10 achievements of public health that resulted in lifespan increase
•Control of the infectious diseases
•Vaccination
•Safety of motor vehicles
•Safety at work
•Decrease of mortality from CHD and stroke
•Safe and healthy food
•Improvement of mother child care
•Family planning
•Fluorination of drinking water
•Understanding of harm caused by smoking
Medicine at the turn of the century
•Pathomorphosis – change of the course of classical diseases.
Occurrence of new diseases. Attacks of «old» diseases
•Development of evidence-based medicine
•Prediction of the diseases (predictive medicine)
•Convergence of fundamental and clinical medicine
•Informative storm
•Powerful pressure of tobacco, alcohol and food industry
Classes and levels of evidence in guidelines
Class I
Benefit >>> Risk
Treatment or procedure should be performed
Class III
Risk ≥ Benefit
Additional methods are not needed
Procedure or treatment should not be done because can do harm not benefit
Medicine at the turn of the century
•Pathomorphosis – change of the course of classical diseases.
Occurrence of new diseases. Attacks of «old» diseases
•Development of evidence-based medicine
•Prediction of the diseases (predictive medicine)
•Convergence of fundamental and clinical medicine
•Informative storm
•Powerful pressure of tobacco, alcohol and food industry
Medicine at the turn of the century
Preventive orientation (Relieving – Preventive)
•The superior doctor prevents sickness;
•The mediocre doctor attends to impending sickness;
•The inferior doctor treats actual sickness
•Chinese proverb 2600 BC.
What will you learn today?
•How the medicine is changing at the turn of the century?
•What are the most common illnesses and why?
•Subject «propaedeutics of internal diseases»
•History of physical examination and main diagnostic methods
•Physical examination vs modern medical technologies
Chances to die next year….
• |
Heart diseases |
1/ 388 |
• |
Car accident |
1/ 6.585 |
• |
Bad healthcare |
1/ 83.720 |
• |
Air crash |
1/ 659.779 |
• |
Terror attack |
1/ 16.817.784 |
• |
Asteroid`s fall |
1/ 1.960.000.000 |
Wired, Fed 2002& Centers for Disease Control; AHA Scientific Sessions, 2006
Cardio-vascular mortality in different countries (per 100 000)
Russia is a country with high CV risk and CV mortality
World Health Organization, 2015
Statistics
1900 г: CV death comprised less than 10% of all the deaths in the world
2000 г: |
in |
developed
2020 г: |
death. |
Every 3rd
Epidemy of cardio-vascular diseases
Possible causes
х
Bad fate |
|
High prevalence of standard |
|
risk factors |
|
Bad genetics |
|
|
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Ineffective correction of risk factors |
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Unknown causes |
|
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