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Модель совместного принятия решений посредством 3-х об
elgru в посте Metapractice (оригинал в ЖЖ)
Хотелось бы обсудить эту модель, предложенную для совместного принятия решений больным и врачом.
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Re: Тема: "нейрология возбуждения" = сознание Joel N. H. Stern
elgru в посте Metapractice (оригинал в ЖЖ)
Осталось уточнить, что в этом контексте подразумевается под сознанием? И кем подразумевается? Явно не авторами статьи.
О сознании в статье речи нет)
Речь идет о поддержании возбуждения посредством связи с талямусом.http://www.pnas.org/content/115/29/E6900/tab-article-info
Significance
Certain large neurons deep in the brainstem, in the nucleus gigantocellularis (NGC), are crucial for waking up the brain from deep sleep, anesthesia, or injury. NGC neurons, which project axons to central thalamus, should be especially important because central thalamic stimulation heightens CNS arousal in animals and in human patients. We have used the retroTRAP technique to discover mRNAs enriched in such NGC neurons. One mRNA, for endothelial nitric oxide synthase (eNOS), is uniquely expressed. By experiments both on the environmental/sensory side and with respect to motoric regulation, endothelial nitric oxide expression is shown to be functionally important. Five independent lines of evidence indicate that these eNOS neurons have a significant relation with their blood supply.
Abstract
Neurons of the medullary reticular nucleus gigantocellularis (NGC) and their targets have recently been a focus of research on mechanisms supporting generalized CNS arousal (GA) required for proper cognitive functions. Using the retro-TRAP method, we characterized transcripts enriched in NGC neurons which have projections to the thalamus. The unique expression and activation of the endothelial nitric oxide (eNOS) signaling pathway in these cells and their intimate connections with blood vessels indicate that these neurons exert direct neurovascular coupling. Production of nitric oxide (NO) within eNOS-positive NGC neurons increases after environmental perturbations, indicating a role for eNOS/NO in modulating environmentally appropriate levels of GA. Inhibition of NO production causes dysregulated behavioral arousal after exposure to environmental perturbation. Further, our findings suggest interpretations for associations between psychiatric disorders and mutations in the eNOS locus.
Речь идет о поддержании возбуждения посредством связи с талямусом.http://www.pnas.org/content/115/29/E6900/tab-article-info
Significance
Certain large neurons deep in the brainstem, in the nucleus gigantocellularis (NGC), are crucial for waking up the brain from deep sleep, anesthesia, or injury. NGC neurons, which project axons to central thalamus, should be especially important because central thalamic stimulation heightens CNS arousal in animals and in human patients. We have used the retroTRAP technique to discover mRNAs enriched in such NGC neurons. One mRNA, for endothelial nitric oxide synthase (eNOS), is uniquely expressed. By experiments both on the environmental/sensory side and with respect to motoric regulation, endothelial nitric oxide expression is shown to be functionally important. Five independent lines of evidence indicate that these eNOS neurons have a significant relation with their blood supply.
Abstract
Neurons of the medullary reticular nucleus gigantocellularis (NGC) and their targets have recently been a focus of research on mechanisms supporting generalized CNS arousal (GA) required for proper cognitive functions. Using the retro-TRAP method, we characterized transcripts enriched in NGC neurons which have projections to the thalamus. The unique expression and activation of the endothelial nitric oxide (eNOS) signaling pathway in these cells and their intimate connections with blood vessels indicate that these neurons exert direct neurovascular coupling. Production of nitric oxide (NO) within eNOS-positive NGC neurons increases after environmental perturbations, indicating a role for eNOS/NO in modulating environmentally appropriate levels of GA. Inhibition of NO production causes dysregulated behavioral arousal after exposure to environmental perturbation. Further, our findings suggest interpretations for associations between psychiatric disorders and mutations in the eNOS locus.
как-то все не так:
https://www.cochrane.org/CD000980/ARI_vitamin-c-for-preventing-and-treating-the-common-cold
... vitamin C may be useful for people exposed to brief periods of severe physical exercise. Regular supplementation trials have shown that vitamin C reduces the duration of colds, but this was not replicated in the few therapeutic trials that have been carried out. Nevertheless, given the consistent effect of vitamin C on the duration and severity of colds in the regular supplementation studies, and the low cost and safety, it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them. Further therapeutic RCTs are warranted.
https://www.cochrane.org/CD000980/ARI_vitamin-c-for-preventing-and-treating-the-common-cold
... vitamin C may be useful for people exposed to brief periods of severe physical exercise. Regular supplementation trials have shown that vitamin C reduces the duration of colds, but this was not replicated in the few therapeutic trials that have been carried out. Nevertheless, given the consistent effect of vitamin C on the duration and severity of colds in the regular supplementation studies, and the low cost and safety, it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them. Further therapeutic RCTs are warranted.
Если доказательства противоречивы, то врач может пользоваться этим методом диагностики или лечения под свою ответственность.
Её нет, и в ближайшем будущем не ожидается.
Но многие о ней говорят.
Но многие о ней говорят.
Является ли тремор ресурсом на этом видео для Стива Андреаса?
The earlier the better
Landewé writes, "We may have to acknowledge in rheumatology that 'earlier' (diagnosis) is not always necessarily 'better', that 'more' (treatment) is not automatically 'more effective', and that 'increased sensitivity' (of diagnostic tests) is not synonymous to 'better yield'. We need to better distinguish 'disease' from the 'risk of disease'. We need trials investigating how to best manage all those milder cases that come to us as a result of our early diagnosis initiatives. We need to learn what does and does not really matter to patients with inflammatory rheumatic diseases. We need to pay more attention to possible overdiagnosis and overtreatment in our clinical research."
Landewé writes, "We may have to acknowledge in rheumatology that 'earlier' (diagnosis) is not always necessarily 'better', that 'more' (treatment) is not automatically 'more effective', and that 'increased sensitivity' (of diagnostic tests) is not synonymous to 'better yield'. We need to better distinguish 'disease' from the 'risk of disease'. We need trials investigating how to best manage all those milder cases that come to us as a result of our early diagnosis initiatives. We need to learn what does and does not really matter to patients with inflammatory rheumatic diseases. We need to pay more attention to possible overdiagnosis and overtreatment in our clinical research."
Теперь про верхний правый квадрат.
Прецизионная медицина.
"Precision medicine" refers to the idea that patients can be separated into subgroups based on genetic, cellular, or molecular markers and that those markers can be used to improve treatment of individual patients. Landewé dismisses precision medicine as "a current hype" that is appealing to the public and to funding bodies, but is "unlikely to become the holy grail of rheumatology" as a result of the complex interplay of factors involved in rheumatic disease pathways.
Прецизионная медицина.
"Precision medicine" refers to the idea that patients can be separated into subgroups based on genetic, cellular, or molecular markers and that those markers can be used to improve treatment of individual patients. Landewé dismisses precision medicine as "a current hype" that is appealing to the public and to funding bodies, but is "unlikely to become the holy grail of rheumatology" as a result of the complex interplay of factors involved in rheumatic disease pathways.
Дочитали до конца.