The MCG Pediatric Podcast

Trisomy 13 & 18 Ethical Considerations with Dr. Paul Mann

Trisomy 13 & 18 Ethical Considerations with Dr. Paul Mann

PARTICIPANTS:

• Paul Mann, MD
• Zachary Hodges, MD

About Our Guest:

Dr. Paul Mann is an Associate Professor of Pediatrics, Chief of the Division of Neonatology and practicing neonatologist at the Medical College of Georgia. He also is the Director of Clinical Ethics for the Augusta University Center for Bioethics and Health Policy.

Free CME Credit: https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=7772

Learning Objectives:

By the end of listening to this episode, learners should be able to:

1. Recognize aneuploidies as a common cause of genetic abnormalities in pregnancy.
2. Recognize the historically pessimistic counseling given to families of children with trisomy 13 and 18 and how this might continue to influence our counseling today.
3. Recall how most babies are prenatally diagnosed with trisomy 13 and 18.
4. Describe the life-limiting malformations associated with trisomy 13 and 18.
5. Recognize the recent improvement in prognosis of children with trisomy 13 and 18 as they are being selectively offered more intensive and surgical care.
6. Sensitively counsel families about the general prognosis of newborns with trisomy 13 and 18 while avoiding inaccurate and problematic language such as “lethal and incompatible with life.”

       Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia. If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu. Remember that all content during this episode is intended for informational and educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios. We look forward to speaking to you on our next episode of the MCG Pediatric Podcast.  

 

Peer Reviewers: Amy Thompson, MD & MCG Pediatric Podcast Committee

 

References:

1. Kett JC. Who Is the Next "Baby Doe?" From Trisomy 21 to Trisomy 13 and 18 and Beyond. Pediatrics. 2020;146(Suppl 1):S9-S12. doi:10.1542/peds.2020-0818D
2. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics; Committee on Genetics; Society for Maternal–Fetal Medicine. Practice Bulletin No. 162: Prenatal Diagnostic Testing for Genetic Disorders. Obstet Gynecol. 2016;127(5):e108-e122. doi:10.1097/AOG.0000000000001405
3. Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs. Stamford, Conn: Appleton & Lange, 1999. Print.
4. McCaffrey MJ. Trisomy 13 and 18: Selecting the road previously not taken. Am J Med Genet C Semin Med Genet. 2016;172(3):251-256. doi:10.1002/ajmg.c.31512
5. Bajinting A, Munoz-Abraham AS, Osei H, Kirby AJ, Greenspon J, Villalona GA. To operate or not to operate? Assessing NSQIP surgical outcomes in trisomy 18 patients [published online ahead of print, 2020 Jun 5]. J Pediatr Surg. 2020;S0022-3468(20)30369-9. doi:10.1016/j.jpedsurg.2020.05.037
6. Neubauer K, Boss RD. Ethical considerations for cardiac surgical interventions in children with trisomy 13 and trisomy 18. Am J Med Genet C Semin Med Genet. 2020;184(1):187-191. doi:10.1002/ajmg.c.31767
7. Wightman A, Kett J, Campelia G, Wilfond BS. The Relational Potential Standard: Rethinking the Ethical Justification for Life-Sustaining Treatment for Children with Profound Cognitive Disabilities. Hastings Cent Rep. 2019;49(3):18-25. doi:10.1002/hast.1003
8. Nelson KE, Rosella LC, Mahant S, Guttmann A. Survival and Surgical Interventions for Children With Trisomy 13 and 18 [published correction appears in JAMA. 2017 May 2;317(17 ):1803]. JAMA. 2016;316(4):420-428. doi:10.1001/jama.2016.9819

Congenital Hypothyroidism

TITLE: Congenital Hypothyroidism 

Last Updated: April 30, 2021 

PARTICIPANTS: 

• Host: Dr. Zachary Hodges 
• Learner: Dr. John Baek 
• Specialist: Dr. Jacqueline Chan 

PEER REVIEWERS: 

• Dr. Christopher Houk 
• MCG Pediatric Podcast Committee

Free CME Credit: https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=7771

Learning Objectives: 

After listening to this podcast, learners should be able to: 

1. Recall the incidence of and risk factors associated with congenital hypothyroidism. 
2. Understand the importance of early diagnosis and the harms of delayed treatment. 
3. Understand the normal hypothalamic-pituitary-thyroid axis. 
4. Understand the methods of newborn screening for congenital hypothyroidism and interpret abnormal results. 
5. Create a differential diagnosis for the potential causes of congenital hypothyroidism.  
6. Recognize findings on physical exam that would support the diagnosis of congenital hypothyroidism. 
7. Interpret confirmatory testing required to diagnose congenital hypothyroidism. 
8. Recognize that interpreting thyroid function tests should be considered in the context of special circumstances (i.e., premature infants). 
9. Initiate appropriate treatment for suspected congenital hypothyroidism. 
10. Understand the prognosis, need for continued close follow-up and common methods of weaning thyroid replacement therapy.  

 

Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia.  

If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu 

Remember that all content during this episode is intended for informational and educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios 

 

References:

• Alejandro Diaz and Elizabeth G. Lipman Diaz. Hypothyroidism. Pediatrics in Review August 2014, 35 (8) 336-349; DOI: https://doi.org/10.1542/pir.35-8-336
• Agrawal P, Philip R, Saran S, et al. Congenital hypothyroidism. Indian J Endocrinol Metab. 2015;19(2):221-227. doi:10.4103/2230-8210.131748
• Bowden SA, Goldis M. Congenital Hypothyroidism. [Updated 2020 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558913/ 
• Gammons S, Presley BK, White PC. Referrals for Elevated Thyroid Stimulating Hormone to Pediatric Endocrinologists. J Endocr Soc. 2019;3(11):2032-2040. Published 2019 Sep 16. doi:10.1210/js.2019-00244
• Alejandro Diaz and Elizabeth G. Lipman Diaz. Hypothyroidism. Pediatrics in Review August 2014, 35 (8) 336-349; DOI: https://doi.org/10.1542/pir.35-8-336

Childhood Obesity

Did you know that 1 out of 5 children in the United States ages 6 to 19 are overweight or obese?

Dr. Jamie Lawson, a Pediatric Hospitalist, joins Pediatric Resident Ashley Miller to discuss the evaluation and management pediatric obesity. Specifically, they will:

• Review the key history and physical exam findings associated with obesity.
• Discuss the initial diagnostic approach to obesity
• Identify associated co-morbidities of patients with obesity
• Guide pediatricians on how to initiate appropriate therapy for children who are overweight or obese
• Advise on strategies to counsel patients and their families

Special thanks to Dr. Rebecca Yang and Dr. April Hartman who peer reviewed today’s episode. 

Free CME Credit Available: https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=7596

References:

Alizadeh, Zahra, et al. “Obese and Overweight Children and Adolescents: an Algorithmic Clinical Approach.” Iranian Journal of Pediatrics, Tehran University of Medical Sciences, Dec. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4025117/. 

Barlow, Sarah E. “Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report.” Pediatrics, vol. 120, no. Supplement 4, 2007, doi:10.1542/peds.2007-2329c. 

Cuda, Suzanne E., and Marisa Censani. “Pediatric Obesity Algorithm: A Practical Approach to Obesity Diagnosis and Management.” Frontiers in Pediatrics, vol. 6, 2019, doi:10.3389/fped.2018.00431. 

“Defining Childhood Obesity.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 July 2018, www.cdc.gov/obesity/childhood/defining.html. 

Flegal, Katherine M, et al. “Characterizing Extreme Values of Body Mass Index–for-Age by Using the 2000 Centers for Disease Control and Prevention Growth Charts.” The American Journal of Clinical Nutrition, vol. 90, no. 5, 2009, pp. 1314–1320., doi:10.3945/ajcn.2009.28335. 

Gulati, A. K., et al. “Clinical Tracking of Severely Obese Children: A New Growth Chart.” PEDIATRICS, vol. 130, no. 6, 2012, pp. 1136–1140., doi:10.1542/peds.2012-0596. 

Lang, Jason E., et al. “Being Overweight or Obese and the Development of Asthma.” Pediatrics, vol. 142, no. 6, 2018, doi:10.1542/peds.2018-2119. 

Ludwig, David S. “Epidemic Childhood Obesity: Not Yet the End of the Beginning.” Pediatrics, vol. 141, no. 3, 2018, doi:10.1542/peds.2017-4078. 

“Overweight & Obesity.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 29 Oct. 2020, www.cdc.gov/obesity/index.html. 

Pont, Stephen J., et al. “Stigma Experienced by Children and Adolescents With Obesity.” Pediatrics, vol. 140, no. 6, 2017, doi:10.1542/peds.2017-3034. 

Puhl, R. M., and M. S. Himmelstein. “Adolescent Preferences for Weight Terminology Used by Health Care Providers.” Pediatric Obesity, vol. 13, no. 9, 2018, pp. 533–540., doi:10.1111/ijpo.12275. 

Yanovski, Jack A. “Pediatric Obesity. An Introduction.” Appetite, vol. 93, 2015, pp. 3–12., doi:10.1016/j.appet.2015.03.028. 

E-cigarettes

Dr. Alice Caldwell, general pediatrician and member of the AAP Executive Committee on Tobacco Control joins pediatric resident Dr. Kate Peralta, to discuss E-cigarettes and vaping in adolescents.  

 

In this episode we will discuss: 

1. How national policy has shaped tobacco use and the shift from combustible cigarettes to vaping.
2. Why E-cigarettes have grown in popularity among youth and young adults.
3. Side effects of vaping, including nicotine addiction, nicotine withdrawal, other toxins and carcinogens, E-cigarette, or Vaping product use-Associated Lung Injury (EVALI), burns, and explosions 
4. How primary care clinicians can use the 5As to screen and treat E-cigarette or vape use.
5. What pharmacotherapy can be used in adolescents to teat nicotine withdrawal. 
6. Alternative interventions to treat E-cigarette or vape use in adolescents.

Free CME: https://mcg.cloud-cme.com/course/courseoverview?EID=7358&P=3000&CaseID=17 

 

Special thanks to Dr. Lisa Leggio, Dr. Rebecca Yang, and Dr. Zac Hodges for providing peer review for this episode. 

Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia.  

If you have any comments, suggestions, or feedback- please email us at mcgpediatricpodcast@augusta.edu  

Remember that all content during this episode is intended for informational and educational purposes only.  It should not be used as medical advice to diagnose or treat any particular patient.  Clinical vignette cases presented are based on hypothetical patient scenarios 

 

References: 

1. www.cdc.gov – Youth and Tobacco Use or Current Cigarette Smoking Among Adults in the United States  
2. E-Cigarettes and Similar Devices. Brian P. Jenssen, Susan C. Walley, SECTION ON TOBACCO CONTROL. Pediatrics Feb 2019, 143 (2) e20183652; DOI: 10.1542/peds.2018-3652 
3. National Academies of Sciences, Engineering, and Medicine. Public Health Consequences of E-Cigarettes. Washington, DC: The National Academies Press; 2018 
4. US Department of Health and Human Services. E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General pdf icon . Atlanta, GA: US Department of Health and Human Services, CDC; 2016. Accessed July 27, 2018. 
5. www.tobaccofreekids.org 
6. https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html  
7. https://services.aap.org/en/learning/e-cigarette-curriculum/ 
8. Gaiha SM, Cheng J, Halpern-Felsher B. Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19. J Adolesc Health. 2020 Oct;67(4):519-523. doi: 10.1016/j.jadohealth.2020.07.002. Epub 2020 Aug 11. PMID: 32798097; PMCID: PMC7417895. 
9. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Richmond-Center/Documents/TobaccoCodingFactSheet.pdf  
10. https://downloads.aap.org/RCE/Factsheet_Supporting_Youth_Addicted_to_Nicotine.pdf 
11. Graham AL, Jacobs MA, Amato MS. Engagement and 3-Month Outcomes From a Digital E-Cigarette Cessation Program in a Cohort of 27,000 Teens and Young Adults. Nictotine & Tobacco Research. 2020, 859-960. 
12. Sanchez S, Kaufman P, Pelletier H, Baskerville B, Feng P, O’Connor S, Schwartz R, Chaiton M. Is vaping cessation like smoking cessation? A qualitative study exploring the responses of youth and young adults who vape e-cigarettes. Addictive Behaviors. 2020. Retrieved from https://doi.org/10.1016/j.addbeh.2020.106687. 

Quitting Resources: 

• Georgia Tobacco Quit Line: 1-877-270-STOP (7867) or for Spanish speakers: 1-877-2NO-FUME (1-877-266-3862) offers free professional tobacco cessation for Georgia adults, pregnant women and teens (ages 13 and older) + 4-week supply of free Nicotine Replacement Therapy (ages 18 and older)  

• This is Quitting: https://www.thetruth.com/articles/hot-topic/quit-vaping:   Text DITCHJUUL to 88709  
• Smokefree Teen – sponsored by the National Institute of Health (Go to www.teen.smokefree.gov) 
• Become an Ex:  www.becomeanex.org – text messages, customized quit plan from the Mayo Clinic 
• My Life My Quit: www.mylifemyquit.com – Text “Start my Quit” to 855-891-9989 

 

Multisystem Inflammatory Syndrome in Children (MIS-C)

TITLE: Multisystem Inflammatory Disease in Children (MIS-C)

Last Updated: January 22, 2021

PARTICIPANTS:

• Hosts: Sonal Dugar, Zachary Hodges, Pushpa Shivaram, Julisa Patel
• Peer Reviewer #1: Smitha Mathew
• Peer Reviewer #2: Reda Bassali

By the end of listening to this podcast, learners should be able to:

• Recognize the general clinical presentation of MIS-C.
• Create a differential diagnosis for children presenting with a non-specific hyperinflammatory syndrome.
• Recall the CDC case definition of MIS-C.
• Recall the general approach to the initial evaluation of a patient with possible MIS-C.
• Compare and contrast the general presentation of MIS-C and Kawasaki disease.
• Recall the initial treatment of MIS-C including supportive care, IVIG and corticosteroids.
• Recall that anakinra and other immunomodulating drugs may be indicated for refractory MIS-C.
• Recognize that aspirin and anticoagulation may be indicated in severe cases of MIS-C.
• Recall the follow-up required for children with moderate to severe COVID-19 and MIS-C prior to return to normal activities.

Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia.

If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu

Visit our website at https://www.augusta.edu/mcg/pediatrics/residency/podcast.php for more information and show-notes.

Remember that all content during this episode is intended for informational and educational purposes only.  It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios. We look forward to speaking to you on our next episode of the MCG Pediatric Podcast.  

 

References:

1. Godfred-Cato S, Bryant B, Leung J, et al. COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020. MMWR Morb Mortal Wkly Rep 2020;69:1074–1080. DOI: http://dx.doi.org/10.15585/mmwr.mm6932e2external icon
2. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020;395:1607–8.
3. Dufort EM, Koumans EH, Chow EJ, et al.; New York State and CDC Multisystem Inflammatory Syndrome in Children Investigation Team. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020;383:347–58.
4. Feldstein LR, Rose EB, Horwitz SM, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020;383(4):334-346. doi:10.1056/NEJMoa2021680
5. Whittaker E, Bamford A, Kenny J, et al.; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA 2020;324:259–69.
6. Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H, et al. American College of Rheumatology Clinical Guidance for Pediatric Patients with Multisystem Inflammatory Syndrome in Children (MIS‐C) Associated with SARS‐CoV‐2 and Hyperinflammation in COVID‐19. Version 1. Arthritis Rheumatol doi: https://onlinelibrary.wiley.com/doi/10.1002/art.41454.
7. Abrams JY, Godfred-Cato SE, Oster ME, Chow EJ, Koumans EH, Bryant B, Leung JW, Belay ED, Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2: A Systematic Review, The Journal of Pediatrics (2020), doi: https://doi.org/10.1016/jpeds.2020.08.003.
8. 1161.CIRCULATIONAHA.120.049836. Review of Cardiac Involvement in MISC. Circulation
9. Kaushik, Ashlesha MD*; Gupta, Sandeep MD†; Sood, Mangla MD‡; Sharma, Seema MD§; Verma, Shikha MD§ A Systematic Review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection, The Pediatric Infectious Disease Journal: November 2020 - Volume 39 - Issue 11 - p e340-e346 doi: 10.1097/INF.0000000000002888
10. CDC MIS-C Information Webpage. https://www.cdc.gov/mis-c/cases/index.html

One Pill Can Kill

Did you know that a single tablet from the medicine cabinet or ingestion of a teaspoon of a liquid  household product can potentially cause morbidity and even death in a child? 

 

Dr. Jennifer Tucker, a Pediatric Emergency Physician, joins Dr. Rebecca Yang and Pediatric Resident James Davis to discuss the evaluation and management for specific common but dangerous household medications and substances in the household.  

• Review the basic assessment skills and evaluation for a child presenting with a potential toxic ingestion 
• Discuss the role of decontamination, diagnostic options, treatment and monitoring for toxic ingestions 
• Medications reviewed: Calcium Channel Blockers, Clonidine, Oral Hypoglycemics 
• Household products reviewed are those that contain toxic alcohols, benzocaine, Imidazoline, Camphor, and methylsalycylate 
• Anticipatory guidance to families regarding potential exposure/ingestion  

 Special thanks to Dr. George Hsu and Dr. Eric Ring for peer reviewing this episode. 

 

Check out our website for detailed show-notes: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php

Questions, comments, or feedback? Please email us at mcgpediatricpodcast@augusta.edu 

 

References:

1. Deadly Pediatric Poisons: Nine Common Agents that Kill at Low Doses. MichaelJB, Sztajnkrycer MD. Emerg Med Clin North Am. 2004;22(4):1019–1050
2. Toxic Ingestions: Initial Management. Courtney W. Mangus, Therese L. Canares. Pediatrics in Review Apr 2018, 39 (4) 219-221
3. Tucker MD, Jennifer. "One Pill (Or Sip) Can Kill." MCG Pediatric Grand Rounds Presentation. Augusta, Georgia. July 15,2016.

 

IV Fluid Update

Pediatric intensivist, Dr. Will Cagle joins the show to discuss the AAP Maintenance IV fluid guidelines and considerations when choosing IV fluids for pediatric inpatients.

What do you need to know from the 2018 AAP maintenance IV fluid guideline? 

How common is hyponatremia in hospitalized patients and why does it matter to your practice? 

What is SIADH and how does it contribute to hyponatremia in acutely ill children? 

How can we prevent hyponatremia in our hospitalized patients? 

What are the differences between hypotonic and isotonic fluids? 

What are balanced solutions and why might they be preferred as compared to saline in some clinical settings? 

All of this and more from the Department of Pediatrics and the Medical College of Georgia. 

Check out our website for detailed show-notes: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php

Special thanks to Dr. Asif Mansuri and Dr. Gene Fisher for providing peer review for this episode.

Questions, comments, or feedback? Please email us at mcgpediatricpodcast@augusta.edu 

Want Further Reading? Check out the clinical practice guideline from the AAP and our other references below.

• Feld LG, Neuspiel DR, Foster BA, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics. 2018;142(6):e20183083. doi:10.1542/peds.2018-3083 
• Semler MW, Self WH, Wanderer JP, et al. Balanced Crystalloids versus Saline in Critically Ill Adults. N Engl J Med. 2018;378(9):829-839. doi:10.1056/NEJMoa1711584 
• Cuzzo B, Padala SA, Lappin SL. Vasopressin (Antidiuretic Hormone, ADH) [Updated 2020 Apr 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526069/ 
• Chowdhury, Abeed H. BSc, MRCS*; Cox, Eleanor F. PhD†; Francis, Susan T. PhD†; Lobo, Dileep N. DM, FRCS, FACS* A Randomized, Controlled, Double-Blind Crossover Study on the Effects of 2-L Infusions of 0.9% Saline and Plasma-Lyte® 148 on Renal Blood Flow Velocity and Renal Cortical Tissue Perfusion in Healthy Volunteers, Annals of Surgery: July 2012 - Volume 256 - Issue 1 - p 18-24 doi: 10.1097/SLA.0b013e318256be72 
• Peti-Peterdi J, Harris RC. Macula densa sensing and signaling mechanisms of renin release. J Am Soc Nephrol. 2010;21(7):1093-1096. doi:10.1681/ASN.2009070759 

• Wilcox CS. Regulation of renal blood flow by plasma chloride. J Clin Invest. 1983;71(3):726-735. doi:10.1172/jci110820 

Kawasaki Disease

Dr. Pushpa Shivaram, an assistant professor of pediatrics and pediatric cardiologist at the Medical College of Georgia, joins Dr. Zac Hodges and Sonal Dugar (M4) to discuss this very important topic in pediatric medicine.

What exactly is Kawasaki disease and why is this topic so important?

How do you make the diagnosis and what other diagnoses should you consider?

How can you diagnosis incomplete Kawasaki when the classic features are not all present?

What is the first-line treatment?

When should you get an echocardiogram?

When should you get your referral center involved?

All of this and more from the Department of Pediatrics and the Medical College of Georgia. 

Check out our website for detailed show-notes: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php

Special thanks to Dr. Reda Bassali, Dr. Leizl Domingo and Dr. Julisa Patel for providing peer review for this episode.

Questions, comments, or feedback? Please email us at mcgpediatricpodcast@augusta.edu 

Further Reading? Check out the clinical practice guideline from the American Heart Association with citation below.

McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association [published correction appears in Circulation. 2019 Jul 30;140(5):e181-e184]. Circulation. 2017;135(17):e927-e999. doi:10.1161/CIR.0000000000000484  

 

 

Bronchiolitis

Dr. Reda Bassali, professor of pediatrics and pediatric hospitalist at the Medical College of Georgia, joins Dr. Zac Hodges and Gavriella Mendel (M3) to discuss this very important topic in pediatric medicine.

What exactly is bronchiolitis and why is this topic so important?

How do you make the diagnosis and what other diagnoses should you consider?

What treatments work, and more importantly, which treatments do not?

What patients can go home and who needs to be admitted?

All of this and more from the Department of Pediatrics and the Medical College of Georgia. 

Check out our website for detailed show-notes: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php

Special thanks to Dr. Kathryn McLeod for providing peer review for this episode.

Citation:

Hodges, Z. (Host). Bassali, R. (Host).  Mendel, G. (Host). McLeod, K. (Contributor). (2020, Nov 15). Bronchiolitis. (S1:18) [Audio Podcast Episode]. MCG Pediatric Podcast. Medical College of Georgia Augusta.

Questions, comments, or feedback? Please email us at mcgpediatricpodcast@augusta.edu 

Links: 

NoseFrida-- https://www.nosefrida.com 

References/further reading:

1. Silver AH, Nazif JM. Bronchiolitis. Pediatr Rev. 2019;40(11):568-576. doi:10.1542/pir.2018-0260  
2. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis [published correction appears in Pediatrics. 2015 Oct;136(4):782]. Pediatrics. 2014;134(5):e1474-e1502. doi:10.1542/peds.2014-2742 
3. Florin TA, Plint AC, Zorc JJ. Viral bronchiolitis. Lancet. 2017;389(10065):211-224. doi:10.1016/S0140-6736(16)30951-5  
4. Cunningham S, Rodriguez A, Adams T, et al. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet. 2015;386(9998):1041-1048. doi:10.1016/S0140-6736(15)00163-4
5. Franklin D, Babl FE, Schlapbach LJ, Oakley E, Craig S, Neutze J, Furyk J, Fraser JF, Jones M, Whitty JA, Dalziel SR, Schibler A. A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis. N Engl J Med. 2018 Mar 22;378(12):1121-1131. doi: 10.1056/NEJMoa1714855. PMID: 29562151.
6. Lin J, Zhang Y, Xiong L, Liu S, Gong C, Dai J. High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis. Arch Dis Child. 2019 Jun;104(6):564-576. doi: 10.1136/archdischild-2018-315846. Epub 2019 Jan 17. PMID: 30655267.

Jude's Story & 22q11 Deletion Syndrome

Dr. Charles Scarborough joins the show to discuss the story of his son Jude, and his family's experience with his son's diagnosis with 22q11 deletion syndrome. 

In addition to hearing about the Scarborough's personal experience, we talk about the genetic considerations and common clinical manifestations of 22q11.2 deletion syndrome.

How do you approach the general diagnostic testing and screening evaluation of a child with 22q11.2 deletion syndrome?

We also discuss the impact that genetic and chronic disease has on our pediatric patients and their families.

Thanks to Dr. Paul Mann, Dr. Liezl Domingo and Dr. Jacqueline Chan for providing guidance and peer review of the technical material in this episode. 

Citation:

Hodges, Z. (Host). Scarborough, C. (Host).  Mann, P. (Contributor). Chan, J. (Contributor). Domingo, L. (Contributor).  (2020, Nov 1). Jude’s Story/22q11 Deletion Syndrome. (S1:17) [Audio Podcast Episode]. MCG Pediatric Podcast. Medical College of Georgia Augusta.  

Links:

MCG Pediatric Podcast: https://www.augusta.edu/mcg/pediatrics/residency/podcast.php 

Georgia Medicaid Katie Beckett: https://medicaid.georgia.gov/programs/all-programs/tefrakatie-beckett 

Clinica La fuente in Cusco, Peru http://www.lafuenteclinica.com/clinic-ingles/ 

If you would like to donate to Clinica La fuente https://www.mtw.org/projects/details/pe-la-fuente-centro-de-salud-integral 

 

Questions or comments? Contact us by email at mcgpediatricpodcast@augusta.edu 

 

References:

Cohen JL, Crowley TB, McGinn DE, et al. 22q and two: 22q11.2 deletion syndrome and coexisting conditions. Am J Med Genet A. 2018;176(10):2203-2214. doi:10.1002/ajmg.a.40494

Campbell IM, Sheppard SE, Crowley TB, et al. What is new with 22q? An update from the 22q and You Center at the Children's Hospital of Philadelphia. Am J Med Genet A. 2018;176(10):2058-2069. doi:10.1002/ajmg.a.40637

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