NOWADAYS,Fontan circulation always refers to the hemodynamic status after total cavo-pul-monary connection, which was first created in the 1990s. There are two modern surgeryforms, one creating a channel within the r...NOWADAYS,Fontan circulation always refers to the hemodynamic status after total cavo-pul-monary connection, which was first created in the 1990s. There are two modern surgeryforms, one creating a channel within the right atrium and another making an extra-cardiac channel to connect infe-rior venous cava directly to the right pulmonary artery. Parturients with Fontan circulation are at increased risk of cardiac morbidity and thrombotic complications. We pre-sented a parturient with reduced platelet status of un-known reason undergoing an emergent cesarean delivery.展开更多
Medicines are a global, strategic and diplomatic issue [1]. The UN General Secretary’s High Level Task Force [2] on Access to Medicines calls for a new approach to reduce the gap between medical innovations and acces...Medicines are a global, strategic and diplomatic issue [1]. The UN General Secretary’s High Level Task Force [2] on Access to Medicines calls for a new approach to reduce the gap between medical innovations and access to medicines. Inequality in access to quality pharmaceutical products in a framework of global health democracy poses a threat to the ethical and equitable management of the provision of quality health care, particularly during global health crises. In French-speaking Africa, the lack of a unified production of pharmaceutical medicines forces wholesalers （public and private） to import almost all of their medicine demands resulting in a risk of dependence and major pharmaceutical quality defects. These central purchasing units are therefore often faced with the major challenge of guaranteeing the performance of their services and the security of their supplies. In order to achieve component 3 （“Access to Health”） of the SDOs （sustainable development goals）, in particular the access to affordable medicines, it is essential for a country to have a strategy of pharmaceutical independence [3] by anticipating the epidemiological transition and the management of health crises. This strategy of pharmaceutical independence is based in the short and medium term on the strengthening of central purchasing units and the establishment of a public-private partnership between central purchasing units and wholesalers, and in the long term on the establishment of competitive production units that comply with international standards. However, recent health crises have shown the fragility of public central purchasing units and make it difficult to anticipate health crises.展开更多
文摘NOWADAYS,Fontan circulation always refers to the hemodynamic status after total cavo-pul-monary connection, which was first created in the 1990s. There are two modern surgeryforms, one creating a channel within the right atrium and another making an extra-cardiac channel to connect infe-rior venous cava directly to the right pulmonary artery. Parturients with Fontan circulation are at increased risk of cardiac morbidity and thrombotic complications. We pre-sented a parturient with reduced platelet status of un-known reason undergoing an emergent cesarean delivery.
文摘Medicines are a global, strategic and diplomatic issue [1]. The UN General Secretary’s High Level Task Force [2] on Access to Medicines calls for a new approach to reduce the gap between medical innovations and access to medicines. Inequality in access to quality pharmaceutical products in a framework of global health democracy poses a threat to the ethical and equitable management of the provision of quality health care, particularly during global health crises. In French-speaking Africa, the lack of a unified production of pharmaceutical medicines forces wholesalers （public and private） to import almost all of their medicine demands resulting in a risk of dependence and major pharmaceutical quality defects. These central purchasing units are therefore often faced with the major challenge of guaranteeing the performance of their services and the security of their supplies. In order to achieve component 3 （“Access to Health”） of the SDOs （sustainable development goals）, in particular the access to affordable medicines, it is essential for a country to have a strategy of pharmaceutical independence [3] by anticipating the epidemiological transition and the management of health crises. This strategy of pharmaceutical independence is based in the short and medium term on the strengthening of central purchasing units and the establishment of a public-private partnership between central purchasing units and wholesalers, and in the long term on the establishment of competitive production units that comply with international standards. However, recent health crises have shown the fragility of public central purchasing units and make it difficult to anticipate health crises.
