Children's Hospital Boston presents at the 2006 Pediatric Academic Societies annual meeting

Topics range from substance abuse to gene-chip profiling of disease to "million dollar zip codes" with soaring child injury rates

This year's Pediatric Academic Societies Annual Meeting, from April 29-May 2 in San Francisco, will include nearly 100 presentations from Children's Hospital Boston researchers. Below are presentations of special interest. Media attending the meeting may register in the Press Room located on the Overlook at the Moscone West Convention Center; hours are 8 AM-6 PM. Abstracts are available at http://www.pas-meeting.org. All presentations are embargoed to the day of presentation (no time specified). All times noted are Pacific Time.

SATURDAY, APRIL 29

THE ECONOMIC BURDEN OF DAYCARE-ASSOCIATED ILLNESS
Embargo: Saturday, April 29, 2006
Presentation Time: 11:15 am

Upper respiratory and gastrointestinal infections are a significant burden for families with children in daycare. Research led by Children's Hospital Boston physicians Dr. Grace Lee and Dr. Fabienne Bourgeois has found that non-medical costs – mainly lost wages due to missed work days – are considerably greater than the actual medical costs of treating the illnesses. The study was based on illness diaries kept by 834 participants, from 208 families, for seven months. The researchers stress the need for targeted interventions to reduce disease transmission in daycare settings.

[2325.4] The Economic Burden of Daycare-Associated Illness
Platform Session: General Pediatrics I (10:30 AM - 12:30 PM)
Room 2009 - Moscone West

BOOSTING NEWBORNS' IMMUNE RESPONSES
Embargo: Saturday, April 29, 2006
Presentation times: see below

Newborn babies have immature immune systems, making them highly vulnerable to severe infections. Moreover, newborns can't mount an effective response to most vaccines, frustrating efforts to protect them. Dr. Ofer Levy and colleagues at Children's Hospital Boston now believe they have found a way to overcome these problems. In three parallel studies, they demonstrate ways in which the newborn immune system functions differently than that of adults. They believe their findings could be used to boost immunity in these tiny infants, possibly making infections like respiratory syncytial virus, pneumococcus, pertussis, HIV and rotavirus much less of a threat.

[2620.2] Unique Efficacy of Toll-Like Receptor 8 Agonists in Activating Human Neonatal Antigen-Presenting Cells
Poster Symposium: Neonatal Hematology–Immunology (1-3 PM)
Moscone West, Room 3024, Board Number 2.
Presentation Time: 1:00 pm

[2753.9]The Adenosine System Remodels Toll-Like Receptor-Mediated Innate Immunity in the Human Newborn
Poster Symposium: Neonatal Infectious Diseases (3:15 - 5:15 PM)
Moscone West, Room 3003-3005, Board Number: 9
Presentation Time: 3:15 pm

[2856.186] Innate Immunity of the Human Newborn Is Polarized Towards a High Ratio of IL-6/TNF-á Production In Vitro and In Vivo
Poster Session I (5:15-7:15 PM), Board Number: 186
Presentation Time: 5:15 pm

FETAL EXPOSURE TO COCAINE, CIGARETTES AND ALCOHOL IMPAIRS BRAIN DEVELOPMENT
Embargo: Saturday, April 29, 2006
Presentation Time: 5:15 pm

MRI imaging studies find that children exposed to cocaine in utero had significantly lower brain volumes and significantly less cortical gray matter. Children exposed to cigarettes and alcohol prenatally had a similar pattern. The study, led by Children's Hospital Boston neurologist Dr. Michael Rivkin, involved 35 children aged 10-14, of whom 14 had prenatal exposure to cocaine.

[2880.330] MRI Study of Brain Development in Children with In Utero Cocaine Exposure
Poster Session: Poster Session I (5:15-7:15 PM), Board Number: 330

SUNDAY, APRIL 30 WHICH TEEN MOTHERS WILL GET PREGNANT AGAIN?
Embargo: Sunday, April 30, 2006
Presentation time: 9:15 AM

Although teen pregnancy has declined over the past 15 years, similar declines haven't been reported for repeat pregnancies. Dr. Makia Powers and colleagues at Children's Hospital Boston investigated predictors of repeat pregnancy among 275 adolescent mothers receiving care in 2 urban hospital-based teen-tot clinics. The teens underwent detailed interviews at enrollment and at 3-month intervals for 2 years, giving data on clinic visits, contraception, infant health care, education, relationships, family history, social risk factors, and social supports. Two predictors were found: Adolescents who engaged in a new relationship or did not live with parents were more likely to have a repeat pregnancy within the first year. Factors like contraception, intervention and health visits were not good predictors.

[3155.6] Predictors of Repeat Pregnancies Among Adolescent Mothers in a Teen-Tot Clinic
Platform Session: Underserved Populations I (8:00 AM - 10:00 AM)
Room 2009 - Moscone West

PARENTAL CONSENT: DOES IT INHIBIT RESEARCH ON SUBSTANCE ABUSE?
Embargo: Sunday, April 30, 2006
Presentation Time: 9:45 am

Requiring parental consent when teens are surveyed about substance use may skew the results, report Dr. Neal Rojas and colleagues from Children's Hospital Boston. They compared data collected from two previous studies: one required parental consent and one didn't. The study that didn't require parental consent had much greater participation rates (80% vs. 41%), a greater proportion of white participants (51% vs. 17%), and higher substance abuse screening test scores.

[3155.8] The Effect of Requiring Parental Consent in Adolescent Substance Use Research
Platform Session: Underserved Populations I (8:00 AM - 10:00 AM)

Room 2009 - Moscone West

WHO SAYS YOUR CHILD NEEDS GROWTH HORMONE?
Embargo: Sunday, April 30, 2006
Presentation Time: 12:00 pm

When a child has short stature, clinicians can choose among several algorithms to predict adult height and decide whether the child qualifies for growth hormone, which was approved by the FDA in 2003. Dr. Lisa Swartz and colleagues in the Boston Combined Residency Program (Children's Hospital Boston and Boston Medical Center) used three published formulas to analyze 200 theoretical cases – children of varying ages, heights, weights, bone age, and parental heights. The results varied widely: the number of children judged to qualify for growth hormone ranged from 0 to 17. "Prediction of adult height is not an exact science," the researchers conclude.

[3516.136] Predicting Adult Height: Variations Among Algorithms
Poster Session II (12:00 PM - 2:00 PM), Board Number: 136

USING GENE CHIPS TO PREDICT LUNG DISEASE IN PREMATURE BABIES
Embargo: Sunday, April 30, 2006
Presentation Time: 12:00 pm

About half of all infants born before 28 weeks' gestation develop bronchopulmonary dysplasia (BPD), a chronic lung disease. They have trouble breathing, need extra oxygen and may even need help from a breathing machine. Researchers in newborn medicine, neuroepidemiology and informatics profiled gene activity in 21 very-low-birth-weight infants, extracted their RNA from umbilical cord tissue. They obtained an "expression profile" that predicts BPD and, in the future, could be used to find biochemical pathways that could be targeted as preventive treatment.

[3601.463] Expression Profiles as Predictors of Bronchopulmonary Dysplasia in Extremely Low Gestational Age Newborns
Poster Session II (12:00 PM - 2:00 PM), Board Number: 463

DISEASE SURVEILLANCE: TAPPING INFORMATION PATIENTS GIVE
Embargo: Sunday, April 30, 2006
Presentation Time: 3:30 PM

In this age of avian flu and other emerging infections, real-time disease surveillance systems – with "live" data feeds from emergency departments (ED) – have become a top national priority. Dr. Florence Bourgeois and colleagues at Children's Hospital Boston now report that information reported by patients and parents while in the ED waiting room is much better at capturing the right disease category (e.g. respiratory illness, fever, allergic reaction) than the more limited data currently used by real-time surveillance systems.

[3730.7] The Value of Patient Reports in Disease Surveillance
Platform Session: Public Health and Prevention II (2:00 PM - 4:00 PM)
Room 2007 - Moscone West

MONDAY, MAY 1

VALIDATING AN OBESITY GENE
Embargo: Monday, May 1, 2006
Presentation Time: 8:00 AM

The genes that cause complex traits like obesity are extremely hard to pin down: such traits likely involve many genes and are influenced by environmental factors. A large study from Boston University and the Harvard School of Public Health (HSPH) found an association between obesity and a common variant of a gene known as INSIG2 (insulin-induced gene 2). Drs. Helen Lyon and Joel Hirschhorn from Children's Hospital Boston and the Broad Institute, along with collaborators at Loyola University in Chicago, HSPH and other institutions, have now replicated the finding in five of six large samples from diverse populations, establishing INSIG2 as a likely contributor to obesity in the general population and making the INSIG2 pathway a valid target for intervention. Their results indicate that 10% of the population carries the trait.

[4124.1] Replication of an Association Between Common Variation Upstream of INSIG2 and Obesity
Platform Session: Genetics and Dysmorphology (8-10:00 AM)
Room 2006 - Moscone West

ADHD DRUGS STUNT CHILDREN'S GROWTH
Embargo: Monday, May 1, 2006
Presentation Time: 5:15 pm

A meta-analysis of 22 trials finds that treating attention-deficit hyperactivity disorder (ADHD) with stimulant drugs like Ritalin is associated with growth restriction. The analysis found significant reductions in weight and height after adjustment for age, study quality, type of stimulant and duration of treatment. The authors, from Children's Hospital Boston, Brigham and Women's Hospital and the Karolinska Institute, call for growth monitoring in children receiving stimulant drugs, the mainstay of treatment for ADHD for the last 40 years.

[4885.458] Growth in Children with ADHD Treated with Stimulant Medications: A Meta-Analysis
Poster Session III (5:15 PM - 6:45 PM), Board Number: 458

TUESDAY, MAY 2

GENE CHIPS REVEAL NEW THINGS ABOUT APPENDICITIS
Embargo: Tuesday, May 2, 2006
Presentation Time: 9:15 a.m.

Clinicians often have a difficult time telling whether a patient has appendicitis, and little is known about how the condition arises. Dr. Charles Murphy and colleagues at Children's Hospital Boston are using gene chips to compared inflamed and normal appendices, analyzing the activity of some 14,000 genes at once. They've found that in acute appendicitis, genes involved in the innate immune response are highly active, whereas genes involved in other types of inflammatory conditions (such as inflammatory bowel disease) are not. The researchers hope to tap this new knowledge to develop diagnostic urine tests that would avoid exploratory surgery.

[5156.6] Gene Expression Profiling Reveals a Potent Innate Immune Response in Patients with Acute Appendicitis
Platform Session: Emergency Medicine III (8:00 AM - 10:00 AM)
Room 2004 - Moscone West

USING ZIP CODES TO TARGET INJURY-PREVENTION STRATEGIES
Embargo: Tuesday, May 2, 2006
Presentation Time: 12:00 pm

When it comes to injuries in children, not all zip codes are equal, finds an analysis of the nearly 200,000 pediatric injuries in Massachusetts that required a hospital visit in 2002. Eric Fleegler and colleagues at Children's Hospital Boston mapped out the injury rates in 503 zip code areas, and found 39 "million dollar" zip codes that accounted for the highest pediatric injury rates and 30% of all hospital charges. Their zip-code map should be a useful guide for focusing scant injury-prevention resources.

[5550.290] Million Dollar Zip Codes: A Spatial Analysis of Pediatric Injury Care
Poster Session: Poster Session IV (12:00 PM - 1:30 PM), Board Number: 290

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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