For 1998, the PPA Board adopted a comprehensive program to empower psychiatrists to respond to the increasing demands on and broadening concerns of psychiatrists. All activities were tailored to fit the theme "Taking on the Challenge of the Future." Goals and strategies were articulated and functioned as guidelines for the relevance and coherence of activities to the overall theme. The PPA Board notes that its program was implemented as designed. For making this possible, special mention goes to PPA members, the pharmaceuticals and our secretariat. The incoming PPA Board can continue the gains made this year, improve attention areas and implement the plans designed this year Moving into the next millenium, anticipating the next twenty-five years, the PPA faces the critical task of facilitating change for itself and its community. Hopefully, this years program has empowered him to take on the challenge of the future.
PSYCHIATRY ; POLICY ; CONSTITUTION AND BYLAWS

Objective: To develop a Pilot Comprehensive Consultation-Liaison Program for the SLMC-Hemodialysis Unit. Method: A Comprehensive Consultation-Liaison Program was developed for the SLMC-Hemodialysis Unit based on aneeds assessment survey conducted on patients, their families and the Renal Unit staff. The program consisting of: a) educational activities, b) group activities, and c) appropriate referrals to Psychiatry, was implemented for a 6-month period. Results: A total of six (6) patients undergoing hemodialysis at the SLMC-Renal Unit were recruited, with 5 of their families agreeing to participate. Four of the 6 patients (67%) were found to be clinically depressed, with another patient experiencing minimal symptoms of anxiety and depression. Objective quality of life was good and subjective QOL was moderate to high, with the activity domain being most affected. Majority (60%) of the family members had physical symptoms associated with burnout (low energy, fatigue) and was starting to manifest with psychological symptoms of depression, while 40% complained of anxiety symptoms. Quality of life was rated to be high by 80% of the family members. No psychopathology was identified in any of the Unit's staff, with quality of life rated to be high. Inspite of difficulties in the implementation of the group activities for the patients and families/caregivers, majority of the program strategies were implemented. Conclusion: A Comprehensive Consultation-Liaison Program for the Unit, which uses a biopsychosocial framework was developed and implemented. These included educational activities, group therapy and appropriate referrals to Psychiatry. The group therapy strategy, however, may not be the best approach for patients in this setting. Instead, individual psychotherapy is best suited and psychiatric consultation, for this purpose, is recommended.
Human ; Male ; Female ; HEALTH SERVICES ; MENTAL HEALTH SERVICES ; RENAL DIALYSIS

Acrodermatitis continua of Hallopeau (ACH) is a chronic, rare pustular form of psoriasis that affects the distal extremities, particularly the fingers and toes. Although pustules are characteristic, they may not always be clinically apparent, especially in the earlier stages. This condition is often resistant to treatment; therefore, early and accurate diagnosis is essential for proper management and preventing complications.

A 34-year-old male farmer presented with a one-year history of pruritic erythematous scaly plaques involving both palms, thumbs and thumbnails. Pertinent history showed that the lesions appeared after contact with rubber gloves and fertilizers. Irritant versus allergic contact dermatitis were considered, but a negative patch test result ruled out the allergic component. He was treated with topical corticosteroids and was advised to wear cotton gloves under rubber gloves while working which provided relief. However, the plaques recurred now with appearance of pustules on both hands. A skin punch biopsy was done revealing psoriasiform dermatitis with subcorneal pustules, consistent with ACH. The patient was started on methotrexate 7.5 mg/week and topical clobetasol, alternating with calcipotriol with improvement of the palmar plaques and pustules.

ACH is often misdiagnosed due to its pus-filled lesions which may mimic infection or secondarily infected contact dermatitis or dyshidrotic eczema. In this case, the initial presentation mimicked a contact dermatitis, and it was only after patch testing and skin biopsy, that a definitive diagnosis was made.

OBJECTIVES: The objectives of this study are: assess the burden of care and quality of life among family caregivers of patients undergoing hemodialysis at the Renal Unit of the UP-PGH Medical Center; describe the socio-demographic data of these family caregivers and the association of this data with burden of care; and describe the association between burden of care and quality of life. METHODS: This is a hospital based cross-sectional study conducted at the Renal Unit of the UP-PGH Medical Center from October 1, 2002- November 28, 2002, using the WHO Burden Assessment Schedule in Pilipino and the PGH-DOH Quality of Life Scale, also in Pilipino. RESULTS: This study showed that most of the caregivers are in the 21-60 years age range, married, female, unemployed, roman catholic, either a parent or a spouse, with either a high school or college level of education. Burden was significantly correlated with location of patient and the presence of illness among caregivers. Quality of life was generally high. There was no correlation between burden of care and quality of life. To some extent there was a negative impact on the marital relationship, which may be due to the fact that the illness of the patient and the strain of caregiving may have prevented the spouses from fulfilling their marital roles. However, these caregivers felt appreciated to some extent and more, by their patients, relatives and friends, which may account for the decreased feeling of burden and good quality of life. Caregiver burden was greater among those whose patients were confined, signifying possible deterioration, additional expenses and time spent caring for the patient. Burden was also experienced more by caregivers who were ill themselves, probably due to their own physical limitations and the added expenses that their own illness entailed. CONCLUSION: The BAS scores of the caregivers without spouses, correlated with the location of patient and the presence of illness among caregivers. The BAS scores of those with spouses correlated with sex, location of patient and the presence of illness among caregivers.
Human ; Female ; Middle Aged ; Adult ; QUALITY OF LIFE ; CAREGIVERS ; RENAL DIALYSIS

Cutaneous metastases are uncommon dermatologic manifestations, occurring in 0.7–0.9% of cancer patients. They typically originate from malignancies of the breast, lung, or gastrointestinal tract, with only a few reported cases arising from malignant cardiac tumors. Herein, we present a rare case of cutaneous metastasis from a primary cardiac myxofibrosarcoma (MFS). Based on available literature, this is the first documented case in the Philippines.

A 26-year-old man presented with rapidly enlarging nodules on the mandible and left thigh following the early recurrence of a previously excised cardiac myxoma. A biopsy of the skin lesions demonstrated a bottom-heavy distribution of atypical spindle cells in a myxoid stroma, raising suspicion of either a primary spindle cell neoplasm or cutaneous metastasis. This prompted a multidisciplinary investigation into the underlying malignancy. Histopathology and immunohistochemical staining of both the cardiac mass and skin lesions confirmed a diagnosis of cardiac MFS with cutaneous metastasis. The aggressive nature of MFS, combined with the presence of metastasis and the patient’s decision to decline further treatment, led to rapid clinical deterioration and ultimately, death.

Cutaneous metastasis from cardiac tumors is exceedingly rare and difficult to diagnose given the paucity of reported cases. This case highlights the pivotal role of dermatologists in recognizing these dermatologic manifestations, prompting further investigation into the underlying malignancy. Dermatologists must maintain a high index of suspicion when evaluating skin lesions of patients with a history of malignancy, given the significant treatment and prognostic implications.

PURPOSE: Association between body mass index (BMI) and doses in organs at risk during postoperative vaginal cuff brachytherapy (VCB) treatment has not been evaluated. The aim of this study was to analyse the impact of BMI on the dose delivered to bladder and rectum during high-dose-rate VCB using computed tomography (CT) scans at every fraction. MATERIALS AND METHODS: A retrospective analysis of 220 planning CT sets derived from 59 patients was conducted. Every planning CT was re-segmented and re-planned under the same parameters. Rectum and bladder dose-volume histogram values (D0.1cc, D1cc, and D2cc) were extracted and evaluated. The mean values for all applications per patient were calculated and correlated with BMI, as well as other factors influencing rectal and bladder doses. Multiple regression analysis performed to model organ at risk dose-volume parameters. RESULTS: According to World Health Organization (WHO), 6.8% of patients were normal, 35.6% were overweight, and 57.6% were class I obese. Median rectal doses were 133.5%, 110.9%, and 99.3% for D(0.1cc), D(1cc), and D(2cc), respectively. The corresponding median bladder doses were 96.2%, 80.6%, and 73.3%, respectively. BMI did not show significant association with rectal doses. However, BMI did show a significant association with evaluated bladder dose metrics (D(0.1cc), r=-0.366, p=0.004; D(1cc), r=-0.454, p < 0.001; D2cc, r=-0.451, p < 0.001). BMI was retained in the multivariate regression models (D(0.1cc), p=0.004; D(1cc), p < 0.001; D(2cc), p=0.001). CONCLUSION: In this group of Mediterranean, overweight, and moderately obese patients, BMI showed association with lower bladder dose values, but not with rectal doses.
Body Mass Index* ; Brachytherapy* ; Humans ; Obesity ; Organs at Risk* ; Overweight ; Rectum ; Retrospective Studies ; Urinary Bladder ; World Health Organization

·AIM: To analyze the management of patients with macula- on retinal detachment who received surgical treatment in our department. Placing special emphasis on the time elapsed between diagnosis and surgery, we sought to establish whether a relationship exists between time to surgery and loss of visual acuity.·METHODS: A retrospective study in which the medical records of 77 patients with macula-on retinal detachment who underwent surgery in Hospital Universitario Fundación Jiménez Díaz were reviewed.·RESULTS:A total of 77 patients, 72 were included in the study. The primary anatomic success rate was 94. 44%(68/72), and the success rate in all patients after either 1 or 2 interventions was 98. 61% ( 71/72 ) . The mean time before surgery was 5. 3 ± 2. 26d. Seven patients ( 9. 72%) lost two or more lines of vision. A statistically significant relationship was found between loss of visual acuity and patient age ( P = 0. 001 ) . Our findings also suggest a possible link between the need for further surgical intervention to reattach the retina and decline in visual acuity test ( P= 0. 045 ) . We failed to find a statistically significant relationship between loss of visual acuity and days until surgery ( P= 0. 100 ) or type of surgery ( P=0. 578) or status of the crystalline lens (P=0. 413).·CONCLUSION: It is important that each hospital study how this type of retinal detachment is being managed in order to optimize the use of available resources and guarantee the most favorable anatomic and functional outcomes possible.

Although its use in daily practice is not common, optical coherence tomography (OCT) is a powerful research tool in invasive cardiology. This report describes a hazy angiography image after percutaneous coronary intervention that has been assessed using OCT. Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation. After implantation of the stent, an intracoronary hazy image was seen on angiography. The use of OCT permitted a correct diagnosis and a successful treatment. This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.
Angiography ; Angioplasty ; Cardiac Catheterization ; Cardiology ; Humans ; Percutaneous Coronary Intervention ; Stents ; Thrombosis ; Tomography, Optical Coherence ; Ultrasonography, Interventional

OBJECTIVES: The main objective of this study was to describe the knowledge, attitudes, sexual practices, and utilization of health services of the MSM population in the Philippines.

METHODS: The study design was cross-sectional. Data was collected through an online survey of Filipino MSMs with accounts at any of the three (3) major MSM websites. This was supplemented by focus group discussions and key-informant interviews of informal MSM leaders. Only 682 men satisfied the eligibility criteria and were included in the analysis.

RESULTS: Forty eight percent (48%) of the respondents had low levels of knowledge on Human Immunodeficiency Virus (HIV). Majority (54%) engaged in unprotected sex despite having positive attitudes toward condom use. MSMs had multiple sex partnerships to satisfy their "high libido" and get "sexual gratification." Only 17% had submitted themselves for HIV testing and knew their results.

CONCLUSIONS: MSMs remain at high risk for HIV and Sexually Transmitted Infections (STI's). There is a wide gap between knowledge and actual sexual practices, and their health-seeking behavior remains poor. Thus, there is a need for programs that are tailored to the needs, cultural diversities, and unique practices of the MSM community.

Objective: This study aims to describe the socio-demographic profile of the Filipino OCD patient consulting a private psychiatrist, the nature of the obsessions and compulsions experienced, the character and severity of the symptoms associated with the disorder, and other co-morbid conditions. Methodology: Forty seven patients with OCD were identified in selected private clinics in Metro Manila. Information on the nature, character and severity of the obsessions and compulsions were gathered in 45 patients through chart review. Results and Conclusion: The OCD patient described in this study was more often male, single who has attained college level of education. The most common obsessions were contamination obsessions (in the form of concern with dirt or germs) and sexual obsessions (in the form of forbidden sexual thoughts, images or impulse). The most common compulsions were the cleaning washing compulsions in the form of excessive or ritualized handwashing. The severity and impact of obsessions were moderate to severe, so with compulsions although to a lesser degree. Over half of all the patients (59.6 percent) had at least one other illness aside from OCD. The most common co-morbid disorders were major depression and dysthymia.
Human ; Male ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; OBSESSIVE-COMPULSIVE DISORDER