El objeto de los contratos

Fil: Vega, Francisco A. de la. Universidad de Buenos Aires. Facultad de Derecho. Cátedra de Derecho Civil III. Buenos Aires, Argentin

"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

Total Intravenous Anesthesia to Reduce Metastasis and Recurrence Rates in Patients Presenting for Breast Cancer Surgery: An Educational Intervention

Background: Surgical intervention for breast malignancy is the treatment of choice for the breast cancer patient population. Extensive research has established the correlation between the mode of anesthetic delivery and breast cancer recurrence and metastasis in patients undergoing surgical intervention for breast cancer. Researchers have identified the implications of volatile anesthetic agents (VAA), or inhalational agents, on the suppression of the immune response throughout the perioperative period; thus, cultivating an environment that is ideal for cancer cell proliferation, migration, and eventual metastasis via systemic circulation. Although the standardization of the anesthetic management for this patient population has not been declared, total intravenous anesthesia (TIVA) has been identified as the optimal anesthetic method to reduce the risk of breast cancer recurrence and metastasis in patients undergoing breast surgery, due to the immunologic protectant effects proffered by the drugs utilized in TIVA anesthetic administration. Methods: PubMed, Google Scholar, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) search engines were accessed via the Florida International University (FIU) library database to compose a comprehensive search for peer-reviewed research studies within the last 10 years that examined the effects of VAA or TIVA anesthetic on breast cancer recurrence and metastasis in patients undergoing surgical intervention for breast cancer. Results: Eight high-level research articles were selected for appraisal and inclusion of this review due to novelty and relevance. The articles included in this review evaluate the long-term effects of VAA or TIVA anesthetic delivery on breast cancer recurrence and metastasis in the breast cancer patient surgical population and identify the existing research-to-practice gap that must be addressed in the anesthesia community to yield the best possible outcomes for the aforementioned target population. Conclusion: Current evidence-based research has illuminated the impactful role that anesthesia providers may have on the long-term outcomes of patients with breast malignancy presenting for surgical intervention via the selection of a TIVA-based anesthetic approach. It is anticipated that the implementation of a QI project will enhance the anesthesia providers’ capacity to improve the quality of life and reduce the risk of life-altering implications with the selection of their anesthetic approach in breast cancer patients

Compresión del nervio supraescapular por un ganglión en un deportista: a propósito de un caso

Se describe el caso de un joven jugador de balonmano con un síndrome de compresión del nervio supraescapular de su hombro derecho por un ganglión, haciendo una revisión de la etiología, clínica, diagnóstico y tratamiento de este raro síndrome.Supraescapular nerve entrapment caused by a ganglion in a young handball player is reported. Ethiology, clinical, diagnosis and treatment of this rare syndrome is revised

Characterization of non-intentional emissions from distributed energy resources up to 500 kHz: A case study in Spain

Narrow Band Power Line Communications (NB-PLC) systems are currently used for smart metering and power quality monitoring as a part of the Smart Grid (SG) concept. However, non-intentional emissions generated by the devices connected to the grid may sometimes disturb the communications and isolate metering equipment. Though some research works have been recently developed to characterize these emissions, most of them have been limited to frequencies below 150 kHz and they are mainly focused on in-house electronic appliances and lightning devices. As NB-PLC can also be allocated in higher frequencies up to 500 kHz, there is still a lack of analysis in this frequency range, especially for emissions from Distributed Energy Resources (DERs). The identification and characterization of the emissions is essential to develop solutions that avoid a negative impact on the proper performance of NB-PLC. In this work, the non-intentional emissions of different types of DERs composing a representative microgrid have been measured in the 35–500 kHz frequency range and analyzed both in time and frequency domains. Different working conditions and coupling and commutation procedures to mains are considered in the analysis. Results are then compared to the limits recommended by regulatory bodies for spurious emissions from communication systems in this frequency band, as no specific limits for DERs have been established. Field measurements show clear differences in the characteristics of non-intentional emissions for different devices, working conditions and coupling procedures and for frequencies below and above 150 kHz. Results of this study demonstrate that a further characterization of the potential emissions from the different types of DERs connected to the grid is required in order to guarantee current and future applications based on NB-PLC.This work has been financially supported in part by the Basque Government (Elkartek program)

The antenna DSA 3 and its potential use for Radio Astronomy

The European Space Agency (ESA) will inaugurate its third Deep Space Antenna (DSA 3) by the end of 2012. DSA 3 will be located in Argentina near the city of Malarg"ue in the Mendoza province. While the instrument will be primarily dedicated to communications with interplanetary missions, the characteristics of its antenna and receivers will also enable standalone leading scientific contributions, with a high scientific-technological return. We outline here scientific proposals for a radio astronomical use of DSA 3.Comment: 4 pages, submitted as Proceedings for the BAA

Application of International Human Rights Law in State and Federal Courts

This article provides a substantive discussion of international human rights law and how it can be used in federal and state courts to protect human rights within and outside the United States. It provides a comprehensive analysis of cases and examples of possible areas in which international human rights standards may be used to interpret United States laws. Specifically, the article seeks to promote more extensive use of international human rights laws by United States lawyers. State and federal courts have traditionally used international law for the application and enforcement of treaties to which the United States has been a party. But because the United States ratified few human rights treaties, protection of human rights in this manner has proved difficult. Nonetheless, federal and state court decisions have provided promising precedents for additional applications of human rights law. This article identifies two significant developments: federal courts have held that allegations of violation of customary international law state a cause of action; and federal and state courts have relied upon international human rights laws and standards to defend and expand individual rights. This article addresses the developments in these cases and in cases involving direct application of human rights treaties