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A leprától a spanyolnátháig.

Szemelvények a medicina egyetemes és magyar vonatkozásaiból, kitekintéssel annak hadtörténeti vonatkozásaira az első világháborúig

Leprosy to Spanish Fever.

Excerpts of the Universal and Hungarian Aspects of Medicine with a View to their Military-Historical Aspects
Scientia et Securitas
Authors: Katalin Mária Kincses and Sándor Szakály

Összefoglaló. A tanulmány az egyetemes és magyar medicina járványtörténeti és hadtörténeti összefüggéseit vizsgálja történeti példák alapján, a kérdés fontosabb vonatkozásainak vázlatát igyekszik megrajzolni. A szerzők megállapítják, hogy a járványtörténet az orvostörténetnek egyik azon fejezete, amelyik a hadtörténelemhez is szorosan kapcsolódik, ily módon a téma a tágabb értelemben vett, korszakokon átívelő védelempolitika tárgykörébe is illeszkedik. A felsorakoztatott példák rávilágítanak, hogy a járványok természetszerűleg a háborúk kísérői voltak, ugyanakkor azok terjedéséhez is hozzájárultak. Az európai társadalmak a történeti korokban a legnagyobb járványokat intézményi szinten csak a katonaság bevonásával, valamint már a középkortól kezdve egészen a legutóbbi időkig csak katonai szigorúságú intézkedésekkel voltak képes megfékezni.

Summary. The foundations of modern medicine were formed during the Enlightenment. Medical treatment in Europe took its present form in the second half of the 19th century, when healing based on observations, experience, idealistic philosophical theories and beliefs were supplanted by medicine based on scientific empiricism due to the turbulent development and specialization of natural sciences. Today, healing is based on basic laboratory research. Hygiene, supported by bacteriological research, has come to the fore in clinical practice. The healing network (hospitals, medical institutions and healing society in general, from doctors to caregivers) and the public health insurance system have been established.

The history of human conflicts coincides with the history of medicine. The history of war and the epidemics that have plagued humanity are an extreme form of both of these. A common feature between ancient and modern societies is that their greatest public health challenge is/was caused by infectious and epidemic diseases, which are/were the leading cause of mortality from time to time. The authors cite examples from epidemiological history and solution strategies in Europe and Hungary. The history of epidemics in the Middle Ages, Early Modern and Modern Ages is one of the chapters of medical history closely related to military history. In this way, the topic naturally fits into the scope of defense policy (military) in a broader sense, spanning the epochs. The examples show that epidemics not only accompanied the wars, but that the movement of soldiers also caused large-scale epidemics in Europe to a large extent or facilitated their spread. At the same time, the solution was in the hands of the armies, the military administration. In the Middle and Early Modern Ages, the only effective way to deal with epidemics, i.e., quarantine, could be implemented and maintained only with the participation of military forces.

In Europe, epidemic management has been changing since the 18th century. At the same time, the greatest epidemics from the 18th century until the end of the First World War could only be curbed at the institutional level with the broad involvement of the army. Military mentality and rigor have been reflected (in a good sense) in effective epidemic management in European culture. From the Middle Ages to the present day, the management and possible curbing of major epidemics, in addition to extensive vaccination efforts, could have been maintained only with the participation of the military.

Open access

Összefoglaló. A klinikai orvosbiológiai vizsgálatok elkezdéséhez a kutatásban részt vevők biztonságát ellenőrző Egészségügyi Tudományos Tanács (ETT) kutatásetikai bizottságainak hozzájárulása szükséges. A járványt csak tudományos eredményekkel lehet legyőzni, ezért kitörésekor gyorsították a COVID–19 kutatási protokollok bírálatát. A koronavírus világjárvány szükségessé tett egy megváltozott kutatási adatkezelést is. A járványok megoldása a megelőzés. Bár a vírusellenes vakcinák adása hamar megkezdődött, ami jelentős tudományos teljesítmény, mégis tudományellenes hullám söpör végig a világon, és a kötelező védőoltások körüli jogi, etikai viták fellángoltak. Áltudományos érvelésekkel félrevezetnek embereket. Az ETT nemzeti kutatásfejlesztési programot javasolt a járvány következményeinek leküzdésére.

Summary. Biomedical research activities are subjects to prior professional-ethical approval. ETT (the Medical Research Council in Hungary) through its research-ethics committees ensures the safety of people and protects their interests and health in various clinical investigations and trials. Thus, science, ethics, and safety cannot be separated in biomedical research. The ETT operates three national ethics committees. The opinions of ethical bodies are binding; clinical and biomedical research may not be initiated without the consent of the relevant ETT committees. This is in line with international regulations. The ETT has published the “Codex of Bioethics. On the concepts and practice of biomedical research” on its website.

When the epidemic broke out, the ETT Presidency initiated immediate legislative changes that allowed for online meetings as well as digital consent to investigations, in addition to the previously exclusive personal ones. In the epidemic, time became the determining dimension, but this and the aim of the research could not be combined with such “lightening” that would endanger the safety and interests of the participants in the COVID studies. Thus, under the still strict requirements, the time for reviewing the COVID-19 protocols had to be radically shortened. However, the ETT research ethics committees also rejected submissions during the epidemic. A total of 171 COVID-19-related research protocols were approved in Hungary in 2020. The ETT Presidency initiated a national Research and Development program on infectious diseases, a call for scientific clinical R&D proposals on COVID-19, and also elaborated its priorities.

Throughout human history, the solution to epidemics has always been to prevent the spread of disease through vaccinations. The average production time for traditional vaccines is about 15 years, whereas in the year of the SARS-CoV-2 virus pandemic outbreak, mass vaccinations began with completely new coronavirus vaccines partly made using brand new molecular biology technology that had never been used before. Despite the tremendous professional scientific achievements, a wave of hostilities is sweeping across the world, and the ethos and successes of science, and scientific communities in research are being questioned when their roles are dominant and outstanding. The concept of compulsory vaccination has been arguably classified as a human right. With this, the world of vaccinations was tied to concepts that it really had nothing to do with. Arbitrary pairing and joint treatment of remote concepts favours the spread of fatal diseases such as measles and poliomyelitis, for which there are already vaccines. Meanwhile, pseudosciences are misleading the public.

The coronavirus pandemic has also necessitated changes in data management. The ETT has previously initiated a number of legal and professional proposals on health data management and access to research data, and has developed its own data protection rules following the introduction of the GDPR.

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