With Super Bowl season upon us we wanted to use the occasion to examine a common sports injury seen in our pediatric patient population – ACL injury and treatment.

An ACL tear was once an injury exclusive to professional or elite athletes, but the growing prevalence of specialization and year-around training in youth sports has contributed to a large rise in ACL tears in pediatric patients. In this episode, Jay Albright, MD joins us as we will look at the ACL tear case of a 16 year-old-female to highlight the diagnosis, treatment and recovery for these patients.

Dr. Albright is the Surgical Director of the Sports Medicine Center at Children's Hospital Colorado and Assistant Professor of Orthopedics at the University of Colorado School of Medicine.

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Last season on the podcast we discussed the initial diagnosis and lifestyle management of hypertension in pediatric patients. If you have not had the opportunity to listen to that episode, go back and check out Season 2, Episode 36 as it will set the back drop for today's discussion as we dive more specifically into medication management for pediatric hypertension patients.

In this episode we discuss medication management for pediatric hypertension patients with a pediatric cardiologist, Steve Daniels, MD, PhD and a clinical pharmacist, Dr. Megan Greene.

Dr. Greene is a pediatric clinical pharmacist at Children's Hospital Colorado with a specialization in critical care and kidney and liver transplant pharmaceutical support, and also works in our pediatric hypertension clinic.

Dr. Daniels is the Pediatrician-in-Chief at Children's Hospital Colorado and L. Joseph Butterfield Chair of Pediatrics within the University of Colorado School of Medicine, where he is a professor of pediatrics and epidemiology. He is a cardiologist by training and a sought-out expert in the fields of pediatric hypertension, dyslipidemia, and pediatric nutrition.

If you have feedback or questions about today's episode or suggestions for a future topic, write to us at [email protected]

In this episode we discuss the history of vaccines and religion with Josh Williams, MD. For a discussion about today's anti-vaccination climate, listen to S3:E17, Peter Hotez, MD, PhD: Physician-Scientist, Pediatrician, Advocate.

Dr. Williams is a Pediatrician at Denver Health Medical Center and an Assistant Professor of Pediatrics 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]

Is social media good or bad? How much or how little screen time should kids and adolescents have each day? What is the impact of screen time? What kind of digital footprint or reputation are parents creating for their children?

These questions and more are covered with our guests Jenny Radesky, MD and Michael Rich, MD who discuss social media and its impact on patients and families.

Dr. Radesky is a Developmental/Behavioral Pediatrician whose research focuses on family digital media use, child social/emotional development, and parent-child interaction.

Dr. Rich is the Director of the Center on Media and Child Health at Boston Children's Hospital. He has developed media-based research methodologies and authored numerous papers and AAP policy statements, testified to the United States Congress, and makes regular national press appearances.

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

On behalf of the Charting Pediatrics team, we would like to wish you Happy Holidays and a very Happy New Year! 2019 has been a year of explosive growth for the podcast. We went from averaging 8,000 monthly downloads in January to more than 33,000 monthly downloads last month. Thank you to each one of you for listening and sharing the podcast with your colleagues. Connecting with some of you in person at the 2019 AAP Conference was really a highlight for us. We appreciate you coming by the booth and we love reading the emails and tweets that you send our way. We will be taking the next couple of weeks off from releasing new episodes and will look forward to kicking off our first episode of 2020 on Tuesday, January 7th. Happy Holidays!

On behalf of the Charting Pediatrics team, we would like to wish you Happy Holidays and a very Happy New Year! 2019 has been a year of explosive growth for the podcast. We went from averaging 8,000 monthly downloads in January to more than 33,000 monthly downloads last month. Thank you to each one of you for listening and sharing the podcast with your colleagues. Connecting with some of you in person at the 2019 AAP Conference was really a highlight for us. We appreciate you coming by the booth and we love reading the emails and tweets that you send our way. We will be taking the next couple of weeks off from releasing new episodes and will look forward to kicking off our first episode of 2020 on Tuesday, January 7th. Happy Holidays!

In this episode we are fortunate to be talking with Bernard Dreyer, MD from the New York University School of Medicine discussing school and health care provider partnerships that have been successful in addressing effects of childhood poverty.

Dr. Dreyer is past president of the American Academy of Pediatrics (AAP) having served as the 2016 AAP president.

Dr. Dreyer is a general and development-behavioral pediatrician who has spent his professional lifetime serving poor children and families. He is Professor of Pediatrics at NYU where he leads the Division of Developmental-Behavioral Pediatrics and is Director of Pediatrics at Bellevue Hospital; he also works as a hospitalist.

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

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

In this episode we have the pleasure to talking with Adiaha Spinks-Franklin, MD from Texas Children's Hospital about strategies to help sleepless teens.

Dr. Spikes-Franklin is Associate Professor of Pediatrics at Texas Children's Hospital and the Baylor College of Medicine in Houston.

Dr. Spinks-Franklin's research interests are in the areas of the cultural aspect of child development. Her previous research experience included studying the development of children in Senegal, West Africa, and studying the mental health impact of the aftermath of Hurricane Katrina on school-aged African American children in Houston. Other research experiences including exploring the racial identity development of school-aged African American and Latino children in the Houston area who are participating in a reading intervention program. She has also studied healthcare disparities among children with Autism Spectrum Disorders. She is currently studying the effect of Adverse Childhood Experience (ACEs) among children and adolescents with developmental disabilities.

This episode was recorded live from the 2019 AAP NCE in New Orleans, Louisiana.

Topics Discussed in this Episode:

• Common presentations that primary care providers will see in adolescents with sleep issues.
• The importance of the patient's history in determining the causes of symptoms.
• The various factors, including the homeostatic and circadian drive, in regulating sleep.
• The difference between REM and non-REM sleep and the physiological processes of each.
• How sleep changes from childhood to adolescence.
• Considering both the genetic and environmental components of sleep disorders.
• How social media activity negatively impacts natural sleep rhythms.
• What parents can do to mitigate some of the environmental hindrances such as electronics.
• Maintaining a teen's circadian rhythm by not allowing them to sleep in over weekends.
• Examples of breathing techniques to help calm down hyperactive or anxious kids.
• The benefits of gratitude journaling and general journaling before bed.
• Night sports and adrenaline: encouraging parents to prioritize their children's needs.
• What families' dinner- and bedtime routines reveal about a household.
• Thoughts on medicating sleep disorders and how melatonin should be approached.

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

Substance use among adolescents is pervasive and commonly encountered in primary care pediatrics. According to the most recent Monitoring the Future Study published in 2018, opioid misuse among teens and marijuana use remains stable while vaping device use is climbing to record numbers. The general approach to the assessment and treatment of adolescents with substance use disorders is similar in some respects to adults; however, developmental considerations require an approach tailored to the cognitive, social, and legal status of adolescents.

In this episode we discuss the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of substance use and substance use disorder in adolescents with Christian Thurstone, MD.

Dr. Thurstone is the Director of Behavioral and Health Sciences at Denver Health and Professor of Psychiatry at the University of Colorado Denver.

Discussed in this episode:

• HEADSS Screening Tool
• Motivational Interviewing
• Apply for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000) - Office-based treatment for opioid use in patients aged 16 years and above
• How to diffuse tense family situations in the office
  • Show empathy
  • Slow the conversation down
  • Maintain confidentiality
  • Meet with teens and parents separately
  • EPE - Elicit Permission; Provide Advice; Elicit Feedback "What do you think about what I just said?"
• Another good question to ask teens, "What do you already know about....."

Have feedback about today's episode or suggestions for a future topic? Write to us, [email protected]

Each year thousands of babies born neonatal abstinence syndrome and require specialized medical and psycho-social support. In this episode we discuss the care for newborns who have been exposed to substances, specifically how primary care providers can understand the child's needs and support their caregivers. We are joined by Stephen Patrick, MD from the Vanderbilt University School of Medicine and recorded this discussion live from the 2019 American Academy of Pediatrics NCE in New Orleans.

Dr. Patrick is a neonatologist and associate professor of pediatrics and is Director at the Vanderbilt Center for Child Health Policy. You can view Dr. Patrick's 2019 AAP NCE plenary session on this topic here.

You can reach Dr. Patrick on Twitter @stephenwpatrick and Dr. Brumbaugh on Twitter @DBrumbaughMD

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