BACKGROUND

Continuing Medical Education (CME) serves as a cornerstone for maintaining clinical competence and improving patient care. In the Philippines, CME has become increasingly digital, with the UP Med Webinars emerging as a leading platform for physician education over the past decade. Despite this growth, there has been limited evaluation of how well these webinars align with national health priorities, particularly those reflected in PhilHealth hospital admissions and claims data, which provide insights into the country's disease burden and healthcare utilization patterns.

This study aimed to determine the extent to which the topics and reach of UP Med Webinars correspond with the Philippine health system’s most pressing clinical demands. Specifically, it aimed to analyze the trend in number of webinars by year; analyze the distribution of webinar topics by medical field; assess physician attendance as a proxy for clinical interest and engagement; evaluate the alignment between UP Med Webinar content and national health priorities based on PhilHealth’s top conditions, procedures, and reimbursed claims.

The study used a qualitative content analysis of all Continuing Professional Development (CPD)-accredited UP Med Webinars from 2015 to 2024, supported by descriptive statistics. Webinar titles were coded thematically and categorized by topic and medical field. Attendance figures were analyzed to identify high-demand topics. These results were compared with PhilHealth Claims Reports (2020–2024), focusing on the top reimbursed medical diagnoses and procedures, to assess alignment with disease burden and health service delivery trends. These findings can help inform strategic planning for CME programs to ensure they remain responsive to the country's evolving public health needs.

From 2015 to 2024, a total of 686 CPDaccredited UP Med Webinars were conducted, attended by 685,994 participants. The annual number of webinars and attendees steadily increased, peaking during the COVID-19 pandemic (2020–2022) with heightened demand for virtual CME and pandemic-related topics. Internal Medicine consistently emerged as the most frequently covered field, accounting for 54.1% of webinars and 48.8% of total attendance, followed by Obstetrics and Gynecology (14.4% of webinars; 19.6% of attendance) and Pharmacotherapeutics (6.0% of webinars; 6.9% of attendance). Certain fields, including COVID-19 and Psychiatry, attracted disproportionately high attendance despite fewer sessions, indicating strong interest during periods of public health urgency. The top 10 webinar topics included Diabetes, Pregnancy, Cancer, Hypertension, Reproductive Health, COVID-19, Heart Disease, Antimicrobial Treatment, Vertigo, and Vaccination, reflecting a mix of chronic disease management, maternal health, infectious diseases, and emergent health concerns.

Comparison with PhilHealth claims data (2020– 2024) revealed a high disease burden in Internal Medicine, Obstetrics, and Pediatrics, with top medical conditions including Pneumonia, Dengue, Hypertensive emergencies, and Stroke. These findings indicate a strong alignment between the most covered webinar topics and national healthcare utilization trends, particularly in high-burden clinical areas.

Findings suggest that the UP Med Webinars have generally aligned with national health priorities, as indicated by PhilHealth claims data, particularly in highburden fields such as Internal Medicine and Obstetrics. However, gaps in coverage for certain high-priority conditions and procedures point to opportunities for more inclusive and data-driven CME planning. Aligning CME content with evolving health system needs can enhance its relevance, support clinical practice improvements, and ultimately contribute to better population health outcomes in the Philippines.

Atherosclerosis is a primary cause of vascular disease worldwide, resulting in diverse clinical manifestations that contribute to significant morbidity and mortality. It is widely recognized as a multifactorial condition involving both metabolic and oxidative mechanisms.The initiation of atherosclerotic plaques arises from endothelial injury caused by excess lipid-carrying lipoproteins, which trigger an exaggerated pro-inflammatory response.This response is mediated by proteins such as galectin-3 (Gal-3), secreted by monocytes and macrophages, which stimulate and accelerate plaque formation. Because of its largely asymptomatic progression, atherosclerosis remains difficult to diagnose. In recent years, clinical and preclinical research on Gal-3 has expanded considerably, revealing elevated Gal-3 levels in patients with atheroma. Moreover, preclinical studies demonstrate that Gal-3 inhibition or gene suppression can effectively attenuate the development of atherosclerosis.These findings highlight the involvement of monocytes, macrophages, foam cells, and Gal-3 in the initiation and progression of the disease. Consequently, Gal-3 has emerged as a promising biomarker for endothelial dysfunction and other cardiovascular conditions.This review therefore summarizes current evidence on the role of Gal-3 in the pathogenesis, clinical features, diagnosis, treatment, and prognosis of atherosclerosis, while also encouraging discussion of Gal-3 as a potential therapeutic strategy.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Objective: To study the influence of bracket base meshes on shear bond strength and observe them using a scanning electron microscopy (SEM) before and after debonding. Methods: Ninety brackets were divided into nine groups of 10 samples each: G1-Alexander, G2-Mini Sprint® Brackets, G3-In-Ovation R CCO,  G4-Gemini SL Self-Ligating Bracket, G5-Classic mini 2G Stylus® , G6-Gemini Metal Brackets, G7-ClarityTM Advanced, G8-Crystall-Ize® , and G9-Ceramic Series Flexx 2G® . Groups G1 to G6 and G7 to G9 consisted of metallic and aesthetic brackets, respectively. Initial photographs of all brackets were taken through SEM at 25X magnification. The brackets were then bonded to premolars using TransbondTM XT, and a shear bond strength test was conducted after 24 hours using an Instron machine at 1 mm/min. After debonding, the bracket meshes were observed using SEM. Results: Before bonding, 72.22% of brackets didn’t present mesh defects, while 27.77% did. SEM analysis revealed that G4 and G5 presented defects in 100%, G7 in 40%, and G8 in 10%. The average shear bond strength of 9.67 ± 2.84 MPa and 11.21 ± 4.99 MPa were obtained for both metallic and aesthetic brackets, respectively. A Pairwise–Wilcoxon test with Benjamini–Hochberg correction was conducted to determine specific statistical differences between the groups, revealing significant differences based on bracket type and shear bond strength (P < 0.009). Conclusions This study suggested that the shape of bracket meshes influenced shear bond strength.

OBJECTIVE

This study aims to describe the design, development, and implementation of the UP Med Webinars as a method for delivering continuing medical education online.

Thematic analysis was done to organize information to describe the three phases of development: design, planning, and implementation of the UP Med Webinars for the period of 2015-2021.

The University of the Philippines Medical Alumni Society, in collaboration with seven units from the University of the Philippines Manila, contributed resources to the design of the UP Med Webinars. A committee on continuing medical education composed of alumni celebrating their silver jubilee led the planning each year. A total of 435 webinars were conducted from 2015 to 2021. Attendance steadily grew from less than 50 to more than 600 participants per session. These webinars covered a wide range of topics and were attended by medical professionals from different disciplines. Continuing professional development units were provided for free.

The UP Med Webinars was able to deliver post-graduate content online to healthcare professionals in the Philippine medical community. A well-organized set of partners collaborating to design and develop continuing medical education online was key to its continuous implementation and expansion.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Objective: To study the influence of bracket base meshes on shear bond strength and observe them using a scanning electron microscopy (SEM) before and after debonding. Methods: Ninety brackets were divided into nine groups of 10 samples each: G1-Alexander, G2-Mini Sprint® Brackets, G3-In-Ovation R CCO,  G4-Gemini SL Self-Ligating Bracket, G5-Classic mini 2G Stylus® , G6-Gemini Metal Brackets, G7-ClarityTM Advanced, G8-Crystall-Ize® , and G9-Ceramic Series Flexx 2G® . Groups G1 to G6 and G7 to G9 consisted of metallic and aesthetic brackets, respectively. Initial photographs of all brackets were taken through SEM at 25X magnification. The brackets were then bonded to premolars using TransbondTM XT, and a shear bond strength test was conducted after 24 hours using an Instron machine at 1 mm/min. After debonding, the bracket meshes were observed using SEM. Results: Before bonding, 72.22% of brackets didn’t present mesh defects, while 27.77% did. SEM analysis revealed that G4 and G5 presented defects in 100%, G7 in 40%, and G8 in 10%. The average shear bond strength of 9.67 ± 2.84 MPa and 11.21 ± 4.99 MPa were obtained for both metallic and aesthetic brackets, respectively. A Pairwise–Wilcoxon test with Benjamini–Hochberg correction was conducted to determine specific statistical differences between the groups, revealing significant differences based on bracket type and shear bond strength (P < 0.009). Conclusions This study suggested that the shape of bracket meshes influenced shear bond strength.

Background: Sepsis is a life-threatening condition that affects the cardiovascular and renal systems. Severe hypotension during sepsis compromises tissue perfusion, which can lead to multiple organ dysfunction and death. Phosphodiesterase 5 (PDE5) degrades intracellular cyclic guanosine monophosphate (cGMP) levels which promotes vasodilatation in specific sites. Our previous studies show that inhibiting cGMP production in early sepsis increases mortality, implying a protective role for cGMP production. Then, we hypothesized that cGMP increased by tadalafil (PDE5 inhibitor) could improve microcirculation and prevent sepsis-induced organ dysfunction. Methods: Rats were submitted to cecal ligation and puncture (CLP) sepsis model and treated with tadalafil (2 mg/kg, s.c.) 8 hours after the procedure. Hemodynamic, inflammatory and biochemical assessments were performed 24 hours after sepsis induction. Moreover, the effect of tadalafil on the survival of septic rats was evaluated for 5 days. Results: Tadalafil treatment improves basal renal blood flow during sepsis and preserves it during noradrenaline infusion. Sepsis induces hypotension, impaired response to noradrenaline, and increased cardiac and renal neutrophil infiltration, in addition to increased levels of plasma nitric oxide and lactate. None of these dysfunctions were changed by tadalafil. Additionally, tadalafil treatment did not increase the survival rate of septic rats. Conclusions Tadalafil improved microcirculation of septic animals; however, no beneficial effects were observed on macrocirculation and inflammation parameters. Then, the potential benefit of tadalafil in the prognosis of sepsis should be evaluated within a therapeutic strategy covering all sepsis injury mechanisms.

The liver hanging maneuver (LHM), introduced by Belghiti et al. in 2001, has been widely adapted to various hepatectomy techniques to reduce blood loss and facilitate parenchymal transection. However, its primary limitation is the risk of vascular injury, particularly near the inferior vena cava (IVC). In this report, we describe a modified “Loop-Hanging” maneuver designed as an alternative to enhance exposure during parenchymal transection and improve the control of Glissonean pedicles. In this case, we employed the technique during an open right hemihepatectomy on a 47-year-old male patient with a complex bile duct injury following two unsuccessful Roux-en-Y hepaticojejunostomies (RYHJ). The patient was referred to our institution due to an RYHJ stricture. Imaging identified a right hepatic artery pseudoaneurysm and a fistula to the biliary limb. After two failed attempts at endovascular embolization, a surgical approach was determined through multidisciplinary discussions. During the surgery, the liver was looped with a nasogastric tube positioned anterior to the IVC, allowing gentle upward traction that facilitated the transection, minimized bleeding, and enhanced pedicle control. The LHM is known to reduce blood loss but carries risks for patients with anatomical variations, scarring, or cirrhosis.Our “Loop-Hanging” technique retains the core advantages of LHM, simplifies the process, and diminishes the risk of vascular injury.Further research is required to assess its safety and broader applicability.