From Goya to Afghanistan. An essay on the ratio and ethics of medical war pictures

For centuries pictures of the dead and wounded have been part and parcel of war communications. Often the intentions were clear, ranging from medical instructions to anti-war protests. The public's response could coincide with or diverge from the publisher's intention. Following the invention of photography in the nineteenth century, and the subsequent claim of realism, the veracity of medical war images became more complex. Analysing and understanding such photographs have become an ethical obligation with democratic implications. We performed a multidisciplinary analysis of War Surgery (2008), a book containing harsh, full-colour photographs of mutilated soldiers from the Iraq and Afghanistan wars. Our analysis shows that, within the medical context, this book is a major step forward in medical war communication and documentation. In the military context the book can be conceived as an attempt to put matters right given the enormous sacrifice some individuals have suffered. For the public, the relationship between the 'reality' and 'truth' of such photographs is ambiguous, because only looking at the photographs without reading the medical context is limiting. If the observer is not familiar with medical practice, it is difficult for him to fully assess, signify and acknowledge the value and relevance of this book. We therefore assert the importance of the role of professionals and those in the humanities in particular in educating the public and initiating debate. © 2010 Taylor & Francis

Long non-coding RNA LASSIE regulates shear stress sensing and endothelial barrier function

Blood vessels are constantly exposed to shear stress, a biomechanical force generated by blood flow. Normal shear stress sensing and barrier function are crucial for vascular homeostasis and are controlled by adherens junctions (AJs). Here we show that AJs are stabilized by the shear stress-induced long non-coding RNA LASSIE (linc00520). Silencing of LASSIE in endothelial cells impairs cell survival, cell-cell contacts and cell alignment in the direction of flow. LASSIE associates with junction proteins (e.g. PECAM-1) and the intermediate filament protein nestin, as identified by RNA affinity purification. The AJs component VE-cadherin showed decreased stabilization, due to reduced interaction with nestin and the microtubule cytoskeleton in the absence of LASSIE. This study identifies LASSIE as link between nestin and VE-cadherin, and describes nestin as crucial component in the endothelial response to shear stress. Furthermore, this study indicates that LASSIE regulates barrier function by connecting AJs to the cytoskeleton

The Natural History of Leber Congenital Amaurosis and Cone-Rod Dystrophy Associated with Variants in the GUCY2D Gene

OBJECTIVE: To describe the spectrum of Leber congenital amaurosis (LCA) and cone-rod dystrophy (CORD) associated with the GUCY2D gene, and to identify potential clinical endpoints and optimal patient selection for future therapeutic trials. DESIGN: International multicenter retrospective cohort study. SUBJECTS: 82 patients with GUCY2D-associated CORD and LCA from 54 molecularly confirmed families. METHODS: Data were gathered by reviewing medical records for medical history, symptoms, best-corrected visual acuity (BCVA), ophthalmoscopy, visual fields, full-field electroretinography and retinal imaging (fundus photography, spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence). MAIN OUTCOMES MEASURES: Age of onset, annual decline of visual acuity, estimated visual impairment per age, genotype-phenotype correlations, anatomic characteristics on funduscopy, and multimodal imaging. RESULTS: Fourteen patients with autosomal recessive LCA and 68 with autosomal dominant CORD were included. The median follow-up time was 5.2 years (interquartile range (IQR), 2.6-8.8) for LCA, and 7.2 years (IQR, 2.2-14.2) for CORD. Generally, LCA presented in the first year of life. The BCVA in LCA ranged from no light perception to 1.00 logMAR, and remained relatively stable during follow-up. Imaging for LCA was limited, but showed little to no structural degeneration. In CORD, progressive vision loss started around the second decade of life. The annual decline rate of visual acuity was 0.022 logMAR (P A and the c.2512C>T GUCY2D variant (P = 0.798). At the age of 40 years the probability of being blind or severely visually impaired was 32%. The integrity of the ellipsoid zone (EZ) and external limiting membrane (ELM) on SD-OCT were correlated significantly with BCVA (Spearman's ρ = 0.744, P = 0.001 and ρ = 0.712, P < 0.001, respectively) in CORD. CONCLUSION: LCA due to variants in GUCY2D results in severe congenital visual impairment with relatively intact macular anatomy on funduscopy and available imaging, suggesting a long preservation of photoreceptors. Despite large variability, GUCY2D-associated CORD generally presented during adolescence with a progressive loss of vision and culminated in severe visual impairment during mid to late-adulthood. The integrity of the ELM and EZ may be suitable structural endpoints for therapeutic studies in GUCY2D-associated CORD

Genetic correlation between amyotrophic lateral sclerosis and schizophrenia

A. Palotie on työryhmän Schizophrenia Working Grp Psychiat jäsen.We have previously shown higher-than-expected rates of schizophrenia in relatives of patients with amyotrophic lateral sclerosis (ALS), suggesting an aetiological relationship between the diseases. Here, we investigate the genetic relationship between ALS and schizophrenia using genome-wide association study data from over 100,000 unique individuals. Using linkage disequilibrium score regression, we estimate the genetic correlation between ALS and schizophrenia to be 14.3% (7.05-21.6; P = 1 x 10(-4)) with schizophrenia polygenic risk scores explaining up to 0.12% of the variance in ALS (P = 8.4 x 10(-7)). A modest increase in comorbidity of ALS and schizophrenia is expected given these findings (odds ratio 1.08-1.26) but this would require very large studies to observe epidemiologically. We identify five potential novel ALS-associated loci using conditional false discovery rate analysis. It is likely that shared neurobiological mechanisms between these two disorders will engender novel hypotheses in future preclinical and clinical studies.Peer reviewe

De oprichting van de ‘Nederlandsche Vereeniging voor Tropische Geneeskunde’: een zaak van nationaal belang

The foundation of the Dutch Society for Tropical Medicine: an affair of national importance The ‘Nederlandsche Vereeniging voor Tropische Geneeskunde’ (Dutch Society for Tropical Medicine – in short: NVTG) was founded in 1907, a time not only of colonial expansion, but also a time in which the economic interest of the Dutch East-Indies for the Netherlands grew exceptionally. This had its effect on the motivations behind medical aid. Hygienic measures were financially backed because healthy workers had a positive effect on profits. This atmosphere of economic interest and political-military expansion had its effect on the foundation of the NVTG as well. Colonialism was generally approved of, and the goal of the society – apart from sociability motives – was to support research into illnesses torturing mainly the Dutch colonies. This was in line with the reasoning that the colonies were rightfully governed by the Netherlands, because the peoples living there had proven not to be able to look after themselves in a proper manner. The foundation of the Society should have been a part of the foundation of an international society for tropical medicine, but this failed. Although internationalism generally was seen as an important feature of science and certainly of medical science, it is not strange this was not seen as a major problem. For it was national and not international reasons that had led to founding the Dutch society. It was the Dutch position as a colonial power that had convinced Dutch tropical doctors a society should be called into being. A generally shared spirit of internationalism had little to do with this unless internationalism is defined as: what others have, we need to have as well, and let us see in international conferences what could be of national benefit. That nevertheless this spirit of internationalism – and not nationalism – is commonly hailed as the main reason behind the foundation, is probably due to the fact that around 1900 nationalism was such a normal state of mind and so fully incorporated in man’s way of thinking and acting, that, as for instance was the case with racism, it was hardly noticed and recognised as such.

'Een getuige tegen het kwaad van het materialisme.' De medische faculteit van de Vrije Universiteit en de homeopathie

From its start at the end of the nineteenth century, the protestant Free University in Amsterdam had its protagonists of homeopathic medicine. Especially the founder of the university, Abraham Kuyper, was a strong advocate. Homeopathy was seen as an ally in the struggle against materialistic science. But due to lack of money and, later on, the building up of a conventional medical curriculum, for a long time these feelings did not result in the founding of a chair in homeopathic medicine. It was not until the beginning of the 1960s that the board of the university decided that a teacher of homeopathic medicine should be appointed. The (very small) faculty of medicine, however, now objected. Doubts about the scientific status of homeopathy had never been completely silent and by now, its weaknesses appeared too obvious. The faculty would make itself ridiculous in the eyes of other medical faculties - the very faculties that in the beginning of the twentieth century were cursed as hotbeds of irreligion. In spite of these protests, the board insisted and a teacher was appointed. A real chair of homeopathic medicine, however, stood no chance. Kuyper's shadow had faded

Een poging tot samengaan van humanitarisme en pacifisme. Het Rode Kruis en de Nederlandse beweging voor internationale vrede

An attempt to combine hiiinanitarianism and pacifism. The Red Cross and the Dutch movement for international peace Both the International and the Dutch Red Cross were heavily damaged by World War II. The Red Cross movement especially was blamed for its lack of care for persecuted Jews and political prisoners. To restore its reputation all kinds of initiatives were taken. Amongst these was an attempt of the Dutch Red Cross to cooperate with several pacifist movements in the Dutch Movement for International Peace and Security. It seemed a good and sensible initiative, especially in 1945, but, although it was supported by international Red Cross resolutions, it failed. The DRC grew immensely in numbers in the years after 1945. With the cold war coming up the peace movement lost most of its popularity and therefore also lost its attraction for the Red Cross as a partner. As in the rest of its mutual history, the attempt to humanise war did not mix with the wish to abolish it