sábado, 21 de marzo de 2015

¿Es efectiva la homeopatía?

¿Es efectiva la homeopatía?
SALUD 12/03/15
Desde que fue inventada por el médico alemán Samuel Hahnemann en 1796, la homeopatía ha sido practicado alrededor del mundo. Sin embargo, no existe evidencia confiable de que el tratamiento sea efectivo. Así lo afirma el Consejo Nacional de Salud e Investigación Médica (NHMRC) de Australia, tras revisar más de 1,800 estudios al respecto.
La declaración fue emitida hoy, 11 de marzo, ante la falta de evidencia que compruebe la efectividad de la homeopatía en el tratamiento de 68 condiciones médicas, desde la tos común hasta la malaria. Únicamente se identificaron estudios describiendo su utilidad en la curación de 29 enfermedades, los cuales fueron considerados poco fiables, ya sea por contar con pocos participantes o estar mal diseñados. 
No es la primera vez que científicos intentan refutar la homeopatía; en 2002, 2010 y 2014 diferentes expertos médicos dieron a conocer su inefectividad. Al igual que sucedió en el pasado, la nueva declaración probablemente “no detendrá inmediatamente el uso de tratamientos homeopáticos”,  de acuerdo con Paul Glasziou, director del Centro para la Investigación Basada en la Evidencia de la Universidad de Bond.
La intención detrás de la declaración de la NHMRC es proporcionar a los pacientes información precisa y actualizada acerca de sus opciones de tratamiento, para que puedan tomar la mejor decisión sobre su salud. 
El Prof. Glasziou asegura que la falta de investigación científica en el campo de la medicina homeopática no es inusual, ya que se refleja en gran parte de los tratamientos alternativos. 

Fuente: http://www.muyinteresante.com.mx/salud/15/03/12/homeopatia-no-es-efectiva.html

jueves, 5 de marzo de 2015

Do NOT Touch the Insulin

Perhaps I’m biased, but it seems to me that more errors occur in the hospital in the management of diabetes than with any other disorder. Approximately 40% of hospitalized patients have diabetes. As an endocrinologist, I see a very small fraction of these patients. And yet, almost every other day, I see it mismanaged.
Patients who are on insulin at home have their basal insulin and their premeal doses held on admission, and they are put on a scale alone. This has led to the development of DKA during the patient’s admission. Or, patients who were on sulfonylureas at home, are kept on them even in the face of renal failure or poor PO intake. This leads to hypoglycemia. Or, patients are having glucose readings of 300 for days without any medication adjustment. Patients on insulin pumps are being told to remove their pumps even if they are awake and alert and perfectly capable of managing the pump in the hospital.
Even after I am consulted, my orders are either ignored by nurses or changed by other physicians. If the patient is made NPO, the basal insulin is held, sometimes with another doctor’s order, but sometimes without one. If the patient’s premeal glucose is 80, the prandial insulin is held because it is “not necessary.” And this is despite order sets and protocols that clearly state which insulins are to be held or not held and under what conditions. I don’t see staff or other physicians changing chemo orders or dialysis orders. They don’t even touch anticoagulants without checking with cardiology first. But insulin? Oh sure, that they can mess with. And this is not isolated to the hospital I am at now. This was a problem in the hospitals I worked at before. It happens in nursing homes, too.
I am currently part of a committee that is trying to improve the order sets and protocols in our hospital. This includes nursing, physician, and patient education. If more than a third of hospitalized patients have diabetes, and uncontrolled diabetes has an impact on hospital stay and on patient morbidity and mortality, it is imperative that improvements in patient care be made.

Have you had similar experiences? How have you tried to instigate change?


Melissa Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson Medical School, and a working suburban mother of two in Freehold, N.J.
- See more at: http://www.consultantlive.com/diabetes/do-not-touch-insulin?GUID=24510CEB-E6AD-4B62-B3CC-131041EACD56&XGUID=&rememberme=1&ts=05032015#sthash.zikd00t3.dpuf