Request for Funding
Medical Student Research Fellowship for Summer 2011

All descriptions must contain enough detail to permit an assessment of the problem that is to be addressed and the methodologies that are to be employed. Please be careful to outline the role that the student will play in the project that is described. Please ensure that all relevant approval numbers (IRB, IACUC) are provided.

Mentor:                       George R. Buchanan, MD
Department:               Pediatric Hematology
Room number:          
Mail Code:                 9063
Phone number:          214-648-8594
E-mail:                        George.buchana@utsouthwestern.edu

Project title:    Clinical research involving childhood cancer and blood disorders.       

Human subjects IRB approved project number (where applicable):      

Animal subjects IRB approved project number (where applicable):      

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)

Patient-oriented research involving children with blood disorders, including sickle cell disease, iron deficiency, other anemias, and bleeding disorders.

A.  Sickle Cell Disease

1. Review of cholecystectomy procedures in our sickle cell population – 1990 to the present
2. Randomized controlled intervention trials of inpatients and outpatients with sickle cell disease and vaso-oclusive crisis, including: a) Corticosteroids (oral or IV), b) Comparison of non-opioid analgesics, c) Study of alternative hydration strategies
3. Prospective studies of cerebral oximetry in children with sickle cell disease and other acute or chronic anemias, as baseline and following blood transfusion or other intervention
4. Non-invasive measurement of hemoglobin concentration in children with sickle cell disease and/or with other hematologic conditions, validating the precision of the available instrument, and determining its clinical utility in pediatric hematology-oncology practice
5. Clinical studies of pain management in patients with vaso-occlusive crisis (analgesics, pain assessment, biomarkers, etc.)
6. Young couples with children with sickle cell anemia: impact of prior counseling and subsequent childbearing behavior
7. Tonsillar and adenoidal hypertrophy in children with sickle cell disease and following splenectomy.  Does it occur and is it relevant?
8. Prospective study of tonsillectomy/adenoidectomy
9. Outcome of bacteremia in febrile patients managed initially as outpatients
10. Validation of reasons for hospitalization in sickle cell data base
11. Correlation of splenic function with markers of atherothrombosis
12. Update of Dallas Newborn Cohort database
13. Central nervous system “vital signs”
14. Vital signs before, during, and after blood transfusions in children with sickle cell diseaseAnalgesic administration in the emergency department: timing and effect on pain score, and hospital admissionParents beliefs regarding quality of care
15. Efficacy and adverse effects of leuprolide in our sickle cell patients with recurrent priapism
16. Trends in age of initiation of prophylactic penicillin in newborn infants with sickle cell disease and/or cessation of prophylactic penicillin at age 5 years (and reasons for not doing so)
17. Headache in children with sickle cell disease: frequency, diagnosis, and management
18. High-school graduation in children with sickle cell disease: do rates differ among the various genotypes and in comparison with African-American children without sickle cell disease?
19. Tuberculous osteomyelitis in sickle cell disease (and case reports describing other unusual complications)

B.  Hemophilia, ITP, and Other Bleeding Disorders

1. Anemia and diminished haptoglobin concentration in hemophilia patients – does it still occur?
2. Scalp goose eggs as a presenting manifestation of mild hemophilia
3. A pilot randomized trial comparing several therapeutic interventions (e.g., various steroid doses) in children with newly diagnosed ITP
4. Quantitative assessment of bleeding in children with ITP and/or other causes of severe thrombocytopenia, including stool guaiac, urinalysis, oral bleeding measurement, retinal hemorrhage (ophthalmologic screening), and/or MRI or other brain imaging
5. Assessment of the influence of hemoglobin concentration on clinical bleeding in thrombocytopenic patients (leukemia, aplastic anemia, ITP, etc.)
6. Evaluation of the child with a prolonged PTT: retrospective review of our recent experience
7. Variation in platelet count in children with chronic ITP
8. The stool guaiac test (and other more sensitive tests for occult blood) in children with various degrees of thrombocytopenia.  How sensitive is it?
9. Amicar or tranexamic acid for epistaxis and/or oral bleeding in children with thrombocytopenia – randomized control trial
10. Thrombocytopenia in the pediatric intensive care unit: frequency, etiology, intervention, and hemorrhagic sequelae
11. Major bleeding following initial diagnosis and therapy in children with ITP – past 10 years experience
12. Development of an epistaxis grading/severity instrument to be used in patients with bleeding disorders and in “normal” children
13. Case report (we have two cases) of pseudoaneurysm in boys with hemophilia

C.  Miscellaneous Hematology

1. Health-related quality of life in children with hereditary spherocytosis pre- and post-splenectomy
2. Development of a jaundice grading/scoring instrument to be used for quality of life assessment for patients with chronic hemolytic anemia
3. Prospective study of biomarkers of vascular complications following splenectomy for diverse indications
4. Mouse model of post-splenectomy vascular complications
5. The hematology of rheumatoid arthritis (a retrospective examination of all hematologic parameters, including the leukocyte count, hemoglobin, platelet count, etc.).  The focus would be on the severity, time course, and mechanism of anemia
6. Determination of the normal values for WBC count during infancy and early childhood and changes during acute infection
7. Randomized trial of ferrous sulfate vs. carbonyl iron (ICAR) in infants and toddlers with iron deficiency
8. Single dose of intravenous iron replacement in children with established refractory iron deficiency and/or gastrointestinal disorders characterized iron malabsorption or ongoing hemorrhage
9. Retrospective and prospective study of severe iron deficiency anemia in our patient population (etiology, risk factors, response to therapy)
10. Documenting the “value” of a pediatric hematologist by reviewing new referrals and requests for referral for anemia, demonstrating the misdiagnosis and overuse of tests by primary physicians and the ease, using few tests, with which we make the diagnosis and successfully treat the patient
11. Study of occult celiac disease in children with iron deficiency unexplained by poor diet alone and/or evaluation of the oral iron absorption test
12. Dietary iron deficiency during the second and third years of life: causes and patterns of referral
13. Assessment of iron loading in multi-transfused pediatric cancer patients
14. Infection in African American children with mild to moderate leukopenia/neutropenia (“ethnic pseudoneutropenia”)
15. Evaluation of abnormal hemoglobin variants identified by newborn screening
16. Abnormal hemoglobins identified by newborn screening:  strategy for assessing and managing babies with “F, A, Other” newborn screens