1,721,088 research outputs found
New psychoactive substances: concerted efforts and common legislative answers for stemming a growing health hazard
Full text linkOBJECTIVE: New psychoactive substances (NPS), are a range of drugs designed to mimic the effects of established illicit drugs, being legal at the time of their distribution in illicit markets. The review aims to shed a light on the growing threat caused by NPS, and on the dynamics and developments that have led to their spread, including the risk of new adulteration practices which can cause a serious health threat, due to their increased toxicity, e.g., through fentanyl and its analogs. MATERIALS AND METHODS: An overview of statistical trends relative to NPS use has been provided, in addition to regulatory and legislative approaches in several countries and recommendations and data from International institutions: UN Office on Drugs and Crime, United Nations Commission on Narcotic Drugs, WHO, European Parliament, European Monitoring Centre for Drugs and Drug Addiction, Europol and international collaborative efforts such as the Trans European Drug Information (TEDI) project and the Spanish Energy Control. RESULTS: Given the elusive nature of NPS, spontaneous pharmacovigilance reporting systems are needed to identify new trends of drug abuse. Broad-ranging legislative initiatives are needed in order to set common international standards (e.g., the European Parliament Regulation 2017/2101, with information exchange, an early warning system and risk assessment procedure for NPS) to tackle a potentially catastrophic and growing threat. CONCLUSIONS: By virtue of all the complexities and hurdles that have to be overcome in the fight against NPS, and to assist national governments in their identification and reporting, supranational organizations can come to play a key role. Only through international measures, supplementing national legislative initiatives, can this multi-faceted problem be effectively addressed and information about NPS be gathered and disseminated in a timely fashion
Assisted heterologous fertilization and the right of donorconceived children to know their biological origins
Full text linkThe paper's main goal is to elaborate on the ethical issues that heterologous fertilization has raised as to the right of children thus conceived to find out about their origins. Such a quandary revolves around the following questions: Is it the right thing to inform the child as to the way he or she was conceived? If it is, does said child have a right to know his or her biological parent and genetic background too? Authors point out that there is no unanimity of judgment among experts, and it is worth weighing all reasons in favor and against acknowledging the children's right to full knowledge of their biological parents' data. Laws regulating the issue in different countries vary substantially as well. Therefore, the authors advocate for shared legislation, centered on the children's best interest
Total tryptase or β-tryptase in post mortem settings: Which is to be preferred?
No full textDear Editor,
We have read with attention and interest the Tsea et al.
manuscript [1] entitled “Post mortem tryptase cut-off level for
anaphylactic death” where a 5-year retrospective study has
compared totaltryptase levels in the femoral blood of 9 anaphylactic
deaths and 45 controls. A cut-off of 53.8 mg/L was identified for total
post mortem tryptase in femoral blood with a sensitivity of 89% and
specificity of 93% through a receiver-operating characteristic (ROC)
curve analysis to diagnose anaphylaxis
Guidelines and best practices: remarks on the Gelli-Bianco law
Full text linkThe paper's authors aim to elaborate on the innovations brought by law n. 24/2017, issued by the Italian Parliament with a close focus on art. 5, which pertains to the drafting of guidelines and the adoption of best practices. The guidelines constitute in fact an element of innovation brought by the above-mentioned law, and compliance with them can shield from possible liability those health care professionals who find themselves embroiled in professional accidents while in the fulfillment of their duties. Besides, there are several critical aspects within the law that need to be highlighted as well. As far as best practices are concerned, the lawmakers who drafted the legislation make no mention as to the standards of evidence needed in order to characterize any given professional behavior as "best practice". The reform appears unlikely to be effective in providing doctors with clear behavioral standards, thus reducing the margin for liability claims against them
Comment on the article by Zaami S, et al. “CRISPR-based techniques: Cas9, Cas13 and their applications in the era of COVID-19”. Eur Rev Med Pharmacol Sci 2021; 25 (3): 1752-1761
Full text linkComment on the article by Zaami S, et al.
“CRISPR-based techniques: Cas9, Cas13 and their
applications in the era of COVID-19”.
Eur Rev Med Pharmacol Sci 2021; 25 (3): 1752-176
New trends of substance abuse during COVID-19 pandemic: an international perspective
Full text linkIn the late 2019, an epidemic of cases with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) has spread from China to the rest of the world, resulting in a global pandemic (COronaVIrus Disease 19, COVID-19 pandemic). Starting from the first months of 2020, several restrictions have been imposed by governments to face the public health threat, impacting the usual patterns of drug abuse throughout the world (1). The temporary border closure affected the usual illicit drug route of shipping from country to country, resulting in scarcity of classic street drugs (2). Moreover, restrictive measures internationally adopted by several countries made necessary to close all the usual recreational settings in which stimulants drugs are commonly abused. On the contrary, since in house drugs abuse became the most feasible option, other private encounters might have caught on, such as chemsex (3). In particular this phenomenon, which originated mainly in the large cities of Northern Europe, has gradually spread across the continent and is now a worrying reality in western European countries. Other rising trends of substance abuse include cognitive enhancers and new psychoactive substances (4, 5). Furthermore, the consequent social isolation and the likely limited access to detoxification centers caused additional psychological distress, pushing drug addicts toward alternative psychotropic drugs, possibly through illegal online marketplaces. An international overview of the new trends of drug abuse during the current COVID-19 pandemic and the related health risks are hereby discussed, taking into consideration different points of view
Intensive and pharmacological care in times of COVID-19: a “special ethics” for emergency?
Full text linkBackground: The Authors have laid out an analysis of Italian COVID-19 confirmed data and fatality rates, pointing out how a dearth of health care resources in northern regions has resulted in hard, ethically challenging decisions in terms of granting patient access to intensive care units (ICU). Main text: Having to make such decisions certainly entails substantial difficulties, and that has led many health care professional to seek ethical guidance. The Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has attempted to meet that growing need by a set of recommendations, applying “clinical soundness” as a beacon standard; that approach tends to prioritize patients with higher life expectancy, which could be characterized as a “moderately utilitarian” approach. Yet, such a selection has engendered daunting ethical quandaries. The authors believe it can only be warranted and acceptable if rooted in a transparent decision-making process and verifiable, reviewed criteria. Moreover, the authors have stressed how clinical experimentation in a pandemic setting is a subtext of great interest from an ethical perspective. In Italy, no drug therapy and trials were undertaken for COVID-19 patients for a rather long period of time. When the epidemic was already circulating, an intervention proved necessary on the system of administrative procedures, aimed at expediting the authorization and validation of protocols, then bogged down by bureaucracy. A new system has since been instituted by a government decree that was signed about one month after the first Covid-19 case was officially recorded in the country. Such a swift implementation, which took just a few weeks, is noteworthy and proves that clinical trials can be initiated in a timely fashion, even with a pandemic unfolding. The concerted, action of supportive care and RCTs is the only way to attain effective forms of treatments for COVID-19 and any other future outbreak. Conclusions: The authors have arrived at the conclusion that the most effective and ethically sound response on the part of any national health care system would be to adequately reconfigure its organizational mechanisms, by making clinical trials and all related administrative procedures consistent with the current state of emergency
Commentary- Increasing abuse of anabolic steroids and chemsex drugs as performance and image-enhancing agents
Full text linkAnabolic Androgenic Steroids (AAS) are a
family of synthetic “Appearance and Performance
Enhancing Drugs” (APED) derived from natural
sex hormones, such as testosterone and its derivatives or precursors (e.g., dihydrotestosterone)1
.
Whereas testosterone is the androgen responsible
for the development of male secondary sex characteristics and elicits both anabolic and androgenic effects, AAS mostly simulate the anabolic effect of endogenous testosterone, and induce only
partial androgenic effects2
. In the 1930s, anabolic
steroids were shown to facilitate muscular growthhand consequently became rapidly popular among
bodybuilders and other athletes, and were already
widespread in the 1960s. AAS have been and still
are among the doping agents most frequently misused by athletes, regardless of the type of sport,
both in preparations containing natural anabolic
drugs [e.g., testosterone and dehydroepiandrosterone (DHEA)] and in those with synthetic substances (e.g., dianazole, nandrolone, stanozolol
and tetrahydrogestrinone
The highly complex issue of conscientious objection to abortion: can the recent European Court of Human Rights ruling Grimmark v. Sweden redefine the notions of care before freedom of conscience?
No full textPurpose: The article aims to elaborate on two recent European Court of Human Rights (ECtHR) decisions which have rejected, on grounds of non-admissibility, the appeals by two Swedish midwives who refused to carry out abortion-related services, basing their refusal on conscientious objection, and to expound upon the legal and ethical underpinnings and core standards applied to the framing process of such a ECtHR decision. Materials and Methods: By drawing upon relevant recommendations from international institutions, the authors have aimed to assess how the ECtHR rationale could affect the balance between CO and patient rights; searches have been conducted up until December 2020. Results: In both decisions the European Court has asserted that the right to exercise conscientious objection must give way to the protection of the right to health of women seeking to have an abortion. Conclusions: ECtHR judges concluded that the failure to provide for a right to conscientious objection does not constitute, in fact, a violation of the more general right to freedom of thought, conscience and religion, if provided for by a state law to protect the right to health. The legal ethical and social ramifications of such a decision are of enormous magnitude
- …
