Cardiac Lipoma of the Interventricular Septum.

Cardiac lipomas are rare benign primary neoplasms of the heart, usually found incidentally, that can become symptomatic depending on their size and location. We report the case of a 61-year-old man presenting with chest pain and elevated troponin and a normal EKG and D-dimers. A transthoracic echocardiogram revealed an intracardiac mass attached to the interventricular septum protruding to the left ventricle, later confirmed to be a lipomatous mass consistent with a cardiac lipoma on cardiac magnetic resonance imaging. Due to the mass characteristics and favourable evolution, it was decided not to excise the tumour, and the patient remains asymptomatic after a 4-year follow-up period. LEARNING POINTS: Cardiac lipomas are rare benign tumours, usually found incidentally, although they can cause a wide array of symptoms depending on their size and location.Cardiac magnetic resonance imaging is the most accurate diagnostic method to characterize lipomatous cardiac masses and to distinguish lipomas from liposarcomas.Surgical excision is the mainstay of the treatment when feasible, although small asymptomatic lipomas can be managed with a vigilant non-invasive approach.

Microbiological Changes during Ripening of Chihuahua Cheese Manufactured with Raw Milk and Its Seasonal Variations.

Chihuahua cheese is a traditional cheese produced in Northwest Mexico that is consumed shortly after production. Cheeses prepared during autumn, winter and summer were collected from five dairies, and analyzed to determine seasonal influence on proximate analysis, texture profile and the microbiological dynamic during a ripening period of 270 days. Coliforms, coagulase-positive staphylococci, molds, yeast, as well as presumptive mesophilic lactobacilli, thermophilic lactobacilli, lactococci, thermophilic cocci and enterococci, were enumerated by plate count on selective agar. Manufacturing dairy had an effect on Chihuahua cheese composition and texture profile. Seasonality influence on the microbial dynamic was observed, since the highest initial counts of coliforms (5.14 log CFU/g), coagulase-positive staphylococci (4.13 log CFU/g) and mesophilic lactobacilli (7.86 log CFU/g) were detected on summer samples. Also, ripening time affected the survival of coliforms and presumptive lactococci after 270 days (1.24 and 5.89 log CFU/g respectively) while from day 90th, coagulase-positive staphylococci were absent. Microbial changes and seasonal influence provide information on the microbiota that can influence the sensorial characteristics of Chihuahua cheese.

Disparities in Human Papillomavirus Vaccine Completion Rates Among Females in an Integrated Health Care System.

OBJECTIVE: To estimate the rate of human papillomavirus (HPV) vaccine completion by race and ethnicity. METHODS: In this retrospective cohort study, we analyzed females aged 11-26 years who initiated HPV vaccination from 2008 through 2012 in a community-based health care system in California. Vaccine completion was defined as having received at least three injections. Demographic data including age, race, ethnicity, and language preferences were obtained. Among Hispanic patients, acculturation was categorized as low or high using written and spoken Spanish vs English language as a proxy. Age groups were defined as younger adolescents (11-14 years), teens (15-17 years), and young adults (18-26 years). Bivariate analyses using χ tests and age-adjusted logistic regression were performed. RESULTS: Among 102,052 females who initiated HPV vaccination, a total of 41,847 (41%) completed the series. Younger adolescents had the highest completion rates (43.4%, P<.001) vs teens and young adults (37.4% and 38.0%, respectively). By race and ethnicity, Asian patients had the highest completion rates (49.5%, 95% CI 48.8-50.2), and the lowest rates were seen among black and Hispanic patients (28.7% [95% CI 27.8-29.6] and 38.9% [95% CI 38.3-39.5], respectively). Among Hispanic patients, the adjusted odds for vaccine completion was 1.2-fold higher for the low acculturated vs the highly acculturated group (adjusted odds ratio 1.23 [95% CI 1.16-1.31]). CONCLUSION: More than half of the females who initiated HPV vaccination did not complete the series, and black and Hispanic patients were least likely to have completed the series. Among Hispanic patients, the highest acculturated group had the lowest completion rate. These disparities emphasize the need for cancer prevention across all racial and ethnic groups.

The rise and fall of the Latino dentist supply in California: implications for dental education.

The purpose of this study was to determine the number of Latino dentists in California, identify the schools and countries where they were educated, and compare Latino dentist demographics with that of the state's new demographics. From the 2000 California Department of Consumer Affairs list of 25,273 dentists, we identified Latino U.S. dental graduates (USDGs) by "heavily Hispanic" surnames and Latino international dental graduates (IDGs) by country and school of graduation. From the 2000 U.S. census Public Use Microdata Sample (PUMS), we described Latino dentist characteristics such as Spanish language capacity and practice location. The number of Latino dentists acquiring licenses to practice in California has fallen dramatically, by nearly 80 percent, between 1983 and 2000. This decline is not merely an affirmative action issue; it results in an issue of access. Latino dentists are far more likely to speak Spanish and be located in a heavily Latino area than non-Latino dentists. Currently, although the supply of Latino dentists is dwindling, the Latino population is growing rapidly. In California and out-of-state schools, first-year matriculation of Latino USDG must increase. Further, non-Latino dentists should be prepared and given incentives to learn Spanish and locate practices in areas of need. The reintroduction of IDG Latino dentists needs to be seriously considered.

Hepatitis A: the burden among Latino children in California

OBJETIVO: Determinar la tasa de prevalencia de la hepatitis A entre ciertos grupos de población de los condados del sur de California. MATERIAL Y MÉTODOS: Se calcularon las tasas de hepatitis A por edad y raza/etnia utilizando los datos de los archivos del Centro de Servicios de Salud y Vigilancia de California, y los denominadores demográficos del ciclo 1996-2001 de la Sección de Estadísticas del Departamento de Finanzas de California. RESULTADOS: Los 2.3 millones de niños latinos (de 0 a 14 años) de cinco condados del sur de California presentaron una tasa de 31.1 casos por cada 100 000 niños, lo que muestra que es cinco veces más alta que la tasa anglosajona. CONCLUSIONES: El Comité Consejero de Prácticas de Inmunización del CDC recomienda vacunar rutinariamente a los niños con índices "muy altos" de hepatitis A. La frecuencia anual de hepatitis A, especialmente en el sur de California, alcanzó el índice "muy alto" de acuerdo con lo establecido por el CDC; por lo tanto, debería considerarse a los niños latinos de estos condados para la administración rutinaria de vacunas contra la hepatitis A. Como la salud no tiene fronteras, este problema debería tomarse en cuenta por los servicios de la salud pública de ambos países, México y Estados Unidos.

A randomised study of GnRH antagonist (cetrorelix) versus agonist (busereline) for controlled ovarian stimulation: effect on safety and efficacy.

OBJECTIVE: To assess safety and efficacy of cetrorelix utilisation in controlled ovarian stimulation (COS). STUDY DESIGN: Phase III, randomized, single center study of 131 patients undergoing COS and IVF with or without ICSI, in a University affiliated Hospital. Sixty-six patients were allocated to the protocol with antagonist and 65 to the agonist protocol arm. The Student's t-test, the Mann-Whitney test and the chi-square test were applied as required, using SPSS for Windows with a two-sided 5% significance level. RESULTS: The mean (+/-S.D.) duration of stimulation was 9.5+/-1.7 days in the antagonist group and 10.6+/-2.1 days in the agonist group (P=0.02). The mean (+/-S.D.) duration of suppression was 4.6+/-1.3 days in the antagonist group and 27.3+/-5.2 days in the agonist group (P<0.0001). No significant differences were noted in other outcome measures: amount of rFSH required, estradiol level on hCG day, number of follicles>or=15 mm and endometrial thickness on oocyte retrieval day, number of oocytes retrieved, fertilization rate and number of OHS cases. Clinical pregnancy rates per-attempt and per-transfer were 15.1% and 17.0% in the antagonist group and 16.9% and 20.0% in the agonist group (P=0.79 and 0.71, respectively). CONCLUSIONS: GnRH antagonists are an effective, safe and well tolerated alternative to agonists for COS.

Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context.

This chapter provides an overview of the concept of acculturation and reviews existing evidence about the possible relationships between acculturation and selected health and behavioral outcomes among Latinos. The effect of acculturation on Latino health is complex and not well understood. In certain areas-substance abuse, dietary practices, and birth outcomes-there is evidence that acculturation has a negative effect and that it is associated with worse health outcomes, behaviors, or perceptions. In others-health care use and self-perceptions of health-the effect is mostly in the positive direction. Although the literature, to date, on acculturation lacks some breadth and methodological rigor, the public health significance of findings in areas in which there is enough evidence justifies public health action. We conclude with a set of general recommendations in two areas-public health practice and research-targeted to public health personnel in academia, community-based settings, and government agencies.

Hepatitis A: the burden among Latino children in California.

OBJECTIVE: To determine the prevalence of Hepatitis A within subpopulations of southern California counties. MATERIAL AND METHODS: Age and race/ethnic-specific hepatitis A rates were derived from the California Department of Health Services Surveillance and Statistics Section for 1996-2001 and from demographic data of the California Department of Finance. RESULTS: 2.3 million Latino children (aged 0-14 years) in five southern California counties had a rate of 31.1 cases per 100,000, five times higher than the non-Hispanic white rate. CONCLUSION: The CDC Advisory Committee on Immunization Practices recommends routine vaccination for children with "very high" rates of hepatitis A. The annual prevalence of hepatitis A in California, especially in southern California, met the CDC's "very high" definition, therefore Latino children in these counties should be considered for routine childhood hepatitis A vaccination. As health has no borders, this issue should be addressed by the public health services of both, the United States' and Mexico's public health services.