Objectives: This study aims to determine the healthcare workers’ (HCWs) attitudes, perceptions, and practices regarding Antimicrobial Stewardship (AMS) at the Philippine Children's Medical Center (PCMC). Materials and Methods: This cross-sectional study employed a validated online survey. Results: The study included 288 healthcare workers, predominantly female (77.35% ) and aged 31-40 years (47.74%), with physicians being the largest professional group (57.14%). HCWs had positive attitudes toward AMS. They perceived moderate to high antimicrobial resistance (AMR) levels in different contexts but believed the hospital had lower AMR levels than the country. HCWs agreed that AMR impacts antimicrobial choices, patient outcomes, and safety. Contributors to AMR were prescribing inappropriate antimicrobials, unnecessary prescriptions, poor patient adherence, and inadequate infection control measures. HCWs, except medical technologists, were aware of the Antimicrobial Stewardship Program (ASP) and its interventions. Only nurses and pharmacists were aware of the hospital policies against AMR. Barriers to AMS implementation include inadequate training in antimicrobial use, lack of infectious disease/ microbiology services, lack of electronic medication management services, and personnel shortages. HCWs had high self-reported AMS practices, but a practice gap in single-dose surgical antibiotic prophylaxis was identified, with low physician adherence (50.6%). Conclusion This study revealed positive attitudes and high self-reported AMS practices among HCWs. They also perceived moderate to high AMR in different contexts but believed that the hospital has lower AMR levels than the country. Addressing the identified barriers to implementation and practice gaps is crucial for achieving antimicrobial stewardship goals.
Antimicrobial Stewardship ; Viperidae ; Health Personnel

PURPOSE: Though web-based tests have many advantages, they do not become the main test form in medical education because of their many technical or operational limitations. We have developed a new web-based test system to overcome these limitations and, ultimately, to replace conventional paper and pencil tests. METHODS: We developed a web-based test system using a windows 2000 server, mySQL, visual basic 6.0 and ASP script as developing tools. We applied this system to formal examinations. The system was modified and optimized based on users' demands and problems identified during testing. RESULTS: Since web-based testing was first administered in 2003 to the third-year students during their clinical practice examinations, it has been used in 51 examinations at the College of Medicine in Chungbuk National University. In 2004, it was used in more than a half of the regular examinations at our medical college. At the beginning, lecturers were reluctant to adopt a new test system because of unfamiliarity and fear of additional workload. Shortly, however, they found that they were able to handle the multimedia contents more easily and obtain much information from results analysis without additional work. Examinees also favored web-based tests in presenting multimedia data but had some difficulties in focusing on the test. Overall, examinees' preference for web.based tests was comparable to conventional tests. According to user demand, we improved this test system by verifying question formats and making test analysis. CONCLUSION: Web-based tests can replace paper and pencil tests in medical education. Improvement of this testing system is expected with serious and continuous concerns from examiners.
Chungcheongbuk-do ; Education, Medical* ; Humans ; Multimedia ; Viperidae

PURPOSE: The standardized patient (SP) is a person carefully trained to represent a real patient case for consistent and accurate use in student performance evaluation and/or training, has added a very important dimension in OSCE. The purpose of this study is compared a well-trained professional SP (PSP) and a amateur SP (ASP) in OSCE. METHODS: We surveyed 378 students apprentices and staffs involving OSCE of Daegu-Kyungbuk Consortium and analysed the validity between the PSP and ASP after OSCE. RESULTS: Of 92 total stations in which students were evaluated by staff evaluator, SP were used in 47 stations (48%). Of the 47 stations, professional SP 7 stations (16%). The questionnaires were made to know the effectiveness and realistics of SP. The results were different between station used PSP and ASP. Moreover, it was significantly different between the staffs and the students. The SP can offer advantages such as availability, adaptability and effectivity. If trained well, they also can provide positive effects to the students and the staffs. The PSP provides efficient and reliable opportunity to assess clinical skills in a safe situation without any harm to the real patients. CONCLUSION: It is suggested that the use of SP is stimulating and challenging way of evaluating the OSCE. Also, It appeared to be financially and availably feasible if it commonly owned in the boundary of the land such Daegu-Kyungbuk Consortium.
Clinical Competence ; Humans ; Viperidae ; Surveys and Questionnaires

One of the major clinical issues encountered after lumbar spinal fusion is the development of adjacent segment pathology (ASP) caused by increased mechanical stress at adjacent segments, and resulting in various radiographic changes and clinical symptoms. This condition may require surgical intervention. The incidence of ASP varies with both the definition and methodology adopted in individual studies; various risk factors for this condition have been identified, although a significant controversy still exists regarding their significance. Motion-preserving devices have been developed, and some studies have shown their efficacy of preventing ASP. Surgeons should be aware of the risk factors of ASP when planning a surgery, and accordingly counsel their patients preoperatively.
Humans ; Incidence ; Pathology* ; Risk Factors ; Spinal Fusion* ; Stress, Mechanical ; Viperidae

Recently, Wireless internet market has reached to the induction and growth stage by rapid development of Mobile service by fusion of Internet and wireless technology of communications. This paper improved the problem of a result report system of the donation of blood inspection which is delivered to the mail currently. We can confirm the result of the blood inspection to the execution. The user uses cellular phone taking the security of the individual into account. We used ASP language with WML and developed in this paper, Database used MS-SQL2000 Servr and Web server used a host server which offers Mnuri.
Cellular Phone ; Internet ; Postal Service ; Viperidae ; Wireless Technology

BACKGROUND/AIMS: We evaluated the status of antibiotic stewardship programs (ASPs) for physicians. This survey was a follow-up study of data from 2006 and was performed with some new questions about ASPs. METHODS: The online survey collected information on infectious diseases from doctors in 84 hospitals. The questions included some about ASPs. The data were analyzed and compared with a previous report. RESULTS: Responses came from 40 hospitals. ASPs existed in 87.5% of these (95.5% in 2006), and a computerized preauthorization system was the most common method (85.0%, 59.1% in 2006). An antimicrobial management team existed in 33 hospitals (82.5%), and the preauthorization systems were mainly implemented by infectious disease doctors (72.5%). Incentives to set up ASPs existed in only 12.5% of hospitals (2.3% in 2006). CONCLUSIONS: Computerized preauthorization ASP systems are relatively more common. To improve the uptake of ASPs in each hospital a team approach from the medical institutions is required, along with the cooperation and willingness of those involved.
Anti-Bacterial Agents ; Communicable Diseases ; Follow-Up Studies ; Motivation ; Viperidae

Alveolar soft part sarcoma (ASPS) is a rare form of soft tissue sarcoma, and frequently, metastases are found at diagnosis. In patients with metastatic or unresected ASPS, systemic treatment is extremely limited, because conventional chemotherapeutic agents have not been effective in most cases. A novel agent inhibiting angiogenesis, pazopanib, has been proven to be effective for metastatic soft tissue sarcoma in a second-line setting. However, the efficacy of pazopanib in ASPS has not yet been reported. A 22-year-old man presented with right calf ASPS and multiple lung metastases. Pazopanib as a second-line treatment showed significant tumor response. To the best of our knowledge, this is the first report of the effectiveness of pazopanib in ASPS.
Diagnosis ; Humans ; Lung ; Neoplasm Metastasis ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Viperidae ; Young Adult

OBJECTIVE: Research of electroencephalograph (EEG) power spectrum and mean frequency has shown inconsistent results in patients with schizophrenic, schizoaffective and bipolar disorders during medication when compared to normal subjects thus; the characterization of these parameters is an important task. METHODS: We applied quantitative EEG (qEEG) to investigate 38 control, 15 schizophrenic, 7 schizoaffective and 11 bipolar disorder subjects which remaine under the administration of psychotropic drugs (except control group). Absolute spectral power (ASP), mean frequency and hemispheric electrical asymmetry were measured by 19 derivation qEEG. Group mean values were compared with non parametrical Mann-Whitney test and spectral EEG maps with z-score method at p < 0.05. RESULTS: Most frequent drug treatments for schizophrenic patients were neuroleptic+antiepileptic (40% of cases) or 2 neuroleptics (33.3%). Schizoaffective patients received neuroleptic+benzodiazepine (71.4%) and for bipolar disorder patients neuroleptic+antiepileptic (81.8%). Schizophrenic (at all derivations except for Fp1, Fp2, F8 and T6) and schizoaffective (only at C3) show higher values of ASP (+57.7% and +86.1% respectively) compared to control group. ASP of bipolar disorder patients did not show differences against control group. The mean frequency was higher at Fp1 (+14.2%) and Fp2 (+17.4%) in bipolar disorder patients than control group, but no differences were found in frequencies between schizophrenic or schizoaffective patients against the control group. Majority of spectral differences were found at the left hemisphere in schizophrenic and schizoaffective but not in bipolar disorder subjects. CONCLUSION: The present report contributes to characterize quantitatively the qEEG in drug treated schizophrenic, schizoaffective or bipolar disorder patients.
Antipsychotic Agents ; Bipolar Disorder* ; Electroencephalography ; Fourier Analysis ; Humans ; Psychotic Disorders ; Psychotropic Drugs ; Schizophrenia* ; Viperidae

Alveolar soft part sarcoma (ASPS) is a rare soft tissue tumor that accounts for 5% of pediatric non-rhabdomyosarcoma soft tissue sarcomas. The disease presents as a indolent asymptomatic mass and affects primarily younger patients. The clinical course is often indolent and late metastases can develop even after prolonged disease-free intervals. Radiotherapy and chemotherapy play a very limited role in the treatment. We report a pediatric case of ASPS with a brief review of the literature.
Child* ; Drug Therapy ; Humans ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Viperidae

Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor of uncertain origin, and it has a strong propensity for metastasis to the lungs, bones and brain. We report upon an unusual case of ASPS, presenting as multiple lung nodules with no other detectable primary site, in a 44-year-old man. A fine needle aspiration of the nodules yielded scattered, discohesive cells, each containing an eccentrically displaced nucleus and prominent nucleolus, on a granular background. Tumor cells with numerous bared nuclei, and occasional sheets of epithelioid cells were also found. Under the cytological diagnosis of an unclassified epithelioid malignant tumor, resection of the lung nodules was performed. The histologic findings were consistent with ASPS, showing positive TFE3-nuclear immunoreactivity. There is limited literature concerning cytological findings associated with pulmonary ASPS: especially in cases where the primary site is unknown. Here, we present a cytological review of pulmonary ASPS, investigating the significance of TFE3 staining in the diagnosis of ASPS.
Adult ; Biopsy, Fine-Needle ; Brain ; Epithelioid Cells ; Humans ; Lung ; Neoplasm Metastasis ; Sarcoma, Alveolar Soft Part ; Viperidae