4.Association of intrapartal maternal blood glucose control and neonatal hypoglycemia in a private tertiary hospital.
De Leon Maria Edwardina G. ; Gonzaga Zarinah R.
Philippine Journal of Obstetrics and Gynecology 2016;40(1):1-8
OBJECTIVE: Diabetes in pregnancy is associated with maternal and fetal risks that include maternal hyperglycemia and neonatal hypoglycemia. Intrapartal plasma glucose concentration has a stronger association with decreased neonatal hypoglycemia paralleled with antepartum plasma glucose levels. The objective of the study is to determine the association between intrapartal glucose monitoring and neonatal hypoglycemia.
METHODS: This is a retrospective cohort study that involves parturients of any age with term gestation (>37 weeks) with gestational type or overt type of diabetes mellitus, either insulin-requiring or on medical nutrition therapy, with or without mean capillary blood glucose levels during labor. Multiple logistic regression was used for analysis, which quantifies the magnitude of association between maternal blood glucose control and neonatal hypoglycemia adjusted for significant confounders.
RESULTS: The incidence of diabetes among pregnants in this private tertiary hospital over the study period was 7.82%. Most of the diabetic parturients were primigravid, with gestational type of diabetes mellitus, and on medical nutrition therapy. More than half were referred to an endocrinologist intrapartum. The incidence of maternal hyperglycemia intrapartum is 33%. The birthweights of the neonates ranged from 2095 to 5250 grams. Among the diabetic parturients, the incidence of neonatal hypoglycemia is 10%. There was no significant association between neonatal hypoglycemia and intrapartummaternal hyperglycemia (p=0.05).
CONCLUSION: There is no significant association between intrapartum maternal hyperglycemia and development of neonatal hypoglycemia. Antepartum and intrapartum management of maternal hyperglycemia did not appear to be associated with the development of neonatal hypoglycemia. A standardized institutional management protocol on glucose monitoring and control among diabetic parturients is strongly suggested.
Human ; Female ; Adult ; Pregnancy ; Insulin ; Blood Glucose ; Endocrinologists ; Hyperglycemia ; Hypoglycemia ; Birth Weight ; Gravidity ; Nutrition Therapy
5.Are PET and PET/CT useful in pediatrics?
de Leon Dennis R ; Barrenechea Emerita A ; Santiago Jonas Y
The Philippine Journal of Nuclear Medicine 2012;7(1):23-29
The value of PET in the evaluation of various disease states, particularly in oncology, has been well documented. Compared with its widespread application in adults, clinical use of PET in pediatrics is limited. Concerns of radiation exposure to the child, as well as lack of studies evaluating the diagnostic benefit of PET/CT in children, are a contributing factor. This study was conducted to review the usefulness of PET and PET/CT in the evaluation of pediatric patients and to identify unique FDG physiologic distribution in the sample population. All pediatric patients referred for PET scan from March 2002 - September 2010 were included in the study. The indication for referral was predominantly oncology-related (93.5%). Of the 85 patients included, PET/CT was able to detect new sites of metastases in 5 patients and help resolve equivocal CT findings in 12 patients. Of six patients presenting with seizures, PET successfully localized hypometabolic areas in the brain in all cases, as probable seizures foci. Physiologic distribution of F18-fluorodeoxyglucose (FDG)was noted in the thymus, adenoids/tonsils, laryngeal area and supraclavicular brown fat. PET/CT is useful in selective pediatric cases. Its value in effectively evaluating pediatric malignancies allows for early initiation of appropriate treatment and discourages unnecessary diagnostics and treatments for benign lesions. Physiologic uptake unique to children should be considered to avoid misinterpretations, reduce unnecessary treatments and follow-ups as well as provide an overall improvement in patient care.
Human
;
Male
;
Female
;
Adolescent
;
Child
;
Child Preschool
;
Infant
;
POSITRON-EMISSION TOMOGRAPHY
;
DIAGNOSIS
;
DIAGNOSTIC TECHNIQUES AND PROCEDURES
;
DIAGNOSTIC IMAGING
;
IMAGE INTERPRETATION, COMPUTER-ASSISTED
;
TOMOGRAPHY, EMISSION-COMPUTED
8.Prevalence of asthma among Filipino adults based on the National Nutrition and Health Survey (NNHeS).
Varona Linda L. ; Alava Hilda Diana A. ; Abong Jovilia M. ; Castor Mary Anne R. ; De Leon Julia C. ; Kwong Shirley L.
Philippine Journal of Internal Medicine 2014;52(4):182-188
BACKGROUND: Prevalence surveys are important to aid in assessing the current burden of diseases, which will impact on the public health agenda as well as preventive interventions and health policies. Three previous local surveys on asthma prevalence of Filipino adults have been carried out. This is the fourth local survey and is also a part of the second NNHeS study, which is carried out every five years. The purpose of the survey is to determine the trend in asthma prevalence and to aid in formulating and evaluating local initiatives.
OBJECTIVE: To determine the prevalence of asthma among Filipino adults
METHODOLOGY: Using a multi-staged cluster sampling methodology, this study evaluated 7,202 adults at least 20 years old, from 3,744 households, 79 provinces and 17 regions. A pre-validated written questionnaire for wheezing among children based on the International Study of Asthma and Allergies of Childhood (ISAAC) was used as the survey instrument. This instrument was adopted since it has been widely used as a case definition for asthma, which allows for comparison of prevalence outcomes across time and population.
RESULTS: The overall prevalence of asthma based on wheezing for the past 12 months was 8.7% (SE 0.4%). Males had a higher prevalence of wheezing for the past 12 months at 9.4% (SE 0.5%) compared to females at 8.2% (SE 0.5%). The overall prevalence of asthma based on wheezing at any time was 14.3% (SE 0.5%). Males had a higher prevalence of wheezing at any time of 14.8% (SE 0.7%) compared to females at 13.8% (SE 0.6%). The prevalence of adult asthma in the rural area was slightly higher than in the urban area (15.3% vs 13.3%), but the difference was not statistically significant.
CONCLUSION: The overall prevalence of adult asthma in the Philippine based on the second NHHeS is 8.7%. This figure is lower than previous reported local prevalence data. The prevalence of adult asthma in the rural and urban setting is almost similar.
Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Asthma ; Characteristics ; Health Policy ; Hypersensitivity ; Philippines ; Prevalence ; Public Health ; Respiratory Sounds
9.Evolution of a lateral medullary syndrome to a bilateral medial medullary infarct: A case report.
Peter Johan R. De Leon ; John Harold B. Hiyadan
Philippine Journal of Neurology 2021;24(1):15-19
Medial medullary infarction is a rare type of stroke and is usually secondary to a large
artery atherothrombosis and small penetrating artery disease. Bilateral medial medullary
infarction is even less frequent with a much poorer outcome. We present the case of a 55-yearold Filipino male, hypertensive, who initially complained of vertiginous dizziness with signs and
symptoms of right lateral medullary infarction. Within 24 hours of hospitalization, patient’s
symptoms evolved into a bilateral medullary infarct. Up to this date, this is the first case report
of a Wallenberg syndrome that evolved into a bilateral medial medullary infarct.
10.Survival analysis of patients with stage IB to IIA2 Cervical Cancer: A five-year single institution review
Zelda Sue C. De Leon ; Benjamin D. Cuenca
Philippine Journal of Obstetrics and Gynecology 2019;43(2):34-41
Objective:
This study aims to determine the disease-free survival and overall survival outcome of patients with IB to
IIA cervical cancer managed with surgery, chemoradiation, or a combination of both in a tertiary government training hospital.
Methodology:
This is a retrospective study of patients diagnosed with stage IB-IIA2 cervical cancer from January 2013 to June 2017. Data were encoded using Microsoft Excel. Statistical analyses were computed using SPSS. Cox regression and Kaplan Meier analyses were used to predict survival outcomes.
Results:
Out of 135 patients were included in the study, 111 received treatment. 61 had no evidence of disease. Median age is 46 years with stage IB1 disease. Majority of patients underwent surgery followed by adjuvant therapy. Tumor recurrence was highest in the surgery alone group, with median time to recurrence of 19 months. Median follow-up time was 10 months. Overall 5-year survival is 51.4%; 5-year disease-free survival is 54.8%.
Conclusions
Age is a statistically significant factor in survival. Surgery with adjuvant chemotherapy + radiation had the most favorable survival outcome. Neoadjuvant treatment gave the least number of recurrences. Despite a small sample size, this study provides baseline data into the survival outcome of patients with locally advanced cervical cancer in our institution given the different treatment recommendations.
Uterine Cervical Neoplasms
;
Disease-Free Survival
;
Hysterectomy
;
Chemotherapy, Adjuvant
;
Neoadjuvant Therapy