Managed Services and Cloud computing are 2 efeifrdnt aspects. They can be
used separately or conjointly. For me managed services in a Cloud
environment is an extra layer of services that the Cloud provider offers to
its  managing the offered services, the provider will be able to guaranty
better SLA, resiliency, high-availability environments. In counter part, as
the provider will provide more guaranty on the service, it will reduce the
flexibility of a customer to have a full customized environment. For
example, the provider will restrict his service catalog and will be able to
give SLA on a given database solution only if he manage himself the patches
lifecycle.