PNCA: Is Medical Response treatment or cure?

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Logo-620x512By Victor Layug

This is the second in a series of four articles covering topics presented at the Philippine National Convention on AIDS conducted on October 19, 2012 at the Bayleaf Hotel in Intramuros, Manila.

 

The first stage of the Philippine National Convention on AIDS was entitled “Medical Response: Is it treatment or cure?” The first speaker for that segment was Dr. Jose Gerard Belimac, the manager of the National AIDS/STI Prevention and Control Program (NASPCP) of the Department of Health (DOH).

Dr. Belimac began by stating to the audience that his goal during the convention was to understand the implications of stem cell transplantation in HIV management. Dr. Belimac continued by telling the audience the story of Timothy Ray Brown, more commonly known as the Berlin Patient, widely believed to be the first person who has been functionally cured of AIDS.

In 1995, Timothy Ray Brown, then aged 45, was diagnosed with HIV. In 2006 was, he diagnosed with leukemia. Mr. Brown then underwent three bone marrow stem cell transplants from 2008-2009, and was functionally cured of AIDS. These transplants came from a donor whose ancestor was able to survive the Great Plague, and as a result, was part of the less that 5% of Caucasians who are believed to be immune to HIV-AIDS. The immunity was credited to the fact that they have no gene to code for CCR5 and CCR2, or have a mutation in the CCR5 gene known as CCR5-delta32, which results in a smaller protein that is no longer on the outside of the cell.

However, there are other potential uses for stem cell research that go far beyond treating HIV/AIDS. Stem cell research can be used to study and treat birth defects, test new drugs and can be used for cell based therapy. This last option can be used to generate new white blood cells, replace damaged heart cells and treat Parkinson’s and Alzheimer’s.

The second speaker for stage 1 of the convention was Rowena Capistrano from the Research Institute for Tropical Medicine. She spoke about nursing care. In her talk, she stressed the importance of several ethical guidelines when it comes to nursing care. Among those guidelines were:

  • Make sure that patients are not harmed
  • Explain to patients the treatment they are undergoing since they have the right to make decisions affecting their treatment.
  • Treat all patients equally regardless of age, sex, religion, sexual orientation or status in life.
  • Keep all information obtained/provided private unless disclosure is necessary, such as in legal matters to ensure the safety of patients, and only after consulting with supervisors.
  • Make sure that patients give permission and have a full understanding of what is going on.

Nurse Capistrano also stated how some nurses have difficulty when taking care of certain patients, and that these nurses should learn to recognise and prevent stress if possible.  She ended her talk by saying that professional behavior is considered an important part of clinical teams, as they are expected to act professionally whether during home visits or in clinics and hospitals.

The third and last resource person for Stage 1 of the convention was Dr. Arlan Lopez of the STD/AIDS Cooperative Central Laboratory (SACCL), which conducts various training programs necessary in the diagnosis of STIs. Dr. Arlan was there to speak about quality assurance when it comes to HIV testing kits.

Dr. Arlan stated that quality assurance is achieved by conforming to worldwide standards of quality. He explained that it involves a very systematic approach that takes into account the individual and collective quality of all components in a system. He also stated the importance of the quality of testing kits so as to get real results and avoid false positive results.

He also stressed the importance of recognising the difference between quality assurance and quality control. Quality assurance involves various activities that ensure that a process is adequate enough for a system to achieve its objectives, whereas quality control covers activities that properly evaluate the product or work result.

Dr. Arlan ended his talk by mentioning that the SACCL Quality Assurance Program encompasses 3 things: the External Quality Assessment scheme, the Training of Medical Technologists, and kit evaluations for the purpose of establishing the highest quality.

 

 

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