Biomedical subjects

G Emilien

Publications and source records attributed to G Emilien.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Future European health care: cost containment, health care reform and scientific progress in drug research.

The cost of the development of a new pharmaceutical product from its conception and synthesis through to the regulatory approval process has more than quadrupled in the last 20 years. Both clinical and total development times have increased substantially. To amortize the costs incurred, the pharmaceutical industry has taken an international dimension. The incentives for pharmaceutical firms to discover and develop new drugs depend on the length of the development and regulatory review process plus the potential market size. Recent regulatory, economic and political changes may have significant implications for the future of new drug developments in Europe. The European Union industrial policy felt that there is a need for convergence in the area of pricing. It is recommended that the policy should aim to contain growth in pharmaceutical expenses by means specific to reimbursement rather than direct price controls. By encouraging doctors to prescribe and customers to use generics, competition is enhanced to bring down drug prices. More emphasis is being laid by government in educating customers to cost-awareness and cost-benefit ratios with regard to pharmaceuticals. Concerning clinical trials, European harmonization has been achieved by significant developments: the rights and integrity of the trial subjects are protected; the credibility of the data is established; and the ethical, scientific and technical quality of the trials has improved. Future European health care forecasts a whole change in the pharmaceutical business. Important issues in cost and outcome measurement should be carefully planned and considered in drug development. Due to important mergers and acquisitions, the pharmaceutical sector will consist mainly of important multinational corporations. In this way, valuable new products may be brought to the market.

Cost Control↗

PubMedDate not supplied

Effects of clonidine, yohimbine and eserine on the quantified EEG of rats.

The effects of three different classes of drugs were analyzed on the EEG of rats on two cortical derivations (parieto-occipital and fronto-occipital) and one deep structure, the locus coeruleus. Clonidine, an alpha 2-agonist (0, 0.10, 0.30 and 0.50 mg/kg, i.p.), yohimbine, an alpha 2-antagonist (0, 2, 4 and 8 mg/kg, i.p.) and eserine, an anticholinesterase (0, 0.10, 0.30 and 0.50 mg/kg, i.p.), affected the EEG in different significant ways. Clonidine significantly decreased frequency in the theta-band (3.7-7.5 Hz) and increased it in the alpha-band (7.6-13.5 Hz). A general significant increase in power was also observed. For yohimbine, there was a significant dose-dependent increase of power, particularly in the theta-, alpha- and beta-bandwidth. Moreover, its effects on EEG varied in accordance to the derivations analyzed. Finally, eserine significantly decreased power in the high frequency bandwidths. A synchronization, as a function of dose, with a peak at 5-6 Hz was observed shortly after its administration. The results are discussed in terms of the potentiality of the technique of quantitative pharmaco-electro-encephalography and drug interaction studies in the analysis of psychoactive substances.

Animals↗

PubMedDate not supplied

Lithium therapy in the treatment of manic-depressive illness. Present status and future perspectives. A critical review.

This article reviews critically the present status of lithium in the treatment and prophylaxis of manic-depressive illness compared to the two anticonvulsant drugs, carbamazepine and valproic acid. Lithium is used successfully in the prophylaxis and treatment of manic-depression. The mechanism by which it exerts its effects is still not very clear. There is much evidence to indicate that lithium may exert its therapeutic action by interfering with the metabolism of phosphoinositides which play an important role in synaptic transmission. Because of lithium's narrow therapeutic/toxic ratio, blood concentration monitoring is crucial. Published data suggest that, compared to lithium, carbamazepine is similar in its relative specificity in treating mania. It is often faster in achieving its antimanic effects and best established as an alternative for patients not responding or intolerant to lithium. Carbamazepine is a good substitute for lithium when severe renal problems exclude the use of lithium. The therapeutic profile of valproic acid in manic-depression, although less extensively studied, appears to be similar to that of carbamazepine. As carbamazepine, it seems to be best indicated in patients with rapid cycles. Whereas lithium inhibits myo-inositol monophosphatase, carbamazepine shows a stimulating effect and valproic acid has no effect on this biochemical target. The implication of the inositol pathway in the pathogenesis of adverse effects, such as neurotoxicity and dermatological irritation, is discussed. A further understanding of this pathway is important for the future development of new lithium-like compounds in order to maximize the therapeutic benefits without the adverse effects.

Anticonvulsants↗

PubMedDate not supplied

Cognitive impairment in depressive disorders. Neuropsychological evaluation of memory and behavioural disturbances.

The purpose of this article is to discuss the contribution that clinical neuropsychology and neuropsychological assessment can conter to neuropsychiatry, particularly in the evaluation of cognitive disturbances and pharmacological treatment of depression. Six patients (4 females, 2 males; age: 16-54 years old) suffering from depressive disorders underwent a clinical neuropsychological examination. Depending on the memory scores obtained on the Rey-Osterrieth complex figure test, the patients were classified as having mild or no memory impairment (< 20% decrease), moderate memory impairment (20-40% decrease) or severe memory alteration (> 60% deterioration). Evaluation of memory scores of two other memory tests (Wechsler memory scale and Rey visual design learning test) were also considered. Patients who were classified as having severe memory impairment were consistently reported as seriously impaired on all memory tests. The severity of cognitive dysfunction is in accordance with the serious ness of the neuropsychiatric disturbances of the patients as revealed by personality testing (MMPI, IDS and Eysenck questionnaires) or by personal details as assessed during the interview. This paper discusses the importance of the utility of a comprehensive neuropsychological evaluation of depressed patients and seriously considers the possibility of the use of this approach for pharmacological treatment evaluation.

Adolescent↗