Homeopatia: uma forma de tratamento e prevenção da COVID-19. Revisão da literatura / Homeopathy: a form of treatment and prevention of COVID-19. Review

A COVID-19 é uma doença multifatorial infecciosa causada pela SARS-COV-2, cepa advinda de uma ampla família de vírus, que podem causar desde um resfriado comum até doenças mais graves, como síndrome respiratória aguda grave (SRAG). Reportada primariamente em Wuang, na China, no ano de 2019, esta doença foi declarada pandemia pela Organização Mundial de Saúde (OMS) no ano seguinte. A manifestação da doença pode variar de pessoas assintomáticas, a casos leves, moderados e graves. Por na época ser uma doença com alta transmissibilidade, virulência e mortalidade, as organizações de saúde se esforçaram para criar o mais rápido possível vacinas para evitar as formas mais graves desta patologia. Em contrapartida, os praticantes da homeopatia hahnemanniana focaram em pesquisar medicamentos homeopáticos para curar e prevenir, por meio do "gênio epidêmico", ou seja, conforme o conjunto de sinais e sintomas peculiares à doença coletiva. Diversos medicamentos foram considerados para prevenir e tratar a COVID-19, com resultados positivos em sua maioria. No entanto, há ainda a necessidade de realizar estudos com uma qualidade metodológica mais rigorosa para se obter evidências científicas melhores.

COVID-19 is a multifactorial infectious disease caused by SARS-CoV-2, a strain derived from a broad family of viruses that can cause anything from the common cold to more severe diseases, such as severe acute respiratory syndrome (SARS). Initially reported in Wuhan, China, in 2019, this disease was declared a pandemic by the World Health Organisation (WHO) the following year. The manifestation of the disease can vary from asymptomatic individuals to mild, moderate, and severe cases. At the time, as it was a disease with high transmissibility, virulence, and mortality, health organisations made efforts to create vaccines as quickly as possible to prevent the more severe forms of this pathology. In contrast, practitioners of Hahnemannian homeopathy focused on researching homeopathic remedies to cure and prevent it through the "epidemic genius", which means according to the set of peculiar signs and symptoms of the collective disease. Various remedies were considered to prevent and treat COVID-19, with mostly positive results. However, there is still a need to conduct studies with more rigorous methodological quality to obtain better scientific evidence.

Homeopatia em trombocitopenia canina: relato de caso / Homeopathy in canine thrombocytopenia: case report

Hemoparasitoses constituem-se de enfermidades cosmopolitas que são causadas por parasitos intracelulares obrigatórios de células sanguínea. Os mais frequentemente encontrados nos cães são a babesiose, erliquiose e anaplasmose. O tratamento consiste no uso de antibiótico do grupo das tetraciclinas, sendo a doxiciclina o medicamento mais indicado. O objetivo deste relato de caso é descrever o tratamento homeopático em um cão da raça shih-tzu, senil (8 anos de idade), cardiopata com trombocitopenia discreta secundário a hemoparasitose ­ ehrlichiose. O medicamento homeopático repertorizado foi Phosphorus 30 cH 3 glóbulos 2x ao dia por 3 dias. Foi administrado também a Calcarea Carbonica 6 cH 3 glóbulos 2x ao dia por 7 dias. Tal sucesso terapêutico foi atingido em 3 dias de tratamento, com melhora laboratorial da trombocitopenia e do quadro de dispnéia. Este estudo contribui com pesquisas existentes a caráter de novos tratamentos para a ehrlichiose canina.

Hemoparasitoses are cosmopolitan diseases that are caused by obligate intracellular parasites of blood cells. The most frequently found in dogs are babesiosis, ehrlichiosis and anaplasmosis. Treatment consists of the use of antibiotics from the tetracycline group, with doxycycline being the most indicated medication. The objective of this case report is to describe the homeopathic treatment in a dog of the shih-tzu breed, senile (8 years old), heart disease with mild thrombocytopenia secondary to hemoparasitosis - ehrlichiosis. The repertorized homeopathic medicine was Phosphorus 30 cH 3 globules 2x a day for 3 days. Calcarea Carbonica 6 cH 3 globules was also administered twice a day for 7 days. Such therapeutic success was achieved in 3 days of treatment, with laboratory improvement of thrombocytopenia and dyspnea. This study contributes to existing research on new treatments for canine ehrlichiosis.

Rattus norvegicus infectados com Trypanosoma cruzi: efeitos clínicos do tratamento com Lycopodium clavatun e phosphorus ultradiluídos / Rattus norvegicus infected with Trypanosoma cruzi: clinical effects of treatment with highly diluted Lycopodium clavatun and phosphorus / Rattus norvegicus infectado con Trypanosoma cruzi: efectos clínicos del tratamiento con Clavatun licopodio altamente diluido y fósforo

A doença de Chagas causada pelo parasita Trypanosoma cruzi acomete milhões de pessoas no mundo e não conta com um medicamento de ação efetiva para o seu tratamento etiológico. As drogas disponíveis, o nifurtimox e o benznidazol possuem índices de cura baixos com efeitos colaterais e toxidade que dificultam a adesão dos pacientes à terapia. Este fato impulsiona a busca por alternativas de tratamento que sejam mais efetivas e menos agressivas. Sendo assim, este trabalho teve como objetivo a avaliação dos efeitos clínicos apresentados por Rattus norvergicus infectados por T. cruzi e tratados com soluções ultradiluídas de Lycopodium clavatum ou Phosphorus. O estudo envolveu 93 ratos com quarenta e cinco dias de idade infectados intraperitonealmente com 5x106 formas tripomastigotas sanguíneos da cepa Y de T. cruzi, distribuídos nos grupos: Sadio SD (n=13) - controle não infectado e não tratado, grupo CI (n=27) - controle infectado e tratado com solução hidroalccólica 7% (etanol ­ água), grupo LY diluição 1:1x1026 (n=27) - infectado e tratado com Lycopodium, grupo PH diluição 1:1x1026 (n=26) - infectado e tratado com Phosphorum. Os animais foram avaliados clinicamente através dos parâmetros peso, temperatura, consumo de água e ração, quantidade de excretas, diâmetro e comprimento intestinal, aspecto da pelagem e consistência das fezes. Este estudo mostrou que os parâmetros utilizados foram importantes para a definição clínica da infecção de Rattus novergicus, linhagem Wistar pelo T. cruzi. Mostrou que os medicamentos LY e PH apresentam efeitos benéficos na evolução da clínica dos animais tratados. A utilização de Lycopodium clavatum e Phosphorus diluídos na proporção de 1:1x1026, apresentaram efeitos diferentes. Oito e seis parâmetros de quatorze analisados mostraram efeitos positivos para LY e PH, respectivamente. Os parâmetros consumo de água e ração, quantidade de excretas, diarreia, alopecia difusa e comprimento intestinal apresentaram diferenças significativas em relação ao controle infectado mostrando que mais estudos são necessários com o uso de medicamentos ultradiluídos na infecção pelo T. cruzi.

Chagas disease caused by the parasite Trypanosoma cruzi affects millions of people worldwide and does not have an effective drug for its etiological treatment. The available drugs, nifurtimox and benznidazole, have low cure rates with side effects and toxicity that make it difficult for patients to adhere to therapy. This fact drives the search for treatment alternatives that are more effective and less aggressive. Therefore, this work aimed to evaluate the clinical effects presented by Rattus norvergicus infected by T. cruzi and treated with ultradiluted solutions of Lycopodium clavatum or Phosphorus. The study involved 93 forty five day old rats intraperitoneally infected with 5x106 blood trypomastigotes forms of the Y strain of T. cruzi, distributed in the following groups: Healthy SD (n=13) - non-infected and untreated control, CI group (n =27) - infected control and treated with 7% hydroalcoholic solution (ethanol ­ water), LY group dilution 1:1x1026 (n=27) - infected and treated with Lycopodium, PH group dilution 1:1x1026 (n=26) - infected and treated with Phosphorum. The animals were clinically evaluated through the parameters weight, temperature, water and feed consumption, amount of excreta, intestinal diameter and length, coat appearance and feces consistency. This study showed that the parameters used were important for the clinical definition of infection of Rattus novergicus, Wistar lineage by T. cruzi. It showed that LY and PH drugs have beneficial effects on the clinical evolution of treated animals. The use of Lycopodium clavatum and Phosphorus diluted in the ratio of 1:1x1026, showed different effects. Eight and six parameters out of fourteen analyzed showed positive effects for LY and PH, respectively. The parameters water and feed consumption, amount of excreta, diarrhea, diffuse alopecia and intestinal length showed significant differences in relation to the infected control, showing that more studies are needed with the use of ultradiluted drugs in T. cruzi infection.

La enfermedad de Chagas causada por el parásito Trypanosoma cruzi afecta a millones de personas en todo el mundo y no cuenta con un fármaco eficaz para su tratamiento etiológico. Los fármacos disponibles, nifurtimox y benznidazol, presentan bajas tasas de curación con efectos secundarios y toxicidad que dificultan la adherencia terapéutica de los pacientes. Este hecho impulsa la búsqueda de alternativas de tratamiento más eficaces y menos agresivas. Por lo tanto, este trabajo tuvo como objetivo evaluar los efectos clínicos presentados por Rattus norvergicus infectados por T. cruzi y tratados con soluciones ultradiluidas de Lycopodium clavatum o Fósforo. En el estudio participaron 93 ratas de cuarenta y cinco días de edad infectadas intraperitonealmente con 5x106 formas tripomastigotes sanguíneas de la cepa Y de T. cruzi, distribuidos en los siguientes grupos: SD sano (n=13) - control no infectado y no tratado, grupo CI (n =27) - control infectado y tratado con solución hidroalcohólica al 7% (etanol - agua), grupo LY dilución 1:1x1026 (n=27) - infectado y tratado con Lycopodium, grupo PH dilución 1:1x1026 (n=26) - infectado y tratado con Phosphorum. Los animales fueron evaluados clínicamente mediante los parámetros peso, temperatura, consumo de agua y pienso, cantidad de excrementos, diámetro y longitud intestinal, aspecto del pelaje y consistencia de las heces. Este estudio demostró que los parámetros utilizados eran importantes para la definición clínica de la infección de Rattus novergicus, linaje Wistar por T. cruzi. Demostró que los fármacos LY y PH tienen efectos beneficiosos en la evolución clínica de los animales tratados. El uso de Lycopodium clavatum y Phosphorus diluidos en la proporción de 1:1x1026, mostró efectos diferentes. Ocho y seis parámetros de los catorce analizados mostraron efectos positivos para LY y PH, respectivamente. Los parámetros consumo de agua y pienso, cantidad de excretas, diarrea, alopecia difusa y longitud intestinal mostraron diferencias significativas en relación al control infectado, mostrando que son necesarios más estudios con el uso de fármacos ultradiluidos en la infección por

New treatments for rare bone diseases: hypophosphatemic rickets/osteomalacia.

Phosphorus is one of the most abundant minerals in the human body; it is required to maintain bone integrity and mineralization, in addition to other biological processes. Phosphorus is regulated by parathyroid hormone, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], and fibroblast growth factor 23 (FGF-23) in a complex set of processes that occur in the gut, skeleton, and kidneys. Different molecular mechanisms - overproduction of FGF-23 by tumors responsible for oncogenic osteomalacia, generation of an FGF-23 mutant that is resistant to cleavage by enzymes, and impaired FGF-23 degradation due to a reduction in or loss of the PHEX gene - can lead to FGF-23-stimulating activity and the consequent waste of urinary phosphate and low levels of 1,25(OH)2D3. Conventional treatment consists of multiple daily doses of oral phosphate salts and vitamin D analogs, which may improve radiographic rickets but do not normalize growth. Complications of the conventional long-term treatment consist of hypercalcemia, hypercalciuria, nephrolithiasis, nephrocalcinosis, impaired renal function, and potentially chronic kidney disease. Recently, burosumab, an antibody against FGF-23, was approved as a novel therapy for children and adults with X-linked hypophosphatemia and patients with tumor-induced osteomalacia. Burosumab showed good performance in different trials in children and adults. It increased and sustained the serum phosphorus levels, decreased the rickets severity and pain scores, and improved mineralization. It offers a new perspective on the treatment of chronic and disabling diseases.

Tratamento da diarreia crônica com o medicamento homeopatico phosphorus: relato de caso / Treatment of chronic diarrhea with the homeopathic medicine phosphorus: case report

Há poucos estudos sobre a eficácia do tratamento homeopático na diarréia crônica, por isso relatos de casos são os primeiros degraus da evidência clínica [1]. As pesquisas utilizando medicamentos altamente diluídos têm avançado significativamente e a Medicina sempre está em busca de novas abordagens terapêuticas. Sendo a Homeopatia uma possibilidade no tratamento devido à sua alta resolutividade e baixo custo, comentamos sobre este tema que vem assumindo a cada dia mais importância na sociedade, devido aos impactos que provoca. Este relato de caso tem como objetivo principal apresentar o tratamento Unicista orientado por Hahnemann. Apresentamos o caso de uma paciente adulta que procurou consulta homeopática por diarréia crônica, após longo período de tratamento alopático sem resolução. Relatamos o atendimento, a repertorização e o tratamento com o medicamento policresto Phosphorus (simillimum da paciente). Demonstramos o surpreendente resultado obtido com o tratamento, respeitando a individualidade da paciente e observando os fundamentos da Homeopatia. Concluímos que a atuação do médico tem importância relevante na condução do tratamento e na melhora de qualidade de vida do seu paciente, e que a Homeopatia é uma grande aliada ao minimizar os danos deste transtorno. A cura de uma doença pode ser feita com tratamento homeopático Unicista segundo os ensinamentos do Pai da Homeopatia.

There are few studies on the effectiveness of homeopathic treatment in Chronic Diarrhea, so case reports are the first steps of clinical evidence. Researchs using highly diluted drugs has advanced significantly. Considering a challenge, Medicine is looking for new therapeutic approaches and Homeopathy is a possibility in the treatment due to its high resolution and low cost. We briefly comment on this topic, which is becoming increasingly important in society, due to the impacts it causes. This case report has as main objective to present the homeopathic treatment in a Unicist way according to the guidelines of Hahnemann. In the patient's search for homeopathy, we studied the case, performed the repertorization and found Phosphorus as the patient's simillimum. We demonstrate the surprising result obtained with the homeopathic treatment, respecting the patient's individuality and observing the fundamentals of Homeopathy. We conclude that the doctor's performance has relevant importance in the conduct of the treatment and in the improvement of the patient's quality of life, and that homeopathy is a great ally in minimizing the damage of this disorder. The cure of a disease can be done with Unicist homeopathic treatment according to the teachings of the Father of Homeopathy.

Homeoatia e cutting: relato de três casos clínicos / Homeopathy and cutting: report of three clinical cases

A autolesão (self-injury, self-cutting ou cutting) é uma condição de alta prevalência entre adolescentes e adultos jovens, constituindo importante fator de risco para suicídio. As propostas terapêuticas convencionais têm poucas evidências de eficácia. Neste trabalho são apresentados três casos de adolescentes com quadro grave de cutting e que apresentaram melhora após tratamento homeopático individualizado. (AU)

Self-injury (self-cutting or cutting) is a highly prevalent condition among adolescents and young adults and it is an important risk factor for suicide. Conventional therapeutic proposals have little evidence of effectiveness. This work presents three cases of adolescents with severe cutting that improved after individualized homeopathic treatment.(AU)

Tratamento homeopático em criancas com TDAH: relato de caso

Trabalho realizado a partir de um relato de caso clínico de Transtorno de Déficit de Atenção e Hiperatividade, a autora procura demonstrar a eficácia de tratamento Homeopático, respeitando a individualidade de cada paciente e observando os princípios da Homeopatia. Comenta brevemente sobre o tema que vem assumindo a cada dia, mais importância na sociedade. Conclui pelo sucesso, obtido com a abordagem homeopática, que inclui minuciosa anamnese e individualização.(AU)

Work carried out from a clinical case report of Attention Deficit Hyperactivity Disorder, the author seeks to demonstrate the effectiveness of Homeopathic treatment, respecting the individuality of each patient and observing the principles of Homeopathy. Briefly comment on the theme that has been assuming more importance in society every day. It concludes with the success obtained with the homeopathic approach, which includes a detailed anamnesis and individualization.(AU)

Evaluación del riesgo radiológico en la radiosinoviortesis y el tratamiento mielosupresor de la policitemia vera / Radiological risk assessment in radiosynoviorthesis and the myelosupressor treatment of polycythemia vera

Introducción: La aplicación del método de la matriz de riesgo para la evaluación del riesgo radiológico en la medicina permite identificar de manera proactiva debilidades en las etapas del proceso y hacer un plan de acciones de mejora para la seguridad y calidad. Objetivo: Evaluar los riesgos radiológicos de la radiosinoviortesis y el tratamiento mielosupresor con Fósforo-32 de la policitemia vera. Método: Se utilizó el método de matriz de riesgo y se realizó el análisis y tratamiento de los riesgos radiológicos por medio del código cubano SECURE-MR-FMEA 3.0. Resultados: El 17 por ciento del riesgo alto se eliminó con las medidas adicionales adoptadas; predominaron las consecuencias medias para los trabajadores y el público, 30 por ciento y el 14 por ciento, respectivamente. Las defensas más importantes fueron: levantamiento radiológico inicial de las áreas del departamento; revisión independiente del proyecto con las regulaciones de seguridad aplicables; inspección de trabajos de construcción civil y montaje de equipos antes de iniciar la operación del departamento; capacitación de los médicos nucleares en los tratamientos; existencia de protocolos de tratamiento; análisis de lecciones aprendidas de incidentes radiológicos; levantamiento radiológico periódico de las áreas del servicio y procedimiento de emergencia para reducir la dosis en órganos críticos en caso de administración errónea de radiofármacos. Se creó una base de datos de incidentes utilizada como referencia para el modelo utilizado. El factor humano fue la causa mayor de los sucesos radiológicos analizados (88 por ciento). Conclusiones: Estos resultados facilitan la toma de decisiones para el mejor desempeño de la radiosinoviortesis y el tratamiento de la policitemia vera con Fósforo-32 en Cuba. Se sugiere elaborar el plan de mejora de la seguridad con especial atención a las operaciones de administración del radiofármaco en ambos casos.(AU)

Introduction: The application of risk matrix for ionizing radiation medicine allow identify in proactive way the weakness of the process' step, which implies in the design of safety and quality improvement plan for this. Method: Risk matrix method applied for radiosynoviorthesis and the myelosupressor treatment with Phosphorus-32 of polycythemia vera. The Cuban code SECURE-MR-FMEA 3.0 is used. Results: It was eliminated the 17 percent of the high risk with additional measures, and the medium consequences for workers and public are 30 percent and 14 percent, respectively. The most important identified safety measures were the initial radiological monitoring from different nuclear medicine department areas; the project revision based on the applicable safety regulations; a survey of civil construction works and equipment assembly before work began; training of nuclear medicine doctors in related aspects of nuclear medicine treatments; existence of treatment protocols; the analysis of learned lessons from radiological incidents; the periodical radiological monitoring from different services areas and the emergency procedure for the cases of mistake in the radiopharmaceuticals administration. Human factor was the major cause in analyzed radiological events (88 percent). Conclusions: These results facilitate taking decisions for the best performance of radiosynoviorthesis and the myelosupressor treatment with Phosphorus-32 of polycythemia vera in Cuba. It is recommended to elaborate the safety improvement plan from these and focussing in the radiopharmaceutical administration operations in both cases.(AU)

Effects of Homeopathic Phosphorus on Encephalitozoon cuniculi-Infected Macrophages In-Vitro.

INTRODUCTION: Encephalitozoon cuniculi (E. cuniculi), a fungus that acts as an intracellular pathogen, causes a marked neurological syndrome in many host species and is a zoonotic concern. Although no well-established treatment for this syndrome is known, previous successful clinical experience using homeopathic phosphorus has been described in which symptom remission with no mortality occurred in 40/42 animals by means of unknown immunological mechanisms. The latter observation was the main motivation for this study. OBJECTIVE: To verify, in an in-vitro model, if macrophages infected with E. cuniculi can change in function after treatment with different potencies of phosphorus. MATERIALS AND METHODS: RAW 264.7 macrophages were infected with E. cuniculi in-vitro and treated with various homeopathic potencies of phosphorus. The vehicle was used as a control solution (0.06% succussed ethanol). After 1 and 24 hours, the following parameters were analyzed: parasite internalization (by the Calcofluor staining method), lysosome activity (by the acridine orange method), cytokine/chemokine production (by the MAGPIX system), and cell ultrastructure. Automatic image analysis was used when applicable, and the experiments were performed in triplicate. RESULTS: Treatment with vehicle alone increased interleukin (IL)-6, tumor necrosis factor alpha and monocyte chemotactic protein -1 production (p ≤ 0.05) and reduced the number of internalized parasites (p ≤ 0.001). A progressive and time-dependent increase in RANTES (regulated on activation, normal T-cell expressed and secreted) and lysosome activity (p ≤ 0.002) was observed only after treatment with the highest potency of phosphorus (Phos 200cH), together with decreased apoptosis rate, intense parasite digestion, and the presence of non-internalized spores. CONCLUSIONS: Phos 200 cH has a modulatory action on the activity of infected macrophages, especially a specific increase in RANTES, a key element in the prognosis of E. cuniculi-infected and of immunosuppressed patients bearing infections.

Anxiolytic and antidepressive effects of the homeopathic complex Homeo-pax® (pre-clinical study) / Anxiolytic and antidepressive effects of the homeopathic complex Homeo-pax® (pre-clinical study)

The homeopathic complex Homeo-Pax® has been used as an antidepressant and anxiolytic homeopathic medicine available in Brazil. It is a complex mixture prepared with Aconitum nap.6cH, Aurum met. 6cH, Phosphorus 6cH, Argentum nitricum 6cH, Arsenicum alb. 6cH, and Valeriana officinalis 3cH. This study had evaluated the behavior in rats after treatment with Homeo-Pax® in pre-clinical models of depression and anxiety. Elevated Plus Maze Test (EPM), Forced Swimming Test (FST), Open Field Test (OFT) and the Rota Rod Test (RRT) behavior assays were used to confirm its activity. In the EPM, the animals treated with Homeo-pax® on the 1st day and until the 20th day of treatment remained longer in the open arms of the maze than on 30th day. This result was statistically significant compared with the control group (p < 0.05). In the FST, the treatment with Homeo-pax® (0.5 ml, p.o) increased the swimming time, compared to the control group. This effect was dependent on treatment time, resulting in a similar effect to that presented by amfepramone (10 mg/kg, p.o). In the OFT, crossing by the animals was significantly increased by the treatment with amfepramone (10mg/kg, p.o), and also with the 30- day treatment with Homeo-pax® . In the RRT, the 30-day treatment with Homeo-pax® (0.5 ml, p.o) did not affect the animals? motor coordination, compared with the control group, which presented the same behavior. Based on the results obtained, it can be suggested that the homeopathic complex Homeo-pax® has anxiolytic and antidepressant properties without affecting motor coordination capacity.

O complexo homeopático Homeo-Pax® tem sido usado no Brasil como um medicamento homeopático de ação antidepressiva e ansiolítica. O Homeo-Pax® é um complexo preparado com Aconitum nap. 6cH, Aurum met. 6cH, Phosphorus 6cH, Argentum nitricum 6cH, Arsenicum alb. 6cH e Valeriana officinalis 3cH. Este estudo avaliou o comportamento de ratos após o tratamento com Homeo-Pax® em modelos pré-clínicos de depressão e ansiedade. Testes de labirinto em cruz elevado (EPM), nado forçado (FST), campo aberto (OFT) e Rotarod (RRT) foram usados para avaliar a atividade dos animais. No EPM, os animais tratados com Homeo-pax® permaneceram mais tempo nos braços abertos do labirinto, durante do 20 primeiros dias de tratamento, em relação ao 30º dia. Este resultado foi estatisticamente significativo quando comparado com o grupo controle (p < 0.05). No FST, o tratamento com Homeo-pax® (0.5 ml, p.o) aumentou o tempo de nado, comparado ao grupo controle. Este efeito foi dependente o tempo de tratamento, resultando similar ao efeito da amfepramona (10 mg/kg, p.o). No OFT, o movimento dos animais foi significativamente aumentado pelo tratamento com amfepramona (10mg/kg, p.o) e também no 30º dia de tratamento com Homeo-pax® . No RRT, o tratamento por 30 dias com Homeo-pax® (0.5 ml, p.o) não afetou a coordenação motora dos animais, em relação ao grupo controle. Baseado nesses resultados, pode ser sugerido que o complexo homoepático Homeo-pax® tem propriedades ansiolíticas e antidepressivas sem afetar a coordenação motora.

El complejo homeopático Homeo-pax® viene siendo usado en Brasil como un medicamento homeopático de acción antidepresiva y ansiolítica. El Homeo-pax® es un complejo preparado con Aconitum nap 6cH, Aurum Met 6cH, Phosphorus 6cH, Argentum Nitricum 6cH, Arsenicum Alb 6cH y Valeriana officinalis 3cH. Este estudio evaluó el comportamiento de camondongos después del tratamiento con Homeo-pax® en modelos preclinicos de depresión y ansiedad. Testes de laberinto en cruz elevado (EPM) nado forzado (FST), campo abierto (OFT) y Rotarod (RRT) fueron usados para evaluar la actividad de los animales. En el EPM los animales tratados com Homeo-pax® permanecieron mas tiempo en los brazos abiertos del laberinto durante los 20 primeros dias de tratamiento en relación al 30º dia. Este resultado fue estadísticamente significativo si comparado con el grupo control (p<0.05). En el FST, el tratamiento con Homeo-pax® (0.5 ml,p.o) aumentó el tiempo de nado, comparado al grupo control. Este efecto fue dependiente del tiempo de tratamiento, resultando similar al efecto de la anfepramona (10 mg/kg, p.o). En el OFT, el movimiento de los animales fue significativamente aumentado por el tratamiento con anfepramona (10mg/kg, p.o) y tambien en el 30º dia de tratamiento con Homeo-pax® . En el RRT el tratamiento por 30 dias con Homeo-pax® (0.5 ml, p.o) no afectó la coodinación motora de los animales, en relación al grupo control. Basado en esos resultados puede ser sugerido que el complejo homeopático Homeo-pax® tiene propiedades ansiolíticas y antidepresivas sin afectar la coordinación motora.

Contribución de la vigilancia del crecimiento a la calidad de atención: un modelo de gestión / Contribution to the monitoring of growth and quality of patient care: a management model

El estudio del crecimiento a largo plazo de niños con raquitismo hipofosfatémico familiar, demostró que 18 de los 30 pacientes estudiados no crecían adecuadamente, y que a su vez este pobre crecimiento estaba asociado a una falta de cumplimiento de la ingesta de fósforo indicada por el médico tratante, medicación que forma parte esencial de la terapia. Entre las principales causas identificadas de falta de cumplimiento se encontró la incapacidad de muchas farmacias del país de preparar la solución de sales de fósforo, las dificultades de transporte y conservación de dichas sales, la inestabilidad de la solución, la falta de recursos de los pacientes sin cobertura, la dificultad de las obras sociales en financiar las sales en los pacientes con cobertura. Luego de reuniones mantenidas entre miembros de un equipo multidiciplinarios formado ad hoc, la farmacia del hospital logró preparar una cápsula con sales de fósforo para ser disuelta en agua en el hogar, se estableció un circuito de entrega gratuita del medicamento al paciente aprobado por las autoridades del Hospital, y un sistema de cobro a los organismos pagadores en los casos que correspondiera. La autorización de la Dirección fue tomada en base a la necesidad de mejorar la calidad de atención en estos pacientes, al relativo bajo costo del medicamento (1180 pesos por pacientes por año), y el escaso número de pacientes bajo tratamiento. La vigilancia del crecimiento en pacientes crónicos probó en este caso ser una herramienta confiable y sencilla para detectar un problema generalizado en el tratamiento de una enfermedad y mejorar la calidad de la atención.

Urolitíase em caprinos e ovinos / Urolithiasis in sheep and goats

A urolitíase é uma doença freqüente no semi-árido em ovinos e caprinos alimentados com grãos, principalmente quando a relação Ca:P não é corrigida e são utilizadas grandes quantidades de concentrado. De 28 ovinos com urolitíase atendidos no Hospital Veterinário da UFCG, 19 morreram e 9 receberam alta, dos 15 caprinos 12 morreram e 3 receberam alta. As alterações mais freqüentes foi presença de cálculos na uretra e bexiga, uretrite hemorrágica difusa severa, uretrite purulenta, ruptura de uretra com presença de urina no tecido subcutâneo, cistite hemorrágica necrosante, ruptura de bexiga, hidronefrose, nefrite necrosante difusa, abscesso renal, pielonefrite, hemorragia renal e ruptura renal. A gravidade das lesões observadas justifica a alta letalidade apesar dos tratamentos medicamentosos e cirúrgicos. A medida preventiva mais importante é a correção dos níveis de Ca e P. Recomenda-se, também, a administração de volumosos em boa quantidade e qualidade e, nos casos em que a quantidade de concentrados seja superior a 1,5 por cento do peso vivo, a administração de cloreto de amônia a 1 por cento no concentrado e a administração de cloreto de sódio em concentrações de 0,5 até 4 por cento. Deve ser administrada água de boa qualidade à vontade. É necessário abolir a prática, extremamente utilizada em caprinos e ovinos, de administrar sal mineral em animais alimentados com grãos e subprodutos dos mesmos.(AU)

Urolithiasis is a common disease in the Brazilian semiarid in rams and bucks fed with grains, mainly with low C:P ratio. From 28 rams with urolithiasis sent to the Veterinary Hospital of the Federal University of Campina Grande, Paraíba, 19 died and 9 survived, and from the bucks, 13 died and 3 survived At necropsy the main lesions were presence of calculi in the urethra and urinary bladder, diffuse purulent urethritis, hemorrhagic necrotizing urethritis, rupture of the urethra with presence of urine in the subcutaneous tissue, hydronephrosis, urinary bladder rupture, necrotizing diffuse nephritis, pyelonephritis, renal hemorrhage, and renal rupture. The severity of the lesions is responsible for the high case fatality rate despite medical and chirurgic treatment. The most important preventive measure is the correction of the Ca:P ratio to at least 2:1. The administration of good quality roughage in the food is also necessary. In cases in which the amount of concentrate food is higher than 1.5 percent live weight, the addition of 1 percent ammonium chloride and 0.5-4 percent of sodium chloride in the diet could be also necessary. Water had to be offered ad libitum. It is necessary to abolish the use of ad libitum mineral supplementation in sheep and goats fed grains or their byproducts.(AU)

Urolitíase em caprinos e ovinos / Urolithiasis in sheep and goats

A urolitíase é uma doença freqüente no semi-árido em ovinos e caprinos alimentados com grãos, principalmente quando a relação Ca:P não é corrigida e são utilizadas grandes quantidades de concentrado. De 28 ovinos com urolitíase atendidos no Hospital Veterinário da UFCG, 19 morreram e 9 receberam alta, dos 15 caprinos 12 morreram e 3 receberam alta. As alterações mais freqüentes foi presença de cálculos na uretra e bexiga, uretrite hemorrágica difusa severa, uretrite purulenta, ruptura de uretra com presença de urina no tecido subcutâneo, cistite hemorrágica necrosante, ruptura de bexiga, hidronefrose, nefrite necrosante difusa, abscesso renal, pielonefrite, hemorragia renal e ruptura renal. A gravidade das lesões observadas justifica a alta letalidade apesar dos tratamentos medicamentosos e cirúrgicos. A medida preventiva mais importante é a correção dos níveis de Ca e P. Recomenda-se, também, a administração de volumosos em boa quantidade e qualidade e, nos casos em que a quantidade de concentrados seja superior a 1,5 por cento do peso vivo, a administração de cloreto de amônia a 1 por cento no concentrado e a administração de cloreto de sódio em concentrações de 0,5 até 4 por cento. Deve ser administrada água de boa qualidade à vontade. É necessário abolir a prática, extremamente utilizada em caprinos e ovinos, de administrar sal mineral em animais alimentados com grãos e subprodutos dos mesmos.

Urolithiasis is a common disease in the Brazilian semiarid in rams and bucks fed with grains, mainly with low C:P ratio. From 28 rams with urolithiasis sent to the Veterinary Hospital of the Federal University of Campina Grande, Paraíba, 19 died and 9 survived, and from the bucks, 13 died and 3 survived At necropsy the main lesions were presence of calculi in the urethra and urinary bladder, diffuse purulent urethritis, hemorrhagic necrotizing urethritis, rupture of the urethra with presence of urine in the subcutaneous tissue, hydronephrosis, urinary bladder rupture, necrotizing diffuse nephritis, pyelonephritis, renal hemorrhage, and renal rupture. The severity of the lesions is responsible for the high case fatality rate despite medical and chirurgic treatment. The most important preventive measure is the correction of the Ca:P ratio to at least 2:1. The administration of good quality roughage in the food is also necessary. In cases in which the amount of concentrate food is higher than 1.5 percent live weight, the addition of 1 percent ammonium chloride and 0.5-4 percent of sodium chloride in the diet could be also necessary. Water had to be offered ad libitum. It is necessary to abolish the use of ad libitum mineral supplementation in sheep and goats fed grains or their byproducts.

[Minerals in the nutrition of extremely low birth weight infants]. / Importância dos minerais na alimentação do pré-termo extremo.

OBJECTIVE: To review the literature on the role of calcium, phosphorus and trace elements in the nutrition of extremely low birth weight infants, considering their importance for metabolism, bone mineralization and as dietary components. SOURCES OF DATA: MEDLINE, the Cochrane Database of Systematic Reviews and books on nutrition were searched between 1994 and 2004. Original research studies and reviews were selected. SUMMARY OF THE FINDINGS: Extremely preterm infants are frequently growth-restricted at hospital discharge as a consequence of difficulties in the provision of adequate nutrition. The long-term effects of this growth restriction need to be determined. There is a paucity of studies about the role of minerals, especially micronutrients, in the nutrition of extremely preterm infants. The principal focus of this review was on calcium and phosphorus metabolism, bone mineralization and parenteral and enteral supplementation. A critical evaluation of post-discharge nutrition and its influence upon growth and bone mineralization was presented. Selenium and zinc requirements and the role of selenium as an antioxidant with possible effects on free radical diseases of the preterm infant were discussed. CONCLUSIONS: Extremely preterm infants have low mineral reserves and, as a consequence, may have deficiencies in the postnatal period if they do not receive parenteral or enteral supplementation. More studies are needed to elucidate the actual requirements and the appropriate supplementation of micronutrients. There are controversies about the outcome and the influence of post-discharge nutrition on bone disease of prematurity.

Importância dos minerais na alimentação do pré-termo extremo / Minerals in the nutrition of extremely low birth weight infants

OBJETIVO: Revisão crítica da literatura sobre os minerais cálcio, fósforo e microelementos na nutrição do pré-termo extremo, considerando a importância no crescimento, mineralização óssea e como componente de dietas. FONTES DOS DADOS: Utilizamos o banco de dados MEDLINE e o Cochrane Database of Systematic Reviews, de 1994 a 2004. Selecionamos artigos com enfoques originais, artigos de revisão e livros específicos. SíNTESE DOS DADOS: As dificuldades na nutrição de prematuros extremos aumentam a freqüência de prematuros com restrição de crescimento, cujas conseqüências futuras estão para serem determinadas. Todavia, há pouca literatura sobre minerais, especialmente sobre micronutrientes na nutrição do pré-termo extremo, considerando-se o deficiente armazenamento e a importância destes em nutrição. O principal enfoque desta revisão foi sobre o cálcio e o fósforo na mineralização óssea e na suplementação em nutrição parenteral e enteral, bem como a avaliação crítica da nutrição pós-alta sobre a mineralização óssea. São abordadas as necessidades de micronutrientes, principalmente selênio e zinco, e a função antioxidante do selênio na provável prevenção de doenças do prematuro com atuação de radicais livres. CONCLUSAO: Considerando os baixos estoques de minerais em prematuros extremos, há necessidade de mais pesquisas sobre minerais na nutrição destes prematuros para definir suas reais necessidades, os aspectos metabólicos, bem como aplicar os conhecimentos na formulação de dietas que permitam prevenir quadros de deficiência e conseqüências a longo prazo. Ainda há controvérsias sobre a influência de fórmulas pós-alta sobre a evolução da doença óssea da prematuridade.

Parathyroid hormone changes during phosphorus load in patients with chronic renal insufficiency with low serum parathyroid hormone or adynamic bone disease.

UNLABELLED: Adynamic bone disease (ABD) is frequently associated with low serum parathyroid hormone (PTH) concentrations. Many clinical and therapeutic conditions have been associated with ABD, and recently, a low phosphorus intake accompanied by low serum concentration of phosphorus and PTH has been described. AIM: To evaluate the parathyroid gland response of chronic renal insufficiency patients (CRI) with low serum PTH or ABD to a phosphorus load. METHODS: We examined the effects of 0.5 and 1.0 g/d of phosphorus load over a period of 60 days in 18 patients with mild CRI with a bone biopsy showing ABD (n = 7) or with low serum PTH (serum intact PTH < or = 40 ng/l) and serum phosphorus < 4.5 mg/dl (n = 11). RESULTS: Serum intact PTH increased significantly only after 1 g of phosphorus (58.5 to 83 ng/l) with a median percent increase of 72%. PTH secretion increased more in patients with lower basal PTH levels (81%). Serum phosphorus did not change significantly and urinary phosphorus increased from 487 to 1,062 mg/dl (p < 0.05). Significant decreases in serum ionized calcium (from 1.26 to 1.19 mmol/l) and calcitriol (from 34.5 to 24.9 pg/ml) were observed. Changes in PTH were inversely correlated with changes in serum ionized calcium (r = -0.54, p < 0.05) and the final PTH concentrations were positively correlated with changes in serum phosphorus (r= 0.52, p < 0.05). CONCLUSIONS: The parathyroid glands of chronic renal insufficiency patients with "relative hypoparathyroidism" or ABD responded to a phosphorus load with an increase in serum PTH levels. The decrease in serum ionized calcium and calcitriol as well as minimal changes in serum phosphorus appeared to be involved in this response.

Analysis of dental health education activity carried out by dentistry students.

During their career, students of dentistry acquire techniques which they will employ later on their patients. Since the health of these patients and society itself cannot be left exclusively to the professional activity of these future dentist, an experimental extra-class experience was carried out with pupils from primary and secondary schools. The students gave the pupils presentations on Nutrition, Calcium and Phosphorus and Caries. The aim of this study was to evaluate: a) the influence of society on the teaching process, and training during the first university year, and b) epidemiologic aspects. Our results indicated that 32.2% of the primary and 15.6 % of the secondary school pupils were unfamiliar with the disciplines presented by the students. According to the evaluations 78.1% of the primary and 94.0% of the secondary school pupils achieved or exceeded the minimum requirements considered necessary for correct nutritional and oral health habits. Evaluations of the students demonstrated that the students who had participated in the activity did not have knowledge superior to that of non-participating students. Therefore this experience can be considered an exercise in utilizing human resources for primary prevention rather than an innovative methodology which improves the teaching-learning process. It also seems recommendable in view of the low cost of the exercise.

Osteomalacia with hypophosphatemia and hypercalciuria: a possible new variant of osteomalacia.

A 12-year-old girl had a severe genu valgum deformity and osteomalacia with hypophosphatemia, hypercalciuria, and modestly elevated levels of 1,25-dihydroxyvitamin D3 and intact parathyroid hormone. This patient seems to have a different type of hypophosphatemic osteomalacia from that previously described.

Effect of parenteral calcium and phosphorus therapy on mineral retention and bone mineral content in very low birth weight infants.

HYPOTHESIS: If calcium and phosphorus are administered to very low birth weight infants in amounts larger than those currently used in standard parenteral nutrition solutions, apparent retention of calcium and phosphorus (intake minus urinary excretion) will increase and bone mineralization will improve. DESIGN: Randomized, controlled, double-blind trial. SETTING: Neonatal intensive care unit. PATIENTS: Twenty-four very low birth weight infants (< 1.2 kg) expected to receive parenteral nutrition exclusively for approximately 3 weeks beginning 3 days after birth. INTERVENTIONS: Infants received parenteral nutrition solutions, either the standard mixture containing 1.25 mmol calcium and 1.5 mmol phosphorus per deciliter (group STAND: n = 12, birth weight 921 +/- 171 gm, gestational age 27 +/- 2 weeks (mean +/- SD)) or 1.7 mmol calcium and 2.0 mmol phosphorus per deciliter (group HIGH: n = 12, 857 +/- 180 gm, 27 +/- 2 weeks). MAIN OUTCOME MEASURES: Intake, urinary excretion, and apparent retention of calcium, phosphorus, and magnesium every 3 days during parenteral nutrition therapy. Serum indexes of mineral status twice during therapy. Bone mineral content of the distal segment of the left radius at 1, 4, 8, and 26 weeks. RESULTS: Apparent calcium retention (1.2 +/- 0.2 vs 1.6 +/- 0.2 mmol.kg-1.d-1) and phosphorus retention (1.4 +/- 0.2 vs 1.8 +/- 0.4 mmol.kg-1.d-1) differed significantly (p < 0.01) between groups STAND and HIGH, respectively; neither changed with the duration of parenteral nutrition therapy. Serum calcium, magnesium, parathyroid hormone, 25-hydroxyvitamin D, and osteocalcin concentrations were similar in both groups. Serum phosphorus concentration was significantly higher in group HIGH than in group STAND (p = 0.025). The absolute bone mineral content and the rate of increase in bone mineral content between 1 and 4, 1 and 8, and 1 and 26 weeks were significantly greater in group HIGH than in group STAND. CONCLUSIONS: Increased parenteral intakes of calcium and phosphorus resulted in greater retention of these minerals during parenteral nutrition therapy and in greater bone mineral content after therapy.

Homoeopathy in the treatment of haemophilia

Six patients with haemophilia were treated with homoeopathic medicines. A rational attempt has been made to improve their general health, cope with side effects of Factor VIII, cut down the bleeding episodes and reduce the amount of Factor VIII needed. This has necessitated a search of the homoeopathic literature (British Homoeopathic Journal) and a study of the repertories and materia medicas. Each patient treated has had aspects of his health improved, and the overall impression is that less Factor VIII was needed