Advances in Neonatal and Pediatric Nutrition July 19-21, 2018 London, UK

Maria Livia Ognean is an Assistant Professor at Faculty of Medicine, University Lucian Blaga, Sibiu. She completed her MD from the University of Medicine and Pharmacy Tg. Mures, PhD from University of Medicine and Pharmacy Cluj Napoca, Senior Neonatologist, Chief of Neonatology Department I, Clinical County Emergency Hospital Sibiu, Romania. She is working as Associate Professor at University Lucian Blaga Sibiu since 2006. She is a member of national and international neonatology and perinatology societies, member of the Executive Committee of UENPS, Secretary of the Romanian Association of Neonatology during 2010-2017, Former Scientific Secretary of the Romanian journal Neonatologia,, published over 140 papers in national and international journals.

Introduction: Late Preterm Infants (LPI) - 34 weeks 0 days to 36 weeks 6 days - are representing the largest proportion of preterm infants. Breastfeeding difficulties are frequently reported in LPI compared to term infants due to immaturity of the oral-motor reflexes, difficulties in coordinating sucking with deglutition and breathing, hypotonia, immaturity of state control and perinatal associated comorbidities. Also, studies have consistently reported an increased risk for lack of breastfeeding initiation and shorter duration of breastfeeding in LPI. Aim: The authors aimed to find risk factors for breastfeeding difficulties and lower rates of breastfeeding in LPI. Material & Methods: The retrospective study included LPI (340-366 weeks gestation) born between January 1, 2013 and December 31, 2016 in the maternity of the Clinical County Emergency Hospital Sibiu, a level III regional unit. The unit protocol for breastfeeding follows the 10 steps recommended by the Baby Friendly Hospital initiative. Infants not fed at discharge were excluded. Maternal and neonatal characteristics, epidemiological and clinical data were extracted from neonatal charts and comparatively analyzed between exclusively breastfed LPI and fed with breast milk and/or formula (mixed feeding). Statistical analysis was performed using SPSS for Windows 10.0; p was considered statistically significant if < 0.05 (CI 95%). Results: During the study period 489 LPI were care in our unit, 3 of them being submitted, without feedings to pediatric surgery. Therefore, the final study group comprised 486 LPI, 103 exclusively breastfed (21.2%), 36 exclusively fed with formula (7.4%) and 347 with mixed feedings (71.4%). No significant difference was found as regards birth weight, gestational age, gender, maternal age and parity area of residence, maternal education, pregnancy care, delivery mode, most important postnatal conditions (respiratory distress, birth asphyxia and need for resuscitation, maternal-fetal infections, persistent fetal circulation, jaundice needing phototherapy, anemia), need for hospitalization in the Neonatal Intensive Care Unit (NICU) or hospitalization length (p>0.05) between the study groups. Late preterm infants exclusively breastfed at discharge had significantly lower Apgar scores at 5 minutes (9.0±1.4 vs. 9.3±0.9; p 0.017) and spent significantly more days in the NICU (8.8±13.4 vs. 5.4±6.0 days; p 0.015) compared to those with mixed feedings. A low rate of exclusive breastfeeding was noted in LPI twins (13.7%) and those born form pregnancies obtained with assisted reproductive techniques (ART) (1.7%). Of note, an increased rate of exclusive breastfeeding was noted in 2016 compared to previous years of study (33.6% vs. 13.2% in 2015, 8.9% in 2014 and 22.3% in 2013; p 0.005). Conclusions: Breastfeeding rate is high but improvements can be done as regards exclusive breastfeeding rates in LPI, with efforts focused mostly for twins and infants from ART pregnancies. Concordant with other studies, we also found that longer NICU admission is associated with improved breastfeeding rates and exclusive breastfeeding.

I Polychroni have completed her degree in Medicine, Athens Medical School and she did specialization in Pediatrics. She was appointed to IKA- Social Insurance Institute in Nea Ionia as a Pediatrician. From 1992 until today she has been a working in the Growth Surgery of the Clinic, where she works twice a week as a non-paid associate with the approval of the Hospital Paidon P. & A. Kyriakou. For the last 14 months, she has been training on diabetes and has been participating in research programs, with the approval of IKA-EOPYY (Insurance Fund), where she works. She is a member in Greek Pediatric Association, Athens Medical Association, Greek Association of Children and Teenager Endocrinology and Greek Endocrinology Association.

Background: The current study was aiming to report prevalence of 25(OH)D3 deficiency-insufficiency among children - adolescents in Greece and to see the role of sex and seasonality on vitamin D status. Material & Methods: A sample of 285 healthy children and adolescents aged 3 to 18 years (M/168, F/117), who came from district of Attiki (urban area) was examined. They were grouped into three groups: Group I: 3-10 years of age (72), Group II: 10-14 years of age (89) and in Group III: 15-18 years of age (124). Blood samples were taken during spring (April to June) and during autumn (October to December). Results: The prevalence of vitamin D concentration <20 ng/mL and <30 ng/mL (Vit D deficiency and insufficiency respectively was 5.5% and 53.2% respectively). Girls had a higher prevalence of 25(OH) D3<20 ng/Ml (6.8 vs. 4.1) and 30 ng/mL (38.2 vs. 47%) than boys (P<0.001). The highest prevalence rates of 25(OH)D3<20 and 30 ng/mL (8.5 vs. 70.2% respectively) were observed during spring (April to June), whereas the lowest (1.4 and 30.5% respectively) during autumn (October to December). Female sex living in an urban area and spring months are found to increase the likelihood of vitamin D deficiency and insufficiency. Conclusions: Even in a sunny country like Greece children and adolescents living in an urban area are in high risk for vitamin D deficiency and insufficiency. The prevalence of vitamin D status among children and adolescents is comparable to or exceeds the prevalence reported among those on a European level. Girls living in urban areas during spring months are at highest risk for vitamin D deficiency and insufficiency. This indicates the need of effective initiatives to support adequate vitamin D status in these population groups.

Deepti is pursuing her PhD for the past 4 yrs at Defence Institute of High Altitiude Research, Leh-Ladakh (DRDO) under the guidance of Dr Sunil Kumar Hota. Her area of work was to understand the behavioral, physiological, biochemical and molecular mechanisms associated with hypoxia induced neurodegeneration and with the objective to develop suitable prophylactic for ameliorating high altitude induced memory impairment neurodegenration and cognitive dysfunction. She has published 2 research paper in reputed journal.

In recent years the high altitude medicinal plant has become a subject of interest owing to the presence of high concentration of secondary metabolite and bioactive compounds in their fruits, seed, leaves, stem and roots to endure the environmental stress. Cicer microphyllum Benth, commonly called wild gram, is abundant in the high altitude Himalyan regions and is reported to be a natural reservoir of phytoestrogens. Recent studies suggest several pharmacological properties of the plant that include anti-oxidant, anti-inflammatory, anti-diabetic, anti-convulsant, anti-cancer, immunomodulatory and anti-diarroheral activity. Hypoxia induced oxidative stress and neurodegeneration in the hippocampus has been implicated for memory impairment in conditions like stroke, ischemia and hypobaric hypoxia. The present study, aimed at investigating the potential of ethanolic extract of Cicer microphyllum seeds (CSE) CSE supplementation considerably reduced neurodegeneration and dendritic atrophy in CA1 neurons This effect of CSE was partly attributed to its antioxidant activity resulting in reduction of lipid peroxidation, protein oxidation and DNA damage during exposure to chronic hypoxia. CSE also promoted dendritic arborization through activation of Estrogen Receptor beta (ERβ) and phosphorylation of extracellular signal regulated kinase (ERK1/2) which was independent of Brain Derived Neurotrophic Factor (BDNF) mediated signalling mechanisms. Extra nuclear activation of ERK1/2 by ERβ resulted in phosphorylation of cyclic AMP response element binding protein (CREB) leading to increased expression of PSD-95. Our findings not only suggest the neuroprotective potential of CSE in hypoxia but also provide evidence for involvement of estrogen receptor and pCREB mediated nootropic effect of the extract.

Jung In Kim has completed her Ph.D. at the age of 30 years from University of California at Berkeley Department of Nutritional Sciences. She is a professor at Inje University Department of Smart Foods and Drugs. She has published more than 30 papers in reputed journals.

Diabetes mellitus increases oxidative stress which contributes to the development of cardiovascular complications, the leading causes of premature mortality among patients with type 2 diabetes. Fruit of autumn olive (AO, Elaeagnus umbellata) is a good source of phytochemicals including lycopene which shows strong antioxidant activity. The purpose of this study was to investigate the antioxidant effect of AO in db/db mice, an animal model of type 2 diabetes. Five-week-old male C57BL/KsJ-db/db mice (n=28) were fed AIN-93G diet or diet containing 0.4% (low AO (LAO) group) or 0.8% ethanol extract of autumn olive fruit (high AO (HAO) group) or 0.04% acarbose, an oral hypoglycemic agent, for 7 weeks after 1 week of adaptation. The animals were sacrificed after an overnight-fast and levels of lipid peroxides and activities of antioxidant enzymes in the liver were measured. Thiobarbituric Acid Reactive Substances (TBARS) levels of LAO and HAO groups were lower by 25% and 38%, respectively, than those of the control group (p<0.05). Consumption of acarbose did not significantly affect hepatic TBARS levels in db/db mice. Activities of superoxide dismutase, catalase and glutathione peroxidase of LAO and HAO groups were significantly elevated compared with the control and acarbose groups (p<0.05). These results indicate that fruit of autumn olive could be effective in improving antioxidant status in db/db mice, suggesting that it may be useful in the prevention of cardiovascular complications.

Professor Kyung Ja Chag has completed her PhD at University of Minnesota in 1989 and she has been worked in Human Nutrition and Biochemistry Lab at Inha University since 1990. She has published more than 200 papers in reputed journals and has been serving as an editor in chief and editorial board members of repute. Co-authors Mi ae Bae and So hee Han are graduate students in doctoral and master program at Inha University, respectively. Co-author professor Sung Hoon Kim is working in Natural Products and Organic Synthesis Lab at Konkuk University.

Dementia is a neurodegenerative disease, which is higher in women elderly. The Lotus Seed (LS) is a natural oriental medicine effective for dementia and Taurine (TA) has been reported to play a significant role in brain function. The purpose of this study was to investigate the effects of dietary supplementation of LS and TA on the cognitive function (Mini-Mental State Examination-Dementia Screening, MMSE-DS) of elderly women with dementia. The subjects were 30 elderly women with dementia in one geriatric hospital in Korea. They were divided into two groups, 15 subjects in the LS and TA supplement group (LTG) and 15 subjects in the Control Group (CG). The two groups were matched in age, number of diseases, total score of cognitive function, height, weight BMI and blood pressure. The LTG and CG were provided scorched rice water made with powder of roasted LS (5g), TA (3g) and scorched glutinous rice (5g) and scorched rice water except the LS and TA for 4 weeks, respectively. The total score of MMSE-DS of before dietary supplementation was not significantly different between CG (14.1 points) and LTG (13.8 points). However, after dietary supplementation, total score of LTG was significantly increased (p<0.008). In particular, scores of ‘place orientation’ and ‘judgement and abstract thinking’ were significantly increased (p<0.05). These results showed that dietary supplementation of LS and TA has positive effects on the cognitive function (MMSE-DS) of the elderly women with dementia. Therefore, LS and TA may be used for the treatment and prevention of dementia.

P. Goetghebeur has completed his MSc in Neuroscience from the Institute of Psychiatry in London. He is Principal Clinical (cognition) at Bracket LCC (UK), clinical trial technology and specialty services provider. He has 20 years’ experience within the pharmaceutical industry.

As interest continues to grow in substances which can enhance cognitive function, natural products are increasingly being recognized to possess such properties. For both regulatory and marketing purposes, it is critical that such product claims are backed up by solid scientific evidence. The International Life Sciences Institute Europe Nutrition and Mental Performance Task Force has published recommendations for cognitive testing in such work includes the use of standardized, sensitive, valid and reliable procedures. One issue they raise is that due to the vast range of cognitive used to study in this field, it is difficult to compare the cognitive effects of different products. The CDR System is a highly sensitive extensively validated set of cognitive tests which has been in worldwide use in clinical trials for over 30 years. It possesses the properties to satisfy all of the task force recommendation. It is user and participant friendly and enables the assessment of cognitive domain-specific effects in a wide range of populations. It is designed to show minimal practice effects and assesses core cognitive domains relevant for everyday life. The CDR System has been used in over 50 studies to evaluate the beneficial cognitive effects of a wide range of compounds and nutrients in different populations. In this presentation these findings will be summarized, so that the diverse range of substances studied can be contrasted across core cognitive domains for their ability to enhance function.

Juliana Schmidt is a M.S student in neuroscience and has a bachelor’s degree in nutrition sciences. Julio Tolentino is an Assistant Professor of Internal Medicine and Ph.D student. Guilherme Schmidt is a neurologist and Ph.D student. Eunice Simões is a licensed neuropsychologist and Ph.D. student. Lea Fonseca is a full Professor of Nuclear Medicine. Sergio Schmidt is a Full Professor of Neurophysiology. Carolina Pessoa is an Associate Professor of Nuclear Medicine. Yolanda Tolentino is a gastroenterologist at Gaffrée e Guinle University Hospital. Angela Obongo has a bachelor’s degree in nutrition sciences and currently is a Ph.D student.

Celiac Disease (CD) is an immune-mediated systemic disorder triggered by gluten and related prolamines in genetically predisposed individuals. Previous investigations using Single Photon Emission Tomography (SPECT) reported brain perfusion abnormalities in untreated CD patients with neuropsychiatric manifestations. Here, we described a case of a 31-yearold Caucasian woman who exhibited cerebellar and psychiatric dysfunctions. The patient underwent SPECT images before and after a Gluten Free Diet (GFD). There was an improvement in cerebellar perfusion accompanied by a remission of cerebellar manifestations. The patient’s psychiatric symptoms did not change after 4 months and a half under a GFD. The maintenance of the psychiatric manifestations was related to the persistence of the hypoperfusion in frontal lobes. To our knowledge, this is the first case that shows the relationship between improvement in cerebellar perfusion and remission of cerebellar clinical manifestations in a CD patient under a GFD.