BACKGROUND: Cervical cancer ranks fourth among the malignancies in women worldwide and remains to be one of the leading causes of morbidity and mortality despite being a highly preventable disease. With this alarming burden, efforts are geared towards prevention with the strengthening of opportunistic screening programs to encourage women to be assessed.

OBJECTIVES: This study aimed to determine if there will be increase in the cervical cancer screening utilization rate if an opportunistic screening program was introduced in the patients' waiting area during regular health consultation services.

SUBJECTS AND SETTING: Female patients aged 21-65 years who consulted at the University of the Philippines -- Philippine General Hospital Out-patient Department Family Medicine Clinic (UP-PGH OPD FMC) in July 2014 were included in the study.

DESIGN: The study was a before and after design. Women who were eligible to be screened were invited during the month long program implementation and those who agreed were asked to choose their preferred screening method between Pap smear and VIA.

DATA COLLECTION: Data was collected through a self-administered questionnaire and recorded with the gynecological examination findings and result of the screening procedure. Utilization rates during the period of opportunistic screening was compared to that of the previous month when there was no existing program and the mean change was determined.

RESULTS: The utilization rate with the intervention was 27%, an increase by 25% from the previous month's 2% utilization rate. There were more women (166, 38%) who preferred screening through VIA over Pap smear (69,16%). Majority of the subjects were married, housewife, with high school education and multiparous. Most of the women in the study had no previous screening and were not informed about cervical cancer.

CONCLUSION: Opportunistic screening program in the Family Medicine Clinic had increased the screening uptake of women when given during waiting hours of regular health clinic consultations, and offering VIA as an option for screening procedure further increased cervical cancer screening.

Human ; Female ; Middle Aged ; Adult ; Young Adult ; Acetic Acid ; Uterine Cervical Neoplasms- ; Mass Screening, diagnosis ; Papanicolaou Test

The growing interest of the pharmaceutical industry in Near Infrared-Chemical Imaging (NIR-CI) is a result of its high usefulness for quality control analyses of drugs throughout their production process (particularly of its non-destructive nature and expeditious data acquisition).In this work,the concentration and distribution of the major and minor components of pharmaceutical tablets are determined and the spatial distribution from the internal and external sides has been obtained.In addition,the same NIR-CI allowed the coating thickness and its surface distribution to be quantified.Images were processed to extract the target data and calibration models constructed using the Partial Least Squares (PLS) algorithms.The concentrations of Active Pharmaceutical Ingredient (API) and excipients obtained for uncoated cores were essentially identical to the nominal values of the pharmaceutical formulation.But the predictive ability of the calibration models applied to the coated tablets decreased as the coating thickness increased.

Acute coronary syndromes (ACS) are the leading causes of death in the elderly. The suspicion and diagnosis of ACS in this age group is more difficult, since typical angina is less frequent. The morbidity and mortality is greater in older age patients presenting ACS. Despite the higher prevalence and greater risk, elderly patients are underrepresented in major clinical trials from which evidence based recommendations are formulated. The authors describe, in this article, the challenges in the diagnosis and management of ST elevation myocardial infarction in the elderly, and discuss the available evidence.

BACKGROUND: Challenged with insufficient number and maldistribution of pathologists, the Philippines seemed poised to benefit from telemedicine.

METHODS: The first modern Internet-based telepathology consultation was conducted between the University of the Philippines Manila and the Armed Forces Institute of Pathology in 1997.

RESULTS: While the first remote telepathology consult was a success, more than a decade after this historic referral, telepathology remains in the fringes of mainstream pathology practice despite its huge potential to benefit the underserved population. Challenges with human, organizational, and technology factors hinder its progress.

CONCLUSIONS: While the original consultation faced difficulties in human capacity, connectivity and infrastructure, rapid developments in governance and technology have the potential to eliminate these problems. Substantial improvements in recent years now provide a more conducive environment to deliver telepathology services to remote areas. This paper proposes a framework for the establishment of mature telepathology services to enable its use in areas of greatest need in the country

Human ; Telepathology ; Vulnerable Populations ; Pathologists ; Telemedicine ; Referral And Consultation ; Organizations ; Government ; Internet

CONTEXT: Evolution of the scope and context of privacy and confidentiality brought about by use of information and communications technology in healthcare.

OBJECTIVE: To review the legal, professional and ethical landscape of health information privacy in the Philippines.

METHODOLOGY: Systematic review of literature and policy frameworks.

RESULTS: Philippine laws jurisprudence recognize and protect privacy of health information as a general rule; impose upon individual practitioners and institutions the obligation to uphold such right; and may apply in both the traditional and eHealth milieu. There is no existing policy framework that addresses issues relating to [a] access to health information by non-health professionals, [b] use of health information for non-health purposes, and [c] rules relating to collection, storage and utilization of electronically-derived or -stored information. A privacy culture, on either the provider's or client's side, is also lacking in the country.

CONCLUSION: Technological developments have outpaced policy and practice. There is a need to unify the patchwork of regulations governing the privacy of health information; advocate for a privacy culture among professionals and patients alike; fortify the evidence base on patient and provider perceptions of privacy; and develop and improve standards and systems to promote health information privacy at the individual and institutional levels. 

Human ; Privacy ; Confidentiality ; Delivery Of Health Care ; Telemedicine

OBJECTIVE: The Harris hip score (HHS) is a 100-point scale for rating pain, function, absence of deformity, and range of motion. The purpose of this study is to assess the inter-observer and intra-observer reliability of the Harris hip score among senior orthopedic residents at the Philippine General Hospital.

METHODS: Twenty-four hips from 20 patients were evaluated using the Harris hip score by four senior residents from the Department of Orthopedics, Philippine General Hospital. All patients were interviewed twice in the clinic and the reliability of the HHS was evaluated.

RESULTS: The inter-observer coefficient of concordance (Kendall coefficient of concordance W) was 0.9 for both groups of observers. The intra-observer coefficients of concordance were 0.8, 1.0, 0.9, and 0.9, for the four observers. A 0 value indicates no concordance among a set of raters while a score of 1 indicates perfect concordance. Obtaining a score greater than 0.75 represents excellent level of agreement.

CONCLUSION: We conclude that the Harris hip score has high interobserver and inter-observer reliability among senior Orthopedic residents at the Philippine General Hospital.

Human ; Male ; Female ; Hip ; Orthopedics ; Hospitals, General ; Reproducibility Of Results ; Philippines ; Orthopedic Procedures ; Range Of Motion, Articular ; Ambulatory Care Facilities ; Pain

Amplification of the 16S rRNA gene from a blood sample obtained from a dog in southeastern Brazil was used to confirm a naturally acquired Ehrlichia (E.) canis infection. Following isolation and culturing of the new bacterial strain called Uberlandia, partial sequences of the dsb and p28 genes were obtained. The dsb partial sequence of the novel strain was 100% similar to dsb gene sequences of E. canis obtained from different geographic areas around the world. Conversely, the p28 partial sequence for the E. canis Uberlandia strain differed at several nucleotides from other sequences available in GenBank. To confirm the antigenic profile of the Uberlandia strain, an indirect immunofluorescence assay against E. canis antigens was performed using dog sera collected from two different areas in Brazil (Uberlandia and Sao Paulo). The results suggest that both antigens were able to identify animals seropositive for E. canis in Brazil since these Brazilian strains appear to be highly conserved.
Animals ; Antigens, Bacterial/blood/*diagnostic use ; Bacterial Outer Membrane Proteins/genetics/metabolism ; Bacterial Proteins/*genetics/metabolism ; Base Sequence ; Brazil ; Dog Diseases/diagnosis/*microbiology ; Dogs ; Ehrlichia canis/*genetics/*immunology/isolation & purification ; Ehrlichiosis/diagnosis/microbiology/*veterinary ; Fluorescent Antibody Technique, Indirect/veterinary ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction/veterinary ; RNA, Ribosomal, 16S/genetics/metabolism ; Sequence Alignment/veterinary

Maxillary sinus lift for dental implant installation is a well-known and versatile technique; new techniques are presented based on the physiology of intrasinus bone repair. The aim of this review was to determine the status of graftless maxillary sinus lift and analyze its foundations and results. A search was conducted of the literature between 1995 and 2015 in the Medline, ScienceDirect, and SciELO databases using the keywords “maxillary sinus lift,”“blood clot,”“graftless maxillary sinus augmentation,” and “dental implant placement.” Ten articles were selected for our analysis of this technique and its results. Despite the limited information, cases that were followed for at least six months and up to four years had a 90% success rate. Published techniques included a lateral window, elevation of the sinus membrane, drilling and dental implant installation, descent of the membrane with variations in the installation of the lateral wall access and suturing. The physiology behind this new bone formation response and the results of the present research were also discussed. We concluded that this is a promising and viable technique under certain inclusion criteria.
Blood Coagulation ; Dental Implants ; Foundations ; Maxillary Sinus* ; Membranes ; Osteogenesis ; Physiology ; Sinus Floor Augmentation

INTRODUCTION: Fournier's gangrene is the development of a progressive necrotizing infection in the genital and perianal region with findings of gangrenous and necrotic tissueinvolving the skin and subcutaneous tissue down to the fascia. This study aims to review cases of Fournier's gangrene in the Hospital from 2004 up to 2010 and to provide a profile of patients afflicted with the disease and describe its surgical management in this institution.?

METHODOLOGY: A retrospective chart and database review wasperformed involving patients with a diagnosis of Fournier's gangrene treated at the Hospital from 2004-2010. The following variables were analyzed: 1) total number of cases; 2) gender; 3) age range, distribution and mean age; 4) source of infection, whether the initial lesion started from the urogenital or perianal area; 5) associated co-morbid conditions; 6) the extent of infection, whether it's confined to the urogenital or perineal area or has involved adjacent areas; 7) the time between initial symptoms to the first hospital consult; 8) number of debridement done at the operating room for each patient; 9) the presence of other surgeries aside from debridement; 10) outcome (recovered or expired).?

RESULTS: The incidence of Fournier's gangrene is 8.7 patients per year in our institution. There were 36 patients included in this study. There is a male preponderance, affecting 4 males for every 1 female. The mean age is 49.5 years with a range of 18-73. Sixty four percent had infection starting from the perianal area while the rest had an initial lesion from the urogenital area. Seventy two percent had lesions confined to the perianal/urogenital areas while the rest had extended infections. Diabetes mellitus was the most common comorbid condition, involving 47 percent of the cases. Majority of the patients (70%) underwent just a single debridement. Ourinstitution mortality rate is 11 percent.No statistical significance was established between number of debridement and time of consult with mortality.?

CONCLUSION: The optimal management of Fournier's gangrene include all the ff: 1) appropriate anti-microbial therapy; 2)intensive pre and post-operative resuscitation; 3) aggressive and timely surgical intervention.While this disease may be rare, it always presents a challenge to the surgeon and the intensives, requiring a more thorough understanding of its presentation and treatment outcomes.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Gangrene ; Subcutaneous Tissue ; Debridement ; Fournier Gangrene ; Comorbidity ; Surgeons ; Fascia ; Genitalia ; Diabetes Mellitus

BACKGROUND: eHealth in the Philippines is poised to take off but adoption of eHealth applications in the country's public health sector is limited in scale.

OBJECTIVE: This paper examines the context and status of eHealth policy in the Philippines. The aim is to lay out the domains of policy issues that should be addressed for the successful implementation of eHealth in the Philippines.

METHODS: The themes and issues of policies on eHealth cited by Khoja, Durrani, Nayani and Fahim (2012) were used to describe and analyze the status of eHealth policy context in the Philippines. These are: (1) networked care, (2) interjurisdictional practice, (3) diffusion of eHealth/digital divide, (4) eHealth integration with existing systems, (5) response to new initiatives, (6) goal-setting for eHealth policy, (7) evaluation and research, (8) investment, and (9) ethics in eHealth. Documents and policies in the form of enacted laws, memoranda, implementing rules and regulations were retrieved and reviewed to answer whether or not policy themes and issues are addressed currently.

RESULTS AND CONCLUSION: Current policies in the status quo do not adequately address the issues that enable effective implementation of eHealth in the Philippines. While preconditions for eHealth to flourish such as strategic frameworks for ICT and eHealth have been established, they are inadequate in addressing licensing, diffusion of innovation, handling innovation, evaluation and research, and investment.

Human ; Public Health ; Investments ; Digital Divide ; Goals ; Telemedicine ; Research ; Diffusion Of Innovation ; Public Sector