Almeida Filho Naomar
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil.
Rev Saude Publica. 2014 Apr;48(2):192-205. doi: 10.1590/s0034-8910.2014048005196.
This article presents a systematic framework for modeling several classes of illness-sickness-disease named as Holopathogenesis. Holopathogenesis is defined as processes of over-determination of diseases and related conditions taken as a whole, comprising selected facets of the complex object Health. First, a conceptual background of Holopathogenesis is presented as a series of significant interfaces (biomolecular-immunological, physiopathological-clinical, epidemiological-ecosocial). Second, propositions derived from Holopathogenesis are introduced in order to allow drawing the disease-illness-sickness complex as a hierarchical network of networks. Third, a formalization of intra- and inter-level correspondences, over-determination processes, effects and links of Holopathogenesis models is proposed. Finally, the Holopathogenesis frame is evaluated as a comprehensive theoretical pathology taken as a preliminary step towards a unified theory of health-disease.
本文提出了一个用于对几类疾病（命名为整体发病机制）进行建模的系统框架。整体发病机制被定义为将疾病及相关状况作为一个整体的过度决定过程，涵盖了复杂对象“健康”的选定方面。首先，将整体发病机制的概念背景呈现为一系列重要界面（生物分子 - 免疫、生理病理 - 临床、流行病学 - 生态社会）。其次，引入源自整体发病机制的命题，以便将疾病 - 病症 - 疾病复合体描绘为一个分层的网络之网络。第三，提出了整体发病机制模型的层内和层间对应、过度决定过程、效应及联系的形式化表述。最后，对整体发病机制框架作为一种综合理论病理学进行评估，将其视为迈向健康 - 疾病统一理论的初步步骤。
