Articles: disease.
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Cochrane Db Syst Rev · Nov 2023
ReviewPhosphodiesterase 5 inhibitors (PDE5i) for the treatment of Raynaud's phenomenon.
Raynaud's phenomenon is a vasodilatory phenomenon characterised by digital pallor, cyanosis, and pain of the extremities. Primary Raynaud's phenomenon has no underlying disease associated with it, while secondary Raynaud's phenomenon is associated with connective tissue disorders such as systemic sclerosis. Systemic sclerosis causes fibrosis and commonly affects the skin and internal organs such as the gastrointestinal tract, lungs, kidney, and heart. Phosphodiesterase 5 inhibitors (PDE5i) are a class of drugs that increases blood flow to the extremities and may be beneficial in the treatment of Raynaud's phenomenon. ⋯ Based on low-certainty evidence, PDE5i may reduce the frequency of attacks of Raynaud's phenomenon by a small amount per week, result in a small reduction in the duration of attack, improve patients' global assessment of their disease, and result in little to no difference in pain. PDE5i probably result in little or no difference in serious adverse events but slightly increase the likelihood of withdrawing from treatment due to an adverse event.
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Is disease demotion more important than health promotion? The question is crucial for the ethos of medicine and for priority setting in healthcare. When things get tough, where should our attention and resources go: to health or disease? This study investigates two general perspectives on health and disease to address whether there is a stronger moral appeal from people's disease than from their health. While naturalist conceptions of health and disease are mute on moral appeal, normativist conceptions give diverse answers. ⋯ Other normativist positions argue that there is an asymmetry between health and disease providing substantial support for a stronger moral appeal from disease than from health. This has a wide range of radical implications, especially within priority setting. In particular, treatment, palliation, and prevention of disease should have priority to the promotion and enhancement of health.