2921. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial.
作者: Sean Kehoe.;Jane Hook.;Matthew Nankivell.;Gordon C Jayson.;Henry Kitchener.;Tito Lopes.;David Luesley.;Timothy Perren.;Selina Bannoo.;Monica Mascarenhas.;Stephen Dobbs.;Sharadah Essapen.;Jeremy Twigg.;Jonathan Herod.;Glenn McCluggage.;Mahesh Parmar.;Ann-Marie Swart.
来源: Lancet. 2015年386卷9990期249-57页
The international standard of care for women with suspected advanced ovarian cancer is surgical debulking followed by platinum-based chemotherapy. We aimed to establish whether use of platinum-based primary chemotherapy followed by delayed surgery was an effective and safe alternative treatment regimen.
2923. Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial.
作者: Robert Pickard.;Kathryn Starr.;Graeme MacLennan.;Thomas Lam.;Ruth Thomas.;Jennifer Burr.;Gladys McPherson.;Alison McDonald.;Kenneth Anson.;James N'Dow.;Neil Burgess.;Terry Clark.;Mary Kilonzo.;Katie Gillies.;Kirsty Shearer.;Charles Boachie.;Sarah Cameron.;John Norrie.;Samuel McClinton.
来源: Lancet. 2015年386卷9991期341-9页
Meta-analyses of previous randomised controlled trials concluded that the smooth muscle relaxant drugs tamsulosin and nifedipine assisted stone passage for people managed expectantly for ureteric colic, but emphasised the need for high-quality trials with wide inclusion criteria. We aimed to fulfil this need by testing effectiveness of these drugs in a standard clinical care setting.
2925. Pinpointing clinical diagnosis through whole exome sequencing to direct patient care: a case of Senior-Loken syndrome.
作者: Jamie M Ellingford.;Panagiotis I Sergouniotis.;Rachel Lennon.;Sanjeev Bhaskar.;Simon G Williams.;Kate A Hillman.;James O'Sullivan.;Georgina Hall.;Simon C Ramsden.;I Christopher Lloyd.;Adrian S Woolf.;Graeme C M Black.
来源: Lancet. 2015年385卷9980期1916页 2927. A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex.
The Ebola virus disease outbreak in west Africa is pivotal for the worldwide health system. Just as the depth of the crisis ultimately spurred an unprecedented response, the failures of leadership suggest the need for innovative reforms. Such reforms would transform the existing worldwide health system architecture into a purposeful, organised system with an empowered, highly capable WHO at its apex and enduring, equitable national health systems at its foundation. It would be designed not only to provide security against epidemic threats, but also to meet everyday health needs, thus realising the right to health. This retrospective and prospective analysis offers a template for these reforms, responding to the profound harms posed by fragile national health systems, delays in the international response, deficient resource mobilisation, ill defined responsibilities, and insufficient coordination. The scope of the reforms should address failures in the Ebola response, and entrenched weaknesses that enabled the epidemic to reach its heights.
2928. Global health security: the wider lessons from the west African Ebola virus disease epidemic.
作者: David L Heymann.;Lincoln Chen.;Keizo Takemi.;David P Fidler.;Jordan W Tappero.;Mathew J Thomas.;Thomas A Kenyon.;Thomas R Frieden.;Derek Yach.;Sania Nishtar.;Alex Kalache.;Piero L Olliaro.;Peter Horby.;Els Torreele.;Lawrence O Gostin.;Margareth Ndomondo-Sigonda.;Daniel Carpenter.;Simon Rushton.;Louis Lillywhite.;Bhimsen Devkota.;Khalid Koser.;Rob Yates.;Ranu S Dhillon.;Ravi P Rannan-Eliya.
来源: Lancet. 2015年385卷9980期1884-901页
The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security--its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing.
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