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[Department of Error] Department of Error
Watts N, Amann M, Ayeb-Karlsson S, et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet 2018; 391: 581 –630—In this Review (published online first on Oct 30, 2017), Jonathan Chambers, Ian Hamilton, Robert Lowe, and Steve Pye's affiliation has been corrected to UCL Energy Institute, London, UK; Fereidoon Owfi and Mahnaz Rabbaniha's affiliation has been corrected to Iranian Fisheries Science Resear ch Institute, AREEO, Tehran, Iran; Meisam Tabatabaei's affiliation has been corrected to Biofuel Research Team, Agricultural Biotechno...
Source: LANCET - November 23, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Articles] Intrauterine insemination with ovarian stimulation versus expectant management for unexplained infertility (TUI): a pragmatic, open-label, randomised, controlled, two-centre trial
IUI with ovarian stimulation is a safe and effective treatment for women with unexplained infertility and an unfavourable prognosis for natural conception. (Source: LANCET)
Source: LANCET - November 23, 2017 Category: General Medicine Authors: Cynthia M Farquhar, Emily Liu, Sarah Armstrong, Nicola Arroll, Sarah Lensen, Julie Brown Tags: Articles Source Type: research

[Comment] Stimulated intrauterine insemination for unexplained subfertility
Unexplained subfertility is defined as a conception delay of at least 1 year when the standard tests (test of ovulation, tubal patency, and semen parameters) are normal, and is the diagnosis given to up to 40% of couples seeking fertility treatment.1 Because no definitive diagnosis exists, the course of treatment for these couples remains unclear. Although expectant management remains a valid option for young couples with a short duration of conception delay, other couples will prefer a more proactive approach. (Source: LANCET)
Source: LANCET - November 23, 2017 Category: General Medicine Authors: Anupa Nandi, Tarek El-Toukhy Tags: Comment Source Type: research

[Articles] Long-term effects of glucocorticoids on function, quality of life, and survival in patients with Duchenne muscular dystrophy: a prospective cohort study
In patients with Duchenne muscular dystrophy, glucocorticoid treatment is associated with reduced risk of losing clinically meaningful mobility and upper limb disease progression milestones across the lifespan as well as reduced risk of death. (Source: LANCET)
Source: LANCET - November 22, 2017 Category: General Medicine Authors: Craig M McDonald, Erik K Henricson, Richard T Abresch, Tina Duong, Nanette C Joyce, Fengming Hu, Paula R Clemens, Eric P Hoffman, Avital Cnaan, Heather Gordish-Dressman, CINRG Investigators Tags: Articles Source Type: research

[Comment] How glucocorticoids change life in Duchenne muscular dystrophy
Chronic glucocorticoid treatment is well anchored in the standards of care for Duchenne muscular dystrophy and is supported by evidence of efficacy in short-term randomised controlled trials.1,2 In clinical practice, different compounds are prescribed in a range of doses and regimens and are most often tailored to the individual side-effect profile because there is a paucity of strong data to guide duration of treatment and regimen, with only non-randomised studies and retrospective studies showing evidence of functional benefit or effect on survival. (Source: LANCET)
Source: LANCET - November 22, 2017 Category: General Medicine Authors: Nathalie Goemans Tags: Comment Source Type: research

[Editorial] Heart failure in an ageing population
An Article by Nathalie Conrad and colleagues published online on Nov 21 in The Lancet provides the most comprehensive epidemiology to date of the changing burden of heart failure in the UK according to age, sex, regional location, and socioeconomic status. Their data show an increase in the number of new heart failure diagnoses, at least partly because of an ageing population. Comorbidities also continued to increase for multiple chronic conditions such as hypertension, atrial fibrillation, diabetes, cancer, and osteoarthritis. (Source: LANCET)
Source: LANCET - November 22, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals
Despite a moderate decline in standardised incidence of heart failure, the burden of heart failure in the UK is increasing, and is now similar to the four most common causes of cancer combined. The observed socioeconomic disparities in disease incidence and age at onset within the same nation point to a potentially preventable nature of heart failure that still needs to be tackled. (Source: LANCET)
Source: LANCET - November 21, 2017 Category: General Medicine Authors: Nathalie Conrad, Andrew Judge, Jenny Tran, Hamid Mohseni, Deborah Hedgecott, Abel Perez Crespillo, Moira Allison, Harry Hemingway, John G Cleland, John J V McMurray, Kazem Rahimi Tags: Articles Source Type: research

[Comment] Rising incidence of heart failure demands action
Heart failure is a life-threatening syndrome with substantial morbidity and mortality and is a burden to patients, their carers, and health systems. Estimates of heart failure incidence and prevalence are difficult to generate. Accurate epidemiological estimates of heart failure, however, are crucial to ensure resources are appropriately and adequately allocated to treat patients with existing disease, and to inform prevention methods among those at risk. (Source: LANCET)
Source: LANCET - November 21, 2017 Category: General Medicine Authors: Faiez Zannad Tags: Comment Source Type: research

[Articles] Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial
Surgical groups had better outcomes for shoulder pain and function compared with no treatment but this difference was not clinically important. Additionally, surgical decompression appeared to offer no extra benefit over arthroscopy only. The difference between the surgical groups and no treatment might be the result of, for instance, a placebo effect or postoperative physiotherapy. The findings question the value of this operation for these indications, and this should be communicated to patients during the shared treatment decision-making process. (Source: LANCET)
Source: LANCET - November 20, 2017 Category: General Medicine Authors: David J Beard, Jonathan L Rees, Jonathan A Cook, Ines Rombach, Cushla Cooper, Naomi Merritt, Beverly A Shirkey, Jenny L Donovan, Stephen Gwilym, Julian Savulescu, Jane Moser, Alastair Gray, Marcus Jepson, Irene Tracey, Andrew Judge, Karolina Wartolowska, Tags: Articles Source Type: research

[Comment] No benefit of arthroscopy in subacromial shoulder pain
Since its introduction nearly 100 years ago,1 arthroscopy of the knee has revolutionised the care of patients with meniscal lesions, ruptures of the anterior cruciate ligament, and cartilage damage. Although knee arthroscopy has proved to be an asset that is highly beneficial to many patients, it is not a panacea for all knee problems. The clinical benefit is especially questionable for patients with degenerative osteoarthritis: in a trial using a sham surgery,2 knee arthroscopy had no effect, and this finding was confirmed in another study. (Source: LANCET)
Source: LANCET - November 20, 2017 Category: General Medicine Authors: Berend W Schreurs, Stephanie L van der Pas Tags: Comment Source Type: research

[Department of Error] Department of Error
Colombel J-F, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet 2017; published online Oct 31. http://dx.doi.org/10.1016/S0140-6736(17)32641-7. In figure 3B of this Article, the percentage of patients with an endoscopic response in the tight control group should have been 50 ·8%. In figure 4 of this Article, at randomisation, the number of patients in the tight control group who received adalimumab every other week should have been 79. (Source: LANCET)
Source: LANCET - November 20, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Practical applications of evolutionary biology in public health
Jonathan Wells and colleagues,1 Grazyna Jasienska and colleagues,2 and Graham Rook and colleagues3 are to be congratulated on producing a fascinating and thought-provoking Series on how evolutionary biology could contribute to public health. The key insight that our goal in life might be reproductive success, rather than longevity, provides a means to re-conceptualise public health and could inform some of the major conundrums in global public health. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: C Mary Schooling Tags: Correspondence Source Type: research

[Correspondence] On evidence-based medicine – Authors' reply
We thank Marjolein A van der Marck and colleagues, Feras Ali Mustafa, and Jan Matthys for their interest in our Review.1 We agree with van der Marck and colleagues that tackling multimorbidity is an enormous challenge for evidence-based practice that, so far, has not been met. Authors within the evidence-based medicine (EBM) community have, however, suggested initial strategies for those who write guidelines2 and for the broader scientific community,3 and have emphasised the need for approaches that are minimally disruptive to patients' lives. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Benjamin Djulbegovic, Gordon H Guyatt Tags: Correspondence Source Type: research

[Correspondence] On evidence-based medicine
In their Review,1 Benjamin Djulbegovic and Gordon H Guyatt do not adequately address the undue emphasis placed on randomisation in clinical research, which is arguably the main criticism of evidence-based medicine (EBM). (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Feras Ali Mustafa Tags: Correspondence Source Type: research

[Correspondence] On evidence-based medicine
In the Review1 of evidence-based medicine by Benjamin Djulbegovic and Gordon H Guyatt, different or conflicting interpretation of the literature was not mentioned. Although such data selection might not be deliberate, it can be problematic and could result in different interpretations of the evidence by guidelines on the same topic.2 (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Jan Matthys Tags: Correspondence Source Type: research

[Correspondence] On evidence-based medicine
In their Review1 published in The Lancet (July 22, p 415), Benjamin Djulbegovic and Gordon H Guyatt provide a comprehensive overview of the challenges evidence-based medicine (EBM) will probably face in the next 25 years. Rightly, they conclude that it is a triumph that no critic of EBM has ever suggested that reliable evidence should not be key to medicine. EBM's next challenge will be the continued development of more efficient and rapid ways of disseminating evidence and guidelines. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Marjolein A van der Marck, Ren é J F Melis, Marcel G M Olde Rikkert Tags: Correspondence Source Type: research

[Correspondence] Bisphosphonates in osteoporosis: NICE and easy?
The recent National Institute for Health and Care Excellence (NICE) updated multiple technology appraisal on bisphosphonate use in osteoporosis1 demonstrates how, for a common disorder, the strict application of cost-effectiveness thresholds for inexpensive drugs might lead to counterintuitive and potentially harmful guidance. The multiple technology appraisal incorporates the development of fracture risk calculators based on individualised clinical risk factors, such as FRAX and QFracture (recommended by NICE for the assessment of fracture risk in some sections of the population2), and the availability of low-cost generic...
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Nicholas C Harvey, Eugene McCloskey, John A Kanis, Juliet Compston, Cyrus Cooper Tags: Correspondence Source Type: research

[Correspondence] Charlottesville: blatant racism, not grievances, on display
We recently published a paper1 on structural racism in a Lancet Series on equity and equality in health in the USA. Structural racism refers to the many ways in which racial subjugation is embedded in US society —not just in one individual, or groups of individuals, or one institution, but in all of our institutions—from culture to housing to employment to law enforcement, and beyond.1,2 Racism is supported by wealthy and working class whites alike.2,3 The ultimate weapon to maintain and reproduce this system is terror. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Mary T Bassett, Nancy Krieger, Zinzi Bailey Tags: Correspondence Source Type: research

[Perspectives] Picturing health: Rohingya refugees in Bangladesh
Since August, 2017, when violence broke out in Myanmar's northern Rahkine State, it is estimated that more than 600  000 Rohingya people have fled to Bangladesh. To accommodate the steady flow of people, vegetation on steep hillsides and between swathes of paddy fields in Bangladesh has been razed to build spontaneous settlements. Although Bangladesh is planning to build a camp that would house 800 000 people , Rohingya refugees are currently trying to survive in these crowded, haphazard camps. Humanitarian assistance is being provided by the Bangladesh Government, non-governmental organisations (NGOs), UN agencies, WH...
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Danielle Villasana Tags: Perspectives Source Type: research

[World Report] 2017 Prince Mahidol Award winners announced
Public health prize recognises scientists who advanced the field of Haemophilus influenzae type b vaccination, and medicine award goes to the Human Genome Project. Andrew Green reports. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Andrew Green Tags: World Report Source Type: research

[World Report] Towards introducing ACOs in the NHS
The UK Government is moving towards introducing Accountable Care Organisations to the NHS; some worry that this might happen without public consultation. Talha Burki reports. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Talha Burki Tags: World Report Source Type: research

[Comment] Offline: WHO —a roadmap to renewal?
The honeymoon for WHO's new Director-General, Dr Tedros, is over. Now the serious work begins. At a special session of the agency's Executive Board next week, his proposed General Programme of Work (GPW) for 2019 –23 will be tabled, debated, and judged for the first time. This document represents WHO's promise to the world. In many ways, it conveys urgency and ambition. The agency's mission is to promote health, keep the world safe, and serve the vulnerable. It will do so by achieving a “triple billion” target—1 billion more people with health coverage, 1 billion more people made safer, and 1 billio...
Source: LANCET - November 17, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Editorial] Food industry must act to safeguard the future of antibiotics
WHO has urged farmers and the food industry to stop routine use of antibiotics in healthy animals to promote growth and prevent infectious diseases. WHO guidelines, which were released ahead of World Antibiotic Awareness Week (Nov 13 –19), aim to tackle the growing threat of antimicrobial resistance to human health. Use of antibiotics promotes development of drug-resistant bacteria in food-producing animals, which can subsequently be transmitted to humans, and curbing use of antibiotics in animals can reduce the prevalence of resistant bacteria in animals and humans. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Does mobile health matter?
Widespread adoption of digital health applications (apps) in five patient populations (diabetes prevention, diabetes, asthma, cardiac rehabilitation, and pulmonary rehabilita-tion) could save the US health system $7 billion a year according to a report published by the IQVIA Institute for Human Data Science (formerly QuintilesIMS) on Nov 7. The report examines the impact of internet-connected mobile devices on human health and describes a doubling of health condition management mobile apps in the past 2 years. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Alcohol and cancer
The Nov 7 publication of Alcohol and Cancer: a Statement of the American Society of Clinical Oncology (ASCO) emphasises the prominence of alcohol as a proven cause of many cancers. This view is not novel and comes exactly 30 years after a working group of the International Agency for Research on Cancer determined that alcoholic beverages were carcinogenic to humans. It has been echoed by other cancer societies since then but seemingly ignored by the wider medical community and by society. The influential endorsement by ASCO provides a powerful impetus to act on decades of evidence that alcohol harms health. (Source: LANCET)
Source: LANCET - November 17, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Review] Investment in child and adolescent health and development: key messages from Disease Control Priorities, 3rd Edition
The realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5 –9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10–14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15–1...
Source: LANCET - November 16, 2017 Category: General Medicine Authors: Donald A P Bundy, Nilanthi de Silva, Susan Horton, George C Patton, Linda Schultz, Dean T Jamison, Disease Control Priorities-3 Child and Adolescent Health and Development Authors Group Tags: Review Source Type: research

[World Report] Misoprostol drug to be withdrawn from French market
Misoprostol drug Cytotec will be pulled from the French market on March 1, 2018, after reported adverse effects of off-label use. Barbara Casassus reports from Paris. (Source: LANCET)
Source: LANCET - November 16, 2017 Category: General Medicine Authors: Barbara Casassus Tags: World Report Source Type: research

[Comment] Retraction and republication —Misoprostol drug to be withdrawn from French market
On Oct 28, 2017, The Lancet published the World Report “Misoprostol drug to be withdrawn from French market” as an epage.1 After further information was provided to us, The Lancet Editors have decided to retract this World Report, and republish it having removed the information that we believe to be inaccurate.2 The old version of the World Report w ill be added to a webappendix attached to the new version and will be marked as retracted. Additionally, the following sentence should have read: “One issue is that the 200 μg Cytotec tablets have to be split into eight identical sections to obtain the 25 &...
Source: LANCET - November 16, 2017 Category: General Medicine Authors: The Editors of The Lancet Tags: Comment Source Type: research

[Articles] Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial
In this population it is more difficult to initiate patients to XR-NTX than BUP-NX, and this negatively affected overall relapse. However, once initiated, both medications were equally safe and effective. Future work should focus on facilitating induction to XR-NTX and on improving treatment retention for both medications. (Source: LANCET)
Source: LANCET - November 14, 2017 Category: General Medicine Authors: Joshua D Lee, Edward V Nunes, Patricia Novo, Ken Bachrach, Genie L Bailey, Snehal Bhatt, Sarah Farkas, Marc Fishman, Phoebe Gauthier, Candace C Hodgkins, Jacquie King, Robert Lindblad, David Liu, Abigail G Matthews, Jeanine May, K Michelle Peavy, Stephen Tags: Articles Source Type: research

[Comment] Medications for opioid use disorder: bridging the gap in care
For the past two decades, the USA has been in the throes of an opioid crisis marked by a rising number of deaths; in 2016, opioids were responsible for most of the nation's estimated 64  000 fatal drug overdoses.1 The problem began with overprescribing of opioid analgesics in the 1990s, which exposed pain patients to the risks of addiction and produced large surpluses of pain pills that were diverted for misuse by the larger community. Additionally, the escalating numbers of opio id-addicted Americans led to increased HIV and hepatitis C transmission among people who misuse these drugs by injecting them2 and increased nu...
Source: LANCET - November 14, 2017 Category: General Medicine Authors: Nora D Volkow Tags: Comment Source Type: research

[Comment] Extended-release naltrexone: good but not a panacea
Unlike other addictions, opioid-use disorder has several highly effective medication treatments available, in particular methadone, buprenorphine, and naltrexone.1 –3 Methadone is the least accessible or acceptable of these in many settings, so providers and patients are often faced with a choice between buprenorphine-naloxone (BUP-NX) and extended-release naltrexone injection (XR-NTX). (Source: LANCET)
Source: LANCET - November 14, 2017 Category: General Medicine Authors: David C Lott Tags: Comment Source Type: research

[Department of Error] Department of Error
Lu J, Lu Y, Wang X, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from 1 ·7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet 2017; 390: 2549–58—In figure 1 of this Article (published online first on Oct 25, 2017), the labels ‘Awareness’ and ‘Control’ should be swapped round. This correction has been made to t he online version as of Nov 14, 2017, and the printed Article is correct. (Source: LANCET)
Source: LANCET - November 14, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Articles] Nations within a nation: variations in epidemiological transition across the states of India, 1990 –2016 in the Global Burden of Disease Study
Per capita disease burden measured as DALY rate has dropped by about a third in India over the past 26 years. However, the magnitude and causes of disease burden and the risk factors vary greatly between the states. The change to dominance of NCDs and injuries over CMNNDs occurred about a quarter century apart in the four ETL state groups. Nevertheless, the burden of some of the leading CMNNDs continues to be very high, especially in the lowest ETL states. This comprehensive mapping of inequalities in disease burden and its causes across the states of India can be a crucial input for more specific health planning for each ...
Source: LANCET - November 14, 2017 Category: General Medicine Authors: India State-level Disease Burden Initiative Collaborators Tags: Articles Source Type: research

[Perspectives] Lalit Dandona: surveying the burden of disease in India
India is not only a large country but a diverse one. As the Director General of the Indian Council of Medical Research, Soumya Swaminathan, points out, “A lot of planning and policy making are done locally, so it's important for each state to have an idea of their particular disease burden and what their risk factors are and how they've changed over time.” For offering precisely this, the India State-level Disease Burden Initiative Collaborator s' Lancet article on variations in epidemiological transition across Indian states in the Global Burden of Disease Study will be welcomed. (Source: LANCET)
Source: LANCET - November 14, 2017 Category: General Medicine Authors: Geoff Watts Tags: Perspectives Source Type: research

[World Report] The health system in India: the underserved majority
India's national health policy was reformed this year, but lack of accessibility and out-of-pocket expenses still leave rural areas behind. Patralekha Chatterjee reports from Uttar Pradesh. (Source: LANCET)
Source: LANCET - November 14, 2017 Category: General Medicine Authors: Patralekha Chatterjee Tags: World Report Source Type: research

[Editorial] India —a tale of one country, but stories of many states
Colonialism leaves disfiguring scars among those who are colonised. Few countries inflicted such deep wounds as Britain did during its centuries-long colonial rule of India. Understanding the history of colonialism and its consequences is therefore essential if one is to understand the predicaments of nations today. This week, The Lancet publishes the most comprehensive assessment yet of India's present health predicaments. But India's contemporary challenges in alleviating its burden of disease must first be examined in the context of Britain's colonial legacy. (Source: LANCET)
Source: LANCET - November 14, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] Relationship of C-reactive protein reduction to cardiovascular event reduction following treatment with canakinumab: a secondary analysis from the CANTOS randomised controlled trial
The magnitude of hsCRP reduction following a single dose of canakinumab might provide a simple clinical method to identify individuals most likely to accrue the largest benefit from continued treatment. These data further suggest that lower is better for inflammation reduction with canakinumab. (Source: LANCET)
Source: LANCET - November 13, 2017 Category: General Medicine Authors: Paul M Ridker, Jean G MacFadyen, Brendan M Everett, Peter Libby, Tom Thuren, Robert J Glynn, CANTOS Trial Group Tags: Articles Source Type: research

[Comment] Treatment concentration of high-sensitivity C-reactive protein
The landmark CANTOS trial evaluated the use of canakinumab, a monoclonal antibody targeting interleukin 1 β, in 10 061 patients with previous myocardial infarction who had high-sensitivity C-reactive protein (hsCRP) concentrations of 2 mg/L or higher.1 Interleukin 1β has multiple potential mechanisms that contribute to the pathogenesis of atherothrombotic cardiovascular disease.2 Induction of interl eukin 6 leads to the release of acute phase reactants including hsCRP. Thus, hsCRP serves as a surrogate marker of the overall inflammatory milieu,2 often in situations where patients have multiple co-morbidities,3 ...
Source: LANCET - November 13, 2017 Category: General Medicine Authors: Erin D Michos, Roger S Blumenthal Tags: Comment Source Type: research

[Lecture] Planetary health: protecting human health on a rapidly changing planet
The impact of human activities on our planet's natural systems has been intensifying rapidly in the past several decades, leading to disruption and transformation of most natural systems. These disruptions in the atmosphere, oceans, and across the terrestrial land surface are not only driving species to extinction, they pose serious threats to human health and wellbeing. Characterising and addressing these threats requires a paradigm shift. In a lecture delivered to the Academy of Medical Sciences on Nov 13, 2017, I describe the scale of human impacts on natural systems and the extensive associated health effects across ne...
Source: LANCET - November 13, 2017 Category: General Medicine Authors: Samuel S Myers Tags: Lecture Source Type: research

[Review] What works in inclusion health: overview of effective interventions for marginalised and excluded populations
Inclusion health is a service, research, and policy agenda that aims to prevent and redress health and social inequities among the most vulnerable and excluded populations. We did an evidence synthesis of health and social interventions for inclusion health target populations, including people with experiences of homelessness, drug use, imprisonment, and sex work. These populations often have multiple overlapping risk factors and extreme levels of morbidity and mortality. We identified numerous interventions to improve physical and mental health, and substance use; however, evidence is scarce for structural interventions, ...
Source: LANCET - November 11, 2017 Category: General Medicine Authors: Serena Luchenski, Nick Maguire, Robert W Aldridge, Andrew Hayward, Alistair Story, Patrick Perri, James Withers, Sharon Clint, Suzanne Fitzpatrick, Nigel Hewett Tags: Review Source Type: research

[Articles] Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis
Our study shows that homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals experience extreme health inequities across a wide range of health conditions, with the relative effect of exclusion being greater in female individuals than male individuals. The high heterogeneity between studies should be explored further using improved data collection in population subgroups. The extreme health inequity identified demands intensive cross-sectoral policy and service action to prevent exclusion and improve health outcomes in individuals who are already marginalised. (Source: LANCET)
Source: LANCET - November 11, 2017 Category: General Medicine Authors: Robert W Aldridge, Alistair Story, Stephen W Hwang, Merete Nordentoft, Serena A Luchenski, Greg Hartwell, Emily J Tweed, Dan Lewer, Srinivasa Vittal Katikireddi, Andrew C Hayward Tags: Articles Source Type: research

[Comment] Inclusion health: addressing the causes of the causes
The social gradient in health describes a graded association between an individual's position on the social hierarchy and health: the lower the socioeconomic position of an individual, the worse their health.1 The fact that the social gradient extends from the highest echelons of society to the lowest suggests that everyone is affected to a greater or lesser extent by the social determinants of health. One component of social cohesion is making common cause between people at various points on the social ladder. (Source: LANCET)
Source: LANCET - November 11, 2017 Category: General Medicine Authors: Michael Marmot Tags: Comment Source Type: research

[Department of Error] Department of Error
El-Maouche D, Arlt W, Merke DP. Congenital adrenal hyperplasia. Lancet 2017; 390: 2194 –210—In this Seminar (published online first on May 30, 2017), the Contributors section should be added and read “DPM conceived the framework for the Seminar, wrote the Controversial therapies and Future directions sections, contributed to the writing and editing of all sections and figures, a nd coordinated oversight of the final manuscript. DE-M wrote the first versions of the manuscript, created the figures, and did most of the scientific literature searches. (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Intravitreal aflibercept for proliferative diabetic retinopathy – Authors' reply
We would like to thank the authors for their comments on our study report and address the issues they have raised.1 (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Sobha Sivaprasad, A Toby Prevost, Joana Vasconcelos, Amy Riddell, Philip Hykin Tags: Correspondence Source Type: research

[Correspondence] Intravitreal aflibercept for proliferative diabetic retinopathy
We applaud the CLARITY study group for their efforts.1 We raise three issues aimed at a deeper understanding of the published data and its implications. (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Authors: David M Brown, Charles C Wykoff Tags: Correspondence Source Type: research

[Correspondence] Intravitreal aflibercept for proliferative diabetic retinopathy
We congratulate Sobha Sivaprasad and colleagues (June 3, p 2193)1 for their interesting paper on the clinical efficacy of intravitreal aflibercept versus panretinal laser photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy (the CLARITY study). The authors concluded that aflibercept was non-inferior and superior to panretinal laser photocoagulation in both the modified intention-to-treat population and the per-protocol population. These findings provide new, provocative data that should be taken into consideration when formulating a treatment management plan for individuals ...
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Lei Liu, Yih-Chung Tham, Ching-Yu Cheng Tags: Correspondence Source Type: research

[Correspondence] Ocular gene therapy for neovascular AMD: a new era? – Authors' reply
Irina Chatziralli and Theodoros Sergentanis note that after intravitreous injection of AAV2-sFLT01, 40% of patients in cohorts 4 and 5 received rescue anti-vascular endothelial growth factor (anti-VEGF) injections.1 They ask for the criteria and implications of rescue injections. They also ask why the presence of subretinal fibrosis was not required in cohort 5. (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Peter A Campochiaro, Jeffrey S Heier, Saleema Kherani, Annaig Le-Halpere, Abraham Scaria Tags: Correspondence Source Type: research

[Correspondence] Ocular gene therapy for neovascular AMD: a new era?
We read with great interest the study by Jeffrey S Heier and colleagues (July 1, p 50)1 on the beneficial effects of an intravitreal injection of AAV2-sFLT01 in patients with advanced neovascular age-related macular degeneration (AMD). Despite the original findings, there are methodological concerns that need to be further addressed. (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Irini P Chatziralli, Theodoros N Sergentanis Tags: Correspondence Source Type: research

[Correspondence] Patients are denied care because of corruption in Romania
On Sept 1, 2017, the prosecutors of the Romanian National Anticorruption Directorate detained 14 people on charges of corruption, with the president of the National Health Insurance House (NHIH), the head of the NHIH's Antifraud Department, and the director of the Bucharest Health Insurance House among them.1 They are accused of having orchestrated reimbursement of home care services for fictional patients to the detriment of real patients on waiting lists, who had been denied services. Initial estimates indicate damage of at least €3 million to the NHIH budget between January, 2016, and August, 2017. (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Marius-Ionu ţ Ungureanu, Adrian Gheorghe, Ştefan Adrian Voinea Tags: Correspondence Source Type: research

[Obituary] Johannes Joseph van Rood
Pioneering immunogeneticist. He was born in Scheveningen, the Netherlands, on April 7, 1926, and died of vascular disease in Leeuwarden, the Netherlands, on July 21, 2017, aged 91 years. (Source: LANCET)
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research