Fusing tradition with technology
Integrating traditional and modern health care was the focus of the 12th annual convention of the Community Pediatrics Society of the Philippines (CPSP) held on January 13 to 14. Carrying the theme Fusion: From the Traditional to the Technological, the convention dealt with issues involving early schooling and child behavior, use of nutraceuticals, alternative medicine, immunization, and childhood injuries.
Keynoting the convention, Dr. Ramon Arcadio, professor of pediatrics at the University of the Philippines-College of Medicine, called for stronger laws and program to prevent deaths and injuries among children arising from traffic accidents, drowning, burns, poisoning, and falls. Saying these are among the "social concerns and advocacies for Filipino families and communities" that physicians should involved themselves in, he enjoined the CPSP to organize programs in these areas.
"Injuries are the third-leading cause of death among children one to 14 years old," said Arcadio, lamenting the absence of appropriate child-protection laws in the Philippines. Observed Arcadio: "Children are not required to use child restraints in cars or to use helmets when riding in bikes. Child-resistant containers are not required for poisons and dangerous chemicals, but there is a poison hotline. Cigarette lighters are not required to be child-resistant….There are no standards for playgrounds, personal flotation devices, and swimming- pool enclosures." He said putting in place these measures can save thousands of children each year from injury and death.
Arcadio also called attention to the growing problem of child pornography, citing the rescue last year of 70 children from a child-pornography syndicate in Laguna. He said a study has shown that the Philippines is a haven for child pornographer because of lack of stringent laws and weak prosecution of those caught involved in the crime. "This is not acceptable. We, at the CPSP, must work together and support efforts to put a stop to it," he asserted.
He also lashed at proponents of legislative measures that, according to him, threaten the Filipino family and community. "The two-child-policy bills, and other death bills, like the ones on euthanasia, total population management, and some of the reproductive-health bills should be scrutinized since they may be sugar-coated or disguised proabortion bills," he said.
Among the speakers in the convention were Dr. Emenilda Avendano on effects of early schooling on child behavior, " Dr. Milagros Neri and Ms. Ma. Teresa Jopson on counseling methods and skills for health-care providers, Dr. Alfonso Lagaya on acupuncture and acupressure, Dr. Alicia Tamesis on immmunization, and Dr. Lydia Nano on childhood injuries.
J.R. Bustamante
Physicians look at atherosclerosis
At the 10th joint annual convention of the Philippine Society of Hypertension and Philippine Lipid Society on February 2 to 4, society presidents Dr. Esperanza Cabral and Dr. Mary Anne Lim-Abrahan stressed that, as daunting as the task seems, Meeting Challenges in Atherosclerosis Prevention should be easier if everyone acts together.
The convention is an opportunity to be able to control atherosclerotic diseases through "the control of hypertension and dyslipidemia, as well as its other contributory conditions," they pointed out. The program thus focused on the preventive aspects of the different vascular diseases.
In a lecture on dysfunctional fat in type 2 diabetes mellitus (DM), Lim-Abrahan noted that "most type 2 diabetic patients are overweight/obese and have too much fat in the abdomen."
She pointed out that besides insulin resistance and impaired insulin secretion, there is also evidence of dysfunctional fat in the pathogenesis of type 2 DM. Dysfunctional fat cells secrete excessive amounts of cytokines that cause insulin resistance, inflammation, hypercoagulability, dyslipidemia, and atherosclerosis. At the same time, they secrete less of the normal insulin-sensitizing antiathero-genic adipocytokine adinopectin, she explained.
The fact that we have biological clocks that influence how our bodies change throughout the day, including blood pressure, was Cabral's concern. She talked about how chronotherapeutics could protect those with fluctuating blood pressures against "death at dawn," since its major objective is to deliver medicine in higher concentrations at the time of greatest need (early morning) and in lesser concentrations when the need is less (middle of sleep cycle).
Dr. Dante Morales, medical director of Manila Doctors Hospital, also talked about how abnormal cholesterol levels can lead to atherosclerosis, which is the most common cause of cardiovascular diseases.
Citing observational data, he related that for every 10-percent increase in serum cholesterol, there is a 20-percent increase in the risk of coronary heart disease (CHD).
He discussed secondary prevention trials that showed that "cholesterol-reduction promotes regression of decreased progression of atherosclerotic plaques;" trials in acute coronary syndrome, which showed that early initiation of statin therapy reduces subsequent ischemia; and a metaanalysis of dietary intervention trials, which showed lower rates of CHD in the active treatment groups.
The 2003-2004 national nutrition and health survey was discussed, as well. Other lectures included combination therapy in dyslipidemia, and practice guidelines in hypertension and lipid management in chronic kidney disease.
M. Ciriacruz
PAAMS tackles antiageing therapies
An ageing population, coupled with people's desire to look young and feel, is fueling the growth of a sector of the health-care industry and the medical profession that caters to the needs of the elderly.
Seven percent of Asians, for example, are 65 years old or older. They are a sector of the population whose needs are being given special attention by government agencies and private companies.
Dr. Joel Mendez, president of the Philippine Anti-Ageing Medical Society (PAAMS), noted that new products and services are being developed for these ageing men and women. Keynoting the second annual convention of at the Westin Philippine Plaza Hotel on February 23, Mendez said that in the United States, "nearly 90 million Americans consumers use antiageing products as shown in a survey conducted by Harris Interactive. "Survey respondents overwhelmingly agreed that a youthful appearance is an important factor for both professional success and personal happiness," Mendez noted.
The convention focused on nonsurgical antiageing therapies such as sclerotherapy, mesotherapy, aquamid, hylaform, botolinum toxin (botox), and intense pulsed light (IPL).
Dr. Felicisimo Agas discussed the BioEnterics Intragastric Balloon system for the treatment of obesity in which a saline-filled biocompatible silicone balloon, which limits food consumption, is placed inside the stomach using an endoscope. The use of fillers aquamid and hylaform to correct facial-skin volume was demonstrated by Dr. Joel Nicdao while Dr. Joseph Galvez discussed new indications for botox. Neville Richards Ledger, owner of Xenolite Limited, talked about the use of IPL for facial rejuvenation among Asians. Other speakers were Drs. John Cenica on the treatment of varicose veins with sclerotherapy, Philippine Association of Reconstructive Aesthetic Surgeons president Florencio Lucero on correcting cellulite problems with mesotherapy, and Eric Chan on the use of laser.
PAAMS members also took up nontechnical issues--the exodus of doctors to the nursing profession by Dr. Jose Sabili and medicolegal concerns by Dr. Bu Castro, Philippine Medical Association president.
Aside from Mendez, the other officers of PAAMS are Drs. Rimando Saguin, vice president; Luisa Santos, secretary; Arthur Estuita, treasurer; NymPHA Mundin, assistant treasurer; Alfredo Balintong, auditor; Elias Adamos, public relations officer; and Jose Sanchez and Salvador Flores, advisers.
J.R. Bustamante
Education for quality health care
At the core of each student's mind are the questions: Am I getting quality education? Is it going to be relevant or useful later in my profession?
In medical education, where graduates will serve as leaders in health-care delivery, the answers are, literally, of life-and-death importance.
At the 38th annual convention of the Association of Philippine Medical Colleges (APMC) Foundation hosted by St. Luke's College of Medicine William H. Quasha Memorial on January 20 to 22, these issues were tackled. A gathering of medical-school administrators, faculty, and students, the convention focused its program this year on the Interface of Medical Education with Health-Care Delivery.
In his keynote address, Fr. Rolando de la Rosa, chair of the Commission on Higher Education (CHED), said that Filipinos should think of quality medical education not in terms of knowledge but of understanding. Included in the things the CHED is looking into to keep this in sight are:
He reports that CHED is studying what the demand for doctors is here and abroad versus the number of graduates produced by medical schools. There are 36 medical schools licensed by CHED. State colleges and universities do not require CHED's approval to open new courses in medicine or nursing. From the study, CHED can determine how many medical schools are needed to meet demand; what subsidies will be given to medical schools with exceptional programs, faculty, and facilities; and which schools have to be closed because of noncompliance with minimum requirements for continued operation, he explained.
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To support the retention of the Technical Committee for Medical Education under CHED, as well as its policy of admission quota, which will "assure the survival of medical schools suffering from low enrollment."
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To study the advantages of restoring a national mental aptitude test (NMAT) cut-off score.
Students whose NMAT score is below the cut-off will not be enrolled in any medical school, de la Rosa said. "Based on a seven-year statistical study by the Center for Educational Measurement, there is a close correlation between the NMAT score and the passing score in the physicians' licensure examinations," he explained.
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To look into formulating a policy that will require medical schools to utilize only teaching-based hospitals recognized by CHED.
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To keep bioethics in the medical curriculum--to prevent "what medicine without a conscience could do."
De la Rosa also announced that CHED plans to review the licensure examinations for physicians to make it more congruent with current curriculums.
M. Ciriacruz
Media gurus train docs on advocacy
It's not another doctor-shifting-to-nursing trend. Instead, heart doctors get help from experts in media and communication on how to get their message across to people they want to inform about cardiovascular diseases, how to avoid them, and how to deal with them.
The event was a workshop dubbed Advocating the Prevention of Cardiovascular Diseases: Understanding How Media Work held April 9 to 10 under the auspices of the Philippine Heart Association (PHA). The society's officers and members listened to former Press Secretary Rod Reyes, publicist-turned-Manila-Times-publisher Dante Ang, television journalist and professor Chi-chi Fajardo-Robles, United Nation's consultant on advocacy Offie Valdecañas, journalist and professor Vergel Santos, radio broadcaster Mario Garcia, and advertising executive Bong Osorio, who dished out helpful tips on crafting successful information campaigns and using the mass media to the full.
"We want to utilize the advantage of mass communication in the advancement of our advocacy," said Dr. Norbert Lingling Uy, PHA president.
Early this year, the PHA bared the results of the latest National Nutrition and Health Survey showing that nine out of every 10 adult Filipinos have at least one risk factor for CVD. That means around 44 million Filipinos smoke and/or suffer from at least one of these conditions: obesity, hypertension, dyslipidemia, or diabetes.
"The ever increasing CVD prevalence rate requires renewed zealous commitment to find new strategies to turn the tide," said Dr. Mariano Lopez, PHA vice president. "The PHA is gearing up for a series of high-intensity CVD-prevention [projects] and this workshop is meant to strengthen the association's capabilities by developing a core of members with communication skills and passion for advocacy."
Dr. Saturnino Javier, PHA Newsbriefs editor, said the PHA is at war with CVD and it needs powerful weapons in its communications arsenal to make its voice heard. That "added arsenal" is what the workshop meant to provide cardiologists, commented Ramy Diez, PHA vice president for external affairs.
Valdecañas, president of the Philippine Association of Nutrition, urged the PHA and its members to go beyond increasing public awareness. She said that there's more to advocacy than telling the public what needs to be done. According to her, this includes persuading the decision-makers "in whose hands the power lie" like the government and private sectors to commit and act in the prevention of CVD in the country.
Sharing his expertise on effective communication, Osorio, president of Campaigns Advocacy and Public Relations, advised doctors to touch people's hearts rather than their minds. He said that advocacy is pushing for behavioral change and in effecting change, "emotion sells better than reason."
Garcia, vice president of Radio Veritas, talked about the intricacies of radio communication and gave tips on appropriate language for radio and how to reach out to radio broadcasters in the country.
Ang, chair of the Commission on Filipinos Overseas, said that involving journalists in advocacy can increase the chances of having press releases published.
Reyes offered tips on how to tap the massive power of television to generate public reaction and inspire change.
Robles and Santos critiqued the group's workshop output on writing press releases and video scripts on the second day.
A. Mendoza
POGS launches sex-education drive
Teenage pregnancy is a creeping problem that obstetricians and gynecologists must help address because they are the first to recognize it, according to Dr. Rosendo Roque, former president of the Philippine Obstetrical and Gynecological Society (POGS).
Citing a survey that showed increasing numbers of teenagers engaging in premarital sex--at times resulting in "unwanted" pregnancies--Roque stressed the need to increase young women's knowledge of sexuality and reproductive health. He said the survey also showed that half of the respondents did not think they could get pregnant with their first sexual contact while most did not know their fertile period or the biological function of menstruation.
Not only that, many teenagers also have liberal attitudes about premarital sex and pregnancy, living in, divorce, and homosexuality. Roque said it is not surprising then that teenage mothers account for 10 percent of births in the country.
It is with a desire to help address these issues that POGS and Sanofi-Synthelabo teamed up for an information campaign to educate adolescent women on reproductive and women's health. Called Teens Xpressing Themselves (TxT), the program has four modules.
The first module talks about basic facts regarding adolescence. The second corrects misconceptions young people have on menstruation, hygiene, and sex. The third tackles the behavior prevalent among adolescents, aiming to help young people recognize these behaviors and guide them during decision-making. The fourth discusses sex and the consequences of irresponsible sex, the differences in behavior towards sex, and homosexuality. It also encourages young people to seek medical help in addressing sexuality and other concerns.
The modules were developed by a team of specialists that included Drs. Ditas Decena, Blanca de Guia, Rosalie Junio, Diosdado Mariano, Benjamin Cuenca, Enrique Oblepias, Anne Marie Trinidad, Lety Chua, Mario Festin, Juanito Miguel Teotico, Ma. Socorro Solis, Susan Pelea-Nagtalon, Agnes Teotico, Ma. Carmen Quevedo, Anthony Marc Ancheta, and Jennifer Go.
J.M. Nailes, MD
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