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
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0054
Carlo F Fernandez, Byron S Angeles, Carmelo L Braganza
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
背景：股骨头血管性坏死（AVN）是由骨内病变导致的功能障碍。早期诊断可采取核心减压等保守治疗，从而推迟全髋关节置换术的时间。研究目的本荟萃分析旨在总结富血小板血浆（PRP）作为核心减压术（CD）的辅助手段对髋关节 AVN 治疗效果和股骨头保留的影响。研究方法该研究使用 PubMed、Cochrane Library、Science Direct、Google Scholar 和 Med Line 进行了全面的文献检索，包括各种数据库中的随机对照试验 (RCT) 和以往的荟萃分析。研究采用随机效应模型，比较了在 AVN 患者中使用 PRP+CD+ 植骨疗法和仅使用 CD+ 植骨疗法的效果，评估了患者的功能、疼痛评分、疾病进展和髋关节手术需求。分析结果荟萃分析研究了 1041 份记录，包括三项研究。主要结果是使用哈里斯髋关节评分（HHS）和视觉模拟量表（VAS）进行的功能和疼痛评分。最终随访时的术后 HHS 评分显示，PRP+CD 组明显优于单纯 CD 组。术后 VAS 评分显示，单纯 CD 组的评分呈上升趋势。与单纯 CD 相比，PRP+CD 组的疾病进展存活率更高。总之，研究表明，在髋关节 AVN 的治疗中，PRP+CD 比单纯 CD 能带来更好的功能预后和疾病进展预后。结论与单纯 CD 相比，PRP+CD 治疗组对 AVN 患者有显著疗效，包括更高的 HHS 评分、更好的疾病进展存活率和更少的髋关节手术需求。虽然 PRP+CD 可降低 VAS 评分，但差异无统计学意义。关键词 ：血管性坏死/AVN 骨坏死 股骨头 富血小板血浆 核心减压 随机对照试验
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0045
Maria Grace A De Guzman, Raymond L Rosales
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
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0081
Kurt Lenard T Gutierrez, P. M. Viacrusis
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
新兴的生成式人工智能（GAI）领域及其一些著名的技术：正如 Med-PaLM 和 ChatDoctor 等医学微调模型所示，ChatGPT、Google Bard 和 Claude 因其在医疗保健应用中的巨大潜力而大受欢迎。虽然这些进步令人印象深刻，但人工智能的发展对数据量和质量的依赖性也引发了对这些模型通用性的质疑。医学研究成果较少的地区有可能在人工智能生成的内容中出现偏差和错误表述，尤其是在用于辅助临床实践时。在测试有关菲律宾人与其他民族和种族群体的异烟肼剂量的提示时，GPT-4、GPT-3、Bard 和 Claude 的回答导致 4 项输出中有 3 项显示出令人信服但虚假的内容，扩展提示说明了 GAI 模型是如何产生幻觉的。为解决这一问题，建议采用微调和提示组合等模型完善技术；然而，针对本地情况完善人工智能模型需要数据可用性、数据质量和质量保证框架。我们呼吁菲律宾和其他代表性不足地区的临床医生和研究人员启动能力建设工作，为医疗保健领域的人工智能做好准备。所有利益相关者都需要尽早做出努力，以防止医疗不平等的加剧，尤其是在全球人工智能带来的新临床领域。关键词人工智能 偏差 ChatGPT 医疗保健 菲律宾
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0021
Meliza Angelica J De Leon, Alejandro C. Baroque II
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
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0077
Tommy C Sim
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.
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2021-0002
Irene B Cua, Eleanor Lo-Letran
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
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0070
Maria Leila M Doquenia
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
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2023-0084
Raymond L Rosales
{"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}
Pub Date : 2023-10-31DOI: 10.35460/2546-1621.2022-0089
Diane S Mendoza-Sarmiento, Alison M Hill
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
{"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}
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