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November: Studying drugs in newborns.
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 metabolized 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!
September: Seven great achievements.
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. Related Article.
July: Neonatal Nutrition.
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.
May: Participatory research: Getting children involved.
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.
March: Preterm diagnostics: The SafeboosC II trial.
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.
February: Child health: Nature and nurture.
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.
November: Brain damage: Are stem cells safe?
A lack of oxygen or blood to the brain in newborn babies can lead to brain damage. One promising treatment currently being trialed 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.
September: Caffeine in prematurity: Friend or foe?
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.
July: Gut bacteria in preterm babies.
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.
May: Baby learns to breathe.
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.
March: What causes ‘false brain tumour’?
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.
January: Getting the dose right?
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.
November: Social inequality and childhood health.
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.
September: A new way to understand SIDS.
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.
July: Malnutrition and cystic fibrosis in India.
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.
May: The Bayley Scales: Measuring infants
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.
March: Catch-up growth.
In this podcast we're focusing on children born with extremely low birth weights. Researchers are interested in how quickly these children grow and catch up with their normal birth weight peers. A new study, of children born in the 1990s, suggests that improvements in neonatal nutrition have led to improvements in catch-up growth. The study also looked at gender differences and obesity. Study leader Maureen Hack talks us through the findings.
January: A new way to track red blood cell survival in infants.
Researchers normally use a radioactive label to track red blood cell survival. But this method is deemed unsafe for infants and children. So an alternative method - one using biotin to label the cells, instead of radioactive Chromium 51 - is good news for pediatrics. Dr. Jack Widness and colleagues from the University of Iowa have tested the biotin labeling method on a group of critically ill premature babies. In this podcast Dr. Widness presents their results and explains how the method could be used to improve transfusion practices for infants with anemia.
November: A plastic baby for DXA machines.
Roman Shypailo and his colleagues at Baylor College of Medicine have built a 7kg baby out of PVC, nylon and polyethylene. Their plastic baby - or 'phantom' - is a calibration tool. Roman hopes that it will be used to standardize infant scans in DXA machines, which are used to measure bone density.
September: Improving mild hypothermia treatment.
Mild hypothermia is a well-established treatment for babies at risk from long-term brain damage following a lack of oxygen at birth. Doctors would like to tailor the treatment to individual cases and predict long-term outcomes. To this end, two studies published in Pediatric Research investigate ways to guide therapy; the first identifies brain metabolites in a mouse model; the second tests a combination of two bedside monitoring techniques. We hear from authors of both studies on this month's podcast.
July: Placebo effects in children.
We have a good understanding of placebo effects in adults, but how about children? The current literature suggests some significant differences in the way children respond to placebos, but more research is needed to understand these differences properly. In this podcast, Katja Weimer from University Hospital Tübingen explains why it's difficult to study placebo effects in children and how we might overcome these difficulties.
May: Prematurely born children and exercise.
We have become very good at looking after babies born extremely prematurely, before 32 weeks of gestation. Now researchers are turning their attention to how these children develop, and what specialist care they might need as they grow up. A new study finds that prematurely born children have significant breathing problems after running on a treadmill for several minutes. François Marchal and Jean-Michel Hascoet, who carried out the study, are our May podcast guests.
March: Kawasaki disease and soy.
The causes of this childhood disease are largely unknown. What we do know is that a child in Japan is 10 times more likely to show symptoms than a child in the United States. Michael Portman, from Seattle Children's Research Institute, thinks this difference is down to diet. In this podcast, he proposes a link between soy consumption and Kawasaki disease.
January: Breast milk and childhood growth.
Over the last thirty years, our diets have changed and obesity has become more prevalent. In particular, we're now eating fewer foods rich in omega-3. A study based in Copenhagen has found a link between the amount of omega-3 in a mother's breast milk and her child's physical development. In this podcast, study leader Louise Pedersen explains how this finding relates to obesity and gives some advice to pregnant mothers.
November: Developing an artificial placenta.
For 50 years, scientists have been trying to make an artificial placenta. Such a device could revolutionize the treatment of extremely premature babies. On this podcast, Yuichiro Miura from Tohoku University in Japan talks about his new, compact design.
September: Smoking and the developing lungs.
It's well known that smoking during pregnancy damages the developing lungs, increasing the risk of infections in newborns. Researcher Cherry Wongtrakool thinks this damage could extend all the way into adulthood, explaining some of the cases of asthma she sees in her clinic. To work out exactly how this damage occurs, Cherry and colleagues have been taking a closer look at nicotine, the fat soluble and addictive component of tobacco. On this podcast, Cherry explains how nicotine crosses the placenta and affects the function of immune cells in the lung.
July: Diagnosis by computer.
Our daily lives rely on the power of computers. So why not medical diagnosis? Getting the right diagnosis is a challenge, particularly in the emergency room, where up to 15% of patients are misdiagnosed. Could computers lend a guiding hand? Doctors have been trying to use computerized support for decades - but current systems are quite crude, built to deliver 'yes' or 'no' answers. Lorenz Grigull and his colleague Werner Lechner from the Hannover Medical School, Germany, have been working on something new
May: From the lab to the clinic.
Getting a new drug or treatment from the lab to the clinic, where it can be used to improve the health of patients, takes time. To speed up this process, in 2006 the National Institutes of Health launched a new science award program - the CTSA. In this podcast, we hear how the program is affecting child health research in the US. The results of an initial evaluation are encouraging, but there's room for improvement says pediatric researcher Charles Huskins.
March: Project Ice Storm.
When a severe ice storm hit the Canadian Province of Quebec, it gave researchers at McGill University the chance to study prenatal stress. On this podcast, we hear how the hardships faced by pregnant women in the weeks after the storm are affecting their children.