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[Comment] Progress on dementia —leaving no one behind
The Lancet Commission Dementia Prevention, Intervention, and Care1 makes a timely evidence-driven contribution to global efforts to improve the lives of people with dementia and their carers, and limit the future impact on societies. The Commission proposes ambitious prevention targets, treatment of cognitive symptoms in people with Alzheimer's disease or dementia with Lewy bodies, individualised dementia care, provision of care for carers, planning for the future for patients and families, risk protection balanced with respect for autonomy, management of neuropsychiatric symptoms, consideration of dementia in end of life ...
Source: LANCET - July 20, 2017 Category: General Medicine Authors: Martin Prince Tags: Comment Source Type: research

[Comment] Prevention and management of dementia: a priority for public health
Today, nearly 50 million people worldwide have dementia, with this figure projected to increase to 75 million by 2030 and to 132 million by 2050,1 largely driven by population ageing. Dementia causes not only disability and dependency for individuals affected by the disorder, but can also have a profoundly detrimental effect on family and other carers, who are at high risk of developing depression and anxiety disorders.2 The cost of caring for people with dementia is more than US$800 billion per year globally, rising to $2 trillion by 2030. (Source: LANCET)
Source: LANCET - July 20, 2017 Category: General Medicine Authors: Helen Frankish, Richard Horton Tags: Comment Source Type: research

[Articles] Population health and regional variations of disease burden in Japan, 1990 –2015: a systematic subnational analysis for the Global Burden of Disease Study 2015
Japan has been successful overall in reducing mortality and disability from most major diseases. However, progress has slowed down and health variations between prefectures is growing. In view of the limited association between the prefecture-level health system inputs and health outcomes, the potential sources of regional variations, including subnational health system performance, urgently need assessment. (Source: LANCET)
Source: LANCET - July 19, 2017 Category: General Medicine Authors: Shuhei Nomura, Haruka Sakamoto, Scott Glenn, Yusuke Tsugawa, Sarah K Abe, Md M Rahman, Jonathan C Brown, Satoshi Ezoe, Christina Fitzmaurice, Tsuyoshi Inokuchi, Nicholas J Kassebaum, Norito Kawakami, Yosuke Kita, Naoki Kondo, Stephen S Lim, Satoshi Maruya Tags: Articles Source Type: research

[Comment] Health inequality across prefectures in Japan
Japan has exemplary records in human development as measured by a human development index of 0 ·903 in 2016 (ranked 17th in the world).1 Universal access to health services with no financial barrier for every citizen in Japan launched in 1961 and has contributed to nearly equitable access and relatively small gaps in health status across regions and socioeconomic groups in the country.2 Agei ng is homogeneously distributed across all communities,3 which has led to high demand for health care in all prefectures (provinces). (Source: LANCET)
Source: LANCET - July 19, 2017 Category: General Medicine Authors: Churnrurtai Kanchanachitra, Viroj Tangcharoensathien Tags: Comment Source Type: research

[Articles] 2-year outcomes with the Absorb bioresorbable scaffold for treatment of coronary artery disease: a systematic review and meta-analysis of seven randomised trials with an individual patient data substudy
BVS was associated with increased rates of composite device-oriented adverse events and device thrombosis cumulatively at 2 years and between 1 and 2 years of follow-up compared with EES. (Source: LANCET)
Source: LANCET - July 18, 2017 Category: General Medicine Authors: Ziad A Ali, Patrick W Serruys, Takeshi Kimura, Runlin Gao, Stephen G Ellis, Dean J Kereiakes, Yoshinobu Onuma, Charles Simonton, Zhen Zhang, Gregg W Stone Tags: Articles Source Type: research

[Comment] Bioresorbable scaffolds: in search of event-free dissolution
Celebrating its 40th anniversary, percutaneous coronary intervention has evolved from balloon angioplasty over bare metal stents to the routine use of drug-eluting stents. Coronary artery stents introduced in the late 1980s marked an important milestone in the development of percutaneous coronary intervention by scaffolding the treated arterial segment and thereby eliminating the risk of abrupt vessel closure due to dissections following balloon angioplasty as well as negative remodelling due to elastic recoil. (Source: LANCET)
Source: LANCET - July 18, 2017 Category: General Medicine Authors: Raffaele Piccolo, Peter J üni, Stephan Windecker Tags: Comment Source Type: research

[Correspondence] Ending our shame: call for a fundamental reconsideration of Australian refugee policy
We, as members of the Australian public health community, reaffirm The Lancet's call for urgent action to end mandatory detention in the Editorial “Asylum seekers: Australia's shame” (June 24, p 2444).1 We highlight the compelling evidence of deleterious health impacts caused by current arbitrary immigration detention practices in both offshore “processing centres” and indefinite detention in Australia.2,3 (Source: LANCET)
Source: LANCET - July 18, 2017 Category: General Medicine Authors: Elizabeth A Bennett, Louise Newman, Julian WK Burnside, Barri Phatarfod, Robert M Thomas, A Rob Moodie, Michael J Moore Tags: Correspondence Source Type: research

[Articles] Ataluren in patients with nonsense mutation Duchenne muscular dystrophy (ACT DMD): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial
Change in 6MWD did not differ significantly between patients in the ataluren group and those in the placebo group, neither in the intention-to-treat population nor in the prespecified subgroups with a baseline 6MWD of less than 300 m or 400 m or more. However, we recorded a significant effect of ataluren in the prespecified subgroup of patients with a baseline 6MWD of 300 m or more to less than 400 m. Baseline 6MWD values within this range were associated with a more predictable rate of decline over 1 year; this finding has implications for the design of future DMD trials with the 6-minute walk test as the endpoint. (Source: LANCET)
Source: LANCET - July 17, 2017 Category: General Medicine Authors: Craig M McDonald, Craig Campbell, Ricardo Erazo Torricelli, Richard S Finkel, Kevin M Flanigan, Nathalie Goemans, Peter Heydemann, Anna Kaminska, Janbernd Kirschner, Francesco Muntoni, Andr és Nascimento Osorio, Ulrike Schara, Thomas Sejersen, Perry B Sh Tags: Articles Source Type: research

[Comment] Treatment of Duchenne muscular dystrophy: first small steps
Duchenne muscular dystrophy (DMD) is a progressive and life-limiting X-linked recessive disorder caused by mutations in the DMD gene that result in reduced or absent dystrophin production. Dystrophin is part of the dystrophin –glycoprotein complex, which acts as a scaffold between the actin cytoskeleton and the extracellular matrix and, as such, maintains muscle fibre integrity. Absence of dystrophin causes progressive and irreversible tissue damage, resulting in muscle fibrosis and fatty replacement. (Source: LANCET)
Source: LANCET - July 17, 2017 Category: General Medicine Authors: Claire L Wood, Tim Cheetham Tags: Comment Source Type: research

[Department of Error] Department of Error
Reich K, Papp KA, Blauvelt A, et al. Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2): results from two randomised controlled, phase 3 trials. Lancet 2017; 390: 276 –88– In the findings section in the summary of this Article, the sentence “186 patients (59%) in the 200 mg group, and 168 patients (55%) in the 100 mg group achieved PASI 75, compared with …”, should have read “186 patients (59%) in the 200 mg group, and 168 patients (55%) in the 100 mg group achieved a PGA response, compared with …”. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Avidan MS, Maybrier HR, Abdallah AB, et al. Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial. Lancet 2017; 390: 267 –275—In this Article, the eighth author's name should have read “Hilary P Grocott”. This correction has been made to the online version as of July 13, 2017, and the printed Article is correct. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Burnout or depression: both individual and social issue
In view of the profound problems attached to the construct of burnout, we recommended in our Correspondence (April 8, p 1397)1 that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. In a reply to our letter, Ronald Epstein and Michael Privitera (April 8, 1398)2 rejected our recommendation on the grounds that burnout is not a “purely individual syndrome”. The authors further argued that “considering burnout solely as a mental illness of individual workers rather than work-related distress would be disastrous”. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent Tags: Correspondence Source Type: research

[Correspondence] Science is what we need in the treatment of anxiety disorders
It is very surprising that Michelle Craske and Murray Stein (May 13, p 1883)1 assert that “Given the paucity and quality of studies of PDT [psychodynamic therapy] for anxiety disorders compared with CBT [cognitive behavioural therapy], the weight of the evidence enables us to confidently recommend only CBT at this time for the treatment of anxiety disorders.” In their response, Crask e and Stein did not provide any evidence for either the poor or poorer quality of studies of PDT for anxiety, or for superiority of CBT. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Patrick Luyten, John R Keefe, Mark Hilsenroth, Allan Abbass, Jacques Barber Tags: Correspondence Source Type: research

[Correspondence] Intensive speech and language therapy after stroke – Authors' reply
We thank Ryo Sakamoto and colleagues for their Correspondence regarding our FCET2EC trial on the effectiveness of intensive speech and language therapy in chronic post-stroke aphasia.1 Their point regarding the minimal clinically important difference of the primary outcome measure (Amsterdam-Nijmegen Everyday Language Test [ANELT] A-scale) is of major concern, as already acknowledged in our Article ( “To our knowledge, no previously published studies exist on the association of change in ANELT scores with clinical effect.”). (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Caterina Breitenstein, Peter Martus, Klaus Willmes, Wolfram Ziegler, Annette Baumgaertner Tags: Correspondence Source Type: research

[Correspondence] Intensive speech and language therapy after stroke
Caterina Breitenstein and colleagues (April 15, p 1528)1 reported that 3 weeks of intensive speech and language therapy significantly enhanced verbal communication in people aged 70 years or younger with chronic aphasia after stroke. The primary outcome measure was assessed using the Amsterdam-Nijmegen Everyday Language Test (ANELT) A-scale, and the mean difference of the ANELT A-scale score improved 2 ·61 (SD 4·94) points from baseline to after intensive speech and language therapy, but not from baseline to after treatment deferral. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Ryo Sakamoto, Asaka Higuchi, Kenji Tsuda, Tetsuya Tanimoto, Masahiro Kami Tags: Correspondence Source Type: research

[Correspondence] Crying wolf: the misuse of hospital data
We have received a letter from the Care Quality Commission informing us that our institution, Papworth Hospital, has triggered an Imperial College Dr Foster mortality outlier alert, instigated by an apparent finding of 46 deaths for March, 2015, to February, 2016, compared with the 27 ·8 expected deaths. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Samer A M Nashef, Sarah Powell, David P Jenkins, Simon Fynn, Roger Hall Tags: Correspondence Source Type: research

[Correspondence] New mercury pollution threats: a global health caution
The Minamata Convention —a global agreement to tackle mercury—will enter into force on Aug 16, 2017, as the required 50th of the 128 signatory countries recently ratified the treaty, marking a long-awaited moment for the advancement of public health. However, while this achievement is celebrated, questions about whethe r governments are prepared to tackle complex issues surrounding implementation of the Convention remain rife. The Trump Administration has been actively working to revoke a host of environmental and health regulations, including restrictions on mercury discharges from coal-fired power plants, des...
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Samuel J Spiegel Tags: Correspondence Source Type: research

[Correspondence] Crisis in the National Health Service: a call to action
The Lancet's Editor-in-Chief, Richard Horton, criticised National Health Service (NHS) front-liners in his Offline Comment1 (May 6, p 1783) after attending a seminar at the London School of Hygiene& Tropical Medicine. We were disappointed by his interpretation of an “extraordinary inability of health leaders to reflect critically on their own failings, preferring instead to blame others.” 1 (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Daniela Kirwan, Tehmina Bharucha, Aaminah Verity, Aliki Traianou, Catherine Dunlop, David Mabey Tags: Correspondence Source Type: research

[Correspondence] Response to Offline: Is the NHS in crisis?
The accusation by Richard Horton in The Lancet (May 6, 2017, p 1783)1 that it is “intellectual delusion” to suggest the National Health Service (NHS) is in crisis is surprising considering that this conclusion has been reached by many commentators. Unlike Horton, we are front-line clinicians and see first-hand the human cost of a struggling service, which has been termed a “ humanitarian crisis” by the Red Cross,2 and a “burning platform” by Sir Michael Richards of the Care Quality Commission.3 (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Jeeves Wijesuriya, Ben White, Neena Modi Tags: Correspondence Source Type: research

[Obituary] Osmund Reynolds
Key figure in the foundation of UK neonatology. Born in Brighton, UK, on Feb 3, 1933, he died in London, UK, on April 24, 2017, aged 83 years. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research

[Perspectives] Bridges
“Why are you helping me?” he asked. “I'm a doctor”, I replied. I wasn't, technically. I was a medical student, and although I'd finished clinical rotations and matched into surgery, I was not a doctor quite yet. But blood was pouring from the man's face and we were nowhere near a medical fac ility, so I spoke with the unfounded bravado of a young doctor-to-be. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Rachel J Kwon Tags: Perspectives Source Type: research

[Perspectives] Augmenting diagnostic vision with AI
In the span of their professional lives a radiologist will read over 10 million images, a dermatologist will analyse 200  000 skin lesions, and a pathologist will review nearly 100 000 specimens. Now imagine a computer doing this work over days, rather than decades, and learning from and refining its diagnostic acumen with each new image. This is the capability that artificial intelligence (AI) will bring to medic al care: the potential to interpret clinical data more accurately and more rapidly than medical specialists. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Giorgio Quer, Evan D Muse, Nima Nikzad, Eric J Topol, Steven R Steinhubl Tags: Perspectives Source Type: research

[Perspectives] Ebola: transforming fear into appropriate action
It is interesting that so many of the experts who proffered guidance on outbreak control during the west African Ebola crisis had no previous field experience of Ebola, with some seeming to lack understanding of Ebola epidemiology. They, along with others, seeded and perpetuated fear, with statements that ranged from predicting that this high mortality pathogen could become endemic in humans if not rapidly contained, and declaring the need for a vaccine if the outbreak were to be effectively stopped, through to the prediction that patient numbers would continue to increase exponentially, requiring a huge input of hospital ...
Source: LANCET - July 14, 2017 Category: General Medicine Authors: David L Heymann Tags: Perspectives Source Type: research

[World Report] Frontline: the vital need for information
Vickie Hawkins is the executive director of Medecins Sans Fronti ères (MSF) UK. She was recently in Libya, where conversations with detainees made her aware of the limitations of medical care, and the need for information. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Anita Makri Tags: World Report Source Type: research

[World Report] France bans sodium valproate use in case of pregnancy
France has imposed a partial ban on prescribing sodium valproate for women and girls, claiming to be the first country in Europe to take such a step. Barbara Casassus reports. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Barbara Casassus Tags: World Report Source Type: research

[World Report] Staff protest against care conditions for child patients
Concern over a budget-driven care plan for child patients with cancer in top hospital in Israel has led to staff resignations, supported by parents ’ hunger strike. Sharmila Devi reports. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Shamila Devi Tags: World Report Source Type: research

[World Report] What lies in the future of the UK's medicine regulation?
In a letter to The Financial Times, the UK Government offers a rare glimpse of the plan for medicine regulation after its departure from Europe. Experts say they need more insight. Talha Burki reports. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Talha Burki Tags: World Report Source Type: research

[Comment] Offline: The G20 and health —platitudes and broken promises
Imagine “Anycountry”. A low-income nation-state with a weak health system. People have begun to report a mysterious respiratory infection that is rapidly fatal. The cause is an unknown virus. A localised outbreak quickly spreads from village to village. The virus is not only extremely pathogenic but als o highly transmissible. The epidemic soon crosses the country's border to neighbouring states. A global health emergency beckons. This scenario is fictional. But earlier this year G20 health ministers were locked in a room in Berlin to test their ability to deal with such a global health crisis. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Eliminating acute rheumatic fever and rheumatic heart disease
Acute rheumatic fever and its major sequela rheumatic heart disease are conditions of poverty. Acute rheumatic fever is an autoimmune response to pharyngitis caused by infection with Streptococcus pyogenes that is characterised by various combinations of fever, arthritis, cardiac valvular disease, chorea, and skin manifestations. Chronic valvular damage due to repeated episodes of acute rheumatic fever is known as rheumatic heart disease and is the major cause of morbidity and mortality from acute rheumatic fever. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Magdi Yacoub, Bongani Mayosi, Ahmed ElGuindy, Alain Carpentier, Salim Yusuf Tags: Comment Source Type: research

[Editorial] Curbing the rise in gonococcal AMR
Last week, at the start of the G20 summit and ahead of the Sexually Transmitted Infections (STI)& HIV World Congress, on July 9 –12, WHO released new data on antimicrobial resistance (AMR) in gonococci. 70 (97%) of 72 countries surveyed from 2009 to 2014 reported finding resistant Neisseria gonorrhoeae isolates. Continued and increased resistance to primary antibiotics was observed and 51 (66%) of 77 countries surveyed rep orted some resistance to last-resort antibiotics. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Canada ’s feminist foreign aid agenda
Since his election in November, 2015, Prime Minister Justin Trudeau ’s Liberal Government has promised forward-looking health policies. Canada has always been seen as a global citizen in health, international affairs, and foreign aid, but under Stephen Harper’s Conservative Government (2006–15), credibility was questioned as he tilted Canada’s development pr ogramme for health and overseas aid priorities to align with trade goals, and his flagship Muskoka Initiative for maternal and child health ignored women’s reproductive health rights. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Public genomes: the future of the NHS?
On July 4, Sally Davies, the UK Chief Medical Officer, issued her annual report. Entitled “Generation Genome”, the report examines the potential for genomics to form a major part of British health policy in the future. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] Safety and efficacy of ebselen for the prevention of noise-induced hearing loss: a randomised, double-blind, placebo-controlled, phase 2 trial
Treatment with ebselen was safe and effective at a dose of 400 mg twice daily in preventing a noise-induced TTS. These data lend support to a role of GPx1 activity in acute noise-induced hearing loss. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Jonathan Kil, Edward Lobarinas, Christopher Spankovich, Scott K Griffiths, Patrick J Antonelli, Eric D Lynch, Colleen G Le Prell Tags: Articles Source Type: research

[Articles] Telemedicine for management of inflammatory bowel disease (myIBDcoach): a pragmatic, multicentre, randomised controlled trial
Telemedicine was safe and reduced outpatient visits and hospital admissions compared with standard care. This self-management tool might be useful for reorganising care of inflammatory bowel disease towards personalised and value-based health care. (Source: LANCET)
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Marin J de Jong, Andrea E van der Meulen-de Jong, Mari ëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens Tags: Articles Source Type: research

[Comment] Ethical considerations in noise-induced hearing loss research
Animal studies have shown that glutathione peroxidase 1 (GPx1) is highly expressed in the sensory epithelium of the inner ear, and a targeted mutation of the gene for Gpx1 was found to increase noise-induced hearing loss in mice.1 Based on these observations and given the overlapping role of oxidative stress and cellular injury in noise-induced hearing loss, Jonathan Kil and colleagues2 examined the prophylactic benefits of the administration of ebselen, a GPx1 mimic, in a randomised trial of 83 participants who were exposed to 4 h of standardised sound calibrated to cause a temporary elevation of hearing thresholds, the r...
Source: LANCET - July 14, 2017 Category: General Medicine Authors: St éphane F Maison, Steven D Rauch Tags: Comment Source Type: research

[Comment] Building evidence for care beyond the medical centre
Digital health has been defined as the “convergence of the digital and genomic revolutions with health, health care, living, and society”.1 The term is often used interchangeably with mHealth or mobile health because of the central role played by mobile devices. Remote patient monitoring and telemedicine constitute a subset of digita l health technologies that enable monitoring of patients outside conventional clinical settings, such as in the comfort of their own homes. Evidence regarding the efficacy, effectiveness, economics, and clinical preferences of remote patient monitoring and telemedicine is growing i...
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Thomas A Ullman, Ashish Atreja Tags: Comment Source Type: research

[Articles] Efficacy and safety of voretigene neparvovec (AAV2-hRPE65v2) in patients with RPE65-mediated inherited retinal dystrophy: a randomised, controlled, open-label, phase 3 trial
Voretigene neparvovec gene replacement improved functional vision in RPE65-mediated inherited retinal dystrophy previously medically untreatable. (Source: LANCET)
Source: LANCET - July 13, 2017 Category: General Medicine Authors: Stephen Russell, Jean Bennett, Jennifer A Wellman, Daniel C Chung, Zi-Fan Yu, Amy Tillman, Janet Wittes, Julie Pappas, Okan Elci, Sarah McCague, Dominique Cross, Kathleen A Marshall, Jean Walshire, Taylor L Kehoe, Hannah Reichert, Maria Davis, Leslie Raff Tags: Articles Source Type: research

[Comment] Gene therapy for RPE65-mediated inherited retinal dystrophy completes phase 3
The eye is an attractive organ for gene therapy because of the small amount of tissue that needs to be transfected, surgical accessibility for gene delivery, and the inbuilt control of the second eye. However, despite these benefits, no licensed ocular gene therapy exists for patients with otherwise incurable eye diseases. Stephen Russell and colleagues1 are therefore to be congratulated for doing the first, to our knowledge, phase 3 randomised controlled trial of a gene therapy for a genetic disease. (Source: LANCET)
Source: LANCET - July 13, 2017 Category: General Medicine Authors: Helena Lee, Andrew Lotery Tags: Comment Source Type: research

[World Report] The UN adopts treaty to ban the use of nuclear weapons
On July 7, the UN voted on a treaty to ban the use of nuclear weapons, to which nuclear powers did not partake. John Zarocostas reports. (Source: LANCET)
Source: LANCET - July 13, 2017 Category: General Medicine Authors: John Zarocostas Tags: World Report Source Type: research

[Articles] Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns)
Procalcitonin-guided decision making was superior to standard care in reducing antibiotic therapy in neonates with suspected early-onset sepsis. Non-inferiority for re-infection or death could not be shown due to the low occurrence of re-infections and absence of study-related death. (Source: LANCET)
Source: LANCET - July 12, 2017 Category: General Medicine Authors: Martin Stocker, Wendy van Herk, Salhab el Helou, Sourabh Dutta, Matteo S Fontana, Frank A B A Schuerman, Rita K van den Tooren-de Groot, Jantien W Wieringa, Jan Janota, Laura H van der Meer-Kappelle, Rob Moonen, Sintha D Sie, Esther de Vries, Albertine E Tags: Articles Source Type: research

[Comment] Procalcitonin-guided antibiotic stewardship from newborns to centennials
In 1993, Assicot and colleagues1 reported in The Lancet that procalcitonin was a marker of systemic infections in neonates and paediatric patients. In 2004, Christ-Crain and colleagues2 reported that procalcitonin guidance substantially reduced antibiotic use in adult patients presenting to the emergency room with lower respiratory tract infections, and in 2010, Bouadma and colleagues3 reported that a procalcitonin-guided strategy to treat suspected bacterial infections in non-surgical adult patients in intensive care units reduced antibiotic exposure and selective pressure with no apparent adverse outcome. (Source: LANCET)
Source: LANCET - July 12, 2017 Category: General Medicine Authors: Philipp Schuetz, Beat Mueller Tags: Comment Source Type: research

[Review] Global hearing health care: new findings and perspectives
In 2015, approximately half a billion people had disabling hearing loss, about 6 ·8% of the world's population. These numbers are substantially higher than estimates published before 2013, and point to the growing importance of hearing loss and global hearing health care. In this Review, we describe the burden of hearing loss and offer our and others' recommendations for haltin g and then reversing the continuing increases in this burden. Low-cost possibilities exist for prevention of hearing loss, as do unprecedented opportunities to reduce the generally high treatment costs. (Source: LANCET)
Source: LANCET - July 10, 2017 Category: General Medicine Authors: Blake S Wilson, Debara L Tucci, Michael H Merson, Gerard M O'Donoghue Tags: Review Source Type: research

[Articles] Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study
Exposure to MeNZB was associated with reduced rates of gonorrhoea diagnosis, the first time a vaccine has shown any protection against gonorrhoea. These results provide a proof of principle that can inform prospective vaccine development not only for gonorrhoea but also for meningococcal vaccines. (Source: LANCET)
Source: LANCET - July 10, 2017 Category: General Medicine Authors: Helen Petousis-Harris, Janine Paynter, Jane Morgan, Peter Saxton, Barbara McArdle, Felicity Goodyear-Smith, Steven Black Tags: Articles Source Type: research

[Comment] Gonorrhoea vaccines: a step in the right direction
The sexually transmitted infection gonorrhoea is a global public health problem for which no vaccine is available. More than 106 million new cases of gonorrhoea are estimated to occur yearly worldwide.1 Furthermore, incidence is rising,2 and is expected to continue to rise because of the prevalence of multidrug-resistant strains of Neisseria gonorrhoeae.3 As a result, the US Centers for Disease Control and Prevention and WHO have prioritised N gonorrhoeae as an urgent public health threat for which immediate action is needed. (Source: LANCET)
Source: LANCET - July 10, 2017 Category: General Medicine Authors: Kate L Seib Tags: Comment Source Type: research

[Department of Error] Department of Error
Zellweger M. Picturing the past and present of health care in Germany. Lancet 2017; 390: 835 –844—In this Perspectives piece (published Online First on July 3, 2017), the caption for the eighth photograph now mentions Medizin Hilft e.V. This correction was made to the online version as of July 10, 2017, and the printed Perspectives piece is correct. (Source: LANCET)
Source: LANCET - July 10, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Articles] Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis
On the basis of the available data, we see no role for single-agent paracetamol for the treatment of patients with osteoarthritis irrespective of dose. We provide sound evidence that diclofenac 150 mg/day is the most effective NSAID available at present, in terms of improving both pain and function. Nevertheless, in view of the safety profile of these drugs, physicians need to consider our results together with all known safety information when selecting the preparation and dose for individual patients. (Source: LANCET)
Source: LANCET - July 7, 2017 Category: General Medicine Authors: Bruno R da Costa, Stephan Reichenbach, Noah Keller, Linda Nartey, Simon Wandel, Peter J üni, Sven Trelle Tags: Articles Source Type: research

[Department of Error] Department of Error
Ball P. Naming the victims of Nazi medicine. Lancet 2017; 389: 2182 –83—In this Exhibition Review, the text to accompany the photograph of Renate and Rene Guttmann should have been “…Josef Mengele experimented on both twins when they were deported to Auschwitz…”. This correction has been made to the online version as of July 6, 2017. (Source: LANCET)
Source: LANCET - July 7, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Morris T. James Hardy and the first heart transplant. Lancet 2017; 389: 2280 –81—In this Art of Medicine, the first name of Murray in the seventh paragraph should have been Joseph E. This correction has been made to the online version as of July 6, 2017. (Source: LANCET)
Source: LANCET - July 7, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Jaffe S. Judith Bradford: a pioneer of research on LGBT health. Lancet 2016; 387: 1048 —In this Profile, the fourth sentence of the fourth paragraph should have ended “from 1984–85”. This correction has been made to the online version as of July 6, 2017. (Source: LANCET)
Source: LANCET - July 7, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Retinal detachment in severe myopia
We read with interest the Case Report by Elad Moisseiev and Glenn Yiu (March 18, p 1133)1 of the 15-year-old boy who presented with a giant retinal tear leading to rhegmatogenous retinal detachment, and would like to highlight the very likely possibility of Stickler syndrome as the underlying diagnosis. (Source: LANCET)
Source: LANCET - July 7, 2017 Category: General Medicine Authors: Ioannis Dragoumis, Allan Richards, Philip Alexander, Arabella Poulson, Martin Snead Tags: Correspondence Source Type: research