Family-based health needs along the Texas-Mexico border

BACKGROUND

The population in the Texas-Mexico border is rapidly increasing and exacerbating a number of public health problems and healthcare services. The needs of this area have been predominantly assessed through a professional lens. To better inform public policy and serve the area, this study assessed the needs of families living along the Texas-Mexico border.

METHODS

Approximately 2000 households along the Texas-Mexico border were interviewed for their basic demographic information and health needs.

RESULTS

It was found that children's healthcare services were the highest reported need among families along the border. The probability of reporting healthcare needs increased by 43% among families with children under the age of 5, whereas the probability of reporting healthcare needs decreased by 40% among families with children 13 and older.

CONCLUSION

The findings from this study suggest child healthcare services, particularly for families with young children, is the most pressing need of the area.

Tacrolimus and sirolimus cause insulin resistance in normal sprague dawley rats

BACKGROUND

Tacrolimus-sirolimus immunosuppression has improved islet graft survival but may affect islet function.

METHODS

We studied the effects of tacrolimus, sirolimus, or both in normal adult male Sprague Dawley rats. Glucose and insulin response to oral glucose load and pancreas pathology were evaluated after two weeks of daily tacrolimus (1-8 mg/kg/day), sirolimus (0.08-8 mg/kg/day), or low-dose sirolimus (0.08 mg/kg/day) plus tacrolimus (1 mg/kg/day) treatment compared to controls.

RESULTS

Tacrolimus and sirolimus each caused dose-dependent hyperglycemia with hyperinsulinemia in response to oral glucose compared to controls, suggesting insulin resistance. At the highest doses of sirolimus, fasting insulin concentrations were high and did not increase with oral glucose suggesting loss of first phase insulin release. The combination of low doses of tacrolimus and sirolimus, at concentrations used in clinical transplantation, resulted in hyperglycemia without hyperinsulinemia after oral glucose administration. The combination of tacrolimus and sirolimus decreased islet size, and increased islet apoptosis more than either medication alone, or controls.

CONCLUSIONS

In summary, short-term therapy with either tacrolimus or sirolimus causes insulin resistance in normal rats. Combination tacrolimus-sirolimus causes greater islet changes suggesting early islet failure.

The prognostic value of thought disorder in psychotic depression

Thirty-eight patients with psychotic depression were compared to 40 patients with severe, nonpsychotic depression. Psychiatric variables, along with demographic data, were used to predict relapse over a 7-year period in a multiple regression model. Initial formal thought disorder was a strong predictor of relapse during the follow-up (F = 43, p < .001). The predictive value of this symptom in psychotic depression was not enhanced by the addition of other symptomatic or demographic variables. It appears that individuals with psychotic depression who experienced formal thought disorder are much more likely to have a relapse within a 7-year period than other people with depression.