# Special Topics in Pediatric Surgery — GCMD Library living collection

Updated: n/a · 3 episodes · 33 cited statements

## Episodes
### Obesity and Metabolic Surgery
- [Treating pediatric obesity as a disease: medications, surgery, and health equity](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857) — podcast · 6:48 · [machine version](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857.md)

### Child Abuse
- [Child Physical Abuse Trauma Evaluation and Management: A Western Trauma Association and Pediatric Trauma Society Critical Decisions Algorithm](https://library.globalcastmd.com/article/child-physical-abuse-trauma-evaluation-and-management-a-western-trauma-associati-3880) — article · [machine version](https://library.globalcastmd.com/article/child-physical-abuse-trauma-evaluation-and-management-a-western-trauma-associati-3880.md)

### Professional Practice
- [Locum Tenens Guidelines, Clavien-Madadi Validation, and Transitional Care Challenges](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864) — podcast · 4:20 · [machine version](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864.md)

## Chapters
- [0:01](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=1) Introduction and paradigm shift: obesity as a disease (Ep 1)
- [1:37](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=97) Continuum of care: treatment options under new guidelines (Ep 1)
- [2:30](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=150) Treatment effectiveness and weight regain challenges (Ep 1)
- [4:09](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=249) Metabolic dysfunction-associated steatotic liver disease prevalence (Ep 1)
- [5:06](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=306) Health equity and advocacy for treatment access (Ep 1)
- [0:16](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=16) APSA Locum Tenens Guidelines (Ep 3)
- [1:40](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=100) Clavien-Madadi Classification Validation (Ep 3)
- [2:50](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=170) Transitional Care Systematic Review (Ep 3)
- [4:04](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=244) Closing Remarks (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Obesity is a disease impacted by behavior and is a multifactorial disease impacted by a robust gene-environment interaction — Justin Ryder (clinical) [Ep 1 · 0:32](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=32)
- Obesity is impacted by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles — Justin Ryder (clinical) [Ep 1 · 0:44](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=44)
- Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity — Justin Ryder (epidemiological) [Ep 1 · 1:08](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=68)
- The new AAP clinical practice guidelines clearly state that obesity is a disease — Justin Ryder (guideline) [Ep 1 · 1:15](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=75)
- Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting — Justin Ryder (guideline) [Ep 1 · 1:25](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=85)
- The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period — Justin Ryder (guideline) [Ep 1 · 1:41](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=101)
- Pharmacotherapy for adolescents with obesity is FDA labeled for those above the age of 12 — Justin Ryder (guideline) [Ep 1 · 1:55](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=115)
- There are 5 medications that are FDA approved for the treatment of adolescents with obesity — Justin Ryder (clinical) [Ep 1 · 2:02](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=122)
- Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile — Justin Ryder (guideline) [Ep 1 · 2:08](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=128)
- Wagovi, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents — Justin Ryder (clinical) [Ep 1 · 2:30](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=150)
- Data in adults on tirzepatide shows significant change in body weight compared to placebo — Justin Ryder (clinical) [Ep 1 · 2:44](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=164)
- Oral GLP-1 medications are on the way in a few short years — Justin Ryder (opinion) [Ep 1 · 2:53](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=173)
- Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years — Justin Ryder (clinical) [Ep 1 · 2:55](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=175)
- There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period — Justin Ryder (clinical) [Ep 1 · 3:03](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=183)
- There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem — Justin Ryder (clinical) [Ep 1 · 3:18](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=198)
- Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids — Justin Ryder (clinical) [Ep 1 · 3:24](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=204)
- Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones — Justin Ryder (clinical) [Ep 1 · 3:40](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=220)
- Weight regain factors are influenced by genetics and the environment, including puberty, race, and socioeconomic status — Justin Ryder (clinical) [Ep 1 · 3:56](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=236)
- It is much easier to lose weight than to keep it off, which is demonstrated across many studies — Justin Ryder (clinical) [Ep 1 · 4:03](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=243)
- Metabolic dysfunction associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease — Justin Ryder (epidemiological) [Ep 1 · 4:22](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=262)
- Obesity is a significant risk factor for MASLD — Justin Ryder (clinical) [Ep 1 · 4:31](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=271)
- About 20% of youth in the United States have obesity, which is roughly 15 million children — Justin Ryder (epidemiological) [Ep 1 · 4:34](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=274)
- Approximately 5 million children have both obesity and MASLD — Justin Ryder (epidemiological) [Ep 1 · 4:40](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=280)
- Between 250,000 and a million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma — Justin Ryder (epidemiological) [Ep 1 · 4:45](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=285)
- There are racial and ethnic differences in MASLD prevalence — Justin Ryder (epidemiological) [Ep 1 · 4:56](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=296)
- Obesity affects at least 35% of adults and 20% of children in Illinois alone — Justin Ryder (epidemiological) [Ep 1 · 5:09](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=309)
- The rates of severe forms of obesity are only increasing — Justin Ryder (epidemiological) [Ep 1 · 5:13](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=313)
- Obesity significantly increases the risk of long-term health problems and early death — Justin Ryder (clinical) [Ep 1 · 5:19](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=319)
- The economic impact of obesity is substantial, with reductions in GDP and increases in state spending — Justin Ryder (epidemiological) [Ep 1 · 5:24](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=324)
- Obesity is a disease driven by biology and it is no one's fault — Justin Ryder (opinion) [Ep 1 · 5:30](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=330)
- Access to effective obesity medications is a health equity issue — Justin Ryder (opinion) [Ep 1 · 5:37](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=337)
- Obesity disproportionately affects people of color and those living in poverty — Justin Ryder (epidemiological) [Ep 1 · 5:41](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=341)
- There is significant variation across the country in how states are covering obesity medications in Medicaid programs — Justin Ryder (epidemiological) [Ep 1 · 5:49](https://library.globalcastmd.com/watch/treating-pediatric-obesity-as-a-disease-medications-surgery-and-health-equity-16857?t=349)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- APSA published best practices for locum tenens surgeons, hospitals, and agencies — Lizzy Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:02](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=62)
- APSA guidelines stress the importance of patient safety and support for surgeons in locum tenens practice — Lizzy Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:12](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=72)
- Locum tenens can help prevent burnout by offering flexible work options for a better work-life balance — Lizzy Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:17](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=77)
- Hospitals should avoid relying solely on locum tenens pediatric surgeons without any full-time surgeons because this may cause patients to slip through handoffs — Lizzy Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:23](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=83)
- Locum tenens agencies should sponsor CME and conduct formal exit interviews — Lizzy Lee summarizes what Dr. Alex Halpern said [Ep 3 · 1:32](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=92)
- A working group of pediatric surgeons from Europe created 19 case scenarios with unexpected events to validate the Clavien-Madadi classification — Alex Halpern summarizing a resource [Ep 3 · 2:01](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=121)
- The validation scenarios were circulated within the European Reference Network of inherited and congenital anomalies, and surgeons rated them using either Clavien-Dindo or Clavien-Madadi classification — Alex Halpern summarizing a resource [Ep 3 · 2:10](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=130)
- 59 surgeons completed the Clavien-Madadi validation questionnaire — Alex Halpern summarizing a resource [Ep 3 · 2:23](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=143)
- The Clavien-Madadi classification showed significantly better agreement rates than Clavien-Dindo and was less frequently considered inaccurate — Alex Halpern summarizing a resource [Ep 3 · 2:27](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=147)
- More pediatric surgeons preferred using the Clavien-Madadi classification over Clavien-Dindo — Alex Halpern summarizing a resource [Ep 3 · 2:34](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=154)
- The Clavien-Madadi classification is both an accurate and useful tool in grading unexpected events in pediatric surgery — Alex Halpern summarizing a resource [Ep 3 · 2:38](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=158)
- A UK systematic review aimed to establish and categorize challenges and solutions related to transitional care in colorectal patients with anorectal malformation and Hirschsprung's disease — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:10](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=190)
- The transitional care systematic review included 234 studies — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:23](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=203)
- Patient's lack of understanding of their own pathology is a challenge in transitional care for colorectal patients — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:29](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=209)
- Lack of education and awareness of adult surgeons about pediatric colorectal pathologies is a challenge in transitional care — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:34](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=214)
- Lack of a structured transitional care program is a challenge for colorectal patients moving from pediatric to adult care — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:42](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=222)
- Fostering young adult patients' autonomy is a proposed solution for transitional care challenges — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:46](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=226)
- Conducting joint pediatric-adult transitional clinics is a proposed solution for transitional care challenges — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:46](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=226)
- Creating a structured and coordinated transition program is a proposed solution for transitional care challenges — Cecilia Gigena summarizes what Dr. Alex Halpern said [Ep 3 · 3:46](https://library.globalcastmd.com/watch/locum-tenens-guidelines-clavien-madadi-validation-and-transitional-care-challeng-16864?t=226)

---
Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai