10

Philippine Focus
February 2013
A young pioneer in the field of research
Dr. James Salisi
D
r}ohnMarkVeIascovassuosed
to just take a break from clinical
medicine when he started working
al lhe NalionaI Inslilules of HeaIlh NIH in
lheUniversilyoflheIhiIiinesUIManiIa
bulilselhimloanaIlernalivealhavayfrom
the clinics.
I denileIy needed a brealher and a re-
spite from clinical work and tried applying
for some moonlighting jobs; and also for a
|ob oening al lhe NIH UI ManiIa in
where I was accepted and worked under
lhe lhen deuly head of NIH Dr Vicenle
eIizario }r I credil him for iniliaIIy heI-
ingmearecialeresearchandvievilasan
aIlernalivecareeralhVeIascosaid
Gradualing vilh a degree in ioIogy in
al lhe Universily of lhe IhiIiinesVi-
sayasinMiagaoIIoiIoVeIascovasacceled
lolheUICoIIegeofMedicineyearvherehe
nished his medicaI degree in During
his time in medical school, he claimed that
he was more interested in surgery than in re-
search.
IniliaIIy I vas lhinking of seciaIizing in
uroIogyandlookilasaneIeclivesinceIvas
lhinkinglhalIcanlakeoverlhemedicaIrac-
liceofmyuncIeauroIogislraclicingalWesl
VirginiaUSOnhindsighlIdonllhinkIvas
really cut-out to become a surgeon. I was not
really thinking that far ahead in terms of ca-
reerduringmedicaIschooIVeIascorecaIIed
HisslinlallheNIHvherehecoordinaled
research projects being implemented then in
variousarlsoflhecounlryheIedhimIand
a|obasaresearchcoordinalorforlheArmed
IorcesResearchInsliluleofMedicaISciences
AIRIMS ViroIogy Research Unil IAVRU
In 2006, he became one of the founding mem-
bers of IAVRU vhich is under lhe Dearl-
menl of ViroIogy of lhe Uniled Slales Army
MedicaI comonenlAIRIMS USAMCAI-
RIMSIocaledinangkokThaiIand
VeIascoconsidersreceivingacerlicaleof
merilorioushonorfromAIRIMSforeslabIish-
ing ties and collaborations with the medical
commandoflheArmedIorcesoflheIhiIi-
pines as one of the accomplishments he is
most proud of. Together with our collabora-
lorsallheVLunaGeneraIHosilaIVLGH
Armed Iorces of lhe IhiIiines MedicaI
CenlerAIIMCvereaclivaledlheDearl-
ment of Research and Training and created a
BEYOND CLINIC
11
Philippine Focus
February 2013
nationally and internationally registered Eth-
icsRevievoardherecounled
He aIso searheaded lhe renovalion of
a SL moIecuIar Iaboralory for inuenza
ICRdengueICRandleslingformuIlidrug
resislanl organisms al VLGH This Iabora-
lory vas inauguraled by lhe IhiIiine Sec-
relary of Defense and lhe US ambassador in
MarchandserveslheneedsoflheIhiI-
ippine military population and their direct
dependents.
VeIasco is nov lhe deuly head and
research coordinalor of IAVRU Togelher
with the country head, he coordinates and
oversees USAMCAIRIMS research ro|ecls
and aclivilies in ManiIa and Cebu His vork
aIso invoIves communicaling and mainlain-
ing good working relationships with Philip-
ine governmenl agencies such as lhe De-
arlmenl of HeaIlh and inlernalionaI NGOs
based in lhe IhiIiines He is aIso lheAI-
RIMS Iiaison ocer for lhe US embassy and
lheArmedIorcesoflheIhiIiinesMedicaI
Command
The career path that he has decided to take
avay from cIinicaI vork is nol vilhoul di-
cuIliesVeIascohadloIearnlhingsonlhey
eseciaIIy vhen he |oined IAVRU vhere he
managed research projects and coordinated
vilh dierenl governmenl and nongovern-
menl agencies ul a osilive ailude has
helped him cope and perform well in his line
of work.
I donl viev lhem as dicuIlies bul as
chaIIenges vhich rovide me vilh oorlu-
nities for learning new things and further add
to my skill-set. I constantly encounter many
challenges which were not taught in the con-
nes of lhe cIassroom or hosilaI and vhich
are nol even reIaled lo lhe eId of medicine
such as management, administration, logis-
tics, diplomacy and communication skills
or lhings vhich are noveI or cuingedge in
lhe eId of research and eidemioIogy such
as biosecurily and eIeclronic disease surveiI-
lance, he said.
ullherearemuchmoreloIikeinhis|ob
lhanlovievaschaIIengesVeIascoexIained
The suorl from his suervisors and lhe
exibiIily lo exIore and ursue inleresls in
hischoseneIdarefevoflhemanylhingshe
en|oys aboul his |ob AddilionaIIy lhere are
many lraveI oorlunilies and occasions lo
interact with a lot of interesting people who
are decision-makers, leaders and experts in
lheirresecliveeIdsThe|obisnolrouline
and I am constantly challenged, learning new
lhingseverydayhesaid
InhisfreelimeVeIascoengagesindier-
enlacliviliessuchaslryingoulnevsorlsIike
dragon boat, swimming and biking, as well
asvoIunleeringalaIocaIchurchHis|obhas
aIsoaIIovedhimlonishhismaslersdegree
in Public Health at UP Manila, a post-gradu-
alecerlicaleinImergingInfecliousDisease
IidemioIogyallheUniversilyofIovaUSA
and a oslgraduale diIoma in CIinicaI Tri-
aIsunderlheLondonSchooIofHygieneand
TroicaIMedicineUniversilyofLondonSys-
tem. He is now taking his last modules for a
MaslerofScienceinCIinicaITriaIsinLondon
IIanlofocusmoreonlheeIdofcIinicaI
lriaIs and vaccinoIogy Somelimes due lo lhe
intricacies in research, it is easy to get lost in
the minutiae and details in the design of pro-
locoIs I vanl lo be beer equied and os-
sess the necessary background to be able to ap-
preciate the many facets of doing research and
aroachvaccinoIogyandcIinicaIlriaIsfroma
morehoIislicersecliveVeIascoshared
VeIasco admied lo having second
thoughts about his present career, that there
were times he missed clinical practice and
seeing alienls Hovever seeing lhal he is a
12
Philippine Focus
February 2013
Dr. Carol Tan
P
atients with systemic lupus erythe-
malosus SLI have an increased in-
cidence of psychological illnesses,
accordingloasludyconducledbyDrGeraI-
dine Racaza el aI from lhe Universily of lhe
IhiIiinesIhiIiineGeneraIHosilaI
This nding is suorled by lhe resuIls
of another study conducted by Dr. Robelle
TanangunanelaIfromlheUniversilyofSan-
loTomasvhichreorledonlhevariousco-
ingslralegiesemIoyedbyalienlsvilhSLI
olhsludieseIaboraledonlhesychoIogicaI
andemolionaIdicuIliesofhavingSLI
The rsl sludy vhich vas a caseconlroI
sludy conducled in lhe IhiIiine GeneraI
HosilaI aimed lo evaIuale if lhere vas a
signicanl increase in lhe incidence of anxi-
elyandderessionamongSLIalienlscom-
pared to matched disease-free controls. The
sludy invoIved aduIl alienls diagnosed
vilh SLI using lhe American CoIIege of
RheumaloIogycIassicalioncrileriaand
heaIlhyconlroIsvereinlervievedinlhis
sludyThesearlicianlsveregivenlheIiIi-
inoversionoflheHosilaIAnxielyandDe-
ression Score queslionnaires lo assess lheir
IeveIs of anxiely and deression Rheuma-
tologists independently assessed the patients
diseaseaclivilySlalislicaIleslsvereaIsoem-
ployed to determine any association between
anxiely or deression and severily of lhe
diseaseaclivily
Results of this study showed that patients
vilh SLI had signicanlIy increased inci-
dence of anxiely and deression Anxiely
disorders were seen in 49 percent of those
AsianLupus5ummitNnvcmbcrED5A5hangriLaHntc!Manda!uynngCity
Psycho-emotional symptoms observed in
lupus patients
CONFERENCE COVERAGE
part of and doing something worthwhile that
can help not just a few patients but a large
population is enough for him to regret noth-
ing about his decision.
He advised young medicaI sludenls and
doctors to know their passion which will
give lhem a sense of urose and a sense of
direction.
A career in research is nol for everybody
|usl as becoming a neurosurgeon is nol for
everyonevilhamedicaIdegreeDonollhink
rsl of lhe maleriaI gains Think rsl if lhis
eIdviIIrovideyouvilhsalisfaclionanda
sense of fuIIImenl or if you en|oy doing il
Knov your urose in Iife and if lhis ur-
ose is lhe one driving you lhe resuIl viII
be exceIIence in lhal arlicuIar eId because
you enjoy what you are doing, and subse-
quenlIy lhe maleriaI revards viII foIIov
he said.
13
Philippine Focus
February 2013
vilh SLI comared lo ercenl among
the healthy controls. In addition, 21 percent
oflheSLIalienlssueredfromderession
comaredloercenlamonglheconlroIsNo
correIalionvasfoundbelveenlheseverilyof
disease aclivily and incidence of sychoIogi-
cal illness.
The second study, which was funded by
lhe Luus Insired Advocacy or Rheuma-
tology Educational Trust Foundation, Inc.,
is a descrilive sludy of lhe coing slrale-
gies emIoyed by SLI alienls and lheir
caregivers Grou discussions and faciIi-
lalormedialed surveys vere heId for
SLI alienls and caregivers lo assess lhe
sychoemolionaI dicuIlies commonIy en-
counlered Coing slralegies on lhe hysi-
cal, psychological, emotional and social
dicuIlies of having SLI vere aIso eIiciled
The most common coping strategies reported
in this study include support groups, prayers
and family encouragement.
olh sludies emhasized lhe imorlance
of early detection of psychological problems
among SLI alienls and immedialeIy insli-
luling inlervenlions lo aIIay such robIems
Since SLI is a chronic iIIness alienls are al
increased risk for sychoemolionaI dicuI-
lies vhich imair lheir quaIily of Iife Thus
a holistic approach to therapy is important
lo address nol |usl lhe hysicaI asecls of
the disease, but also the psycho-emotional
burden faced by SLI alienls and lheir
caregivers
Dr. Nicolo Cabrera
T
he Ialesl immunizalion recommenda-
lionsoflheIuroeanLeagueAgainsl
Rheumalism IULAR for alienls
vilh auloimmune inammalory rheumalic
diseases AIIRD and lhe Cenlers for Dis-
easeConlroICDCAdvisoryCommieeon
Immunizalion Iraclices ACII for immu-
nocompromised patients are guides for the
vaccinalion of alienls vilh syslemic Iuus
erylhemalosusSLIaccordingloDrMaria
Rhona Galandanerganlin of lhe Univer-
sily of Sanlo Tomas HosilaI and IacuIly of
MedicineandSurgery
Sheremindedlheaudiencelhalinfeclions
are still the leading cause of morbidity and
morlaIilyinSLIAmonglhereasonsshecil-
ed were dysfunctions of complement system
and mannose-binding lectin as well as innate
and acquired immunily secondary lo lhe
disease itself. The use of immunosuppres-
sive medicalions lo lreal lhe disease aIso in-
creased the lupus patients risk for infection.
EULAR, CDC update lupus vaccination
guidelines