RESUMO
OBJECTIVES: This study aimed to comprehensively evaluate Mexico's health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator. STUDY DESIGN: A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO). METHODS: HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach. RESULTS: Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed. CONCLUSIONS: The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico's healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services.
RESUMO
Development of Schistosoma mansoni in the intermediate host Biomphalaria glabrata is influenced by a number of parasite and snail genes. Understanding the genetics involved in this complex host/ parasite relationship may lead to an often discussed approach of introducing resistant B. glabrata into the field as a means of biological control for the parasite. For the snail, juvenile susceptibility to the parasite is controlled by at least four genes, whereas one gene seems to be responsible for adult nonsusceptibility. Obtaining DNA from F2 progeny snails from crosses between parasite-resistant and -susceptible snails, we have searched for molecular markers that show linkage to either the resistant or susceptible phenotype. Both restriction fragment length polymorphism (RFLP) and random amplified polymorphic DNA (RAPD) approaches have been used. To date, using a variety of snail and heterologous species probes, no RFLP marker has been found that segregates with either the resistant or susceptible phenotype in F2 progeny snails. More promising results however have been found with the RAPD approach, where a 1.3 kb marker appears in nearly all resistant progeny, and a 1.1 kb marker appears in all susceptible progeny.
Assuntos
Biomphalaria/crescimento & desenvolvimento , Biomphalaria/genética , Biomphalaria/parasitologia , Esquistossomose mansoni/parasitologia , Animais , Interações Hospedeiro-Parasita , Polimorfismo de Fragmento de Restrição , Técnica de Amplificação ao Acaso de DNA Polimórfico , Schistosoma mansoni/crescimento & desenvolvimento , Schistosoma mansoni/isolamento & purificação , Schistosoma mansoni/fisiologiaAssuntos
Doenças da Aorta/tratamento farmacológico , Recém-Nascido Prematuro , Terapia Trombolítica , Trombose/tratamento farmacológico , Ativador de Plasminogênio Tecidual/uso terapêutico , Cateterismo Periférico/efeitos adversos , Humanos , Recém-Nascido , Ativador de Plasminogênio Tecidual/administração & dosagem , Ultrassonografia , Artérias UmbilicaisRESUMO
Newborn rabbits were given a single intravenous dose (100 mg/kg) of either alpha-tocopherol or alpha-tocopheryl acetate to compare disposition characteristics of these two forms of vitamin E. The resulting tissue concentrations of alpha-tocopherol and alpha-tocopheryl acetate differed significantly. Tissue concentrations of either form of vitamin E were much higher than those provided by normal nutrition, and remained unchanged (except in the liver) for 6 days after dose. alpha-Tocopheryl acetate was not completely converted to alpha-tocopherol, and only 50% of the dose was recovered 3 days after administration. The entire dose of alpha-tocopherol was recovered intact 3 days after administration. The persistence of very high tissue vitamin E concentrations after a single intravenous dosing, the disappearance from the body of half of the administered dose of alpha-tocopheryl acetate, and the lack of complete conversion of alpha-tocopheryl acetate to alpha-tocopherol when given intravenously have profound implications regarding the current clinical practice of giving repeated pharmacologic doses of vitamin E to newborn infants.