No abstract available.
Standard of Care

Background: Management of COVID--19 patients during surges have been a challenge as hospitals have to deal with staff, room, and medication shortages. Among these medications is tocilizumab which is given to patients with severe/critical conditions. In Ospital ng Makati, patients are given baricitinib as alternative immunomodulator to prevent possible cytokine storm during tocilizumab shortages. The current recommendation for baricitinib is to give it in addition to dexamethasone and remdesivir for hospitalized COVID-19 patients requiring low to high-flow oxygen, and non-invasive ventilation. However, there is not enough evidence to recommend it as an alternative to tocilizumab in COVID--19 patients. This study aims to find out the real-world efficacy of baricitinib in addition to standard of care among admitted patients with severe COVID-19 pneumonia admitted in Ospital ng Makati. Methods: This is a retrospective, case control study that reviewed records of adult patients admitted at Ospital ng Makati from December 2020 to May 2021 due to severe COVID-19. Patients who were given standard of care was compared to those who were given baricitinib by measuring the duration of clinical improvement, in-hospital all-cause mortality, number of hospital stay, and progression to acute respiratory distress syndrome (ARDS) and need for mechanical ventilator. Results: The use of baricitinib led to a faster improvement time (10 vs 12 days) however did not reach level of significance (p=0.069). There was also no significant difference in the mortality, number of hospital days, and progression to ARDS between the two groups. Conclusion There is not enough evidence to recommend baricitinib as an alternative to tocilizumab in patients with severe COVID--19 infection.
COVID-19 ; Standard of Care

Surgical resection is considered the standard of care in the management of symptomatic insulinoma. In this video, we describe the successful management of a symptomatic insulinoma by using linear array endoscopic ultrasound (EUS)-guided ethanol ablation in a poor surgical candidate. EUS-guided ethanol ablation of insulinoma offers a safer, effective, and less invasive alternative to surgery.
Ethanol ; Insulinoma* ; Standard of Care ; Ultrasonography

Since 2005, the American Diabetes Association has published the annual Clinical Practice Recommendations, which include the "Standards of Medical Care in Diabetes." This publication has been recognized as one of the primary references for medical care in diabetes. In this paper, I provide a summary of the "Executive Summary on Standards of Medical Care in Diabetes-2016" in Korean. This Korean version of the executive summary will be a good reference for daily clinical practice of diabetes care.
Diabetes Mellitus ; Publications ; Standard of Care

Since 2005, the American Diabetes Association (ADA) has published annual Clinical Practice Recommendations, which include "Standards of Medical Care in Diabetes." This publication has been recognized as one of gold standards of medical care in diabetes. In this paper, I provide a summary of the "Executive Summary on Standards of Medical Care in Diabetes-2012" in Korean. I hope this Korean version executive summary will be a good reference for daily clinical practice of diabetes care.
Diabetes Mellitus ; Publications ; Standard of Care

Lipiodol based conventional transarterial chemoembolization (TACE) is a standard of care for unresectable, non-invasive, and multinodular Hepatocellular carcinoma (HCC)s. The procedure relies on the intra-arterial administration of lipiodol/cytotoxic agent emulsion followed by the infusion of embolic material. Lipiodol, with its oily nature and radiopacifying properties, is in the center of the TACE procedure. Unstability and unpredictable therapeutic effect of hydrophilic cytotoxic drugs emulsified in the lipiodol and technical problems lie beyond the control of clinicians. Thus, interest in the properties and respective roles for lipiodol in the management of HCC is essential for the clinicians.
Carcinoma, Hepatocellular* ; Ethiodized Oil* ; Standard of Care

The efficacy of beta and gamma emitters in reducing clinical and angiographic restenosis in patients with in-stent restenosis has been confirmed by a number of studies. This review is intended to give an overview of the individual trials, summarize pertinent lessons that have been learned and give insight into the future of intracoronary radiation. The encouraging results from the clinical trials have established vascular brachytherapy as a standard of care for patients with in-stent restenosis.
Brachytherapy ; Coronary Restenosis ; Humans ; Standard of Care ; Stents

The precut sphincterotomy is used to facilitate selective biliary access in cases of difficult biliary cannulation. Needle-knife precut papillotomy is the standard of care but is associated with a high rate of complications such as pancreatitis, duodenal perforation, bleeding, etc. Sometimes during bowing of the sphincterotome/cannula and the use of guide wire to facilitate biliary cannulation, inadvertent formation of a false passage occurs in the 10 to 11 o'clock direction. Use of this step to access the bile duct by the intramucosal incision technique was first described by Burdick et al., and since then two more studies have also substantiated the safety and efficacy of this non-needle type of precut sphincterotomy. In this review, we discuss this non-needle technique of precut sphincterotomy and also share our experience using this "Burdick's technique."
Bile Ducts ; Catheterization ; Hemorrhage ; Pancreatitis ; Standard of Care

Pancreatic cancer has a high mortality rate and short survival as a result of the high incidence of metastatic disease at diagnosis, the fatal clinical course, and the lack of successful therapeutic strategies. Gemcitabine remains the only standard of care for this disease. Increasing combination therapies containing gemcitabine have been tested or are undergoing investigation. In the last decade, despite a number of clinical trials assessing novel cytotoxic agents and cell signaling inhibitors, the overall survival has reached a plateau that remains difficult to improve on. This review presents recent developments involving newer chemotherapeutic and molecular targeted agents, and identifies efforts for individualized treatment strategies.
Cytotoxins ; Deoxycytidine ; Incidence ; Pancreatic Neoplasms ; Standard of Care

Pancreatic cancer has a high mortality rate and short survival as a result of the high incidence of metastatic disease at diagnosis, the fatal clinical course, and the lack of successful therapeutic strategies. Gemcitabine remains the only standard of care for this disease. Increasing combination therapies containing gemcitabine have been tested or are undergoing investigation. In the last decade, despite a number of clinical trials assessing novel cytotoxic agents and cell signaling inhibitors, the overall survival has reached a plateau that remains difficult to improve on. This review presents recent developments involving newer chemotherapeutic and molecular targeted agents, and identifies efforts for individualized treatment strategies.
Cytotoxins ; Deoxycytidine ; Incidence ; Pancreatic Neoplasms ; Standard of Care