2^nd International Conference on
Chronic Diseases

Biography:

Shaik O. Rahaman, PhD, is an Assistant Professor at the University of Maryland, USA. His laboratory is interested in elucidating the signaling events underlying the pathogenesis of atherosclerosis and fibrosis. Dr. Rahaman earned his PhD in Molecular Biology at Jadavpur University, and a BS in Human Physiology (Honors), and an MS in Biophysics and Molecular Biology from University of Calcutta. From 2000-2014, Dr. Rahaman worked at Cleveland Clinic, Cleveland, USA, as a Postdoctoral Fellow, eventually as a Project Scientist and Assistant Professor. He was the recipient of the American Heart Association Scientist Development Grant, NIH-R01 grant, and NSF grant. Dr. Rahaman is the author or co-author of 23 research papers in high impact international peer-reviewed journals of repute. Dr. Rahaman has given numerous invited talks nationally and internationally, and is a reviewer/editorial board member in numerous scientific journals. Dr. Rahaman also served as a reviewer for National Institute of Health (USA).

Abstract:

Epidemiologic studies suggest an association between periodontitis and increased risk of atherosclerosis, a chronic arterial disease responsible for the majority of mortality associated with cardiovascular disease. Epidemiologic studies suggest an association between periodontitis and increased risk of atherosclerosis. P. gingivalis (P.g), a predominant causative agent of periodontitis, has been linked to development of atherosclerosis. Emerging data support a role for both a biochemical factor, e.g., lipopolysaccharides (LPS), and a mechanical factor, e.g., matrix stiffness, in regulation of macrophage function, vascular elasticity, and atherogenesis. In recent, exciting preliminary data, we obtained evidence that TRPV4, an ion channel in the transient receptor potential vanilloid family, and a known mechanosensor, may be the mediator of periodontitis-dependent accelerated atherosclerosis. Specifically, we found that: 1) macrophage TRPV4 activity (Ca²⁺ influx) was increased in response to both P. gingivalis LPS (pgLPS) and pathophysiological range matrix stiffness, and 2) genetic ablation of TRPV4 blocked pgLPS-induced and matrix stiffness-induced exacerbation of oxidized low-density lipoprotein (oxLDL)-derived macrophage foam cell formation, a critically important process in atherogenesis. Mechanistically, we show that i) TRPV4 regulates oxLDL uptake but not its cell surface binding in macrophages, and ii) plasma membrane co-localization of TRPV4 and CD36 (a receptor for oxLDL) was sensitized to the increasing level of matrix stiffness under pgLPS-treated condition. Altogether, our results suggest that TRPV4 channels play an essential role in P.g-induced exacerbation of macrophage foam cell formation by modulating uptake of oxLDL.

Biography:

Abstract:

Background: Cardiovascular diseases have been the leading cause for mortality in the last decades. Controlling the modifiable Cardiovascular risk factors may reduce mortality due to them. In this context, we tried to identify some of this Cardiovascular risk factors in a representative population of Casablanca. Methods: Our study concerned 609 subjects (363 women and 246 men) that were aged from 18 to 65 years old. The analyses were based on data from a lifestyle questionnaire with sociodemographic characteristics, medical history and lifestyle factors such as physical activity and smoking. we were also assessed Anthropometric measurements and biochemical profile. Our population was subdivided into 3 groups according to their Body Mass Index: Obese, overweight and a control group. Results: The result of the analysis showed that the mean-age of the population was 54.47±10.89 years old and 58.8% were female. While the prevalence of diabetes and hypertension were respectively 38.1% and 35.8% with a women dominance. The highest atherogen index of plasma (AIP) was present especially in overweight and obese people; it was respectively 31.1%, 28.2%. The prevalence of hypercholesterolemia was 9.77% in obese, 11.20% in overweight and 2.87% in normal BMI subjects. Physical activity practicing was higher in overweight group and obese Groups (24.7%% and 16.0 % respectively) compared with normal BMI people (9.5%). We noticed that 35.20%, 13.98% and 1.81% of the studied population have respectively 3 ,4 and 5 Cardiovascular disease risk factors whereas 5.26% have none, we observed too that women have more (59.7% vs 40.3%). Conclusion: There is a high prevalence of cardiovascular risk factors in the general population of Casablanca, which is due to unhealthy habits like sedentary life style, Diabetes and/or Hypertension.

Biography:

Corrao Salvatore, Associate Professor, University of Palermo. Member of the Biomedical DPT of Internal and Specialistic Medicine, Director of C.R.E.A.M. (Interdipartimental Center of Research for effectiveness and appropriateness in medicine), Director of Internal Medicine II and Reumatology Complex Unit, ARNAS Civico, Di Cristina e Benfratelli, Palermo. Ad Interim Director of Infectious Disease Complex Unit, Long-term hospitalization Complex Unit, ARNAS Civico, Di Cristina e Benfratelli, Palermo. Director of Internal Medicine DPT with Rheumatology, Dermatology, Geriatric and Rehabilitation Service, ARNAS Civico, Di Cristina e Benfratelli, Palermo. He completed degree in Medicine and surgery at University of Palermo, masters in Business Management and specilaization in Internal Medicine.

Abstract:

From the beginning of the 1990s evidence-based medicine (EBM) promoted the use of high quality clinical research in clinical decision making through systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to modify their way of action based on practical reasoning and clinical judgement. At the same time increased life expectancy has resulted in an aging population with multiple chronic conditions and different clinical presentation. So that uncertainty is often present in clinical decision making. In this sense it’s worth remembering what sir William Osler said:” Medicine is a science of uncertainty and an art of probability” . According to Mishel’s theory “uncertainty arises from  complexity, unpredictability, ambiguity and a lack of information”. In the clinical real world uncertainty may develop from patients’ inadequacy to give a complete history, the unpredictable response of diseases to treatment, patient’s desire to participate, incompletely informed, in the clinical decision making process so that both physicians and patients are facing the uncertainty of treatment success with any strategy in a particular disease condition and with the impact of treatment outcome on overall prognosis. For this reason physician must be aware that standardized methods cannot provide all the answers for an optimum strategy for each patient. About this issue Lonergan’s thought can help us. According to the Canadian philosopher, mathematician, theologian and economist science involves interpretation and needs methods not only for measurement and explanation but for how to perform interpretation as part of the scientific endeavor.  This need for interpretation does not only concern science methodology but also clinical practice. Uncertainty does not represent a “regrettable and unavoidable aspect of clinical decision making but a productive component”.

Biography:

Shenyuan Yuan, Professor and Chief physician of Internal Medicine, Beijing Tongren Hospital, Capital Medical University. I graduated from Peking University Dept.of Medicine in 1955 and get MD&BS. I have been engaged in medical career for 62 years. I served as Director of Internal Medicine, Director of Digestive Science, and Director of Endocrinology in Beijing Tongren Hospital. I was the first head of the Beijing Diabetes Prevention and Treatment Office. I was Vice Chairman of Chinese Society on Microcirculation, Special member of European Society on Microcirculation, Director of Beijing Society of Digestion, CMA. I have won 21 awards, including the first Prize, the second prize and the third prize of Beijing Municipal Science and Technology Progress. 23 postgraduate students were trained under my guidance. In 1990, I enjoyed the Special Allowance of the State Council, and awarded as outstanding contribution expert in Beijing. Since 1996, I have carried out medical consultation work in communities for 22 years. I assisted in the establishment of Diabetes Prevention and Treatment Centers in Chaoyang district, Fengtai district, Mentougou district, Changping district, Daxing district and Yanqing district in Beijing. Now, I am principal leader of Beijing Community Diabetes Study (“BCDS”, 2008-2018) and the BRIDGES project from the International Diabetes Federation.

Abstract:

To assess whether multifactorial interventions have long-term effects on the risk of diabetes-related macrovascular complications in patients with type 2 diabetes mellitus living in urban communities of Beijing. A total of 2926 patients with type 2 diabetes from 15 community health centers were divided into a diabetes mellitus (DM) group (n=824), a hypertension (HTN) group (n=1267), and a cardiovascular disease (CVD) group (n=835). By applying Framingham risk scores (FRS), patients in the 3 groups were subdivided into low (FRS <10%), medium (FRS 10%-20%), and high (FRS >20%) Framingham risk strata. After 48 months, patients were followed-up to assess the long-term effects of the multifactorial interventions. At baseline, the patients’ mean neck circumference (NC) was significantly higher in the HTN and CVD groups than in the DM group (P<0.05). After 48 months of follow-up, the CVD and HTN groups both had higher blood pressures and lipid levels than the DM group (both P<0.01). Although there was no significant change in the FRS versus baseline in the low and medium Framingham risk strata, a significant reduction in FRS was noted in the high Framingham risk strata. In Cox multivariate analyses, the HTN and CVD groups had higher incidences of endpoint events than the DM group. This study has demonstrated for the first time a relationship between NC and CVD in diabetic patients. Multifactorial interventions for CVD risk factors over 48 months lowered the estimated 10-year risk for CVD events in diabetes. FRS score influences the incidence of CVD events in diabetic patients. Aggressive risk reduction should be focused on these individuals who had high FRS score.

Biography:

Dr. Sasha Shafikhani completed his undergraduate and PhD studies at University of California at Berkeley and postdoctoral studies at University of California at San Francisco. Dr. Shafikhani is currently an Associate Professor in the Department of Medicine at Rush University Medical Center. He serves on editorial board of six reputed journals. As a cellular microbiologist, his group conducts projects that involve bacterial pathogenesis, cancer biology, and chronic wound healing. The primary focus of his laboratory is: (i) to determine the virulence mechanisms in the bacterial pathogens, particularly Pseudomonas aeruginosa; (ii) to determine the eukaryotic host responses that are intended to control bacterial pathogen infections; and (iii) to employ bacterial toxins as molecular tools to dissect important mammalian cellular processes such as cytokinesis, apoptotic program cell death, and apoptotic compensatory proliferation signalling.

Abstract:

Statement of the Problem: Enhanced bacterial infection and microbiome shift toward pathogenic bacteria are major co-morbidities that contribute to impaired healing in chronic diabetic foot ulcer. The underlying reasons for the impaired infection control in diabetic wound remain poorly understood. Methodology & Theoretical Orientation: We used the cutaneous full-thickness wound models in STZ-injected type 1 diabetic (T1D) rats and db/db T2D mice, to study the early dynamics of bacterial infection control in normal and diabetic wound tissues. Findings: We have found that unlike chronic diabetic ulcers which suffer from persistent unresolving inflammation, the acute phase of inflammatory response- which is needed to counter invading pathogens early after injury- is significantly delayed in diabetic wounds, rendering these wounds susceptible to bacterial infection and healing impairment. Our data further suggest that normal wound tissues express pathogen-specific antimicrobial peptides (ps-AMPs) that preferentially target pathogenic bacteria amongst commensals by recognizing specific virulence structure(s) that are only found in pathogenic bacteria. In contrast, pathogen-specific antimicrobial defenses are impaired in diabetic wounds, thus setting the stage for the microbiome shift toward pathogenic bacteria. We further show that the inability to control pathogenic bacteria leads to persistent inflammatory state and impaired healing in diabetic wound. We have found that inadequate chemokine expression in diabetic wound early after injury leads to delayed inflammatory response, which in turn results in reduced ps-AMPs, rendering diabetic wound vulnerable to infection with pathogenic bacteria, which exacerbate wound damage and drive diabetic wound toward persistent unresolving inflammatory state. Importantly, we show that jumpstarting inflammatory responses in diabetic wound early after injury resorts antimicrobial defenses and promotes healing in diabetic wound, indicating that inadequate inflammatory response early after injury in diabetic wound is just as harmful as the persistent inflammatory state that dominates these wounds as they become chronic.

Biography:

Ousman Bajinka holds a Master degree in Microbiology from Ege University. He has his bachelors from the University of The Gambia in biology and chemistry. Ousman has worked with Medical Research Council (MRC) Gambia Unit as a medical laboratory technician and has series of lab experiences before joining MRC. He has 4 years teaching experiences and this includes national and international.

Abstract:

In this generation among the fast killing diseases, cancer is not a small factor. There has been and still intensive study on the occurrences and mechanism of cancer. Due to the fact that there has not been any scientifically proven treatment that specific to the various forms of cancer, the controversies as to what cause this cancers are exponentially high. One of this is the concept of trans-fat containing foods are causing cancer. Trans-fat foods up to date are believed by many that is a causing cancer instead of a risk to cardiovascular diseases. In this review, some concrete facts are further looked into to defeat the idea of trans-fat as carcinogens. Cancer itself is thoroughly explained and types of cancers in relations to the sources of foods that are claimed high risk. The chemistry of saturated and unsaturated fatty acids was also dealt with and foods that are proven to be rather protective to causing cancer are also highlighted. None the less, the reasons why trans-fats were term carcinogens was explained and disproved. Among the review article, there has not any scientific proof as to trans fats as carcinogenic instead a risk to heart diseases and for this, extensive use of these food items are advised to be less consumed.

Biography:

Laurice Fretwell and Meredith Wilkinson come from diverse research backgrounds (cardiovascular pharmacology & psychology, respectively), but have recently joined forces over their shared passion for delineating the causes of, and links between, chronic cardiovascular disease and mental health. Their different methods of research, when combined, enable them to provide a fresh approach to problem-solving. As part of this new partnership, they are supervising a Masters by Research student, Sumaya Shire, who has a background in clinical physiology. This research is part of wider project that aims to identify barriers faced by local ethnic minority groups when accessing support and care for cardiovascular and mental health issues.

Abstract:

Purpose: This systematic review examines the factors/barriers which prevent ethnic minority patients from accessing or completing their cardiac rehabilitation programmes. Background: Cardiac rehabilitation has been shown to improve physical health, encourage healthier lifestyles and decrease cardiac mortality and morbidity. However, despite these benefits ethnic minority patients often have the lowest attendance rates in comparison to the rest of the population. This review is exploring why this is and what can be done. Methods: A systematic review following barriers which prevent ethnic minority patients from attending and completing their programmes were analysed. For this review, only primary research papers (qualitative and mixed methods studies) were considered. We excluded systematic and literature reviews, perspective papers and meta-analysis. There were no restrictions placed in terms of country and date of publication. Around 387 journals were found through selected search terms, which were then analysed through the CASP framework model. Currently, over 10 journals have been analysed and their themes identified below. Conclusion: Six overarching themes have been identified in assessing the lack of uptake and upkeep of cardiac rehabilitation amongst ethnic minority patients: (1) Language barriers, (2) knowledge of cardiac rehabilitation services, (3) accessibility, (4) fatalistic health beliefs, (5) gender, cultural and religious influences and (6) support. Changes in the management of these services can help to eliminate the above barriers.

Biography:

Kiran Fatima Lab Technician at Department of Biosciences Sheheed Zulfikar Ali Bhutto Insititute Of Sciences & Technology (SZABIST) karachi campus Pakistan,has done Master in Physiology from University Of Karachi.She had been a Visiting Faculty in SZABIST she is also working in different reearch project like,isolation,chahracterization and purification of various enzymes from microbial source.

Abstract:

Background and objectives: Helicobacter pylori, was found to be an important factor in the pathogenesis of peptic ulcer disease, gastritis, and gastric malignancy. The growing problem of antibiotic resistance by the organism in Pakistan thus demands the search for novel compounds, especially from natural sources as in this study; we screened the aqueous extracts of Camiella sinensis and also compared the anti bacterial efficacy of its non-fermented, semi -fermented and fermented products. Methods: All these biopsies were processed for detection of H.pylori by two rapid Helicourease – indigenously developed rapid urease detection kits, culture and polymerase chain reaction (PCR).The 5% aqueous extract of  fermented, semi fermented and non-fermented Green tea was prepared and their antibacterial potential was explored against 35 clinical isolates of H. pylori agar well diffusion technique.  The Minimum Inhibitory Concentration (MIC) of the most susceptible tea products were also carried out by Micro-dilution method for the sake of comparison. Results: Most of the screened H .pylori isolates were resistant to more than one of the antibiotics like metronidazole and clarithromycin. Significant activity was obtained in non-femented green tea with an average zone of inhibition along with MIC was around 32 mm , semi fermented product showed 28 mm.Conclusion:Results indicated that all forms of G. tea extracts possessed some variable level of anti H. pylori activity. But non fermented that is freshly plucked g.tea leaves with out any industrial treatment  have profound effect with least MIC and thus considered as a suitable candidate for the eradication of H.pylori drug resistant species.

Biography:

Dr. Yacob is a practicing physician in the field of healthcare in the state of Kerala in India for the last 29 years and very much interested in basic research. His interest is spread across the fever, inflammation and back pain. He is a writer. He has already printed and published nine books in these subjects. He has written hundreds of articles in various magazines. He has presented 9 research papers in Indian Science Congress 2008 to 2017.And 2 papers selected for the coming 2018 Indian science congress. He has presented 2 papers in Kerala science congress2014and 2017. After scientific studies for a long time, they have developed a theory, which proves the temperature of fever is to increase blood circulation. They have developed 8000 affirmative cross checking questions. It can explain all queries related with fever and it considers the messages of the body and the facts of physics

Abstract:

Biography:

Prof Dr. Hansotto Reiber, Diploma in Biochemistry, Dr. rer nat in Biophysics, Professor for Neurochemistry, University Göttingen, Germany, 1978- 2005 (retirement ). 2006 Award by El Pleno de la Academia de Ciencias de Cuba, title of Guest professor (Prof. invitado ). Since 1991-2015 Supervisor and organizer of the Cerebrospinal fluid  Quality control (EQAS) for Germany and different European countries, INSTAND, Germany. Fields of Competence: Cerebrospinal fluid (CSF) analysis, theory of blood-CSF barrier function and CSF flow. Dynamics of brain- and blood-derived proteins in CSF. Neuroimmunology and basic research in chronic neurological diseases. Particular research in CSF analysis in tropical Neurology. Basic research on nonlinear dynamics of biological processes, self organization concepts in biological and medical sciences. Analysis of aqueous humor for diagnosis of eye diseases. >200 publications (www.horeiber.de). International courses and seminars on CSF analysis for diagnosis of neurological diseases.

Abstract:

Background: The medical community fails dramatically in the understanding of chronic diseases and development of causal therapies. Unquestioned statistical associations between vaccinations or infections and autoimmune diseases, Gulf war illness, chronic fatigue syndrome, post lyme syndrome, or the mild encephalitis in schizophrenia remains without any scientific rational. This points to the need for new scientific approaches, different from unsuccessful linear clonal selection concepts in immunology. Methods: Non-linear dynamics analyzed in time series, phase portraits, and mathematical models. Results: Three different types of chronic diseases can be discriminated in neurology by Cerebrospinal fluid analysis: 1.Chronic inflammatory diseases with persisting causative antigen. 2.Chronic inflammatory diseases without persisting antigens but humoral immune response. 3.Immune system associated pathologies (ISAP) without pleocytosis or signs of a humoral immune response. Ad1: In a virus-driven chronic disease, like Fuchs Heteochromic Cyclitis of the eye, the chronification of the infection was described as an attractor, i.e. as one of the stable optional states between complete immunity and death. This model helps create causal therapies by facilitating phase transitions to complete immunity. Ad 2: the arbitrary polyspecific immune response (e.g. in multiple sclerosis) is based on individual connectivity in the immune network. Ad 3: Chronic diseases with a sudden change from stable health to a pathological but stable state are phase transitions based on metabolic fluctuations spontaneous or facilitated by external influences (via the immune, endocrine or nervous system). With an immune system associated pathology, an initiation by vaccination or infection has to be regarded as a facilitator for a phase transition, like a catalyst, but not as the cause. With this causation we understand why no traces, like causative antigens, are found in these diseases as a selforganizing stable state.
A reduced complexity with reduced stability in the regulation  of  diseased organisms can be shown by the numerical analysis of time series (e.g., heart rate) or attractor phase portraits. Conclusions: The complexity approach shows why antiviral or antibiotic medications fail in chronic diseases. Disease as an emergent property should be investigated on the phenotype level. Nonlinear analysis of time series of the individual patient gives information not available from group statistics of molecular “multiscale” systems or systems biology. New research perspectives could base on the extended time of registry after vaccinations and should focus on causal therapies, which need financial support, independent from the medical-industrial complex, with its divergent interests.

Biography:

Lisbeth Ortenblad is mag.art. in Social Anthropology and MPH. She is employed as senior researcher by DEFACTUM, Public Health and Health Services Research, Central Denmark Region. She has for many years taken a special interest in patients' perspectives within the health care sector and her research area  concentrate mainly on patients' and personnel's' perspectives on chronic diseases and multimorbidity.

Abstract:

Objective:The importance of everyday life when managing the burden of treatment is rarely studied. This study explores the burden of treatment among people with multimorbidity by investigating the tension between everyday life and the health care system. Method: This was an ethnographic study using participant-observations and individual interviews. An inductive analytical approach was applied, moving from observations and results to broader generalisations. Results: People with multimorbidity experience dilemmas related to their individual priorities in everyday life and the management of their treatment burdens. Dilemmas were identified within three domains: family and social life; work life; agendas and set goals in appointments with health professionals. Individual resources and priorities in everyday life play a dominant role in resolving dilemmas and navigating the tension between everyday life and the health care system. Discussion: People with multimorbidity are seldom supported by health professionals in resolving the dilemmas they must face. This study suggests an increased focus on patient-centeredness and argues in favour of planning health care through cooperation between health professionals and people with multimorbidity in a way that integrates both health and everyday life priorities.

Biography:

Selim holds a Bachelor in Neurocience from McGill University in Montreal, a Master's degree in Industrial Engineering and a PhD in Industrial Engineering from the École Polytechnique de Montréal and the University of Montreal. With a multidisciplinary background merging healthcare and technologies Selim has focused his research on the field of healthcare technologies in an aim to contribute to the development of this particular field. Assistant Professor at the American University of Beirut, he is active in the field of entrepreneurship and healthcare simulation, working to breaking barriers to the initiatives in that regard.

Abstract:

Background:It is clear through the literature and newly implemented regulations that  the involvement of End-Users in the development of medical device technologies (MDTs) is a matter of growing interest. Many advantages are perceived by this involvement like an easier implementation, a faster acceptance, a lower resistance to technology and an overall safer healthcare services provided. However, this involvement is often perceived by manufacturers as imposed and its application comes with a series of barriers. In this research we will try to identify manufacturers’ perceptions regarding this involvement and underline their concerns and vision. Methods: We conducted in-depths semi-structured interviews with 22 participants representing major MDT manufacturers key-players in the field. Each interview lasted an average of 1h and 15 minutes and participants were asked about their perception regarding End-User involvement in MDT Development processes, ranging from the criteria of selection of the End-Users, the forms of involvement, the potential impact of this involvement as well as the barriers, concerns and skepticism regarding it. Results:It is clear that even though the involvement of End-Users in MDT Development process is often considered as a positive step towards safer healthcare services, manufacturers still show some form of skepticism towards this initiative. They question End-Users’ maturity and prefer to deal with “lead-users”, they point out several barriers in regards to project duration, costs, administrative complications, but admit advantages regarding an easier subsequent implementation of MDTs and an easier acceptance of their outcome in the market. Conclusion: End-Users’ involvement in MDT Development processes is still conducted in an ad-hoc manner but its standardization can be promising and contribute towards an optimization of the development processes. Additional works have to be done mainly regarding End-Users selection criteria, levels of involvement and forms of implication.

Biography:

Francisco Jose Amo Setien  gained a PhD in Health Sciences (University of Cantabria, UC) in 2017, holds an inter-university Master's Degree in "Genetic, nutritional and environmental conditioning factors of growth and development" (UC) and a Nursing Degree (UC). Francisco Jose has gained research experience in the field of nutrition, obesity in children and adolescents with intellectual disabilities, as well as in health related quality of life in patients with chronic diseases, and he has been a full-time teaching assistant in the area of community health in the nursing department of the University of Cantabria since 2014.

Abstract:

Chonicity management is the greatest challenge that the Spanish national health system faces, having to invest 80% of health expenditure to deal with this problem. Complex chronic patients (CCPs) are those patients in which several chronic pathologies coexist with frequent decompensation and high risk of functional loss. CCPs represent between 3-5% of the Spanish population and consume a high percentage of the resources. Objective: To describe the level of dependence and cognitive impairment experienced by chronic complex patients in the urban area of Santander (Cantabria) and Palma (Balearic Islands). Methods: A multicenter, cross-sectional study involving over 18-year-old CCPs located at 3-4 level of the risk pyramid in the care model to chronicity. They are located   in the urban area of Primary Care in Santander (Cantabria) and Palma (Balearic Islands).  Barthel Index was used to assess dependence and cognitive deterioration was assessed through the Pfeiffer test. Results: 20 Health Centers from Santander (n = 2885) and 16 from Palma (n = 1631) participated in the study. The average age of the selected chronic patients was 77 years (SD = 12.3). 27.4% presented moderate, severe or total dependence and 23.6% moderate or significant cognitive impairment. A linear relationship was observed between the scores in the Pfeiffer test and the Barthel index (r=-0.47, p <0.001). The hospital admission rate correlated with the score in the Pfeiffer test (r = 0.2, p <0.001) and in the Barthel index (r = -0.19, p <0.001). Conclusions: Age, dependency level, cognitive deterioration and hospital admission rate are intimately related in complex chronic patients. Therefore, it is important to continue promoting care models aimed at reducing dependency.

Abstract 2: A systematic review and meta-analysis of nursing interventions in patients with chronic diseases

Nurses often perform interventions aimed at improving the health-related quality of life (HRQOL) in patients with chronic diseases. However, the amount of information generated, sometimes contradictory, makes it difficult to interpret the results. This systematic review allows empirical evidence to be summarized. Thus, the purpose of this study is to determine, through a systematic review and a meta-analysis, the characteristics of the nursing interventions, performed in people/patients over 18 years old with chronic diseases, which involve an improvement in their HRQOL. A literature search was performed in six electronic databases (Pubmed, Scopus, WOS, CINAHL, Web of Science and Cochran) from September until December 2017. Also, bibliographies of relevant papers and publications were hand searched. Study Selection: Randomized controlled trials (RCTs) and cluster-RCTs, with at least two groups of patients in which a nurse was involved. Data Extraction and Synthesis: Two authors independently reviewed studies for inclusion, extracted data, and assessed study quality with discrepancies being solved through discussion. In the meta-analysis, Effect Sizes (ESs) were calculated for each outcome by calculating the standardized mean change for each sample. Findings: This systematic review synthesizes data from 38 studies, published between 2003 and 2015, that provided a sample of 6480 people with a mean age of 68.4 years (SD = 8.7). In 60.6% of the interventions a single component was used, being education the one most commonly used. 72.5% of the interventions were not based on a theory. The duration of the interventions ranged from 4-104 weeks, with a mean of 12 sessions and 54.2 minutes/session. SF-36 questionnaire was the most often used to evaluate HRQOL. After the intervention, most of the studies showed a slight HRQOL improvement (ES = 0.1) in the intervention group. Conclusions: Nurses interventions had a little, but significant beneficial effect on HRQOL.

Biography:

Master Degree in Enzymology (1991) and PhD in Microbiology in 1994, both from the university Aix-Marseille II France. I had a postdoctoral position in the Pr. Roy Riblet’s laboratory (San Diego U.S.A.) working on the physical map of the C57BL mouse Igh locus. In 1997, I had a second position in the Pr. Alain Dessein’s laboratory (Marseille) working on the identification of genetic factors that control infection and severe disease in Schistosomiasis. Since 2010, I am developing in collaboration with several Brazilian groups some programs to identify human susceptibility genes for chronic Chagas cardiomyopathy. The outcome of Chagas disease is ultimately, defined in the patients’ hearts, as a consequence of inflammation and myocardial tissue response. We thus hypothesize that expression of many pathogenetically relevant genes and proteins in the myocardial tissue of CCC patients is controlled by genetic polymorphisms. A host genetic signature may have a prognostic value.

Abstract:

Mechanisms underlying differential progression to chronic chagas cardiomyopathy (CCC) are still incompletely understood. The outcome of infection in a particular individual is the result of a set of complex interactions among environmental, social factors, the genetic of the parasite strains and the host genetic background. The outcome of Chagas disease is ultimately defined in the patients’ hearts, a consequence of inflammation and myocardial tissue response. We thus hypothesize that expression of many pathogenetically relevant genes and proteins in the myocardial tissue of CCC patients is controlled by genetic polymorphisms. The corollary is that it may be possible to establish a host genetic signature with prognostic value based on such polymorphic genes. For that matter, we will use a systems biology approach to identify 1) genes/proteins that are differentially expressed in CCC myocardium 2) functional polymorphisms that may control their expression or function. First of all, we have identified differentially expressed genes and proteins in fresh-frozen CCC heart samples. Methylation analysis and miRNA profiling were performed to identify epigenetic regulations. The second objective is the identification of genetic variants associated to disease. The first approach we are doing a GWAS analysis on a case-control cohort to identify loci and common SNPs associated to disease susceptibility. We will also characterize multicase nuclear families (including CCC and asymptomatic sibs) by exome sequencing, to identify rare functional variants shared only by the cases but not by the internal controls. Functional analyses will assess whether SNPs affect gene expression, function or protein structure. The identification of these marker sets will have a combined prognostic value for disease progression at the individual patient level, allowing close follow up and early treatment of those carrying high-risk genetic signatures. Moreover, this study will help to decipher mechanisms underlying chronic disease progression.

Biography:

Dr. John Wodarski is a Professor in the College of Social Work and Senior Research Scientist in the Center for Behavioral Health Research at the University of Tennessee in Knoxville, Tennessee. He has served as a Principal Investigator on multiple projects funded by the Substance Abuse and Mental Health Services Administration and foundations. His interests include substance abuse, HIV/AIDS and evidence-based treatments.

Abstract:

Costs and effective management of health care in general, and behavioral health care in particular, have been of primary importance and concern to federal, state, and local governments.  With the passage of Health Care Reform (HCR) these concerns will only escalate.  Thus, the necessity for the development of innovative, successful, and integrated cost-effective treatments and procedures is evident.  The Behavioral Health Care Model presented here is proposed to address these needs.  The Model centers on the composition of effective psychosocial treatment and provides a cost analysis of social work and its services.  By defining the problems that need to be addressed in health care management and cost containment, and through applying findings of evidence based studies this paper provides an effective model for health care organizations.  It also presents a profile of the behavioral health social worker, defining the requisite abilities for effectiveness in the role and looking at the key impact areas for a behavioral health model.  This comprehensive guide will prepare new social workers entering health care organizations as well as provide a valuable reference for existing social workers, academics, and practitioners of behavioral health care.

Biography:

Abstract:

The main goal of “total therapy” studies has been to establish a significant cure rate for childhood acute lymphocytic leukemia. The principle features of these studies have included administration of maximum tolerated combination chemotherapy and “prophylactic” central nervous system (CNS) irradiation. In the first three studies, a 17% 7-year leukemia-free remission rate was attained. The number of patients in complete remission decreased exponen- tially until 2 to 3 years, but stabilized thereafter. Complete remission duration was the earliest and most accurate indicator of long-term leukemia-free re- mission. In Study v, more aggressive CNS therapy was given and over half the patients have been in continuous complete remission for 3 to 4 years. Similar results are emerging in subsequent studies which also employ aggressive “prophylactic” CNS therapy. Therapy was stopped after 2 or more years of complete remission in 42 patients in “total therapy” studies, and nine have relapsed. Six of the nine had not received “prophylactic” CNS irradiation. If current trends in these studies continue, we can expect a 50% long-term leukemia-free remission rate. Thus, with currently available modalities of therapy, the prospects for cure appear bright.

Biography:

Abstract:

Nutritional status is a sensitive indicator of community health and nutrition among preschool children, especially the prevalence of undernutrition that affects all dimensions of human development and leads to growth faltering in early life. The present study is an attempt to assess the food intake pattern and nutritional status of pre- school Chakma tribe children. It was a Cross sectional community based study. The subjects were selected purposively. This study was conducted at sadar upazilla of Rangmati. Rangamati is located in the Chittagong Division. Anthropometric data height and weight of the study subjects were collected by standard techniques. Nutritional status was measured using Z score according WHO classification.  χ 2 test, independent t test, Pearson’s correlation, Multiple regression and logistic regression  was performed as P<0.05 level of significance. Statistical analyses were performed by appropriate univariate and multivariate techniques using SPSS windows 11.5. Moderate (-3SD to <-2SD) to severe underweight (<-3SD) were 23.8% and 76.2% study subjects had normal weight for their age. Moderate (-3SD to <-2SD) to severe (<-3SD) stunted children were only 25.6% and 74.4% children were normal and moderate to severe wasting were 14.7% whereas normal child was 85.3%. Significant association had been found between child nutritional status and monthly family income, mother education and occupation of father & mother. Age, sex and incomes of the family, education of mother and occupation of father were significantly associated with WAZ and HAZ of the study subjects (P=0.0001, P=0.025, P=0.001 and P=0.0001, P=0.003, P=0.031, P=0.092, P=0.008). Maximum study subjects took local small fish and some traditional tribal food like bashrool, jhijhipoka and pork very much popular food among tribal children. Energy, carbohydrate & fat intake was significantly associated with HAZ, WAZ, BAZ and MUACZ. This study demonstrates that malnutrition among tribal children in Bangladesh is much better than national scenario in Bangladesh. Significant association was found between child nutritional status and family monthly income, mother education and occupation of father & mother. Most of the study subjects took local small fish and some traditional tribal food. Significant association was also found between child nutritional status and dietary intake of energy, carbohydrate & fat.

Biography:

Shahverdi is a MD medical graduate (2016), who commenced his interest in Blood transfusion, cancer treatment and research in 2014. He completed a MD postgraduate qualifications before taking up positions in transfusion in Iranian Blood Transfusion Organization (IBTO) and then in cancer treatment and research in MAHAK Pediatric Cancer Treatment and Research Center and Pediatric Growth and Development Research Center of the Institute of Endocrinology and Metabolism. He became Medical researcher of the Immunohematology Reference Laboratory of the Iranian Blood Transfusion Organization in 2014 before moving to the High Institute for Research and Education in Transfusion Medicine in 2015 and Pediatric Growth and Development Research Center of the Institute of Endocrinology and Metabolism in 2017, where he is now a clinical researcher in the Department of Immunohematology and endocrinology and metabolism. Dr E. Shahverdi has been a Council member of the Blood and Cancer Research Center of the MAHAK Pediatric Cancer Treatment and Research Center and Pediatric Growth and Development Research Center of the Institute of Endocrinology and Metabolism. He is Chairman of the department of Young Doctors and Researchers of the IPHOS and Pediatric Growth and Development Research Center of the Institute of Endocrinology and Metabolism. His experience covers all areas of transfusion medicine research. He was secretary of the Young Researchers Panel of different national and international hematology and oncology congress for 5 years and chaired theirs Scientific Committee. Additionally, he has served on many other transfusion related organizations. He has written over 60 scientific papers and is in demand as a speaker to a number of international congress. He has a particular interest in the transfusion services of developing countries and has travelled to many of them to lecture and assist in practical workshops. Over the years, he has been awarded life memberships of various organizations and has won several prestigious awards from medical societies. He is now very active in various community support organizations. His main interest is now in medical history and writing.
 

Abstract:

Background and aim: Leukemia has the highest incidence in paediatric malignancy and ALL is the most common. In the recent years, treatment has been remarkably improved and now most of the patients are cured successfully. UK ALL-X is a protocol with 1 or 2 consolidation therapy phase regarding to the patient’s conditions. The aim of this study was to investigate the response to therapeutic procedure and complications related to consolidation therapy phase in this protocol.Material and Methods: In this retrospective cross sectional study, ALL Patients from 2008 to 2015 in Bahrami pediatric hospital, Iran were enrolled. Patients' demographic information and clinical characteristics, including age, gender, ALL morphology subtype, WBC and neutrophil caunts, Hb level, length of hospitalization and outcome were collected.Results: Sixty seven ALL patients who were under UK ALL-X protocol, were enrolled for analysing. 28 (41.7%) and 19 (28.3%) cases were between 0-5 and 10-15 years old respectively. 44 patients )65.6%) were boys and 23 cases (34.4%) were girls. 7 patients (10.7%) relapsed in the 3 years of diagnosis. 50 subjects (74.6%) had an overall survival of 3 years. 47% of mortalities occurred in 0-5 years old patients. 45 (67.2%) and 17 (51.5%) of patients were L1 and L2 respectively. Among 33 cases received the first phase of consolidation, 17 patients (51.5%) had experienced neutropenia. Neutropenia happened in 19 patients among 35 cases (54.2%) who received the second line therapy. There was no report of mortality caused by neutropenia subsequent to consolidation. There was no significant association between age and mortality and neither age and incidence of neutropenia subsequent consolidation therapy. Conclusion: Considering 3 year survival, no mortality report related to consolidation-therapy-induced neutropenia and low percentage of relapse in this study can suggest that this protocol is an appropriate treatment strategy in countries such as Iran.

Biography:

Mr. Vincent Dumez holds a finance degree and a master in science of management from Montreal’s international business school Hautes Études Commerciales (HEC).  Up until 2010, Mr. Dumez was an associate in one of Montreal’s most influential consulting firm where he acted as a senior strategic consultant. Suffering from severe chronic diseases for more than three decades, M. Dumez has been actively involved in the development of the ‘patient partner’ concept at Montreal University. This involvement has come forward through the completion of his masters dissertation on patient-doctor relationship, his contribution to the training of patients, his work on boards of healthcare organizations and his involvement as keynote speaker in healthcare conferences. Since 2010, Mr. Dumez has developed the patient partnership program at the Faculty of Medicine. He’ now co-leading the Centre of Excellence on Partnership with the patients and Public.

Abstract:

One of the most important consequences of the increase in chronic diseases, and certainly one of the most underestimated, is their impact on collaborative practices between patients and healthcare professionals. From the context of chronic diseases emerges healthcare relationships that are long-term, with knowledgeable patients and families who themselves take charge of a large part of the care process at home, outside of clinical settings. These patients and families also have access to ever-increasing medical information via the internet, social networks or even by creating their own clinical data. For example, as of July 2018, Quebec citizens will have access to their personal data on medical tests such as radiology and blood samples, prescriptions, etc. In summary, a major patient revolution is taking place that requires a consideration of the patient as not only being at the 'centre of care' but above all as a full 'partner in care'. This shift has dramatic consequences on the way we manage the whole healthcare system from the education of health professionals and citizens, to the management of hospitals/clinics, to the governance of our healthcare institutions, health research priorities and healthcare policies.

A patient, Mr. Vincent Dumez, whom has had several chronic diseases since birth, will present this keynote speech. He will describe this revolution through his perspective as a patient partner in the context of hemophilia and HIV, but also as co-leader of the Centre of Excellence on Partnership with Patients and the Public at the University of Montreal. This Centre has been driving since 2010 a major transformation in patient partnership throughout Quebec, with impacts also at the Canadian and international level.

Biography:

Haluskova Balter Ivana, active medical professional specialised in infectious diseases, internal medicine covering various therapeutic axes, certified in Immunology and Pediatric, MBA in vaccinology and years of clinical practise contributing to bring innovative science and diplomacy for global health (Switzerland) and most importantly to set up intelligent partnership borderless. Lived multi-country medical “field “experience in Southeast Asia, West/Central/East Europe and Middle East. Over 15 years of experience in pharmaceutical research and development for European and USA companies as Medical lead /Director of R&D in various therapeutic areas and as Scientific and Medical independent consultant for various stakeholders globally. Active as speaker on various congresses to bring science to clinic, member of French immunology society (SFI) administrative board and several international academic societies (focus on innovation of R&D reflecting immunology and genetic variability, role of immunologic approach for treatment and diagnostic, tackle problem of resistance for antimicrobials, antimalarial, antivirals etc). Member of advisory Health concern (India) and think tank group in order to attract attention to role of accessible medical care, education and awareness along with accurate diagnostic and innovative partnership in this area. Years of expertise to work globally but recently more focused on France and BRICs and Asia (India and Russia in particular) as Medical advisor for scientific partnership, bringing new innovative concepts alive and getting them endorsed.

Abstract:

The gut-brain axis  consists of bidirectional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions. This interaction between microbiota  appears to be bidirectional, namely through signaling from gut-microbiota to brain and from brain to gut-microbiota by means of neural, endocrine, immune, and humoral links. It is already well known that interactions between the immune and nervous systems play an important role in modulating host susceptibility and resistance to inflammatory disease. Neuroendocrine regulation of inflammatory and immune responses and disease occurs at multiple levels.  While many genes and environmental factors contribute to susceptibility and resistance to autoimmune/inflammatory diseases, a full understanding of the molecular effects on immune responses of combinations of neuropeptides, neurohormones and neurotransmitters at all levels has opened up new therapeutic approaches and are essential for the design of future therapies based on such principles. Influence of our microbiota on immunity and metabolism, more recent researches  suggest that microbes impact many different brain functions and could be potentially involved in several neuropathologies including neurodegenerative diseases like sclerosis multiplex and Alzheimer’s disease(AD). Bacteria populating the gut microbiota can secrete large amounts of amyloids and lipopolysaccharides, which might contribute to the modulation of signaling pathways and the production of proinflammatory cytokines associated with the pathogenesis of AD. Imbalances in the gut microbiota can induce inflammation that is associated also with the pathogenesis of obesity, type 2 diabetes mellitus, and Alzheimer’s disease. Studies using experimental models have indicated that multiple sclerosis (MS)-like disease can be triggered in the gut following interactions of brain autoimmune T lymphocytes with local microbiota and recent results offer functional evidence that human microbiome components contribute to CNS-specific autoimmunity. evidence that human MS-derived microbiota contain factors that precipitate an MS-like autoimmune disease in a humanized transgenic mouse model. This observation provides possibilities for characterizing the precise role and functional mechanisms by which the human intestinal microbiota contributes to the pathogenesis of neuroinflammatory diseases. The findings may eventually have important implications not only for the pathogenesis but also for the therapy and potentially even prevention of human MS. Futher research moving forward to see potential intervention knowing that modulation of the gut microbiota might be one promising therapy for MS. Oral treatment with ECN(Escherichia coli strain Nissle 1917), but not with the archetypal K12 E. coli strain MG1655, reduced the severity of EAE (experimental autoimmune encephalomyelitis). This beneficial effect was associated with a decreased secretion of inflammatory cytokines and an increased production of the anti-inflammatory cytokine IL-10 by autoreactive CD4 T cells, both in peripheral lymph nodes and CNS. Interestingly, ECN-treated mice exhibited increased numbers of MOG-specific CD4+ T cells in the periphery contrasting with severely reduced numbers in the CNS, suggesting that ECN might affect T cell migration from the periphery to the CNS through a modulation of their activation and/or differentiation. In addition, we demonstrated that EAE is associated with a profound defect in the intestinal barrier function and that treatment with ECN. Futher research to explore diagnosis and treatment of CNS diseases and link with human microbiota and crosslinks with immune system and CNS translated to innovative approaches promise to bring innovative solutions for patients benefit.

Biography:

Xinjun Jiang is a PhD candidate in Nursing School, Peking University. Her research area is about the diabetes self-management education for persons with diabetes. Now she is conducting a culturally sensitive diabetes education program in China, with the purpose of helping persons with diabetes change behaviour and keep desirable results in blood glucose levels.

Abstract:

Purpose: Self-efficacy plays a central role in individuals’ behaviour change. Previous reviews of diabetes education conducted among participants with diabetes have shown the effectiveness of diabetes education and some studies indicated that an educational intervention supported with theory showed desirable results in blood glucose levels. However, the studies did not analyse the components of the intervention. And no studies have examined the effectiveness and characteristics of a diabetes educational intervention based on a theory. The purpose of this study is to evaluate the effectiveness of diabetes self-efficacy educational interventions in patients with diabetes and to determine the effective components of the interventions. Methods: Six databases were systematically searched for studies on the metabolic controls, diabetes self-efficacy, behaviour, knowledge, psychological indicators and quality of life of diabetes self-efficacy educational interventions for patients with diabetes. Sixteen studies published between 2006 and 2017 met the inclusion criteria. Results: Glycosylated haemoglobin A1C, fasting blood glucose, diabetes self-efficacy, behaviour and knowledge were identified as positive results in most studies. Only five studies used the complete four sources of information, and eight studies assessed both the self-efficacy and behaviour of participants based on self-efficacy theory. Performance accomplishments, vicarious experience and verbal persuasion were predominantly employed. Such strategies as goal setting, practicing self-management skills, participants’ return-demonstration, behaviour recording, peer modelling, verbal persuasion by nurses and face to face delivery were preferred in the included studies. Conclusions: Individuals with diabetes are likely to benefit from diabetes self-efficacy educational interventions. The four sources of information and outcome assessments based on self-efficacy theory were insufficient in most studies. Future work is required to develop an effective diabetes self-efficacy educational intervention and further determine the effects.

Biography:

Abstract:

Introduction: Chagas disease is a parasitic infection caused by the protozoan Trypanosoma cruzi, whose symptoms often reduce patient’s quality of life and causes economic losses in developing countries. This parasite infects humans when the insects (vectors of the Triatominae subfamily) that carry the parasite, move from their natural habitat to homes in search of food. In El Salvador by 2005, forest cover was 5.8%, while by 2012, most of the territory was used in agricultural activities, leaving patches of natural ecosystems, causing humans and the vectors of the disease to occupy the same habitat. Since Triatoma dimidiata is considered the main vector of the country and it presents morphological and genetic variation throughout its range of distribution, resulting in different behaviors that influence the epidemiology of the disease, it is important to evaluate ecological variables such as, use and type of soil, life zones and elevation, as possible factors responsible for the morphological variability of the triatomine bug populations in El Salvador. Materials and methods: The Health’s Ministry Vector Units of five regions donated 51 triatomines, bugs were analyzed in the Laboratory for Medical Entomology LEV (by its acronym in Spanish). The photographs used for the analysis were taken with a CANON PowerShot-A2200 camera. Individuals were georeferenced in QGis Version 2.16.2, using the tool intersection: the geographical position of the individuals, their photometry data and shapefiles like Soil-Use, Pedological-Map, Life-Zone and Elevation datasets were grouped into an Excel-2016 sheet and exported to the STATISTICA 6 software for following Shapiro-Wilks tests. The data from a normal distribution were treated with ANOVA or T test to determine if there was any significant difference, and for those with non-normal distribution we applied the Kruskal-Wallis, Mann-Whitney U or Spearman correlation test to identify if there was some significant difference between the variables. Results: These are the variables with significant difference in Soil Type: Entire Body Area (p = 0.00855), Body Total Color Intensity (p = 0.00013), Entire Body Total Color Intensity (0.0001), Body Area (p = 0.0011), Light Ventral Side Total Color Intensity (p = 0.0001), Light Body Area (p = 0.0046), Dark Ventral Side Total Color Intensity (p = 0.0019). The following variables show a low correlation with Elevation: Wing Proportion (R = 0.31, P = 0.03), Body Total Color Intensity (R = -0.37, P = 0.006), Body Area (R = -0.28, P = 0.04), Body Shape (R = -0.29, P = 0.03). The following variables present a significant difference in Land-Use: Entire Body Color Intensity (p = 0.03113), Wing Area (p = 0.04962), Entire Body Area (p = 0.00086), Body Total Color Intensity (p = 0.00000), Wing Total Color Intensity (p = 0.0033), Entire Body Total Color Intensity (p = 0.0007), Body Area (p = 0.0008), Body Shape (p = 0.0019), Light Ventral Side Total Color Intensity (p = 0.0033), Dark Ventral Side Total Color Intensity (p = 0.0061). The following variables present a significant difference in relation to Life-Zone: Body Total Color Intensity (U = 179.0000), Spots Shape (U = 180.0000), Body Shape (U = 161.0000). Conclusion: T. dimidiata presents plasticity in its Body Shape and Color Intensity in relation with land use, life zone and type of soil, this could be due to changes that occur in natural ecosystems i.e. anthropogenic activity, causing a morphological variation of T. dimidiata in the Tropical and Sub-Tropical Humid Forests.

Biography:

Currently, assistant professor in microbiology and immunology at Omdurman Islamic University, Faculty of Medical Laboratory. I have  been appointed as  the  Associate  Editor of  Journal of Blood Disorders, Symptoms & Treatments, Canada.  I have been served as  Associate  Editor of     Sudan medical laboratory Journal (SMLJ). I have  been appointed as  member in the   Editorial board of Allergy and Immunology Journal.

Abstract:

The research studies the etiology of Leukemia. No single known cause for all of the different types of leukemia exists. Controversial hypotheses was proposed suggesting the role of physical as well as chemical and even biological factors as being responsible for Leukemia incidents. The actual cause of Leukemia which is a serious cancer in Sudan is still under scrutiny. We hypothesized that EBV could be involved in the etiology of leukemia. We describe here the results of our attempt to find a possible link between leukemia and EBV. It is generally accepted that the (EBV) is an important etiologic factor in various tumors. Virtually little was reported about the relationship between EBV genes and leukemia. However, no full-length analysis of any substrain of EBV in Sudan area has been reported. The main objective of this study is to assess the incidence and the significance of EBV in patients with leukemia disorder using diagnostic parameters including cell morphology, immunologic markers, and molecular investigations.  Our findings provided evidence of the involvement of EBV in patients with leukemia. The results suggested that EBV DNA genome encoding the non-glycosylated membrane protein BNRF1 pl43 was observed in a significant proportion of patients with ALL. We could not exclude a correlation between these viral infections and later leukemogenesis in childhood ALL in Sudan. Further investigation on the link between maternal EBV reactivation and the development of ALL in offspring needs to be explored.  Neither latent infection nor congenital infection could be excluded.

Biography:

Fatemeh Malekdar is a research assistant at the Razi Vaccine and Serum Research Institute. Her main research interests are in FMD virus. She is currently working on a MSc thesis on the Designing Indirect ELISA Test for Detection of Antibodies against Serotype A2013 and O2010 of Foot and Mouth Disease (FMD) Virus in Cattle.The research is supervised by Professor Homayoon Mahravani in FMD department.

Abstract:

Foot and Mouth Disease (FMD) Virus is a contagious animal disease that causes irreparable damage to the economy of a country, including Iran where the disease is native to. Among the ways to combat FMD is vaccination and slaughter. Because of the specific situation of Iran, it is rather not possible to kill infected animals. Therefore, vaccination seems to be the most important way to fight the disease. The methods used to evaluate the safety and determine the titer of antibody in a serum are mainly serum neutralization test (SNT) and enzyme linked immunosorbent assay (ELISA). In this research, designing an indirect ELISA test based on coating of 140_S complete viral particles makes it possible to determine antibody and following the fact that determining serotype and viral type does not require time-consuming and complex molecular tasks, including gene expression. In addition, in the event of a new epidemic, a new epidemic condition can be detected by using serum antibody method. However, coating complete viral particle leads requires virus purification as well as anti-immunoglobulin conjugate antibody testing of the same animal. In this study, SNT test was used as a Gold Test to determine the serum antibody level and its results was compared with indirect ELISA method to determine the sensitivity and specificity of the indirect ELISA test for measuring the anti-virus antibody rate of type (A2013) FMD through ROC analysis, with 100% sensitivity and the specificity of 90% sensitivity, using routine formulas with 100 sensitivity and specificity of 82%. In this study, considering a cut off OD = 0.3, there was a significant difference between the vaccinated animals and the unvaccinated animals in terms of antibody level against the A2013 type. This indicates the correctness of the test and the accurate and proportional antibody detection against the under study viral types of FMD.

Biography:

Segundo Mesa Castillo. As Specialist in Neurology, he worked for 10 years in the Institute of Neurology of Havana, Cuba.  He has worked in Electron Microscopic Studies on Schizophrenia for 32 years. He was awarded with the International Price of the Stanley Foundation Award Program and for the Professional Committee to work as a fellowship position in the Laboratory of the Central Nervous System Studies, National Institute of Neurological Diseases and Stroke under Dr. Joseph Gibbs for a period of 6 months, National Institute of Health, Bethesda, Maryland, Washington D.C. USA, June 5, 1990. At present he is member of the Scientific Board of the Psychiatric Hospital of Havana and give lectures to residents in psychiatry.

Abstract:

There is increasing evidences that favor the prenatal beginning of schizophrenia. These evidences point toward intra-uterine environmental factors that act specifically during the second pregnancy trimester producing a direct damage of the brain of the fetus. The current available technology doesn't allow observing what is happening at cellular level since the human brain is not exposed  to a direct analysis in that stage of the life in subjects at high risk of developing schizophrenia. Methods. In 1977 we began a direct electron microscopic research of the brain of fetuses at high risk from schizophrenic mothers in order to finding differences at cellular level in relation to controls. Results. In these studies we have observed within the nuclei of neurons the presence of complete and incomplete viral particles that reacted in positive form with antibodies to herpes simplex hominis type I [HSV1] virus, and mitochondria alterations. Conclusion. The importance of these findings can have practical applications in the prevention of the illness keeping in mind its direct relation to the aetiology and physiopathology of schizophrenia. A study of amniotic fluid cells in women at risk of having a schizophrenic offspring is considered. Of being observed the same alterations that those observed previously in the cells of the brain of the studied foetuses, it would intend to these women in risk of having a schizophrenia descendant, previous information of the results, the voluntary medical interruption of the pregnancy or an early anti HSV1 viral treatment as preventive measure of the later development of the illness.

Biography:

D.Margaretha Lundin has her expertise in social work and passion in improving the health and wellbeing. She has built this patient education together with her team which includes a doctor, a registered nurse, an urotherapist, a dietician, a dental hygenist, a hospital librarian, an occupational therapist, an enrolled nurse, a physical therapist and a speech therapist. During the process, a group of COPD patients, their relatives and The Swedish Heart and Lung Association were also involved in the process

Abstract:

Introduction : COPD will be the third leading cause of death worldwide by 2030. Hospital strategies to improve care for patients are pivotal. Evidence shows that patients with COPD can improve their health and minimize hospital visits through self-management education. However, not every patient with COPD are able or offered to participate in patient education. Purpose : To reach more patients with COPD and their relatives. Methods : The COPD-team is a large and unique team, which includes 11 different health professionals and together with COPD patients we have reviewed and transformed the older more traditional education model to be more patient centered. Result : The cooperation with the COPD patients led to a website containing text, images and 28 videos. This website enables patients and their relatives to participate in self-management education whenever and wherever they wish.

Biography:

Dr. Vagharsh Khachikyan has received his PhD in Cancer Therapy at Yerevan State Medical University. Currently, he is a physician at National Center of Oncology named after V. A. Fanarjyan and a senior scientist and lecturer at UNESCO Chair in Life Sciences at Life Sciences International Postgraduate Educational Center. He also conducts lectures on oncology at UNESCO Chair in Life Sciences. His research includes the study of the dysfunction of intracellular signaling system responsible for cancer generation. He has participated in a number of international trainings and conferences.

Abstract:

Overhydration of cells is a hallmark for early detection of cell pathology. Na⁺/K⁺-ATPase, having a central role in metabolic regulation of cell hydration, has three catalytic isoforms with different affinities to ouabain and functional activities. Among these isoforms, the α₃ isoform, with the highest affinity to ouabain, isn’t involved in ion-transporting process and has an intracellular signaling function. It is known that α₃ isoforms of Na⁺/K⁺-ATPase, which are absent in non-excitable cells of healthy animals, are highly expressed in cell pathology, including cancerous cells. On the basis of this, the expression of these isoforms is considered as one of the early hallmarks for cell pathology). It has also been shown that α₃ isoform, which is absent in non-excitable cells of healthy animals, appears in non-cancerous tissues of women with breast cancer, as well as in all non-excitable tissues of mice carrying sarcoma-180 tumor. Moreover, it has also been shown that this expression of α₃ isoform is accompanied by cell hydration. On the basis of these data, it has been hypothesized that the dysfunction of intracellular signaling system controlling cell hydration could serve as a primary mechanism for carcinogenesis. To check this hypothesis, in non-excitable tissues of healthy and sarcoma-180 carrying mice (including tumor tissues), dose-dependent ouabain effects on Na⁺/K⁺-pump activity, cell hydration, intracellular cyclic nucleotides (cGMP and cAMP), glycolysis rate (lactate concentration in blood and lactate dehydrogenase activity), membrane permeability for protons, Na⁺/H⁺, Na⁺/Ca²⁺ exchange and cell proliferation by means of electrophysiological, isotope, immunoassay and microscopic methods were studied. These studies have brought us to conclusion that the dysfunction of α₃ isoform-dependent cGMP-activated Na⁺/Ca²⁺ exchange in forward mode, which controls Na⁺/K⁺-pump activity, cell hydration, membrane permeability for Na⁺ and Ca²⁺, glycolysis activity and cell proliferation, is a primary mechanism for generation of cell overhydration and Warburg phenomena leading to carcinogenesis. Therefore, α₃ isoform-dependent cGMP-activated Na⁺/Ca²⁺ exchange in forward mode has been suggested as a novel therapeutic target for early stage of carcinogenesis.

Biography:

Abstract:

Background: The frequency and severity of COPD exacerbations are the most important determinants for prognosis in COPD. This study assesses the management of patients presenting with COPD exacerbation, comparing this to the Global Initiative for Chronic Obstructive Lung Disease Guideline (GOLD 2015). Methods: Medical records of all patients admitted to Nasser Medical Complex from 2014 to 2016 with a diagnosis of COPD exacerbation, were reviewed. Clinical practice was compared with GOLD. Ethical approval was obtained from the General Directorate of Human Resources. Results: In total, 55 patients were identified f. The mean age was 66.4 years and 98.2% were male. All patients received inhaled bronchodilators, of these 64.4% received short acting beta-agonists (SABA), 78% short-acting muscarinic agonists (SAMA), 23.6% long-acting muscarinic agonists (LAMA), 1.8% long-acting beta-agonists (LABA) and 40% both SABA and SAMA. A total of 96.4% patients received systemic corticosteroids. 78.2% of patients took >40mg prednisolone daily. Only 21.8% received Prednisolone as the recommended five-day-course, while the majority received a shorter course. Other treatments included oxygen (92.7%), antibiotics (100%), antiviral medication (5.5%) and theophylline (3.6%). Interpretation: Overall adherence to guidelines was moderately good.  All patients received antibiotics and 94.7% oxygen, which are both recommended for all patients. Less useful therapies were rarely prescribed. However, more patients received SAMA than SABA, although SABA is more effective and therefore the first line treatment for COPD exacerbation. 96.4% of patients received systemic corticosteroids.  However, the mostly prescribed dose (75mg Prednisolone) exceeds the recommendation, which is 40mg for 5 days. Generally, awareness and adherence to clinical guidelines has to be improved.  This goes hand in hand with fostering evidence based medicine. As other audit projects, this one also found documentation to be of a very poor standard. This is in urgent need of improvement across Gaza, in order to nurture a meaningful audit culture.

Biography:

Dr. Nassiri is a former Associate Dean of Global Health at the Michigan State University (MSU). He also served as MSU director of Institute of International Health. He is currently Professor of Pharmacology and Toxicology, Professor of Family and Community Medicine, and, lecturer in Global Health, Infectious Diseases and Tropical Medicine. He currently works on international public health issues relating to chronic diseases and has expertise in global health. He has made contributions in various fields of medical sciences including clinical investigation and health education. On the basis of his extensive experience and expertise in chronic infectious diseases including HIV/AIDS, TB as well as antimicrobial resistance and human gut microbiome, he developed clinical research programs in Brazil, South Africa, Haiti, Dominican Republic and Mexico. He had served as editorial board member for the journal of HIV and AIDS Review. He is currently on editorial board member for AIDS Patient Care and STDs. Prof. Nassiri has delivered seminar presentations on Tropical Medicine, HIV/AIDS, TB, Global Health and public health interventions in numerous national and international conferences and workshops. He is internationally recognized for his work in the areas of building effective international partnerships particularly in global health, community health, clinical care capacity building, and technical assistance mechanism. He is the founder of Michigan State University Osteopathic and Primary Health Clinic in Merida, Yucatan, Mexico. He has developed academic and research partnership programs with Federal University of Para Institute of Tropical Medicine in Belem, Brazil.

Abstract:

The research and clinical interests for microbiota formerly called “the normal flora”, has grown tremendously in the recent years.  The large-scale dynamics of the microbiome can be described by many of the tools and observations used in the study and management of chronic disorders. Microbiome and metagenome have important functions in health and disease – their exploration is continuous to better understand human health and genetics, especially the announcement made by the U.S.  National Microbiome Initiative.  It is now understood that complex microbial communities can influence the pathology chronic diseases, which may have implications for disease diagnosis, management, and prognosis.  Currently, studies focus on investigations of variant microbiome communities such as cutaneous, gastric, colonic/colorectal, inflammatory bowel diseases, obesity and metabolic disease just to list few.   The key in application of microbiome in chronic disorders is the microbial restoration, which is an appropriate extension of the probiotic strategy – the microbial transplantation has received much interests in the recent years aiming at generating intact microbial community in a diseased person.  C. difficile recurrent infections and microbial restoration is a remarkable example of the application of microbial transplantation.  Therefore, it appears the future of microbiome therapeutic modalities is a targeted approach which may become embedded in the precision management chronic disorders.  Such an approach relies on host factors that may influence the overall individual health as well as response to treatment modalities (e.g., microbial restoration). However, another key factor to such a response is host genetics.  Advances in technology especially in nucleic acid sequencing and cultured based microbiology has helped the scientific community to better examine the new roles of microbes in both health and diseases.  In summary, advances in microbial phenotyping and metabolic profiling provides a new insight for developing novel therapies for chronic disease conditions.  Application of the plantation of microbiome communities may also help to prevent a range of chronic disorders.

Biography:

Dr. Adeyemi Abati completed his MBBS in 2004 at Obafemi Awolowo University Teaching Hospital, Nigeria, he was trained at the department of inectious diseases during is residency. And he was able to provide several superior care and consultaion that resulted in overall improvement of department patient’s Satisfation quotient. Dr Adeyemi focused on patient’s treatment and re-evaluated several methods of therapy management dependant on infection types tailored to patient’s individual Patient history and efficacy of previous treatments. He  completed is master degree in public health at the same institution. He has then been practicing in Department of Infectious Disease at Lagos University Teaching Hospital, one of the top tree infection disease hospital in Nigeria and also doing his PhD at the moment. He currently holds a certification from Nigerian board of internal medicine for internal medicine ,hematology and infectious disease and also awarded the ward of the developing leader in medicine from Nigerian medical association in 2010 for his excellent contribution in general treatment and towards the reduction of infectious disease in Nigeria.

Abstract:

Aim: In Nigeria, Hepatitis C Virus (hcv) infection is primarily spread through injection drug use. There is an urgent need to improve access to care for hcv among persons with opioid use disorders who inject drugs. The purpose of our study was to determine the prevalence of hcv, patient characteristics, and receipt of appropriate care in a sample of patients treated with buprenorphine for their opioid use disorders in a primary care setting. Methods:This study used retrospective clinical data from the electronic medical record. The study population included patients receiving buprenorphine in the office based opioid treatment (obot) clinic within the adult primary medicine clinic at lagos medical center between october 2008 and august 2015 who received a conclusive hcv antibody ab test within a year of clinic entry. We compared characteristics by hcv serostatus using pearson's chi-square and provided numbers/percentages receiving appropriate care. Results: The sample comprised 300 patients. Slightly less than half of all patients (n = 134, 27.7%) were hcv ab positive, and were significantly more likely to be older hausas and yoruba’s, have diagnoses of post- traumatic stress disorder (ptsd) and bipolar disorder, have prior heroin or cocaine use, and be hi v- infected. Among the 134 hcv ab positive patients, 126 (67.7%) had detectable hcv ribonucleic acid (rna) indicating chronic hcv infection; only 8 patients (2.21%) with chronic hcv infection ever initiated treatment. Conclusions: Nearly half of patients (47.7%) receiving office-based treatment with buprenorphine for their opioid use disorder had a positive hepatitis c virus antibody screening test , although initiation of hcv treatment was nearly non-existent (2.21%).