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Croup is a clinical syndrome of upper airway obstruction defined by barking cough, stridor, and hoarseness. Management hinges on severity assessment, universal corticosteroid use, and selective epinephrine. The key clinical task is distinguishing typical croup from high-risk mimics that require urgent airway intervention. Learning Objectives Differentiate croup from other causes of pediatric upper airway obstruction using key historical and physical exam features. Apply a severity-based approach to croup management, including appropriate use of corticosteroids and nebulized epinephrine. Recognize clinical features that suggest alternative or life-threatening diagnoses requiring escalation of care. References Cooke A, Conway S, Griffin L. Croup: Rapid Evidence Review. Am Fam Physician. 2026;113(3):254-258. Gates A, Johnson DW, Klassen TP. Glucocorticoids for Croup in Children. JAMA Pediatr. 2019;173(6):595-596. doi:10.1001/jamapediatrics.2019.0834 Bjornson CL, Klassen TP, Williamson J, et al. A Randomized Trial of a Single Dose of Oral Dexamethasone for Mild Croup. N Engl J Med. 2004;351(13):1306-1313. doi:10.1056/NEJMoa033534 Bjornson CL, Johnson DW. Croup. Lancet. 2008;371(9609):329-339. doi:10.1016/S0140-6736(08)60170-1 Bjornson C, Russell K, Vandermeer B, Klassen TP, Johnson DW. Nebulized Epinephrine for Croup in Children. Cochrane Database Syst Rev. 2013;(10):CD006619. doi:10.1002/14651858.CD006619.pub3 Transcript This transcript was generated using Descript and subsequently reviewed and lightly edited for spelling, grammar, and clarity. Minor inaccuracies may remain, and the audio recording should be considered the definitive version of this content.  Welcome to PEM Currents: The Pediatric Emergency Medicine Podcast. As always, I'm your host, Brad Sobolewski. And today we're gonna talk about croup. We're gonna focus on diagnosis, severity based management, and how to differentiate it from scarier high risk conditions that may present similarly, but behave very differently. So croup is best understood as a clinical syndrome of upper airway obstruction caused by inflammation at the level of the larynx and subglottis. So in most cases this is viral laryngotracheitis, most commonly due to parainfluenza virus. But as you'd expect multiple viruses can cause it. The subglottis is the narrowest portion of the pediatric airway. So even small amounts of edema create large increases in airway resistance. So that's why the clinical picture is so consistent. You've got inspiratory stridor, hoarseness, and that characteristic barking cough, which either sounds like a seal or a dog, and yes, of course, I know the difference between the two coughs because I was a biology major. This is primarily a disease of children between six months and three years of age with a peak incidence in the second year of life. It's really, really common, like one and a half percent of all ED visits, maybe 350,000 visits a year, and 85% of these kids have mild disease. Hospitalization is rare. The range is variable, about two to 8% of cases, and return visits occur in about three to 5%. Fewer than 1% of children, a lot fewer, require intensive care or airway intervention. Honestly, most kids do really well. The ones who don't can get sick very quickly, and that's been my clinical experience. In the Northern Hemisphere, we see croup throughout the fall and winter, usually starting in around November and sort of tapering off by April. But that being said, I've seen croup-like symptoms every month of the year over the past couple of decades. Croup is absolutely a classic clinical diagnosis. A typical case begins with 12 to 48 hours of viral prodrome, you know, body aches, fever, congestion, cough, followed by often abrupt nighttime onset of barky cough and stridor. Symptoms fluctuate, and they're generally worse with agitation and get better when the kid is calm. That variability is the key feature. So what you'll have is a child who wakes up after sleeping for a few hours with a barky cough and then noisy stridor. This freaks parents out, and this is not hyperbole. There's this little center in the back of your brain that's like, please don't stop breathing and die. So appropriately, they're worried about the kid, they call emergency medical services, they bring them to the emergency department, and by and large, by the time they get there, the stridor has resolved. The kid is calm, and parents will say, I swear he looked a lot worse at home. Trust me, we believe you parents, this is what croup does. When I'm taking a history of croup, I get all of these details. Are there any sick contacts? If the parents are worried about a foreign body inhalation or ingestion, then I'm worried about a foreign body inhalation or ingestion. Listen to the lungs, inspect their airway. Always check the ears for concomitant otitis and I'll feel their trachea. I'll actually grab and hold the trachea and move it. Kids with croup really don't have a painful trachea. Kids with bacterial tracheitis, aside from looking more toxic, actually have a lot of pain when they move their trachea. Testing for croup is generally unnecessary. Labs and viral studies do not change management, and imaging is really reserved for atypical presentations or when you're considering an alternative diagnosis like a foreign body. If you do get an X-ray, what you're looking for is the classic steeple sign on the AP view. It is seen in croup, but it's not 100% sensitive nor specific. Once you've made the diagnosis of croup, it's important to assess severity, and remember that I said that most kids are mild. So mild croup is defined by the absence of stridor at rest. So they may have some stridor when they're upset or even a little bit of hoarseness or noise. It's important to listen to many, many children with croup to get a sense of this. Moderate croup includes stridor at rest with mild to moderate retractions. So at rest means that the child is in a position of comfort. They're calm with a parent, and they've generally been that way for about 10 to 15 minutes. Sometimes that's how long it can take for the stridor to dissipate once you get the kid calm. Severe croup, which is fortunately rare, involves marked work of breathing, agitation, fatigue, need for oxygen, altered mental status, and this aligns with the Westley croup score. It formalizes stridor, retractions, air entry, cyanosis, and mental status. But really, in practice, most of us get very good at bedside assessment of croup. Management of croup starts with corticosteroids. This is one of the highest-yield interventions that we have in pediatric emergency medicine. Every child with croup should receive dexamethasone. Typically 0.6 milligram per kilogram as a single dose up to a maximum of 10 milligrams. Some places will use 0.15 milligram per kilogram. Locally, we often give the IV formulation orally. It's 10 milligrams per mL. Tastes bad, but pairs reasonably well with apple juice. The oral suspension is 1 milligram per mL, tastes terrible, and pairs nicely with being spit on the ground by toddlers. The evidence behind dexamethasone is very robust. The main benefit is that it reduces return visits and hospital readmissions by about half, and those return visits include doctor's offices and emergency departments. In a Cochrane review of 1,679 children, glucocorticoids reduce return visits or readmissions with a risk ratio of 0.52, so that translates to a number needed to treat of seven. I've certainly seen seven or more croup kids during one shift, so for every seven children treated with dexamethasone, one return visit is prevented. Symptom improvement begins within about two hours and lasts at least 24 hours, but maybe up to a couple of days. Hospital length of stay for kids that get steroids is reduced by an average of 15 hours as well. Serious adverse events are rare. It's well tolerated, and other than the taste, kids do fine with it. And importantly, the benefit is consistent across all severities of croup, mild, moderate, and severe. So when you explain this to families who are very scared about their kids, but now their kid is looking better and you're only giving them a single medicine, not doing any tests or X-rays or anything, I think you have to frame the medicine in terms of what it's going to do for them over the next couple of days. So one way of explaining this to families would be to say something like this is a steroid called dexamethasone. It reduces the swelling in your child's airway that's causing the barky cough and noisy breathing. Most children start feeling better within a couple of hours, and the benefit lasts at least a full day, if not longer. Without this medicine, about one in five children need to come back because symptoms get worse again. You really get two bad days with croup in most cases. With this medicine, the risk of returning drops to about one in 10, so it cuts the chance of coming back in half. We can expect your child's cough to start improving over the next day or two. Most children are feeling a lot better within 48 hours, though a little bit of hoarseness and cough can last for a week to about 10 days. So it's possible that when your child goes to sleep later tonight, they may experience that barking cough and noisy breathing again. They're almost certainly going to be upset. The steroid blunts enough of the swelling so that you are much more likely to have them free of distress and stridor, that noisy breathing, once you get them calm. So if they're upset, get them calm, and if in about 10 minutes the stridor and noisy breathing get better, that's the dexamethasone doing its job and you can safely stay home. For children with moderate or severe croup, we're gonna use nebulized racemic epinephrine. It works fast by reducing airway edema by constricting inflamed blood vessels. You'll see improvement in stridor and work of breathing often within 30 minutes. The effect is transient and largely gone by about two hours, and you need to do a structured reassessment at about 30 minutes after the racemic epinephrine. If the child's clearly better, continue that observation for up to two hours. If they're unchanged or worse, repeat the epinephrine and start thinking more carefully about your diagnosis and disposition. Because it's got such a short duration, that two hours after treatment is the most common time period, though some institutions and some children will need to be observed a little bit longer. If they remain well appearing with no stridor at rest, normal oxygenation, minimal work of breathing, and they can tolerate oral fluids, they can be discharged. If symptoms recur, they require repeated epinephrine, or they fail to improve, then you may have to escalate care and consider admission. Honestly, with croup, supportive care is still one of the most important things. You gotta keep kids calm by minimizing agitation. Parents are experts at this with their own children. Agitation worsens airway obstruction. Airway resistance is fourfold greater when the kid's upset. Give oxygen if the kid's hypoxic. Fortunately, this is rare. Antipyretics and fluids are great, do them. Humidified air has not been shown to provide meaningful benefit, and obviously we should avoid sedatives because they can suppress respiratory drive without improving airway patency. Many parents will say that their kid was better when they were exposed to cool air or mist in the shower. Those can help, but honestly, don't stick your kid's head in the freezer if it upsets them. Keep them calm, hold them, and comfort them. Alright, croup, barking cough, stridor, variable symptoms, easy, right? There are some other diagnoses that can mimic this or overlap that you shouldn't miss. Spasmodic croup is a related phenotype. You've got sudden nighttime onset, often minimal prodrome, and recurrent episodes. These kids are typically well between episodes, and the pattern becomes more apparent over time. Some kids will bark with every mild cold or stuffy nose up until about eight or nine, but they usually don't have stridor and respiratory distress. Bacterial tracheitis is progression to a more severe and dangerous airway infection. These children often start with viral symptoms and then rapidly worsen. They've got a high fever, they appear toxic. Most importantly, they fail to respond to standard croup therapy. Toxic appearance plus lack of response should immediately shift your diagnostic reasoning. These kids may have a lot of pain when you grab and move their trachea. The cough can be more junky because again, they've got purulent mucus in their trachea. Epiglottitis is defined by the absence of barking cough and the presence of drooling, dysphagia, and tripod positioning. These children are very anxious, they're very ill, their airway is at risk, and so your immediate priority is keeping them calm and having the airway managed in the safest environment, generally the operating room. Deep neck space infections, including retropharyngeal cellulitis and abscesses and peritonsillar abscesses, present with fever, neck stiffness, sometimes even torticollis, and lymphadenopathy. Kids won't really have a barky cough and the exam localizes to the neck rather than the airway alone. Acute foreign body aspiration presents with sudden onset symptoms, no viral prodrome, no barking cough, and sometimes some asymmetric exam findings. The diagnosis is frequently missed when clinicians anchor too early on croup. If you have an esophageal foreign body, remember that 70% of these get stuck at the thoracic inlet. So always think about a kid who sounded like they had croup and got croup treatments, but also has some swallowing issues and is the right age to put things in their mouth. This is when you see coins and button batteries and other things stuck not in the upper airway, but in the esophagus right behind it. Alright, now when it comes to disposition, most kids with croup are gonna be sent home. Children who improve, they have no stridor at rest, minimal work of breathing, can be discharged home with clear return precautions. Those with persistent symptoms, need for repeated racemic epinephrine, hypoxia, or concerning features should be admitted. For kids who continue to worsen despite standard therapy, escalation includes high-flow nasal cannula, noninvasive ventilation as a bridge. Heliox can be used as a temporizing measure to reduce work of breathing. Fortunately, needing to intubate a child with croup is rare, but when it's needed, it can be challenging due to subglottic narrowing. You need the best proceduralists, and you should downsize your endotracheal tube by 0.5 to 1 millimeter smaller than usual. And I'll reiterate this again. The natural course of croup is really favorable for most kids. The fear's not gonna go away for the parents, this is a scary diagnosis, but I think with some reassurance, we can help them understand that this is something that is unlikely to cause significant problems and will get better. Most kids improve significantly within 48 hours, though like any other respiratory illness, symptoms can persist for a week or so. Severe outcomes are fortunately rare, and they almost always occur in children whose severity or alternative diagnosis was not recognized early. So again, here's my take-home points. Croup is a clinical diagnosis. Severity determines your management. Steroids, dexamethasone, should be given to all patients. Racemic epinephrine is used for moderate to severe disease with mandatory reassessment and observation. And most importantly, always reassess the diagnosis when the presentation does not fit the expected patterns. Things can get rough when you're barking up the wrong tree and thinking it's croup when it's actually something else. Well, I hope you enjoyed this episode on honestly one of the most classic conditions that we see in the pediatric emergency department. If you've got any feedback on the episode, send it my way. As the kids would say, like, rate, and review. I would love it if you left a review on your favorite podcast site. It helps more people find the show. I do this as a labor of love because I enjoy teaching, and I think that this is a wonderful way to reach my colleagues and learners. If you've got suggestions on other topics or episodes, I'd love to hear them. For PEM Currents: The Pediatric Emergency Medicine Podcast, this has been Brad Sobolewski. See you next time.

In this Complex Care Journal Club podcast episode, Drs. Ryan Coller, Jay Berry, Allysa Ware, and Ms. Dania Champion describe the Systems and Policy Research Network (SPRNetwork), a multi-site research collaborative focused on children with special healthcare needs. They discuss the network's core research areas — child quality of life, family well-being, and family engagement — as well as recent work leveraging national Medicaid and hospitalization data to inform federal policy. They also highlight the network's Early Investigator Program, its lived experience partner advisory model, and pathways for researchers and families to get involved at SPRnetwork.org. SPEAKERS Ryan Coller, MD, MPH Co-Director, SPRNetwork Associate Professor, Chief, Division of Hospital Medicine & Complex Care, University of Wisconsin School of Medicine and Public Health, UW Health American Family Children's Hospital Jay Berry, MD, MPH Executive Director, SPRNetwork Co-Director of the Children's Hospital Association Health Services Research Academy Chief of Complex Care in the Division of General Pediatrics, Department of Pediatrics and Department of Plastic and Oral Surgery, Boston Children's Hospital Associate Professor of Pediatrics, Harvard Medical School‌ Allysa Ware, PhD, MSW Co-Director, SPRNetwork Executive Director, Family Voices Dania Champion, MS, BS Network Manager, SPRNetwork University of Wisconsin School of Medicine and Public Health HOST Kristina Malik, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine Medical Director, KidStreet Pediatrician, Special Care Clinic, Children's Hospital Colorado DATE Initial publication date: April 13, 2026. JOURNAL CLUB ARTICLE Systems & Policy Research Network. Research. Accessed March 18, 2026. https://sprnetwork.org/research/ OTHER ARTICLES REFERENCED Berry JG, Williams DJ, Wright SM, Sanders LM, Agarwal D, Foster C, Vasquez J, Perrin JM, Lomangino S, Hall M. US Pediatric Hospitalizations Among Children Enrolled in Medicaid. JAMA Pediatr. 2026 Jan 1;180(1):101-103. doi: 10.1001/jamapediatrics.2025.4537. PMID: 41247751; PMCID: PMC12624467. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/wgbphpxjfcg8npb66hc7jj7/Final_CCJCP_april_transcript_4-9-26‌ Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. 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 thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Coller R, Berry J, Ware A, Champion D, Malik K. Network Effects: Multi-Site Research for Children with Medical Complexity. 04/2026. OPENPediatrics. Online Podcast.

In this episode of "PICU Doc on Call," Drs. Monica Gray, Pradip Kamat, and Rahul Damania discuss the use of intranasal medications in pediatric intensive care. Using the case of a four-month-old infant needing an MRI, they explore when and why intranasal drugs are preferred over IV access, the science behind nasal drug delivery, safe administration techniques, and common medications used. The episode highlights the benefits of intranasal sedation—such as rapid onset and needle-free delivery—while emphasizing teamwork and careful monitoring for safe, effective pediatric care.Show Highlights:Use of intranasal medications in pediatric intensive care settingsCase study of a four-month-old infant requiring sedation for an MRI.Advantages of intranasal delivery over IV accessPharmacokinetics and neuroanatomy related to intranasal drug absorptionTechniques for safe and effective administration of intranasal medicationsComparison of intranasal dosing to oral and IV routesCommon intranasal medications used in the pediatric ICUImportance of timing and monitoring during sedation proceduresTeamwork and communication in administering intranasal medicationsClinical applications and implications for patient comfort and care deliveryReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter ***.Reference 1: Tsze DS, Woodward HA, McLaren SH, Leu CS, Venn AMR, Hu NY, Flores-Sanchez PL, Stefan BR, Shen ST, Ekladios MJ, Cravero JP, Dayan PS. Optimal Dose of Intranasal Midazolam for Procedural Sedation in Children: A Randomized Clinical Trial. JAMA Pediatr. 2025 Sep 1;179(9):979-986. doi: 10.1001/jamapediatrics. 2025.2181.Reference 2: Prescott MG, Iakovleva E, Simpson MR, Pedersen SA, Munblit D, Vallersnes OM, Austad B. Intranasal analgesia for acute moderate to severe pain in children - a systematic review and meta-analysis. BMC Pediatr. 2023 Aug 18;23(1):405. doi: 10.1186/s12887-023-04203-x.Reference 3: Chabowski L, Mahboobi Z, Navolokina A. Intranasal ketamine for procedural sedation in children. Am J Emerg Med. 2023 Jun;68:195. doi: 10.1016/j.ajem.2023.04.013.Reference 4: Sulton C, Kamat P, Mallory M, Reynolds J. The Use of Intranasal Dexmedetomidine and Midazolam for Sedated Magnetic Resonance Imaging in Children: A Report From the Pediatric Sedation Research Consortium. Pediatr Emerg Care. 2020 Mar;36(3):138-142. doi: 10.1097/PEC.0000000000001199.

Send a textIn this Journal Club episode, Ben and Daphna review the highly anticipated TREOCAPA trial results exploring the prophylactic use of acetaminophen for PDA closure in extremely preterm infants. They break down the study's tailored dosing regimens, safety outcomes like cholestasis, and discuss why achieving a higher rate of early ductal closure didn't necessarily translate to improved survival without severe morbidity. Plus, they share a nod to recent Neo Conference interviews and the realities of conducting clinical research in private practice. Tune in for a nuanced discussion on individualizing PDA management in the NICU!----Prophylactic Treatment of Patent Ductus Arteriosus With Acetaminophen: A Randomized Clinical Trial. Rozé JC, Cambonie G, Flamant C, Patkaï J, Mühlbacher T, Gascoin G, Rideau Batista Novais A, Tauzin M, Le Duc K, Beuchée A, Joye S, Babacheva E, Bouissou A, Ligi I, Tammela O, Plourde M, Dempsey E, Tosello B, Nguyen K, Vincent M, Andresson P, Binder C, Kruse C, Barcos Munoz F, Kuhn P, Proença E, Bartocci M, Kermorvant-Duchemin E, Nellis G, Lumia M, Giapros V, Rigo V, Sankilampi U, Mendes da Graça A, Rønnestad A, Soukka H, Mondì V, Aikio O, Torre-Monmany N, Rüegger C, Baud O, Zeitlin J, Morgan AS, Baruteau AE, Ancel PY, Carbajal R, Bouazza N, Diallo A, Levoyer L, Kemper R, Hallman M, Alberti C, Ursino M; TREOCAPA Study Group.JAMA Pediatr. 2026 Feb 16:e256150. doi: 10.1001/jamapediatrics.2025.6150. Online ahead of print.PMID: 41697673Support 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!

This episode of EM Pulse dives into one of the most stressful scenarios in the ED: the febrile infant in the first month of life. Traditionally, a fever in this age group has meant an automatic “full septic workup,” including the dreaded lumbar puncture (LP). But times are changing. We sit down with experts Dr. Nate Kuppermann and Dr. Brett Burstein to discuss a landmark JAMA study that suggests we might finally be able to safely skip the LP in many of our tiniest patients. The Study: A Game Changer for Neonates Our discussion centers on a massive international pooled study evaluating the PECARN Febrile Infant Rule specifically in infants aged 0–28 days. While previous guidelines were conservative due to a lack of data for this specific age bracket, this study provides the evidence we've been waiting for. The Cohort: A large pool of infants across multiple countries. The Findings: The PECARN rule demonstrated an exceptionally high negative predictive value for invasive bacterial infections. The Big Win: The rule missed zero cases of bacterial meningitis. Defining the Danger: SBI vs. IBI The experts break down why we are shifting our terminology and our clinical focus. Serious Bacterial Infection (SBI)  Historically, this was a “catch-all” term including Urinary Tract Infections (UTIs), bacteremia, and meningitis. However, UTIs are generally more common, easily identified via urinalysis, and typically less life-threatening than the other two. Invasive Bacterial Infection (IBI)  This term refers specifically to bacteremia and bacterial meningitis. These are the “high-stakes” infections the PECARN rule is designed to rule out. Dr. Kuppermann notes that we should ideally view bacteremia and meningitis as distinct entities, as the clinical implications of a missed meningitis case are far more severe. The HSV Elephant in the Room One of the primary reasons clinicians hesitate to skip an LP in a neonate is the fear of missing Herpes Simplex Virus (HSV) infection. Low Baseline Risk: While the overall risk of HSV in a febrile infant is low, the risk of “isolated” HSV (meningitis without other signs or symptoms) is even rarer. Screening Tools: Most infants with HSV appear clinically ill. Clinicians can also use ALT (liver function) testing as a secondary screen – transaminase elevation is a common marker for systemic HSV. Clinical Judgment: If the baby is well-appearing, has no maternal history of HSV, no vesicles, and no seizures, the risk of missing HSV by skipping the LP is exceptionally low. Practical Application: Shared Decision-Making This isn’t just about the numbers—it’s about the parents. “Families don’t mind their babies being admitted… They do not want the lumbar puncture. It is the single most anxiety-provoking aspect of care.” — Dr. Brett Burstein The PECARN “Low-Risk” Criteria:  (Remember, this rule applies only to infants who are not ill-appearing.) Urinalysis: Negative Absolute Neutrophil Count (ANC): ≤ 4,000/mm³ Procalcitonin (PCT): ≤ 0.5 ng/mL The Bottom Line: If an infant is well-appearing and meets these criteria, physicians can have a nuanced conversation with parents about the risks and benefits of forgoing the LP, while still admitting the child for observation (often without empiric antibiotics) while cultures brew. Key Takeaways The “Well-Appearing” Filter: If an infant looks ill, the rule does not apply. These patients require a full workup, including an LP, regardless of lab results. Meticulous Physical Exam: Assess for a strong suck, normal muscle tone, brisk capillary refill, and any rashes or vesicles. History is Key: Always ask about maternal GBS/HSV status, pregnancy or birth complications, prematurity, sick contacts, and any changes in feeding, stooling or activity. Procalcitonin: PCT is the superior inflammatory marker for this rule. If your facility only offers traditional markers like CRP, the PECARN negative predictive value cannot be strictly applied. In the words of Dr. Kuppermann: “If you don’t have it, for God’s sakes, just get it! ALT to Screen for HSV: While not part of the official PECARN rule, our experts suggest that significantly elevated liver enzymes should raise suspicion for systemic HSV. Observe, Don’t Discharge: Being “low risk” does not mean the infant goes home. All infants ≤ 28 days still require admission for 24-hour observation and blood/urine cultures. We want to hear from you! Does this change how you approach febrile neonates in the ED? How do you handle shared decision-making with parents? Connect with us on social media @empulsepodcast or on our website 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. Brett Burstein, Clinician-Scientist and Pediatric Emergency Medicine Physician at Montreal Children’s Hospital, McGill University Resources: Burstein B, Waterfield T, Umana E, Xie J, Kuppermann N. Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. 2026 Feb 3;335(5):425-433. doi: 10.1001/jama.2025.21454. PMID: 41359314; PMCID: PMC12687207“Hot” Off the Press: Infant Fever Rule “Hot” Off the Press: Infant Fever Rule Do I really need to LP a febrile infant with a UTI? PECARN Infant Fever Update: 61-90 Days 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.  

In this episode of "PICU Doc On Call," Drs. Pradip Kamat and Rahul Damania discuss the acute management of a 14-year-old boy with severe rectal bleeding and hypertension, ultimately diagnosed with inflammatory bowel disease (IBD). They review the approach to pediatric lower GI bleeding, diagnostic workup, and imaging, emphasizing early recognition and resuscitation. They outline IBD management, including steroids, biologics such as infliximab, and nutritional support, while highlighting the importance of screening for infections before immunosuppression. The episode provides practical insights for PICU physicians on handling acute GI emergencies in children.Show Nighlights: Clinical case of a 14-year-old male with hypertension and rectal bleeding.Diagnosis of inflammatory bowel disease (IBD) following significant blood loss.Approach to pediatric rectal bleeding and its implications.Diagnostic workup including laboratory tests and imaging modalities.Management strategies for IBD in acute pediatric care.Importance of early recognition and resuscitation in cases of shock.Physiological principles related to blood loss and shock in children.Differential diagnoses for lower gastrointestinal bleeding in pediatrics.Initial evaluation and stabilization protocols for pediatric patients.Nutritional support and multidisciplinary care in managing IBD. References:Romano C, Oliva S, Martellossi S, et al. Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol. 2017;23(8):1326-1337.Pai AK, Fox VL. Gastrointestinal bleeding and management. Pediatr Clin North Am. 2017;64(3):543-561.Padilla BE, Moses W. Lower gastrointestinal bleeding and intussusception. Surg Clin North Am. 2017;97(1):63-80.Kaur M, Dalal RL, Shaffer S, Schwartz DA, Rubin DT. Inpatient management of inflammatory bowel disease-related complications. Clin Gastroenterol Hepatol. 2020;18(11):2417-2428.Ashton JJ, Ennis S, Beattie RM. Early-onset paediatric inflammatory bowel disease. Lancet Child Adolesc Health. 2017;1(2):147-158.Bouhuys M, Lexmond WS, van Rheenen PF. Pediatric inflammatory bowel disease. Pediatrics. 2022;150(6):e2022059341.Rosen MJ, Dhawan A, Saeed SA. Inflammatory bowel disease in children and adolescents. JAMA Pediatr. 2015;169(11):1053-1060.Conrad MA, Rosh JR. Pediatric Inflammatory Bowel Disease. Pediatr Clin North Am. 2017 Jun;64(3):577-591.

Los artículos que se tratan en el episodio de hoy están listados aquí: The neonatal SOFA score in very preterm neonates with early-onset sepsis. Tagerman M, Sahni R, Polin R. Pediatr Res. 2025 Oct 9. doi: 10.1038/s41390-025-04068-z. Online ahead of print.PMID: 41068313Systemic Postnatal Corticosteroids, Bronchopulmonary Dysplasia, and Survival Free of Cerebral Palsy. Doyle LW, Mainzer R, Cheong JLY. JAMA Pediatr. 2025 Jan 1;179(1):65-72.doi: 10.1001/jamapediatrics.2024.4575.PMID: 39556404 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: @laincubadorapodcastCreado 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. 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

Wenn Zarah früher stundenlang auf Social Media unterwegs war, ging es ihr danach häufig schlecht. Welchen Einfluss endless Scrolling auf unser Gehirn hat und ob es das sogar verändern kann, erklären zwei Experten. (Wiederholung vom 13.10.2025)**********Ihr hört: Gesprächspartnerin: Zarah, hatte früher eine Bildschirmzeit von sechs Stunden täglich und versucht, sie zu reduzieren. Gesprächspartner: Lars Kellert, Professor für Neurologie, Klinikum Großhadern Gesprächspartner: Christian Montag, Psychologe und Neurowissenschaftler, University of Macau Autor und Host: Przemek Żuk Redaktion: Ivy Nortey, Anne Bohlmann, Yevgeniya Shcherbakova, Celine Wegert Produktion: Oskar Kühl**********Quellen:Karim F., Oyewande A.A., Abdalla L.F., et al. (2020). Social Media Use and Its Connection to Mental Health: A Systematic Review. Cureus 12(6): e8627. doi:10.7759/cureus.8627.Maza M.T., Fox K.A., Kwon S., et al. (2023). Association of Habitual Checking Behaviors on Social Media With Longitudinal Functional Brain Development. JAMA Pediatr.;177(2):S. 160–167. doi:10.1001/jamapediatrics.2022.4924.Skowronek, J., Seifert, A. & Lindberg, S. (2023). The mere presence of a smartphone reduces basal attentional performance. Sci Rep 13, 9363 (2023).Brailovskaia, J., Becherer, I., Wicker, V., et al. (2023). Less social media use – more satisfied, work-engaged and mentally healthy employees: an experimental intervention study. Behaviour & Information Technology, 43(15), 3737–3749. Brailovskaia, J., Siegel, J., Precht, L.-M. et al. (2024). Less Smartphone and More Physical Activity for a Better Work Satisfaction, Motivation, Work-Life Balance, and Mental Health: An Experimental Intervention Study, in: Acta Psychologica,Alle Quellen findet ihr hier.**********Mehr zum Thema bei Deutschlandfunk Nova:Mental Health und Social Media: Das Geschäft mit unserer PsycheAnti-Digital-Detox: Wie uns Social Media, Serien und Filme entspannen  Social Media und Depressionen: Nix wie raus!**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .**********Meldet euch!Ihr könnt das Team von Facts & Feelings über Whatsapp erreichen.Uns interessiert: Was beschäftigt euch? Habt ihr ein Thema, über das wir unbedingt in der Sendung und im Podcast sprechen sollen?Schickt uns eine Sprachnachricht oder schreibt uns per 0160-91360852 oder an factsundfeelings@deutschlandradio.de.Wichtig: Wenn ihr diese Nummer speichert und uns eine Nachricht schickt, akzeptiert ihr unsere Regeln zum Datenschutz und bei Whatsapp die Datenschutzrichtlinien von Whatsapp.

Overview: In this episode, Dr Melissa Jones and Dr Christian Ramers discuss the importance of pan-viral screening for HIV and hepatitis. They emphasize the need for integrated testing and prevention strategies and the current barriers to implementation. The views expressed are those of the panelist(s) and not necessarily Gilead Sciences, Inc. The information provided in this podcast is not intended to be and should not be understood to provide medical advice. Listeners should note that our discussions in this episode are relevant to the USA only and may not be appropriate for other regions. This episode was recorded in August 2025 and the content reflects the information available at that time. Guest: Christian B Ramers, MD, MPH, FIDSA, AAHIVS; Melissa Jones, DNP, APRN-BC   For more information, please visit: https://www.pri-med.com/clinical-resources/curriculum/hiv-in-focus  References AASLD/IDSA. HCV guidance: recommendations for testing, managing, and treating hepatitis C. 2025. Available from: https://www.hcvguidelines.org/ (Accessed June 10, 2025). Arora DR et al. ISRN AIDS 2013;2013:287269 Alter MJ. J Hepatol 2006;44:S6–9. Bazargan M, Cobb BMS, Assari S. Ann Fam Med 2021;19:4–15. Beard N, Hill A. Open Forum Infect Dis 2024;11:ofad666. Bottero J, Boyd A, Gozlan J et al. Open Forum Infect Dis 2015;2:ofv162. Brunetto, Maurizia Rossana et al. J Hepatol 2023;79:433–60. Calabrese SK, Krakower DS, Mayer KH. Am J Public Health 2017;107:1883–89. CDC. Status neutral HIV care and service delivery eliminating stigma and reducing health disparities. 2022. Available from: https://stacks.cdc.gov/view/cdc/129024 (Accessed June 10, 2025). CDC. Clinical guidance for PrEP. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/prep/index.html (Accessed June 10, 2025). CDC. Clinical screening and diagnosis for hepatitis C. 2025. Available from: https://www.cdc.gov/hepatitis-c/hcp/diagnosis-testing (Accessed June 10, 2025). CDC. Clinical testing and diagnosis for hepatitis B. 2025. Available from: https://www.cdc.gov/hepatitis-b/hcp/diagnosis-testing/  (Accessed June 10, 2025). CDC. Clinical testing guidance for HIV. 2025. Available from: https://www.cdc.gov/hivnexus/hcp/diagnosis-testing/index.html (Accessed June 10, 2025). CDC. Getting tested for HIV. 2025. Available from: https://www.cdc.gov/hiv/testing/ (Accessed June 10, 2025). CDC. Hepatitis A vaccine. 2025. Available from: https://www.cdc.gov/hepatitis-a/vaccination/index.html (Accessed June 10, 2025). CDC. Hepatitis B vaccine. 2025. Available from: https://www.cdc.gov/hepatitis-b/vaccination/index.html (Accessed June 10, 2025). CDC. HIV infection among heterosexuals at increased risk--United States, 2010. MMWR Morb Mortal Wkly Rep 2013;62:183-8. CDC. Viral hepatitis among people with HIV. 2025. Available from: https://www.cdc.gov/hepatitis/hcp/populations-settings/hiv.html (Accessed June 10, 2025. Clinical info HIV.gov. Considerations for Antiretroviral Use in People With Coinfections, Hepatitis B Virus/HIV Coinfection. 2024. Available from: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/hepatitis-b-virus-hiv-coinfection (Accessed July 21, 2025). Cornberg M, Sandmann L, Jaroszewicz J et al. J Hepatol 2025; doi: 10.1016/j.jhep.2025.03.018. Coukan F, Murray KK, Papageorgiou V et al. HIV Med 2023;24:893–913. DHHS. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. 2024. Available from: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf (Accessed June 25, 2025). GHTF. Breaking the silence: combating stigma and misinformation in the fight against hepatitis. 2024. Available from: https://www.globalhep.org/news-blogs/breaking-silence-combating-stigma-and-misinformation-fight-against-hepatitis (Accessed June 10, 2025) Grieb SM, Harris R, Rosecrans A et al. Ann Med 2022;54:138–49. HIV.gov. US statistics. 2025. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics (Accessed June 10, 2025). Kitt H et al. HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2024 report. 2024. Available from https://www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2024-report (Accessed June 10, 2025) Mayer KH, Agwu A, Malebranche D. Adv Ther 2020;37:1778–811. Mohareb AM, Larmarange J, Kim AY et al. Lancet HIV 2022;9:e585–e94. Moorman AC, Bixler D, Teshale EH et al. Public Health Rep 2023; doi: 10.1177/00333549231181348 Orkin, C. Open Forum Infect Dis 2024;11:ofad668. Post Z et al. Clin Liver Dis 2023;27:973-84 Saleska JL, Lee SJ. JAMA Pediatr 2020;174:1133–34. Symum H, Van Handel M, Sandul A et al. Prev Med Rep 2024;44:102777. UNAIDS. Global HIV & AIDS statistics — Fact sheet. 2025. Available from: https://www.unaids.org/en/resources/fact-sheet (Accessed July 18, 2025). UNM. Project ECHO. 2025. Available from: https://projectecho.unm.edu/ (Accessed June 10, 2025). Wejnert C et al. MMWR Morb Mortal Wkly Rep. 2016;65:1336–1342 WHO. Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations (Geneva). 2022. Available from: https://www.who.int/publications/i/item/9789240052390 (Accessed June 10, 2025). WHO. Fact sheet: hepatitis A. 2025. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-a (Accessed June 10, 2025). WHO. Fact sheet: hepatitis B. 2025. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-b (Accessed July 18, 2025). WHO. Fact sheet: hepatitis D. 2025. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-d (Accessed June 10, 2025). WHO. Guidelines on HIV self-testing and partner notification: a supplement to the consolidated guidelines on HIV testing services. 2016. Available from: https://iris.who.int/handle/10665/251655 (Accessed June 10, 2025). WHO. Recommendations and guidance on hepatitis C virus self-testing. 2021. Available from: https://www.who.int/publications/i/item/9789240031128 (Accessed June 10, 2025). Xiao Y et al. Cells. 2020;9:2233

Reference:  Boutin A, et al. Removable Boot vs Casting of Toddler's Fractures: A Randomized Clinical Trial. JAMA Pediatr. Published April 2025. Date: July 23, 2025 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. He is the co-founder and website lead of Don't Forget the […] The post SGEM#490: These (Removable) Boots are Made for Walking first appeared on The Skeptics Guide to Emergency Medicine.

BRUE, Brief Resolved Unexplained Events, are a common and anxiety-provoking condition that presents to the Emergency Department. In this episode we explore the definition of BRUE, contrast it with ALTE, and walk through evidence-based approaches to risk stratification. We'll explore the original AAP framework and two subsequent prediction models to see where the recommendations stand today. This is a classic example of scary event / well child that you will see in the Emergency Department. Learning Objectives By the end of this episode, you will be able to: Define BRUE and contrast it with the older concept of ALTE. Recognize evolving risk stratification criteria Apply evidence-based strategies for evaluation and counseling of infants with BRUE, including safe discharge decisions and the role of home monitoring. References Tieder JS, Bonkowsky JL, Etzel RA, et al. Brief resolved unexplained events (formerly apparent life-threatening events) and evaluation of lower-risk infants: Executive summary. Pediatrics. 2016;137(5):e20160591. doi:10.1542/peds.2016-0591 Carroll AE, Bonkowsky JL. Acute events in infancy including brief resolved unexplained event (BRUE). In: McMillan JA, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed October 2025). Carroll AE, Bonkowsky JL. Use of home cardiorespiratory monitors in infants. In: McMillan JA, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed October 2025). Carroll AE, Bonkowsky JL. Sudden infant death syndrome: Risk factors and risk reduction strategies. In: McMillan JA, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed October 2025). Carroll AE. Patient education: Brief resolved unexplained event (BRUE) in babies (The Basics). In: UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Accessed October 2025). Nama N, Neuman MI, Finkel MA, et al. Risk prediction after a brief resolved unexplained event. JAMA Pediatr. 2023;177(12):1263–1272. doi:10.1001/jamapediatrics.2023.4197 Nama N, Neuman MI, Finkel MA, et al. External validation of brief resolved unexplained events prediction rules for serious underlying diagnosis. JAMA Pediatr. 2024;178(4):398–407. doi:10.1001/jamapediatrics.2024.0114    

Wenn Zarah früher stundenlang auf Social Media unterwegs war, ging es ihr danach häufig schlecht. Die Reizüberflutung war zu viel. Welchen Einfluss endless Scrolling auf unser Gehirn hat und ob es das sogar verändern kann, erklären zwei Experten.**********Ihr hört: Gesprächspartnerin: Zarah, hatte früher täglich mehr als 6 Stunden Bildschirmzeit und versucht das zu reduzieren Gesprächspartner: Lars Kellert, Professor für Neurologie, Klinikum Großhadern Gesprächspartner: Christian Montag, Psychologe und Neurowissenschaftler, University of Macau Autor und Host: Przemek Żuk Redaktion: Ivy Nortey, Anne Bohlmann, Yevgeniya Shcherbakova, Celine Wegert Produktion: Oskar Kühl**********Quellen:Karim F., Oyewande A.A., Abdalla L.F., et al. (2020). Social Media Use and Its Connection to Mental Health: A Systematic Review. Cureus 12(6): e8627. doi:10.7759/cureus.8627.Maza M.T., Fox K.A., Kwon S., et al. (2023). Association of Habitual Checking Behaviors on Social Media With Longitudinal Functional Brain Development. JAMA Pediatr.;177(2):S. 160–167. doi:10.1001/jamapediatrics.2022.4924.Skowronek, J., Seifert, A. & Lindberg, S. (2023). The mere presence of a smartphone reduces basal attentional performance. Sci Rep 13, 9363 (2023).Brailovskaia, J., Becherer, I., Wicker, V., et al. (2023). Less social media use – more satisfied, work-engaged and mentally healthy employees: an experimental intervention study. Behaviour & Information Technology, 43(15), 3737–3749. Brailovskaia, J., Siegel, J., Precht, L.-M. et al. (2024). Less Smartphone and More Physical Activity for a Better Work Satisfaction, Motivation, Work-Life Balance, and Mental Health: An Experimental Intervention Study, in: Acta Psychologica,Alle Quellen findet ihr hier.**********Mehr zum Thema bei Deutschlandfunk Nova:Mental Health und Social Media: Das Geschäft mit unserer PsycheAnti-Digital-Detox: Wie uns Social Media, Serien und Filme entspannen  Social Media und Depressionen: Nix wie raus!**********Den Artikel zum Stück findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .**********Meldet euch!Ihr könnt das Team von Facts & Feelings über Whatsapp erreichen.Uns interessiert: Was beschäftigt euch? Habt ihr ein Thema, über das wir unbedingt in der Sendung und im Podcast sprechen sollen?Schickt uns eine Sprachnachricht oder schreibt uns per 0160-91360852 oder an factsundfeelings@deutschlandradio.de.Wichtig: Wenn ihr diese Nummer speichert und uns eine Nachricht schickt, akzeptiert ihr unsere Regeln zum Datenschutz und bei Whatsapp die Datenschutzrichtlinien von Whatsapp.

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!

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!

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!

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 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)

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)

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.