ADAP releases guidelines for Alzheimer disease diagnosis, treatment
The Alzheimer's Disease Association of the Philippines (ADAP) recently launched Recommendations on the Diagnosis, Prevention, and Treatment of Alzheimer's Disease, a practice guide for physicians in dealing with the disease.
Dr. Marita Reyes, chancellor of the University of the Philippines Manila, who was guest at the launch, described the book as "comprehensive and culture-sensitive."
Neurologist Ma. Socorro Martinez, ADAP president, said the book is a "mission in progress" for the association, in keeping with its goal to raise awareness about the disease and improve care for patients suffering from it. "As a staunch ally of the Philippine Neurological Association, Philippine Psychiatric Association, Philippine Society of Geriatric Medicine, and Alzheimer's Disease International, ADAP [has a] mission to be at the forefront of [providing] disease-management and treatment guidelines for AD and related disorders," she said.
Martinez warned of the growing incidence of AD and dementia that she said could reach "epidemic proportions in Asia," especially as the population in the region ages. In the Philippines, the National Statistics Office estimates that the current four million Filipinos 65 years old and above would be more than 10 million by year 2030.
AD and other dementing disorders affect about 2.9 percent of the world's population. If the rate were applied to the Philippines, it means about 2.5 million Filipinos may suffer from these disorders, "potentially a great burden to the health-are system," the book warned.
Noting that the diagnosis of AD is often missed or delayed, the guidelines recommend a two-step process of recognition and diagnosis: first, establishing whether a dementia syndrome exists and determining its severity; and second, determining whether the clinical presentation of dementia is characteristic of AD using a standard diagnostic clinical criteria.
The diagnostic process is presented in flow charts to help the attending physician assess patients properly and make appropriate referrals when necessary.
As for management, ADAP recommends both nonpharmacological and pharmacological strategies. Nonpharmacologic management "is the most appropriate first step toward treating behavioral disturbances in patients with AD." This includes education, support, and counseling of both patients and their caregivers; maintenance of good physical health and function through physical and occupational therapy, proper diet, and adequate exercise; recreation and therapeutic activities; and music, cognitive, reminiscence, and validation therapies.
The guidelines also present evidence on the use of cholinesterase inhibitors and recommend that they be used as first-line treatment for patients with mild to moderate AD. Agitation and other problem behaviors, especially if they pose a danger to the life of the patient and the caregiver, should also be treated with appropriate drugs. The ADAP, however, stresses caution in the use of certain drugs to treat behavioral symptoms.
As for prevention, the guidelines say there is evidence to support the use of antihypertensive agents to reduce dementia risk, as well as to screen patients for cardiovascular risk factors associated with an increased risk for AD and vascular dementia. The guidelines also encourage the elderly to do mentally stimulating activities, exercise regularly, and socialize, although the ADAP points out that there is no strong evidence either for or against them.
Geriatrician Shelley de la Vega, ADAP director, said the making of the guidelines and their publication into a booklet were part of ADAP's educational campaign to combat AD.
In coming up with the guidelines, three technical panels reviewed evidence-based results and pored over more than 2, 000 articles on the prevention, diagnosis, and management of AD. These groups were composed of Drs. Martinez, de la Vega, Lourdes Ledesma, Grace Orteza, Paulino Tenchavez, Medelyn Balatbat, Ester Bitanga, Miguel Ramos, Doris Camagay, Monina Cruz, Joven Cuanang, Mayvelyn Gose, and Teresa Ramirez.
Copies of the guidelines are available at the ADAP secretariat (+63-2-7165384 or +63-2-7231039.
A. Mendoza
PLAE marks epilepsy week
Psychosocial issues confronted by persons with epilepsy and their caregivers will be the focus of this year's National Epilepsy Week Celebration slated September 5 to 11. Now in its fourth year, the celebration is spearheaded by the Philippine League Against Epilepsy (PLAE). This year's theme is Building Ties, Building Lives.
Among the activities are a press conference at Annabel's Restaurant on September 5 at 9 AM to be followed at 3 PM by the opening of the "Fruits of the Spirit" art exhibit by visual artist Baldwin Kho, one of the 2004 PLAE Epilepsy Exemplar Awardees. The exhibit will run from September 6 to 10 at the Kaisa Heritage Center in Intramuros. Proceeds from the exhibit will go to the PLAE Drug Bank.
Dr. Leonor Cabral-Lim, PLAE president, said 45 lay forums and symposiums will be held simultaneously across the country during the weeklong celebration. Experts in neurology, psychology, and other fields of medicine will discuss issues affecting persons with epilepsy like marriage, intimacy, pregnancy, family life, education, and employment will be discussed. Livelihood workshops will be scheduled to train patients to engage in income-generating activities.
Dr. Ces Alincastre, chair of the organizing committee, said PLAE and its lay arm, the Epilepsy Awareness Advocates, will hold the third National Lay Symposium on September 11 at the Philippine Columbian Association in Paco, Manila. With the theme Epilepsy, Marriage, and Family, the forum will be attended by members of the various epilepsy support groups in the country as well as patients and their caregivers. This will be followed by bingo socials where cash and other interesting prizes will be given to lucky participants.
For more details, please contact the Epilepsy Week Secretariat at +63-2-5254996; +63-2-7113946; +63-917-9428637; +63-920-9606498.
PSMID hosts 24th ICC
More than 40 countries were represented in the 24th International Congress of Chemotherapy (ICC), a biennial convention of the International Society of Chemotherapy (ISC), held at the Philippine International Convention Center on June 3 to 6 with the theme Confronting Health Challenges, Strengthening Strategies. The Philippine Society for Microbiology and Infectious Diseases (PSMID) hosted the event.
Prof. Jean-Claude Pechère, ISC president, said the convention program highlighted emerging and reemerging infections, advances in chemotherapy, innovative management of infection and cancer, and sustainable strategies in infection control.
Dr. Thelma Tupasi, president of this year's ICC, said the program organized into five tracks "reflect[ed] the most important concerns we are faced with in the chemotherapy of infection and cancer."
Keynoting the conference, former health secretary Manuel Dayrit called for "shared responsibility and partnership" in facing global health challenges, particularly those posed by infectious diseases that have the potential for global disaster.
Dayrit stressed that as discussed in the World Health Assembly in Switzerland in May, international health authorities and experts need to strengthen pandemic preparedness and response in view of emerging health threats. He also called on the ICC and ISC to do their share in addressing other global health concerns such as sustainable financing for tuberculosis control and prevention, global immunization, antimicrobial resistance, and infant and child nutrition.
This year's recipient of the Hamao Umezawa Memorial Award was Prof. Calvin Kunin, world-renowned authority on infectious diseases and antimicrobial therapy, who was cited for his advocacy on the prudent use of antimicrobials to prevent the emergence of bacterial resistance.
In his lecture on "Antibiotic usage: historical perspective and challenges," Kunin warned of the dire consequences of antibiotic abuse and misuse even as he acknowledged that decreasing the casual use of antibiotics is a difficult task. He said there is also a need to discover new antimicrobial drugs and virulence inhibitors, to develop effective vaccines, and devise inexpensive rapid diagnostic tests that can be used in offices and at bedside.
Dr. Edward Quinto of the University of Santo Tomas Hospital was one of the recipients of the Tom Bergan Memorial Award. He was cited for his study on "Novel biotherapeutics from Lactobacillus acidophilus USTCMS 1073 exhibiting potent inhibitory activity against bacteria, Flamentous fungi, and Candida albicans." "Antimicrobial biotherapeutics from lactic acid bacteria can be an alternative to existing synthetic antimicrobials which pose health and environmental risks," Quinto said in his presentation.
A. Mendoza
PCS bares six pillars of good health
The Philippine Cancer Society (PCS) is focusing its education efforts on the role of a healthy lifestyle in cancer prevention. Sylvia Palma, PCS director for development said it is important for Filipinos to cultivate a culture of well-being and healthy living from hereon to lower the cancer incidence in the country.
"Our collective risk of having cancer will continue to rise if we keep ourselves open to harmful elements in society," Palma said.
She explained that healthy lifestyle is anchored on six pillars: maintaining a healthy diet, exercising regularly, avoiding bad vices such as smoking and excessive drinking of alcoholic beverages, close monitoring of one's weight gain or loss, managing stress, and regularizing medical checkups.
Palma said researchers estimate that 80 percent of cancer types are lifestyle-related and only 20 percent are caused by genetics.
"Cancer is caused by improper dietary habits, physical inactivity, exposure to bad vices like smoking, obesity, and lack of personal health monitoring. The risk of Filipinos having cancer will continue to increase if these unhealthy habits remain unchecked," she said.
Palma said that the PCS aims to introduce programs that will help promote healthy lifestyle across the country. Healthy habits can't be formed in just one year so there is a need for at least three years to ensure that the campaign will generate results, Palma said.
The PCS decision to focus its education efforts on the benefits of a healthy lifestyle has earned the support of various organizations including Roche (Philippines) Inc.
Roche recently partnered with the PCS and the Department of Health to help raise cancer consciousness among Filipinos through a cancer-advocacy project called The C-Network. The C-Network provides knowledge, resources, and innovations that aim to prevent and cure cancer.
"We, at Roche, are very proud to be involved with the Philippine Cancer Society in their National Cancer Consciousness Campaign. Together, we seek changes in how Filipinos manage their lifestyles to steer clear from cancer," said Warwick Bedwell, general manager of Roche.
A. Mendoza
PCTO holds first assembly
The Philippine Center for TMJ-Orthodontics (PCTO) recently held its first scientific seminar and commencement exercises with wellness advocate Cory Quirino as guest speaker. Dr. Michael Alexius Sarte, chief of otolaryngology-head and neck surgery at The Medical City, delivered a lecture on "ear symptoms (hearing loss, tinitus, ear pain, and dizziness) associated with temporomandibular-joint (TMJ) disorder."
Dr. Heminia Chavez, founder of PCTO, who trained in the United States on TMJ, has been conducting postgraduate courses on TMJ preceptorship since September 2003. To date, PCTO has produced 30 graduates who eventually became members of the center.
Chavez said TMJ disorder is "a medical-like problem that may require dental solutions."
Officers of the Philippine Dental Association, Aster Campanero, Leodegario Lopez, and Leo de Castro, along with Prof. Jaime Licauco, attended the commencement exercises.
A. Mendoza
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