Medicine and Health
Is the Placebo Effect Beneficial or Detrimental to Us?
Chances are, you are familiar with the placebo effect. The concept is that a treatment lacking active components or established medical benefits can nonetheless alleviate symptoms if the patient has faith in its effectiveness. Placebos are commonly used in clinical trials as a standard for comparison with novel drugs. However, it is worth noting that physicians occasionally give inert medications or unneeded treatments. Is this truly beneficial?
Which placebo therapies do doctors employ?
The formal utilization of placebos in medicine originated in the 18th century, despite the concept being far older.
In 2013, a study discovered that an astonishing 97 percent of UK doctors had administered a placebo medication at least once throughout their professional lives. It is crucial to analyze the various implications of a placebo in diverse situations, beyond just being an inert substance.
The poll results, as published in PLOS ONE, indicated that most respondents had utilized an “impure placebo.” These are interventions or examinations that are recognized to provide advantages, albeit not specifically for the targeted medical condition.
At the less severe end of the range, this could involve recommending a vitamin supplement without evidence of its effectiveness for the patient’s symptoms or conducting a physical examination for reassurance even when it is not clinically necessary. Prescribing an antibiotic for a suspected viral infection is not beneficial and can contribute to antibiotic resistance.
Recent research in Australia revealed that 77% of surveyed general practitioners had utilized a contaminated placebo, with the majority being antibiotics.
A “pure placebo” refers to a pill or injection that contains only inactive, non-pharmacological substances such as sugar or saline.
Both treatments attempt to provide the patient with a remedy, with the expectation that the act of taking medication or receiving an examination will improve their well-being. Occasionally, it appears to be effective.
What are the advantages of placebos?
Cardiologist Dr. Christopher Labos, in an article for the Montreal Gazette, demonstrated how individuals often utilize the placebo effect on themselves using over-the-counter cold drugs as an example.
“We all frequently fall into this pattern.” Labos contends that numerous over-the-counter cold drugs lack clinical efficacy, although people frequently use them when they are ill. When we are ill, taking action is preferable to inaction, as being inactive is usually unbearable. This is especially challenging for parents caring for an ill child.
Scientists are continuously discovering the impact of treating illnesses such as anxiety on total wellbeing, recognizing the interconnectedness of mental and physical health. Indulging in an unneeded medical procedure or consuming a placebo can potentially alleviate a patient’s worry, leading to potential improvements in their physical health.
Various research across several medical fields has identified a beneficial impact of the placebo effect on various ailments, such as utilizing colored overlays to enhance reading and treating Parkinson’s disease.
Can you agree to get a placebo?
In Western medicine, a fundamental principle is the concept of informed consent. Patients should have access to comprehensive information regarding a medical intervention, including its risks and benefits, prior to deciding whether to undergo the therapy.
At first glance, it is difficult to understand how administering a treatment that the doctor is aware is not effective aligns with this ethical paradigm. Nevertheless, an intriguing aspect of the placebo effect is that it remains effective even when patients are aware that they are receiving a placebo. Deception is unnecessary, and the patient is still capable of providing informed consent.
In 2017, a tiny study showed that participants who received a sham topical anesthetic before a heating plate was put on their skin exhibited a similar effect. Participants were divided into three groups: one group was informed that the cream was an anesthetic, although it was not; another group was told it was a placebo, and the placebo effect was explained to them; and the third group received the placebo without any explanation.
The participants who believed they were receiving an anesthetic saw a reduction in discomfort, as anticipated. Similarly, this was likewise the case for the group that fully comprehended they were receiving a placebo. The lead author of the study stated that openly giving a placebo presents new opportunities for utilizing the placebo effect in a morally acceptable manner.
An American Medical Association (AMA) Code of Medical Ethics Opinion emphasizes the importance of patients being informed about and giving consent to the use of placebos in medical practice. The document also specifies that placebos should not be used only to appease a challenging patient.
Physicians may use placebos if they genuinely believe they will benefit the patient, but not for their own convenience or in a way that undermines patient confidence.
“Primum non nocere?”
Placebos, such as sugar pills, are unlikely to have any harmful effects on a patient. However, impure placebos do not have the same effect. When considering a medical intervention, it is important to evaluate the risks in comparison to the potential benefits.
We have already discussed this in relation to antibiotic resistance, but there are several additional instances where similar questions arise. A case report in 2022 detailed a man who was hospitalized for excessive vitamin D intake, highlighting the potential risks even in seemingly harmless vitamin tablets. Additionally, several herbal supplements have been associated with liver damage.
Some doctors may prescribe needless tests to reassure their patients, but procedures like X-rays, although generally deemed safe, should not be done excessively. Even the most basic blood tests have a slight risk of bruising, clotting, and infection.
Labos emphasized that placebos are not inherently harmless, arguing against their use. He further noted that, while they may not cause bodily harm, consuming excessive, needless drugs might put a financial burden on patients.
Some clinicians are reluctant to incorporate placebos into their therapeutic practice.
Some patients may believe that any treatment leading to improvement is beneficial; however, the placebo effect is both uncertain and not lasting. Dr. David Eidelberg, head of the Center for Neurosciences at the Feinstein Institute for Medical Research, stated in an interview with the Michael J. Fox Foundation that it is not a feasible therapeutic technique.
“The notion of utilizing placebos as a universal remedy for various health conditions is highly problematic.” Dr. Chris Maher from the University of Sydney School of Public Health expressed that it is detrimental to science and patients.
Maher authored a perspective in the Medical Journal of Australia criticizing the weak data supporting the widespread clinical use of placebos. “It might be more effective to disregard placebos and focus on treating patients with evidence-based therapies.”
The credibility of the placebo effect’s evidence has been questioned before. Despite facing criticism, it is evident that numerous physicians have utilized placebos in specific situations.
Determining whether medical interventions are intrinsically beneficial or evil is a challenging subject to answer. A medicine that effectively treats one person’s illness may have lethal effects on another individual if taken differently. Physicians must consider each patient’s distinct, distinctive circumstances when suggesting a treatment plan. Many individuals consider a placebo to be a viable choice.
Before publication, fact-checkers ensure that all “explainer” articles are accurate. Content, images, and hyperlinks can be modified, deleted, or included in the future to ensure the material is up-to-date.
This material does not serve as a replacement for professional medical advice, diagnosis, or treatment. Always consult qualified health professionals for any inquiries on medical conditions.
Medicine and Health
A recently identified strain of deadly fungus poses a significant risk to public health
Researchers have recently discovered a new group of Candida auris, a potentially dangerous pathogen. The finding increases the total number of identified clades of the fungus, which is a newly emerging superbug resistant to multiple drugs, to six.
Candida auris is a strain of yeast that has the potential to cause serious illness and is frequently impervious to antifungal drugs. While individuals who are in good health generally do not fall ill, the transmission of the disease is highly prevalent within medical institutions and poses a significant risk to individuals with compromised immune systems. The yeast can induce a variety of conditions ranging from superficial infections of the skin to more severe and life-threatening illnesses, such as bloodstream infections. Due to its high level of resistance to multiple drugs, treating it can be challenging, and in some cases, even impossible.
The authors state that the pathogen is a significant global public health threat due to its widespread distribution, resistance to multiple drugs, high ability to spread, tendency to cause outbreaks, and high mortality rate. Although infections are still relatively uncommon, there has been a significant increase in cases in recent years.
Previously, the fungus had been categorized into five distinct clades, each located in different geographic regions: South Asia, East Asia, Africa, South America, and Iran.
In April 2023, doctors from the Singapore General Hospital identified a patient carrying a unique strain of C. auris as part of a routine screening program, adding it as the most recent clade to be discovered. Typically, these cases arise from individuals who have recently traveled, but this particular patient had not traveled outside the country for a period of two years, which raised some concerns.
Upon conducting a genetic analysis of the strain, the researchers determined that it did not align with any of the five known clades of the fungus. Therefore, it can be concluded that the strain belongs to a previously unidentified, sixth clade. Subsequently, they conducted tests on strains obtained from previous patients and identified two additional isolates of this particular group of C. auris in Singapore, as well as another isolate in Bangladesh.
The extent of the new clade’s prevalence and its potential to cause invasive infections and outbreaks remains uncertain at present. However, the researchers emphasize the importance of promptly identifying and controlling it in order to safeguard patient well-being.
“The ramifications of this breakthrough transcend the confines of the laboratory.” “Given the recent discovery of the sixth Candida auris clade, it is imperative to enhance surveillance capability or create new methods to strengthen existing surveillance strategies. This will enable health care facilities to closely monitor its emergence and effectively control its spread,” stated Dr. Karrie Ko, co-first author of the study.
Fortunately, the cases described in the study remained vulnerable to all antifungals that were tested. This should alleviate concerns about a pandemic similar to the one depicted in The Last Of Us. However, it is evident that the threat of C. auris is persistent. Therefore, additional efforts are required to identify new strains, monitor their spread, and control any negative clinical consequences.
The research is published in The Lancet Microbe journal.
Medicine and Health
What makes your chest hurt when something makes you jump?
Have you ever been scared so badly that you grabbed your chest? You feel like someone or something just zapped you behind the sternum. As you rest, you lean against the wall and think about why your friend is such a jerk and why you can feel it in your chest whenever you get scared.
People often use words like “heart-stopping” when they write fiction about fear, but the science of fear tells us that this isn’t what’s happening because it wouldn’t make sense. Our bodies are getting ready to deal with an impending threat when we’re scared, and going into cardiac arrest wouldn’t help us get very far if a lion was after us.
What do we do when we’re scared?
The sympathetic nervous system is what gets you excited when something makes you jump. It’s a tool inside our bodies that releases hormones and changes the way our bodies work to get us ready for the fight-or-flight response.
One important part is adrenaline, which is also known as epinephrine. The adrenal glands squeeze it out into the blood. The heart starts beating faster, sending more blood to your muscles and organs right away. Because they need all the oxygen they can get if they want to get away from a dangerous animal.
How do you feel when you go for a run?
Anyone who has ever used an EpiPen knows how bad it is to feel a sudden rush of adrenaline. It’s a stress hormone that makes you feel nervous and anxious, like you would before doing a bungee jump. Getting a rush when you think about a traumatic event from the past can be a sign of PTSD.
A medicine called adrenaline is used because it can help people who are having a medical emergency. If you have anaphylaxis from an allergen like peanuts, this can help because it can open your airway. Because it changes the strength and speed of heartbeats, it is also sometimes used to help people who are having a cardiac arrest.
When your adrenaline level goes up quickly, you may feel shaky, your heart beat quickly, and your chest get tight. When you add in the fact that you’re more alert, you become very aware of the changes in your body. This is especially clear when you’re not in danger, like when your partner surprised you at home when you thought you were alone.
When you’re scared, your sympathetic nervous system usually kicks in, which is normal. But, some heart conditions can get worse when you’re scared. Should anyone be having chest pain or ongoing discomfort, they should see a doctor. In the end, it is possible to be so scared that you die.
This article is not meant to be a replacement for medical advice, diagnosis, or treatment from a trained professional. If you have questions about a medical condition, you should always talk to a qualified health professional.
Medicine and Health
The Lacks family is suing again over her “stolen” cells
The family of Henrietta Lacks has filed a new lawsuit against two sizable drug companies for using her genetic material without her consent.
In the US District Court for the District of Maryland, Lacks’ living relatives are suing Novartis Pharmaceuticals Corporation, Novartis Gene Therapies, Inc., Viatris, Inc., and its subsidiary, Mylan Pharmaceuticals. They say the companies have used the “stolen” HeLa cell line to make hundreds of patents and have made a lot of money from it.
The suit wants the money made from using these cells to be “rightfully transferred” to Henrietta Lacks’s estate.
Novartis and Viatris chose to sell Henrietta Lacks’ living genetic material. Lacks was a black grandmother, community leader, and woman whose doctors took her tissue without her knowledge or permission, according to Chris Ayers, an attorney at Seeger Weiss LLP who is representing the Lacks family.
Ayers added, “We will keep looking for justice for Mrs. Lacks and her family.”
Henrietta Lacks died on October 4, 1951, from cervical cancer. She was 31 years old. Some of her cells are still alive today. A doctor at Johns Hopkins Hospital took a sample of her cervical cells without her knowledge just before she died. They were doing a cancer check. It was seen that her cells kept multiplying quickly, even after most of the cells in other samples would have died without their host.
Because scientists saw the potential, they found that these cells could be a cheap and easy way to help researchers do more research. The “HeLa immortal cell line” is what scientists call these cells, and they are very useful for biomedical research.
Over 75,000 scientific studies around the world have used these cells, which amount to about 55 million tons. They have been very important in making progress in areas like polio vaccines, cancer treatments, HIV/AIDS treatments, and much more.
All of this was done, though, without Lacks’ knowledge or permission. For many years, her family also didn’t know that the cells were being used for business.
Selling HeLa cells for money brings up important issues in medical ethics and genetics. As a black woman living in America in the 1950s, Lacks’ case shows how medical racism still affects minorities who aren’t getting enough help.
Even though a lot of people know about these problems, HeLa cells are still used in medical research for profit, which makes some companies a lot of money.
“Now that everyone knows Henrietta Lacks’ story, it’s shocking, but not surprising, that drug companies like Novartis and Viatris are still making money off of the deeply unethical origins of HeLa cells and the disturbing history of medical racism,” said Chris Seeger, another lawyer for the family.
A historic deal was made by Lacks’ family in 2023 after they sued Thermo Fisher Scientific, Inc., another biotech company, in the US District Court for the District of Baltimore. During that time, the lawyers said that the settlement was only the beginning and that there could be many more lawsuits about the use of HeLa cells.
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