Functional diseases and clinical medicine

Author(s):  
А.Б. Салтыков ◽  
С.В. Грачев

Редукционистский подход в медицине рассматривает живые системы в качестве закрытых (замкнутых) образований, функции которых полностью детерминированы свойствами соответствующих материальных компонентов. Каждое нарушение функции объясняется предшествующими изменениями структур, реализующих эту функцию. Из этого следует, что любая патология структурно-функциональна по своей сути, а понятие «функциональные заболевания» - принципиально ошибочно из-за искажения причинно-следственных отношений. По мере прогресса медицины ожидается открытие собственно первичных структурных маркеров «функциональных» заболеваний, что будет иметь решающее значение для их ранней диагностики и патогенетического лечения (ориентированного прежде всего, на устранение первичного звена расстройств). Вместе с тем, в медицине существует более общий холистический (функционально ориентированный) подход, формирующий иной стереотип клинического мышления. В этих рамках любая патология объясняется недостаточностью адаптивных функций организма в изменившихся условиях существования. Обычно сложный характер функциональных взаимодействий делает невозможным их описание на основе текущих характеристик материальных компонентов системы, особенно при воздействии на организм внешних патогенных факторов. Именно внешние воздействия способны инициировать первичный дефицит адаптивных механизмов с заведомо вторичными структурными изменениями, что позволяет перестать рассматривать «функциональные болезни» как принципиально ошибочное понятие. Первичный дефицит функций наиболее нагляден при информационной патологии, идеальная природа которой не сводится к соответствующим материальным носителям. Все это ставит под сомнение возможность обнаружения собственно первичных структурных маркеров некоторых заболеваний, особенно если в их основе лежит информационная патология (невроз, нервная анорексия, психическая аменорея, морская болезнь, некоторые формы фантомных болей и др.). Reductionist approach in medicine considers living systems as closed (closed) formations whose functions are completely determined by the properties of the corresponding material components. Each disturbance of the function is explained by previous changes in the structures that realize this function. From this it follows that any pathology is structurally functional in its essence, and the concept of «functional diseases» is fundamentally erroneous because of the distortion of cause-effect relationships. As medicine progresses, the actual primary structural markers of «functional» diseases are expected to be discovered, which will be crucial for their early diagnosis and pathogenetic treatment (primarily aimed at eliminating the primary link of disorders). At the same time, in medicine there is a more general holistic (functionally oriented) approach, forming a different stereotype of clinical thinking. Within this framework, any pathology is due to the lack of adaptive functions of the organism in the changed conditions of existence. Usually the complex nature of functional interactions makes it impossible to describe them on the basis of the current characteristics of the material components of the system, especially when external pathogenic factors influence the organism. It is external actions that can initiate a primary deficit of adaptive mechanisms with known secondary structural changes, which allows us to stop treating «functional diseases» as a fundamentally wrong concept. The primary deficit of functions is most evident in information pathology, the ideal nature of which is not reduced to the corresponding material carriers. All this calls into question the possibility of detecting the primary structural markers of certain diseases, especially if they are based on information pathology (neurosis, anorexia nervosa, mental amenorrhea, seasickness, some forms of phantom pains, etc.).

2020 ◽  
pp. 5-6
Author(s):  
В.И. Ерохов ◽  
В.Ф. Васюков

Стремительное развитие технологии блокчейн сделало криптовалюты широко распространенными по всему миру платежными средствами, используемыми в качестве альтернативной онлайн-валюты. Одновременно с этим криптовалюты также зарекомендовали себя как идеальная валюта для киберпреступников из-за их нерегулируемого и псевдоанонимного характера. Такое положение дел привело к возникновению возможности использования криптовалют в качестве инструмента содействия преступлениям, совершаемым как в киберпространстве, так и в реальном мире, включая легализацию (отмывание) денежных средств, кибер-вымогательство, фишинг, взлом, кибермошенничество и иные преступления в финансовой сфере. Учитывая высокотехнологичный, децентрализованный и, следовательно, сложный характер криптовалют, криминологам важно иметь базовое представление о методах работы, используемых в криптовалютных преступлениях. Таким образом, в представленных тезисах проанализированы проблемы, связанные с использованием криптовалюты для содействия преступной деятельности, и рассмотрены методы противодействия им. The rapid development of blockchain technology has made cryptocurrencies widespread around the world, used as an alternative online currency. At the same time, cryptocurrencies have also established themselves as the ideal currency for cybercriminals due to their unregulated and pseudo-anonymous nature. This state of affairs has led to the emergence of the possibility of using cryptocurrencies as a tool to facilitate crimes committed both in cyberspace and in the real world, including money laundering, cyber extortion, phishing, hacking, cyber fraud and other crimes in the financial sector. Given the high-tech, decentralized and therefore complex nature of cryptocurrencies, it is important for criminologists to have a basic understanding of the methods of operation used in "cryptocurrency crimes." Thus, this article analyzes the issues of using cryptocurrency to promote criminal activity, as well as countering issues.


Author(s):  
Emily Sequin ◽  
Karen Bellman ◽  
Scott Koch ◽  
Joseph West ◽  
Shaurya Prakash ◽  
...  

Measurement of the electromagnetic (EM) properties of tissue such as electrical conductivity, permittivity, and eddy current characteristics can be used in clinical medicine for characterizing and distinguishing soft tissue morphology. Such measurements can yield complementary information to what can be obtained using analysis with an optical microscope. An example is the assessment of margins during the surgical resection of occult tumors. In current practice, the surgeon relies on pre-operative imaging modalities, sight and palpation to locate and attempt to fully resect the tumor(s). Frozen section pathological assessment offers the only other resource available to the surgeon for margin analysis, but it is incomplete because only a small fraction of the resected tissue is examined and it is often not feasible to wait for the results of the frozen section analysis before completing the surgery. This paper describes a characterization and imaging method based on variations in electromagnetic tissue properties to assess the surgical margins of resected tissues. This is noteworthy because accurate margin assessment has been shown to significantly improve long term patient outcomes[1].


2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Valerie R. Yanofsky ◽  
Hiroshi Mitsui ◽  
Diane Felsen ◽  
John A. Carucci

Dendritic cells (DC) represent a diverse group of professional antigen-presenting cells that serve to link the innate and adaptive immune systems. Their capacity to initiate a robust and antigen-specific immune response has made them the ideal candidates for cancer immunotherapies. To date, the clinical impact of DC immunotherapy has been limited, which may, in part, be explained by the complex nature of DC biology. Multiple distinct subsets of DCs have been identified in the skin, where they can be broadly subcategorized into epidermal Langerhans cells (LC), myeloid-derived dermal dendritic cells (mDC) and plasmacytoid dendritic cells (pDC). Each subset is functionally unique and may activate alternate branches of the immune system. This may be relevant for the treatment of squamous cell carcinoma, where we have shown that the tumor microenvironment may preferentially suppress the activity of mDCs, while LCs remain potent stimulators of immunity. Here, we provide an in depth analysis of DC biology, with a particular focus on skin DCs and their role in cutaneous carcinoma. We further explore the current approaches to DC immunotherapy and provide evidence for the targeting of LCs as a promising new strategy in the treatment of skin cancer.


10.12737/5947 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Кузьмина ◽  
Natalya Kuzmina ◽  
Добрынина ◽  
Irina Dobrynina ◽  
Нелидова ◽  
...  

In recent decades there have been significant changes in the clinic of infectious endocarditis. In the presented scientific review detailed analysis of the current characteristics of the clinic and diagnosis is carried out. There is a growing incidence worldwide. Persons of elderly and senile age began to hurt more. According to the latest data, both in Western countries and in Russia to first place in the etiologic structure of infective endocarditis is Staphylococcus aureus. Modern disease is characterized by further increase in the frequency of primary infective endocarditis caused by unmodified heart valves. The septic forms of the disease began to meet less frequently, im-mune pathological manifestations of the disease are observed more often. The classic clinical picture is revealed not always, atypical forms of the disease, the cases of myocardium failure in the patients with infectious endocarditis are detected often. Thromboembolic complications still are among the most frequent and severe complications of infective endocarditis and its have a tremendous impact on his forecast. Recently come to the forefront of cerebral thromboembolic complications. Relapsing course of the disease is more common. The frequency of infective endo-carditis with damage to the valves of the right heart increases. Thus, timely diagnosis of infective endocarditis re-mains a topical problem of modern clinical medicine. The authors conclude that it is necessary to carry out further research in this direction.


2021 ◽  
Author(s):  
Dami Lee

In order to adapt to the explosion of technology and information, our culture has organized knowledge into distinct categories, and has privileged the “known” as the ideal truth. While this reductionist approach allows us to efficiently examine a specific topic, it has also led to a fragmented and oversimplified understanding of an otherwise enigmatic world. Umberto Eco, semiotician and novelist, criticized this rigid categorization and preferred a more complex, labyrinthine system, organizing his personal ad-hoc collection of books into unconventional categories. Venice, the labyrinthine city, is a physical manifestation of the concept of non-linearity and becomes a metaphor and strategy for exploring the idea of mystery and the dérive. The thesis explores the themes of slow reading, serendipity, and mystery, through the design of a Research Library that brings together Eco’s collection.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Svetlana Pundik ◽  
Aleca Scoco ◽  
Margaret Skelly ◽  
Jessica McCabe ◽  
Janis J Daly

Introduction: Loss of somatosensory function after stroke weakens the ability to adequately relate to our environment, thus significantly reduces quality of life. Neuroplastic processes of sensory recovery are poorly understood. The objective of this study was to identify cortical regions that undergo structural changes (measured by change in cortical thickness (CT)) during sensory recovery. The hypothesis was that for subjects who improve sensory acuity, CT change in regions of the bilateral sensory network correlates with change in sensory acuity. Methods: Chronic stroke survivors were treated with 12-weeks rehabilitation. Outcome measures were sensory acuity (monofilament), Fugl-Meyer upper limb coordination and CT (T1 Magnetic Resonance Imaging). CT change was calculated based on T1 images using Freesurfer longitudinal processing stream. General linear regression modeling identified cortical regions where change in CT was associated with change in sensory acuity after controlling for baseline sensory impairment and change in motor function. Cluster-wise correction for multiple comparisons was conducted using Monte-Carlo simulation at p<0.05. Results: Subjects, who improved in sensory acuity (n=18), were 55.8±13.7 year old; 10% female; 1.8±0.9 years after first ever stroke. Acuity improved from 43.9±14mm to 40.53±13mm (p=0.004). FM improved from 22.4±8 to 34.5±10 (p<0.0001). For the ipsilesional hemisphere, CT increase correlated with sensory improvement in lateral occipital gyrus (size=1543mm2; peak vertex coordinates in MNI space x=-10.9, y=-97, z=10.9, cluster wise p=0.0002) and in middle temporal gyrus (795mm2, x=-57.2, y=-56.5,z=0.9, p=0.002). For the contralesional hemisphere, increased CT was associated with improved monofilament acuity within supramarginal gyrus (930mm2 ; x=47.2, y=-43.0, z=43.2, p=0.0002) and middle temporal gyrus (974mm2; x=53.5, y=-59.6, z=-1.7; p= 0.0001). Conclusion: Rehabilitation produces modality-specific structural brain changes that can be measured by changes in cortical thickness. Improved sensation correlates with increased thickness in bilateral high-order association sensory cortices reflecting a complex nature of sensory rehabilitation.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wanjun Zhao ◽  
Linye He ◽  
Wenyi Deng ◽  
Jingqiang Zhu ◽  
Anping Su ◽  
...  

Abstract Background This study aimed to evaluate the effectiveness and efficiency of PBL–CBL combined teaching in thyroid surgery and make observations from the students’ perspectives, based on their satisfaction with the learning process. Methods We prospectively enrolled 354 fourth-year students majoring in clinical medicine, along with 232 residents, from September 2014 to June 2019. These participants were randomly allocated into either the combined PBL–CBL teaching group or the traditional lecture-based classroom group to attend a course about thyroid nodules. Both pre- and post-class quizzes were conducted. An anonymous questionnaire was also administered to both groups to evaluate the students’ perceptions and experiences. We compared the two teaching methods among all the students as well as with the fourth-year students and residents in subgroups. Results The traditional group’s pre-class quiz scores were significantly higher than the PBL–CBL group’s (as determined by a two-tailed t-test at a 95% confidence interval, T = 16.483, P < 0.001). After class, in the PBL–CBL group, the mean total quiz score and the basic knowledge and case analysis scores increased significantly (P < 0.001). The PBL–CBL group’s performance improvement was significantly higher than the traditional group’s (increasing from 52.76 to 70.51 vs. from 67.03 to 71.97). Furthermore, the scores for learning motivation, understanding, student–teacher interaction, the final examination, communication skills, clinical thinking skills, self-learning skills, teamwork skills, and knowledge absorption, as measured by the survey, were significantly higher in the PBL–CBL group than in the traditional group (P < 0.001). Meanwhile, the survey scores representing the amount of students’ free time the course consumed were significantly lower in the PBL–CBL group than in the traditional group (P < 0.001). Conclusions PBL combined with CBL may be an effective method for improving medical students’ and residents’ performance and enhancing their clinical skills.


2019 ◽  
Vol 75 (2) ◽  
pp. 260-272 ◽  
Author(s):  
Paul Benjamin Klar ◽  
Iñigo Etxebarria ◽  
Gotzon Madariaga

The benefit of computational methods applying density functional theory for the description and understanding of modulated crystal structures is investigated. A method is presented which allows one to establish, improve and test superspace models including displacive and occupational modulation functions from first-principles calculations on commensurate structures. The total energies of different configurations allow one to distinguish stable and less stable structure models. The study is based on a series of geometrically optimized superstructures of mullite (Al4+2x Si2−2x O10−x ) derived from the superspace group Pbam(α0½)0ss. Despite the disordered and structurally complex nature of mullite, the calculations on ordered superstructures are very useful for determining the ideal Al/Si ordering in mullite, extracting atomic modulation functions as well as understanding the SiO2–Al2O3 phase diagram. The results are compared with experimentally established models which confirm the validity and utility of the presented method.


Author(s):  
S. Gonizzi Barsanti ◽  
G. Guidi

Conservation of Cultural Heritage is a key issue and structural changes and damages can influence the mechanical behaviour of artefacts and buildings. The use of Finite Elements Methods (FEM) for mechanical analysis is largely used in modelling stress behaviour. The typical workflow involves the use of CAD 3D models made by Non-Uniform Rational B-splines (NURBS) surfaces, representing the ideal shape of the object to be simulated. Nowadays, 3D documentation of CH has been widely developed through reality-based approaches, but the models are not suitable for a direct use in FEA: the mesh has in fact to be converted to volumetric, and the density has to be reduced since the computational complexity of a FEA grows exponentially with the number of nodes. <br><br> The focus of this paper is to present a new method aiming at generate the most accurate 3D representation of a real artefact from highly accurate 3D digital models derived from reality-based techniques, maintaining the accuracy of the high-resolution polygonal models in the solid ones. The approach proposed is based on a wise use of retopology procedures and a transformation of this model to a mathematical one made by NURBS surfaces suitable for being processed by volumetric meshers typically embedded in standard FEM packages. The strong simplification with little loss of consistency possible with the retopology step is used for maintaining as much coherence as possible between the original acquired mesh and the simplified model, creating in the meantime a topology that is more favourable for the automatic NURBS conversion.


2021 ◽  
Vol 9 (4) ◽  
pp. 82
Author(s):  
Gaigai Su

<p><span lang="EN-US">Human anatomy is a science to study the normal human body shape and structure. It is an important basic medical course, and closely related to various medical disciplines, especially to clinical medicine. Under the concept of comprehensive quality education, anatomy teachers should not only impart theoretical knowledge and professional skills, but also pay attention to the cultivation of students’ clinical thinking ability, so as to lay a solid foundation for students’ subsequent professional study and clinical practice. This paper focuses on the training of clinical thinking in human anatomy teaching.</span></p>


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