OBJECTIVE: This report aims to raise physician clinical awareness of radial artery pseudoaneurysm (RAP) and promote early recognition of this potentially serious complication. The article highlights various proposed treatment strategies in the management of this condition. BACKGROUND: Radial artery pseudoaneurysm is a rare potentially serious complication following transradial artery coronary angiography for left heart catheterization and percutaneous coronary intervention. Risk factors associated with the development of RAP include multiple arterial puncture attempts, use of systemic anticoagulation, inadequate hemostasis following post-procedural compression, vascular site infection, use of larger sheaths, female gender, age of 70 years and older, diabetes mellitus, obesity and/or patients with high body mass index.1-3 Conservative medical treatment and/or surgical repair are the primary therapeutic approaches in the management of RAP. CONCLUSION Transradial artery access is associated with a significantly lower risk of major bleeding and vascular access site complications, reduces morbidity and mortality compared with the transfemoral approach. It is important to recognize though that complications do still occur with the transradial approach. RAP is one such entity wherein prevention is key - with adequate post-procedural compression, frequent observation, and careful assessment of the radial access site.
Aneurysm, False ; Radial Artery

BACKGROUND

The Influenza Pandemic has made the world health authorities vigilant for the next pandemic. The First cases of the Novel Influenza A(H1N1) in Mexico infected 5,000 people in a span of 40 days. On May 22, 2009, the first case was reported in the Philippines. The rising incidence of people affected by this disease in several regions of the world prompted the WHO to declare a “pandemic”. The mounting number of affected people in the Philippines lead the Makati Medical Center to start a surveillance program.

OBJECTIVE

To describe in an epidemiologic prespective the cases managed at the MMC.

DESIGN AND METHODOLOGY

This is a descriptive observational study of patients with suspected or confirmed influenza A (H1N1) infection treated at the Makati Medical Center. The study period was from May 3, 2009 to July 4, 2009. Patient consults were trended and analyzed. Confirmed cases were patients with nasopharyngeal throat swab specimens that tested positive for Influenza A (H1N1) by Real Time Reverse Transcription Polymerase Chain Reaction (PT-PCR). Demographics were presented.

RESULTS

There were 548 patients seen at the MMC who were suspected of being infected with Influenza A (H1N1). Two hundered sixty (47%) were confirmed to be positive for the Influenza A(H1N1) infection. The reported cases were distributed in Cities around Makati and near by provinces. Most patients seen were aged 19 to 49 years. One hundred seventy one (66%) of cases had no travel history or exposure to patients with known cases of Influenza A (H1N1). Most common presenting symptoms are fever, couh, nasal congestion and sore throat. Most of the cases were treated as outpatient (89%) and only 16% were treated with oseltamivir. Only 1 out of the 260 confirmed cases expired.

CONCLUSION AND RECOMMENDATIONS

There is a heightened health-awareness among Filipino communities. The Makati Medical Center cohort shows the value and importance of multi-sectoral collaboration. The MMC data provided clinical evidence of a community level transmission. A great number of patients in the cohort was treated as out-patient without anti-viral therapy.

Pandemics ; Influenza, Human

BACKGROUND: Coronary Artery Disease (CAD) is closely associated with several major risk factors including many that can be modified or eliminated. Hypertension, diabetes mellitus, dyslipidemia, smoking and obesity are among these. Early identification of these risk factors gives the physician opportunities for primary and secondary prevention of CAD.
OBJECTIVE: To assess the practice of physicians with regards identification and management of risk factors of patients with CAD at the Makati Medical Center.
METHODOLOGY: Two hundred and one (201) patients admitted at the Makati Medical Center from July 2001 up to December 2001 with symptomatic or objective evidence of myocardial ischemia during treadmill exercise and angiographic findings of CAD were assessed. Identification and management of the different risk factors by the physicians were reviewed.
RESULTS: Of the 201 patients 167 (83 percent) were male, 65 (32 percent) were over 65 years old and 7 (3 percent) had strong family history of CAD. One hundred twenty seven (63 percent) had hypertension, 77 (38 percent) had diabetes mellitus, 96 (47 percent) had dyslipidemia, 113 (63 percent) were obese and 103 (51 percent) were smokers. Active management was done for the hypertension, diabetes and dyslipidemia. Only 39 percent of the smokers were off the habit for more than a year and only 19 percent of the obese received counseling for weight loss and exercise.
CONCLUSION: All patients identified with hypertension, dyslipidemia and diabetes mellitus were placed on appropriate diet and medications, patients with smoking problems and obesity were less consistently managed with smoking cessation approaches and weight losing manipulation through diet and exercise.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Coronary Artery Disease ; Weight Loss ; Risk Factors ; Smoking Cessation ; Smokers ; Obesity ; Diabetes Mellitus ; Dyslipidemias ; Hypertension ; Smoking ; Diet