Since the CCTR Pediatric Pilot Fund program began in 2008, these funds have been used to support a wide variety of research. Below are descriptions of the personnel and goals of each Pilot Fund project as stated at the time of the award.
2010 Pediatric Pilot Fund Recipients
Yuk Law, MD
Effect of remote ischemic preconditioning in children undergoing cardiac surgery
Dr. Yuk Law is director of the cardiac transplant and heart failure service and an associate professor in the Department of Pediatrics at the University of Washington. In his pilot project, he will investigate the use of remote ischemic preconditioning (RIPC) as a simple and practical intervention that could reduce the risk of post-operative cardiac and renal dysfunction in children undergoing open heart surgery. RIPC is a noninvasive treatment that involves using a tourniquet to squeeze the extremities prior to cardiac surgery. Results of the pilot study will be useful in applying for larger-scale funding for full-scale clinical and translational research in this area.
Sarah Ringold, MD, MS
Development of a pediatric-specific disease activity index for juvenile idiopathic arthritis
Dr. Sarah Ringold is an acting assistant professor in the Department of Pediatrics at the University of Washington. In her pilot project, she will use a previously-collected dataset of children with juvenile idiopathic arthritis (JIA) to perform principal component analyses and factor analyses that will be used in development of a standardized pediatric-specific composite disease activity index for JIA. The results of this study will provide key data about which variables will be included in the index and their respective weights, thus setting directions for the design of future studies to test additional properties of the index and incorporate data collected via consensus methodology.
Julie Brown, MD, MPH
A controlled trial evaluating pediatric lumbar puncture success using the Compass™, a compact quantitative pressure transducer
Dr. Julie Brown is the co-director of emergency medicine research at Seattle Children’s and an assistant professor in the Department of Pediatrics at the University of Washington. In her pilot project, she will study the effectiveness of the Compass™ Lumbar Puncture, a new digital pressure measuring device specifically designed for use during lumbar puncture. Lumbar punctures (LPs) are common procedures in the pediatric emergency department, most involving infants less than four months of age. However, many patients require multiple attempts and some LPs are unsuccessful. Julie expects that the Compass™ device will improve the likelihood of first attempt LP success and will decrease the total amount of time required to perform an LP. These benefits may translate into a reduction of traumatic LPs in the clinical population, leading to fewer unnecessary hospital admissions and decreased use of antibiotics.
Luke Hoffman, MD, PhD, and Daniel Wolter, PhD
Community-level physiologic profiling: a novel method for studying chronic, polymicrobial Infections
Dr. Luke Hoffman is an assistant professor and Dr. Daniel Wolter is a senior fellow, both in the Department of Pediatrics at the University of Washington. In their pilot project, they will use cutting-edge techniques known collectively as “community-level physiologic profiling” (CLPP) as a novel approach for studying the behavior of cystic fibrosis (CF) multispecies infections. Hoffman and Wolter recently developed new CLPP methods to probe multispecies consortia of microbes and will apply these new techniques to test the metabolic properties and antibiotic susceptibilities of intact microbial communities from chronically infected CF airways. This study should give these researchers sufficient preliminary data to apply for a larger translational grant, where they hope to show that this tool will be clinically useful in identifying more effective therapeutic regimens for CF patients.
Ann Vander Stoep, PhD, and Molly Adrian, PhD
Genetic influences on co-occurring depression and conduct problems in adolescence
Dr. Ann Vander Stoep is an associate professor and Dr. Molly Adrian is a post-doctoral fellow, both in the Department of Epidemiology at the University of Washington. In their pilot project, Vander Stoep and Adrian will collect DNA from adolescents participating in an epidemiological study to investigate genetic associations with combined depression and conduct problems. They will compare subjects with comorbid depression and conduct problems to adolescents suffering from depression without comorbid conduct problems, as well as those without psychopathology. This pilot research will lay the ground work for future genetic studies and investigations of gene-environment interactions likely to be involved in the etiology of depression and conduct problems.
2009 Pediatric Pilot Fund Recipients
Richard Hopper, MD
Measurement of nasal morphological changes following use of the Seattle alar molding (SAM) device in infants born with unilateral complete cleft lip deformities
Dr. Richard Hopper is an associate professor in the Division of Plastic Surgery, Department of Surgery at the University of Washington. In his pilot project, he is evaluating the clinical effectiveness of the Seattle Alar Molding (SAM) device, a patent pending 510K exempt novel invention. The SAM device is used on infants with unilateral cleft lip and palate (UCLP) who are undergoing pre-surgical molding in preparation for primary cleft lip repair and rhinoplasty. Hopper will refine the prototype for clinical efficacy and compare the changes in nasal morphology associated with SAM treatment with the nasal changes occurring over the same time period in patients undergoing traditional molding treatment. This pilot study will perform initial evaluation of the SAM device, which is intended to optimize long term nasal symmetry and function in children with UCLP.
Danielle Zerr, MD, MPH, and Emily Martin, PhD
Natural history of bocavirus in young infants
Dr. Danielle Zerr is an associate professor and Dr. Emily Martin is a post-doctoral fellow in the Department of Pediatrics at the University of Washington. In their pilot, they will test Human bocavirus (HBoV) with a new salivary assay they have developed. By defining the illness characteristics associated with HBoV detection in a birth cohort, more detailed specific studies can be conducted to look at HBoV disease in high risk populations such as children with cancer or immunosuppression. By testing salivary samples with their HBoV assay, the investigators will be able to obtain the detailed longitudinal data that is necessary to define the association between HBoV and disease and to understand the implications of an HBoV positive result in a clinical setting.
Jonathan Perkins, DO
Identification of biomarkers associated with propranolol induced infantile hemangioma regression
Dr. Jonathan Perkins is an associate professor in the Department of Otolaryngology at the University of Washington. In his pilot project, he will examine the effect of propranolol on infantile hemangiomas (IH), proliferative endotherial cell tumors that are the most common pediatric head and neck tumors. Rapidly expanding IH can impair vision and breathing during infancy and early childhood. Propranolol has been effective in reducing IH size and IH associated complications. Perkins will compare genotypically matched IH tissue gene expression before and after propranolol treatment to IH tumors that are treated with standard therapy. The proposed project will add to the understanding of how beta adrenergic blockade stops tumor growth and induces tumor regression.
Nathalia Jimenez, MD, MPH
Effects of polymorphisms in the μ-opioid receptor and UDP-glucuronosyltransferase genes on analgesic response and side effects to morphine in Latino and non-Latino pediatric patients
Dr. Nathalia Jimenez is an assistant professor in the Department of Anesthesiology and Pain Medicine at University of Washington. In her pilot project, she will analyze the role of genetic factors on occurrence of morphine side effects in Latino and non-Latino Caucasian pediatric patients. A preliminary analysis of a study on morphine pharmacokinetics and pharmacodynamics found significant differences in the occurrence of side effects between these two groups. This study will provide preliminary data for future studies on the role of genetic variation on morphine effect in different ethnic populations. It will also increase the current knowledge on genetic variability in the response to morphine and other opioids for all patients regardless of the racial or ethnic background.
Margarett Shnorhavorian, MD, MPH, FAAP, FACS
Genes involved in male reproductive tract anomalies and the risk of testis cancer: a candidate genetic polymorphism study
Dr. Margarett Shnorhavorian is an assistant professor in the Department of Urology at the University of Washington. In her pilot project, she will test the testicular dysgenesis syndrome (TDS) theory that proposes that testicular germ cell tumors (TGCT), undescended testes (UDT), and hypospadias have a common etiology. The goal of this study is to identify genetic risk factors of TGCT by evaluating variations in the genes for two conditions, UDT and hypospadia, which are hypothesized to be part TDS. These findings will provide evidence for or against the TDS theory as well as provide a basis for targeted screening and prevention strategies for TGCT.
2008 Pediatric Pilot Fund Recipients
Eric J. Chow, MD, MPH
Dr. Eric Chow is an acting instructor in hematology/oncology at the University of Washington School of Medicine. In his pilot project, he is examining a cohort of 200 pediatric patients who have been treated for childhood acute lymphoblastic leukemia (ALL). He will be looking at the role played by high-dose glucocorticoids, e.g., prednisone and dexamethasone, given to children who have been treated for ALL, in producing an elevated risk of obesity. Results of this research may help identify those children with ALL who would benefit most from early interventions to reduce future obesity and insulin resistance.
Christian L. Roth, MD
Dr. Christian Roth is an associate professor in the Department of Pediatrics at the University of Washington School of Medicine. In his pilot project, he is examining patients with hypothalamic obesity. Using an established functional magnetic imaging (fMRI) protocol, he is observing food-related responses of brain centers involved in appetite control. The goal is to establish a translational research project identifying neuroendocrine and behavioral mechanisms that lead to overeating and weight gain in patients with medial hypothalamic brain lesions and also to establish interdisciplinary fMRI studies at Seattle Children’s Hospital in the field of neuroendocrine disorders of energy homeostasis.
Sheela Sathyanarayana, MD, MPH
Dr. Sheela Sathyanarayana is an assistant professor in the Department of Pediatrics at the University of Washington and is a member of Seattle Children’s Research Institute's Center for Child Health, Behavior and Development. Her pilot project is looking at the use of phthalate — a synthetic chemical used to make plastics flexible — in medical products. She is measuring urinary phthalate concentrations in infants at the Swedish Neonatal Intensive Care Unit in Seattle, where efforts are under way to change to equipment that is free of di-ethylhexyl phthalate. For the study, infants will be randomized to phthalate-containing medical equipment or phthalate-free medical equipment to determine if significant exposure differences exist. Data gathered in this study will be invaluable in future research efforts to determine the impact of endocrine-disrupting chemicals on infant health and development.
Thor A. Wagner, MD
Dr. Thor Wagner is an acting instructor in the Department of Pediatrics at the University of Washington School of Medicine. His project is motivated by the observation that 50% of all children with HIV die before they are diagnosed. His pilot project seeks to explore a novel, high-sensitivity, microcapillary approach to infant HIV-1 diagnosis, with the goal of enabling an affordable point-of-care diagnostic test for infant HIV. If successful, this approach might be applicable to diagnostic testing for other infectious diseases in low-resource settings.
Danielle M. Zerr, MD, MPH
Dr. Danielle Zerr is an associate professor in the Department of Pediatrics at the University of Washington School of Medicine. Her pilot project looks at emerging multidrug resistance and aims to characterize the associations between clinical factors, bacterial strain background, intrinsic virulence, plasmid structure and broad spectrum β-lactam resistance in pediatric E. coli isolates. The results will serve as preliminary data for a multicenter grant application to describe national molecular and epidemiological trends in pediatric plasmid-borne broad-spectrum β-lactam resistance in Enterobacteriaceae bacteria.