Focus On Children's Health

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

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 fight

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 ye

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.