Day 1 :
Keynote Forum
Wagih El Masri
Keele University, USA
Keynote: Traumatic spinal cord injuries (SCI): Prognostic indicators of neurological recovery – Contribution of early clinical and radiological findings
Time : 9:30am to 10:15am
Biography:
Wagih El Masri WEM trained in the speciality of spinal injuries at Stoke Mandeville, Oxford, Guys Hospitals & the USA between 1971 and 1983. To date he personally treated 10,000 Patients with traumatic Spinal Injuries acute, sub-acute, rehabilitation phases as well as in the Long term. He is the author of the concept of “Physiological Instability of the Injured Spinal Cord “and an advocate for the evidence-based Active Physiological Conservative Management of the patient.
Abstract:
The management of traumatic spinal cord injury (TSCI) has remained controversial since the early 19th century. Better understanding of the Biomechanical Instability (BI), the development of CT and MRI; improving instrumentation & increased safety of anaesthetic resulted in a change of practice from Active Physiological Conservative Management (APCM) of the spinal injury and all its effects to a focused surgical management of the spine often with little attention to the multi-system physiological impairment and malfunction and the non-medical effects of cord damage. Surgical stabilisation is undoubtedly beneficial to patients with injury of the bony spine with intact neurology. Although these patients can be treated with APCM of their spinal injury, Surgery will expedite their discharge from hospital ie the patient can be discharged home within a few days of surgery. The short, medium and long term outcomes in terms of pain and range of movement of the affected region of injury are however unknown following surgery. A TSCI results in a multi-system impairment and malfunction, paralysis, sensory loss and a potential wide range of medical and non-medical complications. The injured spinal cord is Physiologically Unstable and can be further damaged by non-mechanical complications. Hypoxia, hypertension, hypotension, sepsis, hypothermia, fluid overload can easily occur causing more neurological damage. Patients require scrupulous simultaneous attention of all effects of paralysis to ensure: maximum neurological recovery, prevent complications including pain, maximum range of movement of the spine and independence to minimise cost of support in the community, safe and convenient functioning of all body systems, long term maintenance of health to minimise readmission with complications and enable patient to contribute to the society. The prognostic indications of neurological recovery following APCM have been repeatedly documented in the last seven decades. Although there are some claims that early surgery may may yield better outcomes than late surgery; there has been no attempt to compare the outcomes of surgery with those of APCM. The early prognostic indicators of neurological recovery during the first 48-72 hours of injury, the value of any initial neurological sparing however little and in particular the value of pin prick sensory sparing down to the second sacral segmental distribution of the spinal cord will be demonstrated. The insignificance of the BI, Canal encroachment and Traumatic Cord Compression as prognostic indicators of recovery provided the patient is adequately treated with APCM and the possible advantages, disadvantages, complications of Surgical Stabilisation, Surgical Decompression and APCM will be discussed.
Keynote Forum
Umur A Kayabasi
Istanbul Medical Faculty, Turkey
Keynote: Tau protein in the retina
Time : 10:15 to 11:00
Biography:
Umur A Kayabasi, MD. Being a graduate of Istanbul Medical Faculty completed his neuron-ophthalmology clinical fellowship at Michigan State University, MI in1995. He also worked as a researcher and server at the neuron-ophthalmology department of Wills Eye Institute, Philadelphia, PA in 2007. He has been working at World Eye Hospital, Istanbul for three years. He has written chapters in different books and published and presented many clinical studies and cases.
Abstract:
Background: Recent research suggests that Tau is the culprit lesion along with neuroinflammation in the etiology of Alzheimer' s Disease (AD). Retina is the extention of the brain and is the most easily approachable part of the central nervous system. Detection of the pathological protein accumulations may be possible by using spectral domain optical coherescent tomography (SD-OCT) and fundus autofluorescein (FAF). There is evidence showing that retinal plaques start accumulating even earlier than the ones in the brain. Most recent Tau protein images in the brain consist of normal or reverse C-shaped paired hellical filaments.
Methods: 20 patients with PET proven AD were examined by SD-OCT and FAF. Mean age was 72. Hypo or hyperfluorescent retinal lesions were scanned by SD-OCT and C shaped paired hellical filaments were investigated in a masked fashion. The researchers agreed on the shape of the lesions. Both C-shaped (normal or reverse) filaments and thinner fibrillary structures were taken into consideration.
Results: In all the patients, paired hellical filaments that exactly corresponded with the histopathologic and cryo-EM images of Tau in terms of shape and dimension were detected along with thin fibrils and lesions similar to amyloid beta. The number of the retinal filaments and other abnormal proteins was in concordance with the severity of the disease process. The advanced retinal filaments had normal or reverse paired C shapes and thin fibrils had the shape of histopathologic images seen in early developmental stages of the disease.
Conclusions: Retinal images of Tau were disclosed for the first time in live AD patients. Retinal neuroimaging is a trustable biomarker and tool for monitoring the disease
Keynote Forum
Yavuz Selim Silay
ICG (Istanbul Consulting Group), Turkey
Keynote: Current trends in physician entrepreneurship in USA, Europe, Turkey & emerging markets
Time : 11:15am-12:00 pm
Biography:
Yavuz Selim Silay is the chairman of Istanbul Consulting Group. ICG(Istanbul Consulting Group) was founded in 2013 and provided guidance to the Turkish ministry of health as part of a World Bank project.Yavuz is currently the Co-Founder of BioCube Ä°stanbul Bioentrepreneurship & Innovation Center and Corporate Communication Director of Sumitomo Group/ Expel Ä°laç Archem Diagnostices Endmed and Diagen. He previously managed the largest distributor of Siemens Healthcare in Turkey managing 250 employees and director of Avcılar Hospital R&D Center, Chief Medical Officer of Lifematrix GmbH. Previously he worked as the Market Access & Health Policy Director for AIFD in Turkey. Yavuz previously worked as the Vice President of Ipsen pharmaceutical and Director of Teva pharmaceutical in USA managing large clinical trials as well as Investigator Initiated Trials and developing relationships with Key Opinion Leaders. Previously, Yavuz was the Associate Director at KV Pharmaceuticals and Director in Clinical Development department at Forest Laboratories. Yavuz earned his MD from the Faculty of Medicine, the University of Ankara in Ankara, Turkey. He completed a clinical internship at Baylor College of Medicine in Houston, followed by continued research training at The University of Texas MD Anderson Cancer Center in Houston. He recently completed his Executive MBA at the Olin Business School at Washington University in St. Louis. Yavuz currently resides with his wife Dr Kamile Sılay and their two daughters and one son in Ankara, Turkey.
Abstract:
Pharmaceutical, Biotech and Medical Device companies are constantly evaluating how innovation management can be improved and managing expectations of Key opinion leaders. To gain these critical insights for Physician Entrepreneurship, Our goal at Society of Physician Entrepreneur is to accelerate innovations in order to improve healthcare. We seek to empower doctors, other healthcare providers and entrepreneurs with the information, resources, connections, and experience they need to commercialize their ideas, inventions and discoveries. Current Trends in Physician Entrepreneurship in USA Europe. Turkey and Emrging Markets will be provided with unique cases. Dr. Yavuz Selim SILAY a global leader and seasoned expert in Physician Entrepreneurship, Government engagement, Commercial Diplomacy, Corporate Communications, Government affairs & Medical Affairs will discuss how Venture Capital and angel Invetstment networks are utilizing physician entrepreneurs to acquire these insights in a convenient, cost-effective, and compliant manner in this current changing global entrepreneurial
landscape.
- Stroke Rehabilitation and Brain Hemorrhage | Neurophysiology and Neurodegeneration| Neuroplasticity and Blood Brain Barrier
Location: Akdeniz 3
Chair
Gülçin Gülşen
Florence Nightingale Hospital, Turkey
Session Introduction
Mahmoud Mando
Abha Private Hospital, Saudi Arabia
Title: Medical complications of brain tumors
Time : 12:00-12:30Pm
Biography:
Mahmoud Mando, Neurologist & Neurophysiologist, Board certified since 2008, currently practicing Neurology at Abha Private Hospital / Saudi Arabia. Pain Management Fellowship / India / 2016. Has published several books and released several articles.
Abstract:
Clinical studies and systematic reviews published in recent years have improved knowledge regarding the incidence of neurologic and medical complications occurring in patients with primary brain tumors. Studies in tumor-related epilepsy and venous thromboembolism provide data for the clinician to make Evidence-Based decisions about perioperative management, prophylaxis, and therapy. Patients with brain tumors experience unique toxicities related to novel drugs and chemotherapeutics that result in hematologic, infectious, and endocrine disorders. Recent work that has focused on quality of life in patients with brain tumors highlights the importance of good supportive care and optimal medical management of neurobehavioral symptoms And late complications of treatment.
Gulcin Gulsen
Florence Nightingale Hospital, Turkey
Title: The Effectiveness of Continuous passive motion and Pilates Exercise in People with Chronic Stroke
Time : 12:30Pm - 13:00PM
Biography:
Gülçin GülÅŸen completed her medical education in the Faculty of Medicine at Ä°stanbul University. In 1983. S he started his specialization in 1990 at ÅžiÅŸli Etfal Hospital Physical Therapy and Rehabilitation Clinic. She completed her specialty training in 1994. Between 1994 and 2005, she worked as a specialist doctor and clinical chef at Istanbul Physical Medicine and Rehabilitation Training and Research Hospital. He received the title of Associate Professor in 2000. Dr. Gülçin GülÅŸen has been the head of the Physical Therapy and Rehabilitation Department at Yeditepe University since 2005 and the head of Physical Therapy and Rehabilitation at the Faculty of Health Sciences at Yeditepe University. As of December 2017, Prof.Dr. Gulçin GulÅŸen, evaluate the patients with technological equipment and scientific approaches and benefit from the treatment facilities in Florence Nightingale AtaÅŸehir hospital
Abstract:
The aim was to determine whether strengthening of the lower limbs can improve strength, balance and walking abilities in patients with chronic stroke. This study was to observe the influence of continious pasiive motion and ilates training on balance ,walking and quality of life in chronic stroke (hemiparetic)patients. Forty-six chronic stroke patients participated in this study. They were divided into same number of work group (WG) and control group (CG) A 16-week (3 days/week) program consisting of a warm-up, 25 minutes continious passive motion(CPM) and 15 minutes pilates exercises, ool-down. Control group subjects received only routine exercises of hysiotherapy Before the training, the patients were evaluated using the balance Berg and MMSE tests, 5 repetition sit-to-stand test (STST), Stroke Impact Scale (SIS),spasticity(Aschworthpeterson scale) This study demonstrated that individuals with chronic stroke whose lower extremity function is compromised in a normal gravity environment can perform reaching and drawing movements while using CPM and pilates exercises. By comparison of the results before and after intervention, these chronic stroke patients presented significant reduction in balance Berg and MMSE tests, 5 repetition sit-to-stand test (STST), Stroke Impact Scale and 10-minute walking speed (p<0.01) The findings provide initial evidence that CPM and Pilates exercise can enhance balance, walking abilities, quality of life in patients
with chronic stroke.
Kaan Yilancioglu
Uskudar University, Turkey
Title: Applications of machine learning in pharmaceutical science and medicine
Time : 13:00PM-13:30PM
Biography:
Kaan Yilancioglu has complete his PhD in Sabanci University. He is the director of TRGENMER, Uskudar University, a transgenic and epigenetic research center. He has published numerous papers in reputed journals. He is working on data science, medical genetics and molecular microbiology.
Abstract:
Big data and machine learning applications will undoubtedly improve efficiency of research in various medicinal and pharmaceutical fields. These applications will provide new tools of numerous health practices for physicians, consumers, insurers, and regulators. Therefore, the present-day challenge of machine learning in healthcare: finding ways to effectively collect and use many different types of data for better analysis, prevention, and treatment of individuals. Everyday, one of the biggest players is joining the team for taking part of the very near future’s diagnostic and therapeutic services. In this presentation, we discuss about using artificial intelligence (AI) in pharmaceutical and medicinal sciences. Current research efforts in medicinal fields mostly include dosage management in cancer treatment, detection of various cancer types using data science. Personalized medicine is another important field and closely related to AI. Supervised learning methods allows physicians to select from more limited sets of diagnoses. For example, these methods can estimate patient risk based on symptoms and genetic information. In pharmaceutical science, the use of machine learning in early-stage drug discovery has the potential for numerous uses, from initial screening of drug compounds to predicted success rate based on biological and physicochemical factors.
Break: 13:30PM-14:30PM
Engin KN
Saglık University, Turkey
Title: Is clinical course of optic neuropathy associated with oxidative damage and dynamics of antioxidant response?
Time : 14:30PM-15:00PM
Biography:
Engin KN is an ophthalmologist and PhD on Biochemistry. He has a strong focus on optic nerve and his areas of interest are glaucomatous neurodegeneration, oxidative stress, neuroprotection and Vitamin E. Currently, his review article “Alpha Tocopherol: Looking beyond an antioxidant” have been cited over 90 times. Along with other academic activities, he is author of 39 publications, 7 special lectures, more than 70 presentations, and he received 6 awards. He is member of ARVO, EVER, Society of Free Radicals and Antioxidants Research (Turkey). Since 2005, he has been serving as an active member of glaucoma division of Turkish Ophthalmology Society.
Abstract:
Optic neuropathy is recognized one of the most frequent causes of vision loss, which 85% of them are in no arterial anterior ischemic optic neuropathy (NAION) form. Glaucoma –another major form of optic neuropathy represents a group of neurodegenerative diseases characterized by structural damage to the optic nerve and the slow, progressive death of retinal ganglion cells. The nervous system is rich in lipids and oxidative stress plays a crucial role in neurologic damage. We carried out two multicenter case control studies in order to evaluate the oxidative stress profile in large series of glaucoma and NAION patients. In both studies, a comprehensive systemic oxidation profile was evaluated in control and patient groups. In order to assess the oxidative stress, markers of this destructive process, main antioxidants, along with SOD and Gpx systems were studied. 8-hydroxy-2’-deoxiguanosine –marker of oxidative stress related DNA damage in urine, levels were also determined in the NAION study. In both studies, oxidative stress parameters varied significantly in the patient groups. For vitamin E and MDA, extremely significant increases were found. Significant correlations have been found between clinical findings and oxidative stress parameters. In these studies, not only clear evidences were obtained regarding optic neuropathy-oxidative stress connection, but certain interactions of antioxidants that have unique neurohormone- like activities and regulatory mechanisms were pointed out as well. A more comprehensive understanding of oxidative damage and response dynamics will enable us to determine more efficient diagnosis, follow-up and treatment strategies and facilitate to answer important questions about optic neuropathies.
Irhad Trozic
Medical University of Graz, Austria
Title: Postural hemodynamic parameters in older persons have a season-dependency
Time : 15:00PM-15:30PM
Biography:
Irhad Trozic is a 31-year-old from Bosnia currently doing his PhD at the medical university In Graz at Gravitational Physiology & Medicine research Unit at the Institute of Physiology. His project is title: Vascular Function in Health and Disease, a gender comparative study. The study focuses on differences in vascular
response to orthostatic stress between age, gender, health and diseases. His special topic is vascular function assessment.
Abstract:
Objectives: The regulation of blood pressure (BP) during upright standing depends on many factors. It is well known that the effects of temperature on the cardiovascular system and BP values are higher in winter months. But there is a lack of studies that have analysed how the cardiovascular system in post-stroke patients responds to postural changes during cold and warm months. The aim of this study was to examine how temperature in two seasons (cold months and warm months) affects the responses of hemodynamic mechanisms and heart rate variability during a sit-to-stand test in stroke patients and non-stroke participants.
Methods: We investigated 41 participants: stroke (n= 16) and age-matched non-stroke participants (n=25), age >55 yrs, during a sit-to-stand test (5 min of sitting followed by 5 min of standing) in two different seasons. We used a Task Force Monitor® device to continuously monitor beat to beat systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), stroke index (SI) and cardiac index (CI), and power spectral analysis of the heart rate Variability (HRV).
Results: Mean values of baseline DBP (stroke: 90.624 ± 4.522; non-stroke participants: 84.846 ± 2.018) and MBP (stroke:107.803 ± 5.084; non-stroke participants: 103.318 ± 4.1825) were significantly higher during colder months compared to warmer months in both groups. Mean values of baseline SI (stroke: 26.820 ± 1.552; non-stroke participants: 28.781 ± 1.4382), and CI in non-stroke participants (2.142 ± 0.1052) were found to be significantly lower during colder months. After standing, there was a significant decrease in SBP, and MBP values in non-stroke participants only and stroke patients in warmer months only.
Conclusions: Our study of the effects of seasonal variations in postural blood pressure changes and differences in postural blood pressure change between stroke and non-stroke participants shows that BP values depend on season, being higher in colder months in both groups. Furthermore, standing up in warmer months in non-stroke participants leads to a significant decrease in BP but not in stroke patients. Since postural instability and falls are common in older persons, the results of our study point for a season-dependent reduction in blood pressure during standing up in older persons that could predispose such persons to orthostatic intolerance and falls in warmer months.
Suzane Lousse
The institute of neuroscience application. Paris
Title: The power of the happy brain
Time : 15:30PM-16:00PM
Biography:
Ms Suzane Lousse is the Therapist specialized in neuroscience, Therapist expert in neuroscience also creator of therapeutic tools in the institute of neuroscience application, Paris. She associated with Professor Denis Ducreux, Neuroradiologists Brain analyst software creator in department Kremlin Bicêtre-Hospital.
Abstract:
During our life, we lived all at least once the stroke of a person of our entourage. The man improved the emotions and the feelings thanks to an extraordinary specialisation of his brain. According to the degrees of handicap of the subject, the regard of oneself and the emotions are impacted. It is one favourable moment to put the good questions. A question can go up to 850 thoughts in the direction of the question. How to put moving the system of thought? Even if it is complicated after an accident, one can always act by making new trainings. We will learn how the neuroplasticity is related to the experiment.
Biography:
Busra Yıldırım has completed her bachelor degree at the age of 22 years from Yeditepe University. She is still the student of the Master Program of Physiotherapy and Rehabilitation. She is also working as a physiotherapist at the Formed Healthcare Scoliosis Center and one of the constituent of the Scoliosis Research and Treatment Society in Turkey.
Abstract:
Scoliosis is a three-dimensional deformity, with extension of the intervertebral segment in the sagittal plane inducing lordosis, laterals intervertebral tilting in the frontal plane, and rotation in the axial planes of the spine. Any lateral deviation of the spine of >10º on an anterior-posterior radiograph of the whole spine associated with vertebral rotation is considered to indicate scoliosis. (1) Scoliosis is not a disease in its own right, but is always consequence or complication of some other disorders such as neuromuscular disorders.(2) Postural management is a crucial question in the treatment regime of people with neuromuscular disorders who are at the risk of spinal deformities or/and pelvic malalignment. There is a growing interdisciplinary awareness of the importance of postural management defined as ‘’the use of any technique to minimize postural abnormality and improve function’’ (3) Adaptive seating systems and orthosis can be used for that and also physiotherapy program is essential for the patients with neuromuscular scoliosis.
Break: 16:30PM-16:45PM
Argjend Shala
University Clinical Center of Kosova, Kosova
Title: Myoclonic seizures in patient with cortical laminar necrosis due from hypoglycaemia and anaemia
Biography:
We chose to present this case for some reasons: because Cortical Laminar Necrosis is relatively rare disease; at our patient we had three etiologic factors which can cause CLN (hypoglycemia, anemia, brain ischemia); and also associations between myoclonic seizures and frontal cortical leas ions (necrosis).
Abstract:
Cortical laminar necrosis is necrosis of neurons in the cortex of the brain in situations when supply of oxygen and glucose is inadequate to meet regional demands. This is often encountered in cardiac arrest, brain ischemia, global hypoxia, hypoglycemia, anemia, status epilepticus etc. Early cytotoxic oedema causes high signal seen on DWI. CLN is a permanent brain injury, radiologically characterized by high intensity cortical lesions on T1 and Flair weighted MRI image. Myoclonic seizures are brief, shock-like jerks of a muscle or a group of muscles. Usually, they don't last more than seconds. There can be just one, but sometimes will occur within a short time. In epilepsy, myoclonic seizures usually cause abnormal movements on both sides of the body at the same time.