Journal of Medicine, University of Santo Tomas最新文献_第7页

Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin abnormalities (POEMS) Syndrome in a Filipino Nurse Returning to Work Following Bortezomib Treatment: A Case Report 菲律宾护士在接受硼替佐米治疗后重返工作岗位的多神经病变、器官肿大、内分泌病变、单克隆γ病变和皮肤异常(POEMS)综合征:一例报告

Journal of Medicine, University of Santo Tomas Pub Date : 2022-10-31 DOI: 10.35460/2546-1621.2022-0044

Nadine J Endaya, R. Rosales

{"title":"Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin abnormalities (POEMS) Syndrome in a Filipino Nurse Returning to Work Following Bortezomib Treatment: A Case Report","authors":"Nadine J Endaya, R. Rosales","doi":"10.35460/2546-1621.2022-0044","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-0044","url":null,"abstract":"POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) also known as Crow-Fukase syndrome or Takatsuki syndrome is a rare and disabling paraneoplastic syndrome that frequently occurs in the fifth or sixth decade of life without a known standard first-line therapy. A 34-year-old Filipino male nurse, who presented with gradually progressive distal lower extremity weakness and sharp shooting pain in bilateral legs accompanied by mild joint effusion on the left knee, hypertrichosis, bilateral conjunctival injection, and gynecomastia underwent extensive workup and was diagnosed with POEMS syndrome. Complete blood count revealed erythrocytosis and thrombocytosis with elevated serum VEGF (vascular endothelial growth factor) and elevated monoclonal serum free lambda light chains. The electrophysiologic studies revealed chronic demyelinating sensorimotor polyneuropathy while bone marrow core biopsy and bone marrow aspirate smear immunohistochemical staining showed it to be positive for lambda and CD138. He had an initial unsuccessful treatment course with melphalan and prednisone. Hence, bortezomib and dexamethasone were given which gave significant improvement in symptoms from the overall neuropathy limitation score of 5 to 1.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127042374","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}

引用次数: 0

Fork in the Road: Pick Research and Publication 岔路口:挑选研究和出版物

Journal of Medicine, University of Santo Tomas Pub Date : 2022-10-31 DOI: 10.35460/2546-1621.2022-0086

引用次数: 0

Cognitive Impairment Among HIV-positive Individuals in a Tertiary Infectious Disease Hospital in the Philippines 菲律宾某三级传染病医院hiv阳性个体的认知障碍

Journal of Medicine, University of Santo Tomas Pub Date : 2022-10-31 DOI: 10.35460/2546-1621.2022-0043

J. Catindig, F. Rasay, M. C. Folloso, R. Abrenica

{"title":"Cognitive Impairment Among HIV-positive Individuals in a Tertiary Infectious Disease Hospital in the Philippines","authors":"J. Catindig, F. Rasay, M. C. Folloso, R. Abrenica","doi":"10.35460/2546-1621.2022-0043","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-0043","url":null,"abstract":"Background: Disruption of neurocognitive functioning is one of the most frequent complications in patients infected with Human immunodeficiency virus. It manifests as a form of subcortical dementia characterized by psychomotor slowing, changes in mood and anxiety levels and deficits in memory, abstraction, information processing, verbal fluency, decision-making, and attention. The primary objective of this study is to determine the prevalence of neurocognitive impairment among HIV-positive individuals in the Philippines. Methods: This is a cross-sectional study done at the outpatient department of a tertiary infectious disease hospital located in Manila, Philippines conducted from May to July 2015. The Montreal Cognitive Assessment – Filipino (MoCA-P) was used to differentiate non-cognitively impaired and cognitively impaired participants. Demographic data was obtained using structured interviews including the CD4 count. Results: One hundred and twelve HIV positive patients were examined and 56.7% of them were noted to have cognitive impairment while none of them met the criteria for dementia. After logistics regression analysis, only the CD4 count (x=224) was shown to have significant association with cognitive impairment (p=0.0001, OR 0.96). Conclusion: Cognitive impairment was significantly associated with low CD4 count, with a sensitivity of 100% for a count of <224. More than half or 58.7% of subjects with cognitive impairment did not show any neuropsychiatric symptoms. Neurocognitive impairment is still an important component of HIV infection and this study highlights the need to further increase awareness regarding this HIV complication.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133939131","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}

引用次数: 0

Viewpoint: Decentralized Clinical Trials Have Arrived and Staying for Good 观点:分散的临床试验已经到来，并将永远持续下去

Journal of Medicine, University of Santo Tomas Pub Date : 2022-10-31 DOI: 10.35460/2546-1621.2022-0051

Mary Suzette R Cody

引用次数: 0

‘When all think alike, then no one is thinking’: Understanding the Praxis of Creative Insubordination as a Decision-Making Strategy in Philippine Medical Schools “当所有人的想法都一样时，那么没有人在思考”:理解菲律宾医学院创造性不服从的实践作为一种决策策略

Journal of Medicine, University of Santo Tomas Pub Date : 2022-04-30 DOI: 10.35460/2546-1621.2022-0033

Maria Minerva P. Calimag, Allan B. de Guzman

{"title":"‘When all think alike, then no one is thinking’: Understanding the Praxis of Creative Insubordination as a Decision-Making Strategy in Philippine Medical Schools","authors":"Maria Minerva P. Calimag, Allan B. de Guzman","doi":"10.35460/2546-1621.2022-0033","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-0033","url":null,"abstract":"Background – Exercising discretion is vital when making decisions. While decision‐making implies having to choose between predefined alternatives, discretion requires sifting through several solutions and critically choosing the desired one that implies a choice between many alternatives without rigid guidelines pointing to one direction or the other. While previous studies have constantly investigated the nature and dynamics of creative insubordination or discretionary insubordination in primary and secondary education little is known as to how such a construct operates in higher education. Purpose – This study was undertaken to address the central question: “What attributes define creative insubordination as a decision‐making strategy among Philippine medical school deans?” Design – Anchored on descriptive phenomenology, 21 medical deans who have been in the position for at least 4.5 years (range 4.5‐26 years) were purposively selected for in‐depth semi‐structured interviews. Guided by the rules of cool and warm analyses, transcribed texts were phenomenologically reduced and interpreted, and validated via member checking procedure. Findings – Five interesting elements that typify the modes of behavior in the practice of creative insubordination surfaced, namely: cognitional elasticity, emotional sensitivity, conational sincerity, relational mobility and axiological reflectivity. Conclusion – This study provides eidetic images of the multidimensional facets of individual attributes necessary for the praxis of discretionary decision‐making by a select group of Philippine medical deans in varied instances. Keywords: creative insubordination; discretionary decision-making; prosocial rule-breaking; medical deans; higher education","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123829073","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}

引用次数: 0

Giving Insulin Is Not a Guessing Game: Insulin Replacement Therapy in Type 2 Diabetes Mellitus 给胰岛素不是一个猜谜游戏:胰岛素替代治疗2型糖尿病

Journal of Medicine, University of Santo Tomas Pub Date : 2022-04-30 DOI: 10.35460/2546-1621.2022-0032

N. A. B. Luna, L. Mercado-Asis

{"title":"Giving Insulin Is Not a Guessing Game: Insulin Replacement Therapy in Type 2 Diabetes Mellitus","authors":"N. A. B. Luna, L. Mercado-Asis","doi":"10.35460/2546-1621.2022-0032","DOIUrl":"https://doi.org/10.35460/2546-1621.2022-0032","url":null,"abstract":"In 2021, 537 million adults were living with diabetes. Being a progressive disease, there would eventually be failure of oral hypoglycemic agents (OHA) to maintain good glycemic control and a majority will require insulin. However, optimal glycemic control has not been satisfactory in a significant proportion of patients who were on insulin therapy. Patient factors (eg, awareness, compliance, socioeconomic) have been identified but physician-related factors are as important. These include incorrect choice and inappropriate combination of insulin therapy which could be corrected by making the treatment physiologic. The purpose of this article is to improve management decisions in type 2 diabetes by reviewing its pathophysiology and identifying the optimum insulin regimen that could mimic such. Since eventual beta cell failure is central to its pathophysiology, it is but reasonable to replace insulin by mimicking its physiologic secretion. Hence, the term Insulin Replacement Therapy (IRT) should be utilized. This could be provided by the combination of premix insulin (ie, NPH + regular insulin) and rapid-acting insulin which has been reported to provide an initial 17.5% HbA1c reduction and even 18% reduction on 5-year follow-up providing sustainable control. A stepwise approach is an effective tool for insulin intensification. Hypoglycemia in insulin therapy could be prevented with an appropriate dietary regimen through automatic snacking. Keywords: Insulin replacement therapy, type 2 diabetes mellitus, pathophysiology","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131944370","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}

引用次数: 0

Self-efficacy of Filipino Physicians Towards Research and Research Utilization: A Single-Center Quantitative Descriptive Survey 菲律宾医生对研究和研究利用的自我效能:一项单中心定量描述性调查

Journal of Medicine, University of Santo Tomas Pub Date : 2022-04-30 DOI: 10.35460/2546-1621.2020-0056

Mary Joeline D Arada, John Armand E Aquino, Redmond Benigno S Aquino, Miguel Arkoncel, Belisarius Arandia, I. M. Tabangay-Lim

{"title":"Self-efficacy of Filipino Physicians Towards Research and Research Utilization: A Single-Center Quantitative Descriptive Survey","authors":"Mary Joeline D Arada, John Armand E Aquino, Redmond Benigno S Aquino, Miguel Arkoncel, Belisarius Arandia, I. M. Tabangay-Lim","doi":"10.35460/2546-1621.2020-0056","DOIUrl":"https://doi.org/10.35460/2546-1621.2020-0056","url":null,"abstract":"Research Question: What is the current status of self-efficacy beliefs towards research and research utilization (RU) of University of Santo Tomas Faculty of Medicine and Surgery (UST-FMS) graduates who had Clinical Epidemiology in their basic medical education curriculum? Significance of the Study: There is an increase in research and RU trends globally as adherence to practice based on evidence results in improved patient outcomes. Limited studies are available in describing research and RU of Filipino physicians and there is no study available specific for UST-FMS graduates. Objectives: The study aims to describe self-efficacy beliefs towards research and RU of UST-FMS graduates’ batches 2012-2016 who had Clinical Epidemiology in their basic medical education. Study Design: A single-center, quantitative descriptive survey design was used. Methodology: Participants were graduates of UST-FMS batches 2012-2016, currently working at the University of Santo Tomas Hospital. Evidence-based Practice Confidence Scale (EPIC scale) and Edmonton Research Orientation Survey (EROS) were used to assess the research and RU of the participants gathered through snowball sampling. Statistical Analysis: Descriptive statistics such as means and standard deviations were used to analyze the EPIC and EROS scores. Results: The UST-FMS graduates value research and are generally confident in their ability to participate in evidence-based medicine. However, they rarely conduct research and have a low understanding of statistics. Conclusion: The self-efficacy beliefs of UST-FMS graduates towards research and RU may be attributed to several factors. Clinical epidemiology as a subject may be improved by adding more lectures on statistics while hospitals should create avenues to support the conduct of research. Keywords: self-efficacy belief, research and research utilization, Clinical Epidemiology, medical education curriculum","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128273548","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}

引用次数: 0

Severe Hematologic Manifestations Among Filipino Patients With Systemic Lupus Erythematosus: a 5-Year Retrospective Cohort Study 菲律宾系统性红斑狼疮患者的严重血液学表现:一项5年回顾性队列研究

Journal of Medicine, University of Santo Tomas Pub Date : 2022-04-30 DOI: 10.35460/2546-1621.2019-0045

Rodeo V Navarroza, S. Navarra

{"title":"Severe Hematologic Manifestations Among Filipino Patients With Systemic Lupus Erythematosus: a 5-Year Retrospective Cohort Study","authors":"Rodeo V Navarroza, S. Navarra","doi":"10.35460/2546-1621.2019-0045","DOIUrl":"https://doi.org/10.35460/2546-1621.2019-0045","url":null,"abstract":"Objective: Determination of the prevalence of severe hematologic manifestations among Filipino patients with systemic lupus erythematosus (SLE) and analysis of any association with organ involvement and serology. Methods: This cross-sectional study included SLE patients 19 years old and above seen at the UST Hospital from 2012 to 2017. Patients with severe hematologic manifestations (severe hemolytic anemia, severe thrombocytopenia, and ES[ES]) were identified and their prevalence determined. Independent t-test was used to compare continuous variables. Categorical variables were measured using the chi-square test; odds ratios (OR) with their corresponding 95% confidence interval were calculated using the SPSS software version 21. This study has been approved by the Institutional Review Board. Results: Of the 253 patients (238 females, 94.07%), the mean age at diagnosis was 27.04 (SD 9.96) years. Severe hematologic involvement was noted in 12.26% (n=31); severe hemolytic anemia was the most prevalent (14, 5.53%), followed by severe thrombocytopenia (13, 5.14%) and ES (4, 1.58%). Higher prevalence of major organ involvement was observed among patients who manifest with severe hematologic disease. Severe thrombocytopenia was more likely to have cardiac involvement (OR 7.39, 95% CI 1.90 to 28.81, p=0.004). A higher prevalence of negative baseline anti-dsDNA serology was seen among patients who developed ES. Conclusion: Severe hematologic involvement was noted in 12.26% of Filipino SLE patients, with hemolytic anemia as the most frequently recorded. Severe thrombocytopenia was associated with cardiac involvement among these patients. Patients developing ES tend to have a negative anti-dsDNA serology. Keywords: systemic lupus erythematosus, severe hematologic manifestations, hemolytic anemia, thrombocytopenia","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134468615","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}

引用次数: 0

Double Whammy: A Case Report of a 71-Year-Old Filipino Female Leprosy Patient Diagnosed With Crusted Scabies 双重打击:一个71岁菲律宾女性麻风病患者被诊断为结痂疥疮的病例报告

Journal of Medicine, University of Santo Tomas Pub Date : 2022-04-30 DOI: 10.35460/2546-1621.2022-0021

John Benjamin B Gochoco

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Growth and Neurodevelopment Outcome Among Preterm and Very Low Birth Weight Neonates Given Early Aggressive Amino Acid Therapy Admitted in the NICU of a Tertiary Hospital 某三级医院新生儿重症监护室接受早期积极氨基酸治疗的早产儿和极低出生体重新生儿的生长和神经发育结局

Journal of Medicine, University of Santo Tomas Pub Date : 2022-04-30 DOI: 10.35460/2546-1621.2020-0046

Ana Kristina Garcia-Sobrevega, Wilfredo R. Santos

{"title":"Growth and Neurodevelopment Outcome Among Preterm and Very Low Birth Weight Neonates Given Early Aggressive Amino Acid Therapy Admitted in the NICU of a Tertiary Hospital","authors":"Ana Kristina Garcia-Sobrevega, Wilfredo R. Santos","doi":"10.35460/2546-1621.2020-0046","DOIUrl":"https://doi.org/10.35460/2546-1621.2020-0046","url":null,"abstract":"Long-term outcomes of preterm and very low birth weight (VLBW) infants have been the focus of published research due to improved neonatal care. One of the long-term morbidities associated with being born too early or VLBW is postnatal growth failure and neurodevelopment delay. Because of this, different strategies were implemented to address this, one of which is initiating early aggressive amino acid therapy at 3 g/kg/day within 24 hours of life with its goal to improve previously mentioned outcomes. This study aims to determine the growth and neurodevelopment outcome among neonates born preterm and VLBW who were given 3 g/kg/day of amino acid. It is important that such delays are detected early on so that appropriate interventions can be initiated to maximize the infant's capabilities. A total of 34 neonates were included in the study where baseline anthropometrics were taken and followed up at the 6th, 9th, and 12th month of corrected age. Results showed 35.2% of the participants were discharged with their anthropometrics below the target range. By the 6th month of corrected age, only 2.94% were below normal and by the 9th month of corrected age, all participants have normal for age anthropometrics. As for the neurodevelopment aspect, 4 of 34 participants (13.8%) were found to be classified as emerging risk and were referred to a neurodevelopment specialist. By the 9th month of corrected age, only 2 were classified as emerging risk and by the 12th month of corrected age, only 1 remained to be at risk for neurodevelopment delay. In conclusion, early aggressive amino acid therapy proves to have a positive effect in the growth and neurodevelopment outcome among preterm and VLBW infants. However, we would like to recommend continued monitoring of neurodevelopment in neonates from this population until 2 years of age, since some delays can be evident later on in life.","PeriodicalId":399180,"journal":{"name":"Journal of Medicine, University of Santo Tomas","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133454193","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}

引用次数: 0