The MCG Pediatric Podcast

Celiac Disease

Did you know that a single crumb of bread is enough to cause an autoimmune response in children with celiac disease? Dr. Pankaj Vohra, Professor of Pediatrics and Board-Certified Pediatric Gastroenterologist, joins medical student Andrea Smith to discuss the evaluation and management of celiac disease, as well as essential guidance for following a gluten-free diet. Specifically, they will:

• Review the epidemiology of celiac disease and identify common symptoms and presentations of celiac disease
• Describe the pathophysiology of celiac disease including histopathological changes to the duodenum
• Identify diagnostic tests and criteria for diagnosing celiac disease in the pediatric population
• Identify common sources of gluten and the basics of identifying gluten on food labels
• Discuss typical management of celiac disease including appropriate screening tests and managing accidental gluten ingestion

Special thanks to Dr. Rebecca Yang and Dr. Neeharika Bade for peer reviewing this episode.

CME available free with sign up: Link coming soon!

References:

1. Bolia, R., & Thapar, N. (2023). Celiac Disease in Children: A 2023 Update. In Indian Journal of Pediatrics. Springer. https://doi.org/10.1007/s12098-023-04659-w
2. Gidrewicz, D., Potter, K., Trevenen, C. L., Lyon, M., & Butzner, J. D. (2015). Evaluation of the ESPGHAN celiac guidelines in a North American pediatric population. American Journal of Gastroenterology, 110(5), 760–767. https://doi.org/10.1038/ajg.2015.87
3. Hill, I. D., Fasano, A., Guandalini, S., Hoffenberg, E., Levy, J., Reilly, N., & Verma, R. (2016). NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. Journal of Pediatric Gastroenterology and Nutrition, 63(1), 156–165. https://doi.org/10.1097/MPG.0000000000001216
4. Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M. L., Ribes-Koninckx, C., Shamir, R., Troncone, R., Auricchio, R., Castillejo, G., Christensen, R., Dolinsek, J., Gillett, P., Hróbjartsson, A., Koltai, T., Maki, M., Nielsen, S. M., Popp, A., Størdal, K., … Wessels, M. (2020). European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. In Journal of Pediatric Gastroenterology and Nutrition (Vol. 70, Issue 1, pp. 141–156). Lippincott Williams and Wilkins. https://doi.org/10.1097/MPG.0000000000002497
5. Nenna, R., Tiberti, C., Petrarca, L., Lucantoni, F., Mennini, M., Luparia, R. P. L., Panimolle, F., Mastrogiorgio, G., Pietropaoli, N., Magliocca, F. M., & Bonamico, M. (2013). The celiac iceberg: Characterization of the disease in primary schoolchildren. Journal of Pediatric Gastroenterology and Nutrition, 56(4), 416–421. https://doi.org/10.1097/MPG.0b013e31827b7f64
6. Sahin, Y. (2021). Celiac disease in children: A review of the literature. In World Journal of Clinical Pediatrics (Vol. 10, Issue 4, pp. 53–71). Baishideng Publishing Group Co. https://doi.org/10.5409/wjcp.v10.i4.53
7. Salden, B. N., Monserrat, V., Troost, F. J., Bruins, M. J., Edens, L., Bartholomé, R., Haenen, G. R., Winkens, B., Koning, F., & Masclee, A. A. (2015). Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers. Alimentary Pharmacology and Therapeutics, 42(3), 273–285. https://doi.org/10.1111/apt.13266
8. Schuppan, D., Mäki, M., Lundin, K. E. A., Isola, J., Friesing-Sosnik, T., Taavela, J., Popp, A., Koskenpato, J., Langhorst, J., Hovde, Ø., Lähdeaho, M.-L., Fusco, S., Schumann, M., Török, H. P., Kupcinskas, J., Zopf, Y., Lohse, A. W., Scheinin, M., Kull, K., … Greinwald, R. (2021). A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. New England Journal of Medicine, 385(1), 35–45. https://doi.org/10.1056/nejmoa2032441
9. Tack, G. J., van de Water, J. M. W., Bruins, M. J., Kooy-Winkelaar, E. M. C., van Bergen, J., Bonnet, P., Vreugdenhil, A. C. E., Korponay-Szabo, I., Edens, L., von Blomberg, B. M. E., Schreurs, M. W. J., Mulder, C. J., & Koning, F. (2013). Consumption of gluten with gluten-degrading enzyme by celiac patients: A pilot-study. World Journal of Gastroenterology, 19(35), 5837–5847. https://doi.org/10.3748/wjg.v19.i35.5837
10. Husby S, Koletzko S, Korponay-Szabó IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136–160

Acyanotic Congenital Heart Diseases

Did you know that congenital heart defects (CHDs) affect nearly 40,000 babies born in the United States every year?

On this episode, Pediatric Cardiologist Dr. Melissa Lefebvre and medical student Marina Hashim discuss the evaluation and management of common acyanotic congenital heart conditions. Specifically, they will:

• Review the classification of CHDs as cyanotic versus acyanotic.
• Discuss the pathophysiology of the three most common acyanotic CHDs – ASD, PDA, and VSD.
• Describe early clinical findings and use of diagnostic tools.
• Cover management options, ranging from spontaneous closure to surgical intervention.
• Explore prognosis and long-term outcomes on physical activity, neurodevelopment, and overall health.

Special thanks to Dr. Rebecca Yang and Dr. Abeer Hamdy for peer reviewing this episode.

CME available free with sign up:  Click Here!

References:

• Dimopoulos, K., Constantine, A., Clift, P., & Condliffe, R. (2023). Cardiovascular complications of down syndrome: Scoping review and expert consensus. Circulation, 147(5). https://doi.org/10.1161/CIRCULATIONAHA.122.059706   Dugdale, D. C. (Ed.). (n.d.). Pediatric heart surgery - discharge. Mount Sinai. Retrieved April 26, 2024, from https://www.mountsinai.org/health-library/discharge-instructions/pediatric-heart-surgery-discharge   Eckerström, F., Nyboe, C., Maagaard, M., Redington, A., & Hjortdal, V. (2023). Survival of patients with congenital ventricular septal defect. European Heart Journal,  44 (1,1), 54-61. https://doi.org/10.1093/eurheartj/ehac618  
• Heart MRI. (2022, July 24). Cleveland Clinic. Retrieved April 19, 2024, from https://my.clevelandclinic.org/health/diagnostics/21961-heart-mri
• Leihao, S., Yajiao, L., Yunwu, Z., Yusha, T., Yucheng, C., & Lei, C. (2023). Heart-brain axis: Association of congenital heart abnormality and brain diseases. Frontiers in Cardiovascular Medicine, 10. https://doi.org/10.3389/fcvm.2023.1071820
• Meyer, K. (Ed.). (2022, May 1). What is a ventricular septal defect (VSD)? Cincinnati Children's. Retrieved March 12, 2024, from https://www.cincinnatichildrens.org/health/v/vsd
• Minette, M. S., & Sahn, D. S. (2006). Ventricular septal defects. Circulation, 114(20). https://doi.org/10.1161/CIRCULATIONAHA.106.618124
• Mussatto, K. A., Hoffmann, R. G., Hoffman, G. M., Tweddell, J. S., Bear, L., Cao, Y., & Brosig, C. (2014). Risk and prevalence of developmental delay in young children with congenital heart disease. Pediatrics, 133(3), e570–e577. https://doi.org/10.1542/peds.2013-2309
• Pruthi, S. (Ed.). (2022, October 21). Ventricular septal defect (VSD). Mayo Clinic. Retrieved April 9, 2024, from https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/symptoms-causes/syc-20353495    
• Right heart catheterization. (2022, July 24). Cleveland Clinic. Retrieved April 19, 2024, from https://my.clevelandclinic.org/health/diagnostics/21045-right-heart-catheterization
• Shah, S., Mohanty, S., Karande, T., Maheshwari, S., Kulkarni, S., & Saxena, A. (2022). Guidelines for physical activity in children with heart disease. Annals of pediatric cardiology, 15(5-6), 467–488. https://doi.org/10.4103/apc.apc_73_22
• Sigmon, E., Kellman, M., Susi, A., Nylund, C., & Oster, M. (2019). Congenital heart disease and Autism: A case-control study. Pediatrics, 144(5). https://doi.org/10.1542/peds.2018-4114
• Thacker, D. (Ed.). (2022, January 1). Ventricular septal defect (VSD). Nemours Kids Health. Retrieved April 10, 2024, from https://kidshealth.org/en/parents/vsd.html   Tierney, S., & Seda, E. (2020). The benefit of exercise in children with congenital heart disease. Current Opinion in Pediatrics, 32(5), 626-632. https://doi.org/10.1097/MOP.0000000000000942  Ventricular septal defects (VSD). (2021, November 9). Cleveland Clinic. Retrieved April 2, 2024,from https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd    Ventricular septal defect surgery for children. (n.d.). Johns Hopkins Medicine. Retrieved April 11,2024, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ventricular-septal-defect-surgery-for-children#:~:text=During%20this%20surgery%2C%20a%20surgeon,the%20hole%20between%20the%20ventricles
• Wernovsky, G., & Licht, D. J. (2016). Neurodevelopmental Outcomes in children with congenital heart disease - what can we impact?. Pediatric Critical Care Medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 17(8 Suppl 1), S232–S242. https://doi.org/10.1097/PCC.0000000000000800

Adolescent Gynecology

Join medical students Binal Patel and Aashka Sheth as they discuss adolescent gynecology with pediatrician Dr. Shreeti Kapoor.  Specifically, they will discuss:

• What exactly is adolescent gynecology.
• The proper approach to taking a comprehensive history for a pediatric patient with a gynecologic chief complaint.
• The various causes of dysmenorrhea in the early menarche period and its presentation.
• The diagnostic approach to dysmenorrhea in adolescents.
• The approach to treatment of dysmenorrhea in a pediatric population.
• And how to approach addressing safe sex practices and sexually transmitted infections with adolescents.

References:

21 reasons to see a gynecologist before you turn 21. ACOG. (n.d.). https://www.acog.org/womens-health/infographics/21-reasons-to-see-a-gynecologist-before-you-turn-21  

Adams Hillard P. J. (2008). Menstruation in adolescents: what's normal?. Medscape journal of medicine, 10(12), 295. 

Breehl L, Caban O. Physiology, Puberty. [Updated 2023 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534827/ 

Centers for Disease Control and Prevention. (n.d.). About heavy menstrual bleeding. Centers for Disease Control and Prevention. https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html 

Primary dysmenorrhea in adolescents. UpToDate. (n.d.). https://www.uptodate.com/contents/primary-dysmenorrhea-in-adolescents?search=Primary+Dysmenorrhea+&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2 

professional, C. C. medical. (2024, September 20). Pediatric gynecology. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/24574-pediatric-gynecology 

professional, C. C. medical. (2025, February 18). Puberty. Cleveland Clinic. https://my.clevelandclinic.org/health/body/puberty  

Sachedin, A., & Todd, N. (2020). Dysmenorrhea, endometriosis and chronic pelvic pain in adolescents. Journal of Clinical Research in Pediatric Endocrinology, 12(1), 7–17. https://doi.org/10.4274/jcrpe.galenos.2019.2019.s0217  

Sexuality, Sexual Health, and Sexually Transmitted Infections in Adolescents and Young Adults. (2020). Topics in Antiviral Medicine, 28(2). https://pmc.ncbi.nlm.nih.gov/articles/PMC7482983/pdf/tam-28-459.pdf  

UpToDate. (n.d.). Abnormal uterine bleeding in adolescents. https://www.uptodate.com/contents/abnormal-uterine-bleeding-in-adolescents-evaluation-and-approach-to-diagnosis?search=heavy%2Bbleeding&usage_type=default&source=search_result&selectedTitle=3~150&display_rank=3  

Obsessive Compulsive Disorder in Pediatrics

Did you know that Obsessive-Compulsive Disorder (OCD) affects approximately 1 in 200 children, with symptoms often emerging between the ages of 7 and 12? As pediatricians, you're likely the first to encounter these patients, making early recognition and intervention critical for achieving optimal outcomes. In this episode, we’ll provide you with the knowledge and tools nee ded to accurately diagnose and effectively manage OCD, laying the foundation for better long-term care.

Dr. Theresa Fiagbe, a second-year Child Psychiatry Fellow, Dr. Dale Peeples, Associate Professor of Child Psychiatry, and Alisha Patel, Medical Student at the Medical College of Georgia, join forces to unpack the complexities of OCD in children and adolescents.

Tune in as we:

• Explore key diagnostic criteria and the most effective screening tools for identifying OCD in pediatric patients
• Discuss evidence-based treatments such as Cognitive Behavioral Therapy (CBT) and SSRIs, and how to incorporate them into your practice
• Review common comorbid conditions, like anxiety and PANDAS, that can complicate diagnosis and treatment
• Examine the impact of OCD on school performance, social interactions, and family life
• Share practical guidance on managing long-term care to prevent relapse and ensure successful outcomes

Whether you're encountering OCD symptoms in a patient for the first time or seeking to enhance your expertise, this episode will equip you with the essential tools to improve diagnosis and treatment. Special thanks to Dr. Yang for editing and Dr. Sarah Straka, and Dr. Baris Olten for peer reviewing this episode.

CME Credit Available: 

https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=25556

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Berman, L., & Flessner, C. A. (2014). Pediatric obsessive-compulsive disorder: Diagnostic and treatment issues. Journal of the American Academy of Child and Adolescent Psychiatry, 53(2), 123-131. https://doi.org/10.1016/j.jaac.2013.10.003

Clark, C. A., & Scharf, R. (2020). Cognitive-behavioral therapy for obsessive-compulsive disorder in children and adolescents: Current trends and future directions. Journal of the American Academy of Child and Adolescent Psychiatry, 59(9), 971-979. https://doi.org/10.1016/j.jaac.2020.05.007

Fahrion, S., & Goodwin, G. M. (2019). Pharmacological treatment of pediatric obsessive-compulsive disorder: SSRIs, clomipramine, and beyond. Current Psychiatry Reports, 21(8), 58-66.

https://doi.org/10.1007/s11920-019-1040-3

Franklin, M. E., & March, J. S. (2015). Treatment of obsessive-compulsive disorder in children and adolescents.

Pediatric Clinics of North America, 62(3), 529-545. https://doi.org/10.1016/j.pcl.2015.02.004

March, J. S., & Mulle, K. (2017). OCD in children and adolescents: A review of treatments and practical guidance. The Psychiatric Clinics of North America, 40(2), 199-208. https://doi.org/10.1016/j.psc.2017.01.002

Murphy, T. K., & Pincus, D. B. (2019). Pediatric obsessive-compulsive disorder: Diagnosis, treatment, and future directions. Current Opinion in Pediatrics, 31(4), 517-524. https://doi.org/10.1097/MOP.0000000000000801

PANDA Study Group. (2017). Pediatric autoimmune neuropsychiatric disorders associated with streptococcal

infections (PANDAS). Journal of the American Academy of Child and Adolescent Psychiatry, 56(11), 933-940. https://doi.org/10.1016/j.jaac.2017.07.866

Peris, T. S., & Piacentini, J. (2021). Pediatric obsessive-compulsive disorder: Treatment strategies and challenges. Journal of Clinical Child and Adolescent Psychology, 50(1), 32-43. https://doi.org/10.1080/15374416.2020.1831504

Reaven, J. (2018). Screening for pediatric obsessive-compulsive disorder: Tools, guidelines, and challenges.

Child and Adolescent Mental Health, 23(3), 133-139. https://doi.org/10.1111/camh.12267

Thienemann, M., & McGuire, L. (2019). Treating pediatric OCD with a focus on cognitive-behavioral therapy: Evidence and efficacy. Journal of Clinical Child and Adolescent Psychology, 48(4), 530-538. https://doi.org/10.1080/15374416.2019.1612851

Neonatal CMV and Universal Screening

Did you know that congenital cytomegalovirus (cCMV) is the most common congenital viral infection in newborns and a leading cause of non-genetic hearing loss? Despite its prevalence, awareness and screening for cCMV remain inconsistent across healthcare systems. In this episode, we dive into the critical importance of cCMV screening, early diagnosis, and intervention. Join our expert guests Dr. Ingrid Camelo and Dr. John Noel as they discuss:

• The impact of cCMV on neonatal and long-term health outcomes
• Best practices for screening and diagnostic methods
• The role of early intervention, including antiviral therapy
• How advocacy efforts are shaping the future of universal screening policies

Tune in to stay informed on how pediatricians and healthcare providers can play a vital role in improving outcomes for infants affected by cCMV.

Special thanks to Dr. James Grubbs for peer reviewing this episode.

CME Credit (requires free sign up): Link Coming Soon!

References: 

• American Academy of Pediatrics. A targeted approach for congenital cytomegalovirus. Available at: https://publications.aap.org/pediatrics/article/139/2/e20162128/60211/A-Targeted-Approach-for-Congenital-Cytomegalovirus. Accessed August 13, 2024.
• Chiopris G, Veronese P, Cusenza F, Procaccianti M, Perrone S, Daccò V, Colombo C, Esposito S. Congenital cytomegalovirus infection: update on diagnosis and treatment. Microorganisms. 2020 Oct 1;8(10):1516. doi: 10.3390/microorganisms8101516. PMID: 33019752; PMCID: PMC7599523.
• Gantt S. Newborn cytomegalovirus screening: is this the new standard? Curr Opin Otolaryngol Head Neck Surg. 2023 Dec 1;31(6):382-387. doi: 10.1097/MOO.0000000000000925. Epub 2023 Oct 11. PMID: 37820202.
• Minnesota Department of Health. Minnesota implements universal newborn screening for cytomegalovirus. Available at: https://www.health.state.mn.us/news/pressrel/2023/ccmv020823.html. Accessed August 13, 2024.
• National CMV Foundation. Advocacy: universal newborn CMV screening. Available at: https://www.nationalcmv.org/about-us/advocacy#:~:text=Minnesota%20was%20the%20first%20state%20to%20enact%20universal%20newborn%20CMV%20screening. Accessed August 13, 2024.
• New York State Department of Health. Newborn screening for cytomegalovirus. Available at: https://www.health.ny.gov/press/releases/2023/2023-09-29_newborn_screening.htm#:~:text=ALBANY%2C%20N.Y.,all%20babies%20for%20the%20virus. Accessed August 13, 2024.
• UpToDate. Congenital cytomegalovirus (CMV) infection: clinical features and diagnosis. Available at: https://www.uptodate.com/contents/congenital-cytomegalovirus-ccmv-infection-clinical-features-and-diagnosis?search=cmv%20screening&source=search_result&selectedTitle=1%7E28&usage_type=default&display_rank=1#H92269684. Accessed August 13, 2024.
• UpToDate. Congenital cytomegalovirus (CMV) infection: management and outcome. Available at: https://www.uptodate.com/contents/congenital-cytomegalovirus-ccmv-infection-management-and-outcome?search=congenital%20cmv&source=search_result&selectedTitle=2%7E66&usage_type=default&display_rank=2. Accessed August 13, 2024.
• UpToDate. Ganciclovir and valganciclovir: an overview. Available at: https://www.uptodate.com/contents/ganciclovir-and-valganciclovir-an-overview?search=ganciclovir&source=search_result&selectedTitle=2%7E80&usage_type=default&display_rank=1#H6. Accessed August 13, 2024.
• University of Texas Medical Branch. Neonatology manual: infectious diseases. Available at: https://www.utmb.edu/pedi_ed/NeonatologyManual/InfectiousDiseases/InfectiousDiseases3.html#:~:text=may%20be%20required.-,Cytomegalovirus,Clinical%20findings. Accessed August 13, 2024.
• National Center for Biotechnology Information. Cytomegalovirus (CMV) infection. Available at: https://www.ncbi.nlm.nih.gov/books/NBK541003/. Accessed August 13, 2024.

                                                                                                            

Contraception Counseling in Adolescents

The adolescent population is experiencing increasing pressure to take part in sexual activity. It is part of our role as pediatricians to counsel our patients appropriately & thoroughly through their sexual & reproductive health. Dr. Shreeti Kapoor, a general pediatrician, joins Pediatric Resident Dani Watson & MS3 Irielle Duncan to discuss contraception options & how to have those conversations with adolescent patients. Specifically, they will:

• Review the efficacy, mechanism of action, potential adverse effects, and benefits of various contraceptive options, including abstinence, barrier methods, combination hormonal contraceptives, Depo Provera, and LARCs. 

• Discuss how to obtain relevant medical and sexual history to help in choosing an appropriate contraceptive for an adolescent patient. 

• Identify potential barriers or considerations that are specific for adolescent patients when discussing contraceptives. 

• Discuss options for emergency contraception & their mechanisms of action. 

Special thanks to Drs. Rebecca Yang & Danielle Rosema for peer reviewing this episode.

CME Credit (requires free sign up):  Click Here

References: 

• https://www.aafp.org/pubs/afp/issues/2003/0401/p1571.html
• https://www.cdc.gov/nchs/products/databriefs/db366.htm#:~:text=By%20age%2015%2C%2021%25%20of,had%20ever%20had%20sexual%20intercourse.
• https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-method/how-effective-is-withdrawal-method-pulling-out#:~:text=What%20we%20do%20know%20is,or%20not%20you%27re%20ovulating.
• https://www.acog.org/womens-health/faqs/barrier-methods-of-birth-control-spermicide-condom-sponge-diaphragm-and-cervical-cap
• https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devices
• https://www.acog.org/womens-health/faqs/combined-hormonal-birth-control-pill-patch-ring
• https://www.acog.org/womens-health/faqs/progestin-only-hormonal-birth-control-pill-and-injection
• https://www.aafp.org/pubs/afp/issues/1998/0801/p522.html
• https://www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods

 

 

 

Early Language Developmental Delay

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:

1. Define and understand language delay.
2. Recognize the initial signs and symptoms of language delays.
3. Identify and explain clinical pearls of potential etiologies of language delays.
4. Recognize the developmental milestones for language based on age.
5. Discuss the prevalence of language delays as well as identify the risk factors and patient demographics that have an increased susceptibility.
6. Understand the initial diagnostic approach to the child with suspected language delay.
7. Review the most common interventions when a child has language delay.
8. Understand how to best discuss the prognosis for language delays and counsel the families and caregivers

CME Credit (requires free sign up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19528

References:

1. 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.
2. 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
3. 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.
4. 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/
5. 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/
6. 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
7. Young, Allen. and Matthew Ng. “Genetic Hearing Loss.” StatPearls, StatPearls Publishing, 17 April 2023.
   https://www.ncbi.nlm.nih.gov/books/NBK580517/
8. 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.

Male Neonatal Circumcision

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
• Discuss the benefits and risks associated with circumcision
• Depict the potential complications from circumcision that may require further intervention from urology
• Present the current guidelines on male circumcision from the American Academy of Pediatrics (AAP)
• Explore the history and cultural traditions surrounding circumcision
• Special thanks to Dr. Rebecca Yang and Dr. Alice Little Caldwell for peer reviewing this episode

CME Credit (requires free sign up):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=19526

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
2. Blank MD, S., Brady MD, M., Buerk MD, E., Carlo MD, W., Diekema MD, D., Freedman MD, A., Maxwell MD, L., Wegner MD, S. (2012). TASK FORCE ON CIRCUMCISION. Circumcision Policy Statement. Pediatrics, 130 (3): 585-586. https://doi.org/10.1542/peds.2012-1989
3. Blank MD, S., Brady MD, M., Buerk MD, E., Carlo MD, W., Diekema MD, D., Freedman MD, A., Maxwell MD, L., Wegner MD, S. (2012). TASK FORCE ON CIRCUMCISION. Male Circumcision Technical Report. Pediatrics, 130 (3): e756–e785. 10.1542/peds.2012-1990

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
2. Kaweblum, Y. A., Press, S., Kogan, L., et al (1984). Circumcision using the Mogen clamp. Clin Pediatr (Phila.) 23:679-82.

6. 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
7. Owings M, Uddin S, Williams S. (2013). Trends in circumcision for male newborns in U.S. hospitals: 1979-2010. Atlanta, Georgia: Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013.pdf
8. Smith, L. The History of Male Infant Circumcision(Medical resident thesis). 
9. WHO, UNAIDS (2010). Neonatal and child male circumcision: A global review. www.circlist.com/considering/neonatal_child_MC_UNAIDS.pdf

Specific Learning Disorders

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/.
2. Dominguez, O. and P. Carugno, Learning Disability, in StatPearls. 2024, StatPearls Publishing: Treasure Island (FL).
3. About learning disorders and disabilities. Available from: https://www.childrenshospital.org/conditions/learning-disorders-and-disabilities.
4. Learning Disabilities: Overview. Available from: https://www.nhs.uk/conditions/learning-disabilities/.
5. Intellectual Developmental Disorder (Intellectual Disability). 2022, American Psychiatric Association.
6. Developmental, A.S.o. and B. Pediatrics, AAP Developmental and Behavioral Pediatrics, ed. R.G. Voigt, et al.: American Academy of Pediatrics.
7. Burns, M.K., et al., Toward a Unified Response-to-Intervention Model: Multi-Tiered Systems of Support, in Handbook of Response to Intervention: The Science and Practice of Multi-Tiered Systems of Support, S.R. Jimerson, M.K. Burns, and A.M. VanDerHeyden, Editors. 2016, Springer US: Boston, MA. p. 719-732.
8. Health Issues & Treatments for Spina Bifida. 2023; Available from: https://www.cdc.gov/NCBDDD/spinabifida/treatment.html.
9. Leonard, H., et al., A systematic review of the biological, social, and environmental determinants of intellectual disability in children and adolescents. Frontiers in Psychiatry, 2022. 13.
10. Snowling, M.J., A. Gallagher, and U. Frith, Family risk of dyslexia is continuous: individual differences in the precursors of reading skill. Child Dev, 2003. 74(2): p. 358-73.
11. Felitti, V.J., et al., Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 1998. 14(4): p. 245-258.
12. Zarei, K., et al., Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children. Children (Basel), 2021. 8(9).
13. CDC’s Developmental Milestones. 2023; Available from: https://www.cdc.gov/ncbddd/actearly/milestones/index.html.
14. Lipkin, P.H., et al., Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020. 145(1).
15. IEP and 504 plans. Available from: https://www.choa.org/-/media/Files/Childrens/patients/school-program/iep-504-resource-page.pdf?la=en&hash=BF719764C11B474F8659306C061E00FD938CE5D0.
16. Individuals with Disabilities Education Act Sec. 300.8 Child with a disability. 2018.
17. Affects focus, attention and behavior and can make learning challenging. Available from: https://ldaamerica.org/disabilities/adhd/.
18. Sahoo, M.K., H. Biswas, and S.K. Padhy, Psychological Co-morbidity in Children with Specific Learning Disorders. Journal of Family Medicine and Primary Care, 2015. 4(1): p. 21-25.
19. Ee, J., B. Stenfert Kroese, and J. Rose, A systematic review of the knowledge, attitudes and perceptions of health and social care professionals towards people with learning disabilities and mental health problems. British Journal of Learning Disabilities, 2022. 50(4): p. 467-483.
20. From the Boston Globe: "How to Support your Dyslexic Child". 2021; Available from: https://dyslexia.yale.edu/boston-globe-support-dyslexic-child/.
21. Resources https://ldaamerica.org/resources/
22. American Academy of Pediatrics. https://www.healthychildren.org/English/health-issues/conditions/learning-disabilities/Pages/default.aspx

Common Pediatric Eye Emergencies

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
• Discuss causes, symptoms, treatment options, and the vital role pediatricians play in early detection and management.
• Review common case presentations of the emergent eye conditions in children
• Highlight the vital role pediatricians play in early detection and management.

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.