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Túl az etikán – a humán kutatások kockázatérzékenysége és pszichológiai aspektusai

Beyond ethics – risk sensitivity and psychological aspects of human research

Scientia et Securitas
Author: Valéria Csépe

Összefoglaló. A humán kutatások eredményeit bemutató közlemények számos adattal szolgálnak a megismerni kívánt jelenségre vonatkozóan. Általánosan elfogadott elvárás a vonatkozó etikai szabályok szigorú betartása, az előírt vizsgálati protokollok betartása. Az emberekkel végzett vizsgálatoknak azonban van egy olyan dimenziója, amelyre az etikai szabályok nem térnek ki, s amelyek a vizsgálati eredményeket, illetve azok reprezentativitását is befolyásolják. Ezek mindegyike a pszichológia vizsgálódási területéhez tartozik, legyen szó a pszichológiai kutatások etikai kérdéseiről, vagy az orvosbiológiai kutatások, orvosi beavatkozások, illetve azok elfogadásának pszichológiai aspektusairól. A tanulmány a pszichológia megváltozott etikai felfogásának rövid bemutatását követően a genetikai kutatások pszichológiai aspektusait és az egészség-magatartás kritikus kérdéseit elemzi. Az utóbbiak esetében a kockázatészlelés, valamint a bizalom, megbízhatóság pszichológiai modelljeiből kiindulva mutatja be az oltási hajlandóság és az oltásellenesség ismert pszichológiai faktorait.

Summary. Publications presenting the results of human research provide a wealth of data on the phenomenon to be explored. It is a generally accepted expectation to adhere strictly to the relevant ethical rules and to the required protocols. However, studies in humans have a dimension that is not fully covered by ethical rules and that also affects the studies’ results and their representativeness. All of these belong to the field of research in psychology, be it the ethical issues of psychological research or the psychological aspects of biomedical research, medical interventions, and their acceptance. Researchers of these and other scientific areas widely believe that science is morally neutral, that is, its task is the discovery of facts, the further development of the investigations’ tools and methods to perform correct analysis and draw reliable conclusions. However, research and development are characterized by a kind of moral neutrality, the essence of which is that the researcher not participating in the decisions on applications is neutral in general. This means that the curiosity driven research should not pay attention to risks associated with the use of results. However, many recent concerns related to the long-term effects of broadly applied inventions speaks for the need on consensus how the consequences could or should be forecasted.

Following a brief presentation of the changed ethical perception of psychology, I give some examples on the psychological aspects of genetic research and that of the critical issues in health behavior. Concerns psychological in nature have been articulated in the last decade and it became increasingly clear that genetic testing can also have psychological factors that must be considered. Moreover, the recent focus on psychological aspects of human research shed light on the complexity of health behavior, and questions have been raised about the known psychological factors of the human reactions to suggested therapies, especially those of the vaccination propensity, rejection, and anti-vaccination movements. Although there are only a few systematic studies on this issue, the proper solutions of the Covid-19 should consider the psychological aspects of the acceptance and rejection of vaccination. We may consider that the first waves of the Covid-19 epidemic created situations requiring altered psychological coping, to which psychological research responded primarily by examining the epidemiological situation, illness, and the resulting psychological aspects of lifestyle (treatment of social isolation, stress management, anxiety, depression). Therefore, scientific data on risk perception and psychological factors of vaccine acceptance may contribute to preparedness for globally predicted epidemics and decision-making processes.

Open access

A COVID–19 patológiája.

Halálok SARS-CoV-2-fertőzésben: vírusfertőzésben vagy vírusfertőzéssel?

Pathology of COVID-19.

Cause of death in SARS-CoV-2 infection: viral infection or other chronic diseases with SARS-CoV-2 (death “in” or “with” COVID-19)
Scientia et Securitas
Authors: Zsuzsa Schaff, Krisztina Danics, Adrián Pesti, Gábor Lotz, Tibor Várkonyi, Deján Dobi, István Vályi-Nagy, Klára Törő, Tibor Glasz, and András Kiss

Összefoglaló. A SARS-CoV-2-pandémia óta a Semmelweis Egyetemen és egyéb intézményekben rendszeresen végeznek boncolásokat, melyek feltárták a COVID–19 jellegzetességeit. A legsúlyosabb kép a tüdőben mutatkozik, melynek légtelensége változó kiterjedésű, oka összetett, így tüdővizenyő, fehérjében gazdag izzadmány, az erek vérrög okozta elzáródása és gyulladás. A szív, a vese, az agy és a máj változó mértékben érintett, érrögösödés, elhalás, degeneratív elváltozások mutatkoznak. A SARS-CoV-2-vírus fehérjéi (tüske, nukleokapszid) és a vírus genetikai anyaga (RNS) kimutatható az egyes szervekben, leginkább a tüdőben. Klinikopatológiai elemzéssel megállapítható, hogy a halál a SARS-CoV-2-fertőzés mint közvetlen kórok következménye, vagy egyéb krónikus megbetegedés, melyet súlyosbított a SARS-CoV-2-fertőzés, vagy a halál a vírusfertőzéstől függetlenül következett be.

Summary. Since the beginning of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic with substantial mortality, serial autopsies at the Semmelweis University Budapest Hungary and other institutions revealed the most characteristic pathological changes and cause of death of patients in Coronavirus Disease-19 (COVID-19). The virus primarily affects the respiratory system and the most severe alterations can be seen in the lungs. The most characteristic changes, however, are non-specific, as the atelectasis of various extents and severe congestion. The alveoli are filled with edema fluid, protein-rich alveolar exudates, often forming hyalin membranes. Diffuse alveolar damage (DAD) can be noted, which have exudative and fibroproliferative forms. The desquamated alveolar epithelial and inflammatory cells which fill the alveolar spaces further block the oxygen transportation, causing hypoxia and induces ventilation problems. Vascular thrombosis and emboli coming from thrombotic vessels from other organs, might involve the small and larger vessels are common findings in COVID-19 sometimes associated with vasculitis. Extended hemorrhages and giant cells are common findings too. Superimposed bacterial infection might cause purulent bronchopneumonia. Aspiration pneumonia, in which remnant of food and parts of filters etc might be present in the bronchi, causing acute bronchopneumonia, occurs specially in intubated patients. Other organs such as the heart, kidneys, the central nervous system and the liver are similarly, though less severely involved by thrombosis, necrotic and degenerative changes. Myocardial fibrosis is common, however usually associated with previous chronic diseases similarly to the findings in the kidneys. Liver steatosis is common, partly as the result of infection, however treatment and previous liver diseases could be in the background too. Smaller and larger cerebral bleedings, cerebral infarcts of various sizes are detected often. The protein components (spike and nucleocapside) of the SARS-CoV-2 could be demonstrated by immunohistochemical methods and the RNA genome of the SARS-CoV-2 by in situ hybridization in several organs, with highest amounts in the lungs. Clinicopathological analyses effectively determine whether the cause of death in SARS-CoV-2 infection had been the direct result of the infection, or any other previously known chronic disease, which had been superposed by the viral infection. However, in certain cases, the death might not be associated with the SARS-CoV-2 infection. The correct determination of the cause of death of the patients with COVID-19 is by consultation between clinicians and pathologists.

Open access

COVID–19 járvány hatása a pszichiátriai megbetegedések gyakoriságára – PTSD

Effects of the COVID-19 pandemic on the incidence of psychiatric illnesses – PTSD

Scientia et Securitas
Authors: Mária Zsóka Bellavics, Zsombor Hermann, and József Haller

Congress of the United States Congressional Budget Office (2012) The Veterans Health Administration’s Treatment of PTSD and Traumatic Brain Injury Among Recent Combat Veterans. https://www.cbo.gov/publication/42969

Open access

A gyógyszerkutatás új irányzatai: hatékonyság és biztonságosság

New directions in drug discovery: safety and efficiency

Scientia et Securitas
Author: András Kotschy

-Karam, N., Pinto, G. P., Poso, A., & Kokkonen, P. (2020) Transcription and Translation Inhibitors in Cancer Treatment. Frontiers in Chemistry, Vol. 8. Article 276. 10.3389/fchem.2020

Open access