Pramono Laurentius Aswin
1. School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia. 2. Department of Internal Medicine, Saint Carolus Hospital, Jakarta, Indonesia.
Acta Med Indones. 2020 Apr;52(2):99-101.
The year of 2020 teaches us to prevent is always better than to cure. It is an old phrase that is being used for decades, but it is never been implemented cordially by our society nowadays. Covid-19 is a good lesson that reminds us to carefully prevent the spread of coronavirus which is now a pandemic worldwide. People now wash their hands more often and clean, wear a mask everywhere - everytime, do physical distancing, do healthy lifestyle such as physical activity, healthy diet, and consume multivitamins. They obey the cough and sneeze etiquette. Prevention awareness is never been such popular like todays.For internal medicine specialist, the role for prevention is very broad. Besides we still have a role in primary prevention, we can take our part in both secondary and (of course) tertiary prevention. Primary prevention can be defined as an action not allow a disease to occur, for examples vaccination (for internal medicine specialist more specific as adult vaccination), smoking cessation, physical activity (exercise) and healthy diet. Health promotion and prevention is the core of primary prevention. Secondary prevention aims to detect the disease as early as possible, in at risk population, such as mammography for breast cancer, swab test for Covid-19, colonoscopy for colon cancer in high risk patients. Last, tertiary prevention propose to hamper the progress of clinical disease and prevent more severe complications of the disease, for examples cardiac rehabilitation, or medications for prevent chronic kidney disease in patients with diabetes or hypertension. It is overlapping the curative or treatment strategies as it is states "to cure is to prevent". In 2020, in which each underlying conditions require effective treatment and each disease should be prevented. We are now facing the era of preventive medicine. As an internal medicine specialist, we need to put in mind a philosophy of prevention in every of our action towards patient's care and services.
2020年让我们明白预防总是胜于治疗。这是一个沿用了几十年的老说法,但如今我们的社会却从未真诚地践行过。新冠疫情是一个很好的教训,提醒我们要谨慎预防冠状病毒的传播,这种病毒目前已在全球大流行。现在人们更频繁且认真地洗手,到处都戴着口罩——随时随地,保持社交距离,采取健康的生活方式,如进行体育活动、保持健康饮食并服用多种维生素。他们遵守咳嗽和打喷嚏礼仪。预防意识从未像如今这样深入人心。对于内科专家而言,预防的作用非常广泛。除了在一级预防中仍发挥作用外,我们还可以参与二级预防(当然还有三级预防)。一级预防可定义为采取行动防止疾病发生,例如接种疫苗(对于内科专家来说更具体的是成人疫苗接种)、戒烟、体育活动(锻炼)和健康饮食。健康促进和预防是一级预防的核心。二级预防旨在尽早发现处于风险中的人群中的疾病,例如乳腺癌的乳房X光检查、新冠病毒的拭子检测、高危患者的结肠癌结肠镜检查。最后,三级预防旨在阻碍临床疾病的进展并预防该疾病更严重的并发症,例如心脏康复,或为糖尿病或高血压患者预防慢性肾病的药物治疗。它与治疗策略重叠,因为俗话说“治愈即预防”。在2020年,每种基础疾病都需要有效治疗,每种疾病都应得到预防。我们现在正面临预防医学时代。作为内科专家,在我们对患者的护理和服务的每一个行动中,都需要牢记预防的理念。