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?
Stories from the clap bar continue…
Few of my colleagues remember the glorious time when not only a comprehensive approach based on objective knowledge was used in the treatment of skin diseases and sexually transmitted infections, but also Immunostimulants were used, especially for the treatment of late forms of syphilis.
But in this place it would be necessary to remember that the origins of immunotropic therapy, in fact, go back to the distant past, when the well-known adventures of count Cagliostro treated patients with syphilis (and himself as well), with... crystal balls. Crushed into small crumbs, they poured into a Cup of coffee, which, gulped down, immediately caused massive intestinal bleeding, accompanied, as is known, an increase in body temperature to 40 degrees. So if the patient didn't die of bleeding and convulsions, he was... cured of syphilis.
Another example was the way doctors in nineteenth – century Russia, in an abundance of wetlands, treated syphilis by walking patients through swamps inhabited by mosquitoes carrying malaria Plasmodium-the causative agent of malaria. Malaria also caused body temperature to rise to 40 degrees for several days, and if the patient did not die from malaria, then... he was recovering from syphilis.
However, in the story I want to tell, it was like this.
Twenty years ago, for the treatment of late forms of syphilis, of course, in complex therapy, the drug Pirogenal was used, which moderately stimulated nonspecific immunity, while increasing body temperature. It was produced in ampoules, and doses were calculated in IVD (minimum pyrogenic doses), the maximum dose was 1000 IVD per day.
But everything is changing in our fleeting world, and at some point Pirogenal began to be dosed, like other injectable drugs, in micrograms per ml of solution. The maximum dose was considered to be 100 µg per day. But did not take into account these innovations nurse treatment room and, accustomed to the figure with three zeros, she prepared a dose to the patient in 10 times the allowable.
Acrobatic sketches of 160-kilogram patient due to the terrible convulsive syndrome, hyperthermia 40+, respiratory arrest and other equally vivid symptoms could not expect even the doctors of the intensive care team who have seen a lot. The nurse's prolonged hysteria to the heart-rending screams of her neighbors, terrified by the information about the "new complex therapy" of their disease, completed the fullness of the drama observed by all.
How, after all, it's good to be fat. Say, while the thick dries, thin dies. So it is in our story: the excess weight saved the patient's life, and hyperthermia from a repeatedly exceeded dose of pyrogenal saved him from syphilis, and the need to continue treatment with antibiotics, crystal balls and mosquito bites that carry malaria.
Because Treponema pallid, the causative agent of syphilis, dies at 39.7 degrees.
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?
As a doctor, I repeatedly observed the development of a human embryo from several cells, witnessing the mystery of the appearance of life in the embryological laboratory. Also, as when a long time ago an organism emerged from the first cells, and then a person developed, now having made a population of the planet in seven billion three hundred million, life on the Earth also originated. But, one thing is birth, and the other is development. Read more...
Quite early on, I realized that to truly help a large number of patients, I needed to go beyond the individual approach and create a methodology. I recall the words of Edith Piaf, who said, "I don't sing for everyone—I sing for everyone." And yet, she sang for everyone. So it was for me—there was that inspiration, that moment when the idea of phenotypic dermatology first arose. It was from this moment that the path to a systemic view of the skin began—not as a surface, but as an entire biological universe.
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".