Charting Pediatrics

By Children's Hospital Colorado

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Description

Children's Hospital Colorado faculty examine the latest treatment options for the most common chief complaints in pediatric medicine. We will talk about significant research and advances in pediatric medicine, the nuanced art of practicing pediatrics and everything in between.

Episode Date
Introducing Pediatrics On Call from the AAP with Joanna Parga-Beslinkie, MD and David Hill, MD (S3:E63)
30:55

When most of us were going through medical training the word podcast had still yet to be uttered. A mash-up of broadcast and ipod, the word was first introduced in 2004. But by 2020 the podcast platform has developed into an essential tool for dissemination of information amongst humans. Now we can get information on any conceivable topic and it seems inevitable that this will transform all continuing education, including medical education. We know that in pediatrics we still need trusted resources and in that spirit, today we are excited to introduce you to a new podcast on the block that you need to be aware of, AAP’s new Pediatrics On Call Podcast, we’re going to talk to its co-hosts and  discuss the future of CME and learning for pediatricians.

Today we are pleased to be joined by Joanna Parga-Beslinkie, MD and David Hill, MD, co-hosts of the AAP’s new podcast, Pediatrics On Call.

Joanna is assistant professor of clinical pediatrics at the University of Pennsylvania  and a pediatrician at Children’s Hospital of Philadelphia. She co-created the podcast Baby Doctor Mamas as her first foray into podcasting and has been a contributor and writer for many news outlets including The New York Times, NPR and NBC News.

David is a pediatrician at Goldsboro Pediatrics in Wayne County, North Carolina, where he practices both hospitalist pediatrics and outpatient pediatrics. He is an adjunct assistant professor of pediatrics at the University of North Carolina Chapel Hill. He has written and commentated for NPR’s All Things Considered, is a frequent contributor to Parents Magazine and author of several books.

Aug 04, 2020
CAR-T Cellular Therapy: Advancing Pediatric Cancer Treatment with Terry Fry, MD and Michael Verneris, MD S3:E62
39:37

Cellular therapy is a new type of immunotherapy that is bringing hope to pediatric patients with blood cancers. 

The therapy is more specifically known as chimeric antigen receptor T cell therapy (or CAR-T cell therapy), and it has been hailed as a breakthrough in the field of immunotherapy. CAR-T cell therapy "takes the brakes" off the immune system's response. Essentially, it trains the cells within the immune system, called T cells, to see tumors they weren't naturally developed to recognize.

Two years ago, we had the brilliant team of Terry Fry, MD and Mike Verneris, MD join us to discuss this therapy for patients with leukemia and other cancers; you can go back and listen to that initial discussion on Season 1, episode 33. We continue to hear from listeners how much they enjoyed this discussion of clinical invocation and application and decided that it was time to bring Dr. Fry and Dr. Verneris back to hear an update on their work and what the latest in the space of CAR-T cell therapy is.

Jul 29, 2020
Kawasaki Disease or MIS-C: What We Are Learning About COVID-19 Presentation in Pediatrics with Mimi Glode, MD and Jim Todd, MD (S3:E61)
45:02

As the COVID-19 pandemic enters its 8th month, we continue to learn more about how SARS-CoV2 impacts our pediatric population, including the severe Kawasaki-like disease, Multisystem Inflammatory Syndrome in Children Associated with COVID-19, or MIS-C. In this, our 17th COVID-19 podcast we will cover the clinical presentation of MIS-C, how it differs from Kawasaki’s and what the early literature is saying. We are fortunate to be joined by two giants in the field of Pediatric Infectious Diseases: Jim Todd, MD and Mimi Glode, MD. 

Dr. Glode is the former Section Head of Infectious Diseases at Children’s Colorado and is Professor Emerita of Pediatric Infectious Disease at the University of Colorado School of Medicine. Dr. Glode is an internationally recognized as an expert on Kawasaki disease and immunization pioneered the use of IVIG for the treatment for Kawasaki disease.

Dr. Todd is the former-Jules Amer Chair in Community Pediatrics and Section Head of Epidemiology at Children’s Hospital Colorado and Clinical Professor Emeritus in Pediatrics at the University of Colorado School of Medicine and is known for his discovery of Toxic Shock Syndrome.

What We Know About Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Jul 23, 2020
Overcoming Demographic Disparities in Medicine with Vijaya Vemulakonda, MD, JD (S3:E60)
34:57

Prenatally diagnosed with hydronephrosis, babies of ethnic minorities get surgery sooner than white ones, often within the first year. That's well documented; the trickier question is why. What role does implicit bias play, or at what point during the process does it come into play? What imaging studies do surgeons order, and how do they interpret the findings? How do those interpretations influence the decision whether to do surgery, or when?

On today’s episode, we are going to talk with Vijaya Vemulakonda, MD, JD, about her work studying demographic disparity in medicine and how the electronic health record can help close the gap. Dr. Vemulakonda is a pediatric urologist at Children’s Colorado and Associate Professor of Surgery and Urology at the University of Colorado School of Medicine.

Read more about Dr. Vemulakonda's research

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Jul 16, 2020
COVID-19 School Re-Entry Guidance with Sean O'Leary, MD and Heidi Baskfield, JD (S3:E59)
33:21

In this our 16th COVID-19 podcast, we will delve into the return to school guidance that both Children’s Hospital Colorado and the American Academy of Pediatrics have released and talk about how pediatricians can be advocates for the safe return to in-person learning in their communities.

When schools across the United States halted in-person learning because of COVID-19 this Spring, many of us never predicted that students would remain in a remote learning status for the remainder of the school year. As school districts and teachers worked tirelessly to utilize all resources at their disposal, it became apparent that virtual learning was not an ideal education setting. From the lack of learning equity and access to critical services for many students to mental health impacts, many educators and pediatricians began talking about the importance of in-person learning resuming in some fashion for fall 2020. 

Today we are joined by returning guest Sean O’Leary, MD. Sean is an infectious disease physician at Children’s Colorado and Director of the Colorado Pediatric Practice-Based Research Network.

And we are happy to welcome Heidi Baskfield, JD to the podcast. Heidi is a lawyer by training and the Vice President of Population Health and Advocacy at Children's Hospital Colorado.

COVID-19 Return to School Risk-Based Guide from Children's Hospital Colorado

COVID-19 Planning Considerations: Guidance For School Re-Entry from the AAP

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Jul 01, 2020
What We've Learned About COVID-19 in Pediatrics with Sam Dominguez, MD (S3:E58)
25:45

Months of progress in the United States has been overshadowed this week by a resurgence of COVID-19 cases, with areas of the South and West experiencing their first strong wave of cases. Earlier this week Texas Children’s Hospital announced they are admitting adult patients to help with surge capacity in Houston. As pediatric providers, we are considering ongoing PPE preparedness for an unknown future, what the latest literature is telling us about the virus in kids and what a vaccine or treatment option might look like. In this our 15th COVID-19 podcast, we will delve into these topics and more as we unpack what we’ve learned about COVID-19 in pediatrics with Dr. Sam Dominguez.

Today we are fortunate to be joined once again by my un-official Charting Pediatrics co-host, Sam Dominguez, MD. Sam is a pediatric infectious diseases physician at Children’s Hospital Colorado and Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

COVID-19 Risk/Benefit Gauge from the Colorado Department of Public Health & Environment  

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Jun 26, 2020
Passion into Progress - Providing Positive Impact to Equity in Pediatric Medicine (S3:E57)
23:27

Across our organization, our Children’s Hospital Colorado team members have engaged in dialogue about the institutional origins of systemic racism, the targeted injustices that continue in Black communities, and the ways our social structures produce disparities in education, housing, economics, and health. Today we want to bring this conversation to the podcast and talk about the opportunity our pediatric provider community has in turning the passion of these conversations into progress by providing positive impact to equity in pediatric medicine. In this moment, it is necessary for us all to demonstrate clarity, courage and fortitude to address these long-standing injustices.

Today our guest is Brandi Freeman, MD. Dr. Freeman is a pediatrician at the Children’s Colorado Child Health Clinic and Assistant Professor of Pediatrics at the University of Colorado School of Medicine. She is an advocate for Diversity and Inclusion in the Health Professions workforce.

Jun 18, 2020
Return to Sport During COVID-19 with Aubrey Armento, MD and Julie Wilson, MD (S3:E56)
35:10

As communities begin to emerge from stay-at-home orders, the question of return to sports and recreation is on the minds of many. While professional and collegiate sports may take longer to resume play and allow spectators in the stands, youth sports organizations are hopeful that they may be able to lead the way in restoring a sense of normalcy to everyday life. Given the unprecedented circumstances posed by the COVID-19 pandemic, there is no clear prescription for success, but guidance is emerging to help shape the re-opening of youth sports. In this our 14th COVID-19 podcast, we will discuss those considerations and guidance with Julie Wilson, MD and Aubrey Armento, MD.

Dr. Wilson has joined us on Season 1 and 2 of the podcast to discuss the topic of concussion management – she serves as Club Outreach Medical Director of the Children’s CO Sports Medicine Center and is an Assistant Professor of Orthopedics and Pediatrics at the University of Colorado School of Medicine.

Dr. Armento is a Primary Care Sports Medicine Physician at Children’s Sports Medicine Center and Assistant Professor of Orthopedics at the University of Colorado School of Medicine.

Resources Mentioned in this Episode:

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Jun 11, 2020
Clinical Effectiveness in Pediatric Medicine with Lalit Bajaj, MD (S3:E55)
27:46

Clinical effectiveness seeks to answer the question “What works?” in healthcare; what are the best ways to prevent, diagnose and treat diseases in children? Today we are going to talk with Lalit Bajaj, MD, MPH/MPSH and dive in to clinical effectiveness and look at how those practices are be applied here at Children’s Colorado and beyond and the impact of this work to the primary care setting.

Dr. Bajaj is a Pediatric Emergency Medicine Physician, Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine, and Director of Clinical Effectiveness at Children’s Hospital Colorado.

Pediatric Clinical Pathways

Button Lalit Mentions in the Podcast

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org

This episode was recorded prior to COVID-19.

Jun 09, 2020
Innovation in Pediatric Medicine with John Barnard, MD (S3:E54)
26:07

We are privileged to have John Barnard, MD join us on the podcast today to discuss exciting pediatric research breakthroughs in fields of genomics, gene therapy, and more.

Dr. Barnard is from Nationwide Children’s Hospital where he serves as the chief of Pediatrics, president of The Research Institute and holds the Ann I. Wolfe Endowed Chair in Pediatric Research Leadership. He is also the chair of the Department of Pediatrics and professor of Pediatrics, Gastroenterology, Hepatology and Nutrition at The Ohio State University College of Medicine. 

This episode was recorded prior to the COVID-19 pandemic.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Jun 02, 2020
COVID-19 En Pediatria en Español with Edwin Asturias, MD (S3:E53)
31:30

In this episode we cover the COVID-19 global pandemic, en Español with Edwin Asturias, MD.

Dr. Asturias is part of the Infectious Disease Team and Director for Latin America at Children’s Colorado and Professor of Pediatrics & Infectious Diseases at the University of Colorado School of Medicine. Dr. Asturias is headed for Guatemala on May 24 to become their Presidential Commissioner for the COVID-19 Response.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

May 21, 2020
Healthy Habits Weight Gain for Kids in COVID-19 (S3:E52)
28:11

Register for our Weekly COVID-19 Town Hall, 5/21 from 6-7 p.m. MST

The COVID-19 Pandemic has presented unprecedented challenges to maintaining healthy habits and healthy weight for our patients and families. We know that kids tend to loose structure and gain excess weight in the summer – we saw this prior to COVID-19 and we are now facing the most stressful and unpredictable summer of our lifetime. In this our 12th COVID-19 podcast, we will discuss healthy routines for pediatricians to discuss with patients and parents in their practice to help protect and preserve healthy habits and weight.  

Today we are fortunate to be joined by Matt Haemer, MD and Richard Boles, PhD of our Clinical Nutrition Team at Children’s Hospital Colorado.

Dr. Haemer helps to lead the nutrition team at Children’s Hospital Colorado and is Associate Professor of Pediatrics and Nutrition at the University of Colorado School of Medicine.

Dr. Boles is psychologist with the Clinical Nutrition Team at Children’s and Associate Professor of Pediatrics and Nutrition at the University of Colorado School of Medicine.

Key Points
  • The habits that help kids maintain healthy weight during the COVID19 pandemic are the same habits that help with mental health, good school performance, and healthy peer relationships. By focusing on the healthy routines we’ll talk about today, pediatricians can support parents as they help their children achieve all these goals. Lifestyle Medicine Psychologist Richard Boles PhD offers practical advice that pediatricians can share with families to help maintain healthy habits during this very challenging time.
  • Pediatricians play a critical role in helping parents to promote healthy habits. They can help parents realize when a child’s weight gain is unhealthy, offer brief follow-up counseling to help families set goals for lifestyle change, refer families for extra help when needed, and share  resources like those below. 
  • A primary care provider can make a single referral to Children’s Hospital Colorado’s Lifestyle Medicine Program to address any and all medical problems from excess weight that a child may have, or to help children prevent these medical problems at any age. You can reach any of the Lifestyle Medicine team for consult or referral via OneCall, 720-777-3999.

Fitness:

Children's Hospital Colorado's Lifestyle Medicine Exercise Physiologist, Michael Witten MS has compiled a variety of fitness videos that kids of different ages and fitness levels can do at home, maybe with their parents! Subscribe to the CHCO Wellness Center gym Youtube channel:

https://www.youtube.com/playlist?list=PLpuAXaEwLGbpvi_sqs9ZdhUJchqVGInP2

 

Nutrition and Food Resources 

The Food Bank of the Rockies has an updated list of all the food banks and food distribution sites: https://www.foodbankrockies.org/emergency-assistance/

Our dietitians recommend families try kid-friendly healthy recipes from the CHOP CHOP website: https://www.chopchopfamily.org/recipes/ 

Food preparation videos from the professional society of Registered Dietitians: https://www.eatright.org/food/planning-and-prep/cooking-tips-and-trends/basics-of-meal-prepping

Shopping and meal preparation tips to save money on healthy food from Cooking Matters, an organization dedicated to reducing food insecurity for families with kids: http://cookingmatters.org/tips

Psychology and Mental health:
American Psychological Association: tips on learning at home, supporting play, and parenting in the era of COVID-19:  https://www.apa.org/topics/covid-19/parenting-caregiving

Children’s Hospital Colorado has recommendations to help pediatricians and parents talk with children about the pandemic: https://www.childrenscolorado.org/conditions-and-advice/coronavirus-covid19-resources-updates/ 

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

May 19, 2020
Multisystem Inflammatory Syndrome in Children Associated with COVID-19 (S3:E51)
27:49

Register for our weekly Provider Town Hall During COVID-19, May 21 from 6-7 p.m. MST.

In recent weeks, there has been an outbreak of severe Kawasaki-like disease at the Italian epicenter of the SARS-CoV2 epidemic and as of May 12, the state of New York Health Department had identified 102 kids with potential infection. Up to this point, our pediatric population had seen a relatively mild disease course during this pandemic, but these recent developments have captured the attention of pediatricians, parents and the global news media. Yesterday the CDC officially named this the Multisystem Inflammatory Syndrome in Children, Associated with COVID-19. In this, our 13th COVID-19 podcast we will cover the clinical presentation of MIS-C, how it differs from Kawasaki’s and what the early literature is saying.

Sam Dominguez, MD, PhD, is an Infectious Disease physician at Children's Colorado and Associate Professor of Pediatrics at the University of Colorado School of Medicine.

Todd Carpenter, MD, is Director of the Pediatric Intensive Care Unity at Children's Colorado and Professor of Pediatrics at the University of Colorado School of Medicine.

 

May 16, 2020
Women and Babies in the Era of COVID-19 (S3:E50)
54:06

In this our 11th COVID-19 podcast, we will discuss clinical considerations for women and babies in the era of COVID-19 with Jessica Cataldi, MD and Erica Wymore, MD.  

Join us for this week's Provider Town Hall, Thursday, May 14 from 6-7 p.m. MST: https://attendee.gotowebinar.com/register/5938843139417544973

The global pandemic has impacted every area of life, including the considerations and concerns that new mothers have bringing their babies into the world – will they be able to have a partner’s support in their birthing room? Is it safe to breastfeed their baby if they, the new mother, test positive for SARS-CoV2? Should any family or friends be allowed around the baby? Is it safe to bring the baby in for routine checkups and well-child care in the middle of the pandemic? There are many questions that surround this special and critical time in a new mother and baby’s life. 

Dr. Cataldi is a pediatric infectious disease physician at Children’s Colorado and is Assistant Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Dr. Wymore is a neonatologist at Children’s Colorado and Assistant Professor of Pediatrics and Neonatology at the University of Colorado School of Medicine.

https://perinatalcovid19.org/neoclear/

 

May 13, 2020
COVID-19: Caring for Adult Patients During the Pandemic with Aaron Manning, MD and Steven Humphrey, MD (S3:E49)
40:11

In this, our 10th COVID-19 podcast, we will have a case discussion around functional and high-yield adult medicine topics that might be useful for pediatricians helping to care for adult patients in the middle of this pandemic.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3 of the podcast.

Today we are fortunate to be joined by Dr. Aaron Manning and Dr. Steven Humphrey.

Steven is a pediatric hospitalist at Children’s Hospital Colorado and Instructor of Pediatrics at the University of Colorado School of Medicine.

Aaron is also a pediatric hospitalist at Children’s Colorado and is Assistant Professor of Hospital Medicine at the University of Colorado School of Medicine.

  1. POPCoRN (Pediatric Overflow Planning Contingency Response Network): https://www.popcornetwork.org/. This site is a multi-institutional collaboration that was created during the COVID-19 pandemic as a vehicle for optimizing adult care in pediatric environments. It contains many “one-pagers” which review the management of a variety of common adult conditions, links to adult protocols shared by various institutions, and recommendations regarding care of patients with COVID-19 among others.
  2. Adult medicine guidebooks: Several organizations have made available their adult medicine guidebooks free of charge.
    1. UCSF Department of Medicine Hospitalist Handbook (currently free in the Apple and Google App Stores)
    2. MGH Resource Guide for Commonly-Encountered Inpatient Topics (available via the POPCoRN website)
    3. Society for Hospitalist Medicine: Non-Hospitalist Onboarding. This resource offers a step by step guide to preparing non-hospitalists for the inpatient management of adult care (available via the POPCoRN website)
    4. University of Pennsylvania Hospitalists Primer. A resource meant to prepare non-hospitalists for the care of hospitalized adults (http://pennhspprimer.com/)

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

May 05, 2020
COVID-19 Convalescent Plasma & Antibody Testing with Sam Dominguez, MD and Kyle Annen, DO (S3:E48)
31:57

One of the bright spots during the COVID-19 pandemic has been the promising and experimental use of convalescent plasma, which was recently approved by the FDA for emergency treatment. The donation of antibody-rich blood from patients who have recovered from the SARS-CoV2 virus has been pioneered by Dr. Kyle Annan and the team at Children’s Colorado. I

n this, our 9th COVID-19 podcast we will cover the topic of convalescent plasma, discuss the current epidemiology of the pandemic, and talk through the impacts of loosened shelter-in-place orders around the country.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3 of the podcast.

Today we are fortunate to be joined once again by un-official Charting Pediatrics co-host, Dr. Sam Dominguez. Sam is a pediatric infectious diseases physician at Children’s Hospital Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Additionally, we are joined by Dr. Kyle Annen who is Director of the Blood Donor Center at Children’s Colorado and Assistant Professor of Pathology at the University of Colorado School of Medicine.

Join our weekly COVID-19 Virtual Provider Town Hall - Thursday, April 30, 2020 from 6-7 p.m. MST

Donate convalescent plasma

ABC News Coverage of convalescent plasma for COVID-19

Do you have thoughts about today's episode or suggestions for a future podcast? Write to us, chartingpediatrics@childrenscolorado.org 

Apr 27, 2020
Toxic Shock Syndrome with the Physician Who Discovered it, Jim Todd, MD (S3:E47)
34:58

In this episode we will discuss the diagnosis and management of TSS and are privileged to be joined by Jim Todd, MD who first discovered TSS in 1975. 

Toxic shock syndrome (TSS) is a cluster of symptoms that involves many systems of the body. Certain bacterial infections release toxins into the bloodstream, which then spreads the toxins to body organs and can cause severe damage and illness. 

Dr. Todd is the previous Section Head of Infectious Diseases, Jules Amer Chair, and Community Pediatrics and Director of Epidemiology at Children’s Hospital Colorado. He is also a Professor Emeritus in Pediatrics at the University of Colorado School of Medicine.

Apr 21, 2020
Recovered from SARS-CoV-2: Two Doctors Share Their Experience (S3:E46)
30:12

In this, our 8th COVID-19 podcast, I talk to two of my pediatric colleagues, Sean O’Leary, MD and Robin Larabee, MD who have had COVID-19 and are now recovered. We will discuss their symptoms and disease course in depth in hopes that it provides greater education and context for how different people have experienced COVID-19.

As we move into our second month of the global pandemic most of us know someone who has contracted the SARS-CoV2 virus; this especially probable for you our listeners, as fellow healthcare workers who have many colleagues caring for COVID-positive and exposed patients.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3, Episodes 31, 36 and 38, 41, 42, 43 and 44.

Sean has joined us several times on the podcast to discuss vaccines and vaccines hesitancy, he is a pediatric infectious diseases physician at Children’s Hospital Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine. Sean is also an active spokesperson with the AAP on the topic of vaccines and services as the Director of the Colorado Children’s Outcome Network.

Additionally, we are pleased to have Dr. Robin Larabee join us today as well. Robin is a pediatrician in Denver and partner with Sapphire Pediatrics.

Apr 20, 2020
New FDA-Approved Drug for Cystic Fibrosis Patients with Scott Sagel, MD (S3:E45)
29:50

Today’s guest is Dr. Scott Sagel, here to discuss the care of patients with cystic fibrosis (CF) and the clinical research that has led to the advances in access to these breakthrough therapies. Dr. Scott is a Pediatric Pulmonologist at Children’s Hospital Colorado and a Professor of Pediatrics at the University of Colorado School of Medicine.

Apr 14, 2020
Coronavirus SARS-CoV-2 or COVID-19 All About That PPE (S3:E44)
32:40

In recent weeks, the podcast has received hundreds of questions from listeners around the topic of PPE. So today, this episode is for you. We are going to cover all things PPE while reviewing the current epidemiology of COVID-19.

We are now entering our second month of the global COVID-19 Pandemic. Our world has never experienced anything like this before – some days feel like they have contained an entire month’s worth of change and challenges. One of the difficult realities that many healthcare providers have faced is a shortage of necessary PPE. Additionally, what is the truth about the efficacy and use of homemade cloth face coverings? How should providers approach PPE as we move out of the peak of the pandemic? We will cover these topics and more in this episode.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3, Episodes 31, 36 and 38, 41, 42 and 43.

Today we are fortunate to be joined once again by un-official Charting Pediatrics co-host, Sam Dominguez, MD, PhD. Sam is a pediatric infectious diseases physician at Children’s Hospital Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Additionally, we are excited to have Pat Givens, DHA, EdM, RN, NEA-BC, as a guest today as we dive in to PPE. Pat is the Chief Nursing Executive for Children’s Hospital Colorado and is serving as our PPE Guardian during the COVID-19 Pandemic.

Do you have questions about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Apr 10, 2020
Coronavirus, SARS-CoV-2 or COVID-19 Mental Health During the Pandemic (S3:E43)
24:53

In this episode, we are going to discuss practical ways primary care providers can protect their own mental health needs and also deliver meaningful mental health support to their patients and families during the COVID-19 global pandemic.

Mental health; never has there been a more crucial time for our primary care providers to talk openly about finding creative and innovative ways to support the mental health needs both of their patients and for themselves. The COVID-19 pandemic has impacted every area of life. Nothing feels normal. Maintaining one’s mental health while practicing social distancing, online learning and school, loss of routine and regular social interactions is a challenge! 

On the podcast we have previously covered a number of topics related to the COVID-19 pandemic – you can go back and listen to those discussions on Season 3, Episodes 31, 36 and 38, 41 and 42.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Apr 07, 2020
Coronavirus, SARS-CoV-2 or COVID-19 Implementing Telemedicine (S3:E42)
35:27

In this episode, we are going to talk to the Telehealth team at Children’s Hospital Colorado and share how primary care providers could operationalize the delivery of care through telehealth quickly to help navigate the COVID-19 pandemic and looking to the future post-pandemic.  

For all the reasons that COVID-19 has turned our personal and professional lives upside down, it has positively accelerated the delivery of care through telehealth.

Until a few weeks ago, most of our ambulatory providers administered care through telehealth as a secondary, less preferred option in cases where distance between provider and patient was too far to be together in person. In this episode we are joined by Christina Olson, MD; Fred Thomas, PhD and Alison Brent, MD.

Christina Olson, MD is Telehealth Medical Director at Children’s Colorado and Assistant Professor of Pediatrics at the University of Colorado School of Medicine

Fred Thomas, PhD is Director of Telehealth at Children’s Colorado and Executive Director of ECHO Colorado; He has academic appointments in the Departments of Psychiatry, Pediatrics and Family Medicine in the Colorado School of Medicine.

And finally, we turn the mic on Charting Pediatrics co-host, Alison Brent, MD. Alison is a Pediatric Emergency Medicine Physician at Children’s Colorado and Professor of Pediatrics at the University of Colorado School of Medicine. She is currently serving on the Executive Committee of the AAP Section of Telehealth Care.

Telehealth Resources Mentioned:

Do you have questions about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

 

Mar 31, 2020
Coronavirus, SARS-CoV-2 or COVID-19 Innovative Approaches to Primary Care (S3:E41)
34:55

As the COVID-19 global pandemic has entered its third week, our healthcare providers are realizing the dramatic impact this has had on how we deliver care. Our lives have been touched not only professionally, but certainly personally as well. The uncertainty that this pandemic has driven into our lives is equally matched by the resiliency and ingenuity of our healthcare providers and larger community to come together to face this head on. In this episode, we will cover the current epidemiology of COVID-19, answer listener submitted questions and talk about the creative delivery of primary care that you could consider implementing in your practice as you navigate the pandemic.

On the podcast we have previously covered the clinical presentation of the coronavirus in pediatrics, what providers should do if their clinical suspension is high and approaches to pediatric care during the mitigation phase of this pandemic – you can go back and listen to those discussions on Season 3, Episodes 31, 36 and 38.

Today we are fortunate to be joined again on the podcast by Sam Dominguez, MD, PhD a pediatric infectious diseases physician at Children’s Hospital Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Maya Bunik, MD is the Medical Director of the Child Health Primary Care Pediatrics Clinic at Children's Hospital Colorado and Professor of Pediatrics at the University of Colorado School of Medicine. Dr. Bunik was previously on the podcast to discuss Breastfeeding Management, you can listen to that on Season 1, Episode 10.

Kelly Galloway, RN, is the Director of Patient Care Services for primary care at Children's Hospital Colorado.

COVID-19 Resources for Providers

COVID-19 Resources for Patients and Families

Do you have thoughts about this episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Mar 25, 2020
Changes in the Delivery of Pediatric Critical Care with Todd Carpenter, MD and Cameron Gunville, DO (S3:E40)
27:54

In this episode we talk with Todd Carpenter, MD and Cameron Gunville, DO about drivers behind general growth in pediatric critical care bed occupancy that has outpaced the general inpatient population; the most important critical care interventions in the last 10 years that has benefited children and the important outcome metrics that define success in pediatric critical care.

Dr. Carpenter is the Medical Director of the PICU at Children’s Hospital Colorado and is Professor of Pediatrics and Critical Care at the University of Colorado School of Medicine.

Dr. Gunville is the Associate Medical Director of the PICU at Children’s Hospital Colorado and is Associate Professor of Pediatrics and Critical Care at the University of Colorado School of Medicine.

Do you have thoughts about this episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Mar 25, 2020
Managing Button Battery & Other Foreign Body Ingestions with David Brumbaugh, MD (S3:E39)
29:10

Kids are notorious for exploring small objects and putting them up their nose, in their ear or swallowing them. Some ingestions like button batteries and small, b-b sized magnets are potentially life-threatening for children and adolescents. Catastrophic and fatal injuries can occur when the object becomes lodged in the esophagus, where injury can extend beyond the esophagus to the trachea or aorta.

In this episode, we are going to turn the mic on host, David Brumbaugh, MD, to look at the presentation and treatment of ingested foreign objects and the anticipatory guidance primary care providers can give to their patients and families.

What our listeners may not know about Dr. Brumbaugh is that he has a job beyond co-hosting Charting Pediatrics; he is a pediatric gastroenterologist and Associate Chief Medical Officer at Children’s Hospital Colorado and is Associate Professor of Pediatrics at the University of Colorado School of Medicine.

Ingested Button Battery Clinical Pathway

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Mar 17, 2020
Coronavirus SARS-CoV-2 or COVID-19 Important Updates Mitigation Phase with Sam Dominguez, MD (S3:E38)
25:53
Coronavirus. COVID-19. Since we last recorded the podcast the World Health Organization has named COVID-19 a global pandemic.
 
We have previously covered the clinical presentation of the coronavirus in pediatrics and what providers should do if their clinical suspension is high – you can go back and listen to both of those discussions on Season 3, Episodes 31 and 36.
 
Given the rapidly changing nature of this situation and the virus’ spread throughout our local Colorado communities we wanted to provide you with an update as we move from a containment to a mitigation strategy. In this episode we will cover the current epidemiology of COVID-19, answer listener submitted questions and provide you with resources of where to find ongoing resources.
 

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Mar 14, 2020
Rural and Tertiary Care Bridges with Bird Gilmartin, MD (S3:E37)
24:56

There are many great things about living in rural communities. Across a broad range of healthcare indicators, our children in rural America are doing more poorly urban areas — higher all cause mortality rates, higher disability rates, higher rates of obesity and higher risks for suicide and unintentional injury. More than 50% of rural counties in the United States do not have a pediatrician and the number of patients per physician and healthcare professional shortage areas is twice that of a traditional urban area.

What is it like to practice and take care of kids in a more rural setting? In this episode we will discuss rural and tertiary care bridges with Bird Gilmartin, MD.

Dr. Gilmartin is the Pediatric Medical Director at Uinta Medical Group in Evanston, Wyoming. She is a member of the American Academy of Pediatric's (AAP) Section on Early Career Physicians and was the recipient of the AAP's 2019 Award for Outstanding Service to Maltreated Children.

Do you have thoughts about this episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Mar 10, 2020
Coronavirus, SARS-CoV-2 or COVID-19 Important Updates for Providers with Sam Dominguez, MD (S3:E36)
35:37

Coronavirus. COVID-19. It is safe to say that this virus is on the minds of people across the globe and there is increased anxiety among the general public who are seeking guidance from their healthcare providers. And many healthcare providers are looking to their regional healthcare centers and the local/national health authorities for guidance – this is an emerging, rapidly evolving situation.

In mid-February we recorded our first episode about COVID-19 where we covered the clinical presentation of the coronavirus in pediatrics and what providers should do if their clinical suspicion is high – you can go back and listen to that on Season 3, Episode 31.

Today we are going to examine the current epi of the situation, answer listener submitted questions in follow-up to our previous COVID-19 episode and provide you with resources of where to find ongoing resources.

Today we are going to examine the current epi of the situation, answer listener submitted questions in follow-up to our previous COVID-19 episode and provide you with resources of where to find ongoing resources. We are fortunate to be joined again on the podcast by Dr. Sam Dominguez, a pediatric infectious diseases physician at Children’s Hospital Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Mar 05, 2020
The Importance of Social Networks, Social Norms & Attitudes in Infant Care Practice Decisions with Rachel Moon, MD (S3:E35)
22:04

In this episode we have the privilege of welcoming Rachel Moon, MD back to the podcast to discuss the importance of social networks, social norms and attitudes in infant care practice decisions.

Dr. Moon first joined us on Charting Pediatrics at the 2018 AAP Conference, you can go back and listen to Dr. Brumbaugh’s interview with her on Infant Safe Sleep Practices on Season 2, Episode 13

Dr. Moon is the Harrison Distinguished Teaching Professor of Pediatrics and the Division Head of Pediatrics at the University of Virginia School of Medicine.

Do you have questions about today's episode or suggestion for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

Mar 03, 2020
State-Level Vaccination Advocacy with Zach Zaslow (S3:E34)
25:23

State-level vaccination advocacy is the topic of today's podcast with Zach Zaslow, Director of Government Affairs at Children's Hospital Colorado.

Colorado’s current vaccination rate for the measles, mumps and rubella vaccine among kindergarteners is 87.4%, one of the lowest in the nation. After more than 15 hours of testimony in committee hearing on February 19, Colorado Senate Bill 163, which aims to standardize and challenge vaccine exemption, passed its first hearing 3-2. Today we are bringing you a special edition of Charting Pediatrics to discuss vaccine legislation and advocacy in our local state of Colorado, specifically Senate Bill 163, which sets a Colorado- statewide immunization goal of 95%.

Zach Zaslow, Director of Government Affairs for Children’s Hospital Colorado, directs local, state, and federal policy and advocacy efforts with the goal of improving child health by being a voice for kids when and where public policy decisions are being made.

Join our 11,000+ advocates who speak up clearly and powerfully for kids’ health when public policy decisions are made by signing up today to be a Child Health Champion: https://bit.ly/2uixrab. To learn more about general advocacy efforts at Children’s Hospital Colorado visit www.childrenscolorado.org/advocacy. Finally, email advocacy@childrenscolorado.org with questions or if you’d like to get more involved by joining our and the Colorado AAP's statewide pediatricians' advocacy network, penning letters to the editor, attending advocacy events and more.
 
Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org
Feb 26, 2020
Management of Fecal Incontinence with Andrea Bischoff, MD (S3:E33)
27:27

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, chartingpediatrics@childrenscolorado.org 

Feb 25, 2020
Seizures & Spells: Diagnosis and Management of Events That Worry Us with Shavonne Massey, MD, MSCE and Mered Parnes, MD (S3:E32)
24:38

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, chartingpediatrics@childrenscolorado.org 

Feb 18, 2020
Coronavirus: What you need to know about COVID-19 with Sam Dominguez, MD, PhD (S3:E31)
26:09

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 chartingpediatrics@childrenscolorado.org

Feb 13, 2020
Medical Missions in Pediatric Medicine with Brian Shaw, MD (S3:E30)
25:22

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, chartingpediatrics@childrenscolorado.org 

Feb 11, 2020
Chronic Pelvic Pain with Stephen Scott, MD (S3:E29)
30:54

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, chartingpediatrics@childrenscolorado.org 

 

Feb 04, 2020
E-Cigarette or Vaping product use Associated Lung Injury EVALI Update with Robin Deterding, MD (S3:E28)
26:28

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:

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org

Jan 30, 2020
Pediatric ACL Injury and Repair with Jay Albright, MD (S3:E27)
30:17

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, chartingpediatrics@childrenscolorado.org 

Jan 28, 2020
Medication Management for Pediatric Hypertension Patients with Steve Daniels, MD (S3:E26)
29:22

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 Green.

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.

Dr. Green 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 chartingpediatrics@childrenscolorado.org 

Jan 21, 2020
The History of Vaccines and Religion with Josh Williams, MD (S3:E25)
27:08

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, chartingpediatrics@childrenscolorado.org 

Jan 14, 2020
Social Media: Friend or Foe? With Jenny Radesky, MD and Michael Rich, MD (S3:E24)
34:49

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, chartingpediatrics@childrenscolorado.org 

 

Jan 07, 2020
Happy Holidays
01:14

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!

Dec 31, 2019
Happy Holidays
01:14

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!

Dec 24, 2019
Addressing Poverty in Pediatric Care with Benard Dreyer, MD (S3:E23)
25:48

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, chartingpediatrics@childrenscolorado.org

Dec 17, 2019
Strategies to Help Sleepless Teens with Adiaha Spinks-Franklin, MD (S3:E22)
29:07

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, chartingpediatrics@childrenscolorado.org 

 

Dec 10, 2019
Adolescent Substance Abuse (S3:E21)
27:38

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, chartingpediatrics@childrenscolorado.org 

Dec 03, 2019
Newborns Exposed to Substances with Stephen Patrick, MD (S3:E20)
20:36

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, chartingpediatrics@childrenscolorado.org 

Nov 26, 2019
Housing and Child Health with Megan Sandel, MD (S3:E19)
23:27

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:

Do you have thoughts about this episode or suggestions for a future topic? Write to us, chartingpediatrics@childrenscolorado.org 

 

Nov 19, 2019
Child Abuse Management in Pediatrics (S3:E18)
15:57

Today’s guest is Dr. Andy Sirotnak, here to discuss child abuse and how it can best be dealt with in the hospital environment. 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.

Nov 14, 2019
Peter Hotez, MD, PhD: Physician-Scientist, Pediatrician, Advocate (S3:E17)
30:50

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, chartingpediatrics@childrenscolorado.org 

Nov 12, 2019
AAP Policy Statement on Bariatric Surgery (S3:E16)
17:47

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, chartingpediatrics@childrenscolorado.org 

Nov 07, 2019
In Case You Missed It: Published Studies that Could Change the Way You Practice With Lewis First, MD and Alex Kemper, MD (S3:E15)
43:19

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, chartingpediatrics@childrenscolorado.org 

 

Nov 05, 2019
Eosinophilic Esophagitis, EoE (S3:E14)
24:05

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, chartingpediatrics@childrenscolorado.org 

Oct 29, 2019
Biliary Atresia (S3:E13)
20:40

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!

 

Oct 22, 2019
Sepsis (S3:E12)
33:13

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:

 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2595569

https://www.ncbi.nlm.nih.gov/pubmed/26711848/

https://www.ncbi.nlm.nih.gov/pubmed/25778743/

Oct 15, 2019
2019 AAP National Conference & Exhibition Live Recordings
01:59

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!

Oct 10, 2019
Functional Abdominal Pain (S3:E11)
23:20

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

Oct 08, 2019
Hospitalist Medicine in Pediatric Care (S3:E10)
18:31

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.

Oct 01, 2019
Depression Management and Medication in Pediatrics (S3:E9)
31:09

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:

 

Sep 24, 2019
Urologic Cancer in Children and Adolescents (S3:E8)
33:55

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, chartingpediatrics@childrenscolorado.org 

Send Dr. Brent a Tweet @AlisonBrentMD 

Sep 17, 2019
Most Common Eye Issues in Pediatrics (S3:E7)
32:37

Today’s guest is Dr. Nicholas Cost, here to discuss the diagnosis and management of pediatric urologic cancer in children and adolescents. 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.

Sep 10, 2019
Vaping Associated Pulmonary Injury (S3:E6)
20:23

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)

Sep 05, 2019
Recurrent Headache in Pediatrics (S3:E5)
22:11

Today’s guest is Dr. Mario Coleman, here to discuss the diagnoses and management of recurring 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. 

Sep 03, 2019
Renal Tubular Acidosis, RTA (S3:E4)
32:15

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 

Aug 27, 2019
Diagnosis and Management of Hirschsprung Disease (S3:E3)
26:16

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.

Aug 20, 2019
Undescended and Retractile Testis (S3:E2)
22:08

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. 

Aug 13, 2019
Through the Lens of the CBC: Bleeding Disorders in Pediatrics (S3:E1)
36:57

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.

Aug 06, 2019
14th Annual People’s Choice Podcast Award Nominations
01:27

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!

Jul 30, 2019
School Anxiety and School Refusal in Kids (S1:E25 Rebroadcast)
29:32

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:

 

Jul 30, 2019
Season 3: Teaser
01:22

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!

Jul 27, 2019
Toxicity and the Most Common Pediatric Overdoses (S2:E29 Rebroadcast)
33:26

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, chartingpediatrics@childrenscolorado.org 

Jul 23, 2019
Pain Management in Kids (S2:E24 Rebroadcast)
22:16

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.

Jul 16, 2019
E-Cigarettes and Vaping (S2:E23 Rebroadcast)
26:56

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:

Feedback on this episode or suggestions for a future topic? Write to us at chartingpediatrics@childrenscolorado.org - we love hearing from our listeners!

Jul 09, 2019
Abnormal Head Growth and Shapes in Pediatrics (S2:E18 Rebroadcast)
33:36

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.

 

Jul 02, 2019
Atopic Eczema (S2:E17 Rebroadcast)
27:56

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.

Jun 25, 2019
Henoch–Schönlein Purpura, HSP: Diagnosis and Management (S2:E12 Rebroadcast)
23:43

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.

Jun 18, 2019
Case Study: Laryngomalacia (S2:E11 Rebroadcast)
31:43

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
Jun 11, 2019
STDs in Teens: Testing and Treatment (S2:E7 Rebroadcast)
25:19

Treating STDs in adolescent patients can be a challenge for today’s busy pediatrician. Eliza Buyers, MDof the Pediatric and Adolescent Gynecologyteam 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:

Jun 04, 2019
Compassion Fatigue: Strategies for Provider Self Care – Season 2 Finale (S2:E39)
26:40

Today’s episode is a round table with all three hosts, here to discuss provider self-care and compassion fatigue.

May 28, 2019
Management of Sinusitis in Pediatrics (S2:E38)
22:02

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

 

May 21, 2019
Severe Feeding and Swallowing Issues in Infants (S2:E37)
41:53

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. 

May 14, 2019
Hypertension in Pediatrics (S2:E36)
21:52

Pediatric hypertension occurs in 2-5% of all pediatric patients and is one of the top five chronic diseases in children and adolescents. According to the National Heart, Lung and Blood Institute, the diagnosis is missed in up to 75% of pediatric patients in primary care settings and appropriate medication initiation occurs much less frequently than is indicated, according to current guidelines. In today’s episode we talk with Steve Daniels, MD about the pediatric hypertension clinical practice guideline he helped to co-author, how you can incorporate blood pressure screening at well child visits, replacing the term “prehypertension” with “elevated blood pressure” and treatment recommendations for your patients.

Dr. Daniels is a pediatric cardiologist, Pediatrician-in-Chief and the L. Joseph Butterfield Chair of Pediatrics at Children's Hospital Colorado, Professor of Pediatrics at the University of Colorado School of Medicine, Professor of Epidemiology at University of Colorado School of Public Health. Dr. Daniels is a sought-out expert in the field of pediatric hypertension and pediatric nutrition.

May 07, 2019
Acute Flaccid Myelitis (AFM) in Pediatrics (S2:E35)
26:21

Acute flaccid myelitis (AFM) is a rare but serious condition; one that strikes fear into the hearts of parents and providers alike. AFM affects the nervous system, specifically the gray matter of the spinal cord, which results in the presenting symptoms of a flaccid paralysis.

This condition is not new. Acute flaccid myelitis appears to be caused most often by viruses, especially EV-D68, which is a member of the polio family. Although poliomyelitis has been mostly eradicated worldwide, in recent years large outbreaks of the related enterovirus 71 has been seen in Asia-Pacific countries. This virus, that some have coined “the new polio” mostly affects children, manifesting as hand, foot, and mouth disease, aseptic meningitis, poliomyelitis-like acute flaccid paralysis, brainstem encephalitis, and other severe systemic disorders.

In today’s episode we are joined by Kevin Messacar, MD to talk through the most common presentations and treatment of enterovirus infections. Dr. Messacar is both an Infectious Disease Specialist and Hospitalist at Children’s Hospital Colorado and is an Assistant Professor of Pediatrics at the University of Colorado School of Medicine. Dr. Messacar's interview in this episode is expressly his own and not on a behalf of the professional organizations he serves. 

CDC AFM Guidelines and Resources for Providers

What did you think of today's episode? Tweet Dr. Brent, @AlisonBrentMD or write to us chartingpediatrics@childrenscolorado.org.

Apr 30, 2019
Pediatrician Turned Legislator: An Interview with Rep. Dr. Yadira Caraveo (S2:E34)
27:43

Today we are fortunate to be joined by a home-grown Denver pediatrician, child health advocate and legislator for the Colorado House of Representatives, Rep. Dr. Yadira Caraveo.

Dr. Caraveo was born and raised in Denver and attended medical school at the University of Colorado. She completed her residency in pediatrics in Albuquerque, New Mexico at the University of New Mexico and is currently a pediatrician at Peak Pediatrics in Denver. She has been interested in political and child advocacy since medical school and was elected to the Colorado House of Representatives to represent House District 31 in the November 2018 mid-term election.

What did you think of today's episode? Send Dr. Brumbaugh a tweet @DBrumbaughMD or write to us at chartingpediatrics@childrenscolorado.org 

Apr 23, 2019
High Altitude Health: Impact of Altitude on Pediatric Patients (S2:E33)
40:18

As we head into a busy travel season increasing numbers of our patients and families are venturing to high altitude to partake in activities such as sight-seeing, hiking and climbing.

Children who travel to high altitude are at risk for developing some form of acute altitude illness and will seek advice from their primary care physician before traveling.

In today’s episode we talk to Christine Ebert-Santos, MD to unpack what we know and what we don’t about children residing at or visiting high altitude and how you can provide anticipatory guidance to your patients and families. 

Dr. Ebert-Santos is a pediatrician at the Ebert Family Clinic in Summit County, Colorado. Summit County is comprised of mountainous elevations ranging from 7,957 feet (2,425 m) at Green Mountain Reservoir to 14,270 feet (4,350 m) at Grays Peak. The elevation of the county seat of Breckenridge is 9,602 feet (2,927 m), making it one the highest cities in the state of Colorado and the United States.

High Altitude Health

Apr 16, 2019
Art and Science of Managing AOM (S2:E32)
24:07

Acute otitis media (AOM) is one of the most common reasons that patients present to our office. Not surprisingly, ear infections are also the most common reason why children receive a prescription for a course of antibiotics.

In today’s episode, we are going to talk to Peggy Kelley, MD about the classic symptoms and treatment for acute otitis media, safe antibiotic prescribing practices, and how to approach treatment failure and ear tubes. Dr. Kelley is a pediatric otolaryngologist at Children’s Hospital Colorado and Associate Professor of Otolaryngology at the University of Colorado School of Medicine.

Send Dr. Nicklas a tweet and let him know what you thought about today's episode, @DanielNicklasMD

 

Apr 09, 2019
Alleviating Seasonal Allergies (S1:E1 Rebroadcast)
22:19

In this episode, Daniel Searing, MD, Professor of pediatrics and allergies at Children's Colorado, talks about seasonal allergies and pollen. He discusses the effects of pollen, how to treat and alleviate allergies, and more.

In this episode, Dr. Searing discusses:

  • Pollen and how it affects allergies
  • Why cottonwood trees are a big pollinator, especially in the springtime
  • Why rain and humidity shut down pollen levels
  • Why Colorado's climate makes people more susceptible to allergies
  • How allergy symptoms will vary from year to year
  • The importance of monitoring the quantitative level of pollen in the environment
  • How physicians should manage the initial approach to a child with allergy symptoms
  • Key features to look out for
  • Why treating pollen allergies with persistent treatment is more effective
  • What role the prescription drug Montelukast plays in treating allergic rhinitis
  • What you can do to help prevent pollen from spreading
  • Which medicines and therapies can help alleviate allergies
  • When to see a doctor for seasonal allergies
  • The approach of an immunotherapy treatment plan and the two phases of a typical treatment schedule
Apr 02, 2019
Cognitive Error in Diagnosis (S2:E31)
27:34

As providers, the safety of our patients is paramount. In recent years, increased attention has been given to diagnostic error in medicine, specifically those that arise through error in cognitive perception, failed heuristics and biases. In today’s episode, we are talking with Joe Grubenhoff, MD about error in diagnosis and strategies for reducing cognitive bias. Dr. Grubenhoff is the Associate Medical Director of Clinical Effectiveness and is a pediatric emergency medicine physician at Children’s Colorado. He is also an Associate Professor of Pediatrics at the University of Colorado School of Medicine.

Resources mentioned in today's episode:

What did you think of today's episode? Send Dr. Brumbaugh a tweet @DBrumbaughMD.

Mar 26, 2019
Measles (S2:E30)
27:25

Measles is a highly contagious respiratory disease that spreads easily through the air or on infected surfaces; According to the American Academy of Pediatrics, of every 1,000 people who get measles, 1 to 2 will die.  And the numbers are even higher in developing countries where the case fatality rate is 4-10%.  As providers who care for kids, we urge our parents, schools and communities to protect each other by vaccinating for measles.

In today’s episode Edwin Asturias, MD joins us to talk through the classic symptoms, treatment and vaccination recommendations for measles. 

Dr. Asturias is the Director for Latin American Infectious Disease at Children’s Hospital Colorado. He is also an Associate Professor or Pediatric Infectious Disease at the University of Colorado School of Medicine.

Let Dr. Nicklas know what you thought of today's episode - send him a tweet @DanielNicklasMD

 

Mar 19, 2019
Toxicity and the Most Common Pediatric Overdoses (S2:E29)
33:26

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, chartingpediatrics@childrenscolorado.org 

Mar 12, 2019
Overcoming HPV Vaccination Hesitancy (S2:E28)
24:46

HPV vaccine rates remain low with only about 16 percent of U.S. adolescents being fully vaccinated by the time they turn 13 according to the CDC. With about 34,000 cases of HPV-induced cancers annually, we as providers have an opportunity to encourage more parents to vaccinate their children.

In this episode we talk with guests Brian Gablehouse, MD and Sean O’Leary, MD about HPV vaccination hesitancy, recent updates to the HPV vaccination schedule and how to utilize motivational interviewing techniques when talking with parents.

Dr. Gablehouse is a pediatrician at Peak Pediatrics located in Wheat Ridge and Thornton, Colorado. Dr. O’Leary is Director of the Colorado Pediatric Practice-Based Research Network and works on the Infectious Disease team at Children’s Hospital Colorado; he is Associate Professor at the University of Colorado School of Medicine.

Let us know what you think of today's episode! Drop us an email.

Check out S2:E12 for further discussion about the topic of Vaccinations & Motivational Interviewing Techniques. 

Mar 05, 2019
Food Allergy Immunotherapy (S2:E27)
59:50

Historically, there has not been a Food and Drug Administration – approved medical therapy to treat food allergies. This is about to change with emerging research in immune desensitization and clinical trials with food immunotherapy products that will likely soon hit the market. In today’s episode, we will talk about these clinical trials, what two products are likely to be FDA-approved by the end of 2019 and what that means for your food-allergic patients.

Today’s guests are David Fleischer, MD and Matthew Greenhawt, MD. Dr. Fleischer is Director of the Allergy and Immunology Center at Children’s Hospital Colorado and Associate Professor in Pediatrics and Allergy at the University of Colorado School of Medicine. Dr. Greenhawt is Director of the Food Challenge and Research Unit at Children’s Hospital Colorado Associate Professor of Pediatrics and Allergy at the University of Colorado School of Medicine.

Related Research:

We love hearing from our listeners - email the Charting Pediatrics team to suggest a future topic or tell what you thought of this one.

Feb 26, 2019
Congenital Heart Disease: Ongoing Management (S2:E26)
18:39

As a continuation of our discussion of congenital heart disease from Season 2, Episode 21, we are going to look at the primary care provider’s ongoing role caring for these patients; signs and symptoms of undiagnosed patients and how to support adolescent patients transitioning to adult care.

Today’s guest is Joe Kay, MD. Dr. Kay is Program Director of the joint Adult Congenital Heart Disease Program at the University of Colorado Hospital and Children’s Hospital Colorado, and Associate Professor of both Pediatrics and Medicine at University of Colorado School of Medicine.

We love hearing from our listeners! Reach out and tell us what you would like to hear in a future episode.

 

Feb 19, 2019
Repeat Concussion and Sports Retirement Case Study (S2:E25)
26:56

How many concussions are too many for a young athlete? When should sport retirement be considered?

In today's episode we are going to look at the case of a high school athlete as the basis for exploring these questions with Julie Wilson, MD. Dr. Wilson is Co-Director of the Concussion Program at Children's Hospital Colorado and Assistant Professor at the University of Colorado School of Medicine.

Tell us what you thought about today's episode.

Charting Pediatrics is now on Spotify!

Feb 12, 2019
Pain Management in Kids (S2:E24)
22:16

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.

Feb 05, 2019
E-Cigarettes and Vaping (S2:E23)
26:56

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:

Feedback on this episode or suggestions for a future topic? Write to us at chartingpediatrics@childrenscolorado.org - we love hearing from our listeners!

Jan 29, 2019
Integrative Approach to Pediatric Medicine (S2:E22)
27:11

Integrative health care describes the blending of complementary and conventional therapies by practitioners to include all appropriate therapies in a patient-centered and evidence-based fashion.

Today we will offer up some practical tips about how you can incorporate an integrative approach to your care of kids and adolescents with Rachel Workman, MD. Dr. Workman runs the Integrative Medicine Clinic at Children’s Hospital Colorado and is Assistant Professor of Pediatrics at the University of Colorado School of Medicine.

Resources mentioned in this episode:

Jan 22, 2019
Critical Congenital Heart Disease (CCHD) (S2:E21)
20:42

In this episode we discuss how to respond to abnormal results of the newborn Critical Congenital Heart Disease (CCHD) screening with Chris Rausch, MD. Dr. Rausch is the Director of the Cardiopulmonary Exercise Laboratory at Children’s Hospital Colorado and Associate Professor of Pediatric Cardiology at the University of Colorado School of Medicine.

 In this Episode:

  • Why Critical Congenital Heart Disease (CCHD) requires attention from pediatric provider
  • Reasons why CCHD can be missed in prenatal screenings
  • CCHD screening protocols and toolkits for nurseries
  • The recommended screening window for newborns
  • How to ensure that newborns get the appropriate evaluations
  • Understanding the effect of elevation on CCHD screening results
  • The false-positive rate of CCHD screenings
  • Improvement in outcome rates for newborns with CCHD
  • Occurrences when screenings will be performed by the primary care physician
Jan 15, 2019
Pediatric Trigger Thumb (S2:E20)
18:57

Today we discuss pediatric trigger thumb (also know as Trigger Finger, Flexor Tenosynovitis, or Stenosing Tenosynovitis) with Sarah Sibbel, MD. Dr. Sibbel is the Director of the Pediatric Hand and Upper Extremity Program and Surgical Director of the Brachial Plexus Center at Children’s Hospital Colorado and Assistant Professor of Orthopedics at the University of Colorado School of Medicine.

 In this episode: 

  • Defining pediatric trigger thumb and the path of physiology
  • Hypothesis of why trigger thumb occurs in children and adults
  • Diagnosing trigger thumb in primary care
  • Helpful imaging to obtain
  • Operative and non-operative treatment plans and their associated risks
  • The success rate of surgery as a treatment
  • Time optimal period between observation and surgery for trigger thumb
  • How trigger thumb impacts a child’s day-to-day life
  • Role for non-steroidal anti-inflammatory agents in trigger thumb treatment
  • Follow-up plans for the outpatient setting
Jan 08, 2019
Happy Holidays
01:35

Happy holidays to you, our Charting Pediatrics listeners. Whether the snow is falling where you are, or your palm trees are wrapped in lights, we hope you will be enjoying these next couple of weeks with family and friends. In this season of celebration and reflection, we wanted to say thank you to you, our Charting Pediatrics listeners. Each week we get the opportunity to interview our pediatric colleagues to bring you meaningful educational content, and we have the best time doing this. Indeed, when we do each of these podcasts, it’s the very best part of our day. It’s truly humbling to know that there are more than 10,000 of you tuning in each month as part of our amazing Charting Pediatrics community. Like you, we will be taking the next couple of weeks off for friends and family. But don’t worry! The show will return on January 8th with new and exciting content that you won’t want to miss. Thank you for sharing a piece of your week with us. So until next time, keep on keeping kids safe out there and Happy Holidays!

Dec 20, 2018
Ovarian Cysts and Torsion Risk (S2:E19)
29:08

On this episode we discuss the diagnosis and management of ovarian cysts and torsion risk with Patricia Huguelet, MD. Dr. Huguelet is the Section Chief of Pediatric and Adolescent Gynecology at Children’s Hospital Colorado and Associate Professor of Obstetrics and Gynecology at the University of Colorado School of Medicine.

In this episode:

  • Most common presentations/symptoms of ovarian cysts reported to a primary care provider.
  • Why many ovarian cysts can be asymptomatic.
  • Differentiating between other abdominal pain versus ovarian cyst pain.
  • Determining whether ovarian cysts are benign or malignant.
  • The differences in symptoms and pain in benign versus malignant cysts.
  • Three mechanisms of ovarian pain: ischemia from torsion, acute rupture and hemorrhage, rapid capsular stretch.
  • The optimal modality for ovarian cyst imaging diagnosis.
  • Symptoms and pain that would lead more towards ovarian torsion diagnosis.
  • When ovarian torsion might occur without the presence of a cyst or mass.
  • Why it is always better to preserve the ovary after torsion; resilience of function.
  • The fertility outlook for women who have had ovarian torsion.
  • Best treatment course for a hemorrhagic cyst; preserving fertility.
  • Laboratory tests to consider when diagnosing ovarian cysts/torsion.
  • Outpatient followup care for patients after treatment/diagnosis for ovarian cysts or torsion.
  • Likelihood of recurrence of ovarian cysts and risk for torsion.
  • The role of non-steroidal use in ovarian cyst pain control.
Dec 18, 2018
Abnormal Head Growth and Shapes in Pediatrics (S2:E18)
33:36

In this episode we discuss abornormal 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.

 

Dec 11, 2018
Atopic Eczema (S2:E17)
27:56

On today's episode we discuss the most common clinical presentations, causes and treatments of atopic eczema with Lori Prok, MD and Julieann Tibbetts, PNP.

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.

 

Dec 04, 2018
Care for Young Mothers in Your Pediatric Practice (S2:E16)
20:24

Today we discuss the art and science of caring for young mothers in the pediatric practice. Hana Smith, MD and Amy Ehmer, PsyD, join us to discuss the Young Mothers Clinic and the Colorado Adolescent Maternity Program and opportunities to adopt aspects of this care model into the primary care practice. Dr. Smith is the Medical Director of the Young Mother’s Clinic at Children's Colorado and assistant professor at the University of Colorado School of Medicine. Dr. Ehmer is a psychologist at the Young Mothers Clinic and Colorado Adolescent Maternity Program, and a Senior Instructor at the University of Colorado School of Medicine.

 

In today's episode: 

Nov 27, 2018
Addiction Prevention in Primary Care - Live! From the 2018 AAP Annual Meeting (S2:E15)
24:52

This episode was recorded live from the 2018 American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando, Fla. with Leslie Walker-Harding, MD discussing addiction prevention in primary care.

Dr. Walker-Harding is the chair of the Department of Pediatrics and the pediatrician-in-chief at Penn State Health Milton S. Hershey Medical Center and the Medical Director of Penn State Children’s Hospital.

Nov 20, 2018
Marijuana as Medicine - Live! From the 2018 AAP Annual Meeting (S2:E14)
39:12

This episode was recorded live from the 2018 American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando, Fla. with Elissa Miller, MD and Sam Wang, MD discussing the timely and controversial cultural topic of marijuana as medicine. Dr. Miller is the Chief of the Division of Palliative Medicine at Nemours/Alfred I. duPont Hospital for Children and Clinical Associate Professor of Pediatrics at Thomas Jefferson University in Philadelphia, Pa. Dr. Wang is a Pediatric Emergency Physician and Medical Toxicologist at Children’s Hospital Colorado and Assistant Professor at the University of Colorado School of Medicine in Denver.

Nov 13, 2018
Safe Infant Sleep - Live! From the 2018 AAP Annual Meeting (S2:E13)
21:47

This episode was recorded live from the 2018 American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando, Fla. with Rachel Moon, MD discussing safe infant sleep. Dr. Moon is the Division Head of General Pediatrics and professor of pediatrics at the University of Virginia School of Medicine, and Chair of the AAP SIDS Task Force.

Nov 06, 2018
American Academy of Pediatrics Live Recording
01:38

Welcome back Charting Pediatrics listeners! Today we are excited to announce that with Season 2 of Charting Pediatrics, we are taking our show on the road. We are going to be live podcasting from Orlando next month at the American Academy of Pediatrics National Conference and Exhibition, which of course is the big general pediatrics conference of the year!

Dr. David Brumbaugh and Dr. Alison Brent are thrilled to have the opportunity to sit down and record with some wonderful pediatric experts from around the US and discuss the timely topics they are covering in their specific conference presentations. Our guests will include Dr. Elissa Miller from Nemours/Alfred I. duPont Hospital for Children, and Dr. Sam Wang from our own Children’s Hospital Colorado. In addition, we have Dr. Leslie Walker-Harding from Penn State Children’s Hospital, as well as Dr. Rachel Moon from the University of Virginia School of Medicine.

We’d love the opportunity to meet you, our listeners. So please stop by the exhibit hall where we will be live podcasting from Booth 1113. Stop in, say hello, and catch some of the live recordings that will be taking place on Saturday, November 3rd with this fantastic panel of guests. Until next time, keep on keeping kids safe out there!

Oct 30, 2018
Henoch–Schönlein Purpura, HSP: Diagnosis and Management (S2:E12)
23:43

Today we are discussing the diagnosis and treatment of Henoch–Schönlein purpura, HSP with Jens Goebel, MD and Robert Fuhlbrigge, MD. 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.

 Key Points From This Episode:

  • Effects of systemic corticosteroids on HSP symptoms and potential complications.
  • The incidence of HSP in the community and what ages are most likely to be affected.
  • Classification criteria for the onset of HSP in patients.
  • Understanding the events and drive of HSP at a molecular level.
  • Tests that are helpful to understand risk of progression or to confirm diagnosis of HSP.
  • How often HSP patients who are at risk for nephritis should be screened.
  • Treatment decisions for patients with more severe HSP and complications.
  • The percentage of recurrent flares of HSP symptoms in patients.
  • Unusual presentation of HSP symptoms in pediatric patients.
Oct 23, 2018
Case Study: Laryngomalacia (S2:E11)
31:43

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
Oct 16, 2018
American Academy of Pediatrics Live Recording
01:38

Welcome back Charting Pediatrics listeners! Today we are excited to announce that with Season 2 of Charting Pediatrics, we are taking our show on the road. We are going to be live podcasting from Orlando next month at the American Academy of Pediatrics National Conference and Exhibition, which of course is the big general pediatrics conference of the year!

Dr. David Brumbaugh and Dr. Alison Brent are thrilled to have the opportunity to sit down and record with some wonderful pediatric experts from around the US and discuss the timely topics they are covering in their specific conference presentations. Our guests will include Dr. Elissa Miller from Nemours/Alfred I. duPont Hospital for Children, and Dr. Sam Wang from our own Children’s Hospital Colorado. In addition, we have Dr. Leslie Walker-Harding from Penn State Children’s Hospital, as well as Dr. Rachel Moon from the University of Virginia School of Medicine.

We’d love the opportunity to meet you, our listeners. So please stop by the exhibit hall where we will be live podcasting from Booth 1113. Stop in, say hello, and catch some of the live recordings that will be taking place on Saturday, November 3rd with this fantastic panel of guests. Until next time, keep on keeping kids safe out there!

Oct 12, 2018
Child Sexual Abuse (S2:E10)
44:46

Navigating the waters of child sexual abuse is difficult. This patient population necessitates a delicate approach. Andy Sirotnak, MD, Director of the Child ProtectionTeam and nurse practitionerDenise Abdoo, PhDdiscuss adolescent and child sexual abuse, its indicators and how to approach and care for these patients.

 In this episode:

  • How providers can normalize conversations around sexual abuse with patients and families
  • When concerns about child sexual abuse most commonly arise
  • Most common indicators and signs of sexual abuse in children
  • Why it is critical to teach children not to take photos of their bodies or keep secrets and good touch versus bad touch
  • What a pediatrician should do when a parent calls with concerns of possible child sexual abuse
  • Key components of a sexual abuse exam and the focus on external genitalia
  • The bathing suit concept for talking to children about private parts
  • Importance of building the family story and why having the parents’ history is crucial for treating patients of childhood sexual abuse
  • The role of mental health issues in the spectrum of child sexual abuse
  • Recommended follow-up care and resources to help families through child sexual abuse

 Resources for sexual abuse:

Oct 09, 2018
Scoliosis Diagnosis and Management (S2:E9)
23:50

Scoliosis management will vary according to each patient’s unique situation and presentation. Mark Erickson, MD, Rose Brown Chair of Pediatric Orthopedic Surgeryand Medical Director of the Children’s Colorado Spine Center, joins us to discuss the diagnosis and treatment of scoliosis.

In this episode: 

  • The three primary types of scoliosis and their common presentations, symptoms, causes and treatments:
  • The key components of a physical examination for scoliosis
  • Recommended imaging to order for aiding a scoliosis diagnosis
  • Red flags that may indicate more serious problems and non-idiopathic scoliosis
  • Scoliosis surgeryand treatment and its evolution
  • Risk factors for disease progression
  • The long-term prognosis for a child with scoliosis
Oct 02, 2018
Telephone Triage in Pediatric Primary Care (S2:E8)
22:00

Bart Schmitt, MD, pioneer and father of telephone triage pediatric protocols, discusses the role of telephone triage in the pediatrician’s office. Dr. Schmittis the Medical Director of General Pediatric Consultations at Children’s Colorado.

 In this episode:

  • Introduction to telephone triage and pediatric telephone protocols for nurses
  • The benefits and importance of having protocols for a call center and medical practice caring for pediatric patients
  • Why pediatricians offer telephone care and telehealth more often than other specialists
  • Why electronic protocols are better than a book
  • The importance of second-level physician triage for after-hours calls
  • How pediatric telephone triage protocols and resources like the symptom checker support patient-centered care

 

Telephone triage resources:

Sep 25, 2018
STDs in Teens: Testing and Treatment (S2:E7)
25:19

Treating STDs in adolescent patients can be a challenge for today’s busy pediatrician. Eliza Buyers, MDof the Pediatric and Adolescent Gynecologyteam 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:

Sep 18, 2018
Infant Feeding and Swallowing Problems (S2:E6)
32:59

Feeding an infant brings about joys and challenges for every family. In this episode, we discuss the identification and treatment of feeding and swallowing problems in infants with Laura Pickler, MD and Nancy Creskoff Maune.

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.

 In this episode:

  • Recognizing the signs of pediatric feeding and swallowing problems
  • The most common presentations of feeding difficulties that primary care pediatricians encounter
  • Differentiating between feeding problems versus swallowing problems
  • The visual and auditory signs of swallowing problems
  • Referral criteria for a videofluoroscopic swallowing study (VFSS)
  • Different approaches to feeding and swallowing issues for breast-fed versus bottle-fed babies
  • Approaching feeding and swallowing problems in a breast-fed baby whose mom is returning to work
  • Questions to ask and what to look for to avoid missing the big problems
  • The importance of observing a feeding to evaluate meal-time behavior, stressors and physical findings
  • A primary care physician’s toolbox of questions surrounding feedings
  • Recommended resources on feeding and swallowing for pediatricians
Sep 11, 2018
Transgender Medicine and Caring for Gender Diverse Patients (S2:E5)
26:59

Caring for transgender, gender diverse and gender non-conforming patients is complicated, and it’s made even more complex by the dynamic nature of gender itself. In this episode, Natalie Nokoff, MD,from the Children’s Colorado TRUE Center for Gender Diversity, joins us to discusshealthcare for transgender and gender diverse patients.

In this episode:

  • Common gender terminology physicians may encounter when talking with gender diverse patients
  • How to communicate with pediatric patients about their gender identity
  • Proactive strategies pediatricians can use surrounding early gender issues
  • Understanding the relationship between puberty and gender or body distress (gender dysphoria)
  • When to refer young patients experiencing gender dysphoria
  • Why it’s important to ask all teens questions about gender identity
  • Understanding the family dynamic and needs before referring gender diverse patients to a specialist
  • Ensuring a safe environment at school and in the community before gender transition
  • Hormone therapy and puberty blocking protocol and WPATH criteria for starting hormone therapy
  • Most common methods and forms of hormone therapy and the side effects pediatric primary care providers should be aware of
  • The unique mental health, social and emotional support needs of this patient population

 

Resources for transgender healthcare:

 

Sep 04, 2018
Caring for Children with Down Syndrome (S2:E4)
38:35

Caring for children with Down syndrome can be complicated. Francis Hickey, MD, Medical Director of the Sie Center for Down Syndrome, joins us to discuss primary care for kids and adolescents with Down syndrome (trisomy 21 syndrome).

In this episode:

  • Recommendations for making an initial Down syndrome diagnosis
  • The importance of congratulating parents on the birth of their child
  • Helpful tips for siblings of children with Down syndrome
  • What pediatricians should expect for growth and developmental milestones
  • The importance of early visual stimulation for children with Down syndrome
  • Why it’s more important to focus on progress rather than on hitting specific goals
  • Common Down syndrome-related GI, ENT, pulmonary and orthopedic problems to watch for
  • The three most important screenings for Down syndrome patients: thyroid, vision and hearing
  • Endocrine challenges and the autoimmune cluster
  • How to recognize the onset of autism in children with Down syndrome
  • Significant concerns to watch out for when adolescents with Down syndrome move into puberty
  • Practical references available for primary care providers
  • Special accommodations and educational advocacy for children with Down syndrome in the public school system

 

Browse our Down syndrome resourcesto share with patient families.

Aug 28, 2018
A Primary Care Perspective on HLHS (S2:E3)
21:43

HLHS care poses a unique challenge for pediatric primary care providers. Pediatric cardiothoracic surgeon James (Jim) Jaggers, MD joins us today to discuss the primary care, treatment and future for patients with hypoplastic left heart syndrome (HLHS).

Dr. Jaggers is Co-Director of the Heart Institute and the Barton-Elliman Chair in Pediatric Cardiothoracic Surgery at Children's Colorado.

In this episode:

  • Dr. Jaggers' approach to surgical intervention for HLHS
  • How pediatricians and family doctors can support their patients and families confronting an HLHS diagnosis
  • Ongoing and follow-up care for HLHS patients in the pediatricians' office
  • The long-term prognosis for HLHS patients
  • How the nation's leading pediatric hospitals are collaborating to provide solutions for patients with HLHS in a groundbreaking consortium
  • Future innovation and care for HLHS patients

 

Aug 21, 2018
Maintenance of Certification and Quality Improvement for the Pediatric Primary Care Office (S2:E2)
22:23

Dan Hyman, MD, and Heather Howman join us today to discuss the four parts of the American Board of Pediatrics' Maintenance of Certification (MOC) program. Dr. Hyman is the Patient Safety Officer at Children's Colorado and Heather Howman is the MOC Program Manager at CU Medicine.

Listen in as they share their expertise on the MOC and quality improvement projects for the pediatric primary care office.

In this episode:

  • What is MOC?
  • Four parts of the Maintenance of Certification (MOC) for board-certified pediatricians and pediatric subspecialists
  • Achieving the credits that you need to maintain your certification
  • Choosing a quality improvement project for your office
  • Turning quality improvement into a team effort
  • The length of time to complete quality improvement projects
  • Barriers in a private office setting for these kinds of projects
  • Leveraging your EMR in your practice
  • Resources and tools to use in part four of ABP's MOC program
  • Consensus building strategies to use within your pediatric practice

The American Board of Pediatrics 

Aug 14, 2018
Discussing Firearm Safety in the PCP Office (S2:E1)
29:40

Welcome to season two of Charting Pediatrics. In this episode we address the timely and serious topic of firearm safety with Eric Sigel, MD. Dr. Sigel is the Fellowship Director of Adolescent Medicine at Children's Colorado and professor of pediatrics at CU Medicine.

In this episode:

  • The AAP gun safety guidelines
  • Principles that implicate firearms in suicide deaths
  • The risks of having firearms in the home
  • What age to start addressing firearm safety with your patients and families
  • Approaches for addressing gun safety with parents and patients
  • Informing people of the importance of safe storage for firearms
  • Ways to become involved in the advocacy efforts around gun safety

American Academy of Pediatrics Gun Violence Policy Recommendations

American Academy of Pediatrics Gun Violence Prevention

AAP News & Journals: Firearm Related Injuries Affecting the Pediatric Population

Aug 07, 2018
School Anxiety and School Refusal in Kids (S1:E25 Rebroadcast)
28:44

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:

 

Jul 31, 2018
Top 10 Pediatric Rheumatology Diagnoses (S1:E19 Rebroadcast)
33:30

Today Robert Fuhlbrigge, MD joins us to discuss the 10 most common pediatric rheumatology diagnoses. Dr. Fuhlbrigge is the Chair of Rheumatology at Children's Colorado and professor of pediatrics and rheumatology at the University of Colorado School of Medicine.

In this episode:

  • What swollen joints can indicate when assessing potential diagnoses in the realm of rheumatology
  • The most common identifier in determining a systemic problem
  • The role of morning stiffness in the differential diagnosis
  • The difference between mechanical pain and inflammatory disorders
  • Defining how helpful an elevated ANA is in treating a patient with Lupus
  • Outlining the best tests for inflammation: CSR, CSR and ANA
  • Why rheumatologists find unexpected fevers in children interesting
  • Unexplained weakness and what it means
  • Which rashes may indicate that it's necessary to refer to rheumatology
  • The role fatigue plays in the rheumatology world
  • Usefulness of radiology studies, MRI, CT and other imaging modalities
  • Helpful apps clinicians use for rheumatological diseases today
  • The role of genetics and development in rheumatological diseases
Jul 24, 2018
Neonatal Jaundice and Bilirubin Levels in Newborns (S1:E21 Rebroadcast)
24:01

Today on the podcast, Dave Scudamore, MD joins us to talk about neonatal jaundice. Dr. Scudamore is the Director of Inpatient Medicine for the Network of Care at Children's Colorado, and he is also an assistant professor of pediatrics in hospital medicine at the University of Colorado School of Medicine.

In this episode:

  • The major risk factors for severe jaundice that can cause complications with neonates
  • How to assess mom and baby for the risk factors of neonatal jaundice by reviewing patient history and birth data
  • Difference between the risk factors for elevated bilirubin and the risk factors for neurotoxicity
  • The significance of the ratio between albumin and bilirubin
  • Standard protocols for bilirubin workups and monitoring for risk factors
  • How you can provide elevated patient care by using a patient-centered care approach and considering the context of the case
  • The way to utilize the Bhutani curve to assess risk and the AAP guidelines to initiate phototherapy
  • Understanding the importance of follow ups and their role in intervention
Jul 17, 2018
Food Allergies Diagnosis and Hot Topics (S1:E16 Rebroadcast)
28:39

With us today is Matthew Greenhawt, MD, associate professor of pediatrics and allergy at the University of Colorado School of Medicine. Dr. Greenhawt discusses hot topics surrounding food-related allergies, including the early introduction of peanuts.

In this episode:

  • What initial steps to take before referring patients to an allergist
  • The importance of getting a complete patient history to diagnose food allergies
  • Tools primary care providers can utilize in the diagnostic process
  • Why the presence of IGE may not be an effective marker for a food allergy
  • Understanding the cross-reactivity between different allergies
  • How to implement a food allergy action plan
  • Methods and recommendations for early introduction of the peanut
  • Where providers can find resources for on-going food allergy education
  • Recommendations on prescribing epinephrine

Links from today's episode

 

Jul 10, 2018
Constipation Treatment and Management (S1:E4 Rebroadcast)
23:49

The host of this podcast is Dr. David Brumbaugh, pediatric gastroenterologist and Associate Chief Medical Officer at Children's Colorado. In this episode, Joel Friedlander, MD, pediatric gastroenterologist at Children's Colorado, addresses the management of constipation and the effects of leaving it untreated, especially in young children.

In this episode, Dr. Friedlander discusses:

  • Addressing constipation and uncomfortable stools early
  • Potential long-term complications associated with constipation
  • Two key components to focus on in the physical examination
  • Miralax, a common used laxative for the treatment of constipation
  • The use of lactulose for young children
  • Categorizing medications for constipation
  • Different medications with different adverse effects
  • Steps to behavioral modification
  • Constipation split between organic and functional
  • Why medication to treat constipation won't work without a change in behavior
Jul 03, 2018
Heart Arrhythmia in Pediatric Primary Care (S1:E5 Rebroadcast)
23:12

In this episode, Johannes von Alvensleben, MD, pediatric cardiologist and electrophysiologist at Children's Hospital Colorado and assistant professor of pediatrics at the University of Colorado School of Medicine, talks about heart arrhythmias. He discusses some of the most common heart arrhythmias in the primary care setting, including identifiable characteristics and treatments.

In this episode:

  • Palpitations and syncope (commonly known as fainting) as symptoms for heart arrhythmia
  • Characteristics of common heart arrhythmias
  • Supraventricular tachycardia (SVT) in an infant versus a young child
  • Differences in children with syncope
  • Inherited heart arrhythmia syndromes
  • Importance of obtaining an electrocardiogram (ECG)
  • Co-morbidities in children that can impact diagnosis with arrhythmias
  • Drug-related arrhythmias in older children
  • Treatment options for heart arrhythmias in young children
  • The success rate of ablation for arrhythmia
Jun 26, 2018
ADHD Medication Management (S1:E15 Rebroadcast)
25:46

In this episode we discuss attention-deficit/hyperactive disorder (ADHD) medication management with Marissa Schiel, MD. Dr. Schiel is the Medical Director of the Outpatient Psychiatry Program at Children's Colorado and an assistant professor of child psychiatry at the University of Colorado School of Medicine. Also joining us is Danielle Stutzman, R.Ph., a clinical pharmacist at Children's Colorado with a special interest in psychiatry medication.

In this episode:

  • The importance of getting a detailed history when assessing a child for ADHD
  • Understanding the spectrum of ADHD symptoms and how they affect a child's function
  • How to approach the medication management conversation when it comes to ADHD
  • The most common side effects that are associated with stimulants or psychotropic medication
  • Management strategies for dealing with potential medication side effects
  • The importance of screening a child for cardiac concerns before prescribing stimulant medications
  • Understanding the functional benefits of the two different classes of stimulants
  • The ideal target doses for specific ADHD medications
  • A recommended follow-up regime and titration strategy for patients
  • How to counsel families on medication management as the child ages
  • Medication recommendations to consider when trialing the non-stimulant class
  • Techniques to use in therapeutic relationships with ADHD patients

 

Jun 19, 2018
Vaccinations and Motivational Interviewing (S1:E12 Rebroadcast)
21:10

In this episode, Sean O'Leary, MD discusses vaccine safety and hesitancy from parents. He also suggests motivational interviewing techniques to use when talking with your patients and families. Dr. O'Leary is a pediatric infectious disease specialist at Children's Colorado and associate professor pediatrics and infectious diseases at the University of Colorado School of Medicine.

In this episode:

  • How to help families identify the good information from misinformation regarding vaccines
  • The prevalence of vaccine resistance
  • Effectively and efficiently delivering vaccines information to parents
  • Using motivational interviewing techniques when talking with parents about vaccines
  • How to pivot the conversation when a parent is resistant to a care plan
  • Why asking permission is a key component to motivational interviewing
  • Understanding the differences between a recommended and alternate vaccine schedule
  • Techniques for communicating relative risks about vaccines
  • Working with parents who are vaccine resistant
  • Vaccines that receive the most resistance and hesitancy
Jun 12, 2018
Teen Reproductive Health (S1:E6 Rebroadcast)
27:17

In this episode, Eliza Buyers, MD, talks about reproductive health in teenagers. Dr. Buyers is a pediatric and adolescent gynecologist at Children's Colorado and a senior instructor of obstetrics and gynecology at the University of Colorado School of Medicine.

In this episode:

  • How to talk to teens and their parents about reproductive health
  • Implementing a universal screening approach in your practice
  • Dealing with push back from parents
  • Setting up one-on-one time with adolescent patients
  • Misconceptions about teens and their reproductive health
  • Long-acting reversible contraceptive (LARC) methods
  • Non-contraceptive benefits of LARC
  • Importance of hormonal therapy
  • Reversing long-term hormonal care and contraception
  • Talking to teens about screening for sexually transmitted diseases
  • When to send a patient to a specialist
Jun 05, 2018
That's a Wrap Season 1 (S1:E34)
10:32

This episode is the season one wrap up show; thank you to all of our listeners! In light of this celebratory occasion, we’re going to take a little departure from our regular clinical episodes to reflect on season one and preview what listeners can look forward to in season 2 starting August 7, 2018.

Suggestions or feedback? Write to us at chartingpediatrics@childrenscolorado.org 

May 29, 2018
CAR-T Cellular Therapy for Leukemia (S1:E33)
27:40

Joining us today are Terry Fry, MD and Mike Verneris, MD to explore cellular therapy for the treatment of pediatric cancers.

Dr. Fry is the Robert and Kathleen Clark Endowed Chair in Pediatric Cancer Therapeutics and Dr. Verneris is the Barton Family Endowed Chair of Bone Marrow Transplant at Children's Colorado.

In this episode:

  • A new immunotherapy known as cellular therapy, or specifically the chimeric antigen receptor T cell therapy (CAR-T cell), is bringing hope to pediatric patients with blood cancers.
  • Two breakthrough events in the field of immunotherapy made CART-T cell therapy possible:
    • Checkpoint inhibitors: a concept where agents can "take the brakes" off the immune, unleashing a sort of preexisting immune response against the tumor
    • Adult epithelia cancers
  • For cancers like pediatric tumors, mutations aren't present or aren't present at high enough levels for checkpoint inhibitors to work.
  • CAR-T cell therapy is different from checkpoint inhibitors in that the immune system, the T cells, are taken and essentially educated in a different way. The T cells are redirected so they can see the tumors that they weren’t naturally developed to see.
  • The FDA labor indication is refractory leukemia at the time of diagnosis, relapse or second relapse.
  • There is a 70 to 90% complete remission induction rate in phase one CAR-T therapy clinical trials in patients who had estimated durations of survival of only weeks to months.
  • The CAR-T cell approach may be considered an alternative to chemotherapy.
  • Side effects of CAR-T cell therapy include:
    • Patients become neutropenic, have low counts and are at risk for bacterial infection (because chemotherapy is given before cells are infused)
    • Cytokine release syndrome
    • Transient neurotoxicity, ranging from subtle neurologic changes to severe side effects like seizures or even coma
  • Because of leukemic resistance, half of patients that go into remission will relapse by year, in spite of a successful CAR-T cell treatment upfront.
  • The pros and cons of a bone marrow transplant (BMT) versus CAR-T cell therapy are:
    • BMT patients get mild oblation, likely face sterility, late complications, secondary malignancies and more. With CAR-T cells, patients get a single infusion and risk about a month of significant toxicity, but side effects are mitigated after that. The only long-term side effect is potentially a lack of b-cells.
May 22, 2018
Nocturnal Enuresis and Bedwetting (S1:E32)
20:02

In this episode, we discuss the management of and treatments for nocturnal enuresis, nighttime bedwetting. Joining us is pediatric urology nurse practitioner, Marguerite Korber, NP, who runs many of the enuresis clinics at Children's Colorado.

In this episode:

  • At age 5, the primary care physician should make a formal diagnosis of nighttime wetting and give the family a proactive, therapeutic treatment plan.
  • It's recommended that families come to a urology specialist or enuresis clinic around age 7
  • The reasons for bedwetting may differ according to whether patient has primary or secondary nocturnal enuresis.
  • Before making a referral to urology, primary care physicians can perform an initial workup, evaluating:
    • If the child is ready to become potty-trained and, therefore, dry at night
    • Functional bladder capacity to see if nocturnal enuresis has anything to do with diabetes or UTI concerns
    • If their bladder is releasing earlier than it should and/or doesn't have the appropriate, expected capacity
  • Despite the parents' frustration, until the child is affected by their nighttime bedwetting, initiating them to be responsible for some of their behavioral modifications during the day will be difficult.
  • The important aspects to focus on in a physical exam are the abdominal exam, lumbar spine evaluation, neurologic evaluation and urethral opening evaluation.
  • Constipation plays a large role in nocturnal enuresis.
    • The abdominal exam will tell you whether or not constipation is a contributing factor, specifically in that descending colon. "If you can palpate stool, then you know that it's probably sitting in the rectum as well."
  • The urethral opening tends to be more of an issue for boys specifically.
  • Bedwetting enuresis management options include behavioral therapy, fluid shifting and addressing constipation.
  • How to effectively implement the use of alarm therapy as a bedtime wetting management option – and what parents need to know up front.
  • What criteria allows for using Desmopressin, a DDAVP, as the right option when pursuing pharmacologic therapy
  • Options for managing chronic nocturnal enuresis:
    • By changing any dysfunctional voiding components to their day time habits, patients will be better prepared for the natural progression of the night time to occur.
  • Providers need to provide alternative treatments for patients when cost is a barrier to care, such as with a bed alarm.
    • Pull-ups can be a cost effective solution to involuntary nighttime bed wetting.
  • Oftentimes with nocturnal enuresis, it's necessary to treat the whole family, helping parents to manage their frustration.
May 17, 2018
Neck Mass Diagnosis and Management for Pediatricians (S1:E31)
16:45

On today's episode, we're discussing the diagnosis and management of neck masses in children. Joining us is Melissa Scholes, MD, Director of the Pediatric Balance and Vestibular Disorders Clinic at Children's Colorado.

In this episode:

  • Common presentations of neck masses in children
  • The questions pediatricians should be asking when they encounter a neck mass
  • The various locations and types of neck masses that can be found
  • How to evaluate and address the consistency of a neck mass
  • What information in the child's history is particularly important to look at
  • The increase in head and neck malignancies in children today
  • Possible lab tests and imaging for neck masses in children
  • When pediatricians should send children to an ENT clinic
  • Antibiotics and treatments to consider for infectious neck masses
  • Infectious lymph nodes and the possibilities of them going viral
May 08, 2018
Common Sleep Disorders in Children and Teens (S1:E30)
22:05

Joining us is Ricky Mohon, MD to discuss the most common sleep disorders and sleep issues affecting pediatric and adolescent patients.

Dr. Mohon is Medical Director of Sleep Medicine and Program Director of Pediatric Pulmonology here at Children's Colorado, as well as a professor of pediatrics at CU Medicine.

In this episode:

  • The prevalence of sleep disorders in children and how these issues have evolved
  • Answering "How much sleep should my child be getting?"
  • How to counsel family members on their teenager's sleep needs
  • The disruptive impact electronic devices have on children's sleep patterns
  • The most common sleep disorders Dr. Mohon sees in infants, children and adolescents
  • Whose responsibility is it to change the diaper in the middle of the night?
  • Behavioral changes that parents can make to limit continuous night calls
  • The full extinction technique: How and why parents should let baby learn to self-soothe
  • Managing sleep-related breathing disorders and snoring in children
  • The process of conducting pediatric sleep studies and what sleep specialists monitor
  • The effects of sleep apnea and insomnia on a child’s health and school life
May 01, 2018
Asthma Management (S1:E3 Rebroadcast)
21:11

In this podcast, Bill Anderson, MD, co-director of the multidisciplinary Asthma Program at Children's Colorado and assistant professor of pediatrics at the University of Colorado School of Medicine, talks about asthma. He discusses challenges in the management of asthma, the effect of asthma on pediatric patients and treatment options now available.

In this episode, Dr. Anderson discusses:

  • Common challenges for managing asthma in pediatric patients
  • Factors that come into play when choosing controller medications
  • Why steroids are better suited for atopic patients
  • Teaching patients and families how to use a spacer
  • How co-morbidities affect children with asthma
  • The impact that psychosocial factors have on asthma
  • Working with social workers to help families overcome hurdles
  • Latest treatment options for treating pediatric asthma
  • Overcoming the adherence barrier using technology
  • Natural medications available to pediatric asthma patients
  • Advice for people with dog allergies
Apr 10, 2018
Alleviating Seasonal Allergies (S1:E1 Rebroadcast)
22:53

In this episode, Daniel Searing, MD, Professor of pediatrics and allergies at Children's Colorado, talks about seasonal allergies and pollen. He discusses the effects of pollen, how to treat and alleviate allergies, and more.

In this episode, Dr. Searing discusses:

  • Pollen and how it affects allergies
  • Why cottonwood trees are a big pollinator, especially in the springtime
  • Why rain and humidity shut down pollen levels
  • Why Colorado's climate makes people more susceptible to allergies
  • How allergy symptoms will vary from year to year
  • The importance of monitoring the quantitative level of pollen in the environment
  • How physicians should manage the initial approach to a child with allergy symptoms
  • Key features to look out for
  • Why treating pollen allergies with persistent treatment is more effective
  • What role the prescription drug Montelukast plays in treating allergic rhinitis
  • What you can do to help prevent pollen from spreading
  • Which medicines and therapies can help alleviate allergies
  • When to see a doctor for seasonal allergies
  • The approach of an immunotherapy treatment plan and the two phases of a typical treatment schedule
Apr 03, 2018
Celiac Disease Diagnosis and Management with Dr. Edwin Liu (S1:E29)
20:07

Today, we're discussing celiac disease with guest Edwin Liu, MD. Dr. Liu is an international leader in the research and management of celiac disease, the Director of the Colorado Center for Celiac Disease at Children's Colorado and a professor of pediatrics at the CU School of Medicine.

In this episode:

  • How the prevalence of celiac disease has changed over time and what that means
  • The hygiene hypothesis and its role in infectious diseases
  • The ways that the clinical representations of children with celiac disease have changed
  • Untraditional symptoms and signs of celiac disease in children
  • The relationship between type 1 diabetes and celiac disease
  • An outline and definition of the non-genetic, environmental triggers of celiac disease
  • The tests to order if you suspect a child may have celiac disease
  • The populations that should be screened for celiac disease because of their risk factors
  • What distinguishes celiac disease from gluten sensitivity
  • The importance of and how to go about educating families on diet after their child is diagnosed with celiac disease
  • The answer of whether or not there's a chance that children can grow out of having celiac disease
  • Exploring the misconception of celiac disease as an "under dog" condition
Mar 27, 2018
Hip Pain in Children Diagnosis and Management (S1:E28)
23:09

In this episode, Stephanie Mayer, MD, joins us to share her insights on diagnosing hip pain in pediatric patients. We're discussing this issue from its symptoms and causes to how to manage hip pain.

Dr. Mayer is a pediatric orthopedic surgeon at Children's Colorado and an assistant professor of orthopedics at the CU School of Medicine.

In this episode:

  • The common hip pain causes to watch for in adolescents
  • Sports that lend themselves to hip pain
  • Practices for starting an evaluation of the patient and their injury
  • The importance of the patient history when dealing with and considering hip pain
  • The questions to ask, signs to look for and specifics to consider when diagnosing hip pain and differentiating between infection and oncologic hip injuries
  • Signs and factors possibly indicating a patient's hip pain is systemic or rheumatological and when it's time to look for Lyme disease
  • How to determine where hip pain originates from and the conditions to consider
  • The mechanical indicator that the cause of hip pain is slipped capital femoral epiphysis (SCFE)
  • Diagnosing and addressing other causes of hip pain such as Legg-Calvé-Perthes
  • Discussing urgency and when it's time to refer to an orthopedic specialist
  • When and why it's appropriate to order an MRI early on
  • The central role imaging plays in determining a proper hip pain treatment and when it's the right time to order an x-ray for hip pain
  • The benefits of getting images of the entire hip versus radiation exposure
Mar 20, 2018
Autism Spectrum Disorder: Diagnosis and Symptoms in Children (S1:E27)
22:01

In today's episode we discuss autism spectrum disorder with Elizabeth Coan, PsyD. Dr. Coan is a doctor of psychology at the Neuroscience Institute at Children's Colorado and is an instructor of developmental pediatrics at the CU School of Medicine.

In this episode:

  • How a PCP can take the first steps towards diagnosing autism
  • How you can implement autism screening tools in your practice
  • How to sensitively discuss autism spectrum disorder with parents and families
  • Tips for managing screenings and referrals after diagnosing autism
  • The reason why there are things to celebrate once you've made an autism diagnosis
  • Tips PCPs can share with families to help develop the strengths of a child with autism
  • Counseling families on how they use the internet when researching autism

Autism Speaks

ABA Therapy 

M-CHAT Screening Tool

Mar 13, 2018
Physician Burnout (S1:E26)
23:12

In this episode, we explore the stigmatized topic of physician burnout with Jenny Reese, MD, Director of the Resilience Program at CU Anschutz and Inpatient Medicine at Children's Colorado and Sonja O'Leary, MD, Medical Director of Denver Health's School-Based Health Centers Team.

Drs. Reese and O'Leary share their personal experiences with burnout and offer valuable insights on what physician burnout is, its effects and how hospitals can reduce burnout by implementing preventative measures.

In this episode:

  • Defining burnout and the golden measurement of burnout
  • The three main domains of burnout
  • The prevalence of burnout according to the numbers
  • The trends surrounding burnout over time
  • The effects and realities behind compassion fatigue and the second victim phenomenon amongst physicians
  • Outlining if and how burnout differs according to a physician's gender and parental role
  • Why it's important to implement reflective supervision in the workplace
  • Actions to prevent, normalize and reduce the stigma of burnout in medicine
Feb 27, 2018
School Anxiety and School Refusal in Kids (S1:E25)
28:13

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:

 

Feb 20, 2018
Teen Suicide: Risk Factors, Screening and Prevention (S1:E24)
20:10

Today we're discussing the serious topic of teen suicide with Jenna Glover, PhD, MS, BS, of the Pediatric Mental Health Institute at Children's Colorado. Dr. Glover is the Director of Clinical Psychology Training at Children's Colorado and an assistant professor of child psychiatry at the University of Colorado School of Medicine.

Mental health and suicide prevention resources from the episode:

Feb 13, 2018
Bronchiolitis (S1:E23)
26:55

In this episode we're discussing bronchiolitis with Monica Federico, MD, Medical Director of both the Asthma Program and Clinical Alignment at Children's Colorado. Dr. Federico is also an associate professor of pediatrics and pulmonary medicine at the University of Colorado School of Medicine.

In this episode:

  • How to diagnose the classic presentations of bronchiolitis
  • How providers can identify the significant signs of respiratory distress
  • How to utilize the Bronchiolitis Clinical Pathway (.pdf) from Children's Colorado
  • When to use bronchodilators and steroids for treatment
  • Identifying children who are most likely to develop bronchiolitis
Jan 30, 2018
Adolescent Bariatric Surgery with Dr. Thomas Inge (S1:E22)
28:11

Today on the podcast, we're discussing adolescent bariatric surgery with Thomas Inge, MD. Dr. Inge is the division head of Pediatric Surgery and the Director of the Bariatric Surgery Center at Children's Colorado, as well as a professor at the University of Colorado School of Medicine.

In this episode:

  • Where bariatric surgery fits within available options for the morbidly obese adolescent patient
  • Common medical indicators that a patient could be a successful candidate for bariatric surgery, as they indicate general readiness and suitability to a primary care provider
  • Key contraindications for bariatric surgery
  • The impact of patient age and how to assess maturity, both skeletal and psychological
  • The types of bariatric operations that are suitable for adolescents
  • What the Multicenter Teen-LABS study, led by Dr. Inge, means for adolescents
Jan 16, 2018
Neonatal Jaundice and Bilirubin Levels in Newborns (S1:E21)
24:01

Today on the podcast, Dave Scudamore, MD joins us to talk about neonatal jaundice. Dr. Scudamore is the Director of Inpatient Medicine for the Network of Care at Children's Colorado, and he is also an assistant professor of pediatrics in hospital medicine at the University of Colorado School of Medicine.

In this episode:

  • The major risk factors for severe jaundice that can cause complications with neonates
  • How to assess mom and baby for the risk factors of neonatal jaundice by reviewing patient history and birth data
  • Difference between the risk factors for elevated bilirubin and the risk factors for neurotoxicity
  • The significance of the ratio between albumin and bilirubin
  • Standard protocols for bilirubin workups and monitoring for risk factors
  • How you can provide elevated patient care by using a patient-centered care approach and considering the context of the case
  • The way to utilize the Bhutani curve to assess risk and the AAP guidelines to initiate phototherapy
  • Understanding the importance of follow ups and their role in intervention
Dec 26, 2017
Noisy Breathing in Pediatric Patients (S1:E20)
21:15

In this episode, Jeremy Prager, MD, talks us through a common issue in pediatric patients — noisy breathing. He outlines the underlying causes and presentations of, as well as available treatment options for noisy breathing. Dr. Prager is a pediatric otolaryngologist, Director of the Aerodigestive Program at Children's Colorado and associate professor of otolaryngology at the University of Colorado School of Medicine.

In this episode:

  • How an ENT defines noisy breathing
  • Categorizing noisy breathing into age groups
  • The presentations of noisy breathing the infants and toddlers age group
  • The presentations of noisy breathing the school-age children age group
  • Audible examples of a stridor sound versus a stertor sound
  • Questions providers should ask when seeking the cause of noisy breathing
  • The relationship between pediatric obesity and sleep apnea
  • Diagnostic exams and tests that providers can run before a consultation
  • Treatment options available to a child with noisy breathing
  • The effectiveness of natural remedies and oxygen therapies
Dec 19, 2017
Top 10 Pediatric Rheumatology Diagnoses (S1:E19)
33:30

Today Robert Fuhlbrigge, MD joins us to discuss the 10 most common pediatric rheumatology diagnoses. Dr. Fuhlbrigge is the Chair of Rheumatology at Children's Colorado and professor of pediatrics and rheumatology at the University of Colorado School of Medicine.

In this episode:

  • What swollen joints can indicate when assessing potential diagnoses in the realm of rheumatology
  • The most common identifier in determining a systemic problem
  • The role of morning stiffness in the differential diagnosis
  • The difference between mechanical pain and inflammatory disorders
  • Defining how helpful an elevated ANA is in treating a patient with Lupus
  • Outlining the best tests for inflammation: CSR, CSR and ANA
  • Why rheumatologists find unexpected fevers in children interesting
  • Unexplained weakness and what it means
  • Which rashes may indicate that it's necessary to refer to rheumatology
  • The role fatigue plays in the rheumatology world
  • Usefulness of radiology studies, MRI, CT and other imaging modalities
  • Helpful apps clinicians use for rheumatological diseases today
  • The role of genetics and development in rheumatological diseases
Dec 15, 2017
International Adoption Medicine (S1:E18)
22:18

On today's episode, we're diving into the topic of international adoption and international adoption medicine best practices. We explore how primary care providers can support families who are expanding their families through international adoption.

Joining us is Gretchen Domek, MD, Director of the International Adoption Clinic and Senior Investigator for the Center of Global Health at Children's Colorado. Dr. Domek is also the assistant professor of pediatrics at the University of Colorado School of Medicine.

In this episode:

  • Why pre-adoption reviews are critical for families
  • The importance of a post-adoption evaluation
  • Expectations and guidelines for conducting a follow-up consultation
  • Common health issues to look for in internationally adopted children
  • Behavioral problems that are common in internationally adopted children
  • Methods for adapting to culturally different feeding techniques
  • Common questions adoptive families may ask and how to respond
  • How a careful assessment can help you determine a child's age
Dec 08, 2017
Non-IgE Mediated Food Allergies (S1:E17)
20:45

On today's episode, we welcome back Matthew Greenhawt, MD to discuss non-IgE related food allergies, including Food Protein-Induced Enterocolitis Syndrome (FPIES). Dr. Greenhawt is an associate professor of pediatrics and allergy at the University of Colorado School of Medicine.

In this episode:

  • How non-IgE mediated food allergies most commonly presents in children
  • The fact that non-IgE food allergy symptoms appear more slowly
  • Identifying the various presentations and triggers of dietary protein-induced enterocolitis
  • The benefits of using extensively hydrolyzed infant formulas or amino acid-based infant formulas
  • Treating atopic dermatitis with a topical steroid versus allergy screening
  • Creating awareness of eosinophilic esophagitis in the primary care discipline
  • The importance of identifying family history patterns to diagnose allergies
  • How the presentation of FPIES differs between environments globally
Nov 28, 2017
Food Allergies Diagnosis and Hot Topics (S1:E16)
28:39

With us today is Matthew Greenhawt, MD, associate professor of pediatrics and allergy at the University of Colorado School of Medicine. Dr. Greenhawt discusses hot topics surrounding food-related allergies, including the early introduction of peanuts.

In this episode:

  • What initial steps to take before referring patients to an allergist
  • The importance of getting a complete patient history to diagnose food allergies
  • Tools primary care providers can utilize in the diagnostic process
  • Why the presence of IGE may not be an effective marker for a food allergy
  • Understanding the cross-reactivity between different allergies
  • How to implement a food allergy action plan
  • Methods and recommendations for early introduction of the peanut
  • Where providers can find resources for on-going food allergy education
  • Recommendations on prescribing epinephrine

Links from today's episode

 

Nov 21, 2017
ADHD Medication Management (S1:E15)
25:46

In this episode we discuss attention-deficit/hyperactive disorder (ADHD) medication management with Marissa Schiel, MD. Dr. Schiel is the Medical Director of the Outpatient Psychiatry Program at Children's Colorado and an assistant professor of child psychiatry at the University of Colorado School of Medicine. Also joining us is Danielle Stutzman, R.Ph., a clinical pharmacist at Children's Colorado with a special interest in psychiatry medication.

In this episode:

  • The importance of getting a detailed history when assessing a child for ADHD
  • Understanding the spectrum of ADHD symptoms and how they affect a child's function
  • How to approach the medication management conversation when it comes to ADHD
  • The most common side effects that are associated with stimulants or psychotropic medication
  • Management strategies for dealing with potential medication side effects
  • The importance of screening a child for cardiac concerns before prescribing stimulant medications
  • Understanding the functional benefits of the two different classes of stimulants
  • The ideal target doses for specific ADHD medications
  • A recommended follow-up regime and titration strategy for patients
  • How to counsel families on medication management as the child ages
  • Medication recommendations to consider when trialing the non-stimulant class
  • Techniques to use in therapeutic relationships with ADHD patients

 

 

Nov 14, 2017
Headaches and Migraines in Children Management (S1:E14)
20:38

Our guest for this episode is Marcy Yonker, MD. We discuss headache and migraine management in primary care, including their prevalence, triggers and treatment options. Dr. Yonker is the Director of the Headache Program at Children's Colorado and visiting professor of pediatrics at the University of Colorado School of Medicine.

In this episode:

  • The prevalence of headaches and migraines in children
  • Creating a differential headache diagnosis
  • When imaging should be used
  • Common medications prescribed for migraine headaches
  • Newer treatments for headaches and migraine
  • Natural remedies for headaches and migraines
  • Triggers for migraines in children and teenagers
  • The influence of family history on migraine prevalence
  • The role of psycho-psychology in migraine diagnosis
  • Other uncommon migraines
  • Using Botox as treatment for migraines
Oct 31, 2017
Vascular Malformations in Pediatric Primary Care (S1:E13)
24:32

In this episode Taizo Nakano, MD, discusses the most common vascular anomalies in the primary care setting. Dr. Nakano is the Medical Director of the Vascular Anomalies Center at Children's Colorado and assistant professor of pediatrics, hematology and oncology and bone marrow transplant at the University of Colorado's School of Medicine.

In this episode:

  • Common presentation of a vascular anomaly
  • The two major categories of a vascular anomaly
  • Defining the genetics lesions
  • Lab testing for vascular anomalies
  • Vascular emergencies and the features of a lesion that can be detrimental
  • Top 10 things to be concerned about with a vascular anomaly
Oct 24, 2017
Vaccinations and Motivational Interviewing (S1:E12)
21:10

In this episode, Sean O'Leary, MD discusses vaccine safety and hesitancy from parents. He also suggests motivational interviewing techniques to use when talking with your patients and families. Dr. O'Leary is a pediatric infectious disease specialist at Children's Colorado and associate professor pediatrics and infectious diseases at the University of Colorado School of Medicine.

In this episode:

  • How to help families identify the good information from misinformation regarding vaccines
  • The prevalence of vaccine resistance
  • Effectively and efficiently delivering vaccines information to parents
  • Using motivational interviewing techniques when talking with parents about vaccines
  • How to pivot the conversation when a parent is resistant to a care plan
  • Why asking permission is a key component to motivational interviewing
  • Understanding the differences between a recommended and alternate vaccine schedule
  • Techniques for communicating relative risks about vaccines
  • Working with parents who are vaccine resistant
  • Vaccines that receive the most resistance and hesitancy
Oct 17, 2017
Back Pain Management in Pediatrics (S1:E11)
20:48

In this episode Sumeet Garg, MD, discusses back pain management, including identifying characteristics and the relationship between scoliosis and back pain. Dr. Garg is a pediatric orthopedic surgeon at Children’s Colorado and associate professor of orthopedics at the University of Colorado School of Medicine.

In this episode:

  • The incidence of back pain in kids, especially adolescence
  • Identifying what to look for on physical examination
  • When to obtain imagining
  • The challenge with MRI in younger kids
  • Suggestions for talking with patients and families about back pain
  • Tight hamstrings and weak core abdominal muscles as an underlying driver of back pain
  • What type of patients should see an orthopedic surgeon for back pain
  • The relationship between scoliosis and back pain in pediatric and adolescent patients
  • Bad posture as a habit and not a deformity
  • Scoliosis and what families can expect over time
Oct 10, 2017
Breastfeeding Management and Support for Nursing Moms (S1:E10)
19:46

In this episode, Maya Bunik, MD, discusses common challenges and myths surrounding breastfeeding management and how to support new moms in your practice. Dr. Bunik is an executive committee member of the American Academy of Pediatrics (AAP) section on breastfeeding, Medical Director of the Child Health Clinic at Children's Colorado and a professor of pediatrics at the University of Colorado School of Medicine. Dr. Bunik is also the author of the AAP's breastfeeding telephone protocols and advice.

In this episode:

  • Why breast is best
  • Approaches to working with a new mom who is struggling with breastfeeding
  • Identifying reasons why a mom is struggling with breastfeeding
  • Impacts of sleep deprivation on new moms and their milk supply
  • How to know whether a baby is getting enough milk
  • The importance of babies' weight checks
  • Ways to boost milk supply through milk removal
  • Power pumping
  • Indication of needing a lactation professional
  • When a mom should start pumping after delivery
  • Why breastfed babies need Vitamin D
  • Common myths associated with breastfeeding
  • Impact of cleft lip and palate with breastfeeding
Oct 03, 2017
Seizure Management (S1:E9)
20:54

In this episode, Amy Brooks-Kayal, MD, discusses acute seizure management. The conversation includes the importance of gathering a detailed history of a seizure event, identifying provocations of a seizure and options for anti-seizure and rescue medications.

Dr. Brooks-Kayal is the Chief of the Pediatric Neurology, Co-Director of the Translational Epilepsy Research Program and past president of the American Epilepsy Society.

In this episode:

  • Responding to a patient's first seizure
  • Importance of a detailed history of a seizure event
  • Identifying provocations of a seizure
  • Neurological examination
  • Focal onset versus a generalized seizure
  • Chances of seizure reoccurrence
  • Anti-seizure and rescue medications
  • Managing the anxiety of families
  • Basic seizure safety
  • Current research into pediatric epilepsy
Sep 26, 2017
Acute Scrotum Pain Management (S1:E8)
18:41

In this episode, Duncan Wilcox, MD, talks about acute scrotum management. The conversation includes the most common indications of acute scrotum and how to differentiate an incarcerated hernia and a hydroceles scrotal trauma.

Dr. Wilcox is the Chair of Pediatric Urology and Surgeon-in-Chief at Children's Colorado. He is also a professor of surgery at the University of Colorado School of Medicine.

In this episode:

  • The most common indications of acute scrotum
  • The role trauma plays in acute scrotum
  • How to treat testicular torsion and urgent treatment
  • Differentiating an incarcerated hernia and a hydroceles scrotal trauma
  • Why an incarcerated hernia needs to be treated rapidly
  • The three groups of acute scrotum patients
  • Long-term outcome for patients living with one testicle
Sep 19, 2017
Fidget Spinners and Other Ingested Foreign Objects (S1:E7)
18:47

In this episode, Robert Kramer, MD, talks about the dangers of kids and adolescents swallowing common household toys and a recent case involving ingested fidget spinner parts. Dr. Kramer is a pediatric gastroenterologist at Children's Colorado.

In this episode:

  • Recent cases of patients ingesting fidget spinner parts
  • Dangers of ingesting button batteries and other small components
  • Why magnets represent a special threat for kids
  • Age groups impacted by incidental ingestion of objects
  • Batteries ingested into the gastrointestinal tract and how to manage them
  • Types of injuries that can occur beyond damage to the blood vessels
  • The importance of getting the battery out as soon as possible after ingestion
Sep 12, 2017
Teen Reproductive Health (S1:E6)
27:17

In this episode, Eliza Buyers, MD, talks about reproductive health in teenagers. Dr. Buyers is a pediatric and adolescent gynecologist at Children's Colorado and a senior instructor of obstetrics and gynecology at the University of Colorado School of Medicine.

In this episode:

  • How to talk to teens and their parents about reproductive health
  • Implementing a universal screening approach in your practice
  • Dealing with push back from parents
  • Setting up one-on-one time with adolescent patients
  • Misconceptions about teens and their reproductive health
  • Long-acting reversible contraceptive (LARC) methods
  • Non-contraceptive benefits of LARC
  • Importance of hormonal therapy
  • Reversing long-term hormonal care and contraception
  • Talking to teens about screening for sexually transmitted diseases
  • When to send a patient to a specialist
Sep 05, 2017
Heart Arrhythmia Diagnosis (S1:E5)
23:12

In this episode, Johannes von Alvensleben, MD, pediatric cardiologist and electrophysiologist at Children's Hospital Colorado and assistant professor of pediatrics at the University of Colorado School of Medicine, talks about heart arrhythmias. He discusses some of the most common heart arrhythmias in the primary care setting, including identifiable characteristics and treatments.

In this episode:

  • Palpitations and syncope (commonly known as fainting) as symptoms for heart arrhythmia
  • Characteristics of common heart arrhythmias
  • Supraventricular tachycardia (SVT) in an infant versus a young child
  • Differences in children with syncope
  • Inherited heart arrhythmia syndromes
  • Importance of obtaining an electrocardiogram (ECG)
  • Co-morbidities in children that can impact diagnosis with arrhythmias
  • Drug-related arrhythmias in older children
  • Treatment options for heart arrhythmias in young children
  • The success rate of ablation for arrhythmia
Aug 29, 2017
Constipation Treatment and Management (S1:E4)
23:49

In this episode, Joel Friedlander, MD, pediatric gastroenterologist at Children's Colorado, addresses the management of constipation and the effects of leaving it untreated, especially in young children.

In this episode, Dr. Friedlander discusses:

  • Addressing constipation and uncomfortable stools early
  • Potential long-term complications associated with constipation
  • Two key components to focus on in the physical examination
  • Miralax, a common used laxative for the treatment of constipation
  • The use of lactulose for young children
  • Categorizing medications for constipation
  • Different medications with different adverse effects
  • Steps to behavioral modification
  • Constipation split between organic and functional
  • Why medication to treat constipation won't work without a change in behavior
Aug 22, 2017
Asthma Management (S1:E3)
20:35

In this podcast, Bill Anderson, MD, co-director of the multidisciplinary Asthma Programat Children's Colorado and assistant professor of pediatrics at the University of Colorado School of Medicine, talks about asthma. He discusses challenges in the management of asthma, the effect of asthma on pediatric patients and treatment options now available.

In this episode, Dr. Anderson discusses:

  • Common challenges for managing asthma in pediatric patients
  • Factors that come into play when choosing controller medications
  • Why steroids are better suited for atopic patients
  • Teaching patients and families how to use a spacer
  • How co-morbidities affect children with asthma
  • The impact that psychosocial factors have on asthma
  • Working with social workers to help families overcome hurdles
  • Latest treatment options for treating pediatric asthma
  • Overcoming the adherence barrier using technology
  • Natural medications available to pediatric asthma patients
  • Advice for people with dog allergies
Aug 22, 2017
Approaching Concussions in Primary Care (S1:E2)
20:25

In this episode, Julie Wilson, MD, co-director of the Concussion Program at Children's Colorado and assistant professor of orthopedics at the University of Colorado School of Medicine, discusses pediatric concussions in sports. She also talks about the concussion recovery process, working with parents and coaches to return young athletes to play and the classroom, comorbidities that impact concussion recovery, and more.

In this episode, Dr. Wilson discusses:

  • The signs and symptoms of a concussion in a young or adolescent patient
  • Why grading scales for concussions no longer exist
  • Comorbidities that can impact concussion recovery
  • How long a patient needs to rest after a concussion
  • Current guidelines on concussions in sports
  • "Return to play" concussion protocol is and why it's important
  • How to address parent concerns in a treatment plan
  • The correlation between concussion rates and sports
  • How the primary care provider can address the whole patient as they treat for a concussion
  • Red flags in concussion treatment
  • How many concussions are too many
  • Latest treatment options for concussion management

See our clinical care guidelines from Children's Hospital Colorado - for concussion (.pdf).

Aug 22, 2017
Alleviating Seasonal Allergies (S1:E1)
22:19

In this episode, Daniel Searing, MD, Professor of pediatrics and allergies at Children's Colorado, talks about seasonal allergies and pollen. He discusses the effects of pollen, how to treat and alleviate allergies, and more.

In this episode, Dr. Searing discusses:

  • Pollen and how it affects allergies
  • Why cottonwood trees are a big pollinator, especially in the springtime
  • Why rain and humidity shut down pollen levels
  • Why Colorado's climate makes people more susceptible to allergies
  • How allergy symptoms will vary from year to year
  • The importance of monitoring the quantitative level of pollen in the environment
  • How physicians should manage the initial approach to a child with allergy symptoms
  • Key features to look out for
  • Why treating pollen allergies with persistent treatment is more effective
  • What role the prescription drug Montelukast plays in treating allergic rhinitis
  • What you can do to help prevent pollen from spreading
  • Which medicines and therapies can help alleviate allergies
  • When to see a doctor for seasonal allergies
  • The approach of an immunotherapy treatment plan and the two phases of a typical treatment schedule
Aug 11, 2017