Pediatric Research Podcast

Neonatal opioid withdrawal syndrome (NOWS) represents a major public health problem in the US with a high socioeconomic burden. The pathophysiology of this condition is not yet fully understood. Data from animal models have shown that opioids modulate brain reward signalling via an inflammatory cascade, however no such data exist for opioid-exposed neonates.

In this episode of Pediapod we meet Early Career Investigator Elizabeth Yen, an assistant professor of pediatrics at Tufts University School of Medicine. She recently published a pilot study which looked at the effects of prenatal opioid exposure on gene expression and white matter injury. 

Read the full study here: Sex-specific inflammatory and white matter effects of prenatal opioid exposure: a pilot study | Pediatric Research (nature.com)

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Rare diseases affect millions of people in the USA. However, access to subspecialty care is not distributed equitably and there may be other barriers to clinic attendance. Furthermore, once established within the genetics clinic, families may still face barriers along the path to getting a molecular diagnosis.

In this episode, we meet Early Career Investigator, Monica Wojcik, a neonatologist and geneticist at Boston Children's Hospital who ran a study to determine the influence of social determinants of health on the care-cascade following referral to a high-volume pediatric outpatient genetics clinic. 

Read the full study here: Rare diseases, common barriers: disparities in pediatric clinical genetics outcomes | Pediatric Research (nature.com)

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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, India to discuss his study of neutrophil activity in patients with pediatric SLE and what it reveals about the etiology of this condition.

Read the full study here. Pediatric systemic lupus erythematosus: phagocytic defect and oxidase activity of neutrophils | Pediatric Research (nature.com)

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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 screen use. 

Read the full article here: Social epidemiology of early adolescent problematic screen use in the United States | Pediatric Research (nature.com)

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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 Icahn School of Medicine at Mt Sinai, New York. She tells us about her study which aimed to assess contemporary neonatologists' perceptions of the Baby Doe Regulations and to compare them to the views of neonatologists when they were first enacted.

Read the full study here.

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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)

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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.

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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.

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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.

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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

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