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CRITICAL CARE

9:15am-12:00pm
Mini Course
4011 Stem Cell Transplantation
Chair: Nancy Bunin, Children's Hospital of Philadelphia, Philadelphia, PA
This mini course will provide participants with an update on both the current status and future of stem cell transplant in pediatrics. Both malignant and non-malignant diseases will be addressed. Advances in graft engineering have made many of these advances possible, and this will be discussed in an overview of autologous stem cell transplant for solid tumors. Allogeneic stem cell transplant may be curative for some patients with hemoglobinopathies and metabolic diseases. Non-myeloablative approaches to hemoglobinopathies are a relatively novel approach, which may be curative without some of the short and long-term toxicities of a myeloablative regimen. Disease-specific characteristics that impact upon transplant outcome of patients with inherited metabolic storage disorders will be identified and discussed. Finally, the concepts of mesenchymal cell transplant and the future of mesenchymal cell transplant therapy will be summarized and discussed.

12:00pm-3:00pm
Mini Course
4105 Update on Injury Control
Chair: Gary A. Smith, Children's Hospital, Columbus, OH
The field of injury control continues to evolve. Over the past decade new sources of injuries have arisen, new information on old or overlooked causes has been obtained, and new techniques for preventing and minimizing the impact of certain injuries have been developed and evaluated. This session will review these advances and outline pertinent next steps for health policy, research and clinical care.

3:15pm-5:15pm
Topic Symposium
4200 Cloning and Embryonic Stem Cells
Chair: Judith Hall, University of British Columbia, Vancouver, Canada
There is enormous public interest in cloning and embryonic stem cells. This symposium will update the pediatric community on recent developments and raises a variety of policy and ethical issues.

3:15pm-5:15pm
Topic Symposium
4202 Stroke in Childhood
Chair: Donna Ferriero, University of California, San Francisco, CA
This session will update physicians on epidemiology and risk factors for perinatal and childhood stroke. Emphasis will be placed on identifying risk factors, increasing recognition, and providing possibilities for treatment.

3:15pm-5:15pm
Platform Session
4258 Pulmonary Vascular Biology
Chairs: Jeffrey R. Fineman and Robin L. Steinhorn

8:00am-10:00am
Topic Symposium
5000 Inflammatory Disorders of the Cardiovascular System
Chair: James Bristow, University of California, San Francisco, CA
Inflammatory diseases of the cardiovascular system remain an important cause of morbidity and mortality in infants and children. While we do not think of these as genetic diseases, the application of powerful molecular genetic tools to these diseases has begun bear fruit. This session will provide an update on the pathogenesis of Kawasaki syndrome, the importance of viral infection and persistence of viral genomes in dilated cardiomyopathy and transplant rejection, and the mechanism of autoimmunity in congenital complete heart block.

8:00am-10:00am
Topic Symposium
5001 Measuring and Improving Quality in Academic Medical Centers
Chair: Michael Apkon, Yale University School of Medicine, New Haven, CT
Applying scientific approaches to quality management presents an important leadership challenge for Academic Medical Centers to enhance health care delivery. This symposium will review new paradigms with which to examine opportunities for measuring and improving the process of care delivery. The symposium will also consider areas of congruence as well as areas of opposition between the educational and care-delivery missions of Academic Medical Centers where often-competing interests of research, clinical care, and education create a particularly challenging environment for quality management.

1:45pm-2:30pm
State of the Art Plenary
5590 Children as Victims of Bioterrorism: Protecting the Fragile Host
Chairs: Phyllis Dennery, Stanford University School of Medicine, Palo Alto, CA and Tina Lee Cheng, Johns Hopkins University School of Medicine, Baltimore, MD
With the recent world events and new threats of biowarfare, what should pediatricians know? Due to their size and physiology, children are at higher risk of injury from bioterrorism. This session will address the biology, clinical manifestations, and possible preventive strategies for likely biowarfare agents. The unique vulnerability of the child will be addressed.

2:00pm-4:00pm
Topic Symposium
5700 Cancer, Blood and the Kidney: Common Themes
Chair: Ellis D. Avner, President-Elect, American Society of Pediatric Nephrology and George R. Buchanan, President, American Society of Pediatric Hematology/Oncology
Many children with cancer, hematological disorders, or kidney disease have complex, multisystem problems. Advances in cell and molecular biology provide insights into the interrelationships of cancer, blood, and the kidney and have led to new diagnostic and therapeutic approaches for the clinician. Such approaches are reviewed in this symposium, which focuses specifically on the nephrological complications of sickle cell anemia and bone marrow transplantation, hematological complications of nephrotic syndrome, and the molecular pathophysiology of WT-1-associated disorders.

2:00pm-4:00pm
State of the Art Plenary
5701 Children as Research Subjects: Ethical and Regulatory Issues
Chair: Myron Genel, Yale University School of Medicine, New Haven, CT
A number of highly publicized adverse events, including the death of two volunteers participating in non-therapeutic research, and the federal shutdown of research at many well-recognized academic institutions because of inadequate compliance with regulatory requirements have intensified scrutiny of the protection afforded to human subjects participating in research, including children. Furthermore a Maryland court has recently decreed that children cannot participate in research without the potential for direct benefit. As a consequence there has been increasing media attention and Congressional concern regarding the adequacy of institutional oversight and investigator attentiveness to established standards and regulations. In addition, new regulations issued under the Health Insurance Portability and Accountability Act of l996(HIPAA) threaten the capacity to conduct health services and outcomes research. These issues will be addressed in the 9th annual Public Policy Plenary Symposium in an interactive format intended to stimulate dialogue among the members of the panel and with the audience.

4:15pm-6:15pm
Topic Symposium
5800 End-of-Life Palliative Care
Chair: Marcia Levetown, Independent Pain and Palliative Care Consultant, Houston, TX
53,000 children die annually in the United States and many more live with chronic, life-threatening conditions. Yet, pediatric education and subspecialty training do not currently prepare practitioners to care for these needy children, their parents, community and survivors. This symposium, presented by a pediatric hematologist/oncologist, pediatric palliative care physician and a bereaved parent, will discuss how to incorporate palliative care into pediatric care. Specific highlights are the presentation of an integrated model of care, beginning at the time of diagnosis of a potentially life-threatening condition, parental and patient perspectives on the fight against disabling symptoms and death, and the ethics behind the decision-making process that confronts the family and medical care team.

4:15pm-6:15pm
Platform Session
5901 Brain Imaging
Chair: William D. Gaillard

4:15pm-6:15pm
Platform Session
5910 Pain: Opportunities and Outcomes
Chair: Robert M. Kennedy
FEATURED SPEAKER:
Jeffrey L. Blumer

4:15pm-6:15pm
Platform Session
5912 Pulmonology
Chair: Marie M. Egan

8:00am-10:00am
Topic Symposium
6000 Human Brain Imaging: Insights into Development and Plasticity
Chairs: Sherin U. Devaskar, University of California, Los Angeles, CA and Joseph J. Volpe, Boston Children's Hospital, Harvard Medical School, Boston, MA
State-of-the-art imaging of the human brain has been achieved by advances in magnetic resonance imaging (MRI) and positron emission tomography (PET). Recent work with MRI and PET has provided remarkable insights into the structure and the function of the brain of infants and children during normal development and with plasticity. In this session, reviews of the insights obtained with such techniques as 3D-volumetric and diffusion tensor MRI, functional MRI, and PET-based studies of brain receptors and metabolism will be presented by leaders in the field. Emphasis will be on the most recent findings, including considerable unpublished work.

8:00am-10:00am
Topic Symposium
6001 New Strategies in Pediatric Heart Failure: Basic Science to Clinical Practice
Chair: Daniel Bernstein, Stanford University Medical Center, Palo Alto, CA
Recent advances in molecular cardiology have dramatically improved our understanding of the pathophysiology of heart failure. These advances have led to the development of new pharmacologic tools for more effectively managing heart failure and avoiding or postponing transplantation. However, the benefits of these new approaches have not always been shared by pediatric-age patients. This session will review two major areas of recent research breakthroughs in myocardial damage and remodeling, discuss the issues involved in translating adult clinical trials into pediatric practice, and introduce an initiative by pediatricians in the Heart Failure Society to develop pediatric heart failure management guidelines.

2:45pm-4:45pm
Poster Symposium
6560 Perinatal Lung Growth and Function
Chairs: Lucky Jain and A. Keith Tanswell

2:45pm-4:45pm
Poster Symposium
6562 Ventilator Strategies: Benefits and Limitations
Chairs: James Cummings and Rita Ryan

4:45pm-6:30pm
Poster Session III
– Critical Care

8:00am-10:00am
Topic Symposium
7001 Neonatal Cholestasis
Chairs: Frederick Suchy, Mount Sinai School of Medicine, New York, NY and William Berquist, Stanford University School of Medicine, Palo Alto, CA
This symposium will highlight the significant recent progress made in defining the etiology of neonatal cholestasis. The advances in this area over the past few years have been breathtaking. For example, the genetic basis of a number of important pediatric liver diseases has been defined, including mutations in transporters that result in several forms of progressive familial intrahepatic cholestasis. The viral etiology and genetic causes of some forms of biliary atresia have also been elucidated. Insight into liver development has also come form the identification of the gene responsible for Allagile’s Syndrome. Advances in these areas of research have been important in elucidating the pathophysiology of these disorders and have provided new insights into the molecular and cellular physiology of the normal hepatocyte.

8:00am-10:00am
Platform Session
7050 Cardiology II
Chairs: Ronald M. Payne and Jeffrey A. Towbin

8:00am-10:00am
Platform Session
7051 Clinical Trials: Perinatal and Neonatal
Chairs: David P. Carlton and Robin K. Ohls

8:00am-10:00am
Platform Session
7052 Developmental Pharmacology
Chairs: Sylvain Chemtob and Deborah G. McCarver

8:00am-10:00am
Poster Symposium
7056 Inflammation in Lung Injury and Remodelling
Chairs: Carl T. D'Angio and David Warburton

8:45am-11:45am
Mini Course
7090 Controlling Asthma in the New Millennium
Chair: James S. Seidel, Harbor-UCLA Medical Center, UCLA School of Medicine, Torrance, CA
Although we have an understanding of the pathophysiology and treatment of asthma, the incidence, severity, and mortality from the disease is increasing. Twice in the past 10 years the National Heart Lung and Blood Institute has issued Guidelines for Diagnosis and Management of Asthma. These have not been widely adopted nor used. This mini course will explore the management of asthma in the emergency department and office setting and explore new methods to form care partnerships between practitioners, families and children to improve the care of asthma.

10:00am-11:45am
State of the Art Plenary
7200 Pediatric Pain
Chairs: K. J. S. Anand, Arkansas Children's Hospital, Little Rock, AR and R. Whit Hall, University of Arkansas for Medical Sciences, Little Rock, AR
Critical periods for early brain development are associated with neurogenesis, neuronal migration, exuberant synaptogenesis, and developmental regulation of cell differentiation and apoptosis. Exposure to repetitive or prolonged pain during critical windows in development can permanently alter the neural substrates associated with pain processing as well as other behavioral domains. This symposium will describe age related changes in pain processing, recent advances in analgesic pharmacology for pediatric patients, and the long-term effects of neonatal pain on subsequent cognition and behavior. Translational research applied to pain processing and analgesic management will be emphasized, to provide the practicing pediatrician with the scientific rationale for current clinical practice.

10:00am-11:45am
State of the Art Plenary
7201 Regenerative Medicine—From Stem Cells to Tissues
Chair: Clifford W. Bogue, Yale University School of Medicine, New Haven, CT
The potential to repair tissues and organs from stem cells has generated great excitement over the past year. Many diseases and pathological conditions, such as liver failure, spinal cord injury, Alzheimer’s disease and myocardial infarction, are now being viewed as potentially curable conditions through the use of stem cells. This session will focus on the developmental biology of stem cells and their amazing ability to give rise to many different fully-differentiated cell types. Investigators in the field of stem cell biology will discuss the potential advantages and limitations of using human embryonic stem cells, the plasticity of bone marrow-derived stem cells, and the therapeutic use of stem cells to regenerate damaged organs.

10:00am-11:45am
State of the Art Plenary
7202 Pharmacogenomics: Clinical and Therapeutic Implications
Chair: James Padbury, Women & Infant's Hospital of Rhode Island, Brown University, Providence, RI
The availability of high density sequence databases for large segments of the human genome has lead to the identification of single nucleotide polymorphisms (SNPs) in many important genes. If these SNPs occur in regulatory regions of important catalytic proteins, occur in binding domains of transmembrane signaling molecules or occur in the regulatory region of a gene, they can profoundly affect the function of that gene and on an individual patient basis. It has become clear these mechanisms account for some of the highly variable, once considered "idiosyncratic", responses to drug therapy. Pharmacogenomics is the study of how genetics affects responses to drugs. Pharmacogenomics holds the promise that drugs might one day be tailor-made for and adapted to each person's own genetic makeup. In this symposium speakers will present prominent examples of how pharmacogenomic implications affect the biology of disease and therapy from the fields of behavioral genetics and sychotherapeutics, cancer chemotherapy and the treatment of asthma. The perspectives presented will help the attendee understand a pathobiological and clinically sound approach to these disorders. The discussion will include basic science, clinical research and an industry perspective on this rapidly emerging area of importance.

1:45pm-3:45pm
Hot Topic
7702 Disaster Preparedness: Beyond 9/11
Chairs: Tina L. Cheng, Johns Hopkins University School of Medicine, Baltimore, MD; Danelle Laraque, Mount Sinai School of Medicine, New York, NY; and Benard Dreyer, New York, NY
The impact of 9/11 and the public health aftermath have affected us personally and professionally. This session will address what the child health professional needs to know regarding disaster planning and preparedness. Speakers will review and provide updates on national and regional systems for emergency management and how those systems interact with local public health agencies, the pediatrician's role in the community's preparedness including what the school system, the pediatric office and the patient should be doing to prepare and respond, recognition and management of chemical and biologic agents of terrorism, and the psychological reactions to disaster and stress.

1:45pm-3:45pm
Platform Session
7801 Critical Care
Chairs: Clifford W. Bogue and David N. Cornfield