[Show abstract][Hide abstract] ABSTRACT: To assess the potential risk of tuberculosis (TB) in patients treated with anti-tumor necrosis factor-alpha (TNF-α) agents in Asia.
Absolute risk increase (ARI) of TB was estimated for three widely used anti-TNF-α therapies using published standardized incidence ratios (SIR) from the French Research Axed on Tolerance of bIOtherapies registry and incidence (absolute risk [AR]) of TB in Asia. Assuming an association of increased TB risk with anti-TNF-α therapy and country TB AR (incidence), the ARI of TB by country was calculated by multiplying the SIR of the anti-TNF-α therapy by the country's TB AR. The numbers needed to harm (NNH) for each anti-TNF-α agent and numbers needed to treat (NNT) to reduce one TB event using etanercept therapy instead of adalimumab or infliximab were also calculated for each country.
The ARI of TB with anti-TNF-α therapies in Asian countries is substantially higher than Western Europe and North America and the difference between etanercept versus the monoclonal antibodies becomes more evident. The NNH for Asian countries ranged from 8 to 163 for adalimumab, 126 to 2646 for etanercept and 12 to 256 for infliximab. The NNT to reduce one TB event using etanercept instead of adalimumab therapy ranged from 8 to 173, and using etanercept instead of infliximab therapy the NNT ranged from 13 to 283.
Higher numbers of patients are at risk of developing TB with anti-TNF-α therapy in Asia compared with Western Europe and North America. The relative lower risk of TB with etanercept may be particularly relevant for Asia, an endemic area for TB.
International Journal of Rheumatic Diseases 10/2013; 17(3). DOI:10.1111/1756-185X.12188
[Show abstract][Hide abstract] ABSTRACT: This paper is the first to present the incidence and overall survival of patients with squamous cell carcinoma of the head and neck (SCCHN) from the extreme northern part of the Philippines. We retrospectively retrieved the records of patients with histologically-confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx and larynx at the Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines, from 2003 to 2012 and analysed prognostic factors associated with survival. Of the 150 cases, only 80 (53.3%) were still living when the study was terminated. Median age at initial diagnosis was 61.5 years and the male to female ratio was 7:3. The majority of the cases had tumours in the oral cavity (50.7%), followed by the larynx (36.7%). Sex (log rank=1.94, p value/α=0.16), tumor site (log rank=0.02, p value/α=0.90), tumor grade (log rank=1.74, p value/α=0.42), and node stage (log rank=0.07, p value/α=0.80) were not shown to be associated with the survival of our cases. Only 45 (30.0%) had no regional lymph node involvement (N0) at presentation and 12 (8.0%) had already developed distant metastases. Among the 150 patients, 71 (47.3%) were not able to receive treatment of any kind. Oddly, treatment (log rank=1.65, p value/α=0.20) was also shown to be not associated with survival. The survival rate of those who underwent surgery, radiotherapy, or both was not statistically different from those who did not receive any treatment. Only the tumor stage (log rank=4.51, p value/α=0.03) was associated with patient survival. The overall mean survival was 49.3 months, with survival rate diminishing from 88.3% during the 1st year to 1.80% by end of the study. This relatively low survival rate of our cases only reflects their poor access to quality diagnostic and treatment facilities.
Asian Pacific journal of cancer prevention: APJCP 08/2013; 14(8):4769-4774. DOI:10.7314/APJCP.2013.14.8.4769
[Show abstract][Hide abstract] ABSTRACT: The study aimed to assess the association between childhood obesity and snacking. A total of 396 students in grades 4 to 6 enrolled in an elementary school in the Philippines were the participants in this study. Demographic profile; anthropometric measures of height, weight, body mass index; and information about snacking were gathered. Obese group had statistically more servings of sweetened drinks and low-quality snacks. Female obese subjects have statistically more servings at nighttime and greater total snack servings. For the whole cohort, the odds ratio of being overweight with high total snack servings was 2.12 (95% confidence interval = 1.25-3.62) whereas the odds ratio of being obese with calories obtained from snacking was 2.08 (95% confidence interval = 1.01-4.26). Nighttime snacks and bad-quality foods should be minimized. Moreover, reducing food portions at any snack time will protect children from being overweight.
Asia-Pacific Journal of Public Health 07/2013; 27(2). DOI:10.1177/1010539513491416
[Show abstract][Hide abstract] ABSTRACT: Background and Objectives: Cancer Rehabilitation is currently not a common area of practice for Filipino Physical Therapists (PT). The study aims to obtain the perspectives of Filipino PTs about the present state of cancer rehabilitation in the country, particularly: (1) to know if there are existing protocols in cancer care; (2) to identify the role of PTs in rehabilitating patients with cancer and; (3) to determine the preparedness of Filipino PTs in handling these patients.
Methods: A descriptive qualitative study was conducted. Two focus group discussion (FGD) were organized and participated by a total of 13 licensed Filipino Physical Therapists (M:7; F:6) who are currently working in tertiary hospitals in Metro Manila where patients with cancer are referred to physical therapy services. The mean length of clinical experience of the participants is 4 years.
Analysis: Thematic Analysis was utilized to analyze the transcribed and validated data obtain from the 2 FGDs.
Results and Conclusion: Filipino PTs expressed that cancer rehabilitation in the country is not well established and that there is no current existing protocol being observed in their respective hospitals. This is compounded by the limited number of referrals due to the lack of awareness among oncologists as well as knowledge of general population about what PTs can do for patients with cancer. The participants conveyed that the major role of PTs in cancer rehabilitation is to improve level of function and quality of life. They also expressed that in terms of readiness to handle patients with cancer, there is lack of knowledge in this area which they consider as a specialized area of practice.
Recommendations: Further studies need to be conducted to explore the status of cancer rehabilitation in other areas of the country. Awareness campaign must be done to promote services that PTs can provide specifically for patients with cancer among oncologists and the general population. There is also a need to evaluate the current curriculum used in PT schools to determine the amount of course work devoted in undergraduate or graduate studies about cancer care.
Keywords: cancer rehabilitation, physical therapy, focus group discussion, perspectives
Hong Kong Physiotherapy Journal 06/2013; 31(1):48–49. DOI:10.1016/j.hkpj.2013.01.015