11^th International Conference on Pediatric Pathology & Diagnosis March 15-16, 2017 London, UK

Biography:

Lisa Chan is a Board Certified in Anesthesiology with subspecialty certifications in Pediatric Anesthesiology and Transesophageal Echocardiography. In addition, she is pursuing her Master’s Degree in Health Informatics at University of Illinois-Chicago, with an interest in Social Media and Mobile Application in improving
healthcare. She was formerly the Director of Clinical Informatics at Joe DiMaggio Children’s Hospital. She sits on the social media committee in American Society of Regional Anesthesia and Society of Technology in Anesthesia. In the American Society of Anesthesiology, she is a member of the Committee on Communications and Electronic Media and Information Technology Committee.

Abstract:

Adolescents are known for their need to find their own voice and identity, as well as form pack relationships to enforce their peer
acceptance. Both dueling desires are matched in the world of social networking. One can easily post and voice their opinion on
matters without resistance, meanwhile receiving almost instantaneous input from peers with likes, responses, etc. This dissociated yet intimate world of social media is what increasing numbers of pre-adolescents and predominate adolescents are growing up with, which inadvertently is shaping their communication skills. After looking at the psychosocial aspects of social media, the different types of social media will be explored, stressing the advantages and disadvantages of each medium in its use for healthcare outreach. Lastly, guidelines will be explored as to what is medically legal and suggest best practices in communicating with adolescents who protect the rights of the adolescent while also maintaining the professionalism of the medical provider.

Biography:

Kankana De has completed her PhD from Vidyasagar University and has worked as a Counselor at Anwesha Clinic in Salboni Rural Hospital. She has completed four Post-graduate studies in Anthropology, Botany, Business Administration and Social Work. She is a Reviewer of Journal of Social Science Research. She has
presented her work at the Vinod Gupta School of Management organized by Indian Institute of Technology, Kharagpur IIT, India; Vidyasagar University, Midnapore, India, etc. She has published six papers in reputed journals.

Abstract:

The BMI is an attempt to quantify the amount of tissue mass (muscle, fat and bone) in an individual, and then categorize that
person as underweight, normal weight, overweight, or obese based on that value. The BMI is generally used as a means of correlation between groups related by general mass and can serve as a vague means of estimating adiposity. The duality of the BMI is that, while it is easy to use as a general calculation, it is limited as to how accurate and pertinent the data obtained from it can be. Generally, the index is suitable for recognizing trends within sedentary or overweight individuals because there is a smaller margin of error. The BMI has been used by the WHO as the standard for recording obesity statistics since the early 1980s. The study are a considered was Salboni block which is 25 km away from Midnapore town. Total 1009 adolescent girls were considered for this study (10-19 years). Structured questionnaires were followed to know details of socio-economic status of studied adolescent and stature was also measured to the nearest 0.1 cm in bare feet with participants standing upright against a wall-mounted stadiometer. It was observed that FMI and BMI have weak correlation, among them, 24.4% were under nutrient based on BMI and 99.8% are undernutrition based on the percentage of body fat. Around 34.2% had low health status by assessing Rohrer index. According to ROC curve, 18.45 kg/m2 was the obtained cut off value for this study. Malnutrition affects HIV transmission by increasing the risk of transmission from mother to child and also by increasing replication of the virus. In communities or areas that lack access to safe drinking water, these additional health risks present a critical problem. Lower energy and impaired function of the brain also represent the downward spiral of malnutrition as victims are less able to perform the tasks they need to in order to acquire food, earn
an income, or complete their education.

Biography:

B.B. education: BA (Hons), MA, Nat. Sci., Cambridge; D.Phil. Biochemistry, Sussex (R.C. Bray);Postdoc UEA (A.J. Thomson OBE) and Utah State (R.C. Holz). Research positions: CCLRC Daresbury Laboratory; EU Fellowship, Fachrichtung Biophysik, Universität des Saarlandes. Faculty positions: 2001-2014, Medical College of Wisconsin; 2014-present, Chair and Wehr Distinguished Professor of Physics, Marquette University, Milwaukee, WI, USA.

Abstract:

Mitochondrial disease (MD) presents with a wide range of clinical, pathological, and biochemical outcomes and is, consequently, very difficult to diagnose conclusively. EPR is a magnetic resonance technique that detects and characterises unpaired electrons that are present in transition metal ions in certain oxidation states (e.g. FeIII, CuII, MnII), clusters thereof (e.g. [2Fe2S]+red, [3Fe4S]+ox, [4Fe4S]+red), and  free  radicals  (e.g.  UQ•−,  FADH•).  The  mitochondrial respiratory chain complexes I - IV contain 23 potentially paramagnetic centers that exhibit distinct EPR signals depending on their redox potentials, the availability of electrons, the catalytic competence of each of the enzymatic complexes, and the integrity of the electron transport chain (ETC). In addition, EPR signals may be observed from UQ•−, and from the [3Fe4S]+ cluster of m- aconitase that arises due to oxidative stress. Key factors thought to be involved in the symptoms and pathology of MD are lowered ATP production, and the production of toxic reactive oxygen species (ROS). Either or both of these can occur when electron transfer is impeded due to lowered expression, lowered activity, or structral alteration of ETC complexes, or compromised ingress or egress of reducing equivalents. EPR of rapidly-frozen fresh biopsy tissue is uniquely able to provide a snapshot of the electron distribution among the redox centers in the functioning mitochondrial ETC, against a background of other biochemical and pathological assays. We recently described the first application of this methodology, to a rat model of MD (Bennett et al. 2016 Free Rad. Biol.Med. 92, 141-151), and will here describe progress toward translation of the approach for diagnosis and differentiaition of MDs in children.

Biography:

Hiroyuki Shimada has completed his MD and PhD at Yokohama City University School of Medicine and Ohio State University College of Medicine.  He is Professor of Pathology at University of Southern California Keck School of Medicine, the founder of International Neuroblastoma Pathology Classification, and director of the COG Neuroblastoma Pathology Reference Laboratory.  He has been reviewing ~700 neuroblastoma cases/year from US, Canada, Australia, and New Zealand, and participating in various clinical and translational research activities in the filed of pediatric oncology.  He authored/co-authored >180 peer-review papers and made >40 invited lectures and keynote addresses at the national/international scientific meetings.

Abstract:

“Neuroblastoma” is often used as an omnibus term for all types of peripheral neuroblastic tumors including neuroblastoma, ganglioneuroblastoma, and ganglioneuroma.  Tumors in this group are biologically diverse: molecular/genomic properties of individual cases are closely related to their unique clinical behaviors.  Biologically favorable tumors have a potential of spontaneous regression or tumor maturation, and are often associated with a hyperdiploid pattern (whole chromosomal gains without structural abnormalities). While biologically unfavorable tumors, characterized by a diploid pattern, segmental chromosomal alterations, and/or gene amplification/rearrangements/mutations, are often refractory to therapy. 

For neuroblastoma clinical trials, the Children’s Oncology Group utilizes their risk-grouping system for patient stratification and protocol assignment based on the combination of clinical stage, age at diagnosis, International Neuroblastoma Pathology Classification, MYCN status, DNA index, and segmental chromosomal aberrations.  Estimated survival rate for the non-High-Risk patients is ~90% with surgery alone (Low Risk) or with biopsy/surgery and moderate chemotherapy (Intermediate Risk).  In contrast, estimated survival rate for the High-Risk patients remains as low as 45~50% even after intensive treatment followed by stem-cell transplantation.

Continuous efforts are being made for discovery of actionable/druggable targets in High-Risk neuroblastomas. Those potential targets include (1) ALK activating mutation/amplification (dysregulating cell signaling and leading to uncontrolled proliferation of neuroblasts); (2) TERT rearrangement and ATRX/DAXX mutation (preventing neuroblasts from telomere-mediated senescence); and (3) MYC family protein overexpression – a new concept of highly aggressive “MYC family-driven neuroblastomas” with augmented expression of MYCN or MYC protein, also morphologically characterized by nucleolar hypertrophy (promoting MYC/MAX heterodimer formation for activating down-stream gene targets).

Biography:

Ismé de Kleer is a paediatrician and fellow Pediatric Pulmonology at the department of Pediatric Pulmonology of the Erasmus Medical Center, Rotterdam, The Netherlands. She completed her PhD in 2004 from Utrecht University and did postdoctoral studies at Ghent University, the Flamish Institute for Biotechnology and at the Laboratory of Pulmonary Medicine of the Erasmus MC. She is a member of the European Respiratory Society (ERS), Netherlands Respiratory Society (NRS) and Dutch Pediatric Society and has (co-) authored 27 peer-reviewed articles in international journals.

Abstract:

Allergic diseases have their origin in early life when lungs and immune system are still developing. Sensitisation to aeroallergens is an important risk factor for asthma in children and influenced by genetic polymorphisms. Ontology of asthma genes indicate the existence of two central themes conferring asthma susceptibility, (i) activation of an innate immune response leading to type-2 immunity (IL33 and IL1RL1, coding for IL-33R and decoy receptor sST2) and (ii) integrity and repair of the airway epithelium (PCDH1 and CDHR3).

To understand the susceptibility to allergic asthma of young children we studied epithelial permeability and innate and type 2 immunity in response to house dust mite (HDM) exposure in neonatal mouse lungs. Ad (i) we found that innate lymphoid type 2 cells (ILC2) and eosinophils spontaneously accumulate in lungs during postnatal alveolarization in an IL-33 dependent manner. HDM exposure further increased IL-33, boosted cytokine production in ILC2, and promoted the migration and Th2 skewing capacity of dendritic cells leading to enhanced sensitization (Immunity, dec 2016). Ad (ii) we found that exposition to high dose HDM resulted in free flow of antigen through the epithelial barriere to the lung draining lymph nodes. This phenomenon was the result of an impaired alveolar barrier due to claudin-18 deficiency expression in alveolar cells. Challenges with high doses of antigen resulted in strong T cell proliferation in lung interstitium and lymph nodes and dendritic cell independent sensitization.

We conclude that enhanced neonatal Th2 skewing to inhaled allergens occurs during a phase of postnatal lung remodeling, when the epithelial barriere is not competely closed and the IL-33 axis and spontaneous type 2 immunity drive immunity to allergens.

Biography:

Abstract:

Hirschsprung’s disease is caused by the failed migration of colonic ganglion cells during gestation. Varying lengths of the distal colon are unable to relax, causing functional colonic obstruction.  Early diagnosis is important to prevent complications. A rectal suction biopsy can detect hypertrophic nerve trunks and the absence of ganglion cells in thee colonic submucosa, confirming the diagnosis.  Acetylcholinesterase histochemistry (AChE) facilitates diagnosis but is not universally employed, in part because it requires special tissue handling. Calretinin immunohistochemistry (IHC) may be a useful alternative, because loss of calretinin immunoreactive nerves reportedly correlates spatially with aganglionosis.  In suction rectal biopsies that contain ganglion cells, small nerves in the lamina propria, muscularis mucosae, and superficial submucosa contain granular aggregates of calretinin immunoreactivity.

Biography:

Abstract:

Aims/Objectives: The main objective of the study is to determine the epidemiology, treatment and outcome of the acquired ano rectal conditions seen at the GNCPS.

Patients and methods: This study was a retrospective and prospective descriptive hospital based study, involving (131) child with Acquired anorectal conditions (AARC) who presented to GNCPS during the study period (March 2012-March 2014). Data regarding the presentation, management and post-operative course to look after complications and outcome were collected. Data were collected using a formulated questionnaire and analyzed using (SPSS 17). Data was considered statistically significant when P value is less than 0.05.

Results: The study involved a total number of 131 child with AACS. The mean age of presentation is (5.78 years). With overall 1.4:1 male to female ratio. Most of the study subjects is from rural areas 66.4%. Most of them were treated surgically 83.2% and 16.8% medically. With overall complication rate of 24.4%.

Conclusion : Acquired Ano Rectal Conditions are commonly seen at the preschooler age, mean (5.78 years). Rectal polyps and rectal Prolapse were among the most frequently seen acquired ano rectal conditions in children. Most of the cases treated surgically with overall complication rate of 24.4%.

Biography:

Miroslav Elek, 34 years old, currently working at East Sarajevo Hospital as Pediatrician. He is educated from University of Novi Sad and University of Beograd.

Abstract:

Introduction: In previous echocardiographic studies less importance is given to the right heart chambers due to the dominant opinion that the right heart plays a minor role in the global cardiac function. Recent studies emphasized the undoubted importance of the right heart and indicated the study of right heart cavities as priority.

Aim: The aim of this study was to perform echocardiographic measurements of morphological and functional parameters of the right atrium and right ventricle in healthy children and present the results as a possible reference values.

Materials & Methods: The study included a group of 93 healthy children ( 48 boys and 45 girls), aged 1 month to 18 years. Dimensions and function of the right atrium and ventricle were examined by standard and new echocardiographic techniques.

Results: The values (average ± SD) of the parameters were as follows: VCI / BSA: 11.25±2.67 mm/m2, RAVI: 23±6.2 ml/m2, TAPSE: 22.4±3.7 mm , diameter of the RVOT: 16.2±4.5 mm. PW of hepatic veins: S: 0.58±0.16 m/s, D: 0.43±0.15 m/s, AR: 0.26±0.06 m/s. PW of tricuspid flow E: 0.67±0.15 m/s, A: 0.44±0.14 m/s, E/A ratio 1.63±0.5. TDI values of speed of tricuspid annulus movements: Sm: 0.14±0.02 m/s, Em: 0.16±0.03 m/s, Am: 0.11±0.03 m/s, Em/Am ratio of 1.58±0.47, E/Em ratio 4.4±1.3, Tei index 0.32±0.07.

Conclusion: Transthoracic echocardiography is applicable and reliable method for measuring the parameters of the morphology and function of the right heart cavities in children. The values obtained in our study with the supposed limits of average  ± SD or ± 2SD, could be used as reference values.

Biography:

Abstract:

OBIECTIVE. This retrospective study reviews our results with unifocalization procedure of major aortopulmonary collateral arteries (MAPCAS) in patients with single- and two-ventricle physiology.

METHODS. From August 2006 to September 2015, 15 patients with pulmonary atresia and MAPCAS have been operated at our institution. Median age was 13 months ((interquartile range (IQR) 0.13 – 109) and median weight 7,8 kg (IQR 3.2 – 24) respectively. In eleven patients, unifocalization was the first procedure, while in four patients this was done as a second procedure following modified BT shunt implantation to a pulmonary artery branch in two patients (in one of them together with correction of a total anomalous pulmonary venous connection of supracardiac type), stent implantation in one patient and explorative sternotomie (in another institution) in one patient. In three patients the intracardiac anatomy was not suitable for a two-ventricle correction. In all patients the unifocalization of the MAPCAS has been performed through a median sternotomie only. The unifocalization was performed concomitant with a modified BT shunt as a pulmonary blood flow source in three patients, with a Glenn procedure in two patients and with an intracardiac repair (closure of the ventricular septal defect and right ventricle (RV) to pulmonary artery (PA) valved conduit) in ten patients. A Glenn procedure and two intracardiac repairs with RV-PA conduit have been performed thereafter in the three patients with primary unifocalization and shunt procedure. In three patients with unifocalization and intracardiac repair a fenestrated patch has been used for the ventricular septal defect closure.

RESULTS. All patients survived the unifocalization procedure and are alive at a median follow-up of 57 months (IQR 12 – 121 months). Two patients with single-ventricle physiology already received the Fontan palliation with a non-fenestrated extracardiac conduit. Four patients with two-ventricle physiology needed catheter interventions for peripheral pulmonary artery stenosis and eventually stent implantation in three cases. In the group of the patients with two-ventricle physiology after unifocalization and intracardiac repair, two patients had an RV pressure estimate of one half systemic pressure, four patients had an RV pressure estimate of more than two thirds systemic pressure while six patients had an RV pressure estimate of less than one third systemic pressure. All three patients with single-ventricle physiology have good hemodynamics after unifocalization and bidirectional Glenn (1 patient) as well as after unifocalization and total cavo-pulmonary connection (two patients).  

CONCLUSIONS. In our experience very good results can be obtained after unifocalization in patients with single- and two-ventricle physiology. There is a need for conduit replacement due to growth of the patient or conduit degeneration as well as for catheter-based interventions for peripheral pulmonary artery stenosis. Residual high pulmonary artery pressure and right ventricular dysfunction remain of concern for long-term survival in this very difficult group of patients.

Biography:

Dr. Reza Saeidi has completed his Medical faculty at the age of 27 years from Tehran University, Pediatric Specialist from Tehran University of Medical sciences in Iran and neonatology sub specialty from Mashhad University of Medical sciences. From 2000 to now He is published more than 50 articles. He is Editor-in-Chief of Iranian Journal of Neonatology. He has attended 100 national & international as speaker or participant.   
 

Abstract:

Whenever neonatal sepsis is associated with neutropenia, increase mortality and morbidity. We know in the preterm infants, neutropenia is common. In this study we evaluated effects of G-CSF administration on early onset neonatal sepsis in premature infants.

This study was performed in the College of Medicine, Mashhad University, NICU of Qaem Hospital between May 2012 and February 2013. In this study we enrolled fifty premature neonates with GA <35 weeks and a mean birth weight of 1500 ± 499g, who were under 5 days old that were admitted to NICU with the clinical diagnosis of sepsis. The study population was divided to the case (G-Csf) and control groups placebo (dextrose 5%).  To analyze the data with nominal scale, Pearson Chi-Square was used. In cases which more than 20% of expected frequencies of tables were less than 5, (Cochran) Fisher's test (Fisher's Exact Test) was used. SPSS v.19 and Statistical V.8 software were used. 

There was significant difference between two groups for absolute neutrophil count (ANC) in second sampling (P =0.010), but for other cases, the difference wasn’t statistically significant (P > 0.05). Also the change in absolute neutrophil counts between two blood exams showed significant difference in control group, (P = 0.006), but the difference wasn’t statistically significant in the study group (P=0.627).

Routine administration of G-CSF is not recommended as an adjuvant therapy for neonatal sepsis in non-neutropenic premature neonates.

Biography:

Dr.Kankana De has completed her PhD at the age of 34years fromVidyasagar University and she had worked as a lady counsellor in Anwesha clinic at Salboni Rural hospital. shee had published six papers in reputed journals and has been continuing her  research works.She had completed four postgraduate studiesin Anthropology,Botany,Business Administration,Social works.she act as reviewer in Journal of social science research.She had delivered seminar in 8 confeences , Among those 2 international conferences , which had held at Vinod Gupta school of Management organised by Indian institute of technology,Khargapur IIT,India..another in Vidyasagar University,Medinipur,India. Among rest conferences are organised by Indian statistical Institute,Kolkata,India, Burdwan University,Dibrugarh university, University of calcutta.
 

Abstract:

Introduction: The BMI is an attempt to quantify the amount of tissue mass (muscle, fat, and bone) in an individual, and then categorize that person as underweight, normal weight, overweight, or obese based on that value.

The BMI is generally used as a means of correlation between groups related by general mass and can serve as a vague means of estimating adiposity. The duality of the BMI is that, while it is easy to use as a general calculation, it is limited as to how accurate and pertinent the data obtained from it can be. Generally, the index is suitable for recognizing trends within sedentary or overweight individuals because there is a smaller margin of error. The BMI has been used by the WHO as the standard for recording obesity statistics since the early 1980s.

The study area of Salboni Block is 25 km away from  Medinipur town. Subjects are 10-19 years  adolescent girl. The study were done on 1009 girls. .

For these study different types of anthropometric measurements were taken like Weight, Height. Height is measured through Anthropometric rod; Weight is taken by weighing machine. Biceps skinfolds and Triceps skinfolds measurements are taken by skinfold Calliper.  Height is measured to the nearest 0.1 cm and weight to the nearest 0.5 kg. Each subject was weighed with minimum clothing and no footwear.

Structured questionnaires were followed to know details of socio-economic status of studied adolescent Stature was measured to the nearest 0.1 cm in bare feet with participants standing upright against a wall-mounted stadiometer. Body mass was measured to the nearest 0.5 kg with participants lightly dressed (using a portal digital scale (Tanita HD 309, Creative Health Products, MI USA). BMI was calculated from the ratio of body mass index.

Statistical analysis: Data were entered in Microsoft excel 2007 and was analysed using SPSS 19.0. Descriptive statistics and chi square test were used wherever required, to test statistical significance. Statistical significance was set at p <0.05.

Results: FMI and BMI have weak correlation , Among them  24.4 % are under nutrient  based on BMI and  99.8 % are undernutrient based on percent body fat.34.2 %  low health status by assessing Rohrer index. According to Roc curve 18.45 kg/sqm will  cut off value of ced this study.

Discussion: Under nutrient when reach at reproductive age still they are mal nourished and  do not  get sufficient nutritional supplement ,at child bearing stage they give low birth weight children and those children donot  have nutrition ;they face the situation cycle  which will go on . Malnutrition affects HIV transmission by increasing the risk of transmission from mother to child and also by increasing replication of the virus. In communities or areas that lack access to safe drinking water, these additional health risks present a critical problem. Lower energy and impaired function of the brain also represent the downward spiral of malnutrition as victims are less able to perform the tasks they need to in order to acquire food, earn an income, or gain an education.

Conclusion: Due to undernutrition adolescence experience development delay, which cause delayed puberty and delayed menarche. Malnourished adolescence is  suffering from kwashikor , marasmus; undernutrition compromises with immune system, in rural areas poor sanitary system , open defecation causes worm infestation as its further effect they become anaemic.