pediatrics Tag

29 Nov

Posted at 18:39h in Author Interviews, Education, Pediatrics
MedicalResearch.com Interview with: Sonia Kandel PhD Professor at the GIPSA-Lab Université Grenoble Alpes  MedicalResearch.com: What is the background for this study? What are the main findings? Response: How do we recall a word’s spelling from memory? How do we execute the movements to produce letters? A series of studies conducted by Professor Sonia Kandel at the GIPSA-Lab/University of Grenoble Alpes in France provide evidence indicating that writing is a linguistic process that affects the way we execute the manual movements when we write. For example, the movements involved in writing T-H-R are easier to execute in a word that is pronounced as it is spelled, (e.g. “thrill”) than in a word that is orthographically irregular (e.g. “through”). What happens with writing when spelling processes are impaired like, in dyslexia and dysgraphia?

21 Nov

Posted at 01:48h in Author Interviews, JAMA, Mental Health Research, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_38436" align="alignleft" width="158"]Julie M. Zito, PhD Professor of Pharmacy and Psychiatry University of Maryland, Baltimore Pharmaceutical Health Services Department Baltimore, MD 21201 Dr. Zito[/caption] Julie M. Zito, PhD Professor of Pharmacy and Psychiatry University of Maryland, Baltimore Pharmaceutical Health Services Department Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The growth of antipsychotic use in children, mainly for the treatment of behavior, has been of increasing concern in recent years. Clinical safety issues (Burcu et al. 2017) and government reports on overuse in the treatment of poor and foster care children (GAO, 2017; 2012) motivated our assessment of peer review programs. These programs are a relatively new approach to Medicaid oversight intended to monitor and assure clinical appropriateness of second generation antipsychotics in children. Critically important is the fact that most antipsychotic use is for child behavioral problems which are off-label conditions, i.e. without sufficient evidence of effectiveness or safety.

20 Nov

Posted at 02:33h in Asthma, Author Interviews, Dermatology, Pediatrics
MedicalResearch.com Interview with: “Eczema” by NIAID is licensed under CC BY 2.0Malcolm R. Sears, MB ChB Firestone Institute for Respiratory Health St Joseph's Healthcare and McMaster University Ontario Canada.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Canadian Healthy Infant Longitudinal Development (CHILD) Study was initiated in 2008, funded by AllerGen NCA and CIHR, to determine root causes of allergy and asthma. We recruited 3623 pregnant mothers in 4 centers across Canada and are following 3495 eligible children from pregnancy to age 5 years. In this paper we describe some of the findings in early childhood, namely that children who develop skin conditions generally called eczema or atopic dermatitis, who are also sensitized to food allergens (milk, egg, peanut) at 1 year are at high risk of developing subsequent asthma, whereas those with these skin conditions but not sensitized are not at such risk.

15 Nov

Posted at 17:32h in Author Interviews, Diabetes, Heart Disease
MedicalResearch.com Interview with: “Diabetes Test” by Victor is licensed under CC BY 2.0Jesper Svane Medical student The Heart Center, University Hospital Rigshospitalet Copenhagen  MedicalResearch.com: What is the background for this study? Response: At the beginning of this research project, we were aware that persons with diabetes have an increased risk of death, which is partly explained by an increased risk of sudden cardiac death. However, previous studies on causes of death and mortality among young persons with diabetes, particularly type 2 diabetes, are sparse. Furthermore the incidence of sudden cardiac death among young persons with diabetes in a nationwide setting is unknown. The main purpose of the study was to illuminate the risk of death and especially the risk of cardiac death among children/young adults with diabetes. On a personal note, a friend of mine, who was healthy and fit, died suddenly a few years ago at the age of 19. This tragic death raised a lot of feelings as well as questions in me. When I got the chance to work with Dr. Lynge and Dr. Tfelt, I saw this as an opportunity to expand my knowledge of sudden cardiac death among the young. Furthermore, the opportunity of contributing to research in order to prevent these devastating events in the future was personally appealing to me. I initiated the project together with Thomas Hadberg Lynge, MD, last year, with Jacob Tfelt-Hansen, MD, DMSc as supervisor. Both are experienced researchers within the field of sudden cardiac death. Dr. Tfelt-Hansen leads a very productive research group at Rigshospitalet, Copenhagen, whose main focus is arrhythmias and sudden cardiac death.

14 Nov

Posted at 16:00h in Asthma, Author Interviews, JAMA, Orthopedics, Pediatrics

MedicalResearch.com Interview with: “Asthma” by Michael Havens is licensed under CC BY 2.0Teresa To, PhD Biostatistics, Design and Analysis Scientific Director The Hospital for Sick Children Dalla Lana School of Public Health, University of Toronto Institute for Clinical Evaluative Sciences Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: We studied asthma prescription drug use in Ontario children aged 2 to 18 years with physician diagnosed asthma between 2003 and 2014. We found that:
  1. Currently in Ontario, nearly 50% of children with asthma did not fill a prescription for an inhaled corticosteroid during the study period, despite these medications being considered the gold-standard for asthma management.
  2. Our findings did not show clinically important association between inhaled corticosteroids and fracture among children with asthma.
  3. However, systemic corticosteroids (oral or injection) are associated with higher fracture risk in children with asthma (17% higher risk).

08 Nov

Posted at 23:53h in Author Interviews, HIV, Mental Health Research, Pediatrics
MedicalResearch.com Interview with: Marcin Jankiewicz  University of Cape Town Cape Town, South AfricaMarcin Jankiewicz  University of Cape Town Cape Town, South Africa  MedicalResearch.com: What is the background for this study? Response: The Children with HIV Early Antiretroviral (CHER) trial, conducted in Cape Town and Soweto, was designed when there was uncertainty whether to start antiretroviral therapy (ART) as soon as HIV was diagnosed (below 12 weeks of age) or to wait until there was evidence of immuno-compromise and disease progression. Also, there were concerns about maintaining adherence, long-term toxicity and also resistance in the setting of few antiretroviral options. Early outcomes showed a decreased risk in childhood mortality in the early treatment arms compared to deferred treatment, becoming standard of care globally. The CHER cohort is one of the largest and best documented of children receiving ART within the first year of life. Also, age- and community-matched HIV exposed uninfected (HEU) and HIV unexposed (HU) uninfected infants were enrolled in parallel for a linked vaccine study. We therefore had an amazing opportunity to link with a neurodevelopmental sub-study in participants from Cape Town and apply sophisticated neuroimaging modalities that could link with clinical, virological and immunological characteristics.

06 Nov

Posted at 21:40h in Author Interviews, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_37911" align="alignleft" width="100"]Sally H. Adams, PhD, RN Specialist, Division of Adolescent and Young Adult  Medicine Adolescent and Young Adult Health National Resource Center University of California, San Francisco Benioff Children’s Hospital San Francisco, CA 94118 Dr. Adams[/caption] Sally H. Adams, PhD, RN Specialist, Division of Adolescent and Young Adult  Medicine Adolescent and Young Adult Health National Resource Center University of California, San Francisco Benioff Children’s Hospital San Francisco, CA 94118 MedicalResearch.com: What is the background for this study? Response: Major causes of adolescent illness and mortality are preventable. To address this, in the 1990s, professional medical organizations developed healthcare provider guidelines for the delivery of adolescent preventive healthcare. These include the receipt of anticipatory guidance and risk screening services in the effort to promote healthy behaviors and avoid risky behaviors that are intended to be covered within a preventive care visit, but could be addressed in other healthcare visits. The adolescent developmental period is an important time for adolescents to be engaged with the healthcare system. Transitioning from childhood to adulthood, adolescents are becoming increasingly independent - having more responsibility and freedom for decision making in many areas, including healthy choices in behaviors and activities. While families and community settings (schools, churches) play strong roles in this process, the healthcare system also plays an important role.

01 Nov

Posted at 18:23h in Author Interviews, Brigham & Women's - Harvard, Chocolate, Pediatrics, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_13134" align="alignleft" width="125"]Jorge E. Chavarro, M.D., Sc.D. Assistant Professor of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Assistant Professor of Medicine Harvard Medical School Boston, MA 02113 Dr. Chavarro[/caption] Jorge E. Chavarro, MD, ScD Associate Professor Departments of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that sugared sweetened beverages (SSBs) promote excessive weight gain and obesity in children. The excess sugars in chocolate milk and other flavored milks puts them in a category that may be closer to sugared sweetened beverages than to plain milk. However, data on whether flavored milks promote weight gain is scarce. We followed a cohort of 5,321 children and adolescents over a four year period to evaluate whether intake of chocolate milks was related to weight gain. We found that children who increased their intake of flavored milk gained more weight than children whose intake of flavored milk remained stable over this period. Moreover, among those children who did not drink any chocolate milk at baseline, those who started drinking chocolate milk over the course of the study gained substantially more weight than children who remained non-consumers of chocolate milk.

25 Oct

Posted at 21:47h in Author Interviews, Epilepsy, NEJM, Neurological Disorders, Pediatrics, Surgical Research
MedicalResearch.com Interview with: Dr. Manjari Tripathi Professor, Epileptology, Neurology Dr. P Sarat Chandra, Chief epilepsy Neurosurgeon AIIMS, New Delhi MedicalResearch.com: What is the background for this study?:
  1. Surgery for drug resistant epilepsy (DRE) is an accepted procedure for children and there have been multiple surgical series and surgical techniques published in literature. However, till date there are no randomized controlled trials (RCT) available to objectively demonstrate the safety and efficacy of surgical therapy in children with DRE. There are till date only 2 randomized trials for adult patients with drug resistant epilepsy (both for mesial temporal sclerosis only, Wiebe S et al, New Eng J Med, 2001 & Engel J et al, JAMA, 2012).
  2. Children constitute a significant proportion of patients undergoing surgical therapy for DRE (close to 50% in tertiary centers). They have unique problems associated due to uncontrolled epilepsy and some of these include epileptic encephalopathy and status epilepticus. In addition, surgery is also associated with problems like hypothermia, issues related to blood loss etc. Thus the senior author (Manjari Tripathi) and her team felt that a RCT would be very important to objectively assess the role of surgery and hence designed this study.

18 Oct

Posted at 19:54h in Author Interviews, Diabetes, JAMA, Pediatrics
MedicalResearch.com Interview with: Prof. Dr. med. Reinhard Holl Division of Endocrinology and Diabetes, Medical Faculty Aachen University, Aachen, Institute of Epidemiology and Medical Biometry University of Ulm, Ulm Germany  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Today there are two accepted strategies to treat type-1 diabetes: pump or multiple daily injections. In a large group of patients we compared both strategies, and our results indicate advantages for pump therapy with fewer severe hypos, fewer events of diabetic ketoacidosis, and better metabolic control.

18 Oct

Posted at 17:46h in Anesthesiology, Author Interviews, Pediatrics, Surgical Research, Technology
MedicalResearch.com Interview with: Dr. Sunghee Han Professor Seoul National Unversity College of Medicine Seoul National University Hospital Department of Anesthesia and Pain Medicin What is the background for this new technology and study? What are the main findings? Response: The time from patient arrival in the operating theatre to induction of general anesthesia is one of the most stressful moments for children undergoing surgery. Various strategies such as 'pre-operative guided operating room tour' or 'therapeutic play intervention' have been developed in order to reduce children's pre-operative anxiety. Although these existing simulation-based approaches may be effective, they have not been widely used in real clinical settings with limited budget and resources such as manpower and space. Virtual Reality(VR), a relatively new technology in the field of healthcare, can allow the user to experience an immersive environment. In this study, using VR technology, we provided the children with a realistic trip to the operating theatre accompanied by ‘My best friend’ Pororo. “Pororo, The Little Penguin” is a very famous cartoon character in Korea and Asia. Most children in Korea watch Pororo in TV, play with Pororo toys since early yeas and perceive Pororo as a ‘close friend’. In the VR content used in this study, Pororo acts as a patient and is subjected to anesthesia and surgery himself. Pororo kindly brings his friend(the viewer; paediatric patient) to the theatre and shows all that is going on in there. Intervention with the VR content was able to reduce the level of anxiety in paediatric patients and promote collaborative behavior and acceptance of the invasive procedures, especially general anesthesia. Parental satisfaction level was also relatively higher in the VR group.

12 Oct

Posted at 05:21h in Author Interviews, Education, Pediatrics, Sleep Disorders
MedicalResearch.com Interview with: Jack Peltz, Ph.D. Clinical assistant professor in Psychiatry Rochester Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 90% of high-school aged adolescents get either insufficient sleep during school nights or barely meet the required amount of sleep (ie, 8–10 hours) expected for healthy functioning.(1) In fact, sleep problems and insufficient sleep are so pervasive for adolescents that they could be considered an epidemic due to their adverse impact on adolescent mental and physical health.(2–5) As a result,addressing insufficient adolescent sleep represents a critical point of study and intervention. The growing body of evidence suggests that later school start times (SST), 8:30 AM or later as recommended by the American Academy of Pediatricians,6 convey multiple benefits on adolescents, including improved sleep, better mental and physical health, and improved academic outcomes.(7–10) This research, however, has focused on the direct effects of delaying school start times, or specifically how moving SST back directly predicts changes in an outcome (eg, mental health, academic achievement). This type of analysis precludes examining the important role that SST might play as a condition or context under which other sleeprelated processes take place. For instance, earlier school start times might exacerbate the impact of sleep-related processes on adolescent behavioral health outcomes. Thus, incorporating school start times as a larger contextual variable that might moderate models of sleep and adolescent functioning represents a gap in the literature and a unique opportunity to advance conceptual models. Accordingly, the current study examines the moderating role of school start times on the associations between sleep hygiene, sleep quality, and mental health.

06 Oct

Posted at 01:37h in Author Interviews, CDC, Cost of Health Care, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_37390" align="alignleft" width="180"]Scott D. Grosse, PhD National Center on Birth Defects and Developmental Disabilities CDC  Dr. Scott Grosse[/caption] Scott D. Grosse, PhD National Center on Birth Defects and Developmental Disabilities CDC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The U.S. Institute of Medicine (IOM) in 2007 published estimates of the economic costs associated with preterm birth. That report is publicly available: https://www.ncbi.nlm.nih.gov/pubmed/20669423. The total societal cost over a lifetime of a single year’s cohort of infants born preterm was estimated as $26 billion in 2005 US dollars. The study in Pediatrics sought to provide more current estimates of one component of those costs: medical care between birth and 12 months and to answer two additional questions:
  1. What costs are specifically incurred by employer-sponsored private health plans?
  2. How much of the overall cost burden of prematurity is attributable to infants born preterm with major birth defects (congenital malformations and chromosome abnormalities)?

06 Oct

Posted at 00:23h in Allergies, Asthma, Author Interviews, Pediatrics, Respiratory
MedicalResearch.com Interview with: [caption id="attachment_37385" align="alignleft" width="160"]Giovanni Piedimonte, MD Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education Professor & Chair of Pediatrics Cleveland Clinic Lerner College of Medicine Case Western Reserve University Dr. Piedimonte[/caption] Giovanni Piedimonte, MD Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education Professor & Chair of Pediatrics Cleveland Clinic Lerner College of Medicine Case Western Reserve University MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study proves that asthmatic children already have a hyperactive calcium channel that’s extremely sensitive to environmental triggers. If these children contract a virus, such as RSV, the hyperactive channel causes more severe symptoms that may require care in a hospital setting. When a child developed asthma or bronchitis in the past, doctors thought these conditions could only be triggered by environmental allergens. There was no explanation why two out of three children ages five and under who wheeze and cough – and still test negative for allergies. We needed to explore the mechanisms of the calcium molecule and the epithelial cells, which seem to trigger these symptoms without an allergic reaction. If the molecule’s behavior is producing the cough, we just need to figure out how to control the molecule to properly deactivate the cough mechanism in the asthmatic child

28 Sep

Posted at 19:16h in Allergies, Author Interviews, Dermatology, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_37216" align="alignleft" width="250"]Hives-Urticaria Wikipedia image Hives-Urticaria
Wikipedia image[/caption] Elena Netchiporouk, MD, FRCPC, MSc Dermatology Resident - PGY5 and Dr. Moshe Ben-Shoshan, MD, FRCPC, MSc McGill University MedicalResearch.com: What is the background for this study? Response: We have followed a pediatric cohort of 139 patients with chronic urticaria (CU) (hives) between 2013 and 2015 in a single tertiary care center and assessed the comorbidities, the rate of resolution and determined predictors of resolution.

22 Sep

Posted at 14:55h in Author Interviews, Education, Karolinski Institute, Pediatrics, Psychological Science
MedicalResearch.com Interview with: [caption id="attachment_37074" align="alignleft" width="125"]Malin Bergström PhD Center for Health Equity Studies Karolinska Institutet   Dr. Bergstrom[/caption] Malin Bergström PhD Center for Health Equity Studies Karolinska Institutet   MedicalResearch.com: What is the background for this study? Response: The increase in children who move between their parent's homes after a divorce is one of the major changes in children's life circumstances during the last decade. Spending equal amounts of time in both parents' homes means that these children move fifty times a year. Child experts have claimed this to be stressful and potentially harmful to children's attachment relations to their mothers. Especially for children this young the practice of joint physical custody has been questioned.

19 Sep

Posted at 19:17h in Author Interviews, Emergency Care, Infections, Pediatrics, Technology
MedicalResearch.com Interview with: Prof. Alain Gervaix Head of the Emergency Division Department of Children and Adolescents University Hospitals of Geneva Switzerland MedicalResearch.com: What is the background for this study? Response: Many are familiar with the following ‘seemingly’ simple clinical dilemma that occurs on a daily basis across the world. A patient visits the doctor with a fever. Commonly, assigning a diagnosis comes down to deciding whether the infection is bacterial or viral. Accordingly, the doctor decides if to treat or not to treat with antibiotics. The problem is that bacterial and viral infections often present with very similar symptoms, causing uncertainty that leads to antibiotics being used, in many instances, when they are not needed. This antibiotic misuse contributes to the rise of antimicrobial resistance, one of the biggest health threats of the 21st century. Host biomarkers hold great promise as routine diagnostic tools that can assist doctors in making correct antibiotic treatment decisions, as they overcome key limitations of currently applied pathogen-based tests. Recently, a novel host-assay (ImmunoXpert™) for differentiating bacterial from viral infections was developed and validated to yield high sensitivity and specificity. The three-protein host-assay comprises tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), Interferon gamma-induced protein-10 (IP-10) and C-reactive protein (CRP).

19 Sep

Posted at 12:23h in Author Interviews, JAMA, OBGYNE, Pediatrics, Smoking
MedicalResearch.com Interview with: [caption id="attachment_36987" align="alignleft" width="112"]Filippos Filippidis MD MPH PhD Lecturer in Public Health School of Public Health Imperial College London London Dr. Filippidis[/caption] Filippos Filippidis MD MPH PhD Lecturer in Public Health School of Public Health Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Smoking kills millions of people every year. It is well established that increasing tobacco prices is the most effective way to reduce tobacco consumption and hence mitigate the devastating effects of tobacco on health. Taxation on tobacco products is high in the European Union, which makes cigarettes less affordable. However, transnational tobacco companies are known to manipulate prices, ensuring that cheap or ‘budget’ cigarettes are still available. This is particularly important for younger smokers and those of low socioeconomic status who are more sensitive in price increases. Smoking during pregnancy, as well as exposure of pregnant women and babies to cigarette smoke increase infant mortality. There is also evidence that increasing tobacco prices is associated with lower infant mortality. However, researchers typically use average or premium cigarette prices. We analysed 54 million births from 23 European Union countries to see if the differential between average priced and budget cigarettes (i.e. the availability of cigarettes much cheaper than average priced ones) is associated with infant mortality. We found that increasing average cigarette prices by 1 Euro per pack was associated with 0.23 fewer deaths per 1,000 live births in the same year and an additional 0.16 fewer deaths per 1,000 live births in the following year. A 10% increase in the price differential between budget and average priced cigarettes was associated with 0.07 more deaths per 1,000 live births the following year. This means that 3,195 infant deaths could potentially have been avoided in these 23 countries if there was no price difference between cigarette products over the 10-year study period.

05 Sep

Posted at 23:41h in Author Interviews, Nature, OBGYNE, Pediatrics, Toxin Research
MedicalResearch.com Interview with: [caption id="attachment_36776" align="alignleft" width="130"]Ashley Larsen, PhD Assistant professor Bren School of Environmental Science & Management University of California, Santa Barbara Dr. Larsen[/caption] Ashley Larsen, PhD Assistant professor Bren School of Environmental Science & Management University of California, Santa Barbara MedicalResearch.com: What is the background for this study? What are the main findings? Response: The relationship between pesticides and adverse birth outcomes has been recognized as an important question for quite some time, and there have been many good studies on the topic. Since randomly exposing people to different levels of pesticides is clearly unethical, researchers focused on the health consequences of non-occupational pesticide exposure often have to choose between detailed studies that follow a couple hundred or couple thousand individuals through pregnancy or larger scale studies that use easier to observe, but less accurate metrics of pesticide exposure (e.g. nearby crops or crop types). Here we tried to provide complementary insight by bridging the gap between detail and scale using detailed pesticide use data and individual birth certificate records for hundreds of thousands of births in an agriculturally dominated region of California. While we found negative effects of pesticide use on birth outcomes including low birth weight, preterm birth and birth abnormalities, these effects were generally in the magnitude of a 5-9% increase in probability of an adverse outcome, and only observed for individuals exposed to very high levels of pesticides.

30 Aug

Posted at 13:27h in OBGYNE, Pediatrics, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_36700" align="alignleft" width="164"]Leanne M. Redman MS, PhD LPFA Endowed Fellowship Associate Professor Pennington Biomedical Research Center Baton Rouge, Louisiana Dr. Redman[/caption] Leanne M. Redman MS, PhD LPFA Endowed Fellowship Associate Professor Pennington Biomedical Research Center Baton Rouge, Louisiana  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Two well-documented risk factors for aberrant weight gain and obesity is whether your mother was obese when she was pregnant and the amount of weight she gained. Up until now few studies have asked questions about whether the pattern of weight gain in pregnancy affect outcomes in offspring, such as birth weight. In a cohort of over 16,000 pregnant women and infants, we found that regardless of the obesity status (BMI) of the mother at the time of pregnancy, weight gain that occurs up until week 24, had the strongest effect on infant birth weight. Infants born to mothers who had weight gain in excess of the 2009 IOM guidelines from conception until week 24, had a 2.5 times higher likelihood of being born large for gestational age. The weight gain that occurred after 24 weeks until delivery, did not attenuate this risk.

22 Aug

Posted at 13:52h in Anesthesiology, Author Interviews, Emergency Care, JAMA, Pediatrics

MedicalResearch.com Interview with: [caption id="attachment_36523" align="alignleft" width="150"] Dr. Bhatt[/caption] Maala Bhatt MD, MSc., FRCPC Director, Pediatric Emergency Research Staff Physician, Emergency Medicine Children's Hospital of Eastern Ontario  MedicalResearch.com: What is the background for this study? Response: Procedural sedation, defined as the administration of medications to minimize pain and awareness, has become standard practice in pediatric emergency...

21 Aug

Posted at 13:49h in Author Interviews, BMJ, Pediatrics
MedicalResearch.com Interview with: Dr. Andrei Morgan and Dr.Veronique Pierrat Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Cité Research Center INSERM, Paris France Descartes University, Paris, France Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France.  MedicalResearch.com: What is the background for this study? Response: The risk of neurodevelopmental and behavioural disabilities remains high in children and adults born preterm. In the 2000s, outcomes of neonates born extremely preterm was described in several settings, but the outcome of neonates born very and moderately preterm was rarely reported. However, in absolute numbers, these infants represent a larger proportion of preterm births and account for more children with long-term deficits and learning disabilities. EPIPAGE-2 is a national study which aims to study short and long term outcomes of children born at 22-26 weeks’gestation, 27-31 weeks’gestation and 32-34 weeks’gestation in France in 2011. We also compared results from this study with the first EPIPAGE study, carried out in 1997. At two years of age, neuro motor and sensory impairment, as well as overall development, were investigated by sending questionnaires to the attending physician and the parents.

16 Aug

Posted at 00:26h in Author Interviews, Diabetes, Education, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_36476" align="alignleft" width="146"]Jane E. Harding, DPhil Liggins Institute The University of Auckland Auckland, New Zealand Prof. Harding[/caption] Jane E. Harding, DPhil Liggins Institute The University of Auckland Auckland, New Zealand MedicalResearch.com: What is the background for this study? Response: Neonatal hypoglycaemia – low blood sugars in newborns – affects up to one in six babies born. It involves a sustained dip in blood sugar levels following birth. Blood glucose is the only fuel for babies’ brains (adults have alternative, back-up sources). So, if left untreated, this condition can cause developmental brain damage and lowered education outcomes later in life. In developed economies, as many as a third of babies born are at risk. Risk factors include being born smaller or larger than usual, preterm babies and babies whose mothers have any form of diabetes – this last a growing group, with the rising incidence of gestational (pregnancy-related) diabetes. We wanted to systematically track a cohort of babies to see if hypoglycaemia in babies affects their long-term health and development. So we designed the CHYLD study – Children with Hypoglycaemia and their Later Development. We are following 614 New Zealand babies born at risk of low blood sugar levels (neonatal hypoglycemia) into childhood to see if the condition affects their later growth and development. Our team includes researchers from the Liggins Institute, the University of Auckland, Waikato Hospital, the University of Canterbury and the University of Waterloo. Half of the babies in the study were diagnosed with, and treated for low blood sugars. Seventy percent received extra, continuous monitoring of their blood sugar levels, which detected in some babies low levels that were not diagnosed by the heel-prick tests.

10 Aug

Posted at 21:01h in AHA Journals, Author Interviews, Heart Disease, Pediatrics, Social Issues
MedicalResearch.com Interview with: Lead author, Dr Richard Liu, MCRI Ph.D. student and Senior author - Professor David Burgner PhD The Child Health CheckPoint Investigator Group Murdoch Children’s Research Institute The Royal Children’s Hospital Parkville, Victoria, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: The socioeconomic gradient in cardiovascular disease is well recognised in adults. The more disadvantaged someone is, the higher their risk of heart attack and stroke. The mechanisms by which this occurs are not well understood, but we know the pathological process underlying this, thickening of the arteries, or atherosclerosis, begins very early in life. Our current understanding of the early development of atherosclerosis has previously been limited mainly to autopsy studies. Non-invasive imaging is increasingly being used to examine the early development of atherosclerosis. We wanted to determine if there was an association between socioeconomic disadvantage and the thickness of the carotid artery wall in mid-childhood, which in adults is a proxy for atherosclerosis and indicates higher risk for heart attack and stroke in later life. We analysed both family and neighbourhood socioeconomic position data from 1477 Australian families, which included data on income, education and occupation of parents, as well as the relative socioeconomic status of the immediate neighbourhood.

10 Aug

Posted at 00:47h in Author Interviews, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_36384" align="alignleft" width="130"]Layla Parast PhD Statistician RAND Dr. Parast[/caption] Layla Parast PhD Statistician RAND MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study examined the association between pet ownership, specifically dog or cat ownership, and children’s physical and mental health. There has been a lot of previous work looking at this association and these previous results seemed to show that kids with pets have better health than those without pets. The hypothesis has been that pets can improve children’s health by increasing physical activating and improving young people’s empathy skills. We used data from over 5,000 households in California which was obtained from the California Health Interview Survey and looked at physical and mental health outcomes among children in households with pets vs. without pets. We found that children in households with pets do have better health than those without pets, but that after we account for factors such as family income and housing type, for example, there is no evidence of an association between pet ownership and health. That is, households that have pets are more likely to be higher income, to be in a house as opposed to an apartment, and to have healthier adults in the household, for example - and these factors are also associated with better child health.

04 Aug

Posted at 10:27h in Author Interviews, BMJ, Brigham & Women's - Harvard, Opiods, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_27170" align="alignleft" width="179"]Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine at Harvard Medical School Epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital. Boston, MA 02120 Dr. Krista Huybrechts[/caption] Krista F. Huybrechts, MS PhD Assistant Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Neonatal drug withdrawal is common; in the U.S. about 1 infant is born every 25 minutes with signs of drug withdrawal. Neonatal drug withdrawal is a well-recognized complication of intrauterine exposure to illicit or prescription opioids, but other psychotropic medications can also cause signs of withdrawal. Psychotropic medications are frequently co-prescribed with opioids in pregnancy, and the use of both has increased significantly, raising concerns about an increase in the incidence and severity of neonatal drug withdrawal due to potential drug-drug interactions, but these risks are not well understood. In this study, we found a 30-60% increase in the risk of neonatal drug withdrawal associated with co-exposure to antidepressants, benzodiazepines and gabapentin, compared to opioids alone; no significant increase in risk was observed for atypical antipsychotics and Z-drugs. Exposure to psychotropic polypharmacy along with opioids was associated with a two-fold increased risk of withdrawal.

30 Jul

Posted at 11:51h in Author Interviews, Hearing Loss, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_36161" align="alignleft" width="180"]Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC , Rotterdam  Dr. Carlijn M. P. le Clercq[/caption] Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC , Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been increasing interest for acquired hearing loss among children, and concerns about its prevalence possibly rising over time. One of the questions that come up, is whether there is an association with the growing use of portable music players with headphones, including smartphones and tablets. There have been few longitudinal studies to explore this relation. In order to examine this relation, among other factors, we have conducted a formal hearing screening among more than 5000 9- to 11-year-old children from a population-based birth cohort in the Netherlands. Our study showed that nearly one in five children did not have normal hearing. Of the cohort, 7.8% of the children showed signs of permanent hearing loss.

26 Jul

Posted at 22:20h in Author Interviews, JAMA, Pediatrics, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_36168" align="alignleft" width="147"]Rachel Y. Moon, M.D. Division Head, General Pediatrics Professor of Pediatrics University of Virginia School of Medicine Charlottesville, VA 22908 Dr. Moon[/caption] Rachel Y. Moon, M.D. Division Head, General Pediatrics Professor of Pediatrics University of Virginia School of Medicine Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 3500 babies die suddenly and unexpectedly during sleep in the US every year. Even though there are safe sleep recommendations, many parents do not follow them because of misinformation or misconceptions. Therefore we tested 2 complementary interventions to promote infant safe sleep practices. The first was a nursing quality improvement intervention aimed at ensuring that mothers would hear key messages and that there was appropriate role modeling of safe sleep practices by hospital personnel. The second was a mobile health intervention, in which mothers received videos and text messages or emails with safe sleep information during the baby's first two months of life. We randomized mothers to receive either the safe sleep interventions or breast-feeding interventions (the control interventions). Mothers who received the mobile health intervention reported statistically significantly higher rates of placing their babies on their back, room sharing without bed sharing, no soft bedding use, and pacifier use, compared with mothers who received a control intervention. Although the nursing quality improvement intervention did not influence infant safe sleep practices, there was an interaction such that mothers who received both the safe sleep nursing quality improvement intervention and the safe sleep mobile health intervention had the highest rates of placing their babies on the back.

19 Jul

Posted at 14:57h in Author Interviews, OBGYNE, Pediatrics
MedicalResearch.com Interview with: Francesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, ItalyFrancesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: Newborn infants, placed skin-to-skin on their mother’s chest instinctively have the ability to crawl to their mother’s breast, exploring with their hands and massaging the breast to support the first feed.  Left undisturbed, the infant will make several attempts until it finds and latches onto the nipple and begins to nurse. What leads mammalian infants who are placed on their mothers’ chests to seek out, without any assistance, the nipple and to attach themselves to it to nurse is not fully understood. When we turned our attention to the thermal properties of the female’s nipple-areolar complex (NAC) in lactating mothers soon after birth, we found that it had a higher temperature and pH value and lower elasticity with respect to the surrounding breast skin. We hypothesised that the higher temperature could help the newborn infant to locate the nipple and to latch onto it, leading to the first sucking experience.  In addition, the diffusion of odorous molecules is presumably enhanced by the relatively high surface temperature of the areola in view of the rich supply of blood capillaries that irrigate the region. There is, in fact, some scientific evidence that show that infants respond to the odours released by the breasts of lactating women; breast odours, which are enhanced by the skin’s greater warmth, are another factor that facilitates breastfeeding by helping the infant to recognize its mother participating in the mother-to-infant bonding.

18 Jul

Posted at 16:52h in Author Interviews, Infections, JAMA, Pediatrics, Respiratory, Vitamin D
MedicalResearch.com Interview with: [caption id="attachment_35936" align="alignleft" width="200"]Jonathon Maguire MD MSc FRCPC Scientist, Li Ka Shing Knowledge Institute Dr. Maguire[/caption] Jonathon Maguire MD MSc FRCPC Scientist, Li Ka Shing Knowledge Institute Staff Pediatrician, Department of Pediatrics, St. Michael’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vitamin D has been hypothesized as being protective of seasonal viral upper respiratory tract infections.  In this randomized clinical trial, high dose wintertime vitamin D supplementation (2000 IU/day) was compared with standard-dose vitamin D supplementation (400 IU/day) among 703 children.  The number of laboratory confirmed viral upper respiratory tract infections was not statistically different between groups.