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音量 1, 問題 1 (2012)

社説

Medicine of the Future: Pessimistic Versus Optimistic Prognosis

Olga Golubnitschaja

Pessimistic versus optimistic prognosis is considered for the healthcare systems worldwide depending on the paradigm which medical survices will apply over the next 2 decades. Current healthcare deals with dramatic problems created by the concept of delayed (or reactive) medical approaches resulting in a low cost effectiveness of treatments and outcomes considered as inadequate for many acute and chronic pathologies. In contrast, Predictive Preventive and Personalised Medicine (PPPM) is the new philosophy utilising an integrative concept of medical services that enables to predict individual predisposition before onset of the disease, to provide targeted preventive measures and create personalised treatment algorithms tailored to the person. The optimistic outcomes by PPPM are well justified as promoting healthcare sector by following measures: effective prevention early in life, identification of persons at-risk, patients’ stratification, optimal therapy planning, prediction and reduction of adverse drug-drug or drug-disease interactions, etc. Emerging technologies, such as omics, medical imaging, pharmacogenetics, pathology-specific patterns of biomarkers, disease modelling, individual patient profiles, etc. are expected to play a pivotal role in the advancing of medical services. Being at the forefront of this process, the European Association for Predictive, Preventive and Personalised Medicine promotes the integrative concept of PPPM among professionals, governmental institutions, funding bodies, patient organisations and in the public domain. An integrative approach by PPPM is considered as the medicine of the future.

総説

Widening the Paradigm in Medicine and Health: The Memorandum of Understanding between the European Association for Predictive, Preventive and Personalised Medicine EPMA and the Italian Charity “Association for Person Centred Medicine”

Paolo Roberti di Sarsina , Mauro Alivia and Paola Guadagni

The Authors describe the process of widening the paradigm within EPMA incorporating into its actions the Person-Centred Medicine Paradigm. It is a humanistic and at the same time evidence-based approach. It allows for that individual psycho-physical equilibrium which is the basis for any sustainable equilibrium in society at present or in the future (responsibility). Person-Centred Medicine calls for wider medical knowledge and practice, not only of how to treat pathology but how to generate health (salutogenesis). It is a systemic approach and adopts a unitary view of sentient being and the world. The Person Centred Medicine Paradigm aims to incorporate the holistic approach, the relationship-based care and the treatment systems of biomedicine into the technological advances of mainstream medicine in order to provide more personalised and sustainable healthcare.

社説

The Method of Research Subject Chosen and Clinical Orientation in the Secondary Development of Famous and Excellent Chinese Patent Medicines

Shang Hongcai

Secondary development of famous and excellent Chinese patent medicines is one of the principal pathways for significant new drug creation. A well-chosen topic for in-depth study and a more precise definition of the drug’s medicinal uses and indications play a decisive role to successful drug redevelopment. The author puts forward a four-step method of “grasping the baseline information of target diseases and related Chinese patent medicines, choosing an initial research topic and orientating the medicine in question to a specific clinical use, analyzing the scientificity and risk of the study and making a strategic decision for the research”, followed by explanations and illustrations in a specific case study.

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