1.Research advances in the expression and regulation of non-coding RNAs in ischemic stroke
Journal of Apoplexy and Nervous Diseases 2026;43(1):85-91
Ischemic stroke is a cerebrovascular disease with high incidence and disability rates. Non-coding RNAs, as important regulatory factors for gene expression, play a key role in the development and progression of ischemic stroke, but their specific mechanisms of action remain unclear. This article systematically reviews the expression characteristics and regulatory roles of microRNAs, long non-coding RNAs, and circular RNAs in ischemic stroke and reveals the pathophysiological mechanisms of non-coding RNAs in ischemic injury by regulating the processes of cell apoptosis and autophagy, inflammatory response, blood-brain barrier integrity, and neuroregeneration. In addition, non-coding RNAs have shown the potential as biomarkers for the prediction, diagnosis, and prognostic evaluation of ischemic stroke. This article also analyzes the limitations of current research and proposes future research directions, so as to provide a theoretical foundation for exploring the mechanism of action of non-coding RNAs in ischemic stroke and developing innovative diagnostic and therapeutic strategies.
Review
2.Valacyclovir-Associated Neurotoxicity presenting as acute encephalopathy in an elderly hemodialysis patient: A case report.
Mark Jenzen H. TRIVILEGIO ; Joselito B. DIAZ
Journal of Medicine University of Santo Tomas 2026;10(1):1923-1927
Valacyclovir-associated neurotoxicity (VAN) is a recognized adverse effect in elderly patients with renal impairment but remains underdiagnosed due to its nonspecific presentation and overlap with acute neurologic emergencies. We report a 78-year-old Filipino female with end-stage renal disease on maintenance hemodialysis who developed acute disorientation, agitation, vivid visual hallucinations and generalized weakness shortly after initiation of valacyclovir for herpes zoster. Given the abrupt onset of neuropsychiatric symptoms, viral encephalitis was initially considered. Magnetic resonance imaging of the brain showed no evidence of acute infarction or encephalitis, while electroencephalography demonstrated diffuse generalized slowing consistent with an encephalopathic process. Review of the medication history revealed valacyclovir dosing that exceeded recommendations for patients with end-stage renal disease. Valacyclovir was discontinued and emergent hemodialysis was initiated resulting in marked improvement in sensorium after the second session and complete resolution of symptoms after the third. This case shows VAN as an important diagnostic mimic of acute encephalopathy in elderly patients with renal failure and emphasizes the critical role of early medication review in preventing unnecessary investigations and enabling prompt, reversible management.
Human ; Female ; Aged: 65-79 Yrs Old ; Magnetic Resonance Imaging ; Kidney Failure, Chronic ; Magnetic Resonance Spectroscopy ; Electroencephalography ; Medication Review ; World Health Organization
3.Cost-utility analysis of r-chop vs chop in patients with Non-Hodgkin's lymphoma:A systematic review.
Camille Francesca T. Cadag ; Althea B. Lorenzo ; Justine Marie M. Mercado ; Frances Lois U. Ngo
Acta Medica Philippina 2026;60(2):84-114
BACKGROUND AND OBJECTIVES
Non-Hodgkin Lymphoma (NHL) ranks 11th in cancer incidence and mortality in the Philippines with the combination chemotherapy composed of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) being commonly used as treatment. However, the addition of Rituximab to CHOP (R-CHOP) has been shown to exhibit higher response rates and longer remissions, potentially improving quality of life. Currently, there is conflicting evidence on the cost-utility of CHOP versus R-CHOP. The study aimed to describe the patient- and country-specific factors, and treatment modalities used for NHL and systematically review cost-utility evidence of R-CHOP versus CHOP in adult NHL patients.
METHODSA systematic literature search of cost-utility studies on R-CHOP versus CHOP for NHL treatment was performed on eight databases: PubMed/MEDLINE, Scopus, Web of Science, EBSCOHost, Cochrane, York Research Database, Centre for Reviews and Dissemination Database, and HERDIN, where 607 studies were identified. Upon screening using an eligibility criteria, 10 studies were included and critically assessed using four appraisal tools: CHEERS, Drummond, Cooper, and ECOBIAS. These were performed independently by two authors with a third author assisting to help reach a consensus.
RESULTSAll studies from high-income countries (HICs) (n=8) and low-middle-income country (LMIC) (n=1) suggested that R-CHOP was more cost-effective for NHL treatment than CHOP in terms of utility outcomes. The study conducted in a low-income country (LIC) (n=1) suggested the opposite, favoring CHOP over R-CHOP. Methodological differences such as perspective, discount rate, willingness-to-pay (WTP), time horizon, and economic model were observed. Methodological limitations include completeness of data reported and credibility of sources used.
CONCLUSIONThe results of this review shall be interpreted with caution as those favoring R-CHOP over CHOP for NHL treatment in terms of cost-utility were concentrated in HICs. More economic evaluations from LICs, LMICs, and upper-middle income countries (UMICs) are needed for a robust conclusion. Additionally, establishing a universally recognized guideline for economic evaluations is essential to guide researchers effectively.
Cost-benefit Analysis ; Hodgkin Disease ; Lymphoma ; Systematic Review ; Lymphoma, Non-hodgkin
4.A systematic review of the Philippine plants' antibacterial properties against Staphylococcus aureus.
Ryan Christopher C. Lao ; Jessa Louise T. Turreda ; Monica Angelique O. Ramos-Saycon ; Ailyn Yabes
Acta Medica Philippina 2026;60(2):115-123
BACKGROUND AND OBJECTIVES
Staphylococcus aureus poses a significant public health threat globally, where both community and hospital-acquired infections are prevalent. The escalating antimicrobial resistance highlights the urgent need for alternative therapies. Hence, traditional medicine using plant extracts offers a potential avenue for novel antibacterial agents. This systematic review aimed to evaluate the existing literature on the antibacterial properties of Philippine plants against S. aureus to provide focus on drug development of a plant-derived antibacterial for this pathogen.
METHODSFollowing PRISMA guidelines, a comprehensive search was conducted in PubMed/Medline, SCOPUS, and Herdin databases. Inclusion criteria encompassed in-vitro studies evaluating the antibacterial activity of crude plant extracts sourced from Philippines plants against S. aureus. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved by the third and fourth reviewers.
RESULTSOf the 413 initial studies identified, nine (9) met the eligibility criteria. The highest zone of inhibition was demonstrated by Lippia micromera L. leaf essential oil at 26.3±1.5 mm, while moderate antibacterial activity was shown by essential oils from Alpinia elegans, Piper quinqueangulatum, and Alpinia cumingii at MIC values of 512 µg/mL, 512 µg/mL, and 1,024 µg/mL, respectively. Other Philippine plants showed a wide range of activity, with MIC values between 50 ?g/mL and 25 mg/mL, MBC values from 78 to 5000 ?g/mL, and ZOI ranging from 5 to 38 mm. However, the overall quality of evidence in these other studies are compromised by bias and incomplete reporting.
CONCLUSIONLeaf essential oils from Alpinia elegans, Piper quinqueangulatum, and Alpinia cumingii demonstrated moderate antibacterial activity against S. aureus. Additionally, the essential oils of Lippia micromera L., Plectranthus amboinicus Lour. Spreng, and Cymbopogon citratus exhibited antibacterial activity against both S. aureus and Methicillin-resistant S. aureus (MRSA) in disk diffusion assays. Majority of the studies gathered had high risk of bias according to the quality assessment criteria tool used in the study. Thus, this systematic review also emphasizes the need for improved methodological rigor on reported in-vitro antibacterial studies.
Staphylococcus ; Staphylococcus Aureus ; Systematic Review
5.Global Diagnostic Criteria for Gestational Diabetes Mellitus: A Scoping Review Protocol to Inform Policy in Malaysia
Siti Sarah Hamzah ; Shazana Rifham Abdullah ; Nur Zati Iwani Ahmad Kamil ; Liyana Ahmad Zamri ; Nur Azlin Zainal Abidin ; Sharifah Nortasya Sayed ; Muhamad Kamarudin
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):47-48
Introduction:
Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and
neonatal outcomes, including hypertensive disorders,
caesarean delivery, macrosomia, and increased lifetime
risk of type 2 diabetes. Despite its clinical importance,
considerable international variation exists in GDM
screening and diagnostic criteria. Multiple frameworks are currently used, including those from the World Health
Organization (WHO), International Association of Diabetes
and Pregnancy Study Groups, Carpenter and Coustan, and
the National Diabetes Data Group. Differences in glucose
thresholds, testing protocols (one-step versus two-step),
and universal versus risk-based screening contribute
to heterogeneity in reported prevalence and healthcare
burden. In multi-ethnic, middle-income settings such as
Malaysia, identifying an evidence-informed and contextappropriate diagnostic approach is critical.
Methodology:
This scoping review follows the Joanna Briggs Institute
methodology and will be reported in accordance with the
PRISMA Extension for Scoping Reviews (PRISMA-ScR).
PubMed, Scopus, and ScienceDirect will be searched for
English-language studies, reviews, guidelines, and consensus statements reporting GDM diagnostic criteria. Two
reviewers will independently screen and select studies.
Results:
Data will be charted on country, study type, diagnostic
criteria, gestational age at screening, and reported
challenges. Findings will be synthesized descriptively and
presented in tables and figures. No formal risk-of-bias
assessment will be conducted.
Conclusion
This review will provide a comprehensive overview of
global diagnostic practices, highlight variations and gaps,
and support evidence-based selection of a suitable GDM
screening and diagnostic strategy for Malaysia.
Diabetes, Gestational
;
Malaysia
;
Policy
;
Review Literature as Topic
6.Publication woes in the AI era.
Philippine Journal of Cardiology 2026;54(1):147-148
Scientific publishing faces growing challenges from rapid technological change, artificial intelligence (AI), research integrity concerns, and resource limitations, particularly in low- and middle-income countries. Editors, authors, and peer reviewers must navigate increasingly complex editorial requirements while operating within constrained institutional and financial environments. The emergence of AI-generated content and fabricated citations further threatens scholarly integrity and adds to editorial burdens. The unique challenges confronting regional journals necessitate strengthening editorial capacity, ethical governance, reviewer competency, and requires collaborative effort to sustain scientific publication that is relevant to the region.
Artificial Intelligence ; Peer Review ; Publishing ; Research ; Editorial ; Publications
7.Publication woes in the AI era.
Philippine Journal of Cardiology 2026;54(1):147-148
Scientific publishing faces growing challenges from rapid technological change, artificial intelligence (AI), research integrity concerns, and resource limitations, particularly in low- and middle-income countries. Editors, authors, and peer reviewers must navigate increasingly complex editorial requirements while operating within constrained institutional and financial environments. The emergence of AI-generated content and fabricated citations further threatens scholarly integrity and adds to editorial burdens. The unique challenges confronting regional journals necessitate strengthening editorial capacity, ethical governance, reviewer competency, and requires collaborative effort to sustain scientific publication that is relevant to the region.
Artificial Intelligence ; Peer Review ; Publishing ; Research ; Editorial ; Publications
8.Navigating the digital shift: Review of literature and recommendations for enhancing nursing informatics education in the Philippines
Neil Roy B. Rosales ; Reiner Lorenzo J. Tamayo
Acta Medica Philippina 2025;59(Early Access 2025):1-11
OBJECTIVES
The objective of this study was to synthesize existing literature on nursing informatics (NI) and propose updates to the Philippine Nursing Informatics curriculum that embrace current trends and integrate a globally acknowledged framework.
METHODSA literature search was conducted on PubMed and ScienceDirect. This search identified 79 articles, of which only eight met the inclusion criteria. The Technology Informatics Guiding Education Reform (TIGER) initiative provided the framework for analyzing the literature review outcomes and for developing the revised course structure for the Nursing Informatics (NI) curriculum in the Philippines.
RESULTSThe revised course outline incorporated 31 topics across the six domains outlined by the TIGER framework. Upon comparison, it was found that numerous topics identified were absent from the existing NI curriculum in the Philippines. Key subjects identified for inclusion encompass research, examination of standards and terminologies, application in community health, cybersecurity, project management, and advocacy. These areas hold particular relevance for the Philippines, attributed to the limited recognition of NI and the ongoing advancements related to technological applications in healthcare.
CONCLUSIONThe nursing informatics curriculum in the Philippines is not up to date, failing to align with global NI standards. It is recommended that a thorough revision and enhancement be undertaken to ensure alignment with international frameworks and current industry practices.
Human ; Nursing Informatics ; Education, Nursing ; Curriculum ; Review ; Philippines
9.A scoping review on the status of clinical simulation in healthcare education in the Philippines
Christopher S. Constantino ; Rowena F. Genuino ; Nicole Katrina P. Kilem ; Glenmarie Angelica S. Perias ; Gere Ganixon T. Ang
Acta Medica Philippina 2025;59(6):9-23
BACKGROUND
Simulation immerses learners in guided replications of real-life experiences. Simulation-based learning in the health profession allows trainees and professionals to practice skills in a controlled environment using various modalities, enhancing patient safety and minimizing clinical errors.
OBJECTIVETo describe the profile of Philippine studies on clinical simulation in healthcare professional education and assess the methodological quality of these studies.
METHODSWe conducted a scoping review of studies on clinical simulation studies in healthcare education in the Philippines. We followed the methods for scoping review and reported using the PRISMA Scoping review checklist. We searched for relevant studies from electronic databases (PubMed, Scopus, CENTRAL, Herdin, and Cochrane) as of May 17, 2024, and summarized descriptive data on the characteristics of the study, population, clinical simulation technique, and outcomes, using graphical summaries and tables. We assessed the methodological quality of included studies using the Modified Medical Education Research Study Quality Instrument (MMERSQI).
RESULTSWe included 13 studies mostly published in the 2020s (7), by faculty as main author (9), with hospital affiliation (10), single-center (11), setting in NCR (11), analytic (10), medical field (10), educational purpose (7), using task trainers (5), low- to medium-fidelity (11), with technical competencies (mostly skills) as desired outcome (9), median sample size of 40, and including mostly postgraduate level participants (7). There was moderate methodological quality (median MMERSQI score, 51 [range, 40, 77] with the ‘type of data’ item being highly reported and ‘validity of instrument tool’ item poorly reported.
CONCLUSIONThe observed gaps in methodological rigor, study design, and fidelity of simulation techniques in healthcare education in the Philippines highlight opportunities for advancing the field. Future research should aim to address these gaps, particularly by increasing the use of RCTs, enhancing the validity of measurement tools, and incorporating comprehensive simulation components.
Human ; Simulation Training ; Scoping Review ; Philippines
10.A scoping review of worldwide patent applications in anatomical education (2018-2022)
Rowena F. Genuino ; Rafael C. Bundoc ; Florida F. Taladtad ; Kevin L. Ocampo ; Gere Ganixon T. Ang ; Joseph Daniel S. Timbol ; Christopher S. Constantino
Acta Medica Philippina 2025;59(6):24-32
BACKGROUND AND OBJECTIVE
Anatomical education utilizes mainly cadaver dissection, but it also depends on innovations such as novel preservation techniques, simulation models, and virtual dissection apps. There is no review on anatomical patents. This study aimed to review the worldwide landscape of existing patents on anatomical education to identify gaps and opportunities for utilization and further innovations.
METHODSWe conducted a scoping review for inventions, utility models, and industrial design applications on anatomical education. We searched the following databases as of December 31, 2022 (WIPO Patentscope, Espacenet, and Derwent). We deduplicated the records, screened them for eligibility, and extracted information on characteristics of the patent application and applicant. We computed frequency and percentage according to country, type of applicant, number of inventors, type of patent, scope of patent, purpose of patent, organ system, status of patent, and time to patent granting.
RESULTSOut of 667 merged records from the initial search, we removed 312 duplicates, excluded 97 records, and included 258 reports in the review. The median number of patent applications per year was 58 (range, 32, 61). Majority of the applications were from China and USA (36.0 and 34.9%, respectively), national in scope (62.8%), industry as applicant (49.6%), inventions (77.5%), usable beyond anatomy (70.9%), physical models (53.1%) and with pending status (63.6%). The median time to granting for 65 patents was 316 days (range, 40 to 1568).
CONCLUSIONFor the period 2018-2022, there were 258 patent applications related to anatomical education, both as a basic science and in clinical applications, were mostly inventions, applied for by industry, contributed by US and China, only national in scope, physical 3D models (mostly musculoskeletal, head/neck and sensory organs, and whole body), and usable beyond basic anatomy. The majority of patent applications are still pending with only 65 granted patents. Plastinated specimens, and the urinary, reproductive, and pulmonary organ system models were least represented.
Intellectual Property ; Patent ; Inventions ; Review ; Anatomy ; Education ; Training


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