Urban Violence, Migration and Alcohol, Tobacco, and Marijuana Use among Transnational Students in Northern Mexico

This article reports on the findings of a study of the relationship between transnational experiences in the United States (US) and the use of alcohol, tobacco, and marijuana among 7th grade students (n = 1418). The study was guided by a cross-national framework for research on immigrant health and assessed the accumulation of risk factors for transnational adolescents. Data came from a survey conducted in 2017 in Nogales, Mexico. In this study, the last 30-day prevalence of use of alcohol, tobacco, and marijuana among students was 21.7%, 8.3%, and 2.4%, respectively. Most students were born in Nogales (69.6%), while 10.5% were born in the US, 7.5% attended school in the US, and 3.6% engaged in health-related risk behaviors while living in or visiting the US. Students with transnational experiences, such as attending school in the US, reported the highest 30-day prevalence of tobacco (13.3%) and marijuana (9.5%) use. After adjusting for family, school, access to substances and neighborhood violence variables, students who engaged in health-related risk behavior in the US had significantly increased odds of alcohol and marijuana use while later attending school in Mexico. The article discusses the findings from a prevention science perspective and provides implications for policy, practice, and future research on the Mexico-US border region.

Migration Intentions and Alcohol Use Among Adolescents in West-Central Mexico

This study explores the association between migration intentions and alcohol use among west-central Mexico adolescents living in high migration communities. This study used the baseline data from the Family Migration and Early Life Outcomes (FAMELO) project (N = 1286), collected in 2018. We used multiple imputations to address missingness and propensity score matching to reduce the selection bias. We also conducted subgroup analyses to compare gender difference (i.e., boys vs. girls) on the relationship between migration intention and alcohol use. The findings show that for the whole sample, youth with migration intentions had significant higher odds (OR = 1.78; p = .010) of having a lifetime drinking experience when compared to youth who reported no interest in living abroad, but this association remained significant only for boys (OR = 2.14; p = .010). This study makes an important contribution to our understanding of the etiology of migration intentions and alcohol use for adolescents living in sending migration communities. The findings have specific alcohol prevention, policy, and future research implications in Mexico and the U.S.

Pelvic pain and associated characteristics among women in northern Mexico

CONTEXT

Until recently, the reproductive health agenda has focused on a restricted number of morbidity indicators, particularly those associated with life-threatening diseases. However, gynecologic morbidities that are a source of pelvic pain, although not life-threatening, do impose a substantial burden because of their potential to reduce women's overall well-being.

METHODS

In 2005, a cross-sectional population-based study was conducted in Hermosillo, Mexico, to assess self- reported pelvic pain conditions in a random sample of 1,307 women aged 25-54. The 12-month prevalence of each condition was calculated, and logistic regression was used to assess the association between pelvic pain and social, demographic, anthropometric and reproductive characteristics, and other medical conditions.

RESULTS

The 12-month prevalence of pelvic pain during menstruation among 1,007 menstruating women was 40%. Pelvic pain during or after sexual intercourse was reported by 12% of the 1,183 sexually active respondents. Among 1,201 nonpregnant women, 6% reported chronic pelvic pain. In adjusted analyses, younger age (25-34 years) and having a history of STIs or pelvic inflammatory disease (PID) were associated with an increased risk of pain during menstruation and chronic pelvic pain (odds ratios, 1.6-3.1). An interaction term for younger age and history of STIs or PID was associated with an elevated risk of intercourse-related pelvic pain (6.4). Chronic pelvic pain and pain during menstruation were more frequently reported as interfering with daily activities than was intercourse-related pelvic pain. The proportion of women who had talked with a physician about their condition was highest among those with chronic pelvic pain (40%).

CONCLUSION

Pelvic pain associated with menstruation, pelvic pain during or after sexual intercourse, and chronic pelvic pain are common complaints among Mexican women of reproductive age. Health care providers should pay greater attention to these conditions.

[Determination of the dose of dialysis with integrated modules in the same monitor]

The "gold standard" method to measure the mass balance achieved during dialysis for a given solute is based on the total dialysate collection. This procedure is unfeasible and too cumbersome. For this reason, alternative methods have been proposed including the urea kinetic modelling (Kt/V), the measurement of effective ionic dialysance (Diascan), and the continuous spent sampling of dialysate (Quantiscan). The aim of this study was to compare the reliability and agreement of these two methods with the formulas proposed by the urea kinetic modelling for measuring the dialysis dose and others haemodialysis parameters. We studied 20 stable patients (16 men/4 women) dialyzed with a monitor equipped with the modules Diascan (DC) and Quantiscan (QC) (Integra. Hospal). The urea distribution volume (VD) was determined using anthropometric data (Watson equation) and QC data. Kt/V value was calculated according to Daurgidas 2nd generation formula corrected for the rebound (eKt/V), and using DC (Kt/VDC) and QC (Kt/VQC) data. The total mass of urea removed was calculated as 37,93 +/- 16 g/session. The VD calculated using Watson equation was 35.7 +/- 6.6 and the VDQC was 35.06 +/- 9.9. And they showed an significative correlation (r:0,82 p < 0.001). The (VDQC-VDWatson) difference was -0.64 +/- 5.8L (ns). Kt/VDC was equivalent to those of eKt/V (1.64 +/- 0.33 and 1.61 +/- 0.26, mean difference -0.02 +/- 0.29). However, Kt/VQC value was higher than eKt/V (1.67 +/- 0.22 and 1.61 +/- 0.26 mean difference 0.06 +/- 0.07 p < 0.01). Both values correlated highly (R2: 0.92 p < 0.001). Urea generation (C) calculated using UCM was 8.75 +/- 3.4 g/24 h and those calculated using QC was 8.64 +/- 3.21 g/24 h. Mean difference 0.10 +/- 1.14 (ns). G calculated by UCM correlated highly with that derived from QC (R2: 0.88 p < 0.001). In conclusion, Kt/VDC and Kt/VQC should be considered as valid measures for dialysis efficiency. However, the limits of agreement between Kt/VQC and eKt/V were closer than Kt/VDC.

[Guidelines of the Spanish Society of Nephrology. Clinical practice guidelines for peritoneal dialysis]

In Spain and in each of its autonomous communities, the dialysis treatment of chronic renal disease stage 5 is totally covered by public health. Peritoneal dialysis, in any of its modalities, is established as the preferred home dialysis technique and is chosen by high percentage of patients as their choice in dialysis treatment. The Spanish Society of Nephrology has promoted a project of creation of performance guides in the field of peritoneal dialysis, entrusting a work group composed of members of the Spanish Society of Nephrology a with the development of these guides. The information offered is based on levels of evidence, opinion and clinical experience of the most relevant publications of the topic. In these guides, after defining the concept of << peritoneal dialysis>>, the obligations and responsibilities of the sanitation team of the peritoneal dialysis unit are determined, and protocols and performance procedures that try to include all the aspects that concern the patient with chronic renal disease in substitute treatment with this technique are developed. They propose prescription objectives based on available clinical evidence and, lacking this, on the consensus of the experts' opinions. The final aim is to improve the care and quality of the of the patient in peritoneal dialysis, optimizing in this way the survival of the patient and of the technique. In Spain, as in other neighbouring countries, peritoneal dialysis has an incidence and prevalence that is much lower than that of hemodialysis, ranging in the last evaluation by the Spanish Society of Nephrology between 5 and 24% in the different autonomous communities. The great majority of peritoneal dialysis units form part of the public network of the Spanish state, with special representation as a Satellite Unit or Concerted Center related to the public hospital of reference, on which it must depend.

[Outcome of tunneled hemodialysis catheters as permanent vascular access]

Tunneled cuffed hemodialysis catheters (THC) are developed as a means of short hemodialysis access while a more permanent form of access are maturing. The aim of this study is to investigate the effectiveness, survival and complications of the THC used for long-term vascular access.

METHODS

In a retrospective study we looked at 42 THC inserted between November 2000 and October 2003, in 40 elderly patients, with systemic disease or when other vascular access was not possible.

RESULTS

Procedural complications occurred in 5 cases (11.9%), which included: local haemorrhage (3), hemothorax (1) and one fatal venous tear. 6 catheters (14.2%) were removed due to complications (non-function 3 and bacteraemia 3). The total incidence of THC related infections was 0.18 episodes/1,000 catheters-days. Patients were followed up for a mean 379 days (range 1-1,140) and a total of 15,946 catheter-days. Qb and KT/V achieved at one month were 278.3 +/- 34.1 ml/min and 1.48 +/- 0.27 respectively. At the end of the follow-up, 23 patients (54.7%) were alive with catheter functioning. One, three and twelve months survival was 90.4%, 73.1% and 59.5% respectively.

CONCLUSION

The THC may be a useful alternative permanent vascular access for hemodialysis patients when others vascular access are not possible.

[Usefulness of the Biofeedback Diacontrol module in the automatic programming of plasmatic conductivity and ionic mass transfer]

Programmed variable sodium in the dialysate can improve hypotension during hemodialysis but may also alter sodium balance and thus resulting in a increase of water intake and weight gain between dialysis sessions. The aim of this study was to evaluate the changes on plasma volume (PV), Ionic Mass Transfer (IMT) and plasma conductivity (PC) with two different hemodialysis techniques. We studied 10 patients during a four-period protocol (one week each: PF1-DC1-DC2PF2): 120 dialysis sessions. During periods PF1 and PF2, the dialysis procedure was as usual, with exponential decrease of dialysate conductivity (DC) profile (15.7 mS/cm at start, 14.4 mS/cm at middle and 13.8 mS/cm at the end of the session) and UF profile (1.7 1/h at start and 0.1 1/h at the end). During periods DC1 and DC2, DC was automatically determined by a biofeedback modulae (Diacontrol) in order to reach a plasma water conductivity fixed at 14 mS/cm. All hemodialysis parameters were the same for the four periods: duration, blood and dialysate flow rates, dialysis membrane. A lower reduction of PV was evident on PF1 and PF2 (104 +/- 3.26% and -4.36 +/- 2.7%) compared with DC 1 and DC2 (-6.53 +/- 3.31% and -6.67 +/- 3.12%) (p < 0.001). No significant differences were seen in systolic, mean and diastolic blood pressure pre-HD or post-HD, UF, and weight gain, between the four periods. Hypotensive episodes were seen in 33.3% of PF1, 20% of DC1, 23.3% of DC2 and 26.6% of PF2 sessions (NS). PF1 and PF2 periods resulted in a significantly higher 30', mid and post-dialysis PC as compared to DC1 and DC2 periods (p < 0.001). The mean difference between the actual value and the prescribed value of PC at the end of the session was -0.01 +/- 0.07 mS/cm (n: 60). There was a negative correlation between the mean DC during session and the PC at 30' of session. IMT was 420.73 +/- 126.9 mEq in PF1, 311.96 +/- 161.75 in DC1, 278.34 +/- 153.14 in DC2 and 417.66 +/- 152.17 in PF2 (p > 0.001 PF1 and PF2 vs. DC1 and DC2). Diacontrol determines automatically an individualized DC profile for each patient, and accurately reaches the prescribed PC target. By reaching both the dry weight and PC settings, the water and sodium pool is maintained lower in the hemodialysis session using a biofeedback module. Clinical tolerance was similar in the two different dialysis procedures.

[Secondary amyloidosis (AA) and renal disease]

Amyloidosis is a disease resulting from extracellular deposition of fibrillar protein in various organs. AA amyloidosis may complicate chronic inflammatory diseases, chronic infections and another chronic diseases. We review 31 patients (13 males and 18 females) with biopsy proven renal or rectal AA amyloidosis, referred to out hospital between january 1999 and november 2002. Renal failure was defined as serum creatinine > or = 1.5 mg/dl. Mean age was 58.4 +/- 15.7 years. The causes of AA amyloidosis were an underlying chronic rheumatologic disease (51.6%), chronic infection (41.9%) and a chronic inflammatory intestinal disorder (6.5%). Renal failure (RF) was detected in 20 patients (61.2%) and proteinuria and hematuria were found in 90.3% and 45.5 respectively. Proteinuria at diagnosis was 5.2 +/- 3.9 g/24 h and mean serum creatinine 3.5 +/- 3.7 mg/dl. Survival of patients without dialysis was 66.8 (51.1% RF, 90.9% non-RF) and 53.4% (38.2 RF, 77.9% non-RF) at 12 and 24 months respectively (p = 0.017). End-stage renal disease developed in 13 patients (41.9%). Ten patients were maintained on hemodialysis and 3 on CAD. Survival in dialysis at 6 and 12 months was 68.3% and 42.7% respectively. Fifteen patients died and the main causes of death were: infections (46.6) haemorrhagic complications (33.3%), cardiovascular events (13.3%) and cachexia (6.6%).