Cardiovascular Disease Bệnh tim mạch

Endocrinology Nội tiết

Diabetes Tiểu đường
Metabolism Chuyển hóa
Gastroenterology khoa tiêu hóa
Hematology Huyết học
Infectious Disease Bệnh truyền nhiễm
Nephrology thận học
Neurology khoa thần kinh
Pulmonary Disease bệnh phổi
Rheumatology bệnh thấp khớp
Allergy Dị ứng
immunology miễn dịch học
infectious disease bệnh truyền nhiễm
Neonatology khoa sơ sinh
Neurodisability suy nhược thần kinh
Gastroenterology Khoa tiêu hóa
hepatology khoa gan
nutrition dinh dưỡng
Respiratory medicine thuốc hô hấp
First-line treatment Điều trị đầu tay
Empiric treatment điều trị theo kinh nghiệm
Evidence-based medicine Y học dựa trên bằng chứng
Clinical trial Thử nghiệm lâm sàng
Placebo effect Hiệu ứng giả dược
Diagnostic criteria tiêu chuẩn chẩn đoán
Specificity độ đặc hiệu
Sensitivity Nhạy cảm
Treatment algorithm Thuật toán điều trị
Risk factor yếu tố rủi ro
Absorption Hấp thụ
Distribution Phân bổ
Bioavailability sinh khả dụng
clearance độ thanh thải
half life Bán chu kỳ
Metabolism Sự trao đổi chất
Pharmacokinetics dược động học
Toxicokinetics độc động học
sensitivity độ nhạy
specificity độ đặc hiệu
 internal medicine nội khoa
pediatrics khoa nhi
clinical expertise chuyên môn lâm sàng
adverse effects tác dụng phụ
outpatient clinic Khoa ngoại trú
patient follow-up theo dõi bệnh nhân
be on-call Túc trực sẵn sàng
long-term condition tình trạng lâu dài
outpatient consultation tư vấn ngoại trú
clinical rotation luân phiên lâm sàng
cerebral palsy bại não
behavioral problem vấn đề hành vi
multidisciplinary team đội ngũ đa ngành

In 1996, 56 volunteers took part in a study to test a new painkiller called Trivaricaine. On each
subject, one index finger was covered in the new painkiller while the other remained
untouched. Then, both were squeezed in painful clamps. The subjects reported that the treated
finger hurt less than the untreated one. This shouldn't be surprising, except Trivaricaine wasn't
actually a painkiller, just a fake concotion with no pain-easing properties at all. What made the
students so sure this dummy drug had worked? The answer lies in the placebo effect, an
unexplained phenomenon wherein drugs, treatments, and therapies that aren't supposed to
have an effect, and are often fake, miraculously make people feel better. Doctors have used the
term placebo since the 1700s when they realized the power of fake drugs to improve people's
symptoms. These were administered when proper drugs weren't available, or if someone
imagined they were ill. In fact, the word placebo means "I shall please" in Latin, hinting at a
history of placating troubled patients. Placebos had to mimic the real treatments in order to be
convincing, so they took the form of sugar pills, water-filled injections, and even sham surgeries.
Soon, doctors realized that duping people in this way had another use: in clinical trials. By the
1950s, researchers were using placebos as a standard tool to test new treatments. To evaluate a
new drug, for instance, half the patients in a trial might receive the real pill. The other half
would get a placebo that looked the same. Since patients wouldn't know whether they'd
received the real thing or a dud, the results wouldn't be biased, researchers believed. Then, if
the new drug showed a significant benefit compared to the placebo, it was proved effective.
Nowadays, it's less common to use placebos this way because of ethical concerns. If it's possible
to compare a new drug against an older version, or another existing drug, that's preferable to
simply giving someone no treatment at all, especially if they have a serious ailment. In these
cases, placebos are often used as a control to fine-tune the trial so that the effects of the new
versus the old or alternative drug can be precisely compared. But of course, we know the
placebos exert their own influence, too. Thanks to the placebo effect, patients have experienced
relief from a range of ailments, including heart problems, asthma, and severe pain, even though
all they'd received was a fake drug or sham surgery. We're still trying to understand how. Some
believe that instead of being real, the placebo effect is merely confused with other factors, like
patients trying to please doctors by falsely reporting improvements. On the other hand,
researchers think that if a person believes a fake treatment is real, their expectations of
recovery actually do trigger physiological factors that improve their symptoms. Placebos seem
to be capable of causing measurable change in blood pressure, heart rate, and the release of
pain-reducing chemicals, like endorphins. That explains why subjects in pain studies often say
placebos ease their discomfort. Placebos may even reduce levels of stress hormones, like
adrenaline, which can slow the harmful effects of an ailment. So shouldn't we celebrate the
placebo's bizarre benefits? Not necessarily. If somebody believes a fake treatment has cured
them, they may miss out on drugs or therapies that are proven to work. Plus, the positive
effects may fade over time, and often do. Placebos also cloud clinical results, making scientists
even more motivated to discover how they wield such power over us. Despite everything we
know about the human body, there are still some strange and enduring mysteries, like the
placebo effect. So what other undiscovered marvels might we contain? It's easy to investigate
the world around us and forget that one of its most fascinating subjects lies right behind our
eyes.