Philippine guidelines on periodic health examination: Pediatric immunization

Executive Summary@#This Clinical Practice Guideline for the Periodic Health Examination (Pediatric Immunization) is an output from the joint undertaking of the Department of Health and National Institutes of Health-Institute of Clinical Epidemiology. This clinical practice guideline is a systematic synthesis of scientific evidence on immunization for the prevention of human papilloma virus (HPV) infection, influenza, typhoid fever, Japanese encephalitis, poliomyelitis, meningococcal infection, and Hepatitis A in the pediatric population. The CPG provides nine (9) recommendations on prioritized questions regarding the relevant vaccines for preventing these seven (7) diseases. Recommendations are based on the appraisal of the best available evidence on each of the eight identified clinical questions. The CPG is intended to be used by general practitioners and specialists in the primary care setting, policy makers, employers and administrators, allied health practitioners and even patients. The guideline development process followed the widely accepted Grading of Recommendations, Assessment, Development, and Evaluation or the GRADE approach including GRADE Adolopment, a systematic process of adapting evidence summaries and the GRADE Evidence to Decision (EtD) framework. 1,2 It includes 1) identification of critical questions and critical outcomes, 2) retrieval of current evidence, 3) assessment and synthesis of the evidence base for these critical questions, 4) formulation of draft recommendations, 5) convening of a multi-sectoral stakeholder panel to discuss values and preferences and assess the strength of the recommendations, and 6) planning for dissemination, implementation, impact evaluation and updating. The recommendations in this CPG shall hold and will be updated after 3 years or when new evidence arise.

2021 clinical practice guidelines in the evaluation and management of pediatric community-acquired pneumonia

Preface@#The Clinical Practice Guidelines (CPG) for the Diagnosis and Management of Pediatric Community-Acquired Pneumonia (PCAP) was initiated by the Philippine Academy of Pediatric Pulmonologists, Inc. (PAPP) and the Pediatric Infectious Disease Society of the Philippines (PIDSP), in cooperation with Philippine Pediatric Society, Inc. (PPS) way back in 2004. Several CPG updates were then undertaken by the PAPP PCAP CPG Task Force from 2008 to 2016. Clinically-relevant research questions were answered with recent and current recommendations based on evidence from local and international data. The 2021 PCAP CPG initiative was envisioned in March 2018 upon the recommendations of the 2018 PAPP Board for the purpose of updating the evidence in the PCAP CPG 2016 clinical questions. This led to the collaboration of PAPP and PIDSP to develop this CPG. Individual members were identified from each society as content experts to form the Steering Committee along with a clinical epidemiologist and technical writer as review experts. The committee identified the scope and target end user of the CPG as well as additional clinical questions to be included in the 2021 update aside from the questions on the previous CPGs. Selected members from the two societies formed the Technical Working Group (TWG) who did the literature search, appraisal of evidences, and formulation of recommendations. These recommendations were then presented to the stakeholders who became part of the consensus panel. There was no identified conflict of interest among the CPG developers, TWG members and stakeholders. A survey to determine potential competing interests were conducted during the development of this CPG. This initiative was fully funded by the PAPP and PIDSP societies. The 2021 PCAP CPG significantly differs from the previous CPGs in several aspects. First, the current guideline is a consensus between two pediatric societies. Second, much of the literature review has been centered on meta-analyses or systematic reviews instead of individual studies. Finally, appraisal of published literature was based on Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. Such methodological differences may provide difficulties in defining evolution of care through the years. As identified in the previous CPG updates, there is lack of local data hence most of the evidences gathered came from international studies. The applicability of such data to the local setting needs to be critically assessed for its value and relevance. Corollary to this, several gaps in knowledge are identified and these may serve as a guide for future research.

Philippine pediatric COVID-19 living clinical practice guidelines as of March 2022

Executive Summary@#The Coronavirus disease 2019 (COVID-19) pandemic has triggered a global crisis and has affected millions of people worldwide. With the evolution of the different variants of concern, the incidence of COVID- 19 in the pediatric population has risen. The Surveillance and Analysis of COVID-19 in Children Nationwide (SALVACION) Registry, developed by the Pediatric Infectious Disease Society of the Philippines (PIDSP) and the Philippine Pediatric Society (PPS), has reported 3,221 cases as of March 31, 2022, with 90.4% requiring hospitalization and 36.2% with moderate to critical disease severity. Given the magnitude of the impact of COVID-19, with most of the clinical recommendations available designed towards adult patients, there was an urgent need for clinicians, public health officials and the government to also prioritize evidence-based clinical practice guidelines for the pediatric population. Hence, the development of the Philippine Pediatric COVID-19 Living Clinical Practice Guidelines was conceptualized. This independent project, funded and supported by the PPS and PIDSP, aimed to formulate up-to-date, evidence-based recommendations on the treatment, diagnosis, infection prevention and control of COVID-19 in children. Following the standard CPG development process outlined in the DOH Manual for CPG Development and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology, 15 evidence summaries and 24 recommendations were generated by 12 consensus panelists representing their specific health organizations and institutions.

Genetic variants associated with poor responsiveness to sulfonylureas in Filipinos with type 2 diabetes mellitus / Journal of the ASEAN Federation of Endocrine Societies

Introduction@# Sulfonylureas (SUs) are commonly used drugs for type 2 diabetes mellitus (T2DM) in the Philippines. This study aimed to associate genetic variants with poor response to gliclazide and glimepiride among Filipinos.@*Methodology@#Two independent, dichotomous longitudinal substudies enrolled 139 and 113 participants in the gliclazide and glimepiride substudies, respectively. DNA from blood samples underwent customized genotyping for candidate genes using microarray. Allelic and genotypic features and clinical associations were determined using exact statistical methods.@*Results@#Three months after sulfonylurea monotherapy, 18 (13%) were found to be poorly responsive to gliclazide, while 7 (6%) had poor response to glimepiride. Seven genetic variants were nominally associated (p<0.05) with poor gliclazide response, while three variants were nominally associated with poor glimepiride response. For gliclazide response, carboxypeptidase-associated variants (rs319952 and rs393994 of AGBL4 and rs2229437 of PRCP) had the highest genotypic association; other variants include rs9806699, rs7119, rs6465084 and rs1234315. For glimepiride response, 2 variants were nominally associated: CLCN6-NPPA-MTHFR gene cluster – rs5063 and rs17367504 – and rs2299267 from the PON2 loci.@*Conclusion@#Genetic variants were found to have a nominal association with sulfonylurea response among Filipinos. These findings can guide for future study directions on pharmacotherapeutic applications for sulfonylurea treatment in this population.

Alimentos orgánicos disminuyen la incidencia de cáncer / Organic foods reduce the incidence of cancer

En todo el mundo, el número de casos nuevos de cáncer se estimó en 2012 en más de 14 millones,1,2 y el cáncer sigue siendo una de las principales causas de mortalidad en Francia. Entre los factores de riesgo ambientales para el cáncer, existen preocupaciones sobre la exposición a diferentes clases de pesticidas, en particular a través de la exposición ocupacional.3 Una revisión reciente4 concluyó que el papel de los pesticidas para el riesgo de cáncer no podía ponerse en duda dado el creciente cuerpo de evidencia que vincula el desarrollo del cáncer a la exposición a plaguicidas. Si bien las respuestas a dosis de tales moléculas o los posibles efectos de coctel no se conocen bien, se ha sugerido un aumento de los efectos tóxicos, incluso a bajas concentraciones de mezclas de pesticidas.5

Worldwide, the number of new cases of cancer was estimated in 2012 at more than 14 million, 1,2 and cancer remains one of the leading causes of death in France. Among the environmental risk factors for cancer, there are concerns about exposure to different kinds of pesticides, particularly through occupational exposure.3 A recent review4 concluded that the role of pesticides in cancer risk could not be put in place. doubt given the growing body of evidence linking the development of cancer to exposure to pesticides. While responses to doses of such molecules or possible cocktail effects are not well known, an increase in toxic effects has been suggested, even at low concentrations of pesticide mixtures.5

Dietary phytoestrogen scoring database for prostate cancer studies and their role in prostate cancer risk

Objectives: To create a dietary isoflavones scoring database for future use in cancer epidemiologic studies. To investigate the role of isoflavones in aetiology of prostate cancer

Materials and Methods: A population based case- control study was conducted on 525 cases and 843 controls. To create an isoflavones scoring database, a creditable phytoestrogens database, and data from publications were used to create a mathematical computerised calculation program. Then after obtaining isoflavone intake for each individual, an unconditional logistic regression with various models was carried out

Results: There are 131 food items in the Food Frequency Question [FFQ]. Isoflavones values have been assigned to 56 items out of 131. The results of the analysis to explore the role of isoflavones either as a continuous or quintile variable were not significant, not a single quintile of isoflavones showed any significant association with prostate cancer risk

Conclusion: The isoflavones scoring database has been created. The analysis of the young prostate cancer study dataset and the role of isoflavones in disease aetiology has not shown a statistically significant association

International Symposium on Infection-Immunity and Cancer

not available

Juventude e segurança: PROTEJO Osasco / Youth & Security: PROTECT Osasco

O Projeto Proteção de Jovens em Território Vulnerável (PROTEJO) foi instituído pelo Governo Federal no ano de 2008 e integra as ações do Programa Nacional de Segurança com Cidadania (PRONASCI), este programa foi desenvolvido pelo Ministério da Justiça.

Guía de procedimiento terapeúticos de medicina natural y tradicional para situaciones de desastres para medicina, estomatología y enfermería / Guide therapeutic procedure natural and traditional medicine to disaster situations for medicine, dentistry and nursing

Manual que constituye una guía terapéutica de Medicina natural y tradicional, para el tratamiento de enfermedades que aparecen después de la ocurrencia de desastres naturales, ta-les como: enfermedades respiratorias, digestivas, parasitismo, úlceras, hepatitis, cólera, fiebre tifoidea, entre otras muchas. No se expresa en este documento las afecciones que pueden producir en la población los desastres industriales y los sanitarios, que hacen más complejo el aseguramiento médico. A continuación exponemos el tratamiento de las enfermedades más frecuentes en condiciones de desastres con distintas técnicas de Medicina Tradicional y Natural.

Ética médica y bioética / Medical and bioética ethics

El libro de Ética y Bioética, que verá la luz proximamente gracias a la solidaridad de la Oficina de la OPS/OMS en Cuba y especialmente, de la Dra. Lea Guido López, su Representante, abarca 4 capítulos y un epílogo, dedicados a los principales problemas relacionados con la fundamentación ética de la conducta moral de los profesionales y las características, con sus particularidades, del ejercicio moral en las políticas y estrategias de salud, en la ética clínica, en la actividad científica y en la gestión de los servicios de salud.

Effects of Traffic Exhausts on Children's Behavioral Problems Parasat / 环境与健康杂志

Objective To explore the health effect of traffic exhausts on children's behavioral problems by using the Achenbach's Child Behavior Checklist.Methods Three primary schools were chosen based on the counts of passed by automobiles and the monitoring data of ambient air pollutants.Air pollutants including NO_x,SO_2,PM 2.5 and CO were analzed around the schools.There were 1 821 students in total from Grade 2 to Grade 5 were chosen as the target population and were investigated with the self-designed questionnaire as well as Achenbach's Child List.Finally,1 363 cases were analyzed,of whom have been local resident for more than 2 years and were in condition during investigation.Results A total of 141 children,with the rate of 10.34%,were reported to be with behavioral problem.The reported rates of behavioral problem were 9.04% in School A1, 9.77% in School A2,and 11.99% in School A3 respectively,however,there was no significant difference was seen(x~2=2.556,P= 0.279).The reported rate of behavioral problem of boys' was higher than that of girls' in all schools.Analysis of 11 behavioral problem factors showed that,highest rates of factor depression,social withdrawn,hyperactivity,sexual problem,cruelty,forcing were found in School A3.Single-factor analysis showed that fever experience,eye sight condition,drinking experience of children, experience of being beaten and scold,second hand smoking,drinking habit of father,occupation of parents,education level of parents,born of full-term,medical history in neonatal period,history of unhealthy pregnancy of mother,history of touching adverse factors and drinking experience of mother during pregnancy had significant influence on the reported rate of behavioral problem. Conclusion Traditional factors are still the main influencing factors of children's behavioral problems,long term-low level exposure to traffic exhausts has weak effect on children's behavioral problems.

Effect of Abnormal Savda Munziq on MDR and Expression of mRNA of Bel/Fu Cell Line / 中国中医药信息杂志

Objective To study the effect of Abnormal Savda Munziq (ASMq) on MDR and expression of mRNA of Bel/Fu cell line. Methods Several genes expression including MDR1, MRP, TOPOII? and GST-? were analyzed by RT-PCR. Results ASMq has been found to down-regulate MDR1 gene and simultaneously up-regulate TopoⅡ?mRNA. Conclusion ASMq can reverse the drug resistance against 5-Fu in Bel/Fu cells. Inhibition of MDR1 mRNA and up-regulate TopoⅡ? mRNA may contribute to the mechanisms.