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

Biography:

Silvia Strambi is a Post-graduate Pediatric Surgery student and a Scientific Consultant of Department of Surgical, Medical, 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 7th 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. 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 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 paediatricians. 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:

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 has completed his MD at the age of 30 years from Oran School of Medicine.

Abstract:

The supernumerary urethra, also called urethral duplication or accessory urethra is a rare congenital anomaly interesting primarily the boy. It is defined by the juxtaposition of two or more channels in smooth muscle.

Materials and methods

This is a boy aged 02ans with épispadias, clinical examination revealed a complete foreskin; two openings through which the child urine, normal glandular apical hole and another hole epispadias from joining forces is the root of the penis.The passage of two urinary probes confirms duplication.After treatment catheterization of both ureters by two probes and clouding; we find the confluence was about 3 cm of the neck confirmed by the endoscope.

The procedure is the dissection of the ectopic urethra epispadias to confluence and resection at this level.

Biography:

Robert E. Cilley, MD 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:

Nataliya Piletska is a final year medical student of King’s College London due to begin her foundation year placement in Oxford University Hospitals Trust this autumn. She has a special interest in microbiology and paediatrics, intending to continue participating in research alongside her work.

Abstract:

During the course of appendicectomies, microbiological swabs are often taken for culture and sensitivities; however, the results rarely impact the antibiotic regime. The aim of this audit was to explore the frequency with which swabs are taken for acute appendicitis and what impact their results have on subsequent management and outcome.Data was compiled from all appendicectomies performed over a 12-month period at the Evelina London Children’s Hospital from January 2014-15. In the sample of 101 patients, 35 were performed electively and 66 for acute appendicitis. Both electronic and paper-based information was collected regarding clinical presentation, intraoperative findings, whether bacteriological samples were taken and how the results influenced management.This audit studies the bacteriological epidemiology of acute appendicitis, which antibiotics are most frequently prescribed, the most common complications and their management. Ultimately it explores the impact of intraoperative microbiological sampling on treatment and outcome.

Biography:

Dr. David Partrick completed his Docorate of Medicine from the University of Washington School of Medicine, and completed clinical surgical and pediatric surgical training at the University of Colorado. He is the Director of Surgical Endoscopy and Surgical Director of the Digestive Health Institute at Children’s Hospital Colorado, and Professor of Surgery at the University of Colorado. He has published more than 100 papers in reputed journals and is active in many professional societies.
 

Abstract:

We hypothesized that children with solid tumors who receive a PRBC transfusion within 30 days of tumor resection will have higher rates of recurrence, mortality, and infectious complications.

Materials & Methods: A retrospective review was performed of all children who underwent resection of a solid malignancy over an 11-year period. Outcomes variables included ICU stay, hospital length of stay (LOS), infectious complications, disease free interval, tumor recurrence, and mortality. Univariate and multivariate analyses were performed. 

Biography:

Robert P. Foglia, M.D. is Professor of Surgery and Pediatrics, Chief of Pediatric Surgery at the University of Southwestern Medical Center and Surgeon-in-Chief at Children’s Medical Center Dallas.  He is co-editor of a major textbook of pediatric surgery and has 30+ years of experience in Perioperative Management and Performance Improvement. Dr. Foglia is responsible for the clinical growth of surgical programs at Children’s and leads process improvement initiatives in the areas of quality, service, and stewardship. 

Abstract:

Our health system had a strategic plan to recruit surgeons, develop new programs, and shift volume outside of the Main OR (MOR) suite. Previously, many of perioperative processes were dysfunctional, data with paper charting often had inaccuracies, and physicians had a healthy skepticism of the data, leading to a lack of engagement. Our aims included optimizing space, personnel, and processes, developing performance metrics, setting clear expectations for resource allocation, and sharing credible data with stakeholders. Perioperative performance improvement is the orchestration of a multidisciplinary team to achieve a series of goals, which are sustainable.  Three elements were essential to achieve these goals, prompt communication with shared goal expectation, operations management, and the electronic health record (EHR).

The results from 2006 to 2015 were: a) cases increased from 19,148 to 29,308 (53%), b) block utilization increased from 47% to 72% (+53% ), c) on time starts increased six-fold (12% to 80%), d) case cancellations reduced three-fold (14% to 4%), e) MOR cases increased +2%, f) cases outside of MOR increased from 5,606 to 15,443 (+175%), while MOR cases increased 2%, g) revenue increased 99%, from $116M to $231M in 2015. Prompt and consistent communication with physicians and perioperative leadership, the use of operations management to change processes, and the EHR resulted in marked improvement in multiple performance metrics and a concomitant increase in engagement and "buy in" by physicians, administrative and nursing leadership.

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:

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:

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 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.

Abstract:

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. 20 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. 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 honored 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:

Prof Mehmet Emre Atabek has completed his PhD at the age of 24 years from Selcuk University,Turkey and postdoctoral studies from Selcuk University School of Medicine and Erciyes University School of Medicine . He is the director of Pediatric Endocrinology Department in Necmettin Erbakan University School of Medicine,Konya,Turkey. He has published more than 140 papers in international journals and  most of them indexed  in SCI/SCI-Expanded list.  He has existing intensive studies on obesity and he is a specialist in this field.

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.

   143 obese children and adolescents aged between 8-17 recruited in the study. Metabolic syndrome was defined using International Diabetes Foundation (IDF) and World Health Organisation (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, Paediatric surgeon in Guangdong Women and Children Hospital and Health Institute. 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, BPS. He has published more than 20 papers in reputed journals .

Abstract:

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. Summarized experience of surgical treatment by comparing the  cVATS 、VAMT and thoracotomy.

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:

Dr. Peng Liu got his MD&PHD degree of Neurosurgery in 2011 from Southern Medical University, he also has been a postdoctoral 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 three 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 González, MD, is anesthetist who performed a Fellow in Pediatric Anesthesia in 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. Preoperative information could relieve those feelings.

 Patients and 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.

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:

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:

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.

  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.

   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:

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 Paediatrics, BPKIHS, Dharan.

Abstract:

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.

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:

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 patient 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).

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:

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

Biography:

Giuseppe Castaldo is an 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.

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

Abstract:

Introduction: :

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.