243. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group.
作者: Leontine Alkema.;Doris Chou.;Daniel Hogan.;Sanqian Zhang.;Ann-Beth Moller.;Alison Gemmill.;Doris Ma Fat.;Ties Boerma.;Marleen Temmerman.;Colin Mathers.;Lale Say.; .
来源: Lancet. 2016年387卷10017期462-74页
Millennium Development Goal 5 calls for a 75% reduction in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed projections to show the requirements for the Sustainable Development Goal (SDG) of less than 70 maternal deaths per 100,000 livebirths globally by 2030.
245. Costs, affordability, and feasibility of an essential package of cancer control interventions in low-income and middle-income countries: key messages from Disease Control Priorities, 3rd edition.
作者: Hellen Gelband.;Rengaswamy Sankaranarayanan.;Cindy L Gauvreau.;Susan Horton.;Benjamin O Anderson.;Freddie Bray.;James Cleary.;Anna J Dare.;Lynette Denny.;Mary K Gospodarowicz.;Sumit Gupta.;Scott C Howard.;David A Jaffray.;Felicia Knaul.;Carol Levin.;Linda Rabeneck.;Preetha Rajaraman.;Terrence Sullivan.;Edward L Trimble.;Prabhat Jha.; .
来源: Lancet. 2016年387卷10033期2133-2144页
Investments in cancer control--prevention, detection, diagnosis, surgery, other treatment, and palliative care--are increasingly needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Cancer (the third volume of nine in Disease Control Priorities, 3rd edition) developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of early breast cancer, cervical cancer, and selected childhood cancers; and widespread availability of palliative care, including opioids. These interventions would cost an additional US$20 billion per year worldwide, constituting 3% of total public spending on health in low-income and middle-income countries. With implementation of an appropriately tailored package, most countries could substantially reduce suffering and premature death from cancer before 2030, with even greater improvements in later decades.
248. Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial.
作者: Jonathan M Morris.;Christine L Roberts.;Jennifer R Bowen.;Jillian A Patterson.;Diana M Bond.;Charles S Algert.;Jim G Thornton.;Caroline A Crowther.; .
来源: Lancet. 2016年387卷10017期444-52页
Preterm pre-labour ruptured membranes close to term is associated with increased risk of neonatal infection, but immediate delivery is associated with risks of prematurity. The balance of risks is unclear. We aimed to establish whether immediate birth in singleton pregnancies with ruptured membranes close to term reduces neonatal infection without increasing other morbidity.
251. Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial.
作者: William T Abraham.;Lynne W Stevenson.;Robert C Bourge.;Jo Ann Lindenfeld.;Jordan G Bauman.;Philip B Adamson.; .
来源: Lancet. 2016年387卷10017期453-61页
In the CHAMPION trial, significant reductions in admissions to hospital for heart failure were seen after 6 months of pulmonary artery pressure guided management compared with usual care. We examine the extended efficacy of this strategy over 18 months of randomised follow-up and the clinical effect of open access to pressure information for an additional 13 months in patients formerly in the control group.
254. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis.
作者: Xinfang Xie.;Emily Atkins.;Jicheng Lv.;Alexander Bennett.;Bruce Neal.;Toshiharu Ninomiya.;Mark Woodward.;Stephen MacMahon.;Fiona Turnbull.;Graham S Hillis.;John Chalmers.;Jonathan Mant.;Abdul Salam.;Kazem Rahimi.;Vlado Perkovic.;Anthony Rodgers.
来源: Lancet. 2016年387卷10017期435-43页
Recent hypertension guidelines have reversed previous recommendations for lower blood pressure targets in high-risk patients, such as those with cardiovascular disease, renal disease, or diabetes. This change represents uncertainty about whether more intensive blood pressure-lowering strategies are associated with greater reductions in risk of major cardiovascular and renal events. We aimed to assess the efficacy and safety of intensive blood pressure-lowering strategies.
256. Public health impact and cost-effectiveness of the RTS,S/AS01 malaria vaccine: a systematic comparison of predictions from four mathematical models.
作者: Melissa A Penny.;Robert Verity.;Caitlin A Bever.;Christophe Sauboin.;Katya Galactionova.;Stefan Flasche.;Michael T White.;Edward A Wenger.;Nicolas Van de Velde.;Peter Pemberton-Ross.;Jamie T Griffin.;Thomas A Smith.;Philip A Eckhoff.;Farzana Muhib.;Mark Jit.;Azra C Ghani.
来源: Lancet. 2016年387卷10016期367-375页
The phase 3 trial of the RTS,S/AS01 malaria vaccine candidate showed modest efficacy of the vaccine against Plasmodium falciparum malaria, but was not powered to assess mortality endpoints. Impact projections and cost-effectiveness estimates for longer timeframes than the trial follow-up and across a range of settings are needed to inform policy recommendations. We aimed to assess the public health impact and cost-effectiveness of routine use of the RTS,S/AS01 vaccine in African settings.
258. Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial.
作者: Noriaki Ohuchi.;Akihiko Suzuki.;Tomotaka Sobue.;Masaaki Kawai.;Seiichiro Yamamoto.;Ying-Fang Zheng.;Yoko Narikawa Shiono.;Hiroshi Saito.;Shinichi Kuriyama.;Eriko Tohno.;Tokiko Endo.;Akira Fukao.;Ichiro Tsuji.;Takuhiro Yamaguchi.;Yasuo Ohashi.;Mamoru Fukuda.;Takanori Ishida.; .
来源: Lancet. 2016年387卷10016期341-348页
Mammography is the only proven method for breast cancer screening that reduces mortality, although it is inaccurate in young women or women with dense breasts. We investigated the efficacy of adjunctive ultrasonography.
259. Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention (REGULATE-PCI): a randomised clinical trial.
作者: A Michael Lincoff.;Roxana Mehran.;Thomas J Povsic.;Steven L Zelenkofske.;Zhen Huang.;Paul W Armstrong.;P Gabriel Steg.;Christoph Bode.;Mauricio G Cohen.;Christopher Buller.;Peep Laanmets.;Marco Valgimigli.;Toomas Marandi.;Viliam Fridrich.;Warren J Cantor.;Bela Merkely.;Jose Lopez-Sendon.;Jan H Cornel.;Jaroslaw D Kasprzak.;Michael Aschermann.;Victor Guetta.;Joao Morais.;Peter R Sinnaeve.;Kurt Huber.;Rod Stables.;Mary Ann Sellers.;Marilyn Borgman.;Lauren Glenn.;Arnold I Levinson.;Renato D Lopes.;Vic Hasselblad.;Richard C Becker.;John H Alexander.; .
来源: Lancet. 2016年387卷10016期349-356页
REG1 is a novel anticoagulation system consisting of pegnivacogin, an RNA aptamer inhibitor of coagulation factor IXa, and anivamersen, a complementary sequence reversal oligonucleotide. We tested the hypothesis that near complete inhibition of factor IXa with pegnivacogin during percutaneous coronary intervention, followed by partial reversal with anivamersen, would reduce ischaemic events compared with bivalirudin, without increasing bleeding.
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