Critical illness-related corticosteroid insufficiency during difficult weaning from mechanical ventilation.

BACKGROUND: Critical illness-related corticosteroid insufficiency (CIRCI) is common during critical illness and is usually associated with poor outcomes, as prolonged duration of mechanical ventilation (MV) and higher mortality. CIRCI may alter cardiac and vascular functions. Weaning-induced pulmonary oedema (WiPO) is a major mechanism of weaning failure. The aim of this study was to evaluate the role of CIRCI in patients with difficult ventilator weaning and its possible relation with WiPO. METHODS: This is a prospective study conducted in the intensive care of a university hospital in France. Patients under MV for more than 24 h, meeting weaning criteria and having failed the first spontaneous breathing trial (SBT) underwent a corticotropin stimulation test, with assessment of total blood cortisol levels immediately before (T0) 0.25 mg iv of tetracosactrin and 30 and 60 min afterward. Δmax was defined as the difference between the maximal value after the test and T0. CIRCI was defined as T0 < 10 µg/dL (276 nmol/L) and/or Δmax < 9 µg/dL (248 nmol/L) and inadequate adrenal reserve as Δmax < 9 µg/dL. Biomarkers (natriuretic peptide and protidemia) sampling and echocardiograms were performed during the second SBT and were used to diagnose WiPO, which was defined according to two definitions (one liberal and one conservative) derived from recent publications on the topic. Successful extubation was defined as patient alive without reintubation 7 days after extubation. A competing risk analysis was used to assess extubation failure and mortality. RESULTS: Seventy-six consecutive patients (63 ± 14 years; 49 men) with difficult weaning were enrolled. CIRCI and inadequate adrenal reserve occurred in 25 (33%) and 17 (22%) patients, respectively. The probability of successful extubation was significantly decreased in patients with CIRCI or inadequate adrenal reserve, as compared to their counterparts, and this association persisted after adjustment on severity (SOFA score at first SBT). WiPO occurred in 44 (58%) and 8 (11%) patients, according to the liberal and conservative definition, respectively. WiPO was not associated with CIRCI nor with inadequate adrenal reserve. CONCLUSION: CIRCI was common during difficult weaning and was associated with its prolongation. We did not find a significant association between CIRCI and WiPO.

WIPO Re:Search: Catalyzing Public-Private Partnerships to Accelerate Tropical Disease Drug Discovery and Development.

Tropical diseases, including malaria and a group of infections termed neglected tropical diseases (NTDs), pose enormous threats to human health and wellbeing globally. In concert with efforts to broaden access to current treatments, it is also critical to expand research and development (R&D) of new drugs that address therapeutic gaps and concerns associated with existing medications, including emergence of resistance. Limited commercial incentives, particularly compared to products for diseases prevalent in high-income countries, have hindered many pharmaceutical companies from contributing their immense product development know-how and resources to tropical disease R&D. In this article we present WIPO Re:Search, an international initiative co-led by BIO Ventures for Global Health (BVGH) and the World Intellectual Property Organization (WIPO), as an innovative and impactful public-private partnership model that promotes cross-sector intellectual property sharing and R&D to accelerate tropical disease drug discovery and development. Importantly, WIPO Re:Search also drives progress toward the United Nations Sustainable Development Goals (SDGs). Through case studies, we illustrate how WIPO Re:Search empowers high-quality tropical disease drug discovery researchers from academic/non-profit organizations and small companies (including scientists in low- and middle-income countries) to leapfrog their R&D programs by accessing pharmaceutical industry resources that may not otherwise be available to them.

WIPO Re:Search-A Platform for Product-Centered Cross-Sector Partnerships for the Elimination of Schistosomiasis.

Schistosomiasis is an acute and chronic disease that affects over 200 million people worldwide, and with over 700 million people estimated to be at risk of contracting this disease, it is a pressing issue in global health. However, research and development (R&D) to develop new approaches to preventing, diagnosing, and treating schistosomiasis has been relatively limited. Praziquantel, a drug developed in the 1970s, is the only agent used in schistosomiasis mass drug administration (MDA) campaigns, indicating a critical need for a diversified therapeutic pipeline. Further, gaps in the vaccine and diagnostic pipelines demonstrate a need for early-stage innovation in all areas of schistosomiasis product R&D. As a platform for public-private partnerships (PPPs), the WIPO Re:Search consortium engages the private sector in early-stage R&D for neglected diseases by forging mutually beneficial collaborations and facilitating the sharing of intellectual property (IP) assets between the for-profit and academic/non-profit sectors. The Consortium connects people, resources, and ideas to fill gaps in neglected disease product development pipelines by leveraging the strengths of these two sectors. Using WIPO Re:Search as an example, this article highlights the opportunities for the PPP model to play a key role in the elimination of schistosomiasis.

Fostering innovative product development for neglected tropical diseases through partnerships.

Neglected tropical diseases are a group of infectious diseases that threaten and impact a significant portion of individuals living in low- and middle-income countries. Healthcare product R&D, which has been relatively limited for this group of infectious diseases, is timely and requires significant risk and resource investment by companies. Regardless of these costs, the global community has recognized the impact on human health that developing products for these diseases could have. Incentives, including 'push' and 'pull' funding, and platforms that support sharing of intellectual property through partnerships, such as The World Intellectual Property Organization Re:Search, are driving R&D. These mechanisms entice more organizations to participate in global health product development activities, and combine assets and capabilities while reducing costs and risk.

Gastroretentive carrier systems in the delivery of therapeutic actives: an updated patent review.

Gastroretentive drug-delivery systems have the potential to prolong the gastric retention time and provide controlled/sustained release of a drug at the absorption site, thereby improving the bioavailability. Advantageous features include reduction in dose, side effects and dosing frequency. Research inputs have led to exploration of novel gastroretentive systems. The present review explores various patents issued on gastroretentive drug delivery on the basis of the therapeutic category of drugs. It traces US, EP and WIPO patents issued in the last 10 years. Various patents have revealed that gastrocarriers can effectively enhance therapeutic activity of a drug. Drugs acting on the CNS have been prominently investigated, followed by antimicrobials and locally acting drugs. Areas of future research can be drugs acting on the cardiovascular system.

WIPO Re:Search: Accelerating anthelmintic development through cross-sector partnerships.

Neglected tropical diseases (NTDs), malaria, and tuberculosis have a devastating effect on an estimated 1.6 billion people worldwide. The World Intellectual Property Organization (WIPO) Re:Search consortium accelerates the development of new drugs, vaccines, and diagnostics for these diseases by connecting the assets and resources of pharmaceutical companies, such as compound libraries and expertise, to academic or nonprofit researchers with novel product discovery or development ideas. As the WIPO Re:Search Partnership Hub Administrator, BIO Ventures for Global Health (BVGH) fields requests from researchers, identifies Member organizations able to fulfill these requests, and helps forge mutually beneficial collaborations. Since its inception in October 2011, WIPO Re:Search membership has expanded to more than 90 institutions, including leading pharmaceutical companies, universities, nonprofit research institutions, and product development partnerships from around the world. To date, WIPO Re:Search has facilitated over 70 research agreements between Consortium Members, including 11 collaborations focused on anthelmintic drug discovery.

Análisis biotecnológico de Latinoamérica a través de las patentes en Inmunología / Biotechnological overview of Latin America from the perspective of immunological patents

Introducción: se admite que hay un abismo tecnológico entre los diversos continentes. Si bien contamos con multitud de informes sobre la producción científica y su evolución a nivel mundial, faltan estudios de esta misma índole en el campo de las patentes. Los estudios cienciométricos sobre patentes son escasos y limitados, especialmente sobre áreas específicas del conocimiento. Objetivo: analizar la situación tecnológica de la Inmunología en Latinoamérica, entre 2004 y 2011. Métodos: los documentos de patentes en el área de la Inmunología se obtuvieron a través de SCOPUS, con el análisis de las patentes solicitadas vía Tratado de Cooperación en Materia de Patentes, valorando los solicitantes, sus países de origen, los sectores económicos que patentan, así como la cooperación entre países. Resultados: en el período de estudio, 89 países solicitaron 17 281 patentes en Inmunología. Los países de la OCDE solicitaron el 97,28 % de estas, la Unión Europea el 30,76 % y Latinoamérica el 149 (0,86 %). Los países que más patentes solicitaron fueron Brasil con 43 y Cuba con 31. Los principales cosolicitantes fueron: Argentina y Brasil con EE.UU. (10 cada uno), y México con EE.UU. (8); entre los países latinoamericanos se encontraron Bahamas-Belice, Brasil-Uruguay, Chile-Ecuador, Cuba-México y Honduras-México. Las patentes inmunológicas se centraron, especialmente, en productos farmacéuticos y la Biotecnología. Las entidades privadas latinoamericanas solicitaron el 46 % de las patentes, las OPIs el 28 %, las universidades el 25 % y los hospitales el 3 %. Conclusiones: las diferencias tecnológicas, al menos en esta área de conocimiento, se han ido reduciendo. Bermudas e Islas Caimán ocupan la octava y novena posición mundial, respectivamente, por patentes/habitante; Brasil es el vigésimo país en patentes/INB-PP; Uruguay es el onceno en patentes/inversión en I+D+i en % INB, y México es el vigésimo en patentes/I+D+i en % del INB. Somos conscientes de que, al analizar únicamente un área de conocimiento, se produce un sesgo importante, pero nos permite ver y valorar la evolución de cada país hacia esta disciplina.

Introduction: a great technological divide is recognized to exist between the continents. Even though there is a multitude of reports about scientific production and its evolution around the world, relevant studies are still lacking in the field of patents. Scientometric studies dealing with patents are few and limited, particularly in certain knowledge areas. Objective: analyze the technological status of immunology in Latin America between 2004 and 2011. Methods: Immunological patent documentation was obtained from Scopus, and an analysis was conducted of the patents applied for through the Patent Cooperation Treaty. An evaluation was carried out of applicants, their country of origin, the patenting economic sectors and the cooperation between countries. Results: during the study period 89 countries applied for 17 281 immunological patents. Countries from the Organization for Economic Co-operation and Development applied for 97,28 % of the patents, the European Union for 30,76 % and Latin America for 0,86 %. The Latin American countries applying for most patents were Brazil (43) and Cuba (31). The main applicants were Argentina and Brazil (10 each) and Mexico (8). Latin American co-applicants included Bahamas-Belize, Brazil-Uruguay, Chile-Ecuador, Cuba-Mexico and Honduras-Mexico. Most immunological patents were for pharmaceutical products and biotechnology. Latin American private institutions applied for 46% of the patents, public research offices for 28 %, universities for 25 % and hospitals for 3 %. Conclusions: technological differences, at least in this knowledge area, have gradually lessened. Thus Bermuda and the Cayman Islands rank 8th and 9th worldwide, respectively, in patents per inhabitant. Brazil ranks 20th in patents/Gross National Income-Purchasing Power Parity. Uruguay ranks 11th in patents/investment in RDI in % of the Gross National Income, and Mexico ranks 20th. Significant bias may result from analyzing just one knowledge area, but it makes it possible to determine and assess the evolution of the study subject in each country.

International situation surrounding Japanese acupuncture and moxibustion / 全日本鍼灸学会雑誌

Currently, the international environment surrounding traditional medicine, including acupuncture and moxibustion, is changing faster than we can imagine. In recent years there are some Far East Asian countries that have registered the classical medical books of traditional medicine and a part of traditional medicines in their own countries to the Memory of the World and the Intangible Cultural Heritage in UNESCO. In addition, preparations to include traditional medicine in ICD-11 have been carried out with revision of ICD-10 in WHO. Furthermore, the working of international standardization of traditional medicine of Far East Asia is underway in ISO. Also WFAS is working on the international standardization of acupuncture and moxibustion in an official relationship with WHO. Furthermore, genetic resources and traditional knowledge related to traditional medicine have been discussed in CBD. The matters concerning traditional medicine have been discussed separately elsewhere in a wide variety of international organizations such as WIPO, WTO/TRIPS and FAO.<BR>In this panel discussion, firstly, we outlined the main points about the protection of traditional knowledge by CBD and the Nagoya Protocol, clarified the current status of discussions in WIPO about traditional medicine and registration of traditional knowledge under the Intangible Cultural Heritage in UNESCO, and examined future protection of traditional knowledge of acupuncture and moxibustion. Secondly, we summarized the current status and progress of the international standardization of acupuncture and moxibustion driven by WFAS as commissioned by WHO, clarified the viewpoint of JSAM about problems with the efforts of WFAS for the international standardization of acupuncture and moxibustion, and discussed the relationship of the international standardization of acupuncture and moxibustion in WFAS and ISO. Finally, we summarized the progress of the international standardization of acupuncture and moxibustion from the 1980s when international standardization of acupuncture and moxibustion was first initiated by WHO up until the present when international standardization of acupuncture and moxibustion is included in ISO/TC249, surveyed the present situation of the international standardization of traditional medicine in the countries that are leading the international standardization of acupuncture and moxibustion, and discussed about the aspects of the struggle for supremacy lurking behind the international standardization of traditional medicine and the issues associated with the future of the international standardization of traditional medicine.