[Correspondence] Teriparatide vs risedronate for osteoporosis – Authors' reply
Yair Liel stated that the VERO clinical trial1 results were of relatively minor clinical significance because of the nature of the active comparator used (risedronate) and because bone turnover markers were not measured, suggesting that the inferior anti-fracture efficacy in the risedronate group was not evaluated properly. He suggested that a clinically relevant comparison could be made between teriparatide and zoledronate, or between teriparatide and denosumab, given their superior effects on bone mineral density observed when compared with oral bisphosphonates. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: David L Kendler, Piet Geusens, Cristiano A F Zerbini, Salvatore Minisola, Fernando Marin Tags: Correspondence Source Type: research

[Correspondence] Teriparatide vs risedronate for osteoporosis
David L Kendler and colleagues (Jan 20, p 230)1 compared the anti-fracture efficacy of subcutaneous teriparatide injections with that of oral risedronate in patients with severe osteoporosis, and indicated that the risk of new vertebral and clinical fractures is significantly lower in patients receiving teriparatide than in those receiving risedronate. Nevertheless, it seems to me that a comparison between a parenteral and an oral anti-osteoporosis drug might be of relatively minor clinical significance. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Yair Liel Tags: Correspondence Source Type: research

[Correspondence] Drawing conclusions from the VIVA trial – Authors' reply
In their letter, Karsten Juhl J ørgensen and Minna Johansson highlighted the fact that the VIVA trial1 showed a reduction in overall mortality that could not be attributed to individual causes of death. They further made the case that this overall effect on mortality is inconsistent with current evidence on the effects of general health checks. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Jes S Lindholt, Rikke S øgaard Tags: Correspondence Source Type: research

[Correspondence] Drawing conclusions from the VIVA trial
The VIVA trial by Jes Lindholt and Rikke S øgaard (Nov 18, 2017, p 2256)1 assessed the effects of screening for abdominal aortic aneurysm, peripheral arterial disease, and hypertension, showing a small but statistically significant reduction in total mortality in the screening group versus the non-screening group. The authors concluded that “the observed reduction of mortality risk from abdominal aortic aneurysm, peripheral arterial disease, and hypertension” should lead policy makers to “consider implementing combined screening”. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Karsten Juhl J ørgensen, Minna Johansson Tags: Correspondence Source Type: research

[Correspondence] Time to eradicate HTLV-1: an open letter to WHO
Human T-cell leukaemia virus 1 (HTLV-1) is the most potent carcinogenic oncovirus and potentially the most oncogenic risk factor including chemical carcinogens.1 A unique and aggressive T-cell leukaemia (adult T-cell leukemia) was discovered in Japan,2,3 from which a new retrovirus, HTLV-1, was identified in the USA4 and then in Japan,5 independently. In addition to adult T-cell leukaemia, HTLV-1 causes progressive and disabling inflammatory conditions, such as HTLV-1-associated myelopathy/tropical spastic paraparesis6,7 (HAM/TSP), associated with high morbidity and mortality. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Fabiola Martin, Yutaka Tagaya, Robert Gallo Tags: Correspondence Source Type: research

[Obituary] Robert Johns Haggerty
Paediatrician who reinvented his specialty. He was born in Saranac Lake, NY, USA, on Oct 20, 1925, and died of cancer in Canandaigua, NY, USA, on Jan 23, 2018, aged 92 years. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research

[Perspectives] Not much to say really
When I was collecting autobiographical stories for a project called Showing Your Age, 86-year-old Joan began our conversation by saying, “there's not much to say really”. She then talked about her life for several hours. Other people's responses followed the same pattern: hesitation, then a pouring out of intriguing, humorous, and heart-breaking recollections of individuals weighing up their lives. The book that came out of this project, Not Much To Say Really, was a poetic and artistic account of my extended conversations with these patients. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Kelvin Corcoran Tags: Perspectives Source Type: research

[Perspectives] The pressures of medical practice
Caroline Elton is a chartered psychologist who has had an unusual career. She worked to challenge outdated models of medical education by observing doctors at work, and then went on to become Head of the Careers Unit for trainee doctors at the London Deanery. She now works for a private counselling company specialising in medical and dental careers. Also Human: the Inner Lives of Doctors draws on her more than two decades of work with physicians. Elton's book is a frequently angry and shocked response to the tools used for selection for medical school, the induction into and nature of medical training, and the management o...
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Margaret McCartney Tags: Perspectives Source Type: research

[World Report] Concern over reported number of measles cases in Yemen
Over 3000 suspected measles cases have been reported in 2018 across Yemen, where conflict has plunged the country into the world's largest humanitarian crisis. Xun Yuan reports. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Xun Yuan Tags: World Report Source Type: research

[World Report] Cochrane postpones comprehensive free access to reviews
Cochrane postpones implementation of the target to make all Cochrane Reviews open access immediately upon publication. Talha Burki reports. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Talha Burki Tags: World Report Source Type: research

[World Report] EMRO Regional Director to be elected to head office
The election of the Regional Director of the WHO Eastern Mediterranean Regional Office is due to take place on May 19. John Zarocostas reports. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: John Zarocostas Tags: World Report Source Type: research

[Comment] Offline: John E Fogarty and the defeat of Donald J Trump
If President Trump had had his way, the Fogarty International Center would now be a footnote in history. Targeted for elimination in 2017, the Trump administration viewed the Fogarty mission —to support and facilitate global health research—as contrary to the spirit of America First. Yet last week, the Fogarty Center celebrated its 50th birthday in a stronger and more stable position than at any time in its short existence. Francis Collins, Director of the National Institutes of Hea lth (NIH), underlined the importance of Fogarty to the US scientific enterprise. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Emergency deployment of oral cholera vaccine for the Rohingya in Bangladesh
Cholera is a threat to vulnerable populations caught in humanitarian emergencies.1 WHO has recommended that inactivated oral cholera vaccines (OCVs), in conjunction with provision of appropriate rehydration therapy, clean water, and sanitation, be considered for use in humanitarian and emergency settings at high risk for cholera.2 Since 2013, inactivated vibrio whole cell OCVs have been made available for deployment from a global OCV stockpile, funded by Gavi, the Vaccine Alliance, which is intended for cholera control in outbreaks, humanitarian crises, and settings with endemic cholera. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: Firdausi Qadri, Abul Kalam Azad, Meerjady Sabrina Flora, Ashraful Islam Khan, Md Taufiqul Islam, G Balakrish Nair, Poonam Khetrapal Singh, John D Clemens Tags: Comment Source Type: research

[Editorial] Vitamin A distribution in danger
Vitamin A deficiency affects almost half of children under 5 years in south Asia and sub-Saharan Africa. A new UNICEF report, released on May 2, highlights the current problems facing vitamin A supplementation programmes around the world. Coverage at a crossroads: new directions for vitamin A supplementation programmes claims that vitamin A distribution has reached a 6-year low, with 62 million children in high-mortality countries not receiving the supplement. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Cancer drugs in China: affordability and creativity
Cancer is a major public health concern in China. According to the National Central Cancer Registry of China, there were around 4 ·3 million new cancer cases and 2·8 million cancer deaths in China in 2015. Improving the accessibility and availability of effective treatments is key to tackling the huge burden of cancer in China. However, in terms of local affordability of cancer drugs, China emerges as one of the countries wi th the least affordable prices in the world. (Source: LANCET)
Source: LANCET - May 11, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research