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This study selected the top five general hospitals in the United States of America, collected the practice information of acupuncturists through the official website, and analyzed the professional department, expertise, professional title, education background, residency, fellowship, board certification, etc. of these acupuncturists to understand the practice situation of acupuncturists in the hospitals. The results of the study showed the practice of acupuncturists in the United States of America is improving. With further localization, locally trained acupuncturists have gradually become the main body of acupuncturists; acupuncture treatment is still mainly for analgesia, but the scope of treatment continues to expand, and departments that accept acupuncturists are gradually increasing. However, the group of licensed acupuncturists is still a minority in the group of acupuncturists in the United States of America. Native American physicians still use acupuncture as an alternative option and neglect to obtain a license. The entry barrier for acupuncturists still needs to be raised.
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Aims: Oral health problems include dental caries, gum diseases, loss of natural teeth, and other mucosal diseases. The present research aimed to study the factors affecting periodontal health in the residents of the United States of America. This study examined if there were significant differences in the health of teeth and gums with respect to last visit to the dentist, intake of fluoride drops or tablets, gender, and educational level. Materials & Methods: The study analyzed secondary data from the National Health and Nutrition Examination Survey 2017-18. This study examined a population of 9,254 residents aged 1 and older. The Chi-Square Test of Independence was used to test significance among the variables of last visit to the dentist, received fluoride drops or tablets, gender, and educational level. Results: The study found no statistically significant differences in health of teeth and gums with respect to intake of fluoride drops or tablets, gender, and educational level. However, the study did find a statistically significant difference in the health of teeth and gums with regard to the last visit to the dentist among residents of the US. Individuals who have visited the dentist in the last six months have rated their health of teeth and gums as excellent as compared to those who did not visit the dentist in the last six months. Conclusions: Future studies should review other factors affecting oral health such as high sugar intake, diabetes, chronic diseases, and genetics. Emphasis should be given to the identification of inequities associated with periodontal health among various cultural and ethnic groups in the United States of America.
Objetivos: Los problemas de salud oral incluyen la caries dental, las enfermedades de las encías, la pérdida de los dientes naturales y otras enfermedades de las mucosas. El presente estudio tuvo como objetivo examinar los factores que afectan la salud periodontal en los residentes de los Estados Unidos de América. Este estudio examinó si había diferencias significativas en la salud de los dientes y de las encías con respecto a la última visita al dentista, ingesta de gotas o tabletas de flúor, género y nivel educativo. Materiales y Métodos: El estudio se analizó con datos provenientes de la Encuesta y Examinación Nacional de Salud y Nutrición NHANES del 2017-2018. Este estudio examinó una población de 9.254 residentes de 1 año o de mayor edad. Se usó la prueba de independencia Chi-Cuadrado para probar la significancia entre variables como la última visita al dentista, ingesta de gotas o tabletas de flúor, sexo y nivel educativo. Resultados: El estudio no encontró diferencias estadísticamente significativas en la salud de los dientes y de las encías con respecto a la ingesta de gotas o tabletas de flúor, sexo y nivel educativo. Sin embargo, el estudio encontró una diferencia estadísticamente significativa en la salud de los dientes y de las encías con respecto a la última visita al dentista entre los residentes de los Estados Unidos. Las personas que visitaron al dentista en los últimos seis meses calificaron la salud de sus dientes y encías como excelente en comparación con quienes no visitaron al dentista en los últimos 6 meses. Conclusiones: Los estudios futuros deberían revisar otros factores que afectan la salud bucal como la ingesta de alto contenido de azúcar, la diabetes, al igual que las enfermedades crónicas y factores de genética. Se debe hacer énfasis en la identificación de inequidades asociadas con la salud periodontal entre diversas culturas y grupos étnicos en los Estados Unidos.
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Abstract In June 2012, a tick was found parasitizing a man in the city of São Paulo, who had recently returned from a visit to Pennsylvania, in the northeast of the United States. The tick was removed and sent to the São Paulo State Department of Health, where it was identified as a male of the species Dermacentor variabilis (Say, 1821), according to the literature and taxonomic keys. The tick was subjected to a PCR test to search for rickettsiae, but the result was negative. The fact that a human entered Brazilian territory unaware that he was parasitized by a hard tick not belonging to the national tick fauna is significant because of the possibility that an exotic species could be introduced and take hold in this country. Another major risk to public health is that this arthropod could be infected with the bacterium Rickettsia rickettsii, as this ectoparasite is the main vector of Spotted Fever on the East Coast of North America.
Resumo Em junho de 2012, foi enviado ao serviço da Secretaria de Estado da Saúde de São Paulo um carrapato que foi encontrado em parasitismo sobre um homem adulto na cidade de São Paulo, que havia chegado recentemente de uma viagem de turismo aos Estados Unidos, onde visitou o estado da Pensilvânia, situado na região Nordeste Americana. O carrapato foi identificado como um macho da espécie Dermacentor variabilis, (Say, 1821), de acordo com a literatura e chaves taxonômicas, sendo submetido ao teste da PCR para pesquisa de riquétsias, porém o resultado foi negativo. O fato de um ser humano ter cruzado a fronteira do Brasil, parasitado, sem o seu prévio conhecimento, por um carrapato duro, não pertencente à ixodofauna nacional, é de grande importância pela chance de introdução e estabelecimento no território brasileiro de uma espécie exótica. Outro grande risco para a saúde pública é que esse artrópode poderia estar infectado com a bactéria Rickettsia rickettsii, pois esse ectoparasito é o principal vetor da Febre Maculosa na costa Leste Norte Americana.
Subject(s)
Humans , Animals , Male , Rickettsia/genetics , Dermacentor , Spotted Fever Group Rickettsiosis/veterinary , Rickettsia rickettsii , BrazilABSTRACT
Resumen Se examina la gestión de Donald Trump, presidente de los EEUU, en la pandemia de covid-19.
Abstract This article examines President Donald Trump's handling of the covid-19 pandemic in the United States.
Subject(s)
Humans , Politics , COVID-19/epidemiology , Government , United States/epidemiologyABSTRACT
RESUMEN A partir del trabajo etnográfico con mujeres inmigrantes indocumentadas que desarrollaron episodios depresivos a causa de diversas formas de violencia, se recupera su experiencia sobre la atención que recibieron en el espacio clínico del país de acogida. A través de itinerarios terapéuticos de atención, el trabajo se centra en los estudios de caso de dos mujeres de origen mexicano en la ciudad de New York, para describir, con base en su experiencia, la comunicación y el encuentro entre médico y paciente; las expectativas de las migrantes en relación con los servicios de atención en salud mental; y los modelos explicativos sobre la depresión por parte de los pacientes y los médicos tratantes. Con lo anterior, buscamos contribuir al conocimiento sobre las formas de atención de los problemas de salud mental de mujeres indocumentadas en contextos de violencia.
ABSTRACT Based on ethnographic work with undocumented immigrant women who developed depressive episodes due to various forms of violence, this article recovers the women's experience of care in the clinic space of their host country. Through therapeutic itineraries of care, the article focuses on the case studies of two women of Mexican origin in New York City to describe, based on their experience, the communication and the encounter between the doctor and patient; the expectations of migrant women regarding mental health care services; and the explanatory models of depression of both the patients and the treating physicians. This analysis seeks to contribute to the knowledge regarding ways of treating the mental health problems of undocumented women in contexts of violence.
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Humans , Female , Transients and Migrants , Undocumented Immigrants , Mental Health Services , Violence , Anthropology, CulturalABSTRACT
Background: Many doctors who trained in developing countries always travelled to developed countries for specialization. After specialization, many of them do not return to their countries of origin but stay put in the host countries, and get absorbed into the health delivery system of the host countries. To stop this exodus of much needed man-power in the developing countries, many of these developing countries devised their own postgraduate programs so that there will be no need for doctors that aspire to specialize to leave the country any more. This review article is to assess the quality of the various postgraduate programs in the Third World countries. Study design: The postgraduate programs in some developing countries like Nigeria, Ghana and some countries in the South Pacific were studied and compared with some programs in the developed countries like the United States of America and Canada. There are differences in these programs. We therefore attempt to identify the weaknesses of the programs in the developing countries and make suggestions in some aspects of the programs so as to produce Residency training programs that will satisfy the needs and the peculiarities of the developing countries, and yet measure up to international standards. Results and findings: Many of the postgraduate programs in the developing countries, as they are now, fall far short of international acceptable standard. There are essentially two main reasons for this: some of the programs are directly under the control of the Governments in those countries, where the priorities are more economic than quality. Also, there is this notion among the doctors in the developing countries that surgical postgraduate training must be treated like preparation for a university PhD degree, even though university Senate has no in-put in awarding fellowship certificate. In the Third World countries, it is felt that “special breed” of surgeons must work in the university environment because it is considered “prestigious” to work in the universities. Conclusion:Even though the aim to retain doctors in their countries can be said to have been achieved, it came at a great price because the programs are very different from the well established residency training program as introduced by William Halsted and Churchill. This gives rise to a program comparative to residency training in the specialty of General Medical Practice, which is very different and of lower standard than internationally accepted surgical residency training program. It also equates the training, in some aspects, to that of a university Master's and PhD degrees. Abbreviations: RTP, Residency Training Program; LSP, Local Specialist Program; GCPS, Ghana College of Physician and Surgeons; NPGMC, National Post Graduate Medical College; WACS, West African College of Surgeons; LST, Local Surgical Training; MCQ, Multiple Choice Questions; OSCE, Objective Structured Clinical Examination; SRTP, Surgical Residency Training Program; MMed, Master's degree in Medicine.
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Abstract Objective: Following the notable work accomplished by the Mexican Association of Specialists in Congenital Heart Disease (Asociación Mexicana de Especialistas en Cardiopatías Congénitas) with the development of a national registry for congenital cardiac surgery, the World Society for Pediatric and Congenital Heart Surgery has implemented an international platform to collect data and analyze outcomes of children with congenital heart disease. Methodology: This manuscript proposes a possible collaboration between Mexico's national congenital cardiac database (Registro Nacional de Cirugía Cardíaca Pediátrica) and the World Database for Pediatric and Congenital Heart Surgery. Conclusion: Such a partnership would advance the countries' desire for the ongoing development of quality improvement processes and improve the overall treatment of children with congenital heart disease.
Resumen Objetivo: Siguiendo el notable trabajo realizado por la Asociación Mexicana de Especialistas en Cardiopatías Congénitas (Asociación Mexicana de Especialistas en Cardiopatías Congénitas: AMECC) con el desarrollo de un registro nacional para la cirugía cardíaca congénita, la Sociedad Mundial de Pediatría y Cirugía Cardíaca Congénita ha implementado una plataforma internacional para recopilar datos y analizar los resultados de los niños con cardiopatía congénita. Metodología: Este manuscrito propone una posible colaboración entre la base nacional de datos cardiacos congénitos de México (RENACCAPE) y la Base de Datos Mundial para la Cirugía Cardíaca Pediátrica y Congénita (WDPCHS). Conclusión: Esta asociación promovería el deseo de los países de seguir desarrollando procesos de mejora de la calidad y mejorar el tratamiento general de los niños con cardiopatía congénita.
Subject(s)
Child , Humans , Registries , Heart Defects, Congenital/surgery , Heart Diseases/surgery , Heart Diseases/congenital , Databases, Factual , Internationality , Cardiac Surgical Procedures/methods , MexicoABSTRACT
BACKGROUND:We compare educational environments (i.e. physical, emotional and intel ectual experiences) of emergency medicine (EM) residents training in the United States of America (USA) and Saudi Arabia (SA). METHODS:A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure (PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales (autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance. RESULTS:A total of 219 surveys were returned for 260 residents across six programs (3 SA, 3 USA), with a response rate of 84％. Program-specific response rates varied from 79％–100％. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher:118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries (P=0.243); however, role autonomy (P<0.001) and teaching (P=0.005) were better in USA programs. There were no significant differences by post-graduate training year. CONCLUSION:EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.
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By means of literature review and comparative study, the paper studied the organization and policy system of emergency drug administration in the U.S. As found by the authors, that the U.S. has established a horizontal and vertical organizational structure system centering on the Department of Health and Human Services. This system covers a series of policy and legal regulations, such as the research and development, procurement, storage, emergency use, and clinical treatment of emergency medical products. In consideration of the experience of emergency drug administration in the U.S. and problems existing in China's current system in command and management, departmental coordination, resource allocation, and legal system construction of emergency drug, it is suggested that China should establish a core organization for emergency drug command and management, and improve relevant legal system. China also needs to focus on enhancing capabilities of local medical emergency rescue and information transmission, in order to establish a coordinated, well-organized, resource-sharing system of drug emergency administration in the country.
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Resumo O trabalho descreve e analisa o quadro legal e normativo que orienta o uso de unidades móveis em Portugal, Estados Unidos e Brasil, que buscam melhorar o acesso e a continuidade dos cuidados em saúde de pessoas em situação de rua. Utilizou-se a análise comparada, por meio de revisão bibliográfica e documental relacionando três categorias: contexto (demográfico, socioeconômico e epidemiológico), sistema de serviços (acesso, cobertura, organização, gestão e financiamento) e as unidades móveis especificamente (concepção, modelo de atenção e financiamento). A análise fundamentou-se na teoria da convergência/divergência entre os sistemas de saúde, pela perspectiva da equidade em saúde. A melhoria do acesso, a abordagem do uso abusivo de substâncias psicoativas, busca ativa e trabalho multidisciplinar mostrou-se comuns aos três países, com potencial para reduzir as iniquidades. As relações com a atenção primária, uso de veículos e o tipo de financiamento são consideradas de maneira divergente nos três países, influenciando o maior ou menor alcance da equidade nas propostas analisadas.
Abstract This paper describes and analyzes the legal and normative framework guiding the use of mobile units in Portugal, United States and Brazil, which seek to improve access and continuity of care for people in homelessness. We used a comparative analysis through literature and documentary review relating three categories: context (demographic, socio-economic and epidemiological), services system (access, coverage, organization, management and financing) and, specifically, mobile units (design, care and financing model). The analysis was based on the theory of convergence/divergence between health systems from the perspective of equity in health. Improving access, addressing psychoactive substances abuse, outreach and multidisciplinary work proved to be common to all three countries, with the potential to reduce inequities. Relationships with primary healthcare, use of vehicles and the type of financing are considered differently in the three countries, influencing the greater or lesser extent of equity in the analyzed proposals.
Subject(s)
Humans , Ill-Housed Persons , Health Services Accessibility , Mobile Health Units/organization & administration , Portugal , Primary Health Care/economics , Primary Health Care/organization & administration , United States , Brazil , Health Status Disparities , Healthcare Disparities/statistics & numerical data , Healthcare Financing , Mobile Health Units/economicsABSTRACT
Estudios anteriores mostraron avances en la toma de perspectiva y la empatia a lo largo de la infancia, y sugieren la existencia de relaciones entre estas variables y los aspectos de la cultura. El estudio presentado aquí investigó la relación entre empatia y toma de perspectiva en una muestra compuesta por niños brasileños y estadounidenses, entre 6 y 13 años de edad. En el método, se utilizo el Indice de Empatia para Niños y Adolescentes - IECA (Bryant, 1982) y una tarea de toma de perspectiva (Flavell, I960). Los resultados mostraron que los niños estadounidenses obtuvieron un puntaje más alto en la toma de perspectiva que los participantes brasileños. Por otro lado, los niños brasileños obtuvieron calificaciones más altas en empatia que los estadounidenses. Los resultados se discuten considerando estudios transculturales previos sobre desarrollo social y cognitivo.
Previous studies have showed development in perspective-taking abilities and empathy along childhood, and suggested the existence of relationships between these variables and aspects of culture. The study presented here investigated the relationship between empathy and role taking in a sample composed by American and Brazilian children, aged ó to 13. The method involved the administration of the Index of Empathy for Children and Adolescent IECA (Bryant, 1982) and one Role-taking task. Results showed that American children scored higher in Role taking than Brazilian participants. On the other hand, Brazilian children scored higher in empathy than American participants. Results are discussed considering previous cross-cultural studies on social and cognitive development.
Subject(s)
Child , Child Development , Empathy , Cultural DiffusionABSTRACT
Growth of demand for endoscopic services and limited medical resources have brought the efficiency of endoscopic services in spotlight in the world .A retrospective efficiency analysis of endoscopic centers in the United States , as made by the authors , revealed their selection of efficiency indicators , benchmark establishment , evaluation and intervention .These efforts help summarize the experiences of improving efficiency and provide references for such centers in China to improve their efficiency .
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This paper detailed the Coleman concept and practice of coach-led transitional care of elderlies,team members and their responsibilities,intervention aspects and main tasks,as well as the intervention program and its effect analysis.Then the authors analyzed the present transitional care development in China,and recommended on development of a likewise care model for senior chronic disease patients in the country,such as building multi-disciplinary transitional care teams to provide uninterrupted care and service,encourage patients and caregivers to embrace self-management of diseases,and build an appraisal mechanism to ensure quality of care.
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In the decades to come,the increasing development of biotechnology may give a significant boost to bioweapons.Herein,we summarize bioterror attacks and critical laboratory accidents that have happened in the United States since the late 20th Century.Based on this description,we analyze its policies involved and the strategic shift the US government came up with.In view of with the current situation and potential risks of biotechnology,we make recommendations on the administration of Chinese biosafety laboratories and ways of responding to biothreat.
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Por medio de esta revisión, se busca realizar un recuento y una explicación sobre el entorno de intercambio bibliográfico BibFrame a partir del conocimiento que ha sido diseminado, en su mayor parte, por un grupo de profesionales de la Biblioteca del Congreso de los Estados Unidos de América. En este trabajo, se muestran aspectos clave de esta iniciativa en y se enfocan cuestiones medulares de su funcionamiento como entorno ubicado en la web. Se discute su posible normalización partiendo del traslado de MARC21 a esta herramienta.
This review aims to report on and explain the bibliographic exchange environment BibFrame taking as starting point the knowledge that has been disseminated, mainly, by a group of professionals from the Library Of Congress of the United States of America. This work shows key aspects of this initiative and focus on medular points regarding its functioning as a web environment. The work discusses the possible standardization of this environment, starting with transferring from MARC21 to this tool.
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A escassez de profissionais de saúde em áreas remotas e vulneráveis é um importante obstáculo para a universalização do acesso à saúde em diversos países. Este artigo examina as políticas de provimento de profissionais de saúde na Austrália, nos Estados Unidos da América e no Brasil. Apesar do sucesso parcial de iniciativas anteriores, foi apenas com o ProgramaMais Médicos que a provisão de médicos em áreas vulneráveis teve a magnitudee a resposta em tempo adequado para atender a demanda dos municípiosbrasileiros. Estão em curso, no país, mudanças quantitativas e qualitativas naformação médica, que buscam garantir não apenas a universalidade, mas, também, a integralidade e sustentabilidade do Sistema Único de Saúde. O êxito dessas iniciativas dependerão da continuidade da articulação interfederativa, de políticas regulatórias de estado, bem como, do constante monitoramento e aprimoramento do programa.
The shortage of health professionals in remote and vulnerable areas is an important obstacle for universal access to health in several countries. This paper examines the policies of provision of health professionals in Australia, in the United States of America, and in Brazil. In spite of the partial success of previous initiatives, it was only with the Mais Médicos (MorePhysicians) Program that the provision of physicians in vulnerable areas had the magnitude and the response in adequate time to respond to the demands of the Brazilian municipalities. Quantitative and qualitative changes in the training of physicians are in course and they seek to assure not only universality, but also integrality and sustainability in the BrazilianNational Health System (Sistema Único de Saúde SUS). The success of theseinitiatives will depend on the continuity of the intefederative articulation, of State regulation policies, as well as of the continuous monitoring and improvement of the program.
La escasez de profesionales de la salud en áreas remotas y vulnerables es un importante obstáculo para la universalización del acceso a la salud en diversos países. Este artículo examina las políticas de provisión de profesionales de salud en Australia, Estados Unidos de América y Brasil. A pesar del éxito parcial de iniciativas anteriores, fue solamente con el Programa Más Médicos que la provisión de médicos en áreas vulnerables alcanzó la magnitud y la respuesta en tiempo adecuado para atender la demanda de los municipios brasileños. En el país están en curso cambios cuantitativos y cualitativos en la formación médica cuyo objetivo es garantizar no solo la universalidad sino también la integralidad y sostenibilidad del Sistema Único de Salud. El éxito de estas iniciativas dependerá de la continuidad de la articulación inter-federativa, de políticas regulatorias de estado, así como del constante monitoreo y perfeccionamiento del programa.
Subject(s)
Humans , Physicians, Primary Care/supply & distribution , Primary Health Care , National Health Programs/statistics & numerical data , BrazilABSTRACT
The paper summarizes the background, development history and current state of good review prac-tice ( GRP) in the United States of America. On this basis, the paper then focuses on measures for the realization of GRP policy objective and introduces the effects of GRP by using the statistical data of the median time to application approval and approval rates of New drug applications( NDAs) and Biological License Applications( BLAs) on the first cycle. Through research, the paper considers a set of scientific and comprehensive GRP that can effectively guarantee the quality of drug reviews and improve the efficiency of drug reviews. However, China’s GRP is not complete yet. So it also suggests that improving GRP in China further by detailing the timeline of drug review in China, developing workable review templates, emphasizing training and the continuous improvement of GRP.
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The aim of this study was to estimate the evolution of the field of Pharmaceutical Care (PC) by measuring the quality and quantity of the scientific production on the topic of PC in Brazil compared to two pioneering countries in the field, the United States of America (USA) and Spain. The databases Web of Science, Scopus, Medline, Lilacs and SciELO were used as sources for the literature search. Pharmaceutical Care, or the appropriate translations, was used as the search term for the literature search, which was limited to articles published between 1990 and 2009. A score of quality (SQ) was calculated using variables such as impact factor and the frequency of the citations. We included 3265 articles published in 544 journals. We found that there was a steady increase in scientific production since 1990 and that the USA had a higher quality of scientific production than Spain, whereas the Spain produced the highest quantity of articles. In comparison, the Brazilian production of scientific publications on PC is low in terms of both quality and quantity but has increased steadily since 2002. Nevertheless, Brazil has not yet reached the level of the USA or Spain. In conclusion, Brazil's scientific production has evolved over the second decade studied in this work, with particularly high levels of production in the last five years. However, an increase in the quantity and quality of the publications should be encouraged.
O objetivo deste estudo foi estimar a evolução da área de atenção farmacêutica (AF) através da medição da qualidade e quantidade da produção científica na área de AF no Brasil, comparando-a com os países pioneiros no ramo: Estados Unidos da América (EUA) e Espanha. Os bancos de dados Web of Science, Scopus, Medline, Lilacs e SciELO foram usados como fontes para a pesquisa. AF ou as respectivas traduções foram usadas como descritor para a pesquisa bibliográfica sendo incluídos artigos publicados no período de 1990 a 2009. A pontuação da qualidade (PQ) foi calculada, utilizando variáveis como fator de impacto e frequência das citações. Foram cincluídos 3.265 artigos publicados em 544 revistas. Verificou-se um aumento constante na produção científica desde 1990 sendo que os EUA possuíam maior qualidade, enquanto a maior quantidade de artigos foi produzida na Espanha. Em comparação, a produção brasileira na AF é baixa em qualidade e quantidade, mas tem aumentado desde 2002. Apesar disso, o Brasil ainda não atingiu o nível dos EUA ou Espanha. Em conclusão, o Brasil apresentou expressiva evolução na última década com maior desenvolvimento nos últimos cinco anos. Entretanto, melhoria na quanitdade e qualidade das publicações deve ser incentivada.
Subject(s)
Benchmarking/methods , Scientific and Technical Activities , Pharmaceutical Services/classification , Scientific and Technical Publications , /classificationABSTRACT
The vein of Galen aneurysmal malformation (VGAM) is an extremely rare arteriovenous malformation. The VGAM clinical manifestations vary depending on the magnitude of vascular compromise and the age at initial presentation. Neonates typically present with severe congestive heart failure. Here we present a case in which a systolic heart murmur was the first manifestation of high output heart failure due to a VGAM.
Las malformaciones de la vena cerebral de Galeno (MVG) son extremadamente raras. Sus manifestaciones clínicas varían dependiendo de la magnitud del compromiso vascular y la edad inicial de presentación. En neonatos, típicamente se presenta con una insuficiencia cardiaca congestiva grave. Se presenta un caso en el cual un soplo sistólico cardiaco fue la primera manifestación de una insuficiencia cardíaca de gasto alto secundaria a una malformación aneurismática de la vena de Galeno.
Subject(s)
Humans , Infant, Newborn , Male , Heart Failure/diagnosis , Heart Failure/etiology , Systolic Murmurs/etiology , Vein of Galen Malformations/complicationsABSTRACT
OBJECTIVE: To provide a brief history of the illicit tobacco trade between Mexico and the United States. MATERIALS AND METHODS: Research included a previously published study: "Cigarette taxes and smuggling: A statistical analysis and historical review", published by the Mackinac Center for Public Policy; US Customs and Border Protection data; various US court documents; General Accountability Office reporting; media reports; other historical material, and a personal interview. RESULTS: The research revealed that there is no credible evidence of organized criminal activity related to the illicit trade in tobacco products from Mexico into the United States. However, there is clear and convincing evidence of organized criminal activity in smuggling tobacco products from the United States into Mexico for at least 167 years. CONCLUSION: Historical records from 1845 into the 21st century clearly demonstrate that the United States was usually the source country for tobacco products moving illegally between the two countries.
OBJETIVO: Describir brevemente la historia del comercio ilícito de tabaco entre Estados Unidos y México. MATERIAL Y MÉTODOS: La investigación incluye publicaciones previas, como "Impuestos sobre los cigarrillos y el contrabando: Un análisis histórico y estadístico"; datos de la Agencia de Aduanas y Protección Fronteriza; varios documentos de la Corte; los informes de la Oficina General de Rendición de Cuentas de EU; notas de prensa; materiales históricos, y una entrevista personal. RESULTADOS: La investigación reveló que no hay pruebas creíbles de actividad delictiva organizada relacionada con el comercio ilícito de productos de tabaco de México a EU. Sin embargo, hay pruebas claras y convincentes de que esta actividad se ha realizado de EU a México por lo menos durante 167 años. CONCLUSIÓN: Los registros históricos desde el año 1845 claramente demuestran que EU solía ser el país de origen del tabaco ilegal entre los dos países.