OBJECTIVES

Timely access to appropriate levels of care is essential for improving maternal, newborn,
and child health outcomes. To address persistent service delivery fragmentation and strengthen referral systems, the Philippine Department of Health issued Administrative Order 2020-0019 to guide the design of Health Care Provider Networks (HCPNs) under the Universal Health Care Act of 2019. This study assessed the extent to which sixteen municipalities across four provinces in Eastern Visayas comply with the HCPN service delivery guidelines in the context of maternal and newborn care.

The study employed a descriptive cross-sectional mixed-methods design, utilizing structured facility checklists to assess compliance with HCPN standards. Qualitative data were gathered through key informant interviews and focus group discussions with purposively selected stakeholders—decision makers, health personnel, and mothers—to contextualize findings. A three-lever framework for integrated care (policy, operational, and cross- cutting) guided the analysis

The findings revealed significant gaps between the current capacities of study health facilities and the requirements outlined in the HCPN guidelines. Major gaps included (1) weak cooperative governance mechanisms to support network-wide coordination; (2) limited systematic linkages between facilities, including fragmented referral protocols and non-interoperable health information systems; (3) inadequate investments in infrastructure, health human resources, and medical commodities; and (4) absence of performance monitoring systems across HCPNs.

Asthma is a diverse disease that can be categorized into various phenotypes and endotypes, including obesity-re-lated asthma and allergic asthma. "Treatable traits (TTs)" represent a new approach to managing asthma. Asthma accompanied by dyslipidemia would be a distinct asthma phenotype that is becoming increasingly common. Therefore, dyslipidemia can potentially serve as a target for the management of asthma. Nevertheless, it remains highly under-researched compared to other observable traits. Gaining knowledge about the clinical and inflammatory characteristics, underlying mechanisms, and potential therapeutic medications for asthma with dyslipidemia is crucial for its effective management. This review aimed to provide a comprehensive overview of asthma with dyslipidemia, consolidating existing knowledge and ongoing research.
Humans ; Asthma/complications* ; Dyslipidemias/epidemiology*

Objective: To evaluate the application value of a digital technology-based multiparameter vital signs monitoring system in perioperative comprehensive full-cycle surveillance. Methods: A comprehensive multidimensional vital signs monitoring system was developed through the integration of medical-grade wireless wearable devices, incorporating patch-type ambulatory electrocardiographic monitor, continuous glucose monitoring sensor, pulse oximeter, wireless digital thermometer, smart wristband, and bioelectrical impedance analyzer. This system facilitates continuous real-time acquisition of multiple physiological parameters including electrocardiogram, blood glucose, oxygen saturation, body temperature, physical activity, and body composition indices. The acquired data were systematically integrated and analyzed through a four-level digital architecture consisting of nurse mobile interfaces, bedside patient terminals, centralized ward monitoring displays, and hospital management information systems. One patient with gastric cancer complicated by diabetes mellitus was selected for full-cycle digital monitoring from preoperative evaluation to hospital discharge. The technical performance of the monitoring system was assessed in terms of data acquisition continuity and timeliness of abnormal event alerts. Results: The monitoring system effectively identified early postoperative abnormalities, such as decreased oxygen saturation and blood glucose fluctuations, providing timely guidance for clinical intervention. The built-in algorithm enabled visualization of perioperative stress levels through heart rate variability indices and continuous glucose monitoring data. The patient demonstrated good compliance with early postoperative mobilization, and the satisfaction score for monitoring management was 4 points based on the Likert 5-point scale. Conclusions: The multiparameter vital signs monitoring system enhanced the precision of perioperative management through continuous and dynamic physiological status assessment. Its modular design aligns with the principles of enhanced recovery after surgery, offering a novel technological solution for intelligent perioperative management.
Humans ; Stomach Neoplasms/physiopathology* ; Vital Signs ; Monitoring, Physiologic/instrumentation* ; Diabetes Mellitus ; Wearable Electronic Devices ; Perioperative Period

Objective: To review the implementation of essential reproductive health services in Eastern Visayas, Philippines.Materials and Methods: We reviewed four national policies through a qualitative research design using a series of key informant interviews conducted with service providers and focus group discussions with service beneficiaries.Results: There was a gap between the policies and the implementation of reproductive health services in the Eastern Visayas region. This gap is mainly due to the refusal of service providers to cater to teenagers’ needs regarding reproductive health services. This has resulted in teenagers hesitating to seek reproductive health services and related support from primary healthcare facilities. Service beneficiaries have also reported on the unavailability of several reproductive health services in primary healthcare facilities.Conclusion: The gap between national policies and program implementation must be bridged. This can be achieved by creating culturally-specific policies that can improve the implementation of reproductive health programs in the study areas.

Enterococcus hirae (E. hirae) infection is an uncommon pathogen in human infections. Bacteremia due to E. hirae associated with urinary tract infection is uncommon. We present a case of E. hirae bacteremia in a young woman with no underlying comorbidities. This case report emphasizes the importance of considering E. hirae as a potential pathogen in urinary tract infections.

Enterococcus hirae (E. hirae) infection is an uncommon pathogen in human infections. Bacteremia due to E. hirae associated with urinary tract infection is uncommon. We present a case of E. hirae bacteremia in a young woman with no underlying comorbidities. This case report emphasizes the importance of considering E. hirae as a potential pathogen in urinary tract infections.

Enterococcus hirae (E. hirae) infection is an uncommon pathogen in human infections. Bacteremia due to E. hirae associated with urinary tract infection is uncommon. We present a case of E. hirae bacteremia in a young woman with no underlying comorbidities. This case report emphasizes the importance of considering E. hirae as a potential pathogen in urinary tract infections.

Enterococcus hirae (E. hirae) infection is an uncommon pathogen in human infections. Bacteremia due to E. hirae associated with urinary tract infection is uncommon. We present a case of E. hirae bacteremia in a young woman with no underlying comorbidities. This case report emphasizes the importance of considering E. hirae as a potential pathogen in urinary tract infections.

BACKGROUND

While adolescent pregnancies in the Eastern Visayas region of the Philippines have declined over the past five years, young mothers remain at risk of repeat pregnancies, which continue to expose them and their children to health and socioeconomic risks in this vulnerable region.

This study aims to collect baseline information on mothers who experienced early pregnancy in Eastern Visayas and to identify significant differences in maternal characteristics based on type of residence and age. The findings will be used by a nongovernmental organization to plan and develop targeted interventions for this vulnerable population.

This study utilized a descriptive cross-sectional design to collect data on mothers who experienced early pregnancy in four selected provinces of Eastern Visayas. Data were analyzed using descriptive statistics, chi-square tests, an independent t-test, and the Mann-Whitney U test.

A total of 296 mothers participated in the survey. Among them, 80.1% were in high school during their first pregnancy, and 88.2% were unemployed at the time of the study. The youngest age at first pregnancy was 12 years. The participants' male partners were at least five years older (39.8%) and ten years older (11.1%). Significant differences were observed in the use of family planning method, number and status of pregnancies, and history of preterm labor.

Results suggest that adolescent pregnancy remains a public health concern in Eastern Visayas, particularly among lowincome teenagers with limited educational attainment, whose parents also had minimal education. The youngest reported age of pregnancy was 12 years. Therefore, efforts should focus on increasing access to family planning services, providing comprehensive reproductive health education, and enhancing maternal and child health services.

Radical gastrectomy with D2 lymphadenectomy has been widely performed as the standard surgery for patients with gastric cancer in major medical centers in China and abroad. However, the exact extent of lymph node dissection is still controversial. In the latest version of the Japanese Gastric Cancer Treatment Guidelines, No. 14v lymph nodes (along the root of the superior mesenteric vein) are again defined as loco-regional lymph nodes, and it is clarified that distal gastric cancer presenting with infra-pyloric regional lymph node (No.6) metastasis is recommended for D2+ superior mesenteric vein (No. 14v) lymph node dissection. To explore the relevance and clinical significance of No.6 and No.14v lymphadenectomy in radical gastric cancer surgery, a review of the national and international literature revealed that No.6 lymph node metastasis was associated with No.14v lymph node metastasis, that No.6 lymph node status was a valid predictor of No.14v lymph node negative status and false negative rate, and that for gastric cancer patients with No. 14v lymph node negative and No.6 lymph node positive, the dissection of No.14v lymph node may also have some significance. The addition of No. 14v lymph node dissection in radical gastrectomy is safe, but it is more important to distinguish the patients who can benefit from it. Professor Liang Han of Tianjin Medical University Cancer Hospital is currently leading a multicenter, large-sample, prospective clinical trial (NCT02272894) in China, which is expected to provide higher level evidence for the clinical significance of lymph node dissection in No.14v.
Humans ; Stomach Neoplasms/pathology* ; Lymphatic Metastasis/pathology* ; Prospective Studies ; Retrospective Studies ; Lymph Nodes/pathology* ; Lymph Node Excision ; Gastrectomy ; Multicenter Studies as Topic