Introduction: The primary issue following lumbar discectomy for disc herniation is the risk of reherniation in the post-operative period. Many surgical techniques have been proposed to treat disc reherniation, however, the optimal one remains variable. This meta-analysis aimed to investigate the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the contributing factors. Materials and methods: Identification of published literature was performed on PubMed, Google Scholar, Scopus, and Web of Science databases. Studies published until 14 February 2024 reported the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the associated contributing factors. A random effects model was used to conduct Bayesian frequentist network meta-analysis and pair-wise meta-analysis, with the assessment based on standardised mean difference (SMD) and 95% confidence interval (CI). Results: Eleven studies published in 2012 − 2022 recruiting a total of 5195 patients were included in the meta-analysis. The prevalence of reherniation in ACD and control groups was 23.2% (95% CI: 18.2% − 28.1%) and 36.4% (95% CI: 28.2% − 44.5%), respectively. The moderator effect of sample size is significant for pooled data of the ACD group (p-mod=0.002), but not for the control group (pmod=0.278). After the adjustment with sample size, the prevalence rates were 13.6% (95% CI: 6.2% − 21.1%) and 29.6% (95% CI: 14.9% − 33.2%) for ACD and control groups, respectively. Conclusion: Comparatively to lumbar discectomy alone, using a Bone-anchored annular closure device following lumbar discectomy decreased the symptomatic reherniation rate and post-operative complications, as well as the necessity for subsequent surgeries.

Objective: This study aimed to demonstrate the benefits of using SaTScan (Boston, MA, USA), a cluster-detection software programme, and whole genome sequencing to investigate a suspected outbreak of Serratia marcescens infections in a tertiary government hospital in the southern Philippines. The hospital is part of the national Antimicrobial Resistance Surveillance Program’s network of sentinel sites. Methods: The investigation followed national outbreak investigation protocols. In May 2022, when evaluation of daily hospital laboratory census data revealed an increase in the number of Serratia species in the hospital, an alert was triggered. A concurrent, routine SaTScan analysis of the hospital’s surveillance data by the Antimicrobial Resistance Surveillance Reference Laboratory confirmed a cluster of cases. The Reference Laboratory requested isolates from clinical specimens from the hospital for confirmation of bacterial identification, antimicrobial susceptibility testing and whole genome sequencing. Results: Six isolates were submitted for genomic analysis, two of which were from the identified cluster. Although originally identified as S. marcescens, five of the isolates were subsequently confirmed as S. sarumanii. Phylogenetic analysis showed that the two isolates from the cluster were closely related and belonged to the same clade, which may suggest a common source. Three antimicrobial resistance genes were identified, but their phenotypic expression was limited, with one isolate exhibiting resistance mechanisms. Discussion: This study highlighted the utility of SaTScan for the early detection of potential disease outbreaks. The use of whole genome sequencing enhanced the investigation by enabling the analysis of potential transmission pathways at the genetic level, identification of the outbreak source and the detection of novel species.

BACKGROUND AND OBJECTIVE

The incidence of ischemic stroke typically increases with age; however, recent studies have shown a concerning trend of stroke cases among adults under the age of 45. This neurologic condition is called “Stroke in the Young” (SITY). SITY poses public health concerns due to its long-term consequences on individuals and their families. Despite significant impact, published literature on SITY among Filipinos is scarce. Given the potential differences in genetic background and lifestyle, the clinical characteristics and outcomes of SITY Filipinos may vary considerably from other populations. Therefore, the aim of this study is to describe the clinical features and outcomes of ischemic SITY Filipinos.

METHODS

The study was a two-center, five-year retro- spective cohort design involving 19- to 45-year-old  patients admitted between January 1, 2017, and December 31, 2022, diagnosed clinically and radiologically with ischemic stroke for the first time. Medical records were reviewed, including demographic data, stroke symptoms, cardiovascular or non-cardiovascular risk factors, and laboratory results. Ischemic stroke subtypes were categorized into cardioembolic, small artery occlusion, stroke of other determined causes, and stroke of undetermined cause through the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. Functional outcomes on hospital discharge were assessed by the Modified Rankin Scale (mRS). All data were analyzed using descriptive statistics in the Statistical Package for the Social Sciences (SPSS software, version 29).

RESULTS

A total of 205 cases of ischemic SITY were chart reviewed. The mean age was 37.30, with a female predominance of 68.3%. The most reported cardiovascular risk factors were obesity (56.6%), hypertension (51.2%), heavy alcohol consumption (36.5%), and diabetes mellitus type 2 (19.5%). Concurrently, the non-cardiovascular risk factors identified were pregnancy, particularly in the postpartum period (4.8%), use of estrogen-containing pills (4.8%), and migraine without aura (4.4%). Based on TOAST classification, small vessel occlusion (42.1%) and large artery atherosclerosis (30.2%) were the most frequent ischemic stroke subtypes of SITY Filipino females. Mostly showed no symptoms of disability (35.1%) on hospital discharge.

CONCLUSION

This study highlights the difference in the clinical profile of young Filipino adults with ischemic stroke. Contrary to previous studies, ischemic stroke was more predominant among young females. Aside from hypertension, obesity has emerged as the leading cardio- vascular risk factor for ischemic SITY. Moreover, noncardiovascular risk factors, specific to females (pregnancy, use of estrogen-containing pills, and migraine), were also identified in the study. With regards to stroke subtypes, small vessel occlusion and large artery atherosclerosis were frequently seen in young female patients. These f indings suggest a need for gender-specific approaches in the evaluation, management, and prevention of ischemic SITY.

Human ; Young Adult: 19-24 Yrs Old ; Ischemic Stroke

BACKGROUND

Pulmonary aspergilloma is the most common pulmonary involvement due to Aspergillus. It usually develops in a pre-existing cavity in the lung, most often due to tuberculosis. Hemoptysis occurs secondary to local invasion of the blood vessels lining the cavity. Recurrence of which, is an indication to do surgery, lobectomy in particular. Antifungals like amphotecin B given intravenously and itraconazole given orally, have been the traditional management. But with the emergence of newer antifungals, Echinocandins in particular, which functions to inhibit the β-(1,3) p-glucan synthase, an enzyme necessary for the synthesis of an essential component of the cell wall of fungi, one may need not undergo surgery. The most common antifungal medication for Aspergillus is voriconazole, a second-generation triazole. This case demonstrates the efficient utilization of Voriconazole along with Anidulafungin, which is necessary for the fungal cell wall integrity. For immunocompromised patients with pulmonary aspergilloma, this dual therapy presents a viable substitute for surgical intervention and an efficient treatment approach.

CASE

We present a case of a 54-year-old married patient, who presented with massive hemoptysis four days before consulting a private physician. She had ten episodes of hemoptysis four hours before admission and was rushed to the hospital. The patient had multiple comorbidities, including diabetes, hypertension, and asthma, contributing to an immunocompromised state. She had a history of anti-tuberculosis treatment in 2000, which was discontinued due to an allergic reaction. During her hospital stay, she experienced febrile episodes, and capillary glucose monitoring was beyond acceptable levels, prompting antibiotic initiation. A chest CT scan revealed pulmonary tuberculosis with cicatricial atelectasis of the lingular segment and infected cavitary formation. A bronchoscopy and biopsy of the cavitary lesion were scheduled. Surgical intervention, particularly lobectomy, was not pursued due to multiple factors, including the patient's immunocompromised status, her underlying comorbidities, and the response to antifungal therapy. After eight to 14 fourteen (8-14) hospital days, no episodes of hemoptysis were noted, and the biopsy result revealed fungal colonization consistent with Aspergillus species. The patient was discharged with oral Voriconazole and other maintenance medications. A repeat chest CT scan after five months of antifungal therapy showed regression of the fungus ball.

CONCLUSION

In this case, pulmonary aspergilloma in an immunocompromised patient was successfully treated with a combination antifungal therapy utilizing anidulafungin and voriconazole. The favorable clinical response to dual antifungal therapy provides a feasible non-surgical alternative to surgical intervention, which has historically been the preferred option for treating recurrent hemoptysis, particularly in high-risk patients. The fungus ball's regression and the fungal infection's resolution support the growing role of more recent antifungal medications in the treatment of complicated pulmonary infections. This case suggests that echinocandins combined with triazole therapy are a viable less invasive treatment option for pulmonary aspergilloma than surgery.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Anidulafungin ; Immunocompromised Host ; Patients ; Therapeutics ; Voriconazole

BACKGROUND

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva—a potential viral reservoir—and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings.

OBJECTIVE

This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic.

METHODS

Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols.

RESULTS

Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosolgenerating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic’s engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities.

CONCLUSION

The data shows that with the guidelines posted by both the PDA and CDC, the city’s dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; World Health Organization ; Residence Characteristics ; Quarantine ; Public Health ; Centers For Disease Control And Prevention (u.s.) ; Covid-19 ; Centers For Disease Control And Prevention, U.s.

OBJECTIVES

This study explored the interplay of three Filipino cultural values—hiya (modesty/self-restraint), pakikisama (conflict-avoidance dimension of social harmony), and pakikipag-ugnayan (professional engagement, characterized by vigor, dedication, and absorption)—among Generation Z nurses in Quezon City. Specifically, it assessed their levels, examined interrelationships through correlation and path analysis, and developed a framework to illustrate their influence on nursing practice. In the Filipino context, hiya encompasses both positive dimensions, such as conscientiousness, moral accountability, and social responsibility, and constraining dimensions, including excessive self-restraint, fear of criticism, and inhibition. Pakikisama, while fostering harmony, may discourage assertiveness and limit open communication. Pakikipag-ugnayan, conceptualized here as engagement, reflects dedication, vigor, and absorption, which are vital for performance, patient safety, and workforce retention.

METHODS

A descriptive–correlational design was utilized to assess the relationships among hiya, pakikisama, and pakikipag-ugnayan. Data were gathered through a structured, self-administered questionnaire comprising validated scales for each construct, distributed in online formats to accommodate participants’ availability and work schedules. The purposive sample consisted of 115 Filipino Generation Z nurses engaged in direct patient care in various healthcare facilities in Quezon City. Data analysis involved descriptive statistics to summarize variable scores, Spearman’s rho to examine bivariate correlations, and path analysis to determine the direct and indirect effects among the variables. The results of the path analysis were used to develop a proposed framework illustrating the interplay of these cultural values in nursing practice.

RESULTS

Path analysis revealed distinct patterns in the interplay of hiya, pakikisama, and pakikipag-ugnayan among Generation Z nurses in Quezon City. Very high hiya scores (mean = 5.32) reflected both moral accountability and restraint-oriented tendencies. Despite these positive indicators, hiya showed a negative correlation with pakikipag-ugnayan, suggesting that its inhibiting side—marked by fear of criticism and avoidance of mistakes—may overshadow its constructive moral aspects. In contrast, the path analysis identified a moderate positive direct effect between hiya and pakikipag-ugnayan (β = 0.400, pCONCLUSION

Among Generation Z nurses, hiya demonstrates a dual role: while its ethical and conscientious aspects can strengthen pakikipag-ugnayan, its inhibiting side may suppress pakikipag-ugnayan. Pakikisama, operationalized as conflict avoidance and withholding dissent, emerged as a barrier to pakikipag-ugnayan by discouraging open communication. These findings informed the development of the Hiya–Pakikisama– Pakikipag-ugnayan Cultural Dynamics Framework, which illustrates how cultural values can simultaneously enable and constrain professional engagement. The framework has potential applications in nursing education and organizational practice, particularly in designing reflective learning, mentorship, and communication strategies that balance cultural sensitivity with assertiveness. Further validation across generations and healthcare settings is recommended to refine its applicability.

Human ; Weights And Measures ; Sensitivity And Specificity ; Retention (psychology) ; Education, Nursing ; Social Responsibility ; Appointments And Schedules ; Conflict (psychology)

Mechanical pain is one of the most common causes of clinical pain, but there remains a lack of effective treatment for debilitating mechanical and chronic forms of neuropathic pain. Recently, neurotoxin GsMTx4, a selective mechanosensitive (MS) channel inhibitor, has been found to be effective, while the underlying mechanism remains elusive. Here, with multiple rodent pain models, we demonstrated that a GsMTx4-based 17-residue peptide, which we call P10581, was able to reduce mechanical hyperalgesia and neuropathic pain. The analgesic effects of P10581 can be as strong as morphine but is not toxic in animal models. The anti-hyperalgesic effect of the peptide was resistant to naloxone (an μ-opioid receptor antagonist) and showed no side effects of morphine, including tolerance, motor impairment, and conditioned place preference. Pharmacological inhibition of TRPV4 by P10581 in a heterogeneous expression system, combined with the use of Trpv4 knockout mice indicates that TRPV4 channels may act as the potential target for the analgesic effect of P10581. Our study identified a potential drug for curing mechanical pain and exposed its mechanism.

Understanding microbial-host interactions in the oral cavity is essential for elucidating oral disease pathogenesis and its systemic implications. In vitro bacteria-host cell coculture models have enabled fundamental studies to characterize bacterial infection and host responses in a reductionist yet reproducible manner. However, existing in vitro coculture models fail to establish conditions that are suitable for the growth of both mammalian cells and anaerobes, thereby hindering a comprehensive understanding of their interactions. Here, we present an asymmetric gas coculture system that simulates the oral microenvironment by maintaining distinct normoxic and anaerobic conditions for gingival epithelial cells and anaerobic bacteria, respectively. Using a key oral pathobiont, Fusobacterium nucleatum, as the primary test bed, we demonstrate that the system preserves bacterial viability and supports the integrity of telomerase-immortalized gingival keratinocytes. Compared to conventional models, this system enhanced bacterial invasion, elevated intracellular bacterial loads, and elicited more robust host pro-inflammatory responses, including increased secretion of CXCL10, IL-6, and IL-8. In addition, the model enabled precise evaluation of antibiotic efficacy against intracellular pathogens. Finally, we validate the ability of the asymmetric system to support the proliferation of a more oxygen-sensitive oral pathobiont, Porphyromonas gingivalis. These results underscore the utility of this coculture platform for studying oral microbial pathogenesis and screening therapeutics, offering a physiologically relevant approach to advance oral and systemic health research.
Coculture Techniques/methods* ; Humans ; Fusobacterium nucleatum/physiology* ; Gingiva/microbiology* ; Keratinocytes/microbiology* ; Host Microbial Interactions ; Mouth/microbiology* ; Host-Pathogen Interactions ; Epithelial Cells/microbiology* ; Cells, Cultured ; Porphyromonas gingivalis

BACKGROUND

Social Innovation in Health Initiative Philippines introduced the community engagement self-monitoring strategy in two community-managed social innovations in 2021. Phase 1 demonstrated the strategy's viability by identifying community “local monitors,” selecting indicators, monitoring, and conducting feedback sessions. In 2022, a second phase was implemented to improve the process by integrating capacity-building activities and praxis sessions, and gathering insights on the strategy’s sustainability.

OBJECTIVE

In this paper, we sought to describe the stages of the CE-SM strategy applied within a Philippine local health system in geographically isolated and disadvantaged contexts. Specifically, we: 1) Identified the key competencies of the local CE-SM monitors; 2) facilitated capacity building to strengthen their skills and abilities; 3) explored sustainability mechanisms; and 4) identified integration points of the CE-SM in strengthening local health systems.

METHODS

Two communities in a rural municipality implementing a social innovation called the “Seal of Health Governance'' were chosen for the expanded community engagement self-monitoring (CE-SM) pilot. Profiling of local monitors and self-assessment of competencies were facilitated. Capacity-building activities were conducted for community engagement, data processing, and data analysis, complemented by praxis sessions guided by people-centered principles.

RESULTS

Local monitors from both communities showed determination in performing their responsibilities but differed in their levels of participation. Their appreciation of their role increased as it broadened from merely collecting data to understanding and using it to advocate for their community’s needs. The minimum resources for communities to implement the strategy include financial mechanisms to ensure the availability of resources. Local monitors have improved their ability to analyze their communities' realities, particularly regarding health leadership and governance.

CONCLUSIONS

Community engagement self-monitoring is a feasible and sustainable strategy for monitoring and evaluating health interventions if adequate support is provided and complemented by capacity-building and praxis sessions. It promotes listening to the community and empowering them to participate in decision-making, which are vital in fostering ownership and sustainability of social innovations in health.

BACKGROUND

Telemedicine as a response to the need for consultation amidst limited face to face interaction during the pandemic became part of the services of most tertiary hospitals in Davao City. In order to ensure the client’s needs are addressed by existing telemedicine services, it is important to look at the level of client satisfaction and identify factors that influence it.

OBJECTIVE

The main objective of the study was to determine the level of satisfaction and the factors influencing it among the patients of the Family Medicine Department of a tertiary hospital in Davao City on the telemedicine services they received.

METHODS

The study employed a descriptive cross-sectional design utilizing a self-administered telemedicine satisfaction questionnaire developed from the Clinician and Group Adult Visit Survey 4.0 (beta) and Telehealth Usability Questionnaire (TUQ). Participants were 18 years old and above and sought teleconsultation in the institution during the pandemic. Excluded were those who did not give consent. The data gathered were analyzed using an Epi-Info software to determine what factors were associated with level of satisfaction, a chi-square test was done for nominal and ordinal data while a t-test or ANOVA as applicable was used for continuous data.

RESULTS

A total of 278 patients were surveyed. More than ninety-five percent of the respondents perceived high satisfaction rating on the telemedicine service while less than five percent were dissatisfied. Eight factors were identified that seem to affect level of satisfaction. These include employment status, network connection and frequency of telemedicine.

CONCLUSION

The study identified that the telemedicine in SPMC DFCM provides high level of satisfaction among patients availing the service. It was also identified that factors such as employment status, network connectivity and frequency of using the service affects the level of satisfaction.

Human ; Telemedicine ; Patient Satisfaction