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dinsdag 31 oktober 2017

The Lancet: [Articles] Availability, cost, and prescription patterns of antihypertensive medications in primary healt...

[Articles] Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey
China has marked deficiencies in the availability, cost, and prescription of antihypertensive medications. High-value medications are not preferentially used. Future efforts to reduce the burden of hypertension, particularly through the work of primary health-care providers, will need to improve access to, and use of, antihypertensive medications, paying particular attention to those with high value.
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[Editorial] Putting research evidence at the heart of policy making
To improve patient outcomes, research must inform and shape policy. As history sadly teaches, this ideal is not always realised. But in today's Lancet, two Articles display how research addressing knowledge gaps can inform policy for hypertension control in China.
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[Comment] Circadian rhythm and ischaemia–reperfusion injury
Every day, thousands of patients are exposed to ischaemia-reperfusion injury, either in uncontrolled circumstances (eg, acute myocardial infarction or ischaemic stroke) or under controlled conditions (eg, heart, kidney, or liver surgery, or transplantation). Whatever the clinical setting is, the extent of final tissue damage (ie, infarct size) is mainly determined by the duration of the ischaemic phase and the amount of jeopardised tissue.1 Experimental and proof-of-concept clinical trials have shown that infarct size results from the addition of an ischaemia-induced injury plus a reperfusion-induced injury, and that timely interventions might attenuate the latter.
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[Articles] Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-ErbĪ± antagonism: a single-centre propensity-matched cohort study and a randomised study
Perioperative myocardial injury is transcriptionally orchestrated by the circadian clock in patients undergoing aortic valve replacement, and Rev-ErbĪ± antagonism seems to be a pharmacological strategy for cardioprotection. Afternoon surgery might provide perioperative myocardial protection and lead to improved patient outcomes compared with morning surgery.
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[Review] The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health
The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris Agreement,1 and the health implications of these actions. It follows on from the work of the 2015 Lancet Commission on Health and Climate Change,2 which concluded that anthropogenic climate change threatens to undermine the past 50 years of gains in public health, and conversely, that a comprehensive response to climate change could be "the greatest global health opportunity of the 21st century".
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