Dr. Tirone David: "Criatividade em Medicina".

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Médico brasileiro e radicado no Canadá, Tirone David é novo membro Honorário Estrangeiro da Academia Nacional de Medicina. Em sua palestra de posse, falou sobre criatividade na medicina e em outros campos do saber.
Na área de medicina, David relatou sua experiência própria de como usou a criatividade para solucionar casos críticos na sala de cirurgia – culminando em descobertas que revolucionaram a cirurgia cardíaca em todo o mundo. Leia a matéria sobre a apresentação em: http://www.anm.org.br/conteudo_view.asp?id=1299

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Dr. Tirone David: "Criatividade em Medicina".

  1. 1. Creativity in Surgery Tirone E. David University of Toronto
  2. 2. CREATIVITY1. Genius theory
  3. 3. Leonardo da Vinci 1452 - 1519
  4. 4. Works of Leonardo da Vinci
  5. 5. CREATIVITY1. Genius theory2. Stepwise, logical evolution of new ideas, products, operative procedures, etc…
  6. 6. Model of the DNA Watson & CrickNature 1953; 171:737-8
  7. 7. "Father of Genetics"Gregor Mendel Son of a farmer who became a catholic monk, conducted an experiment that involved growing thousands of pea plants, which 1822-1884 led to the discovery of genes. His ideas were published in 1866 but went largely unrecognized until 1900.
  8. 8. Virulent + = DeathFrederick Griffith Pneumococcus 1881 - 1941 Non-virulent + = Live Pneumococcus Heated virulent + = Live Pneumococcus Non-virulent +Experiments with + heated virulent = DeathPneumococcus in 1928 Pneumococci
  9. 9. Non-virulent ++ = Death Oswald Avery heated 1877 - 1955 virulent Pneumococci + Non-virulent Virulent with destroyed lipids, + ribonucleic acids, = Death carbohydrates, and proteins Non-virulent + Virulent with + destroyed = Live deoxyribonucleicExperiments with acidsPneumococcus in 1935
  10. 10. Erwin Chargaff In 1950 he concluded that there must 1905-2002 be as many types of DNA as there are different species. The number of purine bases (adenine and guanine) was equal to the number of pyrimidine bases (cytosine and thymine). The number of adenine bases was equal to the number of thymine bases and the number of guanine bases was equal the number of cytosine bases. Chargaff’s rule: A = T, and G = C
  11. 11. Linus Pauling 1901-1994In May 1951, he described the structures of anumber of proteins, including the structure ofthe single most important basic form of proteinchain, the alpha helix (a hydrogen-bondedhelical chain that is a structural component ofmost proteins).
  12. 12. Cavendish Laboratory Randall’s Laboratory Cambridge King’s CollegeJames Francis Rosalind MauriceWatson Crick Franklin Wilkins 1928- 1916-2004 1920-58 1916-2004
  13. 13. Rosalind Franklin Franklin’s x-ray 1920-58 diffraction of DNA
  14. 14. Watson and CrickOriginal Model of DNA Nature, 1953
  15. 15. Nobel Prize of Physiology or Medicine 1962 Francis Crick James Watson Maurice Wilkins 1/3 prize 1/3 prize 1/3 prize
  16. 16. Rosalind FranklinDied in 1958 at 37 years Franklin’s x-raysof age of ovarian cancer diffraction of DNA
  17. 17. 1953 – Watson & Crick 1952 - Franklin 1951 - Pauling 1950 - Chargaff 1935 - Avery 1928 - Griffith 1866 - Mendel
  18. 18. Leonardo da Vinci“The Paragon of Creativity”
  19. 19. Thomas Alva Edison 1847 - 1931 “Creativity is 1% inspiration and 99% perspiration”
  20. 20. Creative PeopleSkillfulSelf-motivatedKnowledgeable
  21. 21. Creativity results from the interaction ofa system composed of three elements: Domain Field Person
  22. 22. Domain is an area of our cultureExamples of domains: Medicine Heart valve surgery Mitral valve surgery
  23. 23. Field = gatekeepers of a domainWithout the assessment of competent outsiders there is noreliable way to decide whether the claims of a self-styledcreative person are valid.
  24. 24. PersonThe individual that is able to create a new idea, product, oran operation
  25. 25. Left Ventricular Rupture AfterMVR Treasure RL et al. Chest 1974;66:511
  26. 26. Left Ventricular Rupture AfterMVR
  27. 27. Reconstruction of the Mitral Annulus
  28. 28. Reconstruction of the Base of the LV
  29. 29. Reconstruction of the Base of the LV
  30. 30. Reconstruction of the Base of the LV
  31. 31. Reconstruction of the Base of the LV
  32. 32. Reconstruction of the Base of the LV
  33. 33. Reconstruction of the Base of the LV
  34. 34. Post-Acute Myocardial Infarction VSD Repair by Infarct Exclusion
  35. 35. Post-Acute Myocardial Infarction VSD Repair by Infarct Exclusion
  36. 36. Endocardial patch for LV rupture Reconstruction the mitral annulus Reconstruction of the base of the heart Reconstruction of the LV wall
  37. 37. Peer-reviewed publicationsLeft ventricular rupture after mitral valve replacement: endocardial repair withpericardial patch.David TE. J Thorac Cardiovasc Surg. 1987 Jun;93(6):935-6Reconstruction of the mitral anulus.David TE, Feindel CM. Circulation. 1987 Sep;76(3 Pt 2):III102-Postinfarction ventricular septal rupture: repair by endocardial patch with infarctexclusion.David TE, Dale L, Sun Z. J Thorac Cardiovasc Surg. 1995 Nov;110(5):1315-22.... Plus 28 other publications on this topic
  38. 38. Surgical Creativity• A process that unfolds during a lifetime
  39. 39. Mitral Valve SurgeryLV function after MV repair is better than after MVR Gore-Tex for replacement of chordae tendineae Techniques of MV repair in Barlow’s valves
  40. 40. Aortic Valve Surgery Stentless aortic valves
  41. 41. Aortic Valve SurgeryAortic valve sparing operations
  42. 42. Creativity results from the interaction ofa system composed of three elements: Domain Field Person
  43. 43. Surgical CreativityArises from the synergy of many sources andnot from the mind of a single person
  44. 44. Outliers:Albert EinsteinIQ 150Christopher LanganIQ 195
  45. 45. Christopher LanganBorn in San Francisco, 1952“The smartest man in America" IQ = 195 - 210He rose to prominence in 1999while working as a bar bouncerin Long IslandThe Cognitive-Theoretic Modelof the Universe
  46. 46. Gladwell:“No one –not even rock stars,not professional athletes, notsoftware millionaires, and noteven geniuses – ever makesit alone”
  47. 47. The End of Europe’s Middle AgeFlorence, Italy – Renaissance’s Birthplace
  48. 48. Where do creative ideas come from?Come from the pastCome from previous knowledge and experiencesCreative works begin in continuity with the past
  49. 49. Surgical CreativityArises from the synergy of many sources andnot from the mind of a single person
  50. 50. “Creativity is 1% inspiration and 99% perspiration” Thomas Edison
  51. 51. Thank you

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