1.Utilization of an opportunistic screening program for cervical cancer in family medicine clinic.
The Filipino Family Physician 2015;53(2):67-72
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
2.ST Elevation Myocardial Infarction in the elderly
Marcelo FRANKEN ; Amit NUSSBACHER ; Alberto LIBERMAN ; Mauricio WAJNGARTEN
Journal of Geriatric Cardiology 2012;09(2):108-114
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.
3.Determination of drug, excipients and coating distribution in pharmaceutical tablets using NIR-CI
Anna PALOU ; Jordi CRUZ ; Marcelo BLANCO ; Jaume TOMàIS ; Manel ALCALà
Journal of Pharmaceutical Analysis 2012;02(2):90-97
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.
4.Telepathology in the Philippines: A review and future prospects.
Arcellana-Nuqui Elizabeth ; Fontelo Paul A. ; Marcelo Alvin B.
Acta Medica Philippina 2016;50(4):201-205
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
5.Health information privacy in the Philippines: Trends and challenges in policy and practice.
Antonio Carl Abelardo T. ; Patdu Ivy D. ; Marcelo Alvin B.
Acta Medica Philippina 2016;50(4):223-236
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
6.Inter-observer and intra-observer reliability of the Harris hip scoring system.
Ganal-Antonio Anne Kathleen B ; Azores Gregorio Marcelo S
Acta Medica Philippina 2012;46(2):32-37
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
7.Isolation, in vitro propagation, genetic analysis, and immunogenic characterization of an Ehrlichia canis strain from southeastern Brazil.
Rosiane Nascimento ALVES ; Susana Elisa RIECK ; Carlos UEIRA-VIEIRA ; Marcelo Bahia LABRUNA ; Marcelo Emilio BELETTI
Journal of Veterinary Science 2014;15(2):241-248
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
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Antigens, Bacterial/blood/*diagnostic use
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Bacterial Outer Membrane Proteins/genetics/metabolism
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Bacterial Proteins/*genetics/metabolism
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Base Sequence
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Brazil
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Dog Diseases/diagnosis/*microbiology
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Dogs
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Ehrlichia canis/*genetics/*immunology/isolation & purification
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Ehrlichiosis/diagnosis/microbiology/*veterinary
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Fluorescent Antibody Technique, Indirect/veterinary
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Male
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Molecular Sequence Data
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Polymerase Chain Reaction/veterinary
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RNA, Ribosomal, 16S/genetics/metabolism
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Sequence Alignment/veterinary
8.Clinical and biological analysis in graftless maxillary sinus lift.
Marcelo PARRA ; Sergio OLATE ; Mario CANTÍN
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2017;43(4):214-220
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
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Dental Implants
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Foundations
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Maxillary Sinus*
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Membranes
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Osteogenesis
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Physiology
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Sinus Floor Augmentation
9.Factors associated with COVID-19 vaccine acceptance among adult patients in primary care clinics in Laguna, Las Piñas and Parañaque: A cross sectional study
Justin Vincent A. Lim ; Darice E. Casas ; Daisy M. Medina ; Ma. Louella Estrada-Marcelo
The Filipino Family Physician 2022;60(1):98-105
Background:
Since its surfacing in 2019, COVID-19 has spread all over the world and became an international concern. Vaccines against COVID-19 are expected to be the key in controlling this pandemic. To achieve this, studying factors that affect COVID-19 vaccine acceptance is crucial in order to increase the vaccine uptake rate of Filipinos to attain herd immunity.
Objective:
The study aimed to determine the factors affecting COVID-19 vaccine acceptance among adult patients in primary care clinics in Laguna, Las Piñas and Parañaque.
Methods:
This cross-sectional study was conducted last June 2021 with 137 adult patients from 6 clinics. The participants were given self-administered questionnaires containing items on sociodemographic profile and perception on vaccines. MS Excel and IBM SPSS were used for statistical analysis. Categorical variables were summarized as frequencies and percentages and continuous variables as means and standard deviations. Chi square was used to compare outcomes. Variables with statistically significant differences (p-value of <0.05) were included in multinomial regression analysis to determine association with vaccine acceptance.
Results:
Residence (p=0.0166), educational level (p=0.017), perceived effectiveness of vaccines to prevent and control COVID-19 (p=0.001), safety (p=0.001), doctor’s recommendation (p=0.039), risk of being infected (p=0.025) and refusal of any type of vaccine in the past (p=0.003) were associated with COVID-19 vaccine acceptance.
Conclusion
Through this study, the authors found that most of the respondents are willing to get vaccinated regardless of their sociodemographic characteristics. Concerns about vaccine availability and accessibility can hinder the promotion of vaccine uptake in the future. This study can be used as a basis for development and planning of COVID -19 vaccination programs.
COVID-19
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COVID-19 Vaccines
10.Phylogenetic Analysis of RhoGAP Domain-Containing Proteins
M.Brand(a)o MARCELO ; L.Silva-Brand(a)o KARINA ; F.Costa FERNANDO ; T.O.Saad SARA
Genomics, Proteomics & Bioinformatics 2006;4(3):182-188
Proteins containing an Rho GTPase-activating protein (RhoGAP) domain work as molecular switches involved in the regulation of diverse cellular functions. The ability of these GTPases to regulate a wide number of cellular processes comes from their interactions with multiple effectors and inhibitors, including the RhoGAP family, which stimulates their intrinsic GTPase activity. Here, a phylogenetic approach was applied to study the evolutionary relationship among 59 RhoGAP domain-containing proteins. The sequences were aligned by their RhoGAP domains and the phylogenetic hypotheses were generated using Maximum Parsimony and Bayesian analyses. The character tracing of two traits, GTPase activity and presence of other domains, indicated a significant phylogenetic signal for both of them.