Search

Spain played an ambiguous and pragmatic role during the Second World War and its policy evolved as the war progressed. While Francoist Spain was friendly towards Nazi Germany, it never declared war on the Allies, even if it contributed Division Azul to the Reich’s invasion of the Soviet Union. Spanish neutrality allowed its territory to become a temporary safe haven for refugees fleeing the Nazi terror in Europe. Miranda de Ebro concentration camp (1937–1947) saw the internment of soldiers from the International Brigades who had fought on the Republic’s side in the Spanish Civil War, and of European refugees escaping from the Nazis. After the French, Poles represented the second biggest national group at Miranda and it is the Polish doctors on whom I focus in this paper because of Poland’s situation during and after the war. Most of the Polish doctors held in Miranda were Jews who had come to France before the war, where they had studied while keeping Polish citizenship. After release from Miranda, many joined the Allied forces fighting against the German Reich. But when the war ended, Poland – though formally independent – became a satellite country of the Soviet Union. Only one of the physicians ever returned to Poland. The rest continued their careers in Great Britain or the USA despite all the difficulties this entailed.

Torture is a practice as old as humanity itself, although its objectives have changed throughout history. The participation of medical personnel in the exercise of torture has been common in some historical moments. During the middle ages, torture was the instrument used by justice to obtain confessions, but doctors did not regularly participate in it. For the first time, the Constitutio Criminalis Carolina (1532) is the body of laws that requires the official presence of a doctor in the torture sessions, acting as another judicial official. The twentieth century represented a drastic change in the role of the health professional in relation to torture, who began to play an active part in this process. Torture methods changed drastically, going from the classic methods of inflicting physical pain, to other more modern methods, in which psychological and psychiatric techniques and psychotropics predominate. The Nazi doctors applied mind control techniques with psychotropic drugs to prisoners. In dictatorial countries, such as the former Soviet Union and China, punitive psychiatry was used to punish political dissidents, and in the South American dictatorships, doctors actively collaborated in the exercise of physical torture. The paradigm of torture changed with the events of Abu Ghraib, and the use of torture was justified by the democratic authorities as a war weapon against terrorism. To avoid the participation of health professionals in torture, additional actions are required, such as promoting extra ethical training in doctors, and close monitoring for compliance with all international covenants, agreements and treaties against torture.

Miranda de Ebro was created in 1937 to imprison Republicans and foreigners who fought with the International Brigades in Spanish Civil War. From 1940, the camp was used only to concentrate detained foreign refugees with no proper documents. More than 15 000 people, most of them from France and Poland, were kept there until the camp was closed in January 1947. Playing both sides of the international divide, fascist Spain at various points in time allowed passage and was a country of refuge both for those escaping Nazism and for Nazis and collaborators who, at the end of World War II (WWII), sought to escape justice. Treatment of each of these groups passing through Miranda was very different: real repression was meted out to the members of the International Brigades (IB), tolerance shown towards those escaping Nazism, and protection and active cooperation given to former Nazis and their collaborators. For the first time, data about foreign physicians imprisoned in Miranda de Ebro were consulted in the Guadalajara Military Archive (Spain). From 1937 to 1947, 151 doctors were imprisoned, most of them in 1942 and 1943, which represents around 1% of the prisoners. Fifty-two of the doctors were released thanks to diplomatic efforts, thirty-two by the Red Cross, and ten were sent to other prisons, directly released or managed to escape. All of them survived. After consulting private and public archives, it was possible to reconstruct some biographies and fill the previous existing gap in the history of migration and exile of doctors during the Second World War.

After World War II, Sachsenhausen Nazi concentration camp (Oranienburg) was administered until the spring of 1950 by Soviet occupation forces (Special Camp Number 7) and used mainly for political prisoners. Our study analyzes suicides in this camp during the Soviet period. Data was collected from the archives of Sachsenhausen Memorial, Special Camp Collection. Original documents containing certificates or autopsy reports of prisoners who committing suicide were reviewed. In this period, authorities registered 17 suicides. The age of suicides was between 19 and 64 years. The most frequent cause of imprisonment was Blockleiter (Kapo in Nazi period, n = 4), Mitarbeiter Gestapo (member of the Gestapo, n = 3) and Wehrmacht (military, n = 3). Hanging was the most frequent method of suicide. The average time spent in the camp until suicide was 715 days. The number of recorded suicides under Soviet control is considerably lower (calculated rate 2.8/10,000 per year) than under Nazi control (calculated rate 11/10,000 per year). This could be due to comparably more favorable conditions for prisoners and the abolishment of the death penalty during this period. Possible motives for suicides include feelings of guilt for crimes committed, fear of punishment and a misguided understanding of honor on the eve of criminal trials.

Between August 1945 and February 1950, the Nazi concentration camp of Buchenwald was turned into the Soviet Special Camp Number 2 by the Soviet secret service to house individuals perceived as opponents of the Soviet system. We have investigated the system of health care for psychiatric patients in this camp. We have consulted and reviewed the archives of Buchenwald concentration camp (Arkiv der Gedenkstatte Buchenwald). Archival documents regarding the Soviet period have been partially declassified recently. During its five years of operation, 28 455 prisoners were held. In Buchenwald, psychiatric patients were held in the Psychiatric Station (barrack VIIc), guarded by a neuropsychiatrist and a nurse. The number of inmates who passed through this station is unknown, however, at one point there were more than 60. The medical system run in Gulags for decades was already exported to camps created in German territory after the end of the war. The internment of dissidents in psychiatric centers was a common practice of the Soviet authorities.

Intense pulsed light (IPL) devices have been shown to be highly effective for the skin rejuvenation. In our study, we try to elucidate effects of IPL in fibroblast proliferation, in gene expression, and in extracellular matrix protein production. 1BR3G human skin fibroblasts were used to test the effects of an IPL device (MiniSilk FT, Deka®). Fibroblasts were divided into three groups: group 1 was irradiated with filter 800-1200 nm (frequency 10 Hz, 15 s, fluence 60.1 J/cm) twice; group 2 was irradiated with filter 550-1200 nm (double pulse 5 ms + 5 ms, delay 10 ms, fluence 13 J/cm2) twice; and group 3 was irradiated with filter 550-1200 nm (frequency 10 Hz, 15 s, fluence 60.1 J/cm2) twice. To determine changes in gene expression, messenger RNA (mRNA) levels for collagen types I and III and metalloproteinase 1 (MMP-1) were performed 48 h after irradiation. To determine changes in hyaluronic acid, versican, and decorin, mRNA and ELISA tests were performed after 48 h of treatment. In addition to this, a Picro-Sirius red staining for collagen was made. The study showed an increase of mRNA and hyaluronic acid, decorin, and versican production. With RT-PCR assays, an increase mRNA for collagen type I, type III, and MMP-1 was observed. Collagen and hyaluronic synthesis was increased in all groups with no differences among them, while decorin and versican synthesis was higher in those groups irradiated with 550-1200-nm filters with no dependence of type pulse or total energy dose. IPL applied in vitro cultured cells increases fibroblasts activity. Synthesis of extracellular proteins seems to be produced more specifically in determined wavelengths, which could demonstrate a biochemical mechanism light depending.

Background and objectives Light devices emitting near infrared have been shown to be highly effective for the skin rejuvenation but biochemical and molecular mechanism or optimum dose treatment are not well-known. In our study we try to elucidate why systems emitting near infrared produce skin improvement such as fibroblasts proliferation, increase in gene expression or extracellular matrix (ECM) protein production. Study design/materials and methods 1BR3G human skin fibroblasts were used to test the effects of an intense pulsed light device emitting with an 800–1200 nm filter (MiniSilk FT manufactured by Deka ® ). In our protocol, fibroblasts were irradiated twice successively with a 10 Hz frequency, with a total fluence up to 60 J/cm 2 for 15 s each pass. After incubating for 48 h, fibroblasts were harvested from the culture plates to test cell proliferation by flow cytometer. To determine changes in gene expression (mRNA levels for collagen types I and III and metalloproteinase 1 (MMP-1)) and protein production (hyaluronic acid, versican and decorin) tests were performed after irradiation. Results After 48 h irradiation, 1BR3G human skin fibroblasts were observed to proliferate at a fast rate. The study of ECM macromolecules production using ELISA showed an increase of hyaluronic acid and versican production but no changes were observed for decorin. With RT-PCR assays, an increase in mRNA for collagen type I, type III and MMP-1 were observed. Conclusion Intense pulsed light emitting near infrared applied in vitro cultured cells increases fibroblasts proliferation and activity, which can be a possible mechanism of action for these devices in aging skin treatment.

Background: Semicircular lipoatrophy (SL) is a benign pathology characterized by subcutaneous adipose tissue atrophy. Objective: To determine causes of SL. Methods: We performed research on 42 cases of SL who had developed symptoms of lipoatrophy with a technical study of the building and clinical study of the affected patients. Results: Electromagnetic field and electrostatic charge measurements were performed. No signals different from typical radio, TV and other wireless communication devices were recorded. Electrostatic charges were recorded in floors, environments and on different furniture; they were positive, and all charges disappeared on contact with the worker's skin. Data about the workplace were collected, and clinical examinations were performed, including blood and biochemistry tests and 18 ultrasound skin tests. Conclusions: As no abnormal electromagnetic measurements were found and electrostatic changes and occupational behaviors showed some relevant data and as after changes in order to control the electrostatic environment all of them improved, we can conclude that electrostatic charges but not electromagnetic ones are the main cause of SL.

Even after the Nuremberg code was published, research on syphilis often continued to fall far short of ethical standards. We review post-World War II research on this disease, focusing on the work carried out in Guatemala and Tuskegee. Over a thousand adults were deliberately inoculated with infectious material for syphilis, chancroid, and gonorrhea between 1946 and 1948 in Guatemala, and thousands of serologies were performed in individuals belonging to indigenous populations or sheltered in orphanages. The Tuskegee syphilis study, conducted by the US Public Health Service, took place between 1932 and 1972 with the aim of following the natural history of the disease when left untreated. The subjects belonged to a rural black population and the study was not halted when effective treatment for syphilis became available in 1945.

Resumen Incluso despues de la promulgacion del codigo de Nuremberg las investigaciones sobre sifilis continuaron alejandose en muchas ocasiones de los estandares eticos. En este articulo hemos revisado las investigaciones que sobre esta enfermedad tuvieron lugar despues de la Segunda Guerra Mundial, centrandonos en los casos de Guatemala y de Tuskegee. En Guatemala durante los anos 1946 a 1948 se inoculo deliberadamente a mas de 1.000 adultos sifilis, chancroide y gonorrea, y se hicieron miles de serologias a poblaciones indigenas o a ninos huerfanos. El experimento Tuskegee sobre sifilis fue realizado entre 1932 y 1972 por el Servicio Publico de Salud de los Estados Unidos para estudiar la evolucion natural de esta enfermedad en ausencia de tratamiento. Se realizo sobre un grupo de poblacion rural de raza negra y no se interrumpio a pesar de la introduccion de tratamientos eficaces para la resolucion de la enfermedad durante estos anos (1945).

Resumen Durante siglos la sifilis ha sido objeto de investigacion por parte de los medicos, dado que la etiologia, la forma de contagio, la profilaxis y el tratamiento eran desconocidos. En muchas ocasiones las investigaciones se han alejado de los estandares eticos actuales. En este articulo hemos revisado desde un punto de vista historico y etico las investigaciones que sobre esta enfermedad se han ido realizando a lo largo de los siglos, centrandonos sobre todo en aquellos experimentos realizados en el siglo xx . Describimos con detalle los estudios realizados en los anos que tuvieron lugar alrededor de la Segunda Guerra Mundial: experimentos realizados por los medicos norteamericanos en prisiones de Estados Unidos, la sifilis en la Alemania nazi o los ensayos realizados por los japoneses en centros de experimentacion creados a tal fin en los territorios ocupados.

Physicians have conducted research on syphilis for centuries, seeking to understand its etiology and the means of transmission as well as find ways to prevent and cure the disease. Their research practices often strayed from today's ethical standards. In this paper we review ethical aspects of the long history of research on syphilis with emphasis on the experiments performed in the 20th century. The description of research around the time of World War II covers medical experiments carried out in US prisons and in the experimentation centers established by Japanese doctors in occupied territory, as well as experiments in Nazi Germany and the treatment of syphilitics there.

Desde los inicios de la Medicina se han utilizado los cuerpos de los fallecidos con fines docentes. El cuerpo humano es un material necesario para los futuros medicos, no solo en los aspectos meramente anatomicos, sino tambien en los relacionados con el analisis de tejidos sanos o enfermos e incluso como un medio de aprender diferentes tecnicas especificas por parte de medicos especializados o en fase de especializacion.

Background : Skin rejuvenation requires a treatment combination including lasers, intense pulsed light (IPL), radiofrequency, botulinum toxin (BT) and fi llers. A combined approach is considered optimum but usually same-day combined treatments are avoid and lasers are performed prior to fi or toxin injections owing to the concern that the light may inactivate or degrade them. Objective : To review the literature on the use of combination treatments with radiofrequency, IPL, non ablative and ablative lasers plus fi llers or BT. Results : review of the literature identifi ed 15 studies of combination treatments: three of them on animal models and 12 were clinical studies. Seven studies contained combined light system treatments with fi llers and eight studies combined physical therapies with botulinum toxin injection. In all of them treatments were used as standard protocols. Six studies documented no histological changes in fiinjected after applying radiofrequency, IPL or laser treatments and one studied documented improvement in collagen after IPL treatment and toxin injection. These studies reported clinical improvement in various features of photodamaged skin, no increase of adverse effects and neither decrease on effi cacy of substances injected. Conclusions : review of the literature demonstrates safety of same day combined treatments for rejuvenation, which improve clinical results, are more comfortable for patients have no loss of effi cacy or other apparent adverse effect.

Resumen —Una mujer de 50 anos presentaba cientos de pequenas lesiones papulosas hiperqueratosicas distribuidas por el tronco y la zona proximal de extremidades, sin afectacion palmoplantar ni de los anejos cutaneos. Al microscopio las lesiones mostraban hiperqueratosis ortoqueratosica. La hiperqueratosis digitada diminuta multiple tiene varias formas de presentacion: familiar (con inicio en la segunda y tercera decada de la vida), esporadica y postinflamatoria. El estudio histopatologico demuestra que las formas familiares y esporadicas tienen caracteristicas semejantes, diferentes de las formas postinflamatorias.

Resumen .—Se presenta un caso de eccema alergico de contacto por tetracaina en una mujer que al cuidado de una hija con paralisis cerebral se sensibiliza al utilizar sondas urinarias a las que aplicaba un unguento (Organon®) que contienen tetracaina. Se discute si la sensibilizacion tenia o no un caracter profesional.

Introduction: Cutaneous reactions due to use of non-steroidal anti-inflammatory drugs (NSAID) are frequently described. In the Contact Unit from the Department of Dermatology of Juan Canalejo Hospital, we compiled all cases studied during 4 years (from 2000 to 2003) to analyze the incidence, frequency and type of reactions derived from NSAIDs use. Material and methods: We used a NAIDs battery (Aristegui lab.O) on 55 patients with clinical suspicion of adverse reaction from NSAIDs. We performed epicutaneous study on 17 and additional photoallergic study, after UVA irradiation (from 5 to 7,5 J/cm2), on 38 cases. In some cases we patched the drug used by patient as is and/or the active substance provided by the laboratory if it was not included on NSAIDs battery. Readings were done following ICDRG criteria at 48 and 96 hours on patch tests and 24 and 72 hours on photopatch tests. Healthy controls were patched. Results: 22 patients showed positive test: 15 cases were diagnosed as photoallergic dermatitis (etofenamate 5; dexketoprofen 4; ketoprofen 3; piroxicam 2; diclophenac 2 and aceclophenac 1). Five cases were explained as allergic contact dermatitis (etofenamate 2; fepradinol 2 and phenylbutazone 1) and two cases of fixed drug eruption from piroxicam were found. Conclusion: In this study we observed that cutaneous reactions due to ketoprofen and piroxicam are still high. It is important to note the high incidence of allergic and photoallergic reactions from dexketoprofen, a recently introduced NSAID, reporting always a cross reaction between ketoprofen and dexketoprofen.