2491. Implications of suboptimal measles immunity in UK health-care workers.
作者: Antonia Ho.;Oliver Galgut.;Sian Faustini.;Nicholas Peters.;Adrian Shields.;Paul Klenerman.;Susan Hopkins.;Victoria Hall.;Susanna Dunachie.;Alex Richter.
来源: Lancet. 2024年404卷10447期23-24页 2494. Livebirth rate after one frozen embryo transfer in ovulatory women starting with natural, modified natural, or artificial endometrial preparation in Viet Nam: an open-label randomised controlled trial.
作者: Vu N A Ho.;Toan D Pham.;Nam T Nguyen.;Rui Wang.;Robert J Norman.;Ben W Mol.;Tuong M Ho.;Lan N Vuong.
来源: Lancet. 2024年404卷10449期266-275页
Use of frozen embryo transfer (FET) in in-vitro fertilisation (IVF) has increased. However, the best endometrial preparation protocol for FET cycles is unclear. We compared natural and modified natural cycle strategies with an artificial cycle strategy for endometrial preparation before FET.
2495. Neonatal bacterial sepsis.
作者: Tobias Strunk.;Eleanor J Molloy.;Archita Mishra.;Zulfiqar A Bhutta.
来源: Lancet. 2024年404卷10449期277-293页
Neonatal sepsis remains one of the key challenges of neonatal medicine, and together with preterm birth, causes almost 50% of all deaths globally for children younger than 5 years. Compared with advances achieved for other serious neonatal and early childhood conditions globally, progress in reducing neonatal sepsis has been much slower, especially in low-resource settings that have the highest burden of neonatal sepsis morbidity and mortality. By contrast to sepsis in older patients, there is no universally accepted neonatal sepsis definition. This poses substantial challenges in clinical practice, research, and health-care management, and has direct practical implications, such as diagnostic inconsistency, heterogeneous data collection and surveillance, and inappropriate treatment, health-resource allocation, and education. As the clinical manifestation of neonatal sepsis is frequently non-specific and the current diagnostic standard blood culture has performance limitations, new improved diagnostic techniques are required to guide appropriate and warranted antimicrobial treatment. Although antimicrobial therapy and supportive care continue as principal components of neonatal sepsis therapy, refining basic neonatal care to prevent sepsis through education and quality improvement initiatives remains paramount.
2498. Call to action for a life course approach.
作者: David Simmons.;Yashdeep Gupta.;Teri L Hernandez.;Naomi Levitt.;Mireille van Poppel.;Xilin Yang.;Christina Zarowsky.;Helena Backman.;Maisa Feghali.;Karoline Kragelund Nielsen.
来源: Lancet. 2024年404卷10448期193-214页
Gestational diabetes remains the most common medical disorder in pregnancy, with short-term and long-term consequences for mothers and offspring. New insights into pathophysiology and management suggest that the current gestational diabetes treatment approach should expand from a focus on late gestational diabetes to a personalised, integrated life course approach from preconception to postpartum and beyond. Early pregnancy lifestyle intervention could prevent late gestational diabetes. Early gestational diabetes diagnosis and treatment has been shown to be beneficial, especially when identified before 14 weeks of gestation. Early gestational diabetes screening now requires strategies for integration into routine antenatal care, alongside efforts to reduce variation in gestational diabetes care, across settings that differ between, and within, countries. Following gestational diabetes, an oral glucose tolerance test should be performed 6-12 weeks postpartum to assess the glycaemic state. Subsequent regular screening for both dysglycaemia and cardiometabolic disease is recommended, which can be incorporated alongside other family health activities. Diabetes prevention programmes for women with previous gestational diabetes might be enhanced using shared decision making and precision medicine. At all stages in this life course approach, across both high-resource and low-resource settings, a more systematic process for identifying and overcoming barriers to preventative care and treatment is needed to reduce the current global burden of gestational diabetes.
2500. Colorectal cancer.
作者: Cathy Eng.;Takayuki Yoshino.;Erika Ruíz-García.;Nermeen Mostafa.;Christopher G Cann.;Brittany O'Brian.;Amala Benny.;Rodrigo O Perez.;Chiara Cremolini.
来源: Lancet. 2024年404卷10449期294-310页
Despite decreased incidence rates in average-age onset patients in high-income economies, colorectal cancer is the third most diagnosed cancer in the world, with increasing rates in emerging economies. Furthermore, early onset colorectal cancer (age ≤50 years) is of increasing concern globally. Over the past decade, research advances have increased biological knowledge, treatment options, and overall survival rates. The increase in life expectancy is attributed to an increase in effective systemic therapy, improved treatment selection, and expanded locoregional surgical options. Ongoing developments are focused on the role of sphincter preservation, precision oncology for molecular alterations, use of circulating tumour DNA, analysis of the gut microbiome, as well as the role of locoregional strategies for colorectal cancer liver metastases. This overview is to provide a general multidisciplinary perspective of clinical advances in colorectal cancer.
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