1.
The Powerful Placebo Effect in Cough: Relevance to Treatment and Clinical Trials.
Eccles, R
Lung. 2020;(1):13-21
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Abstract
Interest in the placebo effect of medicines has developed from the use of placebo treatments as controls in clinical trials into a whole new area of research around how placebos fit into a psychosocial model of therapeutics. The large placebo effect associated with cough medicines is both a problem and an opportunity for researchers: a problem for clinical trials on new actives as the active must beat the large placebo effect, and an opportunity for harnessing the placebo effect to produce effective cough medicines without any pharmacologically active ingredient. This review discusses the mechanisms associated with the placebo effect of cough medicines and distinguishes between a 'perceived placebo effect' and a true 'placebo effect'. The efficacy of sweeteners in cough syrups is discussed as well as viscosity, mucoadhesion, and flavoring. The complexity of modern cough medicines is demonstrated by an example of a medicine which contains one active ingredient, and eighteen excipients which provide a complex and intense sensory experience to enhance the placebo effect and complement the pharmacological activity of the medicine.
2.
The nasogastric tube is stuck - and causes coughing and dyspnoea: A rare complication.
Walldorf, J, Michl, P, Krug, S
Intensive & critical care nursing. 2020;:102786
Abstract
For critically ill patients, it is very important that enteral nutrition is established as early as possible. Nasogastric tubes are commonly used for transient enteral nutrition and are generally considered safe to use and handle. However, in unconscious patients special care is needed to detect - possibly life threatening - complications. Here we report the case of a nasogastric tube, which inadvertently looped around the epiglottis. The symptoms and treatment of this rare complication are described and possible measures to prevent this situation are discussed.