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[Articles] Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial
In patients with medically treated angina and severe coronary stenosis, PCI did not increase exercise time by more than the effect of a placebo procedure. The efficacy of invasive procedures can be assessed with a placebo control, as is standard for pharmacotherapy. (Source: LANCET)
Source: LANCET - November 2, 2017 Category: General Medicine Authors: Rasha Al-Lamee, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Kare Tang, John Davies, Thomas Keeble, Michael Mielewczik, Raffi Kaprielian, Iqbal S Malik, Sukhjinder S Nijjer, Ricardo Petraco, Christopher Cook, Yousif Ahmad, James Howard, Christopher Bake Tags: Articles Source Type: research

[Comment] Last nail in the coffin for PCI in stable angina?
Interventional cardiology began in Switzerland in 1977, when Andreas Gruentzig performed the first successful percutaneous transluminal coronary angioplasty (PTCA) on a 38-year-old man with angina and a focal proximal stenosis of the left anterior descending coronary artery. Despite numerous subsequent randomised trials and meta-analyses of these trials, which have shown no reduction in death or myocardial infarction,1 the use of percutaneous coronary intervention (PCI) has grown exponentially. Some of this growth was driven by data from clinical trials suggesting that PCI was more effective in relieving angina than medica...
Source: LANCET - November 2, 2017 Category: General Medicine Authors: David L Brown, Rita F Redberg Tags: Comment Source Type: research

[Comment] Ireland's Public Health Bill: crucial to reduce alcohol harm
Ireland has become the fourth heaviest drinking nation in the Organisation for Economic Co-operation and Development in terms of quantity of alcohol consumed,1 and ranked joint third for binge drinking in an analysis of 194 nations by WHO.2 Irish adults consume on average 11 ·5 L of pure alcohol per person every year, an increase of more than 100% compared with 60 years ago.3 Most alcohol in Ireland is now consumed at home and alcohol retailing off licences have increased by five-fold since 1990. (Source: LANCET)
Source: LANCET - November 2, 2017 Category: General Medicine Authors: Frank Murray Tags: Comment Source Type: research

[Articles] Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Among elderly patients who have PCI, a DES and a short duration of DAPT are better than BMS and a similar duration of DAPT with respect to the occurrence of all-cause mortality, myocardial infarction, stroke, and ischaemia-driven target lesion revascularisation. A strategy of combination of a DES to reduce the risk of subsequent repeat revascularisations with a short BMS-like DAPT regimen to reduce the risk of bleeding event is an attractive option for elderly patients who have PCI. (Source: LANCET)
Source: LANCET - November 1, 2017 Category: General Medicine Authors: Olivier Varenne, St éphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Jos Tags: Articles Source Type: research

[Comment] A SENIOR moment? Bare-metal stents in elderly patients
The WHO International Day of Older Persons1 was on Oct 1, 2017, and saw the release of guidelines on integrated care and equality of care for older people. Now, 40 years since the first percutaneous coronary intervention (PCI),2 we still do not know the optimal revascularisation strategy in elderly patients. Interventionalists face two important questions when considering PCI in elderly patients. First, should drug-eluting stents (DES) be mandated in elderly patients since they tend to have greater numbers of complex coronary lesions with calcification, tortuosity, and bifurcations than do younger patients3 and DES have be...
Source: LANCET - November 1, 2017 Category: General Medicine Authors: Robert T Gerber, Anthony H Gershlick Tags: Comment Source Type: research

[Articles] Effect of tight control management on Crohn's disease (CALM): a multicentre, randomised, controlled phase 3 trial
CALM is the first study to show that timely escalation with an anti-tumour necrosis factor therapy on the basis of clinical symptoms combined with biomarkers in patients with early Crohn's disease results in better clinical and endoscopic outcomes than symptom-driven decisions alone. Future studies should assess the effects of such a strategy on long-term outcomes such as bowel damage, surgeries, hospital admissions, and disability. (Source: LANCET)
Source: LANCET - October 31, 2017 Category: General Medicine Authors: Jean-Frederic Colombel, Remo Panaccione, Peter Bossuyt, Milan Lukas, Filip Baert, Tomas Va ňásek, Ahmet Danalioglu, Gottfried Novacek, Alessandro Armuzzi, Xavier Hébuterne, Simon Travis, Silvio Danese, Walter Reinisch, William J Sandborn, Paul Rutgeert Tags: Articles Source Type: research

[Comment] Targeting Crohn's disease
There are many similarities between Crohn's disease and rheumatoid arthritis, such as in pathogenesis; in disconnect between symptoms, biological inflammatory activity, and structural damage; and in effective therapies (such as corticosteroids, conventional immunomodulators, and inhibitors of tumour necrosis factor). However, one area of divergence is the concept of disease modification in rheumatoid arthritis by cessation or stabilisation of structural damage to joints, which is assessed by simple x-rays of hands and calculation of joint space narrowing and erosions as a so-called “sharp score”. (Source: LANCET)
Source: LANCET - October 31, 2017 Category: General Medicine Authors: Stephen B Hanauer Tags: Comment Source Type: research

[Review] The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health
The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris Agreement,1 and the health implications of these actions. It follows on from the work of the 2015 Lancet Commission on Health and Climate Change,2 which concluded that anthropogenic climate change threatens to undermine the past 50 years of gains in public health, and conversely, that a comprehensive response to climate change could be “the greatest global health opportunity of the 21st century”. (Source: LANCET)
Source: LANCET - October 30, 2017 Category: General Medicine Authors: Nick Watts, Markus Amann, Sonja Ayeb-Karlsson, Kristine Belesova, Timothy Bouley, Maxwell Boykoff, Peter Byass, Wenjia Cai, Diarmid Campbell-Lendrum, Jonathan Chambers, Peter M Cox, Meaghan Daly, Niheer Dasandi, Michael Davies, Michael Depledge, Anneliese Tags: Review Source Type: research

[Department of Error] Department of Error
Coleman RL, Oza AM, Lorusso D, et al, for the ARIEL3 investigators. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2017; 390: 1949 –61—In table 1 and figure 4 of this Article (published online first on Sept 12, 2017), the two categories for “Time to progression with penultimate platinum” should have been “6 to ≤12 months” and “>12 months ”. In the last sentence of the second paragraph of the Results section, “rucaparib” was miss...
Source: LANCET - October 27, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Department of Error] Department of Error
Williams HC, Wojnarowska F, Kirtschig G, et al, on behalf of the UK Dermatology Clinical Trials Network BLISTER Study Group. Doxycycline versus prednisolone as an initial treatment strategy for bullous pemphigoid: a pragmatic, non-inferiority, randomised controlled trial. Lancet 2017; 389: 1630 –38—In this Article (published online first on March 6, 2017), in the UK Dermatology Clinical Trials Network BLISTER Study Group list of names, C DeGiovanni was incorrectly listed as C Barnard. This correction has been made to the online version as of Oct 26, 2017. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Tags: Department of Error Source Type: research

[Correspondence] Snake bite in India: a neglected disease of poverty
We are grateful to The Lancet for their Editorial (July 1, p 2)1 on snake-bite envenoming, an acute time-limiting, life-threatening neglected tropical disease affecting farmers, labourers, hunters, shepherds, snake rescuers, and migrant populations in tropical and subtropical countries. In India, 49  000 people die of snake-bite envenoming every year,2 although this figure is probably underestimated because most patients in rural India attend village healers and so their cases go unreported. Doctors at primary health centres in India are replaced every 6–12 months and have poor knowledge ab out, and experience in, ...
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Himmatrao Saluba Bawaskar, Parag Himmatrao Bawaskar, Pramodini Himmatrao Bawaskar Tags: Correspondence Source Type: research

[Correspondence] The 2014 Yazidi genocide and its effect on Yazidi diaspora
Throughout history, the Yazidis have suffered from systematic destruction, deprivation of their religious and socioeconomic rights, and other human rights violations. This community has experienced multiple traumas on both the individual and collective levels.1 Since the so-called Islamic State's attack on Yazidi settlements in Northern Iraq on Aug 3, 2014, 3100 Yazidis have been killed and 6800 have been kidnapped.2 Germany's Yazidi community is the largest Yazidi diaspora, and many of these individuals have relatives in Iraq and Syria. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Sefik Tagay, Dogan Ayhan, Claudia Catani, Ulrich Schnyder, Martin Teufel Tags: Correspondence Source Type: research

[Obituary] Abdulah Alkhamesi
Specialist in tropical medicine and health administration who was founder of the Yemen Red Crescent Society. Born in Sana'a, Yemen, on Feb 26, 1941, he died from complications after heart surgery in Sana'a on Aug 31, 2017, aged 76 years. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Andrew Green Tags: Obituary Source Type: research

[Perspectives] Human behaviour —it's complicated
There has never been a better time for Robert Sapolsky's Behave: the Biology of Humans at Our Best and Worst to appear. For those as perplexed and conflicted as me about such seismic political events as Brexit and the election of US President Donald Trump, the book helps not only to tease apart the factors that can lead people to behave in ways that seem to make no sense, but also to explain our own reaction. There is no part of the current craziness of the world this book does not touch, from terrorism and nationalism to nuclear posturing and ethnic cleansing. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Philip Ball Tags: Perspectives Source Type: research

[Perspectives] Catherine Kyobutungi: leading African health research capacity
Catherine Kyobutungi leads an organisation with a broad mandate to generate evidence and strengthen research capacity in Africa. As Executive Director of the Nairobi-based African Population and Health Research Center (APHRC) since Oct 1, 2017, she's clear about her mission: “For me the important thing is that we are doing research not for the sake of research, but to generate policy-relevant evidence while building credible profiles to be able to speak and be listened to where it matters. So that people making policy decisions have the best evidence available to them and they think about it and they look for it, and...
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Philippa Berman Tags: Perspectives Source Type: research

[Perspectives] Dengue
In 1780 Benjamin Rush —a physician and a founding father of the USA—noted the appearance of an alarming epidemic in his home city of Philadelphia. Rush was familiar with the intricate nosologies of fevers generated by his late-Enlightenment colleagues, but this outbreak had a distinctive symptom: “the pains which a ccompanied this fever were exquisitely severe in the head, back and limbs”. He deployed the usual purging, soothing, and strengthening remedies, but with little success, and he observed that “its general name among all classes of people was the break-bone fever”. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Richard Barnett Tags: Perspectives 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 - October 27, 2017 Category: General Medicine Authors: Barbara Casassus Tags: World Report Source Type: research

[World Report] The African Population and Health Research Center
The African Population and Health Research Center (APHRC) has a new leader and a new strategic vision. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Andrew Green Tags: World Report Source Type: research

[World Report] Frontline: caring for soldiers after the peace deal in Colombia
Over the course of Colombia's 52-year war, over 220  000 people were killed and nearly 7 million displaced by the violence between the leftist guerrillas and the state. Bogotá's Central Military Hospital bore the brunt of that war, treating thousands of injured soldiers. The hospital became a byword for the horrific effects of conflict, its waitin g rooms packed with gunshot and landmine victims (Colombia is the world's second-most landmine-scarred country, after Afghanistan).That conflict is now winding down following a peace deal brokered 1 year ago. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Joe Parkin Daniels Tags: World Report Source Type: research

[Comment] Offline: Dr Tedros, Robert Mugabe, and WHO
Oct 18, 2017: “Today I am also honoured to announce that President Mugabe has agreed to serve as a Goodwill Ambassador on NCDs for Africa to influence his peers in his region to prioritise NCDs.” Oct 22, 2017: “Over the last few days, I have reflected on my appointment of H.E. President Robert Mugabe as WHO Goodwill Ambassador for NCDs in Africa. As a result I have decided to rescind the appointment.” Effective leadership means being prepared to change one's mind. Dr Tedros, WHO's Director-General, did change his mind. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] The British 1967 Abortion Act —still fit for purpose?
Oct 27, 2017, marks the 50th anniversary of the British Abortion Act, written “to amend and clarify the law relating to termination of pregnancy by registered medical practitioners”.1 Amended in 1990 to include selective reduction of a multiple pregnancy, the Abortion Act governs abortion in England, Scotland, and Wales, the first law in western Europe to formally legalis e abortion for several indications. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Lesley Regan, Anna Glasier Tags: Comment Source Type: research

[Comment] Protect trans people: gender equality and equity in action
#ProtectTransPeople has surfaced on social media as transgender (trans) civil rights have come into US national discussion.1 Trans people continue to experience hostility and overt discrimination, as exemplified by US President Donald Trump's proposed ban on trans people serving in the US military2 and his administration's support of reversal of workplace protections and “bathroom” bills that oppose gender-neutral bathrooms.3 Gender equality and equity for trans populations is at stake as 16 US states to date have introduced “bathroom bills” restricting access to sex-segregated facilities on the bas...
Source: LANCET - October 27, 2017 Category: General Medicine Authors: Arjee J Restar, Sari L Reisner Tags: Comment Source Type: research

[Editorial] Organ donor research: towards a more effective system
The NHS Blood and Transplant Service has recently told the BBC that over the past 5 years more than 500 families in the UK have blocked organ donation from a deceased relative, despite them being on the organ donor register. In the USA, more than 117  000 people await an organ transplant, says a report from the National Academy of Sciences (NAS) on the Opportunities for Organ Donor Intervention Research, published on Oct 10. The Global Observatory on Donation and Transplantation reports that despite there being over 126 000 organ transplants each year across more than 100 countries, many patients remain on waiting lists. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Xi Jinping's roadmap for China prioritises health
During the week of Oct 18, General Secretary Xi Jinping presided over the 19th Party Congress of the Communist Party of China. This twice-in-a-decade meeting an-nounces the leadership's ideology and elects the party's top positions. Xi has consolidated power and political will for deeper reform, including establishing the Healthy China initiative for primary health-care services, medical insurance, and modernising hospital management. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] The next phase for adolescent health: from talk to action
Close to 1000 delegates from more than 65 countries are expected in New Delhi, India, on Oct 27 –29, for the 11th World Congress of the International Association for Adolescent Health—a doubling of participants compared with the last conference 4 years ago. In addition, many more representatives are from low-income and middle-income countries (LMICs), and 125 youth delegates are attending, as are many more UN agencies and international non-governmental organisations, who have discovered adolescents as an important new group to focus on. (Source: LANCET)
Source: LANCET - October 27, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erb α antagonism: a single-centre propensity-matched cohort study and a randomised study
Perioperative myocardial injury is transcriptionally orchestrated by the circadian clock in patients undergoing aortic valve replacement, and Rev-Erb α antagonism seems to be a pharmacological strategy for cardioprotection. Afternoon surgery might provide perioperative myocardial protection and lead to improved patient outcomes compared with morning surgery. (Source: LANCET)
Source: LANCET - October 26, 2017 Category: General Medicine Authors: David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, St éphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Tags: Articles Source Type: research

[Comment] Circadian rhythm and ischaemia –reperfusion injury
Every day, thousands of patients are exposed to ischaemia-reperfusion injury, either in uncontrolled circumstances (eg, acute myocardial infarction or ischaemic stroke) or under controlled conditions (eg, heart, kidney, or liver surgery, or transplantation). Whatever the clinical setting is, the extent of final tissue damage (ie, infarct size) is mainly determined by the duration of the ischaemic phase and the amount of jeopardised tissue.1 Experimental and proof-of-concept clinical trials have shown that infarct size results from the addition of an ischaemia-induced injury plus a reperfusion-induced injury, and that timel...
Source: LANCET - October 26, 2017 Category: General Medicine Authors: Thomas Bochaton, Michel Ovize Tags: Comment Source Type: research

[Articles] Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey
China has marked deficiencies in the availability, cost, and prescription of antihypertensive medications. High-value medications are not preferentially used. Future efforts to reduce the burden of hypertension, particularly through the work of primary health-care providers, will need to improve access to, and use of, antihypertensive medications, paying particular attention to those with high value. (Source: LANCET)
Source: LANCET - October 25, 2017 Category: General Medicine Authors: Meng Su, Qiuli Zhang, Xueke Bai, Chaoqun Wu, Yetong Li, Elias Mossialos, George A Mensah, Frederick A Masoudi, Jiapeng Lu, Xi Li, Sebastian Salas-Vega, Anwen Zhang, Yuan Lu, Khurram Nasir, Harlan M Krumholz, Lixin Jiang Tags: Articles Source Type: research

[Articles] 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)
Among Chinese adults aged 35 –75 years, nearly half have hypertension, fewer than a third are being treated, and fewer than one in twelve are in control of their blood pressure. The low number of people in control is ubiquitous in all subgroups of the Chinese population and warrants broad-based, global strategy, such as great er efforts in prevention, as well as better screening and more effective and affordable treatment. (Source: LANCET)
Source: LANCET - October 25, 2017 Category: General Medicine Authors: Jiapeng Lu, Yuan Lu, Xiaochen Wang, Xinyue Li, George C Linderman, Chaoqun Wu, Xiuyuan Cheng, Lin Mu, Haibo Zhang, Jiamin Liu, Meng Su, Hongyu Zhao, Erica S Spatz, John A Spertus, Frederick A Masoudi, Harlan M Krumholz, Lixin Jiang Tags: Articles Source Type: research

[Comment] Hypertension in China: the gap between policy and practice
The high prevalence of hypertension in China is well known, with stroke being the most common cause of death and disability.1 Two large nationwide studies reported in The Lancet2,3 highlight that although the prevalence of hypertension in China is similar to that suggested in previous studies, it is simple deficiencies in the country's health system that make a large contribution to the disease burden. Both studies used data from the PEACE (Patient-Centred Evaluative Assessment of Cardiac Events) Million Persons Project (MPP), which enrolled 1 ·7 million adults aged 35–75 years from across China. (Source: LANCET)
Source: LANCET - October 25, 2017 Category: General Medicine Authors: Therese Hesketh, Xudong Zhou Tags: Comment Source Type: research

[Editorial] Putting research evidence at the heart of policy making
To improve patient outcomes, research must inform and shape policy. As history sadly teaches, this ideal is not always realised. But in today's Lancet, two Articles display how research addressing knowledge gaps can inform policy for hypertension control in China. (Source: LANCET)
Source: LANCET - October 25, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Correspondence] Concerns related to the nocebo effect – Authors' reply
We thank Zhen Zhou and colleagues for their comments on our Article.1 (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Ajay Gupta, Tom Godec, Peter Sever Tags: Correspondence Source Type: research

[Correspondence] Concerns related to the nocebo effect
We read with interest the finding of Ajay Gupta and colleagues (June 24, p 2473)1 of an absence of attributable risk of muscle-related adverse events to statin therapy in the blinded randomised controlled phase by contrast with an excess risk in the non-randomised, open-label extension phase in the same population. These results were attributed to the nocebo effect. We note that the overall proportion of participants reporting muscle-related adverse events was lower in the non-blinded, non-randomised phase than in the masked randomised phase. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Zhen Zhou, Andrea Curtis, Monique Breslin, Mark Nelson Tags: Correspondence Source Type: research

[Correspondence] You're not speaking my language: reframing NCDs for politicians and policy makers
Richard Horton correctly identified inadequate framing as an important reason for why the world's leading causes of death and disability —non-communicable diseases (NCDs)—are not being seriously addressed by global leaders (July 22, p 346).1 (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Luke N Allen Tags: Correspondence Source Type: research

[Correspondence] From (re-)framing NCDs to shaping public health policies on NCDs and communicable diseases
A senior adviser to the Global Fund taught Richard Horton (July 22, p 346)1 some lessons that were drawn from the struggle against three communicable diseases —tuberculosis, malaria, and AIDS—that keep scourging global health. To raise funds to combat non-communicable diseases (NCDs), one should “translate [one's] evidence into clear and simple political (not technical) messages”, “articulate why [one] need[s] money—what exactly will [one] spe nd it on and what will be the results of that investment”, “break down [one's] broad global demands into tangible country-specific nee...
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Catherine Cavalin, Alain Lescoat Tags: Correspondence Source Type: research

[Correspondence] Turning the tide on NCDs by engaging the next generation
In The Lancet (July 22, p 346),1 Richard Horton asked why the global health community is failing to effectively respond to the global rise of non-communicable diseases (NCDs). A number of opportunities for progress were highlighted. Our two organisations, NCDFREE and the Young Professionals Chronic Disease Network (YP-CDN), are firmly committed to tackling the global challenge of NCDs through advocacy and collaboration that leverages the power of young people. We fully support the recommendations outlined by Horton, and these two organisations represent the beginnings of the bold social movement that is so urgently needed. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Prachi Bhatnagar, Jack Fisher, Jessica Renzella, Ishu Kataria, Jordan D Jarvis Tags: Correspondence Source Type: research

[Correspondence] Type 2 diabetes in youth is a disease of poverty
We commend the Review by Russell Viner and colleagues (June 3, p 2252)1 on the topic of type 2 diabetes in adolescents. We were pleased that the authors acknowledged the crucial importance of the psychological and social challenges that adolescents with type 2 diabetes face. However, few clinical guidelines or expert recommendations acknowledge that these challenges might be grounded in the social conditions in which these adolescents live.2 Specifically, a substantial proportion of young people with type 2 diabetes live in poverty or socially disadvantaged households (table). (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Jonathan McGavock, Brandy Wicklow, Allison B Dart Tags: Correspondence Source Type: research

[Obituary] Dame Margaret Elizabeth Harvey Turner-Warwick
Architect of modern UK respiratory medicine. Born in London on Nov 19, 1924, she died there of pneumonia on Aug 21, 2017, aged 92 years. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Geoff Watts Tags: Obituary Source Type: research

[Perspectives] Cartography of the unseen
Whether bathed in pearly sunlight reflected by its surrounding lagoon or shrouded in mist, Venice presents a sumptuous mirage, a surfeit for the eyes. But what must it be like for blind or visually impaired residents or visitors? How do they navigate its narrow alleys and large irregularly shaped squares? How do they avoid falling into its canals? Does the city offer other aesthetic pleasures to compensate for the beauty that remains unseen by them? (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Colin Martin Tags: Perspectives Source Type: research

[Perspectives] How to make peace
As a character said in Jean Renoir's 1939 movie The Rules of the Game, “The awful thing about life is this: everybody has their reasons.” Pertinent for our daily interactions with other people, this point is also relevant when we think of politics and international disputes. At a time when diplomacy and peace-making skills are disregarded by some political leaders, it's refreshing to be reminded that listening to other people made a big difference in a peace process, even in the most unlikely conditions. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Marco De Ambrogi Tags: Perspectives Source Type: research

[Perspectives] Talking in the air
Juliet Stevenson last appeared at the Young Vic in 2015 as Winnie in Samuel Beckett's Happy Days. The role required some forbearance; initially, she was buried to her waist in shale and later she was buried up to her neck. With Wings, Stevenson is reunited with Happy Days director Natalie Abrahami in a play about a different sort of imprisonment. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Stephen Ginn Tags: Perspectives Source Type: research

[Perspectives] Inspirational women in medicine
The headquarters of medical professional bodies are invariably decorated with portraits of eminent historical figures —almost all of them men. Such places can feel alienating to the women who now make up an increasing proportion of their membership. So to enter the UK's Royal College of Physicians (RCP) in London and find its grand atrium hung with 25 huge, colour photographs of eminent medical women—all still living and extremely active—is a breath of fresh air. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Georgina Ferry Tags: Perspectives Source Type: research

[World Report] 2017 Nobel Peace Prize supports treaty to ban nuclear weapons
Awarding the 2017 Nobel Peace Prize to the International Campaign to Abolish Nuclear Weapons will help rally support for the new treaty to ban nuclear weapons. John Zarocostas reports. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: John Zarocostas Tags: World Report Source Type: research

[Comment] Second Raffles Dialogue on Human Well-Being and Security
In an increasingly unpredictable world, human wellbeing and security are under threat as never before. As the global community strives to achieve the Sustainable Development Goals (SDGs), it is clear that the time of realising easy gains is over. Going forwards, innovation (ie, the successful development of invention) will have a crucial role in ensuring humanity's future survival. The world faces a complex range of interconnected political, economic, financial, social, and environmental challenges. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Tikki Pang, Helena Legido-Quigley, Joanne Su-Yin Yoong, Yap Seng Chong, Khay Guan Yeoh, Dow Rhoon Koh, Kishore Mahbubani, John Eu-Li Wong Tags: Comment Source Type: research

[Comment] Offline: AIDS —learning from history (and human beings)
After 400 pages of exhaustive (and occasionally exhausting) remembering, Michael Merson and Stephen Inrig conclude their “useful history” (The AIDS Pandemic: Searching for a Global Response, 2017) with seven lessons. The world is capable of responding to new pandemics. Donor nations must better understand what it takes to deliver such a global response. International actors should live up to their promises. Any gl obal response needs to address the entire continuum of need, from prevention and control to therapy and care. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Richard Horton Tags: Comment Source Type: research

[Comment] Biodegradable polymer drug-eluting stents: caveat emptor
Percutaneous coronary intervention is one of the most widely done medical procedures worldwide. The success of this therapy has been largely dependent on the development of coronary stents, which enabled the procedure to become safer and more effective than balloon angioplasty alone.1 Drug-eluting stents, in particular, were a breakthrough technology. They facilitated the treatment of more complex disease patterns, previously not well managed by percutaneous intervention, because of a high rate of restenosis. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Robert A Byrne, Tibor Schuster Tags: Comment Source Type: research

[Editorial] Gun deaths and the gun control debate in the USA
The numbing parade of mass shootings in the USA —like the one in Las Vegas that left at least 59 people dead—has often obscured the gun debate's open secret: horrific, attention-grabbing, mass shootings represent only a small minority of gun deaths each year. Two-thirds of all gun deaths in the USA are attributable to suicide, a fact highligh ted by a new report from the US Centers for Disease Control and Prevention (CDC) on over half a million deaths by suicide from 2001 to 2015. Rural counties have a higher prevalence of suicide than do small and medium metropolitan, or urban counties (17·3 vs 14&middo...
Source: LANCET - October 20, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] “Junior” doctors: does terminology matter?
In a letter published online this week, David Matthews from the Oxford Health Alliance suggests abandoning the term “junior” to address the low morale of UK “trainee” hospital doctors, aged between 23 and 40 years. This proposal, supported by Sally Davies, the UK's Chief Medical Officer, is well intentioned, but an intervention beyond re-branding is urgently needed. It is not only the label that is damagi ng, but also the culture and mechanics of a system that rotates doctors between hospitals 60–70 miles apart every 6–12 months for up to 15 years, usually with less than 6 weeks' notice ...
Source: LANCET - October 20, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Editorial] Decisions only she should make
From a teenager seeking safe abortion in the USA, to the multiple actresses with sexual harassment allegations against the film producer Harvey Weinstein, recent media reports concerning the rights of women and girls share the familiar sense of objectification of female bodies by men in power and lost agency in sexual and reproductive rights. The latest draft of the 2018 –22 strategic plan of the the US Department of Health and Human Services (HHS) defined the HHS mission as “serving and protecting Americans at every stage of life, beginning at conception”. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

[Articles] PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group
The favourable outcome of patients treated with eBEACOPP could not be improved by adding rituximab after positive PET-2. PET-2 negativity allows reduction to only four cycles of eBEACOPP without loss of tumour control. PET-2-guided eBEACOPP provides outstanding efficacy for all patients and increases overall survival by reducing treatment-related risks for patients with negative PET-2. We recommend this PET-2-guided treatment strategy for patients with advanced-stage Hodgkin's lymphoma. (Source: LANCET)
Source: LANCET - October 20, 2017 Category: General Medicine Authors: Peter Borchmann, Helen Goergen, Carsten Kobe, Andreas Lohri, Richard Greil, Dennis A Eichenauer, Jos ée M Zijlstra, Jana Markova, Julia Meissner, Michaela Feuring-Buske, Andreas Hüttmann, Judith Dierlamm, Martin Soekler, Hans-Joachim Beck, Wolfgang Will Tags: Articles Source Type: research