Une réflexion sur l'amour, la médecine et l'euthanasie : Je connais ce que j'aime et j'aime ce que je connais, mais est-ce bien vrai ? A reflection on love, medicine and euthanasia : I know what I like and I like what I know, but is that true ?

RESUME Cet article se propose d'aborder la pratique de la médecine sous un angle philosophique, en faisant référence aux courants principaux de la pensée occidentale (Platon, Spinoza, Kant). En particulier, les rapports entre médecine et " amour " (eros, philia, agape) seront développés, de même que la notion de dignité et d'autonomie. La réflexion portera sur l'importance de ces aspects, notamment en fin de vie. Il est admis que si la médecine ne peut faire l'économie de la morale, de l'éthique, de la déontologie, elle s'inscrit également dans un champ philosophique et doit garantir le respect de la dignité humaine, surtout lorsqu'un médecin est amené à aider son patient à mourir. Rev Med Brux 2010 ; 31 : PROLOGUE -Dominique, as-tu complété nos références de " neuro oncologie " ? -Non, Jerzy, je n'en ai vraiment pas eu le temps ces dernières semaines, et d'ailleurs je… -Cher ami, il faut trouver le temps. Moi-même, je… -Je l'ai consacré à mes lectures philosophiques, l'éthique, Jerzy… -Tu es un peu jeune pour cela… C'est une affaire de vieux médecins… -Je ne suis pas du tout d'accord et… -La seule véritable éthique du médecin, c'est de connaître son métier, il faut que la pâte soit bonne, peu importe la cerise qu'on met dessus… -Je ne suis pas d'accord avec toi, on ne peut faire l'économie de l'éthique, de la réflexion, quels que soient le moment, la période de sa carrière. Le nier, c'est perdre toute sagesse, et le patient lui- ABSTRACT This paper presents the medical practice according to the occidental philosophy (Platon, Spinoza, Kant). Relationships with the concept of " love " (eros, philia, agape) will be described, and the concept of dignity and autonomy as well. The reflection will focus on the end of life aspects. Although medicine cannot avoid morality, ethic, and deontology, it is also part of philosophy and must warrant the respect of human dignity, especially when a physician helps a patient to die. Rev Med Brux 2010 ; 31

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This paper presents the medical practice according to the occidental philosophy (Platon, Spinoza, Kant). Relationships with the concept of "love" (eros, philia, agape) will be described, and the concept of dignity and autonomy as well. The reflection will focus on the end of life aspects. Although medicine cannot avoid morality, ethic, and deontology, it is also part of philosophy and must warrant the respect of human dignity, especially when a physician helps a patient to die

Systematic overview of the pharmacological management of postherpetic neuralgia : an evaluation of the clinical value of critically selected drug treatments based on efficacy and safety outcomes from randomized controlled studies

OBJECTIVE: This study systematically reviews current evidence on drug treatments commonly used in postherpetic neuralgia. METHODS: Randomized controlled trials were critically selected using predefined search criteria. Efficacy was evaluated as percentage of improvement in pain intensity between baseline and endpoint, tolerability by number of study discontinuations because of adverse events and incidence of adverse events. RESULTS: Currently published trials enrolled different patient populations and small patient numbers. The great variability in doses, titration schemes, designs and washout periods together with other design flaws made comparison between different studies scientifically impossible. CONCLUSIONS: There is a real need for well-performed clinical trials with standardization in design and reporting. Development of adequate and validated questionnaires for evaluation and comparison of efficacy and safety of treatments is also needed. Based on the evaluation of individual studies, it is concluded that only gabapentin is studied in large (over 200 patients), placebo-controlled studies showing good efficacy and safety

EGF105084, a phase II study of lapatinib for brain metastases in patients (pts) with HER2+ breast cancer following trastuzumab (H) based systemic therapy and cranial radiotherapy (RT)

1012 Background: CNS disease is a major problem among pts treated with H for stage IV HER2+ breast cancer with a reported incidence of 28–43%. This study was designed to characterize further the activity reported with lapatinib in an initial phase II trial in women with HER2+ disease metastatic to brain (Lin et al ASCO ‘06). Methods: Eligible pts had HER2+ breast cancer, prior H therapy and cranial RT, ECOG PS 0–2, and radiographic evidence of progressive brain metastases with at least one measurable (LD = 10mm) brain lesion. Pts received lapatinib 750 mg PO BID. Brain MRIs were obtained at 3.0 mm slices without gaps in the axial dimension. The primary endpoint was CNS response as defined by a = 50% volumetric (vol) reduction of CNS lesions in the absence of: new lesions, need for increased dose of steroids, progressive neurological signs/symptoms (NSS), or progressive extra-CNS disease. CNS disease progression was defined as either a = 40% vol increase from nadir, increase in steroid requirements, or progression of NSS. Results: The study exceeded its accrual goal of 220 pts in &lt; 1 year; 238 pts were enrolled from Jan-Nov 06. Preliminary data from the initial 104 pts have undergone independent radiology review. 8 pts (7.7%) met vol criteria for partial response with a median absolute vol reduction of CNS disease of 3.6 cm3 (range 0.4 to 29.7 cm3). Exploratory analysis revealed that 17 of the initial 104 pts (16.3%) experienced a = 20% vol reduction of CNS disease with a median absolute vol reduction of 3.3cm3. The median time to vol progression in these 17 pts was 16 wks (range 12 -24 wks). Analysis of efficacy and tolerability based upon protocol defined criteria from all 238 pts will be presented. Conclusions: Preliminary data from this large multicenter trial provides evidence that lapatinib has activity based on vol reductions in pts with progressive HER2+ CNS disease following prior H-based systemic therapy and cranial RT. Definitive conclusions will be based on the entire database. Additional studies are warranted incorporating lapatinib in combination with other therapies and/or in a less refractory setting to optimize its use in HER2+ CNS disease. [Table: see text] </jats:p

La douleur est-elle une norme universelle?

Aim: This paper is a reflection on pain under its normative consideration. Questions of ethnicity and gender are also considered. A short reflection is made about the relationship of pain and language. Materials and methods: Most references are taken from philosophical and medical publications. The author will also bring his own reflection on the subject. Results: Pain imposes its own norms but its approach may also lead to normative considerations, sometimes questionable. Conclusion: Pain is a language’s purpose and production, regarding its expression and its management, leading to its very particular representation. Pain meets philosophical and ideological contingencies. If pain can be and must be treated, it cannot be a universal norm.SCOPUS: ar.jinfo:eu-repo/semantics/publishe