PATHOPHYSIOLOGY IN POSTGENOMIC ERA – NATURAL ETIOPATHOGENETIC ALGORHYTHMS AND CLUSTERS OF HEALTH DISORDERS

Objectives Medical reasoning takes in consideration both quantitative and qualitative analysis in attempts to figure out natural regularities. Postgenomic throughput methodologies and theoretical visions have become a real challenge to medicine, and vice versa . Databases are pilling up copious amounts of verifiable data and myriads of new nano‐scale relations. Big data and statistical treatment of data generate important insights into the complexity of human physiology. On the other side, the macro‐scale world of clinical medicine is faced with a lower degree of certainty, vast variability, redundancy, nonlinearity, etc. Diagnostic improvements added up to quantitative power of whole body functional and morphological evaluation. Yet, comprehensive understanding of pathophysiological pathways and networking remains as a global challenging issue. In order to upgrade understanding we have developed etiopathogenetic algorhythm and cluster approaches. The tools Methods Horizontal, vertical and longitudinal integration is driven by the method of algorhythmic elaboration . It has for steps. 1. The exposition of problem is in form of “raw data” (clinical, molecular, and case‐based). 2. The repetition of relevant concepts and mechanisms via MCQ. 3. The algorhythmic workout imposes the development a causeconsequence sequence of events out of pre‐given 25–30 units. Students develop a graphic representation of etiopathogenetic cause‐sequel relations, and regulatory pathways. 4. Systematization and quantitative aspects. Natural tendency to form the common crossing points of reactivity of heterogeneous pathways was noticed. They converge and form etiopathogenetic clusters (EPC). EPCs integrate multiple inputs and multiple exits in the natural development of various diseases. They look like natural integrators, the common „hubs“ of human body response. Results Quantitative survey of >4000 medical students and any newcomers, over last 2 decades, pointed out that algorhythmic workouts have been 2.3 times more efficient in comparison to classical methods. 11 out of 12 teaching staff professionals think that matrix approach prevents negative effects of “compartmentalization” in medicine, and, all of them agree on higher efficiency and unique integrative power of the method. 91 EPCs are “distilled” from 1165 study cases. The EPCs have tendency to form interactive networks, with “connecting index” of 20.2/EPC. Conclusion Both methods, the algorhythms and EPCs, do bridge the basic science – clinical gap. Both physicians and scientists may benefit from these integrative innovations. Stratification and subsidiarity of etiopathogenetic events their intercommunications and networking add up to more complete understanding. Some limitations of scientific methodological reductionism are confronted with integral clinical reactivity and interpretations. The EPC‐crossing points on etiopathogenetic pathways are often therapy targets, leading to a prompt correction of connected physiological deviations. For example, the EPC of hypoglycemia treated with glucose infusion improves all hypoglycemia related dysfunctions and symptoms.