The ability to repair is the most important property of the skin that determines the closure of a wound or injury "at all costs". However, healing can be with or without scarring. So what is the secret?
I will not tire of repeating: the doctor treats what he sees, and sees what he knows. When we see a stagnant erythema of the face – a pathognomonic sign of rosacea or all subsequent morphological elements – papules, papulo-pustules, tubercular infiltration - we need to know what is happening behind the scenes, in the depths of the skin layers.
Under the influence of numerous and various endo - and ecofactor that remains to be seen, there is a clear sequence of pathophysiological events that lead to the dynamics of the process, namely:
These events are the final stage of sterile inflammation. Manifestations of rosacea at this time will be either minimal (transient spontaneous erythema of the face, transient swelling, periodic and weak itching) or invisible at all.
At this point, the doctor's eye opens stagnant erythema spilled character.
These events are manifested by the appearance (of course, against the background of erythema) papules.
The inflammation ceases to be sterile. This is accompanied by the appearance of pustules, mainly on the surface of papules (papulo-pustules).
the focus of inflammation is surrounded by the peripheral shaft, there comes a stage of autoagression of local immunity, and after that the systemic one.
The totality of what is happening, along with autoimmune mechanisms leads to the fact that we see the emergence of bugorkova infiltration and granulomatous inflammation (Atofina, rhinophyma, gnathophyma, metafile).
Now, colleagues, when we see this or that morphological element on the face, we not only suspect the diagnosis of rosacea and think about the differential diagnosis, but also understand what processes and events preceded its appearance.
Easy meditation for everyone!
The ability to repair is the most important property of the skin that determines the closure of a wound or injury "at all costs". However, healing can be with or without scarring. So what is the secret?
A good leader must combine several important qualities at once and perform many functions: competently manage the budget, be a mentor for subordinates and a friend to his clients, create a working atmosphere, set an example, solve problems, set tasks ... Simply put, to be the center of your business .
But there is one more duty that among others is usually not called: if the boss defaults, encourages and directs, he must also punish, and sometimes - severely. Of course, this is very few people enjoy, but it is - as an integral part of the leadership process, like the others.
About what misdemeanors of subordinates deserve indulgence, and which ones can not be forgiven in any case, and also what will be the most serious punishment for a doctor working in a medical institution, we talked with the "Aesthetic Guide".
It was for a good reason that our penetration into the island as well as the Papuan culture was carried out in a gradual and unhurried way… Including the most ancient form of relationship, the trade. More...
Любой предмет можно увидеть, потрогать рукой, обозначить именем, наделить смыслом. Это легко! А как быть с умозрительными объектами? Например число пять, это что? Как его подержать в руке? Не в смысле пять яблок, а как число. А воображение - можно ли его потрогать? Это будет посложнее. Или вот, например, культура – это что? Как её увидеть? И, можно ли? А изучить ее закономерности сохранения или развития? Сложно!