Pediagogy‪™‬ Lidia Park and Tammy Yau

Learn how to classify and manage pneumonia in today’s episode!This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Natasha Nakra. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Pneumonia can be due to bacteria or viruses and there is no reliable way to distinguish the two* Pneumonia can be diagnosed clinically based on exam or with a CXR. Lab work is not always necessary* Treatment of bacterial pneumonia depends on if you think it is community acquired (first line amoxicillin), atypical (first line azithromycin), or nosocomial/hospital acquired (consider antibiotics for pseudomonal or MRSA coverage)Sources:* AAP 2023, Pinto: https://doi.org/10.1542/aap.ppcqr.396216 (https://doi.org/10.1542/aap.ppcqr.396216) * Pediatrics in Review 2017, Messinger: https://doi.org/10.1542/pir.2016-0183 (https://doi.org/10.1542/pir.2016-0183) * Pediatric Care Online 2016, Light: https://publications.aap.org/pediatriccare/book/348/chapter/5785224/Pneumonia-Chapter-315 (https://publications.aap.org/pediatriccare/book/348/chapter/5785224/Pneumonia-Chapter-315)* IDSA 2013: https://doi.org/10.1093/cid/cir531 (https://doi.org/10.1093/cid/cir531) 

Prolonged viral upper respiratory symptoms or is it actually sinusitis in disguise? Join us as we discuss all things sinusitis in this episode!This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Natasha Nakra. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. Key Points:* Acute bacterial sinusitis can be clinically diagnosed based on persistent respiratory symptoms lasting more than 10 days without improvement, worsening or new respiratory symptoms after initial improvement, or severe symptoms at onset lasting more than 3 days. * First line antibiotic treatment for acute bacterial sinusitis is with amoxicillin or amoxicillin-clavulanate* Complications include orbital or intracranial spread of infectionSources:* Pediatrics in Review 2013, Demuri and Wald: https://doi.org/10.1542/pir.34-10-429 (https://doi.org/10.1542/pir.34-10-429) * AAP Pediatrics 2013, Wald et al: https://doi.org/10.1542/peds.2013-1071 (https://doi.org/10.1542/peds.2013-1071)  * Pediatrics 2024, Conway et al: https://doi.org/10.1542/peds.2023-064244 (https://doi.org/10.1542/peds.2023-064244)  

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Lisa Rasmussen. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. Key points:* Vitamin K is important in preventing early and late onset bleeding in newborns (up to 6 months of age), most importantly, intracranial bleeding. * Intramuscular vitamin K is most effective but oral vitamin K regimens are used outside of the US and are better than not giving any vitamin KSources/Supplemental Information:* AAP Pediatrics 2022, Hand: https://doi.org/10.1542/peds.2021-056036CDC Vitamin K Handout: https://www.cdc.gov/ncbddd/vitamink/vitamin-k-fact-sheet-general.html (https://www.cdc.gov/ncbddd/vitamink/vitamin-k-fact-sheet-general.html)

Can someone with HIV breastfeed their child? You might be surprised at the answer! Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com). This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Laura Kair. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. Key points: * New guidelines from the CDC recommend allowing mothers with HIV on antiretroviral therapy (ART) with an undetectable viral load to breastfeed their child if they desire, whether or not they live in a developed or underdeveloped country. The risk for HIV transmission through breastmilk in these cases is 0.6% * In the US, you can call the national perinatal HIV/AIDS hotline at 1-888-448-8765 for advice * Sources * CDC 2023 Infant Feeding for Individuals with HIV in the US: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html (https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html)     

Stay up to date with new research on shortening antibiotic treatment duration for urinary tract infections (UTIs) with our episode today where we review a recently published randomized control trial (RCT). Learn how to critically analyze study data and what key points we take away. Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com. This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Michelle Hamline. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. Key points: * A single RCT found similar risk of UTI recurrence in children who received a 5 day course vs 10 day course of antibiotics within the first 30 days  Sources * Pediatrics 2024, Montini et al: https://doi.org/10.1542/peds.2023-062598 (https://doi.org/10.1542/peds.2023-062598)  * BMJ 2007, Montini et al: https://doi.org/10.1136/bmj.39244.692442.55 (https://doi.org/10.1136/bmj.39244.692442.55)  * Cochrane Rev 2012, Altamimi et al: https://doi.org/10.1002/14651858.CD004872.pub3 (https://doi.org/10.1002/14651858.CD004872.pub3)  * JAMA Ped 2021, Pernica et al: https://doi.org/10.1001/jamapediatrics.2020.6735 (https://doi.org/10.1001/jamapediatrics.2020.6735)  * JAMA Ped, 2022, Williams et al: https://doi.org/10.1001/jamapediatrics.2021.5547 (https://doi.org/10.1001/jamapediatrics.2021.5547)  

Ever seen a tuft of hair over the lower back or a sacral dimple? Learn how to recognize and manage normal vs abnormal back and spinal findings in our episode today. Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com (mailto:pediagogypod@gmail.com). This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Laura Kair. Drs. Tammy and Lidia take full responsibility for any errors or misinformation. Key points: * Spinal dysraphism is the incomplete fusion of the spine during development. * Not all spinal dysphraphisms will have abnormal cutaneous manifestations that you can see on exam * Diagnose spinal dysphraphisms with spinal ultrasound in young children and MRI in older children * Sacral dimples can be normal but should be worked up if they are larger than 5 mm at the base, above 2.5cm from the anus, not midline, or if there are multiple dimples Sources * Pediatrics in Review 2019, Holmes and Li: https://doi.org/10.1542/pir.2018-0155 (https://doi.org/10.1542/pir.2018-0155)  * Peds in Review 2011, Zywicke and Rozzelle: https://doi.org/10.1542/pir.32-3-109 (https://doi.org/10.1542/pir.32-3-109)  * Hospital Pediatrics 2020, Aby et al: https://doi.org/10.1542/hpeds.2019-0264 (https://doi.org/10.1542/hpeds.2019-0264)