Day :
- General Pediatrics | Pediatric Neurology | Neonatal/Pediatric Intensive & Critical Care | Pediatric Cardiology | Pediatric Endocrinology | Pediatric Gastroenterology | Pediatric Psychology | Pediatric Pulmonology | Pediatric Rheumatology
Chair
Professor James Oleske
Rutgers New Jersey Medical School, USA
Session Introduction
Dr Gerald Katzman
Wayne State University School of Medicine, USA
Title: The bioethics and neuropsychology of children learning to hate or help and pursue violent or non-violent resolution of conflict
Time : 14:05-15:05
Biography:
Dr. Gerald Katzman received his MD degree from the Wayne State University School of Medicine in 1968. He served a Pediatric Residency at the University of Chicago and the Children’s Hospital of Michigan. After serving two years as a physician in the US Navy, he completed a fellowship in Neonatal-Perinatal Medicine at Temple University Hospital. Clinical positions have included Director of Nurseries at The Toledo Hospital, Chairman of Pediatrics at Sinai Hospital of Detroit and Chief of Pediatrics at Detroit Riverview Hospital. Dr. Katzman has been a Clinical Associate Professor of Pediatrics at the Wayne State University School of Medicine since 1986. He received the designation of Certified Physician Executive by the American College of Physician Executives. In recent years, Dr. Katzman has developed an interest in the teaching of hatred to children and the potentially violent actions that result from such indoctrination. Potential solutions to this problem have been suggested in a series of papers dealing with the subject. Explaining the psychodynamics of hatred development through an emphasis on recent understandings in neuropsychology has been a particular focus of these publications.
Abstract:
Learned hatred in childhood leads to violent speech and subsequent violent actions. The process often begins with authoritarian parenting. The fear and anger evoked by such treatment is projected onto socially endorsed targets. These targets are developed through false narratives that are repeatedly espoused in authoritarian societies. The resultant violent actions are further facilitated by the stifling of emotional empathy that results from coercion and intimidation. Authoritative parenting characterized by discipline through reasoning offers a healthy alternative. The trust that develops between parent and child can be used to model caring behaviors inside and outside the family. Sharing stories with a moral and that teach a lesson promote the incorporation of virtues and the avoidance of vices. The emotional empathy that results is the catalyst for acts of compassion. Resistance to adverse influences and promotion of initiatives that support tolerance and appreciation of individual differences are more likely when parents and societies key in on enhancing the moral development of children. Restricting moral development through a planned program of indoctrination to militancy is mental maltreatment. By exposure of children to an atmosphere where reason has been emphasized over might, non-violent resolution of conflict is an attainable result.
Biography:
Dr Alia Chauhan is an Associate director Pediatric hospital Medicine at Southside Hospital, NY and Assistant professor of Pediatrics & Family Medicine Residency Program, North well-Zucker School of medicine at Hofstra University. She is a Preceptor for family medicine residents of Southside & Peconic bay family medicine residency programs, Touro College PA program. She has mentored residents for publications, research & QI projects and poster presentations at national level. In acknowledgement of her work with FMRP she is awarded with honorary title of Assistant professor of FMRP by Zucker School of Medicine in 2014. She is recently awarded an Out Standing Physician Award by Medical Staff at Southside hospital-2017. She has special interest in pediatric hyperlipidemia and have multiple publications on this subject, she published:
- Book chapter on Hyperlipidemia and Xanthomas The Color Atlas of Pediatrics, Usatine, Lippincott Williams & Wilkins, published in November 2014.
- Manuscript, Update on Pediatric Hyperlipidemia, Current Opinion in Pediatrics, published March 2014.
- Disorders of childhood growth and development, Precocious puberty
FP- Essentials AAFP, published 2013 Jul; 410:25-31.
- Clinical Column, Guidelines on Pediatric Hyperlipidemia,
Family Doctor, Healthy living, NY chapter of AFP, published in September 2013. She presented her QI/ Research work about bilirubin at American academy of Pediatrics National conference in Sanfrancisco 2017, and at STFM (Society of Teachers of Family medicine) Annual conference in Orlando, 2015.
Abstract:
Purpose of review: The purpose of this study is to review NHBLI guidelines on screening and management of Hyper lipedema in children, and discuss critics and their concerns regarding universal screening. Recent Findings: Among young adults, ages 12 to 19 years, 20.3 percent have abnormal lipids; boys are more likely than girls to have at least 1 lipid abnormality (24.3% versus 15.9%, respectively). Several studies have shown that atherosclerosis begins in childhood and can lead to coronary heart disease in adults. They have also demonstrated a strong correlation between pediatric hyperlipidemia, carotid intimal thickening, and cardiovascular events in adults. Such as The Young Finns study, The Princeton– Lipid Research Clinics follow up Study etc( detail findings will be discussed). The study by the US Centers for Disease Control and Prevention have shown a favorable trend in serum Lipid among children and adolescents aged 6years to 19 years, between (1988-1994) and (2007-2010) Mean total cholesterol decreased from 165 mg/dl to 160 mg/dl, and the prevalence of elevated total Cholesterol decreased from 11.3% to 8.1%.In the view of prevalence of obesity 1 in 6 adolescents and mean TC decreasing, is universal screening an appropriate step? In the view of multiple studies, discussion will lead towards existing controversies. Management will be discussed including recommendations about universal screening, 2010 Dietary Guidelines for Americans Cardiovascular Health Integrated Lifestyle Diet and medications. Summary: The guidelines provide clinicians with necessary evidence and balanced perspective to make their own informed judgment in implementation of these recommendations. Schematic approach provided by NHBLI commissioned Expert Panel will help Primary care physicians with screening and proper dietary & drug therapy. It will eventually decrease cost on health system by early identification & intervention. Key words: Hyperlipidemia, Cardiovascular, Familial hypercholesteremic, Estimated Energy Requirement, Body Mass Index, Low density lipoprotein, high density lipoprotein.
Dr Gábor Veres
Semmelweis University, Hungary
Title: Adherence to the porto criteria in the diagnostic procedure in Hungary based on the data of Hungarian pediatric IBD registry (HUPIR)
Time : 15:50-16:15
Biography:
Gabor Veres, MD, PhD, Dsc, Med. Habil. is a Professor of Pediatrics at the Semmelweis University, Budapest, Hungary. He is the President of the Hungarian Paediatric Gastroenterology Society, Deputy director, and Head of the Gastroenterology Unit of Ist Dept. of Paediatric Clinic in Budapest. Currently, he is a member of ESPGHAN Porto Group (2007-) and was a Committee member of Paediatric ECCO from 2013 to 2016. He was a Committee member of ESPGHAN and UEG, and Education secretary of ESPGHAN from 2013 to 2017. He organized the Hungarian Paediatric IBD Registry (HUPIR) in 2007 and published 174 peer-reviewed papers and 13 book chapters mainly in the field of paediatric IBD.
Abstract:
Introduction: Despite the continuous research efforts, the exact ethiology of chronic inflammatory bowel diseases (IBD) are still largely unknown. The incidence of pediatric-onset IBD is constantly growing in Hungary. It is of note however, that the necessary evaluation of the cases according to the Porto criteria are not always conducted completely (to do upper endoscopy, entering to the terminal ileum, and evaluation of small intestine involvement with imaging techniques, preferably with MRI). Aim: The Hungarian Pediatric IBD Registry (HUPIR) is a nationwide database for prospectively registering pediatric IBD cases. The aim of our study was to evaluate the changes in adherence to the Porto criteria in the diagnostic evaluations over time according to the data of HUPIR. Results: The average incidence rate of pediatric IBD was 8.4/100 000 between 2007 and 2016. According to the data collected in HUPIR, the incidence rate elevated by 23% in this period (from 7/100 000 to 9.1/100 000). The incidence rate of Crohn’s disease elevated from 4.2/100 000 to 5.7/100 000 (26%), and the rate for colitis ulcerosa changed form 2.1/100 000 to 2.7/100 000 (22%). The diagnostic procedure adhered completely to the Porto criteria only in 27% of the cases in the first year, but this rate improved to 46% by 2015. The frequency of illeocolonoscopic evaluation improved from 51% to 88%, in addition, the rate of upper endoscopy increased from 51% to 87% in the same period. Diagnostic assessment of the small intestine with imaging techniques was conducted in 46% of the cases registered in HUPIR. Conclusions: Based on the evaluation of data of HUPIR, the diagnostically adherence to Porto criteria grew approximately two fold in the last eight years. This improvement should be multi-factorial, but HUPIR must have a significant role in the process. Our positive experiences could stand as an example for countries where nationwide registry for IBD is not yet established.
Dr Iwona Ben-Skowronek,
Medical University of Lublin, Poland
Title: Effect of associated autoimmune diseases on type 1 diabetes mellitus incidence and metabolic control in children and adolescents
Time : 16:15-16:40
Biography:
Iwona Ben-Skowronek has completed her PhD at the age of 25 at the Medical University of Lublin and she conducted postdoctoral studies in this University. She is the Head of the Dept. Pediatric Endocrinology and Diabetology, Medical University in Lublin. She has published more than 55 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome). The incidence of type 1 diabetes in the syndromes is 4-18% in PAS-1, 60% in PAS-2, and 14,5% in PAS-3. Although clinical manifestations of the disease are usually observed in the third decade of life, the first symptoms may appear in childhood. Therefore, every pediatrician should know PAS symptoms, especially in relation to multiple autoimmune comorbidities accompanying type 1 diabetes The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. The author also presents suggestions concerning screening for other autoimmune diseases indispensable in subjects with diagnosed type 1 diabetes
Dr Laura Reigada
Brooklyn College, USA
Title: Analysis of anxiety symptoms and disease severity in children and adolescents with crohn’s disease
Time : 16:40-17:05
Biography:
Laura Reigada is an Associate Professor at the City University of New York at Brooklyn College and faculty in the Health Psychology and Clinical Science doctoral program at the Graduate Center. She is a licensed clinical psychologist and an Adjunct Assistant Professor in the Department of Pediatrics at Icahn School of Medicine at Mount Sinai. Her research focuses on early identification and treatment of medical patients who are at increased risk for comorbid psychological problems, with emphasis on the dynamic interplay between psychological and disease processes. Her research aims to increase multidisciplinary collaboration within the medical setting to enhance detection and treatment.
Abstract:
Objectives: Children and adolescents diagnosed with Crohn’s disease (CD), a type of inflammatory bowel disease (IBD), have increased vulnerability for anxiety symptoms that may be related to disease-related processes. The aims of this paper are threefold: 1) to report the proportion of pediatric CD patients whose self-reported anxiety symptoms are indicative of distress; 2) to describe the constellation of anxiety symptoms; and 3) to examine the relationship between anxiety and disease symptoms. Methods: Retrospective medical chart review was performed for 93 youths with CD (ages 9-18) who had completed the Screen for Child Anxiety Related Disorders (SCARED) during their gastroenterology visit. Medical records were reviewed for demographic and disease characteristics. Harvey Bradshaw Index (HBI) was used as a measure of CD activity. Results: Thirty percent of the youths reported experiencing elevated anxiety symptoms (SCARED score >20) and 50% had scored above cutoff in one or more anxiety domains, with school anxiety, general anxiety, and separation anxiety symptoms reported most frequently. Youth rated with moderate/severe disease activity on the HBI (n=4) self-reported more anxiety symptoms compared to youth with inactive disease (n=78; p=.03). Greater school anxiety was significantly associated with decreased well-being (p=.003), more abdominal pain (p<.001), and the number of loose stools (p=.01). Having extraintestinal symptoms was significantly associated with higher somatic/panic anxiety (p=.01). Conclusions: Implementing a brief anxiety screen in tertiary pediatric settings may be one approach to identify young patients with CD in distress. Health providers should consider periodic assessment of school anxiety among youth with CD.
Dr Keyur K Mehta
Nicklaus Children’s Hospital, USA
Title: Cerebral abscess in a septic toddler with an undiagnosed superior sinus venous defect
Time : 17:05-17:30
Biography:
Dr. Mehta completed his MBBS from Grant Medical College, Mumbai and residency from SUNY Downstate Medical Center, Brooklyn NY where he was also chosen as a Chief Resident and received awards for research and excellence in pediatric education. He is currently a second year cardiology fellow at Nicklaus Children’s Hospital in Miami. He has presented his research work at various national and international conferences.
Abstract:
Cerebral abscess is most commonly seen in the first two decades of life. Approximately 90% of brain abscess result from extra-cardiac infections (sinusitis, mastoiditis and otitis media). Cardiac causes of cerebral abscess are generally related to left sided bacterial endocarditis and congenital cyanotic cardiac lesions. We report an unusual case of a less than 2 years old patient who presented with urinary tract infection, who developed brain abscess, and subsequently was diagnosed with an acyanotic cardiac defect. A 17 months old uncircumcised male with an unremarkable past medical history presented to a community hospital with fever, vomiting, diarrhea and lethargy. A full work up was performed and the patient was diagnosed with Citrobacter Koseri urinary tract infection (UTI). The patient was started on the appropriate antibiotics. However, his fever persisted and he developed a dysconjungate gaze. An immediate MRI demonstrated multiple cerebral abscess. The patient was transferred to Nicklaus Children’s Hospital and underwent an emergent endoscopic exploration of the left cerebral ventricular system with washout and placement of an external drain. A transthoracic echocardiogram was performed and revealed a moderate superior sinus venous defect (SVD) with partial anomalous pulmonary venous return (PAPVR) of the right upper and middle veins to the superior vena cava, there was right atrial and ventricular dilatation. The patient received 6 weeks of antibiotics and showed excellent recovery of his motor and cognitive function. After completing medical therapy, the patient underwent a successful two patch repair of the SVD and PAPVR and was discharged on third post-operative day. This case illustrates an uncommon association between cerebral abscess and acyanotic heart disease. Cardiac imaging either transthoracic or transesophageal echocardiogram are invaluable in the assessment of brain abscess with suspected hematogenous spread.
Dr Araxi Balian
University of Milan, Italy
Title: Class II non-extraction treatment with intermaxillary elastics using aligners versus standard multi-brackets appliances: a comparative study
Time : 17:30-17:55
Biography:
Dr. Balian achieved her Dental Degree (DDS) at the University of Padua, Italy in 2011. She has completed a 3-yr Orthodontics residency program at the Dental Clinic of San Paolo Hospital, University of Milan, Italy and she was awarded the MS degree in Orthodontics in 2015. Dr. Balian is currently Consultant in Pediatric Dentistry and Orthodontics at the Dental Clinic of ASST Santi Paolo e Carlo Hospital, University of Milan and Clinical Instructor at the Master of Interceptive Orthodontics, University of Padua. She is author of several national and international publications and winner of the 2016 International Align Research Award.
Abstract:
Class II malocclusion is a major and common challenge clinicians face in daily practice, as it affects more than one third of adolescents seeking orthodontic treatment. Most of Class II malocclusion presents a normal or at least a slightly altered skeletal pattern with mild-to-moderate anteroposterior occlusal discrepancy, which can be successfully treated with non-extraction orthodontics supported by intermaxillary elastics. It is claimed that Invisalign aligners (Align Technology, Inc., San José, CA, USA) can effectively correct Class II malocclusion when the total amount of anteroposterior discrepancy is within 4-5mm. Even though Invisalign has become a popular treatment choice for clinicians because of the aesthetics and comfort of the removable clear aligners (RCA), there is a general lack of research. Moreover, the majority of research have investigated the feasibility of Invisalign in producing single specific movements rather than evaluate the overall outcome of the treatment of a given malocclusion. The purpose of the present study was to evaluate the Class II non-extraction treatment outcomes of Invisalign supported by intermaxillary elastics and to compare with those observed in a control group treated with standard multi-brackets appliances. Statistical comparison has been carried out to assess post-treatment outcomes of the two groups, as well as to determine differences regarding patients’ complaints and compliance during orthodontic therapy.
Dr Francesca Rusalen
University of Padua, Italy
Title: Perinatal palliative care: A dedicated care pathway
Time : 17:55-18:20
Biography:
Francesca Rusalen has her expertise in paediatric pallitive care and pain management in children. She is involved in the creation of care dedicated pathways for newborns and chiildren with life-limiting and life-threatening diseases She works and researchs fpr the Italian University Hospital in Padua and collaborates in the Paediatric Task Force of the European Association of Palliative Care (EAPC).
Abstract:
In recent years there has been a progressive increase in premature babies, with simultaneous increase of their survival, as well as that of infants with incurable disease. Increased diagnostic-therapeutic potential, even invasive, has strongly contributed to this trend, but at the same time has increased the risk of therapeutics excitement and/or disproportion with a consequent emerging need to define eligible populations for perinatal palliative care (NPC), as well as the need to define a shared pathway for their application. The creation of a shared NPC pathway, within the Maternal-Infant Department should ensure access to NPC to all eligible fetuses/infants/parents; to ensure, as much as possible, the adequacy and quality of care provided, also identifying the most appropriate place of care; to monitor the effectiveness and efficiency of the care pathway, through specific indicators. In a tertiary facility, a multidisciplinary work-group (GdL) was formed, consisting of all the professional staff involved in the process management in order to create a shared care path for NPC. Work Foreword was the literature review, including ethical and regulatory reference documents. 12 GdL meetings were carried out, leading to the creation of a shared document on the NPC pathway and its flow chart. Effectiveness and efficiency indicators were then defined for tracking the application of the care pathway itself. At the end of the work, the document was then presented to the leaders involved for discussing the application criticalities.The NPC is an emerging field within the pediatric palliative care and, as such, calls for the development of dedicated and shared pathways to ensure accessibility and quality of care.
Dr Gao Weiwei
Guangdong Province Hospital for Women and Children Health Care, China
Title: Early HHHFNC versus NIPPV for primary respiratory support in preterm infants
Time : 18:20-18:45
Biography:
Prof. Gao Weiwei has completed her MBBS from SUN YAT-SEN University of Medical Science and PHD from JINAN University. She is the consultant of Neonatal Department, Guangdong Province Hospital for Women and Children Health Care, Professor of Pediatrics, Guangzhou Medical University. Tutor of International postgraduate Paediatric Certificate, Westmead Children’s Hospital Sydney University. Her research interests are respiratory support and lung protection in newborn, particularly in premature and critical ill infants. She has been active in researches for invasive and non-invasive mechanical ventilation
Abstract:
Background and Objective
There are limited data to inform the choice between early treatment with heated humidified high-flow nasal cannulae (HHHFNC) and early treatment with nasal intermittent positive pressure ventilation (NIPPV) as the initial support for preterm infants with respiratory distress syndrome(RDS).The objective was to assess the efficacy and safety of HHHFNC compared with NIPPV for preterm infants with RDS in our NICU.
Methods
In this prospective trial, infants, who were born between 28 weeks 0 days to 36 weeks 6 days of gestation, were randomized to HHHFNC or to NIPPV treatment initiated in the neonatal intensive care unit. The primary outcome was the incidence of intubation, defined as the need for intubation within 72 hours or within 7 days.
Results
A total of 208 infants were enrolled in the study. The incidence of intubation did not differ significantly between the two groups. The relative risks (RR) for the primary outcome of incidence of intubation within 72 hours or 7 days were 0.89 (95% CI, 0.37 to 2.11; p=0.79) and 0.00 (95% CI, 0.00 to 0.00), respectively. The rate of bronchopulmonary dysplasia in each of the two groups was similar (RR 1.49; 95% CI, 0.24 to 9.08; p=0.67). The rates of other adverse neonatal outcomes did not differ significantly between the two groups.
Conclusion
HHHFNC is an alternative to NIPPV for the early treatment of respiratory distress in preterm infants.
Dr Mohammed Beshir Yesuf
Jimma University Medical Center, Ethiopia
Title: Typhoid Glomerulonephritis in a child: A rare complication of typhoid fever
Time : 18:45-19:10
Biography:
Dr. Mohammed Beshir Yesuf is a pediatrician with interest in pediatric nephrology & Assistant Professor in Jimma University Medical Center. I graduated from jimma University medical school, Ethiopia
Abstract:
One of the unusual manifestations of typhoid fever is Typhoid glomerulonephritis and accounts for about 1% of its extra intestinal complications of typhoid fever. Although 25% of patients excrete Salmonella typhi in the urine during the acute illness, renal complication may result from diverse pathophysiological mechanisms. The severity of acute glomerulonephritis due to typhoid fever is variable; generally, it resolves completely with treatment of typhoid fever but occasionally it may be fatal.
Here we report a 10 year old male child with typhoid glomerulonephritis who presented with fever, abdominal pain, edema and hypertension. Urine examination showed microscopic hematuria and proteinuria. Salmonella typhi was isolated from a blood culture. Renal biopsy was not performed. The child recovered completely with treatment.
Biography:
Inas mahfouz has completed her PhD at the age of 30 years from cairo University. She is the organizer of pdiatric medical awareness conference in Egypt inside and outside, one of the pulmonology team in national research centre, was resident of pediatric in pediatric hospital cairo university. She has published more than 5 papers in reputed journal.
Abstract:
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation, Acupuncture is one of complementary and alternative medicine modalities and is a key component of traditional Chinese medicine (TCM), Laser acupuncture is one of interesting modalities of low-level laser therapy (LLLT), a noninvasive form of phototherapy. The present study is a randomized clinical trial done on sixty asthmatic children under conventional medical treatment divided randomly in to 3 groups. Group A: Twenty children were subjected to laser Acupuncture session three times per week for four weeks, group B twenty patients using needle acupuncture sessions for 1 month (3times / week) and group C (control group) under conventional medical treatment only. Measuring Pulmonary functions of the patient and assess their use of medications before and after the study and Assessing of the clinical condition of the patient (frequency of attack and severity of asthma). Pulmonary function at follow up were higher in group A than group B and in group B than C the differences were statistically significant in VC cent (A: p<0.001, B: p=0.002 and C: p=0.626) FVC cent (A: p<0.001, B: p<0.001 and C: p=0.516) and PEF cent (A: p=0.016, B: p= 0.044and C: p= 0.432), however in medications used there were a statistically significant different in group A (p=0.004) more than in group B (p=0.017) and C (p=0.490), Frequency of asthmatic attack diminished in group A (p<0.001) more than in group B (p= 0.002) and least in group C (p=0.147) at the end of the study, Clinical severity of group A significantly improved (p<0.001) than group B and C, so we can say that application of laser or needle acupuncture sessions beside conventional medical treatment results in more improvement of the pulmonary functions, Frequency of asthmatic attack and reduces the medications used
- Pediatric Gastroenterology and Nutrition | Pediatric Mental Processes | Pediatric Care and Nursing | Clinical Pediatrics | Neonaology and Perinatology | Pediatric Allergy and Infectious Diseases | Pediatric Lungs Care
Location: New York
Co-Chair
Dr Iwona Ben-Skowronek
Medical University of Lublin, Poland
Session Introduction
poster 5: Satoshi Ibara & Masahiro Kajiki
Kagoshima City Hospital & Asahi Kasei Pharma Corporation, Japan
Title: Recombinant soluble human thrombomodulin (thrombomodulin alfa) in the treatment of neonatal disseminated intravascular coagulation
Time : 15:45-16:30
Biography:
Satoshi Ibara has completed his PhD at the age of 30 years from Nihon University and postdoctoral studies from University California Irvine. He is the director of Perinatal Medical center,Kagoshima City Hospital,Japan. He has published more than 30 papers in reputed journal
Abstract:
Background: Recombinant soluble human thrombomodulin (TM-α) has been shown to be useful in the treatment of disseminated intravascular coagulation (DIC) in a heparin controlled study and has been available for clinical use in Japan since 2008. However, data on its use for neonatal DIC have not been reported from any clinical studies, so efficacy and safety were analyzed in 60 neonatal DIC patients identified in post-marketing surveillance. Methods: The standard dose of TM-α was 380 U/kg/day and dose adjustment was based on their reanal function levels. Therapeutic effects of TM-α on DIC and on the survival of DIC patients were evaluated with the DIC diagnostic criteria of the Japanese Ministry of Health, Labor and Welfare established, and with the survival rate on day 28 after the completion of TM-α administration, respectively. Adverse events as well as adverse side effects associated with TM-α administration also were analyzed. Results: The DIC resolution rate as of the day after last administration of TM-α was 47.1 %, and the survival rate at 28 days after last administration was 76.7 %. Hemostatic test result profiles revealed decreased levels of fibrin/fibrinogen degradation products and increased platelet counts and antithrombin activity. Incidences of adverse drug reactions, bleeding-related adverse drug reactions, and bleeding-related adverse events were 6.7, 6.7, and 16.7 %, respectively, with no significant differences between neonatal, pediatric (excluding neonates), and adult DIC patients. Conclusion: This surveillance provided real-world data on the safety and effectiveness of TM-α in the treatment of neonatal DIC in general practice settings.
Dr Lourdes Mary Daniel
KK Women’s and Children’s Hospital, Singapore
Title: Prospective evaluation of the ages and stages questionnaire 3rd edition in very-lowbirthweight infants
Time : 17:45-18:15
Biography:
Lourdes Mary Daniel is the Head and Senior Consultant in the Department of Child Development in KK Women’s and Children’s Hospital in Singapore. She is an Adjunct Associate Professor in the three medical schools in Singapore. She is a trained Neonatologist with 20 over years of experience in the NICU and with long term developmental follow-up of VLBW children. She was the director of the universal newborn hearing program that has seen more than 100,000 newborns. She received her developmental training from the Kennedy Krieger Institute in Baltimore, Boston Children's Hospital and the Harvard Graduate School of Education
Abstract:
Aim: To evaluate the predictive and concurrent diagnostic agreement of the Ages and Stages Questionnaire 3rd Edition (ASQ-3) with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) in infants born preterm and very-low-birthweight (PT/VLBW; ≤1250g).
Method: We evaluated 141 PT/VLBW infants (68 males, 73 females) born at the KK Women's and Children's Hospital between January 2010 and December 2011, to determine predictive and concurrent diagnostic agreement between the ASQ-3 at 9, 12, 18, and 24 months corrected age and Bayley-III at 24 months. Cut-offs on the ASQ-3 at 24 months were estimated by receiver operating characteristic curves.
Results: Sixty (43%) and 25 (18%) failed in any domain of the ASQ-3 and Bayley-III (<70) respectively. A negative predictive value (NPV) >98% was achieved for the motor domain from 9 months, and >90% for the communication domain and the overall results at 24 months. Optimal referral ASQ-3 score at 24 months to achieve 100% NPV was 243.
Interpretation: In PT/VLBW infants, ASQ-3 screening at 24 months can reduce the need for costly psychometric assessments in children with normal results. Clinicians can be assured of normal motor development at 9 months using the ASQ-3, but should continue to screen children on other domains.
Dr Iwona Ben-Skowronek
Medical University of Lublin, Poland
Title: Adrenal causes of hypertension in children
Time : 17:20-17:45
Biography:
Iwona Ben-Skowronek has completed her PhD at the age of 25 at the Medical University of Lublin and she conducted postdoctoral studies in this University. She is the Head of the Dept. Pediatric Endocrinology and Diabetology, Medical University in Lublin. She has published more than 55 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Arterial hypertension in children is defined as average systolic and/or diastolic BP that is over the 95th percentile for the gender, age and height on over 3 occasions. The cause of arterial hypertension in 1 to 2% of children is overproduction of catecholamines as the effect of pheochromocytoma development. Mutations of the genes VHL, RET, NF1 (Gene 17 Neurofibromatosis type 1), SDHB and SDHD are all known to cause up to 25% familial pheochromocytoma. Pheochromocytoma may be a tumor of the multiple endocrine neoplasia syndrome, type IIA and type IIB (also known as MEN IIA and MEN IIB). The monogenic defects of mineralocorticoid production in the cortex of adrenals lead to hypertension with a decreased serum renin concentration. Most common is the congenital adrenal hyperplasia (CAH), especially 11-beta hydroxylase deficiency ( 5-8% of CAH) connected with fetal virilisation in girls and steroid 17- hydroxylase deficiency associated with the abnormal sex phenotype. Hyperaldosteronism as the cause of hypertension may be diagnosed as familial hyperaldosteronism type I with a chimeric gene between CYP11B1 and CYP11B2- glucocorticoid remediable aldosteronism sensitive to dexamethasone treatment or familial hyperaldosteronism type II – without hybrid mutation. A rare form is the apparent mineralocorticoid excess ( AME) – an inherited form of hypertension caused by 11-beta hydroxisteroid dehydrogenase type 2 deficiency. Primary aldosteronism is the common cause of hypertension in adults (to 37%) and rare in children that suggests development of aldosterone-producing adenomas in children prior to development of hypertension and vascular damage. The differential diagnosis of hypertension in children is necessary for choice of adequate treatment.
Dr Toan Ngoc Pham
Vietnam National Children’s Hospital (VNCH), Vietnam
Title: Assessment of immune status in children under 5 years old with recurrent pneumonia at the National Hospital of Pediatrics, Hà Nôi, Vietnam
Time : 16:55-17:20
Biography:
Dr. Pham completed his MD at the age of 26 from Hanoi Medical University. He is a Senior Consultant in the Emergency and Poison Control Department of the Vietnam National Children’s Hospital in Hà Nôi, Vietnam, a national-level tertiary referral center for northern Vietnam. He has studied risk factors for high acuity on admission to the emergency department (ED), gender disparities in care-seeking in Vietnamese children, and a comparison of AVPU and Glasgow coma scales in the management of pediatric encephalitis.
Abstract:
Background: Pneumonia accounts for 10% of all hospitalizations for children less than 5 years old, increasing healthcare costs, morbidity (30-35%), and mortality (7-13%). [1] Recurrent pneumonia occurs in 7-15% [2] of children with pneumonia. Immunodeficiency may contribute to recurrent pneumonia in children. [3] There has been no prior research about the prevalence of immunodeficiency in Vietnamese children with recurrent pneumonia. Methods: Descriptive study of 80 children aged 6 months to < 5 years with recurrent pneumonia (>2 episodes in a single year or >3 episodes ever, with radiographic clearing between occurrences) [4] admitted to the VNCH Emergency Department from 9/2015 - 8/2017. Children with known immunodeficiency, immunosuppressive therapy, asthma, chronic lung disease or congenital heart disease were excluded. Patients with radiographic and clinically diagnosed recurrent pneumonia had quantitative assays of serum immunoglobulins, IgG subclasses, and T, B and NK lymphocytes. [5] Results: Mean chronologic age of 12.8+8.3 SD months; 60% were male; 11.2% were premature. Mean number of prior pneumonia episodes was 3.4+1.7 SD. On admission, medians for weight and height were 8+2.2 kgs. Of the 80 patients, the following immunoglobulin deficiencies were noted: (3.8%), IgM (3.8%), IgG (2.5%) IgG1 (5%), IgG2 (1.2%), IgG3 (7.5%), IgG4 (11.2%). Other causes of recurrent pneumonia were airway abnormalities (6.2&), aspiration syndromes 11.2%) and gastroesophageal reflux (7.5%). Conclusion: Immunodeficiency is an important cause of recurrent pneumonia in Vietnamese children. Assessment of children with recurrent pneumonia can facilitate diagnosing underlying primary immunodeficiency, thereby decreasing mortality and morbidity.
Dr Kun Soo Lee
Kyungpook National University School of Medicine, Republic of Korea
Title: ITP, IVIG and I
Time : 16:50-17:15
Biography:
I graduated from KNU School of Medicine in 1973, completed pediatric residency in 1978 and received Ph.D. in 1988. I started an instructor at same KNU in 1981 and retired in 2014. I studied hematology/oncology subspecialty at Division of Pediatric Hematology/Oncology, UCLA, LA, USA. Almost 200 articles have been published. I performed as a President of the Korean Society of Hematology (2002-3), Pediatric Hematology/Oncology (2003-4), BMT (2007), Medical Genetics (2009-11), Pediatrics (2012), internationally Asia Hematology Association (2013~), East Asia Hemophilia Forum (2013), and Advisor of Advanced Neuroblastoma Research Association (2010~). I received a Korea President Award Certificate in 2009.
Abstract:
The main reason for intravenous immunoglobulin G (IVIG) treatment in acute phase of immune thrombocytopenic purpura (ITP) is prevention of possible life-threatening hemorrhage since 1981. On the 1st trial, I just followed the dose of 400 mg/kg/d of IVIG for 5 days for 8 patients with good result in 1983-1984 (Korean J Pediatr. 28:483-491, 1985). On the 2nd, I stopped medication when platelet was over 100,000 /μL for 73 in 1985-1993. Mean treatment days were 2.8 days. The relapse and chronic ITP was less developed in rapid responders (RR: 1-3 treatment days) than in slow responders (SR: more than 3 days) (P<0.05) (Korean J Hematol 2001;36:241-6). On the 3rd, I also stopped medication when the platelet was over 50,000 /μL for 68 in 1993-2001. Mean treatment days were 2.9 days. Seven of 28 RR and 6 of 8 SR were chronic type (p=0.016) (Korean J Hematol 2001;36:247-52). On the 4th, I reduced daily dose to 200 mg/kg/d when the platelet was over 50,000/μL for 26 in 2005-2006. Average 2 days treatment were needed to increase the platelet count 50,000/μL. Although all 10 non re-treat group who were follow-up over 6 months were acute, all 3 re-treat group who were follow-up over 6 months were chronic (p<0.003) (Clin Pediatr Hematol Oncol 2006;13:143-9). No one died with 4 studies. The IVIG dose was different according to one’s clinical response. In some patient only 1/10 of usual doses (2 g/kg) were sufficient to reach a safe platelet counts in usual life.
Poster 9: Margaux N Yap
St. Luke’s Medical Center, Philippines
Title: The relationship between the parents’ knowledge, attitude and practices on immunization and the immunization status of their adolescent children in the out patient
Time : 15:45-16:30
Biography:
Margaux N. Yap has completed her MD at the age of 24 years from University of Santo Tomas and had pediatric residency training from St. Luke’s Medical Center Quezon City.
Abstract:
Objective: To determine the relationship between the knowledge, attitude and practices of parents and the immunization status of their children aged 11 to 18 years old. Design: Prospective cross-sectional study. Subjects: 70 guardians of patients aged 11 to 18 years for follow up at the St. Luke’s Medical Center QC (SLMC) Pediatric Out-Patient Department (OPD). Purposive sampling was done. Methodology: Interviewer-administered questionnaire/face to face interview and review of immunization records was conducted from December 2016 to February 2017 among parents of Adolescent patients who followed up at the Pediatric OPD of SLMC QC. Results: Patients were most often partially or non-adherent to their recommended adolescent vaccination schedules. About 93% received at least one dose of the Hepatitis B vaccine, but none received any booster or catch-up dose. Hepatitis A and Td/Tdap vaccines were given to 17% and 10% of adolescents, respectively. The coverage rates for annual influenza (5.7%) and HPV (2.9%) were the lowest among all vaccines recorded. More than 90% of respondents correctly replied to items on seriousness of the diseases targeted by MMR, varicella, and hepatitis A and B. In contrast, only half recognized the possibility of a serious sequelae of HPV infection. The cost of getting immunized was the leading barrier (87%) to availment of this service. Conclusion: No significant associations were found between parents’ range of knowledge scores and the actual immunization status of their adolescent children. However, score of ≥75% appeared to be associated with increased MMR and lower hepatitis A and influenza vaccination rates. In these findings we can conclude that availability of the vaccines in the health center can increase the adherence to adolescent immunization. The top 3 identified barriers in availing immunization were: Financial problems, Lack of knowledge and Lack of vaccines in the health center.
Poster 8: Rachel Talbot
University of Michigan, USA
Title: Addressing stigma on the child and adolescent psychiatry consultation service through use of video
Time : 15:45-16:30
Biography:
Dr. Rachel Talbot graduated from Ross University Schol of Medicine in 2013. Psychiatry internship and residency were completed at Wright State University in Dayton, Ohio. She is currently a 2nd year child and adolescent psychiatry fellow, PGY-5, at Michigan Medicine at the University of Michigan in Ann Arbor, MI.
Abstract:
Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating “real problems” and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.
Poster 7: So Hyun Nam & Eun jeong Jang
Dong-A University Hospital, Korea
Title: When/How to manage meconium related ileus? - Always it needs enterostomy?
Time : 15:45-16:30
Biography:
So Hyun Nam is pediatric surgeon in South Korea. I have been working a member of Korean Pediatric Surgeons Society for 11 years. I am an associate professor in Dong-A University College of Medicine. I’m interested in intestinal rehabilitation program and neonatal surgery especially for premature baby. Long term parenteral nutritional support for motility disorder and short bowel syndrome is always my concern.
Abstract:
Meconium related ileus (MRI) is one of cause for neonatal intestinal obstruction, especially in premature baby. It is associated with cystic fibrosis, but it is very rare in East Asia. MRI can present not only bowel perforation but also persistent abdominal distension with feeding intolerance. We introduced the surgical options of MRI and reviewed the surgical outcome. Material and Method) We retrospectively reviewed the medical records for 45 infants who underwent the operation for MRI from March, 2010 to August 2017 in Haeundae Paik hospital and Dong-A university medical center by single surgeon. We excluded the congenital anomalies and NEC in this study. Results) 45 infants (M:F=23:22) underwent the operation at 20.9 ± 20.6 days after birth. All except 3 were premature baby. Mean gestational age was 28.7 weeks ± 3.9 days and birth weight was 1,235 ± 777.1 g. 13 patients showed the free air on the X-ray and 27 patients showed severe abdominal distension despite of aggressive gastrograffin enema. 4 patients showed fixed bowel loop on the X-ray. The weight at operation was mean 1482.1 ± 779.8 g and bedside operation was done for 31 babies, and the operating time was 71.42 ± 27.2 minutes. Enterostomy was performed in 35 patients. We extracted thick meconium fully via appendix orifice, and then only did appendectomy for 7 patients. 2 patients underwent side to side anastomosis. We could extract meconium via enterotomy and repaired the enterotomy immediately. 2 patients (4.4%) had underlying Hirschsprung’s Disease. 12 patients (26.6%) died from sepsis, respiratory failure, and liver failure. They could start feeding around 7 days regardless of operation method, and the time to full enteral feeding was mean 36.34 ± 34.24 days. Conclusion) Still mortality is high in extremely low birth weight infants. Decompression via appendectomy and primary anastomosis could be another surgical option.
Poster 6: Thi-Ut Nguyen
National Pediatric Hospital, Vietnam
Title: Evidence of intra- familial of Helicobacter pylori by PCR- based RAPD fingerprinting in Vietnam
Time : 15:45-16:30
Biography:
Thi-Ut NGUYEN,a pediatrictian, has been working as gastroenterologist at Gastroenterology Department of the National Pediatric Hospital. She has conducted several studies on Helicobacter pylori antibiotics resistance and virulence of gastritis and peptic ulcer among children.
Abstract:
Statement of the problem: Helicobacter pylori (H. pylori) is the major cause of gastritis and peptic ulcer disease in children. Transmission between familiy members could be increasing risks of reinfection in children. The objective of this study is to assessed transmission by DNA fingerprinting analysis of H. pylori culture from pediatric patients and their family members. Methodology & Theoretical Orientation: We selected 17 households with H. pylori patients. 50 H. pylori strains were isolated from patients and family members, of whom 17 were from pediatric patients, 33 from family members including fathers, mothers and brothers/sisters. All 50 H. pylori strains were analyzed by RAPD technique between January, 2012 through September, 2013 in National hospital of pediatrics, Hanoi, Vietnam. Findings: Results show that 46.1% (6/13) mothers had genotypes similar to the ones of their children. In contrast, only 8.3% (1/12) fathers had genotypes similar to the ones of their children. 11.8% (2/17) H. pylori strains of pediatric patients were similar to the ones of their brothers/sisters. However, only one strain of fathers and mothers have similar genes but is not identical to their offspring. Conclusion & Significance: The results show that there is a link between the mother-to-child isolate, which may be evidence of mother-to-child transmission, especially in young children. The results of our study provide further proof of the molecular level of H. pylori transmission between family members in Viet Nam. further studies on H. pylori transmission among family members with larger sample sizes are needed.
Muhammad Riaz
Walsall Manor Hospital, UK
Title: Rare presentation of Tuberculosis meningitis
Time : 13:40-14:00
Biography:
Dr. Muhammad Riaz has completed MBBS at the age of 25 years from Punjab medical college Faisalabad affiliated with Punjab University, Lahore Pakistan. He has completed fellowship training in Paediatrics from Pakistan and completed MRCPCH in 2013. Currently he is working in Walsall Manor hospital as middle grade in the Paediatrics department.
Abstract:
Tuberculosis (TB) meningitis is the most severe manifestation of acute TB because morbidity and mortality are very high. Evidence suggests that Bacillus Calmette-Guerin (BCG) vaccination reduces the risk of disseminated TB however we present a case report of a 15-year old Bangladeshi girl who suffered from TB meningitis despite having had the BCG vaccination as a newborn but did not develop a scar. She was admitted with six weeks history of pyrexia, headaches and weight loss with no TB contacts or pulmonary signs. Her inflammatory markers were unremarkable and after an initial normal CT scan, her LP showed increased pressure of 40 cmHg. We drained 10 ml of CSF, which was clear and colorless with mildly raised protein of 0.98, glucose 1.2, RBC 1 and WBC 1. She was treated for acellular meningoencephalitis and TB workup was started. In the next 24 hours, her condition deteriorated with reduced GCS of 9-11. Her mantoux was strongly positive within 24 hours and she was started on anti TB medication. Repeated CT scan on day three, showed hydrocephalus and needed a ventricular drain insertion. CSF PCR and culture were positive for TB. GeneXpert claims to give a diagnosis within two hours for TB using gene PCR.
Poster 4: Tung Van Nguyen
108 Military Central Hospital, VietNam
Title: Assessment of diffusion tensor MRI tractography of the pyramidal tracts injury correlates with gross motor function levels in children with spastic cerebral palsy
Time : 15:45-16:30
Biography:
Nguyen Van Tung works as a Senior Consultant in the Pediatric Department at the 108 Military Central Hospital in Hanoi, Vietnam. Since graduating, he has shown himself to be a very hard-working, reliable and enthusiastic member of staff. In the professional work he indicates his very good background knowledge and skill of clinical doctor in pediatric field. He has been studying the PhD course at Hanoi Medical University for 3 years. He has studied clinical features, brain MRI findings, treatment efficacy of Botulinum toxin type A injection and combination with rehabilitation in children with spastic cerebral palsy at at Rehabilitation Department- National Hospital of Pediatrics. He has published more than 5 papers in national journals.
Abstract:
Background: Cerebral palsy (CP) affects movement and posture is caused by brain damage before, during, or after birth [1]. Accurate assessment of neurological damage and their relationship to motor dysfunction levels are important for the diagnosis, treatment and prognosis of cerebral palsy. Objestives:To evaluate the correlation between DTI parameters of each pyramidal tract with the GMFCS level in children with spastic cerebral palsy. Materials and Methods: Descriptive study of 44 children with spastic cerebral palsy from 2 to 12 years were recruited at Rehabilitation Department from 10/2015 to 8/2017. We evaluated clinical characteristics and the distribution of Gross Motor Function Classification System (GMFCS) levels [5]. All participants were studied with brain conventional MRI findings and the following three diffusion tensor imaging (DTI) parameters including tractography for each pyramidal tract: fibre number (FN), fractional anisotropy (FA) and Apparent diffusion coefficient (ADC) [3]. Results: In 44 children with spastic CP mean age: 4.5 ± 2.1y; mean gestational age: 35.34 ± 4.6 wks. Clinically, 22 (50.0%) had quadriplegia, 15 (34.1%) had diplegia and 7 (15.9%) hemiplegia. The distribution of GMFCS levels: 25 (56.8%) level II, 13 (29.8%) level III and 6 (13.6%) level IV. Brain conventional MRI scans showed that 33 (75%) abnormal findings, within periventricular white-matter damage was the hinghest finding 27 (61.4%), and only 11 (25%) normal MRI findings. The FA values of both tracts < 0.05. Conclusions: The DTI (FN, FA and ADC) parameters of each pyramidal tract were significantly correlated with GMFCS levels in children with spastic cerebral palsy (p < 0.001). Keywords: spastic cerebral palsy, diffusion tensor imaging, pyramidal tract.
Poster 3: Nam Huu Dao
Vietnam National Children’s Hospital, Vietnam
Title: Effective method of CVVH treated acute crisis of organic academias
Time : 15:45-16:30
Biography:
I am Dao Huu Nam, I have graduated from medical university since 2005 and finished resident doctor of pediatric since 2009. After that I worked in pediatric intensive care unit. I works as a Senior Consultant in PICU at the Vietnam National Children’s Hospital in Hanoi, Vietnam. I have shown myself to be a very hard-working, reliable and enthusiastic member of staff. In the professional work I indicate my very good background knowledge and skill of clinical doctor in pediatric field. I have been studying the PhD course at Hanoi Medical University for 3 years. I have studied about: effective of method of CVVH treated acute crisis of organic academias at pediatric intensive care unit – Vietnam National Hospital of Pediatrics. I has published more than 7 papers in national journals and 2 international journals with professor Noriko Nakajima, Japanese Red Cross Medical Center, Tokyo,Japan.
Abstract:
Background: Organic academia is 1 of 2 kinds of inborn errors of metabolism has often acute crisis in neonate or infection. They will die if we do not diagnose exactly and treat immediately. continuous venovenous hemofiltration (CVVH) is a rescue therapy to remove quickly ammoniac plasma or others toxics of metabolic. Objective: Common about effective of method of CVVH treated acute crisis of organic academias. Materials and methods: describe, prospective 6 severe patients, deep coma, metabolic acidosis, hyperamonaemia, was treated acute crisis of organic academias by CVVH, from 1/2014 to 3/2015. Results: Plasma ammonia levels 822 µmol/l (151-3000 µmol/l) before CVVH, were significantly reduced by 171 ± 54 µmol/l after 12h with CVVH, pH (7,1 ± 0,2) increased 7,32± 0.05 after 48h with CVVH and time medium CVVH is 4.1 ± 4.3 days, Time treatment in ICU is 6,4 ± 5,4 days. Three patients alive, clinical normal, one patient withdrawal treatment due to deep coma., two patients died due to MODS, one patient had nosocomial infection, one patient had Filter clotted. Conclusion: CVVH effectively and quickly eliminates plasma ammonia and correct metabolic acidosis to treat acute crisis of organic academias. Key word: CVVH, organic acidemias, acute crisis, hyperammoniac.
Poster 2: Natasha Piracha
Rutgers New Jersey Medical School, USA
Title: Furthering the integration of palliative care in the community
Time : 15:45-16:30
Biography:
Circle of Life Children’s Center, Inc. (COLCC) is a non-profit 501c foundation founded in 2004 providing comprehensive pediatric palliative and end of life care for families at University Hospital, Newark and throughout NJ. Pediatric age patients frequently do not receive adequate pain and/or symptom management nor do their families receive supportive services, both of which compromise quality of life. Current models of care for seriously ill children are neither sufficiently funded nor physically available to adequately address the needs of the many infants, children and adolescents with life-threatening conditions and their families. At University Hospital, COLCC has been actively involved in the care of more than 200 families and fifty infants annually, who experience premature death or are born with life-threatening and life-limiting conditions, many of whom have limited resources. By partnering with New Community Corporation, one of the largest community development not-for-profit corporations in the US, we are able to continue with our mission: providing integrative services and programs to the underserved community of Newark. This includes inpatient and home-based pediatric palliative and end of life care, professional consultation and education services, family support services, bereavement counseling, community and family education, and volunteer programs. The unique advantage of this partnership allows a full-bodied approach to pain and palliative care, where physicians are able to provide the medical care needed, while community organizations can provide the emotional and social support lacking in physician focused models of palliative care.
Abstract:
Natasha Piracha graduated with her bachelors degree from Rutgers University in New Brunswick, NJ and then subsequently with her MD from Rutgers New Jersey Medical School (NJMS). She is now the chief resident for the combined internal medicine and pediatrics residency program at Rutgers NJMS. She has focused her recent efforts on furthering the efforts of pediatric palliative and end of life care with Dr. James Oleske, Professor of Pediatrics and founder of Circle of Life Children’s Center, Inc and with Dr. Onajovwe Fofah, Assistant Professor and director of neonatology at Rutgers NJMS.
Poster 1: Sarah Critch
Memorial University of Newfoundland, Canada
Title: The effects of resistance exercise on insulin sensitivity in adolescents
Time : 15:45-16:30
Biography:
Sarah Critch is the Physiotherapist with the Janeway Lifestyle Program at the Janeway Children’s Health and Rehabilitation Centre, Eastern Health. Sarah obtained a Masters of Science in Medicine (Clinical Epidemiology) from Memorial University, a Bachelor’s degree in Kinesiology (Honours) from Memorial University, and a Bachelor’s degree in Science (Physiotherapy) from Dalhousie University.
Abstract:
An escalating incidence of type 2 diabetes among adolescents is thought to be sparked by rising population-wide prevalence of insulin resistance. Resistance exercise has been shown to reduce insulin resistance, however only immediate, post-intervention effects have been demonstrated. The purpose of this study was to assess the effects, up to six months, of resistance exercise on insulin sensitivity, cardiorespiratory fitness, muscle strength, activity levels, and anthropometric measures among adolescents with insulin resistance. Participants, recruited from a chronic disease prevention program, completed a physiotherapist-supervised 10-week resistance exercise program, 60-minutes, three times per week. A body positive approach was used focusing on health behaviours. Using a repeated-measures design, participants were assessed during a control period then at pre, post, and 6-month follow-up assessments. The primary outcome was insulin sensitivity, measured by the oral glucose tolerance test. Secondary outcomes included cardiorespiratory fitness, muscle strength, activity level, and anthropometric measures. Thirteen participants (14.16±1.19 years old; 8 males,5 females) completed the intervention. Improvements in insulin sensitivity were found, observed as reduced fasting insulin [F(2,22)=7.54,p=0.003,ηp2=0.41], fasting glucose [F(2,22)=3.58,p=0.045,ηp2=0.25], and HOMA-IR [F(2,22)=7.60,p=0.003, ηp2=0.41], which were maintained at follow-up. Cardiorespiratory fitness, waist circumference, and waist-to-hip ratio significantly improved at post and follow-up. The findings suggest that a supervised 10-week resistance exercise program improves insulin sensitivity, cardiorespiratory fitness, waist circumference, and waist-to-hip ratio in adolescents who are at high risk of developing type 2 diabetes. Importantly, these benefits are maintained up to six months. Supervised, resistance exercise adds significant long-term benefit in the management of insulin resistance in adolescents.
Li-Xiao Xu
Children’s Hospital of Soochow University, China
Title: Autophagy-regulated AMPAR subunit up-regulation in in vitro oxygen glucose deprivation/reoxygenation-induced hippocampal injury
Time : 14:50-15:45
Biography:
Li-Xiao Xu is working as an Assistant Professor of Clinical Research Institute of Soochow University. She got her Doctorate degree in Biochemistry and Molecular Biology at Sun Yat-Sen University in 2012. Since 2012, she has been working in Children’s Hospital of Soochow University and focused on the research of brain damage, studies on the mechanisms of autophagy in hypoxia-ischemia-induced brain damage. Currently, she has hosted a National Natural Science Foundation-Youth Foundation (No.81502157), and obtained awards from Jiangsu Provincial Medical Youth Talent (No. QNRC2016758) and applied for Foundational Research of Medical and Health Care of Suzhou City (No.SYS201646). She also have been published many papers.
Abstract:
Autophagy has been implicated to mediate experimental cerebral ischemia/reperfusion-induced neuronal death; the underlying molecular mechanisms, though, are poorly understood. In this study, we investigated the role of autophagy in regulating the expression of AMPAR subunits (GluR1, GluR2, and GluR3) in oxygen glucose deprivation/reperfusion (OGD/R)-mediated injury of hippocampal neurons. Our results showed that, OGD/R-induced hippocampal neuron injury was accompanied by accumulation of autophagosomes and autolysosomes in cytoplasm alongside a dramatic increase in expression of autophagy-related genes, LC3 and Beclin 1 and increased intracellular Ca 2+ levels. Pre-treatment with autophagy inhibitor 3-methyladenine (3-MA) significantly reduced this effect. Moreover, the OGD/R-induced up-regulation of mRNA and protein expressions of GluR1, GluR2 and GluR3 were also effectively reversed in cells pretreated with 3-MA. Our findings indicate that OGD/R induced the expression of GluRs by activating autophagy in in vitro cultured hippocampal neurons, which could be effectively reversed by the administration of 3-MA.
Mahapatra C Sushil
AIIMS, India
Title: A novel way to express the Gluten load during micro-challenge tests in celiac children
Time : 14:25-14:50
Biography:
Sushil Chandra Mahapatra is a Physiologist with medical background has been working in the area of human nutrition since 1982 at the All India Institute of Medical Science, the most premier institute in India. His area of interest is largely being dietary fiber and nutritional management of diabetes. He got interested in the nutritional management of celiac children when Shikha Nayar joined him for her PhD. The concept of %Gmax was conceptualized while discussing the available literature and the difficulty in deciding the dose of micro-challenge.
Abstract:
Celiac disease (CD) is an autoimmune disease that occurs in genetically predisposed persons where ingestion of gluten leads to damage of intestine. The only method of treatment of CD is to provide a gluten-free diet (GFD). The intestinal biopsy returns to normal on complete compliance with GFD, while even a small exposure to gluten again leads to histo-morphological changes in the intestinal mucosa. There is considerable heterogeneity across studies concerning complete mucosal recovery ratios achieved by a gluten-free diet in celiac disease. Several celiac patients fail to achieve complete mucosal recovery even if a strict dietary regimen is followed. Number of studies has tried to find out the minimum amount of gluten that can produce appreciable damage to intestinal mucosa. The unit of expression of gluten content of a diet or the gluten load to the intestine has been either in mg or in ppm. Both of them have certain limitations, therefore a novel concept of %Gmax has been evolved to express the gluten load which is more individualized, country specific as well as scientific. Gmax or gluten maximum is defined as the estimated amount of gluten in the diet, where all the cereal consumed according to the recommended dietary guidelines (RDGs) for an individual is from wheat or wheat products. Using this novel method of expressing gluten load and conducting a controlled clinical trial, it was found out that the gluten load capable of inducing noticeable mucosal changes in the small intestine of Indian CD children could be as low as below 0.1% Gmax. While this dose was sufficient to bring out mucosal damage could show immunological changes in few and hematological changes in none. Therefore more studies are required to find out the %Gmax which can produce other sign or symptoms.
Kenji Sasaki
Home Medical Care Supporting Clinic Sendai, Japan
Title: Bleeding ectatic vascular lesion involving the sigmoid colon, endoscopically indistinguishable from angiodysplasia, in an 8-year-old boy
Time : 14:00-14:25
Biography:
Born and brought up in Japan, Kenji Sasaki received his MD and, as an immunologist, PhD from Tohoku University School of Medicine in 1973 and 1977, respectively. Trained at Miyagi Cancer Center, he is a Board Certified Fellow and Preceptor of the Japan Gastroenterological Endoscopy Society, Board Certified Gastroenterologist of the Japanese Society of Gastroenterology, Board Certified Member of the Japanese Society of Internal Medicine and Editorial Board Member of CRIM. He has published several papers on gastroenterology in international journals and served as a reviewer for JMM, JPP and J Gastrointest Dig Syst.
Abstract:
An 8-year-old Japanese boy was hospitalized, complaining of active hematochezia. He was shown to have a cherry-red, blood-oozing area of vascular dilatation with mucosal prominence in the sigmoid colon by endoscopy but had no other mucocutaneous vascular abnormalities. His family history was noncontributory. Under the clinical diagnosis of angiodysplasia of the sigmoid colon, he underwent an elliptical resection of the part, based on the intraoperative endoscopic findings. Histological examination of the specimen, however, revealed a totally different picture from that seen in angiodysplasia: the thin-walled, markedly ectatic, nontortuous veins with hemorrhage were seen only just below the muscularis mucosae, around which the normal ones were shown to coexist. He has had no rebleeding for the past several years. This lesion is considered to be an isolated congenital visceral telangiectasia involving veins.