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ADOLESCENT MEDICINE

12:00pm-3:00pm
Mini Course
4100 Adolescent Medicine - Part I—Current Research Issues
Chair: Donald E. Greydanus, Michigan State University, Kalamazoo, MI
An update of various issues in adolescent health care will be presented. Dr. Charles Irwin Jr. will present current research on Preventive Health Services in Adolescents. Dr. Anna-Barbara Moscicki will discuss the changing Pap Smear guidelines for adolescents, which are being developed by the American Cancer Society. Finally, Dr. Renee Jenkins and Dr. Tina Raine will review current research issues in emergency contraception for adolescents. Questions will be encouraged from the audience.

12:00pm-3:00pm
Mini Course
4103 Sports Participation by Chronically Ill Children and Adolescents: Let the Games Begin!
Chair: Dilip Patel, Michigan State University, Kalamazoo Center for Medical Studies, Kalamazoo, MI
This mini course will focus on helping children and adolescents with chronic illness take full part in sports play (competitive and non-competitive). The role of sports in the lives of our children has become increasingly important in the enhancement of their development. A variety of illnesses will be reviewed in this perspective, with emphasis on diabetes mellitus, asthma and developmental disabilities. Questions from the audience will be sought. The course will be taught by a sports medicine pediatrician, a pediatric endocrinologist and a neurodevelopmental specialist.

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
Platform Session
4250 Adolescent Medicine I
Chair: Donald E. Greydanus

– Adolescent Medicine

Sunday, May 5, 2002

8:00am-11:00am
Mini Course
5090 Adolescent Medicine - Part II—Eating Disorders
Chair: Donald E. Greydanus, Michigan State University, Kalamazoo, MI
This presentation will present an overview of the research on the diagnosis, assessment, and treatment (therapy: including psychological and pharmacological; settings: inpatient, day treatment, and outpatient) of adolescents with eating disorders. A brief comparison of the diagnostic criteria used by the American Psychiatric Association and the World Health Organization will be presented and discussed regarding the relevance to research design and diagnosis. Special issues (such as research design, subject selection, research settings, geographical location, definitions, terminology, race and culture, managed care, and reimbursement) and their impact on our current knowledge base and on treatment choices will be addressed. Recommendations for future directions in assessment, treatment, and research will be offered.

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
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.

2:00pm-5:00pm
Workshop
5608 Pediatric Obesity: Practical Evaluation and Treatment Strategies for Primary Care Providers
The United States is experiencing an epidemic of pediatric obesity. However, many primary care providers report that obesity is one of the most frustrating and difficult problems in their practices. In this workshop, we will provide practical strategies for evaluating and treating obese children in primary care. To maximize learning and relevance the session will be split. Approximately one-third of the session will focus on expert committee recommendations for evaluation and behavioral treatment strategies. We will address skills for identification of obesity, screening for both rare endogenous causes of obesity and more common obesity-associated conditions or risk factors, assessment of emotional and psychosocial states, eating and activity assessment, and indications for consultation with an obesity specialist. For treatment, we will address the most successful strategies for diet and physical activity counseling, changing the household environment, self-monitoring, goal setting and contracting, parenting skills training, maintenance and relapse prevention, and the potential role of drug therapies. The other two-thirds of the session will consist of case discussions and group problem solving. Cases will address practical evaluation and management challenges facing primary care providers.
T. N. Robinson and S. E. Barlow, Dept. of Pediatrics, Stanford University, Palo Alto, CA, and Dept. of Pediatrics, St. Louis University School of Medicine, St. Louis, MO

2:30pm-4:00pm
State of the Art Plenary
5703 Insulin Resistance Syndromes
Chairs: Alan Rogol, Insmed Pharmaceuticals, Inc., Glen Allen, VA and Charlotte Boney, Rhode Island Hospital, Providence, RI
Insulin resistance is the underlying factor in many of the consequences of obesity in childhood and adolescence, including ovarian hyperandrogenism, hypertension, hyperlipidemia, and Type 2 diabetes. Obesity, dyslipidemia, and Type 2 diabetes are components of SyndromeX in adults, a serious public health issue. In addition, insulin has a role in the regulation of leptin, the major signal of adiposity to the brain. Dr. Arslanian will discuss insulin resistance in polycystic ovary disease and Type 2 diabetes. Dr. Freedman will review the cardiac risk factors related to insulin resistance, and Dr. Roemmich will discuss the insulin-leptin axis in obesity and puberty.

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
Poster Symposium
5900 Adolescent Medicine II
Chair: Trina Anglin

4:15pm-6:15pm
Poster Symposium
5906 Neonatal Epidemiology and Follow-Up
Chair: Mark A. Klebanoff and Saroj Saigal

1:30pm-5:30pm
APA Presidential Plenary
6450 APA Presidential Plenary and Armstrong Lecture
Chairs: Steve Ludwig

2:45pm-4:45pm
Platform Session
6552 Clinical Bioethics
Chairs: Susan Hintz and Jon E. Tyson

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
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.

– Behavioral Pediatrics
– General Pediatrics and Preventive Pediatrics

1:45pm-3:45pm
Hot Topic
7700 Models for Building Mental Health Capacity in Pediatric Primary Care
Chair: Anne M. Gadomski, The Mary Imogene Bassett Research Institute, Cooperstown, NY
This session will describe three models presently under study for building the capacity of pediatric primary care sites to manage children’s mental health problems. Two models are based on enhancements or extra resources for primary care providers, and the third is based on primary providers' skills.

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.

Disaster Planning and Preparedness for Child Health Professionals
George L. Foltin, New York University School of Medicine and Bellevue Hospital Center, New York, NY
Biologic Agents of Terrorism
Anne Fine, New York City Department of Health, New York, NY
Chemical Agents of Terrorism
Fred Henretig, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA
Helping Children Cope With Terrorism and Disasters
David J. Schonfeld, Yale University School of Medicine, New Haven, CT
Discussion