Charting Pediatrics

There are few things that are more frustrating to parents and young patients than issues involving chronic constipation and involuntary defecation. These issues often have a significant negative impact on the quality of life for the child and the family. In today's episode we are going to talk through the key features, diagnostic evaluation and treatment for fecal incontinence in children with Andrea Bischoff, MD. Dr. Bischoff is an Associate Professor of Pediatric Surgery at the University of Colorado, School of Medicine, she's also the Assistant Director of the International Centre for Colorectal and Urogenital Care at Children's Hospital Colorado. Connect with Doctors Pena Bischoff: Facebook: @DrsPenaBischoff Twitter: https://www.linkedin.com/in/andreabischoff YouTube: https://www.youtube.com/watch?v=FMqLE0sE3zc Instagram: @penabischoff Website for Pena course is: www.penacourse.org Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

In this episode we discuss seizures and spells, and the diagnosis and management of events that worry us. This episode was recorded at the 2019 American Academy of Pediatrics NCE in New Orleans with Mered Parnes, MD and Shavonee Massey, MD, MSCE. Dr. Massey is is a pediatric neurologist in the Division of Neurology at Children's Hospital of Philadelphia, specializing in the care of children with epilepsy and a Clinical Instructor in Pediatrics and Neurology. Dr. Parnes is the Director of the Pediatric Movement of Disorders Clinic and an Assistant Professor of Child Neurology at Texas Children's Hospital and Baylor College of Medicine. Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

What do you need to know about COVID-19? In this special episode we are joined by Sam Dominguez, MD to discuss the clinical presentation of the coronavirus in pediatrics, what providers should do if their clinical suspicion is high, and updated epidemiology of the situation. Dr. Dominguez is a pediatric infectious disease physician at Children's Hospital Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine. This episode was recorded on Tuesday, February 11, 2020. Do you have thoughts about today's episode or suggestions for a future topic? Write to us at [email protected]

In this episode we dive in to the topic of medical missions, specifically surgical and perioperative care in resource-limited settings, with Brian Shaw, MD. Dr. Shaw is a pediatric orthopedic surgeon from Children's Hospital Colorado, Colorado Springs Hospital, Chief of the Section of Pediatric Surgery at Memorial Hospital for Children in Colorado Springs, Associate Professor of Orthopedic Surgery at the University of Colorado School of Medicine and Vice-Chair of the AAP Section on Orthopedics. This episode was recorded live at the 2019 American Academy of Pediatrics NCE in New Orleans, La. Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

Pelvic pain most often involves the gastrointestinal or the urinary systems in pre-pubertal girls. However, during late adolescence, gynecologic conditions become more prevalent as etiologies for pelvic pain. Dysmenorrhea and noncyclic pelvic pain are common in adolescents and the management of chronic pelvic pain is often more complex than in adult women. In today's episode we will discuss how to diagnosis and treat possible gynecologic and non-gynecologic conditions of chronic pelvic pain in the adolescent female with Stephen Scott, MD. Dr. Scott is the endowed chair of Perinatal Mental Health and a member of the Pediatric and Adolescent Gynecology team at Children's Hospital Colorado. Dr. Scott is an Associate Professor of Obstetrics and Gynecology and Pediatrics at the University of Colorado School of Medicine. Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

Earlier this fall we shared a special episode to update providers about the growing associations between vaping and more acute, severe lung injury called Vaping Associated Pulmonary Injury – you can listen to that content from Season 3, Episode 6. Today we are going to circle back to this topic with Robin Deterding, MD, and discuss its rapid evolution during the recent months. Dr. Deterding is the Chief of Pediatric Pulmonary Medicine at Children's Hospital Colorado and a Professor of Pediatrics at the University of Colorado School of Medicine. Resources Mentioned in this Episode: Update: Interim Guidance for Health Care Professionals Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use, US Department of Health and Human Services/Center for Disease Control and Prevention MMWR - January 3, 2020 Partnership for Drug-Free Kids: What you Need to Know and How to Talk with Your Kids About Vaping CDC: Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products Previous Charting Pediatrics Episodes about Vaping: E-Cigarettes and Vaping (S2:E23) Vaping Associated Pulmonary Injury (S3:E6) Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

With Super Bowl season upon us we wanted to use the occasion to examine a common sports injury seen in our pediatric patient population – ACL injury and treatment. An ACL tear was once an injury exclusive to professional or elite athletes, but the growing prevalence of specialization and year-around training in youth sports has contributed to a large rise in ACL tears in pediatric patients. In this episode, Jay Albright, MD joins us as we will look at the ACL tear case of a 16 year-old-female to highlight the diagnosis, treatment and recovery for these patients. Dr. Albright is the Surgical Director of the Sports Medicine Center at Children's Hospital Colorado and Assistant Professor of Orthopedics at the University of Colorado School of Medicine. Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

Last season on the podcast we discussed the initial diagnosis and lifestyle management of hypertension in pediatric patients. If you have not had the opportunity to listen to that episode, go back and check out Season 2, Episode 36 as it will set the back drop for today's discussion as we dive more specifically into medication management for pediatric hypertension patients. In this episode we discuss medication management for pediatric hypertension patients with a pediatric cardiologist, Steve Daniels, MD, PhD and a clinical pharmacist, Dr. Megan Greene. Dr. Greene is a pediatric clinical pharmacist at Children's Hospital Colorado with a specialization in critical care and kidney and liver transplant pharmaceutical support, and also works in our pediatric hypertension clinic. Dr. Daniels is the Pediatrician-in-Chief at Children's Hospital Colorado and L. Joseph Butterfield Chair of Pediatrics within the University of Colorado School of Medicine, where he is a professor of pediatrics and epidemiology. He is a cardiologist by training and a sought-out expert in the fields of pediatric hypertension, dyslipidemia, and pediatric nutrition. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents If you have feedback or questions about today's episode or suggestions for a future topic, write to us at [email protected]

In this episode we discuss the history of vaccines and religion with Josh Williams, MD. For a discussion about today's anti-vaccination climate, listen to S3:E17, Peter Hotez, MD, PhD: Physician-Scientist, Pediatrician, Advocate. Dr. Williams is a Pediatrician at Denver Health Medical Center and an Assistant Professor of Pediatrics at the University of Colorado School of Medicine. Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

Is social media good or bad? How much or how little screen time should kids and adolescents have each day? What is the impact of screen time? What kind of digital footprint or reputation are parents creating for their children? These questions and more are covered with our guests Jenny Radesky, MD and Michael Rich, MD who discuss social media and its impact on patients and families. Dr. Radesky is a Developmental/Behavioral Pediatrician whose research focuses on family digital media use, child social/emotional development, and parent-child interaction. Dr. Rich is the Director of the Center on Media and Child Health at Boston Children's Hospital. He has developed media-based research methodologies and authored numerous papers and AAP policy statements, testified to the United States Congress, and makes regular national press appearances. Do you have feedback about today's episode or suggestions for a future topic? Write to us, [email protected]

On behalf of the Charting Pediatrics team, we would like to wish you Happy Holidays and a very Happy New Year! 2019 has been a year of explosive growth for the podcast. We went from averaging 8,000 monthly downloads in January to more than 33,000 monthly downloads last month. Thank you to each one of you for listening and sharing the podcast with your colleagues. Connecting with some of you in person at the 2019 AAP Conference was really a highlight for us. We appreciate you coming by the booth and we love reading the emails and tweets that you send our way. We will be taking the next couple of weeks off from releasing new episodes and will look forward to kicking off our first episode of 2020 on Tuesday, January 7th. Happy Holidays!

On behalf of the Charting Pediatrics team, we would like to wish you Happy Holidays and a very Happy New Year! 2019 has been a year of explosive growth for the podcast. We went from averaging 8,000 monthly downloads in January to more than 33,000 monthly downloads last month. Thank you to each one of you for listening and sharing the podcast with your colleagues. Connecting with some of you in person at the 2019 AAP Conference was really a highlight for us. We appreciate you coming by the booth and we love reading the emails and tweets that you send our way. We will be taking the next couple of weeks off from releasing new episodes and will look forward to kicking off our first episode of 2020 on Tuesday, January 7th. Happy Holidays!

In this episode we are fortunate to be talking with Bernard Dreyer, MD from the New York University School of Medicine discussing school and health care provider partnerships that have been successful in addressing effects of childhood poverty. Dr. Dreyer is past president of the American Academy of Pediatrics (AAP) having served as the 2016 AAP president. Dr. Dreyer is a general and development-behavioral pediatrician who has spent his professional lifetime serving poor children and families. He is Professor of Pediatrics at NYU where he leads the Division of Developmental-Behavioral Pediatrics and is Director of Pediatrics at Bellevue Hospital; he also works as a hospitalist. This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana. Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

In this episode we have the pleasure to talking with Adiaha Spinks-Franklin, MD from Texas Children's Hospital about strategies to help sleepless teens. Dr. Spikes-Franklin is Associate Professor of Pediatrics at Texas Children's Hospital and the Baylor College of Medicine in Houston. Dr. Spinks-Franklin's research interests are in the areas of the cultural aspect of child development. Her previous research experience included studying the development of children in Senegal, West Africa, and studying the mental health impact of the aftermath of Hurricane Katrina on school-aged African American children in Houston. Other research experiences including exploring the racial identity development of school-aged African American and Latino children in the Houston area who are participating in a reading intervention program. She has also studied healthcare disparities among children with Autism Spectrum Disorders. She is currently studying the effect of Adverse Childhood Experience (ACEs) among children and adolescents with developmental disabilities. This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana. Topics Discussed in this Episode: Common presentations that primary care providers will see in adolescents with sleep issues. The importance of the patient's history in determining the causes of symptoms. The various factors, including the homeostatic and circadian drive, in regulating sleep. The difference between REM and non-REM sleep and the physiological processes of each. How sleep changes from childhood to adolescence. Considering both the genetic and environmental components of sleep disorders. How social media activity negatively impacts natural sleep rhythms. What parents can do to mitigate some of the environmental hindrances such as electronics. Maintaining a teen's circadian rhythm by not allowing them to sleep in over weekends. Examples of breathing techniques to help calm down hyperactive or anxious kids. The benefits of gratitude journaling and general journaling before bed. Night sports and adrenaline: encouraging parents to prioritize their children's needs. What families' dinner- and bedtime routines reveal about a household. Thoughts on medicating sleep disorders and how melatonin should be approached. Do you have thoughts about this episode or suggestions for a future topic? Write to us, [email protected]

Substance use among adolescents is pervasive and commonly encountered in primary care pediatrics. According to the most recent Monitoring the Future Study published in 2018, opioid misuse among teens and marijuana use remains stable while vaping device use is climbing to record numbers. The general approach to the assessment and treatment of adolescents with substance use disorders is similar in some respects to adults; however, developmental considerations require an approach tailored to the cognitive, social, and legal status of adolescents. In this episode we discuss the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of substance use and substance use disorder in adolescents with Christian Thurstone, MD. Dr. Thurstone is the Director of Behavioral and Health Sciences at Denver Health and Professor of Psychiatry at the University of Colorado Denver. Discussed in this episode: HEADSS Screening Tool Motivational Interviewing Apply for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000) - Office-based treatment for opioid use in patients aged 16 years and above How to diffuse tense family situations in the office Show empathy Slow the conversation down Maintain confidentiality Meet with teens and parents separately EPE - Elicit Permission; Provide Advice; Elicit Feedback "What do you think about what I just said?" Another good question to ask teens, "What do you already know about....." Have feedback about today's episode or suggestions for a future topic? Write to us, [email protected]

Each year thousands of babies born neonatal abstinence syndrome and require specialized medical and psycho-social support. In this episode we discuss the care for newborns who have been exposed to substances, specifically how primary care providers can understand the child's needs and support their caregivers. We are joined by Stephen Patrick, MD from the Vanderbilt University School of Medicine and recorded this discussion live from the 2019 American Academy of Pediatrics NCE in New Orleans. Dr. Patrick is a neonatologist and associate professor of pediatrics and is Director at the Vanderbilt Center for Child Health Policy. You can view Dr. Patrick's 2019 AAP NCE plenary session on this topic here. You can reach Dr. Patrick on Twitter @stephenwpatrick and Dr. Brumbaugh on Twitter @DBrumbaughMD Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

In this episode we were privileged to sit down with Megan Sandel, MD, at the 2019 American Academy of Pediatrics NCE in New Orleans to discuss the impact of housing on child health. Dr. Sandel is an associate professor of pediatrics at the Boston University School of Medicine as well as an associate professor of environmental health at the Boston University School of Public Health. She has held both of these positions for the last eight years, but has been working with the university since 2002, first as an assistant professor. She is the former pediatric medical director of Boston Healthcare for the Homeless program and the first medical director of the founding site for medical-legal partnerships, Medical-Legal Partnership-Boston. In addition to publishing articles and serving on committees, she is considered an expert in her field on the topic of housing and child health. Resources Mentioned in this Episode: HowHousingMatters.Org The Hunger Vital Sign Screening Tool by Children's HealthWatch Evicted by Mike Desmond PRAPARE Assessment Tool This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana. Do you have thoughts about this episode or suggestions for a future topic? Write to us, [email protected]

In this episode we discuss the diagnosis and management of child abuse in primary care pediatrics. We are pleased to be joined by Andy Sirotnak, MD who recently released his new book at the 2019 AAP NCE, Child Abuse Medical Diagnosis and Management. Dr. Sirotnak is a Professor and Vice-Chair for Faculty Affairs in the Department of Pediatrics and the Director of the Child Protection Team at Children's Hospital Colorado. Do you have questions about this episode or suggestions for a future topic? Write to us, [email protected]

The development and deployment of childhood vaccines represents the most important life saving achievement in the last century, but the status of our protection against vaccine-preventable illness is as fragile as ever in the United States. In 2019 we have already seen the most cases of measles since 1992 — over 1200 — this for a disease that was declared eliminated from the U.S. in 2000. Vaccine hesitancy among families has been fueled by an anti-vaccine movement that has steadily organized during the last two decades, represents an existential threat to the health of children and is the subject of today's podcast. Our guest is a physician-scientist, pediatrician and advocate we admire greatly — Peter Hotez, MD, PhD. In today's episode we are going to talk about his new book, Vaccines Did Not Cause Rachel's Autism: My Journey as a Vaccine Scientist, Pediatrician and Autism Dad. Dr. Hotez is Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine where he is also the Director of the Texas Children's Center for Vaccine Development (CVD) and Texas Children's Hospital Endowed Chair of Tropical Pediatrics. He is also University Professor at Baylor University, and Fellow in Disease and Poverty at the James A Baker III Institute for Public Policy. Thoughts about this episode or suggestions for a future topic? Write to us, [email protected]

Pediatric patients, ages 13 to 18 years, with severe obesity should have greater access to bariatric surgery, according to a new American Academy of Pediatrics (AAP) policy statement. For pediatricians, that means seeking out high-quality multidisciplinary centers for patients who meet criteria; providing timely referrals; and facilitating care before and after surgery for adolescents with severe obesity, defined as a BMI ≥35 or ≥120% of the 95th percentile for age and sex, whichever is lower. The policy statement, and a supporting technical report, were simultaneously published in Pediatrics. Today's guest is Thomas Inge, MD, discussing the new AAP policy statement on bariatric surgery. Dr. Inge is a Professor of Surgery and Pediatrics at the University of Colorado School of Medicine and Associate Surgeon in Chief, Director of Pediatric Surgery and the Director of the Center for Bariatric Surgery at Children's Hospital Colorado. This episode of Charting Pediatrics Podcast was recorded live from the 2019 American Academy of Pediatrics NCE in New Orleans. Do you have questions about this episode or suggestions for a future topic? Write to us, [email protected]

In this episode we talk with Lewis First, MD and Alex Kemper, MD about studies published in the last year that could change the way you practice pediatrics. Dr. First (@lewis_first) is Professor and Chair of the Department of Pediatrics at the Larner College of Medicine at the University of Vermont and Chief of Pediatrics at the University of Vermont Children's Hospital. He serves as the Editor-in-Chief of Pediatrics, the peer-reviewed medical journal of the American Academy of Pediatrics. Dr. Alex Kemper (@AlexRKemper) is the Division Chief of Primary Care Pediatrics at Nationwide Children's Hospital and Professor of Pediatrics at The Ohio State University College of Medicine. He serves as the Deputy-Editor-in-Chief of Pediatrics. Articles Covered that can be found from Pediatrics: Vaccines Updates - What can pediatricians do to increase vaccination rates in their practice? How to evaluate a febrile infant under 2 months of age Issues in Adolescent and Teen Patients — Suicidality and identifying risk Cannabis Concentrate and Cannabinoids — Impact on children and adolescents, including vaping LGBTQ Patient Care, including bullying issues and impact/outcomes based on state legislation (i.e. Proposition 8 from California) Smoking and Vaping - Combustable cigarettes and e-cigarettes CRAFFT instrument - Adapted screening for teens with substance abuse disorders Firearm Safety and Protection of Children from Firearms - Where pediatric firearm mortality has occurred relative to gun laws in the United States; morbidity and mortality of children in homes with firearms Telehealth - Quality of Care, antibiotic prescribing stewardship, patient satisfaction for Telehealth visits Electronic vs Print Books in Kids — Parents interact more with their children when they use a traditional print book than an ebook. Maintenance of Certification - Importance of improving quality of care This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana. Do you have a question about this episode or a suggestion for a future topic? Write to us, [email protected]

In young children, many of the symptoms of eosinophilic esophagitis resemble those of gastroesophageal reflux disease (GERD)—including feeding disorders and poor weight gain—so the child may be mistakenly diagnosed with GERD. In today's episode we talk to Glenn Furuta, MD about the importance of a proper diagnosis of esophagitis in children, signs/symptoms to look for and effective treatment options. Dr. Furuta is the La Cache Endowed Chair for GI Allergic and Immunologic Diseases, the Director of Gastrointestinal Eosinophilic Diseases Program at Children's Colorado and a Professor of Pediatrics in Gastroenterology at the University of Colorado School of Medicine. Do you have a suggestion for a future episode or feedback about this one? Write to us, [email protected]

Biliary atresia is a rare gastrointestinal disorder, occurring approximately 1 in 10,000 to 15,000 births in the United States, and is characterized by a destruction or absence of, all or a portion of the extrahepatic bile duct. Affected infants present with jaundice and fibrosis. In some cases, additional abnormalities may be present, including cardiac defects and intestinal, spleen and kidney malformations; the exact cause of biliary atresia is unknown. In today's episode we talk with Cara Mack, MD to unpack the clinical presentation, management and ongoing care for patients with biliary atresia. Dr. Mack is a Professor of Pediatrics at the University of Colorado School of Medicine, a practicing Pediatric Hepatologist and the Director of the Pediatric Liver Center at Children's Hospital Colorado. Let us know if you have a suggestion for a future topic or thoughts about this episode!

Sepsis remains one of the leading causes of morbidity and mortality in children despite improved understanding of the pathophysiology leading to better clinical management and survival. Recent studies have identified several areas that must be addressed by the clinician in order to continue to impact the morbidity and mortality associated with sepsis. In today's episode we talk with Halden Scott, MD about the presentation, management and follow-up care of pediatric patients with sepsis. Dr. Scott is an Associate Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine and a Pediatric Emergency Medicine Physician at Children's Hospital Colorado. Resources mentioned in today's episode: The Children's Hospital Association Improving Pediatric Sepsis Outcomes Collaborative Children's Hospital Colorado Pathways: Scroll to Emergency Department/Urgent Care Sepsis for the sepsis pathway The most recent pediatric sepsis guidelines Articles that Dr. Scott referred to in the podcast about the role of lactate in sepsis, and the problems with SIRS criteria for sepsis screening: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2595569 https://www.ncbi.nlm.nih.gov/pubmed/26711848/ https://www.ncbi.nlm.nih.gov/pubmed/25778743/

Join us as we podcast live from the American Academy of Pediatrics National Conference and Exhibition in New Orleans on October 26 & 27, 2019! Stop by Booth #632 in the Exhibit Hall to say hello – our host team of Dr. Alison Brent, Dr. David Brumbaugh and Dr. Dan Nicklas would love to meet you!

Functional abdominal pain disorders are the most common cause of chronic abdominal pain in children and adolescents. On today's episode we are talk with Jaime Belkind-Gerson, MD to unpack the presentation, diagnosis and management of functional abdominal pain from the primary care perspective. Dr. Belkind-Gerson is Director of the Neurogastroenterology and Motility Program at Children's Hospital Colorado. He is al an associate professor of pediatric gastroenterology, hepatology and nutrition at the University of Colorado School of Medicine. Red Flag Symptoms Concerning for an organic cause of GI Pain Weight Loss Persistent Diarrhea Blood in stool Waking from a dead sleep with pain Persistent vomiting Chronic fever Photo described at the beginning of today's episode: Photomicrograph of the lining of the intestine of a young female patient who had a biopsy done during a colonoscopy

Things have changed over the last 20 years, with more hospitals using people with expertise in Hospital medicine, known as "Hospitalists," to care for patients who are admitted for an inpatient stay. In the mid-1990s, as pressures to provide outpatient care to large populations increased for general pediatricians, it became less efficient for them to care for patients in the hospital simultaneously. The field of hospital medicine arose, with physicians who were dedicated to the complexity of inpatient care. Fellowship training followed soon thereafter to prepare doctors further for excellence in the inpatient ward environment. In today's episode, we will talk with Mark Brittan, MD about the history of "Hospitalists," "Hospitalist" training, and where the field is heading in the future. Dr. Brittan is an Associate Professor of Pediatrics in the Pediatric Hospital Medicine section and the Fellowship Director for Pediatric Hospital Medicine at the University of Colorado School of Medicine.

According to the American Academy of Pediatrics, studies show that up to 9% of teenagers meet criteria for depression at any one time, with as many as 1 in 5 teenagers having a history of depression at some point during adolescence. In primary care settings, point prevalence rates are likely higher, with rates up to 28%. Because adolescents face barriers to receive specialty mental health services, only a small percentage of depressed adolescents are treated by mental health professionals. As a result, primary care settings have become the de facto mental health clinics for this population, although most primary care clinicians feel inadequately trained, supported, or reimbursed for the management of depression. In today's episode we sit down with Jenna Glover, PhD and clinical pharmacist Dr. Danielle Stutzman to talk through practical approaches to depression screening, anticipatory guidance and medication management. Dr. Glover is the Director of Clinical Psychology training at Children's Hospital Colorado and Assistant Professor of Child Psychiatry at the University of Colorado School of Medicine. Dr. Stutzman is a Clinical Pharmacist at Children's Hospital Colorado with a special interest in psychiatry medication. Resources mentioned in today's episode: Severity Measure for Depression, child age 11-17 PROMIS Measure

In today's episode we talk with Nicholas Cost, MD about the diagnosis and management of pediatric urologic cancer in children and adolescents, including initial presentations and ongoing and follow-up management for primary care providers. Dr. Cost is a Pediatric Urologist at Children's Hospital Colorado and Associate Professor of Pediatrics of Surgery and Urology at the University of Colorado School of Medicine. Let us know what you think about today's episode or share a suggestion for a future episode by writing to us, [email protected] Send Dr. Brent a Tweet @AlisonBrentMD

Vision problems are common among school-age kids and there are many eye diseases and conditions that can affect a child's vision. According to Prevent Blindness America, one in four school-age children have vision problems that, if left untreated, can affect learning ability, personality and adjustment in school. In today's episode we are going to talk with Dr. Emily McCourt to unpack the most common eye issues in pediatrics and front line screening in the primary care office. Dr. McCourt is an ophthalmologist at Children's Hospital Colorado and is associate professor of pediatric ophthalmology and strabismus at the University of Colorado School of Medicine.

Providers may have seen the reports from around the country of growing associations between vaping and more acute, severe lung injury; this is being called Vaping Associated Pulmonary Injury (VAPI). The CDC is involved and many states are now reporting vaping-associated pulmonary cases. In today's special episode we are discussing VAPI and how to diagnosis, report and treat; our expert guest is Robin Deterding, MD, Chief of Pediatric Pulmonary Medicine at Children's Hospital Colorado and Professor of Pediatrics at the University of Colorado School of Medicine. Children's Colorado is notifying providers that may see these patients. It is very unclear what is happening, but there is a severe, noninfectious respiratory failure spectrum with an ARDS-like picture. If you know of a past or current patient case that fits the below criteria please contact the Pulmonary Team via OneCall, 720-777-3999. Additional Resources: What Parents Need to Know About Teen Vaping Reporting suspected cases to the CDC Report suspected cases to CDPHE's Disease Reporting Line, 303-692-2700 or 303-370-9395 (after hours). This includes potential cases who presented since June 1, 2019. CDPHE personnel will conduct a medical record review and contact the patients to administer a thorough investigation questionnaire. Charting Pediatrics Podcast: Teen E-Cigarette Use and the Vaping Epidemic (S2:E23)

Nearly 60 percent of children report having headaches; by the age of 18, that number increases to 90 percent. Recurrent, severe headaches also are common in this population. In the United States, one study reported that approximately 20 percent of children aged 4 to 18 years report having had notable recurrent headaches (including migraine) in the past 12 months. In today's episode we are talk with Mario Coleman, MD about the diagnosis and management of reoccurring headaches in children and adolescents. Dr. Coleman is a Pediatric Neurologist and an Assistant Professor of Pediatrics and Neurology at the University of Colorado School of Medicine.

Renal tubular acidosis, or RTA, refers to a group of disorders characterized by defective renal acid-base regulation. The capacity for normal urinary acidification is impaired, resulting in net acid retention and hyperchloremic metabolic acidosis. In this episode, Danielle Soranno, MD reviews basic mechanisms of the disease that are important for diagnosis and management of RTA in your patients. Dr. Soranno is an Associate Professor of Pediatrics, Bioengineering, and Medicine at the University of Colorado School of Medicine and a Pediatric Nephrologist at Children's Hospital Colorado. Tell us what you thought about today's episode or make a suggestion for a future episode! Send a tweet to Dr. Brent, @AlisonBrentMD

Hirschsprung disease occurs in approximately one in 5,000 newborns. Despite advances in the diagnosis and management of the disease, patients remain at risk for long-term gastrointestinal morbidity, including obstructive symptoms, fecal incontinence, and enterocolitis, with negative implications on quality of life. In today's episode we are talking with Luis De la Torre, MD, to unpack the diagnosis and management of Hirschsprung disease and discuss new treatments being explored. Dr. De la Torre is a Visiting Associate Professor of Surgery at the University of Colorado School of Medicine and the newest member of our International Center for Colorectal and Urogenital Care team at Children's Hospital Colorado. We'd love to hear from you! Share your thoughts about today's episode or ideas for a future topic by emailing the Charting Pediatrics host team.

Cryptorchidism or undescended testis (UDT) is one of the most common pediatric disorders of the male endocrine glands and the most common genital disorder identified at birth. The main reasons for treatment of cryptorchidism include increased risks of impairment of fertility potential, testicular malignancy, torsion and/or associated inguinal hernia. In today's episode we will talk with Brian Caldwell, MD about the difference in presentation of undescended vs retractile testis, approaches to treatment and long-term prognosis for these patients. Dr. Caldwell is a Pediatric Urologist from the Children's Hospital Colorado, Colorado Springs faculty and is an associate professor of surgery and urology at the University of Colorado School of Medicine. Let us know your suggestion for a future podcast topic. Dr. Caldwell can be reached through OneCall, 720-777-3999.

Welcome to Season 3 of Charting Pediatrics! In today's season kick-off show we discuss the most common bleeding disorders in pediatrics through the lens of the CBC with Tazio Nakano, MD. Dr. Nakano is Medical Director of the Vascular Malformation and Tumor Center at Children's Hospital Colorado and is Assistant Professor of Pediatrics of Hematology/Oncology and Bone Marrow Transplant at the University of Colorado School of Medicine. Thank you to each of you who cast a vote of support for Children's Hospital Colorado in the 14th Annual People's Choice Podcast Award Nominations! Send Dr. Nicklas at tweet and let him know what you think about today's episode. Let us know if you have a suggestion for a future podcast topic.

Charting Pediatrics Podcast has received initial nomination eligibility for the 14th Annual People's Choice Podcast Award in the Science and Medicine category! Now we need your support – visit https://www.podcastawards.com/app/signup to help Charting Pediatrics move to the next stage of listener voting! You will have to create an account to vote – then visit the nomination page and scroll to the Science & Medicine Category and select Charting Pediatrics. You can only nominate once and support nominations close on July 31. Finalists will be announced on August 10. Thank you for your ongoing support!

Our guest for this episode is Jessica Malmberg, PhD, the Clinical Director of Outpatient Services at the Pediatric Mental Health Institute and assistant professor of child psychiatry at CU School of Medicine. Dr. Malmberg talks us through a common behavioral issues of school-aged children – school refusal – and provides insights, advice and tools to help prevent, manage and understand this behavior. In this episode: Outlining and identifying the underlying symptoms and signs associated with a child refusing to attend school How primary care providers (PCPs) can assist parents who are experiencing guilt Identifying the four most common reasons that children refuse to go to school Exploring the effects of social media on children's behavior when it comes to school refusal How a PCP should approach treatment of school refusal The recommended frequency of follow-up care for kids who are refusing to go to school The importance of connecting parents to community-based resources Preventative practices parents can set up in the home to prevent this behavioral issue What an excellent prognosis looks like for children experiencing school refusal When it's time to refer to a mental health professional PCPs in the Denver Metro Area can refer patients to the Children's Hospital Colorado Outpatient Psychiatry Clinic or to a local community mental health center Resources for dealing with school refusal: School Refusal: Information for Educators (.pdf) from the National Association for School Psychologists School Refusal in Children and Adolescents from American Family Physician The Functional Assessment of School Refusal Behavior Effective Child Therapy Division 53 of the Society of Clinical Child & Adolescent Psychology website School Refusal from the American Academy of Child & Adolescent Psychiatry

Welcome back Charting Pediatrics listeners! We are so excited to announce the third season of the podcast which will release on August 6th. With the success of Season 2, going from under 500 to almost 20,000 listeners per month, we are expectant to see what Season 3 will have in store. In this new season, we will explore case studies in the nuanced art of practicing pediatric medicine, covering topics from innovative care approaches to bread-and-butter diagnoses that you deal with on a daily basis. The podcast is also going on the road again, where we will be broadcasting live from the American Academy of Pediatrics National Conference and Exhibition in New Orleans from October 25th through to the 28th of this year. On behalf of the host team, thank you for your faithful support in listening and engaging with us and also sharing the content with your colleagues. Be sure to join us weekly for yet another great season!

In today's episode we dive in to the topic of toxicity and the most common overdoses in pediatric medicine. Our guest is Sam Wang, MD, returning from earlier this season when we covered the topic of Marijuana as Medicine (S2:E14). Dr. Wang is a Pediatric Emergency Medicine Physician and Medical Toxicologist at Children's Hospital Colorado and the University of Colorado School of Medicine. Let us know what you thought of today's episode: Tweet Dr. Brent (@AlisonBrentMD) or write to us, [email protected].

The practice of pediatric pain management has developed significantly in the last decade with the use and validation of pain assessment tools specific to pediatric patients, yielding evidence-based pain management guidelines in children of all ages. Still, pharmacological intervention options coupled with practicing safe prescribing can be overwhelming in the primary care setting. In today's episode we are joined by Tom Majcher, DO, to discuss a practical approach to outpatient pain management in pediatrics and the prevalence of conditions associated with acute and chronic pain. Dr. Majcher is Chair of Anesthesiology at Children's Hospital Colorado and Professor of Anesthesiology at the University of Colorado School of Medicine.

A real public health problem has snuck up on us as pediatricians - vaping and e-cigarettes use. On today's episode, we will unpack the facts about e-cigarettes and vaping, provide you with practical tools to counsel your patients and families and talk about upcoming advocacy and policy work pertaining to e-cigarettes. Our guests today are Jennifer Woods, MD, Medical Director of the Adolescent Medicine Clinic at Children's Hospital Colorado and associate professor of pediatrics at the University of Colorado School of Medicine; and Heather Hoch, MD pediatric pulmonologist at Children's Hospital Colorado and assistant professor the CU School of Medicine. From today's episode: The 2018 NIH Monitoring the Future Survey Results were released last month. The survey found that 37% of 12th graders and 18% of 8th graders have vaped in the last year and the number of kids who used vaping products in the last month jumped from 11 to 21% in 12th graders and from 9 to 16% in 10th graders — those changes are the biggest jumps in adolescent substance use that has been seen in the 4 decades of conducting the Monitoring the Future Survey. From the AAP: 5 Facts to talk to Teens about Vaping The FDA held a public hearing on January 18, 2019 to discuss efforts to eliminate youth e-cigarette use, with a focus on the potential role of drug therapies to support cessation and the issues impacting the development of such therapies. If this is a topic you are passionate about, we encourage our listeners to visit the FDA website to submit a public comment, those public comment submissions will be available through February 1, 2019 https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm) Pediatricians Push for Laws to Prevent Teen Vaping Colorado Bill Introduced to Combat Skyrocketing Youth E-Cigarette Use, Clean Indoor Air Act, House Bill 19-1076 Feedback on this episode or suggestions for a future topic? Write to us at [email protected] - we love hearing from our listeners!

In this episode, we discuss abnormal pediatric head growth, shape and treatment options with Todd Hankinson, MD. Dr. Hankinson is a Pediatric Neurosurgeon at Children's Hospital Colorado and Associate Professor of Neurosurgery at the University of Colorado School of Medicine.

Today's guests are Dr. Lori Prok and Pediatric Nurse Practitioner, Julieann Tibbetts, here to discuss the most common clinical presentations, causes, and treatment of Atopic Eczema. Dr. Prok is a Pediatric Dermatologist at Children's Colorado and Associate Professor of Dermatology at the University of Colorado School of Medicine. Julieann is a Pediatric Nurse Practitioner in the Dermatology Department at Children's Colorado and Senior Instructor of Dermatology at the University of Colorado School of Medicine.

Today's guests are Dr. Jens Goebel and Dr. Robert Fuhlbrigge, here to discuss Henoch-Schönlein purpura (HSP). Dr. Goebel is the Section Head of Nephrology at Children's Colorado and Professor of Pediatrics at the University of Colorado School of Medicine. Dr. Fuhlbrigge is Section Head of Rheumatology at Children's Colorado and Professor of Pediatrics also at the University of Colorado School of Medicine.

In today's episode, we're examining a case that started in a primary care pediatrician's office and ended in the Children's Hospital Colorado Aerodigestive Program. Joining us are the three physicians involved in the patient's care examine: Larissa Applegate, MD, a pediatrician at Pediatrics West in Wheat Ridge, Colorado; RyanCaltagirone, MD, a pediatricemergency room physician at Children's Colorado; and Sven Streubel, MD, an otolaryngologist with Children's Colorado. In this episode: Our three guests examine their roles in the patient's care and share their key takeaways to inform other medical professionals The origins of the case and how the patient, baby Rachel, first presented in the hospital Steps taken once Rachel's respiratory struggles were evident and next steps to get her to the Emergency Department Importance of clear communication between departments and with patient families in complex, multidisciplinary cases Approaching a patient who presents with laryngomalacia from an ENT perspective Using a bedside scope to determine the severity of the laryngomalacia The various elements of Rachel's multidisciplinary care, including: admission procedure, observation of feedings, continued oxygen support and plan for next steps Most common medical treatment plan for patients with laryngomalacia Designing a long-term management plan for a child with laryngomalacia that supports the patient as well as their family Accounting for comorbidities that come along with laryngomalacia Update from patient and key takeaways from the case

Treating STDs in adolescent patients can be a challenge for today's busy pediatrician. Eliza Buyers, MD of the Pediatric and Adolescent Gynecology team at Children's Colorado returns to our pediatric podcast to provide practical tools for preventing and treating sexually transmitted infections in teens. In this episode: Why STD rates are higher in adolescents and young adults How PCPs can address teen reproductive health challenges Why we need to consider age as the primary risk factor for STDs Examining the issue of STD rates as a health disparity Importance of conducting universal screening in sexually active adolescents Expedited partner therapy (EPT) and its importance Recommended STD and HIV screening periods for different populations Screening guidelines for STD examinations in the absence of symptoms. Approaching one-to-one time with teen patients Importance of promoting condom use to prevent STDs in teens When to consider screening for less common STDs Why it's crucial to know confidential screening clinics you can send your patients STD management resources: The CDC STD treatment guidelines mobile app CDC STD treatment guidelines for special populations

In today's episode all three hosts are in the recording studio for a round table discussion about provider self-care and compassion fatigue. The host team shares personal experiences and strategies they utilize for keeping them energized when cases have challenging outcomes. The host team includes is David Brumbaugh, MD, pediatric gastroenterologist and Associate Chief Medical Officer at Children's Colorado; Alison Brent, MD Pediatric Emergency Medicine Physician and Medical Director of Physician Relations and the Network of Care at Children's Colorado; and Dan Nicklas, MD, pediatrician and Medical Director of the Pediatric Call Center at Children's Colorado. Thank you to all of our listeners for a fantastic Season 2 of Charting Pediatrics! Season 3 will launch on August 6. If you have suggestions for a future topic email us.

Approximately 6 to 7 percent of children presenting with respiratory symptoms have acute sinusitis. In today's episode we are going to talk to Steven Hamilton, MD about the causes, diagnosis, treatment and safe antibiotic prescribing practices for the management of sinusitis in pediatric patients. Dr. Hamilton is a pediatric otolaryngologist from our Colorado Springs-based faculty and is an assistant professor of otolaryngology at the University of Colorado School of Medicine. Let us know what you thought about today's episode or suggest a future topic - Send Dr. Nicklas a tweet, @DanielNicklasMD or send us an email. Children's Hospital Colorado, Colorado Springs is set to open in late Spring 2019. Read more about our new hospital! AAP Clinical Practice Guideline for this Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

Feeding is a primary concern for families of pre-term and low birth weight babies following NICU discharge. Many of these infants have gagging, swallowing, vomiting, aspirating concerns or feeding aversions; they don't seem to experience the sensation of hunger, making feeding each meal an arduous task for their caregivers. In today's episode, we talk with returning guests Laura Pickler, MD and Nancy Creskoff Maune, OT about approaches to diagnosis and treatment options for infants with severe feeding and swallowing issues, including helpful diagnostic tests and therapies. Dr. Pickler is the Chair of Family Medicine and Medical Director of the Feeding and Swallowing Program at Children's Colorado. Nancy is an occupational therapist in the program with an extensive background in the evaluation and treatment of infants and children with feeding and swallowing problems. Tell Dr. Brumbaugh what you thought of today's episode, send him a tweet @DBrumbaughMD.