Journal of Medicine, University of Santo Tomas最新文献

{"title":"A Review of the Clinical Significance of Lumbar Puncture in the Diagnostic Approach of Aneurysmal Subarachnoid Hemorrhage (SAH): A Case Report of CT-Negative and Lumbar Puncture–Positive SAH","authors":"Maria Vashti Zerlinda Lesmana, Edrik Wiyogo, Frandy Susatia, Candra Wiguna, Harsan Harsan","doi":"10.35460/2546-1621.2023-0074","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0074","url":null,"abstract":"Headaches are a common presentation in the emergency department (ED). Even though not all are potentially serious, some such as subarachnoid hemorrhage (SAH) can be more dangerous than others. SAH is a medical emergency with an almost 50% mortality rate. It is crucial not to miss the diagnosis of SAH, as a missed or delayed diagnosis can be severely detrimental. It classically presents as thunderclap headache, a severe, sudden-onset headache. There are various approaches in diagnosing or excluding SAH, which is classically done by performing a computed tomography (CT) scan followed by a lumbar puncture (LP). But with the improved sensitivity of more modern diagnostic tools, more physicians are in support of changing this classical teaching. The aim of this case report is to review the advantages and disadvantages of LP in diagnosing SAH, along with other diagnostic tools commonly used. Keywords: subarachnoid hemorrhage, lumbar puncture, cerebrospinal fluid, aneurysmal subarachnoid hemorrhage, brain ct scan, brain ct angiography, brain mr angiography","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139307003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Platelet-Rich Plasma as an Adjunct to Core Decompression to Treatment Outcomes and Femoral Head Preservation in Avascular Necrosis of the Hip: A Meta-Analysis of Randomized Controlled Trials","authors":"Carlo F Fernandez, Byron S Angeles, Carmelo L Braganza","doi":"10.35460/2546-1621.2023-0054","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0054","url":null,"abstract":"Background: Avascular necrosis (AVN) of the femoral head results from intraosseous pathology causing functional impairment. Early diagnosis allows conservative treatment like core decompression, delaying total hip arthroplasty. Objective: This meta-analysis aims to summarize platelet-rich plasma's (PRP) impact as an adjunct to core decompression (CD) on treatment outcomes and femoral head preservation in hip AVN. Methods: The study conducted a comprehensive literature search using PubMed, Cochrane Library, Science Direct, Google Scholar and Med Line, including randomized controlled trials (RCTs) and previous meta-analyses from various databases. Using a random effects model, it compared PRP+CD with bone grafting to CD with bone grafting alone in AVN patients, evaluating function, pain scores, disease progression and the need for hip surgery. Results: The meta-analysis examined 1041 records and included three studies. The primary outcomes were function and pain scores using Harris Hip Scoring (HHS) and Visual Analog Scale (VAS). Postoperative HHS scores at final follow-up favored the PRP+CD group significantly over CD alone. Postoperative VAS scores showed a trend towards higher scores in the CD alone group. The PRP+CD group demonstrated higher survival from disease progression compared to CD alone. Overall, the study suggests that PRP+CD led to better functional outcomes and disease progression outcomes than CD alone in AVN of the hip. Conclusion: The PRP+CD treatment group showed significant benefits in AVN patients compared to CD alone, including higher HHS scores, improved disease progression survival and reduced need for hip surgery. Although PRP+CD resulted in decreased VAS scores, the difference was not statistically significant. Keywords : Avascular Necrosis/AVN, Osteonecrosis, Femoral Head, Platelet-Rich Plasma, Core Decompression and Randomized Controlled Trial","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139306721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Basic Review of Sarcopenia Diagnosis","authors":"Maria Grace A De Guzman, Raymond L Rosales","doi":"10.35460/2546-1621.2023-0045","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0045","url":null,"abstract":"Associated with aging, sarcopenia is characterized by a decline in skeletal muscle mass, muscle strength and physical performance, eventually resulting in reduced physical capability, disability, poor quality of life, mortality in older people and high health care expenditure. The prevalence varies significantly by population characteristics, disease status, diagnostic criteria and measurement tools. It is essential to achieve an accurate diagnosis of sarcopenia for the management plan to be effective. This review briefly discusses the essential steps in diagnosing sarcopenia: Find – Assess – Confirm - Severity. Keywords: sarcopenia, sarcopenia diagnosis, case finding, muscle strength, performance, muscle mass","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139307646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap or Widening the Divide: A Call for Capacity-Building in Artificial Intelligence for Healthcare in the Philippines","authors":"Kurt Lenard T Gutierrez, P. M. Viacrusis","doi":"10.35460/2546-1621.2023-0081","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0081","url":null,"abstract":"The emerging field of generative artificial intelligence (GAI) and some of its well-known technologies: ChatGPT, Google Bard and Claude, have gained substantial popularity due to their enormous potential in healthcare applications, as seen in medically fine-tuned models such as Med-PaLM and ChatDoctor. While these advancements are impressive, the dependence of AI development on data volume and quality raises questions about the generalizability of these models. Regions with lower medical research output risk bias and misrepresentation in AI-generated content, especially when used to assist clinical practice. Upon testing of a prompt concerning the isoniazid dosing of Filipinos versus other ethnic and racial groups, responses from GPT-4, GPT-3, Bard and Claude resulted in 3 out of 4 outputs showing convincing but false content, with extended prompting illustrating how response hallucination happens in GAI models. To address this, model refinement techniques such as fine-tuning and prompt ensembles are suggested; however, refining AI models for local contextualization requires data availability, data quality and quality assurance frameworks. Clinicians and researchers in the Philippines and other underrepresented regions are called to initiate capacity-building efforts to prepare for AI in healthcare. Early efforts from all stakeholders are needed to prevent the exacerbation of health inequities, especially in the new clinical frontiers brought about by GAI. Keywords: Artificial Intelligence, Bias, ChatGPT, Healthcare, Philippines","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Morbidities After Stroke in Asia: A Systematic Review","authors":"Meliza Angelica J De Leon, Alejandro C. Baroque II","doi":"10.35460/2546-1621.2023-0021","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0021","url":null,"abstract":"Background: Stroke is currently the second leading cause of death worldwide and is one of the leading causes of long-term disability . Mood disorders are prevalent after a stroke and may hinder physical, functional, and cognitive recovery; hence, it is undeniably necessary to recognize them early. Stroke mortality is generally higher in Asia as most of the countries therein are in economic transition . Socioeconomic status is a major contributor to stroke burden as greater odds of disability are found in patients with lower educational status and income. Objectives: The primary objective of this study is to identify the psychiatric morbidities commonly seen after a stroke in Asia. Search Methods: The following databases were utilized for extensive literature search: PubMed (January 2002 to June 2022), Cochrane Library (January 2002 to June 2022), and EBSCO (January 2002 to June 2022). The search made use of keyword combinations, Boolean operators \"AND\" and \"OR,\" truncations, and field tags last October 2022. Selection Criteria: Articles on the prevalence and cross-sectional studies were included if they involved stroke survivors who developed post-stroke psychiatric morbidities in Asia. Additional inclusion criteria consisted of studies that have to be written in the English language and having free full texts available. Data Collection and Analysis: This systematic review made use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and guidelines. The JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data was used in the assessment for the quality of articles to be included in this systematic review. Results and Conclusion: Affective disorders and generalized anxiety disorder were the common psychiatric morbidities identified post-stroke. The Hospital Anxiety and Depression Scale (HADS) may be used to diagnose post-stroke depression and anxiety. Males in their middle to late adulthood with higher National Institutes of Health Stroke Scale (NIHSS) scores and poor stroke outcomes (higher scores in the Modified Rankin Scale) were associated with a higher likelihood of developing the aforementioned psychiatric morbidities. Keywords: post-stroke, depression, anxiety, mania, psychosis, Asia","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Insights into Covid-19 Vaccination","authors":"Tommy C Sim","doi":"10.35460/2546-1621.2023-0077","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0077","url":null,"abstract":"Almost a year after the worldwide appearance of the coronavirus (SARS-CoV-2), several novel vaccines of diverse platforms have been successfully developed and administered. Two mRNA vaccines represented a new type of vaccine that comprised of synthetic mRNA molecules containing the code sequence necessary to build the SARS-CoV-2 spike protein. These mRNA vaccines almost single handedly carried the brunt of the US COVID-19 immunization strategy during the past three years. The known and potential benefits of COVID-19 vaccination outweigh the risks and adverse complications. The ongoing COVID-19 pandemic has stimulated unprecedented research on aspects of the vaccines’ ability to reduce the risk of severe infection and death. Likewise, basic immunological studies are pivotal to unraveling the potential and long-term effects of the vaccines as well as to be able to make adjustments to new vaccine development. As the circulating virus strain continues to evolve, updated vaccines will be critical to protecting the population, particularly the elderly and immune compromised.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139306694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Dermatologic Conditions Among Elderly Patients at the Ambulatory Care Service of a Tertiary Hospital in Metro Manila from 2014 to 2018: A Five-year Review","authors":"Irene B Cua, Eleanor Lo-Letran","doi":"10.35460/2546-1621.2021-0002","DOIUrl":"https://doi.org/10.35460/2546-1621.2021-0002","url":null,"abstract":"Introduction: Ageing is a progressive degenerative process that leads to decline in the physiological function and reserve capacity of the whole body system, including the skin. As the Filipino geriatric population escalates, the incidence of skin diseases becomes more widely acknowledged. Presently, there are only a few studies that have been reported locally describing the nature of geriatric dermatoses. Objectives: To describe the epidemiology of dermatologic conditions among Filipino elderly patients that prompted a consult at the ambulatory care service of a tertiary hospital between the years 2014 and 2018. Methodology: All Filipino elderly patients with dermatological conditions seen at the dermatology ambulatory care service from 2014 to 2018 was studied through a single-center, retrospective, descriptive study. Results: Elderly patients comprised 16.76% of the total patients who sought dermatological consultation at the ambulatory care service of the hospital. Majority of the patients were females. Xerosis/xerotic eczema (10.02%) was the most frequently encountered skin disease. The top 10 diseases were irritant contact dermatitis (7.00%), lichen simplex chronicus (6.67%), psoriasis (5.56%), seborrheic dermatitis (5.24%), allergic contact dermatitis (4.37%), tinea pedis (3.51%), herpes zoster (3.49%), seborrheic keratosis (3.23%), and milia (2.54%). Based on the nature of disease, inflammatory condition was the most commonly seen. Conclusion: Dermatological disorders are ubiquitous in older people with a significant impact on the quality of life. Inflammatory dermatoses comprise a wide array of skin diseases as evidenced in this study, which account for most of the cutaneous problems in the elderly. Similar to other epidemiological studies, xerosis/xerotic eczema still comprises majority of the cases prompting elderly patients to seek a dermatological consultation. Keywords: elderly, geriatric, dermatologic diseases, ambulatory, epidemiology","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developments in Post-Stroke Spasticity Care with Early Use of Botulinum Toxin A: A Review","authors":"Maria Leila M Doquenia","doi":"10.35460/2546-1621.2023-0070","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0070","url":null,"abstract":"Spasticity is one of the most common and disabling complications of stroke. Most of these patients notably experience both muscle-based and non-muscle-based pain. This negatively affects their quality of life as well as aggravates caregiver burden. Post-stroke spasticity (PSS) may furthermore lead to several complications related to limited mobility, both motor (eg, contractures) and non-motor (cognitive decline, depression) if left untreated. It is thus crucial to address this with safe and effective means such as botulinum toxin therapy as early as possible. We aim to demonstrate the utility of botulinum toxin (BoNT) in PSS treatment and how early intervention may be preferable to late spasticity control for patients. Literature search and evaluation were done using the traditional evidence hierarchy. Early intervention with botulinum toxin A (BoNTA) demonstrated a more marked reduction in both spasticity and spasticity-related pain with longer required intervals to reinjection. Keywords: Botulinum Toxin, Early Use/Intervention, Poststroke Spasticity, Pain","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139309363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It’s Time to Engage: AI Is Trending","authors":"Raymond L Rosales","doi":"10.35460/2546-1621.2023-0084","DOIUrl":"https://doi.org/10.35460/2546-1621.2023-0084","url":null,"abstract":"","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"193 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Pigmented Rice in Reducing Cardiovascular Disease Risk: A Mini-Review of Animal and Human Studies","authors":"Diane S Mendoza-Sarmiento, Alison M Hill","doi":"10.35460/2546-1621.2022-0089","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-0089","url":null,"abstract":"Higher dietary intake of polyphenols is associated with a reduced risk of cardiovascular disease (CVD) events and mortality. However, these phytochemicals are predominantly present in fruits and vegetables, which are inadequately consumed by some populations, including Filipinos. This narrative mini-review explores the potential role of polyphenol-containing pigmented rice consumption in modulating risk through a range of mechanisms identified in animal studies. Further, human studies have demonstrated promising but inconsistent effects on risk factors associated with the development of CVD, such as dyslipidemia, hyperglycemia, overweight and obesity. Therefore, this review identifies the need for more clinical trials to examine the effect of pigmented rice on CVD risk factors. Keywords: pigmented rice, cholesterol, glucose, weight, polyphenols","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139308390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}