Therapie
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Letter Case Reports
[Accidental intrathecal vindesine administration: a report of two cases].
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The objective of our survey is to value the availability of the antidotes in the main Moroccan hospitals. ⋯ The found results are troubling and often unveil sometimes a big problem of management of these products vital and constituent the unique treatment.
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Review Comparative Study
Public-private partnership models in France and in Europe.
The workshop entitled "Public-Private partnerships models in Europe-- comparison between France and European countries" brought together representatives of academia and industry, of national or European health research programs, of regional or national public-private partnership (PPP) initiatives, and of biotechnology with the following objectives: sharing a common vision on the needs, expectations and challenges of public-private partnership, based on the analysis of actual and original cases, and of new initiatives on public-private partnership, drawing conclusions and identifying key success factors, identifying trails for progress and drawing recommendations. The major event in this field is a European public-private partnership initiative between pharmaceutical industry (European Federation of Pharmaceultical Industry and Associations, EFPIA) and the European Commission (DG Research--health priority) resulting in the European Technology Platform project "Innovative Medicines Initiative" (IMI). Its architecture is based on the identification of the main bottlenecks to the development of innovative treatments (predictive pharmacology and toxicology, identification and validation of biomarkers, patients' recruitment, risk evaluation, and cooperation with the regulatory authorities). ⋯ Improvement may also result from adaptation in the carreer, recruitment and mobility, from support to scientists in the management of projects, and from consistent support (without maintaining them artificially alive) to emerging companies from concept through clinical development. Pathways have been proposed to improve the efficiency of clinical research in France and Europe, involving the public hospital sector, and this requires the connection of disease-oriented networks and integrated infrastructures in Europe. As stated in the IMI strategic research agenda on efficacy, the quality of public infrastructures in Europe will be a key factor for its competitiveness and attractiveness for both academic and industry projects.
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The use of placebos within controlled clinical trials for the placebo effect; last 50 years suggests that psycho-physiological effects can be objectified and measured. These are related to the therapeutic measurement; results covered by the term "placebo effect". Since Beecher's pioneer article in 1955, this effect is recognised and cited in randomised clinical trial; medical articles as being on average 35% effective on the majority of symptoms. ⋯ Is it possible then to measure and to objectify what is called the placebo effect? And if that is possible, how? This article calls into question the extent of the placebo effect evaluated by means of controlled clinical trials, without denying its importance in medical practice. Firstly it raises the epistemological problem of the real possibility, via experimentation, of objectifying psychological therapeutic effects. And secondly, the question is also raised of the interest for medical care of objectifying those effects.
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Pharmacoepidemiological studies exploring utilisation of psychotropic medications in real-life conditions are required to identify extension of indications, since the risk of gap between the theoretical target population and the population actually treated is especially marked for this class of drugs. A large proportion of subjects from the general population are exposed to psychotropic medications, so even a small increase in the risk of adverse effect may have major deleterious consequences for the health of the general population. ⋯ These studies may provide answers to currently unsolved public health questions, such as the long-term cognitive impact of exposure to benzodiazepines, the impact of antidepressant on suicidal behaviour, or the risks associated with enlarged use of antipsychotics. Only findings obtained by such studies may allow risk management and elaboration of guidelines based upon factual data.