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Pediatric Academic Societies, May 2-5, 2009

Last Updated: May 12, 2009.

Pediatric Academic Societies 2009 Annual Meeting

The Pediatric Academic Societies' 2009 Annual Meeting, which took place May 2 to 5 in Baltimore, is the country's largest conference dedicated to pediatric clinical research and education. Member organizations include the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics. In addition, the American Society of Pediatric Nephrology and the Lawson Wilkins Pediatric Endocrine Society had concurrent programming and exhibits during this year's meeting. Approximately 5,700 individuals, primarily pediatricians from academic medical centers, attended the meeting. These attendees took part in nearly 3,200 presentations.

Wendy Pomerantz, M.D., of the Cincinnati Children's Hospital Medical Center, reported a study which found that obese children were significantly more likely to suffer lower body injuries than their non-obese counterparts. The study, which included 23,349 children (mean age of 8.2 years) who presented in the emergency department for an injury, included 16.5 percent obese patients. In a statement, Pomerantz said of the injuries, "the most common lower body injuries were sprains. Because obese patients have an increased body mass and force, they are more likely to twist or roll on a lower extremity and cause injury than the non-obese children."

Pomerantz added in a statement that in addition to a greater risk for injuries, obesity could also prolong recovery time in children. "Though it is not well studied, we suspect that increased force due to increased weight puts undue strain on the ligaments, tendons, muscles, joints and bones of these particular children. Repetitive forces with increased weight likely results in more damage to their bodies and lengthy recovery times." She suggested that this study could have important implications for injury prevention, providing one more reason for obese children to lose weight.

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Cozumel S. Pruette, M.D., of the Johns Hopkins Children's Center in Baltimore, discussed a study which showed that hypertensive black children are more likely than other hypertensive children to develop left ventricular hypertrophy (LVH). This, coupled with higher cholesterol levels, may increase their risk for cardiovascular disease. The study included 139 children (ages 3 to 21 years) diagnosed with primary hypertension. Specifically, Pruette showed that LVH developed in nearly twice as many black children as children of other races (60 versus 37 percent, respectively). Additionally, black children with LVH had significantly higher cholesterol levels compared with black children without LVH, a difference not observed among other races.

"Our study identifies black children with hypertension as a special group who may be at particularly high risk for heart disease as they age because of several risk factors," Pruette said in a statement, adding "pediatricians treating these kids should follow them very closely."

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Gabriel Escobar, M.D., with the Kaiser Permanente Division of Research in Oakland, Calif., presented findings which showed that, like extremely premature infants, infants born mildly premature (33 to 36 weeks gestational age) also have a significantly elevated risk of medically attended respiratory syncytial virus (RSV) infection. RSV is a leading cause of lower respiratory tract infection and pneumonia in infants. The retrospective cohort study included 108,794 infants who were born and discharged from the hospital at at least 33 gestational weeks. Compared with babies born between 38 to 40 weeks, those born less than 38 weeks were at a significantly higher risk of experiencing an RSV infection during their first year of life, with babies born between 34 and 36 weeks experiencing a 70 percent increased risk. Comparatively, babies born at at least 41 weeks had a 14 percent lower risk of infection. Among several factors investigated, the use of supplemental oxygen during the birth hospitalization increased the odds of RSV infection by between 50 and 120 percent.

Escobar said in a statement, "although extreme prematurity is a known risk factor for severe RSV infection, this study helped us to learn more about risk factors for RSV infection among mildly premature infants." He further noted that this increased risk was apparent "even in babies born at 37 weeks." Escobar concluded that "further research is needed to determine whether strategies to prevent or mitigate RSV infections are indicated in late preterm infants."

This study was funded by Medimmune L.L.C., the manufacturer of pavilizumab, a humanized monoclonal antibody used to prevent RSV infection in infants.

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Amed Soliz, M.D., of Miami Children's Hospital, presented research from a multicenter study which suggested that the phosphodiesterase inhibitor sildenafil (Viagra®), currently indicated for erectile dysfunction, was an effective method for improving oxygenation for neonates with persistent pulmonary hypertension of the newborn (PPHN). According to Soliz, although inhaled nitric oxide is the "gold standard" treatment in the United States for this life-threatening disorder, "in many developing countries, nitric oxide is not available." A total of 49 newborns were randomized to receive either placebo or sildenafil through an orogastric tube within 72 hours of birth. Within the first hour following administration, neonates receiving sildenafil exhibited significantly improved oxygenation compared with those receiving placebo, demonstrated by lower changes in oxygenation index and higher arterial blood oxygen. The mortality rate was significantly decreased with sildenafil treatment (8 versus 50 percent, respectively).

In a statement, Soliz concluded "use of the widely available sildenafil shows promise as an alternative therapy not only for patients in developing countries but may in the future offer more affordable treatment for patients in developed countries as well."

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Alan L. Mendelsohn, M.D., of the New York University School of Medicine and Bellevue Hospital Center in New York City, reported findings from a randomized controlled trial investigating the impact of parenting interventions in the pediatric primary care setting on parent-child interactions at 14 months. In the study, families were divided into three groups, two receiving interventions to facilitate positive interactions with their children, while the third control group received only routine care with no parenting intervention. The results led Mendelsohn to conclude that parenting interventions, especially through a video interaction project, resulted in an improved cognitive home environment, a higher number of maternal utterances, and reduced parental stress.

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In a newly added special symposium entitled "H1N1 Influenza A: What the Pediatrician Needs to Know", researchers, physicians, and other experts specializing in pediatric infectious diseases provided an up-to-date assessment on the H1N1 flu, including a description of the current epidemiology and use of antiviral therapies. While flu cases were expected to decrease in the coming weeks, a reemergence later in the fall was predicted. Rapid testing in children with a fever and flu-like symptoms, especially in those having contact with a suspected case, was recommended.

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PAS: Many Factors Adversely Affect Immunization

TUESDAY, May 5 (HealthDay News) -- Multiple parental, practice, provider and community factors affect the likelihood that parents will keep immunization appointments for young children, according to research presented at the annual meeting of the Pediatric Academic Societies held May 2 to 5 in Baltimore.

Abstract (registration may be required)

PAS: Nutrition, Metabolic Issues in Autism Examined

MONDAY, May 4 (HealthDay News) -- Autistic children may be at risk for serious nutritional deficiencies and may have significantly different red blood cell fatty acid composition than non-autistic children, according to research presented at the annual meeting of the Pediatric Academic Societies, held from May 2 to 5 in Baltimore.

Abstracts (registration may be required)

PAS: Program Benefits Children With Hearing Loss

MONDAY, May 4 (HealthDay News) -- In young children with permanent hearing loss, enrollment in an early intervention program significantly increases the likelihood of achieving and maintaining appropriate language skills, according to research presented at the annual meeting of the Pediatric Academic Societies, held from May 2 to 5 in Baltimore.

Abstract (registration may be required)

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