Day 2 :
Keynote Forum
Joel Gailledreau
Cabinet Medical Ambroise Pare, France
Keynote: How the administration of self questionnaires may help refer a mentally ill patient to the most appropriate therapist
Biography:
Joel Gailledreau is the Head of the Private CIC Ambroise Paré and General Manager of PsyLib. He has founded PsyLib with the vision of helping people to access to high quality psychiatric and psychologist care, wherever they live. He has been working in the field of clinical research for 36 years and has acquired an expertise in managing psychiatric and psychologist scales and questionnaires. He is the Former President of the GICIPI, group of French investigators in clinical trial.
Abstract:
Aim: The aim of this study is to assess the sensitivity and the specificity of a diagnosis procedure issued from analysis of the data of a set of self-questionnaires: HAD (Hospital scale for Anxiety and Depression) (Sigmund & Snaith), PDQ4 (Personality Diagnostic Questionnaire 4th Edition), Spiegel, Epworth, ASEX (Arizona Sexual EXperience Questionnaire) and CBI (Copenhagen Burn out Inventory).
Method: Every patient requesting mental health care to our center, along with every victim and criminal offenders sent by justice from September 1st, 2017 to March 1st, 2018 completed this set of self-questionnaires of the PsyLib.fr web site. For each of them, the diagnosis procedure generated one diagnosis hypothesis (Dg A). Next, each of them had a clinical interview with a psychiatrist or a psychologist, blind from the questionnaire data and received a clinical diagnosis (Dg B). Three diagnoses were assessed: Characterized Depression (MDD), General Anxiety (GAD) And Post-Traumatic Stress Disorder (PTSD). For each of these diagnoses, the sensitivity was defined by the percentage of Dg A among the participants with Dg B and the specificity by the percentage of Dg B among those with Dg A.
Result: Data from 155 patients, 97 victims and 66 criminal offenders were computed to generate Dg A. A total of 123 participants received a diagnosis of MDD, 78 of PTSD and 117 of GAD. The diagnosis procedure generating Dg A had 95% sensitivity for MDD, 100% for PTSD and 81% for GAD. The specificity was 88% for MDD, 94% for PTSD and 69% for GAD.
Conclusion: Analysis of self-questionnaire data may provide a real help in pre assessing patients, victims and even offenders before referring them to the most appropriate therapist.
Keynote Forum
Valerie Adrian
Bordeaux Universitary Hospital, France
Keynote: Transgender coming out in adolescence: Co-innovating therapeutical setting
Time : 10:10-10:50
Biography:
Adrian Valerie is a Child and Adolescent Psychiatrist working at Bordeaux University Hospital in the Reference Center for Transgender Youth and Reference Center for Adolescence Psychopathology directed by Professor Bouvard. She is a Member of the French Association of Clinical Research for Adolescence (ARCAD), Member of the French Society for Child and Adolescent Psychiatry (SFPEADA), Member of the Société Medico-Psychologique (SMP) and Reviewer for L’Encephale.
Abstract:
Nowadays, the concept of transsexualism has evolved to the concept of transidentity while the binarity of gender has been replaced by gender creativity and fluidity. In a context of contemporary digital revolution, the number of transgender coming-outs in adolescence has grown significatively.Three years ago, we created a clinical center for adolescents with gender dysphoria. We provide psychopathological evaluation and care as well as access to medical Standard of Care for transgender youth. Living his transidentity at adolescence appears to be an individual and self-created process co-occuring with the developmental one. Furthermore, as coming-outs are challenging parentality in a new way, innovating therapeutical settings are needed. From watchful waiting to supporting social transition (including use of new name and prounom, changes in gender role, changes in physical appearance) and access to hormonotherapy, the transgender process in adolescence invites the therapist to co-create and therapeutical setting with the adolescent and his/her parents. We will propose to discuss the role of narrativity in the transgender coming-out process. Supporting narrative skills may be an efficient therapeutic tool that helps the construction of a narrative identity, as defined by the philosopher Paul Ricoeur and allows to take into account the importance of cultural and transgenerational considerations.
Keynote Forum
Gerald C Hsu
EclaireMD Foundation, USA
Keynote: Using math-physical medicine to study the probability of having a Heart attack or stroke based on combination of metabolic conditions, lifestyle and metabolism index
Biography:
Gerald C Hsu has completed his PhD in Mathematics and majored in Engineering at MIT. He attended different universities over 17 years and studied seven academic disciplines. He has spent 20,000 hours in T2D research. First, he studied six metabolic diseases and food nutrition during 2010-2013, then conducted research during 2014-2018. His approach is math-physics and quantitative medicine based on mathematics, physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning and AI. His main focus is on preventive medicine using prediction tools. He believes that the better the prediction, the more control you have.
Abstract:
Background & Aim: The author has extended his 8-year T2D research along with ~1.5M data to examine the relationship among metabolic conditions, lifestyle, metabolism index, and the probability of having a heart attack or stroke.
Material & Methodology: In 2014, he researched and built a metabolism model to measure the multiple interactions of four metabolic disease outputs and six lifestyle inputs. Initially, he chose age, gender, race, family history, smoking, drinking, substance abuse, personal medical history and waistline to establish a static baseline. He then applied the hemodynamics concept to develop a dynamic macro-simulated model for blood blockage and artery rupture. He utilized 368,513 data which include 72,893 metabolic conditions (obesity, diabetes, hypertension, hyperlipidemia) and 295,620 lifestyle conditions (food, exercise, water, sleep, stress, daily life routine) within 2,274 days (1/2012-3/2018) to compute three different sets of risk probabilities separately. Finally, he integrated them into one overall risk probability. He also conducted sensitivity analyses to cover the probability variance by using different Weighting Factors (WF).
Results: The risk probabilities are 74% in 2000 (followed by three cardiac episodes 2001-2006) From 69% in 2012 decrease to 26.4% in 2017 (compatible with 26.7% by Framingham Study) WF sensitivity: ±10% to 18%.
Conclusion: The mathematical simulation results are validated by past 17-years health examination reports. This big data dynamic simulation approach using math-physical medicine will provide an early warning to patients with chronic disease of having a heart attack or stroke in the future.
- Thyroid Disorders
Session Introduction
Philip James
W. P. Carey School of Business -Arizona State University, USA
Title: What every doctor needs to know about personal branding: 2019 and beyond
Biography:
Abstract:
- Poster Presentations
Session Introduction
Gernot Kriegshausera
Vienna University, Austria
Title: Serum lipid profiling in individuals with and without depression
Biography:
Abstract:
Statement of the Problem: So far, studies on the association of serum lipid levels and depressive disorder are contradictory. Therefore, the objective of the this study was to investigate possible associations between serum lipid alterations in a large sample of well-characterized patients including men and women over a broad age range sub-grouped by the presence or absence of major depression.
Methodology & Theoretical Orientation: A total of 246 participants aged between 18-70 years were recruited of whom 94 suffered from major depressive without any other psychiatric comorbidity. A total of 152 individuals with neither a depressive symptomatology nor a former history of psychiatric disorder served as healthy controls. All study participants filled out the Beck Depression Inventory (BDI-II) questionnaire and were investigated for their complete lipid status (i.e., triglycerides, total cholesterol, LDL/HDL-cholesterol).
Findings: 94 patients with major depression showed significantly higher median (interquartile range) serum triglyceride levels (108.0 [75.8-154.1] vs. 84.0 [63.0-132.2] mg/dL, p=0.014) and significantly lower HDL-cholesterol levels (55.0 [46.9-123.0] vs. 61.5 [47.4-72.6] mg/dL, p=0.049) compared to 152 individuals without depression. Significant positive correlation was found between triglycerides, total cholesterol and LDL-cholesterol concentrations and the BDI-II score (p=0.027, 0.048 and 0.018).
Conclusion & Significance: Depressive individuals were found with adverse serum lipid patterns of higher triglycerides and lower HDL-cholesterol levels compared to healthy controls. On this basis, the authors would suggest the implementation of routine serum lipid measurements in order to stratify these patients by their cardiovascular risk.
Hastuti Sri
University of Syiah Kuala, Indonesia
Title: Benign Epilepsy of childhood with Central-Temporal Spikes
Time :
Biography:
Hastuti Sri is a Lecturer and Neurologist in Aceh Province, Indonesia. She worked as Faculty of Medicine at Syiah Juala Universit. She completed her Specialist Education at the University of Indonesia. She worked as a Neuropediatric Fellow at University Malaya Medical Center, Kuala Lumpur. She is a Staff of Neurology Department, Zainoel Abidin Hospital, Banda Aceh, Indonesia, Staff of Neuropediatric Division in Neurology Department, Zainoel Abidin Hospital, Banda Aceh Indonesia and Lecturer of Medical Faculty, Syiah Kuala University, Banda Aceh, Indonesia.
Abstract:
Background & Aim: Benign Epilepsy of Childhood with Central-Temporal Spikes (BECTS) is the most common focal epilepsy. It is more common in males and the onset between the ages of 3 and 13 years. Onset of the seizure is during sleep, the incident reaches until 80% of time. The clinical manifestations that mostly appear are secondary generalized seizure with a facial/perioral focal onset. The focal, perioral seizure will be reflected either in the aura or in the form of temporary postictal signs or symptoms. The typical features of this seizure include unilateral paraesthesia of the tongue, lips, gums or cheek; speech arrest, hyper salivation, poor swallowing postictally; involuntary movement of the tongue or jaw; or clonus affecting one side of the face. The feature of EEG is diphasic sharp waves in the central-midtemporal area and usually activated by sleep and unilaterally appears in any given EEG recording. The treatment is required if the seizures are frequent or long and typically respond well to carbamazepine, gabapentine, levetiracetam, sultiame or sodium valproate. Aim is to identify clinical features of signs, symptoms and characteristic of EEG pictures.
Method: Observational descriptive study of patient’s medical records. Case report is of 11 years old girl who has got epilepsy from 9 years old. Seizures occur with facial twitching and eye blinking. Patient came in for breakthrough seizure which occurs upon sleeping during bedtime, sometimes upon awakening. No preceding aura, but her mother noticed the automatism (lip smacking) prior to seizure attack. Semiology shows generalized tonic clonic seizure with lip smacking, head version to right. No frank serotyped eye movement (sometimes uprolling of eyeballs/eye deviation).
Findings: EEG examination found during sleep showed occasional low voltage stereotyped sharp wave discharge was seen independently over the right and left central-temporal region. These discharges activated in sleep and become bisynchronous. The EEG indicates that the child has a liability to benign rolandic epilepsy (Benign Epilepsy with Centro-Temporal Spikes (BECTS). No clinical events seen throughout recording.
Conclusion: The secondary generalized seizures that happen in childhood especially with perioral and facial signs and symptoms should be suspected as BECTS and should be confirmed by EEG examination. This seizures only need to be treated if its happen frequently. But 90% of these symptoms achieve remission within several years and most by the age of 16 years.
Si Nae Kang
Seoul National University College of Medicine, Republic of Korea
Title: The association between risk of metabolic syndrome and occupational, leisure-time and commuting physical activity in Korean workers: KNHANES 2014-2016
Biography:
Si Nae Kang is medical doctor specialized in Family Medicine, currently has been research fellow in Department of Family Medicine, Seoul National University Hospital, with experience in research, evaluation, teaching . She has special interest in Health promotion and Public health and conducted research on Korean smokers last year. She has developed pilot project of visiting care system for elderly, that is operated successfully now.
Abstract:
While the relationship of leisure time physical activity (LPA) and metabolic syndrome (MetS) is well documented, effect of occupational physical activity (OPA) on MetS is conflicting. Aim of this study is to examine the relationship between different type of physical activity and risk of metabolic syndrome using a representative sample of South Korean adults.
Study included 7057 workers (3795 men and 3262 women) aged 20 to 65 without cancer and arthritis at baseline, from the Korea National Health and Nutrition Examination Survey in 2014-2016. Information on OPA, LPA and commuting physical activity (CPA) were self-reported and blood pressure and biochemical determinations of the blood were also obtained. MetS was defined as the presence of three or more of the National Cholesterol Education Program-Adult Treatment Panel III criteria. Chi-square test and multiple logistic regression analysis were used to investigate relationship between different type of physical activity and MetS.
The prevalence of MetS was 25.7 % in the study subject. The percentages of active OPA in MetS and non-MetS groups were 6.7% and 5.0%, respectively. Compared with inactive level of LPA, sufficient level of LPA showed a significantly lower risk of MetS (OR 0.73, 95% CI 0.60-0.89) after adjustment for confounding factors. Conversely, active OPA showed increased risk of MetS (OR 1.09, 95% CI 0.77-1.52), but not reaching statistical significance. CPA was not associated with MetS.
LPA showed protective effect of MetS, but OPA showed marginal negative effect on MetS. This difference needs to be considered when recommendations for prevention of MetS are developed.
Gong Deuk Bae
Lee Gil Ya Cancer and Diabetes Institute, Republic of Korea
Title: Effect of liquiritigenin on apoptotic beta-cell death by palmitate-induced lipotoxicity in INS-1 cells
Biography:
Gong Deuk Bae is a PhD course student in Gachon university. His research topic is The effect of natural products on the prevention and treatment of type 2 diabetes focusing on pancreatic beta-cells.
Abstract:
Objective: Activation of estrogen receptor signaling plays an important role to preserve functional beta‑cell mass in treatment of diabetes. Liquiritigenin (LQ), a flavonoid isolated from Glycyrrhiza uralensis, is an estrogenic compound which acts as an agonist for the estrogen receptor β. In this study, we investigated protective effect of LQ on palmitate (PA)-induced apoptosis in INS-1 cells.
Methods: To examine effect of LQ on beta cells, glucose stimulated insulin secretion (GSIS) by enzyme immunoassay (EIA) method and cell viability by MTT were measured in rat beta-cell line INS-1 cells. To induce lipotoxicity, PA (400 μM) was treated for 24 h and amount of apoptotic cells were analyzed using a flow cytometer with annexin-V staining. Expression level of apoptotic proteins and endoplasmic reticulum (ER) stress markers were analyzed by western blot analysis after LQ treatment. Tunicamycin and thapsigargin were used to ER stress inducer and AKT inhibitor (AKTi-1/2) was used to inhibit LQ-induced AKT phosphorylation at ser 473.
Results: Exposure of INS-1 cells to 5 μM of LQ significantly increased GSIS as well as cell viability. PA treatment increased annexin-V stained cells and apoptotic proteins such as cleaved caspase-3, cleaved poly (ADP-ribose) polymerase and bax, but these increases were significantly inhibited by LQ treatment. LQ treatment inhibited cell death by ER stress inducers and PA induced ER stress marker proteins such as CHOP and phosphorylated forms of PERK and eIF2α was also significantly downregulated in LQ treated cells. LQ phosphorylated AKT at ser 473 via estrogen receptor element dependent pathway and blocking AKT signaling inhibited LQ induced decrease in level of phosphorylated PERK, consequently cell viability was not recovered.
Conclusion: Our data demonstrated that LQ has anti-apoptotic effect against PA induced lipotoxicity and AKT mediated ER stress inhibition was involved in the anti-apoptotic effect of LQ.