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Pierre Pichot et ses rapports avec la psychiatrie espagnole. Notes de sa présence au Pays basque espagnol, 1993–2006Résumé Pierre Pichot est fortement lié au développement de la psychiatrie espagnole au cours de la deuxième moitié du xxe siècle. Ses rapports avec les figures les plus importantes de la vie académique espagnole sont montrés dans cette communication. Mais il s’agit surtout ici de remarquer sa présence dès 1993 et jusqu’à 2007 de façon non interrompue à Vitoria pour son cours d’Actualisation en Psychiatrie. Celle-ci constitue la réunion psychiatrique espagnole la plus ancienne, hors les congrès nationaux. Pendant les 15 séances inaugurales que Pierre Pichot développa s’étendent toute une pensée et une réflexion sur les grandes questions de la psychiatrie. Son livre La Psychiatrie à l’époque actuelle est le compendium de toutes ses conférences. Enfin l’influence de Pierre Pichot sur la psychiatrie espagnole est représentée aussi par la formation de nombreux psychiatres espagnols dans sa chaire de la Clinique de Santé mentale et de l’Encéphale. Abstract Not only is Pierre Pichot closely connected to the development of Spanish psychiatry in the second half of the 20th century, but is known for his ties with the most significant people in the Spanish academic world. As an expert in Spanish history, he maintains a close relationship with Hispanists in France, which makes him a reference in Spanish psychiatry. However, our intention is to highlight his uninterrupted presence from 1993 until 2006 to inaugurate the Psychiatric Convention in Vitoria on the latest psychiatric developments. At present this Congress is the longest – lasting gathering of experts in Psychiatry in Spain apart from the National Yearly Congress of Psychiatry. During these 15 inaugural conferences presented by Pichot, one can find a complete thought and reflection on the important questions and debates in Psychiatry. His book, Present Day Psychiatry, is a compendia of each one of his presentations. The studies found in this work do not shy away from the most controversial topics. Pierre Pichot's rigour of psychiatric thought is initially found in the 60s with the publication of Los Test Mentales. As has been previously pointed out, this text replaced the Pieron Tratado. Undoubtedly, Pichot is the one to whom today's psychologists and psychiatrists owe the advance of psychometry in dealing with mental pathology. In the best sense of the word Pichot was an eclectic, capable of dealing with topics of interest from a wide range of perspectives. Therefore, he reflected on psychotherapy and to need to avoid sectarianism in schools, which is so closely related to present day efforts to spread and insure psychotherapeutic trading for psychiatric professionals. This, in this article we will summarize some of the contributions Pichot carried out in his presentations while he attended the congresses in Vitoria for 15 years. The first contribution to be covered is the evolution of the concept of affective disorders. This is proof of how week he was familiar with the semiological evolution itself concerning this matter. In addition, the term, psychosis and its lack of clarity will be dealt with. This will provide the opportunity to later continue on with the history of severe psychotic disorder and the influence Pichot holds as a representative of the French school for the autonomous inclusion of severe psychotic disorder in DSM-III and above all in CIE-10. Pichot does not shy away from the debate on the medical discipline to which the treatment of Alzheimer's belongs. In his opinion the discovery of cerebral lesions from Alzheimer's is not a decisive argument to include Alzheimer's or any mental disorder in the field of neurology. Finally and beyond all that is the importance of Pichot as the one who introduced DSM-III in Europe, which definitely makes him worthy to form part of Psychiatry itself in Europe. Without a doubt, Pichot forms part of a line of psychiatrists who have changed everything, who defined what mental illness was as well as what a psychiatrist was. Together with the group from Washington University in Saint Louis, Pichot dealt with the question of diagnosis in a rational way, far from the unclear way of DSM-II. The contribution of all those men and women to modern Psychiatry is fundamental to the history of our specialization.
Assessment of the Injection Performance of a Tapered Needle for Use in Prefilled Biopharmaceutical ProductsThe design of injection devices, including prefilled syringes (PFSs) and autoinjectors, requires an understanding of the optimization of injection conditions. The injection of highly concentrated biopharmaceuticals can lead to exceptionally high injection forces, due to their high viscosity. To overcome this challenge, a tapered needle has been recently developed by Terumo Corporation. In the present study, we measured the injection forces in PFSs equipped with 24G-29G tapered needle (29G TNN), 27G thin-wall needle (27G TW), and 29G TW using several model and pharmaceutical protein solutions. The injection forces measured in the 29G TNN PFSs were lower than those in 29G TW for all solutions, similar to those in 27G TW PFSs for Newtonian solutions, and were lower than those in the 27G TW PFSs for non-Newtonian solutions which demonstrated shear-thinning behavior. No significant changes in aggregates or micron-size particle concentrations were observed upon injection, regardless of the needle type. Mathematical modeling supported the experimental findings that under similar flow rate conditions injection pressure in a tapered needle is lower than that in a cylindrical needle. Our results indicate that there are advantages of using tapered needles for the injection of biopharmaceutical formulations particularly those showing shear-thinning behavior.