Integrative medicine: Breaking down silos of knowledge and practice an epigenetic approach.

The future of medicine is discussed in the context of epigenetic influences during the entire life course and the lived experiences of each person, avoiding as much as possible the "medicalization" of the individual and taking a more humanistic view. The reciprocal communication between brain and body via the neuroendocrine, autonomic, metabolic and immune systems and the plasticity of brain architecture provide the basis for devising better "top down" interventions that engage the whole person in working towards his or her welfare. The life course perspective emphasizes the importance of intervening early in life to prevent adverse early life experiences, including the effects of poverty, that can have lifelong consequences, referred to as "biological embedding". In the spirit of integrative, humanistic medicine, treatments that "open windows of plasticity" allow targeted behavioral interventions to redirect brain and body functions and behavior in healthier directions. Policies of government and the private sector, particularly at the local, community level, can create a supporting environment for such interventions. See "Common Ground for Health: Personalized, Precision and Social Medicine McEwen & Getz - https://www.youtube.com/watch?v=IRy_uUWyrEw.

Integrative Medicine and Case Management.

The evolution of the integration of health care modalities has changed. The National Institutes of Health founded office of the National Center for Complementary and Alternative Medicine in the early 1990s to investigate integrative therapies through scientific research. In December 2014, the name and mission were updated to the National Center for Complementary and Integrative Health. Case managers, the coordinators of health care, must understand the changes to "integrative medicine" and the allure of the alternative modalities.

Supporting the integrative health care curriculum in schools of nursing.

The concepts of integrative health or integrative medicine are reviewed with an analysis and synthesis of the meaning of these concepts for nursing and nursing education. The passages of public laws that have influenced US health policy are reviewed along with the increase in funding for research as it relates to the increased use of these modalities by health care consumers. It is proposed that schools of nursing adopt and implement curriculum that addresses integrative health care. The goal is to educate nurses about these important concepts and prepare them for the health care consumers that increasingly use them.

Concepts of scientific integrative medicine applied to the physiology and pathophysiology of catecholamine systems.

This review presents concepts of scientific integrative medicine and relates them to the physiology of catecholamine systems and to the pathophysiology of catecholamine-related disorders. The applications to catecholamine systems exemplify how scientific integrative medicine links systems biology with integrative physiology. Concepts of scientific integrative medicine include (i) negative feedback regulation, maintaining stability of the body's monitored variables; (ii) homeostats, which compare information about monitored variables with algorithms for responding; (iii) multiple effectors, enabling compensatory activation of alternative effectors and primitive specificity of stress response patterns; (iv) effector sharing, accounting for interactions among homeostats and phenomena such as hyperglycemia attending gastrointestinal bleeding and hyponatremia attending congestive heart failure; (v) stress, applying a definition as a state rather than as an environmental stimulus or stereotyped response; (vi) distress, using a noncircular definition that does not presume pathology; (vii) allostasis, corresponding to adaptive plasticity of feedback-regulated systems; and (viii) allostatic load, explaining chronic degenerative diseases in terms of effects of cumulative wear and tear. From computer models one can predict mathematically the effects of stress and allostatic load on the transition from wellness to symptomatic disease. The review describes acute and chronic clinical disorders involving catecholamine systems-especially Parkinson disease-and how these concepts relate to pathophysiology, early detection, and treatment and prevention strategies in the post-genome era.

Ayurveda - a medicina clássica indiana / Ayurveda - the classical indian medicine

O objetivo do presente artigo é apresentar de forma sucinta as bases da Medicina Clássica Indiana, o Ayurveda. A palavra sânscrita Ayurveda significa literalmente o conhecimento (veda) da longevidade (ayus). Apresentamos um histórico das principais influências de outras medicinas ancestrais que conviveram com o Ayurveda, principalmente graças às várias invasões que o território indiano sofreu ao longo de toda sua história. Diferenciamos o Ayurveda de caráter experimental e de refinada observação de sintomas e sinais das doenças de outras formas de medicina mística praticadas no mesmo território indiano por sacerdotes brâmanes ritualistas. São delineados os princípios fundamentais do Ayurveda, desde a Filosofia Samkhya que oferece suas bases metafísicas, passando pela doutrina dos três humores (tridosha vidya) e dos cinco elementos básicos, pela fisiopatologia com a descrição das várias etapas evolutivas das doenças e seus prognósticos e pela funcionalidade dos sete tecidos corporais, tanto na sua forma saudável como patológica. Descrevemos também os canais de circulação (srotamsi) com suas respectivas funções de conduzir materiais densos como o sangue, a transpiração, as fezes e a urina, bem como os canais de energia sutil responsáveis pela condução dos pensamentos e das funções mentais. As técnicas de diagnóstico são também apresentadas em conjunto com as variadas formas de tratamento, baseadas em terapias mente-corpo como as práticas de ioga e meditação.

The aim of this article is to introduce briefly the foundations of the Classical Indian Medicine, Ayurveda. The Sanskrit word Ayurveda literally means the knowledge (veda) of longevity (ayus). We present a history on the main influences of other ancient medicines that coexisted with Ayurveda, due to the several invasions that the Indian Territory suffered throughout all of its history. Ayurveda has an experimental character and a refined observation of symptoms and signs of diseases, distinct from other forms of mystic medicines practiced within the Indian Territory by orthodox Brahmins priests. The fundamental principles of Ayurveda go from the Samkhya Philosophy that offers its metaphysical bases, through the three humours (tridosha vidya) and five basic elements doctrines, the pathophysiology with the description of the numerous evolutionary steps of diseases and prognosis according to functionality of the seven basic body tissues, in both their healthy and pathological forms. Likewise, we describe the channels of circulation (srotamsi) with their respective functions of conducting dense materials such as blood, perspiration, feces and urine, as well as the subtle energy channels, responsible for the conduction of thoughts and mental functions.

The evolution of complementary and alternative medicine (CAM) in the USA over the last 20 years.

Medical practices that reside outside the mainstream medical structures have existed for centuries, often waxing and waning in prominence and use for various reasons. Recently, there has been a resurgence in interest and use of such practices in the USA generally referred to under the label of 'complementary and alternative medicine' (CAM). In this article we summarize some of the highlight events that punctuated this resurgence over the last 20 years. As in the past, social forces affecting these trends circulate around power, resources, and scope of practice. However, a prominent feature of this dynamic is a discussion about the role of science and 'evidence-based medicine' in addressing pluralistic healthcare-related practices. In the early years of this period, attempts to formulate the place of CAM practices as they relate to epistemology, nonconventional assumptions about health and healing, and the complexity of understanding 'whole systems' were discussed and often examined. Less attention is being paid to those core assumptions in more recent times. The focus now seems to be on how CAM practices can be judiciously and effectively 'integrated' into mainstream medicine. Examples of how this dynamic is evolving are described.