Geographic Variation in Sex Ratios of the US Immigrant Population: Identifying Sources of Difference

This paper describes geographic variation in the sex composition of the foreign-born population in the US since 1990, and uses Blinder-Oaxaca decomposition to identify key sources of variation in regional sex ratios. We use data from the 1990 and 2000 US Censuses, and from the 2007–2011 American Community Survey, to create estimates of the size and characteristics of foreign-born populations at the level of Consistent Public-Use Microdata Areas. We find substantial local- and region-level variation in population sex ratios, with the highest sex ratios in the South and Midwest. This variation is partly explained by differences in the age- and national origin-composition of immigrants, but the effects of immigration history, age, and national origin on sex ratio vary substantially by region. The West in particular stands out as having high levels of unexplained difference from other regions. Future research is necessary to understand these regional differences in gendered immigration patterns

Gender, Family, and Community Attachment in a New Destination

As new immigrant destinations in the USA have become home to more settled immigrant populations, they are also becoming less male-dominated and attracting more women and families. But this process is occurring unevenly, with some new destinations much more attractive to women than others. The factors that might lead a destination to attract or retain women are not well understood. We draw on interviews with long-time Latin American residents in a non-metropolitan community in Utah with a fairly high proportion of women immigrants to analyze the ways in which gender and other factors relate to community attachment in this specific context. We examine gender differences in satisfaction with the community and experiences of discrimination and plans to remain in the community. Surprisingly, given current anti-immigrant trends in national politics, we found high levels of community attachment among both men and women. Although experiences of racism were common in our sample, many of the respondents were quick to downplay these experiences and focused instead on their overall positive assessment of the community. Women were more attuned to the experience of discrimination and less willing to downplay it. They were also less likely to have a long-term plan to remain in the community, but this appeared to be more related to their consideration of other family members’ long-term plans, rather than due to their experiences of discrimination. These findings have implications for understanding gendered settlement patterns as well as for promoting immigrant integration at the local level in an unfavorable political context

A Rare Case of Subependymoma with an Atypical Presentation: A Case Report

A rare case of subependymoma in a young patient presenting with sensory dysesthesia is reported. Computed tomography scan and magnetic resonance imaging revealed a posterior fossa mass occluding the fourth ventricle with infiltration to the right side immediately behind the pontine tegmentum and impinging on the right spinothalamic tract. Postoperative tumor histopathology revealed the classical appearance of subependymoma. Subependymoma is a rare, asymptomatic, slow-growing, low-grade glioma of the central nervous system. If symptomatic, the clinical features are commonly secondary to hydrocephalus, but subependymoma presenting with sensory dysesthesia has never been reported in the literature

A Rare Case of Occipital Stroke as a Consequence of Nonbacterial Thrombotic Endocarditis in Ovarian Clear Cell Carcinoma: A Case Report

Hypercoagulability occurs in 15% of patients with malignancy and represents a clinical spectrum ranging from abnormal coagulation tests but no clinically evident thromboembolic disease, to arterial and venous thrombosis, migratory thrombophlebitis, nonbacterial thrombotic endocarditis (NBTE) and disseminated intravascular coagulation. The combination of increased procoagulant activity and decreased fibrinolytic activity accelerates the prothrombotic potential of endothelial cells in malignancy. NBTE is a rare manifestation of cancer-induced hypercoagulability and is commonly seen with mucin-producing adenocarcinomas, but rarely seen with ovarian clear cell carcinoma (OCCC). Cerebrovascular embolization ranges from 14–91% in NBTE. We report a rare case of a 62-year-old female presenting with occipital stroke as a consequence of NBTE in OCCC. Association of NBTE in OCCC has only been reported in 2 cases so far, but presentation with stroke has never been reported in the literature

Myasthenia Gravis: A Review

Acquired myasthenia gravis is a relatively uncommon disorder, with prevalence rates that have increased to about 20 per 100,000 in the US population. This autoimmune disease is characterized by muscle weakness that fluctuates, worsening with exertion, and improving with rest. In about two-thirds of the patients, the involvement of extrinsic ocular muscle presents as the initial symptom, usually progressing to involve other bulbar muscles and limb musculature, resulting in generalized myasthenia gravis. Although the cause of the disorder is unknown, the role of circulating antibodies directed against the nicotinic acetylcholine receptor in its pathogenesis is well established. As this disorder is highly treatable, prompt recognition is crucial. During the past decade, significant progress has been made in our understanding of the disease, leading to new treatment modalities and a significant reduction in morbidity and mortality

Immigration and Environment in the U.S.: A Spatial Study of Air Quality

Environmental consequences are frequently cited as a justification for restricting immigration to the United States, but there is little empirical research on the environmental consequences of immigration to support such arguments. The research that does exist shows immigration to be less environmentally harmful than native population growth, but is hampered by small samples and fails to account for spatial autocorrelation of air quality. We use the air quality domain of the Environmental Protection Agency’s Environmental Quality Index (EQI) to examine the association between immigrant and native populations and local air quality across all counties in the continental U.S. We employ spatial models to account for spatial autocorrelation of air quality across the counties, controlling for indicators of economic development and location characteristics. We find that native population is strongly associated with worse air quality, while foreign-born population is associated with better air quality. However, this association varies by immigrant country of origin, with East Asian immigrants in particular associated with worse air quality, and by immigrants’ year of entry, with some immigration cohorts positively associated with air quality, and others negatively. These findings highlight the importance of population characteristics in understanding population-environment linkages

Pure Red Cell Aplasia after 13 Years of Sodium Valproate, and Bone Marrow Suppression after 17 Years of Carbamazepine

A 38-year-old woman presented with acute hematological toxicity from her anticonvulsants, even though she had been taking them for many year

Posterior Reversible Encephalopathy Syndrome in a Patient with Newly Diagnosed HIV Infection and End Stage Renal Disease

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome in which patients present with an acute or subacute clinical presentation of seizures, visual disturbances, headache, and altered mental status. The pathophysiology of PRES may be explained by endothelial dysfunction that leads to transudation of fluids and protein, resulting in vasogenic cerebral edema. PRES is typically associated with many conditions such as hypertension, uremia, immunosuppressive drugs, and sepsis. This is a case report of a 39-year-old woman with untreated HIV infection and end-stage renal disease (ESRD) who developed PRES with a normal blood pressure and no other known causes of PRES. Untreated HIV is associated with known endothelial dysfunction and we believe that this, in combination with her untreated end-stage renal disease, contributed to her unique presentation of PRES. Although uncommon in HIV-infected patients and challenging to diagnose, prompt recognition of PRES is critical to provide appropriate care and ensure reversibility of the vasogenic edema seen in PRES