International Conference on Internal Medicine November 01-02, 2016 San Francisco, USA

Biography:

Dr. Flavio Cadegiani is a board certified endocrinologist and internicist from Federal University of Sao Paulo, has master degree in Endocrinology at Federal University of Sao Paulo and he is finishing his PhD in Endocrinology at the same university. He has presented ten posters in the last Obesity Week, in November 2015, and thirteen in the last International Congress on Obesity, in Vancouver, (in preparation for paper format). He is also the founder and CEO of the most successful obesity clinic in Latin America (corpometriainstitute.com and corpometria.com.br) and has become the first bariatric surgery prevention center in the world

Abstract:

Obesity is a complex syndrome (not only a disorder) that involves psychiatric, metabolic, inflammatory, hormonal and the system dysfunctions. Complications triggered by obesity includes more than fifty conditions, such as hypertension, diabetes, several types of cancer, autoimmune disorders, liver dysfunctions, psychiatric. Indirectly, and it is reasonable to say that obesity is the most important indirect cause of chronic renal failure and non-traumatic deaths in USA and other countries.
Unfortunately, we are losing the battle against this epidemic. All the efforts done so far seem to be insufficient, once obesity prevalence is still growing. A paradoxical correlation has been observed worldwide, once there is a direct, and not inverse, correlation between awareness levels of steps for a healthy life and weight loss strategies and obesity prevalence: the more a certain population is aware, the more obese this same population is, and not the contrary, which should have been expected. Certainly this relation does not show causality, but it does show that lifestyle approach is not enough, once obesity pathophysiology includes important changes in orexigenic and anorectic pathways, neurotransmitters dysfunctions and real addiction to high density calorie meals (sugar and cocaine has similar brain pathways and reward mechanisms, for instance).
Given the epidemic and high prevalence of obesity, there is still an inertness from medical community. Thus, several actions should be done:
- All physicians, not only obesity and endocrinology board certified, should be skilled and familiar to treat obesity.
- Psychotherapy, a strong tool, should be offered to obese patients.
- Psychotherapists should receive intensive training programs.
- New emerging diets, already scientifically validates, such as intermittent fasting diet, carb cycling diet and diets that allow free meals as part of the diet, have been shown to be as or more effective than traditional hypo caloric diets, and brings light to most patients, whose prohibition of certain foods brings anxiety and brings short life to diet programs.
- Real understanding of obesity as a psychiatric and metabolic conditions, and real actions regarding effective pharmacotherapy are still unknown by most doctors.
- The too-easy way to bariatric surgery: medical doctors have given up treating clinically obese subjects, and referred too quick to bariatric surgeons. Issues with this modality have been underestimated and clinical approach to obesity has failed, partly due to the lack of real knowledge about obesity approach.
- New paradigms over obesity therapy, that do now allow patients to regain weight after the loss period, the change of the over weight-centered approach, and how to create and manage a bariatric surgery prevention center.
All these actions and others should be urgently spread among clinicians in order to prevent dozens of millions of bariatric surgeries and its still unknown long-term complications (as many vitamins and minerals are not absorbed once duodenum stays in the blind handle) and to save hundreds of billions of dollars.

Biography:

Dr . Seemin Afshan Shiraz completed her MRCP(UK) in 2007 and then European Diploma in Critical Care in 2009. She has extensive experience in internal medicine and critical care. She has been invoved in teaching of medical students at University of Sharjah along with the training and teaching of post graduate students of family medicines, internal medicine and critical care medicine. She as an ACLS instructor.  She has been taking part in several oral and poster presentations both at national and international level. Currently, she is working as an incharge of a critical care fascility in Dubai, United Arab Emirates.

Abstract:

Heart Failure(HF) is a clinical syndrome which includes symptoms (breathlessness, ankle swelling & fatigue) ,signs (elevated JVP, pulmonary crackles and peripheral edema, caused by a structural and/or functional cardiac abnormality which results in reduced cardiac output and/or elevated intracardiac pressures . Identification of the precise pathology determines the specific treatment. In developed countries, the incidence of Heart failure is 1–2% of the adult population which raises  to ≥10% among people 70 years of age.The lifetime risk of HF at age 55 years is 33% for men and 28% for women.The plasma natriuretic peptides (NPs)  is the  initial diagnostic test in the non-acute setting.Elevated NPs help establish an initial working diagnosis. Patients with normal plasma NP concentrations are unlikely to have HF.The negative predictive values are very similar and high (0.94–0.98) in both the non-acute and acute setting. There are numerous cardiovascular and non-cardiovascular causes of elevated NPs. Abnormal ECG increases the likelihood of the diagnosis of HF but has low specificity.Some abnormalities on the ECG provide information on etiology (e.g. MI), and findings on the ECG might provide indications for therapy (e.g. anticoagulation for Atrial Fibrilation, pacing for bradycardia) .HF is unlikely in patients presenting with a completely normal ECG (sensitivity 89%). To prevent or delay the development of overt heart failure or death before the onset of symptoms, we need Optimum control of BP,Empaglifozin reduces mortality and HF. Physical activity and the risk of HF has inverse relationship.Statins have no role only in  atherosclerosis.