Estrógeno potenciado en el tratamiento homeopático del dolor pélvico asociado a endometriosis: un estudio aleatorizado, doble ciego, controlado con placebo, de 24 semanas / Potentiated estrogen in the homeopathic treatment of pelvic pain associated with endometriosis: a 24-week randomized, double-blind, placebo-controlled study

Evaluar la eficacia y seguridad del estrógeno potenciado en comparación con el placebo en el tratamiento homeopático del dolor pélvico asociado a endometriosis (EAPP, por sus siglas en inglés). Diseño del estudio: El presente fue un estudio clínico aleatorizado, doble ciego, controlado con placebo, de 24 semanas, el cual incluyó a 50 mujeres de entre 18 y 45 años de edad con diagnóstico de endometriosis infiltrante profunda con base en ultrasonido transvaginal o imágenes de resonancia magnética después de preparación intestinal, así como puntaje ≥ 5 en una escala visual analógica (VAS: rango de 0 a 10 puntos) para el dolor pélvico asociado con la endometriosis. Se administró estrógeno potenciado (12cH, 18cH y 24cH) o placebo dos veces al día por vía oral. La medida principal de resultado fue el cambio en la severidad de los puntajes parcial y global de EAPP (VAS) de la línea basal a la semana 24, determinada como la diferencia en el puntaje medio de cinco modalidades de dolor pélvico crónico (dismenorrea, dispareunia profunda, dolor pélvico no cíclico, dolor intestinal cíclico y/o dolor urinario cíclico). Las medidas secundarias de resultado fueron la diferencia media de puntaje para la calidad de vida evaluada con el Cuestionario de Salud SF-36, los síntomas de depresión en el Inventario de la Depresión de Beck (BDI) y los síntomas de ansiedad en el Inventario de Ansiedad de Beck (BAI). Resultados: El puntaje global de EAPP (VAS: rango de 0 a 50 puntos) se redujo en 12.82 (p < 0.001) en el grupo tratado con estrógeno potenciado de la línea basal a la semana 24. El grupo que utilizó estrógeno potenciado también presentó una reducción en el puntaje parcial (VAS: rango de 0 a 10 puntos) en tres modalidades de EAPP: dismenorrea (3.28; p < 0.001), dolor pélvico no cíclico (2.71; p = 0.009) y dolor intestinal cíclico (3.40; p < 0.001). El grupo de placebo no mostró cambio significativo alguno en los puntajes global o parcial de EAPP. Además, el grupo de estrógeno potenciado mostró un mejoramiento significativo en tres de ocho ámbitos de SF-36 (dolor de cuerpo, vitalidad y salud mental) y síntomas de depresión (BDI). El grupo de placebo no mostró un mejoramiento significativo a este respecto. Estos resultados demuestran la superioridad del estrógeno potenciado sobre el placebo. Se asociaron pocos eventos adversos con el estrógeno potenciado. Conclusiones: El estrógeno potenciado (12cH, 18cH y 24cH) en dosis de 3 gotas dos veces al día durante 24 semanas fue significativamente más efectivo que el placebo para reducir el dolor pélvico asociado con la endometriosis. Registro del estudio clínico: ClinicalTrials.gov Identificador: https://clinicaltrials.gov/show/NCT02427386.

To evaluate the efficacy and safety of potentized estrogen compared to placebo in homeopathic treatment of endometriosis-associated pelvic pain (EAPP). Study design: The present was a 24-week, randomized, doubleblind, placebocontrolled trial that included 50 women aged 18-45 years old with diagnosis of deeply infiltrating endometriosis based on magnetic resonance imaging or transvaginal ultrasound after bowel preparation, and score ≥ 5 on a visual analogue scale (VAS: range 0 to 10 points) for endometriosis-associated pelvic pain. Potentized estrogen (12cH, 18cH and 24cH) or placebo was administered twice daily per oral route. The primary outcome measure was change in the severity of EAPP global and partial scores (VAS) from baseline to week 24, determined as the difference in the mean score of five modalities of chronic pelvic pain (dysmenorrhea, deep dyspareunia, non-cyclic pelvic pain, cyclic bowel pain and/or cyclic urinary pain). The secondary outcome measures were mean score difference for quality of life assessed with SF-36 Health Survey Questionnaire, depression symptoms on Beck Depression Inventory (BDI), and anxiety symptoms on Beck Anxiety Inventory (BAI). Results: The EAPP global score (VAS: range 0 to 50 points) decreased by 12.82 (p < 0.001) in the group treated with potentized estrogen from baseline to week 24. Group that used potentized estrogen also exhibited partial score (VAS: range 0 to 10 points) reduction in three EAPP modalities: dysmenorrhea (3.28; p < 0.001), non-cyclic pelvic pain (2.71; p = 0.009), and cyclic bowel pain (3.40; p < 0.001). Placebo group did not show any significant changes in EAPP global or partial scores. In addition, the potentized estrogen group showed significant improvement in three of eight SF-36 domains (bodily pain, vitality and mental health) and depression symptoms (BDI). Placebo group showed no significant improvement in this regard. These results demonstrate superiority of potentized estrogen over placebo. Few adverse events were associated with potentized estrogen. Conclusions: Potentized estrogen (12cH, 18cH and 24cH) at a dose of 3 drops twice daily for 24 weeks was significantly more effective than placebo for reducing endometriosis-associated pelvic pain.

Patogenesias recentes / Recent pathogenesies

Na presente mesa-redonda apresentamos a evolução do nosso aprendizado como diretor de experimentação. Relata-se o trabalho comparado de três experimentações: A primeira com alunos do 3º ano do curso de especialização em homeopatia da Associação Médica Homeopática do Paraná e as duas seguintes com pacientes da clínica homeopática do diretor de experimentação que acederam participar das mesmas. Estes pacientes funcionais, agora experimentadores em estado de equilíbrio estável, foram convidados a participar da experimentação pelo fato de terem sido bem estudados e conhecido o medicamento homeopático que reequilibrou cada um deles. Experimentou-se, pois, um medicamento pelo "duplo-cego" em experimentadores cujo medicamento era conhecido, proceder até então inédito na experimentação homeopática. Enveredou-se por esse tipo de pesquisa pelo fato de nunca antes haver sido feita a comparação entre os sintomas comuns ao medicamento do experimentador e o medicamento experimentado. Inicialmente tal proceder objetivava, além de efetuar a comparação supracitada, confirmar ou refutar a afirmação de que os sintomas que surgem durante a experimentação são comuns ao medicamento experimentado e o experimentador e não apenas exclusivos do medicamento. Com o desenrolar das experimentações outros fatos importantes foram sendo constatados, como o retorno, anos depois, de sintomas desencadeados durante a experimentação, a confirmação do perfil dos medicamentos, sintomas não registrados na descrição das patogenesias etc. Todos esses dados são discutidos à medida que é apresentada a técnica do experimento (material e método), visto que o objetivo desta mesa-redonda é discutir os encaminhamentos para novas experimentações. Nestes encaminhamentos propõe-se: algumas adições à Ficha Clínica modelo LUIMO para experimentações, discussão sobre o perfil do experimentador ideal, formação de centrais de experimentação ancoradas em diretores de experimentação, independentemente da instituição a que pertençam, visto que as instituições permanecem mas os homens por que elas passam nem sempre têm as mesmas intenções.

Estudo dos efeitos de placebo X medicamento homeopático na totalidade sintomática característica em hipertensos / Pilot comparative study of the placebo effects and homoeopathic drugs, on the pressure levels of high blood pressure patients

Os autores realizaram um estudo piloto de investigação clínica, no ambulatório da Associação Paulista de Homeopatia, para verificar os efeitos de placebo e de medicamentos homeopáticos, escolhidos por totalidade sintomática característica individual, com um grupo de pacientes portadores de hipertensão arterial. Foi enfocada a capacidade de atuação do placebo e de dinamizações sucessivas de medicamento único, 6C, 12C, 30C e 200C, em doses repetidas, 2 vezes ao dia, na referida totalidade sintomatológica, considerando-se seu desaparecimento ou melhoria. Placebo e homeopatia foram fornecidos em frascos idênticos, a cada 4 semanas, começando pelo placebo, até atingir a 200C. Consultas de controle a cada 2 semanas. Concluise pela significância do medicamento homeopático, que não produziu praticamente agravações ou patogenesias, em doses repetidas. A partir da experiência, os autores sugeres condições melhores para feitura de trabalhos semelhantes, para uma melhor avaliação estatística. (AU)

Nineteen patients with idiopathic high blood pressure were subjected to treatment with placebo and homeopathic medicines. Their effects on the characteristic symptoms used to select the individual medication of each patients were analyzed. Statistically significant effect was found for the homeopathic drugs. No aggravation of pathogenetic symptoms practically occurred with doses taken twice daily. Based on their experience, the authors suggest how to improve studies in this field. (AU)

Estudo piloto comparativo dos efeitos de placebo e medicação homeopática sobre os níveis pressóricos de pacientes hipertensos / Pilot comparative study of the placebo effects and homoeopathic drugs, on the pressure levels of high blood pressure patients

Os autores realizaram um estudo piloto, na Associação Paulista de Homeopatia, para averiguar os efeitos de placebo e medicação homeopática sobe os níveis pressóricos de pacientes portadores de hipertensão arterial sistêmica idiopática. Foram estudados 19 pacientes em uso concomitante ou não de drogas hipotensoras, sendo 14 do sexo feminino, com idade média de 53 anos, e 5 do sexo masculino, com idade média de 44 anos. Fez-se uso do medicamento homeopático único, escolhido por totalidade sintomática característica, nas dinamizações 6C, 12C, 30C, 200C, em doses repetidas, 2 vezes ao dia, por 4 semanas cada. Todos os pacientes receberam previamente placebo por um período de 4 semanas (fase "washout"). Constatou-se efeito significativo da terapêutica homeopática, porém, dentro de uma dinamização individualizada para cada paciente, além da individualização do medicamento. Os autores finalmente fazem considerações para estudos futuros. (AU)

The authors performed a pilot study at the São Paulo Medical Homeopathic Association to investigate the effects of placebo and homeopathic treatment on the blood pressure of patients with idiopathic hypertension. We analyzed 19 patients concomitantly using or not antihypertensive agents, 14 females, with average age 53 years old, and 5 males, with average age 44 years old. One single homeopathic drug was selected as per the total set of characteristic symptoms, and prescribed in dilutions 6C, 12C, 30C and 200C, in repeated doses, twice per day, over 4 weeks each. All the patients previously received placebo over 4 weeks (washout). We found significant effect of homeopathic treatment, however, only for the best individual dilution, in addition to the individualization of the prescribed drugs. The authors finally make some considerations relative to future studies. (au)

El placebo en la homeopatía / The homeopathy placebo

Numerosos estudios en todo el mundo han tratado de entender al placebo y al efecto que produce en el paciente, sin que hasta el momento se haja clarificado por completo su naturaleza. Los conocimientos que tenemos nos muestran que muchos factores influyen en el estado de salud de una persona, y que lo hacen de manera tan caprichosa e impredecible que la definición más utilizada en la actualidad, que señala que el placebo es una sustancia, procedimiento o intervención sin efecto fisiológico ni bioquímico sobre un padecimiento o condición en estudio, es imprecisa.(AU)

Numerous studies worldwide have tried to understand the placebo and the placebo effect on the patient, but ultil now it not has been completely clarified in its nature. The knowledge we have to date shows that many factors influence the health of a person, and they do it so erratically and unpredictably that the definition used today, which indicates that the placebo is a substance, procedure or intervention physiological or biochemical void on a disease or condition under study,it could be inaccurate.(AU)

Sobre as Altas Diluições: efeitos globais causados por quantidades ínfimas / On Ultra-High Dilutions: global effects caused by minimal quantities

Introduction: The role played by minimum quantities, generating large scale effects, and even of catastrophic consequence, is very commonly observed in many areas of science. In Physics, for example, the doping of impurities in materials like silicon (as low as one atom per billion) results in spectacular semiconductor properties. In Biology, the effects of pheromones produced by insects and other animals are so dramatic that females of the emperor moth can attract mating males from kilometers away. And, concerning human health, severe body reactions may occur following the ingestion of very diminutive quantity of some allergic food. In this paper, the question of how Nature provides mechanisms for developing such dramatic and many times unexpected results, from very faint stimulus, will be proposed and discussed. In particular, a model for the controversial issue of how homeopathic remedies can influence and impose organic responses will also be addressed. This model particularly rely on the here named infotrans mechanism, which is based on a type of resonant property that may induce living organisms to promptly over-react after a pseudo environmental aggression. Finally, arguments will be provided to demonstrate that water, mainly due to its very high dielectric constant, can be considered a very good mediator for the infotrans. The Role of Water in Important Biological Mechanisms: Assuming that water molecules can indeed rearrange themselves to form larger clusters, it is reasonable to accept that different external excitations might induce these structures to assemble in distinctive ways. As matter of fact, experimental evidences already exist in literature showing that ultra-high dilutions of different substances, when compared to pure water, do exhibit relevant physico-chemical differences. More recently, investigations have shown that water plays a crucial role in biological systems such as the protein folding process or the twisting of DNA helixes. Thus, it is reasonable to accept that water, having the possibly of structuring itself in an almost endless variety of ways, it will impact in a unique and own peculiar way the individual cells and even entire organs. That is, the codified information related to the specific architecture of the water cluster, in result to previous stimulus (infotrans), will be passed on to the living organism through the nervous system and induce, in consequence, a prompt reaction. The specific type of response commanded by the mind, after detecting a particular infotrans, will depend on the array of experiences the living being had previously undergone. In some circumstances, however, the mind may mistake the information received from the nervous system, treating a harmless organic process as a dangerous attack. In this situation the overall body reaction can be very dramatic, as the reported cases of children that had to be hospitalized in serious health conditions (even with some fatal occurrences) after the ingestion of only residual amounts of allergic foods like peanut, wheat and milk.The Transfer of Information (InfoTrans) and the Placebo Effect: Interestingly, the mechanism of infotrans is much more extensive and does not restrict itself to transference of information by material means. All our five senses are channels that bring information to the mind and which might cause global bodyInt J High Dilution Res 2011; 10(36):97-100Proceedings of the XXV GIRI Symposium and VIII CBFH; 2011 Sep 04-07; Foz do Iguaçu (Brazil)98reactions. The picture of a grotesque insect, for example, may induce a sensitive (entomophobic) person to sweat, feel dizzy and, sometimes, even trigger severe emotional reactions like panic and terror. Moreover, different persons that listen to a playing music are observed to react in different ways. Of course, it is not the music being played that causes, by itself, these reactions. What happens is that each individual?s mind will process the same stimulus (the music) differently, based on the various situations experienced throughout the person?s existences, and which had been stored in his sub-conscience. To finalize, it is not difficult to conclude, from the discussion above, that the ?placebo effect? can be easily understood in terms of the here proposed infotrans mechanism. By accepting the suggestion from any health personnel, and/or truly believing that a prescribed healing procedure will be effective, the mind eventually triggers many sorts of organic reactions that turn out to be efficient enough to resolve a person?s medical problem. Conclusions: In this work the mechanism of infotrans (transferred information) is proposed as an explanation of how homeopathic remedies are very successful in restoring people?s health. It is based on the innumerous experiences a person has undergone throughout his lives and which have been imprinted in his sub-conscience. After receiving the information from an homeopathic preparation (codified by the way the water clusters structured themselves), if the corresponding infotrans does resonate with some archetypal experience the patient has stored in his sub-conscience (related to an ancient case in which he had suffered a type of illness which has caused the same kind of symptoms he is now experiencing), his defensive immune system will automatically receive from the mind a command to counterattack the (hypothetical) aggression by strongly intensifying the defensive measurements already on course and/or initiating new ones.(AU)

The 2005 Lancet review proved superior quality of homeopathy trials: what's next? / A revisão em 2005 de the lancet comprovou a qualidade superior dos ensaios homeopáticos. O que vem a seguir?

Several former reviews showed positive effects of homeopathy, but in 2005 The Lancet published a review which claimed that homeopathy is a placebo effect. This review was criticised for not revealing essential information. A reconstruction of post-publication data challenges the negative conclusion. The only conclusion that was rectified by the methodology of the 2005 review was that the quality of homeopathy trials, and especially of smaller trials, is better than quality of conventional trials. The comparison of the effect of 110 homeopathy trials with 110 matched conventional trials was flawed by selection bias, different publication bias, different quality, and different safety. Nevertheless, there is no significant difference of effects between both methods. Discussions about proof for homeopathy are in fact discussions about science. The prior assumption that homeopathy cannot work pervades all aspects of this discussion and is not properly evaluated in the introduction of most analyses.(AU)

Algunos aspectos sobre asma y homeopatía, acerca del tratamiento. ¿ Es eficaz o es un efecto placebo? / Some aspects of asthma and homeopathy, about treatment. Is it effective or is a placebo effect?

En los Estados Unidos viven aproximadamente 10 millones de asmáticos. Entre 1980 y 1987, las tasas de prevalencia de asma aumentaron en un 29% y entre 1970 y 1987, el número de altas hospitalarias debidas al asma casi se triplicó.

El placebo y su importancia en la clínica homeopática / Placebo and its importance in homoeopathic clinic

La medicina alopática reporta en muchos estudios doble ciego sobre la eficacia del (placebo = pso) en el alivio del dolor. El pso como analgésico puede ser tan efectivo como la morfina hasta en un 55% de los casos (cifra muy elevada) en otras palabras la reducción del dolor con el pso corresponde un 55% por ciento de lo que se obtiene en la alopatía con la morfina y analgésicos.

Importancia del placebo en Homeopatia, segun Hahnemanann / Importancy of placebo in homeopathy

El autor pasa revista las distintas indicaciones dadas poe rl propio Hahnemann para el empleo de la medicacion placebo en Homeopatia. (AU)

Importancia del placebo en Homeopatia, segun Hahnemanann / Importancy of placebo in homeopathy

El autor pasa revista las distintas indicaciones dadas poe rl propio Hahnemann para el empleo de la medicacion placebo en Homeopatia. (AU)

Le placebo / The placebo

Si le recours a la technique du placebo n'est pas interessant pour "demontrer" l'homeopathie, il est essentiel pour faire la part de l'effet "consultation" de l'effet reel de nos traitements homeopathiques. Il permet de reveler... (AU)

More trials, fewer placebos, please

The argument that randomized placebo-controlled trials of homeopathy might usefully be replaced by observational studies, audit and quality-of life assessment is considered. Randomized equivalence and patient-preference trials are proposed as more... (AU)

Connaissez-vous la medecine fondee sur les "faits prouves"? / Do you know the evidence based medecine?

La medecine fondee sur les faits prouves cherche a resoudre les problemes rencontres dans notre activite clinique. Dans cette optique, deux etudes concernant l'efficacite des antibiotiques dans les... (AU)