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PubMed2006

A two-generation chronic mixture toxicity study of Clophen A60 and diethyl phthalate on histology of adrenal cortex and thyroid of rats.

This study was undertaken to observe the type of interaction that exists between polychlorinated biphenyls (Clophen A60) and diethyl phthalate (DEP) on the adrenal and thyroid glands of male and female Wistar rats. Animals were divided into four groups of six animals each, group I male and female rats were fed on a normal diet and water ad libitum. Groups II, III and IV male and female rats were given Clophen A60, DEP, or mixture of Clophen A60 and DEP, respectively, each dissolved in corn oil mixed with the diet at 50mg/kg of the diet/day. One hundred days after treatment, females were mated with males for 10 days. Exposure to the pollutants was continued throughout mating, gestation (21 days) until termination at weaning (21 days), which was 150 days of total treatment period of the parental generation. When the F1-generation pups (six males and six females of each group) were 75-100g in weight, they were treated in a similar manner to the parental generation, again for a period of 150 days, with the dose reduced to 25mg/kg of the diet/day in all treated groups. After 150 days of treatment, animals were sacrificed and histology of the adrenal and thyroid glands was asessed. An antagonistic interactive effect of treatment was seen in male parental and F1-generation rats, while an inhibitory type of interactive effect was observed in female rats. In the zona fasciculata region of the adrenal cortex of treated rats of both generations, vacuolations and degeneration were seen in samples from male animals and intracellular vacuolations in samples from females. A synergistic interactive toxic effect to the thyroid gland was observed in treated parental generation male rats, and mild changes in F1-generation-treated male rats, showing follicular shrinkage, loss of thyroglobulin and fibrosis of the interfollicular epithelium. In females, an antagonistic effect to the thyroid gland was observed in both parental and F1-generation-treated rats, showing similar effects as observed in males. From this study, we can conclude that combined administration of Clophen A60 and DEP shows an enhanced toxic effect on adrenal glands of F1-generation male and female rats, but the effect is much more marked in the thyroid gland of F1-generation male rats, and seen to a lesser extent in F1-generation female rats.

Adrenal Cortex↗
PubMedDate not supplied

The psoralens adversely affect reproductive function in male wistar rats.

The psoralens occur naturally in produce and are widely used in skin therapy. Studies show that 5-methoxypsoralen and 8-methoxypsoralen reduced birth rates in rats. We determined the effect of psoralens on reproductive function in male rats. Male Wistar rats were dosed daily with 5-methoxypsoralen or 8-methoxypsoralen (75 or 150 mg/kg, p.o.), or vehicle control. Treated males had significantly smaller pituitary glands, fewer sperm per ejaculate, and fewer sperm in the vasa defferentia and epididymides than controls. Dosing significantly elevated levels of testosterone and increased relative testis weight, but did not directly affect testicular weight. Females bred to dosed males required more time to become pregnant, and these males required more breeding attempts. The findings demonstrate the importance of determining the potential risk for infertility and/or birth defects in humans who are exposed to therapeutic, dietary, or occupational psoralens.

5-Methoxypsoralen↗
PubMed1985

Roles and responsibilities: theoretical issues in the definition of consultation liaison psychiatry.

Central to much medical ethical analysis is the concept of the role of the physician. While this concept plays an important role in medical ethics, its function is largely tacit. The present paper attempts to bring the concept of a social role to prominence by focusing on an historically recent and rather richly contextured role, namely, that of consultation liaison psychiatry. Since my intention is primarily theoretical, I largely ignore the empirical studies which purport to develop the detailed functioning of the role. My limited intent is to draw attention to the theoretical complexity of the consultation liaison role as an example of the general relevance of role concepts to medical ethics. For this reason, consultation liaison psychiatry will function as an illustration of fundamental concepts of medical ethics rather than as a subject of analysis in its own right. Similarly, the concept of the social role will be developed only as is necessary to explore the general relationship between the consultation liaison role and ethical analysis.

Authoritarianism↗
PubMed2005

Can a teaching and learning perspective deepen understanding of the concept of compliance? A theoretical discussion.

Patients' noncompliance is regarded as a major problem in health care and efforts have been made to understand the mechanisms behind compliance and noncompliance. The concept of compliance has been analysed and criticized because of the limited way it defines the roles of patients and health professionals and for being supportive of the authority of health professionals. Attempts have been made to change the paternalistic meaning of the concept of compliance and alternative terms have been introduced. However, there is a lack of studies about the teaching and learning component of compliance. The aim of this theoretical article was to examine the meaning of the concept of compliance as is it used in health care, and relate it to a patient-centred, teaching and learning perspective. It is argued that instead of focusing on noncompliant patient behaviour, it would be more powerful to focus on the way the patients experience and understand and on how to create conditions for developing understanding, as this in turn might influence the behaviour or way of acting. It is suggested that the teaching part of compliance could be carried out by 'to follow and let oneself be followed', which means a teaching and learning situation where the health professional follows the patient, guided by patient experiences, and need for understanding. At the same time it means that following the patient's experiences creates possibilities for the health professional to reason and act in a way that the patient can follow. The concept of 'play' is used when putting 'to follow and let oneself be followed' into effect. To this end, the health professional needs to develop a considered pedagogical standpoint.

Attitude of Health Personnel↗
PubMed2005

What is the role of the research ethics committee? Paternalism, inducements, and harm in research ethics.

In a recent paper Edwards, Kirchin, and Huxtable have argued that research ethics committees (RECs) are often wrongfully paternalistic in their approach to medical research. They argue that it should be left to competent potential research subjects to make judgments about the acceptability of harms and benefits relating to research, and that this is not a legitimate role for any REC. They allow an exception to their overall antipaternalism, however, in that they think RECs should have the power to prohibit the use of financial inducements to recruit research subjects into trials. In this paper it is argued that these claims are unjustified and implausible. A sketch is provided of an alternative model of the role of the REC as an expert body making judgments about the acceptability of research proposals through a consensual weighing of different moral considerations.

Attitude to Health↗
PubMed1995

Influence of social factors on sugary products behavior in 4-year-old children with regard to dental caries experience and information at child health centers.

The aim was to analyze the steering effects of 15 social factors on sugary products behavior at 4 years of age in 177 children. The parents had in most cases received information on dental health care at child health centers, with due respect to the level of caries among the children, who were classified as 'healthy' (no caries experience) (n = 83) or 'diseased' (caries experience) (n = 84). The parents filled in a mailed diet history form. Only sugary products unsuitable from a cariologic point of view were considered. The products were given scores reflecting the frequency of intake. The social factors were social background, family, information, and conceptual factors. By means of multiple regression analysis, explanatory values of the social variables for sugary products behavior were estimated. For the total material, 13% of the variance was explained by all variables combined. Among the social background factors, 'parents' age' was statistically significant (p < 0.05). Among family factors, 'day-care mainly at home' and 'oldest child' were the most important. All information factors proved to be nonsignificant. Of the conceptual factors, only 'importance of genetic factors' was statistically significant. For the healthy group 26% of the variance was explained by all variables. 'Mother's age', 'importance of genetic factors', and 'oldest child' were statistically significant. For the diseased group all variables were nonsignificant. Explanatory values were negligible. The important conclusions were that very few traditionally conceived social variables seem to influence 4-year-old children's sugar behavior. Parents of children with caries appear to be a heterogeneous group with an irrational behavior.

Attitude to Health↗
PubMed2002

Genetic research and communal narratives.

The use of DNA evidence to prove Thomas Jefferson's paternity of Sally Hemmings' children is a powerful example of how genetic research can have an impact upon the communal narratives of families and nations.

Black or African American↗
PubMedDate not supplied

Methuselah moms.

Explore the source record for details and available documents.

Adult↗
PubMed1990

On informed consent.

The question of whether patients should influence medical decisions, and if so how much, is not simple. Among other things, it is necessary to decide whether the patient's well-being should take precedence over respect for the patient's autonomy, or vice versa; whether or not the patient has the capacity to exercise true autonomy; what information should be furnished in order to provide the patient with the basis for making a decision about treatment; and how such information should be provided. This article examines these matters, reviews the pros and cons of various methods for obtaining patients' informed consent, presents some broad guidelines for dealing with informed consent issues in a therapeutic setting, and discusses ethical principles that should be applied in obtaining patients' informed consent to participate in clinical research.

Clinical Trials as Topic↗
PubMedDate not supplied

Reassessing autonomy in long-term care.

The realities of long-term care call for a refurbished, concrete concept of autonomy that systematically attends to the history and development of persons and takes account of the experiences of daily living.

Aged↗
PubMed1988

[Vasectomy: criteria of choice or protocol?].

The authors describe the experience of a medical staff specialized in welcoming, advising and realizing vasectomies on patients, and this according to a particular method in which traditional preliminary criteria of age, fatherhood and autoconservation are substituted by a continuous effort to listen and advise patients over a long period of time. 1385 cases have been selected over a period of one to ten years. The socio-demographic analysis defines an "ideal-type candidate": he is a middle or upper white collar; aged 37; married; he has fathered more children than the average and at a younger age than the average; and he has used up every well-tried means of contraception. The only technical variation observed was the length of the resected canal. The more widely defined failure rate can be evaluated at 2.3% of the 1426 cases. This failure rate appears to be linked with the size of the resection, too small (less than 5 mm) during two years. This caused the repermeabilization through granulomas, histologically authentified, of half of the observed cases that failed over a period of twelve years. The psychosexual consequences, analyzed through questionnaires, are judged satisfactory and confirm the possibility for the authors to accept vasectomy demands in a humanistic perspective, conciliating individual autonomy and safety in selecting candidates.

Adult↗