3^rd International Conference on Pediatrics May 18-20, 2015 Texas, San Antonio, USA

Biography:

Guillermo Godoy graduated from San Carlos University in Guatemala, the only Medical School at that time in Guatemala. He did a residency in Pediatrics at Roosevelt Hospital and again when he came to United States of America, he repeated a Pediatrics residency at The University of Arkansas Medical Sciences/Arkansas Children's Hospital from 1980 to 1982. Then he did his Perinatal Medicine-Neonatology fellowship at The University of Alabama in Birmingham from 1982 to 1985 and stayed on the Neonatology staff for one year. He is in Tuscaloosa, Alabama at the DCH Health System NICU's since 1986. He is an Associate Professor of Pediatrics and Obstetrics at The University of Alabama, Tuscaloosa. He was Chairman of the Pediatrics Department and the Chief of Medical Staff. He helped to establish the Ethics Committee at the DCH Health System Hospitals in 1987. He published many manuscripts, especially in the areas of neonatal infections and cardiopulmonary pathophysiology. He have been invited to lecture about these topics in several institutions. He is actively involved in the development of CPOE/EMR and electronic progress notes at his institution.

Abstract:

Before we tackle the specific clinical problems and situations in the neonatal population, I will highlight the principles and most common thoughts to deal with them in an appropriate, systematic and standardized manner. The Ethical problems in the Neonatal Intensive Care setting have increased as the therapies and procedures have become more invasive, more technical and more expensive. The ethical dilemmas vary depending on the population studied. We will discuss these factors that individualize how we make decisions in the NICU.

Biography:

Abstract:

BACKGROUND: Catheter-associated Candida bloodstream infections are a common and serious problem in Newborn Intensive Care Units (NICU). Several prophylactic regimens have been developed including oral administration of non-absorbable antifungals and intravenous infusions. No reports to date have employed a topical regimen. PURPOSE: To evaluate the effectiveness of topical nystatin cream in reducing catheter-associated Candida sepsis. STUDY DESIGN: A retrospective descriptive design was used to determine the incidence of Candida sepsis in Extremely Low Birth Weight (ELBW, <1000 grams at birth) infants who were treated with topical nystatin cream for Candida bloodstream infection prophylaxis between January 1, 2000 and December 31, 2010. The electronic medical records of all infants less than 1,000 grams admitted to the study NICU were reviewed to establish the incidence of Candida sepsis. RESULT: 464 ELBW infants were admitted to the NICU during the study period. Three infants (0.65%) developed Candida sepsis. CONCLUSIONS: These data demonstrate that a topical nystatin cream protocol is associated with a very low rate of Candida sepsis in ELBW infants with central catheters. Use of this protocol may contribute to a decrease in the morbidity and mortality associated with catheter-associated Candida infections in ELBW infants.

Biography:

Andrea Cevasco-Trotter is the Director of Music Therapy and an Associate Professor at The University of Alabama. She researches the effects of developmental music therapy interventions on premature infants’ physiological and behavioral parameters. Dr. Cevasco’s work has been published in the Journal of Music Therapy, Music Therapy Perspectives, and Pediatric Nursing; recently, she has published several textbook chapters. She serves as a member of the Editorial Committee for the Journal of Music Therapy and Music Therapy Perspectives as well as on the Board of Directors for the Certification Board for Music Therapists.

Abstract:

Premature infants in the Neonatal Intensive Care Unit (NICU) are exposed to loud noises, bright lights, and medical procedures that inhibit necessary sleep for neurological growth and development. Since the 1990s, researchers found that music assists in pacifying infants. The purpose of this presentation is two-fold: 1) to describe evidence-based music therapy protocols that are designed to meet the developmental needs of premature infants in the NICU and provide positive outcomes, and 2) to describe the outcomes of a research study involving a developmental music therapy program, based on existing protocols, to enhance and expand music therapy services for infants in the NICU. This study was especially novel in that infants as young as 25 weeks post corrected age (PCA) received live music, recorded music was utilized once infants were 30 weeks and older, and music and multimodal stimulation (MMS) was implemented for infants once they were 32 weeks and older. Infants in the experimental group went home earlier 3.6 days sooner than infants in the control group; experimental infants weighing less than 1500 gram went home 13 days earlier than those in the control group. Analysis of oxygen saturation levels and heart rate prior to, during, and post music therapy indicate positive trends. Special emphasis will be placed on how music therapist can meet the needs of very low and extremely low birth weight infants.

Biography:

Abstract:

Background: Respiratory distress syndrome (RDS) is the major cause of neonatal respiratory distress. RDS results from lung immaturity in pre-term infants as a result of surfactant deficiency and is associated with increased morbidity and mortality among this population. Purpose: Update neonatal providers on advancements in surfactants for the management of RDS. Objectives: Review latest primary literature for natural and synthetic surfactants indicated for the management of RDS. Discuss efficacy and safety data for the pipeline surfactants, aerosolized KL4 surfactant (AEROSURF®) and lyophilized KL4 surfactant (SURFAXIN LS™), currently in early phase clinical trials. Discuss the variances in delivery methods and neonatal tolerance among natural and synthetic surfactants and possible advantages offered by these pipeline surfactants.

Biography:

Ann Misra has a passion for the role she plays in healthcare. She recently received her hospital’s prestigious Excellence Award which the administrator presents to one nurse at her hospital every six months after being nominated by their peers.! ! Ann graduated with her nursing degree from Georgia Southwestern State University in 1991. A member of the Gamma Beta Phi Honor Society she served as President of the college’s chapter of the National Student Nurses Association and Student Representative at Faculty Meetings. Upon graduation she received both the Faculty Award and the Best All-Around Nursing Student Award.! By choice, Ann has always worked night shift with neonates. She received her certification in Neonatal Intensive Care Nursing in 2000, has served on a transport team, been a NRP Instructor, charge nurse, preceptor, mentor and chaired the journal club which she initiated in her unit.! ! Ann is eager to share her perspective on bedside nursing in her Level 3 NICU located in west central Alabama. She will share tips and suggestions which can make your interactions with bedside nurses more productive and meaningful.!

Abstract:

Neonatal Nurse bedside approach to the sick neonate: Physical Examination: Systems review and monitoring: Signs and symptoms. Coordination of multidisciplinary teams care: RT, Radiology, PT/OT, Child Life and consultations. Laboratories and procedures coordination. Neurodevelopmental: Enviroment. Stimulation. Feedings. Cluster Care. Kangooro Care. Social issues: Parents, guardians bonding. Breast feeding. Siblings. Teaching. Identification of social, family problems, issues. Social services coordination and plan development.

Biography:

Anita Berry received her Masters Degree in Advance Practice Nursing from DePaul University a certificate in Infant Mental Health from Erikson Institute, a certification as a Pediatric Nurse Practitioner from RUSH University, and has a Certification in Pediatric Primary Care Mental Health from the Pediatric Nursing Certification Board. She is the director of the Healthy Steps Program at Advocate Children’s Hospital, the largest network provider of pediatric services in Illinois and among the top 10 in the nation. She has spoken at numerous national conferences and published articles in several journals.

Abstract:

A project called Enhancing Developmentally Oriented Primary Care, with the goal of increasing the financing and delivery of preventive developmental services for children birth to age 3 years in the state of Illinois, provided training and technical assistance to primary care providers throughout the state of Illinois. Primary care providers have opportunities to screen and observe infants and toddlers and their caregivers more than any other professional, because they see them up to 13 times in the first 3 years of life for well-child visits. The project used a 1-hour, on-site training for primary care providers and their entire office staff as the method of increasing knowledge. Training focused on intent to change practice and implement validated routine early childhood developmental screening, and early referrals to Early Intervention or other community resources. Although many primary care providers routinely use only developmental surveillance in their practices, clinical practice guidelines recommend routine use of standardized developmental screening, using validated developmental screening tools. This presentation will share lessons learned and recommendations based on clinical practice guidelines and experiences of the team members during implementation of the EDOPC project and others. Primary care providers are critical to this process because children with developmental disorders have the best long-term outcomes and opportunities for improved family functioning with early detection, diagnosis, and treatment. J Pediatr Health Care. (2014) -,

Biography:

Patty Mack has been a nurse for over 30 years and in addition is a Licensed Marriage and Family Therapist and infant Mental Health Specialist. She is a Healthy Steps Specialist for the Advocate Children’s Hospital –Park Ridge Pediatric Residency Program. She trained pediatric providers, residents and staff across Illinois in developmental screening and referral for over 10 years as part of the Enhancing Developmentally Oriented Primary Care project. She provides therapy for individuals and families at the Chrysallis Center for Individual and Family Development. Patty presents at state and national conferences on child and family developmental issues.

Abstract:

A project called Enhancing Developmentally Oriented Primary Care, with the goal of increasing the financing and delivery of preventive developmental services for children birth to age 3 years in the state of Illinois, provided training and technical assistance to primary care providers throughout the state of Illinois. Primary care providers have opportunities to screen and observe infants and toddlers and their caregivers more than any other professional, because they see them up to 13 times in the first 3 years of life for well-child visits. The project used a 1-hour, on-site training for primary care providers and their entire office staff as the method of increasing knowledge. Training focused on intent to change practice and implement validated routine early childhood developmental screening, and early referrals to Early Intervention or other community resources. Although many primary care providers routinely use only developmental surveillance in their practices, clinical practice guidelines recommend routine use of standardized developmental screening, using validated developmental screening tools. This presentation will share lessons learned and recommendations based on clinical practice guidelines and experiences of the team members during implementation of the EDOPC project and others. Primary care providers are critical to this process because children with developmental disorders have the best long-term outcomes and opportunities for improved family functioning with early detection, diagnosis, and treatment. J Pediatr Health Care. (2014) -,

Biography:

Dr. Alicia Kodsi received her Doctor of Medicine degree from St. George’s University, School of Medicine in June 2014. She is currently doing her pediatric residency at Maimonides Infant and Children’s Hospital in Brooklyn, NY, where she is involved in multiple clinical research studies, particularly in her field of interest, Pediatric Emergency Medicine. Dr. Kodsi was a tutor in Toronto for children with learning disabilities, where she continued to tutor up until she began her medical training.

Abstract:

Objectives: To analyze a large group of febrile neonates < 28 days of age who received outpatient sepsis evaluation and nasopharyngeal aspirate antigen testing [NPAT] for respiratory syncytial viral [RSV] infection to determine whether there is a clinically-significant association between viral study results and risk for serious bacterial infection [SBI: bacterial meningitis, bacteremia, urinary tract infection, bacterial enteritis]. Methods: We evaluated consecutive febrile neonates < 28 days of age presenting to our urban pediatric emergency department [MMC] during a 6-year period, all of whom received a sepsis evaluation [CSF, blood, urine cultures] and RSV NPAT testing. To achieve adequate power [80%], the MMC data was combined with similar data reported from a prior prospective PEM-CRC study1 of like-aged febrile neonates who received similar evaluation. Results: From the MMC data of consecutively evaluated cases, the prevalence rate of +RSV in 387 febrile neonates was 6%. Of these, 378 [98%] received both a sepsis evaluation and RSV NPAT; +SBI occurred in 4/22 [18.1%] with +RSV vs 58/356 [16.2%] with -RSV [p = 0.77]. Combined with the PEM-CRC1 cohort of 411 febrile neonates < 28 days of age who received similar evaluation, a total of 789 cases were analyzed using meta-analysis. Overall, there were 117 cases of +SBI [14.8%]; and 104 cases of +RSV [13.2%]. The rate of +SBI was 11.5% in those with +RSV vs 15.3% in those with –RSV. Meta-analysis performed showed no significant difference in rates of +SBI between those with and without +RSV [OR = 0.78, 95% CI 0.41 – 1.50; p = 0.46]. Conclusion: Rates of +SBI are not significantly different between febrile neonates < 28 days of age with and without +RSV. Respiratory viral infection status is not an accurate clinical determinant in distinguishing SBI risk in febrile neonates.

Biography:

Maite Hartwig MD has completed her study of medicine at the “Free University of Berlin” 2003. Internship was done at the children`s hospital of Greifswald. Since 2007 she has been working at the Dept. for Paediatric Haematology/Oncology at the University Hospital Hamburg. Four years ago she also started working at the Paediatric Pain Center Hamburg, where children of all ages with bride variety of chronic pain are treated.

Abstract:

The increasing number of pupils suffering from headache as well as the limited longterm power of drugs forced us to think about non-pharmacological solutions. We wanted to find possible answers for children suffering on headaches specially in combination with high muscle tension and/or allergic comorbidity. Knowing that children with migraine react on special food and additives (Egger et al 1983), we started to look for a oligoantigenic diet. Procedure-A: History of the family situation, life events, the child's troubles and strains, school-situation and nutritional habits were examined. After a run-in phase of 4 weeks headache documentation the children were randomized into two groups (RCT): one with an oral one-hour counselling, the other was only handled over a brochure with the necessary dietary informations. A diet was provided avoiding artificial additives, coffein, milk and fast food for 12 weeks. Results-A: 117 school children suffering from migraine or tension-type headache were recruited. 58% oft he pupils reduced their headache significantly. Results for migraine were even better. There was no significant difference between the two treatment groups. Procedure-B: Pupils with tension-type headache have been examined concerning their upper cervical function (C1/2). Approximately 95% oft hem showed a unilateral reduced rotation of at least 10º. A 1-point scalp Laser-acupuncture at the frontal B-zone according to Yamamoto was performed with approximatly 2 Joule. Directly afterwards and one month later cervical function was controlled. Results-B: Nearly all patients showed an improvement of their cervical function directly after the 1-point-acupuncture intervention. About one third of endurance during the following month till the next date including significant improvement of headache parameters could be documented. Conclusion: Dietary regimes in chronic pediatric headaches and migräne seems to be a valid regime specially in children with a comorbidity of allergies. 1-point-Laser-acupuncture seems to be as effective as ostheopathic interventions. This method could be well integrated in a multimodal program.

Biography:

Corena de Beer has completed her PhD in 2004 and holds the position of Senior Medical Scientist and Senior Lecturer in the Division of Medical Virology of Stellenbosch University, Cape Town, South Africa. She started research on SUDI cases in collaboration with Forensic Pathology in 2009. She has published 32 papers, of which 3 were on SUDI. She has successfully supervised 18 postgraduate students and is currently supervising 2 PhD, 2 MSc and 1 Honours BSc students. She serves on the Editorial Board of Annals of Forensic Research and Analysis and on several national review boards.

Abstract:

Sudden and unexpected death in infancy (SUDI) is an under-researched field in South Africa. Identifying causes of death remains challenging despite full medico-legal investigations inclusive of autopsy, scene visit and ancillary studies. Viral and bacterial infections have been implicated repeatedly as risk factors for SUDI, but no standard laboratory investigation protocol exist in South Africa. A total of 148 SUDI cases from the Tygerberg Medico-legal Mortuary were collected over a one year period and investigated for respiratory viruses. Samples were collected from the lungs for viral and bacterial culture as part of the institutional SUDI investigation protocol. Two additional molecular assays were performed on nucleic acids extracted from lung tissue to screen for respiratory viruses and individual results were compared with routine histology on lung sections. Agreement between positive viral results and severe interstitial pneumonitis in a small number of cases suggested infection as the cause of death. Disagreement between viral results and histology occurred often and caused doubt on the cause of death in many cases. Demographic information confirmed several risk factors that correspond with the literature. Molecular assays produced higher positive yields for respiratory viruses than routine shell vial culture, but the agreement with interstitial pneumonitis was still suboptimal. Careful interpretation of molecular assays is necessary, due to latent or non-pathogenic viral loads of identified viruses. Agreement between molecular assays was also not significant and reconfirmed the need for different approaches in order to formulate an optimal screening protocol in determining the cause of death in SUDI cases.

Biography:

Carmen Liliana Barbacariu, MD, PhD, is a teaching assistant at “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania. She is specialized in general practice and pediatrics and holds a PhD reflecting extensive research regarding childhood developmental disorders. Her main research interest is promoting child health and development through a range of early intervention strategies that address families with young children. She is a founding member of AREPMF (Romanian Association for Pediatric Education amongst General Practitioners) willing to perfect primary care for children at a national level. She has over 50 scientific publications and co-authorships in scientific articles, textbooks, and monographs.

Abstract:

Over the last few years, many controversies related to immunization safety have arisen, leading to an increasing number of parents who refuse to vaccinate their children. We performed a qualitative research study to investigate the reasons behind child immunization safety concerns. Our results reflected a decrease in vaccination coverage, a tendency also observed in the statistics reports of the Romanian National Centre for Infectious Disease Control and Prevention. As in many other countries, in Romania, the anti-vaccination movement had a negative impact on parents’ immunization behaviour. Nowadays, parents with young children do not have personal experience with vaccine-preventable diseases and they perceive low potential health risks from getting these infectious diseases. Disagreement among the medical experts is a frustrating concern for many parents, because even if they know that vaccination is supported by most of the medical community, they also recognize the expertise of researchers (immunologists, virologists, or microbiologists) who suggest a risk of severe long-term adverse events following immunization. The numerous controversies and statements surrounding immunization side effects caused an erosion of public trust in the efficiency and safety of vaccination programs. Therefore, the researchers along with the government must evaluate claims against vaccines and create new health policies presenting unambiguous information regarding the safety and importance of vaccination. Whether vaccination is voluntary or compulsory, each option faces complex ethical challenges because humans depend on each other in infectious diseases matter.

Biography:

Dr. Rojas is a medical doctor with actually training in Pediatric Infectious Diseases Fellowship Program in the Universidad El Bosque, Bogotá, Colombia and ample experience in Research of infectious diseases. He completed him M.D. degree from the Faculty of Ciencias de la Salud, Universidad Libre, Cali, Colombia followed by a postgraduate degree of Pediatrician from the Universidad Libre, Cali, Colombia. He has extensive experience in clinical and epidemiological research in areas such as Infectious Diseases, Bacterial Resistance, Dengue, as well as experience in training/teaching in the fields of clinical and epidemiological research. He has published over 20 articles on Pediatrics, epidemiology and control of infectious diseases. Recognition of the Colombian Society of Pediatrics, Resident Featured at 2013, in the 28th Colombian Congress of Pediatrics, done in the city of Cartagena, Colombia on 13 and 15 June 2013.

Abstract:

Ecthyma gangrenosum (EG) is a rare infection of the skin, known as a characteristic lesion caused by Pseudomoma aeruginosa, but also can occur from other types of bacteria like Staphylococcus aureus or beta hemolytic group, among others. This condition is often associated with primary and secondary immunodeficiencies. The lesions present clinically as scaly, erythematous violacious macules that rapidly evolve into papule-vesicles, bleeding and crusty blisters leaving a deep punch ulcer with a necrotic base. Mortality is high, between 40% and 75% of immunologically compromised individuals. We describe the case of a girl of 5 years of age who initially presented chickenpox and then superinfection with Staphylococcus aureus, causing a clinical picture of EG. The diagnosis was reached based on symptoms, cultures and skin biopsies. Management was achieved with acyclovir, intravenous clindamycin and cefepime, with a good and quick response by the patient.

Biography:

Ashok Kapse is consulting Pediatrician practicing in the city of Surat in the Gujrat state of India, besides owning a private pediatric hospital he is also head of the pediatric department at a prestigious Mahavir super specialty hospital. He has special interest and skill in infectious diseases. Working along with CDC Atlanta he evolved simple clinical approach for diagnosis and management of Dengue illnesses particularly in resource limited situations. Recipient of many oration awards he is a popular and sought after speaker, he has delivered hundreds of lectures on Dengue, Malaria, Typhoid and antibiotic uses across the India. He has published more than 10 articles in reputed national & international journals also has contributed chapters in prestigious books.

Abstract:

Child presenting with rash is common occurrence in pediatrics. Rash presenting with fever provides you material for microbiological evaluation, offers you unique opportunity to make clinical diagnosis, and gives clinician vital leads towards severity markers. A case could be approached in different ways however rash based approach is the easiest way for clinical evaluation. Classification and evaluation of rash as erythematous, maculopapular, papulovesicular, petechial, blisterous and so on leads clinician to correct diagnosis and proper management. Correct typing of rash directs clinician towards a careful wait and watch approach in certain clinical situation while dictates him to act emergently in others. I intend to provide an easy clinico-pictorial approach for a case presenting with rash in day to day practice.

Biography:

Mir Anwar graduated Medicine from Bangladesh in 1975 He did his post-graduation in Pediatrics from Ireland in 1982. He did his MPH concentration Maternity and Child Health from University of Massachusetts, USA in 2003. Then he joins in UN/ WHO and worked as a Pediatric Consultant & Public Health Specialist, around the world including Asia, Japan, Middle East, Africa, Pacific Island, Ireland and USA. Since 2007 he has been working in South Africa in different provinces of South Africa with the Department of Health. Presently he is working as a Clinical Medical Manager in Richmond Chest Hospital, KZN. South Africa. Presently His main interest is in Childhood TB and HIV in Sub-Saharan Africa. In his long carrier in Pediatric and Public Health he had attended several International Congress, Conferences, and Seminars and presented his original work. Some of them were published in International Journal Including American Child Neurology Journal, Japan Pediatric Neurology Journal, Pakistan Pediatric Journal, Bangladesh Child Medical Journal , Nigerian Journal of Obstratics and Gynecology Etc. For his work he is honored by American Academy of Pediatrics, Royal College of Health, UK, and International College of Pediatrics. Etc. His Biography was published in Who’s Who in Medicine Cambridge, UK in 1985.

Abstract:

Background- TB is surging much of the Africa because of HIV epidemic, it is observed that TB rate is much higher then what is reported it in public health system. In South Africa out of all TB case 16% are amongst children. Objective- Childhood mortality is increasingly higher in sub-Saharan Africa. To know the reason of child mortality- is it because of TB or HIV or both? Method – TB & HIV infection in children in retrospective study was in our mind In 2010, 8.8 million new TB cases globally, 1.1 million deaths (excluding HIV). 1.1 Million new HIV associated TB cases, 82% living in Sub Saharan-Africa. About 26 % of all HIV patients when start with ART, had TB in their life time.TB is number one cause of death, in HIV infected patients. Results- Deaths Worldwide, HIV: 6000/day, TB: 5000/day South Africa,-TB case Incidence: 4 th in the world, Childhood TB- 16% of all TB cases. Co-infection of TB&HIV – Globally- 13%, South Africa- are around 25- 60% of amongst children. WHO endorsed in 2010 new diagnostic tool to confirm TB, like Gene Xpert MDR/RIP, PCR based test even in children. Presently it is not widely available in Sub Saharan Africa because of high cost. South Africa lucky to have Gene XPRT test kit available even in district hospital. It is observed that the patterns of TB symptoms are also changing then that of traditional one. Conclusion- Problem persists still on diagnosis of TB as 87% of the TB patients shows smear negative even with fluorescent microscope. It shows that smear negative TB patients have high mortality even with proper TB treatment. It also observed that HIV patients have low TB organism in sputum even with low CD4 count.TB is a multisystem diseases. TB and HIV are correlated with each other; if we can decrease the incidence of HIV we can decrease the incidence of TB both in morbidity and mortality, I will discuss all these issue and facts in this topic.

Biography:

Gilson Capilouto is an associate professor in the Department of Rehabilitation Sciences at the University of Kentucky. She has lectured and practiced extensively in the area of infant and pediatric feeding. Her current research focus includes development of an instrument to facilitate decisions regarding readiness to feed in fragile infants.

Abstract:

The lingual musculature contributes significantly to the coordinated suck, swallow and breathe required for independent infant feeding. However, clinical benchmarks of lingual function fundamental to feeding are unexplored. The aims of the current study were to compare: (1) tongue muscle force during nutritive and nonnutritive sucking for a cohort of healthy full term (FT) infants and healthy preterm (PT) infants; and, (2) mean values of posterior tongue thickness between the two cohorts. Our primary measures of interest were nonnutritive (NNS) and nutritive (NS) tongue force and posterior tongue thickness; secondary measures of interest were nonnutritive and nutritive sucking frequency. Muscle force data was collected using a custom fabricated pacifier and flow-through nipple. Muscle thickness was estimated from measures of posterior tongue thickness using ultrasonography. We found clinically significant differences in mean tongue force and frequency during NNS between the two groups; NNS tongue force and suck frequency was greater for FT infants compared to PT, after adjusting for weight and age at exam. A statistically significant difference in NS tongue force was also found; PT infants demonstrated significantly lower NS force as compared to FT infants. No significant difference in NS frequency between cohorts was found. Results also indicated clinically significant differences in mean posterior tongue thickness. PT infants were found to have smaller mean tongue thickness as compared to FT after adjusting for age and weight at exam. Post-hoc linear regression indicated that posterior tongue thickness may be a more significant predictor of NS force than postmenstrual age.

Biography:

Dr DiMario completed his M.D. at Tufts University and his M.A. in Adult Education from the University of Connecticut. His academic focus is in clinical teaching and conducting research in children with non-epileptic paroxysmal disorders and neurocutaneous diseases. He has authored over 100 peer-reviewed publications and the textbook, Non-Epileptic Childhood Paroxysmal Disorders, Oxford University Press. He has received multiple outstanding teacher awards, has served on the editorial boards of Pediatrics and J Child Neurology, the medical advisory boards for the National Tuberous Sclerosis Alliance, Epilepsy Foundation of America, and is a reviewer for numerous pediatric and neurological journals. He is an active member of the; CNS, AAP, AAN, ANA and SPR.

Abstract:

This is a review of some of the spells of childhood, which are often erroneously thought to be seizures. The initial segment of the presentation will provide the listener with a format and clinical approach toward best categorizing an entity being described by any forlorn parent. Specific case descriptions and video examples are provided for clarity and diagnostic assessment. This will be followed by a thoughtful discussion of the examples provided. The goal is to help clinicians better distinguish between non-epileptic and epileptic events by reviewing commonalities and differences between the two. These events are common in any pediatric practice and well worth knowing. This presentation can be augmented by use of the author’s accompanying textbook and related publications.

Biography:

Abstract:

Introduction The Acute Disseminated Encephalomyelitis (ADEM) is an auto-immune diffuse demyelinating disorder of the central nervous system after a viral infection or a vaccination. Observation Thomas, 12 years without preceding neurological abnormalities, consults to the emergency department for dysuria, pains and paresis of the lower limbs. A month ago, he had a mesenteric lymphadenitis. Two weeks ago, Thomas had an erythematous rash during 3 days. The physical examination reveals a bladder distention, constipation and a pyramidal syndrome to the lower limbs. The cerebral and spinal-cord MRI reveals encephalitis (left frontal lobe lesion) and a multifocal myelitis (median thoracic, low thoracic and conus medullaris). The viral serologic tests are negative; the cerebrospinal fluid is sterile with lymphocyte pleocytosis. The diagnosis of ADEM is established. After corticotherapy, the low thoracic lesion is the only one persisting on the 2-months MRI. Four months after the diagnosis, the neuro-motor evaluation is normal. Thomas complains of dysuria, urinary and fecal incontinence and erectile dysfunction. Discussion The ADEM is an uncommon disease which the initial differential diagnosis is multiple sclerosis. The acute treatment by high dose of corticoid is widely accepted. There is no data about an optimal treatment. The outcome is mostly with complete recovery. Four retrospective pediatric reviews report that only 2.5% (4/161) have a neurogenic bladder. None colon or erectile dysfunction are related. The few cases of neuro-sphincter troubles related show both the rarity of these symptoms and the lack of diagnosis. These must be consistently sought and followed-up behind the acute phase and the resolution of MRI lesions. The aim is to avoid renal damages and urinary and fecal incontinence. We detail the symptoms and the specific care modalities for the teenagers.

Biography:

Dr. Eyad Al-Midani has completed his MBBS at the age of 25 in King Saud University and taken the Residency Training Program in King Faisal Specialist Hospital and Fellowship Training in University of Toronto, Canada. Dr. Al-Midani has several administrative appointments namely: Section Head and Consultant of Neonatology, department of pediatrics, King Faisal Specialist Hospital and research center in Riyadh, Chairman, Pediatric Quality Management Team and Director, Neonatal Resuscitation Program. He is an Assistant Professor of Pediatrics, Alfaisal University; In addition, he is currently reviewer in more than one journal

Abstract:

Objective: To assess the compliance rate and overall quality of discharge summaries among KFSH & RC patients according JCIA standards, during three years. Methods: A multidisciplinary team formulated, including the Quality director in the department of pediatrics as a chair person, the chairman of the department of pediatrics, the chief resident, a representative from medical records, a representative from the quality management, a representative from the information technology department and a representative from the medical and clinical affairs. An analysis of the situation as well as an explanation of the project idea was discussed with all team members and the process was built up as following: (See appendix 1) Results: Between the first quarter of 2011 and the first quarter 2014, a significant drop in the number of delinquent records have been documented where it was 1131 at the end of the first quarter of 2011 and dropped down to 68 records at the end of the second quarter of 2014. as well as the compliance to the JCIA standards which represent the documentation quality that has been audited by the hospital quality management department using a random, retrospective audits for 20 charts selected from the ICIS and reported on quarterly basis It shows improvement from 70% in the first quarter of 2013 up to 79% in the first quarter of 2014, and 86% in the second quarter of 2014, making the department of pediatrics ranking the first position across the hospital in comparison to the other department in regard to the quality of the discharge summaries. Conclusions: It is been found that by implementing a systematic framework in building up a discharge summaries for the patients will lead to a better quality of documentation and will minimize unnecessary delay. Comprehensive and precise clinical documentation improves the quality of patient care as well as the health information that is critical for ideal management of the health care system.

Biography:

Omar Farouk Helal completed his PhD at the age of 35 years from Cairo University. He is an Assistant Professor in the Department of Physical Therapy, College of Applied Medical Sciences, Umm Al-Qura University and now is the director of Graduates and Academic Accreditation Committees. Omar has served on roughly thirty conference and workshop. He has published more than 10 papers in Cardiopulmonary and Geriatrics Rehabilitation and directs multiple research programs focused on the exercise intensity and geriatrics care. He has been serving as an editorial board member in Pediatric Physical Therapy Journal.

Abstract:

The purpose of this study is to examine effects of a rowing exercise regimen versus a chest physical therapy program on pulmonary function in children with Down syndrome. Methods: Twenty-nine participants of both sexes, between 8 to 12 years of age, participated in this study. They were assigned randomly into 2 study groups. The first group (A) received a chest physical therapy program, while the second group (B) received an aerobic exercise regimen using a rowing ergometer. Vital capacity, forced vital capacity, forced expiratory volume after 1 second, and peak expiratory flow rate were measured before and after 12 successive weeks of treatment. Results: Significant improvements in all measured variables were found post treatment in both study groups. No significant difference between the 2 groups was found post treatment. Conclusion: Rowing exercise could be effective in improving pulmonary functions in children with Down syndrome.

Biography:

Khaled T. Muhammad is a professor of pediatrics, Head of Tanta PICU, Tanta faculty of Medicine, Tanta University, Egypt. He has supervised more than 50 master and 10 doctoral degrees in PICU, published more than 30 articles in various national and international peer reviewed pediatric journals. He is active member of 5 pediatric societies in various fields of pediatric subspecialities.

Abstract:

Background: The risk factors of childhood obesity include; energy intake, positive family history and lifestyle. Obesity is associated with numerous co-morbidities such as cardiovascular diseases, type 2 diabetes, Objective: to study the effect of obesity on some myocardial functions and lipid profile. Design: 9-months prospective case controlled study. Setting: Pediatric Department Tanta University Hospital Patients and Methods: 30 patients were included 24 males and 6 females; aged 6-15 years with BMI ˃ age and sex specific cut off points. Exclusion criteria included organic causes of obesity, hormonal medications, corticosteroids, hypertension & diabetes mellitus. Twenty healthy children with matched age and sex set as a control group. All studied children were subjected to: Anthropometric measurements: weight, height & BMI. Echocardiographic evaluation; LVEF, LVFS, LVEDD, predicted LVEDD, %LVEDD, LVM, LVMI & LMPI. Lipid profile assessment included serum TCh, LDL, TCh / HDL ratio & TG. Results: there was highly significant increase in body weight, serum TCh, LVEDD, LVM & LVMI. There was significant increase in BMI, LDL, HDL, serum TG, TCh / HDL-cholesterol ratio, %LVEDD, predicted LVEDD & LMPI of obese as compared to controls. There was no significant difference between the two studied groups as regards height, LVEF & LVFS. There was significant decrease in HDL in obese as compared to control group. Conclusions: LMPI is an early echocardiographic detector of LV global dysfunction in obese children. This; in combination with lipid profile must be included in routine evaluation and identification of the high-risk obese children in addition to weight-control/reduction. It is recommended to clarify the effects of obesity on cardiac function and lipid profile in infants and young children

Biography:

Hsiu-Lin Chen has completed Master of medical science in 2007 from Kaohsiung Medical University, Graduate of Medicine. She is the attending physician in division of neonatology, the department of pediatrics, Kaohsiung Medical University Hospital and also the associate professor in department of respiratory therapy, school of medicine, Kaohsiung Medical University. She has published more than 30 papers focusing on neonatal intensive care and development of premature infants in reputed journals.

Abstract:

There is a high rate of antibiotics use in sick newborns in the neonatal intensive care unit (NICU). To reduce unnecessary use of and provide appropriate guidance for administration of antibiotics, we have developed a “Neonatal bacterial infections screening score” (NBISS) for each new patient admitted to the NICU of Kaohsiung Medical University Hospital. The NBISS was designed based on maternal risk factors, clinical presentations, and laboratory data. The total score for each new patient was calculated at the time of admission. The first period of study was an observational survey. Receiver-operating characteristic curve was used to determine the best cut-off value of NBISS for diagnosis of bacterial infection to guide antibiotics used in the second period of study. Of 250 neonates admitted to the NICU, 237 (94.8%) received antibiotics during the first period of study. The items including C-reaction protein, the presentation of a bulging fontanelle, pus from the ear canal, redness around the umbilicus, reduced movement, and not being able to feed were weighted to make significant difference between the bacterial infection and non-bacterial infection groups (p=0.015). Weighted scores higher than 8 points had best diagnostic accuracy for indicating bacterial infection for new neonatal patients needing NICU care. After the introduction of NBISS for predicting bacterial infection in new patients admitted to NICU, the rate of antibiotic use significantly decreased, from 94.8% to 60.3%, between the two periods. Through this simple screening strategy without increased cost for lab exam, we achieved a clinical reduction in unnecessary antibiotics use.

Biography:

Ashok Kapse is consulting Pediatrician practicing in the city of Surat in the Gujrat state of India, besides owning a private pediatric hospital he is also head of the pediatric department at a prestigious Mahavir super specialty hospital. He has special interest and skill in infectious diseases. Working along with CDC Atlanta he evolved simple clinical approach for diagnosis and management of Dengue illnesses particularly in resource limited situations. Recipient of many oration awards he is a popular and sought after speaker, he has delivered hundreds of lectures on Dengue, Malaria, Typhoid and antibiotic uses across the India. He has published more than 10 articles in reputed national & international journals also has contributed chapters in prestigious books.

Abstract:

Asthma is a considerable public health issue, with more than 300 million people affected by it worldwide. It remains the most common chronic disease of childhood in the world. A concomitant rise in allergic diseases is creating a major public health problem. The greatest burden of these diseases is during childhood, when the rapidly rising rates of disease are most evident. There is a possibility that some environmental factors are driving the allergy and asthma epidemic. Recently variations in vitamin D status and intake has been implicated in allergy development and considered as one of a number of explanations for epidemiological and immunological associations. The main role of the immune system is to protect us from infectious microorganisms, but it simultaneously has to distinguish these from harmless antigens such as self antigens and environmental antigens. The immunologic tolerance to self antigens and harmless air born antigens is primarily mediated through a group of lymphocytic cells termed as T regulatory (Treg cells). Depletion of Treg enhances immune responses to non-self antigens, to tumour cells and to commensal microbes. Consequently, a lack or a deficient function of regulatory ‘T’ cells breaks the tolerance to self antigens and environmental antigens such as allergens and leads to autoimmune diseases, allergic diseases, and asthma. Recent works suggest that a vitamin D has significant role in generation, maintenance, enhancement and restoration of Treg cell function in asthma. The role of vitamin D in induction and/or maintenance of essential Treg cell populations, coupled with the capability to promote antimicrobial pathways have led to the suggestion that vitamin D might promote homeostasis required for the unique pulmonary environment and is one of the most essential element for protecting airways and lungs from allergens and infections. Moreover Perinatal vitamin D deficiency could mechanistically drive both the proximal and distal airways to a myogenic phenotype, molecularly and structurally, predisposing the offspring to asthma. Modern lifestyle patterns and environments deprive adequate sun exposure (indoor occupation, “screen time” and active sun avoidance) this predispose to inadequate vitamin D synthesis and status which in turn has resulted in more asthma and allergy.

Biography:

Professor Rana is working as faculty in field of Clinical Biochemistry related to Gastroenterology since 1988.Throughout her career; she has worked on non-invasive malabsorption diagnostic tests for various gastrointestinal diseases. Her field of specialization is various aspects of gastrointestinal problems in different diseases like celiac, type 1 diabetes, IBS, IBD etc. She is actively involved in the research studies related to pathological, risk factors and preventive aspects of malabsorption syndromes.Her expertise is also in oxidative stress and antioxidants in different gastrointestinal diseases, hepatotoxicity and its prevention, She has published various research papers and review articles in National and International journals.

Abstract:

Celiac disease may be asymptomatic or symptomatic with severe malabsorption. Symptoms of malabsorption in celiac disease include chronic diarrhea, abdominal distention, failure to thrive and nutritional deficiencies. Celiac disease could lead to lactase deficiency. It can lead to lactose intolerance but it has not been reported in North Indians. Therefore, the study was planned to elucidate lactose intolerance in children with celiac disease. Lactose intolerance was estimated by using non-invasive lactose hydrogen breath test in 155 children suffering from celiac disease and 110 age & sex matched apparently healthy controls. 25g lactose dissolved in 250 ml water was given orally for lactose hydrogen breath test to all subjects after measuring fasting breath H2 and CH4 concentrations. End expiratory breath was collected every 30 minutes up to 4 hrs. H2 & CH4 concentrations were measured by using Microlyzer. Rise ≥ 20ppm over base line value in H2 and/or CH4 concentration in two consecutive readings was considered as lactose intolerance. Results: Out of 155 children, 90 (58.06%) were boys and 65 (41.94%) were girls. The age range of children was 3-13 years. The Mean SD of age was 7.5 2.9 years. Out of 110 healthy controls, 65 (59.09%) were boys and 45 (40.91 %) were girls. Lactose intolerance was significantly higher (p<0.0001) in celiac patients (106/155; 68.4%) as compared to controls (40/110; 36.4%) Conclusion: This study indicates that lactose intolerance is common among children with celiac disease which can be one of the causes for gastrointestinal symptoms.

Biography:

Wang is the Director of Neuroapoptosis Drug Discovery Laboratory, Department of Neurosurgery, Brigham and Women’s Hospital/Harvard Medical School. Dr. Wang received her PhD from Hebrew University of Jerusalem. She did her postdoctoral training at University of Michigan and Harvard Medical School. Dr. Wang has published about 70 peer-reviewed articles and has served as the Guest Editor, Handling Editor, and Editorial Board Member for a number of peer-reviewed journals, as well as the scientist reviewer for institutes or foundations including NIH, DOD, BSF, and others, and invited reviewer for 30 peer-reviewed journals.

Abstract:

We and other researchers have reported that melatonin plays neuroprotective role in a variety of neurological conditions including acute cerebral ischemia and chronic Huntington's disease and Amyotrophic lateral sclerosis. However its role as a protective agent against newborn hypoxic-ischemic (H-I) brain injury is not yet well studied, while the mechanisms by which melatonin causes neuroprotection in neurological diseases is still evolving. The present study demonstrated that there was significant reduction in MT1 receptors in ischemic brain in mouse pups in vivo with H-I brain injury and in primary cortical neurons and primary astrocytes in vitro as the result of environmental stress and melatonin offers protection through upregulation of MT1 receptors and inhibition of mitochondrial cell death pathways. The direct role of MT1 receptors was further supported by observation of increased mortality in MT1 knockout mice and the protective effects in neuronal cell death and the inhibitory role of mitochondrial cell death pathways including mitochondrial potential gradient dissipation, mitochondrial permeability transition pore opening, mitochondrial fragmentation, and inhibition of the subsequent cytochrome c/Smac/AIF releases and caspase-3 activation by melatonin were reversed by melatonin receptor antagonist luzindole. Taken together, these data demonstrate that melatonin mediates its neuroprotective effect in models of newborn H-I brain injury, at least in part, by the restoration of MT1 receptors.

Biography:

Emmanuel Rudatsikira is Dean of the School of Health Professions and Professor of Public Health at Andrews University. He has a significant history of research, much achieved through receipt of grants from federal, state and private funding agencies. He has conducted research in more than 30 countries in all regions of the World Health Organization, published over 90 articles in peer-refereed journals, and given a variety of presentations both in the United States and internationally.

Abstract:

The objective of this study was to estimate the prevalence of cannabis use and its socio-demographic correlates among in-school adolescents. We conducted secondary analysis of data obtained from the 2004 Zambia Global School-Based Health Survey. Logistic regressions analysis was conducted to identify the socio-demographic factors associated with cannabis use. A total of 2,257 adolescents participated in the survey, of which 53.9% were females. The overall prevalence of self-reported ever-used cannabis was 37.2% (34.5% among males and 39.5% among females). In multivariate analysis, males were 8% (AOR=0.92; 95% CI [0.89, 0.95]) less likely to have ever smoked cannabis. Compared to adolescents aged 16 years or older, adolescents aged 14 years were 45% (AOR=1.45; 95% CI [1.37, 1.55]) more likely, and those aged 15 years were 44% (AOR=1.56; 95% CI [0.53, 0.60]) less likely to report having ever smoked cannabis. Other factors that were significantly associated with cannabis use were history of having engaged in sexual intercourse (AOR=2.55; 95% CI [2.46, 2.64]), alcohol use (AOR=4.38; 95% CI [4.24, 4.53]), and having been bullied (AOR=1.77; 95% CI [1.71, 1.83]). Adolescents who reported being supervised by parents during free time were less likely to have smoked cannabis (AOR=0.92; 95% CI [0.88, 0.95]). The use of cannabis is prevalent among Zambian in-school adolescents. Efforts to prevent drug use among Zambian adolescents should be designed considering the factors associated with drug use in this study.

Biography:

Jos Draaisma has completed his MD at the age of 26 years from Radboudumc and PhD at the age of 29 years. He is head of the department of general pediatrics, director of the pediatric residency program, and director of the pediatric education program. He has published more than 70 papers in reputed journals and has been serving as an editorial board member of different pediatric and medical education journals.

Abstract:

Advanced Pediatric Life Support guidelines are widely adopted for healthcare provider training and focus on individual knowledge and skills. Although team members may be sufficiently trained individually, teamwork skills have traditionally been less emphasized in pediatric training. However, the knowledge that fatal errors due to human factors occur in 70-80% of medical mishaps has led to a growing interest in pediatric teams’ cognitive and interpersonal skills, such as leadership and situational awareness. For this reason, we have developed different video-assisted real-time simulation programs: for medical students, for pediatric residents only, for multidisciplinary pediatric and neonatal teams and for ECMO-teams. The training program for the multidisciplinary pediatric team will be presented in detail, as well as the results of different studies we have performed. Effective leadership varies, not only with the person or group, but also depends on the task, job or function that needs to be accomplished. We have evaluated the leadership styles of our pediatric residents. Pediatric residents most often use the coaching style (two way communication). More recently we have focused on teaching and assessing situational awareness. One of the major challenges of all these trainings is the transfer of the learning on the job. Major components to influence this transfer are intervention readiness, realism and self-efficacy. Providing adequate preparation material and extensive debriefing of the scenarios is important in creating intervention readiness. The perspectives of realism depend strongly on setting and learning goals. There is a significant increase in self-efficacy, which remains increased for at least three months.

Biography:

Dr. Ariza is an anesthesiologist focused in major surgery, Fellow of Anesthesia in Solid Organ Transplantation at Hospital Vall d Hebrón in Barcelona and Magister in Epidemiology and Clinical Research at Universidad de la Frontera in Chile. He works as researcher in perioperative medicine and adverse events since 10 years ago and currently as IRB Chairman at Fundación Valle del Lili in Cali, Colombia. He has published several papers about adverse events prevention strategies and has participated as Board Member in Transfusional Medicine and Transplants Committee at Colombian Society of Anesthesiology. Is one of the founders of the Advance Bleeding Control in Trauma and Major Surgery (CASTYM) Course-Workshop that currently is held around the world.

Abstract:

Gastrointestinal endoscopic procedures (GEP) include a variety of diagnostic and therapeutic minimal invasive approaches that are performed outside the operating room or in specially designed areas. Children constitute a subpopulation who benefits from general anesthesia (GA) or deep sedation (short periods of unconsciousness obtained by intermittent low dose induction agents) for this type of procedures due to their autonomic protective roll and derived immobility, trying to offer a friendly and safe experience for the child and his/her family. Inhaled or intravenous drugs with rapid pharmacokinetic profiles are preferred for these scenarios due to their relation with “fast-track” procedures and cost-efficacy. It has been determined a very low incidence of global complications (0.13%) and mortality (0.004%) in this population for GEP, while more frequent post-procedure symptoms found were sore throat and dysphonia. In fact, most of these procedures are currently performed in a “free-hazard” base where IV access and airway protection devices are frequently obviated. We show a retrospective analysis to determine the current prevalence of serious and non-serious AEs for children less than 12 y-o under GEP who required anesthesia care and propose a predictive model with the most significant perioperative factors in an environment where GA is the most frequent anesthetic approach.

Biography:

Dr. Rizk graduated from Alexandria University, Egypt in 1995, then granted MRCPCH in 2008, FRCPCH in 2012 from the Royal College of Paediatrics and Child Health (UK), He obtained teh specialty Certificate in Paediatric Neurology in 2012 from the British Paediatric Neuroloogy Association. Dr. Rizk is an active member of multiple international Child Neurology societie. He has published more than 30 papers in reputed journals and he has been serving as an editorial board member of multiple reputable journals in the field of paediatric neurology and Neurosciences. He is a consultant Paediatric Neurologist in Sulaiman Alhabib Medical Group; KSA.

Abstract:

Objective: The aim of the study is to show the functional contribution of botulinum toxin-A in the treatment of postoperative pediatric stiff hips. Methods: Four pediatric patients with postoperative stiff hips were included. Three patients with complicated developmental dysplasia of the hip after multiple revision surgeries, and a case of cerebral palsy after hip surgery were given botulinum toxin injections in selected muscles as an adjunctive therapy to the standard orthopedic and rehabilitation management. Results: All patients experienced a significant reduction in pain with a significant improvement in posture, range of motion and mobility. Conclusion: The preliminary results of botulinum toxin-A injection when given to selected muscles seem to be promising in relieving pain and improving range of motion in pediatric patients with postoperative stiff hips. It may be considered as an option in the treatment of difficult cases of postoperative stiff hips refractory to physiotherapy.

Biography:

Abstract:

Exploring the parenting styles, coping strategies and perceived stress in parents of children who have undergone cardiac intervention are challenging issues because they affect the whole family dynamics. Ten mothers of children who have undergone cardiac intervention and ten mothers of healthy children, aged 5 to 14 were administered three questionnaires: Parenting styles Questionnaire, Cope and Perceived stress Questionnaire. The testing was conducted at the final day of their five-day summer camp in June 2011. Exploration of psychosocial characteristics of parents living with the diagnosis of cardiac disease in their child is crucial for the entire team of those providing healthcare. Adequate medical as well as psychological diagnosis can provide adequate psychotherapeutic interventions which can have multi-faceted benefits both for the parents and children in the process of coping.