BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

METHODS

This retrospective cohort study included 145 patients aged

RESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Human ; Adolescent: 13-18 Yrs Old ; Child: 6-12 Yrs Old ; Foreign Bodies ; Endoscopy ; Child ; Retrospective Studies ; Aged ; Cohort Studies ; Eating ; Methods ; Numismatics ; Patients ; Philippines ; Physical Examination ; Time

BACKGROUND/OBJECTIVE

Although nutritional assessment tools have been available internationally, local data for their use in foreseeing adverse outcomes among admitted patients are currently unavailable. The primary objective of this study was to determine the association of nutritional status using Short Nutritional Assessment Questionnaire (SNAQ) and malnutrition risk using the MST (Malnutrition Screening Tool) with ICU admission and in-hospital mortality.

METHODOLOGY

This was a prospective-cohort study which included 122 purposively-selected adult participants who were non-intubated, admitted for medical and surgical managements, stayed for at least 24 hours, had no COVID-19 infection, and were not admitted in any critical care unit. The SNAQ and MST questionnaires, which are validated tools and consists of  two to three easy-to-answer questions, were used among the participants and their scores were tallied in order to get their nutritional status and malnutrition risk. Primary endpoints measured were length of hospital stay, incidence of mortality, and ICU admission rate. Comorbidities were taken into account using the Charlson Comorbidity Index.

RESULT

Categorizing the SNAQ scores showed 33.61% were severely malnourished which was similar when using the MST classification, wherein 34.43% were at risk of malnutrition. None of the participants were admitted to the intensive care unit (ICU). Malnutrition risk and nutritional status was not significantly associated with 30-day in-hospital mortality (p >0.05). On the other hand, results of the Cox proportional hazards showed that SNAQ and MST significantly predicted the hazard of 30-day in-hospital mortality, increasing the hazard of mortality by 2.58 times and 3.67 times, respectively, for every 1-unit increase in SNAQ and MST scores. Similarly, nutritional status using the SNAQ classification indicated the severely malnourished category significantly predicted the hazard of mortality, increasing it by 9.22 times for those who are severely malnourished. Also, malnutrition risk using the MST classification indicated that those who were at risk of malnutrition were 9.80 times at greater hazard of mortality than those who were not at risk of malnutrition.

CONCLUSION

The MST and SNAQ classification are screening tools for nutritional status (SNAQ) and malnutrition risk (MST) that can be administered at the onset of the patient’s hospital course and have been demonstrated in this study to predict 30-day in-hospital mortality. It is important to note that none of the patients included in this study required intensive care unit admission.

Human ; Malnutrition ; Netherlands ; Eating ; Surveys And Questionnaires ; Mortality

OBJECTIVES

To present a case of a 59-year-old male with bilateral symmetrical lipomatosis consistent with Madelung disease.

METHODS

Design:Case Report

Setting:Tertiary Government Training Hospital

Patient: One

RESULTS

A 59-year-old alcoholic man presented with progressive, bilaterally symmetrical masses in the supraclavicular and anterior neck regions over a 12-month period. Computed tomography revealed diffuse, non-enhancing, symmetrical subcutaneous fatty deposits without delineated solid or cystic masses. The masses were surgically excised, and histopathologic analysis confirmed lipoma. Post-operative recovery was unremarkable, with significant cosmetic improvement and no recurrence in the 2 years of regular follow-up.

CONCLUSION

This case highlights the pathognomonic clinical presentation of Madelung disease in a middle-aged Filipino man with a long history of alcohol consumption and no familial predisposition. Recognition of its characteristic features—symmetry, fat distribution, association with alcoholism, and radiologic profile—is essential to avoid misdiagnosis and unnecessary interventions. Lipectomy achieved excellent cosmetic and clinical outcomes in this patient, underlining its role as the primary treatment modality.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Alcohol Drinking ; Lipoma ; Lipectomy ; Diagnostic Errors ; Recurrence ; Therapeutics ; History ; Hospitals ; Alcoholism

OBJECTIVE

The study aims to compare the demographic profile, management, and outcomes of patients with foreign body ingestion before and during the COVID-19 pandemic.

METHODS

Design: Retrospective Review of Records

Setting: Tertiary Government Training Hospital

Participants: Records of 156 patients, 81 from the pre-pandemic period (2018-2020) and 75 during pandemic period (2020-2022), diagnosed with aerodigestive foreign bodies

RESULTS

One hundred fifty-six (156) patients, 81 from the pre-pandemic period (2018-2020) and 75 during pandemic period (2020-2022) were included in this study. Median age pre pandemic is 9 years old (Standard deviation = 22.19) and 16 years old (Standard deviation = 19.63) during pandemic. The male-to-female ratio for pre-pandemic and during pandemic is 54:27 and 52:23, respectively. The majority of the patients ingested coins (53% pre-pandemic and 44% during pandemic) followed by dentures (22% pre-pandemic and 35% during pandemic). T-test results show that Time from Ingestion to Consult shows a borderline statistically significant difference between the pre-pandemic and during-pandemic periods for the time from ingestion to consult (t-value = -1.967; p-value of 0.051), implying a slight difference in the time patients took to seek medical help after ingesting a foreign body between the two periods. Time from Consultation to the Operating Room indicates that there is significant difference between the pre-pandemic and during pandemic time from consultation to the operating room (t-value= -2.037; p-value= 0.043, suggesting significant change in the time taken to move patients from consultation to the operating room between the two periods, possibly indicating changes in hospital protocols or patient flow during the pandemic.

CONCLUSION

Results showed that there was a noticeable shift in the age distribution of patients, with older patients encountered during the pandemic period, suggesting changes in healthcare-seeking behavior and accessibility. Data also showed that more patients in both periods were male, consistent with existing literature on foreign body ingestion demographics. The median time (in hours) from ingestion to consultation increased significantly during the pandemic, indicating delays in seeking medical care. This was likely due to travel restrictions, fear of COVID-19 in public, and changes in public health protocols. Despite these consultation delays, the median time from consultation to the operating room remained consistent, reflecting the efficiency of healthcare providers in the tertiary hospital. Operating time and the level of foreign bodies in the esophagus did not differ significantly between the two periods, implying a stable surgical procedure. The significant difference in the overall time across patients from consultation to the operating room during the pandemic suggests changes in hospital protocols and patient flow management.

Human ; Foreign Bodies ; Eating ; Ingestion ; Esophagoscopy ; Covid-19

OBJECTIVES: This study aimed to investigate the correlation between clinical symptoms and unilateral chewing habits in patients with temporomandibular disorder (TMD) accompanied by tinnitus. METHODS: A total of 285 patients diagnosed with TMD at the Department of Stomatology of the First Medical Center of Chinese People's Liberation Army General Hospital between December 2020 and May 2024 were included and divided into two groups: tinnitus group and non-tinnitus group. Analysis was conducted on the proportion of patients with unilateral chewing habits in both groups, the correlation between the side of tinnitus and the side of unilateral chewing, and the correlation of tinnitus with TMD clinical symptoms (joint clicking, joint pain, and limited mouth opening) and unilateral chewing habits. The correlation of the type of disc displacement with unilateral chewing and tinnitus was also examined. RESULTS: In the tinnitus group, the proportions of patients with and without unilateral chewing habits were 90.70% (39/43) and 9.30% (4/43), respectively. In the non-tinnitus group, the proportions of patients with and without unilateral chewing habits were 76.03% (184/242) and 23.97% (58/242), respectively. The proportion of patients with unilateral chewing habits in the tinnitus group was significantly higher than in the non-tinnitus group (χ²=4.613, P<0.05). Correlation analysis showed a positive correlation between tinnitus and unilateral chewing habits (P<0.05). In the left-sided tinnitus group, the proportion of left-sided unilateral chewers [54.55% (12/22)] was higher than that of right-sided unilateral chewers [45.45% (10/22)]. In the right-sided tinnitus group, the proportion of right-sided unilateral chewers [81.82% (9/11)] was higher than that of left-sided unilateral chewers [18.18% (2/11)]. The difference was statistically significant (χ²=7.282, P<0.05). A positive correlation was also found between the side of tinnitus and the side of unilateral chewing habits (P<0.05). The proportion of patients with pain was significantly higher in the tinnitus group than in the non-tinnitus group (P<0.05). No significant difference in the proportion of joint clicking or limited mouth opening and disc displacement (no disc displacement, unilateral disc displacement, bilateral disc displacement, reducible disc displacement, or irreducible disc displacement) was found between the tinnitus and non-tinnitus groups (P>0.05). CONCLUSIONS TMD with unilateral chewing habits may be a contributing factor to unexplained tinnitus. Unexplained tinnitus is correlated with joint pain in patients with TMD.
Humans ; Tinnitus/physiopathology* ; Temporomandibular Joint Disorders/physiopathology* ; Mastication ; Male ; Adult ; Female ; Middle Aged ; Habits

OBJECTIVES

This study aims to describe the micronutrient intake and diet quality of overweight and obese Filipino adults in the National Capital Region (NCR). Specifically, it seeks to assess micronutrient inadequacy among these individuals and analyze differences in food intake based on their sociodemographic profiles and lifestyle habits.

METHODS

This analytical cross-sectional study utilized data from the Expanded National Nutrition Survey (ENNS) conducted in 2018, 2019, and 2021 by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). A total of 3,154 overweight and obese subjects were included. ANOVA and Kruskal-Wallis tests were employed to analyze the food groups consumed by these adults.

RESULTS

Majority of overweight and obese adults were found to be inadequate in vitamin A (81.7%), vitamin C (88.4%), thiamin (62.5%), riboflavin (70.7%), iron (69.8%), and calcium (88.7%). Significant differences were observed in the mean intake of various food groups across different age groups, sexes, civil statuses, wealth quintiles, educational attainments, employment statuses, and smoking and drinking statuses.

CONCLUSION

Filipino adults who are overweight and obese, and residing in urban settings face significant challenges related to micronutrient inadequacy. When their food intake was assessed based on sociodemographic and lifestyle characteristics, it was found that their diets were more calorie-dense than nutrient-dense. To address this issue, it is recommended to encourage a wider variety of nutrient-dense foods among overweight and obese adults.

Food Intake ; Eating ; Micronutrients ; Overweight ; Obesity ; Nutritional Status

INTRODUCTION: Foreign body (FB) ingestion is a common paediatric emergency. While guidelines exist for urgent intervention, less is known of the natural progress of FBs passing through the gastrointestinal tract (GIT). We reviewed these FB transit times in an outpatient cohort. METHODS: A retrospective review was performed on all children (≤18 years) treated for radiopaque FB ingestion at two major tertiary paediatric centres from 2015 to 2016. Demographic data, FB types, outcomes and hospital visits (emergency department [ED] and outpatient) were recorded. All cases discharged from the ED with outpatient follow-up were included. We excluded those who were not given follow-up appointments and those admitted to inpatient wards. We categorised the outcomes into confirmed passage (ascertained via abdominal X-ray or reported direct stool visualisation by patients/caregivers) and assumed passage (if patients did not attend follow-up appointments). RESULTS: Of the 2,122 ED visits for FB ingestion, 350 patients who were given outpatient follow-up appointments were reviewed (median age 4.35 years [range: 0.5-14.7], 196 [56%] male). The largest proportion (16%) was aged 1-2 years. Coins were the most common ingested FB, followed by toys. High-risk FB (magnets or batteries) formed 9% of cases ( n =33). The 50 th centile for FB retention was 8, 4 and 7 days for coins, batteries and other radiopaque FBs, respectively; all confirmed passages occurred at 37, 7 and 23 days, respectively. Overall, 197 (68%) patients defaulted on their last given follow-up. CONCLUSION This study provides insight into the transit times of FB ingested by children, which helps medical professionals to decide on the optimal time for follow-up visits and provide appropriate counsel to caregivers.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Eating ; Emergency Service, Hospital ; Foreign Bodies/diagnostic imaging* ; Gastrointestinal Tract/diagnostic imaging* ; Gastrointestinal Transit ; Retrospective Studies ; Singapore ; Tertiary Care Centers

BACKGROUND: Deterioration in lifestyle associated with poor mental health could be an important concern during the coronavirus disease 2019 (COVID-19) pandemic. However, few studies have investigated the association between mental health status and lifestyle changes during the pandemic in nationwide Japanese general population. METHODS: This cross-sectional study was conducted using the data among 1,546 participants of the follow-up study of NIPPON DATA2010 in 2021. Recent mental status, as assessed using the Kessler 6 (K6) scale, and lifestyle changes compared to before the pandemic were determined using self-reported questionnaires. Some lifestyle changes such as decreased physical activity were defined as undesirable, whereas others such as decreased alcohol drinking were defined as desirable. The participants were divided into three groups based on the K6 scores: the K6<5, 5≤K6<9, and K6≥9 groups. The odds ratios (ORs) and 95% confidence intervals (CIs) of the K6 groups for each lifestyle change compared with that in the K6<5 group were estimated after adjusting for possible confounders. RESULTS: The ORs of the K6≥9 group for all undesirable lifestyle changes were significantly high, especially increased alcohol drinking (OR 4.64; 95% CI, 2.71-7.93), and decreased physical activity (OR 4.63; 95% CI, 3.29-6.52). Among the desirable changes, the OR of the 5≤K6<9 group was significantly high for increased eating home cooking. CONCLUSIONS Poor mental health showed a significant association with undesirable lifestyle changes, especially increased alcohol drinking and decreased physical activity, in a nationwide general Japanese population during the COVID-19 pandemic.
Humans ; COVID-19/epidemiology* ; Japan/epidemiology* ; Male ; Female ; Mental Health/statistics & numerical data* ; Middle Aged ; Cross-Sectional Studies ; Life Style ; Adult ; Aged ; Exercise ; Alcohol Drinking/epidemiology* ; SARS-CoV-2 ; Pandemics ; East Asian People

The recent three leading risk factors for global disease burden in the world are, in descending order, high blood pressure, tobacco smoking including second-hand smoke, and alcohol use. Alcohol use increases the risk for many acute and chronic health consequences including cancer, road injury and suicide as well as alcohol use disorder. It is known that there is a U- or J-shaped relationship between alcohol consumption and all-cause mortality. The descending leg of the curve showing this relationship is best explained by a decrease in the risk of cardiovascular disease, especially ischemic heart disease, among light-to-moderate alcohol drinkers. However, this relationship carries risks of confounding and selection bias, including the so-called healthy drinker bias. Furthermore, biogenic compounds other than ethanol present in wine may be partially responsible for the beneficial effect, although this also includes several confounding factors such as the drinking patterns associated with wine preference. While some studies suggest that light-to-moderate alcohol consumption may offer cardiovascular benefits, these findings are likely influenced by confounding factors and do not negate the substantial public health burden associated with alcohol use. In fact, from a population health perspective, reducing harmful alcohol consumption remains a critical priority. Social policies aimed at lowering alcohol intake and limiting drinking opportunities can contribute to longer life expectancy by preventing alcohol-related diseases. Unhealthy alcohol use is one of the four major behavioral risk factors-along with smoking, physical inactivity, and poor diet-that accounted for approximately 50% of all deaths and about six years of life expectancy lost between 2001 and 2008. Targeted interventions are particularly important for men and individuals with lower educational attainment, as alcohol-related mortality is higher in men and contributes more to socioeconomic disparities in life expectancy among men than among women. Alcohol consumption is influenced by socioeconomic factors such as education, income, and occupation. While higher socioeconomic status is associated with more frequent drinking, lower status is associated with higher consumption volume. Given that alcohol-related deaths and life expectancy trends vary across countries and over time, public health strategies should be tailored to specific social and temporal contexts.
Humans ; Alcohol Drinking/epidemiology* ; Life Expectancy ; Risk Factors

Per- and polyfluoroalkyl substances (PFAS) have recently been shown to affect human health at low levels in the blood, according to epidemiological evidence. Consequently, human exposure to these chemicals should be strictly controlled to prevent health risks. This review reports on the potential sources of PFAS using Japan as an example. Tap water has attracted attention as a source of exposure to PFAS. PFAS have also been detected in the air, in household dust, and in consumer products. Furthermore, in the general population, diet is the most common source of exposure, and there is particular concern about human exposure to PFAS accumulated in seafood. Continuous monitoring is important for appropriate management of exposure for both humans and the environment.
Seafood/toxicity* ; Fluorocarbons/toxicity* ; Japan ; Drinking Water/standards* ; Air Pollutants/toxicity* ; Humans ; Dust/analysis* ; Environmental Exposure/standards* ; Food Contamination/analysis* ; Environmental Pollutants/toxicity* ; Water Pollutants, Chemical/toxicity*