King Abdulaziz University, Saudi Arabia
Background: Diabetic ketoacidosis (DKA) is an acute complication of both type1 and type2 diabetes mellitus (DM). DKA is characterized by the presence of hyperglycemia, ketosis, ketonuria, and metabolic acidosis. Cerebral edema is a rare but rather a serious complication of DKA.
Case Presentation: An obese 12-year-old, Egyptian boy, previously medically free, presented to the emergency room (ER) of King Abdulaziz university hospital, with two weeksʼ histories of dizziness, shortness of breath, polyuria, polydipsia &nocturia. His symptoms were deteriorating with a change in sensorial and cognitive functions at the time of presentation. He was diagnosed with type 2 DM based upon clinical background, namely the presence of obesity (weight+7.57 Standard Deviation Score (SDS), height+1.4 SDS, and body mass index (BMI) of 34.77 kg/m2 (+3.97SDS) together with the presence of Acanthosisnigricans and biochemically based on, normal level of serum insulin, normal serum level of connecting peptide and negative autoantibodies. He was presented with severe DKA, based on clinical and laboratory criteria. During the first 12 h of hospitalization, the patient has developed cerebral edema based upon clinical and radiological bases with the requirement of intensive therapeutically managements with final complete clinical, biochemical and radiological recovery. The patient was discharged home on oral metformin therapy after gradual weaning from insulin therapy, which was needed initially during his acute presentation. We aimed to present a rare presentation of severe DKA with cerebral edema in a child with Type 2 DM.
Conclusion: Despite type 1 DM is the commonest type of diabetes in children, pediatricians should be aware of other types of diabetes, particularly type 2, as the prevalence of obesity in children is increasing. Children with type 2 DM are also prone to develop DKA, thus proper and rapid investigations to diagnose DKA in suspected patients are mandatory. Those patients are also at risk to develop cerebral edema, thus proper monitoring for neurological symptoms during the management of DKA is crucial.
Biography:
Mohammed AlAgha is a senior medical student at King Abdulaziz University, Jeddah, Saudi Arabia. Currently he is in the internship year and he is enjoying his last eleven months left for him before graduation. During his 6 years in medical school, he had an outstanding performance, and has maintained his position at the top of the deanʼs list for the top ten students. He has started his journey of research by two researches, and has previously presented one of them in a conference held in Jeddah, 2016.
1College of Veterinary Medicine, Konkuk University, Republic of Korea;
2National Institute of Crop Science, Rural Development Administration, Wanju-Gun, Republic of Korea
Obesity is a worldwide public health concern asking for safe dietary strategies. Recent studies suggest that isoflavones from soy or soybeans have beneficial effects on weight loss and reducing fat accumulation. However, the effects of germinated soy germ are not fully investigated, despite the biochemical and nutritional changes during germination. In our study, we aim to evaluate the effects of germinated soy germ extracts (GSGE) on obesity. High-fat diet (HFD) induced obese C57BL/6 were randomly assigned to four groups: (i) HFD: HFD only; (ii) Low: HFD and 1mg/kg of GSGE; (iii) Mid: HFD and 5mg/kg of GSGE; (iv) High: HFD and 20mg/kg of GSGE. The mice received GSGE by intragastric administration for 5 weeks daily andwere assessed for body weight, wet fat weight, micro-CT analysis and histological analysis. All the GSGE treated groups showed decrease in average body weight, gonadal fat weight and adipose tissue volume at 5 weeks. In addition, the average size of adipocytes in subcutaneous and visceral adipose tissues was significantly reduced. Moreover. the expression of genes associated with the adipogenesis and lipogenesis was downregulated in GSGE treated groups. These results demonstrate that germinated soy germ extract has potential to promote weight loss and reduce fat accumulation, being a promising dietary strategy for preventing obesity.
Biography:
Eun-ji Choi received the B.S. degree from the College of Veterinary Medicine, Konkuk University, Korea, in 2016. She is currently a Ph.D. course in Department of Veterinary Clinical Pathology, College of Veterinary Medicine, Konkuk University. Her research interests include obesity, osteoporosis, and arthritis and tumor immunotherapy.
1Granada University, Spain
2Instituto de la Grasa (Seville), Spanish National Research Council (CSIC), Spain
Introduction: The metabolic syndrome (MetS) is defined in adults as a set of risk factors of metabolic precursors of atherosclerotic cardiovascular disease and type 2 diabetes mellitus (DM2). However, data on children and adolescents are still scarce, in part, because of difficulties in transposing the definition from adults. The identification of risk factors for the development of MetS at an early age is essential for prevention purposes with low-grade inflammation acting as a determinant for the association among the MetS components. The aim of this study was to investigate the associations of the MetS with systemic markers of inflammation and ceruloplasmin in a population of adolescents.
Methods: A cross-sectional study performed on 976 adolescents (13.2 ± 1.2 y) randomly recruited from schools in south-east Spain. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by ELISA. High-sensitivity C-reactive protein (hs-CRP) was determined by a solid-phase chemiluminiscentimmunometric assay. Ceruloplasmin was measured by immunoturbidimetry.
Results: Mets adolescents exhibited higher levels of TNF-α, IL-6, CRP, and ceruloplasmin compared to non-MetS individuals. TNF-α, IL-6, and CRP showed strong correlations with the MetS components and insulin resistance but not relevant predictive values according to ROC curves (AUC values 0.544- 0.555). In contrast, ceruloplasmin only showed significant correlations in non-Mets individuals, but exhibited a very high predictive value (AUC=0.941, P < 0.001).
Conclusions: Ceruloplasmin have an elevated predicted value for MetS in adolescents. The determination of serum ceruloplasmin in adolescents might be a useful tool to identify patients with the highest risk of future cardiovascular disease.
Biography:
Ángel Fernández-Aparicio is researcher at Granada University, Granada, Spain. Recently, she finished her nursing studies in 2015, and in this year she is going to start a master entitled “Health Care for the Promotion of the Peopleʼs Autonomy and the Attention to the Processes of the End of Life”.
1Granada University, Spain
2Instituto de la Grasa (Seville), Spanish National Research Council (CSIC), Spain
Introduction: Obesity is a risk factor for the development of insulin resistance. In addition, different studies indicate that obesity is an inflammatory disorder; however, the mechanisms that link inflammation with obesity remain unclear. The objective of this study was to investigate the metabolic and anti-inflammatory properties of Oleanolic Acid (OA) in obese subjects.
Methods: A systematic review was performed following PRISMA recommendations. The Medline and Web of Science databases were consulted, considering articles published in English in the last five years (2012-2017). We used the search equations: “Oleanolic acid” AND “Obesity”, “Oleanolic acid” AND “Metabolic syndrome”, and “Oleanolic acid” AND “Insulin resistance”, obtaining a total of 193 results, of which 28 articles were selected.
Results: In animal models, administration of OA produced an improvement in blood lipid levels, reducing the concentration of free fatty acids and increasing levels of HDL-cholesterol. Also, it has been reported a significant reduction of the surface area of adipocytes. A serum decrease of Interleukin-6 and tumor necrosis factor alpha was found. In studies with 3T3-L1 cells, a decrease in leptin levels, a suppression in resistin synthesis, and increased secretion of adiponectin were observed.
Conclusions: OA improves the lipid profile in obese subjects, particularly reducing the serum concentrations of free fatty acids. Its modulatory capacity on signaling molecules and pathways reduces subclinical inflammation associated with obesity. However, broader studies are needed in this field, especially in humans.
Biography:
Ángel Fernández-Aparicio is researcher at Granada University, Granada, Spain. Recently, she finished her nursing studies in 2015, and in this year she is going to start a master entitled “Health Care for the Promotion of the Peopleʼs Autonomy and the Attention to the Processes of the End of Life”.
De Montfort university, UK
Prediabetes describes a condition whereby an individualʼs level of blood glucose is above normal level, though not high enough to warrant them a T2D diagnosis. The condition is classified into two categories; impaired glucose tolerance (IGT) where blood glucose levels are above the normal 2 hours after glucose loading in the oral glucose tolerance test but not so high to warrant the classification as diabetes. The other is impaired fasting glucose (IFG) where blood glucose have risen to a fasting state but yet again, not so high to warrant the classification as diabetes. Physical exercise improves BG homeostasis but the extent to which exercise is effective strategy as primary prevention mechanism for people whom at risk to develop diabetes is not fully understood.
Purpose: To examine the effects of 6-weekes moderate-intensity combined aerobic and resistance exercise program in preventing or delaying the onset of diabetes for subjects at risk compared to sedentary non-diabetic individuals.
Methods: 20 subjects of a sedentary lifestyle, diagnosed with either prediabetes or at risk to developed T2D (PRE-D) and 5 Subjects were sedentary healthy individuals (ND) met the inclusion criteria. Both PRE-D and ND have been asked to complete 6-weeks of moderate-intensity combined aerobic and resistance exercise for 60 minutes on two days/week. Each exercise session consists of a combined exercise protocol of 30 minutes of resistance exercise (3 sets of 10 repetitions) followed by 20 min cycling. The primary outcome is to concentrate on metabolic results, such as improved HbA1c, blood pressure, heart rate, 1-repition max, lipid profile (reduction in Total Cholesterol, Low Density Lipoproteins, Triglycerides or increase High Density Lipoproteins) and improvements in insulin sensitivity determined by responses to oral glucose tolerance tests on independent days.
Results: There were significant reduction (p=0.00) on the HbA1c after applying of 6 weeksʼ combination exercise intervention in both groups comparing to baseline. OGTT indicated significant differences between Pre Exercise & Post 12th exercise session in both groups with p=0.01. BG concentrations were reduced post each exercise session and was significant Post-EX S12 comparing PRE-EX to P= 0.00 and P= 0.09 in PRE-D and ND respectively. A significant reduction in TC (P= 0.04) and LDL (P= 0.02) in PRE-D only. SBP drops from 127.3±13.1 to 119.6±8.4 mmHg with P= 0.04 in PRE-D while in ND was not significant. HR was significantly reduced (P=0.01) and goes from 73.5±10.3 to 70.3±12.1 in PRE-D and was significantly reduced (P= 0.03). A significant reduction in RPE have been achieved with P=0.00 in PRE-D and P=0.03 in ND group.1RM improved significant in back (P=0.04) and triceps (P=0.04) in PRE-D, while in ND group the significant improvement was in squat (P=0.02) and back (P=0.02).
Conclusion: A combination exercise programs, which involves both RE, and AE performed at moderate intensity (50 – 60% of 1RM) over 6-weeks period can be feasible and economical prevention strategies to minimize the risk factors for T2D in prediabetes subjects.
Biography:
Bandar Manawer al Harbi completed his Master of Science With Merit Pharmaceutical Quality by Design. Currently he is working as a Assistant Director of Pharmacy for Material Management Prince Sultan Military Medical City.
Working experiences; Adjunct clinical assistant professor for the academic year 2013/2014 at King Saud University, college of pharmacy; Assistant Director of Pharmacy for Material Management
Aalborg University, Denmark
Background: Obesity is one of the most obvious appearances of the worldwide epidemic of sedentary lifestyles and excessive energy intake. A lower pain threshold has been proved in obesity both in animals and humans. Among the endogenous factors prompting the obesity, intestinal microbiota has also been proposed to influence pain sensitivity. Probiotics have shown beneficial effects on obesity, but data on their analgesic efficacy is very limited. Hence, this study aimed at investigating effect of oral probiotics on pain sensitivity in female obese mice.
Methods: Six-week old female C57BL/B6-F mice were fed with a high fat diet (week 1-4) to make DIO (diet-induced obesity) mice. The DIO mice were then randomly assigned to 2 groups treated with a single daily dose (1x109CFU) of Lactobacillus Rhamnosus (test group) or physiological saline (control group) for 4 weeks (weeks 5-8). Sensitivity to mechanical stimulation was assessed by an electronic Von Frey every two weeks throughout the study period.
Results: The DIO mice in the test group did not show a significant gain weight after the start of probiotic administration. However the control group maintained a weight rising trend leading to a significant weight difference at week 6, which remained significant at week 8. The test group showed a trend of lower pain sensitivity to mechanical stimulation compared with the control group after two weeks of receiving the probiotic treatment (P>0.01). After 4 weeks of probiotic administration, mice fed with probiotics having a significant less pain sensitivity. (P<0.01).
Conclusion: The results of this study confirmed lower mechanical pain sensitivity in probiotic-treated female obese mice. The protective effect of probiotics on nociception circuits could be associated with the weight reduction or anti-inflammatory properties of the probiotics. Translation of this result in humans can potentially suggest a novel therapeutic strategy in pain management of obese individuals.
Biography:
Fereshteh Dardmeh graduated as a Doctor of Veterinary Medicine (D.V.M.) from Urmia University, Iran in 2012. She then joined the “Laboratory of Reproductive medicine” and Center for Sensory-Motor Interaction (SMI)” in the Department of “Health, Science and technology” of Aalborg University, Denmark and got the Ph.D. degree in 2017. She has since been actively involved in teaching and research in the area of reproductive health and medicine with her current studies focusing on Probiotic supplements as a novel strategy in pain management and translational investigations of possible associations between pain, obesity and fertility. Her studies have until now resulted in several abstracts and publications.
1Systematic-Reviews Unit-Polish Cochrane Branch, Poland
2Studentʼs Scientific Group of Systematic Reviews, Systematic Reviews Unit-Polish Cochrane Branch, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
3Department of Hygiene and Dietetics, Chair of Epidemiology, Systematic Reviews Unit-Polish Cochrane Branch Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
Background: Bariatric surgery is the one of the main treatments of morbidly obese patients. Despite an enormous growth in the number of published systematic reviews (SR) and metaanalyses (MA) in the field of bariatrics, no research on the quality of such studies published have been reported so far.
Objectives: To assess the quality of studies published as SR or MA, which were published since the beginning of 2016 and to compare the quality of such studies published in 2016 to 2017.
Methods: We searched for the studies in electronic databases using specially designed search strategy with no language restrictions. Our inclusion criteria for this pilot sub-analysis were SA and MA, which compared current bariatric surgery with any surgical or non-surgical control. Two authors independently reviewed all titles and abstracts and assessed the full text of potentially eligible studies and assessed the quality of included studies. The quality of each SR and MA was scored using the AMSTAR checklist.
Results: Out of 638 identified papers we finally included 23 papers with a control group. Studies published in 2017 scored higher in AMSTAR checklist than in 2016 (mean 4.67 vs 4.0). In 2016 majority of SR and MA were of low quality (<5 points; 71.43%), in 2017 - medium (>=5 points; 55.56%). In 2016-2017 item “formulating conclusions” was most frequently scoring 0 (70.83%). Score 1 was most frequently observed for the items: “study characteristics” (95.83%) and “search strategy” (75.0%). In AMSTAR the item “publication bias” scored 1 in just 45.83% of study.
Conclusions: Although the quality of studies published as SR and MA in 2016 improved as compared to those published in 2017, it is still unsatisfactory. We highly recommend that journal editors and peer reviewers pay more attention to the methodological quality of accepted SR and MA.
Biography:
Monika Storman, a PhD candidate at Department of Internal Medicine and Diabetology, Medical University of Warsaw, graduated from Jagiellonian University Medical College, Krakow, Poland.
1Studentsʼ Scientific Group at 2nd Department of General Surgery, Jagiellonian University Medical College, Poland
22nd Department of General Surgery, Jagiellonian University Medical College, Poland
Introduction: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are proven as effective long-term weight loss procedures. However, it remains still unclear whether bariatric surgery influences physical activity.
Aim: To assess exercises changes after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.
Materials and Methods: This prospective observational study was conducted from 2015 to 2016 at 2nd Department of General Surgery Jagiellonian University in Cracow, Poland. Inclusion criteria were: age 18-65 y.o., positive qualifiaction to bariatric surgery and consent of participation into this trial. Physical acitivity was measured in metabolic equivalent of task per minute (METminutes) by two validated tools: Paffenbarger Physical Activity Questionnaire and WHO Global Physical Activity Questionnaire before the procedure and at 12-month follow-up.
Results: 54 patients met the inclusion criteria. 24 of them were males (44.44%). Mean age of participants was 43.6±12.2y.o. and mean BMI was 45.94±6.35kg/m2. 44 patients (81.48%) have had at least one obesity-related comorbidity. Mostly performed procedure was LSG (n=37, 71.15%). Follow-up measurement was successful in 40 participants (74.07%). 12 months after surgery MET-minutes has changed from Me:299.75, Q1-Q3:225.78-358.38 to Me:4339.85, Q1-Q3:1590.6-7827.1, p<0.0001. Daily sitting or reclining time has reduced from 480 to 300 min. (p=0.0012). Exertion during normal activities, measured at VAS, has decreased from mean 5 (strong effort) to mean 2.5 (light effort) (p=0.00004). No correlation between changes in BMI and MET-minutes was observed (R=0.0634, p=0.7302).
Conclusions: This trial shows notable exercises level increase 12-months after bariatric surgery. Further investigations is needed to develop post-surgical guidelines and interventions.
Biography:
Beginning researcher from Faculty of Medicine, Jagiellonian University Medical College, Poland. Member of Studentsʼ Scientific Group at 2nd Department of General Surgery and Studentsʼ Scientific Group of Systematic Reviews.
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