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donderdag 27 april 2017

The Lancet: [Editorial] WOMAN: reducing maternal deaths with tranexamic acid

[Editorial] WOMAN: reducing maternal deaths with tranexamic acid
Over 200 million women become pregnant each year. Despite great progress during the past three decades, deaths during pregnancy and childbirth remain a serious (and largely preventable) risk for women in around 75 countries where 98% of maternal mortality occurs. The UN estimates that 532 000 maternal deaths took place in 1990. That number had fallen to 303 000 by the end of the Millennium Development Goal (MDG) era in 2015. Haemorrhage accounts for 18% of these deaths, and is a particularly important cause of maternal mortality in Africa and Asia.
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[Viewpoint] Universal health coverage, priority setting, and the human right to health
Following endorsement by WHO,1,2 the World Bank,3 and the UN's Sustainable Development Goals,4 the drive towards universal health coverage (UHC) is now one of the most prominent global health policies. As countries progress towards UHC, they are forced to make difficult choices about how to prioritise health issues and expenditure: which services to expand first, whom to include first, and how to shift from out-of-pocket payment towards prepayment. Building on extensive philosophical literature on the ethics of priority setting in health care, a 2014 WHO report provided guidance about how states can resolve these issues.
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[Department of Error] Department of Error
Davies C, Pan H, Godwin J, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 2013; 381: 805–16—Following a routine internal audit, the findings in this Article have been slightly updated. In the main paper, this has affected only the incidence of ischaemic heart disease (Summary Findings; last paragraph of Results; table 2), mortality from causes other than breast cancer (Summary Findings), and, also in table 2, mortality among women with unknown ER status (and hence among women with any ER status).
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[Correspondence] 10 5 years of adjuvant tamoxifen: exclusion of 1/402 centres in ATLAS
ATLAS is an international trial of the main effects of prolonging adjuvant tamoxifen. It involves 15 000 women with early breast cancer, randomised in 1995–2005 at 402 centres in many countries. Its 2013 findings1 showed that in oestrogen receptor (ER)-positive disease, 5 years of tamoxifen is significantly less effective than 10 years in reducing 15-year breast cancer mortality, and its 20-year findings are to be reported in 2018.
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[Correspondence] Open letter to WHO DG candidates: keep policy and priority setting free of commercial influence
In May, 2017, WHO Member States will meet in Geneva for the 70th World Health Assembly (WHA) and a new WHO Director-General (DG) will be elected. As public-interest non-government organisations (NGOs) involved in global health governance and the prevention and treatment of chronic diseases, we believe that a fundamental consideration for Member States when electing the DG will be how the new leadership will ensure appropriate interactions with alcohol, food, pharmaceutical, and medical technology industries.
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