The United States may be infecting Mexico with H.I.V., not the other way around. According to 2006 United Nations’ statistics, Mexico’s AIDS rate is about half of the U.S.’s, and a high percentage of new HIV infections in Mexico are traced back to migrant workers returning home from America. Twenty-two percent of patients with HIV at Puebla General Hospital (Puebla, Mexico) can trace their infections back to the U.S.
The news may come as a shock to many in the border regions of Texas, where illegal immigrants are often blamed for the state’s growing healthcare crisis. Texas’ healthcare system is overloaded with uninsured patients commuting from rural areas to the larger cities of Dallas, Houston, and Austin to seek care. As a result of these, and other, unreimbursed costs for the uninsured, most private, family health insurance premiums in Texas are higher than the rest of the nation’s.
In the thirty-two counties comprising Texas’ border region, 85% of the population was Hispanic in 2003, but only 9.8 in 100,000 were infected with HIV. In contrast, more than twice — 22 in 100,000 — on average, in the same year were infected statewide. In fact, Harris County accounts for the highest rate of HIV infections in the state.
Between 41% and 79% of Mexicans infected with HIV lived in the U.S., according to statistics collected from 1983 to the early ’90s. Mexico has not reported comprehensive studies since then, however, and it seems up to joint initiatives, such as studies conducted by the California-Mexico AIDS Initiative, to gather information that reflects the current state of affairs.
Mexico’s AIDS epidemic is still mostly confined to prostitutes and their clients, gay men, and IV drug users. Infected individuals between the ages of 15 and 49 account for only 0.3% of the population, as opposed to 0.6% in the U.S. Rural migrant workers, however, are slowly becoming a high-risk category on their own. Rural areas, where there is the least access to healthcare and testing, also boast the highest migration rates due to the poor economy. Combined, such factors create a near-perfect atmosphere in which the virus can explode. In fact, for most Mexican women, their greatest risk of contracting the disease is from having unprotected sex with their migrant-worker husbands.
“Migration leads to conditions and experiences that increase risks,” said George Lemp, an epidemiologist and director of the University of California’s AIDS research program. He and colleagues are studying the spread of HIV/AIDS among migrants, and says that isolation, different sexual practices, language barriers (including to health services), depression, loneliness, and abuse all contribute to the growing rate of infection. Migrants tend to have more sexual partners than those who stay at home, and there is a considerable lack of condom usage among this population, due, in part, to cultural factors. Migrant women may also be particularly vulnerable, as their risks of sexual abuse and rape are much greater.
Jennifer S. Hirsch, professor of public health at Columbia University, published an article earlier this month in the American Journal of Public Health citing evidence supporting the notion that part of the problem may actually be the emotional fidelity of many Mexican migrant-worker husbands. Rather than forming long-lasting relationships with women in the U.S., they instead seek sexual outlet with high-risk individuals providing short-term interaction, such as prostitutes.
But the subject is often taboo among couples, and routine HIV screenings are still not common. Many women, in fact, only discover they are infected after giving birth to an HIV-positive child. Mexico does provide antiretroviral drugs to even the poorest of migrant workers once diagnosed, but sacrificing the time and finances to travel to cities where they are distributed is a major obstacle. Lack of testing and treatment, in turn, increase the risk of transmitting the disease, especially in a culture in which condom usage is limited, infidelity not discussed, and screenings not routine.
Being aware of your HIV status is an important part of monitoring your health. How you take care of yourself will certainly affect you as you age, and eventually your wallet, as well. If you’re a young individual who tries to keep informed and maintain a healthy condition and lifestyle, you should take a look at the revolutionary, comprehensive and highly-affordable individual health insurance solutions created by Precedent specifically for you. Visit our website, [http://www.precedent.com], for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly-competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance experience.
Your doctor may soon be a robot, or so the whispers warn. Sound like something out of a bad science-fiction movie? Well, maybe you should ask whichever physician shows up on-screen of the RP-7 Remote Presence Robotic System by InTouch Technologies, a maneuverable robotic system designed to allow physicians to videoconference with their patients from remote locations.
Dr. Alex Gandsas, of Baltimore’s Sinai Hospital and holder of stock options with InTouch Technologies, introduced the machine to hospital administrators as a way to closely monitor patients after the weight loss surgeries in which he specializes. Since its introduction, the length of his patients’ stays has been shorter. In Gandsas’ study published earlier this month in the Journal of the American College of Surgeons, 92 of 376 patients had additional robotic visits, and all 92 of them were medically cleared to return home faster than those who did not receive check-ins with the teleconferencing system. Shorter patient stays would be a welcome change for hospitals, health insurance companies, and patients alike — all of which have a vested interested in sending patients home faster.
While further studies should, without a doubt, be performed by physicians who do not hold a financial interest in the technology, these preliminary results do show promise. The robotic visits were not used by Gandsas to replace his personal check-ins with patients — only to add to them. Neither InTouch Technologies, nor Dr. Gandsas envisions the “Bari,” or so it’s nicknamed, as completely replacing personal visits with healthcare professionals. Instead, the joystick-controlled system, which employs cameras, a video screen, and microphone, is intended to supplement physicians’ traditional visits, and to allow patients and healthcare workers to receive advice from qualified physicians and specialists when it may otherwise be impossible. Doctors may soon be able to provide their patients with additional daily check-ins and answer questions much faster, all while sitting in their own homes or while away from the area.
Sinai Hospital isn’t the only one with this technology, however. In fact, robots have been in use for some time to assist with patient care, including guiding stroke patients through therapy, and helping them play video games. Many prosthetic devices are now at least partially robotic, and if it weren’t for a certain amount of robotic technology, the public would not be able to communicate with such great minds as Steven Hawkins.
Johns Hopkins also has a robotic teleconferencing system to help communicate with patients who need a translator when one is not available at the hospital itself. Use of such technology could have tremendously positive effects on Texas’ healthcare system — particularly in Dallas, Houston, and Austin — which handles a high volume of patients who do not speak English. Lack of adequate communication is a major obstacle to receiving quality healthcare for many immigrants in Texas. Lack of quality healthcare, in turn, can lead to serious public health issues, including the transmission of communicable diseases.
Approximately 120 RP-7 Remote Presence Robotic Systems are currently in use around the world, with plans to implement many more in the coming years. China is already using similar systems to help deal with the lack of medical care in rural, inaccessible areas.
Dr. Louis Kavoussi, chairman of the urology department at North Shore-Long Island Jewish Health System, took a special interest in this new trend and conducted a study monitoring the effect of the technology on patient care. The study showed no decrease in patient satisfaction, and no increase in complications due to teleconferencing visits. The technology, Kavoussi said, is “rudimentary,” really, in comparison to other developing systems. The need for fear is minimal.
There are relatively few of InTouch Technologies’ systems available, and further studies have yet to be conducted. If robotic teleconferencing is used as a supplement to personal physicians’ visits, however, it has the potential of dramatically improving many aspects of healthcare — from how quickly patients’ questions are answered, to how many visits, in total, they receive, to whether or not rural residents receive proper care, to how well (or even if) they are provided with a translator to explain their symptoms. States like Texas, in particular, with shortages of doctors and high volumes of patients who do not speak English, stand to benefit. So maybe robots in hospitals aren’t something one needs to fear. In fact, they may even get your unpleasant stay over with a few days faster.
Being aware of medical technology is an important part of taking care of your health. How you take care of yourself will certainly affect you as you age, and eventually your wallet, as well.
If you’re a young individual who tries to keep informed and maintain a healthy condition and lifestyle, you should take a look at the revolutionary, comprehensive and highly-affordable individual health insurance solutions created by Precedent specifically for you. Visit our website,for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly-competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance experience.
As if there weren’t enough things giving us chest pain, new studies reveal that Prilosec and Nexium, made by pharmaceutical giant AstraZeneca, increase the risk of fatal heart attacks after years of use.
The heartburn medications follow closely in the wake of controversies surrounding Vioxx, a painkiller also believed to raise the likelihood of heart attack and cardiovascular problems, and Avandia, a diabetic medication thought to elevate similar risks. Prilosec and Nexium are nearly identical in formula, and belong to a group of drugs known as proton pump inhibitors, which reduce or eliminate heartburn by decreasing the stomach’s production of acid. Prevacid, Protonix, and Aciphex are also in this group.
The effect these court and media battles have had on the health care, health insurance, and pharmaceutical industries is significant, and if similar trends continue, could be astronomical. Giants like Merck, the makers of Vioxx, are seeing their stock market prices recover, but for a while, it was questionable.
The issues extend beyond just Wall Street, however, and certainly are a concern to residents of Dallas, Houston, Austin and throughout Texas. Health insurance companies may be less likely to cover drugs from pharmaceuticals with a history of liability problems.
For states like Texas, where twenty-five percent of the population is already going without any health coverage whatsoever, more bad news could crush the state’s ability to provide adequate care. If, for instance, state medical programs began to limit accessibility to medications made by giants like Merck, healthcare facilities already on the edge may go under entirely due to unreimbursed costs, or, worse, be unable to provide sufficient care at all.
The Food and Drug Administration (FDA) was heavily criticized for not warning the public against Avandia, when it knew for more than a year about studies suggesting its link with higher risks of heart attack and angina. Merck faced formidable damage-control issues over Vioxx, and, in fact, is still in court over the fiasco. AstraZeneca might as well take notes; lawsuits are sure to come.
AstraZeneca recently sent the FDA the results of its fourteen-year study on different treatment options for acid reflux disease. It compared patients who elected to have surgery with those taking Prilosec, and found evidence within one year of the study’s inception that those choosing the medication were more likely to have heart attacks, heart failure and heart-related sudden deaths than those who underwent surgery. These findings continued throughout the study.
Several factors could have led to false negatives, reported the drug company, including the fact that surgery patients are often younger and healthier, and fourteen other studies on Prilosec showed no elevated risk at all.
That AstraZeneca knew of the possibility of these risks thirteen years ago, but did not reveal them, only adds to the lack of trust building against the pharmaceutical industry in general. A study on Nexium found similar risks early on, but the effect seemed to dissipate as the trial continued.
“It’s hard to know if this will play out similarly [to Avandia] until we have completed our analysis,” said Dr. Paul Seligman, the FDA’s associate center director for safety policy and communication, when questioned about Prilosec and Nexium.
In a written statement, the agency said that, “based on everything we now know, the FDA’s preliminary conclusion is that the observed difference in risk of heart attacks and other heart-related problems seen in early analyses of the two small long-term studies is not a true effect.”
The course of these analyses eerily parallels that of Avandia, however — just in reverse. Three dozen short-term studies on the diabetes medication revealed heart risks, but the FDA dismissed the evidence after a long-term trial did not produce similar data. Prilosec’s long-term trial, on the other hand, revealed heart risk, while fourteen shorter-term studies did not. The fact that the FDA seemed, in both cases, to have conveniently ignored one set of data in exchange for emphasizing the other, more profitable one, calls the agency’s process of analysis into question. The FDA has since asked for safety data from all makers of proton pump inhibitors.
“We were cognizant from the earliest submission [on Prilosec and Nexium] about whether and how we should say something,” said Seligman.
It’s hard to know whether or not to be comforted by that.
Being aware of safety issues affecting your health is an important part of taking care of yourself. Minding your health will certainly affect you as you age, and eventually your wallet. If you’re a young individual who tries to keep informed and maintain a healthy condition and lifestyle, you should take a look at the revolutionary, comprehensive and highly-affordable individual health insurance solutions created by Precedent specifically for you. Visit our website, [http://www.precedent.com], for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly-competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance process.