The MCG Pediatric Podcast

To Snip or Not to Snip - prepare for a “Cut” above the rest. On this episode of the MCG Pediatric Podcast, Dr. Bradley Morganstern, a Pediatric Urology physician, joins General Pediatrician Dr. Lauren Smith and Pediatric Resident Dr. My Duyen Vo to discuss the procedure of routine neonatal male circumcision, including benefits, potential complications, and contraindications. In this podcast, they will:

• Review the basic procedure for routine neonatal circumcision

CME Credit (requires free sign up): Link coming soon!

References:

1. Aggleton, Peter (2007). “Just a Snip?”: A Social History of Male Circumcision, Reproductive Health Matters, 15:29, 15-21, DOI: 10.1016/S0968-8080(07)29303-6

1. Centers for Disease Control and Prevention (CDC). (2021). Protect Your Baby from Bleeds – Talk to Your Healthcare Provider about Vitamin K [Fact Sheet]. U.S. Department of Health & Human Services. https://www.cdc.gov/ncbddd/blooddisorders/documents/vitamin-k-p.pdf

1. Morris, B. J., Bailis, S. A., Wiswell, T. E. (2014). Circumcision Rates in the United States: Rising or Falling? What Effect Might the New Affirmative Pediatric Policy Statement Have? Mayo Clinic Proceedings, 89 (5): 677-686. https://doi.org/10.1016/j.mayocp.2014.01.001

Did you know that approximately 1 in 5 children experience learning and attention issues, but only a fraction of them receives an official diagnosis? In this episode of the MCG Pediatric Podcast, hosts Rishab Chawla and Dr. Jennifer Poon delve into the topic of Specific Learning Disorders (SLDs). They discuss the prevalence, diagnostic criteria, assessment methods, and treatment interventions for SLDs. The conversation aims to provide a comprehensive understanding of SLDs and highlight the importance of early intervention and support.

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19525

References:

1. Barto, A. The State of Learning Disabilities: Understanding the 1 in 5. Available from: https://ldaamerica.org/lda_today/the-state-of-learning-disabilities-today/.

Did you know that vision problems in children often go unnoticed until it's too late, potentially leading to irreversible vision loss? Dr. Steven Brooks, professor, and distinguished chair in ophthalmology at the Medical College of Georgia joins MCG students Emily Austin and Arjun Bhatt to uncover the hidden dangers of the 4 most common pediatric eye emergencies.

• Review four basic pediatric eye emergencies: amblyopia, strabismus, leukocoria, red eye emergencies

CME Credit (requires free sign up): Click Here for Link

References:

1. Dr. Brooks' Presentation on Common Pediatric Eye Emergencies

• Brook, S. (2023). Presentation on Common Pediatric Eye Emergencies [Google Slides presentation]. Retrieved from https://docs.google.com/presentation/d/1zpxZZnH5NTTpSq57HUegz_mC5zGkGrhK/edit?usp=share_link&ouid=107180084657435193874&rtpof=true&sd=true

2. AAO Pediatric Eye Evaluation Preferred Practice Patterns (2023)

• American Academy of Ophthalmology. (2023). Pediatric Eye Evaluation Preferred Practice Patterns [PDF]. Retrieved from https://nam02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26source%3Dweb%26rct%3Dj%26opi%3D89978449%26url%3Dhttps%3A%2F%2Fwww.aao.org%2FAssets%2F0b507d20-f419-40ac-ac7c-99b11c95f58e%2F638070751054300000%2Fpediatric-eye-evaluations-ppp-pdf%26ved%3D2ahUKEwiv7P2E1NiFAxXZ4ckDHaPhBhsQFnoECBIQAQ%26usg%3DAOvVaw3ortok8vheUdG_OypWrm4N&data=05%7C02%7CARJBHATT%40augusta.edu%7C2d7137e07d264c7c962708dc6b0c56cb%7C8783ac6bd05b4292b483e65f1fdfee91%7C0%7C0%7C638502947937678385%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=IWSuIMyXuRbmeSh8riz7hbKZaSWRQLkcClHDexm7n58%3D&reserved=0

3. AAO Amblyopia Preferred Practice Pattern (2024)

• American Academy of Ophthalmology. (2024). Amblyopia Preferred Practice Pattern. Retrieved from https://www.aao.org/education/preferred-practice-pattern/amblyopia-ppp-2022

4. AAPOS Guidelines for Pediatric Eye Condition (2022)

• American Association for Pediatric Ophthalmology and Strabismus. (2022). Guidelines for Pediatric Eye Condition. Retrieved from https://www.jaapos.org/article/S1091-8531(22)00009-X/fulltext#:~:text=Astigmatism%2520%253E3.0%2520D%2520in%2520any,Δ%2520should%2520also%2520be%2520identified.

5. AAO Stepwise Approach to Leukocoria (2016)

• American Academy of Ophthalmology. (2016). Stepwise Approach to Leukocoria. Retrieved from https://www.aao.org/eyenet/article/stepwise-approach-to-leukocoria

6. First Aid (2023)

• Le, Tao; Bhushan, Vikas; Qiu, Connie; Chalise, Anup; and Kaparaliotis, Panagiotis. First Aid for the USMLE Step 1 2023. New York: McGraw Hill LLC, 2023.

There has long since been a knowledge gap in medical education regarding care of LGBTQIA+ patients. This has manifested itself in health disparities that detrimentally affect the LGBTQIA+ population. This podcast serves as a way to start bridging the gap on order to mitigate the effects of bias, discrimination, and prejudice that queer patients often face in health care. Research has shown that consistent, early exposure in medical education to patients from the queer community has been beneficial in preparing future practitioners for gender inclusive care. We must also do our parts as pediatricians to make sure our queer youth grow into confident, thriving queer adults. 

Join Dr. Farrah-Amoy Fullerton, a recent graduate of the pediatric residency program at MCG, and Professor of Pediatrics, Dr. Lisa Leggio, as they introduce LGBTQIA+ health care disparities and describe ways to bridge the gap for eager general practitioners who would like to know more.

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19523 

References:

1. Bonvicini, K. A. (2017). LGBT healthcare disparities: What progress have we made? Patient Education and Counseling, 100(12), 2357–2361. https://doi.org/10.1016/j.pec.2017.06.003

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:

1. Educate the listener and general community on signs a child/teenager at risk for suicide.

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19521

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.

Did you know that the treatments used to cure pediatric cancers can potentially cause a life-threatening event known as tumor lysis syndrome (TLS)? Arfa Ul-Haque and Yazmin Reategui, two third-year medical students, are joined by Pediatric intensivist, Dr. Smitha Mathew, to discuss the evaluation and management for TLS so that it is promptly recognized and treated in the inpatient hospital setting.  

Specifically, they will: 

• Review the basic assessment skills and evaluation for a child presenting with potential TLS  

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19520

References:

1. Tumor lysis syndrome. (2022, October 4). Medscape.com. https://emedicine.medscape.com/article/282171-overview

Did you know that undiagnosed developmental dysplasia of the hip (DDH) is the most common cause of arthritis in women under 40? Dr. Melissa Allen, a Pediatric Orthopedic Surgeon, joins 3rd year Pediatric Resident Erica DeMaagd and 4th year medical student Jacob Weiser to discuss the evaluation and management for DDH.  Specifically, they will teach how to: 

• Recognize common history and physical exam findings associated with hip dysplasia.

Special thanks to Dr. Lisa Leggio and Dr. Rebecca Yang for peer reviewing this episode.

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19519

References:

Auriemma, J., & Potisek, N. M. (2018). Developmental dysplasia of the hip. Pediatrics In Review, 39(11), 570–572. https://doi.org/10.1542/pir.2017-0239

Barrera, C. A., Cohen, S. A., Sankar, W. N., Ho-Fung, V. M., Sze, R. W., & Nguyen, J. C. (2019). Imaging of Developmental Dysplasia of the hip: Ultrasound, Radiography and Magnetic Resonance Imaging. Pediatric Radiology, 49(12), 1652–1668. https://doi.org/10.1007/s00247-019-04504-3

Centers for Disease Control and Prevention. (2022, December 8). Important Milestones: Your Baby by One Year. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-1yr.html

Imrie, M., Scott, V., Stearns, P., Bastrom, T., & Mubarak, S. J. (2010). Is Ultrasound Screening for DDH in Babies Born Breech Sufficient? Journal of Children’s Orthopaedics, 4(1), 3–8. Larson, J. E., Patel, A. R., Weatherford, B., & Janicki, J. A. (2019). Timing of Pavlik Harness Initiation: Can We wait? Journal of Pediatric Orthopaedics, 39(7), 335–338. https://doi.org/10.1097/bpo.0000000000000930

Mahan, S. T., Katz, J. N., & Kim, Y.-J. (2009). To Screen or Not to Screen? A Decision Analysis of the Utility of Screening for Developmental Dysplasia of the Hip. The Journal of Bone and Joint Surgery-American Volume, 91(7), 1705–1719. https://doi.org/10.2106/jbjs.h.00122

Nemeth, B. A., & Narotam, V. (2012). Developmental Dysplasia of the Hip. Pediatrics in Review, 33(12), 553–561. https://doi.org/10.1542/pir.33-12-553

Novais, E. (2018). Pavlik Harness. Boston, MA; Boston Children’s Hospital Child and Young Adult Hip Preservation Program.

Shaw BA, Segal LS, AAP SECTION ON ORTHOPAEDICS. Evaluation and Referral for                                    Developmental Dysplasia of the Hip in Infants. Pediatrics. 2016;138(6):e20163107

Scott Yang, Natalie Zusman, Elizabeth Lieberman, Rachel Y. Goldstein; Developmental Dysplasia of the Hip. Pediatrics January 2019; 143 (1): e20181147. 10.1542/peds.2018-1147

Community acquired pneumonia is unfortunately a common condition seen in children of all ages. Dr. Jacob Eichenberger, an associate professor of pediatrics at MCG and a pediatric hospitalist at the Children's Hospital of Georgia, joins recently graduated pediatric resident, Dr. Fahim Thawer, and medical student Sara Attari to discuss the evaluation and management of community acquired pneumonia.

Specifically, they will:

• Discuss common history and physical exam findings associated with community acquired pneumonia

CME Link (requires login): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19518

Coughs are one of the most common symptoms of childhood illness. But when should we start to get worried? What is a child’s cough trying to tell you? Dr. Sunil Kapoor, a Pediatric Pulmonology Physician, joins Dr. Rebecca Yang and medical student Aparna Prasad to discuss the evaluation and management of chronic cough in children.  Specifically, they will: 

• Review the history and physical examination for a child presenting with a chronic cough

Special thanks to Dr. Dionne Adair, Dr.Sunil Kapoor, and Dr. Rebecca Yang for peer reviewing this episode.

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19516 

References:

1. Marchant, J. (2021, September 30). Causes of chronic cough in children. UpToDate. Retrieved June 2, 2022, from https://www.uptodate.com/contents/causes-of-chronic-cough-in-children?search=common+causes+of+chronic+cough+in+young+kids&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1   

Did you know around 15 to 25% of children will have at least one syncopal episode before adulthood? Join medical students Sanya Dudani and Caleb Robertson, along with Pediatric Cardiologist Dr. John Plowden, as they discuss the evaluation and management of syncope in the pediatric patient.  Specifically, they will:

• Discuss the definition of syncope and its underlying pathophysiology

Special thanks to Dr. Rebecca Yang and Dr. Melissa Lefebvre for peer reviewing this episode!

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19514 

References:

Arthur W, Kaye GC  The pathophysiology of common causes of syncope  Postgraduate Medical Journal 2000;76:750-753.

Cipolla MJ. The Cerebral Circulation. San Rafael (CA): Morgan & Claypool Life Sciences; 2009. Chapter 5, Control of Cerebral Blood Flow. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53082/

Clark, BC, Hayman, JM, Berul, CI, Burns, KM, and Kaltman, JR. Selective use of the electrocardiogram in pediatric preparticipation athletic examinations among pediatric primary care providers. Ann Noninvasive Electrocardiol. 2017; 22:e12446. https://doi.org/10.1111/anec.12446]

De, A. and Davidson Ward, S.L. (2014), Syncope at altitude: An enigmatic case. Pediatr Pulmonol., 49: E144-E146. https://doi.org/10.1002/ppul.23062

Gupta A, Menoch M, Levasseur K, Gonzalez IE. Screening Pediatric Patients in New-Onset Syncope (SPINS) Study. Clinical Pediatrics. 2020;59(2):127-133. doi:10.1177/0009922819885660

Hainsworth, R. Pathophysiology of syncope. Clin Auton Res 14 (Suppl 1), i18–i24 (2004). https://doi.org/10.1007/s10286-004-1004-2

Phillip A. Low, Paola Sandroni, Chapter 106 - Postural Tachycardia Syndrome (POTS), Editor(s): David Robertson, Italo Biaggioni, Geoffrey Burnstock, Phillip A. Low, Julian F.R. Paton, Primer on the Autonomic Nervous System (Third Edition), Academic Press, 2012, Pages 517-519, ISBN 9780123865250, https://doi.org/10.1016/B978-0-12-386525-0.00106-2

Zavala, Rennette MD∗; Metais, Benjamin MD†; Tuckfield, Lynnia BS‡; DelVecchio, Michael MD‡; Aronoff, Stephen MD, MBA‡. Pediatric Syncope: A Systematic Review. Pediatric Emergency Care: September 2020 - Volume 36 - Issue 9 - p 442-445 doi: 10.1097/PEC.0000000000002149