Acta Medica Philippina最新文献

{"title":"Heart Rate Variability Analysis to Investigate Autonomic Nervous System Activity among the Three Premature Ventricular Complex Circadian Types: An Observational Study.","authors":"Novita G Liman, Sunu B Raharjo, Ina Susianti Timan, Franciscus D Suyatna, Salim Harris, Joedo Prihartono, Kristiana Siste, Mohammad Saifur Rohman, Bambang Budi Siswanto","doi":"10.47895/amp.vi0.8356","DOIUrl":"10.47895/amp.vi0.8356","url":null,"abstract":"<p><strong>Background and objective: </strong>Premature ventricular complex (PVC) burden exhibits one of three circadian types, classified as fast-type, slow-type, and independent-type PVC. It is unknown whether PVC circadian types have different heart rate variability (HRV) parameter values. Therefore, this study aimed to evaluate differences in HRV circadian rhythm among fast-, slow-, and independent-type PVC.</p><p><strong>Methods: </strong>This cross-sectional observational study consecutively recruited 65 idiopathic PVC subjects (23 fast-, 20 slow-, and 22 independent-type) as well as five control subjects. Each subject underwent a 24-hour Holter to examine PVC burden and HRV. HRV analysis included components that primarily reflect global, parasympathetic, and sympathetic activities. Repeated measures analysis of variance was used to compare differences in HRV circadian rhythm by PVC type.</p><p><strong>Results: </strong>The average PVC burden was 15.7%, 8.4%, and 13.6% in fast-, slow-, and independent-type idiopathic PVC subjects, respectively. Global, parasympathetic nervous system, and sympathetic nervous system HRV parameters were significantly lower in independent-type PVC versus fast- and slow-type PVC throughout the day and night. Furthermore, we unexpectedly found that tendency towards sympathetic activity dominance during nighttime was only in independent-type PVC.</p><p><strong>Conclusion: </strong>The HRV parameters are reduced in patients with independent-type PVC compared to fast- and slow-type PVC. Future research is warranted to determine possible differences in the prognosis between the three PVC types.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"91-98"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078246","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":"R-CHOP and Consolidation Radiotherapy for Limited-stage and Low-IPI High-Grade B-Cell Lymphoma with <i>MYC</i> and <i>BCL2</i> and/or <i>BCL6</i> rearrangements: a Single-center Case Series and Review of Literature.","authors":"Joseff Karl U Fernandez, Michael D San Juan, Edilberto Joaquin V Fragante, Billionario Januario Antonio D Veloso, Timothy Carl F Uy, Michelle Regina L Castillo, Benedict Mihangel P Crisostomo","doi":"10.47895/amp.vi0.8611","DOIUrl":"10.47895/amp.vi0.8611","url":null,"abstract":"<p><p>High-Grade B-Cell Lymphoma (HGBCL) with gene rearrangements in <i>MYC</i> and <i>BCL2</i> and/or <i>BCL6</i> is an aggressive malignancy usually presenting in advanced stages. Current recommendations suggest the use of regimens more intensive than R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, prednisone), which are based on retrospective studies and single-arm prospective trials that included patients who are mostly in the advanced stage, and did not receive consolidation radiotherapy. The optimal approach and treatment of HGBCL, whether limited-stage (LS) or advanced-stage, remains to be determined. Here we describe the promising outcomes of three patients with LS and low IPI HGBCL with the use of R-CHOP as induction chemotherapy regimen, which was followed by consolidation radiotherapy. Three women, 54-, 60-, and 64-years of age diagnosed to have HGBCL with <i>MYC,</i> and <i>BCL2</i> and/or <i>BCL6</i> rearrangements, with Ann Arbor stages I-IIE were included in this case series. All three patients had complete metabolic response to 6 cycles of R-CHOP and was subsequently treated with consolidation involved site radiotherapy (ISRT; total dose 30-36 Gy). Chemotherapy and radiotherapy were tolerated very well. All patients remain to be in remission, with the longest being at 23 months. Outcomes of patients with HGBCL generally remain to be poor, but this may not be the case for patients with limited-stage disease and favorable clinicopathologic risk profile. Nevertheless, the treatment of HGBCL is currently evolving and more studies are needed to determine the ideal approach and preferred chemotherapy regimen. Also, more studies are needed to elucidate the potential role of consolidation radiotherapy in patients with limited-stage HGBCL to improve survival outcomes. Findings of this case series suggest that patients with LS HGBCL may still derive benefit from R-CHOP followed by consolidation ISRT, but prospective trials are needed to confirm this.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"99-109"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078248","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":"Clinical Profile and Outcomes of COVID-19 Positive Patients with Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Government COVID-19 Referral Center.","authors":"Mary Bianca Doreen F Ditching, Joel M Santiaguel","doi":"10.47895/amp.vi0.8578","DOIUrl":"10.47895/amp.vi0.8578","url":null,"abstract":"<p><strong>Introduction: </strong>It is anticipated that Chronic Obstructive Pulmonary Disease (COPD) has greater risk in acquiring COVID-19 infection and poorer outcome. However, current worldwide data are conflicting.</p><p><strong>Objectives: </strong>This study primarily aims to compare the outcomes of COVID-19 patients with COPD and those without COPD in terms of length of hospital stay (LOS), recovery or mortality, treatment received, and predictors of mortality.</p><p><strong>Methods: </strong>This is a retrospective cohort chart review of 1,017 admitted adult COVID-19 patients from July to December 2020. Age, gender, smoking status, current control and medications for COPD, COVID-19 severity, symptoms, treatment, and outcomes of the two study groups were compared.</p><p><strong>Results: </strong>Prevalence rate of COPD was 3.8%. COVID-19 patients with COPD were older (median age of 69 vs 54, p<0.001), male (87% vs 50%, p<0.001), hypertensive (72% vs 48%, p=0.004), and with tuberculosis (31% vs 11%, p=0.002). COVID-19 patients with COPD more commonly needed oxygen therapy, High Flow Nasal Cannula, Mechanical Ventilation, Tocilizumab, Convalescent Plasma Therapy and Dexamethasone, and had longer LOS. Significant risk factors for mortality are malignancy, investigational therapies, smoking, and older age. There was no difference in survival rates between the two groups.</p><p><strong>Conclusion: </strong>COPD increases the risk for severe COVID-19 and lengthens LOS.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078118","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":"Economic Evaluation of Oral Ivermectin, Alone or in Combination with Permethrin, versus Permethrin, in the Treatment of Classic Scabies in the Philippine Setting.","authors":"Rowena F Genuino, Mac Ardy J Gloria, Clarence Pio Rey S Yacapin, Maria Christina Filomena R Batac, Fernando B Garcia, Francis R Capule, Mary Ann J Ladia, Malaya P Santos, Ailyn M Yabes, Ma Stephanie Fay S Cagayan","doi":"10.47895/amp.vi0.8650","DOIUrl":"10.47895/amp.vi0.8650","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Oral ivermectin is recommended as an alternative to topical permethrin in Japanese, European, and CDC-STI guidelines for treating classic scabies. The combination of oral ivermectin and topical permethrin is also used in some settings. Partial economic evaluations conducted in India and Egypt have conflicting results, and no cost-effectiveness analysis in the Philippines has compared ivermectin-based regimens to permethrin for scabies treatment. We aimed to determine the cost-effectiveness of oral ivermectin, alone or in combination with permethrin, compared to permethrin, in the treatment of Filipino adult patients with classic scabies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a decision tree model to estimate the cost-effectiveness of two regimens, oral ivermectin alone or in combination with permethrin, compared with permethrin to treat adults and children aged five years and older with classic scabies in the outpatient setting from the household perspective in the Philippines. We estimated total costs and disability-adjusted life years (DALYs) over a one-month follow-up. Input parameters were obtained from secondary data, such as effect estimates for probabilities of clinical outcomes from a network meta-analysis, DALYs from the Global Burden of Disease 2019, and prevailing market cost in the Philippines (DPRI 2022 with recommended markup by DOH, and leading drugstores) as of August 2022. We computed for incremental cost-effectiveness ratio (ICER) and net monetary benefit (NMB) to determine which of the interventions are cost-effective. Univariate and probabilistic sensitivity analyses, and scenario analyses were conducted to assess the impact of parameter and structural uncertainty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ivermectin-based regimens are suggested to be likely cost-saving compared to permethrin in the Philippine outpatient setting. Base case analysis showed that oral ivermectin had higher cost-savings (change in cost, -1,039.31; change in DALYS, 0.00027), while combination oral ivermectin/permethrin had higher DALYs averted (change in cost, PhP -1,019.78; change in DALYs, 0.00045), compared to permethrin. Combination oral ivermectin/permethrin (56%) was the most cost-effective, followed by oral ivermectin (44%) compared to permethrin (0%) through probabilistic sensitivity analysis. Estimates for ivermectin were sensitive to risk of cure for ivermectin vs permethrin using 1-way deterministic sensitivity analysis. Oral ivermectin was favored over combination oral ivermectin/permethrin at all thresholds based on the cost-effectiveness acceptability curve.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Both ivermectin-based regimens seem to be cost-saving compared to permethrin in the treatment of classic scabies in the Philippine outpatient setting. Clinicians may consider oral ivermectin, alone or in combination with permethrin as an alternative first-line or second-line treatment depending on patient pre","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"18-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078304","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":"Job-related Factors Associated with Depression, Anxiety, and Stress among Healthcare Workers in a Tertiary Government Hospital in Metro Manila during the COVID-19 Pandemic.","authors":"Ana Melissa Hilvano-Cabungcal, Sheila R Bonito","doi":"10.47895/amp.vi0.8590","DOIUrl":"10.47895/amp.vi0.8590","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ensuring the total well-being of healthcare workers (HCWs), including their mental health and psychological well-being, is an essential aspect in the delivery of patient care and the preservation of the health workforce. This study aimed to determine the level of mental well-being and emotional state of HCWs in terms of depression, anxiety, and stress using the DASS-21 scale in a tertiary government hospital during the COVID-19 pandemic in the Philippines and to identify the job-related factors that may be associated with these outcomes.</p><p><strong>Methods: </strong>This is an analytical, cross-sectional study among HCWs involved in direct patient care in a tertiary government hospital in the Philippines during the COVID-19 pandemic. Data collection was conducted from February to March 2022 through an online self-administered questionnaire, which included the Demand-Control-Support Questionnaire (DCSQ), and the 21-item Depression Anxiety Stress Scale (DASS-21). This was sent to doctors, nurses, and allied medical workers actively working in the clinical areas. All responses were collected and analyzed.</p><p><strong>Results: </strong>Three hundred sixty-four healthcare workers were included in the study. Majority were single (62.62%), living with immediate family (50.82%), and working in a COVID-designated area (62.09%). High prevalence of depression (49.18%), anxiety (61.54%), and stress (30.22%) was found among the HCWs. Work in high infection/COVID-designated areas was significantly associated with anxiety and stress, and high-job demand was significantly associated with all three mental health states compared to low job-demand.</p><p><strong>Conclusion: </strong>Focus should be placed on modifying the condition of high job demand among healthcare workers working in hospitals. This includes ensuring optimum staffing levels and patient to HCW ratio which avoids HCWs from being subjected to high workloads and time pressures that subsequently increase risk for stress, anxiety, and depression.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078322","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":"Effect of a Brief Training Program on the Knowledge of Filipino Primary Care Providers in a Rural and a Remote Setting: a Before and After Study.","authors":"Julianne Keane M Pascual, Arianna Maever Loreche, Regine Ynez H De Mesa, Noleen Marie C Fabian, Josephine T Sanchez, Janelle Micaela S Panganiban, Mia P Rey, Carol Stephanie C Tan-Lim, Mark Anthony U Javelosa, Ramon Pedro P Paterno, Ray U Casile, Leonila F Dans, Antonio L Dans","doi":"10.47895/amp.vi0.8869","DOIUrl":"10.47895/amp.vi0.8869","url":null,"abstract":"<p><strong>Background and objective: </strong>Primary care providers are key players in providing quality care to patients and advancing Universal Health Care (UHC). However, effective and quality healthcare delivery may be affected by inadequate knowledge and failure to adhere to evidence-based guidelines among providers. The Philippine Primary Care Studies (PPCS) is a five-year program that pilot tested interventions aimed at strengthening the primary care system in the country. Evidence-based training modules for healthcare providers were administered in Sorsogon and Bataan from the years 2018 to 2021. Module topics were selected based on common health conditions encountered by providers in rural and remote settings. This program aimed to evaluate the effectiveness of training in increasing provider knowledge.</p><p><strong>Methods: </strong>A series of training workshops were conducted among 184 remote- and 210 rural-based primary care providers [nurses, midwives, barangay or village health workers (BHWs)]. They covered four modules: essential intrapartum and newborn care (EINC), integrated management of childhood illness (IMCI), non-communicable diseases (NCD), and geriatrics. A decision support system (UpToDate) was provided as a supplementary resource for all participants. We administered pre-tests and post-tests consisting of multiple-choice questions on common health conditions. Data was analyzed using paired one-tailed t-test, with an alpha of 0.05.</p><p><strong>Results: </strong>The knowledge of nurses, midwives, and BHWs improved after the training workshops were conducted. The largest increase from pre-test to post-test scores were observed among the midwives, with a mean difference (MD) of 32.9% (95% CI 23.9 to 41.9) on the EINC module, MD of 25.0% (95% CI 16.6 to 33.4) in the geriatrics module, and MD of 13.5% (95% CI 6.9 to 20.1) in the NCDs module. The nurses had the greatest improvement in the IMCI module (MD 10.8%, 95% CI 2.5 to 19.1). The knowledge of BHWs improved in all participated modules, with greatest improvement in the NCD module (MD 9.0%, 95% CI 5.77 to 12.14).</p><p><strong>Conclusions: </strong>Primary care workshops, even if conducted as single-sessions and on a short-term basis, are effective in improving short-term knowledge of providers. However, this may not translate to long-term knowledge and application in practice. Furthermore, comparisons across provider categories cannot be made as participant composition for each training workshop varied. Ultimately, this study shows enhancing provider knowledge and competence in primary care will therefore require regular and diverse learning interventions and access to clinical decision support tools.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078240","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":"Coping Strategies to Achieve Food Security among Households with Children in an Urban Poor Community in Quezon City during COVID-19.","authors":"Eryn M Kiunisala, Beatrice Ysabel G Dy, Ralph Alexander T Flores, Ramon Raphael M Montierro, Renaeus Arlchristian Rualdo D Torres, Kim Leonard G Dela Luna, And Ernani R Bullecer","doi":"10.47895/amp.vi0.8647","DOIUrl":"10.47895/amp.vi0.8647","url":null,"abstract":"<p><strong>Background: </strong>In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children.</p><p><strong>Objectives: </strong>This study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI.</p><p><strong>Results: </strong>Sociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level.The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%).</p><p><strong>Conclusion: </strong>Low CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078142","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":"Nutritional Evaluation of Therapeutic Diets for Cardiovascular Diseases in Hospitals of General Santos City, Philippines: A Comparative Cross-sectional Study.","authors":"Karyne June D Simon, Wilmar Jun O Elopre","doi":"10.47895/amp.vi0.8167","DOIUrl":"10.47895/amp.vi0.8167","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the nutritional adequacy and compliance with cardiovascular disease (CVD) guidelines in therapeutic diets implemented in four hospitals in General Santos City, Philippines.</p><p><strong>Methods: </strong>The study employed a cross-sectional study and analyzed the one-day therapeutic menus of four hospitals using the Philippine Food Composition Table and the United States Department of Agriculture nutrient database. The nutrient contents calculated in this study were compared among hospitals and benchmarked against the Philippine Dietary Reference Intakes (PDRI) and CVD-specific guidelines, the Dietary Approaches to Stop Hypertension (DASH), and Therapeutic Lifestyle Changes (TLC). The nutrient adequacy ratios (NARs) and the corresponding mean (SD) values were used to interpret the data.</p><p><strong>Results: </strong>Based on the PDRI, the mean (SD) NARs for proteins, simple sugars, vitamin B6, folate, and vitamin B12 were 116% (11%), 72% (16%), 139% (34%), 115% (7%), and 324% (156%), respectively, which were all interpreted as adequate. However, the mean (SD) NARs for energy, 88% (7%), and dietary fiber, 53% (33%), indicate non-compliance with the requirements for these components. As for the DASH guidelines, the hospitals failed to meet the recommendations for calcium, magnesium, and potassium, with mean (SD) NARs of 45% (14%), 49% (10%), and 51% (7%), respectively. The levels of saturated fatty acids, 195% (53%), and dietary cholesterol, 363% (177%), exceeded the limits set by the guidelines. For the TLC guidelines, the mean (SD) NARs of 70% (24%) and 40% (10%) for monounsaturated fatty acids and polyunsaturated fatty acids, respectively, were interpreted as suboptimal. Conclusive interpretations cannot be drawn for sodium, total carbohydrates, total fats due to large variations in their compositions among the hospitals.</p><p><strong>Conclusion: </strong>At the menu analysis level, while the therapeutic diets adhered to the recommendations for proteins, simple sugars, and the vitamins, they fell short in their provision for energy, unsaturated fats, dietary fiber, and most minerals. They also exceeded the limits for most dietary lipid parameters set by DASH and TLC. The findings of this study highlight the need for improvements in nutritional adequacy and adherence to CVD guidelines in hospital therapeutic diets. Due to the limited number of observations, future research should aim to confirm and clarify these findings.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"7-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078310","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":"Management of Advanced Thymoma Presenting with Myasthenia Gravis in a Resource-limited Setting: A Case Report.","authors":"I Wayan Losen Adnyana, Dian Daniella","doi":"10.47895/amp.vi0.8074","DOIUrl":"10.47895/amp.vi0.8074","url":null,"abstract":"<p><p>Thymomas are rare tumours which generally account for only 0.2 - 1.5% of mediastinal tumours in adults. Around 40% of patients present with systemic symptoms such as motor weakness due to myasthenia gravis (MG), pure red cell aplasia, and hypogammaglobulinemia. Based on recent guidelines, management of advanced thymoma uses a multimodal approach, which is thymectomy followed by radiotherapy, but not all health care centers have radiotherapy facilities. A 52-year-old woman presented with nasal voice and had difficulty swallowing food. Patient was diagnosed with myasthenia gravis (MG). CT scan with contrast of the thorax showed a heterogenous solid mass in anterior mediastinum. Histopathological examination showed thymoma type B2. Thymectomy followed by seven cycles of platinum-based chemotherapy were done on the patient. Evaluation afterward showed complete remission of thymoma. The patient's motor weakness improved after the chemotherapy. Post-chemotherapy period was uneventful at six months on follow-up visit. The dosage of acetylcholinesterase inhibitor drug is reduced periodically due to improvement in motor weakness. The case emphasizes how to manage an advanced thymoma with MG with limited therapeutic options, and the importance of multidisciplinary management involving oncologists, surgeons, and neurologists.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078328","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":"Why do we Need to Evaluate Therapeutic Diets for Cardiac Patients Admitted in Healthcare Institutions?","authors":"Kim Leonard G Dela Luna","doi":"10.47895/amp.v59i1.12568","DOIUrl":"10.47895/amp.v59i1.12568","url":null,"abstract":"","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 1","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078391","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}