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maandag 7 augustus 2017

The Lancet: [Comment] Early-stage breast cancer: falling risks and emerging options

[Comment] Early-stage breast cancer: falling risks and emerging options
Great improvements in the therapeutic ratio of cancer treatment can result from innovative approaches that maintain tumour control benefits while lowering treatment-associated morbidity. The IMPORT LOW trial by Charlotte Coles and colleagues1 in The Lancet is a high-quality randomised trial of treatment de-escalation in the multidisciplinary management of breast cancer.
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[Articles] Exenatide once weekly versus placebo in Parkinson's disease: a randomised, double-blind, placebo-controlled trial
Exenatide had positive effects on practically defined off-medication motor scores in Parkinson's disease, which were sustained beyond the period of exposure. Whether exenatide affects the underlying disease pathophysiology or simply induces long-lasting symptomatic effects is uncertain. Exenatide represents a major new avenue for investigation in Parkinson's disease, and effects on everyday symptoms should be examined in longer-term trials.
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[Comment] Insulin signalling: new target for Parkinson's treatments?
Parkinson's disease is the second most common neurodegenerative disease, and affects 2–3% of people aged 65 years and older.1 The number of affected people is expected to double between 2005 and 2030 as the world's population ages, which will further increase the societal and economic burdens of the disease.1 Although in the past 20 years understanding of the molecular mechanisms underlying neuronal dysfunction and cell death in Parkinson's disease has improved substantially and novel therapeutic targets have been identified, no treatments with proven disease-modifying efficacy have become available.
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[Articles] Trends in international asthma mortality: analysis of data from the WHO Mortality Database from 46 countries (1993–2012)
The trend for reduction in global asthma mortality observed since the late 1980s might have stalled, with no appreciable difference in a smoothed LOESS curve of asthma mortality from 2006 to 2012. Although better implementation of established management strategies that have been shown to reduce mortality risk is needed, to achieve a further substantive reduction in global asthma mortality novel strategies will also be required.
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[Comment] Eliminating asthma deaths: have we stalled?
There has been a marked and progressive reduction in asthma mortality rates since the epidemic of deaths in many countries around the world that preceded major changes in the clinical and public health approaches to asthma in the late 1980s. The effort to turn around rising asthma mortality rates was broad—occurring globally, nationally, and at a local level, through health system change to individual advocacy and clinical leadership.1 Previous approaches to acute and long-term care of asthma, which did not recognise the risks associated with short-acting β2 agonists, were overhauled when it became evident that their overuse was a key reason for the epidemic of asthma deaths at that time, especially in New Zealand, Australia, Canada, and the UK.
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