 Strong Political Will Needed in Enforcing Tobacco Ad Ban
It would require "tremendous political will" to enforce a total ban on tobacco advertising starting July 1, 2008, the day the Tobacco Regulation Act of 2003 (Republic Act 9211) says "all tobacco advertising in mass media shall be prohibited."
Court of Appeals Associate Justice Magdangal de Leon stressed this before members of the Philippine Medical Association as he sounded a call for strict enforcement of the landmark legislation aimed at discouraging smoking and curbing its ill effects among Filipinos, especially the young.
Keynoting the 97th PMA annual convention at the Manila Hotel on May 20, de Leon, a staunch antismoking advocate, challenged convention dele-gates and medical professionals to be at the forefront of antismoking campaigns especially in public places such as hospitals, health centers, and dispensaries.
Among other provisions, RA 9211 prohibits the sale of tobacco to and by minors; bans smoking in public places; bans the sale of cigarettes or the posting of any advertisement within 100 meters of any school, public playground, or other places frequented by minors; phases out tobacco advertising in mass media over a period of five years; and safeguards and protects the interest of workers in the tobacco industry.
"But this policy of the state to protect the general welfare and interest of tobacco farmers is an understatement," de Leon said, noting that "research findings show that one out of five Filipino adults are hypertensive due to the pernicious effects of smoking." In 1999, he said, more than 13,000 Filipinos died of diseases related to smoking such as emphysema and lung cancer.
De Leon lamented "the sad thing that many doctors-and they include cardiologists-do smoke and one out of three doctors who smoke do so in front of their patients."
De Leon also underscored the importance of a more holistic approach in medicine wherein doctors treat their patients as human beings rather than as "mere symptom or disease carrier."
The convention, which had for its theme A Unified and Responsive PMA into the Next Century, assembled distinguished experts from various specialties, subspecialties, and affiliate societies of the PMA to tackle various issues in the field of medicine and to share information on the latest advancement and emerging forms of medical technology.
Various symposiums tackled such topics as choosing the right antihypertensives, pitfalls in ultrasound interpretations, teenage pregnancy, common ENT problems in clinical general practice, thyroid emergencies, alternative to blood transfusion, nutrition and cancer, pain management, management of sexually transmitted diseases, PhilHealth's new accreditation standards, guidelines for osteoporosis screening, new trends in osteoarthritis management, family wellness, rehabilitation of the elderly, and control and treatment of tuberculosis in children.
During the convention, PMA members elected new officers for 2004-2005. They are doctors Bu Castro, president; Jose Asa Sabili, vice president, Rey Melchor Santos, national treasurer; and governors Rose Marlene Lozada (Northeastern Luzon), Jackson Soriano (Northwestern Luzon), Edwin Argonza (Central Luzon), Ma. Minerva Calimag (Manila), Ricardo Costes (Quezon City), Andres Reyes (Rizal), Amelia Europa (Central Tagalog), Mona Lisa Cosme (Southern Tagalog), Angel De Castro (Bicol), Ramon Berjamin Jr. (Western Visayas), Ramon Yap Sy Jr. (Central Visayas), Leo Douglas Cardona (Eastern Visayas), Felicitas Macias (Western Mindanao), Filipina Villa (Northern Mindanao), Ramon Rabago
Jr. (Southeastern Mindanao), Alma Mansueto-Ozaraga (North-Central Mindanao), and Roseller Gayas (Caraga).
Lilia B. Alvarez
POGS Launches Campaign on Adolescent Reproductive Health
Over the years, Filipino teenagers are becoming more sexually active at a younger age, say the surveys: from the 90 percent in 1982, the number of adolescents who took the no-sex-till-marriage stand slid down to 85 percent in 2002; the average age of sexual debut is 17.5 years. Of the premarital sexual encounters among adolescents, 55 percent are unplanned, while 40 percent are unprotected. And so the rate of teenage pregnancies all over the country has risen from nine percent in 1993 to 11 percent in 1998.
A number of sectors find the statistics alarming, and try to come up with ways to intervene.
In its desire to "empower, protect, and [help] the youth become responsible players in society," the Philippine Obstetrical and Gynecological Society, together with Sanofi-Synthelabo Philippines, recently unveiled an education campaign on reproductive health issues called Adolescent Health Issues and Perspectives.
Dr. Rosendo Roque, POGS president, said during the launch held at the Oakwood Premier: "Proper education is the best strategy to prevent unwanted pregnancies and sexually transmitted diseases."
POGS members, in cooperation with other specialists (pediatricians, among others), started the project by preparing four educational modules that shall tackle pressing concerns on adolescent sexuality.
These modules cover sexual health and development, fertility awareness, the myths surrounding teenage reproductive health, and the consequences of sexual behavior.
They also include sections on unwanted pregnancies, unsafe abortions, sexually transmitted infections, and sexual violence and coercion. Doctors themselves will take an active part in discussing the contents of the modules in various schools.
However, no specific section on contraception is included in the project. This, Roque explained, is for a reason. He said that this reflects the organization's stand on the issue of adolescent sexuality-the best way to prevent all problems related to adolescent sexual health is still with sexual abstinence.
Also, this does not mean that the project chooses to ignore the issue of contraception. Pediatrician Agnes Falcotelo explained that while a specific section on contraception is not part of the modules, it is still bound to come up in the open forums after each lecture.
At present, Filipino adolescents (between the ages of 10 and 19) comprise nearly 20 percent of the national population.
J. P. de Guzman
PAMS Meet Tackles Disease Management
The Philippine Academy of Medical Specialists (PAMS), a medical multispecialty organization, recently held its ninth annual convention taking on the theme Specific Actions and Remedial Solutions to Disease Management.
The two-day meet served as a venue for medical and surgical specialists to participate in scientific sessions on various topics such as conservative management of fractures, sex and the facts of life, update on SARS, comprehensive management of osteoarthritis, marriage 911.com, the role of sodium ascorbate in the management of heart disease, and HMOs.
Dr. Kenneth G. Ronquillo, officer-in-charge of the health human resource development unit of the Department of Health, delivered a message on behalf of Health secretary Manuel M. Dayrit. He spoke about the DOH mission of "good governance in health," which he said means achievement of better health for all Filipinos. He cited three strategies of achieving it: preventing illnesses and early death, increasing satisfaction and confidence in the quality of health care, and providing relief from the financial and economic burden posed by illnesses.
He said the DOH seeks to improve the health of Filipinos by enhancing access to quality and affordable health care; ensuring the quality of health-care products and services through effective regulation; lowering the prices of essential medicines; expanding social health insurance specially among indigents; promoting local health systems; and developing national health programs on disease control, immunization, micronutrient supplementation, family planning, and healthy lifestyles.
Dr. Ma. Victoria Garcia, training officer of echocardiography laboratory at the University of Santo Tomas Hospital, presented updates on prevention, evaluation, detection, and treatment of hypertension. Garcia said, "the relationship between the level of blood pressure to the risk of developing future cardiovascular events is continuous, consistent, and independent of the presence of other risk factors, meaning the higher the BP, the higher is the risk of future cardiovascular events."
She warned of the rising incidence of hypertension in the country, noting that "a community-based study sponsored by the Philippine Heart Association placed the incidence of hypertension at as high as 17 percent."
Dr. William Olalia, a specialist in bariatric surgery at UST Hospital, talked about surgical management of morbid obesity, citing the need for a multidisciplinary team and preoperative preparation of the morbidly obese patient. "We have to have a comprehensive preoperative assessment which is the cornerstone for success of this treatment. All comorbid conditions should be identified and treatment instituted before surgery," he stressed.
Miles Dumalagan
Integrating Subspecialties in Practice Highlights PPS Convention
Celebrating the theme, Integrating the Subspecialties in Current Pediatric Practice, the Philippine Pediatric Society (PPS) held its yearly convention April 25 to 28 at the Philippine International Convention Center and the Westin Philippine Plaza Hotel.
Keynoting the convention on its opening night, Health secretary Manuel Dayrit spoke of battles won and still to be fought in the health arena. "There are still many battles to be fought and some more useful, youthful energies to be spent. All I ask myself and everybody else is to be open to all possibilities
perhaps opening impossibilities," he said.
Sharing different stories gathered from his years at the DOH, Dayrit left the participants a poignant message: "For me, final satisfaction boils down to [three things]. One, being able to communicate a sense of caring to the hopeless-this is life-giving in itself, and is a gift we transmit to others from a power larger than ourselves. Two, upholding a sense of fairness to the dispossessed of health care-this is healing in itself, and reestablishes the sense of dignity to anyone who feels they have lost it. [Finally], providing a sense of power to the weak-this is self-generating in itself, and is a fountainhead of victory in the face of adversity. [These] define the infinite possibilities for our future."
The opening ceremonies were highlighted by a special video presentation on the society's origin, direction, and activities, as well as the distribution of awards of recognition to outstanding PPS members, PPS chapters, and subspecialty societies for their work and achievements.
Most Active Chapter awards were given to Cebu Central and Eastern Visayas (continuing medical education), Southern Tagalog (child advocacy), and Negros Occidental and Western Visayas (community service). The Fe del Mundo Award for Outstanding Pediatrician in Community Service was given to Dr. Lea Villalica Umil.
Pediatric hematologist/oncologist Mary Ng Chua, former president of the Philippine Society of Hema-tology and Blood Transfusion, was named most outstanding pediatrician for 2003. Chua was responsible for the creation of the Hemophilia Association of the Philippines for Love and Service (HAPLOS), later officially designated by the DOH as the National Hemophilia Center. A former president of the PPS, she is a prominent researcher with extensive contributions on leukemia and other hematological diseases.
Attended by a record-breaking 5,165 physicians from all over the country, the convention featured more than 30 lectures from the different subspecialties of pediatrics. Participants were treated to a four-day marathon of medically, clinically, and socially significant talks delivered by local and international dignitaries.
Among the major topics dealt on promises and problems in the Human Genome Project by Dr. John Christodoulou, preventive endocrinology by Dr. Margaret MacGillivray, challenges to organ transplantation in developing countries by Drs. Enrique Ona and Christopher Mark Taylor, flu vaccine for children by Drs. Susan Chiu and Kathleen Neuzil, fetal exposure to environmental toxins by Dr. Enrique Ostrea Jr., and issues and controversies in complementary and alternative medicine by Drs. Jaimy Galvez-Tan and Benjamin Co.
The distribution of awards to outstanding researchers in pediatrics capped the convention. Top honors for the PPS-Mead Johnson Research of Pediatric Residents went to Dr. Ma. Jewellie Perez of the University of Santo Tomas. Her research on "effects of dosing interval on pharmacokinetics of rifampicin suspension in combination with isoniazid and pyrazinamide in children" also garnered the Best Poster Presentation award. Winners of the Clinical Research Awards for Noncommunicable Diseases were Dr. Rowena Aman of Manila Doctors Hospital (Efficacy of Shotblocker application in reducing vaccination pain using the modified behavioral pain scale among newborns at the Manila Doctor's Hospital given the first dose of hepatitis B vaccine intramuscularly) and Dr. Celestie Africa-Jobog of Manila Central University (Efficacy of diben-cozide in appetite improvement among children).
Dr. Michelle Tabbada of UST received the Pediatrics Research Award for Consultants and Residents for her research on Iron with vitamin A and iron alone in the treatment of iron-deficiency anemia. Dr. Rowena Fabonan from De La Salle University Medical Center (Developmental quotient in the four components of cognitive skills in school-aged children with and without intestinal parasitism) garnered second place. Dr. Mary Luz Roldan received the Innovative Medical Device Prize (Effectiveness of an upholstered crib jacket heating pad in the thermoregulation of full-term, small for gestational age infants).
R. Y. Cruz, MD
Preventive Cardiology Is Making Headway, says PHA
At its 35th annual convention May 26 to 29, the Philippine Heart Association (PHA) assessed the progress of its war against cardiovascular diseases and concluded it is making great strides by anchoring its campaign on preventive cardiology and by reaching out to the general population through mass media.
The convention, in fact, kicked off with sessions bannered by the society's Puso sa Puso Media Forum.
Said PHA president Dr. Romeo J. Santos: "The use of tri-media-print, radio, and broadcast-was maximized to spread the gospel of CVD prevention. Public lay forums and CV risk factor screening were the other effective methods used."
Still, statistics leave much to be desired, according to noted cardiologist Ramon Abarquez Jr. who delivered the Dr. Homobono Calleja Professorial Lecture on "Problems and Advocacies Then, Proactive Relevance Now."
The prevalence of hypertension and cardiovascular diseases continues to rise to alarming proportions. Last year alone, more than 150,000 Filipinos died of hypertension, cardiovascular, and related disorders.
Hypertension is often diagnosed late, and control and management of patients remain problematic, prompting Abarquez to call on physicians to "be proactive, not merely reactive" in identifying, diagnosing, and treating individuals at risk.
Abarquez cited a number of advocacy initiatives he has been involved in that helped put hypertension and cardiovascular disorders to light and set directions for disease management and research.
The first related to fibrinolysis (circa 1960s), which confirmed thrombosis as the main culprit in acute myocardial infarction. "To date, clot rather than stenosis severity is the acute coronary syndrome pathophisiology," he said.
The metabolic agents were the thrust of advocacy in 1986. "Cellular metabolism then and currently is the focus of clinical research with clinical implications."
The third advocacy related to the need for dynamic exercise electrocardiogram (ECG) testing. "Stress ECG among at risk cases now has diagnostic, therapeutic, and prognostic relevance."
The fourth advocacy proposed 140/90 mmHg as the cutoff point for hypertension (1978). Advocacy five suggested a "proactive option to control or prevent left ventricular hypertrophy among uncomplicated essential hypertension cases."
Among the topics discussed in the convention were "No ifs, no buts, busy docs should find time to exercise" by Dr. Norbert Uy, "Glaring statistics on five leading CVD risk factors are still staring at us" by Dr. Dante Morales, "Dyslipidemia: A more serious threat to women than men?" by Dr. Eugene Reyes, "Dyslipidemia in women" by Dr. Milagros Yamamoto, "BMI, WHR, WC on obesity: Which one?" by Dr. Rodolfo Florentino, "Clinical practice guidelines: Diagnosis and treatment of rheumatic fever" by Dr. Juliet Balderas, "Delaying hypertension: Is it possible?" by Dr. Nelson Abelardo, "Preventive cardiology in women" by Dr Esperanza Cabral, "Brugada syndrome" by Dr. Joseph Brugada, "Holistic approach in the treatment of diabetis mellitus from the cardiovascular standpoint" by Dr. Eugene Reyes, and "Polypharmacy in hypertension" by Dr. Antonio Bautista.
Amzel Ordoņez
Pitfalls, Solutions in Cardio Catheterization
 Know what the problems are and come up with solutions.
This was the thrust of the 11th annual scientific convention of the Philippine Society of Cardiovascular Catheterization and Interventions (PSCCI).
The convention held May 1 at the Subic International Hotel in Olongapo City had a lineup of lectures that centered on Pitfalls in Transcatheter Intervention and their Solutions.
The topics were about how to identify, and avoid and solve problems encountered in the cardiac catheterization laboratories. Newer techniques and devices, like adjunctive pharmacology and drug-eluting stents, also took up a big part of the scientific program.
Prof. Klaus Mathias, a pioneer in carotid angioplasty from Germany, talked about the growing pains in the development of this area of catheter intervention. Prof. Kean-Wah Lau from Hong Kong discussed the clinical impact of stent design and construction. Local speakers emphasized contrast nephropathy, radiation hazards, technical challenges in thrombus-laden coronary lesions, and pediatric cardiovascular interventions in their talks.
According to PSCCI immediate past president Ramoncito Tria, the program was designed to benefit cardiologists, internists, and paramedical people, as well as interventional cardiologists.
Other officers of PSCCI are doctors Eduardo Manrique, president; Saturnino Javier, vice president; Reynaldo Fajardo, secretary; and Ramon Pineda, treasurer. The directors are doctors Timothy Dy, James Ho Khe Sui, and Ariel Miranda.
The PSCCI was formally organized in 1993 as an association of Filipino cardiologists who wish to advance the field of cardiovascular catheterization and interventions in the country. Its founding president is Dr. Bun Yok Dy.
M. Ciriacruz
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