By K. Fedor. Arizona State University West. 2018.

Then a definitive announcement appeared in the press: “Nationwide tests show Krebiozen to be a worthless drug in the treatment of cancer cheap sildigra 25 mg otc erectile dysfunction protocol book pdf. Recent research demonstrates that the placebo response is a complex phenomenon generic 100 mg sildigra overnight delivery medication that causes erectile dysfunction, initiated by the mind and leading to a cascade of real sildigra 100mg vasculogenic erectile dysfunction causes, measurable effects. In brief, the placebo response is the activation of the healing centers of our being in a way that produces profound physiological changes. The first is the inherent internal healing mechanism, vital force, chi, or primitive life support and repair mechanism that operates even in a person who is asleep, unconscious, or comatose. The second mechanism involves the power of the mind and emotions to intervene and affect the course of health and disease in a way that enhances or supersedes the body’s innate vital force. The placebo response seems to involve activation of the higher control center, but that is not to say that its effects are solely in the mind. He has conducted some very detailed studies trying to discover the underlying features of the placebo response. In roughly 56% of patients in clinical studies, a placebo saline injection is as effective as morphine for severe pain; furthermore, this pain relief can be completely nullified by adding naloxone, a drug that blocks the effects of morphine, to the saline. As a result of these sorts of experiments, a great deal of the credit for the placebo response has been given to endorphins, but Dr. Benedetti’s research has shown that a placebo can produce much more profound changes than simply increasing endorphin levels. For example, he has shown that a saline placebo can reduce tremors and muscle stiffness in people with Parkinson’s disease. That is not surprising, perhaps, but what is very interesting is that researchers found that at the same time that the placebo produced noticeable improvements in symptoms, there was a significant change in the measured activity of neurons in the patients’ brains as shown by a brain scan. In particular, as they administered the saline they found that individual neurons in the subthalamic nucleus (a common target for surgical attempts to relieve Parkinson’s symptoms) began to fire less often and with fewer “bursts”—a characteristic feature associated with Parkinson’s tremors. Somehow the saline placebo resulted in the processing of the information by healing centers in the brain to specifically target an effect that would reduce the dysfunction in the areas of the brain affected by Parkinson’s disease. Other studies have shown that both the placebo response and the experience of particular emotions produce demonstrable changes in brain activity visible through modern imaging techniques (e. For example, one study showed that expectation or hope is able to stimulate the part of the brain that is activated by pain medications and associated with pain relief. In addition, numerous changes in chemical mediators of pain, inflammation, and mood have also been demonstrated with the placebo response. The bottom line here is that there is tremendous evidence that the placebo response is a highly specific and targeted healing effect that is triggered by both conscious and unconscious activity in the brain. Rather than discounting and trying to avoid a placebo response, modern medicine should be more intent on developing techniques and practices designed to stimulate the same healing centers within patients as noted in these studies with placebos. In order for a drug to be approved it must show a therapeutic effect greater than that of a placebo. Because the outcome of a trial can be affected by both doctors’ and patients’ beliefs about the value of a treatment, most placebo-controlled trials are usually conducted in double-blind fashion: that is, not only are the patients unaware when they are receiving a placebo; the doctors are unaware as well. Beecher published his groundbreaking paper “The Powerful Placebo,” in which he concluded that across the 26 studies he analyzed, an average of 32% of patients responded to a placebo. The reason is that in the real world the placebo response is enhanced by both the doctor’s and the patient’s expectations. Conditions That Respond Significantly to Placebo Angina Anxiety Arthritis Asthma Behavioral problems Claudication, intermittent Common cold Cough, chronic Depression Diabetes (type 2) Drug dependence Dyspepsia Gastric ulcers Hay fever Headaches Hypertension Insomnia Labor and postpartum pain Ménière’s disease Menstrual cramps Nausea of pregnancy Pain Premenstrual syndrome Psychoneuroses Tremor The Holy Trinity of the Placebo Response Noted Harvard psychologist Herbert Benson, M. Benson believes that the placebo effect yields beneficial clinical results in 60 to 90% of diseases. He states that the placebo “has been one of medicine’s most potent assets and it should not be belittled or ridiculed. Unlike most other treatments, it is safe and inexpensive and has withstood the test of time. If the therapeutic interaction between the physician and the patient does not stimulate the patient’s hope, faith, and belief, the chances of success are measurably diminished no matter how strong or effective a medication may be. It has been repeatedly demonstrated in clinical trials designed to better understand the placebo effect that the beliefs of both the patient and the doctor, as well as their trust in each other and the process, generate a significant portion of the therapeutic results. Conventional medicine often criticizes and belittles therapies that have not been stringently tested using the double-blind, placebo-controlled trial, but in doing so it is arguing against something that is time-tested—the art of healing. The bottom line here is that patients of a compassionate, warm, and caring physician will experience better outcomes and fewer medication-related side effects than patients of an uninterested, cold, and uncaring physician. The Opposite of a Placebo The word placebo comes from the Latin term for “I will please. It describes the experience of having a side effect from an apparently inert treatment or substance. Healthy individuals have adverse effects from placebos about 25% of the time, but if patients are specifically asked about adverse effects, this figure can rise to 70%. While a nocebo response is usually used to describe an adverse reaction to a placebo, it could also be applied to describe an unusual or exaggerated response to a medication. The classic example given is the fact that in the Framingham Heart Study, women were four times more likely to die from a heart attack if they believed they were prone to heart disease, compared with women with similar risk profiles who did not have that belief. Definitions of Some Expectation Effects Behind the Placebo Response Hawthorne effect Subjects respond to knowledge of being evaluated and observed Jastrow effect Subjects respond to explicit expectations about outcome Pygmalion effect Evaluators expect therapeutic benefit, so they see it John Henry effect Control subjects attempt to emulate expected outcomes Halo effect Subjects respond to treatment novelty (i. Prayer costs nothing, has no negative side effects, and fits perfectly into any treatment plan. No matter what faith you embrace, you can use the power of prayer to lead you to better health—of body, mind, and soul.

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In this study generic sildigra 25mg free shipping erectile dysfunction 34 year old male, it was found that purchase sildigra 50 mg on-line erectile dysfunction otc meds, the aqueous extract of turmeric rhizomes produced significant decrease in blood glucose levels at 1 hr (P<0 buy sildigra 100 mg mastercard erectile dysfunction protocol discount. Similarly, the hypoglycaemic effect of aqueous extract (5g/kg) and crude powder of neem leaves (1g/kg) were also investigated on adrenaline-induced hyperglycaemic rabbit model. But the crude powder of neem leaves at maximal feasible dose of 1g/kg did not produce significant decrease in blood glucose level on adrenaline-induced hyperglycaemic rabbit model. Hypoglycaemic effect of standard drug, glibencleamide was also investigated to compare the hypoglycaemic effect of these two plant extracts with that of glibenclamide. Standard drug, glibenclamide (4mg/kg) produced significant decreased in blood glucose levels from 2hr up to 4hr (P<0. In the comparison of hypoglycaemic effects of turmeric rhizomes extracts and glibenclamide, it was found that the hypoglycaemic effect of the extracts of turmeric rhizomes were the similar to that of glibenclamide. In the comparison between hypoglycaemic effect of aqueous extract of neem leaves and glibenclamide, it was observed that the hyopglycaemic effect of aqueous extract of neem leaves was similar to that of glibenclamide. Nwe Nwe Yee; Khin Maung Maung; Khin Tar Yar Myint; Ye Hla; Zin Zin Oo; Thuzar Win; Le Le Win; Pa Pa Cho; Yin Yin Aye. This research is a “preliminary study” regarding the end product of digestion in vitro on traditional medicine. For the sake of simplicity a single medicinal plant is employed as the subject of study. It is based on the premise that different chemical agent would produce different pharmacological actions. Air dried eleven medicinal plants, were extracted either with water of 70% ethanol. These plants were also digested with intestinal digestive enzymes such as natural porcine intestinal enzymes, digestive aids enzyme pancreatin which includes protease, lipase and amylase. Digestive activities of amylase, lipase, protease and pepsin were evaluated according to the standard procedures. In vitro digestion of plant powder underwent gastric phase and intestinal phase of digestion. Ethanol and aqueous extract of crude powder, enzyme digested products and digestive enzymes were compared by thin layer chromatography. Compounds of the digested products represent major and prominent substance markers of both extracts and new substance markers were also appeared. Formation of same substance markers in enzyme digested products relative to ethanol or aqueous extract was 100% (n=6/6; n=11/11). Formation of different substance markers in enzyme digested products relative to ethanol of aqueous extract was 66. These simulated digested materials may represent the bioavailable products which can give pharmacological actions in human biological system. The bioavailable products of the particular plant resulting from this digestion tool can be used as more sensible new testable product of in vitro efficacy determination. It is concluded that this technique could serve as a test of bioavailability of traditional medicine which have undergone in vitro digestion: Beyond extraction technique. The effects of two different extracts of three medicinal plants namely Piper betle L. The extracts inhibited the contractions of guinea pig tracheal muscle induced by carbachol and histamine stimulation. The alcoholic extracts also inhibited the spontaneous movement of guinea pig ileum induced by histamine stimulation. These data suggest that the alcoholic extracts have antihistaminic and anti 5- hydroxytryptamine effects and the active principle may probably resides in the saponin glycoside component. C) (watery and 50% ethanolic extract) was studied in laboratory animals; albino rats of Wistar strain. The phytochemical analysis of watery and 50% ethanolic extract was done and results showed that both extract contained glycosides, flavonoids, steroid, polyphenol, tanninoids, saponin and reducing sugar. Acute toxicity study of both watery and ethanolic extract was done by using albino mice. The diuretic effect of watery and ethanolic extract was studied on albino rats of same sex weighing from 160-260gm. They were then put into metabolic cages after giving watery and ethanolic extract orally and urine was collected for 5 hours. Diuretic effect of both watery and ethanolic extract was carried out by using six dosage levels i. Significant diuretic effect was found in both watery and ethanolic extract of Alysicarpus vaginalis (D. The diuretic effect was found to have dose dependant effects for both watery and ethanolic extract. But the diuretic response produced by watery extract was greater than ethanolic extract for same dosage level. Urinary electrolytes content such as Na and + K in the urine of tested animals were determined by using digital flame analyzer. C) on albino rats was studied by giving watery extract 9g/kg body weight for one month period. In conclusion, a definite diuretic effect was seen with both watery and ethanolic extract of Alysicarpus vaginalis (D. The watery extract produced more powerful diuretic response than ethanolic extract of the plant. C) showed no demonstrable toxicity in both live animal and histology after autopsy.

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Alpha-tocopherol became synonymous with vitamin E for two main reasons: (1) of the eight safe 50 mg sildigra xenadrine erectile dysfunction, it is the most abundant in the human body cheap sildigra 50 mg visa 5 htp impotence, and (2) it is by far the most effective of the eight for what was originally thought of as vitamin E’s main function—to support reproduction generic 100mg sildigra free shipping erectile dysfunction and zantac. Our blood and tissue contain much more alpha-tocopherol than gamma-tocopherol despite the fact that in the typical American diet we consume twice as much gamma-tocopherol as alpha. The reason is that the liver is able to identify the alpha-tocopherol as it is absorbed from the gut and bind it to a special protein, called the alpha-tocopherol transfer protein. It recognizes the alpha- tocopherol and preferentially puts more of it in lipoproteins—proteins that carry fat and cholesterol (e. This compound and other metabolites may act to better protect the prostate from oxidative damage as well as promote apoptosis (programmed cell death), which helps prevent cells from becoming cancerous. In one study, 117 men who developed prostate cancer and 233 matched control subjects had toenail and plasma samples assayed for selenium, alpha-tocopherol, and gamma-tocopherol. For gamma-tocopherol, men with the highest levels had a fivefold reduction in the risk of developing prostate cancer compared with men with the lowest levels. The association between selenium and prostate cancer risk was in the protective direction. Statistically significant protective associations for high levels of selenium and alpha-tocopherol were observed only when gamma-tocopherol concentrations were high as well. These results indicate that in order to achieve the greatest degree of protection, natural mixed tocopherols that include both alpha- and gamma-tocopherol should be used, rather than only alpha-tocopherol. Natural forms of vitamin E are designated d-, as in d-alpha-tocopherol, while synthetic forms are dl-, as in dl-alpha-tocopherol. The prefixes d- and l- refer to two versions of the vitamin E molecule that are, in effect, mirror images of each other, the way your right hand is a mirror image of your left. Although the synthetic form has antioxidant activity, it may actually inhibit the natural form from entering cell membranes. Therefore, natural vitamin E (d-alpha-tocopherol) has greater benefit than the synthetic form (dl-alpha- tocopherol). Selenium Like vitamin E, selenium has also shown benefit in preventing prostate cancer in some studies. A 10- year cancer prevention trial found that selenium supplementation appears to significantly lower the incidence of not only prostate cancer but also lung and colon cancers in people with a history of skin cancer. The results of the study were exciting to researchers because they showed the cancer prevention potential of simply adding a nutritional supplement to a normal diet. Participants in the randomized, double-blind study took either 200 mcg of selenium per day or a placebo for four and a half years and were followed for more than six additional years. Total cancer incidence was significantly lower in the selenium group than in the placebo group (77 cases vs. While the study was planned to last 12 years, it was terminated after 7 years because no effect on the risk of prostate cancer in these relatively healthy men could be demonstrated by selenium, vitamin E, or the combination at the doses and formulations used in the study. However, our feeling is that the researchers may have been looking at the wrong form of tocopherol (see the discussion above about gamma- tocopherol). Also, other trials studying high-dose vitamin E for disease prevention have shown no benefit either. It may be that when taken at such high dosages, vitamin E loses its preventive effects. In the absence of companion antioxidants vitamin E may become a free radical itself or be unable to perform its function (see the discussion of lycopene below). The fact that selenium was ineffective in preventing prostate cancer could be due to the subjects’ having sufficient levels of selenium before the trial started. Lycopene One of the most important anticancer nutrients, especially for the prostate, is lycopene—a carotene that provides the red color in tomato products. Lycopene is one of the major carotenes in the diet of North Americans and Europeans. More than 80% of lycopene consumed in the United States is derived from tomato products, although apricots, papaya, pink grapefruit, guava, and watermelon also contribute to dietary intake. Lycopene content of tomatoes can vary significantly, depending on type of tomato and stage of ripening. In the reddest strains of tomatoes, lycopene concentration is close to 50 mg/kg, compared with only 5 mg/kg in the yellow strains. In fact, the absorption and utilization of lycopene from tomato paste or juice are up to five times greater compared with the absorption from raw tomatoes because it has been better liberated from the plant cell. Lycopene is a more potent scavenger of oxygen radicals than other major dietary carotenes, and it exerts additional anticancer effects. Lycopene’s role as a protector against prostate cancer was highlighted in a finding by Harvard researchers that of all the different types of carotenes, only lycopene was clearly linked to protection against prostate cancer. When the researchers looked at only advanced prostate cancer, the high-lycopene group had an 86% decreased risk (although this did not reach statistical significance due to the small number of cases). In a study of patients with existing prostate cancer, lycopene supplementation (15 mg per day) was shown to slow tumor growth. In subjects consuming the lycopene supplement, prostate tumors shrank and produced reduced levels of prostate-specific antigen. Researchers have also found a statistically significant association between high dietary lycopene and a lower risk of heart disease. Although lycopene supplements are available in pill form, there are excellent food sources of lycopene. For example, a 12-oz can of tomato paste contains 192 mg lycopene and costs around $1. While lycopene alone has clear benefit, it is important to point out that in a test tube study it was found that lycopene alone was not a potent inhibitor of prostate cancer cell proliferation.

Training is the activity that translates information de¿ned as needed by the plan into a coherent programme that can be imparted to responders discount 50 mg sildigra mastercard erectile dysfunction drugs without side effects. Then generic sildigra 50mg with amex erectile dysfunction causes prescription drugs, simulations represent the constructed opportunities to test the protocols and equipment speci¿ed under a plan and taught in the training phase purchase sildigra 100mg on line erectile dysfunction diabetes permanent. Moreover they provide the “experience” needed to reduce errors and that cannot be gained in a real situation due to ethical and practical aspects, as the disaster involves a multitude of victims. The main feature of a simulation is that it is used to reproduce reality in a simpli¿ed way, so that learners can better understand why things happen and how. Participatory simulations are learning games in which players play an active role in the simulation of a system or process. Ingrassia ated by a set of underlying rules that enable enquiry and experimentation [23]. Learners actively participate, analyse information, make decisions and see the outcome of their actions. Advantages in training over real operational systems include: elimination of catastrophic consequences of error; reduction of physical danger; cost containment; elimination of nonsalient attributes; “replay” possibilities; com- pression or expansion of time; and iterative manipulation of variables for evolving design and data collection [25]. The use of simulations in medical education, in general, and in disaster medicine educa- tion, in particular, is well documented [26–30]. When considering simulations, we distin- guish two different kinds: virtual and live. In the former, real people use simulated equip- ment in a simulated world (or virtual environment); in the latter, real people use simulated (or dummy) equipment in the real world. Interactive simulation systems ¿t the requirement of allowing social in- teraction, which is the key element in those scenarios where users are expected to cooper- ate in order to solve a particular problem, such as in response to disasters. Live simulations are major enterprises that demand many resources, a full staff of evaluators and control- lers, a complement of actors (victims and other event-impacted personnel) and realistic simulations of the physical damage and other consequences of the event. Participants at all levels must literally execute their tasks under the disaster plan on the operational ¿eld in real time. Unfortunately, there is no strong evidence to support ¿rm conclusions about the effec- tiveness of speci¿c training methods. The authors conclude that different types of training exercises may have differ- ent roles to play in educating hospital staff in disaster response. Gradually, this attitude changed to an empha- sis on preparedness measures, such as stockpiling of relief goods, preparedness plans and a growing role of education and training. Disasters might no longer be considered as extreme events created entirely by natural forces but as unresolved problems of development. This disaster preparedness and planning approach is the only key to improving the ef¿ciency of relief and response actions and reducing the impact of such inevitable events. Kennedy K, Aghbabian R, Gans L et al (1996) Triage: techniques and applications in decision making. In: Metz B, Davidson O, Swart R, Pan J (eds) Climate change 2001: impacts, adaptation and vulnerability. World Health Organization (1991) Psychosocial consequences of disasters – pre- vention and management. Similarities to the 1988 earth- quake in Armenia: time to teach the public life-supporting ¿rst aid? Colella V (2000) Participatory simulations: Building collaborative understand- ing through immersive dynamic modelling. Kopf S, Scheele N et al (2005) Improving activity and motivation of students with innovative teaching and learning technologies. Ragazzoni L et al (2010) The effectiveness of train- ing with an emergency department simulator on medical student performance in a simulated disaster. Chemical releases arising from techno- logical incidents, natural disasters, and conÀict and terrorism are common [1]. The In- ternational Federation of Red Cross and Red Crescent Societies has estimated that be- tween 1998 and 2007, there were nearly 3,200 technological disasters with approximately 100,000 people killed and nearly 2 million people affected. Unfortunately, the threat of ma- jor events involving chemicals is predicted to increase worldwide for three main reasons. First, the chemical industry is rapidly growing, and the number of chemicals available in the market is increasing [2]. Second, chemical incidents may have an impact beyond their original location, in some cases crossing national borders. Third, there is concern regard- ing the deliberate use of chemicals for terrorist purposes [3]. Thus, emergency involving exposure to chemicals could represent one of the most common di- sasters that occur in the community setting. To minimise these negative impacts, and be- cause chemical incidents often involve acute releases and health risks with a very dynamic time course (as a result of changing conditions, e. It might be taken into consideration that a single patient exposed to a hazardous material may overwhelm even a modern, high-volume facility [4]. Preparation begins with a thorough understanding of the threat and with the develop- ment of simple and ef¿cient countermeasures. When a chemical incident occurs, rapid and effective response is dependent on detailed prevention planning, appropriate medical treatment and subsequent postevent analysis to improve the quality of future response operations. Therefore, the term chemical incident might refer to events caused by humans, such as the explosion of a factory that stores or uses chemicals, contamination of food or water supply with a chemical, an oil spill, a leak in a storage unit during transportation or an outbreak of disease that is (likely to be) associated with chemical exposure. There is increasing awareness that natural disas- ters can trigger technological disasters and that these conjoint events may pose tremendous threats to regions, particularly those unprepared for such events. In fact, natural causes, such as volcanoes, earthquakes and forest ¿res, can cause chemical incidents. Natural disasters may disrupt chemical containment systems and cause secondary anthropogenic chemical incidents (e. The term natech disasters (natural- disaster-triggered technological disasters) refer to this type of incident [6].

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