Public Release: 

Children's Hospital Boston presents at the 2007 Pediatric Academic Societies Annual Meeting

Boston Children's Hospital

All items are embargoed until day of presentation (no time specified).

Children's Hospital Boston presents at the 2007 Pediatric Academic Societies Annual Meeting

May 5 to 8 ~ Toronto, Canada
Metro Toronto Convention Centre

SUMMARY:

Pediatric research frontiers

  • Making marrow transplants safer (Sat., May 5)
  • New treatments on the horizon for newborn brain injury (Sun., May 6; Mon., May 7)
  • Using stem cells to heal lung injuries in newborns (Mon., May 7)
  • Making newborns less susceptible to infections (Tues., May 8)

Parenting/child health

  • Groups boost teens' parenting skills (Sat., May 5)
  • Dance classes help children with Down syndrome stay slim (Sat., May 5)
  • Some chubby babies may be at risk for hypertension (Mon., May 7)
  • Vitamin D deficiency is common in infants and toddlers (Mon., May 7)
  • Are parents taking care of their kids' teeth? (Mon., May 7)

Public health

  • Hospitals seeing more children with neurologic illness (Sat., May 5)
  • The pediatrician's role in emergency preparedness (Sat., May 5)

PEDIATRIC RESEARCH FRONTIERS

Making marrow transplants safer

Most patients undergoing bone-marrow transplant must receive powerful chemotherapy drugs to suppress their immune systems and prevent their bodies from rejecting the donated cells. New research shows that this chemotherapy increases the risk for graft-versus-host disease - but also suggests that this risk can be reduced by replacing a natural antibiotic, known as BPI, which is depleted when patients undergo chemotherapy. A multicenter study, led by Children's Hospital Boston and the Dana-Farber Cancer Institute, is about to test this idea in patients, using a manufactured form of BPI known as rBPI21 (XOMA Ltd.). [Note: For further background see: http://www.childrenshospital.org/newsroom/Site1339/mainpageS1339P1sublevel268.html]

Saturday, May 5, 2007, 10:45 a.m.
Platform Session: Hematology/Oncology I (9:30 to 11:15 a.m.)
Room 716A
Course Number: 5292; Board Number: 6
[5292.6] Potential Therapeutic Intervention Suggested by Profound Deficiency of Neutrophil-Derived Bactericidal/Permeability-Increasing Protein (BPI) and Other Alterations in LPS-Directed Innate Immunity after Myeloablative Hematopoietic Stem Cell Transplantation (HSCT) Ofer Levy, Eugenie E. Suter, Leslie A. Kalish, Janice D. Russell, Patrick J. Scannon, Eva C. Guinan. Childrens Hospital Boston; Pediatric Oncology, Dana-Farber Cancer Institute, Boston; Department of Pediatrics, Harvard Medical School; XOMA (U.S.) LLC, Berkeley, CA.

New treatments on the horizon for newborn brain injury

More in vitro fertilizations and more multiple gestations are leading to more premature, very-low-birthweight infants. With advances in care, more babies are surviving, only to be left with long-term neurologic complications - cognitive, attentional and behavioral deficits; cerebral palsy; and/or epilepsy. Over the past decade, researchers at Children's Hospital Boston have documented a complex web of insults sustained by premature babies' brain cells - but have also showed that many of these insults can be blocked. Now, preclinical data suggests that certain existing drugs, given at the right time, can ameliorate brain injury in vulnerable newborns.

Cerebral palsy. Research led by Frances Jensen, MD, of the Department of Neurology and Program in Neuroscience at Children's, suggests that memantine, approved by the FDA to treat Alzheimer's disease, may help prevent periventricular leukomalacia, a form of brain injury that is the leading cause of cerebral palsy in preterm infants. In a rat model, memantine significantly attenuated injury to the brain's white matter, apparently by preventing damage to immature brain cells. Jensen and colleagues now hope to conduct a clinical trial of memantine in premature infants.

Sunday, May 6, 2007, 4:15 p.m.
Poster Symposium: Neonatal Potpourri: Old Diseases, New Insights (4:15 to 6:15 p.m.)
Room 701B
Course Number: 6725; Board Number: 10
[6725.10] NMDA Receptors Are Implicated in the Pathogenesis of White Matter Injury in a Rat Pup Model of Periventricular Leukomalacia
Simon Manning, Debra Selip, Li An, Hyun K. Park, Chang Park, Delia Talos, Joseph Volpe, Frances Jensen. Department of Neurology, Children's Hospital Boston

Seizures. Newborns who suffer from oxygen deprivation are vulnerable to seizures that can lead to lasting brain damage and epilepsy. Because newborns' brain physiology differs from that of adults, they respond poorly to traditional anticonvulsants - in fact, these drugs can actually excite the brain when they should be calming it. Jensen and colleagues now show that adding bumetanide - an FDA-approved diuretic that has been safely used in newborns - to anticonvulsant treatment had a calming effect that significantly reduced seizure time in a rat model. They are now preparing to conduct a phase I study of bumetanide in newborns. [Note: for a previous press release on this research, see http://www.childrenshospital.org/newsroom/Site1339/mainpageS1339P1sublevel178.html]

Monday, May 7, 2007, 8 a.m.
Poster Symposium: Neonatal Neurology - Neuroprotection (8:00 to 10:00 a.m.)
Room 701B
Course Number: 7145; Board Number: 1
[7145.1] Combination Treatment with Bumetanide and Phenobarbital Suppresses Seizures in a Model of Perinatal Hypoxia
Thanhthao Huynh, Delia Talos, Alexander Rotenberg, Frances E. Jensen. Neurology, Children's Hospital Boston

In a "Hot Topic" session, Jensen and colleagues review the latest research on premature brain injury. [Note: For general background see: http://www.childrenshospital.org/dream/DreamSummer05/tide.html]

Monday, May 7, 2007, 3 to 5 p.m.
PAS Hot Topic - Hall F
[7630] Premature Brain Injury: Unique Patterns, Outcomes and Mechanisms
3 p.m.: Brain Injury in the Premature Infant: Causes, Consequences and Novel Therapeutic Targets - Joseph Volpe, MD, Neurology, Children's Hospital Boston
4 p.m.: Identifying Mechanisms of Cerebrovascular Injury at the Bedside of Premature Infants using Near Infrared Spectroscopy - Adre du Plessis, MD, Neurology, Children's Hospital Boston
4:30 p.m.: Age-specific Mechanisms of Premature Brain Injury: Translating to Therapeutics. Frances Jensen, MD, Neurology, Children's Hospital Boston

Using stem cells to heal lung injuries in newborns

The fragile lungs of premature babies are highly susceptible to injury, often leading to chronic, long-term respiratory problems known as bronchopulmonary dysplasia (BPD). Researchers from Children's Hospital Boston's Division of Newborn Medicine show, in a mouse model, that stem-cell treatment can ameliorate these debilitating injuries. Mesenchymal stem cells, which give rise to a variety of connective tissues, were given through a vein. Treated mice had reduced lung injury, with significant improvement in lung physiology and a reduction in pulmonary hypertension, a major complication of BPD. The researchers are now looking at ways to modify the stem cells to maximize their therapeutic potential.

Monday, May 7, 2007, 3 p.m.
Platform Session: Neonatal Diseases-Interventions and Insights at a Translational Level (3 to 5 p.m.)
Room 801B, Course Number: 7730
[7730.1] Mesenchymal Stem Cell Treatment Ameliorates Lung Alveolar and Vascular Injury in Response to Hyperoxia in Neonatal Mice
Rajiv Baveja, Olin Liang, Angeles Fernandez-Gonzalez, Alex Mitsialis, Stella Kourembanas.
Newborn Medicine, Children's Hospital Boston and Harvard Medical School.

Making newborns less susceptible to infections

Newborn babies' immature immune systems leave them highly vulnerable to severe infections and unable to respond to most vaccines, thereby frustrating efforts to protect them. Researchers Ofer Levy, MD, PhD and Victoria Philbin, PhD of Children's Hospital Boston have found one portion of the newborn immune system that is fully functional, and believe they can exploit this discovery to boost vaccine responses. They show that stimulating a receptor known as TLR8 on the surface of certain white blood cells can trigger a robust immune response in newborns' cells. The researchers now hope to test TLR8 stimulators in monkeys and eventually live infants, with the hope of developing vaccine adjuvants to enhance newborns' immunity.

Tuesday, May 8, 2007, 8 a.m.
Platform Session: Neonatal Infectious Diseases - Host Defense (8 to 10 a.m.)
Room: 801A, Course Number: 8070
[8070.1] Toll-Like Receptor 8 (TLR8) Agonists Trigger a Distinct, Robust Pattern of Monocyte Activation in Neonatal Humans and Rhesus Macaques
Victoria J. Philbin, Eugenie E. Suter, Amity M. Paye, Richard L. Miller, Keith Mansfield, Ariel Shuckett, Ofer Levy. Medicine/Infectious Diseases, Children's Hospital Boston; New England Primate Research Center, MA.

In an educational session, Levy examines differences in the immune systems of newborns vs. adults and ways to translate the science into new treatments. [Note: A recent review article is available for background. For a previous press release on this research, see: http://www.childrenshospital.org/newsroom/Site1339/mainpageS1339P1sublevel202.html.]

Saturday, May 5, 2007, 2 p.m.
PAS/PIDS State of the Art Plenary (1 to 3 p.m.) - Hall F
[5515] Evolving Insights into the Immune Responses of Neonates and Premature Infants
2 p.m.Distinct Innate Immunity of Premature and Full-term Newborns: Basic Mechanisms and Translational Opportunities (Ofer Levy, MD, PhD)

PARENTING/CHILD HEALTH

Groups boost teens' parenting skills

Teenage mothers are often poor, socially isolated, depressed, and lacking in good role models for being a parent. These difficulties stress their relationship with their baby and can lead to poor child outcomes. Clinicians at Children's Hospital Boston report that a 12-week parenting group, offered through a Teen-Tot clinic, significantly improved teen mothers' parenting skills. The girls showed greater empathy toward their babies, were more apt to use disciplinary methods other than corporal punishment, had more appropriate developmental expectations of their infant, and were less likely to engage in "role reversal" (expecting things from the baby, rather than the other way around). These improvements held up after one year, despite rising depression and decreasing social support. [Note: Interviews with mothers can be arranged with some notice.]

Saturday, May 5, 2007, 1 p.m. Poster Symposium: Adolescent Medicine I (1 to 3 p.m.) Room 717AB Course Number: 5545; Board Number: 8 [5545.8] The Impact of Psychoeducational Parenting Groups on Adolescent Parenting Skills, Self-Esteem, Depression and Social Support Joanne Cox, Natalie Pierre Joseph, Matthew Buman, Jennifer Valenzuela, Anna Mitchell, Anuradha Vyavaharkar, Amy Federico, Elizabeth Woods. General Pediatrics, Children's Hospital Boston; Adolescent Medicine, Boston Medical Center; Adolescent/Young Adult Medicine, Children's Hospital Boston.

Dance classes help children with Down syndrome stay slim active

Children with Down syndrome at high risk for obesity. Through a program at Children's Hospital Boston and the Boston Ballet, 12 children participated in a weekly Adaptive Dance class at the Boston Ballet School, led by a trained ballet teacher with live music and two physical therapists. After 10 weeks in the class, the children had a trend toward decreased body mass index in addition to the social benefits - getting to know other children with Down syndrome, and enhanced self-confidence and coordination.
[Note: Interviews and photo/video opportunities are available.]

Saturday, May 5, 2007, 4 p.m.
Poster Session: General Pediatrics (4 to 7:30 p.m.)
Exhibit Hall E
Course Number: 5891; Board Number: 306
[5891.2] The Impact of a Dance Program for Children with Down Syndrome on Body Mass Index
Emily J. Davidson, Michelina Cassella, Donna Snover. Division of General Pediatrics, Department of Medicine, Childrens Hospital Boston

Some chubby babies may be at risk for high blood pressure

Babies who fatten up most rapidly in their first 6 months have higher blood pressure at 3 years of age, particularly if they are thin at birth, report researchers led by Mandy Brown Belfort, MD, MPH, in the Newborn Medicine Division of Children's Hospital Boston. The study, from the Department of Ambulatory Care and Prevention at Harvard Medical School, followed 530 children from the prospective cohort Project Viva and found that blood pressure at age 3 correlated with early increases in weight-for-length, a measure of fatness. Children who were born thin but had the highest weight-for-length score at 6 months of age had an average systolic blood pressure 5.5 mm Hg higher than children whose weight-for-length was highest at birth and lowest at 6 months. While no child had hypertension, this difference is large enough to be clinically significant. "We often try to get small babies to grow quickly in infancy, but we're showing that this practice may have adverse consequences as well as benefits," says Belfort. The researchers plan to check the children's blood pressure again when they reach school age.

Monday, May 7, 2007, 3 p.m.
Poster Symposium: Fetal Origins of Adult Disease (3 to 5 p.m.)
Room 701B
Course Number: 7710; Board Number: 5
[7710.5] Size at Birth, Infant Growth, and Blood Pressure at 3 Years of Age
Mandy B. Belfort, Sheryl Rifas-Shiman, Janet Rich-Edwards, Ken Kleinman, Matthew Gillman. Newborn Medicine, Children's Hospital Boston; Dept of Ambulatory Care and Prevention, Harvard Medical School; Brigham and Women's Hospital, Boston; Depts of Epidemiology; Nutrition, Harvard School of Public Health.

Vitamin D deficiency is common in infants and toddlers

Once our bone mass peaks at about age 18, it can never increase. The first crucial period for building bone is during the infant and toddler years, yet a study now finds that many of these children are at risk for low bone density. Catherine Gordon, MD, director of the Bone Health Program at Children's Hospital Boston, studied 234 healthy infants and toddlers and found that 38 percent had sub-optimal vitamin D levels, with 11 percent frankly deficient. Breastfeeding was a risk factor, since breast milk (unlike fortified cow's milk) lacks vitamin D; 36 percent of infants who were breastfed without vitamin D supplementation were deficient in the vitamin. In addition, 16 percent of 18-month-olds were not drinking milk, and 31 percent of them were vitamin D-deficient. Indeed, more toddlers were receiving juice than milk (91 vs. 84 percent). The findings are likely to guide recommendations for changes in the care of young children.

Monday, May 7, 2007, 3 p.m.
Poster Session: Endocrinology (3 to 6:45 p.m.)
Exhibit Hall E
Course Number: 7916; Board Number: 248
[7916.14] Vitamin D Deficency in Healthy Infants and Toddlers: Prevalence and Risk Factors
Catherine M. Gordon, Henry A. Feldman, Linda Sinclair, Avery L. Williams, Joanne Cox.
Children's Hospital Boston.

Are parents taking care of their kids' teeth?

One in three preschool-age children now get cavities, and in low income communities, that proportion can exceed 50 percent. Untreated, early tooth decay not only causes pain and infection, but can also lead to poor growth and learning disabilities. Researchers at Children's Hospital Boston surveyed 200 caregivers of young children at the hospital's primary care center, serving a largely poor minority population, and found a variety of oral health concerns:

  • Only 53 percent of children brushed teeth twice daily
  • 58 percent rarely or never flossed
  • 30 percent drank in bed, a risk factor for tooth decay.
  • Despite low income, 63 percent of households used bottled water, which often contains little or no fluoride, as their sole source of drinking water.
  • Although the American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend that children have a first dental visit by their first birthday, 59 percent had not yet seen a dentist at 24 months of age.
  • Although pediatricians see children at least 10 times by their second birthday, 24 percent of caregivers did not think their pediatrician ever looked at their child's teeth.

Monday, May 7, 2007, 3 p.m.
Poster Session: General Pediatrics (3 to 6:45 p.m.)
Exhibit Hall E
Course Number: 7900; Board Number: 40
[7900.41] Oral Health Practices of Parents and Children Served by a Large Urban Pediatric Clinic.
J. Post, A. Getzin, M. Ng, R. Webster, B. Grove, I. Chase, W. Risko. Medicine, Children's Hospital
Boston; Dentistry, Children's Hospital Boston.

PUBLIC HEALTH

Hospitals seeing more children with neurologic illness

Advances in pediatric health care have led to an increase in survival of children with complex medical problems, particularly neurologic problems. This study, led by Jay Berry, MD, MPH, of Children's Hospital Boston's Complex Care service, analyzed data from the national Kids Inpatient Database (KID). It found that the number of hospitalizations for children with neurologic illness increased by one-third from 1997 to 2003 (from about 247,000 to nearly 330,000), with concomitantly increased hospital costs.

Saturday, May 5, 2007, 3:15 p.m.
Platform Session: Hospital Medicine I (3:15 to 5:15 p.m.)
Room 705
Course Number: 5730
[5730.1] Changing Trends in Inpatient Pediatric Care
Jay Berry, Rajendu Srivastava.. Complex Care Service, Children's Hospital Boston; Inpatient Medicine, Primary Children's Medical Center, University of Utah, Salt Lake City.

The pediatrician's role in emergency preparedness

This educational session will explore how schools and pediatricians can prepare themselves for sudden outbreaks including natural disasters and terrorist attacks. Sarita Chung, MD from the Center for Biopreparedness at Children's Hospital Boston will discuss the pediatrician's role in disaster planning, while Linda Grant, MD, from the Boston Public Schools, will discuss how pediatricians can work with their area schools to develop action plans.

Saturday, May 5, 2007, 12 p.m.
APA Special Interest Group School and Community Health (12 to 3 p.m.)
Room 808
Course Number: 5473

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Children's Hospital Boston is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine and 10 members of the Howard Hughes Medical Institute comprise Children's research community. Founded as a 20-bed hospital for children, Children's Hospital Boston today is a 347-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children's also is the primary pediatric teaching affiliate of Harvard Medical School. For more information about the hospital and its research visit: www.childrenshospital.org/newsroom.

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