Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 16th Annual World Congress on Pediatrics New York, USA.

Day 2 :

Keynote Forum

Professor Susan B. Waltzman

New York University School of Medicine, USA

Keynote: Pediatric Cochlear Implantation

Time : 09:05-09:45

Pediatrics 2018 International Conference Keynote Speaker Professor Susan B. Waltzman photo
Biography:

Susan B. Waltzman, PhD is the Marica F. Vilcek Professor of Otolaryngology and Co-Director of the NYU Cochlear Implant Center. Her research is focused on two main areas: outcomes with cochlear and brainstem implants and isolating the variables which affect performance including the impact of new technology on outcomes in children, adolescents, older adults and special populations. The most current research at the cochlear implant center focuses on the treatment of those with single-sided deafness, residual hearing and children with compromised auditory nerves. She has been the PI on numerous device-related clinical trials over the past 20 years, the most current trial being the use of auditory brainstem implants in children with compromised auditory nerves. Dr. Waltzman is the author of more than 110 peer-reviewed articles, numerous book chapters and in 2014, the third edition of a textbook with Dr. J. Thomas Roland titled Cochlear Implants. She also has been invited as a Visiting Professor at many institutions world-wide and is a frequent contributor and invited speaker at national and international conferences.

Abstract:

As a result of newborn hearing screening and improved evaluation tools, many children with severe-to-profound hearing loss are being diagnosed as infants, which affords the opportunity to provide these children access to cochlear implantation although medical challenges must be addressed. The purpose of this presentation if to review all aspects of pediatric cochlear implantation including safety and efficacy in very young children. Anesthesia risks, blood volume, skull size and thickness, skull growth and device positon will be discussed  in addition to candidacy and variable affecting outcome in various pediatric age groups.

Keynote Forum

Professor Elisabeth Utens

Erasmus University Medical Centre, Rotterdam and University of Amsterdam

Keynote: Eye Movement Desensitization and Reprocessing (EMDR) in children with unprocessed medical related trauma. A randomized controlled intervention study

Time : 09:45-10:15

Pediatrics 2018 International Conference Keynote Speaker Professor Elisabeth Utens photo
Biography:

Utens  serves as the chairperson of the National Network of Paediatric Psychology (Pediatrische Psychologie-NL) and is a member of the Steering committee of the Psychosocial Working Group of the European Association of Paediatric Cardiology. Utens has funded her research from the numerous external grants she has acquired. Under her supervision, eight PhD candidates have now completed their doctoral thesis on her line of research. Utens has authored numerous international articles which have been published in authoritative academic journals, including the European Heart Journal, International Journal of Cardiology, etc.

Utens studies psychosocial outcomes, particularly anxiety, depression and post-traumatic stress, in children with a physical disorder (such as congenital heart disease, inflammatory bowel disease, cystic fibrosis and HIV) as well as the influence of anaesthesia and psychological preparation of children for surgery. Her research includes examining which factors predict these psychosocial outcomes in the long term. She has carried out both cross-sectional and longitudinal patient-related studies and in recent years has focused primarily on intervention studies, including the effectiveness of cognitive behavioural therapy on anxiety and depression in adolescents with inflammatory bowel diseases, and the effects of sports activities on emotional problems in adolescents with congenital heart disease.

Abstract:

Background. About 3 in every 10 children and adolescents admitted to a hospital or undergoing invasive and/or painful surgery,  develop increased (subclinical) symptoms of PTSS. In addition, about 1 in 10 children even develop a post-traumatic stress disorder (PTSS). Unfortunately, symptoms of unprocessed medical trauma are still poorly recognized. From research it is known that if elevated PTSS symptoms in children are left untreated, this can have a serious impact on their quality of life, psychosocial functioning and can result lead to long term psychiatric complaints. In the Dutch multidisciplinary guidelines for mental health institutions , trauma-focused cognitive behavioral therapy and EMDR are recommended for treating posttraumatic stress complaints. Many psychologists already use EMDR successfully in their daily clinical practice. EMDR works faster, requires less treatment sessions,  is considered less stressful for the patient and therefore fits well in the psychosocial care given in a  children's hospital. Remarkably, the effectiveness of EMDR in medical untreated trauma in children has not previously been systematically investigated. In the Erasmus-MC Sophia Children's Hospital, Rotterdam, a randomized controlled trial (RCT) is being conducted into the effectiveness of EMDR in children / adolescents with a medical related trauma. Design. A randomized, controlled intervention study (RCT). Method. Included are children / adolescents aged 4 to 16 who have undergone a one-time (trauma type 1) or repeated (trauma type 2) hospital admission / medical treatment up to 5 years ago. Participating children are screened for increased PTSS symptoms (partial PTSS). All children with partial PTSS are then randomly assigned to: 1) standardized EMDR or 2) care as usual (CAU = medical care only). Results. The data collection will last from July 2016 to February 2018. During the period from July 2016 to April 2017, 116 participants completed the pre-measurement. Of these, 67% were symptom-free, 28% had subclinical symptoms and 5% had PTSS. The first results of the complete screening assessment will be presented and discussed during the conference. Discussion. The vast majority of children undergoing hospitalization or surgery are not structurally screened for PTSS complaints and do not receive structurally psychological assistance. If EMDR proves effective, this will be implemented structurally in Erasmus MC Sophia. A good network between medical specialists and cognitive behavioral psychotherapists is necessary for optimal psychosocial care.

Pediatrics 2018 International Conference Keynote Speaker Professor Igor Klepikov photo
Biography:

Dr Igor Klepikov is a retired MD PhD Professor

 

 

Abstract:

Treatment of acute pneumonia(АР) in recent decades focused solely on antibiotic therapy,does not include pathogenetic,specific methods of assistance and repeats the principles of treatment of other inflammatory diseases.Reducing the effectiveness of antimicrobial drugs,the emergence and the increasing number of antibiotic-resistant pathogens and a gradual increase in the frequency of purulent complications attach importance and urgency to the solution of this problem.The first step in this decision is a revision of ideas about the nature and mechanisms of АP.This work has been done and tested in a clinical setting in the years 1976-1984 in Novokuznetsk State Institute for postgraduate doctors(USSR,Russia).The basis of the new doctrine АP was based on the following scientific medical axioms,already having previous scientific justification.1. The body's response to any stimulus, including the initiation of inflammation,is highly individual and unique.2.The basis for the inflammatory transformation of the body tissue is a vascular reaction with a specific stage sequence.3.Small and big circles of blood circulation not only have a direct relationship,but an inverse relationship.4.Among the nonspecific forms of inflammation AP is the only process occurring in the system of lesser circulation.5.The same medical procedure can have different effects on inflammation in the small or big circles of blood circulation.Following private studies were additionally performed:1.Experimental model of AP(4 series of experiments, 44 animals) obtaining a model of pleural complications(certificate for invention No 1631574, A1,1 November 1990,USSR.  ).2.X-ray examination 56 lung anatomical preparations with different forms of the AP,taken from the dead patients.3.Record comparative rheopulmonography before and after performing medical procedures(36 patients).4.Analysis of the observation and treatment of 994 children with AP and its various destructive and pleural complications. The revised treatment guidelines were applied in 101 patients in the initial period of aggressive forms of АP.The received results allow to speak about possibility of the guaranteed prevention of suppurative and destructive complications of the disease.

Pediatrics 2018 International Conference Keynote Speaker Dr Lidija Petrovic-Dovat photo
Biography:

Dr. Petrovic-Dovat is a Director of the Child and Adolescent Anxiety Disorder Program at the Penn State Hershey College of medicine.  She is the Associate Director of Pediatric Behavioral Health Collaborative Care Program and the Associate Site Director for Child Services. Dr. Petrovic’s clinical and research interests include anxiety disorders and depression. She actively collaborates with the Department of Pediatrics at the clinical and research level and is involved in the clinical care, as well as resident and medical student’s education.

Abstract:

Only about 25 % of children with mental illness are seen by a child psychiatrist. Pediatricians are often the first line of care for the majority of children with mental and behavioral health issues. However few primary care providers report confidence in their ability to successfully manage mental illness. Additional educational support is needed to help primary care providers in treating children with the mental health issues. Our group administered survey in 2014 to pediatricians to identify if there is interest in additional education opportunities that can fit the busy pediatrician’s schedule. Primary care providers were administered the investigator-designed online survey that was hosted by the secure web application REDCap (Research Electronic Data Capture). Participation was anonymous and voluntary. Of the Total N = 83 providers sent a survey, n = 28 (33%) responded. The topic the majority primary providers wanted to address in lectures were case management and medication treatment.  Most providers reported having difficulties in coordinating services and expressed interest in lectures. We attempted to address these topic in the live lectures at the clinical site. However, after implementation of the initial round of live short lectures on selected topics at the clinical site, it became apparent that busy pediatrician’s schedule was resulting in low lecture attendance. Penn State Hershey Division of the Child and Adolescent Psychiatry decided to develop education web series, addressing symptoms, diagnosis of the most common mental health disorder, including the warning signs for self-harm. Our group has experience with this type of educational activity on the smaller scale. We have participated as the speakers in a Webinar on the mental health topic targeting school nurses across the Commonwealth of Pennsylvania that was the part of the Penn State Hershey PRO Wellness Center and the Highmark Foundation webinars. It was well received. The first challenges was to identify: the level of interest, topics, and possible modes of delivery for this supplemental professional development. The new “needs analysis” survey was conducted in 2017 .This time survey was sent to pediatricians who worked at our pilot site and 60.53% responded. Participation was anonymous and voluntary and the responses demonstrated a significant level of interest in the idea for lecture type mode of delivery. This time, 87 % responded that they are interested in the lecture delivered online as a webcast training, with a majority expressing a wish for online lectures to be no longer than 30 minutes, which should target specific topics and case studies, and which they could access at their own time and as needed. The Division of the Child and adolescent Psychiatry at our institution made a decision to design, record and offer Open Educational Resources in a format of web series, addressing symptoms diagnosis of the most common mental health disorder, Depression, Anxiety, Autism Spectrum Disorder, Behavior Problems, School Psychiatry and Attention Deficit Hyperactivity Disorder. Speaker with expertise in each area agreed to record lectures. Initial lecture on the topic of Depression and Suicide prevention is available as no-cost, pre-recorded Webcast psycho educational opportunity for pediatricians at our institution on the website dedicated to pediatricians and also child advocate website available to the public. Within few weeks public link had over 500 visits and we will continue to monitor the interest.  This education opportunity might also benefit providers and families who live in areas with a shortage of behavioral health specialists by providing no cost short lecture series through school or other organization.

Keynote Forum

Dr Eyad Altamimi

Jordan University of Science and Technology

Keynote: Obesity Epidemic and Liver disease in Children

Time : 11:55- 12:35

Pediatrics 2018 International Conference Keynote Speaker Dr Eyad Altamimi photo
Biography:

Eyad Altamimi is an Associate Professor of Pediatrics at the Faculty of Medicine at Jordan University of Science and Technology. He had his pediatric gastroenterology training at McMaster University, Hamilton, Canada. Dr. Altamimi published many papers on gastrointestinal issues in Jordanian children. His research focused on epidemiology of pediatric gastrointestinal and nutritional disorders in Jordan

Abstract:

Obesity defined as abnormal or excessive fat accumulation in the body exhibiting health risk. It represents the most serious public health challenge facing health authorities worldwide. Children are not spared; on the contrary, childhood obesity is on the rise. Direct body fat percentage estimation is very difficult. Body Mass Index (BMI) is an acceptable marker, where the ratio of the weight to the height is measured. Although BMI can indicate weight problem, it does not differentiate between fat or lean mass. Coupling BMI with other adiposity assessment tool in children like skinfold thickness might improve the precision of BMI. Obesity is a chronic disorder. Obese children are at increased risk of being obese adults. Obesity can adversely affect almost every organ in the body. Liver and gallbladder involvement are the main gastrointestinal diseases. Obesity represents the greatest risk factor for pediatric Non-Alcoholic Fatty Liver Disease (NAFLD). It is already demonstrated that positive correlation exists between abdominal fat and NAFLD. NAFLD is the most common cause of elevated liver enzymes in children. It might progress into liver cirrhosis and even hepatocellular carcinoma. Prevention of obesity and early intervention through gradual and sustained weight loss are the main strategies to prevent such deleterious complications. 

  • Pediatric Oncology | Pediatric Hepatology | Pediatric Nutrition | Pediatric Hematology & Nephrology Pediatric Allergy & Infectious Diseases | Pediatric Trauma & Depression | Pediatric Care & Nursing Pediatric Surgery

Session Introduction

Dr Muhammad Riaz

Walsall Manor Hospital – UK

Title: Rare presentation of Tuberculosis meningitis

Time : 12:35-13:00

Speaker
Biography:

Dr. Muhammad Riaz has completed MBBS at the age of 25 years from Punjab medical college Faisalabad affiliated with Punjab University, Lahore Pakistan. He has completed fellowship training in Paediatrics from Pakistan and completed MRCPCH in 2013. Currently he is working in Walsall Manor hospital as middle grade in the Paediatrics department.

Abstract:

Tuberculosis (TB) meningitis is the most severe manifestation of acute TB because morbidity and mortality are very high. Evidence suggests that Bacillus Calmette-Guerin (BCG) vaccination reduces the risk of disseminated TB however we present a case report of a 15-year old Bangladeshi girl who suffered from TB meningitis despite having had the BCG vaccination as a newborn but did not develop a scar. She was admitted with six weeks history of pyrexia, headaches and weight loss with no TB contacts or pulmonary signs. Her inflammatory markers were unremarkable and after an initial normal CT scan, her LP showed increased pressure of 40 cmHg. We drained 10 ml of CSF, which was clear and colorless with mildly raised protein of 0.98, glucose 1.2, RBC 1 and WBC 1. She was treated for acellular meningoencephalitis and TB workup was started. In the next 24 hours, her condition deteriorated with reduced GCS of 9-11. Her mantoux was strongly positive within 24 hours and she was started on anti TB medication. Repeated CT scan on day three, showed hydrocephalus and needed a ventricular drain insertion. CSF PCR and culture were positive for TB. GeneXpert claims to give a diagnosis within two hours for TB using gene PCR.

Poster 1: Dr Sarah Critch

Memorial University of Newfoundland, Canada

Title: The effects of resistance exercise on insulin sensitivity in adolescents

Time : 14:00-15:00

Speaker
Biography:

Sarah Critch is the Physiotherapist with the Janeway Lifestyle Program at the Janeway Children’s Health and Rehabilitation Centre, Eastern Health. Sarah obtained a Masters of Science in Medicine (Clinical Epidemiology) from Memorial University, a Bachelor’s degree in Kinesiology (Honours) from Memorial University, and a Bachelor’s degree in Science (Physiotherapy) from Dalhousie University.

Abstract:

An escalating incidence of type 2 diabetes among adolescents is thought to be sparked by rising population-wide prevalence of insulin resistance. Resistance exercise has been shown to reduce insulin resistance, however only immediate, post-intervention effects have been demonstrated. The purpose of this study was to assess the effects, up to six months, of resistance exercise on insulin sensitivity, cardiorespiratory fitness, muscle strength, activity levels, and anthropometric measures among adolescents with insulin resistance. Participants, recruited from a chronic disease prevention program, completed a physiotherapist-supervised 10-week resistance exercise program, 60-minutes, three times per week. A body positive approach was used focusing on health behaviours. Using a repeated-measures design, participants were assessed during a control period then at pre, post, and 6-month follow-up assessments. The primary outcome was insulin sensitivity, measured by the oral glucose tolerance test. Secondary outcomes included cardiorespiratory fitness, muscle strength, activity level, and anthropometric measures. Thirteen participants (14.16±1.19 years old; 8 males,5 females) completed the intervention. Improvements in insulin sensitivity were found, observed as reduced fasting insulin [F(2,22)=7.54,p=0.003,ηp2=0.41], fasting glucose [F(2,22)=3.58,p=0.045,ηp2=0.25], and HOMA-IR [F(2,22)=7.60,p=0.003, ηp2=0.41], which were maintained at follow-up. Cardiorespiratory fitness, waist circumference, and waist-to-hip ratio significantly improved at post and follow-up. The findings suggest that a supervised 10-week resistance exercise program improves insulin sensitivity, cardiorespiratory fitness, waist circumference, and waist-to-hip ratio in adolescents who are at high risk of developing type 2 diabetes. Importantly, these benefits are maintained up to six months. Supervised, resistance exercise adds significant long-term benefit in the management of insulin resistance in adolescents.

Poster 2: Dr Natasha Piracha

Rutgers New Jersey Medical School, USA

Title: Furthering the Integration of Palliative Care in the Community

Time : 14:00-15:00

Speaker
Biography:

Circle of Life Children’s Center, Inc. (COLCC) is a non-profit 501c foundation founded in 2004 providing comprehensive pediatric palliative and end of life care for families at University Hospital, Newark and throughout NJ.  Pediatric age patients frequently do not receive adequate pain and/or symptom management nor do their families receive supportive services, both of which compromise quality of life. Current models of care for seriously ill children are neither sufficiently funded nor physically available to adequately address the needs of the many infants, children and adolescents with life-threatening conditions and their families. At University Hospital, COLCC has been actively involved in the care of more than 200 families and fifty infants annually, who experience premature death or are born with life-threatening and life-limiting conditions, many of whom have limited resources. By partnering with New Community Corporation, one of the largest community development not-for-profit corporations in the US, we are able to continue with our mission: providing integrative services and programs to the underserved community of Newark. This includes inpatient and home-based pediatric palliative and end of life care, professional consultation and education services, family support services, bereavement counseling, community and family education, and volunteer programs. The unique advantage of this partnership allows a full-bodied approach to pain and palliative care, where physicians are able to provide the medical care needed, while community organizations can provide the emotional and social support lacking in physician focused models of palliative care.

Abstract:

Natasha Piracha graduated with her bachelors degree from Rutgers University in New Brunswick, NJ and then subsequently with her MD from Rutgers New Jersey Medical School (NJMS). She is now the chief resident for the combined internal medicine and pediatrics residency program at Rutgers NJMS. She has focused her recent efforts on furthering the efforts of pediatric palliative and end of life care with Dr. James Oleske, Professor of Pediatrics and founder of Circle of Life Children’s Center, Inc and with Dr. Onajovwe Fofah, Assistant Professor and director of neonatology at Rutgers NJMS.

Poster 3: Dr Nam Huu Dao

Vietnam National Children’s Hospital, Vietnam

Title: Effective Method of CVVH Treated Acute Crisis Of Organic Academias

Time : 14:00-15:00

Speaker
Biography:

I am Dao Huu Nam, I have graduated from medical university since 2005 and finished resident doctor of pediatric since 2009. After that  I worked in pediatric intensive care unit. I works as a Senior Consultant in PICU at the Vietnam National Children’s  Hospital in Hanoi, Vietnam. I  have  shown myself  to be a very hard-working, reliable and enthusiastic member of staff. In the professional work I indicate my  very good background knowledge and skill of clinical doctor in pediatric field. I have been studying the PhD course at Hanoi Medical University for 3 years.  I have studied about: effective of method of CVVH treated acute crisis of organic academias at pediatric intensive care unit – Vietnam National Hospital of  Pediatrics. I has published more than 7 papers in national journals and 2 international journals with professor Noriko Nakajima, Japanese Red Cross Medical Center, Tokyo,Japan.

Abstract:

Background: Organic academia is 1 of 2 kinds of inborn errors of metabolism has often acute crisis in neonate or infection. They will die if we do not diagnose exactly and treat immediately. continuous venovenous hemofiltration (CVVH) is a rescue therapy to remove quickly ammoniac plasma or others toxics of metabolic. Objective: Common about effective of method of CVVH treated acute crisis of organic academias. Materials and methods: describe, prospective 6 severe patients, deep coma, metabolic acidosis, hyperamonaemia, was treated acute crisis of organic academias by CVVH, from 1/2014 to 3/2015. Results: Plasma ammonia levels 822 µmol/l  (151-3000 µmol/l) before CVVH, were significantly reduced by 171 ±  54  µmol/l after 12h with CVVH,  pH (7,1 ±  0,2) increased 7,32± 0.05 after 48h with CVVH and time medium CVVH is 4.1 ± 4.3 days, Time treatment in ICU is 6,4 ±  5,4 days. Three patients alive, clinical normal, one patient withdrawal treatment due to deep coma., two patients died due to MODS, one patient had nosocomial infection, one patient had Filter clotted. Conclusion: CVVH effectively and quickly eliminates plasma ammonia and correct metabolic acidosis to treat acute crisis of organic academias. Key word: CVVH, organic acidemias, acute crisis,  hyperammoniac.

Speaker
Biography:

Nguyen Van Tung works as a Senior Consultant in the Pediatric Department at the 108 Military Central Hospital in Hanoi, Vietnam. Since graduating, he has shown himself to be a very hard-working, reliable and enthusiastic member of staff. In the professional work he indicates his very good background knowledge and skill of clinical doctor in pediatric field. He has been studying the PhD course at Hanoi Medical University for 3 years. He has studied clinical features, brain MRI findings, treatment efficacy of Botulinum toxin type A injection and combination with rehabilitation in children with spastic cerebral palsy at at Rehabilitation Department- National Hospital of Pediatrics. He has published more than 5 papers in national journals.

Abstract:

Background: Cerebral palsy (CP) affects movement and posture is caused by brain damage before, during, or after birth [1]. Accurate assessment of neurological damage and their relationship to motor dysfunction levels are important for the diagnosis, treatment and prognosis of cerebral palsy. Objestives:To evaluate the correlation between DTI parameters of each pyramidal tract with the GMFCS level in children with spastic cerebral palsy. Materials and Methods: Descriptive study of 44 children with spastic cerebral palsy from 2 to 12 years were recruited at Rehabilitation Department from 10/2015 to 8/2017. We evaluated clinical characteristics and the distribution of Gross Motor Function Classification System (GMFCS) levels [5]. All participants were studied with brain conventional MRI findings and the following three diffusion tensor imaging (DTI) parameters including tractography for each pyramidal tract: fibre number (FN), fractional anisotropy (FA) and Apparent diffusion coefficient (ADC) [3]. Results: In 44 children with spastic CP mean age: 4.5 ± 2.1y; mean gestational age: 35.34 ± 4.6 wks. Clinically, 22 (50.0%) had quadriplegia, 15 (34.1%) had diplegia and 7 (15.9%) hemiplegia. The distribution of GMFCS levels: 25 (56.8%) level II, 13 (29.8%) level III and 6 (13.6%) level IV. Brain conventional MRI scans showed that 33 (75%) abnormal findings, within periventricular white-matter damage was the hinghest finding 27 (61.4%), and only 11 (25%) normal MRI findings. The FA values of both tracts < 0.05. Conclusions: The DTI (FN, FA and ADC) parameters of each pyramidal tract were significantly correlated with GMFCS levels in children with spastic cerebral palsy (p < 0.001). Keywords: spastic cerebral palsy, diffusion tensor imaging, pyramidal tract.

Speaker
Biography:

Satoshi Ibara has completed his PhD at the age of 30 years from Nihon University and postdoctoral studies from University California Irvine. He is the director of Perinatal Medical center,Kagoshima City Hospital,Japan. He has published more than 30 papers in reputed journal

Abstract:

Background: Recombinant soluble human thrombomodulin (TM-α) has been shown to be useful in the treatment of disseminated intravascular coagulation (DIC) in a heparin controlled study and has been available for clinical use in Japan since 2008. However, data on its use for neonatal DIC have not been reported from any clinical studies, so efficacy and safety were analyzed in 60 neonatal DIC patients identified in post-marketing surveillance. Methods: The standard dose of TM-α was 380 U/kg/day and dose adjustment was based on their reanal function levels. Therapeutic effects of TM-α on DIC and on the survival of DIC patients were evaluated with the DIC diagnostic criteria of the Japanese Ministry of Health, Labor and Welfare established, and with the survival rate on day 28 after the completion of TM-α administration, respectively. Adverse events as well as adverse side effects associated with TM-α administration also were analyzed. Results: The DIC resolution rate as of the day after last administration of TM-α was 47.1 %, and the survival rate at 28 days after last administration was 76.7 %. Hemostatic test result profiles revealed decreased levels of fibrin/fibrinogen degradation products and increased platelet counts and antithrombin activity. Incidences of adverse drug reactions, bleeding-related adverse drug reactions, and bleeding-related adverse events were 6.7, 6.7, and 16.7 %, respectively, with no significant differences between neonatal, pediatric (excluding neonates), and adult DIC patients. Conclusion: This surveillance provided real-world data on the safety and effectiveness of TM-α in the treatment of neonatal DIC in general practice settings.

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Poster 7: Dr So Hyun Nam & Dr Eun jeong Jang

Dong-A University Hospital, Korea

Title: When / How to manage meconium related ileus?

Time : 14:00-15:00

Speaker
Biography:

So Hyun Nam is pediatric surgeon in South Korea. I have been working a member of Korean Pediatric Surgeons Society for 11 years. I am an associate professor in Dong-A University College of Medicine. I’m interested in intestinal rehabilitation program and neonatal surgery especially for premature baby. Long term parenteral nutritional support for motility disorder and short bowel syndrome is always my concern.

Abstract:

Meconium related ileus (MRI) is one of cause for neonatal intestinal obstruction, especially in premature baby. It is associated with cystic fibrosis, but it is very rare in East Asia. MRI can present not only bowel perforation but also persistent abdominal distension with feeding intolerance. We introduced the surgical options of MRI and reviewed the surgical outcome. Material and Method) We retrospectively reviewed the medical records for 45 infants who underwent the operation for MRI from March, 2010 to August 2017 in Haeundae Paik hospital and Dong-A university medical center by single surgeon. We excluded the congenital anomalies and NEC in this study. Results) 45 infants (M:F=23:22) underwent the operation at 20.9 ± 20.6 days after birth. All except 3 were premature baby. Mean gestational age was 28.7 weeks ± 3.9 days and birth weight was 1,235 ± 777.1 g. 13 patients showed the free air on the X-ray and 27 patients showed severe abdominal distension despite of aggressive gastrograffin enema. 4 patients showed fixed bowel loop on the X-ray. The weight at operation was mean 1482.1 ± 779.8 g and bedside operation was done for 31 babies, and the operating time was 71.42 ± 27.2 minutes. Enterostomy was performed in 35 patients. We extracted thick meconium fully via appendix orifice, and then only did appendectomy for 7 patients. 2 patients underwent side to side anastomosis. We could extract meconium via enterotomy and repaired the enterotomy immediately. 2 patients (4.4%) had underlying Hirschsprung’s Disease. 12 patients (26.6%) died from sepsis, respiratory failure, and liver failure. They could start feeding around 7 days regardless of operation method, and the time to full enteral feeding was mean 36.34 ± 34.24 days. Conclusion) Still mortality is high in extremely low birth weight infants. Decompression via appendectomy and primary anastomosis could be another surgical option.

Speaker
Biography:

Dr. Rachel Talbot graduated from Ross University Schol of Medicine in 2013.  Psychiatry internship and residency were completed at Wright State University in Dayton, Ohio.  She is currently a 2nd year child and adolescent psychiatry fellow, PGY-5, at Michigan Medicine at the University of Michigan in Ann Arbor, MI.

Abstract:

Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care.  Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health.  For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service.  Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry.  This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry.  Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame.  There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating “real problems” and personality blunting.  Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare.  For this study, families are given a survey highlighting these concerns, prior to and after watching the video.  Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care.  Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Speaker
Biography:

Margaux N. Yap has completed her MD at the age of 24 years from University of Santo Tomas and had pediatric residency training from St. Luke’s Medical Center Quezon City.

Abstract:

Objective: To determine the relationship between the knowledge, attitude and practices of parents and the immunization status of their children aged 11 to 18 years old. Design: Prospective cross-sectional study. Subjects: 70 guardians of patients aged 11 to 18 years for follow up at the St. Luke’s Medical Center QC (SLMC) Pediatric Out-Patient Department (OPD). Purposive sampling was done. Methodology: Interviewer-administered questionnaire/face to face interview and review of immunization records was conducted from December 2016 to February 2017 among parents of Adolescent patients who followed up at the Pediatric OPD of SLMC QC. Results: Patients were most often partially or non-adherent to their recommended adolescent vaccination schedules. About 93% received at least one dose of the Hepatitis B vaccine, but none received any booster or catch-up dose. Hepatitis A and Td/Tdap vaccines were given to 17% and 10% of adolescents, respectively. The coverage rates for annual influenza (5.7%) and HPV (2.9%) were the lowest among all vaccines recorded. More than 90% of respondents correctly replied to items on seriousness of the diseases targeted by MMR, varicella, and hepatitis A and B. In contrast, only half recognized the possibility of a serious sequelae of HPV infection. The cost of getting immunized was the leading barrier (87%) to availment of this service. Conclusion: No significant associations were found between parents’ range of knowledge scores and the actual immunization status of their adolescent children. However, score of ≥75% appeared to be associated with increased MMR and lower hepatitis A and influenza vaccination rates. In these findings we can conclude that availability of the vaccines in the health center can increase the adherence to adolescent immunization. The top 3 identified barriers in availing immunization were: Financial problems, Lack of knowledge and Lack of vaccines in the health center.

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Speaker
Biography:

Sushil Chandra Mahapatra is a Physiologist with medical background has been working in the area of human nutrition since 1982 at the All India Institute of Medical Science, the most premier institute in India. His area of interest is largely being dietary fiber and nutritional management of diabetes. He got interested in the nutritional management of celiac children when Shikha Nayar joined him for her PhD. The concept of %Gmax  was conceptualized while discussing the available literature and the difficulty in deciding the dose of micro-challenge.

Abstract:

Celiac disease (CD) is an autoimmune disease that occurs in genetically predisposed persons where ingestion of gluten leads to damage of intestine. The only method of treatment of CD is to provide a gluten-free diet (GFD). The intestinal biopsy returns to normal on complete compliance with GFD, while even a small exposure to gluten again leads to histo-morphological changes in the intestinal mucosa. There is considerable heterogeneity across studies concerning complete mucosal recovery ratios achieved by a gluten-free diet in celiac disease. Several celiac patients fail to achieve complete mucosal recovery even if a strict dietary regimen is followed. Number of studies has tried to find out the minimum amount of gluten that can produce appreciable damage to intestinal mucosa. The unit of expression of gluten content of a diet or the gluten load to the intestine has been either in mg or in ppm. Both of them have certain limitations, therefore a novel concept of %Gmax  has been evolved to express the gluten load which is more individualized, country specific as well as scientific. Gmax or gluten maximum is defined as the estimated amount of gluten in the diet, where all the cereal consumed according to the recommended dietary guidelines (RDGs) for an individual is from wheat or wheat products. Using this novel method of expressing gluten load and conducting a controlled clinical trial, it was found out that the gluten load capable of inducing noticeable mucosal changes in the small intestine of Indian CD children could be as low as below 0.1% Gmax. While this dose was sufficient to bring out mucosal damage could show immunological changes in few and hematological changes in none. Therefore more studies are required to find out the %Gmax  which can produce other sign or symptoms.

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Dr Kun Soo Lee

Kyungpook National University School of Medicine, Republic of KOREA

Title: ITP, IVIG and I

Time : 16:50-17:15

Speaker
Biography:

I graduated from KNU School of Medicine in 1973, completed pediatric residency in 1978 and received Ph.D. in 1988. I started an instructor at same KNU in 1981 and retired in 2014. I studied hematology/oncology subspecialty at Division of Pediatric Hematology/Oncology, UCLA, LA, USA. Almost 200 articles have been published. I performed as a President of the Korean Society of Hematology (2002-3), Pediatric Hematology/Oncology (2003-4), BMT (2007), Medical Genetics (2009-11), Pediatrics (2012), internationally Asia Hematology Association (2013~), East Asia Hemophilia Forum (2013), and Advisor of Advanced Neuroblastoma Research Association (2010~). I received a Korea President Award Certificate in 2009.

Abstract:

The main reason for intravenous immunoglobulin G (IVIG) treatment in acute phase of immune thrombocytopenic purpura (ITP) is prevention of possible life-threatening hemorrhage since 1981. On the 1st trial, I just followed the dose of 400 mg/kg/d of IVIG for 5 days for 8 patients with good result in 1983-1984 (Korean J Pediatr. 28:483-491, 1985). On the 2nd, I stopped medication when platelet was over 100,000 /μL for 73 in 1985-1993. Mean treatment days were 2.8 days. The relapse and chronic ITP was less developed in rapid responders (RR: 1-3 treatment days) than in slow responders (SR: more than 3 days) (P<0.05) (Korean J Hematol 2001;36:241-6).  On the 3rd, I also stopped medication when the platelet was over 50,000 /μL for 68 in 1993-2001. Mean treatment days were 2.9 days. Seven of 28 RR and 6 of 8 SR were chronic type (p=0.016) (Korean J Hematol 2001;36:247-52). On the 4th, I reduced daily dose to 200 mg/kg/d when the platelet was over 50,000/μL for 26 in 2005-2006. Average 2 days treatment were needed to increase the platelet count 50,000/μL. Although all 10 non re-treat group who were follow-up over 6 months were acute, all 3 re-treat group who were follow-up over 6 months were chronic (p<0.003) (Clin Pediatr Hematol Oncol 2006;13:143-9). No one died with 4 studies. The IVIG dose was different according to one’s clinical response. In some patient only 1/10 of usual doses (2 g/kg) were sufficient to reach a safe platelet counts in usual life.

 

Speaker
Biography:

Dr. Pham completed his MD at the age of 26 from Hanoi Medical University. He is a Senior Consultant in the Emergency and Poison Control Department of the Vietnam National Children’s Hospital in Hà Nôi, Vietnam, a national-level tertiary referral center for northern Vietnam. He has studied risk factors for high acuity on admission to the emergency department (ED), gender disparities in care-seeking in Vietnamese children, and a comparison of AVPU and Glasgow coma scales in the management of pediatric encephalitis.

Abstract:

Background: Pneumonia accounts for 10% of all hospitalizations for children less than 5 years old, increasing healthcare costs, morbidity (30-35%), and mortality (7-13%). [1] Recurrent pneumonia occurs in 7-15% [2] of children with pneumonia. Immunodeficiency may contribute to recurrent pneumonia in children. [3] There has been no prior research about the prevalence of immunodeficiency in Vietnamese children with recurrent pneumonia. Methods: Descriptive study of 80 children aged 6 months to < 5 years with recurrent pneumonia (>2 episodes in a single year or >3 episodes ever, with radiographic clearing between occurrences) [4] admitted to the VNCH Emergency Department from 9/2015 -  8/2017. Children with known immunodeficiency, immunosuppressive therapy, asthma, chronic lung disease or congenital heart disease were excluded. Patients with radiographic and clinically diagnosed recurrent pneumonia had quantitative assays of serum immunoglobulins, IgG subclasses, and T, B and NK lymphocytes. [5] Results: Mean chronologic age of 12.8+8.3 SD months; 60% were male; 11.2% were premature. Mean number of prior pneumonia episodes was 3.4+1.7 SD. On admission, medians for weight and height were 8+2.2 kgs. Of the 80 patients, the following immunoglobulin deficiencies were noted: (3.8%), IgM (3.8%), IgG (2.5%) IgG1 (5%), IgG2 (1.2%), IgG3 (7.5%), IgG4 (11.2%).  Other causes of recurrent pneumonia were airway abnormalities (6.2&), aspiration syndromes 11.2%) and gastroesophageal reflux (7.5%). Conclusion: Immunodeficiency is an important cause of recurrent pneumonia in Vietnamese children. Assessment of children with recurrent pneumonia can facilitate diagnosing underlying primary immunodeficiency, thereby decreasing mortality and morbidity.

Speaker
Biography:

Dr. Maha Mowafy is a medical doctor graduated from Kasr Al-Eini Medical School, Cairo University and holding a Medical Doctorate degree in Family Medicine. She has more than 18 years of experience in the field of health; including 10 years of experience in working with different international organizations. Dr.Maha is an Assistant Professor of Family Medicine and acting Head of Family Medicine Department. Participating in the different training projects in the department. Developing the course specifications and program specifications for the postgraduate students in the department. Experience has taught me how to build strong relationships with different partners and organization.

Abstract:

The impact of behavior on health, with a special emphasis on children and adolescents, is a central focus for current health policy and for the prevention agenda. This is an interventional study with pre/post assessment. The objectives of which are to test  KAP  of children in sixth grade primary school as regards healthy eating habits and  conduct health educational intervention. A pretest (questionnaire) was taken before the program to assess the KAP among school children as regards healthy eating habits. According to KAP analysis outcome the health education material was tailored.  All cases included in this study were subjected to Health education intervention. Posttest was taken after 2 weeks to determine the impact of the program. A total number of 100 student of children aged 11-12 years in the sixth grade primary were included. The results showed that 41% of studied group were boys in comparison to 59% of Girls. The majority of students had a normal BMI 64%, overweight were 29% (23% boys & 33% girls), and only 14% were obese (12% boys& 16% girls). There was a great improvement in Knowledge in relation to the number of meals per day from 6.7 to 50. For attitude the highest percentage of improvement was related to Milk and yogurt snacks from 11.5 to 85.6 after intervention and for breakfast as a practice. Conclusion: Nutrition education should be introduced to school children as it highly affects their food choices and preferences.

Dr Iwona Ben-Skowronek

Medical University of Lublin, Poland

Title: Adrenal causes of hypertension in children

Time : 18:05-18:30

Speaker
Biography:

Iwona Ben-Skowronek has completed her PhD at the age of 25 at the Medical University of Lublin and she conducted  postdoctoral studies in this University. She is the Head of the Dept. Pediatric Endocrinology and Diabetology, Medical University in Lublin. She has published more than 55 papers in reputed journals and has been serving as an editorial board member of repute.
 

 

Abstract:

Arterial hypertension in children is defined as average systolic and/or diastolic BP that is over the 95th percentile for the gender, age and height on over 3 occasions. The cause of arterial hypertension in 1 to 2% of children is overproduction of catecholamines  as the effect of  pheochromocytoma development. Mutations of the genes VHL, RET, NF1 (Gene 17 Neurofibromatosis type 1), SDHB and SDHD are all known to cause up to 25% familial pheochromocytoma.  Pheochromocytoma may be a tumor of the multiple endocrine neoplasia syndrome, type IIA and type IIB (also known as MEN IIA and MEN IIB). The monogenic defects of mineralocorticoid production in the cortex of adrenals lead to hypertension  with a decreased  serum renin concentration. Most common is the congenital adrenal hyperplasia (CAH),  especially 11-beta hydroxylase deficiency ( 5-8% of CAH) connected with fetal  virilisation in girls and  steroid 17- hydroxylase deficiency associated with the abnormal sex phenotype. Hyperaldosteronism as the cause of hypertension may be diagnosed as familial hyperaldosteronism type I  with a chimeric gene between CYP11B1 and CYP11B2- glucocorticoid remediable aldosteronism sensitive to dexamethasone treatment or familial hyperaldosteronism type II – without hybrid mutation. A rare form is the apparent mineralocorticoid excess ( AME) – an inherited form of hypertension caused by 11-beta hydroxisteroid dehydrogenase type 2 deficiency. Primary aldosteronism is the common cause of hypertension in adults (to 37%) and rare in children   that suggests  development of aldosterone-producing adenomas in children prior to development of hypertension and vascular damage. The differential diagnosis  of hypertension in children is necessary for choice of adequate treatment.