Charting Pediatrics

Racial Disparities Postpartum Dec 17, 2024

The United States has the highest rate of maternal deaths among high-income nations and women of color, are disproportionately affected. For Black women in this country, the rate jumps from 22 deaths with every 100,000 births to 50 deaths for every 100,000 births. When it comes to postpartum depression, these same women are several times more likely to suffer, but less likely to receive treatment.

To understand these disparities and discuss ways to combat them, we are joined by three experts. Shaleah Dardar, MD, and Brigitte McClellan, PsyD, specialize in child and adolescent psychiatry at Children’s Hospital Colorado and are both assistant professors at the University of Colorado School of Medicine. Whitney Dunlap is a lactation consultant and health educator.

Some highlights from this episode include:

Barriers and biases that put Black mothers and their babies at a disadvantage
How primary care providers can create a safe space for parents to be vulnerable
The overlap of adult care and newborn care during post-partum

For more information on Children’s Colorado, visit: childrenscolorado.org.

Caring for Kids in Conflict Dec 10, 2024

Pediatric providers around the world are focused on helping sick children — finding cures, creating new treatment options and developing innovative techniques to improve care. But when it comes to conflict zones and border areas, there are fewer doctors available to protect the health of vulnerable children. Paul Wise, MD, MPH, is a physician who has dedicated his career to taking on that complex and sometimes daunting problem, working to improve and reform systems so that no child suffers needlessly.

Dr. Wise has served as the Juvenile Care Monitor for the U.S. Federal Court, overseeing the treatment of migrant children in the United States detention system. He’s also served as the senior advisor to St. Jude Global’s SAFER Ukraine collaborative since 2022, and he’s supported international work in Gaza, Central America and Venezuela. As a professor and fellow of multiple disciplines at Stanford University, he is dedicated to bridging the fields of child health equity, public policy and international security studies. He is also Co-Director for the Stanford Center for Prematurity Research. He has served in a variety of professional and consultative roles, including special assistant to the U.S. Surgeon General.

Some highlights from this episode include:

A discussion of Dr. Wise’s experiences at the southern border and how they shaped his care recommendations for migrant children.
A global understanding of what children face in unstable environments like border areas and war zones.
A close look at what changes have already been implemented at local, national and international levels to better protect vulnerable children.
Suggestions on the role primary care providers can play in making conflict zones around the world safer for children in need.

For more information on Children’s Colorado, visit: childrenscolorado.org.

100 Years of Children’s Rights Dec 03, 2024

2024 marks 100 years since the Geneva Declaration of the Rights of the Child. In the aftermath of World War I, this declaration called for universal attention to the needs of children, including their health. A century later, we’ve made progress, but children still face vast challenges here in the United States and around the world. How can we advance the global cause of children’s health? In this episode we talk to one of the world’s foremost ambassadors for this work about the struggles and opportunities facing children’s healthcare.

Professor Ann Skelton is a renowned children’s rights expert and Chair of the UN Committee on the Rights of the Child. She is a professor of law at the University of Pretoria and Leiden University, as well as a visiting professor at the University of Oxford and the University of Strathclyde.

Some highlights from this episode include:

A look into Ann Skelton’s work
The current state of children’s rights in the U.S. and around the world
The challenges facing children’s healthcare and how health advocacy can help change that
Tangible opportunities to engage in to ensure all children have access to the healthcare they need

For more information on Children’s Colorado, visit: childrenscolorado.org.

Support for Post-Partum Depression Nov 26, 2024

Bringing a baby into this world is the start of many significant changes, yet one change that some families may not anticipate is post-partum depression (PPD). This condition affects more than the parent’s wellbeing, it can impact children and other family members too. About one in five new parents experience mood or anxiety concerns during pregnancy or after delivery, making maternal mental health conditions the most common complication of pregnancy and childbirth. While 80% of them will fully recover, setting them up for success can start in the pediatric primary care setting.

To understand how primary care providers can help support parents with post-partum depression, we are joined by two experts for this episode. Celeste St. John-Larkin, MD, specializes in child and adolescent psychiatry at Children’s Hospital Colorado and is an associate professor of child psychiatry at the University of Colorado School of Medicine. She is also The Anschutz Chair in Perinatal Mental Health. Kelly Glaze, PsyD, is a psychologist at Children’s Colorado and an assistant professor of child psychiatry at the University of Colorado School of Medicine.

Some highlights from this episode include:

How long parents are at risk of PPD after birth
The difference between PPD and baby blues
How primary care pediatricians can support the adults alongside their kids
How to navigate support after giving birth

For more information on Children’s Colorado, visit: childrenscolorado.org.

Top CEOs Provide Pediatric Insight Nov 19, 2024

From startups to global corporations, CEOs have the power to make immense strides in any respective industry. In pediatric medicine, they drive advancements in child health through high-quality care, coordinated programs, education, research and advocacy. While providers are working directly with patients, these leaders are preparing the infrastructure for success while pushing us to reimagine healthcare. It’s because of them, institutions like Children’s Hospital Colorado and Nationwide Children's remain among the top 10 pediatric hospital systems in the country. In this episode, we go beyond the white coat by sitting down with two of the most influential CEOs in pediatrics.

Jena Hausmann is the President and CEO of Children’s Colorado and Tim Robinson is the CEO of Nationwide Children’s. Under Jena’s leadership, Children’s Colorado has been recognized nationally and internationally for our medical, research and advocacy programs. Jena has been a champion for increasing research and innovation and improving pediatric mental health. Tim’s leadership has helped transform Nationwide Children’s from an important regional children’s medical center into an internationally prominent academic healthcare system. Nationwide has become a model for how a hospital system can improve neighborhoods, increase health care access in rural communities, drive innovation and pioneer economic development.

Some highlights from this episode include:

The career path of working in healthcare to becoming a CEO
How pediatric healthcare has evolved and where it’s going
The current challenges and threats to the healthcare landscape
The importance of children’s hospitals partnering with community providers

For more information on Children’s Colorado, visit: childrenscolorado.org.

Can We Prevent Congenital CMV? Nov 12, 2024

The most common congenital viral infection in children is cytomegalovirus infection (CMV). Oftentimes the mother will experience little to no symptoms, but the virus can significantly affect the newborn, with outcomes ranging from no symptoms to severe systemic and intercranial complications. What if we could prevent this infection all together with a vaccine? A candidate MRNA vaccine against CMV has elicited promising immune responses to date and is on a pathway towards FDA approval.

To learn more about this treatment, we are joined by one of the nation’s leading experts in vaccine development for the prevention of congenital viral disease. Sallie Permar, MD, is the Nancy C. Paduano Professor and Chair of Pediatrics at Weill Cornell Medicine. She serves as pediatrician-in-chief at New York-Presbyterian/Weill Cornell Medical Center. She is also a professor of immunology and microbial pathogenesis at the Weill Graduate School of Medical Sciences.

Some highlights from this episode include:

The scale of impact of congenital CMV in children
Understanding how the virus originates with the mother and affects the baby
Where the CMV vaccine stands in the vaccine development process
Strategies for educating the public and primary care providers on this new treatment

For more information on Children’s Colorado, visit: childrenscolorado.org.

When is a Bloody Nose Concerning? Nov 05, 2024

As a child, a nosebleed can be painful and embarrassing. Surprisingly, it’s also something primary care providers run into often in their practices. While the great majority of nosebleeds, also called epistaxis, are limited in severity and duration, about 6% of people who experience them will seek medical attention. Interventions range from self-treatment and home remedies to more intensive procedural options and medications. Why are we seeing so many cases of epistaxis in our offices? What is causing the onset of these nosebleeds, and are environmental changes a culprit?

To explore the intricacies of epistaxis, we are joined by Jeremy Prager, MD. Dr. Prager specializes in otolaryngology at Children’s Hospital Colorado and is a Professor of Otolaryngology at the University of Colorado School of Medicine.

Some highlights from this episode include:

How to differentiate between a nosebleed and a more severe epistaxis diagnosis.
The importance of partnership between the specialist and the primary care provider to properly care for a nosebleed.
The most common causes of a nose bleed in children by age.
How to support patients when outpatient management isn’t working.

For more information on Children’s Colorado, visit: childrenscolorado.org.

Addressing Neurologic Conditions with Precision Oct 29, 2024

One of the great medical accomplishments of our time is the evolution of precision medicine. The ability to understand a patient’s unique genetic profile has become more accessible to our patients, and now, there are multiple mechanisms for using that information to overcome disease.

One of the specialties leading the way in precision medicine is pediatric neurology. According to the World Health Organization, more than one in three people are affected by some type of neurological condition. They are a leading cause of ill health and disability worldwide. This subset of precision medicine will not only help us decrease those numbers but also allow us to treat some of these conditions in ways we have never done before.

To detail this exciting work, we’re joined by two experts. Scott Demarest, MD, and Julie Parsons, MD, are both pediatric neurologists at Children’s Hospital Colorado and faculty at the University of Colorado School of Medicine. Dr. Demarest focuses on rare epilepsy conditions, and Dr. Parsons specializes in neuromuscular disease. Dr. Demarest is the Clinical Director of the Precision Medicine Institute at Children’s Colorado.

Some highlights from this episode include:

Understanding precision neurology within the context of precision medicine
Why precision neurology positively impacts diagnosis and treatment options
How families are more easily accessing important genetic testing
The role primary care providers play with caring for these rare diseases

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Courageous Conversations Around Suicide Oct 22, 2024

Many of us avoid talking about suicide, not only because it’s a difficult conversation, but also because we don’t know how to. And avoiding that conversation can be a barrier to helping those most at risk.

One family from Colorado is at the forefront of changing the stigma and creating opportunities for fearless conversations. They courageously shared their story in a powerful documentary released earlier this year called “My Sister Liv.” In this special episode, we honor Liv Kunik’s life and learn about how her story is spurring hundreds of courageous discussions around suicide.

The guests for this episode are family members at the heart and soul of the documentary, as well as mental health advocates. Honey Beuf is Liv’s mom, and she is the co-founder and Executive Director of The Liv Project. Tess Kunik is Liv’s sister and the co-founder of The Liv Project. Her voice also narrates the film, taking us through Liv’s story. Jessica Hawks, PhD, is the Clinical Director of the Pediatric Mental Health Institute at Children’s Hospital Colorado and a child and adolescent psychologist. She is also an Associate Professor at the University of Colorado School of Medicine.

Some highlights from this episode include:

An overview of how the “My Sister Liv” documentary came together and the impact it’s having in the community
Ways for friends, family and providers to have “fearless conversations”
A discussion of how providers can best care for suicidal patients and their families, such as asking direct questions
A look at advocacy efforts underway and tools created to support courageous conversations
A youth suicide prevention resource from the American Academy of Pediatrics and the American Foundation for Suicide Prevention providers can use in their daily practice

Visit The Liv Project website to learn more about their work, how you can access the film and details about the game mentioned in the episode, The Game that Goes There.

For more information on Children’s Colorado, visit: childrenscolorado.org.   

How Substance Abuse Affects Newborns Oct 15, 2024

In the state of Colorado, cases of Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS) increased by 120% from 2011 to 2016. Clinicians provide critical support to improve outcomes for these newborns, and there’s been impressive collaboration among healthcare providers around this issue. Two important examples are the Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative, otherwise known as CHoSEN QIC, and Kids in Care Setting Clinic (KICKS). In this episode, we learn about these initiatives and how they benefit hospitals like Children’s Hospital Colorado to provide the best care for our patients.

Joining us for this discussion are two experts. Bird Gilmartin, MD, is the Medical Director for Kids in Care Settings Clinic (KICS) at Children’s Colorado, as well as an associate professor of clinical pediatrics at the University of Colorado School of Medicine. Sunah (Susan) Hwang, MD, specializes in neonatal and perinatal medicine at Children’s Colorado and is an associate professor of pediatric neonatology at the University of Colorado School of Medicine.

This episode looks at:

The epidemic of perinatal opioid use, as well as illicit and legally prescribed substance abuse
Suggestions on shifting your perspective as a provider about families with substance use issues
The ways these substance abuse programs intertwine with our legal system

Some resources our experts recommend utilizing are the Colorado Perinatal Care Quality Collaborative (CPCQC), Illuminate, and Tough as a Mother.

For more information on Children’s Colorado, visit: childrenscolorado.org.

The Fight Against Child Trafficking Oct 08, 2024

Despite the pervasiveness of child trafficking in the United States, many communities aren’t aware of the scope of the issue. Here in Colorado, the University of Colorado’s Kempe Center is recognized as a leader in the fight against child abuse, and they are important voices in the global conversation around identifying and ending child trafficking. By committing to responding, treating and preventing all forms of child abuse and neglect, medical professionals can make a difference in this crucial effort.

To shed light on these realities and provide insight into how we can all play a part, we are joined by Denise Abdoo, PhD, CPNP., who specializes in child abuse neglect at Children’s Hospital Colorado. She is an associate professor of pediatrics at the University of Colorado School of Medicine, as well as a member of the Kempe Center’s facility.

Some highlights from this episode include:

The current state of child trafficking nationally and globally
The work the Kempe Center is doing to help combat child abuse
The reasons why child trafficking is under reported
Ways the medical community can provide both physical and mental health care

For more information on Children’s Colorado, visit: childrenscolorado.org.

Combatting RSV in Real Time Oct 01, 2024

With kids back in school, pediatric viral illnesses are revving their engines. It seems we have returned to normal seasonality for viral disease after the coronavirus pandemic. Top of mind with the arrival of fall is respiratory syncytial virus (RSV). We know how quickly the onset of RSV season can take over our waiting rooms.

Last year, two important developments occurred that could change the course of RSV prevention: the FDA approval of a maternal vaccine and a monoclonal antibody for infants. Far too few mothers and infants benefitted from these treatments during last year’s respiratory season, but now we’ve had a year to prepare to do better.

Joining us to discuss this hot topic are two expert pediatricians. Sean O’Leary, MD, is an Infectious Disease Physician at Children’s Hospital Colorado, a Professor of Pediatrics at the University of Colorado School of Medicine and is the chair of the American Academy of Pediatrics Committee on Infectious Diseases, also known as the Red Book Committee. Matt Dorighi, MD, specializes in pediatrics at Cherry Creek Pediatrics. He is currently chair of the Pediatric Care Network, the largest clinically integrated network for children in the state of Colorado.

Some highlights from this episode include:

Guidelines for Nirsevimab and the maternal vaccine
Why availability will not be a barrier this respiratory season
How practices can combat vaccine hesitancy

For more information on Children’s Colorado, visit: childrenscolorado.org.

The Connection Between Autism and GI Issues Sep 24, 2024

Children with autism spectrum disorder (ASD) tend to have more medical complications than the average kid. Among the most common challenges are gastrointestinal (GI) disorders like abdominal pain, constipation and diarrhea. Untreated GI distress in kids with ASD has been linked to many other issues, including sleep, behavioral and psychiatric disorders. Many of these same kids also have selective eating, which impacts their intake of necessary nutrients. Due to these many layers of complexity, it can be challenging to know how to help a child with ASD and GI symptoms.

To understand this intricate issue, we are joined by Christine Waasdorp Hurtado, MD, who specializes in gastroenterology at Children’s Hospital Colorado. She is the Southern Colorado Executive Faculty Director of the Department of Pediatrics, as well as a Professor of Pediatrics for the University of Colorado School of Medicine.

Some highlights from this episode include:

The most common GI issues in kids with ASD
How primary care providers can best treat these kids
How certain treatment outcomes can improve quality of life

For more information on Children’s Colorado, visit: childrenscolorado.org.

The Fundamentals of Sharing Data Sep 17, 2024

Sharing data transparently, whether at a local or a national level, is a foundational contributor to healthcare quality. Atul Gawande wrote about this in his 2004 essay labeled ‘The Bell Curve’. Over the last several decades, we have seen many pediatric specialties organize and collaborate around data collection at a national scale to improve care. We’ve seen firsthand how our hospital’s participation in a national cardiac critical care registry has driven quality improvement, better measurable outcomes and improved cardiac arrest rates for patients. Getting the data collection right is the first challenge. In between that first step and actually seeing improvements is a tremendous amount of work. In this episode, we explore the value of data sharing and transparency to improve outcomes for kids.

Our experts for this episode are Carly Scahill, DO, and Kelly O’Neil. Dr. Scahill specializes in pediatric cardiology as a pediatric cardiac intensivist. She is also the Fellowship Director for pediatric cardiology and the cardiac intensive care unit (CICU), as well as an associate professor of pediatrics at the University of Colorado School of Medicine. Kelly O’Neil is a registered nurse and the Manager of the Heart Institute Data Registries and Outcomes. Before her current role, she was a CICU nurse for over ten years.

Some highlights from this episode include:

The purpose and use of clinical registries
How data collection improves measurable outcomes
The future of data collection in healthcare
How to get more entities involved

For more information on Children’s Colorado, visit: childrenscolorado.org.   

The Evolution of APPs Sep 10, 2024

Over the last few decades, the roles of nurse practitioners (NPs) and physician assistants (PAs), also known as advanced practice providers (APPs), have greatly expanded to touch even more patient-family lives. They are an essential part of the care we provide, and their roles have evolved over time. In this episode, we explore the crucial part they play in our medical system and how that might continue to evolve in the future.

For this episode, we are joined by two University of Colorado leaders who continue to help keep our APP programs among the top ranked in the country. Jonathan Bowser is the Child Health Associate and Physician Assistant Program Director at the University of Colorado School of Medicine. He is also the Associate Dean of Physician Assistant Studies, the Section Head of Pediatrics, and an associate professor. Jill Marks, NP, is the Specialty Director of the Acute Care Pediatric Nurse Practitioner Program at the University of Colorado College of Nursing. She is also an inpatient nurse practitioner for the section of pediatric neurology at the University of Colorado School of Medicine.

Some highlights from this episode include:

Background on the creation of NPs and PAs
The ways these roles have changed over time
The impact APPs make on patient care
The role APPs will play in healthcare in the future

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Lowering Emissions in Healthcare Sep 03, 2024

Our medical community is committed to providing excellent patient care, and it’s also our duty for that care to extend to our planet. Climate change is an increasingly important global health issue where children are the most vulnerable to adverse health outcomes. One major contributing factor to climate change in medicine is the use of nitrous oxide in spaces like the operating room and outpatient clinics. Efforts are underway in hospitals across the country to decrease our environmental impact, including at Children’s Hospital Colorado.

To explore the exciting new project happening at Children’s Colorado and to discuss the environmental impacts on a global scale, we are joined by two experts. Tom Majcher, DO, is the Chief of Anesthesiology at Children’s Colorado, as well as a professor of pediatrics and clinical practice for anesthesiology at the University of Colorado School of Medicine. Diane Gordon, MD, specializes in anesthesiology at Children’s Colorado and is an associate professor of pediatric anesthesiology at the University of Colorado School of Medicine.

Some highlights from this episode include:

How nitrous oxide is currently used in medical settings
The damage it does on the environment
What efforts are underway to reduce its impact
How to keep the same standard of care with new alternatives
The importance of this transition in the operating room

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Bringing NG Tubes Home Aug 27, 2024

Over the last few decades, there have been many incredible medical advances in newborn care. At Children’s Hospital Colorado, we’re launching an exciting new initiative to take another step forward in care for our tiniest patients.

For newborns who need to be hospitalized, getting home as soon as possible is critical for their successful development. A common barrier for discharge that can keep babies in the neonatal intensive care unit (NICU) for additional days or weeks is the need for a nasogastric (NG) tube. Ensuring an infant is receiving proper nutrition is essential to securing a safe discharge. What if we could deliver NG tube feeds at home and provide all the necessary support? That’s the game changing idea we explore in this episode with our neonatology experts.

To dive into this topic, we are joined by three neonatologists practicing at Children’s Colorado. Stephanie Bourque, MD, Kathleen Hannan, MD, and Danielle Smith, MD, tell us about a new at-home NG tube feed program that the team at Children’s Colorado is currently developing. Dr. Smith is the Medical Director of the NICU, Dr. Bourque is the Associate Medical Director of the NICU, and all three of our guests are faculty at the University of Colorado School of Medicine.

Some highlights from this episode include:

What the need has been historically for NG tubes
Model for this at-home program
What’s required to make this at-home model a reality
The role of the primary care provider in this partnership
The impact a change like this could have on patient outcomes and family satisfaction

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Season 8 Launching August 27! Aug 20, 2024

Join us for another insightful season of Charting Pediatrics! The same hosts you know and love will continue to bring the latest and greatest information about pediatric medicine to your ears. Joined by renowned experts, we will explore prominent topics while being moved by their personal stories. This is a season you won't want to miss!

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Helpful Headache Insight Aug 13, 2024

We all know what it feels like to have a headache, but each person can experience that intensity for dozens of different reasons. Globally, headache disorders affect approximately 40% of the population, which is about 3.1 billion people. Headaches are also among the three most common neurological conditions for most age groups starting at age 5.

As such a ubiquitous issue, it’s important for providers to understand, diagnose and treat headaches. What are the most common reasons for headaches in children? How should pediatricians know when a headache is more than surface-level discomfort?

To learn about the latest in pediatric headaches, we are joined by two headache experts, Marcy Yonker, MD, and Angelina Koehler, NP. Dr. Yonker is the Director of the Headache Program at Children’s Colorado and the Dale, Cindy and Kristin Francescon Endowed Chair for Headache Treatment with the University of Colorado Department of Pediatrics. Angelina Koehler is a certified pediatric nurse practitioner in the Neuroscience Institute at Children’s Colorado.

Some highlights from this episode include: 

What PCPs should take into account about migraines
How to approach headache treatment options
What to consider with hesitation around certain medications
When to look for signs of a more serious illness

For more information on Children’s Colorado, visit: childrenscolorado.org.   

The Progression of Pediatric Surgery Aug 06, 2024

For almost 50 years, Dr. Fritz Karrer has been wearing a surgeon’s cap, growing as a surgeon alongside the evolution of his specialty. For 40 of those 50 years, he’s been at Children’s Hospital Colorado, making an everlasting impact on kids and their families. On the brink of retirement, we look at his exemplary career and discuss how he’s watched firsthand the progression of pediatric surgery. His half century of perspective makes him the perfect expert to dive into the growth of pediatric surgery.

Dr. Karrer specializes in pediatric surgery and surgical critical care at Children’s Colorado and is a Professor of Pediatric Surgery at the University of Colorado School of Medicine. He’s also a colonel in the U.S. Army Reserve, he was recognized as a top doctor in 2023 by 5280 Magazine and he’s been awarded the James Strain Award and the Military Medical Merit from the U.S. Army.

Some highlights from this episode include:  

The incredible journey of Dr. Karrer’s career
The ways pediatric surgery has evolved over the last 50 years
The influence of technology on pediatric surgery
Advice for young doctors wanting to follow a similar path

For more information on Children’s Colorado, visit: childrenscolorado.org.   

The Challenging Realities of Rural Pediatrics Jul 30, 2024

More than 50% of rural counties in the United States do not have a pediatrician, and more than 80% of counties lack access to healthcare services that are simply needed to maintain the health of their population. The medical experts in those areas are lifelines to their communities. They are providing essential care, approaching resource and access challenges with creativity and innovation, and connecting kids to specialists when needed. Area codes can determine as much about health and life expectancy as issues like genetic predisposition and lifestyle.

Our two guests are doing this work in rural communities every day. Kelly Miller, MD, is a general pediatrician with Pediatric Partners of the Southwest in Durango, CO. Anna Mack, DNP, FNP, is a family nurse practitioner with Peak Vista Community Health Centers in Colorado Springs. She is also faculty at a post-graduate training advanced practice registered nurse fellowship program.

Some highlights from this episode include:  

What are the primary challenges for providers in rural pediatrics
How experts are overcoming rural mental health hurdles for kids
Ways providers are using innovative solutions for issues they face in rural areas
How more urban and rural organizations can work toward stronger partnerships

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Injury Risk for Young Runners Jul 23, 2024

Running is an increasingly popular sport, with high school track and field programs seeing booming participation rates. With rising interest comes more cases of injury, however, incredible sports medicine advancements and programs are helping young runners manage and prevent injuries.

To break down the most common running-related injuries in youth and discuss comprehensive approaches to prevention and recovery, we are joined by three Children’s Hospital Colorado experts. Aubrey Armento, MD is a sports medicine physician, Medical Director of the Runners Clinic for Young Athletes, and an assistant professor of Orthopedics at the University of Colorado School of Medicine. Amanda McCarthy is a program coordinator of sports nutrition and a registered sports dietician. Cameron (Cody) Yeaman, DPT, is a sports physical therapist and a certified specialist in orthopedic sports and strength and conditioning.

Some highlights from this episode include:  

What to know about new diagnoses in young runners
What there is to be learned from dissecting a case study
How patients and families benefit from a variety of specialists at the Runners Clinic
How pediatricians can understand and tap into an athlete mentality to gain buy-in from their patients.

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Long COVID Pediatric Prevalence Jul 16, 2024

For some, COVID-19 may seem like a thing of the past, but for medical professionals, the data regarding post-acute sequalae of COVID infection is only just emerging. Four years ago, the start of the pandemic left doctors puzzled by certain symptoms. Today, we are learning more about the long-term impacts of SARS-CoV-2 in children, often called long COVID or PASC. As the population continues to struggle with persistent and debilitating after-effects and symptoms, we are looking for answers.

To provide insight into this important diagnosis, we are joined by Suchitra Rao, MD. She is an infectious disease specialist at Children’s Hospital Colorado, as well as the Associate Medical Director of Infection Prevention and Control. She is also an associate professor of Pediatrics within the sections of Infectious Diseases, Epidemiology, and Hospital Medicine at the University of Colorado School of Medicine.

Some highlights from this episode include:  

The epidemiology of long COVID in kids
The difference between the data in adults and children
A discussion of how to diagnose asymptomatic patients
A closer look at Dr. Rao’s groundbreaking research

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Insight into Inflammatory Bowel Disease Jul 09, 2024

Inflammatory bowel disease, otherwise known as IBD, is an illness pediatric providers need to consider when they see kids with abdominal pain, diarrhea or weight loss. IBD can present in a fairly straightforward way, or it can be incredibly challenging to diagnose. We’ve seen improvements in IBD diagnosis and care recently, including new screening tools and medications, as well as future treatments currently under investigation. Getting these medications to kids can be a challenge since pharmaceutical companies focus on adult indications and pediatric clinical research can sometimes lag. That delays access to some of the best therapies.

One of our experts in IBD at Children’s Hospital Colorado is our guest for this episode, Edwin De Zoeten, MD. He is the director of the Pediatric Inflammatory Bowel Disease Center, and is the Hoover Family Endowed Chair for Digestive Health and Nutrition. He is a professor of Pediatrics at the University of Colorado school of Medicine and has a basic science research lab focused on better understanding the pathophysiology of IBD and looking at new treatment opportunities.

Some highlights from this episode include:  

Understanding what symptoms look like and how early they can begin
Looking at the underlying pathophysiology that triggers IBD
Sharing tools pediatricians can use for diagnosing and treating IBD
Discussing the durability of treatments and benefits over time

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Breaking Down Bioethics Curriculum Jul 02, 2024

In simple terms, bioethics is the study of ethical, social and legal issues that arise in biomedicine and biomedical research. It provides guidelines for clinical decision-making and is vital to policy change. Despite standards set by medical entities, significant gaps and variabilities exist within bioethics education for pediatric residents. Every resident will face ethical challenges in their career, so it's important that programs prepare learners to navigate these dilemmas. To address these inconsistencies, a chief resident at the University of Colorado School of Medicine has created a new curriculum that could significantly improve our bioethics education.

Joining us for this episode is Ella Sorscher, MD, Brian Jackson, MD, and Brady Slater. Dr. Sorscher is a pediatrics chief resident at the University of Colorado School of Medicine and is one of the brains behind this new bioethics curriculum. Dr. Jackson is the Medical Director of Clinical Ethics and specializes in critical care as a pediatric intensivist at Children’s Hospital Colorado. He is also an associate professor at the University of Colorado School of Medicine. Dr. Slater is a pediatrics and medical genetics resident at the CU School of Medicine.

Some highlights from this episode include:  

Details about this curriculum
The significance of bioethics in a physician’s career
Information on assessing learners and evaluating the curriculum
Opportunities for other institutions to learn from this model

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Gauging New Guidance for Sepsis Jun 25, 2024

Earlier this year, new guidelines were released to improve the diagnosis of pediatric sepsis and septic shock. For the first time, the novel Phoenix Sepsis Criteria provides an objective and data-driven approach to aid in the identification of these life-threatening conditions, including prediction of mortality in children with suspected or confirmed infection. Sepsis is one of the leading causes of death among children worldwide, and these guidelines could be a major step in changing outcomes.

To help us understand these guidelines and apply them to your practice, we are joined by two experts who have been at the forefront of this new research. Tell Bennett, MD, specializes in pediatric critical care at Children’s Hospital Colorado. He is the Vice Chair of Clinical Informatics, as well as a professor of biomedical informatics and pediatrics at the University of Colorado School of Medicine. Halden Scott, MD, is the Director of Research for the section of emergency medicine at Children’s Colorado. She is also an associate professor of pediatrics at the University of Colorado School of Medicine.

Some highlights from this episode include:  

How to diagnosis sepsis under the new guidelines
How these criteria can be applied to primary care practices
What treatment options are and why time is of the essence

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Detecting Disease Before Symptoms Start Jun 18, 2024

Newborn screening has expanded dramatically over the last decade as our detection methods improved and new treatments became available for rare diseases. One of those rare diseases is adrenoleukodystrophy, otherwise known as ALD. ALD is an example of a rare disease where, thanks to expansions in newborn screenings, we are now able to make a precise genetic diagnosis very early in life and offer therapies far in advance of the onset of symptoms. Early detection and treatment of this can potentially spare a family a lifetime of devastating health impacts. In December 2013, New York became the first state to require newborn screening for ALD. Currently, 43 states and Washington, D.C. are testing babies for ALD.

To help us understand the role of newborn screening, we are joined by Kevin Ess, MD. He is the Ponzio Family Chair of pediatric neurology and is the section head of neurology at Children’s Hospital Colorado. He is also a professor of pediatrics at the University of Colorado School of Medicine.

Some highlights from this episode include:  

The pathophysiology of ALD.
The clinical manifestations of ALD that make it the perfect model for newborn screening.
The specifics of diagnosing and treating ALD.
The long-term impact newborn screening can have for the lifetime of children with ALD.

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Implementing AI in Pediatrics Jun 11, 2024

Artificial intelligence (AI) has the potential to transform healthcare and disrupt the field of medicine in significant ways. We have already seen remarkable progress in areas such as diagnostics and data analysis, but what could broader use in patient care looks like? A little over a year ago, the arrival of ChatGPT got everyone talking about AI — how realistic it is, how well it understands certain concepts and, specifically in medicine, how it can benefit our care systems. In this episode, we explore the overarching needs for AI in pediatrics and medical education, as well as where we stand in implementing it.

We are joined by two guests from Children’s Hospital Colorado who are leading the way in understanding how AI could be incorporated into pediatric care. Jim Barry, MD, specializes in neonatal/perinatal medicine at Children’s Colorado and is an associate professor of pediatric neonatology at the University of Colorado School of Medicine. He is also the Medical Director of the UC Health NICU. He co-founded NeoMIND-AI, a learning collaborative for neonatologists and data scientists interested in AI within neonatal and pediatric critical medicine. Sarah Milla, MD, specializes in pediatric radiology and is the John D. Strain Endowed Chair for Radiology, Chief of Pediatric Radiology and Vice Chair of Radiology at Children’s Colorado and the University of Colorado School of Medicine. She is also a visiting professor.

Some highlights from this episode include:  

Examples of how AI is currently being used in medicine
Ways providers can get started with AI
Ideas on how we can advance care in the future with this tool

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Comprehending Childhood Obesity Jun 04, 2024

Over the last decade, we’ve watched childhood obesity emerge as a major health concern, taking over news stories and social media posts worldwide. The evaluation and treatment of children with obesity has evolved, and how we handle these diagnoses today is different than in years past. What’s important to emphasize is that obesity is a chronic disease, and the medical community needs to treat it as such.

To learn more about this important topic and highlight an impressive woman in medicine, we are joined by Ihuoma Eneli, MD. She is the Section Head of Nutrition at Children’s Hospital Colorado and a visiting professor of pediatrics at the University of Colorado School of Medicine. She is an internationally recognized expert on pediatric obesity and serves in leadership and advisory roles for many organizations.

Some highlights from this episode include:

A discussion of the new AAP obesity guidelines
Genetics and how clinicians can reframe their understanding of obesity
Suggestions for motivational interviewing with patients and families
Treatment options that are available to patient-families
The stigma around fault versus genetics
New drugs and their future impact

For more information on Children’s Colorado, visit: childrenscolorado.org.   

The Crucial Role of Colorectal Programs May 28, 2024

Hirschsprung disease. Anorectal and colorectal malformations. These are some of the most challenging surgical problems encountered in young children. The precision of surgical technique required to achieve optimal outcomes takes many years, if not decades, to develop. Colorectal surgery has become a subspecialty in pediatric surgery, requiring close collaboration with other specialists. At Children’s Hospital Colorado, we offer this care through our International Center for Colorectal and Urogenital Care, and our surgical team has some of the most experience in the world.

In this episode, we are joined by Andrea Bischoff, MD, and Luis De la Torre-Mondragon, MD. They both specialize in pediatric surgery at Children’s Colorado and are associate professors of surgery and pediatrics with a specialty in colorectal surgery at the University of Colorado School of Medicine. Dr. Bischoff is also the Medical Director of the International Center for Colorectal and Urogenital Care here at Children’s Colorado.

Some highlights from this episode include:  

The importance of pediatric colorectal programs.
A discussion of when surgical intervention is necessary.
A look at what procedures are offered at Children’s Colorado and how they work.
The role primary care providers can play as it pertains to identification, referral and care of patients who might need colorectal surgery.

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Significance of Sleep Studies May 21, 2024

Sleep problems can occur at any age, but when toddlers, children or young adults are the ones experiencing them, they can have a big impact on the entire family. Specifically, one to five percent of children, from newborns to teenagers, experience obstructive sleep apnea. While the effects may be significant, many children are not diagnosed or treated due to insufficient access to testing. A team at Children’s Hospital Colorado has been preparing a recommendation on how and when to use home sleep apnea testing in kids.

To explore this topic, we are joined by Antoinette Burns, DO, who specializes in pediatrics and sleep medicine at Children’s Colorado. She is also an associate professor of clinical practice, Department of Pediatrics-Pulmonary Medicine, at the University of Colorado School of Medicine.

Some highlights from this episode include:  

An explanation of obstructive sleep apnea.
New modalities for sleep apnea testing.
Barriers for accessing testing and how to combat them.
Suggestions on what primary care providers should do when they think their patient might have obstructive sleep apnea.

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Will an AFM Peak Return? May 14, 2024

Knowing something is wrong with your child is terrifying for any parent, but the mystery becomes more frightening when the symptoms even puzzle the experts. In 2018, at a peak in cases of acute flaccid myelitis, also known as AFM, otherwise healthy kids experienced debilitating paralysis. Researchers of this perplexing illness braced for a surge in 2022 that never came, and now there is talk about a possible increase of AFM this year.

To break down the past and prepare for the future, we are joined by two experts. Kevin Messacar, MD, and Hai Nguyen-Tran, MD, both specialize in pediatric infectious disease at Children’s Hospital Colorado. Dr. Messacar is an associate professor and Dr. Nguyen-Tran is an assistant professor at the University of Colorado School of Medicine.

Some highlights from this episode include:  

What the history of AFM tells the medical community
Why it’s so tricky to diagnose and identify
How primary care providers can properly prepare

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Shifting Into Survivorship May 07, 2024

In just the United States, more than 15,000 children are diagnosed with cancer each year. Globally, that number is greater than 300,000. As difficult as those numbers may be, there is good news: Our cancer therapies continue to improve. In the 1960s, only about 5% of children survived leukemia. Today, that number is 90% or better. Many more pediatric oncology patients are now transitioning into survivors of childhood cancer and have the opportunity to achieve their hopes and dreams as adults. This means primary care providers are caring for these patients in increasing numbers. What’s important to know about this group of kids? In this episode, we discuss how to best integrate survivorship care with pediatric care.

The Children’s Hospital Colorado HOPE Cancer Survivorship Program is one of the longest running survivorship programs in the nation. Leading that charge is Jenna Demedis, MD, who specializes in pediatric hematology and oncology. Dr. Demedis completed her training at Children’s Colorado and is currently an assistant professor at the University of Colorado School of Medicine.

When a patient can transition into survivorship
How to keep patient families engaged in these programs
How primary care providers can partner with survivorship programs

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Dissecting the Dental Divide Apr 30, 2024

The mouth is a fundamental part of the human body. It allows us to eat, drink, breathe, speak, smile and express ourselves. Naturally, that means oral health is connected to our broader physical health, but in the United States, medical and dental care are structurally separate. Despite their connections, the two have entirely different systems of professional training schools, insurance coverage and care networks. This is referred to as the dental divide, and it results in varied levels of access and health outcomes. The repercussions of these barriers are significant, especially for children in our most vulnerable communities.

To discuss this important topic, we are joined by Patricia Braun, MD. Dr. Braun is a primary care pediatrician at Denver Health, as well as a professor of pediatrics at the University of Colorado School of Medicine. She is the immediate past chair of the Section on Oral Health for the American Academy of Pediatrics, and her research focuses on oral health outcomes and program evaluation. She also currently directs the Rocky Mountain Network for Oral Health Integration.

Some highlights from this episode include:  

How to understand the dental divide
Ways this divide leads to poor oral health for children
Options for the medical community to combat these barriers
What primary care providers can look for in their visits with patients

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Turning Tragedy into Triumph Apr 23, 2024

When you work in neonatology, you are surrounded by babies. You’re regularly meeting new parents in the Neonatal Intensive Care Unit, some who are living the best days of their lives, and others who are experiencing the very worst. But as a doctor, you never expect to become the patient. We go beyond the white coat in this episode with a story of tragedy and personal discovery from Laurie Sherlock, MD, that changed how she interacts with her patients and practices medicine. “I’ve been gifted through the accident and my son’s death. I’ve been gifted so much compassion for what our families are going through. I think my bandwidth is so much higher because it’s so easy for me to put myself in their shoes,” says Dr. Sherlock.

Dr. Sherlock specializes in neonatal and perinatal pediatric medicine at Children’s Hospital Colorado and is an assistant professor of pediatrics and neonatology at the University of Colorado School of Medicine. Mostly importantly, she is a survivor who is using her own narrative to help others.

Some highlights from this episode include:  

Dr. Sherlock’s personal story and the impact it’s had on her career
Using personal experience to be a better doctor
Tapping into compassion at the bedside
Advice for patients and families experiencing tragedy

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Spine Surgery Innovations: Advancing Treatment with Technology Apr 16, 2024

Innovations and techniques to enhance spinal surgical care, and support patient- centric outcomes, have made big strides in the last decade. Technology like surgical robots, 3D printed models customized to the patient, and a new procedure called vertebral body tethering are just a few examples of the many incredible advancements.

Two leading experts on scoliosis surgery at Children’s Hospital Colorado join us to discuss these impressive changes and how they are impacting patient care. Mark Erickson, MD, is the medical director of the Children’s Hospital Colorado Spine Program, as well as a specialist in orthopedic surgery. He’s also a professor of pediatrics at the University of Colorado School of Medicine. Sumeet Garg, MD, a pediatric orthopedic specialist, is the quality and safety director for the Spine Program, as well an associate professor at the University of Colorado School of Medicine.

Some highlights from this episode include:  

An orthopedic surgeon’s approach to spinal surgery and how it’s evolved over time
How surgery can improve a patient’s quality of life
A look at new, customized patient approaches
How the use of robotics is advancing treatment
What’s on the horizon in spine surgery innovation

For more information on Children’s Colorado, visit: childrenscolorado.org.   

The Lowdown on Tongue Ties: Breaking Down Fact Versus Fiction Apr 09, 2024

When babies enter the world, there’s a plethora of diagnoses providers need to look out for. Some are simple fixes, while others are a bit more complicated. When parents take their kids home, how should they know what to keep an eye out for?

In this episode, we explore one potential diagnosis for an infant: tongue ties. How can you tell if a baby has one, and if they do, when should it be fixed? Looking at the concerns and consequences of tongue ties is important in making a decision on how to treat it. 

To provide guidance in making these decisions, Soham Roy, MD, is our guest for this episode. Dr. Roy specializes in pediatric otolaryngology at Children’s Hospital Colorado, and he’s a visiting professor of otolaryngology at the University of Colorado School of Medicine. 

Some highlights from this episode include:  

How to identify a tongue tie and variability in diagnoses 
Why tongue ties are controversial  
Identifying fact versus fiction in understanding tongue ties 
The upsides and downsides of the tongue tie procedure 
How providers can learn more

For more information on Children’s Colorado, visit: childrenscolorado.org.   

Care for Cleft Lip and Palate: The Commitment Spanning a Patient’s Lifetime Apr 02, 2024

The care of children with cleft lip and palate spans an entire lifetime. It requires methodical care with a multidisciplinary team, and a special emphasis on the family. Integration with a child’s pediatrician, medical home and their loved ones is key. While the oral cleft is the most common craniofacial malformation in a newborn, the three main types differ vastly.

We are in for a treat with the guest for this episode. We are joined by a gifted plastic surgeon who has traveled the world to perform these life-changing surgeries and bring smiles to everyone involved. Phuong Nguyen, MD, specializes in plastic and reconstructive surgery here at Children’s Hospital Colorado. In addition, he is the associate vice chair of global surgery, chief of plastic surgery, co-director of the cleft lip and palate program and a professor of surgery at the University of Colorado School of Medicine.

Some highlights from this episode include:

Prevalence and diagnosis of cleft lip and palate
The role of the pediatrician or PCP throughout the lifespan of these patients
Understanding if treatment is unique per patient
Global impact of specialists, like Dr. Nguyen, traveling to treat patients

For more information on Children’s Colorado, visit: childrenscolorado.org

A Solution to Sickle Cell: New Gene Editing Therapy Could Lead to a Pain Free Life Mar 26, 2024

You’ve likely heard of CRISPR, the comprehensive gene editing technology that emerged in the 2010s and has since revolutionized biological research. Additionally, the medical community has long been using the concept of gene therapy. What’s new is that both approaches have now successfully been harnessed for the treatment of human disease. In December 2023, the FDA approved two therapies for the treatment of sickle cell disease; one utilizing CRISPR technology and the other using a gene transfer therapy approach. These therapies now have the opportunity to change the life course of this terrible disease.

Our guest for this episode is Christopher McKinney, MD, who specializes in pediatric hematology here at Children’s Hospital Colorado. Dr. McKinney has been the hospital’s site principal investigator in some of the clinical trials that are contributing to these new sickle cell therapies, and he is an assistant professor of pediatrics at the University of Colorado School of Medicine.

Some highlights from this episode include:

How these treatments work for diseases like sickle cell
What we know about the effectiveness of these therapies thus far
Important side effects and risks to take into consideration
Regardless of FDA approval, what barriers are in place
Powerful patient examples

For more information on Children’s Colorado, visit: childrenscolorado.org

We’ve Hit 2 Million Lifetime Downloads! 3 Million, Here We Come Mar 21, 2024

In its 7th season, Charting Pediatrics has hit 2 million lifetime downloads! What an accomplishment. Our podcast team wants to thank each of you, our listeners, for tuning in each week to learn about the latest and greatest in pediatric healthcare. This accomplishment would not be possible without each of you, and we are thrilled to have you on this journey. 2024 has a lot of unique opportunities in store. Get ready for more content, new ideas, and further educational opportunities.

In this special episode, our hosts, David Brumbaugh, MD, Alison Brent, MD, and Dan Nicklas, MD, reflect on the growth of this podcast and the advancements that have happened since its inception. “And I am 100% convinced that we are, right now, in what will eventually be referred to as a golden era of pediatric medicine in terms of developing new treatments,” Dr. Brumbaugh says.

Here’s to 2 million more lifetime downloads, with listeners who are changing the realm of pediatric medicine every day. Thank you for all that you do!

For more information on Children’s Colorado, visit: childrenscolorado.org

Advocating for Health Successes: Filling Gaps with Patient-Family Engagement Mar 19, 2024

Children and their families need a healthcare system that serves them wholeheartedly. Having their unique needs prioritized creates an important opportunity for lifelong health and wellbeing. However, the current health system in our country and globally has massive gaps to fill, especially as it pertains to children of color. The medical community is focusing on preventative measures and connections between children, families, communities and the systems they interact with regularly. While large efforts are being made across the child healthcare field, there is strong agreement that child health transformation, with a focus on family -centered pediatric care, needs to be accelerated.

At the forefront of this work is Hala Durrah, MTA, a patient-family engagement consultant and advocate. Joining us virtually from San Marcos California, she discusses her role on the advisory group of national experts in the pediatric field of accelerating child health transformation initiative. She also has professional experience as a national speaker who has served on a number of national committees. Beyond her professional accomplishments, this topic resonates with her much more personally. Her current work in patient-family-centered care stems from her experiences as a mother of a child who has undergone two liver transplants and a bone marrow transplant. “What I realized when I first knew my daughter was sick, was that this was going to be a journey that required me to be as fully knowledgeable and as fully engaged as possible to advocate for her,” Durrah says.

Some highlights from this episode include:

How providers and practices can partake in this work
The importance of acknowledging patient-family engagement to best care for kids
What gaps exist and how this method helps to fill them

This episode is underwritten by Aegon Transamerica Foundation, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Aegon Transamerica Foundation helps build a better world by committing to the improvement of wellness throughout their communities. Their partnership with Children's Colorado addresses the youth mental health crisis to help create a better mental health future for children. Thank you to Aegon Transamerica Foundation for investing in Children's Colorado.

For more information on Children’s Colorado, visit: childrenscolorado.org

Mitigating Misinformation and Changing the Narrative: Allergies in the Media Mar 12, 2024

Facts and fiction can overlap in movies and television. That’s especially prevalent in medical dramas where the details seem so real but often don’t portray the full picture. While the intention may be to create powerful entertainment, sometimes a storyline can misinform the viewer. Unrealistic circumstances, overexaggerated outcomes and the bending of scientific truth, create confusion. When it comes to food allergies, how a situation is handled can be the difference between a routine medical occurrence and a lifesaving episode. “This is where we see some really dramatic portrayals because you generate that emotional kind of connection and we see it both from how reactions are portrayed inappropriately or very severe consequences or frankly people make fun of food allergies a lot,” David Stukus, MD, says.

In this episode, we dig into how portrayals in the media landscape can impact patient families in the medical community. We are joined by Dr. Stukus, who is otherwise known as the allergy kids doc on social media. Dr. Stukus is the director of the Food Allergy Treatment Center at Nationwide Children’s Hospital, as well as a professor of clinical pediatrics in the division of allergy and immunology. In addition, we have Vivian Hernandez-Trujillo, MD, with us. Dr. Hernandez-Trujillo is the director of the Division of Allergy and Immunology at Nicklaus Children’s Hospital, as well as a clinical professor of pediatrics at Florida International University Herbert Wertheim College of Medicine. These two doctors are at the forefront of important conversations for change. “I honestly think education is just important. Once we’re armed with accurate information, that’s powerful. I can speak as a patient, as a mom of two girls with food allergies, and as someone who is a physician for patients with food allergies, my cup is always half full,” Dr. Hernandez-Trujillo says.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:

Common examples of allergy inaccuracies within media
The narrative around nut allergies
How we remove the stigma around allergies and change how they are portrayed
Undoing outdated practices and updating our information

For more information on Children’s Colorado, visit: childrenscolorado.org

A True Icon of Pediatrics: The Career and Legacy of Barton Schmitt, MD Mar 05, 2024

As doctors, curiosity can be the driving factor to a long, successful, and fulfilling career. It can be the difference between daily repetition and years of practicing evolved education. For Barton Schmitt, MD, curiosity has been a transformative force for over 50 years, influencing his approach to teaching residents, patient encounters and career development. Otherwise known as a true icon of pediatrics, Dr. Schmitt’s humble, down-to-earth nature helped create one of the most prestigious pediatric guidelines in our industry. “Feedback from a variety of sources is really the life blood of all of this. At least 100 to 150 of the protocols are updated every year,” Dr. Schmitt says.

For more than five decades, Dr. Schmitt has elevated the Children’s Hospital Colorado name while creating an honorable legacy of his own. Many of you know him as the author of the ‘Pediatric Telephone Triage Guidelines’ used in our Pediatric Call Center. Those decision-support tools are now used worldwide and have been translated into multiple languages. Throughout his career he’s had numerous other titles such as the Faculty Attending for the Child Health Clinic and the medical director of the Child Protection Team. Now on the brink of his next chapter, we reflect on his incredible legacy and find out what’s next.

“I’m hoping to retire when I’m 90. I’ve got to because I have other things I want to do, including some books I want to write about teaching residents,” Dr. Schmitt says.

Some highlights from this episode include:

Details about the creation and expansion of the Pediatric Telephone Triage Guidelines
The impact that curiosity has had on his career
His hopes for the future
Advice for doctors, nurses and medical professionals

“Continual quality improvement is a team sport," Dr. Schmitt says.

Dr. Schmitt wants to thank the many health care professionals who help him keep the pediatric telehealth guidelines, parent handouts and symptom checker up-to-date. Most of all, his dedicated pediatric editorial team:

Medical editors: Sam Wang, MD, and Julia Bruckner, MD.
Nurse editors: Kelli Massaro, RN and Lisa Swerczek, RN.
Specialists at Children’s Colorado, who provide expert reviews of new topics.
The many triage nurses who have worked in the Children's Colorado call center since 1988 and made observations that led to change.
David Thompson, MD FACEP and the Adult Editorial Team
The nurse leadership at over 40 other U.S. and Canadian call centers who provide the annual user feedback that keep the guidelines reality-based and evolving.

For more information on Children’s Colorado, visit: childrenscolorado.org

Merging Medicine and Storytelling: How Digital Content Can Change Outcomes Feb 27, 2024

Digital content is at the center of our society and its prevalence continues to grow. Storytelling on digital platforms allows the medical community to showcase groundbreaking research and connect with audiences, who otherwise may not be privy to this information. Experts like Joshua Williams, MD, are at the forefront of some of this innovation. In October 2023, he received the Advancement in Research Award at the American Academy of Pediatrics National Conference.

Dr. Williams is an assistant professor of pediatrics at the University of Colorado School of Medicine, as well as a practicing primary care pediatrician with Denver Health. He is the principal investigator on a National Institutes of Health grant to examine the impact of digital storytelling on influenza vaccination equity. In addition, he is a co-investigator at the Denver Health for the Centers for Disease Control and Prevention Vaccine Safety DataLink Project. “And what I hope comes from it is improvement in equity, improvement in the rate of influenza vaccination uptake in groups that historically haven’t had high uptake,” says Dr. Williams

Some highlights from the episode include:

The larger goals of these data- and digital-based projects
How to merge medicine and storytelling
Advice for young doctors and medical professionals
Finding success from rejection

Dr. Williams will be presenting on this very topic at the PAS 2024 meeting in Toronto, Canda.

For more information on Children’s Colorado, visit: childrenscolorado.org

Practices of Prescribing: Critical Learning About Generics and Biosimilars Feb 20, 2024

Pediatricians, families, and pharmacists are faced with increasing drug costs and a vast array of complex biologic therapies. Up-to-date knowledge on prescribing practice is constantly a need, specifically regarding generics and the availability of biosimilar and interchangeable biosimilar agents. According to a report from the Association for Accessible Medicines, the U.S. healthcare system saved $408 billion from using generic and biosimilar drugs in 2022, a huge jump from the $195 billion in savings accumulated in 2013. In today’s episode, we have a rare opportunity to learn critical knowledge about this topic from renowned experts in the field.

We are joined by John Routt Reigart, MD, and Dr. Siu. Dr. Reigart is professor emeritus at the Medical University of South Carolina as well as the chairperson for the American Academy of Pediatrics’ (AAP) Committee on Drugs. “I have been recognized in my state, and to some extent nationally, as being an advocate for improved health for children. I feel that it’s very important that pediatricians be advocates for effective regulations for their patients,” Dr. Reigart says.

Dr. Siu is a clinical professor, the vice chair for teaching and learning, and the director of faculty mentoring at the Ernest Mario School of Pharmacy at Rutgers University. She is a pediatric pharmacy clinical coordinator and practices at the K. Hovnanian Children’s Hospital and Jersey Shore University Medical Center. She has also been appointed to the board of directors of the Board of Pharmacy Specialties and the Pediatric Pharmacy Association liaison for the AAP Section on Clinical Pharmacology and Therapeutics executive committee. “We want to make sure that medications are easily accessible to families and we also want to make sure that they are also cost effective,” Anita Sui, PharmD, says.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:

The difference between biologics and generics
What the orange and purple books are and their roles in the industry
What an interchangeable product is
Patents and exclusivity
What savings could look like with an uptick of biologics and generics

For more information on Children’s Colorado, visit: childrenscolorado.org

Live Show: Jena Hausmann’s Life of Leadership in Pediatric Healthcare Feb 13, 2024

For the second time in Charting Pediatrics history, we brought a live audience together to watch the taping of an episode with a guest who has made an everlasting impression on our hospital system. This time, the show was for our colleagues here at Children’s Hospital Colorado. Our guest is one of the top healthcare executives within pediatric hospitals in North America. Don’t just take our word for it; she was recently selected to be the chair of the board of trustees for the entire Children’s Hospital Association. Under her leadership, Children’s Colorado has been routinely identified as one of the country’s top 10 pediatric healthcare systems. In recent years, her advocacy for greater pediatric behavioral healthcare is a notable example of her dedication to research and innovation.

In today’s episode, we welcome Jena Hausmann, the CEO and president of Children’s Colorado. “I think leaders really should be authentic and should role model, always, their true leadership self and impact. I do think it is important for any of us to see ourselves reflected in whether it’s gender or race or ethnicity or age or you name it,” says Hausmann.

Some highlights from this episode include:

Jena’s career evolution and how she landed in her current role
How to make an impression in healthcare administration
The role that mentors play in career growth
The example she aims to set for women in leadership
How Jena’s authenticity and vulnerability enhance her leadership
The trends in U.S. healthcare that will impact how we care for kids

For more information on Children’s Colorado, visit: childrenscolorado.org

Breaking Down Social Barriers: Analyzing Social Care Programs and Their Impact Feb 06, 2024

Every day, we see patients whose medical hurdles land them at hospitals like Children’s Hospital Colorado. There are many answers our providers and specialists can provide when giving patient families a medical diagnosis, but many of those same children are facing gaps and inequities socially. Often, they fall into different minority groups facing disparities in healthcare equality. Medical insurance may cover labs and procedures, but it doesn’t cover the need for food or housing. Those are just two examples of social barriers that greatly affect one’s health. While many questions remain on best practices for social care programs and how we bring them to fruition, experts, like our guests today, are working hard to use them effectively. “We can’t meet family’s needs if we don’t know what they are. So, the first step is assessing what those needs are,” says Lisa DeCamp, MD.

In today’s episode we are joined by Lisa DeCamp, MD, a practicing general pediatrician at Children’s Colorado and an associate professor at the University of Colorado School of Medicine. Her research focuses on increasing healthcare engagement of Spanish -speaking Latino families and reducing disparities in healthcare equality and safety for patients and families with limited English proficiency. Julie Beaubian is an operations manager here at Children’s Colorado within the community health department. She manages community benefits for the hospital. “So we’re constantly trying to balance what is reasonable, what does the family need and how can we continue to support that family,” Beaubian says.

Read the paper mentioned in this episode.

Some highlights from this episode include:

Outlining this Children’s Colorado social care program
How this program can influence other communities and hospitals
Social barriers and how that impacts healthcare
How we can bridge gaps for communities facing inequities

For more information on Children’s Colorado, visit: childrenscolorado.org

The Truth About Youth Vaping: Health Implications of Nicotine and Tobacco Jan 30, 2024

While considerable progress has been made in reducing cigarette smoking among our nation’s youth, the tobacco product landscape continues to evolve. It includes a variety of tobacco products, including smokeless and electronic products such as e-cigarettes. E-cigarettes entered the U.S. marketplace around 2007, and since 2014 they have been the most used tobacco product among youth. E-cigarette use, among middle and high school students, remains unacceptably high and sets youth up for lifelong nicotine addiction and the effects of toxin exposure.

In today’s episode, we are joined by Brian Williams, MD, a pediatric and adult hospitalist. He is an assistant professor of pediatrics and internal medicine at the University of Wisconsin School of Medicine and Public Health. Dr. Williams has a research interest in how we promote vaping cessation in young people. “As a resident at UC San Diego, I grew sort of tired and frustrated by seeing patients suffering complications from secondhand smoke exposure,” Dr. Williams says.

In San Diego, he founded a program that trained nurses to screen for tobacco exposure among the parents of pediatric patients. It worked, increasing screenings from 66% to nearly 100%. “The popularity of e-cigarettes is concerning, and we are seeing rising rates in both middle schoolers and high schoolers,” says Williams.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:

Why are e-cigarettes so appealing to youth
Harmful ingredients in e-cigarettes
Potential impacts on brain development
How advertising impacts behavior

For more information on Children’s Colorado, visit: childrenscolorado.org

Improving Information Accessibility: Bringing Healthcare Guidance to the Palm of Your Hand Jan 23, 2024

In a busy outpatient practice, timely access to up-to-date clinical resources is crucial to delivering evidence-based care. In the olden days, books and journal articles were the go-to method. Today, technology creates a more user-friendly method of receiving the most recent information. Say goodbye to having to order the latest edition of a book and hello to automatic updates. Our Children’s Hospital Colorado antimicrobial stewardship team, clinical effectiveness and pathways teams, along with other local and state partners have partnered with Firstline, a health technology company, to design a mobile version of our infectious disease guidance. “It is another way to bring clinical decision support directly into somebody’s hand if they are not sitting at a computer, which a lot of times you are not,” Leigh Anne Bakel, MD, says.

A technology like this can change the future of treating patients. With new information comes new treatment choices, and this app is a way to put all of that content in the palm of a provider’s hand. “It’s really about judicious use, so using the right antibiotic for the right length of time but also only in the right patient and then the right dose; I think we understand overtime that antibiotics have a lot more side effects than we previously appreciated,” Sarah Parker, MD, says.

Joining us to talk about this innovative technology are Drs. Sarah Parker and Leigh Anne Bakel. Dr. Parker is the Medical Director of the Antimicrobial Stewardship Program here at Children’s Colorado, as well as a professor of pediatrics in the Division of Infectious Diseases at the University of Colorado School of Medicine. Dr. Bakel is the Medical Director of Clinical Effectiveness here at Children’s Colorado, as well as a practicing pediatric hospitalist. She is also an associate professor of pediatrics.

Some highlights from this episode include:

How the Firstline app works
Why Firstline is beneficial for providers everywhere
How Firstline will enhance rural healthcare
The future of technology for treating patients

For more information on how to download the app visit https://firstline.org/colorado/. Drs. Parker and Bakel would like to acknowledge the brains behind this operation.

With Children’s Colorado:

Sarah Parker, MD
Leigh Anne Bakel, MD, MSc
Michael J Bozzella, DO, MS
Joana Dimo, DO
Matthew Weber, Research Assistant, MPH
Christine MacBrayne, PharmD, MSCS
Matt Miller, PharmD

With Denver Health:

Tim Jenkins, MD
Katie Shihadeh, PharmD
Maggie Cooper, PharmD

With CDPHE:

Chris Czaja, MD, DrPH
Lauren Biehle, PharmD
Rachel Schaefer, MPH

Other:

Local and regional providers, infection preventionists and pharmacists who gave feedback
Firstline
Pfizer Global Bridges Grant
Daniel Dodson, MD, MS

For more information on Children’s Colorado, visit: childrenscolorado.org

Wellness in the Workplace: How to Nurture Positive Culture and Advocate for Yourself Jan 16, 2024

In today’s fast-paced work environment, it can be easy to feel overwhelmed. Due to that intense pace, it’s important for employees and employers alike, to promote healthy working behaviors and surroundings. Healthy employees are more productive, have fewer absences, are less prone to work-related injury and are less likely to burn out. “Leading others is how you support them when they show up to work. Showing thanks, giving appreciation, valuing your staff,” Jennifer Shaer, MD, says. A 2021 survey tells us that 79% of employees believe their company’s wellbeing programs help them be productive employees, but a lot of work still needs to be done.

In today’s episode, Jennifer Shaer, MD, joins us to discuss wellness in the workplace and how to nurture a positive culture. Dr. Shaer is the Chief Wellness Officer of Allied Physicians Group in Melville, New York, as well as a board-certified pediatrician, an International Board-Certified Lactation Consultant and a certified executive and life coach. “Sometimes you just need a change in your working environment, physically. Sometimes you need a change in your internal world. I’ve worked with lots of people who have been able to change their mindset around their work and suddenly enjoy their work and extend their working years,” Dr. Shaer says. Dr. Shaer has her own podcast called ‘Reinventing the White Coat’ which you can find here.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:

How to nurture a positive workplace culture
Implementing discipline appropriately
Identifying a toxic situation
How to advocate for yourself

This episode is underwritten by Aegon Transamerica Foundation, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Aegon Transamerica Foundation helps build a better world by committing to the improvement of wellness throughout their communities. Their partnership with Children's Colorado addresses the youth mental health crisis to help create a better mental health future for children. Thank you to Aegon Transamerica Foundation for investing in Children's Colorado.

For more information on Children’s Colorado, visit: childrenscolorado.org

Safe Storage to Save Lives: The Role of Guns in Adolescent Suicide Jan 09, 2024

Suicide is the second leading cause of death for children, adolescents and young adults ages 10 to 24. Roughly 7% to 8% of adolescents attempt suicide each year and 17% report significant suicidal ideation. However, while so many kids are affected, diagnosing them isn’t so simple. “We know the numbers have climbed significantly. If you look at the trends, we’re probably nearly double what we were 20 years ago,” Eric Sigel, MD, says.

In this episode, we shine a light on how to clinically identify youth at risk for suicide and determine if they have access to lethal means, such as firearms or medications. In addition, we will discuss evidence-based approaches to reduce or eliminate access to lethal means. That includes counseling and safe storage device distribution.

Our guest, Dr. Sigel, specializes in adolescent medicine at Children’s Hospital Colorado. He is the lead for firearm injury prevention, as well as a professor of pediatrics at the University of Colorado School of Medicine. In addition, he serves as co-chair of the American Academy of Pediatrics firearm injury prevention special interest group. “I think it’s an incredible privilege to sit down with a teenager, hear their story and understand a little bit what they may be going through, while being able to help them figure out a better direction to avoid harm,” Dr. Sigel says.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:

The prominence of adolescent suicide in today’s society
Approaches to suicidal identification in a clinical setting
How a change in easy firearm access can prevent suicide
Evidence on counseling and safe storage of firearms

For more information on Children’s Colorado, visit: childrenscolorado.org

Prioritizing Pediatric Readiness: How Proper Preparedness Saves Young Lives Jan 02, 2024

One goal in our healthcare improvement is to achieve equitable access to high quality emergency care for kids, regardless of where that child is physically located. Children have unique characteristics and needs, especially in the emergency setting, and the reality is that not all kids have access to specific pediatric care. In fact, 80% of children receive emergency care in general emergency departments, most of which see less than 15 pediatric patients a day. However, care in those adult settings is not specifically geared towards children. Research shows that pediatric readiness results in lower mortality rates among sick and injured kids. Fortunately, ongoing state and national initiatives are making strides in enhancing pediatric readiness. “The first piece of this is that the focus is on system design. This is not about the failings of a single provider, or the knowledge or skill set of healthcare providers. We are only as good as the system in which we work,” Katherine Remick, MD, says.

In today’s episode we are joined by Dr. Remick as well as Kathleen Adelgais, MD. Dr. Remick joins us from Austin Texas, where she is a pediatric emergency medicine provider and an associate professor of pediatrics at the University of Texas at Austin Dell Medical School. She is also the Associate Chair for Quality, Innovation, and Outreach within the Department of Pediatrics. In addition, she is co-director of both the National EMS for Children Innovation and Improvement Center, as well as the National Pediatric Readiness Project. Dr. Adelgais is an emergency medicine physician here at Children’s Hospital Colorado and the project director of the Colorado EMS for Children Program. “There are a series of research studies coming out left and right, right now that show the real dramatic impact of pediatric readiness, Dr. Adelgais says. “The research we are getting from the rich data set of the pediatric readiness scores across hospitals, you’re hard pressed to find any treatment anywhere for anything that reduces mortality that dramatically.”

Some highlights from this episode include:

What pediatric readiness is and how we achieve it
The importance of system-level improvements
What COPPER is and how it aligns with national efforts
What the pediatric readiness score measures
Success through the data

For more information on Children’s Colorado, visit: childrenscolorado.org

A Happy and Healthy Holiday Season from Charting Pediatrics Dec 26, 2023

2023 has been an impactful year. We kicked it off by continuing to cover topics under our mental health series. The rise of teen substance abuse and addiction, the intersection between physical and mental health, as well as depression and other mood disorders are just a few of the topics we dove into. Season 6 wrapped up by discussing the trauma and care around gun violence and highlighting some incredible women in medicine.

Season 7 launched in August and if you haven’t noticed, we’ve started to make some prominent changes. Our audio is sharper, our show notes are more robust, and our attention to detail is more precise. We are taking all of these positive changes into 2024 and are excited to show you what else we have in store.

This episode was an opportunity to get all our hosts together, Drs. David Brumbaugh, Alison Brent and Dan Nicklas, and end 2023 the right way!

From all of us at Charting Pediatrics and Children’s Hospital Colorado, we wish you and your families a happy and healthy holiday season and New Year. Thanks for listening, we will see you next year!

Patient Information in a Changing Legal Landscape: Cures Act, Open Notes and Electronic Medical Records Dec 19, 2023

In 2021, federal rules from the 21st Century Cures Act mandated that most clinical notes be made available in real-time, online and free of charge to patients. This practice, commonly known as “open notes,” was a significant step towards enhancing medical information transparency–– a vital step in reinforcing trust in the provider-patient relationship. However, it also introduced complexities, raising questions as to what to include in the notes. “The ethical analysis does not always align with the legal analysis, and these are conversations that ethicists are aware of,” Steven Bondi, MD, JD, says.

Dr. Bondi, a lawyer turned doctor, is renowned for his expertise on the Cures Act, Open Notes and Electronic Medical Records. He specializes in pediatric medicine at Golisano Children’s Hospital and is an associate professor within the Department of Pediatrics at the University of Rochester Medical Center. “I think that knowledge is important, and we need to know what the law says and what its parameters are and when we can use the exceptions,” Dr. Bondi says.

Dr. Bondi recommends multiple resources on this topic. He suggests visiting healthit.gov and navigating to their information blocking section for informative FAQs and webinars. He also recommends the Guttmacher Institute as a source for general knowledge around adolescent health and privacy. Lastly, he explains that he was recently a part of the American Academy of Pediatrics’ committee on medical liability and risk management where he helped produce a monthly column called ‘Pediatricians in Law.’

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:

How to navigate difficult situations and avoid labels
The role that ethics play in this discussion
Confidentiality in adolescents by state
Biggest pitfalls and gray areas

Disclaimer: Please note that Dr. Steven Bondi is not an attorney for Children’s Hospital Colorado and the information presented in this podcast does not constitute legal advice. Regarding interpretation or application of any of the laws and regulations referenced in this episode, it is recommended that you consult with legal counsel familiar with the laws and regulations applicable to your particular jurisdiction and/or service area.

For more information on Children’s Colorado, visit: childrenscolorado.org

Critical Vaccine Communication: How Do We Shift Immunization Hesitancy? Dec 12, 2023

Vaccines are so successful that many people have never seen the diseases they prevent, resulting in misperceptions that vaccines are not needed. While anti-vaccination sentiment and misinformation increased during the COVID-19 pandemic, about 88% of Americans still say they feel the overall benefits of childhood vaccines outweigh the risks. Communicating vaccine science to the public is even more crucial than in times past. It’s up to our doctors and medical experts to relay factual information that is backed by science and supported by research. Without receiving proper vaccinations, preventable diseases will keep recurring.

In today’s episode, we are joined by Paul Offit, MD, whose path toward infectious disease prevention started at the young age of 5 when a failed foot operation landed him in a hospital in suburban Baltimore for nearly six weeks. “If you’re in a chronic care facility in the mid 1950s, because I was born in 1951, you’re in a polio ward. So, I remember that,” Dr. Offit says.

Now Dr. Offit is a professor of vaccinology at the Perelman School of Medicine at the University of Pennsylvania. He is an attending physician in the division of infectious diseases at Children’s Hospital of Philadelphia, as well as the director of the Vaccine Education Center. “I think the scars of our childhood invariably become the passions of our adulthood. I think it’s the reason I became a doctor, I think it’s the reason my first book was about polio and the polio vaccine, I think it’s why I went into infectious diseases,” Dr. Offit says.

This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition in Washington, DC. Some highlights from the episode include:

Reasons why people have become so hesitant about vaccines
Some of the biggest misconceptions and stigmas around vaccine science
Why we need more societal trust in vaccines
The role of mRNA
How we can use communication to better our future

For more information on Children’s Colorado, visit: childrenscolorado.org

Specifically Specialized Treatment: How Precision Medicine is Revolutionizing What’s Possible Dec 05, 2023

For most of our careers, our treatments for genetic -based diseases have been supportive, not curative. Our medication recommendations for patients have been based on the expected response of the average individual, but as experts explain, these practices are going to change fast. We are on the cusp of a revolution for two main reasons. First, the ability to understand one’s unique genetic profile through genetic sequencing has become more accessible to clinical teams. Second, there are now mechanisms for manipulating one’s genetic code to overcome diseases. So what does this mean we can expect over the next decade? Scott Demarest, MD, shares his experience in precision medicine and what that foreshadows for treatments to come. “This is sort of the most extreme version of personalized care that you can imagine and it was something that redefined what we think of as possible within medicine,” Dr. Demarest says.

Dr. Demarest is an associate professor of pediatric neurology at the University of Colorado School of Medicine and the clinical director of the Precision Medicine Program at Children’s Hospital Colorado. He’s a perfect expert for this topic, as his research has focused on the characterization of clinical features and clinical trial design for disease -modifying treatments, as well as the development of novel precision therapies for epilepsy and neurogenetic conditions. “I think it’s really important that we embrace the genomic era but that we do it very carefully and responsibly,” Demarest says.

Some highlights from this episode include:

Explanation of precision medicine
What types of treatments have evolved over time that allow us to manipulate someone’s genetic code
Current barriers to more regular use of precision medicine
How ethics play a role in this specified type of medicine
Experience designing a treatment for one individual patient

For more information on Children’s Colorado, visit: childrenscolorado.org

The Power of Pediatric Trainees: How They Can Help Shape Medicine Nov 28, 2023

Our medical community stretches far and wide, with experts that wear many hats. One prevalent group making an impact on the future of childhood medicine is our pediatric trainees. In 1989, the American Academy of Pediatrics (AAP) founded the Section on Pediatric Trainees with a goal to empower and enable pediatric trainees to be strong leaders and advocates for the health and well-being of children. This group aims to be the central source of information, education, and networking for their peers. With over 16,000 members to date, medical students, residents, and fellowship trainees are learning to make a difference in the lives of each child they work with. We recorded this episode at the 2023 AAP National Conference and Exhibition, which couldn’t have served as a more perfect place to discuss this topic. “For the medical students listening out there, if you have any interest or if you think you know what specialty you’re interested in, just going to these conferences and getting plugged in with these organizations really opens your eyes to a lot of networking opportunities,” Amundam Mancho, MD, MPH, says.

Today we are joined by Dr. Mancho, a resident physician at Boston Children’s Hospital and Boston Medical Center. She also leads the Section on Pediatric Trainees as the executive coordinator on equity, diversity, and inclusion, or DEI. DEI work is central to her advocacy, and she hopes to expand opportunities for other students making their way through their medical education. “We want trainees to feel like even though that representative isn’t necessarily there, that people feel empowered they feel culturally competent and also have that understanding to recognize differences that our patients bring to the space,” Dr. Mancho says.

Some highlights from this episode include:

How DEI plays a role within the Section on Pediatric Trainees
Exposing medical students and residents to advocacy opportunities within pediatrics
The benefits organizations like AAP can provide for medical students

For more information on Children’s Colorado, visit: childrenscolorado.org

Remarkable RSV Vaccines: Is This the End of the RSV Burden As We Know It? Nov 21, 2023

Respiratory Syncytial Virus (RSV) is one of the most common causes of childhood respiratory illness, resulting in annual outbreaks among all age groups. In the United States, an estimated 60,000 to 80,000 children, the majority of whom are under 6 months of age, are hospitalized each year. Approximately 100 to 300 kids die from this infection each year. RSV is the single most common cause of death from respiratory illness, after the newborn period, in developing countries. This year, the medical community has made history with the first RSV vaccine approvals for pregnant individuals, infants and the elderly. In this episode, we are taking a deep dive into RSVpref, which is the first RSV vaccine for use in pregnant individuals to protect newborns and infants from severe RSV in the first six months. We are also discussing nirsevimab, a monoclonal antibody, which protects infants and some children against RSV. That includes children 8 –19 at increased risk for severe disease. This is a significant milestone for the scientific community and for public health. “I think now, in another two or three years, we will decrease ER visits, we will decrease hospital visits and I hope we decrease ICU visits. And the next phase of course, hopefully in my lifetime, we get it into developing countries and see impacts on mortality,” Eric Simoes, MD, says.

Dr. Simoes has been a part of the creation of these vaccines since the beginning and is our guest for this highly requested topic. He is a clinical professor of pediatrics and infectious disease at the University of Colorado School of Medicine, as well as a professor of epidemiology at the Colorado School of Public Health. He is currently an active clinical infectious disease physician at Children’s Hospital Colorado. Of important note, Dr. Simoes served as the global primary investigator for the RSVpreF and lead investigator for the development of nirsevimab.

Some highlights from this episode include:

How these vaccines received approval and became available on market
Indications to delivering this vaccine to a pregnant person
Benefits of receiving these vaccines
The future of this vaccine and its impact on people of different ages

For more information on Children’s Colorado, visit: childrenscolorado.org

Managing Menstruation Abnormalities: How We Treat and Recognize These Common Issues Nov 14, 2023

The preteen and teenage years are taxing and have become increasingly difficult for a multitude of reasons. This is a part of the patient population that pediatricians really worry about. Part of the angst of this time of life has always been the changes that occur to kids’ bodies as they grow – particularly for young girls. This experience is different as they experience menarche, the onset of menstruation, which can be both psychologically and physically challenging. Menstrual irregularities are very common, occurring in an estimated 14% to 25% of all women of childbearing age. Many gynecologic conditions diagnosed during childhood require treatment that extends into adulthood and it’s hard to stay abreast of all the new therapies and hormonal management strategies of menstruation. “When you can really connect with a teen who is so vulnerable so has just been struggling that recognizes that this is normal, that they are not alone, and that we can help, that’s pretty great,” Tricia Huguelet, MD, says.

Today we are joined Dr. Huguelet, a pediatric and adolescent gynecologist at Children’s Hospital Colorado. While she didn’t always plan for this career route, she developed a love for pediatrics from an early age. She fondly reflects on her memories going on rounds with her father who was a pediatrician focusing on pediatric infectious disease. Combining her love for children with her passion for surgery, she has become the section chief of pediatric and adolescent gynecology at Children’s Colorado, as well as a faculty member in the OBGYN department at the University of Colorado School of Medicine. “When I discovered that not only could I do reproductive care for women but then specifically focus in kids and teens it was a no brainer that that was where I was going to focus my time,” Dr. Huguelet says.

Dr. Huguelet explains how menstrual abnormalities are not just physically demanding, but can create a strain on mental health. “I mean I’ve had patients with bleeding disorders who we send letters to school and they still aren’t excused. So just the embarrassment over that and day to day life when you don’t want to talk about it, you certainly don’t want to show it, has a tremendously negative impact,” Dr. Huguelet says.

Some highlights from this episode include:

Most common menstrual abnormalities in children
How to normalize these conversations between kids and parents
Management and treatment of these abnormalities
Mental health impacts from menstruation abnormalities

For more information on Children’s Colorado, visit: childrenscolorado.org

A Career of Impressive Care: Highlighting the Leadership of David Keller, MD Nov 07, 2023

We live in a country where medical experts are breaking barriers and changing outcomes on a daily basis, so it’s always exciting when we get to celebrate one of our own. Recorded at the 2023 American Academy of Pediatrics (AAP) National Conference and Exhibition in Washington, D.C., this episode honors David Keller, MD, who was recently named the recipient of the 2023 AAP Job Lewis Smith Award. “I want to be a part of the solution to problems,” Dr. Keller says.

The award recognizes lifelong outstanding career achievement in community pediatrics and is the highest award bestowed by the council. Dr. Keller has dedicated more than 40 years to advancing child health and he currently serves as the Department of Pediatrics Vice Chair of Clinical Strategy and Transformation at Children’s Hospital Colorado. “We as pediatricians need to remember that children always live in context. There is no such thing as an isolated child. They live in the context of their families, but they also live in the context of their communities. If we don’t understand the communities that our kids live in, then it’s really challenging to understand how illness interacts with that community and how you can intervene,” Dr. Keller says.

Some highlights from this episode include:

Dr. Keller’s early career influences
How he earned this prestigious award
How we learn more about the context of our patients
Advice for young doctors and medical professionals trying to make their own imprint

For more information on Children’s Colorado, visit: childrenscolorado.org

The Truth About Ticks: How Vector-Borne Diseases Can Affect Humans Oct 31, 2023

In the United States, 77% of vector-borne diseases are transmitted by ticks and numbers have increased dramatically in recent decades. While Lyme disease may be the most common in the country, with an estimated 475,000 new cases each year, there are many other vector-borne diseases affecting people every day. Information is constantly shifting related to current and predicted changes in the epidemiology of tick-borne diseases, age -specific clinical and laboratory manifestations, as well as treatment. In addition, there are many public misconceptions regarding vector-borne infections and approaches to infection. What is the risk of labeling someone as having Lyme disease and possibly missing the true diagnosis? We answer that question and many more on today’s episode. “When we think about tick-borne infections, I always like to focus on the tick, the organism that it transmits to and then on the disease process,” Lourdes Eguiguren, MD says.

This episode was recoded at the 2023 American Academy of Pediatrics National Conference and Exhibition in Washington, D.C., which provided us an opportunity to speak with experts in- person from across the country. As an infectious disease expert with a focus on tick-borne infection at Children’s Nebraska, Dr. Eguiguren is here to share her knowledge. She is an assistant professor in the division of infectious diseases at the University of Nebraska Medical Center. She has a passion for teaching trainees and connecting with her patients on a personal level. “Many times, we actually come up with a differential diagnosis or even the final diagnosis by talking to parents”, Dr. Eguiguren says.

Some highlights from this episode include:

Key details about Lyme disease
How disease is transmitted from tick to organism
The impact of climate change on the prevalence of ticks
Breaking down misconceptions about vector-borne infections
What treatment options look like

For more information on Children’s Colorado, visit: childrenscolorado.org

Investing in Early Hearing Intervention: The Importance of Newborn Audiology Screening Oct 24, 2023

For parents expecting a newborn, their top priority is bringing a healthy baby into this world. But it’s not just their responsibility while their baby is in the womb. As newborns, important screenings are changing health outcomes. Over 98% of U.S. newborns are screened for hearing loss and about 6,000 U.S. infants born are identified early with a permanent hearing loss. In all 50 states and Washington D.C., there are newborn screening laws to make sure these tests happen. Experts say they are crucial to keep at the forefront of newborn care. It’s doctors like Owen Darr, MD, whose passion is helping these kids live the best life possible. “Working with families, helping them through a difficult time, finding interventions –– sometimes small, sometimes big –– that can really make a positive impact on a child’s life,” Dr. Darr says.

In today’s episode, we are joined by Dr. Darr and Kristin Uhler, PhD. Dr. Darr specializes in otolaryngology at Children’s Hospital Colorado. He is also an assistant professor of otolaryngology, head and neck surgery. Dr. Uhler is an audiologist at Children’s Colorado, as well as an associate professor of physical medicine and rehabilitation. Dr. Uhler explains that 1998 was the year experts provided the efficacy for newborn screening. “Where they realized if you screen a baby by 1 month of age, you then rescreen them at and diagnose them with either hearing loss or normal hearing by 3 months of age, and then enroll them in early intervention by 6 months of age, that they have language on par with their typical hearing peers by preschool,” Dr. Uhler Says.

Some highlights from this episode include:

Why we screen newborns and what we are screening for
Sensitivity and specificity of the hearing test
Intervention options to help children with hearing loss
When physicians should refer kids for a hearing test

Today’s episode is underwritten by the Daniels Fund, in recognition of their longstanding commitment to the Bill Daniels Center for Children's Hearing at Children's Hospital Colorado. Cable television pioneer Bill Daniels suffered hearing loss traced to his service as a decorated fighter pilot in World War II. His experience formed a strong catalyst for the Daniels Fund's gifts to support Children's Colorado, since 2005. Thank you to the Daniels Fund for continued investment in Children’s Colorado to help children who are deaf or hard-of-hearing receive the care that they need to grow into healthy and dynamic citizens.

For more information on Children’s Colorado, visit: childrenscolorado.org

Working Across Language Lines: Highlighting Pediatras en Línea and Its Importance Oct 17, 2023

We have listeners all over the world, many of whom are Spanish-speaking. Did you know we have a sister podcast, Pediatras en Línea? It stands out as one of the only podcasts in Spanish that focuses on medical education. About two and a half years ago, Pediatras en Línea launched and became a critical resource for pediatricians all throughout the U.S. and Latin America. Fast forward to today, they are growing 277% per month and have audience members in 90 countries. In 20 of those countries, Spanish is the official language.

In this episode, we are joined by the host of Pediatras en Línea, Carla Torres-Zegarra, MD. Dr. Torres-Zegarra is a pediatric dermatologist at Children’s Hospital Colorado and assistant professor of dermatology and pediatrics at the University of Colorado School of Medicine. Born and raised in Lima, Peru, Dr. Torres-Zegarra moved to the U.S. in 2009 to pursue medical school and has been practicing at Children’s Colorado since 2013. She says being able to work here at Children’s Colorado is a dream. “Now I feel the need to give back to the people that have allowed me to have this opportunity by being a resource and even an inspiration for those who are listening outside of the states,” Dr. Torres-Zegarra says.

About 42.5 million people in the U.S. speak Spanish, and that number increases to more than 457 million worldwide. However, when we specifically look at the medical profession, only 6% of physicians identify as Hispanic and just 2% of non-Hispanic physicians are Spanish-speaking. Of that 6%, Dr. Torres-Zegarra highlights that only 2.4% are female. Through her podcast, she hopes to inspire other Spanish-speaking women to become physicians. “I am just one of them, and I am very happy to be one of them,” Dr. Torres Zegarra says.

Some highlights from today’s episode include:

An overview of Pediatras en Línea
The power of social media
Challenges faced by overseas-trained doctors when relocating to the U.S.
How these podcast episodes allow pediatricians to always learn something new

For more information on Children's Colorado, visit: childrenscolorado.org

Saving Lives from Day One: Celebrating 60 Years of Newborn Screening Oct 10, 2023

Miracles happen every day and it’s an honor when we can celebrate them. This year marks the 60th anniversary of the start of newborn screening in the United States. The program identifies infants with specific genetic conditions that are asymptomatic at birth and ensures they can receive prompt, lifesaving medical interventions. Over its lifespan, the program has saved countless lives. New research and technological advancements have allowed for innovation and enhanced abilities to screen for certain disorders. Today, newborn screening has evolved into one of the most effective public health programs in the country and its impact won’t stop anytime soon. On this 60th anniversary, experts are celebrating successes while still trying to improve current processes. “False positives are the Achilles’ heel of newborn screening. I know we always think about not missing a case, but the harms are almost all associated with telling a parent their child is positive when they aren’t. Some of these treatments are time critical,” says Ned Calonge, MD, one of our guests on today’s episode and the Chief Medical Officer for the Colorado Department of Public Health and Environment.

Dr. Calonge is joined by Stacey Martiniano, MD, a physician here at Children’s Hospital Colorado and Gregory Bonn, the Colorado newborn screening program manager. They are three experts behind some of the early intervention that ensures every child can live the healthiest life possible. “My favorite part is helping them stay as healthy as possible, live full lives and keeping that relationship with them throughout their childhood and young adulthood,” Dr. Martiniano says.

Some highlights from today’s episode include:

Variations of newborn screening programs in different states and countries
How technology has advanced what's possible to identify and treat
The history of how the program was created
What's on the horizon for newborn screening

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Modernizing Medical School: How a Clinical Curriculum is Changing Student Success Oct 03, 2023

During the 2022-2023 admission cycle, about 22,700 students enrolled in medical school in the United States. In this country alone, we have 154 medical schools offering an MD program. Many of these schools are actively working to incorporate modern learning principles into their structure. It’s all a part of a larger goal to align the forces affecting the delivery of care with educational priorities. Over time, comprehensive care has become a widely accepted standard for modern medicine; it puts positive patient outcomes at the forefront. That’s why creating those environmental opportunities are crucial to medical students as they prepare for a long career at the bedside. A Longitudinal Integrated Clerkship, or LIC, is a clinical curriculum in which students participate in the comprehensive care of patients over time. “LIC students have been found to experience lasting improvements in their patient centeredness, in their empathy, and also student satisfaction is higher,” says Amy Grover, MD, an assistant professor of pediatrics and pediatric hospital medicine.

Patient-student relationships are at the heart of LICs. We see these across the scope of medical education worldwide, but there is something unique about the LIC model here at Children’s Hospital Colorado. Dr. Grover is a guest on today’s episode, along with Meghan Treitz, MD, an associate professor of pediatrics and general pediatrics, and Margie Rodgers, an LIC coordinator. “One of the advantages of this model is students get exposure to the clinical world earlier and also at the end of their second year have had exposure to all of the core disciplines so planning for residency and career is actually made a little bit easier,” Dr. Treitz says.

Some highlights from this episode include:

What an LIC is and how it works
The advantages of an LIC curriculum compared to other medical education practices
How students learn every discipline through an LIC in a pediatric hospital setting
Stories about unique patient care experiences from students

Articles referenced in the podcast:

Hirsh DA, Ogur B, Thibault GE, Cox M. "Continuity" as an organizing principle for clinical education reform. N Engl J Med. 2007 Feb 22;356(8):858-66

Hirsh et al. Better learning, better doctors, better delivery system: possibilities from a case study of longitudinal integrated clerkships. Med Teach 2012;34(7):548-54.

Walters, et al. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ 2012; 46: 1028-1041

Poncelet, et al. Development of a longitudinal integrated clerkship at an academic medical center. Med Educ Online 2011; 16: 5939.

Hirsh D, Gauberg E, Ogur B, et al. Educational outcomes of the Harvard Medical School—Cambridge integrated clerkship: a way forward for medical education. Acad Med. 2012;87:643-50

Teherani, et al. Outcomes of Different Clerkship Models: Longitudinal Integrated, Hybrid and Block. Acad Med 2013; 88: 1-9

Gaufberg E, Hirsh D, Krupat E, et al. Into the future: patient-centeredness endures in longitudinal integrated clerkship graduates. Med Educ. 2014;48:572-82.

Flick RJ, Adams JE. Alliance, trust, and loss: experiences of patients cared for by students in a longitudinal integrated clerkship. Acad Med. 2019

Beard AS, Candy AE, Anderson TJ, Derrico NP, Ishani KA, Gravely AA, Englander R, Ercan-Fang NG. Patient satisfaction with medical student participation in a longitudinal integrated clerkship: a controlled trial. Acad Med. 2020. 95(3):417-424.

McKenna et al. The missing link: connection is the key to resilience in medical education. Acad Med 2016

Wald, Hedy S. PhD Professional Identity (Trans)Formation in Medical Education, Academic Medicine, 2015

For more information on Children’s Colorado, visit: childrenscolorado.org

From Podcast to Paw-cast: How Medical Dogs Can Greatly Impact a Child's Health Sep 26, 2023

The relationship between a child and their furry friend is a very special one, especially when that relationship benefits their physical and mental health. A growing body of evidence demonstrates that animal-assisted therapy helps children cope with and heal from health problems. In addition, we know that interacting with a gentle, friendly pet can decrease pain, reduce anxiety, and encourage communication. A new randomized, controlled study is shining a light on the powerful child-canine connection, telling us that twice weekly sessions with a dog and its handler significantly lowers children’s cortisol levels. Here at Children’s Hospital Colorado, we’ve seen that progress happen in real-time with our Medical Dog Program, and the success of this work is just getting started. “There are those things that you can measure, but then there are the pieces about just knowing for families or hearing from them they couldn’t have coped with the hospitalization if it wasn’t that Halo was a part of their journey,” says Devin Devlin, a medical dog handler and child life specialist at Children’s Colorado.

Devlin, along with Brianne Newman, another medical dog handler and child life specialist, are our guests on today’s episode. However, for the first time in our Charting Pediatrics’ history, they are joined by two special guests, facility dogs Halo, MD, and Galaxy, MD. You may be wondering: Dogs can become medical doctors?! While that would be awesome, the MD for these two stands for medical dog. Devin is the primary handler for Halo, MD and Brianne is the secondary handler for Galaxy, MD. These two beautiful, fluffy golden retrievers turn 6 on October 1st, 2023.

Devin and Brianne are constantly in awe at the impact these dogs make and are so excited to help share their story with our listeners. One patient even named their newborn baby after Halo! They say being on the end of their leashes as they change kids’ lives is a sheer privilege. “I’m going to get a little choked up when I say this because the kids here are so brave, and so getting to watch them, what they go through and what they’re able to accomplish is just incredibly rewarding,” Brianne says.

Some highlights from today’s episode include:

A day in the life of a medical dog handler and their facility animal
Examples of positive health outcomes for patients
The training that goes into the work of a medical dog
How these canines get their creative names!

For more information on Children's Hospital Colorado, visit: childrenscolorado.org

Eliminating Inequities with Interpretation: Effective Communication for Improving Health Outcomes Sep 19, 2023

In the United States, nearly 68 million people speak a language other than English at home. That number has virtually tripled over the last three decades. As our country continues to experience this soaring growth, qualified medical interpreters are becoming more essential to improving health outcomes and achieving health equity goals. Patients with hearing loss or limited health literacy may also require interpretation services. “Effective communication through interpreter utilization is one of the most important things we can do to help our patients with that,” Anna Ruman, MD, says.

Dr. Ruman is one of our guests on today’s episode. She is an assistant professor of pediatrics at the University of Colorado School of Medicine and a hospitalist at Children’s Hospital Colorado. Her passion for this work started before attending medical school. After minoring in Spanish in college, she lived and worked in Mexico. From there, she made her way to Chicago to work as an English-Spanish health educator. She is joined by Nancy Casillas, a medical interpreter and program coordinator for the Medical Interpretation and Translation Department here at Children’s Colorado. Casillas, a first-generation Mexican American, has been with Children’s Colorado for 16 years and understands the challenges of having English as a second language. “I feel that through this work, I’m helping those families who may be newly arrived immigrants to the country, and they may feel a little lost, and with my skills I’m helping them feel not so lost in this country,” Casillas says.

These experts explain how the Centers for Medicare & Medicaid Services has specifically identified language access as one of the five priority areas for the next year, aligning with the shared goal to reduce or eliminate healthcare disparities.

Some highlights from this episode include:

How medical interpreters enhance health equity
Advantages and disadvantages of different types of interpreting
Qualifications for interpretation practice versus being bilingual
Advancements happening at Children's Colorado

For more information on Children's Colorado, visit: childrenscolorado.org

The Predicaments of Picky Eating: Strategies to Approach Meals with Family Sep 12, 2023

Our pediatricians hear it time and time again: “My child is a picky eater.” Many times, it starts when kids are young, which naturally creates worry for parents. “It’s so innate in us that parents want to feed their children,” Dr. Dan Nicklas, our host, says. Researchers looked at the habits of children between 4 and 9 years old and found that because picky eaters don’t tend to grow out of it, parents need to intervene before their child turns 2. When children reach the age of 1, the transition from formula or breast milk to whole milk and table food becomes a pivotal time, as children start forming opinions about food.

In this episode, Stephanie Gilley, MD, and Rebecca McNab join us to provide strategies for navigating conversations with patients about their children and how they approach meals with their family. Dr. Gilley is a pediatric Clinical Nutrition Physician at Children’s Hospital Colorado, as well as an assistant professor at the University of Colorado School of Medicine. Rebecca is an occupational therapist and certified lactation education counselor. They explain this is a journey many parents find themselves on without a single path, but there are ways to create healthy, intuitive relationships with food for their kids.

There are many resources out there for parents to rely on but it’s important to know what you’re looking for. “Parents should not be following any account that makes them feel bad about what they are doing,” Dr. Gilley says. She suggests two resources in particular: Kids Eat in Color and Feeding Littles.

Some highlights from this episode include:

• Parent’s responsibility versus child’s responsibility • Importance of fostering a child’s independence • Creative ways to make food exciting • How feeding disorders are different than picky eating

Today's episode is underwritten by Aegon Transamerica Foundation, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Aegon Transamerica Foundation helps build a better world by committing to the improvement of wellness throughout their communities. Their partnership with Children’s Colorado addresses the youth mental health crisis to help create a better mental health future for children. Thank you to Aegon Transamerica Foundation for investing in Children’s Hospital Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Giving Families a Fighting Chance: How Fetal Surgery Saves Lives Before Birth Sep 05, 2023

For many practicing doctors today, advancements in science currently unfolding seemed futuristic during their years of training. Fetal care and in utero surgery are at the forefront of these advancements. Specifically, over the last 50 years, growth of maternal-fetal medicine and the importance of fetal care centers have grown exponentially. Medical evolutions have paved the way for specialists to treat an unborn child as a separate patient, offering life-saving care before birth.

Our team at Children’s Hospital Colorado has performed more than 1,600 surgeries, making us one of the most experienced fetal centers in the country. That’s why this week we are thrilled to welcome Sarkis (Chris) Derderian, MD, as our guest on Charting Pediatrics. As an expert in this field, he is currently an assistant professor of surgery and a pediatric surgeon at Children's Colorado, but his passion for fetal care began during his medical school years. “It was actually trauma that looped me into pediatric surgery and that I remember a 3-month-old baby that was in a car accident, terribly sick at the time, but at the time I left that rotation that baby was up moving around and it was just really a reflection of how resilient this population is,” Dr. Derderian says.

Throughout this episode we dive into what fetal surgery currently looks like and how its progression gives as a look inside what the next 50 years could look like. “I think it’s going to be revolutionary what we can do,” Dr. Derderian says. It’s a space that’s pushing the envelope to provide a new quality of life.

Some highlights of today’s episode include:

· Conditions being intervened by fetal surgery

· Diagnosing disease processes early in gestation

· How concepts like animation help make information digestible for families

· The future potential of fetal surgery

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

A Diabetes Breakthrough: New Drug to Delay the Onset of Clinical Disease Aug 29, 2023

Welcome back to another exciting season of Charting Pediatrics! For our long-time listeners, we are thrilled to have you back, and for anyone new to our audience, we couldn’t be more excited that you’ve joined us. In this first episode of Season 7, we dive into the world of Type 1 diabetes (T1D). Did you know that one in 300 individuals under the age of 20 is affected by this condition? Our guest on today’s episode, Kimber Simmons, MD, isn’t just an expert in her field; she was a part of that statistic after getting diagnosed at just 8 –years old. Now, as an associate professor of pediatrics and pediatric endocrinology, as well as a pediatric endocrinologist at Children’s Hospital Colorado and the Barbara Davis Center for Diabetes, she’s shedding light on some of the latest research.

Dr. Simmons and other experts explain alternative approaches that modify the natural course of T1D, rather than solely treating hyperglycemia, could dramatically improve both the quality of life and health outcomes for patients. In this episode, we review strategies for early diagnosis of T1D that predict, as well as prevent or delay, the onset of clinical T1D during preclinical stages of the disease. We also discuss an exciting new medication, Tzield (teplizumab-mzwv), with the promise of delaying the onset of clinical disease in T1D. “It is going to shift how we manage Type 1 diabetes in the future,” Dr. Simmons says.

Some highlights from today’s episode include:

How the predictability of T1D has changed over the years
Expansion of screening programs worldwide
New breakthrough medication, Tzield (teplizumab-mzwv), approved in the U.S. to delay the onset of clinical T1D
Children’s Colorado program to help providers identify the disease and follow up

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Season 7 Teaser: It's a Season You Won't Want to Miss Aug 22, 2023

It’s time to jump back into the ever evolving world of pediatrics. On this new season of Charting Pediatrics, one of the top 5 pediatric podcasts in the world, we expand our horizons, discuss cutting edge research and cover hot topics among the medical community. Season 7 will push new boundaries, answer lingering questions and take us on the road for in person interactions. Get ready for August 29th, it’s a season you won’t want to miss.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org .

Advancing the Treatment of Food Allergies (S6:E50) Aug 15, 2023

In this episode, we discuss food allergy, a very important topic for the general pediatrics community. Matthew Greenhawt, MD, joins us for this discussion as an expert in pediatric allergy and a leader of pioneering international studies looking at how we treat life- threatening food allergies in kids.

Guest:

Dr. Matthew Greenhawt specializes in pediatric allergy and immunology and is the director of the Food Challenge and Research Unit at Children’s Hospital Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Understanding Nonsuicidal Self-Injury in Pediatric Care Aug 08, 2023

Imagine you have a new 13-year-old patient in your practice. When you perform a return-to-school physical examination, you notice healed linear cutting marks on both of their wrists. The remainder of your exam is normal. In light of this finding, what are your next steps? What questions should you be asking the family and the patient, and what should you be concerned about today?

As part of our mental health series, in this episode we discuss nonsuicidal self-injury (NSSI). This is a common problem in teenagers and young adults, with some studies estimating a prevalence of up to 18% in high school students. Considered a developmental-timed problem, NSSI becomes much less common with age. Which begs the question, what’s happening inside that teenage brain? Two Children’s Hospital Colorado experts join us to help decode what is going on.

Guests:

Evadine Codd, PhD, is a licensed psychologist at Children’s Colorado within the Pediatric Mental Health Institute.

Luke Miller, MD, is a child and adolescent psychiatrist at Children’s Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Women in Medicine: The Gendered Divide in Finding Work-Life Balance (S6:E48) Aug 01, 2023

The important but ever-elusive goal of work-life balance is still more out of reach for women than men. Studies of home workloads for physicians indicate that the bulk of the nonprofessional work at home still falls to women. As a result, female physicians experience more work-family conflict than their male counterparts. This dynamic can lead to decreased job satisfaction, fewer women seeking professional advancement and increased burnout. In this episode, we talk with Children’s Hospital Colorado experts about their research in the area of work-life balance for female interventional radiologists.

Guests:

Jenny Zablah Alabi, MD, an associate professor of pediatrics and interventional cardiology at the University of Colorado School of Medicine, and a pediatric cardiologist at Children’s Colorado.

Natalie Soszyn, MD, a second-year fellow in interventional cardiology at Children’s Colorado.

This episode is underwritten by Aegon Transamerica Foundation, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Aegon Transamerica Foundation helps build a better world by committing to the improvement of wellness throughout their communities. Their partnership with Children's Colorado addresses the youth mental health crisis to help create a better mental health future for children. Thank you to Aegon Transamerica Foundation for investing in Children's Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado

Resource: Work-Life Balance: The Expectations and Perspectives as a Female Interventional Cardiologist

The Gut-Brain Axis: Understanding the Microbiome (S6:E47) Jul 25, 2023

The gut microbiome is a fascinating area of human health that we just started to better understand in the last two decades. With the arrival of PCR sequencing and advanced PCR techniques, we’ve been able to characterize the microbiome by looking at what organisms live there and how they vary by location and diet, as well as how the microbiome is influenced by things like exposure to antibiotics. We’re beginning to understand the relationship between the microbiome and health, from how these bacteria influence human metabolism and immune system development to their association with autoimmune diseases. Although we’ve learned a great deal, there’s still a lot for us to understand about our microbiome, including the relationship between our nervous system and the bacteria in our gut. In this episode, we’ll explore what we know and what we have left to discover with our guest Jaime Belkind-Gerson, MD.

Guest:

Jaime Belkind-Gerson, MD, is a pediatric gastroenterologist at Children’s Hospital Colorado. Dr. Belkind-Gerson is an expert in neurogastroenterology and gastrointestinal motility, and he’s an associate professor of pediatrics at the University of Colorado School of Medicine.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Youth Suicide Prevention & Research (S6:E46) Jul 18, 2023

One of the most concerning trends in child health is the increase in suicide rates over the last two decades in the United States. Suicide is the second leading cause of death in teenagers and young adults, and we should be alarmed both as pediatricians and citizens. We also need to ask questions about what this says about our society, what kind of promise and opportunity kids see for themselves, whether they are receiving the support they need, and if our healthcare system has the capacity to manage kids before and during a mental health crisis. As part of our ongoing mental health series, in this episode we discuss the alarming increase in suicide rates and some potential solutions to prevent suicide in children.

Guests:

Lisa Horowitz, PhD, MPH, is a pediatric psychologist and senior associate scientist at the National Institute of Mental Health (NIMH) Intramural Research Program at the National Institutes of Health in Bethesda, Maryland, and is a principal investigator at the NIMH studying detection of suicide risk in the medical setting.

Jeff Bridge, PhD, is an epidemiologist and director of the Center for Suicide Prevention and Research in the Abigail Wexner Research Institute at Nationwide Children’s Hospital in Columbus, Ohio. He is also the Nationwide Foundation Endowed Chair of Innovation in Behavioral Health Research and professor of pediatrics, psychiatry and behavioral health at The Ohio State University College of Medicine.

Today's episode is underwritten by Modivcare Foundation, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Modivcare Foundation is committed to improving the health of their members in communities across the country while advocating for the future of care through philanthropic funding. Their partnership allows Children’s Colorado to make important changes to our state’s mental health system, prevent suicide, and give youth the support and services they need to thrive. Thank you to Modivcare Foundation for your investment in Children’s Hospital Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Craniosynostosis and Development with Brooke French, MD and Allyson Alexander, MD (Rebroadcast S6:E4) Jul 11, 2023

It is not uncommon for newborn babies to have slight imperfections in their heads. Most of the time, these imperfections will fix themselves over time, or once they begin to develop. However, sometimes a more serious diagnosis will require medical interventions. Craniosynostosis is a condition where a baby’s skull begins to fuse together too early. This occurs at birth or shortly after and if not treated, can affect brain development.

Guests: Dr. Brooke French and Dr. Allyson Alexander. Dr Allyson is a Pediatric Neurosurgeon here at Children’s Hospital Colorado and is also an Assistant Professor at University of Colorado School of Medicine. Dr. Brooke French is the Co – Director of Cleft and Craniofacial Surgery Programs and is also the Director of Cosmetic Surgery here at Children’s Hospital Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Safe Infant Sleep with Sunah Hwang, MD and Aniekan Udoko, MD (S6:E45) Jul 04, 2023

Sudden unexplained infant death, commonly known SUID, SIDS or crib death, affects approximately 3,400 infants each year. Sudden unexpected infant deaths usually occur when an infant is sleeping, and causes can include suffocation, unknown infection, ingestion and other unknown causes. Not only has there been minimal improvement in rates of sleep-related deaths over the past two decades, but racial and ethnic disparities in SUID persist, including increased mortality rates. These disparities are indicative of the broader landscape of inequities within our healthcare systems. Today, we are talking about how providers and healthcare professionals can educate families and help them catch early signs of SUID.

Guests: Sunah Hwang, MD, is a neonatologist at Children’s Hospital Colorado and an associate professor of pediatrics at the University of Colorado School of Medicine. Aniekan Udoko, MD is a neonatal-perinatal medicine fellow at Children’s Hospital Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Fighting Gun Violence with Maya Haasz, MD (S6:E44) Jun 27, 2023

In 2020, firearm injuries were the leading cause of death in Americans 18 years old and younger. There was a total of 3,230 children’s deaths, of which 63% were homicide, 30% were suicide, 4% were unintentional injury, 2% were undetermined and 0.4% were legal intervention. Healthcare providers who interact regularly with parents and children are well-positioned to discuss evidence-based strategies that reduce unauthorized access to firearms and minimize the risk of firearm injury.

Guest: Maya Haasz, MD, is a pediatric emergency medicine physician at Children’s Hospital Colorado.

Resources: The Journal of Pediatrics: Firearms, Physicians, Families, and Kids: Finding Words that Work

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Evolving Trends in Common Pediatric Diseases with Rhae Gamber & Raphe Schwartz (S6:E43) Jun 20, 2023

No day is the same as the last when you work in pediatrics. Not only are viruses and public health outbreaks always changing, so are regulatory and administrative factors that impact pediatric healthcare and caring for patients. In this episode, we look at the ever-changing landscape of pediatrics, including the evolving trends in payor mix and common pediatric diseases including RSV, diabetes and obesity. These conditions affect millions of people worldwide and have a significant impact on health systems around the world.

Guests:

Raphe Schwartz serves as Chief Strategy Officer at Children's Hospital Colorado.

Rhae Gamber is a senior consulting director at Sg2 Healthcare Intelligence Services, a healthcare consulting firm.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Treatment of Acute Sinusitis in Children with Matthew Kronman, MD (S6:E42) Jun 13, 2023

Sinusitis is a common viral or bacterial infection that causes swelling in the sinuses. Although some patients need prescription medication, often sinusitis can be triggered by allergies or the common cold. In general, sinusitis is overtreated with antibiotics. In the United States, there are five million antibiotic prescriptions for children and adolescents with acute sinusitis, and around 65% of patients are prescribed either amoxicillin or amoxicillin/clavulanate as first-line treatments. To date, there have been little to no studies to compare the effectiveness and safety of these prescriptions. In today’s episode, we discuss a study done by Timothy Savage, MD, and Matthew Kronman, MD, to determine the effectiveness of antibiotics and how to determine who needs antibiotic treatment and who does not.

Guest:

Matthew Kronman, MD, MSCE, is the fellowship program director for Pediatric Infectious Diseases and the medical director of outpatient antimicrobial stewardship at Seattle Children’s Hospital, and an associate professor at University of Washington School of Medicine.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Women in Medicine: Novel Medications and Treatments to Prevent Necrotizing Enterocolitis with Gail Besner, MD (S6:E41) Jun 06, 2023

Necrotizing enterocolitis, or NEC, is a life-threatening illness with a mortality rate as high as 50% that almost exclusively affects neonates. The complex pathophysiology of NEC is based on an immature intestinal system that makes babies more susceptible to injury once they are fed. Ultimately, this can result in a breakdown of the gut, necrosis and then sepsis and death. There’s still no known cure for NEC, but we will discuss the potential of probiotics, specifically lactobacillus reuteri, with our guest Gail Besner, MD. As part of our Women in Medicine series, we are pleased to talk to Dr. Besner, whose research at Nationwide Children’s Hospital focuses on identifying novel therapeutic strategies to protect the intestines from intestinal injury, including necrotizing enterocolitis.

Guest:

Gail Besner, MD, is a surgeon-scientist at Nationwide Children’s Hospital and The Ohio State University, holds the H. William Clatworthy, Jr. Chair in Surgery, and has been the Chief of Pediatric Surgery at Nationwide Children’s Hospital for the past eleven years. She is a member of the Center for Perinatal Research at the Research Institute at Nationwide Children’s Hospital. She was the Program Director of the Pediatric Surgery Residency Training Program for many years, and now serves as the Associate Program Director. She’s also a scientific Co-Founder of Scioto Biosciences, Inc., a company designed to bring scientific findings from the laboratory to the bedside.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Depression and Other Mood Disorders with Melissa Batt, MD, and Joel Stoddard, MD (S6:E40) May 30, 2023

An article published this spring reported that between 2008 and 2018, there was a 250% increase in suicide rates among 13- and 14-year-old youth in the United States across categories of gender, race and region. There are many factors that contribute to the startling suicide rates in the U.S., including the instability we experienced after the end of this study with the pandemic disrupting our lives.

As part of our 12-episode mental health series, host Dr. David Brumbaugh discusses depression and other mood disorders with two mental health providers from Children’s Hospital Colorado.

Guests:

Dr. Melissa Batt specializes in Child and Adolescent Psychiatry at Children’s Colorado as part of the Pediatric Mental Health Institute and is an assistant professor at the University of Colorado School of Medicine.

Dr. Joel Stoddard specializes in Psychiatry in the Pediatric Mental Health Institute at Children’s Colorado and is an associate professor at the University of Colorado School of Medicine.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org. 

Resident Files: Using Kotter’s 8 Step Change Model to Revive Educational Conferences with Jennifer Sedler, MD, Elizabeth Nguyen, MD, and Ryan Lion, MD (S6:E39) May 23, 2023

During the COVID-19 pandemic, we couldn’t bring folks together to learn about and discuss important concepts in clinical medicine. Nationally, pediatrics board exam passage rates have been falling every year since 2019, hitting its lowest point of just 80% in 2023. For this episode, we talk with a group of residents who saw conference attendance dwindling at their institution and used Kotter’s change model to get teachers and learners back together. They share their results, the challenges they faced, and the lessons they learned along the way about pediatric resident education in this new era.

Guests: Drs. Sedler, Nguyen and Lion are all chief residents at Stanford University.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

How Delays in Emergency Department Antibiotic Delivery for Sepsis Can Increase Risk of Mortality with Roni Lane, MD, and Halden Scott, MD (S6:E38) May 16, 2023

In the emergency department, sepsis is a common problem and often lands patients in the ICU. Although there are many reasons patients may develop sepsis, it’s critical to diagnose and treat this condition in a timely manner. In today’s episode, we discuss sepsis and the point at which delays in antibiotics delivery increases the risk of mortality.

Roni Lane, MD, works in the Division of Pediatric Emergency Medicine at Primary Children’s Hospital (PCH) and is the project lead for the PCH Emergency Department Septic Shock Program. Dr. Lane is also an associate professor of pediatrics at the University of Utah.

Halden Scott, MD, is an emergency medicine physician at Children’s Hospital Colorado and an associate professor at the University of Colorado School of Medicine.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Establishing a Medical Home for Kids with Autism with Katharine Zuckerman, MD (S6:E37) May 09, 2023

Pediatricians see an array of patients with unique and individual needs, and each child requires their own specialized and unique care plan. As the rate of children diagnosed with autism continues to increase, it’s important that pediatricians adapt and tailor visits to the needs of their patients. In this episode, we discuss some of the simple changes primary care providers can make to ensure patients with autism feel seen, comfortable and understood in their medical home.

Guest: Katharine Zuckerman, MD, is a general pediatrician and associate professor at Oregon Health & Science University. Dr. Zuckerman is also a member of the of the AAP Council on Children with Disabilities Executive Committee.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org 

Long Walk Out Of The Woods: A Physicians Story of Addiction, Depression, Hope, and Recovery with Adam B. Hill, MD (S6: E36) May 02, 2023

Today on the podcast, we are going to be doing something a little different. As pediatricians and health care professionals, we dedicate our lives and our careers to helping others. Day in and day out we spend our time making sure our patients receive the best care possible to live life to the fullest. Although this can be one of the most fulfilling careers out there, it can also be physically and mentally demanding. Today, I want to ask each of you, how often do you take the time to check in with yourself? How often do you reflect on your own physical and mental health? If you are struggling physically or emotionally, are you taking the time to get help? Today we are honored to have Dr. Adam B. Hill, a Pediatric oncologist and palliative care physician, join us to share his story from the battle with depression, suicidal thoughts and alcoholism while working in the field of medicine.

Guest: Adam B. Hill, MD is the Palliative Medicine Department Chair at Children’s Hospital Colorado. He recently wrote and published a book called “Long Walk Out of the woods: A Physicians Story of Addiction, Depression, Hope, and Recovery.”

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Providing Trauma-Informed Care to Patients and Families with Lyndsay Gaffey, LPC, and Steven Berkowitz, MD (S6:E35) Apr 25, 2023

As primary care providers, it’s easy to assess a patient based on the symptoms and circumstances they present with when they walk in the door. However, patients who had adverse childhood experiences (ACEs) may have psychological injuries from that trauma that are more difficult to recognize. These patients also have a lifelong risk for health problems. What if healthcare professionals changed their mindset from “what is wrong with this child?” to “what has happened to this child?” In this episode, we explore childhood trauma with two experts and dive into the concept of trauma-informed pediatric care.

Guests: Lyndsay Jensen Gaffey, LPC, is the Director of Patient Care Services for the Pediatric Mental Health Institute at Children’s Hospital Colorado.

Steven Berkowitz, MD, works in the child and adolescent psychiatry unit at Children’s Hospital Colorado and is the Director of the START (Stress, Trauma, Research and Treatment) Center. Dr. Berkowitz is also a professor at the University of Colorado School of Medicine.

Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado. Ent, Colorado’s largest credit union, has a passion for people, not for profit. Ent has more than 45 service centers located up and down the Front Range, including the Denver Metro area and Northern Colorado. Insured by NCUA.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

The Connection Between Pediatricians and School Health with Sara Kihn (S6:E34) Apr 18, 2023

Children spend the majority of their time either at home or at school. In the state of Colorado, most children spend over 180 days, or 1,080 hours, a year at school. With so much time spent in the school environment, pediatric healthcare workers can collaborate with school health professionals by sharing a child’s medical history, allergies, and medications to ensure children are receiving the best care possible. In this episode, we discuss the care children can receive while at school and how pediatricians can communicate effectively with their patient’s school health professionals.

Guest: Sara Kihn is a pediatric nurse who has been in the profession for over 30 years. She is the associate clinical manager for the school health program at Children’s Hospital Colorado.

Resources:

Children’s Hospital Colorado School Health Website (coming soon!)

Colorado Department of Education, School Nursing and Health: www.cde.state.co.us/healthandwellness/snh_home

National Association of School Nurses: www.nasn.org/home

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Transitioning Kids from Pediatric to Adult Care with Daniel Wood, MD (Rebroadcast S5:E24) Apr 11, 2023

The transition from adolescent to adult care can often be a series of challenging obstacles for patients, families, and providers. This time of adjustment can be both overwhelming and difficult, especially for patients with congenital health conditions. Moving from a parent supervised visit to an independent patient model takes time and often takes a lot of discussion. In this episode, we are going unpack and inform primary care providers on how they can play a pivotal role in the transition of care.

Dr. Daniel Wood is the newest addition to our Urology department here at Children’s Hospital Colorado.

Resources: Twitter for pediatric healthcare professionals.

Empowering Patients and Families Through Reading with Michelle Shiffman, MD (S6:E33) Apr 04, 2023

Learning how to read is a pivotal point in childhood development. Incorporating reading into a family’s daily routine not only helps with brain development, but it also fosters an emotional relationship between children and their caregivers. Pediatric healthcare workers can help promote healthy reading habits by educating and assisting their patients and families at their pediatric well visits. Michelle Shiffman, MD, joins us on this episode to discuss approaches that help families integrate reading into their home lives. Dr. Shiffman is the Medical Director of Reach Out and Read, a nonprofit organization that helps equip families and pediatric practices with the tools and information they need to make reading aloud a daily routine.

Guest: Michelle Shiffman, MD, is a pediatrician at Denver Health and the Medical Director for Reach Out and Read.

Resources:

Reach Out and Read Colorado: https://reachoutandreadco.org

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Combatting the Rise of Anxiety in Children with Cassidy McNitt, MD, and Benjamin Mullin, PhD (S6:E32) Mar 28, 2023

There has been an overwhelming amount of change and disruption in the lives of kids over the last few years. Without the foundation of stability and predictability, many children are struggling with an array of anxiety disorders. As part of our ongoing Mental Health Series, Drs. Cassidy McNitt and Benjamin Mullins discuss how to support these kids and make sure they have access to the resources and help they need.

Guests: Cassidy McNitt, MD, is an assistant professor of Child and Adolescent Psychiatry for the Children’s Hospital Colorado Consultation and Liaison Service and the Colorado Pediatric Psychiatry Consultation and Access Program.

Benjamin Mullin, PhD, is an associate professor of Psychiatry at the University of Colorado School of Medicine and a clinical psychologist. Dr. Mullin is the director of the Colorado OCD and Anxiety Program at Children’s Colorado.

Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado. Ent, Colorado’s largest credit union, has a passion for people, not for profit. Ent has more than 45 service centers located up and down the Front Range, including the Denver Metro area and Northern Colorado. Insured by NCUA.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Conjunctivitis: Should I Prescribe Medication for This? with Nicole Poole, MD (S6:E31) Mar 21, 2023

Conjunctivitis, commonly known as pink eye, is a common eye infection that presents at pediatrician offices and often keeps kids out of school or daycare. Although conjunctivitis is commonly caused by viral infections, there are other reasons why a patient might get pink eye. As a pediatric provider, it is essential to understand the signs and symptoms of pink eye and to weigh the risks and benefits of prescribing antibiotics. This episode discusses the treatment of conjunctivitis and the role pediatricians play in antibiotic stewardship.

Guest: Nicole Poole, MD, is an assistant professor of pediatrics in the Division of Infectious Diseases at the University of Colorado and the Associate Medical Director of the Antibiotic Stewardship Program at Children’s Hospital Colorado. 

Episode resources:

Colorado Department of Public Health and Environment (CDPHE) website: https://cdphe.colorado.gov/child-care-health-regulations
How Sick is Too Sick? (CDPHE): https://drive.google.com/file/d/1RcdCmU4SYXwmVhJrA3Pyk0gP0MTDClkF/view
AAP Managing Infectious Diseases in Child Care and Schools: https://shop.aap.org/managing-infectious-diseases-in-child-care-and-schools-6th-edition-paperback/
Ophthalmic antibiotic use for acute infectious conjunctivitis in children: https://pubmed.ncbi.nlm.nih.gov/34737083/
Uncomplicated Acute Respiratory Tract Infections (ARTI) Clinical Pathways: https://www.childrenscolorado.org/health-professionals/clinical-resources/clinical-pathways/uncomplicated-acute-respiratory-tract-infections/

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

A Promise Fulfilled – A Pediatrics Story of Love and Caring with Jennifer England, MD, and Sunit Gill, MD (S6:E30) Mar 14, 2023

We're exploring something different in this episode and intentionally not discussing pediatric care. In this episode we share the incredible story of an enduring friendship between two pediatricians — a friendship that’s been both generous and life-changing.

Guests: Dr. Jennifer England, a pediatrician with Pediatrics at Cherry Creek, and Dr. Sunit Gill, a pediatrician at Greenwood Pediatrics, both located in Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

The Rise of Teen Substance Abuse and Addiction with Christian Thurstone, MD (S6:E29) Mar 07, 2023

As the pandemic continues to shine a light on the mental health crisis in America, the devasting effects of substance abuse and addiction are increasing. Teens across the country continue to use and abuse alcohol, marijuana and nicotine-based vaping, and the rate of deaths linked to fentanyl has hit an all-time high.

In the latest episode of our Mental Health series, we are joined by Christian Thurstone, MD, who discusses what’s new in adolescent substance use, how it's affecting kids and what providers can do about it.

Guest: Christian Thurstone, MD, the Director of Behavioral Health Services at Denver Health and a professor of psychiatry at the University of Colorado School of Medicine.

Today's episode is underwritten by Businessolver, who is partnering with Children's Hospital Colorado to create a better mental health future for children. Businessolver is creating a mentally healthy, well-educated workplace where diversity, equity and inclusion matter. Together, we can change the state of pediatric mental health.

A Closer Look at Sacral Dimples with Mark Erickson, MD (S6:E28) Feb 28, 2023

How do you know if a sacral dimple needs a closer look? Sacral dimples can be nothing at all, or they may be an indication of something more serious, such as tethered cord syndrome, dermal sinus tract or spina bifida oculate. In this episode, learn how sacral dimples should be evaluated and when providers should run more tests or refer to a specialist.

Guest: Dr. Mark Erickson is the Medical Director of the Spine Center and the Pediatric Orthopedics Fellowship Director at Children’s Hospital Colorado, and a professor in the Department of Orthopedics at the University of Colorado School of Medicine.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Resident Files: Health Equity Rounds with Kathryn Kalata, MD (S6:E27) Feb 21, 2023

Implicit bias and systemic racism contribute to health disparities, and they cannot be accounted for only by the social determinants of health (income, education, marital status, employment, etc.). Everyone brings their own biases and lived experiences to the table, and as physicians, it is our responsibility to recognize the role bias plays in our interactions with patients and team members, as well as within our healthcare system.

In the latest episode in our Resident Files series, we talk with Kathryn Kalata, MD, about Health Equity Rounds, an initiative to address bias in the care we provide our patients.

Guest: Dr. Kathryn Kalata, a current resident at the University of Colorado.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Effective Vaccine Communication with Peter Hotez, MD, PhD (S6:E26) Feb 14, 2023

Effective communication is needed to ensure the public is getting accurate information when it comes to vaccinations. Over the past few years of the COVID-19 pandemic, we’ve seen an increase of anti-vaccination sentiment and misinformation. In this episode, we discuss the importance of vaccines, the science behind vaccine development, and the impact of effective communication.

This episode was recorded live from the 2022 AAP NCE Conference in Anaheim California. 

Guest: Dr. Hotez is from Texas Children’s Hospital where he is the Endowed Chair of Tropical Pediatrics. Dr. Hotez is a professor at Baylor College of Medicine and Texas A&M University. As both a pediatrician and vaccine scientist, he is a passionate advocate for vaccines in the face of the growing anti-vaccine movement and is certainly a hero for all pediatricians.

For more information on Children’s Hospital Colorado, visit: childrenscolorado.org

Women in Medicine: Breathe In, Breathe Out, Repeat with Robin Deterding, MD (S6:E25) Feb 07, 2023

When we think about our basic physiological needs, food, water, shelter, and clothing comes to mind yet oxygen is the crucial element for survival. The brain uses about 20% of the body’s oxygen supply, which allows it to perform both conscious and autonomic processes and without oxygen brain damage occurs after three to six minutes of anoxia. Since breathing takes little to no effort for most of us, we often neglect to think about how it affects our daily lives. In this episode, we are going to discuss the importance of breathing and the scale at which children are impacted.

We are excited to announce that this episode is part of our women in medicine series where we learn from the stories and expertise of amazing women in medicine.

Today, I am so fortunate to be joined by an exceptional woman in medicine, my colleague Dr. Robin Deterding.

Dr. Deterding is an internationally known pediatric pulmonologist, executive leader of one of the largest academic and clinical pediatric pulmonary practices for children in the country and a serial entrepreneur committed to improved care models for patients. She is a tenured Professor of Pulmonary and Sleep Medicine in the Department of Pediatrics at the University of Colorado School of Medicine and Children's Hospital Colorado.

Pediatric Mental Health: Working with the Whole Family with William Mowle and Julia Barnes, PhD (S6:E24) Jan 31, 2023

In this series, we have talked about the importance of family-based therapy and family centered care. Today we are going to discuss what family-based care looks like from the perspective of a psychologist and from a Dad.

Today, I am excited to be speaking with Julia Barnes, MD and William Mowle.

Dr. Julia Barnes is a licensed clinical psychologist at the pediatric mental health institute here at Children’s Hospital Colorado. She is the faculty co-chair for Children’s mental health family advisory board council and an assistant professor at the university of Colorado school of medicine. Bill Mowle is the parent co-chair for the mental health family advisory council.

Today’s podcast is underwritten by Alpine Bank, supporters of Charting Pediatrics and Children’s Hospital Colorado. Alpine Bank is proud to call Colorado home and is committed to supporting the community through philanthropic initiatives like their Loyalty Debit Card program, where the bank partners with its customers to raise funds to directly benefit Children’s Colorado. Learn how you can get involved at Alpine Bank dot com slash CHCO card. Thank you to Alpine Bank for the continued support of Children’s Colorado.

Resources:

https://www.childrenscolorado.org/community/patient-advocacy/family-advisory-council/

The Importance of Dairy in a Child’s Diet with Stephanie Gilley, MD, PhD (Rebroadcast S5:E23) Jan 24, 2023

A question that commonly presents to those of us in primary care is what role dairy should play in a child’s diet. Rich in nutrients and health benefits, most dairy products are key components for building and maintaining strong bones. Today, we are going to be discussing both the blessings and the challenging implications dairy can have on a child’s health.

Today, I am happy to be speaking with my colleague, Dr. Stephanie Gilley.

Addressing Behavioral Health in Patients with Down Syndrome with Lina Patel PsyD, and Monique Germone, PhD (S6:E22) Jan 17, 2023

Many children struggle with certain behavior challenges such as aggression, impulsivity, and poor listening skills. Although this is normal for a typically developing child, over 90% of children with Down Syndrome experience one or more behavioral problems on a weekly or daily basis. These behaviors not only impact the child, but also can become major stressors for parents and caregivers. In this episode, we are going to talk about the different strategies and methods primary care providers can use to help persons with down syndrome cope with these challenges in order to live life to the fullest.

Today, I am excited to be speaking with Dr. Lina Patel and Dr. Monique Germone.

Dr. Lina Patel is the director of the Down Syndrome Behavioral Health Collaborative at Children’s Hospital Colorado and is an associate professor in the department of Psychiatry at the Colorado School of Medicine. Dr. Monique Germone is the associate director of the Down Syndrome Behavioral Health Collaborative and an associate professor at the Colorado School of medicine.

Resources:

Video

Understanding Behaviors in Individuals with Down syndrome

https://vimeo.com/617189510

password: childrens

Books

The Guide to Good Health for Teens & Adults With Down Syndrome Paperback by Brian Chicoine and Dennis McGuire (Available on Amazon)

Supporting Positive Behavior in Children and Teens with Down Syndrome, Revised Edition: The Respond But Don't React Method by Dr. David Stein Psy.D. (Available on Amazon)

Teaching Children with Down Syndrome about Their Bodies: A Guide for Parents and Professionals by Terri Couwenhoven (in the process of being republished)

Potty Time for Kids with Down Syndrome: Lose the Diapers, Not Your Patience by Terry Katz, Ph.D., and Lina Patel, Psy.D. (in the process of being republished)

Websites

https://www.childrenscolorado.org/doctors-and-departments/departments/down-syndrome-behavioral-health/

https://www.globaldownsyndrome.org/

https://www.dsmig-usa.org/

https://www.childrenscolorado.org/doctors-and-departments/departments/down-syndrome/

https://medschool.cuanschutz.edu/linda-crnic-institute

Paradigm Shift: How Living Donors are Revolutionizing the Field of Pediatric Liver Transplant with Amy Feldman, MD and Megan Adams, MD (S6:E21) Jan 10, 2023

Each year hundreds of children are listed for liver transplants across the United States. Whether these children have chronic liver disease or acute liver failure, too many children spend months or even years waiting for an organ. Historically, deceased organ transplants have been the most common type of organ donation. However, the outcome for many children with chronic liver disease is to experience long wait times with poor quality of life. Too many children die while waiting for a transplant. Living donor transplants have emerged as a new way to care for children with chronic liver disease. Relatives, friends and even strangers serve as living donors to help patients bypass long and uncertain wait times. In this episode, we are joined by two experts from our living donor program to share more about this organ donation option.

Today, I am excited to be speaking with Dr. Amy Feldman and Dr. Megan Adams.

Dr. Feldman is a pediatric Gastroenterologist and is the Director of the Liver Transplant program here at Children’s Hospital Colorado. Dr. Megan Adams is the surgical director of the pediatric living donor transplantation and pediatric transplant clinical reach team here at Children’s Hospital Colorado.

Resources:

https://www.childrenscolorado.org/doctors-and-departments/departments/transplant/liver/

Intersection Between Physical and Mental Health with Lauren Wood, PhD and Beau Carubia, MD (S6:E20) Jan 03, 2023

Many people view mental and physical health as two separate and unrelated issues. However, there are many intersections between the two. For example, it is not uncommon for children and adolescents to develop and experience emotions as physical symptoms. Children who experience Somatic Symptoms, or SSRDs, account for 10-15% of medical visits to primary care providers. Today, we are going to be talking about the connection between physical and mental health and how health care professionals can better understand, diagnose, and treat these patients in the medical home.

Today, I am excited to be speaking with my colleagues Dr. Lauren Wood and Dr. Beau Carubia.

Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado. Ent, Colorado’s largest credit union, has a passion for people, not for profit. Ent has more than 45 service centers located up and down the Front Range, including the Denver Metro area and Northern Colorado. Ent dot com. Insured by NCUA.

The Role of a Pediatrician in Bullying Prevention with Daniel J. Flannery, PhD and Seth Scholer, MD (S6:E19) Dec 27, 2022

Children these days face a myriad of social pressures. Kids come from different homes and backgrounds. They grow at different rates. They walk, talk, and act differently. This diversity and individualism can be something to embrace, but often leads to insecurities about being different and not fitting in socially. These insecurities can have detrimental effects on the mental health of kids during their formative years.

Today I am speaking with Dr. Daniel Flannery and Dr. Seth Scholer. Dr. Flannery is a professor at the Mandel school at Case Western Reserve University, Director of the Begun Center for Violence Prevention, and Professor of Pediatrics and Psychiatry. Dr. Scholer is a professor of pediatrics in the division of general pediatrics at Vanderbilt University Medical Center.

Wishing you a Happy Holiday Season! Dec 22, 2022

Happy Holidays from the Charting Pediatrics team!

Advancing Health Equity in the NICU and Beyond with Nicolle Dyess, MD and Paula Dias Maia, MD (S6:E18) Dec 20, 2022

In past episodes of Charting Pediatrics, we have discussed the health equity challenges that organizations and healthcare systems face and the importance of a diverse workforce. Differences such as race, gender, and socioeconomic status are all associated with the disparities we see in health care systems each day. An important step to help providers close this gap, starts within healthcare professional education. In this episode, we are going to take a deep dive into how health systems can help protect and advocate for the most vulnerable patients of all, the patients in the NICU.

Today, I am excited to be speaking with Dr. Paula Dias Maia and Dr. Nicolle Dyess.

Dr. Paula Dia Maia is a neonatal-perinatal fellow and was previously one of the leaders of the diversity in pediatrics committee. Dr. Nicolle Dyess works in the Division of Neonatal-Perinatal medicine and is an assistant professor and the University of Colorado.

Today's episode is underwritten by Aon, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. Aon believes that businesses thrive when the communities they serve flourish. Thank you to Aon for helping our community flourish through this partnership.

It's Getting Hot In Here: Update on AAP Guidelines for Febrile Infants with Samir Shah, MD (S6:E17) Dec 13, 2022

About 14 out of every 1,000 healthy infants born full term develop a fever during the ages 8 days to 60 days old. While most fevers do not lead to severe illness, it can be challenging to immediately identify the cause of a baby’s fever and identifying infants who may be at risk for developing serious bacterial infections. In this episode, we will discuss the updated AAP guidelines for well-appearing infants between 8-60 days old who develop a fever at or above 100.4 degrees Fahrenheit (38 degrees Celsius). We will take a deep dive into the changing epidemiology of serious bacterial infection in febrile infants, advances in technology, and evolving research strategies.

This episode is being broadcasted live from the AAP NCE in Anaheim California. Today, I am delighted to be speaking with Dr. Samir Shah.

Dr. Shah is joining us from Cincinnati Children’s hospital where he is the Director of the Division of Hospital Medicine and a professor of pediatrics.

Eating Disorders: Pre & Post COVID-19 with Amy Sass, MD and Jennifer Hagman, MD (S6:E16) Dec 06, 2022

Data from multiple countries have shown an uptick in eating disorder presentations in youth during the pandemic. Here in Colorado, we have certainly seen an increase in medically unstable eating disorder patients admitted to the hospital. As part of our series this year on mental health today we will focus on disordered eating, which encompasses a spectrum of different problems in children. I am joined by two experts between them with many decades of experience caring for children and adolescents with disordered eating so this is going to be a lot of fun.

This episode is part of our 12-episode mental health series where we aim to give primary care providers useful tools and relevant clinical information to support them in the care of patients with mental health needs.

Today I am happy to be speaking with Dr. Amy Sass and Dr. Jennifer Hagman.

Dr. Sass works in the adolescent medicine department at Children’s Hospital Colorado and is a professor at the University of Colorado School of Medicine. Dr. Jennifer Hagman works in the child and adolescent psychiatry department here at Children’s Colorado and is professor at the University of Colorado school of medicine.

Resources:

AAP -

https://publications.aap.org/pediatrics/article/147/1/e2020040279/33504/Identification-and-Management-of-Eating-Disorders

NEDA – National Eating Disorders Association

www.nationaleatingdisorders.org

Families Empowered And Supporting Treatment of Eating Disorders (FEAST)

www.feast-ed.org

Academy of Eating Disorders

www.aedweb.org

NIH - National Institutes of Health

www.nlm.nih.gov (Search “Eating Disorders”)

Information on Maudsley Method

www.eatingwithyouranorexic.com, http://www.maudsleyparents.org/, www.aroundthedinnertable.org

Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado.

Resident Files: Equity, Diversity, and Inclusion in the Section of Pediatric Trainees with Jeffrey Edwards, MD (S6:E15) Nov 29, 2022

In our series, the Resident Files, we feature the thoughts and work of talented pediatric residents here in Colorado and around the country.

The section on pediatric trainees has implemented several initiatives into making pediatrics a more diverse and inclusive workforce. This group is working towards achieving child health equity in a global sense. The equity, diversity, and inclusion work group has focused their efforts on increasing visibility of underrepresented in medicine groups highlighting both trainees and faculty members using social media campaigns.

This episode was broadcasted live from the AAP conference in Anaheim California. Today I am privileged to be joined by Jeffrey Edwards.

Jeffrey is a member of the section on pediatric trainees currently wrapping up his time as the executive coordinator for equity diversity and inclusion with the section on pediatric trainees leadership council.

Controversies Around Treatment of Appendicitis with Lorraine Kelley-Quon, MD (S6:E14) Nov 22, 2022

Although Acute Appendicitis(AA) is the most common acute surgical conditions encountered by children, multiple aspects of the approach to management of AA remain well debated. Despite recent advancements in management, including scoring systems, imaging, antibiotics, the variations in management options, from appendectomy to a laparotomic approach to non-operative management (NOM) remain topics of intense discussion. And with no absolute consensus in the literature, controversy among surgeons and faculty persists.

This episode was broadcasted live from the AAP conference in Anaheim California. Today, I am delighted to be speaking with Dr. Lorraine Kelley-Quon.

Dr. Kelley-Quon is joining us from Children’s Hospital Los Angeles, where she practices as a pediatric surgeon and is an assistant professor of surgery and population and public health sciences at Keck school of Medicine at the University of Southern California.

Common Orthopedic Injuries Among High School Athletes with Curtis VandenBerg, MD (S6:E13) Nov 15, 2022

Today, a vast majority of teenagers and adolescents dedicate their time to athletics. In fact, nearly 8 million students participate in high school sports. With the increasing popularity of club sports, most kids are practicing and playing their dedicated sports year-round. Participating in organized sports allows kids to become a part of a team and improves both physical and mental health. However, an injury to an athlete can impact their ability to perform and practice and can be devastating mentally. On today’s episode, we will be discussing common orthopedic injuries among student athletes and how these injuries can be treated and prevented.

Welcome to Charting Pediatrics. I’m your host Dan Nicklas. If you are new with us, welcome to our pediatric provider community where we release an episode every Tuesday, and special updates to cover hot topics that impact pediatric providers.

Today I am happy to be speaking with Dr. Curtis VandenBerg.

Dr. Curt VandenBerg is a Sports medicine surgeon with Children's Hospital Colorado and the University of Colorado school of medicine.

Resources:

https://www.joinmyhuddle.com/about

Stress Management in Kids with Jessica Hawks, PhD and Jenna Glover, PhD (S6:E12) Nov 08, 2022

It is no surprise that more and more kids are experiencing stress and anxiety. With the recent current events including COVID-19, these last few years have been stressful for everyone. As kids get older and begin to take on more responsibility and experience more changes in life, stress becomes more apparent. Today we are going to talk about strategies that provider can incorporate into clinic, the right questions to ask patients and families, and talk about the post pandemic stress epidemic that we are seeing in kids.

 This episode is part of our 12-episode mental health series where we aim to give primary care providers useful tools and relevant clinical information to support them in the care of patients with mental health needs.

Today I am happy to be speaking with Dr. Jenna Glover and Dr. Jessica Hawks.

Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado. Ent, Colorado’s largest credit union, has a passion for people, not for profit. Ent has more than 45 service centers located up and down the Front Range, including the Denver Metro area and Northern Colorado. Visit Ent.com. Insured by NCUA.

Palliative Care for all in Pediatrics with Adam Hill, MD (S6:E:11) Nov 01, 2022

Today's episode is underwritten by Transamerica, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. Transamerica is committed to helping improve the overall wellness within all communities. Their partnership supports the urgent need in our community of pediatric mental health. Thank you Transamerica.

When a child is diagnosed with a serious illness, it is important for the whole family to get the support and care that they need. Palliative care not only helps children and families with the pain and symptoms of their illnesses, but it also helps to enhance the child’s quality of life. In this episode, we are going to discuss how palliative care teams can partner with Primary care providers to help treat and ease the symptoms, pain, and stress of seriously ill patients.

Today I am happy to be speaking with Dr. Adam B. Hill.

Dr. Adam B Hill is the Palliative Medicine Department Chair here at Children’s Hospital Colorado.

What to Expect With a Tonsillectomy and Adenoidectomy with Soham Roy, MD (S6:E10) Oct 25, 2022

Getting your tonsils out used to mean spending a few days in the hospital and getting ice cream for breakfast, lunch, and dinner. Tonsillectomy and adenoidectomy, or T&A, is the second most common childhood surgery performed. It is important for pediatricians to have a detailed understanding of indication for referral, pre- and post-surgical management, and how this procedure has evolved over time. Today we are joined by an Otolaryngology expert to talk about tonsillectomy and adenoidectomy surgeries, when it is needed, and how this surgery is beneficial to patients.

Today I am happy to be speaking with Dr. Soham Roy.

Dr. Roy Soham is the chair of Pediatric Otolaryngology at Children’s Hospital Colorado and is a professor and vice chair at the university of Colorado school of medicine.

Cardiac Screening and Return to Play Guidelines with Chris Rausch, MD (S6:E9) Oct 18, 2022

Approximately 35 to 45 million youths, 6 to 18 years of age, participate in some form of athletics. The COVID-19 pandemic has affected many aspects of the lives of children and families, including youth sport activity. As children present for health supervision visits and preparticipation physical evaluations, parents and athletes likely will ask questions about how best to ensure safety when considering a return to sports participation and physical activity. In addition, there are lingering concerns about the risk of myocarditis in this population, from disease and vaccination. In this episode we will evaluate the most current guidance on this topic and discuss the risk of myocarditis, all from a cardiology perspective.

Today I am happy to be speaking with Dr. Chris Rausch.

Resources:

https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.02.003

https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-interim-guidance-return-to-sports/

Updated Hyperbilirubinemia Management Guidelines with Christine Gold, MD (S6:E8) Oct 11, 2022

Recently, the American Academy of Pediatrics (AAP) revised clinical guidelines on hyperbilirubinemia and how to treat infants born at at least 35 weeks. Although it is common for many newborn infants to experience jaundice, it is important for physicians and primary care providers to understand and monitor newborn babies to ensure they don’t develop hyperbilirubinemia. In this episode, we are going to discuss what primary care providers should know about these new guidelines and how they are different than the previous guidelines.

Today I am happy to be speaking with Dr. Christine Gold.

Resources:

New 2022 AAP Hyperbilirubinemia guidelines: https://publications.aap.org/pediatrics/article/150/3/e2022058859/188726/Clinical-Practice-Guideline-Revision-Management-of?autologincheck=redirected?nfToken=00000000-0000-0000-0000-000000000000 Old 2004 AAP guidelines: https://publications.aap.org/pediatrics/article/114/1/297/64771/Management-of-Hyperbilirubinemia-in-the-Newborn Bili Tool: https://bilitool.org Pedicalc: https://peditools.org/bili2022/

Screening for Mental Health Risk Factors in Primary Care with Robert Hilt, MD and Sandra Fritsch, MD (S6:E7) Oct 04, 2022

Primary care providers and Pediatricians play a vital role in the identification, prevention, and management of pediatric mental health. With the increased need for mental health services and limited access to resources, early detection is a crucial first step. On this episode, we are going to discuss the importance of routine mental health screenings and the tools and resources primary care providers can leverage within the medical home.

Today I am happy to be speaking with Dr. Robert Hilt and Dr. Sandra Fritsch. Dr. Hilt is a professor at the University of Washington, Department of Psychiatry and Behavioral Sciences and a psychiatrist at Seattle Children’s Hospital. Dr. Fritsch is a psychiatrist that works in our Child and Adolescent Psychiatry department here at Children’s Colorado. Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado.

Re-Emergence of Polio and New Wave of EVD-68 with Kevin Messacar, MD (S6:E6) Sep 27, 2022

In the early 1950’s, Polio was one of the most unknown and feared disease in the United States. According to the CDC, polio caused hundreds of thousands of cases of paralysis before the development of a vaccine. Since the vaccine, there have been no new cases, until now. In addition, we are seeing the continued spread of another virus that can cause paralysis, Enterovirus D68. Today we will talk about the possible relationships between these two viral diseases and what you our healthcare providers need to be aware of for prompt diagnosis and treatment.

Today I am delighted to be speaking with my colleague Dr. Kevin Messacar.

Kevin works in the Infectious Disease department at Children’s Hospital Colorado and is an Associate professor in the department of pediatrics at the University of Colorado school of Medicine.

Resources:

Polio MMWR: https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e2.htm

EV-D68 MMWR: https://www.cdc.gov/mmwr/volumes/71/wr/mm7140e1.htm

AFM Consensus Recommendations: https://www.thelancet.com/article/S0140-6736(20)32723-9/fulltext

CDC Job Aid for AFM Reporting: https://www.cdc.gov/acute-flaccid-myelitis/downloads/job-aid-for-clinicians-508.pdf

AFM Physician Support Portal: https://wearesrna.org/living-with-myelitis/resources/afm-physician-support-portal/

https://www.cdc.gov/acute-flaccid-myelitis/downloads/examining-proximal-muscle-weakness-508.pdf

How to Treat and Overcome Daytime Wetting with Brian Miller, PA-C (S6:E5) Sep 20, 2022

Toilet training is a natural milestone that many children master by the age of 3. Although accidents are bound to happen from time to time, consistent day time wetting may be linked to a more serious medical condition. On average, daytime wetting, or Diurnal enuresis, happens in about 3-4% of children and is commonly associated with dysfunctional voiding. Today, we are going to unpack some of the common reasons kids experience daytime wetting and what primary care providers can do to treat this in the medical home.

Today I am happy to be speaking with Brian Miller.

Brian Miller is PA-C Lead Advanced Practice Provider for Pediatric Urology here at Children’s hospital Colorado.

Craniosynostosis and Development with Brooke French, MD and Allyson Alexander, MD (S6:E4) Sep 13, 2022

It is not uncommon for newborn babies to have slight imperfections in their heads. Most of the time, these imperfections will fix themselves over time, or once they begin to develop. However, sometimes a more serious diagnosis will require medical interventions. Craniosynostosis is a condition where a baby’s skull begins to fuse together too early. This occurs at birth or shortly after and if not treated, can affect brain development.

Today, I am excited to be speaking with my colleagues Dr. Brooke French and Dr. Allyson Alexander. Dr Allyson is a Pediatric Neurosurgeon here at Children’s Hospital Colorado and is also an Assistant Professor at University of Colorado School of Medicine. Dr. Brooke French is the Co – Director of Cleft and Craniofacial Surgery Programs and is also the Director of Cosmetic Surgery here at Children’s Hospital Colorado.

Launching Point and Introduction - History of Pediatric Mental Health in the U.S with Ron-Li Liaw, MD and Vice Admiral Vivek H. Murthy, MD, MBA (S6:E3) Sep 06, 2022

The youth mental health crisis in America is not a new problem. The pandemic drove unprecedented numbers of kids to seek care at all levels and really brought this to the public’s attention. In 2021, to highlight the mental health crisis in the United States, the surgeon general’s office issued the Youth Mental Health Advisory. Today, as we begin our season 6 focus on mental health with our Charting Pediatrics Mental Health series, we are privileged to talk with our U.S Surgeon General, Dr. Vivek Murthy, and our very own Mental Health In-Chief Ron-Li Liaw.

Vivek Murthy serves as the 21st Surgeon General of the United States. Dr. Murthy is a renowned physician, research scientist, and entrepreneur. As the Nation's Doctor, the Surgeon General's mission is to help lay the foundation for a healthier country. Dr. Ron- Li Liaw is the Cannon Y. & Lyndia Harvey Chair in Child and Adolescent Psychiatry, the vice chair of Diversity, Equity, and inclusion and most recently, Ron-Li has been announced as the first ever Mental Health In-Chief for Children’s Hospital Colorado.

Today's episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado.

Impacts on Pediatric Medicine as we Emerge from the Pandemic with Raphe Schwartz and Rhae Gamber (S6:E2) Aug 30, 2022

Since 2020, life as we know it has been turned upside down. Every person has had to deal with the repercussions of the global COVID-19 pandemic in their own individual ways. Pediatrics is no different. Pediatrics has changed immensely over the last few years, and as we emerge from the pandemic, many people are anticipating the “normal” of life to come back. However, it is important to understand that there may be a “new normal”. In this episode, we will be discussing what has changed in the landscape of pediatrics, what will stay, and what areas will not recover.

Raphe Schwartz serves as Chief Strategy Officer at Children's Hospital Colorado and joining us from health care analytics and intelligence firm Sg2, Rhae Gamber, Senior Consulting Director of Women’s Health & Pediatric Intelligence.

If any children’s hospital leaders or pediatric providers are looking for more info on Sg2 visit https://www.sg2.com/childrens

Sleepless Nights and When to Refer to a Specialist with Antoinette Burns, DO (S6:E1) Aug 23, 2022

Sleep is an essential function that is vital to the health and well-being of every individual yet millions of people either neglect or have trouble sleeping. Sleep issues in kids are among the most common problems that parents report when visiting their Primary Care provider. In fact, 20% of all children suffer from some type of sleeping problem. In today’s episode, we are going to discuss common sleep disorders and when Primary Care providers should refer patients to a sleep specialist.

Today I am happy to be speaking with my colleague Dr. Antoinette Burns. Dr. Burns is a pediatric sleep physician. She is the Associate Medical Director of the Pediatric Sleep Lab in Colorado Springs, Colorado and is also an Associate Professor of Clinical Practice in the Department of Pediatrics at the University of Colorado school of Medicine.

Innovations in Fertility Preservation with Leslie Appiah, MD (Rebraodcast S5:E4) Aug 16, 2022

When our pediatric and adolescent patients are diagnosed with cancer or another life-altering conditions, the focus is often on treatment and not the changes chemotherapy, radiation and surgery may have on their body’s long-term function. In this episode, we are joined by Leslie Appiah, MD to discuss the innovative topic of fertility preservation for pediatric and adolescent patients -- both at cancer diagnosis and in survivorship.

Dr. Appiah is part of the Pediatric and Adolescent Gynecology team at Children’s Colorado and is Division Chief, Academic Specialists in Obstetrics and Gynecology and Director of the Fertility Preservation and Reproductive Late Effects Program at the University of Colorado School of Medicine. She is co-founder of the Pediatric Initiative Network of the Oncofertility Consortium where she served as chair for 5 years and is current co-chair of the Adolescent and Young Adult Reproductive Late Effects Committee.

Season 6 Teaser: Mental Health Series Aug 12, 2022

Welcome back Charting Pediatrics listeners! We are so excited to announce that the sixth season of the podcast will release on August 23rd. In this new season, our host team will bring you the latest and greatest in pediatrics along with the bread-and-butter topics that help you in your daily practices. In addition, the Charting Pediatrics team is excited to launch a 12-part Mental Health Series. This series will take a deep dive into relevant behavior health topics that will help inform and equip primary care providers in these challenging times. These episodes will cover a variety of topics such as the history of pediatric mental health, stress and resiliency management, trauma informed care and more.

In today’s teaser episode, we are joined by Ron-Li Liaw. Ron-Li is our inaugural Mental Health-in-Chief at Children’s Hospital Colorado and has teamed up with us to create this exciting new series.

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!

Early Identification of Central Nervous System Tumors in Primary Care Pediatrics with Adam Green, MD (Rebroadcast S5:E10) Aug 09, 2022

Central nervous system (CNS) tumors account for a quarter of all cancers in children aged 1 to 19 years. Nearly 70% of CNS tumors can be effectively treated, but early detection is critical to allow for the best possible treatments and outcomes. Too often, CNS tumors are initially misdiagnosed as more common pediatric conditions such as migraine, gastroenteritis or other psychologic and behavioral problems. In this episode, we discuss the classic signs and presentations of CNS tumors to support early detection.

Our guest for today's episode is Dr. Green. Dr. Green is part of the Center for Cancer and Blood Disorders Team at Children’s Hospital Colorado and is Assistant Professor of Pediatrics, Hematology/Oncology/and Bone Marrow Transplantation at the University of Colorado School of Medicine.

Flu Vaccine, Egg Allergy & the COVID Vaccine with Matthew Greenhawt, MD (Rebroadcast S5:E3) Aug 02, 2022

Annual seasonal influenza vaccination remains the most effective means of protection against contracting influenza illness and preventing spread of the disease. It is estimated that more than 23,000 deaths occur each year in the United States because of influenza, including approximately 124 children. Egg-allergic children are a subgroup who may be at higher risk for influenza-related complications. In this episode we are joined by Matt Greenhawt, MD to review the incidence, suspected epidemiology and current policy related to allergic reactions to the influenza vaccine and steps for avoiding potential adverse reactions.

Dr. Greenhawt is the Director of the Food Challenge and Research Unit at Children’s Hospital Colorado and Associate Professor of Pediatrics, Section of Allergy & Immunology at the University of Colorado School of Medicine.

Nonalcoholic fatty liver disease (NAFLD) in Pediatrics with Shikha Sundaram, MD (Rebroadcast S5:E9) Jul 26, 2022

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States, affecting almost 10 percent of all children. Sometimes referred to as "fatty liver disease," it is actually a range of diseases that all begin when excess fat gets deposited in the liver, most significantly impacting our obese patients.

In today’s episode we are joined by guest Shikha Sundaram, MD to discuss the clinical presentation and treatment of NAFLD, including how primary care providers can provide critical support to families making significant lifestyle changes as part of their treatment.

Dr. Sundaram is the Medical Director of the Pediatric Liver Transplant Program at Children’s Hospital Colorado and is Associate Professor of Pediatrics, Gastroenterology, Hepatology and Nutrition at the University of Colorado School of Medicine.

International Programs to Reduce Infant Mortality with Beena Kamath- Rayne, MD Jul 19, 2022

Each year, global neonatal mortality accounts for nearly 2.4 million deaths. Most of these occur during the first weeks or even within the first few minutes of life. With simple resuscitation training and newborn care interventions, many of these deaths can be prevented. Helping Babies Breathe (HBB) is a skills-based program for medical staff in settings that have limited resources. Since its release in 2010, it has been implemented in over 80 countries. Today we are going to be talking with a pediatrician who has dedicated her career to serving kids in a global context. As an individual provider on the front lines to now directing these programs.

This episode was recorded at the 2022 PAS Conference in Denver, Colorado. I am honored to be speaking with Dr. Beena Kamath- Rayne.

Beena Kamath-Rayne is currently the Vice President of Global Newborn and Child Health in the Division of Global Health and Life Support. In her role at the AAP, Dr. Kamath-Rayne is advancing AAP training programs and technical assistance in global newborn and child health.

Addressing Racism and Health Inequities with Ndidi Unaka, MD and David Turner, MD Jul 12, 2022

Entrustable Professional Activities, or EPAs, are a concept that was developed by Olle ten Cate in 2005 as a way to operationalize and assess competency-based medical education. EPAs are observable, routine activities that a general pediatrician or subspecialist should be able to perform safely and effectively to meet the needs of their patients. The American Board of Pediatrics, or ABP, collaborated with the education community several years ago to develop 17 core EPAs that are essential activities needed for practice in general pediatrics and that can be used as a framework for curriculum and assessment. The ABP also worked with the subspecialty community to develop EPAs that define what patients need from our subspecialty physicians. However, the original pediatric EPA framework developed by the ABP in conjunction with the general pediatrics and subspecialty communities did not adequately address structural racism, discrimination, and social determinants of health and their contribution to inequities. Today, we are going to hear about the development and content of a revised EPA entitled: Use of Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations.

Today, I am happy to be speaking with Dr. Ndidi Unaka and Dr. David Turner. Ndidi is a pediatric hospitalist who is involved in Cincinnati Children’s Community Health initiatives, medical director of QI and data analytics for Cincinnati Children’s ACO called HealthVine and until recently was the associate program director of the pediatric residency program at Cincinnati Children’s. David is the Vice President of Competency-Based Medical Education at the American Board of Pediatrics.

The Practice of a Non-Anxious Presence with Sylvia Klauser, PhD (Rebroadcast S5:E2) Jul 05, 2022

It is impossible to ignore the deep, and ongoing impact the COVID-19 pandemic has on every aspect of our lives. As providers who have uniquely felt these changes because of our profession, it is imperative to take time to consider our own resiliency. On today’s episode we are joined by Sylvia Klauser, PhD to talk through the practice of bringing a non-anxious presence as an avenue towards resilience and healing.

Dr. Klauser is the Manager of Spiritual Care and Bereavement Services at Children’s Hospital Colorado.

References:

“What is happening to our nervous system” and interview of Dr. Christine Runyan, PhD, with Krista Tippett at On Being

Wintering: The Power of Rest and Retreat in Difficult Times by Katherine May. This is a book, but also in interview with Krista Tippett and the author Katherine May

For the more spiritual, or theological minded folks:

Serene Jones, PhD, Trauma and Grace: Theology in a Ruptured world. Serene Jones is the President of Union Theological Seminary.

And one for all healthcare providers who would like to learn to be more mindful and present a more contemplative approach:

Roshi Joan Halifax, PhD: Standing at the Edge: Finding Freedom where Fear and Courage meet.

And here the link to her book

Suicide Screening and The Blueprint for Youth Suicide Prevention with Alex Kemper, MD, Kristen Beck, MD, and Lisa Horowitz, PHD Jun 28, 2022

Suicide rates continue to increase across the United States and around the world at an alarming rate. In fact, suicide is now the second leading cause of death for youth age 10-24 years. While suicide is complex, it is often preventable. Suicide risk screening has been identified as a direct method to detect youths at risk for suicide. Today, the medical home as well as many other settings are perfectly positioned to screen adolescents at risk. In this episode, we are going to unpack the use of evidence-based screening and how primary care providers play a critical role in the identification and prevention of youth suicide.

This episode was recorded at the 2022 PAS Conference in Denver, Colorado. Today I am joined by Alex Kemper, Kristen Beck, and Lisa Horowitz. Alex Kemper is joining us from Nationwide Children’s Hospital where he serves as the Division Chief in Ambulatory Pediatrics and is a professor at the Ohio State University college of Medicine. Kristen Beck is also joining us from Nationwide Children’s where she works in the department of pediatrics in the primary care setting. Lisa Horowitz is joining us from the National Institute of Mental Health where she is a pediatric Psychologist and Senior Associate Scientist.

COVID-19 Vaccines for Kids Ages 6mo-4yr with Sean O' Leary, MD Jun 24, 2022

Note: This was recorded on June 22, 2022.

After reviewing the data submitted by both Pfizer and Moderna, the FDA authorized the COVID-19 vaccines under emergency use authorization (EUA) for children ages 6 months to 4 years.

Finding Culturally Sensitive Interventions in Primary Care with Maya Ragavan, MD, and John Cowden, MD Jun 21, 2022

The American Academy of Pediatrics defines culturally sensitive care as “the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of all cultural distinctions leading to optimal health outcomes.” In addition, providing culturally safe and sensitive care enhances patient-centered care which is one of the 6 aims of quality as defined by the Institute of Medicine and a part of the Triple Aim for populations as defined by the Institute for Health Improvement. Today, we are going to hear from the authors of a review article that identified culturally sensitive interventions in pediatric primary care settings. It was published in the February 2022 issue of Pediatrics.

Today, I am happy to be speaking with Dr. Maya Ragavan and Dr. John, JC, Cowden. Maya is an Assistant Professor of Pediatrics at the University of Pittsburgh and UPMC Children's Hospital of Pittsburgh. Maya is also a Community Partnered Researcher, and a general Pediatrician. JC is Professor of Pediatrics, a qualified bilingual primary care pediatrician, the Culture and Language Coaching Program Director and the Health Equity Integration Project Leader at Children’s Mercy Kansas City.

The Recent Hepatitis Wave with Amy Feldman, MD Jun 14, 2022

Providers and health systems around the world are seeing mysterious Hepatitis outbreaks in pediatric patients. Worldwide, there have been hundreds of cases linked to an “unknown origin.” Although medical professionals are scrambling to find answers, there seems to be a link between Adenoviral viruses. In today’s episode, we are going to talk about this hepatitis outbreak, possible causes, and what our Primary Care Providers need to know.

Today, I am excited to be speaking with my colleague Dr. Amy Feldman.

Dr. Feldman is a pediatric Gastroenterologist and is the Director of the Liver Transplant program here at Children’s Hospital Colorado.

Baby Formula Shortage: Resources for Primary Care Providers With Liliane Diab, MD Jun 09, 2022

As the shortage of baby formula continues, it is important that primary care providers are giving timely and helpful information to their patient families.

Today, we are going to hear from Dr. Liliane Diab who works in the Department of Pediatric Nutrition at Children's Hospital Colorado.

If you and your practice would like some additional resource and guidance on this topic, please click HERE.

Patients In It For the Long Haul After COVID-19 with Ben Katz, MD Jun 07, 2022

Medical experts are racing to unravel one of COVID'S greatest mysteries -- the lingering effects of the COVID in children, when symptoms last months or longer. Patients who contract COVID-19 can experience a wide range of symptoms that span from mild to severe. For most children, mild COVID-19 symptoms include a fever, cough, and body fatigue which often lasts around two to three weeks. However, it is becoming increasingly apparent that large number of children with symptomatic and asymptomatic COVID-19 are experience long term effects months after the initial infection.

This episode was recorded at the 2022 PAS Conference in Denver, Colorado. We are honored to be speaking with Dr. Ben Katz. Ben is joining us from Lurie Children’s Hospital where he is a professor of Pediatrics specializing in infectious diseases.

That's a Wrap: Season 5 Reflection and What's Next with Alison Brent, MD; David Brumbaugh MD and Dan Nicklas, MD (S5:E37) May 31, 2022

Throughout season 5 of Charting Pediatrics, we have had the pleasure to talk with an array of guests discussing topics including Asthma Care guidelines, Health inequities and disparities, COVID-19 and Vaccine updates, and other relevant topics that relate to your daily practice. We have loved learning alongside each of you, our listeners and pediatric community. As we close out this season of the podcast, I am honored to be joined with the entire host team to discuss what’s next in Pediatrics, and what we have to look forward to in the comming season of Charting Pediatrics.

As we plan for season 6, we would love to hear from you! If you have a topic that you would like to hear on Charting pediatrics, please email them to ChartingPediatrics@Childrenscolorado.org.

Celebrating One Year of Pediatras En Línea May 26, 2022

Charting Pediatrics is excited to celebrate the 1 year anniversary of Pediatras En Línea!!

Pediatras En Línea is our weekly podcast in Spanish for pediatric healthcare providers hosted by Carla Torres-Zegarra, MD. In the first year, Pediatras En Línea released 55 episodes and has reached over 69 total countries. We can’t wait to see what year two brings! Listen and subscribe on Spotify, iTunes, Google Podcasts and Google Play.

The Evolution and Improvements in Pediatric Oncology with Adam Green, MD, and Kelly Faulk, MD (S5:E36) May 24, 2022

Today's episode is underwritten by Aflac, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. For more than 20 years, Aflac has dedicated its heart and philanthropic mission to helping children with cancer. Thank you to Aflac for envisioning a world without pediatric cancer by supporting our Center for Cancer and Blood Disorders. Please visit our Charting Pediatrics website to learn more about becoming an underwriting sponsor.

Pediatric cancer is a devastating diagnosis that thousands of patients and families receive a year. When faced with such a diagnosis, it is crucial that patients and families have access to the most current and effective treatment options as possible. In the past few decades, pediatric cancer survival rates have improved immensely. Today, we are going to be discussing the treatment options, clinical trials, and the disparities and equity in pediatric oncology.

Today, I am happy to be speaking with my collogues Dr. Adam Green and Dr. Kelly Faulk.

Both Dr. Green and Dr. Faulk are a part of the Center for Cancer and Blood Disorders Team at Children’s Hospital Colorado. Dr. Green specializes in Pediatric Oncology and is an Associate Professor of Pediatrics at the University of Colorado School of Medicine. Dr. Faulk is also an Assistant Professor of Pediatrics and specialize in pediatric Leukemia and Lymphoma, with research focused on early phase trial design and experimental therapeutics for high risk forms of leukemia.

HEEADSSS Assessment within Primary Care with Samantha Hill, MD (S5:E35) May 17, 2022

As a pediatrician, it can be easy to screen your patients for physical health problems, treat them, and send them on their way. But what about other medical conditions that are not as obvious? Conversations with adolescent patients can be tough in an office setting but with a little guidance, pediatricians can feel equip to ask their teens about sex, sexuality, gender, and sexual abuse all in just 3 minutes. In this episode, we will be discussing the importance and practicality of the HEEADSSS assessments and how to conduct an effective, trauma sensitive, and time efficient exam.

Today, we are excited to be recording from the 2022 PAS Conference in Denver, Colorado. I am honored to be speaking with Dr. Samantha Hill.

Resident Files: Advocacy Project for Formula and Diaper Insecurity with Brooke Pfister, MD, and Alisa Chandrabose (S5:E34) May 10, 2022

In our series, the Resident Files, we feature the thoughts and work of talented pediatric residents here in Colorado and around the country.

In this Resident Files series, we are going to hear from a resident who is working to ensure that patients and families are adequately screened for diaper and formula needs in the medical home.

Today, I am happy to be speaking with Dr. Brooke Pfister and Alisa Chandrabose.

Brooke is currently a Chief resident and Alisa is the Director of Ambulatory and Satellite Services at Lurie Children’s Hospital of Chicago.

Contact Information Email: bpfister@luriechildrens.org

Resources

National Diaper Bank Network: https://nationaldiaperbanknetwork.org/get-help-now/

Find Relief Near You: Call 211 or visit their website at www.211.org

Find Your Local Food Bank: https://www.feedingamerica.org/find-your-local-foodbank

NowPow (Unite Us): https://www.nowpow.com/

Social Media: Follow #EndDiaperNeed

Articles Referenced

Sobowale, Clayton and Smith (2021):https://pubmed.ncbi.nlm.nih.gov/33130154/

Smith, Kruse, Weir and Goldblum (2013):https://pubmed.ncbi.nlm.nih.gov/23897910/

Berry and Blatt (2021): https://pubmed.ncbi.nlm.nih.gov/32896645/

Championing A Diverse Pediatric Workforce: Why Inclusive Excellence Matters Now, And In The Future with Ray Bignall II, MD (S5:33) May 03, 2022

An important measure of success for healthcare institutions is how well they recruit, develop, and value a diverse workforce that mirrors the communities they serve. From physicians and nurses to therapists and administrative staff, inclusive excellence matters. Today we are going to define inclusive excellence, discuss many aspects of the diverse healthcare workforce, and how we encourage our facilities to move towards developing providers and staff that resemble their patients.

Welcome to Charting Pediatrics LIVE at PAS.

Today, we have a very special guest joining us on Charting Pediatrics. Please help me give a warm welcome to O.N. Ray Bignall II. Ray joins us from Nationwide Children’s Hospital in Columbus, Ohio where he is the Assistant Chief Diversity and Health Equity Officer and the Director of Kidney Health Advocacy and Community Engagement for the Division of Nephrology and Hypertension. He is also an assistant professor of pediatrics at The Ohio State University college of Medicine.

The Pfizer Clinical Trial and the Road to Success with Lalit Bajaj, MD, Erin Sandene, and Eric Simoes, MD (S5:E32) Apr 26, 2022

Today's episode is underwritten by Metlife, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. MetLife is commited to expanding opportunities for low-and moderate-income people around the world to create financial health solutions and build stronger communities. Children's Colorado is grateful for MetLife and their support of our community. Late in 2021, the FDA approved the COVID-19 vaccine for children ages 5-11, a milestone many parents were anxiously awaiting. The FDA and CDC signed off on the use of this vaccine after a historic clinical trial demonstrated it was both safe and effective. Children’s Hospital Colorado had the privilege to advance the use of the COVID-19 vaccine by becoming the largest supersite for Pfizer’s clinical trial. Today, we are going to hear from some of my colleagues who worked tirelessly and ultimately paved the way for the EUA for children ages 5-11 in November 2021. Lalit Bajaj is the Chief Quality officer here at Children’s Hospital Colorado, Erin Sandene is the Director of Research operations and Administration, and Eric Simoes is an Infectious Disease expert here at Children’s and professor of pediatrics at the University of Colorado School of Medicine.

Serving the Underserved Communities in Primary Care with Ilan Shapiro, MD (S5:E31) Apr 19, 2022

Today, there are many complicated pediatric issues that are often hard to discuss in an office setting. The drivers of these modern health care dilemmas are often the social determinants of health or the conditions in which people are born, work, live, and age. Because these social determents vary considerably across the communities that we serve, health disparities exist for many Americans. In this episode, we are going to be talking with a pediatrician who is trying to get up stream on many of the health care problems in Southern California. Dr. IIan Shapiro is the Medical Director of Health and Wellness Education and currently serves as the Chief Health Correspondent and Medical Affairs Officer at AltaMed. Ilan has spent his entire career providing care to medically underserved populations.

Impacts of COVID and Type 2 Diabetes in Youth with Megan Kelsey, MD (S5: E30) Apr 12, 2022

Diabetes, both type 1 and type 2, are among the most serious chronic conditions in children and teens. Unfortunately, there is an increasing prevalence of both types of diabetes, especially in T2DM. During the last 2 years, COVID-19 has uniquely impacted this patient population. Stay at home orders have exacerbated and increased Type 2 risk factors including being overweight or being physically active less than 3 times a week. In this episode, we are going to discuss the impacts COVID-19 has had on kids with Type 2 Diabetes and how primary care providers can help support patients as they identify them in the medical home.

Today I am delighted to be speaking with my colleague Dr. Megan Kelsey.

 Megan is the Medical Director of Lifestyle Medicine and Metabolic and Bariatric Surgery at Children’s Colorado and is an Associate Professor of Pediatric Endocrinology at the University School of Medicine.

Resident Files: Improving Maternal Postpartum Depression Screening with Kate Schertz, MD and Natasha Dilwali, MD (S5:E29) Apr 05, 2022

In our series, the Resident Files, we feature the thoughts and work of talented pediatric residents here in Colorado and around the country.

In this Resident Files series, we are going to hear from a couple of residents who aim to improve the care of mothers with postpartum depression and discuss the role of a pediatrician.

Today, I am happy to be speaking with Dr. Natasha Dilwali and Kate Schertz. Kate and Natasha are currently PGY3 residents at Weill Cornell Medical Center.

Expectant Mothers and COVID-19 with Anna User, MD (S5:28) Mar 29, 2022

Over the last few years, the coronavirus pandemic has raised concerns for expectant mothers and their babies, ranging from concerns over fertility, breastfeeding, vaccine safety and the risk of covid infection. Recent reports show that pregnant women have a higher risk of getting severely ill from respiratory viruses like COVID-19. In this episode, we are going to unpack the risks and implications that COVID may have on pregnant women and what primary care providers can do to allay fears, dispel rumors and foster optimal care in medical home setting.

Today, I am honored to be speaking with my colleague Dr. Anna Euser.

Constipation Management with Kerry Reed, NP (Rebroadcast S4:E35) Mar 22, 2022

Today Kerry Reed, NP and host David Brumbaugh, MD talk about constipation management, one of the most common issues in pediatrics.

Kerry is a nurse practitioner in the Digestive Health Institute at Children’s Colorado and is Senior Instructor of Pediatrics, Gastroenterology, Hepatology & Nutrition at the University of Colorado School of Medicine.

Medical Home for Kids with Complex Needs with David Fox, MD (S5:E27) Mar 15, 2022

Today's episode is underwritten by Voya, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. Voya Cares is committed to being a leader in making a positive difference in the lives of people with disabilities and special needs. Thank you to Voya for their generous support of our mission at Children's Colorado. Please visit Childrens Colorado dot o-r-g slash charting pediatrics to learn more about becoming an underwriting sponsor.

Patients with medical complexity have more fragile and intensive care needs that thrive with support from their primary care provider. In this episode we are discussing the role of the medical home for children with complex needs, including high-risk newborns and children with complex medical conditions and siblings of patients with special needs, and how intentional care models support the care and outcomes for these children and their families.

Listeners you are in for a great discussion today – I am happy to be joined by my colleague Dr. David Fox. David is a pediatrician with the Special Care Clinic at Children’s Colorado and is Associate Professor of Pediatrics at the University of Colorado School of Medicine.

Resident Files: Building Kindergarten Readiness Through the Imagination Library with Matthew Present, MD (S5:E26) Mar 08, 2022

In our series, the Resident Files, we feature the thoughts and work of talented pediatric residents here in Colorado and around the country .

In this Resident Files series, we are going to explore a primary care program that is working to close the gap in disparities that emerge before formal schooling begins.

Today, I am happy to be speaking with Dr. Matthew Present. Matthew is a PGY pediatric resident at the U. Of Rochester School of Medicine.

Women in Medicine: Pivoting the Non-traditional Path to Pediatric Mental Health with Ron-Li Liaw, MD (S5:E25) Mar 01, 2022

This episode is part of our Women in Medicine series where we are pleased to feature the journey and experiences of women leaders in pediatric medicine. Today, I am so fortunate to be joined by an exceptional woman in medicine, my colleague Dr. Ron- Li Liaw. Ron-Li is the Cannon Y. & Lyndia Harvey Chair in Child and Adolescent Psychiatry, the vice chair of Diversity, Equity, and inclusion and most recently, Ron-Li has been announced as the first ever Mental Health In-Chief for Children’s Hospital Colorado.  

Transitioning Kids from Pediatric to Adult Care with Daniel Wood, MD (S5:E24) Feb 22, 2022

The transition from adolescent to adult care can often be a series of challenging obstacles for patients, families, and providers. This time of adjustment can be both overwhelming and difficult, especially for patients with congenital health conditions. Moving from a parent supervised visit to an independent patient model takes time and often takes a lot of discussion. In this episode, we are going unpack and inform primary care providers on how they can play a pivotal role in the transition of care.

Dr. Daniel Wood is the newest addition to our Urology department here at Children’s Hospital Colorado.

Resources: Twitter for pediatric healthcare professionals.

The Importance of Dairy in a Child’s Diet with Stephanie Gilley, MD, PhD (S5:E23) Feb 15, 2022

For most children, a healthy and well-balanced diet incorporates components from each major food group that nourishes their body and plays a significant role in development. A question that commonly presents to those of us in primary care is what role dairy should play in a child’s diet. Rich in nutrients and health benefits, most dairy products are key components for building and maintaining strong bones. Today, we are going to be discussing both the blessings and the challenging implications dairy can have on a child’s health.

Today, I am happy to be speaking with my colleague, Dr. Stephanie Gilley.

Stephanie works in our Growth and Parenting nutrition clinic here at Children’s Hospital Colorado. She is also an instructor in Nutrition at the University of Colorado School of Medicine. Resources: Twitter for pediatric healthcare professionals.

Little League, Big Business - the Impact of Sport Specialization on Young Athletes with Greg Walker, MD (S5:E22) Feb 08, 2022

Today's episode is underwritten by The Hartford, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Hartford works to empower others to achieve their full potential in order to help communities thrive. Thank you to The Hartford for helping Children's Colorado families thrive. Please visit our Charting Pediatrics website to learn more about becoming an underwriting sponsor.

Once upon a time, American youth played pick-up games in the street and tried out for their first organized school sport teams as they entered middle and high school. And occasionally, a local hometown hero went on to play at the collegiate level … and even more rare, someone made it to the pros. Fueled by families paying big money for private club teams, today’s youth sports have gone pro. According to TIME Magazine, kids’ sports make up a more than $15 billion industry. Children as young as five attend tryouts, are ranked in their discipline and shuttled around the country to play with the best. We are talking about the impact of sport specialization on young athletes.

 Joining us to talk through this important topic is my colleague, Dr. Greg Walker. Greg is part of our Sports Medicine and Orthopedics Institute teams, and he is Assistant Professor of Pediatrics at the University of Colorado School of Medicine.

Child Life in the Primary Care Setting with Jennifer Staab and Stephanie Barta (S5:E21) Feb 01, 2022

It is no secret that medical visits of any kind can sometimes be scary for children and their families. Certified Child Life Specialists are educated and clinically trained in the healthcare setting to help children and their families navigate and cope with the hardships of illness, hospitalization, diagnosis, and trauma. Their work improves patient and family care, satisfaction, and overall experience. In this episode, we are going to discuss how primary care providers can incorporate Child Life tools into daily practice in support of their patient families.

Today, I am happy to be speaking with my colleagues, Jennifer Staab & Stephanie Barta.

Both Jennifer and Stephanie work in our Child life department here at Children’s Hospital Colorado. Jennifer is the Manager of the department and Stephanie is a Child life Specialist.

Resources:

Comfort Holds

Guidelines of Diagnosis and Management of Infantile Hemangiomas with Carla Torres-Zegarra, MD (S5:E20) Jan 25, 2022

Infantile Hemangiomas is a common skin disorder that usually appears on children at birth or during the first few months of life. Hemangiomas are blood vessels that have incorrectly formed and multiply rapidly. Although they can form on any part of the body, they most often appear on the face, chest, scalp or back. Most of the time, Infantile Hemangiomas go away on their own, but some situations may require you to refer your patient to a specialist. In this episode we will unpack the presentation and management of infantile hemangiomas in the primary care setting. Today I am happy to be speaking with my colleague, Dr. Carla Torres-Zegarra.

Dr. Torres-Zegarra is a Dermatologist here at Children’s Hospital Colorado and is an Assistant Professor at the University of Colorado School of Medicine. Dr. Torres-Zegarra is also the host for our sister podcast, Pediatras En Linea. Pediatras En Linea is Childrens first ever Spanish speaking podcast. Just like Charting Pediatrics, she and her team release weekly episodes for our provider community.

Resources:

Clinical care Guidlines for the Management of Infantile Hamangiomas - Pediatrics - American Academy of Pediatrics

Infantile Hamagioma Referral Score: A validated Tool for Physicians - Pediatrics - American Academy of Pediatrics

Instagram for Dr. Torres- Zegarra: www.instagram.com/dermaskinmd

Health Equity In Primary Care with Robert Franklin II and Brandi Freeman, MD (S5:E19) Jan 18, 2022

Systemic racism is a crisis that daily impacts our patients and the communities in which we as Pediatricians practice medicine. As healthcare providers it is our responsibility to uphold values of justice, inclusion and equity as we serve our patient families as child advocates. Today, we will dive into what health equity is and the challenges that must be navigated in addressing health disparities, including understanding gaps of inclusion and equity in our hospital and clinics as a crucial first step in ensuring health justice for our patient families and colleagues.

Today's discussion is such an important conversation for us to share with each of you, our listeners. I am fortunate to be joined by my colleagues Robert Franklin II and Dr. Brandi Freeman.

Brandi and Robert work together for Diversity Health Equity and Inclusion at Children’s Hospital Colorado. Robert serves as the Program Manager and Brandi as the Associate Vice Chair for Diversity, Equity and Inclusion in the department of Pediatrics. Brandi is also Assistant Professor of Pediatrics at the University of Colorado School of Medicine.

COVID and the Impact on Pediatric Critical Care with Cameron Gunville, MD (S5:E18) Jan 13, 2022

Today's episode is underwritten by Allstate, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. Allstate believes in empowering youth and transforming communities. Thank you to Allstate for partnering with Children's Colorado to create innovative, long-term solutions for those in need. Please visit our Charting Pediatrics website to learn more about becoming an underwriting sponsor.

 While our pediatric patients have been at lower risk for severe disease during the COVID pandemic, its direct and indirect repercussions on pediatric illnesses have been experienced. In this episode we are going to unpack the impact that COVID has had on pediatric critical care.

Today I am joined by my colleague, Dr. Cam Gunville. Cam serves as our Medical Director of our PICU and is Associate Professor of Pediatrics and Critical Care at the University of Colorado School of Medicine.

Introducing the Charting Pediatrics Underwriting Sponsorship Program Jan 12, 2022

If you are interested in learning more about the impact that can be made to child health through underwriting sponsorship of Charting Pediatrics visit our website or contact Kali Wallace at the Children’s Hospital Colorado Foundation, kwallace@childrenscoloradofoundation.org

Eosinophilic Esophagitis, EoE with Glenn Furuta, MD (Rebroadcast S3:E14) Jan 04, 2022

Last week my colleague, Dr. Glenn Furuta, was named recipient of the 2021 Harry Shwachman Award by the North American Society for Pediatric GI, Hepatology and Nutrition. This is the highest honor given by NASPGHAN and is awarded to one person each year who has made outstanding lifetime achievements and contributions to the field of pediatric gastroenterology, hepatology and nutrition. Glenn’s lifelong work in the field of eosinophilic and allergic GI disorders has been a game changer for all pediatric (and adult) gastroenterologists and allergists, and he continues to be a global thought and research leader in all aspects of these disorders. In recognition of this honor, we wanted to rebroadcast my discussion with Glenn about Eosinophilic Esophagitis from Season 3 of the podcast. Congratulations Glenn!!

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

2021 Reflections in Pediatric Care with Mike DiStefano, MD and David Brumbaugh, MD (S5: E17) Dec 28, 2021

If the pandemic has taught us nothing else, it is that we humans are a hopeful people. I think most of us entered 2021 with high hopes that the new year would make the COVID-19 pandemic a distant memory… we kicked off the year vaccinating healthcare workers and had great promise for living in a post-pandemic world, personally and professionally. As we come to the end of this year, I think many of us might even consider 2021 even more challenging than 2020 … today we are going to reflect on the last year of pediatric care and how this shared experience has shaped us as pediatric providers.

Today I am joined by my friend and colleague, Dr. Mike DiStefano. Mike serves as our Chief Medical Officer to our Southern Colorado region. He is a practicing emergency medicine physician and is Associate Professor of Pediatrics at the University of Colorado School of Medicine.

Wishing You a Happy Holiday Season! Dec 22, 2021

Happy Holidays from the Charting Pediatrics team!

Iron Deficiency and Microcytic Anemia with Taizo Nakano, MD (S5:E16) Dec 21, 2021

Due to deficient synthesis of hemaglobin that may be caused by inadequate heme production or abnormalities of globin chain synthesis, Microcytic anemias are among the most common types of anemia in pediatric patients. Today, we will talk through their screening, workup, and treatment. Thank you to listener, Dr. Michelle Shiffman, a colleague from Denver Health, who inspired this episode.

Today I am joined by Dr. Taizo Nakano, Medical Director of the Vascular Anomalies Center at Children’s Colorado and Associate Professor of Pediatrics, Hematology/Oncology & Bone Marrow Transplantation at the University of Colorado School of Medicine.

Compassion Fatigue - Strategies for Provider Self Care (Rebroadcast S2-E39) Dec 15, 2021

In today’s episode all three hosts are in the recording studio for a round table discussion about provider self-care and compassion fatigue. The host team shares personal experiences and strategies they utilize for keeping them energized when cases have challenging outcomes.

The host team includes is David Brumbaugh, MD, pediatric gastroenterologist and Associate Chief Medical Officer at Children’s Colorado; Alison Brent , MD Pediatric Emergency Medicine Physician and Medical Director of Physician Relations and the Network of Care at Children’s Colorado; and Dan Nicklas, MD, pediatrician and Medical Director of the Pediatric Call Center at Children’s Colorado.

What We Know About the Omicron Variant & Pediatrics with Sam Dominguez, MD (S5:E15) Dec 08, 2021

For the latest information about Omicron, please join us at our next town hall this Thursday, December 10, from 6-7:30.

Register Here: Registration (gotowebinar.com)

On November 26 the World Health Organization declared Omicron the fifth variant of concern. First detected two weeks ago, South African researchers were the first to sequence this variant, identifying more than 20 mutations of SARS-CoV-2 that had never been seen before. In this episode, I am joined once again by my un-official Charting Pediatrics co-host, Dr. Sam Dominguez, to unpack what this variant means for pediatrics. Is the Omicron variant more contagious? Does it cause more severe illness? Are the vaccines still effective against it and are our pediatric patients more or less suspectable? These are all good questions.

Even if you are unable to join us live, go ahead and register and you will receive a copy of the recording sent to your email at the conclusion of the live event.

If you have any questions you would like specifically addressed on the Town Hall, please email chartingpediatrics@childrenscolorado.org

HealthySteps: Assuring Better Child Health and Development (S5: E14) Dec 07, 2021

Developmentally, the first five years of a child’s life are crucial. If children do not get the support for healthy development early on, these children and their families may experience serious challenges down the road. Assuring Better Child Health and Development, or ABCD, was established in Colorado in 2006 to address some of these needs. As a statewide nonprofit, they are focused on improving the lives of Colorado children through early identification of developmental needs. Within this nonprofit, is a program called HealthySteps. This program is the only program of its kind that places a child with a development specialist within a pediatric primary care team. Their mission is to align and mobilize pediatric and community partners to improve early childhood developmental outcomes.

Melissa Buchholz is the state director for HealthySteps in Colorado. She is a licensed clinical psychologist and an associate professor at the University of Colorado School of Medicine. Susan Burton is the Manager of Practice Improvement for HealthySteps. She offers clinical quality improvement and supports community partner’s professional development through trainings on child development and HealthySteps implementation.

1 Million Downloads: Join us on the Podcast Dec 01, 2021

In celebration for reaching 1 Million Downloads we have set up a forum to have one of you, our listeners, join us on the podcast as a guest covering one of two topics:

What is the most creative and innovative practice solution that you have implemented since the start of the pandemic?
Tell us about an intervention that has improved the mental health of your patients or team working in your practice?

Click this link to record a 90 second spot submission: https://www.speakpipe.com/Charting_Pediatrics

We will be taking submissions until December 20, 2021 when Dan, Alison and David will review your submissions and choose the best to record an episode with us!

If you have any questions, email us at chartingpediatrics@childrenscolorado.org. We can’t wait to hear from you and have one of you join us on the other side of the mic soon.

Heavy Menstrual Bleeding & Blood Disorders with Patricia Huguelet, MD and Genevieve Moyer, MD (S5: E13) Nov 30, 2021

Many young women and adolescents experience heavy or abnormal menstrual cycles. Typically, if a cycle lasts longer than 8 days, it is considered abnormal. Some other abnormalities include bleeding that occurs more than every three weeks and cycles that require one to change products every hour or less during menstruation. These symptoms can also cause fatigue, dizziness, or other signs of anemia. In today’s episode, we are going to unpack and inform providers on how to best support young women in their practices that have abnormal menstrual cycles.

Dr. Huguelet is the Section Chief for the Division of Pediatric and Adolescent Gynecology and the Fellowship Program Director at Children’s hospital Colorado. Dr. Moyer is part of the Hematology/ Oncology internal Medicine team at Children’s and is also an Assistant Professor at the University of Colorado School of Medicine. Both Dr. Huguelet and Dr. Moyer run the “Spots and Dots Clinic” here at Children’s.

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

Live Recording: COVID-19 Vaccines for Kids Ages 5-11 Roundtable Discussion with David Brumbaugh, MD Nov 24, 2021

Note: This Live Event was recorded on October 28, 2021.

We are sharing the live recording of our Special Roundtable Town Hall covering the topic of COVID-19 Vaccines for Kids Ages 5-11.

This event was recorded live on October 28, 2021, is hosted by David Brumbaugh, MD and was attended virtually by more than 900 providers across the United States.

The panelists include Sean O'Leary, MD; Sam Dominguez, MD; Jessica Cataldi, MD; Lalit Bajaj, MD; Shen Nagel, MD; Jann Hodge, RN. Discussed in this Town Hall:

Latest vaccine data
Risk/benefit conversations with patient families
Vaccine distrust from communities of color
Motivational Interviewing techniques to leverage with patient families
Resources you and your practice can use to support patient family questions
Idea/information sharing about hosting COVID-19 Vaccine clinics in your practice
Live Q&A
COVID Vaccine Resources for Providers

Click HERE to visit previous COVID-19 Virtual Town Hall recordings

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

1 Million Downloads: Join us on the Podcast Nov 23, 2021

In celebration for reaching 1 Million Downloads we have set up a forum to have one of you, our listeners, join us on the podcast as a guest covering one of two topics:

What is the most creative and innovative practice solution that you have implemented since the start of the pandemic?
Tell us about an intervention that has improved the mental health of your patients or team working in your practice?

Click this link to record a 90 second spot submission: https://www.speakpipe.com/Charting_Pediatrics

We will be taking submissions until December 20, 2021 when Dan, Alison and David will review your submissions and choose the best to record an episode with us!

If you have any questions, email us at chartingpediatrics@childrenscolorado.org. We can’t wait to hear from you and have one of you join us on the other side of the mic soon.

Breastfeeding & Marijuana with Maya Bunik, MD and Erica Wymore, MD (S5:E12) Nov 23, 2021

Colorado and Washington became the first states to fully legalize the recreational use of marijuana back in 2012. Since then, many states have followed. Although marijuana is usually a natural and non-harmful drug, researchers do not know the effect THC can have on a fetus during the prenatal period or on infants during breastfeeding. As a start, researchers set out to understand how much THC is excreted in breast milk and for how long.

Today, I am happy to be speaking with my colleagues, Dr. Maya Bunik & Dr. Erica Wymore.

Dr. Bunik is the Medical Director for our Child Health Clinic and is a Professor for General Pediatrics at the University of Colorado School of Medicine. Dr. Wymore is a Neonatologist here at Children’s. She is also an Assistant Professor for Pediatrics Neonatology at the University of Colorado School of Medicine.

Resources cited in this episode:

Colorado Department of Public Health & Environment - Healthcare Provider Resources Marijuana: Health care provider resources | Department of Public Health & Environment (colorado.gov)
1(800) CHILDREN will connect patients with substance use disorder resources
Alcohol and Substance Abuse Screening, Brief Intervention, Referral to Treatment (SBIRT) - Online Training — SBIRT Colorado

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

COVID Vaccine & Kids: Managing Potential Allergic Reactions with Matthew Greenhawt, MD (Rebroadcast S4:E38) Nov 16, 2021

After a long 18 months of living through a pandemic, vaccines have paved a way forward to a new normal – Just 6 weeks ago, the Pfizer vaccine received emergency use authorization for adolescents down to age 12; and here at Children’s Colorado, we are a Pfizer vaccine trial site for kids ages 5-11. As more of our pediatric patients become eligible for the vaccine, primary care providers will be considering how to safely vaccinate patients with a risk of allergic reaction. In this episode, we will talk about the incidence, suspected epidemiology and current policy related to allergic reactions to the SARS-CoV-2 vaccines and steps for avoiding potential adverse reactions.

Today's guest is Dr. Matt Greenhawt, Director of the Food Challenge and Research Unit at Children’s Hospital Colorado and Associate Professor of Pediatrics, Section of Allergy & Immunology 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

Applying the Updated Asthma Guidelines in Primary Care with Bill Anderson, MD and Monica Federico, MD (S5:E11) Nov 09, 2021

As the pandemic continues to alter our expectations for typical respiratory season patterns it has become especially important for patients to have good control and management of their asthma. In today’s episode, we are going to discuss the recent asthma guideline updates and how to apply them to your clinical practice.

Today I am happy to be joined by my colleagues Dr. Bill Anderson and Dr. Monica Federico.

Bill is the Director of the Multidisciplinary Asthma Clinic at Children’s Colorado and Assistant Professor of Pediatrics at the University of Colorado School of Medicine.

Monica is Medical Director of the Asthma Program and Clinical Alignment for the Breathing Institute at Children’s Colorado and is Associate Professor of Pediatrics & Pulmonary Medicine 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.

Early Identification of Central Nervous System Tumors in Primary Care Pediatrics with Adam Green, MD (S5:E10) Nov 02, 2021

Central nervous system (CNS) tumors account for a quarter of all cancers in children aged 1 to 19 years. Nearly 70% of CNS tumors can be effectively treated, but early detection is critical to allow for the best possible treatments and outcomes. Too often, CNS tumors are initially misdiagnosed as more common pediatric conditions such as migraine, gastroenteritis or other psychologic and behavioral problems. In this episode, we discuss the classic signs and presentations of CNS tumors to support early detection.

Our guest for today's episode is Dr. Green. Dr. Green is part of the Center for Cancer and Blood Disorders Team at Children’s Hospital Colorado and is Assistant Professor of Pediatrics, Hematology/Oncology/and Bone Marrow Transplantation 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

Nonalcoholic fatty liver disease (NAFLD) in Pediatrics with Shikha Sundaram, MD (S5:E9) Oct 19, 2021

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States, affecting almost 10 percent of all children. Sometimes referred to as "fatty liver disease," it is actually a range of diseases that all begin when excess fat gets deposited in the liver, most significantly impacting our obese patients. In today’s episode we are joined by guest Shikha Sundaram, MD to discuss the clinical presentation and treatment of NAFLD, including how primary care providers can provide critical support to families making significant lifestyle changes as part of their treatment.

Dr. Sundaram is the Medical Director of the Pediatric Liver Transplant Program at Children’s Hospital Colorado and is Associate Professor of Pediatrics, Gastroenterology, Hepatology and Nutrition 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

Special Town Hall: Delivering COVID-19 Vaccines for Kids Aged 5-11 Oct 15, 2021

After last week’s announcement that Pfizer had applied for their EUA we have heard from a number of you requesting a special podcast episode in preparation for delivering the COVID vaccine to our kids aged 5-11. We have set up something even better for you – vaccine expert and past Charting Pediatrics guest, Dr. Sean O’Leary is going to join Dr. Brumbaugh to host a live COVID Vaccine Town Hall scheduled for Thursday, October 28 at 6PM MST.

Register Here: https://attendee.gotowebinar.com/register/6229170295675128332

This Town Hall will be an interactive session with the latest information about the vaccines, motivational interviewing techniques and other resources to leverage in support of vaccinating this younger pediatric population. We will also have a time for live Q&A from you.

Even if you are unable to join us live, go ahead and register and you will receive a copy of the recording sent to your email at the conclusion of the live event.

If you have any questions you would like specifically addressed on the Town Hall, please email chartingpediatrics@childrenscolorado.org

Our leadership panel includes: Lalit Bajaj, MD, Chief Quality Officer David Brumbaugh, MD, Chief Medical Officer Jessica Cataldi, MD, Pediatric Infectious Diseases Sean O'Leary, MD, Pediatric Infectious Diseases Shen Nagel, MD, Pediatrics West, Primary Care Pediatrician in Denver

We look forward to connecting with many of you on October 28 as we prepare to vaccinate our younger pediatric patients and take one step closer to closing out the pandemic.

The Power of Play with Gabriella Gonzales, MD & Alex Rakowsky, MD (S5:E8) Oct 12, 2021

While the majority of Western culture tends to focus on a child’s academic readiness & success, the importance and benefits of play are critical to development. In today’s episode, we are joined by our colleagues from Nationwide Children’s Hospital to talk about a recent article they published about the important role that individual and group play has in child development.

This episode is part of our Resident Files series where we are pleased to feature the thoughts and work of the talented pediatric residents.

Today's guests are Dr. Gabriella Gonzales, PGY3 at Nationwide Children’s Hospital and Dr. Alex Rakowsky, Associate Program Director of the Pediatric Residency Program at Nationwide Children’s Hospital and Assistant Professor of Pediatrics at The Ohio State University.

Article cited in this episode: The Importance of Play by Gabriella Gonzales, MD and Alex Rakowsky, MD to be published Fall 2021 in Peds in Review.

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

Respiratory Roulette: COVID, RSV and other Viruses with Heather De Keyser, MD and Oren Kupfer, MD (S5:E7) Oct 11, 2021

COVID-19 Town Hall for Providers: Join Dr. Brumbaugh and the Children's ID team this Thursday, October 14 at 6P MST to hear the latest information about the impact of the pandemic on pediatrics: https://attendee.gotowebinar.com/register/5597455784941724942

Fitting the unprecedented nature of the last 18 months, Summer 2021 ushered in an unusual, very early respiratory season in pediatrics, causing many of us to pause to consider what the typical Winter respiratory season may hold. Between the rise of the Delta variant, national nursing shortages, contentious mask mandates and the eager anticipation of EUA approval for the COVID vaccine use in kids aged 5-11... we in healthcare find ourselves in a sobering reality. In this episode, we are joined by our pediatric pulmonary colleagues to talk through clinical pearls for determining if patients are presenting with RSV, COVID or some other viral infection.

Heather De Keyser, MD is a faculty member in the Breathing Institute at Children’s Colorado and Assistant Professor of Pediatrics and Pulmonary Medicine at the University of Colorado School of Medicine.

Oren Kupfer, MD is the Inpatient Medical Director of the Breathing Institute at Children’s Colorado and Associate Professor of Pediatrics and Pulmonary Medicine 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

Penicillin Allergy Delabeling with Kirstin Carel, MD (S5:E6) Oct 05, 2021

While more than 10% of patients in the U.S. have a penicillin allergy noted in their medical record, many of these patients are not allergic and have either outgrown their allergy or actually experienced viral rash or nonimmunological adverse reactions. In this episode, we will talk through recently published studies that inform efforts to delabel patients who are incorrectly labeled as penicillin allergic.

Our guest for today's episode is Dr. Kirstin Carel. Dr. Carel is part of our Allergy and Immunology Team at Children’s Hospital Colorado and is Associate Professor of Pediatric Allergy and Immunology 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

How COVID-19 Continues to Change Pediatric Healthcare with Raphe Schwartz and Rhae Gamber (S5:E5) Sep 21, 2021

For the last 18 months we have collectively navigated personal and professional challenges related to the pandemic – We have celebrated the achievements of science with the development of the COVID vaccines and we have grieved the compounding impacts to all things “normal” in life, including how we deliver care to our patient families. Today, we face a national shortage of healthcare workers converging with an increased demand for care as a historic early respiratory season and the Delta variant circulate in our communities. In this episode we are joined by Raphe Schwartz and Rhae Gamber to discuss the pediatric healthcare landscape and unique considerations for pediatric providers.

Raphe serves as Chief Strategy Officer at Children's Hospital Colorado and joining us from Sg2 Healthcare Intelligence services, Rhae Gamber, Consulting Director of Women’s Health & Pediatric Intelligence.

If any children’s hospital leaders or pediatric providers are looking for more info on Sg2 visit https://www.sg2.com/childrens

To listen to our last discussion about the impacts of the COVID-19 pandemic on primary care pediatrics and the broader pediatric healthcare delivery system, listen to COVID-19 & the Pediatric Healthcare Landscape with Madeleine McDowell, MD, Karyl Kopaskie, PhD and Raphe Schwartz (S4:E8)

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

Innovations in Fertility Preservation with Leslie Appiah, MD (S5:E4) Sep 14, 2021

When our pediatric and adolescent patients are diagnosed with cancer or another life-altering conditions, the focus is often on treatment and not the changes chemotherapy, radiation and surgery may have on their body’s long-term function. In this episode, we are joined by Leslie Appiah, MD to discuss the innovative topic of fertility preservation for pediatric and adolescent patients -- both at cancer diagnosis and in survivorship.

Dr. Appiah is part of the Pediatric and Adolescent Gynecology team at Children’s Colorado and is Division Chief, Academic Specialists in Obstetrics and Gynecology and Director of the Fertility Preservation and Reproductive Late Effects Program at the University of Colorado School of Medicine. She is co-founder of the Pediatric Initiative Network of the Oncofertility Consortium where she served as chair for 5 years and is current co-chair of the Adolescent and Young Adult Reproductive Late Effects Committee.

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

Flu Vaccine, Egg Allergy & the COVID Vaccine with Matthew Greenhawt, MD (S5:E3) Sep 07, 2021

Annual seasonal influenza vaccination remains the most effective means of protection against contracting influenza illness and preventing spread of the disease. It is estimated that more than 23,000 deaths occur each year in the United States because of influenza, including approximately 124 children. Egg-allergic children are a subgroup who may be at higher risk for influenza-related complications. In this episode we are joined by Matt Greenhawt, MD to review the incidence, suspected epidemiology and current policy related to allergic reactions to the influenza vaccine and steps for avoiding potential adverse reactions.

Dr. Greenhawt is the Director of the Food Challenge and Research Unit at Children’s Hospital Colorado and Associate Professor of Pediatrics, Section of Allergy & Immunology at the University of Colorado School of Medicine.

Listen to COVID Vaccine & Kids: Managing Potential Allergic Reactions with Matthew Greenhawt, MD (S4:E38)

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

The Practice of a Non-Anxious Presence with Sylvia Klauser, PhD (S5:E2) Aug 31, 2021

It is impossible to ignore the deep, and ongoing impact the COVID-19 pandemic has on every aspect of our lives. As providers who have uniquely felt these changes because of our profession, it is imperative to take time to consider our own resiliency. On today’s episode we are joined by Sylvia Klauser, PhD to talk through the practice of bringing a non-anxious presence as an avenue towards resilience and healing.

Dr. Klauser is the Manager of Spiritual Care and Bereavement Services at Children’s Hospital Colorado.

References:

“What is happening to our nervous system” and interview of Dr. Christine Runyan, PhD, with Krista Tippett at On Being

Wintering: The Power of Rest and Retreat in Difficult Times by Katherine May. This is a book, but also in interview with Krista Tippett and the author Katherine May

For the more spiritual, or theological minded folks:

Serene Jones, PhD, Trauma and Grace: Theology in a Ruptured world. Serene Jones is the President of Union Theological Seminary.

And one for all healthcare providers who would like to learn to be more mindful and present a more contemplative approach:

Roshi Joan Halifax, PhD: Standing at the Edge: Finding Freedom where Fear and Courage meet.

And here the link to her book

Join Dr. Brumbaugh, Dr. Dominguez and Dr. Cataldi for our next COVID-19 Virtual Town Hall on Thursday, September 9 at 6PM (MST). Register here: https://attendee.gotowebinar.com/register/1065070942537572367

Access previous Town Hall recordings and other COVID-19 resources for providers by visiting https://www.childrenscolorado.org/covid19

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

Delta Rising: The Pandemic and Pediatrics with Jessica Cataldi, MD and Sam Dominguez, MD (S5:E1) Aug 24, 2021

Join Dr. Brumbaugh, Dr. Cataldi and Dr. Dominguez for the next Virtual COVID-19 Town Hall for Pediatric Providers, Thursday, September 9 at 6PM MST. Register here: https://bit.ly/3jcQVDR

COVID-19 is once again dominating concerns for pediatric providers as we prepare for back to school across the U.S.

Between the rise of the Delta variant, national nursing shortages, mask mandates and the eager anticipation of EUA approval for the COVID vaccine use in kids aged 5-11... we in healthcare find ourselves in a sobering reality. In this episode we are joined by Jessica Cataldi, MD and Sam Dominguez, MD, PhD to overview the latest impacts of the pandemic on pediatrics.

Resources:

Masks and development/learning in young kids

Masking in Schools Literature Review

Low secondary transmission in schools when masking in place

Note that the most frequently cited article about masks and children being harmful has been retracted due to concerns of fraud and misrepresentation of methods and findings.

Dr. Cataldi's recipe for marinated cucumber and tomato salad (add dill & feta)

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

Charting Pediatrics Season 5 is Here! Aug 24, 2021

We are excited to kick off Season 5 of Charting Pediatrics today! Listen to hosts David Brumbaugh, Alison Brent and Dan Nicklas preview what this season has in store. Thank you to the more than 50,000 providers in 179 countries who tune in to Charting Pediatrics each month -- your support and engagement has made this new season possible.

Do you have a suggestion for a guest or future topic? Write to us, chartingpediatrics@childrenscolorado.org -- we promise to write you back!

Season 5 Launches August 24! Aug 23, 2021

We have spent the month of July preparing for Season 5 of the podcast where we will continue to explore everything from how the COVID-19 pandemic is impacting pediatrics, to the pediatric mental health crisis and other common topics and innovations that you can apply to your daily medical practice.

Our host team would love to hear from you – if you have a specific topic or guest you would like to suggest for the show, write to us, chartingpediatrics@childrenscolorado.org

Look for Season 5 to start on Tuesday, August 24!

The Intersection Between Aviation & Medicine with United Airlines (Rebroadcast S4:E12) Aug 13, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

Safety and teamwork are second nature for pediatric providers. In medicine, we have long looked to the airline industry as a leader in the application of crisis response and as the ideal of high reliability. Coming from a shared reality that even the most experienced professionals are vulnerable to human error, both aviation and medical professionals rely on problem-solving strategies to optimize responses to critical incidents.

In this episode we discuss the collaborative work of physicians at Children's Colorado's Heart Institute and Human Factors and Pilot Development leaders at United Airlines.

Our guests are Robby Bishop, MD, Director of the Simulation Lab at the Children's Hospital Colorado Heart Institute; Rob Strickland, Senior Manager of Human Factors and Pilot Development at United Airlines; and Carlos Porges, Psy.D, Neuropsychologist, Boeing 757/767 Pilot and member of the Human Factors and Development Team at United Airlines.

Paper: Crisis Resource Management in Medicine: A Clarion Call for Change

Video: Crisis Resource Management in Medicine: A Clarion Call for Change

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

Medication Management for Pediatric Hypertension Patients with Steve Daniels, MD (Rebroadcast S3:E26) Aug 03, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

In Season 2 on the podcast we discussed the initial diagnosis and lifestyle management of hypertension in pediatric patients. If you have not had the opportunity to listen to that episode, go back and check out Season 2, Episode 36 as it will set the back drop for today’s discussion as we dive more specifically into medication management for pediatric hypertension patients.

In this episode we discuss medication management for pediatric hypertension patients with a pediatric cardiologist, Steve Daniels, MD, PhD and a clinical pharmacist, Dr. Megan Greene.

Dr. Greene is a pediatric clinical pharmacist at Children’s Hospital Colorado with a specialization in critical care and kidney and liver transplant pharmaceutical support, and also works in our pediatric hypertension clinic.

Dr. Daniels is the Pediatrician-in-Chief at Children’s Hospital Colorado and L. Joseph Butterfield Chair of Pediatrics within the University of Colorado School of Medicine, where he is a professor of pediatrics and epidemiology. He is a cardiologist by training and a sought-out expert in the fields of pediatric hypertension, dyslipidemia, and pediatric nutrition.

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

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

Seizures & Spells: Diagnosis & Management of Events That Worry Us with Shavonne Massey, MD, MSCE and Mered Parnes, MD (Rebroadcast S3:E32) Jul 27, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

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

School Anxiety and School Refusal in Kids (Rebroadcast S1:E25) Jul 27, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

Our guest for this episode is Jessica Hawks, 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. Hawks 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 can approach treatment of school refusal
The recommended frequency of follow-up care for kids who are refusing to go to school
The importance of connecting parents to community-based resources
Preventative practices parents can set up in the home to prevent this behavioral issue
What an excellent prognosis looks like for children experiencing school refusal
When it's time to refer to a mental health professional
PCPs in the Denver Metro Area can refer patients to the Children's Hospital Colorado Outpatient Psychiatry Clinic or to a local community mental health center

Resources for dealing with school refusal:

School Refusal: Information for Educators (.pdf) from the National Association for School Psychologists
School Refusal in Children and Adolescents from American Family Physician
The Functional Assessment of School Refusal Behavior
Effective Child Therapy
Division 53 of the Society of Clinical Child & Adolescent Psychology website
School Refusal from the American Academy of Child & Adolescent Psychiatry

Toxicity and the Most Common Pediatric Overdoses (Rebroadcast S2:E29) Jul 22, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

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.

Common Breathing Issues During Respiratory Season with Ben Hughes, MD (Rebroadcast S4:E18) Jul 20, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

Respiratory diseases account for nearly a quarter of all pediatric consultations. And in addition to the usual suspects on our differentials, we now have the consideration of COVID-19. In today’s episode, we talk with Ben Hughes, MD about the most common breathing issues during respiratory season, important diagnostic considerations and treatments options.

Dr. Hughes is a pediatric pulmonologist at Children’s Hospital Colorado and lives locally on the Western Slope of Colorado in Grand Junction; he is Assistant Professor of Pediatrics and Pulmonary Medicine 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

Sepsis with Halden Scott, MD (Rebroadcast S3:E12) Jul 14, 2021

Our Summer 2021 Series features the rebroadcast of some of our most listened-to episodes from the last 4 seasons of Charting Pediatrics. Do you have a guest or topic suggestion for Season 5? Let us know, chartingpediatrics@childrenscolorado.org

Sepsis remains one of the leading causes of morbidity and mortality in children despite improved understanding of the pathophysiology leading to better clinical management and survival. Recent studies have identified several areas that must be addressed by the clinician in order to continue to impact the morbidity and mortality associated with sepsis. In today’s episode we talk with Halden Scott, MD about the presentation, management and follow-up care of pediatric patients with sepsis.

Dr. Scott is an Associate Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine and a Pediatric Emergency Medicine Physician at Children’s Hospital Colorado.

Resources mentioned in today's episode:

The Children’s Hospital Association Improving Pediatric Sepsis Outcomes Collaborative
Children’s Hospital Colorado Pathways: Scroll to Emergency Department/Urgent Care Sepsis for the sepsis pathway
The most recent pediatric sepsis guidelines

Articles that Dr. Scott referred to in the podcast about the role of lactate in sepsis, and the problems with SIRS criteria for sepsis screening:

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

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

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

That's a Wrap: Season 4 Reflections with Alison Brent, MD; David Brumbaugh MD and Dan Nicklas, MD (S4:E39) Jul 13, 2021

Season 4 of Charting Pediatrics is a wrap! Thank you for listening, writing in and creating this dynamic pediatric podcast community.

Throughout the month of July 2021 we will be re-broadcasting some of our most popular episodes from Season 4 and we look forward to launching Season 5 in August. If you are looking for new content and want to brush up on your Spanish skills, check out our new Spanish podcast for pediatric providers, Pediatras En Línea.

Until next time, keep on keeping kids safe out there.

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

Introducing Pediatras En Línea Jun 26, 2021

A new podcast from Children’s Hospital Colorado. Pediatras En Línea is a weekly podcast in Spanish for pediatric healthcare providers hosted by Carla Torres-Zegarra, MD. In this series, providers from around the globe will discuss the latest treatments and innovations for the delivery of pediatric medicine and the nuanced art of delivering care in their home communities. Listen and subscribe on Spotify, iTunes, Google Podcasts and Google Play.

Read more about Pediatras En Línea

Do you suggestions for a topic or guest for Pediatras En Línea? Write to us, pediatrasenlinea@childrenscolorado.org

COVID Vaccine & Kids: Managing Potential Allergic Reactions with Matthew Greenhawt, MD (S4:E38) Jun 25, 2021

After a long 18 months of living through a pandemic, vaccines have paved a way forward to a new normal – Just 6 weeks ago, the Pfizer vaccine received emergency use authorization for adolescents down to age 12; and here at Children’s Colorado, we are a Pfizer vaccine trial site for kids ages 5-11. As more of our pediatric patients become eligible for the vaccine, primary care providers will be considering how to safely vaccinate patients with a risk of allergic reaction. In this episode, we will talk about the incidence, suspected epidemiology and current policy related to allergic reactions to the SARS-CoV-2 vaccines and steps for avoiding potential adverse reactions.

Today's guest is Dr. Matt Greenhawt, Director of the Food Challenge and Research Unit at Children’s Hospital Colorado and Associate Professor of Pediatrics, Section of Allergy & Immunology 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

More than Meets the Eye: Plastic Surgery and Pediatrics with Aaron Mason, MD (S4:E37) Jun 22, 2021

Plastic surgery conjures up associations with cosmetic and aesthetic improvements, often in the name of vanity. However, plastic surgeons play an important role in pediatrics for addressing congenital defects, post-traumatic deformities, skin infectious and benign and malignant tumors. In this episode ,we are going to talk through the most common pediatric plastic surgery referrals from primary care.

Dr. Mason is the Chief of Plastic Surgery at Children’s Hospital Colorado and is Visiting Associate Professor of Plastic & Reconstructive Surgery 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

Resident Files: Leading Clinical Change Management with Nadia Hoekstra, MD & Joe Zakhar, MD (S4:E36) Jun 15, 2021

In our series, the Resident Files, we feature the thoughts and work of the talented pediatric residents of Children's Hospital Colorado and the University of Colorado School of Medicine.

We are joined by Nadia Hoekstra, MD and Joe Zakhar, MD to explore the tenets of how our resident and fellow teams collaborated with leadership from the Children's Colorado Heart Institute to implement a program called Codes on the Go, which aimed to reduce cardiac arrest rates in the CICU, resulting in the lowest rates among any pediatric heart programs in the country.

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

Constipation Management with Kerry Reed, NP (S4:E35) Jun 10, 2021

Today Kerry Reed, NP and host David Brumbaugh, MD talk about constipation management, one of the most common issues in pediatrics.

Kerry is a nurse practitioner in the Digestive Health Institute at Children’s Colorado and is Senior Instructor of Pediatrics, Gastroenterology, Hepatology & Nutrition at the University of Colorado School of Medicine.

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

Refugee & Immigrant Health in Pediatrics with Janine Young, MD (S4:E34) Jun 01, 2021

According to the American Academy of Pediatrics, 1 in 4 children in the United States are part of an immigrant family unit. By definition, immigrant children are those born outside the United States or who have at least one foreign-born parent. In the last decade, global conflicts have propelled the migration of these families, creating a more diverse migrant population and given rise to divisive sociopolitical policy in our country. Like all children, the experiences of this patient population are diverse and have direct impacts on their biopsychosocial development. Additionally, this patient population may face unique challenges of inequity that can threaten their health and wellbeing. In this episode, we will talk through considerations that pediatric medical providers can make that are uniquely supportive to the refugee and immigrant patient population.

For this discussion we are pleased to be joined by a colleague from the broader pediatrics community in Denver, Janine Young, MD.

Dr. Young is the Medical Director of the Denver Health Refugee Clinic; Co-Medical Director of the Denver Health Human Rights Clinic and Medical Advisor for the Colorado Refugee Services Program. She is also Associate Professor of Pediatrics at the University of Colorado School of Medicine.

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

Cutting-edge Therapies for Neuromuscular Disease with Sue Apkon, MD & Julie Parsons, MD (S4:E33) May 25, 2021

In this episode we are joined by Sue Apkon, MD and Julie Parsons, MD to discuss the impact cutting edge therapies for neuromuscular disease have had on improving the outcome and quality of life for patients.

Sue is the Fischahs Endowed Chair of Pediatric Rehabilitation Medicine at Children’s Colorado and is Professor of Physical Medicine & Rehabilitation at the University of Colorado School of Medicine.

Julie is the Haberfeld Family Endowed Chair in Pediatric Neuromuscular Disorders at Children’s Colorado and Professor of Clinical Pediatrics and Neurology 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

COVID Vaccines and Kids with Eric France, MD, CMO of the Colorado Dept. of Public Health & Environment (S4:E32) May 20, 2021

Last week, the federal government took a final step toward making the Pfizer COVID vaccine available to adolescents in the U.S. when the CDC formally recommended the vaccine for use in children ages 12 to 15. The approval of the vaccine for our adolescent patients is exciting. It also presents a unique opportunity for us, as pediatricians, to spend time engaging with families to address their questions and share our confidence in this vaccine.

In this episode, we are fortunate to be joined by Dr. Eric France, Chief Medical Officer at 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

Managing Button Battery & Other Foreign Body Ingestions with David Brumbaugh, MD (Rebroadcast S3:E39) May 19, 2021

Today we are joining Trainees for Child Injury Prevention (T4CIP) for their Day of Action in bringing attention to high-powered magnet injuries in kids and teens. T4CIP is a group of pediatricians and medical trainees from across the country who are passionate about childhood injury prevention. High-powered magnets have caused thousands of injuries and are considered to be among the most dangerous ingestion hazards in children.

Calls to Poison Centers about High-Powered Magnets Increased by 444% after Ban Lifted

We encourage you to join this national collaboration by posting messages on social media throughout today (May 19, 2021) using #MagnetSafety and participating in a Twitter chat at 1-2 p.m. ET using the same hashtag.

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 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

Resident Files: Improving Care for Medically Complex Young Adults (S4:E31) with Michelle Brajcich, MD, Sam Robin, MD & Hannah Friedman, MD May 13, 2021

Complex patients are increasingly common in primary care and often have poor clinical outcomes. Barriers within our healthcare system challenge effective care for complex patients within our hospital systems, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Today, we are going to talk about improving care for medically complex young adults, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care.

In our series, the Resident Files, we explore efforts of Children's Hospital Colorado and CU School of Medicine pediatric residents to examine the social determinants of health that impact the patients they see in primary care clinic and how all pediatric providers can make considerations for these impacts in their own practice.

Our guests for this Resident File episode are Dr. Michelle Brajcich, PGY3; Dr. Samantha Robin PGY2 and Dr. Hannah Friedman PGY2.

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

Introducing Pediatras En Línea May 12, 2021

A new podcast from Children’s Hospital Colorado. Pediatras En Línea is a weekly podcast in Spanish for pediatric healthcare providers hosted by Carla Torres-Zegarra, MD. In this series, providers from around the globe will discuss the latest treatments and innovations for the delivery of pediatric medicine and the nuanced art of delivering care in their home communities. Watch for the launch on May 18, 2021.

Listen and subscribe on Spotify, iTunes, Google Podcasts and Google Play beginning May 18.

Do you suggestions for a topic or guest for Pediatras En Línea? Write to us, pediatrasenlinea@childrenscolorado.org

The Pandemic & Pediatrics: An Update on Vaccines, Variants and Schools with Jessica Cataldi, MD, Sam Dominguez, MD and Sean O'Leary, MD (S4:E30) May 04, 2021

Join Dr. Brumbaugh and the Children's Colorado ID Team on May 13 at 6 p.m. MST for the next COVID-19 Provider Town Hall, featuring live Q&A, Register now: https://bit.ly/2RoiezA

It has been almost a month since Pfizer requested to expand use of its COVID-19 vaccine to adolescents ages 12 to 15. The request asks the Food and Drug Administration to amend their vaccine’s emergency use authorization, which the FDA originally granted late last year for people ages 16 and up. Meanwhile, our colleagues in Michigan are seeing record numbers of hospitalized pediatric patients, creating a greater sense of anticipation and urgency for the vaccine’s approval down to age 12. In this episode we will delve into vaccines, variants, schools and more as we examine the latest impacts the pandemic has had on pediatrics.

Today we are fortunate to be joined once again by un-official Charting Pediatrics co-host, Dr. Sam Dominguez. And not only is Sam with us, but we have the expertise of returning Infectious Diseases experts Dr. Sean O’Leary and Dr. Jessica Cataldi.

For those of you who don’t know, Children’s Colorado has hosted virtual COVID-19 Town Halls for pediatricians since March 2020 – these Town Halls have been anchored and fueled by the expertise of Sam, Sean & Jess and we are exceptionally fortunate to be joined by all of them on the podcast today. Register for our next Town Hall here: ://bit.ly/2RoiezA

Don't miss Post-Acute COVID Syndrome in Pediatrics with Donna Curtis, MD & Rachel Workman, MD (S4:E29)

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

Post-Acute COVID Syndrome in Pediatrics with Donna Curtis, MD & Rachel Workman, MD (S4:E29) Apr 27, 2021

While statistics indicate that children have largely been spared from the worst effects of COVID-19, little is known about what causes a small percentage of them to develop serious illness. Providers are now reporting the emergence of downstream complications that mimic what’s seen in adult “long haulers.” In this episode, Dr. Donna Curtis and Dr. Rachel Workman join us as we consider how pediatricians can support patients who are dealing with the lingering effects of post-COVID infection.

Donna Curtis, MD is an infectious diseases physician at Children’s Colorado and Associate Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Rachel Workman, MD runs the Integrative Medicine Clinic at Children’s Colorado and is Assistant Professor of Pediatrics at the University of Colorado School of Medicine.

Patient-Led Research Collaborative for COVID-19

Join us for our next Virtual COVID-19 Town Hall on May 13 at 6 p.m. (MST) where we unpack the latest research on the pandemic and how it is impacting kids, as well as Q&A with the Children's Colorado Infectious Diseases team. Register today: https://bit.ly/3tZ1CwH

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

Screening for Iron & Vitamin D Deficiency with Liliane Diab, MD (S4:E28) Apr 20, 2021

In the last decade, studies have shown the fundamental role Vitamin D plays in disease and health. Vitamin D deficiency often develops in childhood and is estimated to impact one in 10 U.S. children. Prolonged and untreated vitamin D deficiency can impact multiple organs and functions, but it rarely causes overt symptoms and often goes unnoticed. In this episode, we are joined by Liliane Diab, MD to discuss screening for iron and Vitamin D deficiency.

Dr. Diab is part of the Clinical Nutrition team at Children’s Hospital Colorado and is 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

Bone Stress Injuries with Aubrey Armento, MD & Amanda McCarthy, Sports Nutritionist (S4:E27) Apr 09, 2021

The growing prevalence of specialization and year-around training in youth sports has contributed to an increase in bone stress injuries in children. In today’s episode we are going to discuss the factors which contribute to stress injuries, including nutrition, hormonal health, age of the athlete and more.

Our guests on this episode are Aubrey Armento, MD and Amanda McCarthy, Sports Nutritionist from the Sports Medicine Center at Children's Hospital Colorado.

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

A Difficult Week in Colorado: Discussing Firearm Safety (S4:E26) Mar 29, 2021

This has been a tragic week on top of an already difficult year for us in Colorado. On Tuesday, March 23, a gunman opened fire at a local grocery store in Boulder, killing 10 people; the suspect is a 21-year-old. Our community mourns another mass shooting.

As our Charting Pediatrics team grieves with our neighboring community, we are reminded of the critical role that we as pediatricians can play in promoting gun safety and safe storage of fire arms.

Locally, in Colorado Children’s Hospital Colorado is supporting HB21-1106, a firearm storage safety legislation which requires three main things:

Gun owners to securely store their guns
Federally licensed gun dealers to provide a locking device
The Colorado Department of Public Health and Environment to publish information on safe storage

The bill passed the House on March 9 and has been introduced in the Senate and assigned to the Senate Judiciary Committee for a hearing. We encourage our Colorado listeners to contact your local lawmakers to support the bill. If you have questions about how you can be further involved in advocacy efforts please email us, chartingpediatrics@childrenscolorado.org

This is a rebroadcast from Season 2 that covers practical tips for talking with your patient families about firearm safety.

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

Sacral Dimples with Todd Hankinson, MD (S4:E25) Mar 23, 2021

Join Dr. Brumbaugh and the Children's Colorado Infectious Diseases team this Thursday, March 25 at 6 p.m. MST for our virtual COVID-19 Town Hall with live Q&A and discussion about the latest developments in the ongoing pandemic and the impact to pediatrics. Register here: https://register.gotowebinar.com/register/2692793450142707472

Sacral dimples are relatively common and seen in around 2-4% of healthy, newborn babies and are not cause for concern. Although the cause of them is unknown, in most cases, sacral dimples are simply signs of minor abnormalities as the baby grows inside the womb, but in rare cases, they can indicate a deeper spinal abnormality. In this episode, we are joined by Todd Hankinson, MD to discuss the epidemiology of sacral dimples, their associated pathophysiologic conditions and indications they are associated with congenital anomalies.

Dr. Hankinson is the Chief of Neurosurgery at Children’s Hospital Colorado and is Professor of Neurosurgery 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

Resident Files: Just Like Us Books, Why Representation Matters in Children's Literature (S4:E24) Mar 09, 2021

Many of our patients grow up never seeing a character that looks like themselves in a book. In fact, research suggests that 75% of characters in children’s books are white. Being able to relate to a character in a book helps entice our early readers that reading is fun and link themselves to the story. Seeing ones-self as the lead character of a book gives our patients an idea of what they might become. Diversity in literature matters. In today’s Resident Files episode, we discuss an initiative called Just Like Us Books that pediatric residents at Children’s Hospital Colorado have launched.

Our guests for today's episode are all PGY3 pediatric residents at Children's Hospital Colorado and the University of Colorado School of Medicine: Alexis Ball, MD; Katelyn Soares, MD and Ariel Porto, MD.

Books included in Just Like Us Project:

It’s Okay to Be Different by Todd Parr (Preschool-1 year)
First Laugh, Welcome Baby! By Rose Ann Tahe
Antiracist Baby by Ibram X. Kendi (baby-3 years)
Hair Love by Matthew A. Cherry (Preschool-3 years)

Worm Loves Worm by J.J. Austrian (Preschool-3 years)
And Tango Makes Three by Justin Richardson (2-5 years)
Antiracist Baby by Ibram X. Kendi (baby-3 years)
Round is a Tortilla by Roseanne Thong (3-5 years)

Fry Bread by Kevin Noble Maillard (3-6 years)
The Proudest Blue by Ibtihaj Muhammad(Preschool-3 years)
Same, Same, but Different by Jenny Kostecki-Shaw (4-7)

A Family Is a Family Is a Family by Sara O’Leary (4-7 years)
Sulwe by Nyong’o Lupita (4-8)
Just Ask, Be Different, Be Brave, Be You by Sonia Sotomayor (4-8 years)
Anh’s Anger by Gail Silver (4-8 years)
Other Words for Home by Jasmine Warga (8-12years)

List of books we like with some broad categories that we were thinking about for inclusivity:

Inclusive books - characters from all types of backgrounds

It’s Okay to Be Different by Todd Parr (Preschool-1 year)
I Am Me by Tristan Towns
Little Dreamers: Visionary Women Around the World by Vashti Harrison (8-12 years)
Think Big, Little One by Vashti Harrison (Baby-3 years)
Dream Big, Little One by Vashti Harrison (Baby-3 years)
Be Kind by Pat Zietlow Miller (4-8 years), characters are very diverse and inclusive, not explicitly about that, but nice to see all of the different kids getting along
Same, Same, but Different by Jenny Kostecki-Shaw (4-7). Penpals in US and India tell each other about their lives and they see that even though they live in different parts of the world, they do a lot of the same things

Inclusive families: parents who look different

Life with My Family by Renee Hooker and Karl Jones (3-7 years)
A Family Is a Family Is a Family by Sara O’Leary (4-7 years)
Heather Has Two Mommies by Leslea Newman (Preschool-2 years)
I am Perfectly Designed by Karamo Brown (4-8 years)

Black/African/African American

Amazing Grace by Mary Hoffman (4-8 years)
I Am Enough by Grace Byers (4-8 years)
Little Leaders: Bold Women in Black History by Vashti Harrison (8-12 years)
Little Legends: Exceptional Men in Black History by Vashti Harrison (8-12 years)
Change Sings: A Children’s Anthem by Amanda Gorman (4-8 years)
All Because You Matter by Tami Charles (Preschool-3 years)
Hair Love by Matthew A. Cherry (Preschool-3 years)
I Like Myself by Karen Beaumont (4-8)
Sulwe by Nyong’o Lupita (4-8): about colorism within the Black community, photo of Lupita on the back cover
New Kid by Jerry Craft (pre-teen, graphic novel/chapter book)
Miami Jackson Sees It Through by Patricia McKissack (8-11, early chapter book)
Brown Boy Joy by Dr. Thomshia Booker (3-7)

LatinX/Hispanic

Julian Is a Mermaid by Jessica Love (4-8 years)
Round is a Tortilla by Roseanne Thong (3-5 years)
Green is a Chile Pepper by Roseanne Thong (3-5 years)
One is a Pinata by Roseanne Thong (3-5 years)
The Day of the Dead by Bob Barner (2-5 years)
Schomburg: The Man Who Built a Library by Eric Velasquez (7-12, lots of words but also great pictures on every page). True story about an afro-Puerto Rican man who immigrated to the US from Puerto Rico and collected books created a library about the achievements of African people/descendants throughout the ages
Separate is Never Equal by Duncan Tonathiuh (4-12). True story about Sylvia Mendez’ family’s fight for desegregation in CA, family was Mexican.
All around us by Xelena Gonzalez - gentle story that celebrates family, culture, community and the connectedness of all thing

Indigenou/Native American

Fry Bread by Kevin Noble Maillard (3-6 years)
We Are Water Protectors by Carole Lindstrom (Preschool-1 year)
The Pencil by Susan Avingaq. About an Inuit family who lives in an iglu
First Laugh, Welcome Baby! By Rose Ann Tahe. Story about a new baby and the significance of the first laugh in Navajo culture
Sweetest Kulu by Celina Kalluk (1-3). Poem written for a baby about Inuit values and respect for the land, seems like a good bedtime story.

Immigrants/Refugees

The Proudest Blue by Ibtihaj Muhammad(Preschool-3 years)
Watch Me: A Story of Immigration and Inspiration by Doyin Richards (3-5 years)
Islandborn by Junot Diaz (5-8 years)
Other Words for Home by Jasmine Warga (8-12years) (pre-teen, chapter book). About a girl who wears a hijab who moves from Syria to the US and is newly labeled “Middle Eastern”, and embraces her culture and grows into herself

Disability

I Just Do It Differently by Donna Grinyer
I Will Dance by Nancy Bo Flood (Preschool-3 years)
Just Ask, Be Different, Be Brave, Be You by Sonia Sotomayor (4-8 years): kids of many different ethnicities with medical and developmental differences. Sotomayor was diagnosed with DM as a kid!
My Brother Charlie by Holly Robinson Peete and Ryan Elizabeth Peete. Black author co-wrote with her son who has autism. Story about Black siblings, one of whom has autism

Gender/Sexual Orientation Diversity

It Feels Good to be Yourself: A Book About Gender Identity by Theresa Thorn (5-8 years)
Julian Is a Mermaid by Jessica Love (4-8 years)
Stella Brings the Family by Miriam B. Schiffer (5-8 years)
Worm Loves Worm by J.J. Austrian (Preschool-3 years)
And Tango Makes Three by Justin Richardson (2-5 years)

Different religions/culture (some overlap with immigrants/refugees)

Hats of Faith by Medeia Cohan (1-3, board book). Pictures of different “hats” that people of different faiths wear
The Diwali Gift by Shuchi Mehta (3-8). About Indian culture
Same, Same But Different by Jenny Sue Kostecki-Shaw (4-7). About two children who are penpals in the US and India

Anti-bias/Activism

V is for Voting by Kate Farrell and Caitlin Kuhwald (3-6 years)
A is for Activist by Innosanto Nagara (3-7 years)
Antiracist Baby by Ibram X. Kendi (baby-3 years)
No! My First Book of Protest by Julie Merberg (baby-3 years)
An ABC of Equality by Chana Ginelle Ewing (baby-5 years)
Woke Baby by Mahogany L. Browne (baby-3 years)

Emotions

When You Can’t See Me Smile: A book for children to help express and understand emotions, moods, and feelings while wearing a mask by Emily Alston
Anh’s Anger by Gail Silver (4-8 years)
Steps and Stones by Gail Silver (4-8 years)
Peace, Bugs, and Understanding by Gail Silver (Preschool-3 years)
My Magical Words by Becky Cummings

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

When the Loss of Smell Lingers, Olfactory Training for Post-COVID-19 Infection with Kenny Chan, MD (S4:E23) Mar 05, 2021

Register for our next COVID-19 Town Hall on March 11 at 6 p.m. MST: https://register.gotowebinar.com/register/3191284534166093839

COVID-19 has disrupted people’s ability to smell, for days or months and has been well-documented at this point in the pandemic, but researchers aren’t sure why. Even less is known about the long-term effects on children who have not regained their sense of smell months after recovering from COVID-19, a phenomenon that is believed to be vastly underreported. Pediatric patients are less likely to articulate to a provider or to their parents that they cannot smell or taste normally.

On today’s episode, we talk with Kenny Chan, MD about the existing supportive evidence for olfactory training to help with post-COVID-19 infection recovery and a new research study being launched at Children’s Colorado to help learn more about these patients.

Dr. Chan is the Chair of Pediatric Otolaryngology at Children’s Hospital Colorado and is Professor of Otolaryngology and Surgery at the University of Colorado School of Medicine.

JAMA Insights Article: Olfactory Dysfunction in COVID-19 Diagnosis & Management

The Eyes Have It: Common Pediatric Eye Emergencies with Emily McCourt, MD (S4:E22) Feb 23, 2021

The first person to see a child following an eye emergency plays a critical role in preventing and treating an eye injury and subsequent visual loss. A basic, five minute eye exam can help providers determine how urgent an ocular problem is and the appropriate treatment approach. In today’s episode Emily McCourt, MD shares clinical pearls to help providers diagnose and triage a child who presents with an eye injury.

Dr. McCourt is the Chair of Pediatric Ophthalmology at Children’s Hospital Colorado and is Associate Professor of Pediatric and Adult Strabismus 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

Resident Files: Hearing Screening in Pediatrics with Jordan Yoeli, MD (S4:E21) Feb 16, 2021

Hearing loss is the most common developmental disorder identifiable at birth and its prevalence increases throughout school‐age due to the additions of late‐onset, late identified and acquired hearing loss. Under identification and lack of appropriate management of hearing loss in children has broad effects and impact on educational, cognitive and social development. According to the American Academy of Pediatrics For all children, regular surveillance of developmental milestones, auditory skills, parental concerns, and middle-ear status should be performed in the medical home. On today’s Resident Files episode we are going to walk through the hearing screening schedule and risk indicators with Jordan Yoeli, MD, PGY-3 pediatrics resident at Children's Hospital Colorado and 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

A Pandemic & Pediatrics Update: Vaccines, Variants & MIS-C with Sam Dominguez, MD (S4:E20) Feb 09, 2021

Register for our next COVID-19 Town Hall - Thursday, February 11 at 6 p.m. MST. Read more about our COVID-19 Town Hall series for pediatric providers here.

The number of COVID-19 cases, deaths and hospitalizations are steadily declining in the U.S., signaling we may have turned a corner in the pandemic. And after a challenging start to rolling out the vaccine, about 31.6 million people in the US have received at least one dose of the COVID vaccine, including about 9.1 million people who are fully vaccinated. In today’s episode, we discuss the latest in the journey to end the pandemic and what it means for pediatrics with Sam Dominguez, MD.

Dr. Dominguez 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.

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

Healthy Weight, Stigma & Eating Disorders with Jennifer Hagman, MD and Matt Haemer, MD (S4:E19) Feb 02, 2021

Join our next COVID-19 Provider Town Hall on Thursday, February 11 at 6 p.m. MST: https://bit.ly/3cMwxH5

Throughout the COVID-19 pandemic we have examined various impacts this time has had on the pediatric population. In recent months, the Charting Pediatrics host team has received multiple emails from pediatricians around the globe who are observing increased number of patients struggling with health weight stigma and eating disorders as the pandemic lingers on. The clinical experiences and observations of our colleagues writing in inspired today’s discussion with Jennifer Hagman, MD and Matt Haemer, MD.

Dr. Hagman is Director of the Eating Disorder Program at Children’s Hospital Colorado and Professor of Psychiatry at the University of Colorado School of Medicine.

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

Resources Mentioned:

Children's Colorado Obesity Clinical Pathway
- Resources for screening and discussing health behaviors can be found on page 2
Food Security Resources
Cooking Matters
Fitness Blender
National Association of Anorexia Nervosa and Associated Disorders
Children's Colorado Eating Disorder Program

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

Common Breathing Issues During Respiratory Season with Ben Hughes, MD (S4:E18) Jan 26, 2021

Respiratory diseases account for nearly a quarter of all pediatric consultations. And in addition to the usual suspects on our differentials, we now have the consideration of COVID-19. In today’s episode, we talk with Ben Hughes, MD about the most common breathing issues during respiratory season, important diagnostic considerations and treatments options.

Dr. Hughes is a pediatric pulmonologist at Children’s Hospital Colorado and lives locally on the Western Slope of Colorado in Grand Junction; he is Assistant Professor of Pediatrics and Pulmonary Medicine 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

Why It's Time to Return to In Person Learning with Sean O'Leary, MD (S4:E17) Jan 22, 2021

New studies from Germany, Norway and the U.S. offer yet more data to show that childcare facilities and elementary schools should remain open or re-open to full-time, in-person learning as quickly as possible. Despite these research findings, schools across the US have largely been closed to in-person learning since the pandemic reached critical mass in the U.S. in March 2020. On today’s episode, we are going to talk through these recent studies and the advocacy needed to support the re-opening of schools to full-time, in-person learning.

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.26.1.2002011

https://www.nejm.org/doi/10.1056/NEJMc2026670

https://pediatrics.aappublications.org/content/early/2021/01/06/peds.2020-048090

Today we are joined by returning guest Dr. Sean O’Leary, an Infectious Disease physician at Children’s Colorado and Director of the Colorado Pediatric Practice-Based Research Network. Sean is also a spokesperson for the American Academy of Pediatrics and can regularly be found being interviewed and quoted in the New York Times, C-SPAN, PBS and CNN to name a few.

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

When Substance Use Disorders Come to Pediatrics with Debbie Singer, MD & Paula Riggs, MD (S4:E16) Jan 12, 2021

In this episode we are joined by Dr. Debbie Singer and Dr. Paula Riggs to discuss their successful collaboration screening adolescents for substance use disorders, implementing the SBIRE (screening for evaluation) vs SBIRT (referral for treatment) approach, and its rationale and effectiveness in this partnership between primary care pediatrics and psychiatry.

Debbie Singer, MD is a primary care pediatrician at Every Child Pediatrics in Denver, Colo. and Fellow of the American Academy of Pediatrics (FAAP).

Paul Riggs, MD is Director of the Division of Addiction Science, Prevention & Treatment; Vice Chair of Faculty Affairs for the Department of Psychiatry and Professor of Psychiatry at the University of Colorado School of Medicine; and Director of the Encompass Clinic.

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

A Twist: New COVID-19 Variants with Sam Dominguez, MD (S4:E15) Jan 06, 2021

COVID-19 Provider Town Hall: COVID-19 Variants & Vaccine Focus: https://bit.ly/3ndY8Cs on Thursday, January 7, 2021 at 6 p.m. MST.

For the last month of the pandemic, hope and excitement have surrounded the COVID vaccination deployment as more than 3 million Americans received their first vaccine dose by the close of 2020. While the pandemic is far from over, there is a sense of hope that the vaccine represents the beginning of the end. As this hope was rising, a new variant of the virus emerged with an unusually large number of mutations. This variant seems to spread more easily and quickly than other variants and was first detected in September 2020. It is now highly prevalent in London and southeast England, and has since been detected in numerous countries around the world, including the United States and Canada. In today’s episode, we are going to talk with Sam Dominguez, MD about the details of the virus variant mutations and what that means for pediatrics and the vaccine.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3 and 4 of the podcast.

We are pleased to welcome back Dr. Sam Dominguez to the podcast. 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.

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

Autism, Developmental Delays & the Impact of COVID with Caitlin Middleton, PhD and Abigail Angulo, MD (S4:E14) Jan 05, 2021

The COVID-19 pandemic has presented uncountable challenges for each of us, but as we considered some specific patient populations that have particularly been impacted our kids with autism and developmental delays come to mind. These children are especially vulnerable to the effects of the pandemic due to overall more significant healthcare needs, their dependency on community-based and school-based services and global mental health concerns. On today’s episode we talk with Caitlin Middleton, PhD and Abigail Angulo, MD through the considerations primary care providers should make for their patients with autism and developmental delays as we move through the latest wave of the pandemic.

Dr. Middleton is part of the Developmental Pediatrics team at Children's Hospital Colorado and is Assistant Professor of Pediatrics at the University of Colorado School of Medicine.

Dr. Angulo is part of the Developmental Pediatrics team at Children's Hospital Colorado and is 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

Part II: Foster Care, COVID-19 & Pediatric Care with James Kaferly III, MD & Sara Hills, PhD (S4:E13) Dec 15, 2020

Last month we introduced you to Part I of primary care for children and teens living in out-of-home care -- In today’s follow-up episode, we will discuss important aspects of the physical exam; considerations for ACE scores and their impacts to overall child health; and finally, how to advocate for this patient population particularly during the pandemic.

We are fortunate to be joined by Denver Health pediatrician Dr. James Kaferly and happy to welcome Dr. Sara Hills, Clinical Psychologist from Denver Health.

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

The Intersection Between Aviation & Medicine with United Airlines (S4:E12) Dec 08, 2020

Safety and teamwork are second nature for pediatric providers. In medicine, we have long looked to the airline industry as a leader in the application of crisis response and as the ideal of high reliability. Coming from a shared reality that even the most experienced professionals are vulnerable to human error, both aviation and medical professionals rely on problem-solving strategies to optimize responses to critical incidents.

In this episode we discuss the collaborative work of physicians at Children's Colorado's Heart Institute and Human Factors and Pilot Development leaders at United Airlines.

Our guests are Robby Bishop, MD, Director of the Simulation Lab at the Children's Hospital Colorado Heart Institute; Rob Strickland, Senior Manager of Human Factors and Pilot Development at United Airlines; and Carlos Porges, Psy.D, Neuropsychologist, Boeing 757/767 Pilot and member of the Human Factors and Development Team at United Airlines.

Paper: Crisis Resource Management in Medicine: A Clarion Call for Change

Video: Crisis Resource Management in Medicine: A Clarion Call for Change

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

Rebroadcast: COVID-19 Taking Care of Adult Patients During the Pandemic with Aaron Manning, MD and Steven Humphrey, MD (S3:E49) Dec 02, 2020

Join us for our bi-weekly COVID-19 Virtual Provider Town Hall series featuring updates from Children's Infectious Diseases team and live Q&A: https://bit.ly/3qiKGzV - our next Town Hall is on Thursday, December 3, 2020 from 6-7:30p.m. MST.

With COVID-19 cases surging across the United States and Europe we hope this episode is a timely refresher for any of our pediatric colleagues who are being called into service to care for adult patients.

In this rebroadcast of S3:E49, we 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 the pandemic.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3 & 4 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.

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.
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

Resident Files: Social Determinants of Health (S4:E11) Dec 01, 2020

In our new series, the Resident Files, we explore efforts of Children's Hospital Colorado and CU School of Medicine pediatric residents to examine the social determinants of health that impact the patients they see in primary care clinic and how all pediatric providers can make considerations for these impacts in their own practice.

Our guests today are CU School of Medicine Pediatric Residents, Telly Cheung, MD and Elizabeth Kerr, MD.

Social Determinants of Health Resources from the AAP

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

Advancement Towards a COVID-19 Vaccine with Sean O'Leary, MD (S4:E10) Nov 20, 2020

Register for the next Provider COVID-19 Town Hall on Thursday, December 3 from 6-7:30 p.m. MST: https://bit.ly/33eMy2D

Today on Charting Pediatrics, we will talk about what to expect from the public release of the COVID-19 vaccine, what it means for pediatrics and facts you can begin sharing with parents in your practice to arm them with knowledge and confidence in this vaccine.

Major breakthroughs have developed since we last visited the topic of Operation Warp Speed and the race for a COVID-19 vaccine. Pfizer’s vaccine candidate has shown to be 95 percent effective and Moderna’s has been similar at 94.5 percent, rivaling some of the most potent vaccines that we have. With vaccine candidates showing robust immune response there is mounting anticipation for a vaccination that could bring an end to the pandemic. This news comes as community spread of the virus is raging and hospitalizations have surged across the United States.

Sean O’Leary, MD is our guest for this episode. Dr. O'Leary is an Infectious Disease physician at Children’s Colorado and Director of the Colorado Pediatric Practice-Based Research Network. Sean is also a spokesperson for the American Academy of Pediatrics and can regularly be found quoted in publications like the New York Times.

Antimicrobial Stewardship in Primary Care with Nicole Poole, MD and Sarah Parker, MD (S4:E9) Nov 18, 2020

The CDC estimates that at least 30 percent of antibiotic prescriptions dispensed from the outpatient setting are unnecessary. Providers working in primary care are perhaps the most influential healthcare providers in addressing the issue of antibiotic resistance, as the inappropriate antibiotic prescribing practices remain high. In this episode Sarah Parker, MD and Nicole Poole, MD join us to discuss the use of antimicrobial stewardship programs and how they be implemented in primary care.

Dr. Parker is the Medical Director of Children’s Antimicrobial Stewardship Program and Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Dr. Poole is an Infectious Diseases Physician focused on Outpatient Antimicrobial Stewardship at Children’s Colorado and is Assistant Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

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

COVID-19 & the Pediatric Healthcare Landscape with Madeleine McDowell, MD, Karyl Kopaskie, PhD and Raphe Schwartz (S4:E8) Nov 12, 2020

As the United States enters the eighth month of the pandemic surrounded by a backdrop of payer pressures, demands for virtual care and societal unrest, our healthcare system is challenged daily to navigate uncharted territory. From rapid scaling COVID-19 testing and safety operations to securing PPE from disrupted supply chains, and trying to assure patient families that it is safe to continue to come to clinics and hospitals for care….

Our pediatric healthcare landscape has forever been changed by COVID-19. And as COVID-19 cases are surging across the U.S. and parts of Europe, we are acutely reminded that end of the pandemic is not readily in sight. In this episode, we will discuss the pediatric healthcare landscape and its forecasted pandemic recovery and considerations for primary care providers.

On this episode we are joined by Children's Hospital Colorado Chief Strategy Officer Raphe Schwartz, and from Sg2 Healthcare Intelligence services, Karyl Kopaskie, PhD, Associate Principal; and Madeleine McDowell, MD, Principal and Medical Director.

If you have thoughts about today's episode or suggestions for a future topic, write to us: chartingpediatrics@childrenscolorado.org

Where is This Pandemic Headed for Pediatrics with Sam Dominguez, MD (S4:E7) Nov 04, 2020

Register for this week's Provider Town Hall: Thursday, November 5 from 6-7:30 p.m. MST: https://attendee.gotowebinar.com/register/3768862387713545741

COVID-19 cases are surging across the U.S. and parts of Europe, outpacing the anticipated winter respiratory season. Locally in Colorado, community transmission is also on the rise with the Colorado Department of Public Health and Environment warning that hospitalizations in the state are likely to blast through the peaks of April and could overwhelm the state’s intensive care units by January. In this our 27th COVID-19 podcast, we will delve into the latest epidemiology of the pandemic and where things are headed for pediatrics.

You can go back and listen to our previous coverage on the COVID-19 Pandemic on Season 3 and 4 of the podcast.

We are fortunate to be joined once again by 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.

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

Part I: Foster Care, COVID-19 & Pediatric Care with James Kafferly III, MD (S4:E6) Nov 03, 2020

Register for this week's Provider Town Hall: Thursday, November 5 from 6-7:30 p.m. MST: https://attendee.gotowebinar.com/register/3768862387713545741

In today’s episode, we discuss special health care considerations for children and teens living in out-of-home placements, including foster care/kinship care/group home settings, particularly during the COVID-19 pandemic.

Today we are joined by James Kafferly III, MD, pediatrician from Denver Health.

Fostering Health Resources for Providers by the AAP

Healthy Foster Care America from the AAP

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

Pediatrics: How the Pandemic Accelerated Publication with Lewis First, MD and Alex Kemper, MD (S4:E5) Oct 27, 2020

Register now for the next COVID-19 Pediatric Provider Town Hall:

https://register.gotowebinar.com/register/3768862387713545741

As a trusted pediatric publisher of peer-reviewed research, clinical references, patient education and coding & payment resources, the American Academy of Pediatrics has played a pivotal role in making the latest research and articles from its Pediatrics Journal related to COVID-19 available for free. In this episode, we are going to talk about the unique rapid scaling and dissemination of reliable clinical information during COVID-19 with Lewis First, MD, Editor-in-Chief of Pediatrics and Alex Kemper, MD, Deputy-Editor-in-Chief of Pediatrics.

The editor of Pediatrics is Lewis R. First, MD, MS, [lewis.first@uvm.edu] Professor and Chair, Department of Pediatrics, University of Vermont College of Medicine, and Chief of Pediatrics, University of Vermont Children’s Hospital.

The deputy editor is Alex R. Kemper, MD, MPH, MS, Division Chief, Ambulatory Pediatrics, Nationwide Children’s Hospital [alex.kemper@nationwidechildrens.org].

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

Open Hearts: Outcomes and Transparency in Pediatric Cardiology (S4:E4) Oct 20, 2020

Register for this week's COVID-19 Provider Town Hall! Live Q&A with the Children's Colorado pediatric infectious disease team and updated epidemiology of the pandemic : https://register.gotowebinar.com/register/7276255001809281037

Hospitals and pediatric practices are under increasing pressure to be publicly transparent about their quality and safety outcomes. The rapid growth of quality improvement initiatives and surgical outcomes in pediatric heart care has made national news headlines in recent years, demonstrating the correlation between pediatric heart surgical volumes and outcomes for kids. On today’s episode we are going to discuss outcomes transparency in pediatric heart care and the work that one nonprofit has done to lead the way in data transparency.

Today we are fortunate to be joined by David Kasnic, Executive Director for the non-profit, Conquering CHD.

15 Participating Centers AdventHealth for Children – Orlando, FL Advocate Children’s Hospital – Oak Lawn, IL Ann & Robert H. Lurie Children’s Hospital – Chicago, IL Children’s Healthcare of Atlanta – Atlanta, GA Children’s Hospital Colorado – Aurora, CO Children’s Hospital Los Angeles, Los Angeles, CA Children’s National – Washington, DC Children’s Wisconsin – Milwaukee, WI Cincinnati Children’s Hospital – Cincinnati, OH Medical University of South Carolina – Charleston, SC Nationwide Children’s Hospital – Columbus, OH New York Presbyterian Hospital – Columbia – Cornell – New York, NY Seattle Children’s Hospital – Seattle, WA University of California at Davis Health – Sacramento, CA University of Michigan Congenital Heart Center – Ann Arbor, MI How to Get Involved: Patients and Families

Visit the Hospital Navigator launch blog at conqueringchd.org/hospital-navigator-launch
Check the list of participating centers
Use the Patient and Family Advocacy Toolkit to talk to your center about joining

How to Get Involved: Providers/Hospitals

Visit the Hospital Navigator launch blog at conqueringchd.org/hospital-navigator-launch
Download the invitation letter and submission form
Send questions to Rebeka Acosta, Education Coordinator, at racosta@conqueringchd.org

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

COVID-19 & Return to Play Cardiac Screening Guidelines with Chris Rausch, MD (S4:E3) Oct 07, 2020

Register for tomorrow night's COVID-19 Virtual Provider Town Hall! Thursday, October 8 2020 from 6-7 p.m. MST

In this episode, we will focus on when to order an ECG and other cardiac considerations for return to play after COVID-19 infection.

Approximately 35 to 45 million youth ages 6 to 18 participate in some form of athletics. As more of these young athletes return to sport amid the lingering pandemic, primary care providers are navigating new guidance about the evaluation and clearance of patients who have recovered from COVID-19. And because COVID-19 infections in pediatric patients are more likely to be asymptomatic or mild compared to adults, pediatric providers will frequently be presented with return-to play questions for patients who had asymptomatic or very mild disease.

On Season 3, Episode 56 of the podcast we covered the initial guidance on the return to sport during COVID-19.

Chris Rausch, MD is the Pediatric Cardiology Medical Director and Director of the Cardiopulmonary Exercise Laboratory at Children’s Colorado and is Associate Professor of Pediatrics and Cardiology at the University of Colorado School of Medicine.

Cardiac Evaluation for Post COVID-19 (SARS-CoV-2) Infection Return to Play in Children and Adolescents by the Children's Hospital Colorado Scientific Advisory Council

I Get By With a Little Help From My Friends: Resiliency with Jenny Reese, MD (S4:E2) Sep 29, 2020

On this episode we are going to talk with Jenny Reese, MD about practical approaches to self-care and resiliency as we continue to move through this pandemic.

Societal interruptions at every turn. Working remotely. Virtual school. Financial and health uncertainties. Massive disruptions to the delivery of healthcare, including impacted volumes and private practice business. The impact of the COVID-19 pandemic on every aspect of our lives is apparent. As providers who have uniquely felt the impacts of these changes because of our profession, it is imperative to take time to consider our own resiliency.

Dr. Reese is the Section Head of Pediatric Hospital Medicine at Children’s Colorado and is Associate Professor of Clinical Practice and Pediatrics at the University of Colorado School of Medicine.

COVID-19 & Vaping: A Call to Advocacy and Intervention with Robin Deterding, MD (S4:E1) Sep 22, 2020

Register today for our next COVID-19 Virtual Provider Town Hall with updates from our Infectious Diseases team and live Q&A from participants. https://register.gotowebinar.com/register/8317728907959325456

Just before the COVID-19 pandemic we were witnessing a fast-growing and new epidemic for pediatricians --the association between teen vaping and acute lung injury. It is not surprising that a recent study by researchers at Stanford University has shown a link between vaping and a substantially increased risk of COIVD-19 among teenagers and young adults. Today we are going to revisit the topic of EVALI – E-Cigarette or Vaping Associated Lung Injury – and the impact and of COVID-19 on teens who vape with Robin Deterding, MD.

Dr. Deterding is the Chief of Pulmonary Medicine at Children’s Colorado and is Professor of Pediatrics at the University of Colorado School of Medicine.

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

Introducing: Charting Pediatrics Season 4 Sep 18, 2020

A new season of Charting Pediatrics launches on Tuesday, September 22!

Hear Dr. Brent, Dr. Brumbaugh and Dr. Nicklas reflect on Season 3, the pandemic and what is to come on an exciting new season of the podcast.

Association for Medical Education in Europe: Charting Pediatrics e-Poster

Do you have topic or guest suggestions for Season 4 of the podcast? Write to us, chartingpediatrics@childrenscolorado.org

Cold Case: Will the Flu Season be Canceled? COVID-19 Pediatric Updates with Sam Dominguez, MD (S3:E69) Sep 15, 2020

Join our next Virtual COVID-19 Provider Town Hall

As countries in the Southern Hemisphere move through what would normally be their influenza season, early data indicates that efforts to stop COVID-19 have all but eliminated the typical viral spread of flu in those communities. These early behaviors have providers in the Americas speculating if influenza will take a similarly mild course, while others warn of a “Twindemic” dual impact of COVID-19 and influenza. In this our 21st COVID-19 podcast, we will delve into the latest epidemiology of the pandemic, how pediatricians might think about the approaching flu season and what testing to order.

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 Professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine.

Resources and Publications Mentioned in this Episode:

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

En Español: Afecciones cutáneas comunes en el primer año de vida with Carla Torres-Zegarra, MD (S3:E68) Aug 31, 2020

En este episodio nos acompaña Carla Torres-Zegerra, MD, para discutir los problemas dermatológicos más comunes en el primer año de vida en español.

In this episode we are joined by Carla Torres-Zegerra, MD, to discuss the most common dermatology issues in the first year of life, the episode was recorded in Spanish.

You can follow Dr. Torres-Zegerra on Instagram @dermaskinmd where she posts dermatology tips for providers.

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

Drowning Prevention with Laura Bricklin, MD and Emma Harding, MD (S3:E67) Aug 27, 2020

Drowning is quick and silent.

It is also the single-leading cause of death among children aged 1-4 and is a top cause death among teens. As pediatricians, we offer an important voice to help educate our parents, patients and community about how to keep kids safe in and around the water. Recently two of our pediatric residents, Dr. Laura Bricklin and Dr. Emma Harding, were awarded a CATCH grant for drowning prevention and are joining us today to review important water safety information for bathtubs, pools and open water.

Operation Warp Speed & the Race to Develop a COVID-19 Vaccine with Sean O'Leary, MD (S3:E66) Aug 20, 2020

Join us for our next COVID-19 Virtual Provider Town Hall on Thursday, August 27 from 6-7:30 p.m. MST with the Children's CO Infectious Disease Team, including epi and literature updates: https://attendee.gotowebinar.com/register/4385745584068080396

Countries around the world are racing to develop a vaccine to end the COVID-19 global pandemic. In the United States, Operation Warp Speed – led by the Department of Health and Human Services and the Department of Defense -- involves almost $11 billion funding to seven different companies to develop vaccines. Three of these companies – Monderna, AstraZeneca and Pfizer – are in late stage trials. Today on Charting Pediatrics we are joined by Sean O'Leary, MD to talk about these accelerated efforts and what role a vaccine would play in pediatrics.

Today we are joined by returning guest Dr. Sean O’Leary, an Infectious Disease physician at Children’s Colorado and Director of the Colorado Pediatric Practice-Based Research Network. Sean is also a spokesperson for the American Academy of Pediatrics – if you have seen any major media coverage on the return to school, you have probably seen Sean quoted.

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

Diagnosis & Management of Scoliosis with Lori Karol, MD (S3:E65) Aug 18, 2020

Scoliosis affects between 2 and 3 percent of the population with the primary onset age being between 10-15 years old, occurring equally among both genders.

On this episode, Lori Karol, MD joins us to unpack the diagnosis and management of scoliosis. Dr. Karol in the new Chief of Pediatric Orthopedic Surgery at Children’s Colorado and is Visiting Professor of Orthopedics at the University of Colorado School of Medicine.

Masks, COVID-19, Asthma & the Return to School (S3:E64) Aug 11, 2020

Please join us for this week's COVID-19 Virtual Provider Town Hall, Thursday, August 13 from 6-7:30 p.m. MST:

https://attendee.gotowebinar.com/register/4458292460271814414

The topic of face masks or face coverings use and their efficacy has rapidly morphed into one of the most divisive topics in American culture. Mandated by many government bodies in the US and around the globe, these face coverings have been encouraged to slow the spread of COVID-19. We have heard from many of you, our listeners, that parents are asking for anticipatory guidance around mask wearing and their children, particularly chronic asthmatics. In this our 18th COVID-19 podcast, we will discuss the AAP guidance around pediatric patients and face coverings, considerations for asthmatic patients and how these fit in with the return to school.

In this episode we are joined by returning guest Monica Federico, MD, Medical Director of the Clinical Alignment and Asthma Programs at Children’s Colorado and Associate Professor of Pediatrics at the University of Colorado School of Medicine.

Mask Exemptions During the COVID-19 Pandemic: A New Frontier for Clinicians, published by JAMA

Cloth Face Coverings for Children During COVID-19 from the American Academy of Pediatrics

Example letters referenced by Dr. Federico are forthcoming at the Charting Pediatrics website.

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

Introducing Pediatrics On Call from the AAP with Joanna Parga-Belinkie, MD and David Hill, MD (S3:E63) Aug 04, 2020

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-Belinkie, 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.

CAR-T Cellular Therapy: Advancing Pediatric Cancer Treatment with Terry Fry, MD and Michael Verneris, MD S3:E62 Jul 29, 2020

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.

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) Jul 23, 2020

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

Overcoming Demographic Disparities in Medicine with Vijaya Vemulakonda, MD, JD (S3:E60) Jul 16, 2020

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

COVID-19 School Re-Entry Guidance with Sean O'Leary, MD and Heidi Baskfield, JD (S3:E59) Jul 01, 2020

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

What We've Learned About COVID-19 in Pediatrics with Sam Dominguez, MD (S3:E58) Jun 26, 2020

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

Passion into Progress - Providing Positive Impact to Equity in Pediatric Medicine (S3:E57) Jun 18, 2020

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.

Return to Sport During COVID-19 with Aubrey Armento, MD and Julie Wilson, MD (S3:E56) Jun 11, 2020

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

Clinical Effectiveness in Pediatric Medicine with Lalit Bajaj, MD (S3:E55) Jun 09, 2020

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

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.

Innovation in Pediatric Medicine with John Barnard, MD (S3:E54) Jun 02, 2020

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

COVID-19 En Pediatria en Español with Edwin Asturias, MD (S3:E53) May 21, 2020

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

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

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

Multisystem Inflammatory Syndrome in Children Associated with COVID-19 (S3:E51) May 16, 2020

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.

Women and Babies in the Era of COVID-19 (S3:E50) May 13, 2020

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/

COVID-19: Caring for Adult Patients During the Pandemic with Aaron Manning, MD and Steven Humphrey, MD (S3:E49) May 05, 2020

Join us for our weekly Virtual Town Hall for Providers during COVID-19, Thursdays from 6-7 p.m. MST

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.

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.
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

COVID-19 Convalescent Plasma & Antibody Testing with Sam Dominguez, MD and Kyle Annen, DO (S3:E48) Apr 27, 2020

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

Toxic Shock Syndrome with the Physician Who Discovered it, Jim Todd, MD (S3:E47) Apr 21, 2020

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.

Recovered from SARS-CoV-2: Two Doctors Share Their Experience (S3:E46) Apr 20, 2020

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.

New FDA-Approved Drug for Cystic Fibrosis Patients with Scott Sagel, MD (S3:E45) Apr 14, 2020

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.

Coronavirus SARS-CoV-2 or COVID-19 All About That PPE (S3:E44) Apr 10, 2020

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

Coronavirus, SARS-CoV-2 or COVID-19 Mental Health During the Pandemic (S3:E43) Apr 07, 2020

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

Coronavirus, SARS-CoV-2 or COVID-19 Implementing Telemedicine (S3:E42) Mar 31, 2020

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:

email your questions to the AAP: Covid-19@aap.org
From the AAP: Coding During the COVID-19 Pandemic
AAP Guidance: Telehealth Payer Policy during the COVID-19 Pandemic
State Notices on Telehealth Policy
From the AAP: Telehealth and After Hours Care
Join the Colorado ECHO online learnings about COVID-19

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

Coronavirus, SARS-CoV-2 or COVID-19 Innovative Approaches to Primary Care (S3:E41) Mar 25, 2020

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

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

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

Managing Button Battery & Other Foreign Body Ingestions with David Brumbaugh, MD (S3:E39) Mar 17, 2020

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

Coronavirus SARS-CoV-2 or COVID-19 Important Updates Mitigation Phase with Sam Dominguez, MD (S3:E38) Mar 14, 2020

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

Rural and Tertiary Care Bridges with Bird Gilmartin, MD (S3:E37) Mar 10, 2020

There are many great things about living in rural communities. Across a broad range of healthcare indicators though, 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 Pediatrics (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

Coronavirus, SARS-CoV-2 or COVID-19 Important Updates for Providers with Sam Dominguez, MD (S3:E36) Mar 05, 2020

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.

The Importance of Social Networks, Social Norms & Attitudes in Infant Care Practice Decisions with Rachel Moon, MD (S3:E35) Mar 03, 2020

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

State-Level Vaccination Advocacy with Zach Zaslow (S3:E34) Feb 26, 2020

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

Management of Fecal Incontinence with Andrea Bischoff, MD (S3:E33) Feb 25, 2020

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

Seizures & Spells: Diagnosis and Management of Events That Worry Us with Shavonne Massey, MD, MSCE and Mered Parnes, MD (S3:E32) Feb 18, 2020

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

Coronavirus: What you need to know about COVID-19 with Sam Dominguez, MD, PhD (S3:E31) Feb 13, 2020

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

Medical Missions in Pediatric Medicine with Brian Shaw, MD (S3:E30) Feb 11, 2020

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

Chronic Pelvic Pain with Stephen Scott, MD (S3:E29) Feb 04, 2020

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

E-Cigarette or Vaping product use Associated Lung Injury EVALI Update with Robin Deterding, MD (S3:E28) Jan 30, 2020

Earlier this fall we shared a special episode to update providers about the growing associations between vaping and more acute, severe lung injury called Vaping Associated Pulmonary Injury – you can listen to that content from Season 3, Episode 6. Today we are going to circle back to this topic with Robin Deterding, MD, and discuss its rapid evolution during the recent months.

Dr. Deterding is the Chief of Pediatric Pulmonary Medicine at Children’s Hospital Colorado and a Professor of Pediatrics at the University of Colorado School of Medicine.

Resources Mentioned in this Episode:

Update: Interim Guidance for Health Care Professionals Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use, US Department of Health and Human Services/Center for Disease Control and Prevention MMWR - January 3, 2020
Partnership for Drug-Free Kids: What you Need to Know and How to Talk with Your Kids About Vaping
CDC: Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products
Previous Charting Pediatrics Episodes about Vaping:
- E-Cigarettes and Vaping (S2:E23)
- Vaping Associated Pulmonary Injury (S3:E6)

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

Pediatric ACL Injury and Repair with Jay Albright, MD (S3:E27) Jan 28, 2020

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

Medication Management for Pediatric Hypertension Patients with Steve Daniels, MD (S3:E26) Jan 21, 2020

Last season on the podcast we discussed the initial diagnosis and lifestyle management of hypertension in pediatric patients. If you have not had the opportunity to listen to that episode, go back and check out Season 2, Episode 36 as it will set the back drop for today’s discussion as we dive more specifically into medication management for pediatric hypertension patients.

In this episode we discuss medication management for pediatric hypertension patients with a pediatric cardiologist, Steve Daniels, MD, PhD and a clinical pharmacist, Dr. Megan Greene.

Dr. Greene is a pediatric clinical pharmacist at Children’s Hospital Colorado with a specialization in critical care and kidney and liver transplant pharmaceutical support, and also works in our pediatric hypertension clinic.

Dr. Daniels is the Pediatrician-in-Chief at Children’s Hospital Colorado and L. Joseph Butterfield Chair of Pediatrics within the University of Colorado School of Medicine, where he is a professor of pediatrics and epidemiology. He is a cardiologist by training and a sought-out expert in the fields of pediatric hypertension, dyslipidemia, and pediatric nutrition.

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

If you have feedback or questions about today's episode or suggestions for a future topic, write to us at chartingpediatrics@childrenscolorado.org

The History of Vaccines and Religion with Josh Williams, MD (S3:E25) Jan 14, 2020

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

Social Media: Friend or Foe? With Jenny Radesky, MD and Michael Rich, MD (S3:E24) Jan 07, 2020

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

Happy Holidays Dec 31, 2019

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!

Happy Holidays Dec 24, 2019

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!

Addressing Poverty in Pediatric Care with Benard Dreyer, MD (S3:E23) Dec 17, 2019

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

Strategies to Help Sleepless Teens with Adiaha Spinks-Franklin, MD (S3:E22) Dec 10, 2019

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

Adolescent Substance Abuse (S3:E21) Dec 03, 2019

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

Newborns Exposed to Substances with Stephen Patrick, MD (S3:E20) Nov 26, 2019

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

Housing and Child Health with Megan Sandel, MD (S3:E19) Nov 19, 2019

In this episode we were privileged to sit down with Megan Sandel, MD, at the 2019 American Academy of Pediatrics NCE in New Orleans to discuss the impact of housing on child health.

Dr. Sandel is an associate professor of pediatrics at the Boston University School of Medicine as well as an associate professor of environmental health at the Boston University School of Public Health. She has held both of these positions for the last eight years, but has been working with the university since 2002, first as an assistant professor. She is the former pediatric medical director of Boston Healthcare for the Homeless program and the first medical director of the founding site for medical-legal partnerships, Medical-Legal Partnership-Boston. In addition to publishing articles and serving on committees, she is considered an expert in her field on the topic of housing and child health.

Resources Mentioned in this Episode:

HowHousingMatters.Org
The Hunger Vital Sign Screening Tool by Children's HealthWatch
Evicted by Mike Desmond
PRAPARE Assessment Tool

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

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

Child Abuse Management in Pediatrics (S3:E18) Nov 14, 2019

In this episode we discuss the diagnosis and management of child abuse in primary care pediatrics. We are pleased to be joined by Andy Sirotnak, MD who recently released his new book at the 2019 AAP NCE, Child Abuse Medical Diagnosis and Management.

Dr. Sirotnak is a Professor and Vice-Chair for Faculty Affairs in the Department of Pediatrics and the Director of the Child Protection Team at Children’s Hospital Colorado.

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

Peter Hotez, MD, PhD: Physician-Scientist, Pediatrician, Advocate (S3:E17) Nov 12, 2019

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

AAP Policy Statement on Bariatric Surgery (S3:E16) Nov 07, 2019

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

In Case You Missed It: Published Studies that Could Change the Way You Practice With Lewis First, MD and Alex Kemper, MD (S3:E15) Nov 05, 2019

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

Eosinophilic Esophagitis, EoE with Glenn Furuta, MD (S3:E14) Oct 29, 2019

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

Biliary Atresia with Cara Mack, MD (S3:E13) Oct 22, 2019

Biliary atresia is a rare gastrointestinal disorder, occurring approximately 1 in 10,000 to 15,000 births in the United States, and is characterized by a destruction or absence of, all or a portion of the extrahepatic bile duct. Affected infants present with jaundice and fibrosis.

In some cases, additional abnormalities may be present, including cardiac defects and intestinal, spleen and kidney malformations; the exact cause of biliary atresia is unknown. In today’s episode we talk with Cara Mack, MD to unpack the clinical presentation, management and ongoing care for patients with biliary atresia.

Dr. Mack is a Professor of Pediatrics at the University of Colorado School of Medicine, a practicing Pediatric Hepatologist and the Director of the Pediatric Liver Center at Children’s Hospital Colorado.

Let us know if you have a suggestion for a future topic or thoughts about this episode!

Sepsis (S3:E12) Oct 15, 2019

Sepsis remains one of the leading causes of morbidity and mortality in children despite improved understanding of the pathophysiology leading to better clinical management and survival. Recent studies have identified several areas that must be addressed by the clinician in order to continue to impact the morbidity and mortality associated with sepsis. In today’s episode we talk with Halden Scott, MD about the presentation, management and follow-up care of pediatric patients with sepsis.

Dr. Scott is an Associate Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine and a Pediatric Emergency Medicine Physician at Children’s Hospital Colorado.

Resources mentioned in today's episode:

The Children’s Hospital Association Improving Pediatric Sepsis Outcomes Collaborative
Children’s Hospital Colorado Pathways: Scroll to Emergency Department/Urgent Care Sepsis for the sepsis pathway
The most recent pediatric sepsis guidelines
Articles that Dr. Scott referred to in the podcast about the role of lactate in sepsis, and the problems with SIRS criteria for sepsis screening:

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

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

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

2019 AAP National Conference & Exhibition Live Recordings Oct 10, 2019

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

Functional Abdominal Pain (S3:E11) Oct 08, 2019

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

Hospitalist Medicine in Pediatric Care (S3:E10) Oct 01, 2019

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.

Depression Management and Medication in Pediatrics (S3:E9) Sep 24, 2019

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:

Urologic Cancer in Children and Adolescents (S3:E8) Sep 17, 2019

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

Most Common Eye Issues in Pediatrics (S3:E7) Sep 10, 2019

Vision problems are common among school-age kids and there are many eye diseases and conditions that can affect a child’s vision. According to Prevent Blindness America, one in four school-age children have vision problems that, if left untreated, can affect learning ability, personality and adjustment in school.

In today’s episode we are going to talk with Dr. Emily McCourt to unpack the most common eye issues in pediatrics and front line screening in the primary care office.

Dr. McCourt is an ophthalmologist at Children’s Hospital Colorado and is associate professor of pediatric ophthalmology and strabismus at the University of Colorado School of Medicine.

Vaping Associated Pulmonary Injury (S3:E6) Sep 05, 2019

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)

Recurrent Headache in Pediatrics (S3:E5) Sep 03, 2019

Nearly 60 percent of children report having headaches; by the age of 18, that number increases to 90 percent. Recurrent, severe headaches also are common in this population. In the United States, one study reported that approximately 20 percent of children aged 4 to 18 years report having had notable recurrent headaches (including migraine) in the past 12 months. In today’s episode we are talk with Mario Coleman, MD about the diagnosis and management of reoccurring headaches in children and adolescents.

Dr. Coleman is a Pediatric Neurologist and an Assistant Professor of Pediatrics and Neurology at the University of Colorado School of Medicine.

Renal Tubular Acidosis, RTA (S3:E4) Aug 27, 2019

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

Diagnosis and Management of Hirschsprung Disease (S3:E3) Aug 20, 2019

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.

Undescended and Retractile Testis (S3:E2) Aug 13, 2019

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.

Through the Lens of the CBC: Bleeding Disorders in Pediatrics (S3:E1) Aug 06, 2019

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.

14th Annual People’s Choice Podcast Award Nominations Jul 30, 2019

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!

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

Our guest for this episode is Jessica Malmberg, PhD, the Clinical Director of Outpatient Services at the Pediatric Mental Health Institute and assistant professor of child psychiatry at CU School of Medicine.

Dr. Malmberg talks us through a common behavioral issues of school-aged children – school refusal – and provides insights, advice and tools to help prevent, manage and understand this behavior.

In this episode:

Outlining and identifying the underlying symptoms and signs associated with a child refusing to attend school
How primary care providers (PCPs) can assist parents who are experiencing guilt
Identifying the four most common reasons that children refuse to go to school
Exploring the effects of social media on children's behavior when it comes to school refusal
How a PCP should approach treatment of school refusal
The recommended frequency of follow-up care for kids who are refusing to go to school
The importance of connecting parents to community-based resources
Preventative practices parents can set up in the home to prevent this behavioral issue
What an excellent prognosis looks like for children experiencing school refusal
When it's time to refer to a mental health professional
PCPs in the Denver Metro Area can refer patients to the Children's Hospital Colorado Outpatient Psychiatry Clinic or to a local community mental health center

Resources for dealing with school refusal:

School Refusal: Information for Educators (.pdf) from the National Association for School Psychologists
School Refusal in Children and Adolescents from American Family Physician
The Functional Assessment of School Refusal Behavior
Effective Child Therapy
Division 53 of the Society of Clinical Child & Adolescent Psychology website
School Refusal from the American Academy of Child & Adolescent Psychiatry

Season 3: Teaser Jul 27, 2019

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!

Toxicity and the Most Common Pediatric Overdoses (S2:E29 Rebroadcast) Jul 23, 2019

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.

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

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.

E-Cigarettes and Vaping (S2:E23 Rebroadcast) Jul 09, 2019

A real public health problem has snuck up on us as pediatricians - vaping and e-cigarettes use. On today’s episode, we will unpack the facts about e-cigarettes and vaping, provide you with practical tools to counsel your patients and families and talk about upcoming advocacy and policy work pertaining to e-cigarettes. Our guests today are Jennifer Woods, MD, Medical Director of the Adolescent Medicine Clinic at Children’s Hospital Colorado and associate professor of pediatrics at the University of Colorado School of Medicine; and Heather Hoch, MD pediatric pulmonologist at Children’s Hospital Colorado and assistant professor the CU School of Medicine.

From today's episode:

The 2018 NIH Monitoring the Future Survey Results were released last month. The survey found that 37% of 12th graders and 18% of 8th graders have vaped in the last year and the number of kids who used vaping products in the last month jumped from 11 to 21% in 12th graders and from 9 to 16% in 10th graders — those changes are the biggest jumps in adolescent substance use that has been seen in the 4 decades of conducting the Monitoring the Future Survey.
From the AAP: 5 Facts to talk to Teens about Vaping
The FDA held a public hearing on January 18, 2019 to discuss efforts to eliminate youth e-cigarette use, with a focus on the potential role of drug therapies to support cessation and the issues impacting the development of such therapies. If this is a topic you are passionate about, we encourage our listeners to visit the FDA website to submit a public comment, those public comment submissions will be available through February 1, 2019 https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm)
Pediatricians Push for Laws to Prevent Teen Vaping
Colorado Bill Introduced to Combat Skyrocketing Youth E-Cigarette Use, Clean Indoor Air Act, House Bill 19-1076

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

Abnormal Head Growth and Shapes in Pediatrics (S2:E18 Rebroadcast) Jul 02, 2019

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.

Atopic Eczema (S2:E17 Rebroadcast) Jun 25, 2019

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.

Henoch–Schönlein Purpura, HSP: Diagnosis and Management (S2:E12 Rebroadcast) Jun 18, 2019

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.

Case Study: Laryngomalacia (S2:E11 Rebroadcast) Jun 11, 2019

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

STDs in Teens: Testing and Treatment (S2:E7 Rebroadcast) Jun 04, 2019

Treating STDs in adolescent patients can be a challenge for today’s busy pediatrician. Eliza Buyers, MD of the Pediatric and Adolescent Gynecology team at Children’s Colorado returns to our pediatric podcast to provide practical tools for preventing and treating sexually transmitted infections in teens.

In this episode:

Why STD rates are higher in adolescents and young adults
How PCPs can address teen reproductive health challenges
Why we need to consider age as the primary risk factor for STDs
Examining the issue of STD rates as a health disparity
Importance of conducting universal screening in sexually active adolescents
Expedited partner therapy (EPT) and its importance
Recommended STD and HIV screening periods for different populations
Screening guidelines for STD examinations in the absence of symptoms.
Approaching one-to-one time with teen patients
Importance of promoting condom use to prevent STDs in teens
When to consider screening for less common STDs
Why it’s crucial to know confidential screening clinics you can send your patients

STD management resources:

Compassion Fatigue: Strategies for Provider Self Care – Season 2 Finale (S2:E39) May 28, 2019

In today’s episode all three hosts are in the recording studio for a round table discussion about provider self-care and compassion fatigue. The host team shares personal experiences and strategies they utilize for keeping them energized when cases have challenging outcomes.

The host team includes is David Brumbaugh, MD, pediatric gastroenterologist and Associate Chief Medical Officer at Children’s Colorado; Alison Brent , MD Pediatric Emergency Medicine Physician and Medical Director of Physician Relations and the Network of Care at Children’s Colorado; and Dan Nicklas, MD, pediatrician and Medical Director of the Pediatric Call Center at Children’s Colorado.

Thank you to all of our listeners for a fantastic Season 2 of Charting Pediatrics! Season 3 will launch on August 6. If you have suggestions for a future topic email us.

Management of Sinusitis in Pediatrics (S2:E38) May 21, 2019

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

Severe Feeding and Swallowing Issues in Infants (S2:E37) May 14, 2019

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.

Hypertension in Pediatrics (S2:E36) May 07, 2019

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.

Acute Flaccid Myelitis (AFM) in Pediatrics (S2:E35) Apr 30, 2019

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.

Pediatrician Turned Legislator: An Interview with Rep. Dr. Yadira Caraveo (S2:E34) Apr 23, 2019

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.

High Altitude Health: Impact of Altitude on Pediatric Patients (S2:E33) Apr 16, 2019

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

Art and Science of Managing AOM (S2:E32) Apr 09, 2019

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

Alleviating Seasonal Allergies (S1:E1 Rebroadcast) Apr 02, 2019

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

Cognitive Error in Diagnosis (S2:E31) Mar 26, 2019

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.

Measles (S2:E30) Mar 19, 2019

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

Toxicity and the Most Common Pediatric Overdoses (S2:E29) Mar 12, 2019

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.

Overcoming HPV Vaccination Hesitancy (S2:E28) Mar 05, 2019

HPV vaccine rates remain low with only about 16% 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 and Motivational Interviewing Techniques.

Food Allergy Immunotherapy (S2:E27) Feb 26, 2019

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:

Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial, JAMA February 22, 2019

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

Congenital Heart Disease: Ongoing Management (S2:E26) Feb 19, 2019

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.

Repeat Concussion and Sports Retirement Case Study (S2:E25) Feb 12, 2019

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!

Pain Management in Kids (S2:E24) Feb 05, 2019

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.

E-Cigarettes and Vaping (S2:E23) Jan 29, 2019

A real public health problem has snuck up on us as pediatricians - vaping and e-cigarettes use. On today’s episode, we will unpack the facts about e-cigarettes and vaping, provide you with practical tools to counsel your patients and families and talk about upcoming advocacy and policy work pertaining to e-cigarettes. Our guests today are Jennifer Woods, MD, Medical Director of the Adolescent Medicine Clinic at Children’s Hospital Colorado and associate professor of pediatrics at the University of Colorado School of Medicine; and Heather Hoch, MD pediatric pulmonologist at Children’s Hospital Colorado and assistant professor the CU School of Medicine.

From today's episode:

The 2018 NIH Monitoring the Future Survey Results were released last month. The survey found that 37% of 12th graders and 18% of 8th graders have vaped in the last year and the number of kids who used vaping products in the last month jumped from 11 to 21% in 12th graders and from 9 to 16% in 10th graders — those changes are the biggest jumps in adolescent substance use that has been seen in the 4 decades of conducting the Monitoring the Future Survey.
From the AAP: 5 Facts to talk to Teens about Vaping
The FDA held a public hearing on January 18, 2019 to discuss efforts to eliminate youth e-cigarette use, with a focus on the potential role of drug therapies to support cessation and the issues impacting the development of such therapies. If this is a topic you are passionate about, we encourage our listeners to visit the FDA website to submit a public comment, those public comment submissions will be available through February 1, 2019 https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm)
Pediatricians Push for Laws to Prevent Teen Vaping
Colorado Bill Introduced to Combat Skyrocketing Youth E-Cigarette Use, Clean Indoor Air Act, House Bill 19-1076

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

Integrative Approach to Pediatric Medicine (S2:E22) Jan 22, 2019

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:

Critical Congenital Heart Disease (CCHD) (S2:E21) Jan 15, 2019

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

Pediatric Trigger Thumb (S2:E20) Jan 08, 2019

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

Happy Holidays Dec 20, 2018

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!

Ovarian Cysts and Torsion Risk (S2:E19) Dec 18, 2018

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.

Abnormal Head Growth and Shapes in Pediatrics (S2:E18) Dec 11, 2018

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.

Atopic Eczema (S2:E17) Dec 04, 2018

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.

Care for Young Mothers in Your Pediatric Practice (S2:E16) Nov 27, 2018

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:

Addiction Prevention in Primary Care - Live! From the 2018 AAP Annual Meeting (S2:E15) Nov 20, 2018

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.

Marijuana as Medicine - Live! From the 2018 AAP Annual Meeting (S2:E14) Nov 13, 2018

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.

Safe Infant Sleep - Live! From the 2018 AAP Annual Meeting (S2:E13) Nov 06, 2018

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.

SIDS and other Sleep-Related Infant Deaths: Updated 2016 Recommendations for Safe Infant Sleeping Environment

American Academy of Pediatrics Live Recording Oct 30, 2018

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!

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

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 Chief of Nephrology at Children’s Colorado and professor of pediatrics at the University of Colorado School of Medicine. Dr. Fuhlbrigge is Chief 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.

Case Study: Laryngomalacia (S2:E11) Oct 16, 2018

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

American Academy of Pediatrics Live Recording Oct 12, 2018

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!

Child Sexual Abuse (S2:E10) Oct 09, 2018

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:

Sirotnak recommends physicians:
- Be familiar with local child advocacy center and victim assistance programs
- Use local experts in their communities
- Call other pediatricians for insight or resources
National Child Traumatic Stress Network
International Society for the Prevention of Child Abuse & Neglect
Child abuse and neglect resourcesfrom the American Academy of Pediatrics
The Resilience Project
Council on Child Abuse and Neglect

Scoliosis Diagnosis and Management (S2:E9) Oct 02, 2018

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:
- Congenital scoliosis
- Neuromuscular scoliosis
- Idiopathic scoliosis
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

Telephone Triage in Pediatric Primary Care (S2:E8) Sep 25, 2018

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:

ChildrensMD, the pediatric symptom checker app for parents (iTunes,Google Play)
“Pediatric Telephone Protocols”
ParentSmart HealthlineTM, Children’s Hospital Colorado’s 24/7 telephone triage

STDs in Teens: Testing and Treatment (S2:E7) Sep 18, 2018

Treating STDs in adolescent patients can be a challenge for today’s busy pediatrician. Eliza Buyers, MD, of the Pediatric and Adolescent Gynecology team at Children’s Colorado returns to our pediatric podcast to provide practical tools for preventing and treating sexually transmitted infections in teens.

In this episode:

Why STD rates are higher in adolescents and young adults
How PCPs can address teen reproductive health challenges
Why we need to consider age as the primary risk factor for STDs
Examining the issue of STD rates as a health disparity
Importance of conducting universal screening in sexually active adolescents
Expedited partner therapy (EPT) and its importance
Recommended STD and HIV screening periods for different populations
Screening guidelines for STD examinations in the absence of symptoms.
Approaching one-to-one time with teen patients
Importance of promoting condom use to prevent STDs in teens
When to consider screening for less common STDs
Why it’s crucial to know confidential screening clinics you can send your patients

STD management resources:

Infant Feeding and Swallowing Problems (S2:E6) Sep 11, 2018

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

Caring for Children with Down Syndrome (S2:E4) Aug 28, 2018

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 resources to share with patient families.

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

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

Maintenance of Certification and Quality Improvement for the Pediatric Primary Care Office (S2:E2) Aug 14, 2018

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

Discussing Firearm Safety in the PCP Office (S2:E1) Aug 07, 2018

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

School Anxiety and School Refusal in Kids (S1:E25 Rebroadcast) Jul 31, 2018

Our guest for this episode is Jessica Malmberg, PhD, the Clinical Director of Outpatient Services at the Pediatric Mental Health Institute and assistant professor of child psychiatry at CU School of Medicine.

Dr. Malmberg talks us through a common behavioral issues of school-aged children – school refusal – and provides insights, advice and tools to help prevent, manage and understand this behavior.

In this episode:

Outlining and identifying the underlying symptoms and signs associated with a child refusing to attend school
How primary care providers (PCPs) can assist parents who are experiencing guilt
Identifying the four most common reasons that children refuse to go to school
Exploring the effects of social media on children's behavior when it comes to school refusal
How a PCP should approach treatment of school refusal
The recommended frequency of follow-up care for kids who are refusing to go to school
The importance of connecting parents to community-based resources
Preventative practices parents can set up in the home to prevent this behavioral issue
What an excellent prognosis looks like for children experiencing school refusal
When it's time to refer to a mental health professional
PCPs in the Denver Metro Area can refer patients to the Children's Hospital Colorado Outpatient Psychiatry Clinic or to a local community mental health center

Resources for dealing with school refusal:

School Refusal: Information for Educators (.pdf) from the National Association for School Psychologists
School Refusal in Children and Adolescents from American Family Physician
The Functional Assessment of School Refusal Behavior
Effective Child Therapy
Division 53 of the Society of Clinical Child & Adolescent Psychology website
School Refusal from the American Academy of Child & Adolescent Psychiatry

Top 10 Pediatric Rheumatology Diagnoses (S1:E19 Rebroadcast) Jul 24, 2018

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

Neonatal Jaundice and Bilirubin Levels in Newborns (S1:E21 Rebroadcast) Jul 17, 2018

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

Food Allergies Diagnosis and Hot Topics (S1:E16 Rebroadcast) Jul 10, 2018

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

Constipation Treatment and Management (S1:E4 Rebroadcast) Jul 03, 2018

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

Heart Arrhythmia in Pediatric Primary Care (S1:E5 Rebroadcast) Jun 26, 2018

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

ADHD Medication Management (S1:E15 Rebroadcast) Jun 19, 2018

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

Vaccinations and Motivational Interviewing (S1:E12 Rebroadcast) Jun 12, 2018

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

Teen Reproductive Health (S1:E6 Rebroadcast) Jun 05, 2018

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

That's a Wrap Season 1 (S1:E34) May 29, 2018

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

CAR-T Cellular Therapy for Leukemia (S1:E33) May 22, 2018

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.

Nocturnal Enuresis and Bedwetting (S1:E32) May 17, 2018

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.

Neck Mass Diagnosis and Management for Pediatricians (S1:E31) May 08, 2018

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

Common Sleep Disorders in Children and Teens (S1:E30) May 01, 2018

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

Asthma Management (S1:E3 Rebroadcast) Apr 10, 2018

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

Alleviating Seasonal Allergies (S1:E1 Rebroadcast) Apr 03, 2018

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

Celiac Disease Diagnosis and Management with Dr. Edwin Liu (S1:E29) Mar 27, 2018

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

Hip Pain in Children Diagnosis and Management (S1:E28) Mar 20, 2018

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

Autism Spectrum Disorder: Diagnosis and Symptoms in Children (S1:E27) Mar 13, 2018

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

Physician Burnout (S1:E26) Feb 27, 2018

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

School Anxiety and School Refusal in Kids (S1:E25) Feb 20, 2018

Our guest for this episode is Jessica Malmberg, PhD, the Clinical Director of Outpatient Services at the Pediatric Mental Health Institute and assistant professor of child psychiatry at CU School of Medicine.

Dr. Malmberg talks us through a common behavioral issues of school-aged children – school refusal – and provides insights, advice and tools to help prevent, manage and understand this behavior.

In this episode:

Outlining and identifying the underlying symptoms and signs associated with a child refusing to attend school
How primary care providers (PCPs) can assist parents who are experiencing guilt
Identifying the four most common reasons that children refuse to go to school
Exploring the effects of social media on children's behavior when it comes to school refusal
How a PCP should approach treatment of school refusal
The recommended frequency of follow-up care for kids who are refusing to go to school
The importance of connecting parents to community-based resources
Preventative practices parents can set up in the home to prevent this behavioral issue
What an excellent prognosis looks like for children experiencing school refusal
When it's time to refer to a mental health professional
PCPs in the Denver Metro Area can refer patients to the Children's Hospital Colorado Outpatient Psychiatry Clinic or to a local community mental health center

Resources for dealing with school refusal:

School Refusal: Information for Educators (.pdf) from the National Association for School Psychologists
School Refusal in Children and Adolescents from American Family Physician
The Functional Assessment of School Refusal Behavior
Effective Child Therapy
Division 53 of the Society of Clinical Child & Adolescent Psychology website
School Refusal from the American Academy of Child & Adolescent Psychiatry

Teen Suicide: Risk Factors, Screening and Prevention (S1:E24) Feb 13, 2018

Today we're discussing the serious topic of teen suicide with Jenna Glover, PhD, MS, 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:

Primary care provider toolkit from the Suicide Prevention Resource Center
PHQ-9 (.pdf) screening tool
Columbia Suicide Severity Rating Scale (.pdf)
"13 Reasons Why"
Colorado Crisis Services
Second Wind Fund
National Suicide Prevention Line: 1-800-273-TALK (8255)
MentalHealth.gov

Bronchiolitis (S1:E23) Jan 30, 2018

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

Adolescent Bariatric Surgery with Dr. Thomas Inge (S1:E22) Jan 16, 2018

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

Neonatal Jaundice and Bilirubin Levels in Newborns (S1:E21) Dec 26, 2017

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

Noisy Breathing in Pediatric Patients (S1:E20) Dec 19, 2017

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

Top 10 Pediatric Rheumatology Diagnoses (S1:E19) Dec 15, 2017

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

International Adoption Medicine (S1:E18) Dec 08, 2017

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

Non-IgE Mediated Food Allergies (S1:E17) Nov 28, 2017

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

Food Allergies Diagnosis and Hot Topics (S1:E16) Nov 21, 2017

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

ADHD Medication Management (S1:E15) Nov 14, 2017

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

Headaches and Migraines in Children Management (S1:E14) Oct 31, 2017

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

Vascular Malformations in Pediatric Primary Care (S1:E13) Oct 24, 2017

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

Vaccinations and Motivational Interviewing (S1:E12) Oct 17, 2017

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

Back Pain Management in Pediatrics (S1:E11) Oct 10, 2017

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

Breastfeeding Management and Support for Nursing Moms (S1:E10) Oct 03, 2017

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

Seizure Management (S1:E9) Sep 26, 2017

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

Acute Scrotum Pain Management (S1:E8) Sep 19, 2017

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

Fidget Spinners and Other Ingested Foreign Objects (S1:E7) Sep 12, 2017

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

Teen Reproductive Health (S1:E6) Sep 05, 2017

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

Heart Arrhythmia Diagnosis (S1:E5) Aug 29, 2017

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

Constipation Treatment and Management (S1:E4) Aug 22, 2017

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

Asthma Management (S1:E3) Aug 22, 2017

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

Approaching Concussions in Primary Care (S1:E2) Aug 22, 2017

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).

Alleviating Seasonal Allergies (S1:E1) Aug 11, 2017

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

Our TOPPODCAST Picks

Follow Us

Stay Connected

Related Podcasts

Links

Stay Connected