16^th International Conference on Pediatrics and Pediatric Cardiology February 18-19, 2019 - Hotel Novotel Amsterdam Schiphol Airport - Amsterdam, Netherlands

Biography:

Cindy Rodrigues Cleto is a sixth year Medical Student at the University of Liverpool, UK. She completed an MReS in Cardiovascular Science at the University of Newcastle where she carried out this research.

Abstract:

Introduction: Primary cilia on endocardial cells could prove to be a cause of congenital heart defects. Endocardial cells mainly contribute to the outflow tract (OFT) and atrioventricular (AV) endocardial cushion; later developing into the four heart valves. Knocking out IFT88 creates abnormal primary cilia and in turn causes cardiac malformations.

Aims: The aims of this study were to establish the spatiotemporal expression of primary cilia on endocardial derived cells; and by using an IFT88 mouse model, to discover if defecting to the primary cilia in endocardial derived cells causes an abnormal cardiac phenotype?

Methods: For the spatiotemporal expression of primary cilia, Tie2Cre positive mouse embryos of age’s e10.5-e12.5 were stained with anti-green fluorescent protein and acetylated tubulin to show the endothelial cells and primary cilia respectively. For the IFT88 mouse model, three mutants were collects at e15.5; two were hematoxylin and eosin stained to look at histology and one was stained with acetylated tubulin to show any defect in the primary cilia.

Results: The spatiotemporal expression of primary cilia mainly highlighted that there is an abundance of cilia in the OFT and AV endocardial cushions at e10.5 and e11.5 but this significantly drops by e12.5. The IFT88 mouse model showed that knocking out IFT88 significantly decreases the number of primary cilia in mutants, causing cardiac malformations including atrio-ventricular septal defects and dysplastic mitral and tricuspid valves.

Conclusion: Primary cilia are present in the endocardial derived cells at earlier time points. Knocking out IFT88 does produce defective cilia that lead to cardiac malformations.

Biography:

Veena Dhawan has completed her PhD from PGIMER and did Post-doctoral Research at Minneapolis USA and Postgraduate Institute of Medical Education and Research, Chandigarh, India. At present, she is working as a Professor in the Department of Experimental Medicine and Biotechnology at PGIMER a National Institute of repute. She has published around 90 papers in reputed journals and written around seven book chapters.

Abstract:

Macrophage heterogeneity within atherosclerotic lesions has attracted much interest owing to the importance of balance between M1 and M2 population. Though, it remains unknown how macrophage heterogeneity is regulated. Moreover, the regulation of macrophage polarization and activation also involve DNA methylation. However, it remains unknown which genes are directly regulated by DNA methylation. The aim of the study was to assess the gene-specific promoter DNA methylation status of M1/M2 macrophage polarization markers STAT1, STAT6, MHC2, IL12b, iNOS, JAK1, JAK2 and SOCS5 in peripheral blood mononuclear cells of CAD patients. A case-control study was performed with 25 CAD patients and 25 controls to investigate the gene-specific promoter DNA methylation status using MS-HRM analysis. Our data indicates that there was a clear-cut difference in the pattern of gene-specific promoter DNA methylation of above mentioned genes in CAD patients as compared to controls. A consistent hypomethylated pattern was observed for most of the samples including both CAD patients and controls, which was heterogeneous DNA methylation as evident by their melting profiles. A significant difference was observed between the mean percentage methylation of STAT1, IL12b, MHC2, iNOS, JAK1 and JAK2 in CAD patients and control subjects. Our data showed that MS-HRM assay is a rapid and inexpensive method for qualitatively investigation and identification of aberrant gene-specific promoter DNA methylation changes in CAD. Since, monocytes and macrophages play a significant role in atherosclerosis, we propose that epigenetic markers including gene-specific promoter DNA methylation based on monocyte/macrophage might aid as diagnostic markers or drug targets for clinical application. Therefore, skewing the M1/M2 balance towards a more preferable phenotype through DNA methylation-related interventions may offer novel possibilities for atherosclerotic disease management.

Biography:

Abstract:

Transglutaminase 2 (TG2) is a calcium-dependent enzyme and in the cardiovascularsystem, TG2 has been reported to be involved in the development of cardiac hypertrophy, vessel remodeling, and age related vascular stiffness. Interestingly, TG2 is implicated in the regulation of muscle metabolism via modification of respiratory complexes and the ADP/ATP transporter in the mitochondria of myocardium. However, the role of TG2 in the heart during conditions of pressure overload in relation to fatty acid(FA) oxidation has not been investigated. Hence, we investigated the involvement of TG2 in cardiomyocytes contraction under FA supplementation. Using TG2 inhibitor and TG2-deficient mice, we demonstrated that FA-supplementation activated TG2 and increased ATP level and contractility of cardiac myocyte from normal heart. By contrast, in cardiac myocytes from angiotensin-II treated rats and mice, the effects of FA-supplementation on TG2 activity, ATP level and myocyte contraction were abolished. Furthermore, TG2 was inhibited by S-nitrosylation and its level increased in hypertensive myocytes. Treatment with inhibitor for neuronal nitric oxide synthase (nNOS) restored FA-induced increase of TG2 activity and myocyte contraction. Moreover, intracellular Ca2+ levels were increased by FA-supplementation in both normal and hypertensive myocytes, showing that S-nitrosylation of TG2 but not alteration of intracellular Ca2+ levels are responsible for contractile dysfunction. These results indicate that TG2 plays a critical role in the regulation of myocyte contractility by promoting FA metabolism and provide a novel target for preventing contractile dysfunction in heart with high work-load.

Biography:

Ahdi Amer is a Professor of Pediatrics at Wayne State University School of Medicine, Detroit, Michigan. He has expertise in the field of General Academic Pediatrics and Pediatric Infectious Diseases. His main areas of interest are vaccine development, vaccine safety, and various pediatric infectious and dermatological disorders. He has conducted clinical research supported by the WHO, Merck and Pfizer on vaccines and other infectious and dermatological topics. He has authored and co-authored >40 articles published in peer-reviewed journals. He has presented in several national and international settings on vaccine-related topics.

Abstract:

Abstract

Background & Objective: Non-nutritive sucking (NNS) using a finger or pacifier is a natural reflex for infants. In gratifying this innate need, NNS can be soothing and may facilitate a smooth transition to sleep. We hypothesized that infants with their innate desire for gratification through NNS may overfeed if the bottle or breast is constantly offered instead of a pacifier. Our primary objective was to determine whether the use of pacifier in early infancy is associated with lower incidence of obesity at 9-15 month of age.

Methods: Parents of 399 infants 9 to 15 months old visiting the General Academic Pediatric Clinic were interviewed. They were asked whether a pacifier was used consistently ≥9 months and the reason for its use. BMIs at birth, 6 months and on the day of interview were calculated.

Results: Of the 399 recruited infants, 204 (51%) used a pacifier consistently for ≥9 months and 195 (49%) were non-user. More infants in the pacifier non-user group were significantly either overweight, 40 (21%) with BMI ≥85% or obese, 32 (16%) with BMI ≥95% than in the pacifier user group: 22 (11%) and 22 (11%) respectively (P.003). Formula fed infants accounted for the increased number of overweight and obese infants in the non-user group.

Conclusions: The use of a pacifier in infancy was associated with a lower incidence of obesity at 9-15 month of age. Given the current prevalence of childhood obesity, we believe that offering a pacifier between feeds can provide a protective effect against infantile obesity.

Biography:

Abel Gidey is one of the youngest energetic and affable pediatricians working in Ayder specialized Comprehensive Hospital, Ethiopia. He has finished his Medical Doctor in 2014 and is an Assistant Professor of Pediatrics since October 2018. He was one of the speaker at the World Pediatric Conference December 2018 which was held in Abu Dhabi, UAE.

Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause that can affect the multiple organs of the body. Cardiac involvement among children with SLE ranges in various studies from 12 to 54 percent. The manifestations are varied in nature and severity. Valvular lesion is the most encountered form of heart disease in systemic lupus erythematosus (SLE). The mitral valve being the commonest site. We report a case of 16 years old male adolescent who was referred from district hospital in Tigray region. He was newly diagnosed Systemic lupus erythematosus with rapid progression of valvular insufficiency and congestive heart failure. This is one of the rare case reports with diagnostic and therapeutic challenge.

Biography:

Lidia Sileshi Tefera has completed her graduation from Hawassa University school of Medicine with a Medical degree and completed her Residency in Pediatrics and Child health from Addis Ababa University School of Medicine. She is the Head of Department of Pediatrics and Child health in Adare General Hospital and Affiliated Staff of Hawassa University College of Medicine and Health Sciences.

Abstract:

While the health-related quality of life (HRQOL) of children with congenital heart defects is primarily affected, caring for a child with birth defect has an impact on the family’s quality of life as well. Understanding the level of quality of life of the parents, which is likely to vary in different cultural settings, beliefs and parental educational status may help to implement educational programs and other interventional measures that may improve the HRQOL of parents of such children. This cross-sectional comparative study reports the health-related quality of life of mothers of children with congenital heart diseases in a sub-Saharan setting. Mean age of the mothers in the study group was 32.2±7.1 years where as that of the control group was 30.5±6.5 years (p=.054). One hundred-four children had congenital cardiac lesions classified as mild to moderate while 31 patients had severe lesions. On average, mothers in the study group showed poor performance on the Short Form-36 (SF-36) survey with statistically significant differences on all sub-scales including general health perception, physical functioning, role physical, role emotional, social functioning, bodily pain, vitality and mental health. Severity of the congenital heart defect was not associated with statistically significant difference in the health-related quality of life of the mothers. Mothers of children with congenital heart disease in our study have significantly lower quality of life in all domains of SF-36 compared to the control group. Planning and devising a strategy to support these mothers may need to be part of management and clinical care of children with congenital heart diseases.

Biography:

Angela Harrinanan is a nursing professor at Centennial College with extensive pain management experience in acute pain service. She also works at Centennial Health Simulation center as a simulation support for faculty with limited simulation experience. Angela holds a Master in Nursing from University of Toronto, specializing in Nurse Practitioner.

Abstract:

Introduction: Pain management has been identified as one critical element in nursing practice and students are required to assess and manage pain appropriately. Many studies support the effectiveness of simulation as a teaching methodology; however there is a gap in measuring students’ learning outcomes in pain simulation. The purpose of this study is to assess students’ knowledge of pain assessment and management. Furthermore this research study is to explore students’ perspectives in pain simulation.

Research Question/Hypothesis: Will the pain simulation experience improve students’ knowledge of pain (a) assessment and (b) management? (c) What is the students’ perspective/experience when participating with the pain simulation?

Methods: A mixed methods approach was utilized to gain an understanding of student’s learning of pain assessment and management in simulation. A convenience sample of 159 year two BSc Nursing students were recruited for Adapted Pain Knowledge and Attitude Pre- and Post-Simulation Surveys during their scheduled simulation experience in winter 2018 semester. Additionally, 10 students participated in focus group sessions to explore nursing students’ experience in pain simulation.

Results: Descriptive and qualitative data were analyzed with five themes emerging: Developing appropriate pain assessment skills, administrating pain medication with clinical reasoning, enlightening pain management from patient’s perspective, developing clinical decision making and providing new perspective of pain management. Themes were derived from qualitative focus group findings and aligned with the pre- and post-pain knowledge and attitude survey (PPKAS) quantitative results (McCaffery and Ferrel, 2012). Key learning points that student have gained from pain simulation experience are: Communicating effectively with patient, do not underestimate patient’s pain, acquiring “solid” pain medication knowledge to provide safe patient care, “Practice makes perfect” and tailoring pain medication based on patient’s conditions.

Conclusion: The PPKAS surveys and focus group discussions reveal student’s learning perspectives and suggestions for future pain simulation to; supporting student learning in pain simulation; fostering student centered learning simulation environment and; providing faculty support in pain simulation.

Biography:

Stavros Theologou works as a Registered ITU Nurse in Cardiac Surgery ICU of ‘Evangelism’s’ General Hospital of Athens. He completed a Post-graduate course in ‘Intensive Therapy Units and Emergency Nursing’ in Medical School of National and Kapodistrean University of Athens and a Post-graduate course in Health and Social Welfare Services in School of Business Administration of University of West Attica and currently is a PhD candidate in Medical School of Athens. He has also contributed in publications in several reputed scientific health journals.

1: Registered ITU Nurse, ΜSc, PhD (c) Cardiac Surgery ICU, ‘Evangelismos’ General Hospital of Athens, Greece.  

2: Research Fellow,  MSc,  PhD (c),  Department of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.

3: Assistant Professor, ΜSc, PhD,  Department of Economics of the University of Piraeus, Director at the Laboratory of the Health Economics and Management of University of Piraeus

Abstract:

Introduction: The hospitalization of post cardiac surgery ICU patients constitutes a complex mixture of procedures affected by a variety of clinical, administrational and technical aspects of care. The respective cost may drastically increase due to these patients’ increased clinical needs, including also the clinical state of delirium which is a quite common complication following this type of operation.

Methods: Τhe study included 179 consecutive patients who underwent open heart operation with cardiopulmonary bypass. The Confusion Assessment Method (CAM-ICU) was used for delirium diagnosis. Hospitalization outcomes were recorded by measuring certain intra - and post - operative procedure time intervals, along with the ICU and in-hospital length of stay as well.

Results:

A total of 179 patients post cardiac surgery were investigated, 129 of them were male and the rest 50 were female. The delirium complication was recorded in 20 out of 179 patients of the study (11.2%)

Bivariate analysis revealed that prolonged intraoperative time in cardiopulmonary bypass (p<0,001), prolonged sedation time (p=0,005) and prolonged length of stay with endotracheal tube (p<0,001) were significantly correlated with increased total health care cost.

Multivariate analysis showed that the level of complexity of the surgical operation (p<0,001), delirium complications (p<0,001) and the prolonged in-hospital length of stay (p<0,001), formulated altogether a group of factors for total health care cost increase.

Conclusions: A variety of factors seem to increase post cardiac surgery ICU patients’ total hospitalization cost and jeopardize quality of care and health outcomes. Resource management and monitoring, analytical process of health care costing in the Cardiac ICU and Ward, and recruitment of nursing staff with advanced