3^rd International Conference on Cardiovascular Medicine and Cardiac Surgery July 05-06, 2018 Golden Tulip Berlin – Hotel Hamburg

Cynthia Kallás Bachur has PhD in Sciences in the Graduate Program in Fundamental Nursing at the University of São Paulo. She graduated in Physiotherapy from the University of Ribeirão Preto, Specialization in Exercise Physiology and Master in Health Promotion by France - Brazil. She is a Member of the Interdisciplinary Research Group on Hypertension of the School of Nursing of Ribeirão Preto. A contributing member of the Blood Pressure Screening Programs Group - World Hypertension League. She is a collaborating member of the Brazilian Advisory Committee on Hypertension; Member of the Research Ethics Committee of the University of France and; Scientific Coordinator of the League of Cardiology of the Medicine course of the University of France. and Preceptor in the Medicine course of the University of France, with practice in the active methodology problem based learning. She develops projects in the area of blood pressure measurement;evaluates exercise-induced cardiovascular adaptations and projects to evaluate risk factors for cardiovascular disease.

Statement of the Problem: The indirect measurement of blood pressure (BP) is part of the physical examination of extreme importance to the knowledge of health students and is routinely performed in clinical practice. The purpose of this study is to evaluate the effects of an educational intervention on the theoretical knowledge of the indirect measurement of BP in health students. Methodology & Theoretical Orientation: This is a descriptive, observational study carried out in regular students of the Physiotherapy and Medicine course of a private university in 2016, which evaluated the theoretical knowledge about the BP measurement procedure through a questionnaire (27 questions) following the recommendations of the current scientific papers. The Wilcoxon test was used for paired samples. Findings: 30 students from Physiotherapy and 30 from Medicine, from the 8th graduation period, with a mean age of 21.50 + 2.20 years participated. All students, from both courses, in the theoretical evaluation presented a significant difference (p<0.001) in the questionnaire score when compared to pre and post educational intervention. Conclusion & Significance: Based on the results of the present study, it can be observed that the educational intervention applied from a workshop was effective and should be implemented periodically at the undergraduate level, considering that this may influence the improvement of the development of skills and abilities in the procedure of the indirect measurement of BP in clinical practice.

Akram’s career in ultrasound spans 15 years and he is one of Australia’s most highly regarded sonographers especially in the field of vascular ultrasound. Akram initially obtained his Bachelor of radiologic sciences in 1986 from Kuwait university- Faculty of Allied Health Sciences and then obtained his Master degree in Anatomy from Kuwait University-Faculty of Medicine in 1994 then he completed examinations in the Diploma of Medical Ultrasound (General) in Australia and as a Registered Technologist in the USA. In 2006 Akram completed his PhD thesis at Monash University entitled “What makes the veins incompetent”? Since 2002 Akram has been a clinical senior lecturer at the Department of Radiologic Sciences-Faculty of Allied Health Sciences, Kuwait University, providing comprehensive training in radiologic Imaging, Musculoskeletal and Vascular Ultrasound Imaging in a clinical environment. He is currently hold an assistant professor position at Department of Radiologic Sciences, Faculty of Allied Health Sciences, Kuwait University and He is appointed as an adjunct senior lecturer to Monash University,Faculty of Medicine, Department of Medical Imaging from 1/6/2014 till 1/6/2018.

Introduction: Transcranial Doppler (TCD) is used to identify patients with sickle cell disease (SCD) at risk for stroke. We have carried out TCD studies in patients from four countries in the Arabian Peninsula (Kuwait, Oman, Southern Iraq and UAE) to document the prevalence of abnormal TCD findings. Methods: The patients were recruited form outpatient clinics and studied in steady state. TCD was performed using standard equipment with experienced operators. Time-averaged mean of maximum velocity (TAMMV) was documented in the arteries of the circle of Willis. The hemoglobin (Hb) genotype was confirmed and the fetal Hb (HbF) level and complete blood counts were determined. Results: There were 415 patients in the study, aged 2 to 18 years (mean of 8.6±3.5). None of the patients had abnormal TAMMV (i.e. >200 cm/sec), while only 13 (3.1%), all from Iraq had conditional values in the right middle cerebral artery (MCA) and 7 (1.7%) in the left MCA. There were no significant gender differences, and both the Hb genotype (SS, Sβ0thal or SD) and the use of hydroxyurea did not show consistent influence on TAMMV. Total hemoglobin, reticulocyte count, serum bilirubin and HbF showed varying degrees of correlation with TAMMV in the different vessels. Conclusions: This study has demonstrated the rarity of abnormal TCD in SCD from the Arabian Peninsula. This might be related to the haplotype, elevated HbF or may represent a racial variation. The guidelines for TCD screening in this population need further studies and recommendations.

Andronikashvili Irine is an Associate Professor at the Department of Internal Medicine, Tbilisi State Medical University. Her field of scientific interest includes etiology and pathophysiology of hypertension, particularly mechanism of development salt sensitivity and salt sensitive essential hypertension, elaboration of adequate methods of treatment and prevention. She is a member of Georgian and European Societies of Cardiology.

Statement of the Problem: The majority of patients with hypertension have salt-sensitive form of disease, however little has known about mechanisms of salt sensitivity. Salt sensitivity and circadian rhythm of blood pressure might be the keys for understanding the connections between cardiovascular and renal complications. Proximal sodium reabsorption is considered to be the key determinant of response of blood pressure to sodium intake. The purpose of study was to elucidate the role of proximal sodium reabsorption in the development of salt-sensitivity and salt-sensitive hypertension, to find connections between the cardiovascular and renal systems, with regard to the salt sensitivity and circadian rhythm of blood pressure (BP). Material & Methods: Typing of normotensive subjects and hypertensive patients by salt-sensitivity test; assessment of proximal sodium reabsorption in salt-resistant and salt-sensitive normotensive and hypertensive subjects; determination of circadian rhythm of blood pressure in normotensive and hypertensive patients. A total of 140 middle aged (30-50 yrs.) subjects – 70 normotensives and 70 hypertensives of stage I essential hypertension (JNC VIII) were examined. All subjects were tested for salt-sensitivity. Proximal sodium reabsorption was assessed by lithium clearance and its fractional excretion. Determination of circadian rhythm of blood pressure was performed by 24-hr ambulatory blood pressure monitoring. Findings: 25 healthy subjects had salt-sensitivity and 56 had salt-sensitive essential hypertension. Sodium proximal reabsorption in salt-sensitive hypertension was significantly decreased compared to salt-sensitive normotensives (23.08±0.55% and 19.2±0.40%, p<0.05). Study of circadian rhythms revealed significant (p <0.05) perversion of circadian rhythm in saltsensitive subjects (both in normotensives and in having essential hypertension) compared to salt-resistant subjects. Conclusions: The results of this study clarify interrelationship between main causative factors leading to salt-sensitivity: inadequate proximal sodium reabsorption and specificities of blood pressure circadian rhythm.

Ekaterina I Shishatskaya, MD, PhD, has her expertise in biotechnology of degradable natural materials for biomedical purposes. More than fifteen years she devoted to research of applications of natural polymers, PHAs, working towards development of scaffolds for tissue engineering and systems of controlled drug delivering.

Restoration of injured vessel wall due to formation of atherosclerotic plug is the target of percutaneous transluminal coronary angioplasty (PTCA) in ischemic heart disease treatment. Development of smart materials for vascular stents is a key point in the solution of the problem of neoatherosclerosis and restenosis. Nanostructure of such smart stents may have the specific influence to cell elements of vessel wall through the mechanisms of mechanotransduction; realize the phenomenon of guided tissue formation. Macrophages have the leading role in the development of atherosclerotic changes, as foam cells of plugs. The creation of smart nano-structured stents requires their estimation in adequate in vitro model systems. Development of ischemic hart disease is accompanied by the appearance in circulating blood of monocytes of pro-inflammatory, proatherogenic phenotype, co-expressing CD14 and CD16. PTCA can be contemplated as a provoking factor, triggering the cascades of negative chemokine reactions and causing neoatherosclerosis development. Good candidates for applications in reconstructive tissue remodeling is the group of natural polyesters of alkanoic acids, - polyhydroxyalkanoates (PHAs). This class has high biocompatibility, controllable periods of biodegradation and good construction properties thanks to their structure variations. PHAs are synthesized in microbial cultures depending on strain specificity monomer composition can vary. We tested five monomer compositions, obtained in Ralstonia eutropha B5786 in short-term cultures of monocytes of patients, before and after PTCA. Surface nano-reliefs of samples differ in significant, as seen in atomic force microscopy (AFM). Phenotypic differences in monocytes cultured were observed also, in SEM and molecular analyses.

Cynthia Kallás Bachur has PhD in Sciences in the Graduate Program in Fundamental Nursing at the University of São Paulo. She graduated in Physiotherapy from the University of Ribeirão Preto, Specialization in Exercise Physiology and Master in Health Promotion by France - Brazil. She is a Member of the Interdisciplinary Research Group on Hypertension of the School of Nursing of Ribeirão Preto. A contributing member of the Blood Pressure Screening Programs Group - World Hypertension League. She is a collaborating member of the Brazilian Advisory Committee on Hypertension; Member of the Research Ethics Committee of the University of France and; Scientific Coordinator of the League of Cardiology of the Medicine course of the University of France. and Preceptor in the Medicine course of the University of France, with practice in the active methodology problem based learning. She develops projects in the area of blood pressure measurement;evaluates exercise-induced cardiovascular adaptations and projects to evaluate risk factors for cardiovascular disease.

Statement of the Problem: Objective structured clinical examination (OSCE) is recognized as a highly reliable and efficient method, where simulated scenarios are used close to the reality of clinical practice with standard patients. Purpose: The purpose of this study is to analyze the practical knowledge about the indirect measurement of BP in health students, using the OSCE method. Methodology & Theoretical Orientation: This is a descriptive, observational study developed in students of the Physiotherapy and Medicine courses, who evaluated the practical knowledge about the BP measurement procedure, through a simulated practice in the evaluation method: OSCE, from observation and checklist completion, following the recommendations of the current scientific documents, pre and post educational intervention carried out on the subject. The Wilcoxon test was used for paired samples. Findings: Sixty students enrolled in the Physiotherapy and Medicine course, from the 8th graduation period, with a mean age of 21.50+2.20 years. A significant difference (p<0.001) was observed in the practical evaluation, based on the checklist applied in the OSCE method, when compared to pre and post educational intervention. Conclusion & Significance: Based on the results of the present study, it can be observed that the educational intervention, based on the use of practical simulation strategies based on the OSCE method, improved the practical knowledge of physical therapy and medicine students in relation to the stages of indirect measurement of BP.