"Hospital utilization by Mexican migrants returning to Mexico due to health needs"

<p>Abstract</p> <p>Background</p> <p>A total of 12.7 million Mexicans reside as migrants in the United States, of whom only 45% have health insurance in this country while access to health insurance by migrants in Mexico is fraught with difficulties. Health insurance has been shown to impact the use of health care in both countries. This paper quantifies hospitalizations by migrants who return from the US seeking medical care in public and private hospitals in the US-Mexico border area and in communities of origin. The proportion of bed utilization and the proportion of hospitalizations in Mexico out of the total expected by migrants in the US were estimated.</p> <p>Methods</p> <p>The universe included 48 Ministry of Health and 47 private hospitals serving municipalities of high or very high migration in Mexico, where 17% of remittance-receiving households are located, as well as 15 public and 159 private hospitals in 10 Mexican cities along the border with the US. Hospitals were sampled through various methods to include 27% of beds. Patients and staff were interviewed and data triangulated to quantify migrants that returned to Mexico seeking medical care. Official hospital discharge statistics and secondary data from migration databases and published statistics were analyzed to identify bed occupancy, general migrant hospitalization rates and the size of the migrant population that maintains close relationships with households in communities of origin.</p> <p>Results</p> <p>Up to 1609 migrants were admitted to public hospitals (76.6%) and 492 to private hospitals (23.4%) serving municipalities of high and very high migration intensity in 2008. Up to 0.90% of public hospital capacity was used. In the border area up to 908 and 2416 migrants were admitted to public (27.3%) and private (72.7%) hospitals, respectively. Up to 1.18% of public hospital capacity was used. Between 2.4% and 20.4% of the expected hospitalization needs of migrants with dependent households are satisfied through these services. The most common diagnostic categories mentioned across hospitals were traumatisms, complications of diabetes and elective surgery, in that order. Private hospitals mention elective surgeries as the main diagnostic category followed by complications of diabetes.</p> <p>Conclusions</p> <p>Hospitals in communities of origin in Mexico are devoting few resources to respond to hospitalization needs of migrants in the US. Currently no hospital programs exist to stimulate migrant demand or to cater to their specific needs. Registering migratory history in clinical and administrative records can be readily implemented. Developing bi-national referral networks and insuring migrants in the US within current Mexican federal programs could greatly increase migrant access to hospitals.</p

mm-Wave DRW Antenna Phase Centre Determination

This document presents an approach to the phase centre determination of a dielectric rod waveguide (DRW) antenna by means of measurements obtained with a planar measuring system at millimeter wave lengths. Phase centre determination by the least squares fit technique is described in this document for different DRW antennas (silicon and sapphire). Results at different operating frequencies are offered

Lipoprotein particles in patients with pediatric Cushing disease and possible cardiovascular risks.

BackgroundCardiovascular (CV) complications are the most significant cause of mortality in adults with Cushing disease (CD); little is known about CV risk factors in children with CD. Measurement of lipoprotein particles by nuclear magnetic resonance (NMR) spectroscopy is a novel technology to assess CV risk. The objective of the current study is to analyze the NMR lipid profile in pediatric CD patients before and 1 year after remission.MethodsNMR lipid profile was obtained via the Vantera NMR analyzer, using frozen serum samples from 33 CD patients (mean age 13.8 ± 4.0 years) evaluated between 1997 and 2017 at the National Institutes of Health (NIH) Clinical Center (CC).ResultsGlycA (glycosylated acute-phase proteins), triglyceride-rich particles (TRLP medium and very small sizes), low-density lipoprotein (LDL) particles (LDLP total and large size), high-density lipoprotein (HDL) particles (HDLP total, medium and small sizes), total cholesterol, LDL-cholesterol, HDL-cholesterol, GlycA inflammatory biomarker, and apolipoprotein B and apolipoprotein A1 (ApoA1) concentrations showed statistically significant changes after remission of CD (p &lt; 0.05).ConclusionIn our study population, most of the lipid variables improved post-CD remission, with the exception of HDL and ApoA1, indicating that NMR lipoprotein profile may be a helpful tool in assessing the CV risk in pediatric patients with CD

Study of the anticancer properties of optically active titanocene oximato compounds

New water soluble and optically active cyclopentadienyl titanium derivatives [(¿5-C5H5)2Ti{(1R, 4S)-¿ON, (R)NH}Cl] (R = Bn (Benzyl) 1a’, 2-pic (2-picolylamine) 1b’) have been synthesized. The novel compounds along with those previously described [(¿5-C5H5)2Ti{(1S, 4R)-¿ON, (R)NH}Cl] (R = Bn 1a, 2-pic 1b) were evaluated by polarimetry, ultra-violet and circular dichroism spectroscopy. The structure of 1b was determined by single crystal X-ray crystallography and showed a unique terminal monohapto Ti–O disposition of the oximato ligand. All enantiomers have been tested against several cancer cell lines in vitro: prostate PC-3 and DU-145, lung A-549, pancreas MiaPaca-2, colorectal HCT-116, leukemia Jurkat and cervical HeLa. In addition, 1a, 1b and 1b’ were tested against non-tumorigenic prostate RWPE-1 cell line. After 24 h of incubation, 1b and 1b’ were moderately active against Jurkat and A-549 cells. The anti-proliferative effect of titanium compounds on prostate PC-3, DU-145 and RWPE-1 cell lines was also assessed after 72 h of drug exposure. The cytotoxic profile of the enantiomers was similar, exception made for the PC-3 cells, with S, R-isomers exhibiting cytotoxicities 2 to 3 times higher than R, S-compounds. Under these conditions, derivative 1b showed calculated IC50 values better than those of Tacke''s Titanocene-Y (bis-[(p-methoxybenzyl)cyclopentadienyl]titanium(IV) dichloride) on both the prostate PC-3 and DU-145 cells. 1a and 1b cytotoxic behaviour shows certain selectiveness, with activities 2–4 times lower on normal prostate RWPE-1 than on cancer PC-3 cells. Furthermore, 1b produces higher cytotoxicity on prostate PC-3, DU-145 and RWPE-1 cells than the additive dose of titanocene dichloride and pro-ligand b·HCl. Additionally, compound-DNA interactions have been investigated by equilibrium dialysis, Fluorescence Resonance Energy Transfer (FRET) melting assays and viscometric titrations, which suggest that these metal complexes and/or their hydrolysis products bind DNA either in the minor groove or externally

Identifying masked uncontrolled hypertension in the community pharmacy setting

© 2015 Wolters Kluwer Health, Inc. Masked uncontrolled hypertension (MUCH) is associated with an increased cardiovascular risk. This condition is frequent in the community pharmacy (i.e., CP-MUCH), but there is no evidence on the factors associated with its presence in that setting. The aim of this analysis was to explore these factors. A sample of 98 treated hypertensive patients from the MEPAFAR study, with normal community pharmacy blood pressure (CPBP <135/85 mmHg), were analyzed. Blood pressure (BP) was also measured at home (4 days) and monitored for 24 h. CP-MUCH was identified when either ambulatory (daytime) or home BP averages were equal to or higher than 135/85 mmHg. A multivariate logistic regression analysis was carried out to identify the factors associated with CP-MUCH. The prevalence of CP-MUCH tends to be higher as systolic and diastolic CPBP increase, reaching 47% in patients with both systolicand diastolic CPBP equal to or higher than 123 mmHg and 79 mmHg, respectively.The multivariate regression analysis showed only systolic CPBP as an independent factor of CP-MUCH [≥123 mmHg: odds ratio=16.46 (P=0.012); from 115 to 122.9 mmHg: odds ratio=10.74 (P=0.036); systolic CPBP <115 mmHg as the reference]. Further assessment, using ambulatory and/or home BP monitoring, is recommended in patients with normal CPBP, but systolic CPBP equal to or higher than 115 mmHg. A more feasible approach would be evaluating patients with systolic CPBP equal to or higher than 123 mmHg and diastolic CPBP equal to or higher than 79 mmHg

Altered sleep and neurovascular dysfunction in alpha-synucleinopathies: the perfect storm for glymphatic failure

Clinical and cognitive progression in alpha-synucleinopathies is highly heterogeneous. While some patients remain stable over long periods of time, other suffer early dementia or fast motor deterioration. Sleep disturbances and nocturnal blood pressure abnormalities have been identified as independent risk factors for clinical progression but a mechanistic explanation linking both aspects is lacking. We hypothesize that impaired glymphatic system might play a key role on clinical progression. Glymphatic system clears brain waste during specific sleep stages, being blood pressure the motive force that propels the interstitial fluid through brain tissue to remove protein waste. Thus, the combination of severe sleep alterations, such as REM sleep behavioral disorder, and lack of the physiological nocturnal decrease of blood pressure due to severe dysautonomia may constitute the perfect storm for glymphatic failure, causing increased abnormal protein aggregation and spreading. In Lewy body disorders (Parkinson’s disease and dementia with Lewy bodies) the increment of intraneuronal alpha-synuclein and extracellular amyloid-β would lead to cognitive deterioration, while in multisystemic atrophy, increased pathology in oligodendroglia would relate to the faster and malignant motor progression. We present a research model that may help in developing studies aiming to elucidate the role of glymphatic function and associated factors mainly in alpha-synucleinopathies, but that could be relevant also for other protein accumulation-related neurodegenerative diseases. If the model is proven to be useful could open new lines for treatments targeting glymphatic function (for example through control of nocturnal blood pressure) with the objective to ameliorate cognitive and motor progression in alpha-synucleinopathies

Power quality events detection using fourth-order spectra

This paper introduces the use of a fourth-order frequency-domain statistical estimator, the spectral kurtosis (SK), in the field of power-quality analysis. The research has been organized in the frame of a research national project and points towards the implementation of these techniques into an automatic platform to perform PQ analysis in power plants and power inverters. Higher-order statistics in the frequency domain manage to distinguish 3 types of electrical anomalies (sags, swells and transients), with an accuracy of 83%

Exogenous Measurements from Basic Meteorological Stations forWind Speed Forecasting

This research presents a comparative analysis of wind speed forecasting methods applied to perform 1 h-ahead forecasting. The main significant development has been the introduction of low-quality measurements as exogenous information to improve these predictions. Eight prediction models have been assessed; three of these models [persistence, autoregressive integrated moving average (ARIMA) and multiple linear regression] are used as references, and the remaining five, based on neural networks, are evaluated on the basis of two procedures. Firstly, four quality indices are assessed (the Pearson’s correlation coefficient, the index of agreement, the mean absolute error and the mean squared error). Secondly, an analysis of variance test and multiple comparison procedure are conducted. The findings indicate that a backpropagation network with five neurons in the hidden layer is the best model obtained with respect to the reference models. The pair of improvements (mean absolute-mean squared error) obtained are 29.10%–56.54%, 28.15%–53.99% and 4.93%–14.38%, for the persistence, ARIMA and multiple linear regression models, respectively. The experimental results reported in this paper show that traditional agricultural measurements enhance the predictions