Pioneers in ethics, medical science and relations with patients
From the early days professional teams associated with Dr. Bittencourt have established a long succession of new trans-disciplinary techniques in diagnosis and therapeutics of disorders of the central nervous system. This has been related to the application of the scientific method to Medicine. We investigate what has been done in a certain field, follow with the replication of something that has been done in the past, until the technique is refined to the point of perfection. Then we follow with small improvements. This has led to a number of good predictions in the clinical application of techniques and concepts in areas involving neuroimaging, electrophysiology and clinical pharmacology. In this fashion, the teams at Rua Padre Anchieta have established a number of pioneering techniques, sometimes nationally, other times internationally. All the advances mentioned in this article are published in the specialized, peer-reviewed, indexed medical literature
It was in our teams that the concept of Alzheimer’s disease and the frontotemporal dementias were introduced in Brazil; the Ambulatory EEG; Digital Electrocortigography; epilepsy surgery with non-invasive digital EEG; our statistics of more than 110 cases of epilepsy surgery without permanent morbidity or mortality is unsurpasssed. Our own Digital Brain EEG Mapping; the first hippocampal measurement with magnetic resonance imaging in Brazil; the clinical pharmacology of amiodarone, drugs for neurocysticercosis, epilepsy and multiple sclerosis; the intensive use of serum concentrations of antiepileptic drugs, r-TPA for stroke and sleep studies in Paraná, visualization of multiple sclerosis lesions in the spinal cord; the use of high dose gadolinium in MR stdudies in multiple sclerosis; the treatment of normal pressure hydrocephalus with repeated lumbar punctures.
It was in 2005 that the group introduced the concept of hematopoietic stem cell mobilization therapy for auto-immune diseases, including multiple sclerosis, ankylosing encephalitis, rheumatoid arthritis, systemic lupus erythematosus. At the time we documented, perhaps at an international level, what must have been one of the very first cases of neurological recovery and disappearance of demyelinating lesions of the central nervous system. It was in this manner that we participated in a conceptual revolution in Neurology and the Neurosciences, contemplating, for the first time, the possibility of the recovery of function in patients with neurological deficits, something unheard of until then. To restore neurological function became a possibility.
This intense scientific involvement has been the constant companion of activities in the interest of patients. It was in this same group of professionals that the first association of people with multiple sclerosis was established. The Brazilian MS Society of Curitiba was set up one year before the São Paulo society, and the curitibanos allowed the paulistas to have the national society, in view of their much larger size. It was for this reason that the late Dr Roberto Melaragno inserted Dr Paulo Rogério Mudrovitsch de Bittencourt in the Medical Council of the ABEM in a definitive manner. Our involvement with Liga Brasileira de Epilepsia and International League Against Epilepsy are specified in Medical and Administrative Director.
Involvement with Medical Ethics and Bioethics was very early, to give support to the great number of new diagnostic and therapeutic procedures being introduced at Unidade de Neurologia Clínica, the 5thBrazilian, and the 1st private institution to have an ethics committee, recognized by the first CONEP, in the times of Professor E. Carlini. The criteria for the clinical diagnosis of brainstem death were first introduced at Hospital NS Graças very early on.
Between August and November 1998 we trained professionals who had been selected for the initiative and abilities to develop new projects, as well as for their fluency in the English language. Priscila Campos, Maria Paula Bock da Silva and Sheila Tanaka, initially under the supervision of Dr. Paulo Rogério Mudrovitsch de Bittencourt, started a modern, scientific and ethical method of supporting our patients with mental and physical health concepts, specifically in areas related to obesity, chronic fatigue and fibromyalgia. With a view towards health rather than disease, this team developed a physical and psychological approach, linked conceptually to the principles of cognitive behavioral psychology. It was in relation to these concepts that the clinic pioneered in Brazil principles of prevention of Alzheimer’s disease, supported by a group of pharmaceutical substances the value of which had been supported by clinical research. We established, for the terror of cardiologists, the idea that the control of high blood pressure is more efficient and simple with a daily pill that contains the very established anti-hypertensive drugs, the poly-pill of a couple of British researchers. And so we continue in the quest for improved patient care, with Dimpna.
In 2012, we started to gradually change our name of Unineuro to Dimpna, for several reasons. First, the brand Unineuro is is widely used, there is Unineuro in many places. Worse, there is a dispute over the intellectual property of the brand. Second, the clinic on the Street Padre Anchieta is once again going through an upgrade of its physical and functional structure. So this is a good time for the change, something we should have done long ago.You, our collaborator, client, friend, visitor of our site, are going to see the brand Dimpna having replaced Unineuro.
Prof. Dr. Paulo Rogério M. de Bittencourt, PhD, FAAN