91 research outputs found
Central peak position in magnetization loops of high- superconductors
Exact analytical results are obtained for the magnetization of a
superconducting thin strip with a general behavior J_c(B) of the critical
current density. We show that within the critical-state model the magnetization
as function of applied field, B_a, has an extremum located exactly at B_a=0.
This result is in excellent agreement with presented experimental data for a
YBCO thin film. After introducing granularity by patterning the film, the
central peak becomes shifted to positive fields on the descending field branch
of the loop. Our results show that a positive peak position is a definite
signature of granularity in superconductors.Comment: $ pages, 6 figure
The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials – A secondary analysis
BACKGROUND AND PURPOSE: Placebo response rates in clinical trials vary considerably and are observed frequently. For new drugs it can be difficult to prove effectiveness superior to placebo. It is unclear what contributes to improvement in the placebo groups. We wanted to clarify, what elements of clinical trials determine placebo variability. METHODS: We analysed a representative sample of 141 published long-term trials (randomized, double-blind, placebo-controlled; duration > 12 weeks) to find out what study characteristics predict placebo response rates in various diseases. Correlational and regression analyses with study characteristics and placebo response rates were carried out. RESULTS: We found a high and significant correlation between placebo and treatment response rate across diseases (r = .78; p < .001). A multiple regression model explained 79% of the variance in placebo variability (F = 59.7; p < 0.0001). Significant predictors are, among others, the duration of the study (beta = .31), the quality of the study (beta = .18), the fact whether a study is a prevention trial (beta = .44), whether dropouts have been documented (beta = -.20), or whether additional treatments have been documented (beta = -.17). Healing rates with placebo are lower in the following diagnoses; neoplasms (beta = -.21), nervous diseases (beta = -.10), substance abuse (beta = -.14). Without prevention trials the amount of variance explained is 42%. CONCLUSION: Medication response rates and placebo response rates in clinical trials are highly correlated. Trial characteristics can explain some portion of the variance in placebo healing rates in RCTs. Placebo response in trials is only partially due to methodological artefacts and only partially dependent on the diagnoses treated
European Headache Federation recommendations for placebo and nocebo terminology
Background and aim
Despite recent publications, practitioners remain unfamiliar with the current terminology related to the placebo and nocebo phenomena observed in clinical trials and practice, nor with the factors that modulate them. To cover the gap, the European Headache Federation appointed a panel of experts to clarify the terms associated with the use of placebo in clinical trials.
Methods
The working group identified relevant questions and agreed upon recommendations. Because no data were required to ans
Ocular lesions in hereditary hemorrhagic telangiectasia: genetics and clinical characteristics
Background:
The aim of our study is to study the association between eye lesions in Hereditary Hemorrhagic Telangiectasia (HHT) and other signs of the disease, as well as to characterize its genetics.
Methods:
A cross-sectional study was conducted of a cohort of 206 patients studied in the HHT Unit of Hospital de Sierrallana, a reference centre for Spanish patients with HHT. Odds ratios for several symptoms or characteristics of HHT and ocular lesions were estimated using logistic regression adjusting for age and sex.
Results:
The ocular involvement was associated with being a carrier of a mutation for the ENG gene, that is, suffering from a type 1 HHT involvement (OR = 2.09; 95% CI [1.17–3.72]). p = 0.012). In contrast, patients with ocular lesions have less frequently mutated ACVRL1/ALK1 gene (OR = 0.52; 95% CI [0.30–3.88], p = 0.022).
Conclusions:
In conclusion, half of the patients with HHT in our study have ocular involvement. These eye lesions are associated with mutations in the ENG gene and ACVRL1/ALK1 gene. Thus, the ENG gene increases the risk of ocular lesions, while being a carrier of the mutated ACVRL1/ALK1 gene decreases said risk
Interaction between expectancies and drug effects: an experimental investigation of placebo analgesia with caffeine as an active placebo
In a randomised placebo-controlled clinical trial it is assumed that psychosocial effects of the treatment, regression to the mean and spontaneous remission are identical in the drug and placebo group. Consequently, any difference between the groups can be ascribed to the pharmacological effects. Previous studies suggest that side effects of drugs can enhance expectancies of treatment effects in the drug group compared to the placebo group, and thereby increase placebo responses in the drug group compared to the
placebo group.
The hypothesis that side effects of drugs can
enhance expectancies and placebo responses was tested.
Painful laser stimuli were delivered to 20 healthy
subjects before and after administration of a drink with 0 or 4 mg/kg caffeine. The drink was administered either with information that it contained a painkiller or that it was a placebo. Laser-evoked potentials and reports of pain, expectancy, arousal and stress were measured.
Results Four milligrammes per kilogramme of caffeine reduced pain. Information that a painkiller was administered increased the analgesic effect of caffeine compared to caffeine administered with no drug information. This effect
was mediated by expectancies. Information and expectancies had no effect on pain intensity when 0 mg/kg was administered.
The analgesic effect of caffeine was increased by
information that a painkiller was administered. This was due to an interaction of the pharmacological action of the drug and expectancies. Hence, psychosocial effects accompanying a treatment can differ when an active drug is administered compared to a placebo
Abnormal increase in urinary aquaporin-2 excretion in response to hypertonic saline in essential hypertension
<p>Abstract</p> <p>Background</p> <p>Dysregulation of the expression/shuttling of the aquaporin-2 water channel (AQP2) and the epithelial sodium channel (ENaC) in renal collecting duct principal cells has been found in animal models of hypertension. We tested whether a similar dysregulation exists in essential hypertension.</p> <p>Methods</p> <p>We measured urinary excretion of AQP2 and ENaC β-subunit corrected for creatinine (u-AQP2<sub>CR</sub>, u-ENaC<sub>β-CR</sub>), prostaglandin E2 (u-PGE<sub>2</sub>) and cyclic AMP (u-cAMP), fractional sodium excretion (FE<sub>Na</sub>), free water clearance (C<sub>H2O</sub>), as well as plasma concentrations of vasopressin (AVP), renin (PRC), angiotensin II (Ang II), aldosterone (Aldo), and atrial and brain natriuretic peptide (ANP, BNP) in 21 patients with essential hypertension and 20 normotensive controls during 24-h urine collection (baseline), and after hypertonic saline infusion on a 4-day high sodium (HS) diet (300 mmol sodium/day) and a 4-day low sodium (LS) diet (30 mmol sodium/day).</p> <p>Results</p> <p>At baseline, no differences in u-AQP2<sub>CR </sub>or u-ENaC<sub>β-CR </sub>were measured between patients and controls. U-AQP2<sub>CR </sub>increased significantly more after saline in patients than controls, whereas u-ENaC<sub>β-CR </sub>increased similarly. The saline caused exaggerated natriuretic increases in patients during HS intake. Neither baseline levels of u-PGE<sub>2</sub>, u-cAMP, AVP, PRC, Ang II, Aldo, ANP, and BNP nor changes after saline could explain the abnormal u-AQP2<sub>CR </sub>response.</p> <p>Conclusions</p> <p>No differences were found in u-AQP2<sub>CR </sub>and u-ENaC<sub>β-CR </sub>between patients and controls at baseline. However, in response to saline, u-AQP2<sub>CR </sub>was abnormally increased in patients, whereas the u-ENaC<sub>β-CR </sub>response was normal. The mechanism behind the abnormal AQP2 regulation is not clarified, but it does not seem to be AVP-dependent.</p> <p>Clinicaltrial.gov identifier</p> <p><a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=00345124">NCT00345124</a>.</p
''Consensus on placebo and nocebo effects connects science with practice:'' reply to ''questioning the consensus on placebo and nocebo effects”
Health and self-regulatio
Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain
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