Chuanxi Cai, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Enhancing the effectiveness of human cardiac stem cell therapy with the HO-1 inducer-Cobalt Protoporphyrin (CoPP) Chuanxi Cai Albany Medical College, USA
he regenerative potential of c-kit+ cardiac stem cells (CSCs) is severely limited by the poor survival of cells after Ttransplantation in the infracted heart. We have previously demonstrated that preconditioning human CSCs (hCSCs) with the HO-1 inducer, CoPP, has significant cytoprotective effects in vitro. Here, we examined whether preconditioning hCSCs with CoPP enhances CSC survival and improves cardiac function after transplantation in a model of myocardial infarction induced by a 45-min coronary occlusion and 35-day reperfusion in immunodeficient mice. At 30 min of reperfusion, CoPP- preconditioned hCSCsGFP+, hCSCsGFP+, or medium were injected into the border zone. Quantitative analysis with real time qPCR for the expression of the human specific gene HLA revealed that the number of survived hCSCs was significantly greater in the preconditioned-hCSC group at 24 hours, 7 and 35 days compared with the hCSC group. Co-immunostaining of tissue sections for both GFP and human nuclear antigen further confirmed greater hCSC numbers at 35 days in the preconditioned- hCSC group. At 35 days, compared with the hCSC group, the preconditioned-hCSC group exhibited increased positive and negative left ventricular (LV) dP/dt, end-systolic elastance and anterior wall/apical strain rate (although ejection fraction was similar), reduced LV remodeling, and increased proliferation of transplanted cells and of cells apparently committed to cardiac lineage. In conclusion, CoPP-preconditioning of hCSCs enhances their survival and/or proliferation, promotes greater proliferation of cells expressing cardiac markers, and results in greater improvement in LV remodeling and in indices of cardiac function after infarction.
Biography Chuanxi Cai has completed his PhD from the Institute of Biophysics at Chinese Academy of Sciences in Beijing, China and Post-doctoral studies from UMDNJ- Robert Wood Johnson Medical School (RWJMS). Currently, he is the Associate Professor of Cardiovascular Medicine in the Albany Medical College. He has published 17 papers in reputed journals and has been serving as Editorial Board Member of several scientific journals.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 25 Bala Joshi, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
The role of the asthma educator in pediatric practices Bala Joshi Queens Hospital Center, USA
he role of the asthma educator within a pediatric practice has been shown to enhance and improve patient outcomes. TData has shown exactly how much of a change occurs during a pediatric well child visit when there is the intervention of an education specialist. In the New York City database from the 379NYC Department of Health and Mental Hygiene, the percentage of pediatric patients hospitalized due to asthma exacerbations has declined from the high 80% to the lower 30% due to the introduction of an asthma educator providing extensive asthma education, teaching and reinforcement of all medications and devices during the well-child care visit. Additional data has shown a decrease in the number of school absences due to asthma, again upon the proactive intervention of an asthma educator within the pediatric practice. Before the year 2000, at Queens Hospital Center, studies have shown pre-asthma educator involvement lead to higher well-child visit hospital admissions, emergency department (ED) visits and missed days of school. Clearly, there was a need for more intervention. The NYC Department of Health and Mental Hygiene had started to recognize these high rates within their public hospitals and, therefore, established initiatives tailored to meet the needs of these patients and allow them to be more involved with their care. The NYC Asthma Initiative was presented to public hospital outpatient clinics with mandatory requirements at all well-child pediatric visits. Some of these requirements were: The introduction of a written asthma action plan at each visit; the completion of the medications administration form (MAF); the use of a chamber or spacer always with all prescribed inhalers, and; lastly, to have an asthma educator provide teaching and asthma education during the well-child visit. The asthma initiative along with the NYC Asthma Partnership (NYCAP) wanted to improve outcomes of pediatric asthmatic patients with the implementation of these mandatory requirements. Queens Hospital Center, in the year 2000, decided to implement an education specialist within their pediatric practice, in particular as an addition to their pediatric pulmonary clinic. The asthma educator would work with the provider, nurse and team to ensure a well-rounded educational experience for the asthmatic patient. Weekly visits with the introduction of an asthma educator during the well-child visit had started to show more improvements in declining hospitalization rates, ED visits for asthma and school absences. This data was evident over the years by the NYC Department of Health and Mental Hygiene, citywide, as well as, borough to borough. Patients now became more empowered and more connected with their condition, and knew they could always contact the asthma educator for any services they needed. There was also more compliance to keeping all their appointments and follow-up with their providers. Over the years, we can say that the impact of having an education specialist within a practice has shown great outcomes and has shown sustainability as well.
Biography Bala Joshi has completed her BA from Queens College, 1987 and RRT in Respiratory Therapy from NYU School of Graduate Studies, 1994. Currently, she is working at Queens Hospital Center, USA. She is a Pediatric Health Educator for the last 16 years. She has been a member of many organizations and associations and has been a consistent team player within a pediatric practice.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 26 Andreas C Petropoulos, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Bicuspid aortic valve- A defect of many clinical presentations and in any age Andreas C Petropoulos Azerbaijan State Medical University, Azerbaijan
icuspid Aortic Valve (BAov) is the most common congenital heart defect (CHD). It’s prevalence rises from 0.5-2% of the Bgeneral population. This unique defect can create a variety of clinical conditions presenting from fetal to late adulthood. The aim of this paper is to highlight the many unique clinical presentations of a BAov. These range from nearby asymptomatic mild valve stenosis of incompetence to coactation of the Aorta, aneurysms, dissections of Ascending Aorta or cerebrovascular vessels and sever double valve disease in any age. The extreme spectrum of it can lead in fetal life in Hypoplastic Left heart Syndrome. BAov is commonly seen in Turner’s, William’s and Marfan’s Syndromes as well as related with VSD’s and coronary arteries abnormalities. The paper finally aims to alert the Pediatric Cardiology community on the long life surveillance that individuals with BAov need and address the variety of interventional and surgical techniques that can be used to address the many and in any age clinical presentations of it.
Biography Andreas C Petropoulos graduated from Aristotle University’s Medical School, Greece in 1989. Following 30 year career as a Medical Officer, he joined as a senior Flight Surgeon in the Hellenic Air-Force. He has specialized in Aviation, Hyperbaric Medicine, Pediatrics, Fetal, Pediatrics and Congenital Cardiology in USA and Europe. He holds MSc in Preventive Cardiology. He is AEPC Prevention Working Group member. He has worked and lectured in Athens and Brussels universities. Currently, he consults in Fetal, Pediatrics, Congenital Cardiology in Merkezi Klinika and is Associate Professor at the State University and Post-graduate at CME Center in Azerbaijan. His research focuses on prevention, CVD imaging techniques, fetal cardiology and heart failure.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 27 Seliem Z S et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Early identification of subtle left ventricular dysfunction among asymptomatic survivors of childhood acute myeloid leukemia: Insights from the novel three dimensional speckle tracking echocardiography Seliem Z S1,2, Abd E L Rahman M Y1, Helal M Y1, Sonia Magdy1,2, Rania M H El Kaffas1, Mohamed Saber2 and Mohamed Sabry2 1Cairo University Children Hospital, Egypt 2Children’s Cancer Hospital, Egypt
Aim: To assess the value of novel three dimensional (3D) echocardiography and 3D speckle tracking echocardiography (3D-STE) for early detection of subtle LV myocardial dysfunction in asymptomatic survivors of childhood myeloid leukemia after anthracycline therapy. Methods: Thirty five survivors of childhood acute myeloid leukemia (mean age 13.5±4.4 years) treated with anthracycline and 23 age-matched controls were studied. The mean period of follow up after anthracylines therapy was 2.3±1.5 years. All patients and control underwent 3D echocardiography and 3D-STE to assess global longitudinal (GLS), circumferential (GCS) and area strain (GAS). Result: Compared to controls, patients had reduced GLS (16±3.11 vs. 18.30±2.38%, p=0.006), and area strain (24.29±4.12 vs. 26.78±2.64 0.015, p=0.015). No significant statistical difference was found between patients and control regarding GCS. Conclusions: 3D-STE enables assessment of the deleterious effect of anthracyclines on the longitudinal myocardial deformation thus providing a novel tool for early detection of subtle LV dysfunction in childhood myeloid leukemia survivors.
Biography Seliem Z S has completed her MD from Cairo University and Post-doctoral studies from Faculty of Medicine, Pediatric Hospital, Cairo University. She is the Former Head of Pediatric Cardiology Department, Postoperative Cardiac ICU as well as Cardiomyopathy Clinic in the Pediatric Hospital, Cairo University. Currently, she is the Head of Cardiology Department in Children Cancer Hospital, the biggest pediatric health facility for cancer in Egypt and Middle East. She is the Principal Investigator of the project for creating Egyptian Center of Excellence for Pediatric Cardiology in the Children Hospital Cairo University, the biggest health facility in Egypt.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 28 Lei Yang et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Sildenefil increases connexin 40 in smooth muscle cells through activation of BMP pathways in pulmonary arterial hypertension Lei Yang1, Ning Yin3, Liang Hu1, Huanhuan Fan2, Di Yu1, Weiyan Zhang1, Song Wang1, Yu Feng1, Changfeng Fan1, Fang Cao1 and Xuming Mo1 1Nanjing Children’s Hospital Affiliated of Nanjing Children’s Hospital Affiliated of Nanjing Medical University, China 2Jiangsu Hospital of Traditional Chinese Medicine, China 3Zhongda Hospital & Southeast University, China
Background: Pulmonary arterial hypertension (PAH) is a cardiovascular disorder associated with enhanced proliferation and suppressed apoptosis of pulmonary arterial smooth muscle cells (PASMCs). The sildenafil can regulate the Connexin (Cx) 43 in the PASMCs and thus inhibit the PASMCs proliferation and the remodeling of pulmonary arterial. However, how sildenafil exert regulation in the Cx40 in the PASMCs in PAH remains unclear. Methods & Results: Using the rat PAH model induced by the monocrotoline, we demonstrated that the Cx40 in the PASMCs is down-regulated in the PAH. The sildenafil promotes the up-regulation of Cx40 in the PASMCs via bone morphogenetic protein (BMP) signaling, accompanied by an anti-proliferative response in PASMCs. Inhibition of the BMP axis reverses the up-regulation of Cx40 and anti-proliferation of the sildenafil in these cells. In monocrotaline-induced PAH rat models, which display reduced levels of BMP signaling, this study further indicates that the BMP-Cx40 axis is activated in lungs following the sildenafil treatment. Furthermore, we also find in vitro that sildenafil increases the Cx40 expression of PASMCs isolated from MCT-PAH rats and inhibit the proliferation of these cells. These phenomenon are reversed by LDN-193189, the antagonist of type II receptor for bone morphogenetic protein (BMPR2) treatment, providing strong evidence for the protect effect of sildenafil and the BMP-Cx40 axis involvement. Conclusions: Taken together, these data suggest the sildenafil activate BMP-Cx40 signaling in the PAH. This axis may be a potential therapeutic target in PAH.
Biography Lei Yang completed his Doctorate degree of Pediatrics from Nanjing Medical University. After his graduation, he was engaged in clinical and research work of Congenital Heart Disease in Nanjing Children’s Hospital affiliated to Nanjing Medical University. So far, he has chaired and completed development of science and technology of Nanjing Medical University foundation project. His study has been based on the development mechanism of the occurrence, clinical diagnosis and treatment in children with congenital heart disease. He has published 7 SCI papers. As the first inventor, he obtained 2 national patents (authorized), as the second inventor; he obtained 1 national patent (authorized).
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 29 Randy Richardson, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Impact of pre-procedural simulation and planning using 3D resin (solid) and photopolymer (flexible) models on interventional cardiac procedures Randy Richardson Creighton University School of Medicine, USA
re-surgical planning using imaging in pediatric congenital and acquired heart disease has played a vital role in patient Poutcomes for many decades. With advances in 3D printing technology we are now able to take patient specific imaging data and create 3D patient specific physical models. These models can be used to for pre-procedural patient specific simulations of cardiac procedures. We have successfully performed pre-procedure simulated procedures on physical modelsina patient with aortic stenosis undergoing percutaneous aortic valve placement where the size of the valve was in question, two patients with VSD from myocardial infarction that needed a device closure and to predict compatibility of donors and recipients for heart transplants. In all cases the simulated procedure had a significant impact on the actual procedure resulting in decreased time of procedure compared to standards, influenced the choice of the device chosen and was key in predicting correct sizing of implant. All though the numbers are small the impact seems to be significant.
Biography Randy Richardson is the Chairman of Radiology at St. Joseph's Hospital and Medical Center and the Associate Dean for Creighton University School of Medicine Phoenix Campus. He is Professor of Radiology for the Creighton Schools of Medicine and Adjunct Professor at Arizona State University School of Biological and Health Systems Engineering. He is the author of a textbook, 31 book chapters, 11 syllabi, 44 scientific exhibits, 24 scientific papers, 22 peer reviewed journal articles, 3 websites and 14 multimedia presentations. His area of expertise and research has been in the field of cardiac MRI and CT imaging in children.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 39 Marie-Pierre Flament, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Multi-particulate dosage form for pediatric use Marie-Pierre Flament University of Lille, France
n recent years, regulations on pediatric medicines have induced an increased need for research into novel child - appropriate Idosage forms. Indeed, children cannot be considered as “small adults” as they present different anatomical and physiological characteristics. Whatever the route of administration, the age-appropriateness of the formulation is of major importance and has to be taken into consideration. The development of new pediatric dosage forms encounters technical complexities such as dose modification, ease of administration/swallowing, taste-masking, chemical and physical stability, preservation, considerations of a multi-phase and/or multi-use product, packing, providing/designing the measuring device. Innovations are important and the research of new ways to deliver medicines tends to improve compliance, convenience and pharmacokinetics. Recently, the World Human Organization recommended that small sized solid forms or orally disintegrating solid forms should be favored. Solid multi-particulate systems such as pellets have the advantage to cover a broad range of doses for different patients. Dose adjustment can be accurately done by means of dosing device such as a multi-particulate counting device. Developing multi- particulate dosage form with fast disintegration can be useful for children as they present both advantages of solid and liquid formulations. This led to the concept of Orally Dispersible Tablet which disintegrates rapidly in the mouth into small particles or pellets. Their small size enables them to be well distributed along the gastrointestinal tract improving the bioavailability while reducing local drug concentration, risk of toxicity and side effects. They offer easy swallowing and dose flexibility for pediatric patients and caregivers.
Biography Marie-Pierre Flament obtained a PhD (1994) in Pharmaceutical Technology from the University of Lille by studying nebulization for pulmonary delivery of alpha 1 protease inhibitor. She became Lecturer at the University of Lille in 1995 and Professor in Pharmaceutical Technology in 2012. She is Vice-dean of the Faculty Engineering and Health Management (Lille) since 2015. She is a member of the research unit INSERM U 1008 “Controlled Drug Delivery Systems and Biomaterials”. Her research activity focuses mainly on pulmonary drug delivery and paediatric formulations but also on powder characterization, extrusion- spheronization, compression and coating.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 40 Yousef Etoom, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Sudden cardiac death in children Yousef Etoom University of Toronto, Canada
udden cardiac death (SCD) and sudden cardiac arrest (SCA) in children and adolescents are rare. The underlying cardiac Sdisease associated with SCA varies with age. For children two years old or younger, congenital heart disease is the predominant cause of SCA. For older children and adolescents, there is no dominant cause of SCA. Cardiac disorders include congenital heart disease, primary arrhythmias. Genetic cardiac diseases associated with SCA and SCD include cardiomyopathies, ion channelopathies resulting in conduction defects and familial Wolff-Parkinson-White syndrome. The immediate cause of SCA and SCD appears to be a life-threatening and often lethal ventricular tachyarrhythmia. Although SCA is often the initial presenting event, warning signs or symptoms (e.g., chest pain, fatigue, seizures and syncope/light headedness) are noted in at least 40% and up to 70% of individuals prior to SCA. Other disorders that need to be distinguished from an underlying cardiac disease include vasovagal syncope, migraine headaches, seizures, musculoskeletal conditions that present with chest pain, asthma, near-drowning and sudden infant death syndrome (SIDS). Preventive strategies to reduce SCD include primary screening to identify and manage at-risk individuals and secondary prevention with successful resuscitation of individuals with SCA.
Biography Yousef Etoom is an Assistance Professor at University of Toronto, Department of Pediatrics and Staff Physician of Pediatric Emergency Medicine at the Hospital for Sick Children, Staff Pediatric Cardiology and Post-Graduate Medical Education Director of Pediatric Department at St. Joseph Health Center, Toronto, Canada. He has received his Medical degree from Jordan University of Science and Technology and earned his Fellowship training in Pediatric Intensive Care, Cardiology and Pediatric Emergency at The Hospital for Sick Children, Toronto. He holds a Master’s degree of Health Professions Education, Joint program of Maastricht University with Suez Canal University.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 41 Chun Ming Jiang et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Ligusticum wallichii elevates the proliferation of hypoxia-stimulated human microglia through promoting HIF-1α-mediated MET expression Chun Ming Jiang1, You Peng1, Xiang Fang1, Xiao Hua Wang1, Jin Shu1, Liang Hua Zhu1, Wei Xia Yang2, Li Li Zhuang1 and Guo Ping Zhou1 1The First Affiliated Hospital of Nanjing Medical University, China 2The Affiliated Hospital of Nantong University, China
uring the hypoxia-involved neonatal stroke, microglial cells take part in endogenous defense mechanisms to prevent the Dbrain injury. Thus, the reasonable therapeutic intervention in this disease may be the increase of microglia proliferation. In our study, we primarily found that Ligusticum wallichii enhances the proliferation of hypoxia-stimulated human microglia by increasing the cell cycle. Furthermore, Ligusticum wallichii differentially regulated the expression of a lot of genes, in which MET gene, encoding a cell surface receptor tyrosine kinase for recognizing hepatocyte growth factor ligand, acts an important down-stream effective molecule for Ligusticum wallichii in treatment with hypoxia-induced human microglia by using RNAi technique. Moreover, Ligusticum wallichii enhances the binding of HIF-1α to the promoter of MET gene in hypoxia-treated human microglia, providing the rational explanation why Ligusticum wallichii plus hypoxia-administrated human microglia have highest MET expression. Collectively, we have identified a potential mechanism by which MET regulated by HIF-1α contributes to Ligusticum wallichii-mediated increase of proliferation of hypoxia-induced human microglia. Thus Ligusticum wallichii and targeting MET should be considered as two potential strategies for enhancing the hypoxia-stimulated human microglia.
Biography Chun Ming Jiang has completed his MM from Wenzhou Medical University and MD studies from Nanjing Medical University of Medicine. He is the Attending Doctor and Senior Researcher of the Affiliated Hangzhou Hospital of Nanjing Medical University. He has published more than 10 papers in peer-reviewed journals and has been serving as an Editorial Board Member of repute.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 42 Takashi Sasaki, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Prenatally planned hybrid cardiac procedure in critically ill neonates with complex congenital heart disease Takashi Sasaki 1Nippon Medical School, Japan 2Kanagawa Children’s Medical Center, Japan
Objective: To review the outcomes of hybrid cardiac surgery for critically ill neonates with complex congenital heart disease. Methods: Retrospective review in five hybrid cases performed between 2010 and 2015. Results: Age at surgery was as follows; within the first 90 minutes after birth in 3, 1 day in 1 and 2 days in 1. All but one was diagnosed prenatally and planning for hybrid procedure was made before birth. There were hypoplastic left heart syndrome (HLHS) with severely restrictive atrial septal defect (ASD) in 3 and critical aortic stenosis (AS) with borderline left ventricular function in 2. All procedures were performed through a median sternotomy. In neonates with HLHS, ASD was created with a stent inserted through the right atrial wall followed by bilateral pulmonary artery banding (PAB). In neonates with AS, bilateral PAB was performed followed by balloon aortic valvotomy via the brachiocephalic artery. ASD was created in one of two patients with critical AS for LV rehabilitation. One died of coronary hypoperfusion after ASD stent insertion presumably due to sinusoidal communication. There were two late deaths including one in HLHS caused by peripheral pulmonary venous obstruction and one in AS due to hemorrhage during balloon dilatation of PA. One completed Fontan and one completed biventricular repair. Conclusions: Hybrid procedure enabled us to perform ASD creation and regulation of pulmonary blood flow as well as aortic valvotomy simultaneously without use of cardiopulmonary bypass immediately after birth in critically-ill neonates. Prenatal diagnosis was useful in planning hybrid procedures before birth. A highly advanced collaboration among a multidisciplinary team must be a crucial step to further success.
Biography Takashi Sasaki graduated from Nippon Medical School in 1998. After cardiothoracic residency, he studied optimal cardiopulmonary bypass management for neonates with arch anomaly at Stanford University. Then he completed pediatric cardiac surgery fellowship at British Columbia Children’s Hospital. He came back to Japan in 2012 and is currently working at Nippon Medical School and Kanagawa Children’s Medical Center.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 43 Guy Hugues Fontaine, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Epsilon wave on insertable loop recorder in ARVD suspected by repeated myocarditis Guy Hugues Fontaine Universite Pierre et Marie Curie, France
20-year-old boy had repeated episodes of precordial chest pain and palpitations. The troponin T increased to 0.8 µg/l A(normal <0.6 µg/l) suggesting an episode of acute myocarditis. ECG and echocardiography remained within normal limits. Two years later, he had another episode of chest pain. His troponin was 2 µg/l. Negative T waves in V1 - V5. LVEF dropped to 55% with signs of anteroseptal and apical hypokinesia. CMR showed late enhancement in the sub-epicardial and mediomural layers. Two years later, he experienced a new episode with a near syncopal episode during soccer game. Negative T waves in leads V1 and in V2. Signal Averaging ECG was positive for both 25 and 40 Hz. His troponin T (HS) was 487 ng/l (normal<50 ng/l) suggesting a severe episode of myocarditis. Contrast angiography confirmed the diagnosis of ARVD. He was positive for PKP2. Electro physiological study induced VT only after isoproterenol administration. An AICD was recommended but was refused despite the finding from an insertable loop recorder that showed three spontaneous asymptomatic short lasting episodes of VT up to 260 bpm. The loop recorder showed also before the start and after the end of VT a clear fragmented potential of small amplitude (approximately 30 microvolts) immediately following the ventricular Electro Grams (EGM) complex of 0.4 mv. This is the first case in whoman Epsilon wave not visible on surface ECG is reported with an insertable loop recorder located under the skin in close proximity to the RV. It is also the first confirmation of ARVD detected after repeated episodes of myocarditis (Lopez-Ayala HR 2015).
Biography Guy Hugues Fontaine has made 15 original contributions at the inception of cardiac pacemakers in the mid-60s. He has published more than 900 scientific papers including 201 book chapters. He is included in the Profiles in Cardiology (W Hurst 2003) book of the 216 individuals who have made a significant contribution to the study of cardiovascular diseases since the 14th century. He has been included in the book “500 Greatest Geniuses of the 21st Century” of the American Biographical Institute (ABI 2005). He was the reviewer of 17 journals both in Clinical and Basic Science. He served during 5 years as a Member of the Editorial Board of Circulation. He has been invited to give 11 master lectures of 90 minutes each during three weeks in the top universities of China (2014).
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 49 Sonia A El Saiedi et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Tissue doppler derived left ventricular global diastolic and regional systolic function in children with dilated cardiomyopathy Sonia A El Saiedi1, Nevin M M Habeeb2, Rania M H El Kaffas1, Mona A Gabre1 and Ahmad M Badr1 1Cairo University, Egypt 2Ain Shams University, Egypt
Background & Aim: Dilated cardiomyopathy (DCM) is characterized by impaired systolic function of one or both ventricles. The aim of this study is to assess left ventricular (LV) regional systolic as well as global systolic and diastolic functions in children with DCM using tissue Doppler imaging. Subjects & Methods: The study comprised 30 patients with DCM (4.4±3.3 years) and 10 healthy children as a control group. ECG-gated echocardiography was done using m-mode and conventional Doppler as well as Tissue Doppler imaging to obtain modified Tei index, mitral annular wave velocities (S', E' and A') as well as offline analysis of color tissue velocity imaging to obtain the peak systolic velocities of 12 LV points in 4 chamber apical, 2 chamber and long axis views. Results: The peak systolic velocities of Mitral annulus as well as the different LV segments of patients were significantly lower than that of the control group. The E/E' ratio of patients was (11.39±2.4). S' and E' wave of lateral and septal aspects of mitral annulus were correlated. The Tei index of LV of patients (0.568±0.1136) was significantly higher than that of the control group. The averaged mid LV segments showed significantly lower peak systolic velocity (3.018±0.777 cm/sec). There was significant difference between different LV segments as regards the peak systolic velocities (P<0.05). Conclusion: In pediatric DCM the diastolic dysfunction lies in the borderline zone, systolic and diastolic dysfunctions are correlated. There is regional heterogeneity of left ventricular systolic velocities being in general lower in mid segments.
Biography Sonia A El Saiedi graduated from Medical School, Cairo University 1987. She is trained in Boston Children Hospital in 1998. She is now working as Professor of Pediatric Cardiology in Cairo University Children Hospital, Egypt as well as Director of Pediatric Cardiac ICU and Cardiomyopathy Clinic.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 50 Sonia Shahid et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Neonatal and pediatric otology [NaP otology study] Sonia Shahid1, Muhammad Wasay Latif Shaikh1, Fizza Hasan1, Muhammad Hammad2, Fahad Tariq2, Abdul Basit Muhammad Arif2, Muhammad Omer Khan2, Owais Shahid2, Muhammad Faiq Mukhtar2, Saba Siddiqui1, Muhammad Rafay Latif Shaikh3 and Daud Sultan1 1Abbasi Shaheed Hospital, Pakistan 2Karachi Medical and Dental College, Pakistan 3Altamash Dental College, Pakistan
Objectives: To determine the frequency of pediatric patients visiting Pediatric out-patient department with ear-related illnesses in a tertiary care hospital of Karachi, Pakistan. Aims: The aim of the study was to specify the burden of ear infections in the pediatric population. Introduction: Ear diseases in children can have consequences if not treated promptly, and can result in high morbidity, hearing disabilities and even mortality. Diagnosing such conditions untimely, and treating them effectively, can reduce the undesired outcomes. According to World Health Organization, approximately 278 million people in developing countries, like Pakistan, suffered from moderate to profound hearing impairment. Out of which, 25% had hearing impairment since childhood. Methodology: This cross-sectional study was conducted from January 2015-December 2015. Pediatric patients under 7 years of age were recruited in this study. A history and examination form designed particularly for the study was filled by concerned doctor. Inclusion Criteria: Pediatric patients of age ≤7 years regardless of gender presenting to pediatric clinic with principal complain of otalgia, discharge from ear, decreased hearing, pulling in the ear, tinnitus, itching, aural blockage, localized symptoms in and/or around ear (swelling, redness) associated with vertigo and perforation. Exclusion Criteria: Patients having systemic illnesses like autoimmune disorders, metabolic syndromes, congenital hearing defect and neoplastic disorders of ear and immunocompromised patients. Results: Most of the patients presented with complaints of Earache 59%, hearing impairment 57% and aural blockage or heaviness 34%. Other symptoms were itching 27%, discharge 22%, tinnitus 1% and vertigo1%. Many of the patients presented with multiple and bilateral symptoms except for tinnitus, which was unilateral. Majority of patients had impacted wax 34% and otomycosis 26%. Other conditions were furunculosis 4%, foreign body 3%, acute Otitis media 4%, traumatic tympanic membrane perforation 3%, Otitis media with effusion 3% and chronic suppurative Otitis media 1%. Conclusion: Infections in growing age can cause permanent hearing impairment. Hearing loss may impact the academic performance of the children. Thus addressing the incidence and prevalence of otological infections in pediatric patients is a matter of great concern.
Biography Sonia Shahid is a final year MBBS student of Karachi Medical and Dental College, Karachi, Pakistan. She has been a part of several national and international researches and many are ongoing. She has attended several national and international seminars and conferences. She is an inquisitive student with a passion for education as a power for change and improvement in the healthcare field of her country and is very ambitious in pursuing her career.
Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 51 Fizza Hassan et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Awareness of antibiotic stewardship program amongst doctors of pediatric unit Fizza Hassan1, Sonia Shahid1, Mohammad Wasay Latif Sheikh1, Sadaf Abdul Samad2, Sheikh Mohammad Anwar Ali2 and Saba Siddiqui1 1Abbasi Shaheed Hospital, Pakistan 2Karachi Medical and Dental College, Pakistan
Objective: To study the awareness about Antibiotic Stewardship Program (ASP) in doctors of pediatric unit of tertiary care hospitals of Karachi, Pakistan Introduction: Inappropriate antimicrobial prescribing is common and is a key factor in the increase of rates of drug resistance, which causes a significant public health burden in terms of morbidity, mortality, and cost. Antimicrobial stewardship programs (ASP) is designed to optimize antimicrobial prescribing, to lower costs, to prevent medication errors, to improve therapeutic outcomes, and to prevent the development of antimicrobial resistance. Given increasing trends in antimicrobial resistance and the resulting limited treatment options, the treatment of hospital-acquired infections poses a significant challenge to healthcare providers. Optimization and conservation of current antimicrobials are necessary. Aims: The aim of the study is to measure the knowledge of Antibiotic Stewardship Program (ASP) amongst doctors of tertiary care hospital. By doing this we can know that how many and how frequent awareness programs regarding ASP should be conducted in our tertiary care hospital. Methodology: This cross-sectional study is based on questionnaire which was filled by doctors of pediatric units of tertiary care hospitals. Awareness amongst doctors was determined by this questionnaire. Inclusion criteria: Doctors registered by Pakistan Medical and Dental College working in Pediatric unit. Exclusion criteria: Doctors who were conducting the study were excluded. Doctors practicing in local clinics or Primary health care centers were not made the part of study. Results: A total of 257 doctors were recruited in this study. Out of these Head of departments were 3.11% (n=8), Consultant, 10.89% (n=28), Senior Registrar 24.9% (n=64), Post-graduate trainees 38.13% (n=98), and Registered medical officers 22.95% (n=59). The percentage of awareness amongst doctors of Pediatric units was 85.21% (n=38), of which only 47.36% (n=18) had complete information regarding Antibiotic Stewardship Program. All the doctors enrolled in the study were willing to gain awareness of this program. 5.83% of the doctors had opinion that awareness program only might not help, a strict check and balance has to be kept on pharmacies and drug suppliers when issuing antibiotics whereas the rest 94.17% strongly agreed that awareness in doctors will be helpful in reduction in overuse and unnecessary prescription of antimicrobial agents. Conclusion: The successful implementation of antimicrobial stewardship strategies will have a significant impact on reducing targeted and non-targeted antimicrobial use, improving quality of care of hospitalized children and preventing emergence of resistance, thus, reducing morbidity and mortality in young patients.
Biography Fizza Hassan is a currently a final year MBBS Student at Karachi Medical and Dental College, affiliated with Karachi University. She has been a keen Researcher since high school and took part in many scientific projects at city level. She has attended several national and international workshops and conferences. She has taken part in many researches, which have been successfully published in international journals and many are ongoing. She is looking forward to a bright future in medical career.
Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 52 Christine Eloise B Pascua et al., Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Prevalence and associated factors of cardiovascular risk among adolescents in Jacobo Z Gonzales Memorial National High School Christine Eloise B Pascua, Hedda Paula Mae C Pasion, Esviel S Payte, Abigail Lois M Pira, Diana Jean Marie N Pobre, Kristina Marie D Pollack, Amir H Ranjbar, Klarysse G Raymundo, Bianca G Relova, Therese Franz B Reyes and Chevy Lou F Ricio University of the East-Ramon Magsaysay Memorial Medical Center, Philippines
ardiovascular disease (CVD) is one of the leading causes of serious illness and death worldwide. Screening for the risk Cfactors of CVD (i.e. hypertension, hyperglycemia, hypercholesteremia and obesity) allows for early prevention and decreased risk of the development of CVD. We looked at the prevalence of these risk factors among adolescents at Jacobo Z. Memorial National High School Laguna, Philippines. An analytical cross-sectional design was done using a convenience sampling of 303 adolescents aged 12-17 in Jacobo Z. Gonzales Memorial National High School. The information on dependent and independent variables were determined through questionnaires, actual measurements and blood chemistry analysis. Data was analyzed using State SE to determine the Odds Ratio for each group. The groups were divided based on diet, physical activity, familial history of disease and smoking status. The prevalence of hypertension, hyperglycemia, hypercholesterolemia, central obesity, and obesity was 36.33%, 48.51%, 38.94%, 35.31%, and 7.61%, respectively. Attributes related to hypertension included a family history of diabetes. Those related to hyperglycemia were passive smoking and a family history of heart disease. Attributes related to hypercholesterolemia were sodium consumption above the daily allowable limit. There are certain variables that increase the odds of developing different risk factors. Family history of heart disease, being a passive-smoker and low physical activity increases the odds of having hyperglycemia. Sodium consumption above allowable daily intake increases the odds of having hypercholesterolemia. Family history of diabetes mellitus is associated with increased odds of developing hypertension.
Biography Christine Eloise B Pascua is currently a 3rd year Medical student at the University of the East Ramon Magsaysay Memorial Medical Center, Inc. (UERMMCI). She graduated with a Bachelor of Science in Health Sciences at the Ateneo de Manila University (AdMU) with an award-winning thesis entitled “AsTig (Asensong Tubig): A Quasi-experimental Study of Point Source Chlorination, Cloth Filtration and Adsorption by Activated Carbon to Treat Pump Water”. She is currently pursuing her Doctor of Medicine in May 2017.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 53 Tanyi Samuel Tanyi, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Antibacterial and oral acute toxicity studies of Euphorbia hirta Tanyi Samuel Tanyi Federal University Dutsinma, Nigeria
ue to high cost, undesirable side effects of conventional antibiotics and emergence of multi-drug resistant bacteria, there is Da need to search for novel antibacterial agents from medicinal plants. In this study, clinical isolates of Staphylococcus spp, Salmonella spp, Shigella spp. and Escherichia coli were obtained from Usmanu Danfodio University Teaching Hospital Sokoto, Nigeria. The isolates were tested for susceptibility to crude leave extracts of E. hirta by agar diffusion methods. Minimum inhibitory concentration (MIC) of the extract was determined by broth dilution method. The results showed that the most susceptible bacterium to the extract was Shigella, with a zone of inhibition of 23.33 mm, while the most resistant bacterium was E. coli, with a zone of inhibition of 9.43 mm. MIC and MBC of the extract against Shigella was 21.87 mg/ml respectively. Alkaloids, saponsins, flavonoids, anthraquinones, tannins and polysterols were revealed in the extract by phytochemical analysis. Oral acute toxicity of the extract showed no mortality in Sprague Dawley rats at concentration of 50, 300, 2000 and 5000 mg/kg body weight. Result showed that the LD50 was>5000 mg/kg. The MBC: MIC ration>4, suggesting the crude extract was bactericidal. This study showed that leaves of E. hirta can serve as a potential antibacterial agent.
Biography Tanyi Samuel Tanyi has completed his BSc and MSc from Usmanu Danfodio University Sokoto, sokoto state, Nigeria. He is currently an Assistant Lecturer at Federal University Dutsinma, Dutsinma, Katsina state, Nigeria at the Department of Biological Science. He is involved in teaching and research in Microbiology at the University.
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Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 54 Sonia El Saiedi, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Sonia El Saiedi Cairo University, Egypt
Radiofrequency perforation versus hybrid procedure in the treatment of pulmonary atresia- IVS: Challenges faced in developing countries ulmonary atresia with intact ventricular septum is an infrequent but enigmatic disorder with significant morphological Pheterogeneity. In the absence of aright ventricular– dependent coronary circulation, pulmonary valvotomy is a good choice to save the right heart a biventricular repair instead of univentricular repair currently practice in our country. The use of percutaneous RF-assisted perforation of theatretic valve and subsequent balloon dilation provides an easy but expensive overall procedure. The procedure, while technically challenging, can be expected to establish ante-grade flow successfully through the pulmonary valve in most of patients. More than 65 patients presenting with PA-IVS presenting to Cairo University Children Hospital (CUCH) were taken for RF perforation using Baylis RFP 100 generator with trials for cost limitations. For example, to minimize expenses: We stopped using the Protrack microcatheter and replaced this in most cases by the “wire tracks a wire” technique. We also replaced the use of the micro snare from the arterial end to mark the pulmonary valve by looping a coronary wire. Telescopic Luma catheter was replaced by using Mullin long sheath 5 or 6F through which the 4F catheter is passed. Fixing the wire and trying to limit the number of balloons used, replacing the Tayshack Mini balloons which was not always available with regular coronary balloons which are readily available. In case of unavailable 4F sheath with special curve we mostly used either 4F VER and reshaped it. We resorted to Hybrid procedure with the surgeon opening the chest and fixing the sheath in RV directed towards the pulmonary valve in case of failed peripheral vascular access. The challenges faced by the operator in the cath lab (especially in countries with less than optimal facilities) and the different solutions to overcome those challenges will be presented.
Biography Sonia El Saiedi has completed her graduation from Medical School, Cairo University in 1987. She was trained in Boston Children Hospital in 1998. Currently, she is working as Professor of Pediatric Cardiology in Cairo University Children Hospital, Egypt as well as she is the Director of Pediatric Cardiac ICU and Cardiomyopathy Clinic.
Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
Page 32 Guy Hugues Fontaine, Pediat Therapeut 2016, 6:5(Suppl) http://dx.doi.org/10.4172/2161-0665.C1.030 conferenceseries.com
2nd Global Congress and Expo on Pediatric Cardiology & Healthcare September 22-24, 2016 Las Vegas, USA
Guy Hugues Fontaine Universite Pierre et Marie Curie, France
An ARVCs Overview: Right ventricular cardiomyopathy rrhythmogenic Right Ventricular Dysplasia (ARVD) most frequent form is due to PKP2 desmosomal mutation with Aincreased RV size with thinness of the free wall and segmental anomalies of contraction. This is in contrast with increased trabeculations at the RV apex. It is the result of the presence of apoptosis, fat and interstitial fibrosis mostly observed in the RV free wall and LV apex. This disease is frequent in the general population but become clinically apparent in a small number of cases. Disease starts in the embryo in the mediomural layers and has been detected in one case by Echo sonography. It is also the result of a unique PLN mutation. Clinical presentation is mostly ventricular arrhythmias which can lead to unexpected sudden cardiac death especially in young people and during endurance sports. Biventricular form is less frequent but caries a poorer prognosis. Some of these patients seen at a late stage of the disease can be misclassified as IDCM. Pathology of Heart Tx will re-establish the diagnosis. Fatty non-compaction (FNC) is common in the general population (60%) due to the presence of an excessive amount of fat in the RV free wall up to typical ARVD but without fibrosis. It is a determinant of prognosis in case of LV failure. Mutation is unknown. Brugada syndrome (BrS) has a unique ECG pattern of coved type observed only in lead V1. Structural changes are sometimes suggesting ARVD. However, BrS and ARVD are two different entities with some degree overlap both phenotypically and genotypically in a small number of cases. The vast majority in each entity has its own unique features. RVOT VT is generally benign but one personal case of SD with pathologic documentation demonstrated a localized infundibular anomaly suggesting ARVD with fragmentation of potentials by needle infundibular transmural electrode in another case. Uhl’s anomaly shows a huge RV with apposition of epicardium against endocardium. However, this can be a differential diagnosis with an extreme form of ARVD. Naxos disease originally detected by Echocardiography is the most impressive form of these RVCs because of its genotype in which both parents are affected by the same mutation of a desmosomal protein called Plakoglobin. However, the heterozygous form shows only minor ECG changes but no clinically significant disease. All of these cardiomyopathies can be affected by a wide clinical spectrum of superimposed myocarditis (which has also in some cases) a genetic background, frequently the determinant of prognosis. However, in some rare patients, the disease can stop completely spontaneously its progression.
Biography Guy Hugues Fontaine has made 15 original contributions at the inception of cardiac pacemakers in the mid-60s. He has published more than 900 scientific papers including 201 book chapters. He is included in the Profiles in Cardiology (W Hurst 2003) book of the 216 individuals who have made a significant contribution to the study of cardiovascular diseases since 14th century. He has been included in the book “500 greatest Geniuses of the 21st century” of the American Biographical Institute (ABI 2005). He was the Reviewer of 17 journals both in clinical and basic science. He has served for 5 years as a Member of the Editorial Board of Circulation. He has been invited to give 11 master lectures of 90 minutes each during three weeks in the top universities of China (2014).
Pediat Therapeut 2016 Volume 6 Issue 5(Suppl) ISSN: 2161-0665 Pediatrics, an open access journal Pediatric Cardiology 2016 September 22-24, 2016
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