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dinsdag 21 november 2017

The Lancet: [World Report] Misoprostol drug to be withdrawn from French market

[World Report] Misoprostol drug to be withdrawn from French market
Misoprostol drug Cytotec will be pulled from the French market on March 1, 2018, after reported adverse effects of off-label use. Barbara Casassus reports from Paris.
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[Review] Investment in child and adolescent health and development: key messages from Disease Control Priorities, 3rd Edition
The realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5–9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10–14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15–19 years), when new responses are needed to support brain maturation, intense social engagement, and emotional control.
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[Comment] No benefit of arthroscopy in subacromial shoulder pain
Since its introduction nearly 100 years ago,1 arthroscopy of the knee has revolutionised the care of patients with meniscal lesions, ruptures of the anterior cruciate ligament, and cartilage damage. Although knee arthroscopy has proved to be an asset that is highly beneficial to many patients, it is not a panacea for all knee problems. The clinical benefit is especially questionable for patients with degenerative osteoarthritis: in a trial using a sham surgery,2 knee arthroscopy had no effect, and this finding was confirmed in another study.
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[Articles] Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial
Surgical groups had better outcomes for shoulder pain and function compared with no treatment but this difference was not clinically important. Additionally, surgical decompression appeared to offer no extra benefit over arthroscopy only. The difference between the surgical groups and no treatment might be the result of, for instance, a placebo effect or postoperative physiotherapy. The findings question the value of this operation for these indications, and this should be communicated to patients during the shared treatment decision-making process.
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[Department of Error] Department of Error
Colombel J-F, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2017; published online Oct 31. http://dx.doi.org/10.1016/S0140-6736(17)32641-7. In figure 3B of this Article, the percentage of patients with an endoscopic response in the tight control group should have been 50·8%. In figure 4 of this Article, at randomisation, the number of patients in the tight control group who received adalimumab every other week should have been 79.
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