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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.

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.

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.

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®.

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.

Tumanan-Mendoza B.A.,University of the Philippines at Manila | Mendoza V.L.,De La Salle Health Sciences Institute
Value in Health Regional Issues | Year: 2013

Objective: To determine the cost-effectiveness of lipid-lowering therapy in the secondary prevention of cardiovascular events in the Philippines. Methods: A cost-utility analysis was performed by using Markov modeling in the secondary prevention setting. The models incorporated efficacy of lipid-lowering therapy demonstrated in randomized controlled trials and mortality rates obtained from local life tables. Average and incremental cost-effectiveness ratios were obtained for simvastatin, atorvastatin, pravastatin, and gemfibrozil. The costs of the following were included: medications, laboratory examinations, consultation and related expenses, and production losses. The costs were expressed in current or nominal prices as of the first quarter of 2010 (Philippine peso). Utility was expressed in quality-adjusted life-years gained. Sensitivity analyses were performed by using variations in the cost centers, discount rates, starting age, and differences in utility weights for stroke. Results: In the analysis using the lower-priced generic counterparts, therapy using 40 mg simvastatin daily was the most cost-effective option compared with the other therapies, while pravastatin 40 mg daily was the most cost-effective alternative if the higher-priced innovator drugs were used. In all sensitivity analyses, gemfibrozil was strongly dominated by the statins. Conclusions: In secondary prevention, simvastatin or pravastatin were the most cost-effective options compared with atorvastatin and gemfibrozil in the Philippines. Gemfibrozil was strongly dominated by the statins. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

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