Category Archives: Uncategorized

Is Acupuncture a Placebo?

By: Barbara Gruszka

You may have seen the Grey’s Anatomy episode where Dr. Meredith Grey ruins Dr. Dereck Shepard’s Alzheimer disease trial with the placebo drugs by interfering with the randomization of the placebo and the experimental drugs.[1] These “placebo trials” are not at all a Hollywood dramatization of the real world- the placebo effect is used to test various kinds of medications and surgical operations to see how patients react psychologically to the treatment.

What is the Placebo Effect?

A placebo is an inactive treatment, much like a “sugar pill”, that does not contain any active substance or ingredient.[2] In simpler terms, a placebo is not a medication. A placebo can be administered in many forms: pill, injection, or surgical procedure.

The placebo effect, on the other hand, is the psychological belief that the “treatment” administered is working for the greater good of the patient. The subject of the treatment feels that the placebo is working, and the medical condition is resolved even upon application of an inactive, or fake, treatment. Some medical studies require a double-blind control placebo, where the patient does not know whether they are receiving an active or inactive treatment, and the doctor does not know which is administered. This way, the results are reported without any bias and the full effect of the placebo versus that of the drug being tested can be measured.

As always, there may be a negative result that can be experienced even when receiving the inactive treatment. In this case, the placebo is a nocebo, and the patient experiences negative symptoms.[3]

Acupuncture and Theoretical Placebo

Acupuncture is a traditional Chinese practice of inserting needles in specific points around the body called “acupoints”.[4] These points are believed to influence certain parts of the body through a natural flow of energy, known as chi.[5]

While there have been many studies conducted to test the effectiveness of acupuncture, there have been no real conclusive results. In fact, some studies run by Harvard professor Ted Kaptchuk have examined the placebo effect in the context of acupuncture, where retractable needles are “inserted” into the test subject and the patient is observed for any medical changes or symptoms.[6] Ironically enough, the test subjects of the placebo experiment noted negative results after the placebo acupuncture.

With this in mind, could the idea of receiving  acupuncture treatment trick the mind into believing that certain parts of the body are healing? “Tricking” the mind through acupuncture, to many a well-accepted medical practice, could deliver an effect similar to a placebo treatment and lead one to believe that he or she is healed. Researchers looking to find more about the placebo effect, like Ted Kaptchuk, look to find how the stimulation of placebo treatments affects the brain and how the brain can control our body’s mechanisms, as if to allow the brain to function as its own treatment. [7] Scientists like Kaptchuk hope to uncover the specific neural pathways and encoding that produce the placebo effect: in other words, is “feeling better” after a treatment linked with specific activity in a brain region?

[1] “Grey’s Anatomy” (April 28, 2011). ABC Episode: “It’s a Long Way Back”

[2] http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/placebo-effect

[3] http://www.smithsonianmag.com/science-nature/what-is-the-nocebo-effect-5451823/?no-ist

[4] www.evidencebasedacupuncutre.org

[5] http://www.mayoclinic.org/tests-procedures/acupuncture/basics/definition/prc-20020778

[6] http://harvardmagazine.com/2013/01/the-placebo-phenomenon

[7] http://harvardmagazine.com/2013/01/the-placebo-phenomenon

Medical Metamorphosis: Modifications to Mortal Makeup

By: Tiffany Pham

 

Replacing members and changing parts naturally seems to be a practice in maintaining robots or marionettes. However, recent medical advancements have markedly demonstrated the potential in replacing and altering not robots, but the human body. From external body parts such as eyes to the skeletal structure of the human to the intricate configuration that is DNA, no part of the body is inaccessible to medical modification.

 

Artificial Retinas

Retinal degeneration can stem from disease or simply old age. Nonetheless, its effect is life-altering. As such, scientists are developing an ample range of medical devices designed to assist in visual impairment, namely artificial retinas.

Recent studies have demonstrated the utility of optogenetics in helping to restore damaged retinas. Researchers have combined semiconductor nanorods and carbon nanotube films to create a platform for light-induced neurostimulation. A plasma polymerized acrylic acid midlayer is intermingled between the nanorods and the nanotube films, encouraging covalent bonding between the two surfaces. The final product is a thin, wireless prosthesis which can potentially act in place of a damaged retina.

In conducted studies, some patients were able to use their artificial retinas for simple tasks, such as reading large letters and seeing-slow moving cars; however, other patients experienced no benefit. There is currently a large variation in the success of artificial retinas in individual subjects, presumably due to distinct neural connections and networking in each individual’s eye.

Despite the flaws in ongoing treatment, researchers still remain optimistic, continuing to tweak current systems and experimenting in different methods in retinal stimulation. One of the key challenges is being able to provide “images” with enough clarity the brain can identify what the patient is seeing.

 

3-D Printed Bone Replacement

Year after year, birth defects, injuries, and surgeries leave thousands of people in need of replacement bones in the head or face. Traditionally, treatment involves removing bone from one part of the body, carving it to the shape needed, and transferring it to the necessary region of anatomy. However, the drawbacks of this treatment are considerable; it is difficult to carve bones accurately and the removal of bone may create trauma in that region of the body.

In an attempt to combat the shortfalls of current treatment, biomedical engineer Warren Grayson and his team of researchers look to 3-D printing. Grayson took a material already used heavily in bone scaffolding research, the polyester PCL, and mixed it with pulverized cow bone or bone mixture; Grayson hypothesized that the bone powder would contain key structural proteins and growth factors that would render the composite more effective than PCL alone. The mixture was injected into a 3-D printer, which created a precise scaffold, or frame, of the needed bone, and coated with a healthy dose of stem cells, thrombin, and beta-glycerophosphate nutritional broth, designed to improve calcium deposition onto the scaffolds. The scaffolds were then transplanted into the part of the body with damaged bone and after about three weeks, new bone has grown atop the scaffold. The composite mixture used by Dr. Grayson and his fellow scientists led to significantly more bone growth in mice models then traditional PCL scaffolds.

In future studies, scientists hope to improve the composition of scaffold material to effect stronger and faster bone formation. They also want test composite materials made with powdered human bone, as well as experiment with additives that will allow scaffold implants to better acclimatize to the body.

 

Genome Editing

While human cells possess a volume as little as 30 micrometers cubed, each cell contains the entirety of its host’s genetic code. This code is established from birth and normally will not change. However, recent medical advancements have proved otherwise.

A genome editing tool by the name of CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) was co-discovered by biologists Jennifer Doudna and Emmanuelle Charpentier. The system uses a key protein called Cas9 to lock on to certain parts of DNA and delete or edit them. Already an extremely widely-used gene-editing technique used in the laboratory to modify mammalian and bacterial genomes, some scientists are now looking further to adopt it for therapeutic purposes.While further research is needed to incorporate CRISPR into human therapeutics, the potential applications of genome editing are vast. CRISPR has already been used to correct the sickle-cell mutation in human cells grown in a petri dish.

Despite CRISPR’s current limits, the creation of the genome editing system has revolutionized pathways in modern gene therapy. As for what is planned for the progression of CRISPR, scientists have ambitions to apply CRISPR to more complex genetic diseases as well as the engineering of embryos during in vitro fertilization.

While the majority of this research has a long way to go before it is implemented outside of the lab, its applications possess great potential for the progression of the human body. Current medical studies are not only pushing the boundaries of past precedent, but provide a firm foundation for future advancement.

Measuring up a Vaccine: The Meningitis B Immune Response Study

This past November, students from Princeton University’s incoming freshman class lined up atop Icahn Laboratory’s Oval Lounge to participate in an immune response study to the meningitis B vaccine. That clinic was the second round of a large-scale public health study being conducted by Professor Nicole Basta, an infectious disease epidemiologist in the Department of Ecology and Evolutionary Biology.

After nine cases of meningitis B broke out at Princeton in 2013, University Health Services (UHS) worked with the Centers for Disease Control and Prevention (CDC) to approve an emergency vaccination campaign. Continue reading Measuring up a Vaccine: The Meningitis B Immune Response Study

Suspected Measles Case Reported On-Campus; Student Had Been Vaccinated

Preliminary testing has suggested that a University student could have a case of the measles, Princeton’s University Health Services announced in an email to the student body late Wednesday afternoon.

The email stated that 99.5% of the student body has been vaccinated against the disease. The student with the suspected case is among those who had been immunized against the measles, according to University Spokesperson Martin Mbugua. Continue reading Suspected Measles Case Reported On-Campus; Student Had Been Vaccinated

First Monthly Public Health Table

1. Care to spice up dinner time? 
2. Feeling a significant lack of casual public health discussion in your life? 
3. Want to learn about something meaningful in the comfort of Whitman’s common dining hall?
If you answered yes or were even unsure about any of those questions, then JOIN US!
Don’t overthink it and just come on over.
The Princeton Public Health Review (PPHR) is having its first monthly public health table!
Monday, December 8
6:30-8:00 PM
Whitman Common Dining Hall
**featuring**
Yi-Ching Ong, PhD from the Global Health Department
 presenting new non-profit models for pharmaceuticals and drug development for neglected diseases!

Valley Fever: The Mysterious Fungus Infecting the Southwest without a Vaccine or Cure

Valley Fever or Coccidioidomycosis, also known as cocci, is a fungal disease endemic to the soils of the Southwest. Around 60% of those exposed never have symptoms. The majority of the other 40% have flu-like symptoms. About 5 to 10% of those exposed develop serious and long-term problems with their lungs. In about 1% of those exposed, the fungus spreads throughout the entire body, infecting areas such as the brain and bones (1).

Although the first diagnosis was in 1892, Valley Fever continues to infect people without a vaccine or cure. Continue reading Valley Fever: The Mysterious Fungus Infecting the Southwest without a Vaccine or Cure