Knowledge and preference of Filipino COPD patients on advance care planning: A cross-sectional survey

Objectives@#To explore the current experiences and perspectives of patients with chronic obstructive pulmonary disease (COPD) with advance care planning (ACP).@*Methods@#A cross-sectional survey was conducted among patients diagnosed with COPD in the Philippine General Hospital. Results were illustrated using descriptive statistics.@*Results@#A total of 90 patients were interviewed and included in the analysis. Nearly all patients were unfamiliar with the terms ACP (95.55%), end-of-life care (99.89%), and do-not-resuscitate order (100%). The majority expressed a desire to have ACP discussions (94.44%) which were not viewed as distressing and were deemed beneficial (96.67%). Patients who were employed were more likely to express readiness to sign legal papers. Patients living with their nuclear family or living alone, and those with higher COPD assessment test (CAT) scores were more likely to relegate health care decisions to their doctors.@*Conclusion@#Most patients with COPD in our cohort are unfamiliar with ACP and have not received ACP discussions. Most think that it will improve healthcare and quality of life. Some demographic and clinical factors may make patients more likely to engage in ACP-related activities.

Spleen Factor: The Spleen’s Role as a Respiratory Organ

@#The Bajaus’ ability to free dive for prolonged periods is attributed to their exceptional physiologic response and large spleens. The spleen has been traditionally viewed as a hematologic and immunologic organ. Unconventionally, this review explores the spleen’s role as a respiratory organ and how apnea training can enhance the spleen’s form and function. Eligible articles obtained from Pubmed were discussed. The selected studies have shown that an 8-week home-based apnea training regimen can enhance the spleen volume by as much as 24% and that prolonged apnea training can increase both splenic contraction and baseline serum hemoglobin levels. However, the sample size and heterogeneity of these studies largely limit the generalizability of these findings. Thus, several future studies are needed to further explore the spleen’s respiratory function in humans.