RESUMEN
PURPOSE: Farmworkers frequently live in rural areas and experience high rates of depressive symptoms. This study examines the association between elevated depressive symptoms and health care utilization among Latino farmworkers. METHODS: Data were obtained from 2,905 Latino farmworkers interviewed for the National Agricultural Workers Survey. Elevated depressive symptoms were measured using the Center for Epidemiologic Studies Depression short-form. A dichotomous health care utilization variable was constructed from self-reported use of health care services in the United States. A categorical measure of provider type was constructed for those reporting use of health care. RESULTS: Over 50% of farmworkers reported at least 1 health care visit in the United States during the past 2 years; most visits occurred in a private practice. The odds of reporting health care utilization in the United States were 45% higher among farmworkers with elevated depressive symptoms. Type of provider was not associated with depressive symptoms. Women were more likely to seek health care; education and family relationships were associated with health care utilization. CONCLUSIONS: Latino farmworkers who live and work in rural areas seek care from private practices or migrant/Community Health Clinics. Farmworkers with elevated depressive symptoms are more likely to access health care. Rural health care providers need to be prepared to recognize, screen, and treat mental health problems among Latino farmworkers. Outreach focused on protecting farmworker mental health may be useful in reducing health care utilization while improving farmworker quality of life.
Asunto(s)
Agricultura/estadística & datos numéricos , Depresión/epidemiología , Emigrantes e Inmigrantes , Servicios de Salud/estadística & datos numéricos , Medio Social , Adolescente , Adulto , Depresión/etnología , Femenino , Humanos , Masculino , México/etnología , Persona de Mediana Edad , Investigación Cualitativa , Servicios de Salud Rural/estadística & datos numéricos , Factores Sexuales , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto JovenRESUMEN
We present the case of an 18-year-old high-level gymnast who sustained a stress fracture of the scaphoid associated with a distal radial epiphysiolysis. Clinical evaluation demonstrated decreased range of motion of the affected wrist and insidious pain on the snuffbox and tenderness on the distal radial physis. He was submitted to surgical treatment with scaphoid percutaneous fixation and radial styloid process in situ fixation. Clinical features improved, and he got back to competition 6 months after surgery without symptoms and with complete range of motion.
RESUMEN
PURPOSE: To determine the diameter and morphology of infrarenal aortic aneurysms in 78 fresh autopsy specimens. METHODS: To avoid underestimation of the arterial diameter postmortem and to re-establish aneurysm morphology, a device was designed and introduced into the vessel, inflated to 80 mm Hg, and the largest external diameter was measured. RESULTS: The ages of the individuals ranged from 40 to 97 yr (mean 70). Thirty-eight aneurysms were ruptured with diameters ranging from 5.3 to 17.0 cm (mean 7.97), and 40 aneurysms were nonruptured with variations in diameters from 2.8 to 6.1 cm, mean 4.02 cm (P<0.01). Fusiform aneurysms were more frequent, and when they ruptured their diameters were smaller than the diameters of the spherical aneurysms (P<0.05). Aneurysms ruptured more frequently in the posterior wall (67%) and in the inferior portion (61%). A mural thrombus was found at the site of rupture in 80% of the specimens. CONCLUSION: In our samples, rupture was found solely in those aneurysms with a diameter over 5.0 cm, ruptures occurred earlier in fusiform aneurysms, mural thrombus was not a protective factor, and finally, aneurysms ruptured mainly in the posterior and inferior portions.
Asunto(s)
Aneurisma Roto/patología , Aneurisma de la Aorta Abdominal/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
An infant and his uncle, both with adrenal hypoplasia congenita, shared the same DAX1 mutation. The adolescent uncle had hypogonadotropic hypogonadism, but the infant had a normal minipuberty of infancy. These observations suggest differences in the physiologic mechanisms regulating the hypothalamic-pituitary-gonadal axis in infancy and adolescence.