Euro Health Care and Fitness Summit September 01-03, 2015 Valencia, Spain

Niklas Juth is a PhD in Practical Philosophy since 2005 and Associate Professor in Medical Ethics at Karolinska Institute since 2013. His research interests are in ethics and bioethics, genetics and the intersection between political philosophy and medical ethics, e.g. autonomy and justice in health care. He has also published extensively within the areas of experimental ethics, victims of honor related threats within health care, end-of-life care, screening, genetics and health care complaints.

Aim: The aim of the present study is to examine whether physicians’ estimations of medical needs are influenced by the physicians’ own personal values. rnrnDesign & Methods: We used a vignette where a young female requests hymen restoration or virginity certificate due to honor-related threats. We asked whether or not the participating physicians would under certain circumstances be prepared to help the young females. We also asked what would happen to their own trust and what they estimated would happen to the general public’s trust in healthcare if performing such operations or writing such certificates was generally accepted. rnrnResults: The majority of those whose own trust would not be influenced [59.7% (95% CI55.2—64.2)] were found among the respondents who stated that they were prepared to help the young females, as against those [13.5% (95% CI 10—16.5)] stating that they would help under no circumstances. We found an association between those whose own trust would decrease and those stating that they would help under no circumstances [Or 90 (95% CI 12.2—664.3)].rnrnConclusion: The results indicate that factual aspects are influenced by physicians’ own values. If factual aspects such as estimation of the patient’s trustworthiness and medical needs are impregnated by physicians’ personal values, there is a risk of arbitrariness when deciding whether to help young females in distress. In order to avoid arbitrariness in decision-making we suggest that consensus in the area is developed.rnrn

Jhonatan Betancourt Peña is a Physiotherapist, Specialist in Cardiac and Pulmonary Rehabilitation and has an MSc in Business Administration, and is currently conducting MSc studies in Public Health at Universidad del Valle. He belongs to the research group Interdisciplinary Group on Health and Society Research IGHSR ascribed to COLCIENCIAS. He has published at least 5 articles in journals indexed in Colombia and other countries. He has spoken at numerous times in symposia and conferences presenting issues related diseases Cardiopulmonary exercise. Hugo Hurtado Gutiérrez is a Professor at Universidad del Valle. A biologist by profession, he obtained at age 24 an MSc in Public Health as a scholarship holder of the Universidad Nacional de Colombia. Later he obtained a specialization in Demographic and Health at Universidad Javeriana in Bogotá as scholarship holder of PAFCSM (Pan American Federation of Colleges and Schools of Medicine) and subsequently obtained an MSc Biostatistics at Universidad de Chile, Santiago de Chile, as a scholarship holder of the WHO (World Health Organization). He was director of the Masters in Public Health, Epidemiology and Health Administration at the School of Public Health in Universidad del Valle. He has published numerous articles in national and international journals and has won 1 World Award and some national awards. He has written five books related to biostatistics and primary health care.

Diffuse interstitial lung diseases (DILD) are a heterogeneous group of disorders of the lung parenchyma, which are classified into one group to present similar clinical, radiological, pathophysiology and anathopathological features. In patients with DILD exercise has benefits to reduce dyspnea, improve functional capacity and quality of life. The aim of the study was to establish the effects of an exercise program in patients with DILD. It is a quasi-experimental study in a population of patients diagnosed with DILD and those admitted to an exercise program for 8 weeks of continuous exercise on treadmill for 30 minutes starting at 80% of the speed achieved in 6MWT increased at 4 weeks at 90%; upper limb muscle strengthening 4 sets of 12 reps with 1 minute rest at 30% of maximum resistance (MR), increasing to four weeks at 40% of the MR; breathing techniques and mobility of the chest. The data were entered into a template in Excel 2010 and processed in Statistical Package EPIINFO 2000; statistical tests of differences in means ± standard deviation were performed using paired t-test. Previous studies established that patients with DILD to obtain a minimal difference in the walk test six minutes at the end of pulmonary rehabilitation program in the range of 24-34 meters, but was identified that women walked less distance compared with men. Despite the small number of patients involved in the study, there was a significant increase in the distance covered in the walk test of six minutes. Symptomatic patients with DILD, with impaired functional capacity and life quality benefit from an exercise program for 8 weeks, so it is safe and is recommended as an alternative treatment for all symptomatic patients with DILD.

Kyung-Sook Bang has completed her PhD in 2000 from Seoul National University. She is a faculty member of the Seoul National University College of Nursing. She has published many research papers in reputed journals, and has been actively participating as an Editorial Board Member and Committee Member in various academic associations.

In Korea, it is known that many young adult college students are suffered from physical inactivity, high level of stress and depression. However, how lack of physical activity level and health-related behavior affect their health was not sufficiently reported. This study was performed to identify whether physical activity level affects physiological, psychological variables in these ages. Data were collected in February and March, 2015 from 99 undergraduate and graduate students in one university. The participants were assessed for body composition analysis, blood pressure, bone mineral density, heart rate variability (HRV) and blood analysis at the university health care center. Also, physical activity level, health promoting behavior, and depression were measured using self-report questionnaire. In the results, the physical activity level showed significant correlations with Vitamin D (r=.233, p=.021), and muscle amount in body composition (r=.243, p=.015). However, percentage of body fat did not show significant relations with physical activity level (r=-.157). In Heart rate viability (HRV) analysis, we found significant correlations of physical activity with mean heart rate (r=-.331, p=.001), parasympathetic activation (r=.209, p=.038), stress resistance (r=.233, p=.020). In addition, physical activity level showed significant negative correlation with depression (r=-263, p=.008) and positive correlation with health promoting behavior (r=.388, p<.001). In conclusion, the physical activity level showed significant relationships with health status and health promoting behavior of college students. Strategies for improving physical activity and health promoting behavior for young adult college students need to be developed.

Rodriguez P Maria Elizabeth has completed his PhD from San Simon Mayor University and Postdoctoral studies in Dermatology and Dermatopathology at the Dermatology Center \"Ladislao de la Pascua\" Autonomous University of Mexico, DF. She is Professor of General Pathology.

Actinomycosis is a chronic disease localized or hematogenous, produced by Actinomyces israelii, which is often part of the normal flora of the gums, tonsils and teeth. Various traumatic events such as tooth extraction can facilitate microorganism invade these tissues.\r\nMost often affects adult men and can take several forms: cervicofacial, thoracic, abdominal and pelvic. The cervicofacial actinomycosis is the most common variety, it’s presented as a nodular lesion, like an abscess on the skin surface, and it can be confused with neoplasms or granulomatous diseases. The diagnosis is obtained by the findings of microbiology and histopathology. The treatment of choice is penicillin. Sufamethoxazole in allergic patients is therapeutic alternative, the duration of the treatment is weeks to months, or to remission of clinical manifestations. Drainage and surgical resection may be beneficial in some patients.\r\nA male patient, aged 22, who presented with pain and increased volume of the left sub-mandibular region, his disease began two months ago, after a molar extraction. Physical examination revealed a nodular lesion in the left sub-mandibular region, painful, erythematous, three centimeters in size. A biopsy was performed and the histopathological report was actinomycosis. It began treatment with sulfamethoxazole 800 mg every 12 hours for four months because the patient is allergic to penicillin. The clinical outcome was good, currently the fibrosis is observed in the affected area.\r\n

Yaswanth Ala has completed his Masters in Biotechnology from Osmania University and pursuing Ph.D in Genetics. He is a member of Indian Immunology Society and presented more than 10 papers in National and International conferences.

Background: The cyto-toxic T lymphocyte antigen4 (CTLA4) is a negative regulator of T-cell function and encodes a surface molecule with inhibitory effects on activated T cells. Variation in CTLA4 gene has been genetically associated with a number of autoimmune diseases including vitiligo, an acquired pigmentary disorder resulting from loss of melanocytes.rnAim: The present study is aimed at investigating the role of functional polymorphisms of CTLA-4 gene (rs11571317C>T, rs231775A>G and rs5742909C>T) in susceptibility to vitiligo.rnMethods: Genotyping was performed by PCR-RFLP and ARMS-PCR in a total of 410 subjects (200 vitiligo patients and 210 normal healthy controls). Data was subjected to appropriate statistics.rnResults: The two polymorphisms rs11571317 and rs5742909 showed a significant association with vitiligo. The multifactor dimensionality reduction (MDR) analysis of CTLA-4 gene revealed a strong synergy between rs11571317 and rs231775. The two locus model (rs11571317 and rs5742909) and three locus model (rs11571317, rs231775 and rs5742909) was observed to be the best models (with cross validation 10/10) showing the two fold and three fold increased risk respectively towards vitiligo (OR: 2.0, 95% CI: 1.3-3.2 and OR: 3.3, 95%CI: 2.16-5.17respectively). By Multiple logistic regression analysis gender and rs231775 showed the significant variation (p<0.05). Haplotype blocks C-A-T and T-G-C conferred significant protection (OR: 0.42, 95% CI: 0.23-0.78, p=0.005 and OR: 0.48, 95% CI: 0.26-0.88, p=0.018 respectively) and C-G-C a two-fold increased risk towards vitiligo (OR: 1.72, 95% CI: 1.04-2.86, p=0.036).rnConclusion: Our findings suggest the role of CTLA-4 in the vitiligo pathogenesis and for the first time we report the association of rs11571317 and rs5742909 polymorphisms in relation to vitiligo.rn

Surekha Tippisetty was awarded with PhD from Osmania University and credited with 5 international publications and more than 8 national and international conference presentations from academic research. She has 4 years of corporate experience in Pharmaceutical industry as Medical Writer. Currently, she is pursuing Postdoctoral study from Osmania University with high interest to expand her research activities in understanding the underlying mechanisms and various intrinsic and extrinsic factors effecting vitiligo pathogenesis and drug response variation.

Vitiligo, a common disfiguring dermatological disorder, appears as milky white patches on the affected region of the skin. The primary pathogenic event in the causation was reported to be oxidative stress followed by autoimmunity. Cytochrome P450 (CYPs) play a major role in the metabolism of xenobiotics, drugs and other toxic intermediates and supports in cell maintenance and survival. The study aims to evaluate the association of CYP 1A1-M2 and -M1 polymorphisms in susceptibility and drug response variation. Genomic DNA was isolated from blood samples of 455 subjects of Indian origin and genotyped using PCR.The analysis revealed a significantly higher percent of patients to be fast-responders (80.6%) than slow-responders (32.0%). The genotype analysis revealed CYP1A1 M1 CC vs. CT+TT genotype in susceptibility and fast drug response and CYP1A1M1 TT vs. CT+CC was associated with protection towards vitiligo and slow drug response. Further haplotype analysis of M1 and M2 revealed CTAG block significantly associated in susceptibility and CCAA block with fast drug response.To our knowledge this is the first report that contributes to the role of CYP in vitiligo susceptibility and drug response variation. Studies in different ethnic population with large sample size are warranted to establish current findings.

Hussein M Baharetha has completed his MSc at the age of 32 years from Universiti Sains Malaysia, Penang, Malaysia. He is a PhD student at Universiti Sains Malaysia, Penang, Malaysia, School of Pharmaceutical Sciences. He has experience in cancer treatment via Anti-angiogenesis mechanism. He has published more 4 papers in reputed journals and more than 5 abstracts of international conferences. He has been working as a lecturer at college of medicine, Hadhramout University, Yemen.

Nigella sativa is a popular spice that has been used traditionally for centuries for treatment of various human ailments, range from fever to intestinal disturbances to cancer. In this study an attempt was made to investigate the antiangiogenic activity of a supercritical CO2 extract of seeds of Nigella sativa Linn. The extract was prepared at 60ºC and 2500 psi. GC-MS analysis revealed the presence of thymoquinone. The extract showed potent antioxidant activity and strongly inhibited angiogenesis via its anti-proliferative effect against human umbilical vein endothelial cells (HUVECs) with IC50 value of 41.5±1.9 µg/ml. Our study reported that the extract down-regulated the expression of vascular endothelial growth factor (VEGF) in endothelia cells causing inhibition of various events of the angiogenesis cascade, including endothelial cell migration and differentiation on matrigel and consequently inhibited tube formation. This study highlights the therapeutic potentials of N. sativa SC-CO2 oil as anti-angiogenic agent.rnrn

Yolanda Raquel Lapeña Moñux has completed his PhD in July 2012 from University of Alicante (Spain) and Postdoctoral studies from Autonomous University of Madrid of Nursing. She worked as an Assistant Professor for three years at University Jaume I and Secretary of the Department of Nursing at University Jaume I – Castellón de la Plana (Spain). She has published some papers in reputed journals and is Reviewer of Enfermería del Trabajo Journal.

The process of communication-relationship requires considering the skills and/or attitudes nurses should develop in their communicative relationships with other colleagues, in the role of both sender and recipient. The aim of this qualitative study was to know how is the communicative interaction between hospital nurses, about the characteristics of interpersonal communicative interaction and skills that professionals develop in their working relationships. The data were collected using in depth interviews to twenty-one nurses that worked in different units at a general hospital in the centre of Spain. The data were transcribed verbatim and analyzed using qualitative content analysis. Four main themes emerged: 1- communication and sender, 2- communication and awareness of who has the problem, 3- non-verbal communication and 4- communication and recipient. The interviews revealed that most of the professionals had difficulties in clearly expressing their messages at the level of content, feeling and demand, as well as in developing an assertive communication with colleagues. Also, we found lack of feedback in relationships and seldom were an empathetic attitude shown. We conclude that nurses´ relational meeting with other colleagues is characterized by an important emotional load that generates different feelings, difficulties to use “I messages” and to handle nonverbal communication. The results of this study highlight the need to broaden nurses\' relational communication skills in order to increase job satisfaction.