Primary Care Perspectives

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition that affects feeding, growth, and quality of life, traditionally diagnosed and monitored through repeated endoscopies. Recent advancements include the esophageal string test, a minimally invasive method that captures disease activity through biomarkers rather than tissue biopsies, potentially transforming personalized care for EoE patients. This discussion features insights from Amanda Muir, MD, MTR, a pediatric gastroenterology and Melanie Ruffner, MD, PhD, an allergist/immunologist, and highlights how the esophageal string test is being integrated into clinical care programs, such as the Frontier Program at Children's Hospital of Philadelphia, with ongoing research addressing unanswered questions in EoE to enhance patient-centered care.

 

For more information, visit: Center for Pediatric Eosinophilic Disorders | Children's Hospital of Philadelphia

Drowning remains one of the leading causes of death for children. In this episode, Drs. Rotherham and Stafford explain the “layers of protection” concept, including swim lesson timing, effective home pool safety measures, and the risks of floatation devices versus life jackets. We also clarify terms like “dry drowning” and dispel myths around water safety. This episode includes key water safety messages that all pediatricians should share with patients and families.

This episode qualifies for AMA PRA Category 1 Credits™. Visit chop.cloud-cme.com and search for the episode title to claim credit.

The coauthors of a new study in the journal Pediatrics titled “Black Teenage Male and Caregiver Perspectives on Anticipatory Guidance for Police Encounters”, join Katie Lockwood, MD, MEd, in this episode to discuss how pediatricians can help prepare Black youth to safely navigate police interactions. We address the challenges and importance of conversations about racism, especially for racially non-concordant providers, the role of caregivers in facilitating these discussions, and the professional development needs of providers. Thank you to Jeffrey Eugene, MD, and Nikki Jaffe, MD, for sharing their research and lessons learned from their focus groups on how patients and caregivers want to have "the talk" with their pediatric provider.

In this episode, Haley Pearlstein, MD, a CHOP gastroenterologist, discusses cyclic vomiting syndrome (CVS), a pediatric condition marked by recurrent severe nausea and vomiting episodes separated by symptom-free intervals, with a prevalence of up to 3.2% in children. We cover typical presentation in primary care, NASPGHAN guidelines, differential diagnoses including CNS tumors, and diagnostic work-up strategies. In addition, we explore how acute treatments parallel migraine therapies, recommended lifestyle modifications, and preventive medications.

For more information on CVS or to refer to CHOP GI, visit: Division of Gastroenterology, Hepatology and Nutrition | Children's Hospital of Philadelphia

In Philadelphia, a 2007 Board of Health regulation allows capable adolescents ages 11–18 to self-consent to vaccines that prevent reportable diseases, recognizing that teen vaccine coverage remains suboptimal in part due to access barriers and inconsistent uptake when decisions rest solely with parents. This episode explores how that policy works in practice and what it means for autonomy, equity, and public health.

We’re joined by Dr. Marva Schödel, co-author of a recent paper on adolescent vaccine self-consent, to unpack the real-world impact of this approach. This research was done with the Pediatric Research Consortium (PeRC), a primary care practice-based research network at Children’s Hospital of Philadelphia. Dr. Schödel is, as of the time of publication, an employee of Merck, who manufactures the HPV vaccine, Gardasil 9. 

81% of food allergy parents report significant worry about their child. We know that food allergies and anxiety are both common childhood diagnoses, but in this episode we explore the correlation and how we as pediatricians can help recognize when is this anxiety helpful and when is this anxiety unhelpful? In this episode, learn from Tamara Hubbard, MA, LCPC, a licensed clinical professional counselor and family therapist, and Megan Lewis, MSN, RN, PCNP, a Pediatric Nurse Practitioner in the CHOP Division of Allergy and Immunology.  

We have discussed on this podcast before in Episode 143 how to help children who have both food allergies and anxiety, but in this episode, we focus on the parent-child dyad and how parental anxiety may impact a child.

Transition of care from pediatric to adult medicine is sometimes a stressful process, but adolescents with autism and intellectual disabilities have additional considerations and steps that should be taken to make this transition optimal. In this episode, Stacy Ellen, DO, Karin Roseman, LCSW, and Mary Stephens, MD, MPH, from St. Christopher's Hospital for Children tell us about their medical home model, practical tools for preparing for transition, and resources for pediatric primary care providers. 

Why does autism spectrum disorder attract so many myths? In this episode, Kate Wallis, MD, MPH, a developmental behavioral pediatrician, explains why there are so many questions about autism and gives us some expert answers and advice. We discuss acetaminophen, leucovorin, assisted communication, vaccines, and more!

 

#AutismAcceptanceMonth 

Contraception counseling is an important part of comprehensive primary care for adolescents. The past decades have drastically changed the landscape of available contraception options. However, with so many options, contraception counseling can seem overwhelming. In this episode, Gladyne Confident, M.D., an attending in the Division of Adolescent Medicine at Children’s Hospital of Philadelphia, addresses the basics of contraception counseling, how to approach misinformation about contraceptives, and more, using a nuanced and patient-centered approach.

Special thanks to our guest host, Julia Pickel, MD, a pediatric resident at CHOP completing an Advanced Skills in Podcasting.

Eczema, or atopic dermatitis, is common, but it is rare that a food allergy causes atopic dermatitis. In this episode, CHOP allergist Katie Kennedy, MD, explains that only about 25% of children with severe atopic dermatitis have flares driven by foods. She also discusses the pitfalls of allergy testing, approaches to identifying food triggers, and when to refer to an allergist. 

Dr. Kennedy talks about beef tallow and eczema, but for more information view Pediatric Health Chat. CHOP also has a Clinical Pathway for the Evaluation/Treatment of Children with Suspected Atopic Dermatitis. For more information on CHOP's Allergy Program, visit: Allergy Program | Children's Hospital of Philadelphia

 

#foodallergies #eczema