“
“The bark of

Rhizophora mangle L. (Rhizophoraceae), “”red mangrove”", has been used traditionally in folk medicine of Caribbean countries due to its antiseptic, astringent, antifungal and antidyspeptic properties. Owed to its astringent properties is used to treat diarrhea; however, there is no scientific evidence to support the use. This work was designed to determine the antidiarrheal effects of the bark of R. mangle in mice. The liophilized extract was given by oral gavage (125, 250, and 500 mg/kg of weight). Pretreatment with the extract (500 mg/kg) resulted in a significant delay of gastrointestinal motility (p < 0.001). Propranolol (2.5 mg/kg) and verapamil (5.0 mg/kg) antagonized significantly (p < 0.001) the inhibitory effect of the gastrointestinal motility caused by Rhizophora mangle

L. The extract showed dose-dependent inhibitory respons in the range 125-500 mg/kg in castor oil-induced diarrhea. In conclusion, the GSK2126458 cell line present results suggest that the bark of Rhizophora mangle L. produces an inhibitory effect on intestinal function, and we suppose that their action is mediated, 5-Fluoracil at least in part, through beta-adrenergic and calcium systems.”
“Background: Surgeons are increasingly faced with consultation for intervention in residents of geriatric centers or in patients who suffer from end stage medical disease. We review our experience with consult services dedicated to the needs of these frail patients.

Study design: Patients were prospectively followed after being evaluated by three different geriatric surgical Adriamycin consult services: Group 1 was based at a geriatric center associated with a tertiary medical center, Group 2 was based at a community geriatric center, and Group 3 was based with an hospital-based service for ambulatory patients with end stage congestive heart failure.

Results: A total of 256 frail elderly patients underwent

of 311 general surgical procedures ranging from major abdominal and vascular procedures to minor procedures such as debridement of decubitus ulcers, long-term intravenous access, enterostomy and enteral tube placement. Almost half of the surgical volume in Group 1 and 3 were ‘maintenance’ (decubitus debridement, long term intravenous or stomal or tube care); all of Group 2 were for treatment of decubiti. There was minimal morbidity and mortality from surgery itself, and overall one year survival for Groups 1, 2, and 3 was 46%, 60%, and 79%, respectively. Multivariate analysis showed that each group had its own unique indicators of decreased survival: Group 1 dementia and coronary artery disease, in Group 2 gender and coronary artery disease, and Group 3, gender alone. Age, number of comorbid illnesses, and type of surgery (major vs minor) were not significant indicators.

Conclusions: This is the first review of the role of dedicated surgical consult services which focused on residents of geriatric centers and frail elderly.