Author Interviews, Orthopedics, Pediatrics / 30.10.2015

MedicalResearch.com Interview with: Alex L. Gornitzky Medical Student and Theodore J. Ganley, M.D. Director of Sports Medicine, The Children’s Hospital of Philadelphia Associate Professor of Orthopaedic Surgery, The University of Pennsylvania School of Medicine Medical Research: What is the background for this study? Response: Currently, more than half of all high school students participate in organized athletics, and with increasing participation the incidence of ACL injury and subsequent reconstruction are also rising. Furthermore, researchers also know that adolescent and high school athletes have a number of unique risk factors that differentially affect their ACL injury risk profile as compared to older and/or more experienced athletes. To our knowledge, however, no previous studies have described sport-specific seasonal risk for ACL tears in the high school athlete by gender and by sport. More specifically, parents and athletes currently have no available information to more accurately define what their personal risk is for such an important and devastating injury. Therefore, the purpose of our study was to pool data from across the literature in order to objectively quantify an average high school athlete’s risk for ACL injury per season across a variety of varsity-level sports. If a student is injured while playing sports and the school doesn't deal with the injury correctly then it could make the issue worse. This is why it is important for schools to correctly identify is the player has suffered an ACL injury. If you have suffered an injury at school that wasn't properly dealt with then you may want to check out someone like these new york personal injury lawyers to see if you can get compensation. This study will hopefully help students see the risk of them getting an injury meaning they can take measures to prevent one happening to them. Medical Research: What are the main findings? Response: Overall, there is an approximately 1.6 times greater rate of ACL tear per athletic exposure in high school female athletes as compared to males. On a per-season basis, the highest risk sports in females were soccer, basketball and lacrosse at 1.1%, 0.9% and 0.5% risk of ACL tear per athletic season. Comparatively, in males, the highest risk sports were football, lacrosse and soccer at 0.8%, 0.4% and 0.3% risk of ACL tear per athletic season. Looking further at the year-round, multi-sport athlete, this may correspond to either a 2.5% risk per-year or 10% risk per high school career for the female athlete who participates in soccer, basketball and lacrosse, or 1% and 4%, respectively, for the male athlete who plays football, basketball and baseball. (more…)
Author Interviews, Education, Pediatrics / 29.10.2015

MedicalResearch.com Interview with: Chadi El Saleeby, MD. MS. Assistant Professor of Pediatrics, Harvard Medical School Pediatric Hospital Medicine and Pediatric Infectious Disease Units Mass. General Hospital for Children Boston, MA 02114  Medical Research: What is the background for this study? What are the main findings? Dr. El Saleeby: The Institute of Medicine, the Accreditation Council of Graduate Medical Education, and the American Board of Pediatrics stress the importance of appropriate supervision of trainees to reduce errors, lower patient mortality, and improve quality of care.  However, how appropriate supervision should be implemented in clinical practice is not well defined. After-hours supervision can be especially difficult when attendings or fellows may not be immediately available on-site and residents must determine when to contact a supervising physician regarding a clinical issue. The purpose of this study was to evaluate expectations when a pediatric resident should a contact a supervising physician while working after hours. To that effect, we developed 34 scenarios of the most common or the most serious issues encountered by residents on a general pediatric floor. We included these scenarios in an online survey, which was sent to the residents, fellows and attendings, asking for each scenario, if they would communicate immediately to discuss, or delay communication until the following day. There were two main findings of the study. First, in half of the scenarios, there were significant differences in communication preferences between residents and their supervisors. In all of these 17 discrepant scenarios without one single exception, more supervising clinicians wanted immediate communication compared to the residents. Second, there was no internal agreement between supervising physicians themselves. The junior attendings were more similar in their responses to residents while the more senior group (attendings with 5 or more years of clinical experience) asked to be immediately contacted much more frequently. (more…)
Alcohol, Author Interviews, Pediatrics / 28.10.2015

MedicalResearch.com Interview with: Heather Fay, MHS Program Services FCD Educational Services Newton, MA Medical Research: What is the background for this study? What are the main findings? Response: This study was conducted by FCD Prevention Works, an international non-profit focused on school-based, substance abuse prevention. Using FCD’s database of over 50,000 6th-12th grade student survey responses, we sought to explore the relationship between parental permission of student substance use and negative consequences related to substance use. We compared student alcohol and other drug use in the home, with or without a parent’s knowledge, to students’ self-reported negative consequences related to their own alcohol use. As might be expected, students who used alcohol or other drugs at home without their parents knowing were more likely to report negative consequences in the past 12 months related to their alcohol own use. Students who used at home with their parents knowing were protected against some negative consequences. These students were less likely than students who did not report this behavior to feel guilty about their drinking or regret something they did while drinking. However, these same students were at an increased risk of experiencing negative consequences related to addiction. These consequences included those which are indicative of a mounting dependency on alcohol, such as needing a drink or other drug first thing in the morning, using alcohol or other drugs alone, passing out because of drinking, and getting hurt or injured as a direct result of their alcohol use. (more…)
Alcohol, Author Interviews, Pediatrics / 28.10.2015

MedicalResearch.com Interview with: Daniel J. Dickson, M.A. Graduate Student and Brett Laursen PhD Department of Psychology Florida Atlantic University Medical Research: What is the background for this study? What are the main findings? Response: With age, adolescents spend more time with peers, and engage in drinking behaviors at increasing levels. In particular, girls who reach puberty at earlier ages than their peers are at higher risk for abusing alcohol. This may be because early maturing girls seek out the company of older more mature peers, ​who have greater access to alcohol and (in the case of those prone to delinquency) may be more welcoming to younger girls who are having difficulties with agemates. Our study investigates the association between changes in parental autonomy granting and girls’ alcohol abuse over a three year period (ages 13-16), as a function of timing of pubertal maturation. (more…)
AHA Journals, Author Interviews, Heart Disease, Nutrition, Pediatrics / 28.10.2015

MedicalResearch.com Interview with: Michael D. Miedema, MD, MPH Minneapolis Heart Institute Foundation Abbott Northwestern Hospital Minneapolis, MN Medical Research: What is the background for this study? Dr. Miedema: A healthy diet is an essential component in the prevention of cardiovascular disease. A dietary pattern high in fruits and vegetables has been associated with reduced rates of cardiovascular disease outcomes in multiple observation cohorts of middle-aged and older adults. However, the cardiovascular impact of fruit and vegetable intake in younger adults is less clear. Medical Research: What are the main findings? Dr. Miedema: To evaluate this relationship, we studied 2,506 young adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study to determine the association between fruit and vegetable intake during young adulthood and subsequent development of coronary artery calcium 20 years later. After adjusting for age, gender, and lifestyle variables, including smoking and physical activity, we found an inverse relationship between fruit and vegetable and subsequent coronary artery calcium across tertiles of fruit and vegetable intake (p-value <0.001). Individuals in the top third of fruit and vegetable intake at baseline had 26% lower odds of developing calcified plaque 20 years later. This inverse linear relationship remained significant after adjusting for fruit and vegetable intake at year 20 as well as after adjustment for other dietary variables such as dairy, nuts, fish, salt, and refined grains. (more…)
Author Interviews, Gluten, Pediatrics / 26.10.2015

MedicalResearch.com Interview with: Maria Ines Pinto Sanchez, MD MSc​ Post-doctoral Clinical ​ Research Fellow and Dr Elena Verdu, MD, PhD Farncombe Family Digestive Health Research Institute McMaster University Health Sciences Centre Hamilton, ON Medical Research: What is the background for this study? What are the main findings? Response: Celiac disease is a condition caused by ingestion of gluten in people with genetic predisposition, in which the finger like projections of the intestinal lining are damaged by inflammation. The “celiac” genes are necessary, but not sufficient, to develop celiac disease. For this reason, it is believed that additional factors could influence the risk of a predisposed child to develop celiac disease. Some studies have indeed suggested that the ideal time for the introduction of gluten to the diet would fall between the 4th and 6th month of life, when gluten should be introduced in “small quantities” and progressively, while maintaining breastfeeding whenever possible. The Nutrition Committee of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition recommended avoiding the introduction of gluten before 4 months and after 7 months of age in an attempt to prevent celiac disease. However, not all clinical studies reached this conclusion and we therefore conducted an updated analysis of the literature published on this subject to evaluate the relationship between time and amount of gluten introduction, breastfeeding and the risk of developing celiac disease. Our systematic analysis revealed that based on the studies published to date there is no strong support that early gluten introduction to an infant’s diet increases the chances to develop celiac disease or that breastfeeding specifically protects from it. (more…)
Author Interviews, Pediatrics, Weight Research / 24.10.2015

MedicalResearch.com Interview with: Brian S. Schwartz, MD, MS Professor of Environmental Health Sciences, Epidemiology, and Medicine Co-director, Program on Global Sustainability and Health Senior Investigator, Geisinger Center for Health Research (Danville, PA) Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland 21205 Medical Research: What is the background for this study? What are the main findings? Dr. Schwartz: Sub-therapeutic doses of antibiotics (not a high enough dose to treat an infection in the animal) have been added to animal feeds for decades to promote weight gain. An increasing number of studies of therapeutic uses of antibiotics in humans have reported weight gain, mostly in young children. Using electronic health record data on over 163,000 children between 3 and 18 years of age from the Geisinger Health System, our study was the first one to study the full childhood age range among mostly healthy children; to find effects of antibiotics on weight gain at all ages; to find that the more the cumulative number of antibiotics the greater the weight gain; and that some of the effects were progressive, in that the cumulative number of antibiotics caused an increasing divergence of the body mass index trajectory over time from the trajectory in children who had not received antibiotics. (more…)
Author Interviews, Education, Pediatrics / 16.10.2015

Arielle Borovsky, PhD Assistant Professor Department of Psychology Florida State University Tallahassee, FL 32306 MedicalResearch.com Interview with: Arielle Borovsky, PhD Assistant Professor Department of Psychology Florida State University Tallahassee, FL 32306 Medical Research: What motivated this research? Dr. Borovsky: Early vocabulary learning sets the stage for many other language and academic skills. It is important to understand how this process proceeds normally so that we can identify children who may be in need of other clinical language interventions as early as possible. One of the emerging observations in early vocabulary acquisition research is that while the number of words that infants know is important, the structure of this knowledge also matters. That is, children do not learn words randomly, nor is their vocabulary a representative subset of adult vocabulary. Young children learn words that matter for communication in their daily activities, and these words tend to be related in meaning. It is highly possible that children are learning new language even when watching an Official Video on Youtube. Young children's early semantic structure in vocabulary knowledge suggests is that it may be easier for them to learn new words that have greater connections to their existing knowledge. However, although there had been some promising observational research on this topic, this idea had not yet been experimentally tested. So that is what we decided to do. Medical Research: What did you find? Dr. Borovsky: We found that children were be able to understand new words more effectively when those words had more connections to their exisiting vocabularies. We found this by asking parents of 32 two-year-old children to complete a detailed survey of the words their child says. We then taught these children the same six words and identified for each individual child the three words came from categories that they knew the most about, and the three that came from the child's least well-known categories. In this way, we could control for the child's overall vocabulary size, while selecting words that had relatively more or fewer connections to their own vocabulary. Afterwards, we used an eye-tracking task to test how children understood these high and low connection words. This allowed us to probe the child's knowledge without requiring them to talk or point, they simply had to do what they like to do naturally - watch a simple video on a computer screen with pictures that corresponded to the words they learned. We found that when the new items were named in this computer game, children looked more towards the words that had more connections rather than fewer connections. This suggested that they understood these high density words more easily than the more sparsely connected words. (more…)
Author Interviews, Heart Disease, JACC, Metabolic Syndrome, Pediatrics / 07.10.2015

Mark DeBoerMedicalResearch.com Interview with: Mark DeBoer, MD Children's Hospital's Department of Pediatrics University of Virginia  Medical Research: What is the background for this study? What are the main findings? Dr. DeBoer: We have been interested in how the severity of the metabolic syndrome relates to long term risks, both for children and adults.  We formulated a score that takes the different components of the metabolic syndrome (body mass index, blood pressure, fasting blood sugar, triglycerides and high density cholesterol) for an individual and forms a score estimating how severe the metabolic syndrome is in that individual.  When we looked at long-term data from individuals followed for 40 years, we found that children and adults with higher scores were more much likely to develop cardiovascular disease. (more…)
Author Interviews, Kaiser Permanente, Pediatrics, Weight Research / 05.10.2015

MedicalResearch.com Interview with: Dr-Corinna-Koebnick Corinna Koebnick, PhD Research scientist with Research & Evaluation Kaiser Permanente Southern California MedicalResearch: Please describe your study, what you were looking for, and why.  Dr. Koebnick: This study is based on the Kaiser Permanente Southern California Children’s Health Study, which includes all children and adolescents 2–19 years of age in Southern California who are actively enrolled in a large, integrated, managed health care system. We examined the body weight from electronic health records of more than 1.3 million children and adolescents 2-19 years of age from 2008 to 2013. The objective of this study was to investigate recent trends in pediatric obesity in Southern California between 2008 and 2013. Several recent studies have investigated national trends in childhood obesity in the United States and indicated that childhood obesity rates may have reached a plateau, but are not declining. Ours is one of the few studies that is large enough to be able to detect small changes in the prevalence of obesity in time periods of less than 10 years. MedicalResearch: What are the findings of this study?  Dr. Koebnick: Our study provides strong indication that the prevalence of overweight and obesity between 2008 and 2013 has not only plateaued, but also is slowly declining. While the decline in overweight and obesity was less pronounced in girls, adolescents, some minority groups and youth living in low income and low education areas, the decline was remarkably stable across all groups and significant even in minority youth and youth of lower socioeconomic status. We found the prevalence of overweight and obesity decreased overall by 2.2 percent and 1.6 percent, respectively. This change corresponds to a relative decline of 6.1 percent in overweight youth and 8.4 percent in obese youth. Although a decline was seen across all groups, the decrease was not as strong in adolescents aged 12-19 years, in girls compared to boys, and Hispanic and black children compared to non-Hispanic whites. (more…)
Author Interviews, Pediatrics, Technology / 05.10.2015

Ichiro Morioka, M.D. Professor of Pediatrics, Kobe University Graduate School of Medicine Chuo-ku, Kobe, JapanMedicalResearch.com Interview with: Ichiro Morioka, M.D. Professor of Pediatrics, Kobe University Graduate School of Medicine Chuo-ku, Kobe, Japan  Medical Research: What is the background for this study? What are the main findings? Dr. Morioka: Japan has the highest survival rate for preterm infants due to recent advanced medical treatment and the availability of Neonatal Intensive Care Units (NICU). Despite this, cases of cerebral palsy and hearing loss caused by neonatal jaundice continue (kernicterus) to occur, with cases reported for at least 2 in every 1000 infants born before the 30th week of gestation. It has also been established that cases of jaundice can worsen even two weeks after birth and thereafter, meaning that there is a need for continuous long-term jaundice monitoring of infants in the NICU. However, jaundice in preterm infants is difficult to detect through physical observations, and monitoring through a daily blood test is not a realistic option. We focused on transcutaneous jaundice monitoring used in daily health tests for full term infants. The bilirubin levels of 85 infants with a birth weight of under 1500 grams were monitored in NICUs at Kobe University, Kakogawa City Hospital, Hyogo Prefectural Kobe Children’s Hospital, Japanese Red Cross Society Himeji Hospital, and Takatsuki General Hospital, and were taken a total of 383 transcutaneous and blood bilirubin measurements at the same time. Through our results we were able to ascertain that the chest and back areas of preterm infants have the highest levels of sensitivity, and transcutaneous bilirubin levels in those areas were close to bilirubin levels in the blood. In addition to expanding the possibilities for transcutaneous monitoring of jaundice in preterm infants, we discovered the optimum area of skin to monitor it. (more…)
Author Interviews, Depression, OBGYNE, Pediatrics / 02.10.2015

Marte Handal PhD Division of Epidemiology Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com Interview with: Marte Handal PhD Division of Epidemiology Norwegian Institute of Public Health Oslo, Norway  Medical Research: What is the background for this study? Dr. Handal: The prevalence of depression during pregnancy is estimated to be as high as between 7 and 15%. It is well understood that untreated maternal depression may be harmful to both the mother and the child. When medical treatment of pregnant women is necessary, selective serotonin reuptake inhibitors (SSRIs) is the most common treatment. However, limited information is available on the potential effect of prenatal exposure to SSRIs on the child’s motor development. Medical Research: What are the main findings? Dr. Handal: We did find a week association between prolonged maternal use of SSRIs during pregnancy and delayed motor development in the child even after we had taken the mothers history of depression and her symptoms of anxiety and depression during and after pregnancy into account. However, only a few children were in the least developed category, corresponding to clinical motor delay, indicating that clinical importance is limited. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 30.09.2015

Nadine Parker M.Sc Injury Prevention Research Office Li Ka Shing Knowledge Institute Keenan Research Centre St. Michael’s Hospital Toronto, Ontario, CanadaMedicalResearch.com Interview with: Nadine Parker M.Sc Injury Prevention Research Office Li Ka Shing Knowledge Institute Keenan Research Centre St. Michael’s Hospital Toronto, Ontario, Canada Medical Research: What is the background for this study? What are the main findings? Response: TV toppling injuries in children have become increasingly more common in recent years. Including in countries with developing economies where televisions are becoming more affordable. Unfortunately, most people don’t recognize televisions as a hidden home hazard. These easily preventable injuries can be severe or even fatal. Of the deaths due to TV toppling 96% were caused by a head injury. Most of these injuries occur at home with 75% of them unwitnessed by a parent or caregiver. Often furniture such as dressers are used as TV stands but they are not designed to support the weight of TV sets making them unstable. Unfortunately, curious and resourceful young children like to climb these unstable support furniture leading to a toppling event. Play or pushing and pulling the TV set are also common causes of tip-overs. (more…)
Author Interviews, HIV, Pediatrics / 24.09.2015

MedicalResearch.com Interview with: Gayatri Mirani MD and Tulane University School of Medicine New Orleans, Louisiana Paige L. Williams, PhD Department of Biostatistics Harvard T. H. Chan School of Public Health Boston, MA 02115 Medical Research: What is the background for this study Response: Combination antiretroviral therapy (cART) has resulted in a dramatic decrease in HIV-related opportunistic infections and deaths in US youth, but both continue to occur. IMPAACT P1074, a long-term US-based prospective multicenter cohort study funded through NIH was conducted from April 2008 to June 2014. We reviewed complications and mortality rates in HIV-infected US youth enrolled in this study. Comparisons were made with a previous observational cohort study, P219C. While P219C was conducted from 2000 to 2007, we restricted our analysis to 2004-2007 in order to evaluate changes over the past decade. A total of 1201 HIV-infected youth were enrolled in the IMPAACT P1074 study, with most (1040, or 90%) infected with HIV at birth. The overall study population was 52% female, 58% black non-Hispanic and 28% Hispanic. Their mean age at the first chart abstraction was 17.4 (±5.4 Std. Dev.) years. The majority were on cART, had a stable CD4 count (baseline mean > 500 cells/mm3) and a suppressed viral load over a median follow-up of 3.7 years. The P219C group was younger, with a mean age of 11.9 (±5.0 Std. Dev.) years at the start of the 2004-2007 follow-up period. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Pediatrics, Social Issues / 22.09.2015

Avik Chatterjee, MD, MPH Physician, Boston Health Care for the Homeless Program Instructor, Harvard Medical School Associate Epidemiologist, Division of Global Health Equity, Brigham and Women's Hospital Boston, MAMedicalResearch.com Interview with: Avik Chatterjee, MD, MPH Physician, Boston Health Care for the Homeless Program Instructor, Harvard Medical School Associate Epidemiologist, Division of Global Health Equity, Brigham and Women's Hospital Boston, MA Medical Research: What is the background for this study? What are the main findings? Dr. Chatterjee: Substance use, sexual activity and violent behaviors are common during adolescence. Understanding risk factors for these behaviors will improve our ability to prevent them and their sequelae. The Chaos, Hubbub and Order Scale (CHAOS) is a measure of household physical and social disorder, and higher CHAOS score, as reported by parents, has been shown to be correlated with less self-regulatory behavior in children. Thus, CHAOS could be a risk factor for the above behaviors in adolescents. We used data from the RISE study, in which 929 adolescents completed face-to-face and computer-assisted (for sensitive questions) interviews about their health behaviors to analyze the relationship between CHAOS score and risky health behaviors. We found that students with highest CHAOS score, compared to those with zero CHAOS score, had elevated odds for tobacco use (3x), alcohol use (2.5x), any substance use at school (6x) and fighting in the past 12 months (2x). (more…)
Author Interviews, Nutrition, Pediatrics / 18.09.2015

Juliana F. W. Cohen, ScD, ScM Harvard T. H Chan School of Public Health Department of Health Sciences, Merrimack College North Andover, MAMedicalResearch.com Interview with: Juliana F. W. Cohen, ScD, ScM Harvard T. H Chan School of Public Health Assistant Professor Department of Health Sciences School of Science and Engineering Department of Health Sciences, Merrimack College North Andover, MA  Medical Research: What is the background for this study? What are the main findings? Dr. Cohen:  There is a substantial amount of variation in the amount of time students have to eat lunch because there are no national standards for lunch period lengths. This study found that when students had less than 20 minutes of seated time in the cafeteria, they were less likely to select a fruit and consumed significantly less of their entrees, milk and vegetables compared with students who had at least 25 minutes to eat their lunch. (more…)
Author Interviews, Pediatrics, Weight Research / 16.09.2015

MedicalResearch.com Interview with: Annemarie Schalkwijk, MSc/MD PhD candidate, GP in training Diabetes Research Group EMGO Institute for Health and Care Research VU University Medical Center Amsterdam The Netherlands Medical Research: What is the background for this study? Dr. Schalkwijk: Overweight and obese children are at increased risk of becoming overweight and obese adults and therefore are an important risk factor for developing type 2 diabetes. It is known from the literature that being overweight or obese is associated with environmental, parental and socioeconomic status (SES) characteristics. However, the interdependence of these variables has not been studied before.Therefore, the aim of our study is to assess the influence of the amount of green space, accessibility to a garden and the safety of the surroundings during ages 3-5 on being overweight or obese at age 7. Furthermore, we want to assess if parental choices and SES moderate or mediate this influence. Medical Research: What are the main findings? Dr. Schalkwijk: Statistically significant associations (p≤0.05) were found between low levels green space, not having access to a garden, shabbiness of the neighborhood and childhood obesity (OR (95% CI) respectively: 1,14 (1,02-1,27), 1,35 (1,16-1,58), 1,22 (1,05-1,42)). Parental determinants were related to the environmental determinants and childhood overweight/obese but did not moderate or mediate the association between the latter two. Therefore no parental variables were left in the model. As for SES, the highest level of education in the household did diminish the magnitude of the associations found between the environmental determinants and being overweight/obese. In the final model the remaining significant associations with childhood overweight/obese were no garden access for lower educated households and shabbiness of the neighborhood for higher educated households (OR (95% CI) respectively: 1,38 (1,16-1,58), 1,38 (1,12-1,70). We can conclude from our study, that environmental factors do have an association with children being overweight or obese. However, these associations are complex and might not be as distinct as previously assumed. (more…)
Author Interviews, CDC, Pediatrics, Weight Research / 15.09.2015

MedicalResearch.com Interview with: Jessica M. Robbins, PhD Adjunct Assistant Professor Public Health Epidemiologist Philadelphia Department of Public Health  Medical Research: What is the background for this study? Response: The rapid increase in child obesity rates across the US in recent decades has affected Philadelphia as it has other cities.  The Philadelphia Department of Public Health has worked with the School District of Philadelphia to analyze data on students' heights and weights to determine trends in obesity since the 2006-2007 school year.  Data we had examined through the 2009-2010 school year indicated that the prevalence of obesity and severe obesity were declining in this population, and notably were declining in African-American and Hispanic students as well.  We updated the analyses with data through the 2012-2013 school year to see if that trend had continued. Medical Research: What are the main findings? Response: Overall, the prevalence of obesity and particularly of severe obesity continued to decline, although more slowly than in the earlier period.  However, there were some disturbing disparities, with improvement largely limited to boys.  Girls in grades kindergarten through 5 and Hispanic girls actually saw increased obesity since 2009-2010. (more…)
Author Interviews, JAMA, Pain Research, Pediatrics, Race/Ethnic Diversity, Surgical Research / 14.09.2015

Monika Goyal, MD Pediatric emergency medicine Children’s National Hospital Washington, DC MedicalResearch.com Interview with: Monika Goyal, MD Pediatric emergency medicine Children’s National Hospital Washington, DC Medical Research: What is the background for this study? What are the main findings? Dr. Goyal: Appendicitis is a painful surgical condition and adequate analgesia, particularly with opioids, are considered one of the mainstays of management. We found that almost half of all children diagnosed with appendicitis did not receive any analgesia. Furthermore, among the patients that did receive analgesia, there were marked racial differences with black children having lower rates of opioid medication receipt than white children, even after we took pain scores or acuity level into account. (more…)
Allergies, Author Interviews, Pediatrics / 12.09.2015

Merja Nermes, MD Dept. of Pediatrics Turku University Hospital Turku, FinlandMedicalResearch.com Interview with: Merja Nermes, MD Dept. of Pediatrics Turku University Hospital Turku, Finland Medical Research: What is the background for this study? What are the main findings? Response: Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease.  Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive. Our results are the first to show that specific bifidobacteria present in pets can be transferred to the infant gastrointestinal tract during a close contact.  Bifidobacteria in general are a part of the microbiota in healthy breast fed infants, and many studies have shown that human-specific bifidobacteria have beneficial effects to health, e.g. lower the risk of allergic disease. The same might hold true for bifidobacteria of animal origin which may  enhance and strengthen the development of the infants´ immune system to be protective against allergies. Our results showed that animal-derived bifidobacteria were found in a higher proportion in infants of pet-keeping families than in those without such exposure.  We also found  that  B. thermophilum (pet-derived Bifidobacterium) was associated  with a lower risk for atopic sensitization  at  6 months of age. (more…)
Author Interviews, Genetic Research, Pediatrics, Psychological Science / 02.09.2015

Beate W. Hygen PhD Student Department of Psychology Norwegian University of Science and Technology Social ScienceMedicalResearch.com Interview with: Beate W. Hygen PhD Student Department of Psychology Norwegian University of Science and Technology Social Science Medical Research: What is the background for this study? Response: The study is part of the Trondheim Early Secure Study (TESS) conducted at the  Department of Psychology, Norwegian University of Science and Technology (NTNU) and NTNU Social Science. The main aim of TESS is to detect risk and protective factors with regards to children’s mental health and well-being.  TESS examines multiple factors which may play a role in children`s development. There is substantial research, based on diathesis-stress theorizing, indicating that some individuals, including children, are more susceptible to the negative effects of contextual adversity than are others. However, according to differential susceptibility theory, such "vulnerable" individuals may also be the ones that benefit the most from positive environmental conditions. Thus, some individuals are more malleable for "better and for worse" to environmental exposures. The article Child exposure to serious life events, COMT, and aggression: Testing differential susceptibility theory was designed to examine if the COMT polymorphism moderated the effect of early-life adversity on aggressive behavior. Thus, we sought to competitively evaluate which model of person X environment interaction best accounted for the anticipated differential effects of life event stress on children's aggressive behavior. (more…)
Author Interviews, Pediatrics, Vaccine Studies / 21.08.2015

Gary S. Marshall, M.D. Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases Director, Pediatric Clinical Trials Unit University of Louisville School of Medicine MedicalResearch.com Interview with: Gary S. Marshall, M.D. Professor of Pediatrics Chief, Division of Pediatric Infectious Diseases Director, Pediatric Clinical Trials Unit University of Louisville School of Medicine     Medical Research: What is the background for this study? What are the main findings? Dr. Marshall: The infant immunization schedule has become crowded. That’s great news, in a sense, because it means that our children have become better protected against more diseases. At the same time, this has led to well child visits during which many shots are recommended, and some parents want to limit the number of injections their children receive at one time. This leads to deferrals, poor timeliness and decreased coverage rates, all of which could impair protection. This study shows that a hexavalent vaccine—one that combines diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B vaccines in one syringe—is safe and just as immunogenic as the currently used component vaccines.  (more…)
Addiction, Author Interviews / 17.08.2015

MedicalResearch.com Interview with: Kathrine Sullivan Ph.D. Candidate University of Southern California School of Social Work Medical Research: What is the background for this study? What are the main findings? Response: Military families and military-connected youth exhibit significant strengths; however, a sizeable proportion of these families appear to be struggling in the face of war-related stressors. Understanding the consequences of war is critical as a public health concern and because additional resources may be needed to support military families. This study used a large, normative, and geographically comprehensive dataset to determine whether military-connected youth are at risk of adverse outcomes, including substance use, victimization, and weapon-carrying, during wartime.  Results indicated that military-connected 7th, 9th and 11th grade students had greater odds of substance use, victimization, and weapon-carrying compared to non-military connected peers. Specifically, more military-connected students reported using alcohol (45 percent vs. 39 percent), being hit, kicked, slapped or pushed (36 percent vs. 27 percent) or bringing a gun to school (10 percent vs. 5 percent) than other students.  Children with parents or a caregiver in the armed forces were also much more likely to have used prescription medications (36 percent vs. 27 percent), brought a knife to school (15 percent vs. 9 percent), been in a fight (27 percent vs. 17 percent) or feared being beaten up (24 percent vs. 18 percent). (more…)
Author Interviews, HIV, NIH, Pediatrics, Vaccine Studies / 15.08.2015

George K Siberry, MD, MPH, Medical Officer Maternal and Pediatric Infectious Disease (MPID) Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda, MDMedicalResearch.com Interview with: George K Siberry, MD, MPH, Medical Officer Maternal and Pediatric Infectious Disease (MPID) Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda, MD Medical Research: What is the background for this study? Dr. Siberry:  Vaccines may not work as reliably in children with HIV infection, especially when their HIV is not under effective treatment. Today, most children in the United States who were born with HIV infection are receiving effective HIV treatment and have reached school age or even young adulthood. However, many received their childhood vaccines before they got started on their HIV treatment (because modern HIV treatments weren’t available when they were very young or their HIV infection was diagnosed late). So we wanted to see if these older children still had immunity from the vaccines they received when they were much younger. Medical Research:  What are the main findings? Dr. Siberry: We looked specifically at whether older children with HIV since birth were protected against measles, mumps, and rubella, the three viral infections covered by the measles-mumps-rubella (or MMR) vaccine. We found that 1/3 up to almost 1/2 of these children were not protected against these viruses, even though nearly all of the children had received at least 2 MMR doses, as recommended. And even if their HIV was currently under excellent control.  When we analyzed factors that were linked to being protected, we found that one of the most important factors was whether you got your MMR vaccine doses after you got on good treatment for your HIV infection.  For instance, over 85% of children who had gotten at least 2 MMR vaccine doses after being on effective HIV treatment were protected against measles compared to less than half of those who didn’t get both of their MMR vaccine doses while on effective HIV treatment. (more…)
Author Interviews, Hospital Readmissions, JAMA, Pediatrics / 11.08.2015

MedicalResearch.com Interview with: Alisa Khan, MD Pediatric hospitalist Boston Children's Hospital and Instructor of Pediatrics Harvard Medical School Medical Research: What is the background for this study? Dr. Khan: Patients can be readmitted to the same hospital they were discharged from or to a different hospital.  In adults, readmissions to different hospitals make up about 20% of all readmissions.  We don’t know a lot about how often different-hospital readmissions happen in children. Insurance companies know hospitals’ true readmission rates (which include when a hospital’s patients are readmitted to the same hospital and when they are readmitted to a different hospital).  However, hospitals don’t know their true readmission rates since they don’t have access to the full information that insurance companies have. If hospitals don’t know their true rates, they may think they are doing better at preventing readmissions than they really (for instance, if all their discharged patients are simply being readmitted to a different hospital).  Hospitals may also draw incorrect conclusions when they compare themselves to one another (like through benchmarking), and may not be able to predict whether they will be subject to penalties by insurers for having excessively high readmission rates. Medical Research: What are the main findings? Dr. Khan: We found that about 1 in 7 pediatric readmissions in New York over a 5-year period were to a different hospital than the hospital the patient was discharged from.   The percentage of different-hospital readmissions varied by hospital and patient characteristics.  Patients who were admitted to non-children’s hospitals, lower-volume hospitals, or urban hospitals had a higher chance of being readmitted to a different hospital, as did patients who were younger, white, privately insured, or who had certain chronic conditions (like mental health, neurologic, and circulatory conditions). We also found a lot of variability in how much individual hospitals would underestimate their true readmission rates if they only used this incomplete same-hospital readmission info.  Some hospitals would underestimate their true readmission rates by only 0.6 relative percentage points while others would underestimate them by 68 points. (more…)
Author Interviews, Pediatrics / 08.08.2015

Prof. Abdel-Latif MohamedDiscipline of Neonatology, Medical School, College of Medicine, Biology & Environment Australian National University Acton, Canberra, ACT, AustraliaMedicalResearch.com Interview with: Prof. Abdel-Latif Mohamed Discipline of Neonatology, Medical School, College of Medicine, Biology & Environment Australian National University Acton, Canberra, ACT, Australia Medical Research: What is the background for this study? What are the main findings? Prof. Mohamed: Despite decades of research and debate amongst neonatologists, consensus regarding optimal management of Patent Ductus Arteriosus (PDA) in the premature infant is yet to be established. The vast majority of premature infants are treated with oral or intravenous medication and surgical ligation is usually reserved to severely ill infants. Our study demonstrated that treatment for Patent Ductus Arteriosus , particularly of a surgical nature, maybe associated with a greater risk of adverse neurodevelopmental outcome at 2-3 years of age. This was particularly so among infants born below 25 weeks gestation. This result may support permissive tolerance of PDAs. However, reasons for this association remain to be elucidated through carefully designed prospective trials. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics / 28.07.2015

MedicalResearch.com Interview with: Wade Harrison, MPH The Dartmouth Institute for Health Policy & Clinical Practice Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire Medical Research: What is the background for this study? What are the main findings? Dr. Harrison: This study used national birth certificate data to examine time trends in Neonatal Intensive Care Unit (NICU) admission rates for all U.S. newborns and the composition of the cohort of admitted newborns.  Most of the existing studies of neonatal intensive care are limited in examining specific groups of newborns (e.g. those <1500 g, those with a specific complication, within limited geographies, etc.) or only looking at how care is delivered after a baby is admitted, leaving aside the question of whether to admit them in the first place.  This is an important area to study because the newborn period is a critical time for babies and their families to establish good feeding practices and increase bonding among other important needs; also, neonatal intensive care is very expensive and like all medical interventions can carry certain risks.  We found that NICU admission rates increased for all newborns across the birth weight spectrum.  Additionally, although NICUs were initially developed to care for very small and premature newborns, just under half of current NICU admissions are for normal birth weight and full term infants, who are likely to be less ill. (more…)
Author Interviews, CDC, Pediatrics, Vitamin D / 25.06.2015

Katherine Ahrens Ph.D. MPH National Center for Health Statistics Centers for Disease Control and Prevention Hyattsville, MDMedicalResearch.com Interview with: Katherine Ahrens Ph.D. MPH National Center for Health Statistics Centers for Disease Control and Prevention Hyattsville, MD Medical Research: What is the background for this study? Dr. Ahrens: In 2008, the American Academy of Pediatrics (AAP) revised their recommended minimum daily intake of vitamin D for infants and children to 400 IU. Medical Research: What are the main findings? Dr. Ahrens: Approximately one quarter of US infants aged 0 to 11 months met the 2008 AAP vitamin D recommendations on a given day in 2009 to 2012. Fewer than 1 in 5 breastfed infants met the vitamin D recommendations compared to nearly 1 in 3 non-breastfed infants. (more…)
Author Interviews, C. difficile, Columbia, Gastrointestinal Disease, Microbiome, Pediatrics / 19.06.2015

Daniel E. Freedberg, MD, MS Assistant Professor of Medicine Division of Digestive and Liver Diseases Columbia University, New YorkMedicalResearch.com Interview with: Daniel E. Freedberg, MD, MS Assistant Professor of Medicine Division of Digestive and Liver Diseases Columbia University, New York Medical Research: What is the background for this study? Dr. Freedberg: Acid suppression medications are increasingly prescribed to relatively healthy children without clear indications, but the side effects of these medications are uncertain. Medical Research: What are the main findings? Dr. Freedberg: Acid suppression with (proton pump inhibitors ) PPIs or (histamine-2 receptor antagonists) H2RAs was associated with increased risk for C. diff infection in both infants and older children. Medical Research: What should clinicians and patients take away from your report? Dr. Freedberg: Increased risk for C. diff should be factored into the decision to use acid suppression medications in children.  Our findings imply that acid suppression medications alter the bacterial composition of the lower gastrointestinal tract. (more…)
Author Interviews, Cannabis, Pediatrics / 15.06.2015

Dr. Gary Smith MD, DrPH Center for Injury Research and Policy Nationwide Children's Hospital Columbus, OhioMedicalResearch.com Interview with: Dr. Gary Smith MD, DrPH Center for Injury Research and Policy Nationwide Children's Hospital Columbus, Ohio Medical Research: What is the background for this study? What are the main findings? Dr. Smith: As of January 2015, 23 states and Washington D.C. have legalized marijuana for medical use. Four of those same states and Washington D.C. have also voted to legalize marijuana for recreational use. The debate about legalization often focuses on health effects among adults, economic benefits, and crime rates. Lost in the discussion is the potential harm to young children from unintentional exposure to marijuana. The study found that the rate of marijuana exposure among children 5 years of age and younger rose 147.5 percent from 2006 through 2013 across the United States. The rate increased almost 610 percent during the same period in states that legalized marijuana for medical use before 2000. In states that legalized marijuana from 2000 through 2013, the rate increased almost 16 percent per year after legalization, with a particular jump in the year that marijuana was legalized. Even states that had not legalized marijuana by 2013 saw a rise of 63 percent in the rate of marijuana exposures among young children from 2000 through 2013. Most children were exposed when they swallowed marijuana – that may be related to the popularity of marijuana brownies, cookies and other foods. (more…)