Dr. Tomas Fernandez, a 1966 graduate of the school and former health officer of Cebu City, will be the keynote speaker. The congress will tackle such topics as sex and the elderly, winning the battle against ageing, making rheumatoid arthritis less debilitating, therapeutic options for recurrent urinary-tract infection in women, reducing obesity in children and adolescents, emotional intelligence, recurrent pregnancy loss, basic infertility work-up, infection on and under the skin, painless hemorrhoidectomy, rational use of antibiotics in pediatric infections, myths and fallacies in vitamins and mineral supplementation, issues and controversies in immunization, evolution of diabetes treatment, clinical assessment of the dizzy patient, management of multiple injuries, management of cancer and noncancer pain.

    The Cebu Institute of Medicine was established in June 1957 as the Cebu Institute of Technology's (CIT) college of medicine. Its pioneering class of 33 students graduated in 1962. In 1966, Velez College was established while the CIT college of medicine spun off from CIT and became Cebu Institute of Medicine (CIM), a nonstock and not-for-profit institution, now affiliated with Velez College.

    Founded in 1980, CIMAA is headed by Dr. Thelma La Rosa-Fernandez. Its other officers are Drs. Pek Eng Lim, vice president; Leonard Cimafranca, secretary; Fidelis Quiza, assistant secretary; Nerissa Sanchez, treasurer; and Corazon Meneses, assistant treasurer. M

Milking resources for child health

The Philippine Pediatric Society (PPS) addressed the numerous and diverse needs of children at its 43rd annual convention on April 2 to 5 at the Philippine International Convention Center which had for its theme, Optimizing Pediatric Health Care Utilizing Limited Resources. The idea behind the convention, said PPS president Estrella Paje-Villar, was not to bemoan the plight of pediatricians, but "to make use of innovative and cost-effective ways to enable families and their children to confront various opportunities and challenges."

    The goal is to help pediatricians promote the health and well-being and improve the survival of their target patient population-children.

    "Next to God and parents, you are the ones responsible for nurturing the future of the human race," Alexander Padilla, health undersecretary for standards and regulations, told pediatricians who attended the convention. In his talk on "Producing a Brilliant Child or a Gifted Cow?" during one of the plenary sessions, he extolled pediatricians for their role in "nurturing the nation's future," and deplored the heavy promotion of milk formulas and breast-milk substitutes.

    He examined issues concerning the human breast against the cow's teat as the source of infant nourishment, and explained the rationale for Executive Order No. 51 or the Milk Code. The code regulates the marketing and promotion of infant formulas and strongly recommends breast-feeding over the use of commercial milk products.

    "Bring back nature's way of nurturing our babies and young children," said Padilla, "if only for the sake of their health and the future of our nation because I believe that stronger babies build stronger nations."

    The convention covered various issues ranging from the prescription and dispensation of drugs by physicians to the role of broadcast media in the promotion of pediatric health care. They were lumped under umbrella topics that included social pediatrics, updates on childhood immunization, neonatology and pediatric surgery, hematology and oncology, endocrinology and genetics, ambulatory pediatrics, medical informatics, nephrology, pulmonology and critical-care medicine, legal medicine and bioethics, rheumatology, cardiology, gastroenterology, evidence-based guidelines in pediatric disease, allergology and dermatology, pediatric neurology, and pediatric otorhinolaryngology and opthalmology. M C. Samaniego, MD

OSPF, MSD give "Life to the Max"

To encourage a full life even with old age and osteoporosis, the Osteoporosis Society of the Philippines Foundation and Merck Sharp & Dohme (MSD) launched the advocacy program, Life-to-the-Max on February 28 at the Crowne Plaza Galleria in Pasig City.

    Experts shared ways on maximizing life despite the crippling effects of osteoporosis, along with actress and Mowelfund executive director Boots Anson-Roa as campaign spokesperson. At 61, Roa is a fine example of what Life-to-the-Max envisions-preservation of the energetic lifestyle of all postmenopausal women, whether they have osteoporosis or not. "This advocacy is all about the prevention of the osteoporosis of the soul," said Roa, summing up the advocacy's goals.

    "Osteoporosis causes the bones to lose mass and become brittle," explained Dr. Sandra Torres, a rheumatologist and clinical epidemiologist. " Weakened bones could lead to fractures of the hip, spine, and wrist."

    Factors that may add to the risk of developing the disease are menopause, low levels of vitamin D, a sedentary lifestyle, smoking, positive family history, excessive alcohol intake, poor nutrition, and use of steroids. Studies have also suggested that Caucasian or Asian ancestry, thin or small build, and early menopause (before 45 years old), are also risk factors for osteoporosis.

    Osteoporosis can lead to severe disability, loss of independence, and death. It commonly affects women after menopause and also a small number of men. Because bone loss occurs without symptoms, osteoporosis can go undiagnosed and untreated for years until fractures occur.

    This is why Torres stressed the importance of seeking prompt diagnosis and treatment. Having a healthy lifestyle also helps, especially intake of vitamin D and calcium. She also highlighted the benefits of the bone-mineral-density test, a painless procedure that accurately assesses risk for fractures. "Once diagnosed, effective treatment can reverse the deterioration in bone health and restore quality of life," Torres said. M S. Molarto

PSEM surveys new trends

With the theme Current Concepts and Future Trends in Endocrinology, the Philippine Society of Endocrinology and Metabolism (PSEM) held its annual convention on March 20 to 21. Tackling novel concepts and pioneering trends in the diagnosis and management of diabetes mellitus and thyroid disorders, the convention focused on recent research, practice guidelines, innovations, and clinical trials that could revolutionize the management of endocrine disorders.

    Among the highlights was the second Prof. Agusto D. Litonjua Lecture of Distinction, established in honor of the "Father of Philippine Endocrinology." Noted endocrinologist Mary Anne Lim-Abrahan, who delivered this year's lecture, explored the role of oral hypoglycemic agents in the management of gestational diabetes mellitus.

    The most awaited lecture was that of Prof. Gerald Reaven on the relationship between insulin resistance and the various definitions of metabolic syndrome. It was Reaven in 1999 who first suggested the concept that the cluster of obesity, hypertension, dyslipidemia, and diabetes mellitus in individuals posed a substantially larger chance for cardiovascular disease and mortality. The combination of these so-called "lifestyle diseases" would later be known by such names as syndrome X, Reaven's syndrome, metabolic syndrome, or insulin-resistance syndrome.

    Four simultaneous interactive sessions discussed how to diagnose and manage complicated endocrine cases. Topics included secondary hypertension, endocrine complications in pregnancy, management of DM complications, and the problem of the thyroid nodule. There were also two breakfast symposiums in which Dr. Leilani Mercado Asis discussed a paradigm shift in the management of type 2 diabetes mellitus and Dr. Lina Lantion-Ang talked about balancing simplicity of treatment with glycemic control via new insights in insulin therapy.

    Lunch symposiums tackled the following issues: implications of aggressive high-density-lipoprotein management, diabetes mellitus and related disorders, new perspectives in lipid management, the role of incretins in the treatment of diabetes mellitus, and hypertension management in the prediabetic and diabetic patient. In the other symposiums, Drs. Elizabeth Paz-Pacheco, Jocelyn Jayme-Wohldorf, and Cynthia Halili-Manabat talked about inflammatory markers in insulin resistance, pharmacologic tools for combating metabolic syndrome, and incretins in the management of type 2 DM. Drs. Ma. Honolina Gomez and Ruby Go discussed the management of hyperglycemic hyperosmolar states and diabetic ketoacidosis, and the recognition and management of thyroid emergencies. M L. Victor Jr., MD

OSP unveils "MODOS Operandi"

"Pag matanda ka na, there's no such thing as hindi mo na kailangan ng calcium at vitamin D," said Dr. Julie Li-Yu, treasurer of the Osteoporosis Society of the Philippines (OSP). Similarly, just because someone is still young, she doesn't need to consume calcium and vitamin D.

    In a forum held in celebration of Mother's Day in May, the OSP has repeatedly stressed the importance of preventing osteoporosis as early as childhood. One important way to achieve this is by consuming adequate amounts of calcium and vitamin D.

    But Pinoys are poor milk drinkers. Dr. Florante Gonzaga, OSP president, said that based on latest data from the Food and Nutrition Research Institutes (FNRI), Filipinos meet only 67 percent of the recommended dietary allowance for calcium. And the calcium that Pinoys consume hardly comes from milk.

    Based on the FNRI's recommended energy and nutrient intake (RENI, 2002), the time when Filipinos should take the most calcium (about 1,000 mg daily) is between age 10 and 18. Males between 19 and 64 years old should take about 750 mg daily, as should females between 19 and 49 years. By age 50, women should be taking 800 mg of calcium, as should men 65 years and above. Meanwhile, vitamin D intake should be five micrograms for all adults between 19 and 49 years; 10 µg for those between 50 and 64 years; and 15 µg for those 65 and above.

    And the very low calcium intake of Pinoys-together with other modifiable risk factors as smoking, alcohol drinking, and lack of physical activity-has led to a rise in osteoporosis cases.

    But the nonmodifiable risk factors should also be considered. For instance, being a postmenopausal woman is a very important risk factor for osteoporosis. The fact that menopause brings a dramatic decrease in estrogen levels significantly diminishes the bones' capacity to incorporate calcium-leading to decrease in bone density.

    Another important risk factor is Asian ancestry. Asians are known to have lower bone density. Based on projections, 6.4 million people will suffer osteoporosis-related hip fractures by 2050, with 51 percent of them occurring in Asia. In the Philippines, no definitive data on osteoporosis rates are available. However, some studies have thrown up clues. A small descriptive study, for instance, from the University of Santo Tomas Hospital showed an osteoporosis prevalence of about 11 percent in women 40 years and above.

    The consequences in terms of expenses and quality of life are large.

    This is why starting Mother's Day, the OSP, in cooperation with Sanofi-Aventis, has unveiled "MODOS Operandi: A MOther's Day Osteoporosis Screening." The project involves the holding of lay forums on osteoporosis as well as screening activities. Conducted in select hospitals nationwide, MODOS Operandi employed the osteoporosis self-assessment tool (OSTA) for women who have a relatively lower risk for the condition. Meanwhile, those considered higher-risk were subjected to central dual-energy X-ray absorptiometry (DEXA). M Jin Paul de Guzman

A FRESH start for PSHOA

"If you want your program to be effective, focus your resources," said Dr. Amado Parawan to explain the idea behind the Focusing Resources for Effective School Health (FRESH) initiative of the Private School Health Officers' Association (PSHOA).

    Parawan, acting manager for health, population, and nutrition of Save the Children/USA country office in the Philippines, shared his experiences in applying the framework to health programs in public schools in Parañaque with the members of the PSHOA during their 25th annual convention on April 6 and 7.

    Dr. Cynthia Cuayo Juico, chair of pediatrics at the Manila Doctors Hospital, explained that FRESH is a loose framework upon which school health teams can build their own programs to address specific needs of their population. It emphasizes the role of good health and nutrition in education. Poor health and malnutrition have been identified as the main factors that lead to low school enrollment, absences, poor classroom performance, and early dropout.

    FRESH identifies four core components for a cost-effective school- health program. These are school-health policies; water, sanitation and environment; skills-based health education; and school-based health services.

    Keynoting the convention, Angelina Sebial, director of the National Center for Health Promotion, took the opportunity to open a dialog between the government and private schools while sharing the government's program on promoting health in public schools to provide students with "integrated positive experiences" and "structures that promote and protect their health."

    Parawan suggested that the survey conducted by the Department of Social Welfare and Development and the Department of Health on the nutritional status and health needs of children in public schools be replicated in private schools to complete the FRESH framework. He said there is a need to establish the health and nutritional status of students in private schools.

    The FRESH core component of skills-based health education involves both parents and children and focuses health education on hygienic practices such as handwashing that children must learn.

    Dr. Alejandro Pineda Jr. of the University of Sto. Tomas Hospital discussed special needs and special care of schoolchildren while dentist Manuel Vallesteros talked about dental health for schoolchildren. M Chiles Samaniego, MD

Hepa B summit goes to Cebu

The second leg of the Hepatitis B Summit, an advocacy program that aims to build awareness not only among chronic-hepatitis-B (CHB) patients but also among members of the medical community and the public, will be held on June 14 at the Cebu Waterfront Hotel in Cebu City.

    The summit is spearheaded by the Asian Pacific Association for the Study of the Liver (APASL), Philippine Society of Gastroenterology (PSG), Hepatology Society of the Philippines (HSP), Philippine Cancer Society (PCS), Philippine Association for the Study of Liver Diseases (PASLD), and Philippine Foundation for Vaccination (PFV).

    Vaccination, latest treatment options, and employment of persons with hepatitis B are among the issues to be discussed in the summit. Discussion will also focus on a pending Senate bill requiring all newborn babies to be vaccinated against hepatitis B within 24 hours from birth.

    Hepatitis B is recognized by the World Health Organization as the most common serious liver infection that, if not treated, may lead to cirrhosis of the liver, liver cancer, liver failure, and eventually death.

    The problem is compounded by the fact that very few hepatitis B patients are aware that they are infected. A study by Synovate Healthcare revealed that most patients suffering from chronic hepatitis B (CHB) in Asia initially were not aware that they had been infected by the virus. The same study conducted in the Philippines from November to December 2004 showed similar results. The survey also showed that most CHB patients hardly understand the disease and how it can be acquired.

    The respondents in the Philippine survey expressed initial shock upon finding out that they were infected, giving them deep concern about their condition. This concern was more on possibly infecting others, social stigma, and career threats.

    Despite the lack of awareness, the patients surveyed gave their doctors high ratings of satisfaction and confidence in terms of consultation, additional education about CHB, and treatment care.

    Hepatitis-B infection is treated with antivirals like lamivudine and adefovir dipivoxil, which have been shown in studies to significantly reduce progression to cirrhosis and liver cancer. Adefovir has also shown potent antiviral activity with less risk of developing resistance.

    For registration and further information, please call the HepB hotline (02) 8921782 or email at HepaB_Summit@yahoo.com. M

World Cancer Congress in July

One in every eight deaths worldwide is due to cancer, which claims twice as many lives as AIDS. If current trends continue, more than 10 million people will die of cancer in 2020, and the number of new cases will jump to 16 million each year.

    Cancer is the second leading cause of death in developed countries, and epidemiological evidence shows that the trend in developing countries is in the same direction. By 2020, three out of every five new cancer cases will occur in the developing world.

    It is against this backdrop that the World Cancer Congress will be held July 8 to 12 in Washington DC under the auspices of the International Union Against Cancer (UICC) in partnership with the US National Cancer Institute, Centers for Disease Control, and the American Society of Clinical Oncology . The congress is followed on July 12 to 15 by the 13th World Conference on Tobacco OR Health, marking the first time the two events are held back to back.

    Former US president Bill Clinton has been invited to address the opening session of the congress on July 8. He is expected to propose ways of mobilizing international action against cancer.

    MEDICAL OBSERVER has been invited by the UICC to represent the Philippines in the congress and to cover both meetings.

    At least 123 countries have registered so far for the congress, which brings together scientists, the medical community, and public-health practitioners to challenge the international community to act and to ensure that cancer control is a priority on every country's economic, political, health, and development agendas.

    "We need to put cancer on the public-policy agenda all around the world. We know that every country needs to develop a cancer plan. If you're not planning, you're planning to fail," said John Seffrin, UICC president.

    The conference offers a unique opportunity to connect one of the most diverse international groups ever assembled. By combining its quadrennial International Cancer Congress with its triennial Conference for Global Cancer Control Organizations-in conjunction with the Centers for Disease Control and Prevention's 2006 Cancer Partners Summit-UICC brings together governments, individuals, and organizations in an unparalleled opportunity to enhance the global fight against cancer.

    As the world's largest independent, not-for-profit, nongovernmental association of cancer-fighting organizations, UICC is a catalyst for responsible dialogue and collective action. UICC brings together a wide range of organisations, including voluntary cancer societies, research and treatment centers, public health authorities, patient support networks and advocacy groups.

    Both globally, through its partners and volunteer experts, and locally, through its member organisations and grassroots networks, UICC is well placed to disseminate knowledge and foster best practices on a wide scale. With over 270 member organizations in more than 80 countries, UICC is a resource for action and a voice for change.

    For more information and to register for the congress, visit www.worldcancercongress.org. M