Scientific Program

Sessions:

Women Health-2019

Abstract

Autophagy is a cellular process that maintains the homeostasis of the normal cell.Autophagy is an evolutionarily conserved intracellular catabolic process that is used by all cells to degrade dysfunctional or unnecessary cytoplasmic components through delivery to the lysosome. Increasing evidence reveals that autophagic dysfunction is associated with human diseases, such as cancer. In cancer, autophagy can be neutral, tumor-suppressive, or tumor-promoting in different contexts. Large-scale genomic analysis of human cancers indicates that the loss or mutation of core autophagy genes is uncommon, whereas oncogenic events that activate autophagy and lysosomal biogenesis have been identified.Thus, the role of autophagy in cancer is determined by nutrient availability, microenvironment stress, and the presence of an immune system.The interdependency of metabolism and cellular mechanisms such as autophagy are becoming more evident and important. The initial signal to form auto-phagosomes is by the class III phosphatidyl-inositol (PI) 3 kinase complex consisting of sequence genes, Beclin1/Atg6, p150hVSp35, and class III PI3K (Vps34). This process is negatively regulated by binding of Bcl-2 family members such as Bcl-xL to Beclin1 preventing Beclin1 binding to the PI3K-III complex and thereby reducing autophagy. Binding of Beclin 1 to Bcl-2 or Bcl-xL is much weaker than that of proapoptotic BH3-only proteins, such as Bid, Bad, Bak, and Bim. Upon nutrient deprivation, which is the most potent autophagy inducer, BH3-only proteins induce autophagy by competitively disrupting the interaction between Beclin 1 and Bcl-2 or Bcl-Xl. At this point, it is unclear whether the autophagy-inhibitory Beclin 1–Bcl-2 or Beclin 1–Bcl-xL interaction plays any role in the tumor promoting function of the anti-apoptotic Bcl-proteins, especially since only endoplasmic reticulum (ER)-targeted Bcl-2 binds Beclin 1 and the interaction between these two proteins is disrupted under conditions of metabolic stress, which is a frequent occurrence in tumors in vivo. Thus, autophagy may function in tumor suppression by mitigating metabolic stress and, in concert with apoptosis, by preventing tumor cell death by necrosis. However, the specific interactions between necrotic tumors, their microenvironment and the immune system, as well as the specific molecular pathways implicated in tumorigenesis under these conditions, have yet to be elucidated. Keywords: autophagy, apoptosis, Beclin1, Bcl-proteins, phosphatidyl-inositol (PI) 3 kinase complex.

Biography

Aurelian Udristioiu currently works at the Clinical Laboratory, Emergency County Hospital Targu Jiu. Aurelian does research in Internal Medicine (General Medicine), Cancer Research and Biochemistry. Their current project is 'The correlation between the cellular energy expressed in ATP and levels of mutant p53 protein in CLL”. Aurelian Udristioiu is the President of the Conference, "3rd International Conference on Women Health and Breast Cancer", during May 30-31, 2019 at Nice, France. Aurelian Udristioiu, M.D, PhD, Emergency County Hospital Targu Jiu, City Targu Jiu, Romania Associate Professor at UTM University, Medicine Faculty, Molecular Biology Department, Member in American Academy of Biochemical Chemistry AABC/AACC

Speaker
Aurelian Udristioiu / Titu Maiorescu University
Romania

Abstract

Presently pregnant women are monitored frequently to distinguish normal progress in gestation and to identifypotential problems and possible treatments. Observation of progress is particularly important during late gestation to detect the onset of labour by changes in uterine contractility and cervical dilation which are necessary for normal vaginal delivery of the fetus. However, present methods used to measure uterine contractility, cervical dilation and fetal well being are totally inadequate to make precise and quantitative measurements on the advances of labour. Cardiotocography, a noninvasive method, is used to estimate fetal heart rate and uterine activity in most pregnant patients but this method is of limitedvalue in determination of contraction parameters. Intrauterine pressure monitoring is more precise in terms of contractionamplitude, but this is an invasive procedure. Contractions of skeletal, cardiac and most smooth muscle tissues, such as the uterus, depend upon the electrical activity of the muscle. Thus, measurement of electrical activity of muscle using electromyographic methods offers more understanding of the dynamics which control contractions. Our studies, and many observations by others, have demonstrated that electrical events of the uterus control contractility. This lecture will briefly review the fundamental basis for electrical activity of the uterus and explain how this technology can be used effectively in a pregnant patient. The frequency, duration and amplitude of uterine contractions are all proportional to the frequency, duration and propagation of electrical events, usually arranged in bursts of electrical activity. Furthermore, the onset and progression of term and preterm labor can be predicted (positive predictive value = 100% and negative predictive value = 90%) from receiver operator characteristics curves with high accuracy using the characteristics of uterine EMG signals. In addition, artificial neural network processing demonstrates that EMG burst characteristics can identify animals in term and preterm labor. Recently we have completed studies to compare the association of uterine electrical events and cervical effacement and dilation in normal nulliparous pregnant patients and in patients with arrest of labor during the 1st stage of labor. These studies demonstrate that the EMG burst characteristics increase progressively during cervical dilation in patients proceeding normally in pregnancy. However, in patients with arrest of labor the EMG burst parameters are significantly lower but are increased with oxytocin treatment. We conclude from these studies that: 1. Electrical bursts directly dictate contraction patterns of the uterus and thereby indirectly regulate cervical effacement and cervical dilation; 2. Analysis of EMG can be used to monitor uterine contractions and cervical dilation, the two cardinal signs for the onset and progress of labour; 3. The onset of the active phase of labor occurs at the time of full cervical effacement; 4. EMG monitoring is useful for the diagnosis of secondary arrest of labor. In total these and other studies demonstrate the value of electromyography in evaluation of onset and progression of labour and inassessment of problems and treatments related to labour.

Biography

Robert E Garfield obtained his undergraduate training from the University of Wyoming (BSc in Biology and MSc in Physiology) and PhD degree in Pharmacology with Professor Edwin Daniel at the University of Alberta in Canada. Later he did postgraduate studies with Professor Andrew Somlyo at the University of Pennsylvania, Philadelphia, PA. He later returned to Canada for his first faculty appointment at McMaster University, Hamilton, Ontario in the Department of Biomedical Sciences and Obstetrics and Gynecology (Ob/Gyn). During this period, he worked with Professor Arpad Csapo (Washington University, St Louis, Mo), father of the progesterone withdrawal hypothesis and Etienne Baulieu (University of Paris, France), discoverer of antiprogestins. Seventeen years later he accepted an appointment as Director of Reproductive Sciences in the Department of Ob/Gyn at the University of Texas Medical Branch. Galveston, Texas. He then transferred to the Department of Ob/Gyn at St. Joseph’s Hospital in Phoenix, Arizona. During the past four years Dr. Garfield was visiting Professor at the Department of Ob/Gyn at the Women and Children’s Medical Center and Medical University in Guangzhou, China. Presently Dr. Garfield is Professor and Research Scientist in the Department of Ob/Gyn at Banner University Medical Center – Phoenix, Arizona, USA and the University of Arizona Medical College of Medicine – Phoenix. During his career he has been fortunate to work and mentor about 150 young medical and graduate students, post PhD and MD fellows, developing faculty, and midwifes. He continues to collaborate worldwide with outstanding clinical and basic science faculty. Professor Garfield has published over 500 peer reviewed papers, textbooks and about 1000 published abstracts at international meetings, and holds many patents on drugs and medical devices. He is most noted for his discoveries on the structure and function of the uterus and cervix, methods to diagnose true labor at term and preterm and treatment of premature labor.

Speaker
Robert E Garfield / University of Arizona
USA

Abstract

Genital infections constitute one of the most common reasons why a woman visits a gynecologist and natural therapies are increasingly popular among patients who suffer from those infections. In addition, current resistance to conventional antibiotics led to the search for new antimicrobial agents, namely those of botanical origin. Thus, the influence of phytochemicals in this area is quite marked, being a great proportion of drugs derived or extracted from plants. In the last years, special attention has been devoted to some classes and sub-classes of plant secondary metabolites, namely to tea polyphenols. In this lecture, we will be focused on the most relevant studies about the antimicrobial activity of phytochemicals and botanical extracts upon microorganisms usually involved in women’s genital infections, such as Candida spp., Gardnerella vaginalis, Trichomonas vaginalis and Human papillomavirus. The relationship between the phytochemical composition and the antimicrobial effects will be highlighted.

Biography

Branca M. Silva has completed her Ph.D in Pharmaceutical Sciences (Nutrition and Food Chemistry branch) from the Faculty of Pharmacy – University of Porto (Porto, Portugal) in 2005. Currently, she is an Associate Professor at the Faculty of Health Sciences – University of Beira Interior (Covilhã, Portugal). She is (co)author of about 100 scientific papers and book chapters, has more than 3650 citations and an h-index of 33. Her research interests are oriented to the Medicinal Phytochemistry, Food Chemistry and Nutrition areas. Currently, she is an Academic Editor of the Journal of Chemistry (Hindawi Publishing Corporation). She is also Editorial Board Member and reviewer of several international journals and co-editor of 2 books (Bentham Science Publishers).

Speaker
Branca M. Silva / University of Beira Interior
Portugal

Abstract

A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, Personalized and Precision Medicine (PPM). To achieve the implementation of PPM concept into the practice, it is necessary to create a fundamentally new strategy based upon the subclinical recognition of biomarkers long before the disease clinically manifests itself. Each decision-maker values the impact of their decision to use PPM on their own budget and well-being, which may not necessarily be optimal for society as a whole. It would be extremely useful to integrate data harvesting fromGENOMIC, PHENOMIC and EXPOSOMIC sources (including the microenvironment)different databanks for applications such as prediction, preventionand personalization of further management to thus provide more tailored measures for patients and/or persons-at-risk (including family members) resulting in improved outcomes, reduced adverse events, and more cost-effective use of healthcare resources. In particular, PPM is becoming crucial for women, kids and the families whist dictating the needs to get personalized health management and wellness programs outlined and developed A lack of medical guidelines has been identified by the majority of responders as the predominant barrier for adoption, indicating a need for the development of best practices and guidelines to support the implementation of PPM into the practice! The latter requires a lot before the current model “physician-patient” could be gradually displaced by a new model “medical advisor-healthy person-at-risk”. This is the reason for developing global scientific, clinical, social, and educational projects in the area of PPM to elicit the content of the new branch.

Biography

Sergey Suchkov was born in the City of Astrakhan, Russia. In 1980, graduated from Astrakhan State Medical University with MD. In 1985, maintained his PhD at the I.M. Sechenov Moscow Medical Academy and Inst of Med Enzymology. In 2001, his Doctor Degree at the Nat Inst of Immunology in Russia. From 1989 through 1995, was a Head of the Lab of Clin Immunology, Helmholtz Eye Research Inst in Moscow. From 1995 through 2004 - a Head of the Dept for Immunology, Moscow Clin Res Inst (MONIKI). In 1993-1996, was a Secretary-in-Chief of the Edit Board, Biomedical Science, an IntJ published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK. At present, Dr Sergey Suchkov, MD, PhD, is: ● Professor in Medicine, Director, Center for Personalized Medicine, Sechenov University and Professor in Immunology, Dept of Clinical Immunology, A.I.Evdokimov Moscow State Medical and Dental University; ● Professor in Medicine, Chair, Dept for Translational Medicine, Moscow Engineering Physical Institute (MEPhI), Russia ● Secretary General, United Cultural Convention (UCC), Cambridge, UK. DrSuchkov is a member of the:● New York Academy of Sciences, USAl; ● American Chemical Society (ACS), USA;● American Heart Association (AHA), USA;● European Association for Medical Education (AMEE), Dundee, UK;● EPMA (European Association for Predictive, Preventive and Personalized Medicine), Brussels, EU;● ARVO (American Association for Research in Vision and Ophthalmology);● ISER (International Society for Eye Research);● Personalized Medicine Coalition (PMC), Washington, DC, USA; DrSuchkov is a member of the Editorial Boards of EPMA J., American J. of Cardiovascular Research and “Personalized Medicine Universe”etc

Speaker
Sergey Suchkov / Sechenov University
Russian Federation

Abstract

Introduction: The presence of electrophysiological abnormalities of the atrial myocardium with increasing age could explain the differences in the genesis of atrial fibrillation in women with paroxysmal atrial fibrillation. Material and Methods: Right atrial endocardial mapping were performed in 54 female patients who had paroxysmal atrial fibrillation, idiopathic or associated to other arrhythmias. Results: A total of 648 right atrial endocardial electrograms were assessed and quantitatively measured. The number of abnormal atrial electrograms showed a significantly positive correlation with age (r=0.37; p<0.0005). Women with paroxysmal atrial fibrillation over 60 years of age had a significantly greater mean number of abnormal electrograms (2.722.01) than those younger than 60 years (1.412.05; p<0.004). The longest duration (r=0.38; p<0.0005) and the maximal number of fragmented deflections (r=0.32; p<0.005) of atrial electrograms among the 12 right atrial sites also showed a significantly positive correlation with age. Conclusions: There is a significantly greater predisposition to atrial fibrillation in aging women because they develop a significantly greater abnormally prolonged and fractionated atrial electrograms with increasing age.

Biography

Professor Osmar Antonio Centurión, is a cardiologist with expertise in Coronary Heart Diseases and Cardiac Arrhythmias, Hemodynamics and Electrophysiology and Arrhythmia Ablation. He is Professor of Medicine at the School of Medical Sciences from the Asuncion National University (UNA) in Asunción, Paraguay. He received is PhD degree in Cardiology, at the Nagasaki University School of Medicine, Nagasaki, Japan in 1994. He is the Founding Member of Sociedad Latinoamericana de Cardiología Intervencionista (SOLACI). Author of more than 200 medical articles published in peer-reviewed American, European and Japanese journals in cardiology. He is a Fellow of the American College of Cardiology, American Heart Association, and member of more than 10 International Cardiovascular Societies. He is currently chief of the Department of Cardiology, Hospital de Clinicas. In addition, he is the Director of the Department of Health Science Investigation at the Metropolitan Hospital. He is currently Member of the Editorial Board of more than 50 international scientific journals. He is Past-Editor-In-Chief of the Revista de la Sociedad Paraguaya de Cardiología, and current Editor-in-Chief of Mathews Journal of Cardiology, and Blood, Heart and Circulation Journal.

Speaker
Osmar Antonio Centurión / Asunción National University
Paraguay

Abstract

Introduction: Breast reconstruction after total mastectomy and irradiation is a real challenge for the surgical teams. And is a crucial step for the patient in the life after breast cancer. The effect of radiotherapy on the skin often leads to preferring the reconstructions by flaps. However, reconstructions by prosthesis carries a high risk of complications and unsatisfactory cosmetic results. The optimization of skin trophicity by lipofilling and its positive impact on the results of secondary prosthetic breast reconstruction led us to perform an autologous fat grafting prior to secondary implant breast reconstruction after mastectomy and radiotherapy. Patients and method: All patients were treated at the same center between 2012 and 2015. They all had a total mastectomy and irradiation. They all had one or more sessions of lipofilling prior to breast implant reconstruction. Patients were followed to collect this data: postoperative complications, prosthesis removal, cosmetic result, and tumor recurrences. Results: Fifty-four patients were included. The mean pre-pectoral lipofilling session was 1.1 (1-2). The average volume of fat injected is 150cc (80-250). The average time between the end of treatment and the first session of lipofilling is 20.4 months (3-60). The mean volume of the prosthesis is 400cc (290-620). The mean follow-up time is 22 months. No local tumor recurrence was reported. One patient had a cutaneous necrosis after lipofilling. Implant explantation was performed in three cases (5.5%). The mean cosmetic result is 4.7 (3.5-5). Conclusion: Pre-pectoral lipofilling prior to implant breast reconstruction improves the chances of success by optimizing the trophicity of the skin. It significantly reduces the risk of prosthesis explantation. Therefore, this protocol allows us to propose a minimal invasive breast reconstruction, with no additional scar and no additional pain.

Biography

Dr. Kais Razzouk-Breast Surgery-Breast Reconstruction-Gynecological surgery-Gynecological and mammary cancerology-Nice Santa Maria Breast Institute

Speaker
Kais Razzouk / Nice Breast Institute
France

Abstract

Preeclampsia/eclampsia are more prevalent in low- than in high-income countries and associate with immediate health risks to mothers and offspring. Further, preeclampsia, as well as gestational hypertension alone, associates with increased risk of developing maternal hypertension following pregnancy. Early observations of the low risk of preeclampsia in low-income countries where the diet contained high amounts of calcium stimulated research into calcium’s role in preeclampsia prevention. WHO currently recommends that 1.5-2.0 g of calcium be provided to pregnant women when dietary calcium intake is insufficient with particular focus on women with preeclampsia risk factors. However, the role of calcium in hypertension prevention is controversial and the role of calcium in hypertension prevention in women who had a hypertensive pregnancy is not known. We explored calcium intake in mid-pregnancy for it’s prediction of incident hypertension within 10 years post delivery in a Norwegian Mother and Child (MoBa) cohort of women. The lowest relative to highest calcium intake quartile associated with a 62% greater risk of subsequent hypertension among women who had gestational hypertension with weaker associations observed among women who were normotensive during pregnancy. A low calcium intake predisposes to salt-sensitive hypertension and women who have had gestational hypertension have a greater likelihood of salt-sensitive blood pressure after pregnancy than women who have had normotensive pregnancies. The study results with evidence from the prevailing literature (which will be presented) suggests the need for additional nutritional research of high-risk women for the development of risk reduction strategies.

Biography

Prof. Egeland has expertise in epidemiological methods and analyses of complex data in cross-disciplinary research involving cardio-metabolic diseases, reproduction, and nutritional health. She currently works as Senior Researcher at the Norwegian Institute of Public Health and is Adjunct Professor at the Dept. of Global Public Health and Primary Care, University of Bergen, Norway. She has over 135 publications including book chapters; is currently engaged in registry-based research, and leads several research projects spanning disciplines in life-course epidemiology.

Speaker
Grace M. Egeland / University of Bergen & Norwegian Institute of Public Health
Norway

Abstract

Background Many breast cancer patients suffer from hot flush and medical menopause as side effects of treatment. Some patients undergo acupuncture, rather than hormone therapy, to relieve these symptoms, but the efficacy of acupuncture is uncertain. This meta-analysis evaluated the efficacy of acupuncture on hot flush and menopause symptoms in women with breast cancer. Methods A literature search was performed, following the PRISMA Statement and without language restrictions, of 7 databases from inception through 2017. All selected studies were randomized clinical trials (RCTs) that examined the effect of needle acupuncture on hot flush and menopause symptoms in patients with breast cancer. The methodological quality of these trials was assessed using Cochrane criteria, and meta-analysis software (RevMan 5.2) was used to analyze the data. Results We examined 844 breast cancer patients (average age: 58 years-old) from 13 RCTs. The trials had medium-to-high quality, based on the modified Jadad scale. The meta-analysis showed that acupuncture had no significant effect on the frequency and the severity of hot flush (p = 0.34; p = 0.33), but significantly ameliorated menopause symptoms (p = 0.009). None of the studies reported severe adverse events. Conclusions Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer.

Biography

Dr. Tsai-Ju Chien is a Hemato-Oncologist as well as a TCM doctor. The unique character of her is that she practices both TCM and western medicine in the same time in clinical for years. She devotes herself in bridging the gap between TCM and main stream medicine. What she focused is not only clinical care but also the basic research. She therefore extends her interest and research from clinical trial to basic study; from TCM herb to acupuncture. She has the passion to coordinate oriental and western medicine by applying modern method and therefore to reconcile the holism and reductionism

Speaker
Chien Tsai-Ju / National Yang-Ming University
Taiwan

Abstract

Background: Although opioids are commonly used for postsurgical analgesia after cesarean section, they are associated with adverse events and the potential for chronic opioid use. These concerns drive the need for effective opioid-free analgesic regimens. Liposomal bupivacaine (LB) is a prolonged-release formulation of bupivacaine designed to provide sustained postsurgical analgesia after a single dose. Cases: Three case reports describe multimodal pain management after cesarean section using LB, non-steroidal anti-inflammatory drugs, and acetaminophen. All three women reported excellent pain control; early ambulation, resumption of food intake, and voiding. All three were entirely opioid free throughout their hospital care and post-partum, with rapid return to activities of daily living. Conclusion: Opioid-free cesarean section using LB provided improved analgesia and rapid recovery compared with traditional cesarean section pain management. Further studies of LB in cesarean section are warranted.

Biography

Speaker
Richard Chudacoff / Moore County Hospital
USA

Abstract

Iron metabolism was found implicated in breast cancer (BC). Although dietary iron showed inconsistencies regarding its possible associations with BC risk, its source might be important. We have reported that an animal/plant ratio of dietary iron was directly associated to this risk [http://dx.doi.org/10.16966/jbcra.102]. Based on estimates of heme and non-heme iron contents in representative foods, we carried out the present study, with the aim of more accurately reanalyze dietary iron and its role on BC risk. A case-control study, performed on 572 BC cases and 889 controls, used a specific multi-topic questionnaire including a food frequency questionnaire. Controls were age-frequency matched to cases. Food-derived nutrients were calculated from available databases. Total dietary iron was calculated according its heme or non-heme source, additionally adjusted by energy. Odds Ratios (ORs) were estimated by logistic regression, adjusting for potential confounders. Data were categorized into tertiles, for analyses purpose. Total iron intake was not associated with BC risk. Heme iron was positively associated among postmenopausal women and for the overall sample. Non-heme iron showed an inverse association among premenopausal women and among the overall sample. Regarding heme/non heme ratio, risks tended to increase in all analyzed groups: premenopausal (OR=2.07), postmenopausal (OR=1.99) and both groups together (OR=1.93). Therefore, source and proportions of available iron might be of importance as a link to breast carcinogenesis. Further studies are needed to clarify this point.

Biography

Dr. Alvaro Ronco (Montevideo, 1958) is a Uruguayan M.D. with large expertise in nutritional epidemiology of cancer, focused on breast cancer. He is Associated Professor of Cancer Epidemiology at the CLAEH University in Uruguay and has published 140 papers in international peer-reviewed specialized journals. Author of Nutritional Epidemiology of Breast Cancer (Springer, Dordrecht 2012), the first book published on this area. Distinguished by AACR as one of the 12 Latin American referent researchers in cancer. He is a Non-EU expert member in the database of the European Commission.

Speaker
Alvaro Ronco / Pereira Rossell Women Hospital
Uruguay

Abstract

Hormone receptor positive (HR+) breast cancer (BC) is the most commonly diagnosed molecular subset of BC. Modification of estrogen activity or synthesis represents the treatment of choice for HR+ BC. Resistance to existing endocrine therapies remains a major challenge, with recent advances in identifying molecular mechanisms of resistance including cross-talk between estrogen receptor and various growth factor receptor and/or intracellular signalling pathways. The activation of cyclin-dependent kinases(CDK) 4/6 is finely regulated by the cyclin family members and negative modulators including members of the INK4, CIP, and KIP family. Increased cyclin D1 expression, due to genetic abnormalities or increased transcription of CCND1 (e.g. hyper-activation of the ER signaling network), is frequently seen in human malignancies and can lead to CDK4/6 mediated cell proliferation via activation of a unique signaling network . Functional studies have indicated that Retinoblastoma (pRb) and FoxM1 are direct and natural downstream substrates of CDK4/6 which play a crucial role in the regulation of the G1/S transition through regulation mainly, of the phosphorylation state of the pRb. Hyper phosphorylation of pRb causes release of transcription factors that allow the transition from G1 to S phase and progression through the cell cycle. There are three available oral CDK 4/6 inhibitors (Palbociclib, Ribociclib and Abemaciclib) for the treatment of HR+ advanced BC which have resulted in significant improvements in progression free survival. Furthermore, there are several ongoing clinical trials evaluating predictive markers or response to these agents, their clinical utility in the adjuvant setting, and in other subtypes of BC.

Biography

Dr. Maysa Abu-Khalaf is the director of Breast Medical Oncology for the Division of Solid Tumor, and co-director of the Jefferson Breast Care Center for the Sidney Kimmel Cancer Center at Thomas Jefferson University in Philadelphia, PA. She is a medical oncologist with clinical expertise in the management of breast cancer. Her research focus is evaluating novel agents for the treatment of breast cancer and predictive markers of response to these therapies.

Speaker
Maysa Abu-Khalaf / Thomas Jefferson University
USA

Abstract

Introduction: Aging could influence the atrial response to premature atrial depolarizations increasing the vulnerability of the atrial myocardium to develop atrial fibrillation in elderly women. Material and Methods: Programmed atrial stimulation with single extrastimulus were performed in 102 female patients, 48 of them had normal sinus node function and did not have atrial fibrillation (Group I), and 54 of them had paroxysmal atrial fibrillation, idiopathic or associated to other arrhythmias (Group II). Results: The incidence of induction of repetitive atrial firing (68% vs 36%; p<0.02), fragmented atrial activity (85% vs 47%; p<0.005), and sustained atrial fibrillation (43% vs 5%; p<0.001) was significantly higher in Group II than in Group I. The zone of induction of repetitive atrial firing (34±33 vs 10±19 ms; p<0.005), fragmented atrial activity (49±40 vs 12±15 ms; p<0.001), and interatrial conduction delay (51±32 vs 26±28 ms; p<0.02) was significantly wider in Group II than in Group I. Conclusions: The electrophysiological indicators of augmented atrial vulnerability are significantly altered with increasing age in women with paroxysmal atrial fibrillation. There is a significantly greater predisposition to atrial fibrillation in aging women because they develop a significantly greater augmented atrial vulnerability with increasing age.

Biography

Professor Osmar Antonio Centurión, is a cardiologist with expertise in Coronary Heart Diseases and Cardiac Arrhythmias, Hemodynamics and Electrophysiology and Arrhythmia Ablation. He is Professor of Medicine at the School of Medical Sciences from the Asuncion National University (UNA) in Asunción, Paraguay. He received is PhD degree in Cardiology, at the Nagasaki University School of Medicine, Nagasaki, Japan in 1994. He is the Founding Member of Sociedad Latinoamericana de Cardiología Intervencionista (SOLACI). Author of more than 200 medical articles published in peer-reviewed American, European and Japanese journals in cardiology. He is a Fellow of the American College of Cardiology, American Heart Association, and member of more than 10 International Cardiovascular Societies. He is currently chief of the Department of Cardiology, Hospital de Clinicas. In addition, he is the Director of the Department of Health Science Investigation at the Metropolitan Hospital. He is currently Member of the Editorial Board of more than 50 international scientific journals. He is Past-Editor-In-Chief of the Revista de la Sociedad Paraguaya de Cardiología, and current Editor-in-Chief of Mathews Journal of Cardiology, and Blood, Heart and Circulation Journal.

Speaker
Osmar Antonio Centurión / Asunción National University
Paraguay

Abstract

According to ACS (American Cancer Society) 2017 registry, breast cancer is the most frequently diagnosed cancer in women (30%).Regardless thesuccess story of 97% 5/yr survival rate that comes with diagnosis at an early stage, breast cancer still remains the second leading cause of cancer related death in women. Breast cancer treatment planning, besides disease staging with lymph node status and metastasis is based widely on ER , PR, Her2/neustatus and ki 67 or ΜΙΒ1 markers.But favorable profiling is not always associated with excellent prognosis so various genomic tests of the tumor (OncotypeDx , Mammaprint..) have been developed in order to try to predict more accurately tumor’s biology and customize treatment . (Also breast cancer awareness and screening strategies, have come up with the dilemmas how to deal with high risk and precancerous lesions: not all patients will develop breast cancer but some will.?? In the forthcoming era of tailored strategiesand individualized medicine it is vital in order to write a success story, to study and understand the interactions between the tumor and the hosting environment ie breast and axillary tissue with the draining lymph nodes.The presence of TILs (Tumor- infiltrating lymphocytes) and TLS (tertiary lymphoid structures)in the tumor’s microenvironment (TME) have attracted much attention and seem to play a key role for improved prognosis. Studies of subpopulations of T cells within the TLS indicate that different Tcell subsets play an important role on functionality and immunes’ system efficiency. All the aforementioned are an area of ongoing research in order to understand immune and tissue dynamics around a tumor. Archival paraffin-embedded tissue from breast cancer patients with different characteristics and also fresh tissue collected during breast cancer surgery is being investigated regardingT cell dynamics.

Biography

Speaker
Antigoni Poultsidi / University of Thessaly
Greece

Abstract

The odds of preserving gonadal function after gonadotoxic chemotherapy are significantly better for prepubertal girls than for boys.Although ovarian function has been preserved in most long-term female survivors treated prepubertally for lymphoma, but only in approximately half of the similarly treated adult reproductive-age women, it is clinically logical to generate a temporary and reversible prepubertal milieu before and during the gonadotoxic chemotherapy. Many groups of clinicians have been using gonadotropin-releasing hormone agonist (GnRHa) cotreatment for minimizing the gonadotoxic effects of chemotherapy, by simulating a prepubertal hormonal milieu, with the rationale that preventing premature ovarian insufficiency (POI) is preferable to treating it. However, reported results addressing this strategy have been conflicting, and several major international guidelines still consider it experimental.

Biography

Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Rambam Health Care Campus, Rappaport Institute, Technion‐Israel Institute of Technology, Faculty of Medicine, Bath‐Galim, Haifa, Israel

Speaker
Zeev Blumenfeld / Technion–Israel Institute of Technology
Israel

Sessions:

Women Health-2019

Abstract

Purpose of Study: Identifying mutations in breast cancer genes (BRCA1/2, PABL2) has important clinical implications on a woman's lifetime susceptibility for breast cancer development. Nearly 10% of immigrants to the United States come from the Caribbean and few studies exist that examine breast cancer gene mutations in African-Caribbean women with existing breast cancer. The purpose is to review breast cancer epidemiology statistics and prevalence of breast cancer genetic mutations in this cohort. Summary of Results Although breast cancer cumulative incidence risk of Caribbean women (5-9%) appear to be less than that of the US women (10%), the cumulative mortality risk in the Caribbean cohort (up to 2.7%) appears greater than that of the US (1.6%). Through a PUBMED literature search, we have also identified five cross-sectional cohort studies on breast cancer patients of Caribbean women who have undergone genetic mutation testing for BRCA1/2 and PALB2 with 27% cases in Bahamas (N=214 women); 2.8% cases in Jamaica (N=179 women); 10.4% cases in Trinidad/Tobago (N=268 women); none in Barbados (N=118 women); 2.6% in Cuba (N=307 women). No study accounted for ascertainment bias. Conclusions This study summarizes the estimate of breast cancer incidence and mortality in Caribbean women and known prevalence of BRCA1/2 and PALB2 breast cancer gene mutations in this cohort. This is critical as part of a formal genetic risk assessment and counseling of patients with breast cancer. Further research and understanding the contributions of inherited gene mutations will guide the optimal health policy in breast cancer screening and risk management.

Biography

Gordon Moffat has his experience if Life Sciences with an Honors in Biology with training in Radiology. His passion for science and interest in microbiology lead him to pursue and obtain a Doctor of Medicine. Currently he is working at the State University of New York Brooklyn Health Sciences Center in Internal Medicine and the forthcoming Medicine Chief Resident. His professional interests include: Medical Oncology, Hospice and Palliative Medicine, and Geriatric Medicine. He is currently working on research projects at Memorial Sloan Kettering Cancer Center in Manhattan, New York that are expected to be published. He is also a candidate for the Alpha Omega Alpha Honor Medical Society Postgraduate Fellowship Award.

Speaker
Gordon Moffat / State University of New York
USA

Abstract

Breast cancer is worldwid e incident among women, whose surgery is frequent and associated with numerous functional changes. Objective: To assess the range of motion and upper limb function postoperatively before and after physiotherapy intervention of women who underwent mastectomy and quadrantectomy. Methods: This is interventional study, descriptive and exploratory, quantitative approach, with 64 women undergoing conservative surgery and mastectomy with follow up at the gynecology outpatient clinic and referred for physical therapy at the Hospital das Clinicas, UNESP. Was performed goniometry of flexion / extension, abduction / adduction and internal rotation / side, measures performed before and three months after the herapy. Results: The chi square test with 0.005 significance level showed that quadrantectomy or mastectomy, not differentiated in relation to the variables; schooling, family income, color, marital status, religion, breast affected, clinical staging, menarche, body mass index and contraceptive methods. There was no association between type of surgery and the median age (type 1: 55 (37-57) x 2 type: 54 (37-82), p = 0.331 by Mann-Whitney). Conclusion: After physiotherapy, the flexion of the homo- and contralateral arm, as well as the homolateral abduction and homolateral extension increased significantly in both surgeries. The contralateral abduction was maintained in both surgeries. The physiotherapeutic intervention provided a significant improvement in the range of movements.

Biography

Speaker
Maria de Lourdes da Silva Marques Ferreira / São Paulo State University
Brazil

Abstract

States of vitD deficiency are associated with adverse pregnancy outcomes, including preeclampsia and preterm birth (PTB). We conducted 3 RCTs and found circulating 25(OH)D was linked with outcome. In a 3rd RCT, from 2012-2016, 257 women were randomized to 1 of 2 vitD daily regimens (400 vs 4400 IU VitaFusion gummies) beginning at 8-12 weeks' gestation until delivery. Maternal/fetal health status, circulating 25(OH)D, and calcium and urinary calcium/creatinine (Ca/Cr) ratio were measured monthly. Comorbidities of pregnancy were recorded for each maternal/fetal/neonatal pair: hypertension (HTN), diabetes, preeclampsia, preterm delivery, chorioamnionitis, miscarriage, intrauterine fetal death or bacterial vaginosis (BV). Data were analyzed using R (Vienna, Austria). Baseline characteristics were similar between the treatment groups. By 2nd month, 25(OH)D remained significantly higher in 4400 IU compared to 400 IU group through delivery (p<0.001) withno differences in serum calcium and urinary Ca/Cr ratios. After adjusting for age, BMI, race/ethnicity, and baseline 25(OH)D, 4400IU was not associated with any single pregnancy morbidity; however, higher dose was associated with lower risk of combined pregnancy comorbidities among African Americans (OR=0.26, p=0.034) not demonstrated in Hispanics and Caucasians.When the 3 RCT data were combined, PTL/PTBwas associated with lower 25(OH)D concentration (89.0 nmol/L) vs. 103.8 nmol/L in mothers who delivered at term without a history of PTL (p=0.0002). Results from our 3 RCTs show that the women most impacted by suboptimal vitD status are African American women,who have higher rates of adverse events during pregnancy.

Biography

Carol L. Wagner, MD is Professor of Pediatrics at the Medical University of South Carolina, Charleston, SC, USA, where she works as an academic neonatologist and translational researcher in the area of vitamin D requirements during pregnancy and lactation for more than 18 years. She has published more than 130 papers in reputed journals and has been serving as an editorial board member and reviewer for several journals.

Speaker
Carol L Wagner / Medical University of South Carolina
USA

Abstract

Despite the liberal use of episiotomy, instrumental delivery is associated with an increased risk of obstetric anal sphincter injuries (OASIS). Traditionally, lists of the risk factors linked to OASIS have ignored the human factor. The anterior non-episiotomy forceps (ANEF) or natural forceps delivery signifcantly reduces the rate of OASIS, and indeed, perineal trauma, by refning the human factor and improving the operator’s practice. Furthermore, it is associated with improved maternal recovery because it minimizes the need for episiotomy, and therefore, peripartum blood loss. After implementing ANEF in a series of 360 consecutive Neville–Barnes forceps deliveries in primiparae, the rate of OASIS was 1.9%, compared to the reported prevalence of 8.9% in traditional forceps deliveries with routine episiotomy. Enhanced recovery pathways (ERPs) are increasingly being implemented across surgical specialties to reduce the impact of operative procedures and improve patient experience. Part of the authors’ ongoing work to reduce the rate of perineal injury and OASIS, this article describes the ANEF delivery, which should become part of the ERPs in obstetrics.

Biography

Dr Konstantinos Papadakis was also born in Athens, and studied medicine at the National and Kapodistrian University of Athens. He worked in various training posts in London, the East of England, Wessex and the East of Scotland Deanery. Konstantinos is currently in the specialty training programme in obstetrics and gynaecology at the West of Scotland Deanery. He works at the Princess Royal Maternity Hospital in Glasgow. Konstantinos has a special interest in minimally invasive gynaecological surgery. He is also passionate about academic clinical research projects, and simulation training in both advanced endoscopy and innovative acute intrapartum care. Konstantinos has been working on the ANEF project for 2 years.

Speaker
Konstantinos Papadakis / Princess Royal Maternity Hospital
UK

Abstract

Background: In Pakistan triple negative breast cancer is getting common. Its aggressive behavior accounts for its detection at advanced stage. Neoadjuvant chemotherapy is very helpful before local surgical treatment. Platin based chemotherapy has proven beneficial for treating patients. Cost of drugs and limited resources are very important factors in treating poor patients.Cisplatin and doxorubicin were used as chemotherapeutic agents to see outcome in patients. Methods: Patients were enrolled from Sir Ganga Ram Hospital Lahore, Mayo Hospital Lahore and Services hospital Lahore. All patients had biopsy proven locally advanced invasive triple negative breast cancer. There was no evidence of metastatic disease on (CT chest, CT abdomen and bone scan). Patients were planned for treatment with cisplatin(60 mg/m2) and doxorubicin (50 mg/m2) every three weeks for six cycles. Evaluation was done at regular interval after two cycles for response using response evaluation criteria in solid tumors. Patients showing signs of toxicity or progressive disease were excluded and shifted to other chemotherapy. After completion of chemotherapy, local surgical treatment was givenfollowed by loco regional radiation therapy. End point was to access response rate and disease free survival. Complete response, partial response, stable disease and progressive disease were assessed using response evaluation criteria for solid tumors. Patients with recurrent disease were offered further chemotherapy regimen in follow up. Overall survival was also assessed. Results: A total of 243 patients were enrolled. 10% of the patients progressed during neoadjuvant chemotherapy and were excluded. 230 patients were evaluated for response assessment, disease free interval and overall survival. 28% patients showed complete response, 40% showed partial response and 30% showed stable disease. No acute toxicity was observed during chemotherapy. Conclusion: Cisplatin and doxorubicin are effective as neoadjuvant chemotherapeutic agents in locally advanced disease. More randomized trial can be carried out to clearly define their efficacy. These drugs can prove helpful in better outcome of breast cancer patients.

Biography

Speaker
Azka / Sir Ganga Ram hospital Lahore
Pakistan

Abstract

The psychological cannon highlights on a new paradigm shift from the traditional models such as the bio-psychosocial model to disease and treatment to the inculcation of spirituality (Bio-psychosocial-S) in holistic treatment plan. Breast cancer is the second leading malignancy in Ghana and appears to be on the ascendency in recent times. Emerging studies have documented increasing diagnosis among premenopausal women which conflicts with previous findings. However, an attempt to handle the disease has been crippled with logistic and structural challenges. Breast cancer patients have adopted various strategies over the years in attempt to cope with the structural challenges inherent in the diagnosis, treatment and post treatment plan. Using qualitative research methodology, twelve participants were conveniently sampled and interviewed. This preliminary study explored views and perceptions of breast cancer patients on breast cancer and how they have coped with the condition. Results were analyzed using Interpretative Phenomenological Analysis (IPA) to explore how participants make meaning of their experiences. Findings showed that socio-cultural factors play an integral role in participants’ interpretations of the disease and this also informed the culture-specific coping ties which were employed respectively. Implications for psychological models, treatment, and research are discussed.

Biography

Dr Yvonne Otubea Otchere is a lecturer/researcher at Lancaster University Ghana, and an alumni of the University of Ghana. Her research has primarily focused on understanding the African sexuality, masculinity and neuropsychological functioning in typical and atypical populations. Dr Otchere’s research concerns are focused on specifically dissecting the layers of the African sexuality. She is known to be one of the avid African scholars documenting on gender roles among homosexual men in Ghana. With funding support from Global Research Challenge Fund, she is currently involved in landscape projects such as the use of technology/apps in mental health among Men who Sleep with other Men (MSM) in Ghana. Her teaching interests include social behaviour, brain and behaviour, understanding organisational psychology, sexuality, understanding psychological assessments, Psychology of religion and spirituality in the African context. As part of her earnest zeal for research work and social responsibility, she serves as the treasurer for the Ghana Psychological Association.

Speaker
Yvonne Otubea Otchere / Lancaster University
Ghana

Abstract

The decades-old public health policy of universal vitamin D (vitD) supplementation of breastfeeding infants is based on the premise that breast milk, while the best source of nutrition for the infant, provides minimal vitD and necessitates supplementation to prevent rickets. Yet, two methods are equally effective in providing an adequate supply of vitD to the exclusively breastfeeding infant: direct infant supplementation (400 IU vitD/day) or maternal supplementation (6400 IU vitD/day) to raise her vitD status and not supplement the infant. There is evidence that suggests that the health status of both the mother and her recipient breastfeeding infant affects the cellular and immune content of the breast milk, thereby affecting the infant’s immune response to infection. Using 2D-differential gel electrophoresis to quantitatively compare proteomic profiles of the milk fat globule membrane (MFGM) obtained from either vitD-deficient or -sufficient mothers, we found significant fold-changes in relative expression/post-translational modifications for >30 known immune regulator proteins that correlated with maternal vitD status, including perilipin, lactoferrin, and TGF-α. Differential acyl chain lengths of sphingomyelin (known mediator of the immune system), differential in vitro milk macrophage responses to LPS, and mRNA and protein expression of other cytokines also were associated with maternal vitD status. Significant association between infant hepatitis B (HBV) IgG titers, soluble CD14 (sCD14), as well as atopy risk at 4 months with maternal but not infant 25(OH)D were noted, suggesting that the milk itself confers differential immune function in the infants. Maternal vitD status appears to impact milk immune signalling and properties.

Biography

Carol L. Wagner, MD is Professor of Pediatrics at the Medical University of South Carolina, Charleston, SC, USA, where she works as an academic neonatologist and translational researcher in the area of vitamin D requirements during pregnancy and lactation for more than 18 years. She has published more than 130 papers in reputed journals and has been serving as an editorial board member and reviewer for several journals.

Speaker
Carol L Wagner / Medical University of South Carolina
USA

Abstract

Introduction Here in India almost 75% of cancer patient die a sad death of neglect due to lack of awareness about palliative care and low economic level. Surveys in India show that two third of cancer patient do not get proper care during the terminal phase of their life. Palliative care through volunteers can make a significant difference in this respect. Objective To identify and try to solve, to the extent possible, the main difficulties in giving palliative care to the terminal cancer patients of the area. And evaluate the impact of volunteer’s direct care of palliative patients and their families. Methods Feedback from patients and their relatives regarding the palliative care they receive from nursing home and from volunteers and compare the two. Also feedback from volunteers regarding their positive and negative experience while delivering palliative care service. Then evaluate the data to compare and improve the quality of service. Results We carried out two studies. One study was undertaken in nursing home palliative care and another was in home setting by volunteers. Both studies were in adult palliative care services. Since January 2016, 552 cases were studied to enquire about their experience in both home based care and nursing home care. Both the studies fulfilled our quality appraisal criteria. One found that those families and patients who received home visits from volunteers were significantly more satisfied. The study highlighted the value of the role of volunteers in better satisfaction of patients and their families. Conclusions Further research is needed to evaluate the role of volunteers in palliative care and how it can be delivered appropriately and effectively. We also wish to compare our findings with similar studies elsewhere.

Biography

Aditya Manna has completed his under graduate degree from Vidyasagar University, India and psyco-oncology training from UICC. He is the founder president & chief caregiver of Narikeldaha Prayas, a nonprofit Organization for cancer palliative care in rural West Bengal, India. He has published more than 16 papers in natational and internationally.

Speaker
Aditya Manna / NARIKELDAHA PRAYAS
India

Abstract

Purpose: This study compares Metformin and sulfonylureas used to treat Type 2 Diabetes and their effect on the prevalence of Triple negative breast cancer in AA women. Methods: A retrospective study was conducted to determine the prevalence of breast cancer in African American women currently treated for their type 2 diabetes with Metformin and/or sulfonylureas. Women ages 38-89 years of age who presented for routine eye exams at The Eye Institute from 2014-2016 and with a diagnosis of Type 2 Diabetes mellitus were included. Women diagnosed with breast cancer less than one year after the Diabetes diagnosis were excluded (n=40), a total of 350 subjects meeting these criteria were identified and classified into one of four groups; Metformin only n=191, sulfonylureas only n=84, both metformin and sulfonylureas n=43 and diet controlled treatment as a control group n=32. Fisher exact test as well as Chi square was used with and without Yates correction to determine an association between these groups. Results: A history of metformin use compared to no metformin cases and controls use was associated with a 3.32 times decreased risk of the presence of breast cancer (p<0.01 for both Chi Square and Fisher Exact test). This association was statistically significant. For subjects using sulfonylureas there was no difference between the sulfonylureas only group and no sulfonylureas group for breast cancer rates. Conclusion: The results of this study supports previous work indicating that Metformin may be protective against comorbidities associated with diabetes, especially those associated with inflammation.

Biography

Maryjo Thomas was MSc student at Salus University. Research interests include Breast cancer and Ocular Metastases, Primary Care Eye disease. Instructor at The Eye Institute of the Pa. College of Optometry. Residency trained in Primary Care Optometry and Low Vision Rehabilitation Optometry/Special Populations

Speaker
Maryjo Thomas / Salus University
USA

Abstract

Purpose: The aim of the present study was to evaluate the association between vitamin D deficiency and bacterial vaginosis in the first trimester of pregnancy. Methods: acrossection study was conducted on 100 pregnant women attending Elshatby Maternity University Hospital during their first antenatal visit between April - December 2014 (6 months). Women were subjected to a pelvic speculum examination at the initial obstetrical visit to ascertain for the presence of BV and vaginal swab was taken to be evaluated by Gram’s stain for presence of bacterial vaginosis. Plasma 25-OH-D concentration, the major circulating form of vitamin D, was assayed using a commercially available ELISA kit. Results: Our results found that, the age of the included pregnant woman ranged from 20-32 with a mean of 24.9±2.91 years, most of the studied women were less than or equal 25 years (60.0%). The gestational age ranged from 8.0-12.0 weeks with a mean of 9.93±1.59 weeks. Most of the studied women had a BMI more than 25 kg/cm2 (95.0%). 82 cases were positive for bacterial vaginosis, while the other 18 cases (18%) were negative for bacterial vaginosis. The majority of the patients had vitamin D deficiency (53.0% of the patients), while 35.0% of them had insufficient vitamin D. Only 12 cases (12.0%) had sufficient amount of vitamin D. The level of vitamin D ranged from 1.54-40.0 IU with a mean of 13.97±9.57 IU. There was a significant low level of vitamin D deficiency among the cases of bacterial vaginosis. Conclusions: There was an association between vitamin D deficiency in the first trimester of pregnancy and bacterial vaginosis, all women with sufficient serum level of vitamin D were free from bacterial vaginosis compare those with deficient serum vitamin D level.

Biography

DrNermeen El Beltagy MD, PhD, MS, MPH, Professional C is a Professor of in the Department of Obstetrics and Gynecology, Alexandria University, Egypt. She is a member of the International weight management in pregnancy (I-WIP collaborators of the European Union). She received her medical degrees from Egypt, but the PhD in environmental health, and MPH in epidemiology degrees were from Saint Louis University in the USA. She earned her Professional Certificate in women's heath from Exeter University, UK. She authored and coauthored over 10 peer reviewed publications mainly on the subjects of Causes and recommendations of Maternal mortality and morbidity in Egypt, preeclampsia, maternal obesity and contraception. She is an editor of the American journal of cancer prevention.

Speaker
Nermeen El Beltagy / Alexandria University
Egypt

Abstract

Background/objective: The purpose of this study is to investigate the use of a more biologic parameter for evaluation of the effect of nuchal cord tightness; the study of blood flow in the umbilical arteries of nuchal cord using Doppler ultrasonography. Methods: This prospective cohort study was conducted at Ain Shams University Maternity Hospital, Cairo, Egypt in the period between August 2015 and August 2017. Hundred primigravidas were recruited with nuchal cord diagnosed by Doppler ultrasonography; whereas the rest of the study population was included in the “Control group”. Doppler velocimetry study was then performed on a free-floating loop of the umbilical cord and Doppler indices were calculated. Both groups were followed up during labor: intrapartum events, mode of delivery, and neonatal outcome were recorded. Results: Intrapartum fetal heart rate abnormalities were significantly more common in the nuchal cord group compared to the control group. The overall cardiotocography category was significantly more commonly reflecting abnormal fetal heart rate patterns in the nuchal cord group compared to the control group with 46.74% of the nuchal group patients falling within the “suspicious – pathological – need urgent intervention” categories. Intervention rate was significantly higher in the nuchal cord group than the control group (33.69 versus 21.84%). Moreover, incidence of intrapartum fetal heart rate abnormalities and intervention rate were significantly higher in the nuchal cord with abnormal Doppler subgroup compared to both nuchal cord with normal Doppler subgroup and the control group; with a calculated number needed to harm of 2.11. Conclusions: In view of these results, it might be concluded that umbilical cord tightness affecting fetal hemodynamics (expressed by changes in umbilical artery Doppler) might be a determinate factor affecting the intrapartum course.

Biography

Lecturer of Obstetrics and Gynecology, Ain Shams University - Consultant of Obstetrics and Gynecology Consultant in IVF IVF - Gynecologic Oncology

Speaker
Ahmed Alanwar / Ain Shams University
Egypt

Abstract

Introduction: As in any developing countries state of West Bengal in India has a huge burden of metastatic breast cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Our goal is to give a pain free good quality of life in these advanced stage breast cancer patients. Method: Advanced breast cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement, repeated home visit, awareness built up, proper training to home care giver, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Biography

Aditya Manna has completed his under graduate degree from Vidyasagar University, India and psyco-oncology training from UICC. He is the founder president & chief caregiver of Narikeldaha Prayas, a non profit Organization for cancer palliative care in rural West Bengal, India. He has published more than 16 papers in natational and internationally.

Speaker
Aditya Manna / NARIKELDAHA PRAYAS
India

Abstract

Background: Breast cancer possesses serious health risk for women in Pakistan. It is estimated that one in nine Pakistani women will develop breast cancer at some stage in their lives. Early detection can help save lives. Objectives: To exploreknowledge, attitude and practices regarding breast cancer detection in Pakistaniwomen. Unfortunately no statistical data is available in this regard. Very few researches have been carried out. In Pakistan we do not have a registry at national level. Method: Descriptive exploratory study was carried out. Two hundred Pakistani women, age 30 and above, notsufferingfrom cancer were interviewed from lady Wallingtonhospital, Sir Ganga ram hospital and services hospital Lahore. The interview designed contained questions regarding knowledge, attitudes and practices about symptoms of breast cancer, breastself-examination (BSE) and clinical breast examination (CBE).Data was obtained by face to face interview in local language, translated into English afterwards. Results:20% of participants had knowledge about symptoms of breast cancer.16% of participants did BSE only once.10% of participants practiced BSE monthly.8% had undergone at least once CBE during their lives. The majority (70%) didn’t know much about breast cancer. Age and education showed no statistically significant relationship with breast health practices. Conclusion: Pakistani women have minimal knowledge about breast cancer. They don’t engage themselves in breast cancer detection practices. They need to be better informed about breast cancer and benefits of BSE and early detection.

Biography

Speaker
Azka / Sir Ganga Ram Hospital Lahore
Pakistan

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