Radionuclide therapies have been applied in the diverse fields of medicine, and it has been demonstrated the usefulness of it, especially in the field of oncology. Accurate dosimetric assessment is imperative during radionuclide therapy, in order to optimize the treatment efficacy for target sites and to minimize the radiation exposure for normal organ. Recent advancement in imaging technology permits the precise determination of the absorbed dose non-invasively. This imaging based dosimetry can be routinely applicable to the bedside in the near future.
Treatment Outcome

OBJECTIVE: This study described childhood interstitial lung disease profiles at the Philippine Children‘s Medical Center (2013-2022). MATERIALS AND METHODS: A retrospective chart review at PCMC analyzed pediatric interstitial lung disease cases (Jan 2013-Dec 2022). Included were patients aged 0-18 with childhood interstitial lung disease. Excluded were those with specific conditions. Data included clinical course, tests, therapeutic management, and short-term outcomes based on a previous study. RESULTS: Twenty-three patients were included in this study. Most (52.17%) were diagnosed between 2013-2017, and were within the ages of 0-2 years. Majority of patients had normal nutritional status (52.17%). Common clinical presentation on admission included breathing difficulties, with chest retractions, crackles, and hypoxemia. Few had a family history of chronic lung disease. Comorbidities included pulmonary hypertension (30.43%) and pulmonary tuberculosis (21.74%). Chest radiography revealed infiltrates in all cases, and HRCT scans showed ground glass opacities in 82.61%. Prednisone was the primary treatment (86.96%). Lung biopsy results (43.48%) were mostly unclassified or nondiagnostic, with lymphoid interstitial pneumonia as the predominant diagnosis (20%). Improvement of signs and symptoms was seen in 39.13% of cases, whereas death occurred in 21.74%. Furthermore, the outcome remained undetermined in as much as 34.78% of cases due to inadequate follow-up. CONCLUSION This retrospective study emphasizes chILD's prevalence in infants under 2 years, with male predominance. Nutritional variations underscore the need for supplementation. Various common signs include crackles, retractions, and hypoxemia, with breathing difficulty as a frequent symptom. The diagnostic process involves imaging and ancillary tests, advocating a systematic approach with noninvasive methods like CXR and HRCT, reserving lung biopsy for inconclusive cases. Corticosteroids, whether used alone or in combination, prove beneficial in managing chILD by suppressing inflammation.
Treatment Outcome

No abstract available.
Leiomyoma* ; Treatment Outcome*

No abstract available.
Adult* ; Humans ; Treatment Outcome*

Child ; Humans ; Treatment Outcome

No abstract available.
Influenza, Human* ; Treatment Outcome*

Introduction: Tetanus remains a public health threat in developing countries and is associated with a high morbidity and mortality rate. There is paucity of published data regarding the management of tetanus in the Philippines, hence, the study was conducted to determine the demographic, clinical profile, and prognostic factors that are associated with mortality among adult tetanus patients admitted in Cagayan Valley Medical Center (CVMC). Methods: This is a retrospective study of patients who presented with a clinical diagnosis of tetanus, above 19 years old at CVMC between September 1, 2012 to October 31, 2018. Results: A total of 194 patients were studied. The male to female ratio was 11:1.Majority of patients were aged > 40 years (68.56%), rural dwellers (88.66%), farmers (84.02%) and males (91.75%). Only 3.09% of patients had prior tetanus immunization. Most common antecedent injury is trauma (84.53%), most commonly due to punctured wounds (63.40%). All patients had generalized tetanus, and majority were admitted in moderate grade (68.56%). Most common manifestations were trismus (92.78%), spasms (84.02%), dysphagia (80.93%) and rigidity (68.04%). Complication rate is 64.43%. Mortality rate is 38.66%. Most common cause of death is acute respiratory failure. Poor prognostic factors determined by univariate analysis were age more than 40 years (OR=2.24, p-value=0.0160), incubation period less than seven days (OR=2.65, p-value= 0.0027), period of onset less than three days (OR=2.52, p-value=0.0150) , severity of disease (OR=17.35, p-value=<0.0001), need for ventilatory support (OR=22.20, p-value=<0.0001) and presence of complications (OR=2.96, p-value= 0.0013). In multivariate analysis, only need for ventilatory support is associated with mortality (OR=31.57, p-value=0.000). Conclusion Mortality rate of adult tetanus in Cagayan Valley Medical Center is high. Therefore, health education is highly encouraged to promote awareness, specifically in immunization and basic wound management.
Tetanus ; Treatment Outcome ; Philippines

Introduction: In 2017, the American Thyroid Association (ATA) revised their guidelines that when trimester and assay specific TSH reference intervals is unavailable, a TSH cut-off of 4.0 mIU/L replacing the previously recommended 2.5-3.0 mIU/L may be used to define maternal hypothyroidism. It states that levothyroxine treatment is considered if anti-TPO levels are elevated and TSH is between 2.5 mIU/L and the trimester-specific upper limit. These recommendations are a major departure from our current practice because the local TSH trimester-specific reference interval is not applicable due to a different assay used and the anti-TPO result is not readily available. In this population-based study, we aimed to determine and compare the maternal and perinatal outcomes of pregnant women who are euthyroid (TSH 0.3-2.4 mIU/L) versus those with subclinical hypothyroidism at different TSH cut-off levels (TSH 2.5-4.0 mIU/L, TSH 4.0-10.0 mIU/L) treated with levothyroxine. Methods: This is a single-center, prospective cohort study conducted at Chong Hua Hospital, Cebu City from September 2017 to September 2018 where a total of 505 pregnant women qualified. The cohort was divided into three groups: the euthyroid group of 404 women with TSH 0.3-2.4 mIU/L as control subjects; 101 women with subclinical hypothyroidism treated with levothyroxine further subdivided into TSH level 2.5-4.0 mIU/L (81 women) and TSH level >4.0-10.0 mIU/L (20 women). These patients were followed through to delivery to document and compare the maternal and perinatal outcomes versus euthyroid patients. Results: There was no statistically significant difference among the group of patients with subclinical hypothyroidism treated with levothyroxine versus euthyroid patients in documented complications of pregnancy, such as GDM, gestational HPN, pre-eclampsia, PROM, low APGAR score and fetal distress. However, in patients with baseline TSH 2.5-4.0 mIU/L there was preterm delivery in six (7.41%) patients, post-term delivery in two (2.5%) patients, with seven (8.6%) small for gestational age (SGA) infants and two (2.5%) large for gestational age (LGA) infants. In patients with baseline TSH > 4.0-10.0 mIU/L, preterm delivery occurred in two (10%) patients. In secondary analysis adjusted for age and parity at enrolment, pregnant women treated with levothyroxine at baseline TSH 2.5-4.0 mIU/L and TSH > 4.0-10.0 mIU/L versus the untreated women with TSH < 2.5 mIU/L showed no difference in the maternal and perinatal outcomes of pregnancy measured. Conclusion This study has shown a 12.5% prevalence of subclinical hypothyroidism in our setting. There was no difference in the maternal and perinatal outcomes of pregnant patients who are euthyroid versus those with subclinical hypothyroidism treated with levothyroxine at a TSH threshold of 2.5-4.0 mIU/L and >4.0-10.0 mIU/L. These findings support the view that levothyroxine treatment in pregnant women with subclinical hypothyroidism at a TSH cut-off of 2.5 mIU/L shows no harmful effects.
Pregnancy ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Although several methods of repositioning maneuver have been introduced for the benign paroxysmal positional vertigo involving horizontal canal (HC-BPPV), no study has investigated the nystagmus pattern during the repositioning maneuver and its correlation with the repositioning results. Therefore, we evaluated the predictive value of the nystagmus for successful repositioning by studying the nystagmus pattern during the position of the Gufoni's maneuver. MATERIALS AND METHODS: Seventeen consecutive patients (age range=36~76 years, median age=64), with a diagnosis of HC-BPPV were recruited between July and August 2010. The Gufoni's maneuver for apogeotropic and geotropic nystagmus was performed. After 30 minutes, the treatment outcome was evaluated according to the nystagmus pattern at the individual stage of Gufoni's maneuver. Successful treatment was defined by the resolution of positional vertigo in geotropic HC-BPPV and nystagmus shifted from apogeotropic to geotropic in apogeotropic HC-BPPV. RESULTS: In the successfully treated patients, 4 of 6 patients had the contralesional nystagmus between 1st and 2nd position of Gufoni's maneuver. Ipsilesional nystagmus in 1st position of Gufoni's maneuver was observed in 1 patient with apogeotropic nystagmus. And the other 1 patient with Geotropic HC-BPPV showed no nystagmus in 2nd position after contralesional nystagmus in 1st position of Gufoni's maneuver. Unsuccessfully treated 11 patients had a conversion of nystagmus direction in 2nd position after 1st step. CONCLUSION: During the 2nd position of the Gufoni's maneuver, a nystagmus toward unaffected side predicts a successful repositioning, whereas reversed nystagmus is suggestive of poor response to repositioning.
Humans ; Treatment Outcome ; Vertigo

OBJECTIVE: This study aimed to determine the clinical effectiveness of double-shaft classification and sequential diagnosis and treatment of food impaction. METHODS: A total of 227 patients with food impactionwere subjected to double-shaft classification and subsequently treated by sequential diagnosis and treatment method. Treatment effectiveness was evaluated according to the subjective feelings of patientsat five time points (immediately after treatment and at 1, 3, 6, and 12 months after treatment). RESULTS: The average scores of patient's subjective perception were 2.00, 1.93, 1.59, 1.20, and 0.98 immediately and at 1, 3, 6, and 12 months after treatment, with treatment-efficiency values of 87.17%, 81.70%, 73.21%, 55.80%, and 44.59%, respectively. There were differences in scores of patient's subjective perception at each time point (P<
0.05). CONCLUSIONS Double-shaft classification and sequential diagnosis and treatment can effectively guide the treatment of food impaction.
Food ; Humans ; Treatment Outcome