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Primary Care Perspectives

Latest episodes

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Jul 26, 2021 • 17min

Primary Care Perspectives: Episode 107 - Managing Suspected Extremity Fractures

As children and teenagers return to summer activities and school sports, particularly after the pandemic down-time, injuries, including fractures, are on the rise. Brendan Williams, MD, attending pediatric orthopaedic surgeon, Sports Medicine and Performance Center, Children’s Hospital of Philadelphia, discusses: physical exam findings that raise suspicion for fractures; the Ottowa Ankle Rules; clavicle fractures in older children (not newborns); how skeletal maturity changes fracture management decisions; pain management and immobilization guidance for sprains; when to send patients who are still in pain for follow-up evaluation or additional imaging; injury prevention advice to share with patients and families; when to send patients straight to the emergency room; and more. Published July 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Jul 1, 2021 • 19min

Primary Care Perspectives: Episode 106 - Acne

Acne is one of the most common skin conditions, affecting about 80% of all teens. While some teens will only experience mild symptoms, others may develop scarring, hyperpigmentation and negative psychosocial effects. Amanda Shepard-Hayes, MD, an Attending Pediatrician specializing in dermatology at Children’s Hospital of Philadelphia, discusses the importance of recognizing and treating this condition; the combination of factors that cause acne including hormone level changes during puberty or when certain drugs (i.e., corticosteroids, oral birth control) are started or stopped; the different types of acne lesions, and when distribution patterns may indicate a more serious health issue; treatment goals and therapies including topical and systemic medications. In many cases, combination therapy is appropriate, which includes low-dose benzoyl peroxide to kill the bacteria and tretinoin to halt the development of new acne lesions. Recurrent acne that occurs in young children (aged 1 to 7), or in unusual places (like the groin area), should be sent for further evaluation. Published July 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Jun 24, 2021 • 22min

Primary Care Perspectives: Episode 105 - What to Know About Lice/Scabies in the Primary Care Setting

Did you know that the pincers of head lice are perfectly suited to the caliber of children’s hair? And they need a blood-meal every 24 hours to survive? If you hate lice – and love puns – tune in for this discussion with Albert Yan, MD, pediatric dermatologist, Children’s Hospital of Philadelphia. He reviews: the epidemiology of lice, including why they may be more common in certain types of hair; distinguishing between nits and dandruff during exam; treatments for lice and resistance to permethrin and pyrethrum; and newer treatment options like spinosad and topical ivermectin. Scabies are also discussed: a review of transmission, findings and risk factors; where to look for lesions; correctly applying permethrin for scabies; differential diagnosis for scabies; secondary infections from scabies; when to consider referral to dermatology for lice or scabies; and more. Published June 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Jun 9, 2021 • 22min

Primary Care Perspectives: Episode 104 - Menstruation and Period Poverty

At what age should pediatricians worry if a patient hasn’t had their first period? How can they help patients manage chronic period pain?What is “period poverty” and how can doctors help? Shelby Davies, MD, a fellow in the Division of Adolescent Medicine, Children’s Hospital of Philadelphia, discusses a variety of period-related topics, including: a review of the normal sequence of puberty and menarche and a normal menstrual cycle; etiologies of amenorrhea and how to evaluate for different causes ; laboratory tests to consider in cases of primary and secondary amenorrhea; a review of causes and management suggestions for irregular cycles and heavy flow;  a review of management options for dysmenorrhea, including effectiveness of different OTC painkillers; an explanation of menstrual cups and reusable period underwear, alternatives to tampons and pads that are increasingly popular; a discussion of “period poverty” and the barriers some teenagers face in managing their periods, and how doctors can screen for this and help; and more. Published June 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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May 26, 2021 • 16min

Primary Care Perspectives: Episode 103 - Feeding Concerns in Children

In this discussion, Colleen Lukens, a psychologist specializing in children's feeding concerns, joins Sherri Cohen, a medical director at the Pediatric Feeding and Swallowing Center. They unpack various underlying causes of feeding disorders and the importance of a multidisciplinary approach. Topics include common referrals, key feeding milestones, and strategies for parents dealing with picky eaters. They also highlight when to consider additional GI referrals and provide practical tips to encourage healthier eating habits in children.
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May 11, 2021 • 24min

Primary Care Perspectives: Episode 102 - Effective Communication w/ Behavioral Health Patients

Approximately 15% of school-age children and adolescents in the U.S. are thought to have an emotional or behavioral disorder, and nearly two-thirds receive no formal mental health care. Pediatricians are increasingly being called on to screen for and treat mental health problems. Billie Samantha Schwartz, PhD, a Psychologist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children's Hospital of Philadelphia, sits down to tackle common communication challenges faced by primary care providers, and how to find a common factors approach (as recommended by the AAP) to build into practice. Published May 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Apr 22, 2021 • 22min

Primary Care Perspectives: Episode 101 - Environmental Pediatrics: A Conversation with Leo Trasande

Parents often have questions about organic foods and environmental toxins such as BPA and phthalates. This conversation will help provide answers. Leonardo Trasande, MD, MPP, Jim G. Hendricks, M.D. Professor of Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, and author of “Sicker, Fatter, Poorer: The Urgent Threat of Hormone-disrupting Chemicals to Our Future...and What We Can Do” discusses a range of topics, including why environmental medicine is important in pediatrics; the importance of studying disease-related costs of chemicals; racial disparities in exposures to pesticides and other harmful chemicals; and information about topics parents often ask about, such as benefits of organic food, minimizing phthalate exposure, plastics versus glass, BPA and BPA-like chemicals in canned food and drinks, the safest water (probably from your tap!), safe baby food, and more. Published April 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Apr 6, 2021 • 34min

Primary Care Perspectives: Episode 100 - The Addiction Inoculation

In celebration of the 100th episode of the Primary Care Perspectives podcast, Dr. Katie Lockwood welcomes a special guest, author Jessica Lahey, to discuss her most recent book, “The Addiction Inoculation: Raising Healthy Kids in a Culture of Dependence.” Lahey, whose perspective is informed by her own recovery from alcohol addiction and her experiences as a writing teacher and parent, writes for The New York Times and The Washington Post and is the author of the bestseller “The Gift of Failure: How the Best Parents Learn How to Let Go So Their Kids Can Succeed,” from 2015. Here she shares insight on topics including: countering myths about drinking and drugs (such as “everyone does it”); the gateway hypothesis; how pediatricians can be an ally for parents and teenagers in decision-making around alcohol and drugs; the AAP guidelines for substance abuse in youth; tips for effective discussions with teenagers; and more. Published April 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Mar 25, 2021 • 25min

Primary Care Perspectives: Episode 99 - Balancing Act: Assessing Vestibular Disorders

A baby who can’t sit up by 7 months of age. A “clumsy” child who struggles with tasks such as riding a bike. A teenager experiencing dizziness 2-3 months after concussion. What do these patients have in common? They may benefit from assessment for a vestibular disorder. Robert O’Reilly, MD, attending physician, Division of Otolaryngology, and director, Balance and Vestibular Program, Children’s Hospital of Philadelphia, discusses vestibular issues in children and teenagers. Includes: a review of the vestibular apparatus; clinical symptoms and signs of chronic vestibular issues; review of common causes of vestibular issues; when to refer for post-concussion dizziness or post-concussion positional vertigo; and more.  Published March 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.
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Mar 2, 2021 • 22min

Primary Care Perspectives: Episode 98 - Virtual Learning Ergonomics

Ergonomics is the science of fitting a given environment to a person, to limit exposure to physical stressors that could lead to discomfort or injury. Ian Leahy, PT, DPT, a physical therapist with the Sports Medicine and Performance Center at Children’s Hospital of Philadelphia, discusses: the basics of a good home set-up; whether to recommend a standing desk; advice to help parents avoid unnecessary costs; tips for laptop users; importance of variability of position; tips to encourage movement; how static positions can cause adaptive shortening and trigger soft-tissue injury with return-to-sport; what to ask in the history to elicit information about home learning set-ups; relationship between forward head posture and new onset of headache; and more.  Published March 2021. 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. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

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