COMBINED (WEEK 7&8)

R.A. No. 7170

An Act authorizing the legacy or donation of all or part of a human body after death for specified purposes

Kidney

the most common transplanted organ

Organ Donation Act of 1991

updates the “1949 Act” to legalize permissions to use human organs

Way of legacy or will

Under the new legislation, each individual can donate all or any part of his body by:

Therapy

Research

Medical Education

Donations are only valid when made for:

Department of Health

International sharing of organs is recognized but subject to approval by the agency:

18 years of age

Sound mind

In R.A 7170 - Section 3: Peson who may execute legacy, these are the primary qualifications

Testator

an individual who makes a legacy of all or part of his body

Donors

an individual authorized under this Act to donate all or part of the body or decedent

Spouse

Son/Daughter of legal age

Parent

Brother/Sister of legal age

Guardian over the person at that time of his death

People who is legitimate to receive all or part of the decedent’s body for any purposes: (in correct order)

Forensic pathologist

Conducts autopsy on the cadaver of accident, trauma, or other medico-legal cases immediately after pronouncement of death, to determine qualified and healthy human organs for transplantation and/or in furtherance of medical science

Cornea

• Safest organ to donate due to lack of blood vessels connections

• Avascular and Low MHC Class I and absence of MHC Class II

3 signature

The document legacy must be signed by how many people?

Testator

2 witness

In document legacy, who must sign?

Attending Physician

Recipient of the organ

Surgeon

The one who will remove the organ

48 hours

How many hours needed to locate nearest relatives of the decedent at the time of death

Signed statement

Oral statement with 2 witness

A statement to the attending physician

A signed card / document found on the donor

In R.A. 7170 - Section 12: Amendment or Revocation of Legacy or Donation, the testator or donor may amend or revoke the legacy or donation either by:

R.A. 7885

An Act to advance Corneal transplantation in the Philippines, amending for the purpose republic act numbered seven thousand one hundred and seventy (R.A. 7170). otherwise known as the Organ Donation Act of 1991

12 hours after death

Authorized time of removal of the cornea or corneas of the decedent within how many hours?

February 20,1995

Approved date of the law? (organ donation)

Fidel V. Ramos

President who approved the Organ Donation Act?

Organ Bank Storage Facility

a facility licensed, accredited or approved under the law for storage of human bodies or parts thereof.

Decedent

a deceased individual, and includes a still born infant or fetus

Testator

• an individual who makes a legacy of all or part of his body

• it can also be a decedent (if they die / deceased donor)

Donor

an individual authorized under this Act to donate all or part of the body or decedent

Legatee

One who receives the legacy

Donee

• The recipient of the organ

• can also be a relative of the legatee

Hospital

a hospital licensed, accredited or approved under the law, and includes a hospital operated by the government

Part

includes transplantable organs, tissues, eyes, bones, arteries, blood, other fluids and other portions of the human body

Person

an individual, corporation, estate, trust, partnership, association, the Government or any of its subdivisions, agencies or instrumentalities, including government owned or controlled corporations; or nay other legal entity

Physician/Surgeon

licensed or authorized to practice medicine under the laws of the Republic of the Philippines

Immediate Family of the Decedent

• the person enumerated in Section 4(a) of the Act

• according to Bereavement Policy, it defined as “the employees’ spouse, domestic partner, legal guardian, son, daughter, mother, father, sister, brother, grandparents, aunt, uncle, niece, nephew, and in-laws”

Death

• the irreversible cessation of circulatory and respiratory function

• the irreversible cessation of all functions of the entire brain, including the brain stem

Attending Physician

Who is/her primary/family doctor

Consulting Physician

Who is present in the ER department

Follow-up

Monitoring of a newborn

Health Institutions

Hospitals, health infirmaries, health centers, lying-in centers, puericulture centers (public/private)

Health care practitioners

physicians, nurses, midwives, nursing aides, and traditional birth attendants

Heritable conditions

condition that can result in mental retardation, physical deformity, or death

Mental retardation

Physical deformity

Death

Heritable conditions that can results in:

Newborn

Means a child from the time of complete delivery to 30 days old

Newborn Screening

Process of collecting a few drops of blood from the newborn onto an appropriate collection card and performing biochemical testing for determining if the newborn has a heritable condition

Newborn Screening Center

Facility equipped with a newborn screening laboratory that complies with the standards

Newborn Screening Reference Center

Central facility at the NIH that defines testing and follow up protocols, maintains an external laboratory proficiencies and national database

Parent Education

Various means of providing parents or legal guardians information

Recall

Procedure of locating a newborn

Treatment

The provision of prompt, appropriate and adequate medicine, medical and surgical management or dietary prescription to a newborn for purposes of treating or mitigating the adverse health consequences

Severe Mental Retardation

Effect if Congenital Hypothyroidism is not screened

Death

Effect if Congenital Adrenal Hyperplasia is not screened

Death / Cataracts

Effect if Galactosemia is not screened

Severe Mental Retardation

Effect if Phenylketonuria is not screened

Severe Anemia, Kernicterus

Effect if G6PD Deficiency is not screened

Death

Effect if Maple Syrup Urine Disease is not screened

Normal

Effect if Congenital Hypothyroidism is screened

Alive and Normal

Effect if Congenital Adrenal Hyperplasia is screened

Alive and Normal

Effect if Galactosemia is screened

Normal

Effect if Phenylketonuria is screened

Normal

Effect if G6PD Deficiency is screened

Alive and Normal

Effect if Maple Syrup Urine Disease is screened

RA NO. 9288 - Newborn Screening Act of 2004

An act promulgating a comprehensive policy and a national system for ensuring newborn screening

National Institute of Health (NIH)

Is the technical arm in the implementation of newborn screening and other concerned partners

National Institute of Health (NIH)

Reference Center for Newborn Screening

Copy of Refusal documentation

When the parent or legal guardian refuses for newborn screening on the grounds of religious beliefs, what kind of documents shall be made out of the newborn’s medical record?

Religious beliefs

Parent or legal guardians can refuse to newborn screening in what grounds?

24 hours of life but not later than 3 days

Collection time for Newborn Screening

NICU newborn

Exempted from the 3-days requirement but must be tested by 7 days of age

7 days of age

NICU newborns may be exempted to the 3-day requirement, but they must be tested by:

Lateral plantar surface of heel

SPECIFIC PLACE to puncture when using heel prick method

Heel prick method

A method used for newborn screening wherein few drops of blood are taken from the baby’s heel

Special absorbent filter card

Small drop of blood is collected for newborn screening and is blotted on:

4 hours

Blood must be dried for _____ before sent to Newborn screening center

Dried blood spots

Sample for Newborn Screening Test (must be exact answer!!)

Whole blood

Where is the dried blood spots derived from?

immediately within 4 hours

If (+) result for Newborn Screening, result must be released:

7 working days

If (-) result for Newborn Screening, result must be released ____ after receipt in NBS Lab

Lifetime Management

All of the congenital metabolic disorders require

2 NSC in Luzon

2 in Visayas

1 in Mindanao

Establishment of NSCs, depends on the overall demand in the country:

Comprehensive

Integrative

Sustainable

According to R.A. 9288 - Section 2: Declaration of Policy, the state shall institutionalize a national newborn screening system:

(characteristics of newborn screening)

8 members

According to R.A. 9288 - Section 11: Advisory Committee on Newborn Screening, how many members is needed for the committee?

National testing database

Case registries, training, technical assistance

Continuing education for laboratory staff

According to R.A. 9288 - Section 13: Establishment of a Newborn Screening Reference Center, NIH shall establish a NBS Reference Center with: (exact answers only…)

Screening

Management

Follow-up

Diagnosis

Quality Assurance

Components of the Philippine Newborn Screening System

April 07, 2004

Date of Approval of R.A 9288

Gloria Macapagal-Arroyo

President who approved the R.A 9288

Department of Health (DOH)

Lead agency in implementing this Act.

Department of Interior and Local Government (DILG)

• coordinate with the NIH Newborn Screening Reference Center for:

  • Accreditation of Newborn Screening Centers

Newborn Screening

• Enable early detection and management of certain metabolic disorders

• Which if left untreated, may lead to mental retardation and death

• The early diagnosis and treatment of these disorders assures the child’s right live and safeguards him/her to reach his/her potential

Congenital hypothyroidism

Congenital adrenal hyperplasia

Phenylketonuria

Galactosemia

Glucose-6-phosphate dehydrogenase deficiency

Maple Syrup Urine Disease (MSUD)

Metabolic Disorders (Newborn Screening)

Congenital hypothyroidism / Cretinism

• Newborn babies who are unable to make enough thyroid hormone

• Diagnosis: T3, T4, TSH

• LOW levels of (T3 and T4)

• HIGH levels of (TSH)

T3

T4

TSH

Hormones for diagnosing Congenital hypothyroidism / cretinism

Congenital adrenal hyperplasia

People with CAH lack one of the enzymes needed for proper function of the adrenal glands

21-Hydroxylase

The most common deficiency implicated in congenital adrenal hyperplasia

11-Hydroxylase

18-Hydroxylase

enzymes involved in adrenal steroid production

Cretinism

• Hypothyroidism developing in infancy or early childhood

• short stature

• severe mental retardation

• coarse facial features

• protruding tongue

• umbilical hernia

Phenylketonuria (PAH)

Babies with PKU are missing an enzyme called phenylalanine hydroxylase, which is needed to break down an essential amino acid called phenylalanine

Phenylketonuria (PAH)

Patients have a mousy urine odor

phenylalanine hydroxylase

Missing enzyme of a baby with PKU

Phenylalanine

An essential amino acid that is broken down by an enzyme (phenylalanine hydroxylase)

Learning disabilities

Behavioral difficulties

Epilepsy

If phenylketonuria isn’t treated, it can lead to effects such as: (specific answers)

Brain (organs)

Nervous System (system)

Damages caused by PKU