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Shifting paradigms in periodontal disease. Implications for prevention in the elderly.

Our understanding of periodontal diseases has evolved considerably. No longer are the notions of universal susceptibility to plaque and calculus with automatic reliance on mechanical debridement valid. The interplay between specific bacteria and the immune response within a complex context of risk factors forms the new paradigm of periodontal disease pathogenesis. New approaches to treatment and prevention and their implications in the elderly will be discussed.

Aged↗

A paradigm shift.

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Evidence-Based Medicine↗

Paradigm shift.

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Analgesia, Obstetrical↗

Continuity and change: paradigm shifts in neural induction.

The problem of "primary embryonic induction" was one of the first areas of developmental biology to become "molecularized." What had been seen as an intractable series of problems became amenable to the techniques of Northern blotting, ectopic RNA insertion, and in situ hybridization. These molecular analyses showed that some of the fundamental concepts of primary embryonic induction concluded by experimental embryologists were false. First, primary embryonic induction was not primary. The organizer tissue, itself, was the product of a prior induction. Second, the neural fate of cells was not being induced. Rather, the epidermal fate was induced and the neural state was the default, uninduced, fate of ectodermal tissues. Third, primary embryonic induction was not something unique to vertebrates. Rather, the ventral neural cord of insects formed using the same mechanisms as the dorsal neural tube of vertebrates. Fourth, the brain formed in a matter distinctly different from that the spinal cord. Despite these differences, there has been a clear and strong continuity between the experimental embryological tradition and the molecular genetic tradition, and these new results are seen by many contemporary developmental geneticists as strengthening, rather than destroying, the older science.

Animals↗

Integrative medicine: a paradigm shift in medical education and practice.

The use of alternative/complementary medicine has been increasing considerably. Conventional medicine must begin to address issues related to the use, safety, regulation, research and education of alternative/complementary medicine. Integrative medicine combines conventional medicine and alternative complementary practices. Integrative medicine is an innovative approach to medicine and medical education. It involves the understanding of the interaction of the mind, body and spirit and how to interpret this relationship in the dynamics of health and disease. Integrative medicine shifts the orientation of the medical practice from disease based approach to a healing based approach. It does not reject conventional medicine nor uncritically accepts unconventional practices. Integrative medicine is an effective, more fulfilling human approach to medicine based on the benefit of the patient by following good medicine practices in a scientific manner.

Complementary Therapies↗

[Role of orthogonal electrocardiography and vectorcardiography in a paradigm shift in diagnosis of left ventricular hypertrophy].

A new contingency approach to the ECG diagnostics of left ventricular hypertrophy, its theoretical background, and first results of experimental and clinical studies are presented. This approach considers false negative ECG results as a consequence of the relative voltage deficit and introduces a new parameter: the specific potential of myocardium. As well it considers nonlinear changes of non-spatial determinants with respect to the stage and progression of left ventricular hypertrophy. The potential advantages of the concept of the specific potential of myocardium can be summarized as follows: (1) It utilizes equally both electrocardiographic and echocardiographic information, without stressing the priority or neglecting any of particular methods and creates a broader basis for the clinical diagnosis of left ventricular hypertrophy, (2) It utilizes also the false negative ECG results for diagnostics and quantifies the relative voltage deficit.

Electrocardiography↗

Shifting Paradigms and Changing Horizons in Medicine: Challenges and Opportunities for the Asian Pacific American Medical Students Association (APAMSA).

PURPOSE OF THE PAPER: This article is based on the Keynote Address by the author at the APAMSA National Convention on October 28, 1995 in Philadelphia, PA. PRINCIPAL FINDINGS: The author first highlights the profound changes in health care that are taking place and their impact on minorities such as Asian Pacific Americans (APAs). Secondly, he draws attention to certain diseases and risk factors that are of greater importance to different segments of APAs. And finally, he discusses the vital role of APAMSA in addressing these challenges. CONCLUSIONS: Three major challenges face APA medical students: 1) the uncertain future of the medical profession; 2) corporate medicine driving a wedge between patients and physicians; and 3) the myth of the model minority. However, together, APAs and APAMSA can be an important influence to affect the future.

Journal Article↗