Pediatric Research Podcast

One system which is thought to falter in preterm neonates is the cerebrovascular autoregulatory system, which helps to maintain a constant supply of oxygen to the brain. When this system falters in the setting of hypotension, it can lead to intraventricular haemorrhage, which in turn, can lead to serious neuro-developmental impairment. In this episode, we meet Zachary Vesoulis, a Pediatrician at Washington University in St. Louis, who recently published a Pediatric Research paper testing the effects of gestational age on the cerebrovascular autoregulatory system. We also discuss what Zach sees as a missed opportunity to collect data in the clinic.

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It has been known for over 20 years that antidepressant exposure in utero may be associated with poor neonatal adaptation and discontinuation like symptoms in neonates. Poor neonatal adaptation syndrome, or 'PNAS' presents as a distinct set of gastrointestinal, neurological and respiratory symptoms. In this episode we meet Professor Megan Galbally, Foundation Chair in Perinatal Psychiatry at the University of Notre Dame, to discuss her recent Pediatric Research paper examining the use of the Neonatal Abstinence Scoring System in assessing neonates exposed to antidepressants in utero and providing some rare long-term follow up of these children's developmental outcomes at 6 months. We also discuss a commentary article from the Pediatric Policy Council on this topic, and how her study can be expanded upon by following these results further with the children, preferably up to adulthood.

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Veerajalandhar Allareddy is a pediatric cardiac critical care physician in the Stead Family Children's Hospital, University of Iowa. In recent years, he has become interested in marrying his clinical work with studies into public health issues in pediatrics, which he believes are under researched and under reported. In this episode we discuss one such issue: the rising trend of opioid abuse in children across the US.

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Hypoxia-ischemia (HI) is a major cause of neurological damage in preterm neonates. Physical exercise in mothers serves as a non-pharmacological intervention to counteract obesity, hypertension, and other such risk factors for prematurity. For this reason, women are widely encouraged to swim throughout their pregnancy. In this episode, Eduardo Farias Sanches discusses how he and his team wanted to test the neuroprotective effects of pregnancy swimming against the damage caused by HI and to understand possible mechanisms behind these effects.

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Simone Schuller is a pediatrician at the Boston's Children Hospital. She was awarded the Max Kade fellowship to conduct research into neonatal innate immune pathways to aid the development of vaccines for the very young. Previously, Simone was at the Medical University of Vienna, where she recently completed her residency and clinical training. In this episode, we hear how she has strengthened her laboratory experience over the years in a number of countries and has used some of these in vitro skills in a recent Pediatric Research paper about the effect of Pentoxyfylline on the preterm infant immune system in a model of sepsis.

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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.

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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.

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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.

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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.

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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!

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