Summarizing main message concerning needed development within all medicine domains: Increased knowledge and increased complexity within and between systems levels over time, where a western science/clinical medicine reductionistic limitations becomes increasing problems for effective investigations/hypotheses diagnostics/multifaceted treatments in real world living individuals (who also vary within and between individuals, situation and time) biopsychosocial-cultural living conditions. Needed is a Human and Artificial Intelligence “synergetic amalgamating” development enabling approaching extremely complex systems interacting processes, which may also “work according to different “time-activation-functioning”!
Introduction:
Increased knowledge and increased complexity within and between systems levels over time, where a reductionistic limitations becomes an increasing problem for real world individuals (who also vary within and between systems, situation and time) biopsychosocial-cultural living conditions. One of the challenges i termer of avoiding treats for too simple simplifications – a Occam’s razor (which may also “become” a trap)(https://www.britannica.com/topic/Occams-razor), around the corner.
The emerging knowledge- and practice development within microorganisms unhealth/dysfunction/.. intervening within human diseases/dysfunctions increase the complexity largely by many reasons where one is, it is not seldom it is complex to identify for a useful hypothesis diagnosis but also hard to treat.
Clearly, needed is a Human and Artificial Intelligence “synergetic amalgamating” development enabling approaching extremely complex systems interacting processes (which may “work according to different “time-activation-functioning”! Impossible? Maybe, but we need to work for it WHILE this is what it al is about! Individual (ideographically approached) in real life conditions, which are – at present very limited understood! Some diseases are of course more understood than others, but, e.g. moving from inflammation to InflmmAging is example on a smal but important step ahead!
The extreme focus on pharmacological, simplistic, reductionistic solution have basically prevent a since long (Long before George Engel´s 1977 argument/proposal), showing that profit is not the humanistic way to increased health, humanism and care, worth the name of Health Care Services for man and not for profit.
Content
- I use the title from 2010 publications Garth L. Nicolson and Jörg Haier – presented abstracts below
- Then I go into a concrete example
- BUT, what can we do about this extremely complexity highly needed for effective clinical work as well as health promotion
Publications by Garth L. Nicolson and Jörg Haier
1 https://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au
“Chronically ill patients with neurodegenerative, neurobehavioral and psychiatric diseases commonly have systemic and central nervous system bacterial and viral infections. In addition, other chronic illnesses where neurological manifestations are routinely found, such as fatiguing and autoimmune diseases, Lyme disease and Gulf War illnesses, also show systemic bacterial and viral infections that could be important in disease inception and progression or in increasing the number and severity of signs and symptoms. Evidence of Mycoplasma species, Chlamydia pneumoniae, Borrelia burgdorferi, human herpesvirus-1, -6 and -7 and other bacterial and viral infections revealed high infection rates in the above illnesses that were not found in controls. Although the specific roles of chronic infections in various diseases and their pathogeneses have not been carefully determined, the data suggest that chronic bacterial and/or viral infections are common features of progressive chronic diseases.”
“Chronically ill patients with neurodegenerative and neurobehavioural and psychiatric diseases commonly have systemic and central nervous system bacterial and viral infections. In addition, other chronic illnesses where neurological manifestations are routinely found, such as fatiguing and autoimmune diseases, Lyme disease and Gulf War illnesses, also show systemic bacterial and viral infections that could be important in disease inception, progression or increasing the types/severities of signs and symptoms.
Evidence of Mycoplasma species, Chlamydia pneumoniae, Borrelia burgdorferi, human herpesvirus-1, -6 and -7 and other bacterial and viral infections reve aled high infection rates in the above i llnesses that were not found in controls. Although the specific roles of chronic infections in various diseases and their pathogeneses have not been carefully determined, the data suggest that chronic bacterial and/or viral infections are common features of progressive chronic diseaseChronically ill patients with neurodegenerative and neurobehavioural and psychiatric diseases commonly have systemic and central nervous system bacterial and viral infections. In addition, other chronic illnesses where neurological manifestations are routinely found, such as fatiguing and autoimmune diseases,
Lyme disease and Gulf War illnesses, also show systemic bacterial and viral infections that could be important in disease inception, progression or increasing the types/severities of signs and symptoms. Evidence of Mycoplasma species, Chlamydia pneumoniae, Borrelia burgdorferi, human herpesvirus-1, -6 and -7 and other bacterial and viral infections reve aled high infection rates in the above i llnesses that were not found in controls. Although the specific roles of chronic infections in various diseases and their pathogeneses have not been carefully determined, the data suggest that chronic bacterial and/or viral infections are common features of progressive chronic disease
Then I go into a concrete example
Mycobacteria (mostly known from Tubercle Mycobacteria) has a long history; “Johann Schonlein coined the term “tuberculosis” in the 1834, though it is estimated that Mycobacterium tuberculosis may have been around as long as 3 million years!” https://www.cdc.gov/tb/worldtbday/history.htm (see also https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432783/)
Nontuberculous mycobacteria (NTM) “are mycobacteria other than M. tuberculosis (the cause of tuberculosis) and M. leprae (the cause of leprosy). NTM are also referred to as atypical mycobacteria, mycobacteria other than tuberculosis (MOTT), or environmental mycobacteria .
- NTMs can cause infections in a wide variety of body sites, most commonly the lungs and in the following areas:
- Skin and soft tissue (typically following surgery, trauma, injection of medications or other substances)
- Device associated infections (e.g., central line associated bloodstream infection, exit site infections, pacemaker pocket site infections, etc.)
- Lymph nodes (most commonly in children)
- Blood or other usually sterile locations in the body (disseminated) (most commonly in immunocompromised patients, such as those with HIV or AIDS, but may also be due to invasive medical devices or procedures)
- Symptoms can be vague and nonspecific, such as:
- Fever
- Weight loss
- Night sweats
- Decreased appetite
- Loss of energy
- Other symptoms depend on the site of infection and can include cough, shortness of breath, blood in the sputum, and rashes.” https://www.cdc.gov/hai/organisms/nontuberculous-mycobacteria.html
A few own comments before I refer to NonTubercle Mycobacterium | BOAIM2: Bergvik Open Academia for Innovative Medicine Management
Increased argument for NTM as a not expected/not diagnosed (“The clinical presentation for most NTM infections is non-specific, often resulting in delayed diagnosis. Further complicating matters is that NTM organisms can be difficult to isolate. Medications used to treat NTM infection can be difficult for patients to tolerate, and prolonged courses of anti-mycobacterial therapy are often required for adequate suppression or eradication. Herein, we review different NTM syndromes, appropriate diagnostic tests, and treatment regimens” https://www.sciencedirect.com/science/article/pii/S2405579421000334 .
More coming
BUT, what can we do about this extremely complexity highly needed for effective clinical work as well as health promotion, something we need to learn to effectively deal with – at individual level in clinical work – the patient in front of us? Evidenced based falsification of data or validation of the individual patient in front of us? | Biopsychosocial Medicine
More soon … I hope …