Pediatric Research Podcast

Electronic cigarettes are used almost as much as conventional cigarettes in some parts of the world and are particularly popular among young people. They are often advertised as a means of stopping smoking but there is a lack of consistent evidence for this claim. In this episode, we hear from Dr. Man Pin Wang from the School of nursing, University of Hong Kong. He and his team performed a longitudinal study of adolescents that called the Youth Quitline in Hong Kong, in order to investigate the links between e-cigs and quitting smoking in this population.  See acast.com/privacy for privacy and opt-out information.

This is the first in a series of bi-monthly episodes centered around an Early Career Investigator who publishes in the journal. This month, we meet Dr. Adam Frymoyer, a clinical assistant professor in the department of pediatrics at Stanford University. He describes himself as a 39 year old physician-scientist, passionate about promoting the safe and efficacious use of therapeutic drugs in neonates and children. He has established a cross-disciplinary research program that focuses on the application of clinical pharmacokinetics and pharmacodynamics to guide therapeutic decision making in children.  See acast.com/privacy for privacy and opt-out information.

Neonatal sepsis is a common cause of mortality in newborns. Often, it is the inflammation in response to the pathogen, rather than the pathogen itself, that causes the most harm to the sick patient. Neonatal sepsis is currently treated with corticosteroids but they come with a significant number of adverse effects. One promising new anti-inflammatory drug is a phosphodiesterase inhibitor called pentoxyfylline. Esther Speer, a pediatrician specialized in neonatology at Stony Brook Children's Hospital, carried out an in vitro study using cord blood from healthy-term neonates, providing further evidence that pentoxyfylline represents a promising alternative to corticosteroids.  See acast.com/privacy for privacy and opt-out information.

The legality of medical and recreational marijuana use is on the rise across the US, and this has led to an increase in its usage. But the effects of second hand marijuana smoke on young infants is unknown. Taking advantage of a newly developed high sensitivity assay, Dr. Karen Wilson showed that 16% of a cohort of young children hospitalized with bronchiolitis between 2013 and 2015 showed detectable levels of secondhand marijuana smoke metabolites in their urine and are potentially at risk for negative health effects.  See acast.com/privacy for privacy and opt-out information.

We know that drugs can work differently in adults and in children. But in newborns? We know their physiology is different, and that can affect how drugs are metabolised and processed; for instance, their heart doesn't respond as readily to drugs meant to increase its force. But neonates are often excluded from studies of medicinal products. Clinicians need more specific guidelines as to how to study and use drugs in this vulnerable population. Hear more from Robert Ward!  See acast.com/privacy for privacy and opt-out information.

Researchers in pediatrics have much to be proud of from their last four decades of work. From cutting fatalities from Sudden Infant Death Syndrome, to vaccinations that have protected the lives of millions, Dr. Tina Cheng and colleagues believe that these achievements would not have been possible without a strong research base. Hear more from Tina in this podcast.  See acast.com/privacy for privacy and opt-out information.

A baby's healthy growth depends on receiving the right balance of energy and nutrients. If a baby is born pre-term, its carers must provide the nutrition it would otherwise have received in the womb. Surprisingly, there is very little consistency in studies of neonatal nutrition and growth regarding how much energy and nutrients should be administered to preterm infants, and the expected growth trajectories. A team from the University of Auckland in New Zealand have looked at 22 studies and developed a way to standardize this information.  See acast.com/privacy for privacy and opt-out information.

It's usually the job of the researcher to devise a hypothesis, set up a trial, and collect data. But in participatory research, some of this power is handed to the study participants; in the case of paediatric research, it's given to children. The idea is to have children play an active role in the questions being asked, the data collection process, and any actions that result from a study. A new paper sets out to find examples of participatory research in paediatrics and gives suggestions on best practices.  See acast.com/privacy for privacy and opt-out information.

The brains of preterm babies are delicate - and mysterious. It can be difficult to assess what is happening in the brains of babies born preterm, in order to work out the best course of action. The SafeboosC II trial tested whether using a brain imaging technique called NIRS (Near Infrared Spectroscopy) on preterm infants could guide diagnosis, and whether it could help reduce the burden of hypoxia. It had the desired clinical effect - but two biomarkers of brain injury were not reduced in line with the burden. Researchers Gorm Greisen and Anne Mette Plomgard discuss this unexpected result.  See acast.com/privacy for privacy and opt-out information.

It's not just biology that determines the health of an infant or child - and the adult they will become. Social and environmental factors such as parenting, the home environment, substance use in the home or child abuse can have important impacts on pediatric health and later life repercussions. The January 2016 issue of Pediatric Research features several reviews on the social determinants of health. Guest editor Margie Skeer talks through a few examples.  See acast.com/privacy for privacy and opt-out information.

A lack of oxygen or blood to the brain in newborn babies can lead to brain damage. One promising treatment currently being trialled in animal models involves giving a type of stem cell by inhalation. Before the therapy can be tested in humans, though, scientists need to know it is safe and won't cause uncontrolled cell growth in the brain. A new report in Pediatric Research now establishes its safety.  See acast.com/privacy for privacy and opt-out information.

Caffeine makes the adult world go round - but could it also be used as a therapy for premature babies? Several studies have suggested that in premature babies with breathing difficulties, caffeine could help stimulate them to breathe on their own and even have a positive effect on their brain development. But by contrast, a new study in Pediatric Research finds that a high dose of caffeine can have harmful effects.  See acast.com/privacy for privacy and opt-out information.

Our bodies are home to more bacterial cells than human cells. These bugs are collectively known as our microbiota. But when we're born, we have very few. Max Vento studies how infants amass their community of bugs and what effect being born preterm has. And it's the subject of a review, in which he and his colleagues also outline how the microbiota of preterm babies can be impaired, and how to coax it into health.  See acast.com/privacy for privacy and opt-out information.

At the moment of birth, babies go through the most disruptive physiological transition they will ever experience: they rid their lungs of fluid and start to breathe. Then the umbilical cord is clamped, shutting off air and blood supply from the mother and cementing their independence. New insights into this process, detailed in a review article by Stuart Hooper and colleagues, could help ease the transition for babies who have problems beginning to breathe on their own.  See acast.com/privacy for privacy and opt-out information.

Sometimes, adults or children experience the symptoms of a brain tumour - headaches and vision problems - without an actual tumour. The formal name for this mysterious condition is Pseudotumor Cerebri Syndrome. Shana McCormack thinks that insights from kidney biology might help us to understand it. She's our podcast guest this month.  See acast.com/privacy for privacy and opt-out information.

Most drug doses for newborns are based on studies done in adults or older children. In this podcast, Brian Smith outlines the problems with this method, and suggests ways to test drugs in this vulnerable population.  See acast.com/privacy for privacy and opt-out information.

Early childhood is a crucial period. The environment that a child grows up in - their family and neighborhood - influences their health and development for the rest of their life. In this podcast we hear about an ambitious attempt to synthesize 200 studies linking social inequity to childhood health outcomes in Europe.  See acast.com/privacy for privacy and opt-out information.

Occasionally, a baby under a year dies unexpectedly in sleep, for no apparent reason. This is known as sudden infant death syndrome, or SIDS. Studies have thrown up genes and molecules that are sometimes associated with SIDS deaths, but we're a long way from fully understanding the causes. Now, Nathan Salomonis has created a systems-level model of SIDS, to help researchers see how pathways in the brain, heart and immune system are involved - and to identify new targets for research  See acast.com/privacy for privacy and opt-out information.

Case studies in the US show that children with cystic fibrosis often suffer from vitamin deficiencies. In India, this problem is exacerbated by malnutrition, as Dr Angurana discovered when he studied patients in the northern city of Candigarh.  See acast.com/privacy for privacy and opt-out information.

The Bayley Scales are a suite of IQ-like tests for babies and young children. They're used to assess infant development. But the latest edition of the tests, the Bayley-III, seems to produce higher test scores than its predecessor, the Bayley-II. This is causing problems for researchers like Neil Marlow who use the tests to check the effectiveness of different interventions. Neil decided to compare the two tests. He talks about the results of his study, and its implications, on this month's podcast.  See acast.com/privacy for privacy and opt-out information.