Recent publications


  • No preview · Article · Nov 2015 · Asian Journal of Pharmaceutical Sciences
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    ABSTRACT: Pyrostria triflora, a new species of the tribe Vanguerieae of Rubiaceae from the Philippines is described and illustrated. The new species is unique from other representatives of the genus by its strictly 3-flowered inflorescences and geographic distribution.Bangladesh J. Plant Taxon. 22(1): 55–58, 2015 (June)
    Preview · Article · Jun 2015 · Bangladesh Journal of Plant Taxonomy
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    Full-text · Article · Apr 2014 · International Journal of Infectious Diseases
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    Full-text · Article · Apr 2014 · International Journal of Infectious Diseases
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    Full-text · Article · Apr 2014 · International Journal of Infectious Diseases
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    Full-text · Article · Dec 2013 · The Journal of allergy and clinical immunology
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    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.
    Full-text · Article · Oct 2013 · International Journal of Rheumatic Diseases
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    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.
    Full-text · Article · Aug 2013 · Asian Pacific journal of cancer prevention: APJCP
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    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.
    No preview · Article · Jul 2013 · Asia-Pacific Journal of Public Health

  • No preview · Article · Jun 2013 · Hong Kong Physiotherapy Journal

  • No preview · Article · Jun 2013 · Hong Kong Physiotherapy Journal
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    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
    No preview · Article · Jun 2013 · Hong Kong Physiotherapy Journal

  • No preview · Article · Jun 2013 · Hong Kong Physiotherapy Journal
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    ABSTRACT: Education is paramount in effectively reducing the significant burden of stroke in the Philippines. Dedicated academic institutions and dynamic professional organizations in the Philippines have collaborated to involve themselves in the plight against stroke through systematic curriculum development for undergraduates, continuous regulation of quality residency and fellowship training program, hosting up-to-date Continuing Medical Education (CME) activities for local and international audience, and active participation in clinical stroke trials. Most recently, the University of Santo Tomas Faculty of Medicine & Surgery and the Department of Neurology & Psychiatry offered a 72-hour Certification Course in Stroke Medicine that commenced in 2011 in anticipation of the Master on Health Sciences in Stroke Medicine course being prepared for 2013.
    Full-text · Article · Mar 2013 · International Journal of Stroke
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    ABSTRACT: To evaluate the clinical efficacy and safety of Tinospora cordifolia lotion including its cure rate and clearance time compared with permethrin lotion. A single blind, randomized, controlled, pilot clinical study was performed in three government institutions to investigate clinical efficacy of T. cordifolia lotion in sixty-six clinically-diagnosed scabies-infected patients. The patients were treated with T. cordifolia or permethrin lotions for three consecutive days for two weeks and clinical assessment of each patient was performed for five weeks. T. cordifolia lotion and permethrin significantly reduced the mean global evaluation score after four weeks of treatment. The two lotions showed comparable effects as anti-scabies agent. Moreover, the clearance time (days) and cure rate using the two lotions did not differ. Clinical improvement, mean clearance time and cure rate of T. cordifolia lotion are comparable with permethrin. Tinospora cordifolia lotion exhibits anti-scabies activity comparable with permethrin. Its incorporation as therapeutic reagent in Sarcoptes scabiei infections is highly recommended.
    Full-text · Article · Mar 2013 · Journal of Pharmacology and Pharmacotherapeutics
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    ABSTRACT: Body size and environmental prey availability are both key factors determining feeding habits of gape-limited fish predators. However, our understanding of their interactive or relative effects is still limited. In this study, we performed quantitative dietary analysis of different body sizes of goby (Gymnogobius isaza) specimens collected from Lake Biwa between 1962 and 2004. First, we report that the diet was composed mainly of zooplankton (cladocerans and copepods) before the 1980s, and thereafter, shifted to zoobenthos (gammarids). This foraging shift coincided with, and thus can be linked to, known historical events in the lake at that time: decrease in zooplankton abundance with the alleviation of eutrophication, increase in fish body size resulting from fish population collapse, and increase in gammarid abundance due to reduced fish predation pressure. Supporting this view, our data analyses revealed how the long-term changes in the diet composition would be co-mediated by changes in fish body size and environmental prey availability. Specifically, while zoobenthos abundance strongly affected the fish diet composition, larger (smaller) fish preferred zoobenthos (zooplankton). Furthermore, the body size effects were stronger than those of prey availability. These results provide the best long-term evidence that fish feeding habits vary over decades with its body size and prey community due to anthropogenic disturbances.
    Full-text · Article · Dec 2012 · PLoS ONE
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    ABSTRACT: The patterns of impaired internal anal sphincter activity were studied in patients with anal fissure (AF). Twenty healthy controls and 61 patients with acute AF were studied, using anorectal manometry with electromyography (EMG), and 53 patients with chronic AF using high-resolution manometry and ultrasonography. Mean and maximal resting anal pressure (MRAP), spontaneous rhythmic slow and ultraslow waves (USW) and relaxation induced by rectal distension were measured. Patients with acute AF had higher mean (106.4 ± 28.1 mmHg) and maximal resting anal pressure (161.5 ± 43.7 mmHg) than those with chronic AF (P < 0.05); 95% of patients had slow waves (SW) and 67% ultraslow waves. Patients with chronic AF had higher mean (92.4 ± 22.6 mmHg) and maximal resting anal pressure (117.5 ± 32.0 mmHg) than controls and 94% of patients had slow waves and 69% ultraslow waves. Patients with ultraslow waves (with either acute or chronic AF) had increased internal sphincter hypertonicity (mean and maximal resting pressure), decreased internal sphincter relaxation and increased after-contraction following rectal distension. Patients with acute AF had higher hypertonicity than those with chronic AF and both had increased spontaneous rhythmic activity (waves). Patients with AF and ultraslow waves had higher internal anal sphincter hypertonicity and reduced internal sphincter relaxation and enhanced after-contraction following rectal distension.
    No preview · Article · Dec 2012 · Colorectal Disease
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    ABSTRACT: Mangrove fungi are vastly unexplored for enzymes with industrial application. This study aimed to assess the biocatalytic activity of mangrove fungal xylanases on recycled paper pulp. Forty-four mangrove fungal (MF) isolates were initially screened for xylanolytic activity in minimal medium with corn cob xylan as the sole carbon source. Eight MF were further cultivated under submerged fermentation for the production of crude xylanases. These crude enzymes were then characterized and tested for the pretreatment of recycled paper pulps. Results showed that 93 % of the tested MF isolates exhibited xylanolytic activity in solid medium. In submerged fermentation, salinity improved the growth of the fungal isolates but did not influence xylanase production. The crude xylanases were mostly optimally active at 50 °C and pH 7. Changes in pH had a greater effect on xylanase stability than temperature. More than half of the activity was lost at pH 9 for majority of the crude enzymes. However, two thermophilic xylanases from Fusarium sp. KAWIT-A and Aureobasidium sp. 2LIPA-M and one alkaliphilic xylanase from Phomopsis sp. MACA-J were also produced. All crude enzymes exhibited cellulase activities ranging from 4 to 21 U/ml. Enzymatic pretreatment of recycled paper pulps with 5 % consistency produced 70-650 mg of reducing sugars per gram of pulp at 50 °C after 60 min. The release of high amounts of reducing sugars showed the potential of mangrove fungal crude xylanases in the local paper and pulp industry. The diverse properties shown by the tested crude enzymes also indicate its potential applications to other enzyme-requiring industries.
    Full-text · Article · Dec 2012 · World Journal of Microbiology and Biotechnology (Formerly MIRCEN Journal of Applied Microbiology and Biotechnology)
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    Full-text · Article · Dec 2012
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    ABSTRACT: Introduction: It is essential that allied health practice decisions are underpinned by the best available evidence. Therefore, effective training needs to be provided for allied health professionals to do this. However, little is known about how evidence-based practice training programs for allied health professionals are delivered, the elements contained within them, how learning outcomes are measured or the effectiveness of training components in improving learning outcomes. Methods: We conducted a systematic literature review to identify effectiveness of evidence-based practice training programs and their components for allied health professionals. Key words of evidence-based practice programs OR journal clubs OR critical appraisal AND allied health OR physiotherapists OR occupational therapists OR speech pathologists AND knowledge OR skills OR attitudes OR behaviour were applied to all available databases. Papers were critically appraised using the Joanna Briggs Institute and McMaster tools and the checklist of recommendations for educational interventions. Data were extracted on participants, training program components and underpinning theories, methods of delivery and learning outcomes. Data were synthesised using a combination of narrative and realist synthesis approaches. Results: Six relevant studies (four randomised controlled trials and two before-and-after studies) reported on the effectiveness of evidence-based practice training programs for evidence-based practice for groups of health professionals. Specifically, only three of these studies (one randomised controlled trial and two before-and-after studies) reported on allied health professionals (physiotherapists, occupational therapists and social workers). Among these three studies on allied health, outcomes were variably measured, largely reporting on knowledge, skills, attitudes and/or behaviours. Significant changes in knowledge and skills were reported in all studies. Only the social work study, which reassessed outcomes after 3 months, reported significant changes in attitudes and behaviours. Training took from 3 hours to 2 days. While there was information on training program components, there was no evidence of effectiveness related to learning outcomes. Conclusion: Overall, there is limited research regarding training of allied health professionals in evidence-based practice and learning outcomes. From the limited evidence base, there was consistent evidence that any training significantly influenced knowledge, skills and attitudes, irrespective of the allied health discipline. There was little information, however, regarding how to change or measure behaviours. This review cannot recommend components of training for allied health professionals in evidence-based practice, which significantly improve learning outcomes.
    No preview · Article · Dec 2012 · International Journal of Evidence-Based Healthcare
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    ABSTRACT: Highlights ► First phytochemical study on P. gitingensis. ► First isolation of vomifoliol from genus Psychotria. ► No alkaloids detected from P. gitingensis. ► Vomifoliol is moderately active against Klebsiella oxytoca.
    Full-text · Article · Dec 2012 · Biochemical Systematics and Ecology

  • No preview · Article · Dec 2012 · Hong Kong Journal of Occupational Therapy
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    ABSTRACT: Considering the paucity of studies dealing with the holistic aspect of the cancer experience, this grounded theory study seeks to conceptualize the process of cancer survivorship among Filipinos. Twenty-seven Filipino cancer survivors were purposively selected, and a two-part instrument, specifically robotfoto and focus group interviews, was used to gather data. The Glaserian method of grounded theory analysis was used, and extended texts were analyzed inductively via a dendrogram. Member checking and correspondence were observed to validate the surfacing stages, leading to the conceptualization of a theoretical model termed as the Ribbon of Cancer Survivorship. The said model describes the trifling (living before), transfusing (accepting the reality), transforming (being strong), and transcending (living beyond) phases of cancer survivorship. Ten interesting substages were also identified, namely: tainting, desolating, disrupting, and embracing for the transfusing phase; tormenting, distressing, awakening, and transfiguring for the transforming phase, and trembling and enlivening for the transcending phase. The resulting theoretical model has clearly and successfully described the entire process of cancer survivorship among Filipinos. It is hoped that the model be used as a reference for future studies about cancer survivorship and as a guide for nurses in providing a more empathetic care among cancer patients.
    No preview · Article · Oct 2012 · Journal of Holistic Nursing
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    ABSTRACT: Shrimp, like other invertebrates, relies solely on its innate immune system, to combat invading pathogens. The invertebrate immune system has ancient origins that involve cellular and humoral responses. The clotting system of the humoral immune response is the first line of defense against pathogens and also serves to prevent blood loss during injury and wound healing. Tranglutaminase and clotting protein are molecules involved in the blood clotting system of crayfish and shrimp. Studies have shown that the shrimp clotting system is linked with the activation of antimicrobial peptides, similar to that of the horseshoe crab. Unlike the horseshoe crab and crayfish blood coagulation which are well studied systems, blood clotting in shrimp remains poorly understood. Here we review the shrimp clotting system and its involvement in innate immunity.
    Full-text · Article · Oct 2012 · Fish & Shellfish Immunology
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    ABSTRACT: To investigate the inhibitory activity of the chloroform extract, petroleum ether and chloroform sub-extracts, lead-acetate treated chloroform extract, fractions and secondary metabolites of Uvaria rufa (U. rufa) against Mycobacterium tuberculosis (M. tuberculosis) H(37)Rv. The antituberculosis susceptibility assay was carried out using the colorimetric Microplate Alamar blue assay (MABA). In addition, the cytotoxicity of the most active fraction was evaluated using the VERO cell toxicity assay. The in vitro inhibitory activity against M. tuberculosis H(37)Rv increased as purification progressed to fractionation (MIC up to 23 μg/mL). The chloroform extract and its sub-extracts showed moderate toxicity while the most active fraction from chloroform sub-extract exhibited no cytotoxicity against VERO cells. Meanwhile, the lead acetate-treated crude chloroform extract and its fractions showed complete inhibitions (100%) with MIC values up to 8 μg/mL. Phytochemical screening of the most active fraction showed, in general, the presence of terpenoids, steroids and phenolic compounds. Evaluation of the antimycobacterial activity of known secondary metabolites isolated showed no promising inhibitory activity against the test organism. The present results demonstrate the potential of U. rufa as a phytomedicinal source of compounds that may exhibit promising antituberculosis activity. In addition, elimination of polar pigments revealed enhanced inhibition against M. tuberculosis H(37)Rv. While several compounds known for this plant did not show antimycobacterial activity, the obtained results are considered sufficient reason for further study to isolate the metabolites from U. rufa responsible for the antitubercular activity.
    Preview · Article · Oct 2012 · Asian Pacific Journal of Tropical Medicine
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    ABSTRACT: Antidesma bunius Spreng. (Phyllantaceae), Averrhoa bilimbi L. (Oxalidaceae), Biophytum sensitivum (L.) DC. (Oxalidaceae), Ceriops tagal (Perr.) C.B. Rob. (Rhizophoraceae), Kyllinga monocephala Rottb. (Cyperaceae), and Rhizophora mucronata Lam. (Rhizophoraceae) are used as remedies to control diabetes. In the present study, these plants were screened for their potential α-glucosidase inhibitory activity. The 80% aqueous ethanolic extracts were screened for their α-glucosidase enzyme inhibitory activity using yeast alpha glucosidase enzyme. Except for A. bilimbi with IC(50) at 519.86±3.07, all manifested a significant enzyme inhibitory activity. R. mucronata manifested the highest activity with IC(50) at 0.08±1.82μgmL(-1), followed by C. tagal with IC(50) at 0.85±1.46μgmL(-1) and B. sensitivum with IC(50) at 2.24±1.58μgmL(-1). This is the first report on the α-glucosidase inhibitory effect of the six Philippine plants; thus, partly defining the mechanism on why these medicinal plants possess antidiabetic properties.
    Full-text · Article · Aug 2012 · Journal of ethnopharmacology
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    ABSTRACT: Aim: The objective of this study is are to examine the association of preadolescent obesity using body mass index (BMI) and waist circumference (WC) with health-related physical fitness components. Methods: Grades 4 to 6 students in 2 private schools in Manila were included in this study. Height, weight, WC, and BMI were obtained. Physical fitness field tests were sit-and-reach test, 1-minute sit-ups, standing broad jump, 40-m sprint, and 20-m shuttle run. Results: Obese subjects had poorer scores in the field tests except in the sit-and-reach test. BMI and WC were significantly negatively associated with all the physical fitness parameters, except for the 40-m sprint where positive correlation was observed, and in the sit-and-reach test where no correlation was seen. Conclusion: In the management of preadolescent overweight and obesity, exercise programs should therefore be designed toward enhancing these fitness parameters, while not sacrificing enjoyment and creativity.
    No preview · Article · Aug 2012 · Asia-Pacific Journal of Public Health
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    ABSTRACT: The role of clinical instructors in preparing student nurses for the realities and dynamics of clinical practice cannot be underestimated. Previous literature has identified scaffolding as a diagnostic tool that enables both supervisor and learner to recognize knowledge-in-waiting and knowledge-in-use (Spouse, 1998). The pivotal role of scaffolding in the teaching-learning process cannot be underestimated. However, literature pertaining to its use in nursing is hard to locate (Dickieson, Carter and Walsh, 2008; Spouse, 1998). Hence, this qualitative study was conducted to capture nursing students' views and experiences of the scaffolding moves of their clinical instructors as they learn medication administration. From the thickness and richness of the descriptions of a select group of nursing students (n=31) in a comprehensive university in the Philippines, three interesting and yet intersecting themes surfaced relative to the scaffolding moves employed by clinical instructors, which include: (1) thought-provoking; (2) focus-steering; and (3) action-enabling. The said moves are carried out in a timely fashion to facilitate students' acquisition of knowledge, skills and attitudes pertaining to medication administration. Through the understanding of clinical instructors' scaffolding behaviors, this study provides a platform for more effective clinical instruction aimed at supporting future nurses' role in medication safety.
    No preview · Article · Jul 2012 · Nurse education today

  • No preview · Article · Jul 2012 · Radiologic technology
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    ABSTRACT: A synthesis of a new alkaloid-fullerene conjugate (1) is reported. The reaction was carried out by photoinduced [3+2] cycloaddition of the Alstonia indole alkaloid, 6,7-seco-angustilobine B (2), to fullerene[C60] (3) under aerobic conditions. The major monoaddition photoadduct (1) was characterized unambiguously by UV, IR, MALDI-TOFMS and NMR experiments. A mechanism highlighted by sequential photoinduced electron transfer andradical recombination pathways is also proposed. No significant enhancement in inhibition against M. tuberculosis H37Rv was observed for 1 compared with its parent compounds 2 and 3.
    No preview · Article · Jun 2012 · Natural product communications
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    ABSTRACT: Villarinol (1), a new alkenoyloxy alkenol metabolite, has been isolated from the dichloromethane extract of Villaria odorata, an endemic Rubiaceae Philippine plant, along with the known compounds stigmasterol and 4-hydroxybenzaldehyde. The structure of 1 was elucidated on the basis of spectroscopic and spectrometric studies. The extracts of V. odorata exhibited moderate inhibition against Mycobacterium tuberculosis H37Rv, based on the colorimetric microplate alamar blue assay.
    No preview · Article · Jun 2012 · Natural product communications
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    ABSTRACT: Botulinum neurotoxin type A (BoNT-A) reduces upper-extremity poststroke spasticity when given 6 or more months after stroke. Effects on functional use of the arm and hand are less apparent. To determine the effect and safety of very early use of BoNT-A for patients with upper-limb spasticity. The Asia Botulinum Toxin-A Clinical Trial ed for Early Post-stroke Spasticity (ABCDE-S; NCT00234546) was a multicenter, randomized, placebo-controlled trial conducted in patients recruited within 2 -12 weeks of first-ever stroke. Participants with a Modified Ashworth Scale (MAS) score of 1+ or above received BoNT-A (Dysport) 500 U or placebo to one or more wrist and elbow mover muscles, plus unstructured rehabilitation. The primary outcome was the MAS score in the most affected joint 4 weeks after first injection. Follow-up was 24 weeks. A total of 163 patients were enrolled and assigned to placebo (n = 83) or BoNT-A (n = 80). Mean time since stroke was about 7 weeks. At 4 weeks postinjection, BoNT-A significantly improved MAS scores. Treatment effect-size estimates increased with higher baseline MAS scores from 0.45 (Q1) to 0.70 (Q3). MAS scores for all secondary end points improved with BoNT-A versus placebo at all time points (P < .0001, all visits). The Functional Motor Assessment Scale did not reveal clinically significant differences. No group differences in adverse events were found. Interpretation. BoNT-A 500 U can provide a sustained reduction in poststroke upper-limb spasticity when combined with rehabilitation in Asian patients who have mild-to-moderate hypertonicity and voluntary movement, within 2 -12 weeks of stroke. Functional use of the arm and hand was not affected.
    No preview · Article · Feb 2012 · Neurorehabilitation and neural repair
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    ABSTRACT: Across medication error literature, much attention has been given to incidence, types, causes and prevention of medication errors. Despite these efforts, medication errors continue to occur among registered and student nurses. Considering the numerous studies on medication errors committed by registered nurses, little is known on the nature of student nurses' medication error. This study employed factor analysis and structural equation modeling to explore the factors affecting medication errors by student nurses. With the participation of 329 junior and senior student nurses recruited from a comprehensive university in the Philippines, five factor dimensions of the causes of student nurses' medication error were identified, namely: In-violation, In-writing, In-excess, In-experience and In-tension. Results of path analysis showed an interaction among these variables. Additionally, poor adherence to the "five rights" was identified as an important mediator between In-violation, In-writing, In-excess, In-experience and In-tension and student nurses' medication error. By developing a model to explain how student nurses' medication errors occur, this study sheds light on the nature of student nurses' medication error and provides a basis for error prevention strategies.
    No preview · Article · Feb 2012 · Nurse education today
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    ABSTRACT: BACKGROUND AND PURPOSE: The link between autoimmunity and infectious agents has been strongly suggested by reports of lupus or lupus-like syndromes following immunization. This report describes three patients with either newly diagnosed systemic lupus erythematosus (SLE) or SLE flare, following vaccination for human papilloma virus (HPV). CASE 1: A 17-year-old female completed two doses of HPV vaccine uneventfully. Two months later, she developed arthralgias with pruritic rashes on both lower extremities, later accompanied by livedo reticularis, bipedal edema with proteinuria, anemia, leucopenia, hypocomplementemia and high titers of anti-nuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA). Kidney biopsy showed International Society of Nephrology/Renal Pathology Society Class III lupus nephritis. She was started on high dose steroids followed by pulse cyclophosphamide therapy protocol for lupus nephritis, and subsequently went into remission. CASE 2: A 45-year-old housewife, previously managed for 11 years as having rheumatoid arthritis, had been in clinical remission for a year when she received two doses of HPV immunization. Four months later, she developed fever accompanied by arthritis, malar rash, oral ulcers, recurrent ascites with intestinal pseudo-obstruction, and behavioral changes. Cranial MRI showed vasculitic lesions on the frontal and parietal lobes. Laboratory tests showed anemia with leucopenia, hypocomplementemia, proteinuria, ANA positive at 1:320, and antibodies against dsDNA, Ro/SSA, La/SSB and histone. She improved following pulse methylprednisolone with subsequent oral prednisone combined with hydroxychloroquine. CASE 3: A 58-year-old housewife diagnosed with SLE had been in clinical remission for 8 years when she received two doses of HPV immunization. Three months later, she was admitted to emergency because of a 1-week history of fever, malar rash, easy fatigability, cervical lymph nodes, gross hematuria and pallor. Laboratory exams showed severe anemia, thrombocytopenia, active urine sediments, and hypocomplementemia. Despite pulse steroid therapy, blood transfusions, intravenous immunoglobulin and aggressive resuscitative measures, she expired a day after hospital admission. SUMMARY: These cases narrate instances of the onset or exacerbation of lupus following HPV immunization suggesting adjuvant-induced autoimmunity. On the other hand, there are reports of higher incidence of HPV infection in SLE, with the infection per se possibly contributing to disease activity. Thus, the benefit of HPV immunization may still outweigh the risk among these individuals.
    No preview · Article · Feb 2012 · Lupus
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    ABSTRACT: Common antigens between intestinal parasites and environmental allergens may play a role in the modulation of allergic immune responses. There is a growing interest in investigating cross-reactivity between common helminths and dust mites affecting humans, particularly in the tropics. This study examined the cross-reactivity between the human roundworm Ascaris lumbricoides (Al) and three house dust mite (HDM) species. Specific serum IgE levels to HDM species Blomia tropicalis (Bt), Dermatophagoides pteronyssinus (Dp), and Dermatophagoides farinae (Df ); and Al extracts among allergic (n=100) and ascariasis (n=60) subjects were measured through enzyme-linked immunosorbent assay (ELISA). IgE-reactive components of HDM and Al extracts were detected through Western-Blot Analysis. Cross-reactivity between HDMs and Al was determined by ELISA inhibition using HDM and Al-specific sera from allergic (n=15) and ascariasis (n=15) subjects. The IgE-binding capacity of a recombinant paramyosin peptide (Blo t 11-fD) to allergic (n=50) and ascariasis (n=50) subjects' sera were likewise determined. Among allergic subjects, 70% exhibited Al-specific positive IgE-reactivity, while 20-28% of ascariasis subjects demonstrated HDM-specific positive IgE-reactivity. Multiple IgE-reactive components of HDM allergens (14-240 kDa) and Al antigens (15-250 kDa) were detected, indicating multi-allergen sensitization among the subjects tested. Al antigens can inhibit up to 92% of HDM-specific IgE-reactivity among allergic subjects, while up to 54% of Al-specific IgE-reactivity among ascariasis subjects was inhibited by HDM allergens. Positive rBlo t 11-fD-specific IgE reactivity was observed in 80% of the allergic subjects and 46% of the ascariasis subjects. This study showed the presence of multiple cross-reactive antigens in HDM and Al extracts. Identification of these molecules may provide basis for designing novel diagnostic and therapeutic strategies. The potential role of paramyosin as a specific cross-reactive allergen present in HDMs and Al has been shown.
    Full-text · Article · Jan 2012
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    ABSTRACT: More than a third of stroke patients will develop post-stroke spasticity, especially involving the paretic upper limbs. Despite established, intensive rehabilitation programmes in place, spasticity may still affect a post-stroke patient's quality of life and create economic and caregiver burdens. Hence, there is a need to explore how botulinum toxin (BTX) therapy may further improve patient outcomes. Consensus guidelines on the clinical use of BTX for established and symptomatic upper-limb spasticity are now available. While BTX therapy has been universally shown to reduce muscle tone in spasticity, its corresponding improvement in functional-outcome measures are far from consistent. This review article attempts to analyse the reasons for the inconsistency and makes the case that improved and reliable functional outcomes after BTX therapy may be achieved when: patient-specific goals that incorporate realistic expectations (such as improving passive as well as active functions and reducing pain) are used as functional-outcome measures; patients are followed up over a reasonable amount of time so as to optimise learning, rehabilitation and possibly even allow plasticity to occur; and, correct and thoughtful muscle targeting that considers various factors, such as spread, technique and avoidance of compensatory muscles, is employed. This article also summarises the characteristics of post-stroke patients who are at greatest risk for developing spasticity and those who are most likely to become the "best responders;" and, it attempts to outline the potential advantages of early BTX therapy in the acute to sub-acute post-stroke period, while spasticity is still evolving.
    No preview · Article · Nov 2011 · Parkinsonism & Related Disorders
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    ABSTRACT: Evidence is conflicting regarding the effectiveness of creating a low-allergen environment or reducing allergen exposure to control asthma exacerbations. This study determined the association of house dust mite (HDM)-specific IgE levels with asthma symptom control, selected medications, family history of allergic disease, and exposure to second-hand smoke and household pets. Serum samples from 102 doctor-diagnosed allergic asthma patients and 100 non-atopic controls were subjected to enzyme-linked immunosorbent assay using the HDM species Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), and Blomia tropicalis (Bt) allergens. Point-biserial correlation coefficient, Pearson R correlation, and logistic regression analyses were used to determine association of HDM-specific IgE levels with the abovementioned variables. Of the 102 cases, 38.24%, 47.06%, and 33.33% were sensitized to Bt, Df, and Dp, respectively. Sensitized patients showed greater probability [Bt (OR = 1.21), Df (OR = 1.14), and Dp (OR = 1.35)] to manifest symptoms than those who were not. Obtained p-values [Bt (p = 0.73), Df (p = 0.83), and Dp (p = 0.59)], however, proved that HDM-specific IgE levels had no significant contribution in predicting or explaining occurrence of asthma symptoms. Bt- and Df-specific IgEs showed moderately weak but significant relationship with bambuterol HCl and expectorant, respectively. Patients currently on said medications registered higher HDM-specific IgE levels than those who were not. No significant correlation between IgE levels and family history of allergic disease or with exposure to second-hand smoke was seen. Dp-specific IgE levels of patients exposed to household pets were significantly lower compared to those without exposure. This study proves that sensitization to Bt, Df, and Dp allergens is not significantly associated with asthma symptoms and control. Although cases were shown to be sensitized to HDMs, their current medications were at least effective in controlling their asthma symptoms.
    Full-text · Article · Oct 2011
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    ABSTRACT: The little known Rubiaceae genus Villaria is endemic mostly to the coastal forests of the Philippines. Traditionally, it has been placed in the tribe Gardenieae. Later it was transferred to Octotropideae sensu Robbrecht and Puff. Villaria was placed among the “primitive” genera of the tribe, which are essentially characterized by large fruits, horizontal ovules and numerous seeds. Parsimony and Bayesian analyses of the combined plastid (rps16 and trnT-F) dataset strongly support the inclusion of Villaria in Octotropideae as well as monophyly of the genus. However, our molecular results do not conform to the current informal groups of the tribe delimited by fruit size, ovule position, number of seeds and exotesta thickenings. Instead, a close relationship between Villaria and two “central genera” (Hypobathrum and Pouchetia) is revealed for the first time. This clade is sister to a group comprising “primitive” (Fernelia), “advanced” (Kraussia and Polysphaeria) and “central” (Feretia) representatives. In addition, our combined tree strongly supports a sister taxa relationship between Canephora and Paragenipa. Villaria is characterized by unilocular ovaries, parietal placentation and strictly horizontal ovules. These features are unique within the Octotropideae. We recognize a total of five Villaria species, one new species (V. leytensis) is described here, and two species (V. philippinensis and V. rolfei) are transferred into synonymy with V. odorata. Each species is fully described, and a key to the species, a distribution map and illustrations are provided. KeywordsIxoroideae–Octotropideae–Philippines– rps16 intron–Rubiaceae– trnT-F region– Villaria
    Full-text · Article · Sep 2011 · Plant Systematics and Evolution
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    ABSTRACT: Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness. Moreover, little is known about this relationship among Filipino preteens. This cross sectional study reports the association between childhood obesity, measures of physical activity, and fitness. Children aged 11 to 12 from randomly selected schools from San Juan, Metromanila were included. Outcome measures were body mass index, Filipino modified Physical Activity Questionnaire for Older children (F_PAQ-C), standing broad jump, 50 m sprint and 20 m multistage shuttle run. 380 children participated in the study. Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children. Overweight children had lower scores in the standing broad jump, 50 m sprints and predicted VO2max as compared with children with normal BMI. There were modest associations between the 50 m sprint, predicted VO2max, and F_PAQ-C. Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity. If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases, there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future.
    No preview · Article · Aug 2011 · Journal of Physical Activity and Health
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    ABSTRACT: In cross-national studies, mean levels of self-reported phenomena are often not congruent with more objective criteria. One prominent explanation for such findings is that people make self-report judgements in relation to culture-specific standards (often called the reference group effect), thereby undermining the cross-cultural comparability of the judgements. We employed a simple method called anchoring vignettes in order to test whether people from 21 different countries have varying standards for Conscientiousness, a Big Five personality trait that has repeatedly shown unexpected nation-level relationships with external criteria. Participants rated their own Conscientiousness and that of 30 hypothetical persons portrayed in short vignettes. The latter type of ratings was expected to reveal individual differences in standards of Conscientiousness. The vignettes were rated relatively similarly in all countries, suggesting no substantial culture-related differences in standards for Conscientiousness. Controlling for the small differences in standards did not substantially change the rankings of countries on mean self-ratings or the predictive validities of these rankings for objective criteria. These findings are not consistent with mean self-rated Conscientiousness scores being influenced by culture-specific standards. The technique of anchoring vignettes can be used in various types of studies to assess the potentially confounding effects of reference levels. Copyright © 2011 John Wiley & Sons, Ltd.
    Full-text · Article · Jul 2011 · European Journal of Personality
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    ABSTRACT: Globospiramine (1), a new spirobisindole alkaloid possessing an Aspidosperma-Aspidosperma skeleton, together with deoxyvobtusine (2), deoxyvobtusine lactone (3), vobtusine lactone (4) and lupeol (5), were isolated and identified from Voacanga globosa through a bioassay-guided purification. The gross structure and absolute stereochemistry of 1 were established by circular dichroism spectroscopy, HR-MS and unambiguous NMR spectroscopic experiments. In addition, a new biogenetic pathway for the formation of the spiro-Aspidosperma-Aspidosperma skeleton is proposed. Alkaloid 1 showed potent antituberculosis activity against Mycobacterium tuberculosis H(37)Rv as evidenced in microplate Alamar blue assay (MIC = 4 μg/mL) and low-oxygen recovery assay (LORA (MIC = 5.2 μg/mL). The bisindole alkaloids also exhibited promising activity against acetylcholinesterase and, especially butyrylcholinesterase, with deoxyvobtusine (2) (IC(50) = 6.2 μM) as the most strongly inhibiting compound. This study extends the variety of alkaloid structural platforms which exhibit antimycobacterial and anticholinesterase activity.
    No preview · Article · Jul 2011 · European Journal of Medicinal Chemistry
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    ABSTRACT: The aim of this study was to assess the effects of an aerobic training program as complementary therapy in patients suffering from moderate depression. 82 female patients weredivided into a group that received traditional pharmacotherapy (Fluoxetine 20 mg) and a group that received pharmacotherapy plus an aerobic training program. This program was carried out for eight consecutive weeks, three days per week, and included gymnastics, dancing, and walking. Depressive symptoms were measured with the Beck Depression Inventory and the ICD-10 Guide for Depression Diagnosis, both administered before and after treatments. The results confirm the effectiveness of the aerobic training program as a complementary therapy to diminish depressive symptoms in patients suffering from moderate depression.
    Full-text · Article · Jun 2011 · Perceptual and Motor Skills
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    ABSTRACT: There is currently no strong evidence regarding the most effective training approach for allied health professionals that will support them to consistently apply the best research evidence in daily practice. Current evidence-based practice training tends to be 'one size fits all', and is unlikely to be appropriate for all allied health disciplines because of the variability in their tasks and scope of practice. The scant body of evidence regarding the effectiveness of evidence-based practice training for allied health practitioners provides some support for improving knowledge and skills, but equivocal evidence about influencing behaviors and attitudes. We propose a new model of evidence-based practice training, based on the concept of complex interventions reported in the literature. We believe that by offering training in evidence-based practice based on complex interventions relevant to the needs of the attendees, using fixed and variable components, there may be greater success in significantly influencing knowledge skills, attitudes, and behaviors.
    Full-text · Article · May 2011
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    ABSTRACT: To evaluate the wrinkle-reducing effects of 4-MHz radiofrequency (RF) energy applied to human periorbital, frontal, and midface facial skin using clinical wrinkle grading, patient self-satisfaction survey, and limited histologic studies. Thirty-two patients, ranging from 29 to 71 years of age with skin types varying from class I to class III using the Fitzpatrick Wrinkle Classification system, underwent 8 weekly treatment sessions of nonablative RF therapy on the periorbital, frontal, and midface regions and were subjected to follow up for 6 months after treatment. Pretreatment and post-treatment evaluations were compared. Two female subjects gave informed consent for RF treatment for the right upper eyelid and no treatment for left upper eyelid. Specimens from both upper eyelids then underwent histologic examination using light and transmission electron microscopy. Pre- and post-RF treatment evaluation by 3 independent observers using the Fitzpatrick wrinkle classification system showed progressive improvements in wrinkle score at 1-, 3-, and 6-month intervals (p < 0.01). Self-evaluation of 32 patients using a 9-point rating scale after application of RF treatment also showed improving satisfaction (p < 0.01). The most commonly noted adverse reaction was transient erythema (62.5%) lasting from a few hours to a day. Transmission electron microscopy (25,000×) showed scattered diffuse changes in collagen fibril architecture with a shift from smaller-diameter collagen fibers in the untreated samples to larger-diameter fibers in the treated samples and a loss of distinct fibril borders. Four-megahertz dual RF wand delivery rejuvenation treatment produces a reduction in periorbital and midface rhytides.
    Preview · Article · May 2011 · Ophthalmic plastic and reconstructive surgery
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    ABSTRACT: Two new benzopyranones, diaportheone A (1) and B (2), were obtained via bioassay-guided isolation of the secondary metabolites from the endophytic fungus Diaporthe sp. P133 isolated from Pandanus amaryllifolius leaves. Their structures were determined from spectral analysis including mass spectrometry, 1D and 2D nuclear magnetic resonance. Both 1 and 2 inhibited the growth of the virulent strain of Mycobacterium tuberculosis H(37)Rv with minimum inhibitory concentrations of 100.9 and 3.5 μM, respectively.
    Full-text · Article · Mar 2011 · Journal of Natural Medicines
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    ABSTRACT: The use of traditional art in recreational therapies is unexplored. This paper, thus, attempts to surface the unique power of traditional Filipino arts (TFA) as synergizing lens in capturing the individual and the collective experiences of a select group of Filipino elderly in an institutionalized care setting relative to their feelings of depression and self-esteem. Three Filipino elderly housed in an institutionalized care setting were chosen for this phenomenological study, a robotfoto and a series of semistructured interviews constitute the main data gathering tool. Field texts were subjected to phenomenological reduction via the repertory grid analysis. Emerged themes were subjected to a series of member checking procedures to ensure the trustworthiness of the reported data. Depression and self-esteem were interpreted via two emerged themes. The themes were Me, Myself, and Melancholy and Will Not Let My Worth Wither. Through recreational therapies in the form of traditional Filipino arts, participants found novel psychological crutches that overcame the challenges of depression and give them hope toward more positive views of themselves and life.
    No preview · Article · Feb 2011 · Educational Gerontology

  • No preview · Article · Dec 2010 · Hong Kong Physiotherapy Journal

  • No preview · Article · Dec 2010 · Hong Kong Physiotherapy Journal

  • No preview · Article · Dec 2010 · Journal of Surgical Oncology
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    ABSTRACT: This study surveyed the frequency of autoantibodies among un-affected first-degree relatives (FDRs) of Filipino systemic lupus erythematosus (SLE) patients compared with healthy un-related Filipino controls. The sensitivity, specificity and predictive value of the autoantibodies for SLE diagnosis were also assessed in this Filipino cohort. Filipino patients included in the University of Santo Tomas (UST) Lupus Database and un-affected FDRs were recruited. Healthy controls included those with no known personal or family history of autoimmune disease. The following autoantibodies were tested in all subjects: anti-nuclear antibody (ANA), anti-dsDNA, anti-Ro/SSA, anti-chromatin, anti-thyroid microsome, and anti-cardiolipin antibodies. Participants included 232 SLE patients, 546 FDRs, and 221 healthy controls. Median age of patients was 27 (range 8-66) years with median disease duration of 27.5 (range 1-292) months. Median age of FDRs was 42.0 (range 5-87) years. Compared with healthy controls, there were significantly more FDRs with positive ANA at titers 1 : 40 to 1 : 160 (p < 0.001) and 1 : 320 (p = 0.003), anti-Ro/SSA (4.94% versus 0.45%, p = 0.003), and anti-dsDNA ≥ 5.0 IU/ml (4.58% versus 1.36%, p = 0.031). ANA titer ≥1  :  160, anti-dsDNA, anti-Ro/SSA and anti-chromatin had the highest predictive value for SLE diagnosis. These findings reinforce the role of genetic influence in SLE risk among Filipinos, with a significant proportion of un-affected FDRs of SLE patients testing positive for autoantibodies compared with healthy Filipino controls. A longitudinal observational study in this same cohort will determine which proportion of these un-affected FDRs will evolve into clinical SLE disease in the future.
    No preview · Article · Dec 2010 · Lupus
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    ABSTRACT: This randomized controlled trial was conducted to evaluate the tolerability of a new baby cleanser formulation — Johnson’s Top-to-Toe cleanser (JTT) on infantile skin. 180 healthy infants (60 in each group) were enrolled and JTT Sebamed Baby Liquid cleanser (SM), and lukewarm tap water were used on the skin of the subjects as whole body cleansers twice a week for 2 weeks. Assessment was done at baseline, 1 week and 2 weeks clinically by a dermato-logist, instrumentally, and by the parents. Clinical assessment (erythema, edema, dryness and scaling); skin moisture content; skin surface pH; trans-epidermal water loss; skin oxyhemoglobin and deoxyhemoglobin; and consu-mer satisfaction were the outcome measures. There was no significant erythema, edema, dryness, or scaling elicited by any of the three test components. Parents did not report any side-effects. All the three studied interventions used as whole body cleansers were efficacious and well tolerated by infants. Key wordsBaby cleanser-Infant-Moisture-Tolerability-Epidermal water loss-Skin
    Full-text · Article · Nov 2010 · Indian pediatrics
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    ABSTRACT: Infections are an important cause of morbidity and mortality in systemic lupus erythematosus (SLE). Survival rates for SLE patients in developing countries are comparatively lower than those reported in industrialized countries, with early death from infection and active disease. In addition to the role of immunosuppressive agents in enhancing susceptibility to infection, infectious agents are also known to trigger lupus disease expression and activity. The endemicity of certain infections like tuberculosis further poses a special health issue in developing countries.
    No preview · Article · Oct 2010 · Lupus
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    ABSTRACT: Alpinia purpurata or red ginger was studied for its phytochemical constituents as part of our growing interest on Philippine Zingiberaceae plants that may exhibit antimycobacterial activity. The hexane and dichloromethane subextracts of the leaves were fractionated and purified using silica gel chromatography to afford a mixture of C(28)-C(32) fatty alcohols, a 3-methoxyflavone and two steroidal glycosides. The two latter metabolites were spectroscopically identified as kumatakenin (1), sitosteryl-3-O-6-palmitoyl-β-D-glucoside (2) and b-sitosteryl galactoside (3) using ultraviolet (UV), infrared (IR), electron impact mass spectrometer (EIMS) and nuclear magnetic resonance (NMR) experiments, and by comparison with literature data. This study demonstrates for the first time the isolation of these constituents from A. purpurata. In addition to the purported anti-inflammatory activity, its phytomedicinal potential to treat tuberculosis is also described.
    Full-text · Article · Oct 2010 · Pharmacognosy Magazine
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    ABSTRACT: To describe a new endoscopic procedure to restore the passage of tears in an obstructed lacrimal drainage system and to compare its efficacy with the standard external dacryocystorhinostomy (SE-DCR). Patients with complete and partial primary acquired nasolacrimal duct obstruction (PANDO) were randomly allocated to 2 treatment groups using completely randomized design. The first group was treated using endoscopic lacrimal duct recanalization (ELDR), while the second group was treated using SE-DCR. Follow-up was conducted for at least 6 months and evaluated for anatomical and functional patency. Complications were also noted for both groups. A total of 86 patients underwent ELDR, 60 of whom had complete PANDO, while 26 patients had partial PANDO. Eighty patients underwent SE-DCR; 58 had complete PANDO, and 22 had partial PANDO. The combined success rate in terms of anatomical patency for ELDR was 93.02% (95% confidence interval [CI], 0.88-98) compared with 93.75% (95% CI, 0.87-90) for SE-DCR (p = 0.85). Meanwhile, the combined success rate (functional patency) for ELDR is 84.88% (95% CI, 0.77-93) versus 90.00% (95% CI, 0.83-97) for SE-DCR (p = 0.32). ELDR using microendoscope is as efficacious as SE-DCR, without its associated major complications.
    No preview · Article · Sep 2010 · Ophthalmic plastic and reconstructive surgery
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    ABSTRACT: A piezoelectric quartz crystal (PQC) sensor based on a molecularly imprinted polymer (MIP) has been developed for enantioselective and quantitative analysis of d-(+)-methamphetamine (d(+)-MA). The sensor was produced by bulk polymerization and the resulting MIP was then coated on the gold electrode of an AT-cut quartz crystal. Conditions such as volume of polymer coating, curing time, type of PQC, baseline solvent, pH, and buffer type were found to affect the sensor response and were therefore optimized. The PQC-MIP gave a stable response to different concentrations of d(+)-MA standard solutions (response time = 10 to 100 s) with good repeatability (RSD = 0.03 to 3.09%; n = 3), good reproducibility (RSD = 3.55%; n = 5), and good reversibility (RSD = 0.36%; n = 3). The linear range of the sensor covered five orders of magnitude of analyte concentration, ranging from 10(-5) to 10(-1) microg mL(-1), and the limit of detection was calculated as 11.9 pg d(+)-MA mL(-1) . The sensor had a highly enantioselective response to d(+)-MA compared with its response to l(-)-MA, racemic MA, and phentermine. The developed sensor was validated by applying it to human urine samples from drug-free individuals spiked with standard d(+)-MA and from a confirmed MA user. Use of the standard addition method (SAM) and samples spiked with d(+)-MA at levels ranging from 1 x 10(-3) to 1 x 10(-2) microg mL(-1) showed recovery was good (95.3 to 110.9%).
    No preview · Article · Aug 2010 · Analytical and Bioanalytical Chemistry
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    ABSTRACT: We have used electrochemical scanning tunneling microscopy (EC-STM) to obtain molecular insights on the adlayer structures and electrochemical polymerization of 3,4-ethylenedioxythiophene (EDOT) on a bare Au(111) single crystal electrode in 0.1 M HClO(4) solution. Cyclic voltammetric (CV) studies showed an increase in anodic current at 0.90 V with the oxidation of EDOT monomer occurring at E = 1.10 V (vs reversible hydrogen electrode). In situ STM revealed, for the first time, that EDOT molecules can spontaneously form organized adlayers on a bare Au(111) surface with 18 muM concentration of EDOT in aqueous solution. Molecularly resolved STM images of the EDOT adlayer showed two domains consisting of disordered and ordered structures with the formation of vacancy islands or "etch pits". Several EDOT structures were observed at +0.60 V, namely, (4 x 7), (5 x square root(37)), and (square root(7) x 3) with calculated coverages of 0.107, 0.114, and 0.111 ML, respectively. Electropolymerization was also carried out using in situ STM in 0.10 M HClO(4) under potential control.
    No preview · Article · Jul 2010 · Langmuir
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    ABSTRACT: Dystonia may produce co-contractions and constant strain in numerous muscle fibers, including those of the muscle spindles. As proprioceptors, muscle spindles detect dynamic or static changes in muscle length and their afferent projections to the spinal cord play a central role in control of antagonistic muscles. Their parallel arrangement with extrafusal muscle fibers and association with the earlier recruited oxidative motor units allow them to conveniently sample the activity of all motor units and effectively modulate movement. At the same time, fusimotor muscle spindle innervation contracts the striated polar portions of the intrafusal muscle fibers and prevents their slackening during extrafusal muscle contractions. Botulinum toxin remains the most efficient therapy of dystonia. Its muscular mechanism of action is hinged on cholinergic blockade not only of extrafusal, but also of intrafusal muscle fibers. Besides being a targeted muscular therapy, the alteration of the corresponding sensory input following an effect of botulinum toxin on the intrafusal muscle fibers is pivotal in modulating loss of pre-synaptic inhibition in dystonia, including suppression of the tonic vibration reflex. Whether or not trans-synaptic botulinum toxin migration occurs, a modification of the central motor programming is bound to happen in dystonia, with botulinum toxin acting either as another 'sensory trick' or as a form of 'short-term plasticity'. Knowledge of the muscle spindle anatomy and function is key to unify our understanding of abnormal movements and of effects of botulinum toxin therapy. Thus, in dystonia, overactivity of muscles and increased spindle sensitivity are germane to botulinum toxin targets of action.
    No preview · Article · Jul 2010 · European Journal of Neurology
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    ABSTRACT: We describe a new species of terrestrial limestone forest frog of the genus Platymantis from Biak Na Bato National Park in central Luzon Island, Philippines. Platymantis biak is assigned to the primarily arboreal Platymantis guentheri Species Group, and is distinguished from these and other congeners by features of its external morphology and preferred terrestrial limestone microhabitat. Several distinguishing morphological characters include a moderately large body (32.3–39.9 mm SVL for 23 males and 37.4–42.4 mm SVL for 8 females), moderately expanded finger discs and slightly expanded toe discs, smooth skin, and limb banding pattern. The new species is yet another species in a rapidly growing group of newly discovered Philippine forest frogs with preferences for forested, karst habitats.
    Full-text · Article · May 2010 · Zootaxa

  • No preview · Conference Paper · May 2010
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    ABSTRACT: A 69-year-old hypertensive woman presented with eye and mouth dryness, bilateral parotid gland enlargement, associated with anasarca and proteinuria. Family history was notable for malignancies including breast, nasopharyngeal and colon cancers. Physical exam disclosed hypertension, bilaterally enlarged, firm, non-tender parotid glands, fine bibasilar crackles and bipedal edema. Anti Ro/Sjögren's syndrome antigen A antibody was positive, with negative tests for anti La/Sjögren's syndrome antigen B and anti-nuclear antibody (ANA). Chest radiographs showed basal infiltrates. Sjögren's syndrome associated with glomerulonephritis and interstitial lung disease was diagnosed, and she received pulse methylprednisololone followed by oral prednisone with dramatic improvement. Two months later, while on prednisone 5 mg/day, she returned to the clinic with an enlarging fixed non-tender right breast mass. She underwent modified radical mastectomy of the right breast, and pathologic report revealed diffuse, small cell, non-Hodgkin's lymphoma of the breast; axillary lymph nodes were negative for tumor. She opted for alternative therapy and did not return to the clinic until 7 months later when she developed sudden monocular blindness in the right eye with no other systemic manifestations. Magnetic resonance imaging (MRI) revealed swelling and enhancement of intracanalicular and pre-chiasmatic segments of the right optic nerve and right side of the optic chiasm. Considerations were Devic's disease versus metastases. She received pulse methylprednisolone therapy (1 g/day for 3 days) with partial recovery of vision. She is scheduled for lymphoma chemotherapy to include rituximab.
    No preview · Article · May 2010 · International Journal of Rheumatic Diseases
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    Full-text · Article · Apr 2010 · Journal of Cancer Education

  • No preview · Article · Jan 2010 · Plastic and Reconstructive Surgery
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    ABSTRACT: Systemic lupus erythematosis (SLE) patients are highly susceptible to infections. We aim to present our experience regarding the manifestations and outcomes of Salmonella infections in a group of Filipino SLE patients. This study reviewed the medical records of Filipino SLE patients with documented Salmonella infection seen at the Rheumatology Clinics of the University of Santo Tomas (UST) Hospital, Manila, Philippines from 2002 to 2009. Included were 12 patients (11 female), with mean age of 25.75 years (range 11-53 years) and average SLE disease duration 4.45 years to Salmonella infection. Five had septic arthritis (knee in 4, hip in 1), one of whom had concomitant typhoid fever. Another two patients had typhoid fever only. Sepsis syndrome was noted in three. One patient each had soft tissue abscess and meningitis. Salmonella typhi was isolated in seven patients, Salmonella sp. in four, and S. enteritidis in one patient. Two patients developed acute respiratory distress syndrome (ARDS), another had mixed Salmonella and Klebsiella pneumonia. Eleven patients were on high-dose steroids for active disease, including one patient with antecedent first infusion of cyclophosphamide plus rituximab. Management consisted of antimicrobials and adjunct surgery for arthritis and abscess. Except for three patients with Salmonella sepsis, all other patients improved with appropriate therapy.
    No preview · Article · Dec 2009 · International Journal of Rheumatic Diseases
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    ABSTRACT: The objective of the study was to describe a Filipino woman with systemic lupus erythematosus (SLE) who developed gigantomastia associated with hyperoestrogenemia and successfully treated by reduction mammoplasty. A 37-year-old Filipino woman with SLE of 5-year duration presented with enlargement of breasts, which became more noticeable and progressive during disease flares requiring increased steroid dose (+ or - 40 mg/day). Following control of the last SLE flare, with prednisone effectively tapered to 15 mg/day, she consented to surgical breast reduction. Preoperative physical examination recorded the right and left breast measurement of 61 cm and 54.5 cm from sternal notch to nipple tip, respectively. serum oestrogen assay was elevated. She successfully underwent reduction mammoplasty with free nipple graft, with an uneventful postoperative course. The breast tissue oestrogen and progesterone receptor assays were strongly positive. In the succeeding months, SLE disease remained stable with prednisone tapered to 10 mg daily. This case illustrates a rare occurrence of gigantomastia associated with hyperoestrogenemia in a patient with SLE, successfully treated with reduction mammoplasty.
    No preview · Article · Oct 2009 · Lupus
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    ABSTRACT: Infections including those of the central nervous system (CNS) are a major contributor to morbidity and mortality in systemic lupus erythematosus (SLE). This case series describes the etiology, contributing factors and outcomes of CNS infections in a group of Filipino patients with SLE. Retrospective case series. We reviewed the medical records of SLE patients diagnosed and confined for a CNS infection at the University of Santo Tomas Hospital in Manila, Philippines, from 1997 to 2007. A total of 23 SLE patients (22 females) diagnosed with CNS infection were included in this study. The mean age was 25.8 years (range 12-51) at SLE diagnosis, and 30.9 years (range 14-58) at CNS infection, with a mean disease duration of 55 months (range 7-125). Nineteen cases (82.6%) were meningitis, and four (17.4%) were diagnoses of brain abscess. The etiologic agents were identified as Cryptococcus neoformans in seven (30.4%), Mycobacterium tuberculosis in seven (30.4%), Streptococcus pneumoniae in two (8.7%), Salmonella sp. in one (4.4%), Corynebacterium bovis with Actinomyces sp. in one (4.4%), and no isolate in five (21.7%). The average daily prednisone dose was 28.9 mg (range 0-60 mg); 10 patients had recently received pulse cyclophosphamide, and two were on mycophenolate mofetil at the time of infection. Most cases had active SLE; the lone patient in disease remission had S. pneumoniae meningitis post-splenectomy. The most common presentation was headache (100%) and fever (87%). The infection resolved completely in nine patients (39.1%), and resolved with sequelae in two patients (8.7%); 12 patients (52.2%) died. We described the etiology and outcomes of CNS infections in a group of Filipino patients with SLE. Risk factors included active SLE in the majority of cases requiring moderate- to high-dose steroids and other immunosuppressants like cyclophosphamide. Although C. neoformans and M. tuberculosis were the most common etiologic agents, it is just as important to search for less common organisms which can produce disease in highly susceptible hosts. A high index of suspicion and early appropriate management are crucial to favorable outcome among these patients.
    No preview · Article · Sep 2009 · International Journal of Rheumatic Diseases
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    ABSTRACT: Little is known about pre-pubescent Filipino children's involvement in moderate-to-vigorous physical activity (MVPA). There are international guidelines regarding required levels of MVPA for healthy children. This study describes participation of 11- to 12-year-olds in randomly selected public and private schools in San Juan, Metromanila, in MVPA and sports during a school day. The Filipino-modified Physical Activity Questionnaire for Older Children (F_PAQ_C) was administered in English and Filipino. Additional data was collected on sex, age, type of school, and amount of time spent using television and computers. Children's self-assessment of physical activities (1 question in the F_PAQ_C) was correlated with their cumulative F_PAQ_C score. Three hundred eighty subjects (167 boys, 213 girls) participated. Participation in MVPA varied between sex and age groups, from 56.1% to 65.0%. Fewer than 10% of participants were very active. The children were more active during physical education classes than at recess or lunch, after class, or in the evening. Walking for exercise, jumping, jogging and running, free play, and dance were most common. Boys, younger children, and private school students most commonly engaged in MVPA. Self-assessed physical activity had modest correlation (r(2)= 0.21) with cumulative F_PAQ_C score, after adjusting for sex, age, and school type. Most children were not physically active during the school day, except in physical education classes. To reduce the gap between recommended and current activity levels, more opportunities should be provided for preteen Filipino children to engage in MVPA during and after school.
    No preview · Article · Aug 2009 · Journal of School Health
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    ABSTRACT: Epidemiological studies have shown that 10-28% of all sports injuries are ankle sprains, leading to the longest absence from athletic activity compared to other types of injuries. This study was conducted to evaluate the effectiveness of external ankle supports in the prevention of inversion ankle sprains and identify which type of ankle support was superior to the other. A search strategy was developed, using the keywords, ankle supports, ankle brace, ankle tapes, ankle sprains and athletes, to identify available literature in the databases (MEDLINE, PubMed, CINAHL, EMBASE, etc.), libraries and unpublished papers. Trials which consider adolescents and adults, elite and recreational players as participants were the study of choice. External ankle supports comprise ankle tape, brace or orthosis applied to the ankle to prevent ankle sprains. The main outcome measures were frequency of ankle sprains. Two reviewers assessed the quality of the studies included using the Joanna Briggs Institute (JBI Appraisal tool). Whenever possible, results were statistically pooled and interpreted. A total of seven trials were finally included in this study. The studies included were of moderate quality, with blinding as the hardest criteria to fulfill. The main significant finding was the reduction of ankle sprain by 69% (OR 0.31, 95% CI 0.18-0.51) with the use of ankle brace and reduction of ankle sprain by 71% (OR 0.29, 95% CI 0.14-0.57) with the use of ankle tape among previously injured athletes. No type of ankle support was found to be superior than the other.
    Preview · Article · Aug 2009
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    ABSTRACT: Gout is a common rheumatologic condition with characteristic clinical presentations during the acute arthritis and chronic tophaceous stages. Because of this, there is a tendency to overlook rare but important conditions which are independent of, but can co-exist with gout. This case of severe hip and knee pain in a patient with tophaceous gout takes the reader on a problem-solving exercise which simulates the analytical processes and decisions made in the clinic. © 2009 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.
    Preview · Article · Apr 2009 · International Journal of Rheumatic Diseases
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    ABSTRACT: Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare type of non-Hodgkin's lymphoma comprising approximately 0.9-9.0% of all cutaneous lymphomas. PCALCL is characterized by the absence of systemic involvement, spontaneous regression and low recurrence rate especially in localized lesions.We present a 47-year-old female with a 1½-year history of two asymptomatic erythematous indurated plaques on the right arm. Skin punch biopsy revealed dense infiltrates of non-epidermotropic, large, irregularly-shaped lymphocytes with hyperchromatic and pyknotic nuclei. Immunohistochemistry revealed that these atypical cells are anaplastic lymphoma kinase (ALK) positive, CD30+, CD3-, CD20- and epithelial membrane antigen (EMA) negative. Clinical, histopathological and immunohistochemical findings are consistent with PCALCL. Work-ups revealed no systemic involvement. Short course CHOP (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) chemotherapy resulted in total resolution of skin lesions; however, recurrence was noted 12 months after treatment. She then underwent radiotherapy and achieved complete remission.Because the clinical presentation of PCALCL can be variable, a high index of suspicion is necessary in patients presenting with chronic plaques and nodules unresponsive to topical or oral medications.
    Preview · Article · Oct 2008 · Journal of Dermatological Case Reports
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    ABSTRACT: Antimicrobial resistance is a worldwide problem. For patients with hospital-acquired or ventilator-associated pneumonia, resistant pathogens pose a significant challenge to successful treatment outcomes and to the cost-effective delivery of health care. In the developing world, antibiotic resistance may be relatively more prevalent compared with Western countries. Common resistant pathogens include methicillin-resistant Staphylococcus aureus, multidrug resistant Pseudomonas aeruginosa, multidrug resistant Acinetobacter species, and extended-spectrum beta-lactamase-producing strains of Escherichia coli and Klebsiella pneumoniae. The emergence of these strains has provided a major impetus toward development of the present consensus treatment recommendations of the Asian HAP Working Group. The following review provides summary data regarding the incidence and prevalence of antibiotic-resistant pathogens in 10 Asian countries.
    Preview · Article · Jun 2008 · American journal of infection control
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    ABSTRACT: In the present paper, we examined the incidence of polymorphic genes involved with the detoxification of exogenous chemicals, including carcinogens, namely GSTT1 (glutathione transferase theta1), GSTM1 (glutathione transferase micro1) and NQO1 (NAD(P)H:quinone oxidoreductase 1) in 60 Filipino paediatric patients with ALL (acute lymphoblastic leukaemia). We found a significantly high incidence of the GSTM1 null genotype in ALL children (71.7%) compared with 51.7% in the control group of children (P<0.05). The GSTT1 null genotype was observed in 35.0% and 33.3% of the ALL cases and the control subjects respectively, with no significant difference. Screening for NQO1 (609C>T) mutant alleles showed a high incidence of the NQO1 C/C genotype (NQO1 homozygous wild-type allele genotype) in 60.0% of ALL cases and was significantly higher than in the control group (23.3%) (P<0.01). These GSTM1 null and NQO1 wild-type genotypes are independently associated with the risk of ALL in Filipino patients. When these two genotypes, GSTM1 null and NQO1 C/C, were combined, the hazard rate for childhood leukaemia was significantly increased (P<0.001). We also noticed that the incidences of GSTM1 null mutations and the NQO1 C/C genotype were significantly higher among Filipinos. These findings suggest a possible role of the GSTM1 null and NQO1 C/C genotypes in the susceptibility of paediatric ALL cases in the Philippines.
    Preview · Article · May 2008 · Bioscience Reports
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    ABSTRACT: Bioassay-guided chromatographic purification of the antitubercular chloroform extract of Pandanus tectorius Soland. var. laevis leaves afforded a new tirucallane-type triterpene, 24,24-dimethyl-5 beta-tirucall-9(11),25-dien-3-one (1), squalene and a mixture of the phytosterols stigmasterol and beta-sitosterol. Microplate Alamar Blue Assay (MABA) showed that 1 inhibited the growth of Mycobacterium tuberculosis H(37)Rv with a MIC of 64 microg/mL, while squalene and the sterol mixture have MICs of 100 and 128 microg/mL, respectively.
    No preview · Article · May 2008 · Journal of Natural Medicines
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    ABSTRACT: Botulinum toxin type A (BoNTA) has been suggested as an effective anti-spastic drug. In this article, we summarized the data of randomized, placebo-controlled, double- blind trials and conducted a meta-analysis to assess if BoNTA is an adequate treatment for spasticity following stroke. To evaluate the relevant literature and assess the effectiveness and safety of BoNTA in (1) reducing spasticity based on mean change in the Modified Ashworth Scale (MAS) for upper and lower limb spasticity from baseline; (2) reducing spasticity based on the percent of patients having > or = 1point(s) change in the MAS; (3) improving the patient's or caregivers' Global Assessment Scale (GAS); and (4) total adverse events. We selected all randomized, placebo controlled, double-blind clinical trials or previous meta-analyses evaluating the efficacy and safety of BoNTA (Botox or Dysport) for the treatment of spasticity in both upper and lower limbs after stroke. Validity assessment of studies was performed, and Revman 4.2.7 from Cochrane Collaboration and SPSS (statistical package for the social sciences), v 9.0, were applied for analysis. Overall analysis showed clinical improvement between baseline and 4-6 weeks after application of BoNTA of the patient's spasticity score using the MAS (weighted mean difference [WMD] = 0.87, 95% CI = 0.52-1.22). The odds ratio of the MAS spasticity score showing one or more points improvement at 4-6 weeks after giving BoNTA showed clinically significant improvement (OR = 4.5, 95% CI = 2.79-7.25). The odds ratio of having an improved GAS at 4-6 weeks after injecting BoNTA showed clinically significant improvement (Odds ratio = 5.85, 95% CI = 3.12-10.95). The odds ratio of having an adverse event during the entire study did not show any significant difference between placebo and BoNTA (odds ratio = 0.84, 95% CI = 0.55-1.28). BoNTA improves muscle tone in upper and lower limb spasticity following stroke. A global assessment of improvement was noted by the patients or the caregivers following BoNTA injection. BoNTA is considered a safe therapeutic agent.
    No preview · Article · Feb 2008 · Journal of Neural Transmission
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    ABSTRACT: The aim of this study was to describe the presenting clinical manifestations and syndromes of Filipino patients on diagnosis of systemic lupus erythematosus (SLE). We performed a retrospective review of medical records of Filipino SLE patients included in the lupus database of the University of Santo Tomas (UST) in Manila, Philippines. All patients fulfilled the American College of Rheumatology criteria for SLE. The following data were recorded: (1) demographic profile, (2) clinical manifestations on SLE diagnosis, and (3) clinical syndromes prior to and during fulfillment of diagnostic criteria for SLE and disease interval from diagnosis of a clinical syndrome to SLE diagnosis. Clinical data of 1,070 patients entered into the UST lupus database as of October 2005 were analyzed. The average age at SLE diagnosis was 28.5 +/- 11.5 (range 5-71) years, with 1,025 female and 45 male subjects. The most common presenting manifestation was arthritis (68%), followed by malar rash (49%), renal involvement (47%), photosensitivity (33%), and oral ulcers (33%). The following clinical syndromes were recorded prior to or during SLE diagnosis: nephrotic syndrome (30%), undifferentiated connective tissue disease (UCTD) (22%), autoimmune hemolytic anemia (AIHA) (6%), and idiopathic thrombocytopenic purpura (ITP) (6%). Among these, AIHA preceded the diagnosis of SLE at the longest interval (20.3 +/- 30.6, range 1-194 months). In this large database of Filipino patients with SLE, the most common presenting manifestation was arthritis, with renal involvement occurring in almost 50%. Among the clinical syndromes, nephrotic syndrome was the most common, whereas AIHA recorded the longest interval preceding SLE diagnosis, at an average of 20.3 months. Our findings are similar to data from other countries and emphasize the broad range of manifestations of SLE. The findings also reinforce the need to establish and maintain SLE databases to enhance awareness, early diagnosis, and more efficient management of the disease.
    Full-text · Article · Feb 2008 · Modern Rheumatology
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    ABSTRACT: While it is true that understanding the attributes and unique distinction of the nursing faculty has been the subject of most of the studies, little is known about how the use of doodles can help surface the persona of the clinical instructors. This study aims to capture the essence or the lebenswelt of the concept of "clinical instructor" from the lens of students' doodles which have been considered as a powerful qualitative tool in articulating individual experiences. A total of 195 senior nursing students recruited from a comprehensive university in the Philippines were the subjects in this qualitative study. Data were gathered from self-generated illustrations and written explanations made by the subjects to identify their concept of effective and ineffective clinical instructors. Phenomenological reduction was observed through a repertory grid, where doodles drawn were listed, categorized and thematised to reveal the qualities of the clinical instructor. The subjective nature of the findings, though not generalizable, has surfaced how doodling can be a potent tool in identifying collective interpretation of the essence of health professions construct such as the one under study. The doodles revealed that an effective clinical instructor (enlightening, engaging and embracing) is one who is able to facilitate the learning of the students as well as being able to establish a harmonious learning atmosphere for and with the students. On the other hand, an ineffective clinical instructor (detrimental, dangling, and disturbing) impedes students' development in the clinical practice by causing conflict through their personal attitudes and their teaching strategies. This can have benefits for clinical instructors, to improve themselves and realize the impact of their attributes to the clinical learning of students.
    No preview · Article · Feb 2008 · Nurse Education Today

  • No preview · Article · Feb 2008 · The Alkaloids Chemistry and Biology
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    ABSTRACT: Intracranial arterial stenosis increases flow velocities on the upslope of the Spencer's curve of cerebral hemodynamics. However, the velocity can decrease with long and severely narrowed vessels. We assessed the frequency and accuracy for detection of focal and diffuse intracranial stenoses using novel diagnostic criteria that take into account increased resistance to flow with widespread lesions. We evaluated consecutive patients referred to a neurovascular ultrasound laboratory with symptoms of cerebral ischemia. Transcranial Doppler mean flow velocities were classified as normal (30 to 99 cm/s), high and low. Pulsatility index >or=1.2 was considered high. Focal intracranial disease was defined as >or=50% diameter reduction by the Warfarin Aspirin in Symptomatic Intracranial Disease criteria. Diffuse disease was defined as stenoses in multiple intracranial arteries, multiple segments of one artery, or a long (>1 cm) stenosis in one major artery on contrast angiography (CT angiography or digital subtraction angiography) as the gold standard. One hundred fifty-three patients (96 men, 76% white, age 62+/-15 years) had previous strokes (n=135) or transient ischemic attack (n=18). Transcranial Doppler detection of focal and diffuse intracranial disease had sensitivity 79.4% (95% CI: 65.8% to 93%), specificity 92.4% (95% CI: 87.7% to 97.2%), positive predictive value 75.0% (95% CI: 60.9% to 89.2%), negative predictive value 94.0% (95% CI: 89.7% to 98.3%), and overall accuracy 89.5% (95% CI: 84.5% to 94.4%). After adjustment for stroke risk factors, transcranial Doppler findings of low mean flow velocities and high pulsatility index in a single vessel were independently associated with angiographically demonstrated diffuse single vessel intracranial disease, whereas low mean flow velocities/high pulsatility index in multiple vessels were related to multivessel intracranial disease (OR: 19.7, 95% CI: 4.8 to 81.2, P<0.001). Diffuse intracranial disease may have a higher than expected frequency in a select stroke population and can be detected with noninvasive screening.
    Preview · Article · Jan 2008 · Stroke

  • No preview · Article · Dec 2007 · Digestive Endoscopy
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    ABSTRACT: Chronic pain is one of the more disturbing sequelae of spinal cord injury, often interfering with the basic activities, effective rehabilitation, and quality of life of the patient. Pain in the cord-injured patient is often recalcitrant to treatment. This dilemma is amplified by the limited availability of effective pharmacological and nonpharmacological treatment options. We identified relevant articles regarding pain after spinal cord injury from the Medline database from 1975 to 2005 using the search terms "spinal cord injury" or "spinal cord injuries" and "pain" or "spasticity or "muscle spasms." We also searched by hand the review articles in a recently published book from the International Association for the Study of Pain Press on spinal cord injury pain, and identified relevant articles through reference lists. We present a patient with intractable spinal cord injury pain who was successfully treated with a pain management plan that addressed the various aspects of spinal cord injury pain. The evidence for treatment options is reviewed.
    No preview · Article · Dec 2007 · Anesthesia and analgesia
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    ABSTRACT: Phytoplankton supports fisheries and aquaculture production. Its vital role as food for aquatic animals, like mollusks, shrimp, and fish cannot be overemphasized. Because of its contribution as a food source for fish, the growth kinetics of Microcystis aeruginosa, a dominant cyanobacterium in the lake, was studied. The regular occurrence of M. aeruginosa is experienced during the months of May to July or from September to November in Laguna de Bay, the largest freshwater lake in the Philippines. M. aeruginosa was collected from Laguna de Bay, isolated, and established in axenic conditions. Data on the growth kinetic parameters for nitrate-nitrogen and phosphate-phosphorus utilization by M. aeruginosa gave the following values: half-saturation constant (K s ), 0.530mg N. L−1 and 0.024mg P. L−1 respectively; maximum growth rate (μ max ), 0.671. d−1 and 0.668. d−1 respectively; maximum cell yield, 6.5 and 6.54 log, cells. ml−1 respectively; nutrient level for saturated growth yield, 8.71mg N. L−1 and 0.22mg P. L−1 respectively; and minimum cell quota (Q 0 ), 2.82pg N. cell−1 and 0.064pg P. cell−1 respectively. The low K s value and high maximum growth rate (μ max ) for phosphorus by M. aeruginosa would suggest a high efficiency of phosphorus utilization. On the other hand, the high K s value for nitrogen indicated a low rate of uptake for this nutrient.
    No preview · Article · Dec 2007 · Journal of Applied Phycology
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    ABSTRACT: Entecavir demonstrated superior benefit to lamivudine at 48 weeks in nucleoside-naive patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB). We evaluated continued entecavir and lamivudine treatment through 96 weeks. 709 HBeAg-positive CHB patients were randomized to entecavir 0.5 mg (n = 354) or lamivudine 100 mg (n = 355) once daily. At week 52, protocol-defined virologic responders could continue blinded treatment for up to 96 weeks. Patients continuing in year 2 (entecavir, n = 243; lamivudine, n = 164) were assessed for serum hepatitis B virus (HBV) DNA, alanine aminotransferase (ALT) normalization, HBeAg seroconversion, and safety. Cumulative confirmed proportions of all treated patients who achieved these responses were also analyzed. Among patients treated in year 2, 74% of entecavir-treated versus 37% of lamivudine-treated patients achieved HBV DNA <300 copies/mL by polymerase chain reaction (PCR), and 79% of entecavir-treated versus 68% of lamivudine-treated patients normalized ALT levels. Similar proportions of entecavir-treated and lamivudine-treated patients achieved HBeAg seroconversion (11% vs 12%, respectively). Higher proportions of entecavir-treated than lamivudine-treated patients achieved cumulative confirmed HBV DNA <300 copies/mL by PCR (80% vs 39%; P < .0001) and ALT normalization (87% vs 79%; P = .0056) through 96 weeks. Cumulative confirmed HBeAg seroconversion occurred in 31% of entecavir-treated versus 25% of lamivudine-treated patients (P = NS). Through 96 weeks, no patient experienced virologic breakthrough due to entecavir resistance. The safety profile was comparable in both groups. Entecavir treatment through 96 weeks results in continued benefit for patients with HBeAg-positive CHB.
    No preview · Article · Nov 2007 · Gastroenterology
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    ABSTRACT: The Philippine school system is considered as one of the largest in the world with 41,989 public elementary and secondary schools and 7790 private schools under the supervision and regulation of the Department of Education (DepEd Fact Sheet, 2005). This paper chronicles various decentralization initiatives carried out by the basic education sector in the country specifically along the areas of education financing, teacher effectiveness, curriculum development, textbooks and instructional materials, and school–community dynamics and student learning and assessment. This discourse culminates with the discussion of the lessons learned from a decentralized system of education for better school operation and management.
    No preview · Article · Nov 2007 · International Journal of Educational Development
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    ABSTRACT: In Asia, the incidence of gastroesophageal reflux disease diagnosed through endoscopy has increased from 3-9% to 14-16% in the last decade. The aim of this study was to determine the prevalence of erosive esophagitis (EE) over a span of 10 years in a tertiary care facility in the Philippines. All patients diagnosed with EE from 1994 to 1997 (period A) and from 2000 to 2003 (period B) were included in the study. The modified Savary-Miller and Los Angeles classifications were used to grade EE for periods A and B, respectively. A total of 15 981 upper endoscopies were evaluated for this study. There was no significant difference in the male: female ratio (period A 1.43:1 vs period B 1.25:1, P = 0.459) and in the mean age of patients with EE (period A 46.4 vs period B 47.5, P = 0.395). The prevalence of EE was significantly higher (P < 0.0001) in period B (6.3%) as compared to period A (2.9%). However, despite a higher prevalence, more patients had mild esophagitis in period B as compared to period A. Conversely, there were more patients with esophageal ulcers (18.6%vs 5.9%, P < 0.001), esophageal strictures (2.3%vs 0%, P = 0.003), and hiatal hernia (15.8%vs 7.5%, P = 0.001) in period A. The presence of concomitant Barrett's esophagus was not significantly different between the two time periods (period A 3.2%vs period B 5%, P = 0.367). The prevalence of EE was higher in 2000-2003 than in 1994-1997, although the complications associated with the disease diminished. The prevalence of concomitant Barrett's esophagus remained stable.
    No preview · Article · Oct 2007 · Journal of Gastroenterology and Hepatology
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    ABSTRACT: Although the concept of clinical credibility has attracted the interest of some researchers in the field, it is interesting to note the substantive paucity of literature on this since the mid 1990s [Fisher, M., 2005. Exploring how nurse lecturers maintain clinical credibility. Nurse Education in Practice 5, 21-29.] specifically from an Asian context. This qualitative study purports to capture how a select group of senior nursing students view their clinical instructors' credibility. A total of 22 senior nursing students recruited from a comprehensive university in the capital of the Philippines participated voluntarily in this qualitative study. With the use of individual indepth interview as a qualitative tool, findings of the study yielded three significant themes that elucidate the essence of credibility from the lens of Filipino nursing students. These include (1) credibility as an image building activity; (2) credibility as a work in progress; and (3) credibility as an influencing agent.
    No preview · Article · Sep 2007 · Nurse Education Today
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    ABSTRACT: Disease history and clinical features can influence treatment response in patients with acute gout. The purpose of this pooled subgroup analysis was to assess the association of baseline disease and patient characteristics with response to treatment in acute gout using data from two identical studies. Patients > or = 18 years of age with onset of acute gout within 48 h associated with moderate, severe, or extreme pain involving less than four joints were eligible for inclusion in the primary studies, and were randomized to etoricoxib 120 mg once daily (N = 178) or indomethacin 50 mg three times daily (N = 161). The primary and secondary efficacy endpoints were analyzed using an analysis of covariance model to detect potential differential treatment responses across several subgroups: joint involvement (mono-articular vs. oligo-articular), baseline pain severity (moderate vs. severe), concomitant allopurinol and/or colchicine use (users vs. nonusers), age (< 45, 45-55, and > 55 years), gender, and race (white or other). Overall, etoricoxib and indomethacin demonstrated comparable efficacy across all subgroups. Compared with patients with oligo-articular disease, those with mono-articular disease had significantly greater improvements in patient assessment of pain, patient global assessment of response to therapy (PGART), investigator global assessment of response to therapy (IGART), and study joint tenderness (p < 0.001 for all). Greater improvements were seen in patient assessment of pain (p < 0.001) and study joint tenderness (p < 0.05) for severe/extreme baseline pain compared with moderate baseline pain. Concomitant use of colchicine and/or allopurinol was associated with significantly worse IGART (p < 0.05). This pooled subgroup analysis demonstrated significantly greater response of acute gout to either etoricoxib or indomethacin among those with monoarticular disease, severe/extreme baseline pain, and non-use of colchicine and/or allopurinol. These results should be interpreted in the context of a pooled subgroup analysis with a limited sample size, and with the understanding that associations identified in such analyses do not define causation. Despite limitations, the results provide insights into the types of patients more likely to respond better to anti-inflammatory medication, and reiterate the importance of earlier effective control of the disease.
    No preview · Article · Aug 2007 · Current Medical Research and Opinion
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    ABSTRACT: Risk factors for development of non-alcoholic steatohepatitis include obesity, especially central adiposity, glucose intolerance or type 2 diabetes mellitus (T2DM), and dyslipidemia. Non-alcoholic fatty liver disease (NAFLD) is now considered a manifestation of metabolic syndrome. During the last two decades, NAFLD has become the most common chronic liver disease in North America and Europe, but until recently was thought to be uncommon (perhaps due to the lack of study) in Asia. Fatty liver can be identified on imaging modalities (ultrasonography, computed tomography scans, and magnetic resonance imaging) with high sensitivity, but steatohepatitis and fibrosis cannot be distinguished. Thus, an inherent drawback in studying the epidemiology of NAFLD is the lack of definitive laboratory tests, no uniform definition-with different studies using cut-off values of alcohol consumption from <20 g/week to 210 g/week, and case selections where biopsy was used for definition. In studies outside the region, the prevalence of NAFLD varies from 16% to 42% by imaging, and 15-39% of liver biopsies. The major risk factors for NAFLD, central obesity, T2DM, dyslipidemia, and metabolic syndrome, are now widely prevalent and are increasing geometrically in the Asia-Pacific region. It is therefore not surprising that NAFLD is common in this region. Estimates of current prevalence range from 5% to 30%, depending on the population studied. Central obesity, diabetes, and metabolic syndrome are the major risk factors. To date, however, data on the natural history and impact of NAFLD causing serious significant chronic liver disease are lacking and there is a need for prospective, cooperative studies.
    Full-text · Article · Jun 2007 · Journal of Gastroenterology and Hepatology
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    ABSTRACT: Comfort has been an integral component of nursing interventions. It is also supposed that the degree to which comfort is evidenced in nursing performance depends in great measure on the way forthcoming nurses perceive the said construct during their educational training. This study purports to describe student nurses' outlook of the words "comfort" and "comforting", through conscious doodling, and at the same time to find out instances of similarity or striking distinctions in students' perception on the said terms. A sample of 163 freshmen and 116 senior students were provided with a 2-part questionnaire. The first part used a robotfoto to determine the student subject's cartographic sketch. In the second part, a sheet of paper was given to each respondent who was asked to sketch a particular object, event or thought with which he associates the words, comfort and comforting. Moreover, a brief explanation of their illustrations was also called for. Metaphor representations were drawn up and analyzed and clustered according to their similarities in meaning, representation and the number of times the sketches were utilized by the respondents in order to comprehend how they interpret their sketches. Interestingly, this study yielded four major aspects that reflected the respondent's perception on the words "comfort" and "comforting", namely; physiologic, socio-environmental, psycho-spiritual and emotional. Results of this qualitative study did not show any marked difference in the interpretation of the construct under investigation on the comparison of the student's perception of the terms "comfort" and "comforting".
    No preview · Article · Jun 2007 · Nurse Education Today

  • No preview · Article · Jun 2007 · International Journal of Antimicrobial Agents
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    ABSTRACT: This quantitative study aims to ascertain the significant relationship existing between parents’ profile, and their school choice and school loyalty. Data were gathered using the researcher’s two-part made instrument. Respondents were first asked to fill in a robotfoto for purpose of profiling their baseline characteristics and were later asked to rate listed indicators, using a modified 8-point Likert scale. Using statistical tools such as the ANOVA, factor analysis, correlation, mean, and standard deviation, data were treated indepth. It is interesting to note that although parents are loyal to their alma mater, this does not have a much impact on their choice of school for their children. On the whole, parents’ choice of school is based on its indispensable qualities. Among the three interval-scale profiles of the parent respondents such as age, income, tuition fee payment and number of children, none of these relate to school choice, but age, income, and tuition fee payment negatively relate to school loyalty. From their nominal-scale profiles, significant differences were noted in their school choice when grouped according to civil status, place of work, and terms of payment. With respect to school loyalty, significant differences occurred in their responses when classified according to gender, terms of payment and their active participation in the Parent-Teacher Association (PTA).
    No preview · Article · Jun 2007 · Educational Research for Policy and Practice
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    ABSTRACT: Both transcranial Doppler (TCD) and spiral computed tomography angiography (CTA) are used for noninvasive vascular assessment tools in acute stroke. We aimed to evaluate the diagnostic accuracy of TCD against CTA in patients with acute cerebral ischemia. Consecutive patients presenting to the Emergency Department with symptoms of acute (<24 hours) cerebral ischemia underwent emergent high-resolution brain CTA with a multidetector helical scanner. TCD was performed at bedside with a standardized, fast-track insonation protocol before or shortly (<2 hours) after completion of the CTA. Previously published diagnostic criteria were prospectively applied for TCD interpretation independent of angiographic findings. A total of 132 patients (74 men, mean+/-SD age 63+/-15 years) underwent emergent neurovascular assessment with brain CTA and TCD. Compared with CTA, TCD showed 34 true-positive, 9 false-negative, 5 false-positive, and 84 true-negative studies (sensitivity 79.1%, specificity 94.3%, positive predictive value 87.2%, negative predictive value 90.3%, and accuracy 89.4%). In 9 cases (7%), TCD showed findings complementary to the CTA (real-time embolization, collateralization of flow with extracranial internal carotid artery disease, alternating flow signals indicative of steal phenomenon). Bedside TCD examination yields satisfactory agreement with urgent brain CTA in the evaluation of patients with acute cerebral ischemia. TCD can provide real-time flow findings that are complementary to information provided by CTA.
    Preview · Article · Apr 2007 · Stroke
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    ABSTRACT: Elevated systolic blood pressure (SBP) and lack of early vessel recanalization are predictors of poor outcome among patients with stroke treated with systemic tissue plasminogen activator (tPA). We aimed to evaluate the potential relationship between pretreatment SBP and tPA-induced recanalization. Consecutive patients with acute ischemic stroke resulting from intracranial artery occlusion were treated with standard intravenous tPA and assessed with 2-MHz transcranial Doppler for arterial recanalization. Early arterial recanalization was determined with previously validated Thrombolysis in Brain Ischemia flow grading system at 120 minutes after tPA bolus. Functional outcome at 3 months was evaluated using the modified Rankin Scale. A total of 351 patients received intravenous tPA (mean age: 68.7+/-13.4 years, median National Institutes of Health Stroke Scale score 16.5). Patients with complete recanalization (n=94) had lower mean pretreatment SBP values (152+/-23 mm Hg) than patients with incomplete or absent recanalization (n=257, 160+/-22 mm Hg, P=0.010). Pretreatment SBP levels were inversely associated with complete recanalization (OR per 10-mm Hg increase: 0.85; 95% CI: 0.74 to 0.98, P=0.022) after adjustment for demographics, risk factors, stroke severity, pretreatment Thrombolysis in Brain Ischemia grades, and continuous versus intermittent exposure to transcranial Doppler. Although patients with poor functional 3-month outcomes (modified Rankin Scale >2) had higher pretreatment SBP values (160+/-25 mm Hg) than functionally independent patients (154+/-20 mm Hg, P=0.027), pretreatment SBP levels were not independently associated with functional outcome on multivariable analysis. Age, complete recanalization, baseline National Institutes of Health Stroke Scale score, and time from symptom onset to tPA bolus were independent (P<0.05) predictors of 3-month outcome. Higher pretreatment SBP levels are associated with poor recanalization in patients with acute stroke treated with intravenous tPA.
    Full-text · Article · Apr 2007 · Stroke
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    ABSTRACT: Domestic arthropods are chief sources of potent allergens that trigger sensitization and stimulate IgE-mediated allergies. Diagnosis and immunotherapy of arthropod allergies rely on the use of natural allergen extracts which are associated with low specificity and efficacy, the risk of anaphylactic reactions, and the extended period of treatment. Most of the problems associated with natural allergen extracts for allergy diagnosis and immunotherapy can be circumvented with the use of recombinant allergens and peptides. Recombinant allergens are recently developed for microarray-based multi-allergen tests which provide component-resolved diagnosis (CRD) of the patient's sensitization profile. Moreover, recombinant protein technology and peptide chemistry have been used to construct isoallergens, allergen mutants, allergoids, T and B cell peptides, hypoallergens, and mimotopes with reduced allergenicity but enhanced immunogenicity for allergen-specific immunotherapy (SIT) and vaccination. The basics of recombinant arthropod allergen technology are in place providing a lucid future for the advancement of diagnosis and immunotherapy of arthropod allergies.
    Full-text · Article · Feb 2007 · Protein and Peptide Letters
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    ABSTRACT: A piezoelelectric quartz crystal sensor for sodium dodecyl sulfate was developed based on molecularly imprinted polypyrrole. The polypyrrole membrane was deposited onto one side of the electrode of the quartz crystal by galvanostatic polymerization, and molecular imprinting was achieved by incorporating SDS in the electrolysis reaction mixture. The electropolymerization parameters were optimized to produce a sensor with high sensitivity and high response. The sensor exhibited a linear response in a buffered solution in the concentration range 10−8 to 10−4 M SDS, with a sensitivity of 283.78 Hz/log M and a correlation coefficient of 0.9790. Its favorable performance in measuring SDS in river water samples was demonstrated.
    Full-text · Article · Jan 2007 · Sensors and Actuators B Chemical
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    ABSTRACT: This qualitative study aims to describe how the Filipino grade school pupils in a private sectarian school in the capital of the Philippines identify their views and images of a librarian. Two hundred fifty eight (258) pupils were asked to fill-out a robotfoto, box for illustration and a diagram to be filled in. Subsequent to the data gathered and data analysis, two (2) faces of librarians came into view. Results showed the perception of the children based on their doodles and given characterization, which may be either a desirable or undesirable librarian. On the one hand, the desirable librarian represents the enticing, enduring, and engaging types. On the other hand, disappointing, depressing and depriving types characterize the librarian who is undesirable. The doodlings indicate that being desirable attracts library clients to visit the library and develops interest in using the library facilities more often. The undesirable qualities make students hesitate in entering the library. This study dwells on the need for librarians concerned to improve their images and develop desired qualities for the benefit of their student clientele. .
    Preview · Article · Jan 2007 · Libri
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    ABSTRACT: The first example of supramolecular metallomesogens derived from palladium complexes exhibiting columnar phase is reported, and the formation of the mesophase is induced by H-bonding in a tetrameric assembly.
    No preview · Article · Jan 2007 · Chemical Communications

  • No preview · Article · Jan 2007 · Biochemical Systematics and Ecology
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    ABSTRACT: Salmonella infections occur more frequently among immunocompromised patients such as those with systemic lupus erythematosus (SLE), with high propensity for extra-intestinal, including osteoarticular, involvement. Hemarthrosis following trauma, typhoid fever and septic arthritis of the knee developed in a 20-year-old female lupus patient with pulmonary hypertension, maintained on corticosteroids and warfarin. This article takes the reader through the clinical problem-solving process with an SLE patient whose illness is confounded by prolonged fever, with manifestations indistinguishable from that of either lupus activity and/or an infection. Early diagnosis, appropriate antibiotics, and if necessary, surgical intervention are essential principles of management to improve prognosis and prevent long-term disabilities such as destructive arthropathy.
    Preview · Article · Nov 2006
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    ABSTRACT: Aim: To provide an overview of the clinical manifestations, survival and causes of mortality of systemic lupus erythematosus (SLE) patients in Asia. Methods: Literature retrieval utilized the following sources: (i) computerized bibliographic database of the National Library of Medicine (MEDLINE 1986–2006) by PubMed; (ii) articles on SLE published in journals of national medical or rheumatology societies; and (iii) abstracts presented in national, regional and international rheumatology and SLE conferences. The available materials were cited to summarize and extrapolate data deemed most representative of each Asian country. Results: The average age at SLE diagnosis ranged from 24–33 years, with a ratio ranging from 8–28 females to one male. Cutaneous and musculoskeletal manifestations were the most frequently observed, ranging from 45–98% and 36–85%, respectively. Renal involvement ranged from 6–100% (overall), or 26–74% (excluding presenting manifestations, and data obtained from a renal centre). Survival rates ranged from 65–98% at 5 years, and 50–84% at 10 years, with a trend for improved survival in more recent reports. Infection and active SLE disease were the predominant causes of mortality, with renal and central nervous system involvement as the main organs involved at time of death. Summary: This overview substantiates the potential vastness of clinical material on SLE in Asia, and reinforces the need for concerted efforts to encourage more research designed to address special issues and develop a more efficient health care delivery system tailored to the Asian lupus patient.
    Preview · Article · Nov 2006
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    ABSTRACT: The incidence of colorectal cancer is rising rapidly in some Asian countries. To determine the prevalence and the distribution of colorectal neoplasm in Asian populations. A multicenter colonoscopy survey. Between July 2004 and April 2005, consecutive symptomatic patients undergoing colonoscopic examinations in 10 different Asian countries. The location and the histologic features of all colonic neoplasms were recorded. Advanced neoplasm was defined as adenoma larger than 10 mm in size, with >25% villous features or with high-grade dysplasia or invasive carcinoma. The prevalence and the distribution of colorectal neoplasm and advanced neoplasm. A total of 5464 eligible patients underwent colonoscopy. Advanced neoplasm was found in 512 patients (9.4%). Factors associated with the presence of advanced neoplasm in this symptomatic Asian population included male sex (relative risk [RR] 1.52, 95% confidence interval [CI] 1.26-1.84), older age (RR 1.05, 95% CI 1.04-1.06), and ethnicity (P = .001). Advanced proximal neoplasm was detected in 136 patients (2.5%); 83 (61.0%) of the patients had normal distal colon. The RR of proximal advanced neoplasm was 2.5, 95% CI 1.7-3.7 in those with any adenoma in the distal colon compared with those with normal distal colon. Possible underrepresentation of some ethnic groups because of uneven ethnic group distribution and the lack of population-based registry. This was the first multicenter colonoscopy survey that examined the characteristics of colorectal neoplasm in Asia. The results will have important implications on the planning for future colorectal cancer screening in this region.
    No preview · Article · Nov 2006 · Gastrointestinal Endoscopy
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    ABSTRACT: Blo t 11, a dust-mite (Blomia tropicalis) paramyosin, is an allergen with significant IgE reactivity that has potential as a diagnostic/therapeutic reagent for house-dust-mite allergy. The present study describes the successful expression of Blo t 11 and its immunodominant peptide fD in insect cells using a baculovirus expression system. The Blo t 11 and fD genes were cloned into the pMelBacA vector and the resulting vectors were co-transfected into Sf9 insect cells with Bac-N-Blue DNA. Plaque assay was used to select for recombinant virus that was then used to infect High Five insect cells for protein expression. Secreted proteins were harvested by immuno-affinity purification using monoclonal antibodies to Blo t 11. Purified proteins were analysed by immunoblotting, N-terminal sequencing and ELISA. Immunoblot analyses revealed the full-length Blo t 11 cDNA expressed as a minor protein band of approx. 200 kDa and two major protein bands of approx. 60 and 70 kDa. Clones expressing fD cDNA fragment produced a protein of approx. 30 kDa that was confirmed to be fD by N-terminal sequencing. Approx. 4-7.5 mg/l of fD and 1 mg/l of Blo t 11 were obtained by affinity purification. ELISA results showed that human IgE reactivity to these recombinant allergens was lower as compared with that of the native Blo t 11, suggesting that these baculovirus-expressed allergens exhibiting reduced allergenicity could be useful for the development of immunotherapeutic reagents for mite allergy.
    No preview · Article · Aug 2006 · Biotechnology and Applied Biochemistry

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