Adolescent Medicine

Last updated February 4, 2005

Saturday, MAY 14

8:00am–11:00am
4155—Institute of Medicine (IOM) Committee on Prevention of Obesity in Children and Youth: Recommendations and Assessment
PAS Educational Workshop
Leader: Thomas N. Robinson, Stanford, CA; Co-leaders: Dennis M. Bier, Vivica I. Kraak

The Institute of Medicine (IOM) Committee on Prevention of Obesity in Children and Youth is charged with assessing the nature of obesity in children and youth in the United States and developing a prevention-oriented action plan to reduce its prevalence. A summary of the report's findings and recommendations will be presented with a focus on public health approaches that promote energy balance by integrating diet and physical activity interventions at home, schools, medical care settings and in communities. Discussion and question-and-answer sessions with members of the Committee will address responses to the recommendations and public and policy reactions after the initial release. Participants will then create an individual action plan to advocate for their choices of specific recommendations.

Objectives:

1. Participants will become familiar with the concept of energy balance and be able to identify factors that contribute to obesogenic environments and promising public health approaches that support obesity prevention in children and youth.

2. Participants will develop a personal plan of action for implementing specific IOM recommendations when they return home from the meeting.

Method of Instruction: Brief presentation of highlighted IOM Committee results followed by (a) question-and-answer, (b) group discussion, and (c) development of action plans.

Target Audience: Trainee, junior faculty, mid-level faculty, senior faculty
 

8:00am–11:00am
4156—Mobilizing High-Risk Communities To Prevent Injuries to Youth
PAS Educational Workshop
Leader: Michael A. Gittelman, Cincinnati, OH; Co-leaders: Andrea Gielen, Wendy J. Pomerantz, Mahseeyahu B. Selassie

The purpose of this workshop is to expand the participants' skills in advocating for high-risk, underserved communities through local involvement. Concentration on reviewing and analyzing data to target problems in a community, assessing the needs of the community members, obtaining community support and utilizing existing resources will be addressed. How to utilize this model to prevent injuries will be the example given, yet this model could work to employ any community intervention. Experiences from the staff and participants along with evidence of best techniques will be discussed.

Objectives:

1. Review and analyze data to target problems within a high-risk community.

2. Mobilize and empower a high-risk community to prevent injuries among their youth.

Method of Instruction: Powerpoint presentation, small work group break-out sessions, problem solving and sharing of experiences.

Target Audience: Trainee, junior faculty, mid-level faculty
  

11:45am–2:45pm
4500—Domestic Violence: The Role of the Pediatric Provider
PAS/SAM Mini Course
Chair: Sheryl Ryan, University of Rochester School of Medicine, Rochester General Hospital, Rochester, NY

This mini course will focus on the problem of domestic violence as a pediatric issue, its direct and indirect effects on children and their caregivers and the specific challenges facing pediatricians in screening, preventing and intervening.

The initial part of this mini course will focus on the extent of the problem of domestic violence, its overlap with child abuse, the health consequences for both children and families and strategies for identification in both primary care and emergency settings. The second part will focus on approaches to intervention, legal aspects of domestic violence specific to mandated reporters and how to create interdisciplinary collaborations across the many agencies that may serve as resources for pediatricians. Finally, we will address training tools that have been developed for physicians in the areas of both prevention and intervention of domestic violence and child abuse. Discussion following each of the sections will offer the opportunity for group input.

Target Audience: General pediatricians, pediatric emergency medicine specialists and providers working in child protection and advocacy.

Introductions and Overview
Sheryl A. Ryan, University of Rochester School of Medicine, Rochester General Hospital, Rochester, NY

Epidemiology of Domestic Violence and Issues Related to Screening, Prevention, Intervention and Teaching
Danielle Thomas-Taylor, Center for Child Health Research, Rochester, NY

Domestic Violence and the Pediatric Emergency Setting: Strategies for Identification and Legal Aspects of Mandated Reporting
Megan H. Bair-Merritt, Children's Hospital of Philadelphia, Philadelphia, PA

Sponsored jointly by the Society for Adolescent Medicine and the Pediatric Academic Societies
 

11:45am–2:45pm
4504—Nonendocrine Causes of Short Stature and Their Management
PAS/LWPES Mini Course
Chairs: Craig A. Alter, Children's Hospital of Philadelphia, Philadelphia, PA; and Alan Rogol, University of Virginia, Charlottesville, VA

Short stature is the most common cause of referral to the pediatric endocrinologist. This symposium will draw on the expertise of geneticists, orthopedic surgeons and radiologists and promises to be instructive to all attendees regardless of their background. It will also help generalists identify clinically those patients in their practice who may benefit from further evaluation for growth and adolescent development.

Target Audience: Any clinician who encounters short stature in his practice will benefit from this mini course. Imparted by nationally recognized leaders in genetics/dysmorphology, radiology and orthopedics, this mini course will help generalists, geneticists and endocrinologists identify which patients may benefit from further evaluation and work up.

The Clinical Approach to Nonendocrine Short Stature—The Pediatrician's Nightmare
Judith G. Hall, The University of British Columbia, British Columbia's Children's Hospital, Vancouver, Canada

The Radiographic Approach to Short Stature
Bruce R. Parker, Texas Children's Hospital, Houston, TX

The Orthopedic Approach to the Child with Congenital Deformity and Short Stature
David Feldman, Hospital for Joint Diseases, NYU Medical Center, New York, NY

Discussion

Sponsored jointly by the Lawson Wilkins Pediatric Endocrine Society and the Pediatric Academic Societies
 

11:45am–2:45pm
4540—Adolescent Parents and Parenting: Care of the Young Family
PAS Educational Workshop
Leader: Victoria Garriett, Washington, DC; Co-leaders: Lee S. Beers, Tininka Rahman

This workshop will address strategies for caring for adolescent parents and their children in pediatric practice. Pediatricians are commonly faced with the question of how best to provide care to these young families.

During the first half of the workshop, the participants will discuss strategies and barriers to providing health care to adolescent parents and their children. Adolescent parents and/or former adolescent parents from the community will be invited to participate in this discussion. Current literature and policy statements as well as established models for teen-tot care will be briefly reviewed. 

During the second half of the workshop, case-based discussion and role play will be used to illustrate the unique circumstances and challenges encountered when caring for these young families.

Objectives:

1. The participant will gain knowledge of strategies to effectively deliver family-centered health care to adolescent parents and their children.

2. The participant will use case-based studies and role play to improve their skills as providers to adolescent parents and their children.

Method of Instruction: Roundtable discussion, case-based discussion and role play.

Target Audience: Trainee, junior faculty, mid-level faculty
  

11:45am–2:45pm
4572—Obesity
APA Special Interest Group
Chairs: Jennifer Bass, yenbass@aol.com; and Sandy Hassink, shassink@nemours.org

Implementing Obesity Prevention and Treatment—How To Translate What We Know into What Works

A panel discussion will lead off with short presentations of up and running obesity programs. Discussions will include clinic set up and structure, practical patient and family interventions, reimbursement issues and working in hospital and community settings. Attendees will be encouraged to share their own experiences and participate in discussion. The AHRQ video for pediatricians on obesity management will also be previewed and available to the audience.
 Saturday, MAY 14

1:00pm–3:00pm
4653—Public Health Topics
PAS Original Science Abstracts - Platform Session

3:15pm–5:15pm
4800—Behavior Problems, Brain Maturation and the Pediatrician
PAS/SAM Topic Symposium
Chair: Kathleen A. Pajer, Children's Hospital, Columbus, OH

This symposium will summarize research on behavior problems in the pediatric population, presented in the context of new research on brain maturation during childhood and adolescence. Clinical implications of this synthetic approach will be discussed. The first presentation will give an overview of brain maturation and neural plasticity, focusing on the mechanisms of postnatal development. We will then review abnormalities in brain maturation that may underlie emotional and behavioral dysregulation, constructs strongly correlated with behavior problems in children and adolescents. Next, we will present data on how premature adrenarche and the developing brain may be associated with childhood behavior problems. The final presentation will discuss adolescent brain maturation, puberty and behavior problems, with a focus on hypothalamic pituitary adrenal axis function. Our discussant will talk about the integration of the two bodies of work presented and its application to clinical problems seen by the pediatrician. Our session will conclude with an opportunity for the audience to ask questions of the speakers.

Target Audience: Clinical researchers in behavioral pediatrics and practicing pediatricians.

Behavior Problems, Brain Maturation and the Pediatrician
Kathleen A. Pajer, Children's Hospital, Columbus, OH

Brain Development and Neural Plasticity
Charles A. Nelson, University of Minnesota, Minneapolis, MN

Dysregulation and the Developing Brain
Kathleen A. Pajer, Children's Hospital, Columbus, OH

Mood and Behavior Problems in Early School-Age Children: Relationships with Early Puberty and the Adrenal Axis
Lorah D. Dorn, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Circadian Variations in Gonadal and Adrenal Hormones and Behavior Problems in Young Adolescents
Elizabeth J. Susman, The Pennsylvania State University, University Park, PA

Discussant
Ronald Dahl, University of Pittsburgh, Pittsburgh, PA

Questions and Discussion with Panel

Sponsored jointly by the Society for Adolescent Medicine and the Pediatric Academic Societies
Supported in part by an unrestricted educational grant from Columbus Children's Hospital
 

3:15pm–5:15pm
4890—AIDS/HIV
APA Special Interest Group
Chairs: Nancy Hutton, nhutton@jhmi.edu; and Lois Chandler Howland, lois.howland@umassmed.edu

HIV/AIDS is becoming increasingly prevalent among the U.S. adolescent population due to “aging up” of perinatally infected children and to adolescents becoming infected through high-risk behaviors. Providing effective health education to reduce HIV transmission risk, offering accessible and confidential HIV counseling and screening and identifying effective strategies to improve HIV treatment adherence among adolescents are the key issues to be addressed in the AIDS/HIV Special Interest Group meeting this year. An interactive format will bring clinicians and researchers together to provide the most recent information and to discuss the most effective approaches to these issues.
 

5:15pm–7:15pm
Poster Session I
PAS Original Science Abstracts - Poster Session

General Pediatrics and Preventive Pediatrics:
4900—Adolescent Health
 

Sunday, MAY 15

8:00am–11:00am
5202—Update on Adolescent Gynecology
PAS/SAM Mini Course
Chair: Donald E. Greydanus, Michigan State University College of Human Medicine, Kalamazoo, MI

This mini course will review basic concepts of adolescent gynecology, including contraception, emergency contraception and menstrual disorders. The presentation on general contraception will focus on new oral contraceptives (including those that extend menstrual-free cycles) and new methods of steroid delivery (including the patch and vaginal ring). The menstrual disorders presentation will cover current issues in the management of adolescents with amenorrhea, dysfunctional uterine bleeding and dysmenorrhea. Questions from the audience will be encouraged.

Target Audience: General pediatricians and adolescent medicine specialists

Introduction
Donald E. Greydanus, Michigan State University College of Human Medicine, Kalamazoo, MI

Adolescents, Sex and the Media
Victor C. Strasburger, University of New Mexico School of Medicine, Albuquerque, NM

Update on Menstrual Disorders in Adolescents
Lyubov Matytsina, Donetsk Medical University, Donetsk, Ukraine

Emergency Contraceptives: The Controversy and the Benefits
Dilip R. Patel, Michigan State University College of Human Medicine, Kalamazoo Center for Medical Studies, Kalamazoo, MI

Contraception in Adolescents: New Pills, the Patch, the Ring
Renee R. Jenkins, Howard University College of Medicine, Washington, DC

Sponsored jointly by the Society for Adolescent Medicine and the Pediatric Academic Societies
 

2:00pm–4:00pm
5520—Consequences of Metabolic Syndrome in Children: Hypertension, Diabetes and Renal Disease
PAS/ASPN/IPHA/LWPES Topic Symposium
Chairs: Joseph Flynn, Montefiore Medical Center, Bronx, NY; and Henry Anhalt, Saint Barnabas Medical Center, Livingston, NJ

The incidence of the metabolic syndrome and of type 2 diabetes mellitus (T2DM) is now exploding in children as a consequence of the obesity epidemic. These children may be at significant risk of target-organ damage, including hypertension, atherosclerosis and diabetic nephropathy. This symposium will examine key aspects of this epidemic, with special focus on the pathogenesis of the target-organ effects of the metabolic syndrome in the young.

Target Audience: Any physician who cares for children with obesity, diabetes or their consequences—pediatricians, pediatric cardiologists, pediatric endocrinologists, pediatric nephrologists.

Can We Agree on a Definition of the Metabolic Syndrome in Children?
Sonia K. Caprio, Yale University School of Medicine, New Haven, CT

Pathogenesis of Structural Vascular Changes in Patients with Hypertension and the Metabolic Syndrome
Albert P. Rocchini, University of Michigan Health Center, Ann Arbor, MI

Diabetic Nephropathy in Patients with Type 1 and Type 2 Diabetes
Kumar Sharma, Jefferson Medical College, Philadelphia, PA

Mechanisms of Diabetic Nephropathy: Insights from Genomics/Proteomics
Erwin Bottinger, Mount Sinai School of Medicine, New York, NY

Sponsored jointly by the American Society of Pediatric Nephrology, International Pediatric Hypertension Association, Lawson Wilkins Pediatric Endocrine Society and the Pediatric Academic Societies
 

2:00pm–5:00pm
5561—Pediatric Neuropharmacology—Current Controversies
PAS Mini Course
Chair: Faye Silverstein, University of Michigan, Ann Arbor, MI

This mini course will highlight issues of interest to many pediatricians. Neuroactive drugs are used to treat a wide range of neurological and behavioral disorders in children and adolescents. Often, these drugs have not been systematically evaluated in this age group, and the issue of “off-label” use of neuroactive drugs has recently received considerable national attention.

We have recruited five experts in pediatric therapeutics for this mini course. Four will discuss treatment issues, and the fifth will discuss ethical issues that must be considered in pediatric drug testing.

Graham Emslie will discuss the safety and efficacy of selective serotonin release inhibitors (SSRIs) in children and adolescents with depression and related disorders. The controversies regarding the use of these agents in the pediatric age group have raised important questions for all pediatricians. He will also highlight important questions for future research to improve clinical outcomes of children with psychological disorders.

James McCracken will provide his perspective on the use of second generation antipsychotics in children and adolescents. These drugs are widely used to treat a broad range of behavioral disorders. He will review current information about the efficacy and tolerability of these drugs and suggest guidelines for clinical monitoring.

Carter Snead will provide his perspective on the roles of the new generation of anti-convulsant drugs (introduced over the past 10 years) in the treatment of childhood epilepsy. He will discuss some of the drugs that have already gained widespread usage in children and discuss their potential risks and benefits.

Judith Owens will discuss current approaches to drug therapy of pediatric sleep disorders. As new drug therapies are introduced, both to induce sleep and to sustain wakefulness, it is likely that their use will extend to children and adolescents. The diagnosis of sleep disorders is rapidly increasing in children, and Dr. Owens will discuss major diagnostic and therapeutic issues.

Joel Frader will discuss ethical issues in pediatric drug testing. His topics will include: who should give “consent” for study participation, the circumstances permitting placebo controls, implications of FDA and/or NIH incentives/mandates for pediatric testing, conflicts between care giving and researcher roles, obligations to provide study results to participants and special considerations for phase I testing.

Target Audience: Broad range of clinicians who treat children with neurological and psychological disorders.

Introduction
Faye S. Silverstein, University of Michigan, Ann Arbor, MI

SSRIs in Pediatrics: What Do We Really Know?
Graham Emslie, University of Texas–Southwestern Medical Center, Dallas, TX

Promises and Pitfalls of Newer Antipsychotics in Children and Adolescents
James McCracken, UCLA Neuropsychiatric Institute, Los Angeles, CA

New Anticonvulsants—Roles in Treatment of Childhood Epilepsy
O. Carter Snead, The Hospital for Sick Children, University of Toronto, Toronto, Canada

Drug Therapy of Pediatric Sleep Disorders
Judith A. Owens, Brown University, Providence, RI

Pediatric Drug Testing: Ethical Considerations
Joel E. Frader, Children's Memorial Hospital, Chicago, IL

Discussion
 

2:00pm–5:00pm
5571—Childhood Obesity—Assessment, Surveillance and Intervention Within the School Setting
PAS Educational Workshop
Leader: Linda M. Grant, Boston, MA; Co-leaders: Anne McHugh, Sylvia Stevens-Edouard

This workshop will explore various strategies to address obesity in a school setting without competing with the prime educational mandate of teaching and learning. The pros and cons of conducting school-based obesity surveillance activities will be debated in a point–counterpoint forum that will highlight the challenges and offer solutions. Creative community partnerships to address school-based nutrition and fitness will be presented from several viewpoints, including that of a health insurance company and a school administrator.

Objectives:

1. Understand the supports needed to do school-based obesity surveillance activities.

2. Identify evidence-supported, school-based nutrition and fitness interventions and recognize collaborative partnership opportunities and the strategies to achieve them.

Method of Instruction: There will be point–counterpoint presentations by community partners to highlight issues from different vantage points followed by didactic that illustrates solutions.

Target Audience: Trainee, junior faculty, mid-level faculty, affiliate members.
 

4:15pm–6:15pm
5740—Adolescent Medicine I
PAS Original Science Abstracts - Platform Session

Monday, MAY 16

8:00am–10:00am
6142—Obesity and Metabolism I
PAS Original Science Abstracts - Platform Session

9:00am–12:00pm
6202—Child and Adolescent Bariatrics: Merging Policy, Scholarship, Research and Advocacy
PAS Educational Workshop
Leader: Karen L. Young, Little Rock, AR; Co-leaders: Margaret Harris, Alba Morales, J. Darrell Nesmith, Pippa Simpson, Joseph W. Thompson, Wendy L. Ward-Begnoche, Judith L. Weber, J. Gary Wheeler

Child and adolescent bariatrics (the study of obesity) is a new area in pediatric medicine. The Arkansas experience with the BMI (Body Mass Index) Health Initiative will be presented to show how a statewide initiative can be a collaborative effort, coordinated with research and educational activities. This will serve to jumpstart discussions among the registrants and faculty:

1. Attendees will be given an opportunity to present experiences from their own community involvement and partnership development, specifically discussing how to effect translation of obesity research into policy, clinical care, education or advocacy.

2. Registrant groups will discuss research problems in childhood obesity including

a) how to create and manage databases for clinics or larger populations

b) ethical and psychological issues

c) starting an academic child and adolescent bariatrics center

d) research collaborations

e) policy and politics of obesity

Objectives:

1. Learn how to effect translation of obesity research into policy, clinical care, education and advocacy.

2. The learner will be able to discuss childhood obesity research problems, including creating a database, ethical issues, starting a new obesity center, collaboration, policy and politics.

Method of Instruction: Presentations by faculty, followed by short presentations by selected registrants, then roundtable discussions.

Target Audience: Trainee, junior faculty, mid-level faculty, senior faculty.
 

10:15am–12:15pm
6350—Adolescent Medicine II
PAS Original Science Abstracts - Poster Symposium

3:00pm–5:00pm
6701—Endocrine Complications of Cancer Therapy
PAS/ASPHO/LWPES Topic Symposium
Chairs: H. Stacy Nicholson, Oregon Health & Science University, Portland, OR; and Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY

The primary objective of this session is to review common endocrine sequelae of anti-cancer therapies, focusing particularly on fertility outcomes. In addition to discussing sequelae, interventions will also be a particular focus, in particular assisted fertility (present and future options).

Target Audience: Oncologists and endocrinologists who must counsel patients and families regarding fertility outcomes and options following treatment for childhood cancer.

Reproductive Challenges After Childhood Cancer
Henry Stacy Nicholson

Fertility Deficits in Survivors of Childhood Cancer
Charles A. Sklar, Memorial Sloan-Kettering Cancer Center, New York, NY

The Promise of Ovarian Cryopreservation
David Lee, Oregon Health & Science University, Portland, OR

Fertility Preservation Options for Males
Peter Schlegel

Sponsored jointly by the American Society of Pediatric Hematology/Oncology, the Lawson Wilkins Pediatric Endocrine Society and the Pediatric Academic Societies
 

3:00pm–5:00pm
6734—Obesity and Metabolism II
PAS Original Science Abstracts - Poster Symposium

3:00pm–5:00pm
6771—Pediatric Tobacco Issues
APA Special Interest Group
Chairs: Dana Best, dbbest@cnmc.org; and Deborah Moss, mossdr@chp.edu

Information not yet available.
 

5:15pm–6:45pm
Poster Session III
PAS Original Science Abstracts - Poster Session

Adolescent Medicine:
6800—Health Services Research/Health Care Delivery
6801—Provider Behaviors and Knowledge
6802—Spectrum of Eating Disorders
6803—Sexually Transmitted Infections (STIs) and Reproductive Health
6804—Health Risk Behaviors and Violence
 

Tuesday, MAY 17

8:00am–10:00am
7102—Transitioning Complex Pediatric Patients to Adult Care
PAS/ASPN/LWPES Hot Topic
Chair: Sandra L. Watkins, University of Washington, Seattle, WA

Transitions are a part of everyone's life experience. Most young people with special health care needs and disabilities (SHCN/D) become independent members of adult society, but some need deliberate guidance and support. With increasing success in reducing the mortality of once devastating pediatric diseases, the latter group is growing in number. A new consensus statement from the American Academy of Pediatrics and the U.S. Federal Government (Healthy People 2010) has focused attention on the need to assist young people with SHCN/D in attaining their potential in adulthood. This symposium will discuss the growing number of young people with SHCN/D and present approaches for effecting these transitions.  Specific disease-related examples will be used to highlight the issues, the barriers and the key elements of successful programs that transition patients from pediatric care to the adult system.

All Grown Up and Wondering What To Do: Transitioning Complex Pediatric Patients to Adult Care
Patience H. White, George Washington University School of Medicine, Washington, DC

Transition Best Practices
Cecily L. Betz, University Center For Excellence in Development Disabilities, Children's Hospital Los Angeles, CA

Transition to Adult Care in the Nephrology Population–Renal Failure or Success
Maria Ferris, University of North Carolina-Chapel Hill, NC

Training and Workforce Issues for Successful Transition
Roberta G. Williams, University of Southern California, Los Angeles, CA

Discussion

Sponsored jointly by the American Society of Pediatric Nephrology, Lawson Wilkins Pediatric Endocrine Society and the Pediatric Academic Societies

8:00am–10:00am
7154—Exposures to Tobacco
PAS Original Science Abstracts - Platform Session

8:00am–10:00am
7160—Variations on the Theme of Violence
PAS Original Science Abstracts - Platform Session

8:45am–11:45am
7211—Treating Childhood Obesity in Primary Care
PAS Educational Workshop
Leader: Ellen R. Wald, Pittsburgh, PA; Co-leader: Linda J. Ewing

To overcome barriers to the identification and treatment of obesity in children, we have developed a program directed at primary care providers and families of overweight 8–12 year olds. This program, successful in a research setting, was adapted and applied in the primary care setting. The program consists of a module for primary care providers and a module to train health educators from among the office staff to deliver a behaviorally based group intervention focusing on a modification of dietary and physical activity habits. This interactive workshop will demonstrate all the components of the program through role play.

Objectives:

1. Participants will gain knowledge about obesity and behaviorally based interventions.

2. Participants will acquire skills in reflective listening.

Method of Instruction: Brief didactic session followed by interactive demonstrations of provider and parent modules.

Target Audience: Trainee, junior faculty, mid-level faculty.
  

10:15am–11:45am
7300—Children's Health and the Federal Government: Research and Public Health Policy
PAS State of the Art Plenary
Chairs: Lisa Guay-Woodford, President, Society for Pediatric Research; and Paul Young, Chair, PAS Program Committee

Elias A. Zerhouni, the Director of the NIH and Vice Admiral Richard H. Carmona, the Surgeon General of the United States, will provide PAS attendees with their views of the critical issues related to pediatric research and the health of our nation's children.

Target Audience: All attendees

Introduction
Paul C. Young, University of Utah School of Medicine, Salt Lake City, UT
Lisa M. Guay-Woodford, University of Alabama at Birmingham, Birmingham, AL

The NIH Roadmap for Medical Research
Elias A. Zerhouni, Director, National Institutes of Health, Bethesda, MD

Promoting Health for U.S. Children and Their Families
Vice Admiral Richard H. Carmona, Surgeon General of the United States, Washington, DC

Discussion

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