placebo

Yo pienso, que cuanto de cosas hacemos en medicina es placebo puro? No pregunto este por que yo tenga problemas con eso, pero por que yo pienso que es difficIl para separar unas cosas de otras. Por ejemplo, muchas personas en EEUU (especialmente, hijos de clase educada) necessitan antibioticos para un sinceta IRS por que sin embargo no salgan la oficina! Quizas, mas filosOficomente, algunos tratamientos son mismos, tambien. Por ejemplo, por que usamos pulsos-fetalis por cada embarazada? No hay ninguna evidencia que este es mejor para madres o bebitos. Quizas, es confortante para padres saber que hay pulsos -- pues como el placebo? (Sin embargo, es ahora necessario, por que los tribunales nos obligan eso.)
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Entonces, yo escribo eso por que yo encontre muchos casos en Guate donde el placebo fue usado. Vimos pacientes con "arthritis" que damos acetominofina (pequena dosis) -- cuando, en actualidad, los tienen acaques y dolores cuando demasiado trabaho, y el tratamiento mejor es descanso!
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Hoy, hubo uno caso unico, que causO mi sonreir. Vino paciente que tiene 53 anos; hace tres anos que ella ha tenido dolores de articulaciones, especialmente en sus rodillas, cinturas, y brassos. Ella ha venido en il semana pasada con mismos sintomas. En il semana pasada, Claudia (mira la imagen) diagnosticO ella con "arthritis" y diO pastillas de ibuprofina para ayudarle. Pero, no le ayudaron. Por eso, hoy decidimos dar o mas "fuerte." El tratamiento regular, Claudia me dijo, es inyecciones de piroxicam. Entonces, yo ella di inyecciones -- 6 mg en cada nalga y 3 mg en cada brasso. Fue increible! Esta mujer, que no puede caminar, de repente (un poco menos de 30 segundos) puede saltar arriba y bajo! Ella monstrO nos eso. Como fue magia magnifica. No piensI que piroxicam trabahe eso! :)
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I wonder, how much of what we do in medicine is pure placebo? I don't ask this because I have any problems with that, but because I think that it's difficult to separate some things from others. For example, lots of people in the US (especially the sons and daughters of the educated classes) require antibiotics for even a simple URI -- without which they would refuse to leave your office! Perhaps, more philosophically, some treatments are practically the same too. For example, why do we use a fetal heart tracing monitor for every pregnant woman? There is no evidence that is it better for mothers or babies. Perhaps, it is more comforting for the parents to know that there *is* a pulse...perhaps like a placebo? (In any case, now it is mandatory because the courts and law suits oblige us to use it).
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But I'm writing this because I've found many cases in Guate where the placebo was used. We see patients with "arthritis" whom we give acetominophen (very small doses) -- when, in reality, the have aches and pains from laboring too hard, and the better treatment is just rest and relaxation!
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Today, there was a unique case, which caused me to smile. A patient came in, aged 53 years; she had felt pain in her joints for three years, especially in her knees, hips, and arms. She had come in the week before with the same symptoms. Last week, Claudia (see the picture) diagnosed her with "arthritis" and gave her tablets of ibuprofen to help her. But...they did not help her. For that reason, we deicded to use more "force." The regular treatment, Claudia told me, is injection of Piroxicam. Then, I gave the injections -- 6 mg in each buttock, and 3 mg in each arm. It was incredible! This woman, who wasn't able to walk suddenly (in less than 30 seconds) was able to p up and down! She even showed this to us. Kind of like a magic trick. I didn't think piroxicam works like that!