1.Validation of the selection process of PhilHealth sponsored members in 4 barangays in a municipality in Batangas using the participatory action research
Salvador Vincent Bryan DG ; Paterno Ramon P ; Regalado-Paterno Elizabeth C ; San Juan Michael D ; Sabalo Ma. Angeli B ; Saceda Sylvette A ; Pineda Carminda J ; Unson Enrique Miguel S ; Taveros Mel Clark R ; Sales Cecille Marie C ; Puzon Gretel B ; Rafael Tonilene E ; Permites Abel Santini G
Acta Medica Philippina 2012;46(1):4-13
Objective. The present study aims to correlate the LGU list of PhilHealth Sponsored Members in a municipality of Batangas with the list of poor residents as identified by the Participatory Action Research (PAR) methodology.
Method. Interview of key informants documented the processes utilized by the LGU in determining PhilHealth beneficiaries for the Sponsored Program and the Participatory Action Research (PAR) survey in the classification of households into poor, middle and rich in four barangays of the municipality. The list of LGU Sponsored members was then cross matched with the PAR household classification.
Results. The comparison of the LGU list of Sponsored members and the household classification by the PAR survey showed a wide discrepancy: (1) 464 "Not Found" Sponsored households or 70% of the LGU's Sponsored list; (2) inclusion of the non-poor: 140 middle class families as classified by the PAR survey or 21.1% of the LGU's Sponsored list; and (3) exclusion of 413 or 87.5% of true poor families identified by the PAR Survey. Only 59 families or 8.9% of the LGU Sponsored list were classified as poor families by PAR.
Conclusion. PAR offers communities, LGUs and the National Health Insurance Program a tool to validate the coverage of the Sponsored program. LGUs and the PhilHealth should consider such tool or similar tools to validate their identification, selection and enrollment of the poor, which is extremely vital in achieving universal coverage. Given the right tool, communities are in the best position to identify the poor for the Sponsored program. By way of collaboration with the underprivileged themselves, the academe has a role in assisting communities in acquiring collective awareness of their own situation and developing capacity for improving their lives. The academe also has a role in assisting LGUs in improving their health systems and national health programs in validating and improving their implementation. Further studies should be done to investigate the following: the identity of the "not found" SP members; the utilization of PhilHealth benefits by the poor; and the prospect of utilizing the PAR method by other non-academic institutions in monitoring the progress of community programs.
Human
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Male
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Female
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PUBLIC-PRIVATE SECTOR PARTNERSHIPS
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HEALTH SERVICES
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INSURANCE, HEALTH
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HEALTH CARE ECONOMICS AND ORGANIZATIONS
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ECONOMICS
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FINANCING, ORGANIZED
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INSURANCE
2.R-CHOP and consolidation radiotherapy for limited-stage and low-IPI high-grade b-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements: A single-center case series and review of literature
Joseff Karl U. Fernandez ; Michael D. San Juan ; Edilberto Joaquin V. Fragante, Jr. ; Billionario Januario Antonio D. Veloso, Jr. ; Timothy Carl F. Uy ; Michelle Regina L. Castillo ; Benedict Mihangel P. Crisostomo
Acta Medica Philippina 2024;58(Early Access 2024):1-11
High-Grade B-Cell Lymphoma (HGBCL) with gene rearrangements in MYC and BCL2 and/or BCL6 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 MYC, and BCL2 and/or BCL6 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.
3.HIV screening among patients with newly diagnosed solid and hematologic malignancies in a Tertiary Hospital in the Philippines
Jonnel B. Poblete ; Andrew Rufino M. Villafuerte ; Marvin Jonne L. Mendoza ; Anna Flor G. Malundo ; Josephine Anne C. Lucero ; Analigaya R. Agoncillo ; Michael D. San Juan
Acta Medica Philippina 2024;58(5):5-9
Objectives:
This preliminary study determined the prevalence of HIV infection among patients with newly diagnosed solid and hematologic malignancies at the Philippine General Hospital - Cancer Institute.
Methods:
Adult Filipinos aged 19 years and above with biopsy- or imaging-confirmed malignancy and for
chemotherapy, seen at the adult medical oncology and hematology clinic from January to September 2021 were
included. Demographic and clinical data were obtained using a questionnaire. Rapid HIV screening was performed using blood extracted via finger prick. Pre- and post-test counselling were conducted.
Results:
Of the 124 patients included in our study, majority were female (91, 73.4%), and 45 years old and above with a median age of 49 (20 – 74). Majority had solid tumors (121, 97.6%) with breast cancer being the most common (67, 54.0%) followed by colorectal (18, 14.5%), and head and neck cancer (14, 11.3%). Among those with hematologic malignancies, two had acute myelogenous leukemia and one had multiple myeloma. Six patients had AIDS-defining malignancies (NHL, cervical cancer). HIV risk factors and associated conditions were present in 18 patients (14.5%). Ten patients reported prior HIV testing. None of the patients tested positive for HIV.
Conclusion
The absence of HIV cases detected in our cohort may be due to the low prevalence of HIV risk factors and associated conditions. At this time, there is insufficient evidence to routinely recommend HIV testing among newlydiagnosed cancer patients. However, physicians are encouraged to offer HIV testing to cancer patients, especially to those with HIV risk factors, given the benefits of early detection and management of HIV.
HIV
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Philippines
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Neoplasms
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Mass Screening