Ethnic differences in the association between body mass index and hypertension. (49/759)

Interest in ethnicity-specific definitions of obesity has been hindered by a lack of data clarifying whether or not obesity-related comorbid conditions occur at different levels of body mass index (BMI) (weight (kg)/height (m)(2)) in different ethnic groups. The objective of this study was to examine ethnic differences in the strength of the association between BMI and hypertension. Cross-sectional data obtained from adults aged 30-65 years in China (1997, n = 3,423), the Philippines (1998, n = 1,929), and the United States (1988-1994, n = 7,957) were used. Higher BMI was associated with a higher prevalence of hypertension in all ethnic groups. However, at BMI levels less than 25, prevalence difference figures suggested a stronger association between BMI and hypertension in Chinese men and women but not in Filipino women, compared with non-Hispanic Whites. Non-Hispanic Blacks and Filipino women had a higher prevalence of hypertension at every level of BMI compared with non-Hispanic Whites and Mexican Americans. These ethnic differences in the strength of association between BMI and hypertension and in underlying prevalence warrant further investigation into the use of ethnicity-specific BMI cutoffs in clinical settings to more accurately identify individuals at risk from obesity.  (+info)

Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space. (50/759)

This study reviews the experience of decentralization in four developing countries: Ghana, Uganda, Zambia and the Philippines. It uses two analytical frameworks to describe and compare the types and degrees of decentralization in each country. The first framework specifies three types of decentralization: deconcentration, delegation and devolution. The second framework uses a principal agent approach and innovative maps of 'decision space' to define the range of choice for different functions that is transferred from the centre to the periphery of the system. The analysis finds a variety of different types and degrees of decentralization, with the Philippines demonstrating the widest range of choice over many functions that were devolved to local government units. The least choice was transferred through delegation to an autonomous health service in Ghana. Uganda and Zambia display variations between these extremes. There was insufficient evidence of the impact of decentralization to assess how these differences in 'decision space' influenced the performance of each health system. The authors suggest that this is a major area for future research.  (+info)

Serologic evidence of Lyssavirus infections among bats, the Philippines. (51/759)

Active surveillance for lyssaviruses was conducted among populations of bats in the Philippines. The presence of past or current Lyssavirus infection was determined by use of direct fluorescent antibody assays on bat brains and virus neutralization assays on bat sera. Although no bats were found to have active infection with a Lyssavirus, 22 had evidence of neutralizing antibody against the Australian bat lyssavirus (ABLV). Seropositivity was statistically associated with one species of bat, Miniopterus schreibersi. Results from the virus neutralization assays are consistent with the presence in the Philippines of a naturally occurring Lyssavirus related to ABLV.  (+info)

Cancer and the Philippine Cancer Control Program. (52/759)

Cancer is the third leading cause of morbidity and mortality in the Philippines. Leading cancer sites/types are lung, breast, cervix, liver, colon and rectum, prostate, stomach, oral cavity, ovary and leukemia. There is at present a low cancer prevention consciousness and most cancer patients seek consultation only at advanced stages. Cancer survival rates are relatively low. The Philippine Cancer Control Program, begun in 1988, is an integrated approach utilizing primary, secondary and tertiary prevention in different regions of the country at both hospital and community levels. Six lead cancers (lung, breast, liver, cervix, oral cavity, colon and rectum) are discussed. Features peculiar to the Philippines are described; and their causation and prevention are discussed. A recent assessment revealed shortcomings in the Cancer Control Program and urgent recommendations were made to reverse the anticipated 'cancer epidemic'. There is also today in place a Community-based Cancer Care Network which seeks to develop a network of self-sufficient communities sharing responsibility for cancer care and control in the country.  (+info)

Chronological and spatial analysis of the 1996 Ebola Reston virus outbreak in a monkey breeding facility in the Philippines. (53/759)

To describe the transmission pattern of natural infection with Ebola Reston (EBO-R) virus in a breeding colony, the chronological and spatial analysis of mortality during the 1996 EBO-R virus outbreak was done in this study. The EBO-R virus infection among monkeys in the facility was widespread. Over a period of 3 months, 14 out of 21 occupied units were contaminated with antigen positive animals. A large number of wild-caught monkeys were involved in this outbreak suggesting that wild-caught monkeys have a high susceptibility to EBO-R virus infection. In this outbreak, morbidity patterns for individual animal units were very different regardless of the type and size of cages, individual or gang cages. The results suggest that not only the cage size but also poor animal husbandry practices may be risk factors for the spread of EBO-R infection.  (+info)

Pharmacokinetics of sequential and simultaneous treatment with the combination chloroquine and sulfadoxine-pyrimethamine in acute uncomplicated Plasmodium falciparum malaria in the Philippines. (54/759)

The efficacy and kinetics of the combination chloroquine plus sulfadoxine-pyrimethamine (CQ + SP), given sequentially and simultaneously, were investigated in 32 patients with acute uncomplicated Plasmodium falciparum malaria in Palawan Island, the Philippines. Group 1 with 11 patients received oral CQ 25 mg/kg bw over 3 days followed by a single dose of SP (three tablets 250 mg S + 25 mg P) on Day 4 (CQ0 + SP4). Group 2 with 21 patients received a loading dose of CQ 10 mg/kg plus a single dose of SP three tablets on Day 0, and doses of CQ on Days 1 and 2 (CQ0 + SP0). Patients were followed-up for 28 days until after the clinical and parasitological remission of the disease. Serum samples for CQ, des-ethylchloroquine (DCQ), S and P levels were assayed by high-pressure liquid chromatography with UV and spectrofluorometric detection (HPLC-SF) to determine effective therapeutic concentrations achieved. Parasite and fever clearance times (PCT and FCT) in Group 1 were 48 and 33.5 h, respectively, and 39 and 24 h in Group 2. The parasite elimination half-life (pt1/2) in the CQ + SP0 group was 2.5 h, significantly shorter than the CQ + SP4 group of 5.7 h (P=0.006). Late-treatment failures (R I) were observed in 2/11 patients in Group 1 and in 2/21 patients in Group 2. Serum CQ and DCQ concentrations were effectively adequate. Group 1 pharmacokinetic parameters showed a median maximum concentration (Cmax), area under the curve (AUC) and elimination half-life (t1/2) of 285 ng/ml, 2299 day ng/ml and 5.7 days for CQ, and 89 ng/ml 1845 day ng/ml and 7.3 days for DCQ, respectively. SP was not assayed in Group 1 because of very limited time points. In Group 2, the median Cmax, AUC and t1/2 for CQ and DCQ were at 283 ng/ml 1980 day ng/ml and 5.9 days for CQ and 220 ng/ml, 2680 day ng/ml and 8.5 days for DCQ, respectively. For S and P, the median Cmax, AUC and t1/2 were at 169 microg/ml, 2758 day ng/ml and 10.9 days for sulfadoxine, and 591 ng/ml, 3029 day ng/ml and 2.9 days for pyrimethamine, respectively. Both regimens were well tolerated with a minimum of side-effects, mainly nausea and vomiting. The combination CQ + SP administered simultaneously on Day 0 is more efficacious than when administered sequentially. In the absence of an alternative treatment for acute uncomplicated malaria, this combination is well tolerated, and has an advantage over CQ or SP monotherapy, especially in countries where one drug is still highly effective.  (+info)

Gastric carcinoma: pathology findings in a multiethnic population. (55/759)

OBJECTIVES: To assess the pathology of gastric carcinoma and to determine whether carcinoma of the cardia occurs more often among whites than among other ethnic groups in Hawaii. This study focuses on demographic differences in subsite locations and histologic types of gastric carcinoma. METHODS: We reviewed 532 sequential gastric carcinomas accessioned between 1993 and 1999 in the Hawaii Tumor Registry. Pathology reports and slides were reviewed by the study pathologist. RESULTS: Carcinoma of the cardia occurred in 51 (15.8%) of 323 males compared with 18 (8.6%) of 209 females (P = 0.02, after age adjustment). The age-adjusted percent of cardia cases was 41.8% for Hawaiian white males compared with 13.4% for men of all other ethnic groups (P = 0.0002). The age-adjusted percent of cardia cases was 22.4% for Hawaiian white females compared with 7.3% for females of other groups. (P = 0.08). At all age levels, females had more frequent diffuse carcinomas and less frequent intestinal type gastric carcinomas than men. The age-adjusted percent with diffuse carcinoma was 35.3% for females and 13.7% for males (P < 0.0001). Also, the sex-adjusted percent with diffuse carcinoma was 26.0% for patients younger than 75 years of age compared with 17.0% for patients 75 years or older (P = 0.01). Conversely, the sex-adjusted percent with intestinal carcinoma was 67.9% for patients younger than 75 years of age compared with 77.1% for patients 75 years or older (P = 0.02). The proportion of cases showing precursor lesions (intestinal metaplasia or superficial gastritis) increased progressively with the distance of the carcinoma from the cardia. CONCLUSIONS: Carcinoma of the cardia is predominantly a tumor of white males and is not associated with the multifocal gastritis characteristically found with carcinoma distal to the cardia. Diffuse gastric carcinoma shows no ethnic predilection, but expression of this phenotype is clearly related to the age and gender of the patient.  (+info)

Physical activity among older Filipino-American women. (56/759)

Filipino women (N = 530, mean age 63 years, predominantly low income) were recruited through various community based organizations and churches in Los Angeles County. All women were randomly invited to attend a single group session with a Filipino health educator to discuss breast and cervical cancer screening or the health benefits of exercise. At 3 months after the group session, the exercise assessment tool used in the National Health and Nutrition Examination Survey III was completed by 487 women (92 percent retention rate). This paper describes the pattern of physical activity among older Filipino-American women and a physical activity intervention specifically designed for this group.  (+info)