Author Interviews, Diabetes, Pediatrics / 09.07.2019

MedicalResearch.com Interview with: Nelly Mauras, MD Chief, Division of Pediatric Endocrinology, Nemours Children’s Health System Professor of Pediatrics Mayo College of Medicine MedicalResearch.com: What is the background for this study?   Response: Keeping blood sugars close to normal in young children with diabetes is often limited by parental fears of the risks of low blood sugars and impaired cognitive development. Dr. Nelly Mauras, at the Nemours Children’s Health System in Jacksonville FL, along with Dr. Allan Reiss at Stanford University are co-principal investigators of the Diabetes Research in Children Network, a 5-center consortium performing studies in children with diabetes, also including the University of Iowa, Washington University St Louis and Yale University. The investigators recruited 144 children with type 1 diabetes who were 4-7 years old and performed brain imaging (MRIs), did special cognitive tests, and monitored blood sugars using continuous glucose monitors. These studies were repeated after 18 months, approximately 54 months and 74 months, to examine changes in the brain and compare the results with those of 70 children the same age who do not have diabetes. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 28.06.2019

MedicalResearch.com Interview with:

Amanda Fingarson, DO Attending Physician, Child Abuse Pediatrics Ann and Robert H. Lurie Children’s Hospital of Chicago Assistant Professor of Pediatrics Feinberg Northwestern School of Medicine 

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

Response: Child physical abuse is a substantial pediatric public health issue, with significant morbidity and mortality. Studies have found that men, particularly children’s fathers and mothers’ boyfriends are common perpetrators of physical abuse. There is still a lack of knowledge, however, about the specific caregiver features that increase a child’s risk for physical abuse.

Our study design was unique, in that it was a multi-center study that compared young children with abusive and accidental injuries. Our primary finding was that abuse was much more likely when a male caregiver was present, and the resulting injuries were more likely to be severe or fatal. The presence of the mother’s boyfriend was the riskiest scenario, with the highest likelihood of abuse. Similarly, we found that caregiver relationships of less than 1 year increased the odds of abuse. Overall, the likelihood of abuse with female caregivers was much lower, with the exception of female babysitters.  A final important finding of our study was that caregiving arrangements that were different than usual at the time of injury were at increased risk of abuse, suggesting that a stable and consistent caregiver is also important.  (more…)

Author Interviews, JAMA, Pediatrics, Sexual Health, Technology / 28.06.2019

MedicalResearch.com Interview with: texting, sextingCamille Mori, B.A. (hons) M.Sc. candidate Clinical Psychology Program Determinants of Child Development Lab University of Calgary  MedicalResearch.com: What is the background for this study? Response: Sexting, which is the sharing of sexual messages, images, or videos over technological devices, has recently become a cause for concern among parents, teachers, and policy makers. However, the research on sexting among youth is still in early stages, and evidence of the risks associated with sexting is inconsistent. One way to resolve discrepancies in the field is to conduct a meta-analysis, which statistically summarizes existing research. We conducted a meta-analysis in order to examine the association between sexting and sexual activity (having sex, multiple sexual partners, and lack of contraception use). The associations between sexting and mental health related variables, including delinquent behaviour, substance use, and depression/anxiety were also examined. (more…)
Author Interviews, CDC, Cognitive Issues, Infections, Vaccine Studies / 24.06.2019

MedicalResearch.com Interview with: Arindam Nandi  PhD Center for Disease Dynamics, Economics & Policy  MedicalResearch.com: What is the background for this study?   Response: The motivation for this study comes from a small but growing body of evidence on the potential long-term benefits of vaccines. The recent resurgence of measles outbreaks in several countries which had previously eliminated the virus makes our study additionally relevant. There have been over 1,000 measles cases reported across 28 states in the US so far in 2019, which is the largest number of cases the country has seen in almost 3 decades. Similarly high number of cases have been reported in several European countries in recent years. This study reiterates the importance of vaccination and proves the long-term benefits of the measles vaccine in low- and middle-income countries, which account for a large proportion of global measles cases. (more…)
Author Interviews, CDC, JAMA, Nutrition, Pediatrics, Weight Research / 24.06.2019

MedicalResearch.com Interview with: Liping Pan, MD, MPH Epidemiologist Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: Children with severe obesity face significant health and social challenges. Children with obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease such as high blood pressure, impaired glucose tolerance, and high cholesterol than their healthyweight peers. Children with obesity can be bullied and teased more than their healthyweight peers. They are also more likely to suffer from social isolation, depression, and lower self-esteem. Children with obesity are also more likely to have obesity as adults. This can lead to lifelong physical and mental health problems. Adult obesity is associated with a higher risk of type 2 diabetes, heart disease, and many types of cancers.  Childhood obesity is more common among children from lower-income families, as many lack access to healthy, affordable foods and beverages and opportunities for low-cost physical activity. (more…)
Accidents & Violence, Author Interviews, Brain Injury, ENT, Pediatrics / 12.06.2019

MedicalResearch.com Interview with: Amishav Bresler MD Department of Otolaryngology - Head and Neck Surgery Rutgers - New Jersey Medical School  MedicalResearch.com: What is the background for this study? Response: This study was inspired by a personal experience with the rental scooters. The most recent American Academy of Otolaryngology-Head and Neck Surgery annual conference was in Atlanta this year. At the time of the conference, the scooter rental industry had recently entered the region. A friend of mine, another ENT resident, was encouraging others to use these scooters for transportation for both the novelty and convenience. However, he didn't even have a helmet! Here was a well-educated doctor who takes call for craniofacial injuries, who was about to get on a scooter without a helmet. This experience made me wonder if scooters were dangerous scooters and their overall impact on public health. In terms of the backgroud, the personal transportation industry is undergoing a revolution. The search for efficient and environmentally-friendly urban transportation ignited an ongoing debate in the United States regarding the role of motorized scooters. Although known to be a popular method of transportation in Europe and Asia, motorized scooters have only recently begun to make inroads in the United States. The gradual rise in popularity has been attributed to their convenience, affordability, and status as a “green” alternative to vehicles with combustion engines. These advantages combined with the fact electric scooters enable users to travel longer distances than conventional scooters present an attractive method of transportation to school, work, and leisure. (more…)
ASCO, Author Interviews, Bayer, Leukemia, Pediatrics / 05.06.2019

MedicalResearch.com Interview with: Joseph Germino, M.D., PhD Vice President US Medical Affairs Oncology Bayer Healthcare Pharmaceuticals Whippany, N.J. 07981 MedicalResearch.com: What is the background for this study? Response: Sorafenib (Nexavar®) is an oral anticancer therapy approved in more than 100 countries worldwide. It is approved for the treatment of patients with advanced hepatocellular carcinoma (HCC); advanced renal cell carcinoma (RCC) who have failed prior interferon-alpha or interleukin-2 based therapy or are considered unsuitable for such therapy; progressive, locally advanced or metastatic differentiated thyroid carcinoma (papillary/follicular/Hürthle cell), that is refractory to radioactive iodine (RAI). The AAML 1031 is a recently completed Phase III clinical trial evaluating the use of bortezomib and sorafenib in patients 30 years or younger with newly diagnosed acute myeloid leukemia (AML). At the 2019 ASCO Annual meeting, results of a report from the AAML1031 trial, which assessed whether intensification of Induction II chemotherapy (ADE or AraC/ Mitoxantrone) and liberalized stem cell transplant (SCT) donor source criteria improved clinical outcomes in patients with residual AML.  (more…)
Author Interviews, Emergency Care, JAMA, Medical Imaging, Pediatrics / 04.06.2019

MedicalResearch.com Interview with: Eyal Cohen, MD, M.Sc, FRCP(C) Professor, Pediatrics University of Toronto Co-Founder, Complex Care Program The Hospital for Sick Children   MedicalResearch.com: What is the background for this study? Response: Minimizing care that provides little benefit to patients has become an important focus to decrease health care costs and improve the quality of care delivery.  Diagnostic imaging in children is a common focus for campaigns designed to reduce overuse both in Canada and the US. There are some suggestions that there may be more overuse of care in the United States than Canada, but there has been little study in children. We compared the use of low-value diagnostic imaging rates from four pediatric emergency departments in Ontario to 26 in the United States from 2006 to 2016.  We defined low-value imaging as situations where children are discharged from an emergency department with a diagnosis for which routine use of diagnostic imaging may not be necessary, like asthma or constipation.  (more…)
ASCO, Author Interviews, Bayer, Cancer Research, Pediatrics / 03.06.2019

MedicalResearch.com Interview with: Douglas S. Hawkins, M.D. Hematology/Oncology Division Chief and Professor Pediatrics at Seattle Children's Hospital University of Washington School of Medicine MedicalResearch.com: What is the background for this study? Response: TRK fusion cancer is caused by a rare genomic alteration called a neurotrophic receptor tyrosine kinase (NTRK) gene fusion. Larotrectinib is a central nervous system (CNS) active, oral and highly selective TRK inhibitor used for the treatment of adult and pediatric patients with solid tumors that have a rare genomic alteration called an NTRK gene fusion. Larotrectinib was approved at the end of 2018 in the U.S. under the brand name VITRAKVI®, with European and worldwide regulatory submissions underway. At ASCO 2019, we will be presenting results from a new analysis specifically looking at the efficacy and safety of larotrectinib in pediatric patients (n=34) included in the expanded dataset from both adults and children across 24 tumor types, which was presented first at the European Society for Medical Oncology (ESMO) 2019 Annual Meeting.  (more…)
Accidents & Violence, Author Interviews, Pediatrics, Pediatrics, Toxin Research / 03.06.2019

MedicalResearch.com Interview with: Dr. Gary Smith, MD MPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our 2016 study (https://pediatrics.aappublications.org/content/137/5/e20154529) investigated calls to US poison control centers related to laundry and dishwasher detergent exposures among children younger than 6 years old from 2013 through 2014 and found that poison control centers received more than 30 calls a day about children who had been exposed to a laundry detergent packet, which is about one call every 45 minutes. The current study investigated trends in calls to poison control centers across the country for exposure to liquid laundry detergent packets in order to evaluate the impact of the voluntary safety standard for this product with a focus on young children. The study found only a modest decrease (18%) in calls for children younger than 6 years of age following adoption of a 2015 product safety standard as well as an increase in calls for older children and adults. Exposures to the eyes also continued to climb. The observed decrease in exposures among young children is considerably less than the 40% to 55% decrease in toxic ingestions seen after passage of the Poison Prevention Packaging Act. This demonstrates that the current liquid laundry detergent safety standard is inadequate and needs to be strengthened. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 20.05.2019

MedicalResearch.com Interview with: Jeffrey Colvin, MD, JD Department of Pediatrics Children's Mercy Hospital Kansas City, MO 64111  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have found that infants spend an average of 5-6 hours a day in sitting devices. Sitting devices include car seats, swings, infant seats, and strollers. Given how much time infants are spending in sitting devices, we wanted to know if sleep-related infant deaths (such as Sudden Infant Death Syndrome or "SIDS") was occurring in those devices. We examined over 10,000 infant sleep-related deaths from 45 states. We found that 3% (or 348) of the deaths occurred in sitting devices. Two-thirds of the deaths in sitting devices were in car seats. What was most surprising was that less than 10% of the deaths in car seats occurred in cars. Instead, the great majority occurred in the child's home or the home of a relative, friend, or babysitter. In 1/3 of the deaths in car seats, the supervising adult was asleep.  (more…)
Author Interviews, Electronic Records, JAMA, Pediatrics, Primary Care / 07.05.2019

MedicalResearch.com Interview with: Cari McCarty, PhD Research Professor, UW Investigator, Seattle Children’s Research Institute  MedicalResearch.com: What is the background for this study? Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Outcomes & Safety, Pediatrics, Pediatrics / 06.05.2019

MedicalResearch.com Interview with: John P. Galiote, M.D. Neonatologist at Children’s National-Virginia Hospital Center NICU Michelande Ridoré, MS, NICU Quality improvement lead at Children’s National   Lamia Soghier, M.D., MEd, Children’s National NICU Medical Director MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study emphasizes the importance of team work and real-time communication in a quality-improvement project within the neonatal intensive care unit (NICU) setting. Through bedside huddles, weekly reviews of apparent cause analysis reports reducing the frequency of X-rays and the creation of an Airway Safety Protection Team, we were able to focus not only on  reducing unintended extubations, but also on the quality-improvement project’s effect on our staff. Adhering to simple quality principles enabled us to ensure that all members of our staff were heard and had a positive effect on the progress of our project. This allowed us to implement and sustain a series of simple changes that standardized steps associated with securing and maintaining an endotracheal tube (ET). Unintended extubations are the fourth-most common adverse event in the nation’s NICUs. Continual monitoring via this quality-improvement project allowed us to intervene when our rates increased and further pushed our unintended extubation rate downward. (more…)
Author Interviews, JAMA, Pediatrics, Smoking / 06.05.2019

"E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping/Cloud Chasing" by Vaping360 is licensed under CC BY 2.0 CC BY 2.0MedicalResearch.com Interview with:Jenny L. Carwile, ScD, MPH Department of Medicine Maine Medical Center Portland   MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Although e-cigarette aerosols are commonly perceived to be "harmless water vapors" they contain numerous potentially harmful chemicals including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates. Non-users can be exposed to these chemicals through secondhand exposure. We found that in the US 4.9% of adults who lived in a household with children were current e-cigarette users. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics, Weight Research / 26.04.2019

MedicalResearch.com Interview with: Vincent W. V. Jaddoe, MD, PhD Adjunct Professor of Epidemiology Department of Epidemiology MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life. We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.  (more…)
Author Interviews, Infections, JAMA, Pediatrics / 26.04.2019

MedicalResearch.com Interview with: Dr. Matthieu Domenech de Cellès PhD Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines, Versailles, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination. Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex. In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect.    (more…)
Author Interviews, Infections, JAMA, Mental Health Research, Pediatrics / 25.04.2019

MedicalResearch.com Interview with: Lauren Breithaupt, PhD Department of Psychology George Mason University Fairfax, Virginia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders. We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    (more…)
Author Interviews, Pediatrics / 25.04.2019

MedicalResearch.com Interview with: Fern R. Hauck, MD, MS Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine Professor of Public Health Sciences Director, International Family Medicine Clinic University of Virginia Department of Family Medicine MedicalResearch.com: What is the background for this study? Response: Unintentional suffocation is the leading cause of injury deaths among infants under one year of age in the US. 82% of these deaths are attributed to accidental suffocation and strangulation in bed. The Sudden Unexpected Infant Death Case Registry was established by the Centers for Disease Control and Prevention (CDC) in 2009 to collect data on sudden unexpected infant deaths (SUID) to better understand trends and characteristics associated with these deaths. Data from 10 states, which account for about one-third of all US SUID cases, are captured in the Registry. The CDC developed the Case Registry classification system in 2014 to differentiate SUID cases into several groups; explained suffocations with unsafe sleep factors is one of those categories, and the subject of this study. We analyzed infant deaths (children under one year of age) that occurred from 2011-2014 among states participating in the registry at the time of the study (Arizona, Colorado, Georgia, Louisiana, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, and Wisconsin). Among the 1812 cases in the Registry from 2011-2014, 250 (14%) were classified as suffocation. The remaining cases were classified as unexplained SUID. (more…)
Author Interviews, Pediatrics, Weight Research / 23.04.2019

MedicalResearch.com Interview with: M. Pia Chaparro, MS, PhD Assistant Professor Department of Global Community Health and Behavioral Sciences School of Public Health and Tropical Medicine Tulane University New Orleans, LA 70112 MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2009, the WIC program changed the food packages participants receive to better align them with federal dietary guidelines. These changes included the addition of fruits, vegetables, and whole grains; a reduction in the amount of dairy and juice; and a calibration in formula amounts to match infants’ age and needs. We found that this change in the food package was associated with a 10-12% lower obesity risk at age 4 years among children who participated in WIC in Los Angeles County continuously from birth until age 4. (more…)
Author Interviews, Environmental Risks, JAMA, Pediatrics, Primary Care, Toxin Research, USPSTF / 23.04.2019

MedicalResearch.com Interview with: Alex H. Krist, MD, MPH Vice-Chairperson, U.S. Preventive Services Task Force Professor of family medicine and population healt Virginia Commonwealth University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Exposure to lead can have serious lifelong effects on the health and wellbeing of children. There is no safe level of lead exposure, so finding and removing any source of lead exposure is essential. In its review of the evidence, the Task Force found that more research is needed to determine what primary care clinicians can do to help prevent and treat the health problems that can result from lead exposure in childhood and pregnancy. (more…)
Author Interviews, JAMA, Pediatrics, Sugar / 23.04.2019

MedicalResearch.com Interview with: Asher Y Rosinger, PhD, MPH Assistant Professor of Biobehavioral Health and Anthropology Director of the Water, Health, and Nutrition Laboratory Pennsylvania State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sugar-sweetened beverage consumption has been linked to many negative health conditions, such as weight gain, dental caries, and type 2 diabetes. Previous research found that when you replace sugar-sweetened beverages (SSBs) with water intake then total energy intake goes down. We wanted to know how many calories from SSBs children consume when they drink water or not since sugar-sweetened beverages are often used as a replacement for water. SSB intake has been falling among children over the last 15 years, but there are still pockets and sub-populations that have high consumption levels. It is critical to identify which kids are particularly at risk for high SSB intake since this can lead to these negative health effects. Overall we found that kids that did not consume any plain water (from tap or bottled water) consumed almost twice as many calories and percent of total calories from sugar-sweetened beverages than kids that consumed water. And for the sample overall that translated to nearly 100 extra calories on a given day.  (more…)
Author Interviews, Environmental Risks, Global Health, Pediatrics, Toxin Research / 20.04.2019

MedicalResearch.com Interview with: Madhav P. Bhatta, PhD, MPH Associate Professor, Epidemiology & Global Health College of Public Health Kent State University Kent, OH 44242 MedicalResearch.com: What is the background for this study? Response: Lead exposure, especially in children, in any amount is harmful. Lead poisoning is a growing global environmental health problem with increasing lead-related diseases, disabilities, and deaths.  While exposure to lead in US children, in general, has significantly declined in the last three to four decades certain sub-groups of US children such as African Americans, immigrants and resettled refugees, and those from lower socioeconomic backgrounds are still vulnerable to environmental lead exposure. Previous studies among resettled refugee children in the United States had found 4- to 5-times higher prevalence of elevated blood lead level (EBLL) when compared to US-born children. However, most of the studies were conducted when EBLL was defined as blood lead level ≥ 10 µg/dL. In 2012, the US Centers for Disease Control and Prevention changed the reference value for EBLL to ≥ 5 µg/dL. Moreover, because the countries of origin for US resettled refugees change over time, it is important to have epidemiologic studies that provide the current information on EBLL among these vulnerable new US immigrant children. Using blood lead level data from the post-resettlement medical screening, our study examined the prevalence of elevated blood lead level at the time of resettlement among former refugee children who were settled in the state of Ohio from 2009-2016. We had a large and diverse sample (5,661 children from 46 countries of origin) of children for the study, which allowed us to assess EBLL in children from several countries of origin that had not been previously studied. (more…)
Author Interviews, Environmental Risks, Pediatrics, Toxin Research / 20.04.2019

MedicalResearch.com Interview with: Ms. Jacqueline Chiofalo, MPA Director of Policy Research & Analysis The Institute for Family Health Astoria, New York  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Exposure to lead is dangerous and has been banned from use in residential dwellings. However, residual sources of lead still exist. Few studies have examined pediatric lead poisoning between public (NYCHA) and private housing units, and no recent studies performed in New York City. Our study used retrospective chart analysis of routine child lead testing to examine the difference in blood lead levels between the two housing types. Our data showed that children seen in our health centers who lived in New York City public housing had significantly lower mean blood lead levels and fewer children were found with levels over the CDC reference range of 5 μg/dL compared to children who lived in private housing.  (more…)
Author Interviews, Melanoma, Pediatrics, Race/Ethnic Diversity, Stanford / 18.04.2019

MedicalResearch.com Interview with: Susan M. Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Physician Leader, Cancer Care Program in Cutaneous Oncology Stanford University Medical Center and Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Stanford Pigmented Lesion and Melanoma and Program and Pediatric Dermatology Division participated in the long-term management of children, adolescents and young adults (<25 years of age) with melanoma and atypical melanocytic neoplasms, including atypical Spitz tumors (ASTs) that may be histopathologically challenging to differentiate from true melanoma. Over a 23-year period, we have observed increased racial-ethnic diversity in young patients with these diagnoses, especially in the presentation of young individuals with darker skin phenotypes and more clinically amelanotic (nonpigmented) lesions compared to patients with lighter skin.  (more…)
Asthma, Author Interviews, Environmental Risks, Lancet, Pediatrics / 12.04.2019

MedicalResearch.com Interview with: Ploy Pattanun Achakulwisut, PhD Postdoctoral Scientist in Climate change, Air pollution, and Public Health Milken Institute School of Public Health (Anenberg Group The George Washington University, D.C  MedicalResearch.com: What is the background for this study? Response: Dozens of epidemiological studies have found positive and generally statistically significant associations between long-term exposure to traffic-related air pollution (TRAP) and asthma development in children. The evidence is most robust for nitrogen dioxide (NO2), a major component of and commonly used surrogate for the complex TRAP mixture. Recent reviews conducted by the US Environmental Protection Agency and Health Canada concluded that there is “likely a causal relationship” between long-term NO2 exposure and pediatric asthma development. Using NO2 as a proxy for TRAP, our study provides the first global estimate of the number of new asthma cases among children that are attributable to traffic pollution, using fine spatial-scale global datasets that can resolve within-city and near-roadway NO2 exposures. (more…)
Author Interviews, ENT, JAMA, Pain Research, Pediatrics, Surgical Research / 05.04.2019

MedicalResearch.com Interview with: Gillian R. Diercks, MD, MPH Instructor in Otolaryngology, Harvard Medical School Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston, Massachusetts  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pediatric tonsillectomy is a commonly performed procedure, representing the second most common ambulatory surgery performed on children in the United States, with over half a million children undergoing the surgery annually.  A major concern for surgeons, patients, and their families is the issue of postoperative pain control as pain can last up to 10-14 days after surgery, be quite severe, and result in readmission to the hospital or ED visits for medications and dehydration. In young children and children with sleep apnea we cannot safely administer narcotic pain medications at home.  This leaves limited options for pain control, including acetaminophen and ibuprofen.  However, there are concerns that ibuprofen could potentially increase bleeding risk after surgery because of its effects on platelet function in the blood.  At baseline, the risk of postoperative hemorrhage within the first two weeks after tonsillectomy is around 4.5%, with about 1-1.5% of children requiring a return to the operating room to control severe bleeding.  Our study set out to show that the risk of severe postoperative bleeding when ibuprofen is given for 9 days after tonsillectomy was not increased compared with the bleeding risk when acetaminophen was administered instead. Our study could not conclude that the risk of bleeding is no different when ibuprofen is used, and was suggestive that the bleeding risk may actually be higher. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 31.03.2019

MedicalResearch.com Interview with: Abhay K Lodha MD, DM, MSc Department of Pediatrics Alberta Health Services   MedicalResearch.com: What is the background for this study? Response: There is no physiological rationale for clamping the umbilical cord immediately after birth. In moderate (32+0 weeks-33+6 weeks) and late preterm infants (34+0 to 36+6), delayed cord clamping reduces the need for blood transfusions, leads to circulatory stability and improves blood pressure. However, the information on the association of delayed cord clamping with outcomes for extremely low gestational age neonates (22-28 weeks of gestation) is limited. (more…)
Author Interviews, JAMA, Karolinski Institute, Pediatrics / 26.03.2019

MedicalResearch.com Interview with: Mikael Norman, MD, PhD, Professor Karolinska Institutet & Karolinska University Hospital Stockholm, Sweden  MedicalResearch.com: What is the background for this study? Response: So far, preterm birth has been difficult to predict and prevent. In particular, extremely preterm birth has continued to be an issue in terms of optimal care before and after birth, costs and long term health outcomes. Therefore, studies on how the management and outcome varies over time in these patients are important. (more…)
Author Interviews, JAMA, Pediatrics / 26.03.2019

MedicalResearch.com Interview with: Edward Bell, MD Vice Chair for Faculty Development Department of Pediatrics Professor of Pediatrics - Neonatology Carver College of Medicine University of Iowa Health Care  MedicalResearch.com: What is the background for this study? Response: The study is an analysis of what happened to the 205 babies with birth weigh below 400 grams and gestational age of 22 through 26 weeks who were born between 2008 and 2016 at 21 academic medical centers that are members of the National Institute of Child Health and Human Development Neonatal Research Network. The Network exists to collaborate in finding ways to improve the survival and health of premature and other critically-ill newborn infants. 400 grams is very small. By comparison, 1 pound is 454 grams. (more…)