Acta Medica Philippina最新文献

{"title":"Recurrent Vegetative Pyoderma Gangrenosum of the Face: A Case Report.","authors":"Koreen Blossom T Chan, Raisa Celine R Rosete, Claudine Yap Silva","doi":"10.47895/amp.v58i17.7480","DOIUrl":"10.47895/amp.v58i17.7480","url":null,"abstract":"<p><p>A 46-year-old male presented with an erythematous papule progressing into a vegetative plaque on the right cheek that resolved with cribriform scarring. Eight months after, a similar looking erythematous papule appeared on his left cheek. This papule rapidly progressed into a vegetative plaque within a week, and was associated with a pain score of 7 out of 10. Histopathology of the second lesion revealed suppurative dermatitis with diffuse dense infiltrates composed mostly of neutrophils. Cultures revealed few colonies of <i>Enterobacter cloacae</i> which was inconclusive. Pathergy test was negative. High dose systemic corticosteroids were started, with an observed rapid reduction of pain, inflammation, and ultimately resolution of the lesion with formation of cribriform scarring, confirming a case of vegetative pyoderma gangrenosum. It is important to note that not all inflamed and purulent lesions are infectious-neutrophilic dermatoses should always be considered.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 17","pages":"74-78"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UP-PGH Department of Dermatology: 100 Years of Skin Health Advocacy in the Service of the Filipino. <i>Is there a place for the dermatologist in primary health care?</i>","authors":"Maria Christina Filomena R Batac","doi":"10.47895/amp.v58i17.11680","DOIUrl":"10.47895/amp.v58i17.11680","url":null,"abstract":"","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 17","pages":"6-7"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicodemographic and Dermoscopic Features of Basal Cell Carcinoma among Filipino Patients Seen in a Tertiary Care Clinic.","authors":"Juan Paolo David S Villena, Mary Antonette D Atienza, Nicole Marella G Tan, Val Constantine S Cua, Blythe N Ke, Arunee H Siripunvarapon","doi":"10.47895/amp.v58i17.7486","DOIUrl":"10.47895/amp.v58i17.7486","url":null,"abstract":"<p><strong>Background: </strong>Dermoscopy enhances detection of basal cell carcinoma (BCC), especially for the pigmented subtype common among Asians. However, there is limited data on dermoscopic features of BCC in Filipinos.</p><p><strong>Objectives: </strong>The objective of this study is to describe the clinicopathologic profile and dermoscopic features of BCC in Filipinos seen in a tertiary care clinic.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in the Philippines from November 2019 to December 2021 in a tertiary care clinic. Fifty-three (53) lesions suspicious for BCC were analyzed using dermoscopy prior to histologic confirmation. Fifty (50) biopsy-proven BCC lesions were included in the analysis.</p><p><strong>Results: </strong>Lesions were more commonly seen in females (72.50%), and located on the head and neck (88%). The most common histopathologic subtype was nodular (74%). The most common dermoscopic features were large blue-gray ovoid nests (86%) and ulcerations (70%).</p><p><strong>Conclusion: </strong>The most common BCC type among the study participants was nodular, with large blue-gray ovoid nests and ulceration seen on dermoscopy.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 17","pages":"42-49"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination Doxycycline and Topical Corticosteroids in the Treatment of Ulcerative Pyoderma Gangrenosum: A Case Report.","authors":"Doha Mae Laurisse M Manalo-Legas, Erickah Mary Therese D Calayag, Eillen Luisa A Chen","doi":"10.47895/amp.v58i17.7462","DOIUrl":"10.47895/amp.v58i17.7462","url":null,"abstract":"<p><p>Pyoderma gangrenosum (PG) is a chronic inflammatory neutrophilic dermatosis often presenting as a solitary enlarging painful ulcer with red to violaceous undermined borders. This report delves into the role of doxycycline in the treatment of PG in a 44-year-old male COVID-19 positive patient who has concomitant active tuberculosis infection and end-stage kidney disease, for which both first-line treatments (systemic corticosteroid and cyclosporine) are contraindicated. After three months on doxycycline and topical corticosteroids, there was resolution of the ulcers and no note of recurrence up to three months from completion of the treatment regimen.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 17","pages":"79-82"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Health Operational Research Improve Health Care in a Clinical Department?","authors":"Marissa N Valbuena","doi":"10.47895/amp.v58i16.11584","DOIUrl":"https://doi.org/10.47895/amp.v58i16.11584","url":null,"abstract":"","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 16","pages":"6-7"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Prolonged Waiting Time on Visual Outcomes of Patients with Pediatric Cataract in a Tertiary Public Hospital.","authors":"Marie Jeazelle Redondo Villanueva, Alvina Pauline D Santiago","doi":"10.47895/amp.vi0.8653","DOIUrl":"https://doi.org/10.47895/amp.vi0.8653","url":null,"abstract":"<p><strong>Background: </strong>Pediatric cataract is one of the most common preventable cause of childhood blindness worldwide. Early and timely intervention of pediatric cataract is important to maximize the visual outcomes and start prompt visual rehabilitation.</p><p><strong>Objectives: </strong>This study aimed to determine the average time from the day of initial consult at the outpatient clinic to the day of the cataract surgery and compare the effects of delayed surgery on visual outcomes of patients.</p><p><strong>Methods: </strong>This is a retrospective chart review of medical records from January 2015 to June 2022. The dates of the different steps in the process up to the day of intervention were noted and the average interval duration and the total waiting time were determined. Patients operated on within 2 weeks from initial consult was defined as no delay while those operated >2 weeks had delayed surgery. Pre-operative and post-operative best corrected log MAR visual acuity were compared within each group to determine if delay in surgical intervention has a significant effect on the visual outcomes of patients.</p><p><strong>Results: </strong>Median age at initial consult was 4.9 years while median age at surgery was 5.2 years. Ninety-nine (99) patients had developmental cataract and 123 patients had bilateral cataract. Leukocoria was the most common chief complaint (63.45%). Pre-operatively, 94 patients had strabismus, 49 had eye preference, 48 had nystagmus, and 43 had amblyopia in the diagnosis. There was significantly faster admission to cataract surgery during the pandemic compared to pre-pandemic period but there was no difference in the total waiting time. Patients with congenital cataract had the least total waiting time followed by developmental, and rubella cataract. There is no significant difference in visual outcomes between patients operated without delay and with delay.</p><p><strong>Conclusion: </strong>There is delayed age at diagnosis and surgery of pediatric cataract patients in the Philippine General Hospital. Early surgery did not reflect better visual outcomes compared to delayed surgery probably due to delay in consultation of patients.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 16","pages":"77-84"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Technical Review Process of the UP PGH Department of Medicine.","authors":"Cecilia A Jimeno, Faye Reina Lee C Jimeno, Thahanni Apryll T Bajunaid","doi":"10.47895/amp.v58i16.7810","DOIUrl":"https://doi.org/10.47895/amp.v58i16.7810","url":null,"abstract":"<p><strong>Background and objective: </strong>The technical review process involves an evaluation of the scientific merits of the research proposal and is a necessary part of the ethics review but can be done separately and ahead of the formal ethics evaluation. The aim of this paper is to determine the efficiency and quality of the technical review process of the Philippine General Hospital (PGH) Department of Medicine Research Office.</p><p><strong>Methods: </strong>This is a cross-sectional study which involved retrieval of the technical review forms of protocols evaluated in the PGH Department of Medicine from the years 2018-2019, and then an evaluation of these metrics: timelines of the review process indicating efficiency, including time from (1) receipt of submission to receipt of reviewer (secretariat efficiency); (2) receipt of reviewer to first decision (reviewer metric); (3) initial receipt to final decision (total review time); and (4) number of re-submissions. To evaluate the quality of the reviews, the specific review findings in each part or section of the protocol were also extracted.</p><p><strong>Results: </strong>In the years 2018-2019, a total of 199 protocols underwent technical review, with one protocol having no further data after the submission so only 198 proposals were analyzed. Majority of the protocols or 139/198 (70.2%) were submitted only once and were approved without comments, while the remaining 59/198 (29.8%) were submitted twice for technical review (mode of 1, mean of 1.32). The protocols were sent to the reviewers within the same day of receipt 100% of the time. The time from receipt of submission to receipt of reviewer was within the same day and the time from receipt of reviewer to first decision (mean, standard deviation working days) was 10.52, 8.54 days, range 0-51 days. Around one-fourth (21.51%) of the protocols were returned to the secretariat beyond the 14-working day deadline. The time from second review of technical reviewer to return to secretariat was a mean, SD of 6.72, 6.45 days, with a range of 1 day to 36 days, and time from initial receipt to final decision was a mean of 16.16 days, SD 18.3 days, range 0-111 days. The most common reason for the delay was the failure of the author to resubmit the paper for the second review in 17/23 (74%), while the other reason was the long duration of the initial review by the reviewer in 6/23 (26%). Half of the protocols (49.5%) were returned without comments. Majority of the comments were on the methodology.</p><p><strong>Conclusions: </strong>The technical review process is generally efficient with each step within the acceptable timelines. However, for 12% of the protocols, the over-all review process was still prolonged (>28 working days) because of the failure of the author to submit the paper for the second review in 74% of cases, and the long duration of the initial review in 26% of papers.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 16","pages":"127-132"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Psychological Distress and Coping Styles among Physicians and Nurses in a COVID-19 Referral Hospital in Manila: A Cross-sectional Study.","authors":"Rommel V Gonzales, Krisstella D Gonzales, Josefina T Ly-Uson","doi":"10.47895/amp.vi0.8308","DOIUrl":"https://doi.org/10.47895/amp.vi0.8308","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the levels of depression, anxiety, and stress, and the coping styles among physicians and nurses in a COVID-19 referral hospital in Manila from June to July 2020.</p><p><strong>Methods: </strong>A cross-sectional study among medical residents and nurses selected via convenience sampling was employed. Data were obtained through COVID Stressors and Stress Reduction Questionnaire, Depression, Anxiety, and Stress Scale-21, and Filipino Coping Strategies Scale. Descriptive and inferential analysis of data was done.</p><p><strong>Results: </strong>Five hundred seventy-one (571) healthcare workers (total population: 1,650 nurses and physicians) participated in the study, representing 81.6% of the computed sample size of 700 respondents. Among the participants, 60.6 %, 69.0%, 48.9% reported symptoms of depression, anxiety, and stress, respectively. Nineteen percent (19%) of nurses reported severe to extremely severe depression, and 42.0% reported severe to extremely severe anxiety. In contrast, 30.8% of residents reported severe to extremely severe depression, and 28.4% conveyed severe to extremely severe anxiety. There was no association observed between perceived levels of stress between the two healthcare professions.There were more mildly to extremely severe anxious healthcare workers in the COVID areas (74.6%) compared to the non-COVID areas (61.2%). Differences in coping styles were observed among the participants' clinico-demographic characteristics. Top healthcare worker stressors include being negligent and endangering co-workers (88.6%), frequent modification of infection control procedures (87.0%), and discomfort from protective equipment (81.4%). Top stress-reducing factors include provision of food and vitamins (86.7%), sufficient rest (84.2%), and support from higher-ranking colleagues (73.7%).</p><p><strong>Conclusion: </strong>This study has shown that more than half of the healthcare workers reported mild to extreme levels of depression and anxiety, while a little less than half reported mild to extreme levels of stress. The development and implementation of hospital interventions and programs based on the sources of distress and stress-reducing factors is recommended to mitigate the impact of sustained psychological distress on mental health and physical wellbeing of hospital healthcare workers.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 16","pages":"85-102"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear of COVID-19 among Frontline Nurses in a National University Hospital in the Philippines: A Mixed-Methods Study.","authors":"Ericka Louise C Gilo, Maricel Grace T Tuanquin, Carina Luisa G Bangayan, Jennifer Anne O Arada, Frese L Ticar, Aubrey Jell B Juano, Jacqueline B Araquil, Neil Roy B Rosales, Angelique A Rosete","doi":"10.47895/amp.v58i16.8416","DOIUrl":"https://doi.org/10.47895/amp.v58i16.8416","url":null,"abstract":"<p><strong>Background: </strong>Nurses are at the forefront of caring for patients during the height of the COVID-19 pandemic. Nurses themselves are exposed to serious risk and even death while providing care for these patients. Among other healthcare professionals, nurses are mostly exposed to psychologically distressing situations during this time of crisis. Fear of COVID-19 can affect nurses' overall well-being, which in turn may affect their job performance and lead to a decline in the quality of patient care.</p><p><strong>Objectives: </strong>To determine the level of fear of COVID-19, and to explore the experiences of COVID-19-related fear of frontline nurses in a national university hospital in the Philippines.</p><p><strong>Methods: </strong>To achieve the study objectives, the study utilized a convergent mixed methodology approach. In the quantitative phase, a random sample of participants completed the Fear of COVID-19 scale (FCV-19S) in order to assess their level of fear of COVID-19. Semi-structured interviews were conducted in the qualitative strand. Participants in the qualitative phase was selected using maximum variation sampling. Integration of data was done through a narrative contiguous approach.</p><p><strong>Results: </strong>Quantitative data was obtained from 206 frontline registered nurses. The mean age of the participants was 35.5 years (SD =8.17). Overall, the composite score of the fear of COVID-19 scale was 21.76 (SD = 4.92), indicating an elevated level of fear. Having friends and relatives who tested positive predicted fear of COVID-19 (β = -3.658; <i>p</i> = 0.005; CI: -6.213 to -1.104). Three major themes categories emerged from qualitative data analysis: (1) balancing feelings of fear and moral obligation, (2) challenges experienced while providing frontline work, and (3) resilience amidst challenges. For the reporting and integration of our mixed-method results, a narrative contiguous approach was implemented.</p><p><strong>Conclusions: </strong>Frontline nurses reported an elevated level of fear during the height of the COVID-19 pandemic. This study was also able to capture the impact of COVID-19 on the mental health of nurses, specifically on their fear experiences. Understanding the underlying causes of fear, such as uncertainties surrounding guidelines and protocols, shortage of personal protective equipment, and moral distress, offers invaluable insights for shaping proactive strategies and policies aimed at mitigating these concerns in subsequent pandemics.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 16","pages":"103-116"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse Empowerment in a Tertiary University Hospital during Pandemic Crisis.","authors":"Ma Stefanie P Reyes, Mildred B Campo, Mariel Rosette M Delos Santos, Andrew B Sumpay, Ma Carmela M Gatchalian, Marivin Joy F Lim, Mickaela Louise D Gamboa, Louriane P Ledesma, Sarah Joy B Maypa, Queenie H Quintana, Ariel T Laurenciana","doi":"10.47895/amp.v58i16.5530","DOIUrl":"https://doi.org/10.47895/amp.v58i16.5530","url":null,"abstract":"<p><strong>Objectives: </strong>Nurse empowerment is essential to ensure delivery of the best quality patient care and attaining positive nurse outcomes. Studies describe its relationship to retention, patient safety, commitment, productivity, job satisfaction, and positive outcomes. The study aimed to determine the level of empowerment of nurses in a tertiary university hospital during the pandemic crisis.</p><p><strong>Methods: </strong>The study was an exploratory descriptive cross-sectional design. Participants (N = 176, Nurses) were randomly selected through a sampling frame. The validated self-administered questionnaire, the Conditions of Work Effectiveness Questionnaire II, was used for data collection. One-way analysis of variance (ANOVA) was used to determine whether there were statistically significant differences between the means of the participants' empowerment scores when grouped according to their demographic profile.</p><p><strong>Results: </strong>The study found that the nurses in the tertiary university hospital have an overall moderate level of empowerment (TSE <math><mover><mtext>x</mtext> <mo>¯</mo></mover> </math> = 22.69, SD = 3.53; GE <math><mover><mtext>x</mtext> <mo>¯</mo></mover> </math> = 3.72, SD = 1.01). It was also found that there were statistically significant differences between the means of their total structural and global empowerment scores when grouped according to their age group, civil status, length of service, level of position, and area designation; while no statistically significant difference existed when grouped by their sex and level of education.</p><p><strong>Conclusion: </strong>Since nurse empowerment leads to positive nurse and patient outcomes, improving levels of empowerment is thus essential. The results of this study will help administrators identify groups of nurses with relatively lower levels of empowerment and in turn develop programs that will help improve their levels of empowerment.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"58 16","pages":"117-126"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}