2 ^nd World Congress on
Pediatrics and Neonatology

Day 1 : 2021-04-23

Keynote Forum

Iwona Ben-Skowronek

Medical University in Lublin, Poland

Keynote: The insulin pump therapy – long-term outcome in children with type 1 diabetes

Time : 10:00-10:40

Biography:

Professor Iwona Ben-Skowronek is the endocrinologist, head of Department of Pediatric Endocrinology and Diabetology in Medical University in Lublin. She is engaged in improving the health and wellbeing of children with  endocrinology disorders. She is coauthor of neonatal  screening tests model in Poland. Iwona Ben-Skowronek has built this model after years of experience in research, evaluation, teaching and administration  both in hospital and university.

Abstract:

The growing popularity of type 1 diabetes (DM1) treatment based on continuous subcutaneous insulin infusion (CSII) raises a question of the group of patients that benefit most from the treatment. The greatest benefits from the treatment with CSII using an insulin pump were noted in type 1 diabetes children aged 1-5: the mean HbA1c decreased in these patients from 7,98% to 6,75%  over 6 years. Slightly lesser outcomes were noted in the group of 6-10-year olds: the mean HbA1c value increased slightly from 7,6% before the CSII to 7,89% after 6 years of treatment. Somewhat worse outcomes were reported in the group of 11-15-year-old children: HbA1c increased from 8,05% to 8,72% . The lowest outcomes were found in the group of the 16-19-year-old patients, as HbA1c rose from 7,8% to 8,82%  over 6 years.  The children receiving the CSII treatment as early as in the first year of treatment exhibited better diabetes control (HbA1c 8,1 % declined after 6 years to do 7,1%, p<0,01) than patients who received CSII at an older age (HbA1c increased from 7,92% to 8,2%, p<0,01).Conclusions: The CSII on offers the greatest benefits for patients aged 1-5 and those with the treatment commenced in the first year after diagnosis of type 1 diabetes.

Keynote Forum

Ralf-Bodo Troebs

Helios Klinikum Duisburg, Germany

Keynote: Severe Metabolic Acidosis and Hypercapnia Predict Major Bowel Resection in (Preterm) Infants with Surgical Abdomen

Time : 10:40-11:20

Biography:

Ralf-Bodo Troebs has special interests in neonatal pediatric surgery, esophageal and bowel atresia, bowel problems of the neonate, pyloric stenosis, and perioperative physiology. Formerly he was the head of the Department of Pediatric Surgery, Ruhr-University of Bochum, Sankt Elisabeth Group, Herne, Witten, Germany (data source).

Abstract:

Surgery of preterm and newborn infants with acute abdomen is one of the most serious problems in pediatric surgery. The aim of the presented study is to find out the predictive value of preoperative acid-base analysis [ABA] for bowel involvement. Material:  A total of 211 subsequent neonatal cases with acute surgical abdomen was operated between 2012 and 2018. 137 infants fulfilled the inclusion criteria and had a complete data set. Postnatal age at surgery varied between 0 and 91 days (median 8 days); body weight was between 415 and 4730 g (median 1555 g). Predominating diagnoses were necrotizing enterocolitis (n=48), small bowel atresia (n=36), meconium obstruction syndromes (n=21), volvulus (n=10) and miscellaneous. The extend of bowel affection was classified according to the length of resected bowel, and/or presence of subtotal NEC: no or moderate (less than 10 cm), major (10 – 34 cm), and extended/subtotal (> 34 cm and/or resection of the ileocoecal valve). For estimation of the resected length primary operation and subsequent laparotomies were taken into account. Data Source: Sankt Elisabeth Group, Marienhospital Herne. Results. Major resections were required in 26 infants, and extended resections in 26 infants (n=52, 38 %). The overall mortality was 9.5% (n=13). We found a good relationship between the degree of metabolic acidosis (pH, BE, lactate), subsequent respiratory de-arrangement (pCO₂), and the extend of bowel resection (Table). In contrast to severe acidosis, all infants with alkalosis (pH≥7.45) survived. Conclusion. Surgery of this delicate group of infants was associated with high percentage of mortality and long-term sequel. Preoperative blood gas analysis gives important information regarding the degree of illness and the expected length of destroyed bowel. Severe metabolic acidosis and elevated pCO_2, indicate a high risk for loss of relevant bowel length. Alkalosis indicated a more benign course.

Keynote Forum

Milica Rankovic Janevski

Institute of Neonatology Belgrade, Serbia

Keynote: Skin-to- skin care in the NICU

Time : 11:40-12:20

Biography:

TBA

Abstract:

TBA

Keynote Forum

Robert Piekarski

Medical University in Lublin, Poland

Keynote: Serum β-endorphin and cortisol changes in children with simple obesity

Time : 12:20 - 13:00

Biography:

Robert Piekarski has his experience in clinical and experimental endocrinology with the special interest for diabetes mellitus. He combines scientific and didactic activities with work with patients. Present position is Senior Assistant in Department of Pediatric Endocrinology and Diabetology, Medical University of Lublin, Poland and Children’s University Hospital in Lublin. The present research activities focused on type 1 diabetes with the special interest for aspects concerning the prevention and the possibility of residual pancreatic beta cells protection on the onset of diabetes (e.g. the role of vitamin D3).  

Abstract:

Statement  of  the  Problem The results of experimental examinations concerning simple obesity suggest hypothalemic control disturbances of pituitary β-endorphin (β-E) and ACTH secretion. It is known that β-E take part in food intake stimulation through hunger and satiety centers control and the human endogenous opioid system is linked with variety of mood and hedonic functions. Although hyperendorphinaemia in obesity is well documented, it is unclear whether altered ß-endorphin secretion and metabolism is directly involved in the pathogenesis of obesity or only a consequence of obesity. Patients and methods Morning plasma β-E (ρmol/L) (RIA Kit Incstar corp.) and cortisol (nmol/L) (FPIA Abbott) levels in 30 children (10-16 year old) with simple obesity (body mass >95 c, mean BMI=29) and 30 healthy pears were determined before and after lasting treatment (diet of 1000 kcal) when 10% body mass reduction was obtained. Findings In healthy children mean β-E levels were 8,43 ± 1,4. In children with obesity β-E levels (M=12,87±2,3) were increased (p<0,01). And next have been decreasing (p<0,001) to 6,32 ± 1,2 at the same time with body mass reduction. The cortisol levels in healthy children were 480,24±57,9. In children with obesity the cortisol levels were higher (p<0,01) M=686,41±71,7. At the same time during body mass reduction the cortisol levels (M= 400,77 ± 50,6) were decreased (p<0,01). Normalizing tendencies of β-E and cortisol levels with body mass reduction concerned over 80% of children. Conclusion In children with simple obesity β-E and cortisol levels were higher than in healthy children. β-E and cortisol levels tend to normalize at the  same time with body mass reduction. It seems that treatment with an endorphin blockers drugs may have an additional beneficial role in the treatment of people with obesity.

 

Session Introduction

Stepan Aborin

Samara state medical hospital named by V.D. Seredavin, Russian Federation

Title: Acute kidney injury in neonates. Renal replacement therapy and management problems

Biography:

Stepan Aborin has a scientific interest in neonatal nephrology, devotes special attention to the problem of neonatal acute kidney injury, as well as the use of methods of renal replacement therapy in the neonatal period. In his work is based on the principles of evidence-based medicine. He is the head of the neonatal intensive care unit, engaged in teaching. He has a scientific degree of candidate of medical sciences.

 

Abstract:

Statement of the problem: Acute kidney injury (AKI) in the neonatal period is a very urgent problem worldwide. According to our data, the incidence of AKI among patients in neonatal intensive care units (NICU) is 23%. At the same time, the disease has a very high mortality rate, an among AKI survivors there is a high risk of developing chronic kidney disease. Treatment of AKI in newborns and premature infants is a complex task. The basis of treatment is the correct management of intravenous infusions, strict accounting of hydro balance, optimal nutrition support and renal replacement therapy. Currently, the use of dialysis in newborns remains a serious problem. The methods of choice are peritoneal dialysis and continuous renal replacement therapy. A particular problem is the management of AKI in premature infants with very low and extremely low birth weight (VLBW, ELBW). The purpose of this study: to describe the experience of treatment of critically ill neonates with AKI, to identify the main problems of management AKI. Methodology and theoretical orientation: We conducted a study among premature infants with VLBW and ELBW is entering the NICU. The reasons of hospitalization were violations of vital functions. We assessed the anamnesis, clinical and laboratory data, the dynamics of renal excretory function, as well as the study of novel urinary biomarker NGAL. Results: According to our study, the incidence of AKI among premature infants with VLBW and ELBW is 42?3 with 77?3% occurring at the 1 stage of AKI. The presence of AKI in premature neonate is significantly associated with respiratory dysfunction, hemodynamic instability and cerebral insufficiency. We have identified a number of risk factors, the presence of which allows predicting the development of AKI. We have formulated recommendations for early detection and possible non-dialysis prevention.

 

Adail Orrith Liborio Neto

Federal University of Rio de Janeiro Campus Macae, Brazil

Title: Concordance of congenital heart defect in monozygotic twins in Brazil: Tetralogy of Fallot

Biography:

Academic and Intern of Medicine at the Federal University of Rio de Janeiro Campus Macae (UFRJ Macaé). Currently working in research in the area of Neonatal Clinical Microbiology as a student PIBIC UFRJ Working in the areas of Clinical Pathology and Nutrition and Gynecology and Obstetrics. I worked in the project Prevalence of congenital toxoplasmosis in an endemic area for toxoplasmosis in northern Rio de Janeiro. QualiVida project extensionist - Multidisciplinary intervention as a health health strategy in the objectives of the University City of Macaé - Rio de Janeiro, linked to the Laboratory of Research and Innovation in Sports Sciences - LAPICE UFRJ Macaé. He was an intern at the Cardiology outpatient clinic at the Dr. Jorge Caldas Health Center. Currently, trainee in Rheumatology at Cliged Macae.

 

Abstract:

Tetralogy of Fallot consists of four cardiac changes: interventricular communication, pulmonary stenosis, aortic dextroposition and right ventricular hypertrophy. The prevalence is 0.21 per 1,000 live births, corresponding to approximately 3.36% of congenital heart diseases. A primiparous mother with gestational age of 38 weeks  and without proof of prenatal exams came to the emergency. At the time of the obstetric examination, it was verified in her twin pregnancy that one fetus had tetralogy of Fallot, thus being scheduled pregnancy interruption for the following day. The first female twin had an Apgar score of 7 and 8, 2640 g and length: 46 cm. The second female twin had an Apgar score of 8 and 8, 3015 g and length: 47.5 cm. In the neonatal physical examination of both, were found localized acrocyanosis, regular heart rhythm with the presence of pancardic murmur and good peripheral perfusion. The echocardiogram of first twin revealed: patent foramen ovale, wide perimembranous interventricular communication of misalignment with aorta riding the septum by 50%, hypertrophied infundibulum with pulmonary infundibulo-valvular stenosis with Δmax 66mm Hg and long, confluent and small pulmonary arteries measuring APD: 0.35 and APE: 0.35, pulmonary valve annulus: 0.56 and patent ductus arteriosus measuring 0.19 mm. The echocardiogram of second twin showed: patent foramen ovale, wide perimembranous interventricular communication of misalignment with aorta riding the septum by 50%, hypertrophied infundibulum with stenosis pulmonary infundibulo-valve with Δmax of 33 mm Hg, reduced confluent pulmonary arteries measuring APD : 0.40 and APE: 0.55, pulmonary valve annulus: 0.72, closed arterial canal and mild aortic regurgitation. Tetralogy of Fallot is a multifaceted syndrome, underreported and with a high prevalence in pediatrics.. According to research done in the Literature this case is, so far, the first case of congenital heart defect concordance for TOF in monozygotic twins in Brazil.

Basavarajaiah Doddagangavadi Mariyappa

Bengaluru Medical College and Research institute, India

Title: Prediction of Upper Limits of Normal Values of AntiStreptolysin ‘O’ Titres in Normal Healthy School Going Children of 6–16 Years

Biography:

TBA

Abstract:

Antistreptolysin O test, an internationally gold standard test is widely used in detection of group A streptococcal infections and their sequelae at global level. However, Prior studies have failed to estimate the feasibility and accurate prediction of standard cut-off values of ASO from standard simulation methods. In this juxtapose the present study perceived to fill the research gap at larger extent. An observational study was conducted at Bengaluru city during 2015-16. A total 454 children were randomly selected from the different Schools in Bangalore city. As per the results, the sex ratio was 1:1(Male 230/454, Female 224/454) with mean age 12.58±2.63 years. The titre mean ASO value was 275.93±248.73 IU, median value was 202 IU. The average cut of ASO value was 256.53IU with good specificity (95.0%), sensitivity (88.05%), PPV (85.33%), NPV (68.93%); AUC was 0.93. The resulted findings was found to be statistically significant (P=0.008) and also this mean value will help for detection of streptococcal infections at population level (p<0.01). Majority of the cases were suffering from acute rheumatic fever (80%). Test algorithms was formulated by ROC artificial neural network work analysis(ANN), the results showed that, the AUC of nonsuppurative sequelae of Group-A streptococcal (GAS) infection of the throat (63.0%). The summing of the results concludes that, the ASO is a gold standard for the investigation of the disease progression at early stage (streptococcal and rheumatic fever). This present study will help to clinician’s for diagnose streptococcal infection at greater accuracy.

Jhon Camacho

Sanitas University Foundation, Colombia

Title: Experience of the home breastfeeding program. Pioneer program in Colombia: Clínica Universitaria Colombia y Clínica Reina Sofía

Biography:

TBA

Abstract:

INTRODUCTION: The Home Breastfeeding Program has as its main objective to strengthen health promotion and disease prevention, providing comprehensive advice and care in breastfeeding, childcare and childcare both for the mother and the newborn. Home visits have reduced neonatal deaths by 60% in the world, which is why they are considered advisable, as a complementary strategy for the provision of postnatal services if they are carried out during the first week of life. OBJECTIVES AND METHODOLOGY: Perform a descriptive review of the statistics of the home breastfeeding program. The methodology used is to present the percentage of mothers visited at home who receive advice on breastfeeding, the coverage of the program at the Bogotá level and other relevant findings found during the home visit at the Colombia University Clinic (CUC) and the Reina Sofía Clinic ( CRS). RESULTS: During the 6 years analyzed, a total of 30,926 home visits have been made. Program coverage extends throughout Bogotá D.C. with the exception of some neighborhoods that are not easily accessible by location or security. The total number of mothers visited at home who receive advice on breastfeeding is shown (Graph 1). In addition, the percentage of infants with exclusive breastfeeding at the time of the visit is shown (Graph 2). The most relevant findings of the maternal are also shown (Graph 3). CONCLUSION: Numerous investigations have shown that mothers and other caregivers need active support to initiate and maintain appropriate breastfeeding practices, which is why, with the strategy of the Home Breastfeeding Program, it seeks to "promote, protect and support breastfeeding".

Manal Mohamed Helmy Nabo

Al Rayan college, Kingdom of Saudi Arabia

Title: Can multi-detector computed tomography classify non-compacted left ventricle in coloration to the genetic structure

Biography:

Manal Mohamed Helmy Nabo has completed the master of pediatrics from Sohag University. The PhD and MD degree in 2012 from Japan, Tokushima university in the feild of pediatric cardiology.

 

Abstract:

Isolated left ventricular non-compaction (LVNC) is a genetic cardiomyopathy. Many genes are affected in this type of cardiomyopathy. Commonly echocardiography is used for diagnosis. Recently, Multi-detector computed tomography is used in diagnosis of cardiac and extracardiac structures. The LVNC runs in families. The goal of our research to show that MDCT can diagnose LVNC clearer than echocardiography. We suggest that MDCT can detect the genetic pattern of the LVNC. This mean special shape and arrangement of cardiac muscle guide to special form of genetic disorder. There is a great advance in diagnosis and management of congenital heart disease. One of the great interests is multi detector computed tomography (MDCT). The echocardiography is the standard of the diagnosis of cases with cardiac disease. There are many types of genetic disorders that result in different arrangement of the endocardium. These differences can’t be clearly evaluated by echocardiography in contrast to MDCT. MDCT will find correlation between the morphological and the genetic pattern.

Reem Al Qutami Al Suwaidi

Mohammad Bin Rashid University for Medicine and Health Sciences, UAE

Title: Radio-Nuclear Investigations in Children Aged 16 Years and Younger with Confirmed Urinary Tract Infection: A Cross Sectional Retrospective Study

Biography:

Currently, the world is going through intense vagaries with emergence of new diseases and ailments and it is for this reason, that the world needs vastly educated and proficient research in the medical field. Impelled by this observation and as a student, Reem has a vision in empowering the field of medical research. Such vision roots back to her interest and passion for research in the medical field. Curiosity is what made her always motivated to conduct research. With Reem’s commitment and hard work, she has conducted a cross sectional retrospective study about Renal Radio nuclear investigations in children and is seeking to share the findings of this project with the world. Reem is also looking forward to conducting her 2^nd research this year.

 

Abstract:

A retrospective cross-sectional study conducted at Mediclinic City Hospital; a teaching hospital in collaboration with Mohammad Bin Rashid University for Medicine and health sciences in Dubai, United Arab Emirates (UAE). The aim of this study is to ascertain conduction of renal radio nuclear investigations, explicitly Kidney ureter bladder ultrasound scans (KUB US), Micturating cystourethrogram (MCUG), and Dimercaptosuccinicacid (DMSA) in children following Urinary Tract Infection (UTI), based on; age, type of UTI, and recurrence. Medical records of 421 patients aged 0-16 years with UTI were retrospectively studied. Sociodemographic variables were age, gender, type of UTI, and recurrence. Results showed that the most carried out investigation was KUB US (38.2%) (n=161). In children aged between 7 months and 3 years, 15% (n=8) of them had VUR or renal scarring, while only12% (n=11) of children aged > 3 years showed abnormal MCUG or DMSA regardless of the KUB US results. Interestingly more than half (56%) (n=236) of all patients (n=421) with recurrent UTI showed abnormalities by MCUG and or DMSA, while only 12.3% (n=14) of children with atypical UTI showed abnormalities. It is concluded that VUR and renal scarring predominantly occurred in patients with recurrent UTI and atypical UTI. Thus, children presenting with recurrent UTI are recommended to undergo MCUG and DMSA after the second recurrent episode rather than waiting for the third UTI incident. This study suggests that children aged 7 months to 3 years post UTI should undergo KUB US, MCUG (if it was a recurring UTI) plus DMSA or MAG3 with post-micturition study instead. Children older than 3 years presenting with recurrent UTI are recommended to undergo DMSA (regardless of the US results) and MAG3 with post-micturition study or MCUG especially if DMSA is abnormal. Keeping in mind, evaluating risk factors like family and past medical history are crucial before conducting any investigation, this is to avoid unnecessary scans, and at the same time implement measures to reduce risks resulting from complicated UTIs.