The Philippine Council for Health Research and Development (PCHRD), through the initiative of its Institution Development Division (IDD) and Human Resource Unit, conducted an “Orientation on Ethics in Research” for Council staff on 1 February 2015.

“Basta driver, sweet lover” is a playful slogan commonly displayed inside public utility vehicles in the country; yet it might not be sweet for jeepney drivers after all, as a study revealed that their working conditions pose threats to their health and safety.

The study conducted by the College of Engineering of the University of the Philippines Diliman noted that the average jeepney driver spends at least 10 hours behind the wheel, a situation that causes them to be subjected to awkward positions for extended periods, resulting in discomfort and body pains.

Immediate treatment of hyperthyroidism may be needed to prevent heart disease, researchers at the De La Salle University Medical Center declared after a study linked hyperthyroidism to various signs and symptoms associated with heart disease.

The researchers stressed that even those diagnosed with hyperthyroidism but show no signs and symptoms, known as subclinical hyperthyroidism, should be given the same medical attention for possible onset of failing heart.

Hyperthyroidism is a medical condition wherein the thyroid glands, found beneath the Adam’s apple, secrete excessive amount of thyroid hormones. Patients with observable signs and symptoms of the disease, known as overt hyperthyroidism, experience heart palpitation, poor heat tolerance, diarrhea, enlargement of the thyroid, and weight loss due to increase in the body’s metabolism.

Changes in the heart’s function due to hyperthyroidism has been well reported. However, the researchers explained that such changes were predominantly reported in cases of overt hyperthyroidism, which prompt immediate treatment of the thyroid condition.

Reports linking abnormal functioning of the heart to subclinical hyperthyroidism, on the other hand, had always been inconsistent and limited. Hence, experts’ opinion on treatment of the subclinical hyperthyroidism to prevent heart disease had been varied. “In effect, controversies whether to treat this subclinical hyperthyroidism remain unsettled,” the researchers said.

In the study, the researchers found correlation with both types of hyperthyroidism with the onset of various abnormal phenomena in the heart’s physiology.

Abnormal physiologic changes in the heart were observed in both types of hyperthyroidism. The thickening of heart muscles changes the shape and size.

Increased in mass of heart’s left lower chamber as well as impairment in its ability to relax was also observed, although it was revealed that this was much more pronounced in overt hyperthyroidism. Researchers also found that the heart’s ability to pump blood was compromised.

The researchers confirmed that both types of hyperthyroidism affect the heart’s normal physical condition and functioning. However, lack of instruction with regard to subclinical hyperthyroidism in current guidelines is a challenge. They stressed that subclinical hyperthyroidism has similar effects on the heart, which warrant similar medical attention accorded to overt hyperthyroidism.

“With cardiac parameters affected even in subclinical hyperthyroidism, treatment might be indicated regardless if hyperthyroidism is overt or subclinical,” the researchers concluded.

Researchers recommended the adoption of a set of guidelines for tasks and responsibilities of health professionals after a survey revealed that doctors do not agree on who gets to do what in the care of patients with breast cancer.

The study, done in collaboration by researchers at the University of the Philippines - College of Medicine and Cardinal Santos Medical Center, surveyed medical oncologists and surgeons from tertiary hospital in Metro Manila involved in Human Epidermal Growth Factor Receptor-2 (HER2) Testing, an important diagnostic exam for breast cancer.

HER-2 testing is a widely recommended diagnostic procedure for breast cancer. From patient education, to collection of specimen, and overall patient care, the procedure involved a team of health care practitioners with varying tasks and responsibilities.

The survey asked medical oncologists and surgeons about their and their colleagues’ responsibility throughout the procedure; and found varying and often different opinion on who does what in the team.

For requesting the procedure of HER-2 testing, only 69% of the medical oncologists and surgeons answered that it is the medical oncologist’s responsibility or whomever the patient saw first.

About 54% of the surveyed participants said that it was the responsibility of the surgeon and the staff in the operating room (OR) to collect the specimen.

With regard to patient education, 59% of the surveyed agreed that the responsibility is in the hands of medical oncologists or whomever sees the patient first.

With the varying answers, researchers lamented, “Though the differences are minor, these may reveal a lack of interdisciplinary awareness.”

Interdisciplinary awareness is a health professional’s knowledge on one’s own responsibility as well as responsibility of other members of the health care team with regard to the medical and therapeutic interventions done to a patient. The researchers explained that the awareness of interdisciplinary roles team is essential, not only for the well-being of the patient, but also the medical practitioners. Patients get more effective service while the medical team increase their morale and work satisfaction.

The lack of interdisciplinary awareness can only be sufficiently addressed through strong compliance to international accepted guidelines with patient care. The researchers discussed that while guidelines on HER-2 testing has been set up by the American Society of Clinical Oncology/Colelge of American Pathologists (ASCO/CAP), the Philippines currently has no central body  or authority that will implement the adoption of a similar guidelines.

Until the Philippines has find away to successfully set up guidelines for HER-2 testing, cohesive and effective medical service for Filipino breast cancer patient will remain a challenge.