Day 2 :
- General Pediatrics
Dr. Peter Averkiou
Florida Atlantic University, Florida
Title: Early Clinical Exposure in Medical Education: The Newborn Nursery Clinical Experience
Dr. Peter Averkiou is a pediatrician and an Associate Professor of Pediatrics at the Charles E. Schmidt College of Medicine at Florida Atlantic University. He is the Co-Director of the four Foundations of Medicine Courses, the Director of the Service Learning Projects, the Director of the Newborn Nursery Clinical Rotation and the Director of the Synthesis and Transition Course at the medical school.
The Newborn Nursery Clinical Experience is an innovative, early exposure for medical students to the hospital setting and family medicine. Early in their second year, our medical students are immersed into the Newborn Nursery, while also experiencing the neonatal intensive care unit (NICU) and attending obstetrical deliveries. They witness, first hand, the interprofessional and interdisciplinary workings of pediatricians, obstetricians, neonatologists, anesthesiologists, nurses and other professionals. The medical students are also instructed on how to read a medical chart and on proper medical documentation and its importance. They also interact with the mother of the patient, as well as other family members that are in attendance, and long-term continuity of integrated care and the focus on the personal patient/patient’s guardian(s) - physician relationship is stressed. This experience is always well-received and highly evaluated by our medical students. It also helps to prepare them for their third-year clinical rotations in family medicine, pediatrics and Ob/Gyn.
Taipei Veterans General Hospital, Taiwan
Title: Maternal, perinatal, and postnatal predisposing factors of hearing deficit in full-term children: A matched case–control study
As an academic neonatologist and pediatric intensive care physician, Dr. Tsao work in neonatal and pediatric intensive care, congenital airway anomalies, newborn screening. Dr. Tsao’s current research interests include i) universal newborn screening program of critical congenital heart disease, congenital CMV infection, and congenital toxoplamosis, ii) diagnosis and therapeutic intervention of airway anomalies via flexible bronchoscopy, iii) underlying mechanism and management of pediatric ARDS and HIE, and iv) long-term outcomes of high-risk infants.
Introduction: Studies on risk factors for childhood hearing deficit (HD) are usually based on questionnaires or small sample sizes. Therefore we conducted a nationwide population-based case–control study to comprehensively analyze the maternal, perinatal, and postnatal risk factors for HD in full-term children.
Methods: We retrieved data from three nationwide databases related to maternal characteristics, perinatal comorbidities, and postnatal characteristics and adverse events. We used 1:5 propensity score matching to include 12,873 full-term children with HD and 64,365 age-, sex-, and enrolled year-matched controls. Conditional logistic regression was used to evaluate the risk factors for HD.
Results: Among the various maternal factors, maternal HD (adjusted odds ratio [aOR]: 8.09, 95% confidence interval [95%CI]: 7.16–9.16) and type 1 diabetes (aOR: 3.79, 95%CI: 1.98–7.24) had the highest odds of childhood hearing impairment. The major perinatal risk factors for childhood hearing impairment included ear malformations (aOR: 58.78, 95%CI: 37.5–92.0) and chromosomal anomalies (aOR: 6.70, 95%CI: 5.25–8.55), and the major postnatal risk factors included meningitis (aOR: 2.08, 95%CI: 1.18–3.67) and seizure (aOR: 3.71, 95%CI: 2.88–4.77). Other factors included acute otitis media, postnatal ototoxic drug use, and congenital infections.
Conclusions: Many risk factors for childhood HD identified in our study are preventable, such as congenital infection, meningitis, ototoxic drug use, and some maternal comorbidities. Accordingly, more effort is required to prevent and control the severity of maternal comorbidities during pregnancy, initiate genetic diagnostic evaluation for high-risk children, and aggressive screening for neonatal infections.
- Pediatric Hepatology
Shiraz university of Medical Sciences, Iran
Title: Diagnostic Value of a Modified Version of Wilson’s Diagnostic Score in Pediatrics
Sarvin Sajedianfard graduated from Shiraz University of Medical Sciences. She is working at oncology center in Shiraz, Iran as a pediatrician for 2 years.
Background and objectives: Wilson’s disease (WD) is a genetic disorder of liver affecting copper metabolism and is one of the common causes of liver failure. In this study we aimed to test the diagnostic value of a questionnaire for the diagnosis of WD in pediatrics age group.
Materials and Methods: Two groups of 70 children with the diagnosis of WD and 70 without WD were included in the study. The gold standard test for the diagnosis of WD was liver biopsy. Then a modified questionnaire with 4 items was used and the results were compared to the definite diagnosis made by pathology.
Results: The median (IQR) modified score in those with WD was significantly higher than that for the comparison group. The sensitivity and specificity were 100% and 98.6%, respectively, according to an NPV of 100%.
Conclusion: As WD is one of the causes of liver transplant, this modifies scoring system helps to diagnosis of WD in children especially in regions with limited access to specific laboratory tests for the diagnosis of WD.
- Pediatric Allergy & Infectious Diseases
Kaohsiung Veterans General Hospital, Taiwan.
Title: Shedding Duration of Household ESBL-Producing, and Sequence Type 131 Escherichia coli among Different Regions in Taiwan
School of Medicine, China Medical University, Taiwan. 1993, M.D. Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Pediatric Residency 1999. Research fellowship, Division of Infectious Diseases, National Health Research Institute, Taipei, Taiwan 2001. Research fellowship, Division of Pediatric Infectious Diseases, Children Hospital Boston, MA, USA 2007. Research fellowship, School of Medicine, Harvard University, MA, USA 2007. Associate Professor, School of Medicine, National Yang Ming University, Taipei, Taiwan 2016. Professor, School of Medicine, National Yang Ming University, Taipei, Taiwan 2023. Lately, I conducted several studies and published several SCI literatures in the field of ESBL E. coli infection in children, adults as well as environment and community carriage, such as the article Extended-spectrum β-lactamase-producing Escherichia coli bacteremia: comparison of pediatric and adult populations in J Microbiol Immunol Infect. In 2018. Bloodstream Infection with Extended-spectrum Beta-lactamase–producing Escherichia coli: the role of virulence genes in J Microbiol Immunol Infect. In 2019. Prevalence and Risk Factors for Colonization by Extended-spectrum β-lactamase-producing or ST 131 Escherichia coli among Asymptomatic Adults in Community Settings in Southern Taiwan in Infection and Drug Resistance in 2019. Prevalence and Household Risk Factors for Fecal Carriage of ESBL-Producing, Sequence Type 131, and Extraintestinal Pathogenic Escherichia coli among Children in Southern Taiwan in J Microbiol Immunol Infect, and Distribution and Genomic Characterization of Third Generation Cephalosporin Resistant Escherichia coli Isolated From a Single Family and Home Environment: A 2-Year Longitudinal Study in Antibiotics in August, 2022. Published and/ or presented over 70 abstracts and peer reviewed publications.
Background: Broad-spectrum drug-resistant (defined as resistant to 3rd generation of cephalosporines or new quinolones) Escherichia coli (E. coli), particularly clonal group sequence type 131 (ST131) that produce CTX-M types of extended-spectrum beta-lactamase (ESBL)-producing E. coli have dramatically increased worldwide. In our prior studies, we found that the prevalence of community-onset ESBLproducing E. coli UTIs among infants was similar in urban and rural populations in southern Taiwan. We also found in that study that most infants with UTIs were previously healthy with no apparent risk factors. The increase of ESBL-producing E. coli infections may be related to the infection by asymptomatic carriers or environmental circulation of ESBL-containing microorganisms. However, the distributions of resistant E. coli in households in different geographic regions of Taiwan are still unknown. Additional prospective multicenter studies are required to investigate the prevalence of community-onset E. coli infections in different geographic regions. Methods: E. coli isolates from the stool of children with uropathogenic or fecal carriage of BDR E. coli and their families and from their household environments were prospectively identified in different regions of Taiwan. The E. coli isolates identified as BDR were tested for ESBL, and multilocus sequence typing (MLST) was used to detect ST131. Fecal shedding duration of different regions was compared. Purpose: This study investigated the prevalence of BDR E. coli, particularly for ST131 and ESBL-producing strains, in human carriage, the environment, and households and the duration of shedding of BDR E. coli in different geographical regions of Taiwan.