The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

Essential alopecia syphilitica (AS) is a rare presentation of secondary syphilis, known to affect 3-7% of the population. To the best of our knowledge, this is the first reported case in the country. Herein we present a rare case of alopecia syphilitica in a 27-year-old MSM.

A 27-year-old male presented with a 3-week history of irregularly-shaped, moth-eaten appearing alopecia without any history or presence of mucosal ulcers and copper penny-looking macules and plaques on the palms and soles. History-taking revealed multiple casual unprotected sexual practices. Syphilis enzyme immunoassay and rapid plasma reagin titer were reactive. Biopsy was consistent with syphilitic alopecia.

Syphilis, a highly prevalent STI presents in different spectra. Patients usually present with copper penny-looking erythematous to hyperpigmented macules and plaques on palms and soles, condylomata lata, erythematous papules and plaques on the trunk, and rarely as moth-eaten alopecia. Atypical presentation might lead to a missed diagnosis and untreated disease. This may give rise to an infectious and potentially debilitating deadly disease.

AS may be mistaken as any other alopecia. Keen clinical eye, high index of suspicion, thorough history-taking with emphasis on sexual history and complete physical exam are needed to prevent missed diagnoses in these cases. Prompt treatment, close follow-up and proper counselling are essential to completely diagnose and treat.

Human ; Male ; Adult: 25-44 Yrs Old ; Syphilis

BACKGROUND

Disorders of hyperpigmentation can affect the quality of life and pose a significant psychological burden for patients. However, little is known about sun protective behaviors within patient populations with hyperpigmentation disorders.

OBJECTIVE

This study aimed to evaluate the knowledge, attitudes, and practices on sun exposure and protection among patients with cutaneous hyperpigmentation.

METHODS

This was a single center analytical cross-sectional study which used a self-administered questionnaire on knowledge, attitudes, and practices on sun exposure and protection. Study subjects were 135 patients aged 13-59 years old who sought consult at a tertiary hospital and diagnosed with cutaneous hyperpigmentation. The level of knowledge, type of attitude, and practices on sun exposure and protection were determined. The association between the sociodemographic factors and knowledge, attitudes, and practices was determined using multivariate logistic regression model.

RESULTS

In this study, majority of the patients have adequate knowledge (80%), desirable attitudes (82%), and good practices (79%) towards sun exposure and protection. None of the demographic factors were found to be significantly associated with knowledge. The odds of having a desirable attitude among those in the construction sector was 803 times the odds for those in the transportation sector. Only the attribution of hyperpigmentation to the sun was a factor found to be significantly associated with good practices.

CONCLUSION

This study recommends that dermatologists caring for patients with cutaneous hyperpigmentation continue to emphasize patient education on sun exposure and protection since adequate knowledge consistently translates to good practices for this group of highly motivated patients.

Hyperpigmentation

Objective: This study aimed to: 1) describe the current state of research activity/involvement and capacity among selected tertiary level government and private hospital dietitians; 2) identify factors associated with research capacity and involvement; and 3) develop policy recommendations to improve the current research activity/involvement towards evidence-based practice among hospital dietitians.

Methods: This is a cross-sectional descriptive study. A total of randomly selected 181 hospital dietitians from selected hospitals in Metro Manila completed a pre-tested structured self-administered questionnaire, which elicited the socio-demographic characteristics, research activity/involvement, research capacity, perception, attitude and knowledge (PAK) of the respondents.

Descriptive statistics were generated. Pearson Correlation was determined between socio-demographic characteristics and research activity/involvement score and research capacity score. Linear multiple regression analysis was conducted to test whether perceptions, attitudes and knowledge score are factors that predicted research activity/involvement and research capacity.

Results: No significant difference was observed in hospital dietitians' research capacity scores based on gender, age, educational attainment, hospital affiliation, and job description. Majority (97%) of the hospital dietitians had very little participation (10%) or involvement in any type of research activity/involvement. The significant factors that were predictive of research activity/involvement scores and research capacity scores were percent of time for research and hours per week devoted to research, respectively. Percent of time for research was significantly predictive of research knowledge of respondents.

Conclusion: The findings in this present study showed the research activity/involvement and capacity of hospital dietitians in Metro Manila were dismally low. The significant factors that were predictive of research activity/involvement scores and research capacity scores were percent of time for research and hours per week devoted to research, respectively. To support the development of research capacity and involvement of hospital dietitians, policy-makers and healthcare organizations can optimize capability-building strategies at the academic level, hospital dietitian level, and institutional level.

Nutritionists

OBJECTIVES: The objective of the study was to determine whether postburn reduction of bone formation occurred earlier than 2–3 weeks after burn injury and whether that reduction was inversely related to marrow adiposity. METHODS: Using a rat model of burn injury with sacrifice at 3 days postburn, we measured serum osteocalcin, a biomarker of bone formation, as well as a regulator of glucose metabolism, and counted tibial marrow adipocytes. RESULTS: Serum osteocalcin was reduced as early as 3 days postburn, coinciding with a trend toward decline in marrow adipocyte number rather than demonstrating an inverse relationship with adipocyte count. CONCLUSIONS: Factors that may be responsible for the dissociation include lack of circulating sclerostin, previously reported, increased energy demands following burn injury, increased sympathetic tone and perhaps oxidative stress. The relationship between bone formation and marrow adiposity is complex and subject to a variety of influences.
Adipocytes ; Adiposity ; Animals ; Bone Marrow ; Burns ; Child ; Glucose ; Humans ; Metabolism ; Models, Animal ; Osteocalcin ; Osteogenesis ; Oxidative Stress ; Rats

BACKGROUND: Morbidity and mortality from acute coronary syndrome (ACS) primarily depends on prompt evaluation and management of patients. Despite available recommendations on ACS management, there is limited data regarding Filipino physician's knowledge and adherence with these guidelines in the emergency room (ER).
OBJECTIVES: To describe the initial management of ACS patients by Filipino physicians at the ER and to document their adherence with the 2007 American College of Cardiology/American Heart Association (ACC/AHA) ACS guidelines for the management of patients with unstable angina (UA)/ non-ST-segment elevation myocardial infraction (NSTEMI) and ST-segment elevation myocardial infraction (STEMI).
METHODS: This was an open-label, descriptive, multicenter, non-interventional study that enrolled patients ? 18 years of age, seen at the ER and suspected to have UA or MI with or without ST-segment elevation. Patient demographics, medical history, physical and laboratory examinations, medications or interventions done at the ER and the specialty of physicians who provided the initial management were recorded. Adherence with the 2007 ACC/AHAACS guidelines was also assessed. Data were summarized using descriptive statistics.
RESULTS: A total of 1,398 eligible patients (mean age 61.58+ 12.03 years) were included in the study. At least one cardiac enzyme test was requested in up to 93% of patients, with troponin I being the most common (72.53%). Upon diagnosis, 95.78% of patients were given antiplatelet therapy (16.95% clopidogrel alone, 15.31% aspirin alone and 1.07% other antiplatelet drugs), the combination therapy. Moreover, 86.27% were given anticoagulant therapy (75.75% enoxaparin, 5.94% fondaprinux and 3.97% IV UFH). Ninety-eight percent of patients we subsequently admitted in the hospital and 26.68% of patients were considered to undergo percutaneous coronary intervention (PCI). Majority of these patients were initially managed by ER physicians (52.22%).
CONCLUSION: Filipino physicians at the ER provide an appropriate management strategy to individual ACS patients because their management adheres to the 2007 and the current ACC/AHA ACS guidelines. The outcome and impact of these strategies should be assessed to encourage more physicians to conform with available recommendations. Moreover, a review of adherence of physicians to other disease management guidelines should be conducted to further improve care and outcomes in ER.

Human ; Male ; Female ; Aged ; Middle Aged ; Acute Coronary Syndrome ; American Heart Association ; Angina, Unstable ; Anticoagulants ; Aspirin ; Disease Management ; Emergency Service, Hospital ; Enoxaparin ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; Ticlopidine ; Troponin I ; United States ; Myocardial Infarction