Author Interviews, Herpes Viruses, Pediatrics / 19.12.2014

Ann J. Melvin MD, MPH Division of Pediatric Infectious Disease Department of Pediatrics Seattle Children's Hospital, Seattle, WA 98105.MedicalResearch.com Interview with: Ann J. Melvin MD, MPH Division of Pediatric Infectious Disease Department of Pediatrics Seattle Children's Hospital, Seattle, WA 98105. Medical Research: What is the background for this study? What are the main findings? Dr. Melvin: While relatively uncommon, neonatal Herpes Simplex Virus is a potentially devastating infection with significant morbidity and mortality.  We reviewed all of the neonatal HSV cases treated at our institution between 1993 and 2012 who had HSV DNA PCR results available from the plasma and/or CSF.  Most of the infants had quantitative PCR results available.  The objective of the study was to determine the clinical correlation of HSV PCR levels in the plasma and CSF.  We found a clear association between the plasma HSV level, clinical presentation and mortality.  All of the infants who died had HSV plasma DNA levels of greater than 7 log10 copies/ml.   However, neither plasma nor CSF HSV levels predicted neurologic outcome.   Clinical evidence of CNS disease was more predictive of neurologic outcome than was the CSF PCR level. We also showed the most sensitive test for diagnosis of neonatal HSV to be HSV PCR on the plasma.  However, no single test diagnostic test (plasma PCR, CSF PCR, surface cultures) was positive across all infants, so it is important to obtain samples from plasma, CSF and surface swabs in infants with symptoms consistent with HSV infection. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 12.12.2014

Dr. Gary A. Smith Center for Injury Research and Policy Nationwide Children’s HospitalMedicalResearch.com Interview with: Dr. Gary A. Smith Center for Injury Research and Policy Nationwide Children’s Hospital   Medical Research: What is the background for this study? What are the main findings? Dr. Smith: The study found that from 1990 through 2011, an estimated 3,278,073 children younger than 18 years of age were treated in United States emergency departments for toy related injuries. The annual injury rate per 10,000 children increased by nearly 40% during that time period. The increase was largely associated with ride-on toys, particularly foot-powered scooters. Ride-on toys accounted for 34.9% of all injuries and 42.5% of hospital admissions. The study is the first to comprehensively investigate toy-related injuries among children using a nationally representative data set, the National Electronic Injury Surveillance System (NEISS). (more…)
Accidents & Violence, Author Interviews, JAMA, Pediatrics / 02.12.2014

Prof. Denise Kendrick Professor of Primary Care Research Division of Primary Care, University Park Nottingham UKMedicalResearch.com Interview with: Prof. Denise Kendrick Professor of Primary Care Research Division of Primary Care, University Park Nottingham UK Medical Research: What is the background for this study? What are the main findings? Prof. Kendrick: More than 1 million US children aged 0-4 years attend emergency departments because of  a fall each year. Approximately half of all ED attendances in this age group are for falls, and most of these are falls from furniture, most commonly from beds, chairs , baby walkers, bouncers, changing tables and high chairs. In the US around 18,000 0-4 year olds are admitted to hospital following a fall each year  and in 2012 there were 31 deaths in the US in 0-4 year olds from falls. Healthcare costs for falls in the US  were estimated at $439 million for hospitalised children and $643 million for  ED attendances in 2005. We found that children were more likely to attend hospital because of a fall from furniture in families that did not use safety gates across doorways or on stairs. For infants (aged 0-12 months) we found they were more likely to attend hospital because of a fall from furniture if they had been left on a raised surface (e.g. beds, sofas, work tops etc), had diapers changed on a raised surface or been put in a car seat or bouncing cradle on a raised surface. We also found that children aged over 3 years who had climbed or played on furniture were more likely to have a fall requiring a hospital visit than children who had not. Finally we found that children whose parents had not taught their children rules about climbing on objects in the kitchen were more likely to have a fall needing a hospital visit than children whose parents had taught these rules. (more…)
Author Interviews, JAMA, Pediatrics, Vaccine Studies / 15.11.2014

Elyse O. Kharbanda MD MPH HealthPartners Medical and Dental GroupMedicalResearch.com Interview Elyse O. Kharbanda MD MPH HealthPartners Medical and Dental Group Medical Research: What is the background for this study? What are the main findings? Dr. Kharbanda: In 2010, due to a pertussis outbreak and neonatal deaths, the California Department of Public Health recommended that the Tdap vaccine be administered during pregnancy.  Tdap is now recommended by the Advisory Committee on Immunization Practices (ACIP) for all pregnant women during each pregnancy.  We wanted to assess the impact of this recommendation. The main findings were that Tdap vaccination during pregnancy was not associated with increased risk for hypertensive disorders of pregnancy, preterm birth, or having a baby who is small for his or her gestational age. The study found a small increased risk for being diagnosed with chorioamnionitis, an inflammation of the fetal membranes caused by bacterial infection.  These findings should be interpreted with caution as the magnitude of the risk was small.  In addition, there was no associated risk for preterm birth, which often occurs as a result of chorioamnionitis.  Furthermore, among the subset of women with a chorioamnionitis diagnosis whose charts were reviewed, many did not have a clinical picture that was clearly consistent with chorioamnionitis. (more…)
Author Interviews, Pediatrics, Toxin Research / 11.11.2014

Marcel J Casavant MD FACEP FACMT Chief of Toxicology, Nationwide Children's Hospita Medical Director, Central Ohio Poison Center Clinical Professor, The Ohio State University Colleges of Medicine & Pharmacy Columbus OH USA 43205-2696MedicalResearch.com Interview with: Marcel J Casavant MD FACEP FACMT Chief of Toxicology, Nationwide Children's Hospita Medical Director, Central Ohio Poison Center Clinical Professor, The Ohio State University Colleges of Medicine & Pharmacy Columbus OH USA 43205-2696 Medical Research: What is the background for this study? What are the main findings?  Dr. Casavant: Laundry detergent pods reached the US market shelves in early 2012; almost immediately parents started calling poison control centers about their children’s exposures to these products. Since then the CDC, the CPSC, the American Association of Poison Centers, and others have issued warnings about these products. Several papers and numerous abstracts have described injuries to various groups of children; we therefore chose to analyze and describe what happened to all US children with exposure to one of these products reported to a poison control center in 2012 and 2013. The main finding: these products are dangerous to children! Over those two years we found more than 17,000 young children exposed to pods, more than 6,000 seen in an emergency department, more than 700 admitted to a hospital, and among these, more than half required intensive care. Two young children died, both in 2013. Our study was published online on November 10, 2014 (http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Laundry-Detergent-Pods-Can-Be-a-Serious-Poisoning-Risk-in-Children.aspx) and will appear in the December 2014 print edition of Pediatrics (volume 134 number 6). (more…)
Author Interviews, CDC, Infections, Pediatrics, Vaccine Studies, Vanderbilt / 07.11.2014

MedicalResearch.com Interview with: Marie R Griffin MD MPH Director, Vanderbilt MPH Program Department of Health Policy Vanderbilt University Medical Center Nashville TN 37212 Marie R Griffin MD MPH Director, Vanderbilt MPH Program Department of Health Policy Vanderbilt University Medical Center Nashville TN 37212 Medical Research: What is the background for this study? What are the main findings? Dr. Griffin: In Tennessee, the introduction in 2010 of a new pneumococcal vaccine for infants and young children was associated with a 27 percent decline in pneumonia hospital admissions across the state among children under age 2. The recent decline in Tennessee comes on top of an earlier 43 percent decline across the United States associated with the introduction in 2000 of the first pneumococcal vaccine for children under 2 years of age. (more…)
Author Interviews, Orthopedics, Pediatrics, Rheumatology / 06.11.2014

Professor Flavia Cicuttin School of Public Health and Preventive Medicine Monash University and Alfred Hospital Melbourne, AustraliaMedicalResearch.com Interview with: Professor Flavia Cicuttin School of Public Health and Preventive Medicine Monash University and Alfred Hospital Melbourne, Australia Medical Research: What is the background for this study? What are the main findings? Prof. Cicuttin: Previous research found that low birth weight and preterm birth have been linked to hypertension, cardiovascular disease, insulin resistance and reduced bone mass in adulthood.  Given these adverse outcomes related to birth weight and preterm birth we set out to investigate if low birth weight and preterm birth also played a role in increase risk of joint replacement surgery as adults. We found that  low birth weight and preterm birth were associated with a 2-fold increased risk of hip but not knee replacement surgery. (more…)
Author Interviews, Erasmus, Gastrointestinal Disease, Pediatrics / 05.11.2014

MedicalResearch.com Interview with: Anne Tharner, PhD and Jessica C. Kiefte-de Jong, PhD Department of Epidemiology Erasmus Medical Center, Rotterdam The Netherlands Medical Research: What is the background for this study? What are the main findings? Response: Constipation is one of the most common health problems in children, and occurs in most cases without organic reason. In our study, we examined if fussy eating behavior might be related to constipation in children. “Fussy eaters” are children who reject specific foods – often (green and bitter) vegetables – and often compensate this with the intake of less healthy but highly palatable foods (such as fast food or sweets). This kind of diet might be one of the reasons for constipation in children, but at the same time, children might develop difficult eating patterns due to digestive problems such as constipation. Therefore, we examined whether fussy eating and functional constipation mutually affect each other, which might point to the development of a vicious cycle. We examined this in a large study including almost 5000 children aged 2-6 years who participated in a longitudinal study in Rotterdam, the Netherlands. Families were regularly followed up starting in pregnancy. Our main finding was that fussy eating co-exists with functional constipation and also predicts subsequent development of functional constipation. In addition, we also found evidence for the reverse, as functional constipation predicted subsequent fussy eating behavior. Together with previous studies, our findings suggest that indeed a vicious cycle may develop throughout childhood in which children’s constipation problems and problematic eating behavior mutually affect each other. On the one hand, fussy eating might affect the development of functional constipation via poor dietary quality which is a characteristic for the diet of fussy eaters. On the other hand, our findings show that functional constipation in also predicts future fussy eating. This pathway is less well studied, but it is conceivable that children with constipation and the accompanying abdominal pain and painful defecation may develop problematic eating behavior. (more…)
Author Interviews, JAMA, Pediatrics / 27.10.2014

MedicalResearch.com Interview with: Ian M. Paul, M.D., M.Sc. Professor of Pediatrics and Public Health Sciences Chief, Division of Academic General Pediatrics Associate Vice Chair for Research, Department of Pediatrics Penn State College of Medicine Hershey, PA 17033-0850 Medical Research: What are the main findings of the study? Dr. Paul: This study highlights that a significant placebo effect exists in the treatment of young children with cough due to colds because agave nectar and placebo both resulted in improvement of child symptoms by parents compared with no treatment. (more…)
Author Interviews, Pediatrics, Vaccine Studies / 24.10.2014

MedicalResearch.com Interview with: Louise-Anne McNutt, PhD Associate Director, Institute for Health and the Environment University at Albany, State University of New YorkLouise-Anne McNutt, PhD Associate Director, Institute for Health and the Environment University at Albany, State University of New York Jessica Nadeau, PhD Epidemiologist, University at Albany, State University of New YorkJessica Nadeau, PhD Epidemiologist, University at Albany, State University of New York Medical Research: What are the main findings of the study? Response: The study found that about 25% of infants consistently deviated from the routine vaccine schedule recommended by the American Academy of Pediatrics (AAP).  Alterations included either consistently refusing a recommended vaccine or reducing the number of vaccines given at each visit. These deviations are generally associated with intent to use an alternative vaccination schedule. Infants who did not follow the AAP recommended schedule were more likely to be unprotected against vaccine preventable diseases for a longer period of time. Only 1 in10 infants vaccinated on an alternative schedule were up-to-date at 9 months of age. (more…)
Allergies, Author Interviews, Infections, Nutrition, Pediatrics / 22.10.2014

Georg Loss, PhD Dr. von Hauner Children’s Hospital Ludwig Maximilians University of Munich Munich, GermanyMedicalResearch.com Interview with: Georg Loss, PhD Dr. von Hauner Children’s Hospital Ludwig Maximilians University of Munich Munich, Germany Medical Research: What are the main findings of the study? Dr. Loss: In this large population based cohort study we observed that consumption of fresh unprocessed cow’s milk protected from respiratory infections, febrile illness and inflammation of the middle ear during the first year of life. The risk of developing these conditions was reduced by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT (Ultra-heat-treatment) processing eliminated the effect altogether. Importantly, the positive impact of fresh milk could be clearly separated from the confounding effects of other elements of the children’s nutrition. Furthermore, infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status. (more…)
Author Interviews, CMAJ, Pediatrics, Vitamin D / 22.10.2014

Jonathon Maguire MD MSc FRCPC Pediatrician and Scientist Department of Pediatrics Li Ka Shing Knowledge Institute St. Michael’s Hospital University of TorontoMedicalResearch.com: Interview with: Jonathon Maguire MD MSc FRCPC Pediatrician and Scientist  Department of Pediatrics Li Ka Shing Knowledge Institute St. Michael’s Hospital University of Toronto   Medical Research: What is the background for this study? What are the main findings? Dr. Maguire: One of the main health benefits of cow’s milk is vitamin D.  We were interested to know if non-cow’s milk supports children’s vitamin D blood levels as well as cow’s milk. (more…)
Author Interviews, Pediatrics / 20.10.2014

MedicalResearch.com: Interview with: Dr. Huiyun Xiang, MD, MPH, PhD Center for Injury Research and Policy The Ohio State University College of Medicine, Columbus, OhioDr.  Huiyun Xiang, MD, MPH, PhD Center for Injury Research and Policy The Ohio State University College of Medicine, Columbus, Ohio Jeb Phillips, BA Project Specialist, Injury Research and Policy Staff Nationwide Children’s Hospital, Columbus, OhioJeb Phillips, BA Project Specialist, Injury Research and Policy Staff Nationwide Children’s Hospital,  Columbus, Ohio   Medical Research: What are the main findings of the study? Response: From 2002-2012, a child younger than 6 years old experienced an out-of-hospital medication error every 8 minutes. That’s a total of 696,937 during the study period, or 63,358 per year. Almost all happened at the child’s residence. The rate and number of errors decreased with increasing age. Analgesics were the mostly commonly involved medications (25.2%), followed by cough and cold medications (24.6%). More than 1 in 4 (27%) of the errors happened when a child inadvertently took or was given medication twice. Errors also happened when children took or were given an incorrect dose, when medication measurements were confused, and when the wrong medication was taken or given. (more…)
Author Interviews, CDC, Pediatrics / 24.09.2014

Dr. Lorraine Yeung Division of Birth Defects and Developmental Disabilities National Center on Birth Defects and Developmental Disabilities, CDCMedicalResearch.com Interview with: Dr. Lorraine Yeung Division of Birth Defects and Developmental Disabilities National Center on Birth Defects and Developmental Disabilities, CDC Medical Research: What are the main findings of the study? Dr. Yeung: In this report, we looked at the percentages of children who received various recommended clinical preventive services. We found that millions of infants, children, and adolescents in the U.S. did not receive key clinical preventive services. This report provides a baseline snapshot of the use of 11 key clinical preventive services before or shortly after the Affordable Care Act went into effect. A focus of the Affordable Care Act is on improving prevention of illness and disability and it does so by requiring new health insurance plans to provide certain clinical preventive services at no additional cost — with no copays or deductibles. This is important because we know increasing the use of these services can improve children’s health and promote healthy lifestyles that will enable them to reach their full potential. Some of the important findings in this report were:          In 2007, parents of almost eight in 10 (79 percent) children aged 10-47 months reported that they were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.          In 2009, more than half (56 percent) of children and adolescents did not visit the dentist in the past year and nearly nine of 10 (86 percent) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.          Nearly half (47 percent) of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.          Approximately one in three (31 percent) outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; eight of 10 (80 percent) of those who screened positive for tobacco use did not receive any cessation assistance.          Approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement. (more…)
Author Interviews, Cancer Research, CDC, Pediatrics / 16.09.2014

Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health PromotionMedicalResearch.com Interview with: Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Medical Research: What are the main findings of the study? Dr. Li: Using the 2001 to 2009 National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) data, which represent 94.2% of the US population, we identified 120,137 pediatric cancer cases with an incidence rate of 171 cases per million children and adolescents. Overall cancer incidence rates were stable from 2001-2009. However, we found rates were increasing significantly at 1.3% per year in African American children and adolescents.  This increase might be partially attributed to the rise among renal tumors and thyroid cancer. We also found rising incidence in thyroid cancer and renal carcinoma among children and adolescents. As has been previously established, pediatric cancer is more common in males, in white, in adolescents, and in the Northeast. Leukemia is the most common pediatric cancer, followed by central nervous system (CNS) neoplasms, and then lymphomas. (more…)
BMJ, General Medicine, Pediatrics / 05.09.2014

Dr. Steve Turner Child Health, Royal Aberdeen Children's Hospital Aberdeen,UKMedicalResearch.com: Interview with: Dr. Steve Turner Child Health, Royal Aberdeen Children's Hospital Aberdeen,UK   Medical Research: What are the main findings of the study? Dr. Turner: There is evidence that being small for a given gestational age is associated with a broad range of what could be loosely considered “disadvantageous” outcomes in early childhood, eg increased risk for wheeze, increased blood fat levels, increased blood pressure and low bone mineral density.  Many of these outcomes are subclinical – ie unless they were measured no-one would be any the wiser – and what remains to be determined is whether as these individuals grow up these subclinical measurements become important.  Follow up may take many years, decades for outcomes such as coronary artery disease and type II diabetes. (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics / 03.09.2014

MedicalResearch.com Interview with: Cade M. Nylund, MD, MS, FAAP Major, United States Air Force, Medical Corps Assistant Professor of Pediatrics F. Edward Hébert School of Medicine Uniformed Services University Bethesda, Maryland
Medical Research: What are the main findings of the study? Dr. Nylund: The main findings of our study were that among children who were identified as having a diagnosis of Clostridium difficile infection (CDI), CDI was about twice as likely to occur during periods when the child was taking either a proton pump inhibitor or histamine-2 receptor antagonist. In brief, we performed a type of observational study called a self-controlled case series. Our data source was the military health system database which contains billing records for patients seen in military and civilian facilities. We identified all cases of Clostridium difficile infections in children ages 2-18 over the period of October 2001 to July 2013. We also identified periods when children were prescribed both proton pump inhibitors and histamine-2 receptor antagonists over the same time period. We compared the incidence of CDI during periods prescribed acid suppression medications to periods not prescribed these medications. (more…)
Author Interviews, Pediatrics, Vaccine Studies, Vitamin K / 25.08.2014

dr_shannon_macdonaldMedicalResearch.com interview with: Dr. Shannon MacDonald PhD Department of Pediatrics, University of Calgary, Calgary and Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada Medical Research: What are the main findings of the study? Dr. MacDonald: We found that vitamin K was refused by only a very small number of parents in our study population (0.3%) but that the number appears to be increasing (almost doubling in the past 7 years). The parents that refused vitamin K for their child were more likely to be those that delivered at home and/or with a midwife. We also found that parents who refused vitamin K for their child were also much more likely to go on to refuse all vaccinations by 15 months of age. (more…)
Author Interviews, CMAJ, Outcomes & Safety, Pediatrics / 20.08.2014

Dr Prakesh S Shah MSc, MBBS, MD, DCH, MRCP, FRCPC Professor, Departments of Paediatrics and HPME Mount Sinai Hospital and University of Toronto CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research Director, Canadian Neonatal Network Toronto Ontario Canada M5G 1X5MedicalResearch.com Interview with: Dr Prakesh S Shah MSc, MBBS, MD, DCH, MRCP, FRCPC Professor, Departments of Paediatrics and HPME Mount Sinai Hospital and University of Toronto CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research Director, Canadian Neonatal Network Toronto Ontario Canada M5G 1X5 Medical Research: What are the main findings of the study? Dr. Shah: The main findings of our study are that by embracing collaborative quality improvement program in 25 of 28 Neonatal ICUs in the country, we were able to show significant reduction in adverse outcomes of necrotizing enterocolitis, severe retinopathy of prematurity and nosocomial infections among preterm neonates born at less than 29 weeks of gestation. This resulted in significant overall reduction of composite outcome of mortality or severe morbidities and improved overall outcomes over 3 years of study period. (more…)
Author Interviews, JAMA, Pediatrics, Pulmonary Disease / 19.08.2014

Suzanne Schuh, MD, FRCP(C), FAAP, ABPEM Staff Paediatrician, Division of Paediatric Emergency Medicine Senior Associate Scientist, Research Institute, Hospital for Sick Children Professor of Paediatrics, University of TorontoMedicalResearch.com Interview with: Suzanne Schuh, MD, FRCP(C), FAAP, ABPEM Staff Paediatrician, Division of Paediatric Emergency Medicine Senior Associate Scientist, Research Institute, Hospital for Sick Children Professor of Paediatrics, University of Toronto Medical Research: What are the main findings of this study? Dr. Schuh: Our study shows that in previously healthy infants presenting to the Emergency Department with mild to moderate bronchiolitis (a viral lower respiratory tract disease producing breathing distress) who had their oxygen saturation measurements artificially elevated by a physiologically small amount experienced significantly reduced rate of hospitalizations within 72 hours compared to infants with unaltered oximetry readings. (more…)
Author Interviews, Pediatrics, Vaccine Studies / 01.08.2014

Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210MedicalResearch.com Interview with: Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210 Medical Research: What are the main findings of the study? Dr. Shaw: In this study, we looked at exemptions to school immunization requirements in the US during 2009-2010 school year. We found that private schools have higher rates for all types of exemptions (medical, religious, and personal belief/philosophical). In addition, states that permitted personal belief exemptions had higher rates of exemptions overall compared to states that did not allow them. (more…)
Accidents & Violence, Author Interviews / 17.07.2014

Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242MedicalResearch.com Interview with: Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242   MedicalResearch: Why did you perform this study?  Dr. Jennissen: More youth 15 years and younger in the United States are killed in all-terrain vehicle (ATV) crashes than on bicycles. Since 2001, children represent nearly 30% of all ATV-related injuries and 20% of all ATV-related deaths.  Although previous studies have shown children to have high exposure to ATVs, these studies have been mostly limited to select rural and agricultural groups.  With this study, we wanted to investigate the epidemiology of ATV use and safety-related behaviors among a large cross-sectional sample of adolescents. (more…)
Author Interviews, Infections, Lancet, Pediatrics / 10.07.2014

Pete Dodd (BA, BSc, MMath, PhD) Research associate in health economic modelling Health Economics and Decision Science ScHARR Regent Court SheffieldMedicalResearch.com Interview with: Pete Dodd (BA, BSc, MMath, PhD) Research associate in health economic modelling Health Economics and Decision Science ScHARR Regent Court Sheffield Medical Research: What are the main findings of the study? Dr. Dodd: We found that over 650,000 children under the age of 15 developed tuberculosis in the 22 highest burden countries in 2010, with around 7.6 million becoming infected with the bacillus and more than 50 million harboring latent infection. Our work points to a much larger gap between notifications and incidence in children compared to adults. (more…)
Author Interviews, Gastrointestinal Disease, Genetic Research, NEJM, Pediatrics / 03.07.2014

Dr. Daniel AgardhMedicalResearch.com Interview with: Dr. Daniel Agardh M.D., Ph.D Department of Pediatrics Diabetes and Celiac Disease Unit Skåne University Hospital Malmo, Sweden, MedicalResearch: What are the main findings of the study? Dr. Agardh: In this study, we stratify the risk of celiac disease among children according to their HLA genotype and country of residence. We confirm that HLA-DQ2/2 genotype is the major risk factor for early celiac disease, but also show how the risk differs between the participating countries despite of sharing similar HLA risk. This points to the direction of an interaction between HLA and the environment that eventually lead to an autoimmune response in genetic susceptible children. (more…)
Author Interviews, JAMA, Pediatrics, Surgical Research / 26.06.2014

Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics - Neonatology University of Iowa Carver College of MedicineMedicalResearch.com Interview with: Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics  - Neonatology University of Iowa Carver College of Medicine   MedicalResearch: What are the main findings of the study? Dr. Morriss: Our aim was to assess the association between surgery performed during the initial hospitalization of very low- birth-weight infants and subsequent death or neurodevelopmental impairment at 18-22 months’ corrected age. We conducted a retrospective cohort analysis of patients who were prospectively enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 to 2009. Surgery was classified by the expected anesthesia type as either major surgery that likely would have been performed under general anesthesia; or minor surgery, that is, procedures that could have been performed under non-general anesthesia and in general were shorter in duration. There were 2,186 major surgery patients and 784 minor surgery patients and more than 9,000 patients who did not undergo surgery. We found that any surgical procedure  increased the adjusted risk of death or neurodevelopmental impairment in low birth weight infants by about 30%. Not all surgical procedures were associated with increased risk, however. Compared with those who did not undergo surgery, patients  who were classified as having major surgery had a risk-adjusted odds ratio of death or neurodevelopmental impairment of 1.52 (95% confidence interval 1.24-1.87). However, those who were classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who did not undergo surgery the risk-adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26-1.93), and the risk-adjusted mean Bayley II Mental Developmental Index and mean Psychomotor Developmental Index values were significantly lower. (more…)
Author Interviews, BMJ, Infections, Pediatrics, Vaccine Studies / 25.06.2014

Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UKMedicalResearch.com: Interview with Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UK MedicalResearch: What are the main findings of the study? Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough.  We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children. (more…)
Author Interviews, JAMA, Pediatrics, Stanford, Surgical Research / 24.06.2014

Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric OtolaryngologyMedicalResearch.com Interview with: Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric Otolaryngology MedicalResearch: What are the main findings of the study? Dr. Chang: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points, and body mass index percentiles increased by a mean of 8.0 percentile points. The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight and younger than 4 years at the time of surgery. An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight. (more…)
Author Interviews, Pediatrics, Weight Research / 17.06.2014

Michelle A. Mendez, PhD Assistant Professor Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill, NMedicalResearch.com Interview with: Michelle A. Mendez, PhD Assistant Professor Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill, NC MedicalResearch: What are the main findings of the study? Dr. Mendez: Using national surveillance data to examine trends in energy intake among children, we found that there was an initial decline in intakes from 2003-4 through 2007-08, which mirrored evidence that child obesity in the US may have begun to decline in that period. Subsequently, however, in 2009-10, energy intake increased in older children aged 12-19y, and reached a plateau in children aged <11y. This shift is consistent with reports that, particularly in older children, the downward trend in obesity levels may have been reversed in recent years. (more…)
Author Interviews, Diabetes, Diabetologia, Pediatrics / 13.06.2014

MedicalResearch.com Interview with: Dr. Marcus de Goffau and Dr. Hermie Harmsen Department of Medical Microbiology University Medical Center Groningen MedicalResearch: What are the main findings of the study? Dr. Marcus de Goffau: In this study we aimed at analysing the gut microbiota composition of children aged 1–5 years with new-onset type 1 diabetes with the microbiota of age-matched healthy controls with a 16S rRNA based method (HITChip). The reason for this selection is that the increase in the incidence of type 1 diabetes worldwide is particularly sharp under the age of 5 years; recent studies indicate that adverse changes in gut microbiota are associated with the development of type 1 diabetes, but little is known about the microbiota in children who have diabetes at an early age. In this study we found that the differences between healthy controls and diabetics change over time, highlighting the importance of a normal gut microbial development. Diabetic children younger than 3 years old often had lower numbers of the Clostridium clusters XIVa and IV, which contain many of the beneficial butyrate producers, than their healthy age-matched controls. The diabetic children older than 3 years have normal numbers of Clostridium clusters XIVa and IV yet not the right species composition; the ones which produce butyrate were underrepresented. The development of the microbiota of diabetic children appears to be one step behind that of healthy controls and/or appears to be going into an aberrant direction. The abundances of other bacteria such as Bacteroides and streptococci were also found to be aberrant in diabetic children. (more…)
Author Interviews, JAMA, Pediatrics, Pulmonary Disease / 29.05.2014

Susan Wu MD Division of Hospital Medicine, Children's Hospital Los Angeles Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern CaliforniaMedicalResearch.com Interview with: Susan Wu MD Division of Hospital Medicine, Children's Hospital Los Angeles Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern California MedicalResearch: What are the main findings of the study? Dr. Wu: We performed a randomized trial at 2 urban free-standing children's hospitals, comparing inhaled 3% hypertonic saline to 0.9% normal saline in patients under 24 months with bronchiolitis. Patients with prematurity less than 34 weeks, cyanotic heart disease, chronic pulmonary disease, and previous episodes of wheezing or bronchodilator use were excluded. Patients were 4 mL of study medication nebulized up to 3 times in the emergency department; if admitted, patients continued to receive the assigned study medication three times a day until discharge. A total of 408 patients were analyzed. We found that 28.9% of patients treated with hypertonic saline required hospital admission, compared with 42.6% of patients in the normal saline group. (more…)