Presentation number: IPS 1
CHALLENGES ASSOCIATED WITH MEDICAL TRAVEL FOR CANCER PATIENTS IN THE ARAB WORLD: A SYSTEMATIC REVIEW
Wafa K. Alnakhi1,2, Faryal Iqbal3, Waleed Al Nadabi4, Amal Al Balushi5
1Dubai Health Authority, Health Research & Survey Section, Data Analysis, Research & Studies Department Strategy & Corporate Development, Dubai, United Arab Emirates, 2Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates, 3Burjeel Medical City, Innovation and Research Center – Burjeel Cancer Institute, Abu Dhabi, United Arab Emirates, 4Ministry of Health, Directorate General of planning and studies, Al Khuwair, Sultanate of Oman, 5Ministry of Health, Oman College of Health Sciences, Nursing Program, Al Khuwair, Sultanate of Oman
Each year, millions of patients around the world seek medical care abroad. Medical travel is becoming very common in the Gulf Cooperation Council Countries (GCC) due to many motivational factors. Cancer seems to be one of the top medical conditions for patients from the GCC to seek healthcare overseas. There are many factors associated with cancer patients seeking treatment overseas. However, unfortunately, there are very few studies that discuss the risks and challenges associated with the medical travel experience for those patients. We conducted a systematic review to summarize the evidence related to the complications and challenges associated with the medical travel experience for oncology patients in the Arab world. This systematic review was guided by PRISMA. PubMed was used as a search database by using a combination of medical travel, complications, and cancer keywords for publications which yielded 76 articles. Four coders independently determined eligibility based on PICOS and then extracted information from 14 articles. The resulting articles are based on three main categories, i.e., primary, and secondary data collection, and review articles. Of the total 76 articles, only 14 were included because they met the criteria. 62 articles were excluded because of irrelevance of the title, abstract, and insufficient data. Although this systematic review aimed to look at the medical complications that may arise from the medical travel experience for oncology patients, other challenges were found. The challenges reported can be grouped into the following themes: a) financial and economic aspects, b) medical care aspects, c) social and cultural aspects. Overall, more research studies are required in the Arab world for cancer patients treated overseas. The existence of such information around this topic will help in improving policies and strategies related to medical travel for the different stakeholders involved in the medical travel market. Moreover, these studies will not only aid in improving the quality of care for cancer patients who are engaging in medical travel, but they will also help in overcoming the challenges associated with medical travel experience for cancer patients at the different stages of the experience.
Key words: medical travel, treatment overseas, outsourced patients, treatment destinations, oncology
Presentation number: IPS 2
PRECISION MEDICINE AND CARDIOVASCULAR DISEASES: WHICH BIO JURIDICAL ISSUES MUST BE CONSIDERED?
Antonina Argo, Giuseppe Davide Albano, Giulio Perrone, Clio Bilotta, Ginevra Malta, Stefania Zerbo
University of Palermo, Department Pro.Mi.SE, Medico legal Unit, Palermo, Italy
The area of cardio-vascular diseases – in translation from the animal to the human model – needs to test and validate many of the biomarkers identified, by demonstrating the presence/absence of a marker (be it a cDNA, a miRNA, a protein, a metabolite or a metabolomic profile) in healthy and affected tissue, that can be implemented in common clinical practice. Genetic variants were identified that modify the response to some relevant cardiovascular drugs, including beta-blockers (ADRB1, ADRB2, GRK5, GRK4); angiotensin converting enzyme inhibitors (ACE, AGTR1); diuretics (ADD1, NPPA, NEDD4L); and calcium channel blockers (CACNB2, CACNA1C). To date, however, genetic testing has not been employed routinely to guide selection of these drugs, and many genetic variants require confirmation in larger studies. The highlight topics can support the translational clinical application, with collaboration between knowledge that is the basis of precision medicine, in add taking evidence of unresolved bio juridical issues. The authors analyze some questions underlying precision medicine: equity in access preventive and therapeutic treatments based on pharmacogenetic principles; a guaranteed access to diagnoses and personalized treatments; the use of precision medicine diagnostics in the context of gender differences and its non-discriminatory use; use of precision medicine approach in prevention and its use in the workplace, with guarantees of the freedom and dignity of the person; integrity in the use of information located in biobanks. The guidelines proposed by scientific societies and National Institution of health are considered; the aspects worthy of discussion and bio-juridical implementation are emphasized. However fascinating, the area of interest of precision medicine, especially in the broad field of cardiovascular pathologies, also highlights some aspects that require careful evaluation and investigative criticism; therefore, requiring further regulatory interventions.
Key words: Precision Medicine, cardiovascular, genetic variants, biojuridical
Presentation number: IPS 3
AWARENESS REGARDING ORAL HEALTH AMONG ORTHODONTIC PATIENTS AND NON-ORTHODONTIC PATIENTS
Ingrid Kovačević1, Katarina Major1, Ivana Zovak1, Sanja Šuper-Kirsch1, Dora Dragičević1, Dorotea Petrović1, Marija Čandrlić1, Allesia Cerin1, Katarina Judnić1, Marta Furdi1, Marko Babić1, Marko Matijević2
1Faculty of Dental Medicine and Health Osijek, Department of Dental Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia, 2Health Center Osijek, Osijek, Croatia
The aim of the study was to examine oral health awareness among orthodontically treated and orthodontically untreated patients, to examine their attitude about the importance of oral hygiene, their familiarity with toothbrushing techniques and familiarity and source of information on the use of toothbrushes and other toothpastes. Also, the aim was to examine their opinion on the importance of brushing teeth and their interest in expanding their own knowledge about oral hygiene. The study is organized as a cross-sectional study. Study included 98 patients of dental and orthodontic surgeries of the Health Center in Osijek. The examination was conducted during April 2020. An anonymous survey questionnaire was used to conduct the research. 98 patients participated in the study. Orthodontically treated patients use a toothbrush three times a day, far more than orthodontically untreated patients. They use a soft toothbrush and interproximal (interdental) toothbrushes significantly more than orthodontically untreated patients. They no longer use mouthwash, compared to orthodontically untreated patiens, but they go to regular check-ups much more than orthodontically untreated patients. Also, the orthodontist / dentist far more explains to them the importance of brushing teeth, which is not the case with orthodontically untreated patients. This study has shown that orthodontically treated patients have significantly more awareness regarding oral health and the importance of oral hygiene protocols, than orthodontically untreated patients.
Key words: oral hygiene, teeth, orthodontically patients, knowledge, attitudes
Presentation number: IPS 4
CONTRADICTORY ARGUMENT OF HYPERTENSION AMONG YOUTHFUL AGES
Agbaje Olatunde Faliud
The Vision for Teenagers Adolescents and Youths Wellbeing Initiative
Hypertension is one of the major community health challenges among elderly people on the risk of cardiovascular disease, is now a disease that is found among people who fall within the age brackets between 20 and 30 years. Our community outreaches reveal this at Ikorodu and Lagos Mainland Local Governments in particular. A community cross-sectional research was carried out and it was shocking that people of the aforementioned age brackets were found hypertensive during one of our Community Medical Outreaches at the aforementioned Local Government Areas. Our discovery was terrific that the prevalence of hypertension was found among males than females during the BP test to found results as 125.27 ± 17.08 mmHg and 93.55 ± 9.48 mmHg, respectively. TV-TAY Wellbeing Initiative has a pre-conclusive agreement to present this that the odds of being hypertensive in the community is majorly the problem of challenges such as economic instability the situation, social unrest, and political disenchantment in the country which bring about the unnecessary taking of uncontrollable alcoholic drink, tobacco, illiteracy unawareness of the danger with continuous indulging and engagement because of unawareness risk of it based on our findings.
Key words: uncontrollable alcoholic drink, tobacco, illiteracy unawareness, hypertensive
Presentation number: IPS 5
IRRITABLE BOWEL SYNDROME (IBS) MICROBIOME DIVERSITY
Jasmin Ramić1, Irina Milovac2, Zoran Mavija3, Naida Lojo-Kadrić1, Maida Hadzić1, Stojko Vidović2, Beate Niesler4, Nikolas Dovrolis5, Maria Gazouli6, Naris Pojskić1, Lejla Pojskić1
1Institute for genetic engineering and biotechnology, Sarajevo, BiH, 2Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina, 3Department of Gastroenterology, Clinical Center of Republic of Srpska, Banja Luka, Bosnia and Herzegovina, 4Institute of Human Genetics, Department of Human Molecular Genetics, University of Heidelberg, Germany, 5Laboratory of Medical Biology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece, 6Laboratory of Biology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
(Dys)functional gut brain gastrointestinal (GI) disorder known as irritable bowel syndrome (IBS) have a rather high prevalence in working population. 10-15% of members of this group have problems with constipation or diarrhea followed by abdominal pain, all of which can usually be associated with IBS (10, 1 % according to Rome III and 4, 1% according to Rome IV, Enck P. et al 2016, Sperber A.D. et al 2020, Black C.J. et al 2020). Frequency of these symptoms is a major obstacle to the functional physical and social wellbeing of patient diagnosed with IBS. One of potential pathogenic mechanisms responsible for this condition include microbiome dysbiosis in patients with IBS. Intestinal microbiome is a ecosystem of localized microorganisms and inner gastrointestinal (GI) tract lining cells with all kind of genetic, biochemical and ecological interactions between them. Diversity of microbiome is age, sex, habit and physiologically (pregnancy or disease) related. In persons with IBS diagnosis these diversities can be seriously impaired, and aim of this study was to determine if we can establish statistically significant connection between IBS condition and microbial taxa present in feces of examinees with IBS and control group. We are also looking forward to see differences in relative abundance of microbial composition in these two groups. Fecal microbiota profiling in search for eventual change of composition and abundance in nine clinically confirmed IBS patients and six corresponding healthy controls is profiled based on their species specific 16s RNA gene using Illumina NGS mini seq platform. Initial raw data were analyzed using Illumina 16s Metagenomics application, and further analyses were performed on the MicrobiomeAnalyst online platform. Total Sum Scaling (TSS) was applied to the data. Alpha-diversity was calculated using the CHAO1 index and ANOVA on the OTU level. Beta-diversity was calculated and visualized using non-metric multidimensional scaling (NMDS) and Principal Coordinate Analysis (PCoA) on the OTU level. Correlation analysis was carried out using Spearman’s correlation algorithm. Mann-Whitney U test was used to compare differences between IBS and healthy controls and variance in taxonomic distribution between clinical subtypes (Med Calc v.19.0.4).
Key words: IBS, fecal microbiome, 16s rRNA gene, dysbiosis
Presentation number: IPS 6
ASSOCIATION BETWEEN POLYGENIC RISK SCORES FOR PLASMA PROTEIN N-GLYCOSYLATION TRAITS AND 273 ICD-10 DISEASES
Olga O. Zaytseva1, Arina V. Nostaeva2, Sodbo Zh. Sharapov2, Elizaveta E. Elgaeva2, Gordan Lauc1, Yurii S. Aulchenko2, Yakov A. Tsepilov2
1Genos Glycoscience Research Laboratory, Zagreb, Croatia, 2Institute of Cytology and Genetics, Novosibirsk, Russia
N-glycosylation is a post-translational modification of proteins by covalent attachment of a carbohydrate structure to an asparagine residue. N-glycans physical properties and biological activity of the serum proteins. The composition of the N-glycome of blood plasma proteins is changing in ageing and diseases, therefore, N-glycans are often regarded as promising biomarkers of various physiological and pathologic states. Recently, genome-wide association studies (GWAS) identified a number of loci that are involved in regulation of plasma protein N-glycosylation. Some of these loci are also associated with inflammatory, autoimmune, cancer and other diseases. Elucidating the degree of genetic architecture overlap and causal relationships between plasma N-glycome and diseases, remains one of the important tasks of the glycobiology field. To answer this question, we have used polygenic risk score (PRS) analysis. We have calculated PRSs for 117 plasma N-glycosylation traits using summary statistics of a GWAS performed in a cohort of European descent (N = 7541), where 31 loci were found to be associated with N-glycosylation. As a next step we are planning to perform an association study of the PRS for the 117 plasma glycan traits and 273 diseases included in the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) list, available through the UK BioBank (UKBB) database, with prevalence > 0.05 and < 0.95. For the pairs of glycan trait and disease that show a statistically significant association we plan to perform Two-sample Mendelian randomization (MR) analysis in both directions to answer the question of causal relationships between the said traits. As exposure and outcome for the Two-sample MR we are going to use summary statistics from GWAS for plasma N-glycosylation traits performed in a cohort of European descent (N = 7541) and those available from UKBB for the diseases. We expect our research project to shed light on the connection between plasma protein N-glycome and various pathologies, on the genetic basis of protein N-glycosylation, to improve the existing glycan biomarkers and potentially to discover new ones. Acknowledgments: This work was supported by a grant from the Russian Science Foundation (RSF) No. 19-15-00115.
Key words: N-glycosylation, plasma proteins, polygenic risk scores, Mendelian randomisation
Presentation number: IPS 7
SEX DIFFERENCES IN RISK OF BLOODSTREAM AND SURGICAL SITE INFECTIONS
Stefania Zerbo, Giulio Perrone, Clio Bilotta, Ginevra Malta, Giuseppe Davide Albano, Antonina Argo
University of Palermo, Department Pro.Mi.SE, Medico legal Unit, Palermo, Italy
Due to the exponential increase in the incidence of nosocomial infections and the increasing rates of antibiotic resistance, the identification of nosocomial infections’ risk factors remains a current topic. Sex is one of the risk factors currently under study. The role of sex in the context of urinary tract infections (UTI) is well known. Conversely, the link between sex and bloodstream (BSI) and surgical site (SSI) infections is less well known and more uncertain. the author analyzed the literature data about the role of sex in the BSI and SSI development. significantly higher BSI and SSI incidence rates were observed in the male population. It has been hypothesized that it may be due both to genetic factors related to the thicker and coarser hair in men, and to the shaving of the hair. This hypothesis is further supported by the absence of sex differences with regard to the incidence of BSI and SSI in the pediatric population. Conversely, in the adolescent population the girls had significantly lower odds of community-associated BSI and lower odds of SSI. Biological differences between men’s and women’s skin could constitute another possible reason for gender differences in the case of BSI and SSI incidence. A greater bacterial colonization of the skin surrounding the surgical insertion site of the central venous catheter was observed in men compared to women. Furthermore, sex would affect the immune system’s response via the hormonal system. In fact, the levels of estrogen promote the response of the immune system, playing a protective role; differently androgens suppress it. The increased rates of infection in the female population observed during menopause would confirm these observations. It has also been hypothesized that women may be at greater risk for SSI in the case of cardiac surgery due to the small size of the arteries and the increased tension of the thoracic incisions due to the pendulous breasts. New studies are expected regarding cultures of the bacterial colonization of the skin surrounding a central venous catheter at the insertion site or a surgical wound to clarify the role of genetics and sex in the development and incidence of BSI and SSI in order to customize the preventive and therapeutic strategies of BSI and SSI and reduce their mortality.
Key words: sex, risk infection, surgical site infection, bloodstream infection