Undocumented Motherhood: Gender,Maternal Identity,and the Politics of Health Care

ABSTRACT

Undocumented Mexican immigrants have had to regularly confront a prohibiting health care system despite alienation, marginalization, and the threat of deportation. In this article, I explore the impact of political exclusion and alienating discourses on the health habitus of undocumented Mexican mothers through the narrative of one mother, Marta Garza, who finds herself at the painful intersection of political and medical alienation. Marta’s narrative reflects an analytical framework that centers undocumented motherhood as a space of necessary resilience and strain, wherein she is forced to advocate for her children’s health despite prohibitive barriers and dangerous potential consequences.     

腰椎融合术前相邻节段存在退变因素对术后早期临床疗效的影响

目的探讨腰椎拟融合节段的相邻节段术前存在的椎管狭窄因素对术后早期临床疗效的影响。方法采用前瞻性对比研究，将 2015 年 7 月—2017 年 12 月收治的符合选择标准的 183 例 L₄～S₁ 腰椎管狭窄症患者，根据术前椎间盘退变情况及椎管狭窄情况判断的相邻节段退变（adjacent segment degeneration，ASD）状态不同分成两组，A 组 98 例（术前相邻节段无退变），B 组 85 例（术前相邻节段已退变）。两组患者性别、美国麻醉医师协会（ASA）分级、体质量指数（body mass index，BMI）、合并滑脱状态及术前腰、腿痛疼痛视觉模拟评分（VAS）、日本骨科协会（JOA）评分、Oswestry 功能障碍指数（ODI）等一般资料比较差异无统计学意义（P>0.05）；A 组患者年龄显著小于 B 组（t=−3.560，P=0.000）。记录并比较两组患者手术时间、术中出血量、住院时间、围术期并发症；末次随访时采用腰、腿痛 VAS 评分、JOA 评分、ODI 评分评价疗效。比较两组间末次随访时 ASD 发生情况，采用 logistic 回归分析影响患者术后出现 ASD 的独立危险因素。 结果两组患者手术时间、术中出血量及住院时间比较差异均无统计学意义（P>0.05）。A、B 组围术期并发症发生率分别为 13.3% 和 20.0%，比较差异无统计学意义（χ²=1.506，P=0.220）。两组患者均获随访，A、B 组随访时间分别为（24.9±8.8）个月和（24.8±7.8）个月，差异无统计学意义（t=0.050，P=0.960）。至末次随访时，两组患者均未出现相邻节段病变。两组患者末次随访时椎间盘 Pfirrmann 分级与术前比较差异均无统计学意义（P>0.05）；术前及末次随访时两组间 Pfirrmann 分级差异均有统计学意义（P<0.001）。至末次随访时 A、B 组分别有 21 例（21.4%）和 53 例（62.4%）出现 ASD，比较差异有统计学意义（χ²=31.652，P=0.000）；术后相邻节段椎管狭窄程度加重是术后发生 ASD 的主要原因。两组患者末次随访时各临床评分均较术前显著改善（P<0.05），末次随访时 A 组 JOA 评分显著高于 B 组（P<0.05）。B 组患者中术后出现 ASD 患者末次随访时的腰痛 VAS 评分、ODI 评分显著高于非 ASD 患者（P<0.05）。logistic 回归分析显示，术前相邻节段存在退变因素与 BMI 是影响患者术后出现 ASD 的独立危险因素（P<0.05）。 结论术前相邻节段存在退变因素，会显著影响患者术后早期临床疗效及增加术后出现 ASD 的风险，相邻节段椎管狭窄程度加重是术后早期 ASD 主要的病理类型。应根据术前相邻节段椎管的整体退变情况评估术前相邻节段的退变状态。     

Child and parent perspectives of life quality of children with physical impairments compared with non-disabled peers

Background: Life quality has become a widely used concept within rehabilitation and occupational therapy practice.

Aim: This study explored child and parent perspectives of life quality of children with physical impairments compared with a group of non-disabled children.

Method: Data were collected with the Icelandic self- and proxy-reported versions of the KIDSCREEN-27. For children with physical impairments, reports from 34 children and 40 parents were included in the analyses, and in control group reports from 429 children and 450 parents were included.

Results: Children with physical impairments evaluated their life quality within the average range on four out of five life quality dimensions. The lowest scores were within the physical well-being dimension. Self-reported scores of children with physical impairments were higher than those of their parents on all dimensions except autonomy and parent relations. Thus, the parents considered more environmental and personal factors to negatively influence their child’s life quality than children did themselves.

Conclusion: Children with physical impairments experience their life quality similarly to non-disabled children.

Significance: Focus on life quality can help occupational therapists to identify what circumstances positively or negatively influence client well-being and to focus more on contextual factors that contribute to disablement.     

Hernias de la incisión de asistencia tras resección colorrectal laparoscópica. Influencia de la localización de la incisión y del uso de una malla profiláctica

Objectives

To determine the incidence of incisional hernia (IH) in the extraction incision (EI) in colorectal resection for cancer. To analyze whether the location of the incision has any relationship with the incidence of hernias and whether mesh could be useful for prevention in high-risk patients.

Utilidad de la tomografía computarizada cerebral multiparamétrica en el diagnóstico diferencial de patología comicial en el código ictus. Estudio preliminar

Objective

Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events.

膝关节骨软骨损伤评估及治疗方法

目的探讨膝关节骨软骨损伤评估、治疗方法以及疗效。方法2010 年 1 月—2016 年 1 月，收治 17 例膝关节骨软骨损伤患者。男 2 例，女 15 例；年龄 15～33 岁，平均 19.3 岁。致伤原因：扭伤 14 例，膝关节过伸、内翻暴力致伤 3 例。骨软骨骨折部位：髌骨 8 例，股骨外髁 4 例，股骨内髁 1 例，胫骨平台 4 例。新鲜骨折 15 例，陈旧性骨折 2 例。术前膝关节 Lysholm 评分为（31.6±2.3）分。14 例骨软骨骨折切开复位后，根据骨质情况分别选择可吸收棒（9 例）、可吸收软骨钉（3 例）或可吸收缝线（2 例）固定；3 例骨块位于胫骨内侧平台边缘非负重区直接取出。结果术后 1 例发生切口脂肪液化，再次清创后愈合；其余患者切口均Ⅰ期愈合。患者均获随访，随访时间 6 个月～2 年，平均 13 个月。14 例行内固定患者中，13 例骨折愈合良好，1 例髌骨骨软骨骨折未愈合；3 例非负重区骨软骨取出患者，随访期间未见膝关节内侧关节间隙变窄及创伤性关节炎发生。术后 1 年，膝关节 Lysholm 评分为（91.3±1.1）分，较术前明显改善（t=7.136，P=0.001）。 结论对于膝关节骨软骨损伤，骨软骨骨块带有全层松质骨时可选择切开复位内固定，带点状松质骨时可直接取出。     

Incidencia de segundos tumores en pacientes con cáncer de próstata de alto riesgo según el tratamiento primario aplicado

Introduction and objectives

The onset of second primary tumours should be considered in high-risk prostate cancer patients in the natural course of the disease. Our aim was to evaluate the influence of primary treatment with curative intent for these patients on the development of second primary tumours.

Dynamic changes in miR-124 levels in patients with acute cerebral infarction

Objective: To investigate the changes in serum miR-124 levels in patients with acute cerebral infarction (ACI) and elucidate the underlying mechanism by a dynamic monitor.

Methods: Fifty-four patients with ACI and 51 healthy controls were included in our study. Baseline characteristics and blood samples were collected for further analysis. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to measure the serum miR-124 levels. The dual-luciferase reporter assay was used to evaluate the effect of miR-124 on iASPP, a protein that inhibits apoptosis stimulating proteins in the p53 family.

Results: Compared with normal controls, the miR-124 levels in the ACI group rapidly decreased at phase 1 (within 24?h after ischemia) (p?<?0.001) and then gradually increased at phase 2 (48?～?72?h after ischemia) (p?<?0.001) and phase 3 (the 7th day after ischemia) (p?<?0.001). The dual-luciferase reporter assay showed that miR-124 down-regulates iASPP expression in 293T cells.

Conclusion: The miR-124 levels are down-regulated in ACI patients. The dynamic changes of miR-124 might provide a possible method for the detection of ischemic stroke.

• Highlights

• The difference in miR-124 expression levels between ACI patients and normal controls.

• Dynamic changes of miR-124 expression levels in ACI patients.

• The down-regulation of miR-124 upon iASPP expression.