Filipino Research Articles

Beyond the Innocence of Globalization: The Abiding Necessity of Carlos Bulosan's Anti-Imperialist Imagination

This essay analyzes Carlos Bulosan’s writing in terms of the way he works todevelop an aesthetic that comprehends and cognitively maps the repetitive dynamicsof US and global colonial capitalism. More precisely, the essay examines howBulosan’s aesthetic practice both grapples with the question of how an individualand collective consciousness can grasp the systemic processes that conditionexperience and also how it fosters that consciousness in the way it representsthe relationships among experience, the larger class and colonial dynamics thatproduce that experience, and the ideological processes that intervene in ourcomprehension of those dynamics. In developing an aesthetic that aligns ideologyand experience and grasps the dynamics of the global colonial system, Bulosan’sfiction, this essay argues, generates a narrative of class struggle and a consciousnessthat grasps the national dimension of the Filipino working-class, comprehendingthe need for national liberation.The essay explores the way Bulosan’s political narratives work through andconfront ideological tensions between a facile internationalism and a more concretenational liberation politics in his fiction by deploying, at times, an innocent narratorwhose idealistic values and approach to the world are challenged through thatcharacter’s experiences of racial and economic injustice, violence, exploitation, anddeprivation. This technique allows Bulosan to articulate a utopian worldview, thatis, an ideal sense of what a world framed on principles of justice would entail, andalso to address the political and economic realities that betray that ideal and thus require repair and transformation through collective political struggle. Typically, inconstructing plots that move through innocence to experience, Bulosan works tocreate an aesthetic that aligns representation and the lived experience of Filipinos inthe United States and the Philippines in ways that highlight the national dimensionsof Filipino life and foster a national consciousness, challenging a premature orunder-theorized internationalism or universalism.

Herpes simplex virus limbic encephalitis in a Filipino man with advanced stage testicular cancer: A case report

A 66-year-old Filipino Male, Hypertensive, Diabetic, diagnosed with Advanced Testicular Cancer presented with a five day history of fever, productive cough associated with sudden onset of behavioral changes, memory lapses and disorientation. On admission, the patient was disoriented, with poor comprehension and inability to follow commands. There were no focal motor deficits or signs of meningeal irritation. Cranial CT scan and serum electrolytes were unremarkable. CBC showed leukocytosis with predominant neutrophils, chest xray revealed pneumonia. Piperacillin+ Tazobactam and Azithromycin was started On the second hospital day, he had seizures manifested as blank stares, teeth grinding, lip smacking and fidgety movement of the right hand. Electroencephalogram showed epileptiform discharges in both frontal-prefrontal and both frontal-central regions. A cranial MRI with Contrast revealed high T2W and FLAIR signal changes and edema in the mesial temporal lobes and right insula (Figure 1) and right lentiform nucleus (Figure 2). EEG and MRI findings are consistent with Limbic Encephalitis based on the diagnostic criteria by Gultekin et al.1(2014). A lumbar puncture yielded a colorless cerebrospinal fluid (CSF) with normal opening pressure, normal RBC and WBC, lymphocytic predominance (96%), elevated CSF protein and normal CSF glucose. CSF Acid Fast Bacilli (AFB), KOH and India Ink were all negative. Further CSF analysis for neuronal autoantibodies specifically Anti-NMDA, Anti- Hu and Anti- Ma2 were likewise negative. Polymerase Chain Reaction (PCR) assay for Herpes Simplex Virus was positive for HSV-1. Intravenous Acyclovir was started at 15mg/kg per day. After three weeks of antiviral therapy the patient's condition improved.

A 44 year old male Filipino with spontaneous acute subdural hematoma and subarachnoid hemorrhage caused by a dural arteriovenous fistula of the occipital lobe

Spontaneous acute subdural hematoma (ASDH) comprises only 2.6% of all ASDH. In one study, only 178 cases of spontaneous ASDH were documented, however, only 1 case among them was attributed to the presence of dural arteriovenous fistula (dAVF).Only less than 10% of all subarachnoid hemorrhage (SAH) are caused by vascular malformations. Spontaneous ASDH and SAH occurring together is extremely rare. There is a scarcity of literature on cases with dAVF of the occipital lobe as a cause of simultaneous spontaneous ASDH and SAH. A 44 year old Filipino male with no history of trauma, presented with severe headache, vomiting, and decreasing sensorium. CT scan revealed acute parenchymal bleed in the left occipital lobe with subarachnoid extension and subdural hematoma in the left frontoparietotemporal convexity and posterior interhemispheric falx. Due to the location of the lesion seen on CT scan and the gender distribution, Arteriovenous malformation (AVM) was initially considered, thus proceeded to CTA to establish the diagnosis of vascular anomaly, however, revealed dAVF instead. Four-vessel angiogram was done to assess the tributaries of the dAVF and confirmed the diagnosis. Complete obliteration of dAVF of the occipital lobe was done with Onyx Embolization in one session. This is the first case of Borden type II, Cognard type IIa+IIb dAVF, as reported in this institution. Although extremely rare as a cause of SAH and ASDH, dAVF should be considered as a differential in patients with the absence of identifiable common cause of new onset of severe headache and poor neurologic status.

3100 Acute Esophageal Necrosis (Gurvits Syndrome) in a 78-Year-Old Male Filipino Patient

INTRODUCTION: Acute Esophageal Necrosis (AEN), also known as Gurvits Syndrome and commonly referred to as Black Esophagus, is a rare life-threatening clinical entity with an estimated prevalence of 1 to 200 in 100,000 and a mortality rate of approximately 30%. Only 88 patients over a span of 40 years have been reported. It is associated with geriatric males, diabetes mellitus, GERD, CKD, hypertension, vascular disease, alcohol abuse, malnourishment, ingestion of caustic agents and some medications. These factors predispose a patient to AEN through hemodynamic compromise, low-flow states, tissue hypoperfusion, corrosive injury and diminished mucosal defenses. Upper GI bleeding is the presenting complaint in around 90% of cases. It is diagnosed on endoscopy where characteristically, a diffuse, circumferential, necrotic esophageal mucosa is seen. The treatment for AEN aims to address the underlying medical illness, maintain and restore hemodynamic stability with intravenous fluid resuscitation and blood transfusions, attain complete esophageal rest, gastric acid suppression and antimicrobials. CASE DESCRIPTION/METHODS: A 78-year-old Filipino man developed hematemesis on a background of T2DM, hypertension, NSAID use and excessive alcohol use. He had no GI signs or symptoms prior to this episode. Four hours later he became drowsy and confused and was noted to be in hyperosmolar hyperglycemic state. An endoscopy revealed a distinctly diffuse circumferential necrosis of the esophagus with abrupt demarcation at the gastroesophageal junction. The gastric mucosa and biopsies were unremarkable. CT showed a distended aperistaltic esophagus with circumferential thickening with no evidence of perforation. Post endoscopy he was treated in ICU where he was maintained on parenteral nutrition, meropenem, nystatin, pantoprazole and insulin. Repeat endoscopy 7 days later showed pink mucosa after appropriate glycemic control, bowel rest and hemodynamic stabilization. He was discharged 3 days later. DISCUSSION: This is the first known report of a Filipino diagnosed with AEN. He presented with hematemesis, many of the risk factors associated with AEN, and his endoscopic findings were classic for AEN. However, he was only diagnosed sometime after endoscopy. This case highlights that AEN may be underdiagnosed and that clinicians should be mindful of it as populations develop more co-morbidities and risk factors that predispose them to developing it. This case also highlights the reversibility of this life-threatening condition.

TB OR NOT TB?

SESSION TITLE: Monday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Testing for active pulmonary TB is often triggered by symptoms such as fever, cough, night sweats. We present an atypical case of pulmonary TB. CASE PRESENTATION: A 69-year-old Filipino man presented to ED for psychiatric clearance due to report of domestic violence. Initial work-up was only remarkable for chest XR finding of bilateral upper lobe infiltrates. Quantiferon was negative. Patient denies any cough, fever, night sweat, or weight loss. He had moved from the Philippines over 40 years ago, but had no recent foreign travels or known TB exposures. However, given chest XR finding, airborne isolation and TB rule-out testing with MTB-PCR and sputum cultures were pursued. CT chest showed bilateral upper lobe cavitary nodules. As patient could not produce sputum samples, he underwent bronchoscopy. Result of MTB-PCR was positive. Bronchial washing culture later was also positive for MTB, which confirmed the diagnosis of active pulmonary TB. DISCUSSION: Current diagnostic approach to pulmonary TB involves an initial clinical suspicion followed by chest imaging and if indicated, testing with MTB-PCR or sputum culture. However, in our case, the patient presented with a completely different chief complaint, and did not have any history or physical exam findings suggestive of TB. Had a chest X-ray not been done, the incidental finding of bilateral upper lobes infiltrates would not have been found, work-up for TB would not have been pursued, and his active pulmonary TB would not have been discovered. Also interestingly, his Quantiferon was negative, although final confirmatory TB testing was positive. Upon literature search, case report of subclinical active pulmonary TB in immunocompetent adults is rare. One population-based study in China in 2015 did find a high percentage of asymptomatic pulmonary TB patients, and called into question the conventional criteria for initiating TB testing. However, there was no follow-up study performed according to the best of our knowledge. Our patient similarly reminds us that subclinical pulmonary TB may not be uncommon as presumed. In addition, based on a study done in Europe in 2011, Quantiferon, which tests for interferon-gamma response to TB antigens, has a sensitivity of only 80% for active TB. Therefore, Quantiferon should not be used as a rule out test for active TB. Also of note, old age is a recognized risk factor for false negative Quantiferon, as the interferon-gamma response to TB antigenic targets decreases with age. CONCLUSIONS: Active pulmonary TB can present subclinically. Delay in treatment in these patients, due to our current symptoms-based trigger for TB testing, can have widespread effect on patient outcome and epidemiological consequences. Further re-examination of our diagnostic approach to active TB testing should be pursued. It is also important to remember that a negative Quantiferon test does not rule out active pulmonary TB Reference #1: M. Sester, et al. Interferon-γ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis. European Respiratory Journal Jan 2011 Reference #2: Cheng J, Wang L, Zhang H, Xia Y. Diagnostic value of symptom screening for pulmonary tuberculosis in China. Reference #3: Veerle de Visser, et al. False-negative interferon-γ release assay results in active tuberculosis: a TBNET study. European Respiratory Journal Jan 2015 DISCLOSURES: No relevant relationships by Chia-Dan Kang, source=Web Response No relevant relationships by Arhama Malik, source=Web Response

China’s Belt and Road Initiative (BRI) and the Duterte Administration’s Appeasement Policy: Examining the Connection Between the Two National Strategies

This article examines the link between the Belt and Road Initiative (BRI) and the Duterte Administration’s appeasement policy on China. Relative to the South China Sea dispute, China uses the BRI as a means to ease and stabilize its strained relations with claimant countries like the Philippines. The BRI has enabled China to influence the Philippines in changing its policy on Chinese maritime expansion in the South China Sea. Lured by the BRI, President Rodrigo Roa Duterte is undoing his predecessor’s policy of balancing China’s expansive claim in the disputed waters. Based on his calculation, the Philippines will benefit from the BRI initiative—particularly in the revival of the maritime silk route—as it dovetails with his administration’s massive infrastructure build-up program. In conclusion, the article contends that President Duterte is convinced that his appeasement policy toward China is worth pursuing because it makes the Philippines a beneficiary of the BRI. However, 3 years into his term, he has yet to see the implementation of BRI-funded infrastructure projects, which have been delayed by technical problems, the Philippine military, and the Filipino people’s distrust of China because of the South China Sea issue in particular, and its behavior as emergent power in East Asia in general.

Media Use of Children and Adolescents in the Digital Age: Views and Practices of Filipino Pediatricians in a Tertiary Care Hospital

Background. Children and adolescents nowadays are exposed to digital media, altering the way they live, communicate, learn and play. Policy statements on digital media are published internationally, and modified accordingly with media’s increasing influence in children’s daily lives. Across these recommendations, the pediatrician’s role is emphasized. Locally, no research has been done in exploring pediatricians’ knowledge and practices regarding media use recommendations, and no local guidelines have been published. Objectives. To determine Filipino pediatricians’ knowledge, attitudes, and counseling practices (KAP) on digital media use of children and adolescents. KAP were …

Community Gardening in a Society With High Malnutrition Prevalence Helps Reduce Malnutrition but Increases Obesity

Background: Malnutrition is a leading cause of childhood mortality worldwide in children under 5 years. While many efforts have been made to address malnutrition, with varying success, few have tried a community garden approach. Objective: To determine if the introduction of a community garden with concurrent education on plant care/proper diet affects the rate of malnutrition and food security in a rural Filipino village. Methods: Families of 67 children participated in a community garden program where each family was given 6 crops to tend (okra, …

1523-P: Variation in Diabetes Prevalence by Sex and Weight in Middle-Aged Chinese and Filipino Adults

Background: Contemporary data comparing weight status and diabetes (DM) prevalence among U.S. East Asians and Filipinos are limited. Methods: Among 23,050 Chinese and 28,201 Filipinos aged 45-64 years (mean age 55±6) with a 2016 outpatient visit in a U.S. integrated healthcare delivery system, body mass index (BMI) and DM prevalence (based on clinical diagnosis and pharmacotherapy) were ascertained. BMI was classified using Asian-specific thresholds: healthy or underweight (BMI <23), overweight (23-27.4) and obese (≥27.5 kg/m2). Differences were examined by subgroups and log-binomial regression was used to examine the independent association of ethnicity and DM risk. Results: Among Chinese women (14,871) and men (8,179) and Filipino women (18,406) and men (9,795), overweight/obesity was higher in men vs. women and Filipino vs. Chinese (Figure, BMI distribution). Obesity was highest in Filipino men (50%). DM prevalence was highest in those with obesity; however, Filipinos of both sexes had higher DM prevalence across all weight categories (Figure) compared to Chinese, with a relative risk of 1.7 (CI 1.6-1.8), adjusting for age, BMI and sex. Conclusion: Filipino adults have substantially higher BMI and independently higher risk of DM compared to Chinese adults. While limited to adults receiving healthcare, the data highlight the need for heightened DM surveillance and targeted care in high risk ethnic populations. Disclosure K. Gu: None. N.P. Gordon: None. M. Chandra: None. G. Lau: None. J.R. Gonzalez: None. J.C. Lo: Research Support; Self; Amgen Inc. Research Support; Spouse/Partner; GlaxoSmithKline plc., Novartis Pharmaceuticals Corporation, Sanofi-Aventis. Research Support; Self; Sanofi-Aventis. Funding Kaiser Permanente Northern California

1581-P: Increase of Diabetes and Obesity among Descendants of First-Generation Filipino Immigrants to Italy

Aims: Filipino people are one of the largest immigrant populations in Italy. Aim of this study was to assess differences in T2D, prediabetes and obesity between native Italians and Filipino immigrants living in Rome. Changes in metabolic characteristics and dietary habits between first-generation immigrants and their descendants were examined. Methods: A cross-sectional survey was carried out adopting principles of community-based participatory research. A total of 132 first-generation Filipinos aged 35-60 years resident in Rome for ≥ 5 years, 164 age and sex-matched native Italians and 27 descendants of the first-generation immigrants aged 10-18 years were studied. Diabetes history and dietary habits were investigated by standardized questionnaires; anthropometrics, blood pressure and fasting capillary blood glucose were measured. Results: T2D, impaired fasting glucose and obesity were all more prevalent among first-generation immigrants (13.5%, 35.4% and 41.7% respectively) than Italians (7.2%, 22.6% and 36.8%). Descendants showed higher prevalence of overweight and obesity (48.1%) than first-generation immigrants (p<0.05). First-generation immigrants consumed traditional food more days per week compared to their descendants, who preferred western food, with a large consumption (>4 times/week) of eggs (96%), processed meat (74%) and sweet foods or beverages (96%). Body Mass Index was directly related to years spent in Italy (r=0.19, p=0.03) and educational level (r=0.19, p=0.04). Size of household was directly related to weight gain in first-generation immigrant women (r=0.40, p<0.001). Conclusion: This survey reveals a higher prevalence of diabetes and its risk factors among the Filipino community resident in Rome. Obesity prevalence is higher in the second-generation, probably due to unhealthy changes in dietary pattern. These alarming data stress the need of appropriate health programs addressed to the minority groups immigrating in western countries. Disclosure S. Pieralice: None. R. Del Toro: None. Y. Khazrai: None. E. Maddaloni: Speaker's Bureau; Self; Merck & Co., Inc., Pikdare. A. Maurizi: Consultant; Self; AstraZeneca. S. Manfrini: None. P. Pozzilli: None.

Clinically Amyopathic Dermatomyositis Associated with a Metastatic Undifferentiated Carcinoma in an Adult Filipino Male: A Case Report

A 40-year old Filipino male was managed as a case of clinically amyopathic dermatomyositis (CADM) after presenting only with pruritic photodistributed symmetric erythematous-violaceous patches, nail fold telangiectasia and the pathognomonic Gottron papules. There was no clinical evidence of muscle involvement. The patient shortly presented with a metastatic undifferentiated carcinoma on the cervical lymph nodes. This case demonstrates that dermatomyositis can present uncommonly as CADM with associated metastatic undifferentiated carcinoma.

Sacred Texts and Symbols: An Indigenous Filipino Perspective on Reading

Reading in the Philippines is a process whereby the body, mind and spirit are engaged. Even though Filipinos are predominantly Catholic, many believe that creative energy, in the form of spirits, dwells in nature. These spirits must be respected or else they can unleash their wrath through sickness and natural calamities. As a contribution to preserving Filipino indigenous knowledge, this paper will explore whatok, the tattooing tradition of the Butbut people of Kalinga and t’nalak, the weaving tradition of the T’boli people of Mindanao. The aim of this paper is to preserve the unique culture of the Philippines’ indigenous peoples’ while sharing a decolonized perspective on reading. The term “decolonized” is used to mean peeling away the layers of nearly 400 years of Spanish and American colonial influence on Filipino culture. I will do this by studying the ways in which indigenous Filipino people record memory. The Philippines has an ancient syllabary system, but I will focus on older forms of transmitting ancestral knowledge, tattooing and textile making. Hopefully, this method will challenge readers to see tattoos and textiles as a valid means of documentation beyond printed text.

Post-traumatic stress disorder (PTSD) among Filipino boys subjected to non-therapeutic ritual or medical surgical procedures: A retrospective cohort study.

In the Philippines, non-therapeutic genital cutting is viewed as a culturally sanctioned rite of passage from boyhood to manhood. Strong social and peer pressure is exerted on boys aged between 8-16years to submit to destructive genital cutting, despite the fact that many men who have been subjected to genital cutting during infancy or childhood often describe their experiences in the language of violence, torture, mutilation, and sexual assault. Among a group of 505 Filipino boys subjected to ritual genital cutting (Tuli), 69% fulfilled the DSM-IV criteria for a diagnosis of PTSD, while among 1072 boys circumcised by medical operators or their assistants, 51% exhibited PTSD symptoms. Pursuant to ritual genital cutting, almost 3 out of every 4 boys exhibited PTSD-like symptoms.

The Roles of Parents in Shaping Fathering Across Generations in Cebu, Philippines

AbstractObjective: This study examined how parental caregiving and parent–child closeness are associated with future fathering among 335 Filipino men who are participants in a long‐running birth cohort study.Background Few studies have multidecade longitudinal data to test the pathways through which parenting is transmitted across generations, with most relevant research conducted in the United States, Europe, and other similar settings. The roles of mothers and fathers in shaping their sons' future parenting is particularly understudied despite fathers having the potential to positively influence child health and development.Method: Participants' mothers (Generation 1 [G1]) reported on caregiving during Generation 2 (G2) participants' early life, and the G2 males reported parent–child closeness during adolescence. G2 fathers reported on their own child‐care involvement and the salience of caregiving to their parenting identity. We tested whether parent–child closeness moderated the effect of early‐life care to predict later‐life fathering.Results: G1‐G2 closeness moderated the association between G1 parents' caregiving and G2 fathers' parenting identity (for both G1 parents) and caregiving time (for G1 fathers only). When the G1‐G2 mother–son relationship was not close, there was a negative correlation between G1 maternal care and G2 fathers' caregiving identity. For G2 men who were close to their fathers, there were positive associations between G1 paternal care and G2 fathers' caregiving identity and time, respectively. Among G2 men who were not close to their fathers, the slopes relating G1 paternal care to G2 fathers' caregiving identity and time, respectively, were negative.Conclusion: These findings reflect that developmental experiences with both mothers and fathers are predictive of men's identity as parents in adulthood and that closeness between fathers and sons moderates whether sons' paternal care tends to emulate or diverge from their fathers' caregiving patterns.

Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report

BackgroundSchistosomiasis is prevalent in tropical and subtropical areas and rarely reported in developed countries. Schistosomiasis often occurs as a chronic illness, which can cause liver and intestinal damage. Appendicitis is an unusual complication of schistosomiasis. We herein present a case of acute appendicitis associated with the presence of schistosome eggs in a sailor from the Philippines.Case presentationA 34-year-old Filipino man who worked as a sailor presented to our hospital with a 2-day history of acute right lower quadrant abdominal pain and fever. A physical examination revealed right lower quadrant abdominal pain with signs of peritoneal irritation, including rebound tenderness. Computed tomography revealed thickening of the appendix associated with mural calcification and fluid collection around the cecum. Based on these findings, the preoperative diagnosis was acute appendicitis. Laparoscopic appendectomy was performed. Swelling of the appendix and contaminated ascites were observed intraoperatively, but there was no evidence of appendiceal perforation. A histopathological examination showed inflammation of the appendix wall and numerous ovoid bodies present within the submucosa, many of which were calcified. Severe infiltration of lymphocytes and fibrosis were recognized around the oval bodies. The numerous oval bodies were morphologically consistent with schistosomiasis. The final diagnosis was acute phlegmonous appendicitis associated with the presence of schistosome eggs. We examined the patient for signs of adult worm activity, but the results of stool ova and parasite examinations performed twice were negative. He was discharged and returned to his country on postoperative day 9.ConclusionsThe incidence of schistosomal appendicitis, which is seldom reported in developed countries, is expected to increase in Japan in the near future. Clinicians should suspect schistosome eggs as a cause of acute appendicitis in patients who have emigrated from or are traveling from endemic areas, and when mural calcification of the appendix is observed on imaging.

INCIDENCE OF BULLYING AND ACADEMIC PERFORMANCE OF GRADE 7 LEARNERS

The study determined the incidence of bullying and academic performance of learners in public secondary schools in Dulag, Leyte during the School Year 2017-2018. The measured variables included the learners’ profile (age, sex, custodian, types of family, types of personality), bullying incidence (physical, verbal, psychological and cyberbullying) and academic performance (Filipino, English, Mathematics, Sciences, Social Studies [Araling Panlipunan], Technology and Livelihood Education [TLE], Music, Arts, Physical Education and Health [MAPEH], and Values Education [Edukasyon sa Pagpapakatao – EsP]). The study likewise examined the association between the selected profile indicators, bullying incidence and academic performance of learners. Quota sampling was employed to randomly chosen one thousand Grade 7 respondents for the study. Descriptive and correlational research designs were employed where data generation was carried out utilising a research questionnaire. The Pearson r was used to test the association among the study variables. Findings revealed that there were more female respondents than their male counterpart. Their combined mean age was 12.78 years with parents as their custodian. The large majority belonged to nuclear type of family. They exhibited moderate level type of personality and experienced various forms of bullying: physical, verbal, psychological, and cyber bullying. Sending harmful text messages on Facebook and other social media platform emerged as most bullying acts experienced by Grade 7 learners. The learners manifested very satisfactory academic performance on courses (or subjects) not requiring highly technical and critical thinking (MAPEH, TLE and EsP) while only satisfactory performance in Mathematics and Science courses which required analytical skills. In conclusion, age, type of family and type of personality are statistical associated with the incidence of bullying such that bullying has negative bearing on academic performance. Younger learners are more likely to experience physical and cyber bullying than their older counterpart. The incidence of bullying has opposite bearing on academic performance, the higher the incidence of bullying among learners, the lower their academic performance. This study confirms the arguments put forward in the Social Dominance Theory (Sidanius and Pratto, 1999), the Choice Theory (Glasser, 1998) and the Social Ecological Theory (Bronfenbrenner, 1999). Article visualizations:

Political Perspective on the Proposed Federal System of Government of Local Government Officials in Samarica, Occidental Mindoro

On January 22 to 25, 1986, the Filipino people made history by overthrowing the 13-year Marcos dictatorship through a peaceful people power revolution. As a result, the country restored democracy and free elections through the 1987 Constitution which promised to empower citizens and Local Government Units (LGUs). Decentralization and local autonomy were further enhanced to put greater freedom and autonomous powers to local governments through the Local Government Code of 1991 in accordance with the provision stipulated in the said Constitution (Brillantes, 2016). However, Brillantes (2016) added that it was the shortcomings of decentralization that paved the way for the interest of conversion to federalism. As stated by Balisacan, Hill, and Piza (2006), over the past 25 years, decentralization has not delivered what some of its proponents might have expected: a decisive shift of power and resources out of the center, a vibrant, efficient and responsive system of local government, and a general shift in the quality of governance through the competitive “voice and exit” accountability mechanisms. Although it doesn't mean that decentralization has failed because there are local governments who have performed well even those outside Luzon. Still, this prompted former Senator Aquilino Pimentel, father of the Local Government Code, and even President Rodrigo Duterte to consider Federalization as an alternative strategy for regional and national development for the Philippines. According to Brillantes (2016), if there would be major lessons that the country has learned for the past 25 years, decentralization offered positive effects such as strong leadership at the local level, wider participation, and engagement with civil society institutions. However, there are still emerging issues and questions such as inadequate local finance, weak local – and national – capacity, or unclear and inadequate corporate and taxing powers of local governments. With that, given the Philippine context, and given our experience over the past quarter of a century, proponents believe that a federal system is more hospitable as an enabler of deepening local autonomy for local governments. In this regard, the researcher conducted this study which in the end would hopefully contribute in formulating the salient features of the proposed federal system of our government.

Years of Potential Life Lost Because of Cardiovascular Disease in Asian-American Subgroups, 2003-2012.

BackgroundAsian‐American subgroups (Asian‐Indian, Chinese, Filipino, Korean, Japanese, and Vietnamese) display varied cardiovascular disease mortality patterns, especially at younger ages. This study aims to examine the years of potential life lost because of ischemic heart disease and cerebrovascular disease among the 6 largest Asian‐American subgroups compared with non‐Hispanic whites.Methods and ResultsWe used National Center for Health Statistics Multiple Causes of Death mortality files from 2003 to 2012 to calculate race‐specific life expectancy, mean years of potential life lost, and years of potential life lost per 100 000 population for each Asian subgroup and non‐Hispanic whites. Asian‐American subgroups display heterogeneity in cardiovascular disease burden. Asian‐Indians had a high burden of ischemic heart disease; Asian‐Indian men lost 724 years per 100 000 population in 2012 and a mean of 17 years to ischemic heart disease. Respectively, Vietnamese and Filipino men and women lost a mean of 17 and 16 years of life to cerebrovascular disease; Filipino men lost 352 years per 100 000 population in 2012. All Asian subgroups for both sexes had higher years of life lost to cerebrovascular disease compared with non‐Hispanic whites.ConclusionsCardiovascular disease burden varies among Asian subgroups, and contributes to greater premature mortality in certain subgroups. Asian‐Indian and Filipino populations have the highest years of life lost because of ischemic heart disease and Filipino and Vietnamese have the highest years of life lost because of cerebrovascular disease. Analysis of risk factors and development of subgroup‐specific interventions are required to address these health disparities.

Lues Maligna in a Patient with Human Immunodeficiency Virus: Case Report and Review of the Literature

Syphilis is a sexually transmitted infection with rising incidence in recent years due to increased rates of highrisk sexual behaviors. Often called “the great imitator,” syphilis can have many different presentations in its various stages: latent, primary, secondary and tertiary. One form of secondary syphilis is ulceronodular syphilis, also known as lues maligna. We report a case of a 48-year-old Filipino man who presented with a diffuse, ulcerating, papular rash and was subsequently diagnosed concurrently with both lues maligna and human immunodeficiency virus.

Differences in Tobacco Use Among a Sample of At-Risk Chinese, Filipino, and Vietnamese Adult Men Living in the SF Bay Area.

Background:Smoking among Asian men has been studied, but differences in tobacco and cigarette use among US- and non-US-born Asian subgroups, especially those at risk for substance use or sexually transmitted diseases, has not been well-studied.Aims:To learn about the smoking of cigarettes or blunts among Asian ethnic groups, and whether place of birth, age, or primary language spoken at home is associated with smoking.Methods:Study participants were 125 adult (age > 18 years) Chinese, Filipino, or Vietnamese men living in San Francisco, Daly City, or San Jose, California, who self-reported substance use in the past 30 days. Information collected included sexual orientation, past year contact with the criminal justice system, place of birth, and primary language spoken at home. Bivariate analyses were used to compare the differences in self-reported smoking of cigarettes or tobacco-marijuana blunts by ethnicity, age, place of birth, and primary language spoken at home.Results:Filipinos had significantly higher rate of cigarette use (51%; P = .02) and smoking blunts (28%; P = .02) compared with Chinese (23% and 5%, respectively) or Vietnamese (34% and 17%, respectively); US-born Filipinos also had more days of cigarette use in the past 30 days (16 days; P = .05) compared with Chinese (8 days) or Vietnamese (6 days) participants.Conclusions:This study found differences in self-reported rates of cigarette and blunt use among Asian ethnic groups which suggest opportunities for targeted interventions. Future studies of tobacco or blunts use for these largely immigrant groups should take into account country of birth and language spoken at home in developing tobacco prevention services for this population.