El determinismo de Newton-Laplace en el derecho positivo de la legislación colombiana frente a la incertidumbre de Heisenberg en el ejercicio médico Translated title: Newton's and Laplace's determinism in the positive law of colombian legislation vs. Heinsenberg's uncertainty in medical practice
There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Objetivo: hacer una reflexión sobre la tendencia de la legislación colombiana que
regula el ejercicio médico, cada vez más impregnada del positivismo de Lombroso, Ferri
y Garofalo, seguidores de la corriente determinista de Newton-Laplace, según la cual
todo es pronosticable. Tesis: la medicina es una de las disciplinas humanas con más
alta probabilidad de producir beneficios o desenlaces aleatorios. Conclusiones: la
normatividad debe estar embebida de la prudencia que le es propia, para no sitiar
a los profesionales de la medicina.
Translated abstract
Objective: To reflect on Colombian legislation regulating medical practice, increasingly
permeated by the positivism of Lombroso, Ferri and Garofalo, followers of Newton's
and La Place's deterministic think ing according to which every thing is predictable.
Thesis: Among human sciences, some of the highest odds of producing random benefits
or outcomes are found in medicine. Conclusions: Regulations must be imbued with the
wisdom inherent to them in order to avoid placing medical practitioners under siege.
Hypertrophic scars and keloids remain a challenge in surgery. We appreciate that our understanding of the process at cellular and molecular level, profound as it is, when it comes to the clinical evidence much is left to be desired. Although the bench to bedside conundrum remains, the science of translational research calls for an even higher level of cooperation between the scientist and the clinician for the impetus to succeed.The clinicians alerted us to the possible theories in the pathogenesis of keloid formation, inter alia, the ischemia theory, mast cell theory, immune theory, transforming growth factor β interaction, mechanical theory, and the melanocyte stimulating hormone theory. All of the above presupposed a stimulus that would result in an uncontrolled upregulation of collagen and extracellular matrix expression in the pathogenesis of the keloid. This bedside to bench initiative, as in true science, realized more ponderables than possibilities.By the same token, research into the epidermal-mesenchymal signaling, molecular biology, genomics, and stem cell research holds much promise in the bench top arena. To assess efficacy, many scar assessment scores exist in the literature. The clinical measurement of scar maturity can aid in determining end points for therapeutics. Tissue oxygen tension and color assessment of scars by standardized photography proved to be useful.In surgery, the use of dermal substitutes holds some promise as we surmise that quality scars that arise from dermal elements, molecular and enzyme behavior, and balance. Although a systematic review shows some benefit for earlier closure and healing of wounds, no such review exists at this point in time for the use of dermal substitutes in scars.Adipose-derived stem cell, as it pertains to scars, will hopefully realize the potential of skin regeneration rather than by repair in which we are familiar with as well as the undesirable scarring as a result of healing through the inflammatory response.Translational research will bear the fruit of coordinating bench to bedside and vice versa in the interest of progress into the field of regenerative healing that will benefit the patient who otherwise suffers the myriad of scar complications.