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[Case Report] Two red eyes and one asymptomatic donorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In October, 2008, a 30-year-old man underwent penetrating keratoplasty (PK) for keratoconus. A week later, he presented with ocular pain, ciliary injection, and graft oedema, with keratic precipitates. Despite treatment with antibiotics and steroids there was no improvement, and he underwent a re-grafting procedure in November. Analysis of the excised corneal button showed the presence of acanthamoeba cysts deeply embedded within the stroma (). We treated him with topical hexamidine and 0·02% polihexanide. Keratitis recurred and a third PK was done in February, 2009, after the second graft melted. When last seen, in June,...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Davide Camposampiero, Guido Caramello, Patricia Indemini, Georg Gerten, Antonella Franch, Federica Birattari, Pietro Maria Donisi, Adolfo Paolin, Stefano Ferrari, Diego Ponzin Tags: Case Report Source Type: journals

[Public Health] Establishment of public health security in Saudi Arabia for the 2009 Hajj in response to pandemic influenza A H1N1Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Mass gatherings of people challenge public health capacities at host locations and the visitors' places of origin. Hajj—the yearly pilgrimage by Muslims to Saudi Arabia—is one of the largest, most culturally and geographically diverse mass gatherings in the world. With the 2009 pandemic influenza A H1N1 and upcoming Hajj, the Saudi Arabian Ministry of Health (MoH) convened a preparedness consultation in June, 2009. Consultants from global public health agencies met in their official capacities with their Saudi Arabian counterparts. The MoH aimed to pool and share public health knowledge about mass gatherings, and revie...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: ZA Memish, SJN McNabb, F Mahoney, F Alrabiah, N Marano, QA Ahmed, J Mahjour, RA Hajjeh, P Formenty, FH Harmanci, H El Bushra, TM Uyeki, M Nunn, N Isla, M Barbeschi, the Jeddah Hajj Consultancy Group Tags: Public Health Source Type: journals

[Seminar] Cleft lip and palateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Clefts of the lip and palate are generally divided into two groups, isolated cleft palate and cleft lip with or without cleft palate, representing a heterogeneous group of disorders affecting the lips and oral cavity. These defects arise in about 1·7 per 1000 liveborn babies, with ethnic and geographic variation. Effects on speech, hearing, appearance, and psychology can lead to longlasting adverse outcomes for health and social integration. Typically, children with these disorders need multidisciplinary care from birth to adulthood and have higher morbidity and mortality throughout life than do unaffected individuals. Th...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Peter A Mossey, Julian Little, Ron G Munger, Mike J Dixon, William C Shaw Tags: Seminar Source Type: journals

[Articles] Premature deaths attributable to blood pressure in China: a prospective cohort studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hypertension is a major global-health challenge because of its high prevalence and concomitant risks of cardiovascular disease. We estimated premature deaths attributable to increased blood pressure in China. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Jiang He, Dongfeng Gu, Jing Chen, Xigui Wu, Tanika N Kelly, Jian-feng Huang, Ji-chun Chen, Chung-Shiuan Chen, Lydia A Bazzano, Kristi Reynolds, Paul K Whelton, Michael J Klag Tags: Articles Source Type: journals

[Articles] Effect of β2-adrenergic receptor polymorphism on response to longacting β2 agonist in asthma (LARGE trial): a genotype-stratified, randomised, placebo-controlled, crossover trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Some studies suggest that patients with asthma who are homozygous for arginine at the 16th aminoacid position of the β2-adrenergic receptor (B16 Arg/Arg) benefit less from treatment with longacting β2 agonists and inhaled corticosteroids than do those homozygous for glycine (B16 Gly/Gly). We investigated whether there is a genotype-specific response to treatment with a longacting β2 agonist in combination with inhaled corticosteroid. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Michael E Wechsler, Susan J Kunselman, Vernon M Chinchilli, Eugene Bleecker, Homer A Boushey, William J Calhoun, Bill T Ameredes, Mario Castro, Timothy J Craig, Loren Denlinger, John V Fahy, Nizar Jarjour, Shamsah Kazani, Sophia Kim, Monica Kraft, Stephen Tags: Articles Source Type: journals

[Articles] Human embryonic stem-cell derivatives for full reconstruction of the pluristratified epidermis: a preclinical studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cell therapy for large burns is dependent upon autologous epidermis reconstructed in vitro. However, the effectiveness of current procedures is limited by the delay needed to culture the patient's own keratinocytes. To assess whether the keratinocyte progeny of human embryonic stem cells (hESCs) could be used to form a temporary skin substitute for use in patients awaiting autologous grafts, we investigated the cells' capability of constructing a pluristratified epidermis. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Hind Guenou, Xavier Nissan, Fernando Larcher, Jessica Feteira, Gilles Lemaitre, Manoubia Saidani, Marcela Del Rio, Christine C Barrault, François-Xavier Bernard, Marc Peschanski, Christine Baldeschi, Gilles Waksman Tags: Articles Source Type: journals

[Department of Error] Department of ErrorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ravishankar N, Gubbins P Cooley RJ, et al. Financing of global health: tracking development assistance for health from 1990 to 2007. Lancet 2009; 373: 2113–24—In this Article (June 20), the fourth sentence of the Findings section of the Summary should have read: “Of the $13·8 billion DAH in 2007 for which project-level information was available, $4·9 billion was for HIV/AIDS, compared to $0·6 billion for tuberculosis, $0·7 billion for malaria, and $0·9 billion for health-sector support”. Additionally, the second and third sentences in the sixth paragraph of the results should have read: “Disbursements for HI...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: journals

[Department of Error] Department of ErrorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pfeffer MA, Swedberg K, Granger CB, et al. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 2003; 362: 759–66—In this Article (Sept 6, 2003), the second sentence of the fourth paragraph in the Results section should have read: “The incidence of non-fatal neoplasms detected during the programme was, however, similar in the two treatment groups (185 [4·9%] vs 194 [5·1%], p=0·49).” (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: journals

[Department of Error] Department of ErrorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Moloney A. Latin America faces hurdles in health research. Lancet 2009; 374: 1053–54—In this World Report, the abbreviation for the Council on Health Research for Development (p 1054) should have been “COHRED”. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: journals

[Correspondence] Insulin glargine and cancer – Authors' replyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We appreciate these further insights from Lars Hemkens and colleagues. However, we disagree with their understanding of prescribing decisions and the issue of time-changing exposure status during follow-up. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Liam Smeeth, Stuart Pocock Tags: Correspondence Source Type: journals

[Correspondence] Insulin glargine and cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Stuart Pocock and Liam Smeeth (Aug 15, p 511) criticise our study because allocation to treatment groups and drug dose was not determined before follow-up, but treatment and dose cannot be determined prospectively in registry studies. Real-life treatment decisions are made by doctors and patients, and not according to a protocol, as in randomised controlled trials. We showed that the risk of cancer diagnosis increased with the dose of insulin. This important factor is essential because of its biological effects, and it must be corrected for in the primary analysis. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Lars G Hemkens, Ralf Bender, Ulrich Grouven, Peter T Sawicki Tags: Correspondence Source Type: journals

[Correspondence] Occlusion of left atrial appendage to treat atrial fibrillation – Author's replyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We appreciate the comments from Patrick Calvert and colleagues. They are extremely relevant and important to the field. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: David R Holmes Tags: Correspondence Source Type: journals

[Correspondence] Occlusion of left atrial appendage to treat atrial fibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study shows, via statistical modelling, that a new strategy—occlusion of the left atrial appendage (LAA) with the WATCHMAN device—is non-inferior to warfarin in patients with atrial fibrillation. Does this result mean a “new dawn” in management of these patients? Well perhaps, but if this device is to have a future, we need to understand the complications better so we can reduce them. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Patrick A Calvert, Bushra S Rana, David A Begley, Leonard M Shapiro Tags: Correspondence Source Type: journals

[Correspondence] Cardiovascular effects of tight versus usual blood-pressure control – Authors' replyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Saurabh Rai and colleagues suggest that imbalances in drug treatment between the two groups may partly explain the different pattern of left-ventricular hypertrophy (LVH). However, this possibility is unlikely for several reasons. First, the number of antihypertensive drug classes patients were taking increased from baseline in both study groups (p (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Paolo Verdecchia, Fabio Angeli, Jan A Staessen, Gianpaolo Reboldi Tags: Correspondence Source Type: journals

[Correspondence] Cardiovascular effects of tight versus usual blood-pressure controlEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Cardio-Sis trial asks whether a lower goal for systolic blood pressure ( (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Jonas B Green, Adam K Richards Tags: Correspondence Source Type: journals

[Correspondence] Cardiovascular effects of tight versus usual blood-pressure controlEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We would like to draw the attention of readers to some important limitations of the study by Paolo Verdecchia and colleagues (Aug 15, p 525). (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Saurabh Rai, Nidhi Nandan, Rashmi Tiwari-Pandey, Nihar R Pandey Tags: Correspondence Source Type: journals

[Obituary] Obituary: Sula WolffEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Influential child psychiatrist. Born on March 1, 1924, in Berlin, Germany, she died on Sept 21, 2009, in Edinburgh, UK, aged 85 years. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Geoff Watts Tags: Obituary Source Type: journals

[Perspectives] Profile: Jerome Kabakyenga: prioritising rural health research in UgandaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the 20 years since Jerome Kabakyenga graduated from the Makarere School of Medicine, in Kampala, Uganda, his career has gone full circle. As a young doctor he worked as a medical officer treating patients at a rural hospital in the Bushenyi district of western Uganda. Now Kabakyenga wants to return to Uganda's rural communities to undertake research on the key health issues that affect these populations. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Paul Webster Tags: Perspectives Source Type: journals

[Perspectives] Film In Brief: Afghanistan's addictsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Kabul's Russian Cultural Centre is a burnt-out shell of a building; destroyed in the chaos that followed the Soviets' withdrawal in 1989. Today, the erstwhile arts centre stands in stately decay—gaping holes where once there were windows, its gardens covered in dust and dotted with fallen brickwork. Occasionally, NATO helicopters cross overhead. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Talha Burki Tags: Perspectives Source Type: journals

[Perspectives] Book: Force-feeding prisoners and the role of physiciansEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In his Sept 29 address to the United Nations General Assembly, President Barack Obama told the world that for those “who question the character and cause of my nation” two “concrete actions” should be taken as proof that the USA really has changed: the prohibition, “without exception or equivocation” of the use of torture and ordering the prison at Guantanamo Bay to be closed. Both are critical steps for my country to try to regain its position in the world as a human rights leader. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: George J Annas Tags: Perspectives Source Type: journals

[World Report] Uganda registers successes with child-health volunteersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Thanks to a small cadre of village volunteers, trained in basic health-care concepts, western Uganda is beginning to see some promising improvements in child health. Paul C Webster reports. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Paul C Webster Tags: World Report Source Type: journals

[Comment] Ann Veneman: a second term at UNICEF?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The appointment of the Executive Director of UNICEF, although officially made by the UN Secretary-General, is traditionally in the gift of the US Government. Carol Bellamy was appointed in 1995 during President Clinton's term in office. Ann Veneman, President Bush's former Secretary of Agriculture, was appointed in 2005. As a new President, should Barack Obama follow usual political practice and support his own nominee as UNICEF's leader? Or should he allow Veneman to complete a second term, as most incumbents are allowed to do? Answers to these questions will come in the next few months. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Richard Horton Tags: Comment Source Type: journals

[Comment] Government vs science over drug and alcohol policyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
My statement in October that alcohol was more dangerous than many illegal drugs, including cannabis, ecstasy, and LSD, referred back to a paper I published in The Lancet 2 years ago. It would be an understatement, given the political, media, and academic interest, to say that I stirred up a hornets' nest in the UK Parliament and elsewhere. The Home Secretary, Alan Johnson, sacked me from my role as chair of the ACMD (the government's Advisory Council on the Misuse of Drugs, on which I had served with distinction for 10 years), and the Conservative shadow minister said it should have happened earlier this year when I publis...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: David Nutt Tags: Comment Source Type: journals

[Comment] Sceptical optimism: a new take on global health dataEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
What was the state of the US manganese market in 1916? The USA imported 308 000 tonnes of manganese in 1916, with a unit value of US$50 per tonne. What was the weather like in Seattle on Sunday, Sept 6, 1970? One could safely assume it rained—and indeed, it rained 9 mm and the temperature was a moderate 15°C. Finally, how many people died of HIV/AIDS in 2007? Even though HIV has captivated public discourse and funding, including over $5·1 billion in development assistance for health in 2007 alone, there are only rough estimates of its disease burden. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Jeanette Birnbaum, Krycia Cowling, Kyle Foreman, Nancy Fullman, Paul Gubbins, Alison Levin-Rector, Susanna Makela, Jacob Marcus, Rebecca Myerson, Matthew Schneider Tags: Comment Source Type: journals

[Comment] Responding to China's hypertensive crisisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Raised blood pressure, as with HIV/AIDS, tuberculosis, and malaria, exacts its greatest toll on the world's poor. A third of China's 1·3 billion people still live on US$2 a day or less, making the country home to one of the world's largest impoverished populations. Poverty is a powerful facilitator of chronic as well as infectious diseases, and is undoubtedly a major contributor to the 1·3 million premature deaths from increased blood pressure estimated by Jiang He and colleagues, in The Lancet today, to occur in China each year. These investigators followed up a cohort of nearly 170 000 Chinese adults for almost 10 yea...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Stephen MacMahon, Lijing Yan Tags: Comment Source Type: journals

[Comment] β2-receptor polymorphisms in asthmaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In The Lancet today, Michael Wechsler and colleagues, from the Asthma Clinical Research Network (ACRN) of the US National Heart, Lung, and Blood Institute, report the LARGE study of the effects of a single-nucleotide polymorphism of the β2-adrenergic receptor on the addition of the longacting inhaled β2 agonist, salmeterol, to inhaled corticosteroid therapy. These investigators found significant improvements in baseline lung function as measured by morning peak expiratory flow with no genotype difference. They concluded that their data supported the current guideline recommendations for the use of these agonists in conju...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: H William Kelly Tags: Comment Source Type: journals

[Comment] Bioengineered human skin from embryonic stem cellsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The therapeutic use of human embryonic stem cells (hESCs) is currently prevented by several important hurdles. These hurdles include the availability of well-characterised, appropriately monitored cell lines that can be specified into the required lineages reproducibly and efficiently, without resulting in tumour formation or eliciting an immune response resulting in rejection. However, recent progress has provided hope that these challenges are not insurmountable and might eventually result in the use of hESCs for regenerative therapies for various diseases, including spinal cord injury, Parkinson's disease, and major tis...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: Holger Schlüter, Pritinder Kaur Tags: Comment Source Type: journals

[Editorial] Hajj and 2009 pandemic influenza A H1N1Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
More than 2·5 million Muslims from over 160 countries will be going on Hajj—a pilgrimage to Mecca, Saudi Arabia—this year during Nov 25–30. Such a mass gathering, with up to seven people per m2, increases the risk of spreading infectious diseases, particularly the 2009 pandemic influenza A H1N1. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: journals

[Editorial] Force-feeding of prisoners—a shameful practiceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A judge in Connecticut, USA, is considering whether to continue to allow a prisoner on hunger strike to be force-fed. Superior Court Judge James Graham is expected to rule on the case of William Coleman, who is in the Corrigan-Radgowski Correctional Center, in the coming weeks. Coleman and his lawyers argue that he has a constitutional right to determine what happens to his body, and the right to refuse medical treatment including resuscitation or assisted feeding. He has been force-fed via a nasogastric tube inserted by a physician on occasions since January, 2008, when Judge Graham issued a temporary injunction that allo...
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: journals

[Editorial] 20 years on: the clinical importance of children's rightsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
During the past week, the Australian Government apologised for the mistreatment of UK children who were resettled in Australia between 1930 and 1970 as part of the child migrants programme; a similar apology from the UK Government is expected. This forced resettlement of 500 000 children is a reminder of their vulnerability. The 20th anniversary on Nov 20 of the UN Convention on the Rights of the Child (CRC) gives an opportunity to reflect on children's rights today—and the responsibility of health professionals to respect and defend those rights in all settings, including the clinic. (Source: LANCET)
Source: LANCET - November 20, 2009 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: journals

[Case Report] Time to revisit mumps vaccination in Japan?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In June, 2008, a 30-year-old Japanese man presented to our emergency department with a sore throat and fever. The previous day he had been to a local clinic and prescribed antibiotics and non-steroidal anti-inflammatory drugs. However, treatment was ineffective and his fever increased (up to 38·1°C). On admission, he was transferred to our otolaryngology department with possible diagnosis of acute parotitis. He had a fever (38·0°C), was hoarse, and had difficulty speaking. His neck was very swollen with redness of the skin. There was no rash. We made a preliminary diagnosis of cervical abscess, rather than parotitis. L...
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Toru Sasaki, Koichi Tsunoda Tags: Case Report Source Type: journals

[Review] Physician wellness: a missing quality indicatorEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When physicians are unwell, the performance of health-care systems can be suboptimum. Physician wellness might not only benefit the individual physician, it could also be vital to the delivery of high-quality health care. We review the work stresses faced by physicians, the barriers to attending to wellness, and the consequences of unwell physicians to the individual and to health-care systems. We show that health systems should routinely measure physician wellness, and discuss the challenges associated with implementation. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Jean E Wallace, Jane B Lemaire, William A Ghali Tags: Review Source Type: journals

[Seminar] Biliary atresiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Biliary atresia is a rare disease of infancy, which has changed within 30 years from being fatal to being a disorder for which effective palliative surgery or curative liver transplantation, or both, are available. Good outcomes for infants depend on early referral and timely Kasai portoenterostomy, and thus a high index of suspicion is needed for investigation of infants with persistent jaundice. In centres with much experience of treating this disorder, up to 60% of children will achieve biliary drainage after Kasai portoenterostomy and will have serum bilirubin within the normal range within 6 months. 80% of children wh...
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Jane L Hartley, Mark Davenport, Deirdre A Kelly Tags: Seminar Source Type: journals

[Clinical Picture] Carotid plaque ruptureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 74-year-old man presented with left-sided monocular visual loss as a result of branch retinal artery occlusion. Carotid ultrasonography showed mild (20%) left carotid artery stenosis but no embolic source was identified. MRI of the carotid artery showed a large atherosclerotic plaque at the origin of the left internal carotid artery, despite only mild luminal stenosis (). Cross-sectional imaging (B-T1 weighted, C-T2 weighted), showed a thin fibrous cap with rupture and a large lipid core (). Carotid endarterectomy was done. In the pathological specimen, a large lipid laden plaque was present () showing evidence of plaque...
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Niall G Keenan, Mary N Sheppard, David M Nott, Dudley J Pennell, Raad H Mohiaddin Tags: Clinical Picture Source Type: journals

[Articles] Efficacy and safety of a modified killed-whole-cell oral cholera vaccine in India: an interim analysis of a cluster-randomised, double-blind, placebo-controlled trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Oral cholera vaccines consisting of killed whole cells have been available for many years, but they have not been used extensively in populations with endemic disease. An inexpensive, locally produced oral killed-whole-cell vaccine has been used in high-risk areas in Vietnam. To expand the use of this vaccine, it was modified to comply with WHO standards. We assessed the efficacy and safety of this modified vaccine in a population with endemic cholera. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Dipika Sur, Anna Lena Lopez, Suman Kanungo, Allison Paisley, Byomkesh Manna, Mohammad Ali, Swapan K Niyogi, Jin Kyung Park, Banawarilal Sarkar, Mahesh K Puri, Deok Ryun Kim, Jacqueline L Deen, Jan Holmgren, Rodney Carbis, Raman Rao, Nguyen Thu Van, Allan Tags: Articles Source Type: journals

[Articles] Comparison of routine and on-demand prescription of chest radiographs in mechanically ventilated adults: a multicentre, cluster-randomised, two-period crossover studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Present guidelines recommend routine daily chest radiographs for mechanically ventilated patients in intensive care units. However, some units use an on-demand strategy, in which chest radiographs are done only if warranted by the patient's clinical status. By comparison between routine and on-demand strategies, we aimed to establish which strategy was more efficient and effective for optimum patient care. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Gilles Hejblum, Ludivine Chalumeau-Lemoine, Vincent Ioos, Pierre-Yves Boëlle, Laurence Salomon, Tabassome Simon, Jean-François Vibert, Bertrand Guidet Tags: Articles Source Type: journals

[Articles] 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the 2·8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Diabetes Prevention Program Research Group Tags: Articles Source Type: journals

[Correspondence] Access to pain treatment a luxury for mostEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Guy Micco and colleagues (Sept 12, p 872) are right to emphasise that, whenever possible, patients near the end of their lives must be free to choose whether their care includes optimum pain relief, or more limited use of opioids with the aim of promoting consciousness and lucidity. However, for most patients worldwide, there is no such choice. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Joseph Amon, Diederik Lohman, Laura Thomas Tags: Correspondence Source Type: journals

[Correspondence] Role of the UK Biobank Ethics and Governance CouncilEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In their Comment (Sept 12, p 861), David Jones and Calum McKellar misunderstand the role of the UK Biobank Ethics and Governance Council (EGC). The EGC is an independent body set up to advise and monitor UK Biobank; it is not a creation of UK Biobank. The EGC does not decide on uses of UK Biobank, as suggested by Jones and McKellar, but rather recommends action as the project develops. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Graeme Laurie Tags: Correspondence Source Type: journals

[Correspondence] Lessons and myths in the HIV/AIDS response – Authors' replyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We agree with Ann Starrs that many important causes of ill health in low-income and middle-income countries are seriously underfunded, and that “general funding for health as well as specifically for AIDS must increase significantly”. The momentum created by the global AIDS response has already led to increased funding for health, but clearly not enough. Additionally, efficiency gains can be made in HIV interventions, and we should do as much as we can to ensure that the synergies between the AIDS response and other health programmes are optimised. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: P Piot, M Kazatchkine, M Dybul, J Lob-Levyt Tags: Correspondence Source Type: journals

[Correspondence] Lessons and myths in the HIV/AIDS responseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Peter Piot and colleagues neglect to mention the most egregious oversight made by the public health community in dealing with the HIV epidemic: the avoidance of surveillance and contact tracing and the secrecy involved in dealing with potentially infectious cases. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Jon E Rohde Tags: Correspondence Source Type: journals

[Correspondence] Lessons and myths in the HIV/AIDS responseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Peter Piot and colleagues' list of lessons learnt and myths dispelled in the AIDS response is by no means exhaustive. Another myth is that myths about HIV will disappear on their own; as a result, not much effort is expended in fighting them. Consequently, the myths become ingrained and gain credibility. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Charles Shey Wiysonge, Adamson S Muula, Eugene J Kongnyuy, Muki S Shey, Gregory D Hussey Tags: Correspondence Source Type: journals

[Correspondence] Lessons and myths in the HIV/AIDS responseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Peter Piot and colleagues' Viewpoint offers a succinct and well reasoned analysis of what has been achieved and what remains to be done to address the global HIV and AIDS pandemic. There is one element of their argument, however, that is incomplete. They note that the Global Fund, the US President's Emergency Plan for AIDS Relief (PEPFAR), and the GAVI Alliance are major investors in health systems, and argue that these investments have led to hiring more health workers, refurbishing health centres, purchasing essential equipment, and expanding laboratory capacity. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Ann M Starrs Tags: Correspondence Source Type: journals

[Correspondence] Lessons and myths in the HIV/AIDS responseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although it is good to see HIV industry leaders admit to getting so much wrong in the past (July 18, p 260), it is alarming to see that they still are. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Roger England Tags: Correspondence Source Type: journals

[Correspondence] Clinical diagnostic criteria for isolating patients admitted to hospital with suspected pandemic influenzaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Australian hospitals have now experienced the first wave of pandemic H1N1 influenza during a southern hemisphere winter. Patients admitted to Australian hospitals with suspected pandemic influenza during this period were identified by use of approved national clinical diagnostic criteria. However, the imprecise nature of clinical diagnosis limited the ability of hospitals to isolate infectious patients effectively before the laboratory confirmation of infection (which typically takes a minimum of 48 h). (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: John Gerrard, Gerben Keijzers, Ping Zhang, Caleb Vossen, Deborough Macbeth Tags: Correspondence Source Type: journals

[Obituary] Obituary: Peter DunnillEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Leading biochemical engineer. Born on May 20, 1938, in London, UK, he died in London on Aug 10, 2009. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Geoff Watts Tags: Obituary Source Type: journals

[Perspectives] Explaining the unbiased creation of treatment comparison groupsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A class of 11-year-old children in Norway were given a supply of coloured sweets, and asked to design an experiment to find out whether red sweets helped children to think more quickly. The children pointed out that an experiment comparing the effects of red and non-red sweets would need to hide the colour of sweets from the participants: knowledge of the sweet colour might otherwise affect judgments about thinking speed. They understood the need to try to reduce the biases of the observers. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Iain Chalmers Tags: Perspectives Source Type: journals

[Perspectives] Lunch with The Lancet: Jonah LehrerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Jonah Lehrer's star is in the ascendant. Although the neuroscientist-turned-writer is still a 20-something, he has written two books that have been well received by the elder statesmen of neuroscience Antonio Damasio and Oliver Sacks. His latest book, The Decisive Moment, is a sort of hitchhiker's guide to neuroscience, it zooms between theories and behavioural studies to shore up his central argument; that when we make decisions, our gut feelings can be as important as rational thought. “It seems counterintuitive that you would use your gut to make big decisions like buying a car”, he says, “but given the processing...
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Priya Shetty Tags: Perspectives Source Type: journals

[Perspectives] HysteriaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The changing meanings of hysteria have mirrored the preoccupations of the societies that used the term. Ancient Egyptians, and subsequently Greeks, blamed a displaced hystera, or womb, for many women's afflictions, including choking, mutism, and paralysis, although the term hysteria was not applied until later. Hippocratic writings speak of a dry womb rising towards the throat in search of moisture, thereby impeding breathing. As anatomical knowledge increased, such notions became untenable and Galen instead blamed blocked menstrual flow and sexual abstinence. Galen suggested that retained sperm could contribute to male hy...
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Martin Edwards Tags: Perspectives Source Type: journals

[Perspectives] Book In Brief: A magnificent resource on tropical diseasesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Manson's Tropical Diseases was first published in 1898 by Sir Patrick Manson (1844–1922), who spearheaded a new medical specialty during an era of global British imperialism. The legendary book has continued to evolve for the past 110 years, keeping pace with new advances in the dynamic field of tropical medicine. (Source: LANCET)
Source: LANCET - November 13, 2009 Category: Journals (General) Authors: Philip Chukwuka Onyebujoh Tags: Perspectives Source Type: journals