Lancet
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Biography Historical Article
The Nobel Chronicles. 1968: Har Khorana (b 1922); Robert Holley (1922-93); Marshall Nirenberg (b 1927).
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Randomized Controlled Trial Multicenter Study Clinical Trial
Neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled trial. International collaboration of trialists.
Several non-randomised trials have shown that transitional-cell carcinoma of the bladder is a moderately chemosensitive tumour. We investigated whether the addition of neoadjuvant cisplatin-based chemotherapy to radical surgery or radiotherapy would improve survival. ⋯ Three cycles of neoadjuvant chemotherapy before cystectomy or radiotherapy did not give the 10% improvement in 3-year survival that was judged to be necessary for introduction into routine use. The chemotherapy regimen was associated with a higher pathological complete-response rate in primary tumours, but there was no clear evidence that it would increase survival.
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Global and regional estimates show that non-communicable diseases in old age are rising in importance relative to other causes of ill health as populations age, and as progress continues against communicable diseases among infants and children. However, these estimates, which cover population groups at all income levels, do not accurately reflect conditions that prevail among the poor. We estimated the burden of disease among the 20% of the global population living in countries with the lowest per capita incomes, compared with the 20% of the world's people living in the richest countries. ⋯ Our estimates are crude, but despite their limitations, they give a more accurate picture of changes in attributable mortality among the world's poor than do the global averages in current use.