INFECTIOUS DISEASES

This year’s theme will be “Promoting Adherence to HIV Treatment Recommendations”.  Our Baltimore based programs will present a range of activities we have used to try to support successful adherence.  Other programs are invited to share their efforts—especially if they work!  If you are willing to present in this small group, workshop format, please email Nancy Hutton at nhutton@jhmi.edu.

Over 75,000 children, from 36 countries, have been adopted by U.S. families since 1990. During 1998 alone, almost 16,000 children have been internationally adopted. It is quite likely that the primary care provider will encounter at least one internationally adopted child in his or her practice. While most of these children may appear healthy and well nourished, more than 50% have an undiagnosed medical condition at the time of the initial evaluation in the United States, regardless of age, sex, or country of origin. This workshop is designed to educate and alert the participants to the unique medical needs of these children so that early treatment and intervention is optimized. The workshop will familiarize the primary care provider working with international adoptees and will clarify his or her role in caring for the internationally adopted child. The first part of the workshop will focus on the following topics: 1) review medical records (photos, video) of the child from abroad, 2) travel preparation for parents, 3) post-adoptive medical screening, diagnoses, and treatment of medical conditions, 4) immunizations, 5) assessment of growth, development and nutrition, 6) coordinating care of special-needs children, and 7) guidance on adjustment problems, language delays, preparation for preschool and school, adoption procedures, cultural issues. The second part of the workshop will consist of small group discussions involving several case studies. The workshop team consists of general pediatricians, infectious disease experts, developmentalists, and international adoption clinic directors who provide services to a large number of internationally adopted children and their parents throughout the country. Written materials reviewing workshop concepts and a list of adoption clinics will be distributed.

E. E. Schulte, J. E. Aronson, L. M. H. Albers, S. Blatt; Children's Hospital at Albany Medical College, International Adoption Medical Consultation Services, Mineola, Children's Hospital, Boston, Department of Pediatrics, Syracuse

This symposium will provide a broad overview of the state of the pediatric AIDS pandemic. The results of recent trials investigating approaches to prevention and treatment of vertical HIV transmission in the developing world will be discussed. Collaborative approaches and opportunities for partnership in international pediatric AIDS treatment, education, and research will be highlighted.

Overview
Mark W. Kline, Baylor College of Medicine, Houston, TX

Pediatric AIDS: State of the Pandemic
Meg Gwynne Ferris, Baylor College of Medicine, Houston, TX

Approaches to Prevention of Mother-to-Child HIV Transmission in the Developing World
Lynne M. Mofenson, National Institute of Child Health and Human Development, Rockville, MD

Collaborative Approaches to International AIDS Training and Research
Kenneth Bridbord, Fogarty International Center, National Institutes of Health, Bethesda, MD

Models of Partnership in Pediatric AIDS Treatment, Education and Clinical Research: Romania and Botswana
Mark W. Kline, Baylor College of Medicine, Houston, TX

The diagnosis and treatment of H. pylori in children is a controversy surrounded with questions of who should be tested, what are the most reliable tests, who should be treated, and what is the preferred therapy. A panel of experts will examine the epidemiology and clinical outcomes of infection, microbial and host factors, and the newly published clinical practice guidelines from the North American Society for Pediatric Gastroenterology and Nutrition.

Overview
Benjamin D. Gold, Associate Professor of Pediatrics and Microbiology, Emory University School of Medicine, Atlanta, GA

Epidemiology and Clinical Outcomes of Infection
John D. Snyder, Professor of Pediatrics, University of California Medical Center, San Francisco, CA

Microbial Genome and Virulence Determinants
Philip M. Sherman, Professor of Paediatrics and Microbiology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

Host Responses as Determinants of Disease Outcome
Sheila Crowe, Associate Professor of Medicine, University of Texas Medical Branch, Galveston, TX

NASPGN Clinical Practice Guideline Summary and Recommendations
Steven J. Czinn, Director, Division of Pediatric Gastroenterology and Nutrition, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH

Increasingly, scientific evidence is becoming available that links chronic diseases such as atherosclerosis, neuropsychiatric disorders and certain malignancies with infectious roots. Faculty will expose the fascinating existing information and help put novel findings and theories in perspective.

Are All Diseases Infectious?
Bennett Lorber, Temple University School of Medicine, Philadelphia, PA

Chlamydia pneumoniae and Atherosclerosis: Weighing the Evidence
Thomas C. Quinn, Johns Hopkins University School of Medicine, Baltimore, MD

Epstein-Barr Virus, Lymphoproliferation and Cancer
John L. Sullivan, University of Massachusetts School of Medicine, Worcester, MA

The Human Genome Project is impacting every aspect of medicine. Dr. Craig Venter, President of Celera Genomics, one of the chief architects of this venture, will discuss the accomplishments of the human genome project and implications for future impact on health and disease in this special one-hour state of the art lecture.

Sequencing the Human Genome
J. Craig Venter, President, Celera Genomics, Rockville, MD

Supported in part by an educational grant from the Columbus Children's Hospital, Columbus, OH

Previously we have thought that most infections are the circumstance of "bad luck". This session will highlight the exploding information on our innate immunity, subtle defects that cause susceptibility to certain pathogens, and the remarkable mechanisms of microbial pathogenesis.

Toll-like Receptors, Innate Immunity and Responses to Microbial Antigens
Moshe Arditi, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA

Evading Host Defenses: Lessons from Bordetellae
Jeff F. Miller, UCLA School of Medicine, Los Angeles, CA

Recurrent Urinary Tract Infections: Acute or Chronic?
Scott Hultgren, Washington University School of Medicine, St. Louis, MO

A major challenge of daily professional life is keeping abreast of the rapid changes in infectious diseases — pathogens, antimicrobial resistance, therapies and prevention. Four topics are selected because of their timeliness and the importance of new information.

Vaccines: The Good, Bad and Ugly
Jon S. Abramson, Wake Forest University School of Medicine, Winston-Salem NC

Meningococcal Vaccine: Experience and Experiment
Dan M. Granoff, Children's Hospital Oakland Research Institute, Oakland, CA

The MRSA Shows No Mercy
Betsy C. Herold, Mt. Sinai School of Medicine, New York, NY