Neuroscience

AAN: Oral BTK inhibitor superior to placebo in multiple sclerosis

(HealthDay)—The selective Bruton's tyrosine kinase (BTK) inhibitor evobrutinib at a dose of 75 mg once daily is associated with fewer enhancing lesions during weeks 12 through 24 among patients with relapsing multiple sclerosis, ...

Cardiology

Alteplase seems beneficial at 4.5 to 9.0 hours after stroke

(HealthDay)—The use of alteplase between 4.5 and 9.0 hours after stroke onset results in a higher number of patients with no or minor neurological deficits, according to a study published in the May 9 issue of the New England ...

Diabetes

Dapagliflozin improves glucose outcomes in type 1 diabetes

(HealthDay)—In patients with type 1 diabetes, treatment with dapagliflozin for 24 weeks improves time in range, mean glucose, and glycemic variability, according to a study published online April 9 in Diabetes Care.

Diseases, Conditions, Syndromes

No benefit seen with rituximab for chronic fatigue syndrome

(HealthDay)—In patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), B-cell depletion using several infusions of rituximab over 12 months is not associated with clinical improvement, according to a ...

Obstetrics & gynaecology

Late preterm steroid therapy found to be cost-effective

(HealthDay)—In women at high risk for late preterm delivery, antenatal treatment with betamethasone is a cost-effective strategy, according to a study published online March 11 in JAMA Pediatrics.

Other

Men are fooled by placebo more often than women

It was not until the 1990s that researchers fully began to include both genders in health research. Sara Magelssen Vambheim has contributed with valuable new insights in her study of gender differences in pain experiences.

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Placebo

A placebo is a sham medical intervention. In one common placebo procedure, a patient is given an inert sugar pill, told that it may improve his/her condition, but not told that it is in fact inert. Such an intervention may cause the patient to believe the treatment will change his/her condition; and this belief does indeed sometimes have a therapeutic effect, causing the patient's condition to improve. This phenomenon is known as the placebo effect.

Placebos are widely used in medicine, and the placebo effect is a pervasive phenomenon; in fact, it is part of the response to any active medication. However, the deceptive nature of the placebo creates tension between the Hippocratic Oath and the honesty of the doctor-patient relationship. The placebo effect points to the importance of perception and the brain's role in physical health.

Since the publication of Henry K. Beecher's The Powerful Placebo in 1955 the phenomenon has been considered to have clinically important effects. This view was notably challenged when in 2001 a systematic review of clinical trials concluded that there was no evidence of clinically important effects, except perhaps in the treatment of pain and continuous subjective outcomes. The article received a flurry of criticism, but the authors later published a Cochrane review with similar conclusions. Most studies have attributed the difference from baseline till the end of the trial to a placebo effect, but the reviewers examined studies which had both placebo and untreated groups in order to distinguish the placebo effect from the natural progression of the disease.

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