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maandag 13 november 2017

The Lancet: [Articles] Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with ...

[Articles] Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis
Our study shows that homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals experience extreme health inequities across a wide range of health conditions, with the relative effect of exclusion being greater in female individuals than male individuals. The high heterogeneity between studies should be explored further using improved data collection in population subgroups. The extreme health inequity identified demands intensive cross-sectoral policy and service action to prevent exclusion and improve health outcomes in individuals who are already marginalised.
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[Comment] Inclusion health: addressing the causes of the causes
The social gradient in health describes a graded association between an individual's position on the social hierarchy and health: the lower the socioeconomic position of an individual, the worse their health.1 The fact that the social gradient extends from the highest echelons of society to the lowest suggests that everyone is affected to a greater or lesser extent by the social determinants of health. One component of social cohesion is making common cause between people at various points on the social ladder.
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[Articles] Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data
Despite Australia's adolescents having one of the best health profiles globally, Indigenous adolescents have largely been left behind. Adequate responses will require intersectoral actions, including a health system responsive to the needs of Indigenous adolescents. Without a specific focus on adolescents, Australia will not redress Indigenous health inequalities.
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[Articles] Relationship of C-reactive protein reduction to cardiovascular event reduction following treatment with canakinumab: a secondary analysis from the CANTOS randomised controlled trial
The magnitude of hsCRP reduction following a single dose of canakinumab might provide a simple clinical method to identify individuals most likely to accrue the largest benefit from continued treatment. These data further suggest that lower is better for inflammation reduction with canakinumab.
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[Comment] Treatment concentration of high-sensitivity C-reactive protein
The landmark CANTOS trial evaluated the use of canakinumab, a monoclonal antibody targeting interleukin 1β, in 10 061 patients with previous myocardial infarction who had high-sensitivity C-reactive protein (hsCRP) concentrations of 2 mg/L or higher.1 Interleukin 1β has multiple potential mechanisms that contribute to the pathogenesis of atherothrombotic cardiovascular disease.2 Induction of interleukin 6 leads to the release of acute phase reactants including hsCRP. Thus, hsCRP serves as a surrogate marker of the overall inflammatory milieu,2 often in situations where patients have multiple co-morbidities,3 with a cumulative dose-response indicating a higher risk.
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