Hymenaea rubriflora Ducke stem bark extract has vasorelaxant and contractile inhibition capacity

Abstract We investigated the vasodilatory effects of Hymenaea rubriflora Ducke stem bark extract (HRHAc). Vascular reactivity of the aortic rings of Wistar rats was tested by in vitro cumulative doses (0.1 - 729 µg/mL). Rats (n=5) were treated with 25 (G25), 50 (G50) and 100 (G100) mg/ kg of HR-HAc or saline (control group - CG) for four weeks. An in vitro assay resulted in dose-dependent relaxation of the aortic rings with functional endothelium, which was inhibited in the presence of L-NAME. Rings of the treated animals increased acetylcholine relaxing potency at all doses, with a greater effect on G50 (pD2 = 7.8±0.1, Emax = 95.6±1.1) and a decreased contractile potency to phenylephrine in G25 (pD2 = 6.9±0.06, Emax = 61.5±6.0%) and G50 (pD2= 6.6±0.06, Emax = 71.0±8.5%) when compared to the CG in the presence and absence of endothelium (pD2= 6.4± 0.1, 6.4±0.1 and 6.9±0.1, respectively). Cumulative doses of nitroprusside resulted in increased relaxing potency in all treated groups and maintained Emax at 100%. It is concluded that HR-HAc has vasorelaxant capacity and inhibitory vascular contraction activity applied either directly to aortic rings or after treatment with in vivo supplementation, which places this extract as a potential nutraceutical or pharmacological agent for treating diseases associated with vascular dysfunction.

The Philippines rolls back advancements in the postabortion care policy.

In 2018, the Philippines announced a postabortion care policy that rolls back crucial safeguards aimed at protecting women who seek medical treatment for postabortion complications from discrimination and abuse. It replaces another policy that was introduced in 2016, following years of advocacy by national and international advocates who were concerned about the mistreatment of women seeking postabortion care due to discriminatory practices in the health system and abortion stigma. The new policy is narrower in scope than the previous policy and reinforces abortion stigma by emphasizing the legal prohibition on abortion, failing to clarify that women seeking postabortion care need not be reported to the authorities, and not recognizing the availability of complaint mechanisms for women who are mistreated. These and other crucial gaps put the new policy at risk of being in violation of ethical standards of medical care and guarantees of human rights.

A guide to community mental health law for district nurses: the right to aftercare.

District nurses frequently provide physical care and treatment to patients in their own homes and care homes who have previously been detained under the Mental Health Act 1983 for the treatment of a mental illness. Such patients are commonly subject to community provisions of the Mental Health Act 1983 and it is important that districts nurses are aware of the implications of these provisions on the patients care and support. In this article the author considers a detained mental health patient's right to aftercare under the Mental Health Act 1983, section 117.

Ethical dilemmas of dental implantology: Ready for aftercare?

Dental implantology is one of the most attractive and dynamic fields of work within clinical dentistry. It provides many patients with new and improved opportunities for stable (implant-supported) rehabilitation and also offers dentists a field that is interesting in both technical and economic terms. Adverse clinical outcomes are, however, often the subject of discussion. These relate both to prosthetic failure and to biologic complications and side effects, namely persistent infections surrounding implants. A further point of discussion relates to the question as to how far the triumphant march of implantology is accompanied by a reduction in the willingness to retain teeth. It thus appears all the more important to ask some questions regarding the normative overall conditions of responsible implantologic care on the basis of the present state of research and currently available studies. In line with this, this paper deals with both existing preconceptions and ethically relevant parameters of responsible implantology. These function simultaneously as concrete clinical-ethical guidelines for dentists practicing implantology.

Conflicting duties over confidentiality in Argentina and Peru.

The medical duty of confidentiality represents a key element for the provision of reproductive and sexual health services. In some Latin American countries, such as Argentina and Peru, the legal systems impose­or are interpreted as imposing­on health professionals the duty of confidentiality, but also the duty to report the commission of a public order offense that they know about owing to the practicing of their profession. In these countries, the conflicting duties and the criminalization of abortion cause severe public health and human rights problems when health professionals assist their patients for post-abortion treatment. Typically, patients are deterred from seeking prompt medical care, and their privacy, autonomy, and dignity are violated. A 2010 ruling from the Supreme Court of Argentina and a 2004 ruling from the Inter-American Court of Human Rights emerge as important instruments that grant a more adequate protection of medical confidentiality.

Newborn screening: a literature review.

Newborn screening is the largest genetic testing effort for newborns in the U.S. Its purpose is to identify newborns who are at risk for metabolic, endocrine, or hematologic disorders. A review of the literature was conducted to determine the benefits of newborn screening; specimen collection timing and handling; ethical considerations of screening; as well as current practices regarding consent, notification of results, and follow-up procedures. The use of tandem mass spectrometry for expanded newborn screening and postmortem diagnosis of unexplained infant death was also reviewed. This article is intended to educate health care providers in the areas of controversy that surround the U.S. newborn screening program, with the hope of encouraging further research in this mportant area of newborn care.

Abortion and postabortion care: ethical, legal, and policy issues in developing countries.

This case study of a woman who wants to terminate her pregnancy but does not have access to safe services explores the technical, ethical, and legal effects of the Mexico City Policy (Global Gag Rule) on health care providers working in developing countries. This woman's self-induced termination resulted in an incomplete abortion, and she sought care from a midwife. The current Mexico City Policy effectively limits a health care provider's ability to offer abortion services and counseling, even when these services are legal. The policy has an adverse impact on women's access to safe care. The provision of comprehensive postabortion care, not restricted by the Mexico City Policy, is the key to preventing abortion-related morbidity and mortality.

Can keeping clinical trial participants blind to their study treatment adversely affect subsequent care?

Subjects in controlled clinical trials obtain experience with study-provided treatment that could inform their further therapy by awareness of the efficacy or inefficacy of the study treatment they received. However, patients in blinded trials typically do not learn right after their participation what treatment they actually received during the study, even though it is possible to do so while maintaining the necessary blinding of investigators. Keeping investigators and subjects blind to treatment assignment throughout a trial is a key element of clinical research methodology, but the value of keeping participants and their medical providers blinded after participation is less certain and may pose risks that include delay in the receipt of efficacious care, exacerbation of symptoms, or prolonged exposure to superfluous or toxic treatment. The significance of these risks is likely to vary with the specific disease and the time course of its response to available therapies. Currently, it seems appropriate for investigators a) to evaluate the risks of keeping subjects blind after participation, b) to justify doing so in relation to serious, identifiable risks to the study's validity and apprise prospective subjects clearly that information about their response to specific treatment during the trial will not be available to guide their post-study care, and c) to consider methods for debriefing subjects before their resumption of open treatment that preserve the integrity of investigator blinding. In the long-run, research on the impact that keeping subjects uninformed about study treatment has on post-study patient outcomes and on study integrity can foster the development of procedures that optimally balance both.

Medication errors in family practice, in hospitals and after discharge from the hospital: an ethical analysis.

Thousands of medical errors are occurring daily in physician's offices, in hospitals, and even upon discharge from the hospital, leading to unnecessary injury and death and costing billions of dollars. We have a systems approach that has been proven to be tried and true in aviation, nuclear energy and many other industrial settings. Being honest when medical mistakes occur, reporting them to national clearing house, objectively searching for root causes, avoiding the fixing of arbitrary blame, and then, where possible, implementing safeguards to minimize the occurrence of future mistakes, is the best way to enhance patient safety. But until the medical establishment takes medical errors and patient safety more seriously, and until the general public rises up in protest, it is up to the state and federal governments to take the lead in protecting the lives of innocent Americans by creating a public policy.