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dinsdag 2 oktober 2018

The Lancet: [Articles] Quantifying the burden of stillbirths before 28 weeks of completed gestational age in high-inc...

[Articles] Quantifying the burden of stillbirths before 28 weeks of completed gestational age in high-income countries: a population-based study of 19 European countries
Present definitions used for international comparisons exclude a third of stillbirths. International consistency of reporting stillbirths at 24 weeks to less than 28 weeks suggests these deaths should be included in routinely reported comparisons. This addition would have a major impact, acknowledging the burden of perinatal death to families, and making international assessments more informative for clinical practice and policy. Ascertainment of fetal deaths at 22 weeks to less than 24 weeks should be stabilised so that all stillbirths from 22 completed weeks of gestation onwards can be reliably compared.
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[Comment] Encouraging awareness of fetal movements is harmful
The concept that perception by pregnant women of reduced or altered movements of their fetuses can be used to predict stillbirth, thereby enabling early birth to save the baby, seems plausible.1 However, although mothers of stillborn babies, with hindsight, remember altered movements preceding the diagnosis of the death more often than controls,2,3 to our knowledge, no one has ever shown this prospectively. With few exceptions,4 the accuracy of tests of fetal health done in response to altered movements has been poorly evaluated, and the only treatment—delivery—can harm as well as benefit.
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[Department of Error] Department of Error
The Lancet. GLOBOCAN 2018: counting the toll of cancer. Lancet 2018; 392: 985—In this Editorial, the estimate of 30 million deaths from cancer by 2030 was incorrect. The number should be 13 million deaths. This correction has been made to the online version as of Sept 27, 2018.
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[Articles] Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial
In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes.
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[Comment] HARMONY or discord in cardiovascular outcome trials of GLP-1 receptor agonists?
In 2017, GlaxoSmithKline announced its intention to withdraw the glucagon-like peptide 1 (GLP-1) receptor agonist albiglutide for commercial reasons. This announcement came before the emergence of definitive evidence regarding the cardiovascular safety and efficacy of albiglutide. In The Lancet, Adrian Hernandez and colleagues1 report results from the Harmony Outcomes trial, which showed, in 9463 participants, that albiglutide has beneficial effects on cardiovascular outcomes when given to people with type 2 diabetes and atherosclerotic cardiovascular disease.
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