Placebos in Medicine - Placebo Effect in Surgery for Ménière's Disease
1. What was the rationale for doing the study?
Torok, an author to another study regarding Ménière's Disease, reviewed 834 articles pertaining to Ménière's Disease between 1951 and 1975. He found that advocates of either medical or surgical treatments claimed success in 60% to 80% of patients. Because there are so many different therapies deemed successful, Torok believed that the placebo effect might be a common factor to all of those treatments.
The goal of any treatment of Ménière's Disease is alleviation of vertiginous attacks as well as removing the fear of getting these attacks. Because the basic cause of this disease is basically unknown, there is no proof that medical, physical, or surgical treatment has the most symptomatic effect over the other. The authors of this study are attempting to prove that the placebo effect is a common factor in treatments for Ménière's Disease, specifically surgery.
2. Briefly, explain the design of the study.
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One group was to receive the active surgery which was an endolymphatic sac shunt operation (Silastic sheet mastoid shunt), while the other group receives the placebo surgery which was a regular mastoidectomy, but neither group was to know which operation they are receiving. All patients were asked to score their dizziness, nausea; vomiting, vertigo, tinnitus, hearing impairment, and pressure in the ears on a scale 3 months preoperational and 12 months post operational. After the 12 months, post op was finished the patients were asked to rate the value of their operation/surgery on a scale of good, reasonable or
The Chupacabra a legendary monster, originating in Puerto Rico South America in themid 1990’s, but lately has came to the United States to start an infamous track record. TheSouthwest of the United States is the Chupacabra’s hunting grounds including Texas, NewMexico, and Arizona. The Chupacabra attacks and sucks the blood of animals. Chupacabra istwo Spanish words together to create a spine shivering name fit for this vampiric monster, chupar“to suck” and cabra “goat”. Legend and science have contributed to the creation of thismonstrosity, evidence is the key to knowing the truth about the famed and mythical Chupacabra.Eyewitness reports of the Chupacabra in South America described as a three foot tallmonster, covered with grey hair with spikes
Imagine going to the doctor and being given medication to heal your pain. Now how would you feel if after taking the medication and feeling better you came to find out you were given a placebo? This may sound upsetting to some, however, “ a recent survey of U.S. internists and rheumatologists found that some 50% regular prescribe placebos.” A placebo is defined as a false treatment without any significant chemical properties or active ingredient. The use of placebos as a primary form of treatment with any pathology is not happening anytime soon, but their positive impact and usefulness in the medical field is becoming hard to deny. In the article, “The Magic of the Placebo”, author David Bjerklie attempts to explain the growing change in
The tympanic membranes play an important role on the hearing process on the patient. In addition TM protects the middle ear against some infections, water, and other bacterial or foreign objects or substances entering to the ear. Some lesions on the conducting system have some negative consequences on the conductive hearing mechanism of the patient, and as result patient can loss hearing.
The mind has often been referred to as the organ of consciousness. Daily functions such as thinking, breathing, and most any task we do rely heavily on use of this precious organ. However, through the use of placebos, it is becoming clear that the mind may have an even greater influence on our daily lives, influencing our perceptions of well- being. The placebo, which is Latin for to please, is a sugar-pill that is given under the guise of being a medication thought to treat an ailment. The use of placebos has shown us that the mind has tremendous potential to induce physiological changes in our body based solely on its perceptions. In example, as we swallow a sugar pill thinking
Medical professionals all over the world have paved the road for further research and technological advances in the hearing impaired spectrum. Implantations, such as the cochlear implant (CI), have given patients with profound sensorineural hearing loss newfound hope for habilitation and rehabilitation services. However, “there exists a small subset of deaf individuals who will not benefit from the CI due to (1) a small or absent cochlea, (2) a small or absent auditory nerve, or (3) injury or scarring of the inner ear or auditory nerve secondary to meningitis, trauma, or tumor” as stated by Kaplan et al. (2015). A treatment option for those who did not meet the candidacy qualifications for a cochlear implant needed to be implemented.
In re-examining my role as a clinician, I now have a better understanding on how to break down the information regarding CIs to better educate my patients regarding treatment options for hearing loss. Consequently, some multidisciplinary medical professionals fail in their duty to deliver appropriate recommendations and allow a bad practice to go unchallenged. To conclude, this opportunity to observe a CI surgery was a wonderful experience and the knowledge I obtained from this surgery will aid in my development as a future
Placebo effect research has shown a varying in strength depending on the personal traits and characteristics of the patient. Research findings of personality differences seem to be non-systemic and conflicting in terms of placebo effect. This article focuses on new theoretical approaches to the phenomenon of the placebo effect. The authors of this report suggest that cognitive structuring moderates the placebo effect to a certain extent and is influenced by the amount of cognitive closure the individual needs and if there is an ability to achieve this. In order to test their assumptions, the researchers informed participants that they would be given a medicine that would improve their mood and their sense of wellbeing After the study they found that the results did in fact
Cochlear Implantation is not as new of an idea as society may think. Interest in stimulating hearing in deaf individuals can be traced back as far as the 18th century. Since then many scientists, doctors and even audiologists from all areas of the world have worked to develop sophisticated high-tech implant systems. Which has resulted in varying viewpoints between the Deaf and Hearing Communities.
A placebo substance is an inert substance that should not directly cause any positive or negative changes in our health. These pills have no medicine in them and the patient gets well. To understand the placebo affect you need to understand the power of the brain. More than half of the population appears to have a positive experience from the placebo effect. Why doesn’t the rest of the population respond in the same way? The human brain is capable of preventing even the best well thought-out drug, medical procedure, therapy or nutritional program from working. Then why do we need supplements of medicine to feel better or reverse disease? Most diseases are related to nutrient deficiencies, chemicals, parasite or metal toxicity.
Tinnitus can be separated into two categories, subjective tinnitus shows no objective sound and is only heard by the patient, Objective tinnitus is the less common type which can often be heard by an observer by stethoscope as it is caused by conductions such as turbulence and pulsation of muscle spasms in body tissues such as middle ear, Eustachian tube or soft palate. Currently, there is no FDA or EMA approved drugs on the market for this specific purpose. (Langguth and Elgoyhen, 2012) Many studies have been carried out to find a successful pharmacological treatment for tinnitus but had critical flaws in their design and methods; Some fail to adopt the correct analytical method to measure their outcomes which affect their external validity, four studies have been chosen each addressing different treatments using single or combination of drugs for analysis in their methodology and experimental design .
Placebos have been used throughout many studies when testing experimental drugs for certain medical conditions. A placebo is a form of treatment that, in a sense, has nothing in it. Patients in clinical drug trials are often enrolled in the trial because many other treatment options have been tried and have failed. For terminal patients these trials are often their last hope of recovering from their diseases. According to Millum et al. (2013), “To be ethical, clinical research requires balancing rigorous science with the protection of human subjects”. It is common for placebos to only be effective in pain- related cases since pain is a mental state and placebos work on the mind. In other cases, patients are administered a placebo when the real medication is unavailable and deceived into thinking they have a chance at getting better. Many nursing professionals do not agree with placebos since often they are the ones administering and interacting with the patients they hope to help. Placebos are only justified in pain related trials, unethical to be used on terminally ill patients, and can potentially cause negative health effects.
The article “One Hundred Years of Solitude, Indigenous Myth, and Meaning” by Jay Corwin argues that the key elements of the story are the parallels with Colombian mythologies and not the Old Testament, which has been mostly exclusively Western (Corwin 112). Jay Corwin states “Disambiguation of the novel 's re-creation of authentic Colombian mythologies and rituals may lead to a clearer understanding of the novel 's themes and ultimately its meanings, thus clarifying its implicit criticism of the rejection of identity” (Corwin 112). To understand the novel, Corwin does an effective job on explaining the parallels with Colombian myths, so that the readers could understand the criticism of One Hundred Years of Solitude.
The first option is a conservative approach, meaning that otosclerosis doesn’t have to be treated. It is usually advised to have a usual hearing test annually to see if hearing worsens. The second option is hearing aids that are usually effective for conductive hearing loss. The third option is a medical treatment that consists of taking sodium fluoride, which is a dietary supplement. This treatment is not widely accepted, but has been proven affected. Also for conductive hearing loss a procedure of stapedectomy is an option. This is a surgery where the stapes are removed and replaced with a prosthetic device. This procedure may allow avoidance of hearing aids and improves tinnitus. However, is doesn’t help the sensory component of hearing loss and at best close the air bone gap. The fourth option is cochlear implants that is used best with patient preoperative with hearing level. This can be performed as initial treatment and followed by a stapedectomy with good
The mystical experience parallels a romantic experience, but rather than a partnership between two lovers, one’s soul develops a partnership with God. Evelyn Underhill, a nineteenth century mystic and author of The Mystics of the Church, defines the mystical experience as having a direct interaction with God and producing a consequential pursuit for a union with Him. To achieve this “spiritual marriage” #, Underhill identifies five stages: awakening, purgation, illumination, the dark night of the soul, and union. It begins with a consciousness of a divine reality. Following that is the purgation, which intends to purify or change oneself to align with the transcendental order. Consequently, developing attachments to others from purgation causes an illumination within the individual, centering cognitive procedures and worldly understanding around the partner, or God. Next, the idea of the dark night of the soul
Poor and/or inconclusive science: Many studies are being conducted and articles are also published in major medical journals every month regarding the evidence in order to provide patients with best available treatments, but none of them provide with useful and valuable clinical data, instead it gives misleading or wrong information which raises problems due to improper study design selection during research. Randomized, double-blind, placebo-controlled studies are considered as the “gold standard” of evidence for determining the cause and effect, whereas observational or epidemiologic studies, case series and reports provide the natural history of design. Although some of the well implemented studies may provide the conclusion only from one side of