MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'LANCET' source. Wed, 08 Feb 2012 18:50:28 +0100 http://www.medworm.com/index.php?rid=5660722&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961711-X%2Ffulltext%3Frss%3Dyes In October, 2010, a 29-year-old man initially presented to a primary care clinic with fevers, sore throat, and odynophagia, and was treated with oral phenoxymethylpenicillin 250 mg four times daily for tonsillitis. He re-presented 72 h later with persisting symptoms and fever of 38·4°C, and was administered 1 000 000 units of intramuscular procaine benzylpenicillin. 4–5 min later, he collapsed with no cardiac output, and cardiopulmonary resuscitation was commenced. Paramedic staff arrived within 20 min and monitoring showed ventricular fibrillation. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660722 Sat, 04 Feb 2012 05:00:00 +0100 5660722 http://www.medworm.com/index.php?rid=5660721&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960610-7%2Fabstract%3Frss%3Dyes Non-specific low back pain has become a major public health problem worldwide. The lifetime prevalence of low back pain is reported to be as high as 84%, and the prevalence of chronic low back pain is about 23%, with 11–12% of the population being disabled by low back pain. Mechanical factors, such as lifting and carrying, probably do not have a major pathogenic role, but genetic constitution is important. History taking and clinical examination are included in most diagnostic guidelines, but the use of clinical imaging for diagnosis should be restricted. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660721 Sat, 04 Feb 2012 05:00:00 +0100 5660721 http://www.medworm.com/index.php?rid=5660720&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960935-5%2Fabstract%3Frss%3Dyes Hereditary angio-oedema is caused by a heterozygous deficiency of C1 inhibitor. This inhibitor regulates several inflammatory pathways, and patients with hereditary angio-oedema have intermittent cutaneous or mucosal swellings because of a failure to control local production of bradykinin. Swellings typically evolve in several hours and persist for a few days. In addition to orofacial angio-oedema, painless swellings affect peripheries, which causes disfigurement or interference with work and other activities of daily living. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660720 Sat, 04 Feb 2012 05:00:00 +0100 5660720 http://www.medworm.com/index.php?rid=5660719&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960103-7%2Fabstract%3Frss%3Dyes Lyme borreliosis (Lyme disease) is caused by spirochaetes of the Borrelia burgdorferi sensu lato species complex, which are transmitted by ticks. The most common clinical manifestation is erythema migrans, which eventually resolves, even without antibiotic treatment. However, the infecting pathogen can spread to other tissues and organs, causing more severe manifestations that can involve a patient's skin, nervous system, joints, or heart. The incidence of this disease is increasing in many countries. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660719 Sat, 04 Feb 2012 05:00:00 +0100 5660719 http://www.medworm.com/index.php?rid=5660718&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961335-4%2Fabstract%3Frss%3Dyes CE-MARC is the largest, prospective, real world evaluation of CMR and has established CMR's high diagnostic accuracy in coronary heart disease and CMR's superiority over SPECT. It should be adopted more widely than at present for the investigation of coronary heart disease. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660718 Sat, 04 Feb 2012 05:00:00 +0100 5660718 http://www.medworm.com/index.php?rid=5660717&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961577-8%2Fabstract%3Frss%3Dyes Intrauterine and neonatal insults have a high risk of causing substantial long-term neurological morbidity. Comparable cohort studies in resource-poor regions should be done to properly assess the burden of these conditions, and long-term outcomes, such as chronic disease, and to inform policy and programme investments. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660717 Sat, 04 Feb 2012 05:00:00 +0100 5660717 http://www.medworm.com/index.php?rid=5660716&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961625-5%2Fabstract%3Frss%3Dyes 10-year gains from a one-third breast cancer mortality reduction depend on absolute risks without chemotherapy (which, for oestrogen-receptor-positive disease, are the risks remaining with appropriate endocrine therapy). Low absolute risk implies low absolute benefit, but information was lacking about tumour gene expression markers or quantitative immunohistochemistry that might help to predict risk, chemosensitivity, or both. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660716 Sat, 04 Feb 2012 05:00:00 +0100 5660716 http://www.medworm.com/index.php?rid=5660715&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960034-8%2Fabstract%3Frss%3Dyes Our findings show that the malaria mortality burden is larger than previously estimated, especially in adults. There has been a rapid decrease in malaria mortality in Africa because of the scaling up of control activities supported by international donors. Donor support, however, needs to be increased if malaria elimination and eradication and broader health and development goals are to be met. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660715 Sat, 04 Feb 2012 05:00:00 +0100 5660715 http://www.medworm.com/index.php?rid=5660714&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960194-9%2Ffulltext%3Frss%3Dyes Glazener C, Boachie C, Buckley B, et al. Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trials. Lancet 2011; 378: 328–37—This Article (July 23) should have contained the following conflicts of interest statement: “BB has received travel expenses from Astellas, Medtronic, and Pfizer. All other authors declare no conflicts of interest”. This correction has been made to the online version as of Feb 3, 2012. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660714 Sat, 04 Feb 2012 05:00:00 +0100 5660714 http://www.medworm.com/index.php?rid=5660712&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960192-5%2Ffulltext%3Frss%3Dyes A 40-year-old woman was sent to our service for a bronchoscopy owing to multiple interstitial pulmonary infiltrates. She complained of a dry cough, dyspnoea, and wheezing of 4 months' duration. She also reported bronchospasm episodes in childhood. The patient had already been seen by three different clinicians and brought with her several test results, including a thorax CT. She had been treated with antibiotics, bronchodilators, and steroids, without improvement. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660712 Sat, 04 Feb 2012 05:00:00 +0100 5660712 http://www.medworm.com/index.php?rid=5660711&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960191-3%2Ffulltext%3Frss%3Dyes Your Editorial “Torture in Syria's hospitals” (Nov 5, p 1606) relays the allegation of Amnesty International's report that patients in state-run hospitals were being targeted and tortured by authorities to “quell dissent”. The undermining of the independence and work of medical personnel has unfortunately been a theme of recent conflicts. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660711 Sat, 04 Feb 2012 05:00:00 +0100 5660711 http://www.medworm.com/index.php?rid=5660710&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960190-1%2Ffulltext%3Frss%3Dyes I fully agree with Syed Wamique Yusuf that the governance of journals should be taken seriously. This is one of the functions of the Committee on Publication Ethics ( COPE). Since 2003, COPE has promoted a Code of Conduct among our members (which now number almost 7000 journal editors worldwide). If anybody feels that a member has not followed this code, they can bring a complaint against them which COPE will consider. The code states that journals should “preclude business needs from compromising intellectual standards” and goes on to state that “editors should make decisions on which articles to publish based on quality and suitability for readers rather than for immediate financial or political gain”. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660710 Sat, 04 Feb 2012 05:00:00 +0100 5660710 http://www.medworm.com/index.php?rid=5660708&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961922-3%2Ffulltext%3Frss%3Dyes Dengue fever is a mosquito-borne disease caused by dengue viruses—members of the family Flaviviridae. Severe forms of dengue infection can be fatal and are a leading cause of hospital admission in many parts of the world, placing tremendous pressure on medical resources and having a heavy economic and societal effect. There has been a 30-fold increase in the number of dengue cases over the past 50 years. Recent studies estimate 50–100 million infections each year, although, owing to under-reporting, this figure could be even higher. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660708 Sat, 04 Feb 2012 05:00:00 +0100 5660708 http://www.medworm.com/index.php?rid=5660707&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960188-3%2Ffulltext%3Frss%3Dyes In 2006, the Integrated Academic Training programme was initiated in the UK as a result of the Walport report on the crisis of decreasing clinical academic numbers. In Oxford, we decided that the most effective way to manage the programme would be to create a dedicated Oxford University Clinical Academic Graduate School ( OUCAGS). We wish to highlight both some advantages of this approach and challenges within the overall programme. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660707 Sat, 04 Feb 2012 05:00:00 +0100 5660707 http://www.medworm.com/index.php?rid=5660706&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960187-1%2Ffulltext%3Frss%3Dyes The International Food & Beverage Alliance (IFBA) includes ten global food and non-alcoholic beverage manufacturers (Coca-Cola Company, Ferrero, General Mills, Grupo Bimbo, Kellogg's, Kraft Foods, Mars, Nestlé, PepsiCo, and Unilever). Although we cannot speak for the entire food and non-alcoholic beverage industry, nor any other industry, our member companies support initiatives to address the global non-communicable disease (NCD) problem and commend the UN for bringing global attention to this issue, particularly in developing countries. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660706 Sat, 04 Feb 2012 05:00:00 +0100 5660706 http://www.medworm.com/index.php?rid=5660705&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960186-X%2Ffulltext%3Frss%3Dyes Pakistan lags far behind in meeting the Millennium Development Goals. Neonatal mortality is responsible for 57% of all deaths in children younger than 5 years in the country, and Pakistan has the highest neonatal mortality rate in the region. The under-5 mortality rate has decreased by 24% since 1990. However, both rates have remained more or less static in the poorest income quintile. With the devolution of the Ministry of Health last year, Pakistan faces the challenge of developing the much needed provincial infrastructure that would integrate the comprehensive efforts of various stakeholders in promoting better health outcomes. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660705 Sat, 04 Feb 2012 05:00:00 +0100 5660705 http://www.medworm.com/index.php?rid=5660704&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960185-8%2Ffulltext%3Frss%3Dyes Sania Nishtar and Ahmed Mehboob's discussion of the abolition of the Health Ministry in Pakistan raises the question of whether the health care problems in Pakistan could be solved by such a move. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660704 Sat, 04 Feb 2012 05:00:00 +0100 5660704 http://www.medworm.com/index.php?rid=5660702&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960183-4%2Ffulltext%3Frss%3Dyes Claire Slater and Alexander Ford note that all three treatments compared in our trial achieved eradication probabilities similar to those reported from previous community-based programmes of Helicobacter pylori screening and treatment and that the less-expensive concomitant regimen might be preferable to the more effective, but more costly, triple therapy regimen in a low-resource environment. We agree with both of these points and said as much in our report. The purchase price of the three regimens varied widely between the seven study sites, with a range of US$12–120 for 14-day triple therapy, $7–56 for 10-day sequential therapy, and $6–44 for 5-day concomitant therapy. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660702 Sat, 04 Feb 2012 05:00:00 +0100 5660702 http://www.medworm.com/index.php?rid=5660701&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960182-2%2Ffulltext%3Frss%3Dyes In their multisite study, Robert Greenberg and colleagues attempted to identify a reliably effective treatment for Helicobacter pylori for use in Latin America. Each study site used locally available drugs and the regimens all contained clarithromycin or clarithromycin–metronidazole, despite the unacceptably low success of triple therapies elsewhere and a high expected prevalence of metronidazole resistance. The success of treatments for infectious diseases is mainly related to the absence of antimicrobial resistance and is predictable if one knows the pattern of resistance and the effect of resistance on the regimens tested. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660701 Sat, 04 Feb 2012 05:00:00 +0100 5660701 http://www.medworm.com/index.php?rid=5660698&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960179-2%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660698 Sat, 04 Feb 2012 05:00:00 +0100 5660698 http://www.medworm.com/index.php?rid=5660697&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960178-0%2Ffulltext%3Frss%3Dyes The place that for many years served London's Middlesex Hospital as its Outpatient Department is not a beautiful building. Yet it's the oldest element of that great London hospital still standing on Cleveland Street, diagonally across from the vast field the institution used to fill, now sadly strewn with dust and broken bricks. This building has recently been the subject of a very public tussle: the owner intent on its replacement by a huge apartment block; locals and others (myself among them) equally determined to preserve it. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660697 Sat, 04 Feb 2012 05:00:00 +0100 5660697 http://www.medworm.com/index.php?rid=5660696&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960177-9%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660696 Sat, 04 Feb 2012 05:00:00 +0100 5660696 http://www.medworm.com/index.php?rid=5660695&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960176-7%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660695 Sat, 04 Feb 2012 05:00:00 +0100 5660695 http://www.medworm.com/index.php?rid=5660694&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960175-5%2Ffulltext%3Frss%3Dyes Arriving at Washington DC's Reagan National airport last year, I, like other visitors, was greeted with large signs featuring the Statue of Liberty and the words: “Welcome to America, home to 5% of the world's people and 25% of the world's prisoners.” The posters were produced by the National Association for the Advancement of Colored People (NAACP) to help publicise their “Misplaced Priority: Over Incarcerate, Under Educate” campaign. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660694 Sat, 04 Feb 2012 05:00:00 +0100 5660694 http://www.medworm.com/index.php?rid=5660693&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960174-3%2Ffulltext%3Frss%3Dyes Portugal's debt crisis is forcing hospital closures and hasty reform of the National Health Service, causing some observers to raise concerns about patient care. Gonçalo Figueiredo Augusto reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660693 Sat, 04 Feb 2012 05:00:00 +0100 5660693 http://www.medworm.com/index.php?rid=5660692&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960173-1%2Ffulltext%3Frss%3Dyes New NICE guidelines on epilepsies have come under fire by several experts who say that they do not reflect clinical experience and focus too much on drug cost effectiveness. David Holmes reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660692 Sat, 04 Feb 2012 05:00:00 +0100 5660692 http://www.medworm.com/index.php?rid=5660691&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960172-X%2Ffulltext%3Frss%3Dyes Ethical violations in clinical trials in India have exposed gaping holes in the country's regulatory system, which has struggled to oversee the booming industry. Amy Yee reports from New Delhi. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660691 Sat, 04 Feb 2012 05:00:00 +0100 5660691 http://www.medworm.com/index.php?rid=5660690&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960786-1%2Ffulltext%3Frss%3Dyes Harm-reduction programmes are remarkably successful in controlling HIV in injecting drug users worldwide, but more effort is needed to prevent even more HIV infections in this group. Recent reviews individual behavioural approaches, and medical treatment and care. Still, little is known about evidence-based educational intervention effects of harm-reduction programmes for injecting drug users. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660690 Sat, 04 Feb 2012 05:00:00 +0100 5660690 http://www.medworm.com/index.php?rid=5660689&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960899-4%2Ffulltext%3Frss%3Dyes Scientific papers on chronic fatigue syndrome (CFS) often evoke much debate and emotional reaction, as exemplified by the recent discussions in The Lancet on the PACE trial. Also, the potential role of a retrovirus in CFS kindled a fierce controversy which has recently culminated. In 2009, in Science, Lombardi and colleagues described the occurrence of the xenotropic murine leukaemia virus (MLV)-related virus (XMRV), a gammaretrovirus, in white blood cells in 67% of patients with CFS and in 3·7% of healthy controls. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660689 Sat, 04 Feb 2012 05:00:00 +0100 5660689 http://www.medworm.com/index.php?rid=5660688&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960156-1%2Ffulltext%3Frss%3Dyes Seen on a plate somewhere in Italy. Brains. Quite a delicacy. Not a chance. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660688 Sat, 04 Feb 2012 05:00:00 +0100 5660688 http://www.medworm.com/index.php?rid=5660687&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960167-6%2Ffulltext%3Frss%3Dyes Antisocial behaviour in adolescence can be associated with ill health in the form of self-harm, drug abuse, and mental disorders, and may presage criminal activity later in life. This is a worldwide problem with far-reaching social and economic implications, for individuals as well as for society as a whole. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660687 Sat, 04 Feb 2012 05:00:00 +0100 5660687 http://www.medworm.com/index.php?rid=5660686&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961671-1%2Ffulltext%3Frss%3Dyes “The rapid advances in cardiology during the first half of the 20th century may be fairly ascribed to the introduction of new techniques.”Paul Wood, 1951 (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660686 Sat, 04 Feb 2012 05:00:00 +0100 5660686 http://www.medworm.com/index.php?rid=5660685&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961788-1%2Ffulltext%3Frss%3Dyes The nature, scale, and interactions of behavioural disorders after neonatal and perinatal insults, including preterm birth and infectious diseases, are not well understood. In The Lancet, Michael Mwaniki and colleagues present a broad systematic review of the type and probability of development of a range of neurodevelopmental sequelae, in which they have included 153 research studies and 22 161 liveborn children. The authors report a very high overall prevalence of at least one deficit in any domain (median risk 39·4%, IQR 20·0–54·8%). (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660685 Sat, 04 Feb 2012 05:00:00 +0100 5660685 http://www.medworm.com/index.php?rid=5660684&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961823-0%2Ffulltext%3Frss%3Dyes This study comes 35 years after the first report of the benefit of adjuvant chemotherapy, and is the 16th publication in the group's 28-year history of bringing together individual patient data from all randomised trials worldwide. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660684 Sat, 04 Feb 2012 05:00:00 +0100 5660684 http://www.medworm.com/index.php?rid=5660683&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960119-6%2Ffulltext%3Frss%3Dyes The National Health Service (NHS) in England has been a leading international model of tax-financed, universal health care. Legal analysis shows that the Health and Social Care Bill currently making its way through the UK Parliament would abolish that model and pave the way for the introduction of a US-style health system by eroding entitlement to equality of health-care provision. The Bill severs the duty of the Secretary of State for Health to secure comprehensive health care throughout England and introduces competitive markets and structures consistent with greater inequality of provision, mixed funding, and widespread provision by private health corporations. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660683 Sat, 04 Feb 2012 05:00:00 +0100 5660683 http://www.medworm.com/index.php?rid=5660682&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960171-8%2Ffulltext%3Frss%3Dyes In July, 2011, the UK's medical regulator, the General Medical Council (GMC), was told by the Commons Health Select Committee to send a “clear signal” to doctors that they were failing in their duties if they did not report concerns about patients' safety. That signal has now come in Raising and acting on concerns about patient safety—new GMC guidance published on Jan 26, which advises doctors about the best ways to alert employers and health-care regulators about poor quality care. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660682 Sat, 04 Feb 2012 05:00:00 +0100 5660682 http://www.medworm.com/index.php?rid=5660681&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960170-6%2Ffulltext%3Frss%3Dyes An independent advisory group has urged the UK Government to integrate genomic medicine into the National Health Service (NHS). The Human Genomics Strategy Group (HGSG), established in 2010 after a House of Lords inquiry into genomic medicine, set out their recommendations in a report published on Jan 25. First, the group proposed that the government outline a policy for expansion of genomic technology in the NHS; HGSG emphasised that commissioning of cost-effectiveness studies will be a necessary step. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660681 Sat, 04 Feb 2012 05:00:00 +0100 5660681 http://www.medworm.com/index.php?rid=5660680&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960169-X%2Ffulltext%3Frss%3Dyes This week we publish surprising and, on the face of it, disturbing findings. According to Christopher Murray and colleagues at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, there were 1·24 million deaths (95% uncertainty interval 0·93–1·69 million) from malaria worldwide in 2010—around twice the figure of 655 000 estimated by WHO for the same year. How should the malaria community interpret this finding? Before we answer that question, we need to look beneath the surface of this striking overall mortality figure. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660680 Sat, 04 Feb 2012 05:00:00 +0100 5660680 http://www.medworm.com/index.php?rid=5660679&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960168-8%2Ffulltext%3Frss%3Dyes Leading influenza researchers have agreed to a voluntary 60-day pause on controversial research involving mutant H5N1 virus strains that are transmissible in mammals. In an announcement on Jan 20, the scientists said the hiatus will allow time for governments, organisations, and the scientific community to discuss potential safety concerns. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5660679 Sat, 04 Feb 2012 05:00:00 +0100 5660679 http://www.medworm.com/index.php?rid=5639289&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961652-8%2Ffulltext%3Frss%3Dyes In October, 2010, a 55-year-old woman was admitted to our department for investigation of recurrent ascites. She had a medical history of adult polycystic kidney disease with hepatic cysts. 9 months earlier, she had started peritoneal dialysis, which was changed to haemodialysis after 5 months because of poor catheter flows and underdialysis. Subsequently, she developed ascites which required frequent drainage. The fluid was borderline for transudate or exudate with no malignant cells and was initially attributed to peritoneal irritation from her dialysis catheter. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639289 Sat, 28 Jan 2012 05:00:00 +0100 5639289 http://www.medworm.com/index.php?rid=5639288&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960283-3%2Fabstract%3Frss%3Dyes Thalassaemia is one of the most common genetic diseases worldwide, with at least 60 000 severely affected individuals born every year. Individuals originating from tropical and subtropical regions are most at risk. Disorders of haemoglobin synthesis (thalassaemia) and structure (eg, sickle-cell disease) were among the first molecular diseases to be identified, and have been investigated and characterised in detail over the past 40 years. Nevertheless, treatment of thalassaemia is still largely dependent on supportive care with blood transfusion and iron chelation. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639288 Sat, 28 Jan 2012 05:00:00 +0100 5639288 http://www.medworm.com/index.php?rid=5639287&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960321-8%2Fabstract%3Frss%3Dyes Acne is a chronic inflammatory disease of the pilosebaceous unit resulting from androgen-induced increased sebum production, altered keratinisation, inflammation, and bacterial colonisation of hair follicles on the face, neck, chest, and back by Propionibacterium acnes. Although early colonisation with P acnes and family history might have important roles in the disease, exactly what triggers acne and how treatment affects the course of the disease remain unclear. Other factors such as diet have been implicated, but not proven. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639287 Sat, 28 Jan 2012 05:00:00 +0100 5639287 http://www.medworm.com/index.php?rid=5639286&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960242-0%2Fabstract%3Frss%3Dyes Cryoglobulins are immunoglobulins that precipitate in vitro at temperatures less than 37°C and produce organ damage through two main pathways: vascular sludging (hyperviscosity syndrome, mainly in type I cryoglobulinaemia) and immune-mediated mechanisms (principally vasculitis, in mixed cryoglobulinaemia). Cryoglobulinaemia is associated with many illnesses, which can be broadly grouped into infections, autoimmune disorders, and malignancies; the most common cause is infection with hepatitis C virus. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639286 Sat, 28 Jan 2012 05:00:00 +0100 5639286 http://www.medworm.com/index.php?rid=5639285&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961624-3%2Fabstract%3Frss%3Dyes A single oral dose of azithromycin is non-inferior to benzathine benzylpenicillin and avoids the need for injection equipment and medically trained personnel. A change to the simpler azithromycin treatment regimen could enable yaws elimination through mass drug administration programmes. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639285 Sat, 28 Jan 2012 05:00:00 +0100 5639285 http://www.medworm.com/index.php?rid=5639284&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961266-X%2Fabstract%3Frss%3Dyes The combined overall proportion of infants carrying a mutation for lysosomal storage disorders was higher than expected. Neonatal screening for lysosomal storage disorders is likely to raise challenges for primary health-care providers. Furthermore, the high frequency of late-onset mutations makes lysosomal storage disorders a broad health problem beyond childhood. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639284 Sat, 28 Jan 2012 05:00:00 +0100 5639284 http://www.medworm.com/index.php?rid=5639283&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961294-4%2Fabstract%3Frss%3Dyes Our analysis showed that self-monitoring and self-management of oral coagulation is a safe option for suitable patients of all ages. Patients should also be offered the option to self-manage their disease with suitable health-care support as back-up. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639283 Sat, 28 Jan 2012 05:00:00 +0100 5639283 http://www.medworm.com/index.php?rid=5639282&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961873-4%2Fabstract%3Frss%3Dyes Adjuvant capecitabine plus oxaliplatin treatment after curative D2 gastrectomy should be considered as a treatment option for patients with operable gastric cancer. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639282 Sat, 28 Jan 2012 05:00:00 +0100 5639282 http://www.medworm.com/index.php?rid=5639281&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961756-X%2Ffulltext%3Frss%3Dyes In your Editorial (Oct 1, p 1198), you rightly stress five reasons to ensure continued financing for the Global Fund as it undergoes necessary reforms. However, there is another compelling, often unremarked, reason to further support the Global Fund: the organisation accelerates the availability of better health products at better prices to developing countries, generating a global public good that maximises the value for money achieved by all global health donors. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639281 Sat, 28 Jan 2012 05:00:00 +0100 5639281 http://www.medworm.com/index.php?rid=5639280&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960148-2%2Ffulltext%3Frss%3Dyes David Holmes's Profile (Oct 22, p 1455) quoted Steve Wesselingh, the dean of Monash University, Melbourne, VIC, Australia, as stating: “academic institutions have an enormous amount of expertise and knowledge, but rarely are they engaged in the process of health and social policy”. The inaugural Inter Academy Medical Panel (IAMP) Young Physician Leaders (YPL) programme held during the third World Health Summit in Berlin, Germany, attempted to address this deficit. IAMP sent out a global call for nominations for physicians aged 40 years or younger with demonstrated leadership skills in medicine or public health, and 22 participants were chosen, representing 18 countries—low-income, middle-income, and high-income—and diverse physician specialties. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639280 Sat, 28 Jan 2012 05:00:00 +0100 5639280 http://www.medworm.com/index.php?rid=5639279&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960147-0%2Ffulltext%3Frss%3Dyes We thank Sarah Bell and colleagues for reinforcing the point that approval processes should be optimised, in terms of delay, without decreasing the rigour of these processes. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639279 Sat, 28 Jan 2012 05:00:00 +0100 5639279 http://www.medworm.com/index.php?rid=5639278&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960146-9%2Ffulltext%3Frss%3Dyes The Correspondence letter by Eloi Marijon and others (Aug 20, p 662) chastises the drug regulation authorities in Europe for the slowness of their assessment processes in the approval of new antithrombotic drugs for use in atrial fibrillation. They claim that the ROCKET-AF and RE-LY studies have shown these new drugs to be superior to vitamin K antagonists. Marijon and colleagues then go on to extrapolate the claimed advantages to the European population with atrial fibrillation and calculate the number of strokes that might have been saved by earlier introduction of these drugs. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639278 Sat, 28 Jan 2012 05:00:00 +0100 5639278 http://www.medworm.com/index.php?rid=5639277&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960145-7%2Ffulltext%3Frss%3Dyes Williams HC, Dellavalle RP, Garner S. Acne vulgaris. Lancet 2012; 379: 361–72—In this Seminar (Jan 28), an affiliation was missing for Sarah Garner. The affiliation should be “The Commonwealth Fund, New York, NY, USA”. This correction has been made to the online version as of Jan 27, 2012, and to the printed Seminar. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639277 Sat, 28 Jan 2012 05:00:00 +0100 5639277 http://www.medworm.com/index.php?rid=5639276&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960144-5%2Ffulltext%3Frss%3Dyes The need to establish quantitative and qualitative indices of scientific production by a researcher or institution is hotly debated. Worldwide, the impact factor and H-index are regarded as the best available. However, the question might arise: is an article written to be cited or to be read? (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639276 Sat, 28 Jan 2012 05:00:00 +0100 5639276 http://www.medworm.com/index.php?rid=5639275&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960143-3%2Ffulltext%3Frss%3Dyes ADDITION-Europe is not a trial of screening for diabetes. We reviewed the evidence for screening and identified the key uncertainties: the effect of early treatment in the lead time after detection by screening and the harms associated with screening. ADDITION-Europe addressed the effect of early treatment. Inclusion of a no-screening control group in one centre enabled us to add to the growing evidence of minimal harms associated with screening. A diagnosis of diabetes certainly has adverse consequences, which are brought forward by screening. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639275 Sat, 28 Jan 2012 05:00:00 +0100 5639275 http://www.medworm.com/index.php?rid=5639274&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960142-1%2Ffulltext%3Frss%3Dyes Intensive risk-factor control did not significantly reduce cardiovascular risk in people screened positive for diabetes in the ADDITION-Europe trial (July 9, p 156). Although the study might have been too small or too brief to show such an effect, the corollary is that absolute benefit is likely to be quite small. Were the benefit significant, it would have required screening of 1829 people, and treatment of 78 screen-positive ones, for 5·3 years to prevent one cardiovascular event. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639274 Sat, 28 Jan 2012 05:00:00 +0100 5639274 http://www.medworm.com/index.php?rid=5639273&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960141-X%2Ffulltext%3Frss%3Dyes Paul Ridker questions the ability of coronary artery calcium to identify appropriate patients for statin therapy. However, his implication that increased coronary artery calcium is a marker for poor response to statins is not supported by the available data. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639273 Sat, 28 Jan 2012 05:00:00 +0100 5639273 http://www.medworm.com/index.php?rid=5639272&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960140-8%2Ffulltext%3Frss%3Dyes The paper by Michael Blaha and colleagues adds to the debate on cardiovascular risk assessment by suggesting that coronary artery calcium could (1) further risk-stratify individuals eligible for the JUPITER trial, (2) be useful to target subgroups of patients for prevention, and (3) be better than high-sensitivity C-reactive protein (hsCRP) alone. Such claims, however, can hardly be solely based on effect sizes for the association of coronary artery calcium with cardiovascular outcomes. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639272 Sat, 28 Jan 2012 05:00:00 +0100 5639272 http://www.medworm.com/index.php?rid=5639270&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960138-X%2Ffulltext%3Frss%3Dyes Differences in results between de-Wahl Granelli and colleagues' study and ours are likely to have arisen because of antenatal screening and timing of pulse oximetry. Detection of critical congenital heart disease by antenatal ultrasound is very variable: we detected 50% of cases of critical congenital heart disease antenatally compared with only 3% in de-Wahl Granelli and colleagues' study. Detection rates of between 15% and 50% have been reported among UK health regions. We noted a lower incremental value of pulse oximetry than did de-Wahl Granelli and colleagues, almost certainly because many more cases were identified by antenatal screening in our study hospitals. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639270 Sat, 28 Jan 2012 05:00:00 +0100 5639270 http://www.medworm.com/index.php?rid=5639269&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960137-8%2Ffulltext%3Frss%3Dyes Although I agree that pulse oximetry is useful as an important vital sign monitor soon after birth, I have doubt in its value as a screening instrument for identifying congenital heart disease. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639269 Sat, 28 Jan 2012 05:00:00 +0100 5639269 http://www.medworm.com/index.php?rid=5639266&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960040-3%2Ffulltext%3Frss%3Dyes While WHO undergoes a wide-ranging reform sparked by a US$300 million budget shortfall, the agency is facing an exodus of qualified staff that is affecting its ability to work. The Executive Board is due to meet on Jan 16 to agree long-term principles and priorities for the organisation; it must ensure, in particular, that core functions are accorded the priority they merit. Oxfam is especially concerned that inadequate funding will severely diminish the WHO Essential Medicines Department, which for more than three decades has had an indispensable role in enabling developing countries to access affordable medicines. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639266 Sat, 28 Jan 2012 05:00:00 +0100 5639266 http://www.medworm.com/index.php?rid=5639265&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960134-2%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639265 Sat, 28 Jan 2012 05:00:00 +0100 5639265 http://www.medworm.com/index.php?rid=5639264&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960133-0%2Ffulltext%3Frss%3Dyes Efforts to find the “real Shakespeare” are fraught with pitfalls. Although ample documentation exists about his business dealings, evidence of the man's inner psychological processes—unfiltered through plays or poetry—is non-existent. Attempts to address the private life of Shakespeare often result in the critic projecting his or her own preoccupations onto the Bard and his works. A case in point is Sigmund Freud's insistence that Hamlet represented Shakespeare's reaction to the death of his father. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639264 Sat, 28 Jan 2012 05:00:00 +0100 5639264 http://www.medworm.com/index.php?rid=5639263&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961428-1%2Ffulltext%3Frss%3Dyes Multidrug-resistant (MDR) tuberculosis and extensively drug-resistant (XDR) tuberculosis have become an important health problem in many countries of the WHO European region and currently threaten global efforts to control tuberculosis. The highest rates occur predominantly in eastern Europe; however, population movement means that drug-resistant tuberculosis is a priority public health issue for all European countries. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639263 Sat, 28 Jan 2012 05:00:00 +0100 5639263 http://www.medworm.com/index.php?rid=5639262&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961884-9%2Ffulltext%3Frss%3Dyes “O that moral science were in as fair a way of improvement, that men would cease to be wolves to one another, and that human beings would at length learn what they now improperly call humanity!”Benjamin Franklin, 1780 (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639262 Sat, 28 Jan 2012 05:00:00 +0100 5639262 http://www.medworm.com/index.php?rid=5639261&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960132-9%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639261 Sat, 28 Jan 2012 05:00:00 +0100 5639261 http://www.medworm.com/index.php?rid=5639260&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960131-7%2Ffulltext%3Frss%3Dyes To the world at large, the late Joseph Rotblat is known as the Polish-born, British-based, scientist who worked on the Manhattan Project to build the atomic bomb, and for the rest of his life campaigned for the abolition of nuclear weapons. He, and the unofficial federation of European, American, Soviet, and other scientists that he founded, known as Pugwash, were jointly awarded the Nobel Peace Prize in 1995. To physicians, Rotblat is also known as a physicist who specialised in understanding the effects on living tissue of radiation and radioactive fallout and in developing nuclear medicine, through his long-held professorship of physics at St Bartholomew's Hospital in London. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639260 Sat, 28 Jan 2012 05:00:00 +0100 5639260 http://www.medworm.com/index.php?rid=5639259&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960130-5%2Ffulltext%3Frss%3Dyes The Wellcome Trust has a long track record of fostering science-art collaborations, but Playing Against Time must be one of the best. It focuses on the life and music of Barbara Thompson, one of Europe's finest jazz saxophonists, who in 1996 was diagnosed with Parkinson's disease. Since then she has continued composing and performing with the constant support of her partner, jazz/rock drummer Jon Hiseman. Film maker Mike Dibb describes Playing Against Time as “a film about Parkinson's disease seen through the prism of music”, and central to his film is Barbara and Jon's collaboration as wife and husband, patient and carer, saxophonist and drummer. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639259 Sat, 28 Jan 2012 05:00:00 +0100 5639259 http://www.medworm.com/index.php?rid=5639258&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960129-9%2Ffulltext%3Frss%3Dyes The Greek Government's austerity drive has inadvertently triggered problems with the country's drug supply, causing shortages of hundreds of medicines. Eva Karamanoli reports from Athens. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639258 Sat, 28 Jan 2012 05:00:00 +0100 5639258 http://www.medworm.com/index.php?rid=5639257&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960128-7%2Ffulltext%3Frss%3Dyes Safety flags for Boehringer Ingelheim's antiblood clotting agent dabigatran serve as a reminder about the risks of rapidly adopting newly approved drugs. Asher Mullard reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639257 Sat, 28 Jan 2012 05:00:00 +0100 5639257 http://www.medworm.com/index.php?rid=5639256&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960127-5%2Ffulltext%3Frss%3Dyes The long-running dispute over patents for the BRCA1 and BRCA2 genes granted to Myriad Genetics may finally be laid to rest by the US Supreme Court. Sharmila Devi reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639256 Sat, 28 Jan 2012 05:00:00 +0100 5639256 http://www.medworm.com/index.php?rid=5639255&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960126-3%2Ffulltext%3Frss%3Dyes While the cause of nodding syndrome in Africa continues to perplex scientists, they are hoping to soon unravel one mystery: which treatments the disease might respond to. John Donnelly reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639255 Sat, 28 Jan 2012 05:00:00 +0100 5639255 http://www.medworm.com/index.php?rid=5639254&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960109-3%2Ffulltext%3Frss%3Dyes Every 5 years in Britain, a gargantuan exercise in judging the performance of our research-based universities takes place. The Higher Education Funding Council of England (HEFCE), for example, will spend £1·6 billion in 2011–12 on research in English universities. (A friend of mine in Italy almost choked on his cappuccino when I told him this figure.) But how should HEFCE, and similar bodies in Wales, Scotland, and Northern Ireland, judge who gets what? In the past, institutions have competed in a Research Assessment Exercise. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639254 Sat, 28 Jan 2012 05:00:00 +0100 5639254 http://www.medworm.com/index.php?rid=5639253&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960117-2%2Ffulltext%3Frss%3Dyes We invite you to submit your best research in respiratory medicine for our annual respiratory theme issue, which will be published to coincide with the 2012 European Respiratory Society (ERS) conference in Vienna, Austria on Sept 1–5. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639253 Sat, 28 Jan 2012 05:00:00 +0100 5639253 http://www.medworm.com/index.php?rid=5639252&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961842-4%2Ffulltext%3Frss%3Dyes Yaws—an infectious disease caused by Treponema pallidum subsp pertenue—affects children and adults in poor rural communities in tropical countries, causing disfiguring lesions of the skin and bones. The yaws elimination programme coordinated by WHO in the 1950s and 1960s screened more than 160 million people, treated more than 50 million people with intramuscular injections of benzathine benzylpenicillin, and reduced the prevalence of yaws by more than 95%; however, yaws was not eliminated. This disease is now re-emerging (largely unnoticed) in parts of Africa, southeast Asia, and the Pacific islands. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639252 Sat, 28 Jan 2012 05:00:00 +0100 5639252 http://www.medworm.com/index.php?rid=5639251&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961744-3%2Ffulltext%3Frss%3Dyes Lysosomal storage disorders are a diverse group of more than 50 serious, progressive diseases. Until recently, treatment was symptomatic with the expected outcomes of great disability and premature death. Improvements in bone-marrow transplantation and development of recombinant enzyme replacement therapies for some of these disorders have raised the expectation that neonatal screening could enable early treatment before irreversible damage occurs. The greatly improved early outcomes of infants treated soon after birth following identification through the Taiwanese Pompe's disease screening programme add support to this contention, but long-term data are not yet available. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639251 Sat, 28 Jan 2012 05:00:00 +0100 5639251 http://www.medworm.com/index.php?rid=5639250&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961748-0%2Ffulltext%3Frss%3Dyes Vitamin K antagonists have been successfully used for more than 50 years as oral anticoagulant drugs in patients at risk of venous or arterial thromboembolism. Because of a narrow therapeutic window and an unpredictable dose response, regular laboratory monitoring is mandatory. A strong association exists between the intensity of anticoagulation and adverse clinical events, with an increased thrombotic risk at an international normalised ratio (INR) of less than 2·0 and an enhanced risk of bleeding when the INR exceeds 4·0. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639250 Sat, 28 Jan 2012 05:00:00 +0100 5639250 http://www.medworm.com/index.php?rid=5639249&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961928-4%2Ffulltext%3Frss%3Dyes Although adjuvant therapy for gastric cancer is known to improve prognosis, controversies remain about the choice of chemotherapeutic regimens, the use of radiation therapy, and the selection of patients who are likely to benefit from different therapies. Adjuvant therapy is used to eradicate potential micrometastases after curative surgery and, therefore, therapeutic strategies vary dependent on anticipated locoregional disease control after surgery, and by institution and country. It seems reasonable to apply adjuvant chemoradiotherapy, providing a combination of radiation therapy for local control and chemotherapy to achieve systemic control and radiosensitisation, to patients with less locoregional control; and systemic adjuvant chemotherapy to those with greater local control after su... LANCET journals http://www.medworm.com/rss/comments.php?id=5639249 Sat, 28 Jan 2012 05:00:00 +0100 5639249 http://www.medworm.com/index.php?rid=5639248&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960120-2%2Ffulltext%3Frss%3Dyes Leaders from international agencies, including WHO and the World Bank, charities, and pharmaceutical companies, together with politicians from donor and recipient countries, will meet in London on Jan 30, 2012, to pledge increased support and collaboration for the control of neglected tropical diseases (NTDs). A London Declaration from this meeting will mark an expanded vision from WHO for the elimination of some NTDs and improved implementation of control efforts for other NTDs by 2020. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639248 Sat, 28 Jan 2012 05:00:00 +0100 5639248 http://www.medworm.com/index.php?rid=5639247&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960125-1%2Ffulltext%3Frss%3Dyes “Academic publishers have become the enemies of science.” So wrote Dr Mike Taylor, a scientist at the UK's University of Bristol. He, and many scientists like him, are angry that publishers are supporting the Research Works Act (RWA), a controversial Bill before the US Congress. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639247 Sat, 28 Jan 2012 05:00:00 +0100 5639247 http://www.medworm.com/index.php?rid=5639246&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960124-X%2Ffulltext%3Frss%3Dyes In an episode of the science fiction series Star Trek: Deep Space Nine, a trio of capitalist aliens find themselves thrown back in time to 1947. They are overjoyed to discover human beings—including medical staff—smoking tobacco. “If they'll buy poison, they'll buy anything!” cackles one of the protagonists, smelling a profit. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639246 Sat, 28 Jan 2012 05:00:00 +0100 5639246 http://www.medworm.com/index.php?rid=5639245&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960123-8%2Ffulltext%3Frss%3Dyes In this week's Perspectives section, Hilary and Steven Rose describe the moving film Playing Against Time. This film describes the life and music of Barbara Thompson, a jazz saxophonist, and her efforts to continue with her music despite the diagnosis of Parkinson's disease in 1996, including her struggle to obtain care and treatment. The diagnosis of a neurological disorder, such as Parkinson's disease, multiple sclerosis, or motor neuron disease, is a devastating one. Not only is there no cure—treatment will at best delay progression—there is also the predicament of a continuing decline in health, functioning, and quality of life, and a long-term reliance on professionals within the health and social care system. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639245 Sat, 28 Jan 2012 05:00:00 +0100 5639245 http://www.medworm.com/index.php?rid=5639244&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960122-6%2Ffulltext%3Frss%3Dyes At the end of 2011, China's urban population overtook its rural population for the first time. The National Bureau of Statistics reports that 51·3% of the country's 1·35 billion people now live in cities. For an economy at China's stage of development, this ratio is still low, possibly due to past constraints on free movement. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5639244 Sat, 28 Jan 2012 05:00:00 +0100 5639244 http://www.medworm.com/index.php?rid=5610672&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961579-1%2Ffulltext%3Frss%3Dyes A 43-year-old Nigerian man presented in April, 2010, with a 1 week history of progressive left leg weakness, urinary incontinence, and weight loss. Neurological examination showed left-sided neglect and hemiparesis. Physical examination was otherwise unremarkable. Blood test results were normal. MRI of the brain showed multiple bilateral ring-enhancing lesions; the largest was centred on the right basal ganglia with pronounced mass effect (). Treatment for cerebral toxoplasmosis was initiated with sulfadiazine (15 mg/kg, four times daily), pyrimethamine (200 mg loading dose followed by 75 mg daily), and folinic acid (10 mg daily). (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610672 Fri, 20 Jan 2012 23:31:02 +0100 5610672 http://www.medworm.com/index.php?rid=5610671&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960069-X%2Fabstract%3Frss%3Dyes Health is the result of biological and social determinants; both are important. Nature dictates the laws for biological determinants; people create the laws for social determinants. Nature's laws are hard to discover and are eternal whether or not they suit humanity; people's laws are easily written and can be changed at anytime to suit humanity better. So why is it that the public health community, which expends much effort and expense probing natural laws, places negligible emphasis on collection, analysis, and making greater use of the world's public health laws? (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610671 Fri, 20 Jan 2012 23:31:02 +0100 5610671 http://www.medworm.com/index.php?rid=5610670&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960051-2%2Fabstract%3Frss%3Dyes We undertook a systematic search and review of individual, family, community, and societal risk and protective factors for mental health in children and adolescents who are forcibly displaced to high-income countries. Exposure to violence has been shown to be a key risk factor, whereas stable settlement and social support in the host country have a positive effect on the child's psychological functioning. Further research is needed to identify the relevant processes, contexts, and interplay between the many predictor variables hitherto identified as affecting mental health vulnerability and resilience. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610670 Fri, 20 Jan 2012 23:31:02 +0100 5610670 http://www.medworm.com/index.php?rid=5610669&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960050-0%2Fabstract%3Frss%3Dyes Children and adolescents who are forcibly displaced represent almost half the world's internally displaced and refugee populations. We undertook a two-part systematic search and review of the evidence-base for individual, family, community, and societal risk and protective factors for the mental health outcomes of children and adolescents. Here we review data for displacement to low-income and middle-income settings. We draw together the main findings from reports to identify important issues and establish recommendations for future work. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610669 Fri, 20 Jan 2012 23:31:02 +0100 5610669 http://www.medworm.com/index.php?rid=5610668&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960703-4%2Ffulltext%3Frss%3Dyes In 2003, after the second Gulf War, the authors were medical doctors at the humanitarian Mission of the Red Cross Field Hospital in Baghdad, Iraq. Our experience in the field indicated that civilians were at a high risk for injuries caused by stray bullets. Whilst we were attending an out-patient activity, we saw a 10-year old boy with a deep lesion of the skin in the left frontal-parietal area of his head caused by a stray bullet 2 months earlier. The bullet had entered the upper parietal portion of the skull (). (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610668 Fri, 20 Jan 2012 23:31:02 +0100 5610668 http://www.medworm.com/index.php?rid=5610667&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961306-8%2Fabstract%3Frss%3Dyes Autoimmune disorders are associated with a high risk of pulmonary embolism in the first year after hospital admission. Our findings suggest that these disorders in general should be regarded as hypercoagulable disorders. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610667 Fri, 20 Jan 2012 23:31:02 +0100 5610667 http://www.medworm.com/index.php?rid=5610666&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961141-0%2Fabstract%3Frss%3Dyes Most self-harming behaviour in adolescents resolves spontaneously. The early detection and treatment of common mental disorders during adolescence might constitute an important and hitherto unrecognised component of suicide prevention in young adults. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610666 Fri, 20 Jan 2012 23:31:02 +0100 5610666 http://www.medworm.com/index.php?rid=5610665&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961623-1%2Fabstract%3Frss%3Dyes Treatment with intravenous salbutamol early in the course of ARDS was poorly tolerated. Treatment is unlikely to be beneficial, and could worsen outcomes. Routine use of β-2 agonist treatment in ventilated patients with this disorder cannot be recommended. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610665 Fri, 20 Jan 2012 23:31:02 +0100 5610665 http://www.medworm.com/index.php?rid=5610664&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961653-X%2Fabstract%3Frss%3Dyes Nevirapine prophylaxis can safely be used to provide protection from mother-to-child transmission of HIV-1 via breastfeeding for infants up to 6 months of age. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610664 Fri, 20 Jan 2012 23:31:02 +0100 5610664 http://www.medworm.com/index.php?rid=5610663&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960106-8%2Ffulltext%3Frss%3Dyes The Lancet NCD Action Group and the NCD Alliance highlight links between non-communicable diseases (NCDs) and some vulnerable groups such as children, young people, women, people with disabilities, and people living in poverty. They acknowledge that “policies, strategies, plans, and calls to action are common in international and national reports” but also note that their “implementation has been slow”. Although calls to action might well exist, the commitment to addressing such calls to the needs of vulnerable and marginalised groups remains largely untested. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610663 Fri, 20 Jan 2012 23:31:02 +0100 5610663 http://www.medworm.com/index.php?rid=5610662&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960105-6%2Ffulltext%3Frss%3Dyes Scaling up of mental health care is a global priority in low-income and middle-income countries, given the tremendous gap between needs and treatment. In Brazil, increased funding for mental health care and improved access have been reported (Oct 29, p 1592). Although these changes are noteworthy, little attention has been paid to the assessment of these initiatives. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610662 Fri, 20 Jan 2012 23:31:02 +0100 5610662 http://www.medworm.com/index.php?rid=5610661&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960104-4%2Ffulltext%3Frss%3Dyes Zhiping Yang and Daiming Fan again bring the notorious Bribegate in Chinese hospitals to public attention. As they point out, Bribegate is just the tip of the iceberg. We do not argue against the need for stricter regulations and salary reform to stop corruption of medical workers by pharmaceutical companies. However, medical bribery seems to be more of a social problem than simply a vocational one. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610661 Fri, 20 Jan 2012 23:31:02 +0100 5610661 http://www.medworm.com/index.php?rid=5610659&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960102-0%2Ffulltext%3Frss%3Dyes Sube Banerjee and colleagues (July 30, p 403) report on sertraline (a Selective Serotonin Reuptake Inhibitor [SSRI]) or mirtazapine (a noradrenergic and specific serotonergic antidepressant) for treatment of depression in people with dementia (HTT-SADD trial). They show that (1) neither compound is superior to placebo in resolving symptoms of depression, and (2) there is a higher rate of adverse events associated with treatment than with placebo. Their findings seem to be consistent with those of other sertraline trials. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610659 Fri, 20 Jan 2012 23:31:02 +0100 5610659 http://www.medworm.com/index.php?rid=5610658&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960101-9%2Ffulltext%3Frss%3Dyes We thank the SCOT principal investigators Keith Sullivan and Daniel Furst, and their colleagues, for comments on our study. First, crossover in ASSIST was allowed at 12 months, not 6 months. The optimum dose or duration of cyclophosphamide treatment that will improve lung function is unknown since no published studies document an improvement in lung function with cyclophosphamide. Second, Sullivan and colleagues' criticism of defining disease progression on the basis of only Rodnan skin score (mRSS) and forced vital capacity (FVC) endpoints overlooks the fact that the endpoints mRSS, FVC, high-resolution CT imaging of involved lung, and 36-item Short Form Health Survey (SF-36) all changed equally in our study. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610658 Fri, 20 Jan 2012 23:31:02 +0100 5610658 http://www.medworm.com/index.php?rid=5610657&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960100-7%2Ffulltext%3Frss%3Dyes Richard Burt and colleagues (Aug 6, p 498) propose, on the basis of a single-centre trial of 19 patients, that autologous haemopoietic stem-cell transplantation (HSCT) might be the new standard of care for diffuse systemic sclerosis. Although the study strongly supports the use of immunosuppression in systemic sclerosis, several limitations are to be noted. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610657 Fri, 20 Jan 2012 23:31:01 +0100 5610657 http://www.medworm.com/index.php?rid=5610656&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960099-3%2Ffulltext%3Frss%3Dyes Your correspondents focus rather narrowly on four issues surrounding our review of novel melatonin-based treatments: the efficacy of agomelatine, the clinical significance of agomelatine for managing depression, the comparative side-effect profile of this compound, and our professional relationships with its manufacturer (Servier Laboratories). (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610656 Fri, 20 Jan 2012 23:31:01 +0100 5610656 http://www.medworm.com/index.php?rid=5610655&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960098-1%2Ffulltext%3Frss%3Dyes Ian Hickie and Naomi Rogers suggest that agomelatine, a synthetic (and therefore copyrightable) melatonin-based therapy, has promising antidepressant properties with minimal side-effects. However, they suggest that the naturally occurring hormone melatonin does not seem to be an effective antidepressant in human beings and cite Carman and colleagues' seriously flawed work as evidence. In that study, eight patients, with multiple diagnoses, received massive doses of melatonin, in some cases throughout the day and intravenously. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610655 Fri, 20 Jan 2012 23:31:01 +0100 5610655 http://www.medworm.com/index.php?rid=5610649&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960092-0%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610649 Fri, 20 Jan 2012 23:31:01 +0100 5610649 http://www.medworm.com/index.php?rid=5610648&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960091-9%2Ffulltext%3Frss%3Dyes When did medicine first pay attention to the development of the child mind? Most histories would focus on the early 20th century, but that is to ignore the important pre-history of the Victorian era, when early psychiatric writings on childhood were emerging in tandem with the great Victorian novels of childhood and new ways of thinking about the child mind were being constructed in the novels of Charles Dickens, Charlotte Brontë, and George Eliot. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610648 Fri, 20 Jan 2012 23:31:01 +0100 5610648 http://www.medworm.com/index.php?rid=5610647&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960090-7%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610647 Fri, 20 Jan 2012 23:31:01 +0100 5610647 http://www.medworm.com/index.php?rid=5610646&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960089-0%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610646 Fri, 20 Jan 2012 23:31:01 +0100 5610646 http://www.medworm.com/index.php?rid=5610645&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960088-9%2Ffulltext%3Frss%3Dyes Panasonic's Toughbook range has been the inspiration for many YouTube videos, in which you will see these machines being dropped, doused with water, and in one case run over by a car. Apparently technology reviewers see the “unbreakable” tag less as a feature, and more as a challenge. I've managed to get hold of the medical version of the Toughbook—the H2—and I'm pleased to say there's more to it than just robustness. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610645 Fri, 20 Jan 2012 23:31:01 +0100 5610645 http://www.medworm.com/index.php?rid=5610644&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960087-7%2Ffulltext%3Frss%3Dyes After bravely ushering in alcohol sale restrictions proposed by its residents, a remote Western Australian community is tackling the long-term effects of alcohol misuse. Tony Kirby reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610644 Fri, 20 Jan 2012 23:31:01 +0100 5610644 http://www.medworm.com/index.php?rid=5610643&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960086-5%2Ffulltext%3Frss%3Dyes Hospitals in Germany are bracing themselves for a mass walkout next week as thousands of doctors are due to strike over poor pay and work conditions. Ed Holt reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610643 Fri, 20 Jan 2012 23:31:01 +0100 5610643 http://www.medworm.com/index.php?rid=5610642&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960085-3%2Ffulltext%3Frss%3Dyes Mismanagement of tuberculosis in Mumbai has led to the emergence of India's first known cases of a totally drug-resistant form of the disease, say doctors. Samuel Loewenberg reports. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610642 Fri, 20 Jan 2012 23:31:01 +0100 5610642 http://www.medworm.com/index.php?rid=5610641&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960137-2%2Ffulltext%3Frss%3Dyes Recently, China's Ministry of Health has continually declared that it will intensify its crackdown on bribery in hospitals, after news of a corruption scandal involving dozens of doctors in east China broke. An online post on Nov 15, 2010 alleged that dozens of doctors at several hospitals in Hangzhou, Zhejiang province, were taking bribes from a health-care company. The doctors were said to have taken cash, motor oil, shopping cards, and digital cameras from a local medical device company, duly buying the company's products in return. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610641 Fri, 20 Jan 2012 23:31:01 +0100 5610641 http://www.medworm.com/index.php?rid=5610640&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960031-2%2Ffulltext%3Frss%3Dyes One of the largest recent cholera epidemics to affect a single country began in Haiti in October, 2010, just 10 months after a devastating earthquake had struck the nation's capital. Within a month, cholera had spread throughout Haiti and cases were being reported by its shared island neighbour, the Dominican Republic. In Dec, 2011, 522 335 cholera cases and 7001 deaths had been reported in Haiti, with an additional 21 432 cases and 363 deaths reported in the Dominican Republic. The 2-year anniversary of the earthquake is an opportune time to refocus national and international efforts on the elimination of cholera transmission in Hispaniola. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610640 Fri, 20 Jan 2012 23:31:01 +0100 5610640 http://www.medworm.com/index.php?rid=5610639&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960070-1%2Ffulltext%3Frss%3Dyes July 7, 2011: 19 members of the UK's Committee on the Safety of Devices (CSD), together with representatives from the Medicines and Healthcare products Regulatory Agency (MHRA) and industry, gather in London to hear a disturbing presentation by Brian Toft, Professor of Patient Safety at Coventry University. Prof Toft had contacted MHRA to express concern about the CE marking process—the method by which medical devices are approved. His presentation was entitled “The Current Regulatory System: Fit for Purpose?” His answer was “no for the people that just do the paperwork and move on, hiding under the CE marking”. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610639 Fri, 20 Jan 2012 23:31:01 +0100 5610639 http://www.medworm.com/index.php?rid=5610638&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961312-3%2Ffulltext%3Frss%3Dyes International Youth Day, on Aug 12, 2011, marked the end of the International Year of Youth, which the UN dedicated to the promotion of dialogue and mutual understanding between governments and young people. The occasion created an opportunity to look back and remember the value of meeting the needs of young people. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610638 Fri, 20 Jan 2012 23:31:01 +0100 5610638 http://www.medworm.com/index.php?rid=5610637&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961270-1%2Ffulltext%3Frss%3Dyes I was diagnosed with schizophrenia in 1991, and as such I have experienced mental health care and the challenges that come with it, from abuse—both physical and emotional—in psychiatric institutions, to inadequate mental health-care services and the detrimental effects of stigma and discrimination. I have spoken to many people with mental illnesses, which has allowed me to gain insight into the flaws and shortcomings of mental health-care services, and the needs of people using these services in South Africa. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610637 Fri, 20 Jan 2012 23:31:01 +0100 5610637 http://www.medworm.com/index.php?rid=5610636&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961510-9%2Ffulltext%3Frss%3Dyes In The Lancet, Bengt Zöller and colleagues have obtained data from the MigMed2 database (constructed from several national Swedish data registers) and report analyses to show that pulmonary embolism is a serious problem in patients with autoimmune disease. The investigators’ conclusion that autoimmune disorders should be regarded as hypercoagulable is well validated in their study. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610636 Fri, 20 Jan 2012 23:31:01 +0100 5610636 http://www.medworm.com/index.php?rid=5610635&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961260-9%2Ffulltext%3Frss%3Dyes Results of several school-based community studies have shown that self-harm (intentional self-injury or self-poisoning) is very common in adolescents, being reported by around 10% of 15 and 16 year olds, In The Lancet Paul Moran and colleagues report a study in which they found that about 8% of adolescents in a sample of nearly 2000 Australian pupils, recruited from schools in the state of Victoria, said they had self-harmed. As in other studies, self-harm was more frequent in girls than boys (risk ratio 1·6, 95% CI 1·2–2·2), and the most common method was self-cutting, which is by stark contrast with the pattern in samples presenting to hospitals, in which overdoses predominate. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610635 Fri, 20 Jan 2012 23:31:01 +0100 5610635 http://www.medworm.com/index.php?rid=5610634&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961845-X%2Ffulltext%3Frss%3Dyes In The Lancet, Fang Gao Smith and the BALTI-2 study investigators report the findings of their phase-3 randomised trial of intravenous salbutamol for acute respiratory distress syndrome (ARDS). The trial, based on reliable preclinical evidence and an encouraging phase-2 trial, was stopped early because of safety concerns. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610634 Fri, 20 Jan 2012 23:31:01 +0100 5610634 http://www.medworm.com/index.php?rid=5610633&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960084-1%2Ffulltext%3Frss%3Dyes The world faces many challenges due to limited natural resources and the environmental and political consequences of using and managing scarce resources. The human consequences of natural disasters, conflict, and climate change look set to worsen. One solution is a resource that is genuinely unlimited and renewable, if well managed: knowledge. In science and technology, knowledge is an indispensable ingredient for progress. Within health care, it is key to the challenges of minimising potential harms and costs, while improving health and wellbeing. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610633 Fri, 20 Jan 2012 23:31:01 +0100 5610633 http://www.medworm.com/index.php?rid=5610632&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960083-X%2Ffulltext%3Frss%3Dyes The greatest burden of surgically treatable diseases falls on people in developing countries, but the poorest third of people receive only 3·5% of operations and have the lowest numbers of surgeons per head of population. These statistics, combined with the emphasis on reducing global deaths from infectious diseases, make surgery feel like a neglected specialty in the current global health arena. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610632 Fri, 20 Jan 2012 23:31:01 +0100 5610632 http://www.medworm.com/index.php?rid=5610631&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960082-8%2Ffulltext%3Frss%3Dyes Last year, the UK Government decided that gently “nudging” people to change their unhealthy behaviours was the key to public health—a strategy that many public health experts and a report by the House of Lords Science and Technology Sub-Committee criticised as ineffective. Now the government is backing something that could easily be called the nag approach. According to the latest report by the NHS Future Forum, a strangely composed group that acts as a cover for the government's efforts to privatise the NHS, health service staff should “use every contact with patients and the public to help them maintain and improve their physical and mental health and wellbeing”. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610631 Fri, 20 Jan 2012 23:31:01 +0100 5610631 http://www.medworm.com/index.php?rid=5610630&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960081-6%2Ffulltext%3Frss%3Dyes In 2012 there will be a major strategic shift in global health, away from development and towards sustainability. Since 2000, the Millennium Development Goals (MDGs), driven by a macroeconomic diagnosis of global poverty, have focused on investment in a small number of diseases as the most effective approach to decrease poverty. Institutions such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, Roll Back Malaria, and GAVI have been created to respond to that diagnosis. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610630 Fri, 20 Jan 2012 23:31:01 +0100 5610630 http://www.medworm.com/index.php?rid=5610629&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960080-4%2Ffulltext%3Frss%3Dyes Public health professionals in the USA have called for a comprehensive investigation into the health effects of hydraulic fracturing (“fracking”) used in shale gas production. Participants at a conference on Jan 9, in Arlington, VA, expressed concern that not enough is known about the health effects of the technology, particularly with regard to possible water and air pollution. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5610629 Fri, 20 Jan 2012 23:31:01 +0100 5610629 http://www.medworm.com/index.php?rid=5599076&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961588-2%2Ffulltext%3Frss%3Dyes In October, 2010, a 20-year-old man was referred to us after having been admitted to hospital four times with community acquired pneumonia since the age of 16 years. His recurrent symptoms included a productive cough, lethargy, fever, night sweats, and rigors. Apart from childhood asthma, he had no important medical history of respiratory illness. He was a life-long non-smoker and denied illicit drug use. Auscultation of the chest showed equal air entry to the lung fields with mild crepitations in the left lower zone posteriorly. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599076 Sat, 14 Jan 2012 05:00:00 +0100 5599076 http://www.medworm.com/index.php?rid=5599075&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961088-X%2Ffulltext%3Frss%3Dyes The UK coalition Government's plans to make groups of general practices responsible for commissioning health services have attracted much attention. Investigation of the experiences of other countries in which doctors control budgets could help the UK to understand how these plans might work. We visited the USA in March 2011 to learn how medical groups manage the budgets that they negotiate with health insurers and how they work with hospitals to control costs and improve outcomes. Our report describes what we learnt and identifies several lessons for the National Health Service (NHS), as the government's plans to establish clinical commissioning groups are taken forward. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599075 Sat, 14 Jan 2012 05:00:00 +0100 5599075 http://www.medworm.com/index.php?rid=5599074&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961506-7%2Fabstract%3Frss%3Dyes SummaryHealth inequalities are present throughout the world, both within and between countries. The Commission on Social Determinants of Health drew attention to dramatic social gradients in health within most countries and made proposals for action. These inequalities are not inevitable. The purpose of this article is to report on activity that has taken place worldwide after the report by the Commission on Social Determinants of Health. First, we summarise the global situation. Second, we summarise an interim report of the emerging findings from an independent review of social determinants and the health divide, which was commissioned by the WHO European region. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599074 Sat, 14 Jan 2012 05:00:00 +0100 5599074 http://www.medworm.com/index.php?rid=5599073&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960178-5%2Fabstract%3Frss%3Dyes SummaryChronic kidney disease is a general term for heterogeneous disorders affecting kidney structure and function. The 2002 guidelines for definition and classification of this disease represented an important shift towards its recognition as a worldwide public health problem that should be managed in its early stages by general internists. Disease and management are classified according to stages of disease severity, which are assessed from glomerular filtration rate (GFR) and albuminuria, and clinical diagnosis (cause and pathology). (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599073 Sat, 14 Jan 2012 05:00:00 +0100 5599073 http://www.medworm.com/index.php?rid=5599072&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2810%2962352-5%2Fabstract%3Frss%3Dyes SummaryMeasles is a highly contagious disease caused by measles virus and is one of the most devastating infectious diseases of man—measles was responsible for millions of deaths annually worldwide before the introduction of the measles vaccines. Remarkable progress in reducing the number of people dying from measles has been made through measles vaccination, with an estimated 164 000 deaths attributed to measles in 2008. This achievement attests to the enormous importance of measles vaccination to public health. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599072 Sat, 14 Jan 2012 05:00:00 +0100 5599072 http://www.medworm.com/index.php?rid=5599071&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2960818-0%2Ffulltext%3Frss%3Dyes (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599071 Sat, 14 Jan 2012 05:00:00 +0100 5599071 http://www.medworm.com/index.php?rid=5599070&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961515-8%2Fabstract%3Frss%3Dyes SummaryBackgroundIn trachoma control programmes, azithromycin is distributed to treat the strains of chlamydia that cause ocular disease. We aimed to compare the effect of annual versus twice-yearly distribution of azithromycin on infection with these strains.MethodsWe did a cluster-randomised trial in 24 subdistricts in northern Ethiopia, which we randomly assigned to receive annual or twice-yearly treatment for all residents of all ages. Random assignment was done with the RANDOM and SORT functions of Microsoft Excel. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599070 Sat, 14 Jan 2012 05:00:00 +0100 5599070 http://www.medworm.com/index.php?rid=5599069&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961483-9%2Fabstract%3Frss%3Dyes This study was undertaken at two UK centres in Manchester and Oxford between April, 2006, and November, 2008. We used whole-body CT and MRI followed by full autopsy to investigate a series of adult deaths that were reported to the coroner. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599069 Sat, 14 Jan 2012 05:00:00 +0100 5599069 http://www.medworm.com/index.php?rid=5599068&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961265-8%2Fabstract%3Frss%3Dyes SummaryBackgroundIndications for chemotherapy in gestational trophoblastic disease include raised human chorionic gonadotropin (hCG) concentrations 6 months after uterine evacuation of hydatidiform mole, even when values are falling. We aimed to establish whether chemotherapy is always necessary in these patients.MethodsWe retrospectively identified women registered between January, 1993, and May, 2008, at Charing Cross Hospital, London, UK, who had persistently high hCG concentrations 6 months after evacuation of hydatidiform mole. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599068 Sat, 14 Jan 2012 05:00:00 +0100 5599068 http://www.medworm.com/index.php?rid=5599067&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961505-5%2Fabstract%3Frss%3Dyes SummaryBackgroundTreatment of pulmonary embolism with low-molecular-weight heparin and vitamin K antagonists, such as warfarin, is not ideal. We aimed to assess non-inferiority of idrabiotaparinux, a reversible longlasting indirect inhibitor of activated factor X, to warfarin in patients with acute symptomatic pulmonary embolism.MethodsIn our randomised, double-blind, double-dummy, non-inferiority trial, we enrolled adults with objectively documented acute symptomatic pulmonary embolism attending 291 centres in 37 countries. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599067 Sat, 14 Jan 2012 05:00:00 +0100 5599067 http://www.medworm.com/index.php?rid=5599066&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960065-8%2Ffulltext%3Frss%3Dyes Mehilli J, Pache J, Abdel-Wahab M, et al, for the Is Drug-Eluting-Stenting Associated with Improved Results in Coronary Artery Bypass Grafts? (ISAR-CABG) Investigators. Drug-eluting versus bare-metal stents in saphenous vein graft lesions (ISAR-CABG): a randomised controlled superiority trial. Lancet 2011;378: 1071–78—In table 1 of this Article (Sept 17), the mean age of the drug-eluting stent group should have been 71·4 (9·0) years. This correction has been made to the online version as of Jan 13. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599066 Sat, 14 Jan 2012 05:00:00 +0100 5599066 http://www.medworm.com/index.php?rid=5599065&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960064-6%2Ffulltext%3Frss%3Dyes Satyakam Bhagavati questions the choice of biochemical outcome measures in our systemic phase 2 exon-skipping study of Duchenne muscular dystrophy. He suggests two RNA-based assays (quantitative RNAse protection and northern-blot analysis), which are theoretically feasible but difficult to do and limited in their scope. To assess exon skipping at the RNA level, we used the standard methods that are regularly used on both animal and human tissue, and in all the published clinical trials to date. We detailed the RNA results in the original webappendix and, although we acknowledge that the methods of RNA detection used are not fully quantitative, the main aim of the study was that of increasing protein expression in these boys. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599065 Sat, 14 Jan 2012 05:00:00 +0100 5599065 http://www.medworm.com/index.php?rid=5599064&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960063-4%2Ffulltext%3Frss%3Dyes Sebahattin Cirak and colleagues (Aug 13, p 595) report impressive results with systemic exon-skipping therapy for patients with Duchenne muscular dystrophy. However, reliance on immunohistochemistry and western blots alone could be very misleading. Of other factors, non-specific, false-positive signals from muscle membrane and inaccurate immunoblot quantitation because of biopsy sample variations are difficult to eliminate. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599064 Sat, 14 Jan 2012 05:00:00 +0100 5599064 http://www.medworm.com/index.php?rid=5599063&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960062-2%2Ffulltext%3Frss%3Dyes Pierre Pasquier and colleagues make the valuable point that coalition soldiers' use of tourniquets in the field might have contributed to our study's finding that fewer coalition soldiers than Iraqi civilians were killed per lethal suicide bombing in Iraq, and to the lower lethality of armed violence generally to US soldiers than to Iraqi civilians. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599063 Sat, 14 Jan 2012 05:00:00 +0100 5599063 http://www.medworm.com/index.php?rid=5599062&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2812%2960061-0%2Ffulltext%3Frss%3Dyes In their Article (Sept 3, p 906), Madelyn Hicks and colleagues describe casualties from suicide bombs in Iraq during 2003–10. During the studied period, lethality was significantly higher for Iraqi civilians than for coalition soldiers. Hicks and colleagues speculate that difficult access to adequate hospital treatment for Iraqi civilians could mainly explain this difference in mortality. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599062 Sat, 14 Jan 2012 05:00:00 +0100 5599062 http://www.medworm.com/index.php?rid=5599061&cid=s_30418_22_f&fid=30418&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736%2811%2961855-2%2Ffulltext%3Frss%3Dyes The Government of the Netherlands has announced that it is all but closing down its tobacco control operations. It has already weakened its existing smoke-free laws. It will reverse a previous decision to ensure that smokers who want to stop but cannot do so by themselves receive evidence-based treatment to help them. And it plans to close down the world-renowned national centre on tobacco control, STIVORO. This at a time when smoking prevalence in the Netherlands is relatively high among western countries at 27%, resulting in an estimated almost 20 000 premature deaths per year. (Source: LANCET) LANCET journals http://www.medworm.com/rss/comments.php?id=5599061 Sat, 14 Jan 2012 05:00:00 +0100 5599061