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Potentized estrogen in homeopathic treatment of endometriosis-associated pelvic pain: A 24-week, randomized, double-blind, placebo-controlled study
Abstract
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, placebo-controlled 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) 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) 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) reduction in three EAPP modalities: dysmenorrhea (3.28; P < 0.001), non-cyclic pelvic pain (2.71; P = 0.009), and cyclic bowel pain (3.40; P < 0.001). Placebo group did not show any significant changes in EAPP global or partial scores. In addition, the potentized estrogen group showed significant improvement in three of eight SF-36 domains (bodily pain, vitality and mental health) and depression symptoms (BDI). Placebo group showed no significant improvement in this regard. These results demonstrate superiority of potentized estrogen over placebo. Few adverse events were associated with potentized estrogen.
Conclusions: Potentized estrogen (12cH, 18cH and 24cH) at a dose of 3 drops twice daily for 24 weeks was significantly more effective than placebo for reducing endometriosis-associated pelvic pain.
Trial registration: ClinicalTrials.gov Identifier: NCT02427386.
... De forma análoga, desde el inicio de la investigación [7][8][9] hemos propuesto el uso de los fármacos modernos siguiendo el principio de similitud terapéutica; en otras palabras, utilizar fármacos que provocan eventos adversos similares a las manifestaciones de la enfermedad para su tratamiento homeopático. Esto significa emplear el efecto de rebote (reacción paradójica) con propósito curativo [37][38][39][40][41][42][43][44][45][46]. Los resultados son prometedores y las indicaciones son innumerables. ...
... Los resultados son prometedores y las indicaciones son innumerables. Uno de los ejemplos es el uso de estrógeno potenciado para el tratamiento del dolor pélvico relacionado con la endometriosis [44][45][46]. ...
... Los estudios de referencia fueron estudios y revisiones sobre el efecto de rebote que hemos publicado desde 1998 [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][37][38][39][40][41][42][43][44][45][46]. Los datos fueron actualizados a través de una búsqueda de estudios recientes incluidos en la base de datos PubMed usando las palabras clave 'rebote', 'retirada', 'paradójico', 'ácido acetilsalicílico', 'antiinflamatorio', 'broncodilatador', 'antidepresivo', 'estatina', 'inhibidor de la bomba de protones', 'bisfosfonato', 'terapia biológica' y 'fármaco inmunomodulador'. ...
Antecedentes: 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.
... In early 2017, homeopathy received a lot of positive attention for its potential role of helping improve the quality of life of patients who were diagnosed with endometriosis. These improvements were reported in the European Journal of Obstetrics and Gynecology and Reproductive Biology [48]. ...
... The article, "Potentized Estrogen in Homeopathic Treatment of Endometriosis-Associated Pelvic Pain: A 24-Week, Randomized, Double-Blind, Placebo-Controlled Study", describes a phase 4 trial including 50 women who received potentized estrogen at 12cH, 18cH, and 24cH, or a placebo, twice daily. After 24 weeks of treatment had endometriosis-associated pelvic pain (EAPP) and showed a reduction in dysmenorrhea (3.28), non-cyclic pelvic pain (2.71), and cyclic bowel pain (3.40), whereas placebo induced no changes [48]. ...
... Patients who received homeopathic treatment also reported significant improvements in body pain, vitality and mental health compared to the patients who received placebo treatment. The study clearly showed that potentized estrogen was associated with significant improvement in the "quality of life and depression symptoms among women with endometriosis" [48]. The authors concluded that "Potentized estrogen might represent an effective and welltolerated complementary treatment for the pain and mental symptoms of endometriosis." ...
Endometriosis is a chronic estrogen-dependent and inflammatory disease that affects the pelvic peritoneum as well as the ovaries and is one of the most commonly diagnosed gynecological conditions in women. It represents a debilitating condition for females and is a challenging and complex disease for clinicians. While conventional treatments are used, there is an unmet medical need for improving treatment outcomes in providing treatments that have a reduced risk of undesirable side effects. The need for a successful integrative approach towards treating endometriosis is growing. The purpose of this review is to conduct and summarize concisely and systematically, the biological pathways involved in endometriosis using available scientific data relating to endometriosis. As well as to provide possible therapeutic recommendations that are clinically and science-based using nutraceuticals and homeopathic medicines.
... Ampliando esse corpo de evidências, expoentes da farmacologia moderna vêm sugerindo, na última década, uma estratégia terapêutica intitulada 'farmacologia paradoxal', semelhante à propagada pelo modelo homeopático há mais de 2 séculos, propondo o emprego de drogas convencionais que causam uma exacerbação da doença em curto prazo para tratar FUNDAMENTAÇÃO CIENTÍFICA DO PRINCÍPIO DE CURA HOMEOPÁTICO NA FARMACOLOGIA MODERNA esta mesma doença em longo prazo [24][25][26][27][28][29][30][31][32][33][34][35][36]. De forma análoga, desde o início de nossos estudos [7][8][9], vimos propondo empregar os fármacos modernos segundo o princípio da similitude terapêutica, sugerindo utilizar as drogas que causam eventos adversos similares às manifestações das doenças para tratá-las homeopaticamente, utilizando o efeito rebote (reação paradoxal) de forma curativa [37][38][39][40][41][42][43], com resultados animadores e inúmeras indicações [44][45][46]. Ilustramos essa tese com a aplicação de estrogênio dinamizado para o tratamento da dor pélvica associada à endometriose (vide artigo específico neste mesmo dossiê). A presente revisão atualizada sobre o efeito rebote dos fármacos modernos visa fundamentar cientificamente o princípio de cura homeopático (similitude terapêutica) perante a farmacologia clínica e experimental, evidenciando as propriedades, particularidades e similaridades de ambos os fenômenos. ...
... Empregando como fonte de referência os estudos e revisões sobre o efeito rebote que vimos publicando desde 1998 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][34][35][36][37][38][39][40][41][42][43], atualizamos os dados com trabalhos recentes citados na base de dados PubMed através de pesquisa com as palavras-chave 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti--inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor', 'bisphosphonate', 'biological therapy' e 'immunomodulatory drug'. Descrevemos também as propostas que sugerem o uso dos fármacos modernos segundo o princípio da similitude terapêutica [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46], empregando o efeito rebote (reação paradoxal) de forma curativa, com exemplos na prática clínica atual. ...
... Dentre outras aplicações [29]. [37][38][39][40][41][42][43][44][45][46] Reiterando que o princípio de cura homeopático tem como prerrogativa a utilização de medicamentos que causem manifestações patogenéticas (sinais, sintomas, alterações fisiológicas ou patológicas, etc.) semelhantes aos distúrbios que se deseja tratar, ele pode ser empregado com qualquer substância (natural ou sintética) e em qualquer dose (ponderal ou infinitesimal), desde que o princípio da similitude seja observado. Assim sendo, os fármacos modernos podem ser utilizados segundo as premissas homeopáticas desde que causem efeitos primários (efeitos terapêuticos, adversos ou colaterais) semelhantes à totalidade de manifestações características do indivíduo doente. ...
Resumo
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. 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 citadas
na 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, os
fármacos modernos também podem ser utilizados segundo o princípio da similitude
terapêutica, empregando o efeito rebote (reação paradoxal) de forma curativa Conclusões:
Evidenciado em centenas de estudos que atestam a similaridade de conceitos e
manifestações, o efeito rebote dos fármacos modernos fundamenta cientificamente o
princípio de cura homeopático. Embora o fenômeno rebote seja um evento adverso
estudado pela farmacologia moderna, ele não é conhecido pelos profissionais da saúde,
privando a classe médica de um saber indispensável ao manejo seguro dos fármacos.
Abstract
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. Following the homeopathic premises, modern drugs might also be used
according to the principle of therapeutic similitude, thus employing the rebound effect
(paradoxical reaction) in a curative manner. 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.
... In other words, using drugs which cause adverse events similar to the manifestations of disease to treat them homeopathically. This means employing the rebound effect (paradoxical reaction) with curative intention [37][38][39][40][41][42][43][44][45][46]; results are promising and indications countless. An example is provided by the use of potentized estrogen for treatment of endometriosis-related pelvic pain [44][45][46]. ...
... This means employing the rebound effect (paradoxical reaction) with curative intention [37][38][39][40][41][42][43][44][45][46]; results are promising and indications countless. An example is provided by the use of potentized estrogen for treatment of endometriosis-related pelvic pain [44][45][46]. ...
... Reference sources were studies and reviews on the rebound effect we published since 1998 [7][8][9][10][11][12][13][14][15][16][17][18][19][20][37][38][39][40][41][42][43][44][45][46]. The data were updated through a search of recent studies included in database PubMed using keywords 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor', 'bisphosphonate', 'biological therapy' and 'immunomodulatory drug'. ...
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. Following the homeopathic premises, modern drugs might also be used according to the principle of therapeutic similitude, thus employing the rebound effect (paradoxical reaction) in a curative manner. 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.
... En un proyecto postdoctoral finalizado en 2017 demostramos la eficacia y seguridad de esta propuesta en el uso de estrógenos potenciados (17beta estradiol) en el tratamiento homeopático del dolor pélvico crónico en pacientes con endometriosis refractaria a tratamientos convencionales, a través de un ensayo clínico, aleatorizado, doble ciego y controlado con placebo [50][51][52][53][54] . Esto fue posible debido al hecho de que la endometriosis es un síndrome dependiente de estrógenos y el 17-beta estradiol tiene efectos patogénicos (eventos adversos), un conjunto de signos y síntomas muy similares al síndrome de endometriosis (ansiedad, depresión, insomnio, migraña, dolor abdominal, dismenorrea, dispareunia e hiperplasia endometrial, entre otros) 55 . ...
... Se estudiarán 50 pacientes (25 en cada grupo: "activo" y "placebo") con enfermedad manifiesta diagnosticada mediante prueba cuantitativa de carga viral (RT-PCR), seguidos en la sala del HRMS. El número de participantes es similar al utilizado en ensayos clínicos homeopáticos anteriores realizados por el autor [51][52][53][54]71 . ...
In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiologic and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this therapeutic and/or prophylactic practice in several epidemics of the past. Therefore, after the survey of possible individualized homeopathic medicine from the epidemic genius of each epidemic, its therapeutic and/or large-scale prophylactic application should be supported by previous clinical trials that demonstrate its effectiveness and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed, in March 2020, this research protocol to investigate, in a randomized, double-blind and placebo-controlled clinical trial, the effectiveness and safety of possible individualized homeopathic medicines of epidemic genius of COVID-19. If effectiveness and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic. To this end, we refer this project to physicians, researchers and managers of several public and private hospitals, requesting an opportunity to apply this proposal to patients hospitalized in wards and/or intensive care units for the treatment of covid-19.
Resumen
Además de su reconocida aplicación en enfermedades crónicas, la Homeopatía individua-lizada también puede actuar de forma resolutiva o complementaria en casos agudos, in-cluidas las enfermedades epidémicas. Sin embargo, para lograr este objetivo presenta una metodología semiológica y terapéutica específica que deben seguirse y respetarse, con el riesgo de no proporcionar la eficacia y seguridad deseadas. En el caso de enfermedades epidémicas, que por la virulencia de sus agentes provocan un cuadro sintomatológico co-mún en la mayoría de los individuos susceptibles, la medicina homeopática individualizada (medicina homeopática del genio epidémico) debe presentar similitud con el conjunto de signos y síntomas característicos de los pacientes afectados en las diferentes etapas de cada brote epidémico. Los estudios demuestran la eficacia y seguridad de esta práctica terapéutica y/o profiláctica en varias epidemias pasadas. Por tanto, tras estudiar posibles medicamentos homeopáticos individualizados a partir del genio epidémico de cada epi-demia, su aplicación terapéutica y/o profiláctica a gran escala debe de estar respaldada por ensayos clínicos previos que demuestren su eficacia y seguridad, en consonancia con los aspectos éticos y bioéticos de la investigación con seres humanos. Cumpliendo estas premisas de buena práctica clínica, en marzo de 2020 desarrollamos este protocolo de in-vestigación para comprobar, en un ensayo clínico aleatorizado, doble ciego y controlado con placebo, la eficacia y seguridad de posibles medicamentos homeopáticos individualizados de la epidemia de covid-19. Si se confirma la eficacia y seguridad, y sólo en esta condición, el medicamento podrá utilizarse de forma generalizada y colectiva en el tratamiento y la prevención de la actual epidemia. Con este objetivo, remitimos este proyecto a médicos, investigadores y directivos de varios hospitales públicos y privados, solicitando la oportuni-dad de aplicar esta propuesta a pacientes hospitalizados en salas y/o centros de cuidados intensivos destinados al tratamiento de la covid-19.
... In a study performed by Stochino Loi et al., with a 90-day pharmaceutical intervention (um-PEA), found significant improvement in QoL scores in all domains was observed (p < 0.0005) [30]. Teixeira et al. also performed pharmaceutical intervention of potentized estrogen and determined that bodily pain, vitality, and mental health domains were significantly improved following treatment (p = 0.013, 0.022, 0.025) [31]. Yela ...
... Roomaney et al. found a significant prevalence of moderate to severe depression symptoms in 43.1% of individuals with endometriosis [58]. Teixeira et al. saw a significant improvement in both depression and anxiety scores following intervention with potentized estrogen (p < 0.001, p = 0.001) [31]. The STAI is a 20-item instrument to assess trait and state anxiety of an individual [59]. ...
While endometriosis is a common gynecologic disease associated with infertility, the psychosocial impact of endometriosis has not been evaluated against various quality of life (QoL) instruments and compared with other chronic illnesses. We rigorously analyzed the psychosocial burden of endometriosis in adult women and compared standardized and validated QoL scores of women with and without endometriosis, before and following treatment, and against other chronic illnesses. We searched PubMed, PsychINFO Embase, and Cochrane Reviews and ClinicalTrials.gov from January 1990 to December 2022 for publications using a detailed list of search terms related to QoL, endometriosis, and questionnaires. Only English-language publications that evaluated the association between Endometriosis and QoL using standardized and validated questionnaires measured at baseline and following treatment were considered. Four reviewers first performed a title and abstract screening followed by full text-review to finalize included articles. QoL scores of women with endometriosis were measured at baseline and analyzed against women without endometriosis and women with endometriosis who had undergone treatment. Additionally, baseline endometriosis scores were assessed against the published QoL scores of populations with other chronic conditions. Assessment of risk of bias was performed in accordance with Cochrane and Newcastle–Ottawa Scale guidelines. A total of 30 articles were included in this review: 4 randomized trials and 26 observational studies. The diagnosis and experience of women with symptomatic endometriosis had an equal or worse QoL score than that of other chronic conditions including heart disease, diabetes, and breast cancer when compared using the 36-Item Short Form Survey and World Health Organization Quality of Life questionnaires. Evidence showed association between low QoL and infertility, sexual dysfunction, mental health struggles, physical pain, poor sleep and fatigue. QoL scores were lower at baseline compared to following treatment in the majority of these domains. Endometriosis is associated with significant psychosocial burden and impaired QoL scores across baseline measurements in comparison to controls and other chronic illnesses. Medical and surgical interventions significantly decreased experienced burdens and improved QoL of women with endometriosis.
... Em projeto de pós-doutorado concluído em 2017, evidenciamos a eficácia e a segurança dessa proposta no emprego do estrogênio (17-beta estradiol) potencializado no tratamento homeopático da dor pélvica crônica em pacientes com endometriose refratária aos tratamentos convencionais, por meio de ensaio clínico randomizado, duplo-cego e placebo-controlado [50][51][52][53][54]. Isso foi possível pelo fato de que a endometriose é uma síndrome estrogênio-dependente e o 17beta estradiol apresenta como efeitos patogenéticos (eventos adversos) um conjunto de sinais e sintomas muito semelhante à síndrome da endometriose (ansiedade, depressão, insônia, enxaqueca, dor abdominal, dismenorreia, dispareunia e hiperplasia endometrial, dentre outros) [55]. ...
... Serão estudados 50 pacientes (25 em cada grupo: 'ativo' e 'placebo') com doença manifesta e diagnosticada por meio de exame quantitativo da carga viral (RT-PCR), acompanhados na enfermaria do HRMS. O número de participantes é semelhante ao utilizado em ensaios clínicos homeopáticos anteriores realizados pelo autor [51][52][53][54]71]. ...
In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiologic and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this therapeutic and/or prophylactic practice in several epidemics of the past. Therefore, after the survey of possible individualized homeopathic medicine from the epidemic genius of each epidemic, its therapeutic and/or large-scale prophylactic application should be supported by previous clinical trials that demonstrate its effectiveness and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed, in March 2020, this research protocol to investigate, in a randomized, double-blind and placebo-controlled clinical trial, the effectiveness and safety of possible individualized homeopathic medicines of epidemic genius of COVID-19. If effectiveness and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic. To this end, we refer this project to physicians, researchers and managers of several public and private hospitals, requesting an opportunity to apply this proposal to patients hospitalized in wards and/or intensive care units for the treatment of COVID-19. //
Resumo - Além da reconhecida aplicação nas doenças crônicas, a homeopatia individualizada também pode atuar de forma resolutiva ou complementar nos casos agudos, incluindo as doenças epidêmicas. No entanto, para atingir esse intento, apresenta uma metodologia semiológica e terapêutica específica que deve ser seguida e respeitada, com o risco de não apresentar a eficácia e a segurança desejada. No caso das doenças epidêmicas, que pela virulência dos seus agentes provoca um quadro sintomatológico comum na maioria dos indivíduos suscetíveis, o medicamento homeopático individualizado (medicamento homeopático do gênio epidêmico) deve apresentar semelhança com o conjunto de sinais e sintomas característicos dos pacientes acometidos nos diferentes estágios de cada surto epidêmico. Estudos evidenciam a eficácia e a segurança desta prática terapêutica e/ou profilática em diversas epidemias do passado. Assim sendo, após o levantamento dos possíveis medicamentos homeopáticos individualizados do gênio epidêmico de cada epidemia, sua aplicação terapêutica e/ou profilática em larga escala deve ser sustentada por ensaios clínicos prévios que demonstrem sua eficácia e segurança, em consonância com os aspectos éticos e bioéticos da pesquisa envolvendo seres humanos. Cumprindo essas premissas da boa prática clínica, elaboramos, em março de 2020, esse protocolo de pesquisa para investigar, em ensaio clínico randomizado, duplo-cego e placebo-controlado, a eficácia e a segurança de possíveis medicamentos homeopáticos individualizados do gênio epidêmico da COVID-19. Caso a eficácia e a segurança se confirmem, e tão somente nessa condição, o medicamento poderá ser utilizado de forma generalizada e coletiva no tratamento e na prevenção da atual epidemia. Com esse intuito, encaminhamos este projeto a médicos, pesquisadores e gestores de diversos hospitais públicos e privados, solicitando uma oportunidade para aplicar essa proposta em pacientes internados em enfermarias e/ou centros de terapia intensiva destinadas ao tratamento da COVID-19.
... Por outro lado, na adaptação dos estudos epidemiológicos clássicos ao paradigma homeopático (epidemiologia clínica homeopática), incluindo o ECHR, torna-se imprescindível que certos preceitos da boa prática clínica homeopática sejam observados no desenho, no planejamento e na execução dos mesmos, segundo as premissas e princípios da episteme homeopática [20][21][22][23]. ...
... Analogamente aos estudos observacionais descritivos e analíticos, existem protocolos para a elaboração e publicação de ensaios clínicos randomizados e controlados em homeopatia [20][21][22][23]33], que devem ser seguidos no delineamento dos mesmos. ...
Clinical epidemiology deals with clinical practice through the study of variation and the determinants of the evolution of diseases, its knowledge being indispensable for the correct design, planning and execution of the different types of clinical studies. Among the homeopathic assumptions, the individualization of treatment is an indispensable condition to reach the efficacy and effectiveness of the therapy, requiring a longer period of follow-up so that the adjustments of the globalizing therapeutic similarity are achieved. Homeopathic clinical epidemiology associates the premises and principles of clinical epidemiology with those of homeopathic episteme, with the aim of increasing the methodological quality of clinical research without disrespecting homeopathic rationality. In this review, we discuss the premises and principles of (homeopathic) clinical epidemiology, highlighting the fundamental aspects for the elaboration of epidemiological studies in homeopathy for the different types of diseases, including epidemics. //
Resumo -
A epidemiologia clínica se ocupa da prática clínica através do estudo da variação e dos determinantes da evolução das doenças, sendo indispensáveis os seus conhecimentos para o correto desenho, planejamento e execução dos diversos tipos de estudos clínicos. Dentre os pressupostos homeopáticos, a individualização do tratamento é uma condição indispensável para se atingir a eficácia e a efetividade da terapia, necessitando um período maior de acompanhamento para que os ajustes da similitude terapêutica globalizante sejam alcançados. A epidemiologia clínica homeopática associa as premissas e princípios da epidemiologia clínica aos da episteme homeopática, com o intuito de incrementar a qualidade metodológica da pesquisa clínica sem desrespeitar a racionalidade homeopática. Nessa revisão, abordamos as premissas e os princípios da epidemiologia clínica (homeopática), destacando os aspectos fundamentais para a elaboração de estudos epidemiológicos em homeopatia para os diversos tipos de doenças, incluindo as epidemias.
... 13 Homeopathy is the second largest medical system in the world today, recognized by the World Health Organization. 14 The effects of this method on pain relief, [15][16][17] cancer recovery, 18 treatment of middle ear infection, 19 chronic periodontitis, 20 and treatment of AUB [21][22][23] have been reviewed. However, researchersare still looking for more evidence in the field about the effectiveness of this method in the treatment of AUB. ...
... The results of this study showed that despite a slight improvement in PBAC score, bleeding day, and depression score in the homeopathic treatment group, the improvement was not statistically significant in the two groups. In this respect, the results of this study were consistent with the study by Das et al 33 and inconsistent with the studies by Ammerman et al 22 and El-Nashar et al. 24 Denisova et al. 34 The results of this study, similar to studies by Mahmoudian and Sadri 15 Teixeira et al. 16 Barkey et al 17 Kundu et al 35 showed a significant improvement in homeopathy compared to routine treatment and inconsistent with the study by Koley et al 36 The reason for this effect can be justified in the fact that in homeopathy the physician's diagnostic and therapeutic approach is based on detecting a disorder in the mental, nervous, glandular, and immune systems that causes symptoms in various organs of the body. The purpose of drug administration in homeopathy is to stimulate these systems. ...
... Homeopathy is a therapeutic model employed worldwide and that has awakened in recent decades, along with other approaches to integrative medicine, the growing interest of users, medical students and physicians (Teixeira et al., 2004(Teixeira et al., , 2005Teixeira and Lin, 2013), in order to be a safe and efficient medical practice, proposing to understand and treat the disease-patient binomial according to a vitalistic, globalizing and humanistic anthropological approach (Teixeira, 2009b(Teixeira, , 2017a "Every agent that acts upon the vitality, every medicine, deranges more or less the vital force, and causes a certain alteration in the health of the individual for a longer or a shorter period. This is termed primary action. ...
... In a postdoctoral project completed in 2017, we evidenced the efficacy and safety of this proposal in the use of potentized estrogen (17-beta estradiol) in homeopathic treatment of chronic pelvic pain in patients with endometriosis refractory to conventional hormone treatments, through a randomized, doubleblind and placebo-controlled clinical trial (Teixeira, 2017b;Teixeira et al., 2016Teixeira et al., , 2017aTeixeira et al., , 2017b. This was made possible by the fact that endometriosis is an estrogen-dependent syndrome and 17-beta estradiol presents as pathogenetic effects (adverse events) a set of signs and symptoms very similar to endometriosis syndrome (anxiety, depression, insomnia, migraine, abdominal pain, dysmenorrhoea, dyspareunia and endometrial hyperplasia, among others) (The United States Pharmacopeial Convention, 2004). ...
In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiologic and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this prophylactic and/or therapeutic practice in several epidemics of the past. Therefore, after the survey of possible homeopathic drugs individualized from the epidemic genius of each epidemic, its prophylactic and/or large-scale therapeutic application should be supported by previous clinical trials that demonstrate its efficacy and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed the current protocol with the objective of investigating, in a randomized, double-blind and placebo-controlled clinical trial, the effectiveness and safety of possible individualized homeopathic drugs of epidemic genius of COVID-19, in adjuvant and complementary treatment of patients affected by the disease. If effectiveness and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic.
... Homeopathy is a therapeutic model employed worldwide and that has awakened in recent decades, along with other approaches to integrative medicine, the growing interest of users, medical students and physicians (Teixeira et al., 2004(Teixeira et al., , 2005Teixeira and Lin, 2013), in order to be a safe and efficient medical practice, proposing to understand and treat the disease-patient binomial according to a vitalistic, globalizing and humanistic anthropological approach (Teixeira, 2009b(Teixeira, , 2017a "Every agent that acts upon the vitality, every medicine, deranges more or less the vital force, and causes a certain alteration in the health of the individual for a longer or a shorter period. This is termed primary action. ...
... In a postdoctoral project completed in 2017, we evidenced the efficacy and safety of this proposal in the use of potentized estrogen (17-beta estradiol) in homeopathic treatment of chronic pelvic pain in patients with endometriosis refractory to conventional hormone treatments, through a randomized, doubleblind and placebo-controlled clinical trial (Teixeira, 2017b;Teixeira et al., 2016Teixeira et al., , 2017aTeixeira et al., , 2017b. This was made possible by the fact that endometriosis is an estrogen-dependent syndrome and 17-beta estradiol presents as pathogenetic effects (adverse events) a set of signs and symptoms very similar to endometriosis syndrome (anxiety, depression, insomnia, migraine, abdominal pain, dysmenorrhoea, dyspareunia and endometrial hyperplasia, among others) (The United States Pharmacopeial Convention, 2004). ...
Abstract:
In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiologic and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this prophylactic and/or therapeutic practice in several epidemics of the past. Therefore, after the survey of possible homeopathic drugs individualized from the epidemic genius of each epidemic, its prophylactic and/or large-scale therapeutic application should be supported by previous clinical trials that demonstrate its efficacy and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed the current protocol with the objective of investigating, in a randomized, double-blind and placebo-controlled clinical trial, the effectiveness and safety of possible individualized homeopathic drugs of epidemic genius of COVID-19, in adjuvant and complementary treatment of patients affected by the disease. If effectiveness and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic.
... Depression, anxiety, and somatization were each assessed as outcome variables in at least one of the seven studies where mental health was an outcome. The Hamilton Depression Rating Scale was used to measure depression in two (Engel, Walker, Engel, Bullis, & Armstrong, 1998;Poleshuck et al., 2014), as was the Beck Depression Inventory (Poleshuck et al., 2014;Teixeira, Podgaec, & Baracat, 2017), while another study used the Inventory of Depressive Symptomatology (Fox, Flynn, & Allen, 2011). Anxiety was measured in one study by the Beck Anxiety Inventory (Teixeira et al., 2017), while Meissner et al.'s (2016) study measured trait anxiety in particular with the State-Trait Anxiety Inventory. ...
... The Hamilton Depression Rating Scale was used to measure depression in two (Engel, Walker, Engel, Bullis, & Armstrong, 1998;Poleshuck et al., 2014), as was the Beck Depression Inventory (Poleshuck et al., 2014;Teixeira, Podgaec, & Baracat, 2017), while another study used the Inventory of Depressive Symptomatology (Fox, Flynn, & Allen, 2011). Anxiety was measured in one study by the Beck Anxiety Inventory (Teixeira et al., 2017), while Meissner et al.'s (2016) study measured trait anxiety in particular with the State-Trait Anxiety Inventory. Both depression and anxiety were assessed by the Hospital Anxiety and Depression Scale in two studies (Lewis et al., 2016;Meissner et al., 2016). ...
Chronic pelvic pain (CPP) is a widespread health issue with unclear etiology that has been linked to a history of trauma among women. This condition is known to be highly comorbid with, and potentially exacerbated by psychiatric conditions, as well as other gynecological concerns and functional pain syndromes. Many comorbid conditions are also related to a history of trauma, and cases of CPP with comorbidity are known to be resistant to treatment. While the prevalence of a traumatic history among females with CPP has been established, less is known about how the role of trauma is addressed in the intervention literature. The purpose of this systematic review was to explore how the role of trauma, and to a lesser extent, mental health, is addressed in modern intervention studies for females with CPP. All qualitative and quantitative studies providing primary or secondary results of an intervention for females with CPP published between January 1998 and May 2018 were included and coded independently by two reviewers. Twenty-eight articles met inclusion criteria. Of these, none focused exclusively on patients with a history of trauma; one study implicitly focused on trauma-specific symptoms as an outcome, while two studies screened patients for a history of trauma. Of the 10 studies with a focus on mental health, only three simultaneously addressed trauma. To address this gap in the literature, future studies can prioritize intervention designs that place emphasis on the role of trauma in regard to patient characteristics and outcome variables.
... El principio de similitud (semejanza) se aborda según el modelo homeopático y la farmacología moderna en el capítulo Bases farmacológicas del principio de similitud, que describe cientos de estudios experimentales y clínicos que apoyan la respuesta curativa del tratamiento homeopático (reacción vital o similitud terapéutica) de acuerdo con las manifestaciones del efecto rebote de los fármacos modernos (reacción paradójica del organismo) [23][24][25] . Además, describe la propuesta de utilizar fármacos modernos según el principio de similitud terapéutica, valiéndose del efecto rebote de los fármacos de forma curativa [26][27][28] . ...
Resumen:
La Homeopatía es una práctica médica reconocida mundialmente desde hace más de dos siglos, que desarrolla actividades asistenciales, docentes y de investigación en diversas instituciones sanitarias y facultades de medicina. Emplea un enfoque clínico basado en principios científicos heterodoxos y complementarios (principio de similitud terapéutica, experimentación patogenética homeopática, uso de medicamentos individualizados y dosis dinamizadas o potenciadas), con el objetivo de despertar una respuesta curativa en el organismo contra sus propios trastornos y/o enfermedades.
Basada en premisas diferentes de las utilizadas por la práctica médica convencional, la Homeopatía suele ser objeto de críticas infundadas y generalizadas por parte de individuos que niegan sistemáticamente los supuestos homeopáticos y cualquier evidencia científica que los demuestre, debido a su postura pseudoescéptica y pseudocientífica, que impide un análisis correcto y libre de prejuicios.
Con el objetivo de ilustrar a médicos, investigadores, profesionales de la salud y
público en general, desmitificando las posiciones dogmáticas culturalmente arraigadas y las falacias pseudoescépticas de que “no hay evidencia científica para la Homeopatía” y “la Homeopatía es efecto placebo”, la Cámara Técnica de Homeopatía del Consejo Regional de Medicina del Estado de São Paulo (TC-Homeopatía, Cremesp) elaboró el “Dossier Especial: Evidencia Científica de la Homeopatía” en 2017, disponible en ediciones trilingües (portugués, inglés y español). Abarcando nueve revisiones narrativas sobre las diversas líneas de investigación en Homeopatía y conteniendo cientos de artículos científicos que describen estudios experimentales y clínicos, el Dossier destacó el estado del arte de la ciencia homeopática.
Al demostrar y ampliar esta evidencia científica en 13 capítulos interactivos, la obra
actual pretende actualizar y clarificar los conocimientos en la materia. Además de dilucidar en detalle las premisas epistemológicas del modelo homeopático, la obra describe los diversos aspectos de la investigación básica y clínica que avalan la práctica y el tratamiento homeopáticos en un continuo de información, datos y referencias bibliográficas. La obra aborda diversos temas relacionados con la investigación en Homeopatía, abarcando desde la “epidemiología clínica homeopática” hasta las “estrategias pseudoescépticas y pseudocientíficas utilizadas en los ataques a la homeopatía”, pasando por las “bases farmacológicas del principio de similitud”, los “estudios experimentales en modelos biológicos”, los “ensayos clínicos controlados aleatorizados”, las “revisiones sistemáticas, metaanálisis e informes globales” y los “estudios observacionales”, entre otros.
Actuando como terapia integradora y complementaria de otras especialidades, la
Homeopatía puede añadir eficacia, efectividad, eficiencia y seguridad a la práctica médica, actuando de forma curativa y preventiva, reduciendo las manifestaciones sintomáticas y la predisposición a enfermar, con bajo coste y mínimos eventos adversos.
... [10][11][12][13][14][15][16][17][18][19][20][21][22] Furthermore, it describes the proposal to use modern drugs according to the principle of therapeutic similitude, using the rebound effect of drugs curatively. [23][24][25] In the field of basic research in homeopathy, the chapter "Experimental studies in biological models (in vitro, plants and animals)" ...
Highlights
•Homeopathy is based on four heterodox and complementary scientific assumptions.
•Pseudoskeptics deny these assumptions and any scientific evidence that proves them.
•The e-book proves the scientific evidence for homeopathy.
•The e-book describes hundreds of experimental and clinical studies in homeopathy.
•The e-book demystifies the fallacy that “homeopathy is placebo effect”.
... Como sugerencia complementaria y reproduciendo nuestro trabajo con los fármacos modernos en la década anterior (con el objetivo de utilizarlos con base en la similitud entre los efectos adversos que inducen y los signos y síntomas de los pacientes, véase New homeopathic medicines: use of modern drugs according to the similitude principle [Nuevos medicamentos homeopáticos: uso de los fármacos modernos conforme al principio de similitud], (http://www.newhomeopathicmedicines.com) [68][69][70][71][72][73], una materia médica homeopática para plantas podría iniciar mediante el estudio, sistematización y organización de los signos y síntomas desencadenados en las plantas por las distintas sustancias utilizadas comúnmente en la práctica agrícola (minerales, pesticidas, fertilizantes, etcétera), para complementarse después con estudios patogénicos homeopáticos clásicos. ...
Efectos de las diluciones homeopáticas altas sobre las plantas: Revisión de la literatura Resumen Abstract Antecedentes: Entre los supuestos no convencionales de la homeopatía, el uso de medicamentos en diluciones altas (HD, por sus siglas en inglés) es una causa de objeciones y escepticismo entre la comunidad científica, formada dentro del paradigma de la dependencia de la dosis de la farmacología clásica. La investigación que busca evidenciar los efectos de las HD homeopáticas recurre a varios modelos experimentales (in vitro, plantas y animales). Objetivo: Describir los resultados de estudios con alta calidad metodológica que han demostrado los efectos positivos de las HD homeopáticas sobre las plantas. Métodos: Tomando como fuente de referencia las revisiones publicadas hasta 2015, actualizamos la información añadiendo datos de estudios recientes inclui-dos en la base de datos PubMed. Resultados: De los 167 estudios experimentales analizados, 48 cumplieron los criterios mínimos de calidad metodológica, de los cuales 29 detectaron efectos específicos de las diluciones homeopáticas altas sobre las plantas mediante la comparación con controles adecuados. Conclusiones: A pe-sar de que la mayor parte de los experimentos presentaba una calidad metodológica por debajo del estándar, los estudios que emplearon sistemáticamente reproducibilidad y controles negativos demostraron indiscutibles efectos significativos de las HD homeopáticas sobre las plantas. Background: Among the non-conventional assumptions of homeopathy, the use of medicines in high dilutions (HD) is a cause for objections and skepticism among the scientific community, trained within the dose-dependency paradigm of classic pharmacology. Research aiming at evidencing the effects of homeopathic HD has resource to several experimental models (in vitro, plants and animals). Aim: To describe the results of studies with high methodological quality that demonstrated positive effects of homeopathic HD on plants. Methods: Ta
... Para probar la validez clínica y científica de esta propuesta, desarrollamos un ensayo controlado aleatorizado empleando estrógeno potenciado (17-β estradiol) para el tratamiento del dolor pélvico asociado a la endometriosis 24 , en vista del hecho de que el estrógeno causa como eventos adversos un conjunto de signos y síntomas similares al síndrome de endometriosis, observándose una mejoría significativa en comparación con placebo en relación con el dolor, la depresión y la calidad de vida 25 . ...
The vitalist philosophical conception considers vital force dystonia as the primary cause of diseases, while the return to health status would occur by vital rebalancing. The homeopathic model expands understanding of the etiopathogenic dynamics, and also considers the manifestation of chronic miasmas (manifest psora) as a fundamental cause of chronic diseases in general, while health restoration would occur through modulating this miasmatic manifestation (latent psora).
According to the biomedical etiopathogenic process, the primary cause of diseases is the expression of genes responsible for the respective physiological disorders, considering the manifestation of disease-promoting epigenetic alterations as a fundamental cause of chronic diseases in general. The return to health status would occur through modulating these epigenetic manifestations and consequent inhibition of pathological gene expression.
Due to presenting similar characteristics and properties, we have suggested in recent studies the philosophical-scientific correlations between vital force and genome (exome plus epigenome) and between chronic miasms and disease-promoting epigenetic alterations, meaning that the genome would be the biological representation of organic vital force, and disease-promoting epigenetic alterations would be the biological representation of chronic miasms.
The properties and functions of the telomere-telomerase complex expand understanding of the gene expression mechanism at the chromosome level (DNA molecule or genomic unit), and reiterate the philosophical-scientific correlations between the vital principle and the genome in view of its recognized role as a biomarker of cellular vitality, biological aging and the health-disease process. In this context, telomere length would indicate the organic vital force state and could be used in the diagnosis and prognosis of diseases according to the vitalist approach, expanding the spectrum and scope of classical homeopathic semiology.
In accordance with these hypotheses, the isopathic use of auto-sarcode of DNA (auto-isotherapic of DNA) could act on the imbalance of the vital principle or genome and in the chronic miasmas or disease-promoting epigenetic alterations as homeopathic therapeutic modulator of gene expression in the management of chronic diseases.
... The proposal entitled "New Homeopathic Medicines: Use of modern drugs according to the principle of similitude" encompasses 1,250 modern drugs and has been available, since 2021, in three free-access digital books indexed in the Virtual Health Library (i.e., PAHO, WHO, and BIREME) 20 : "Scientific basis of the principle of similitude in modern pharmacology," 21 "Homeopathic materia medica of modern drugs," 22 and "Homeopathic repertory of modern drugs." 23 To test the clinical and scientific validity of this proposal, we developed a randomized controlled trial employing potentized estrogen (17-β estradiol) for the treatment of endometriosis-associated pelvic pain 24 , in view of the fact that estrogen causes as an adverse event a set of signs and symptoms similar to the endometriosis syndrome, observing significant improvement compared with placebo in relation to pain, depression, and quality of life 25 . ...
When Samuel Hahnemann systematized homeopathy and the effects of drugs on the state of human health, he described the primary action of drugs and the following secondary and opposite reaction of the body. Seeking to apply this secondary action or vital reaction of the body as therapeutic method, he postulated the “principle of cure by similars”, i.e. the prescription to ill individuals of drugs that cause similar symptoms in the healthy (similia similibus curentur). In modern pharmacology, this secondary action (vital reaction) of the body is known as rebound effect or paradoxical reaction. It has been observed after discontinuation of several classes of palliative drugs, namely those that act according to the “principle of cure by contraries” (contraria contrariis curentur). Since 1998, we have been bridging the gap between homeopathic and conventional pharmacology through the systematic study of rebound effect of modern drugs, scientifically confirming the homeopathic postulate (primary action of the drug followed by secondary and opposite reaction of the body) and the homeopathic healing principle. Following the homeopathic premises, conventional drugs can be employed according to the principle of therapeutic similitude provided they cause primary symptoms (therapeutic, adverse and side effects) similar to the symptomatic manifestations of sick individuals. Since 2003, we are proposing the use of the rebound effect of modern drugs in a curative manner, administering to patients, in ultra-diluted doses, drugs that cause a set of similar adverse events. Since 2021, these two decades of studies are made available in three free-access digital books.
... To test this proposal, we recently developed a clinical research protocol for the use of potentized estrogen (17-β estradiol) for the treatment of endometriosis-associated pelvic pain, since estrogen causes endometrial hyperplasia or proliferation as adverse event 21 . Reporting significant improvement versus placebo in relation to pain, depression, and quality of life 22 , this study suggests the validity of this clinical and scientific proposal. ...
Homeopathy employs the so-called ‘principle of similars’ as therapeutic method - which consists in administering medicines that cause certain primary symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) – in order to induce a secondary and healing reaction of 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). Since 1998, we have been bridging the gap between homeopathic and conventional pharmacology through the systematic study of the rebound effect of modern drugs, scientifically confirming the homeopathic postulate (primary action of the drug followed by secondary and opposite reaction of the organism) and the homeopathic healing principle. Following the homeopathic premises, conventional drugs can be employed according to the therapeutic similitude principle provided they cause primary symptoms (therapeutic, adverse and collateral effects) similar to the symptomatic manifestations of sick individuals. Since 2003, we are proposing the use of the rebound effect of modern drugs in a curative manner, administering to patients, in ultra-diluted doses, the drugs that cause a set of similar adverse events. Entitled “New Homeopathic Medicines: use of modern drugs according to the principle of similitude”, this proposal are been made available in a database composed of three free-access bilingual digital books.
... Teixeira et al demonstrated that potentated estrogens significantly reduced endometriosis-associated pain compared to a placebo (49). Sesti et al demonstrated that, for endometriosis stage III-IV, QOL can be improved through postoperative hormonal suppression treatment or dietary therapy compared to surgery as well as a placebo for relieving pain (50). ...
Endometriosis has a negative influence on the physical, psychological, and social aspects of a patient's life; therefore, it affects the health-related quality of life (HRQoL). The current review aimed to investigate the efficiency of a 36-item generic questionnaire survey (SF-36) for patients with endome-triosis who were undergoing medical or surgical treatment. A search strategy including the key words 'endometriosis', 'quality of life' (QOL), and 'questionnaire SF-36' was applied using the PubMed/MEDLINE, EMBASE, and Cochrane databases in order to include articles that evaluated the QOL among women with endometriosis using the SF-36. Only articles that included interviews of patients both before and after surgical or medical endometriosis treatment or those articles that compared study groups were considered. The qualitative analysis was based on 37 articles, whereas the quantitative analysis utilized 14 articles. The research participants included 11,101 women, among whom 6,888 patients were diagnosed with endometriosis. The analysis recorded 17 studies dealing with all types of endometriosis, 9 studies dealing with deep infiltrative endometriosis (DIE), and 9 studies dealing with bowel endometriosis or DIE with bowel involvement. QOL was evaluated using only SF-36 in 12 studies that collectively included 1,912 women and using SF-36 in association with other questionnaires in 25 studies that collectively included 8,022 women. For patients with endometriosis, physical functioning [odds ratio (OR), 78.87; 95% confidence interval (CI), 68.97-88.77; I 2 =98.77%; P≤0.001] was the most affected life parameter. This parameter showed the highest improvement after surgical intervention (OR, 63.39; 95% CI, 48.71-78.07; I 2 =97.65%; P≤0.001) or hormonal treatment (OR, 38.65; 95% CI, 14.39-62.91; I 2 =38.65%; P≤0.001). The 36-item survey generic questionnaire seems to be an efficient tool for assessment of the QOL of life of women with endometriosis who are undergoing surgical or medical treatment. It can be applied before and after the procedure, and it can also be used for comparing study groups.
... The study concluded that diet and homeopathy were the most frequently used methods in such condition [28]. A double-blind, randomized controlled trial (RCT) concluded that potentized estrogen was significantly more effective than placebo for reducing endometriosis-associated pelvic pain [29]. A clinical trial conducted at the OPD of Central Research Institute of Homoeopathy, Calcutta showed that homeopathic medicines Viburnum opulus and Xanthoxylum americanum produced statistically significant improvements in symptom complex associated with PD [30]. ...
Objective: Homeopathic treatment is claimed to be beneficial for primary dysmenorrhoea (PD); still, systematic research evidences remain compromised. This study was undertaken to examine the efficacy of individualized homeopathic medicines (IH) against placebo in the treatment of PD.
Methods: A double-blind, randomized, placebo-controlled trial was conducted at the gynecology outpatient department of Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, West Bengal, India. Patients were randomized to receive either IH (n=64) or identical-looking placebo (n=64). Primary and secondary outcome measures were 0-10 numeric rating scales (NRS) measuring intensity of pain of dysmenorrhea and verbal multidimensional scoring system (VMSS) respectively; all measured at baseline, and every month, up to 3 months. Group differences and effect sizes (Cohen’s d) were calculated on intention-to-treat (ITT) sample.
Results: Groups were comparable at baseline (all P>0.05). Attrition rate was 10.9% (IH: 7, Placebo: 7). Differences between groups in both pain NRS and VMSS favoured IH over placebo at all time points (all P< 0.001, unpaired t-tests and two-ways repeated measures analysis of variance) with medium to large effect sizes. Natrum muriaticum and Pulsatilla nigricans (n=20 each; 15.6%) were the most frequently prescribed medicines. No harms, serious adverse events and intercurrent illnesses were recorded in either of the groups.
Conclusion: Homeopathic medicines acted significantly better than placebo in the treatment of PD. Independent replication is warranted. Trial registration: CTRI/2018/10/016013.
... Em projeto de pós-doutorado concluído em 2017, evidenciamos a eficácia e a segurança dessa proposta no emprego do estrogênio (17-beta estradiol) potencializado no tratamento homeopático da dor pélvica crônica em pacientes com endometriose refratária aos tratamentos hormonais convencionais, por meio de ensaio clínico randomizado, duplo-cego e placebo-controlado. (Teixeira, 2017b;Teixeira et al., 2016Teixeira et al., , 2017aTeixeira et al., , 2017b (Hahnemann, 1995, § 106) Seguindo as premissas estipuladas por Hahnemann (Hahnemann, 1995 1 parte da substância matriz (mineral, vegetal ou animal) + 99 partes de água 100 sucussões dinamização ou potência 1cH (10 2 mol -1 da substância matriz); 1 parte da 1cH + 99 partes de água 100 sucussões potência 2cH (10 4 mol -1 ); 1 parte da 2cH + 99 partes de água 100 sucussões potência 3cH (10 6 mol -1 ); 1 parte da 3cH + 99 partes de água 100 sucussões potência 4cH (10 8 mol -1 ); E assim sucessivamente... Dinamização ou potência 12cH 10 24 mol -1 da substância matriz (constante de Avogadro: 6,02 x 10 23 mol -1 ) ausência de molécula-grama. cH: centesimal Hahnemanniana. ...
Além da reconhecida aplicação nas doenças crônicas, a homeopatia individualizada também pode atuar de forma resolutiva ou complementar nos casos agudos, incluindo as doenças epidêmicas. No entanto, para atingir esse intento, apresenta uma metodologia semiológica e terapêutica específica que deve ser seguida e respeitada, com o risco de não apresentar a eficácia e a segurança desejada. No caso das doenças epidêmicas, que pela virulência dos seus agentes provoca um quadro sintomatológico comum na maioria dos indivíduos suscetíveis, o medicamento homeopático individualizado (medicamento homeopático do gênio epidêmico) deve apresentar semelhança com o conjunto de sinais e sintomas característicos dos pacientes acometidos nos diferentes estágios de cada surto epidêmico. Estudos evidenciam a eficácia e a segurança desta prática profilática e/ou terapêutica em diversas epidemias do passado. Assim sendo, após o levantamento dos possíveis medicamentos homeopáticos individualizados do gênio epidêmico de cada epidemia, sua aplicação profilática e/ou terapêutica em larga escala deve ser sustentada por ensaios clínicos prévios que demonstrem sua eficácia e segurança, em consonância com os aspectos éticos e bioéticos da pesquisa envolvendo seres humanos. Cumprindo essas premissas da boa prática clínica, elaboramos o atual protocolo com o objetivo de investigar, em ensaio clínico randomizado, duplo-cego e placebo-controlado, a eficácia e a segurança de possíveis medicamentos homeopáticos individualizados do gênio epidêmico da COVID-19, em tratamento adjuvante e complementar de pacientes acometidos pela doença. Caso a eficácia e a segurança se confirme, e tão somente nessa condição, o medicamento poderá ser utilizado de forma generalizada e coletiva no tratamento e na prevenção da atual epidemia.
... Hence they concluded that Potentised estrogen is effective in EAPP. [9] Law of Minimum: According to this law, minutest amount of dose of the selected medicine should be given to the patient. The minutest dose refers to the dose that is sufficient to excite the vital force and effect the change repaired. ...
Every science revolves around approaches, experiments and various theories. Medical science is no exception of
that there are other systems which are referred as the contemporary system of medicine or alternative system of
medicine such as Homoeopathy, Naturopathy, Ayurveda, Unani. As everything which is based on some principles
like that Homoeopathy principles are based on some facts, theories or experiments. Dr. Samuel Hahnemann (1755-
1843) gave fundamental principles of homoeopathy on which the Homoeopathic system is based. This was
established 250 years ago which is far from the modern concept and was not accepted by the medical fraternity.
Dr.Hahnemann faced lot of criticism during his life time. Here these principles when correlated with studies done
by many researchers and they statically proved its efficacy. Homoeopathy is the only system of medicine which
proves its remedies on apparently healthy human beings. It is based on the law Similia Similibus Curentur and
follows the Eight fundamentals principles. Homoeopathy is only accepted by the public due to its mildness and cost
effectiveness. The more controversial theory of homoeopathy is the drug dynamisation which includes the process
of succussion and dilution which could not be proved scientifically till date. Homoeopaths are talking about the
high dilution or highly diluted medicines which they explained by the nanoparticles theories and explained the
medicines are far beyond the avogadro‟s number i.e 6.022.10-23. In this study we are trying to explain the
fundamental principles of Homoeopathy by the researches based on these principles and to explain the scientific
basis of homoeopathy
... Em projeto de pós-doutorado concluído em 2017, evidenciamos a eficácia e a segurança dessa proposta no emprego do estrogênio (17-beta estradiol) potencializado no tratamento homeopático da dor pélvica crônica em pacientes com endometriose refratária aos tratamentos hormonais convencionais, por meio de ensaio clínico randomizado, duplo-cego e placebo-controlado. (Teixeira, 2017b;Teixeira et al., 2016Teixeira et al., , 2017aTeixeira et al., , 2017b (Hahnemann, 1995, § 106) Seguindo as premissas estipuladas por Hahnemann (Hahnemann, 1995 1 parte da substância matriz (mineral, vegetal ou animal) + 99 partes de água 100 sucussões dinamização ou potência 1cH (10 2 mol -1 da substância matriz); 1 parte da 1cH + 99 partes de água 100 sucussões potência 2cH (10 4 mol -1 ); 1 parte da 2cH + 99 partes de água 100 sucussões potência 3cH (10 6 mol -1 ); 1 parte da 3cH + 99 partes de água 100 sucussões potência 4cH (10 8 mol -1 ); E assim sucessivamente... Dinamização ou potência 12cH 10 24 mol -1 da substância matriz (constante de Avogadro: 6,02 x 10 23 mol -1 ) ausência de molécula-grama. cH: centesimal Hahnemanniana. ...
Abstract:
In addition to the recognized application in chronic diseases, individualized homeopathy can also act in a resolutive or complementary way in acute cases, including epidemic diseases. However, to achieve this intent, it presents a specific semiological and therapeutic methodology that must be followed and respected, with the risk of not presenting the desired efficacy and safety. In the case of epidemic diseases, which due to the virulence of their agents causes a common symptomatological picture in most susceptible individuals, the individualized homeopathic medicine (homeopathic medicine of the epidemic genius) should present similarity with the set of characteristic symptoms and signs of the patients affected in the different stages of each epidemic outbreak. Studies show the efficacy and safety of this prophylactic and/or therapeutic practice in several epidemics of the past. Therefore, after the survey of possible homeopathic drugs individualized from the epidemic genius of each epidemic, its prophylactic and/or large-scale therapeutic application should be supported by previous clinical trials that demonstrate its efficacy and safety, in line with the ethical and bioethical aspects of research involving human beings. Fulfilling these premises of good clinical practice, we developed the current protocol with the objective of investigating, in a randomized, double-blind and placebo-controlled clinical trial, the efficacy and safety of possible individualized homeopathic drugs of epidemic genius of COVID-19, in adjuvant and complementary treatment of patients affected by the disease. If efficacy and safety are confirmed, and only in this condition, the medicine may be used in a generalized and collective manner in the treatment and prevention of the current epidemic.
Resumo:
Além da reconhecida aplicação nas doenças crônicas, a homeopatia individualizada também pode atuar de forma resolutiva ou complementar nos casos agudos, incluindo as doenças epidêmicas. No entanto, para atingir esse intento, apresenta uma metodologia semiológica e terapêutica específica que deve ser seguida e respeitada, com o risco de não apresentar a eficácia e a segurança desejada. No caso das doenças epidêmicas, que pela virulência dos seus agentes provoca um quadro sintomatológico comum na maioria dos indivíduos suscetíveis, o medicamento homeopático individualizado (medicamento homeopático do gênio epidêmico) deve apresentar semelhança com o conjunto de sinais e sintomas característicos dos pacientes acometidos nos diferentes estágios de cada surto epidêmico. Estudos evidenciam a eficácia e a segurança desta prática profilática e/ou terapêutica em diversas epidemias do passado. Assim sendo, após o levantamento dos possíveis medicamentos homeopáticos individualizados do gênio epidêmico de cada epidemia, sua aplicação profilática e/ou terapêutica em larga escala deve ser sustentada por ensaios clínicos prévios que demonstrem sua eficácia e segurança, em consonância com os aspectos éticos e bioéticos da pesquisa envolvendo seres humanos. Cumprindo essas premissas da boa prática clínica, elaboramos o atual protocolo com o objetivo de investigar, em ensaio clínico randomizado, duplo-cego e placebo-controlado, a eficácia e a segurança de possíveis medicamentos homeopáticos individualizados do gênio epidêmico da COVID-19, em tratamento adjuvante e complementar de pacientes acometidos pela doença. Caso a eficácia e a segurança se confirme, e tão somente nessa condição, o medicamento poderá ser utilizado de forma generalizada e coletiva no tratamento e na prevenção da atual epidemia.
... Only seven articles [26,34,37,39,41,44,51] gained an overall score ≥23 points (approximatively 88% of the maximum possible total score). Thus, they were the closest to reaching a high-quality status according to the evaluated methodological items. ...
Background and objectives: Informed decision-making requires the ability to identify and integrate high-quality scientific evidence in daily practice. We aimed to assess whether randomized controlled trials (RCTs) on endometriosis therapy follow methodological criteria corresponding to the RCTs’ specific level in the hierarchy of evidence in such details to allow the reproduction and replication of the study. Materials and Methods: Using the keywords “therapy” and “endometriosis” and “efficacy” three bibliographic databases were searched for English written scientific articles published from 1 January 2008 to 3 March 2018. Only the randomized clinical trials (RCTs) were evaluated in terms of whether they provided the appropriate level of scientific evidence, equivalent to level 1, degree 1b in the hierarchy of evidence. A list of criteria to ensure study replication and reproduction, considering CONSORT guideline and MECIR standards, was developed and used to evaluate RCTs’ methodological soundness, and scores were granted. Three types of bias, namely selection bias (random sequence generation and allocation concealment), detection bias (blinding of outcome assessment), and attrition bias (incomplete outcome data) were also evaluated. Results: We found 387 articles on endometriosis therapy, of which 38 were RCTs: 30 double-blinded RCTs and 8 open-label RCTs. No article achieved the maximum score according to the evaluated methodological criteria. Even though 73.3% of the double-blinded RCTs had clear title, abstract, introduction, and objectives, only 13.3% provided precise information regarding experimental design and randomization, and also showed a low risk of bias. The blinding method was poorly reported in 43.3% of the double-blinded RCTs, while allocation concealment and random sequence generation were inadequate in 33.3% of them. Conclusions: None of the evaluated RCTs met all the methodological criteria, none had only a low risk of bias and provided sufficient details on methods and randomization to allow for the reproduction and replication of the study. Consequently, the appropriate level of scientific evidence (level 1, degree 1b) could not be granted. On endometriosis therapy, this study evaluated the quality of reporting in RCTs and not the quality of how the studies were performed.
... Pocos eventos adversos fueron asociados al estrógeno dinamizado. El estrógeno dinamizado (12CH, 18CH y 24CH), a una dosis de 3 gotas dos veces al día, durante 24 semanas, fue significativamente más eficaz que el placebo para reducir el dolor pélvico asociado con la endometriosis, mejorar la calidad de vida y disminuir los síntomas depresivos [30][31][32][33][34] . ...
Homeopathy is based on the law of similarity, which tells us that the use of drugs
that produce symptoms similar to those of diseases stimulates the body’s reaction to
relieve their own ailments. Homeopathic treatment can use all kinds of substances
(natural or synthetic, in weight or infinitesimal doses) provided that this principle is
respected.
Based on the above, since 2003 we have proposed the use of modern
drugs according to the homeopathic healing principle both through research and
publications in scientific journals, and the development of a Homeopathic Materia
Medica Modern Drugs, which includes the primary effects of 1,250 allopathic drugs,
and a Homeopathic Repertory of Modern Drugs. These efforts are part of the New
Homeopathic Medicine project: Use of Modern Drugs according to the Principle of
Similarity, which can be consulted free of charge, in Portuguese and English, on the
website www.newhomeopathicmedicines.com.
Now, the clinical and scientific validity of this proposal has begun with the
performance of a clinical trial to evaluate the efficacy and safety of energized estrogen
in the homeopathic treatment of pelvic pain associated with endometriosis. The result
has been positive, but it requires doctors, pharmacists and researchers to join this
initiative to strengthen it and boost its growth.////////////
Resumen
La Homeopatía se fundamenta en la ley de semejanza, la cual nos dice que el empleo
de medicamentos que producen síntomas similares a los de las enfermedades
estimula la reacción del organismo para aliviar sus propias dolencias. El tratamiento
homeopático puede emplear toda clase de sustancias (naturales o sintéticas, en dosis
ponderales o infinitesimales) siempre que se respete dicho principio.
Con base en lo anterior, desde 2003 hemos propuesto el uso de fármacos
modernos según el principio homeopático de curación tanto a través de investigaciones
y publicaciones en revistas científicas, como de la elaboración de una Materia
Médica Homeopática de Fármacos Modernos, que incluye los efectos primarios de
1,250 fármacos alopáticos, y un Repertorio Homeopático de Fármacos Modernos. Estos
esfuerzos forman parte del proyecto Nuevos Medicamentos Homeopáticos: Uso
de Fármacos Modernos según el Principio de Semejanza, que puede consultarse de
manera gratuita, en portugués e inglés, en el sitio web www.nuevosmedicamentoshomeopaticos.
com.
Ahora, la validez clínica y científica de esta propuesta ha comenzado con la
realización de un ensayo clínico para evaluar la eficacia y la seguridad del estrógeno
dinamizado en el tratamiento homeopático del dolor pélvico asociado a la endometriosis.
El resultado ha sido positivo, pero se requiere que médicos, farmacéuticos e
investigadores se sumen a esta iniciativa para robustecerla e impulsar su crecimiento.
... Excetuando a especificidade na seleção do tratamento isoterápico, que utiliza ultradiluições de agentes patogênicos para prevenir e/ou tratar os efeitos deletérios desses mesmos agentes em plantas (analogamente à imunização e à imunoterapia em humanos, respectivamente), a grande maioria dos medicamentos utilizados no tratamento homeopático dos distúrbios de plantas é escolhida de forma empírica e inespecífica (sem descrever o método de seleção empregado), aplicando-se analogias interpretativas entre os sinais e sintomas descritos nas matérias médicas homeopáticas tradicionais (fruto da experimentação patogenética das substâncias medicinais em seres humanos) e os sinais e sintomas observados nas plantas. Como proposta complementar, reproduzindo o que vimos realizando com os fármacos modernos na última década, sugerindo seu emprego homeopático em conformidade com a aplicação da similitude entre seus eventos adversos e os sinais e sintomas dos indivíduos doentes (Novos medicamentos homeopáticos: uso dos fármacos modernos segundo o princípio da similitude; http://www.newhomeopathicmedicines.com)[68][69][70][71][72][73], poderíamos iniciar a elaboração dessa matéria médica homeopática para plantas com o levantamento, a sistematização e a formatação dos sinais e sintomas despertados nas espécies vegetais pela toxidez de diversas substâncias utilizadas convencionalmente nas práticas agrícolas (minerais, agrotóxicos, fertilizantes, etc.), incrementando esse compêndio inicial com experimentações patogenéticas homeopáticas clássicas. Exemplificando a validade do método anteriormente proposto, ressaltamos o experimento de Betti et al.[45], que utilizou o trióxido de arsênico (As 2 O 3 ) para reduzir a severidade do mosaico do fumo (tabaco), provocado pelo vírus TMV. ...
Resumo
Introdução: Dentre as premissas não convencionais do modelo homeopático, o emprego de doses ultradiluídas de medicamentos desperta questionamentos e ceticismo na classe científica, acostumada ao paradigma dose-dependente da farmacologia clássica. Para evidenciar o efeito das ultradiluições homeopáticas em seres vivos, pesquisas são realizadas em diversos modelos experimentais (in vitro, em plantas e em animais). Objetivo: Descrever os estudos de melhor qualidade metodológica que confirmaram o efeito positivo das ultradiluições homeopáticas em plantas. Métodos: Utilizando como fontes de referência as revisões sobre o tema publicadas até 2015, atualizamos os dados adicionando estudos recentes citados na base de dados PubMed. Resultados: Dentre 167 estudos experimentais analisados nas principais revisões, 48 atingiram os critérios mínimos de qualidade metodológica e 29 identificaram os efeitos específicos das ultradiluições homeopáticas em plantas, empregando controles adequados. Conclusões: Apesar da qualidade metodológica insatisfatória da maioria dos experimentos, estudos com controle negativo sistemático e reprodutibilidade reportaram efeitos significativos e incontestáveis das ultradiluições homeopáticas em plantas.
Abstract
Introduction: Among the non-conventional grounds of homeopathy, the use of medicines in high dilutions is a cause for objections and skepticism among the scientific community, trained within the dose-dependency paradigm of classic pharmacology. Research aiming at evidencing the effects of homeopathic high dilutions has resource to several experimental models (in vitro, in plants and in animals). Aim: To describe the results of studies with high methodological quality that demonstrated positive effects of homeopathic high dilutions on plants. Methods: Taking reviews published until 2015 as reference source, we updated the information through the addition of data in recent studies included in database PubMed. Results: From 167 experimental studies analyzed in the main reviews, 48 met the minimum criteria of methodological quality, from which 29 detected specific effects of homeopathic high dilutions on plants through comparison with adequate controls. Conclusions: Despite the substandard methodological quality of most experiments, studies with systematic use of negative controls and reproducibility demonstrated significant undeniable effects of homeopathic high dilutions on plants. //
... As a complementary suggestion and reproducing our work with modern drugs in the past decade (with the goal to use them based on the similarity between the adverse effects they induce and the signs and symptoms of patients, see New homeopathic medicines: use of modern drugs according to the similitude principle, www.newhomeopathicmedicines.com) [68][69][70][71][72][73] a homeopathic materia medica for plants might begin by the survey, systematization and organization of the signs and symptoms elicited in plants by the various substances commonly used in agricultural practice (mineral, pesticides, fertilizers, etc.) to be later complemented with classical homeopathic pathogenetic trials. ...
Introduction: Among the non-conventional grounds of homeopathy, the use of medicines in high dilutions is a cause for objections and skepticism among the scientific community, trained within the dose-dependency paradigm of classic pharmacology. Research aiming at evidencing the effects of homeopathic high dilutions has resource to several experimental models (in vitro, in plants and in animals). Aim: To describe the results of studies with high methodological quality that demonstrated positive effects of homeopathic high dilutions on plants. Methods: Taking reviews published until 2015 as reference source, we updated the information through the addition of data in recent studies included in database PubMed. Results: From 167 experimental studies analyzed in the main reviews, 48 met the minimum criteria of methodological quality, from which 29 detected specific effects of homeopathic high dilutions on plants through comparison with adequate controls. Conclusions: Despite the substandard methodological quality of most experiments, studies with systematic use of negative controls and reproducibility demonstrated significant undeniable effects of homeopathic high dilutions on plants.
... They concluded that homeopathic remedies control enzyme activities. Teixeira [59] began this new way of homeopathic treatment. He used successfully potentized estrogen in endometriosis-associated pelvic pain. ...
Since Lenger's detection of magnetic photons in homeopathic remedies by magnetic resonance the mystery of homeopathy comes to a solution. Homeopathy is a regulation therapy curing hypo-and hyper-functions of pathological pathways. It reacts according to the principle of resonance. The fundamental principles of homeopathy as proving, symptom picture, curing according to the Law of Similars and the production of homeopathic remedies over the Avogadro number by repeated dilution and succussion are explained to have the same frequencies so that the resonance principle can work. Pathological pathways are cured by using their highly potentized substrates, inhibitors and enzymes, given daily or each second day. This is in contradiction to the normal applied homeopathy. The efficacy of homeopathy now has a scientific base and is completely explained by applying biochemical and biophysical laws.
... 4 Further, there is some evidence to suggest that homeopathy can work faster than conventional pain medications or reduce the need for them, 5,6 without danger of dependence or withdrawal symptoms. 7 There is also research to suggest that homeopathy can work better than placebo in reducing pain, for example from endometriosis, 8 joint pain and stiffness, 9 and hemorrhoids. 10 For those in the throes of withdrawal, homeopathic medicines can minimize suffering and help to ensure a successful rehabilitation outcome, as reported in the forthcoming article on Post-Acute-Withdrawal Syndrome. ...
Homeopathy is often overlooked as a modality for pain management. However, it deserves to be a first-line treatment due to its safety, effectiveness, and cost-effectiveness. Limitations to the acceptance of homeopathy in the United States include physicians' lack of familiarity with the research studies, which primarily come from Europe, where homeopathy is integrated into the national healthcare systems of nearly all European countries. The database of the social security system in France, where citizens can choose a homeopathic or conventional family doctor, shows that the former modality provides comparable results in pain management while significantly reducing the use of conventional painkillers. Research in the United States is minimal due to lack of government or industry funding. In addition, exaggerated media reports as to the potential harm from homeopathy have resulted in undue reluctance to use it among both physicians and the general public. A large-scale review of the German drug safety database has revealed a miniscule number of adverse events. Finally, resistance to the use of homeopathy - based on the mistaken notion that it contains nothing but water - is addressed by citations from the newly emerging field of ultrahigh dilution physics. A description of the most common homeopathic medicines for various types of pain is provided, including back pain, dental pain, labor pains, and trigeminal neuralgia. Homeopathic medicines must be customized to the individual patient in chronic conditions. Yet, a severe acute trauma can respond to the same homeopathic medicine in nearly all individuals. As an example, a standard protocol is provided to speed healing and reduce pain after surgery or dental extraction. While homeopathic medicines are rarely tested against conventional painkillers in a head-to-head trial, certain research studies show that homeopathic medicines can enhance healing for those already on conventional medications and can reduce pain in a condition such as a fracture for which effective drug treatment is lacking.
... Como proposta complementar, reproduzindo o que vimos realizando com os fármacos modernos na última década, sugerindo seu emprego homeopático em conformidade com a aplicação da similitude entre seus eventos adversos e os sinais e sintomas dos indivíduos doentes (Novos medicamentos homeopáticos: uso dos fármacos modernos segundo o princípio da similitude; http://www.newhomeopathicmedicines.com) [68][69][70][71][72][73], poderíamos iniciar a elaboração dessa matéria médica homeopática para plantas com o levantamento, a sistematização e a formatação dos sinais e sintomas despertados nas espécies vegetais pela toxidez de diversas substâncias utilizadas convencionalmente nas práticas agrícolas (minerais, agrotóxicos, fertilizantes, etc.), incrementando esse compêndio inicial com experimentações patogenéticas homeopáticas clássicas. ...
Resumo
Introdução: Dentre as premissas não convencionais do modelo homeopático, o emprego de doses ultradiluídas de medicamentos desperta questionamentos e ceticismo na classe científica, acostumada ao paradigma dose-dependente da farmacologia clássica. Para evidenciar o efeito das ultradiluições homeopáticas em seres vivos, pesquisas são realizadas em diversos modelos experimentais (in vitro, em plantas e em animais). Objetivo: Descrever os estudos de melhor qualidade metodológica que confirmaram o efeito positivo das ultradiluições homeopáticas em plantas. Métodos: Utilizando como fontes de referência as revisões sobre o tema publicadas até 2015, atualizamos os dados adicionando estudos recentes citados na base de dados PubMed. Resultados: Dentre 167 estudos experimentais analisados nas principais revisões, 48 atingiram os critérios mínimos de qualidade metodológica e 29 identificaram os efeitos específicos das ultradiluições homeopáticas em plantas, empregando controles adequados. Conclusões: Apesar da qualidade metodológica insatisfatória da maioria dos experimentos, estudos com controle negativo sistemático e reprodutibilidade reportaram efeitos significativos e incontestáveis das ultradiluições homeopáticas em plantas.
Abstract
Introduction: Among the non-conventional grounds of homeopathy, the use of medicines in high dilutions is a cause for objections and skepticism among the scientific community, trained within the dose-dependency paradigm of classic pharmacology. Research aiming at evidencing the effects of homeopathic high dilutions has resource to several experimental models (in vitro, in plants and in animals). Aim: To describe the results of studies with high methodological quality that demonstrated positive effects of homeopathic high dilutions on plants. Methods: Taking reviews published until 2015 as reference source, we updated the information through the addition of data in recent studies included in database PubMed. Results: From 167 experimental studies analyzed in the main reviews, 48 met the minimum criteria of methodological quality, from which 29 detected specific effects of homeopathic high dilutions on plants through comparison with adequate controls. Conclusions: Despite the substandard methodological quality of most experiments, studies with systematic use of negative controls and reproducibility demonstrated significant undeniable effects of homeopathic high dilutions on plants. //
Background:
Contraceptive methods are well-established in their ability to prevent pregnancy and increase individual agency in childbearing. Evidence suggests that contraceptives can also be used to treat adverse conditions associated with menstruation, including abnormal and prolonged uterine bleeding, heavy menstrual bleeding, painful menstruation, endometriosis, uterine fibroids, and premenstrual dysphoric disorders.This review investigates the effects of contraceptive techniques such as contraceptive pills, and long-acting reversible contraceptives (e.g. intrauterine devices, implants) on menstrual morbidity.
Methods:
Over ten databases with no geographical boundaries were searched from inception until October 2023. Study designs were one of the following types to be included: parallel or cluster randomised controlled trials, controlled clinical trials, controlled before and after studies, interrupted time series studies, cohort or longitudinal analyses, regression discontinuity designs, and case-control studies. Ten team members screened the papers in pairs with a Kappa score of more than 7, and Covidence was used. Conflicts were resolved by discussion, and the full papers were divided among the reviewers to extract the data from eligible studies.
Results:
Hormonal contraceptives are considered a well-tolerated, non-invasive, and clinically effective treatment for abnormal and prolonged uterine bleeding, heavy menstrual bleeding, painful menstruation, endometriosis, uterine fibroids, and premenstrual dysphoric disorders. Our studies investigating quality of life or well-being in women with heavy menstrual bleeding, endometriosis, or uterine fibroids have found improvements in all dimensions assessed.
Conclusions:
Hormonal contraceptives significantly reduce pain, symptom severity, and abnormal bleeding patterns associated with women who suffer from heavy menstrual bleeding, endometriosis, and uterine fibroids.
Endometriosis, a common cause for chronic pelvic pain, significantly affects quality of life, fertility, and overall productivity of those affected. Therapeutic options remain limited, and collating evidence on treatment efficacy is complicated. One reason could be the heterogeneity of assessed outcomes in nonsurgical clinical trials, impeding meaningful result comparisons. This systematic literature review examines outcome domains and patient-reported outcome measures (PROMs) used in clinical trials. Through comprehensive search of Embase, MEDLINE, and CENTRAL up until July 2022, we screened 1286 records, of which 191 were included in our analyses. Methodological quality (GRADE criteria), information about publication, patient population, and intervention were assessed, and domains as well as PROMs were extracted and analyzed. In accordance with IMMPACT domain framework, the domain pain was assessed in almost all studies (98.4%), followed by adverse events (73.8%). By contrast, assessment of physical functioning (29.8%), improvement and satisfaction (14.1%), and emotional functioning (6.8%) occurred less frequently. Studies of a better methodological quality tended to use more different domains. Nevertheless, combinations of more than 2 domains were rare, failing to comprehensively capture the bio–psycho–social aspects of endometriosis-associated pain. The PROMs used showed an even broader heterogeneity across all studies. Our findings underscore the large heterogeneity of assessed domains and PROMs in clinical pain-related endometriosis trials. This highlights the urgent need for a standardized approach to both, assessed domains and high-quality PROMs ideally realized through development and implementation of a core outcome set, encompassing the most pivotal domains and PROMs for both, stakeholders and patients.
Homeopathy has been a medical practice recognized worldwide for more than two centuries, performing care, teaching and research activities in several health institutions and medical schools. It employs a clinical approach based on heterodox and complementary scientific principles (principle of therapeutic similitude, homeopathic pathogenetic experimentation, use of individualized medicines and dynamized or potentiated doses), with the aim of awakening a curative response in the body against its own disorders and/or diseases. Based on different premises from those used by conventional medical practice, homeopathy is often the target of unfounded and widespread criticism from individuals who systematically deny homeopathic assumptions and any scientific evidence that proves them due to their pseudoskeptical and pseudoscientific stance, which prevents a correct and bias-free analysis. In order to enlighten doctors, researchers, health professionals and the general public, demystifying culturally rooted dogmatic positions and the pseudoskeptical fallacies that "there is no scientific evidence for homeopathy" and "homeopathy is placebo effect", the Technical Chamber of Homeopathy of the Regional Council of Medicine of the State of São Paulo (TC-Homeopathy, Cremesp) prepared the "Special Dossier Scientific Evidence for Homeopathy" in 2017, made available in three independent editions (online in Portuguese and English; printed in Portuguese) in the Revista de Homeopatia (São Paulo). Then, the dossier was published in Spanish in the La Homeopatía de México journal in 2023 in an edition commemorating the journal's 90th anniversary. Encompassing nine narrative reviews on the various lines of homeopathy research and containing hundreds of scientific articles describing experimental and clinical studies, the Dossier highlighted the state of the art of homeopathic science. Proving and expanding this scientific evidence in 13 chapters, the current work aims to update and clarify knowledge in the area. In addition to elucidating the epistemological premises of the homeopathic model in detail, the work describes the various aspects of basic and clinical research which endorse homeopathic practice and treatment in a continuum of information, data and bibliographic references. The work discusses various topics related to research in homeopathy, covering everything from "homeopathic clinical epidemiology" to "pseudoskeptic and pseudoscientific strategies used in attacks on homeopathy", including "pharmacological basis of the principle of similitude", "experimental studies in biological models", "randomized controlled clinical trials", "systematic reviews, meta-analyses and global reports" and "observational studies", among others. In view of the fact that it becomes fruitless and tiring to describe and analyze all the studies and experiments from the different research lines, we suggest and systematize in the different chapters for those who want to delve deeper into the areas of interest, bibliographical surveys of existing literature through the different databases. As we reiterate throughout the work, despite the difficulties and limitations that exist in developing research in homeopathy due to both methodological aspects and the lack of institutional and financial support, the set of experimental and clinical studies described is indisputable proof that "there is scientific evidence for homeopathy" and "homeopathy is not placebo effect", contrary to falsely disseminated prejudice. However, new studies must continue to be developed to improve clinical practice and elucidate peculiar aspects of the homeopathic paradigm. Acting as an integrative and complementary therapy to other specialties, homeopathy can add efficacy, effectiveness, efficiency and safety to medical practice, acting in a curative and preventive manner, reducing symptomatic manifestations and the predisposition to falling ill, with low cost and minimal adverse events, helping doctors to fulfill their "highest and only mission, which is to make sick people healthy, which is called healing" (Samuel Hahnemann, Organon of Medicine, § 1).
Em vista da homeopatia estar fundamentada em pressupostos científicos distintos dos empregados pela prática médica convencional, frequentemente, é alvo de críticas infundadas disseminadas por indivíduos que, de forma sistemática, negam os princípios homeopáticos e qualquer evidência científica que os comprovem, por estarem envoltos em um negacionismo dogmático que impede uma análise correta e isenta de preconceitos. São pseudocéticos disfarçados em pseudocientistas. Para esclarecer médicos, pesquisadores, profissionais de saúde e a população em geral, desmistificando posturas dogmáticas culturalmente arraigadas e a falácia pseudocética de que "não existem evidências científicas para homeopatia", em 2017, a Câmara Técnica de Homeopatia do Conselho Regional de Medicina do Estado de São Paulo (CT-Homeopatia, Cremesp) elaborou e publicou o "Dossiê Especial Evidências Científicas em Homeopatia", disponibilizado livremente na Revista de Homeopatia (São Paulo), periódico científico da Associação Paulista de Homeopatia (APH). Englobando nove revisões narrativas em diversas linhas de pesquisa homeopática (histórico-social, educação médica, farmacológica, básicas, clínica, segurança do paciente e patogenética) e dois ensaios clínicos randomizados e placebos-controlados desenvolvidos por membros da CT-Homeopatia, contendo centenas de artigos científicos publicados em inúmeras revistas científicas indexadas e revisadas por pares, este dossiê destaca para a classe médica e científica, bem como para o público em geral, o 'estado da arte' da pesquisa em homeopatia.
Clinical epidemiology deals with clinical practice through the study of variation and the determinants of the evolution of diseases, its knowledge being indispensable for the correct design, planning and execution of the different types of clinical studies. Among the homeopathic assumptions, the individualization of treatment is an indispensable condition to reach the efficacy and effectiveness of the therapy, requiring a longer period of follow-up so that the adjustments of the globalizing therapeutic similarity are achieved. Homeopathic clinical epidemiology associates the premises and principles of clinical epidemiology with those of homeopathic episteme, with the aim of increasing the methodological quality of clinical research without disrespecting homeopathic rationality. In this review, we discuss the premises and principles of (homeopathic) clinical epidemiology, highlighting the fundamental aspects for the elaboration of epidemiological studies in homeopathy for the different types of diseases, including epidemics.
Resumen
La epidemiología clínica se ocupa de la práctica clínica a través del estudio de la variación y de los determinantes de la evolución de las enfermedades, siendo indispensables sus conocimientos para el correcto diseño, planificación y ejecución de los diversos tipos de estudios clínicos. Entre los supuestos homeopáticos, la individualización del tratamiento es una condición indispensable para alcanzar la eficacia y la efectividad de la terapia, necesi-tando un período mayor de acompañamiento para que los ajustes de la similitud terapéutica globalizante sean alcanzados. La epidemiología clínica homeopática asocia las premisas y principios de la epidemiología clínica a los de la episteme homeopática, con el fin de incrementar la calidad metodológica de la investigación clínica sin violar la racionalidad homeopática. En esta revisión, abordamos las premisas y los principios de la epidemiología clínica (homeopática), destacando los aspectos fundamentales para la elaboración de es-tudios epidemiológicos en Homeopatía para los distintos tipos de enfermedades, incluidas las epidemias.
A substantial proportion of adults and children in the United States use complementary and alternative health practices, including homeopathy. Many homeopathic therapies are readily available over the counter, and many individuals access and self-administer these therapies with little or no guidance from health care practitioners. In addition, patients and health care providers are often confused by terminologies associated with complementary practices and may be unable to distinguish homeopathy from naturopathy, herbalism, holistic medicine, Ayurveda, traditional Chinese medicine, or other forms of health care. Compared with European and Asian countries, education in the United States about complementary and alternative health practices is not typically found within traditional nursing, midwifery, or medical education curricula. Given this lack of education and the broad acceptance and popularity of homeopathy, it is necessary for health care practitioners to improve their knowledge regarding similarities and differences among therapies so they can fully inform and make appropriate recommendations to patients. The intent of this article is therefore to examine the state of existing science of homeopathy, distinguish it from other complementary methods, and provide midwives and women's health care providers with an introduction to common homeopathic therapies that may be recommended and safely used by persons seeking midwifery care. This review also presents the evidence base, pharmacology, manufacturing, and regulation of homeopathic therapies. We also consider controversies and misunderstandings regarding safety and efficacy of homeopathic remedies relevant to women and birthing persons. Examples of practical applications of homeopathic therapies for use in midwifery practice are introduced. Implications for practice and sample guidelines are included.
La Homeopatía de México | Evidencias Científicas de la Homeopatía | Edición Especial de Aniversario (90 años) | 2023 || EDITORIAL: Para aquellos que demandan evidencias científicas de la Homeopatía. Marcus Zulian Teixeira. | ARTÍCULOS: Homeopatía: una breve descripción de esta especialidad médica. Marcelo Pustiglione, Eduardo Goldenstein, Y. Moisés Checinski. | Formación médica en la terapéutica no convencional en el mundo (Homeopatía y acupuntura). Marcus Zulian Teixeira. | Bases científicas del principio de curación homeopática en la farmacología moderna. Marcus Zulian Teixeira. | La solidez de la investigación homeopática fundamental. Leoni Villano Bonamin. | Efectos de las diluciones homeopáticas altas sobre los modelos in vitro: revisión de la literatura. Silvia Waisse. | Efectos de las diluciones homeopáticas altas sobre las plantas: revisión de la literatura. Marcus Zulian Teixeira, Solange M.T.P.G. Carneiro. | Investigación clínica en Homeopatía: revisiones sistemáticas y estudios clínicos aleatorizados. Silvia Waisse. | Estrógeno potenciado en el tratamiento homeopático del dolor pélvico asociado a endometriosis: Un estudio aleatorizado, doble ciego, controlado con placebo, de 24 semanas. Marcus Zulian Teixeira, Sérgio Podgaec, Edmund Chada Baracat. | Estudio aleatorizado, doble ciego, sobre la eficacia del tratamiento homeopático en niños con amigdalitis recurrente. Sérgio E. Furuta, Luc L. M. Weckx, Cláudia R. Figueiredo. | ¿Los medicamentos homeopáticos provocan agravación o efectos adversos dependientes de los fármacos? Flávio Dantas. | ¿Los medicamentos homeopáticos inducen síntomas en voluntarios aparentemente sanos? Contribución brasileña al debate sobre los estudios patogénicos homeopáticos. Flávio Dantas. |
La Homeopatía de México | Evidencias Científicas de la Homeopatía | Edición Especial de Aniversario (90 años) | 2023 ||
EDITORIAL:
Para aquellos que demandan evidencias científicas de la Homeopatía.
Marcus Zulian Teixeira. |
ARTÍCULOS:
Homeopatía: una breve descripción de esta especialidad médica.
Marcelo Pustiglione, Eduardo Goldenstein, Y. Moisés Checinski. |
Formación médica en la terapéutica no convencional en el mundo (Homeopatía y acupuntura).
Marcus Zulian Teixeira. |
Bases científicas del principio de curación homeopática en la farmacología moderna.
Marcus Zulian Teixeira. |
La solidez de la investigación homeopática fundamental.
Leoni Villano Bonamin. |
Efectos de las diluciones homeopáticas altas sobre los modelos in vitro: revisión de la literatura.
Silvia Waisse. |
Efectos de las diluciones homeopáticas altas sobre las plantas: revisión de la literatura.
Marcus Zulian Teixeira, Solange M.T.P.G. Carneiro. |
Investigación clínica en Homeopatía: revisiones sistemáticas y estudios clínicos aleatorizados.
Silvia Waisse. |
Estrógeno potenciado en el tratamiento homeopático del dolor pélvico asociado a endometriosis: Un estudio aleatorizado, doble ciego, controlado con placebo, de 24 semanas.
Marcus Zulian Teixeira, Sérgio Podgaec, Edmund Chada Baracat. |
Estudio aleatorizado, doble ciego, sobre la eficacia del tratamiento homeopático en niños con amigdalitis recurrente.
Sérgio E. Furuta, Luc L. M. Weckx, Cláudia R. Figueiredo. |
¿Los medicamentos homeopáticos provocan agravación o efectos adversos dependientes de los fármacos?
Flávio Dantas. |
¿Los medicamentos homeopáticos inducen síntomas en voluntarios aparentemente sanos? Contribución brasileña al debate sobre los estudios patogénicos homeopáticos.
Flávio Dantas. |
Patient Reported Outcome Measures (PROM) evoke measurements that allow capturing patients’ perspectives on their condition. In endometriosis care, physicians’ understanding of the effect of the disease and the treatment on patients is often poor. The use of PROMs in endometriosis clinical practice can facilitate patient-provider communication and the implementation of patient-centered care, improve patients’ quality of life, as well as provide a tool for patients’ self-management of the disease. Today, PROMs are extensively used in research and clinical trials, however they are barely used in clinical practice. The development of digital tools facilitating capturing PROMs can contribute to their use by physicians in routine endometriosis care. However, all PROMs are not adapted to be used in routine care in the context of endometriosis. The objective of this study was to present a catalogue of available PROMs for routine endometriosis care and evaluate them according to selected criteria. To do so, we explored the different PROMs currently in the literature. Consequently, 48 PROM were identified as tools used to evaluate various dimensions of the impact of endometriosis on patients. The selected PROMs were evaluated for their potential to be used as a standard in clinical practice in endometriosis. The selected catalogue of PROMs is the starting point for the integration of digital tools to capture PROMs and the development of patient-centered dashboards to be used by patients and clinicians in endometriosis care and self-management to improve care processes, patient satisfaction, quality of life, and outcomes.
Objectives
The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life.
Content
A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles.
Summary
A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising.
Outlook
Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated.
Background Despite the increasing demand for complementary and integrative medicine, only a few studies have evaluated the effect of these types of treatments on the quality of life (QoL) of patients with chronic diseases. The objective of this study was to evaluate the QoL of women treated with homeopathy within the Public Health System of Belo Horizonte, Brazil.
Methods This is a prospective randomized controlled pragmatic trial. The patients were divided into two independent groups, one group underwent homeopathic treatment in the first 6-month period and the other did not receive any homeopathic treatment. In both randomized groups, patients maintained their conventional medical treatment when necessary. The World Health Organization Quality of Life abbreviated questionnaire (WHOQOL-BREF) was used for QoL analysis prior to treatment and 6 months later.
Results Randomization afforded similar baseline results in three domains of QoL analysis for both groups. After 6 months' treatment, there was a statistically significant difference between groups in the physical domain of WHOQOL-BREF: the average score improved to 63.6 ± (SD) 15.8 in the homeopathy group, compared with 53.1 ± (SD) 16.7 in the control group.
Conclusions Homeopathic treatment showed a positive impact at 6 months on the QoL of women with chronic diseases. Further studies should be performed to determine the long-term effects of homeopathic treatment on QoL and its determinant factors.
In view of homeopathy being based on scientific assumptions different from those employed by conventional medical practice, it is often the target of unfounded criticism spread by individuals who systematically deny the homeopathic principles and any scientific evidence that proves them, because they are wrapped in dogmatic negationism that prevents a correct and prejudice-free analysis. They are ‘pseudosceptics’ disguised as ‘pseudoscientists’.
To clarify physicians, researchers, health professionals and the general population, demystifying culturally entrenched dogmatic postures and the pseudosceptic fallacy that “there is no scientific evidence for homeopathy”, in 2017, the Technical Chamber of Homeopathy of the Regional Council of Medicine of the State of São Paulo (CT-Homeopathy, Cremesp) elaborated and published the “Special Dossier: Scientific Evidence for Homeopathy”, freely available in the Revista de Homeopatia (São Paulo), scientific journal of São Paulo Homeopathic Medical Association (Associação Paulista de Homeopatia, APH).
Encompassing nine narrative reviews in several lines of homeopathic research (historical-social, medical education, pharmacological, basic, clinical, patient safety and pathogenetic) and two randomized and placebo-controlled clinical trials developed by members of the CT-Homeopathy, containing hundreds of scientific articles published in numerous indexed and peer-reviewed scientific journals, this dossier highlights for the medical and scientific class, as well as for the general public, the ‘state of the art’ of the research in homeopathy.
Troubled by the excellence of this vast body of evidence, in November 2020, a group of pseudosceptics who make up the Instituto Questão de Ciência (IQC) published a derisory and fallacious manuscript entitled “Counter-dossier of Evidence on Homeopathy”, in order to evaluate the articles published in the “Special Dossier: Scientific Evidence for Homeopathy” according to “the best scientific rigor” and “inform the population about what science says about the supposed efficacy of homeopathy”.
Unfortunately, none of this occurred in the aforementioned manuscript. Unlike the advertised “better scientific rigor” in the analysis of articles, what is observed throughout the text is a set of criticisms based on known “pseudosceptic strategies” to disqualify certain scientific work: tendency to deny, rather than doubt; use of personal attacks; attempt to disqualify proponents of new ideas by pejoratively taxing them from pseudoscientists, promoters or practitioners of pathological science; conducting judgments without a thorough and conclusive investigation; insufficient or unconvincing evidence (absence of evidence); presentation of unsubstantiated or evidence-based evidence based solely on plausibility, rather than based on evidence; tendency to disqualify any and all evidence; suggestion that unconvincing evidence is sufficient to assume that a theory is false; vitrionic, slanderous or derogatory tone in the comments; non-specific and superficial comments; dissemination in mass media (non-scientific); among others.
In the current digital book (Falácias pseudocéticas e pseudocientíficas do “Contradossiê das Evidências sobre a Homeopatia” / Pseudosceptic and pseudoscientific fallacies of the “Counter-dossier of Evidence on Homeopathy”), we highlight these pseudosceptic strategies in the counter-dossier and respond to the authors’ criticisms. In view that these indications of pseudoscepticism contaminate the entire manuscript, denoting the despicable scientific quality of the same, we leave it up to each author of the dossier, cited or not in the counter-dossier, the initiative to respond or not to the authors’ criticisms.
Introduction
Chronic scrotal content pain (CSP) or chronic orchialgia can be debilitating for patients and difficult to treat. There is a paucity of structured treatment algorithms to approach this difficult condition.
Methods
A review of the literature was performed. Conservative treatment options are presented and then targeted surgical interventions that the urologist may perform are then presented in a structured algorithm format. Many of these patients may obtain a significant reduction in pain with some of these treatments.
Results
This review presents the pathophysiology, a new assessment tool, and various treatment options available for CSP patients, such as targeted spermatic cord blocks, targeted and standard microsurgical denervation of the spermatic cord (77–100% success rates), ultrasound-guided peri-spermatic cord and ilioinguinal cryoablation (59–75% success rates), scrotox (botox) (56–72% success rates), targeted ilioinguinal and iliohypogastric peripheral nerve stimulation (72% success rate), radical orchiectomy (20–75% success rate), targeted robotic-assisted intra-abdominal denervation (71% success rate) and vasectomy reversal (69–100% success rates).
Conclusion
A structured and evidence-based approach to help urologists manage patients with chronic orchialgia or scrotal content pain is presented.
Objectives
Endometriosis and quality of life has been the subject of much research, however, there is little consensus on how best to evaluate quality of life in endometriosis, resulting in many and diverse scales being used. In our study, we aim to identify quality of life scales used in endometriosis, to review their strengths and weaknesses and to establish what would define an ideal scale in the evaluation of endometriosis-related quality of life.
Materials and methods
A search of the MEDLINE and EMBASE databases was carried out for publications in English and French for the period from 1980 to February 2017, using the words ‘endometriosis’ and ‘quality of life’. Publications were selected if they reported on quality of life in patients with endometriosis and specified use of a quality of life scale. A quantitative and a qualitative analysis of each scale was performed in order to establish the strengths and weaknesses for each scale (systematic registration number: PROSPERO 2014: CRD42014014210).
Results
A total of 1538 articles publications were initially identified. After exclusion of duplicates and application of inclusion criteria, 201 studies were selected for analysis. The SF-36, a generic HRQoL measure, was found to be the most frequently used scale, followed by the EHP-30, a measure specific to endometriosis. Both perform well, when compared with other scales, with scale weaknesses offset by strengths. EHP-5 and EQ-5D also showed to be of good quality. All four were the only scales to report on MCID studied in endometriosis patients.
Conclusion
For clinical practice, routine evaluation of HRQOL in women with endometriosis is essential both for health-care providers and patients. Both SF-36 and EHP-30 perform better overall with regard to their strengths and weaknesses when compared to other scales.
Homeopathy is used by just over 2% of the U.S. population, predominantly for respiratory, otorhinolaryngology, and musculoskeletal complaints. Individual users who see a homeopathic provider for care are more likely to perceive the therapy as helpful than those who do not; however, only 19% of users in the United States see a provider. The rest presumably rely upon over-the-counter products. Recent clinical trials highlight several areas in which homeopathy may play a role in improving public health, including infectious diseases, pain management, mental health, and cancer care. This review examines recent studies in these fields, studies assessing costs associated with homeopathic care, safety, and regulations in the United States. Data suggest the potential for public health benefit from homeopathy, especially for conditions such as upper respiratory infections and fibromyalgia.
Para desmistificar a falácia ou pós-verdade de que “não existem evidências científicas em homeopatia”, disseminada indistintamente em todos os meios, a Câmara Técnica de Homeopatia do Conselho Regional de Medicina do Estado de São Paulo (CREMESP) elaborou o Dossiê Especial “Evidências Científicas em Homeopatia”, que acaba de ser disponibilizado online na Revista de Homeopatia da Associação Paulista de Homeopatia (APH).
Englobando 9 revisões (e 2 RCT) sobre diversas linhas de pesquisa existentes nos mais variados campos da ciência, as quais comportam centenas de artigos científicos publicados em periódicos distintos, esse dossiê evidencia à classe médica e científica, assim como ao público em geral, o estado da arte da pesquisa homeopática.
Apesar das dificuldades e limitações existentes para o desenvolvimento de pesquisas na área, tanto pelos aspectos metodológicos quanto pela ausência de apoio institucional e financeiro, o conjunto de estudos experimentais e clínicos citados, que fundamentam os pressupostos homeopáticos e confirmam a eficácia e a segurança da terapêutica, é prova inconteste de que “existem evidências científicas em homeopatia”, ao contrário do preconceito falsamente disseminado.
Com a elaboração e a divulgação desse dossiê, sob os auspícios da Câmara Técnica de Homeopatia do CREMESP, esperamos esclarecer e sensibilizar os colegas de profissão sobre a validade e a importância do emprego da homeopatia como prática médica adjuvante e complementar às demais especialidades, segundo princípios éticos e seguros, a fim de se ampliar o entendimento do processo de adoecimento humano e o arsenal terapêutico, incrementar o ato médico e sua resolutividade nas doenças crônicas, minimizar os efeitos adversos dos fármacos modernos e fortalecer a relação médico-paciente, dentre outros aspectos. Dessa forma, poderemos trabalhar unidos em torno da “mais elevada e única missão do médico que é tornar saudáveis as pessoas doentes, o que se chama curar” (Samuel Hahnemann, Organon da arte de curar, § 1).
In July 2017, to demystify the fallacy – or post-truth – asserting “there are no scientific evidence for homeopathy”, the Technical Chamber for Homeopathy, Regional Medical Council of the State of São Paulo (CREMESP, Brazil) published the Special Dossier “Evidências Científicas em Homeopatia”, available online in the scientific journal of the São Paulo Homeopathic Medical Association (APH), Revista de Homeopatia.
After this publication, in view of the request of homeopathic doctors and institutions from other countries, the Technical Chamber for Homeopathy, CREMESP, produced an edition of the dossier in English, “Scientific Evidence for Homeopathy”, which has just been made available online in the Revista de Homeopatia.
Encompassing 9 revisions (and 2 randomized clinical trials) on several lines of homeopathic research, containing hundreds of scientific articles published in various journals, this dossier highlights to the scientific and medical class, as well as to the general public, the state of the art of homeopathic research:
Despite the ongoing difficulties and limitations opposing the development of research in homeopathy – partly due to methodological aspects, and partly to lack of institutional and financial support – the experimental and clinical studies described in this dossier, which ground the homeopathic assumptions and confirm the efficacy and safety of this approach to therapeutics – provide unquestionable proof for the “availability of scientific evidence for homeopathy”, against the false and prejudiced opinion that is widely divulgated.
With the divulgation of the present dossier, prepared with the support of Technical Chamber for Homeopathy, CREMESP, we hope to dispel doubts and sensitize our colleagues as to the validity and relevance of homeopathy as adjuvant treatment complementary to all other medical specialties according to ethical and safe principles. Our overall goals are to broaden the understanding of human disease, increase the therapeutic resources, contribute to the definition and effectiveness of medicine in chronic diseases, minimize the adverse effects of modern drugs and strengthen the patient-doctor relationship, among other aspects. In this way, we will be able to work together, since “The physician’s high and only mission is to restore the sick to health, to cure, as it is termed (Samuel Hahnemann, Organon of medicine, § 1).
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, placebo-controlled 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) 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) 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) reduction in three EAPP modalities: dysmenorrhea (3.28; P < 0.001), non-cyclic pelvic pain (2.71; P = 0.009), and cyclic bowel pain (3.40; P < 0.001). Placebo group did not show any significant changes in EAPP global or partial scores. In addition, the potentized estrogen group showed significant improvement in three of eight SF-36 domains (bodily pain, vitality and mental health) and depression symptoms (BDI). Placebo group showed no significant improvement in this regard. These results demonstrate superiority of potentized estrogen over placebo. Few adverse events were associated with potentized estrogen. Conclusions: Potentized estrogen (12cH, 18cH and 24cH) at a dose of 3 drops twice daily for 24 weeks was significantly more effective than placebo for reducing endometriosis-associated pelvic pain. Trial registration: ClinicalTrials.gov Identifier: NCT02427386.
The homeopathic treatment is based on the principle of therapeutic similitude, employing medicines that cause certain disorders to treat similar manifestations, stimulating a reaction of the organism against its own ailments. The occurrence of this secondary reaction of the organism, opposite in nature to the primary action of the medicines, is evidenced in the study of the rebound (paradoxical) effect of several classes of modern drugs. In this work, in addition to substantiate the principle of similitude before the experimental and clinical pharmacology, we suggest a proposal to employ hundreds of conventional drugs according to homeopathic method, applying the therapeutic similitude between the adverse events of medicines and the clinical manifestations of patients. Describing existing lines of research and a specific method for the therapeutic use of the rebound effect of modern drugs (http://www.newhomeopathicmedicines.com), we hope to minimize prejudices related to the homeopathy and contribute to a broadening of the healing art.
What are the pain characteristics among women, with no prior endometriosis diagnosis, undergoing laparoscopy or laparotomy regardless of clinical indication?
Women with surgically visualized endometriosis reported the highest chronic/cyclic pain and significantly greater dyspareunia, dysmenorrhea, and dyschezia compared with women with other gynecologic pathology (including uterine fibroids, pelvic adhesions, benign ovarian cysts, neoplasms and congenital Müllerian anomalies) or a normal pelvis.
Prior research has shown that various treatments for pain associated with endometriosis can be effective, making identification of specific pain characteristics in relation to endometriosis necessary for informing disease diagnosis and management.
The study population for these analyses includes the ENDO Study (2007-2009) operative cohort: 473 women, ages 18-44 years, who underwent a diagnostic and/or therapeutic laparoscopy or laparotomy at one of 14 surgical centers located in Salt Lake City, UT or San Francisco, CA. Women with a history of surgically confirmed endometriosis were excluded.
Endometriosis was defined as surgically visualized disease; staging was based on revised American Society for Reproductive Medicine (rASRM) criteria. All women completed a computer-assisted personal interview at baseline specifying 17 types of pain (rating severity via 11-point visual analog scale) and identifying any of 35 perineal and 60 full-body front and 60 full-body back sites for which they experienced pain in the last 6 months.
There was a high prevalence (≥30%) of chronic and cyclic pelvic pain reported by the entire study cohort regardless of post-operative diagnosis. However, women with a post-operative endometriosis diagnosis, compared with women diagnosed with other gynecologic disorders or a normal pelvis, reported more cyclic pelvic pain (49.5% versus 31.0% and 33.1%, P < 0.001). Additionally, women with endometriosis compared with women with a normal pelvis experienced more chronic pain (44.2 versus 30.2%, P = 0.04). Deep pain with intercourse, cramping with periods, and pain with bowel elimination were much more likely reported in women with versus without endometriosis (all P < 0.002). A higher percentage of women diagnosed with endometriosis compared with women with a normal pelvis reported vaginal (22.6 versus 10.3%, P < 0.01), right labial (18.4 versus 8.1%, P < 0.05) and left labial pain (15.3 versus 3.7%, P < 0.01) along with pain in the right/left hypogastric and umbilical abdominopelvic regions (P < 0.05 for all). Among women with endometriosis, no clear and consistent patterns emerged regarding pain characteristics and endometriosis staging or anatomic location.
Interpretation of our findings requires caution given that we were limited in our assessment of pain characteristics by endometriosis staging and anatomic location due to the majority of women having minimal (stage I) disease (56%) and lesions in peritoneum-only location (51%). Significance tests for pain topology related to gynecologic pathology were not corrected for multiple comparisons.
Results of our research suggest that while women with endometriosis appear to have higher pelvic pain, particularly dyspareunia, dysmenorrhea, dyschezia and pain in the vaginal and abdominopelvic area than women with other gynecologic disorders or a normal pelvis, pelvic pain is commonly reported among women undergoing laparoscopy, even among women with no identified gynecologic pathology. Future research should explore causes of pelvic pain among women who seek out gynecologic care but with no apparent gynecologic pathology. Given our and other's research showing little correlation between pelvic pain and rASRM staging among women with endometriosis, further development and use of a classification system that can better predict outcomes for endometriosis patients with pelvic pain for both surgical and nonsurgical treatment is needed.
Supported by the Intramural Research Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (contracts NO1-DK-6-3428, NO1-DK-6-3427, and 10001406-02). The authors have no potential competing interests.
© The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
The homeopathic method of healing is grounded on the application of the principle of therapeutic similitude (similia similibus curentur) by using medicines that cause effects similar to the symptoms of disease in order to stimulate the reaction of the organism against its own disturbs. Such vital, homeostatic or paradoxical reaction of the organism can be scientifically explained on the basis of the rebound effect of modern drugs. This article presents the conclusion of a study aiming at a method to use modern drugs with homeopathic criteria. This claim is epistemologically justified by the fact that a definite class of adverse events described by experimental pharmacology represents actual pathogenetic symptoms of drugs. On these grounds it was possible to elaborate a homeopathic materia medica and repertory comprising 1,251 modern drugs to be employed according to the principle of similitude and the individualizing symptomatic totality. Besides supplying a basis for homeopathy as a medical rationality regarding scientific pharmacology, this study makes available a method that may broaden the scope of intervention of homeopathy in present day diseases. (www.newhomeopathicmedicines.com)
A rigorous and focused systematic review and meta-analysis of randomised controlled trials (RCTs) of individualised homeopathic treatment has not previously been undertaken. We tested the hypothesis that the outcome of an individualised homeopathic treatment approach using homeopathic medicines is distinguishable from that of placebos.
The review's methods, including literature search strategy, data extraction, assessment of risk of bias and statistical analysis, were strictly protocol-based. Judgment in seven assessment domains enabled a trial's risk of bias to be designated as low, unclear or high. A trial was judged to comprise 'reliable evidence' if its risk of bias was low or was unclear in one specified domain. 'Effect size' was reported as odds ratio (OR), with arithmetic transformation for continuous data carried out as required; OR > 1 signified an effect favouring homeopathy.
Thirty-two eligible RCTs studied 24 different medical conditions in total. Twelve trials were classed 'uncertain risk of bias', three of which displayed relatively minor uncertainty and were designated reliable evidence; 20 trials were classed 'high risk of bias'. Twenty-two trials had extractable data and were subjected to meta-analysis; OR = 1.53 (95% confidence interval (CI) 1.22 to 1.91). For the three trials with reliable evidence, sensitivity analysis revealed OR = 1.98 (95% CI 1.16 to 3.38).
Medicines prescribed in individualised homeopathy may have small, specific treatment effects. Findings are consistent with sub-group data available in a previous 'global' systematic review. The low or unclear overall quality of the evidence prompts caution in interpreting the findings. New high-quality RCT research is necessary to enable more decisive interpretation.
What is the optimal management of women with endometriosis based on the best available evidence in the literature?
Using the structured methodology of the Manual for ESHRE Guideline Development, 83 recommendations were formulated that answered the 22 key questions on optimal management of women with endometriosis.
The European Society of Human Reproduction and Embryology (ESHRE) guideline for the diagnosis and treatment of endometriosis (2005) has been a reference point for best clinical care in endometriosis for years, but this guideline was in need of updating.
This guideline was produced by a group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to January 2012 and consensus within the guideline group on all recommendations. To ensure input from women with endometriosis, a patient representative was part of the guideline development group. In addition, patient and additional clinical input was collected during the scoping and review phase of the guideline. PARTICIPANTS/MATERIALS, SETTING, METHODS: NA. MAIN RESULTS AND THE ROLE OF CHANCE: The guideline provides 83 recommendations on diagnosis of endometriosis and on the treatment of endometriosis-associated pain and infertility, on the management of women in whom the disease is found incidentally (without pain or infertility), on prevention of recurrence of disease and/or painful symptoms, on treatment of menopausal symptoms in patients with a history of endometriosis and on the possible association of endometriosis and malignancy.
We identified several areas in care of women with endometriosis for which robust evidence is lacking. These areas were addressed by formulating good practice points (GPP), based on the expert opinion of the guideline group members.
Since 32 out of the 83 recommendations for the management of women with endometriosis could not be based on high level evidence and therefore were GPP, the guideline group formulated research recommendations to guide future research with the aim of increasing the body of evidence.
The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the implementation of the guideline. The guideline group members did not receive payment. All guideline group members disclosed any relevant conflicts of interest (see Conflicts of interest). TRIAL REGISTRATION NUMBER: NA.
Supported in the Hippocratic aphorism primum non nocere, the bioethical principle of non-maleficence pray that the medical act cause the least damage or injury to the health of the patient, leaving it to the doctor to assess the risks of a particular therapy through knowledge of possible adverse events of drugs. Among these, the rebound effect represents a common side effect to numerous classes of modern drugs, may cause serious and fatal disorders in patients. This review aims to clarify the health professionals on clinical and epidemiological aspects of rebound phenomenon.
A qualitative, exploratory and bibliographic review was held in the PubMed database using the keywords 'rebound', 'withdrawal', 'paradoxical', 'acetylsalicylic acid', 'anti-inflammatory', 'bronchodilator', 'antidepressant', 'statin', 'proton pump inhibitor' and 'bisphosphonate'.
The rebound effect occurs after discontinuation of numerous classes of drugs that act contrary to the disease disorders, exacerbating them at levels above those prior to treatment. Regardless of the disease, the drug and duration of treatment, the phenomenon manifests itself in a small proportion of susceptible individuals. However, it may cause serious and fatal adverse events should be considered a public health problem in view of the enormous consumption of drugs by population.
Bringing together a growing and unquestionable body of evidence, the physician needs to have knowledge of the consequences of the rebound effect and how to minimize it, increasing safety in the management of modern drugs. On the other hand, this rebound can be used in a curative way, broadening the spectrum of the modern therapeutics.
http://ramb.elsevier.es/pt/linkresolver/efeito-rebote-dos-farmacos-modernos/90259384/
Study question:
Is there a global consensus on the management of endometriosis that considers the views of women with endometriosis?
Summary answer:
It was possible to produce an international consensus statement on the current management of endometriosis through engagement of representatives of national and international, medical and non-medical societies with an interest in endometriosis.
What is known already:
Management of endometriosis anywhere in the world has been based partially on evidence-based practices and partially on unsubstantiated therapies and approaches. Several guidelines have been developed by a number of national and international bodies, yet areas of controversy and uncertainty remain, not least due to a paucity of firm evidence.
Study design, size, duration:
A consensus meeting, in conjunction with a pre- and post-meeting process, was undertaken.
Participants/materials, setting, methods:
A consensus meeting was held on 8 September 2011, in conjunction with the 11th World Congress on Endometriosis in Montpellier, France. A rigorous pre- and post-meeting process, involving 56 representatives of 34 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement.
Main results and the role of chance:
A total of 69 consensus statements were developed. Seven statements had unanimous consensus; however, none of the statements were made without expression of a caveat about the strength of the statement or the statement itself. Only two statements failed to achieve majority consensus. The statements covered global considerations, the role of endometriosis organizations, support groups, centres or networks of expertise, the impact of endometriosis throughout a woman's life course, and a full range of treatment options for pain, infertility and other symptoms related to endometriosis.
Limitations, reasons for caution:
This consensus process differed from that of formal guideline development. A different group of international experts from those participating in this process would likely have yielded subtly different consensus statements.
Wider implications of the findings:
This is the first time that a large, global, consortium, representing 34 major stake-holding organizations from five continents, has convened to systematically evaluate the best available current evidence on the management of endometriosis, and to reach consensus. In addition to 18 international medical organizations, representatives from 16 national endometriosis organizations were involved, including lay support groups, thus generating input from women who suffer from endometriosis.
Homeopathy is based on principles and a system of knowledge different from the ones supporting the conventional biomedical model: this epistemological conflict is the underlying reason explaining why it is so difficult to accept by present-day scientific reason. To legitimize homeopathy according to the standards of the latter, research must confirm the validity of its basic assumptions: principle of therapeutic similitude, trials of medicines on healthy individuals, individualized prescriptions and use of high dilutions. Correspondingly, basic research must supply experimental data and models to substantiate these principles of homeopathy, whilst clinical trials aim at confirming the efficacy and effectiveness of homeopathy in the treatment of disease. This article discusses the epistemological model of homeopathy relating its basic assumptions with data resulting from different fields of modern experimental research and supporting its therapeutic use on the outcomes of available clinical trials. In this regard, the principle of individualization of treatment is the sine qua non condition to make therapeutic similitude operative and consequently for homeopathic treatment to exhibit clinical efficacy and effectiveness.
To compare efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena) with depot GnRH analogue (GnRH-a; gosareline acetate; Zoladex) on endometriosis-related chronic pelvic pain (CPP) in patients with severe endometriosis during 12 months.
Prospective, randomized, controlled study.
The reproductive endocrinology unit of a tertiary, research and education hospital.
Forty women with severe endometriosis (revised The American Fertility Society [AFS] classification >40) and endometriosis-related CPP and control groups were enrolled in the study.
The patients were treated with either LNG-IUS (n = 20) or GnRH-a (n = 20). The GnRH-a dose was repeated every 4 weeks for 24 weeks.
Scores of CPP were evaluated using a visual analogue scale (VAS) and total endometriosis severity profile (TESP).
The TESP score decreased in the LNG-IUS group at first, third, and sixth month follow-up visits, whereas at the 12th month follow-up visit, the TESP scores were increased to values similar to pretreatment values. Although the VAS score had no significant alteration during the follow-up period in the LNG-IUS group, the GnRH-a group showed a significant decrease in the VAS score and TESP score at the end of 1 year. The LNG-IUS treatment showed a lower patient satisfaction.
Both treatment modalities showed comparable effectiveness in the treatment of CPP-related endometriosis.
To describe clinical and epidemiological aspects of patients with pelvic endometriosis who underwent laparoscopy at our service.
Retrospective study of 892 post-laparoscopy patients with histologically confirmed diagnosis of endometriosis.
Mean age was 33.2 ± 6.3 years, and 78.7% of patients were Caucasian. We found that 76.9% of women in the sample had a higher education. Most (56.5%) patients were nulliparous, and 62.2% reported dysmenorrhea as the chief complaint. Chronic pelvic pain was the most prevalent symptom, followed by deep dyspareunia, reported by 56.8% and 54.7% of patients respectively. Infertility was reported by 39.8% of the 892 patients in the sample.
Endometriosis is most often diagnosed in the fourth decade of life. Patients with this condition present with multiple complaints, and must always undergo thorough questioning to properly guide diagnosis and monitor treatment results.
Successful surgical treatment of deep bowel endometriosis depends on obtaining detailed information about the lesions, prior to the procedure. The objective of this study was to determine the capability of transvaginal ultrasonography with bowel preparation (TVUS-BP) to predict the presence of one or more rectosigmoid nodules and the deepest bowel layer affected by the disease.
A prospective study of 194 patients with clinical and TVUS-BP suspected deep endometriosis submitted to videolaparoscopy. Image data were compared with surgical and histological results.
With respect to bowel nodule detection and presence of at least two rectosigmoid lesions, TVUS-BP had a sensitivity of 97 and 81%, specificity 100 and 99%, positive predictive value (PPV) 100 and 93% and negative predictive value (NPV) 98 and 96%, respectively. Regarding diagnosis of infiltration of the submucosal/mucosal layer, TVUS-BP had a sensitivity of 83%, specificity 94%, PPV 77%, NPV 96%.
These findings show that TVUS-BP is an adequate exam for evaluating the presence of one or more rectosigmoid nodules and the deepest layer affected in deep infiltrating bowel endometriosis, confirming the importance of this technique for defining the most appropriate surgical strategy to be implemented.
A 36-item short-form (SF-36) was constructed to survey health status in the Medical Outcomes Study. The SF-36 was designed for use in clinical practice and research, health policy evaluations, and general population surveys. The SF-36 includes one multi-item scale that assesses eight health concepts: 1) limitations in physical activities because of health problems; 2) limitations in social activities because of physical or emotional problems; 3) limitations in usual role activities because of physical health problems; 4) bodily pain; 5) general mental health (psychological distress and well-being); 6) limitations in usual role activities because of emotional problems; 7) vitality (energy and fatigue); and 8) general health perceptions. The survey was constructed for self-administration by persons 14 years of age and older, and for administration by a trained interviewer in person or by telephone. The history of the development of the SF-36, the origin of specific items, and the logic underlying their selection are summarized. The content and features of the SF-36 are compared with the 20-item Medical Outcomes Study short-form.
This summary corresponds to the translation into Spanish of the Special Communication published in the Journal of the American Medical Association in August 1996, along with the editorial published in the same issue 'How to report Randomized Controlled Trials. The Consort Statement'. It describes the Consolidated Standards for Preparation of Controlled Clinical Trials, prepared by a work group made up of members of the SORT Group and of the Asilomar Work Group, along with the director of a magazine and the author of the report on a clinical trial. The work was carried out by means of a Delphi process and the result was a check list and a process diagram. The check list is made up of 21 items that mainly refer to methods, results and discussions on the report of a controlled clinical trial, identifying the necessary information in order to be able to evaluate the internal and external value of the report, judging the improvement to be positive for the patient, the editors and the reviewers of the magazines.
Homeopathy seems scientifically implausible, but has widespread use. We aimed to assess whether the clinical effect reported in randomised controlled trials of homeopathic remedies is equivalent to that reported for placebo.
We sought studies from computerised bibliographies and contracts with researchers, institutions, manufacturers, individual collectors, homeopathic conference proceedings, and books. We included all languages. Double-blind and/or randomised placebo-controlled trials of clinical conditions were considered. Our review of 185 trials identified 119 that met the inclusion criteria. 89 had adequate data for meta-analysis, and two sets of trial were used to assess reproducibility. Two reviewers assessed study quality with two scales and extracted data for information on clinical condition, homeopathy type, dilution, "remedy", population, and outcomes.
The combined odds ratio for the 89 studies entered into the main meta-analysis was 2.45 (95% CI 2.05, 2.93) in favour of homeopathy. The odds ratio for the 26 good-quality studies was 1.66 (1.33, 2.08), and that corrected for publication bias was 1.78 (1.03, 3.10). Four studies on the effects of a single remedy on seasonal allergies had a pooled odds ratio for ocular symptoms at 4 weeks of 2.03 (1.51, 2.74). Five studies on postoperative ileus had a pooled mean effect-size-difference of -0.22 standard deviations (95% CI -0.36, -0.09) for flatus, and -0.18 SDs (-0.33, -0.03) for stool (both p < 0.05).
The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition. Further research on homeopathy is warranted provided it is rigorous and systematic.
Homeopathy is a therapeutic method based on the application of the similitude principle, utilising medicinal substances that produce effects that are similar to the symptoms being treated. In this process, the organism is stimulated to react against its own disturbances through a vital (paradoxical, secondary or homeostatic) reaction, oriented by the primary effect of the used drug. This effect should have properties that are similar to the symptom that is being treated. This secondary reaction of the organism to a medicinal stimulus is observed in hundreds of modern drugs, and is referred to as a rebound effect. In this study we propose the utilisation of modern drugs according to the principle of homeopathic cure, employing the rebound effect as a curative reaction. For that we suggest the compilation of a Common Materia Medica that would group all symptoms produced by the medications in human individuals (therapeutic, adverse and side effects), utilising them, a posteriori, following a partial or total similitude, in minimal or ponderous doses. By doing that, we can take advantage of the numerous modern pharmacological compendiums, amplifying the spectrum of homeopathic cure with a wide range of new symptoms and medications.
Little is known about the precise nature of the relationship between dysmenorrhoea (DM) and endometriosis. Our aim was to evaluate the relationship between the severity of DM in women with posterior deep infiltrating endometriosis (DIE) and indicators of the extent of their disease.
Various indicators of the extent of DIE were recorded during surgery in 209 women. The severity of their DM was assessed with a pain scale. The scale was retrospective for 155 women and prospective for 54. Correlations were sought with an ordinal logistic regression model with cumulative odds.
On univariate analysis the following variables were related to the severity of DM: number of previous surgical procedures for endometriosis; revised American Fertility society classification; extensiveness of adnexal adhesion; Douglas obliteration; size of the posterior DIE implant; extent of the sub-peritoneal infiltration by the posterior DIE (rectal, vaginal or both versus sub-peritoneal only). Current infertility was associated with less severe DM. After multiple regression analysis, presence of a rectal or vaginal infiltration by the posterior DIE and extensiveness of adnexal adhesion were the only factors that remained related to DM severity.
The concept of 'very deep infiltrating endometriosis', defined as implants invading the wall of the pelvic organ, should be tested in future classification systems specifically addressed to the prediction of endometriosis-related pain.
The objective was to develop recommendations for the diagnosis and treatment of endometriosis and its associated symptoms. A working group was convened comprised of practising gynaecologists and experts in evidence-based medicine from Europe, as well as an endometriosis self-help group representative. After reviewing existing evidence-based guidelines and systematic reviews, the expert panel met on three occasions for a day during which the guideline was developed and refined. Recommendations based solely on the clinical experience of the panel were avoided as much as possible. The entire ESHRE Special Interest Group for Endometriosis and Endometrium was given the opportunity to comment on the draft guideline, after which it was available for comment on the ESHRE website for 3 months. The working group then ratified the guideline by unanimous or near-unanimous voting; finally, it was approved by the ESHRE Executive Committee. The guideline will be updated regularly, and will be made available at http://www.endometriosis.org/guidelines.html with hyperlinks to the supporting evidence, and the relevant references and abstracts. For women presenting with symptoms suggestive of endometriosis, a definitive diagnosis of most forms of endometriosis requires visual inspection of the pelvis at laparoscopy as the 'gold standard' investigation. However, pain symptoms suggestive of the disease can be treated without a definitive diagnosis using a therapeutic trial of a hormonal drug to reduce menstrual flow. In women with laparoscopically confirmed disease, suppression of ovarian function for 6 months reduces endometriosis-associated pain; all hormonal drugs studied are equally effective although their side-effects and cost profiles differ. Ablation of endometriotic lesions reduces endometriosis-associated pain and the smallest effect is seen in patients with minimal disease; there is no evidence that also performing laparoscopic uterine nerve ablation (LUNA) is necessary. In minimal-mild endometriosis, suppression of ovarian function to improve fertility is not effective, but ablation of endometriotic lesions plus adhesiolysis is effective compared to diagnostic laparoscopy alone. There is insufficient evidence available to determine whether surgical excision of moderate-severe endometriosis enhances pregnancy rates. IVF is appropriate treatment especially if there are coexisting causes of infertility and/or other treatments have failed, but IVF pregnancy rates are lower in women with endometriosis than in those with tubal infertility. The management of severe/deeply infiltrating endometriosis is complex and referral to a centre with the necessary expertise is strongly recommended. Patient self-help groups can provide invaluable counselling, support and advice.
The relationship between chronic pelvic pain symptoms and endometriosis is unclear because painful symptoms are frequent in women without this pathology, and because asymptomatic forms of endometriosis exist. Our comprehensive review attempts to clarify the links between the characteristics of lesions and the semiology of chronic pelvic pain symptoms. Based on randomized trials against placebo, endometriosis appears to be responsible for chronic pelvic pain symptoms in more than half of confirmed cases. A causal association between severe dysmenorrhoea and endometriosis is very probable. This association is independent of the macroscopic type of the lesions or their anatomical locations and may be related to recurrent cyclic micro-bleeding in the implants. Endometriosis-related adhesions may also cause severe dysmenorrhoea. There are histological and physiopathological arguments for the responsibility of deeply infiltrating endometriosis (DIE) in severe chronic pelvic pain symptoms. DIE-related pain may be in relation with compression or infiltration of nerves in the sub-peritoneal pelvic space by the implants. The painful symptoms caused by DIE present particular characteristics, being specific to involvement of precise anatomical locations (severe deep dyspareunia, painful defecation) or organs (functional urinary tract signs, bowel signs). They can thus be described as location indicating pain. A precise semiological analysis of the chronic pelvic pain symptoms characteristics is useful for the diagnosis and therapeutic management of endometriosis in a context of pain.
When homeopathy is tested in clinical trials, understanding
and appraisal are likely to be improved if published
reports contain details of prescribing strategies and
treatments. An international Delphi panel was convened
to develop consensus guidelines for reporting homeopathic
methods and treatments. The panel agreed 28
treatment- and provider-specific items that supplement
the CONSORT (Consolidated Standards of Reporting Trials)
Statement items 2, 3, 4 and 19. The authors recommend
these for adoption by authors and journals when
reporting trials of homeopathy.
When homeopathy is tested in clinical trials, understanding and appraisal is likely to be improved if published reports contain details of prescribing strategies and treatments. An international Delphi panel was convened to develop consensus guidelines for reporting homeopathic methods and treatments. The panel agreed on 28 treatment- and provider-specific items that supplement the CONSORT (Consolidated Standards of Reporting Trials) Statement items 2, 3, 4, and 19. The authors recommend these for adoption by authors and journals when reporting trials of homeopathy.
Deeply infiltrating endometriosis affecting the retrocervical region and the rectosigmoid generally requires surgical treatment. Clinical examination, transvaginal ultrasonography (TVUS) and pelvic magnetic resonance imaging (MRI) are useful in the preoperative diagnosis of the involvement of these sites. The objective of this study was to evaluate the capacity of digital vaginal examination, TVUS and MRI to diagnose rectosigmoid and retrocervical involvement.
A total of 104 patients with clinically suspected endometriosis were submitted to clinical examination, pelvic MRI and TVUS until 3 months prior to videolaparoscopy and the findings of these methods were matched with histopathological confirmation of endometriosis.
Endometriosis was histologically confirmed in 98 of 104 (94.2%) patients. With respect to the rectosigmoid and retrocervical sites, respectively, digital vaginal examination had a sensitivity of 72 and 68%, specificity of 54 and 46%, positive predictive value (PPV) of 63 and 45%, negative predictive value (NPV) of 64 and 69% and accuracy of 63 and 55%. For TVUS, sensitivity was 98 and 95%, specificity 100 and 98%, PPV 100 and 98%, NPV 98 and 97% and accuracy 99 and 97%. MRI had a sensitivity of 83 and 76%, specificity of 98 and 68%, PPV of 98 and 61%, NPV of 85 and 81% and accuracy of 90 and 71%.
TVUS had better sensitivity, specificity, PPV, NPV and accuracy in cases of deep retrocervical and rectosigmoid endometriosis when compared with MRI and digital vaginal examination, confirming that it is an important preoperative examination for the definition of surgical strategies.
Background:
Endometriosis is a chronic inflammatory disease that causes difficult-to-treat pelvic pain. Thus being, many patients seek help in complementary and alternative medicine, including homeopathy. The effectiveness of homeopathic treatment for endometriosis is controversial due to the lack of evidences in the literature. The aim of the present randomized controlled trial is to assess the efficacy of potentized estrogen compared to placebo in the treatment of chronic pelvic pain associated with endometriosis.
Methods/design:
The present is a randomized, double-blind, placebo-controlled trial of a homeopathic medicine individualized according to program 'New Homeopathic Medicines: use of modern drugs according to the principle of similitude' (http://newhomeopathicmedicines.com). Women with endometriosis, chronic pelvic pain and a set of signs and symptoms similar to the adverse events caused by estrogen were recruited at the Endometriosis Unit of Division of Clinical Gynecology, Clinical Hospital, School of Medicine, University of São Paulo (Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP). The participants were selected based on the analysis of their medical records and the application of self-report structured questionnaires. A total of 50 women meeting the eligibility criteria will be randomly allocated to receive potentized estrogen or placebo. The primary clinical outcome measure will be severity of chronic pelvic pain. Statistical analysis will be performed on the intention-to-treat and per-protocol approaches comparing the effect of the homeopathic medicine versus placebo after 24 weeks of intervention.
Discussion:
The present study was approved by the research ethics committee of HCFMUSP and the results are expected in 2016.
Trial registration:
ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02427386.
In the first decade of the evidence-based era, which began in the mid-1990s, meta-analyses were used to scrutinize homeopathy for evidence of beneficial effects in medical conditions. In this review, meta-analyses including pooled data from placebo-controlled clinical trials of homeopathy and the aftermath in the form of debate articles were analyzed. In 1997 Klaus Linde and co-workers identified 89 clinical trials that showed an overall odds ratio of 2.45 in favor of homeopathy over placebo. There was a trend toward smaller benefit from studies of the highest quality, but the 10 trials with the highest Jadad score still showed homeopathy had a statistically significant effect. These results challenged academics to perform alternative analyses that, to demonstrate the lack of effect, relied on extensive exclusion of studies, often to the degree that conclusions were based on only 5-10% of the material, or on virtual data. The ultimate argument against homeopathy is the 'funnel plot' published by Aijing Shang's research group in 2005. However, the funnel plot is flawed when applied to a mixture of diseases, because studies with expected strong treatments effects are, for ethical reasons, powered lower than studies with expected weak or unclear treatment effects. To conclude that homeopathy lacks clinical effect, more than 90% of the available clinical trials had to be disregarded. Alternatively, flawed statistical methods had to be applied. Future meta-analyses should focus on the use of homeopathy in specific diseases or groups of diseases instead of pooling data from all clinical trials. © 2013 S. Karger GmbH, Freiburg.
Objective:
To investigate the accuracy of transvaginal sonography (TVS) and contrast-enhanced magnetic resonance-colonography (CE-MR-C) for the presurgical assessment of deep infiltrating endometriosis (DIE).
Methods:
Ninety women were enrolled prospectively for suspicion of DIE. All patients underwent TVS and CE-MR-C, with each operator blinded to the results of the other exam, before laparoscopy. The sites of DIE examined by both imaging techniques were: rectovaginal septum, pouch of Douglas, uterosacral ligaments, vesicouterine pouch, bowel, bladder and vagina. The presence of adhesions and the involvement of adnexa and of a previous abdominal scar, when there was clinical suspicion, were also evaluated. TVS and CE-MR-C findings were compared with laparoscopic and histological results.
Results:
Endometriosis was confirmed by laparoscopy in 95.6% (86/90) of cases. In 82.2% (74/90) of patients there was DIE. The global accuracy for TVS in the detection of DIE was 89.2%, sensitivity was 81.1%, specificity was 94.2%, positive predictive value was 89.6%, negative predictive value was 89.0%, the positive likelihood ratio was 13.9 and the negative likelihood ratio was 0.2. For CE-MR-C, these values were 87.2%, 71.1%, 97.1%, 93.7%, 84.6%, 24.4 and 0.3, respectively. CE-MR-C allowed diagnosis of all cases of bowel involvement; the accuracy for infiltration and stenosis was 100%. The accuracy of TVS for rectosigmoid nodules was 91.1% and that for infiltration was 88.9%.
Conclusions:
Both TVS and CE-MR-C showed satisfactory results for the presurgical assessment of DIE. TVS appears to be a powerful, simple, feasible, cost-effective tool for preoperative staging of DIE. CE-MR-C is an 'X-ray free' technique, which could be reserved for cases with deep infiltrating rectosigmoid lesions and for the prediction of stenosis and involvement of the upper part of the colon and small intestine.