[Articles] Sirolimus in patients with clinically active systemic lupus erythematosus resistant to, or intolerant of, conventional medications: a single-arm, open-label, phase 1/2 trial
These data show that a progressive improvement in disease activity is associated with correction of pro-inflammatory T-cell lineage specification in patients with active systemic lupus erythematosus during 12 months of sirolimus treatment. Follow-up placebo-controlled clinical trials in diverse patient populations are warranted to further define the role of mTOR blockade in treatment of systemic lupus erythematosus. (Source: LANCET)
Source: LANCET - March 15, 2018 Category: General Medicine Authors: Zhi-Wei Lai, Ryan Kelly, Thomas Winans, Ivan Marchena, Ashwini Shadakshari, Julie Yu, Maha Dawood, Ricardo Garcia, Hajra Tily, Lisa Francis, Stephen V Faraone, Paul E Phillips, Andras Perl Tags: Articles Source Type: research
[Comment] CD8 T cells and mTOR: new concepts and targets for systemic lupus erythematosus
Management of systemic lupus erythematosus and its variable clinical manifestations remain considerable challenges for clinicians and patients. Advances in characterising mechanisms of immune system regulation have been applied to studies of systemic lupus erythematosus, implicating type I interferon and highlighting the contributions of T and B lymphocytes to autoantibody production and tissue damage.1 Despite such progress, the pace of development of more effective therapies for patients has been slow. (Source: LANCET)
Source: LANCET - March 15, 2018 Category: General Medicine Authors: David R Fernandez, Mary K Crow Tags: Comment Source Type: research
[Department of Error] Department of Error
Zarocostas J. Libya: war and migration strain a broken health system. Lancet 2018; 391: 824 –25—In this World Report, the third paragraph should have read “Libya is now entering its eighth year of conflict and instability, which first engulfed the nation when in February, 2011, dictator of 42 years Muammar Gaddafi used violence to crush pro-democracy demonstrations. The violent clamp down sparked a civil war that led to Gaddafi's ouster from power in August, 2011, by his rebel opponents—backed by strong aerial and naval support from western powers.” This correction has been made to the online version as of March ...
Source: LANCET - March 14, 2018 Category: General Medicine Tags: Department of Error Source Type: research
[Correspondence] Open letter to The Global Fund about its decision to end DPRK grants
Dear Peter Sands and Aida Kurtovi ć, (Source: LANCET)
Source: LANCET - March 14, 2018 Category: General Medicine Authors: Kee B Park, Uzma Khan, Kwonjune Seung Tags: Correspondence Source Type: research
[Perspectives] Rehumanising the Syrian conflict: photographs of war, health, and life in Syria
The Syrian conflict, which marked its seventh anniversary on March 15, is one of the most live-imaged wars in modern times. Syrian citizen-activists and others have transmitted images extensively to tell the story of the conflict with the hope that this may draw support and change their plight. International media also draw heavily on images —themes of violence, suffering, destruction, and displacement dominate. (Source: LANCET)
Source: LANCET - March 14, 2018 Category: General Medicine Authors: Samer Jabbour, Marvin Gate, Ammar Sabouni, Saeed al-Batal, Humans of Syria Network Tags: Perspectives Source Type: research
[Articles] 6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial
The increased risk of myocardial infarction with 6-month DAPT and the wide non-inferiority margin prevent us from concluding that short-term DAPT is safe in patients with acute coronary syndrome undergoing percutaneous coronary intervention with current-generation DES. Prolonged DAPT in patients with acute coronary syndrome without excessive risk of bleeding should remain the standard of care. (Source: LANCET)
Source: LANCET - March 12, 2018 Category: General Medicine Authors: Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, K Tags: Articles Source Type: research
[Comment] 12 months of DAPT after acute coronary syndrome still beats 6 months
Why does the topic of optimal duration of dual antiplatelet therapy (DAPT) after an acute coronary syndrome treated by coronary stenting continue to generate such intense interest? We have sufficient evidence that acute coronary syndrome is caused by atherothrombosis. We also know that coronary stenting leads to further atherosclerotic plaque disruption, triggering thrombosis. Data from large registries have confirmed that the risk of recurrent myocardial infarction persists in the long term. Results of multiple trials have shown that DAPT reduces this risk. (Source: LANCET)
Source: LANCET - March 12, 2018 Category: General Medicine Authors: Zuzana Motovska, Deepak L Bhatt Tags: Comment Source Type: research
[Series] Out-of-hospital cardiac arrest: in-hospital intervention strategies
The prognosis after out-of-hospital cardiac arrest (OHCA) has improved in the past few decades because of advances in interventions used outside and in hospital. About half of patients who have OHCA with initial ventricular tachycardia or ventricular fibrillation and who are admitted to hospital in coma after return of spontaneous circulation will survive to discharge with a reasonable neurological status. In this Series paper we discuss in-hospital management of patients with post-cardiac-arrest syndrome. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Christian Hassager, Ken Nagao, David Hildick-Smith Tags: Series Source Type: research
[Series] Out-of-hospital cardiac arrest: prehospital management
Sudden out-of-hospital cardiac arrest is the most time-critical medical emergency. In the second paper of this Series on out-of-hospital cardiac arrest, we considered important issues in the prehospital management of cardiac arrest. Successful resuscitation relies on a strong chain of survival with the community, dispatch centre, ambulance, and hospital working together. Early cardiopulmonary resuscitation and defibrillation has the greatest impact on survival. If the community response does not restart the heart, resuscitation is continued by emergency medical services' staff. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Marcus Eng Hock Ong, Gavin D Perkins, Alain Cariou Tags: Series Source Type: research
[Series] Out-of-hospital cardiac arrest: current concepts
Out-of-hospital cardiac arrest (OHCA) is a leading cause of global mortality. Regional variations in reporting frameworks and survival mean the exact burden of OHCA to public health is unknown. Nevertheless, overall prognosis and neurological outcome are relatively poor following OHCA and have remained almost static for the past three decades. In this Series paper, we explore the aetiology of OHCA. Coronary artery disease remains the predominant cause, but there is a diverse range of other potential cardiac and non-cardiac causes to be aware of. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Aung Myat, Kyoung-Jun Song, Thomas Rea Tags: Series Source Type: research
[Articles] Outcome and undertreatment of mitral regurgitation: a community cohort study
In the community, isolated mitral regurgitation is common and is associated with excess mortality and frequent heart failure postdiagnosis in all patient subsets, even in those with normal left-ventricular ejection fraction and low comorbidity. Despite these poor outcomes, only a minority of affected patients undergo mitral (or any type of cardiac) surgery even in a community with all means of diagnosis and treatment readily available and accessible. This suggests that in a wider population there might be a substantial unmet need for treatment for this disorder. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano Tags: Articles Source Type: research
[Department of Error] Department of Error
Annane D, Fuchs-Buder T, Zoellner C, Kaukonen M, Scheeren TWL. EMA recommendation to suspend HES is hazardous. Lancet 2018; 391: 736 –37—Although all authors provided competing interests statements prior to publication of this Correspondence, these details were not included in the published version. The online version of this Correspondence has been updated to include the competing interests statements for all authors as of M arch 8, 2018. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Tags: Department of Error Source Type: research
[Department of Error] Department of Error
Cossu G, Birchall M, Brown T, et al. Lancet Commission: Stem cells and regenerative medicine. Lancet 2018; 391: 883 –910—In this Commission (published online first on Oct 4, 2017), the EC (PluriMes) has been added to the Acknowledgments. This correction has been made to the online version as of March 8, 2018. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Tags: Department of Error Source Type: research
[Correspondence] Safe travels during hurricanes
On the evening of Sept 10, 2017, in Miami (FL, USA), at a time when Hurricane Irma had reached category 4 status, a 91-year-old woman had a stroke. As per local hurricane protocol, emergency medical services are halted when storm winds reach category 3 status or higher. With no viable alternative transportation to navigate through strong winds and the substantial storm surge (appendix), the patient was brought to the emergency room in the backseat of her granddaughter's car. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Ayush Amin, Robert M Starke, Jason T Salsamendi Tags: Correspondence Source Type: research
[Correspondence] Direct visualisation of thrombi for diagnosis of tissue valve thrombosis
Tarun Chakravarty and colleagues (June 17, 2017, p 2383)1 used restricted leaflet motion on CT as the principal surrogate measure to estimate the frequency of subclinical thrombosis after surgical and transcatheter aortic valve replacement. Although restricted leaflet motion (by fluoroscopy) is integral to the diagnosis of symptomatic mechanical heart valve thrombosis,2 it might be less sensitive than direct visualisation for the detection of tissue valve thrombosis, particularly in asymptomatic patients. (Source: LANCET)
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Ganesan Karthikeyan Tags: Correspondence Source Type: research
