Podcasts about Clinical Pediatrics

Alan Beggs, PhDDirector of the Manton Center for Orphan Disease ResearchSir Edwin and Lady Manton Professor of Pediatrics, Boston Children's HospitalHarvard Medical School, Boston, MA, USA Julie A. Parsons, MDHaberfield Endowed Chair in Pediatric Neuromuscular DisordersProfessor of Clinical Pediatrics and NeurologyUniversity of Colorado School of Medicine, Children's Hospital ColoradoAurora, CO, USADoctors Beggs and Parsons discuss the current status of gene therapies in rare neuromuscular disorders in this eight part podcast series. This is derived from the symposium that was presented at the MDA 2025 conference in Dallas, Texas, in March 2025 and is intended for healthcare professionals only. This podcast includes information about investigational compounds that do not yet have a regulatory approval or authorization for a specific indication. The safety and efficacy of the agents under investigation have not been established. In contents of this podcast, shall not be used in any manner to directly or indirectly promote or sell the product for unapproved uses. The ASPIRO clinical trial is on clinical hold since September 2021.In this part, Doctor Beggs will provide an explanation of AAV-mediated gene therapies.Alan Beggs, PhDAAV vectors, which I'm going to be talking about more today, or Adeno associated viral vectors are small viruses. Their DNA gets delivered into the cell and remains extrachromosomal. There are very rare occasional integrations, but the risk of oncogenesis as a result is significantly lower as a consequence of remaining extrachromosomal, though, we do have to think about what happens as the cells divide and potentially the durability of treatment is more limited.There have been a lot of movement and development over the years, starting back in the 1980s when the first AAV genomes were isolated and sequenced. This led to a development of methods to produce recombinant AAVs that would lack the genes necessary for viral replication, but contain a therapeutic gene you wish to deliver. Through this, the structure of AAVs have been developed. There have been isolation of a number of naturally occurring variants. You've heard of AAV8, AAV9, also RH 74, derived from a rhesus monkey for the RH. These have all been used in clinical trials. Then at the end I'll talk a little bit about directed evolution methods to actually engineer capsids with particular properties that are beneficial.Throughout this we've identified some of the issues that arise in this. It was initially thought that AAV vectors were non-immunogenic, but in fact there are immune responses not just to the viral payload to the therapeutic protein, but also to the viral vectors, and you're going to hear about that from Doctor Parsons. Over time, as we've come to understand these challenges, we've also been developing approaches to mitigate them. In terms of clinical trials and treatments, the very first studies were done back in the 1970s.By the early 2000, the very first clinical therapeutic was approved in China. It was actually an oncolytic virus carrying a p53 gene to treat head and neck cancers. By now there are over 40 approved treatments for various types of AAV delivered gene therapies. Of course, the ones we know a lot about are Zolgensma, which was approved in 2019, and Elevidys, which was approved last year. A number of challenges and then also a number of approaches to overcome those challenges. First of all, the preclinical data are not always sufficient to predict the response of a human patient.For example, in X-linked myotubular myopathy we had mouse and dog models that exhibited a myopathy but nothing else, and yet when we treated human patients, we discovered that patients with X-linked myotubular myopathy actually had a previously only poorly recognized hepatopathology that led to potential liver consequences following gene therapy. The animal models don't always predict the clinical outcome in humans.Also, we have small disease populations. These are rare diseases. It's important to understand the natural history of these diseases, understand the heterogeneity among the clinical population. It's very important to engage with families and with patients and communities, understand who might be at increased risk to treatment with one of these. This feeds into safety considerations. We need to think also about some of the immune responses. I think we're starting to learn, for example, with the gene therapies for Duchenne, and we know this from SMA that some patients get into trouble and others don't. We need to understand why that may be, and we don't know about the long term effects. This has been very recent.

Julie A. Parsons, MD Haberfield Endowed Chair in Pediatric Neuromuscular DisordersProfessor of Clinical Pediatrics and NeurologyUniversity of Colorado School of Medicine, Children's Hospital ColoradoAurora, CO, USAAs we talk about the gene transfer therapies and the modalities that we have to use, it's really interesting. Yesterday, with our keynote speaker, you could see this logarithmic growth of the use of gene transfer therapies for these disorders. If you look at the Venn diagram, you can see that really 27% almost of gene transfer therapies that are used are in musculoskeletal and neurology. For many of us as neurologists, we also take care of metabolic disorders.We really own right now this landscape, and of course, our two approved modalities are Onasemnogene and Delandistrogene. We're going to look at three different disorders, monogenic disorders, monogenic diseases, to typify what we look at in terms of some of the risks and benefits of these treatments. SMA, Duchenne, and X-linked myotubular myopathy are all rare disorders. They're all diseases that have a high unmet medical need and a significant disease burden.I think they're all good in terms of typifying where we are clinically with these disorders. The first question is, is it worth it? Are these effective treatments? We know from looking at the information about SMA that just looking early on, we know that if we treat kids early, that we do see a marked improvement in motor scores for kids that are treated early with Onasemnogene.In Duchenne, we have information that there is at least some improvement in the 4-5-year-olds in terms of motor skills treated with Delandistrogene. In terms of X-linked MTM, which was a very dramatic improvement, you could see that for boys who were basically traked, vented, and had no mobility, the bottom line, the blue line, is actually looking at ventilator dependence. Are they effective? Yeah, they're effective, but then we have to say, okay, what's the downside?The downside is that there's tremendous risk associated with treatment with these agents. If we really look at the sobering facts, we know that with SMA, there have been deaths, there have been fatalities related to thrombotic microangiopathy to patients who have liver failure, a couple of patients have died. With Onasemnogene, this is 4,000 plus doses that have so far been given. With Duchenne, unfortunately, many of us got the letter yesterday talking about an additional death in a patient treated with commercial Delandistrogene.We also know with some of the other agents, like fordadistrogene, patient died of heart failure, cardiac arrest, another patient who had acute respiratory syndrome with pulmonary edema. Again, we look at this and say this is significant. With X-linked MTM, as Alan said, there were some unanticipated deaths, four deaths from patients who ended up having cholestatic liver diseases that really wasn't anticipated prior to the patients being treated with the animal models and all that we had. Then many of you have heard about the patient with Rett syndrome who had a systemic hyperinflammatory syndrome. Again, these are rare disorders. They have a high disease burden, but the risk of treatment is significant.In the next part, Dr. Parsons discuss factors impacting safety and efficacy of AAV-mediated gene therapies.

Julie A. Parsons, MDHaberfield Endowed Chair in Pediatric Neuromuscular DisordersProfessor of Clinical Pediatrics and NeurologyUniversity of Colorado School of Medicine, Children's Hospital ColoradoAurora, CO, USAThe gene transfer trials for musculoskeletal disorders, if we look at musculoskeletal and neurologic disorders, we really do have the highest success rate in terms of treatment, but we also carry the highest incidence of treatment-emergent severe adverse events. And why is that true? Yesterday, when we were hearing about Donovan as well, we looked and said, When the first gene transfer therapies were started, he had a single muscle that was injected.When we look at Luxturna, we injected the retina. Now, what is happening with these disorders is that we're giving these huge, massive doses of viral vector to patients. There haven't been a lot of gene transfer therapies that have reached the market. But you saw yesterday, so many gene transfer therapies being worked on, but there are very few that have actually come to market. There are a couple of reasons for that.One is with the indications that we have, we know that the musculoskeletal disorders are most likely to achieve benefit, but there are the high risk of severe adverse events. Route of Administration, IV, for most of our disorders is the way we're going. We may end up having some Intrathecal therapies as well that are coming on board, but right now it's IV, and that means, a huge dose of this viral vector and antigenic risk that is being administered.In the vector design now, we actually have more specific vectors as well as promoters that are being utilized to really target specific tissues, so that we're able to focus in a little bit more on the tissues that we want to have affected. And then the dose has gone from these little tiny local injections to really systemic, much broader. And now our patients, are larger. So we're giving a viral genome per kilo dose that is just massive as we look at that.Then there really are challenges in terms of the translation of clinical trials to commercial treatment with these agents. And we don't always know, we're not always great when we do tests in clinical trials in small populations, about when that's broadened to the commercial availability and we hit larger heterogeneous populations.There are safety issues arising from these therapies, and I think that we have some experience now, certainly with the three diseases that I mentioned at the beginning, in terms of collecting some data and information to have a little bit more of an idea what to expect. Although to me, the recurring esteem is always, expect the unexpected. Because we still are learning about this. Hepatotoxicity. We know that transaminitis is something that we see in almost every gene transfer therapy that has been delivered, and we have to watch really, really closely and follow our patients closely for this. We also have to select patients that we don't think have risk for additional liver injury or underlying liver pathology, because as we found out in the XLMTM boys, we missed that. Thrombotic Microangiopathy. We look at this disorder. We've had deaths in SMA from TMA. We have Duchenne patients that have had TMA.This is scary because as many of us as clinicians who have treated patients, you know that we end up getting thrombocytopenia. So is that it this time, or are they going to be fine, or the platelet is going to go back to normal? This is another one that we have to watch really, really closely for. Cardiac Toxicity. We have had cardio myositis. We've had deaths from cardiac toxicity.Something really, really important for us to think about. In little kids, vomiting could be a sign of cardiac myositis. And for most of us who've treated patients with gene transfer therapy, what's one of the first issues that you get?You get nausea of vomiting, they don't feel good. So is that myocarditis or is it just a standard side effect that we're seeing with treatment? Importantly, as we discovered, there actually can be an immune response to the transgene. It's not just the viral vector capsid, it's actually the transgene as well. That was discovered in patients who were treated for Duchenne. So that's a really important thing in terms of looking now at what's our patient's selection and how do we pick the right patients.Next part, Dr. Parsons will discuss understanding and preparing risk factors associated with AAV gene therapies.

Julie A. Parsons, MDHaberfield Endowed Chair in Pediatric Neuromuscular DisordersProfessor of Clinical Pediatrics and NeurologyUniversity of Colorado School of Medicine, Children's Hospital ColoradoAurora, CO, USANow, with our collective experience, we can at least put together the information that we have in terms of what can we expect and what's the timeline that we expect in terms of our patients having reactions. I will tell you, and I've said this multiple times, when I deliver a gene transfer therapy, I hold my breath for 2 months. Now, maybe it's going to have to be extended to a year, but it's typically at least for 2-3 months. It's like, okay, what's going to happen? You sit on the edge of your seat on pins and needles, going, "Is this kid going to be okay or not?" I think that's the appropriate response to have in terms of the light of things that have happened over time. We have to be really careful.We have a little bit of a framework now to say, when do we need to be really excited? We know that our patients, most all of them, are going to develop a transaminitis, and that ends up happening early on, but we get a couple of peaks. We get really excited that the 4-8 week time point with transaminitis looking for liver failure.The cholestatic liver disease that happened in the patients with X-linked MTM happened a little bit later, so Week 2, all the way out to six months afterwards. The acute cardiomyopathy a little bit earlier, so we're looking a little bit earlier for that effect. TMA, usually the end of the first week to about 2 weeks is when we would expect that to come in. Then the transgene-related myositis and immune-mediated myocarditis, weeks, maybe 2 to a couple of months.How do we adapt our gene transfer programs to the clinical trial experience? I think that there are a couple of points that are important. One is that the outline that I showed you, there are some disease-agnostic issues that come up with transaminitis, with TMA. I think there are some final common pathways related to the immune responses that we see with these patients. Then there are going to be some disease-specific disorders that are going to come up with each of these therapies and agents.We need to have good communication, honestly, in real-time. I still don't know that we have a good mechanism for that as a community, but to share these adverse events that come up so that we can all learn as a collective about what to expect, what to anticipate, and how to best take care of our patients. We know now how we need to monitor patients closely from a laboratory standpoint, from a clinical exam standpoint, and we really need to work on how are we going to mitigate some of these risk issues that we have with these patients.I think the collaborative aspect, particularly at meetings like this, is important. Last year, for the people that were at MDA, you remember that we really spent a lot of time looking at gene transfer delivery. Many of us got together as providers and actually met together to say, "Is there something that we can think about in terms of best practice or consensus in terms of how we would want to manage patients or how we'd want to share information?"Now, actually, on the MDA website, we really do have some guidelines, and there will be a publication coming out shortly that we'll have this available to everybody again. It's not necessarily the right answer, but it's at least from a collective experience, what's the best way that we can go forward? Some of the suggestions were that the adverse events right now, we can put them into some a predictable timeline, but we don't really know all the risks at the time of dosing.We know that gene transfer therapy can be safe for the right patient at the right time for the right disorder. That's really what we want to do. There's a Neurotherapeutic window between efficacy and toxicity. How are we adjusting that? What are we working on to make sure that we're getting that right? The preclinical data is helpful, but it's never the full story. Any time we go from a homogeneous population that we see in a clinical trial to a heterogeneous population, as we throw this out to the world, we're going to have new issues that arise, and we need to be aware and ready for those.We want to be able to predict what happens, but we can't always do that. Then follow-up is so important. The post-marketing study, sharing adverse events, sharing experiences, I think, is really important as well. Clinicians really should be familiar with this entire field before ever delivering gene transfer therapy. I don't think that every site should be delivering gene transfer. I think that from an institutional standpoint, you need to be ready. You need to have a team who knows what they're doing and knows how to handle the issues and the problems, or you need to have lifelines set up in advance if you're going to deliver these treatments.

Julie A. Parsons, MD Haberfield Endowed Chair in Pediatric Neuromuscular DisordersProfessor of Clinical Pediatrics and NeurologyUniversity of Colorado School of Medicine, Children's Hospital ColoradoAurora, CO, USAHow have programs adapted to the experiences from clinical trials? I'm just looking at SMA because we've had SMA. We've had onasemnogene around for the longest period of time. We want to always confirm a diagnosis and know that the patient is right. We do antibody testing for these disorders prior to delivering the AAV therapies. We have to know that the product that is incredibly expensive is handled appropriately by the institution. Dealing with the pharmacy, making certain that you handle the agent properly, patients need to be pretreated at this point with prednisone, and that really has to happen so that you know that they're ready for treatment, that they don't have any infections prior to treatment.Then we need to monitor and provide medication and follow-up afterwards. As I said, I think this is really, really important to make sure that you're connected well with the patient. If you live in an area as we do, that has a huge catchment area with patients that come from hundreds of miles away, sometimes they need to stay with us for a period of time, so that we can ensure the safety and follow-up of these patients after we deliver gene therapies.Again, a recurring theme is the patients that you're treating who are not in a clinical trial are not the homogeneous, well-selected patients. It's really all actors. The population that you're treating commercially is very different. We're now moving into treating patients with larger body masses and older ages. We don't always know, because those patients haven't really been included in the clinical trials. We don't really know what some of the effects are going to be with that group of patients as well.I am a neurologist. I am not an immunologist. I have had to learn a lot of immunology at this point, but it's still not sufficient. I think that we also need to reach out to our subspecialist colleagues who really do have more experience than we do to try to help us with some of these issues, because as we look at these viral vector capsids and the transgenes, we have to say, is there something that we can do to mitigate the immune response that we're seeing when we're giving massive doses of these agents and really taxing the immune system in our patients?Looking at possibilities, we give steroids, and that's really what we've done. That was what was done in the early clinical trials with MENDEL. It's like, okay, prednisone, that's all we have to do is we give steroids and everybody will be fine. That really isn't maybe the answer. As we have more information, we know that we're going to start with steroids, but we're really going to look at, is there a way to block both the B-cell response, the T-cell response? Is there something that we can do so that we don't have to sit on the edge of our seats and not sleep for months after we treat these patients?At least in a trial, was done looking at patients who were treated just with corticosteroids. Those patients had rapid increases in IgM and IgG. There's complement activation. Both the adaptive and the acute immune responses are triggered. That's really what we're doing as standard practice right now, but in the trial looking at treating patients and pretreating patients with rituximab blocking B cells and sirolimus and corticosteroids, then no significant change in IgM, IgG.Is that something that we should be doing? I think that some of the clinical trials that are being set up are looking at instituting some of these immune-modulating features to see whether or not their outcomes are improved. Can we do anything proactively to prevent our patients from having some of these very severe events or fatalities? I think that's really what we need to be looking at now. I think we are looking at that as a community, and to me, is a story that is still unfolding in terms of how we keep our patients safe.In the next part, Doctors Beggs and Parsons will discuss key issues on gene therapy development.

Alan Beggs, PhDDirector of the Manton Center for Orphan Disease ResearchSir Edwin and Lady Manton Professor of Pediatrics, Boston Children's HospitalHarvard Medical School, Boston, MA, USA Julie A. Parsons, MDHaberfield Endowed Chair in Pediatric Neuromuscular DisordersProfessor of Clinical Pediatrics and NeurologyUniversity of Colorado School of Medicine, Children's Hospital ColoradoAurora, CO, USAThe ASPIRO Clinical Trial is on clinical hold since September 2021. In this part, Doctors Beggs and Parsons will discuss key issues on gene therapy development.Question: Is there a standardized immunomodulation regimen being considered for gene therapy?Julie A. Parsons, MDAs I mentioned, right now, I think there are a number of different concepts that are being utilized. We don't really have a recommended standard regimen at this point. There are a number of different trials that are ongoing looking at trying to answer this question. In some of the clinical trials, there is an immune modulating regimen that is being put in place but being looked at. There isn't anything that we have as a standard at this moment for all gene transfer therapies, but I'm hopeful that we will come up with something that really makes sense in each patient population as we go forward with specific gene transfer therapies.Question: What are the long-term implications, safety and efficacy of a one-time gene therapy in pediatric patients with neuromuscular diseases?Alan Beggs, PhDOne question is the efficacy. For example, Donovan Decker's story, he had an experimental treatment of one muscle. It was a phase one safety trial, and he knew that nothing was going to come of it in terms of direct benefit to him. As a result, though, 25, 30 years later, he still has a tighter against AAV vectors. He's not a candidate for gene therapy under current protocols, although there's a lot of work going on to redosing. But for now, it's a one-time treatment. What you get is what you get, and there's not a chance to go back and do it again.The other question is durability. We really don't know about the long-term durability for these treatments. I should say that, for example, in the studies that we did, David Mack, who's here in the audience, managed a dog colony for a dog model of excellent tubular myopathy. Those animals lived 10 years in a... We never used the C-word, but they were cured. They were healthy, happy, normal dogs who would have had to be put down at 6 months of age otherwise. And then, as we heard, I'll let you talk about the concern for unanticipated SAEs as time goes on, but I think there's other aspects we need to think about.Julie A. Parsons, MDYeah. I think that this is really the key question that all of us are going to need to help answer over the next several years. Efficacy, we're looking at outcomes, and outcomes come in a variety of flavors. I think we do a decent job with motor outcomes. We don't do a decent job with some other outcomes. I think we need to look more broadly in terms of what we mean in terms of beneficial outcomes and really take some of those cues from the patients themselves about if these are efficacious treatments, because, again, the risk is high as we deliver these agents, and we need to know that it's worth it to the patients and families.In terms of safety, we're working on it. There are all sorts of things that are coming forward as issues with these patients. I think that collectively as a community, that our responsibility is to follow patients for the long term. There are lots of registries and outcome studies. We're not very good as a community about reporting adverse events to central groups. We're not great about broadcasting that to each other in real-time. I think those are things that we really need to work on as a community in terms of helping with the safety issues so that we all have a communal better understanding of what some of those issues are.

In the November 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss acute radiation sickness and ocular foreign bodies. As always, you'll also hear about the hot topics covered in the regular features, including recurrent palpitations in a middle-aged man in The Critical ECG, primary adrenal insufficiency in Clinical Pediatrics, Lisfranc injury in Critical Cases in Orthopedics and Trauma, active external rewarming of hypothermic patients in The Critical Procedure, managing patients with acute visual loss in The LLSA Literature Review, abdominal pain in a child after a fall in The Critical Image, acetylcysteine for acetaminophen toxicity in The Drug Box, and carbon monoxide toxicity in The Tox Box.

In the October 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss managing thermal burns and diabetic ketoacidosis and hyperosmolar state. As always, you'll also hear about the hot topics covered in the regular features, including syncope and a rapid heartbeat in a young man in The Critical ECG, a boy with hip pain in Clinical Pediatrics, calcaneal fracture in Critical Cases in Orthopedics and Trauma, wedge resection for partial nail removal in The Critical Procedure, albuterol-budesonide rescue inhalation for asthma in The LLSA Literature Review, a patient with a change in mental status in The Critical Image, phenobarbital for alcohol withdrawal syndrome in The Drug Box, and paraquat toxicity in The Tox Box.

In the September 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss vaginal bleeding and hyponatremia managment. As always, you'll also hear about the hot topics covered in the regular features, including a young man with heart palpitations in The Critical ECG, a child with purple vesicles in Clinical Pediatrics, hallux sesamoid fractures in Critical Cases in Orthopedics and Trauma, spermatic cord block in The Critical Procedure, the ISPAD 2022 Guidelines Summary in The LLSA Literature Review, a patient with a thumb injury in The Critical Image, droperidol in The Drug Box, and barium toxicity in The Tox Box.

Welcome to Dr. M's Women & Children First Podcast, where we engage with pioneering voices at the intersection of science, healthcare, and the well-being of families. Today on Dr. M's Women and Children First, we welcome Dr. Elizabeth Mumper, a physician, educator, and thought leader whose career has profoundly influenced the practice of integrative pediatrics. Dr. Mumper earned her Bachelor of Science degree from Bridgewater College, graduating magna cum laude, before attending the Virginia Commonwealth University School of Medicine, where she received her medical degree. She completed her pediatric residency at the University of Virginia and served as Chief Resident in Pediatrics. She remained at UVA as an Associate Professor of Clinical Pediatrics from 1997 to 2005, mentoring future physicians and advancing holistic, evidence-based approaches to child health. Following her time in academia, Dr. Mumper founded The Rimland Center for Integrative Medicine in Lynchburg, Virginia, a clinic dedicated to children with autism spectrum disorders, PANS/PANDAS, allergies, and complex chronic illnesses. Her practice integrates the best of conventional pediatrics with biomedical and functional medicine principles, always guided by compassion and curiosity. She has been a leading educator with the Medical Academy of Pediatric Special Needs (MAPS) and a frequent international lecturer, teaching clinicians how to recognize and treat the root causes of immune dysregulation, inflammation, and neurodevelopmental challenges. Dr. Mumper is also the author of the new book Kids and COVID, an insightful exploration of how the pandemic impacted children, physically, emotionally, and developmentally, and what lessons medicine must learn moving forward. In our conversation, we discuss her book in depth, as well as the broader implications of the COVID-19 pandemic for pediatric care, resilience, and future public health policy. Finally, we dive into the complex topic of vaccines, considering what we've learned from the pandemic years and expanding the conversation begun with Dr. Paul Offit and Dr. Joel Warsh. Dr. Mumper's lifelong dedication to children, her fearless pursuit of truth, and her balanced, science-driven voice make her one of the most respected figures in functional medicine. Please join me in welcoming my friend and colleague,  Dr. Elizabeth Mumper. Dr. M

In the July 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss cardiovascular disorders in the emergency department observation unit and ectopic pregnancy presentations. As always, you'll also hear about the hot topics covered in the regular features, including chest pain in a health young adult in The Critical ECG, periosteal reaction in a newborn in Clinical Pediatrics, lunate dislocation in Critical Cases in Orthopedics and Trauma, intrapleural anesthesia in The Critical Procedure, phenobarbital for alcohol withdrawal syndrome in The LLSA Literature Review, a patient with acute renal failure in The Critical Image, suzetrigine in The Drug Box, and metaldehyde toxicity in The Tox Box.

When it comes to babies, there is one true common denominator for new parents — poop. While it's one of the first things parents can fixate over, pediatricians know what's in the diaper can say a lot about what's going on inside that tiny body. From understanding different stool colors and consistency, to the difference in diaper contents between breast-fed and formula-fed babies, there's a lot to learn about baby poop. This episode was recorded on the exhibit floor at the 2025 Pediatric Academic Societies Conference in Honolulu, Hawaii. Joining us for this episode is Adrienne Hoyt-Austin, DO, a pediatrician and lactation consultant with UC Davis Health. She specializes in general pediatrics and breastfeeding medicine and is also an Assistant Professor of Clinical Pediatrics. Some highlights from this episode include:  What baby poop can reveal about their health How to distinguish between normal variations in stool and potential concerns   Common colors and consistencies  Biggest red flags to look for in baby poop  Charting Pediatrics is in the running for a People's Choice Podcast Award, and we need your help to get nominated! Starting July 1, you can head to www.podcastawards.com and nominate us for the “science and medicine” category, as well as the “people's choice” category. Listeners like you are the reason we have become one of the top pediatric podcasts for providers around the world. Your nomination could make all the difference in us receiving this recognition! Nominate us by July 31 and help Children's Hospital Colorado lead the way in pediatric podcasting. Thank you for your support!   For more information on Children's Colorado, visit: childrenscolorado.org. 

Parents often turn to their child's primary care physician for guidance on illnesses, developmental delays, or other health concerns. ADHD is no exception. In this episode, we're diving into the crucial role pediatricians play in recognizing and managing ADHD. We're giving you real-world tools to support real-world kids. This episode was recorded on the exhibit floor at the 2025 Pediatric Academic Societies Conference in Honolulu, Hawaii. Joining us for this episode is Jennifer Walton, MD, the Section Chief of Developmental Behavioral Pediatrics, and an Associate Professor of Clinical Pediatrics at the University of Miami Miler School of Medicine. Some highlights from this episode include:  The most common signs of ADHD that get overlooked  Differentiating between ADHD and other behavioral or mental health concerns  How to use a standardized rating scale to assess ADHD symptoms  Talking to families about starting medication  Charting Pediatrics is in the running for a People's Choice Podcast Award, and we need your help to get nominated! Starting July 1, you can head to www.podcastawards.com and nominate us for the "science and medicine” category as well as the "people's choice" category. Listeners like you are the reason we have become one of the top pediatric podcasts for providers around the world. Your nomination could make all the difference in us receiving this recognition! Nominate us by July 31st and help Children's Hospital Colorado lead the way in pediatric podcasting. Thank you for your support!  For more information on Children's Colorado, visit: childrenscolorado.org. 

In the May 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss managing protest injuries and xylazine overdose. As always, you'll also hear about the hot topics covered in the regular features, including a man with chest pain and irregular wide-complex tachycardia in The Critical ECG, a child with seizures and tachycardia in Clinical Pediatrics, occult radial head fracture in Orthopedics and Trauma, tracheal suctioning in The Critical Procedure, digital nerve blocks in The LLSA Literature Review, and a patient with abdominal pain and hematemesis in The Critical Image.

In this episode, we sit down with Dr. Chris Dandoy, Associate Professor of Clinical Pediatrics and bone marrow transplant physician at Cincinnati Children's Hospital. Dr. Dandoy shares his deep experience working with adolescents and young adults (AYAs), focusing on the unique challenges they face during and after cancer treatment. Our conversation centers around empowering AYAs to take ownership of their healthcare journey, improving outcomes, and restoring quality of life.Dr. Dandoy introduces us to Engraft, a collaborative learning network he founded, which unites providers, patients, families, industry partners, and nonprofits to improve survival and quality of life post-stem cell transplant. Rather than each center working in isolation, Engraft allows for real-time communication and problem-solving across 15 centers, helping everyone learn from each other's best practices.A core message in our conversation is the importance of ownership—encouraging AYAs to ask questions, understand their medications, and advocate for themselves. We explore the concept of “ownership” through examples, like advocating for the removal of central lines after they're no longer medically necessary, and understanding the role and risks of medications such as immunosuppressants and anti-infectives.Dr. Dandoy walks us through strategies to support medication adherence, such as using reminder apps, setting daily routines, and involving friends or caregivers for support. He also emphasizes the temporary nature of this intense medication schedule, helping patients see it as a phase, not a life sentence.We highlight how important it is for AYAs to stay engaged—learning about their labs, asking what new medications are for, and writing down questions for their healthcare team. Chris stresses that they don't have to memorize everything; the goal is communication and awareness, not perfection.For caregivers, Chris offers validation and encouragement, reminding them this is a marathon with tough stretches, but also moments of progress. He urges caregivers to walk beside their loved ones—not behind or in front—fostering independence and shared decision-making.Dr. Dandoy closes with an inspiring story of a young survivor who endured ICU-level complications but is now back to running races and embracing life fully. It's a powerful reminder that while the transplant journey is grueling, it's also transformative.More:Engraft Learning Network: https://www.engraftlearningnetwork.org/Thanks to our Season 17 Sponsors:Leukemia and Lymphoma Society (LLS): https://lls.org/and Incyte: https://incyte.com/ National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page: https://www.facebook.com/nbmtLINKFollow the nbmtLINK on Instagram! https://www.instagram.com/nbmtlink/The nbmtLINK YouTube Page can be found by clicking here.To participate in the GVHD Mosaic, click here: https://amp.livemosaics.com/gvhd

In the April 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss acute psychosis and lithium toxicity. As always, you'll also hear about the hot topics covered in the regular features, including pelvic inflammatory disease in a non–sexually active teen in Clinical Pediatrics, joint capsule foreign bodies in Critical Cases in Orthopedics and Trauma, male urethral catheterization in The Critical Procedure, high-dose nitroglycerin for SCAPE in The LLSA Literature Review, and a patient with recurrent chest pain in The Critical Image.In the April 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss acute psychosis and lithium toxicity. As always, you'll also hear about the hot topics covered in the regular features, including pelvic inflammatory disease in a non–sexually active teen in Clinical Pediatrics, joint capsule foreign bodies in Critical Cases in Orthopedics and Trauma, male urethral catheterization in The Critical Procedure, high-dose nitroglycerin for SCAPE in The LLSA Literature Review, and a patient with recurrent chest pain in The Critical Image.

In the March 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss pediatric sickle cell disease and trauma-informed care. As always, you'll also hear about the hot topics covered in Critical Decisions' regular features, including a child with difficulty walking in Clinical Pediatrics, sternoclavicular joint septic arthritis in Orthopedics and Trauma, interscalene nerve block in The Critical Procedure, intranasal topical application of tranexamic acid for atraumatic anterior epistaxis in The LLSA Literature Review, and a toddler with arm pain in The Critical Image.

In the February 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss seizure presentations and pediatric growth plate fractures. As always, you'll also hear about the hot topics covered in Critical Decisions' regular features, including a limping child with fever in Clinical Pediatrics, scaphoid fractures in Orthopedics and Trauma, suprapubic aspiration in The Critical Procedure, balloon tamponade for unstable GI bleeds in The LLSA Literature Review, and a stubborn urinary tract infection in The Critical Image.

In this episode, hosts Drs. Peter Lu and Temara Hajjat talk to Dr. Jean Molleston about drug-induced liver injury (DILI) in children.  Dr. Molleston is the former Division Chief of Gastroenterology, Hepatology, and Nutrition at Riley Children's and Professor of Clinical Pediatrics at University of Indiana School of Medicine.Learning Objectives:Understand the definition of DILI and signs that should raise our concern for this diagnosis.Recognize common causes of DILI, including both medications and supplements.Recognize the signs of drug reaction with eosinophilia and systemic symptoms or DRESS syndrome.Links:LiverTox: Searchable resource on drug-induced liver injurySupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

A 2019 report showed that police violence is a leading cost of death for young Black men in the United States. About one in every 1,000 Black men can expect to be killed by the police, with the highest risk amongst all ethnic groups and genders between the ages of 20 and 35 years old. Police violence has been identified as a public health issue among public health experts as well as advocates and activists. What role, then, do doctors and pediatricians have in preparing patients and their families to be aware of this public health risk? On today's show, we're in conversation with two pediatricians who led the research of a recent peer-reviewed research letter, titled “Pediatrician Perspectives on Incorporating Discussion of Police Encounters Into Anticipatory Guidance for Black Youth and Their Caregivers“. Dr Jeffrey Eugene is a pediatrician and adolescent medicine specialist, working with the Children's Hospital of Philadelphia as well as Philadelphia FIGHT Community Health Centers. His clinical expertise is in adolescent and young adult primary care, gender affirming medical care, sexual and reproductive health, medical care for youth living with HIV, and eating disorders. Dr George Dalembert, is a pediatrician at the Children's Hospital of Philadelphia (CHOP) and an Assistant Professor of Clinical Pediatrics at the Perelman School of Medicine. Additionally, he serves on the Governance as well as Diversity, Equity, and Inclusion Committees of the Pennsylvania chapter of American Academy of Pediatrics. He is also an author on the report that we're discussing today. Read their research here: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2829145 — Subscribe to this podcast: https://plinkhq.com/i/1637968343?to=page Get in touch: lawanddisorder@kpfa.org Follow us on socials @LawAndDis: https://twitter.com/LawAndDis; https://www.instagram.com/lawanddis/ The post The Public Health Risk of Police Violence and Pediatric Responsibility w/ Dr Jeffrey Eugene & Dr George Dalembert appeared first on KPFA.

In the January 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss factitious disorder in the emergency department and sickle cell disease in adults. As always, you'll also hear about the hot topics covered in Critical Decisions' regular features, including ingestion of a water-growing toy in Clinical Pediatrics, a posterior knee dislocation in Orthopedics and Trauma, local anesthetic for nasal reduction in The Critical Procedure, Bystander CPR in Black and Hispanic communities in The LLSA Literature Review, and a fall in a parking lot in The Critical Image.

In the December 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss managing alcohol withdrawal in the emergency department and evaluation and management of spontaneous intracranial hemorrhage. As always, you'll also hear about the hot topics covered in CDEM's regular features, including a boy with pharyngitis and a rash in Clinical Pediatrics, a reverse total shoulder arthroplasty dislocation in Orthopedics and Trauma, a zipper injury in The Critical Procedure, diagnosis and treatment of sexually transmitted infections in The LLSA Literature Review, and a newborn with bloody stool in The Critical Image.

In the November 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss investigating lower GI bleeding in the emergency department and testicular torsion presentations. As always, you'll also hear about the hot topics covered in CDEM's regular features, including pediatric facial nerve palsy in Clinical Pediatrics, a distal triceps tendon tear in Orthopedics and Trauma, reverse Valsalva maneuver in The Critical Procedure, high-risk airway management in The LLSA Literature Review, and a patient with foot drop in The Critical Image.

In the October 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss emergency management of hanging and strangulation injuries and peripheral neuropathies. As always, you'll also hear about the hot topics covered in CDEM's regular features, including undifferentiated hypoxia following a home birth in Clinical Pediatrics, a vanishing hip in Orthopedics and Trauma, string yank technique for fishhook removal in The Critical Procedure, acute atrial fibrillation and atrial flutter best practices in The LLSA Literature Review, and a knee injury in The Critical Image.

In the September 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss pediatric wrist injuries and postintubation care of critically ill patients. As always, you'll also hear about the hot topics covered in CDEM's regular features, including muscositis and rash after an acute febrile illness in Clinical Pediatrics, traumatic arthrotomy status post total knee arthoplasty in Orthopedics and Trauma, bursal aspiration and injection in The Critical Procedure, antimicrobial therapy for pediatric community-acquired pneumonia in The LLSA Literature Review, and a diving accident in The Critical Image.

In this episode of the Brain & Life podcast, co-host Dr. Katy Peters is joined by Jessica Patay, mother, caregiver, and founder of the nonprofit We Are Brave Together. Jessica discusser her son's diagnosis with a rare genetic neurologic condition called Prader-Willi Syndrome and how it led her to found an organization whose mission is to preserve and protect the mental health of caregiving moms of disabled and neurodiverse children. Dr. Peters is then joined by Dr. Emily De Los Reyes, attending pediatric neurologist at Nationwide Children's and Professor of Clinical Pediatrics and Neurology at The Ohio State University College of Medicine. They discuss exactly what Prader-Willi syndrome is, how it's diagnosed and treated, and what the future looks like for patients and their families.   Additional Resources We Are Brave Together How Parents Advocate for Their Children with Rare Diseases These Parents are Giving Their Teenager a Life of Adventure Despite Rett Syndrome Sibling Caregivers Share Rewards and Challenges   Other Brain & Life Episodes on this Topic Resiliency and Caregiving with Janet Fanaki Journalist Richard Engel on Parenting a Child with Rett Syndrome Gavin McHugh is Building an Acting Career and a Community with Cerebral Palsy   We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? ·       Record a voicemail at 612-928-6206 ·       Email us at BLpodcast@brainandlife.org   Social Media:   Guests: Jessica Patay @wearebravetogether; Dr. De Los Reyes @nationwidekids Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD

In the July 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss traumatic brain injuries and urinary tract infections. As always, you'll also hear about the hot topics covered in CDEM's regular features, including a rare complication of Meckel diverticulum in Clinical Pediatrics, atraumatic medial foot pain in Orthopedics and Trauma, distal fingertip amputation management in The Critical Procedure, alcoholic ketoacidosis in The LLSA Literature Review, and more than just a migraine in The Critical Image.

In the June 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss identifying and managing patients with sepsis and stridor in pediatric patients. As always, you'll also hear about the hot topics covered in CDEM's regular features, including methotrexate-induced leukoencephalopathy mimicking a stroke in Clinical Pediatrics, medial clavicle fracture in Orthopedics and Trauma, perimortem cesarean delivery in The Critical Procedure, multisystem inflammatory syndrome in children in The LLSA Literature Review, and gastrostomy tube complication in The Critical Image.

In the May 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss spinal epidural hematoma and abscess and upper-extremity pain treatments. As always, you'll also hear about the hot topics covered in CDEM's regular features, including late presentation of hyperthyroidism in a patient with trisomy 21 in Clinical Pediatrics, atypical medial collateral ligament injury in Orthopedics and Trauma, arthrocentesis of the knee in The Critical Procedure, peripheral nerve block for hip fracture in The LLSA Literature Review, and late presentation of sudden severe headache in The Critical Image.

====================================================SUSCRIBETEhttps://www.youtube.com/channel/UCNpffyr-7_zP1x1lS89ByaQ?sub_confirmation=1=======================================================================EL FASCINANTE LABORATORIO DE DIOSDevoción Matutina para Adolescentes 2024Narrado por: Mone MuñozDesde: Buenos aires, Argentina===================|| www.drministries.org ||===================21 DE JULIOSUPERHÉROES DE VERDAD«Por la fe conquistaron países, impartieron justicia, recibieron lo que Dios había prometido, cerraron la boca de los leones, apagaron fuegos violentos, escaparon de ser muertos a filo de espada, sacaron fuerzas de flaqueza y llegaron a ser poderosos en la guerra, venciendo a los ejércitos enemigos» (Hebreos 11: 33-34).LA ÚLTIMA DÉCADA HA ESTADO MARCADA POR EL DOMINIO DE LAS películas de superhéroes. Solo en 2019, cuatro de las diez películas más taquilleras del año fueron de esta temática. Pero, ¿cuál es el mensaje que transmiten estas películas?En un artículo publicado en 2017 en la revista Clinical Pediatrics, los científicos analizaron los temas abordados en 30 películas de superhéroes. Aunque se presentan temas positivos, como el trabajo en equipo y la ayuda a quienes están en peligro, los investigadores concluyeron que los temas negativos son mucho más frecuentes e incluyen violencia, acoso e intimidación.En Hebreos 11, Pablo presenta una lista de superhéroes reales que, aunque también tuvieron puntos negativos, lograron por la fe realizar hazañas inimaginables. En esta lista se menciona a personas como David y Daniel, que aun siendo adolescentes hicieron cosas increíbles. A pesar de la diversidad presentada en Hebreos, todos los héroes tenían algo en común: ¡la fuente de su poder! Sabían que eran pecadores como tú y como yo, pero tenían fe en el poder de Dios.LA FE ES UN SUPERPODER que nos ayuda a hacer cosas asombrosas para honra y gloria de Dios. Con ella, podemos ser una bendición para el mundo, llevando liberación y salvación a las personas que nos rodean.La fe no es un superpoder nuestro por naturaleza, sino que es concedida por Dios a todo aquel que la reclama. ¿Quieres ser un superhéroe y ayudar a salvar a muchas personas del pecado? Pídele a Dios que te conceda fe, ¡y verás que sucederán cosas maravillosas! 

In the January episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss the consequences of envenomation and acute vision loss. As always, you'll hear about the hot topics covered in CDEM's regular features, including persistent dysuria in an adolescent girl in Clinical Pediatrics, an unusual case of osteomyelitis in Critical Cases in Orthopedics and Trauma, tungsten carbide ring removal in The Critical Procedure, cellullitis and abscess in the emergency department in the LLSA Literature Review, and GI bleeding in The Critical Image.

In the April episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss pediatric seat belt injuries and diabetic foot infections. As always, you'll hear about the hot topics covered in CDEM's regular features, including septic shock caused by a perforated appendix in Clinical Pediatrics, chronic cervical myelopathy following a fall in Orthopedics and Trauma, stopping intra-oral bleeding post dental extraction in The Critical Procedure, palliative care in the LLSA Literature Review, and sudden-onset leg pain in The Critical Image.

In the March episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss managing abdominal and neck stab wounds and identifying and assisting victims of human sex trafficking. As always, you'll hear about the hot topics covered in CDEM's regular features, including pediatric rash post vaccination in Clinical Pediatrics, ultrasound-guided aspiration of a septic prosthetic knee joint in Orthopedics and Trauma, removal of magnets from the nares in The Critical Procedure, managing diabetic ketoacidosis in children in the LLSA Literature Review, and pediatric blunt abdominal trauma in The Critical Image.

In the February episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss the pediatric asthma and recognition and management of vaccine-preventable illnesses. As always, you'll hear about the hot topics covered in CDEM's regular features, including the importance of a thorough family history in Clinical Pediatrics, chronic shoulder dislocation secondary to a seizure disorder in Orthopedics and Trauma, reduction of a distal interphalangeal joint dislocation in The Critical Procedure, preventing post-lumbar puncture headache in the LLSA Literature Review, and knee pain after a fall in The Critical Image.

In the January episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss the consequences of envenomation and acute vision loss. As always, you'll hear about the hot topics covered in CDEM's regular features, including persistent dysuria in an adolescent girl in Clinical Pediatrics, an unusual case of osteomyelitis in Critical Cases in Orthopedics and Trauma, tungsten carbide ring removal in The Critical Procedure, cellullitis and abscess in the emergency department in the LLSA Literature Review, and GI bleeding in The Critical Image.

In the December episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss ABEM continuing certification and the evaluation and management of hemoptysis. As always, you'll hear about the hot topics covered in CDEM's regular features, including baking soda intoxication in Clinical Pediatrics, a multiligamentous knee injury in Critical Cases in Orthopedics and Trauma, cerumen removal in The Critical Procedure, managing opioid use disorder in the LLSA Literature Review, and acute flank pain in The Critical Image.

In the November episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss pediatric head injuries and organisms resistant to antibiotics. As always, you'll hear about the hot topics covered in CDEM's regular features, including lung injuries from vaping in Clinical Pediatrics, a high-pressure injection injury in Critical Cases in Orthopedics and Trauma, anoscopy in The Critical Procedure, shoulder dislocations in the LLSA Literature Review, and a child with periorbital swelling in The Critical Image.

In the October episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss opportunistic infections in patients with HIV and presentations of pelvic inflammatory disease. As always, you'll hear about the hot topics covered in CDEM's regular features, including a winged scapula in Clinical Pediatrics, a die-punch fracture of the distal radius in Critical Cases in Orthopedics and Trauma, manual reduction of paraphimosis in The Critical Procedure, early anticoagulant reversal after trauma in the LLSA Literature Review, and a critically ill patient in The Critical Image.

Routine health habits might be easy to ignore, but they make a huge difference in our wellbeing. Today, local physicians and a mental health care provider are here to share what we all need to know — and can do — to take good care of our bodies and minds.This episode was produced by Katherine Ceicys.Guests:  Dr. Carmen Tuchman, primary care physician, Internal Medicine Vanderbilt Dr. Carlenda Smith, associate professor of Clinical Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt Beth Hail, LCSW, Centerstone Dr. Justin Gregory  Briggs, Licensed marriage and family therapist; President, The Briggs Institute;  Sex Life Science podcast co-host  Dr. Kassem Bourgi, Infectious Disease MD, Physician at Nashville Cares Learn more: If you need help, call 988, the TN Suicide and Crisis Lifeline. 988 Offers 24/7 access to trained crisis counselors who can help people experiencing mental health-related distress including thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. Learn more about mental health resources available through the Tennessee Department of Mental Health and Substance Abuse Services.

In the September episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss management of the acutely agitated patient and metabolic acidosis. As always, you'll hear about the hot topics covered in CDEM's regular features, including a feared complication of cystic fibrosis in Clinical Pediatrics, Morel-Lavallée lesions in Critical Cases in Orthopedics and Trauma, phimosis treatment in The Critical Procedure, headache presentations in the emergency department in the LLSA Literature Review, and a cyanotic infant in The Critical Image.

Host Kyle B. Enfield, MD, FSHEA, FCCM is joined by Danielle K. Maue, MD, to discuss improving outcomes for bronchiolitis patients through a high-flow nasal cannula protocol, as discussed in the Pediatric Critical Care Medicine article, "Improving Outcomes for Bronchiolitis Patients After Implementing a High-Flow Nasal Cannula Holiday and Standardizing Discharge Criteria in a PICU." (Maue DK, et al. Pedtr Crit Care Med. 2023 Mar;24:233-244). Together, they explore groundbreaking initiatives that significantly improved outcomes for bronchiolitis patients using a high-flow nasal cannula protocol, the key interventions, and their impact. Dr. Maue is an Assistant Professor of Clinical Pediatrics for Riley Hospital for Children at Indiana University in Indianapolis, Indiana.

In the August episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss liver disease and syphilis. As always, you'll hear about the hot topics covered in CDEM's regular features, including ultrasound of a skin abscess in Clinical Pediatrics, triplane fracture in Critical Cases in Orthopedics and Trauma, intrauterine device removal in The Critical Procedure, emerging and re-emerging sexually transmitted illnesses in the LLSA Literature Review, and thumb pain after a scuffle in The Critical Image.

David Freyer, DO, MS provides a review of hearing loss as a serious and permanent side effect caused by cisplatin chemotherapy, recent research regarding its prevention, and its relevance for young people treated for osteosarcoma.David R. Freyer, DO, MS is Professor of Clinical Pediatrics, Medicine, and Population and Public Health Sciences at the Keck School of Medicine, University of Southern California. He currently serves as Director of the Survivorship and Supportive Care Program in the Cancer and Blood Disease Institute at Children's Hospital Los Angeles, and as Director of the Cancer Survivorship Program and Co-Director of the Adolescent and Young Adult Cancer Program, both at the USC Norris Comprehensive Cancer Center. Dr. Freyer's clinical care and research are concentrated in cancer survivorship, cancer control/supportive care, and AYA oncology with interests in treatment-related toxicity, survivorship care transition, cancer care disparities, and patient-reported outcomes. He had the privilege of leading ACCL0431, a randomized Children's Oncology Group study and pivotal trial leading to FDA approval of sodium thiosulfate as the first proven agent to prevent cisplatin-induced hearing loss in young people treated for cancer.

Are you ready to debunk common myths about allergies and dive into the evolving world of allergy and immunology? In this episode of the "Becoming Immune Confident" podcast, host Dr. Kara Wada hosts her mentor and colleague, Dr. David Stukus. Dr. Stukus discusses his career journey in allergy and immunology, highlighting the importance of countering health misinformation. He provides an in-depth insight into allergies, the different reactions they can cause, and how they differ from intolerances. Dr. Stukus emphasizes the role of patient history in diagnosis. He also provides an overview of the current and emerging treatments for food allergies, Whether you're a medical professional, a patient navigating the complex world of allergies, or just curious about the latest in allergy research and misinformation busting, this episode has something for everyone! Join Dr. Kara and Dr. Stukus as they unravel the intricacies of allergies and the innovative ways medical professionals are using social media to educate and lead. EPISODE IN A GLANCE-Dr. David Stukus' Journey into Allergy and Immunology-Social Media's Role in Medicine-Discovering the Field of Allergy-Understanding Food Allergy-The Complexity of Food Allergy-Future of Food Allergy Treatment-Communicating Medical Information on Social Media-Connect with Dr. David Stukus ABOUT DR DAVID STUKUSDavid Stukus, MD, Professor of Clinical Pediatrics and Director of the Food Allergy Treatment Center at Nationwide Children's Hospital, is renowned for his expertise in allergy and immunology. He founded the Complex Asthma Clinic and is actively involved in clinical care, research, and patient advocacy. An influential speaker and leader in professional organizations like AAAAI and ACAAI, Dr. Stukus also serves as the Social Media Medical Editor for AAAAI, where he hosts the "Conversations From the World of Allergy" podcast. Recognized as a Top Doctor in Pediatric Allergy since 2015, he is committed to evidence-based medicine, educating a wide audience through social media as @AllergyKidsDoc, and has authored a textbook on social media in medicine. Dr. Stukus, a graduate of the University of Pittsburgh School of Medicine, completed his residency and fellowship at Nationwide Children's Hospital and the Cleveland Clinic. He lives in central Ohio with his wife, Kristin, a pediatric emergency physician, and their two children. CONNECT WITH DR DAVID STUKUSInstagram → https://www.instagram.com/allergykidsdoc Twitter → https://twitter.com/AllergyKidsDoc LinkedIn → https://www.linkedin.com/in/david-stukus-04126aa8/ ABOUT DR KARA WADAQuadruple board-certified pediatric and adult allergy immunology & lifestyle medicine physician, Sjogren's patient and life coach shares her recipe for success combining anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine & our minds to harness our body's ability to heal. CONNECT WITH DR WADAWebsite → https://www.drkarawada.com/ LinkedIn → https://www.linkedin.com/in/crunchyallergist/ Instagram → https://www.instagram.com/crunchyallergist/ Facebook → https://www.facebook.com/CrunchyAllergist Twitter → https://twitter.com/CrunchyAllergy TikTok → https://www.tiktok.com/@crunchyallergist SUBSCRIBE TO NEWSLETTER → https://www.drkarawada.com/newsletter Get Dr. Kara's weekly dose of a naturally-minded and scientifically-grounded approach to immune system health. JOIN THE BECOMING IMMUNE CONFIDENT JUMPSTART! If you are looking for support and realize that 2024 is 2024 the year that you gain a deep understanding of your body, learn to trust your ability to navigate the uncertainties that come along with living with chronic inflammation and build a lifestyle that supports and nourishes your immune system...APPLY HERE→ https://www.immuneconfident.com Register for The Demystifying Inflammation Summit 2023 EncoreA free 3-day event to empower families with allergies, asthma & autoimmune conditions. Learn more and grab your free ticket → https://bit.ly/inflammation-summit-encore

Did you know around 15 to 25% of children will have at least one syncopal episode before adulthood? Join medical students Sanya Dudani and Caleb Robertson, along with Pediatric Cardiologist Dr. John Plowden, as they discuss the evaluation and management of syncope in the pediatric patient.  Specifically, they will: Discuss the definition of syncope and its underlying pathophysiology Recall the incidence and risk factors of syncope in the pediatric population Describe the various etiologies and their distinguishing factors Understand the proper approach to taking a history for a pediatric patient with a chief complaint of syncope Recognize findings on the physical exam that help narrow the differential diagnosis Understand the appropriate lab tests and imaging needed Discuss when it's appropriate to refer patients to specialists Special thanks to Dr. Rebecca Yang and Dr. Melissa Lefebvre for peer reviewing this episode! CME Credit (requires free sign up): Link Coming Soon! References: Arthur W, Kaye GC  The pathophysiology of common causes of syncope  Postgraduate Medical Journal 2000;76:750-753. Cipolla MJ. The Cerebral Circulation. San Rafael (CA): Morgan & Claypool Life Sciences; 2009. Chapter 5, Control of Cerebral Blood Flow. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53082/ Clark, BC, Hayman, JM, Berul, CI, Burns, KM, and Kaltman, JR. Selective use of the electrocardiogram in pediatric preparticipation athletic examinations among pediatric primary care providers. Ann Noninvasive Electrocardiol. 2017; 22:e12446. https://doi.org/10.1111/anec.12446] De, A. and Davidson Ward, S.L. (2014), Syncope at altitude: An enigmatic case. Pediatr Pulmonol., 49: E144-E146. https://doi.org/10.1002/ppul.23062 Gupta A, Menoch M, Levasseur K, Gonzalez IE. Screening Pediatric Patients in New-Onset Syncope (SPINS) Study. Clinical Pediatrics. 2020;59(2):127-133. doi:10.1177/0009922819885660 Hainsworth, R. Pathophysiology of syncope. Clin Auton Res 14 (Suppl 1), i18–i24 (2004). https://doi.org/10.1007/s10286-004-1004-2 Phillip A. Low, Paola Sandroni, Chapter 106 - Postural Tachycardia Syndrome (POTS), Editor(s): David Robertson, Italo Biaggioni, Geoffrey Burnstock, Phillip A. Low, Julian F.R. Paton, Primer on the Autonomic Nervous System (Third Edition), Academic Press, 2012, Pages 517-519, ISBN 9780123865250, https://doi.org/10.1016/B978-0-12-386525-0.00106-2 Zavala, Rennette MD∗; Metais, Benjamin MD†; Tuckfield, Lynnia BS‡; DelVecchio, Michael MD‡; Aronoff, Stephen MD, MBA‡. Pediatric Syncope: A Systematic Review. Pediatric Emergency Care: September 2020 - Volume 36 - Issue 9 - p 442-445 doi: 10.1097/PEC.0000000000002149 

Life is filled with roles that are neither made for men nor women. The household for instance, is a place that needs human labor. But how do we break the stereotypes that we've grown up with and knock down the walls of gender equity in the home and at work?  Joining me to talk about this important topic as well as her new book is Dr. Shelly Vaziri Flais. Shelly is a board-certified practicing pediatrician, the mother of 3 sons and 1 daughter, and Assistant Professor of Clinical Pediatrics at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago. She is the author of Raising Twins, Editor in Chief of Caring for Your School-Age Child, and co-editor of The Big Book of Symptoms. She is an American Academy of Pediatrics spokesperson and frequent media contributor Listen as she shares her thoughts on everything from modeling equitable behavior at home, why she was happy to be the “hangout house” for her kids and their friends, and why the change we want to see in the world starts in our homes. If you are raising children, whether they are boys or girls, you'll want to listen in.  Also, don't forget to grab a copy of her new book, Nurturing Boys to Be Better Men.       In this episode, we discuss:  What inspired Shelly to write her latest book Her thoughts on ways that bigger families lean into more well-rounded kids and adults Ways to include your kids in the tasks of the household What it means to model equitable behavior at home Why it's important to also model equitable roles in the workplace Resources:  About Shelly - https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=27113 Nurturing Boys to Be Better Men by Shelly Vziri Flais, MD, FAAP - https://www.aap.org/Nurturing-Boys-to-Be-Better-Men-Paperback  Discount Codes from Our Sponsors:  Copilot - https://go.mycopilot.com/lynzy - for a 14-Day Free Trial with your own personal trainer  Questions: What inspired you to write your latest book?  How can we model equitable behavior at home? Why is it important to include children in household chores from an early age? What can we do to inspire equitable play for our children? What are some ways to open up conversations with our kids about their world and life as they get older?  Learn more about your ad choices. Visit megaphone.fm/adchoices

In this podcast episode, the Nurse Doza discusses the negative effects of Halloween candy on our health, particularly in relation to fatty liver disease. He explains that high fructose corn syrup, which is commonly found in Halloween candy, is directly linked to fatty liver and can be harmful when consumed in excessive amounts. The host advises those with fatty liver disease or concerns about it to avoid eating Halloween candy. TIMESTAMPS: 00:00 START 02:07 Halloween candy can cause fatty liver. 07:06 Candy can cause fatty liver. 10:25 Artificial dyes in candy affect behavior.  20:55. Avoid Halloween candy for health. 21:12 Artificial sweeteners can worsen depression. 30:04 Limit or avoid Halloween candy.   Protect Your Liver with "Liver Boost"! With all the hidden dangers lurking in your favorite treats, give your liver the support it needs. Liver Boost focuses on phases 1 and 2 of liver detox, helping your body combat the effects of harmful ingredients. Take a stand for your health and get ahead of the game. Check out Liver Boost and ensure your liver has the defense it needs. Click here to purchase!   Show Notes 1. The Hidden Dangers of High-Fructose Corn Syrup (HFCS) in Halloween Candy: Most processed foods, including candies, contain HFCS, and the average American consumes about 50 grams daily12. HFCS is created when enzymes are added to corn syrup, converting glucose to fructose3. Fructose triggers the production of fats in the liver[^5^][^6^][^9^][^10^][^11^]. Excessive fructose consumption may cause a leaky gut leading to fatty liver disease[^10^][^11^]. Some sources also indicate the presence of mercury in HFCS.   2. ADHD Links to Artificial Colors in Candy: The increase in ADHD cases may be linked to synthetic food dyes1. Around 33% of children with ADHD might respond positively to a dietary intervention.   3. Effects of Candy Ingredients on Memory and Brain Health: Blue No. 1, used for artificial blue coloring, is permeable to the blood-brain barrier1. Certain chemicals used in candies have been linked to cancer.   4. Artificial Sweeteners & Mental Health: High-aspartame diets have been linked to mood issues and impaired spatial orientation1. Aspartame exposure can produce anxiety-like behavior in mice. 5. Migraines Triggered by Candy Ingredients: Migraines may be triggered by formaldehyde, a byproduct of aspartame.   Give Your Liver the Boost It Deserves! After diving deep into the unsettling truths about Halloween candies, it's clear that our livers have a lot to handle. Fortunately, there's Liver Boost! Specifically designed to aid in phases 1 and 2 of liver detox, it's the best companion your liver can have this spooky season. Protect yourself from the harmful effects of these hidden dangers. Grab your Liver Boost now! https://www.mswnutrition.com/products/liver-love/?ref=nursedoza   Footnotes ^1^ "How High-Fructose Intake May Trigger Fatty Liver Disease." National Institutes of Health (NIH). https://www.nih.gov/news-events/nih-research-matters/how-high-fructose-intake-may-trigger-fatty-liver-disease ^2^ Stevens, L.J., et al. "Dietary Sensitivities and ADHD Symptoms: Thirty-five Years of Research." Clinical Pediatrics. https://journals.sagepub.com/doi/abs/10.1177/0009922810384728 ^3^ "Certain Food Dyes and Cancer." Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/cancer-controversies/cosmetics-and-toiletries#Cosmetics1 ^4^ "Aspartame and its effects on health." BMJ. https://www.bmj.com/content/327/7417/751 ^5^ Abdelmalek, M.F., et al. "Increased fructose consumption is associated with fibrosis severity in patients with nonalcoholic fatty liver disease." Hepatology. https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.23535 ^6^ Small, D.M., DiFeliceantonio, A.G. "Processed foods and food reward." Science. https://science.sciencemag.org/content/363/6425/346 ^7^ "How is high fructose corn syrup made?" University of California, Division of Agriculture and Natural Resources. https://ucanr.edu/sites/WREC/files/271885.pdf ^8^ Dufault, R., et al. "Mercury from chlor-alkali plants: measured concentrations in food product sugar." Environmental Health. https://ehjournal.biomedcentral.com/articles/10.1186/1476-069X-8-2 ^9^ "Hershey's Cookies 'N' Creme Candy Bar." Hersheyland. https://www.hersheyland.com/products/hersheys-cookies-n-creme-candy-bar-1-55-oz.html ^10^ Miele, L., et al. "Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease." Hepatology. https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.22848 ^11^ Spruss, A., Bergheim, I. "Dietary fructose and intestinal barrier: potential risk factor in the pathogenesis of nonalcoholic fatty liver disease." Journal of Nutritional Biochemistry. https://www.sciencedirect.com/science/article/abs/pii/S0955286309000726

Are you tired of hearing people say, “Man up!” or “Boys will be boys” around your son? Or perhaps you've seen boys discouraged from liking the color pink, learning to cook meals, or expressing feelings of sadness or disappointment. If you're ready to break generational stereotypes and raise well-rounded boys who will grow up to be well-rounded men, you won't want to miss this episode. Dr. Amy and Sandy are joined by guest Dr. Shelly Flais, author of “Nurturing Boys to Be Better Men: Gender Equality Starts at Home,” who shares her experience as a mother of three boys and practicing pediatrician.  About Dr. Shelly Flais: Shelly Vaziri Flais, MD, FAAP is a board-certified practicing pediatrician, the mother of 3 sons and 1 daughter, and Assistant Professor of Clinical Pediatrics at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago. She is the author of “Raising Twins,” Editor in Chief of Caring for Your School-Age Child, and co-editor of “The Big Book of Symptoms.” She is an American Academy of Pediatrics spokesperson and frequent media contributor who lives in the Chicago suburbs. Her new book, “Nurturing Boys to Be Better Men: Gender Equality Starts at Home” will be published October 24, 2023. Connect with Shelly Flais:Facebook: @ShellyVazirFlaisMDInstagram: @ShellyVazirFlaisMDTwitter/X: @ShellyFlaisMDBook: “Nurturing Boys to Be Better Men: Gender Equality Starts at Home” (Oct. 24, 2023)CONNECT WITH US Website: www.TheBrainyMoms.com Email: info@TheBrainyMoms.com Social Media: @TheBrainyMoms Dr. Amy's website: www.AmyMoorePhD.comSponsor's website: www.LearningRx.com

In this episode, hosts Drs. Temara Hajjat and Jason Silverman talk to Dr. Charlie Vanderpool about functional components in both human breastmilk and infant formulas, and some of their roles in infant growth and development. Dr. Vanderpool is a pediatric gastroenterologist at Riley Children's Health and an Associate Professor of Clinical Pediatrics at Indiana University School of Medicine.This episode is eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!Resources mentioned in the episode:Webinar on infant nutrition (NASPGHAN members only)Learning Objectives:Define and discuss functional components of human breastmilk and infant formulas.Understand the proven and potential health impacts of a number of these components.Discuss possible modifying influences of these components on the infant microbiome.Produced by: Jason SilvermanSupport the showAs always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes!

Join Dr. Danielle Belardo and her expert of the week, pediatric allergist and immunologist Dr. David Stukus, for a myth-busting episode about food allergies, intolerances, and "sensitivities." Danielle and David crack down on food "sensitivity" scams and unnecessary, unvalidated tests that people all over social media are falling victim to. Even allergies have a dark side, so tune in to learn what is fact and what is, simply, fiction.      Danielle and David discuss:       The basic terminology and meaning of food allergies, sensitivities, and intolerances   The difference between IgG and IgE and why IgG testing isn't validated or accurate   Low histamine diets and the pseudoscience claims these diets make  How to use a trial, elimination, and reintroduction diet to discover food intolerances   Why an oral food challenge is the gold standard for allergy testing   Ways to find a provider to get an accurate allergy diagnosis    Red flags for spotting allergy misinformation on social media     David Stukus, MD, is a Professor of Clinical Pediatrics in the Division of Allergy and Immunology. Prior to becoming the director of the Food Allergy Treatment Center, Dr. Stukus started the Complex Asthma Clinic at Nationwide Children's Hospital in 2011, which treats children with severe or difficult-to-treat asthma. He holds multiple leadership positions in the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the American College of Allergy, Asthma, and Immunology and is one of twelve allergists invited as a member of the Joint Task Force for Practice Parameters. He is the Social Media Medical Editor for the AAAAI, where he produces and hosts their podcast "Conversations From the World of Allergy." He has been named a Top Doctor in Pediatric Allergy every year since 2015.  Thank you so much for taking the time to contribute to a generation that values fact over fiction! Be sure to rate, review, and follow on your favorite podcast app and let us know which not-so-wellness trend you'd like to hear debunked. Follow your host on Instagram @daniellebelardomd and the podcast @wellnessfactvsfiction. All studies discussed can be found @wellnessfvfjournalclub. Follow Dr. Dave @allergykidsdoc. Thank you to our sponsors for making this episode possible. Check out these deals just for you: COZY EARTH - Go to cozyearth.com and enter WELLNESS at checkout to SAVE thirty-five Percent. ZOCDOC - Go to zocdoc.com/wellness and download the Zocdoc app for FREE. Then start your search for a top-rated doctor today.  Learn more about your ad choices. Visit megaphone.fm/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.