Opening Remarks and Awards
Paul H. Saenger, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY

Lawson Wilkins Lecture
Stanley B. Prusiner, University of California, San Francisco, CA

Robert Blizzard Lecture
Annette Grueters, University of Berlin, Campus Virchow Klinikum

Esoterix Lecture
Michael B. Ranke, Department of Pediatric Endocrinology, University of Tuebingen, Tuebingen, Germany
 

Didactic and case-based discussion of obesity and new formulas focused on practical pediatric office-based issues.

Obesity Treatment and Management in the Pediatric Office: What Can One Do?
William J. Klish, Baylor College of Medicine, Houston, TX

Obesity Detection and Prevention from Office Pediatrician Perspective
Robert Murray, The Ohio State University, Columbus, OH

Formulas Additives Probiotics to Trace Elements—What Parents and Pediatricians Should Know
Judith O'Connor, University of Colorado, Children's Hospital, Denver, CO

Fatty Acid Supplementation of Formulas: Facts and Fictions
Frank R. Greer, University of Wisconsin, Wisconsin Perinatal Center, Madison, WI

There are approximately 200,000 school-aged children with diabetes in the United States. Pediatricians must be aware of the increasing complexities of the diabetes regimen and strategies that can be implemented in schools to improve management and prevention. This workshop will address how to set up a diabetes health care plan, empower families, improve the nutrition environment and promote physical activity. Numerous tools will be presented, including a guide for school personnel, materials to energize the student body to form nutrition clubs and support materials for families.
 

This mini course will set the stage for several discussions of particular issues of major importance and interest. What is "preparedness" and what are the real risks of continuing terrorism in the United States? What is the current status of preparedness in the U.S. hospital and public health systems? How do children differ from adults in terms of response to weapons of mass destruction (chemical, biological and radiological)? How do these differences matter in disaster planning? Are the needs of children being incorporated in local, state and federal disaster plans? Smallpox, anthrax and other biological threats: Where do we stand? What do we do? Nuclear power plants, nuclear weapons, dirty bombs and potassium iodide: What do we know? The mental health consequences of terrorism: What have we learned since 9/11, how do we prepare children for an increasingly vulnerable world, building resiliency and sustaining a positive vision. The new pediatric agenda: What do we have to teach students, residents and pediatricians about the pediatric aspects of terrorism planning. Children and exposure to weapons of mass destruction: science and the essential research agenda.

Introduction
Paul H. Saenger, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY

Welcome and Context
Irwin Redlener, National Center for Disaster Preparedness, Columbia University Mailman School of Public Health, New York, NY

Pediatric Preparedness for Terrorism and Disasters
David S. Markenson, Columbia University Mailman School of Public Health, New York, NY

Biological Weapons of Terror: What Pediatricians Need to Know
Theodore J. Cieslak, U.S. Army Research Institute of Infectious Diseases, Ft. Detrick, MD

Helping Children and Families Cope with Terrorism
David J. Schonfeld, Yale University School of Medicine, New Haven, CT

Radiologic Terrorism, Children and the Question of Potassium Iodide
Thomas P. Foley, University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, PA

This symposium will provide an understanding of the pathophysiology and epidemiology of the major co-morbidities of diabetes in childhood: renal disease, hypertension, dyslipidemia and psychosocial dysfunction. Because of the rapidly increasing number of children developing Type II diabetes, differences in the expression of each co-morbidity in Type I and Type II diabetes will be addressed. The data presented should help to provide a basis on which rational surveillance and management programs for co-morbidities can be incorporated into the routine care of diabetic children.

Renal Complications
S. Michael Mauer, University of Minnesota School of Medicine, Minneapolis, MN

Dyslipidemia
Julia Steinberger, University of Minnesota, Minneapolis, MN

Psychosocial Dysfunction
Alan Delameter, University of Miami, Miami, FL
 

Anorexia nervosa is an eating disorder characterized by a relentless and obsessive pursuit of thinness that most commonly develops in adolescent females. The severe restriction of calories and compulsive exercising that can occur in this chronic condition may result in life-threatening weight loss. In addition to the serious medical complications associated with semi-starvation and severe energy deficits, there are often significant psychological and social problems that may precede or follow, as well as complicate the treatment during, the active phase of the illness. Practitioners and researchers in pediatrics and adolescent medicine in the field of eating disorders have generally focused on the acute and the chronic medical complications associated with anorexia nervosa. Although no organ is spared the effects of chronic malnutrition that occur with this condition, two that have the potential of long-term biological morbidity are the skeletal and reproductive systems. The long-term clinical outcomes of continued morbidity in these organs are osteoporosis and amenorrhea with reproductive failure, respectively. The latest research findings and their clinical implications relative to these organ systems will be discussed, and future research directions will be explored. In addition to the biological effects of anorexia nervosa, we shall address the biological vulnerability to developing anorexia nervosa, based on genetic predisposition. Emerging data from research studies and their clinical implications will be presented.

Overview
Richard E. Kreipe, University of Rochester School of Medicine, Golisano Children's Hospital at Strong, Rochester, NY

Morbidity of the Skeletal System in Anorexia Nervosa
Neville H. Golden, Schneider Children's Hospital, New Hyde Park, NY

Morbidity of the Reproductive System in Anorexia Nervosa
S. Jean Emans, Harvard Medical School, Children's Hospital Boston, Boston, MA

Genetic Susceptibility to Anorexia Nervosa
Wade Berrettini, University of Pennsylvania, Institute of Neurological Sciences, Center for Neurobiology and Behavior, Philadelphia, PA

Discussion
 

Controversial issues in the management of steroid replacement therapies will be discussed in the context of case presentations. Specific, practical therapeutic options will be covered.
 

Discussion will focus on how to enhance pediatric endocrinology practices using physician extenders.
 

Controversial issues in the management of the co-morbidities of diabetes will be discussed in the context of case presentations. Specific, practical therapeutic options will be covered.
 

Visit in February 2004 for the poster program schedules.
 

Children who are victims of violent behavior or merely observers of violence may learn destructive or self-destructive patterns of behavior. Violence is a major public health problem. This symposium will focus on breaking the cycle of violence and will showcase speakers who are working on violence prevention in the pediatric emergency department, school and community. The speakers will demonstrate what can be done by physicians who see the importance of this issue and the ways in which we can make a difference.

Violence Prevention in Primary Care: Moving from Public Health to Private Practice
Robert D. Sege, Tufts-New England Medical Center, Boston, MA

Beyond Treat and Street: Violence Prevention in the Emergency Department
Joel Fein, The Children’s Hospital of Philadelphia, PA

Efforts in the Community
Sheryl A. Ryan, University of Rochester School of Medicine, Rochester, NY

Visit in February 2004 for the abstract program schedules.
 

Visit in February 2004 for the poster program schedules.
 

Blood vessels perfuse all tissues in the body and play a vital function in mediating the exchange of metabolites between the tissues and the blood. However, recent experimental evidence indicates that endothelial cells play an important signaling role during embryonic development and cell differentiation. Understanding the nature of the interaction between endothelial cells and the surrounding cells and tissues will provide valuable insight into normal developmental mechanisms and may lead to important therapeutic approaches for a variety of diseases. In this symposium, we will discuss endothelial signaling in early organ development with a particular focus on the interactions that occur between airway and vascular cells during lung organogenesis and how these interactions are perturbed in lung injury and repair. In addition, we will discuss the biology of a molecule critical to development, VEGF, and its role during angiogenesis.

Endothelial Signaling During Embryonic Development
Ondine Cleaver, Harvard University, Cambridge, MA

Impaired Vascular and Alveolar Interactions in the Pathogenesis of Bronchopulmonary Dysplasia
Steven H. Abman, The Children's Hospital, Denver, CO

Extracellular Matrix Imbalance and Abnormal Lung Morphogenesis
Mala Chinoy, Penn State University College of Medicine, Penn State Hershey Medical Center, Hershey, PA

New Insights in the Regulation of Angiogenesis by VEGF and Other Mediators
Napoleone Ferrara, Genentech, Inc., San Francisco, CA
 

The National Children’s Study is a national prospective, longitudinal study of environmental effects, including physical, chemical, biological and psychosocial effects, on child health and development. The goal of the study is to improve the health and well-being of children. The study will examine these environmental effects on the health and development of more than 100,000 children across the United States, following them from before birth until age 21. The study is led by a consortium of federal agency partners: the U.S. Department of Health and Human Services, including the National Institute of Child Health and Human Development (NICHD); the National Institute of Environmental Health Sciences (NIEHS); the Centers for Disease Control and Prevention (CDC); and the U.S. Environmental Protection Agency (EPA). For additional information, visit the website at http://www.nationalchildrensstudy.gov/.

The National Children’s Study—An Overview
Duane Alexander, NICHD, National Institutes of Health, Bethesda, MD

The National Children’s Study—Methods
Peter C. Scheidt, National Institutes of Health, Bethesda, MD

Children’s Health and Environmental Exposures: The Most Important Unanswered but Answerable Questions
Michael Weitzman, The AAP Center for Child Health Research at the University of Rochester, Rochester, NY

Despite the dramatic increase in patient and graft survival following solid organ transplantation over the past decade, complex and potent immunosuppressive regimens have led to significant complications. In this multidisciplinary symposium, the pathophysiology and therapy of infections, lymphoproliferative disease and growth abnormalities following solid organ transplantation will be reviewed. In addition, the problem of non-compliance with complex immunosuppressive regimens—a major cause of organ loss/dysfunction post transplantation—will be reviewed.

Infections Following Solid Organ Transplantation
Michael Green, University of Pittsburgh School of Medicine, Pittsburgh, PA

Post-transplant Lymphoproliferative Disease: Pathophysiology and Treatment
Vikas R. Dharnidharka, University of Florida Health Science Center, Gainesville, FL

Growth Disorders Following Solid Organ Transplantation
Leona Cuttler, Case Western Reserve University, Cleveland, OH

Compliance with Complex Medical Regimens Post-transplantation: Anticipatory Therapies
Robert Wells, Children's Hospital Central California, Fresno, CA

The neuroendocrine and genetic control of puberty remains one of the fundamental mysteries in human biology. Recent advances derived from sequencing the human genome have enabled the identification of novel genes affecting human puberty via clinical investigations of single patients or families with human disorders that were simply not possible even three years ago. Using these techniques, clinical investigators have been able to identify and chart several genetic defects affecting reproductive development and translate these insights into an improved understanding of how the brain controls puberty in the human. The lecture will focus upon several of these major advances and describe a new gene recently discovered that controls puberty.

William F. Crowley, Harvard Medical School, Massachusetts General Hospital, Boston, MA

The application of imaging technologies to solving questions in biology and medicine is revolutionizing medicine by accelerating analyses in situ and in vivo and providing new perspectives on biological processes as diverse as development, neoplasia and injury repair. In this plenary session, three internationally recognized speakers will focus on developmental processes and discuss how these new imaging technologies are providing dynamic insights into the genetic and epigenetic mechanisms that underpin hematopoiesis and vascular development.

Introduction
Lisa M. Guay-Woodford, University of Alabama at Birmingham, Birmingham, AL

Dynamic Imaging of Fluid Forces in Developing Mouse Vasculature
Mary Dickinson, Beckman Institute–Caltech, Pasadena, CA

Microscopic Imaging of Angiogenesis
Donald M. McDonald, University of California, San Francisco, CA

Watching Hematopoietic Stem Cell Engraftment and Hematopoiesis in Living Animals
Christopher H. Contag, Stanford University School of Medicine, Stanford, CA

Questions from the audience
 

Visit in February 2004 for the abstract program schedules.
 

This session will provide insight into the epigenetic mechanisms responsible for gene expression and its impact during development resulting in programming. These mechanisms may underlie interactions between different nutritional and environmental influences on gene expression. Various examples will be discussed, and the life-long impact of these processes on the phenotype described. This session will provide insight into the relationship between fetal/neonatal events and long-term effects that manifest as chronic adulthood diseases. The speakers will present various aspects of this phenomenon and its physiological outcome.

Evolution of Imprinted Disease Susceptibility Genes
Randy L. Jirtle, Duke University Medical Center, Durham, NC

The Contribution of Genomic Imprinting and Epigenetics to Phenotype
Arthur L. Beaudet, Baylor College of Medicine, Houston, TX

Maternal Care, DNA Methylation and the Development of Individual Differences in Stress Reactivity
Michael Meaney, McGill University, Montreal, Canada
 

In July of 2003, the FDA approved the use of growth hormone for the long-term treatment of children with idiopathic short stature, also called non-growth hormone deficient short stature. This new indication restricts therapy to children who are at least 2.25 SD below the mean for age and sex, or the shortest 1.2% of children. This corresponds to adult heights of less than 5' 3" in men and 4' 11" in women. Data demonstrating the efficacy and safety of GH therapy for children with idiopathic short stature will be reviewed. Although "idiopathic" short stature has often been held synonymous with "normal" short stature, cases in which the underlying molecular defect(s) have recently been elucidated will be presented. With the new FDA ruling on GH, the challenges of deciding when and how to prescribe GH have become even greater. This symposium will address the potential impact of this ruling at a societal and individual level. We will discuss the dilemmas physicians face in using growth hormone and how the ethics of growth hormone therapy apply to our general practice of medicine.

Long at Last: 13 Years of Data on GH Treatment in Idiopathic Short Stature
Charmian Quigley, Eli Lilly & Company, Indianapolis, IN

Is There a Biological Rationale for Treatment of Idiopathic Short Stature?
Ron G. Rosenfeld, Lucile Packard Foundation For Children's Health, Palo Alto, CA

Everyday Ethical Dilemmas of Treating Short Stature: The Bread, Butter and Bane of Pediatric Endocrinology
David B. Allen, University of Wisconsin Hospital, Madison, WI

Ethical and Policy Issues in Access to HGH
Norman C. Fost, University of Wisconsin Medical School, Madison, WI

Diabetes mellitus (DM) affects about 17 million people in the United States and is the sixth leading cause of death. Type 1 DM, formerly known as juvenile onset or insulin-dependent diabetes, typically presents in the pediatric age group. The incidence/prevalence of type 2 DM, a disease once seen only in adults, has been rising steadily in children. Type 2 DM is strongly associated with obesity, inactivity, family history of diabetes, history of gestational diabetes and racial or ethnic background. Nephropathy is a serious complication of DM and is associated with significant morbidity and mortality. This symposium will focus on the epidemiology, pathophysiology and emerging therapies for this serious disease.

The Epidemic of Obesity in North American Children
Thomas N. Robinson, Stanford University School of Medicine, Palo Alto, CA

Insulin vs. Glucose in Diabetic Nephropathy
Roland Blantz, University of California at San Diego and VASDHCS, San Diego, CA

Anticipating and Preventing Cardiovascular Complications of Diabetes Mellitus
Rulan Parekh, Johns Hopkins University, Baltimore, MD

Potential Therapies for Diabetic Nephropathy
Tom Hostetter, National Institutes of Health, Bethesda, MD
 

Worldwide, more than 1,500 children per day become infected with HIV through mother-to-child transmission. Currently there are 2.7 million children living with HIV infection across the globe, >90% of whom reside in developing countries. While there have been enormous successes in the prevention and treatment of pediatric AIDS in the United States and Europe, it remains an open question as to how effectively these public health gains can be replicated in the poor countries of the world, which bear the greatest burden of disease. Efforts to develop an HIV vaccine appropriate for preventing infection among the world's children and adolescents are finally under way on a global scale. We will discuss these issues and accompanying controversies as they apply to the children of the developing world.

AIDS in Children—A Global Public Health Crisis
David L. Pugatch, Hasbro Children's Hospital and Brown Medical School, Providence, RI

Preventing Mother-to-Child Transmission of HIV in Developing Countries—Successes, Failures and Challenges
Catherine M. Wilfert, Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, CA and Washington, DC

HIV Treatment for Children—Can the Successes of Rich Countries Be Duplicated in Resource-Poor Settings?
Mark W. Kline, Baylor College of Medicine, Houston, TX

Finding an AIDS Vaccine That Works for the World's Children
Richard A. Koup, Vaccine Research Center, National Institutes of Health, Bethesda, MD

Visit in February 2004 for the abstract program schedules.
 

Visit in February 2004 for the poster program schedules.
 

Controversial issues in the management of patients will be discussed in the context of case presentations. Specific, practical therapeutic options will be covered and technical demonstrations will also be given.
 

Controversial issues in the management of patients will be discussed in the context of case presentations. Specific, practical therapeutic options will be covered.
 

Controversial issues in the management of patients will be discussed in the context of case presentations. Specific, practical therapeutic options will be covered.
 

Obesity is currently one of the greatest health threats facing the health of our children and youth. Reasons for this epidemic are rooted in the changing lifestyle of Americans: one that embraces little physical activity and the consumption of large amounts of processed, high caloric foods. While problems in our societal fabric may take decades to address, pediatricians need effective ways to treat children who are already obese or are at imminent risk. Despite the significance and magnitude of this problem, most attempts at therapy have not been effective. We will discuss current dietary, pharmacologic and surgical approaches to therapy that are gaining in popularity in pediatric populations and will address what is known about the effectiveness of these approaches and the controversies associated with them. The rationale for different diets, including "popular" ones, their efficacy and safety will be discussed. Data concerning safety and efficacy of approved and experimental drug therapies in children will be presented. Finally, we will discuss when to consider bariatric surgery in children.

Novel Dietary Treatments for Obesity and Related Complications
David S. Ludwig, Children's Hospital, Boston, MA

Pharmacotherapy of Childhood Obesity
Robert H. Lustig, University of California, San Francisco, CA

Surgical Weight Loss in Pediatrics
Victor F. Garcia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

The potential applications for using regenerated cells and tissues to treat injury and disease are unlimited. Early stem research concentrated on the hematopoietic stem cells of the bone marrow, but stem cells are now known to exist in most organs of the body. Furthermore, it may be possible to return mature, differentiated cells to a undifferentiated, stem-like state. This symposium will first provide an overview of non-hematopoietic stem cells, then focus on two rapidly-progressing areas of research—those of regenerating nervous tissue and liver.

Neural Stem Cells: Developmental Insights May Suggest Therapeutic Options
Evan Y. Snyder,

Hepatic Stem Cells and the Potential of Liver Repopulation for Cell Therapy
Sanjeev Gupta, Albert Einstein College of Medicine, Bronx, NY