University of the Philippines Manila

About: University of the Philippines Manila is a education organization based out in Manila, Philippines. It is known for research contribution in the topics: Population & Medicine. The organization has 2218 authors who have published 2357 publications receiving 88781 citations. The organization is also known as: UPM.

Governance and management of national telehealth programs in Asia.

Abstract: UNLABELLED Telehealth and telemedicine are increasingly becoming accepted practices in Asia, but challenges remain in deploying these services to the farthest areas of many developing countries. With the increasing popularity of universal health coverage, there is a resurgence in promoting telehealth services. But while telehealth that reaches the remotest part of a nation is the ideal endpoint, such goals are burdened by various constraints ranging from governance to funding to infrastructure and operational efficiency. OBJECTIVES enumerate the public funded national telehealth programs in Asia and determine the state of their governance and management. METHOD Review of literature, review of official program websites and request for information from key informants. CONCLUSIONS While there are national telehealth programs already in operation in Asia, most experience challenges with governance and subsequently, with management and sustainability of operations. It is important to learn from successful programs that have built and maintained their services over time. An IT governance framework may assist countries to achieve success in offering telehealth and telemedicine to their citizens.

An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults

Abstract: Background Mycobacterium tuberculosis (TB) is common worldwide, but is rarely reported after hematopoietic transplantation (HSCT). We reviewed all TB cases among HSCT since 2010 to provide an update on its epidemiology, clinical presentation, management and outcome. Methods Several databases were reviewed from January 1, 2010 to June 30, 2018 using key words tuberculosis and hematopoietic transplantation. Results The 47 cases of TB were reported during the study period. The highest TB frequency was reported from India (2.9%), with a median frequency of 2% (range, 0.18%-2.9%). The majority were recipients of allogeneic transplants (45/47, 95.7%). Pulmonary TB was the most common clinical presentation (20/47, 42.6%). The median time to clinical presentation was 4.6 (range, 3-12.9) and 2.4 (range, 0.6-5) months, based on cohort data and case reports, respectively. Fever was reported in 87.5% (14/16) of patients. First-line quadruple drug therapy was frequently used (29/35, 82.9%), with a median length of 12 and 9 months for cohorts and case reports, respectively. All-cause and attributable mortality was 27.6% (13/47), and 8.5% (4/47), respectively. Conclusions Mycobacterium tuberculosis presents early after HSCT, most commonly as fever. A high index of suspicion is needed for early diagnosis and treatment, to prevent TB-attributable mortality.

Do doctors under-provide, over-provide or do both? Exploring the quality of medical treatment in the Philippines

Abstract: Objective. To assess the quality of medical treatment by disaggregating quality into components that distinguish between insufficient and unnecessary care. Design. Randomly selected doctors were asked how they would treat a sick child. Their responses were disaggregated into how much of an evidence-based essential treatment plan was completed and the number of additional non-essential treatments that were given. Key variables included the expected cost, the health consequences of insufficient and unnecessary care and comparisons between public and private physicians. Responses to 160 clinical performance vignettes (CPVs) were analysed.

Predictive Factors of Gastrointestinal Caustic Injury According to Clinical and Endoscopic Findings

Abstract: Background: Ingestion of caustic substances is the main reason for referral to Philippines National Poison Management and Control Center among other causes of acute poisoning. Rapid assessment of severity of injury is important for treatment and prognosis of these cases. This study was aimed to investigate the correlation of clinical factors with severity of gastrointestinal (GI) mucosal injury. Methods: In this retrospective study, a total of 105 patients were included. Patients were categorized into two groups including 35 patients with low grade and 70 patients with high grade GI injury to compare the predictive value of clinical findings. Results: Mean (SD) age of patients was 27 (10) and 47% of patients were male. Oral burns (P<0.001), dysphagia (P=0.001), hematemesis (P<0.001), number of presenting symptoms (P=0.001), and type of substance consumed (P<0.001) were significantly different between patients with high grade and low grade GI injuries. Multivariate analysis showed that only leukocytosis was a significant predictor of higher grades of GI injury (OR=17.3, P=0.004). Nevertheless, dysphagia (OR=8.1), and higher number of manifestations (OR=2.8) on initial evaluation could be considered as weak factors as they did not reach significance (P=0.09). Conclusion: Following caustic substance injury, prompt assessment of severity of GI injury according to endoscopic and physical examinations can facilitate better treatment plan and prognosis. Patients with leukocytosis should be more carefully monitored as they might be injured with higher grades of GI mucosal lesions.

Method of cooking and risk of breast cancer in the Philippines.

Abstract: Among Asian countries, the highest age-standardized rates of breast cancer have been reported for the Philippines The influence of diet and lifestyle factors as possible contributors to these high rates has not been well-studied We conducted a case-control study in Manila to examine the association between methods of cooking and the risk of breast cancer Eligible subjects were women undergoing evaluation at the Philippine General Hospital (PGH), Manila for a breast problem All of the women completed a risk factor questionnaire prior to the determination of their case (n = 240) or control (n = 240) status Information regarding current, as well as usual method of cooking in the household at 12 years of age was obtained Boiling food in coconut milk was associated with a significantly increased risk of breast cancer (odds ratio (OR) = 22; 95% confidence interval (CI) 13–38) There were positive associations between boiling food in coconut milk and the risk of breast cancer currently (OR = 19; 95% CI 10–33), and at 12 years of age (OR = 29; 95% CI 16–55) A positive association between frying food and breast cancer risk was restricted to women whose household fried food at 12 years of age (OR = 189; 95% CI 11–34) The results of this study suggest that various cooking methods during adolescence and possibly in adulthood may be associated with an increased risk of breast cancer These findings require confirmation