RESUMO
The vast empirical material on pathogenesis of diseases has thus far been accumulated. However, its systematization and philosophical interpretation have not been given due attention since the time of I.V. Davydovsky. The value and topicality of I.V. Davydovsky' ideas need a fresh view andfurther development in the context of knowledges of the XXI century. The analysis of the selected provisions of I.V. Davydovsky offered in the article will hopefully contribute to their introduction into applied medicine.
Assuntos
Doença/etiologia , Filosofia Médica/história , História do Século XX , Humanos , Federação RussaRESUMO
The author presents the clinical and methodological analysis of the problem of medical errors based on the empirical data obtained in the 20 century. Relevant theoretical premises having applied implications are substantiated.
Assuntos
Erros Médicos , Médicos , Prática Profissional/tendências , Competência Clínica , Tomada de Decisão Clínica , Dissidências e Disputas , Humanos , Erros Médicos/prevenção & controle , Erros Médicos/psicologia , Erros Médicos/tendências , Médicos/psicologia , Médicos/normas , Prática Profissional/normasRESUMO
Social aspects of the concept of disease are considered in the context offurther development of philosophical tenets of V.Kh. Vasilenko. Biological aspects were discussed in earlier publications (see <
Assuntos
Doença , Filosofia Médica , HumanosRESUMO
V.Kh.Vasilenko paid much attention to the development of philosophical aspects of the concept of disease and left the rich intellectual legacy and a number of advisory instructions that allow the main challenge in modern medicine (the definition of the notion of disease) to be addressed. One of his principal messages is the necessity of generalization and synthesis of facts. Following Vasilenko's instructions, Part 1 of this review is devoted to systematization of modern views of general features of pathogenesis of internal diseases for obtaining a deeper insight into the essence of the disease.
Assuntos
Doença/história , Filosofia Médica , Doença/etiologia , Doença/genética , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , História Medieval , HumanosRESUMO
Empirical data on the nature of disease were systematized and summarized in Part 1. In Part 2 the same problem is addressed by the deductive method from the general biological and philosophical standpoint. Methodological assessment of the most popular definitions of the disease is undertaken along with expanded medico-philosophical interpretation of the notion of disease as an anthropological phenomenon including its applied aspects.
Assuntos
Evolução Biológica , Morte , Doença , Vida , Filosofia Médica , HumanosRESUMO
The authors discuss I.V. Davydovsky's views expounded in his book "Problems of causality in medicine, Etiology" (1962) where the philosophical method was applied for the first time for the solution of fundamental problems of medicine, such as etiology and pathogenesis. The main provisions of Davydovsky's concept of etiology of internal organ diseases are considered, an attempt is undertaken to develop and apply them in the present-day context.
Assuntos
Doença/etiologia , Filosofia Médica , Humanos , Medicina InternaRESUMO
Scientific (analytical) approach directs researcher to the study of nosology in isolated native view. The phenomenon under consideration- comorbidity becomes significant and to a substantial degree is able to affect all aspects of the process of medical care. This is shown in this review along such directions as frequency of overt or concealed comorbidity or real state of the problem; magnitude of intracardiac and extracardiac comorbidity; difficulties of diagnostics and treatment arising with comorbidity; problems of validity of statistical (and epidemiological) side of the matter; value of social and organizational aspects of patients care in situations when comorbidity is present.
Assuntos
Doença Crônica , Cardiopatias , Administração dos Cuidados ao Paciente , Doença Crônica/classificação , Doença Crônica/epidemiologia , Doença Crônica/terapia , Comorbidade/tendências , Recursos em Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/tendências , Cardiopatias/diagnóstico , Cardiopatias/epidemiologia , Cardiopatias/terapia , Humanos , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/estatística & dados numéricos , Federação Russa/epidemiologia , Análise de SobrevidaRESUMO
This review considers the views of I.V. Davydovsky expounded in his book The Problems of Causality in Medicine. Etiology (1962). The author was the first to apply the philosophical method to address such fundamental medical concepts as etiology and pathogensis. The most important issues concerning diseases of internal organs are reviewed with special reference to their etiology; an attempt is undertaken to further develop and update them.
Assuntos
Doença/etiologia , Medicina Interna/normas , HumanosRESUMO
The scope of knowledge in medical ethics continues to extend. Deontology as a science needs systematization of the accumulated data. This review may give impetus to classification of problems pertaining to this important area of medical activity.
Assuntos
Ética Médica , Relações Médico-Paciente/ética , HumanosRESUMO
Objective causes of fatal extramural pneumonia, such as social factors and the severity of the disease, should be considered along with subjective medical errors. Clinical and deontological analysis of lethal cases revealed a number of defects in providing medical care for such patients especially in terms of correction of cardiovascular disorders. Special analysis of 51 medical histories from the ethical viewpoint indicated that 4/5 of the patients had good reasons to set up deontological claims against their doctors.
Assuntos
Infecções Comunitárias Adquiridas/terapia , Atenção à Saúde/organização & administração , Pneumonia Bacteriana/terapia , Qualidade da Assistência à Saúde/ética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Comunitárias Adquiridas/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/diagnóstico , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto JovemRESUMO
Interest in deontological problems of art of healing has decreased in the last two decades. Deontological literature focuses on idealistic and educational aspects but pays little attention to theoretical and applied issues. Live dialogue is in order to clarify many current deontological views.
Assuntos
Ética Médica , Relações Médico-Paciente/ética , Médicos/ética , HumanosRESUMO
Having analyzed more than 150 original papers dedicated to the study of cardial pathology risk factors from clinical (specific) and methodological (philosophic) points of view, the authors put forward a hypothesis of the etiology of diseases (by the example of coronary artery disease) as a "critical mass" of these risk factors. Reasoning from it, the authors suggest the ways of using this statement by large quantitative evaluation of clinical data, and application of mathematic modeling to the diagnostics and prognostics of cardial pathology in each particular case.
Assuntos
Isquemia Miocárdica/etiologia , Isquemia Miocárdica/fisiopatologia , Adulto , Fatores Etários , Feminino , Humanos , Hiperinsulinismo/complicações , Hiperlipidemias/complicações , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/mortalidade , Obesidade/epidemiologia , Fatores de RiscoRESUMO
Factors of risk of chronic circulatory insufficiency (CCI) were assessed in 263 hypertensive patients with and without ischemic heart diseases. CCI was diagnosed in 218 of these 263 patients. Early stages of CCI may be diagnosed in certain number of these factors. ECG findings in isolated arterial hypertension detected left ventricular dysfunction classified as chronic cardiac failure of functional class I (NYHA criteria).
Assuntos
Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Doença Crônica , Diagnóstico Diferencial , Eletrocardiografia , Insuficiência Cardíaca/epidemiologia , Hemodinâmica/fisiologia , Humanos , Fatores de Risco , Disfunção Ventricular Esquerda/epidemiologiaRESUMO
The authors review their studies conducted for many years on cardiological prognostication in the context of the republican program "Cardiology" performed in the Udmurt Republic. The lines of the research and results obtained are described.