BACKGROUND

Aging is an inevitable aspect of life, and to create a plan for healthy aging, it is crucial to determine the prevalence of geriatric syndromes. This information is essential to reduce morbidity and mortality and to develop tailored intervention programs.

To determine the clinical utility of the 10-minute Geriatric Screener as a screening tool at the Outpatient Department in Southern Philippines Medical Center; and to determine the prevalence of geriatric syndrome and its associated risk factors.

Prospective cross-sectional study design. The study was conducted in the Southern Philippines Medical Center Outpatient Department. This study evaluated 170 geriatric patients at the Southern Philippines Medical Center.

There were 110 cases (164.71%) classified as a low-risk level and 60 (35.29%) as high-risk. Sex does not significantly dictate a pattern of geriatric syndrome classification (X2=0.006; p=0.936). However, a marginal significance was seen for civil status, where widowed patients have a high risk of geriatric syndrome (X2=7.506; p=0.057). Patients with a high risk of geriatric syndrome are significantly older (69+5.91 vs. 65+.98; t=4.014; pCONCLUSION

Those patients aged more than 70 years old, widowed, visually impaired, and with physical disability will more likely be classified as high-risk geriatric syndrome. These findings underscore the complex interplay of age and specific health conditions in determining risk profiles, suggesting the need for targeted interventions and further investigation into the nuanced factors influencing health risks in similar populations.

BACKGROUND

Patients with diabetes are vulnerable and highly susceptible to contracting COVID-19. Stress hyperglycemia ratio (SHR) may provide prognostic information in hospitalized patients. It is debatable whether stress hyperglycemia directly leads to poor outcomes, or is simply a marker of increased stress and inflammation.

This study investigates whether high SHR is associated with poor clinical outcomes among patients with type 2 diabetes mellitus (T2DM) and moderate to critical COVID-19 infection. Moreover, this study aims to compare high SHR versus absolute hyperglycemia as a predictor of poor outcomes.

A chart review was conducted on 146 COVID-19 patients with T2DM from March 2020 to December 2021. The area under the receiver operating curve was conducted to categorize SHR into low and high levels. The association of high SHR levels and absolute hyperglycemia with outcomes was analyzed using the regression analysis. Survival analysis was also utilized to allow differences in the time when in-hospital mortality occurred.

Patients with high SHR had a significantly higher proportion of mortality and invasive ventilation compared to those with low SHR. High SHR significantly increased the likelihood of invasive ventilation by 16.49 times and mortality hazards by 5.70 times compared to low SHR. Kaplan-Meier survival curves showed that those with high SHR had significantly lower survival rates than those with low SHR. In contrast, the survival estimates between those with and without absolute hyperglycemia were not statistically significant.

High SHR (>1.082) was associated with poorer outcomes, increased invasive mechanical ventilatory support and increased mortality.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to an association between COVID-19 and pediatric diabetes. Studies have indicated the increased likelihood of children with COVID-19 infection developing diabetes. Our objective was to assess not only the increase in pediatric diabetes at our hospital and identify possible risk factors, but also to correlate the psychosocial changes resulting from the pandemic with new-onset diabetes. Methods: We analyzed data from 58 children aged 1 to 18 years admitted to our hospital with new-onset diabetes between March 2020 and December 2021. The data included inflammatory biomarkers and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies (Abs), as well as the results of a lifestyle questionnaire. Results: The average number of hospital admissions per month for new-onset diabetes increased from 10 to 18 with the start of the pandemic. Of the 58 children in our analysis, 33% had positive SARS-CoV-2 IgG Ab, 31% had type 1 diabetes mellitus, and 62% had type 2 diabetes mellitus (T2DM). More than half (54%) were experiencing diabetic ketoacidosis. Those with T2DM were older, majority African American, had higher median body mass index (BMI) percentiles, and lower vitamin D levels. There were no significant correlations between any psychosocial risk factors and either diabetes type or SARS-CoV2 Ab status. Conclusion Despite the increased incidence of new-onset diabetes among children in Mississippi during the pandemic, this study was unable to demonstrate a significant correlation between COVID-19 infection and new-onset diabetes. The findings of this study highlighted the correlation between increased BMI and type 2 diabetes, underscoring the significant problems of obesity and diabetes in our study region. Further research is warranted.

Executive Summary Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance imaging. Men with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers (Queen Mary Hospital and Princess Margaret Hospital, Hong Kong, China) between January 2017 and June 2022 were included. Ultrasound-magnetic resonance imaging fusion biopsies were performed after prostate health index testing. Those who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were analyzed. Out of the 747 patients, 47.3% had Prostate Imaging Reporting and Data System score 3 lesions only. The detection rate of clinically significant prostate cancer in this group was 15.0%. The cancer detection rates of clinically significant prostate cancer had statistically significant differences: 5.3% in prostate health index <25.0, 7.4% in prostate health index 25.0-34.9, 17.9% in prostate health index 35.0-54.9, and 52.6% in prostate health index ≥55.0 (P < 0.01). Among the patients, 26.9% could have avoided a biopsy with a prostate health index <25.0, at the expense of a 5.3% risk of missing clinically significant prostate cancer. Prostate health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 lesions. Biopsies could be avoided in patients with low prostate health index, with a small risk of missing clinically significant prostate cancer.

Magnetic resonance neurography (MRN) is increasingly used to visualize peripheral nerves in vivo. However, the implementation and interpretation of MRN in the brachial and lumbosacral plexi are challenging because of the anatomical complexity and technical limitations. The purpose of this article was to review the clinical context of MRN, describe advanced magnetic resonance (MR) techniques for plexus imaging, and list the general categories of utility of MRN with pertinent imaging examples. The selection and optimization of MR sequences are centered on the homogeneous suppression of fat and blood vessels while enhancing the visibility of the plexus and its branches. Standard 2D fast spin-echo sequences are essential to assess morphology and signal intensity of nerves. Moreover, nerve-selective 3D isotropic images allow improved visualization of nerves and multiplanar reconstruction along their course. Diffusion-weighted and diffusion-tensor images offer microscopic and functional insights into peripheral nerves. The interpretation of MRN in the brachial and lumbosacral plexi should be based on a thorough understanding of their anatomy and pathophysiology. Anatomical landmarks assist in identifying brachial and lumbosacral plexus components of interest. Thus, understanding the varying patterns of nerve abnormalities facilitates the interpretation of aberrant findings.

Objective: Neurosurgical boot camps allow trainees to hone practical skills in a risk-free environment, but the models and simulators used are relatively costly. In developing countries like the Philippines, low-cost alternatives have to be devised. The authors aimed to demonstrate the feasibility of using local, readily available, and inexpensive tropical fruits as surrogate models for basic neurosurgical skills training during a neurosurgical boot camp. Methods: Locally available tropical fruits were used to teach basic neurosurgical skills to trainees. Coconut, pomelo, and watermelon were used as models for head clamp application, scalp and dural suturing, and ventriculostomy, respectively. Feedback was obtained from the participants after the boot camp. Results: All eight residents thought that the boot camp was useful in learning new skills, and that the fruit models served their purpose. The trainees favored the fruit models that catered to the skill sets required according to level of training. The use of tropical fruits in the boot camp also provided an informal atmosphere that was conducive to learning. Conclusion The novel use of tropical fruits as surrogate models in basic neurosurgical skills training was a feasible and affordable alternative in resource-limited settings, although the activity was perceived to be more useful to junior than to senior residents. The informal atmosphere generated by the use of the fruits contributed to an improved learning experience for the trainee.
Teaching ; Simulation Training ;

Research Question: What is the current status of self-efficacy beliefs towards research and research utilization (RU) of University of Santo Tomas Faculty of Medicine and Surgery (UST-FMS) graduates who had Clinical Epidemiology in their basic medical education curriculum?

Significance of the Study: There is an increase in research and RU trends globally as adherence to practice based on evidence results in improved patient outcomes. Limited studies are available in describing research and RU of Filipino physicians and there is no study available specific for UST-FMS graduates.

Objectives: The study aims to describe self-efficacy beliefs towards research and RU of UST-FMS graduates' batches 2012-2016 who had Clinical Epidemiology in their basic medical education.

Study Design: A single-center, quantitative descriptive survey design was used.

Methodology: Participants were graduates of UST-FMS batches 2012-2016, currently working at the University of Santo Tomas Hospital. Evidence-based Practice Confidence Scale (EPIC scale) and Edmonton Research Orientation Survey (EROS) were used to assess the research and RU of the participants gathered through snowball sampling.

Statistical Analysis: Descriptive statistics such as means and standard deviations were used to analyze the EPIC and EROS scores.

Results: The UST-FMS graduates value research and are generally confident in their ability to participate in evidence-based medicine. However, they rarely conduct research and have a low understanding of statistics.

Conclusion: The self-efficacy beliefs of USTFMS graduates towards research and RU may be attributed to several factors. Clinical epidemiology as a subject may be improved by adding more lectures on statistics while hospitals should create avenues to support the conduct of research.

Platelet concentrates are derivatives of blood that aid in haemostasis and wound healing after periodontal regenerative procedures. Its ability to act as a natural scaffold of growth factors has gained significance in many surgical procedures. This narrative review discusses the different platelet concentrates, their centrifugation protocols, advantages and disadvantages and their application in periodontal regenerative procedures. An electronic search of PubMed or MEDLINE was conducted for relevant material from the published literature up to 2020. The key words looked for were “Platelet concentrates, Platelet rich plasma, Platelet rich fibrin and periodontal regeneration.” We have used the filters comparative human studies, animal studies, randomized controlled trials, case reports and systematic reviews. The searches were limited to articles in English language and articles describing platelet concentrates and its relation to periodontal regeneration were collected and used to prepare a concise review.

Purpose: To better understand the benefits and harms of engagement with online pediatric liver disease communities within social media. Methods: We conducted a survey of caregivers of children with liver disease participating in online pediatric liver disease communities within social media, as well as a survey of healthcare providers (e.g., physicians, surgeons, nurse coordinators) from this field to better understand the perceived benefits and harms of participation. Results: Among 138 caregivers of children with liver disease that completed the survey, 97.8% agreed social media was a good place to learn about patient experiences and 88% agreed it was a good source of general information. Among caregivers, 84.8% agreed social media helps them to better advocate for their child. While 18% agreed that the information over social media was equal to the information from their healthcare team and 19% neither agreed/disagreed, only 3% indicated they would use this information to change care without telling their provider; in contrast, among 217 healthcare providers, 55% believed social media may lead caregivers to change management without telling their team. Conclusion Engagement with online disease-specific communities in social media yields several benefits for caregivers and, in contrast to healthcare providers' concerns, participation is unlikely to lead to problems including caregivers changing the treatment plan without first discussing these plans with their team. Openness between caregivers and medical teams about the role for social media can help to improve trust and maximize the potential benefits of engagement with these groups.