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dinsdag 7 november 2017

The Lancet: [Comment] Subcutaneous IgG for chronic inflammatory demyelinating polyneuropathy

[Comment] Subcutaneous IgG for chronic inflammatory demyelinating polyneuropathy
Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic autoimmune neuropathy and often responds to corticosteroids, plasmapheresis, and intravenous immunoglobulin (IVIg).1 The only US Food and Drug Administration-approved, and the most commonly applied therapy, is IVIg, which, at 2 g/kg followed by 1 g/kg every 3–4 weeks, has been shown to prevent relapses and maintain stability in 75% of patients.2 Subcutaneous immunoglobulin (SCIg), an alternative route of IgG administration, is approved for IgG replacement therapy in primary immunodeficiency,3 but whether or not it has an effect in balancing immune dysregulation in autoimmune diseases, as IVIg does,4 has not been formally tested.
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[In Context] The CENTER-TBI core study: The making-of
It's a veritable medical mega-production, with results coming soon to a computer screen near you! But only behind the scenes can you appreciate the massive effort to collect and curate the data involved in this vast study. Adrian Burton takes a peek.
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[Comment] Traumatic brain injury: a global challenge
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, with enormous economic consequences. The Lancet Neurology Commission1 on TBI sets priorities and provides recommendations for future clinical practice, research, and policy to reduce this overwhelming burden. The Commission comes at a time when the global incidence of TBI is rising, access to care is severely lacking in many parts of the world, and methods of monitoring and diagnosis are frequently inadequate.
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[Comment] Traumatic brain injury: a priority for public health policy
The Lancet Neurology Commission1 draws attention to the devastating impact of traumatic brain injury (TBI) on patients and their families, and the huge public health burden and economic cost of TBI globally. About 50–60 million new TBI cases are estimated to occur annually, with 2·5 million occurring in the European Union.1 The burden of TBI is greatest in low-income and middle-income countries, where 90% of trauma-related deaths occur.2,3 The Commission sets priorities for prevention, clinical care, and research, calling for a combination of innovative research methods and global collaboration to address the huge but poorly recognised public health challenge of TBI, with steps to ensure that developments in care and progress in research are effectively translated into clinical practice and public health policy.
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[The Lancet Neurology Commission] Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research
A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world's population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs).
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