A Marriage of Large and Small: R & D for Healthcare Products
The most critical factor for success in the pharmaceutical industry is the discovery of novel drugs that treat major illnesses for which there had been, up to then, only inadequate kinds of treatment. Until a decade or so ago, most drugs were discovered through the in-house research of major pharmaceutical companies. But now these major companies are increasingly relying on small firms and academia for drug discovery, while concentrating on their core competences of drug development and marketing. A similar pattern is emerging in other parts of the healthcare industry. This article discusses the synergy between small and large firms in healthcare and suggests that this pattern may become a general one for all innovative industries.
Outsourcing in the pharmaceutical manufacturing process: an examination of the CRO experience
Abstract The pharmaceutical industry is passing through a very challenging period in its evolution with the traditional approaches to drug development constantly expanding. Successful pharmaceutical organisations have recognised the need to leverage resources, and as a result, they have come to rely on the wealth of expertise provided by specialist external sources. One such source is the newly emergent sector comprising Clinical Research Organisations, otherwise known as CROs. This transition to a more integrated approach to conducting pharmaceutical Research and Development (R&D) has however led to a change in practice within the traditional working environment of the pharmaceutical sector. Although pharmaceutical manufacturers have identified a number of advantages and disadvantages as a result of working with these external agents, the potential for enhancing the partnership process still exists. Given the level of co-dependency amongst operators in the industry, it is therefore necessary that pharmaceutical firms reach a much deeper understanding of the intricacies of the buyer–supplier relationship in order to facilitate the drug development process.
Clinical and echocardiographic characteristics of cardiac blood cysts.
BACKGROUND
Cardiac blood cysts (BCs) are rare benign cardiac masses. This study aimed to summarize the clinical and echocardiographic characteristics and clinical outcomes of patients with BCs.


METHODS
This retrospective study enrolled patients diagnosed with BC between 2009 and 2021 at a single center in China. Their clinical and echocardiographic characteristics, management, and outcomes at follow-up are summarized.


RESULTS
The study population comprised 26 patients with BCs with a mean age of 40 ± 19 years (median, 42 years; range, 27-56 years). The cohort was predominantly male (16, 62%). Twenty-two (81%) patients were symptomatic: dyspnea or exertional dyspnea (11, 42%) and palpitations (6, 23%) were the most frequent symptoms. Most cysts appeared as single round, oval, or lobulated anechoic masses, measuring 4-30 mm (mean, 18 mm). Half of the BCs (13, 50%) were pedunculated and mobile, and the others swung with the movement of the valve. The mitral valve (13, 50%) was the most common site of occurrence, followed by the tricuspid valve (6, 23%), right atrium (4, 15%), and aortic valve (3, 12%). Contrast echocardiography, which was performed for two patients, revealed a closed cyst without bubbles. Five cases were complicated by left ventricular outflow tract obstruction and six by valve prolapse. Eighteen patients underwent surgery, and one received antiplatelet therapy. Cardiovascular or cerebrovascular events did not occur in any patient during the follow-up period.


CONCLUSION
Cardiac BCs are most commonly attached to the atrioventricular valve. Echocardiography is considered to be the most useful imaging modality for assessing BC. The management of patients with BC should be individualized based on the symptoms and associated complications.