1.Effectiveness of Tocilizumab in COVID-19 patients with pneumonia: A systematic review
Johanah Laisah M. Salo ; Lyka Jam N. Marcelo ; Ariana Claire A. Sanchez ; Chonamae P. Marcelino ; Hazel Anne Lamadrid-Catublas ; Kevin Jace A. Miranda ; Rogie Royce Z. Carandang
Acta Medica Philippina 2024;58(Early Access 2024):1-9
Background and Objective:
COVID-19 contributes significantly to global morbidity and mortality. Age-related
comorbidities elevate the risk of severe cases. Studies have recently demonstrated that widely available medications, including tocilizumab (TCZ), can manage severe symptoms. However, its effectiveness is unclear, particularly among the older population. Therefore, this review aimed to evaluate TCZ’s efficacy in managing severe pneumonia in individuals aged 50 and older.
Methods:
We systematically search several databases and gray literature including Web of Science, CINAHL, Academic Search Complete, PsycINFO, PsycArticles, SocINDEX, CENTRAL/Cochrane Library, PubMed/MEDLINE for original research articles in English across several study designs published in the year 2020-2022. A narrative synthesis was conducted to summarize the evidence. We employed the NIH quality assessment tool for observational cohort studies to evaluate risk of bias. Additionally, we utilized GRADE to appraise the certainty of evidence.
Results:
Among 539 screened articles, only five studies met the selection criteria. Tocilizumab's impact on severe COVID-19 pneumonia revealed a diverse effect on mortality rate, with 29% in the TCZ group, and 40% in the controls died within 30 days of intubation (OR 0.61; 95% CI, 0.27-1.36). It is also reported that TCZ was not associated with mortality, despite faster decline in pulmonary function and prolonged fever. Hospital mortality in the TCZ group was significantly lower than in the controls, and age over 60 was the only significant risk factor. Moreover, administering TCZ reduced mechanical ventilation needs, with 82% extubated compared to 53% in controls. However, 45% in TCZ group was associated with a higher ventilator-associated pneumonia rate than in the untreated group which was 20% (P < 0.001). Despite this, TCZ-treated patients had shorter hospital stays.
Conclusions
The effects of tocilizumab on reducing mortality risk and improving the survival rate of COVID-19 patients with pneumonia remained inconclusive. Yet, the majority of results suggested that giving tocilizumab leads to shorter hospital stays, lowers the requirement for mechanical ventilation, and decreases the likelihood of ICU transfer. Tocilizumab is linked to the incidence of secondary infections; hence, this medication should be closely monitored for side effects.
COVID-19
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Pneumonia
2.“They say it may cause cancer:” A qualitative exploration of Filipinos' contraceptive misconceptions and primary healthcare interventions
Pamela Mae Q. Aseremo ; Jayne Patricia C. Herco ; Charlene A. Paraleon ; Azel Ruth E. Pumaras ; Nikki M. Matibag ; Kevin Jace A. Miranda ; Rogie Royce Z. Carandang
Acta Medica Philippina 2024;58(Early Access 2024):1-10
Background and Objective:
Contraceptives are widely acknowledged for preventing unwanted pregnancies. However, there is a prevalent lack of awareness regarding contraceptives, leading to unaddressed misconceptions. This study aimed to identify common contraceptive misconceptions among men and women of reproductive age and explore how primary health workers address them.
Methods:
A qualitative study was conducted in two phases within District 5, Manila City. Phase 1 comprised focused group discussions with men and women of reproductive age (n=60), while Phase 2 involved conducting in-depth interviews with primary healthcare providers (n=16). MAXQDA, a qualitative software, to organize and code the data, was utilized.
Results:
Women of reproductive age reported several misconceptions about contraceptives, including concerns about adverse health effects, emotional and behavioral changes, perceived ineffectiveness, and cosmetic or bodily changes. For instance, they believed that contraceptives could lead to serious health complications, such as cancer, genital injury, and even death. Primary healthcare providers addressed these misconceptions through open dialogue during service delivery, particularly during prenatal and postpartum check-ups and infant immunizations. They utilized patient education strategies, including the teach-back method, and conducted community outreach and workshops on contraceptives and family planning, especially during Women’s Month.
Conclusion
Several misconceptions were identified among women of reproductive age regarding the proper use and safety of contraceptive methods, as well as misguided beliefs. In contrast, men did not exhibit any misconceptions about contraceptives, which warrants further investigation. Primary healthcare providers have taken a proactive approach to address this issue by offering comprehensive explanations and ensuring clear understanding between healthcare providers and women. Promoting contraceptive health literacy could help bridge the knowledge gap between men and women of reproductive age.
contraceptives
;
contraceptive agents
;
health literacy
;
Philippines
3.Lifestyle-related changes among Filipinos with comorbidities during the COVID-19 pandemic
Lorraine Ann Nolasco ; Avery Caroleen Valencia ; Mary Rachelle Macapagal ; Jan Mikole Rodriguez ; Hazel Anne Lamadrid-Catublas ; April Mergelle Lapuz ; Kevin Jace Miranda ; Rogie Royce Carandang
Philippine Journal of Health Research and Development 2024;28(1):43-47
Background:
The global impact of the COVID-19 pandemic has been significant, affecting individuals across all health spectrums. Many have adapted their lifestyles to navigate the challenges posed by the pandemic. Despite this, there remains a lack of understanding regarding the specific lifestyle changes made by Filipinos with comorbidities during this time.
Objectives:
We aimed to ascertain the lifestyle changes among Filipinos with comorbidities and examine how their condition and various sociodemographic factors influenced these changes during the pandemic.
Methodology:
We conducted a community-based cross-sectional study involving 402 Filipino adults with comorbidities residing in Metro Manila. Using descriptive statistics, we summarized sociodemographic profiles and considerations for lifestyle changes. We assessed lifestyle changes using principal component analysis. Multiple linear regression was used to identify factors associated with these changes.
Results:
Lifestyle modifications include positive changes in a healthy diet, nutrition, and social support, as well as negative changes in restorative sleep, mental and physical states, and unhealthy eating habits. Monthly household income was positively associated with lifestyle changes. Specifically, individuals belonging to the middle to upper-income categories tend to adopt these modifications compared to those in the lower-income brackets (B [unstandardized beta]=3.99; 95% CI [Confidence Interval)= 0.98, 6.99). The primary reason for embracing these changes was to delay or prevent the progression of diseases, followed by the desire to minimize health complications.
Conclusions
High-income Filipinos are more inclined to adopt lifestyle modifications compared to lower-income individuals. Prioritizing disease prevention and minimizing health complications are common considerations for these changes.
Chronic Disease
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Comorbidity
;
COVID-19
;
Health