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The Lancet
Journal Prestige (SJR): 14.934
Citation Impact (citeScore): 9
Number of Followers: 2642  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0140-6736 - ISSN (Online) 1474-547X
Published by Elsevier Homepage  [3158 journals]
  • Cyclone Idai: 1 month later, devastation persists
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Sharmila Devi
       
  • Tetanus
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Lam Minh Yen, C Louise ThwaitesSummaryTetanus is a vaccine-preventable disease that still commonly occurs in many low-income and middle-income countries, although it is rare in high-income countries. The disease is caused by the toxin of the bacterium Clostridium tetani and is characterised by muscle spasms and autonomic nervous system dysfunction. Global vaccination initiatives have had considerable success but they continue to face many challenges. Treatment for tetanus aims to control spasms and reduce cardiovascular instability, and consists of wound debridement, antitoxin, antibiotics, and supportive care. Recent research has focused on intravenous magnesium sulphate and intrathecal antitoxin administration as methods of spasm control that can avoid the need for ventilatory support. Nevertheless, without access to mechanical ventilation, mortality from tetanus remains high. Even with such care, patients require several weeks of hospitalisation and are vulnerable to secondary problems, such as hospital-acquired infections.
       
  • Laser peripheral iridotomy for the prevention of angle closure: a
           single-centre, randomised controlled trial
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Mingguang He, Yuzhen Jiang, Shengsong Huang, Dolly S Chang, Beatriz Munoz, Tin Aung, Paul J Foster, David S FriedmanSummaryBackgroundPrimary angle-closure glaucoma affects 20 million people worldwide. People classified as primary angle closure suspects have a higher but poorly quantified risk of developing glaucoma. We aimed to assess efficacy and safety of laser peripheral iridotomy prophylaxis against primary angle-closure glaucoma in Chinese people classified as primary angle closure suspects.MethodsIn this randomised controlled trial, bilateral primary angle closure suspects aged 50–70 years were enrolled at the Zhongshan Ophthalmic Center, a tertiary specialised hospital in Guangzhou, China. Eligible patients received laser peripheral iridotomy in one randomly selected eye, with the other remaining untreated. The primary outcome was incident primary angle closure disease as a composite endpoint of elevation of intraocular pressure, peripheral anterior synechiae, or acute angle-closure during 72 months of follow-up in an intention-to-treat analysis between treated eyes and contralateral controls. This trial is registered with the ISRCTN registry, number ISRCTN45213099.FindingsOf 11 991 screened individuals, 889 individuals were randomly assigned from June 19, 2008 (889 treated and 889 untreated eyes). Incidence of the primary outcome was 4·19 per 1000 eye-years in treated eyes compared with 7·97 per 1000 eye-years in untreated eyes (hazard ratio 0·53; 95% CI 0·30–0·92; p=0·024). A primary outcome event occurred in 19 treated eyes and 36 untreated eyes with a statistically significant difference using pair-wise analysis (p=0·0041). No serious adverse events were observed during follow-up.InterpretationIncidence of angle-closure disease was very low among individuals classified as primary angle closure suspects identified through community-based screening. Laser peripheral iridotomy had a modest, albeit significant, prophylactic effect. In view of the low incidence rate of outcomes that have no immediate threat to vision, the benefit of prophylactic laser peripheral iridotomy is limited; therefore, widespread prophylactic laser peripheral iridotomy for primary angle-closure suspects is not recommended.FundingFight for Sight, the Sun Yat-Sen University 5010 Project Fund, Moorfields Eye Charity, and the National Natural Science Foundation of China.
       
  • β blockers to prevent decompensation of cirrhosis in patients with
           clinically significant portal hypertension (PREDESCI): a randomised,
           double-blind, placebo-controlled, multicentre trial
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Càndid Villanueva, Agustín Albillos, Joan Genescà, Joan C Garcia-Pagan, José L Calleja, Carles Aracil, Rafael Bañares, Rosa M Morillas, María Poca, Beatriz Peñas, Salvador Augustin, Juan G Abraldes, Edilmar Alvarado, Ferran Torres, Jaume BoschSummaryBackgroundClinical decompensation of cirrhosis is associated with poor prognosis. Clinically significant portal hypertension (CSPH), defined by a hepatic venous pressure gradient (HVPG) ≥10 mm Hg, is the strongest predictor of decompensation. This study aimed at assessing whether lowering HVPG with β blockers could decrease the risk of decompensation or death in compensated cirrhosis with CSPH.MethodsThis study on β blockers to prevent decompensation of cirrhosis with portal hypertension (PREDESCI) was an investigator-initiated, double-blind, randomised controlled trial done in eight hospitals in Spain. We enrolled patients with compensated cirrhosis and CSPH without high-risk varices. All participants had HVPG measurements with assessment of acute HVPG-response to intravenous propranolol. Responders (HVPG-decrease ≥10%) were randomly assigned to propranolol (up to 160 mg twice a day) versus placebo and non-responders to carvedilol (≤25 mg/day) versus placebo. Doses were individually determined during an open-label titration period after which randomisation was done with 1:1 allocation by a centralised web-based system. The primary endpoint was incidence of cirrhosis decompensation (defined as development of ascites, bleeding, or overt encephalopathy) or death. Since death in compensated cirrhosis is usually unrelated to the liver, an intention-to-treat analysis considering deaths unrelated to the liver as competing events was done. This study is registered with ClinicalTrials.gov, number NCT01059396. The trial is now completed.FindingsBetween Jan 18, 2010, and July 31, 2013, 631 patients were evaluated and 201 were randomly assigned. 101 patients received placebo and 100 received active treatment (67 propranolol and 33 carvedilol). The primary endpoint occurred in 16 (16%) of 100 patients in the β blockers group versus 27 (27%) of 101 in the placebo group (hazard ratio [HR] 0·51, 95% CI 0·26–0·97, p=0·041). The difference was due to a reduced incidence of ascites (HR=0·44, 95%CI=0·20–0·97, p=0·0297). The overall incidence of adverse events was similar in both groups. Six patients (four in the β blockers group) had severe adverse events.InterpretationLong-term treatment with β blockers could increase decompensation-free survival in patients with compensated cirrhosis and CSPH, mainly by reducing the incidence of ascites.FundingSpanish Ministries of Health and Economy.
       
  • Department of Error
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s):
       
  • Department of Error
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s):
       
  • Department of Error
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s):
       
  • Department of Error
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s):
       
  • Department of Error
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s):
       
  • Orphan drugs – Authors' reply
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Lucio Luzzatto, Enrico Costa, Arrigo Schieppati, Giuseppe Remuzzi
       
  • Orphan drugs
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Jaume Puig-Junoy, Carlos Campillo-Artero
       
  • Orphan drugs
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Andrea Messori, Francesco Attanasio, Sabrina Trippoli, Roberto Banfi
       
  • Orphan drugs
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Francesca Cainelli, Sandro Vento
       
  • Functional capacity and preoperative risk evaluation – Authors'
           reply
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Duminda N Wijeysundera, Brian H Cuthbertson, Rupert M Pearse, Paul S Myles, METS Study Investigators
       
  • Functional capacity and preoperative risk evaluation
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Anoop N Koshy, Jay Ramchand, Omar Farouque
       
  • Functional capacity and preoperative risk evaluation
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Jairo Alberto Dussán-Sarria, Claudia De Souza Gutierrez, Luciana Cadore Stefani
       
  • Functional capacity and preoperative risk evaluation
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Ganesan Karthikeyan
       
  • Awareness of the link between obesity and cancer in UK school curricula
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Andrew G Renehan, Kelly Lloyd, Isabella Renehan
       
  • Margaret Susan Povey
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Geoff Watts
       
  • Alzheimer's disease
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Richard Barnett
       
  • The Uninhabitable Earth: Life After Warming, David Wallace-Wells. Tim
           Duggan Books, US (2019), 320, and Allen Lane (UK), US$27·00, £20·00,
           ISBN: 9780525576709
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Laurie Garrett
       
  • Concerns raised about NHS gender identity service
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Talha Burki
       
  • DR Congo Ebola outbreak not given PHEIC designation
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Andrew Green
       
  • A kidney changes size: first increasing and then decreasing
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Dewen Zhong, Yi Yi, Chaolu Lin
       
  • Liberia post Ebola: ready for another outbreak'
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Laura Salm-Reifferscheidt
       
  • Offline: The case for compromise
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Richard Horton
       
  • Opioid analgesics pass the acid test
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Edita Navratilova, Amol Patwardhan, Frank Porreca
       
  • Reporting of artificial intelligence prediction models
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Gary S Collins, Karel G M Moons
       
  • Good news for democracy
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Helen Epstein
       
  • Fetal MRI and prenatal diagnosis of congenital heart defects
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Jimmy Espinoza
       
  • Prophylactic laser iridotomy in primary angle-closure suspects
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Robert N Weinreb, Sasan Moghimi
       
  • Prevention of decompensation in cirrhosis: a new youth for β blockers
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Sharon Levy, Didier Samuel
       
  • Universal health care in 21st century Americas
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): The Lancet
       
  • Assessing researchers with a focus on research integrity
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): The Lancet
       
  • The doctors' predicament: China's health-care growing pains
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): The Lancet
       
  • Tuberculosis
    • Abstract: Publication date: 20–26 April 2019Source: The Lancet, Volume 393, Issue 10181Author(s): Jennifer Furin, Helen Cox, Madhukar PaiSummaryTuberculosis remains the leading cause of death from an infectious disease among adults worldwide, with more than 10 million people becoming newly sick from tuberculosis each year. Advances in diagnosis, including the use of rapid molecular testing and whole-genome sequencing in both sputum and non-sputum samples, could change this situation. Although little has changed in the treatment of drug-susceptible tuberculosis, data on increased efficacy with new and repurposed drugs have led WHO to recommend all-oral therapy for drug-resistant tuberculosis for the first time ever in 2018. Studies have shown that shorter latent tuberculosis prevention regimens containing rifampicin or rifapentine are as effective as longer, isoniazid-based regimens, and there is a promising vaccine candidate to prevent the progression of infection to the disease. But new tools alone are not sufficient. Advances must be made in providing high-quality, people-centred care for tuberculosis. Renewed political will, coupled with improved access to quality care, could relegate the morbidity, mortality, and stigma long associated with tuberculosis, to the past.
       
  • A call for clinicians to act on planetary health
    • Abstract: Publication date: Available online 19 April 2019Source: The LancetAuthor(s): Erika M Veidis, Samuel S Myers, Amalia A Almada, Christopher D Golden, Clinicians for Planetary Health Working Group
       
  • ABO-incompatible renal transplantation
    • Abstract: Publication date: Available online 18 April 2019Source: The LancetAuthor(s): Ian S Currie, Lorna K Henderson
       
  • Community-wide soil-transmitted helminth treatment is equity-effective
    • Abstract: Publication date: Available online 18 April 2019Source: The LancetAuthor(s): Jennifer Keiser, Jürg Utzinger
       
  • Effects, equity, and cost of school-based and community-wide treatment
           strategies for soil-transmitted helminths in Kenya: a cluster-randomised
           controlled trial
    • Abstract: Publication date: Available online 18 April 2019Source: The LancetAuthor(s): Rachel L Pullan, Katherine E Halliday, William E Oswald, Carlos Mcharo, Emma Beaumont, Stella Kepha, Stefan Witek-McManus, Paul M Gichuki, Elizabeth Allen, Tom Drake, Catherine Pitt, Sultani H Matendechero, Marie-Claire Gwayi-Chore, Roy M Anderson, Sammy M Njenga, Simon J Brooker, Charles S MwandawiroSummaryBackgroundSchool-based deworming programmes can reduce morbidity attributable to soil-transmitted helminths in children but do not interrupt transmission in the wider community. We assessed the effects of alternative mass treatment strategies on community soil-transmitted helminth infection.MethodsIn this cluster-randomised controlled trial, 120 community units (clusters) serving 150 000 households in Kenya were randomly assigned (1:1:1) to receive albendazole through annual school-based treatment targeting 2–14 year olds or annual or biannual community-wide treatment targeting all ages. The primary outcome was community hookworm prevalence, assessed at 12 and 24 months through repeat cross-sectional surveys. Secondary outcomes were Ascaris lumbricoides and Trichuris trichiura prevalence, infection intensity of each soil-transmitted helminth species, and treatment coverage and costs. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02397772.FindingsAfter 24 months, prevalence of hookworm changed from 18·6% (95% CI 13·9–23·2) to 13·8% (10·5–17·0) in the annual school-based treatment group, 17·9% (13·7–22·1) to 8·0% (6·0–10·1) in the annual community-wide treatment group, and 20·6% (15·8–25·5) to 6·2% (4·9–7·5) in the biannual community-wide treatment group. Relative to annual school-based treatment, the risk ratio for annual community-wide treatment was 0·59 (95% CI 0·42–0·83; p
       
  • Levetiracetam no better than phenytoin in children with convulsive status
           epilepticus
    • Abstract: Publication date: Available online 17 April 2019Source: The LancetAuthor(s): Robert Silbergleit, Jordan J Elm
       
  • UK Public Health Science 2019: a call for abstracts
    • Abstract: Publication date: Available online 17 April 2019Source: The LancetAuthor(s): Emily J Tweed, Robert W Aldridge, Public Health Science Conference Group
       
  • Population versus individual protection by pneumococcal conjugate
           vaccination
    • Abstract: Publication date: Available online 15 April 2019Source: The LancetAuthor(s): Keith P Klugman, Gail L Rodgers
       
  • A turning point for chronic kidney disease in diabetes
    • Abstract: Publication date: Available online 14 April 2019Source: The LancetAuthor(s): Katherine R Tuttle
       
  • Digital health care for older adults
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Lorraine Evangelista, Steven R Steinhubl, Eric J Topol
       
  • Perioperative opioid analgesia—when is enough too much' A review of
           opioid-induced tolerance and hyperalgesia
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Lesley A Colvin, Fiona Bull, Tim G HalesSummaryOpioids are a mainstay of acute pain management but can have many adverse effects, contributing to problematic long-term use. Opioid tolerance (increased dose needed for analgesia) and opioid-induced hyperalgesia (paradoxical increase in pain with opioid administration) can contribute to both poorly controlled pain and dose escalation. Hyperalgesia is particularly problematic as further opioid prescribing is largely futile. The mechanisms of opioid tolerance and hyperalgesia are complex, involving μ opioid receptor signalling pathways that offer opportunities for novel analgesic alternatives. The intracellular scaffold protein β-arrestin-2 is implicated in tolerance, hyperalgesia, and other opioid side-effects. Development of agonists biased against recruitment of β-arrestin-2 could provide analgesic efficacy with fewer side-effects. Alternative approaches include inhibition of peripheral μ opioid receptors and blockade of downstream signalling mechanisms, such as the non-receptor tyrosine kinase Src or N-methyl-D-aspartate receptors. Furthermore, it is prudent to use multimodal analgesic regimens to reduce reliance on opioids during the perioperative period. In the third paper in this Series we focus on clinical and mechanism-based understanding of tolerance and opioid-induced hyperalgesia, and discuss current and future strategies for pain management.
       
  • Delayed Strongyloides stercoralis hyperinfection syndrome in a renal
           transplant patient with Pneumocystis jirovecii pneumonia receiving
           high-dose corticosteroids
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Daniel Pan, Paul Arkell, Neil R H Stone, Belinda Parkinson, Brendan Tinwell, Catherine A Cosgrove
       
  • The NUTRIREA-2 study – Authors' reply
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Jean Reignier, Jean-Baptiste Lascarrou, Amélie Le Gouge
       
  • The NUTRIREA-2 study
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Alessio Molfino, Alessandro Laviano
       
  • The NUTRIREA-2 study
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Tetsuji Fujita
       
  • The NUTRIREA-2 study
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Simon Bourcier, Alain Combes
       
  • Populations, decreasing fertility, and reproductive health
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Niels E Skakkebaek, Niels Jørgensen, Anna-Maria Andersson, Anders Juul, Katharina M Main, Tina Kold Jensen, Jorma Toppari
       
  • Indigenous Australian children and the impact of adoption legislation in
           New South Wales
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Marlene Longbottom, Hannah McGlade, Marcia Langton, Kathleen Clapham
       
  • William Carter Jenkins
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Adam Marcus
       
  • Closure or retribution'
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Marco De Ambrogi
       
  • Disease X and other unknowns
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Mark Honigsbaum
       
  • Ramani Moonesinghe: anaesthetist with a perioperative vision
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Geoff Watts
       
  • Beneath the Skin: Great Writers on the Body, Naomi Alderman, Ned Beauman,
           Thomas Lynch. Profile Books and Wellcome Collection (2018), 192, £12·99,
           ISBN: 9781788160957
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Sarah Ditum
       
  • Transition from acute to chronic pain after surgery
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Paul Glare, Karin R Aubrey, Paul S MylesSummaryOver the past decade there has been an increasing reliance on strong opioids to treat acute and chronic pain, which has been associated with a rising epidemic of prescription opioid misuse, abuse, and overdose-related deaths. Deaths from prescription opioids have more than quadrupled in the USA since 1999, and this pattern is now occurring globally. Inappropriate opioid prescribing after surgery, particularly after discharge, is a major cause of this problem. Chronic postsurgical pain, occurring in approximately 10% of patients who have surgery, typically begins as acute postoperative pain that is difficult to control, but soon transitions into a persistent pain condition with neuropathic features that are unresponsive to opioids. Research into how and why this transition occurs has led to a stronger appreciation of opioid-induced hyperalgesia, use of more effective and safer opioid-sparing analgesic regimens, and non-pharmacological interventions for pain management. This Series provides an overview of the epidemiology and societal effect, basic science, and current recommendations for managing persistent postsurgical pain. We discuss the advances in the prevention of this transitional pain state, with the aim to promote safer analgesic regimens to better manage patients with acute and chronic pain.
       
  • Italy calls on retired doctors to fill health worker gap
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Marta Paterlini
       
  • Health debate rising around the upcoming Indian election
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Patralekha Chatterjee
       
  • International outrage over Brunei's discriminatory laws
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Sharmila Devi
       
  • Offline: Facing down the violence of liberal communists
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Richard Horton
       
  • Guidelines for the diagnosis and treatment of Chagas disease
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Ana Cristina Pereiro
       
  • Optimal postoperative pain management: redefining the role for opioids
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Markus W Hollmann, James P Rathmell, Philipp Lirk
       
  • Interpregnancy interval after stillbirth: modifiable, but does it
           matter'
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Mark A Klebanoff
       
  • Laser trabeculoplasty as first-line glaucoma treatment
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Jonathan W Young, Joesph Caprioli
       
  • Artificial intelligence in global health: a brave new world
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): The Lancet
       
  • Best practice in managing postoperative pain
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): The Lancet
       
  • Post-Castro Cuba: new constitution expands health rights
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): The Lancet
       
  • Inappropriate opioid prescription after surgery
    • Abstract: Publication date: 13–19 April 2019Source: The Lancet, Volume 393, Issue 10180Author(s): Mark D Neuman, Brian T Bateman, Hannah WunschSummaryWorldwide, the use of prescription opioid analgesics more than doubled between 2001 and 2013, with several countries, including the USA, Canada, and Australia, experiencing epidemics of opioid misuse and abuse over this period. In this context, excessive prescribing of opioids for pain treatment after surgery has been recognised as an important concern for public health and a potential contributor to patterns of opioid misuse and related harm. In the second paper in this Series we review the evolution of prescription opioid use for pain treatment after surgery in the USA, Canada, and other countries. We summarise evidence on the extent of opioid overprescribing after surgery and its potential association with subsequent opioid misuse, diversion, and the development of opioid use disorder. We discuss evidence on patient, physician, and system-level predictors of excessive prescribing after surgery, and summarise recent work on clinical and policy efforts to reduce such prescribing while ensuring adequate pain control.
       
  • Perioperative FLOT: new standard for gastric cancer'
    • Abstract: Publication date: Available online 11 April 2019Source: The LancetAuthor(s): Yoon-Koo Kang, Hyungwoo Cho
       
  • SABR-COMET: harbinger of a new cancer treatment paradigm
    • Abstract: Publication date: Available online 11 April 2019Source: The LancetAuthor(s): Billy W Loo, Maximilian Diehn
       
  • Challenges for immigrant health in the USA—the road to crisis
    • Abstract: Publication date: Available online 10 April 2019Source: The LancetAuthor(s): Dhruv Khullar, Dave A ChokshiSummaryThe USA is home to more immigrants than any other country—about 46 million, just less than a fifth of the world's immigrants. Immigrant health and access to health care in the USA varies widely by ethnicity, citizenship, and legal status. In recent decades, several policy and regulatory changes have worsened health-care quality and access for immigrant populations. These changes include restrictions on access to public health insurance programmes, rhetoric discouraging the use of social services, aggressive immigration enforcement activities, intimidation within health-care settings, decreased caps on the number of admitted refugees, and rescission of protections from deportation. A receding of ethical norms has created an environment favourable for moral and public health crises, as evident in the separation of children from their parents at the southern US border. Given the polarising immigration rhetoric at the national level, individual states rather than the country as a whole might be better positioned to address the barriers to improved health and health care for immigrants in the USA.
       
  • Local trends in immunisation coverage across Africa
    • Abstract: Publication date: Available online 5 April 2019Source: The LancetAuthor(s): Alexandre de Figueiredo, Fredrick Were
       
  • Unite for a Framework Convention for Alcohol Control
    • Abstract: Publication date: Available online 4 April 2019Source: The LancetAuthor(s): Shiu Lun Au Yeung, Tai Hing Lam
       
  • Pembrolizumab for all PD-L1-positive NSCLC
    • Abstract: Publication date: Available online 4 April 2019Source: The LancetAuthor(s): Egbert F Smit, Adrianus J de Langen
       
  • Global diet and health: old questions, fresh evidence, and new horizons
    • Abstract: Publication date: Available online 4 April 2019Source: The LancetAuthor(s): Nita G Forouhi, Nigel Unwin
       
  • Department of Error
    • Abstract: Publication date: Available online 4 April 2019Source: The LancetAuthor(s):
       
  • Science's place in shaping gender-based policies in athletics
    • Abstract: Publication date: Available online 2 April 2019Source: The LancetAuthor(s): Eric Vilain, Maria José Martinez-Patiño
       
  • Keeping promises to women, children, and adolescents
    • Abstract: Publication date: Available online 22 March 2019Source: The LancetAuthor(s): Flavia Bustreo, Marleen Temmerman
       
  • Advancing the repurposing of ivermectin for malaria
    • Abstract: Publication date: Available online 14 March 2019Source: The LancetAuthor(s): Carlos Chaccour, N Regina Rabinovich
       
 
 
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