BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie

BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie

01.06.2013 Views

complaints (the symptoms) to the physician, who then obtains further information about the patient's symptoms, previous state of health, living conditions, and so forth. The physician then makes a review of systems (ROS) or systems inquiry, which is a set of ordered questions about each major body system in order: general (such as weight loss), endocrine, cardio-respiratory, etc. Next comes the actual physical examination and often laboratory tests; the findings are recorded, leading to a list of possible diagnoses. These will be investigated in order of probability. Therapy (in Greek: θεραπεία), or treatment, is the attempted remediation of a health problem, usually following a diagnosis. In the medical field, it is synonymous with the word "treatment". A supportive therapy is one that does not treat or improve the underlying condition, but instead increases the patient's comfort. Supportive treatment may be palliative care. A therapeutic effect is a consequence of a particular treatment which is judged to be desirable and beneficial. This is true whether the result was expected, unexpected, or even an unintended consequence of the treatment. In talk therapy a therapeutic effect can be brought on by insight from the client that is caused by the clinician asking thoughtful and discerning questions regarding the past and/or present moment. Freud's main purpose in therapy was to make the unconscious conscious. A treatment treats a problem, and may lead to its cure, but treatments more often ameliorate a problem only for as long as the treatment is continued. For example, there is no cure for AIDS, but treatments are available to slow down the harm done by HIV and delay the fatality of the disease. Treatments don't always work. For example, chemotherapy is a treatment for some types of some cancers, which may in some cases enact a cure, but not in all cases for all cancers. Cures are a subset of treatments that reverse illnesses completely or end medical problems permanently. A cure is the end of a medical condition. The term may refer specifically to a substance or procedure that ends the medical condition, such as a medication, a surgical operation, a change in lifestyle, or even a philosophical mindset that helps a person suffer. It may also refer to the state of being healed, or cured. The proportion of people with a disease that are cured by a given treatment, called the cure fraction or cure rate, is determined by comparing disease-free survival of treated people against a matched control group that never had the disease. If everyone treated for a disease 57

is cured, then they will all remain disease-free and live as long as any person that never had the disease. Inherent in the idea of a cure is the permanent end to the specific instance of the disease. When a person has the common cold, and then recovers from it, the person is said to be cured, even though the person might someday catch another cold. Conversely, a person that has successfully managed a disease, such as diabetes mellitus, so that it produces no undesirable symptoms for the moment, but without actually permanently ending it, is not cured. Remission is the state of absence of disease activity in patients with known chronic illness that cannot be cured. It is commonly used to refer to absence of active cancer or inflammatory bowel disease when these diseases are expected to manifest again in the future. The term can be used incorrectly with mental illness when the illness is under control. A partial remission may be defined for cancer as 50% or greater reduction in the measurable parameters of tumor growth as may be found on physical examination, radiologic study, or by biomarker levels from a blood or urine test. A complete remission is defined as complete disappearance of all such manifestations of disease. Each disease or even clinical trial can have its own definition of a partial remission. Prevention is another important medical action it is a way to avoid an injury, sickness, or disease in the first place, and generally it will not help someone who is already ill (though there are exceptions). For instance, many babies and young children are vaccinated against polio and other infectious diseases, which prevent them from contracting polio. But the vaccination does not work on patients who already have polio. A treatment or cure is applied after a medical problem has already started. 3.4. The Social Role of Doctors and Patients The doctor-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The quality of the patient-physician relationship is important to both parties. The better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about disease and life, and time available, the better will be the amount and quality of information about the patient's disease transferred in both directions, enhancing accuracy of diagnosis and increasing the patient's knowledge about the disease. Where such a relationship is poor the 58

is cured, then they will all remain disease-free and live as long as any<br />

person that never had the disease.<br />

Inherent in the i<strong>de</strong>a of a cure is the permanent end to the specific<br />

instance of the disease. When a person has the common cold, and then<br />

recovers from it, the person is said to be cured, even though the person<br />

might someday catch another cold. Conversely, a person that has<br />

successfully managed a disease, such as diabetes mellitus, so that it<br />

produces no un<strong>de</strong>sirable symptoms for the moment, but without actually<br />

permanently ending it, is not cured.<br />

Remission is the state of absence of disease activity in patients<br />

with known chronic illness that cannot be cured. It is commonly used to<br />

refer to absence of active cancer or inflammatory bowel disease when<br />

these diseases are expected to manifest again in the future. The term can<br />

be used incorrectly with mental illness when the illness is un<strong>de</strong>r control. A<br />

partial remission may be <strong>de</strong>fined for cancer as 50% or greater reduction in<br />

the measurable parameters of tumor growth as may be found on physical<br />

examination, radiologic study, or by biomarker levels from a blood or<br />

urine test. A complete remission is <strong>de</strong>fined as complete disappearance of<br />

all such manifestations of disease. Each disease or even clinical trial can<br />

have its own <strong>de</strong>finition of a partial remission.<br />

Prevention is another important medical action it is a way to avoid<br />

an injury, sickness, or disease in the first place, and generally it will not<br />

help someone who is already ill (though there are exceptions). For<br />

instance, many babies and young children are vaccinated against polio and<br />

other infectious diseases, which prevent them from contracting polio. But<br />

the vaccination does not work on patients who already have polio. A<br />

treatment or cure is applied after a medical problem has already started.<br />

3.4. The Social Role of Doctors and Patients<br />

The doctor-patient relationship is central to the practice of<br />

healthcare and is essential for the <strong>de</strong>livery of high-quality health care in<br />

the diagnosis and treatment of disease. The quality of the patient-physician<br />

relationship is important to both parties. The better the relationship in<br />

terms of mutual respect, knowledge, trust, shared values and perspectives<br />

about disease and life, and time available, the better will be the amount<br />

and quality of information about the patient's disease transferred in both<br />

directions, enhancing accuracy of diagnosis and increasing the patient's<br />

knowledge about the disease. Where such a relationship is poor the<br />

58

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