Author Interviews, Dermatology, JAMA, Pediatrics, Sleep Disorders, UCSF / 26.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48079" align="alignleft" width="135"]Dr. Katrina Abuabara Dr. Abuabara[/caption] Dr. Katrina Abuabara, MD, MA, MSCE Department of Dermatology Program for Clinical Research, University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: The wellbeing and development of children is strongly influenced by parents’ physical and psychosocial health. Parents of children with chronic illness, in particular, are susceptible to poor sleep, and previous studies have found major sleep impairments among parents of children with ventilator dependency and cystic fibrosis, but few studies have examined sleep patterns among parents of children with more common chronic illnesses like atopic dermatitis (also known as eczema).
Asthma, Author Interviews, JAMA, OBGYNE, Pediatrics, Vitamin D / 12.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47908" align="alignleft" width="133"]Bo Chawes, MD, PhD, DMScAssociate ProfessorC‌openhagen Prospective Studies on Asthma in ChildhoodH‌erlev and G‌entofte H‌ospitalU‌niversity of C‌openhagen Dr. Chawes[/caption] Bo Chawes, MD, PhD, DMSc Associate Professor C‌openhagen Prospective Studies on Asthma in Childhood H‌erlev and G‌entofte H‌ospital U‌niversity of C‌openhagen MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a global surge in vitamin D deficiency happening in parallel with an increase in prevalence of childhood asthma, which suggests that low maternal vitamin D levels during pregnancy may increase asthma risk in the child. Due to that we conducted a randomized double-blinded controlled trial within the Danish COPSAC2010 cohort (www.copsac.com) of 7-fold (2,800 IU/d) vs. standard dose (400 IU/d) of vitamin D supplementation from pregnancy week 24 aiming to reduce offspring asthma risk. At age 3, we observed a non-significant 24% reduced risk of recurrent asthma-like symptoms, ie. recurrent wheeze, in the high-dose vitamin D group. In the current study, we followed 545 of the 581 children in the study till age 6, where an asthma diagnosis can be established and observed no effect of the high-dose vitamin D supplement on the child's risk of asthma. 
Author Interviews, Pediatrics / 08.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47838" align="alignleft" width="200"]Prof. Angela Morgan PhDNHMRC Practitioner Fellow and Leads the Speech and Language GroupMurdoch Children's Research Institute Prof. Morgan[/caption] Prof. Angela Morgan PhD NHMRC Practitioner Fellow and Leads the Speech and Language Group Murdoch Children's Research Institute MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Approximately 5% of school-aged children have a communication impairment that affects speech, language, or both. There are many subtypes of speech sound disorders, but the most severe is  (CAS), which impacts sequencing of speech movements. Childhood apraxia of speech  occurs in around 1 in 1000 children. In persistent cases of CAS, speech cannot easily be understood throughout life. Although CAS is rare, unravelling its neurobiological causes is likely to identify brain networks crucial to more common and less severe forms of speech disorders. Here we provide comprehensive speech and neuroimaging data on a large novel family where one parent and 11 children presented with features of childhood apraxia of speech. Brain MRI scanning revealed changes in core parts of the brain responsible for speech production. Even though CAS manifests as a problem with talking, we found disruptions in an underlying pathway of the brain normally associated with language (the meaning and grammar of what we say), rather than speech production. Our findings identify disruption of the dorsal language stream as a novel finding in developmental speech disorders. Overall, our data confirm the early role of this stream in auditory-to-articulation transformations. 
Allergies, Author Interviews, Pediatrics / 04.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47726" align="alignleft" width="200"]Todd Green MD Vice President, Medical Affairs North AmericaDBV TechnologiesAssociate Professor of PediatricsUniversity of Pittsburgh School of Medicine Dr. Green[/caption] Todd Green MD  Vice President, Medical Affairs North America DBV Technologies Associate Professor of Pediatrics University of Pittsburgh School of Medicine MedicalResearch.com: What is the background for this announcement? What is Viaskin Peanut? Response: Peanut allergy is one of the most common food allergies and can cause severe, potentially life-threatening allergic reactions, including anaphylaxis. Unfortunately, there are no FDA-approved treatment options for peanut or other food allergies – leaving patients with avoidance and readiness to manage reactions to accidental exposures as their only option. Viaskin Peanut uses epicutaneous immunotherapy or EPIT, a method of delivering biologically active compounds to the immune system through the skin. Patients receive about 1/1,000th of a peanut with each daily dose of peanut protein – the equivalent of one peanut every three years – which activates the immune system with very minimal exposure. In February 2019, DBV announced that its planned resubmission of the Biologics License Application (BLA) to the U.S. Food and Drug Administration (FDA) for Viaskin Peanut in the treatment of peanut-allergic children 4 to 11 years of age is anticipated in the third quarter of 2019. DBV is working diligently on its resubmission package, bringing us one step closer to providing an FDA-approved treatment for peanut-allergic children and their families. Viaskin Peanut previously received Breakthrough and Fast Track designations for the treatment of peanut-allergic children from the FDA in 2015 and 2012, respectively. 
Author Interviews, Endocrinology, Pediatrics / 03.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47745" align="alignleft" width="200"]Yehuda Limony, MD, MScPediatric Endocrinology UnitFaculty of Health SciencesBen-Gurion University of the NegevClalit Health ServicesBeer-Sheva, Israel  Dr. Limony[/caption] Yehuda Limony, MD, MSc Pediatric Endocrinology Unit Faculty of Health Sciences Ben-Gurion University of the Negev Clalit Health Services Beer-Sheva, Israel  MedicalResearch.com: What is the background for this study? Response: The variability of the onset age of puberty is the subject of many studies in numerous disciplines; nonetheless, the timing of puberty remains an enigma. The conventional paradigm is that the time of onset of puberty is genetically determined even though genome-wide association studies explain only a very low percentage of the physiologic variability. It is commonly believed, therefore, that many environmental factors interfere with the genetics of timing of puberty. On the other hand, children grow toward an adult height that is the standardized average of parents' height called "target height". That is why children are usually similar in height to parents. This targeted growth process is evident especially in children whose height percentile in childhood is different from their target height percentile (we called this difference the "height gap"). It is known that the timing of puberty is associated with adult height: earlier puberty causes shorter adult height and vice versa. We hypothesized that the targeted process of growth involves adaptation of the age of onset of puberty in accordance with the height gap.
Author Interviews, JAMA, Ophthalmology, Pediatrics, STD, USPSTF / 05.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47324" align="alignleft" width="133"]Michael Silverstein, M.D., M.P.H. Professor of pediatrics Director of the Division of General Academic Pediatrics Vice chair of research for the Department of Pediatrics Boston University School of Medicine Dr. Silverstein[/caption] Michael Silverstein, M.D., M.P.H. Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice chair of research for the Department of Pediatrics Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gonococcal ophthalmia neonatorum, or GON, is a severe infection of the eye that can occur in babies born to women who have gonorrhea. If left untreated, GON can cause serious problems, including blindness, that can appear as soon as 24 hours after delivery. Fortunately, there are effective treatments available that can prevent GON in newborns. The U.S. Preventive Services Task Force reviewed the most current research on the benefits and harms of ocular prophylaxis—which is applying antibiotic ointment to the babies’ eyes at birth—to prevent GON. We found that, if applied within 24 hours after birth, the ointment is very effective at preventing gonococcal ophthalmia neonatorum and the problems it causes. Therefore, we are recommending that clinicians provide this preventive service for all newborns. 
Author Interviews, Education, JAMA, Pediatrics / 03.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47176" align="alignleft" width="178"]Sheri Madigan, Ph.D, R.Psych Canada Research Chair in Determinants of Child Development Assistant Professor, Department of Psychology Alberta Children's Hospital Research Institute University of Calgary Dr. Madigan[/caption] Sheri Madigan, Ph.D, R.Psych Canada Research Chair in Determinants of Child Development Assistant Professor, Department of Psychology Alberta Children's Hospital Research Institute University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parents are reporting that screen time is one of their major concerns, so we wanted to find out more about how large of a role screen time was playing on children’s developmental outcomes. We were especially interested in the long-term impact of screens, which is why we followed children over time, from ages 2 to 5 and repeatedly assessed both screen time use and children’s achievement of developmental milestones. There are three main findings:
  1. Our study revealed that on average children were viewing screens for 2.4, 3.6 and 1.6 hours per day at two, three and five years of age, respectively. This means that the majority of the participants in our sample are exceeding the American Academy of Pediatrics’ guideline.
  2. We found statistically significant, albeit small effects suggesting that greater amounts of screen time at two and three years predict poorer child outcomes at three and five years, respectively. Thus, screen time has a lasting influence on children’s development.
  3. The opposite pattern was not observed. That is, we did not find evidence that children showing poor performance in terms of achieving developmental milestones were more likely to be place in front of screens to help cope with their potentially challenging behaviors.
Author Interviews, Duke, JAMA, Mental Health Research, Pediatrics, Toxin Research / 23.01.2019

MedicalResearch.com Interview with: Aaron Reuben, MEM Department of Psychology and Neuroscience Duke University, Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? (1)  Study members with greater lead exposure in childhood tended to endorse more psychiatric symptoms when assessed for psychiatric disorders in adulthood (between 18 and 38 years of age).
  1. These individuals tended to report more internalizing (e.g., depression, anxiety) and thought disorder (e.g., OCD, schizophrenia, mania) symptoms.
  2. Compared to other findings from this sample, the associations reported in this article are similar to those reported for lead and IQ, and are stronger than those reported for lead and criminal offending.
    1. Informants who knew Study members well reported higher levels of difficult adult personality traits among Study members with greater lead exposure in childhood.
    2. Specifically, Study members with greater blood lead levels at age 11 were rated as more neurotic, less agreeable, and less conscientious by 38 years of age.
    3. These personality traits have been previously linked to a number of poor life outcomes, including greater psychopathology, worse physical health, less job satisfaction, and troubled interpersonal relationships
  3. Psychiatric problems related to lead exposure could be detected as early as 11 years of age. In the 1980’s, parents and teachers of children with higher blood-lead levels had described them as displaying more antisocial behavior, hyperactivity, and negative emotions (e.g., sadness, anxiety).
Author Interviews, Global Health, JAMA, Mental Health Research, Pediatrics, UCLA, Zika / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47036" align="alignleft" width="200"]Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases  David Geffen School of Medicine at UCLA Dr. Nielsen[/caption] Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age. We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months. We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early.
Author Interviews, CDC, Infections, Pediatrics, Vaccine Studies / 18.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47002" align="alignleft" width="200"]Sarah Anne Mbaeyi MD MPH Division of Bacterial Diseases CDC  Dr. Mbaeyi[/caption] Sarah Anne Mbaeyi MD MPH Division of Bacterial Diseases CDC  MedicalResearch.com: What is the background for this study? Response: College freshman living in residence halls, though not college students overall, have previously been identified as being at increased risk for meningococcal disease. However, these evaluations were conducted in the 1990s when rates of disease were higher, serogroup C was the predominant cause of disease, and before the availability of quadrivalent meningococcal conjugate (MenACWY) or serogroup B meningococcal (MenB) vaccines. MenACWY vaccine is routinely recommended for all adolescents at age 11 years and 16 years, as well as unvaccinated or undervaccinated college freshmen living in residence halls. MenB vaccine is not routinely recommended for all adolescents or college students, but may be administered to persons aged 16-23 years, with the preferred age of 16-18 years, based on clinical decision-making. Meningococcal vaccines are also recommended during an outbreak, and in recent years MenB vaccines have been used during multiple outbreaks on college campuses. In this evaluation, we aimed to describe the current epidemiology of meningococcal disease among college-aged young adults in the United States.
Author Interviews, CDC, Infections, JAMA, Pediatrics / 15.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46953" align="alignleft" width="200"]Dr. Nanduri Srinivas Acharya, MBBS, MD, MPH Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases Centers for Disease Control and Prevention Roybal Campus Atlanta, GA 30333 Dr. Nanduri[/caption] Dr. Srinivas Acharya Nanduri, MBBS, MD, MPH Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases Centers for Disease Control and Prevention Roybal Campus Atlanta, GA 3033 MedicalResearch.com: What is the background for this study? Response: Group B Streptococcus (GBS) is a leading cause of serious illness such as meningitis and sepsis in infants. Among infants, there are two main types of GBS disease. Early-onset GBS disease occurs during the first week of life and late-onset GBS disease occurs from the first week through three months of life. Rates of early-onset disease in the United States have decreased significantly since the 1990s through widespread implementation of intrapartum antibiotic prophylaxis (IAP) guidelines. However, IAP does not prevent late-onset disease. Maternal immunization represents a nonantibiotic strategy to prevent both early and late-onset disease. Multivalent polysaccharide-protein conjugate vaccines are under development against GBS capsular types, with candidate vaccines in phase I and II trials. Active Bacterial Core surveillance (ABCs) conducts active surveillance for early and late-onset GBS disease among infants in select counties of 10 states, covering about 10% of live births across the United States. We analyzed data from early and late-onset GBS cases identified from ABCs between 2006 and 2015 to describe their epidemiology, incidence trends, and associated strain characteristics.
Alcohol, Author Interviews, Depression, JAMA / 09.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46863" align="alignleft" width="200"]Dr. Ingunn Olea Lund, PhD The Norwegian Institute of Public Health Oslo, Norway Dr. Ingunn Olea Lund[/caption] Dr. Ingunn Olea Lund, PhD The Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com: What is the background for this study? Response: There are significant amounts of research on children of parents with alcohol use disorders – where the children are shown to be at risk of several adverse outcomes, including mental disorders, substance use disorders, suicide, impaired school performance, and employment problems. There is very little previous research on how other, more normal levels of parental drinking may influence child outcomes, such as mental health. This is a grave oversight, as there are vastly more parents with normal drinking patterns than there are parents who suffer from an alcohol use disorder. This means that there are potentially a lot more cases of adverse effect for children, and the number of children at risk may be higher than previously assumed. In addition to parents' alcohol use, several other risk factors in the family that may affect child mental health outcomes, such as parents' mental health and socio-economic status. Researchers have tended to look at these risk factors separately, but as these risks tend to co-occur, it may be more informative to consider them together. To our knowledge, this is the first study that examines possible harm from normal levels of parental drinking, alone or in combination with other parental risk factors, on children’s anxiety and depression. The sample consists of more than 8700 triads: children and both their parents. We combined information from three health registries with survey data where both adolescents and their parents provided information about health and social conditions. The health registers include information about the children 's actual contact with the health care system; we used information about whether children received diagnoses and/or treatment for anxiety and/or depression.
Author Interviews, JAMA, Pediatrics, Social Issues / 28.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46736" align="alignleft" width="133"]Dr. Richard E. Tremblay, PhD, Professor Department of Pediatrics and Department of Psychology University of Montreal, Montreal, Quebec, Canada School of Public Health, University College Dublin, Dublin, Ireland Dr. Tremblay[/caption] Dr. Richard E. Tremblay, PhD, Professor Department of Pediatrics and Department of Psychology University of Montreal, Montreal, Quebec, Canada School of Public Health, University College Dublin, Dublin, Ireland MedicalResearch.com: What is the background for this study?   Response: Adolescent who have frequently use physical aggression are at high risk of school failure, criminal behavior, as well as physical and mental health problems. A major limit to preventive interventions is our ability to trace the developmental trajectories of physical aggression from infancy to adolescence using a uniform source of information.
Author Interviews / 20.12.2018

[caption id="attachment_46667" align="alignleft" width="200"]Safety 1st Cabinet Slide Lock Safety 1st Cabinet Slide Lock[/caption] By: The Experts at Child Safety Store
  • It is recommended that the majority of your childproofing be done at one time. This insures that it is completed before a new capability results in a preventable injury.
  • All lower drawers and cabinets in the kitchen and bathrooms should be latched before he ever learns he can open them. Accessible electrical outlets (both dormant and in-use) protected, vertical cords raised, pool fence installed, stairway gates in place, sharp corners protected, etc. Other items can be added as the need becomes apparent; door alarms, appliance latches, medicine cabinet latches, door knob covers, deadbolt locks, etc.
  • Get down on your child’s level (that’s hands, knees, roll over on your back to get under furniture) and look up. Look around each room carefully as if seeing it for the first time. Crawl around and try to stick your head behind furniture, reach under furniture and feel around to see what is there (sharp springs or staples sticking out, plastic tags, etc.). Get under tables and look up; what would your child’s head hit if he stood up (sharp corners, manufacturer’s labels attached with staples sticking out, glass in the center of an end stand or coffee table).
Author Interviews, Orthopedics, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46653" align="alignleft" width="160"]Dana L. Duren, PhD Professor, Director of Orthopaedic Research Director of Skeletal Morphology Laboratory Thompson Laboratory for Regenerative Orthopaedics Department of Orthopaedic Surgery Missouri Orthopaedic Institute, University of Missouri Columbia, MO 6521 Dr. Duren[/caption] Dana L. Duren, PhD Professor, Director of Orthopaedic Research Director of Skeletal Morphology Laboratory Thompson Laboratory for Regenerative Orthopaedics Department of Orthopaedic Surgery Missouri Orthopaedic Institute, University of Missouri Columbia, MO 6521 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The motivation for this study is the apparent accelerated maturity in children in the United States. [caption id="attachment_46650" align="alignleft" width="139"]Radiogram of distal tibia (left) and fibula (right) showing two epiphyseal plates. Wikipedia Image Radiogram of distal tibia (left) and fibula (right) showing two epiphyseal plates.
Wikipedia Image[/caption]   We previously demonstrated that skeletal maturity (bone age) is more advanced in today’s children compared to children born in the first half of the 20thCentury (Duren et al., 2015). n the current study (Boeyer et al., 2018) we show that a significant component of this advanced maturity status is the timing of epiphyseal fusion. In our study, nearly half of the epiphyses of the hand and wrist began or completed fusion significantly earlier in children born after 1995 than those born in the early part of the century, with differences as great as six to ten months for some bones, and mean differences on the order of 4 months in boys and 6 months in girls. 
Author Interviews, Hematology, Leukemia, Pediatrics / 05.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46330" align="alignleft" width="200"]Charles G. Mullighan, MBBS (Hons), MSc, MD Member, St. Jude Faculty Co-Leader, Hematological Malignancies Program Medical Director, St. Jude Biorepository William E. Evans Endowed Chair St. Judes Children’s Research Hospital Memphis, TN Dr. Mullighan[/caption] Charles G. Mullighan, MBBS (Hons), MSc, MD Member, St. Jude Faculty Co-Leader, Hematological Malignancies Program Medical Director, St. Jude Biorepository William E. Evans Endowed Chair St. Judes Children’s Research Hospital Memphis, TN MedicalResearch.com: What is the background for this study?   Response: B-lineage acute lymphoblastic leukemia (B-ALL) is the commonest form of ALL, and the commonest childhood tumor. It is a leading cause of childhood cancer death. It consists of multiple subtypes defined by genetic alterations. These are often chromosomal translocations that deregulate oncogenes or form fusion proteins. These alterations are disease initiating events and are associated with distinct patterns of leukemic cell gene expression. Most subtypes also have additional mutations that are important for cells to become fully leukemic. Identifying these initiating genetic changes is very important to identify patients that are likely to respond or do poorly with conventional therapy (multiagent chemotherapy). Also, some identify new opportunities for targeted therapy. However, using standard genetic testing approaches such as chromosomal cytogenetics, about 30% of B-ALL patients don’t have a subtype classifying alteration.
ADHD, Author Interviews, Pediatrics, Race/Ethnic Diversity / 05.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46390" align="alignleft" width="136"]George J. DuPaul, PhD Department of Education and Human Services Lehigh University Dr. DuPaul[/caption] George J. DuPaul, PhD Department of Education and Human Services Lehigh University [caption id="attachment_46407" align="alignleft" width="144"]Charles Barrett. Ph.D. School Psychologist Lehigh University Dr. Barrett[/caption]   Charles Barrett. Ph.D. School Psychologist Loudon County Virginia Public Schools   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD).  However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females.  For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys.  Few empirical studies have examined differences between Black and White boys. The present study sought to address several limitations in the field.  Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children.  Next, maternal figures, rather than teachers, were included as the informants. The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of ADHD).  Notably, although the boys’ behaviors were the same, maternal ratings were not identical. Specifically, using the ADHD Rating Scale, Fourth Edition (ARS-4), Black mothers assigned higher ratings to both Black and White boys.
Author Interviews, Autism, Pediatrics / 05.12.2018

MedicalResearch.com Interview with: Michael Kogan, Ph.D. Director of the office of Epidemiology and Research Health Resources and Services Administration’s Maternal and Child Health Bureau MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a study led by the Health Resources and Services Administration’s Maternal and Child Health Bureau, along with researchers from the Centers from Disease Control and Prevention, Harvard, Drexel, and George Washington Universities.  We used the 2016 National Survey of Children’s Health, a nationally representative survey of over 50,000 children that examines the health and well-being of US children, to examine the prevalence, treatment, and health care experiences of children with Autism Spectrum Disorder (ASD). We found that 1 out of 40 children in the US were reported by their parents to have been diagnosed with Autism Spectrum Disorder.  We also found that children with ASD were significantly less likely to receive services like needed care coordination, referrals to other services, and mental health counseling – even compared to children with other emotional, behavioral or developmental disorders (EBDs).  Parents of children with ASD were also significantly more likely to report being usually or always frustrated in their attempts to get services, again compared to families of children with other EBDs. Finally, we looked at treatment patterns for children with ASD and found that 64% had received behavioral therapy in the year before the interview, and 27% had received medications to treat symptoms of irritability. 
Accidents & Violence, Author Interviews, JAMA, Pediatrics, USPSTF / 28.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46250" align="alignleft" width="200"]Alex Kemper, M.D., M.P.H., M.S.  Dr. Kemper[/caption] Alex Kemper, M.D., M.P.H., M.S.  Dr. Kemper is a board-certified pediatrician and chief of the Division of Ambulatory Pediatrics at Nationwide Children’s Hospital. He is also the deputy editor of Pediatrics. MedicalResearch.com: What is the background for this recommendation statement? What are the main findings and recommendations?  Response: Child maltreatment, which includes abuse and neglect, is a serious health problem that affects too many children in the United States.  Abuse and neglect can have devastating health consequences, including long-term disabilities, depression, physical injury, and even death. In 2016, approximately 676,000 children were subjected to maltreatment, and more than 1,700 children died as a result. Because this is such an important public health issue, the U.S. Preventive Services Task Force looked at the most recent evidence on whether primary care clinicians can help prevent child maltreatment and its negative consequences. We found that, unfortunately, there is not enough evidence to recommend for or against these interventions. The Task Force is calling for more research on this important subject so that we can help prevent children from being abused and neglected.   
Author Interviews, Autism, Nature, Pediatrics / 27.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46215" align="alignleft" width="149"]Michael Lombardo, PhD Assistant professor of Psychology the University of Cyprus  Dr. Lombardo[/caption] Michael Lombardo, PhD Assistant professor of Psychology the University of Cyprus  MedicalResearch.com: What is the background for this study? Response: Autism is a diagnostic label we give to children with difficulties in the areas of social-communication and restricted, repetitive stereotyped behaviors and interests. The diagnosis is made based on observations about behavior and is a consensus label, meaning that clinicians can show high degrees of agreement that a given set of behaviors is ‘autism’. But aside from the diagnostic label, there is a fair degree of heterogeneity within patients that have the diagnosis. One way in which patients are heterogeneous is with regard to early language development. Some toddlers with autism are minimally verbal, while at the other end, many toddlers with autism develop language typically. An important question to answer is whether that kind of difference in language development indicates a subtype with different underlying biology. To examine this question, we first split toddlers with autism into two subtypes defined by their language outcome at 4 years of age. Some toddlers were classified as poor language outcome, because their language performance was 1 standard deviation below typical norms. Other toddlers with autism had relatively good language outcome, as their language performance by 4 years of age was within 1 standard deviation of typical norms. We also measured the biology behind these two autism subtypes. First we used functional magnetic resonance imaging (fMRI), which is a non-invasive method to look at blood oxygenation response that changes according to a task. Blood oxygenation changes are an indirect measure of neural activity. We used fMRI during natural sleep at around 29 months of age while the toddlers were played language stimuli through headphones to elicit neural responses to speech. Second, we measured molecular aspects of biology, by taking blood samples, isolating leukocyte cells, and then quantifying gene expression for all protein coding genes in the genome, at around the same time as the fMRI scan.
Author Interviews, Gastrointestinal Disease, Microbiome, NEJM, Pediatrics, Probiotics / 22.11.2018

[caption id="attachment_46070" align="alignleft" width="155"]Stephen Freedman MDCM, MSc Alberta Children's Hospital Foundation Professor in Child Health and Wellness Sections of Pediatric Emergency Medicine and Gastroenterology Alberta Children's Hospital & Research Institute University of Calgary Calgary, AB Dr. Freedman[/caption] MedicalResearch.com Interview with: Stephen Freedman MDCM, MSc Alberta Children's Hospital Foundation Professor in Child Health and Wellness Sections of Pediatric Emergency Medicine and Gastroenterology Alberta Children's Hospital & Research Institute University of Calgary Calgary, AB  MedicalResearch.com: What is the background for this study? Response: Vomiting and diarrhea remain extremely common diseases in children and are the most common reason children are brought for emergency department care in North America.  While we have options to reduce vomiting there historically has been little physicians can offer to reduce the severity of the diarrhea. Probiotics have recently emerged as an option with some early evidence of benefit in clinical trials but the studies performed to date have been small and few little research has been conducted in North America in outpatient or emergency department children. The one study to date that was performed in a US emergency department did not find probiotic use to be beneficial.  Given the increasing importance of clarifying this issue we undertook this study.
Author Interviews, JAMA, Ophthalmology, Pediatrics / 19.11.2018

MedicalResearch.com Interview with: "i have a lazy eye but it's a good thing" by jessica mullen is licensed under CC BY 2.0Eileen E. Birch, PhD Director, Crystal Charity Ball Pediatric Vision Evaluation Center Retina Foundation of the Southwest Adjunct Professor of Ophthalmology UT Southwestern Medical Center   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We previously reported that amblyopia, but not nonamblyopic strabismus or anisometropia, is associated with slower reading speed (Kelly et al  Journal of AAPOS 2015) and that this is related to abnormal eye movements and unstable fixation associated with amblyopia (Kelly et al 2017).  We have also shown that amblyopic children are slower at completing Scantron answer sheets (JAMA Ophthalmology 2018).  We thought that these difficulties experiences in school-age children with amblyopia might affect their self-perception.
Author Interviews, Global Health, Heart Disease, JAMA, Pediatrics, Surgical Research / 17.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45975" align="alignleft" width="144"]Marcelo G. Cardarelli, MD A member of Inova Medical Group Dr. Cardarelli[/caption] Marcelo G. Cardarelli, MD Inova Children’s Hospita Fairfax, Falls Church, Virginia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Global Humanitarian Medical efforts consume a large amount of resources (nearly $38B in 2016) and donors (Countries, International organizations, WHO, Individuals) make the decisions as to where their funds should be allocated based on cost-effectiveness studies. Most resources go to prevent/treat infectious diseases, sanitation efforts and maternal/child care issues. An insignificant amount of resources is directed to satisfy the surgical needs of the populations in low and middle income countries (LMICs). The idea behind our project was to find out if it was cost-effective to perform a tertiary surgical specialty (pediatric cardiac surgery) in this context and the answer (at $171 per DALY averted) was an overwhelming yes! But most importantly, we believe, as many others do, that judging the cost/effectiveness of an intervention in order to decide resources allocation is valid for diseases that can be prevented, but not relevant when it comes to surgical problems that are not preventable. Instead, we propose the use of another measure of effectiveness, what we call "The Humanitarian Footprint". The Humanitarian Footprint represents the long term benefits, as measured by changes in the life expectancy, extra years of schooling and potential lifetime earnings of patients treated surgically during humanitarian interventions. To our surprise and based on the results, the effects on society of at least this particular surgical intervention were greater than we expected. We suspect this measure can be used in many other surgical humanitarian interventions as well. 
Allergies, Author Interviews, Pediatrics / 16.11.2018

MedicalResearch.com Interview with: Eliane Abou-Jaoude, MD  Allergy and Immunology Fellow Henry Ford Health System Detroit, MichiganEliane Abou-Jaoude, MD  Allergy and Immunology Fellow Henry Ford Health System Detroit, Michigan MedicalResearch.com: What is the background for this study? Response: Early life exposure to diverse types of microbes is necessary for healthy immune development and may impact the risk for developing allergic disorders. Theoretically the transfer of parental microbes to their offspring during infancy can influence a child’s developing gut microbiome and subsequent immune response patterns. We wished to investigate whether parental pacifier cleaning methods, reported at 6-months of age, were associated with altered serum IgE trajectory over the first 18 months of life. 
Allergies, Asthma, Author Interviews, Pediatrics, Science / 16.11.2018

MedicalResearch.com Interview with: "Dogs and Kids Mix Well" by Tony Alter is licensed under CC BY 2.0Catarina Almqvist Malmros MD, PhD Professor | Consultant Pediatrician Dept of Medical Epidemiology and Biostatistics | Karolinska Institutet Lung and Allergy Unit | Astrid Lindgren Children’s Hospital Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously shown an association between growing up with dogs and a lower risk of childhood asthma (doi: 10.1001/jamapediatrics.2015.3219) but it has been unknown whether this link is modified by characteristics of the dog. Sex of the dog may have an effect on expressed allergens, and uncastrated male dogs release more of a certain allergen than castrated male dogs and female dogs. Some breeds are also described as ‘hypoallergenic’, but there is no scientific evidence whether they are more suitable for people with allergies. We examined how variables such as sex, breed, number of dogs or size of dog are associated with the risk of asthma and allergy among children with a dog in their home during the first year of life. We included all Swedish children born between January 2001 and December 2004 whose parents had a registered dog in a dog-owner register and linked the data to the Swedish population- and health data registers. Main findings are that children raised with only female dogs at home had a 16 per cent lower risk of asthma than those with male dogs, and that children living with two or more dogs had a 21 per cent lower risk of asthma than those with only one dog. Importantly, families with parental asthma or allergies had ‘hypoallergenic’ breeds more often than children whose parents did not have asthma or allergies; 11.7% compared to 7.6 . Exposure to these breeds was associated with a 27 per cent higher risk of allergy and no decreased risk of asthma. 
Author Interviews, BMJ, Obstructive Sleep Apnea, Pediatrics, Sleep Disorders, Surgical Research / 09.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45826" align="alignleft" width="200"]A pair of tonsils after surgical removal Wikipedia image A pair of tonsils after surgical removal
Wikipedia image[/caption] Tom Marshall, MSc, PhD, MRCGP, FFPH Professor of public health and primary care Institute of Applied Health Research University of Birmingham, Birmingham, UK MedicalResearch.com: What is the background for this study?   Response: Tonsillectomy is one of the most common childhood surgical procedures. There are two main indications: recurrent sore throat and sleep-related breathing problems (including obstructive sleep apnoea). Jack Paradise’s 1984 study made clear tonsillectomy is modestly effective in children with frequent, severe sore throats: seven in one year, or five yearly in two successive years, or three yearly in three successive years. Sore throats must have symptoms: fever, pus seen on tonsils, lymphadenopathy or confirmed Streptococcal infection. With surgery, children average two sore throats in the next year, without surgery, three. Two years later there is no difference. Further research shows the benefits are too tiny to justify surgery in children with less frequent, less severe or undocumented sore throats. Subsequent randomised controlled trials have not changed the evidence. There isn’t enough good evidence to support surgery in children with obstructive sleep apnoea or sleep related breathing problems. Tonsillectomy is not a trivial procedure, about 2% are readmitted with haemorrhage and about 1 in 40,000 dies. Childhood tonsillectomy is linked to risk of adult autoimmune diseases. It is important to be sure tonsillectomy is only undertaken in children where there are evidence-based indications.
Anesthesiology, Author Interviews, JAMA, Pediatrics, Surgical Research / 08.11.2018

MedicalResearch.com Interview with: "Anesthesia" by Liran Szeiman is licensed under CC BY-NC-ND 4.0James D. O’Leary, MD Department of Anesthesia and Pain Medicine, Child Health Evaluative Sciences The Hospital for Sick Children Department of Anesthesia, University of Toronto Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is substantial evidence from laboratory studies that the developing brain is susceptible to injury from general anesthetic drugs, which culminated in the US Food Drug Administration issuing a safety communication in 2017 stating that the use of general anaesthetic drugs “for lengthy periods of time or over multiple surgeries or procedures may negatively affect brain development in children younger than 3 years”. Considering the substantial number of children who require general anesthesia every year (almost 3 million in the US annually) even small differences in child development outcomes after surgical procedures that require general anesthesia may have significant public health implications. Undertaking studies of anesthesia-related neurotoxicity in humans is difficult as adverse child development is a function of the complex interaction between many risk and protective factors. By examining differences between biological siblings in Ontario, Canada, this study seeks to mitigate differences in risk from biological vulnerability and environmental factors, to provide a more accurate estimate of the adverse effects of anesthesia and surgery on child development. In the current study, young children who had surgical procedures that require general anesthesia were not found to be at increased risk of adverse child development outcomes compared to their biological siblings who did not have surgery. These findings further support that exposure to anesthesia and surgery in early childhood is not associated with detectable adverse child development outcomes.
Author Interviews, Brain Injury, Gender Differences, JAMA, Pediatrics / 05.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45692" align="alignleft" width="142"]Andrée-Anne Ledoux, PhD Children’s Hospital of Eastern Ontario Research Institute Ottawa, Ontario, Canada Dr. Ledoux[/caption] Andrée-Anne Ledoux, PhD Children’s Hospital of Eastern Ontario Research Institute Ottawa, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: The natural recovery processes from a pediatric concussion remains poorly characterized throughout childhood. Children’s brains go through many phases of growth during development and sex differences exist. Therefore a 6-year-old child may not have the same recovery trajectory as an adolescent because of biopsychosocial differences. Thus, this study explored symptom improvement after concussion while considering these two key demographic factors. Understanding symptom improvement at different stages of development is important in order to provide the best possible care. The study examined data from 2,716 children and adolescents who had presented at nine emergency departments across Canada and were diagnosed with concussion. We examined the natural progression of self-reported symptom recovery following pediatric concussion over the initial three months after injury. Participants in the study were aged 5 to 18 years old with acute concussion, enrolled from August 1, 2013, to May 31, 2015. We examined different age cohorts – 5 to 7 years of age, 8 to 12 years of age, and 13 to 18 years of age, and investigated how sex is associated with recovery. Our study represents the largest study to evaluate symptom improvement trajectories in concussed pediatric population.
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