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

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

Guests:  

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

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

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

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

Guests:  

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

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

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

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

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

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

Guest: 

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

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

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

Guests: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Guests: 

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

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

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

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

Guest: 

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

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

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

Guest: 

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

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