Pediatric Research Podcast

For depressed preterm neonates, initiating positive pressure ventilation is the most important factor in facilitating transition. Therefore the recommendation for depressed neonates is to immediately cut the umbilical cord and begin resuscitation. However, many studies have shown that delaying the clamping of the umbilical cord also benefits preterm infants by increasing a neonate's blood volume, oxygenation and circulatory stabilisation, thus aiding transition. In this episode, we meet Early Career Investigator, Praveen Chandrasekharan from the State University of New York. He has used an asphyxiated preterm ovine model to ascertain the best practice of placental transfusion in a depressed neonate requiring resuscitation. Read the full article here. Placental transfusion during neonatal resuscitation in an asphyxiated preterm model | Pediatric Research (nature.com) Our GDPR privacy policy was updated on August 8, 2022. Visit acast.com/privacy for more in

Intraventricular hemorrhage (IVH) occurs in around 45% of infants born below 26 weeks gestational age, causing significant lifelong morbidity and mortality. However, there is currently no effective treatment. In part, this is due to the lack of well-characterised representative preterm animal models with long-term follow up. In this episode, we meet our highlighted Early Career Investigator Olga Romantsik, from Lund University in Sweden. She and her team used an established preterm rabbit pup model of IVH to analyse neurobehavioral and neuropathological outcomes, to one month of age.Read the full article here. See acast.com/privacy for privacy and opt-out information.

A recent study reported that 53% of mothers reported exposure to violence when they were children. And there is evidence that these experiences negatively impact the health and development of their offspring later on. Associations between maternal exposure to violence, psychopathology and children's mental health outcomes is well documented. However, the pre- and postnatal programming pathways between early exposure to violence, maternal psychopathology and children's cognitive and developmental milestones remain understudied. In this episode, we meet Dr Dillon Browne, a clinical psychologist and assistant professor in psychology at the University of Waterloo in Ontario, Canada. He wanted to know if and how maternal early exposure to violence influences the developmental trajectories of children across the first four years of life. Read the full article here. See acast.com/privacy for privacy and opt-out information.

Dilated cardiomyopathy (DCM) is a rare but serious condition of children and often progresses to heart failure. The outcomes for children with DCM are poor, with 50% of pediatric patients dying or needing a heart transplant within 5 years of diagnosis. In this episode, Geoff Marsh meets professor Carmen Sucharov from the University of Colorado Anschutz campus and the director of the Pediatric Cardiology Research Laboratories. She and her team have been studying the regulation of micro-RNAs and their putative target genes in the pediatric DCM heart that may contribute to the distinctive phenotype of this disease in children. Read the article here. See acast.com/privacy for privacy and opt-out information.

Thousands of women have been infected with SARS-CoV2 during the COVID-19 pandemic. While very few of these infections have been shown to transmit vertically from mother to offspring, it remains unclear what effect, if any, a mother's SARS-CoV2 infection has on fetal development. In this episode, we interview Dr Brian Kalish from the University of Toronto and the Hospital for Sick Children, to discuss a study he set up looking into this question by characterizing the composition and cell-type specific translational landscape of umbilical cord blood mononuclear cells.Read the study here: https://www.nature.com/articles/s41390-021-01793-z See acast.com/privacy for privacy and opt-out information.

Twenty-five percent of children who survive acute symptomatic seizures as neonates go on to develop epilepsy. Whilst there are several known risk factors, currently not enough is known about the mechanisms behind the development of epilepsy following neonatal brain injury, and thus it is not yet possible to reliably predict the individual risk of developing this disease in this group of patients.In this episode, we speak to Adam Numis from UC San Francisco. He and his team used whole exome sequencing with targeted gene analysis to look for genetic risk factors for developing epilepsy following acute neonatal seizures, and to identify potential biological processes behind this epileptogenesis. Read the study here.  See acast.com/privacy for privacy and opt-out information.

Most very preterm infants experience apneas of prematurity. It is a common comorbidity of prematurity, and therefore reliable real-time monitoring of respiratory rates is key in these infants. The conventionalmethod is to use chest impedance measured with electrodes on the surface of the thorax. However, this method is known to be unreliable, as it is prone to motion artifacts. For this reason, indirect measurements such as oxygen desaturation or bradycardia are often necessary to identify apneas. In this episode, we meet this month's featured Early Career Investigator, Dr. Kerstin Jost at the Karolinska Institute in Stockholm, Sweden. She describes a recent study of a novel technique using a commercially available nasogastric feeding tube that measures esophageal signals and uses customized software to identify the respiratory rate of non-ventilated preterm infants. Listen in! See acast.com/privacy for privacy and opt-out information.

There is a growing body of evidence showing that excessive early media use is detrimental to children's physical and mental health. As such, the World Health Organization guidelines suggest that screen time for infants should be limited to a maximum of one hour per day. However, with the growing ubiquity of digital media, it is thought that preschoolers are exposed to more than two hours of screen time. With the rapidly changing nature of digital media use, it is not yet clear how this is affecting different aspects of early childhood development. The evidence to date has been increasingly mixed.In this episode, we speak to medical student Clarissa Schwarzer who is doing her doctoral thesis on early childhood development and media use by children and mothers at the Leipzig Research Center for Civilization Diseases. See acast.com/privacy for privacy and opt-out information.

Caffeine administration has been associated with reduced rates of Acute Kidney Injury (AKI) in preterm neonates but the effect of caffeine on renal oxygenation is unknown. In this episode, we meet this month's highlighted Early Career Investigator, Dr. Matthew Harer from the University of Wisconsin School of Medicine and Public Health. He has been investigating the potential use of Near Infrared Spectroscopy (NIRS), a non-invasive means of continuously measuring tissue oxygenation to assess the effects of caffeine on renal oxygenation, in the hope that caffeine might one day be used to prevent and even treat AKI.   See acast.com/privacy for privacy and opt-out information.

Early on in the SARS-CoV-2 pandemic, the majority of infected children were either asymptomatic or had mild COVID-19 disease, prompting many to demand a higher acceptable risk threshold for pediatric vaccines. More recently, as children begin to make up a larger proportion of the infected population and following evidence of the mental and physical toll exacted by the pandemic on children, a pediatric vaccine is now more pressing. But challenges to widespread vaccine uptake remain. In this episode meet Dr. Chulie Ulloa from the University of California Irvine about a recent commentary she wrote with fellow pediatric providers, physician scientists and advocates for children about these challenges and how they might be overcome.   See acast.com/privacy for privacy and opt-out information.

Juvenile idiopathic arthritis (JIA) is one of the most common inflammatory joint diseases in children. Previous studies have shown that in the oligoarticular subtype of this disease, T cells play a central role in pathogenesis. T cell inhibitory receptors (IRs) seem to play an important role in the development of tolerance and recognition of self and non-self antigens. Ligands binding to these IRs inhibit T cell function and modulate the course of the immune response. In this episode, we meet this month's highlighted Early Career Investigator Erdal Sag, a paediatric rheumatologist at Ankara Training and Research Hospital in Turkey. He and his team designed an ex vivo disease model to examine the effects of different co-inhibitory receptors on the pathogenesis of oligoarticular JIA.  See acast.com/privacy for privacy and opt-out information.

Chorioamnionitis is an intrauterine infection of the placenta and fetal membranes. It is the leading cause of preterm delivery and is a common risk factor for adverse pulmonary outcomes such as bronchopulmonary dysplasia. There is evidence to suggest that the first negative impacts on pulmonary development occur in utero in the presence of chorioamnionitis. In this episode, we meet assistant professors Niki Reynaert and Tim Wolfs from Maastricht University in the Netherlands. Together they studied an ovine model of chorioamnionitis in order to study the effects of chronic and acute inflammation on the developing lungs.   See acast.com/privacy for privacy and opt-out information.

Previous studies have shown an association between fluid retention during the early postnatal period and increased BPD. However, these studies were performed nearly two decades ago meaning their results may not apply to the contemporary NICU setting, with its widespread use of surfactants and modern incubators. In this episode we meet this month's featured Early Career Investigator Marc Beltempo from McGill University and the Montreal Children's Hospital in Canada, who has revisited this important question.   See acast.com/privacy for privacy and opt-out information.

Respiratory support plays a crucial role in the care of preterm infants in the NICU, ensuring that they get enough oxygen during this critical period of development. But it is becoming increasingly clear that former preterm infants who have been exposed to ventilatory support are at an increased risk of developing asthma and other respiratory disorders. In this episode, we speak to Peter Macfarlane, an associate professor in the Department of Pediatrics at Rainbow Babies and Children's hospital. He and his team have developed a mouse model to study the effects of CPAP in combination with supplemental oxygen on lung function.  See acast.com/privacy for privacy and opt-out information.

Extremely preterm infants are at a high risk for brain injury, and this risk is most severe in children with intraventricular hemorrhage followed by post-hemorrhagic ventricular dilation. Bedside cranial ultrasound allows clinicians to identify the progressive dilation of the lateral ventricles, however, there is currently no consensus on how to quantitatively estimate this dilation and at what point to intervene. In this episode, we meet this month's highlighted Early Career Investigator, Dr. Rawad Obeid, a pediatric neurologist at the Oakland University School of Medicine. He and his team investigated a new parameter for estimating lateral ventricular dilation called the frontal-temporal horn ratio, in an effort to define normative values and to correlate this parameter with white matter injury at term-age equivalent.   See acast.com/privacy for privacy and opt-out information.

Acute kidney injury (AKI) causes significant morbidity and mortality in children, including prolonged hospital stays, increased risk of in-hospital death and future risk of hypertension and progression to chronic kidney disease. Whilst it is quite common, it often goes unrecognized, especially outside of the critical care setting. In this episode, Geoff Marsh speaks to Dr. Shina Menon, a pediatric nephrologist at Seattle Children's Hospital, who performed a pilot study which evaluated the utility of an e-alert system to alert care providers that a patient had AKI, in conjunction with a care bundle which offered simple guidelines to help with their management.   See acast.com/privacy for privacy and opt-out information.

The latter half of gestation and early neonatal life are critical periods for the maturation of the autonomic nervous system. Premature infants are born with underdeveloped autonomic maturation and must undergo their developmental changes in a vastly different setting to the natural, in utero environment. A number of studies have shown autonomic dysmaturation in premature infants, although these have mainly looked at cohorts of children from high-morbidity NICUs. In this episode, Geoff Marsh talks to Dr. Sarah Mulkey, a fetal neonatal neurologist at Children's National Hospital in Washington DC, who tracked the sympathetic and parasympathetic maturation of a cohort of preterm infants with low medical morbidity in a large community NICU, to assess how birth gestational age affected their autonomic maturation.   See acast.com/privacy for privacy and opt-out information.

Pediatric chronic kidney disease (pCKD) results in a life-long burden that requires routine care. Neurocognitive dysfunction, specifically impairment on tasks of executive function, is a well-established comorbidity but there is a paucity of data exploring the neurobiology of these cognitive deficits. In this episode, we meet early career investigator, Dr Lyndsay Harshman, a pediatric nephrologist at the University of Iowa's Stead Family Children's hospital, who compared the brain morphometry between early stage pCKD children and their typically developing peers, and linked this brain morphometry with disease status and performance on neurocognitive assessments.   See acast.com/privacy for privacy and opt-out information.

Therapeutic Hypothermia has long been the standard of care for infants with moderate to severe neonatal encephalopathy. However, the future of treatment for neonatal encephalopathy (NE) will focus on hypothermia adjuvant therapies. There needs to be a rethink in how future NE clinical trials are designed and analyzed, according to a multi-disciplinary expert panel who met at the 'Hypoxic-Ischemic Encephalopathy Symposium: Developing the Future'. In this episode we meet Dr. Kristen Benninger, a neonatologist at Nationwide Children's Hospital in Columbus Ohio who wrote up the panel's summary.   See acast.com/privacy for privacy and opt-out information.

Pediatric Pulmonary hypertension (PAH) is a heterogeneous disease, characterized by sustained elevation of pulmonary arterial pressures and death from right ventricular failure. Given the extremely high burden of morbidity and mortality associated with this disease, and the risk of the invasive procedures required for diagnostics, novel biomarkers for this disease would be beneficial. In this episode, we meet Early Career Investigator, Dr. Megan Griffiths from Johns Hopkins University, School of Medicine, who examined two candidate IGF axis proteins as potential predictors of PAH severity.   See acast.com/privacy for privacy and opt-out information.