OBJECTIVE: To describe the demographic and stress profile of the participants in the LIFECARE cohort.

METHODS: The Life Course Study in Cardiovascular Disease Epidemiology (LIFECARE) is a community-based prospective cohort of apparently healthy individuals aged 20 to 50 years old with no preexisting cardiovascular disease. The second phase out of four phases of study involves collection of baseline socio-demographic, anthropometric, biochemical and cardiovascular parameters and stress profiles. It was conducted via face-to-face interview using a survey questionnaire.

RESULTS AND CONCLUSION: A total of 3072 participants from Metro Manila and 4 provinces in Luzon were recruited. The female to male ratio was 1.3:1. Majority of the participants were aged 30 years old and above. Most were married, employed and literate. Majority attained at least high school level of education. Loss of job was the most common stressor experienced in the past year. Majority of the cohort reported occasional experience of general stress and moderate level of financial stress. Occurrence of general stress within the past year was higher among females (p < 0.001), younger age-group (p=0.006), and among those who reached college level of education (p<0.001). Furthermore, level of current financial stress was high to severe among older age-group (p=0.004), and among widow/widower/separated (p<0.0001). While the relationship between psychosocial stress and physical illness had not been established in this study, there is a need to investigate demographics and psychosocial stress, and their implications in increasing adverse health outcomes in general, and cardiovascular risk in particular.

Human ; Male ; Middle Aged ; Adult ; Cardiovascular Diseases-Risk Factors ; Demography

OBJECTIVE: This study aims to describe the socio-ecological and health profile of the Philippine LIFECARE study sites, its health care services and leading causes of mortality and morbidity.

METHODS: This is a prospective cohort study that recruited participants aged 20-50 years from Metro Manila and four provinces (Bulacan, Batangas, Quezon, Rizal). Study sites were characterized according to their geographical area, terrain and environmental profile, and available health care system.

RESULTS: 3,072 subejects were included, with male-to-female ratio of 1:1.3 and majority aged 30-50 years. Metro Manila was the most congested site. Two-thirds of the 62 villages (barangays) were rural, outside the town proper, and in lowlands. One-fourth were along coastal area. Almost all were accessible by public transportation. Majority have reduced forest cover, but were relatively safe from environmental hazards. Rural health units, hospitals, and professional health care workers were concentrated in Metro Manila. Leading cause of morbidity was respiratory tract infection, while cardiovascular diseases caused most of mortalities.

CONCLUSION: Study sites were mainly rural, outside the town proper and in lowlands, with available public transportation. There is an unequal distribution of health resources. Cardiovascular diseases is still the leading cause of mortality. The disparities in geographical access to health care play an important role in shaping human health.

Human ; Male ; Female ; Middle Aged ; Adult ; Health Care Facilities, Manpower, and Services ; Delivery of Health Care ; Health Resources

OBJECTIVE: To describe the distribution of the clinical cardiovascular risk profile of the LIFECARE Philippine cohort in relation to its socio-demographic factors.

METHODS: We recruited a total of 3,072 apparently healthy participants from Manila and nearby provinces of Rizal, Batangas, Bulacan and Quezon. Face-to-face interview was done to obtain socio-demographic data. Baseline clinical parameters and biochemical tests were obtained. Prevalence of cardiovascular risk factors was determined by sex, place of residence, level of education and employment.

RESULTS: Overall prevalence of diabetes mellitus was at 5%, similar between sexes, area class, educational attainment and employment status. More smokers were male, employed or with an elementary level of education. Prevalence of hypertension was at 14.5% and was seen more in males, urban dwellers, employed or with an elementary level of education. Dyslipidemia was seen more in males, living in the rural areas, employed or with a college level of education. Lastly, obese participants were seen more in females, living in urban areas, employed with a college level of eduction.

CONCLUSION: Older, male and employed participants who are living in the urban areas have more cardiovascular risk factors.

Human ; Male ; Female ; Middle Aged ; Adult ; Cardiovascular Diseases-Risk Factors ; Demography

Objective: This study aims to determine the prevalence of subclinical thyroid dysfunction among cardiac patients at the Philippine General Hospital, and its association with mortality. Methodology: 163 adult cardiac patients were screened for subclinical thyroid dysfunction, [subclinical hyperthyroidism (SCT), subclinical hypothyroidism (SCHO), non-thyroidal illness syndrome (NTIS)]. Demographic and clinical characteristics were analyzed using ANOVA and Fisher’s exact test. Outcome considered were hospital duration, need for mechanical ventilation, inotropic support and mortality. Crude association between subclinical thyroid dysfunction and outcomes was evaluated using relative risk. Results: Prevalence of subclinical thyroid dysfunction was 32.5% (5.5% SCT, 5.5% SCHO, and 21.5% NTIS). The risk of necessitating mechanical ventilation was about twofold higher in subclinical thyroid dysfunction compared to euthyroid patients (RR=2.64), and was highest in SCHO (RR=3.71). The risk of inotropic support was about twofold higher (RR=2.70) in SCHO compared to euthyroid patients. Overall death rate was higher in subclinical thyroid dysfunction (RR=1.86), and highest in SCHO (RR=2.47) compared to euthyroid patients. Conclusion There is a significant prevalence of subclinical thyroid dysfunction among hospitalized patients with cardiac disease at 32.5%. Cardiovascular risk factors are not statistically significant. We observed a trend of increased risk of requiring mechanical ventilation, inotropes and overall mortality in SCHO.
Prevalence

The traditional binary classification of gender is repeatedly challenged throughout history with the presence of transgenders. Under the umbrella of transgenderism is transsexualism which pertains to individuals who identify with or desire to become the opposite sex. Transsexualism or Gender Dysphoria is classified as a medical condition under ICD 10 and DSM-5. The proposed treatment is sex reassignment that includes all treatments carried out to adapt to the desired sex. Sex reassignment involves a multidisciplinary approach wherein the psychiatrist or mental health practitioner, endocrinologist and surgeon play active roles. Certain legal and ethical issues exist in the treatment of transsexualism. This article provides a review of psychological, medical and surgical issues in the evaluation and treatment of Transgender individuals, with an Asian perspective, and in the context of an actual case.
Gender Dysphoria ; Transsexualism ; Transgender Persons