Charting Pediatrics

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States, affecting almost 10 percent of all children. Sometimes referred to as "fatty liver disease," it is actually a range of diseases that all begin when excess fat gets deposited in the liver, most significantly impacting our obese patients. In today's episode we are joined by guest Shikha Sundaram, MD to discuss the clinical presentation and treatment of NAFLD, including how primary care providers can provide critical support to families making significant lifestyle changes as part of their treatment.

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

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

After last week's announcement that Pfizer had applied for their EUA we have heard from a number of you requesting a special podcast episode in preparation for delivering the COVID vaccine to our kids aged 5-11. We have set up something even better for you – vaccine expert and past Charting Pediatrics guest, Dr. Sean O'Leary is going to join Dr. Brumbaugh to host a live COVID Vaccine Town Hall scheduled for Thursday, October 28 at 6PM MST.

Register Here: https://attendee.gotowebinar.com/register/6229170295675128332

This Town Hall will be an interactive session with the latest information about the vaccines, motivational interviewing techniques and other resources to leverage in support of vaccinating this younger pediatric population. We will also have a time for live Q&A from you.

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

If you have any questions you would like specifically addressed on the Town Hall, please email [email protected]

Our leadership panel includes: Lalit Bajaj, MD, Chief Quality Officer David Brumbaugh, MD, Chief Medical Officer Jessica Cataldi, MD, Pediatric Infectious Diseases Sean O'Leary, MD, Pediatric Infectious Diseases Shen Nagel, MD, Pediatrics West, Primary Care Pediatrician in Denver

We look forward to connecting with many of you on October 28 as we prepare to vaccinate our younger pediatric patients and take one step closer to closing out the pandemic.

While the majority of Western culture tends to focus on a child's academic readiness & success, the importance and benefits of play are critical to development. In today's episode, we are joined by our colleagues from Nationwide Children's Hospital to talk about a recent article they published about the important role that individual and group play has in child development.

This episode is part of our Resident Files series where we are pleased to feature the thoughts and work of the talented pediatric residents.

Today's guests are Dr. Gabriella Gonzales, PGY3 at Nationwide Children's Hospital and Dr. Alex Rakowsky, Associate Program Director of the Pediatric Residency Program at Nationwide Children's Hospital and Assistant Professor of Pediatrics at The Ohio State University.

Article cited in this episode: The Importance of Play by Gabriella Gonzales, MD and Alex Rakowsky, MD to be published Fall 2021 in Peds in Review.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

COVID-19 Town Hall for Providers: Join Dr. Brumbaugh and the Children's ID team this Thursday, October 14 at 6P MST to hear the latest information about the impact of the pandemic on pediatrics: https://attendee.gotowebinar.com/register/5597455784941724942

Fitting the unprecedented nature of the last 18 months, Summer 2021 ushered in an unusual, very early respiratory season in pediatrics, causing many of us to pause to consider what the typical Winter respiratory season may hold. Between the rise of the Delta variant, national nursing shortages, contentious mask mandates and the eager anticipation of EUA approval for the COVID vaccine use in kids aged 5-11... we in healthcare find ourselves in a sobering reality. In this episode, we are joined by our pediatric pulmonary colleagues to talk through clinical pearls for determining if patients are presenting with RSV, COVID or some other viral infection.

Heather De Keyser, MD is a faculty member in the Breathing Institute at Children's Colorado and Assistant Professor of Pediatrics and Pulmonary Medicine at the University of Colorado School of Medicine.

Oren Kupfer, MD is the Inpatient Medical Director of the Breathing Institute at Children's Colorado and Associate Professor of Pediatrics and Pulmonary Medicine at the University of Colorado School of Medicine.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

While more than 10% of patients in the U.S. have a penicillin allergy noted in their medical record, many of these patients are not allergic and have either outgrown their allergy or actually experienced viral rash or nonimmunological adverse reactions. In this episode, we will talk through recently published studies that inform efforts to delabel patients who are incorrectly labeled as penicillin allergic.

Our guest for today's episode is Dr. Kirstin Carel. Dr. Carel is part of our Allergy and Immunology Team at Children's Hospital Colorado and is Associate Professor of Pediatric Allergy and Immunology at the University of Colorado School of Medicine.

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

For the last 18 months we have collectively navigated personal and professional challenges related to the pandemic – We have celebrated the achievements of science with the development of the COVID vaccines and we have grieved the compounding impacts to all things "normal" in life, including how we deliver care to our patient families. Today, we face a national shortage of healthcare workers converging with an increased demand for care as a historic early respiratory season and the Delta variant circulate in our communities. In this episode we are joined by Raphe Schwartz and Rhae Gamber to discuss the pediatric healthcare landscape and unique considerations for pediatric providers.

Raphe serves as Chief Strategy Officer at Children's Hospital Colorado and joining us from Sg2 Healthcare Intelligence services, Rhae Gamber, Consulting Director of Women's Health & Pediatric Intelligence.

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

To listen to our last discussion about the impacts of the COVID-19 pandemic on primary care pediatrics and the broader pediatric healthcare delivery system, listen to COVID-19 & the Pediatric Healthcare Landscape with Madeleine McDowell, MD, Karyl Kopaskie, PhD and Raphe Schwartz (S4:E8)

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

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

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

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

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

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

Listen to COVID Vaccine & Kids: Managing Potential Allergic Reactions with Matthew Greenhawt, MD (S4:E38)

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

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

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

References:

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

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

For the more spiritual, or theological minded folks:

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

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

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

And here the link to her book

Join Dr. Brumbaugh, Dr. Dominguez and Dr. Cataldi for our next COVID-19 Virtual Town Hall on Thursday, September 9 at 6PM (MST). Register here: https://attendee.gotowebinar.com/register/1065070942537572367

Access previous Town Hall recordings and other COVID-19 resources for providers by visiting https://www.childrenscolorado.org/covid19

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]

Join Dr. Brumbaugh, Dr. Cataldi and Dr. Dominguez for the next Virtual COVID-19 Town Hall for Pediatric Providers, Thursday, September 9 at 6PM MST. Register here: https://bit.ly/3jcQVDR

COVID-19 is once again dominating concerns for pediatric providers as we prepare for back to school across the U.S.

Between the rise of the Delta variant, national nursing shortages, mask mandates and the eager anticipation of EUA approval for the COVID vaccine use in kids aged 5-11... we in healthcare find ourselves in a sobering reality. In this episode we are joined by Jessica Cataldi, MD and Sam Dominguez, MD, PhD to overview the latest impacts of the pandemic on pediatrics.

Resources:

Masks and development/learning in young kids

Masking in Schools Literature Review

Low secondary transmission in schools when masking in place

Note that the most frequently cited article about masks and children being harmful has been retracted due to concerns of fraud and misrepresentation of methods and findings.

Dr. Cataldi's recipe for marinated cucumber and tomato salad (add dill & feta)

Do you have thoughts about today's episode or suggestions for a future topic? Write to us, [email protected]