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QUESTION OF THE MONTH |
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December 2000. |
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Some diseases may express a compensated or a decompensated stage resulting from natural homeostatic reactions or due to adequate prophylactic or therapeutic interventions. Typical examples are cardiac problems, diabetic conditions, some infectious diseases, immunologic processes, etc. |
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The transit from compensation to decompensation implies a worsening of the basic condition, but it also rises the possibility of a reverse movement, from decompensation to compensation, meaning that some pathological changes may be partially or even completely reversible. |
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These concepts are essential for therapeutic decisions and for the correct understanding of potentially paradoxical physiopathological data. The immediate goal of a wise medical intervention could only be to achieve a reasonable compensated and stable stage, where more direct and complete therapeutic measures could be taken. Once this stable compensated stage is reached, the issue of reversibility should be addressed. How truly reversible is the whole situation or is it just a therapeutic illusion? |
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Hence, when facing a pre-eclamptic syndrome of a given severity the questions; is it compensated or not?, how stable this compensation seems to be?, how reversible and for how long?, is it compensated and reversible in all affected territories or only in some?, how can we assert and monitor such compensation and reversibility?, should be answered in order to design the most rational therapeutic program, that includes of course, the timing and route of delivery. |
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Are these concepts really fundamental or just academic exercises? |
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