The Public and the Private: Insurers and Medical Attention in Mexico

Objectives: To analyze the evolution of private health insurance in Mexico during from 1986-1992, compared with the development of the insurance industry in Chile, Brazil and Argentina

Alterations of antitumor and metabolic responses in L5178Y-R lymphoma-bearing mice after only 30-minute daily chronic stress exposure

Aim: In stress research, reducing times of stress induction may contribute to improving the well-being of experimental animals, especially in cancer models, already under physiological distress. To support this idea, we evaluated the effects of a short-timed stress protocol on endocrine, metabolic and immune indicators in mice bearing the L5178Y-R lymphoma. Materials and Methods: A 30-minute daily stress protocol was applied for 28 days to healthy and lymphoma-bearing BALB/c mice; body weight, plasma levels of corticosterone, norepinephrine, Th1/Th2 cytokines, insulin, and leptin, were measured. Results: We found a 12% significant decrease in body weight in non-tumor bearing mice under stress (p < 0.007). The disruption of weight evolution was accompanied by a stress induced 85% decrease in plasmatic leptin (p < 0.01) and total reduction of insulin. Tumor burden alone was associated to an increase in more than two-fold of plasmatic levels of norepinephrine (p < 0.008). Neither stress nor tumor or their combination, resulted in an elevation of systemic IL-6. IFN-γ levels were 20 times higher in lymphoma-bearing animals when compared with non-tumor bearing mice (p < 0.01); however, under stress, this response was reduced by half, indicating a suppressing effect of chronic stress on the antitumor immune response. Conclusion: A short-timed stress induction is enough to cause significant alterations in the metabolism and immunity of healthy and tumor-bearing mice, supporting the use of short-timed protocols as an efficient way to induce chronic stress that also considers concerns regarding the well-being of experimental animals in biomedical research

Study of As(III) and As(V) Oxoanion Adsorption onto Single and Mixed Ferrite and Hausmannite Nanomaterials

The removal of arsenic(III) and arsenic(V) from an aqueous solution through adsorption on to Fe3O4, MnFe2O4, 50% Mn substituted Fe3O4, 75% Mn substituted Fe3O4, and Mn3O4 nanomaterials was investigated. Characterization of the nanomaterials using XRD showed only pure phases for Mn3O4, MnFe2O4, and Fe3O4. The 50% and 75% substituted nanomaterials were found to be mixtures of Mn3O4 and Fe3O4. From batch studies the optimum binding pH of arsenic(III) and arsenic(V) to the nanomaterials was determined to be pH 3. The binding capacity for As(III) and As(VI) to the various nanomaterials was determined using Isotherm studies. The binding capacity of Fe3O4 was determined to be 17.1 mg/g for arsenic(III) and 7.0 mg/g for arsenic(V). The substitution of 25% Mn into the Fe3O4 lattice showed a slight increase in the binding capacity for As(III) and As(VI) to 23.8 mg/g and 7.9 mg/g, respectively. The 50% substituted showed the maximum binding capacity of 41.5 mg/g and 13.9 mg/g for arsenic(III) and arsenic(V). The 75% Mn substituted Fe3O4 capacities were 16.7 mg/g for arsenic(III) and 8.2 mg/g for arsenic(V). The binding capacity of the Mn3O4 was determined to be 13.5 mg/g for arsenic(III) and 7.5 mg/g for arsenic(V). In addition, interference studies on the effects of SO2-4, PO3-4, Cl-, and NO-3 investigated. All the interferences had very minimal effects on the As(III) and As(V) binding never fell below 20% even in the presence of 1000 ppm interfering ions

La autoestima, estrés, autoconcepto y apoyo social como factores de eficiencia terminal de la maestría en educación

El estudio en su primer apartado presenta el método trabajado siendo este un enfoque cuantitativo, donde a través de revisiones estadísticas se midieron magnitudes del fenómeno presentado en los educandos de maestría en educación sobre los factores de autoestima, estrés, autoconcepto y apoyo social en su desarrollo como estudiantes, en esta investigación participaron 51 personas que se les suministró cuatro instrumentos de escala Likert donde se analizaron diversas variables que permitieron valorar los resultados donde la edad, el estado civil y si habían reprobado alguna materia era preponderante para el logro de su grado académico

Transapical miniaturized ventricular assist device: Design and initial testing

BackgroundLeft ventricular assist devices are increasingly used to treat patients with advanced and otherwise refractory heart failure as bridge to transplant or destination therapy. We evaluated a new miniaturized left ventricular assist device that requires minimal surgery for implantation, potentially allowing implantation in earlier stage heart failure.MethodsHeartWare (Miami Lakes, Fla) developed transapical miniaturized ventricular assist device. Acute (n = 4), 1-week (n = 2), and 30-day (n = 4) bovine model experiments evaluated hemodynamic efficacy and biocompatibility of the device, which was implanted through small left thoracotomy with single insertion at apex of left ventricle without cardiopulmonary bypass. The device outflow cannula was positioned across the aortic valve. The international normalized ratio was maintained between 2.0 and 2.5 with warfarin. Hemodynamic, echocardiographic, fluoroscopic, hematologic, and blood chemistry measurements were evaluated.ResultsThe device was successfully implanted through the left ventricular apex in all 10 animals. The device was operated at 15,000 ± 1000 rpm (power consumption, 3.5–6.0 W). The device maintained normal end-organ perfusion with no significant hemolysis (0–30 mg/dL). There were no pump failures or device-related complications. At autopsy, no abnormalities were seen in endocardium, aortic valve leaflets, or aortic root. There was no evidence of thromboembolism or abnormalities in any peripheral end organs.ConclusionsWe successfully demonstrated feasibility of a novel intraventricular assist device that can be completely implanted through left ventricular apex. This transapical surgical approach eliminates needs for sternotomy, device pocket, cardiopulmonary bypass, ventricular coring, and construction of an outflow graft anastomosis

Response of obesity-resistant BALB/c mice to a ketogenic diet

Introduction. The ketogenic diet (KD) is a high-fat, low-carbohydrate diet in which the body undergoes metabolic adjustments that stimulate ketogenesis, thereby increasing circulating ketone bodies. Loss of body weight is attributed to these adjustments, as well as neuroprotective properties. However, the mechanisms involved are still not fully elucidated. That aim of this work was to evaluate the effect of a ketogenic diet on body composition, feeding behavior and glucose metabolism in mice of the BALB/c strain, a mouse model resistant to obesity. Materials and methods. BALB/c mice of both sexes, 12 weeks old, were divided into KD and control groups, which received a ketogenic diet (Research Diets) or standard chow (LabDiet 5001), respectively, for 23 days. Throughout the experiment, body weight gain, water and food intake were measured, whereas body mass index (BMI), the percentage of interscapular, inguinal, and visceral adipose tissue and blood b-hidroxybutyrate levels were measured at the end of the protocol. In addition, glucose tolerance tests were carried out at the beginning and at the end of the experiment. Results. Similar body weight gain (10%) was observed in males and females on KD compared to the control group (p\u3c0.05). However, a higher BMI was observed only in males. The KD group consumed 50% less food in both sexes, whereas water consumption was diminished 25% in males and 50% in females, compared to the control (p= 0.0001). The estimated energy intake was lower (12 Kcal) in males on ketogenic diet, but not in females. Regarding the metabolic state at day 23, in KD mice levels of b-hidroxybutyrate increased to 0.4 mmol/L in males and 0.7 mmol/L in females. Mice of both sexes on KD showed increased inguinal and visceral fat, when compared to the control group on standard chow. At day 23, the glucose tolerance test showed an increase in the area under the curve, indicating impaired glucose tolerance, in both males and females on KD. Conclusions. In obesity-resistant BALB/c mice, the consumption of a ketogenic diet for a short period induces a state of nutritional ketosis accompanied by weight gain, increased fat tissue, and impaired glucose intolerance

Thermodynamics, Kinetics, and Activation energy Studies of the sorption of chromium(III) and chromium(VI) to a Mn 3 O 4 nanomaterial

In this study, a manganese oxide, Mn3O4 was used to remove chromium(III) and chromium(VI) from aqueous solutions. The Mn3O4 nanomaterial was synthesized through a precipitation method, and was characterized using XRD, which confirmed the material had a crystal structure similar to hausmannite. In addition, using Scherrer\u27s equation it was determined that the nanomaterial had an average grain size of 19.5 ± 1.10 nm. A study of the effects of pH on the binding of chromium(III) and chromium(VI) showed that the optimum binding pH was 4 and 3 respectively. Batch isotherm studies were performed to determine the binding capacity of chromium(III), which was determined to be 18.7 mg/g, 41.7 mg/g, and 54.4 mg/g respectively for 4°C, 21°C, and 45°C. Chromium(VI) on the other hand had lower binding capacities of 2.5 mg/g, 4.3 mg/g, and 5.8 mg/g for 4°C, 21°C, 45°C, respectively. Thermodynamic studies performed indicated the sorption process was for the most part controlled by physisorption. The ΔG for the sorption of chromium(III) and Chromium(VI) ranged from -0.9 to -13 kJ/mol, indicating a spontaneous reaction was occurring. The enthalpy indicated a endothermic reaction was occurring during the binding and show ΔH values of 70.6 and 19.1 kJ.mol for chromium(III) and Chromium(VI), respectively. In addition, ΔS for the reaction had positive values of 267 and 73 J/mol for chromium(III) and chromium(VI) which indicate a spontaneous reaction. In addition, the sorption process was found to follow pseudo second order kinetic and the activation energy studies indicated the binding process occurred through chemisorption

LASIK monocular en pacientes adultos con ambliopía por anisometropía

ResumenObjetivoDeterminar la eficacia y la seguridad del LASIK en el tratamiento de la ambliopía por anisometropía en pacientes adultos.MétodosSerie de casos. Estudiamos a 12 pacientes adultos ambliopes por anisometropía a los cuales se realizó LASIK monocular de nuestro servicio de Córnea y Cirugía Refractiva. Evaluamos el error refractivo pre y postoperatorio, equivalente esférico (ES), la agudeza visual sin corrección (AVSC) y la agudeza visual mejor corregida (AVMC). La agudeza visual medida por la cartilla de Snellen fue convertida a LogMAR con fines de análisis estadístico.ResultadosLa edad promedio fue de 31.92 (± 12.13) años. El ES preoperatorio promedio en el ojo tratado fue de –3.49 D (± 3.24), el ES promedio del ojo no tratado fue de 0.25 D (± 0.30). La AVSC preoperatoria fue de 1.12 (± 0.3) LogMAR y la AVMC preoperatoria fue 0.31 (± 0.1) LogMAR. El seguimiento promedio fue de 19.1 (rango 6-74) meses. El ES promedio postoperatorio disminuyó a –0.28 (± 0.48). Cinco pacientes (42%) ganaron una línea de visión, un (8%) paciente ganó 2 líneas de visión y un (8%) paciente ganó 3 líneas de visión. El resto (42%) permaneció sin cambios comparados a la AVMC preoperatoria. Se encontraron diferencias estadísticamente significativas entre la AVSC preoperatoria (1.12 [±0.3]) y la AVSC postoperatoria (0.27 [±0.1]) (p=0.002, Z-Wilcoxon) y entre la AVMC postoperatoria (0.23 [±0.12]) y la AVMC preoperatoria (0.31 [±0.1]) (p=0.014, Z-Wilcoxon). No hubo complicaciones relacionadas con la cirugía.ConclusionesLa cirugía refractiva monocular en pacientes con ambliopía por anisometropía es una opción terapéutica segura y efectiva que ofrece resultados visuales satisfactorios, preservando o incluso mejorando la AVMC preoperatoria.AbstractPurposeTo investigate the efficacy and safety of LASIK for the correction of anisometropic amblyopia in adult patients.MethodsA retrospective, case series. We found 12 amblyopic adult patients that underwent monocular LASIK for anisometropía in our Cornea and Refractive service. We evaluated the preoperative and postoperative refractive error, spherical equivalent (SE), uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Snellen visual acuity measurements were converted to LogMAR for statistical purposes.ResultsThe mean age was 31.92 (±12.13) years. The average preoperative SE in the treated eyes was -3.49 (±3.24), the average SE of the untreated eye was 0.25(±0.30). Preoperative UCVA was 1.12 (±0.3) and average preoperative BCVA was 0.31 (±0.1). All patients had LASIK with an average follow-up time of 19.1(6-74) months. The average postoperative SE decreased to -0.28 (±0.48). Five patients (42%) gained 1 line of vision, 1 (8%) patient gained 2 lines of vision, 1 (8%) patient gained 3 lines of vision and the rest (42%) remained unchanged compared to preoperative BCVA. Statistically significant differences were observed between the preoperative UCVA [1.12 (±0.3)] with the postoperative UCVA [0.27 (±0.1)](p=0.002, Z-Wilcoxon) and between the postoperative BCVA [0.23 (±0.12)] with the preoperative BCVA [0.31 (±0.1)] (p=0.014, Z-Wilcoxon). There were no complications related to the surgical procedures.ConclusionsMonocular refractive surgery in adult patients with anisometropic amblyopia is a safe and effective therapeutic option that offers a satisfactory visual outcome, preserving or even improving the preoperative BCVA

Correlation between obesity and severity of distal radius fractures

Introduction: The incidence of obesity has increased significantly worldwide. Our hypothesis was that patients with obesity have a more severe distal radius fracture and we realized a study to evaluate this correlation between obesity and severity of distal radius fractures caused by low-energy injuries. Materials and methods: A total of 114 patients with distal radius fracture were examined in