| 1. |
- Atun, Rifat, et al.
(författare)
-
Sustainable care for children with cancer : a Lancet Oncology Commission
- 2020
-
Ingår i: The Lancet Oncology. - 1470-2045. ; 21:4, s. 185-224
-
Forskningsöversikt (refereegranskat)abstract
- We estimate that there will be 13·7 million new cases of childhood cancer globally between 2020 and 2050. At current levels of health system performance (including access and referral), 6·1 million (44·9%) of these children will be undiagnosed. Between 2020 and 2050, 11·1 million children will die from cancer if no additional investments are made to improve access to health-care services or childhood cancer treatment. Of this total, 9·3 million children (84·1%) will be in low-income and lower-middle-income countries. This burden could be vastly reduced with new funding to scale up cost-effective interventions. Simultaneous comprehensive scale-up of interventions could avert 6·2 million deaths in children with cancer in this period, more than half (56·1%) of the total number of deaths otherwise projected. Taking excess mortality risk into consideration, this reduction in the number of deaths is projected to produce a gain of 318 million life-years. In addition, the global lifetime productivity gains of US$2580 billion in 2020–50 would be four times greater than the cumulative treatment costs of $594 billion, producing a net benefit of $1986 billion on the global investment: a net return of $3 for every $1 invested. In sum, the burden of childhood cancer, which has been grossly underestimated in the past, can be effectively diminished to realise massive health and economic benefits and to avert millions of needless deaths.
|
|
| 2. |
- Williams, Michael A., et al.
(författare)
-
Distortion Product Otoacoustic Emissions and Intracranial Pressure During CSF Infusion Testing
- 2016
-
Ingår i: Aerospace medicine and human performance. - 2375-6314. ; 87:10, s. 844-851
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A noninvasive method to monitor changes in intracranial pressure (ICP) is required for astronauts on long-duration spaceflight who are at risk of developing the Visual Impairment/Intracranial Pressure syndrome that has some, but not all of the features of idiopathic intracranial hypertension. We assessed the validity of distortion product otoacoustic emissions (DPOAEs) to detect changes in ICP. METHODS: Subjects were eight patients undergoing medically necessary diagnostic cerebrospinal fluid (CSF) infusion testing for hydrocephalus. DPOAE measurements were obtained with an FDA-approved system at baseline and six controlled ICP levels in similar to 3 mmHg increments in random order, with a range from 10.8 +/- 2.9 mmHg (SD) at baseline to 32.3 +/- 4.1 mmHg (SD) at level 6. RESULTS: For f2 frequencies between 800 and 1700 Hz, when ICP was >= 12 mmHg above baseline ICP, DPOAE angles increased significantly and DPOAE magnitudes decreased significantly, but less robustly. DISCUSSION: Significant changes in DPOAE angle and magnitude are seen when ICP is >= 12 mmHg above a subject's supine baseline ICP during CSF infusion testing. These results suggest that the changes in DPOAE angle and magnitude seen with change in ICP are physiologically based, and suggest that it should be possible to detect pathological ICP elevation using DPOAE measurements. To use DPOAE for noninvasive estimation of ICP during spaceflight will require baseline measurements in the head-up, supine, and head-down positions to obtain baseline DPOAE values at different ICP ranges.
|
|
