1.Acute renal failure following the use of rosiglitazone in a chronic kidney disease patient.
R Abdul GHANI ; S ZAINUDIN ; N A KAMARUDDIN ; N C T KONG
Singapore medical journal 2009;50(1):e32-4
Drug-induced acute interstitial nephritis is a well-recognised and important reversible cause of acute renal failure. Peroxisome-proliferator activated receptor-gamma agonists, such as rosiglitazone, have been proven to be safe in chronic kidney disease patients. We describe a 65-year-old man with long-standing diabetes mellitus and hypertension, presenting with a five-day history of fluid overload and uraemic symptoms. There was no ingestion of analgesics, alternative medicine and other nephrotoxic drugs, the only new prescription being rosiglitazone, which was commenced during his last clinic follow-up two weeks prior to presentation. He required haemodialysis with minimal improvement in renal profile, despite cessation of the offending drug. Renal biopsy revealed findings consistent with acute interstitial nephritis. An episode of upper gastrointestinal bleeding with bleeding duodenal ulcer limited the use of steroids. He was treated with a course of mycophenolate mofetil which showed good gradual response and he remained stable with residual renal impairment.
Acute Kidney Injury
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chemically induced
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drug therapy
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Aged
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Humans
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Hypoglycemic Agents
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adverse effects
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Immunosuppressive Agents
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therapeutic use
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Kidney Failure, Chronic
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complications
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Male
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Mycophenolic Acid
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analogs & derivatives
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therapeutic use
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Renal Dialysis
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Thiazolidinediones
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adverse effects
2.Evolution of Diabetes Care in Hong Kong: From the Hong Kong Diabetes Register to JADE-PEARL Program to RAMP and PEP Program.
Ivy H Y NG ; Kitty K T CHEUNG ; Tiffany T L YAU ; Elaine CHOW ; Risa OZAKI ; Juliana C N CHAN
Endocrinology and Metabolism 2018;33(1):17-32
The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This “double phenotype” as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality. The experience from Hong Kong had demonstrated that a multifaceted approach, involving team-based integrated care, information technological advances, and patient empowerment programs were able to reduce the incidence of diabetic complications, hospitalizations, and mortality. System change and public policies to enhance implementation of such programs may provide solutions to combat the burgeoning health problem of diabetes at a societal level.
Architectural Accessibility*
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Asia
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Asian Continental Ancestry Group
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Delivery of Health Care
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Diabetes Complications
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Diabetes Mellitus, Type 2
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Health Expenditures
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Hong Kong*
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Hospitalization
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Humans
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Incidence
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Insulin Resistance
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Mortality
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Obesity, Abdominal
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Patient Participation
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Prevalence
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Public Policy
3.Infection Risks Faced by Public Health Laboratory Services Teams When Handling Specimens Associated With Coronavirus Disease 2019 (COVID-19)
Chun-Kwan WONG ; Dominic N.-C. TSANG ; Rickjason C.-W. CHAN ; Edman T.-K. LAM ; Kwok-Kwan JONG
Safety and Health at Work 2020;11(3):372-377
Infection risks of handling specimens associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by public health laboratory services teams were assessed to scrutinize the potential hazards arising from the work procedures. Through risk assessments of all work sequences, laboratory equipment, and workplace environments, no aerosol-generating procedures could be identified except the procedures (mixing and transfer steps) inside biological safety cabinets. Appropriate personal protective equipment (PPE) such as surgical masks, protective gowns, face shields/safety goggles, and disposable gloves, together with pertinent safety training, was provided for laboratory work. Proper disinfection and good hand hygiene practices could minimize the probability of SARS-CoV-2 infection at work. All residual risk levels of the potential hazards identified were within the acceptable level. Contamination by gloved hands was considered as a major exposure route for SARS-CoV-2 when compared with eye protection equipment. Competence in proper donning and doffing of PPE accompanied by hand washing techniques was of utmost importance for infection control.
4.Effects of budesonide, desloratadine and dexamethasone on interleukine-4 release and expression from human mast cell line.
Yu ZHAO ; C Andrew van HASSELT ; Kang-Sang WOO ; Yeuk-Oi WONG ; Chuan-Yu LIANG ; Ping-Chung LEUNG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2005;40(2):124-127
OBJECTIVESince human mast cell is an important source of cytokines, it is of importance to understand the effects of anti-allergic drugs on cytokines modulation in mast cells. In the present study, we aimed at observing whether IL-4 could be released from human mast cell line (HMC-1) after the stimulation of PMA + A23187, and the effects of systemic glucocorticosteroid, dexamethasone, topical glucocorticosteroid, budesonide and H1 antagonist, desloratadine on IL-4 release and mRNA expression.
METHODSHMC-1 was stimulated with 25 ng/ml phorbol 12-myristate 13-acetate (PMA) and 2.5 x 10(-7) mol/L ionomycin (A23187) and cultured for 6 hours, 12 hours and 24 hours respectively in the presence or absence of 10(-6)-10(-10) mol/L concentrations of test drugs. Culture supernatants were collected and the levels of IL-4 were assayed by enzyme-linked immunosorbent assays (ELISA). The mRNA expression of IL-4 was measured by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR).
RESULTSHMC-1 expressed IL-4 mRNA and the resulting protein production of IL-4 released after being stimulated with PMA plus A23187. Dexamethasone, budesonide and desloratadine had potent inhibitory effect on IL-4 release at any concentrations and time points, with significant deference (P < 0.05) compared to the control cells. The inhibitory effect did not show time-dependent and concentration-dependent manner. Desloratadine and budesonide showed neither up-regulatory nor down-regulatory effects on IL-4 mRNA expression at the test concentrations, however, desloratadine could down-regulate IL-4 mRNA expression.
CONCLUSIONSHMC-1 could express and produce IL4 after stimulation. Dexamethasone, budesonide and desloratadine all had inhibitory effects on IL-4 release from HMC-1. In addition, desloratadine could also inhibit the IL-4 mRNA expression.
Budesonide ; pharmacology ; Cell Line ; Dexamethasone ; pharmacology ; Humans ; Interleukin-4 ; biosynthesis ; Loratadine ; analogs & derivatives ; pharmacology ; Mast Cells ; drug effects ; metabolism ; Tetradecanoylphorbol Acetate ; pharmacology
5.2021 Asian Pacific Society of Cardiology Consensus Recommendations on the use of P2Y12 receptor antagonists in the Asia-Pacific Region: Special populations.
W E I C H I E H T A N TAN ; P C H E W CHEW ; L A M T S U I TSUI ; T A N TAN ; D U P L Y A K O V DUPLYAKOV ; H A M M O U D E H HAMMOUDEH ; Bo ZHANG ; Yi LI ; Kai XU ; J O N G ONG ; Doni FIRMAN ; G A M R A GAMRA ; A L M A H M E E D ALMAHMEED ; D A L A L DALAL ; T A N TAN ; S T E G STEG ; N N G U Y E N NGUYEN ; A K O AKO ; A L S U W A I D I SUWAIDI ; C H A N CHAN ; S O B H Y SOBHY ; S H E H A B SHEHAB ; B U D D H A R I BUDDHARI ; Zu Lv WANG ; Y E A N Y I P F O N G FONG ; K A R A D A G KARADAG ; K I M KIM ; B A B E R BABER ; T A N G C H I N CHIN ; Ya Ling HAN
Chinese Journal of Cardiology 2023;51(1):19-31
6.The Community Mental Health Program in Calabarzon: Preliminary report from an internal review of an innovative service integration initiative for Schizophrenia
Eduardo C. Janairo ; Paulina A. Calo ; Marilou R. Espiritu ; Anthony T. Abala ; Kristel Anne N. Buenaventura ; Carl Abelardo T. Antonio
Philippine Journal of Health Research and Development 2021;25(2):69-74
The Community Mental Health Program (CMHP) of the Center for Health Development Calabarzon is an initiative that aims to integrate mental health into primary care to facilitate person-centered and holistic services. At the core of CMHP is a referral pathway between health centers and tertiary-level mental health services for the diagnosis and continuing management of persons with mental health conditions, as well as the use of an innovative medication (specifically for schizophrenia). This commentary presents lessons learned from a one-year implementation of CMHP in four pilot sites in the provinces of Rizal and Laguna, which stakeholders in mental health may consider in the design of community-based mental health programs to further the mandate of the Mental Health Act.
Schizophrenia
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Mental Health Services
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Program Evaluation
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Paliperidone Palmitate
7.Intersectoral collaborations for the prevention and control of Vector Borne diseases: A scoping review
Ma. Sophia Graciela L. Reyes ; Chelseah Denise H. Torres ; Amiel Nazer C. Bermudez ; Kim L. Cochon ; Evalyn A. Roxas ; Sophia Anne S.P. Liao ; Dorothy Jean N. Ortega ; Abegail Visia Marie C. Silang ; Deinzel R. Uezono ; Maria Sonia S. Salamat ; Carl Abelardo T. Antonio
Acta Medica Philippina 2019;53(4):315-326
Objectives:
This scoping review aimed to support a landscape analysis to identify lessons learned about intersectoral collaborations (ISCs) by describing their existing models in the context of dengue, malaria and yellow fever.
Methods:
A scoping review following the methodology of Joanna Briggs Institute was performed using the following inclusion criteria: studies involving humans; studies discussing intersectoral collaborations, malaria/dengue/yellow fever, and prevention or control at any level; and studies in countries endemic for the aforementioned diseases. Studies were screened using Covidence, while data were extracted using NVivo.
Results:
Of the 7,535 records retrieved, 69 were included in the qualitative analysis. Most ISCs were initiated by multilateral organizations and ministries of health, and none by communities. Strategies included advocacy, health education, research, public health measures, resource mobilization, service delivery and training; mostly employed on a community level. Monitoring and evaluation were mostly formative, ongoing, and participatory. Gaps included administrative and policy barriers, resource shortages, and inadequate research and training.
Conclusions
Multiple models of ISC exist in the literature. There is a need to develop a comprehensive framework for an effective and sustainable multisectoral approach for the prevention and control of VBDs ensuring adequate resources, active stakeholders, and strategies that span the entire socio-ecological spectrum.
Dengue
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Disease Vectors
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Intersectoral Collaboration
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Malaria
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Vector Borne Diseases
8.Recovery in schizophrenia: Perspectives from psychiatrists in the Philippines.
Michael P. Sionzon ; Chelseah Denise H. Torres ; Carl Abelardo T. Antonio ; Carlo Eugenio V. Banaag ; Ma. Lourdes Rosanna E. de Guzman ; Monina Garduñ ; o-Cruz ; Mariano S. Hembra ; Benita Sta. Ana-Ponio ; Edgardo Juan L. Tolentino, Jr. ; Jessa Joy C. Malipot ; Dorothy Jean N. Ortega ; Ma. Sophia Graciela L. Reyes ; Angelica Beth T. Sia ; Charlene J. Tinaja ; Patrick Joseph Aldea ; Erwin G. Benedicto
Journal of the Philippine Medical Association 2019;97(2):52-60
BACKGROUND:
A reliable and socially validated definition of recovery in schizophrenia is essential to decrease
stigma associated with the illness. This study aimed to define recovery in schizophrenia in the Philippine context,
determine its specific elements, and describe methods of assessment in clinical practice.
METHODS:
We invited a group of purposively selected Filipino psychiatrists to participate in six simultaneous
roundtable discussions to gather their opinions and perspectives on recovery in schizophrenia. Transcripts of the
discussions were then subjected to framework analysis.
RESULTS AND CONCLUSION
Most Filipino psychiatrists were of the considered opinion that recovery in schizophrenia
is possible, and their vision of a recovered patient resembles a combination of psychological and medical models.
The mini-FROGS tool was deemed generally applicable in the Philippine setting except for self-esteem and sense of
independence primarily because it is difficult to evaluate. The SWN was received with mixed reactions among the
psychiatrists. Spirituality as an element of recovery and the family-oriented culture of the Filipinos were emphasized as important considerations in assessing patients. Other suggestions were given to tailor-fit these tools to
the Philippine context.
Schizophrenia
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Philippines