Day 2 :
Keynote Forum
William J.Rowe
Medical University of Ohio at Toledo, USA
Keynote: Hypertension risk from iron brake particulate matter
Biography:
William J Rowe, MD and FBIS (Fellow British Interplanetary Society), FACN (Fellow American College of Nutrition, Retired Fellow Royal Society of Medicine), is a Board Certified Specialist in Internal Medicine. He received his MD at the University of Cincinnati and was in Private Practice in Toledo, Ohio for 34 years. During that time he supervised over 5000 symptom - limited maximum hospital-based treadmill stress tests. He studied three world class extraordinary endurance athletes and published their exercise-related magnesium deficiencies. This triggered a 20 year pursuit of the cardiovascular complications of Space flight. He has published in Lancet that extraordinary, unremitting endurance exercise can injure a perfectly normal heart. Of only four space syndromes, he has published two: The Apollo 15 Space Syndrome and Neil Armstrong Syndrome. All his publications are posted on his website (www.femsinspace.com).
Abstract:
Of 12 moon walkers, James Irwin on day after return from Apollo 15 mission, showed extraordinary bicycle (B) stress test (ST) hypertension (275/125) after three minutes exercise; supervising >5000 maximum treadmill ST, author never witnessed ST- blood pressure approaching this level. Symptom-limited maximum B stress test showed “cyanotic fingernails”; possibly venous blood trapped peripherally, supporting author’s “Apollo 15 Space Syndrome,” postulating that severe fingertip pain during space walks, triggered by plasma fluid, trapped distally; mechanism could be related to endothelial dysfunction, providing “silent ischemia” warning. Neil Armstrong returned to Earth with severe diastolic hypertension (160/135), consistent with ischemic left ventricular dysfunction; 50 mm increase in comparison with resting BP 110/85. With inhalation of lunar dust, brought into habitat on space suit, with high lunar iron (I) this dust inhalation, along with reduced (R) space flight- transferrin, R antioxidant, calcium (Ca) blocker - magnesium, conducive to severe oxidative stress, Ca overload with potential endothelial injuries, using moon walker studies as example, my recent editorials show that I dust, released from brakes, with over 90% of brakes made of I, is a major hypertension factor and may also contribute to myocardial infarctions.
Keynote Forum
Liyan Wang
Australian National University Medical School, Australia
Keynote: Case series of venous thromboembolism (VTE) in hospitalised hip fracture patients despite thromboprophylaxis: incidence, outcome and risk factors
Biography:
Liyan Wang is currently a Physician’s Trainee in Australia. She completed her Bachelor’s in Biomedical Sciences at The University of Auckland and then received a Doctor of Medicine and Surgery degree at The Australian National University. She is currently working at The Canberra Hospital but has also worked in many other hospitals in New South Wales and Australian Capital Territory. Her interests in Medicine include Cardiology, Geriatric Medicine and Medical Oncology. Her current research hopes to improve patient care and reduce morbidity and mortality in geriatric patients undergoing hip fracture surgery
Abstract:
Introduction: Patients undergoing hip fracture (HF) surgery have the highest rates of postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE). In a proportion of HF patients VTE occurs even despite postoperative thromboprophylaxis; the incidence, outcome and risk factors for this complication remain unknown.
Observations & Analysis: We report a case serious of 36 (19 female, 17 males) HF patients (mean age 79.1±10.0 years) who developed VTE despite receiving thromboprophylaxis with enoxaparin (n=31), heparin (n=4) or apixaban (n=1). VTE occurred in 36 (2.24%) of 1610 consecutive HF patients on average 6.9 days postoperatively. PE was diagnosed in 20 patients, symptomatic DVT in 11 and both complications in five subjects; six (16.7%) patients had a fatal outcome. Comparison of patients with and without VTE (452 randomly selected HF patients) showed no statistically significant differences in prevalence of 12 chronic comorbid conditions and lifestyle factors, 12 medications used and 28 blood parameters. Multivariate analysis (adjusted for age and all variables with p<0.100 on univariate analysis) identified six independent risk factors for VTE: receiving tranexamic acid (OR 17.5, p=0.023), albumin >33 g/L (OR 27.8, p<0.001), history of malignancy (OR 4.1, p=0.013), low alcohol consumption (<3 times/week, OR 5.3, p<0.010), male gender (OR 2.7, p=0.025) and, non-A blood group (OR 2.3, p=0.099).
Keynote Forum
Wael Awada
Al-Ghad International College of applied science, Saudi Arabia
Keynote: Case study of bilateral hip replacement evaluation of continous
Biography:
Wael Awada is an Assistant Professor of Emergency Medicine and Head of the Department of Emergency Medicine at Al-Ghad International College for Applied Science in Riyadh KSA. He is also Lecturer of Anesthesia, Surgical ICU and Pain Management at Cairo University, Egypt. He has published a lot of papers in reputed journals and has been serving as an Editorial Board Member of repute. He is seeking for a challenging opportunity to reveal his capabilities and knowledge, to enhance and further develop his skills and to contribute to the success of the society and the corporation he belongs to.
Abstract:
Introduction: Hemorrhage is a medical emergent that is frequently encountered in emergency - operating rooms and intensive care units. Significant loss of intravascular volume may lead sequentially to hemodynamic instability, cellular hypoxia, organ damage, and death.
Presentation of Case Report: Fifty four (54) years of male patient had spinal fracture with paraplegia, bilateral hip, knee stiffness and programmed for bilateral hip replacement. Intraoperatively we used continuous spectrophotometry (SpHb) and pleth variability index (PVi) monitoring by ADC blood gases obtained to compare SpHb & true hemoglobin (tHb) from CO-oximetry. We confronted severe intra operative uncontrollable bleeding during dissection of the right hip joint. Blood units despite that was reserved pre-operative they were not available perioperative. The total blood loss was 3400 cc, patient was hooked up to a drip administer intravenous fluids (colloids and crystalloids), no inotropic support was needed. The target was patient’s blood pressure to be kept hemodynamically at low level 110_80 systolic and 60_40 diastolic with maintained mean ABP 65-50 mm Hg. Patient was transferred to ICU where he received 6 units blood, 6 units plasma, 2 vial fibrinogen, 4 units cryo ppt and he was extubated fully conscious and vitally stable after four hours.
Conclusion: Noninvasive and continuous Hb measurement could offer accepted range of accuracy for hemoglobin level especially with low hemoglobin levels and its impact on blood transfusion management. The specific case was tider for a series of publications in valid medical journals about noninvasive hemoglobin monitoring.
- Case reports on diabetis , Cardiology case reports , Gastroentrology case reports ,Adverse drug reaction case reports ,Neurology case reports , Obstetrics and Gynecology case reports ,Health administration case reports ,Surgery case reports
Session Introduction
Hila Yariv
Reuth rehabilitation hospital, Israel
Title: An investigation into the role of a rehabilitation hospital pharmacist in determining discrepancies and medication errors during patients admission
Time : 13:45-14:15
Biography:
Hila Yariv has completed her PhD at The Poznan University of Economics and Business and her Master’s in Pharmacy at The Robert Gordon University, Aberdeen. She has vast experience in working in many different health care settings with large number of pharmaceuticals and medical technologies. Her passion is for medical innovations that transform people’s lives and prevent and cure diseases. Today, she is the Chief Pharmacist at The Reuth Rehabilitation Hospital in Israel and serves as The Head of the "Drug and New Technologies Committee". She has published papers in reputed journals and has been teaching since 2002 in international settings ranging from higher education to various industries
Abstract:
Introduction: The importance of correcting medication errors at hospital admission is paramount for promoting an error free delivery and continuity of care. Recently stakeholders have paid considerable attention to patient safety in acute-care hospitals but less is known about discrepancies and medication errors during patients` admission in other health care settings such as post-acute care providers. An increased understanding of errors that occur in rehabilitation hospitals, would better equip stakeholders in taking actions to improve the safety of patient care in this unique setting.
Aims: The primary aim of the current study is to study pharmacist role in identifying and preventing an unintended medication discrepancies at the time of their hospital admission. The secondary objective is to study the source of error, type of discrepancy and class of medicine most frequently implicated during the transition of care from acute to rehabilitation hospital.
Methods: The researcher performed a retrospective investigation and study 356 patients with 3071 prescription medications referred from an acute hospital. The inclusion criteria also include ventilated patients over the age of 18 who received more than five prescription only medicines.
Results: Unexplained errors which resulted in a physician changes affected 154 patients, 43% of the total number of the study participants. The findings show that the most common cause of error found during the reconciliation of medicines at the point of admission is the use of patients own medications in the process.
Conclusions: Pharmacist plays an important role in determining discrepancies and medication errors during patients` admission. This study provides an insight to the discrepancies that occur in this unique setting. Stakeholders may wish to adopt the recommendations provided by the author and act in order to better patients' safety in rehabilitation hospitals. Some of the recommendations are also applicable to other health care settings.
Spyridon Bekas
University of Nicosia Medical School, Cyprus
Title: Case Report:A 25 - Year old male with Neuronal ceroid lipofuscinious caused by a mutation on CLN6 gene
Biography:
Spyridon Bekas has completed his BSc Genetics from University of Leeds, BSc Biomedical Sciences from University of Nicosia and MSc Biomedical Laboratory Sciences from Sheffield Hallam University.
Abstract:
Neuronal Ceroid Lipofuscinoses (NCLs) represent a group of neurodegenerative lysosomal storage diseases also known as Batten Disease. Batten Disease is hereditary and follows mainly autosomal recessive pattern of inheritance, affecting predominantly children. Some early to late adulthood forms which follow autosomal dominant pattern of inheritance have been reported. All the forms which are comprised in the group have similar progression and outcome. Each clinical phenotype differs on the age of onset and the specific lysosomal storage protein encoding gene mutation. Some of the typical disease phenotypes have been described and linked to a specific mutated gene. However, there are subtypes with variable disease onset, progression and outcome which do not have a known gene association. Several common clinical traits include; visual failure, epileptic seizures, dysarthria, ataxia, progressive psychomotor decline and death by the second to third decade of life. Here, we report the first documented case of Batten Disease in Cyprus: a 25-year old male diagnosed with the “Variant Late Infantile-onset”. The identified mutated gene is CLN6 which is located on chromosome 15 encoding for the TPP1 transmembrane protein. The parents went under genetic testing in order to identify the mutated gene and appear that only the mother is a carrier of CLN6 gene mutation. The age of onset of CLN6 is highly variable. Early feature of the specific type is epileptic seizures. Due to the variability of clinical features of Batten Disease, the diagnosis and the classification of the subtype is considered challenging. This variability might indicate how vulnerable different neuronal populations are.
Hela Sarray
Habib Thamer Hospital, Tunisia
Title: A large cardiac hydatid cyst in the interventricular septum
Biography:
Abstract:
Isolated cardiac location is uncommon presentation of echinococcosis (0.5–2%) and involvement of the interventricular septum is even rarer. It may lead to various complications because of rupture and embolization. We report the case of a 26 - year- old man who was diagnosed to have a large inter-ventricular hydatid cyst. Presentation, management and follow-up of the patient are discussed. This case is of particular interest because of the rarity of septal localization of a hydatid cyst, and the conflict between the severity of the complications that occurred and the absence of correlated symptoms.