Pasong Kawayan I, Philippines

De La Salle Health Sciences Institute
Pasong Kawayan I, Philippines

The De La Salle Health science Institute is the medical school of De La Salle University, a Roman Catholic, Lasallian research university in the Philippines. It is an institution involved in health care education and research located along the Mangubat Avenue in Dasmariñas City, Cavite. It was established in 1987 when the Hermano San Miguel Febres Cordero Medical Educational Foundation, Inc. acquired ownership of the Emilio Aguinaldo College of Medicine. In 1994 it was renamed alongside with the Medical Center as the De La Salle-Health science Campus. In 2007, in order to signal the institution's drive to pursue its mission, the institution officially became the De La Salle Health science Institute and is a member of De La Salle Philippines. Currently, the Institute is composed of 3 major units which are the Institutional Colleges , the De La Salle University Medical Center, and the Angelo King Medical Research Center. Wikipedia.

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Ata-Lawenko R.M.,De La Salle Health Sciences Institute | Lee Y.Y.,Universiti Sains Malaysia
Journal of Neurogastroenterology and Motility | Year: 2017

Gastrointestinal sphincters play a vital role in gut function and motility by separating the gut into functional segments. Traditionally, function of sphincters including the esophagogastric junction is studied using endoscopy and manometry. However, due to its dynamic biomechanical properties, data on distensibility and compliance may provide a more accurate representation of the sphincter function. The endolumenal functional lumen imaging probe (EndoFLIP) system uses a multi-detector impedance planimetry system to provide data on tissue distensibility and geometric changes in the sphincter as measured through resistance to volumetric distention with real-time images. With the advent of EndoFLIP studies, esophagogastric junction dysfunction and other disorders of the stomach and bowels may be better evaluated. It may be utilized as a tool in predicting effectiveness of endoscopic and surgical treatments as well as patient outcomes. © 2017 The Korean Society of Neurogastroenterology and Motility.

Torres E.,De La Salle Health Sciences Institute
Journal of the Medical Library Association | Year: 2017

Objectives: This study assessed the book collection of five selected medical libraries in the Philippines, based on Doodys’ Essential Purchase List for basic sciences and clinical medicine, to compare the match and non-match titles among libraries, to determine the strong and weak disciplines of each library, and to explore the factors that contributed to the percentage of match and non-match titles. Method: List checking was employed as the method of research. Results: Among the medical libraries, De La Salle Health Sciences Institute and University of Santo Tomas had the highest percentage of match titles, whereas Ateneo School of Medicine and Public Health had the lowest percentage of match titles. University of the Philippines Manila had the highest percentage of near-match titles. Conclusion: De La Salle Health Sciences Institute and University of Santo Tomas had sound medical collections based on Doody’s Core Titles. Collectively, the medical libraries shared common collection development priorities, as evidenced by similarities in strong areas. Library budget and the role of the library director in book selection were among the factors that could contribute to a high percentage of match titles. © 2017, Medical Library Association. All rights reserved.

Jain V.K.,Glaxosmithkline | Rivera L.,Hospital Maternidad Nuestra Senora Of La Altagracia | Zaman K.,Center for Child and Adolescent Health | Espos Jr. R.A.,De La Salle Health Sciences Institute | And 19 more authors.
New England Journal of Medicine | Year: 2013

BACKGROUND: Commonly used trivalent vaccines contain one influenza B virus lineage and may be ineffective against viruses of the other B lineage. We evaluated the efficacy of a candidate inactivated quadrivalent influenza vaccine (QIV) containing both B lineages. METHODS: In this multinational, phase 3, observer-blinded study, we randomly assigned children 3 to 8 years of age, in a 1:1 ratio, to receive the QIV or a hepatitis A vaccine (control). The primary end point was influenza A or B confirmed by real-time polymerase chain reaction (rt-PCR). Secondary end points were rt-PCR-confirmed, moderate-to-severe influenza and rt-PCR-positive, culture-confirmed influenza. The vaccine efficacy and the effect of vaccination on daily activities and utilization of health care resources were assessed in the total vaccinated cohort (2584 children in each group) and the per-protocol cohort (2379 children in the QIV group and 2398 in the control group). RESULTS: In the total vaccinated cohort, 62 children in the QIV group (2.40%) and 148 in the control group (5.73%) had rt-PCR-confirmed influenza, representing a QIV efficacy of 59.3% (95% confidence interval [CI], 45.2 to 69.7), with efficacy against culturecon-firmed influenza of 59.1% (97.5% CI, 41.2 to 71.5). For moderate-to-severe rt-PCR-confirmed influenza, the attack rate was 0.62% (16 cases) in the QIV group and 2.36% (61 cases) in the control group, representing a QIV efficacy of 74.2% (97.5% CI, 51.5 to 86.2). In the per-protocol cohort, the QIV efficacy was 55.4% (95% CI, 39.1 to 67.3), and the efficacy against culture-confirmed influenza 55.9% (97.5% CI, 35.4 to 69.9); the efficacy among children with moderate-to-severe influenza was 73.1% (97.5% CI, 47.1 to 86.3). The QIV was associated with reduced risks of a body temperature above 39°C and lower respiratory tract illness, as compared with the control vaccine, in the per-protocol cohort (relative risk, 0.29 [95% CI, 0.16 to 0.56] and 0.20 [95% CI, 0.04 to 0.92], respectively). The QIV was immunogenic against all four strains. Serious adverse events occurred in 36 children in the QIV group (1.4%) and in 24 children in the control group (0.9%). CONCLUSIONS: The QIV was efficacious in preventing influenza in children. Copyright © 2013 Massachusetts Medical Society.

Phillips M.,Menssana Research, Inc. | Phillips M.,New York Medical College | Basa-Dalay V.,De La Salle Health Sciences Institute | Blais J.,Menssana Research, Inc. | And 9 more authors.
Tuberculosis | Year: 2012

Rationale: Volatile organic compounds (VOCs) in breath provide biomarkers of tuberculosis (TB) because Mycobacterium tuberculosis manufactures VOC metabolites that are detectable in the breath of infected patients. Objectives: We evaluated breath VOC biomarkers in subjects with active pulmonary TB, using an internet-linked rapid point-of-care breath test. Methods: 279 subjects were studied at four centers in three countries, Philippines, UK, and India, and data was analyzed from 251 (130 active pulmonary TB, 121 controls). A point-of-care system collected and concentrated breath and air VOCs, and analyzed them with automated thermal desorption, gas chromatography, and surface acoustic wave detection. A breath test was completed in 6 min. Chromatograms were converted to a series of Kovats Index (KI) windows, and biomarkers of active pulmonary TB were identified by Monte Carlo analysis of KI window alveolar gradients (abundance in breath minus abundance in room air). Measurements and main results: Multiple Monte Carlo simulations identified eight KI windows as biomarkers with better than random performance. Four KI windows corresponded with KI values of VOCs previously identified as biomarkers of pulmonary TB and metabolic products of M. tuberculosis, principally derivatives of naphthalene, benzene and alkanes. A multivariate predictive algorithm identified active pulmonary TB with 80% accuracy (area under curve of receiver operating characteristic curve), sensitivity = 71.2%, and specificity = 72%. Accuracy increased to 84% in age-matched subgroups. In a population with 5% prevalence, the breath test would identify active pulmonary TB with 98% negative predictive value and 13% positive predictive value. Conclusions: A six-minute point-of-care breath test for volatile biomarkers accurately identified subjects with active pulmonary TB. © 2011 Elsevier Ltd. All rights reserved.

Phillips M.,Menssana Research, Inc. | Phillips M.,New York Medical College | Basa-Dalay V.,De La Salle Health Sciences Institute | Bothamley G.,NHS England | And 5 more authors.
Tuberculosis | Year: 2010

Background: Volatile organic compounds (VOCs) in breath may contain biomarkers of active pulmonary tuberculosis derived from the infectious organism (metabolites of Mycobacterium tuberculosis) and from the infected host (products of oxidative stress). Methods: We analyzed breath VOCs in 226 symptomatic high-risk patients in USA, Philippines, and UK, using gas chromatography/mass spectroscopy. Diagnosis of disease was based on sputum culture, smear microscopy, chest radiography and clinical suspicion of tuberculosis (CSTB). Chromatograms were converted to a series of 8 s overlapping time slices. Biomarkers of active pulmonary tuberculosis were identified with a Monte Carlo analysis of time-slice alveolar gradients (abundance in breath minus abundance in room air). Results: Breath VOCs contained apparent biomarkers of active pulmonary tuberculosis comprising oxidative stress products (alkanes and alkane derivatives) and volatile metabolites of M. tuberculosis (cyclohexane and benzene derivatives). Breath biomarkers identified active pulmonary tuberculosis with C-statistic (area under curve of receiver operating characteristic) = 0.85 (i.e. 85% overall accuracy, sensitivity = 84.0%, specificity = 64.7%) when sputum culture, microscopy, and chest radiography were either all positive or all negative. Employing a single criterion of disease, C-statistic = 0.76 (smear microscopy), 0.68 (sputum culture), 0.66 (chest radiography) and 0.65 (CSTB). Conclusion: A breath test identified apparent biomarkers of active pulmonary tuberculosis with 85% accuracy in symptomatic high-risk subjects. © 2010 Elsevier Ltd. All rights reserved.

Marfori M.L.,De La Salle Health Sciences Institute | Wang E.H.M.,University of the Philippines at Manila
Clinical Orthopaedics and Related Research | Year: 2011

Background: Hip disarticulation and hemipelvectomy are alternatives to limb-salvage procedures for patients with extensive tumors of the upper thigh and buttocks. In cases when neither the conventional posterior gluteus maximus flap nor the anterior quadriceps flap can be used because of the location of the tumor, a medial adductor myocutaneous flap may be an alternative. Description of Technique: The flap is outlined over the anteromedial thigh. The distal extent is at the level of the adductor hiatus. The common femoral vessels and nerve are traced, preserved, and protected. The adductor muscles then are divided above their insertions on the femur and preserved with the flap. En bloc removal of the tumor is performed by either hip disarticulation or hemipelvectomy. The long adductor myocutaneous flap is brought up laterally and proximally to close the wound. Patients and Methods: We reviewed four patients who underwent a medial adductor myocutaneous flap after either hip disarticulation or hemipelvectomy. The medical records and radiographs were analyzed. These patients were followed up for at least a year or until death. Results: Wide surgical margins were achieved in all four patients and the flap remained viable, with no skin necrosis or flap breakdown. The patients were able to sit on the flap, and one patient was able to wear a prosthesis. Conclusions: In patients undergoing hip disarticulation or hemipelvectomy where tumor infiltration or inadvertent contamination by previous surgery will not allow the traditional posterior gluteus maximus or anterior quadriceps flap, this unconventional medial adductor myocutaneous flap is a feasible, technically simple option. Level of Evidence: Level IV therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. © 2010 The Association of Bone and Joint Surgeons®.

Wang E.H.M.,University of the Philippines at Manila | Marfori M.L.,De La Salle Health Sciences Institute | Serrano M.V.T.,University of the Philippines at Manila | Rubio D.A.,University of the Philippines at Manila
Clinical Orthopaedics and Related Research | Year: 2014

Background: To decrease the recurrence rate after intralesional curettage for aneurysmal bone cysts, different adjuvant treatments have been recommended. Liquid nitrogen spray and argon beam coagulation have provided the lowest recurrence rates, but unlike the high-speed burr, these adjuvants are not always available in operating rooms.Questions/purposes: We asked: (1) Is high-speed burring alone sufficient as an adjuvant to curettage with respect to recurrence rates? (2) What is the complication rate from this technique? (3) What are the risk factors for local recurrence?Methods: A retrospective review of the database of the University Musculoskeletal Tumor Unit and the private files of the senior author (EHW) for a period of 19 years (1993–2011) was performed to identify all patients histologically diagnosed with primary aneurysmal bone cyst. During that period, patients with aneurysmal bone cysts were treated with intralesional curettage, burring, and bone grafting if the lesions showed an adequate cortical wall or a wall with thinned out portions which could be reconstructed with bone grafting. Based on those indications, we treated 54 patients for this condition. Of those, 18 were treated using approaches other than burring because they did not meet the defined indications, and an additional five patients were lost to followup before 2 years, leaving 31 patients for analysis, all of whom were followed up for at least 2 years (mean, 7 years; range, 2–18 years).Results: Of these 31 patients, one had a recurrence (3.2%). Complications using this approach occurred in three patients (9.7%), and included growth plate deformity (1) and genu varus (2) secondary to collapse of the reconstructed condyle. With only one recurrence, we cannot answer what the risk factors might be for recurrence; however, the one patient with recurrence presented with a large lesion and a pathologic fracture.Conclusions: Curettage, burring, and bone grafting compare favorably in the literature with other approaches for aneurysmal bone cysts, such as cryotherapy and argon-beam coagulation. We conclude that high-speed burring alone as an adjuvant to intralesional curettage is a reasonable approach to achieving a low recurrence rate for aneurysmal bone cysts.Level of Evidence: Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence. © 2014, The Association of Bone and Joint Surgeons®.

Padla E.P.,De La Salle Health Sciences Institute | Solis L.T.,De La Salle Health Sciences Institute | Ragasa C.Y.,De La Salle University - Manila
Chinese Journal of Natural Medicines | Year: 2012

Aim: To screen for the antibacterial activity of ent-kaurenoic acid (1) from the dichloromethane extract of Smallanthus sonchifolius leaves against Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, and Pseudomonas aeruginosa, and for its antifungal activity against Candida albicans, Trichophyton rubrum, and Epidermophyton floccosum. Methods: Compound 1 was isolated by silica gel chromatography and its structure was elucidated by NMR spectroscopy. For assaying the antibacterial and antifungal activities of 1, the disk diffusion method was used, while the minimum inhibitory concentrations (MICs) were determined by the broth dilution method. Results: With the disk diffusion method, 1 was found to be active against all the Gram-positive organisms tested (S. aureus, S. epidermidis, B. subtilis) at the lowest concentration of 1 000 μg·mL-1, while it was active against the fungus T. rubrum at 10 000 μg·mL-1. No inhibitory activity was observed against C. albicans, E. floccosum and all the Gram-negative test strains. The activity indices (AI) of 1 were noted to be highest against S. aureus and lowest against T. rubrum. Statistically significant differences were found between the mean inhibition zones (IZ) of 1 and the standard drugs (ofloxacin and clotrimazole). The results of the broth dilution MIC determination revealed that 1 exhibited moderate activity against S. aureus and S. epidermidis with MIC values of 125 μg·mL-1 and 250 μg·mL-1, respectively; and weak activity against B. subtilis with a MIC of 1 000 μg·mL-1. The growth of T. rubrum in the MIC assay was not inhibited at the highest tested concentration of 1 (10 000 μg·mL-1). Conclusion: The minimum bactericidal concentration (MBC) indicated that the bactericidal activities of 1 occurred at concentrations higher than its growth inhibitory concentrations. Furthermore, the MBC: MIC ratio of 2:1 clearly demonstrated the in vitro bactericidal effect of 1 against S. aureus and S. epidermidis. © 2012 China Pharmaceutical University.

Hashimoto H.,University of Tokyo | Ikegami N.,Keio University | Shibuya K.,University of Tokyo | Izumida N.,National Institute of Population and Social Security Research | And 5 more authors.
The Lancet | Year: 2011

Japan's health indices such as life expectancy at birth are among the best in the world. However, at 8•5% the proportion of gross domestic product spent on health is 20th among Organisation for Economic Co-operation and Development countries in 2008 and half as much as that in the USA. Costs have been contained by the nationally uniform fee schedule, in which the global revision rate is set fi rst and item-by-item revisions are then made. Although the structural and process dimensions of quality seem to be poor, the characteristics of the health-care system are primarily attributable to how physicians and hospitals have developed in the country, and not to the cost-containment policy. However, outcomes such as postsurgical mortality rates are as good as those reported for other developed countries. Japan's basic policy has been a combination of tight control of the conditions of payment, but a laissezfaire approach to how services are delivered; this combination has led to a scarcity of professional governance and accountability. In view of the structural problems facing the health-care system, the balance should be shifted towards increased freedom of payment conditions by simplifi cation of reimbursement rules, but tightened control of service delivery by strengthening of regional health planning, both of which should be supported through public monitoring of providers' performance. Japan's experience of good health and low cost suggests that the priority in health policy should initially be improvement of access and prevention of impoverishment from health care, after which effi ciency and quality of services should then be pursued. Copyright © 2011 Elsevier B.V. All rights reserved.

Lawenko R.M.A.,De La Salle Health Sciences Institute | Lee Y.Y.,Universiti Sains Malaysia
Journal of Neurogastroenterology and Motility | Year: 2016

Gastroesophageal reflux disease (GERD) is a disease predominantly seen in the West but there is a rising trend in Asia. Ambulatory 24-hour catheter-based pH monitoring has been the de facto gold standard test for GERD that correlates symptoms with acid reflux episodes. However, drawbacks such as patients' discomfort, and catheter displacement render the test as cumbersome and errorprone. The Bravo pH wireless system is designed to be user-friendly and has an added advantage of prolonged pH monitoring. The system is comparable to the catheter-based pH monitoring system in terms of diagnostic yield and symptom-reflux association. Indications include evaluation of patients with refractory GERD symptoms and prior to anti-reflux surgery. Bravo utilizes a wireless pH-sensing capsule with a complete prepackaged system, and a data processing software. The capsule may be positioned indirectly using endoscopic or manometric landmarks or under direct endoscopic guidance. Optimal threshold cut-offvalues are yet to be standardized but based on available studies, for the Asian population, it may be recommended for total % time pH < 4 of 5.8 over 48 hours. Cost is a limitation but capsule placement is relatively safe although technical failures may be seen in small percentage of cases. © 2016 The Korean Society of Neurogastroenterology and Motility.

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