There has been remarkable progress in our understanding of the development and function of the immune system in health and disease. The regulation of immunity impacts profoundly on many of the conditions that pediatricians treat. The objective of this program is to enable PAS attendees coming from diverse disciplines to understand the language of modern immunology and the translation of recent advances in basic science to the diagnosis and treatment of diseases of children. This course will address three areas: immunology of infectious diseases, immunology of auto-immunity and tumor immunology.

Opening remarks
E. Richard Stiehm, UCLA Children's Hospital, Los Angeles, CA
Beverly J. Lange, Children's Hospital of Philadelphia, Philadelphia, PA

Immunology of Infectious Disease
Katherine F. Luzuriaga, University of Massachusetts Medical School, Worcester, MA

Immunology of Autoimmunity
Betty Diamond, Albert Einstein College of Medicine, Bronx, NY

Tumor Immunology
Robert H. Vonderheide, University of Pennsylvania, Philadelphia, PA

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
 

Visit in February 2004 for the abstract program schedules.
 

The program will highlight new developments in clinical management of patients with chronic granulomatous disease as well as an update on the progress of gene therapy of CDG stem cells. There will also be an update on the management and diagnosis of patients with the Shwachman-Diamond syndrome, and, finally, there will be an update on diagnosis, treatment and pathophysiology of severe chronic neutropenias.

Overview
Laurence A. Boxer, Mott Children's Hospital, University of Michigan, Ann Arbor, MI

Severe Chronic Neutropenia Pathogenesis and Treatment
David Dale, University of Washington, Seattle, WA

Shwachman-Diamond Syndrome Pathogenesis and Treatment
Melvin H. Freedman, Hospital for Sick Children, Toronto, Canada

Chronic Granuloma Disease, Pathogenesis, Management
Harry Malech, National Institutes of Health, Bethesda, MD

Visit in February 2004 for the poster program schedules.
 

This session is designed to provide trainees and junior faculty with insight and advice concerning the pursuit of an academic career in pediatric infectious diseases. Specific attention will be given to describing approaches to obtaining the best possible training in clinical infectious diseases, epidemiology, as well as in basic and applied research in the field of pediatric infectious diseases. An overview will be provided of this rapidly evolving field and a 40-year historical perspective of advice concerning how to incorporate both basic and applied research into an academic career most effectively also will be discussed.

Infectious Diseases
Ralph D. Feigin, Baylor College of Medicine and Texas Children's Hospital, Houston, TX
 

Visit in February 2004 for the abstract program schedules.
 

TLRs (Toll-like receptors) are a family of transmembrane germ line coded pattern recognition receptors that bind structural motifs common to pathogenic organisms. These structural motifs include endotoxin, products of gram+ organisms, fungi and mycobacteria, as well as DNA and RNA structures common to bacteria and virus but not mammalian cells. The TLRs are expressed by diverse cell types. TLR signaling initiates the innate immune/inflammatory host response to pathogens and also initiates antigen processing for acquired immunity.

Moshe Arditi will review the recent progress in understanding how children respond to pathogens. Maria Abreau will explore how immune signaling is central to both the maintenance of normal gut function and how chronic GI disease may develop. Christopher Karp will then explore how immune signaling relates to the hygiene hypothesis regarding the striking increase in the prevalence of both allergic and autoimmune diseases in children in Westernized countries over recent decades. The goal is to provide an update about newly described mechanisms signaling inflammation/immunity that are central to multiple homeostatic and disease processes in children.

Toll Like Receptors—Bridging Innate and Adaptive Immunity
Moshe Arditi, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA

TLR Signaling in the Gut in Health and Disease
Maria Abreu, Cedars-Sinai Medical Center / UCLA School of Medicine, Los Angeles, CA

Signaling the Hygiene Hypothesis
Christopher Karp, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

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 poster program schedules.
 

Hot Topics in the Detection of Neonatal Infection

Contact for information:
David Kaufman, M.D.
University of Virginia Children’s Medical Center
Phone: (434) 924-9114
Email: davidkaufman@virginia.edu
 

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

With the advent of highly active antiretroviral therapy (HAART) children infected with the Human Immunodeficiency Virus (HIV) are living longer with fewer complications from opportunistic infections, but more side effects from therapies. HIV infection has transitioned from an almost certain rapid demise to a chronic illness of undetermined prognosis. Quality of life (QOL) has therefore become a more salient outcome for children infected with HIV.

In this meeting of the AIDS/HIV SIG we have three aims: explore the concept of QOL, describe measurement considerations and discuss clinical implications of QOL measurement. The interactive session will include the uses and limitations of QOL measurement and the clinical importance of understanding factors affecting QOL outcomes in children and adolescents infected with HIV.
 

This symposium will cover new methods to detect fungal infections and indications for new drugs. CMV detection and treatment outcome will be discussed in the post-HSCT patient. Finally, other viral infections that can cause significant morbidity in the immunocompromised patient, such as HHV6 and adenovirus, will be discussed.

Introduction
Nancy Bunin, Children's Hospital of Philadelphia, Philadelphia, PA

New Approaches to Diagnosis and Treatment of Invasive Fungal Infections in Immunocompromised Pediatric Patients
Thomas Walsh, National Cancer Institute, Bethesda, MD

New Developments in the Diagnosis and Management of CMV and Adenovirus Infection in Stem Cell Transplant Recipients
Michael Boeckh, Fred Hutchinson Cancer Research Center, Seattle, WA

HHV6 Infections in Immunocompromised Patients
Danielle Zerr, Children's Hospital and Regional Medical Center, Seattle, WA

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
 

This topic symposium is focused on advances in understanding, treating and preventing severe RSV disease. A discussion centered on new insights into the pathogenesis of severe viral pneumonia will be followed by an overview of the evidence linking severe RSV disease to asthma. Unique issues surrounding the diagnosis and management of RSV in the highest risk populations will be discussed. Finally, recent advances in the development of safe and effective RSV vaccines will be presented.

Pathogenesis of Severe Disease: Lessons from the Mouse Pneumovirus Model
Helene F. Rosenberg, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD

RSV and Asthma—Myth or Reality?
Octavio Ramilo, University of Texas Southwestern Medical Center, Dallas, TX

Diagnosis and Management of RSV in High-Risk Patients
John P. DeVincenzo, University of Tennessee, Memphis, TN

Progress in the Development of RSV Vaccine
Ruth A. Karron, Johns Hopkins University, Baltimore, MD

Vaccines have an important function in preventing birth defects. The most obvious one is rubella vaccine and its application for the purpose of preventing congenital rubella syndrome (CRS) will be discussed. In addition, prospects of the development of other relevant vaccines will be presented. These will include: cytomegalovirus, parvovirus, herpes simplex and malaria. The first three, because they affect the fetus directly; the last, because of its adverse effect on pregnancy that results in small-for-gestational-age newborns.

Elimination of Rubella from the Americas by the Year 2010
Mirta Roses Periago, Director of PAHO, Panamerican Health Organization (PAHO), Washington, DC

Prevention of CRS by Universal Application of the Rubella Vaccine
Susan E. Reef, Center for Disease Control, Atlanta, GA

Prospects for a Vaccine Against Cytomegalovirus
Stanley A. Plotkin, Aventis Pasteur and the University of Pennsylvania, Doylestown, PA

Prospects for a Vaccine Against Herpes Simplex
Richard J. Whitley, University of Alabama at Birmingham, Children's Hospital, Birmingham, AL

Prospects for a Vaccine Against Parvovirus B-19
Neal S. Young, National Institutes of Health, Bethesda, MD

Prospects for a Vaccine Against Malaria
N. Regina Rabinovich, Bill & Melinda Gates Foundation, Seattle, WA

Discussion

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

The Six Revolutions in Vaccinology

The Pediatric Infectious Diseases Society (PIDS) has established the Stanley A. Plotkin Lecture in Vaccinology to honor Dr. Plotkin, the Society’s "Founding Father." The lecture, which will take place at the annual PIDS meeting, is sponsored by Aventis’ vaccines business, Aventis Pasteur. Dr. Plotkin was medical director at Aventis Pasteur and remains a medical and scientific advisor.

Inaugural Award Presented to:
Dr. Stanley A. Plotkin, Aventis Pasteur and the University of Pennsylvania, Doylestown, PA.
 

In 1929, a visionary band of 25 pediatric physician-scientists, spurred by their passion for science and their commitment to children, founded the Society for Pediatric Research. In the intervening 75 years, pediatric investigators have wrought a breathtaking suite of therapeutic breakthroughs—from the care of premature neonates, to effective immunoprotection from childhood disease, to novel therapeutic strategies for childhood leukemia. More recently, the completion of the Human Genome Project has identified new opportunities to delineate the impact of genetic variation on childhood disease expression.

Four leaders in Pediatric Research will celebrate the accomplishments of the past 75 years and share their perspectives about the challenges that lay before us.

Introduction
Gail J. Demmler, President, Society for Pediatric Research

The Problem of Prematurity: The Impact of Surfactant and the Challenge of Long-Term Morbidity
Samuel Hawgood, University of California Medical Center, San Francisco, CA

The Problem of Childhood Infectious Diseases: The Impact of Vaccine Development and the Challenge of Emerging Infections
Margaret K. Hostetter, Yale University School of Medicine, New Haven, CT

The Problem of Childhood Leukemia: The Impact of Combination Chemotherapy and the Challenge of Neuro-cognitive Morbidity
Alan L. Schwartz, Washington University Medical Center, St. Louis, MO

The Problem of Genetic Disease: The Impact of the Human Genome Project and the Challenge of Translation to Innovative Therapy
Edward R. B. McCabe, David Geffen School of Medicine at UCLA, Los Angeles, CA

The symposium will be held on May 4, 2004 at the Moscone West Convention Center (8:00am–3:30pm). The symposium will bring together a distinguished, international group of scientists and clinicians to discuss several major childhood health problems of global significance, including:

• Micronutrient deficiency in childhood
• Perinatal aspects of maternal malaria and tuberculosis
• Genetic susceptibility to malaria and tuberculosis

Researchers are invited to submit abstracts relating to the above topics. Abstracts concerning other global health issues suitable for presentation to a diverse audience of paediatric scientists and clinicians will also be considered. Selected abstracts will be chosen for symposium or poster presentations. 

Wednesday, May 5, 8:00am – 5:00pm ~ Hilton San Francisco Hotel

The workshop will be held on May 5, 2004, at the Hilton San Francisco (8:00am – 5:00pm). It will provide an opportunity for individual scientists and clinicians interested in global childhood health issues, and representatives of participating societies, with the unique opportunity to help shape the direction of this new initiative. Plenary sessions and small group meetings will be used to plan for the future of the Programme for Global Paediatric Research. Topics will include:

• Establishing international communication between scientists
• The role of societies and paediatric research organizations in the study of global health problems
• Defining global health problems suitable for collaborative research
• Sites and topics for subsequent symposia

If you wish to attend the workshop and/or require further information please contact:

Contact for information:
Professor Alvin Zipursky
Hospital for Sick Children
555 University Ave.
Toronto, Ontario Canada M5G 1X8
Email: alvin.zipursky@sickkids.ca
Phone: 416-813-8760

Participating organizations are: The American Pediatric Society, Chinese Pediatric Society, International Pediatric Association, Japanese Pediatric Society, Pediatric Research, and the Society for Pediatric Research.
 

Premature birth accounts for nearly 75% of the neonatal mortality and up to 50% of the long-term neurologic disability in children. In the United States, the incidence of premature birth has not decreased over the past 40 years and, in fact, despite considerable investigational, public health and clinical effort, has increased slightly in the past decades. The faculty of this session will discuss the epidemiology of premature birth and our current understanding of the etiology of premature labor. Current and future investigational, interventional and therapeutic strategies will be outlined.

Biological Influences on the Premature Labor
Robert L. Goldenberg, University of Alabama, Birmingham, AL

Insights from Clinical Trials in the Management of Premature Labor
Jay Donald Iams, Ohio State University, Columbus, OH

Hot Topics in General Pediatrics is a potpourri of topics of interest to all pediatricians. The topics include lead poisoning, West Nile Virus infection, sleep disorders and esophagitis. Each of these conditions has varied symptoms, signs and manifestations. For each topic there have been new findings that are in the "need to know" category for all pediatric generalists and subspecialists.

Kawasaki Disease
Jane C. Burns, University of California, San Diego, CA

West Nile Fever
Janak A. Patel, Children's Hospital, University of Texas Medical Branch, Galveston, TX

Lead Poisoning
Kevin Osterhoudt, The Children's Hospital of Philadelphia, Philadelphia, PA