A Novel Method for Controlled Release Coil
Occlusion of Patent Ductus Arteriosus with .052 Inch Coils
This is a prospective study of effacacy and
technical aspects of a novel system.
Principal Investigator(s): Paul Seib, M.D.;
W.R. Morrow, M.D.; Eudice Fontenot, M.D.
A Randomized, Open-Label, Multi-center, Phase 3
Trial to Assess the Safety of Tobramycin Inhalation Powder Compared to TOBI® in Cystic Fibrosis Subjects
Inhaled antibiotics are utilized chronically to
decrease decline in lung function in cystic fibrosis (CF) patients,
improving survival and quality of life. The primary objective of this study
is to evaluate safety in CF subjects of twice-daily dosing of Tobramycin
Inhalation Powder (TIP) compared to TOBI®. Secondary
objectives include assessment of efficacy as measured by FEV(1)% predicted
and subject-reported treatment satisfaction.
Principal Investigator(s): Dennis Schellhase,
M.D.; Ariel Berlinski, M.D.; Holly Hink, A.P.N.
Attention Deficit Hyperactivity Disorder
Medications and Growth Hormone Deficiency
This study looks at the increasing use of
attention deficit hyperactivity medications in children receiving concurrent
growth hormone treatment for short stature.
Principal Investigator(s): Paul Frindik,
M.D.; John Fowlkes, M.D.; Stephen Kemp, M.D.; Kathyrn Thrailkill, M.D.; Alba
Morales, M.D.
Adipokine Profiles in Adolescents With and
Without Features of the Metabolic Syndrome
This project
aims to characterize adipokine dysregulation in obese adolescents and the
association of this dysregulation with specific obesity comorbidities
including hypertension, dylsipidemia, abdominal obesity and glucose
metabolism derangements.
Principal Investigator(s): J. Darrell
Nesmith, M.D.; Margaret Harris, Ph.D.
Aerosol Delivery in Children
A Pediatric Aerosol Research Laboratory has been
established at Arkansas Children’s Hospital Research Institute with the main
goal of finding optimal ways of delivering aerosols to children.
Principal Investigator(s): Ariel Berlinski,
M.D.
Amiodarone`s Effect on Heart Rhythm Entropy and
Fractal Pattern Following Cardiac Surgery in Children
Amiodarone may have important effects on heart
rate variability. Heart rate variability is a measure of autonomic nervous
influence and usually obtained by analyzing nonlinear signals in various
ways. Therefore, nonlinear analysis of heart rate is important to study the
physiologic mechanisms responsible for the control of heart rate
fluctuations, in which the autonomic nervous system appears to play a
primary role. This study will assess the effect of amiodarone on the heart
rhythm entropy and fractal pattern. The RR interval data will be obtained
from the central telemetry monitor data. The entropy analysis and detrended
fluctuation analysis will be performed. Conventional linear HR variability
analysis will also be performed.
Principal Investigator(s): Volkan Tuzcu,
M.D.; Selman Nas, Ph.D.; Parthak Prodhan, M.D.; Adnan Butta, M.D.; Michiaki
Imamura, M.D.; Robert Jaquiss, M.D.; Sana Ullah, M.D.
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Arkansas Center for Birth Defects Research and
Prevention
Studies of the impact of birth defects to the
family and to hospital care.
Principal Investigator(s): Charlotte Hobbs,
M.D., Ph.D.; James Robbins, Ph.D.; Mario Cleves, Ph.D.; Sadia Malik, M.D.;
Jill James, Ph.D.
Arkansas Child and Adolescent Obesity Initiative
The Arkansas Child and Adolescent Obesity
Initiative is a major research endeavor by the state of Arkansas to assess,
inform and investigate the epidemic of childhood obesity. Currently in its
third year, the initiative has the largest longitudinal dataset on child
growth parameters, school and community based interventions and clinical
outcomes related to obesity. Current results suggest that statewide efforts
may have resulted in a halt in progression of the epidemic.
Principal Investigator(s): Joseph Thompson,
M.D.
Arkansas Reproductive Health Monitoring System
Arkansas Reproductive Health Monitoring System is
a state-based active birth defects registry responsible for surveillance
practices, quality of data ascertainment and analysis and reporting of
findings to researchers, public health officials and the Arkansas state
legislature.
Principal Investigator(s): Charlotte Hobbs,
M.D., Ph.D.
Assessment of Paced QRS and JT Durations in
Children with Permanent Pacemakers
Assessing the potential utility of paced QRS
duration and JT intervals as predictors of congestive heart failure and
ventricular dysfunction may help in improved risk stratification of
chronically paced young patients.
Principal Investigator(s): Volkan Tuzcu, M.D.
Assessment of Specific Cognitive Domains in Girls
with a History of Sexual Abuse
This study will examine five different cognitive
functions (short-term memory, motivation, learning, time perception and
color/position discrmination) contained within the National Center on
Toxicological Research Operant Test Battery (OTB) in girls aged 10 years
to12 years (n=50) with substantiated child sexual abuse.
Principal Investigator(s): Sherry Ferguson,
Ph.D.; Merle Paule, Ph.D.; Jerry Jones, M.D.; Karen Worley, Ph.D.;
Janice Church, Ph.D.; John Clemmons, Ph.D.
Asthma in the Delta Region of Arkansas: Impact of
Environmental Factors
Low-income, minority children with asthma from
non-urban locales have been not been studied extensively. It is not known if
environmental factors important in disease expression among the inner-city
poor are important among rural children with asthma living in an
impoverished environment. The proposed study will provide critical
cross-sectional data on low-income, minority asthmatics living in a rural
environment and will be hypothesis-generating for future large scale studies
in rural asthmatics. The specific aims of the study will examine the impact
of home environmental exposure to endotoxin on asthma severity and atopy
status in the rural setting among predominately African-American, low-income
asthmatics. The impact of aeroallergen sensitization, aeroallergen exposure
and other home environment characteristics on asthma severity and morbidity
will be examined.
Principal Investigator(s): Tamara Perry,
M.D.; Stacie Jones, M.D.; Perla Vargas, Ph.D.; Mary Aiken, M.D.
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Asthma in the Delta Region: Prevalence and
Morbidity
Current U.S. pediatric asthma research focuses on
urban children with asthma. These populations consist of predominately
African-American, low-income children living in inner-cities who have
disproportionately high levels of morbidity due to asthma. Low-income,
minority children with asthma from other geographic regions have not been
studied. It is not known if low-income, minority asthmatics living in
different locales experience high levels of asthma morbidity similar to
inner-city asthmatics. Moreover, rural asthma studies are limited to
primarily European farming populations, and virtually nothing is known about
rural populations in the United States. The cross-sectional study will
examine asthma prevalence and morbidity in a predominately minority,
low-income population in rural Arkansas and will allow investigators to
obtain critical preliminary data and examine the feasibility of conducting a
study in this rural population. The PI will utilize these data to apply for
NIH K23 award within 24 months of the start of the study. To date, two rural
school districts in Arkansas, Eudora and Marvell, have been enrolled in the
study. The investigators have a had a >80% response rate with 27% of
children having a diagnosis of asthma or at-risk for asthma. Long-term goals
are to comprehensively characterize children with asthma in rural,
impoverished areas in the Mississippi Delta and to formulate effective
intervention programs targeting those children.
Principal Investigator(s): Tamara Perry,
M.D.; Stacie Jones, M.D.; Perla Vargas, Ph.D.; Pippa Simpson, Ph.D.
Automated White Blood Cell Differential in
Newborns
The white blood cell count and differential is
the best clinical test for identifying neonatal sepsis, but the manual
differential is labor intensive and subject to human variability. This
study will determine whether the automated differential provided by the
newer generation hematology analyzer will provide clinically useful
information to replace the manual differential for newborns.
Principal Investigator(s): Becky Rogers,
M.D.; Gail Woods, M.D.; Bryan Burke, M.D.; Clare Nesmith, M.D.
Beta2-Adrenergic Receptor Trafficking and
Down-Regulation
This project evaluates the role of adrenergic
receptor trafficking and regulation in airway disease, especially asthma,
using viral vector delivery to enhance airway function.
Principal Investigator(s): Stacie Jones,
M.D.
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Beta2-Adrenergic Receptor Transactivation of
Epidermal Growth Factor Receptor in Airway Wound Healing
Beta-agonists are used in the treatment of asthma
to bring about relaxation of the airway smooth muscle. However, the
asthmatic airway also undergoes airway remodeling and exhibits defects in
proper wound healing and expression of the epidermal growth factor receptor
(EGFR), known to be important in wound healing. Since beta-agonists have
been shown to trans-activate EGFRs in other systems and beta-agonists have
been demonstrated to negatively affect wound healing, this study will look
at the effects of beta-agonists on EGFR regulation in airways. The major
goals of this project are to: (1) define the physiological effects of
beta-agonists on wound healing in airway epithelium, (2) determine the cell
signaling pathways involved in beta-agonist transactivation of EGFRs and (3)
determine the itinerary of EGFRs upon transactivation by beta-agonists.
Principal Investigator(s): Bradley
Schnackenberg, Ph.D.; Richard Kurten, M.D.; Stacie Jones, M.D.
Biomarkers of Immune Function From the
Bloodstream of Pediatric Heart Transplant Recipients
The purpose of this study is to identify humoral
markers of immune activation in pediatric heart transplant patients. The
markers, primarily cytokines, will be identified by use of the Luminex7 system and the pattern of appearance of the markers will be correlated with
the occurence of immunologic events such as rejection and transplant
vasculopathy.
Principal Investigator(s): R. Erik Edens,
M.D., Ph.D.; W.R. Morrow, M.D.; Elizabeth Frazier, M.D.; Eudice Fontenot,
M.D.; Paul Seib, M.D.; Selman Nas, Ph.D.; Del Ellison, M.D.; Martin Cannon,
M.D.; Kathleen Gilbert, Ph.D.; Weida Tong, Ph.D.; Terry Harville, M.D.
Brief Intensive In-Hospital Intervention May
Kick-Start Weight Loss in Seriously Overweight Children and Adolescents
Case study of 10 to 15 overweight children
hospitalized for short stay who had a bariatrics consult with implementation
of Fitness Clinic program while hospitalized and whether this intervention
assists in weight loss.
Principal Investigator(s): Maria Sequeira,
M.D.; Karen Young, M.D.; Samiya Razzaq, M.D.; Laura McLeane, M.D.; Gary
Wheeler, M.D.; Pippa Simpson, Ph.D.; Deane Peck, R.D.
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Cell Death and Innate Immunity
Chlamydia species provoke serious infections of
humans and animals worldwide, despite extensive work to better characterize
the biology of the infection and develop vaccines. The biphasic
developmental cycle of chlamydia allows for multiple sites of communication
between the pathogen and the host cell; examples include the signals that
block and then later induce apoptosis. Apoptosis of chlamydia-infected cells
triggered with external ligands is blocked through inhibition of cytochrome
c release and caspase-3 activation, while apoptosis induced by the infection
itself is independent of known caspases and dependent on activation of the
pro-apoptotic factor, Bax. The study’s data show that Bax translocates from
the cytosol to mitochondria in infected cells, and inhibition of Bax
inhibits chlamydia-induced apoptosis and chlamydial propagation.This process
has an intimate role in the host inflammatory response and tissue pathology
as mice genetically deficient in Bax exhibit increased inflammation and
tissue damage despite a lower level of infection. The overall hypothesis to
be tested is that chlamydia induce apoptosis as a quiet means of escape from
the cell, but that infection-related cellular necrosis inevitably occurs,
leading to the release of 'danger' signals and subsequent inflammation. The
primary goal of these studies is to examine the entwined pathways of
apoptosis and inflammation in vitro and in vivo as they relate to chlamydial
disease pathogenesis. The first two goals are to (1) determine mechanisms
for, and roles of chlamydia-induced apoptosis and chlamydia-induced
protection from apoptosis in infection and disease and (2) evaluate whether
danger signals released from necrotic cells, such as ATP and adenosine,
modulate infection and inflammation. Cellular recognition of pathogens
initiates signals related to inflammation, as well as to cell survival.
Thus, the third goal will be to determine the contribution of toll-like
receptors (TLRs), TLR-related proteins, such as Nod1, and downstream
signaling proteins in recognition of chlamydia and initiation of cellular
responses in vitro and in vivo. Studies of chlamydia infection in cell
lines and primary cell cultures from knock-out mice will determine signaling
events and proteins important in the innate immune response to chlamydia in
vitro. The relevance of these data to disease pathogenesis will be
determined with the use of knock-out mice and an established mouse model of
chlamydial genital tract disease.
Principal Investigator(s): Toni Darville,
M.D.; David Ojcius, M.D.
Centers of Excellence for Surveillance, Research,
Service and Evaluation Aimed at Birth Defects
The mission of the Arkansas Center for Birth
Defects Research and Prevention (Arkansas Center) is to reduce the
prevalence and impact of birth defects on a state and national level. The
Arkansas Center's activities include survelliance of birth defeccts,
participation in the National Birth Defects Prevention Study, and
participation in local research studies involving gene-environmental
interactions, epidemiology and surveillance and health services research and
comunity interventions.
Principal Investigator(s): Charlotte Hobbs,
M.D., Ph.D.; Mario Cleves, Ph.D.; Sadia Malik, M.D.; Jim Gibson, M.D.; James
Robbins, Ph.D.; Patrick Casey, M.D.; John Tilford, Ph.D.; Mary Curtis, M.D.
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Central Pulse Pressure as a Predictor of Aortic
Root Dilation in Marfan Syndrome
Aneurysmal dilation of the ascending aorta with
subsequent rupture or dissection occurs frequently in patients with Marfan
syndrome and is the primary cause of morbidity and mortality in this
disorder. Echocardiographic measurements of the aorta are currently used to
guide medical and surgical management of patients with Marfan syndrome. The
purpose of this study is to determine if central pulse pressure can be used
to identify a subset of Marfan syndrome patients who will develop aortic
root dilatation.
Principal Investigator(s): Sadia Malik, M.D.;
Thomas Best, M.D.
Childhood Absence Epilepsy
This is a multi-center study of childhood absence
epilepsy.
Principal Investigator(s): May Griebel, M.D.;
Rolla Shbarou, M.D.
Children with Sexual Behavior Problems
The case study investigates pre-pubescent
children with sexual acting-out behaviors.
Principal Investigator(s): Janice Church,
Ph.D.; Karen Worley, Ph.D
Children’s Health Services Research Group
Studies to determine medical procedures and
technologies that result in superior health outcomes for children while
realizing efficiencies of care to the hospital and family.
Principal Investigator(s): James Robbins,
Ph.D.; John Tilford, Ph.D.; Mary Aitken, M.D.; Perla Vargas, Ph.D.
Children's Sentinal Nutrition Assessment Program
The Children's Sentinal Nutrition Assessment
Program is a multi-site research program designed to evaluate the impact of
welfare reform on children's health and nutrition status and household food
security. Data are collected in the Emergency Departments of six children's
hospitals.
Principal Investigator(s): Patrick Casey,
M.D.
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Chlamydia Trachomatis Persistence in the Female
Gastrointestinal Tract
This study is investigating the possibility that
Chlamydia trachomatis can infect the human large intestine/rectum and can
then serve as a reservoir for reinfection of the genital tract.
Principal Investigator(s): Amy Scurlock,
M.D.; Toni Darville, M.D.; Brian Hardin, M.D.; Steve Matson, M.D.
Cognitive Effects of Lead, Methylmercury and
PCBs in Children Compared to Cognitive Effects Observed in Children with
ADHD
Principal Investigator(s): John Chelonis,
M.D.; Yvette Segura, M.D.; Ron Baldwin, M.D.
Computational Modeling of Human Left Coronary
Artery Bifurcation Flow with Aneurysms under Steady Flow Conditions
Kawasaki disease affects primarily younger
children and can lead to coronary artery aneurysms. The flow phenomena
inside the left coronary artery and its branches with aneurysms located at
various locations were studied computationally under steady flow conditions.
The critical flow regions such as flow separation, flow recirculation, and
wall shear stresses inside the left coronary artery and its branches were
observed with changing magnitudes. These regions with disturbed laminar flow
pattern may cause intimal hyperplasia inside the aneurysms and bifurcation
of the left main coronary artery. Disruption of the normal flow pattern may
eventually lead to the formation of stenosis in the coronary artery. The
rigidity due to the arterial thickening of the arteries may cause ischemia
and even myocardial infarction in the long run. Therefore, simulation of the
flow patterns may provide us important information regarding the possible
long-term implications of Kawasaki disease in children, which may help in
taking appropriate early actions in order to prevent some of the adverse
outcomes. Further clinical studies and experimental modeling studies will
help to understand the flow inside the coronary bifurcation with aneurysm in
detail.
Principal Investigator(s): Selman Nas, Ph.D.;
Volkan Tuzcu, M.D.; Nurullah Arslan, Ph.D.
Delta Nutrition Intervention Research Initiative
The Delta Nutrition Intervention Research
Initiative is a translational research project that attempts to improve the
health and nutrition status of residents of representative communities in
the Arkansas Delta using the Community-Based Participatory Research
approach. Several research interventions are being planned and will be
implemented.
Principal Investigator(s): Judith Weber,
Ph.D.; James Robbins, Ph.D.; Patrick Casey, M.D.
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Determinants of Renal Function in Pediatric Heart
Transplant Recipients in the Pediatric Patient
Principal Investigator(s): Ritu Sachdeva,
M.D.; W.R. Morrow, M.D.; Elizabeth Fraizier, M.D.
Development of a Live Attenuated Vaccine Against
Chlamydia Trachomatis
Chlamydia trachomatis (C. trachomatis) infections
are the leading cause of involuntary infertility and ectopic pregnancy in
women. Trachoma is the leading cause of preventable blindness worldwide.
Although C. trachomatis infection can be treated effectively with
antibiotics, infections may result in tissue damage even with appropriate
antimicrobial therapy. Therefore, development of a vaccine may be the only
effective means to reduce the spread of this pathogen. Tissue damage
resulting from chlamydial infection is a consequence of an aggressive host
inflammatory response. Evidence that the innate immune response is the
primary mediator of pathogenesis comes from the mouse model of genital tract
infection with C.muridarum, where neutrophil infiltrates correlate directly
with development of oviduct fibrosis. Further, the study has previously
demonstrated that genetic deficiency of the innate pathogen recognition
receptor, Toll-like receptor 2 (TLR2), protects mice from oviduct pathology
associated with genital chlamydial infection. The study has derived
plasmid-cured derivatives of C. muridarum which are completely attenuated
for disease in mice. Vaginal inoculation of female mice with these
plasmid-deficient strains results in an infection of normal intensity and
duration, but no oviduct pathology is present upon resolution of infection.
Furthermore, the data indicate the absence of pathology is because the
strains do not express the TLR2 ligand. These strains provide a unique and
unprecedented opportunity to determine if the development of an effective,
live attenuated vaccine against C. trachomatis is possible. The aims of this
study are to (1) determine the host immune responses that lead to effective
resolution of chlamydial genital infection without development of oviduct
disease, (2) determine the efficacy and safety of plasmid-deficient C.
muridarum for use as an attenuated chlamydial vaccine in the mouse model of
genital tract infection, (3) determine how the chlamydial plasmid controls
induction of TLR2-dependent signaling by C. muridarum and (4) identify the
component of the parental C. muridarum strain that induces signaling via
host cell TLR2. Histologic, immunologic, cellular and molecular methods will
be used to define the responses generated in mice and cells exposed to
plasmid-deficient and wild-type C. muridarum. Microscopic, biochemical and
immunologic methods will be used to determine the mechanisms by which loss
of the chlamydial plasmid results in an absence of host tissue pathology.
Understanding of the mechanisms responsible for this phenomenon will greatly
advance the development of a safe and effective chlamydial vaccine.
Principal Investigator(s): Catherine
O'Connell, Ph.D.; Toni Darville, M.D.
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Development of Cerebral Autoregulation in VLBW
Infants
The primary research focus is examining how
disturbances of cerebral autoregulation are associated with brain injury in
premature infants. Contrary to conventional wisdom and dogma from classic
articles, we have observed that a majority of infants >23 weeks’ gestation
have intact cerebral autoregulation early during the first day of life.
Further, premature infants may be most vulnerable to brain injury as
cerebral autoregulation becomes impaired during the second day of life,
possibly as a result of delayed clearance of catecholamines from birth. Most
importantly, we have observed that the cerebral circulation of premature
infants have mature CO2 reactivity. This is especially worrisome given that
premature infants are exposed to permissive hypercapnia during the early
neonatal period. We have also demonstrated that with increasing PaCO2,
cerebral autoregulation becomes increasingly impaired.
Principal Investigator(s): Jeffrey
Kaiser, M.D
Developmental Changes in O2 Sensitivity of Voltage-Gated Calcium Channels in Carotid Body
Preliminary data show that calcium currents in
carotid body glomus cells are inhibited by hypoxia in the newborn, but not
mature, cells. This study employs real-time PCR of channel isoforms and
electrophysiology to address this question.
Principal Investigator(s): John Carroll,
M.D.; Insook Kim, Ph.D.
Differential Gene Expression of O2-Sensitive
Ion Channels During Rat Carotid Body Maturation
Principal Investigator(s): Insook Kim, Ph.D.
Early Recognition of Brain Injury Using the
Amplitude Integrated EEG
Despite improvements in obstetrical and neonatal
care, perinatal cerebral hypoxic-ischemic injury remains a frequent cause of
cerebral palsy, mental retardation, learning disability and epilepsy.
Between 1 and 4/1000 term newborns are asphyxiated, resulting from an
hypoxic-ischemic insult shortly before birth or during labor and delivery.
Evidence suggests that HIE is an evolving process, where the original insult
precipitates a cascade of adverse biochemical events that ultimately leads
to irreversible neuronal injury during the early neonatal period.
Principal Investigator(s): Lina Chalak, M.D.;
Jeffrey Kaiser, M.D.
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Economic Evaluation of Intensive Care Services
for Pediatric Traumatic Brain Injury Patients
This project assembled data on hospitalized
children with traumatic brain injuries to describe use of procedures and
outcomes over time. Follow-up data were collected on children meeting study
inclusion criteria using a consortium of 10 PICUs. The study found a
substantial improvement in survival for critically ill children with
traumatic brain injury over time. Further, the gains in survival were found
to be in the range of acceptability according to cost-effectiveness
criteria.
Principal Investigator(s): John Tilford,
Ph.D.; Jerril Green, M.D.; Mary Aitken, M.D.
Effect of Beta Blockers on Heart Rate Variability
Following Cardiac Surgery in Children
Beta-blockers (esmolol, labetelol) are commonly
administered intravenously in patients with coarctation of aorta in the
immediate post-operative period for the management of hypertension.
Beta-blockers have complex electrophysiological effects. The drugs may also
have important effects on heart rate variability, a measure of autonomic
nervous influence. No previous study has investigated the effects of
beta-blockers on heart rate variability in the post-operative setting. This
study will assess the effect of beta-blockers on the heart rhythm entropy
and fractal pattern.
Principal Investigator(s): Volkan Tuzcu,
M.D.; Selman Nas, Ph.D.; Parthak Prodhan, M.D.; Robert Jaquiss, M.D.;
Michiaki Imamura, M.D.
Effect of Beta Blockers on Heart Rhythm Entropy
Beta-blockers are commonly used drugs in the
treatment of various types of tachyarrhythmia in infants and children.
Beta-blockers have important effects on heart rate variability. Heart rate
variability is a measure of autonomic nervous influence, and is usually
obtained by analyzing nonlinear signals in various ways. Therefore,
nonlinear analysis of heart rate is important to study the physiologic
mechanisms responsible for the control of heart rate fluctuations in which
the autonomic nervous system appears to play a primary role. This study will
assess the effect of different types of beta-blockers on the heart rhythm
entropy. The RR interval data will be obtained from the Holter data. The
entropy analysis and detrended fluctuation analysis will be performed.
Assessing the potential variable effects of beta-blockers on the heart rate
complexity might be important in understanding the physiologic mechanisms.
Effect of various types of beta-blockers in different disease states might
potentially be assessed better using these nonlinear analysis measures.
Principal Investigator(s): Volkan Tuzcu,
M.D.; Selman Nas, Ph.D.; Ahmet Ugur, Ph.D.
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Effect of Perinatal Hyperoxia on Carotid Body
Glomus Cell O2 Sensing Maturation
Pernatal hyperoxia exposure markedly alters
carotid body O2 sensing maturation, which is explored in this
study at the cellular level using PCR, electrophysiology and calcium
imaging.
Principal Investigator(s): John Carroll,
M.D.; Insook Kim, Ph.D.; David Donnelly, Ph.D.
Effects of Diet on Metabolism, Body
Composition and Brain Function in Infants/Children
Through the Brain Function Laboratory at Arkansas
Children’s Nutrition Center, this study focuses on the role of diets
(carbohydrate supplements, soy) on resting brain activity and ERPs in
response to various visual and auditory stimuli and learning paradigms in
infants, children and adults. Examination of the role of nutritional effects
on brain development and function, and its potential predictive role for
later cognitive development in normal and high-risk infants, is unique to
this center.
Principal Investigator(s): Joanne Szabo,
M.D.; R. Terry Pivik, Ph.D.; Thomas Badger, Ph.D.; Janet Gilchrist, Ph.D.
Effects of Perinatal Chronic Hypoxia on Carotid
Body Glomus Cell Ion Channel Gene Expression
Perinatal chronic hypoxia profoundly alters
expression of potassium channels and many other cellular mechanisms in
carotid body O2 sensing cells, which is examined in this study
using real-time PCR of carotid bodies during postnatal maturation in
normoxia versus hypoxia.
Principal Investigator(s): Insook Kim, Ph.D.;
John Carroll, M.D.
Effects of Perinatal Hyperoxia Exposure on
Carotid Body Single Unit Activity Maturation
Hyperoxia from birth suppresses carotid body
neural activity. This study examines cellular mechanisms of the effects of
hyperoxia.
Principal Investigator(s): David Donnelly,
Ph.D.; Inook Kim, Ph.D.; John Carroll, M.D.
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Effects of Type 1 Diabetes on New Bone Formation:
Defining the Role of Insulin, Insulin-Like Growth Factors and Matrix
Metalloproteinases
The goal of this project is to define the role
that dysregulation of insulin, IGF and MMP secretion, as exists in Type 1
diabetes mellitus, plays in the pathogenesis of diabetes-induced
abnormalities in new bone formation.
Principal Investigator(s): Kathryn
Thrailkill, M.D.; Charles Lumpkin, Ph.D.; John Fowlkes, M.D.; R. Clay Bunn,
Ph.D.
Efficacy and Safety of SelectSecure™ Pacemaker
Lead Implantation in Children: Early Results from a Single Center
One of the major concerns in children who need
chronic pacing is development of lead-related complications. Lead fractures
and occlusion of veins are more commonly seen in children. There has been a
need for smaller lead body size for permanent pacemakers in children.
SelectSecure™ lead (Medtronic, Inc.) has recently been released and due to
its small size (4.1 Fr) and new concept of lumenless design has potential
for less lead-related complications in children who need chronic pacing.
This study will determine the efficacy of the SelectSecure™ lead in children
of various ages, including younger children, due to the thin lead size.
Principal Investigator(s): Volkan Tuzcu, M.D.
Efficacy of Antioxidant Support in Children with
Down Syndrome Undergoing Cardiac Surgery
Children with Down syndrome are highly vulnerable
to oxidative stress because of abnormal overexpression of specific genes on
chromosome 21 that regulate antioxidant status. Because cardiopulmonary
bypass results in oxidative stress during cardiac surgery, it is proposed
that supplementation of these children in a randomized controlled trial with
nutrients designed to increase antioxidant defense in the perioperative
period should reduce oxidative stress and promote shorter intubation times
and earlier discharge.
Principal Investigator(s): Sadia Malik, M.D.
Entropy and Fractal Pattern of Near Infrared
Spectroscopy Measurements in Children with Heart Disease
Cerebral oximetery is a patient safety monitor
and management tool that has been shown to significantly reduce adverse
neurological outcomes. The cerebral oximeters use near-infrared spectroscopy
(NIRS) to non-invasively and continuously monitor changes in blood oxygen
saturation. When changes in oxygen delivery or consumption occur, the
physician can respond with simple interventions to minimize or prevent brain
injury. A decreased variability in cerebral oxygen saturation occurs in
association with worsening hemodynamic condition. This study will include a
mathematical analysis to calculate entropy during cardiopulmonary bypass and
after surgery to assess the utility of entropy calculations as predictors of
outcome after cardiac surgery. We hypothesize that cardiac surgery
utilizing cardiopulmonary bypass leads to alteration of the autonomic
nervous system dysfunction and results in decreased variability in NIRS
readings.
Principal Investigator(s): Adnan Bhutta,
M.D.; Volkan Tuzcu, M.D.; Selman Nas, Ph.D.; Parthak Prodhan, M.D.; Sana
Ullah, M.D.; Bryan Watkins, M.D.; Luis Zabala, M.D.; Michael Schmitz, M.D.;
Michiaki Imamura, M.D.; Robert Jaquiss, M.D.
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Evaluation of Cardiac Function Using Doppler
Tissue Imaging and Myocardial Performance Index in Patients with Anorexia
Nervosa
This study will evaluate systolic and diastolic
function, correlated with age- and gender-matched controls, in patients with
anorexia nervosa. Follow-up will reassess systolic and diastolic function
once nutrition is improved, compared with baseline.
Principal Investigator(s): Garrett Sanford,
M.D.; Ritu Sachdeva, M.D.; Maria Portilla, M.D.; Renee Bornemeier, M.D.
Evaluation of Regional Ventricular Synchrony in
Chronically Paced Patients with Congenital Complete Atrioventricular Block
The purpose of this study is to perform
echocardiograms using strain and strain rate imaging in chronically paced
pediatric patients with congenital complete atrioventricular block. The
study aim is to evaluate inter- and intra-ventricular synchrony during
evaluation of the patients` intrinsic junctional escape rhythm in order to
assess for local changes in the myocardial tissue related to long-term
pacing.
Principal Investigator(s): Volkan Tuzcu,
M.D.; Thomas Best, M.D.; Jim Bodtke; Selman Nas, Ph.D.
Extracorporeal Membrane Oxygenation as a
Life-Saving Measure in the Management of Intractable Hemodynamically
Unstable Cardiac Arrhythmias in Infants
Cardiac arrhythmias can present in the neonatal
and infantile period with low cardiac output and cardiogenic shock. Most
antiarrhythmic medications other than digoxin have negative inotropic
effects and may lead to further deterioration of the hemodynamic status. In
the intitial management of some tachyarrhythmias, digoxin is known to be
less effective and may require other “potent” agents for effectual control.
Other acute measures such as adenosine or electrical cardioversion are
effective in most patients; however, in a minority of patients there could
be immediate arrhythmia recurrence thought to be due to the high
catecholamine levels. These patients often develop hemodynamic instability,
necessitating the use of inotropes which can be detrimental to the effective
arrhythmia control and also may not improve the cardiac output. Therefore,
mechanical support of the circulation may provide time for antiarrhythmic
drugs to have an effect, while allowing for myocardial recovery. There have
been only isolated case reports of the use of extracorporeal membrane
oxygenation (ECMO) in the management of intractable arrhythmias in infants.
There have also been rare reports on interventions performed for the
management of arrhythmias during ECMO. The use of ECMO as a temporizing
measure for the management of critically ill neonates with AV block has not
been reported.
Principal Investigator(s): Umesh
Dyamenahalli, M.D.; W.R. Morrow, M.D.
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Fitness Collaborative Research Group
This group meets weekly to discuss the Pediatric
Fitness Clinic database and its use in research for childhood obesity. Much
information is beginning to be accessed now that five years’ worth of data
is available and the data have been cleaned.
Principal Investigator(s): Karen Young, M.D.;
J. Gary Wheeler, M.D.; Pippa Simpson, Ph.D.; James Parker; Chan-Hee Jo,
Ph.D.; Deane Peck, R.D.; Valerie Kellam; Mohammad Ilyas, M.D.
Fluid Overload before Continuous Renal
Replacement Therapy in Critically Ill Children Receiving Extracorporeal Life
Support
Acute renal failure and fluid overload is common
in critically ill children, especially in those requiring Extracorporeal
Life Support (ECLS). A large number of these patients require Continuous
Renal Replacement Therapy (CRRT). Poor outcome has been documented in
critically ill pediatric patients who had >10% fluid overload prior to the
initiation of CRRT, but pediatric patients on ECLS requiring CRRT were
excluded in this analysis. This study intends to investigate whether
degree of fluid overload in critically ill children placed on ECLS affects
the mortality and morbidity. The study will also determine the incidence of
renal failure in this population.
Principal Investigator(s): Mohammed Illyas,
M.D.; Adnan Bhutta, M.D.; Tad Fiser, M.D.; Umesh Dyamenahalli, M.D.; Trenda
Ray; Izabella Kajevska
Folic Acid Education Program
The Arkansas Center for Birth Defects Research
and Prevention serves as the lead organization of the Arkansas Folic Acid
Coalition (FAC), which encourages women both to eat foods naturally rich in
folate or fortified with folic acid, and to take a daily vitamin containing
400 micrograms of folic acid, to improve their chances of having a healthy
baby should they become pregnant. In collaboration with the coalition,
Arkansas Center for Birth Defects Research and Prevention proposes to
implement a folic acid education program with the goal of reducing the
occurrence of folate-preventable birth defects in Arkansas by increasing the
knowledge and intake of folic acid among Arkansas women of childbearing age.
The goal of expanding the target population to include postpartum patients
and health care providers is the emphasis of this proposal.
Principal Investigator(s): James Robbins,
Ph.D.; John Tilford, Ph.D.; Joseph Thompson, M.D.; Mario Cleves, Ph.D.;
Sadia Malik, M.D.; Charlotte Hobbs, M.D., Ph.D.; Anne Elixhauser, Ph.D.
Follow-up of the Neopain Patients
This study will focus on the long-term effects of
NICU care on ventilated preterm neonates at 6- to 8-years-of-age.
Psychological testing will be performed and compare children who received
morphine and those who received placebo.
Principal Investigator(s): Whit Hall, M.D.;
KJS Anand, MBBS, D.Phil.
Fresh Frozen Plasma Transfusion in Critically Ill
Children with Coagulopathy
Fresh frozen plasma (FFP) is commonly used in the
pediatric intensive care unit in critically ill children for treating
coagulopathy. Previous studies among adults have documented the marked
variablility in blood component therapy among critically ill patients and
FFP was commonly transfused outside published guidelines. There are no
studies in children that | 
