APGNN Annual Meeting 

Friday, October 6th 

7:30-8:00 am: Breakfast & Welcome 

8:00-9:00 am: Session I – Keynote Speaker & APGNN Year in Review

     8:00-8:30am: Integrative Medicine 
     Ann Ming Yeh, MD - Lucile Packard Children’s Hospital 
     Learning objectives:

• Provide an Overview of concepts of integrative medicine in pediatrics, emphasizing the interplay between the mind, body and gut
• Discuss how pediatric GI providers and nurses can utilize nutrition and lifestyle modification and mind-body techniques for patients with chronic GI conditions

     8:30-9:00am: APGNN Year in Review
     Elizabeth Burch, MSN, RN, CPNP-PC, APGNN President

9:00-10:00 am:  Session II - Intestinal Rehabilitation 

     9:00-9:30am: Will a spoonful of Medicine Help the TPN go down?
     Danielle Wendel, MD - Seattle Children’s Hospital
     Learning objectives:

• Understand the categories of drugs used to aid in feed advancement/TPN weaning
• Evaluate the evidence for use of medications to aid in feed advancement/TPN weaning
• Identify patients who might benefit from medications to aid in feed advancement/TPN weaning

     9:30-10:00am: Ostomy Overview & Troubleshooting 
     Katherine Brennan, MSN, APRN-NP, FNP-C, CPNP & Teresa Kodiak, MSN, APRN-NP,  FNP-PC  - Ann & Robert H. Lurie Children’s Hospital of Chicago
     Learning objectives:

• Review indications for ostomy and anatomy
• Highlight ostomy complications including prolapse, retraction, peristomal skin irritation/breakdown, high stool output
• Review ostomy complication management strategies through real patient case studies
• Discuss the clinical team’s role in promoting and supporting quality of life for the child with an ostomy

10:00-10:30 am: Committee Meetings & Break

10:30-12:00 pm:   Session III - Allergic Conditions of the GI Tract  

     10:30-11:00am: Update on Pharmacologic Therapies for Pediatric Patients with Eosinophilic Esophagitis 
     Kristen Critelli, MD - UPMC Children’s Hospital of Pittsburgh
     Learning objectives:

• Define current treatment goals for eosinophilic esophagitis according to the evolving characteristics of the disease and its natural history
• Review the standard-of-care treatments that reduce symptoms and prevent disease progression of eosinophilic esophagitis
• Recognize emerging treatment options for the management of eosinophilic esophagitis

     11:00- 11:30am: Dispelling Serum Food Allergy Testing 
     Vincent Mukkada, MD - Cincinnati Children’s Hospital 
     Learning objectives:

• Understand an overview of varying types of food mediated reactions and intolerances
• Be able to identify various common forms of allergy testing
• Be able to discuss the indications for and limitations of allergy testing in GI Clinical care

     11:30- 12:00pm: Assessment & Treatment of Allergic Colitis      
     Patricia Bierly, MSN, CRNP - Children’s Hospital of Philadelphia
     Learning objectives:

• Differentiate between Food protein induced enterocolitis, food protein induced enteropathy, Food protein induced allergic proctocolitis
• Discuss treatment of non IgE GI food allergies
• Review the role of allergy testing in non IgE GI food allergies

12:00-1:30 pm: Lunch and Poster Session

1:30-3:00 pm:  Session IV - Motility & Disorders of Gut-Brain Interaction 

     1:30- 2:00pm: The Pediatric intestinal Pseudo obstruction-what’s new and what’s not 
     Rinarani Sanghavi, MD - UT Southwestern Medical Center
     Learning objectives:

• Understand the definition of Pediatric Intestinal Pseudo-Obstruction (PIPO)
• Understand the Diagnostic Criteria used for PIPO
• Understand the Approach for the management of PIPO
• Understand the Outcomes of PIPO

     2:00- 2:30pm: Biomarkers in Disorders of Gut-Brain Interaction 
     Samuel Nurko, MD, MPH -  Boston Children’s Hospital 
     Learning objectives:

• Review the pathophysiology of DGBIs and current evidence on biomarkers
• Understand how biomarkers are incorporated into the evaluation and treatment of DGBI

     2:30- 3:00pm: IB-Stim: A New Treatment for DGBI
     Katja Karrento, MD - Children’s Wisconsin
     Learning objectives:

• Describe plausible mechanisms underlying DGBI
• Describe physiologic mechanisms behind IBstim therapy
• Review data on IBstim for various DGBI

3:00-5:00 pm:  Session V - Hot Topics

     3:00- 3:30pm: Psychological Exposure Protocols for GI Conditions
     Julie Snyder, Psy.D - Boston Children’s Hospital
     Learning objectives:

• To Increase understanding of the rationale behind using exposures for the treatment of gastrointestinal disorders, and more specifically Disorders of the Gut-Brain Interaction.
• To Describe how and why exposure work assists in decreasing avoidance of activities and situations and increasing functioning for patients diagnosed with GI Conditions
• To explain the different types of exposure tasks that may be utilized depending on the GI diagnosis or presenting GI symptoms

     3:30- 4:00pm: H. Pylori, What’s New, What’s Hot and What’s Not
     Benjamin Gold, MD - GI Care for Kids
     Learning objectives:

• Discuss the importance of the microbiome and it’s evolution as part of human evolution
• Briefly discuss the epidemiology and transmission of H. pylori infection
• Discuss why H. pylori may not always have been “bad” and might have been part of our gastric biome
• Describe the gastroduodenal diseases caused by H. pylori infection
• H. pylori origins and Koch’s postulate
• The relationship of H. pylori to asthma and allergies/atopy – real or not?
• Why when you find H. pylori – you kill it…
• Review the therapeutic approaches to H. pylori infection and importance of antimicrobial resistance

     4:00- 4:30pm: "But I feel fine": Strategies to support nonadherence in asymptomatic patients
     Catherine Naclerio PsyD & Christine Reinhard, PhD – Children’s Hospital Colorado
     Learning objectives:

• Identify the wide variety of risk factors for nonadherence in pediatric GI patients
• Review Strategies to help address and support nonadherence in Pediatric GI patients

     4:30- 5:00pm: Polyps 101
     Seth Septer, DO - Children’s Hospital Colorado
     Learning objectives:

• Discuss the physical features and family history that should lead to evaluation for a hereditary polyposiss syndrome
• Understand inheritance patterns and genetic testing implications for common polyposis syndromes
• Discuss surveillance for intestinal and extra-intestinal manifestations of common polyposis syndromes

5:00-5:30 pm: APGNN Awards & Presentations

    Excellence in Education
    Poster of Distinction
    Susan Moyer Research Grant
    Announcing current year’s winner 
    Grant update from Susan Moyer Research Grant winner of 2021 - Melanie Oates, RN - Nationwide 

6:00 pm: APGNN Social Event

Saturday, October 7th

8:00-8:30 am: Breakfast & Welcome

8:30-10:00am:  Session VI - Inflammatory Bowel Disease

     8:30- 9:00am: Extraintestinal Manifestations of Inflammatory Bowel Disease
     Jonathan Moses, MD - UH Rainbow Babies & Children’s Hospital
     Learning objectives:

• Define Known extraintestinal manifestations (EIM) seen in pediatric patients with inflammatory bowel disease (IBD)
• Discuss the work up and management of EIM in pediatric Patients with IBD
• Discuss response of individual EIM with control of underlying inflammation in pediatric patients with IBD

     9:00- 9:30am: IBD Telephone Triage
     Alicia Witkins, MS, RN, CPN - Children’s Hospital Colorado
     Learning objectives:

• Be able to state three questions to ask when triaging a patient
• List three symptoms of an IBD flare
• Name three urgent concerns that require immediate attention

     9:30- 10:00am: Specialized Diets in IBD
     Jennifer Smith, MS, RD, CPS, LD, LMT - Nationwide Children’s Hospital
     Learning objectives:

• Briefly describe the evidence for use of exclusive enteral nutrition and 2 common food based diets to treat IBD along with indications for use
• Discuss considerations for using special diets in the treatment of IBD
• Identify resources for staff to aid in teaching and patients and families in following the diet

10:00-10:30 am Break

10:30- 12:00 pm:  Session VII - Hepatology

     10:30- 11:00am: Evaluation of Elevated Liver Function Tests
     Karie Robinson, APRN, CPNP - Children's Mercy
     Learning objectives:

• Understand definition of elevation in liver enzymes (AST, ALT, GGT)
• Understand evaluation of etiologies of prolonged elevation in LFTs

     11:00- 11:30am: Drug and Viral Induced Liver Injury
     Noberto Rodriguez-Baez, MD - UT Southwestern Medical Center
     Learning objectives:

• Review the epidemiology, clinical manifestations, diagnosis, and management of common viruses associated with liver injury
• Review the epidemiology, clinical manifestations, diagnosis, and management of common drugs associated with liver injury

     11:30am- 12:00pm: Progressive Familial Intrahepatic Cholestasis
     Amber Hildreth, DO - Rady Children’s Hospital
     Learning objectives:

• Recognize the presentation, diagnosis, and unique management considerations of patients with Progressive Familial Intrahepatic Cholestasis
• Evaluate the use of medications for pruritus, with focus on ileal bile acid transport (IBAT) inhibitors

12:00-2:00 pm: Lunch and Poster Session

2:00-3:30 pm: NASPGHAN Concurrent Session - From the Kitchen to the Clinic: Improving Health Outcomes Through Diet
Moderators: Valerie Marchand, MD, Ste-Justine UHC and Conrad Cole, MD, MPH, MSc, Cincinnati Children's Hospital

2:00 PM     When food becomes medicine: Eat, drink and be wary
                   Kathleen Gura, PharmD, Boston Children's Hospital
                   Learning objectives:
                   At the conclusion of this lecture the participant should be able to:

• Describe how foods can be used therapeutically to treat conditions such as bacterial overgrowth and colic
• List several common drug-nutrient interactions associated with specific foods
• Discuss what clinicians should tell patients when buying nutritional supplements for treating a specific condition

2:25 PM     Abstract
2:37 PM     The anti-inflammatory way
                   Maria R. Mascarenhas, MBBS, Children's Hospital of Philadelphia
                   Learning objectives:

• Understand what the anti-inflammatory way means
• Be aware of the literature supporting the anti-inflammatory way in adults and children
• Learn about implementation in pediatric patients

3:02 PM     Applied ‘colon-ary’ medicine for GI disorders
                    Kaylie Nguyen, MS, Lucile Packard Children's Hospital @ Stanford
                   Learning objectives: Upon completion of this session, the learner will be able to:

• Name 3 dairy products that are naturally lactose-free
• Explain the basic premise of the Specific Carbohydrate diet and its primary clinical application
• List 2 bioactivities of kefir than can benefit gut health

3:45-5:15pm: NASPGHAN Concurrent Session: VROOM: Vomiting, Regurgitation, Ongoing Outbursts through the Mouth
Moderators: Miguel Saps, MD, University of Miami School of Medicine and Corey Baker, MD, Connecticut Children's

3:45 PM     Differential diagnosis of VROOM
                   Anita Rowhani Sicolo, MD, FAAP, Children's Hospital of Los Angeles
4:10 PM     Abstract
4:22 PM     VROOM: Behavioral treatment of Rumination Syndrome
                    Ashley Kroon Van Diest, PhD, Nationwide Children's Hospital
                    Learning objectives:

• Understand why behavioral treatment is the primary treatment of rumination syndrome
• Learn how to discuss behavioral treatment with patients to get them on-board with treatment
• Describe specific behavioral strategies used to treat rumination syndrome

4:47 PM     VROOM debate: Pick your lane - do everything
                    Ajay Kaul, MBBS MD, Cincinnati Children's Hospital Medical Center
                    Learning Objective:

• At the end of the talk, the attendee will learn why investigating a child with vomiting, rumination and similar disorders is essential

                   VROOM debate: Pick your lane - do nothing
                   Anil Darbari, MD, MBA, Children’s National Hospital
                   Learning objectives: At the end of the presentation, for functional disorders associated with vomiting and
                   regurgitation in children, the participant will:

• Learn about the various diagnostic studies available
• Understand the pros and cons of diagnostic studies
• Learn about the clinical utility of these studies