Day 2 :
University Children´s Hospital, Belgium
Keynote: Do new publications on the anatomy of the larynx of neonates and infant help to prevent intubation injury?
Time : 9.00 to 9.30
Dr Josef Holzki is a teaching professor at the University Children´s Hospital Liège, Belgium, after retiring from being Director/Chairman of the department of Pediatric Anesthesia and Surgical Intensive Care Unit (SICU) in Children´s Hospital Cologne, Germany for 23 years. He also served as a President of the FEAPA (Federation of European associations of Pediatric Anesthesia), Lecturer in international meetings of Pediatric Anesthesia and –intensive care and airway endoscopy, honorary member of the Association of Pediatric anesthesia of Great Britain and Ireland (APA).
To give a convincing overview of the pediatric larynx we have to rely on anatomical findings depicting the funnel (conical) shape of the unyielding cartilaginous structures (1) with the apex at the outlet of the larynx (2). However, the distensible part of the larynx, consisting of glottis and anterior wall superior of the arch of the cricoid cartilage, are not convincingly described yet because radiological methods (MRI and CT-scans) cannot demonstrate the distention of this part which occurs during every intubation. These two aspects of the larynx can lead to controversial discussions which affect the work of nurses how to deal with tracheal tube care.rnAirway endoscopy with small endoscopic lenses (type Hopkins) can visualize glottis, sub-glottis space and the narrow outlet of the cricoid ring during spontaneous breathing under anesthesia, confirming rigid anatomical and distensible structures of the larynx. Simultaneous documentation of airway injury leads to desirable early treatment. rnNewer studies, relying on MRI and CT-scans without accompanying endoscopy (3) might lead to inadequate interpretation of their findings in relation to intubation trauma.rnrnVideo-laryngoscopy as a first step to establish endoscopic technology to visualize the intubation procedure can help to prevent airway injury.rn
General Hospital of Ciudad Real, Spain
Keynote: Relationship of Comorbid Depression with Personality Dimensions and Perceived Parental Rearing in Eating Disorders
Time : 09:30 to 10:00
Luis Beato-Fernández (MD. PhD.) has completed his MD from University of Seville (Spain) and postdoctoral studies PhD from University of Cordoba School of Medicine. He is the director of Eating Disorders Unit at the General Hospital of Ciudad Real and he is professor at the School of Medicine University of Castilla La Mancha. He has published more than 25 papers mainly related to Eating Disorders in adolescents.
Up to 40% of patients who suffer from an Eating Disorders have comorbid symptoms of low mood. Personality dimensions and family relationships could be related to depressive mood and constitute a risk factor for depression in EDs. The aims were to see which temperament and character dimensions were associated with depression, controlling the influence of parental rearing styles, mainly with its outcome at two-year follow up in eating disorders (EDs). We also studied the relationship of these variables with self-esteem and anxiety. Methods: Participants (N=94) had 28 Anorexia nervosa (AN), 38 Bulimia nervosa (BN) and 28 Eating disorders not otherwise specified (EDNOS). The Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self Esteem Questionnaire (RSE), Eating Disorder Inventory (EDI-2), Temperament and Character Inventory (TCI) and the EMBU (Swedish acronym for ‘My memories of upbringing’) were administered. Results: Depression at the beginning (t0) was severe in 22% of the cases. Harm Avoidance and Novelty Seeking had an effect on depressed mood at t0, mediated by Ineffectiveness. Responsibility (SD1) was associated with scores on the BDI at two years follow up (ß=-0.37, 95% CI -2.6, -0.6, p<0.01). However we didn't find any relationship between the EMBU and BDI scores one and two years later. Conclusion: Low mood in EDs could be more related to personality dimensions than factors related to "upbringing" and enhancing self-efficacy and self-directness is crucial for a good clinical outcome.