Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 10th Annual World Congress on Pediatrics, Pediatric Gastroenterology and Nutrition Orlando, Florida, USA.

Day 1 :

Pediatrics 2017 International Conference Keynote Speaker Steven J. Melnick photo
Biography:

Dr. Melnick earned his B.SC., Physics and Ph.D, Chemistry at McGill University and M.D. at Queen’s University. He completed his Pathology residency at Mount Sinai Medical Center, Miami Beach, FL and subsequently joined the Department of Pathology and Clinical Laboratories at Nicklaus Children’s Hospital where he serves as Department Chief. He directs research involving therapeutic development in cancer, immunology and metabolic disorders since 1999, published more than 85 papers in peer-reviewed journals and acquired intellectual property based on this research. He serves as an editorial board member of the Journal of Natural Products in Cancer Prevention and Therapy. 

Abstract:

Pediatric nutritional status assessment, typically reserved for children with overt clinical manifestation of nutrition-based disorders require comprehensive and time-consuming clinical and laboratory evaluation. However, many more children may be at risk for these disorders; long latency periods for clinical manifestation of primary and secondary (malabsorption, autoimmune, metabolic, genetic disorders and drug side-effects) nutritional deficiencies/insufficiencies and conditions related to over-nutrition, principally obesity and associated metabolic consequences. The latter form of malnutrition is complex and overlaps with conditions related to nutrient deficiency/insufficiency. Conventional nutritional evaluation is neither appropriate nor practical for the general pediatric population who are at risk for nutrition-based disorders. Given the scope of this societal health challenge, a more practical solution for recognizing children at risk for these disorders is beneficial. Such a screening tool must be evidence-based, easily administered and informative so that children with subtle manifestations of nutritional inadequacy or those at risk can be identified and directed to precise evaluation and nutritional/lifestyle interventions. This is the basis of the nutritional status screening panel known as the TOP™ (Test-Optimize-Perform) test. The panel addresses two principle categories of nutritional status; deficiency/insufficiency and nutrient metabolism. The analytes are; vitamin B12, folate, vitamin D, iron, ferritin, total cholesterol, HDL-c, Non-HDL-c, HbA1c, homocysteine, transthyretin, hs-CRP, GGT and ALT. The panel is designed to directly or indirectly assess nutrient or micronutrient inadequacies and nutrition-acquired metabolic disorders as suggested by analytes that reflect lipid and carbohydrate metabolism, protein status, inflammation/oxidative stress, insulin resistance and mitochondrial dysfunction. Details of the rationale are presented.

Keynote Forum

Rodrigo Vianna

Miami Transplant Institute, USA

Keynote: Multivisceral Transplantation: Where do we stand?
Pediatrics 2017 International Conference Keynote Speaker Rodrigo Vianna photo
Biography:

Dr. Rodrigo Vianna is the Director of the Miami Transplant Institute since January 2013.  Prior to this, he has been the Director of Intestinal/Multivisceral transplant at Indiana University, where, under his direction, the intestinal and Multivisceral transplant program has become the largest and most successful program in the world. He continues to perform a large number of liver transplants and to take care of these patients. His stamina, energy and commitment will continue to equip him for a life of achievements He is fully committed to this project as he believes its successful implementation will lead to better understanding of immunosuppression-related complications such as EBV infection and PTLD and most importantly will lead to improved outcomes for our patients.

Abstract:

Keynote Forum

Michael J. Wilsey

USA

Keynote: Cholestasis Beyond the Neonatal and Infancy Periods

Time : 11:00-11:40

Pediatrics 2017 International Conference Keynote Speaker Michael J. Wilsey photo
Biography:

Dr. Wilsey graduated from the University of Miami School of Medicine and completed residency training in Pediatrics and fellowship training in Pediatric Gastroenterology, Hepatology, and Nutrition at Texas Children's Hospital and the Baylor College of Medicine in Houston, Texas. He is a Clinical Associate Professor of Pediatrics at the University of South Florida College of Medicine and currently serves as vice-chairman of the Department of Pediatric Gastroenterology at Johns Hopkins All Children's Hospital in St. Petersburg, Florida. Dr. Wilsey is the Past-President of the Hillsborough County Pediatric Society and the former Florida Region V Representative for the American Academy of Pediatrics (AAP). Dr. Wilsey is a reviewer for several medical journals and has won numerous awards for teaching excellence. Dr. Wilsey is a member of a prospective, multicenter endoscopic database initiative designed to evaluate indications and technical outcomes of ERCP in pediatric patients at 14 national and international centers.

Abstract:

Cholestasis results from impairment in the excretion of bile, which may be due to mechanical obstruction of bile flow or impairment of excretion of bile components into the bile canaliculus. When present, cholestasis warrants prompt diagnosis and treatment. The differential diagnosis of cholestasis beyond the neonatal period is broad and includes congenital and acquired etiologies. It is imperative that the clinician differentiates between intrahepatic and extrahepatic origin of cholestasis. Treatment may be supportive or curative and depends on the etiology. Recent literature shows that optimal nutritional and medical support also plays an integral role in the management of pediatric patients with chronic cholestasis. This review will provide a broad overview of the pathophysiology, diagnostic approach, and management of cholestasis beyond the neonatal and infancy periods.

  • General Pediatrics Neonatology and Perinatology Pediatric Cardiology Pediatric Neurology Pediatric Endocrinology Pediatric Gastroenterology

Session Introduction

Sridevi Pandya Shah

Rutgers University-New Jersey Medical School, USA

Title: Anesthesia and developing brain...what is the risk..

Time : 12:00 - 12:25

Speaker
Biography:

Shridevi Pandya Shah MD. She is a board certified anesthesiologist with subspecialty expertise in pediatric anesthesiology in practice for more than 15 years. She has had many presentations at both national anesthesia and pediatric anesthesia professional meetings. She is currently an Assistant Professor at Rutgers, NJMS and has made contributions related to pediatric anesthesia in several professional journals.

Abstract:

Almost half a million babies are born prematurely (< 37 weeks gestation) e ach year in the United States. Preterm infants are subject to hospitalization, and surgery is often required to sustain life. Anesthesia for obstetric and pediatric surgery is unavoidable as pregnant mothers and newborn infants with life-threatening conditions can require surgery or prolonged stay in the intensive care unit. Although, brain development begins during the last trimester of intrauterine life, the human brain is not fully developed at birth and continues to grow over the first couple of years of postnatal life.

The delayed effects of anesthetics are not well known because potential interventions cannot be studied directly in humans. Given current findings, the Federal Drug Agency (FDA) has provided preliminary recommendations stating that, if possible, anesthesia should be postponed until the child is at least 6 months of age. Consequently, there exists a need for ongoing research to further elucidate safer anesthetic agents and techniques.

Herewith, I would like to bring up topics of concern when children are exposed to anesthetics, when they are considered vulnerable to toxic effects of anesthesia.

Speaker
Biography:

Dr. Nena Luster-Tucker is an educator with over 16 years of experience in nursing. Since beginning her nursing career as a LPN, she has earned her BSN, MSN with a Family Nurse Practitioner concentration, post-master’s certificate in nursing education, DNP and MBA. Dr. Luster has published a number of journal articles, authored textbook chapters, and presented both nationally and internationally. Currently, she is an assistant nursing professor at Southeastern Louisiana University and the interim director of the university's Center for Faculty Excellence. Dr. Luster's clinical practice is as a nurse practitioner in an inner-city emergency department.

Abstract:

Initially founded to serve those with unexpected, life-threatening illnesses, emergency departments across the country now care for a variety of patients including those without urgent medical conditions. With doors that never close and providers who administer care without regard to ability to pay, the emergency department has become the "safety net" of medicine. This "safety net" is especially important for vulnerable populations such as pediatrics. In addition to traditional emergency conditions, pediatric patients often have limited communication skills, lack of established immunity, minimal health histories, and are at the mercy of their caregivers. The combination of these factors increase the risk for developing unexpected health care needs and the emergency department is the only solution that is available whenever a problem occurs. Emergency departments provide critical healthcare services but they do not provide the same degree of comprehensiveness as primary care providers. Patients and caregivers may believe care is complete when they leave the emergency department but in reality, this is where care actually begins. It is the responsibility of providers, nurses, case managers, educators, and all members of the interdisciplinary team to ensure appropriate follow up care and continuity following an emergeny department encounter. To facilitate this practice amongst healthcare practitioners, this session will discuss the history of the emergency department, standard emergency department resources, standards of care, pediatric preventative health, legal requirements, and best practices.

 

Jyoti Bhagia

Mayo Clinic, USA

Title: ADHD- Diagnostic and Treatment Challenges

Time : 12:50-13:15

Speaker
Biography:

Jyoti Bhagia, M.D., is a Consultant in the Division of Child and Adolescent Psychiatry and Psychology in the Department of Psychiatry & Psychology at Mayo Clinic. Dr. Bhagia serves as the director of the ADHD Clinic at Mayo, where she oversees the treatment of pediatric patients diagnosed with ADHD and related disorders.  She has led quality projects for standardizing the assessment and treatment of ADHD and had received certificate of silver level quality fellow by Mayo Clinic. She is a member of several Mayo Clinic committees including, the Child and Adolescent Psychiatry Education Committee and the Multidisciplinary ADHD Workgroup. Dr. Bhagia’s research is focused on areas including the response to stimulant medications in children with ADHD based on genotype and clinical correlation of ferritin with ADHD. Dr. Bhagia has published articles in Mayo Clinic Proceedings, Therapeutic Drug Monitoring and Global Pediatric Health.  She has written a book chapter in Mayo Neurology Board Review.

Abstract:

ADHD is the most common Neuropsychiatric disorder, affecting 4-7 % of children. Diagnosis of ADHD is done through a clinical interview and the use of ADHD specific rating scales. Diagnosis is challenging in many cases, as presentation is different in different age groups, including in preschool, school age and adolescent children. ADHD also presents with symptoms in two settings, including home and school, and it is very important to address the disorder in both settings. With ADHD, there are many cases where symptoms are present in one setting and other disorders need to be ruled out first. Additionally, there are co-morbid disorders which may change the presentation of ADHD and may need to be addressed separately. For example, diagnosis of Oppositional Defiant Disorder is missed on many occasions and needs to be treated. Furthermore, it is important to tease out ADHD symptoms from learning disabilities and cognitive disorders in children presenting with academic concerns at school. In this talk, the method of using rating scales for ADHD diagnosis will be presented. Treatment of ADHD, particularly the algorithm used for such treatment, will also be discussed. With ADHD, there are many treatment challenges based on age of patient, co-morbidity and medical/neurological problems. When to use short versus long acting medications, and how to address treatment emergent side effects will be discussed.

Avraham Avital

Hadassah University Hospital, Israel

Title: Safety of lipid emulsion in very low-birthweight infants according to cytokine level

Time : 14:15-14:40

Speaker
Biography:

Medical school at Hadassah University Hospital, Jerusalem, Israel. Pediatric Residency and Pediatric Pulmonary training at Hadassah Institute of Pulmonology, Jerusalem  and Health Science Center, at Winnipeg, Canada. My main interest in the last two decades is in the diagnosis of asthma and its differentiation from other chronic respiratory diseases and aspiration syndromes, using specific bronchial challenges for asthma and the PCWheeze method to challenge young children who are unable to cooperate with regular lung function tests. The connection of feeding position of infants with upper and lower airways problems has lately been challenged.

Abstract:

Statement of the problem: Otitis media and respiratory tract infections are major causes of morbidity in infants and young children. The influence of feeding position of the infant in the pathogenesis of ear and airway diseases has not been well established. Methodology: We investigated the influence of instructing mothers to feed their 3-month old infants with their head in an upright position on infant ear and respiratory morbidity during a one-year follow-up. Mothers of 88 infants born during 2011 were instructed by trained nurses at Maternal-Child-Health clinics to feed their infants with their head in upright position (intervention group). The control group consisted of 75 mothers of infants of similar socioeconomic background who fed their infants regularly without any special instructions and were followed at another Maternal-Child-Health clinic. Feeding position was evaluated at the beginning and the end of the twelve-month study, and morbidity data of both groups were evaluated at every 3-month follow-up meeting. Findings: Infants from the intervention group were fed at a more upright head position and had significantly less episodes of ear diseases, less respiratory infections, less episodes of prolonged fever and needed less bronchodilator inhalations and antibiotic courses than infants from the control group.  Conclusions and significance: Instructing mothers to feed infants with their head in upright position led to less morbidity and treatment burden. The successful campaign against prone position of infants during sleep to prevent "Sudden Infant Death           Syndrome" could be reinforced to “back to sleep and up to eat”.

Nabil A Badawy

College of Nursing,Public Authority for Applied Education and Training, Kuwait

Title: Kuwaiti parents’ knowledge of their children’s fever and their patterns of use of Over the Counter Antipyretics

Time : 14:40-15:05

Speaker
Biography:

Dr  Nabil Kamal M.D, had his Docotor degree from faculty of medicine ,Alexanderia university in Egypt.Current position is Acting Dean of the college of nursing ,which is one of 5 colleges belonging to the public authority for applied education and training in Kuwait.Intersted in reseraches about the konwledge and attitude of the public in kuwait regarding OTC drugs as a step for establishing educational programs.         
 

Abstract:

BACKGROUND: Many parents consider fever a disease with the continuation of fever phobia and overuse of antipyretics to reduce it.

OBJECTIVES: Identifying Kuwaiti parents’ knowledge, beliefs, practices about fever management.

METHODS: A descriptive cross-sectional study, in which 614 Kuwaiti mothers of well children aged between 6 months and five years were recruited. Data was collected over six month’s period from 1/9/2015 to 1/3/2016, using a self-administered questionnaire.

RESULTS: Over the study period, a total of 614 mothers participated in the study, with a response rate of 94.5%. Mild fever was reported to be ≤ 37.5 °C by 33.2 %(196) of mothers, and 27.1 %(166) considered a temperature ≤ 38.5 °C to be a high fever. Educational attainment significantly influenced parents’ reports for high fever (F = 4.68, d.f. = 4, P = 0.001, n = 207). Almost all the mothers believed that fever could cause harm, and 48%(294) of them stated that fever is very harmful. Fifty-three percent of mothers (n=309) would give antipyretic medication when body temperature is ≤38 °C. The most commonly administered antipyretic was paracetamol. Sixty-one percent (375) of the mothers had alternated antipyretic paracetamol and ibuprofen. Forty-five percent (274) of mothers thinks that antipyretics are without potential harm. Level of education had a positive impact on the perception of fever [ χ2 (df = 8) = 70.68, p < .001]. Usual practices targeted temperature reduction, antipyretic administration (53.7%), temperature monitoring (49.7%), offering more fluids (43.6%) and light clothing (38. 3%). Forty-nine and 45% of the mothers practiced alcoholic and cold compresses respectively.

CONCLUSION: The knowledge of the parents about fever is poor. Fever phobia” remains extremely widespread, with an overuse of antipyretics. Healthcare professionals have a duty of care to provide parents with accurate and consistent information about childhood fever based on the latest scientific evidence.

Speaker
Biography:

Adel Abdullah Alhusaini is an assistant professor in Rehabilitation department, College of Applied Medical Sciences at King Saud University, Riyadh, KSA. He has obtained his master’s degree in in Physiotherapy from Cardiff University, Cardiff, UK (2005). Also, he has obtain PhD in Pediatric Neurorehabilitation from School of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia (2010). He has published More than 15 peer-reviewed publications and one book published. Chairman of Pediatric Neurorehabilitation Research group at KSU. Presently working on the KACST project regarding sedentary behavior characteristics and physical activity levels in children of Saudi Arabia.

Abstract:

Statement of the Problem: During the past few years’ rapid developments in standards of living, mechanization and urbanization has a profound impact in the Kingdom of Saudi Arabia resulting in low physical activity and high sedentary behavior. Therefore, the purpose of the research is to provide normative data of physical activity and sedentary behavior indices of the Saudi Arabian school children in relation with BMI. Methodology: This school-based cross-sectional study was conducted during the years 2015-2016 in Riyadh. A total of 357 children (boys-82, girls-275), within an age group of 10-16 years, from different schools of central Riyadh constituted the sample. Measurements included weight, height, sedentary behaviors (TV viewing, playing video games, computer use and homework), and physical activity using Physical Activity Questionnaire for Children (PAQ-C), and Godin and Shephard questionnaires. Findings: The proportion of total sample (357), with boys comprising of 82 (23%) and girls of 275 (77%). The sample proportion stratified based on percentile of body weight constituted of 5.3% of underweight (19), 54.6% of normal (195), 18.8% of overweight (67) and 23% of obese (76) children. A high proportion (68.3%) of Saudi school children spent more than 2 hours on screen time (TV+PC) daily. PAQ-C reported 26.3% are less active, 51.5% are moderately active and 22.1% are highly active. Using ANOVA, no significant variation was shown in PAQ-C scores in relation to BMI. PA findings by Godin and Shephard questionnaire concluded that 70.3% are insufficiently active, 20.4% are moderately active and 9.2% are active. Analysis done by Kruskal-Wallis test showed significant difference observed in Godin moderate scores (P = 0.01) and total scores (P = 0.03) but not in other subcategories (strenuous, mild, Sweat) in relation to BMI. Conclusion & Significance: Sedentary behaviors, physical inactivity and increased BMI among Saudi school children is a major public health concern. There is an urgent need for national policy promoting active living and healthy eating and reducing sedentary behaviors among children in Saudi Arabia.

Speaker
Biography:

Ganeswara Rao Melam is a Researcher in Rehabilitation department, College of Applied Medical Sciences at King Saud University, Riyadh. Formerly, he worked as Associate Professor and Head of Physiotherapy Department at Maharishi Markandeshwar University, Ambala, India. He has obtained his master’s degree in Physiotherapy (Neurology) from Hamdard University (2004), New Delhi, India. He has published 24 international articles, and an active member of pediatric research group under the leadership of Dr Adel A Alhusaini. Presently working on the KACST project regarding sedentary behavior characteristics and physical activity levels in children of Saudi Arabia.

Abstract:

Statement of the Problem: Handwriting problems in childhood can have lifelong repercussions, affecting learning and career. Sensorimotor(SM) intervention therefore helps to alleviate these problems. The purpose of this study was to evaluate the additive effects of SM intervention on the child’s handwriting. Research questions involved the possible effects of the intervention on specific qualities of handwriting (legibility, form, alignment, size, and spacing) and on speed. Secondary research questions involved possible effects of training in teacher assessment using the HPSQ and grip strength. Methodology: Thirty-one students (16 boys, 15 girls) were screened using Minnesota Handwriting Assessment (MHA) to assess legibility, form, alignment, size, and spacing (the primary variables) as well as rate. Finally, 10 students (seven boys, three girls) aged 6–8 years (mean age, 77.1 _ 1.45 months) participated in an intervention program. Baseline MHA, Handwriting Proficiency Screening Questionnaire (HPSQ), and grip strength were measured. The same group of students acted as their own controls and were analyzed before the interventions and later after completion of the protocol. The SM-based intervention group met twice per week (Monday and Wednesday) from 11:45 am to 12:35 pm for 5 weeks during regularly scheduled school hours. Each 40 min session consisted of 10 min of gross and fine motor warm-up activities, followed by 30 min of SM component activities in visual perception, visual–motor integration, proprioception/kinesthesia, and in-hand manipulation. Findings: There was a significant improvement in MHA scores for legibility, form, alignment, size and spacing (P <0.05), with the exception of rate. There were also significant changes in legibility, time performance and physical and emotional wellbeing domains in the HPSQ, and grip strength (P < 0.05, paired t-test).Conclusion & Significance: Short-term sensorimotor-based intervention produced significant improvements in the handwriting performance of elementary school children.

Speaker
Biography:

Syamala Buragadda received her master’s in 2005 from Dr.NTR University of Health Sciences (India).  In 2011 she moved to King Saud University (KSA) to work as researcher. Her work has been highly influential in Women’s health and Pediatrics and has been referenced several times. She held a fellowship Diploma in Clinical Rehabilitation-London Academy of Sports and Health Sciences, UK. Her current research interests include the Obesity, physical activity, maximum walking speed, sedentary behavior and academic performance in Saudi school children and Fear avoidance beliefs and health literacy among Saudi women with chronic low back pain. This research is currently changing the way of physical inactivity and sedentary behaviors, with particularly promising results in physical activity among children and women.  She has published 24 international articles, and an active member of pediatric research group and quality committee in the Rehabilitation department of King Saud University.

Abstract:

Statement of the Problem: Handwriting problems in childhood can have lifelong repercussions, affecting learning and career. Sensorimotor(SM) intervention therefore helps to alleviate these problems. The purpose of this study was to evaluate the additive effects of SM intervention on the child’s handwriting. Research questions involved the possible effects of the intervention on specific qualities of handwriting (legibility, form, alignment, size, and spacing) and on speed. Secondary research questions involved possible effects of training in teacher assessment using the HPSQ and grip strength. Methodology: Thirty-one students (16 boys, 15 girls) were screened using Minnesota Handwriting Assessment (MHA) to assess legibility, form, alignment, size, and spacing (the primary variables) as well as rate. Finally, 10 students (seven boys, three girls) aged 6–8 years (mean age, 77.1 _ 1.45 months) participated in an intervention program. Baseline MHA, Handwriting Proficiency Screening Questionnaire (HPSQ), and grip strength were measured. The same group of students acted as their own controls and were analyzed before the interventions and later after completion of the protocol. The SM-based intervention group met twice per week (Monday and Wednesday) from 11:45 am to 12:35 pm for 5 weeks during regularly scheduled school hours. Each 40 min session consisted of 10 min of gross and fine motor warm-up activities, followed by 30 min of SM component activities in visual perception, visual–motor integration, proprioception/kinesthesia, and in-hand manipulation. Findings: There was a significant improvement in MHA scores for legibility, form, alignment, size and spacing (P <0.05), with the exception of rate. There were also significant changes in legibility, time performance and physical and emotional wellbeing domains in the HPSQ, and grip strength (P < 0.05, paired t-test).Conclusion & Significance: Short-term sensorimotor-based intervention produced significant improvements in the handwriting performance of elementary school children.

Kumiko Taira

Tokyo Women’s Medical University Medical Center East, Japan

Title: May neonicotinoid insecticide cause neurodevelopmental disorder by environmental exposure?

Time : 15:55-16:20

Speaker
Biography:

Dr. Kumiko Taira received her medical degree from Kobe University in 1982. Since 2001, she has been involved in studying the effects of environmental exposure of organophosphates and neonicotinoids on the human health in collaboration with Dr. Yoshiko Aoyama in Gunma, and published eleven academic articles.Dr. Taira is a part-time lecturer at the Department of Anesthesiology at Tokyo Women’s Medical University Medical Center East, a part-time lecturer at the Department of Environmental Education at Tokyo Kasei University, a board member of the Japanese Society of Clinical Ecology, and the chair of the Public Health working group of IUCN Task Force on Systemic Pesticides.

Abstract:

In 2004, we started to study the health effect of neonicotinoid insecticide (neonic), because we encountered many patients with unusual symptoms including chest pain with ECG abnormality after a neonic spraying application. Neonics were water systemic pesticide introduced to global market in 1990’s as alternatives of organophosphate insecticide.

 In 2006, neonic spraying application was discontinued, whereas we met a large-scale pandemic of patients with similar symptoms. All of them had became ill after consecutive intake of tea beverages and/or conventional domestic fruits. We started chemical analysis of patients’ urine from 2007, and detected some neonicotinoid metabolites in their urine.

Then we conducted a prevalence case control study prospectively, and analyzed urinary neonics and a metabolite, N-desmethyl-acetamiprid (DMAP). DMAP and thiamethoxam were more detected significantly from the group of patients with typical symptom named neo-nicotinic symptoms including 6 subjective symptoms, i.e. headache, general fatigue, chest pain or palpitation, stomachache, muscle pain or weakness or spam and cough, and 3 objective symptoms, i.e. postural tremor, recent memory loss, and fever.

 Last year, a small-scale epidemiological study in Japan revealed that the detection rate of neonics were increasing linearly in these 20 years, although the domestic shipment has not changed in imidacloprid, acetamiprid, and nitenpyram. Laboratory data show human excretion half life in urine is approx. one and half day for DMAP and imidacloprid. Animal data show neonics accumulate in brain, affect on developing neuron, and cause neurodevelopmental disorders. Acceptable dose of intake of neonics seems to be not low enough, if those data were applied.

 

Inge Pauwels

University Children’s Hospital Brussels - Free University of Brussels, Belgium

Title: Vestibular modifications in deaf children after sequential implantation

Time : 16:40-17:05

Speaker
Biography:

Inge Pauwels has a Masters Degree in Audiology and Speech Therapy from Ghent University and is head of the Audiology department at the University Children’s Hospital Brussels. Since 2012 they have developed  a Vestibular Evaluation Department for young children in this hospital and their first research was recently published in European Annals of Otorhinolaryngology.



 

Abstract:

An early acquired or congenital  absence of sensory input of the vestibule will lead to severe delayed posturomotor milestones. Previous studies have proven modifications and even complete ipsilateral loss of vestibular function after unilateral cochlear implantation.

The objective of this study was to evaluate whether sequential cochlear implantation has an impact on vestibular function.

Methods: Retrospective study from January 2012 to January 2015 including 26 patients. The first stage consisted of determining the vestibular status of 26 hearing impaired children who were candidates for a second cochlear implant. Three months after contralateral implantation we reevaluated the vestibular function of the same patients. The vestibular evaluation consisted of multiple tests for canal and otolith function. A complete clinical vestibular evaluation was performed, including the head thrust test. This was followed by an instrumental assessment composed of the classic bicaloric test and vestibular evoked myogenic potentials testing with tone bursts.

Results: A high prevalence of vestibular dysfunction (69%) was found in our  group of unilaterally implanted children. Three patients had a unique functional vestibule at the not yet implanted ear. Vestibular evoked myogenic potentials responses stayed present in 15 of the 19 patients with a VEMP-response before contralateral implantation. Results of the caloric test changed for 6 patients  after contralateral implantation.

Conclusions: After contralateral implantation nearly 40% of our patients manifested modifications of their vestibular status. Intrasubject comparison of bicaloric and vestibular evoked myogenic potentials testing before and after contralateral cochlear implantation showed that canal function was better preserved than saccular function.

Seeing the high prevalence of vestibular dysfunction in our test group of unilateral implanted children, sequential implantation must be preceded by a vestibular assessment to prevent complete bilateral vestibular areflexia and its potential consequences. Presence of hyporeflexia at the yet-to-be implanted ear seems to be a situation particularly at risk.   

 

Benoit Devroede

University Children’s Hospital Brussels - Free University of Brussels, Belgium

Title: Vestibular modifications in deaf children after sequential implantation

Time : 16:40-17:05

Speaker
Biography:

Benoit Devroede received his Medical Degree in 1998 from the Free University of Brussels, Belgium and has accomplished his ENT residency at the Academic Medical Centre of this University (Erasme Hospital). He is head of the Vestibular Evaluation Department at the University Children’s Hospital Brussels. His clinical and research interests include Otoneurology and Laryngotracheal stenosis treatment in children.

Abstract:

An early acquired or congenital  absence of sensory input of the vestibule will lead to severe delayed posturomotor milestones. Previous studies have proven modifications and even complete ipsilateral loss of vestibular function after unilateral cochlear implantation.

The objective of this study was to evaluate whether sequential cochlear implantation has an impact on vestibular function.

Methods: Retrospective study from January 2012 to January 2015 including 26 patients. The first stage consisted of determining the vestibular status of 26 hearing impaired children who were candidates for a second cochlear implant. Three months after contralateral implantation we reevaluated the vestibular function of the same patients. The vestibular evaluation consisted of multiple tests for canal and otolith function. A complete clinical vestibular evaluation was performed, including the head thrust test. This was followed by an instrumental assessment composed of the classic bicaloric test and vestibular evoked myogenic potentials testing with tone bursts.

Results: A high prevalence of vestibular dysfunction (69%) was found in our  group of unilaterally implanted children. Three patients had a unique functional vestibule at the not yet implanted ear. Vestibular evoked myogenic potentials responses stayed present in 15 of the 19 patients with a VEMP-response before contralateral implantation. Results of the caloric test changed for 6 patients  after contralateral implantation.

Conclusions: After contralateral implantation nearly 40% of our patients manifested modifications of their vestibular status. Intrasubject comparison of bicaloric and vestibular evoked myogenic potentials testing before and after contralateral cochlear implantation showed that canal function was better preserved than saccular function.

Seeing the high prevalence of vestibular dysfunction in our test group of unilateral implanted children, sequential implantation must be preceded by a vestibular assessment to prevent complete bilateral vestibular areflexia and its potential consequences. Presence of hyporeflexia at the yet-to-be implanted ear seems to be a situation particularly at risk.   

 

Speaker
Biography:

Go Ichikawa has completed his PhD at the age of 33 years from Dokkyo Medical University. He is the director of Pediatrics department at Nasu Red Cross Hospital.

Abstract:

Background】The aim of this study was to verify whether lipid emulsion treatment aggravates infection and inflammation in very low-birthweight (VLBW) infants.【Study design】Very low-birthweight (<1500 g) infants born at <32 weeks gestational age between October 2013 and October 2014 at Dokkyo Medical University Hospital (Mibu, Tochigi, Japan) were treated with or without i.v. nutrition with a lipid emulsion. Infants were excluded who had congenital abnormalities, could not receive i.v. nutrition because of poor general condition, or on physician decision. Lipid emulsion with purified soybean oil was initiated at 0.5 g/kg/day on postnatal day 1. The dose was increased to 1 g/kg/day, and then to 1.5 g/kg/day (maximum dose). Blood tests were performed before (day 1) and after (day 8) initiation of lipid emulsion treatment. Interleukin (IL)-6, IL-8, monocyte chemotactic protein 1 (MCP-1), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), total bilirubin (T-Bil), direct bilirubin (D-Bil) and insulin were measured. Changes in respiratory condition, amount of oxygen used, and phototherapy duration were investigated.【Results】A total of 17 treated and 15 untreated VLBW infants were enrolled. IL-6, IL-8, MCP-1, TNF-α, CRP, T-Bil, D-Bil and insulin on days 1 and 8; respirator or surfactant use; amount of oxygen used; and phototherapy duration were not significantly different between the two group.【Conclusions】Lipid emulsion treatment did not increase inflammatory cytokine levels or aggravate respiratory disorders. Lipid emulsions, if proven safe, could be used to treat VLBW infants soon after birth, which may prevent extrauterine growth restriction and improve intellectual development prognosis.

 

Nagwa A Meguid

National Research Centre, Egypt

Title: Dietary adequacy of Egyptian children with autism spectrum disorder

Time : 17:55-18:20

Speaker
Biography:

Nagwa A Meguid is a Professor of Human Genetics, National Research Centre, Egypt. She is a fellow at Uppsala University, Sweden and Yale University, USA. She has authored and co-authored 100 publications. She has used her expertise to identify and describe several novel recessive genes and genetic syndromes. She is working with Neurodevelopmental disorders, where she participated in  determining the spectrum of gene mutations causing common genetic disorders in Egypt. She is a Member in Regional Bio-Ethics Society of UNESCO. She has been awarded for Africa & Middle East UNESCO/L’Oreal, 2002.

 

Abstract:

Although the etiology and pathology of Autism Spectrum Disorder (ASD) is still poorly understood, a number of environmental, neurobiological and genetic factors have been related to the pathophysiology of ASD. Investigations about a reliable relationship between diet and ASD are still lacking. The present study aimed at comparing dietary regimens and habits of normally developing apparently healthy children, without diagnosed ASD, with a pediatric population of individuals affected by autistic disorder. Assessments of nutritional and anthropometric data, in

addition to biochemical evaluation for nutrient deficiencies, were performed. A total of eighty children with autistic disorder and eighty healthy, normally developing pediatric individuals were enrolled in the study. Parents were asked to complete the standardized questionnaire regarding the different types of food and the proportion of a serving for their children. Biochemical analysis of micro- and macronutrients were also done. Plotting on the Egyptian sex-specific anthropometric growth chart, absolute weights as well as weight-related for age classes, were significantly higher in cases than controls. A total of 23.8% of children with autistic disorder vs. 11.3% in the healthy control group had a nutrient intake below the Recommended Dietary Allowance (RDA) of protein. Children with autistic disorder showed low dietary intake of some micronutrients; calcium (Ca), magnesium (Mg), iron (Fe) and selenium (Se) and had significantly high intake of potassium (K) and vitamin C compared to controls. Serum Mg, Fe, Ca, and vitamin B12 in autistic children were significantly low compared with healthy children. Significant positive correlations between serum Mg, Fe, Ca, vitamin B12 and their levels in food were present. These results confirmed that different nutritional inadequacy was observed in Egyptian children with autistic disorder. The evidence reported in the present study should recommend screening of the nutritional status of ASD children for nutrient adequacy to reduce these deficiencies by dietary means or by administering appropriate vitamin and mineral supplements. Nutritional intervention plan should be tailored to address specific needs.