Podcasts about jama pediatr

What happens when a febrile infant presents at 61 days old? Are they suddenly low risk for invasive bacterial infections? In this episode, we explore the gray zone of managing febrile infants aged 61–90 days with the help of two new clinical prediction rules from PECARN. Joining us are two powerhouses in pediatric emergency medicine: Dr. Nate Kuppermann and Dr. Paul Aronson, who walk us through their recent study published in Pediatrics. We discuss why prior research has traditionally stopped at 60 days, what the new data shows about risk in this slightly older age group, and how these rules might help guide clinical decision-making. This study fills a long-standing gap—but should we start using the rules now? Tune in for a nuanced discussion on sensitivity, missed cases, practical application, and the future of risk stratification in young infants with fever. What is your practice in terms of work-up of 2-3 month old febrile infants? Will this change what you do? Hit us up social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children's National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences Dr. Paul Aronson, Professor of Pediatrics (Emergency Medicine); Deputy Director, Pediatric Residency Program at Yale University School of Medicine Resources: “Hot” Off the Press: Infant Fever Rule Do I really need to LP a febrile infant with a UTI? Aronson PL, Mahajan P, Meeks HD, Nielsen B, Olsen CS, Casper TC, Grundmeier RW, Kuppermann N; PECARN Registry Working Group. Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections. Pediatrics. 2025 Sep 1;156(3):e2025071666. doi: 10.1542/peds.2025-071666. PMID: 40854562; PMCID: PMC12432541. Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, Saunders M, Ruddy RM, Roosevelt G, Rogers AJ, Powell EC, Nigrovic LE, Muenzer J, Linakis JG, Grisanti K, Jaffe DM, Hoyle JD Jr, Greenberg R, Gattu R, Cruz AT, Crain EF, Cohen DM, Brayer A, Borgialli D, Bonsu B, Browne L, Blumberg S, Bennett JE, Atabaki SM, Anders J, Alpern ER, Miller B, Casper TC, Dean JM, Ramilo O, Mahajan P; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342-351. doi: 10.1001/jamapediatrics.2018.5501. PMID: 30776077; PMCID: PMC6450281. Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O'Leary ST, Okechukwu K, Woods CR Jr; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 2021 Aug;148(2):e2021052228. doi: 10.1542/peds.2021-052228. Epub 2021 Jul 19. Erratum in: Pediatrics. 2021 Nov;148(5):e2021054063. doi: 10.1542/peds.2021-054063. PMID: 34281996. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Send us a textAntenatal Corticosteroid in Twin-Pregnant Women at Risk of Late Preterm Delivery: A Randomized Clinical Trial.Lee SM, Park HS, Choi SR, Lee J, Kim HJ, Park JY, Oh KJ, Cho GJ, Oh MJ, Chung JH, Kim SM, Kim BJ, Kim SY, Hong S, Jung YM, Lee SJ, Seong JS, Kim H, Oh S, Lee J, Jin YR, Kim JH, Cho HY, Park CW, Park JS, Jun JK.JAMA Pediatr. 2025 Sep 22:e253284. doi: 10.1001/jamapediatrics.2025.3284. Online ahead of print.PMID: 40982289Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textOutcomes of Preterm Infants Born at 22 to 23 Weeks' Gestation in 11 International Neonatal Networks. Isayama T, Norman M, Kusuda S, Reichman B, Lehtonen L, Lui K, Adams M, Vento Torres M, Filippi L, Battin M, Guinsburg R, Modi N, Håkansson S, Klinger G, de Almeida MF, Helenius K, Bassler D, Su YC, Shah PS; International Network for Evaluation of Outcomes (iNeo) Investigators.JAMA Pediatr. 2025 Aug 25:e252958. doi: 10.1001/jamapediatrics.2025.2958. Online ahead of print.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textRespiratory Targets Associated With Lung Aeration During Delivery Room Resuscitation of Preterm Neonates. Rub DM, Hsu JY, Weinberg DD, Felix M, Nadkarni VM, Te Pas AB, Kuypers KLAM, Davis PG, Ratcliffe SJ, Kirpalani HM, Foglia EE.JAMA Pediatr. 2025 Aug 11:e252521. doi: 10.1001/jamapediatrics.2025.2521. Online ahead of print.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textWhole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.Faix RG, Laptook AR, Shankaran S, Eggleston B, Chowdhury D, Heyne RJ, Das A, Pedroza C, Tyson JE, Wusthoff C, Bonifacio SL, Sánchez PJ, Yoder BA, Laughon MM, Vasil DM, Van Meurs KP, Crawford MM, Higgins RD, Poindexter BB, Colaizy TT, Hamrick SEG, Chalak LF, Ohls RK, Hartley-McAndrew ME, Dysart K, D'Angio CT, Guillet R, Kicklighter SD, Carlo WA, Sokol GM, DeMauro SB, Hibbs AM, Cotten CM, Merhar SL, Bapat RV, Harmon HM, Sewell E, Winter S, Natarajan G, Mosquera R, Hintz SR, Maitre NL, Benninger KL, Peralta-Carcelen M, Hines AC, Duncan AF, Wilson-Costello DE, Trembath A, Malcolm WF, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA Pediatr. 2025 Apr 1;179(4):396-406. doi: 10.1001/jamapediatrics.2024.6613.PMID: 39992674 Free PMC article. Clinical Trial.EBNEO Commentary: Is Therapeutic Hypothermia Beneficial to Infants Born Between 33 and 35 Weeks Gestation?Spahic H, Zoubovsky SP, Dietz RM.Acta Paediatr. 2025 Jul;114(7):1742-1743. doi: 10.1111/apa.70098. Epub 2025 Apr 18.PMID: 40251839 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textDeferred Cord Clamping With High Oxygen in Extremely Preterm Infants: A Randomized Clinical Trial.Katheria AC, Ines F, Lee HC, Sollinger C, Vali P, Morales A, Sanjay S, Dorner R, Koo J, Gollin Y, Das A, Poeltler D, Steinhorn R, Finer N, Lakshminrusimha S.JAMA Pediatr. 2025 Jul 21:e252128. doi: 10.1001/jamapediatrics.2025.2128. Online ahead of print.PMID: 40690234Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textDiaphragm Position on Chest Radiograph to Estimate Lung Volume in Neonates.Dahm SI, Sett A, Gunn EF, Ramanauskas F, Hall R, Stewart D, Koeppenkastrop S, McKenna K, Gardiner RE, Rao P, Tingay DG.JAMA Pediatr. 2025 Jul 21:e252108. doi: 10.1001/jamapediatrics.2025.2108. Online ahead of print.PMID: 40690243 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Despite a busy Summer, BSCOS is proud to bring you the 13th Episode of the Paediatric Orthopaedic Digest with Mr Mike Reidy (@mikejreidy) from Aberdeen Childrens Hospital and previous BOA Trainer of The Year! As an incredible educator, surgeon and all round human being, Mike discusses his practice at the Royal Aberdeen Children's Hospital, where he and his colleagues provide general paediatric orthopedic services with subspecialty interests to North Scotland, with Mike focusing on hip and neuromuscular conditions. He shares his experience with dyslexia and how alternative learning methods helped his medical education, noting that he now uses AI tools to assist with processing complex documents in his role as Training Program Director (TPD). We scoured 35 journals & highlighted the most impactful studies that we feel can change practice or improve outcomes in Paediatric Orthopaedics. Also…we discuss our favourite Mikes!Follow Updates on @BSCOS_UK on X / Instagram!REFERENCES: 1.     Comparative Analysis of Postoperative Rotational Malalignment in Pediatric Supracondylar Humerus Fractures: Cross Pinning Versus Lateral Para-olecranon Pinning. Muto et al. J Pediatr Orthop. Sept 2025. PMID: 40323798 2.     Can We Accurately Predict Adult Height in Pediatric Patients Who Undergo Treatment for Sarcoma? Prigmore et al. Clin Orthop Relat Res. Feb 2025. PMID: 39915098 3.     Total Hip Arthroplasty in Children: A Dutch Arthroplasty Register Study with Data from 283 Hips. van Kouswijk et al. J Bone Joint Surg Am. April 2025. PMID: 39946439 4.     Efficacy of a Graftless Salter Osteotomy in Developmental Dysplasia of the Hip. Kim et al. J Pediatr Soc North Am. March 2025. PMID: 40432865 5.     Removable Boot vs Casting of Toddler's Fractures: A Randomized Clinical Trial. Boutin et al. JAMA Pediatr. April 2025. PMID: 40257790 6.     Transverse plane kinematics between walking and running change frequently for children and young adults with idiopathic torsional issues. Maniatopoulos et al. Gait Posture. July 2025. PMID: 40616969. 7.     The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study. PERFORM Study Group. Arch Dis Child. Feb 2025. PMID: 39332842 8.     Completely Displaced Midshaft Clavicular Fractures with Skin Tenting in Adolescents: Results from the FACTS Multicenter Prospective Cohort Study. Willimon et al. J Bone Joint Surg Am. May 2025. PMID: 40446020. 9.     Impact of liberal preoperative clear fluid fasting regimens on the risk of pulmonary aspiration in children (EUROFAST): an international prospective cohort study. EUROFAST Study Group. Br J Anaesth. July 2025. PMID: 40410101 10.  An International Consensus on Evaluation and Management of Idiopathic Genu Valgum: A Modified Delphi Survey. Ranade et al. J Pediatr Orthop. May-June 2025. PMID: 39901664. 11.  Adolescents with Osteochondritis Dissecans of the Femoral Condyle Present with High Rates of Corresponding Coronal Malalignment. Clark et al. J Bone Joint Surg Am. June 2025. PMID: 40153481 12.  Test-retest reliability of clinical measurements of lower extremity joint motion and alignment in the pediatric population. Saabye et al. J Child Orthop. May 2025. PMID: 40386448 13.  Plates for the treatment of long bone metaphyseal and diaphyseal fracture and deformity in osteogenesis imperfecta: A scoping review. Louni & Hamdy. J Child Orthop. April 2025. PMID: 40292352 14.  Long-Term Functional and Radiographic Outcomes of Untreated Tarsal Coalitions: A Community-Based Observational Study. Nash et al. J Pediatr Orthop. August 2025. PMID: 40183211  Follow Hosts: @AnishPSangh @AlpsKothari @Pranai_B

Los artículos que se tratan en el episodio de hoy están listados aquí: Associations of Bronchopulmonary Dysplasia and Infection with School-Age Brain Development in Children Born Preterm.Kim C, Ufkes S, Guo T, Chau V, Synnes A, Grunau RE, Miller SP.J Pediatr. 2025 Jun;281:114524. doi: 10.1016/j.jpeds.2025.114524. Epub 2025 Feb 27. PMID: 40023219.Active Treatment vs Expectant Management of Patent Ductus Arteriosus in Preterm Infants: A Meta-Analysis.Buvaneswarran S, Wong YL, Liang S, Quek SC, Lee J.JAMA Pediatr. 2025 May 27:e251025. doi: 10.1001/jamapediatrics.2025.1025. Online ahead of print.PMID: 40423988 Occurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta-Analysis of Individual Patient Data.Nagy Z, Obeidat M, Máté V, Nagy R, Szántó E, Veres DS, Kói T, Hegyi P, Major GS, Garami M, Gasparics Á, Te Pas AB, Szabó M.JAMA Pediatr. 2025 Feb 1;179(2):145-154. doi: 10.1001/jamapediatrics.2024.5998.PMID: 39786414  Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal. Soy tu host, Maria Flores Cordova, MD. Este podcast está presentado por los médicos neonatólogos Dani de Luis Rosell, Elena Itriago, Carolina Michel y Juliana Castellanos. No dudes en enviarnos preguntas, comentarios o sugerencias a nuestro correo electrónico: nicupodcast@gmail.comSíguenos en nuestras redes:Twitter: @incubadorapodInstagram: @laincubadorapodcast Creado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org

Send us a textSevere Neonatal Morbidity and All-Cause and Cause-Specific Mortality Through Infancy and Late Adolescence.Graham H, Johansson K, Persson M, Norman M, Razaz N.JAMA Pediatr. 2025 Jun 10:e251873. doi: 10.1001/jamapediatrics.2025.1873. Online ahead of print.PMID: 40493844As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Un nouvel épisode du Pharmascope, à saveur pédiatrique, est disponible! Dans ce 158e épisode, Nicolas, Isabelle, Olivier et une illustre invitée discutent du RGO chez les tout-petits et les un peu plus vieux.  Les objectifs pour cet épisode sont les suivants: Expliquer les manifestations cliniques et la prise en charge du RGO en pédiatrie. Discuter de l'approche non-pharmacologique du RGO en pédiatrie. Comparer les données d'efficacité et d'innocuité des différents médicaments utilisés dans le traitement du RGO en pédiatrie. Ressources pertinentes en lien avec l'épisode  Rosen R, et coll. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):516-554. Chevalier I, Beck CE, Doré-Bergeron MJ, Orkin J; Société canadienne de pédiatrie. La prise en charge médicale du reflux gastro-œsophagien chez les nourrissons en santé. Nov 2022. Horvath A, Dziechciarz P, Szajewska H. The effect of thickened-feed interventions on gastroesophageal reflux in infants: systematic review and meta-analysis of randomized, controlled trials. Pediatrics. 2008 Dec;122(6):e1268-77. Kwok TC, Ojha S, Dorling J. Feed thickener for infants up to six months of age with gastro-oesophageal reflux. Cochrane Database Syst Rev. 2017 Dec 5;12(12):CD003211. Tighe MP, Andrews E, Liddicoat I, Afzal NA, Hayen A, Beattie RM. Pharmacological treatment of gastro-oesophageal reflux in children. Cochrane Database Syst Rev. 2023 Aug 22;8(8):CD008550. Fernández-González SM, Moreno-Álvarez A, Solar-Boga A. Proton Pump Inhibitors in Pediatric Gastroesophageal Reflux Disease: A Systematic Review of Randomized Controlled Trials. Children (Basel). 2024 Mar 1;11(3):296. Terrin G, et coll. Ranitidine is associated with infections, necrotizing enterocolitis, and fatal outcome in newborns. Pediatrics. 2012 Jan;129(1):e40-5. Canani RB, et coll; Working Group on Intestinal Infections of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP). Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children. Pediatrics. 2006 May;117(5):e817-20. Lassalle M, Zureik M, Dray-Spira R. Proton Pump Inhibitor Use and Risk of Serious Infections in Young Children. JAMA Pediatr. 2023 Oct 1;177(10):1028-1038. Wang YH, Wintzell V, Ludvigsson JF, Svanström H, Pasternak B. Association Between Proton Pump Inhibitor Use and Risk of Fracture in Children. JAMA Pediatr. 2020 Jun 1;174(6):543-551.

Send us a textActive Treatment vs Expectant Management of Patent Ductus Arteriosus in Preterm Infants: A Meta-Analysis.Buvaneswarran S, Wong YL, Liang S, Quek SC, Lee J.JAMA Pediatr. 2025 May 27:e251025. doi: 10.1001/jamapediatrics.2025.1025. Online ahead of print.PMID: 40423988 Free PMC As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textPrenatal Cannabis Use and Neonatal Outcomes: A Systematic Review and Meta-Analysis.Lo JO, Ayers CK, Yeddala S, Shaw B, Robalino S, Ward R, Kansagara D.JAMA Pediatr. 2025 May 5:e250689. doi: 10.1001/jamapediatrics.2025.0689. Online ahead of print.PMID: 40323610As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Avec Dre Julie Autmizguine, pédiatre-infectiologue, et Stéphanie Tremblay, pharmacienne en pédiatrie générale et en maladies infectieuses, nous allons:définir l'ostéomyélite et l'arthrite septique (définition, physiopathologie, agents pathogènes, diagnostic, complications possibles);décrire les différentes options de traitements (chirurgical, médical);illustrer les notions abordées via des cas patients afin de répondre à des questions pratiques.Références:Société canadienne de pédiatrie. Le diagnostic et la prise en charge des infections ostéoarticulaires aiguës chez les enfants. 2018. Reconduit en janvier 2024. The Royal Children's Hospital Melbourne. Clinical Practice Guideline: Bone and joint infection. Mis à jour en 2021. Peltola H et al. Osteomyelitis-Septic Arthritis Study Group. Short- versus long-term antimicrobial treatment for acute hematogenous osteomyelitis of childhood: prospective, randomized trial on 131 culture-positive cases. Pediatr Infect Dis J. 2010  Ballock RT et al. A comparison of early versus late conversion from intravenous to oral therapy in the treatment of septic arthritis. J Pediatr Orthop. 2009 Autmizguine J et al. Pharmacokinetics and pharmacodynamics of oral cephalexin in children with osteoarticular infections. Pediatr Infect Dis J. 2013Nielsen AB et al. Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark. Lancet Child Adolesc Health. 2024 Alcobendas Rueda RM et al. Oral Versus Intravenous Antibiotics for Pediatric Osteoarticular Infection: When and to Whom? Pediatr Infect Dis J. 2022  Keren R et al. Pediatric Research in Inpatient Settings Network. Comparative effectiveness of intravenous vs oral antibiotics for postdischarge treatment of acute osteomyelitis in children. JAMA Pediatr. 2015  AntibioPed. (2025) Messil inc. (Version 1.5.0) [Application mobile] Disponible sur l'AppStore et Google Play. Également disponible en version web.Captation et montage: Philippe Lacroix, spécialiste en audiovisuelIdée originale, réalisation et animation: Émilie Roy-St-PierreConseillères en communication: Katrine Louis-Seize et Pascale ChatagnierLogo: Équipe des communications et du graphisme du CHU Sainte-JustineMusique: Samuel Ross  Collègues, ami(e)s et famille, merci pour votre précieux soutien. © mgparkilo 2025Merci pour l'écoute! Allez mettre une réaction sur vos épisodes préférés, partagez la bonne nouvelle sur Facebook/Instagram et abonnez-vous pour ne rien manquer

Los artículos que se tratan en el episodio de hoy están listados aquí:Stalter, E. J., Verhofste, S. L., Dagle, J. M., Steinbach, E. J., Ten Eyck, P., Wendt, L., Segar, J. L., & Harshman, L. A. (2025). Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol. Journal of perinatology : official journal of the California Perinatal Association, 45(3), 305–311. https://doi.org/10.1038/s41372-024-02141-9Oikonomopoulou, N., Rodriguez-Castaño, M. J., Corredera, A., Cortés-Ledesma, C., Vierge, E., Martinez-Orgado, J., & Arruza, L. (2025). Extremely preterm infants with adverse neurological outcome present more frequently impaired right ventricular performance. Pediatric research, 10.1038/s41390-025-03959-5. Advance online publication. https://doi.org/10.1038/s41390-025-03959-5Jeanne, Emilya; Alvaro, Rubenb; Shalish, Wissamc. Reimagining apnea monitoring in the neonatal ICU. Current Opinion in Pediatrics 37(2):p 173-181, April 2025. | DOI: 10.1097/MOP.0000000000001432 Faix RG, Laptook AR, Shankaran S, et al. Whole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial. JAMA Pediatr. Published online February 24, 2025. doi:10.1001/jamapediatrics.2024.6613 Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal. Soy tu host, Maria Flores Cordova, MD. Este podcast está presentado por los médicos neonatólogos Dani de Luis Rosell, Elena Itriago, Carolina Michel y Juliana Castellanos. No dudes en enviarnos preguntas, comentarios o sugerencias a nuestro correo electrónico: nicupodcast@gmail.comSíguenos en nuestras redes:Twitter: @incubadorapodInstagram: @laincubadorapodcast Creado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org

Send us a textWhole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.Faix RG, Laptook AR, Shankaran S, Eggleston B, Chowdhury D, Heyne RJ, Das A, Pedroza C, Tyson JE, Wusthoff C, Bonifacio SL, Sánchez PJ, Yoder BA, Laughon MM, Vasil DM, Van Meurs KP, Crawford MM, Higgins RD, Poindexter BB, Colaizy TT, Hamrick SEG, Chalak LF, Ohls RK, Hartley-McAndrew ME, Dysart K, D'Angio CT, Guillet R, Kicklighter SD, Carlo WA, Sokol GM, DeMauro SB, Hibbs AM, Cotten CM, Merhar SL, Bapat RV, Harmon HM, Sewell E, Winter S, Natarajan G, Mosquera R, Hintz SR, Maitre NL, Benninger KL, Peralta-Carcelen M, Hines AC, Duncan AF, Wilson-Costello DE, Trembath A, Malcolm WF, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA Pediatr. 2025 Feb 24:e246613. doi: 10.1001/jamapediatrics.2024.6613. Online ahead of print.PMID: 39992674As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419 Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children's IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic. Episode resource links: Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children's IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025.  Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856.  Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419 Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children's IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic. Episode resource links: Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children's IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025.  Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856.  Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976 Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Send us a textApnea After 2-Month Vaccinations in Hospitalized Preterm Infants: A Randomized Clinical Trial. Greenberg RG, Rountree W, Staat MA, Schlaudecker EP, Poindexter B, Trembath A, Laughon M, Poniewierski MS, Spreng RL, Broder KR, Wodi AP, Museru O, Anyalechi EG, Marquez PL, Randolph EA, Aleem S, Kilpatrick R, Walter EB.JAMA Pediatr. 2025 Jan 6. doi: 10.1001/jamapediatrics.2024.5311. Online ahead of print.PMID: 39761016As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Language delays are one of the most common concerns brought up in pediatric well visits. Dr. Jennifer Poon, a pediatric specialist in Development and Behavior, joins Dr. Sarah Straka and medical student Alisha Patel to discuss how to recognize and manage language delays. Specifically, they will: Define and understand language delay. Recognize the initial signs and symptoms of language delays. Identify and explain clinical pearls of potential etiologies of language delays. Recognize the developmental milestones for language based on age. Discuss the prevalence of language delays as well as identify the risk factors and patient demographics that have an increased susceptibility. Understand the initial diagnostic approach to the child with suspected language delay. Review the most common interventions when a child has language delay. Understand how to best discuss the prognosis for language delays and counsel the families and caregivers CME Credit (requires free sign up):   link coming soon! References: Karani NF, Sher J, Mophosho M. The influence of screen time on children's language development: A scoping review. S Afr J Commun Disord. 2022 Feb 9;69(1):e1-e7. doi: 10.4102/sajcd.v69i1.825. PMID: 35144436; PMCID: PMC8905397. Law, James et al. “Speech and language therapy interventions for children with primary speech and/or language disorders.” The Cochrane Database of Systematic Reviews 2017,1 CD012490. 9 Jan. 2017, doi:10.1002/14651858.CD012490 Sices, Laura, and Marilyn Augustyn. “Expressive Language Delay (‘Late Talking') in Young Children.” Edited by Robert G Voigt and Mary Torchia, UptoDate, Wolters Kluwer, UpToDate, Inc., 25 Jan. 2022, https://www.uptodate.com/contents/expressive-language-delay-late-talking-in-young-children. Spratt, Eve G et al. “The Effects of Early Neglect on Cognitive, Language, and Behavioral Functioning in Childhood.” Psychology (Irvine, Calif.) 3,2 (2012): 175-182. doi:10.4236/psych.2012.32026 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652241/ Sunderajan, Trisha, and Sujata V Kanhere. “Speech and language delay in children: Prevalence and risk factors.” Journal of family medicine and primary care 8,5 (2019): 1642-1646. doi:10.4103/jfmpc.jfmpc_162_19 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559061/ Takahashi I, Obara T, Ishikuro M, et al. Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Years. JAMA Pediatr.Published online August 21, 2023. doi:10.1001/jamapediatrics.2023.3057 Young, Allen. and Matthew Ng. “Genetic Hearing Loss.” StatPearls, StatPearls Publishing, 17 April 2023. https://www.ncbi.nlm.nih.gov/books/NBK580517/ Zuckerman B, Khandekar A. Reach Out and Read: evidence based approach to promoting early child development. Curr Opin Pediatr. 2010 Aug;22(4):539-44. doi: 10.1097/MOP.0b013e32833a4673. PMID: 20601887.

Send us a textOccurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta-Analysis of Individual Patient Data.Nagy Z, Obeidat M, Máté V, et al. JAMA Pediatr. 2024 Dec. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textSystemic Postnatal Corticosteroids, Bronchopulmonary Dysplasia, and Survival Free of Cerebral Palsy. Doyle LW, Mainzer R, Cheong JLY.JAMA Pediatr. 2024 Nov 18:e244575. doi: 10.1001/jamapediatrics.2024.4575. Online ahead of print.PMID: 39556404 Systemic Corticosteroids to Prevent Bronchopulmonary Dysplasia: Balancing Risk and Reward. Jensen EA.JAMA Pediatr. 2024 Nov 18. doi: 10.1001/jamapediatrics.2024.4572. Online ahead of print.PMID: 39556388 No abstract available.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textNational Trends in Infant Mortality in the US After Dobbs.Singh P, Gallo MF.JAMA Pediatr. 2024 Oct 21. doi: 10.1001/jamapediatrics.2024.4276. Online ahead of print.PMID: 39432283As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Hello everyone and welcome to another episode of the Performance Psychcast. Today we are very fortunate to be speaking with David Durand.  David Durand is a sports performance and psychology coach. His background and training is in clinical psychology, while he also has a strength and conditioning certification from the NSCA and a mental performance consultant certification from the AASP.  His business, Real Development LLC, offers sports training services that combine mental, physical, and skill development for athletes. David focuses on helping individuals develop through a holistic perspective that increases their long-term potential rather than over emphasizing short-term success.  His new book, B.E.T. On It: A Psychological Approach to Coaching Gen Z and Beyond, is a guide for coaches looking to make a difference in modern athletes' lives by understanding their brains and bodies on a deeper level and equipping them with tools to increase their health, well-being, and performance.  https://www.amazon.com/B-T-Psychological-Approach-Coaching/dp/B0DB6SFDRK/ref=sr_1_1?crid=3NUQJJCKPWGMG&dib=eyJ2IjoiMSJ9.eoaf9FTSjdtYtTMZE78B8ettggUH6hP5Xd8Et6UOi1MWliBOfilpx9uhNBwUz7zBRIiEpSUgzh01s4g_h5U7d856oXNi6J2FDDpUqgGwHfA.nHVlSaU_r8iqkSfsGvpBJyUcFFkTms88aCfs6sJfjqM&dib_tag=se&keywords=bet+on+it+a+psychological+approach&qid=1722423966&sprefix=%2Caps%2C112&sr=8-1  And here's the study referenced in the podcast: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2799812#:~:text=Motivated%20by%20the%20anticipation%20of,brain%20responds%20to%20its%20environment. Citation: Maza MT, Fox KA, Kwon S, et al. Association of Habitual Checking Behaviors on Social Media With Longitudinal Functional Brain Development. JAMA Pediatr. 2023;177(2):160–167. doi:10.1001/jamapediatrics.2022.4924 www.sportingbounce.com  The online directory of sport performance specialists. Sportingbounce helps connect specialists in sport psychology, nutrition, sports massage, injury rehabilitation, coaching, and fitness training s with clients. With a daily spend on Google Adwords, social media advertising, and excellent organic rankings on search engines your business will get found on sporting bounce. Visit sportingbounce.com to find out how sporting bounce can help you. Don't forget that listeners of this podcast can get 50% off the Premium membership package by entering the code performance, that's “PERFORMANCE” meaning you get the best possible coverage for less than 20 pence a day!   

Send us a textInitial Oxygen Concentration for the Resuscitation of Infants Born at Less Than 32 Weeks' Gestation: A Systematic Review and Individual Participant Data Network Meta-Analysis.Sotiropoulos JX, Oei JL, Schmölzer GM, Libesman S, Hunter KE, Williams JG, Webster AC, Vento M, Kapadia V, Rabi Y, Dekker J, Vermeulen MJ, Sundaram V, Kumar P, Kaban RK, Rohsiswatmo R, Saugstad OD, Seidler AL.JAMA Pediatr. 2024 Aug 1;178(8):774-783. doi: 10.1001/jamapediatrics.2024.1848.PMID: 38913382As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textWhat I Have Learned in the Last 24 Years Being Editor-in-Chief.Rivara FP.JAMA Pediatr. 2024 Sep 3. doi: 10.1001/jamapediatrics.2024.3288. Online ahead of print.PMID: 39226042 As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a Text Message.Infant Deaths After Texas' 2021 Ban on Abortion in Early Pregnancy.Gemmill A, Margerison CE, Stuart EA, Bell SO.JAMA Pediatr. 2024 Jun 24:e240885. doi: 10.1001/jamapediatrics.2024.0885. Online ahead of print.PMID: 38913344As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal.Este podcast está presentado por los médicos neonatólogos Dani de Luis Rosell, Elena Itriago, Carolina Michel y Juliana Castellanos; y su anfitriona Maria Flores Cordova, médico residente de pediatría.No dudes en enviarnos preguntas, comentarios o sugerencias a nuestro correo electrónico: nicupodcast@gmail.comLos artículos que se tratan en el episodio de hoy están listados aquí:Trial of Selective Early Treatment of Patent Ductus Arteriosus with Ibuprofen.Gupta S, Subhedar NV, Bell JL, Field D, Bowler U, Hutchison E, Johnson S, Kelsall W, Pepperell J, Roberts T, Sinha S, Stanbury K, Wyllie J, Hardy P, Juszczak E; Baby-OSCAR Collaborative Group.N Engl J Med. 2024 Jan 25;390(4):314-325. doi: 10.1056/NEJMoa2305582. PMID: 38265644 Clinical Trial.Interventions to Prevent Bronchopulmonary Dysplasia in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-analyses.Abiramalatha T, Ramaswamy VV, Bandyopadhyay T, Somanath SH, Shaik NB, Pullattayil AK, Weiner GM.JAMA Pediatr. 2022 May 1;176(5):502-516. doi: 10.1001/jamapediatrics.2021.6619. PMID: 35226067 Review.Evaluation of the association between patent ductus arteriosus approach and neurodevelopment in extremely preterm infants.Cervera SB, Saeed S, Luu TM, Gorgos A, Beltempo M, Claveau M, Basso O, Lapointe A, Tremblay S, Altit G.J Perinatol. 2024 Jan 26. doi: 10.1038/s41372-024-01877-8. Creado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org Bienvenidos a La Incubadora: una conversación sobre neonatología y medicina basada en evidencia. Nuestros episodios ofrecen la dosis ideal (en mg/kg) de los más recientes avances para el neonato y para las increíbles personas que forman parte de la medicina neonatal. Soy tu host, Maria Flores Cordova, MD. Presentado por los Neonatólogos Elena Itriago MD, Dani de Luis Rosell MD, Carolina Michel MD, las futuras doctoras Marla Fortoul, Valentina Giraldo, Laura Molina. Creado originalmente por Ben Courchia MD y Daphna Yasova Barbeau MD http://www.the-incubator.org

Send us a Text Message.Effect of Low-Dose Iron Supplementation on Early Development in Breastfed Infants: A Randomized Clinical Trial.Svensson L, Chmielewski G, Czyzewska E, Domellöf M, Konarska Z, Piescik-Lech M, Späth C, Szajewska H, Chmielewska A.JAMA Pediatr. 2024 Jul 1;178(7):649-656. doi: 10.1001/jamapediatrics.2024.1095.PMID: 38739382 Clinical Trial.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a Text Message.Initial Oxygen Concentration for the Resuscitation of Infants Born at Less Than 32 Weeks' Gestation: A Systematic Review and Individual Participant Data Network Meta-Analysis.Sotiropoulos JX, Oei JL, Schmölzer GM, Libesman S, Hunter KE, Williams JG, Webster AC, Vento M, Kapadia V, Rabi Y, Dekker J, Vermeulen MJ, Sundaram V, Kumar P, Kaban RK, Rohsiswatmo R, Saugstad OD, Seidler AL.JAMA Pediatr. 2024 Jun 24:e241848. doi: 10.1001/jamapediatrics.2024.1848. Online ahead of print.PMID: 38913382As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

On this episode we were joined virtually by the Tufts DPT student journal club. Factors Associated With Concussion-like Symptom Reporting in High School Athletes Iverson GL, Silverberg ND, Mannix R, et al. JAMA Pediatr. 2015;169(12):1132. doi:10.1001/jamapediatrics.2015.2374 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

With the rise of social media, there has also been a rise in cyberbullying. Dr. Ruth Osondu, a child and adolescent psychiatry fellow joins Dr. Dale Peeples a child and adolescent psychiatrist and medical student Bailey Allen to discuss what pediatricians, parents, and teens should know about cyberbullying and suicide risks. Specifically, they will: Educate the listener and general community on signs a child/teenager at risk for suicide. Understand the effect of cyberbullying on the mental health of the child and adolescent population. Recognize signs that an adolescent is being cyberbullied. Understand potential preventative measures for cyberbullying. Recognize ways for a child or adolescent to get help if they are being bullied. Recognize the role of the parent of victims of cyberbullying CME Credit (requires free sign up): Link Coming Soon! References: Bauman S. Cyberbullying: What Does Research Tell Us? Theory Into Practice, Emerging Issues in School Bullying Research. 2013;52(4): 249-256. DOI: 10.1080/00405841.2013.829727 Chan T, Cheun C, Lee Z. Cyberbullying on Social Networking Sites: A Literature Review and and Future Research Directions. Information and Management. 2021;58(2):103411. https://doi.org/10.1016/j.im.202.103411. Earls M, Foy J, Green C.  “Mental Health Tools for Pediatrics”, Addressing Mental Health Concerns in Pediatrics: A Practical Resource Toolkit for Clinicians. American Academy of Pediatrics. February 2021. https://doi.org/10.1542/9781610024624-2e_s2_02_MH_tools_for_pediatrics Englander E, Donnerstein E, Kowalski R, Lin CA, Parti K. Defining Cyberbullying. Pediatrics. 2017 Nov;140(Suppl 2):S148-S151. doi: 10.1542/peds.2016-1758U. PMID: 29093051. Englander E. Back to the Drawing Board With Cyberbullying. JAMA Pediatr. 2019 Jun 1;173(6):513-514. doi: 10.1001/jamapediatrics.2019.0690. PMID: 31009032. Hamm MP, Newton AS, Chisholm A, Shulhan J, Milne A, Sundar P, Ennis H, Scott SD, Hartling L. Prevalence and Effect of Cyberbullying on Children and Young People: A Scoping Review of Social Media Studies. JAMA Pediatr. 2015 Aug;169(8):770-7. doi: 10.1001/jamapediatrics.2015.0944. PMID: 26098362. John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K. Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review. J Med Internet Res. 2018 Apr 19;20(4):e129. doi: 10.2196/jmir.9044. PMID: 29674305; PMCID: PMC5934539. Timmons-Mitchell J, Flannery D; What Pediatricians Should Know and Do about Cyberbullying. Pediatr Rev. July 2020; 41 (7): 373–375. https://doi.org/10.1542/pir.2019-0165 Tozzo P, Cuman O, Moratto E, Caenazzo L. Family and Educational Strategies for Cyberbullying Prevention: A Systematic Review. Int J Environ Res Public Health. 2022 Aug 22;19(16):10452. doi: 10.3390/ijerph191610452. PMID: 36012084; PMCID: PMC9408628. John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K. Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review. J Med Internet Res. 2018 Apr 19;20(4):e129. doi: 10.2196/jmir.9044. PMID: 29674305; PMCID: PMC5934539. Walrave, Michel, and Wannes Heirman. "Cyberbullying: Predicting victimisation and perpetration." Children & Society 25.1 (2011): 59-72.  

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021. Originally released: May 30, 2019 Since January 1, 2019, there have been nearly 900 confirmed measles cases across 24 states in the United States. This is 10 times greater than the number of cases in the US 3 years ago, and it is the largest outbreak the US has seen since 1994. The month of May also marks the first reported case of measles in the state of Pennsylvania, where BrainWaves is produced. So this week on the program, Jim Siegler speaks with Dr. Erika Mejia (pediatrician) about the medical and sociopolitical triggers for this outbreak, the misconceptions of the measles-mumps-rubella vaccine, and finally, what you can do to keep measles from "going viral."* Produced by James E Siegler and Erika Mejia. Music courtesy of Advent Chamber Orchestra, Coldnoise, Josh Woodward, Kevin McLeod, and Lee Roosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast. REFERENCES Bester JC. Measles and measles vaccination: a review. JAMA Pediatr 2016;170(12):1209-15. PMID 27695849Bester JC. Not a matter of parental choice but of social justice obligation: children are owed measles vaccination. Bioethics 2018;32(9):611-19. PMID 30229958Campbell H, Andrews N, Brown KE, Miller E. Review of the effect of measles vaccination on the epidemiology of SSPE. Int J Epidemiol 2007;36(6):1334-48. PMID 18037676Fournet N, Mollema L, Ruijs WL, et al. Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews. BMC Public Health 2018;18(1):196. PMID 29378545Maglione MA, Das L, Raaen L, et al. Safety of vaccines used for routine immunization of U.S. children: a systematic review. Pediatrics 2014;134(2):325-37. PMID 25086160Murch SH, Anthony A, Casson DH, et al. Retraction of an interpretation. Lancet 2004;363(9411):750. PMID 15016483Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis 2004;189 Suppl 1:S4-16. PMID 15106083Poland GA, Jacobson RM. The age-old struggle against the antivaccinationists. N Engl J Med 2011;364(2):97-9. PMID 21226573Trump's tweet:  https://twitter.com/realdonaldtrump/status/449525268529815552?lang=en  *Truth be told, measles claims the lives of 100,000 people around the globe every year. It has already gone viral. This was just a figure of speech. We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Though measles was declared eliminated in the U.S. decades ago, outbreaks do still happen here, and in other places it's much more common. Before vaccines were widely available, it killed an estimated 2.6 million people worldwide each year. Research: "Measles cases rising alarmingly across Europe: WHO." IANS, 24 Jan. 2024, p. NA. Gale OneFile: Health and Medicine, link.gale.com/apps/doc/A780229341/GPS?u=mlin_n_melpub&sid=bookmark-GPS&xid=624cac48. Accessed 13 Feb. 2024. "The Medical Influence of Rhazes." Science and Its Times, edited by Neil Schlager and Josh Lauer, vol. 2, Gale, 2001. Gale In Context: World History, link.gale.com/apps/doc/CV2643450171/WHIC?u=mlin_n_melpub&sid=bookmark-WHIC&xid=5ed3d18a. Accessed 13 Feb. 2024. Associated Press. “Measles deaths worldwide jumped 40% last year, health agencies say.” 11/16/2023. https://apnews.com/article/measles-epidemic-children-who-cdc-bb62da7Measles%20deaths%20worldwide%20jumped%2040%%20last%20year,%20health%20agencies%20say Berche, Patrick. “History of measles.” La Presse Médicale. Volume 51, Issue 3, September 2022. https://www.sciencedirect.com/science/article/pii/S0755498222000422 Carson-DeWitt, Rosalyn, MD, et al. "Measles." The Gale Encyclopedia of Public Health, edited by Brigham Narins, 2nd ed., vol. 2, Gale, 2020, pp. 675-680. Gale In Context: Environmental Studies, link.gale.com/apps/doc/CX7947900178/GPS?u=mlin_n_melpub&sid=bookmark-GPS&xid=5cb0c749. Accessed 13 Feb. 2024. Centers for Disease Control. “Measles History.” https://www.cdc.gov/measles/about/history.html Conis E. Measles and the Modern History of Vaccination. Public Health Reports. 2019;134(2):118-125. doi:10.1177/0033354919826558 Düx A, Lequime S, Patrono LV, Vrancken B, Boral S, Gogarten JF, Hilbig A, Horst D, Merkel K, Prepoint B, Santibanez S, Schlotterbeck J, Suchard MA, Ulrich M, Widulin N, Mankertz A, Leendertz FH, Harper K, Schnalke T, Lemey P, Calvignac-Spencer S. Measles virus and rinderpest virus divergence dated to the sixth century BCE. Science. 2020 Jun 19;368(6497):1367-1370. doi: 10.1126/science.aba9411. PMID: 32554594; PMCID: PMC7713999. Home, Francis. “Medical facts and experiments.” London, 1759. https://archive.org/details/b30785558/ Manley, Jennifer. “Measles and Ancient Plagues: A Note on New Scientific Evidence.” Classical World, Volume 107, Number 3, Spring 2014, pp. 393-397. https://doi.org/10.1353/clw.2014.0001 Panum, Peter Ludwig. “Observations made during the epidemic of measles on the Faroe Islands in the year 1846.” Gerstein - University of Toronto. https://archive.org/details/observationsmade00panuuoft Papania MJ, Wallace GS, Rota PA, et al. Elimination of Endemic Measles, Rubella, and Congenital Rubella Syndrome From the Western Hemisphere: The US Experience. JAMA Pediatr. 2014;168(2):148–155. doi:10.1001/jamapediatrics.2013.4342 Patel, Minal K. et al. “Progress Toward Regional Measles Elimination — Worldwide, 2000–2019.” Morbidity and Mortality Weekly Report, November 13, 2020, Vol. 69, No. 45 (November 13, 2020). Via JSTOR. https://www.jstor.org/stable/10.2307/26967781 Rāzī, Abū Bakr Muḥammad ibn Zakarīyā. “A treatise on the small-pox and measles.” Translated by William Alexander Greenhill. 1848. https://archive.org/details/39002086344042.med.yale.edu/mode/1up Sydenham, Thomas. “The works of Thomas Sydenham, M.D.” London, 1848. https://archive.org/details/b33098682_0002 The College of Physicians of Philadelphia. “Measles.” History of Vaccines. https://historyofvaccines.org/history/measles/timeline West, Katherine. "THE RETURN OF MEASLES: With modern vaccine skepticism, the once-eliminated disease is surging in the U.S." EMS World, vol. 48, no. 6, June 2019, pp. 44+. Gale General OneFile, link.gale.com/apps/doc/A711878059/GPS?u=mlin_n_melpub&sid=bookmark-GPS&xid=8d0bb2cb. Accessed 13 Feb. 2024. See omnystudio.com/listener for privacy information.

Reference: Zaoutis T, et al. Short-course Therapy for Urinary Tract Infections in Children: the SCOUT randomized clinical trial. JAMA Pediatr. Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children's National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University […] The post SGEM #427: I Want a Treatment with a Short Course…for Pediatric Urinary Tract Infections first appeared on The Skeptics Guide to Emergency Medicine.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-343 Overview: In this episode, we take a look at a study exploring the effects on children's activity levels when their parents reduce smartphone use. Listen in as we discuss compelling findings that shed light on the connection, and come away with guidance on how to navigate the evolving digital landscape to promote healthier, more active lifestyles among children. Episode resource links: JAMA Pediatr. 2022 Aug; 176(8): 741–749 BMJ Open. 2019 Jan 3;9(1):e023191. doi: 10.1136/bmjopen-2018-023191 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-343 Overview: In this episode, we take a look at a study exploring the effects on children's activity levels when their parents reduce smartphone use. Listen in as we discuss compelling findings that shed light on the connection, and come away with guidance on how to navigate the evolving digital landscape to promote healthier, more active lifestyles among children. Episode resource links: JAMA Pediatr. 2022 Aug; 176(8): 741–749 BMJ Open. 2019 Jan 3;9(1):e023191. doi: 10.1136/bmjopen-2018-023191 Guest: Robert A. Baldor MD, FAAFP   Music Credit: Richard Onorato

Episode 3: Severe pediatric asthma-beyond standard therapy, the role of current and future therapies including biologics Description: Though severe pediatric asthma only represents from 2 to 5% of the children suffering with this condition, it represents a major share of the cost, resource utilization, and morbidity. It is important that allergists have a good gasp of this condition and how it differs from the adult population. Topics include appropriate workup, comorbidities, steroid burden.   Learning Objectives: Be able to discuss the burden of severe pediatric asthma and issues in optimal medication adherence in this population Be able to evaluate the child with severe asthma and screen for corticosteroid overuse in and remedies to decrease it in this population Be able to interpret the mechanisms of action, applicable pediatric population, dosing, outcome data, and adverse effects of current and future treatments beyond standard therapy in severe pediatric asthma References:               Perry, R., Braileanu, G., Palmer, T. et al. The Economic Burden of Pediatric Asthma in the United States: Literature Review of Current Evidence. PharmacoEconomics 37, 155–167 (2019). Yao T, Wang J, Chang S, et al. Association of Oral Corticosteroid Bursts With Severe Adverse Events in Children. JAMA Pediatr. Published online April 19, 2021. Katial RK, Bensch GW, Busse WW, Chipps BE, Denson JL, Gerber AN, et al. Changing paradigms in the treatment of severe asthma: the role of biologic therapies. J Allergy Clin Immunol Pract 2017;5:S1–S14. Licari, A., Manti, S., Castagnoli, R. et al. Targeted Therapy for Severe Asthma in Children and Adolescents: Current and Future Perspectives. Pediatr Drugs 21, 215–237 (2019)

Episode 1: Severe pediatric asthma-burden of disease, adherence issues, and comorbidities   Description: Though severe pediatric asthma only represents from 2 to 5% of the children suffering with this condition, it represents a major share of the cost, resource utilization, and morbidity. It is important that allergists have a good gasp of this condition and how it differs from the adult population. Topics include appropriate workup, comorbidities, steroid burden.   Learning Objectives: Be able to discuss the burden of severe pediatric asthma and issues in optimal medication adherence in this population Be able to evaluate the child with severe asthma and screen for corticosteroid overuse in and remedies to decrease it in this population Be able to interpret the mechanisms of action, applicable pediatric population, dosing, outcome data, and adverse effects of current and future treatments beyond standard therapy in severe pediatric asthma References:               Perry, R., Braileanu, G., Palmer, T. et al. The Economic Burden of Pediatric Asthma in the United States: Literature Review of Current Evidence. PharmacoEconomics 37, 155–167 (2019). Yao T, Wang J, Chang S, et al. Association of Oral Corticosteroid Bursts With Severe Adverse Events in Children. JAMA Pediatr. Published online April 19, 2021. Katial RK, Bensch GW, Busse WW, Chipps BE, Denson JL, Gerber AN, et al. Changing paradigms in the treatment of severe asthma: the role of biologic therapies. J Allergy Clin Immunol Pract 2017;5:S1–S14. Licari, A., Manti, S., Castagnoli, R. et al. Targeted Therapy for Severe Asthma in Children and Adolescents: Current and Future Perspectives. Pediatr Drugs 21, 215–237 (2019)

Episode 2:       Severe pediatric asthma-evaluation of the child, diagnostic testing, assessing steroid side effects   Description: Though severe pediatric asthma only represents from 2 to 5% of the children suffering with this condition, it represents a major share of the cost, resource utilization, and morbidity. It is important that allergists have a good gasp of this condition and how it differs from the adult population. Topics include appropriate workup, comorbidities, steroid burden.   Learning Objectives: Be able to discuss the burden of severe pediatric asthma and issues in optimal medication adherence in this population Be able to evaluate the child with severe asthma and screen for corticosteroid overuse in and remedies to decrease it in this population Be able to interpret the mechanisms of action, applicable pediatric population, dosing, outcome data, and adverse effects of current and future treatments beyond standard therapy in severe pediatric asthma References:               Perry, R., Braileanu, G., Palmer, T. et al. The Economic Burden of Pediatric Asthma in the United States: Literature Review of Current Evidence. PharmacoEconomics 37, 155–167 (2019). Yao T, Wang J, Chang S, et al. Association of Oral Corticosteroid Bursts With Severe Adverse Events in Children. JAMA Pediatr. Published online April 19, 2021. Katial RK, Bensch GW, Busse WW, Chipps BE, Denson JL, Gerber AN, et al. Changing paradigms in the treatment of severe asthma: the role of biologic therapies. J Allergy Clin Immunol Pract 2017;5:S1–S14. Licari, A., Manti, S., Castagnoli, R. et al. Targeted Therapy for Severe Asthma in Children and Adolescents: Current and Future Perspectives. Pediatr Drugs 21, 215–237 (2019)

In this Complex Care Journal Club podcast episode, Dr. Eyal Cohen discusses the design and key findings of a randomized controlled trial evaluating the effectiveness of a structured complex care program in Ontario, Canada. He describes implications for clinical practice, opportunities for family partnership in research, and the next steps from this work. SPEAKERS Eyal Cohen, MD, MSc, FRCPC Program Head, Child Health Evaluative Sciences Staff Physician, Division of Pediatric Medicine The Hospital for Sick Children (SickKids), Toronto Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics Boston Children's Hospital Assistant Professor of Pediatrics Harvard Medical School DATES Initial publication: April 26, 2023 CITATION Cohen E, Huth K. Measuring What Matters in a Multicenter RCT: Partnering With Patients/Families and Policymakers. 04/2023. OPENPediatrics. Online Podcast. Links: https://youtu.be/tTimlHM9Oj8, https://soundcloud.com/openpediatrics/measuring-what-matters-in-a-multicenter-rct-partnering-with-patientsfamilies-and-policymakers. ARTICLE REFERENCED Cohen E, Quartarone S, Orkin J, et al. Effectiveness of Structured Care Coordination for Children With Medical Complexity: The Complex Care for Kids Ontario (CCKO) Randomized Clinical Trial [published online ahead of print, 2023 Mar 20]. JAMA Pediatr. 2023;e230115. doi:10.1001/jamapediatrics.2023.0115 https://pubmed.ncbi.nlm.nih.gov/36939728/ TRANSCRIPT https://bit.ly/41Xvaf0 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

In this podcast, an experienced conference and webinar moderator is joined by two doctors in the field of paediatric infectious diseases: David Greenberg and Maria Hemming-Harlo. In this podcast, our guest experts provide information and their perspectives on the following topics: The disease burden of rotavirus The related morbidity and mortality of rotavirus How rotavirus is transmitted The clinical picture of rotavirus infection The evidence supporting routine vaccination with RotaTeq (Rotavirus Vaccine, Live, Oral, Pentavalent) This podcast was funded by Merck Sharp & Dohme LLC. Below please find the reference list for Vax Voices, Podcast 1: The Global Burden of Rotavirus Disease and Evidence Supporting Routine Vaccination With RotaTeq to ensure listeners can further explore the content discussed. View the product information and indication for RotaTeq here. View the Select Safety Information from MSD below. Select Safety Information RotaTeq should not be administered to infants with a demonstrated history of hypersensitivity to the vaccine or any component of the vaccine. Infants with a history of intussusception or who have congenital malformation of the gastrointestinal tract that could predispose infants to intussusception should not receive RotaTeq. Infants with Severe Combined Immunodeficiency Disease or SCID should not receive RotaTeq. Administration of RotaTeq should be postponed in infants suffering from acute severe febrile illness. The presence of a minor infection is not a contraindication for immunisation. The administration of RotaTeq should be postponed in subjects suffering from acute diarrhoea or vomiting. No safety or efficacy data are available from clinical trials regarding the administration of RotaTeq to infants who are potentially immunocompromised. Cases of gastroenteritis associated with vaccine virus have been reported post marketing in infants with severe combined immunodeficiency. Vaccine virus transmission from vaccine recipient to nonvaccinated contacts has been reported. Caution is advised when considering whether to administer RotaTeq to individuals with immunodeficient contacts. In post-marketing experience, intussusception (including death) and Kawasaki disease have been reported in infants who have received RotaTeq. As a precaution, healthcare professionals should follow-up on any symptoms indicative of intussusception (severe abdominal pain, persistent vomiting, bloody stools, abdominal bloating and/or high fever) since data from observational studies indicate an increased risk of intussusception, mostly within 7 days after rotavirus vaccination. Parents/guardians should be advised to promptly report such symptoms to their healthcare provider. The level of protection provided by RotaTeq is based on the completion of all 3 doses. As with any vaccine, vaccination with RotaTeq may not result in complete protection in all recipients. HQ-ROT-00133 | 02/23   Podcast References: 1.Nelson R. COVID-19 disrupts vaccine delivery. Lancet Infect Dis. 2020;20(5):546. 2.Centers for Disease Control and Prevention (CDC). Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Chapter 19: Rotavirus. Available at: https://www.cdc.gov/vaccines/pubs/pinkbook/rota.html. Last accessed: 6 March 2023. 3.Dormitzer PR. "Rotaviruses," Mandell GL, et al, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier Saunders; 2019:1983-96. 4.Centers for Disease Control and Prevention (CDC). Rotavirus. Clinical information. 2021. Available at: https://www.cdc.gov/rotavirus/clinical.html. Last accessed: 13 October 2022. 5.Troeger C et al. Rotavirus vaccination and the global burden of rotavirus diarrhea among children younger than 5 years. JAMA Pediatr. 2018;172(10):958-965. Erratum in: JAMA Pediatr. 2022;176(2):208. 6.GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17(9):909-948. Erratum in: Lancet Infect Dis. 2017 Sep;17(9):897. 7.Van Damme P et al. Rotavirus vaccines: considerations for successful implementation in Europe. Lancet Infect Dis. 2006;6(12):805-12. 8.Paul MO, Erinle EA. Influence of humidity on rotavirus prevalence among Nigerian infants and young children with gastroenteritis. J Clin Microbiol. 1982;15(2):212-5. 9.Finnish Institute for Health and Welfare. Infectious diseases and vaccines: rotavirus vaccine. 2020. Available at: https://thl.fi/en/web/infectious-diseases-and-vaccinations/vaccines-a-to-z/rotavirus-vaccine. Last accessed: 16 September 2022. 10.GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. 11.Franco MA et al. Immunity and correlates of protection for rotavirus vaccines. Vaccine. 2006;24(15):2718-31. 12.Gentsch JR et al. Serotype diversity and reassortment between human and animal rotavirus strains: implications for rotavirus vaccine programs. J Infect Dis. 2005;192(Suppl 1):S146-59. 13.Merck & Co. RotaTeq®. Prescribing information. 2022. Available at: https://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_pi.pdf. Last accessed: 4 January 2023. 14.European Medicine Agency (EMA). RotaTeq. Summary of product characteristics. 2022. Available at: https://www.ema.europa.eu/en/documents/product-information/rotateq-epar-product-information_en.pdf. Last accessed: 4 January 2023. 15.Velasquez-Portocarrero DE et al. Head-to-head comparison of the immunogenicity of RotaTeq and Rotarix rotavirus vaccines and factors associated with seroresponse in infants in Bangladesh: a randomised, controlled, open-label, parallel, phase 4 trial. Lancet Infect Dis. 2022;22(11):1606-16. 16.Cortese MM, Parashar UD; Centers for Disease Control and Prevention (CDC). Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009;58(RR-2):1-25. 17.Vesikari T et al.; Rotavirus Efficacy and Safety Trial (REST) Study Team. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354(1):23-33. 18.Vesikari T et al. Efficacy of a pentavalent rotavirus vaccine in reducing rotavirus-associated health care utilization across three regions (11 countries). Int J Infect Dis. 2007;11(Suppl 2):S29-35. 19.Heyse JF; REST Study Team. Evaluating the safety of a rotavirus vaccine: the REST of the story. Clin Trials. 2008;5(2):131-9. 20.World Health Organization (WHO). Rotavirus vaccines: WHO position paper. Wkly Epidemiol Rec. 2021;96(28):301-20.  

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 There's more to epilepsy than AED titration. (Shocking, I know.) Especially in women, management is undeniably complex. For example, the same enzymatic machinery used to metabolize AEDs is also used to break down estrogen-containing oral contraceptives--an interaction that could literally open a Pandora's box of complications. These and other issues affecting the management of women with epilepsy are addressed by Dr. Danielle Becker in this week's BrainWaves podcast. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. This episode was vetted and approved by Danielle Becker. REFERENCES Crawford P. Best practice guidelines for the management of women with epilepsy. Epilepsia 2005;46 Suppl 9:117-24. PMID 16302885 Harden CL, Hopp J, Ting TY, et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009;73(2):126-32. PMID 19398682 Herzog AG, Fowler KM, Smithson SD, et al. Progesterone vs placebo therapy for women with epilepsy: a randomized clinical trial. Neurology 2012;78(24):1959-66. PMID 22649214 Meador K, Reynolds MW, Crean S, Fahrbach K, Probst C. Pregnancy outcomes in women with epilepsy: a systematic review and meta-analysis of published pregnancy registries and cohorts. Epilepsy Res 2008;81(1):1-13. PMID 18565732 Meador KJ, Baker GA, Browning N, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr 2014;168(8):729-36. PMID 24934501 Reiter SF, Bjørk MH, Daltveit AK, et al. Life satisfaction in women with epilepsy during and after pregnancy. Epilepsy Behav 2016;62:251-7. PMID 27513352 Taubøll E, Sveberg L, Svalheim S. Interactions between hormones and epilepsy. Seizure 2015;28:3-11. PMID 25765693 Velíšková J, Desantis KA. Sex and hormonal influences on seizures and epilepsy. Horm Behav 2013;63(2):267-77. PMID 22504305  We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

In this episode we talk with Emily Chandler and Taylor Washburn, EBB Childbirth Class graduates about their experiences in the childbirth class; their informed and empowered hospital birth; and how they navigated an extended hospital stay for newborn jaundice.   Emily, is a marine scientist, and Taylor, is a teacher and rowing coach in the Boston area. Together, they love hiking, biking, rowing, and taking advantage of the great outdoors. And they're also very busy taking care of their baby. While pregnant, Emily dove headfirst into learning about pregnancy, birth, and the state of maternity care in the United States. Emily and Taylor took the Evidence Based Birth Childbirth Class with EBB instructor Chanté Perryman.   Emily and Taylor share their experiences in the EBB Childbirth Class and how that informed many of the decisions they made regarding their birth plan, including Taylor being both inspired and empowered to “catch” their baby. They also share how they used the advocacy skills learned in class to better communicate with their providers and each other. After experiencing the birth they desired, complications arose when Emily experienced difficulty breastfeeding and inadequate lactation support. Difficulty was further exasperated when their newborn was diagnosed with jaundice leading to an extended hospital stay. Content Warnings: extended hospital stay due to newborn jaundice, “yellow baby,” difficulty breastfeeding, syringe feeding, lack of lactation support poor latch, heel pricks and bilirubin testing, treatment for elevated bilirubin, poor outcomes for Black and Brown infants with jaundice Resources: Access the CDC article on Jaundcie here Access the Evidence Based Birth® Signautre Articles on:  The Evidence on Premature Rupture of Membranes here  The Evidence on Group B Strep here  The Evidence on Pitocin® in the Third Stage here Listen to EBB 145- Fatherhood and Advocacy in Birth with JacMichael Perryman here Listen to EBB 244 - Evidence on AROM, AVD and Internal Monitoring here  Learn more about Chanté Perryman's EBB Childbirth Class and services here or on her Instagram account @babydreamsmc Learn more about The Nest Collaborative for lacation support here References:  Here are the scientific references on jaundice for the blog article: ·      Dunn, P. M. (2003). Dr Erasmus Darwin (1731–1802) of Lichfield and placental respiration. Arch Dis Child Fetal Neonatal Ed;88:F346– 8. ·      Katheria, A. C., Lakshminrusimha, S., Rabe, H., et al. (2017). Placental transfusion: a review. Journal of Perinatology; 37:105-111. ·      McDonald, S. J., Middleton, P., Dowswell, T., et al. (2013). Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD004074 ·      Ashish, K. C., Rana, N., Malqvist, M., et al. (2017). Effects of Delayed Umbilical Cord Clamping vs. Early Clamping on Anemia in Infants at 8 and 12 months: A Randomized Clinical Trial. JAMA Pediatr;171(3):264-270. ·      Mercer, J. S., Erickson-Owens, D. A., Deoni, S. C. L., et al. (2018). Effects of Delayed Cord Clamping on Four-Month Ferritin Levels, Brain Myselin Content, and Neurodevelopment: A Randomized Controlled Trial. ·      Andersson, O., Lindquist, B., Lindgren, M., et al. (2015). Effect of delayed cord clamping on neurodevelopment at 4 years of age: a randomized clinical trial. JAMA Pediatr;169:631–8. ·      CDC article on Jaundice: https://www.cdc.gov/ncbddd/jaundice/facts.html   Go to our YouTube channel to see video versions of the episode listed above!! For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on:  TikTok Instagram Pinterest Ready to get involved?  Check out our Professional membership (including scholarship options) here  Find an EBB Instructor here  Click here to learn more about the Evidence Based Birth® Childbirth Class.  

Date: February 27, 2023 Reference: Walsh PS, Schnadower D, Zhang Y, Ramgopal S, Shah SS, Wilson PM. Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. JAMA Pediatr. 2022. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children's National Hospital in Washington, DC. She is also the […] The post SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza first appeared on The Skeptics Guide to Emergency Medicine.

Episode 130: Epigenetics in childhood obesitySaakshi and Dr. Arreaza discuss some principles of epigenetics implicated in the development of obesity in children. Written by Saakshi Dulani, MS3, Western University College of Osteopathic Medicine of the Pacific. Edited by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.This topic is constantly expanding, and I'm excited to talk about it. It is a fact that epigenetic changes play a role in the development of certain diseases such as Prader-Willi syndrome, Fragile X syndrome, and various cancers. It has been demonstrated that certain foods can alter gene expression in animals, for example. What is epigenetics?Epigenetics is the regulation of gene expression without a change in the base sequence of DNA. Epigenetics means “on top of” the genes. Genes can be turned “on” or “off” as a response to external influences. Obesity and Epigenetics.The link between genetics and obesity is complex, but it is known that epigenetics plays a significant role in childhood obesity. Surprisingly, exposure to environmental factors starts in the uterus. Fetuses are exposed to intrauterine signals that increase their potential to develop obesity. Factors such as in-utero hyperglycemia, gestational diabetes mellitus, and early childhood diet and lifestyle practices can affect the development of the gut microbiome, modify gene expression through DNA methylation, and increase the risk of childhood obesity. These gene expression changes can be passed on to future generations. DNA methylation is the addition of a methyl group to part of the DNA molecule. That methyl group acts as a “chemical cap,” which prevents gene expression. Another example of epigenetics is histone modification. Histones are proteins that are used by DNA as spools to wrap around pieces of information that are “not needed”. The reason why a scalp cell and a neuron are different is that the expression of certain genes is suppressed while other genes are expressed.Factors that influence obesity.Some factors that increase the risk of childhood obesity through epigenetic changes include neonatal intestinal microbiome, C-section delivery, maternal insulin resistance, exposure to antibiotics and other environmental toxins, early introduction of complementary foods, parental diets high in carbohydrates and low in fruits and vegetables, and poor sleep. There are many other factors, but we will discuss only a few of them.Microbiome:The microbiome is a whole new world that is being explored by many investigators. The gut microbiome refers to the diverse community of organisms, including bacteria, fungi, and viruses, that reside in the human intestine. The neonatal intestinal microbiome is established during the first two years of life and may be influenced by factors such as the method of delivery, maternal obesity, and the maternal gut microbiome. Some bacteria worth mentioning are Bacteroides, Clostridium, and Staphylococcus. These gut bacteria are higher in pregnant women who have obesity, and they also have a low count of Bifidobacterium. Infants born to obese mothers have higher levels of bacteria associated with increased energy harvest compared to infants born to normal-weight mothers. The gut microbiome of infants delivered by C-section is different than infants delivered vaginally.Link to antibiotics:Early exposure to antibiotics is associated with the development of resistance in microorganisms. The intestinal microbiota exposed to antibiotics also shows reduced diversity. Antibiotics can decrease the number of mitochondria and impair their function, which is important in maintaining energy metabolism. Evidence suggests that some antibiotics can cause mutations in the mitochondrial genome, and they have a direct effect on the microbiome and influence metabolism. There is a strong association between early-life antibiotic exposure and childhood adiposity, with a strong dose-response relationship. A stronger association has been seen with exposure to broad-spectrum antibiotics and macrolides. Maternal insulin resistance (IR):Insulin resistance means that the mother needs levels of insulin that are higher than normal to stay normoglycemic. It means the insulin receptors are “exhausted” and do not respond to normal levels of insulin. Insulin does NOT cross the blood-placenta barrier, but glucose and other nutrients do. This causes the fetus to have an abundance of glucose that stimulates the secretion of high levels of insulin by the fetal pancreas to stay normoglycemic. The combination of insulin + glucose is the perfect combination for anabolism, adipocyte hyperplasia, and fetal growth. That explains why mothers with insulin resistance deliver larger babies (macrosomia). Maternal insulin resistance is a predictor of infant weight gain and body fat in the first year of life. This is not influenced by the mother's BMI before pregnancy. Maternal insulin resistance causes alterations in gene regulation for lipids, amino acids, and inflammation, leading to long-term health implications for both the mother and future pregnancies.C-section and obesity:C-section delivery is a saving procedure for many obstetrical emergencies. C-sections have improved the survival of larger infants and their mothers. C-sections are more frequent among populations with obesity and sedentary lifestyles. This method of delivery is also strongly associated with childhood obesity. Among many other reasons, whenever a vaginal delivery is feasible, a vaginal delivery is preferred over a c-section.   In summary, we discussed 4 factors that may influence childhood obesity: the newborn microbiome, exposure to antibiotics, maternal insulin resistance, and C-sections. There are many other factors that we did not talk about, but the more we know about genetics, epigenetics, and metabolism, the closer we get to a better understanding of obesity._____________________Conclusion: Now we conclude our episode number 130, “Epigenetics in childhood obesity.” Saakshi discussed with Dr. Arreaza that the in-utero environment can alter gene expression and increase the risk of obesity in children. Some factors, such as maternal insulin resistance and changes in gut microbiome, can be the cause of obesity in some children. This week we thank Hector Arreaza and Saakshi Dulani. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________Sources:Burdge GC, Hoile SP, Uller T, Thomas NA, Gluckman PD, Hanson MA, Lillycrop KA. Progressive, transgenerational changes in offspring phenotype and epigenotype following nutritional transition. PLoS One. 2011;6(11):e28282. doi: 10.1371/journal.pone.0028282. Epub 2011 Nov 30. PMID: 22140567; PMCID: PMC3227644. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227644/Rachael Rettner, Epigenetics: Definition & Examples, Live Science, published on June 24, 2013, available at: https://www.livescience.com/37703-epigenetics.htmlMulligan CM, Friedman JE. Maternal modifiers of the infant gut microbiota: metabolic consequences. J Endocrinol. 2017;235: R1-R12.Aghaali, M. and S. S. Hashemi-Nazari (2019). “Association between early antibiotic exposure and risk of childhood weight gain and obesity: a systematic review and meta-analysis.” J Pediatr Endocrinol Metab 32(5): 439-445.Yuan C, Gaskins AJ, Blaine AI, et al. Association between cesarean birth and risk of obesity in offspring in childhood, adolescence, and early adulthood. JAMA Pediatr. 2016;170(11):e162385. doi: 10.1001/jamapediatrics.2016.2385.Royalty-free music used for this episode: “Gushito - Burn Flow." Downloaded on October 13, 2022, from https://www.videvo.net/

在1歲時看螢幕的時間越長，3歲時得到自閉症的風險越高。但這可能是怎麼形成的呢？ 《美國醫學會-兒科學期刊》（JAMA Pediatrics）今天刊登了一篇我們的評論，分析「在哪段時間看電子螢幕」（screen timing），可能比「看螢幕的時間」（screen time）與自閉症的風險更有關。 #看螢幕的時間會增加自閉症風險 近期JAMA Pediatrics刊登一項日本的大型世代追蹤1歲的嬰兒每天看電子螢幕的時間越長，追蹤到他們3歲的時候，男孩有比較高的自閉類群疾患（autism spectrum disorder，簡稱自閉症）風險。這項研究採用各種嚴謹的統計方法驗證這項發現：例如1歲時候看螢幕的時間，會增加3歲時自閉症的風險，但如果是用3歲時看螢幕的時間，則沒有顯著的關聯性、而每天看螢幕的時間用不同的基準值來比較，結果都顯示看螢幕時間越長，自閉症風險越高的趨勢。 #如何解釋電子螢幕與自閉症風險？ 這項研究在統計分析呈現重要而且可信的結果，但是解釋可能造成自閉症風險的原因其實非常不容易。發表這篇研究的團隊，只在論文簡單提及幾項基礎的動物研究，猜測電子產品的電磁場，可能與自閉症風險有關。 我們的論述則認為，如果在這項研究調查的「每天看電子螢幕的總時間」還進一步能多瞭解「在哪個時間段看」，特別是「睡前看螢幕的時間」，將有助於解釋可能的機制，以及有學理基礎的幼兒使用電子產品對策。 #在哪個時段看電子螢幕為什麼更重要 美國兒科醫學會除了建議不同年齡兒童看電子螢幕的時間，還有一項重要的提醒：為孩子佈置一個沒有電子產品的睡覺空間。這是根據睡前使用電子產品對孩子的睡眠、健康的大量實證研究成果訂下的建議。睡眠作息的擾亂，比起原論文提到的電磁場，有多而且更明確的研究顯示和自閉症風險的關聯性。自閉症的孩子不僅有很高的比例有睡眠的問題，與睡眠相關的褪黑激素（melatonin）也是可能與自閉症相關的一種神經傳導物質。在光照特別是在看電子螢幕時，光線會抑制褪黑激素的分泌，讓人入睡困難或是睡眠品質不佳。褪黑激素也具有抗氧化的作用，特別是在神經生長發育期間如果分泌較少，也被認為會造成較大的氧化壓力，而影響神經系統的發育，增加諸如自閉症等神經發展疾病的風險。 ＃為孩子佈置一個沒有電子產品的睡覺空間 我們的這篇評論，支持在孩子1歲的神經發育早期階段，如果看螢幕時間較長，到了3歲得到自閉症風險增加的重要研究發現；也提出「在哪個時間段看」，特別是「睡前看螢幕的時間」是另一項重點。雖然電子產品可能已經是每個家庭不可或缺的一部分，但為孩子佈置一個沒有電子產品的睡覺空間，仍是值得推廣的健康習慣。 ＊本文感謝兩位共同作者：統計學家林聖軒醫師分析研究方法的詮釋；自閉症研究權威高淑芬副院長對這篇評論嚴謹的修訂 參考文獻 1. 論文原文： Kushima M, Kojima R, Shinohara R, et al; Japan Environment and Children's Study Group. Association between screen time exposure in children at 1 year of age and autism spectrum disorder at 3 years of age: the Japan Environment and Children's Study.  JAMA Pediatr. 2022;176(4):384-391. 2. 我們的評論：Lin YH, Lin SH, Gau SS. Screen Timing May Be More Likely Than Screen Time to Be Associated With the Risk of Autism Spectrum Disorder. 3. 原作者回應：Kushima M, Yamagata Z. Screen Timing May Be More Likely Than Screen Time to Be Associated With the Risk of Autism Spectrum Disorder—Reply Powered by Firstory Hosting

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looked at the impact of screen time on duration of post-concussive symptoms 125 patients aged 12-25 diagnosed with a concussion were randomized to either abstain from or have unrestricted screen time for 48 hours after injury Patients with unrestricted screen time averaged approximately 5 hours/day of screen time Patients in the no screen time group averaged approximately 1 hour/day of screen time Statistically significant difference in duration of post-concussive symptoms Unrestricted screen time cohort averaged 8 days of post-concussive symptoms No screen time cohort averaged 3.5 days of post-concussive symptoms ED physicians should encourage patients to limit screen time as much as possible in the first 48 hours after a concussion to promote faster recovery from post-concussive symptoms   References Macnow T, Curran T, Tolliday C, et al. Effect of Screen Time on Recovery From Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2021;175(11):1124-1131.   Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD   The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.  Donate to EMM today!

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-289 Overview: Excessive screen time has been associated with numerous adverse health outcomes. Join us for a look at a fascinating new study that explores how limiting screen time can increase physical activity in children. Listen to this brief podcast before you counsel your next patient on how screen time can affect their children's (and their) health. Episode resource links: Pedersen J,et al. Effects of Limiting Recreational Screen Media Use on Physical Activity and Sleep in Families With Children: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2022 May 23:e221519 Screen Time and Children. American Academy of Child and Adolescent Psychiatry: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx Guest: Alan Ehrlich MD, FAAFP Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-289 Overview: Excessive screen time has been associated with numerous adverse health outcomes. Join us for a look at a fascinating new study that explores how limiting screen time can increase physical activity in children. Listen to this brief podcast before you counsel your next patient on how screen time can affect their children's (and their) health. Episode resource links: Pedersen J,et al. Effects of Limiting Recreational Screen Media Use on Physical Activity and Sleep in Families With Children: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2022 May 23:e221519   Screen Time and Children. American Academy of Child and Adolescent Psychiatry: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx Guest: Alan Ehrlich MD, FAAFP   Music Credit: Richard Onorato