Transformation of the Nosological Forms into Syndromes: Are Such Aspirations of Some Clinicians Progressive?

Abstract

Introduction. Each disease consists of predictors, symptoms, syndromes, which form the signs of the disease. However, the syndrome is not identical with the disease, it is not a nosological unit. It can be a manifestation of various diseases. Syndrome is a collection of different symptoms. Often syndromes are present in the nosological form. And it is unlikely that in the doctrine of nosology to “open” new syndromes, including several known diseases. Aim. To discuss the problem of transformation of nosological forms into syndromes in medical practice. Materials and methods. The content analysis, the method of system and comparative analysis, the bibliosemantic method of studying the actual scientific opinions of scientists about the doctrine of the diagnose, the problems of transformation of nosological forms into syndromes, some new tendencies of formulation, completeness of the diagnoses were used. Results. The structure of the diagnosis was developed by Ukrainian pathologists in the second half of the last century. The expanded diagnosis – both clinical and pathologoanatomic – is based on a certain principle. At the centre of it are causal relationships. The full diagnosis is: the underlying disease, the complication of the underlying disease, and concomitant diseases. Several logical tendencies can be singled out in the wording in modern clinical practice. The first trend is the combination of several diseases into the syndrome, the second – the transfer of the symptom into the syndrome, the third trend – the obvious complication of treatment is called syndrome, the fourth – the desire to combine several diseases in one, replacing, for example, the well-known complication of a disease (lack of organs’ function), giving this complication a “new”, generalized “disease”, the fifth – comorbidity – the real situation when two or more syndromes or nosological forms are detected in the same patient. Full “diagnose should be nosological, etiologic, pathogenic and “historical”, that is to reflect the disease in the form of a consistent causally caused change in its various stages. It is a document that presents the history of the disease in a concretised, most concise statement. Conclusions. The concept and doctrine of the diagnoses for foreign clinicians are obviously not known. We do not know the theoretical justification of new foreign trends in constructing of the diagnose. And moreover, we emphasize, it is unlikely that the syndrome-molecular approach can contribute to nosological statistics, the search for primary prevention, and the resolution of the problems of preventive medicine.

Keywords

• diagnosis
• nosological forms
• syndrome