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The new world of medicine: prospecting for health.

Throughout past millennia, human beings have shared the common goal of improving health for longevity. However, different cultures around the world have developed their own approaches to achieve this goal. Various traditions have emerged, rendering distinct medical systems such as Ayurveda, Yoga, Chinese-Japanese medicine, shamanism, and Native American healing. Traditional medicine involves a holistic approach to the human body to integrate healing with culture, environment, and tradition. Modern allopathic medicine originated from Greco-Roman Medicine and Northern European traditions and is built on the science of anatomy, physiology, and biochemistry and the structure-function relationship between cells, tissues, and organs. This foundation focuses on diagnosis, treatment, and cure for acute illnesses via potent pharmaceutical drugs, surgery, radiation, and other treatment modalities. Within this past century, we have doubled the life-span of human beings. Genomic medicine, including stem cell research, cloning, and gene therapy, will increase our capability to treat even more diseases. In the new millennium, we face more chronic illnesses related to aging, environment, and lifestyle, such as cancer, diabetes. osteoporosis, and cardiovascular diseases. Thus, health care providers face the challenge of prospecting for health and disease prevention. Modern science and medical advancements provide the rationale for the integration of various traditional healing techniques, which have been termed Alternative and Complementary Medicine, to promote healing, health, and longevity. Advances in medicine must include the holistic approach of traditional medicine to face the current challenges in health care. Therefore, the New World of Medicine must fuse the antiquity of ancient healing with the innovations of modern medicine to increase life-expectancy and improve quality of life throughout the world.

Complementary Therapies↗

Neutralizing IFN-γ autoantibodies are rare and pathogenic in HLA-DRB1*15:02 or 16:02 individuals.

BACKGROUNDWeakly virulent environmental mycobacteria (EM) can cause severe disease in HLA-DRB1*15:02 or 16:02 adults harboring neutralizing anti-IFN-γ autoantibodies (nAIGAs). The overall prevalence of nAIGAs in the general population is unknown, as are the penetrance of nAIGAs in HLA-DRB1*15:02 or 16:02 individuals and the proportion of patients with unexplained, adult-onset EM infections carrying nAIGAs.METHODSThis study analyzed the detection and neutralization of anti-IFN-γ autoantibodies (auto-Abs) from 8,430 healthy individuals of the general population, 257 HLA-DRB1*15:02 or 16:02 carriers, 1,063 patients with autoimmune disease, and 497 patients with unexplained severe disease due to EM.RESULTSWe found that anti-IFN-γ auto-Abs detected in 4,148 of 8,430 healthy individuals (49.2%) from the general population of an unknown HLA-DRB1 genotype were not neutralizing. Moreover, we did not find nAIGAs in 257 individuals carrying HLA-DRB1* 15:02 or 16:02. Additionally, nAIGAs were absent in 1,063 patients with an autoimmune disease. Finally, 7 of 497 patients (1.4%) with unexplained severe disease due to EM harbored nAIGAs.CONCLUSIONThese findings suggest that nAIGAs are isolated and that their penetrance in HLA-DRB1*15:02 or 16:02 individuals is low, implying that they may be triggered by rare germline or somatic variants. In contrast, the risk of mycobacterial disease in patients with nAIGAs is high, confirming that these nAIGAs are the cause of EM disease.FUNDINGThe Laboratory of Human Genetics of Infectious Diseases is supported by the Howard Hughes Medical Institute, the Rockefeller University, the St. Giles Foundation, the National Institutes of Health (NIH) (R01AI095983 and U19AIN1625568), the National Center for Advancing Translational Sciences (NCATS), the NIH Clinical and Translational Science Award (CTSA) program (UL1 TR001866), the French National Research Agency (ANR) under the "Investments for the Future" program (ANR-10-IAHU-01), the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence (ANR-10-LABX-62-IBEID), ANR-GENMSMD (ANR-16-CE17-0005-01), ANR-MAFMACRO (ANR-22-CE92-0008), ANRSECTZ170784, the French Foundation for Medical Research (FRM) (EQU201903007798), the ANRS-COV05, ANR GENVIR (ANR-20-CE93-003), and ANR AI2D (ANR-22-CE15-0046) projects, the ANR-RHU program (ANR-21-RHUS-08-COVIFERON), the European Union's Horizon 2020 research and innovation program under grant agreement no. 824110 (EASI-genomics), the Square Foundation, Grandir - Fonds de solidarité pour l'enfance, the Fondation du Souffle, the SCOR Corporate Foundation for Science, the Battersea & Bowery Advisory Group, William E. Ford, General Atlantic's Chairman and Chief Executive Officer, Gabriel Caillaux, General Atlantic's Co-President, Managing Director, and Head of business in EMEA, and the General Atlantic Foundation, Institut National de la Santé et de la Recherche Médicale (INSERM) and of Paris Cité University. JR was supported by the INSERM PhD program for doctors of pharmacy (poste d'accueil INSERM). JR and TLV were supported by the Bettencourt-Schueller Foundation and the MD-PhD program of the Imagine Institute. MO was supported by the David Rockefeller Graduate Program, the Funai Foundation for Information Technology (FFIT), the Honjo International Scholarship Foundation (HISF), and the New York Hideyo Noguchi Memorial Society (HNMS).

Adult↗

Science in Poland. The Nencki Institute of Experimental Biology.

The Nencki Institute in Warsaw was founded in 1918 to honor one of Poland's most distinguished biochemists, Marceli Nencki. Since its inception, the institute has evolved from a confederation of privately supported laboratories to a center of research productivity intimately associated with the Polish Academy of Sciences. Early relations with Pavlov's laboratory laid the foundation for the emergence of a Polish School of Neurophysiology under the leadership of Jersy Konorski. The impact of Konorski and his colleagues has transformed the interpretation of conditioning to include a systematic physiologic basis that more adequately considers the psychology of learning processes. The prestige of the Nencki Institute within contemporary Eastern European and Soviet science was achieved despite the economic pressures on a new nation and its total devastation of World War II. Moreover, the more than 60 years of scientific work in an independent Poland have provided a critical transition between Eastern and Western research efforts, and the Nencki Institute has filled a leading role in facilitating communication among scientists.

Biology↗

[Social perception of biotechnology: a new tool for decision making].

The increase in critical opinions of scientific and technological development in advanced societies has led to the development of studies examining the links between science, technology and society. Among these studies are those on public perception, a particularly topical issue being the perception of biotechnology. There has been considerable European activity in this area of reflection and research, as evidenced by the wide range of initiatives at European Union and member state level. Some special instruments, such as the consensus conferences which began in Scandinavian countries, are now being applied in various EU countries. In Spain several public bodies and foundations are involved in a growing number of activities in this field. Biotechnology has become a particularly interesting research area for promoting new conditions for analysis of the social and economic repercussions of advances in science and technology. The study of the social perception of biotechnology is a crucial instrument for policy design and management and hence a methodological review is warranted.

Biotechnology↗

Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa).

Outcome after cardiac arrest and cardiopulmonary resuscitation is dependent on critical interventions, particularly early defibrillation, effective chest compressions, and advanced life support. Utstein-style definitions and reporting templates have been used extensively in published studies of cardiac arrest, which has led to greater understanding of the elements of resuscitation practice and progress toward international consensus on science and resuscitation guidelines. Despite the development of Utstein templates to standardize research reports of cardiac arrest, international registries have yet to be developed. In April 2002, a task force of the International Liaison Committee on Resuscitation (ILCOR) met in Melbourne, Australia, to review worldwide experience with the Utstein definitions and reporting templates. The task force revised the core reporting template and definitions by consensus. Care was taken to build on previous definitions, changing data elements and operational definitions only on the basis of published data and experience derived from those registries that have used Utstein-style reporting. Attention was focused on decreasing the complexity of the existing templates and addressing logistical difficulties in collecting specific core and supplementary (ie, essential and desirable) data elements recommended by previous Utstein consensus conferences. Inconsistencies in terminology between in-hospital and out-of-hospital Utstein templates were also addressed. The task force produced a reporting tool for essential data that can be used for both quality improvement (registries) and research reports and that should be applicable to both adults and children. The revised and simplified template includes practical and succinct operational definitions. It is anticipated that the revised template will enable better and more accurate completion of all reports of cardiac arrest and resuscitation attempts. Problems with data definition, collection, linkage, confidentiality, management, and registry implementation are acknowledged and potential solutions offered. Uniform collection and tracking of registry data should enable better continuous quality improvement within every hospital, emergency medical services system, and community.

Adult↗

European science. Bug Bastille to open under new management.

In the next few weeks, Europe's most advanced high-security pathogen lab is expected to open for business in the southern French city of Lyons, but the long-anticipated debut of this "hot" lab is not turning out to be a joyous occasion for some of those involved. Last week, the Marcel Mérieux Foundation, which paid for the lab's construction, announced that the Pasteur Institute will take over its "scientific direction" and gave Pasteur the authority to name the lab's director. The leading candidate is a Pasteur scientist, which would leave the lab's current director out in the cold.

Containment of Biohazards↗

[Certification according to ISO 9001--waste of time or necessity?].

Quality management (QM) systems are widely established management tools in the industry and business world today. In the health care sector, the need for quality, the implementation of quality management systems and economic orientation of the hospital management are strongly encouraged. Centers of excellence are created to offer special medical services of the highest possible quality. Furthermore, there is a worldwide tendency to establish standards in clinical medical settings, in teaching profession and medical science. These trends make the implementation of a quality management system in health care system highly desirable. The present manuscript reviews the fundamental principles and concepts and the aims of internationally accepted QM systems. It focuses on the ISO-9000 certificates and the European Foundation of Quality Management (EFQM) model. The advantages and disadvantages are discussed. The resources necessary for installation of a QM system and the different phases of implementation are reported. According to the experience of several groups, QM systems can be reliably used in a radiology department and lead to continuous improvement of the quality of services.

Austria↗

A population-based, cross-sectional survey of the Zuni Pueblo: a collaborative approach to an epidemic of kidney disease.

Approximately 80% of the Zuni Indians live in Zuni Pueblo in rural New Mexico. The Zuni are relatively endogamous and differ culturally and ethnically from neighboring tribes. The Zuni Pueblo is experiencing an epidemic of renal disease. The prevalence of end-stage renal disease (ESRD) among the Zuni Indians, adjusted for age and gender, is 6-fold and 21-fold higher than the prevalence rates for Native Americans and European Americans. Almost all Zuni tribal members have a relative with ESRD. This has led to strong public support for renal research. In response, the Zuni community has partnered with the Indian Health Service (IHS), University of New Mexico Health Sciences Center (UNMHSC), Southwest Foundation for Biomedical Research (SFBR), Dialysis Clinic Inc (DCI), and the National Institutes of Health (NIH) to establish a research consortium, the Zuni Kidney Project (ZKP). The goal of the ZKP is to reduce the burden of renal disease in the Zuni community. The ZKP combines traditional, population-based, epidemiologic methods with modern techniques of population genetics. The foundation of the ZKP is a population-based, cross-sectional survey (PBCSS). The PBCSS has 3 specific aims: (1) estimate the prevalence of renal disease in Zuni; (2) assess risk factors for renal disease susceptibility; and (3) identify participants for planned case-control, longitudinal cohort, and family studies designed to identify environmental, familial, and genetic risk factors for the susceptibility and/or progression of renal disease. Preliminary results of the PBCSS confirm that the epidemic of renal disease in Zuni Indians is due to high rates of both diabetic and nondiabetic renal disease.

Adolescent↗

Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa).

Outcome following cardiac arrest and cardiopulmonary resuscitation is dependent on critical interventions, particularly early defibrillation, effective chest compressions, and advanced life support. Utstein-style definitions and reporting templates have been used extensively in published studies of cardiac arrest, which has led to greater understanding of the elements of resuscitation practice and progress toward international consensus on science and resuscitation guidelines. Despite the development of Utstein templates to standardize research reports of cardiac arrest, international registries have yet to be developed. In April 2002 a task force of ILCOR met in Melbourne, Australia, to review worldwide experience with the Utstein definitions and reporting templates. The task force revised the core reporting template and definitions by consensus. Care was taken to build on previous definitions, changing data elements and operational definitions only on the basis of published data and experience derived from those registries that have used Utstein-style reporting. Attention was focused on decreasing the complexity of the existing templates and addressing logistical difficulties in collecting specific core and supplementary (i.e., essential and desirable) data elements recommended by previous Utstein consensus conference. Inconsistencies in terminology between in-hospital and out-of-hospital Utstein templates were also addressed. The task force produced a reporting tool for essential data that can be used for both quality improvement (registries) and research reports and that should be applicable to both adults and children. The revised and simplified template includes practical and succinct operational definitions. It is anticipated that the revised template will enable better and more accurate completion of all reports of cardiac arrest and resuscitation attempts. Problems with data definition, collection, linkage, confidentiality, management, and registry implementation are acknowledged and potential solutions offered. Uniform collection and tracking of registry data should enable better continuous quality improvement within every hospital, EMS system, and community.

Adult↗

Biotechnology in Switzerland and a glance at Germany.

The roots of biotechnology go back to classic fermentation processes, which starting from spontaneous reactions were developed by simple means. The discovery of antibiotics made contamination-free bioprocess engineering indispensable, which led to a further step in technology development. On-line analytics and the use of computers were the basis of automation and the increase in quality. On both sides of the Atlantic, molecular biology emerged at the same time, which gave genetic engineering in medicine, agriculture, industry and environment new opportunities. The story of this new advanced technology in Switzerland, with a quick glance at Germany, is followed back to the post-war years. The growth of research and teaching and the foundation of the European Federation of Biotechnology (EFB) are dealt with. The promising phase of the 1960s and 1970s soon had to give way to a restrictive policy of insecurity and anxiousness, which, today, manifests itself in the rather insignificant contributions of many European countries to the new sciences of genomics, proteomics and bioinformatics, as well as in the resistance to the use of transgenic agricultural crops and their products in foods.

Agriculture↗

Conceptual foundations of schizophrenia: I. Degeneration.

OBJECTIVE: This is the first of two papers that aim to identify some of the institutional processes of 19th century European psychiatry, and some prevailing cultural themes of that era that played a role in shaping the development of schizophrenia as a disease concept. METHOD: Three areas of psychiatric history are examined: the first is concerned with the key figures who coined the concept of dementia praecox; the second with the rise of the asylum; and the third is to do with the ideology of 19th century psychiatric science and its relationship to a broader intellectual milieu. These three literatures are examined for common themes. RESULTS: The theme of degeneration is evident in all three literatures, and denotes both a biological process (neuro-degeneration) and a moral state (degeneracy). CONCLUSIONS: The idea of degeneration, a pervasive cultural theme of the 19th century, dominated psychiatric thinking long before schizophrenia was developed as a diagnostic category. It contributed to the ideational form-work that gave foundation, structure and shape to the concept of schizophrenia.

Disease Progression↗

Civilization as a threat to human health?

Civilization can be defined as the distinctly human attributes and attainments of a particular society. In general, the development of civilization is viewed as a positive step for the well-being of the human species, leading to an increased duration and quality of human life. The accelerated progress of civilization (mainly industrialization, urbanization and nutrition) has lead to new possibilities for adverse effects on human health. A collection of problems referred to as 'civilization diseases' has become the subject of serious concern but review of available data indicates that this concept appears to add very little to our understanding of modern environmental influences on human health. Important limitations in the continued use of this term are its non-specificity, the lack of a unifying scientific foundation, and provision of virtually no direction for remediation of these diseases or for future research. In addition, the use of this term has been localized to primarily post-socialist European countries. In view of these limitations, it seems more productive for scientists, in all parts of the world, to embrace the discipline of environmental health science and to discontinue use of the term "civilization diseases".

Civilization↗

Certain aspects of medical research and its support.

The origins of the National Institutes of Health (NIH) are linked with European science. Few Americans had participated in the advances in bacteriology led by Koch and Pasteur when a laboratory from which the NIH eventually developed was established in New York in 1887, but its first director patterned this laboratory after ones already established in Germany, France, and England. The era of modern biomedical research in the United States began during World War II with the cooperation of government and nongovernment (mostly academic) research laboratories. Today, the philosophical foundation underlying all research-supporting programs of the NIH is that a close connection exists between improved medical care and research and that any expansion of medical facilities must be accompanied by an expansion of medical training and research. In addition, government grants should not interfere with the freedom and integrity of academic institutions and should allow scientists complete independence in determining the nature, scope, and methodology of their investigations. Discoveries in genetics in the 1950's and 1960's heralded an era of science in which it was necessary to address major questions with immediate relevance to human health. Impelled by pressure from the public, the scientific community, and the Congress, the NIH participates in formulating safety guidelines regarding potential applications of biotechnology. The annual increase in funds appropriated by Congress to the NIH attests to a high level of public commitment to the support of biomedical research and underlines the degree of accountability to which the NIH is subject.

History, 19th Century↗

The attack of the clones: patent law and stem cell research.

This article considers the integral role played by patent law in respect of stem cell research. It highlights concerns about commercialization, access to essential medicines and bioethics. The article maintains that there is a fundamental ambiguity in the Patents Act 1990 (Cth) as to whether stem cell research is patentable subject matter. There is a need to revise the legislation in light of the establishment of the National Stem Cell Centre and the passing of the Research Involving Embryos Act 2002 (Cth). The article raises concerns about the strong patent protection secured by the Wisconsin Alumni Research Foundation and Geron Corporation in respect of stem cell research in the United States. It contends that a number of legal reforms could safeguard access to stem cell lines, and resulting drugs and therapies. Finally, this article explores how ethical concerns are addressed within the framework of the European Biotechnology Directive. It examines the decision of the European Patent Office in relation to the so-called "Edinburgh patent", and the inquiry of the European Group on Ethics in Science and New Technologies into "The Ethical Aspects of Patenting Involving Human Stem Cells".

Animals↗

Report on the first congress of the Spanish Proteomics Society.

This report describes the first congress of the Spanish Proteomics Society (SEProt) and the Foundation Meeting of the European Proteomics Association (EuPA), which were held in Cordoba, Spain, February 13-17, 2005. The EuPA meeting joined together thirty European representatives from 17 national European proteomics organisations to discuss the opportunity of creating a supranational association aimed to promote all aspects of proteomics as a scientific discipline throughout Europe. The main subjects of the SEProt congress, which was attended by over 350 researchers mainly from Spain and other European countries, were the current status and applications of proteomics in medical and biological sciences.

Congresses as Topic↗

[125th anniversary of the Serbian Medical Society].

Serbian Medical Society was founded on April 22, 1872. Foundation initiators were physicians of the following nationalities: 5 Serbs, 3 Czechs, 2 Poles, 3 Germans, 1 Slovak and 1 Greek. Josip Pancić was one of its founders as well, and the first president of the Serbian Academy of Sciences and Arts. Dr. Aćim Medović was elected its first President at the Inaugural Assembly, and Dr. Vladan Dordević its Secretary. Later, on October 17, 1874 Constitution of the Serbian Medical Society was passed and its was acknowledged by the Serbian Interior Minister. The first professional meeting was held on August 5, 1872, when they started the first medical journal named "Serbian Archives for All Physicians" ("Srpski arhiv za celokupno lekarstvo") that is being published regularly even today. At the proposal of SLD a Law on Medical Protection was passed (1881). This Law was translated into two European languages, German and French, and sent to be reconsidered by 400 towns throughout Europe. This Law included, beside the other things, the following: "...penny intended for health cannot be spent either by King, or by the Government or by any political party because it is intended for the health, tratement of the sick and doctors' salaries..." The first Congress of the Serbian physicians and scientists devoted to natural sciences was held in Belgrade from 5th to 7th of September, 1904, and it gahtered about 433 participants, among which over hundred were from abroad. In 1907 SLD organized in Belgrade "The First Scientific Conference of Yugoslav Doctors for Operating Surgery". Red Cross in Serbia was founded upon the initiative of SLD. The first initiative to establish the School of Medicine in Belgrade was given by SLD as well. Members of SLD proved their loyalty and devotion to their people, democracy and liberty during liberation wars in XIX and XX century by putting themselves in service of the sich and wrecked. Today, SLD realizes its professional activity through the work of 76 specialized sections, over 100 branches throughout the Republic of Serbia and the Medical Academy of SLD. Specialized sections publish 11 specialized medical journals. We want to emphasize that the Serbian Medical Society has remained, since its foundation, a non-governmental and apolitical organization.

History, 19th Century↗

[Clinical research: where does it come from? Where is it going?].

In this editorial the author examines briefly the past, present and future of clinical investigation in general and particularly in Switzerland, where the same problems are encountered as in other European countries and North America. The main problems reside in the fragmentation of internal medicine into subspecialities with their own separate meetings and journals, at the expense of multidisciplinary sources of information on medical progress, thus widening the gap between the practitioners and the scientific community. Through examples, it is pointed out that the progression of medical knowledge follows the path from basic research in biochemistry, cellular biology, animal experiments, clinical investigation and finally clinical medicine not unidirectionally but bidirectionally. Thanks to the Swiss National Science Foundation, the Medical Schools of the five Universities and many private foundations, a considerable effort has been made in past decades to foster basic and clinical research, resulting in a most favorable position for our country on the international scene. There is a fear that political and administrative decision could jeopardize the present situation and imperil the future. Finally, citing Osler from his work "Aequanimitas", the author stresses that "the true test of a nation's life... is to be found in its intellectual and moral standards", and that "the measure of the value of a nation to the world is neither the bushel nor the barrel, but mind".

Clinical Trials as Topic↗

[Federal Department of Health and Environment and its connection with the Academy of Medicine at Belgian and international levels].

Point of departure of the lecture is the note "Activities of the Royal Academy of Medicine of Belgium", written by professor Lacquet on 15 April 1994, in which he outlines the statutory links of the Academy with the federal administration. After having questioned the truly federal status of the National Foundation for Scientific Research and the Foundation for Medical Scientific Research, the links between the Academy and the federal ministry of Health are reaffirmed by the author with regard to the matters enumerated in article 2 of the statutes of the Academy. Subsequently the author discusses the international treaties and relations with its ensuing obligations for the ministry of Health. The obligations are in many cases shared with the Communities and the Regions. The author mentions: the bilateral agreements with regard to health care and medical sciences, concluded with twelve countries, the BENELUX, the European Union, NATO, the European Council and the WHO. In conclusion the author stresses that there remain only few formal links between the Academy and the federal ministry of Health, but that functional relations concerning important health matters still exist.

Academies and Institutes↗