Focus on Children's Health: Recent Episodes
ReachMD
Every generation strives to make the lives of our children happier, healthier and more productive. From cases of otitis media and current lipid management strategies, to the latest treatment options for traumatic brain injury, and the manifestation of rare chromosomal abnormalities, ReachMD explores the realm of children's health with a balanced lineup of leading medical experts in pediatrics and adolescent medicine. Join us to learn more!
Host: Alka Goyal, MD
Higher Postinduction Infliximab Serum Trough Levels Are Associated With Healing of Fistulizing Perianal Crohn’s Disease in Children.
Wael El-Matary, MD, MSc Thomas D Walters, MD Hien Q Huynh, MDJennifer deBruyn, MD David R Mack, MD Kevan Jacobson, MD Mary E Sherlock, MDPeter Church, MD Eytan Wine, MD, PhD Matthew W Carroll, MD, Eric I Benchimol, MD, PhD Sally Lawrence, MD Anne M Griffiths, MD
Background: There is some evidence in adults that higher serum infliximab (IFX) levels are needed to adequately treat fistulizing perianal Crohn's disease (CD). However, data in children are lacking. We aimed to determine postinduction serum trough IFX levels that are associated with healing of fistulizing perianal CD (PCD) at week 24.
Methods: In a multicenter inception cohort study, consecutive children younger than age 17 years with fistulizing perianal CD treated with IFX between April 2014 and June 2017 who had serum trough IFX titers measured before the fourth infusion were included. Area under the receiver operating characteristic curve (AUROC) was calculated to determine the best cutoff to predict fistula …
Host: Brian P. McDonough, MD, FAAFP
Guest: Teresa Gil, PhD
Since about 21 million mothers in America experienced sexual abuse in their childhood, there’s a good chance that some of these women are our patients. So as their physicians, how can we provide them with the best possible care as they continue to cope with the lifelong effects of sexual abuse? That’s what Dr. Brian McDonough explores with Dr. Teresa Gil, author of Women Who Were Sexually Abused as Children: Mothering, Resilience, and Protecting the Next Generation.
Host: Paul Rokuskie
Did you know that in just 10 years, the national prevalence rate for autism spectrum disorder (ASD) has nearly tripled, going from 1 in 166 to 1 in 59? Or that 2 percent of the US population under the age of 18 now carries a diagnosis of ASD? Join Paul Rokuskie as he speaks with Dr. Stuart Shapira, Associate Director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities, about these and other findings from the 2018 study regarding prevalence rates for ASD.
Host: Paul Rokuskie
Guest: David S. Mandell, ScD
As prevalence rates for autism spectrum disorder (ASD) increase, so do economic costs. On average, medical expenditures for individuals with an ASD were 4 to 6 times greater than those without an ASD. Join Paul Rokuskie and his guest Dr. David Mandell, Associate Director of the Center for Autism Research at the Children’s Hospital of Philadelphia, as they dive into the economic impact of ASD.
Host: Paul Rokuskie
As diagnostic information becomes more readily available, the importance of early diagnosis cannot be underestimated when it comes to helping those with autism spectrum disorder (ASD) and their families. Join Paul Rokuskie and his guest Dr. Stuart Shapira, Associate Director for Science at CDC’s National Center on Birth Defects and Developmental Disabilities, as they discuss the diagnosis criteria for ASD.
Host: Jennifer Caudle, DO
Guest: Sarah E. Domoff, PhD
To address the growing issue of prolonged screen time and media use among children, Dr. Jennifer Caudle speaks with Dr. Sarah Domoff, Director of the Family Health Lab at Central Michigan University, about the tools available to help physicians identify and curb screen addiction.
Host: Brian P. McDonough, MD, FAAFP
Guest: Tanya Altmann, MD
To investigate the concerning rise in both asthma and allergies in children, Dr. Brian McDonough is joined by Dr. Tanya Altmann, pediatrician and Editor in Chief of the American Academy of Pediatrics parenting books, to discuss why a missing component of the gut microbiome may be the potential cause and how nutrition and probiotics play a vital role in a child's growth and development.
Host: Jennifer Caudle, DO
Guest: Jean Bennett, MD, PhD
Guest: Albert Maguire, MD
Power couple Drs. Jean Bennett and Albert Maguire discuss how their new therapy for the RPE65 gene, which causes retinal blindness, was recently approved by the FDA to become the first gene therapy treatment for a genetic disease in the United States and the first worldwide treatment for inherited blindness. Not only do they delve into the mechanics of the corrected gene injection, but they also explain what this milestone means for patient eligibility and how their marriage has played a role in the success of their research partnership.
Dr. Jean Bennett is the F.M. Kirby Professor of Ophthalmology at the Perelman School of Medicine at the University of Pennsylvania, and Dr. Albert Maguire is a Professor of Ophthalmology at the Hospital of the University of Pennsylvania and Attending Physician in the Division of Pediatric Ophthalmology at Children’s Hospital of Philadelphia.
Host: Philip Stein, MD
Guest: Neilanjan Nandi, MD
Guest: Susan Peck, MSN, CRNP
From the ReachMD studios in Fort Washington, Pennsylvania, host Dr. Philip Stein talks with Dr. Neilanjan Nandi and nurse practitioner Susan Peck about their respective experiences with The Crohn’s & Colitis Foundation's Camp Oasis. This camp gives children with IBD the opportunity to meet other kids with the same chronic illness, teaching them how to cope with their disease, manage their own medical needs, try new sports and activities, build confidence and independence, and most importantly, spend quality time just being a kid.
Host: John J. Russell, MD
Guest: Thomas Doyle, MD
About 40,000 babies are born with Congenital Heart Disease each year, making it one of the most common birth defects and causes of infant death in the US. CHD is usually present at birth but shows very few outward signs and, in most cases has no known cause or origin.
New and evolving surgical techniques, along with the dawn of pediatric heart transplant, are transforming the field of pediatric cardiology and offer new options for CHD patients.
Host Dr. John Russell talks with Dr. Thomas Doyle about how continued research, improved surgical treatments and, emerging technology have altered the course of treatment for CHD, resulting in approximately 69% of children with CHD now living to age 18.
Dr. Thomas Doyle is the Ann and Monroe Carell Jr. Family Associate Professor of Pediatrics at Vanderbilt University. Dr. Doyle was a 2016 Project Heart CHD research grant recipient.
Host: Paul Rokuskie
Scientists have been doing research into many areas of autism spectrum disorder in the hopes of explaining the doubling of its prevalence rate over the past decade.
Both environmental risk factors and genetic components are areas of intense scrutiny for researchers seeking to understand the root causes of autism.
Host Paul Rokuskie talks with Craig Newschaffer, Professor, Associate Dean for Research, and Director of the A.J. Drexel Autism Institute, about the risk factors for autism spectrum disorder that scientists are working to better define.
Host: John J. Russell, MD
Do pets help prevent allergies? Does the 5-second rule actually exist? And is dirt really good for a child’s immune system?
Host Dr. John Russell talks with Jack Gilbert, Ph.D., Professor of Surgery at the University of Chicago and Director of the Microbiome Institute. Dr. Gilbert is author of the book Dirt is Good,answering questions about the potential benefits of exposure to germs and bacteria. He and Dr. Russell sift through common misconceptions about microbiomes to better understand their actual risks and benefits for the body's immune system, explaining its role in disease and health.
Host: Shira Johnson, MD
Guest: Robert Vonderheide, MD
For years, the foundations of cancer treatment, surgery, chemotherapy, and radiation therapy were utilized with the objective of weakening cancer.
But over the past several years, immunotherapy – therapies that enlist and strengthen the power of a patient’s immune system to attack tumors - has emerged as a new tool for fighting cancer. In August 2017, one such treatment approach, called Chimeric Antigen Receptor or CAR T-cell Therapy, received FDA approval for the treatment of children and young adults with acute lymphoblastic leukemia (ALL). Additionally, research is continuing to look at CAR-T therapy’s effectiveness for treating solid tumors as well.
Host Dr. Shira Johnson sits down with Dr. Robert Vonderheide, Director of the Abramson Cancer Center of the University of Pennsylvania and the John H. Glick, MD, Abramson Cancer Center Director’s Professor, to talk about the potential of CAR-T therapy alongside other emerging immunotherapies in fighting cancer.
Host: Paul Rokuskie
Over the past two decades, the world has seen a dramatic rise of individuals being diagnosed with autism spectrum disorder. For decades scientists and medical professionals have been researching various aspects of this disease to uncover genetic and environmental factors explaining this rapid increase in prevalence; however, discovering definitive clues to causality has proven elusive.
Host Paul Rokuskie talks with Dr. Craig Newschaffer, Professor, Associate Dean for Research, and Director of the A.J. Drexel Autism Institute about the latest research findings into environmental factors affecting autism risk.
Host: Paul Rokuskie
Researchers have been challenged for years by the simultaneous results of numerous studies into brain network connections in individuals with Autism Spectrum Disorder. Some results show strong connections, while others suggest the opposite. New research has helped bring some clarity to this ongoing paradox.
Host Paul Rokuskie is joined by Dr. Benjamin Yerys, a child psychologist in the Center for Autism Research (CAR) at the Children’s Hospital of Philadelphia. They talk about how it’s possible to see conflicting results and, paradoxically, for both to be true.
Host: Maurice Pickard, MD
Guest: Bonnie Rochman
With the ever-expanding array of prenatal and postnatal tests, from carrier screening to genome sequencing, parents’ access to this previously unknown information is altering perceptions of disability, redefining the question of what sort of life is worth living, and who draws the line. Is this technology a triumph of modern medicine or a Pandora’s box of possibilities?
Host Dr. Maurice Pickard chats with Bonnie Rochman, author of the book The Gene Machine: How Genetic Technologies are Changing the Way We Have Kids - and the Kids We Have, about the new frontier of gene technology and how it is transforming medicine, bioethics, health care, and the factors that shape a family.
Host: Paul Rokuskie
Autism Spectrum Disorder affects communication skills as well as emotional & social development. Researchers have been studying the brain for decades to better understand how these developmental differences manifest as autism. Recent studies that measure rapid eye movement (REM) have been showing great promise in elucidating the origins and mechanisms of disease.
Host Paul Rokusie sits down with Dr. John Foxe to talk about his study on rapid eye movement, its implications on disease pathogenesis, and new insights it can bring to future autism research.
Anti-TNFα Treatment After Surgical Resection for Crohn's Disease Is Effective Despite Previous Pharmacodynamic Failure
Assa A1, Bronsky J, Kolho KL, Zarubova K, de Meij T, Ledder O, Sladek M, van Biervliet S, Strisciuglio C, Shamir R.
BACKGROUND: The outcome of patients with Crohn's disease who failed anti-tumor necrosis factor alpha (anti-TNFα) therapy despite adequate serum drug levels (pharmacodynamic failure) is unclear. We aimed to assess such pediatric patients who underwent intestinal resection and were re-treated with the same anti-TNFα agent postoperatively.
METHODS: Pediatric patients with Crohn's disease who underwent intestinal resection and were treated with anti-TNFα agents postoperatively were assessed retrospectively. Patients were stratified to those with preoperative anti-TNFα pharmacodynamic failure and those with no preoperative anti-TNFα treatment.
RESULTS: A total of 53 children were included, 18 with pharmacodynamic failure and 35 controls. Median age at intestinal resection was 14.8 years with 23 (43%) girls. The median time from intestinal resection to anti-TNFα initiation was 8 months (interquartile range 4-14 months). At the time of postoperative anti-TNFα initiation, there were no differences in clinical, laboratory, and anthropometric measures between groups. Similar proportions of patients from both groups were in clinical remission on anti-TNFα treatment after 12 months and at the …
Host: Brian P. McDonough, MD, FAAFP
Could constant cell phone use be damaging children's brains?
Host Dr. Brian McDonough chats with Daniel Debaun, author of Radiation Nation: The Fallout of Modern Technology," about how electromagnetic frequency (EMF) radiation produced by modern technology such as cell phones, tablets, laptops, Wi-Fi, and smart meters may be emerging as a health threat with many unknown consequences.
Host: Adam Ehrlich, MD, MPH
Guest: Philip Stein, MD
The majority of adolescents with inflammatory bowel disease (IBD) will transition from a pediatric to an adult specialist. This process can be daunting, especially if patients are not ready to take control of their health care. However, with the right communication and preparation, the transition can be smooth for the patient, parent, and physician. Host Dr. Adam Ehrlich joins Dr. Philip Stein, a pediatric gastroenterologist at St. Christopher’s Hospital for Children, to discuss how physicians can best prepare patients to transition and overcome potential difficulties.
Host: Brian P. McDonough, MD, FAAFP
Guest: Howard Spiva
Wearing a helmet is an overlooked but critical safety precaution, particularly among children. Attorney Howard Spiva knows the lifelong struggle of individuals recovering from traumatic brain injuries, having devoting much of his career to providing helmet safety education for children. Joined by host Brian McDonough, Mr. Spiva discusses important details about helmet safety, the current status of helmet laws, and continuing efforts to reduce traumatic brain injuries nationwide.
Host: Maurice Pickard, MD
Guest: Elijah Nealy, PhD
These days, it is practically impossible not to hear about some aspect of transgender life, and kids are coming out as trans at younger and younger ages. But what resources are available to parents, teachers, and mental health professionals who need to support these children?
Host Dr. Maurice Pickard chats with Elijah C. Nealy, therapist and former deputy executive director of New York City’s LGBT Community Center. Mr. Nealy is the author of Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition, which provides insights about the physical, social, and emotional aspects of transition and the best practices to support trans kids.
Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease in Patients Naïve to or Who Have Failed Tumor Necrosis Factor Antagonist Therapy.
Sands BE1, Sandborn WJ, Van Assche G, Lukas M, Xu J, James A, Abhyankar B, Lasch K.
BACKGROUND: Vedolizumab is a gut-selective α4β7 integrin antagonist for the treatment of moderately to severely active Crohn's disease (CD). Aims of this study were to characterize the efficacy and safety of vedolizumab induction and maintenance therapy in patients who were naïve to tumor necrosis factor-alpha (TNF-α) antagonist therapy (TNF-naïve) or who had discontinued TNF-α antagonist therapy because of inadequate response (i.e., primary nonresponse), loss of response, or intolerance (collectively classified as the TNF-failure population).
METHODS: Post hoc analyses of the efficacy data for 516 TNF-naïve and 960 TNF-failure patients from the GEMINI 2 and GEMINI 3 trials were evaluated at weeks 6, 10, and 52 and included clinical remission (CD Activity Index [CDAI] score ≤150), enhanced clinical response (≥100-point decrease from baseline in CDAI score), durable clinical remission (remission at ≥80% of visits), and corticosteroid-free remission. Adverse events were summarized for the TNF-naïve and TNF-failure subgroups by treatment received.
RESULTS: Among patients who responded to vedolizumab induction at week 6, 48.9% …
Guest: KT Park, MD
Recorded on location at the Crohn’s & Colitis Foundation's Annual Meeting in Orlando, host Dr. Sophie Balzora, Crohn's & Colitis Foundation Reach-IBD member and faculty advisor of the Greater New York Chapter Fellows' Education Committee, discusses general strategies for clinicians and families to optimize growth in pediatric IBD with Dr. K.T. Park, Assistant Professor of Pediatric Gastroenterology at Stanford University School of Medicine & Co-Director of Stanford Children’s Inflammatory Bowel Disease Center.
Host: Prathima Setty, MD
A couple of extra minutes attached to the umbilical cord at birth may translate into a significant boost in neurodevelopment several years later, research suggests.
Dr. Prathima Setty is joined by Dr. Kecia Gaither, a perinatal consultant at St. Lukes Hospital in Kansas City, MO as they talk about how delaying cutting the umbilical cord can be beneficial.
Host: Jennifer Caudle, DO
Sleep apnea in children can lead to many behavioral, school and social problems. Recent research has even suggested that children who snore loudly were found to be twice as likely to have learning problems as children who don’t snore. What can be done to minimize sleep apnea in children?
On this episode of Everyday Family Medicine, Dr. Jennifer Caudle speaks with Dr. Diana Batoon, dentist and founder of Bonita Dental in Scottsdale, Arizona. Dr. Batoon has devoted much of her dental practice and public education efforts around identifying and treating sleep apnea in children.
Host: David Weisman, MD
Dr. David Weisman explores a study from Wake Forest School of Medicine that examined the effects of concussions for youth football participants.
Host: Paul Rokuskie
As medical professionals gain better understandings of the etiologies, mechanisms, and progressions of autism spectrum disorder, they are looking for ways to standardize this diagnosis. This creates new needs to change the way autism is conceptualized clinically, from severity scales to behavioral impacts on quality of life.
Host Paul Rokuskie welcomes Dr. Sven Bolte, Professor of Child and Adolescent Psychiatric Science and Director of the Center of Neurodevelopmental Disorders at Karolinska Institute in Stockholm, Sweden. The two discuss the complex process for building new diagnostic criteria for autism spectrum disorder.
Host: Brian P. McDonough, MD, FAAFP
Holidays, life events, and even seasonal changes in general can cause an extraordinary amount of stress for young children.
Host Dr. Brian McDonough chats with Christine Bronstein, entrepreneur and author of the children’s series Stewie Boom!, about different methods gleaned from pediatricians and other parents to help children cope with stress.
Host: Paul Rokuskie
New research is vital toward better understanding the complexities of autism spectrum disorder. Joining host Paul Rokuskie to discuss the latest research projects striving to identify the underlying causes as well as effective treatments for autism is Dr. Robert Schultz, Director of the Center for Autism Research at Children’s Hospital of Philadelphia.
Host: Jennifer Caudle, DO
Parents today are bombarded with confusing and sometimes harmful information in regard to which foods are best to give their kids. Nutritional guidelines are constantly changing and parents don’t know who to trust for medically sound and proven advice that works.
Host Dr. Jennifer Caudle sits down with Dr. Tanya Altmann, pediatrician, founder of Calabasas Pediatrics, and author of the book, What to Feed Your Baby: A Pediatrician’s Guide to the 11 Essential Foods to Guarantee Veggie-Loving, No Fuss, Healthy Eating Kids. The two talk about the importance of introducing children to healthy eating habits from an early age to ensure a good eating adult lifestyle.
Host: Patrice L Basanta-Henry, MD, MHSc, FACOG
Approximately just 0.5% of all births occur before the third trimester of pregnancy, yet these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. Care for infants born at the threshold of viability, less than 24 weeks of gestation and with body weights less than 1000 grams, poses many difficult clinical, social, and ethical questions among clinicians and families.
Host Dr. Patrice Basanta-Henry speaks with guest Dr. Fyama Wenner, a maternal-fetal medicine specialist at Atlanta Maternal Fetal Medicine, about special care considerations for extremely preterm infants, as well as effective counseling strategies for families.
[Read the Article]
Since the legalization of marijuana in Colorado, there has been an increase in hospital visits and calls to regional poison centers due to unintentional marijuana exposure among young children. Researchers from the University of Colorado evaluated the number of children with exposures before and after recreational marijuana was legalized.
Between 2009 and 2015 they found a rise in the annual number of unintentional pediatric exposures. On average, these children were about two years old. Most children ingested the drug in edible forms such as candies and baked goods. Almost half of the patients seen in the children's hospital in the 2 years after legalization had exposures from recreational marijuana, suggesting that legalization did affect the incidence of exposures.
[Watch more videos of The JAMA Report]
Host: Maurice Pickard, MD
STDs are widespread in all walks of life, regardless of gender, race, social status, or education. Seduced into complacency by the notion that "it can't happen to me" many sexually active teens and young adults are stunned when they are diagnosed with an STD.
In Seductive Delusions: How Everyday People Catch STDs, author and physician Dr. Jill Grimes reveals the truths about sexually transmitted diseases through narrated accounts of young men and women, their exam room conversations with doctors, and both the physical symptoms and the emotional reactions that can accompany infection.
[Read the Article]
A new study suggests that teens undergoing bariatric surgery can experience benefits in terms of walking speed and joint pain. Researchers from the University of Minnesota School of Medicine are tracking long-term outcomes for 242 teens that underwent bariatric surgery at five centers around the United States.
For the current study, researchers specifically focused on improvements in mobility and pain related to muscles and joints is a subset of 206 patients. All patients participated in a quarter mile walk test before and after surgery at six months, twelve months and twenty-four months. Improvements in time to complete the walk, resting heart rate and heart rate differences continued at one and two years after surgery.
[Watch more videos of The JAMA Report]
Host: Brian P. McDonough, MD, FAAFP
Joe Klest, Chicago attorney and author of The Whole Truth. Mr. Klest has represented victims in over 500 sexual abuse cases. He and Dr. McDonough discuss clinical recognition methods and action plans for child abuse, legal contexts for reporting, and the need for increased awareness by clinicians in primary care settings.
Host: Alan S. Brown, MD, FACC, FAHA, FNLA
Like in the United States, Canadian citizens contend with a high pediatric prevelance of lipid disorders, particularly familial hypercholesterolemia. However, perspectives on clinical care and standards public health priorities to address dyslipidemia differ markedly between these two countries. Can American practitioners and health policy experts alike benefit from Canadian approaches to lipidology?
Dr. Alan Brown welcomes Dr. Julie St. Pierre, Professor of Pediatrics at Sherbrooke University in Canada, to discuss pediatric lipid disorder management across North American borders.
[Read the Article]
Approximately one-third of children who experience a concussion will experience persistent post-concussion symptoms. Researchers have developed a new clinical scoring system that may help predict which patients are at a higher risk for prolonged symptoms.
Canadian researchers evaluated more than 3,000 patients, ages 5 to 18, who presented within 48 hours of an acute head injury. About thirty percent ended up with persistent post-concussion symptoms at 28 days. Researchers identified nine clinical factors that were predictive of post-concussive symptoms. These factors were then used in a twelve point risk score that included items like age, sex, history of migraines or depression, prior history of concussion, and problems with balance.
Although the clinical score was better than a physician's judgement alone, further research is needed before it is fully adopted into clinical practice.
[Watch more videos of The JAMA Report]
Host: Brian P. McDonough, MD, FAAFP
Kidney stones are on the rise, particularly among adolescents, females, and African-Americans in the U.S. This marks a striking change from the historic pattern in which middle-aged white men were at highest risk for the painful condition. While the overall increase in kidney stones in children and adolescents has been known, a recent study published in the Clinical Journal of the American Society of Nephrology provided greater clarity on the specific groups of patients at greatest risk by analyzing age, race and sex characteristics among children and adults in South Carolina over a 16-year period, from 1997 to 2012.
Lead author Dr. Gregory Tasian, Assistant Professor of Urology at the University of Pennsylvania Perelman School of Medicine and an attending pediatric urologist at The Children's Hospital of Philadelphia, joins Dr. Brian McDonough to discuss this startling trend, the factors that may be driving it, and appropriate preventive and treatment strategies for kidney stones.
[Read the Article]
Preschool children who experience repeated episodes of severe lower respiratory tract infections (LRTI) often present with symptoms like wheezing and difficulty breathing. A new study looked at whether the use of the common antibiotic, azithromycin, would help prevent progression of the illness, if given early enough in the episode.
Researchers from Washington University in Saint Louis School of Medicine, studied more than 600 children, ranging from ages one to six years old, with a history of repeated episodes of severe respiratory illness. Children were randomly assigned to either receive azithromycin or a placebo early in these episodes.
They found that children in the antibiotic group experienced a lower risk of progressing to severe LRTI than the placebo group.
[Watch more videos of The JAMA Report]
[Read the Article]
Autism Spectrum Disorder (ASD) represents a diverse group of neurodevelopmental conditions. If researchers can better understand the genetics of ASD, it may be possible to identify and diagnose at-risk children sooner. A new study looked at the results of two newer genetic testing technologies, chromosomal microarray and whole-exome sequencing, in children diagnosed with ASD.
Researchers from Newfoundland, Canada studied more than 250 children diagnosed with ASD. All participants underwent the chromosomal microarray analysis, however, only 95 randomly selected participants had whole-exome sequencing. Results found that sixteen percent of the children had an ASD related genetic finding on either microarray or whole-exome sequencing.
In addition to the new tests, researchers also closely examined the children for subtle physical differences and screened them for birth defects. Based on these exams, they were put into three groups of increasing physical severity: essential, equivocal, and complex. Researchers found that thirty-five percent of children in the complex group had a positive genetic test. In that group, the diagnosis of autism was more delayed than in the children of the other groups.
[Watch more videos of The JAMA Report]
JAMA Report videos provided pursuant to license. ©2015 American …
[Read the Article]
Electronic cigarettes (e-cigarettes) are becoming increasingly popular among teens. A new study looks at whether younger teens who never smoked cigarettes and who begin using e-cigarettes might be more likely to go on to use conventional tobacco products.
Researchers from the University of Southern California, Los Angeles surveyed more than 2,300 Los Angeles area high school students who reported never using tobacco products at the beginning of 9th grade. The students were surveyed again six months later and also when entering the 10th grade.
In a comparison of teens who had used e-cigarettes to those who had not, the researchers found that those who had used e-cigarettes were four times more likely to have gone on to use conventional tobacco products, including cigarettes and cigars. The researchers acknowledge that their findings, while suggestive, cannot prove that e-cigarette use directly causes subsequent tobacco use.
[Watch more videos of The JAMA Report]
JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.
Guest: David Freyer, DO, MS
Host: Jerome Lisk, MD
The National Cancer Institute defines the 'lost generation' of cancer patients as adolescent and young adult patients 15 to 39 years of age. These patients have demonstrated lower rates of improvements in survival and the lowest rate of participation in federally-funded clinical trials. Host Dr. Jerome Lisk talks with Dr. David Freyer, director of the LIFE Survivorship and Transition Program at Children's Hospital Los Angeles, about the challenges facing this group of cancer patients.
Guest: Sally Ward, MD
Host: Jerome Lisk, MD
Dr. Sally Ward, who heads the division of pediatric pulmonology and is the medical director of the sleep laboratory at Los Angeles's Children's Hospital, talks to host Dr. Jerome Lisk about the physiological changes in children who experience sleep apnea and other sleep problems. They discuss how some sleep problems come about, how being overweight contributes, and how to help pediatric patients battling obesity and sleep problems.
Host: Mimi Secor, DNP, FNP-BC, FAANP
Guest: Kimberly Comparetto, NP
Alcohol, ecstacy and marijuana use has always been an issue for teens in the United States, but there are other alarming trends as well. More than five percent of 12 year-olds in this country say they have abused prescription drugs. As a medical professional on the front lines, how do you talk to teens and their parents if you suspect an addiction problem with your patients? Kimberly Comparetto, a psychiatric mental health NP who works in the adolescent in-patient unit of Spring Harbor Hospital in Westbrook, Maine, joins host Mimi Secor to talk about risk factors, warning signs, treatment options and ways to open the lines of communication between patients and parents who may have a child with an addiction problem.
Guest: Evelyn Resh, CNM, MPH
Host: Mimi Secor, DNP, FNP-BC, FAANP
All parents want to make sure their teenage daughters are well-informed about issues related to sex, but how do advanced practice clinicians make sure teens are comfortable about their sexuality as they move into adulthood? Certified nurse midwife Evelyn Resh, director of women's health and sexuality counseling at Miraval Resorts, Tucson, Arizona, joins host Mimi Secor to talk about giving girls the knowledge and information they need to make healthy decisions about sex. They also discuss the impact that mothers have on their daughters' body image, and new sexual issues facing girls today.
Guest: Douglas Diekema, MD
Host: Maurice Pickard, MD
Although female genital mutilation and circumcision are banned in the US, these brutal procedures are still part of a ceremonial ritual for some cultures. This issue was brought to national attention in the US when a recent statement from the American Academy of Pediatrics suggested a pinprick or nicking procedure performed by pediatricians in this country might be an effective way to discourage families from traveling overseas for more disfiguring procedures. The statement was retracted soon after its release. Dr. Douglas Diekema, director of education for the Treuman Katz Center for Pediatric Bioethics, and professor in the division of bioethics, department of pediatrics at the University of Washington School of Medicine, discusses the original intent of this policy suggestion, and the greater issue of female genital mutilation and circumcision in the US and worldwide. How often do American pediatricians see girls who have had complications from these procedures? Dr. Maurice Pickard hosts.
Guest: Berish Rubin, PhD
Host: Bruce Bloom, DDS, JD
Only a few years ago familial dysautonomia (FD) was a fatal disease, but some "Rediscovery Research" from the FD lab at Fordham University in Bronx, New York, is turning this killer into a chronic manageable disease. What have we learned from familial dysautonomia research, and how might this help patients with other diseases? Joining host Dr. Bruce Bloom to provide an update on current FD research and treatment is Dr. Berish Rubin, professor in the department of biological sciences and head of the laboratory for familial dysautonomia research at Fordham University.
Guest: Lynne Mofenson, MD
Host: Maurice Pickard, MD
Although HIV transmission through breast milk is a significant global health issue, many mothers and their babies depend on breastfeeding for survival. About 90% of children who become infected with HIV each year are in sub-Saharan Africa. What therapeutic interventions are recommended for mothers with HIV in order to prevent transmission of the virus to their babies? Dr. Lynne Mofenson, chief of the pediatric, adolescent and maternal AIDS branch at the National Institute of Child Health and Human Development, at the National Institutes of Health in Rockville, Maryland, discusses two exciting new developments found to reduce the risk of HIV transmission from mothers to their babies in places where replacement feeding for infants isn't available. Hosted by Dr. Maurice Pickard.
Guest: Jonathan Fanaroff, MD, JD, FCLM, FAAP
Host: Maurice Pickard, MD
About 500,000 births in the US every year are pre-term, making premature delivery far from uncommon. And with the increasing survival of pre-term infants, parents and caretakers are having to make more difficult decisions then ever before. How are prenatal consultations beneficial, and when is the most appropriate time for physicians to have a prenatal discussion with parents? Dr. Jonathan Fanaroff, associate medical director of the Neonatal Intensive Care Unit at Rainbow Babies & Children's Hospital and director of the Rainbow Center for Pediatric Ethics in Cleveland, Ohio, suggests strategies for approaching this type of conversation with parents, and emphasizes the role of these discussions in strengthening the relationship and trust between physicians and parents. Dr. Maurice Pickard hosts.
Host: Bruce Bloom, DDS, JD
Guest: Stephen Hunger, MD
What is the presentation of pediatric patients with acute lymphoblastic leukemia, and how old are these children? What factors help determine the prognosis for a child? Dr. Stephen Hunger, section head of pediatric oncology and hematology, oncology and bone marrow transplantation, at the University of Colorado School of Medicine, talks with host Dr. Bruce Bloom.
Host: Bruce Bloom, DDS, JD
Guest: Charles Mullighan, MBBS, MSc, MD
How does understanding the genetics of rare disease help us understand other pressing pediatric problems? Dr. Charles Mullighan is assistant member of the faculty, pathology department, St. Jude Children's Research Hospital. He joins Dr. Bruce Bloom to discuss the genetics of acute lymphoblastic leukemia.
Guest: Ron Pollack, JD
Host: Bruce Japsen
As the health reform law breaks down hurdles to medical care coverage until it is fully implemented in 2014, the nation's children will be among the first benefactors during the first year of the law's implementation. Ron Pollack, founding executive director of Families USA, a Washington-based advocacy group for healthcare consumers, tells host Bruce Japsen about the law's benefits for children, such as health insurers' inability to deny coverage to children with pre-existing medical conditions that are important to providers.
Guest: Bruce Komiske, MHA
Host: Bruce Japsen
As if finding treatments and cures for diseases and injuries of children was not a big enough of a challenge for researchers, try your hand at building a facility to meet tomorrow's needs for specialized pediatric care. Bruce Komiske, chief of hospital design and construction at the Ann and Robert H. Lurie Children's Hospital of Chicago, tells host Bruce Japsen about the complex and rewarding challenges involved in planning and building new pediatric facilities.
Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA
Guest: Rear Admiral Michael Milner, PA-C
Surgeon General Dr. Regina Benjamin has two new priorities: to combat childhood obesity and to encourage all Americans to put their health histories online. So how do practitioners get involved in these new government initiatives? Rear Admiral Michael Milner, assistant surgeon general and chief of the US Public Health Services Corps, joins host Lisa Dandrea Lenell to get the message out about the latest technology allowing patients to easily share their medical records with doctors and family members, as well as getting kids to start exercising and eating healthily.
Guest: Paul Ehrmann, DO
Host: Mary Leuchars, MD
The general public and medical community alike face a difficult question on childhood obesity: are we witnessing the development of a supersized generation of children? Could this generation even fail to outlive their parents? Dr. Paul Ehrmann, a family practice physician and award-winning community activist, argues that this potential outcome is a reality. Host Dr. Mary Leuchars overviews Dr. Ehrmann's leading efforts with the novel Children's Health Initiative Programs (CHIPs) to counter national trends toward 'Generation XL' at the community level.
Guest: Barry Sarvet, MD
Host: Jennifer Shu, MD, FAAP
Research tells us that roughly one in 20 teenagers in the United States suffers from clinical depression. The problem is most are not receiving treatment because they haven't been diagnosed. In a recent report, the US Preventive Services Task Force issued a recommendation for the routine screening of all adolescents in the primary care setting, even if they don't show signs of depression. Is this recommendation practical? And, can our healthcare system accommodate the likely increase in teens who would subsequently become candidates for mental health treatment? Dr. Barry Sarvet, chief of child and adolescent psychiatry at Baystate Medical Center in Springfield, Massachusetts, joins host Dr. Jennifer Shu for a discussion of the pros and cons of routine depression screening for teenagers.
Guest: Captain Timothy Harrelson
Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA
For his efforts in Afghanistan stabilizing victims wounded in Taliban offensives and providing clean water to families, Cpt. Timothy Harrelson was awarded the Bronze Star. Cpt. Harrelson talks with host Lisa Dandrea Lenell about his lifesaving work with malnourished children in Qalat, Afghanistan. Cpt. Harrelson was involved in the formulation of nutrition that reduced the pediatric mortality rate in Qalat by 25 percent.
Guest: Susan Weisberg, MD
Host: Michael Greenberg, MD
Dr. Janucz Korczak (1878-1942) was a Polish-Jewish pediatrician who had revolutionary ideas about humanism for children, and was one of the first proponents of children's rights. He established the first progressive orphanages in Poland, and wrote numerous books on child psychology, including How to Love a Child and the Child's Right to Respect. Pediatrician Dr. Susan Weisberg describes how Dr. Korczak has inspired her life's work, and tells the story of Dr. Korczak's tragic but noble Holocaust death. Dr. Michael Greenberg hosts.
Guest: Christine Ren, MD
Host: Mary Leuchars, MD
When does surgery become the best option for treating obese adolescents? Dr. Christine Ren, founder and director of the New York University (NYU) Program for Surgical Weight Loss and assistant professor of surgery at NYU School of Medicine, addresses this question and identifies target patients for whom surgery is recommended. She also discusses both physical and psychosocial outcomes for adolescents undergoing weight loss procedures, as well as important post-op nutritional complications clinicians should anticipate. Hosted by Dr. Mary Leuchars.
Guest: Mark Boucek, MD
Host: Mark Nolan Hill, MD
For years, we have performed pediatric heart transplants following the declaration of brain death in donors. To this point, those who die of cardiovascular complications have not been considered for heart donorship. How are advances in this area forcing us to reconsider the prospect of a heart transplant after cardiocirculatory death? Host Dr. Mark Nolan Hill considers the potential ramifications of this fascinating investigation with Dr. Mark Boucek, director of pediatric cardiovascular services at Joe DiMaggio Children's Hospital in Hollywood, Florida, and the lead author of research published in the New England Journal of Medicine on three cases of pediatric heart transplantation after cardiocirculatory death. Does this successful restarting of the heart in transplant recipients suggest that the donor's heart stoppage was not irreversible?
Host: Jennifer Shu, MD, FAAP
Guest: E. Steve Roach, MD
Pediatric and adolescent stroke differ from adult stroke in frequency, presentation, management and prognosis. What causes childhood stroke, and how can we diagnose and treat the condition? Dr. E. Steve Roach, professor of pediatrics and neurology at the Ohio State University College of Medicine, and chief of the division of child neurology at Nationwide Children's Hospital in Columbus, Ohio, explains who, among our young patients, is at greater risk for stroke and how the clinical presentation is often very similar to that of an elderly stroke victim. Looking at the long-term ramifications, how do our young stroke patients fare as they get older? Dr. Jennifer Shu hosts.
Guest: Martin Myers, MD
Host: Jennifer Shu, MD, FAAP
Patients are increasingly seeking accurate information about vaccine safety. Many reach out to friends and family and others scan media reports or search the Internet. But most patients still consider their primary care physician the main source for reliable information. Host Dr. Jennifer Shu welcomes Dr. Martin Myers, an internationally recognized vaccine expert and former director for the Department of Health and Human Service's National Vaccine Program Office. He is co-author of the book Do Vaccines Cause That?! A Guide for Evaluating Vaccine Safety Concerns.What are the most pertinent questions for our patients, and are you prepared with the answers?
Host: Mark Nolan Hill, MD
Guest: Randi Hagerman, MD
Diagnosis of the genetic disorder Fragile X syndrome can be devastating for our young patients and their families, knowing that both the patient and their elders can be affected by this condition. Should we expand current screening measures for Fragile X? As clinicians, how do we guide patients and their families through this process of understanding their diagnosis? Dr. Randi Hagerman, professor and endowed chair of Fragile X research, and medical director of the Medical Investigation of Neurodevelopmental Disorders (MIND) Institute at the University of California, Davis School of Medicine, joins host Dr. Mark Nolan Hill to talk about the nuances of this genetic condition.
Host: Mark Nolan Hill, MD
Guest: Randi Hagerman, MD
We are rapidly learning more about the genetic disorder Fragile X syndrome, and a series of conditions related to Fragile X. We're also seeing great progress in promising therapies under investigation. How will these therapies, along with other treatment strategies, improve the lives of children and families affected by Fragile X and related conditions? Who should supervise care, and should treatment for children be coordinated with care of potentially affected relatives? Dr. Randi Hagerman, professor and endowed chair of Fragile X research, and medical director of the Medical Investigation of Neurodevelopmental Disorders (MIND) Institute at the University of California, Davis School of Medicine, shares her expansive expertise on Fragile X syndrome and associated conditions with host Dr. Mark Nolan Hill. If a child is diagnosed with Fragile X, is genetic screening inevitably warranted for parents and grandparents?
Host: Mark Nolan Hill, MD
Guest: Randi Hagerman, MD
It's responsible for more than five percent of all cases of autism, and it's the most common cause of inherited mental retardation. But are we as familiar as we need to be with Fragile X syndrome, and a series of genetic conditions related to Fragile X? Host Dr. Mark Nolan Hill welcomes Dr. Randi Hagerman, professor and endowed chair of Fragile X research, and medical director of the Medical Investigation of Neurodevelopmental Disorders (MIND) Institute at the University of California, Davis School of Medicine, for a stimulating conversation about our rapidly expanding knowledge of these genetic conditions. How do the signs and symptoms manifest in children, and how does Fragile X impact our elder generations?
Guest: Andrea Asnes, MD, MSW
Host: Cathleen Margolin, PhD
Although young patients and their families may present with troublesome behaviors or unrealistic expectations, it is the pediatric practitioner's responsibility to uphold the principles of professionalism and steer the doctor-patient encounter toward its best outcome. With this is mind, many practitioners may welcome the sound advice of Dr. Andrea Asnes, assistant professor of pediatrics at the Yale University School of Medicine, who joins host Dr. Cathleen Margolin to talk about strategies to successfully navigate the difficult pediatric encounter.
Guest: Andrea Asnes, MD, MSW
Host: Cathleen Margolin, PhD
How can clinicians be prepared during a difficult pediatric encounter to create a favorable outcome? Dr. Andrea Asnes, assistant professor of pediatrics at the Yale University School of Medicine, talks with host Dr. Cathleen Margolin about how to handle difficult clinical encounters.
Guest: Jennifer Christner, MD
Host: Michael Benson, MD
Patients requesting early prescription refills, reporting lost medication, and other deviations from a standard dosing regimen are certainly worth noting. Given the frequency with which we prescribe medications for ADD, ADHD and other illnesses to our young patients, these irregularities may serve as warning signs of a larger problem. Host Dr. Michael Benson discusses prescription stimulant abuse in children with Dr. Jennifer Christner, an adolescent medicine specialist and a clinical assistant professor in the department of pediatrics and communicable diseases at the University of Michigan Medical School.
Guest: Marlene Schwartz, MS, PhD
Host: Leslie P. Lundt, MD
Studies show that people who eat breakfast have better overall nutrition, improved cognitive functioning and are less likely to be overweight. What should we advise our pediatric patients to eat for breakfast? Up to 50% of school-aged children eat cereal for breakfast. How much nutritional value is present in cereal? How best can we advise parents on feeding their children? Dr. Marlene Schwartz, deputy director for the Rudd Center for Food Policy and Obesity at Yale University, describes her research into children's nutrition with host Dr. Leslie Lundt.
Guest: Jill Grimes, MD
Host: Jennifer Shu, MD, FAAP
The Centers for Disease Control (CDC) has indicated that 19 million Americans — including one in four teenage girls — are infected with at least one sexually transmitted disease (STD). As physicians, we know that these diseases are far more common than most people think. But are we doing our best to educate our patients and provide appropriate screening measures? How can physicians work to debunk common public misconceptions about STDs? Dr. Jill Grimes, a practicing family physician in Austin, Texas, and author of Seductive Delusions: How Everyday People Catch STDs, addresses a series of erroneous beliefs about STDs and offers counsel on the most effective ways for physicians to help tackle this critical public health problem. Dr. Jennifer Shu hosts.
Guest: William J. Bryan, MD
Host: Sherwin Ho, MD
One of the lessons of Little League is that injuries are almost inevitable— particularly for overworked young pitchers. Dr. Bill Bryan, orthopedic surgeon and former team physician for Major League Baseball’s Houston Astros, talks with host Dr. Sherwin Ho about the best approaches to evaluating and treating shoulder and elbow injuries. Some injuries are only temporary, but Dr. Bryan says other arm troubles may force a pitcher to choose a new position on the field, at least until the patient is older and stronger.
Host: Leslie P. Lundt, MD
Guest: Diann Ackard, PhD
When we hear that a patient has an eating disorder, we almost always think of a female. Yet adolescent boys do have disordered eating. Might knowing the risk factors help us target our interventions? Eating disorders expert Dr. Diann Ackard joins host Dr. Leslie Lundt as they discuss gender differences in eating disorders.
Guest: Roy Sanders, MD
Host: Bill Rutenberg, MD
Dr. Roy Sanders, author of How To Talk to Parents About Autism, speaks frankly with host Dr. Bill Rutenberg about his own family experience in learning of his son's autistic spectrum disorder. He discusses his family's journey and the dynamics involved in caring for a child with special needs. Dr. Sanders also talks about his professional work as director of psychiatric services at the Marcus Institute in Atlanta, an organization which works with children who have developmental disabilities.
Host: Mark Nolan Hill, MD
Guest: Joseph Muenzer, MD
Previously, patients could only receive palliative care for symptoms associated with Hunter syndrome, a rare but serious genetic disorder that inhibits the body’s ability to break down specific complex carbohydrates. Now, a new enzyme therapy is making it possible to prevent Hunter syndrome manifestation, typically occurring as early as year two, which dramatically improves long-term quality of life. How quickly do patients show improvement with enzyme therapy? What are the most common side effects? Join host Dr. Mark Nolan Hill for an interesting conversation with Dr. Joseph Muenzer, professor of pediatrics and genetics at the University of North Carolina School of Medicine, and one of the world’s leading experts on Hunter syndrome.
Host: Mark Nolan Hill, MD
Guest: Joseph Muenzer, MD
Hunter syndrome is a rare but serious genetic disorder that inhibits the body’s ability to break down specific complex carbohydrates. Initial onset symptoms include inguinal hernias, recurrent otitis, and the common cold, frequently manifesting concurrently as part of a multi-system failure sometime after the first year of life. Because many of these symptoms are common in infants, physicians often do not suspect Hunter syndrome, yet treatment for the disease is much more effective when administered early in its progression. How can we minimize the delay typically associated with diagnosis of Hunter syndrome? Dr. Joseph Muenzer, professor of pediatrics and genetics at the University of North Carolina School of Medicine, and one of the world’s leading authorities in Hunter syndrome research, joins host Dr. Mark Nolan Hill to share his expertise.
Host: Mark Nolan Hill, MD
Guest: Joseph Muenzer, MD
Hunter syndrome is a rare but serious genetic disorder that inhibits the body’s ability to break down specific complex carbohydrates. What are the prinicipal symptoms that would lead a primary care physician to consider Hunter syndrome? Dr. Joseph Muenzer, professor of pediatrics and genetics at the University of North Carolina School of Medicine, and one of the world’s leading authorities in Hunter syndrome research, joins host Dr. Mark Nolan Hill to share his expertise.
Host: Michael Greenberg, MD
Guest: Hugh Rienhoff, MD
Dr. Michael Greenberg speaks with Dr. Hugh Rienhoff about www.mydaughtersdna.org, a website he created to help children with rare or difficult-to-diagnose genetic diseases find proper diagnoses and help.
Host: Bruce Bloom, DDS, JD
Guest: David Teachey, MD
Dr. David Teachey, a practicing pediatric hematologist-oncologist, a world class laboratory and clinical researcher and an Instructor in the Department of Pediatrics, Division of Oncology, at the Children’s Hospital of Philadelphia discusses his new research repurposing pharmaceutical and botanical medicines for diseases like Lupus and ALPS.
Host: Bruce Bloom, DDS, JD
Guest: David Teachey, MD
Dr. David Teachey, a practicing pediatric hematologist-oncologist, a world-class laboratory and clinical researcher and an Instructor in the Department of Pediatrics, Division of Oncology, at the Children’s Hospital of Philadelphia discusses his research breakthrough in treating Autoimmune Lymphoproliferative Syndrome.
Host: Bruce Bloom, DDS, JD
Guest: David Teachey, MD
Dr. David Teachey, a practicing pediatric hematologist-oncologist, laboratory and clinical researcher, and instructor in the department of pediatrics, division of oncology, at the Children’s Hospital of Philadelphia, explains to host Bruce Bloom his breakthrough research that may resolve symptoms for children saddled with the rare genetic disorder, Autoimmune Lymphoproliferative Syndrome.
Host: Andrew Krakowski, MD
Guest: Bari Cunningham, MD
Imagine that you have a rare condition called Xeroderma Pigmentosum (XP) in which even the slightest amount of UV radiation from the Sun turns your skin to cancer; left untreated, you can expect to die within the first 10 years of your life. Also imagine that your brothers and sisters suffer from this same affliction, but your family lacks the resources to do anything about it.
Join Dr. Andrew Krakowski as he joins Dr. Bari Cuningham to discuss her remarkable journey through the wilderness of Guatemala to a small town where an autosomal recessive disease has dominated the local population and cast a shadow on life in this village. Then hear how a new day may be dawning for these special people thanks to a support team that is now championing their cause.
Host: Andrew Krakowski, MD
Guest: Bari Cunningham, MD
It's a rare condition in which even minimal amounts of UV radiation are deadly to the skin. Left untreated, a child will likely die before age 10. Sadly, xeroderma pigmentosum has devastated the local population of a small Guatemalan town. Dr. Bari Cunningham, associate professor of pediatric dermatology at the University of California, San Diego School of Medicine, talks with host Dr. Andrew Krakowski about a journey through the wilderness of Guatemala, where the autosomal recessive disease has cast a shadow on life in this village. But a new day may be dawning for these people, thanks to a support team that is now championing their cause.
Host: Andrew Krakowski, MD
Guest: Bari Cunningham, MD
Imagine that you have a rare condition called xeroderma pigmentosum (XP) in which even the slightest amount of UV radiation from the sun turns your skin to cancer. Left untreated, you can expect to die within the first 10 years of your life. Also imagine that your brothers and sisters suffer from this same affliction, but your family lacks the resources to do anything about it. Dr. Bari Cunningham, a pediatric dermatologic surgeon at Rady Children's Hospital of San Diego, journied through the wilderness of Guatemala to a small town where the autosomal recessive disease has dominated the local population and has cast a shadow on life in this simple village. In this segment hear about the fundamentals for the disease process, its prevalence both nationally and globally, and how experts approach XP patients in high- vs low-resource areas. Dr. Andrew Krakowski hosts.