Join us and expert guest Dr. IJ Anosike (The Children’s Hospital at Montefiore) to dissect the complexities of diagnosing and managing Epstein-Barr virus!  From sneaky symptoms to tricky tests, Dr. Anosike provides insight on identifying and tackling this troublesome virus. Don't miss this infectiously enlightening episode!

PART 2. In our last episode, we discussed hyperkalemia management in an otherwise renally healthy patient. But what if your patient has chronic kidney disease? Are they okay if their potassium has been 5.9 for a long time? How does our management change? Nephrologist Dr. Jordan Symons returns to offer his advice on outpatient and inpatient management of acute-on-chronic hyperkalemia.

All is not frost, we’re back to talk through the Hypothermic Infant with Dr. Sriram Ramgopal (Pediatric Emergency Medicine, Lurie Children’s Hospital). How do we know if the baby is septic or is just two blankets short of euthermia? Dr. Ramgopal walks us through the latest research, a differential diagnosis, who needs an infectious workup,  and how much more we have to learn!

Gender affirming care-- time to refer your patient? Think again! Primary care pediatrician, Professor of Pediatrics at Brown Medicine, and Gender and Sexuality expert Dr. Michelle Forcier MD, MPH introduces us to practicing a patient-centered consent-based model of gender affirming care in the primary care setting. Dr. Forcier teaches us how to use a developmental model of gender identity for all of our patients, how clinics can create a safe and supportive environment,  breaks down the variety of social, legal, medical, and surgical options that can be a part of gender affirmation, and how to support families in loving and supporting their kids and adolescents.

Need to close a major “gap” in your Diabetic Ketoacidosis knowledge? Look no further than our conversation with diabetes expert and repeat guest, Dr. Hussein Abdullatif, a dedicated multiple-award-winning clinician-educator at UAB. Join us as Dr. Abdullatif walks us through the diagnosis, management, and social implications surrounding DKA. 

If you’re looking to bring your clinical game to the next level, look no further than this next episode where we’ll discuss three huge areas of medical overuse. By the end of the episode, you’ll know pneumonia, cellulitis, blood cultures, and more than you’d ever expect about constipation. We welcome Drs. Leonard Feldman and Carrie Herzke back to the podcast, both TWDFNR authors, to explore and educate us on these topics. Listen along here, and follow us @TheCribsiders on #MedTwitter!

We’re ear with a new episode with on acute otitis media joined by guest Dr. Eric Baum, a pediatric otolaryngologist in Connecticut. In this episode, we discuss important physical exam findings used to diagnose acute otitis media, as well as the role of pneumatic otoscopy in performing ear exams. Dr. Baum also tells us about treatment options for acute otitis media, how ear tubes work and when they are indicated, and complications to watch out for. Listen in to hear the latest on acute otitis media!

The MS4 producers takeover The Cribsiders for a recap of our favorite clinical pearls from Season 1!

Jump into pediatric mild traumatic brain injury with our guest, Dr. Angela Lumba Brown, a pediatric emergency medicine physician and Associate Professor of Emergency Medicine, Pediatrics, and Neurosurgery at Stanford University. In this episode, we talk about the diagnosis of mild traumatic brain injury, when to get neuroimaging for head trauma, and the five concussion subtypes.  We also discuss how you can support your patients in their recovery to get them back to their daily activities and what disparities exist in head trauma. Join us to have your mind blown with this fascinating topic. 

In this episode, we cover the full spectrum from febrile seizures all the way to status epilepticus with Dr. John Gaitanis, a pediatric neurologist who specializes in care for children with epilepsy. Dr. Gaitanis teaches us what to look out for on neurologic exam, how to counsel families about safety precautions, and the differential diagnosis for seizure-like activity in infants and children. We also discuss the exciting future of epilepsy treatment.

Answer all your burning questions (and your patients’ burning questions) about the different COVID-19 vaccines currently authorized in the US. Infectious diseases / HIV expert, Dr Monica Gandhi @MonicaGandhi9 (UCSF) joins us to cover: the Pfizer-BioNTech and Moderna novel mRNA vaccine mechanisms, trial data, and practicalities of who should receive them.  We discuss data around the Oxford-AstraZeneca adenovirus vaccine, which is authorized in the UK and India, and may be available in the US later this year.  Feel confident recommending COVID-19 vaccines to your patients!

Did you know that NOWS is the new NAS? Learn more about the new AAP Clinical Report on Neonatal Opioid Withdrawal Syndrome with lead author Dr. Stephen Patrick. Dr. Patrick is the Director of the Vanderbilt Center for Child Health Policy, an Associate Professor of Pediatrics and Health Policy, and an attending neonatologist at Monroe Carol Jr. Children’s Hospital at Vanderbilt. In this episode, he teaches us about the approach to treating withdrawal in infants, the importance of keeping moms and babies together, and the need for destigmatizing addiction in healthcare. 

 

Time Stamps

• 7:48 Case from Kashlak Children’s
• 8:38 Definition of neonatal opioid withdrawal syndrome 
• 9:48 Clinical Presentation of NOWS
• 11:30 Scoring Systems
• 14:34 Importance of diagnosing NOWS
• 15:16 Opioid Crisis and Epidemiology
• 16:35 Risk Factors for developing NOWS
• 19:16 The role of structural racism and social determinants of health
• 21:05 Stigma of addiction
• 23:10 Building a therapeutic relationship
• 25:32 Breastfeeding
• 26:40 Toxicology testing
• 29:16 Structural racism 
• 30:14 Non-pharmacologic management
• 31:58 Pharmacologic Management
• 35:16 Clinical course 
• 37:40 Treatment and taper plan
• 40:20 Discharge planning
• 43:20 Outpatient Follow up
• 44:26 AAP Clinical Report Changes
• 46:46 Advocacy and Policy
• 47:14 Buprenorphine 
• 50:18 Outro

With a persistent fever, Kawasaki Disease must be on your differential, but have you not seen many cases or had difficulty with the diagnosis? Look no further, as we bring an expert to walk us through the diagnosis and management of KD! We discuss Kawasaki Disease with Dr. Adriana Tremoulet who is the assistant director of the Kawasaki Disease Research Center at the University of California, San Diego. She has led numerous Phase I through III trials regarding the management of KD, and she walks us through the diagnosis and management of this fascinating disease!

Eating disorders are among the most challenging and consequential mental health diagnoses in pediatric medicine. Join us and Dr. Abigail Donaldson, Medical Director of the Eating Disorders Program at Hasbro Children’s Hospital, as we tackle the complexities of anorexia nervosa and other restrictive eating disorders from a clinical perspective. Tune in as we explore assessment tools, therapeutic approaches, and collaborative strategies for managing these challenging disorders in practice.

Are you interested in implementing Trauma-Informed Care into your pediatric practice but unsure how to start? Join us for our conversation about TIC with Dr. Heather Forkey. Dr. Forkey is the clinical director of the Foster Children Evaluation Services (FaCES), Chief of the Division of Child Protection for the UMass Memorial Children’s Medical Center in Worcester and Associate Professor at the University of Massachusetts Medical School. Dr. Forkey is an expert in childhood trauma, child abuse and the health of foster care children.  She gives us the building blocks to integrate Trauma-Informed Care into our everyday practice!

Tie on your bib and get ready for some serious knowledge food about infant nutrition with Dr. Joan Meek! We discuss normal newborn feeding and voiding patterns, the benefits of breastfeeding, and how to counsel families about their options for supplementation. Dr. Meek also tells us about some of the origins of and existing structures driving disparities in breastfeeding. And don’t miss our feeding frenzy rapid fire questions at the end. You’ll leave this episode like an infant who just finished eating--burping yet satisfied! 

Summary Ever gotten overwhelmed by all the categories of ADHD, or interpreter the scores on a Vanderbilt form? Join us with Dr. Sarah Vinson, a triple-boarded clinician in adult psychiatry, child psychiatry, and pediatrics who helps us optimize a diagnosis and management process of ADHD. What other conditions can masquerade as ADHD? Which type of stimulant should you use? Listen to find out more!

 

Learn all about Sickle Cell Disease and the pediatric to adult transition in care from Dr. Lydia Pecker, a sickle cell doctor for young adults practicing in Baltimore, Maryland. In this episode we cover diagnosing sickle cell, detecting and managing complications, and the major treatments, including new drugs and bone marrow transplants. We’ll start with the basics and build up to expertise! 

Join us on a voyage of diagnosis, triage, and treatment of community-acquired pneumonia! Dr. Susan Lipsett delves into the nuances of triaging patients, teasing out viral versus bacterial pneumonia, and choosing the right antibiotic.

This short companion episode to our Pediatric UTI episode dives deeper into the race correction factor present in the UTI guidelines. We speak with guest Dr. Patricia Poitevien, the Program Director of Brown’s Pediatric Residency, the current President of the Association of Pediatric Program Directors,  and Assistant Dean for the Office of Diversity and Multicultural Affairs at the Warren Alpert School of Medicine at Brown University. Dr. Poitevien breaks down why it is important for academic medicine to be thinking critically about race as a social construct, how race-based medicine may cause more harm than benefit, and next steps for how to move forward in a curious, engaged and evidence-based manner. 

If you’re hoping to catch a clean episode covering a common childhood infection, urine luck! This special segment covers an evidence-based approach to urinary tract infection (UTI) featuring Dr. Ken Roberts, Professor Emeritus of Pediatrics at the University of North Carolina School of Medicine. He is an educator, clinician, and leader in pediatrics. He is also the lead author of both the 2011 AAP UTI guidelines and the upcoming AAP febrile infant guidelines. Listen as wee discuss cloudy diagnostic dilemmas and whiz through the appropriate management of UTI.  

Wondering about how anaphylaxis presents in kids and how to give an epinephrine auto-injector to an infant? We chat with Dr. Julie Brown, a pediatric emergency medicine attending physician at Seattle Children's Hospital, about anaphylaxis, a common pediatric condition that can rapidly become dangerous if not quickly recognized and treated. We also discuss food allergy, adjuncts in anaphylaxis therapy, pediatric epinephrine dosing and auto-injectors, and discharge planning.

Join The Cribsiders as our guest Dr. David Stukus (@AllergyKidsDoc) to discuss "all that wheeze" as he takes us on an in-depth journey through the epidemiology, diagnosis, severity, and management of pediatric asthma. Learn everything from how to handle that wheezing kid in front of you, recommended treatment modalities before inhalers, and how to teach children proper inhaler technique. We also discuss the newest asthma GINA treatment strategies and what they mean for your practice.

We are excited to announce that the Cribsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out cribsiders.vcuhealth.org and create your FREE account!

 

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot! 

Extinguish any fears you have about pediatric burns with our great guest, Dr. Tam Pham. Dr. Pham is a board-certified surgeon and Director of the University of Washington Medicine Regional Burn Center and a Professor of surgery at UW. In our episode we cover: burn classification and triage, first aid of burns, and care for burns in different clinical settings.

Your kid’s got a sore throat--no big deal? Think again! Listen to this episode as we wade into the depths of pediatric and adolescent pharyngitis, with the world-renowned creator of the Centor Criteria Dr. Robert Centor MD, MACP, internist and Professor-Emeritus at The University of Alabama at Birmingham School of Medicine. In this episode, we discuss/review the Centor criteria, the differential diagnosis for acute pharyngitis in the school-aged versus adolescent patient, how to treat bacterial pharyngitis, what complications to watch out for in the pediatric populations, and how we should worry more about Lemierre's syndrome than acute rheumatic fever. 

Four weeks after a COVID exposure, children may not be completely in the clear. MIS-C is a post-infectious inflammatory state that affects pediatric patients and can lead to heart failure, acute abdomen, and a new Kawasaki-like syndrome in older ages. We discuss the emerging evidence with expert, Dr. Adriana Tremoulet ( UCSD), who sits on the American College of Rheumatology MIS-C and COVID-19 Related Hyperinflammation Task Force. She educates us on the presentation, diagnosis, and management MIS-C so when you see this condition, you’ll be ready!

If you’re looking to bring your clinical game to the next level, look no further than this next episode where we’ll discuss three huge areas of medical overuse. By the end of the episode, you’ll know not to give antibiotics in an asthma exacerbation, discharge a well-appearing infant undergoing sepsis rule-out at 24 hours, and how to expertly use metered-dose inhalers in the inpatient setting. We welcome Drs. Leonard Feldman and Carrie Herzke, both TWDFNR authors, to explore and educate us on these topics. Listen along here, and follow us @TheCribsiders on #MedTwitter!

The American Academy of Pediatrics (AAP) recommends that schools strive to reopen in the Fall, but there is hesitation from families and teachers alike. We speak with Dr. Sharfstein, a public health expert and pediatrician, regarding the importance of reopening schools for children, what criteria need to be met prior to opening, and how to keep children and teachers safe. Tune in to learn transmission amongst children, how other countries have reopened, why to cohort children, and how the primary care pediatrician can assist in the coming school year!

 

This episode is sponsored by the AAP: If you provide medical care to children, Pediatrics On Call — the new podcast from the American Academy of Pediatrics — will help you do it better. Each week, hear the latest news and research on children's health, on topics from obesity and mental health to keeping the kiddos safe when they’re stuck at home. Subscribe from your favorite podcast provider or find the latest episodes here.

Dive into one of the most common pediatric problems, bronchiolitis, with our guest Dr. Brian Alverson, director of the Division of Hospital Medicine at Hasbro Children’s Hospital.  In this episode, we review the workup of bronchiolitis, including the role of the chest x-ray, RPP, CBC, and more.  We also discuss the evidence behind treatments such as albuterol, steroids, and high flow nasal cannula. Listen to hear more about this breathtaking topic.

Our very first Cribsiders/Curbsiders crossover episode! Learn about cystic fibrosis care across the lifespan. We dive into the diagnosis of CF (don’t lick your patients!), management of pulmonary and extrapulmonary complications, and the future of CF. You’ll also get tips on CF in adolescents and young adults, as well as recognizing undiagnosed CF in older patients. Our guest, Dr. Whittney Warren, is a pulmonary critical care doctor and the medical director of the Adult Cystic Fibrosis clinic in an academic hospital in Texas.

Check out Episode Zero where hosts Justin Berk and Chris "The Chiu Man" Chiu discuss starting the pediatric spin-off podcast of The Curbsiders and hear some samples of upcoming guests!

A new part of The Curbsiders podcast family, The Cribsiders Pediatric Podcast is here to feed pediatric knowledge food to your adult-sized brain hole & provide weight-based dosings of fun. Subscribe to get the latest episodes on core clinical topics including bronchiolitis, pharyngitis, type 1 diabetes, Things We Do For No Reason high-value care, cystic fibrosis, and many more!

Unlock prescriptions for parenting success in this episode as we delve into tips to address behavior concerns! Join us and expert guest Dr. Nakiya Showell (@NShowell) as we discuss unique challenges and opportunities for addressing everything from the 'terrible twos' to teenage tumult. Tune in to learn parenting pearls tailored for the pediatric provider!

Would you like to be a part of The Cribsiders? We’d love to have you! As we’re expanding, we’re looking to add to our production team. If you’re interested, please write to us at thecribsiders@gmail.com with a paragraph detailing why you would like to be on the show and a pilot script. The script should be a clinical vignette with approximately 10 questions to help take our expert on a deep dive through a core pediatric topic. 

Looking forward to hearing from you,
The Cribsiders

Recap and review the top pearls from episodes #66 Constipation, #75 Reflux, & #89 Celiac with a few members of our production team! It’s Fables from the Cribside! (FFTC), our series providing a rapid review of recent Cribsiders episodes for your spaced learning.

You won’t want to sleep through this eye opening review of Pediatric Obstructive Sleep Apnea with our guest, Dr. Ignacio Tapia. He is the Chief of the Division of Pediatric Pulmonology and Batchelor professor of Cystic Fibrosis and Pediatric Pulmonology at the University of Miami.He is board certified in General Pediatrics, Pediatric Pulmonology and Sleep Medicine. His main research interests are the pathophysiology of the Obstructive Sleep Apnea Syndrome (OSAS) in children, clinical trials focusing on treatment of OSAS in children, health disparities in pediatric sleep, and the consequences of OSAS in individuals with Down syndrome. He teaches us about risk factors, screening, diagnosis, and treatment of pediatric OSA. 

Dr. Buddy Creech of  Vanderbilt teaches us the core signs and symptoms of tick-borne illnesses, the importance of geographic variation in making a diagnosis, why doxycycline is the drug of choice for treatment, and not just what but also why we see lab abnormalities in Ehrlichiosis.

The Curbsiders and Cribsiders are back with a very special Med-Peds collaboration on RSV immunizations! Dr. Buddy Creech, Pediatric Infectious Disease at Vanderbilt, walks us through these breakthrough “vaccines" for both adults and kids. He teaches us about their mechanisms of action, eligibility criteria, and why it’s been so challenging to find doses this season. Get ready for your next shot of fun!

Join us on this eye-opening episode as we explore the predicament of pediatric health in the face of a changing climate. From global changes to the impacts on tiny bodies, we'll delve into the health effects of climate change and opportunities to mitigate its impact. Get ready for a 'temperature checkup' on our planet and discover how we can create a healthier, greener future for the next generation.

We’ve all been there - you’re woken up by a critical page and a bright red potassium number blares at you from the computer screen. How do you make sense of the number? What does it mean for a potassium to be hemolyzed? And what are the steps to treating it? Dr. Jordan Symons (Seattle), walks us through all this and more as we learn all about hyperkalemia.

Check out this milestone episode as we return to Cystic Fibrosis from a more pediatric perspective! Don’t sweat it as Dr. Ina St. Onge returns to walk us through newborn screening,  early clinic visits, and the nuances of CFTR modulator therapy. 

Get ready for a Nap-tastic episode that will feed your parenting knowledge and potty humor! Join us and expert guest Dr. Tanya Altmann (@DrTanyaAltmann) as we unravel the secrets of infant sleep, tackle the picky eating habits of little ones, and flush out the best tips for stress-free potty training. It's a diaper-changing experience you won't want to miss!

Rapid heart rate at a rapid response? Not to worry, this collaboration with PedsCrit will give you the confidence you need to take step right in. Join Dr. Nada Mallick as she takes us through Part 2 of our Rapid Response Series, highlighting calls for tachycardia in high risk patients!

Rapid heart rate at a rapid response? Not to worry, this collaboration with PedsCrit will give you the confidence you need to take step right in. Join Dr. Nada Mallick as she takes us through Part 1 of our Rapid Response Series, highlighting calls for both respiratory distress and hypotension!

Renowned pediatric nephrologist, Michelle Starr, returns to the podcast to help unravel and simplify the approach to pediatric hyponatremia, providing valuable insights into diagnosis and treatment strategies. Tune in to elevate your salt game to the next level!

Don’t “break out” from the stress of treating acne! In this episode, pediatric dermatologist Dr. Brandi Kenner-Bell teaches us about the age distribution of acne,  practical lifestyle tips to give patients, and how to step up therapy like a pro.

Little league shoulder and gymnast’s wrist are extremely common diagnoses that can profoundly impact your patient’s training. Tune into this episode as Dr. Conde makes a comeback to walk us through the proper diagnosis and treatment of these overuse injuries.

Here, we make complex care a little less complex by reviewing the key elements of history-taking for patients with medical technology. We discuss management of acute clinical presentations and the role of the complex care physician in providing excellent care for this unique patient population. 

Does hearing about your patient’s palpitations give YOU palpitations because you don’t know what to do next? Treat your tachycardia  with this episode of the Cribsiders, as we talk with special guest Dr. Anna Kamp, a pediatric electrophysiologist at Nationwide Children’s Hospital, about her approach to stable arrhythmias in the outpatient setting. We learn about “red flags” in the history and physical exam that warrant immediate referral to cardiology, whether you should order an echo or event monitor before sending a patient to cardiology, and how you can incorporate wearable EKG technology into your practice.