7^th European Pediatrics and Pediatric Surgery September 14-16, 2016 Amsterdam, The Netherlands

Biography:

Xianming Carroll has completed her MPH and PhD from Heinrich-Heine University Düsseldorf, Germany. She is Research Assistant Professor at Mercer University School of Medicine in the US. She has published several papers in peer-reviewed journals and has been serving as an Editorial Reviewer of journal Plos One.

Abstract:

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders, affecting an estimated 5 to 12% of school-aged children worldwide. Approximate 15 to 19 million Chinese children suffer from ADHD. The objective of this study was to investigate the association between family-environmental factors and ADHD in a sample of Chinese children. A pair-matched, case-control study was conducted with 161 ADHD children and 161non-ADHD children of matching age and sex, all from 5-18 years of age. The ADHD subjects and the normal controls were all evaluated via structured diagnostic interviews. We examined the association between family-environmental factors and ADHD using the conditional multiple logistic regression with backward stepwise selection to predict the associated factors of ADHD. Having experienced emotional abuse and being a single child were both significant factors associated with children diagnosed with ADHD. ADHD subjects were more likely to have suffered from emotional abuse (OR=11.09, 95% CI=2.15-57.29, P=0.004) and have been a single child in the family (OR=6.32, 95% CI=2.09-19.14, P=0.001) when compared to normal controls. The results were not modified by other confounding factors. Our findings provide evidence that family-environmental factors are associated with ADHD among children in China. These findings, if confirmed by future research, may help to decrease ADHD by increasing the awareness of the effects of childhood emotional abuse.

Biography:

I am professor of pediatrics and neonatology in Cairo University. I was graduated in 1994, had my Master degree in pediatrics in 1998 and doctorate degree in pediatrics in 2001. I am an international board certified lactation consultant since 2004 (got the highest score in Egypt). I am a board member of Lactation education accreditation and approval committee in USA, which provides approval and accreditation to all breastfeeding programs allover the world.  I have 21 published scientific papers (7 are pubmed cited: Tomerak RH, Tomairek RH)

Abstract:

Breast milk is the white blood containing almost all the factors essential for the physical, physiological and psychological maturity of the preterm infant. Its function represents a continuum of the placental function. Preterm infants are inevitably deprived of the placenta in late pregnancy so the human factor should fight to provide the baby with this white blood; the breast milk. This needs a tight strategy to be mastered by the authorized personnel in the NICU. The policy should include the guidelines of milk expression, storage, transfer and providence to the baby. Promotion of the kangaroo mother care is an important adjuvant. Proper counselling of the mother is also of utmost importance together with the post discharge support of the mothers to continue breastfeeding.  

Biography:

Jinfen Liu has completed his MD at the age of 25 years from Shanghai Jiaotong University School of Medicine. He is the director of Shanghai Pediatric Congenital Heart Disease Institute, Member of World Pediatric Heart Surgery Management Commitee, Member of American Association for Thoracic Surgery, and Chairman of the standing committee of Chinese pediatric surgery. He has published more than 104 papers in reputed journals and has been serving as Associate Editor of World Journal for Pediatric & Congenital Heart Surgery. (Up to 100 words)           

Abstract:

Background: Ventricular septal defects (VSDs) are the most common and simplest type of congenital heart diseases (CHDs). Animal studies have suggested that the downregulation of Yes-associated protein 1(YAP1) during embryonic development causes VSD- associated CHDs. However, how YAP1 contributes to isolated VSD (iVSD) is unclear.

Methods and Results: Twenty right atrial specimens were obtained from iVSD patients during routine congenital cardiac surgery and we assessed YAP1 expression in these specimens.  For controls, six right atrial specimens were obtained from normal hearts of children without heart disease, three of whom died from cerebral palsy, and three who underwent heart transplants. YAP1 mRNA and protein levels and nuclear localization were significantly reduced in iVSD specimens compared to normal heart specimens. Concomitantly, mRNA levels of YAP1 downstream targets CTGF and AXL were also significantly decreased in iVSD specimens. Although Ki67-positive cardiomyocytes in iVSD specimens were comparable to normal heart specimens, Ki67-positive non- cardiomyocytes were significantly decreased.

Conclusions: YAP1 expression was markedly decreased in hearts of iVSD children. Given the important role of YAP1 during heart development, downregulation of YAP1 expression may contribute to iVSD and affect the proliferation of non-cardiomyocytes.

Biography:

Alana Jaye Coleman is a nurse who has completed her degree at the University of Pittsburgh. She has over fifteen years of experience in the Neonatal Intensive Care Unit (NICU) caring for infants born with Congenital Diaphragmatic Hernia. She was honoured by The American Association of Colleges of Nursing (AACN) for her prestigious work done within this cohort. She is currently the Clinician of the NICU at the Children’s Hospital of the University of Pittsburgh Medical Center. She is a published first author in the Journal of Pediatric Surgery and continues to sponsor research studies and speak nationally.

Abstract:

A Research Journey- Enhancing the Management of Congenital Diaphragmatic Hernia (CDH) reflects at how one institution has evolved over time and increased survival in this distinct population. The journey was inspired by a nurse who wanted to make a difference after losing a patient to this terrible birth defect. A quality improvement study (QI) was sponsored to look at the current management of CDH patients to see if a change in practice needed to be made. At the completion of the study, a unanimous decision amongst pediatric surgery and neonatology was made to change current management to entail gentle ventilation, permissive hypercapnea, spontaneous respiration and delayed repair approach. A multidisciplinary team emerged to develop a protocol. After implementation of the protocol, the team continued to monitor, modify and explore its success. Six Institutional Review Board (IRB) studies have been sponsored, multiple poster and podium presentations have been given throughout the United States and Canada, and one article was published in the Journal of Pediatric Surgery. A Research Journey will provide specific details on the interventions, management and outcomes that have not only enhanced care but increased survival rate. The protocol starts prenatally, from the time of diagnosis and ends with discharge from the Neonatal Intensive Care Unit. Specific patients with low Magoon Indexes and inadequate total lung volumes, who are not candidates for ECMO, are discussed. Throughout the years we have learned you cannot save them all, but you can find redemption in the fight to try.

Biography:

Professor Mehmet Emre Atabek has completed his PhD at the age of 37 years from Erciyes University and postdoctoral studies from Selcuk University School of Medicine. He is the director of Pediatric Endocrinology, a premier pediatric endocrinolgy and diabetology service organization. He has published more than 120 papers in reputed journals. He has been interested in searching metabolic problems of obese children in most of his articles. His articles have been cites more than 1100 citations so far. 

Abstract:

Obesity is a risk factor for several metabolic complications. Impaired blood glucose regulation and metabolic syndrome are the most frequent of these complications.The aim was to investigate the impact of utilising different criteria on the prevalence of metabolic

A hundred and fourty three obese children and adolescents  aged between 8-17 recruited in the study. Metabolic syndrome was defined using International Diabetes Foundation (IDF) and World HealthOrganisation (WHO) definitions.

 In obese patient , 68 (47.6%) were male with a mean age of 12,22± 2,34 , 75 (%52.4) were female with a mean age of 12,59± 2,45. 112 (78.3%) of all patients were pubertal.  Using WHO criteria, 80 (55.9 %) were newly diagnosed metabolic syndrome. Using  IDF criteria, metabolic syndrome was present in 65 (45.5%) patient. 

The prevalence of metabolic syndrome, and diabetes in children and adolescent  is increasing. In our study we have noted a higher prevalance of metabolic syndrome with WHO criteria.

Biography:

Hongchun is Pediatric Surgeon in Guangdong Women and Children Hospital and Health Institute. He completed Master of Medicine from Guangzhou Medical College. He is the Director of Pediatric Thoracic Surgery. His team worked in the field about Fetal Medicine, especially for birth defect and pediatric surgery postnatal (Complete Video-Assisted Thoracoscopic Surgery) especial for respiratory system, like CCAM and BPS. He has published more than 20 papers in reputed journals.

Abstract:

Abstract

Here we report the largest series of patients with IDEPSs in all bronchopulmonary sequestration cases from March 2011 to Sep 2015 (17cases) and analysis of the surgical treatment.

Purpose: To evaluate the surgical management of intradiaphragmatic extralobar pulmonary sequestration (IDEPS): Complete video-assisted thoracoscopic surgery (cVATS), video-assisted mini-thoracotomy surgery (VAMT) and thoracotomy.

Methods: We retrospectively reviewed cases of bronchopulmonary sequestrations (BPS) diagnosed in our hospital from March 2011 to Sep 2015, in order to identify patients with IDEPS. Diagnosis of IDEPS was confirmed using prenatal doppler ultrasound, postnatal intravascular enhanced computed tomography, and surgery. Experience of surgical treatment was summarized by comparing the cVATS, VAMT and thoracotomy.

Results: The 17 cases diagnosed with IDEPSs were confirmed with histopathology. In our first case, we did not find any mass from abdominal surgery, and then we turned to transthoracic surgery. 6 patients underwent thoracotomy, and 6 cases underwent cVATS; 4 cases underwent VAMT. All surgeries succeeded. MRI prenatal showed a homogeneous mass (2.72 x 2.38 x 4.24 cm) between the diaphragm and the left kidney. It demonstrated high signal intensity on FIESTA and low signal intensity on FIRM. The margin of mass was still clearly defined. Flow empty phenomena were detected. The left adrenal gland was compressed and displaced downward. CT postnatal showed the mass behind the liver, upon the kidney.

Conclusions: IDEPS is a rare type in BPS. It would be better to approach through the chest. Thoracoscopy is safe and effective by experienced surgeon. 

Biography:

Dr.Erik Thaulow is a Professor at the University of Oslo, Department of Pediatrics and has been Head of Section for Congenital Heart Disease for 15 years. He has published several papers on the topic and has two times been part of the committee producing the ESC Guidelines on GUCH. He has been active in congenital heart disease (CHD) for 30 years .He has organized the GUCH-care at the University Hospital and served as Chairman of the Working Group for Adults with CHD in the ESC

Abstract:

There are essentially few restrictions given for exercise in congenital heart disease (CHD). Severe pulmonary hypertension, arrhythmias and risks of sudden drop in cardiac output are the most important factors. In addition some disease (Marfan) collision should be avoided in order to reduce the risk of aortic rupture. A survey on Norwegian children revealed that exercise was very infrequently related to mortality in CHD. It is more important to encourage these patients to be active and also participate in sports than give instructions to avoid sports. Exercise testing is important in individuals both to identify the few in whom exercise should be performed with great care, but most important, to demonstrate to the patient and the family (which should witness the exercise) that exercise activity is safe. Echocardiography done during exercise has been applied in order to study pulmonary hypertension during exercise. This is most often a research tool, but has also in some cases turned out to be of clinical importance. Physical training programs have been applied in CHD. Studies performed conclude that this is safe, there is some increase in oxygen uptake, and activity monitoring has revealed that the effect of such programs is mostly to give the participants greater participation in daily life physical activities. There are several guidelines on exercise in CHD. They should be known by physicians treating CHD patients, but the most important factor is to investigate the individual patients and encourage them to be physically active.

Biography:

Peng Liu got his MD & PhD degree of Neurosurgery in 2011 from Southern Medical University. He also has been a Post-doctoral Visiting Professor at Department of Biomedical Engineering of State University of New York at Stony Brook, USA. He is the Associate Professor of Department of Neurosurgery of Wuhan General Hospital of Guangzhou Military Command in Southern Medical University. His clinical skills includes cerebrovascular surgery (endovascular treatment of intracranial aneurysms, ateriovenous malformation and fistula, endovascular treatment of spinal vascular diseases, endovascular treatment of cerebral ischemic diseases, clipping of intracranial aneurysms, total resection of AVMs, craniocerebral injury surgery and neuro-oncology surgery.

Abstract:

Background: Pediatric traumatic intracranial pseudoaneurysm (TIPA) is a relatively rare clinical entity resulting from blunt, penetrating or iatrogenic head trauma. The diagnosis, management and prognosis of patients with pediatric TIPA is not well-understood. Surgical craniotomy for TIPA is a high-risk operation. Advancements in minimally-invasive technology have allowed for endovascular reconstruction of TIPA.

Case reports: We present our experience with use of endovascular covered stents for treatment of three pediatric cases with TIPA. The clinical and radiological characteristics are presented. No procedure-related complications or deaths occurred during follow-up.

Conclusions: In this study, the use of Willis covered stent was associated with favorable prognoses in 3 patients with TIPA. No major complications were encountered during follow-up. The Willis covered stent appears to be a viable therapeutic modality in these patients. A definitive prognosis assessment will necessitate prospective clinical trials with longer duration of follow-up.

Biography:

Alejandro Gonzalez is Anesthetist who performed a Fellow in Pediatric Anesthesia at Melbourne, Australia, in 1999. Since then, he has been working in Pediatric and Outpatient Anesthesia. He was Director of an Ambulatory Surgery Center for five years (2001-2005), and he also was President of The Chilean Society of Anesthesiologists (2007-2009). He has published several papers about outpatient anesthesia and pediatric anesthesia.

Abstract:

Introduction: Parents feel fear and anxiety before elective surgery is performed on their child, and those feelings could obstruct their preparation for surgery. Pre-operative information could relieve those feelings.

Objective: To determine the preoperative information needs of parents of children undergoing elective surgery.

Patients & Method: A study was conducted on parents of children who underwent elective surgery. Demographic data of parents were recorded. Preoperative information received or would like to have received was assessed in terms of contents, methods, opportunity, place and informant. Descriptive statistics were used.

Results: Thirteen hundred parents were surveyed. More than 80% of them want preoperative information about anesthesia, surgery, preoperative fasting, drugs and anesthetic complications, monitoring, intravenous line management, pain treatment, postoperative feeding, anxiety control, hospitalization room, recovery room and entertainment in recovery room. Most want to be informed verbally, one to two weeks in advance and not on the same day of surgery. The informant should be the surgeon and in his office. In addition, they want information through leaflets, videos and simulation workshops, or guided tours.

Conclusions: Parents need complete preoperative information about anesthesia, surgery and postoperative care, received verbally and in advance.

Biography:

Biniam Ayele graduated from University of Gondar as a Medical Doctor in 2012. Currently he is working as a Physician and Lecturer at Felegehiwot Referral Hospital and Bahir Dar University respectively. He is also a 3^rd year Surgical Resident at Bahir Dar University.    

Abstract:

Volvulus refers to torsion of a segment of the alimentary tract, which often leads to bowel obstruction. The most common sites of volvulus are the sigmoid colon and caecum. Volvulus of other portions of the alimentary tract, such as the stomach, gallbladder, small bowel, splenic flexure and transverse colon are rare. Patients with a caecal volvulus are young, with a mean age varying from 33 years in India to 53 years in Western countries. In contrast, sigmoid volvulus usually occurs in elderly subjects with chronic constipation or distal colon obstruction. The common presentations are colicky abdominal pain, abdominal distention, constipation/obstipation and depending on vascular status, the patient may be febrile and tachycardic. Here I present a case of cecocolic volvulus involving cecum, ascending colon, transverse colon and distal ilium in a 13 years old girl after she presented with colicky abdominal pain, distension, failure to pass feces and flatus for 3 days. She had also previous history of similar complaint but was self-limiting. She was febrile and tachycardic. Diagnosis was made by plain abdominal x-ray which showed air fluid level. She was prepared and operated and intraoperative finding was 360 degree clockwise rotated right colon and transverse colon along its mesentery which was ischemic and the whole large bowel was mobile and redundant with its own long mesentery. We extended right hemicolectomy and iliotransverse anastomosis. The patient was followed for 1 week in the ward and discharge improved. Now she is being followed in the surgical referral clinic. Details of the pathology, diagnosis and management will be discussed.

Biography:

Xiaoyan Wang has completed  her PhD at the age of  23 years from Shanxi Medical University .She has been a developmental pediatrician for nearly 20 years in Hubei Maternal and Children Health Hospital . Treatment specialties include: nutritional diseases (anemia, rickets, malnutrition, lead poisoning, loss of appetite, difficulty feeding, etc.), sleep disorders, high-risk children early intervention and potential development of infants and young children, growth retardation (intelligence, language, etc.), short stature, children's psychological clinic (ADHD, learning difficulties, tic disorder, autism, mood disorders, obesity, enuresis, etc.) of counseling, intervention and treatment, published more than 20 papers.

Abstract:

Background:  Bone  mineral  density  (BMD)  increases  progressively during  childhood  and  adolescence  and  is  affected  by  various  genetic  and  environmental  factors.  The  aim  of  this  study  was  to  establish  reference  values  for  lumbar  BMD  in  healthy Chinese  infants  and young  children  and investigate  its influencing  factors.

Methods and Findings:  Healthy  children  aged  0  to  3  years  who  underwent  regular  physical  examinations  at  the  Child  Health Care Clinic  of Hubei Maternal and  Child Health Hospital  (N = 11,898) were recruited for this study.  We also chose  379  preterm infants  aged 0 to  1 years to preliminarily  explore the development  of BMD in  this special population.  BMD (g/cm2)  measurements of the lumbar  spine (L2–L4) were carried out with dual-energy  X-ray absorptiometry and a questionnaire was  administered  to  full-term  children’s  parents  to  gather  information  on  various  nutritional  and  lifestyle  factors  as  well  as  mothers’ nutritional supplement use  during pregnancy. Lumbar BMD significantly increased  with age among both boys and  girls  (p,0.05), with  fastest growth  observed  during the  first postnatal  year.  There was  no significant  difference  in lumbar  BMD between  boys and girls  of similar age  (p.0.05), either among  healthy reference children or  preterm infants. However,  BMD  values  in   preterm  infants  were  significantly   lower  than  those  in   term  infants  3  to  8   months  old  (p,0.05)  after  adjustment for  gestational  age. Multivariable  linear regression  analysis  indicated significant  positive associations  between  lumbar  BMD  of  healthy children  and  the  child’s  age  and  current  weight,  mother’s weight  gain  during  pregnancy,  birth  weight,  children’s outdoor  activity duration  and  children’s physical  activity duration.

Conclusion:  Our  study  provides   reference  values  of  lumbar  BMD  for   healthy  Chinese  children  aged  0  to   3  years  and  identifies several  influencing  factors.

Biography:

Dr. Kunimoto had graduated from Wakayama Medical College at 1987 and completed his Ph.D. study at 1994. He is an Otolaryngologist. He had presented many study about upper respiratory diseases, focal infection on tonsil, cancer related Epstein-Barr virus and immune response analysis using molecular biological technique at that time. Recently, he has had an office in Hiroshima city since 2004, and now former chairperson of Asa Otolaryngology and member of management committee of Hiroshima Otolaryngology.  Additionally, he had also belonged to Hiroshima University since 2004.           

Abstract:

In 2014, an update to a meta-analysis of heptavalent pneumococcal conjugate vaccine (PCV7) 　effects on acute otitis media (AOM) was reported in the Cochrane collection and one of major conclusion was that the PCV7 had modest beneficial effects in terms of changes in AOM episodes and total number of visits to medical institutions by children. We have same results in Japanese children using the Japan Medical Data Center Claims Database. The Japanese guidelines for AOM in children recommend classifying AOM by age, manifestations and local findings. Myringotomy is recommended for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. We have previously conducted a retrospective multicenter study in the Asa Area of Hiroshima City, Japan to investigate changes in the number of myringotomies performed to treat AOM after public funded inoculation. The myringotomy rate per child-year in <5-year-old children decreased by 29.1% in 2011 and by 25.2% in 2012 compared to the mean rate performed in the 3 years prior to the introduction of public funding in the multicenter study. Our results suggest the public benefit of PCV7 in reducing the AOM morbidity with less financial burden of myringotomy. And we have studied about those subjects with the big data based on the Japan Medical Data Center Claims Database. Our results show that this vaccine may help prevent AOM from aggravation with severe clinical manifestations.

Biography:

Dr Shipra Chaudhary has completed her MD Pediatrics & Adolescent Medicine from B P Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. She is presently working as Assistant Professor in Department of Paediatrics, BPKIHS, Dharan. 

Abstract:

Background: Twins, compared to singletons, have higher perinatal mortality and morbidity. The aim of this study is to describe the twinning rate, epidemiological variables and hospital outcome of twin deliveries at this institution.

Methods: We evaluated retrospectively the outcome of 92 twin pregnancies during one year study period (1^st Jan 2014 to 31^st Dec 2014). Only inborn twins were included. Cases with <28 weeks gestation and those twins delivered outside institution were excluded.  Maternal and neonatal data were retrieved and statistically analysed.

Results: The twinning rate was 9.2/1000 (92/10,031). The mean birth weight was 1636.30 ±339.21 grams and mean gestational age 34.31±2.67 weeks. One hundred eighty-two babies (98.9%) were Low Birth Weight (LBW) while 32.1% were Small for Gestational Age (SGA). There was mild, moderate and severe growth discordance in 68.5%, 23.9% and 7.6% respectively. Three (3.26%) of 92 pairs had twin to twin transfusion syndrome. The mortality rate was 10.87% (20/184).  Out of 181 live babies, 69 (37.5%) had complications. The clinical causes of death were hyaline membrane disease (3.3%), severe birth asphyxia (2.7%), sepsis (1.6%) and congenital malformations (1.6%).

Conclusion: Twin deliveries are common in this hospital and need special consideration due to their substantial higher risk of complications and thereby consumption of relatively large proportion of resources before, during and after birth. Preparedness, early management and follow-ups are required for better management of twin infants in our part.

Keywords: Low Birth Weight (LBW), Preterm, Small for Gestational Age (SGA), Twins, Twin to twin transfusion syndrome (TTTS)

Biography:

Amir Manouchehri has completed his DDS at the age of 25 years from Kerman dental university in Iran. He was he director of university research community. He has done several presentations in multiple domestic and international congresses.

Abstract:

Routine expansion screws produced heavy interrupted forces witch are unfavorable for dental movement and could be harmful to tooth structures. In vitro evaluation of a new expansion screw showed that this new screw could produce light-continuous forces.

The purpose of this study was to compare clinically the new expansion appliance with routine 3.axis expansion appliance in terms of dental arch changes and patient’s problems during treatment. 

38 patients (8-14 years old) with bilateral posterior cross bite and skeletal growth potential were selected. They were randomly divided to two groups: 1) new expansion screw group. 2) 3.axis expansion screw group.

The expansion removable appliances were delivered to the patients. The measurements of dental arch dimensions on study models and requiring of patient’s problems by questionnaires were accomplished every month. For comparison the two groups t-test and Mann-Whitney U-test statistical analysis were used.

Results: There were no significant difference between two groups in terms of mean increase in intermolar, inter premolar and intercanine widths (p> 0.05). the mean score of problems during usage of appliances in two groups was not significantly different (p>0.05 ).

Conclusion: Since the changes in dental arches and problems of patients with new expansion appliance were comparable to 3.axis expansion appliance and need less cooperation of patient for activation of screw, this new expansion screw can replace routine expansion screws.

Biography:

Zaid Rasheed Al-Ani is a professor of pediatrics completed his Bachelor of Medicine from Basrah University, southern Iraq, in 1978, and Arabic Board of Pediatrics specialty (CABP) from Baghdad University in 1992. He is a senior teaching staff in Anbar College of Medicine teaching pediatrics for undergraduates and DCH & CABP postgraduates, and senior consultant pediatrician in Al-Ramadi MCH Teaching Hospital since 1993. He is the project designer and director of the "Western Iraq Center for Congenital Anomalies Registry and Surveillance" (WICCARS) of Al-Ramadi city, and member of different Discussion Committees in DCH, CABP, and PhD theses, published more than 11 papers in reputed journals, and an editor and reviewer of many researches published in different international Journals.

Abstract:

Objectives: To Study the risk of maternal overweight and obesity on congenital anomalies (CAs) using the expected prepregnancy weight and body mass index (EPPBMI) calculated from postpartum weight.

Methods: By deciding a four difference factors, one for low, normal, overweight, and obese pregnant mothers as 60% of the corresponding weight gain during pregnancy, and subtracting every factor from its corresponding postpartum weight, to calculate the corresponding EPPBMI in cases and controls, to study the risk of overweight and obesity on CAs in these types, applied retrospectively on mothers examined in the birth defect center of Al-Ramadi city at 2010. For every case mother, two mothers producing healthy neonates selected randomly as controls. Calculated EPPBMI of cases compared with controls to study the risk of gestational obesity on CAs using Odd's ratio and relevant 95% Confidence interval.

Results: Overweight and obesity was more in postpartum weight and calculated EPPBMI of cases than controls. Both obesity and overweight found a risk factor for development of CAs. Obesity found a risk for development of VSD, ASD, congenital hip dislocation, hydrocephalus, meningomyelocele, cleft lip & palate, and Down's syndrome, while overweight found a risk factor for ASD.

Conclusion: Calculation of the EPPBMI from the postpartum weight is simple, and make studying the risk of maternal obesity on CAs easy in areas with absent or late visiting antenatal care mothers. Overweight and obesity proved a risk factor for CAs. Social education about early antenatal care and alertness for complications of gestational obesity, and the application of the prepregnancy health care system is important to reduce the prevalence of CAs.

Biography:

Silvia Strambi is a Post-graduate Pediatric Surgery student and a Scientific Consultant of Department of Surgical, Medical, and Molecular Pathology and of the Critical Area of University of Pisa (Italy). She is actively involved in clinical care and surgery, as well as in research activities. Her studies have materialized to date in 15 published articles, 9 conference abstracts and 2 books; 1 of them, about sexual development disorders, as author. She has personally presented, as speaker, the results of her original researches in 2 Italian and 4 international conferences. 

Abstract:

The aim of this study is to carry out a comparison of n-butyl-cyanoacrylate plus MS monomer (NBCA-MS) versus suture in pediatric circumcision. 100 boys (age 18 months-14 years) were prospectively randomized in two groups: In 50 boys the wound margins were approximated by NBCA-MS glue while in other 50 boys interrupted polyglycolic acid 5-0 stitches were used. After surgery, 25 patients of each group (subgroup A) received 6 days of Amoxicillin/clavulanic acid and Neomycin sulfate cream, while the other 25 (subgroup B) did not receive any post-operative therapy. Wound was checked on 7^th postoperative day to evidence potential infection or other complications, while resultant scar was examined 30 and 180 days after surgery for assessment of cosmetic outcome. Operative time, pain score, infective complications and cosmesis were statistically evaluated. Operative time was significantly higher in the suture group. Pain severity and duration were less in the glue group but not significantly different. In the glue group, no complications occurred, while the suture group presented 7 (14%) cases of postoperative edema and 5 (10%) cases of infection (in subgroup B). The incidence of infection in suture group as compared to glue group was statistically significant. Cosmetic results were significantly better in the glue group after 1 and 6 months follow-up. NBCA-MS glue is confirmed to be a safe and effective alternative for wound approximation in pediatric circumcision.

Biography:

Yannick Bleyenheuft is Faculty Member at the Université catholique de Louvain (UCL), Institute of Neuroscience. She was trained as a Physiotherapist and completed her PhD in the field of Motor Control in children with cerebral palsy (CP) in 2009 at UCL. She completed her Post-doctorate, sharing her time between UCL and Columbia University (New York), working on intensive rehabilitation processes for children with CP. In 2014, she was appointed as tenured of the Chair for neurophysiological evidences in intensive neurorehabilitation at the Institute of Neuroscience, UCL. She is now Head of the “Motor Skill Learning and intensive neurorehabilitation lab” that was developped in 2015.

Abstract:

Intensive rehabilitation interventions have been shown to be efficacious in improving upper extremity function in children with unilateral spastic cerebral palsy (USCP). These interventions are based on motor learning principles and engage children in skillful movements. Improvements in upper extremity function are believed to be associated with neuroplastic changes. However, these neuroplastic changes have not been well-described in children with cerebral palsy, likely due to challenges in defining and implementing the optimal tools and tests in children. In this study, three different neurological assessments (diffusion tensor imaging-DTI, transcranial magnetic stimulation-TMS and functional magnetic resonance imaging-fMRI) will be documented before and after a bimanual intensive treatment of upper and lower extremities intervention (HABIT-ILE) in children with USCP presenting differential corticospinal developmental reorganization (ipsilateral and contralateral). The aim of this study is to show how to capture neurophysiological changes in maps, brain activity, and associated white matter tracts, and to document the complementary relationship between these measures. Independent of cortical reorganization, children showed changes in activation and increase in size of the motor areas controlling the affected hand, quantified with different techniques. In addition, DTI demonstrated unexpected changes in corticospinal tracts. 

Biography:

Bradley A Kuch is a graduate from Ohio University with a Master in Health Care Administration and Services and Transport Team at Children’s Hospital of Pittsburgh of UPMC. His past roles included Neonatal/Pediatric Transport Therapist and ECMO Coordinator/Researcher in the Dept. of Pediatric Cardiothoracic Surgery. His current research interests include Pediatric Acute Lung Injury and Neonatal/Pediatric Severity of illness modeling during ECMO. His team’s work “First 24-h SNAP-II score and Highest PaCO2 predicts the need for ECMO in Congenital Diaphragmatic hernia” was published in the Journal of Pediatric Surgery.

Abstract:

Congenital diaphragmatic hernia (CDH) continues to carry significant morbidity and mortality despite critical and surgical advances. It is estimated that only 60%-70% survive–usually in high-volume centers. Early pre-surgical management is often complicated by physiologic derangement secondary to varying degrees of lung hypoplasia, pulmonary hypertension and a need for inter-facility transport. Infants who fail to achieve adequate oxygenation and/or perfusion with maximum medical support are regularly supported by extracorporeal membrane oxygenation (ECMO), further complicating the hospital course. These aforementioned challenges have led to a large body of evidence, evaluating best practice outcomes; however, questions remain regarding the best practice approaches to early stabilization and patient selection for ECMO. We have previously reported that pre-transport blood gases, fluid boluses, and ventilation parameters were associated with outcome; however only SNAPP-II score was found to be independently associated with ECMO (OR 1.13 [1.04-1.24]: p=0.007) and mortality (OR 1.11 [1.05-1.12]: p<0.0001) in out-born infants with CDH. In a larger dataset, we demonstrated that SNAPP-II (AUC: 0.77 vs. 0.67) performs better in predicted mortality compared to PaCO₂ in the first 24 hours of life. Discussed will be the importance of severity of illness modeling in the CDH population, as it relates to stabilizing intervention and ECMO support. Current evidence concerning antenatal imaging of CDH and its relationship with severity of illness in the first 24 hours of life and outcome will be presented.             

Biography:

Rania Hosny Tomerak is a Professor of Pediatrics and Neonatology in Cairo University. She has completed her graduation in 1994, Master’s in Pediatrics in 1998 and Doctorate in Pediatrics in 2001. She is an international board certified Lactation Consultant since 2004. She is a board member of Lactation Education Accreditation and Approval Committee in USA, which provides approval and accreditation to all breastfeeding programs all over the world. She has published 21 scientific papers.

Abstract:

Misconceptions run as an ice ball among people. Regarding breastfeeding, misconceptions are widespread and the mother receives a lot of confusing information from her family, friends, nurses and even pediatricians. Breastfeeding is an easy come, easy go process. It can go by one false advice, depriving the mother and her baby from the benefits of breastfeeding. In this presentation, all the common misconceptions about breastfeeding among mothers and paediatricians will be trouble-shooted. Malpractice among paediatricians and obstetricians is also discussed and corrected such as basic advices to breastfeed the healthy new-born, management of insufficient weight gain in a breastfed baby, management of breast infections, nutritional advices to the mothers, and breastfeeding guidelines of the incubated baby. Despite that all these misconceptions can easily drive the mother to terminate breastfeeding, it can be easily avoided and this is the aim of this presentation.

Biography:

M J Witvliet is Pediatric Surgeon in the Netherlands. She has done her Fellowship in Amsterdam and Groningen and finished this in June 2016. From October 2016, she will be Consultant in Pediatric Surgery in the Wilhelmina Children’s Hospital in Utrecht. During her Fellowship, she also worked at a PhD project about quality of life of patients with anorectal malformations or Hirschsprungs disease. This project will be finished in the beginning of 2017. 

Abstract:

Introduction: Anorectal malformations are relative common congenital anomalies in pediatric surgery. After definitive surgery constipation, soiling and fecal incontinence are frequently seen problems. Quality of life (QoL) can be influenced by these problems. The last decades’ QoL has become an important aspect in the treatment and follow-up of patients with anorectal malformations. This resulted in various reports concerning QoL. In order to deduce whether the drawn conclusions in the different studies are correct and can be used to adjust standard care for patients with ARM, a qualitative analysis of the studies was performed.

Material & Methods: A literature study was performed in Pubmed, psychinfo, web of science and the Cochrane library (240 hits). After applying our inclusion-criteria and analyzing the articles, 30 articles could be used. A methodological qualitative analysis was performed and QoL outcome was assessed.

Results: Six authors (20.0%) used validated QoL questionnaires. Four articles were longitudinal and had more than 1 measure moment. Eleven studies (36.7%) used only non-validated questionnaires and 8 studies (26.6%) used only validated questionnaires. Nineteen studies correlated fecal continence to QoL, 7 studies established no correlation. Three of these 7 studies used validated QoL questionnaires. All 12 studies, who did establish a correlation, used non-validated QoL questionnaires.

Conclusions: 83.3 percent of the studies did not use validated QoL questionnaires. Conclusions concerning QoL often were based on functional outcomes, for example fecal incontinence. Longitudinal, high quality research on QoL in this group has not been done so far.

Biography:

Benslimane hammou belongs to pediatric Urology department he published many of the research articles which are related to urethral problems in children. He had completed his MD at the age of 30 years from Oran school of medicine. Currently working as a pediatric surgeon at Becher hospital in Algeria 

Abstract:

Material and method A girl aged 01 year and a half admitted for UTI.

Examination revealed a distended bladder, and a slightly hypertrophic clitoris. Meatus accessory epispadias

ULTRASOUND: bilateral ureteral hydro nephrosis, large capacity bladder thick walls.

UCR: right unilateral reflux .second path epispadias meatus.

TREATMENT:

Initially: a straight-sided configuration Cohen guy with a blindness of the second path by epispadias bladder way.

Secondly treatment of hypospadias

DISCUSSION

The ureteral duplication for the girl is easy to diagnose when viewing the meatus épispadias.

II- Given the small number of cases described in this pathology no classification has been described.

Conclusion

The duplication of the urethra is one of the rarest abnormalities of the urinary tract.

Its diagnosis and determining its type rely on VCUG and endoscopy

If resection of the accessory urethra is relatively easy prognosis depends mainly on the sub bladder obstacle whose surgical treatment is difficult.

Biography:

Robert E Cilley completed General and Pediatric Surgery training at the University of Michigan. He is currently Professor of Surgery and Pediatrics and Ballantine Professor of Surgery at Penn State College of Medicine, Hershey, PA, USA. He is the Chief, Division of Pediatric Surgery and Surgeon-in-Chief at Penn State Children’s Hospital, Milton S. Hershey Medical Center. He was previously the medical director of the Pediatric Trauma Program. He has published over 80 peer-reviewed articles and more than 30 book chapters. His areas of scholarly and professional interest include pediatric trauma, ECMO, lung development, surgical quality and safety. 

Abstract:

Plain radiographs continue to play a role in cervical spine clearance. Inadequate radiographs commonly necessitate repeat x-rays or computed tomography imaging (10×radiation dose). We have used the technique of cephalic stabilization (CS) to improve the results of plain radiographs. Cephalic stabilization lateral radiographs are obtained, with one assistant applying traction to the arms while another placing fingers in the patient's ears and stabilizing the head. This study tests the hypothesis that CS improves visualization of the cervicothoracic junction during lateral cervical spine radiographs. A 2-year review of institutional pediatric trauma registry identified 46 patients with CS, matched 1:3 with controls. Randomized lateral radiographs were evaluated independently by 2 pediatric radiologists to determine adequate visualization of the craniocervical and cervicothoracic junctions. Reviewers were blinded to CS through image cropping. The proportion of adequate visualization of the cervicothoracic junction was 0.85 for cases with stabilization and 0.60 for controls. Odds of obtaining adequate visualization with stabilization are 3.8 times those without stabilization (P=.001) and were even greater for patients younger than 13 years. Cephalic stabilization improves visualization of the cervicothoracic junction in lateral cervical spine radiographs and can reduce radiation exposure in patients who would otherwise require further imaging.

Biography:

Dr Gautam Bir Singh completed his post-graduation in Otolaryngology - Head & Neck surgery [1997] from Pt Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India. He also underwent short term training at AIIMS, New Delhi. He is currently working as Professor at Lady Hardinge Medical College & Associated Hospitals, New Delhi. Prof Gautam Bir Singh has 48 indexed international publications to his credit and has presented/co-presenter 18 scientific papers and 25 posters at various national/international conferences. He is also an Editorial Board Member: Journal Clinics in Surgery- Otolaryngology Otolaryngology & Heighpubs Otolaryngology and Rhinology

Abstract:

Objective: Aim of this study is to determine the minimum age, influencing factors and prognostic significance of tympanometric volume for paediatric tympanoplasty type I in a select age-group of five to eight years.

Methods: A prospective study was conducted in 30 children with chronic suppurative otitis media-inactive mucosal disease of either sex. The contralateral ear was taken as a measure of eustachian tube function. Pre-operative tympanometric volume was recorded in all the cases and statistically analyzed with the graft uptake results post-operatively. All the patients underwent tympanoplasty type I by underlay technique using temporalis fascia graft. An intact graft at the end of six months, and a postoperative hearing improvement of 10 dB or greater in two consecutive frequencies, was regarded as surgical and audiological success, respectively. The statistical analysis was done using Mantel HaenszelX² i.e. Chi square test, and Fisher exact p value test for confirmation.

Results: We recorded an impressive surgical success rate of 87% and an audiological improvement of 70% in this study. No significant role for eustachian tube was found in this study. On the basis of mean tympanometric volume of 1.6 cm³, the patients were divided into two groups: Group A (tympanometric volume<1.6 cm³), and group B (tympanometric volume>1.6 cm³). A graft uptake of 95% and 77% was recorded in group A and B respectively. However, the statistical evaluation of the data revealed no significant effect of this factor.

Conclusions: We observed that graft uptake results are comparable to adults in paediatric patients as eustachian tube has no distinct role. In this study, no correlation between the tympanometric volume and the surgical success of paediatric tympanoplasty in selected age group of 5-8 years was observed.

Biography:

Anil Chandra Phukan has completed his MD (Medical Microbiology) from Dibrugarh University, Diploma in Medical Virology (DMV) from National Institute of Virology, Pune University, India and Diploma in STI & AIDS (DSA) from COTTISA, Bangkok, Thailand under WHO Fellowship. He worked as Biomedical Research Senior Scientist in Indian Council of Medical Research for a long time. He is presently working as Medical Superintendant and Head of Department of Microbiology at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. He has been associated with patient care services, academics and researches with more than 20 national and international publications in reputed journals with involvement in many academic and research institutes of India.

Abstract:

North East India is the northeastern region of the country comprising eight states with 4500 km of international border with China, Myanmar, Bangladesh and Bhutan having population of >40 million with 220 ethnic groups. North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong is the first post graduate institute of Govt. of India in the region and one of apex medical institutes in the country dedicated to the nation in 2010 which is catering tertiary care services to the patients of the entire North Eastern states. The study was planned to know the Hospital Acquired Infections (HAI) trend in the ICUs of this newly started institute hospital considering the global health impact of the emergence and spread of antimicrobial-resistant pathogens in hospitals. The aims were detection of the etiological agents associated with the various types of HAIs in the ICUs and understanding the antimicrobial resistance pattern of isolates from the ICUs in general and PICU in particular. The patients with suspected HAIs admitted in the ICUs of Anesthesiology (AICU), Pediatrics (PICU), Cardiology (ICCU) and Cardio Vascular & Thoracic Surgery (CTVS ICU) Departments of NEIGRIHMS for a period of one year were included. Clinical specimens- urine, tracheal aspirate, sputum, wound swabs; pus, discharges, exudates, blood, cerebrospinal fluid, pleural fluid, peritoneal fluid and pericardial fluid were collected and processed with due ethical clearance. Relevant microbiology laboratory analysis was made for identification of the pathogens including study of the antimicrobial susceptibility pattern employing standard protocols. A total of 276 patients [126 (AICU), 47 (ICCU), 101 (PICU), 2 (CTVS ICU)] were included in the study of which 167 (8%) developed HAIs with the occurrence of 14% in AICU, 8% in PICU and 4% in ICCU respectively. Respiratory tract infections (RTI) (43%) were highest followed by urinary tract infections (34%), blood stream infections & septicemia (11%) and wound infections (10%) found in general. Urinary tract infections (54%) and RTI (24%) were the major HAIs in the PICU. Escherichia coli was the commonest pathogen (26%) followed by Enterococcus species (16%), Pseudomonas aeruginosa (14%) and S. aureus (12%). The Escherichia coli isolated showed resistance to beta lactam (73%) and cephalosporins (68%); Enterococcus species to quinolones (62%), aminoglycosides (46%) and cephalosporins (38%) and Pseudomonas aeruginosa to cephalosporins (67%), beta lactam (50%) where S. aureus was resistant to penicillin (50%) and quinolones (40%) respectively. The study demonstrated that HAIs are found to be a major threat in practice of patient safety in hospitals. Holistic approach for awareness, effective surveillance, antimicrobial policy and strict infection control practices is the present day need to address this global health issue.

Biography:

Background: Twins, compared to singletons, have higher perinatal mortality and morbidity. The aim of this study is to describe the twinning rate, epidemiological variables and hospital outcome of twin deliveries at this institution.

Methods: We evaluated retrospectively the outcome of 92 twin pregnancies during one year study period (1^st January 2014 to 31^st December 2014). Only inborn twins were included. Cases with <28 weeks gestation and those twins delivered outside institution were excluded.  Maternal and neonatal data were retrieved and statistically analysed.

Results: The twinning rate was 9.2/1000 (92/10,031). The mean birth weight was 1636.30±339.21 grams and mean gestational age 34.31±2.67 weeks. 182 babies (98.9%) were Low Birth Weight (LBW) while 32.1% were small for Gestational Age (SGA). There was mild, moderate and severe growth discordance in 68.5%, 23.9% and 7.6% respectively. Three (3.26%) of 92 pairs had twin to twin transfusion syndrome. The mortality rate was 10.87% (20/184). Out of 181 live babies, 69 (37.5%) had complications. The clinical causes of death were hyaline membrane disease (3.3%), severe birth asphyxia (2.7%), sepsis (1.6%) and congenital malformations (1.6%).

Conclusion: Twin deliveries are common in this hospital and need special consideration due to their substantial higher risk of complications and thereby consumption of relatively large proportion of resources before, during and after birth. Preparedness, early management and follow-ups are required for better management of twin infants in our part.

Abstract:

Shipra Chaudhary has completed her MD in Pediatrics & Adolescent Medicine from B P Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. She is an Assistant Professor in Department of Pediatrics, BPKIHS, Dharan.

Biography:

Dr. Mildred Mudany completed her Masters Degree in Paediatrics from the University of Nairobi and her PhD in Tropical Medicine in 2004 from Tokyo Women’s Medical University She is the Country Director of Jhpiego, an affiliate of Johns Hopkins University, Kenya. Prior to this she worked for Centers for Disease Control and Prevention (CDC) as a Senior Technical advisor in PMTCT and Chair for USG Inter-agency Technical Team on Maternal, Newborn and Child Health. She has published more than 15 papers in reputed journals and made significant contributions to Guidelines in PMTCT, Infant Nutrition and Early Infant Diagnosis of HIV. (Up to 100 words)

Abstract:

According to Kenya AIDS Indicator Survey (KAIS) 2012, 1.2 million (5.6%) people live with HIV/AIDS. Globally Kenya ranks among 22 priority countries targeted to reduce new HIV infections in children. Approximately101, 000 (0.9%) children between 18mo-14 years are HIV-infected, majority due to mother to child transmission. In 2013 WHO recommended use of HAART for all HIV positive pregnant and lactating women; guideline adopted by Kenya in October 2013.

Methods:

Dissemination of national guidelines done. Nationwide rollout of option B plus starting with large volume facilities offering ART and facilities with integrated HAART within MCH. APHIAPLUS  Kamili   scaled up Option B plus to 134 high volume facilities in Eastern and Central Kenya. Service providers trained on new guidelines. Regular supervision, mentorship, chart reviews and HIV-exposed infant cohort analysis established.  HIV positive mentor mothers placed in  high volume facilities, to support adherence and retention in care of HIV positive pregnant mothers.  HAART integrated into MCH for easy access.  Exclusive breastfeeding for 6 months encouraged. National EID website monitored for PCR results.

Results:

Between October 2013 to September 2014, 1,320,664 pregnant women were tested for HIV of whom 66,258 (5%) HIV positive. Of positives, 56,137 (85%) put on ARV prophylaxis. Of these, 64.2% were on HAART for life (Option B plus). For KAMILI supported zone, EID positivity reduced between APR 2013 and 2014 as follows: @2mo from 5.9% to 4.8%; @9mo from 7.5% to 6.2%; @12mo from 7.8% to 6.7%; @ 18mo from 8.7% to 7.5%.

Nationally 6 weeks PCR positivity has dropped as follows: 12% (2010); 10% (2011) ; 6% (2012) ; 5% (2013);  4% (2014)..

Biography:

Amir Manouchehri has completed his DDS at the age of 25 years from Kerman dental university in Iran. He was he director of university research team. He has done several presentations in multiple domestic and international congresses.

Abstract:

The aim of this study is to evaluate the correlation between lateral cephalometry and Hand-wrist in short stature in Shiraz and also to evaluate craniofacial morphology in short stature patients.

Method and materials:

178 patients divided into two groups containing 76 patients (38 female and 38 male) as familial short stature and 102 patients (52 female and 50 male) patients as other short stature except as familial origin. Lateral cephalometry and Hand-wrist radiogragh in determining skeletal age were measured using K-statistic. In addition 50 patients were selected for comparing craniofacial morphology in short stature patients with patients with 147 (47 female and 73 male) class II malocclusion without short stature status.

Result: In familial short stature patients the Kappa static between lateral cephalometry and Hand-wrist radiographs for determining skeletal age was measured as 0.6361, which can be considered as good relationship. In short stature patients with other etiologic factors the Kappa statistic between lateral cephalometry and Hand-wrist radiographs for determining skeletal age was measured as 0.615 which is also a good relationship. In evaluation of  craniofacial morphology of patients with short stature male patients had shorter anterior cranial(P=0.01) base and more convex profile than normal patients with class I malocclusion (P=0.005). Female patients had shorter (P=000.1) , more convex profile and more vertical anterior cranial base (P=0.0001). Class II growth tendency than normal class I patients malocclusion patients had more convex profile, larger anterior cranial length and more vertical growth pattern comparing to short stature patients both female and male (p<0.05).

Conclusion: Lateral cephalometry radiographs can be used instead of Hand-wrist radiographs for determining skeletal age without the need for further exposure in short stature patients. Short stature patients have more vertical growth pattern and more convex profile than normal class I malocclusion patients.

Biography:

Zaid Rasheed Al-Ani is a Professor of Pediatrics. He has completed his Bachelor of Medicine from Basrah University, Southern Iraq, in 1978. He is a Senior Teaching Staff in Anbar College of Medicine teaching pediatrics for undergraduates and DCH & CABP post-graduates, and Senior Consultant Pediatrician in Al-Ramadi MCH Teaching Hospital since 1993. He is the Project Designer and Director of the "Western Iraq Center for Congenital Anomalies Registry and Surveillance" (WICCARS) of Al-Ramadi city, and member of different discussion committees in DCH, CABP, and PhD theses. He has published more than 11 papers in reputed journals.

Abstract:

To study the risk of maternal overweight and obesity on congenital anomalies (CAs) using the expected pre-pregnancy weight and body mass index (EPPBMI) calculated from postpartum weight.

Methods: By deciding a four difference factors, one for low, normal, overweight, and obese pregnant mothers as 60% of the corresponding weight gain during pregnancy, and subtracting every factor from its corresponding postpartum weight, to calculate the corresponding EPPBMI in cases and controls, to study the risk of overweight and obesity on CAs in these types, mothers were examined retrospectively at the birth defect center of Al-Ramadi city at 2010. For every case mother, two mothers producing healthy neonates selected randomly as controls. Calculated EPPBMI of cases compared with controls to study the risk of gestational obesity on CAs using odd's ratio and relevant 95% confidence interval.

Results: Overweight and obesity was more in postpartum weight and calculated EPPBMI of cases than controls. Both obesity and overweight found a risk factor for development of CAs. Obesity found a risk for development of VSD, ASD, congenital hip dislocation, hydrocephalus, meningomyelocele, cleft lip & palate, and Down's syndrome, while overweight found a risk factor for ASD.

Conclusion: Calculation of the EPPBMI from the postpartum weight is simple, and makes studying the risk of maternal obesity on CAs easy in areas with absent or late visiting antenatal care mothers. Overweight and obesity is proved to be a risk factor for CAs. Social education about early antenatal care and alertness for complications of gestational obesity, and the application of the pre-pregnancy health care system is important to reduce the prevalence of CAs.

Biography:

MD and European Specialist in Clinical Chemistry and Laboratory Medicine. Full Professor of Laboratory Medicine, School of Medicine, University of Naples Federico II. Recent studies: Cystic Fibrosis: gene analysis, search of new mutations, genotype-phenotype correlation, studies on genes modifier of phenotype; functional studies of novel mutations and drug effect on ex-vivo epithelial nasal cells; epigenetics of CF (methylation and microRNA). Analysis of specific mRNAs in blood from cancer patients. Molecular genetics of congenital diarrhea. Epigenetics of suicide.

Abstract:

Mannose binding lectin (MBL) is a protein of innate immunity that activates the complement and promotes opsonophagocytosis. The deficiency of MBL due to several common gene polymorphisms significantly enhances the risk of severe infections, particularly in the neonatal age and in childhood and a recombinant protein is now available. We demonstrated that in patients affected by cystic fibrosis (CF) the deficiency of MBL acts as a negative modifier gene enhancing significantly the risk for pulmonary bacterial colonisation and for severe liver disease infections. On the contrary, the role of the protein in carcinogenesis and atherogenesis is still debated: MBL has a relevant role against neoplastic cells, in fact our group demonstrated that an MBL deficient haplotype is a risk factor for gastric cancer in subjects with H. pylori infection. Other studies described a protective effect of low levels of MBL toward breast cancer and a longer survival of lung cancer patients with a reduced MBL activity. Similarly, some studies concluded on the protective role of low levels of MBL toward cardiovascular diseases while other focused on a higher risk of myocardial infarction in subjects with a deficient activity of the protein. Finally, a role of MBL in the clearance of senescent cells emerged, and a study by our group in two large cohorts of centenarians demonstrated that a high biological activity of the protein enhances the risk of autoimmune diseases. This body of data strongly suggests that the optimal levels of MBL activity depend on the age and on the environmental context of each subject.