Data Collection during the COVID-19 Pandemic: Learning from Experience, Resulting in a Bayesian Repertory.

BACKGROUND: A novel pandemic disease offered the opportunity to create new, disease-specific, symptom rubrics for the homeopathic repertory. OBJECTIVE: The aim of this study was to discover the relationship between specific symptoms and specific medicines, especially of symptoms occurring frequently in this disease. MATERIALS AND METHODS: Worldwide collection of data in all possible formats by various parties was coordinated by the Liga Medicorum Homeopathica Internationalis. As the data came in, more symptoms were assessed prospectively. Frequent analysis and feedback by electronic newsletters were used to improve the quality of the data. Likelihood ratios (LRs) of symptoms were calculated. An algorithm for combining symptom LRs was programmed and published in the form of an app. The app was tested against 18 well-described successful cases from Hong Kong. RESULTS: LRs of common symptoms such as 'Fatigue' and 'Headache' provided better differentiation between medicines than did existing repertory entries, which are based only on the narrow presence or absence of symptoms. A mini-repertory for COVID-19 symptoms was published and supported by a web-based algorithm. With a choice of 20 common symptoms, this algorithm produced the same outcome as a full homeopathic analysis based upon a larger number of symptoms, including some that are traditionally considered more specific to particular medicines. CONCLUSION: A repertory based on clinical data and LRs can differentiate between homeopathic medicines using a limited number of frequently occurring epidemic symptoms. A Bayesian computer algorithm to combine symptoms can complement a full homeopathic analysis of cases.

Antimonium Tartaricum as a Possible Homeopathic Prophylactic Remedy in the COVID-19 Epidemic.

The current COVID-19 (coronavirus disease 2019) epidemic has proved challenging due to its high impact on physical and mental health. According to Hahnemann, the founder of homeopathy, in an epidemic the most severe symptoms of the clinical condition presented by the population in question should be the basis for selecting the medication that is as similar as possible to them, and which should be administered to individuals who have been exposed to the disease but have not yet developed it. This medicine is called the genus epidemicus. This study aims to demonstrate the reasoning used to propose the homeopathic medicine Antimonium tartaricum (Ant-t) as a genus epidemicus in the COVID-19 epidemic. It was decided to develop the reasoning based on the respiratory symptoms described in the epidemiological bulletins presented by the Health Surveillance Secretariat of the Ministry of Health of Brazil, as these symptoms are the most serious of the disease. After repertorization, it was confirmed in the Materia Medica that Ant-t has a high degree of similarity with these respiratory symptoms, including the most serious situations, of COVID-19. Homeopathic Ant-t is thus a possible prophylactic genus epidemicus in the COVID-19 epidemic; further studies are needed to test this conclusion.

Randomized, blinded, controlled clinical trial shows no benefit of homeopathic mastitis treatment in dairy cows.

Mastitis is one of the most common diseases in dairy production, and homeopathic remedies have been used increasingly in recent years to treat it. Clinical trials evaluating homeopathy have often been criticized for their inadequate scientific approach. The objective of this triple-blind, randomized controlled trial was to assess the efficacy of homeopathic treatment in bovine clinical mastitis. The study was conducted on a conventionally managed dairy farm between June 2013 and May 2014. Dairy cows with acute mastitis were randomly allocated to homeopathy (n = 70) or placebo (n = 92), for a total of 162 animals. The homeopathic treatment was selected based on clinical symptoms but most commonly consisted of a combination of nosodes with Streptococcinum, Staphylococcinum, Pyrogenium, and Escherichia coli at a potency of 200c. Treatment was administered to cows in the homeopathy group at least once per day for an average of 5 d. The cows in the placebo group were treated similarly, using a placebo preparation instead (lactose globules without active ingredients). If necessary, we also used allopathic drugs (e.g., antibiotics, udder creams, and anti-inflammatory drugs) in both groups. We recorded data relating to the clinical signs of mastitis, treatment, time to recovery, milk yield, somatic cell count at first milk recording after mastitis, and culling. We observed cows for up to 200 d after clinical recovery. Base-level data did not differ between the homeopathy and placebo groups. Mastitis lasted for an average of 6 d in both groups. We observed no significant differences in time to recovery, somatic cell count, risk of clinical cure within 14 d after disease occurrence, mastitis recurrence risk, or culling risk. The results indicated no additional effect of homeopathic treatment compared with placebo. The advantages or disadvantages of homeopathy should be carefully assessed for individual farms.

Prevalence and likelihood ratio of symptoms in patients with good therapeutic response to Lycopodium clavatum. A retrospective study.

BACKGROUND: Assessment of the likelihood ratio (LR) of symptoms has been proposed as a rational means for detecting indicators to homeopathic medicines. AIMS: To investigate the prevalence and LR of symptoms commonly attributed to the homeopathic medicine Lycopodium clavatum (Lyc). Secondarily, to answer the question if experienced homeopaths could intuitively infer which the main symptoms of this medicine are. METHODS: The presence of 35 selected symptoms, prescribed medicines and therapeutic response were assessed retrospectively. The symptoms' prevalence in the Lyc responding population and the LR of the symptoms compared to their prevalence in the remainder of the population were calculated. RESULTS: Two hundred and two Lyc and 550 non Lyc cases (total 752) were included for analysis. Twenty-two symptoms were confirmed as pertaining to Lyc's semiology (prevalence %; LR): contemptuous (3.3; 6.7), urinary stones history (2.7; 5.4), egotism (5.6; 3.6), dictatorial (33.3; 3.4), haughty (8.7; 3.3), sleeps on abdomen (3.3; 3.3), intolerance to clothing in abdomen (12.0; 3.1), reproaches (4.0; 3.0), helplessness (24.0; 2.7), fear of failure (10.7; 2.6), irritability on waking in the morning (16.7; 2.5), constipation alternating with diarrhea (8.7; 2.5), intolerant to contradiction (59.3; 2.3), want of self confidence (30.0; 2.4), abdominal distension after eating (23.3; 2.1); ailments from anticipation (32.0; 1.9), irritability before menses (23.3; 1.8), conscientious (26.0; 1.6), desire of sweets (52.0; 1.6), desire of chocolate (16.7; 1.6), lack of vital heat (41.3; 1.3), and flatterer (1.3; ∞). Surveyed homeopaths' intuitive inferences correlated well with symptoms' prevalence but not with their LR. CONCLUSIONS: Lycopodium's main symptoms are well known by homeopaths, but their knowledge correlates well with the symptoms' prevalence and not with their LR. Retrospective assessment of prevalence and LR of symptoms in good responders might be a means for better selection of symptoms for prospective studies.

Determinants of gastroesophageal reflux disease, including hookah smoking and opium use- a cross-sectional analysis of 50,000 individuals.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common cause of discomfort and morbidity worldwide. However, information on determinants of GERD from large-scale studies in low- to medium-income countries is limited. We investigated the factors associated with different measures of GERD symptoms, including frequency, patient-perceived severity, and onset time. METHODS: We performed a cross-sectional analysis of the baseline data from a population-based cohort study of ∼ 50,000 individuals in in Golestan Province, Iran. GERD symptoms in this study included regurgitation and/or heartburn. RESULTS: Approximately 20% of participants reported at least weekly symptoms. Daily symptoms were less commonly reported by men, those of Turkmen ethnicity, and nass chewers. On the other hand, age, body mass index, alcohol drinking, cigarette smoking, opium use, lower socioeconomic status, and lower physical activity were associated with daily symptoms. Most of these factors showed similar associations with severe symptoms. Women with higher BMI and waist to hip ratio were more likely to report frequent and severe GERD symptoms. Hookah smoking (OR 1.34, 95% CI 1.02-1.75) and opium use (OR 1.70, 95% CI 1.55-1.87) were associated with severe symptoms, whereas nass chewing had an inverse association (OR 0.87, 95% CI 0.76-0.99). After exclusion of cigarette smokers, hookah smoking was still positively associated and nass chewing was inversely associated with GERD symptoms (all frequencies combined). CONCLUSION: GERD is common in this population. The associations of hookah and opium use and inverse association of nass use with GERD symptoms are reported for the first time. Further studies are required to investigate the nature of these associations. Other determinants of GERD were mostly comparable to those reported elsewhere.

Avaliação do conhecimento dos anestesiologistas sobre cuidados paliativos / La evaluación del conocimiento de los anestesiólogos acerca de los cuidados paliativos / Evaluation of knowledge among anesthesiologists about palliative care

Avaliar o conhecimento dos cuidados paliativos entre anestesiologistas por meio de questionário individual. A amostra teve 95 profissionais, dos quais 65 do sexo masculino e 30 do feminino. Sessenta e dois anestesiologistas informam que "qualidade de vida" é o termo que melhor expressa os cuidados paliativos e 53 consideram a combinação da assistência casa/hospital a mais conveniente para o atendimento do paciente que requer esses cuidados. Observou-se que 83,2% dos pesquisados (n=79) não receberam preparação para lidar com paciente que requer cuidados paliativos e 88,4% comentam com colegas quando um paciente morre (n=84). A maioria dos entrevistados (n=46) discorda da prática de eutanásia. Quanto à autopercepção do conhecimento sobre cuidados paliativos, numa escala de 0 (nenhum conhecimento) a 10 (conhecimento total), a maioria das respostas alcançou média 5 (n=28), o que mostra a necessidade da reflexão acerca do cuidar na área da anestesiologia...

Evaluar el conocimiento de los cuidados paliativos entre los anestesiólogos a través de un cuestionario individual. La muestra fue de 95, de los cuales 65 eran del sexo masculino y 30 del femenino. Sesenta y dos de los anestesiólogos informan "la calidad de vida" como el término que mejor expresa los cuidados paliativos y 53 consideran que la combinación de cuidado en el hogar / hospital es más conveniente para el cuidado del paciente que lo requiere. Se observó que el 83,2% de los investigadores (n = 79) no recibieron la preparación para lidiar con el paciente que requiere cuidados paliativos y el 88,4% comentan con sus compañeros cuando un paciente muere (n = 84). La mayoría de los encuestados (n = 46) no estaban de acuerdo con la práctica de la eutanasia. En cuanto a la autopercepción del conocimiento sobre los cuidados paliativos, en una escala de 0 (ningún conocimiento) a 10 (pleno conocimiento), la mayoría de las respuestas alcanzó el promedio de 5 (n = 28). Esto demuestra la necesidad de reflexión acerca del cuidar en el área de anestesiología...

To assess anesthesiologists' knowledge about palliative care through an individual questionnaire. The sample was 95, with 65 male and 30 female. Sixty-two of the anesthesiologists reported quality of life as the term that best expresses the palliative care, and 53 consider the combination of home care/ hospital the most convenient for the treatment of a patient who requires palliative care. It was observed that 83.2% of the interviewed (n = 79) have not been prepared for patients who require palliative care and that 88.4% mention to a colleague when a patient dies (n = 84). Most respondents (n = 46) disagreed with the practice of euthanasia. As for the perception of palliative care on a scale of 0 (no knowledge) to 10 (full knowledge), there was a majority of the average response of 5 (n = 28). It shows the need to reflect about care in the filed of anesthesiology...