Bronchial THree

By: Felicitos A. Obillo, MD

ASTHMA- New classification, Simplified Guidelines

The Global Initiative for Asthma (GINA) recently revised its classification. GINA 2004 previously classified asthma by severity (traditionally by the degree of symptoms, airflow limitation, and lung function variability) – as intermittent, mild persistent, moderate persistent or severe persistent. GINA 2006 now classifies asthma by level of control: controlled, partly controlled, and uncontrolled. This classification recognizes that asthma severity involves both the severity of the underlying disease and its responsiveness to treatment. A stepwise approach is used to classify severity; guide treatment, and assess, achieve and maintain control. The number and frequency of medication increase as the need for asthma therapy increases, and decrease when asthma is under control. The Asthma Control Test (ACT) is a validated measure that is used for assessment of clinical control and can be easily applied to our patients in the clinic.

The GINA was created to increase awareness of asthma among health professional, public health authorities, and the general public, to improve prevention and management through a concerted worldwide effort.

A Pocket Guide for physicians and nurses of GINA 2006 is available upon request.

Pulmo Lab Potpourris

Effective last Feb 15, the laboratory started using new ABG forms. Aside from improving its aesthetic look, the new format contains additional information (A-a DO2, a-A, P/F ratio) which may effectively guide a clinician in the assessment of mechanically-ventilated and other critically-ill patients in the ICU. The new form was approved by the Hospital Administrator. Official interpretation is done by the pulmonary consultants on a rotation basis.

And last march 1, a new RT staff was appointed in the laboratory. He was selected from five applicants who underwent a rigid screening process – one written examination and three interviews. The vacancy in the department was created by yet another resignation, that of our Chief RT who qualified for work abroad. While I cannot blame the RTs to seek greener pastures elsewhere as they also seek to provide for a better future for themselves and their families, I have been witness to this evolving pattern over the past few years. As we continue to lose some of our bright and promising staff RTs we continue to search for new talents and seek to employ.

them in our hope that they will continue to maintain if not to upgrade the standard of quality care and service they provide to our patients.

The Pulmonary Laboratory is currently staffed by a director, three Assistant Directors, a Technical Director, a Chief RT, and seven staff RTs. Occasionally, volunteer RTs – graduates who seek experience and further training - work in the laboratory for six months. A certificate is issued after a satisfactory stay. Assistant Directors are Drs. Geraldine Almarinez-So, Ariel Boongaling, and Carol Mendoza. Dra. Ge handles CME and training of the Department. Dr. Ariel - Asthma Education Program under the National Asthma Movement (NAM) and Dra. Carol is in-charge of the PPMD TB-DOTS program.

It is through the combined effort of the staff that the programs of the department are carried out. Keep up the good work!

PCCP Convention

The Philippine College of Chest Physicians held its 26th Annual Chest Convention last March 6-9, 2007 at the Sofitel Phil. Plaza, CCP Complex Pasay City. The theme of the convention was “Synergy Integration in Chest Medicine.” Invited foreign speaker were ATUL MEHTA, MD, MBBS who gave updates on flexible bronchoscopy; and Professor PETER GIBSON, on asthma. Outstanding local speakers also served as faculty in the other sessions. The event found a new venue, a refreshing change, after spending many years at the Shangri-La EDSA Hotel.

What’s in a title?

Yes of course, the “BRONCHIAL THREE” refers to us three adult pulmonary consultants in the Department of Medicine---Ge, Ariel, and myself. With due respect to our fourth member, Dra. Carol Mendoza (Pedia) from whom we asked permission - this column could have been entitled: “Stage 1V” (with some misgivings). They will also share their thoughts and insights in future issues.