Discussant: Rosa Ong, M.D.
Most allergy symptoms are minor annoyances. However, a small number of people are susceptible to a reaction called Anaphylaxis. This is the most severe but rare allergic reaction, and is potentially life threatening. Symptoms may range from hives, tongue swelling, vomiting, to shock.
Common causes of anaphylaxis include medications, insect stings, food, vaccines, animal proteins, hormones, latex, preservatives, x-ray dye; physical causes may include exercise, heat or cold-induced urticaria. Other forms of allergy include:
- Erythema Multiforme, which is a short-lasting skin disiorder occurring as a reaction to an infection or medication;
- Stevens-Johnson Syndrome, which is a hypersensitivity complex that is a severe and life threatening condition arising from a reactin to medication or infection;
- Food Allergy, which is no common but can be serious.
Treatment of the various forms of allergy may include treating the cause such as an infection, eliminating medication causing the reaction, cool compresses, administration of antibiotics and corticosteroids. The best form of treatment, however, is avoidance.
Medical Forum No. 188
Discussant: Gil Gan, M.D.
Sleep is an active process that follows cycles of about 90 minutes. Stage 1 is classified as light sleep; Stage II, III, IV are classified deep or delta-wave characterized by NREM or non-rapid eye movement; and Stage V is characterized by REM or rapid eye movement.
The International Classification of Sleep Disorders recognizes the following types: Dyssomnia or excessive sleepiness; Paranomnias or arousal disorders, sleep-wake transition disorders, or related to rapid eye movement; proposed sleep disorders; sleep disorders associated with medical or psychiatric disorders.
Adults and younger individuals have the following sleep requirements: for newborns, 16 hours daily; 3-5 year-olds, 10 hours daily. Adults should have approximately 8 hours per day of sleep. Adults who sleep less than 4 hours per day or more than 9 hours daily have increased chances of death from coronary arterial disease or stroke.
Medical Forum No. 189
»Stress Urinary Incontinence
Discussant: Arlene Liao, M. D.
Stress Urinary Incontinence or SUI is an involuntary discharge of urine during exertion such as coughing, laughing, sneezing, straining, lifting, or other strenuous activities. This is caused by a weak or malfunctioning sphincter muscle or urethral support, which is unable to counteract the increased bladder pressure during situations of abdominal pressure.
Leakage of urine may vary from minimal to moderate and may require wearing minipad/s. The condition is frequently ignored because people think that nothing can be done. The fact is a majority of patients can be cured.
Treatment may either be non-surgical or surgical. The former relies on exercises called Kegel. The latter involves either an abdominal proceure or the use of a transvaginal sling.
SUI is caused by a number of factors. These include: age, race, gender, obesity, smoking, menopause, constipation, weak collagen, normal vaginal delivery, body mass index, economic status, psychological well-being, weight of largest baby delivered vaginally, and previous gynecological surgeries, hysterectomy, and/or vaginal or bladder surgery.
Medical Forum No. 190
Discussant: Sjoberg Kho, M. D.
Osteoporosis literally means porous bone. It is a disease in which the bone’s density and quality are reduced. Such reduction or loss occurs “silently” and progressively. Often, there are no symptoms until the first fracture occurs.
The disease is common among women following menopause, as well as the elderly. Both Asian and Caucasian women are at risk. Women who have undergone hysterectomies or early menopause are also part of the risk group.
Factors associated with osteoporosis include: smoking, family history, low body weight, less physical activity, more than twelve months after cessation of menstrual cycle, age 50 and above, loss in height, high alcohol intake, history of fracture/frequent falls, diet low in calcium and vitamin D, chronic disorders, long-term use of medications. Prevention includes increased physical activity, cessation of smoking, balance diet and proper nutrition, medications such as anti-resorptive drugs.
The disease is diagnosed through x-ray, laboratory test, and bone mineral dexa screening.
Medical Forum No. 191
Discussant: Dennis Teo, M. D.
Tuberculosis commonly affects the lungs, and can spread to lymphatics, brain, bones, gastrointestinal, genitourinary, and eyes. The infection comes from Mycrobacterium Tuberculosis, which unlike any other bacteria, is very resistant and stay dormant for years. Transmission is usually through droplet infection and inhaled through the respiratory system.
Symptoms of the disease include cough of more than two weeks, fever night sweats, shoulder, chest or back pain, weight loss, anorexia, body malaise (weakness), and hemoptysis (coughing our blood).
Tuberculosis is the number one infectious killer disease, with one third of the world’s population affected and cutting across all social classes. The Philippines is ranked 22nd in worldwide incidence. 75 Filipinos die of tuberculosis daily and 15 million are infected with the disease.
Medical Forum No. 192
Discussant: Sioksoan Chan Cua, M.D.
The clinical criteria to diagnose Metabolic Syndrome include at least three or more of the following conditions: central obesity, raised fasting plasma glucose, high density lipoprotein-cholesterol (HDL-C), raised triglycerides, high blood pressure.
Prevention and treatment of Metabolic Syndrome start with lifestyle changes, which emphasize dietary modification, weight control, and physical activity.
n Dietary modification means balanced diet. There should be significant reduced intake of saturated and trans fat as well as processed foods; increased intake of whole grains, fruits, vegetables, and soluble fibers.
n Weight control is specifically targeted to a decrease in percent body fact. The goal is to lose and to maintain weight without rebound.
n Physical activity should at least be 30 minutes daily of moderate intensity such as brisk walking. Exercise should be regular and should gradually increase in intensity depending on an individual’s capacity.
Medication is specific to certain conditions found in Metabolic Syndrome. For example, metformin is prescribed for diabetes mellitus. For those with lipid problems, fibrates such as gemfibrozil, fenofibrate, bezafibrate, clorifibrate are prescribed as well as omega-3 content of fish oil. Treatment for high blood pressure may be prescribed angiotensin-converting enzyme inhibitors or angiotensin-receptor blocker.