[Comment] Improving access to psychological therapies in England
Most people with mental illness worldwide receive no treatment at all.1 The number benefiting from effective treatment is even fewer —eg, as low as one in six people with major depression receive effective care in high-income countries, and one in 27 people in low-income or middle-income countries.2 For mild-to-moderate depression, the treatments of choice are psychological therapies.3,4 Are there any examples of a health-care system successfully scaling up evidence-based practice for such common mental disorders? Yes: evidence is emerging that the Improving Access to Psychological Therapies (IAPT) programme in Engla...
Source: LANCET - December 7, 2017 Category: General Medicine Authors: Graham Thornicroft Tags: Comment Source Type: research

[Articles] Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis
Among patients who had lumbar puncture, atraumatic needles were associated with a decrease in the incidence of postdural-puncture headache and in the need for patients to return to hospital for additional therapy, and had similar efficacy to conventional needles. These findings offer clinicians and stakeholders a comprehensive assessment and high-quality evidence for the safety and efficacy of atraumatic needles as a superior option for patients who require lumbar puncture. (Source: LANCET)
Source: LANCET - December 6, 2017 Category: General Medicine Authors: Siddharth Nath, Alex Koziarz, Jetan H Badhiwala, Waleed Alhazzani, Roman Jaeschke, Sunjay Sharma, Laura Banfield, Ashkan Shoamanesh, Sheila Singh, Farshad Nassiri, Wieslaw Oczkowski, Emilie Belley-C ôté, Ray Truant, Kesava Reddy, Maureen O Meade, Foroug Tags: Articles Source Type: research

[Comment] Atraumatic lumbar puncture needles: practice needs to change
Lumbar puncture is a procedure used to obtain cerebrospinal fluid for diagnostic or therapeutic purposes and spinal anaesthesia. A retrospective study1 showed that in 2014, lumbar puncture was done in 1 ·4% of patients admitted to hospital and 0·8% of patients who were admitted to Accident and Emergency departments in France. Extrapolating these figures to the National Health Service Accident and Emergency attendance data indicates that more than 160 000 lumbar punctures are done in the UK annu ally. (Source: LANCET)
Source: LANCET - December 6, 2017 Category: General Medicine Authors: Diederik van de Beek, Matthijs C Brouwer Tags: Comment Source Type: research

[Comment] Disease Control Priorities, 3rd edition —from theory to practice
In 2013, the Lancet Commission on Investing in Health published the report global health 2035: a world converging within a generation.1 The authors showed how governments and donors could achieve a “grand convergence” by bringing preventable infectious, maternal, and child mortality rates to low levels universally by 2035, within a generation. Additionally, the report pointed to major reductions in the incidence and consequences of non-communicable diseases that can be achieved in such tim e, and that progress towards Global Health 2035 can be accelerated through universal health coverage (UHC). (Source: LANCET)
Source: LANCET - December 5, 2017 Category: General Medicine Authors: Pamela Das, Richard Horton Tags: Comment Source Type: research

[Articles] Modern contraceptive use, unmet need, and demand satisfied among women of reproductive age who are married or in a union in the focus countries of the Family Planning 2020 initiative: a systematic analysis using the Family Planning Estimation Tool
Whereas the estimate of additional users up to 2017 for women of reproductive age who are married or in a union would suggest that the 120  × 20 goal for all women is overly ambitious, the aggregate outcomes mask the diversity in progress at the country level. We identified countries with accelerated progress, that provide inspiration and guidance on how to increase the use of family planning and inform future efforts, especially in countries where progress has been poor. (Source: LANCET)
Source: LANCET - December 5, 2017 Category: General Medicine Authors: Niamh Cahill, Emily Sonneveldt, John Stover, Michelle Weinberger, Jessica Williamson, Chuchu Wei, Win Brown, Leontine Alkema Tags: Articles Source Type: research

[Articles] Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial
Our findings show that, at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care. (Source: LANCET)
Source: LANCET - December 5, 2017 Category: General Medicine Authors: Michael EJ Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John Tags: Articles Source Type: research

[Comment] Remission of type 2 diabetes: mission not impossible
Type 2 diabetes is a heterogeneous disease with a rapidly increasing prevalence worldwide. The main risk factors are weight gain and obesity, sedentary lifestyle, and unhealthy dietary pattern —all of which are modifiable.1 Well controlled lifestyle interventions in individuals with impaired glucose tolerance can prevent or postpone the development of type 2 diabetes through weight loss, physical activity, and healthy dietary choices.2,3 Moreover, diabetes risk is decreased for many yea rs after the active intervention period, suggesting a legacy effect. (Source: LANCET)
Source: LANCET - December 5, 2017 Category: General Medicine Authors: Matti Uusitupa Tags: Comment Source Type: research

[Articles] Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study
Short-term exposure to traffic pollution prevents the beneficial cardiopulmonary effects of walking in people with COPD, ischaemic heart disease, and those free from chronic cardiopulmonary diseases. Medication use might reduce the adverse effects of air pollution in individuals with ischaemic heart disease. Policies should aim to control ambient levels of air pollution along busy streets in view of these negative health effects. (Source: LANCET)
Source: LANCET - December 5, 2017 Category: General Medicine Authors: Rudy Sinharay, Jicheng Gong, Benjamin Barratt, Pamela Ohman-Strickland, Sabine Ernst, Frank J Kelly, Junfeng (Jim) Zhang, Peter Collins, Paul Cullinan, Kian Fan Chung Tags: Articles Source Type: research

[Comment] Walking to a pathway for cardiovascular effects of air pollution
There is a well documented association between human exposure to fine particulate matter air pollution (PM2.5) and an increased risk of cardiovascular disease and death.1,2 Indeed, the Global Burden of Disease (GBD) study3 recently estimated that exposure to PM2 ·5 contributed to 4·2 million deaths in 2015, representing the fifth-ranked risk factor for global deaths; of these, mortality from cardiovascular disease (CVD; ie, ischaemic heart disease and cerebrovascular disease) accounted for most deaths attributed to ambient PM2·5 air pollution. (Source: LANCET)
Source: LANCET - December 5, 2017 Category: General Medicine Authors: George D Thurston, Jonathan D Newman Tags: Comment Source Type: research

[Articles] Preliminary aggregate safety and immunogenicity results from three trials of a purified inactivated Zika virus vaccine candidate: phase 1, randomised, double-blind, placebo-controlled clinical trials
The ZPIV candidate was well tolerated and elicited robust neutralising antibody titres in healthy adults. (Source: LANCET)
Source: LANCET - December 4, 2017 Category: General Medicine Authors: Kayvon Modjarrad, Leyi Lin, Sarah L George, Kathryn E Stephenson, Kenneth H Eckels, Rafael A De La Barrera, Richard G Jarman, Erica Sondergaard, Janice Tennant, Jessica L Ansel, Kristin Mills, Michael Koren, Merlin L Robb, Jill Barrett, Jason Thompson, Al Tags: Articles Source Type: research

[Articles] Safety, tolerability, and immunogenicity of two Zika virus DNA vaccine candidates in healthy adults: randomised, open-label, phase 1 clinical trials
VRC5283 was well tolerated and has advanced to phase 2 efficacy testing. (Source: LANCET)
Source: LANCET - December 4, 2017 Category: General Medicine Authors: Martin R Gaudinski, Katherine V Houser, Kaitlyn M Morabito, Zonghui Hu, Galina Yamshchikov, Ro Shauna Rothwell, Nina Berkowitz, Floreliz Mendoza, Jamie G Saunders, Laura Novik, Cynthia S Hendel, LaSonji A Holman, Ingelise J Gordon, Josephine H Cox, Srilat Tags: Articles Source Type: research

[Comment] Tradition and innovation in development of a Zika vaccine
In response to the urgent need for a vaccine to prevent congenital syndromes associated with Zika virus, the scientific community has responded swiftly. Several vaccine technologies are in development. In The Lancet, Kayvon Modjarrad and colleagues1 and Martin R Gaudinski and colleagues2 report results of phase 1 clinical trials of candidate Zika vaccines. It has been less than 2 years since the association between Zika virus infection and microcephaly was established in Recife, Brazil,3,4 and to have multiple promising vaccine candidates in so short a time is impressive. (Source: LANCET)
Source: LANCET - December 4, 2017 Category: General Medicine Authors: Ernesto T A Marques, Donald S Burke Tags: Comment Source Type: research

[Department of Error] Department of Error
India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet 2017; 390: 2437 –60—In this Article (published online first on Nov 13, 2017), changes have been made to the list of India State-Level Disease Burden Initiative Collaborators and affiliations. This correction has been made to the online version as of Nov 30, 2017, and the printed Article is correct. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Efficacy of infliximab biosimilars in patients with Crohn's disease – Authors' reply
We thank Pierre Michetti and Davide Giuseppe Ribaldone and colleagues for their interest in our Article.1 In the NOR-SWITCH study, we showed that in patients on maintenance therapy with originator infliximab, switching to the biosimilar infliximab (CT-P13) is safe and efficacious across six indications. In patients with Crohn's disease, the rate difference between the biosimilar CT-P13 and originator infliximab was −14·3% (calculated using the Harvey Bradshaw index and adjusted for diagnosis and length of treatment with infliximab at baseline), which is very close to the predefined non-inferiority margin of 15%. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Kristin K J ørgensen, Knut E Lundin, Inge C Olsen, Tore K Kvien, Jørgen Jahnsen Tags: Correspondence Source Type: research

[Correspondence] Efficacy of infliximab biosimilars in patients with Crohn's disease
The study by Kristen K J ørgensen and colleagues1 assessed the efficacy of switching maintenance therapy from originator infliximab to the biosimilar CT-P13 in several inflammatory diseases. Because of the potential effects biosimilars could have on health and the cost of health care, this is an active area of debate.2–4 (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Davide Giuseppe Ribaldone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano Tags: Correspondence Source Type: research

[Correspondence] Efficacy of infliximab biosimilars in patients with Crohn's disease
The NOR-SWITCH study by Kirsten K J ørgensen and coworkers1 (May 11, p 2304) was a double-blind, non-inferiority trial in which patients on originator infliximab therapy were randomly assigned to continue infliximab therapy or to switch to CT-P13, an infliximab biosimilar that has a decreased affinity for FcγRIII receptors.2 The pre specified margin of non-inferiority was 15%. In patients with Crohn's disease, the non-inferiority margin was 15·3%, which was above the pre-specified non-inferiority margin. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Pierre Michetti Tags: Correspondence Source Type: research

[Correspondence] A global perspective on the history of anaesthesia
The overview of the development of anaesthesia by Thomas Schlich in The Lancet (Sept 9, p 1020)1 provided fascinating insight into the changing relationship between surgeons, physicians, and the patient's body in western medicine. A more global view of medical history affords the opportunity for other sensibilities. The first recorded use of a general anaesthetic in Japan was by Hanaoka Seishu in 1804,2 and it is possible that a similar approach was used by Hua Tao, a Chinese surgeon, in second-century CE. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Desmond O'Neill Tags: Correspondence Source Type: research

[Correspondence] To be a scientist in Mexico … or not to be?
We want to provide some clarifications regarding points discussed in previous letters, published in The Lancet (June 17, p 2373)1 and Science,2 that are related to government cuts to science and fellowships in Mexico. Once again, the Mexican Government has deceived the academic community with false promises.3 (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Manuel Elias-Guti érrez, Martha Valdez-Moreno, Laura Carrillo, Lourdes Vásquez-Yeomans Tags: Correspondence Source Type: research

[Correspondence] Informing women with endometriosis about ovarian cancer risk
We acknowledge the ongoing concerns of women with endometriosis, a chronic gynaecological condition affecting about 176 million women worldwide, regarding information about their increased ovarian cancer risk. Endometriosis is an inflammatory disease process characterised by lesions of endometrial-like tissue outside the uterus —commonly on the pelvic peritoneum and ovaries—that is associated with debilitating pelvic pain and infertility.1 Although benign, endometriosis has cancer-like features,2 a mutation profile similar to that of ovarian cancer,3 and an increased ovarian cancer risk. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Marina Kvaskoff, Andrew W Horne, Stacey A Missmer Tags: Correspondence Source Type: research

[Perspectives] Seven decades of fighting the five giants: a work in progress
On Dec 1, 1942, queues stretched from His Majesty's Stationery Office along High Holborn in London, UK. By lunchtime all copies of Sir William Beveridge's groundbreaking report, Cmd 6404 Social Insurance and Allied Services, had been sold. It was much the same story in provincial cities around the country. In Liverpool my father secured the two-volume report that today takes pride of place in my study. Beveridge's report sits alongside works by others who have guided me in my public health career: Brian Abel-Smith, Douglas Black, Ann Cartwright, Karen Dunnell, Margot Jeffries, Jerry Morris, Richard Titmuss, Peter Townsend,...
Source: LANCET - December 1, 2017 Category: General Medicine Authors: John R Ashton Tags: Perspectives Source Type: research

[Perspectives] Miracle in Cape Town
They called it the “miracle in Cape Town”. On Dec 3, 1967, the world awoke to the news that the South African surgeon Christiaan Barnard had done the first human heart transplantation. Newspapers published pictures of the recipient, a 54-year-old grocer called Louis Washkansky, and—strangely, to modern eyes—th e donor, Denise Darvall, a young woman who had been fatally injured in a road traffic accident. Washkansky lived for only 18 days before succumbing to a postoperative infection but was briefly well enough to give interviews. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Thomas Morris Tags: Perspectives Source Type: research

[Perspectives] 2017 Global Health Film Festival: stories of climate change
On Dec 8 –9, the 2017 Global Health Film Festival returns to London, UK, to pick up where it left last year on its mission to use film and media as a catalyst for discussion and for change on the major health challenges facing the world. It will bring together health professionals, film-makers, industry ex perts, journalists, and the public for global health advocacy through film, Q&As, masterclasses, and virtual reality installations. “While the festival is still in its infancy, it has grown significantly since the first one in 2015 in terms of its offering”, explains Gerri McHugh, Global Health Film...
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Natalie Harrison Tags: Perspectives Source Type: research

[World Report] US Senate considers Alex Azar to lead HHS
Donald Trump's nominee for Secretary of the Department of Health and Human Services (HHS) would be returning to government after a decade in the drug industry. Ted Alcorn reports. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Ted Alcorn Tags: World Report Source Type: research

[Comment] Heart transplantation at 50
Heralded as a miracle of medicine, the world received notice on Dec 3, 1967, that a diseased human heart had been successfully exchanged for a donor allograft.1 In the decade that followed, enthusiasm abated as allograft survival was limited due to defiance of the immune system.2 The introduction of the immunosuppressant ciclosporin —a watershed moment to boost rejection-free survival—and the ability to histologically survey the cardiac allograft using biopsy measurably augmented cardiac allograft outcome. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Mandeep R Mehra Tags: Comment Source Type: research

[Comment] Offline: The latent power of doctors
What will we make of today's waves of human migration (and their associated traumas) in years to come? Kate Clanchy believes they will be seen as a new Holocaust: the vast number of children who have lived side-by-side extraordinary violence. She was speaking at Medicine Unboxed, a festival exploring the cultural place of medicine in society. The theme this year was “Maps”. Clanchy is a writer and poet. She works at a school in Oxford that receives refugees from Afghanistan and Syria. She is wary of those who say the best way to deal with trauma is “to vomit it up and move on”. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Women in science, medicine, and global health: call for papers
Women are rising. Recent reports of sexual harassment and assault of women by men in powerful positions have regalvanised solidarity around women's rights, and remind us that disadvantage, discrimination, and sexism are a regular part of the lived experience of many women. These reflect broader and unjustified inequalities between men and women that have persisted across time, culture, and geography. That disadvantages exist for women in science, medicine, and global health is thus unsurprising —and yet wholly unacceptable. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Jocalyn Clark, Elizabeth Zuccala, Richard Horton Tags: Comment Source Type: research

[Comment] Crucial role of finance ministry in achieving universal health coverage
Universal health coverage (UHC) is now accepted as a core goal for all countries around the world —as one of the Sustainable Development Goals (SDGs) for health (target 3·8). Low-income and middle-income countries (LMICs) are now adopting policies and strategies to help achieve this important goal. Japan is committed to supporting countries to achieve this goal, as part of its national commit ment to human security, as Prime Minister Shinzō Abe emphasised in this journal.1 Japan's past experiences in achieving UHC in 1961 provide policy lessons for other countries. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Taro Aso Tags: Comment Source Type: research

[Editorial] Far from universal access to electricity
Sustainable development goal 7 ensures “access to affordable, reliable, sustainable and modern energy for all”. Yet estimates from the UN conference on trade and development's Least Developed Countries Report 2017, published on Nov 22, show that in 2014, 1·06 billion people—54% of whom were living in the least developed countries (LDCs)—did not have access to electricity. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Hearing loss: time for sound action
Half a billion people, almost 7% of the global population, had disabling hearing loss in 2015, state Blake Wilson and colleagues in a Review examining the burden of hearing loss in this issue of The Lancet. Hearing loss is now the fourth leading cause of years lived with disability, up from the 11th leading cause in 2010 and ahead of headline-grabbing conditions like diabetes and dementia. The 32 million children affected experience delays and usually limits in their communication, literacy, and educational attainments. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] A sirolimus-eluting bioabsorbable polymer-coated stent (MiStent) versus an everolimus-eluting durable polymer stent (Xience) after percutaneous coronary intervention (DESSOLVE III): a randomised, single-blind, multicentre, non-inferiority, phase 3 trial
The sirolimus-eluting bioabsorbable polymer stent was non-inferior to the everolimus-eluting durable polymer stent for a device-oriented composite clinical endpoint at 12 months in an all-comer population. MiStent seems a reasonable alternative to other stents in clinical practice. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Robbert J de Winter, Yuki Katagiri, Taku Asano, Krzysztof P Milewski, Philipp Lurz, Pawel Buszman, Gillian A J Jessurun, Karel T Koch, Roland P T Troquay, Bas J B Hamer, Ton Oude Ophuis, Jochen W öhrle, Rafał Wyderka, Guillaume Cayla, Sjoerd H Hofma, S Tags: Articles Source Type: research

[Comment] MiStent: just another example of non-inferiority?
The Xience everolimus-eluting coronary stent has been shown to reduce the risk for stent thrombosis and target-lesion revascularisation compared with first-generation drug-eluting stents.1 In recent trials of drug-eluting stents, several other new-generation stents, such as Resolute zotarolimus-eluting stent,2 Nobori biolimus-eluting stent,3 Synergy everolimus-eluting stent,4 Ultimaster sirolimus-eluting stent,5 and Orsiro sirolimus-eluting stent,6 were non-inferior to Xience for target-lesion failure; however, no new-generation drug-eluting stent has shown superiority over Xience. (Source: LANCET)
Source: LANCET - December 1, 2017 Category: General Medicine Authors: Takeshi Kimura Tags: Comment Source Type: research

[Department of Error] Department of Error
Kendler DL, Marin F, Zerbini CAF, et al. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 2017; 391: 230 –40—In figure 2F of this Article (published online first on Nov 9, 2017), the confidence interval around the hazard ratio should have been 0·14–0·58. This correction has been made to the online version as of Nov 30, 2017, and the printed Article is correct. (Source: LANCET)
Source: LANCET - November 30, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Comment] A new vision for global health leadership
The complexity of global health problems demands leadership that represents the pluralism in society. The absence of gender parity in the leadership of key global health institutions in academic, governmental, and non-governmental organisations is evidence that this aspiration for diverse and inclusive leadership is not yet a reality.1,2 Women continue to represent most of the health workforce worldwide yet remain the minority in global health leadership.3 For example, only 31% of the world's ministers of health are women, and among the chief executives of the 27 health-care companies in the 2017 global Fortune 500, only o...
Source: LANCET - November 30, 2017 Category: General Medicine Authors: Michele Barry, Zohray Talib, Ashley Jowell, Kelly Thompson, Cheryl Moyer, Heidi Larson, Katherine Burke, Steering Committee of the Women Leaders in Global Health Conference Tags: Comment Source Type: research

[Health Policy] Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK
This report contains new and follow-up metric data relating to the eight main recommendations of the Lancet Standing Commission on Liver Disease in the UK, which aim to reduce the unacceptable harmful consequences of excess alcohol consumption, obesity, and viral hepatitis. For alcohol, we provide data on alcohol dependence, damage to families, and the documented increase in alcohol consumption since removal of the above-inflation alcohol duty escalator. Alcoholic liver disease will shortly overtake ischaemic heart disease with regard to years of working life lost. (Source: LANCET)
Source: LANCET - November 29, 2017 Category: General Medicine Authors: Roger Williams, Graeme Alexander, Iain Armstrong, Alastair Baker, Neeraj Bhala, Ginny Camps-Walsh, Matthew E Cramp, Simon de Lusignan, Natalie Day, Anil Dhawan, John Dillon, Colin Drummond, Jessica Dyson, Graham Foster, Ian Gilmore, Mark Hudson, Deirdre K Tags: Health Policy Source Type: research

[Comment] The global fight against malaria is at crossroads
Since 2000, millions of malaria deaths, especially among young children, have been averted in malaria-endemic countries with the unprecedented global investment in the fight against the disease.1 The malaria targets of the Millennium Development Goals for 2015 were achieved. Remarkably, this progress was reached by the imperfect application of imperfect tools. However, these gains may also have led to complacency about the worrying developments in recent years. (Source: LANCET)
Source: LANCET - November 29, 2017 Category: General Medicine Authors: Pedro Alonso, Abdisalan M Noor Tags: Comment Source Type: research

[Correspondence] Mobilising experience from Ebola to address plague in Madagascar and future epidemics
As of Nov 10, 2017, there were a total of 2119 confirmed, probable, and suspected cases of plague, and 171 deaths from plague in Madgascar. This outbreak is spreading throughout the country, affecting both rural and urban areas, and anthropologists have been mobilised by global health agencies to contribute to the emergency global health response. Many of these specialists previously worked on the 2014 –16 Ebola virus disease epidemic in west Africa and possess experience and expertise gained from this context. (Source: LANCET)
Source: LANCET - November 28, 2017 Category: General Medicine Authors: Kelley Sams, Alice Desclaux, Julienne Anoko, Francis Akind ès, Marc Egrot, Khoudia Sow, Bernard Taverne, Blandine Bila, Michèle Cros, Moustapha Keïta-Diop, Mathieu Fribault, Réseau Ouest Africain Anthropologie des Epidémies Emergentes, Annie Wilkinso Tags: Correspondence Source Type: research

[Comment] The mental health of refugees and asylum seekers on Manus Island
On Oct 31, 2017, the Governments of Australia and Papua New Guinea ended support for the Manus Island Regional Processing Centre, an Australian immigration detention facility on Manus Island, Papua New Guinea. Instead, currently incomplete and substandard facilities without adequate service provision have been hastily constructed to accommodate people.1 379 refugees and asylum seekers refused to leave the centre stating fears for their security.2,3 They managed to survive for several weeks with no provision of food and water or electricity and in poor hygienic circumstances. (Source: LANCET)
Source: LANCET - November 27, 2017 Category: General Medicine Authors: Suresh Sundram, Peter Ventevogel Tags: Comment Source Type: research

[Correspondence] Comment on the PODCAST study – Authors' reply
Susanne Koch and Claudia D Spies suggest that there might have been an absence of delirium reduction in the PODCAST trial1 when patients received ketamine because clinicians might have increased anaesthetic administration in the ketamine groups, thereby neutralising the benefits of ketamine. We agree, some preliminary evidence2,3 supports that a relative excess of anaesthetic administration —possibly when associated with suppression of brain electrical activity—could increase the incidence of postoperative delirium. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Michael S Avidan, George A Mashour Tags: Correspondence Source Type: research

[Correspondence] Comment on the PODCAST study
The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study (July 15, p 267)1 analysed whether application of ketamine after anaesthesia induction would result in a lower incidence of postoperative delirium in elderly patients. Contrary to expectations, ketamine treatment did not result in a lower incidence of postoperative delirium. We think this result might partly be because of the varying depths of anaesthesia in the PODCAST study. At least, the study does not mention by what means a similar depth of anaesthesia was established or guaranteed. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Susanne Koch, Claudia D Spies Tags: Correspondence Source Type: research

[Correspondence] Pembrolizumab is effective for drug-resistant gestational trophoblastic neoplasia
Gestational trophoblastic disease represents a spectrum of pregnancy related disorders, ranging from pre-malignant hydatidiform mole to malignant tumours, collectively referred to as gestational trophoblastic neoplasia. Gestational trophoblastic neoplasia includes malignant invasive mole, choriocarcinoma, and rare placental site trophoblastic and epithelioid trophoblastic tumours.1 Globally, approximately 18  000 women are diagnosed with gestational trophoblastic neoplasia annually, most of whom are cured with chemotherapy guided by the sensitive disease response biomarker, human chorionic gonadotropin. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Ehsan Ghorani, Baljeet Kaur, Rosemary A Fisher, Dee Short, Ulrika Joneborg, Joseph W Carlson, Ayse Akarca, Teresa Marafioti, Sergio A Quezada, Naveed Sarwar, Michael J Seckl Tags: Correspondence Source Type: research

[Perspectives] A check-up on Canada's health system
In 2005, one of us (KMW) watched a close friend go in and out of hospital in Canada many times. An immigrant from one of the worst slums in Mumbai, India, he loved Canada and worked hard over many years to succeed and give his family a better life. However, the last years of his life were dominated by complex medical issues and frequent interactions with the Canadian health-care system, during which he developed a personal dislike and mistrust of hospitals and a frustration with the inefficiencies of medical care. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Kishor M Wasan, Ellen K Wasan, Jawahar Kalra Tags: Perspectives Source Type: research

[Perspectives] Powerful venom
It can't be said that Venom: Killer and Cure, the new exhibition at the Natural History Museum in London, UK, will set your mind at ease. Never mind the giant cobra straight out of B-movie nightmare or the huge, hairy (but harmless to humans) Burgundy Goliath birdeater tarantula; it's the insects that are the worst. A chilling display of nasty little bugs accompanies each one with a description of the effects of their sting. That of the trap-jaw ant is “instantaneous and excruciating: a rat trap snaps your fingernail”; the bullet ant induces “pure, intense, brilliant pain, like walking over flaming charco...
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Philip Ball Tags: Perspectives Source Type: research

[Perspectives] Agn ès Buzyn: France's Minister for Solidarity and Health
Curiously, a career in politics is of little interest to Agn ès Buzyn, distinguished haematologist and Minister for Solidarités et de la Santé in France's Government under Prime Minister Edouard Philippe and President Emmanuel Macron. “I would not have accepted this post in another government. It is a real shift in our democracy to try and get people wor king together across the political spectrum. I accepted this position as I am philosophically in line with President Macron, and I want to see scientific rationality brought into our political decision making”, Buzyn says. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Richard Lane Tags: Perspectives Source Type: research

[World Report] Peter Sands appointed head of the Global fund
The appointment of the new executive director of the Global Fund was announced on Nov 14; it was hailed by some as an important move for global health financing. John Zarocostas reports. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: John Zarocostas Tags: World Report Source Type: research

[World Report] Scotland to implement alcohol pricing legislation
UK Supreme Court ruling opens the door for Scottish Government to implement minimum alcohol unit pricing legislation, the first country in the world to do so. Talha Burki reports. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Talha Burki Tags: World Report Source Type: research

[Comment] Offline: Who is Peter Sands?
The appointment of a new Executive Director to lead the Global Fund to Fight AIDS, Tuberculosis, and Malaria was not a tidy process. The first attempt to find a successor to Mark Dybul ended in ignominious failure, with questions raised, variously, about the moral probity and conflicts of interest of several prominent candidates. The Global Fund Board tried again. Four names made it through to the final shortlist. And then disaster seemed to strike once more. One candidate, Peter Sands, withdrew his name for “personal reasons”. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Why do so many clinical trials of therapies for Alzheimer's disease fail?
Alzheimer's disease is an irreversible, progressive brain disorder that accounts for about 50 –75% of all cases of dementia.1 Alzheimer's disease is characterised by the presence of amyloid plaques (amyloid β) and neurofibrillary (tau) tangles, plus the loss of connections between neurons in the brain. The damage to the brain induced by abnormal deposits of amyloid β and tau tangles is b elieved to start a decade or more before a decline in cognitive function is apparent.1,2 (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Roy M Anderson, Christoforos Hadjichrysanthou, Stephanie Evans, Mei Mei Wong Tags: Comment Source Type: research

[Editorial] Pledge deaths in US colleges
The suspected alcohol-related death of 20-year-old Texas University fraternity pledge Matthew Ellis last week has put US college “Greek week” activities in 2017 firmly in the global spotlight. Texas joins Ohio, Louisiana, Pennsylvannia, and Florida state universities in suspending fraternity and sorority activities either in response to student deaths or reports of hazing—legally defined as the abuse a student must endu re to gain admittance to an organisation. It includes both physical harm (including forcing dangerous amounts of alcohol to be drunk) and the mental harm of forcing a student to behave in ...
Source: LANCET - November 24, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Caring for migrant health-care workers
On Nov 21, WHO published a report Women on the move: migration, care work and health, which throws a much needed spotlight on the plight of female migrant care workers who provide home-based personal care. The report was commissioned by WHO in response to increasing global political interest in labour migration and health after discussions at the G7 meeting in Japan in May, 2016, which called for more attention to be given to migrants and their roles in paid and unpaid care work. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Review] Universal health coverage and intersectoral action for health: key messages from Disease Control Priorities, 3rd edition
The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. (Source: LANCET)
Source: LANCET - November 24, 2017 Category: General Medicine Authors: Dean T Jamison, Ala Alwan, Charles N Mock, Rachel Nugent, David Watkins, Olusoji Adeyi, Shuchi Anand, Rifat Atun, Stefano Bertozzi, Zulfiqar Bhutta, Agnes Binagwaho, Robert Black, Mark Blecher, Barry R Bloom, Elizabeth Brouwer, Donald A P Bundy, Dan Chish Tags: Review Source Type: research