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Plenary Talks

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, M.D,Primary Physician, EuSpLM,City Targu Jiu, Romania National Academy of Biochemical Chemistry (NACB) Member, Washington D.C, USA. Fellow PhD in Molecular Biology, Titu Maiorescu University, General Medicine Faculty, Bucharest, Romania. Man of Medical Year/2015 at the International Bibliographic Center, IBC, Cambridge, UK.

Speaker
Aurelian Udristioiu / Titu Maiorescu University
Romania

Abstract

Liver diseases (LD) are present in 4% of pregnancies. Maternal vaccination against hepatitis B, or A, virus is feasible during pregnancy. In acute LD, drug-induced (DI) LD must always be contemplated. Four conditions may cause pregnancy-specific LD. Hyperemesis gravidarum is exceptionally complicated by accidental chlorpromazine-induced cholestasis or by hyperammonemic acute liver failure (ALF) in women affected by OTC deficiency. Intrahepatic cholestasis (IHC) of pregnancy (IHCP) must be treated immediately by ursodeoxycholic acid (UDCA), at least 12 mg/kg/d, and then confirmed by eliminating DI, or previously unrecognized chronic, IHC. The 95% risk of recurrence associated with familial history of IHCP and/or consanguinity may be prevented by early administration of UDCA. In 2 other pregnancy-specific entities, rapid/immediate termination of pregnancy is life-saving. Pre-eclampsia (PE)-associated major liver ischemic lesions (hepatic infarctus, liver subcapsular hematomas, liver capsular rupture) almost never require abdominal surgery. Acute fatty liver of pregnancy must be diagnosed when recent polydypsia and/or nausea/vomiting are associated with hyperuricemic hypertransaminatis and hyperleukocytosis. The most frequent acute LD not specific of pregnancy is acute hepatitis E virus infection, a potential cause of ALF. Herpes simplex virus liver injury must be diagnosed when recent fever is associated with hypertransaminitis. When the later is > 1 000 U/L, immediate IV acyclovir without proven diagnosis is mandatorily required. Auto-immune hepatitis requires immediate corticosteroids administration. Diagnosis of acute Budd-Chiari syndrome requires urgent liver ultrasonography and immediate anticoagulation must be initiated. Pregnancy may superimpose to compensated chronic LD with or without specific treatment. Liver transplantation is feasible during pregnancy.

Biography

Jacques Bernuau has completed his MD in Paris University. He served as an Assistant Professor in clinical hepatology in the Liver Unit, in Hôpital Beaujon, Clichy, France. He also worked as a hepatologist in the gynecology and obstetrics department of the same hospital. He has published several papers on the topic of liver disease in pregnancy in international journals.

Speaker
Jacques Bernuau / Beaujon Hospital
France

Abstract

An effective prevention program of cervix cancer should consist of: primary prevention (vaccination) and secondary prevention (screening). In Italy, HPV vaccination is recommended for all girls aged 9 to 26 years since the end of 2007. There are currently 3 available vaccines: a bivalent vaccine: it protects against HPV 16-18; a quadrivalent vaccine: it also offers protection against HPV 6-11; a nonavalent vaccine: it protects against HPV 6-11-16-18-31-33-45-52-58. The vaccine is preventive but not curative and is not a substitute for the Pap test. Introduced in 1940, Pap test was for many years the standard screening tool for the early diagnosis of cervix cancer. It consists in taking a small sample of cells from the uterine cervix and subsequent examination under a microscope. The suspected diagnosis of cervix cancer is based on a doubtful or positive report to Pap test, which represents the first level exam. Routine Pap test is often combined with HPV DNA testing. HPV test, introduced in 2008, is a molecular screening methods based on the detection of high-risk HPV DNA in vaginal and/or cervical specimens. HPV test is recommended to investigate suspected precancerous lesions or to follow patients who have reported positive results in previous screening tests. The introduction of HPV DNA testing in cervix cancer screening has brought many benefits, including the ability to increase screening intervals by identifying women at greater risk of developing the disease (those suffering from persistent HPV infection) and the exclusion of those who are unlikely to develop the tumor.

Biography

Franco Borruto has completed his PhD and postdoctoral studies from University of Verona, Italy. He now lives in Montecarlo, Principality of Monaco, member of “Ordre des Medecins” of Monaco, Consultant in Health Policy of the Government of Monaco, and Emeritus Member of the International Papilloma Virus Society. He has published more than 200 papers in reputed journals and books and has been serving as an editorial board member of repute.

Speaker
Franco Borruto / International Papilloma Virus Society
Monaco

Keynote Talks

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

Overall, U.S. women’s breast and cervical cancer incidence is decreasing, but disparate rates of incidence and mortality by racial/ethnic group still exist and differ according to the origin of the cancer. Breast cancer incidence is highest in White women over 40 years of age compared to Black women, who have the highest incidence rates under the age of 40. For example, in Ohio, between1996-2013 breast cancer incidence rates for Black women increased 10% compared to less than 1% for White women. Cervical cancer rates present a different pattern of incidence by racial/ethnic group, with rates in Latinas and American Indian/Alaska Native women exceeding the rates in other ethnic groups. For Black women, death rates are higher than in women from other racial/ethnic groups and ages. The gap in mortality between Black and White women for both breast and cervical cancer arewider now than they were in the 1900s. We conducted a community-based randomized controlled trial with (n=514) Black Latina and Arab women using the Kin KeeperSM Cancer Prevention Intervention (KK) to increase their cancer literacy. Overall, the KK intervention significantly improved the odds of correctly answering a Breast-CLAT question from baseline compared to the control arm, adjusting for the propensity scores (p-value=0.0023). The KK intervention significantly improved the odds of correctly answering a C-CLAT question from baseline compared to the control group, adjusting for the propensity scores (p-value<0.0001).This intervention effect in increasing breast and cancer literacy is strong. The cancer screening should be tested in a clinical setting.

Biography

Dr. William’s research interest is in cancer prevention and control which focuses on cancer disparities. She developed the Kin Keeper Cancer Prevention Intervention to addresses, in part, the continuous cancer burden carried by disenfranchised women of color and women with limited resources. Targeting breast and cervical cancers, the Kin Keeper intervention has been implemented and tested with Black, Latina and Arab women. She is also interested in how families and various culturally-specific networks can be engage in cancer prevention and control.

Speaker
Karen Patricia Williams / The Ohio State University
USA

Sessions:

Women Health-2019

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

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

Since the 1990s, image guided core needle biopsy has gradually replaced surgical biopsy in the initial assessment of breast lesions. Not only cost effective, this approach has also reduced surgical procedures performed for patients with benign lesions, and allowed better treatment planning for patients with malignancy. Although clear guidelines are available for the management of malignant and benign lesions identified on core biopsy, optimal management regarding whether to excise certain lesions detected on core needle biopsy has been controversial. Atypical ductal hyperplasia, lobular neoplasia, papillary lesions, flat epithelial atypia and mucinous lesions are included under this category. These lesions are regarded as high risk lesions, which are not malignant per se, but due to their association with malignancy, their presence in core needle biopsy tissue suggests that the area biopsied may harbor a worse lesion, thus the biopsy findings may be an underestimate of malignancy. However, when excised, the majority of the patients with these lesions on core needle biopsy do not have any upgrade on excision. Therefore, surgical excision of every single such lesion may be an over-treatment for many patients. The literature offers diverse recommendations based on the experiences of the contributing institutions. We studied the literature and examined our institutional data to identify risk factors for underestimation and provide guidelines for management.

Biography

Dr. Lei Huois a practicing pathologist. She is actively involved in clinical and translational research in the field of breast cancer. Her research interests include high risk breast lesions, molecular and immunohistochemical markers in the diagnosis and treatment of breast cancer, among others.

Speaker
Lei Huo / MD Anderson Cancer Center
USA

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

Context: On September 18, 2017, the consequences of Hurricane Maria resulted in the displacement of the Ross University School of Medicine (RUSM) from Dominica, to campuses in St. Kitts, West Indies and Knoxville, Tennessee, USA. This resulted in the suspension of the clinical outreach programs such as the Service Learning Project (SLP) where medical students gained insights into the healthcare needs of their local communities. From the Spring 2018 semester until present, due to the loss of the clinical outreach programs, there was a need to create a modified SLP which would make up for the continued absence of these programs at the RUSM campuses. The SLP is now a rigorous 1000 word essay on one public health issue in the local community. Objectives: To ensure that the SLP would robustly stand in the gap for the loss of the clinical outreach programs while fulfilling the basic tenet of identifying the healthcare needs and challenges of local communities. To ensure that medical students develop the practice of gaining knowledge of the healthcare needs and challenges facing the communities which they serve, particularly underserved or underinsured populations. Key Message: It is vital that Service Learning in any form reflect the geographic, social and cultural diversity of a medical school’s locale. Conclusion: SLP’s demonstrate the compassion of medical students while providing informative, educational and inspirational resources to physician colleagues. They may also serve as a therapeutic and educational support system for medically underserved and vulnerable populations.

Biography

Dr. Hedda Dyer is a graduate of the University of Edinburgh Medical School (MB CHB Ed), a Member of Royal College of Surgeons of Edinburgh (MRCS Ed), a Member of the Association of Surgeons of Great Britain and Ireland (ASGBI), a Member of the American Society of Breast Surgeons, a Member of the Dominica Medical Association. She is also registered with the Barbados Medical Board and the General Medical Council of the United Kingdom. She is a member of the Dominica cancer society advisory board. She possesses a Master of Business Administration (MBA) with a concentration in Health Services from the Keller Graduate School of Management.

Speaker
Hedda G. Dyer / Ross University School of Medicine
USA

Abstract

“Triple negative breast cancer” (TNBC) is a term used to identify the approximately 15% of invasive breast cancers which lack the expression of estrogen and progesterone receptor (ER/PR) and HER2 (ERBB2). TNBCs are a particularly aggressive group of breast cancers; they are generally of a higher grade, occur at a higher rate in young and African-American women, often metastasize to visceral organs early in the disease course, and patients with TNBC have an increased likelihood of distant recurrence and death compared with women with other types of breast. Although aggressive adjuvant chemotherapy, a significant number of early stage TNBCs relapse, often with visceral metastases. In the metastatic setting, despite multiple options for cytotoxic chemotherapy, disease progression is quick, and the median survival of patients with metastatic triple-negative breast cancer is less than two years. Triple-negative breast cancer (TNBC) is a heterogeneous disease; gene expression (GE) analyses recently identified four distinct TNBC subtypes, each displaying a unique biology. Exploring novel approaches to treatment of these subtypes is critical, since less than 30% of women with metastatic breast cancer survive five years and virtually all women with metastatic TNBC will ultimately die of their disease despite systemic therapy. To date, not a single targeted therapy has been approved for the treatment of TNBC and cytotoxic chemotherapy remains the standard treatment. We talk will discuss the current and upcoming therapeutic strategies being explored in an attempt to “target” TNBC.

Biography

Dr. Vandana Abramson received her undergraduate degree in English and Molecular & Cell Biology from the University of California. She then attended medical school at the University of Chicago Pritzker School of Medicine. She completed her residency in Internal Medicine at the Brigham and Women’s Hospital/ Harvard Medical School, and subsequently received subspecialty training in Hematology/Oncology at the University of Pennsylvania. Dr. Abramson’s research interests include novel therapeutic treatments for triple negative breast cancer. She has published over 60 peer reviewed articles and has bee the principal investigator of numerous phase I/II clinical trials.

Speaker
Vandana G. Abramson / Vanderbilt University Medical Center
USA

Abstract

Pregnancy is a state in which complex physical and physiological changes are present, these have important effects on multiple organ systems. Some authors pointed out the possible connection between periodontal disease in pregnant women with the risk of preterm delivery, newborns of a low gestational age with low birth masses and possible cardiovascular disease. Cardiordiovascular disease atherosclerosis is now one of the leading causes of death in developed countries, it begins in childhood, and goes a long time without manifesting symptoms, increasing with age, it begins to seriously threaten health. Insufficient insight into the possible pathological implications of the oral health status of pregnant women with the premature expression of cardiovascular risk factors in children, initiated this research. The aim of the study is to investigate more prominent predictors of early cardiovascular risk factors: increased body mass index, high values of blood pressure and the thickening of the intima-media carotids complex in comparison to children whose mothers had good oral health during pregnancy. Regular dental therapy/care can decrease the frequency of the occurrence of caries and periodontal disease in pregnant women, the frequency of prematurity and low birth weight with all it’s potential complications, decreasing the financial costs of neonatal intensive care management and the cardiovascular repercussions on newborn’s health. Primary prevention of atherosclerosis should begin as early as possible, during pregnancy, in childhood, creating a healthy way of life, which will be able to prevent or at least slow the development of atherosclerosis.

Biography

Senka Mesihović-Dinarević paediatric cardiologist: Faculty of Medicine, University of Sarajevo 1982. 1982-2016. Paediatric Clinic. PhD 1991, 1992-1996: Royal Brompton Hospital London. Professor of Paediatrics 2006.1994. AEPC, 1995. BPCA.1995-2011: Lecturer London MRCP; 2014. Director of Discipline for health protection of women and children. Consultant: RCPCH 1997. 2003-2016. Director of Paediatric Clinic Sarajevo.2000 FESC, 2008. Full Member of Academy of Sciences and Arts of Bosnia and Herzegovina, Honorary Doctorate of Letters in Cambridge: 2014. 2016.Member of the European Academy of Science and Arts; 2017. Full Professor University for Peace-United Nations, over 498 papers, cited 218 times in the ICI Web of Science.

Speaker
Senka Mesihović-Dinarević / Eurofarm Policlinic
Bosnia and Herzegovina

Abstract

Since the 1990s, a rise in the number of registered human echinococcosis cases has been observed Europe as well in in the Baltic states. The data available indicate that CE is often diagnosed at a rather late stage, while little is known about risk factors for CE in the Baltic States The cases were selected retrospectively from the archive of the Riga East Clinical University Hospital, during 1999-2015, a total of 116 individuals had been diagnosed. The case definition was: 1) a resident of Latvia for at least 15 years and alive at inclusion, 2) who was diagnosed by combination of positive serological test result and diagnostic imaging findings, 3) infection had liver involvement. All participants of this study answered the same 45 questions regarding possible risk factors. The age of the cases at the time of answering the questions ranged from 24 to 84 years (mean, 57.3 years, and median, 57 years). The majority (69.6%) of the cases were female. Living in rural dwelling, owning dogs kept or roaming outdoors, owning dogs fed with viscera of livestock, having close contact with dogs or cats, owning livestock, home slaughtering, and having hunters in the family were significantly more common among cases than among controls as well more common in female population. The recognition of risk factors has a critical importance on the improved prevention and control of echinococcosis in humans. The results of this study suggest that preventive measures in Latvia should focus on the role of dogs.

Biography

Ludmila Viksna has completed her PhD from Riga Stradins University in Latvia (former Sovient Union at that time). She is corresponding member of Academy of Sciences of Latvia, Head of Riga Stradins University Department of Infectology and Dermatology and Chief Infectologist of Riga Clinical University Hospital. She has published more than 30 papers in reputed journals and has been serving as an editorial board member of repute. And she is also author for 5 books in the field of infectology.

Speaker
Ludmila Viksna / Riga Stradins University
Latvia

Abstract

Prenatal diagnosis and screening have undergone rapid development in recent years, with advances in molecular technology driving the change. NIPT (noninvasive prenatal testing or screening) for Down syndrome as a highly sensitive screening test is now available worldwide through the commercial sector with many countries moving toward implementation into their publicly funded maternity systems. NIPT offers pregnant women greater choice during their pregnancy as these safer methods avoid the risk of miscarriage associated with invasive testing. The circulating fetal DNA in maternal plasma can be used for screening fetal aneuploidies. First described in 1997 by PR Dennis Lo, the advent of Massively Parallel Next-Generation Sequencing (MPS) has led to widescreen detection of fetal aneuploidy. It relies on the ability to detect a relatively small overrepresentation of the chromosome in question. Detection rates for Down syndrome have been reported in excess of 99%, and slightly lower for trisomies 18 and 13, 96% and 92%, respectively (Nicolaides et al, 2015). NIPT for aneuploidy has been shown to be very sensitive in both high and low risk pregnancies. The conclusion is that the use of NIPT leads to lower more than 95 % in invasive procedures. As the cost of sequencing falls and technology develops further, there may well be potential for whole exome and whole genome sequencing of the unborn fetus using cell-free DNA in the maternal plasma.

Biography

Dr Skander Ben Abdelkrim has completed his PhD from Faculté de Médecine de Sousse, TUNISIA in 1998 and then move to France fot postdoctoral studies from Nantes, Lille, Paris and Clermont-Ferrand. He has diplomas of ultrasound in gynecology and obstetrics, laparoscopy and fertility treatments. He was an MD in the Princess Grace Hospital of Monaco from 2007 to 2018.

Speaker
Skander Ben Abdelkrim / Clinique Paul Picquet
France

Abstract

Complementary and alternative medicine is widely spreading specially between women with herbs being the most common kind used in obstetrical and gynaecological health issues. Some women do not disclose to her health care provider the use of herbal medicine although its safety is still debatable and possibility of interaction with some drugs is present. Lack of knowledge about the possible risks of using some herbs during critical life periods as pregnancy, postpartum and breastfeeding may cause maternal or neonatal health problems. Aim of the study was to assess herbal medicine use among Saudi women during pregnancy, postpartum and breastfeeding in Jeddah. A cross-sectional descriptive design was used to collect data from 300 Saudi women attended the outpatient clinics in King Abdul-Aziz Medical City-Western Region Hospital and Althager General Hospital. Women who were multiparous and more than 18 years old were recruited in convenience then interviewed using a structured questionnaire. The questionnaire incorporated five main sections eliciting information on socio-demographic characteristics, obstetrical and medical history, herbal medicine use in addition to reasons for use and attitudes toward herbal medicine use in pregnancy, postpartum and breastfeeding. Majority of the participants (92.3%) had used at least one type of herbal medicine during pregnancy, postpartum and breastfeeding. The most commonly used types were dates (42.7%), mix herbs (32.7%), cinnamon (32%), fenugreek (30.7%), and honey (28.7%). The main reason for use was being natural substances and safe (86.0%). Saudi women used at least one type of herbal medicine during pregnancy, postpartum and breastfeeding.

Biography

Abeer Orabi has completed her PhD from Faculty of Nursing, Cairo University. She is lecturer of Maternal and Newborn Health Nursing, Faculty of Nursing, Cairo University and Assistant Professor at College of Nursing, King Saud bin Abdul Aziz University, Jeddah. She is the course coordinator of Woman and newborn Health Nursing course for Bachelor students and the coordinator of Master of Sciences of Nurse-Midwifery Program. She supervised 4 Master theses and 3 research projects. She has published more than 15 papers in reputed journals and has been serving as an editorial board member of repute journal.

Speaker
Abeer Orabi / King Saud bin Abdulaziz University
Saudi Arabia

Abstract

Aim: The purposeofthisprospectivecasestudywas to determine the effectof surgicalrepair of diastasis recti abdominis (DRA) on abdominal trunk function, urinary incontinence (UI), and Quality-of-Life (QoL), in postpartumwomen with trunk instability symptoms resistant to training. Materials &Methods: A cohortofsixtypostpartumwomenwith diagnosed DRA and training-resistant symptoms underwent double-rowplicationof the linea alba. Abdominal trunk functionwasevaluated as primary endpoint using a multimodal examination tool, the Abdominal Trunk FunctionProtocol (ATFP). Recurrencewas evaluated by CT-scan, UI wasevaluated using the UDI-6 and IIQ-7questionnaires, and QoL wasassessed with the SF-36 questionnaire. All subjectswereexamined prior to, and oneyearaftersurgery. Results: There was no DRA recurrence at the 1-year follow-up. Self-reported abdominal trunk function had improved in 98.2% of patients, with a mean score improvementof 79.1%. In the physiological tests monitored by a physiotherapist, 76.0% performed better and endured exercise tests longer than beforesurgery. All SF-36 subscales improvedsignificantlycompared to the preoperative scores, and reachedlevels similar to or higherthan the normative Swedish female population. For the UDI-6 and IIQ-7, 46.7%, respectively 36.7%, reported fewer symptoms at follow-up than beforesurgery, while 13.3%, respectively 8.3%, reportedmore symptoms. Conclusion: In this series ofpostpartumwomenpresenting with DRA and symptoms of trunk instabilityresistant to training, surgicalreconstructionresulted in a significantimprovement in abdominal trunk function, UI and QoL.

Biography

Speaker
Anders Olsson / Karolinska Institutet
Sweden

Abstract

Worldwide, breast cancer is the commonest cancer in women and it is characterized by regional variations and late clinical presentation and poor access in low- and middle-income countries including sun Saharan African Countries. It is disproportionately responsible for mortality among women in developing countries compared to those in developed countries. There are several challenges associated with the effective management of breast cancer in sub Saharan Africa; financial barriers limit women's access to screening and treatment services, late-stage presentation, high incidence of triple negative breast cancers and failure in stewardship by government in their inability to provide the best possible cancer care like their counterparts in developed countries. There is an urgent need to step up activities through governmental and non-governmental agencies to promote advocacy, national policy on training of personnel for diagnosis, clinical and self-breast examination and nationwide screening program (mammography) in order to enhance early detection, control the upward trends and reduce the mortality rate of breast cancer. Routine age appropriate and specific breast screening should become an integral part of healthcare system across the African continent allowing for early detection and intervention; aggressive awareness campaign on the advantages of early diagnosis and the dangers of late presentation, need to offer universal and affordable treatment, implementation of a strategy to offer annual mammogram to women above the age threshold for breast cancer, increased budgetary allocation for the diagnosis and management of cancer, more investment in the training of healthcare workers involved in the diagnosis and management of breast cancer, provision of health education encouraging women to conduct routine Breast Self-Examination (BSE). BSE could become a simple, low-priced, secure, effective, appropriate and feasible screening tool across the African continent. There is need to re-emphasize the importance of prompt reporting of any new breast symptoms to a health professional. Clinical Breast Examination (CBE) should become part of a periodic health examination, preferably at least every three years. Asymptomatic women aged 40 and over should be offered a CBE as part of a periodic health examination, preferably annually. Objective implementation of these steps can help reduce the incidence of breast cancer-related mortality across the African continent.

Biography

Professor Erhabor Osaro is a Professor of Haematology, Transfusion Medicine and Laboratory Total Quality Management. He is an Alumni of Rivers State University of Science and Technology, Nigeria,University of Greenwich in the United Kingdom and Francis Tuttle College of Technology in Oklahoma, USA. He is the author of 5 scientific books and 5 chapters of scientific books. A member of the editorial board as well as an article reviewer to several International Scientific Journals.

Speaker
ERHABOR OSARO / USsmanu Danfodiyo University
Nigeria

Abstract

The transition to menopause varies from women to women and especially within women of colour. Menopause is the cessation of periods in women when they have attained certain age or by surgical implications. The decision to focus on women of colour stemmed from lack of other research work within this area although there are many studies carried out outside the United Kingdom. The research used literature review method to narrow the study down to West African women particularly the Nigerian women. Currently 15 women from this background are being approached for their consent and participation in the research to examine their understanding of menopause, symptoms experience and methods chosen to manage symptoms. As the research will be studying life experiences of these women, phenomenological method will be used with semi structured interview method. Ethical approval has already been applied to the University. For analysis, interpretative analytical method will be applied after transcribing the recorded interviews verbatim. This research will give an insight into factors that affects their decision making process during this transition, the symptoms they experience and the different methods of management used. The research study will add to the knowledge already known about menopause, and also serve as a starting point for other research to be carried out within this particular group of women.

Biography

Speaker
Juliet Okoye / Anglian Ruskin University
UK

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

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 vaginal microbiota of healthy reproductive-age women is generally dominated by Lactobacillus species, which preserve the genitourinary tract from the colonization and overgrowth of several infectious agents, including those responsible for sexually transmitted diseases. The protective effect of lactobacilli is exerted through multiple mechanisms, including the production of various antibacterial compounds (lactic acid, hydrogen peroxide, bacteriocins, and biosurfactants), the competitive exclusion for epithelium adhesion and the modulation of the immune system. Chlamydia trachomatis represents a leading cause of sexually transmitted disease worldwide, and, if left untreated, can induce severe sequelae in women, i.e. pelvic inflammatory disease, infertility and ectopic pregnancy. We investigated the possible interference of Lactobacillus species known to be dominant in the healthy vaginal microbiome, with the infection process of C. trachomatis. We therefore evaluated the ability of some vaginal L. crispatus, L. gasseri and L. vaginalis strains to reduce Chlamydia infectivity in human cervical cells (Hela cells). L. crispatus strains proved to be the most active, and Chlamydia inhibition involved lactic acid production and glucose depletion. Looking at the molecular level, coincubation of lactobacilli with cervical cells caused modification of the physical properties of the HeLa plasma membrane, by altering lipid composition and α5 integrin subunit exposure. The research highlighted the protective effect of lactobacilli against the sexually transmitted pathogen C. trachomatis infection and elucidated possible mechanisms, getting insights into the role of the cervico-vaginal microbiota for the woman’s health.

Biography

Carola Parolin graduated in Biotechnology at University of Milan-Bicocca, Italy, and completed her PhD at Bologna Univesity, Italy, where she currently works as a post-doc researcher. Her main interests concern human ecology, particularly the vaginal microbiome, and probiotics. She is co-author of 31 scientific publications, and serves as a reviewer for many reputed journals. This research was supported by Fondazione del Monte di Bologna e Ravenna, Italy.

Speaker
Carola Parolin / University of Bologna
Italy

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

Society as a collective, provides evidence of cultural norms and expectations. These expectations are both motivated from within an individual and also motivated from family, friends and others around us who provide both positive and negative impacts. Most individuals strive to find positive rather than the negative. But what happens when our negative influences blurs social norms? This research examines cultural competency with underage and adult binge drinking in women through the Strategic Prevention Framework – State Incentive Grant (SPF-SIG). The SPF-SIG had two primary goals to address major health concerns for Ransom County: 1) Underage Drinking and 2) Adult Binge Drinking. A total of 1,500 randomly selected households in Ransom County, North Dakota were chosen for the survey. An introductory postcard was mailed to respondents followed by a survey packet (i.e., survey and a postage-paid self-addressed return envelope). Approximately three weeks after the survey was mailed a reminder postcard was sent to non-responders. A total of 236 completed surveys were returned for analysis. The response rate is 18 percent and the confidence level is 95 percent with an error rate of +/- 6 percent. These findings provide evidence that alcohol use and misuse is a problem in Ransom County among adults and teenagers. Adult and Underage Drinking is a problem in Ransom County, North Dakota. There is evidence scientifically through external (i.e., state evaluators and researchers) and internal channels (i.e., community members and professional stakeholders) to support these problems. However, when the problem clearly exists how can cultural competency be influenced when society does not agree on the problem?

Biography

Gina Aalgaard Kelly is working as an associate professor of medical and aging sociology. Aalgaard Kelly is a member of the Department of Sociology and Anthropology in North Dakota State University. She earned both her bachelor’s and master’s degrees from NDSU and her Doctorate of Philosophy from the University of Minnesota.

Speaker
Gina Aalgaard Kelly / North Dakota State University
USA

Abstract

The association between breast cancer and vitamin D level is an area of debate. We aim at examining this relationship in Riyadh City, Saudi Arabia. Method: We conducted a case control study at KAMC that aim at examining the relationship between vitamin D deficiency and newly diagnosed breast cancer cases. Results: We recruited 126 controls and 88 newly diagnosed breast cancer patients. Mean age was 51.93±8 years for controls and 51.72± 12, p= 0.74. BMI was 33±6 for controls and 31±6 for cases p= 0.06. The percentage of unmarried was higher in the cases (28.4%) than controls (4.8%). Nullparity was noted in 10.2% of cases and 2.4% of controls. Sixty-four percent of our cases had an early stage breast cancer and 41% were node negative disease. Mean Vitamin D level was 43±25nmol\L in cases 50.13±22nmol\L. Adjusted odds ratio of breast cancer development in deficient patients in comparison to non-deficient was 2.8 (95%CI=1.2-6.3, p value= 0.016) Conclusion: There is an inverse relationship between vitamin D level and breast cancer risk. The breast cancer risk is 2.8 times more in the vitamin D deficient patient versus non-deficient.

Biography

Lolwah Alriyees, MBBS, SSC-Surg, ABS, MPH-Epi, Currently working as Consultant General Surgery, Department of surgery, King Abdulaziz Medical City, King Fahad Nation Guard Hospital, Surgery block coordinator and Assistant Professor Of Surgery, KSAU

Speaker
Alriyees Lolwah / King Saudi bin Abdulaziz University
Saudi Arabia

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 [1]. 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 [2]. 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 the gametes or the 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. 1. Yolken RH, Torrey EF. Viruses, schizophrenia and bipolar disorders. Clin Microbiol Rev 1995; 8: 131-145. 2. Mesa CS. An ultrastructural study of the temporal lobe and peripheral blood in schizophrenic patients. Rev Neurol 2001; 33: 619-623.

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 ofthe Psychiatric Hospital of Havana and give lectures to residents in psychiatry.

Speaker
Segundo Mesa Castillo / Psychiatric Hospital of Havana
Cuba

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

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

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

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

Abstract

Purpose:The adoption of healthy diet and regular physical activityhas been advanced as non-pharmacological interventions to relieve cancer therapy-related side effects and improve cancer prognosis. A clinical trial carried out at the Cancer Institute of Montpellier (France) has investigated the effect of an Adapted Physical Activity and Diet counseling (APAD) intervention onfatigue, physical, anthropometric and quality-of-life (QoL) outcomes in women undergoing adjuvant therapy for breast cancer. Methods: 143 women diagnosed with breast cancer were randomized to APAD or Control (usual care) group. The APAD group received an intervention including 3 weekly exercise sessions and 9 dietetic consultations in the course of the 26 weeks of chemotherapy and radiotherapy. Patient-reported outcomes (PROs) and objective outcomes (measured by assessors),such as anthropometric, muscular and cognitive variables, have been measured at baseline, 18 and 26 weeks (end of intervention), and at 52- and 78-week of follow-up.Mixed effects models were used to assess the efficacy of the intervention. Results: Beneficial effects of the APAD intervention were observed on allPROs i.e., fatigue, QoL, anxiety, depression and leisure physical activity at 18 and 26 weeks, with persistent significance at 52- and 78-week follow-up for some outcomes. Significant improvements were also observed on body mass index, fat mass, muscular strengthand cognitive flexibility at 26 weeks. Subgroup analyzes revealed that beneficial effects on anthropometric variables, mental fatigue, anxiety/depression, and QoL were predominantly observed in overweight/obese or socially disadvantaged women. It was not necessary to be physically active at baseline to obtain favorable effects from the intervention. Conclusion:The APAD1study relieved breast cancer patients from adjuvant therapy-related side effects at short and long term. Overweight/obese, socially disadvantaged or inactive womenat baseline particularly benefited from the intervention. Funding: Liguecontre le Cancer (PI: G.Romieu); M.Carayol was supported by the Fondation de France (grant#2014-00050542)

Biography

Speaker
Marion Carayol / Université de Toulon
France

Abstract

Roughly 90% of mouth cancer is squamous cell carcinoma. Oral region metastases are considered uncommon. The most frequent sources of metastatic tumors to the mouth are primary cancers from the lung and breast with the latter being the most common site for tumors that metastasize to the jawbones. Treatment involves surgery, radiation, chemotherapy or a combination of these. However, these treatment modalities entail severe aesthetic and functional side effects. The aim of this article is to present an alternative and unprecedented treatment modality for metastatic mandibular bone carcinoma – Cryosurgery. A 37-year-old female patient who presented with gradually increasing pain over several weeks whose radiological tests revealed a form of mass in the left mandibular ramus. A biopsy obtained by bone puncture of the ramus was reported to be metastatic breast squamous cell carcinoma. The patient has been successfully treated without esthetic and functional side effects by using for the first time cryosurgery. We conclude that it is valued promoting this method for current and future use.

Biography

Medical Doctor - Stomatologist (MD, Honour Diploma) Master of Dental Science; MScD (by high Research) London-UK SpecialistOral and Maxillofacial Surgery Member of the International Association of Dental Research (IADR), International Association of Oral and Maxillofacial Surgery (IAOMS) the Pan Arab Association of Oral and Maxillofacial Surgery (PAAOMS) Chief Clinic, Department of Oral and Maxillofacial Surgery at the Lebanese University Dental School Tutor Department of Oral and Maxillofacial Surgery at the Beirut Arab University, Dental School Researcher University Hospital of Wales School of Medicine, UK Director and consultant Doctor of the international health program of Special Olympics International MENA region

Speaker
Wahid Terro / Beirut Arab University
Lebanon

Abstract

Background: It is controversial in the mode of delivery for patients with dead or malformed fetus complicated by placenta previa after second-trimester gestation. This study aimed to find correlative factors with successful vaginal delivery for those patients. Method: A retrospective study was performed on the 139 cases of pregnancy outcomes with fetal death or malformation complicated by placenta previa from January 1, 2002 to April 30, 2018 in West China Second University Hospital, Sichuan University. Clinical data including maternal age, gestational age, obstetric and medical history, classification of placenta previa, complication of placenta accrete syndrome, fetal outcomes and the mode of delivery were collected. The mode of delivery was classified into successfully induced vaginal delivery (vaginal delivery group), emergency cesarean delivery owing to failure of labor induction (failed group) and selective cesarean delivery. Compassion were performed between the vaginal delivery group and failed group using Student’s t-test or Wilcoxon rank sum test for distributed data and Chi-square test or Fisher’s exact probability test for category data. P<0.05 was considered statistically significant. Results: Among 113 patients who attempted to vaginal delivery, 104 of them had finally successful vaginal delivery (92.0%). There were significant increases of gestational age (32.14±6.27 vs 23.66±5.68), prior cesarean section rate (66.7% vs 21.2%), the incidence of placenta accrete syndromes (55.6% vs 2.7% ), fetal length (35.44±8.16 vs 27.04±9.64) and fetal weight (1931.56±816.09 vs 768.22±702.54) in the failed group than those in the vaginal delivery group (P<0.05). The patients complicated by placenta accrete syndrome (OR=9.858, 95% CI: 1.300-74.746, P=0.027) and increased gestational age (OR=1.045, 95% CI: 1.009-1.083, p=0.014) were two independent factors which increase the risk of failed vaginal delivery. Conclusion: In cases of dead or malformed fetus complicated by placenta previa after second-trimester, vaginal delivery is feasible. Mifepristone combined Ethacridine Lactate amniocentesis is a safe and effective measure to induce labor. In the case of late gestational age complicated with placenta accrete syndrome selective cesarean is the recommendation.

Biography

Ms. Jing Xiao Lin is a graduate student majoring in obstetrics and gynaecology of Sichuan University. She has always had a huge passion for obstetrics. She got the full scholarship at school and have submitted several articles.

Speaker
Jing Xiao Lin / West China Second University Hospital
China

Abstract

Fertility-preserving treatment (FPT) was widely used in young patients with endometrial cancer (EC) in early stage. However, disagreements remained in literatures on the effectiveness and safety of FPT. The aim of this study was to further confirm the malignancy alterations in EC after FPT by immunohistochemistry (IHC) and quantitative reverse transcription-polymerase chain reaction (RT-PCR).A retrospective analysis of pre- and post-treatment biopsy specimens from 24 patients with grade 1 endometrioid adenocarcinoma (EAC) or complex atypical hyperplasia (CAH) was performed. The human endometrial Ishikawa cancer cell line was treated with progesterone (P4) for 24, 72 and 120 hours. The expression ofARID1A, PTEN, and β-catenin were assessed by IHC and RT-PCR.The protein expression levels of ARID1A, PTEN, and β-catenin between pre- and post-treatment specimens achieved no significant differences. However, there was significant difference observed between pre-treatment and normal specimens, as well as between post-treatment and normal specimens. The mRNA levels of ARID1A, PTEN and CTNNB1 between untreated cells and treated cells showed no significant difference. The protein expression of β-catenin significantly increased in patients with progression compared with those without progression after FPT.The morphologic normalization of EC patients after FPT may not accompanied by the absence of tumor malignancy. The results may be helpful in better understanding the malignancy transformation of EC after FPT, and in optimizing the treatment strategies for young patients of EC with birth demand.

Biography

Ting wen yi Hu, a junior graduate student of Sichuan University. During master's period, Ms. Ting wen yi Hu have been working on the field of gynecological tumors, especially endometrial tumors. Ms. Ting wen yi Hu published an SCI article as the first author and several articles as co-author. Ms. Ting wen yi Hu have always wished to devote my passion to the great cause of women's health.

Speaker
Hu Ting wen yi / West China Second University Hospital
China

Abstract

PURPOSE: To compare the treatment outcomes of breast conserving surgery plus radiotherapy (BCS+RT) vs. mastectomy plus radiotherapy (Mast+RT) vs. mastectomy without radiotherapy (Mast alone) for patients with pT1-2N1 triple negative breast cancer (TNBC). METHODS: 412 patients with pT1-2N1 TNBC were analyzed. Patients underwent BCS+RT (n=48) or Mast +RT (n=103) or Mast alone (n=261) with negative margins. No neoadjuvant chemotherapy was used and axillary dissection was performed for all patients. All patients received adjuvant chemotherapy, mainly with anthrathycline- and/or taxane-based regimens. The Locoregional recurrence (LRR), disease-free survival (DFS) and overall survival (OS) rates were calculated by the Kaplan-Meier method and compared with log-rank test. Multivariate analysis was performed by Cox model. RESULTS: The median follow-up time was 61 months for all patients. For the BCT+RT, Mast +RT and Mast alone groups, the 5-year LRR rates were 2.4% vs. 6.2% vs. 12.8% (p=0.067), the 5-year DFS rates were 90.4% vs. 85.7% vs. 72.7% (p=0.011), the 5-year OS rates were 91.6% vs. 89.4% vs. 85.6% (p=0.042). In multivariate analysis, there were no significant differences in LRR, DFS and OS between BCT+RT group and Mast +RT group; Mast alone was independently associated with higher LRR (p=0.008, HR:2.86 ) and lower DFS and OS (p=0.002,HR:2.08; and p=0.009, HR:2.35) as compared with BCT or Mast +RT. CONCLUSION: In pT1-2N1 TNBC, breast conserving surgery plus RT achieved comparable outcomes with mastectomy plus RT, and mastectomy without RT had poorer outcomes. This indicates that breast conserving therapy is safe and postmastecomy RT is recommended for all patients.

Biography

Shulian Wang has completed his bacherlor degree from Shanghai Medical College, China and doctoral degree from Peking Union Medical College, China. She is a professor and the deputy director of Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Her research focuses on breast cancer. She has published more than 100 papers in reputed journals and has been serving as an editorial board member of repute.

Speaker
Shulian Wang / Chinese Academy of Medical Sciences & Peking Union Medical College
China

Plenary Talks

Abstract

Epithelial ovarian cancer (EOC) accounts for 4% of all cancers in women and is the leading cause of death from gynecologic malignancies. The molecular basis of EOC initiation and progression is still poorly understood. Previously, we have applied an epigenomics approach to investigate the possible implication of aberrant DNA methylation in EOC etiology. We used methylated DNA immunoprecipitation in combination with CpG island tiling arrays to characterize at high resolution the DNA methylation changes that occur in the genome of serous EOC tumors during disease progression. We found widespread DNA hypermethylation that occurs even in less invasive/early stages of ovarian tumorigenesis. In contrast, significant DNA hypomethylation was observed only in high-grade (G3) serous tumors. This approach led to the identification of novel EOC oncogenes, potentially modulated by epigenetic mechanisms (hypomethylation) in advanced EOC, and displaying implication in different mechanisms of EOC dissemination, including alterations in gene expression control (RUNX1, RUNX2), abnormal metabolism (BCAT1), aberrant O-glycosylation (GALNT3) and importantly, epithelial to mesenchymal transition (EMT) regulation (Ly75, GRHL2, HIC-5). These genes could represent new therapeutic targets and/or novel biomarkers indicative for EOC progression. Moreover, our data are indicative for the implication of aberrant DNA methylation in EMT-mediated EOC progression.

Biography

Dimcho Bachvarov, Professor at Université Laval, Québec PQ Canada, grew up in Bulgaria and received his B.Sc. and M.Sc. degrees from the University of Sofia in 1975-1978. He obtained his Ph.D. degree in 1986 in the Institute of Molecular Biology at the Bulgarian Academy of Science. In 1990, he joined Professor Tom Moss's Laboratory at Université Laval as a Postdoctoral Associate, and in 1994 he was appointed as Adjunct Professor at the Dept. Pharmacology, Université Laval. Consecutively, Dr. Bachvarov was promoted to Assistant Professor (1997), Associate Professor (2002) and since 2005 he is a Full Professor at the Dept. Mol. Medicine, Université Laval. He has been a recipient of different Scholarship Awards, with the most representative being the Ernest J.B. Tomlinson Scholarship Award from the Kidney Foundation of Canada and two consecutive Scholarship Awards (Junior and Senior) from Fonds de recherche du Québec - Santé (FRQS). Dr. Bachvarov is strongly involved in the research activities of the provincial Cancer Research Network (CRN), supported by FRQS, as he is the head of the CRN ovarian tumor bio-bank and the CRN genomic platform in Québec City. Currently Dr. Bachvarov’ research interests are focused on the characterization of novel epigenetically regulated epithelial ovarian cancer (EOC) oncogenes and their role in EOC dissemination, as well as the role of EMT and aberrant glycosylation in EOC progression.

Speaker
Dimcho Bachvarov / University of Laval
Canada

Keynote Talks

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.

Speaker
Sergey Suchkov / Sechenov University
Russian Federation

Abstract

Introduction:The presence of electrophysiological abnormalities of the atrial myocardium with increasing age could explain thedifferences in the genesis of atrial fibrillation inwomen with paroxysmal atrial fibrillation. Material and Methods:Right atrial endocardial mapping were performed in 54female patientswho had paroxysmal atrial fibrillation, idiopathic or associatedto other arrhythmias. Results:A total of 648right atrial endocardial electrograms were assessed and quantitatively measured. The number of abnormal atrial electrogramsshowed 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 theydevelopa significantly greater abnormally prolonged and fractionated atrial electrogramswith 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 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. His biography is published in "Who is Who in the World", "Who is Who in Science and Engineering", "Man of Achievement", "Who is who in Medicine and Healthcare". He is a Fellow of the American College of Cardiology, American Heart Association, and member of other 10 International Cardiovascular Societies. He is currently Chief of the Department of Cardiology, Hospital de Clinicas, Asunción, Paraguay. In addition, He is the Director of the Department of Health Science Investigation at the Metropolitan Hospital, Fernando de la Mora, Paraguay. He is currently Member of the Editorial Board of more than 50 international scientific journals. The following are just some of the cardiovascular international journals: Angiology, JAFIB, Journal of Atrial Fibrillation, The Open Cardiovascular Medicine Journal, Research in Cardiovascular Medicine, The Open Atherosclerosis and Thrombosis Journal, World Journal on Cardiovascular Disease, Hematology and Leukemia, Cardiology and Angiology: An International Journal, Journal of Pharmaceutical Technology & Drug Research, Journal of Bioequivalence & Bioavailability. 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, Blood, Heart and Circulation Journal, and Medplus Journal of Experimental Cardiology and Research.

Speaker
Osmar A. Centurión / Asuncion National University
Paraguay

Sessions:

Women Health-2019

Abstract

Since ancient times, plants have been playing a significant role in women's healthcare and well-being. In fact, numerous phytochemicals have historically been used as starting points in the development of new drugs, and a large proportion of the modern pharmaceuticals and cosmetics have been derived from plants. In addition, an increasing number of herbal products, specifically targeting women's disorders, has appeared in the worldwide marketplace during the last decades. Medicinal plants are the most widespread agents of the traditional medicines and women their most frequent consumers. Often, they are perceived by women as being safer than conventional drugs and some are used by patients to treat a number of gynaecological problems and conditions, such as genital infections, menstrual problems, infertility, discomforts and dysfunctions of pregnancy, and menopause. Plants are also attractive sources of cosmetic ingredients. However, their use for cosmetic purposes has often been neglected in ethnobotanical surveys that focus mainly on plants with medicinal or food uses. In this symposium, we will talk about medicinal and cosmetic plants and the possible impact of using them in the promotion of women´s health and well-being. We will also discuss the evidence supporting plants´ gynaecological and dermatological utilization, the development of innovative formulations and the importance of controlling the quality, efficacy and safety of medicinal and cosmetic plant-based products.

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).

Speaker
Branca M Silva / University of Beira Interior
Portugal

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

Background: Sexually transmitted infections (STIs) are the major global cause of acute illness, infertility, long-term disability and death with serious medical and psychological consequences of millions of men, women and infants. In America, surveillance data revealed that both young men and young women are heavily affected by STI but young women face the most serious long-term health consequences. Due to their high prevalence, particularly in developing settings, STIs result in substantial productivity losses for individuals and communities, particularly in the population which is less than 40 years of age. The problem of reporting STIs in Ethiopia is generally thought to be similar with other developing countries. Objective: This study was assessed knowledge, attitude and preventive practices towards STIs among student in Samara University, Ethiopia. Methods: Institutional based Cross sectional study design with sample size of 396. Stratified cluster sampling technique was used and finally a total of respondents were selected by using systematic random sampling with Self-administered structured questionnaire. Result: 35.4% of respondents had good knowledge about STIs and 65.8% had positive attitude towards STIs. From total participant, 50.8% of them reported as they had history of sexual intercourse and out of them 58.8% had good preventive practice. Conclusion and recommendation: most of respondents in this study had heard about STIs in one or another way however only less than half of respondents have good knowledge regarding the different types of STIs, causes, modes of transmission and method of prevention. Continued and strengthened health education to bring change among students with respect to knowledge, attitude and preventive practices towards STIs is necessary. Key words: STI, Samara, Ethiopia

Biography

Speaker
Surender Reddy Pulluri / Samara University
Ethiopia

Abstract

Major depressive disorder and bipolar disorder are leading causes of disability worldwide, yet many people remain undiagnosed, are misdiagnosed, and/or ineffectively treated. Depression occurs in 10% of women and 5,6% of men. Diagnosis relies on the clinical assessment of symptoms, and there is currently no molecular diagnostic test available. Depression is almost twice as likely to affect women than men and tends to have different contributing causes in women than it does in men. Contributing factors include reproductive hormones, a differing female response to stress, and social pressures that are unique to a woman’s life experiences Identifying and validating blood biomarkers could provide a more accurate and objective means of diagnosis. Epigenetic events are involved in psychiatric aetiology: among them RNA editing modifications have been associated with inflammation and neuropsychiatric disorders. RNA editing is post-transcriptional process that leads to functional diversity of proteins. These marks form the molecular interface between the genome and the environment. Alcediag’s test, EDITDIAG, identifies in blood specific signatures through the RNA editing modifications of patients with major depressive syndroms A cohort of depressed patients (n=163) was compared to controls (n=100). Specific RNA editing signatures were identified in depressed patients and are different in women and men. Using a panel of 5 biomarkers Alcediag’s tests identify depression in women and men with high specificity and sensibility. The test shows that RNA editing-related blood biomarkers allow to stratify patients, characterize psychiatric conditions, and follow up the disease/treatment modifications along time. This test paves the way for a better management of psychiatric patients.

Biography

Dinah Weissmann is PharmD, PhD. She completed her PhD at University Louis Pasteur, Strasbourg. From 2013 she serves as Alcediag’s Executive VP R&D and CSO, a biotech company dedicated to innovative diagnostics in medical disciplines with high needs of objective tools such as psychiatry... Her research background includes 15 years as Director of Research at the CNRS (French academic research institute) and various key positions in pharma companies such as Sanofi. From 2001 to 2011 she founded Biocortech, a biotechnology company developing new generation therapeutics as treatment for depression, which she served as CEO.

Speaker
Dinah WEISSMANN / ALCEDIAG
France

Abstract

Introduction: The purpose of this study is to highlight aspects of the sediment in various types of inflammation as well as urinary tract tumors. The agreement with regard to differences in microscopic techniques in the observation of the sediment elements in both unstained and stained samples is described. Material and Method: The urinary sediment was first screened at a low power and thereafter modified structures were examined at a higher. Initially, we worked on a normal microscope but with reduced light with the condenser placed at a lower position to increase the contrast. The investigation was performed by using different microscopic techniques. Results and Discussions: The examination of the urinary sediment is a useful method in the diagnosis of different types of urinary tract inflammation. The microscopic examination revealed the presence of white blood cells, monocytes, macrophages, eosinophiles, oval fat bodies, squamous cells, transitional cells, renal tubular cells, white blood cells casts, various type of atypical cells and macrophage casts. Immunofluorescence microscopy was performed with anti-Tamm-Horsfall, anti-human globulin IgG, anti-CD3, anti-CD19 and anti-CD5 antibodies. We selected the photos, representing the most interesting cases. The patients were diagnosed with various types of urinary tract inflammations and were hospitalized in either the Nephrology or Dialysis Departments Conclusions: A large number of polymorphonuclear leukocytes are associated with an inflammatory process. If the Sternheimer-Malbin cells represent over 10% from white blood cells population, then we can suspect pyelonephritis. Macrophages are frequent in acute inflammation. The macrophage that is loaded with fat droplets is frequently connected to a chronic inflammatory process. Atypical cells are associated with a tumoral process.

Biography

Speaker
Sorin Giju / County Emergency Hospital Timişoara
Romania

Abstract

Acute appendicitis is the most common surgical pathology in women with multiple pregnancies, which threatens the life of the mother and the newborns. The incidence of acute appendicitis in women with multiple pregnancies is, according to different data, from 0.03 to 5.2% [3, 9, 13]. Mortality in acute appendicitis in pregnant women is 10 and more times higher than outside pregnancy, and is 2.5-3.0%, and in case of complicated appendicitis it reaches 16.7% [1, 9, 10, 16, 18]. In a timely manner appendectomy is not always possible to avoid obstetric and surgical complications, which occur in 17% of cases. [5, 12-15]. The frequency of diagnostic errors in acute appendicitis in women with multiple pregnancies ranges from 11.9-44.0%, with hypo- and overdiagnosis being equally permissible, with a frequency ratio of 25% and 31%, respectively. According to the latest data, 40-55% of pregnant women with acute appendicitis enter surgical hospitals 48 hours after the onset of the disease, as they are initially hospitalized in gynecological hospitals with suspicion of the threat of termination of pregnancy. Thus, most pregnant appendectomy is performed more than a day after the onset of the disease. [31, 37, 27]. Therefore, in pregnant women, especially in later terms, the destructive forms of acute appendicitis occur 5-6 times more often than in non-pregnant ones. Primarily in the III trimester, the destructive forms of acute appendicitis, complicated by perforation and widespread peritonitis, occur three times more often than in I, and 2 times more often than in the second trimester of pregnancy [4, 37]. Emergency surgery is now impossible to imagine without laparoscopy. The rapid development of laparoscopic surgery led to a reassessment of the role of laparoscopy in pregnant women, as a result of which laparoscopic appendectomy became a reasonable alternative to open surgery at different pregnancy times [30, 36]. Multiple pregnancy isn′t considered a contraindication to laparoscopy and laparoscopic appendectomy. In acute appendicitis in patients with multiple pregnancies, an undeniable advantage of the laparoscopic method is the possibility of verifying the diagnosis, which often allows us to limit diagnostic laparoscopy, avoiding unjustified appendectomy. The greatest problem in carrying out laparoscopic surgery in this contingent of patients in conditions of pneumoperitoneum is the possible violations of blood circulation in the mother and fetus. One of the options for a compromise between laparoscopic and open interventions is the use of laparoscopically assisted surgery (LAO). The peculiarities of LAO are that the stage of mobilization of a remote or resected organ is laparoscopically, partially and completely, and its removal and reconstruction is carried out in the open way through mini-access up to 4 cm. Material and methods Under our supervision, between 2010 and 2014 there were 48 women with multiple pregnancies diagnosed with acute appendicitis. 18 (37.5%), women underwent diagnostic laparoscopy and 30 (62.5%) with laparoscopically assisted appendectomy. The range of gestation was 6 to 36 weeks. Pregnant women had 16 (33.3%) in the first trimester, 24 (50%) in the second trimester and 8 (16.7%) in the third trimester. In recent years, we are expanding the indications for the use of diagnostic laparoscopy in cases of suspected acute appendicitis in women with multiple pregnancies in order to shorten the duration of the dynamic observation of patients, which causes the loss of time and progression of the disease, significantly reduce the number of diagnostic errors, and reduce the frequency of unreasonable appendectomy. The patients were activated without threat of termination of pregnancy 6-8 hours after the operation, the average duration of the bed-day in the surgical department was 4.2, 5 patients were transferred for further treatment and supervision to the obstetrics and gynecology department. Prevention of premature termination of pregnancy, as a rule, begins in the preoperative period, we continue during the operation and in the postoperative period regardless of the gestation period. In the first trimester of pregnancy, the use of dydrogesterone or natural micronisine progesterone is indicated. In the II-III trimesters it is advisable to use tocolytics. In order to prevent postoperative inflammatory complications and intrauterine infection of the fetus, pregnant women, operated on for destructive appendicitis, were prescribed antibiotic therapy. In the first trimester, semi-synthetic penicillins, and from the second trimester, semi-synthetic penicillins or cephalosporins in average therapeutic doses for 5-7 days. When prescribing drug therapy in the post-operation period, the recommendations of the American Food and Drug Administration (FDA) on the safety of use during pregnancy, as well as the normatively-decreed documents of the Ministry of Health of Ukraine were taken into account. All operations were performed under endotracheal anesthesia. In the first trimester of pregnancy, the technique of laparoscopy does not differ from the standard technique. Carboxyperitoneumwas created up to a pressure of 10-12 mm Hg. With the needle Veresa. For examination of the abdominal cavity laparoscopes with optics of 30 ° were used, which make it possible to effectively inspect the ileocecal region in most of the observations without introducing additional manipulators. The slope of the operating table on the left side greatly facilitates the laparoscopy. Beginning with the second trimester of pregnancy, the Hassen open laparoscopy technique was used to prevent needle injuries. Hearing of a pregnant uterus [17]. Access was made depending on the size of the uterus [29]. Troakarwas introduced along the middle line just above the upper edge of the uterine fundus. Carrying out a diagnostic laparoscopy in late pregnancy, they took special care, not allowing "blind" manipulation in the abdominal cavity. If the appendix was not visualized, a 5 mm trocar for the manipulator was inserted above the bosom. Depending on the anatomical situation, the operation was performed using 2 or 3 trocar. In the case of double-barrel access, the appendix was grasped at the apex and removed together with the trocar onto the anterior abdominal wall, after which appendectomy was performed. One of the conditions for a successful operation is the correct location of the second trocar above the base of the appendix. With an insufficiently movable dome of the cecum, even a slight deviation of the site of trocar insertion from the optimal leads to significant technical difficulties, which usually cause the conversion or expansion of the trocar wound. Three trocars for appendectomy were used for a short and inactive mesentery of the appendix, atypical appendectomy, gangrenous and perforated appendicitis, as well as peria-pendicular fusions that limit the mobility of the appendectomy. In this case, the mesentery was crossed in the abdominal cavity, applying regimes of mono- and bipolar coagulation. After the intersection of the mesentery, the mobilized process, as in the two-tube technique, was removed from the abdominal cavity together with the trocar. Direct appendectomy was performed in a ligature invagination way, peritonizing the stump of the appendix with a suture seam. During laparoscopy, adequate infusion therapy was performed with the use of tocolytic therapy. Administration of 4-6 g of magnesium sulfate dissolved in 100 ml of physiological solution is carried out iv for 30-45 minutes, after which they switch to continuous iv injection at a rate of 2-4 g / h until cessation or significant contraction of contractions . Sometimes after the termination of labor, minor contractions of the uterus continue. In this case, a vaginal examination is performed regularly. If the cervical dilatation is continued, the dose is increased or another tocolytic agent is prescribed for the prevention of premature birth. Resultsanddiscussion In 18 (37.5%) patients with multiple pregnancies, the initial diagnosis of acute appendicitis was not confirmed. The first trimester of pregnancy was in 10 (20,8%), II - in 6 (12,5%) and III - in 2 (4,2%) women. In one patient with a gestation period of 36 weeks, the clinical picture simulating acute appendicitis was caused by a torsion of the fallopian tube together with a cystically altered ovary. The ovarian tube was defecated. In 4 (8,3%) patients in I and II trimesters there were ruptures of ovarian cysts. In 2 (4.2%) patients in I trimester acute pancreatitis was diagnosed and 9 (18.7%) women in I and II trimesters had no acute diseases of the abdominal cavity organs. Of the 30 patients who underwent laparoscopically assisted appendectomy, the first trimester of pregnancy was in 8 (26.7%), the second trimester in 16 (53.3%) and the third trimester in 6 (20%). Phlegmonous appendicitis was found in 14 (46.7%) pregnant women, gangrenous - in 6 (20%) and perforated - in 3 (10%). The appendix was located in the right iliac region in 36 (75%) patients, of which 20 (41.7%) of women had a pregnancy period corresponding to the second and third trimesters. Atypical location was observed only in 8 (16.7%) pregnant women. Localizations of the appendix in the small pelvis - in 12 (25%) patients, in the subhepatic space - in 4 (8.3%), retrocetically - in 1 (2%) did not complicate the laparoscopic operation. In the first case, we observed in the right ileal fossa a moderate subcutaneous emphysema within 2 days, spontaneously resolved without the use of any measures. Subcutaneous emphysema was caused by gas injection through the Veresk needle. There were no intraoperative complications. In the postoperative period, an inflammatory infiltrate in the anterior abdominal wall appeared in one patient. To prevent purulent-inflammatory complications, avoid contact of the appendix with the tissues of the anterior abdominal wall. No intra-abdominal complications were noted. In 6 patients with gangrenous appendicitis complicated by unrestricted serous and serous-fibrinous peritonitis, and in 3 patients with perforated appendicitis, the operation became more complicated. The exudate was carefully aspirated, the places of its accumulation (right lateral canal and small pelvis) were washed with physiological solution with dioxidine to clean wash water. We consider the indication in such situations of mandatory drainage of the abdominal cavity with the introduction of 4 aseptic per day. Drainage in all cases was removed after 2-3 days. Video laparoscopy makes it possible to adequately place the drainage in the abdominal cavity under the vision control, providing conditions for complete drainage. Laparoscopically assisted appendectomy using 2 trocars managed to perform 12 (40%), 3 trocars - 18 (37.5%) to pregnant women. Conversions to the open operation were not conducted. In 3 (10%) patients there was a transition from a two-barreled technique of laparoscopically assisted appendectomy to a three-barrel. Postoperativecomplicationswerenotobserved. The advantage of laparoscopically assisted appendectomy in comparison with laparoscopic appendectomy is a shorter exposure to the pregnant uterus of strained carboxyperitoneum and a decrease in its negative impact on the fetus. The procedure of the operation involves the creation of carboxyperitoneum only at the stage of diagnostic laparoscopy and, if necessary, for the final sanitization of the abdominal cavity. For laparoscopic appendectomy, carboxyperitoneum is necessary throughout the operation. The average duration of laparoscopically assisted appendectomy in pregnant women was 46.4 minutes, the average duration of carboxyperitoneum was 21.8 minutes. The duration of carboxyperitoneum with laparoscopically assisted appendectomy using 2 trocars is less than using 3 trocar. After discharge from the hospital 2 women at their request pregnancy was artificially interrupted in the early period. Cesarean section was performed according to obstetric indications of 6 (20%) to women and was not associated with a delayed appendectomy or laparoscopy. In 22 (73.3%) women, the births took place without any peculiarities. All babies were healthy. Our experience of performing laparoscopic operations with acute appendicitis in pregnant women suggests that surgeons performing interventions should have extensive experience in urgent surgery, flawlessly own laparoscopic diagnostics and the technique of endoscopic and traditional surgeries. The use of the laparoscopic method in the surgery of acute appendicitis in pregnant women contributes to improving the quality of diagnosis and treatment of fewer postoperative complications, reducing the number of bed-days. The further introduction of these methods in urgent surgery is undoubtedly promising and deserves attention. Conclusions 1. Acute appendicitis is the most common surgical pathology in women with multiple pregnancies, which threatens the life of the mother and the fetuses. 2. Laparoscopically assisted appendectomy in women with multiple pregnancies provides low invasiveness, reliability and high economic efficiency. 3. The advantage of laparoscopically assisted appendectomy in comparison with laparoscopic appendectomy is a shorter exposure to a pregnant uterus of strained carboxiperitoneum and a decrease in its negative impact on the fetus.

Biography

Associate Professor of State Establishment Dnipropetrovsk Medical Academy of Health Ministry of Ukraine Department of Oncology and Radiology , Master of science in medicine Mohammad I.M.Hojouj had been studied for Master’s Degree and performed thesis Effect of hematologic complications effectiveness of chemotherapy for metastatic breast cancer from 01.09.2012 to 31.08.2014. Mohammad I.M.Hojouj has been working as doctor-oncologist of the department of oncology and medical radiology since 15.09.2014 according to the order â„–706-о dated 16.09.2014. Doctor Mohammad I.M.Hojouj performed scientific-research and clinical work, educational process in Internal Medicine and Medical Oncology (totally 7920 hours). Mohammad I.M. Hojouj has completely fulfilled the individual program of lecturer in Oncology based on the standard program of the Ministry of Health of Ukraine and approved by the Academic Council and Rector of SE Dnipropetrovsk Medical Academy of Health Ministry of Ukraine. Doctor Mohammad I.M. Hojouj is an applicant of the doctor of philosophy academic degree in the specialty 222 - medicine (specialization - oncology) according to an extract from State Establishment Dnipropetrovsk Medical Academy Coordination council report dated March 15, 2017 The theme of scientific work is The justification of breast cancer system therapy effectiveness depending on the body mass index. For the period of educational activity Mohammad I.M.Hojouj taught Clinical Ordinators the following topics: 15.09.2014 to 31.08.17. - Internal Medicine (Cardiology, Pulmonology, Gastroenterology ,Infectious Diseases, Rheumatology ,Hematology, Endocrinology, Nephrology, Clinical Immunology and Allergology, Emergency, Medical Biochemistry, Clinical Diagnosis) Doctor Mohammad I.M.Hojouj is a member of ASCO; ESMO; ESGO; NCCN,EDS, certificate NCCN (September, 2015); AAPU; The Arab Medical Union in Europe (ARABMED) (Certificate ARAB MED, November, 2015 року); The Arab Medical Union in UKRAINE (AMUU), non-governmental organization Association of Arabic doctors in Ukraine ( Certificate â„– 08-16). The content, quality and educational value of this ESMO activity have also been reviewed by the Accreditation Council of Oncology in Europe (ACOE) in support of Continuing Medical Education for physicians. ACOE awarded 12 CME credit to this activity. He has more than 43 foreign publications. During the working period as a doctor-oncologist Mohammad I.M.Hojouj took part in organization of cancer care to the population, made diagnosis and treatment of main localization tumors

Speaker
Hojouj Mohammad IM / Dnipropetrovsk Medical Academy of Health Ministry of Ukraine
Ukraine

Abstract

Background; Lead acts as anti-essential trace element in the human body. Breast milk is the ideal nutrient for the newborn, lead reach into breast milk through passive transfer. The aim of the present work is to correlate between the lead levels in drinking water (surface and groundwater) and breast milk of lactating mothers. Materials and Methods; this study was performed on fifty-two drinking tap water samples (surface and groundwater) collected from different districts of Dakahlia Governorate and fifty-two breast milk samples from lactating mothers hosted in Dakahlia Governorate hospitals. All these samples were subjected to lead analysis. Results; Lead level in drinking groundwater showed higher levels than in drinking surface water. In addition, an elevation of lead levels in breast milk of mothers drinking groundwater was noticed when compared with that of mothers drinking surface water. The comparison between mean lead levels in drinking water and mothers’ breast milk samples showed positive relationship. Lead concentrations in breast milk of the studied samples were elevated by exposure to smoking. Conclusions; We conclude that prolonged contact with lead plumbing can increase the lead content in tap water with subsequent increase in lead burden in infant fed formula and infant blood. Recommendations; Also, we recommend that chemical analyses must be carried out periodically for the surface and groundwater to ensure the water suitability for drinking purposes. Passive exposure to smoking during lactation should be avoided.

Biography

Dr. Raafat Abdeldayem is currently working in Mansoura University, Egypt

Speaker
RAAFAT ABDELDAYEM / Mansoura University
Egypt

Abstract

Symptom Definition is the only parameters necessary for a Symptom. As any or all other definitions, symptom definition should be describe the symptom scientifically. If it cannot describe clearly, there is no use of a symptom definition. A symptom is a departure from normal function or feeling which is noticed only by a patient, indicating the presence of disease or abnormality. One cannot be understand directly the temperature is elevated in hypothalamus .A mechanical device is necessary to measure elevated temperature in hypothalamus. In symptom definition, fever definition can’t be found. The elevation of body temperature is not included in symptom definition. The main evidence which proves that fever is not a symptom of disease is symptom definition itself. Elevated temperature or increased temperature never make fever or symptoms of fever. it may create hyperthermia. None of diseases or cause of diseases require fever as its symptom. If the mosquito bites its virus, bacteria, venom gets deposited in the body as a result according to nature and strength of virus, bacteria ,venom symptoms like itching, pain and signals like colour change, inflammation, may occurred. we can see the symptoms, Signals and indications of virus, bacteria, venom which multiple or spreading or damages(disease) the body before fever emerge . The symptoms of virus, bacteria and venom are not based on fever. The symptom, signs and signals are shown every time when virus, bacteria and venom are present in the body. In such a situation fever is not necessary, because fever is not seen in everyone. In a state of multi-disease conditions, if fever is caught and cured, fever will not show the symptoms of other diseases. In H1N1 infections 30% of patients actually had no fever. There is a sharp difference between Symptoms of fever and symptoms of rising temperature. Symptoms of fever includes body pain, fatigue to mind and body, reduced appetite, reduced motion and indigestion, internal and external discomfort, etc., The symptoms, signs, signals of fever are only seen at the presence of fever. During cancer the symptom, signs and signals of cancer are shown every time. A patient having cancer and fever at the same time, symptoms, signs and signals of both cancer and fever are shown every time. A symptom of cancer never become symptom of fever or a symptom of fever can never become symptom of cancer. During cancer the symptom, signs and signals of cancer are shown every time. How can separate symptom of disease and symptom of fever. In fever, both symptom of disease and symptom of Fever are included. Deduct symptom of disease from total symptoms we will get symptom of fever. Like that we can separate signs, signals, and actions of both fever and disease.

Biography

A practicing physician in the field of healthcare in the state of Kerala in India for the last 30 years and very much interested in basic research. My interest is spread across the fever , inflammation and back pain.

Speaker
Yacob Mathai / Marma Health Centre
India

Abstract

Vitamin D, also known as the sunshine vitamin. It is important for calcium absorption and bone growth. Vitamin D status is linked to the pathogenesis of skeletal and non-skeletal disorders. Vitamin D deficiency is relatively prevalent all over the world. The aim of this study was to determine the prevalence of and to identify factors associated with vitamin D deficiency and severe vitamin D deficiency among Afghan adolescents diagnosed at French Medical Institute for Mothers and Children, Kabul. An analytical cross-sectional study design was conducted from Jun to Sep 2016. Blood samples were obtained, serum 25OHD levels were measured, A total of 308 adolescents were part of the sample for the final analysis. Of all, 202(65.6%) were females and 106(34.5%) were males. Out of total, a large number of the participants 107(34.7%) had severe vitamin D deficiency, 81(26.3%) had vitamin D deficiency, 50(16.2%) had vitamin D insufficiency, and only 70(22.7%) had vitamin D sufficiency. Gender, sun-exposure, usage of sun protector, calcium+vitamin D supplement intake, Vitamin D rich foods intake, regular milk intake, skin color, and BMI were found as significant factors associated with vitamin D levels. There was a high prevalence of vitamin D deficiency among adolescents who visited a tertiary healthcare facility, Kabul. Low serum vitamin D concentration is prevalent among general Afghan population. Screening and ongoing investigation for vitamin D deficiency should be considered for all adolescents in the country. Based on our results, the regular use of fortified milk and supplements are suggested in this region.

Biography

Dr. Shabnam Azizi has obtained MD degree from Kabul Medical University in 2013. After graduation she joined FMIC PGME programme at Clinical Pathology Department. After successful training in March 2016 she is working as consultant Pathologist at FMIC, Kabul Afghanistan

Speaker
Shabnam Azizi / French Medical Institute for Mothers and Children
Afghanistan

Abstract

Dr Karina Litvinova is a part of Aston Medical Research Institute and Queen Elizabeth Hospital, Birmingham UK. She received a Ph.D. degree from the SRC Institute for Biomedical Problems, Russian Academy of Science. Dr Litvinova works in the interdisciplinary field of laser optics, biophotonics, and medical spectroscopy diagnostics. She is currently focusing on the development of effective diagnostics and therapy. Most of Dr Litvinova’s research specialises in advancing biophotonic technologies and ultimately providing consistent, reliable and meaningful diagnostic information within clinical practice, especially for the early diagnosis of conditions such as cardiovascular diseases and cancer.

Biography

Dr Karina Litvinova is a part of Aston Medical Research Institute and Queen Elizabeth Hospital, Birmingham UK. She received a Ph.D. degree from the SRC Institute for Biomedical Problems, Russian Academy of Science. Dr Litvinova works in the interdisciplinary field of laser optics, biophotonics, and medical spectroscopy diagnostics. She is currently focusing on the development of effective diagnostics and therapy. Most of Dr Litvinova’s research specialises in advancing biophotonic technologies and ultimately providing consistent, reliable and meaningful diagnostic information within clinical practice, especially for the early diagnosis of conditions such as cardiovascular diseases and cancer.

Speaker
Karina Litvinova / Aston University
UK

Abstract

Preventive, predictive, and personalized medicine (PPPM) has created a wealth of new opportunities but added also new complexities and challenges. The European Cancer Prevention Organization already embraced unanimously molecular biology for primary and secondary prevention. The rapidly exploding genomic language and complexity of methods face oncologists with exponentially growing knowledge they need to assess and apply. Tissue specimen quality becomes one major concern. Some new innovative medicines cost beyond any reasonable threshold of financial support from patients, health care providers, and governments and risk sustainability for the health care system. In this review, we evaluate the path for genomic guidance to become the standard for diagnostics in cancer care and formulate potential solutions to simplify its implementation. Basically, introduction of molecular biology to guide therapeutic decisions can be facilitated through supporting the oncologist, the pathologist, the molecular laboratory, and the interventionist. Oncologists need to know the exact indication, utility, and limitations of each genomic service. Minimal requirements on the label must be addressed by the service provider. The interventionist is there to bring the most optimal tissue sample to pathology where the tissue is expanded to a variety of appropriate liquid-based samples. The large body of results then should be translated into meaningful clinical guidance for the individual patient. Surveillance, with the appropriate application of health economic indicators, can make this system long lasting. For governments and health care providers, optimal cancer care must result in a cost-effective, resource-sustainable, and patient-focused outcome.

Biography

Speaker
Jaak Janssens / Catholic University of Leuven
Belgium

Abstract

Vitamin D, also known as the sunshine vitamin. It is important for calcium absorption and bone growth. Vitamin D status is linked to the pathogenesis of skeletal and non-skeletal disorders. Vitamin D deficiency is relatively prevalent all over the world. The aim of this study was to determine the prevalence of and to identify factors associated with vitamin D deficiency and severe vitamin D deficiency among Afghan adolescents diagnosed at French Medical Institute for Mothers and Children, Kabul. An analytical cross-sectional study design was conducted from Jun to Sep 2016. Blood samples were obtained, serum 25OHD levels were measured, A total of 308 adolescents were part of the sample for the final analysis. Of all, 202(65.6%) were females and 106(34.5%) were males. Out of total, a large number of the participants 107(34.7%) had severe vitamin D deficiency, 81(26.3%) had vitamin D deficiency, 50(16.2%) had vitamin D insufficiency, and only 70(22.7%) had vitamin D sufficiency. Gender, sun-exposure, usage of sun protector, calcium+vitamin D supplement intake, Vitamin D rich foods intake, regular milk intake, skin color, and BMI were found as significant factors associated with vitamin D levels. There was a high prevalence of vitamin D deficiency among adolescents who visited a tertiary healthcare facility, Kabul. Low serum vitamin D concentration is prevalent among general Afghan population. Screening and ongoing investigation for vitamin D deficiency should be considered for all adolescents in the country. Based on our results, the regular use of fortified milk and supplements are suggested in this region.

Biography

Dr. Shabnam Azizi has obtained MD degree from Kabul Medical University in 2013. After graduation she joined FMIC PGME programme at Clinical Pathology Department. After successful training in March 2016 she is working as consultant Pathologist at FMIC, Kabul Afghanistan

Speaker
Shabnam Azizi / French Medical Institute for Mothers and Children
Afghanistan

Abstract

Targeted low dose chemotherapy using Insulin as a biologic response modifier, is a therapy known as Insulin Potentiation Targeted LowDose therapy (IPT). It is an original cancer treatment regimen that allows for the use of chemotherapy drugs selected according to accepted oncological practice. These drugs are delivered at much lower doses than what is accepted as the standard dose. IPT practitioners use 1/10th the dose of conventional chemotherapy drugs. Clinical experience and some studies suggest that the use of insulin as a biological response modifier allows this fractionated dose to yield clinically significant tumor responses Historically, IPT's original was developed in the 1920s as an alternative to treating syphilis with nearly lethal doses of mercury and arsenic. IPT was first used for cancer in 1945. The review of numerous patients medical records suggests that using Insulin Potentiation Targeted or LowDose Chemotherapy (IPT ) and nutrition therapy in the treatment of cancer results in levels of tumor response that are equivalent to full dose chemotherapy in many patient populations. Currently there are only a few published clinical trials exploring the effectiveness of IPT and nutrition therapy. The effectiveness of the lower dose chemotherapy is enhanced by using insulin as a biological response modifier. Clinical experience strongly suggests IPT minimizes the debilitating side-effects associated with conventional treatment. Cancer patients treated with IPT report improvement in quality of life as compared to patients receiving full dose chemotherapy. It is well established that Insulin modifies the cell membrane, also Insulin is known to modify the growth characteristics of cancer cells, furthermore, it is well well-known Scientifically that cancer cell membranes express an excess of insulin-sensitive receptors on. These factors make insulin a significant biological modifier facilitating, enhancing and modulating the transport of chemotherapy drugs across cancer cell membrane concentrating chemotherapy preferentially inside cancer cells making more cancer cells vulnerable to anticancer drug effects. This phenomenon enables a clear differentiation between cancer and normal cells facilitating targeted chemotherapy by using insulin as a biological Modifier targeting Cancer cells. Considering the favorable safety profile of insulin and the long history of its use along with the effectiveness of IPT in allowing Integrative Oncologist to use lower dose of chemo is very attractive and Promising. So, insulin as a biological modifier strategically directs the targeted chemotherapy drugs into the cancer cells only. This is an Off-label use of approved drugs. I will present to you the science, the clinical applications and favorable results.

Biography

Dr. Akoury founder and Medical Director of The AWAREmed Health and Wellness Resource Center is Fellowship trained and certified in Integrative Cancer Therapy, Healthy Aging, Regenerative, Metabolic and Functional Medicine, Dr. Akoury is fellowships in pediatric hematology/oncology. She performed research with the CDC. Dr. Akoury is an advanced Integrative Medicine Authority, Healthcare Educator, Author/Researcher, Media Contributor, Global Speaker. Dr. Akoury published several cancer research papers and written several articles on cancer. Dr. Dalal is an authority on cancer, obesity, fitness, and nutrition, Dr. Akoury writes for The Townsend Letters, she is on the Medical Advisory Board of (IOICP), and Best Answer for cancer.

Speaker
Dalal Akoury / AWAREmed
USA

Abstract

According to the facts of physics, if temperature increases, thermal expansion of an object is positive it will expand and with decrease of temperature it will shrink. Pressure will increase due to increase of temperature. On the contrary, during fever we can see blood vessels and skin are shrunk, pressure decreases, body shivers, sleep increases, motion decreases, inflammation increases, body pain increases, blood circulation decreases, dislike cold substances etc... In fever, the firing rate of Warm sensitive neurons decreases, and the firing rate of Cold sensitive neurons increases. At the same time if we apply hotness from outside by thermal bag or if we drink hot water, our body acts according to the Facts of Physics- increase of temperature pressure will also increase, expands blood vessels and skin, body sweats, motion will increase , inflammation will decrease , body pain will decrease, blood circulation will increase, like cold substances etc.. During fever, why our body acts against Facts of Physics? when disease increases, pressure and temperature will decrease. Blood circulation will decrease due to decrease of pressure. If the essential temperature of the body is going out, essential temperature and pressure will further decrease. This will further endanger the life or action of organ. when disease increase, it is the sensible and discreet action of brain that tends to act against facts of physics to sustain life or protect organ .There is no way other than this for a sensible and discreet brain to protect the life or organ. We will get a clear answer if we find out the purpose of fever, sensible and discreet action of brain . No medical books clarify this1 During fever, if the temperature of fever is not a surplus temperature or if it is not suppose to be eliminated from the body, the shrinking of skin and blood vessels, shivering of body, dislike towards cold substances etc are a protective covering of the body to increase blood circulation to important organs of the body it is against the facts of physics.

Biography

Dr. Yacob Mathai is a practicing physician in the field of healthcare in the state of Kerala in India for the last 30 years and very much interested in basic research. His interest is spread across the fever , inflammation and back pain

Speaker
Yacob Mathai / Marma Heatth Centre
India

Abstract

Breast cancers have been extensively studied, which renders them quite representative of the nature of neoplastic disease. When describing cancer pathogenesis one has to consider the organism as a whole, the tumor microenvironment, and the tumor cells. It is well known that micro environmental factors secreted by stromal cells can influence tumor growth. The permanent evolution of the organism from the embryonic stage on and up to senescence can create variable vulnerability factors for the growth of breast cancers, influenced by environmental factors. We found that a population of fibroblasts in connective tissue of cancer patients, distant from the tumor,has abnormal growth characteristics suggesting that the whole organism – through the microenvironment - participates in the neoplastic process. This population of fibroblasts is present long before the cancer becomes apparent. Finally during senescence the incidence of breast cancers declines due to tissue, cellular and molecular modifications occurring in the organism during the last developmental stage of the human life span.

Biography

Dr. Alvaro Macieira-Coelho is a Research Director at the French National Institute of Health. He received an MD from the University of Lisbon, Portugal, and a PhD from the University of Uppsala Sweden. He made an internship at the University Hospital in Lisbon and was a research associate at the Wistar Institute in Philadelphia (USA) and at the Department of Cell Biology of the University of Uppsala (Sweden). He became Head of the Department of Cell Pathology at the Cancer Institute in Villejuif (France) and was a visiting Professor at the University of Linkoping (Sweden). He published 150 papers in professional Journals and 9 books on cancer and aging. He received the following awards: Fritz Verzar Prize (University of Vienna, Austria), “Seeds of Science” Career Prize (Lisbon, Portugal), Dr. HonorisCausa (University of Linkoping, Sweden), Johananof International Visiting Professor (Institute Mario Negri, Milano, Italy).

Speaker
Alvaro Macieira-Coelho / French National Institute of Health
France

Abstract

Background The diagnosis of breast cancer in combination with the anticipation of surgery evokes fear, uncertainty, and anxiety in most women. Objective In patients who underwent breast cancer surgery, study purposes were to examine how ratings of state anxiety changed from the time of the preoperative assessment to 6 months after surgery and to investigate whether specific demographic, clinical, symptom, and psychosocial adjustment characteristics predicted the preoperative levels of state anxiety and/or characteristics of the trajectories of state anxiety. Interventions/Methods Patients (n=396) were enrolled preoperatively and completed the Spielberger State Anxiety inventory monthly for six months. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of state anxiety. Results Patients experienced moderate levels of anxiety prior to surgery. Higher levels of depressive symptoms and uncertainty about the future, as well as lower levels of life satisfaction, less sense of control, and greater difficulty coping predicted higher preoperative levels of state anxiety. Higher preoperative state anxiety, poorer physical health, decreased sense of control

Biography

Maria Kyranou is an Assistant professor of nursing in Cyprus University of Technology. She had published 5 articles in different peer reviewed Journals.

Speaker
Maria Kyranou / Cyprus University of Technology
Cyprus

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

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

Breast tumors are common for female. Among all the tumors, breast cancer is the most common cancer for the female in the world and has high mortality rate. Among all types of malignancies, breast carcinomas, mainly ductal carcinomas and lobular carcinomas are the most common types. The first step of histopathologic diagnosis of a breast lesion is Fine Needle Aspiration Cytology (FNAC), which is a very sample and minimally invasive procedure. By FNAC procedure histopathologists are able to see the changes only in the cellular level. Comments on the status of stromal invasion, grading, metastasis, staging or resection margins are not possible by the FNAC procedure. The second diagnostic step is needle biopsy for histopathologic evaluation. This is an invasive procedure, mainly done under ultrasound or computed tomography (CT) scan guidance. The main advantage of this procedure can be the accuracy compare with FNAC, but again staging, resection margins and metastasis cannot be commented. Excisional and incisional biopsy procedures are the best diagnostic specimen for a proper histopathologic evaluation. These procedures are invasive and require a proper surgical intervention. Grading, stromal invasion, differentiation, staging and even comment on surgical resection margins is possible on an excisional biopsy or mastectomy specimen. After the initial diagnosis by FNAC, needle biopsy or incisional biopsy, submission of a complete radical mastectomy along with axillary node dissection is very essential for a proper and complete histopathologic evaluation for the complete staging of the tumor for the further therapeutic decision and tumor prognosis. Immunohistochemicalstains for hormone receptors (Estrogen & progesterone receptors and Herb-B2) are done to find out the type of hormone chemotherapy for a good treatment management.

Biography

Jamshid Abdul-Ghafar currently works in Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children, Kabul, Afghanistan. Jamshid does research in Pathology and Medicine.

Speaker
Jamshid Abdul-Ghafar / French Medical Institute for Mothers and Children
Afghanistan

Abstract

Empower her is a SME began in Kenya with the aim of reaching out to young girls who are subjected to female genital mutilation. Being a constantly recurring issue in Kenya, FGM has continued to curtail efforts by ladies who seek to explore both entrepreneurial and education opportunities not only in Kenya but also in the entire African continent. At Empower Her,we empower the young ladies by inducting the young ladies through counseling sessions that help them overcome the stigma and social prejudice that may arise from the community. The organization has so far managed to train and equip a group of 300 young ladies aged 15- 23 with skills on beauty and therapy, sewing, graphic design, internet marketing and dress making across various towns such as Kisii, Kisumu, Nairobi’sKibera area and Busia. Our focus this 2019 is to reach out to as many girls as possible to teach and empower young girls on skills that will enable them work and be independent financially. Reducing financial dependence among the youth is one of the major focus of the Kenyan government. Such a platform is likely to expose this organization to a world platform and thereby encourage the entire Kenyan community to support the fight against FGM.

Biography

Speaker
Kimanga / Empower Her
Kenya

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

Breast cancer (BC) is the most common cancer in women, affecting about 10% of all women at some stages of their life. In recent years, the incidence rate keeps increasing and data show that the survival rate is 88% after five years from diagnosis and 80% after 10 years from diagnosis. Early prediction of breast cancer is one of the most crucial works in the follow-up process. Data mining methods can help to reduce the number of false positive and false negative decisions. Consequently, new methods such as knowledge discovery in databases (KDD) has become a popular research tool for medical researchers who try to identify and exploit patterns and relationships among a large number of variables, and predict the outcome of a disease using historical cases stored in datasets. In this paper, using data mining techniques, authors developed models to predict the recurrence of breast cancer by analyzing data collected from ICBC[1] registry. The next sections of this paper review related work, describe the background of this study, evaluate three classification models (C4.5 DT, SVM, and ANN)[2], explain the methodology used to conduct the prediction, present experimental results, and the last part of the paper is the conclusion. To estimate validation of the models, accuracy, sensitivity, and specificity was used as criteria and was compared. Our analysis shows that the accuracy of DT, ANN and SVM are 0.936, 0.947 and 0.957 respectively.

Biography

Leila GhasemAhmad has completed her bachelor degree in Nursing from the Isfahan University of Medical Science, and master degree in Information Technology Management from Science and Research Branch, Islamic Azad University of Tehran-Iran. She has published papers in interdisciplinary research related to breast cancer and data mining. She is Cooperation with “The Breast Cancer Research Center” and also is a member of against Hunger charity (NGO) in Iran.

Speaker
LEILA Ghasemahmad / Islamic Azad University
Iran

Abstract

To study the apoptosis mechanisms, we used a line of transgenic mice with overexpression of oncogene HER2. This line of mice is characterized by accelerated aging and a high level of breast cancer. HER2 belongs to the family of transmembrane tyrosine kinase receptors which activate a significant number of cascades. HER-receptors are involved in the processes of growth, differentiation, migration and apoptosis. The aim of our investigation was to identify how oncogene HER2 overexpression influence on cytokine-mediated signaling in p53-mediated apoptosis. We studied apoptosis level (TUNEL), expression of members of STAT signaling pathway and apoptosis-associated proteins (Western blotting, immunohistochemistry). We observed antiapoptotic factor STAT1 expression increases and, simultaneously, STAT3(5,6)-survivin expression decreases. These changes correlated with p53-mediated cascade induction, caspase-8,3 activation in neurons of wild-type aged mice. Obviously, there are reasons for increasing cell apoptosis. Activation of STAT3(5,6)-survivin axis causes caspase-8,3 inhibition and low apoptosis in aged HER2-mice. So, HER2 overexpression alters apoptotic cytokine-dependent ways and leads to excess cell survival through activation of STAT-signaling pathway and survivin expression. We conclude that members of STAT signaling pathway (STAT1,3,5,6) may be a target for a new cancer therapy strategy.

Biography

Elena Bazhanova has completed PhD from Sechenov Institute of Evolutionary Physiology and Biochemistry, St. Petersburg, Russia. She is Head of the laboratory of morphology and electron microscopy, Institute of Toxicology, St. Petersburg; Leading Researcher, Sechenov Institute of Evolutionary Physiology and Biochemistry, St. Petersburg and Astrakhan State University, Astrakhan, Russia. Dr. Bazhanova studies mechanisms of neuron apoptosis regulation in aging, using some pharmacological approaches. Her work was supported by 8 Grants of Russian Fund of Fundamental Research (RFFR). She has published 37 papers in reputed journals and has been serving as an editorial board member of 2 reputed journals.

Speaker
Elena Bazhanova / Institute of Toxicology, Saint Petersburg
Russian Federation

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

Gynecology is the one that deals with the extra-uterine life of woman's fruit and health during pregnancy In addition to normal births, we often have problems during this time, which leads to failures In many countries induced (therapeutic) abortion is now legal. The exact conditions vary, but the purposes of legalizing abortion are: • To enable women, irrespective of social or economic status, after counselling to obtain an abortion performed by a trained health professional in hygienic surroundings. • To reduce the frequency of illegal abortions performed in unhygienic surroundings, which are often associated with high morbidity and mortality. The main reasons for abortion are shown in Box 11.1. In most developed countries where abortion is legal, over 95% are performed for social or psychiatric reasons. It should be stressed that women rarely seek an abortion without considerable thought, and are receptive to and welcome counselling during this difficult time. It is also evident that in many cases the pregnancy could have been prevented if effective contraceptive precautions had been taken. Failures in an early pregnancy are often medical complications in the first trimester of pregnancy. Most pregnancies fail during the first month after the last menstruation that is often ignored, especially if they occur at the time when menstrual bleeding occurs 1- Spontaneous failure Spontaneous drug loss before gestational week 20 2- Strained Defeat Treatment Bleeding from the uterus, closed cervix, does not fall into conceptual products 3- Incomplete Failure Some, but not all, parts of the concept have emerged from the pregnancy uterus 4- Failing Without Failure Well-known cervix, the products of the conception have not come out

Biography

Speaker
Nexhibe Rexhepi / UBT-Ferizaj
Albania

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

Abstract

The study aimed to identify possible environmental risk factors for breast cancer among women in Gaza Strip and conducted in 2010. A case- control study design was used with face to face interviews by structured questionnaire with breast cancer patient women as well as healthy women. Statistical Package of Social Science (SPSS) was used to analyze the collected data. The study population was 288 women, 144 were women with breast cancer (cases) and 144 were healthy women (controls) with response rate 100% for cases as well as controls. The study was carried out in the two main hospitals in Gaza Strip (El-Shifa and European Gaza) and on cases who had a regular follow up in each hospital, while controls have been chosen from women who had no history of breast cancer by mammogram or by self examination. In this study the main statistically significant risk factors were; marital status, educational status, physical trauma on breast, medication for infertility treatment, eating red meat 500g or more weekly, eating canned food, eating chicken skin, eating raw and cooked vegetables, using oils with saturated fats in cooking, living in or beside a farm, dealing with crops with naked hands, working in a farm during pesticides application or during 24 hours of pesticides application, cleaning pesticides' equipments, living with people working in a farm or a agricultural field, and application of pesticides personally. In contrary, no statistically significant differences were found between cases and controls in relation to area of residency, exposure to X-ray in the past, having radiation therapy, getting contraceptive pills, using hair dyes, using anti-deodorant underarm, using facial cosmetics, using hair removal ointment, washing vegetables and fruits, buying and transporting pesticides, and wearing protective tools during pesticides mixing and application.

Biography

Speaker
Jamal Safi / Al-Azhar University
Egypt

Abstract

High-risk pregnancy refers to a pregnancy that negatively affects the health of the mother, the baby, or both, and evoking a range of emotional/psychological experiences. Research on high-risk pregnancy is predominantly found in the medical arena, while women’s emotional/psychological experiences are not sufficiently documented. For this reason, the objectives of this study was to examine the medical conditions and complications in the reviewed articles that make a pregnancy high-risk, while at the same time investigating the emotional/ psychological experiences of women throughout their high-risk pregnancies. The systematic review examined qualitative studies, including the qualitative components of mixed method studies published between January 2006 and June 2017. The databases searched are EbscoHost, JSTOR, Sage Journals Online, ScienceDirect, SpringerLink, Sabinet, Scopus, Emerald eJournals Premier, Pubmed, as well as Taylor and Francis Open Access eJournals. The study evaluated the literature found on these databases for methodological quality by using three stages of review (i.e. abstract reading, title reading, and full-text reading) and applying a meta-synthesis to the current evidence on the research topic. The findings provide empirical evidence based on sound research that medical conditions and complications (i.e. HELLP syndrome, thrombophilia, gestational diabetes, maternal near-miss syndrome, foetal abnormality, preterm birth, hypertension, and uterine rupture) are associated with women’s emotional/psychological experiences (i.e. fear, shock, feeling frightened, sadness, worry, alienation, frustration, grief, guilt, anger, ambivalence, despair, upset, loneliness and isolation, anxiety, depression, and PTSD) throughout their high-risk pregnancies. As a result of this, survivors of severe pregnancy complications have subsequent psychological and emotional challenges.

Biography

Nazeema Isaacs is a Registered Counsellor with the Health Professions Council of South Africa (HPCSA) and an HIV/AIDS tester and counsellor. She has over 3 years’ experience working with children, adolescents and adults who have experienced multiple trauma, sexual violence, gender-based violence, child abuse and so forth. During her Honours degree she did a study on HELLP syndrome and women’s coping mechanisms using an online platform (i.e. Facebook). She did a structured Masters Course in Research Psychology at the University of the Western Cape and after her 12 month internship she will apply to HPCSA to write the board exam to be able to register as a Research Psychologist.

Speaker
Nazeema / University of the Western Cape
South Africa

Abstract

Extra-marital affair women, according to a study, have a higher risk for heart disease. Turns out, for women, being extra-marital affair can be injurious to health. According to a study conducted by the New York University, extra-marital affair women have a higher risk for heart disease compared with non-extra-marital affair women across several modifiable risk factors [1-3]. “Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of women and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in extra-marital affair women,” Little is known about the impact of sexual orientation on heart disease risk in women, despite the fact that widow and extra-marital affair women may be at a higher risk based on modifiable factors like tobacco use and poor mental health. In this study, the researchers examined differences in modifiable risk factors for heart disease and heart disease diagnoses in women of different sexual orientations. Risk factors measured included mental distress; health behaviours such as tobacco use, binge drinking, diet, and exercise; and biological risk factors such as obesity, hypertension, diabetes, and cholesterol [4]. Participants who reported having angina, coronary heart disease, heart failure, heart attack, or stroke were considered as having a diagnosis of heart disease. The researchers’ analysed responses from 5000 women data ages 20 to 59 [5,6]. Differences were analysed across four groups based on their sexual identities: gay women, extra-marital affair women, heterosexual women who have sex with women, and heterosexual women. The researchers found no differences in heart disease diagnoses based on sexual orientation, but the risk for heart disease was more complicated. Gay women, heterosexual women, and heterosexual women who have sex with women had similar heart disease risk [7]. Gay women reported lower binge drinking compared with heterosexual women, but otherwise few differences in health behaviours were noted. Extra-marital affair women, however, had higher rates of several risk factors for heart disease relative to heterosexual women: mental distress, obesity, elevated blood pressure, and three different measures of diabetes (medication.

Biography

Dr. Rahul Hajare is bright student of Renowned Immunologist Honorable Respected Dr. Ramesh S Paranjape’’ Retired Director Indian Council of Medical Research New Delhi. He is Fellow Indian Council of Medical Research. He is winner of world academic championship-2017 in pharmacy (antiretroviral therapy). He is among world's 500 most influential experts in pharmacy for the year 2017 on earth. Dr. Hajare is alumni of The Yoga Institute Centenary Celebration Mumbai. He is a member NEWSLETTER MyGov India.

Speaker
Rahul Hajare / Fellow Indian Council of Medical Research
India

Abstract

Breast cancer is the first cause of cancer death in women worldwide and a major concern to public health. The main axes of this work consist in studying the antiproliferative and pro-apoptotic effects of spiro-bisheterocycles on human breast cancer cell lines MCF-7 and MDA-MB-231. On the structural point of view, the compounds feature a hydantoin moiety attached to either diazole, isoxazole, diazepine, oxazepine or benzodiazepine via the privileged tetrahedral spiro-linkage. The treatment with compounds 3 and 6, corresponding to spiro [hydantoin-isoxazole] and spiro [hydantoin-oxazepine] respectively, resulted in a significant decrease of cell proliferation and the induction of the apoptosis in both breast cancer cell lines. However, the compound 4(spiro [hydantoin-diazepine]) demonstrated an antiproliferative activity only against MDA-MB-231. The qRT-PCR revealed an up-regulation of MDM2, strictly p53-dependent, and an increase of the expression of pro-apoptotic genessuch as caspase 3 and BAXin MCF-7wild-type p53 and MDA-MB-231 mutant p53 breast cancer cells. In summary, the results suggested that our compounds promoted the apoptosis of breast cancer cell lines through p53-dependent and independent pathways.

Biography

Centre de Recherche Scientifiqueet Technique en Analyses Physico-Chimiques, Algeria University of Auvergne, France

Speaker
Lamia HAMDAN RAMDANI / CRAPC
Algeria

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