the very large energy expenditure in adolescent growth years; we thought that diet composition would be less important for body weight at that time than energy intake (and APDQS is about diet composition).
17 Sep Children Living In HUD Housing Had Lower Blood Lead Levels Than Those Not Receiving Housing Assistance
MedicalResearch.com Interview with: [caption id="attachment_28039" align="alignleft" width="151"]
Dr. Katherine Ahrens[/caption]
Dr. Katherine Ahrens PhD
Office of Population Affairs
Rockville, MD 20852
MedicalResearch.com: What is the background for this study?
Response: Lead exposure among children is linked to many adverse effects on health and cognitive development, which can be irreversible. The National Center for Health Statistics (NCHS) has linked 1999 to 2012 National Health and Nutrition Examination Survey (NHANES) data to administrative data for the Department of Housing and Urban Development’s (HUD) largest rental assistance programs (1999 through 2014), and these linked data allow calculation of the first-ever national blood lead level estimates among children living in HUD-assisted housing. Here we compare blood lead levels among children 1 to 5 years of age in 2005 to 2012 who received housing assistance during 1999 to 2014 with levels among children who did not receive housing assistance during that period.
14 Sep Some Pediatric Acute Otitis Media Can Be Managed With Close Parental Supervision, Without Antibiotics
MedicalResearch.com Interview with: Johanna M. Uitti, MD Department of Paediatrics and Adolescent Medicine Turku University Hospital Turku, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: According to several national guidelines, close follow-up is required if initial observation without antimicrobial agents is chosen for the management of acute otitis media (AOM) in children. The aim of this study was to examine whether close follow-up with reexamination is needed for children with AOM initially managed without antimicrobial agents who have symptomatic improvement during the first week after diagnosis, as assessed by their parents. Of the 104 children with symptomatic improvement, 3 (2.9%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy. In contrast, of the 54 children with symptomatic failure, 16 (29.6%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy.14 Sep Playing Video Games By Children May Be Helpful In Moderation
MedicalResearch.com Interview with: [caption id="attachment_27906" align="alignleft" width="200"]
Dr. Jesus Pujol[/caption]
Jesus Pujol, MD
Director of the MRI Research Unit.
Department of Radiology. Hospital del Mar
Barcelona
MedicalResearch.com: What is the background for this study?
Response: The pros and cons of video gaming in children have been extensively debated. There are relevant amounts of data indicating both the positive and negative effects of video games. Nevertheless, a key question for many parents remains unanswered: How long should children play? To provide some clarity, we have investigated the relationship between weekly video game use and certain cognitive abilities and conduct-related problems.
12 Sep Low-Intensity Interventions Addressing Social Needs In Pediatric Settings Can Improve Child Health
MedicalResearch.com Interview with: Laura M. Gottlieb, MD, MPH Department of Family and Community Medicine, 2Center for Health and Community University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have demonstrated that childhood exposures to social adversities, like family financial insecurity, food insecurity, and housing instability, lead to poorer health outcomes across the life course. These social adversities disproportionately affect low-income and racial minority populations. In response to this evidence there have been calls to address social needs in pediatric clinical care settings. For example, recently the American Academy of Pediatrics’ Task Force on Childhood Poverty endorsed the promotion of evidenced-based strategies to reduce the negative health effects of poverty on low-income children, including by increasing the availability of clinic-based interventions addressing social risks. In response to these calls to action, a growing number of pediatric health care organizations are screening for and address families’ social needs. There is a critical need for more evidence on the effectiveness of these types of interventions. Many of the studies conducted so far have focused primarily on assessing program process outcomes or impacts on families’ social needs, but have not evaluated actual health outcomes resulting from program participation. To our knowledge, this study was the first randomized clinical trial evaluating the impacts of a pediatric social needs navigation program on child health. The reported number of social needs identified at baseline ranged from 0 to 11 out of 14 possible items, with a mean [SD] of 2.7[2.2] needs identified by participating families. Family participation in the navigation program intervention significantly decreased families’ reports of social needs by a mean (SE) of .39(0.13) vs. an increase of a mean (SE) of .22(0.13) in the active control arm. Participation in the navigation program also significantly improved parent-reported overall child health, with a mean (SE) change of -.036(0.05), compared to the active control arm with a mean (SE) change of -0.12(0.05). At 4 months post enrollment, the number of social needs reported by those that participated in the navigation program decreased by a mean (SE) of .39(0.13).08 Sep Breastfeeding May Protect Against Genetic Tendency Toward Pediatric Asthma
MedicalResearch.com Interview with: Olga Gorlanova Wissenschaftliche Assistenzärztin Paediatric Pneumology Research Group Universitäts-Kinderspital beider Base MedicalResearch.com: What is the background for this study? Response: Previous research has investigated how childhood asthma and early wheeze can develop as the result of a complex interaction between environmental exposures, such as tobacco exposure, older siblings and an individual’s genetic profile. Genes associated with childhood asthma risk are located on chromosome 17, called 17q21. Our study asked the question: could the effect of 17q21 on respiratory symptoms in infants be modified by breastfeeding?07 Sep Food Allergies May Be Higher In Children Who Receive Antibiotics During First Year
MedicalResearch.com Interview with: [caption id="attachment_27718" align="alignleft" width="125"]
Dr. Bryan Love[/caption]
Bryan L. Love, PharmD, BCPS-AQ ID
Associate Professor
Department of Clinical Pharmacy & Outcomes Sciences
South Carolina College of Pharmacy
University of South Carolina
Columbia, South Carolina 29208-0001
MedicalResearch.com: What is the background for this study?
Response: In the US, food allergy has become one of the more common childhood medical conditions diagnosed in young children. Antibiotics are frequently prescribed in young children, and research continues to reveal that as many as 30% of antibiotic prescriptions are not appropriate.* We sought to examine if there was an association between antibiotic prescription and food allergy diagnosis.
07 Sep Over the Counter Lice Remedies Unlikely to Be Effective
MedicalResearch.com Interview with: [caption id="attachment_27707" align="alignleft" width="120"]
Head Louse[/caption]
William Ryan B.V.Sc.
Ryan Mitchell Associates LLC
Westfield, NJ and
Bernard Cohen, MD
Professor Dermatology and
Ellen Koch, MD
Division of Pediatric Dermatology
Johns Hopkins Medicine, Baltimore, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As a group we were concerned about the misinformation that continues to be promulgated on the internet and through other sites. Importantly, the group consisted of experts with specific experience in the management of head louse infestations, from pediatric dermatology, pediatrics, school nursing and head louse research fields. Even information sources that we would have expected to be credible are outdated, unreliable or both, often continuing myths about head louse infestations and how they can be controlled. We wanted to provide a balanced and informed perspective that would help physicians and parents recognize that head louse infestations do not present a serious problem, and can be well managed with an informed approach to treatment.
The main findings are that over the counder products (permethrin/pyrethrins) are unlikely to be effective, and that that there are safe and effective products that are available by prescription.
Interestingly, head lice do affect Indian and African children in their home countries, but virtually nonexistent in African Americans in North America. There has been speculation about hair grooming regimen or structure of African American hair but the cause is unknown. In a study we performed assessing resistance to over the counter pediculicide components over a decade ago in Baltimore, we were not able to find a single African American child with head lice. We were not able to recruit any patients from the Baltimore City Schools.
06 Sep Iron Chelator Can Reduce Cardiac Toxicity From Some Pediatric Chemotherapy
MedicalResearch.com Interview with: [caption id="attachment_27606" align="alignleft" width="133"]
Dr. Steven Lipshultz[/caption]
Steven E. Lipshultz, MD, FAAP, FAHA
Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology /Professor in the Center for Molecular Medicine and Genetics
Wayne State University School of Medicine
President, University Pediatricians & Interim Director, Children’s Research Center of Michigan
Pediatrician-in-Chief, Children’s Hospital of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Surviving childhood cancer has dramatically and increasing improved to the point where more than 80% will achieve a 5-year event free survival. Many of these survivors look forward to decades of active productive life.
More than half of these survivors have been treated with therapies know to be associated with late cardiotoxicity that can be pervasive, persistent, and progressive and associated with cardiovascular morbidity and mortality. In this article we review both the course and prevention of this cardiotoxicity. We focus in part on anthracycline chemotherapy that is widely used and known to be cardiotoxicity.
We further review studies we and others have conducted to examine the effectiveness of dexrazoxane, an iron chelator, that when given before each anthracycline dose results in anthracycline cardioprotection for long term survivors. In some reported studies this has allowed for higher cumulative anthracycline doses to be safely given. In other cases this has allowed for simultaneously being able to safely treat children with malignancies that would be refractory to conventional therapy more potent therapies that would normally have additive cardiotoxicity.
01 Sep Most Childhood Asthma Responds To Evidenced Based Therapy
MedicalResearch.com Interview with: [caption id="attachment_27559" align="alignleft" width="125"]
Prof. Francine Ducharme[/caption]
Francine M. Ducharme, MD, FRCPC
Professor, Departments of Paediatrics and Social and Preventive Medicine
University of Montreal
Associate Director of Clinical Research and Knowledge Transfer, Research Centre, CHU Ste-Justine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The management of asthma attacks in preschoolers has been the subject of much recent debate. The results of a study published in 2009 had shaken the pediatric world. The study reported that preschool children with viral-triggered flare-ups did not respond to standard treatment and, suggesting that this was due to their young age. Such finding was particularly worrisome as the majority of asthma-related emergency room visits and hospitalizations involve preschool children.
We conducted this large cohort study in which children aged 1 to 17 years with a moderate or severe asthma attack were treated using the established evidence-based therapy adjusted to the severity of exacerbation assessed by the Pediatric Respiratory Assessment Measure (PRAM), administered rapidly. We explored the determinants of the failure of emergency therapy. Age was not a factor. Instead, in addition to attack severity and symptoms between attacks, it was rather the presence of respiratory viral infection or fever triggering the attack that was more often associated with treatment failure, i.e., higher hospitalization rates, more returns to the emergency room, and reduced speed of recovery over the 10 days after discharge. Viral detection occurred more frequently in preschoolers (67%) than in older children (46%) with asthma.
Nevertheless, the results confirm the overall effectiveness of standard treatment, adjusted to the severity of the attack and administered early, in the vast majority of children, regardless of age and viral detection. Indeed, although a failure rate of nearly 40% was expected in this group of children with moderate to severe attack, only 17% of the participants did not respond to standard treatment. This rate was significantly higher (19%) in children with viral infection compared to uninfected children (13%).
01 Sep Long-Acting Beta-Agonists-Steroid Combination in Pediatric Asthma
MedicalResearch.com Interview with: David A Stempel, MD Medical Affairs Lead US Medical Affairs GlaxoSmithKline MedicalResearch.com: What is the background for this study? What are the main findings? Response: Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children. It is unknown whether the concomitant use of inhaled glucocorticoids with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children.31 Aug Maternal High Dose Monthly Vitamin D May Be Useful During Breastfeeding
MedicalResearch.com Interview with: [caption id="attachment_27553" align="alignleft" width="125"]
Dr. Ben Wheeler[/caption]
Dr. Ben Wheeler MB ChB(Otago) DCH CCE FRACP
Senior Lecturer / Paediatrician / Paediatric Endocrinologist
Department of Women’s & Children’s Health : Te Tari Hauora Wāhine me te Tamariki
Dunedin School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Vitamin D is essential for calcium and bone metabolism. It is unique among vitamins in that it is mainly derived from synthesis in the
skin after exposure to UV-B radiation. In the absence of fortification, few foods are rich in vitamin D, including human milk, which contains very low amounts. Breastfeeding infants in higher latitude countries such as New Zealand, much of North America and
Central/Northern Europe are at risk of vitamin D deficiency.
The most profound manifestation of vitamin D deficiency in growing children is rickets, characterized by bone deformities, impaired growth, biochemical abnormalities, and depending on the severity of deficiency, seizures. Studies also identified a number of common factors that potentially affect the risk of rickets, including darker pigmented skin, maternal vitamin D deficiency during pregnancy, season of birth, and age.
A potential alternative strategy to improve the vitamin D status of breastfed infants is high-dose vitamin D supplementation to pregnant and lactating women. This would be attractive from a compliance perspective, promote exclusive breastfeeding, and treat both the mother and her infant.
Thus, the primary aim of this randomized, placebo-controlled study was to determine the effect of two different monthly doses of maternal vitamin D supplementation on the vitamin D status of non–vitamin D–supplemented breastfed infants and their mothers.
31 Aug Parents Likely To Use Food To Soothe Fussy Infants
MedicalResearch.com Interview with: [caption id="attachment_27521" align="alignleft" width="133"]
Dr. Kai Ling Kong[/caption]
Kai Ling Kong, PhD, MS
Assistant Professor
Division of Behavioral Medicine
Department of Pediatrics
School of Medicine and Biomedical Sciences
State University of New York at Buffalo
MedicalResearch.com: What is the background for this study?
Response: Infant temperament, or individual behavior styles, can be reliably measured and is related to weight status. However, we know very little about the association of infants’ temperament and their motivation to eat versus engage in other activities (relative food reinforcement). Examining such associations is an important step given the need to use behavioral strategies in obesity prevention in early life. The purpose of our study was to determine if infant temperament, specifically the factors that have been linked with obesity risk, are associated with infant relative food reinforcement.
31 Aug Opportunities for Improvement in Pediatric Resuscitation Across US EDs
MedicalResearch.com Interview with: Marc Auerbach, MD, FAAP, MSc Associate Professor of Pediatrics (Emergency Medicine) and of Emergency Medicine Co-chair INSPIRE (International Network for Simulation Based Pediatric Innovation Research and Education) Director, Pediatric Simulation Yale Center for Medical Simulation; MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severely ill infants and children present to any of over 5000 United States Emergency Departments every day. A direct comparison of the quality of resuscitative care across EDs is challenging due to the low frequency of these high stakes events in individual EDs. This study utilized in-situ simulation-based measurement to compare the quality of resuscitative care delivered to two infants and one child by 58 distinct interprofessional teams across 30 EDs. Composite quality scores correlated with annual pediatric patient volume, with higher volume departments demonstrating higher scores. The pediatric readiness score measures compliance with guidelines created by the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association. The pediatric readiness score correlated with composite quality scores measured by simulation.25 Aug Children With Food Allergies More Likely To Develop Asthma and Allergic Rhinitis
MedicalResearch.com Interview with: David A. Hill, M.D., Ph.D. Fellow Physician Division of Allergy and Immunology The Children's Hospital of Philadelphia Philadelphia, PA 19104-3375 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Eczema, asthma, allergic rhinitis, and food allergies are among the most common childhood medical conditions in the United States. Importantly, disease rates for these conditions are thought to be changing, prompting the need for continued surveillance. In our study, we examined electronic medical record data of over 1 million children to measure incidence and prevalence rates of these conditions in our community. We found that 1 in 5 children seen in our network are diagnosed with asthma, a rate that is among the highest in the nation. Additionally, the large size of our study allowed us to measure the extent to which food allergies are associated with asthma or allergic rhinitis. In this analysis, we found that children with food allergies are 2 to 3 times more likely to develop asthma or allergic rhinitis, as compared with children without food allergy.19 Aug Maternal Gestational Diabetes Increased Risk of Childhood Obesity
MedicalResearch.com Interview with: [caption id="attachment_26918" align="alignleft" width="200"]
Dr. Gang Hu[/caption]
Dr. Gang Hu, Associate Professor
LSU’s Pennington Biomedical Research Center & Director
Chronic Disease Epidemiology Lab
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Some studies have found that maternal gestational diabetes mellitus (GDM) places offspring at increased risk of long-term adverse outcomes, including obesity. However, most of studies are from high income countries, with limited data from low to middle income countries. The present study, conducted at urban and suburban sites in 12 countries, found that the increased risk for children of GDM mothers compared with non-gestational diabetes mellitus mothers was 53% for obesity, 73% for central obesity, and 42% for high body fat.
18 Aug Kids Suffer 50 Injuries Per Day From Strollers or Carriers
MedicalResearch.com Interview with: Kristi Roberts, MS, MPH Research associate Center for Injury Research and Policy Nationwide Children’s Hospital. MedicalResearch.com: What is the background for this study? Response: Strollers (such as these luxury strollers) and carriers are used regularly by caregivers and are intended to provide a safe and secure way to transport young children during everyday activities. However, parents and caregivers should be aware that injuries do occur while using these products.18 Aug No Difference In Asthma Exacerbations Between Acetaminophen and Ibuprofen in Young Children
MedicalResearch.com Interview with: [caption id="attachment_27010" align="alignleft" width="120"]
Dr. Wanda Phipatanakul[/caption]
Wanda Phipatanakul, MD, MS
Associate Professor of Pediatrics
Harvard Medical School
Director, Asthma Clinical Research Center
Boston Children's Hospital
Asthma, Allergy and Immunology
Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Acetaminophen (e.g., Tylenol, Panadol) and ibuprofen (e.g., Advil, Motrin) are the only available treatments for pain and fever in toddlers and the most commonly utilized medications worldwide. Recently there has been controversy and even alarm with suggestive observational data that acetaminophen makes asthma worse. This has led some experts to recommend the avoidance of acetaminophen in children with asthma. We sought to find the answer to this burning question through the first prospective, double-blind, randomized clinical trial comparing acetaminophen versus ibuprofen head to head for use when clinically indicated for fever or pain. Is there a difference in asthma morbidity (exacerbations) in young children between the age of 12-59 months, who have asthma?
16 Aug Live Nasal and Injectable Flu Vaccines Had Similar Effectiveness in Pediatric Study
Posted at 18:25h
in Annals Internal Medicine, Author Interviews, Flu - Influenza, Pediatrics, Vaccine Studies
MedicalResearch.com Interview with:
[caption id="attachment_26888" align="alignleft" width="150"]
Dr. Mark Loeb[/caption]
Dr. Mark Loeb
BSc (McGill), MD (McGill), MSc (McMaster), FRCPC
Professor, Department of Pathology and Molecular Medicine
Joint Member, Dept of Clinical Epidemiology & Biostatistics
Division Director, Infectious Diseases, McMaster University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background for this study is that in the U.S, the Advisory Committee on Immunization Practices (ACIP), the committee that advises the CDC on vaccination policy, decided this June not to recommend LAIV (nasal live vaccine) for children. This is because of non-randomized studies conducted in the U.S suggesting that the vaccine was ineffective. This was an unprecedented decision in influenza vaccine policy making for children.
Our study, a randomized, blinded, controlled trial, which is the most rigorous type of study design, conducted over 3 years (2012-13, 2013-2014, 2014-2015 influenza seasons), showed in fact very similar protection for children and their communities for the live and inactivated vaccines. We conducted the study in the Hutterite community of Western Canada which allowed us to compare the effect of the vaccines in entire communities. That is, we were able to study the direct effect and the indirect effect of these vaccines.
16 Aug Acetaminophen During Pregnancy Linked to Childhood Behavioral Problems
MedicalResearch.com Interview with: [caption id="attachment_26957" align="alignleft" width="200"]
Dr. Evie Stergiakouli[/caption]
Dr Evie Stergiakouli
Lecturer in Genetic Epidemiology and Statistical Genetics
MRC Integrative Epidemiology Unit
University of Bristol
Bristol UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Acetaminophen is considered safe to use during pregnancy. However, research suggests that acetaminophen use in pregnancy is associated with abnormal neurodevelopment. It is possible that this association might be confounded by unmeasured behavioural factors linked to acetaminophen use. We compared acetaminophen use during pregnancy to postnatal acetaminophen use and partner's acetaminophen use. Only acetaminophen use during pregnancy has the potential to cause behavioural problems in the offspring. Any associations with postnatal acetaminophen use and partner's acetaminophen use would be due to confounding. Behavioural problems in the offspring were only associated with acetaminophen use during pregnancy.
16 Aug Not Enough Evidence To Recommend For or Against Cholesterol Screening In Children and Teens
MedicalResearch.com Interview with: [caption id="attachment_27017" align="alignleft" width="142"]
Dr. David Grossman[/caption]
Dr. David Grossman M.D., M.P.H.
Vice chair of the U.S. Preventive Services Task Force and
Professor at the University of Washington Schools of Public Health and Medicine
MedicalResearch.com: What is the background for this recommendation?
Response: The Task Force recognizes the importance of cardiovascular health for young people. Children and adolescents with high cholesterol are more likely to become adults with high cholesterol, and high cholesterol in adulthood can lead to serious health outcomes such as heart attacks and strokes. However, when the Task Force reviewed evidence for cholesterol screening in children and adolescents without any signs or symptoms, we found that there is not enough evidence to recommend for or against screening. In the face of unclear evidence, the Task Force is calling on the research community to prioritize studies on screening and treatment of lipid disorders in children and teens to help us all learn more about the impact that screening at an early age may have on the cardiovascular health of adults.
15 Aug BUZZY Reduces Pain and Fear of Needle Sticks
[caption id="attachment_26992" align="alignleft" width="200"]
Buzzy: Drug Free Pain Control[/caption]
MedicalResearch.com Interview with:
Amy Baxter MD
CEO MMJ Labs LLC
MedicalResearch.com: Would you tell us a little about your background? How did you develop an interest in pain management and prevention?
[caption id="attachment_26993" align="alignleft" width="164"]
Dr. Amy Baxter[/caption]
Response: As a pediatric emergency doctor, I found it interesting that doctors could prevent pain but sometimes couldn't be bothered to do so. The lack of empathy and impatience is built into emergency training - we learn to diagnose and fix things quickly, not comfort and support. I decided to research how pain management would make procedures more successful, or faster, to convince doctors to use pain management for THEIR benefit.
MedicalResearch.com: What is the background for the Buzzy(r) device? How does it impact pain sensation?
Response: When my 4 year old had a horrible vaccination experience, I realized that a fast effective parent-controlled option for pain relief was needed. I knew that cold running water could eliminate the pain from a burned finger using physiology called gate control. Basically, the small pain nerves run alongside big motion nerves, so if you heavily stimulate motion you scramble the pain sensation. Rubbing a bumped elbow is another good example. Vibration alone didn't work enough for needles, but when I added ice the two sensations of cold and motion eliminated pain in 84% of seniors getting a flu shot. We got a grant from the NIH to develop and study Buzzy - it's a palm sized vibration unit with a place on the back to attach ice "wings", that freeze solid. You put them both where an injection will go for a minute or less, then move them "between the brain and the pain" while doing a needle procedure. There are about 14 studies on IV access or blood draws and 6 on injections, showing between 50 and 88% pain reduction.
Several studies have demonstrated that Buzzy is truly a physiologic intervention, not a distraction: it didn't work for injections when only used for 10 seconds, too little time to block the pain nerves. But it worked really well for blood draws in severely cognitively impaired children for whom distraction wasn't an option.
12 Aug Early Onset of Pediatric Acute Otitis Media Raises Risk of More Frequent Episodes
MedicalResearch.com Interview with: [caption id="attachment_26952" align="alignleft" width="162"]
Marieke de Hoog[/caption]
Marieke de Hoog
Assistant Professor
Julius Centrum voor Gezondheidswetenschappen en Eerstelijnsgeneeskunde
UMC Utrecht
The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Acute otitis media (AOM) is a prime reason for doctor consultations and antibiotic use in children. Although symptoms of AOM may resolve spontaneously, these infections have a significant impact on child and family life and carry a considerable health care and economic burden. Acute otitis media occurring early in life, also called early-onset AOM, has been suggested as a risk factor for subsequent Acute otitis media episodes during childhood and could therefore also impact health care resource use. Identifying the critical age-period and quantifying the long-term consequences of early-onset AOM is important to guide future management and prevention programs aiming to reduce the burden of AOM.
10 Aug US Task Force Reviews Lipid Screening For Children and Adolscents
MedicalResearch.com Interview with: [caption id="attachment_26893" align="alignleft" width="142"]
Dr. Paula Lozano[/caption]
Paula Lozano, MD MPH
Associate Medical Director, Research and Translation
Group Health Physicians
Senior Investigator
Group Health Research Institute
Metropolitan Park East
Seattle, WA 98101
MedicalResearch.com: What is the background for this study?
Response: This wasn’t a study, but rather a study of studies, to support the US Preventive Services Task Force in updating its previous recommendation of
I: insufficient to assess the balance of benefits and harms. We conducted two systematic evidence reviews of screening children and adolescents:
1. for familial hypercholesterolemia (FH, a genetic disorder that interferes with the body’s ability to metabolize cholesterol and can result in early coronary heart disease); and
2. for multifactorial dyslipidemia—which we defined as elevated LDL cholesterol or total cholesterol, not caused by familial hypercholesterolemia. LDL and total cholesterol were of interest because they are considered atherogenic.
One of the challenges of lipid screening in youth is that blood levels of these atherogenic lipids are known to fluctuate during the course of childhood and adolescence. It’s sort of a W-shaped curve, with a peak at age 9-11 years. So for a given child, the definition of what’s an elevated LDL or total cholesterol level will change with age. Also, two-thirds of kids identified as having high cholesterol through universal screening would not go on to have high cholesterol as adults.