1.Clinical profile and outcomes of thyroid storm at the University of Santo Tomas Hospital: A 10-year retrospective review in the 21st century
Jeannine Ann O. Salmon ; Ma. Felisse Carmen S. Gomez-Tuazon ; Maria Honolina S. Gomez
Philippine Journal of Internal Medicine 2025;63(1):16-22
BACKGROUND
Thyroid storm (TS) continues to be a diagnostic and therapeutic challenge. It is a life-threatening severe thyrotoxicosis characterized by organ decompensation. This study aims to determine if there are any changes in this present century about TS diagnosis and management. Furthermore, it aims to describe the clinical profile, precipitants, and outcomes of patients with TS seen at the University of Santo Tomas Hospital (USTH) and assess the association of patient characteristics with mortality.
METHODSThis is a retrospective cohort analysis of patients with TS admitted at USTH from 2009 through 2018. Logistic regression analysis was used to determine the association of age, Burch Wartofsky-Point Scale (BWPS) score, clinical manifestations, and precipitating factor with mortality.
RESULTSA total of 21 cases were identified. Majority of the patients were female (90.48%) with a mean age of 42.90 years old. The overall mean BWPS was 49.52 (16.35) while those who expired had higher mean score of 61.67 (5.77). TS as the first clinical presentation was seen in only one patient (4.7%) while majority were previously diagnosed with hyperthyroidism, (95.24%). Graves’ disease (90.48%) was the most common etiology of thyrotoxicosis. Cardiac manifestations were predominant and tachycardia was the most common clinical manifestation (80.95%) with thyrotoxic heart disease as a comorbidity (23.81%). The most common precipitant was infection (52.38%) followed by noncompliance with treatment. The mean hospital length of stay was four days with two patients needing intubation, and both expired afterward. There were three mortalities (14.29%) due to multiple organ dysfunction and fatal arrythmia.
CONCLUSIONTS remains a life-threatening condition. Aggressive treatment is justified once with suspicion of TS. Age, BWPS on admission, clinical manifestation and precipitants did not predict the likelihood of mortality. Since predictive features are still not thoroughly identified due to its infrequency, it remains for us to be vigilant and not delay crucial treatment to improve the morbidity and mortality associated with TS.
Human ; Thyroid Storm ; Thyroid Crisis ; Precipitating Factors
2.Factors associated with stunting among infants and young children in the Fourth District of Camarines Sur, Philippines.
Jeena Sandra R. MANRIQUE-DE HITTA ; Kim Leonard G. DELA LUNA ; Anna Paulina S. RODRIGUEZ ; Mildred O. GUIRINDOLA
Acta Medica Philippina 2025;59(9):62-71
OBJECTIVE
This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.
METHODSAn analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a two stage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.
RESULTSThe study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.
CONCLUSIONThis study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.
Human ; Growth Disorders ; Risk Factors ; Nutritional Status ; Infant Nutrition Disorders
3.Factors associated with mealtime behaviors among Filipino children aged 3–11 years old diagnosed with autism spectrum disorder using the Filipino version of the Brief Autism Mealtime Behavior Inventory (BAMBI) questionnaire: a cross-sectional study
Carolyn Grace T. Madariaga ; Ermenilda L. Avendañ ; o ; Maria Fatima D. Chiong-Boniol
The Philippine Children’s Medical Center Journal 2025;21(1):56-85
:
This study aimed to identify risk factors associated with problematic mealtime behaviors in Filipino children aged 3-11 years diagnosed with ASD and to validate the Filipino-translated Brief Autism Mealtime Behavior Inventory (BAMBI) for clinical use. The study examined demographics, socioeconomic status, and clinical characteristics of children with ASD in relation to feeding difficulties.
MATERIALS AND METHODS:
A cross-sectional study was conducted with 166 caregivers of Filipino children with ASD at the Philippine Children’s Medical Center. The BAMBI questionnaire, translated and validated into Filipino, was administered among patients evaluated under the Section of Neurodevelopmental Pediatrics. Content validity was established through neurodevelopmental pediatric experts, while face validity was achieved with feedback from 17 caregivers during the pilot test. Descriptive statistics and logistic regression were performed to identify the factors.
RESULTS:
The Filipino-translated BAMBI demonstrated good content and face va- lidity based on reviews and pilot testing. The tool showed acceptable internal consistency with a Cronbach’s alpha of 0.75, indicating good reliability. Seventy-seven percent (77%) of participants scored above the threshold for problematic mealtime behaviors, with multivariate analysis revealing a significant association between these behaviors and sensory sensitivities (OR = 3.0, 95% CI: 1.2 to 7.3, p = 0.0150). Additional factors, such as dietary habits and family structure, also showed trends toward significance but did not reach statistical significance.
CONCLUSIONS AND RECOMMENDATIONS
This study validates the Filipino BAMBI as a reliable tool for assessing mealtime behaviors in children with ASD, highlighting the high prevalence of feeding problems in this population. Sensory sensitivities emerged as a significant factor contributing to problematic mealtime behaviors, underscoring the importance of incorporating sensory processing strategies in interventions. Further research should explore other contributing factors, such as dietary habits and family dynamics, to develop more comprehensive, tailored interventions for children with ASD and their families.
Autism spectrum disorder
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mealtime behaviors
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feeding difficulties
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BAMBI
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parent questionnaire
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risk factors
4.Cardiovascular risk in medical students: Is living alone a factor?.
Cyrille Jane O. BARRION ; Christine Gabrielle R. BIEN ; Arian Jaya B. CABALLERO ; Julian John L. CAI ; Jovinian Aji D. DE LA CRUZ ; Jerahmeel Matthew G. DE LEON ; Michelle Anne Maree Y. DEL PILAR ; Francis Charles L. FERNANDEZ ; Jose Ronilo G. JUANGCO
Health Sciences Journal 2025;14(1):24-29
INTRODUCTION
Cardiovascular diseases (CVD) are a leading global health concern. Modifiable behavioral risk factors are increasingly recognized in young adults, especially among medical students who often live independently. This study investigated the association between living alone and modifiable cardiovascular risk factors—sleep quality, sodium intake, physical activity, and body mass index (BMI)—among medical students at UERMMMCI during the 2022-2023 academic year.
METHODSResearchers conducted an analytical cross-sectional study among 220 medical students. Validated tools were used: Pittsburgh Sleep Quality Index (PSQI), Scored Sodium Questionnaire, International Physical Activity Questionnaire (IPAQ), and BMI classification. Researchers performed statistical analyses using Chi-square tests and calculated relative risks (RR) with 95% confidence intervals.
RESULTSA significant positive association was found between living alone and poor sleep quality (RR 2.132 p = 0.047). No significant associations were observed between living alone and sodium intake (RR 0.96 p = 0.6868), physical activity (RR 1.18 p = 0.2239), or BMI (RR 1.03 p = 0.7367).
CONCLUSIONAmong the studied cardiovascular risk factors, only poor sleep quality was significantly more prevalent among students living alone. These findings highlight the importance of interventions targeting sleep hygiene in this demographic.
Human ; Cardiovascular Diseases ; Risk Factors ; Students, Medical ; Sleep Quality ; Living Alone ; Home Environment
5.Risk factors and onset of illicit drug use among Filipino youth: A cross-sectional analysis of sociodemographic and environmental influences.
Enrico U. BAULA ; Kim Ronaline B. SALVADOR ; Laurie S. RAMIRO ; Andrea B. MARTINEZ ; Gaea Marelle J. MIRANDA ; Jan Zsanila D. ESTACIO ; Rowalt C. ALIBUDBUD ; Leonardo R. ESTACIO JR.
Acta Medica Philippina 2025;59(14):145-155
BACKGROUND AND OBJECTIVES
The drug problem in the Philippines is influenced by various factors, but research on the specific risk factors and onset of drug use—an early predictor of severe drug abuse—is limited. This crosssectional study aims to identify factors associated with the onset of illicit drug use, focusing on variables such as sex, perceived socioeconomic status, adverse life events (including physical, verbal, and sexual abuse, and bullying), adverse home environments (like family substance abuse and parental separation), and premorbidities (such as anxiety and depression). Understanding these factors is crucial since early drug use often predicts more severe abuse later.
METHODSThis cross-sectional study involved 354 participants aged 7 to 34 years, all undergoing rehabilitation for at least three months. Data were collected through self-administered questionnaires at their rehabilitation centers. Regression analysis was used to examine the relationship between the onset of drug use and the identified risk factors.
RESULTSRegression analysis revealed that, apart from premorbidities, all the examined factors were significantly correlated with the onset of drug use. Specifically, being male, having higher affluence, experiencing more adverse life events, and living in a more adverse home environment were associated with an earlier onset of drug use. Among these factors, adverse life events and home environment were the strongest predictors of the onset of illicit drug use, while premorbidities did not show a significant relationship with drug use onset.
CONCLUSIONThe study highlights that sex, socioeconomic status, adverse life events, and home environment are significant in the early onset of drug use, while premorbidities are not. Early intervention should focus on these key risk factors. A risk-focused approach, guided by biopsychosocial perspectives, is recommended. Targeted interventions should address adverse life events and home environments to prevent early drug use and subsequent abuse effectively.
Human ; Risk Factors ; Home Environment
8.Expert consensus on fundus photograph-based cardiovascular risk assessment using artificial intelligence technology.
Chinese Journal of Internal Medicine 2024;63(1):28-34
Cardiovascular risk assessment is a basic tenet of the prevention of cardiovascular disease. Conventional risk assessment models require measurements of blood pressure, blood lipids, and other health-related information prior to assessment of risk via regression models. Compared with traditional approaches, fundus photograph-based cardiovascular risk assessment using artificial intelligence (AI) technology is novel, and has the advantages of immediacy, non-invasiveness, easy performance, and low cost. The Health Risk Assessment and Control Committee of the Chinese Preventive Medicine Association, in collaboration with the Chinese Society of Cardiology and the Society of Health Examination, invited multi-disciplinary experts to form a panel to develop the present consensus, which includes relevant theories, progress in research, and requirements for AI model development, as well as applicable scenarios, applicable subjects, assessment processes, and other issues associated with applying AI technology to assess cardiovascular risk based on fundus photographs. A consensus was reached after multiple careful discussions on the relevant research, and the needs of the health management industry in China and abroad, in order to guide the development and promotion of this new technology.
Humans
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Cardiovascular Diseases/prevention & control*
;
Artificial Intelligence
;
Consensus
;
Risk Factors
;
Heart Disease Risk Factors
9.Predicting the Risk of Arterial Stiffness in Coal Miners Based on Different Machine Learning Models.
Qian Wei CHEN ; Xue Zan HUANG ; Yu DING ; Feng Ren ZHU ; Jia WANG ; Yuan Jie ZOU ; Yuan Zhen DU ; Ya Jun ZHANG ; Zi Wen HUI ; Feng Lin ZHU ; Min MU
Biomedical and Environmental Sciences 2024;37(1):108-111
10.Not only baseline but cumulative exposure of remnant cholesterol predicts the development of nonalcoholic fatty liver disease: a cohort study.
Lei LIU ; Changfa WANG ; Zhongyang HU ; Shuwen DENG ; Saiqi YANG ; Xiaoling ZHU ; Yuling DENG ; Yaqin WANG
Environmental Health and Preventive Medicine 2024;29():5-5
BACKGROUND AND AIM:
Remnant cholesterol (remnant-C) mediates the progression of major adverse cardiovascular events. It is unclear whether remnant-C, and particularly cumulative exposure to remnant-C, is associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to explore whether remnant-C, not only baseline but cumulative exposure, can be used to independently evaluate the risk of NAFLD.
METHODS:
This study included 1 cohort totaling 21,958 subjects without NAFLD at baseline who underwent at least 2 repeated health checkups and 1 sub-cohort totaling 2,649 subjects restricted to those individuals with at least 4 examinations and no history of NAFLD until Exam 3. Cumulative remnant-C was calculated as a timeweighted model for each examination multiplied by the time between the 2 examinations divided the whole duration. Cox regression models were performed to estimate the association between baseline and cumulative exposure to remnant-C and incident NAFLD.
RESULTS:
After multivariable adjustment, compared with the quintile 1 of baseline remnant-C, individuals with higher quintiles demonstrated significantly higher risks for NAFLD (hazard ratio [HR] 1.48, 95%CI 1.31-1.67 for quintile 2; HR 2.07, 95%CI 1.85-2.33 for quintile 3; HR 2.55, 95%CI 2.27-2.88 for quintile 4). Similarly, high cumulative remnant-C quintiles were significantly associated with higher risks for NAFLD (HR 3.43, 95%CI 1.95-6.05 for quintile 2; HR 4.25, 95%CI 2.44-7.40 for quintile 3; HR 6.29, 95%CI 3.59-10.99 for quintile 4), compared with the quintile 1.
CONCLUSION
Elevated levels of baseline and cumulative remnant-C were independently associated with incident NAFLD. Monitoring immediate levels and longitudinal trends of remnant-C may need to be emphasized in adults as part of NAFLD prevention strategy.
Adult
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Humans
;
Cohort Studies
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Non-alcoholic Fatty Liver Disease/etiology*
;
Cholesterol
;
Proportional Hazards Models
;
Risk Factors


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