Bases científicas del principio de curación homeopática en la farmacología moderna / Scientific bases of the homeopathic healing principle in modern pharmacology

La homeopatía emplea el denominado 'principio de similares' como método terapéutico ­ el cual consiste en administrar medicamentos que provocan ciertos síntomas en individuos sanos para tratar síntomas similares en individuos enfermos (similia similibus curantur) - para inducir una reacción curativa secundaria del cuerpo en contra de sus propios trastornos. Esta reacción secundaria (vital, homeostática o paradójica) del cuerpo se basa en el 'efecto de rebote' de los fármacos modernos, un tipo de evento adverso que se produce después de interrumpir varias clases de fármacos prescritos según el 'principio de los contrarios' (contraria contrariis curantur). Objetivo: La presente revisión ha buscado justificar científicamente el principio de curación homeopática frente a la farmacología clínica y experimental a través de un estudio sistemático del efecto de rebote de los fármacos modernos o reacción paradójica del cuerpo. Métodos: Empleando como referencia estudios y revisiones sobre el tema publicados a partir de 1998, actualizamos los datos añadiendo estudios recientes incluidos en la base de datos PubMed. Resultados: El efecto de rebote se produce después de interrumpir varias clases de fármacos con acción contraria a los síntomas de las enfermedades, exacerbándolos a niveles superiores a aquellos previos al tratamiento. Independientemente de la enfermedad, fármaco, dosis y duración del tratamiento, el fenómeno del rebote se manifiesta en una pequeña proporción de los individuos susceptibles. Siguiendo las premisas homeopáticas, los fármacos modernos también podrían usarse según el principio de la similitud terapéutica, empleando entonces el efecto de rebote (reacción paradójica) con propósito curativo. Conclusiones: Evidenciado por cientos de estudios que constatan la similitud de conceptos y manifestaciones, el efecto de rebote de los fármacos modernos justifica científicamente el principio de la cura homeopática. Aunque el fenómeno de rebote es un evento adverso estudiado por la farmacología moderna, no es conocido por los profesionales de la atención médica, lo cual priva a los médicos de un conocimiento indispensable para el manejo seguro de los fármacos.

Homeopathy employs the so-called 'principle of similars' as therapeutic method - which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) - to induce a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the 'rebound effect' of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the 'principle of contraries' (contraria contrariis curantur). Aim: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. Methods: Employing as reference studies and revisions on the subject published since 1998, we updated the data adding recent studies included in database PubMed. Results: The rebound effect occurs after discontinuation of several classes of drugs with action contrary to the symptoms of diseases, exacerbating them to levels above the ones before treatment. Regardless of disease, drug, dose and duration of treatment, the rebound phenomenon manifests in a small proportion of susceptible individuals. Following the homeopathic premises, modern drugs might also be used according to the principle of therapeutic similitude, thus employing the rebound effect (paradoxical reaction) with curative intent. Conclusions: Evidenced by hundreds of studies that attest to the similarity of concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is an adverse event studied by modern pharmacology, it is not known by health care professionals, thus depriving doctors of knowledge indispensable for safe management of drugs.

Scientific basis of the principle of similitude in modern pharmacology / New homeopathic medicines: use of modern drugs according to the principle of similitude

Building a bridge between homeopathic pharmacology (principle of similitude) and modern pharmacology, one can find countless reports in pharmacological compendia and clinical and experimental trials published in the scientific media describing the secondary reaction of the organism opposed to the primary action of the drug, which confirm Hahnemann's theory. Such secondary action of the organism to preserve organic homeostasis is known in modern science as rebound effect or paradoxical reaction, being used by homeopathy as a therapeutic response.

Realizando a ponte entre a farmacologia homeopática (princípio da similitude) e a farmacologia moderna, encontramos uma infinidade de relatos, tanto em compêndios farmacológicos como em experimentos e ensaios clínicos publicados em periódicos científicos, que descrevem uma reação do organismo oposta e secundária a uma ação primária da droga, confirmando a teoria hahnemanniana. Essa ação secundária do organismo, no sentido de manter a homeostase orgânica, é denominada de efeito rebote ou reação paradoxal segundo a racionalidade científica moderna, sendo usada pela homeopatia como resposta terapêutica.

Matéria médica homeopática dos fármacos modernos / Novos medicamentos homeopáticos: uso dos fármacos modernos segundo o princípio da similitude / Homeopathic materia medica of modern drugs / New homeopathic medicines: use of modern drugs according to the principle of similitude

Seguindo a mesma dinâmica da homeopatia clássica, essa obra sistematiza uma proposta para empregar os fármacos modernos segundo o princípio da similitude terapêutica, estimulando o efeito rebote (reação vital) curativo do organismo através da administração de substâncias (em doses dinamizadas) que despertaram sintomas semelhantes no estado de saúde humano. Vale ressaltar que os efeitos patogenéticos (ações primárias) dos medicamentos homeopáticos clássicos correspondem aos efeitos terapêuticos, adversos e colaterais dos fármacos modernos, os quais devem apresentar uma totalidade sintomática semelhante ao do paciente para estimular a reação vital curativa (efeito rebote curativo), de acordo ao princípio da similitude terapêutica. Para viabilizar essa proposta, foi necessário elaborar uma Matéria Médica Homeopática dos Fármacos Modernos, agrupando os efeitos terapêuticos, adversos e colaterais das drogas conforme a disposição anátomo-funcional dos capítulos das matérias médicas homeopáticas tradicionais, valorizando a frequência de manifestação dos sintomas observadas nas fases de estudo da droga. Como segundo passo, para facilitar a seleção do medicamento individualizado (semelhança com a totalidade de sintomas do paciente) e a aplicação clínica da proposta, foi elaborado um Repertório Homeopático dos Fármacos Modernos, dispondo os sintomas e seus respectivos medicamentos de forma análoga aos repertórios homeopáticos tradicionais, descrito em outra obra desta coleção.

Following the pattern of traditional homeopathy, this work proposes to employ modern drugs according to the principle of therapeutic similitude, stimulating the healing rebound effect (vital reaction) of the organism through the administration of substances (in infinitesimal doses) that caused similar symptoms in healthy human. Is worth emphasizing that the pathogenetic effects (primary actions) of classical homeopathic medicines correspond to the therapeutic, adverse and side effects of conventional drugs, which should be similar to totality of the symptoms of the patient to stimulate the curative vital reaction (curative rebound effect) according to the principle of therapeutic similitude. To make this proposal operative, a Homeopathic Materia Medica of Modern Drugs was elaborated, where the therapeutic, adverse and side effects of drugs were grouped following the structure of the traditional homeopathic materia medica, while giving particular value to the frequency of the symptoms observed during the phases of study of the drugs. In order to facilitate the selection of the individualized remedy (i.e., similar to the totality of symptoms of the patient), and thus the clinical application of the present proposal, at a later stage it was also elaborated a Homeopathic Repertory of Modern Drugs, where symptoms and remedies are arranged as in the traditional homeopathic repertories, described in another work of this collection.

Homeopathic materia medica of modern drugs / New homeopathic medicines: use of modern drugs according to the principle of similitude

Following the pattern of traditional homeopathy, this work proposes to employ modern drugs according to the principle of therapeutic similitude, stimulating the healing rebound effect (vital reaction) of the organism through the administration of substances (in infinitesimal doses) that caused similar symptoms in healthy human. Is worth emphasizing that the pathogenetic effects (primary actions) of classical homeopathic medicines correspond to the therapeutic, adverse and side effects of conventional drugs, which should be similar to totality of the symptoms of the patient to stimulate the curative vital reaction (curative rebound effect) according to the principle of therapeutic similitude. To make this proposal operative, a Homeopathic Materia Medica of Modern Drugs was elaborated, where the therapeutic, adverse and side effects of drugs were grouped following the structure of the traditional homeopathic materia medica, while giving particular value to the frequency of the symptoms observed during the phases of study of the drugs. In order to facilitate the selection of the individualized remedy (i.e., similar to the totality of symptoms of the patient), and thus the clinical application of the present proposal, at a later stage it was also elaborated a Homeopathic Repertory of Modern Drugs, where symptoms and remedies are arranged as in the traditional homeopathic repertories, described in another work of this collection.

Seguindo a mesma dinâmica da homeopatia clássica, essa obra sistematiza uma proposta para empregar os fármacos modernos segundo o princípio da similitude terapêutica, estimulando o efeito rebote (reação vital) curativo do organismo através da administração de substâncias (em doses dinamizadas) que despertaram sintomas semelhantes no estado de saúde humano. Vale ressaltar que os efeitos patogenéticos (ações primárias) dos medicamentos homeopáticos clássicos correspondem aos efeitos terapêuticos, adversos e colaterais dos fármacos modernos, os quais devem apresentar uma totalidade sintomática semelhante ao do paciente para estimular a reação vital curativa (efeito rebote curativo), de acordo ao princípio da similitude terapêutica. Para viabilizar essa proposta, foi necessário elaborar uma Matéria Médica Homeopática dos Fármacos Modernos, agrupando os efeitos terapêuticos, adversos e colaterais das drogas conforme a disposição anátomo-funcional dos capítulos das matérias médicas homeopáticas tradicionais, valorizando a frequência de manifestação dos sintomas observadas nas fases de estudo da droga. Como segundo passo, para facilitar a seleção do medicamento individualizado (semelhança com a totalidade de sintomas do paciente) e a aplicação clínica da proposta, foi elaborado um Repertório Homeopático dos Fármacos Modernos, dispondo os sintomas e seus respectivos medicamentos de forma análoga aos repertórios homeopáticos tradicionais, descrito em outra obra desta coleção.

Homeopathic repertory of modern drugs / New homeopathic medicines: use of modern drugs according to the principle of similitude

Following the pattern of traditional homeopathy, this work proposes to employ modern drugs according to the principle of therapeutic similitude, stimulating the healing rebound effect (vital reaction) of the organism through the administration of substances (in infinitesimal doses) that caused similar symptoms in healthy human. Is worth emphasizing that the pathogenetic effects (primary actions) of classical homeopathic medicines correspond to the therapeutic, adverse and side effects of conventional drugs, which should be similar to totality of the symptoms of the patient to stimulate the curative vital reaction (curative rebound effect) according to the principle of therapeutic similitude. To make this proposal operative, a Homeopathic Materia Medica of Modern Drugs was elaborated, where the therapeutic, adverse and side effects of drugs were grouped following the structure of the traditional homeopathic materia medica, while giving particular value to the frequency of the symptoms observed during the phases of study of the drugs. In order to facilitate the selection of the individualized remedy (i.e., similar to the totality of symptoms of the patient), and thus the clinical application of the present proposal, at a later stage it was also elaborated a Homeopathic Repertory of Modern Drugs, where symptoms and remedies are arranged as in the traditional homeopathic repertories, described in this work.

Fundamentação científica do princípio da similitude na farmacologia moderna / Novos medicamentos homeopáticos: uso dos fármacos modernos segundo o princípio da similitude / Scientific basis of the principle of similitude in modern pharmacology / New homeopathic medicines: use of modern drugs according to the principle of similitude

Realizando a ponte entre a farmacologia homeopática (princípio da similitude) e a farmacologia moderna, encontramos uma infinidade de relatos, tanto em compêndios farmacológicos como em experimentos e ensaios clínicos publicados em periódicos científicos, que descrevem uma reação do organismo oposta e secundária a uma ação primária da droga, confirmando a teoria hahnemanniana. Essa ação secundária do organismo, no sentido de manter a homeostase orgânica, é denominada de efeito rebote ou reação paradoxal segundo a racionalidade científica moderna, sendo usada pela homeopatia como resposta terapêutica.

Building a bridge between homeopathic pharmacology (principle of similitude) and modern pharmacology, one can find countless reports in pharmacological compendia and clinical and experimental trials published in the scientific media describing the secondary reaction of the organism opposed to the primary action of the drug, which confirm Hahnemann's theory. Such secondary action of the organism to preserve organic homeostasis is known in modern science as rebound effect or paradoxical reaction, being used by homeopathy as a therapeutic response.

Repertório homeopático dos fármacos modernos / Novos medicamentos homeopáticos: uso dos fármacos modernos segundo o princípio da similitude / Homeopathic repertory of modern drugs / New homeopathic medicines: use of modern drugs according to the principle of similitude

Seguindo a mesma dinâmica da homeopatia clássica, essa obra sistematiza uma proposta para empregar os fármacos modernos segundo o princípio da similitude terapêutica, estimulando o efeito rebote (reação vital) curativo do organismo através da administração de substâncias (em doses dinamizadas) que despertaram sintomas semelhantes no estado de saúde humano. Vale ressaltar que os efeitos patogenéticos (ações primárias) dos medicamentos homeopáticos clássicos correspondem aos efeitos terapêuticos, adversos e colaterais dos fármacos modernos, os quais devem apresentar uma totalidade sintomática semelhante ao do paciente para estimular a reação vital curativa (efeito rebote curativo), de acordo ao princípio da similitude terapêutica. Para viabilizar essa proposta, foi necessário elaborar uma Matéria Médica Homeopática dos Fármacos Modernos, agrupando os efeitos terapêuticos, adversos e colaterais das drogas conforme a disposição anátomo-funcional dos capítulos das matérias médicas homeopáticas tradicionais, valorizando a frequência de manifestação dos sintomas observadas nas fases de estudo da droga. Como segundo passo, para facilitar a seleção do medicamento individualizado (semelhança com a totalidade de sintomas do paciente) e a aplicação clínica da proposta, foi elaborado um Repertório Homeopático dos Fármacos Modernos, dispondo os sintomas e seus respectivos medicamentos de forma análoga aos repertórios homeopáticos tradicionais, descrito nessa obra.

Following the pattern of traditional homeopathy, this work proposes to employ modern drugs according to the principle of therapeutic similitude, stimulating the healing rebound effect (vital reaction) of the organism through the administration of substances (in infinitesimal doses) that caused similar symptoms in healthy human. Is worth emphasizing that the pathogenetic effects (primary actions) of classical homeopathic medicines correspond to the therapeutic, adverse and side effects of conventional drugs, which should be similar to totality of the symptoms of the patient to stimulate the curative vital reaction (curative rebound effect) according to the principle of therapeutic similitude. To make this proposal operative, a Homeopathic Materia Medica of Modern Drugs was elaborated, where the therapeutic, adverse and side effects of drugs were grouped following the structure of the traditional homeopathic materia medica, while giving particular value to the frequency of the symptoms observed during the phases of study of the drugs. In order to facilitate the selection of the individualized remedy (i.e., similar to the totality of symptoms of the patient), and thus the clinical application of the present proposal, at a later stage it was also elaborated a Homeopathic Repertory of Modern Drugs, where symptoms and remedies are arranged as in the traditional homeopathic repertories, described in this work.

Fracturas vertebrales múltiples tras la suspensión de tratamiento con denosumab: serie de diez casos / Multiple vertebral fractures following discontinuation of denosumab treatment: ten clinical cases report

OBJETIVOS: Analizar las características clínicas y de metabolismo óseo de una serie de pacientes con fracturas vertebrales tras la suspensión de denosumab (DMab). MÉTODOS: Estudio observacional retrospectivo de 10 pacientes con fracturas vertebrales tras suspender DMab atendidas en el Servicio de Reumatología de un hospital español de tercer nivel entre 2015 y 2018. RESULTADOS: Se registraron un total de 49 fracturas espontáneas tras una media de 6 dosis de DMab y transcurridos 10,9 meses desde la suspensión del fármaco. El 90% había recibido tratamiento previo, 7 de 10 bisfosfonatos orales. Tras la suspensión, CTX y P1NP estaban elevados y la media de T-score en cuello femoral y columna lumbar fue menor que previo a DMab. Las vértebras más afectadas fueron L3, L5, D6, D7, D9 y D11. CONCLUSIÓN: La descripción de nuevos casos de fracturas vertebrales múltiples en los meses posteriores a la suspensión de DMab subraya la preocupación emergente en la comunidad científica siendo preciso apoyar en evidencias sólidas las nuevas recomendaciones sobre su manejo

OBJECTIVES: Analyse clinical and bone metabolism features in a case series of patients with multiple vertebral fractures after discontinuation of denosumab (DMab). METHODS: An observational descriptive study analysing data from ten patients with multiple vertebral fractures after DMab discontinuation that were admitted to our rheumatology department between 2015 and 2018. RESULTS: There were a total of 49 spontaneous fractures after an average of 6 DMab doses and 10.9 months from discontinuation. Ninety percent had already received treatment other than DMab 7 of 10 oral bisphosphonates. After discontinuation, CTX and P1NP remained elevated and mean T-score for femoral neck and lumbar spine was lower than before treatment. The most affected vertebrae were L3, L5, D6, D7, D9 and D11. CONCLUSION: This report of ten new cases suffering multiple vertebral fractures early after discontinuation of DMab highlights the emerging concern on the subject in the scientific community and the need to clarify its pathogenic mechanism, and to support by solid evidence the new recommendations on its management

Pulse therapy combined with oral corticosteroids in the management of severe rheumatic carditis and rebound

Abstract Objective: The aim of the present study was to describe the clinical course, laboratory tests, and thecardiac involvement in rheumatic carditis patients in functional class III and IV, submitted to pulse therapycombined with oral prednisone. Methods: A total of 120 patients with severe carditis due to acute rheumatic feverwere treatment with three cycles of pulse therapy combined with oral corticosteroids. The patients were followedup from the hospital admission until the end of the treatment and returned after 30, 60, and 90 days to control.The patients were evaluated by clinical, laboratory, and transthoracic echocardiogram. Results: In total, 23(19.2%) patients at first attack of rheumatic fever and 97 (80.8%) with recurrent carditis were evaluated. Cardiacsurgery was performed in 8 (6.6%) patients. The patients showed improved laboratory and radiologicalparameters (p<0.001) and were discharged, 74 (61.7%) in functional class I and 46 (38.3%) in functional classII. Hospitalisation time ranged from 21 to 176 days, with a mean of 69.1 days. Reduction of left atrium andventricle diameters was observed, measured by means of transthoracic echocardiography, at hospital admissionand discharge (p <0.001). None of the patients experienced rebound. Conclusions: The pulse therapy was effectivein controlling severe rheumatic carditis and the oral corticosteroid prevented rebound episodes. Prolongedhospital stay was required for the clinical stabilisation of patients and to avoid the interruption of medication...

Fundamentação científica do princípio de cura homeopático na farmacologia moderna / Scientific basis of the principle of homeopathic cure in modern pharmacology

Introdução: O modelo homeopático de tratamento utiliza o ‘princípio dos semelhantes’ como método terapêutico, administrando medicamentos que causam determinados sintomas em indivíduos sadios para tratar sintomas semelhantes em indivíduos doentes (similia similibus curantur), com o intuito de despertar uma reação secundária e curativa do organismo contra os seus próprios distúrbios. Essa reação secundária (vital, homeostática ou paradoxal) do organismo está embasada no ‘efeito rebote’ dos fármacos modernos, evento adverso observado após a descontinuação de diversas classes de drogas que utilizam o ‘princípio dos contrários’ (contraria contrariis curantur) como métodoterapêutico. Objetivo: Esta revisão visa fundamentar cientificamente o princípio de cura homeopático perante a farmacologia clínica e experimental, através do estudo sistemático do efeito rebote dos fármacos modernos ou reação paradoxal do organismo. Métodos: Empregando como fonte de referência os estudos e revisões sobre o tema que vimos publicando desde 1998, atualizamos os dados acrescentando pesquisas recentes citadasna base de dados PubMed. Resultados: O efeito rebote ocorre após a descontinuação de inúmeras classes de fármacos com ação terapêutica contrária aos sintomas das doenças, exacerbando-os a níveis superiores aos anteriores do tratamento. Independente da doença, da droga, da dose e da duração do tratamento, o fenômeno rebote se manifesta numa pequena proporção de indivíduos suscetíveis. Seguindo as premissas homeopáticas, osfármacos modernos também podem ser utilizados segundo o princípio da similitude terapêutica, empregando o efeito rebote (reação paradoxal) de forma curativa Conclusões: [...] Embora o fenômeno rebote seja um evento adversoestudado pela farmacologia moderna, ele não é conhecido pelos profissionais da saúde, privando a classe médica de um saber indispensável ao manejo seguro dos fármacos. (AU)

Introduction: Homeopathy employs the so-called ‘principle of similars’ as therapeutic method, which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur)to arouse a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the ‘rebound effect’ of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the ‘principle of contraries’ (contraria contrariis curantur). Aim: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. Methods: Employing as reference the studies and revisions on the subject that we have published since 1998, we updated the data adding recent studies cited in database PubMed. Results: The rebound effect occurs after discontinuation of several classes of drugs with contrary action to the symptoms of diseases, exacerbating them to levels above the ones present before treatment. Regardless of disease, drug, dose and duration of treatment, the rebound phenomenon manifests in a small proportion of susceptible individuals.[...] Conclusions: Evidenced in hundreds of studies that attest to the similarity of concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is an adverse event studied by modern pharmacology, it is not known by healthcare professionals, thus depriving doctors of knowledge indispensable for a safe management of drugs. (AU)

Estrogênio potencializado no tratamento homeopático da dor pélvica associada à endometriose: Um estudo de 24 semanas, randomizado, duplocego e placebo-controlado / Estrogen potentiated in the homeopathic treatment of endometriosis-associated pelvic pain: A 24-week, randomized, double-blind, placebo-controlled study

Objetivo: Avaliar a eficácia e a segurança do estrogênio potencializado em comparação com o placebo no tratamento homeopático da dor pélvica associada à endometriose (DPAE). Desenho do estudo: Ensaio randomizado, duplo-cego e placebocontrolado de 24 semanas de duração, que incluiu 50 mulheres com idade entre 18-45 anos de idade, diagnóstico de endometriose infiltrativa profunda com base em ressonância magnética nuclear ou ultrassonografia transvaginal após preparo intestinal e escore ≥ 5 na escala analógica visual (EAV: intervalo de 0 a 10 pontos) para DPAE. Estrogênio potencializado (12cH, 18cH e 24cH) ou placebo foi administrado 2 vezes ao dia por via oral. A medida de desfecho primário foi a mudança na severidade da DPAE com base no escore global e parcial (EAV) entre as semanas 0-24, determinado pela diferença entre a pontuação média de 5 modalidades de dor pélvica crônica (dismenorreia, dispareunia de profundidade, dor pélvica acíclica, dor intestinal cíclica e/ou dor urinária cíclica). Os desfechos secundários foram: diferença nos escores médios para qualidade de vida (SF-36), sintomas de depressão (Inventário de Depressão de Beck, IDB) e sintomas de ansiedade (Inventário de Ansiedade de Beck, IAB). [...]O grupo placebo não mostrou qualquer melhora significativa nesses desfechos secundários. Esses resultados demonstraram a superioridade do estrogênio potencializado em comparação ao placebo. Alguns efeitos adversos foram associados com o estrogênio dinamizado. Conclusões: Estrogênio potencializado (12cH, 18cH e 24cH) na dose de 3 gotas 2 vezes ao dia durante 24 semanas foi significativamente mais eficaz que o placebo na redução da dor pélvica associada à endometriose.Registro do estudo: ClinicalTrials.gov Identificador: NCT02427386. (AU)

Objective: 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, double-blind, 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). [...] 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. Trial registration: ClinicalTrials.gov Identifier: NCT02427386. (AU)fier: NCT02427386. (AU)

Scientific basis of the homeopathic healing principle in modern harmacology

Background: Homeopathy employs the so-called ‘principle of similars’ as therapeutic method - which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) - to induce a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the ‘rebound effect’ of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the ‘principle of contraries’ (contraria contrariis curantur). Aim: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. Methods: Employing as reference studies and revisions on the subject published since 1998, we updated the data adding recent studies included in database PubMed. Results: The rebound effect occurs after discontinuation of several classes of drugs with action contrary to the symptoms of diseases, exacerbating them to levels above the ones before treatment. [...]. Following the homeopathic premises, modern drugs might also be used according to the principle oftherapeutic similitude, thus employing the rebound effect (paradoxical reaction) with curative intent. Conclusions: Evidenced by hundreds of studies that attest to the similarityof concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is anadverse event studied by modern pharmacology, it is not known by health care professionals, thus depriving doctors of knowledge indispensable for safe management ofdrugs. (AU)

Potentized estrogen in homeopathic treatment of endometriosis-associatedpelvic pain: A 24-week, randomized, double-blind, placebo-controlled study

Objective: 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, double-blind, 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. [...] 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. Trial registration: ClinicalTrials.gov Identifier: https://clinicaltrials.gov/show/NCT02427386. (AU)

Fundamentação científica do princípio de cura homeopático na farmacologia moderna / Scientific basis of the homeopathic healing principle in modern harmacology

Introdução: O modelo homeopático de tratamento utiliza o ‘princípio dos semelhantes’ como método terapêutico, administrando medicamentos que causam determinados sintomas em indivíduos sadios para tratar sintomas semelhantes em indivíduos doentes (similia similibus curantur), com o intuito de despertar uma reação secundária e curativa do organismo contra os seus próprios distúrbios. Essa reação secundária (vital, homeostática ou paradoxal) do organismo está embasada no ‘efeito rebote’ dos fármacos modernos, evento adverso observado após a descontinuação de diversas classes de drogas que utilizam o ‘princípio dos contrários’ (contraria contrariis curantur) como métodoterapêutico. Objetivo: Esta revisão visa fundamentar cientificamente o princípio de cura homeopático perante a farmacologia clínica e experimental, através do estudo sistemático do efeito rebote dos fármacos modernos ou reação paradoxal do organismo. Métodos: Empregando como fonte de referência os estudos e revisões sobre o tema que vimos publicando desde 1998, atualizamos os dados acrescentando pesquisas recentes citadasna base de dados PubMed. Resultados: O efeito rebote ocorre após a descontinuação de inúmeras classes de fármacos com ação terapêutica contrária aos sintomas das doenças, exacerbando-os a níveis superiores aos anteriores do tratamento. Independente da doença, da droga, da dose e da duração do tratamento, o fenômeno rebote se manifesta numa pequena proporção de indivíduos suscetíveis. Seguindo as premissas homeopáticas, osfármacos modernos também podem ser utilizados segundo o princípio da similitude terapêutica, empregando o efeito rebote (reação paradoxal) de forma curativa Conclusões: [...] Embora o fenômeno rebote seja um evento adversoestudado pela farmacologia moderna, ele não é conhecido pelos profissionais da saúde, privando a classe médica de um saber indispensável ao manejo seguro dos fármacos. (AU)

Estrogênio potencializado no tratamento homeopático da dor pélvica associada à endometriose: Um estudo de 24 semanas, randomizado, duplocego e placebo-controlado / Potentized estrogen in homeopathic treatment of endometriosis-associatedpelvic pain: A 24-week, randomized, double-blind, placebo-controlled study

Objetivo: Avaliar a eficácia e a segurança do estrogênio potencializado em comparação com o placebo no tratamento homeopático da dor pélvica associada à endometriose (DPAE). Desenho do estudo: Ensaio randomizado, duplo-cego e placebocontrolado de 24 semanas de duração, que incluiu 50 mulheres com idade entre 18-45 anos de idade, diagnóstico de endometriose infiltrativa profunda com base em ressonância magnética nuclear ou ultrassonografia transvaginal após preparo intestinal e escore ≥ 5 na escala analógica visual (EAV: intervalo de 0 a 10 pontos) para DPAE. Estrogênio potencializado (12cH, 18cH e 24cH) ou placebo foi administrado 2 vezes ao dia por via oral. A medida de desfecho primário foi a mudança na severidade da DPAE com base no escore global e parcial (EAV) entre as semanas 0-24, determinado pela diferença entre a pontuação média de 5 modalidades de dor pélvica crônica (dismenorreia, dispareunia de profundidade, dor pélvica acíclica, dor intestinal cíclica e/ou dor urinária cíclica). Os desfechos secundários foram: diferença nos escores médios para qualidade de vida (SF-36), sintomas de depressão (Inventário de Depressão de Beck, IDB) e sintomas de ansiedade (Inventário de Ansiedade de Beck, IAB). [...]O grupo placebo não mostrou qualquer melhora significativa nesses desfechos secundários. Esses resultados demonstraram a superioridade do estrogênio potencializado em comparação ao placebo. Alguns efeitos adversos foram associados com o estrogênio dinamizado. Conclusões: Estrogênio potencializado (12cH, 18cH e 24cH) na dose de 3 gotas 2 vezes ao dia durante 24 semanas foi significativamente mais eficaz que o placebo na redução da dor pélvica associada à endometriose.Registro do estudo: ClinicalTrials.gov Identificador: NCT02427386. (AU)

Fundamentação científica do princípio de cura homeopático na farmacologia moderna / Scientific basis of the homeopathic healing principle in modern pharmacology

INTRODUÇÃO: O modelo homeopático de tratamento utiliza o ‘princípio dos semelhantes’ como método terapêutico, administrando medicamentos que causam determinados sintomas em indivíduos sadios para tratar sintomas semelhantes em indivíduos doentes (similia similibus curantur), com o intuito de despertar uma reação secundária e curativa do organismo contra os seus próprios distúrbios. Essa reação secundária (vital, homeostática ou paradoxal) do organismo está embasada no ‘efeito rebote’ dos fármacos modernos, evento adverso observado após a descontinuação de diversas classes de drogas que utilizam o ‘princípio dos contrários’ (contraria contrariis curantur) como método terapêutico...

INTRODUCTION: Homeopathy employs the so-called ‘principle of similars’as therapeutic method, which consists in administering medicines thatcause certain symptoms in healthy individuals to treat similar symptomsin sick individuals (similia similibus curantur) to arouse a secondaryand healing reaction by the body against its own disorders. Thissecondary (vital, homeostatic or paradoxical) reaction of the body isbased on the ‘rebound effect’ of modern drugs, a type of adverseevent that occurs following discontinuation of several classes of drugsprescribed according to the ‘principle of contraries’ (contraria contrariiscurantur)....

Scientific basis of the homeopathic healing principle in modern harmacology

BACKGROUND: Homeopathy employs the so-called ‘principle of similars’ as therapeutic method - which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) - to induce a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the ‘rebound effect’ of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the ‘principle of contraries’ (contraria contrariis curantur). AIM: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. METHODS: Employing as reference studies and revisions on the subject published since 1998, we updated the data adding recent studies included in database PubMed. RESULTS: The rebound effect occurs after discontinuation of several classes of drugs with action contrary to the symptoms of diseases, exacerbating them to levels above the ones before treatment. [...]. Following the homeopathic premises, modern drugs might also be used according to the principle oftherapeutic similitude, thus employing the rebound effect (paradoxical reaction) with curative intent. CONCLUSIONS: Evidenced by hundreds of studies that attest to the similarityof concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is anadverse event studied by modern pharmacology, it is not known by health care professionals, thus depriving doctors of knowledge indispensable for safe management of drugs.

Potentized estrogen in homeopathic treatment of endometriosis-associated pelvic pain: A 24-week, randomized, double-blind, placebo-controlled study

OBJECTIVE: 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, double-blind, 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. [...] 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. Trial registration: ClinicalTrials.gov Identifier: https://clinicaltrials.gov/show/NCT02427386.

Fracaso dietético, oscilaciones de peso y motivo de la cirugía en pacientes bariátricos / Dietary failure, weight oscillations and reason for surgery in bariatric patients

Fundamentos: Analizar la relación entre las oscilaciones de peso y el IMC preoperatorio de 307 pacientes bariátricos. Conocer la causa fundamental del abandono de tratamientos dietéticos y la motivación principal para acudir a una Unidad de Cirugía Bariátrica (UCB). Métodos: Se recogieron prospectivamente en 307 casos las siguientes variables: edad, sexo, IMC máximo alcanzado, ratio 'oscilación máxima peso/peso máximo', motivo de la consulta y del fracaso de los tratamientos anteriores. Se estudió la relación entre el grado de obesidad y las variables mediante el test X2. Resultados: La 'oscilación máxima peso/peso máximo' no se asoció al grado de obesidad (correlación/Pearson -0,79). El 58,9% de los pacientes acudieron a una UCB motivados por el deseo de mejorar su calidad de vida, y un 26,1% para cambiar su imagen corporal. Los pacientes abandonaban las dietas por ser monótonas, poco realistas y por estancamiento en la pérdida de peso. Conclusiones: Los pacientes que acuden a una UCB presentan una mayor preocupación por la calidad de vida como motivo de consulta y refieren haber fracasado con las dietas como causa fundamental por la monotonía de éstas. Las oscilaciones de peso no se asocian al grado de obesidad (AU)

Background: To analyze the relationship between variations in weight and preoperative BMI of 307 bariatric patients. To know what is the principal cause of the abandonment of dietary treatments. To know what is the main motivation for attending a Bariatric Surgery Clinic (BSC). Methods: Age, sex, reached maximum BMI, ratio 'maximum weight fluctuations/maximum weight', reason for consultation and the failure of previous treatments. The following variables were collected retrospectively in 307 cases. We have studied the relationship between obesity and the variables by X2 test. Results: The 'maximum weight fluctuations/maximum weight' is not associated with the degree of obesity (Pearson correlation -0.79). 58.9% of patients come to a BSC motivated by a desire to improve their quality of life, and 26.1% do so to change their body image. Patients leave for being monotonous diets, unrealistic and stagnant in weight loss. Conclusions: Patients who come to a BSC have greater concern for quality of life as the reason for consultation and have failed with diets as a root cause for the monotony of these. Fluctuations in weight are not associated with the degree of obesity (AU)

Efecto rebote de los programas de intervención para reducir el sobrepeso y la obesidad de niños y adolescentes; revisión sistemática / Rebound effect of intervention programs to reduce overweight and obesity in children and adolescents; systematic review

Introducción: los estudios demuestran que el sobrepeso y la obesidad son el resultado de una compleja interacción entre factores genéticos y ambientales que comienza en la etapa prenatal. Dentro de la evidencia de esta relación se analiza el impacto potencial de la experiencia de la nutrición prenatal en el desarrollo de los sistemas endocrino y neuroendocrino que regulan el balance energético, con especial énfasis en el papel de la hormona derivada de los adipocitos, la leptina. Diferentes autores relacionan el riesgo de obesidad con el aumento rápido de peso en los primeros años de vida. Los niños con lactancia natural tienen un menor grado de adiposidad abdominal y, por ello, menor circunferencia de la cintura. Del mismo modo, se ha relacionado la lactancia materna exclusiva con un ritmo más lento de aumento de peso, del orden del 20%. En el estudio de la obesidad se considera efecto rebote cuando el niño recupera su peso de inicio al año de acabar la intervención. Esta problemática es frecuente, por lo que dicha intervención con la familia se hace imprescindible, ya que se trata de lograr la motivación del niño para que lleve una vida saludable. Para esta revisión se han seleccionado estudios que valoren las intervenciones a medio y largo plazo en la obesidad infantil, comprobando la adhesión al tratamiento y el efecto rebote, una vez finalizada la intervención. Objetivo: revisar los estudios que analizan el efecto rebote y la adhesión a los tratamientos de pérdida de peso de los niños y adolescentes con sobrepeso y obesidad. Método: la revisión sistemática fue elaborada siguiendo las directrices PRISMA. Se han seleccionado 19 estudios que analizan la temática planteada. Resultados: varios autores han establecido los efectos beneficiosos a corto y largo plazo de aquellas intervenciones que combinan dieta y actividad física entre niños obesos. Estos resultados muestran la importancia de los programas multidisciplinares para el tratamiento de la obesidad infantil, haciendo hincapié en sus alentadores efectos a largo plazo. Conclusiones: hay estudios en los que se evidencia el efecto rebote, en los programas de corta duración o cuando la intervención se hace al margen de la rutina diaria de los niños. Durante las intervenciones se reduce considerablemente el IMC, pero después aumenta de forma rápida hasta llegar a niveles iniciales o incluso superiores de peso. El tipo de actuaciones más efectivas suelen ser aquellas con una duración superior a un año y que tienen carácter multidisciplinar, con inclusión de la familia y de los centros escolares (AU)

Background: studies show that overweight and obesity are the result of a complex interaction between genetic and environmental factors that begins prenatally. In evidence of this relationship the potential impact of prenatal nutrition experience in the development of the endocrine and neuroendocrine systems that regulate energy balance, with special emphasis on leptin, an adipocytederived hormone. Different authors relate the risk of obesity with rapid weight gain in the first years of life. Breastfeeding children have a lower degree of abdominal adiposity and, therefore, lower waist circumference. Similarly, it has been associated with exclusively breastfeeding with a slower weight gain rate of about 20 %. In the study of obesity, a rebound effect is considered when the child recovers its initial weight a year after finishing the procedure. This problem is common, therefore family intervention is essential in order to achieve the child’s motivation to lead a healthy life. For this review we have selected studies to evaluate interventions of medium and long term in childhood obesity, ensuring adherence to treatment and the rebound effect, once the intervention ended. Aim: to review studies examining the rebound effect and adherence to weight loss treatments for children and adolescents with overweight and obesity. Method: the systematic review was prepared following the PRISMA guidelines. Are selected 19 studies related to the proposed issue. Results: several authors have established the beneficial short and long term effects of interventions that combine diet and physical activity among obese children. These results show the importance of multidisciplinary treatment programs for childhood obesity, emphasizing its encouraging longterm effects. Conclusions: there are studies were the rebound effect in short duration programs is evident. During interventions it is significantly reduced BMI, but then increased quickly to reach even higher levels initial weight. The most effective type of actions tend to be those including the family and schools, they are multidisciplinary and they have a duration longer than 1 year (AU)