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Medicine

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Prehistoric medicine incorporated plants (herbalism), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.

Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine (predecessor to the modern traditional Chinese Medicine), and ancient Greek medicine and Roman medicine. Earliest records of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found.
The Greek physician Hippocrates (ca. 460 BC – ca. 370 BC), generally referred to as the Father of Modern Medicine.

The Greek physician Hippocrates, known as the Father of Medicine, laid the foundation for a rational approach to medicine (although some historians consider Imhotep, the noted Egyptian physician, to hold that honor
Statuette of ancient Egyptian physician Imhotep in the Louvre

). Hippocrates invented the Hippocratic Oath for physicians, which is still relevant and in use today and was the first to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence"[13][14]. The Greek physician Galen was one of the greatest surgeons of the ancient world and performed many audacious operations —including brain and eye surgeries— that were not tried again for almost two millennia. After the fall of the Western Roman Empire and the onset of the Dark Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

After 750, the Muslim Arab world had Hippocrates' and Galen's works translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include polymath Avicenna, who, along with Hippocrates, has also been called the Father of Medicine,Abulcasis, the father of surgery, Avenzoar, the father of experimental surgery, Ibn al-Nafis, the father of circulatory physiology, and Averroes.[17] Rhazes, who is called the father of pediatrics, was one of first to question the Greek theory of humorism, which nevertheless remained influential in both medieval Western and medieval Islamic medicine. However, overall mortality and morbidity levels in the medieval Middle East and medieval Europe did not significantly differ one from the other, which indicates that there was no major medical "breakthrough" to modern medicine in either region in this period. The fourteenth and fifteenth century Black Death was just as devastating to the Middle East as to Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East.[19] In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio and William Harvey.
An ancient Greek patient gets medical treatment: this aryballos (circa 480-470 BCE, now in Paris's Louvre Museum) probably contained healing oil

The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general - see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Ibn al-Nafis and Vesalius improved upon or disproved some of the theories from the past.

Modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at the end of the 18th century (inspired by the method of inoculation earlier practiced in Asia), Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics around 1900. The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austrian doctors such as Rudolf Virchow, Wilhelm Conrad Röntgen, Karl Landsteiner, and Otto Loewi) made contributions. In the United Kingdom Alexander Fleming, Joseph Lister, Francis Crick, and Florence Nightingale are considered important. From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet). In the United States William Williams Keen, Harvey Cushing, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasaburo), and France (Jean-Martin Charcot, Claude Bernard, Paul Broca and others did significant work. Russian (Nikolai Korotkov also did significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. Throughout history and in Europe right until the late 18th century not only animal and plant products were used as medicine, but also human body parts and fluids.[20] Pharmacology developed from herbalism and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc). The first of these was arsphenamine / Salvarsan discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. Vaccines were discovered by Edward Jenner and Louis Pasteur. The first major class of antibiotics was the sulfa drugs, derived by French chemists originally from azo dyes. This has become increasingly sophisticated; modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics is having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The movement is facilitated by the modern global information science, which allows all evidence to be collected and analyzed according to standard protocols which are then disseminated to healthcare providers. One problem with this 'best practice' approach is that it could be seen to stifle novel approaches to treatment. The Cochrane Collaboration leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect

medicine

Temel Sağlık

Otizm

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Otizm üç yaşından önce başlayan ve ömür boyu süren, sosyal etkileşime ve iletişime zarar veren, sınırlı ve tekrarlanan davranışlara yol açan beynin gelişimini engelleyen bir rahatsızlıktır. Bu belirtiler otizmi, Asperger sendromu gibi daha hafif seyreden otistik spektrum bozukluğundan (OSB) ayırır.

Otizm kalıtımsal kökenlidir ancak kalıtsallığı oldukça karmaşıktır ve OSB’nin kökeninin çoklu gen etkileşimlerinden mi yoksa ender görülen mutasyonlardan mı kaynaklandığı çok açık değildir. Nadir vakalarda, doğum sakatlıklarına neden olan etmenlerle yakından bağlantılıdır.[5]Diğer görüşlere göre ise çocuklukta yapılan aşılar gibi nedenler tartışmalıdır ve aşı kökenli varsayımların ikna edici bilimsel kanıtları yoktur. Yakın dönem araştırmaları otizmin prevalansını 1.000 kişiye bir ya da iki vaka olarak tahmin eder, aynı araştırmalardaki tahminlere göre OSB yaklaşık 1.000 kişide altı vakadır ve erkeklerde rastlanma oranı kadınlara göre 4,3 kat daha fazladır. Otizm vakalarının sayısı 1980’lerden beri oldukça fazla oranda artmıştır. Bunun nedeni kısmen tanı koyma yöntemlerindeki değişikliklerdir; gerçek prevalansın artıp artmadığı anlaşılamamıştır.

Otizm beynin birçok kısmını etkiler ama bu etkinin nasıl geliştiği çok iyi anlaşılamamıştır. Ebeveynler genellikle çocuklarının yaşamının ilk iki yılında belirtileri fark eder. Erken davranışsal ya da kavrayışsal müdahaleler çocukların kendine bakabilme yetisi ile sosyal ve iletişimsel yetiler kazanmasına yardımcı olabilir. Otizmin çaresi yoktur. Otistik çocukların çok azı erişkin olduktan sonra bağımsız yaşamakta, bunlardan bir kısmı bunda başarılı olabilmektedir. Bazılarının otizme bir çare aradığı, diğerlerinin de otizmin bir bozukluktan çok bir durum olduğuna inandığı bir otistik kültür ortaya çıkmıştır.

otizm

Temel Sağlık

Pediatrics

Kolesterolü Doğal Yöntemle Düşürmek İçin Kekik Yaprağı Suyu Tıklayınız

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In Europe in the Enfants-Trouvés (1674-1838) in Paris (French = Hospice for Found-Children, ie Foundlings). There was a gradual move to found separate institutions specifically for ill children, partly to avoid exposing them to adults in adult hospitals.

In the Western world, the first generally accepted paediatric hospital is the Hôpital des Enfants Malades (French = Hospital for Sick Children), opened in Paris in June 1802, on the site of a previous orphanage.[3] From its beginning, this famous hospital accepted patients up to the age of fifteen years,[1] and it continues to this day as the paediatric division of the Necker-Enfants Malades Hospital, created in 1920 by merger with the physically contiguous Necker Hospital, founded in 1778 for adults.

This example was only gradually followed in other European countries. The Charité (a hospital founded in 1710) in Berlin established a separate Paediatric Pavillion in 1830, followed by similar institutions at Saint Petersburg in 1834, and at Vienna and Breslau (now Wroclaw), both in 1837. The English-speaking world waited until 1852 for its first paediatric hospital, the Hospital for Sick Children, Great Ormond Street, some fifty years after the founding of its namesake in Paris.[3] In the USA, the first similar institutions were the Children's Hospital of Philadelphia, which opened in in 1855, and then Boston Children's Hospital (1869).
Differences between adult and pediatric medicine

Pediatrics differs from adult medicine in many respects. [5] The obvious body size differences are paralleled by maturational changes. The smaller body of an infant or neonate is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians.

Treating a child is not like treating a miniature adult. A major difference between pediatrics and adult medicine is that children are minors and, in most jurisdictions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility and informed consent must always be considered in every pediatric procedure. In a sense, pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances.
] Training of Pediatricians

The training of pediatrician varies considerably across the world.
Main articles: Medical education and Physician

Like other medical practitioners, pediatricians begin their training with an entry-level medical education: a tertiary-level course, undertaken at a medical school attached to a university. Such a course leads to a medical degree.

Depending on jurisdiction and university, a medical degree course may be either undergraduate-entry or graduate-entry. The former commonly takes five or six years, and has been usual in the Commonwealth. Entrants to graduate-entry courses (as in the USA), usually lasting four or five years, have previously completed a three- or four-year university degree, commonly but by no means always in sciences. Medical graduates hold a degree specific to the country and university in and from which they graduated. This degree qualifies that medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for "internship" or "conditional registration".

Within the United States, the term physician also describes holders of the Doctor of Osteopathic medicine (D.O.) degree. For further information on osteopathic medicine, see the entry on the comparison of MD and DO in the US.

Pediatricians must undertake further training in their chosen field. This may take from four to eight or more years, (depending on jurisdiction and the degree of specialization). The post-graduate training for a primary care physician, including primary care paediatricians, is generally not as lengthy as for a hospital-based medical specialist.

In most jurisdictions, entry-level degrees are common to all branches of the medical profession, but in some jurisdictions, specialization in paediatrics may begin before completion of this degree. In some jurisdictions, paediatric training is begun immediately following completion of entry-level training. In other jurisdictions, junior medical doctors must undertake generalist (unstreamed) training for a number of years before commencing paediatric (or any other) specialization. Specialist training is often largely under the control of paediatric organizations (see below) wale than universities, with varying degrees of government input, depending on jurisdiction.
Paediatric organizations

pediatrics

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Nöroloji

Kolesterolü Doğal Yöntemle Düşürmek İçin Kekik Yaprağı Suyu Tıklayınız

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Personele ilişkin bilgilerin kaynağı, sağlık personeli çalıştıran bütün kurum ve
kuruluşlarda bulunan personel kayıtlarıdır. İl Sağlık Müdürlükleri de özel hastanelerden,
kliniklerden, laboratuarlardan ve özel hekimlerden personel bilgileri toplamaktadır.
Önemli olan bir başka nokta da verilerin halen faal personele ve sağlık çalışanı belgesi
bulunan kişilere dayandığının bilinmesidir. Halen, yardımcı personel, örneğin idari ve yan
hizmetlerde veya eczanelerde çalışanlar kapsam dışıdır.
Ellerinde sağlık çalışanı belgesi bulunan faal personel yapılan işe, cinsiyete, uzmanlık
alanlarına, ile ve çalışılan kuruma göre (örneğin hastaneler, Sağlık Ocakları. Sağlık
Meslek Okulları, üniversiteler, bakanlıklar ve diğer bütün hükümet kuruluşları)
ayrılmaktadır. Sağlık Bakanlığı personeli ise merkez ve taşra teşkilatında çalışanlar olarak
sınıflandırılırlar. İstatistiklerde çifte sayımdan kaçınılamamaktadır; çünkü kişiler (kamu ve
özel olmak üzere) birden çok işte çalışabilmektedirler. Veriler her yıl Aralık ayı sonunda
toplanmaktadır. SB raporla bildirilen sonuçlan bilgisayara girmekte ve yayınlamaktadır.

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