Biography:

Adriano Carnerio  is currently an Oncological Surgeon of the Department of Surgery at the Federal University of Pernambuco, Brazil. He has obtained his Master's degree in Cancer and Oncology Surgery at the A.C. Camargo Cancer Center, Brazil. He is the Fellow of the Department Surgery and Cancer Hammersmith Hospital, Imperial College London 2013.

Abstract:

Background: Colorectal Cancer (CRC) is a neoplasia with high incidence and mortality rates. It had been suggested that the inflammatory response is an important CRC prognostic factor. The disordered and accelerated proliferation of neoplastic cells decreases the oxygen and nutrient supply, generating a microenvironment characterized by hypoxia, necrosis and inflammation.

Aim: This study aimed to evaluate the impact of factors associated with hypoxia, such as HIF1A (Hypoxia-Inducible Factor 1-Alpha) and VEGF (Vascular Endothelial Growth Factor) and with lipid metabolism, including PPARG (Peroxisome Proliferator-Activated Receptor-Gamma), LXRA (Liver X Receptor-Alpha) and LXRB (Liver X Receptor-Beta), on the Overall Survival (OS) of CRC patients.

Methods: This was a cohort study of 101 patients with high-risk stage II-III (TNM) CRC located above the peritoneal reflection. They were treated between 1990 and 2004 at the A.C. Camargo Cancer Center. Immunohistochemical analyses of HIF1A, VEGF, PPARG, LXRA and LXRB protein expression were performed using Tissue Microarrays (TMAs).

Results: There was an association between the presence of vascular invasion and the lack of VEGF expression (p=0.028) as well as with positive HIF1A expression and lymphatic invasion (p=0.045). The 5-year and 10-year OS rates were 76.6% and 60.2%, respectively. Patients with PPARG-positive tumors had a higher OS (p=0.018). There were no correlations between the positive expression of VEGF, HIF1A, LXRA or LXRB and OS. The Cox regression model demonstrated that the risk of death was 2.72-fold higher in patients with PPARG-negative tumors (95% CI=1.08– 6.85).

Conclusion: The PPARG expression was an independent prognostic factor for CRC tumors and might be used for risk stratification to stage II and stage III CRC patients.

Biography:

Ewa Kurowska is an Obstetrics and Gynecology Consultant in Medicover Hospital, Warsaw, Poland. She is the Head Doctor of Obstetrics and Gynecology Department.

Abstract:

Minimally invasive procedures has become preferable method of treatment because of its indubitable advantages such as less postoperative pain, short hospital stay, fast convalescence and small, invisible scars. But those advantages may become disadvantages with potential dramatic outcome at the same time, because of patients’ impression of light, small and not dangerous procedure which is not worth to be mentioned during medical interview. Frequency of uterine rupture during pregnancy is evaluated at 0.006-0.0125%. It rises during the labor to even 0.06%. The most common risk factor is previous cesarean section or other uterine surgery like myomectomy or hysteroscopic resection. As the first surgery is rather hard to miss, the next two, especially laparoscopic myomectomy can be forgotten by the patient. Because of obstetric and neonatal serious consequences we should pay very close attention to what and how we are asking patients about. We would like to present a case of primigravida, who was admitted to our Department because of short strong abdominal pain ca35 weeks of gestational age. She was in good general condition but because of rupture of the uterus and ablation of the placenta we diagnosed fetal death. Insufficiency of communications between doctor and patient may lead to fetal death and dramatic rescue patient’s procedure. We have to understand that important and obvious situations for doctor are not equal with patient’s priorities. That is why it is necessary to ask specific and simple questions during medical interview to make sure of detailed information.

Biography:

Jan Zivny has completed his M.D. in 1993 and Ph.D. in 2000 from First Medical Faculty of Charles University at Prague. He completed postdoctoral fellowship at the University of Alabama at Birmingham School of Medicine and ORISE fellowship at Food and Drug administration (FDA).  He is associate professor at the Institute of Pathological Physiology, First Faculty of Medicine, Charles University at Prague. His work focuses on the biomarkers endothelial activation in health and disease and on pathophysiology of hematological malignancies. He has published more than 40 papers in reputed journals.

Abstract:

Statement of the Problem: Complications during delivery may result in activation and injury of endothelial cells. There is limited information regarding endothelial dysfunction during pregnancy, delivery and in newborns. The purpose of this study was to explore biomarkers of endothelial injury in different modes of delivery and in newborns after delivery.

Method: The study group (Thomayer Hospital Prague, Czech Republic) consisted of mothers and their term healthy newborns after uncomplicated pregnancy and spontaneous delivery (Group A, n=24), after elective cesarean section (Group B, n=12) and after emergency cesarean section (Group C, n=13). Biomarkers were measured in cord blood and in newborns between 48 and 72 hours of life using multiplex immunoassays based Luminex®xMAP multi-analyte profiling platform. Paired t-test and Mann-Whitney test were used for statistical evaluation of the results.

Findings: Significantly higher concentrations of endocan, angiopoietin-2, VEGF and ICAM-1 were found in neonatal samples comparing to cord blood in all three groups (p<0.05). Significant differences were found in cord blood (endocan, angiopoietin-2, VEGF, endothelin-1 and endoglin) when comparing B and C groups (p<0.05).

Conclusion: We found different concentrations of endothelial markers in cord blood compared to neonatal samples. The measured markers according to the mode of delivery showed differences mainly between elective B and acute C cesarean section groups in cord blood. These results show significant changes in concentrations of several potential endothelial dysfunction markers during the first three days following delivery. Concentrations of endothelial markers may be influenced more by complication of pregnancy, e.g. hypoxia leading to acute cesarean section, than by mode of delivery itself.

Biography:

Haniyeh Bashizadeh-Fakhar has completed her PhD from Shahid Beheshti University of Medical Science, Iran. Her studies are on expression proteomics on cancer at Proteomics Research Center. She is working as an Assistant Professor in Azad University. She has published more than 15 papers in reputed journals.

Abstract:

Background & Aim: The risks of Ovarian Malignancy Algorithm (ROMA) and Human Epididymis protein 4 (HE4) appear to be the promising predictors of Epithelial Ovarian Cancer (EOC). However, conflicting results have been obtained in the diagnosis process when we compare ROMA, HE4 and CA125.

Method: The databases Medline/PubMed, Embase, Web of Science, Google Scholar, the Cochrane Library and ClinicalTrials.gov and full texts bibliographies were searched for relevant abstracts. EOC predictive value of ROMA was systematically evaluated and the predictive performance of ROMA, HE4 and CA125 were compared within the same population. In this meta-analysis, the pooled sensitivity, pooled speci­ficity, pooled AUC, pooled p-value of each tumor marker as well as pooled number of patients and healthy individuals were calculated.

Result: Based on meta-analysis of 9 studies, the total sample size was obtained, 785 patients and 667 healthy individuals. The overall estimates of ROMA for EOC predicting pre-menopausal women with 95% CI were sensitivity 86.9, specificity 085.52 and 0.9 AUC. ROMA for EOC predicting pre-menopausal women was sensitivity 90, specificity 80.84 and 0.9 AUC. The overall estimates of Ca125 and HE4 for EOC predicting with 95% CI were as follows, sensitivity (84.5 and 80.37), specificity (83.8 and 88.45) and AUC (0.85 and 0.87).

Conclusion: This meta-analysis is highlighted that ROMA can help distinguish EOC from the benign stage in post-menopausal women. ROMA is less specific but more sensitive than HE4. Both ROMA and HE4 are more specific than CA125 for EOC prediction. CA125 has a higher accuracy for diagnosis than HE4 for EOC. ROMA is a good predictor to replace CA125, but its utilization requires further exploration.

Biography:

Julie Sartori has 25 years of experience in Nursing and 5 years as a Research Assistant with projects such as the RAINE Study, Australian Fathers Study and Placenta Project. She has completed her Bachelor’s in Human Biology. She is a valuable member of the Placenta Project, which is instrumental in developing a research framework used to investigate maternal factors that can affect the growth and development of the placenta.

Abstract:

The quest to understand human conception and subsequent gestational development has evolved significantly over the past 2000 years. This collective knowledge has now culminated in the reproductive revolution of the 21^st century and is crucial to human reproductive development. Current research examining pre and post conception mechanisms, have allowed greater insight into the physiological cascade of events that result in successful pregnancy. These studies also highlight the impact of control mechanisms such as cytoplasmic inheritance and epigenetic regulation on birth outcomes. Human pregnancy is considered viable after three essential processes have occurred, fertilization, implantation and placentation. Preparation for fertilization involves a complex interplay between the maternal pituitary, ovarian and uterine axis. Implantation and placentation results from a complex cascade of events that are orchestrated by fetal, maternal and paternal biochemical signaling. Approximately 75% of unsuccessful pregnancies are lost during the early stages of conceptual development. This is primarily due to inability of the conceptus to attach and implant within the endometrial lining or erroneous modifications during normal trophoblastic differentiation. As part of the placenta project pregnant women from Perth, Western Australia, were recruited from private and public hospitals, with pregnancies resulting from both natural and assisted conceptions. Data will be presented from 630 participants, collected from Maternal Health Questionnaires, gross placental examination and maternal - neonatal medical records. A preliminary examination of current research data has resulted in new information that supports existing reproductive theories and encourages further examination of placental tissue. Using a conceptual approach, maternal factors will be used to highlight the importance of early reproductive mechanisms and the role of the placenta in successful pregnancy, prenatal development and potential long-term health outcome.

Biography:

Hisham Al Matubsi has completed his Graduation in Kuwait University in 1986 and postdoctoral studies in Victoria University, Australia in 1997. He is currently the professor of physiology in Al Mareefa College for Science and Technology.

Abstract:

To evaluate plasma Kisspeptin-10 (KP-10) and assess its relation to altered reproductive hormones in preeclamptic pregnant women. First time pregnant women n=100 at 20 weeks of gestation participated in this study and divided into pre eclamptics n=60 and normotensives n=40. KP-10, Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), beta-Human Chorionic Gonadotropin (β-HCG), Estradiol (E₂) and Progesterone (PRG) were evaluated during second and third trimesters of pregnancy for all women. Kisspeptin-10 levels were reduced in PE women compared with normotensive pregnancies. In 2^nd trimester, area under Receiver-Operator Characteristic (ROC) curve was 0.662, positive and negative predictive values were 32.8 and 94.6 and test sensitivity and specificity were 55% and 87.5%, respectively. In the 3^rd trimester, area under ROC curve was 0.747 positive and negative predictive values were 22.2 and 97.3 and test sensitivity and specificity were 83.3% and 67.5%, respectively. In PE patients, plasma KP-10 demonstrated inverse correlation with E₂ (during the 2^nd trimester), LH and FSH (during the 3^rd trimester) and positively correlated with β-HCG (during the 3^rd trimester). Relatively high KP-10 sensitivity with the largest area under the ROC curves during 2^nd and 3^rd trimester of pregnancy, suggesting that is statistically acceptable as a diagnostic screening tool to rule out the PE especially in 3^rd trimester.

Biography:

Mohammed Ashraf Puthiyachirakkal has completed his Medical School and Pediatric Residency from India. He has completed his Pediatric Residency from Brookdale hospital New York and Neonatal fellowship from Metrohealth Medical Center, Cleveland, Ohio and worked as Attending Neonatologist in Mercy St Vincent Medical center, Toledo. He also worked as Consultant Pediatrician and Neonatologist in Al Zahra Hospital Sharjah.

Abstract:

Human being harbors 100 trillions of microbes in the gastrointestinal tract, which is very diverse and dynamic. The microbiota starts to develop even in the fetal state and continue to develop to reach the adult level by 2-3 years of life. There are various factors involved in the colonization of these bacteria. These microbiota have role in the metabolism, immunologic development, epigenetic effects, act as energy sources, help in synthesis of vitamins, amino acid, have antimicrobial properties and detoxification effects. Alteration in the microbiota, dysbiosis is believed to be responsible for the development of allergic diseases, late onset sepsis, NEC, obesity and Type 1 diabetes. It is very crucial to understand the colonization process and the factors modulating the microbiota so that we can prevent the intestinal dysbiosis and future developments of the physical and behavioral problems.