1504. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials.
作者: Mayank Goyal.;Bijoy K Menon.;Wim H van Zwam.;Diederik W J Dippel.;Peter J Mitchell.;Andrew M Demchuk.;Antoni Dávalos.;Charles B L M Majoie.;Aad van der Lugt.;Maria A de Miquel.;Geoffrey A Donnan.;Yvo B W E M Roos.;Alain Bonafe.;Reza Jahan.;Hans-Christoph Diener.;Lucie A van den Berg.;Elad I Levy.;Olvert A Berkhemer.;Vitor M Pereira.;Jeremy Rempel.;Mònica Millán.;Stephen M Davis.;Daniel Roy.;John Thornton.;Luis San Román.;Marc Ribó.;Debbie Beumer.;Bruce Stouch.;Scott Brown.;Bruce C V Campbell.;Robert J van Oostenbrugge.;Jeffrey L Saver.;Michael D Hill.;Tudor G Jovin.; .
来源: Lancet. 2016年387卷10029期1723-31页
In 2015, five randomised trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischaemic stroke caused by occlusion of arteries of the proximal anterior circulation. In this meta-analysis we, the trial investigators, aimed to pool individual patient data from these trials to address remaining questions about whether the therapy is efficacious across the diverse populations included.
1506. The past and future of haemophilia: diagnosis, treatments, and its complications.
Haemophilia A and B are hereditary haemorrhagic disorders characterised by deficiency or dysfunction of coagulation protein factors VIII and IX, respectively. Recurrent joint and muscle bleeds lead to severe and progressive musculoskeletal damage. Existing treatment relies on replacement therapy with clotting factors, either at the time of bleeding (ie, on demand) or as part of a prophylactic schedule. The major complication of such therapy is the development of neutralising antibodies (ie, inhibitors), which is most frequent in haemophilia A. Treatment might improve considerably with the availability of new modified drugs, which might overcome existing prophylaxis limitations by reducing dosing frequency and thereby rendering therapy less distressing for the patient. Subcutaneous administration of some new therapies would also simplify prophylaxis in children with poor venous access. Gene therapy has the potential for a definitive cure, and important results have been obtained in haemophilia B. Despite improvements in haemophilia care, the availability of clotting factor concentrates for all affected individuals worldwide remains the biggest challenge.
1508. Closure of mesenteric defects in laparoscopic gastric bypass: a multicentre, randomised, parallel, open-label trial.
作者: Erik Stenberg.;Eva Szabo.;Göran Ågren.;Johan Ottosson.;Richard Marsk.;Hans Lönroth.;Lars Boman.;Anders Magnuson.;Anders Thorell.;Ingmar Näslund.
来源: Lancet. 2016年387卷10026期1397-1404页
Small bowel obstruction due to internal hernia is a common and potentially serious complication after laparoscopic gastric bypass surgery. Whether closure of surgically created mesenteric defects might reduce the incidence is unknown, so we did a large randomised trial to investigate.
1513. Averting a malaria disaster: will insecticide resistance derail malaria control?
作者: Janet Hemingway.;Hilary Ranson.;Alan Magill.;Jan Kolaczinski.;Christen Fornadel.;John Gimnig.;Maureen Coetzee.;Frederic Simard.;Dabiré K Roch.;Clément Kerah Hinzoumbe.;John Pickett.;David Schellenberg.;Peter Gething.;Mark Hoppé.;Nicholas Hamon.
来源: Lancet. 2016年387卷10029期1785-8页
World Malaria Day 2015 highlighted the progress made in the development of new methods of prevention (vaccines and insecticides) and treatment (single dose drugs) of the disease. However, increasing drug and insecticide resistance threatens the successes made with existing methods. Insecticide resistance has decreased the efficacy of the most commonly used insecticide class of pyrethroids. This decreased efficacy has increased mosquito survival, which is a prelude to rising incidence of malaria and fatalities. Despite intensive research efforts, new insecticides will not reach the market for at least 5 years. Elimination of malaria is not possible without effective mosquito control. Therefore, to combat the threat of resistance, key stakeholders need to rapidly embrace a multifaceted approach including a reduction in the cost of bringing new resistance management methods to market and the streamlining of associated development, policy, and implementation pathways to counter this looming public health catastrophe.
1515. Association between age and risk of stroke or death from carotid endarterectomy and carotid stenting: a meta-analysis of pooled patient data from four randomised trials.
作者: George Howard.;Gary S Roubin.;Olav Jansen.;Jeroen Hendrikse.;Alison Halliday.;Gustav Fraedrich.;Hans-Henning Eckstein.;David Calvet.;Richard Bulbulia.;Leo H Bonati.;Jean-Pierre Becquemin.;Ale Algra.;Martin M Brown.;Peter A Ringleb.;Thomas G Brott.;Jean-Louis Mas.; .
来源: Lancet. 2016年387卷10025期1305-11页
Age was reported to be an effect-modifier in four randomised controlled trials comparing carotid artery stenting (CAS) and carotid endarterectomy (CEA), with better CEA outcomes than CAS outcomes noted in the more elderly patients. We aimed to describe the association of age with treatment differences in symptomatic patients and provide age-specific estimates of the risk of stroke and death within narrow (5 year) age groups.
1519. Health-care improvements in a financially constrained environment.
作者: Inger Ekman.;Reinhard Busse.;Ewout van Ginneken.;Chris Van Hoof.;Linde van Ittersum.;Ab Klink.;Jan A Kremer.;Marisa Miraldo.;Anders Olauson.;Walter De Raedt.;Michal Rosen-Zvi.;Valentina Strammiello.;Jan Törnell.;Karl Swedberg.
来源: Lancet. 2016年387卷10019期646-647页 |