5241. The multispeciality approach to the management of localised kidney cancer.
作者: Grant D Stewart.;Tobias Klatte.;Laura Cosmai.;Axel Bex.;Benjamin W Lamb.;Holger Moch.;Evis Sala.;Shankar Siva.;Camillo Porta.;Maurizio Gallieni.
来源: Lancet. 2022年400卷10351期523-534页
Historically, kidney cancer was approached in a siloed single-speciality way, with urological surgeons managing the localised stages of the disease and medical oncologists caring for patients if metastases developed. However, improvements in the management of localised kidney cancer have occurred rapidly over the past two decades with greater understanding of the disease biology, diagnostic options, and innovations in curative treatments. These developments are favourable for patients but provide a substantially more complex landscape for patients and clinicians to navigate, with associated challenging decisions about who to treat, how, and when. As such, the skill sets needed to manage the various aspects of the disease and guide patients appropriately outstrips the capabilities of one particular specialist, and the evolution of a multispeciality approach to the management of kidney cancer is now essential. In this Review, we summarise the current best multispeciality practice for the management of localised kidney cancer and the areas in need of further research and development.
5247. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial.
作者: Byeong-Keuk Kim.;Sung-Jin Hong.;Yong-Joon Lee.;Soon Jun Hong.;Kyeong Ho Yun.;Bum-Kee Hong.;Jung Ho Heo.;Seung-Woon Rha.;Yun-Hyeong Cho.;Seung-Jun Lee.;Chul-Min Ahn.;Jung-Sun Kim.;Young-Guk Ko.;Donghoon Choi.;Yangsoo Jang.;Myeong-Ki Hong.; .
来源: Lancet. 2022年400卷10349期380-390页
Drug combinations rather than increasing doses of one drug can achieve greater efficacy and lower risks. Thus, as an alternative to high-intensity statin monotherapy, moderate-intensity statin with ezetimibe combination therapy can lower LDL cholesterol concentrations effectively while reducing adverse effects. However, evidence from randomised trials to compare long-term clinical outcomes is needed.
5251. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020.
The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year.
5252. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis.
作者: Franco De Crescenzo.;Gian Loreto D'Alò.;Edoardo G Ostinelli.;Marco Ciabattini.;Valeria Di Franco.;Norio Watanabe.;Ayse Kurtulmus.;Anneka Tomlinson.;Zuzana Mitrova.;Francesca Foti.;Cinzia Del Giovane.;Digby J Quested.;Phil J Cowen.;Corrado Barbui.;Laura Amato.;Orestis Efthimiou.;Andrea Cipriani.
来源: Lancet. 2022年400卷10347期170-184页
Behavioural, cognitive, and pharmacological interventions can all be effective for insomnia. However, because of inadequate resources, medications are more frequently used worldwide. We aimed to estimate the comparative effectiveness of pharmacological treatments for the acute and long-term treatment of adults with insomnia disorder.
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