4^th International Conference on Pediatrics and Pediatric Emergency Medicine March 29-30,2016 Atlanta, Georgia, USA

Biography:

Laura Odom recently completed her DNP from Vanderbilt University after practicing in an Allergy/Immunology clinic as a Family Nurse Practitioner for the last twelve years. She is a clinical assistant professor at the University of Tennessee, Knoxville and is the Presdient and Co-founder of Medic Apps, LLC. She has filed a provisonal patent and trademark for her asthma action plan application BreatheEasy. She is an allied health member of the AAAAI, and is a member of the Adverse Reactions to Foods Committee and the Asthma, Cough, Diagnosis and Treatment Committee.

Abstract:

Background: Asthma burden affects mortality, morbidity, quality of life, and the economy. The British Medical Journal recently reported that two-thirds of asthma deaths are due to failure to follow recommended guidelines and primary care failings in routine care. Written asthma action plans are standard of care according to national guidelines, but these plans are seldom prescribed. Furthermore, these written care plans are often unavailable at the time of an exacerbation. The purpose of this project was to create an asthma action plan application for smartphones. The goal of the project was improved patient access to their asthma action plan and improved utilization rates among providers. Methods: A development studio was consulted for support in developing a smartphone application to code the software for the asthma action plan and assist in the design process. Following development of the application, a survey was completed to evaluate design and functionality. Results: All survey participants agreed that the application was easy to use, could be used without written instruction and was designed for adolescents with asthma of any severity. Patients and providers noted that the app would help provide information about what to do in the event of an asthma exacerbation and that the application would be used frequently. Conclusions: There was consensus from both patients and providers that this application is not only functional but also helpful in the event of an asthma exacerbation. The project met the goal of creating a mobile phone application that improved patient access to asthma action plans.

Biography:

Dr. Benkwitz obtained her Medical Degree and PhD in Cardiology at the University of Wuerzburg, Germany, before spending several years as a Postdoctoral Research Fellow and Research Scientist at the Dept. of Anesthesiology at the University of Wisconsin. She completed her Anesthesiology Residency in the US at Massachusetts General Hospital and Fellowship Training in Pediatric and Pediatric Cardiac Anesthesia at Lucile Packard Children’s Hospital at Stanford University. She served as Faculty member in Stanford, before moving to Monroe Carell Jr. Children’s Hospital at Vanderbilt University, where she currently holds a position as Assistant Professor and is primarily involved in Pediatric Cardiac Anesthesia. She obtained various research awards, has published in high-ranked peer reviewed journals and co-authored several book chapters in major anesthesia textbooks. Her research interests include basic and clinical neurosciences, with the current focus on neuromonitoring and neurocognitive outcome in pediatric cardiac surgical patients. She is presently involved in clinical research, serving as PI or Co-PI on several different studies.

Abstract:

Congenital heart disease (CHD) is the most common birth defect. Today, an increasing number of affected children, who not long ago were considered “inoperable” are now living into adulthood. In fact, there are now more adults than children living with CHD. This turning point has shifted the focus from “primarily survival” to “improving quality of life” for these patients. For this matter, a major area of concern is neurological morbidity, that affects 30-50% of children with CHD and is attributable to multiple causes. While vital organs are routinely monitored in the pediatric cardiac surgical setting, this typically does not hold true for the brain, where monitoring is still indirect. Yet, reliable and accurate neurological monitoring is essential to reduce the incidence of neurological complications and subsequent potential long-term cognitive dysfunction. In this discussion, we review various modalities of neuromonitoring for children undergoing congenital heart surgery with a focus on Near-Infrared Spectroscopy (NIRS). In addition, our own data will be presented, investigating a next generation NIRS device (FORE-SIGHT Elite Tissue oximeter) in combination with simultaneous vital sign recording in pediatric patients undergoing cardiac catheterization. Our data suggest that NIRS monitoring appears superior to standard vital sign monitoring when assessing “brain well-being”, thereby supporting routine use of NIRS as an independent monitor to achieve safer peri-OP management in this vulnerable and extremely heterogeneous patient population. Clearly, future studies refining efficacy and application of this technology are warranted and are on the way.

Biography:

Andreas Petropoulos graduated from Aristotle University’s Medical School, Greece in 1989. Followed 30 year career as a medical officer, senior Flight Surgeon in the Hellenic Air-Force. Specialized in Aviation & Hyperbaric Medicine, Pediatrics, Fetal, Pediatrics and Congenital Cardiology in USA and Europe. Holds M.Sc in Preventive Cardiology. An AEPC Prevention and Heart Failure/Pulmonary Hypertension, working group’s member. Worked and lectured in Athens and Brussels universities. Currently consults in Fetal, Pediatrics and Congenital Cardiology in Merkezi Klinika and is Associate Professor at the State University and Post Graduate and CME Center in Azerbaijan. His research focuses on prevention, CVD imaging techniques, fetal cardiology, and heart failure.

Abstract:

The aim of this paper is to remind to general pediatricians the risk of viral myocarditis as a part of a common viral infection. To explain the clinical futures, the diagnostic algorithm and the available treatments in primary and in hospital care Myocarditis is an inflammatory disease of heart muscle and the pericardium. It is an important cause of dilated cardiomyopathy worldwide. Viral infections are the commonest cause of myocarditis. The spectrum of viruses known to cause myocarditis has changed in the past 2decades. Several new diagnostic methods, such as cardiac MRI, are useful for diagnosing myocarditis. Endomyocardial biopsy may be used for patients with acute dilated cardiomyopathy associated with hemodynamic compromise, those with life-threatening arrhythmia, and those whose condition does not respond to conventional supportive therapy, to differentiate dilated cardiomyopathy from acute myocarditis. Important prognostic variables include the degree of LV and RV dysfunction, heart block, and specific histopathological forms of myocarditis. We review diagnostic and therapeutic strategies of viral myocarditis

Biography:

S E Morgan is a Registered Respiratory Therapist and an Advanced Respiratory Care Practitioner with the National Board for Respiratory Care. He is an active member of The America Association for Respiratory Care. He serves as Clinical Practice and Development /Educator/ Research Coordinator for the Department of Respiratory Care Services, Section of Pulmonary and Critical Care Medicine at the UCM. He has published more than 30 peer review papers regarding subjects such as; nitric oxide, heliox, infl uenza-related respiratory disease and aerosolized epoprostenol) in different medical journals. He has collaborated with departments of neonatology and pediatrics on respiratory related research projects.

Abstract:

Infl uenza-like respiratory infections is a frequent trigger for status asthmaticus. Helium-oxygen (heliox) gas mixtures, has been used for decades to treat pulmonary exacerbations. The lower density and higher viscosity of heliox relative to nitrogen oxygen mixtures can signifi cantly reduce airway resistance, thought little evidence exist regarding effi cacy in viral-related lung disease. Th e morbidity and mortality of these viruses is signifi cant with regard to infants and children. In the summer of 2014 > 600 kids were admitted to Comer Children’s Hospital with rhinovirus-enterovirus. Infections in children may cause bronchitis, viral bronchiolitis and pneumonia in variable combinations and may impede air-fl ow enough to be the etiology of respiratory failure. We present the case review of two pediatric patients treated with heliox who experienced resolution of respiratory failure through the use of heliox. First case; a10-month old Hispanic male diagnosed with a history of seizures, coronavirus – HCoV-43 and rhinovirus-enterovirus treated with high fl ow nasal cannula and heliox to avoid re- intubation. Before heliox the patient was tachypnea 60-70 breaths/min. Aft er heliox, his respiratory rate fell 31-38 breaths/min.Th e second case review is a 4 year old female, diagnosed with rhinovirus-enterovirus that required mechanical ventilation with heliox to treat refractory hypoxichypercarbic (PaCO2-118 mmHg) respiratory failure. Th e benefi t of heliox appeared to serve as a bridge to support these patients’ while time and pharmacologic measures took eff ect and an underlying infection abated. More study is needed to understand and treat viral-related obstruction lung disease of small airways and the role of heliox.

Biography:

Shridevi Pandya Shah received her Medical degree at the College Maharaja Sayajirao University in India. She went on to complete an internal medicine internship at The Coney Island Hospital, Brooklyn, NY. She then began an Anesthesia Residency and completed at The Montefi ore Hospital-Albert Einstein College of Medicine. Following this, she commenced a fellowship in Pediatric Anesthesia at the Children’s Hospital of Pittsburgh. She has had many presentations at both national anesthesia and pediatric anesthesia professional meetings. She is currently an Assistant Professor at the Rutgers, NJMS and has made contributions related to pediatric anesthesia in several professional journals.

Abstract:

A difficult airway management situation was presented by an eight-week-old infant who presented with a bleeding orbital tumor. Th e infant also had a not yet diagnosed inherited trisomy 15 with facial abnormalities and an upper respiratory tract infection that made the face-mask ventilation and tracheal intubation more challenging. The urgent need for the surgery precluded any further work-up and optimization. Anesthetic challenges included difficult mask ventilation, difficult endotracheal intubation, extremely reactive airway and very labile hemo-dynamics during induction. An Air-Q laryngeal mask airway was used as a rescue airway device and as a portal for endo-tracheal tube placement during the anesthetic management with good outcome.

Biography:

A Boufersaoui completed his Doctoral studies in Medicine from University of Medical Sciences of Algiers and its specialty pediatric studies in the same university. It is currently completing a Doctoral thesis on inhalations foreign bodies in children. He presented his experience in different pediatric congresses: International Congress of Pediatrics in El Baha Saudi Arabia, Congress of the Italian Society of Pediatrics, Congress of the Romanian Society of Pediatrics, First Prize at the Congress of Arab societies of pediatrics at Marrakech, North African pediatrics’ Congress, pediatric pulmonology international Congress in Bruges, Congress of the European respiratory society in Munich. He published an article in the International Journal of Pediatric Otorhinolaryngology on the same subject.

Abstract:

Objectives: Th e objective of this study is to analyze the epidemiological, clinical, radiological and endoscopic characteristics of pediatric foreign body aspiration in Algeria. Methods: In this retrospective study, the results of 2624 children younger than 18 years admitted in our department for respiratory foreign body removal between 1989 and 2012, were presented. Most of them had an ambulatory rigid bronchoscopy. Results: Th e children (62.34% males and 37.65% females) were aged 4 months to 18 years with 66% between 1 and 3 years. Choking was related in 65% of cases. Th e delay between aspiration and removal was 2–8 days in 65.8% and within 24 h in 9.2%. In the most cases, the children arrived with cough, laryngeal or bronchial signs and unilateral reduction of pediatric vesicular murmur. Th e examination was normal in 13%. Th e most common radiologic fi nding was pulmonary air trapping (40.7%).

Th e aspirated bodies were organic in 66.7%, dominated by peanuts, while sunflower seeds, beans and ears of wheat were the most dangerous. In the other cases, they were metallic or plastic as pen caps and recently scarf pins. Th e endoscopic removal by rigid bronchoscopy was successful and complete in 97%. Cases with extraction failure (3%) limited to certain FBs, all of them inorganic were assigned to surgery. Th e complications related to the endoscopic procedure were 0.29% with a mortality of 0.26%. Conclusion: Foreign body aspiration is a real public health problem in Algeria. Th e best way to manage it is an early diagnosis and a rigid bronchoscopy removal under general anesthesia used by fully trained staff . Th e prevention of this domestic accident should consider the population lifestyle and cultural habits to be more eff ective.

Biography:

Keva Bethell has completed her Master’s in Public Health from the University of Oklahoma Health Sciences Centre and Bachelor of Science in Biology (Pre-med) from Oral Roberts University. She is the Director of Research for the Family: People Helping People project, a community based project which provides free group therapy in marginalized Bahamian communities. The project’s goal is to encourage re-socialization of participants who attend the weekly group sessions. She has published four papers in reputed journals and is currently working on a manuscript detailing a phenomenon called ‘The Evil Violence Tunnel’.

Abstract:

The Family: People helping people project is a supportive group process modality involving the sharing of personal stories, self-examination, refl ection and transformation using psychotherapeutic principles. Th e group process was developed to confront the prevailing social fragmentation in the Bahamas associated with or caused by the continuing eff ects of the countrywide crack cocaine epidemic of the 1980s and the fall-out due to the recent international fi nancial downturn. Facing community disintegration, high youth unemployment and burgeoning rates of violent crime and murder, many persons have been severely traumatized. Th is paper reviews the major themes presented in 776 group process sessions indicating the pervasive nature of the negativity of the shame process expressed in the high incidence of anger, violence, grief, relationship issues and abuse. Th is innovative project has been proven to enhance the re-socialization of many participants in the program.

Biography:

Roxanne Bautista is a medical student currently fi nishing her basic sciences at Avalon University School of Medicine. She majored in Biochemistry and Nursing during her undergraduate where she found great passion to pursue Medicine. She is committed to making positive difference, staying proactive with her involvement in medicine, while utilizing her potential in health and science fi eld. She is a former president of Phi Chi Medical Fraternity who continues to stay active in not only in community services within her school, but also within Curacao community. She was presented "The Eben J. Carey" award for having the highest grade in anatomy and "The Rudy F. Sievers" award for being the most outstanding senior class member of Phi Chi. She has worked with the research team in Avalon and her recent research activities include a collaborative study with University of Alberta in Canada to identify and compare the modern lifestyle of Antillean and Canadian Post-Secondary students in contributing to obesity rates; and contributed in writing the pitfalls of nanomaterials with the increasing transformative technology of nanomedicine. She is grateful to present in this conference and she looks forward to contributing with many more.

Abstract:

A neonate child ,primigravida with features of Down syndrome, with multiple intestinal atresias was delivered at Ibensena teaching hospital Sirte Libya by a 39 year old mother. Diagnosis was established with plane and contrast X-Rays and was managed by Multiple intestinal anastomosis aft er appropriate resection. Post operative infection of chest and abdominal cavity was managed with broad spectrum antibiotics (Th ird generation Cephalosporins, Vancomycin) covering Gram (+) ve , Gram(-) ve organisms. Post operative state was uneventful without any complications. Parenteral nutrition supplemented with vitamins and minerals. Patient recovered from illness. Intestinal atresia can involve any position of small bowel. It is characterized by an obliteration of the bowl lumen and its replacement by a fi brous cord that connects the proximal and distal segments. Specifi c sub-types include apple-peel atresia, multiple intestinal atresia with mega duodenum. Traditionally intestinal atresia has been regarded as an embryologic defect. Currently the interpretation that the disease is the result of utero mechanical injury to the vascular system of the bowl is favored. Th is may result from interception incarceration. A causal relationship between the use of methylene blue in second -trimester amniocentesis and the occurrence of jejunel atresia has been suggested. Complications include perforation, meconium peritonitis and as a rare late occurrence -Brown - bowel syndrome.

Biography:

Tran Quynh Nhu Nguyen graduated from University of Medicine and Pharmacy, Ho Chi Minh city, Vietnam in 2007. Since 2008, she has worked as cardiologist in Children’s Hospital 2, Ho Chi Minh city, Vietnam. She has completed master course from School of Medicine, The University of Tokyo, Japan in March 2015 and now continues Ph.D course at the same above university.

Abstract:

Ellis-van Creveld syndrome (EvC) is a ciliopathy with cardiac anomalies, disproportionate short stature, polydactyly, dystrophic nails and oral defects. Approximately 60% of EvC patients have severe congenital heart defects (CHD), of which more than half are atrio-ventricular septal defect and common atrium. In this study, we report one EvC Vietnamese family with an atypical CHD phenotype, short chordalis. A 32-month-old boy had a novel heterozygous EVC mutation (c.1717C>G-p.S572X) in exon 12, inherited from his father whose phenotype was milder than his son’s. Of note, the mother without an EvC phenotype showed a lower expression of EVC mRNA compared with controls. SNP array analysis revealed that the patient and mother had a heterozygous 16kb deletion in EVC, ranging from intron 9 to intron 11. As the patient and the father had an atypical CHD, we screened EFCAB7 and IQCE as the candidate for modifiers of EvC phenotype. EFCAB7 and IQCE are ciliary proteins, which positively regulate the Hh pathway and anchor the EVC-EVC2 complex in a signaling microdomain at the base of cilia. A novel missense mutation c.1171T>C-p.Y391H in EFCAB7 was found in the patient and the father. This mutation located in a possible binding site of EFCAB7 and EVC2, and may have modified the EvC phenotype in this family. Our findings suggested the physiological role of EFCAB7 in cardiac development.

Biography:

Salah Thabit Al Awaidy is a Communicable Diseases Adviser in Health Affairs, Ministry of Health, Oman. He is a medical doctor and holds a Master’s in Epidemiology. He is currently the adviser of Communicable Disease Surveillance, Elimination and Eradication of Communicable Diseases of Public Health Importance, EPI, vaccine supply chain system and IHR at the Ministry of Health, Oman. He was the Director of Communicable Disease Surveillance and Control at MoH, HQ, Oman between 1997-2011, IHR national focal point 2002-2013 and was a member in several of the professional committees namely: Strategic Advisory Group on Immunization (SAGE), WHO Geneva (2005-2007); Strategic Advisor Group on Vaccine and Store Management Training Courses (2005-2008), WHO Geneva; Strategic TB Advisory Board (STAG) 2007-2011 2014- till date. He also currently serves as IHR Emergency Committee on Polio and MERS-CoV. He has authored or been the co-author of over 35 publications on a large variety of health topics.

Abstract:

A retrospective study of infl uenza-like illness (ILI) in Oman was completed to describe the epidemiology of pandemic infl uenza-A, subtype H1N1 activity (pH1N1). From June to December 2009, 8,941 specimens were collected nationwide from patients that met the case defi nition for ILI, of which 6,547 (73%) were tested for pH1N1 by real-time polymerase chain reaction (RT-PCR). Out of these, 4,089 (62%) were found positive for pH1N1 and 712 (11%) were positive for seasonal infl uenza A. Th e mean age of patients positive for pH1N1 was 24 years (28 days-74 years). Out of the total patients who met the defi nition of severe acute respiratory illness (SARI) and required hospitalization, 28.3% were positive for pH1N1. Th e overall case fatality rate was 1.1 deaths/100,000 populations. Two governorates, Muscat and Dhofar, witnessed the greatest intensity of infl uenza activity. Mitigation, containment, pharmaceutical and non-pharmaceutical measures were engaged. Based on the experience and lessons learned in Oman, some recommendations were sought in Oman.

Biography:

Shailesh Adhikary currently works in the Department of Surgery, B P Koirala Institute of Health Sciences, Dharan, Nepal. His research interest is Pediatric Surgery.

Abstract:

Introduction: Penetrating or perforating abdominal or chest injuries are very uncommon in the pediatric age group and are associated with a high mortality. Impalement injuries are consequence of penetration by elongated, usually fi xed objects through the body. Case Summary: A 10-year young child suff ered from a penetrating injury to the left iliac fossa when he had fallen down from a coconut tree on to the sharp bamboo fence. Th e bamboo stick penetrated the abdominal wall, perforated the jejunal loops at two sites along with the fundus of stomach, the left diaphragm, upper lobe of the left lung and the bevelled end of the bamboo had exited at the neck aft er tearing apart the neck muscles and skin sweeping along with it few scattered pieces of jejunal tissues which were seen lying alongside. He was brought to the hospital 5 hours aft er the accident. On arrival he was in agony, dehydrated and scored 15/15 on Glasgow scale, remained hemodynamically stable, saturation of 93% with oxygen supplement. On examination a 75x5cm bamboo stick was in situ, which entered 4 cm medial to the left anterior superior iliac spine and exited 3cm above the skin at the posterior triangle of neck. Operation: Imaging modalities were followed by exploration via the left thoraco-abdominal incision. Th e thorax, mediastinum and neck were assessed in the beginning and aft er confi rming that no great vessels were at risk, the foreign body was then carefully removed. Th e perforated stomach, jejunum and diaphragm were repaired. Th e upper lobe of lung had to be resected. An abdominal drain and two inter-costal drains were placed. Th e total operative time was 3.30 hours and the child was managed in intensive care for 4 days and was fi nally discharged aft er two weeks. Conclusion: A rare penetrating injury with damage to the multiple organs could be managed successfully possibly because of teamwork and also due to some sensible move by the villagers as they did not try to fi ddle around with the foreign body.

Biography:

Dr. Khalil Salameh has completed his M.D at the age of 24 years from Zagreb University and postgraduate residency in Jordan. He has a membership of royal college of physicians in Edinburgh. He is the chairman of pediatrics department in Al Wakrah Hospital, Doha, Qatar. He has published more than 10 articles in international journals.

Abstract:

High-risk populations are scarce despite reported increased risk of rickets in breastfed infants. We determined the prevalence and associated risk factors low vD status in breastfeeding mother-infant dyads in a population with high prevalence of infantile rickets. Patients & Methods: We evaluated vD status of 60 consecutive exclusively breastfeeding Arab mother-infant pairs in Doha, Qatar participating in a high dose vD supplementation study to prevent vD defi ciency, prior to study enrollment during August to September 2014 (sunny months). Serum 25(OH)D and PTH were measured within 1 month postpartum. Demographic, sun exposure and vD supplementation data were collected using standardized questionnaires. Vitamin D defi ciency was defi ned as serum 25(OH)D <50nmol/L and severe defi ciency as 25(OH)D < 25noml/L in mothers and infants. Results: Mean maternal age was 29 years and 77% had college or university education. Maternal median 25(OH)D was 32.5 nmol/L. Seventy-eight percent of mothers were defi cient and 20% had serum 25(OH)D <25 nmol/L. Negative correlation between serum 25(OH)D and PTH was not statistically signifi cant(r= -0.22, p=0.09). In the entire group, only 50% of mothers had reportedly taken vD supplements with median dietary vD of 119 IU/day. Median maternal sun index score (sun exposure (hrs/wk) x body surface area exposed while outdoor) was 0. Maternal serum 25(OH)D correlated with age (p<0.02), and percent BSA exposure while outdoor (p<0.004). Infant median 25(OH)D was 20.0 nmol/L and 83% were defi cient while 64% had serum 25(OH)D <25nmol/L. Infant 25(OH)D correlated with maternal levels (r= 0.41, p =0.001). None of infants had received vD supplement at 1 month of age and median sun index score was 0. Infant’s serum PTH showed signifi cant negative correlations with 25(OH)D (r= -0.28,p=0.03). Conclusion: Vitamin D deficiency is common in breastfeeding mothers-infants dyad and severe deficiency is more common in infants than mothers in this sunny environment. Low maternal and infant vitamin D status is associated with lack of sun exposure and low or lack of vD supplement intake. We suggest corrective vD supplement strategy to prevent vD deficiency in breastfeeding mothers and their infants, which should preferably start during pregnancy.

Biography:

Nasir Uddin Mahmud completed his MBBS at the age of 25 years from Chittagong Medical College, and achieved Diploma in child health under Chittagong University and Fellowship (FCPS) in Pediatrics from Bangladesh College of Physician and Surgeon (BCPS). He has published 15 papers in reputed journals and member of the editorial board of the Journal of Chittagong Medical College Teacher Association and The Healer, an Official Organ of Bangladesh Medical Association Chittagong, Bangladesh

Abstract:

Introduction: A retinopathy specific to severe malaria has been reported in African and Malawi children and in Bangladeshi adults. Detection of this retinopathy can be a useful diagnostic tool. This study was designed to detect retinopathy in severe malaria cases in Bangladeshi children. Methods and subject: A prospective observational study was conducted including consecutive 190 severe malaria patients, aged 6 months to 12 years, admitted to Department of Pediatrics, Chittagong Medical College Hospital, Bangladesh, from April 2008 to March 2009. Eighty patients were cerebral malaria and 50 were severe non-cerebral malaria; 31 meningitis and 29 critically anemic patients were included as control. Direct and indirect ophthalmoscopy was performed by two independent observers. Results: Retinopathy was detected in 61.2% with cerebral malaria and in 48% with severe non-cerebral malaria patients. Retinal haemorrhage was detected in 46.2% and 43.4% of cerebral malaria and 32% and 24% of non-cerebral severe malaria and vascular changes were found in 33.8% and 7.2% of cerebral malaria and in 26% and 2% of non-cerebral severe malaria by indirect and direct ophthalmoscopy respectively. Papilloedema in 13.8% and 6% and peripheral whitening in 41.2% and 34% of cerebral and non-cerebral malaria respectively was detected. Macular whitening was found in 46.2% patients. Death was significantly higher in patients with retinopathy (p<0.001). Blantyre coma score (BCS) on admission was lower and hospital stay and coma recovery time was significantly longer in patients with retinopathy. Conclusion: Malarial retinopathy is an important diagnostic tool for diagnosis and is related to prognosis of patients with severe malaria. Key wards: severe malaria, retinopathy, children, Bangladesh

Biography:

Alejandro Berenstein, MD (Dr B.) was born in Mexico City in 1948, graduated from the UNAM, at present is Professor of Neurosurgery, Radiology and Pediatric, Director of the Hyman- Newman Institute for Neurology and Neurosurgery at Mount Sinai Health System in NYC. He is a pioneer in the new field in medicine “Endovascular Surgery”; he established the first Comprehensive center for the multidisciplinary treatment of head, neck and peripheral vascular lesions, His contributions extend from the description of the functional vascular anatomy, understanding and describing the diseases, to the development of multiple medical devises to treat them used throughout the world. He has authored over 150 publications in peer-reviewed journals, more than 25 chapters in the field, and 9 books including the five volumes groundbreaking textbook, “Surgical Neuroangiography”. Among the more than 30 awards, in 1989 he received the Ramon y Cajal Award in Medicine for distinguished Latin American Physicians. In 1998 The First Cerebrovascular Luessenhop Award from the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS); Section of Cerebrovascular Surgery. In 2001 awarded the Paolo Raimondi Award from the AANS/CNS on Pediatric Neurological Surgery, and is the only physician to received both. In 2007 he received the Physician of the Year from Vascular Birthmark Foundation, for his work with children with vascular birth defects. In 2007 the Boston Scientific Neurovascular Lifetime Achievement Award for excellence in research and clinical applications. In 2008 the Heart of New York Stroke Spotlight Award from the American Heart and Stroke Association. Honorary Member of the Japanese Society of Neuroendovascular Therapy, in 2009 he received the first Serbinenko Golden Sign Award in Neurosurgery in Moscow. He has been visiting professor, lecturer and faculty in over 600 occasions. He became the first President of the World Federation of Interventional and Therapeutic Neuroradiology and third President of the American Society of Interventional and Therapeutic Neuroradiology; and has been the President of SILAN the Latin-American Society of Neuroradiology for 2012-2013.

Abstract:

During this presentation I will review the various vascular lesions of the head and neck and the various endovascular treatments. Will review: Venous Malformations, Arteriovenous Malformations, A-V fistulae, Lymphatic Malformations and Hemangiomas. We will present the various endovascular techniques, including transarterial embolization, percutaneous embolization, combination treatments. Will review: the indications and technical aspects of sclerotherapy. The use of STS, Doxycycline, Bleomycin, and sclerotherapy foams

Biography:

Abstract:

OBJECTIVE and BACKGROUND: Three dimensional echocardiography (3DE) enhances the diagnostic capabilities of cardiac ultrasound. This study was performed to determine the utility of 3DE for acquiring superior anatomical detail for Left sided Valvular and non Valvular Cardiac defects. During early 1990s, von Ramm et al developed the first real-time 3D (RT3D) echocardiography scanner, capable of depicting cardiac motion using volumetric data. METHODOLOGY: Fifty eight 3D transthoracic echocardiograms (TTE) and transesophageal echocardiograms (TEE) were performed during January 2012 and April 2013 at Akron Children Hospital, Heart Centre, with specific indication to evaluate left sided cardiac defects. Patient age range was 4 months to 34 years, with varying diagnoses. IE-33 Philips Medical Systems was used. For Transthoracic 3DE using both reconstruction methods and RT3D, following images were obtained; parasternal long, short axis, apical 4 chamber, Sub costal and particular emphasis on area of interest. Supra-sternal notch were obtained if indicated. For TEE 3DE component using both reconstruction methods and RT3D, following images were obtained; apical 4 chambers with 0 degree angle left 2 chambers with 120 degree angle and particular emphasis on area of interest. Live 3D and off-line reconstruction was performed. Image quality (IQ) 5-level score was employed. RESULTS: Out of 56 studies 24 (43%) were TEE and 32 (57%) were TTE. 3DE was technically feasible in 92% with TTE and 100% with TEE in our study. Time for 3D acquisition, reconstruction and measurement was available in 40 patients and was 8-15 minutes. In TTE studies where 3DE was technically feasible, anatomical detail of cardiac valves and chambers was delineated with the IQ score ranging from 4 to 5. CONCLUSION: 3DE demonstrates detailed cardiac anatomy and has the potential to significantly alter clinical decision-making. 3DE provides improved accuracy and reproducibility over 2D methods.

Biography:

Abstract:

Background and Objectives: Leukemic children face many obstacles that interfere with social activities and are at greater risk for neurocognitive dysfunction. This study aimed at highlighting the problems affecting quality of life in leukemic children given chemotherapy without irradiation. Methods: A Cross-sectional comparative study was conducted in 177 leukemic patients, with 281 subjects as a healthy control. All patients and control were subjected to thorough history and examination. Cognitive functions were examined using the Mini-Mental State Examination. Paediatric quality of life was measured using paediatric quality of life inventory version 4. Results: Health and activity, emotion, social relationship and school achievement were significantly impaired among leukemic children. Orientation, registration, attention, recall and language were adversely affected in leukemic children in comparison to healthy children. Conclusion: Neurocognitive function and quality of life in leukemic children treated with chemotherapy were significantly impaired as compared with the healthy group. Keywords: Leukemia; Children; Cognitive function; Quality of life;Egypt

Biography:

Abstract:

A high level of intensive physical training can be associated with structural and functional myocardial adaptation-the so-called athlete's heart. Despite the increasing involvement of child athletes in intensive training regimens, little is known about the influence of swimming training on right ventricular structure and function for child swimmer. Echocardiography is the tool of choice for the assessment of athlete's heart. The aim of this study was to assess right ventricular structure and function by echocardiography pre and after intensive swim training, 16 weeks,6 times per week,120 min per unit in male child swimmers. Methods: 15 elite child swimmer aged 11.46 years(+-.39),height 143.6 cm(+- 4.2), weight 39.4 kg( +-3.73), took part in intensive swim training. All subject underwent two-dimension-mode and Doppler echocardiography before and after swim training to evaluate right and left ventricular performance, ejection fraction, septal and posterior wall thickness. Statistical methods of SPSS, means+-SD, paired t test, percentage of improvement were used. Results: There was significant difference(p<0.01) and percentage improvement for all echocardiography parameter after swim training, the diastolic and systolic diameter and thickness of the right and left ventricular was incresed,interventricular septum and left ventricular mass significantly increased. Conclusions: Swim training is an effective sport activity to enhance"heart athletes' for children. Keywords: Athlete,s heart heart,right ventricular,ecochardiogrphy,Swim training.

Biography:

K L Ravi Kumar Prof. Emeritus-Microbiology is the Chief of Central Research Laboratory at the Kempegowda Institute of Medical Sciences at Bangalore and is also the Principal Investigator of the Pan India Distribution of Pneumococcal Serotypes (PIDOPS) Study. Dr. Kumar is recognized for his contributions to a number of projects and studies. He has supervised and guided more than 16 research projects. Dr. Kumar has done his MBBS from JJM Medical College in 1979, MD in Microbiology in1986 from BMC, Bangalore and has over 30 years of experience in teaching under graduate, post graduate students including mentoring Ph.D candidates.

Abstract:

Identification and continued monitoring of pneumococcal serotypes is needed to access vaccine efficacy, serotype replacement and to identify emerging new types. Presently available serological methods are expensive, labor intensive and prone to misidentification, while current molecular methods have limited serotype coverage, multistep and time consuming. In PCRSeqTyping method two step amplification and sequencing of cpsB and adjoining genes within the pneumococcal capsular locus is implemented. The assay was compared with conventional blood culture, qmPCR and Quellung reaction for its specificity and sensitivity. ply, lytA, pspA and spn9802 primers were used in qmPCR. 1504 blood and serum samples from children clinically suspected of Invasive Pneumococcal Disease with raised CBC, CRP, PCT and abnormal chest X-ray were subjected to testing. Conventional blood culture and qmPCR were positive in 7% and 30% samples respectively. PCRSeqTyping assay identified 456 serum samples positive for S.pneumoniae showing 100% correlation with qmPCR. The assay detected serotype of 456 qmPCR positive serum samples which included 108 culture positives and 348 culture negatives. The results showed 100% correlation with quellung test. Our study reveals the usefulness of PCRSeqTyping for direct detection and subsequent serotyping of S.pneumoniae from culture negative serum samples. An added advantage of this assay was the precise identification of the homologous types and detection of 91 specific serotypes. This simple, efficient PCR sequence based method with total serotype coverage will improve the accuracy of pneumococcal surveillance, identify non typeable and vaccine escape strains.