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Everybody working in the medical field has noticed over the course of his/her career (no matter how short or long) that there has been a constant progress in the development and use of drugs. It is quite striking, for example, to think that just after the end of WWII anti-hypertensive drugs were practically non-existent and the first of these drugs have long been replaced with more effective and safer drugs, although they are still taught to students. A simple parameter of judgement is comparing the size of pharmacology textbooks through the editions: constantly increasing. In primary care, at present, we are currently working on unmet medical needs of subsets of populations. This is per se a statement of how effective pharmacological progress has been in the last 70 years. Yet, this huge success and the speed with which it has been attained has, possibly, made us lose sight of what our strategy should be, creating a huge amount of contradictions in the pharmacological world. Should resources be placed where we have been most successful so far, for example on small chemical entities, vaccines and biotech drugs or should we focus our attention on new therapeutic interventions such as stem cells and cell therapies? Should we focus on diseases in which we are most likely to suffer from ourselves or should we instead invest in global health? Should we ride the wave of big data or should we ride the wave of personalized medicine? Should health systems concede that, if a drug exists, it should be given to a patient or should there be other considerations upfront? It is obvious that there is no answer for any of these rhetorical questions, and indeed that some should not be formulated in the first place, given that a diversification of approaches might eventually yield better results. Most importantly, it is likely that real advances and innovation will stem from the ability to merge some contrasting issues in the field. Yet, it also true that very rarely opposing arguments are presented together as if they were one while doing so might help speed up the process of innovation. The present meeting, therefore, wants, deliberately, to merge non-adjacent fragments of the pharmacological mosaic, in the hope that the contrasts presented will increase our thirst of knowledge and not our thirst to be on the winning side of the argument. 

Pier Luigi Canonico and Armando Genazzani Co-Presidents of the Meeting

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Il premio Nobel Louis Ignarro



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