Articles: operative.
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Over the past decade, the mechanisms underlying placebo effects have begun to be identified. At the same time, the placebo response appears to have increased in pharmacological trials and marked placebo effects are found in neurostimulation and surgical trials, thereby posing the question whether non-pharmacological interventions should be placebo-controlled to a greater extent. In this narrative review we discuss how the knowledge of placebo mechanisms may help to improve placebo control in pharmacological and non-pharmacological trials. ⋯ Finally, we discuss how systematic investigations into placebo mechanisms across various pain conditions and types of treatment are needed in order to 'personalise' the placebo control to the specific pathophysiology and interventions, which may ultimately lead to identification of more effective treatment for pain patients. In conclusion this review shows that it is important to understand how patients' perception and expectations influence the efficacy of active and placebo treatments in order to improve the test of new treatments. Importantly, this applies not only to assessment of drug efficacy but also to non-pharmacological trials on surgeries and stimulation procedures.
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Minerva anestesiologica · Aug 2019
Comparative StudyComparison of the incidence of perioperative cardiovascular risk events among patients with and without a history of neoadjuvant chemotherapy.
Chemotherapy predisposes individuals to increased risk for future cardiac events. ⋯ Patients who underwent neoadjuvant chemotherapy prior to radical mastectomy were more prone to cardiovascular risk events than those without chemotherapy history.