Pulmonary cement embolism (PCE) can follow cement augmentation procedures for spine fractures due to osteoporosis, traumatic injuries, and painful metastatic lesions. PCE is underreported and it is likely that many cases remain undiagnosed. Risk factors for PCE have been identified, which can help alert clinicians to patients likely to develop the condition, and there are recommended techniques to reduce its incidence. Most patients with PCE are asymptomatic or only develop transient symptoms, although a few may exhibit florid cardiorespiratory manifestations which can ultimately be fatal. Diagnosis is mainly by radiographic means, commonly using simple radiographs and computed tomography scans of the chest with ancillary tests that assess the patient's cardiorespiratory condition. Management depends on the location and size of the emboli as well as the patient's symptomatology. The aim of this review is to raise awareness of the not uncommon complications of PCE following vertebral cement augmentation and the possibility of serious sequelae. Recommendations for the diagnosis and management of PCE are presented, based on the most recent literature.
Diagnosis ; Embolism ; Humans ; Incidence ; Kyphoplasty ; Osteoporosis ; Polymethyl Methacrylate ; Pulmonary Embolism ; Risk Factors ; Spine ; Thorax ; Vertebroplasty

Background: Due to the devolved nature of Philippine local governance, disaster management systems such as relief work and food aid pipelines, have been managed by local government units during natural disasters. Objectives: This study assessed the nutrient adequacy of food aid packs provided during natural disasters in the province of Albay. Specific objectives included assessment of the types of food and food sources, as well as the practices in the food aid pipeline, and assessment of the nutritional quality of food aid packs through comparison with the recommended energy/nutrient intake (REI/RNI) for Filipinos Methods: Key informant interviews were conducted to gather information on food sources and pipelines. Information on the quantities of food components in food aid packs distributed was also collected, and the free iFRNI software used to derive nutrient content. These quantities compared with the REI/RNI for the general population. Descriptive statistics on Microsoft Excel were used to calculate the mean, median and mode for macronutrients as well as Vitamin A and iron to determine the overall intake of individuals relying on these foods. Ethical clearance was secured from the University of the Philippines REB. Results: Analysis of the food components showed that the food aid packs were insufficient to meet the REI/RNI for the general population, particularly for food packs distributed on the barangay and city/municipal levels. Food was sourced from local suppliers as an emergency purchase during the forecast of a disaster, in place of the prescribed practice of stockpiling. Procured food would then be repacked and distributed on the provincial, city/municipal and barangay levels in a staggered schedule depending upon the length of the disaster or evacuation. Conclusion The food packs distributed by the barangay and city/municipal sub-units of the provincial government of Albay are insufficient to meet the daily caloric and micronutrient needs of a general population purely reliant on food aid after a natural disaster.
Natural Disasters Diet ; Vegetarian

INTRODUCTION: Chronically-ill patients are known to pose an impact on the family function (FF) and quality of life (QoL) of their family caregivers and pediatric siblings. However, there is limited literature on the relationship between FF and QoL. This study aimed to determine the correlation of FF and QoL among healthy young adults with siblings with chronic diseases. METHODS: This was an analytical cross-sectional study among young adults, selected by purposive sampling, with chronically-ill siblings. The CAPGAR and WHOQOL-BREF questionnaires were used for data collection. Spearman’s correlation coefficient r was used to determine the correlation between FF and QoL. RESULTS: More than half (53.9%) of the respondents had highly functional families. Majority of the participants (66.5%) had fair QoL. There was a weak but significant positive correlation (r = 0.27, p < 0.001) between FF and QoL. CONCLUSION There is a weak but significant positive correlation between family function and quality of life among healthy young adults with a sibling suffering from a chronic debilitating illness.
quality of life ; Siblings ;

Background: Among the different criteria, the General Weighted Average Grade (PMGWAG) holds the biggest bearing on admission for the UP College of Medicine. However, GWAs are not comparable across different courses, different batches, different UP units and different schools. An Adjustment Factor is necessary to make PMGWAGs comparable and to level the playing field. Objectives: This study covering a 24-year period aimed to compare various proposed Admission Adjusted Factors of %PMGWAG (Pre-Med GWAG) in terms of Pearson's Correlation, Linear Regression Models and Mean Differences with %MGWAG (Medical GWAG), Class Rank and Board Rating as Outcome variables. Methodology: Various proposed Adjustment Factors were applied to %PMGWAG of medical students from Class 1990 to Class 2014 and Pearson's Correlation, Linear Regression Models and Mean Differences with %MGWAG, Class Rank and Board Rating were derived and analyzed. Results: Adjustment Factor A3 as applied to %PMGWAG correlates best with Board Rating and Class Rank while Adjustment Factor A6 with %MGWAG. On Linear Regression, A3 likewise bested other Adjustment Factors in predicting %MGWAG and %Board Rating while A6 on predicting Class Ranking. Among the various adjustments, A3 exerted the most impact on the outcome variables, based on mean differences. Conclusion The A3 Adjustment Factor is the preferred and most ideal among the various proposed adjustment factors. Its application on %PMGWAG, correlated best with, most predictive of and most influential to %MGWAG, Board Rating and Class Rating.
Education, Medical ; Academic Performance

INTRODUCTION: Spontaneous regression of pituitary adenomas is a rare occurrence that is thought to be due to pituitary apoplexy. We would like to review the demograhic data, imaging findings, and neurologic, endocrinologic, and radiologic outcomes of patients who exhibited this unusual phenomenon. METHODS: We present a case of non-functioning pituitary adenoma (NFPA) in a 66-year-old man that underwent spontaneous regression. We also performed a systematic literature review on cases of pituitary adenomas that exhibited spontaneous regression, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: There have been only 27 reported cases of spontaneous regression observed in all pituitary adenomas, 16 of which are NFPAs. Headache was the most common symptom while decreased visual acuity and oculomotor nerve palsy were the most common sign. Pituitary hemorrhage was seen in two-thirds of cases, while findings suggestive of pituitary infarct, such as enhancement of the sphenoid sinus mucosa. were seen in one-third. Complete radiographic remission was observed in 62% of cases, with an 11% recurrence rate seen at least two years after the initial imaging. Neurologic recovery was reported in 88% and endocrinologic recovery from hypopituitarism was 40%. CONCLUSION Most patients exhibited neurologic and endocrinologic improvement concomitant with the regression of the pituitary adenoma. However, these tumors may recur; thus, regular and long- term neuro-ophthalmologic and radiologic follow-up is advised.
Pituitary adenoma ; spontaneous regression

Background: and Purpose The safety and efficacy of tenecteplase in patients with ischemic stroke due to medium vessel occlusion (MeVO) are not well studied. We aimed to compare tenecteplase with alteplase in stroke due to MeVO. Methods: Patients with baseline M2-middle cerebral artery (MCA), M3/M4-MCA, P2/P3/P4-posterior cerebral artery (PCA), A2/A3/A4-anterior cerebral artery (ACA) occlusions from the Alteplase Compared to Tenecteplase (AcT) trial were included. Primary outcome was the proportion of 90-day modified Rankin Scale (mRS) 0–1. Secondary outcomes were 90-day mRS 0–2, ordinal mRS, mortality, quality of life measures (EuroQol 5-Dimension 5-Level, EuroQol visual analog scale), and symptomatic intracerebral hemorrhage (sICH). Initial and final successful reperfusion were reported in patients undergoing endovascular thrombectomy (EVT). Results: Among 1,558 patients with available baseline computed tomography angiography; 455 (29.2%) had MeVO of which 27.5% (125/455) were proximal M2; 16.3% (74/455) were distal M2; 35.2% (160/455) were M3/M4; 7.5% (34/455) were A2/A3/A4; and 13.6% (62/455) were P2/P3/P4 occlusions. EVT was performed in 87/455 (19.1%) patients. mRS 0–1 at 90 days was achieved in 37.9% in the tenecteplase versus 34.7% in the alteplase group (adjusted risk ratio [aRR] 1.07; 95% confidence interval [CI] 0.91–1.25). Rates of 90-day mRS 0–2, sICH, and mortality were similar in both groups. No statistical difference was noted in initial successful reperfusion rates (13.0% vs. 7.5%) among the 87 patients who underwent endovascular thrombectomy. However, final successful reperfusion was higher in the tenecteplase group (71.7% vs. 60.0%, aRR 1.29, 95% CI 1.04–1.61). Conclusion Intravenous tenecteplase had comparable safety, functional outcomes and quality of life compared to intravenous alteplase among patients with MeVO. Among those treated with EVT, tenecteplase was associated with higher successful reperfusion rates than alteplase.