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[Comment] Clemastine fumarate for promotion of optic nerve remyelination
The regulatory approval of 15 disease-modifying medications to reduce inflammatory lesion activity in relapsing multiple sclerosis illustrates the dramatic progress made in the treatment of this frequently disabling condition. None of these medications, however, directly promotes repair of the damaged CNS. As a result, therapies to prevent accumulation of permanent disability and, especially, to reverse pre-existing disability represent major unmet needs. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Authors: Jeffrey A Cohen, Paul J Tesar Tags: Comment Source Type: research

[Department of Error] Department of Error
Kirchhof P. The future of atrial fibrillation management: intergrated care and stratified therapy. Lancet 2017; 390: 1873 –87—In table 4 of this Seminar (published online first on April 28), the dose of edoxaban should be 60 mg once daily. This correction has been made to the online version as of Oct 10, 2017, and the printed Seminar is correct. (Source: LANCET)
Source: LANCET - October 10, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Discussion “Although eastern Asia appeared to be similar to developed regions, fewer than one in two abortions elsewhere in Asia, and ab out one in four abortions in Africa, were safe” should be “Although eastern Asia was similar to developed regions, fewer than one in two abortions in south-central Asia and about one in four abortions in Africa were safe”. (Source: LANCET)
Source: LANCET - October 9, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Comment] Treaty to prohibit nuclear weapons: towards safeguarding humanity
Escalating tensions around nuclear weapons in North Korea remind us that humanity remains vulnerable to their use by design, miscalculation, or accident. About 15  000 warheads exist today, of which nearly 1800 warheads are on alert and ready for use at short notice.1 (Source: LANCET)
Source: LANCET - October 9, 2017 Category: General Medicine Authors: Andy Haines, Ira Helfand Tags: Comment Source Type: research

[Case Report] Jaundice, abdominal pain, and fever in a young woman
A 23-year-old woman presented to the emergency department in December, 2016, with a 10-day history of vomiting, myalgia, and upper abdominal pain. 3 days before presentation she had seen her general practitioner who prescribed empirical clarithromycin, with no improvement in her symptoms, and 2 days later she developed jaundice and pruritus, prompting her attendance at our hospital. She had a history of ulcerative colitis with a pan-proctocolectomy and end ileostomy. She took no regular medication, rarely drank alcohol, and had no history of travel abroad or recent blood transfusions. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Storm D Norman, Iain A Murray, Dushyant Shetty, Richard P Bendall, Harry R Dalton Tags: Case Report Source Type: research

[Department of Error] Department of Error
GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990 –2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet 2017; 389: 1885–1906—In this Article (published online first on April 5, 2017), Karzan A Mohammad's second affiliation was missing from the Affiliations list, and “Joshua Salomon” should have been listed as “ Joshua A Salomon” in the Collaborators list. In the appendix, all column headings in table S8 should have been “rate per 1000”. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Van den Bent MJ, Baumert B, Erridge SC, et al. Interim results from the CATNON trial (EORTC study 26053-22054) of treatment with concurrent and adjuvant temozolomide for 1p/19q non-co-deleted anaplastic glioma: a phase 3, randomised, open-label intergroup study. Lancet 2017; 390: 1645 –53—In the list of affiliations for this Article (published online first on Aug 8, 2017), “Prof R Stuff MD” should have read “Prof R Stupp MD”. This correction has been made to the online version as of Oct 5, 2017, and the printed Article is correct. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] FreeStyle Libre: contact irritation versus contact allergy
Nesrine Brahimi and colleagues (April 8, p 1396)1 recently expressed their concern on the origin and management of cutaneous adverse events arising from FreeStyle Libre (Abbott Diabetes Care, Witney, Oxfordshire, UK), a sensor-based flash-continuous glucose monitoring system. A study by Bolinder and colleagues (Nov 5, 2016, p 2254)2 indeed reported adverse skin effects when participants were using the device, although participants with a known sensitivity to medical adhesives had been excluded from the trial. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Olivier Aerts, Anne Herman, Magnus Bruze, An Goossens, Martin Mowitz Tags: Correspondence Source Type: research

[Correspondence] Abdominal aortic aneurysms in women – Authors' reply
We thank Kosmas Paraskevas for his interest in our study.1 The practice of medicine should be based on the best available evidence.2 The best evidence for when women lose their morphological suitability for endovascular aneurysm repair (EVAR) comes from the study of Sweet and colleagues,3 which showed that attenuation of the proportion of women suitable for EVAR comes only after the 5 ·5 cm threshold has been reached. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Janet T Powell, Pinar Ulug, Michael J Sweeting, Regula S von Allmen, Simon G Thompson Tags: Correspondence Source Type: research

[Correspondence] Abdominal aortic aneurysms in women
Pinar Ulug and colleagues' study in The Lancet (June 24, p 2482)1 showed that fewer women (34%) than men (54%) are eligible for endovascular aneurysm repair (EVAR) of intact abdominal aortic aneurysm (odds ratio [OR] 0 ·44, 95% CI 0·32–0·62). Furthermore, operative mortality after EVAR is higher in women than in men (OR 1·67, 95% CI 1·38–2·04). Ulug and colleagues suggested that if a reduced threshold for abdominal aortic aneurysm repair was introduced in women, this threshold could potentially alleviate mortality. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Kosmas I Paraskevas Tags: Correspondence Source Type: research

[Correspondence] Right Care Series gets it wrong
The well intentioned Right Care Series gets it more wrong than right. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Howard Waitzkin Tags: Correspondence Source Type: research

[Correspondence] Data sharing: experience from a tropical medicine research unit
We applaud the International Committee of Medical Journal Editors (ICMJE) for arriving at a workable compromise on the data sharing requirements it expects of clinical trial authors (June 10, p e12).1 (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Phaik Yeong Cheah, Nicholas Philip John Day Tags: Correspondence Source Type: research

[Correspondence] What's missing in climate change discussions?
President Trump's misguided decision to have the USA withdraw from the Paris Climate Agreement has, ironically, reopened discussions on almost every issue surrounding global warming, including how to push back against the causes and manage the effects of climate change. In the language of specialists, these interventions are called mitigation and adaptation. But something is missing from these discussions. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Anthony Robbins Tags: Correspondence Source Type: research

[Obituary] Tessa Laurie Holyoake
Clinician scientist and expert on chronic myeloid leukaemia. Born in Aberdeen, UK, on March 17, 1963, she died of breast cancer near Loch Tummel in Perthshire, UK, on Aug 30, 2017, aged 54 years. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research

[Perspectives] Scientist, theologian, and heretic
Two centuries ago, William Wordsworth famously contemplated a statue in the chapel of Trinity College, Cambridge, UK, and wrote in The Prelude: “Of Newton with his prism and silent face,/ The marble index of a mind forever/ Voyaging through strange seas of thought, alone.” Half a century ago, the mathematician and broadcaster Jacob Bronowski added another compelling comment on Isaac Newton in his history of science, The Ascent of Man, c omparing him with his greatest scientific admirer, Albert Einstein: “Newton is the Old Testament god; it is Einstein who is the New Testament figure…full of humanit...
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Andrew Robinson Tags: Perspectives Source Type: research

[Perspectives] The junior doctor's tale
“His greatest difficulty is the admission of cases. Towards the end of the week on duty, he has to be very sparing, and to endure some hard words from patients who he is unable to admit. Perchance one rejected case is more dangerously ill than he thinks, and ends badly out of doors. There is an in quest, or an article in a daily paper; and then the young house-surgeon is placed in a most unenviable position, and is absolutely unable to defend himself against temporary public obloquy, though he has only done his duty to the best of his ability.” Though, as The BMJ reported, for “the modern house surgeon&rd...
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Margaret McCartney Tags: Perspectives Source Type: research

[Perspectives] Mary Crow: leader in research on systemic lupus erythematosus
Mary “Peggy” Crow was not one of those people who always wanted to be a doctor. “I absolutely was not on a track toward either medicine or research”, Crow, Physician-in-Chief at the Hospital for Special Surgery (HSS), New York City, USA, and a past President of the American College of Rheumatolog y, told The Lancet. She took biology in 7th grade and loved it, Crow says, but at her private high school in Westchester County, NY, girls didn't get to take science—she “was not even offered science courses”, recalls Crow. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Rita Rubin Tags: Perspectives Source Type: research

[World Report] Puerto Rico's health system after Hurricane Maria
Hurricane Maria has put pressure on Puerto Rico's health-care system, but a looming budgetary shortfall could be even more devastating. Ted Alcorn reports. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Ted Alcorn Tags: World Report Source Type: research

[World Report] Lupus research centre fosters collaboration
The Hospital for Special Surgery (HSS), New York, USA, has been a leader for decades in the study and treatment of rheumatological diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Rita Rubin Tags: World Report Source Type: research

[Comment] Offline: America —the Fourth World
In her compelling account of the 2016 US Presidential election (What Happened, Simon and Schuster), Hillary Clinton invokes a powerful metaphor to express her concerns for the health of America's democracy. She argues that a body politic needs a strong immune system to survive. The elements of that immune protection are facts and reason. But “our immune system had been slowly eroded over years”. Democratic institutions of “the greatest country in the world” became vulnerable to attack. Americans must “heal our democracy”. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] In search of global governance for research in epidemics
The west African epidemic of Ebola virus disease in 2014 –15 became a major tragedy because the global system under the International Health Regulations and the governance of research related to epidemics both failed to function as needed. Research started too late and yielded only one vaccine candidate with probable effectiveness.1 Today, the internati onal framework for epidemic preparedness and response still does not include a role for research.2 Future cross-national epidemics and Public Health Emergencies of International Concern are likely to involve pathogens that have no proven effective vaccines or specific...
Source: LANCET - October 6, 2017 Category: General Medicine Authors: David H Peters, Gerald T Keusch, Janice Cooper, Sheila Davis, Jens Lundgren, Michelle M Mello, Olayemi Omatade, Fred Wabwire-Mangen, Keith P W J McAdam Tags: Comment Source Type: research

[Editorial] Systemic sclerosis: advances and prospects
Of all the rheumatological diseases, systemic sclerosis (scleroderma) has the highest case-specific mortality and substantial non-lethal complications. It is a rare multisystem autoimmune disease of the connective tissue, distinguished by prominent fibrosis and vasculopathy of the skin and internal organs. A Seminar by Christopher Denton and Dinesh Khanna is the first comprehensive clinical review on systemic sclerosis since a formal evidence-based management guideline in 2016 and the results of key trials of stem-cell therapy and immunosuppression were published. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] A new milestone for STIs in the USA
Last year, the number of cases of chlamydia, gonorrhoea, and syphilis in the USA surpassed 2 million for the first time. The US Centres for Disease Control and Prevention (CDC) Sexually Transmitted Disease Surveillance 2016 report presented the rate of these infections by age, sex, race and ethnicity, and geography, and found that each infection saw overall increases since 2015: the rate of chlamydia increased by 4 ·7%; gonorrhoea increased by 18·5%; and primary and secondary syphilis increased by 17·6%. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Cholera: ending a 50-year pandemic
The global annual cholera burden is estimated at around 2 ·9 million cases per year, resulting in 95 000 deaths. In 2017, these estimates could be far exceeded due to a number of devastating outbreaks, including those in Yemen and northern Nigeria. So far this year, 750 000 suspected cases, causing over 2000 deaths, have occurred in Yemen alone. Curre ntly, there is concern about the risk of a cholera epidemic among Rohingya refugees in the Cox's Bazar region of Bangladesh. In response to this public health threat, the Global Task Force on Cholera Control (GTFCC), has brought together representatives from choler...
Source: LANCET - October 6, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomised, double-blind, placebo-controlled, phase 3 trial
In this phase 3 study, the survival benefits indicate that nivolumab might be a new treatment option for heavily pretreated patients with advanced gastric or gastro-oesophageal junction cancer. Ongoing trials that include non-Asian patients are investigating nivolumab for advanced gastric or gastro-oesophageal junction cancer in various settings and earlier treatment lines. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Yoon-Koo Kang, Narikazu Boku, Taroh Satoh, Min-Hee Ryu, Yee Chao, Ken Kato, Hyun Cheol Chung, Jen-Shi Chen, Kei Muro, Won Ki Kang, Kun-Huei Yeh, Takaki Yoshikawa, Sang Cheul Oh, Li-Yuan Bai, Takao Tamura, Keun-Wook Lee, Yasuo Hamamoto, Jong Gwang Kim, Kei Tags: Articles Source Type: research

[Comment] Checkpoint inhibition: an ATTRACTION in advanced gastric cancer?
Annually, more than 950  000 people are diagnosed with gastric or oesophagogastric junction cancer1—the third most lethal cancer worldwide2—for which there is a considerable unmet clinical need. Blockade of immune checkpoints has been successfully integrated into standard treatment regimens for several solid tumours. 3 The ATTRACTION-2 study by Yoon-Koo Kang and colleagues4 in The Lancet is, to my knowledge, the first randomised, placebo-controlled, phase 3 trial of immune checkpoint blockade in gastrointestinal cancers. (Source: LANCET)
Source: LANCET - October 6, 2017 Category: General Medicine Authors: Ian Chau Tags: Comment Source Type: research

[Department of Error] Department of Error
Lear SA, Hu W, Rangarajan S, et al. The effect of physical activity on mortality and cardiovascular disease in 130  000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet 2017; 390: 2643–54—In figure 1 of this Article (published online first on Sept 21, 2017), the labels “lower” and “higher” were incorrectly reversed below the axis. This correction has been made to the online version as of Oct 5, 2017, and the printed Article is correct. (Source: LANCET)
Source: LANCET - October 5, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Treating cholera in severely malnourished children in the Horn of Africa and Yemen
Populations in Yemen, South Sudan, Somalia, and Ethiopia are experiencing starvation and concurrent outbreaks of confirmed or suspected cholera (acute watery diarrhoea [AWD]).1 Drought, conflict, and population displacement in these countries have led to increased food insecurity and a higher incidence of severe acute malnutrition (SAM).1 Limited access to safe water and poor sanitation have exacerbated cholera and AWD outbreaks and led to the dangerous comorbidity of cholera and SAM in young children. (Source: LANCET)
Source: LANCET - October 5, 2017 Category: General Medicine Authors: Mija Ververs, Rupa Narra Tags: Correspondence Source Type: research

[Essay] Civil society and drugs in Russia: moving towards the conservative agenda
The fall of the Soviet Union in the early 1990s brought about important shifts in Russian economic, social, and political life. Along with economic turmoil emerged a wave of drug abuse.1 Political changes and democratic reforms also led to the growth of civil society, and between the late 1990s and mid-2000s, civil society organisations became a strong force in shaping the response to drug-related problems. These groups are very diverse; some are vigilantes in their approach to cleaning their cities of drugs, whereas others are community-based and organised by people who themselves use drugs and have liberal agendas for dr...
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Anya Sarang Tags: Essay Source Type: research

[Essay] Russian medicine: trying to catch up on scientific evidence and human values
At the beginning of the 20th century, medicine as an academic discipline and a vocational training was quite similar in Russia and in western Europe. Most professors in Russian medical faculties had some international training. Pirogov, Sechenov, Mechnikoff, and Pavlov, just to name a few, were not only exceptional scientists but typical with their international training and research experience. Yet medicine as a service to the public was underdeveloped. The access to a nurse or doctor was very limited, as described depressingly clearly in Anton Checkhov's short stories. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Vasiliy V Vlassov Tags: Essay Source Type: research

[Essay] Tuberculosis and HIV/AIDS: the alien and the predator
In 1919, the fight against tuberculosis was declared a national policy by the Bolshevik Party because the morbidity had become very high and many revolutionaries, including Stalin and the KGB founder Dzerzhinsky, had developed tuberculosis during their incarceration for opposing Tsar ruling. Yet not until the 1960s, after the Civil War and World War 2, was a Soviet strategy against tuberculosis finally structured. The strategy included regular and free Mantoux tuberculin skin tests and chest fluorographic imaging, and free care was provided through a system of tuberculosis clinics and so-called dispensaries (outpatient fac...
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Vadim Pokrovsky Tags: Essay Source Type: research

[Essay] Alcohol and health in Russia: good news at last
Alcohol abuse is an important risk factor and a cause of death worldwide. Alcohol not only affects the general health of the consumer, it also causes social problems and harm to other people. A high prevalence of heavy drinking in the population affects the economy and other important determinants of a country's welfare.1 (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: David Zaridze Tags: Essay Source Type: research

[Essay] Public health in Russia: a sad state of affairs
The sad state of affairs in the Russian public health system has nothing to do with President Vladimir Putin, which, of course, is too bad. After all, wouldn't it be wonderful if he could be blamed for that as well? (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Vladimir Pozner Tags: Essay Source Type: research

[Essay] Mental health and human rights in Russia —a flawed relationship
When the Soviet Union disintegrated in 1991, new independent psychiatric associations were established in many of the former Soviet republics, and groups of reform-minded psychiatrists initiated projects to discard the old Soviet psychiatric system, a system notorious for its political abuse of psychiatry and characterised by an almost exclusively biological orientation and institutional form of care. Russia was no exception and even boasted some of the most prominent mental health reformers, such as psychiatrist Yuri Nuller in St Petersburg1 and the Moscow-based lawyer Svetlana Polubinskaya, an associate of the Institute ...
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Robert van Voren Tags: Essay Source Type: research

[Essay] How history shaped the health system in Russia
The Russian health system retains the main characteristics of the Semashko model of medical care, as it was delivered in the Soviet Union.1,2 This model grants all citizens the right to free medical care, and its proclamation in 1918 marked the first example of universal coverage in the world. An extensive network of public medical facilities was created to ensure this right to medical care, but in actual fact, access to medical care was not equal for all citizens. Employees of priority industries, residents of large cities, and officials were treated in medical institutions with the best equipment and staff. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Sergey Shishkin Tags: Essay Source Type: research

[Essay] Health in the Soviet Union and in the post-Soviet space: from utopia to collapse and arduous recovery
“At least in those days, I had no rent and no heating bill to pay, I had free access to doctors, and the state would make sure my children are educated and in good health”, says Evguenia, a babouchka I spoke with recently in Moscow. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Michel D Kazatchkine Tags: Essay Source Type: research

[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial – Authors' reply
Alicia Therese Dennis and James D Griffiths believe that women in high-income countries with post-partum haemorrhage should not receive tranexamic acid for the following reasons: the WOMAN trial1 was mostly done in middle-income countries and so the results are not generalisable and death from bleeding is rare in high-income countries where women more often die from the complications of bleeding. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Ian Roberts, Haleema Shakur Tags: Correspondence Source Type: research

[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial
In their international randomised controlled trial, the WOMAN Trial Collaborative Group1 showed that early administration of tranexamic acid significantly reduced death due to bleeding in patients with post-partum haemorrhage. However, they did not mention how transfusion therapy was administered in the study cohort. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Yuto Maeda, Kana Yamamoto, Tetsuya Tanimoto, Masahiro Kami, Shinya Yoshioka Tags: Correspondence Source Type: research

[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial
As clinicians and researchers of post-partum haemorrhage, we appreciate the clinical trial of tranexamic acid1 and applaud the researchers and results. We want to emphasise the importance of the addition of tranexamic acid to other technologies and strategies to form a complete comprehensive package for post-partum haemorrhage (or emergency post-partum haemorrhage bundle),2 which begins at the community level and proceeds, with attention to context, through primary health care to the referral-hospital level. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Suellen Miller, Thomas Burke, Jos é M Belizán, Carlos Fuchtner, Andre Lalonde, Jaideep Malhorta Tags: Correspondence Source Type: research

[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial
As one of the many collaborators who contributed to the WOMAN trial1 our team's involvement in research that will improve maternal outcomes globally has been gratifying. 1 g of intravenous tranexamic acid given within 3 h of post-partum haemorrhage significantly reduced maternal death and the need for surgery (laparotomy). The fact that post-partum haemorrhage was defined as 500 mL or more for vaginal deliveries but 1000 mL or more for caesarean section is important to note. This difference should be considered when clinicians update local guidelines for post-partum haemorrhage. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Kim Hinshaw Tags: Correspondence Source Type: research

[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial
This study was mainly done in low-income and middle-income countries; thus, we have concerns about its generalisability. Many differences probably exist in the health-care systems (and disease burdens) between many countries included in the trial. Therefore, we do not think the results are immediately translatable to high-income countries. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Alicia Therese Dennis, James D Griffiths Tags: Correspondence Source Type: research

[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial
We read with interest the WOMAN trial (May 27, p 2105).1 Tranexamic acid is an antifibrinolytic drug used to reduce haemorrhage complications in trauma and elective surgery. The WOMAN trial originally planned to enrol 15  000 women with a composite primary endpoint of death from all causes or hysterectomy within 42 days of giving birth. The trial increased the number of participants to more than 20 000 “in the hope that the trial would have enough power to detect a reduction in post-partum haemorrhage death” . (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Hayley L Letson, Geoffrey P Dobson Tags: Correspondence Source Type: research

[Correspondence] The French surgical services after the Paris and Nice terrorist attacks: what have we learnt?
Following the terrorist attacks in Paris and Nice, emergency medical services in France revised their policy on receiving mass casualties and the services' triage scenarios, summarised in The Lancet by Pierre Carli and colleagues (published online July 25).1 Training takes place, including transfers of expertise from military services that improve the quality of the training. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Damien Massalou Tags: Correspondence Source Type: research

[Obituary] Saidi Hassan
Surgeon and Chairman of the University of Nairobi's Department of Human Anatomy. Born in Nairobi, Kenya, on Aug 3, 1965, he died of cancer in Nairobi on Aug 29, 2017, aged 52 years. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Andrew Green Tags: Obituary Source Type: research

[Perspectives] The art of perception: pointillism, pattern, and Optical art
Compton Verney is an English stately home turned contemporary art venue, nestled in the hills of Warwickshire. Open since 2004, the late philanthropist Peter Moores purchased the Lancelot “Capability” Brown designed park and mansion, established a trust and foundation, and launched a programme of innovative art exhibitions guided by his belief that great art should be accessible to everyone. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Tamara Lucas Tags: Perspectives Source Type: research

[Perspectives] Design for life
Mention the name John Snow in conversation, and the odds are that discussion would not revolve around a 19th-century physician. Yet this particular John Snow was responsible for saving many lives after he mapped cholera cases during an 1854 epidemic in London. Snow's map, regarded as a foundation of modern epidemiology, sits without fanfare next to another pioneering work —Florence Nightingale's polar area diagram of causes of death in the Crimean War—in a new Wellcome Collection exhibition, Can Graphic Design Save Your Life? It's refreshing to see these items in the limelight, alongside a collection of objects...
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Sheila Pinion Tags: Perspectives Source Type: research

[Perspectives] On obesity: Roxane Gay's Hunger
Roxane Gay's Hunger: A Memoir of (My) Body is about obesity, but it is nothing like those books that celebrate more typical memoirs about the triumph of will over waist size. Gay writes instead about how, why, and when she became “super morbidly obese”, while also criticising conventional attitudes about weight. As she tells her own story, she confronts the widespread assumption that obese people are simply weak-willed. She encourages readers to think in more complex ways about the actual experiences of obese individuals and about obesity's deep causes. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Ann Jurecic, Daniel Marchalik Tags: Perspectives Source Type: research

[World Report] Contraception implant removed from global market
Manufacturer halts non-US sales of the permanent contraception implant Essure. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Barbara Casassus Tags: World Report Source Type: research

[World Report] Emergency response after Mexico's earthquakes
After successive earthquakes hit Mexico, volunteers organise to provide help and support. Barbara Fraser and Fabi án Carvallo-Vargas report from Mexico City. (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Barbara Fraser, Fabi án Carvallo-Vargas Tags: World Report Source Type: research

[Comment] Offline: Africa does not need a Prince Charming
By the end of this century, one in three people on our planet will be living in sub-Saharan Africa (today, the proportion is one in eight). Yet this profound shift in population power carries with it little agreement on what should be done to secure the future health and wellbeing of African peoples. Economists are divided. Olusegun Obasanjo (President of Nigeria, 1999 –2007), together with several Africa experts, published his prescription for the continent this month (Making Africa Work: a Handbook, Hurst). (Source: LANCET)
Source: LANCET - September 29, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research