Pillars Of Medicine Research Articles

The teaching of the Art and Science of Medicine

Teaching of medicine hails back to the age of Hippocrates; in the “Oath” he considers his teachers equal to his parents. Teaching, clinical practice and research constitute the three pillars of medicine, and they are interconnected. The methods of teaching medicine are very important. Auditorium lectures are being replaced by teaching in small groups and problem-oriented teaching. Still the enthusiasm of the teacher who can also become a mentor is a critical ingredient. The teacher should not just transmit but also create knowledge. The advent of artificial intelligence provides new auxiliary tools but also poses new challenges. We must not forget that we are shaping the future of tomorrow.

AN OPEN LETTER TO DR. WILLIAM BURKE (and the Pillars of Medicine that followed)

We are happy and elated to report to you that in commemoration of our 95th anniversary, we will be proudly showcasing the works from our distinguished faculty and staff through a special issue of the Journal of Medicine of the University of Santo Tomas (JMUST). This issue contains a total of seventeen original articles which include five clinical research articles, six medical education research articles, three perspective articles and two reviews. We are deeply thankful to the editorial team and the members of our peer review committee, and to all authors who contributed to this issue. This is our tribute to you and to all the luminaries and leaders who followed you and led us to where we are today and who will lead us into the next ninety five years.

Biochemical aspects of gout pharmacotherapy with colchicine and allopurinol

Gout is translated from Greek as “like a foot-trap”, and this disease is also known as the “disease of the aristocrats”. Gout has been known to mankind since ancient times; the first written mention of gout was found in ancient Egypt, then this topic was raised more than once in the works of such pillars of medicine as Hippocrates, Celsus, and Galen. This problem remains relevant in the modern world as well. Most often, men over 40 years of age suffer from this disease, but there is currently an increase in the incidence of gout, including in women and young people. So, what is gout? Gout is a chronic polyetiological disease associated with a purine metabolism disorder, characterize by an increase in the level of uric acid in the blood (hyperuricemia) and the deposition of the sodium salt of uric acid (urate) in the joints, periarticular tissues and internal organs with the development of recurrent arthritis and the formation of gouty nodules (tophi). The aim of our research was to study the features of gout pharmacotherapy. To achieve it, the following tasks were set and fulfilled: the mechanism of development of gout as a hereditary polyetiological disease was considered, and the biochemical aspects of the formation and course of the disease were highlighted. Treatment is prescribed depending on the period of the disease, including drugs for stopping an attack (NSAIDs, colchicine, corticosteroids and monoclonal antibodies) and maintenance therapy in the interictal period (allopurinol and uricosuric drugs). In the course of the work, we were interested in the mechanisms of action of drugs such as allopurinol and colchicine, therefore, these were given special attention.

A Primer on Hypothesis Testing for Craniofacial Surgeons: How to Obtain Valid Conclusions From Observations and Experiments

“Ability and judgment” are the only terms that appeared twice in the Hippocratic Oath and are the pillars of medicine and surgery, as clinical decision making and treatments depend on physicians’ judgments and abilities. Sound judgment requires knowledge obtained and accumulated through individual and collective experience, but more importantly from studies employing scientific methods. In a compendium article to this current one, the death of George Washington within days of onset of respiratory infection in 1799 exemplified the futility of ineffective, if not dangerous and harmful, medical treatments. The key question is how can anyone know with certainty that a particular therapy is or is not effective? Since individual differences exist in responses to corrective procedures and medications, absolute certainty is uncommon. However, as the number of patients increases, so does the confidence, at times approaching certainty. Statistical testing allows for the extraction of valid, useful information from data collected and is a critical part of all surgical disciplines. While this mini-review will not replace the need for expert statistical inputs from statisticians, it will provide a deep appreciation of and a working knowledge for these tests. We focus on hypothesis testing, the foundation to synthesize knowledge to guide, improve new treatments, and confirm or repudiate existing ones. The primer begins with hypothesis testing and systematically examine parametric and non-parametric statistical tests, ending with Mendelian randomization.

The COVID-19 pandemic and the future of public health

The COVID-19 pandemic provides us with a rare opportunity to deeply examine the validity of the construction of modern medicine, which is armed by science, and focus more on technologies than on people’s values and more on new ideas than on conventional wisdom. The world’s responses to the COVID-19 emergency have revealed a badly weakened public health system – one of the three pillars of medicine, the other two being basic medicine and clinical medicine. A 100 years ago, public health was the only effective measure for combating infectious diseases, which were then the main cause of human death. It is still a decisive weapon against COVID-19 and other communicable diseases alike, but was barely recognized and trusted at the beginning of the pandemic by the general public and even some international strategists. However, the epidemic has been effectively contained in China by non-pharmacological public health measures, which saved valuable time for the development of vaccines in the country and probably hundreds of thousands of lives as well. Public health aims to improve the health of the entire population by using societal methods. It is not simply a medical issue, and building a strong public health system requires broad participation from various sections of society.

Interprofessional Communication and Health Information Technology Education as Main Pillars of Medicine, Healthcare Administration and Public Health

Canadian healthcare leaders who participated in the pan Canadian National Study of Interprofessional Relationships between Physicians and Healthcare Administrators (CANSIRPH) emphasized that improving interprofessional relationships between physicians and healthcare administrators is the most important factor in success of healthcare systems and patient care quality. The leaders also considered that improving physicianmanager relations, patient care quality, medical errors reduction and efficient budget management are strongly correlated with improving communication and teamwork as well Health Information Technology (HIT). In fact, communication and teamwork shape 56% and HIT shapes 22% of satisfaction level of leaders with quality of interprofessional relationships between physicians and hospital administrators. CANSIRPH results also revealed that healthcare leaders across Canada are from different generations so a practical gap exists in healthcare professionals and leaders’ ability to use various HIT applications as previous generations are more prone to use of pen and paper whereas newer generation of leaders are more technology savvy. HIT applications should be transferable and easy to use by all professionals at different healthcare organizations across continuum of care because HIT tremendously affects interprofessional communication and to improve patient care, improving communications and teamwork among all members of healthcare teams including clinicians and managers seems extremely necessary.

THERANOSTICS: From Molecular Imaging Using Ga-68 Labeled Tracers and PET/CT to Personalized Radionuclide Therapy - The Bad Berka Experience

The acronym THERANOSTICS epitomizes the inseparability of diagnosis and therapy, the pillars of medicine and takes into account personalized management of disease for a specific patient. Molecular phenotypes of neoplasms can be determined by molecular imaging with specific probes using positron emission tomography (PET), single photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), or optical methods, so that the treatment is specifically targeted against the tumor and its environment. To meet these demands, we need to define the targets, ligands, coupling and labeling chemistry, the most appropriate radionuclides, biodistribution modifiers, and finally select the right patients for the personalized treatment. THERANOSTICS of neuroendocrine tumors (NETs) using Ga-68 labeled tracers for diagnostics with positron emission tomography/ computed tomography (PET/CT), and using Lu-177 or other metallic radionuclides for radionuclide therapy by applying the same peptide proves that personalized radionuclide therapy today is already a fact and not a fiction.

Behavioural defences in animals against pathogens and parasites: parallels with the pillars of medicine in humans.

No other theme in animal biology seems to be more central than the concept of employing strategies to survive and successfully reproduce. In nature, controlling or avoiding pathogens and parasites is an essential fitness strategy because of the ever-present disease-causing organisms. The disease-control strategies discussed here are: physical avoidance and removal of pathogens and parasites; quarantine or peripheralization of conspecifics that could be carrying potential pathogens; herbal medicine, animal style, to prevent or treat an infection; potentiation of the immune system; and care of sick or injured group members. These strategies are seen as also encompassing the pillars of human medicine: (i) quarantine; (ii) immune-boosting vaccinations; (iii) use of medicinal products; and (iv) caring or nursing. In contrast to animals, in humans, the disease-control strategies have been consolidated into a consistent and extensive medical system. A hypothesis that explains some of this difference between animals and humans is that humans are sick more often than animals. This increase in sickness in humans leading to an extensive, cognitively driven medical system is attributed to an evolutionary dietary transition from mostly natural vegetation to a meat-based diet, with an increase in health-eroding free radicals and a dietary reduction of free-radical-scavenging antioxidants.

The Pillars of Medicine, Or, Saved by Webster

To the Editor:— In your editorial A Pillar of Medicine ( 195 :1145, 1966) I was amazed to find the phrase manuscripts which... laws of physiology. I had thought that to flaunt and to flout had opposite meanings. I was even more astounded to find in the latest Webster's Third International that flout is given as a synonym of flaunt. This is indeed the world of Alice in Wonderland in which we live, when words can be made to have any meaning that we choose to give them. Do you, Sirs, condemn or condone this tendency? This called to mind the obituary notice of the Canadian physician W. S. Stansbury that appeared in Vox Sanguinis a few years ago, But above all he was loyal to the causes he eschewed....

Some observations and experiments about Vitriol, tending to find out the nature of that substance, and to give further light in the inquiry after the principles and properties of other Minerals: communicated by a Fellow of the R. Society, who maketh use of chymistry chiefly as subservient to physiology

Vitriol is by the Spagyrical Tribe reputed one of the chief Pillars of Medicine and Alchimy ; and is indeed endowed with many excellent and truly admirable properties; being employed by Nature in her most Curious Mineral operations.