Systemic lupus erythematosus (SLE) causes significant long-term morbidity and mortality, particularly in children. There is some evidence that the innate immune system, in particular neutrophil activity, can be compromised in adult-onset lupus. Yet there is a paucity of data on neutrophil activity in pediatric SLE. This month on Pediapod, we join Early Career Investigator, Rakesh Kumar Pilania, an assistant professor at the postgraduate Institute of Medical Education and Research in Chandigarh, ...
Nov 28, 2022•10 min
95% of adolescents in the US have access to a smartphone and 45% report being online "almost constantly". Beyond the general time spent on screens, the control over usage and the interference into other activities are also important considerations and could reflect problematic screen use. This week on Pediapod, we meet Early Career Investigator, Professor Jason Nagata from the University of California, San Francisco to discuss his recent study of the sociodemographic correlates of problematic sc...
Oct 24, 2022•15 min
The Baby Doe Regulations, which regulate the provision of life-sustaining treatment to seriously ill neonates, caused a stir amongst neonatologists when they were first enacted in the 1980s. The fear at the time was that they would restrict their ability to provide optimal care to seriously ill patients by mandating the use of aggressive treatments in all but futile cases, irrespective of a patient's quality of life. In this episode, we meet Early Career Investigator Katherine Guttman from the I...
Sep 29, 2022•14 min
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 Ca...
Aug 23, 2022•10 min
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 mo...
Aug 02, 2022•12 min
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...
Jul 05, 2022•12 min
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 t...
May 25, 2022•14 min
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 spe...
Apr 19, 2022•12 min
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 sequ...
Feb 18, 2022•11 min
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 apnea...
Jan 31, 2022•11 min
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 affect...
Dec 10, 2021•13 min
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 ...
Nov 18, 2021•11 min
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 episo...
Oct 29, 2021•11 min
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 th...
Sep 13, 2021•10 min
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 studi...
Aug 31, 2021•16 min
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 importa...
Jul 21, 2021•12 min
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....
Jun 01, 2021•11 min
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. R...
May 21, 2021•13 min
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 utilit...
Mar 02, 2021•11 min
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 tal...
Feb 15, 2021•12 min
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 be...
Jan 11, 2021•11 min
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 n...
Dec 18, 2020•11 min
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...
Nov 24, 2020•12 min
Effective decision making in the Pediatric Intensive Care Unit relies on quickly ascertaining diagnostic information in order to deliver a tailored clinical response. The utility of rapid genetic testing of critically ill patients has been demonstrated several times, owing to their relatively high diagnostic yield. However the cost and slow turnaround of results have been major barriers in the past to the widespread uptake of this technology in the clinical setting. In this episode, we meet Prof...
Oct 15, 2020•12 min
Smoking in adults and adolescents is at an all-time low today, yet around 1 in 2 children who visit the Emergency Department have been exposed to tobacco smoke. We know that there numerous health consequences associated with tobacco smoke exposure (TSE), and that this also comes at a substantial monetary cost- in 2010, child tobacco smoke exposure resulted in more than 101,570 annual ED visits, costing nearly $63 million. In this episode, we meet Early Career Investigator, Ashley Merianos from t...
Sep 17, 2020•11 min
Institutions and healthcare systems had started to introduce wellness initiatives following the growing realization of the widespread problem of physician distress and burnout. Whilst these programs might be effective, there is currently a lack of evidence about who uses them and whether they are best suited to their target audience. In this episode, we meet Dr. Andrea Weintraub from the Icahn School of Medicine at Mount Sinai, who conducted a cross-sectional national survey amongst different pe...
Aug 27, 2020•14 min
40% of infants with hypoxic ischemic encephalopathy (HIE) go on to develop long-term disability, despite receiving therapeutic hypothermia. Mounting evidence suggests that children with HIE are at a higher risk of both hypoglycemia and hyperglycemia, which may explain the variable outcomes to therapeutic hypothermia. In this episode, we meet this month's featured Early Career Investigator Dr. Paolo Montaldo, from Imperial College London, UK and the University of Campania Luigi Vanvitelli, Italy ...
Jul 23, 2020•11 min
There is a growing body of evidence to suggest that insufficient sleep can have detrimental effects on school-age children's cognitive, emotional and behavioral regulation. But there remains a lack of objectively measured data on the stability and prevalence of insufficient sleep. In this episode, we meet Bror Ranum who is currently doing his PhD at the Norwegian University of Science and Technology. He was involved in a large prospective study of almost 800 children between the ages of 6-12 yea...
Jun 16, 2020•11 min
Young children face unprecedented access to screens in the modern environment. It was recently estimated that children between the ages of 3-8 get almost 3 hours of screen use a day. The American Academy of Pediatrics (AAP) have recommendations for screen-based media use which focus on four variables: access to screens, frequency of use, content and grownup-child interaction, or “co-viewing". In this episode, we meet Early Career Investigator, Dr John Hutton, from Cincinnati Children's Hospital ...
May 19, 2020•12 min
There is a growing body of evidence to suggest that early life stress can have detrimental effects on a child's physical and mental health. Hair cortisol concentrations are increasingly accepted as a cumulative measure of stressful experiences but they are understudied in preschool children. In this episode, we meet Professor Sunny Anand from Stanford University School of Medicine who developed a sensitive assay for hair cortisol concentrations. He and his team took hair samples from children ag...
May 04, 2020•12 min
