By Nancy McCann
We start this edition of In the News with a look at the prevalence of sleep problems in young children with autism spectrum disorder, a study on opioid prescriptions for kids with broken elbows, and Children’s Hospital of Philadelphia’s grand opening of the Healthy Weight Food Pharmacy and the research behind it.
Sleep Problems More Prevalent in Young Children With Autism
In a study published in Pediatrics, the results showed sleep problems are more than twice as likely in 2- to 5-year-olds with autism spectrum disorder (ASD) and developmental delays and disorders (DD) with ASD. The study was the largest of its kind in which researchers used a validated measure of sleep habits (Children’s Sleep Habits Questionnaire) in children with ASD and two control groups (children with DD and children in the general population). The authors, including Susan Levy, MD, MPH, a developmental and behavioral pediatrician, and director of the Autism Integrated Care Program at CHOP, determined it’s important to screen for sleep problems in young children in order to provide appropriate interventions.
“Sleep problems are common in all children 2- to 5-years-of-age, with an even higher prevalence in children with ASD and DD with ASD,” the authors wrote. “Because of the prevalence of sleep problems in young children with ASD features and the impact of poor sleep on daytime behavior and overall health for the child and family, further study is needed to address the etiology and management of sleep problems in children with ASD.”
To learn more about the study and its methodology, read the full article in Pediatrics.
Opioids Overprescribed for Common Childhood Bone Fracture
Research by Apurva Shah, MD, MBA, orthopedic surgeon at CHOP, and colleagues hit mainstream publications this month as their study on opioid prescriptions for children with broken elbows was recently reported by U.S.News & World Report. The study included 81 patients with an average age of 6 years, who had surgery for the most common type of elbow fracture. Published this month in The Journal of Bone and Joint Surgery, it reveals concern for the balancing of analgesia and opioid stewardship, two priorities of orthopedic surgeons.
Data showed patients used less than 25 percent of prescribed opioid medication, suggesting potential for overprescription and opioid diversion (leftover pills being diverted for illicit use). It was determined seven opioid doses after discharge should suffice, allowing for adequate postoperative pain management in most patients while improving stewardship of narcotics.
“This study suggests that orthopedic surgeons really need to think about our current prescribing practices and how we can help decrease the potential for overprescription and opioid diversion,” said Dr. Shah, the study’s senior author.
Alexander Adams, who is a former CHOP clinical research fellow, and researchers from University of Rochester Medical Center, Rochester, N.Y., and University of Iowa Hospitals and Clinics, Iowa City, Iowa, contributed to the study.
CHOP’s Food Pantry Combats Food Insecurity for Philadelphia’s Children
January marked the grand opening of the Healthy Weight Food Pharmacy — the first pediatric, hospital-based food pharmacy to promote healthy nutrition and address food insecurity. Saba Khan, MD, who has conducted years of research on the subject of food insecurity and its link to poor health outcomes, will serve as its director.
“This in-house fresh food pantry is the result of the collaborative efforts of CHOP, Philabundance, and Giant Food Stores and will be administered through CHOP’s Healthy Weight Program, which is designed to treat and prevent childhood obesity,” said Peter Grollman, senior vice president of external affairs at CHOP, in a February Philadelphia Inquirer commentary.
Opinion: Combat Gun Violence With Government-Funded, Data-Driven Research
With the one-year remembrance of the mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., in the news last week, Christian Pulcini, MD, MEd, MPH, FAAP, a pediatric emergency medicine fellow at CHOP, took the moment to share his opinion in the Philadelphia Inquirer: More government funding is needed for research on gun violence prevention.
Referring to gunshot victims and their families whom he treats in the ER, Dr. Pulcini, stated, “They are real people who represent a public health epidemic we must do more to prevent.”
He underscored his plea for more research by citing onerous national statistics on firearm-related deaths close to home: “In Pennsylvania, the firearm mortality rate is 12 per 100,000 people – slightly higher than the national average and higher than any of our neighboring states.”
“We need data to take a public health approach to this epidemic,” Dr. Pulcini stated. “For too long, federal policy has prevented the funding of research by the Centers for Disease Control and Prevention (CDC) on how to prevent firearm injuries and fatalities.”
Read the complete commentary online in the Philadelphia Inquirer.
CHOP Researcher Receives Proof-of-Concept Award from Science Center
The University City Science Center announced the 11th round of awardees for its QED program. Established in 2009, the program supports novel university technologies with market potential, bridging the gap between academic research and product commercialization. The four awardees were selected from a pool of 50 applicants from 12 institutions in Pennsylvania, New Jersey, and Delaware.
John Maris, MD, a pediatric oncologist at CHOP, received this proof-of-concept award to advance his research in developing a T-cell based immunotherapeutic treatment for children with neuroblastoma. Dr. Maris and his research team have identified highly specific biological targets in neuroblastoma tumors and engineered T-cells to attack those targets. In addition to a monetary award, the QED Program has paired Dr. Maris with a business advisor from its own network to collaborate on a plan to obtain commercial funding to bring the new cancer treatment to the market.
“The QED process was rigorous, educational, and at the end of the day, made our entire research program much more translatable to our patients,” Dr. Maris said. “Our QED Business Advisors were outstanding in helping us create the best possible proposal and presentation, and build bridges with essential collaborators. We very much look forward to continuing our work with the Science Center and our QED Business Advisors to realize our dream of curing currently incurable advanced cancers.”
Specialized Lung Cells Appear Early in Fetal Development
Specialized lung cells appear in the developing fetus much earlier than scientists previously thought. A CHOP/Penn research team reported how cells that become alveoli, the tiny compartments in which gas exchange occurs in the lung, begin their specialized roles very early in prenatal life. The researchers said investigating the fetal signaling pathways active in this biological event may offer future opportunities to treat lung damage caused by prematurity and other lung injuries.
The findings of the CHOP/Penn research team led by David Frank, MD, PhD, pediatric cardiologist at CHOP; Edward Morrisey, PhD, director of the Penn Center for Pulmonary Biology; and Rajan Jain, MD, assistant professor of Cardiovascular Medicine at Perelman School of Medicine at University of Pennsylvania, were published this month in Proceedings of the National Academy of Sciences of the USA (PNAS).
The investigators are interested in deciphering the basics of how cells form their identity — essentially, why a cell becomes a lung cell as opposed to a heart cell. In particular, understanding how the lung forms is critical because many babies born prematurely have poorly formed organs.
“What we found is that lung cells take on their intended fate much earlier than expected, which is a critical step toward being able to develop new therapeutics,” Dr. Jain said.
The research team plans to further explore how their findings could eventually contribute to future treatments.
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