PHA Promotes Hearty Lifestyle for Healthy Nation
The Philippine Heart Association (PHA) held its 34th annual convention May 28 to 31 with the theme PHA at 51: Promoting a Hearty Lifestyle for a Healthy Nation, highlighting its collaborative effort with the Department of Health on a nationwide healthy lifestyle campaign.
Opening the convention, PHA president Annette Pizarro-Borromeo called on her colleagues to "have a heart of gold" and rise to the challenge of providing Filipinos with affordable, quality treatment. The PHA, she said, serves as the nucleus of breakthrough advancement in Philippine cardiology.
Dr. Edgardo Ortiz cited the benefits of fetal echocardiogram in detecting fetal abnormalities like congenital heart diseases (CHDs) especially in high-risk pregnancies. He said fetal echocardiogram helps determine if intervention-including fetal surgery-would be necessary to manage or avoid potential complications.
Dr. Gregorio Patacsil, associate professor at the University of the Philippines-Philippine General Hospital, discussed sudden cardiac death in the session on emergencies in adult CHDs and cerebrovascular accidents. He said sudden cardiac death could be due to ventricular fibrillation triggered by high carbohydrate intake leading to hyperglycemia, CNS depression because of drugs and ethanol, and splanchnic pooling because of heavy meals or spinal anesthesia.
Dr. Ranulfo Javelosa, assistant professor at the University of the East Ramon Magsaysay Memorial Medical Center discussed new treatment modalities for heart failure. He cited vasopressin antagonists (vaptans), which reduce systolic vascular resistance, increase cardiac activity, and decrease pulmonary congestion in patients with heart failure. Other modalities are immunomodulating therapy, atrial natriuretic peptide (ANP) inhibitors, endothelin antagonists and growth hormone therapy.
Dr. Anthony King delivered a lecture on patients with unexplained syncope and its relation to sudden cardiac arrest. Syncope occurs at least once in a lifetime in a third of the entire population and accounts for about three percent of emergency room admissions.
In a breakfast symposium, Dr. Benjamin Luna of UP-PGH cautioned clinicians against a "shotgun approach" in diagnosing patients with acute chest pain who could prove to be a diagnostic dilemma. With the vast array of modern diagnostic tests available, he said the clinician might be tempted to depend on them for speedy diagnosis.
He said good history taking and physical examination remain important in diagnosing chest pain. Describing the pain in terms of quality, radiation, severity, and timing will offer clues to whether it is cardiac in nature. Presence of comorbid illnesses such as hypertension and diabetes should be noted. Luna said clinicians should also consider in the differential diagnosis noncardiac conditions like esophageal or peptic ulcer disease, pleurisy, costochondritis, pulmonary embolism, or psychogenic causes.
Jacqueline San Pedro
Hypertension Specialists Needed
Although primary care physicians play a key role in the identification and treatment of patients with hypertension, says the Philippine Society of Hypertension (PSH), physicians with extensive knowledge and training in dealing with more complicated and difficult cases are needed.
PSH has thus created the Philippine Hypertension Specialist Program, a formal method to identify and recognize hypertension specialists.
According to PSH, this will promote the coordinated effort of frontline health-care providers and primary care physicians with expertise in the management of hypertension.
Hypertension specialists will act as consultants and referral physicians and assist in updating and improving the national guidelines for hypertension detection and management.
Until August 30, the PSH will accept applications from physicians who are interested to be certified as Philippine hypertension specialists.
To be eligible, they must by certified by a relevant primary specialty board, have at least 10 years clinical practice and experience in treating difficult hypertension cases, and demonstrate substantial scientific or academic activity in the field of hypertension.
After August 30, in addition to the above requirements, they must pass the certifying examination for the hypertension specialists to be given by PSH on October 18. Candidates have until September 22 to apply.
Physicians may also apply until July 31 for the once only process of certification without examination. Once tentatively approved for certification, they have up to two years to attend the specialist course for the clinical practice of hypertension before certification is finally granted. The first course will be held in September.
Contact PSH for details: 63-2-6877073, 63-2-6872841;
phihyper@pworld.net.ph,
www.psh.org.ph.
Michelle Ciriacruz
Strengthening Cancer Support Groups
The Philippine Cancer Society (PCS) and Biomedis-Oncology have teamed up to find ways of strengthening cancer support groups in the country. The organizations held last April a summit for cancer support groups to help them define their roles, strengths, and weaknesses; enhance their skills; shore up their advocacy campaigns and other activities; and boost their fund-raising capabilities.
Delegates from Metro Manila, northern Luzon, and parts of Visayas and Mindanao participated in the daylong workshop.
PCS chair Roberto Paterno said the summit served as a means not only to strengthen the society's links with cancer support groups but also for the these groups to network with and support one another.
Marianne G. Quebral, executive director of Venture for Fund Raising gave participants tips on raising funds.
"It is very difficult for nonprofit organizations or support groups to raise money for their activities," Quebral admitted, as she advised participants to "view fund raising from another perspective," not just from the point of view of money.
While raising money is the ultimate goal, "fund-raising is also friend-raising," she said. "[When we do fund-raising campaigns,] we find people who share the same values that we have-goodwill, love, honesty, dignity, love for life-and share in our efforts to help others."
She said successful fund-raising leads to an organization's survival, reduction of dependency on a single source, constituency building, viability, and sustainability.
Miles Dumalagan
PSSM Holds First Symposium on Sleep
The Philippine Society of Sleep Medicine (PSSM) held its first symposium on Sleep Medicine in Clinical Practice: A Multi-Disciplinary Approach last March at the Manolo M. Lopez Development Center in Antipolo. Dr. Ma. Felicidad Soto, PSSM president and head of the St. Luke's Medical Center (SLMC) sleep center, opened the two-day event, which also featured exhibits by several pharmaceutical companies.
The symposium focused on five major sleeping disorders: insomnia, parasomnia, snoring, excessive daytime sleepiness, and abnormal movements during sleep.
SLMC's Dr. Ruby Manalastas said insomnia, according to the length or duration, may be transient, short term, or chronic. Transient insomnia affects patients for few days to a week. She said usually no pharmacologic intervention is necessary and while it is not debilitating, it could decrease the patient's efficiency in daily activities.
Short-term insomnia lasts for one to two weeks. Its effects become more manifest and it could progress into chronic insomnia. Short-term and chronic insomnia usually arise from psychiatric or psychological disorders-depression, anxiety and panic, and alcohol or substance abuse. Both can be managed with a combination of pharmacological and nonpharmacological (behavioral therapy like yoga and other types of relaxation, improvement of sleep habits, and other activities conducive to sleep) intervention.
Dr. Rolando dela Eva, pediatric pulmonology consultant at the SLMC sleep center gave an overview of parasomnias-undesirable physical or behavioral phenomena occurring exclusively or predominantly during sleep. These are usually motor or autonomic in nature associated with variable degrees of arousal.
De la Eva said parasomnias are classified into three: arousal disorders (confusional arousals, sleepwalking, and sleep terrors); sleep-wake transition disorders (rhythmic movement disorder, sleep starts, sleeptalking, and nocturnal leg cramps); and rapid eye movement-associated (like nightmares, sleep paralysis, sleep-related impaired or painful erection, sinus arrest, and REM sleep behavior disorder. Other parasomnias are sleep bruxism, sleep enuresis, sleep-related abnormal swallowing syndrome, sudden unexplained nocturnal death syndrome (SUNDS), and sudden infant death syndrome (SIDS).
Soto said SUNDS-more popularly known as
bangungot in the Philippines-usually occurs in healthy Southeast Asian
0males, 25 to 44 years old, and is characterized by labored breathing, choking during sleep, and ventricular fibrillation.
SUNDS has puzzled doctors until now. But Soto cited three explanations as to its causes that have been advanced so far: emotional stress and environmental changes, sleep apnea, or genetics (affecting males in the family).
As for SIDS, Soto said this abrupt, unexpected death during sleep occurring in apparently healthy infants before age six months, with no cause found postmortem, is more prevalent in males and is the leading cause of infant mortality in the US especially in winter. The infant suffers from abnormal reflex coordination or heart rate, blood pressure, and respiration during sleep, resulting in hypotension, bradycardia, apnea, then sinus arrest. Soto said the risk for SIDS is increased by prone sleeping position, exposure to tobacco smoke before and after birth, maternal substance abuse, preterm and multiple births, family history, and apnea of infancy.
Dr. Michael Sarte of The Medical City's center for snoring and sleep disorders said snoring is more prevalent among men (44 percent) than women (28) ages 30 to 60. The prevalence rises among those ages 50 to 60.
Anatomical abnormalities like narrow nasal passages, falling back of the tongue that narrows the airway, and inherently small airway diameter cause snoring. Other factors are craniofacial abnormalities, injury reasons, and congestion of the soft tissues of the airways due to smoking, alcohol, acid reflux, obesity, ageing, and hormones.
Sarte said snoring is a serious sign of sleep apnea syndrome, a condition characterized by cessation of airflow that can result in death. The airflow cessation can last for a few seconds to a minute or two, at which time, the body wakes up. When this occurs, a snorting or gasping sound can be heard. Snoring can contribute to fatigue and morning tiredness, as well as higher risks of hypertension, stroke, and heart attack.
Jacqueline San Pedro
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