Log in to search using one of your social media accounts:

 

[Correspondence] Closing the NIH Fogarty Center threatens US and global health
The budget set out by the Trump administration for the 2018 fiscal year proposes cutting about US$6 billion from the National Institutes of Health (NIH). Specifically, this budget intends to eliminate the John E Fogarty International Center, which currently receives 0 ·2% of the NIH's 2017 budget of $33·1 billion. Despite its modest size, the Fogarty Center has become a crucial contributor to health research worldwide over the past 50 years by funding the training of over 6000 scientists in developing countries, including many of the world's leading scientists in infectious disease research. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Salim S Abdool Karim, Quarraisha Abdool Karim, Alash'le Abimiku, Linda-Gail Bekker, Elizabeth A Bukusi, Marie Marcelle H Deschamps, Miliard Derbew, Patricia J Garcia, Glenda Gray, Moses R Kamya, Soumya Swaminathan, Zunyou Wu Tags: Correspondence Source Type: research

[Obituary] Lawrence Leonard Weed
Inventor of the problem-oriented medical record. He was born in Troy, NY, USA, on Dec 26, 1923, and died in Underhill, VT, USA, on June 3, 2017, aged 93 years. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research

[Perspectives] The radical Mr Parkinson
In An Essay on the Shaking Palsy, which celebrates its 200th anniversary this year, London apothecary-surgeon James Parkinson described with remarkable precision many of the features of the disease that was later to bear his name. For a medical doctor, eponymity is an honour rarely bestowed in the discoverer's lifetime, and then often wrongly attributed, and indeed it took half a century before the great French neurologist Jean-Martin Charcot recognised the London surgeon's formidable scholarship by naming the shaking palsy the maladie de Parkinson. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Steven Rose Tags: Perspectives Source Type: research

[Perspectives] Late, great art
“Nothing I drew before my seventieth year is worth looking at”, wrote the 75-year-old Hokusai. “At 73 I partially understood external form, at 80 I'll progress further, at 90 I'll penetrate the hidden significance of things. By 100 I hope to be divinely inspired. When I'm 110, every dot, every line I draw, will possess a life of its own.” Hokusai: Beyond the Great Wave verifies this prophesy, by celebrating the late, great flowering of this Japanese painter's art. The exhibition is accompanied by events exploring artistic genius in older age. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Thomas Wright Tags: Perspectives Source Type: research

[Perspectives] Fowzan Alkuraya: leading light in Saudi Human Genome Program
Fowzan Alkuraya occupies a unique position in Saudi Arabia's scientific community. As Principal Clinical Scientist of the Developmental Genetics Unit at the King Faisal Specialist Hospital and Research Centre, and as Professor of Human Genetics at the College of Medicine, Alfaisal University, both in Riyadh, his laboratory is focused on understanding genetic disorders specific to the Saudi population, where consanguinity and resultant inherited genetic disorders represent a major public health problem. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Richard Lane Tags: Perspectives Source Type: research

[Perspectives] The blameless tragedy of illness
The world of medicine is often defined by the tragedy of illness that can be unexpected or long anticipated. In some cases, when a diagnosis is certain, there are clear explanations; yet often there are not. For many patients and families, it is such unexplained tragedies that can be the hardest to reconcile. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Daniel Marchalik, Ann Jurecic Tags: Perspectives Source Type: research

[World Report] The omitted epidemic —hepatitis E in the Lake Chad region
Hepatitis E outbreaks have been declared in the Lake Chad region, as humanitarian agencies struggle to cope with care in the absence of knowledge about the virus. Andrew Green reports. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Andrew Green Tags: World Report Source Type: research

[World Report] Dismantling the ACA without help from Congress
If Congress doesn't repeal the ACA, President Trump's changes could go a long way to fulfil Republicans' pledge to scrap it. Susan Jaffe, The Lancet Washington correspondent, reports. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Susan Jaffe Tags: World Report Source Type: research

[Comment] Offline: Medicines leadership —Britain's loss, Europe's gain
The shadow of Brexit continues to darken. One consequence is the loss of the European Medicines Agency (EMA) from London to continental Europe. The EMA, together with the European Banking Authority (EBA), is one of the prized institutions of the European Union. It is responsible for evaluating medicines use across 28 member states. It provides a single route for the authorisation of new medicines, avoiding the duplication of separate member-state approvals. Since its inception in 1995, the EMA has authorised over 1000 products. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Continuing debate about method of delivery and pregnancy outcomes: a 2010 Lancet Article
In 2010, The Lancet published an Article by Pisake Lumbiganon and colleagues1 on the method of delivery in relation to pregnancy outcomes in nine countries in Asia. Shortly after publication, The Lancet received correspondence from Pauline Hull, who was concerned that the conclusion drawn by Lumbiganon and colleagues was not supported by their data. The matter was referred to our Ombudsman who ruled that The Lancet should obtain an independent statistical review of the published Article. This indeed we did, but that review was not passed onto Pauline Hull at the time, contrary to our Ombudsman's ruling, although it was sen...
Source: LANCET - July 28, 2017 Category: General Medicine Authors: The Editors of The Lancet Tags: Comment Source Type: research

[Comment] Avoiding globalisation of the prescription opioid epidemic
In May, 2017, 12 members of the US Congress wrote to the then WHO Director-General Margaret Chan to warn of an expanding international drug epidemic fuelled by what they called a “reckless”, “greedy”, and “dangerous” organisation.1 The subject of their letter was the US-based opioid manufacturer Purdue Pharma and its global counterpart Mundipharma International. The Congressional authors of the letter represent regions of the USA that have been hard hit by the na tionwide epidemic of opioid overdose and addiction,2 and their warning demands urgent attention across the world. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Keith Humphreys Tags: Comment Source Type: research

[Editorial] What can evolutionary theory do for public health?
Evolution is perhaps the most basic scientific theory. Some would say it is the most powerful. And yet its application to health and medicine is vastly underutilised. Evolutionary theory insists we understand the body not as a product of design but of natural selection. As Nesse and Stearns have previously argued, “bodies are vulnerable to disease—and remarkably resilient—precisely because they are not machines built from a plan. They are, instead, bundles of compromises shaped by natural selection in small increments to maximize reproduction, not health.” (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Parkinson's disease: a complex disease revisited
In a book review in this week's issue, Steven Rose describes the remarkable similarity of James Parkinson with The Lancet's founder Thomas Wakley. Both were surgeons as well as public health advocates, political radicals and reformers, and prolific authors. Parkinson is now arguably best known for the disease his name has been given to. 200 years ago, he had already noted many of the characteristic symptoms, presentations, and features of this disorder. He described its progressive nature in six cases in An Essay on the Shaking Palsy with the aim that the medical profession take note. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Preparing for later life today
Last week, the UK Government announced it will be raising the state pension age to 68 years in 2037, to better reflect the demographics of the UK population. In 1948, when the state pension was first introduced, average life expectancy for a person aged 65 years was 13 ·5 years. This period increased to 19·7 years in 2013–15. Elsewhere, the Japan Gerontological Society and the Japan Geriatrics Society have proposed to push back the definition of old age even further, to 75 years of age, calling the current cutoff at 65 years terribly outdated. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Seminar] Coeliac disease
Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations. (Source: LANCET)
Source: LANCET - July 28, 2017 Category: General Medicine Authors: Benjamin Lebwohl, David S Sanders, Peter H R Green Tags: Seminar Source Type: research

[Articles] Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240)
The benefit conferred by incorporation of bevacizumab is sustained with extended follow-up as evidenced by the overall survival curves remaining separated. After progression while receiving bevacizumab, we did not observe a negative rebound effect (ie, shorter survival after bevacizumab is stopped than after chemotherapy alone is stopped). These findings represent proof-of-concept of the efficacy and tolerability of antiangiogenesis therapy in advanced cervical cancer. (Source: LANCET)
Source: LANCET - July 27, 2017 Category: General Medicine Authors: Krishnansu S Tewari, Michael W Sill, Richard T Penson, Helen Huang, Lois M Ramondetta, Lisa M Landrum, Ana Oaknin, Thomas J Reid, Mario M Leitao, Helen E Michael, Philip J DiSaia, Larry J Copeland, William T Creasman, Frederick B Stehman, Mark F Brady, Ro Tags: Articles Source Type: research

[Comment] Bevacizumab in cervical cancer: a step forward for survival
Cervical cancer is the fourth most common cancer affecting women, with more than 500  000 new cases and more than 260 000 deaths worldwide in 2012.1 This statistic is disturbing given the fact that with the introduction of screening and HPV vaccination programmes, cervical cancer is now a preventable and curable disease. Once the disease is not salvageable, any treatment offered to patients is palliative. By contrast with most other solid cancers, the highest incidence of cervical cancer is in young women, with more than half of diagnoses occurring in women aged younger than 45 years. (Source: LANCET)
Source: LANCET - July 27, 2017 Category: General Medicine Authors: Susana Banerjee Tags: Comment Source Type: research

[Correspondence] Defending academic and medical independence in Turkey
We write on behalf of 207 health professionals, academics, and researchers, and 25 health and human rights organisations from many countries (appendix). We wish to bring to the attention of The Lancet's readers alarming events taking place in Turkey, where the state has been waging a campaign of terror and punishment against thousands of health professionals and academics. (Source: LANCET)
Source: LANCET - July 27, 2017 Category: General Medicine Authors: Alexis Benos, Chiara Bodini, Hannah Cowan, David McCoy, Penelope Milsom, David Sanders, 207 individuals and 25 organisations; a full list of signatories is available in the appendix Tags: Correspondence Source Type: research

[Articles] Romosozumab (sclerostin monoclonal antibody) versus teriparatide in postmenopausal women with osteoporosis transitioning from oral bisphosphonate therapy: a randomised, open-label, phase 3 trial
Transition to a bone-forming agent is common practice in patients treated with bisphosphonates, such as those who fracture while on therapy. In such patients, romosozumab led to gains in hip BMD that were not observed with teriparatide. These data could inform clinical decisions for patients at high risk of fracture. (Source: LANCET)
Source: LANCET - July 26, 2017 Category: General Medicine Authors: Bente L Langdahl, Cesar Libanati, Daria B Crittenden, Michael A Bolognese, Jacques P Brown, Nadia S Daizadeh, Eva Dokoupilova, Klaus Engelke, Joel S Finkelstein, Harry K Genant, Stefan Goemaere, Lars Hyldstrup, Esteban Jodar-Gimeno, Tony M Keaveny, David Tags: Articles Source Type: research

[Comment] Bone-forming agents in non-responders to bisphosphonates
Osteoporosis is a chronic disease requiring long-term treatment. Oral bisphosphonates, which act by inhibiting bone resorption, are most commonly prescribed but inadequate response, development of intolerance, or fear of long-term side-effects sometimes necessitate change to an alternative therapy.1 One option is to switch to teriparatide, a bone-forming agent, but enthusiasm for this strategy is tempered by the blunting of the bone mineral density (BMD) response to teriparatide seen in patients previously treated with antiresorptives. (Source: LANCET)
Source: LANCET - July 26, 2017 Category: General Medicine Authors: Juliet Compston Tags: Comment Source Type: research

[Viewpoint] The French emergency medical services after the Paris and Nice terrorist attacks: what have we learnt?
On Nov 13, 2015, Paris was the scene of multiple mass casualty terrorist attacks that were the most violent and devastating events to occur in France since World War 2, resulting in the deaths of 137 people and injuring 413.1 On July 14, 2016, France was targeted again in the attack on Nice in which a truck was deliberately driven into crowds celebrating Bastille Day, resulting in the deaths of 87 people and injuring 458. Since the attack on Nice, several further terrorist attacks have occurred in Europe (figure),3 providing the sad proof that the threat has spread to many countries. (Source: LANCET)
Source: LANCET - July 25, 2017 Category: General Medicine Authors: Pierre Carli, Fran çois Pons, Jacques Levraut, Bruno Millet, Jean-Pierre Tourtier, Bertrand Ludes, Antoine Lafont, Bruno Riou Tags: Viewpoint Source Type: research

[Articles] Recombinant human C1 esterase inhibitor for prophylaxis of hereditary angio-oedema: a phase 2, multicentre, randomised, double-blind, placebo-controlled crossover trial
Prophylaxis with recombinant human C1 esterase inhibitor provided clinically relevant reductions in frequency of hereditary angio-oedema attacks and was well tolerated. In view of the pharmacokinetic profile of recombinant human C1 esterase inhibitor, our results suggest that efficacy of C1-inhibitor replacement therapy might not be a direct function of plasma trough concentrations of C1 inhibitor. (Source: LANCET)
Source: LANCET - July 25, 2017 Category: General Medicine Authors: Marc A Riedl, Vesna Grivcheva-Panovska, Dumitru Moldovan, James Baker, William H Yang, Bruno M Giannetti, Avner Reshef, Sladjana Andrejevic, Richard F Lockey, Roman Hakl, Shmuel Kivity, Joseph R Harper, Anurag Relan, Marco Cicardi Tags: Articles Source Type: research

[Comment] Recombinant human C1 esterase inhibitor for hereditary angio-oedema
Patients with the autosomal inheritable disease hereditary angio-oedema have recurrent swelling of subcutaneous and cutaneous tissues. The frequency of attacks varies enormously between individuals and can range from a few swellings per year to multiple attacks per week. In most cases, acute treatment is sufficient, but prophylactic treatment can reduce the burden of illness for severely impaired patients.1 Available treatments for hereditary angio-oedema prophylaxis comprise either plasma-derived C1 esterase inhibitor concentrates or attenuated androgens, such as danazol. (Source: LANCET)
Source: LANCET - July 25, 2017 Category: General Medicine Authors: Jens Greve, Janina Hahn Tags: Comment Source Type: research

[Articles] Safety and immunogenicity of a mRNA rabies vaccine in healthy adults: an open-label, non-randomised, prospective, first-in-human phase 1 clinical trial
This first-ever demonstration in human beings shows that a prophylactic mRNA-based candidate vaccine can induce boostable functional antibodies against a viral antigen when administered with a needle-free device, although not when injected by a needle-syringe. The vaccine was generally safe with a reasonable tolerability profile. (Source: LANCET)
Source: LANCET - July 25, 2017 Category: General Medicine Authors: Martin Alberer, Ulrike Gnad-Vogt, Henoch Sangjoon Hong, Keyvan Tadjalli Mehr, Linus Backert, Greg Finak, Raphael Gottardo, Mihai Alexandru Bica, Aurelio Garofano, Sven Dominik Koch, Mariola Fotin-Mleczek, Ingmar Hoerr, Ralf Clemens, Frank von Sonnenburg Tags: Articles Source Type: research

[Comment] Is there a future for mRNAs as viral vaccines?
The first trial of an mRNA vaccine in human beings against an infectious disease is reported by Martin Alberer and colleagues1 in The Lancet. Similar mRNA vaccines have been found to induce some immunity against tumour antigens when tested in patients with melanoma or prostate cancer.2,3 (Source: LANCET)
Source: LANCET - July 25, 2017 Category: General Medicine Authors: Mary Warrell Tags: Comment Source Type: research

[Articles] Long-acting intramuscular cabotegravir and rilpivirine in adults with HIV-1 infection (LATTE-2): 96-week results of a randomised, open-label, phase 2b, non-inferiority trial
The two-drug combination of all-injectable, long-acting cabotegravir plus rilpivirine every 4 weeks or every 8 weeks was as effective as daily three-drug oral therapy at maintaining HIV-1 viral suppression through 96 weeks and was well accepted and tolerated. (Source: LANCET)
Source: LANCET - July 24, 2017 Category: General Medicine Authors: David A Margolis, Juan Gonzalez-Garcia, Hans-J ürgen Stellbrink, Joseph J Eron, Yazdan Yazdanpanah, Daniel Podzamczer, Thomas Lutz, Jonathan B Angel, Gary J Richmond, Bonaventura Clotet, Felix Gutierrez, Louis Sloan, Marty St Clair, Miranda Murray, Susan Tags: Articles Source Type: research

[Comment] Long-acting injectable ART: next revolution in HIV?
In the two decades since the arrival of triple antiretroviral therapy (ART),1,2 there have been multiple breakthroughs including new drugs in new classes, simplification from complex, restrictive regimens to single fixed-dose multiclass tablets, and major improvements in tolerability and toxicity.3 –5 There is even an emerging re-examination of the triple therapy paradigm itself. Studies have shown that some dual-therapy combinations appear to confer the same success as conventional triple regimens, whether in individuals who are naive to ART or as a switch strategy. (Source: LANCET)
Source: LANCET - July 24, 2017 Category: General Medicine Authors: Mark A Boyd, David A Cooper Tags: Comment Source Type: research

[Correspondence] Diagnostic accuracy of the PROMIS study – Authors’ reply
We thank Simpa S Salami and colleagues for raising three important issues. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Hashim U Ahmed, Louise C Brown, Richard Kaplan, Chris Parker, Mark Emberton Tags: Correspondence Source Type: research

[Correspondence] Diagnostic accuracy of the PROMIS study
We commend Hashim Ahmed and colleagues (Jan 19, p 815)1 for their rigorous evaluation of multi-parametric MRI (MP-MRI), which indicated that prostate biopsy can potentially be avoided in approximately 27% of patients with a negative MP-MRI result. Deciding how to proceed with a patient who has a positive MP-MRI result is equally important. Notably, the authors did not compare histopathological correlation for MP-MRI with template prostate mapping biopsy (TPM) to assess whether disease was found in the region of interest. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Simpa S Salami, Arvin K George, Jeffrey S Montgomery, Todd M Morgan, Ganesh S Palapattu Tags: Correspondence Source Type: research

[Correspondence] NHS manifesto: the missing piece of the puzzle – Authors' reply
We welcome the interest our Lancet NHS Manifesto1 has generated. In it we call, among other things, for the UK government to take a leadership role in helping to accelerate transformation of the National Health Service (NHS) to a people-centred system. In so doing, we fully agree with Ellen Stewart and colleagues about the importance of encouraging health system transformation in partnership with the wider public. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: David Stuckler, Nigel Crisp Tags: Correspondence Source Type: research

[Correspondence] NHS manifesto: the missing piece of the puzzle
The NHS Manifesto published in The Lancet by Nigel Crisp and colleagues (Dec 10, 2016, e24)1 is a broadly compelling one, and yet it mirrors an error made by National Health Service (NHS) England's Five Year Forward View2 in calling for a major transformation of the UK's largest public service without acknowledging the importance of public engagement in those plans. To be sure, Crisp and colleagues1 call for services to be made patient-centred, and for patients and carers to be engaged “in decision making and care”. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Ellen Stewart, Ingrid Young, Sarah Cunningham-Burley Tags: Correspondence Source Type: research

[Correspondence] The sun is shining on Cyprus's National Health Service
12 years have passed since The Lancet's World Report1 that questioned whether Cyprus would address its substantial health-care challenges, and more than 7 years have passed since we questioned whether any such health-care system would ever be implemented, despite it being “long-awaited” and “carefully planned”.2 On June 16, 2017, the parliament of Cyprus unanimously voted on a game-changing National Health Service—the dawn of a new era for the country's health service and population as a whole. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: George Samoutis, Constantinos Paschalides Tags: Correspondence Source Type: research

[Correspondence] Nelly Mugo and the response to HIV: more than just PrEP advocacy
Tony Kirby recently highlighted the global response to HIV through a profile of Nelly Mugo in The Lancet (April 29, p 1689),1 drawing particular attention to her work on pre-exposure prophylaxis (PrEP). Her impact on HIV policy in Kenya and beyond is also notable for its nuanced appreciation of many other approaches to empowering and supporting serodiscordant couples. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Nathan Hodson, Susan Bewley Tags: Correspondence Source Type: research

[Correspondence] Ending AIDS: myth or reality?
In 2014, prompted by the realisation that an expansion of HIV treatment can prevent illness, death, and transmission of infection, the Joint UN Programme on HIV/AIDS announced their 90-90-90 target and goal to end AIDS by 2030.1 This target and goal were informed by the strategic objective that if at least 90% of people infected with HIV knew their status, and at least 90% of those who knew their status were on antiretroviral therapy, and at least 90% of those who were on antiretroviral therapy were virally suppressed, ending AIDS would be achievable by 2030. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Brian G Williams, Reuben Granich Tags: Correspondence Source Type: research

[Obituary] Simone Veil
Former French Health Minister and architect of the law legalising abortion in France. Born in Nice, France, on July 13, 1927, she died at home in Paris, France, on June 30, 2017, aged 89 years. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Barbara Casassus Tags: Obituary Source Type: research

[Perspectives] Magic and loss
Margaret returns to 1960s London to find John, her fianc é, inexplicably hospitalised. He claims merely to be tired, but rather Margaret finds him much diminished and arranges to meet his doctor. This affords some clarity; it seems a depression John calls “the beast” has returned, having stalked John since he was a young man. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Stephen Ginn Tags: Perspectives Source Type: research

[Perspectives] Taking a dose of Roald Dahl's marvellous medicine
With more than 50  000 shows being staged by over 3000 artists in 300 venues, there are performances to suit all tastes at next month's 70th Edinburgh Festival Fringe—but one show at the arts festival has a special sprinkling of literary magic. Tom Solomon, Professor of Neurology and Director of the Institute of Infection and Global Health at the University of Liverpool, UK, will entertain families with his Roald Dahl's Marvellous Medicine show, which will introduce a new generation to Dahl's tales, while allowing older readers to revisit their favourite books. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Peter Ranscombe Tags: Perspectives Source Type: research

[Perspectives] Putting LGBTQ people back on the canvas of history
It's only 50 years since homosexuality was partly decriminalised in England and Wales —the Sexual Offences Act entered the statute books on July 27, 1967. Scotland had to wait until 1980. A milestone like this is an opportunity to reflect on both the huge strides lesbian, gay, bisexual, transgender, and queer (LGBTQ) people have made since—both in terms of legal equality and soci al acceptance—and to avoid complacency about what remains to be achieved. It also offers a chance to paint LGBTQ people back on to the canvas of history. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Owen Jones Tags: Perspectives Source Type: research

[Perspectives] Tuberculosis
No disease better illustrates the difficulties of early modern medical practice than tuberculosis. Arguments over heredity, nutrition, environment, and contagion all came together within the potent cultural frame of a condition that, by the early 19th century, killed about one in five Europeans. Rather than claiming thousands in swift, savage epidemics tuberculosis took its victims slowly, racking their bodies and exhausting their minds. Older names for the disease —consumption and pthisis (from a Greek word meaning to waste away)—reflect the way in which it seemed to destroy the body from within. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Richard Barnett Tags: Perspectives Source Type: research

[World Report] Public health commissioner appointed to lead US CDC
Brenda Fitzgerald, former Georgia Public Health Commissioner, was named by President Trump as CDC Director. Rita Rubin reports. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Rita Rubin Tags: World Report Source Type: research

[World Report] The HIV response in Ukraine: at a crossroads
The Ukrainian Government is looking to shoulder more of the burden of the response to the HIV epidemic in the midst of a complicated health-care overhaul. Andrew Green reports from Kiev. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Andrew Green Tags: World Report Source Type: research

[Comment] Offline: NCDs —why are we failing?
Why is the global health community failing to respond effectively to the rising burden of non-communicable diseases (NCDs)? The answer can be summed up in one word —fear. Fear of a species-threatening pandemic. A pervasive fear that has displaced all other health concerns. Anxiety among political elites is causing a recalibration of priorities among global health leaders. In his first speech to staff in Geneva this month, WHO's new Director-General, Tedros A dhanom Ghebreyesus, named four urgent issues: health emergencies; universal health coverage; women's, children's, and adolescents’ health; and climate change. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] The International AIDS Society —Lancet Commission on the future of the HIV response and global health
HIV/AIDS has been the most severe and widespread infectious disease pandemic of our time —with more than 75 million people infected, more than 40 million deaths, and some 38 million people living with the virus in 2017 and requiring lifelong, daily treatment to stay well.1 Yet by any measure, the global response to the HIV/AIDS pandemic has been one of the extraordinary success storie s of modern medicine, public health, human rights, and global solidarity. By 2016, more than 18 million people living with HIV had started life-sustaining antiretroviral therapy,2 and new preventive interventions, including pre-exposure...
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Chris Beyrer, Pamela Das, Richard Horton, Owen Ryan, Linda-Gail Bekker Tags: Comment Source Type: research

[Comment] 90-90-90 and ending AIDS: necessary and feasible
More than three decades into the global HIV pandemic, there are still 2 ·1 million new infections each year and 36·7 million people are living with HIV.1 By mid-2016, 18·2 million people were on antiretroviral treatment—about 50% of people living with HIV.1 Yet in 2015, 15 million people living with HIV were estimated to be unaware of their status and 1·1 million died of AIDS-related complications, despite the fact that US$19 billion was invested in HIV in low-income and middle-income countries.1 (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Reuben Granich, Brian Williams, Julio Montaner, Jos é M Zuniga Tags: Comment Source Type: research

[Comment] Saving lives with equity —the efficient route to the SDGs
2 years have now passed since the world's governments adopted the Sustainable Development Goals (SDGs). Apart from embracing some bold targets for 2030, they pledged that each country would undertake a best endeavour to “reach the furthest behind first” and achieve the goals for every group, with noone left behind.1 These commitments put equity—the idea of equality with fairness—at the heart of the SDGs. UNICEF has reinforced the case for equity in its new report, Narrowing The Gaps: the Power of Investing in the Poorest Children. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: Kevin Watkins Tags: Comment Source Type: research

[Editorial] Growing concerns of hepatitis E in Europe
Hepatitis E virus (HEV) infection is an important cause of acute viral hepatitis worldwide, with an increasing incidence in Europe since 2010. Although it is difficult to know the real incidence because most HEV infections are asymptomatic or self-limiting, in some people —such as immunosuppressed individuals or those with pre-existing liver disease—HEV infection can progress to chronic disease. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Medical education reform in China
On July 11, the State Council of China introduced bold plans to revolutionise medical education, effective immediately. Gone will be Soviet-era training in which doctors spent their career in one hospital, and over-crowded outpatient clinics that too often underutilised the expertise of staff and underserved the needs of patients. Instead, medical schools are asked to admit more, higher calibre students, and provide better quality teaching that is accredited by the Chinese Medical Doctor Association. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] The global HIV/AIDS epidemic —progress and challenges
On July 20, UNAIDS released their annual report on the status of the global HIV/AIDS epidemic, which also includes a comprehensive analysis of progress towards ending AIDS as a public health threat. The latest epidemiological estimates and programmatic data from 168 countries in all regions were reviewed. Worldwide, AIDS-related deaths have declined from a peak of about 1 ·9 million in 2005 to around 1·0 million in 2016, largely due to treatment scale-up—for the first time more than half of people with HIV are estimated to be on treatment. (Source: LANCET)
Source: LANCET - July 21, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[The Lancet Commissions] Dementia prevention, intervention, and care
Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society. (Source: LANCET)
Source: LANCET - July 20, 2017 Category: General Medicine Authors: Gill Livingston, Andrew Sommerlad, Vasiliki Orgeta, Sergi G Costafreda, Jonathan Huntley, David Ames, Clive Ballard, Sube Banerjee, Alistair Burns, Jiska Cohen-Mansfield, Claudia Cooper, Nick Fox, Laura N Gitlin, Robert Howard, Helen C Kales, Eric B Larso Tags: The Lancet Commissions Source Type: research

[Perspectives] Gill Livingston: transforming dementia prevention and care
It was during a placement as a junior doctor in the 1980s at Friern Barnet, one of the largest psychiatric hospitals in Europe, that Gill Livingston first witnessed the real human impact of dementia. “People were living in old Victorian wards of 24 people with little privacy. It seemed a terrible way to live”, she recalls. The experience sparked a lifelong interest and a passion to improve the lives of people with dementia and their carers. But for Livingston it also became a personal concer n when dementia affected her own family. (Source: LANCET)
Source: LANCET - July 20, 2017 Category: General Medicine Authors: Rachael Davies Tags: Perspectives Source Type: research