Transfusion medicine: looking to the future

The evolution of transfusion medicine into a clinically oriented discipline emphasising patient care has been accompanied by challenges that need to be faced as specialists look to the future. Emerging issues that affect blood safety and blood supply, such as pathogen inactivation and more stringent donor screening questions, bring new pressures on the availability of an affordable blood supply. Imminent alternatives for management of anaemia, such as oxygen carriers, hold great promise but, if available, will require close oversight. With current estimates of HIV or hepatitis C viral (HCV) transmission approaching one in 2000000 units transfused, keeping to a minimum bacterial contamination of platelet products (one in 2000) and errors in transfusion, with its estimated one in 800000 mortality rate, assume great urgency. Finally, serious difficulties in blood safety and availability for poor, developing countries require innovative strategies and commitment of resources.     

Epidemiology of osteoporotic fracture: looking to the future

This paper reviews the recent literature on candidate genes, anthropometric and environmental factors, and the evolving area of intrauterine fetal programming with regard to the development of osteoporosis.     

辞旧迎新 展望未来

常阅报刊开眼界,深研医技扩胸襟。在辞旧迎新、举国同庆的美好之际,我谨代表《中华结直肠疾病电子杂志》向本刊的编委会成员、广大作者和读者致以新年的祝福和诚挚的问候,祝福大家新年快乐!从创刊至今,《中华结直肠疾病电子杂志》一直秉承为广大结直肠疾病工作者服务的理念,强化学术导向,报道国内外结直肠疾病领域领先的科研成果和临床诊疗经验,同时,也非常重视对基层医师的指导和培养。     

Changing epidemiology and mortality in adult congenital heart disease: looking into the future

Advances in surgical and medical treatment of children born with congenital heart disease have led to a growing number of adult survivors, particularly to a growing number of adults with complex congenital heart disease. Childhood mortality has continuously decreased over the last few decades and mortality has shifted almost entirely to adulthood. However, most patients are not cured and many remain at risk of premature death. The extent of excess mortality among individual congenital disease entities is not well defined. In this article we outline the current demographics of adults with selected congenital heart lesions. Based on these contemporary patient cohorts, we delineate future changes in patient demographics. A better understanding of these trends may help in the optimal planning of future resource allocation for medical care and optimal planning of multicenter research, for this novel and growing population of young, chronically ill adults.     

Platelet inhibitor therapy for patients with cardiovascular disease: looking toward the future

Understanding platelet function and the role of platelets in the response to vascular injury has led to the development of novel platelet-inhibiting therapies that have been proven effective in the treatment of acute and chronic vascular disease. Antiplatelet therapies are cornerstone treatments for patients with acute coronary syndromes and have been essential in reducing the acute and subacute ischemic complications of percutaneous coronary intervention. Furthermore, an increased understanding of the pathobiology behind the platelet's role in atherothrombosis has offered up many new avenues of research and many new targets for therapeutic drug development. This review briefly summarizes the state of available anticoagulant and antiplatelet treatments in cardiovascular disease management and provides a perspective on the key issues in developing new antiplatelet strategies in the future.