Diffuse panbronchiolitis is a disease of obscure aetiology that is traditionally associated with Asian ethnicity. We propose that this disease also occurs in Caucasians and the incidence in this population is greater than currently recognised. We further propose that high resolution computed tomography (HRCT) and response to macrolide therapy should be relied upon to make this diagnosis without verification by lung biopsy. In most circumstances, obtaining a biopsy for histopathology is not practical, and the disease may then be mistaken for other more common airway diseases. Accuracy of diagnosis is important as untreated disease is associated with a poor prognosis, and effective treatment is available. We report four out of a series of cases as evidence that DPB is in fact more common in the Western population than is currently understood.

Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%–5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%. Conclusions There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

Primary cardiac tumors are extremely rare, occurring in 0.001% to 0.3% of autopsies.1 Most cardiac tumors are metastatic, and they are usually diagnosed in approximately 10% of patients with non-cardiac primary tumors at autopsy.2 3 4 About 75% of primary cardiac tumors are benign and are predominantly myxomas.5 Only 25% of these tumors are malignant, and the most common types in both children and adults, are sarcomas (75%).1 6 7 In a retrospective study done among 255 patients with cardiac tumors in the Philippine Heart Center from 1976 to 2006, the incidence of benign tumors was 91.8% while malignant tumors were reported in 8.2% of cases. Eighty-nine percent of the patients were adults, and 11% were from the pediatric age group.8 As in other similar studies,5 9 the most common cardiac tumors in the Philippine study were myxoma among the adult participants and rhabdomyoma among the pediatric participants.
Heart Neoplasms ; Cardiac Surgical Procedures

<p style="text-align: justify;">Authors suggest efforts are needed to further explore the usefulness and utilization of psychoeducation at the community and professional levels as applied to various settings and populations. In addition, if developed and implemented carefully, psychoeducational interventions have promising application on other life challenges across levels of the public health, social, and educational systems. This quasiexperimental three group pre-test post-test study aims to investigate the effect of psychoeducation on the self-esteem and self-efficacy of college students. A total of 105 college students (35 subjects per group) who were enrolled at Saint Louis University, Baguio City, Philippines were included as sample. Sampling technique was purposive. The Rosenberg's Self-esteem Scale and Schwarzer's General Selfefficacy Scale were used as data gathering tools. A self-made psychoeducational module that was validated by experts in mental health and psychiatric nursing was utilized as intervention. SPSS version 20 was used for the statistical analysis. The results on the post-test scores of both treatment arms (informational and comprehensive model) were significantly higher compared to control group after eight sessions of psychoeducation. The researchers therefore conclude that both psychoeducation models (informational and comprehensive) showed evidence of effectiveness in increasing the self-esteem and self-efficacy levels of college students. p>
Human ; Male ; Female ; Adolescent ; Self Efficacy ; Universities ; Mental Health ; Psychiatric Nursing ; Public Health ; Saints ; Self Concept ; Students ; Life

Objective: To determine the risk of malignancy of Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) indeterminate Thyroid Nodules (Bethesda III, IV and V) by combining cytologic (TSBRTC) and Thyroid Imaging Reporting and Data Systems (TI-RADS) ultrasonographic features based on final histopathology. Methods: Design: Retrospective review of records. Setting: Tertiary Private Training Hospital. Participants: 551 records. Results: Among 81 eligible participants, 59 out of 84 nodules (70.24%) wer malignant on histopathology. The malignancy risk of Bethesda classification was 60.87% (28 out of 46) for Bethesda III, 57.14% (8 out of 14) for Bethesda IV and 95.83% for Bethesda V. The malignancy risk for TI-RADS categories was 0 % (0/1) for TI-RADS 2, 50% (10 out of 20) for TI-RADS 3, 71.05 % for TI-RADS 4 and 91.67 % for TI-RADS 5. The highest risk of malignancy (100%) was associated with [Bethesda IV/TI-RADS 1, 2, and 3], [Bethesda V/TI-RADS 1, 2 and 3 [Bethesda IV and V/TI-RADS 1, 2 and 3] and [Bethesda IV/TI-RADS 5]. The lowest risk of malignancy (33.33%) was associated with [Bethesda III/TI-RADS1, 2 and 3]. A high Bethesda classification (Bethesda V) was almost 5x more likely to have a malignant anatomorphology compared with Bethesda III (p = .05) while a TI-RADS 4 or 5 category was almost 5x more likely to have a malignant anatomorphology compared to TI-RADS 1, 2 or 3 (p = .026). Conclusion This study showed that TI-RADS scoring is a sensitive diagnostic classification in recognizing patients with thyroid cancer and combining Bethesda classification and TI-RADS scoring increases the sensitivity in the diagnosis of malignant thyroid nodules. A higher likelihood of malignancy is associated with higher Bethesda classification and TI-RADS scoring.
Thyroidectomy

On July 4, 2021, a Philippine C-130 military plane carrying 104 personnel crashed in Patikul, Sulu after attempting to land at Jolo Airport, killing 53 individuals and injuring 50 others, both on board and on the ground. Some of the injured sustained multiple injuries, including fractures and burns. This incident triggered a swift response from various agencies. Mass casualty incidents, including those with multiple burn-injured patients, pose significant challenges to health care systems and can lead to high morbidity and mortality rates.1 2 3 Burn injuries, which account for at least 200,000 deaths annually, are a major global public health issue, particularly in low-resource settings, and can easily overwhelm the limited burn resources available.4 5 6 Efficient management of mass casualty incidents, proper triage decisions, and sound health care planning are crucial for optimizing patient outcomes and matching potential needs with available resources.7 Burn mass casualty incidents (BMCI) are incidents that involve at least three burn victims. These incidents, whether due to natural or human-caused accidents, can occur anywhere and anytime. The injuries are unpredictable and involve a large number of victims, requiring a significant consumption of logistics and medical attention. Medical response tasks in massive burn injuries are much more challenging than those required in separate burn incidents due to the unexpected nature of the events and the simultaneous involvement of a large number of patients. Such situations require the immediate mobilization of a significant number of personnel, resources, and facilities to address upcoming issues. In this article, we describe the management of BMCIs based on our experiences in responding to the Patikul incident. We elucidate the strategies that are put into action and offer insights aimed at improving protocols for handling BMCIs in the future. Our goal is to contribute to the body of knowledge in this field and aid in the development of more effective responses to such critical situations.
Mass Casualty Incidents ; Burns

<p style="text-align: justify;">Authors suggest efforts are needed to further explore the usefulness and utilization of psychoeducation at the community and professional levels as applied to various settings and populations. In addition, if developed and implemented carefully, psychoeducational interventions have promising application on other life challenges across levels of the public health, social, and educational systems. This quasiexperimental three group pre-test post-test study aims to investigate the effect of psychoeducation on the self-esteem and self-efficacy of college students. A total of 105 college students (35 subjects per group) who were enrolled at Saint Louis University, Baguio City, Philippines were included as sample. Sampling technique was purposive. The Rosenberg's Self-esteem Scale and Schwarzer's General Selfefficacy Scale were used as data gathering tools. A self-made psychoeducational module that was validated by experts in mental health and psychiatric nursing was utilized as intervention. SPSS version 20 was used for the statistical analysis. The results on the post-test scores of both treatment arms (informational and comprehensive model) were significantly higher compared to control group after eight sessions of psychoeducation. The researchers therefore conclude that both psychoeducation models (informational and comprehensive) showed evidence of effectiveness in increasing the self-esteem and self-efficacy levels of college students. p>
Human ; Male ; Female ; Self Efficacy ; Universities ; Mental Health ; Psychiatric Nursing ; Public Health ; Saints ; Self Concept ; Students ; Life ; Nursing ; Students

<p>BACKGROUND: The Philippines has, mandatory service policies to address the insufficiency and maldistribution of human resources particularly for health services. Despite being perceived as an appropriate intervention to bridge the aforementioned HRH gaps, the past and present implementations of such programs in the country have never been formally studied.p><p>OBJECTIVE: This paper aimed to present the history of mandatory service programs in the Philippines, look at their natures, and see how their different implementations relate to each other.p><p>METHODOLOGY: Using a qualitative document analysis method, administrative issuances and reports relevant to past and current implementations of mandatory service policies in the Philippines were obtained and reviewed.p><p>RESULTS: Mandatory service programs have been implemented in the country by institutions from both the private and public sectors as early as 1968. The focus of such has been mostly for government positions and specialized professions including physicians and scientists. While extensive efforts have been made through the years, the policies demonstrated fragmentation and recurring gaps in implementation. Such gaps include the lack of enabling policy mechanisms, formal monitoring and evaluation, and program institutionalization.p><p>CONCLUSION: The historical narrative of return service programs in the country is a potential source for the development of an overarching mandatory service policy framework for human resources in the Philippines, one that is specific to the context and setting of the country. By articulating policy issues identified, this paper provided a stepping-off point for future mandatory service program policy planning, implementation, evaluation, and institutionalization in the Philippines.p>
Workforce ; Institutionalization ; Physicians

Objectives: The study aimed to determine the perception of program administrators and students on the implementation of return service agreement (RSA) in the Philippines. It examined the different components of, and opportunities, and challenges in the implementation of RSA of selected institutions. Methods: Key informant interviews using a topic guide were conducted with ten program administrators and student representatives from selected institutions implementing a return service policy. Interviews were transcribed and responses in Filipino were translated to English. Open coding and focused coding were performed to identify categories and themes from the interview transcripts. Results: Addressing human resource for health (HRH) needs of the country is a common rationale behind RSA implementation among the institutions sampled for the study. A notable difference in implementation arrangements is the manner of rendering service. Majority of RSA programs require promisors to be employed in any part of the Philippines in need of health workers, while other RSA programs recruit students from rural areas in order to deploy them later on in their hometowns. There is also an apparent lack of institutionalized mechanisms for job placement for students to fulfill their return service obligations. One challenge in most institutions is the need for a formal monitoring and evaluation scheme for the policy. Conclusion Integration of the voice of stakeholders is critical in the conceptualization, development, and implementation of RSA policies. This will ensure that issues attendant to operationalization are mitigated if not outrightly avoided.