Primary Care Perspectives

Lupus is one of the most common diseases in pediatric rheumatology, but it is complicated to diagnose because its symptoms can be broad and nonspecific, creating overlap with other diagnoses. Sarah Bayefsky, MD, a pediatric and adult rheumatology fellow at Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania, and Melissa Argraves, MD, MSEd, a pediatric rheumatologist at Nationwide Children’s Hospital, discuss what a primary care physician should look for if suspecting pediatric-onset lupus — a disease that is seen primarily in teenagers, and in particular females of color. They explain the nuances of possible symptoms; what can be observed during a clinical visit; what labs to order; and what a PCP should keep an eye on if a patient has been diagnosed with lupus. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

In the U.S., Black women are 3 times more likely to experience infant mortality and previously healthy Black children are 3.4 times more likely to die within 30 days after a surgery. What do these statistics – and many others around healthcare, housing and other topics – have to do with vaccine hesitancy? Everything. Latasha Easter, MD, a pediatric resident at Children’s Hospital of Philadelphia, provides an overview of: disparities in immunization rates; the historical context for distrust of the medical establishment and government among Black patients, and the importance of acknowledging it; the CASE Approach, a framework for conversations with hesitant families; sample conversations and responses; an HPV vaccination success story; social media as an information source; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Did you know that lack of canal swelling should be a red flag in physical exam of otorrhea? Ryan Ruiz, MD, MS, attending physician, Division of Otolaryngology, Children’s Hospital of Philadelphia, provides a broad review, covering: key physical exam findings that indicate otitis externa; using antibiotic ear drops and/or oral antibiotics; when to culture; the role of cerumen; when to bring patients back to evaluate tympanic membrane closure; guidelines for water precautions, including for children with ear tubes; evaluating for acute mastoiditis; assessments after trauma; tools an ENT and audiologists have at their disposal that primary care doesn’t; and more.  Published August 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

The Philadelphia Youth Sports Collaborative has more than 70 member organizations that help promote leadership, grit, and other important skills through sports. Beth DeVine, executive director, Philadelphia Youth Sports Collaborative, explains the term “sports-based youth development” and provides an overview of the organization’s goals and role, including trauma-informed coaching, outcome measurement, equitable access, sports as a promoter of social and emotional learning, differences between benefits to boys and girls, and more. She also provides advice on how pediatricians can encourage kids to participate in beneficial sports programs, including pointing them to rec centers and specific resources. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Climate change has many health effects, yet doctors and patients don’t routinely discuss this topic. Harleen Marwah, MD, MS, a pediatric resident at Children’s Hospital of Philadelphia who is the founder of Medical Students for a Sustainable Future,provides an overview of the many ways climate changes affects children’s health, including prenatal health and mental health. Presented with overwhelming information about climate change, doctors may struggle to know how to put helpful steps into practice. Dr. Marwah discusses ideas for how pediatricians can incorporate anticipatory guidance and screening questions related to climate change into practice,with the goal of helping families navigate the changing environment; how doctors can participate in advocacy; and the one step every doctor, no matter how busy,can take today to help address climate change. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Dr. Katie Kennedy from Children's Hospital of Philadelphia discusses distinguishing Oral Allergy Syndrome from other allergies, importance of pollen patterns, reactions to raw vs cooked food, antihistamine recommendations, evaluating systemic reaction risk, outgrowing OAS, when to refer to a specialist, and treatment options in primary care.

Roy Hoffman, a medical director focused on infant mortality, and Stacey Kallem, director of Maternal and Child Health in Philadelphia, tackle the pressing issue of sleep-related infant deaths. They discuss alarming statistics revealing these deaths as a significant cause of mortality, particularly among diverse racial-ethnic groups. The duo emphasizes safe sleep practices, the challenges parents face, and supportive resources like lactation assistance. They also touch on the importance of education, genomic research, and community programs aimed at preventing these tragedies.

Daniel Corwin, an emergency medicine physician at Children’s Hospital of Philadelphia, dives into the crucial topic of pediatric head trauma. He discusses the distinctive criteria for assessing children under two, revealing why they differ from older kids. Corwin explains the importance of evaluating injury mechanisms and offers practical guidelines for parents on monitoring their child after a head injury. He also sheds light on recent changes in concussion management, emphasizing a more supportive approach to recovery for young patients.

One in 4 children will have an episode of chronic pain before they reach adulthood, and kids with chronic pain are 3 times as likely to suffer anxiety or depression. How can primary care pediatricians help de-stigmatize the role of psychology in treatment for chronic pain? Jessica Collins, PsyD, and Christina Holbein, PhD, psychologists who run Comfort Ability workshops at Children’s Hospital of Philadelphia for kids with chronic pain, discuss: common diagnoses that come with chronic pain and discomfort; evidence-based interventions for chronic pain, including the role of cognitive behavioral therapy; differences in reporting of pain and discomfort based on culture and race, and how language barriers affect reporting; how to recognize and address bias in pain management referrals and suggestions for how to help families overcome barriers to resources; a review of CHOP resources for chronic pain, including Comfort Ability; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Chlamydia is the most commonly reported bacterial disease in the U.S., and half of the 1.8 million cases reported in 2019 were in youth. A recent publication by Kenisha Campbell, MD, MPH, and Sarah Wood, MD, MSHP, adolescent medicine physicians at Children’s Hospital of Philadelphia, showed providers are much more likely to screen Black adolescent females for chlamydia than white females. In a review of their study, the two doctors discuss how to address biases as individual providers and as practices or systems, and: a review of chlamydia screening guidelines, prevalence of asymptomatic cases, and effects of untreated infections; the recently modified CDC treatment guidelines, with doxycycline now preferred; when to still consider using azithromycin; when to refer to adolescent medicine; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.