Partial splenectomy in children with sickle cell disease and repeated episodes of splenic sequestration.

Twenty-five children with sickle cell disease and repeated episodes of splenic sequestration crises underwent partial splenectomy. They have been followed for 12 to 75 months (median 48 months) after surgery. During this period we have not observed any episode of splenic sequestration and the need for hospitalization and transfusions has been greatly reduced. We believe this is a useful and safe procedure for treating patients with this condition.

Barriers to medical care of Mexican-Americans: the role of social class, acculturation, and social isolation.

Literature on medical care utilization by Mexican-Americans suggests that patterns of utilization can be explained, in part, by acculturation, social class and social isolation. The relative importance of these variables is explored in a survey of a rural Mexican-American community in Southern Texas. Data on 152 families are analyzed using a logit analysis, with utilization as the outcome variable. The results suggest that acculturation has a direct effect, while social class and social isolation interact to have a weak effect independent of acculturation. These results confirm the importance of understanding all three variables in planning and implementing medical care programs in Mexican-American communities.

Mexican-American folk medicine: implications for the family physician.

Literature of Mexican-American folk medicine and on Mexican-American utilization of conventional medical services suggests that folk medicine and utilization of conventional medical services are related. This study reports on interviews with 40 Mexican-American families randomly selected from the community. The results indicate that choice of conventional medical care and/or folk medicine is dependent upon the symptom, that families often use both folk and conventional medicine, that they are more likely to seek medical help for anxiety than for depression, and that knowledge of folk medicine is best acquired by asking about specific folk diseases. These findings have application in family practice.