When global medical experts meet

CONSUMERLINE - Ching M. Alano (The Philippine Star) - May 9, 2016 - 10:00am

It’s not every day that a thousand doctors, a lot of them experts in their fields, come together to exchange views on the latest trends in medicine. Such as what happened at the 2016 ECHO (Experts’ Convergence for Health Outcomes) Summit held last April 28 at Manila Marriott Hotel.

“Our goal is to bring world class medical information to our Filipino doctors,” says Claire Papa of Unilab. “The target of the summit is the Filipino physician as a frontliner in terms of healthcare. We invited doctors in general practice, industrial medicine, internal medicine so they can have a more cohesive idea to keep up with all the latest trends and be able to serve the Filipino patient better.”

The summit zeroes in on topics that are probably closest to our hearts: women’s health, anxiety and depression, diabetes and heart disease.

But the day before that, we got to meet and sit down with four rock stars of medicine, who flew in to add their voices to the ECHO Summit, now in its second year (yes, we did have a heart-to-heart talk with the distinguished doctors).

There’s Dr. Wilfred Fujimoto, professor emeritus of Internal Medicine (Endocrinology and Metabolism) at the University of Washington, Seattle and visiting professor at Jichi Medical University-Saitama Medical Center in Japan. Dr. Fujimoto was the main man behind the Japanese American Community Diabetes Study, which revealed a high incidence of type 2 diabetes in Japanese Americans (who probably instantly converted from sushi/tofu to a fast-food diet when they started living in the US).

“What we found out was the Japanese Americans living in Seattle were not eating more food than the Japanese living in Tokyo, both from the same urban environments, yet the Japanese Americans were heavier,” notes Dr. Fujimoto. “What was different was that they were consuming more of the calories as fat, especially animal fat, while the Japanese in Tokyo were consuming more of the calories as complex carbohydrates, not simple sugars. The second thing was the Japanese Americans’ lifestyle included less physical activity than that of the Japanese in Tokyo who have to commute to work, walk to the train station, go up and down the subway, walk off the train. Whereas in the US, people drive their cars and park as close as possible to the nearest elevator.”

Dr. Fujimoto was also closely involved in the development of the Diabetes Prevention Program in the US, which included 4,000 people, 45 percent of whom were of minority origins — Blacks, Asians, Hispanics, native Americans.  “By just walking half an hour, five days a week, you reduce your risk of developing diabetes in the future. Many Asian Americans have BMIs (body mass index) in the normal range and they don’t even look overweight, but they have pre-diabetes.”

On that not-too-sweet note, we welcome Dr. Seyyed Nassir Ghaemi, professor at the Department of Psychiatry, Tufts University School of Medicine. Armed with two master’s degrees in Philosophy and Public Health and a big smile as warm as sunshine, Dr. Ghaemi sifts through the evidence for treatment of depressive or anxiety symptoms in persons at risk of cardiovascular disease, including the use of selective serotonin reuptake inhibitors and lithium.

Dr. Ghaemi shares, “Among the regions of the world, the region with the highest global burden of depression is Africa, followed by the Middle East and Europe — depression seems to correlate with socio-economic conflict and poverty. Asia would be in between the Middle East and Europe. In China, the experience of depression is much more physical than psychological. They say, ‘I have a headache’ or ‘My stomach hurts.’”

The stress here is on mental stress, a problem often overlooked by doctors. And people don’t like to admit they have psychosocial problems, which is really sad because depression and anxiety can cause heart attack and stroke.

The open forum or Q&A (question-and-answer) session gets into the heart of the matter with Dr. Bertram Pitt, a world-renowned heart failure expert.  Dr. Pitt (no relation to Brad) presents the latest trends in the use of mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone, in the management of heart failure, as well as new drug agents that can help in the management of hyperkalemia which often accompanies the use of MRAs. Severe hyperkalemia (extremely high levels of potassium in the blood) can lead to cardiac arrest and death.

Dr. Pitt, professor emeritus at the University of Michigan School of Medicine, has chaired and co-chaired a number of clinical trials in cardiology and has over 500 articles in peer reviewed journals.

Finally, there’s Dr. Amos Pines who comes all the way from Tel-Aviv to tackle women’s health. Director of the Bone Density Unit, Assuta HMO, Tel-Aviv and co-founder of the Israel Menopause Society, Dr. Pines talks about the potential of hormone replacement therapy (HRT) in reducing the risk of coronary heart disease among menopausal women as well as the protective effect of HRT on the bone.

We ask the good doctor, who has barely shaken off jet lag as he got in just last night:  Is it true that HRT may cause cancer of the breast?

“It depends on how many years you used it,” he replies. “If less than seven to 10 years, there’s no risk of cancer. But if you use HRT for many, many years, there’s a small increase in breast cancer risk. It also depends on what exactly is the type of HRT used, if it’s high dose or average dose. Nowadays, women get a low dose of HRT. Most studies done only involved older preparations, there are no very good data for the newer products. Only in those women who used hormones in the past and then entered the study and then used estrogen plus progestin for about five to six years, there was a little bit of a risk in the range of one in a thousand per year.”

Talking straight from the heart, Dr. Pines addresses women’s menopausal concerns as it is at this period that women develop all the complications that may lead to heart disease, which is the No. 1 cause of death in women today.

Indeed, this summit ECHOes the primary health concerns of people around the world.

* * *

The 2016 ECHO Summit was supported by an unrestricted grant from Unilab’s Specialty Cluster, namely, Therapharma Inc. (Cardiovascular Division), LP Imperial Inc. (Endometabolic Division), Medichem Pharmaceutics (CNS Division), and Biofemme (Women’s Health Division).

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