Day 1 :
Columbia University College of Physicians and Surgeons, New York, USA
Time : 09:05-09:35
Dr. Maxwell M. Chait completed his MD degree at the age of 25 from the University of California School of Medicine at San Francisco. He is a Fellow of several prestigious organizations, including the American College of Physicians, American College of Gastroenterology, American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy. He is a practicing gastroenterologist and assistant professor of medicine Columbia University College of Physicians and Surgeons. In New York City He has authored numerous publications in reputed journals. He is the editor-in-chief of the Journal of Liver Disease and Transplantation and serves on the editorial board of the World Journal of Gastrointestinal Endoscopy.
Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder seen in the older patient. Older patients with GERD may have fewer symptoms. However, they can have more severe esophageal and extraesophageal complications that may be potentially life threatening than in younger individuals, such as erosive esophagitis, esophageal stricture, Barrett’s esophagus, adenocarcinoma of the esophagus, atypical chest pain; ear, nose, and throat (ENT) manifestations such as globus sensation and laryngitis, dental problems; pulmonary problems such as chronic cough, asthma, and pulmonary aspiration. A more aggressive approach may often be warranted in the older patient, because of the higher incidence of severe complications. The evaluation and management of GERD are generally the same in both younger and older patients. However, there are specific issues of causation, evaluation and treatment that must be addressed when dealing with the older patient, such as cognitive impairment, comorbidities and medication side effects.
Texas Center for Voice and Swallowing, USA
Time : 09:35-10:05
Mary Es Beaver is the Director of the Texas Center for Voice and Swallowing in Houston Texas, a division of Texas ENT Specialists which is the fourth largest Otolaryngology group in the United States. She has published previously on causes of chronic laryngotracheitis in numerous peer reviewed journals. She is a reviewer for the Laryngoscope and is a frequent contributor to the literature regarding pathology that affects the larynx.
Hoarseness, throat clearing, chronic cough, globus, and sore throat have been considered to be symptoms of extraesophageal reflux when inflammation of the larynx and trachea is noted on laryngoscopy or upper endoscopy. Many of the patients that present with these symptoms have no other symptoms of reflux such as heartburn or regurgitation. In the US, 10% of ENT clinic visits are patients with symptoms of hoarseness, throat clearing or cough that have lasted more than 6 weeks, and 79% of the time such patients are started on proton pump inhibitors as first line therapy without any diagnostic testing. However, randomized controlled trials have demonstrated that PPI’s are no better than placebo at treating the above symptoms, and studies using impedance pH testing or pharyngeal testing have concluded that reflux is present in less than half of the cases of chronic laryngeal and tracheal inflammation. Additionally, chronic high dose PPI use may increase risk of fractures in adults and young adults. This address will examine causes of chronic upper airway inflammation and suggest protocol for testing and treatment. \\\\r\\\\n\\\\r\\\\n
University of the Western Cape,
Keynote: Environmental exposures during childhood and the subsequent development of Crohn’s disease in the Western Cape South Africa
Time : 10:05-10:35
Abigail Basson has completed her PhD from the University of the Western Cape, South Africa, where she is presently a Lecturer of Nutrigenomics and Medical Nutrition Therapy. She received her MSc degree in Nutrition Science from New York University (USA) and also holds a Postgraduate qualification in Nutrigenomics from the University of Arizona. She has authored several publications in reputed journals and is serving as an Editorial Board Member of repute
Over recent years, the paradigm of the ‘hygiene hypothesis’ has gained wide attention as computerized DNA sequencing technologies revolutionize how we view the human microbiome. We performed a case control study of all consecutive Crohn’s disease (CD) patients seen at 2 large inflammatory bowel disease (IBD) referral centers in the Western Cape, South Africa between September 2011 and January 2013. Numerous environmental exposures during three age intervals; 0-5, 6-10 and 11-18 years were extracted using an investigator-administered questionnaire. One year later, participants completed questionnaire for a second time, in order to measure the agreement between repeated data, using a kappa statistic (κ=0.60-0.99). On multiple Logistic regression analysis, individuals who did not consume raw beef during childhood, did not consume unpasteurized milk those who never had a donkey, horse, cow or sheep living permanently on the property, those whose primary water source was bottled or tap water, as well as those exposed to passive cigarette smoke during childhood, were significantly more likely to develop future CD. However, the inconsistencies between each age interval with regard to the identified risk factors suggest that their effect on the development of immune structures varies according to timing and extent of exposure, although this outcome may be influenced by CD susceptibility mutations. Significant differences in CD susceptibility genotype have been observed between the white, colored and black ethnicities in South Africa. When evaluating the interaction with ethnicity, the passive smoke risk-association exposure maintained significance for colored CD subjects, but not for their white counterparts.