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PubMed2002

Ageing research in Greece.

Ageing research in Greece is well established. Research groups located in universities, research institutes or public hospitals are studying various and complementary aspects of ageing. These research activities include (a) functional analysis of Clusterin/Apolipoprotein J, studies in healthy centenarians and work on protein degradation and the role of proteasome during senescence at the National Hellenic Research Foundation; (b) regulation of cell proliferation and tissue formation, a nationwide study of determinants and markers of successful ageing in Greek centenarians and studies of histone gene expression and acetylation at the National Center for Scientific Research, Demokritos; (c) work on amyloid precursor protein and Presenilin 1 at the University of Athens; (d) oxidative stress-induced DNA damage and the role of oncogenes in senescence at the University of Ioannina; (e) studies in the connective tissue at the University of Patras; (f) proteomic studies at the Biomedical Sciences Research Center Alexander Fleming; (g) work on Caenorhabditis elegans at the Foundation for Research and Technology; (h) the role of ultraviolet radiation in skin ageing at Andreas Sygros Hospital; (i) follow-up studies in healthy elderly at the Athens Home for the Aged; and (j) socio-cultural aspects of ageing at the National School of Public Health. These research activities are well recognized by the international scientific community as it is evident by the group's very good publication records as well as by their direct funding from both European Union and USA. This article summarizes these research activities and discuss future directions and efforts towards the further development of the ageing field in Greece.

Aging↗

PubMed2004

[Spanish scientific output in medicine in the years 1994-1999].

OBJECTIVES: A study through bibliometric indicators of the 1994-1999 Spanish international medical scientific output is presented. METHOD: The international bibliographic databases Science Citation Index and Social Sciences Citation Index were used as data source. RESULTS: The Spanish production in Health Sciences rose in the period studied to 53,878 documents, distributed between Basic Medicine (54%), Clinical Medicine (53%) and Social Medicine (2.7%). Among the Spanish communities with greater production Madrid (31%) and Catalonia (29%) pointed out, followed by Andalusia (12%) and Valencia (9%). The principal institutional sectors involved in research were hospitals (51%) and university (44%). An important increase in the publications from foundations and companies was observed. The disciplines of Biochemistry/Molecular biology, Internal/General medicine and Pharmacology/Pharmacy pointed out by their high production. With regard to the centers of greater production its increase during the period studied, the clinical or basic character of research and the average impact factor of their documents shown to detect centers of excellence. CONCLUSIONS: The analysis carried out shows the growth of clinical and social Medicine, makes possible to identify the principal actors in Health Sciences, detect centers of excellence in the disciplines, and analyze the specialization of Spain in the European context. The publications are more abundant in the journals of the first quartile of each specialty.

Bibliometrics↗

PubMed1994

[The evolution theory in the medical sciences in Chile].

The evolutionist ideas of Lamarck, Darwin and Haeckel entered the country through the arrival of their books. "On the origin of Species" arrived in Chile in 1869. The most outstanding immigrant european physicians that discussed these ideas were Rodulfo A Phillippi (1808-1904) and Juan José Brunner (1825-1899). Both discussed Darwin's ideas in their books and conferences as academics of the Faculty of Medicine of the University of Chile. The first Chilean physicians that read and discussed the validity of evolution theory were Adolfo Valderrama (1834-1902) and Pedro Candia Salgado. Both wrote articles about this matter in Revista Médica de Chile in 1872 and 1874. The professor of general biology, Juan Noé Crevani, italian physician and zoologist that arrived in Chile in 1912, was the first to teach directly the concepts of the evolution theory until his death in 1947. Professor Noé founded the great biological school of the twentieth century in Chile and his disciples introduced the concepts of Mendelian theory and neodarwinism in the decade of fifties. The theory of evolution was taught as a chapter of general biology in the Faculty of Medicine between 1913 and 1947, but its practical applications to medicine were introduced with the birth of medical genetics in the decade of fifties and the foundation of Chilean Genetics society in 1964, under the direction of professors Danko Brncic and Gustavo Hoecker, both awarded with the National Sciences Prize.

Biological Evolution↗

PubMed2002

Two decades of "research-practice" encounters in the development of European therapeutic communities for substance abusers.

In 1981, a "research-practice" breakthrough was realized through the foundation of the European Federation of Therapeutic Communities (EFTC). Since its foundation EFTC regularly organized conferences and symposia. A few years later (in 1983), the European Workshop On Drug policy Oriented Research (EWODOR) was established at the Erasmus University in Rotterdam, including a special section devoted to the therapeutic community (TC). The authors examined the proceedings of all meetings organized by EFTC and EWODOR. The major topics presented throughout the last 20 years are highlighted in a chronological selection and these presentations largely focus on the challenges of the TC and the state of the art regarding scientific knowledge. In this overview only those authors who published articles in scientific journals indexed in the "Web of Science" (Institute for Scientific Information-ISI) were retained. Although research has never been the primary consideration in TCs, it played a far from negligible role in its development. Research findings prompted innovations and thus often provoked resistance, but on the other hand they functioned as a catalyst between the necessity of a belief system and the reality of society. The role of "grey" literature and the availability of information through the Internet will become more and more important in the communication between researchers and practitioners.

Communication↗

PubMed2005

Freedom in responsibility: on the relevance of "sin" as a hermeneutic guiding principle in bioethical decision making.

This essay deals with questions of responsibility concerning technology, in particular, gene technology and the special problem of research on embryos. I raise issues concerning the extent of humans' authority to act and the limits of human freedom. In what way is that freedom given, and what kind of responsibility results from it? By discussing various concepts of human freedom in the tradition of European philosophy, as juxtaposed to the Protestant understanding of freedom, this essay discusses the restricting limits, and the obligation to take responsibility. It will turn out that the question concerning freedom cannot be answered without understanding what being human involves. From a Christian perspective, this implies that the foundational relationship between human freedom and sin will be central to an assessment of the human ability to take responsibility. By obliterating the limits of human freedom, sin jeopardizes the very essence of that freedom. The project of taking into account the sinful state of the human condition thus aims at developing a realistic picture of the authority of humans in action, even in view of the human tasks of promoting science and research.

Bioethics↗

PubMed1999

John Whitridge Williams' contribution to democracy abroad. (The fetus treated as a patient).

The idealism of American pioneers was a driving force in the development of science, democracy, and sociology in the United States. It also served as a model for the development of new democracies abroad. The first American grafted democracy was established in Czechoslovakia in 1918, under Thomas Garrigue Masaryk as President. As a former professor of philosophy, at Charles University in Prague, he built the foundation of Czechoslovakian democracy on the historical principles of Jan Hus' search for the truth (1415), Jan Amos Komensky's use of Science and Humanism (1630), and on the values of American democracy as he conceived it from multiple visits to the United States and from the practical philosophy of his American wife. His major educational means was the use of science. He became a founder of political science. As president he recognized, that democracy, as a state form, does not educate people, they educate themselves through family, school, church, physician and life experience. In the last quarter of the nineteenth century, on the eve of the opening of John Hopkin's University Hospital, a young American scientist by the name John Whitridge Williams came to Prague, Vienna, and other Europeans cities for the purpose of studying scientific obstetrics. He believed in the power of the truth in the power of the truth equally as Masaryk did and used science uncompromisingly in his speciality. He became the founder of American scientific obstetrics. He was shy of political science and ethnic problems. There was no personal connection between Masaryk and Williams. In 1903, John Whitridge Williams published his review of European and American obstetrics: he abolished the craft of obstetrics and worked the science of physiology and pathology into the practice of obstetrics. For Czechoslovaks the political democracy coming out of America through Masaryk was attractive, but of particular interest was native and personal democracy of Americans as a way of life. John Whitridge Williams' book contributed to European families, even though only through obstetricians, the knowledge about American pioneering, optimism, humanism, and a sense of freedom Williams considered the fetus as a patient and thought of education of the physician and patient of equal and fundamental importance: the mother was to participate in the process and the physician to understand the process. He himself understood feto-placental circulation, maternal metabolism, and the need of maternal participation on fetal development. He commanded physicians' respect of the patient and committed the obstetrician to the life long study of his patients. He considered research inseparable from intelligent care, and his book a guide of how and what to study, not a manual of procedures. Williams' greatest contribution to mankind was abolishing the craft of obstetrics and replacing it by sciences that brought to obstetrics humanism, selflessness, and knowledge. He was the first physician in the history of obstetrics who achieved a balance of science and humanism. The second contribution, of equal importance, was his undertaking a scientific review of European and American obstetrics which served the world as a window of the values of America's pioneer civilization. It made obstetrics a scientific discipline, attracted innumerable new students abroad, and through them promoted American democracy in their relations with patients. Williams' impact on European society was considerable. However, subtle at first, it was not included in the literature. He did not participate personally in the establishment of democracy in Czechoslovakia, but strengthened Masaryk's teaching programs through those Czechoslovakian obstetricians who adapted his scientific teachings and made him a model of American democracy as a view on life. Masaryk himself had in his presidential emblem a sign, veritas vincit, and through it, he accomplished twenty years of the most extraordinary democracy in the world.

Czechoslovakia↗

PubMed2000

Human is what is born of a human: personhood, rationality, and an European convention.

In the course of its preparation, the 1997 convention on human rights and biomedicine adopted by the Council of Europe instigated a widespread debate. This article examines one of the core issues: the notion of the human being as depicted in the convention. It is argued that according to the convention, this being may exist in three different legal categories, namely 'human life', 'embryo', and 'personhood', each furnished with an inherent set of somewhat different rights, yet none of them clearly defined, thus leaving it to domestic law to regulate at what point a human being belongs to which category. While this approach is understandable from a political point of view, it creates a vicious circle, since law thereby has to define its own foundation and, in the case of the convention, to protect a being that it cannot define. It appears that this form of life is seen rather as a given entity, taking precedence over the interests of society and science, and its dignity and identity forming criteria for the subsequent systems of culture, simply because this life is human and nothing else. Thus, the convention approaches a natural law position.

Bioethics↗

PubMed1988

Medical ethics and the Islamic tradition.

After tracing the main features of the foundational ethical perspectives and their relationship to the rise of medical practice in early Islam, the paper focuses on the development of the moral concept of adab. This concept served as an important tool in defining and shaping an ethical tradition based on the integration of the Hippocratic tradition into Muslim medicine and its underlying moral values. The existence of plural therapeutic systems and their moral and theological sources are also noted and an attempt is made to show how all of these diverse modes co-existed through most of the pre-modern history of medicine among Muslims. The paper ends by outlining the impact the European colonial and cultural encounter with the World of Islam had, in creating a duality in medical practice, education and institutions, thus limiting sustained and meaningful discourse between modern medical science and the ethical values of Islam.

Cultural Diversity↗

PubMed2005

LIPGENE: an EU project to tackle the metabolic syndrome.

LIPGENE is a new 5-year sixth framework EU project involving researchers from 14 EU countries. It will contribute to a reduction in the economic and social burden of the metabolic syndrome through research that will optimise the health impacts of dietary fat change. LIPGENE aims to: account for variation in genotype response to fatty acid modification; enable greater availability of food products that can enhance human health; enhance consumer awareness, and motivate adoption of dietary approaches to disease prevention. A truly integrated programme, LIPGENE incorporates human nutrition, animal nutrition, plant biotechnology, and economic and social/consumer sciences. The human nutrition packages will utilise data from an existing prospective study (SUVIMAX) to identify genotype and dietary interactions as risk factors for the metabolic syndrome. A multi-centre intervention will examine the effects of dietary fat on various risk factors for the metabolic syndrome, while molecular investigations will be supported by mechanistic and functional studies. The British Nutrition Foundation, as dissemination partners for this EU programme, is initiating a wide-reaching programme to disseminate information about the project and its findings. Further details, including lists of upcoming project-related events, are available at www.lipgene.tcd.ie and www.nutrition.org.uk/lipgene.

Agriculture↗

PubMed2000

AIDS meeting. Companies, donors pledge to close gap in AIDS treatment.

Although basic science and clinical research typically dominate at this biennial event, by far the most riveting sessions at the XIII International AIDS Conference here revolved around the thicket of issues that prevent poor people in sub-Saharan Africa--where a staggering 24.5 million people are estimated to be infected with HIV--from receiving the 14 anti-HIV treatments now used in wealthy countries. Pharmaceutical companies and donors last week loosed a flood of promises about removing barriers. Conference attendees welcomed the offers of help, but many stressed that much more will be needed.

Acquired Immunodeficiency Syndrome↗

PubMed2026

The Continuity Trap in Data Science Health Research.

Secondary use is now the ordinary condition of data science health research rather than an exception to it. Electronic health records collected for clinical care become prediction tools and inputs for generative AI; imaging archives become foundation-model corpora; genomic datasets become resources for polygenic risk scores; and legacy biospecimens become renewable, indefinitely distributable cell lines. Governance has responded by emphasizing verifiable instruments such as provenance logs, repository approvals, broad-consent forms, data-use agreements, model cards, records of processing, and locality-preserving architectures. These instruments are necessary, and they answer real questions about lineage, privacy, institutional responsibility, and accountability, but they are not sufficient to establish that a present use remains ethically justified. We define ethical continuity as the persistence of normatively relevant relationships between the original conditions of data generation or material collection and subsequent downstream uses, such that current uses remain justifiable in light of the expectations, permissions, meanings, and relational obligations present at entrustment. We then define the Continuity Trap as a review-stage governance error in which a salient signal of continuity in one domain is treated as sufficient evidence of ethical continuity overall, causing inquiry into the remaining domains to close prematurely. The trap is not ordinary noncompliance, ethics creep, or a demand for universal rereview; it is a cross-domain inference error that can arise even in careful, good-faith review. We distinguish it from proxy closure, of which it is a continuity-specific subtype, and from Goodhart's and Campbell's laws, which describe how measures degrade once they become targets. We operationalize ethical continuity across 4 domains: provenance, semantics, authorization, and relational standing, developed in our Representational Veracity framework, and we show that these domains can diverge as data are linked, transformed, modeled, and redeployed. We identify the institutional mechanisms-provenance privilege, descriptor sedimentation, authorization fossilization, and community effacement-that cause auditable signals to be overread, and we examine how the US Health Insurance Portability and Accountability Act (HIPAA) of 1996, the General Data Protection Regulation, the European Health Data Space, US Food and Drug Administration guidance, the US National Institute of Standards and Technology (NIST) AI Risk Management Framework, and federated-learning governance can reduce risk while still inducing continuity traps. We apply the framework to consent and nonconsent settings, including public health, immunization, syndromic, and wastewater surveillance, polygenic risk scores, induced pluripotent stem cells, federated learning, and health-related large language models. The policy implication is trigger-based continuity review: rather than rereviewing every reuse, investigators and reviewers should identify the weakest continuity domain at the present data stage and impose a domain-matched safeguard, recorded in a short continuity statement. This reframing is intended for the committees, repositories, funders, and governance bodies that decide whether reuse may proceed, and it matters most in cross-border and low-resource settings. Provenance should begin ethical review; it should not end it.

Data Science↗

PubMed2002

[The age of formation of Czech clinical medicine].

Era of Emperor Francis Joseph I is said to be a golden age for the Czech nation. It can be found in numerous panegyric articles to any jubilee of the emperor's rule. What was formally dictated by respect brought by education and by the system of the Greek and Roman tradition adopted in Austria in Middle Ages, seams to be valid today as most of the contemporary technical and economical progress roots within those days. The Czech cultures namely music and art reached international acknowledgement. Though with difficulties, Czech achieved in education and in science as a full-fledged language. After the year 1848 an average citizen was entitled to such freedom as never before. Technical, economical and cultural progress enabled real ascent of the Czech society and its social differentiation. In sixties, after the Austria-Hungary Alignment, Hapsburg government undertook no serious restrains. Such development was nothing unusual. Similar one underwent after the period of storms all European societies from south to north and form west to east. They brought ideas of the French revolution and years 1848/1849 are therefore called "the spring of European nations". In all countries where revolutionary ideas were represented and various countermeasures were accepted, governments were forced to accept temporary arrangements (in Austrian monarchy it was the promise of constitution, language compromise etc.). Nevertheless, in the second half of the 19th century the most important condition for further revival was the long period of peace and stability of international relations. The internal stability of the Austrian monarchy was achieved for long time by the Austria-Hungary Alignment in 1867. After the lost battle at Hradec Kralove in summer 1866 it became clear that contemporary centralistic organization of the state, balancing between absolutism and constitutionalism is not further tenable. Years long pressure of patriotic forces in the parliament brought about division of the Charles-Ferdinand University. Important role in the partition of the Czech Medical Faculty from the German one had the foundation of the Czech Medical Society and the Czech Medical Journal in 1862 patronaged by professors Purkynĕ, Eiselt, Grégr and others. That was the platform for the conception of the Czech medical terminology. Partition of faculties was decided by the law, which was accepted at February 28, 1882. The Czech Medical Faculty was opened only at 1883 because Emperor resolved that professors themselves had to decide to either faculty their clinics would belong. Only professor Eiselt with the First clinic of internal medicine, Weiss with the clinic of surgery and Streng with clinic of obstetrics were assigned to the Czech faculty. Till the official opening on October 15, 1882 all other departments and clinics had to be organized. Though Professor Vilem Weiss as the head of the department and dean of the faculty had his opening Czech lecture already on April 28, 1882, due to material and personal reasons the Czech Medical Faculty was opened only one year later than Faculties of law and philosophy. Most of the eminent members of the Medical faculty remained at the German faculty. However, having higher number of students the Czech faculty became larger and was attended by students from the whole Slavonic world.

Austria↗

PubMed2006

Shadow of Buddhism and Shintoism in neurosurgical practice in Japan.

BACKGROUND: In Japan, almost all culture and civilization were introduced from abroad; in the past from China and now from U.S. and European countries, owing to her geographical features circumscribed by oceans and separated from the continents. Neurosurgical science and practice have been received in the same way as other activities. However, there are some exceptions such as organ transplantation from the brain dead and brain-dock, which means a brain check-up system of asymptomatic brain diseases. Reasons why these are practised or not in Japan are considered from the viewpoint of Buddhism and Shintoism. If our special practises could appeal to people in other countries, our neurosurgical philosophy might become widespread and welcome worldwide. FINDINGS: Organ transplantations from brain dead have routinely been performed in many countries, while only 37 cases have been executed in Japan, after the Japanese government accepted its application in 1997. In contrast, brain-dock is widely practised without any national insurance systems, while this is rarely practised in other countries. It seems to me that Buddhism and Shintoism have influenced on these special situations, due to extreme fear and impurity of the dead body and a way of comprehending the oneness of body and mind, and also deep concern for the impact of their diseases to their families rather than for themselves. SUMMARY: We neurosurgeons should realize that our profession is directly related to ultimate human sufferings such as aging, disease, and death, as pointed out by Gautama Buddha. We are in fact in a position to study the real way for resolution of the human sufferings, mentally and physically. Based on our experiences, the foundation of a new academic discipline like "cultural medical science" should urgently be considered in all parts of the world and in light of individual cultural, economical, geographical, and population problems.

Attitude to Death↗

PubMed2025

Triazole-resistant Aspergillus fumigatus in the Netherlands between 1994 and 2022: a genomic and phenotypic study.

BACKGROUND: Aspergillus fumigatus is the main cause of invasive aspergillosis and triazole antifungals are the primary treatment option. The effectiveness of triazole therapy is hampered by the emergence of resistance, mainly caused by mutations in the cyp51A gene and a tandem repeat (TR) of 34 bases (TR34/Leu98His) and 46 bases (TR46/Tyr121Phe/Thr289Ala) in the promoter region, which correspond with signature triazole resistance phenotypes. We aimed to investigate the occurrence of triazole phenotype and genotype variation over a 29-year period in the Netherlands. METHODS: In this genomic and phenotypic study, we screened all clinical A fumigatus isolates from Dutch hospitals collected between Jan 6, 1994, and Dec 31, 2022, for resistance to triazole using agar-based methods, and characterised them by sequencing the cyp51A gene and in vitro susceptibility testing using the European Committee on Antimicrobial Susceptibility Testing reference method. Whole-genome sequencing was performed on selected isolates, including those harboring TR34 variants, high-frequency single-nucleotide polymorphisms, and wild-type strains. Clinical information such as age, underlying disease, diagnosis, therapy, and outcomes was collected for patients who had isolates cultured at the Radboud University Medical Centre, Nijmegen, Netherlands, between Jan 1, 2017, and Dec 31, 2022. FINDINGS: 1979 (15·6%) of the screened 12 679 A fumigatus isolates harboured cyp51A triazole resistance mutations, predominately TR34/Leu98His sensu stricto in 1338 (67·6%) resistant isolates and TR46/Tyr121Phe/Thr289Ala sensu stricto in 332 (16·8%) resistant isolates. Phenotype and genotype variations were observed in 325 (17·2%) triazole resistant isolates harbouring a TR-resistance mechanism, including 12 cyp51A genotype variants. Whole-genome sequencing showed that isolates with combinations of TR34-based and TR46-based polymorphisms seemed to be derived from separate populations, but there was some overlap. 59 cases of proven or probable invasive aspergillosis were identified, including 13 triazole-resistant cases, of which three were caused by genotype variants. Mixed genotype infection was observed in 11 (84·6%) of 13 triazole-resistant patients and the number of antifungal treatment switches was higher compared with triazole-susceptible disease (p<0·0001). INTERPRETATION: Our study showed variation in triazole genotypes and phenotypes in clinical A fumigatus isolates with cyp51A-mediated resistance, some of which were cultured from triazole-resistant invasive aspergillosis cases. Triazole resistance variation and mixed A fumigatus genotypes represent a major challenge in clinical management of Aspergillus diseases because current molecular diagnostic tools will increasingly fail to predict the resistance phenotype, underscoring the need for improved detection methods. FUNDING: National Key Research and Development Program of China, National Natural Science Foundation of China, and Wellcome Trust.

Aspergillus fumigatus↗

PubMedDate not supplied

[125 years' of the Serbian Medical Society].

In the second half of the last century and under the influence of the European civilization, Serbia abandoned the conservative and patriarchal way of life and began to introduce a new, contemporary political, cultural and social spirit into the country. The development of these civilizing features was under the influence of young intelectuals who, as former scholarship holders of the Serbian government, were educated in many European countries. Among them, there was a group of physicians who returned to the country after having completed their education. They were carriers and holders of the contemporary medical science in Serbia and the neighbouring areas. On April 22, 1872 a group of 15 physicians founded the Serbian Medical Society with the intention to offer an organized medical help and care to the population. The first president was Dr. Aćim Medović and the first secretary Dr. Vladan Dordević. At the meeting held on May 15, 1872 the text of the Statute of the Society was accepted and immediately submitted for approval to the Ministry of Internal Affairs. In the letter addressed to the minister of internal affairs the following reasons were cited: "... The Belgrade physicians feeling a need for having the main office for their professional and scientific meetings, for which they will find the opportunity and the funds, and in spite of their hard medical labor which requires almost all their time, decided to establish the Serbian Medical Society because they wish to be in trend and follow-up the medical progress and exchange the latest medical information not only among them but also with other graduated doctors living in areas with the Serblan population as well as with all scientists who are willing to contribute to the development of medical science in Serbia...". In the first year of its existence the Serbian Medical Society had 9 regular members, 1 honorary member and 34 corresponding members from Serbia, Slavic and other foreign countries. On August 5, 1872 it was decided to start the publication of a professional journal "Srpski arhiv za celokupno lekarstvo" (Serbian Archives of General Medicine). The journal has still been edited. On suggestion of the Serbian Medical Society the Law of Health Care was promulgated in 1881. It was translated into German and French languages and sent to about 400 addresses in different European countries with the request for their opinion and suggestion. The reply of the Vienna Medical Society was as follows: "... While the Austrians carry out some stupid regulations of health care, at the same time a small Balkan country, Serbia promulgated a Law according to which no one, including the King, the Government or a political party dare not use a cent intended for health service, treatment of the sick people and payment of physicians...". On the occasion of the centenary of the First Serbian insurrection and coronation ceremonies of the King Petar I Karadjordjević, and under the King's patronage, the First Congress of Serbian physicians and naturalists was organized from 5 to 7 September 1904. There were 433 participants of whom more than 100 foreign participants. A Serbian professor of infectious diseases at the University School of Medicine in Vienna, Dr. Jovan Cokor, presented a paper with results of his studies of tuberculosis according to which tuberculosis could be transmitted from a sick cow to man; in this way he complemented the results and explanations of Dr. Robert Koch who discovered Mycobacterium tuberculosis. In 1907 the Serbian Medical Society organized in Belgrade the First meeting of Yugoslav surgeons. At that time, the foundation of a University school of medicine was planned. The Serbian Red Cross Organization was initiated by the Serbian Medical Society in 1876. On February 2, 1891 a procedure was brought for the establishment of the Medical Chamber. Its activity began in 1901. During the First and Second world wars the activity of the Serbian Medical Society was di

History, 19th Century↗