Pediatric Research Podcast

Over-the-counter (OTC) medications are used in an estimated 70% of pregnancies. Acetaminophen, also known as paracetamol is found in a large number of OTC and prescription drugs. Given its prevalence and its ability to freely cross the placenta, researchers are now focusing on the safety of maternal exposure to this drug and its effects on fetal health. There have been inconsistent results in both human and animal studies on the short and long-term effects of acetaminophen use during pregnancy. In this episode, we meet Early Career Investigator, Melissa Smarr, an assistant professor at the Emory University School of Public Health as she describes her study into the effects of prenatal acetaminophen use on fetal growth.

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Almost 10% of newborn infants develop significant hyperbilirubinemia, and many require phototherapy treatment. This is costly and can increase the likelihood of patients developing allergic diseases. However the costs of not treating neonatal jaundice can be more severe as it can cause lifelong disability. Precise patient monitoring and deliberate treatment assignment are therefore essential for at-risk neonates. In this episode, we meet Sven Wellman, then of the University of Basel's Children Hospital in Switzerland. He and his team developed an online tool that uses machine learning methods to accurately predict neonates at risk of developing clinically relevant hyperbilirubinemia.

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Placental dysfunction is a leading cause of morbidity and mortality in children. Yet, despite its central importance, there is a lack of tools to assess in vivo placental health. Ex vivo evaluation of placentas has shown there to be micro-architectural changes with fetal growth restriction (FGR), but currently there are no tools to assess this before birth. In this episode, we speak with this month's Early Career Investigator- Prof. Nickie Andescavage from George Washington University, who recently performed an advanced textural and morphometric of Magnetic Resonance images of the in vivo placenta in healthy and high-risk pregnancies.

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In 2015, Brazil experienced an unprecedented epidemic of zika virus infection. Concurrently, there was an increased incidence of children born with primary congenital microcephaly. Researchers quickly suspected a link between the zika virus infection in pregnant women and congenital microcephaly due to the so-called congenital Zika syndrome (CZS). With the impending threat of a second outbreak, Marcio Leyser from the University of Iowa proposes a multilevel-based research framework for CZS, based on the multifaceted aspects of the disease.

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Bronchopulmonary Dysplasia (BPD) is a form of Chronic lung disease and results from extreme pre-term birth. Systemic corticosteroid therapy is used postnatally to reduce the severity of BPD, however there is a large range in the phenotypic response to this treatment. In this episode, we speak to Tamorah Lewis, a neonatologist at Children's Mercy Hospital in Kansas City, who aimed to identify pharmacogenetic variants associated with the clinical response to systemic corticosteroid treatment.

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Metabolic syndrome has been a growing problem in recent decades in both adult and pediatric populations. Time-restricted feeding (TRF), has been shown to attenuate metabolic disorders and obesity in adults. It is thought to be superior to surgical interventions and other dietary patterns as it is non-invasive, and does not lead to unbearable hunger. However, there is a lack of data on its effects in pediatric populations. n this episode, we meet Dr. Dandan Hu, who during her time at Peking Union Medical College Hospital, carried out an experiment using a paediatric mouse model to assess the effects of TRM on their metabolism and microbiota. The results were unexpected.

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Pediatric asthma is a chronic, heterogeneous disease that can be triggered by environmental exposures, leading to urgent medical visits. Numerous studies have demonstrated increases in emergency department visits and hospitalizations in association with increasing concentrations of outdoor ambient pollutants. Social and environmental stressors have also been shown to be associated with a stronger relationship between environmental pollutants and asthma development and symptoms.In this study, Dr Lovinski-Desir from Columbia University Medical Center and her team aimed to determine if the relationship between ambient pollutants and urgent visits for asthma varied between New York City neighborhoods with high versus low asthma prevalence.

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Metabolomics has the potential to identify specific targets for primary prevention of metabolic disease. Studies in adults have shown that lean vs obese people show distinct differences in their metabolite composition, sometimes preceding the development of established risk factors associated with metabolic disease. The literature in paediatric populations, however is scant. In this episode, we speak to Prof. Wei Perng, who during her time at the University of Michigan School of Public Health, examined the associations between metabolite composition and metabolic risk across adolescence.

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In this episode, we meet Kristin Keunen from The University Medical Centre Utrecht. She and her team used postnatal neuroimaging to map early developmental trajectories of structural brain wiring in preterm and full-term neonates.The study provides valuable insights into the early stages of structural connectome development.

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Telemedicine is estimated to be used in 25% of patient-doctor interactions. It has benefits, including patient's not having to travel and being seen by healthcare professionals when community clinics are closed. But it is considered a high-stress clinical activity and involves decision making under conditions of uncertainty and urgency.In this episode, we speak to Motti Haimi, a Pediatrician and hemato-oncologist at the Clalit Health Services in Israel. He and his team conducted a qualitative assessment of a Pediatric Telemedicine Service operating in Israel in order to assess challenges according to the physicians themselves.

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