Plan ahead for the flu season with our episode today where we talk about how to treat the common flu, also known as influenza.

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This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• The influenza vaccine is important every flu season!
• Anti-viral neuraminidase inhibitors like oseltamivir/Tamiflu (oral), zanamavir (inhaled), and peramavir (IV) prevent the flu virus from fusing with infected cell membranes preventing the release of the virus
• Baloxivir is a endonuclease inhibitor that inhibits mRNA synthesis that can be given as a one time dose to treat influenza infections.
• Otitis media, PNA, retropharyngeal abscesses, Pott puffy tumors, empyema, meningitis, encephalitis, GBS, acute cerebella ataxia, transverse myelitis, myositis, pericarditis, and myocarditis are all serious complications that can occur with influenza infections

Sources:

• O’Leary ST, et al. Recommendations for Prevention and Control of Influenza in Children, 2024–2025: Technical Report. Pediatrics. 2024 Oct 1;154(4). doi: 10.1542/peds.2024-068508
• AAP Red Book, 2023. doi:10.1542/9781610025782-S3_068
• Moscona, A. Neuraminidase Inhibitors for Influenza. N Engl J Med 2005;353:1363-1373. 2025 Sept 9. doi: 10.1056/NEJMra05074

Have you ever wondered if your patient's snoring is concerning or not? Learn about how we screen for obstructive sleep apnea in pediatric patients in this episode.

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This episode was written by pediatricians Lidia Park, Tammy Yau, and Jessica Ahn with content support from Ambika Chidambaram (UCD pediatric pulmonology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points

• Obstructive sleep apnea (OSA) occurs when there is either complete or partial narrowing of the upper airway during sleep that causes an awakening from sleep and/or results in at least 3% drop in oxygen saturation and lasts 2 breath lengths.
• Symptoms of OSA can include episodes of apnea, gasping, choking, frequent awakenings, sleep enuresis, attention difficulties, behavioral problems, daytime sleepiness.
• On physical exam, watch out for enlarged tonsils and/or adenoids, micrognathia, retrognathia, or hypotonia.
• Untreated OSA is an independent comorbid factor for many conditions such as failure to thrive, obesity, and cardiovascular diseases like insulin resistance, fatty liver disease, and hypertension.
• Disorders associated with OSA include Down syndrome, Duchenne Muscular Dystrophy, Prader Willi, achondroplasia, hypothyroidism, and acromegaly.
• The gold standard for diagnosis of OSA is polysomnography and is based off of AHI scores: 1-5 is mild, 6-10 is moderate, and 11 or greater is severe.
• First line treatment for most children is adenotonsillectomy. If this fails, second line treatment is CPAP or BiPAP.

References

• Krishna J, Kalra M, McQuillan ME. Sleep disorders in childhood. Pediatrics in Review. 2023;44(4):189-202. doi:10.1542/pir.2022-005521
• American Academy of Sleep Medicine. Obstructive Sleep Apnea.; 2008. https://aasm.org/resources/factsheets/sleepapnea.pdf. Accessed October 29, 2024.
• Benedek P, Balakrishnan K, Cunningham MJ, et al. International Pediatric Otolaryngology group (IPOG) consensus on the diagnosis and management of pediatric obstructive sleep apnea (OSA). International Journal of Pediatric Otorhinolaryngology. 2020;138:110276. doi:10.1016/j.ijporl.2020.110276
• Basha S, Bialowas C, Ende K, Szeremeta W. Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea. The Laryngoscope. 2005;115(6):1101-1103. doi:10.1097/01.mlg.0000163762.13870.83

Join us for part 2 of our 2 part series on sickle cell disease. In this episode, we’ll go over the acute complications related to sickle cell disease and their management.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (UC Davis pediatric hematology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Consider acute chest syndrome in a patient with cough, fever, hypoxemia, and new infiltrate on CXR
• Acute pain episodes should be treated with IV hydration, oxygen as needed, and adequate pain management.
• Chronic complications often result from chronic vascular blockage and inadequate oxygenation such as splenomegaly, avascular necrosis, retinopathy, nephropathy, and ulcers.

Sources:

• Pediatrics 2024, A. Yates. https://doi.org/10.1542/peds.2024-066842