Enfrentar las enfermedades crónicas

MONTREAL – Muchos de nosotros estamos aterrorizados ante la perspectiva de tener un derrame cerebral o un ataque cardíaco fatal. Pocos de nosotros, sin embargo, respondemos emocionalmente frente a la amenaza que plantean las enfermedades crónicas, un término vago y elástico que es principalmente útil para las organizaciones de servicios de salud. Y, sin embargo, la enfermedad crónica se ha convertido en un grave problema social que requiere una respuesta colectiva.

Históricamente, se denomina como enfermedad crónica a las dolencias que duran un largo período. Pero, debido a la creciente organización de la medicina en torno a enfermedades específicas, el término ha llegado a usarse para referirse a un conjunto abierto de dolencias, incluyendo enfermedades cardiovasculares, cáncer y diabetes, pero no a las enfermedades infecciosas, como ser la tuberculosis y la malaria, o a las enfermedades mentales.

En el siglo XIX, la enfermedad crónica se consideraba problemática, en parte, porque los afectados hacían uso de las escasas camas en los hospitales que cada vez se centraban más en el tratamiento de enfermedades agudas y curables. Sin embargo, las enfermedades crónicas pronto se convirtieron en un problema de salud pública más amplio, a medida que la cifra de muertos por cáncer, enfermedades cardiovasculares y diabetes parecía elevarse. En los hechos, el aumento inicial en el número de muertes por estas enfermedades, muy probablemente, reflejó una mejor identificación y diagnóstico de las mismas. El llenado de los certificados de defunción no es una ciencia exacta, y los médicos se centran en causas con las que están familiarizados.

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