Surgical procedures on the trachea have only been undertaken within the past 50 years. Knowing the unique blood supply of the trachea and how to reduce tension on any anastomosis are key to a successful outcome. Tracheal conditions requiring surgery usually present with shortness of breath on exertion, and preoperative evaluation involves computed tomography and rigid bronchoscopy. Tracheal resection and reconstruction can be safely performed with excellent outcomes by following a well-described technique.
Bronchoscopy ; Dyspnea ; Trachea*

INTRODUCTIONAnti-BP180 IgG titres were observed to parallel disease activity in case series of bullous pemphigoid (BP). This study aimed to examine whether anti-BP180 titres are an indicator of disease severity, clinical course and outcome in Asian patients with BP.

MATERIALS AND METHODSThis was a prospective observational study conducted between March 2005 and March 2008 in the Immunodermatology Clinic at the National Skin Centre, Singapore. Disease activity and anti-BP180 IgG titres were measured 4-weekly for 12 weeks and during disease flares and clinical remission. Associations between anti-BP180 titres and disease activity, disease flare, clinical remission and cumulative prednisolone dose were examined.

RESULTSThirty-four patients with newly diagnosed BP were recruited. Median follow-up duration was 3 years. Notable correlations between disease activity and anti-BP180 titres were at baseline (r = 0.51, P = 0.002), and disease flare (r = 0.85, P <0.001). Lower titres at Week 12 were associated with greater likelihood of clinical remission (P = 0.036). Post hoc, patients with anti-BP180 titres above 87.5 U/mL at time of diagnosis who reached remission within 2 years of diagnosis received significantly higher cumulative doses (mg/kg) of prednisolone (median, 72.8; range, 56.5 to 127.1) than those with titres <87.5 U/mL (median, 44.6; range, 32.5 to 80.8); P = 0.025).

CONCLUSIONAnti-BP180 titres may be a useful indicator of disease activity at time of diagnosis and at disease flare. Lower titres at Week 12 may predict greater likelihood of clinical remission. Titres above 87.5 U/mL at time of diagnosis may suggest the need for higher cumulative doses of prednisolone to achieve remission within 2 years.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Anti-Idiotypic ; blood ; Asian Continental Ancestry Group ; Autoantibodies ; blood ; Autoantigens ; blood ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Middle Aged ; Non-Fibrillar Collagens ; blood ; Outcome Assessment (Health Care) ; Pemphigoid, Bullous ; diagnosis ; ethnology ; immunology ; Predictive Value of Tests ; Prospective Studies ; Singapore

BACKGROUND

The Philippines is experiencing a significant demographic transition with a growing proportion of older adults within its population. This shift is accompanied by rapid urbanization, which is reshaping traditional family structures and altering the dynamics of caregiving. Despite the cultural emphasis on close family ties and the responsibility of caring for elderly relatives, there is a notable scarcity of research focused on elder care in residential facilities within the country. This gap highlights the need for a deeper understanding of how these societal changes impact the care of the elderly, particularly in a context where familial caregiving has historically been paramount.

OBJECTIVE

To determine the relationship between family function and the acceptability of residential care facilities among elderly patients and their families at a tertiary government hospital last December 2024.

METHODS

The study was conducted in Las Piñas General Hospital and Satellite Trauma Center. A survey among elderly patients (n=40) and patient dyads (n=40) was conducted to determine the level of family function by using Family APGAR and their level of acceptability on residential care facility using the Likert scale. The relationship of Family function and acceptability on Residential Care facilities was determined using Spearman’s correlation.

RESULTS

The findings revealed a significant prevalence of functional families among respondents, 42.5% in the elderly, and 65% in the family member dyads, alongside a mixed perception of residential care facilities, 62.5% favorable response in the patient dyads, and 72.5% in the elderly group. Correlation analysis indicated a weak negative association (correlation coefficient -0.193, p-value 0.087) between family function and acceptability, suggesting that as family function decreases, the acceptability of residential care increases, although this relationship was not statistically significant.

CONCLUSION

There is a prevalence of highly functional families in both the elderlies and patient dyads in the selected institution. The level of acceptability of residential care facilities was noted to be high with a negative correlation but not statistically significant with family function. Future investigations are recommended to deepen understanding of the complex relationships between family dynamics and acceptability of residential care facilities. It is imperative to address the implications for healthcare strategies and the support systems that serve aging populations. Efforts must be made to ensure that both elderly individuals and their families are adequately prepared for the transition to residential care, taking into account their unique needs, fears, and expectations.

Human ; Cross-sectional Studies