Title: Botulinum Toxin Usefulness in the Treatment of Drooling in Childhood

Abstract:

Botulinum Toxin Usefulness in the Treatment of Drooling in Childhood

INTRODUCTION:
Drooling is a common and severe problem in different kind of disorders. It affects both adults and children and it is the cause for respiratory infections or dermal complications as minor social participation. Ultrasound botulinum toxin injections could be a successful option to reduce excessive sialorrhea in children independently whose origin it has.

METHOD:
Retrospective-descriptive survey. Period study: 2010-2019. Inclusion criteria: patients under 18 on severe drooling. Measure units: demographic data, glands injected, botulinum toxin dosage, side effects, intensity and frequency drooling scale (IFDS), and daily changes of bibs/tissues before and 1 month after ultrasound guided injection, use of sedation during procedure and feeding mode. Intervention was performed with ultrasound guidance of salivary glands (10 MHZ linear transducer: submental acoustic window of submaxilar glands and transverse scans of parotid glands)

RESULTS:
67 patients, 58,2% females. Mean age 9,03 (limits: 4-14 years). 46,3% were Cerebral Palsy patients. The most frequently gland infiltrated was submaxilar (53,7%). They showed severe drooling (65,7%) or profuse drooling (26,9%) and 88,1% constantly drooled pre treatment. Botulinum toxin total dosage average used, was 53,78 IU (Parotids/ submaxilar mean dosage: 23,06 IU/ 19,49 IU respectively). 30 day post treatment assessment: 6% no drooling and 68,6% mild or moderate drooling, 34,1 % occasionally drooled. Statistical significative difference (p <0,05%) pre-post infiltration. Daily bibs changes post-injection reduction: 48%. Non-response to toxin injection in ten of the treatment sessions: 14,9% cases. Side-effects: 2,98% (hematoma/ mild dysphagia). No differences observed by glands number injected, sedation procedure or underlying disease.

CONCLUSION:
Ultrasound botulinum toxin injections in children with severe drooling, demonstrated clinical improvement in reduction on saliva. The usefulness didn´t depend on the disease that originated the sialorrhea. Some children failed to respond to the treatment due probably to insufficient dosage, inadequate diagnosis or uncontrolled secondary drooling factors. Good results were possible with injections of two glands (instead of four), reducing side effects possibility.

Biography:

Paola Diaz Borrego has completed his PhD at the age of 27 years from Seville University and postdoctoral studies from Seville University School of Medicine. She is Physical Medicine and Rehabilitation Consultant, specialized in Phoniatrics, and the director of Phoniatric/Speech and Language Therapy Unit (Physical Medicine and Rehabilitation Department) in Virgen Macarena University Hospital, Seville, Spain. She has published more than 20 papers in reputed journals and has been serving as an editorial board member in several journals as: Rehabilitacion (Madr), Neurology &Neurosurgery, Ocronos.

Title: Uniform Practice for the Prevention of Healthcare Associated Infections and Occupational Therapy in Pediatry & Neonatology

Abstract:

Uniform Practice for the Prevention of Healthcare Associated Infections and Occupational Therapy in Pediatry & Neonatology

Hygiene rules and practices for preventing healthcare-associated infections evolve with the readjustments in line with advances in science and technology. The awareness that basic health principles are, in some cases, difficult or even impossible to put into practice for various reasons is shown by the current global health crisis caused by Coronavirus strains. Management of political authorities, lack of information, difficulties of access to training, fake news, popular beliefs, individual defensive reactions, individual characteristics of the population and professionals, including patients and their families in pediatrics and neonatology, equipment and procedures that are still not appropriate to prevent the cross transmission of healthcare-associated infections. For example, equipment used for occupational therapy care is very often shared without the possibility of disinfection between patients. The architectural environment of structures, workshops and liberal occupational therapy practices (differentiation of public reception, care, cleaning, disinfection and waste disposal areas, and finally clean storage) do not always allow basic hygiene tasks to be carried out (and when they are carried out, in the right order). There is a real obstacle to the change in practices that is necessary to provide the care that the public expects from professionals.

Biography:

Guylaine HENRY LAMY has been addressing AIAS transmission issues since 2012. She has established close ties with eminent hygienist and ministerial referents. In 2016, she conducted a survey to take stock of the situation among 100 liberal occupational therapists, and wrote articles, one of which was published in the magazine. Today she is the director of a DPC training organization to promote the Hygiene and Health Safety of Occupational Therapy Care.

Title: Overpopulation and Voluntary Family Planning: Setting a New Health Political Agenda

Abstract:

Overpopulation and Voluntary Family Planning: Setting a New Health Political Agenda

Voluntary family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through use of all available contraceptive methods. Family planning is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts.

Contraceptive use has increased in many parts of the world, especially in Asia and Latin America, but continues to be low in sub-Saharan Africa. Nevertheless ‘Three Successful Sub-Saharan Africa Family Planning Programs’ show how African best practises of Ethiopia, Rwanda and Malawi share a common strategy: Contraceptive prevalence has risen steadily from a low starting point and moved upward sharply in most years in all three countries: from 2000 to 2011 in Ethiopia from 6.3% to 27.3%, in Rwanda from 5.7% to 45% and Malawi from 26.1% to 42.2%. Such progress is helping these countries move closer to what the development community calls “the demographic dividend”.In particular these achievements have been possible due two main strategies:

1) countries dramatically reduced financial barriers to access modern contraceptives.

2) huge task shifting, reducing physical distances from the poorest to the provision of services have been done with training schemes: provision of long-acting family planning methods shifted from doctors (therefore from hospitals) to nurses at the health centre level while provision of condom and pills shifted from nurses (health centre level) to trained community health workers, present in every single village. most recent WHO published data estimate that 214 million women of reproductive age in developing regions who want to avoid pregnancy are not using a modern contraceptive method: a huge unmet need. According to WHO and UNFPA, providing access to these women would prevent 67 million unintended pregnancies and would reduce induced abortions from 48 million to 13 million. It would also reduce maternal deaths by 76,000 per year, new-born deaths from 2.9 million to 660,000 per year and HIV infections in new-borns from 130,000 to 9,000.

Biography:

Michele Usuelli has lead and managed the neonatal emergency transport system, STEN. He is lead and managed clinical and research program of Neonatal care in developing countries for 7 years. He is a senior neonatologist at 3rd level NICU with capacity of managing up to 25 ventilated newborns, pre-post operatory management of surgical newborns, intensive/subintensive NICU and the biggest public in Italy. At present on leave. Since May 1st I have been elected in the regional assembly of Lombardy. (In Italy health is directly managed by regions).

Title: Advancement Treatment for Neonatal Development

Abstract:

Advancement Treatment for Neonatal Development

There are various risk factors to neonatal development during neonatal period at the first four weeks of a child’s life. Neonatal development in this period, it presents critical in brain-nerve system maturation, cardiovascular and pulmonary development, this time for a child face to risks at developing of different diseases:

1. Fetal Diseases, as Fetal Nutrition Disorders or Fetal Oxygen Distress;

2. Hereditary Diseases, as Kartagener Syndrome or Cystic Fibrosis;

3. Congenital Abnormal Diseases, as Digestive System Abnormalities or Cardiovascular Abnormalities;

4. Newborn Diseases, as, Persistent Fetal Circulation Syndrome, Neonatal Respiratory Distress Syndrome. And Immunology Immaturity

Neonatal development has studied, and genetic reasons are in basic role to develop diseases of Hereditary Diseases and Congenital Defect or Newborn Diseases. Environmental risk factors are also observed to neonatal development, the risks to neonatal are either from maternal or from the child self by mediated with the factors of infection, nutrition or function immaturity.

The advance treatment in neonatal is applied in life support treatment with oxygen supply, monitor observation and warm keeping assistant machine; pharmacology therapy, surfactant replacement or nitric oxide inhalation therapy and ECMO in pulmonary cardiological support therapy to clinical abnormal presentation. Medical Collaboration has role in critical care for neonatal diseases, there have Neonatal Intensive Care Unit, ambulance transfer and basic research based on national trust groups.

Biography:

Dr. Yan Wang is a doctor and scientist in Medicine Science, she has Medicine Bachelor degree(M.D) in General Medicine and Pediatrics in 1990, and she also has the Doctoral Philosophy Degree(Ph.D) in Emergency and Pulmonary Medicine in 1998 from the Fudan University Medical School in China. She has worked in postdoctoral Scholar and investigator role in the United States of America since 2000 at the University of Miami Medicine School, Jefferson Healthy System Albert Einstein Medical Center and University of Pennsylvania Medicine School. She has critical working experience at the Imperial College in London in 2014. Currently she is attending doctor, professor, author, leader and committee member at hospitals, universities, organizations and Journal Presses with appointed positions.

She has published first-authored articles on peer-reviewed journals and conference abstracts about 100 products, She has written medical books over 10 books in English versions published in the United States or the United Kingdom. Her publications reflect her contribution at Science, Medicine and special Pediatrics. As well, she has working experience at speeches, teaching-courses, textbook and news release during the past more than 25 years longer.

Currently she is in charge of ongoing scholarly project as writing medical books and being organization committee; as she is in endeavor of awarded or honored in science achievement and spiritual life, it has included in my article and theory.

Title: Efficacy of Pediatric Integrative Manual Therapy in Positional Plagiocephaly

Abstract:

Efficacy of Pediatric Integrative Manual Therapy in Positional Plagiocephaly

Biography:

Iñaki Pastor Pons is an expert physiotherapist in child development and neurodevelopment. He is a direct the Institute of Integrative Therapies in Zaragoza, and He have created an international project called TMPI-PIMT (Pediatric Integrative Manual Therapy) in order to improve the way in which child development is used as a supportive tool for both families, as well as professionals and institutions throughout the world. Through his publications as well as his work as a trainer and speaker, he have successfully attempted to focus on the connections between different areas of knowledge and professional disciplines, that should always have worked together for the best development of babies and children.

Title: Regenerative Medicine in Paediatric Age

Abstract:

Regenerative Medicine in Paediatric Age

Actual indications of PRP, lipofilling and SVF therapies to reconstruct defects in children. Biocompatibility and disponibility have guaranteed the frequent use of adipose tissue as graft to reconstruct soft tissue defects of the face, above all, in paediatric patients, in wich survival was apreciated superior and in wich implantation of other materials may origin complications and secuelae at very early ages. A survival analysis has been realized with the stereologic method in order to quantify the grafts take tax and to study differences between adult and childhood groups. This volumetric analysis evidenced a high survival of fat grafts in infants (93%), significantly superior than in adults (63%) in fifteen months follow-up, allowing us to conclude that these regenerative techniques offer a real guaranty of success, although partial and non ever lasting, with good clinical results in selectioned paediatric patients.

Biography:

EDUARDO SERNA CUÉLLAR is a Basic investigator in several areas of Plastic Surgery: Autologous Fat Grafts Survival on the face; Translational investigations with adult stem cells; Protocol of extraction and processing of ADC and SVF cells from adipose tissue; Epidemiology and basic techniques of hair transplants; Safety of breast implants and breast meshes; Clinical use of fillers in Aesthetic Medicine.

Experiences:

1. Sub-Investigator: Cellular Markers in Breast Cancer Prognosis. La Paz University  Hospital-Health Ministry, 1995.

2. Principal Investigator: Stereologic Quantification of Autologous Fat Grafts Survival. La Paz Hospital-UAM, 2002.

3. Pioneer Investigators Team: Translational Researching with Adult Stem Cells for Crohn´s Disease. La Paz H., 2003.

4. Principal Investigator: Several phase III clinical trials of plastic surgery speciality. Valdecilla University H., 2008.