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Journal Cover   The Lancet
  [SJR: 11.563]   [H-I: 514]   [1348 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0140-6736 - ISSN (Online) 1474-547X
   Published by Elsevier Homepage  [2588 journals]
  • Hip fractures: comprehensive geriatric care and recovery
    • Abstract: Publication date: Available online 5 February 2015
      Source:The Lancet
      Author(s): Stefano Volpato , Jack M Guralnik



      PubDate: 2015-02-06T07:00:16Z
       
  • Rituximab as second-line treatment for adult immune thrombocytopenia (the
           RITP trial): a multicentre, randomised, double-blind, placebo-controlled
           trial
    • Abstract: Publication date: Available online 5 February 2015
      Source:The Lancet
      Author(s): Waleed Ghanima , Abderrahim Khelif , Anders Waage , Marc Michel , Geir E Tjønnfjord , Neila Ben Romdhan , Johannes Kahrs , Bernadette Darne , Pål Andrè Holme
      Background Immune thrombocytopenia is characterised by immune-mediated destruction and suboptimum production of platelets. Despite the absence of supporting evidence, rituximab is frequently used off-label in patients with immune thrombocytopenia. We aimed to assess the efficacy of rituximab as compared with placebo as a splenectomy-sparing treatment in patients who were previously treated with corticosteroids. Methods In this multicentre, randomised, double-masked, placebo-controlled trial, we enrolled corticosteroid unresponsive adult patients (aged ≥18 years) with primary immune thrombocytopenia and a platelet count of less than 30 × 109 platelets per L. Patients were randomly assigned (1:1) to four weekly infusions of 375 mg/m2 rituximab or placebo. Concurrent treatment with corticosteroids only was allowed during the study. The primary endpoint was rate of treatment failure within 78 weeks—a composite of splenectomy or meeting criteria for splenectomy after week 12 if splenectomy was not done, assessed in all patients who received at least one dose of study treatment. Secondary endpoints were response rates, relapse rates, and duration of response. Efficacy endpoints were assessed with the Kaplan-Meier method. Safety endpoints were assessed in all patients who received at least one dose. This trial is registered with ClinicalTrials.gov, number NCT00344149. Findings Between Aug 17, 2006, and June 30, 2011, we enrolled 112 patients. 32 (58%) of 55 patients in the rituximab group and 37 (69%) of 54 patients in the placebo group had treatment failure within 78 weeks (Kaplan-Meier cumulative incidence 46% for rituximab vs 52% for placebo (hazard ratio [HR] 0·89, 95% CI 0·55–1·45; p=0·65). The cumulative incidence of overall response was 81% in the rituximab group versus 73% in the placebo group (p=0·15) and complete response was 58% in the rituximab group versus 50% in the placebo group (p=0·12). Of those achieving an overall response, 68% relapsed in the rituximab group and 78% relapsed in the placebo group, and of those achieving complete response, 50% relapsed in the rituximab group and 62% relapsed in the placebo group. Time to relapse in the rituximab group was longer in patients who achieved overall response (36 vs 7 weeks; p=0·01) but not complete response (76 vs 49 weeks; p=0·19). Rates of bleeding were similar in the two groups (21 [38%] in the rituximab group vs 27 [50%] in the placebo group; p=0·08) as were rates of infection (22 [40%] vs 13 [24%]; p=0·09). Interpretation Despite no reduction in the rate of long-term treatment failure with rituximab, a small benefit cannot be ruled out, as suggested by an apparently longer duration of response and numerically higher response rates with rituximab. Funding South-East Regional Health Authority and Østfold Hospital, Norway; Roche, France; and Roche, Norway.


      PubDate: 2015-02-06T07:00:16Z
       
  • Disease Control Priorities, 3rd edition: improving health and reducing
           poverty
    • Abstract: Publication date: Available online 5 February 2015
      Source:The Lancet
      Author(s): Dean T Jamison



      PubDate: 2015-02-06T07:00:16Z
       
  • B-cell depletion in immune thrombocytopenia
    • Abstract: Publication date: Available online 5 February 2015
      Source:The Lancet
      Author(s): Bethan Psaila , Nichola Cooper



      PubDate: 2015-02-06T07:00:16Z
       
  • Essential surgery: key messages from Disease Control Priorities, 3rd
           edition
    • Abstract: Publication date: Available online 5 February 2015
      Source:The Lancet
      Author(s): Charles N Mock , Peter Donkor , Atul Gawande , Dean T Jamison , Margaret E Kruk , Haile T Debas
      The World Bank will publish the nine volumes of Disease Control Priorities, 3rd edition, in 2015–16. Volume 1—Essential Surgery—identifies 44 surgical procedures as essential on the basis that they address substantial needs, are cost effective, and are feasible to implement. This report summarises and critically assesses the volume's five key findings. First, provision of essential surgical procedures would avert about 1·5 million deaths a year, or 6–7% of all avertable deaths in low-income and middle-income countries. Second, essential surgical procedures rank among the most cost effective of all health interventions. The surgical platform of the first-level hospital delivers 28 of the 44 essential procedures, making investment in this platform also highly cost effective. Third, measures to expand access to surgery, such as task sharing, have been shown to be safe and effective while countries make long-term investments in building surgical and anaesthesia workforces. Because emergency procedures constitute 23 of the 28 procedures provided at first-level hospitals, expansion of access requires that such facilities be widely geographically diffused. Fourth, substantial disparities remain in the safety of surgical care, driven by high perioperative mortality rates including anaesthesia-related deaths in low-income and middle-income countries. Feasible measures, such as WHO's Surgical Safety Checklist, have led to improvements in safety and quality. Fifth, the large burden of surgical disorders, cost-effectiveness of essential surgery, and strong public demand for surgical services suggest that universal coverage of essential surgery should be financed early on the path to universal health coverage. We point to estimates that full coverage of the component of universal coverage of essential surgery applicable to first-level hospitals would require just over US$3 billion annually of additional spending and yield a benefit–cost ratio of more than 10:1. It would efficiently and equitably provide health benefits, financial protection, and contributions to stronger health systems.


      PubDate: 2015-02-06T07:00:16Z
       
  • Comprehensive geriatric care for patients with hip fractures: a
           prospective, randomised, controlled trial
    • Abstract: Publication date: Available online 5 February 2015
      Source:The Lancet
      Author(s): Anders Prestmo , Gunhild Hagen , Olav Sletvold , Jorunn L Helbostad , Pernille Thingstad , Kristin Taraldsen , Stian Lydersen , Vidar Halsteinli , Turi Saltnes , Sarah E Lamb , Lars G Johnsen , Ingvild Saltvedt
      Background Most patients with hip fractures are characterised by older age (>70 years), frailty, and functional deterioration, and their long-term outcomes are poor with increased costs. We compared the effectiveness and cost-effectiveness of giving these patients comprehensive geriatric care in a dedicated geriatric ward versus the usual orthopaedic care. Methods We did a prospective, single-centre, randomised, parallel-group, controlled trial. Between April 18, 2008, and Dec 30, 2010, we randomly assigned home-dwelling patients with hip-fractures aged 70 years or older who were able to walk 10 m before their fracture, to either comprehensive geriatric care or orthopaedic care in the emergency department, to achieve the required sample of 400 patients. Randomisation was achieved via a web-based, computer-generated, block method with unknown block sizes. The primary outcome, analysed by intention to treat, was mobility measured with the Short Physical Performance Battery (SPPB) 4 months after surgery for the fracture. The type of treatment was not concealed from the patients or staff delivering the care, and assessors were only partly masked to the treatment during follow-up. This trial is registered with ClinicalTrials.gov, number NCT00667914. Findings We assessed 1077 patients for eligibility, and excluded 680, mainly for not meeting the inclusion criteria such as living in a nursing home or being aged less than 70 years. Of the remaining patients, we randomly assigned 198 to comprehensive geriatric care and 199 to orthopaedic care. At 4 months, 174 patients remained in the comprehensive geriatric care group and 170 in the orthopaedic care group; the main reason for dropout was death. Mean SPPB scores at 4 months were 5·12 (SE 0·20) for comprehensive geriatric care and 4·38 (SE 0·20) for orthopaedic care (between-group difference 0·74, 95% CI 0·18–1·30, p=0·010). Interpretation Immediate admission of patients aged 70 years or more with a hip fracture to comprehensive geriatric care in a dedicated ward improved mobility at 4 months, compared with the usual orthopaedic care. The results suggest that the treatment of older patients with hip fractures should be organised as orthogeriatric care. Funding Norwegian Research Council, Central Norway Regional Health Authority, St Olav Hospital Trust and Fund for Research and Innovation, Liaison Committee between Central Norway Regional Health Authority and the Norwegian University of Science and Technology, the Department of Neuroscience at the Norwegian University of Science and Technology, Foundation for Scientific and Industrial Research at the Norwegian Institute of Technology (SINTEF), and the Municipality of Trondheim.


      PubDate: 2015-02-06T07:00:16Z
       
  • The use of bedaquiline in regimens to treat drug-resistant and
           drug-susceptible tuberculosis: a perspective from tuberculosis-affected
           communities
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Laia Ruiz Mingote , Dorothy Namutamba , Francis Apina , Nomampondo Barnabas , Carmen Contreras , Taharqa Elnour , Mike Watson Frick , Cynthia Lee , Barbara Seaworth , Debra Shelly , Natalie Skipper , Ezio Tavora dos Santos Filho



      PubDate: 2015-02-05T07:00:16Z
       
  • Dengue
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Maria G Guzman , Eva Harris
      Dengue viruses have spread rapidly within countries and across regions in the past few decades, resulting in an increased frequency of epidemics and severe dengue disease, hyperendemicity of multiple dengue virus serotypes in many tropical countries, and autochthonous transmission in Europe and the USA. Today, dengue is regarded as the most prevalent and rapidly spreading mosquito-borne viral disease of human beings. Importantly, the past decade has also seen an upsurge in research on dengue virology, pathogenesis, and immunology and in development of antivirals, vaccines, and new vector-control strategies that can positively impact dengue control and prevention.


      PubDate: 2015-02-05T07:00:16Z
       
  • Countdown to 2015 and beyond: fulfilling the health agenda for women and
           children
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Jennifer Harris Requejo , Jennifer Bryce , Aluisio JD Barros , Peter Berman , Zulfiqar Bhutta , Mickey Chopra , Bernadette Daelmans , Andres de Francisco , Joy Lawn , Blerta Maliqi , Elizabeth Mason , Holly Newby , Carole Presern , Ann Starrs , Cesar G Victora
      The end of 2015 will signal the end of the Millennium Development Goal era, when the world can take stock of what has been achieved. The Countdown to 2015 for Maternal, Newborn, and Child Survival (Countdown) has focused its 2014 report on how much has been achieved in intervention coverage in these groups, and on how best to sustain, focus, and intensify efforts to progress for this and future generations. Our 2014 results show unfinished business in achievement of high, sustained, and equitable coverage of essential interventions. Progress has accelerated in the past decade in most Countdown countries, suggesting that further gains are possible with intensified actions. Some of the greatest coverage gaps are in family planning, interventions addressing newborn mortality, and case management of childhood diseases. Although inequities are pervasive, country successes in reaching of the poorest populations provide lessons for other countries to follow. As we transition to the next set of global goals, we must remember the centrality of data to accountability, and the importance of support of country capacity to collect and use high-quality data on intervention coverage and inequities for decision making. To fulfill the health agenda for women and children both now and beyond 2015 requires continued monitoring of country and global progress; Countdown is committed to playing its part in this effort.


      PubDate: 2015-02-05T07:00:16Z
       
  • Blue–black eyes and legs
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Cassandra C Gauer , Hector I Michelena



      PubDate: 2015-02-05T07:00:16Z
       
  • ST-segment elevation myocardial infarction in China from 2001 to 2011 (the
           China PEACE-Retrospective Acute Myocardial Infarction Study): a
           retrospective analysis of hospital data
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Jing Li , Xi Li , Qing Wang , Shuang Hu , Yongfei Wang , Frederick A Masoudi , John A Spertus , Harlan M Krumholz , Lixin Jiang
      Background Despite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. Methods In a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic–geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. Findings We sampled 175 hospitals (162 participated in the study) and 18 631 acute myocardial infarction admissions, of which 13 815 were STEMI admissions. 12 264 patients were included in analysis of treatments, procedures, and tests, and 11 986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100 000 people increased (from 3·5 in 2001, to 7·9 in 2006, to 15·4 in 2011; ptrend<0·0001) and the prevalence of risk factors—including smoking, hypertension, diabetes, and dyslipidaemia—increased. We noted significant increases in use of aspirin within 24 h (79·7% [95% CI 77·9–81·5] in 2001 vs 91·2% [90·5–91·8] in 2011, ptrend<0·0001) and clopidogrel (1·5% [95% CI 1·0–2·1] in 2001 vs 82·1% [81·1–83·0] in 2011, ptrend<0·0001) in patients without documented contraindications. Despite an increase in the use of primary percutaneous coronary intervention (10·6% [95% CI 8·6–12·6] in 2001 vs 28·1% [26·6–29·7] in 2011, ptrend<0·0001), the proportion of patients who did not receive reperfusion did not significantly change (45·3% [95% CI 42·1–48·5] in 2001 vs 44·8% [43·1–46·5] in 2011, ptrend=0·69). The median length of hospital stay decreased from 12 days (IQR 7–18) in 2001 to 10 days (6–14) in 2011 (ptrend<0·0001). Adjusted in-hospital mortality did not significantly change between 2001 and 2011 (odds ratio 0·82, 95% CI 0·62–1·10, ptrend=0·07). Interpretation During the past decade in China, hospital admissions for STEMI have risen; in these patients, comorbidities and the intensity of testing and treatment have increased. Quality of care has improved for some treatments, but important gaps persist and in-hospital mortality has not decreased. National efforts are needed to improve the care and outcomes for patients with STEMI in China. Funding National Health and Family Planning Commission of China.


      PubDate: 2015-02-05T07:00:16Z
       
  • Global, regional, and national causes of child mortality in 2000–13,
           with projections to inform post-2015 priorities: an updated systematic
           analysis
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Li Liu , Shefali Oza , Daniel Hogan , Jamie Perin , Igor Rudan , Joy E Lawn , Simon Cousens , Colin Mathers , Robert E Black
      Background Trend data for causes of child death are crucial to inform priorities for improving child survival by and beyond 2015. We report child mortality by cause estimates in 2000–13, and cause-specific mortality scenarios to 2030 and 2035. Methods We estimated the distributions of causes of child mortality separately for neonates and children aged 1–59 months. To generate cause-specific mortality fractions, we included new vital registration and verbal autopsy data. We used vital registration data in countries with adequate registration systems. We applied vital registration-based multicause models for countries with low under-5 mortality but inadequate vital registration, and updated verbal autopsy-based multicause models for high mortality countries. We used updated numbers of child deaths to derive numbers of deaths by causes. We applied two scenarios to derive cause-specific mortality in 2030 and 2035. Findings Of the 6·3 million children who died before age 5 years in 2013, 51·8% (3·257 million) died of infectious causes and 44% (2·761 million) died in the neonatal period. The three leading causes are preterm birth complications (0·965 million [15·4%, uncertainty range (UR) 9·8−24·5]; UR 0·615–1·537 million), pneumonia (0·935 million [14·9%, 13·0–16·8]; 0·817–1·057 million), and intrapartum-related complications (0·662 million [10·5%, 6·7–16·8]; 0·421–1·054 million). Reductions in pneumonia, diarrhoea, and measles collectively were responsible for half of the 3·6 million fewer deaths recorded in 2013 versus 2000. Causes with the slowest progress were congenital, preterm, neonatal sepsis, injury, and other causes. If present trends continue, 4·4 million children younger than 5 years will still die in 2030. Furthermore, sub-Saharan Africa will have 33% of the births and 60% of the deaths in 2030, compared with 25% and 50% in 2013, respectively. Interpretation Our projection results provide concrete examples of how the distribution of child causes of deaths could look in 15–20 years to inform priority setting in the post-2015 era. More evidence is needed about shifts in timing, causes, and places of under-5 deaths to inform child survival agendas by and beyond 2015, to end preventable child deaths in a generation, and to count and account for every newborn and every child. Funding Bill & Melinda Gates Foundation.


      PubDate: 2015-02-05T07:00:16Z
       
  • Department of Error
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966




      PubDate: 2015-02-05T07:00:16Z
       
  • Department of Error
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966




      PubDate: 2015-02-05T07:00:16Z
       
  • Exercises to improve function of the rheumatoid hand (SARAH): a randomised
           controlled trial
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Sarah E Lamb , Esther M Williamson , Peter J Heine , Jo Adams , Sukhdeep Dosanjh , Melina Dritsaki , Matthew J Glover , Joanne Lord , Christopher McConkey , Vivien Nichols , Anisur Rahman , Martin Underwood , Mark A Williams
      Background Disease-modifying biological agents and other drug regimens have substantially improved control of disease activity and joint damage in people with rheumatoid arthritis of the hand. However, commensurate changes in function and quality of life are not always noted. Tailored hand exercises might provide additional improvements, but evidence is lacking. We estimated the effectiveness and cost-effectiveness of tailored hand exercises in addition to usual care during 12 months. Methods In this pragmatic, multicentre, parallel-group trial, at 17 National Health Service sites across the UK we randomly assigned 490 adults with rheumatoid arthritis who had pain and dysfunction of the hands and had been on a stable drug regimen for at least 3 months, to either usual care or usual care plus a tailored strengthening and stretching hand exercise programme. Participants were randomly assigned with stratification by centre. Allocation was computer generated and unmasked to participants and therapists delivering treatment after randomisation. Outcome assessors and all investigators were masked to allocation. Physiotherapists or occupational therapists gave the treatments. The primary outcome was the Michigan Hand Outcomes Questionnaire overall hand function score at 12 months. The analysis was by intention to treat. We calculated cost per quality-adjusted life-year. This trial is registered as ISRCTN 89936343. Findings Between Oct 5, 2009, and May 10, 2011, we screened 1606 people, of whom 490 were randomly assigned to usual care (n=244) or tailored exercises (n=246). 438 of 490 participants (89%) provided 12 month follow-up data. Improvements in overall hand function were 3·6 points (95% CI 1·5–5·7) in the usual care group and 7·9 points (6·0–9·9) in the exercise group (mean difference between groups 4·3, 95% CI 1·5–7·1; p=0·0028). Pain, drug regimens, and health-care resource use were stable for 12 months, with no difference between the groups. No serious adverse events associated with the treatment were recorded. The cost of tailored hand exercise was £156 per person; cost per quality-adjusted life-year was £9549 with the EQ-5D (£17 941 with imputation for missing data). Interpretation We have shown that a tailored hand exercise programme is a worthwhile, low-cost intervention to provide as an adjunct to various drug regimens. Maximisation of the benefits of biological and DMARD regimens in terms of function, disability, and health-related quality of life should be an important treatment aim. Funding UK National Institute of Health Research Health Technology Assessment Programme (NIHR HTA), project number 07/32/05.


      PubDate: 2015-02-05T07:00:16Z
       
  • Nitrous oxide in general anaesthesia – Authors' reply
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Paul S Myles , Phillip Peyton , Matthew T V Chan , Kate Leslie



      PubDate: 2015-02-05T07:00:16Z
       
  • Dementia underdiagnosis in Brazil
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Antonio Eduardo Nakamura , Davi Opaleye , Giovanni Tani , Cleusa P Ferri



      PubDate: 2015-02-05T07:00:16Z
       
  • Department of Error
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966




      PubDate: 2015-02-05T07:00:16Z
       
  • Health and the Indian caste system
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Macherla Radhamanohar



      PubDate: 2015-02-05T07:00:16Z
       
  • Health and the Indian caste system
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Himmatrao Saluba Bawaskar , Parag Himmatrao Bawaskar , Pramodini Himmatrao Bawaskar



      PubDate: 2015-02-05T07:00:16Z
       
  • Nitrous oxide in general anaesthesia
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Cyrus Razavi , Sagar Saha



      PubDate: 2015-02-05T07:00:16Z
       
  • Nitrous oxide in general anaesthesia
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Lulong Bo , Jinbao Li



      PubDate: 2015-02-05T07:00:16Z
       
  • Robert Louis Stevenson's The Body Snatcher
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Ruth Richardson



      PubDate: 2015-02-05T07:00:16Z
       
  • Ian George Jacobs
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Geoff Watts



      PubDate: 2015-02-05T07:00:16Z
       
  • Neglecting preventive health threatens child rights in Australia
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Janani Muhunthan , Anne-Marie Eades , Stephen Jan



      PubDate: 2015-02-05T07:00:16Z
       
  • Health and the Indian caste system
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Paul Kowal , Sara Afshar



      PubDate: 2015-02-05T07:00:16Z
       
  • The Lancet Technology: January, 2015
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Naomi Lee



      PubDate: 2015-02-05T07:00:16Z
       
  • Lightning bolts of love and inspiration
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Thomas Wright



      PubDate: 2015-02-05T07:00:16Z
       
  • Rewriting the self Amy JoBurnsCinderland2014Beacon
           Press9780807037034216US$24·95.
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Tania Glyde



      PubDate: 2015-02-05T07:00:16Z
       
  • Matshidiso Moeti: new Director of WHO AFRO
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Dara Mohammadi



      PubDate: 2015-02-05T07:00:16Z
       
  • Surgery: a call for papers
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Naomi Lee , William Summerskill



      PubDate: 2015-02-05T07:00:16Z
       
  • Offline: What makes health an election issue'
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Richard Horton



      PubDate: 2015-02-05T07:00:16Z
       
  • NIH budget shrinks despite Ebola emergency funds
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Susan Jaffe



      PubDate: 2015-02-05T07:00:16Z
       
  • PMNCH gains traction and a new leader
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): John Maurice



      PubDate: 2015-02-05T07:00:16Z
       
  • Towards evidence-based hand exercises in rheumatoid arthritis
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Christina H Opava , Mathilda Björk



      PubDate: 2015-02-05T07:00:16Z
       
  • Causes of child deaths: looking to the future
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Cesar G Victora



      PubDate: 2015-02-05T07:00:16Z
       
  • STEMI care in China: a world opportunity
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Ajay J Kirtane , Gregg W Stone



      PubDate: 2015-02-05T07:00:16Z
       
  • Retraction and republication—ST-segment elevation myocardial
           infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute
           Myocardial Infarction Study): a retrospective analysis of hospital data
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): The Editors of The Lancet



      PubDate: 2015-02-05T07:00:16Z
       
  • Women's, children's, and adolescents' health: who will lead'
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): The Lancet



      PubDate: 2015-02-05T07:00:16Z
       
  • A data toolkit to improve patient care
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): The Lancet



      PubDate: 2015-02-05T07:00:16Z
       
  • Correcting the scientific literature: retraction and republication
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): The Lancet



      PubDate: 2015-02-05T07:00:16Z
       
  • Human wellbeing and security: a whole of planet approach
    • Abstract: Publication date: 31 January–6 February 2015
      Source:The Lancet, Volume 385, Issue 9966
      Author(s): Tikki Pang , Kee Seng Chia , Yap Seng Chong , Eugene Liu , Kishore Mahbubani , John Wong , Khay Guan Yeoh



      PubDate: 2015-02-05T07:00:16Z
       
  • A refractory rash in a seborrheic distribution
    • Abstract: Publication date: Available online 2 February 2015
      Source:The Lancet
      Author(s): Elena Gonzalez , Steven D Billings , Anthony P Fernandez



      PubDate: 2015-02-05T07:00:16Z
       
  • Department of Error
    • Abstract: Publication date: Available online 2 February 2015
      Source:The Lancet




      PubDate: 2015-02-05T07:00:16Z
       
  • Rising wealth, improving health' Adolescents and inequality
    • Abstract: Publication date: Available online 4 February 2015
      Source:The Lancet
      Author(s): John S Santelli , Wendy Baldwin , Jennifer Heitel



      PubDate: 2015-02-05T07:00:16Z
       
  • PHOTON-2: hope for patients with HIV and HCV co-infection'
    • Abstract: Publication date: Available online 4 February 2015
      Source:The Lancet
      Author(s): Susanna Naggie , Arthur Y Kim



      PubDate: 2015-02-05T07:00:16Z
       
  • Sofosbuvir plus ribavirin for treatment of hepatitis C virus in patients
           co-infected with HIV (PHOTON-2): a multicentre, open-label,
           non-randomised, phase 3 study
    • Abstract: Publication date: Available online 4 February 2015
      Source:The Lancet
      Author(s): Jean-Michel Molina , Chloe Orkin , David M Iser , Francisco-Xavier Zamora , Mark Nelson , Christoph Stephan , Benedetta Massetto , Anuj Gaggar , Liyun Ni , Evguenia Svarovskaia , Diana Brainard , G Mani Subramanian , John G McHutchison , Massimo Puoti , Jürgen K Rockstroh
      Background Although interferon-free regimens are approved for patients co-infected with HIV and genotype-2 or genotype-3 hepatitis C virus (HCV), interferon-based regimens are still an option for those co-infected with HIV and HCV genotypes 1 or 4. These regimens are limited by clinically significant toxic effects and drug interactions with antiretroviral therapy. We aimed to assess the efficacy and safety of an interferon-free, all-oral regimen of sofosbuvir plus ribavirin in patients with HIV and HCV co-infection. Methods We did this open-label, non-randomised, uncontrolled, phase 3 study at 45 sites in seven European countries and Australia. We enrolled patients (aged ≥18 years) co-infected with stable HIV and chronic HCV genotypes 1–4, including those with compensated cirrhosis. Once-daily sofosbuvir (400 mg) plus twice-daily ribavirin (1000 mg in patients with bodyweights <75 kg and 1200 mg in those with weights ≥75 kg) was given for 24 weeks to all patients except treatment-naive patients with genotype-2 HCV, who received a 12-week regimen. The primary efficacy endpoint was sustained virological response 12 weeks after treatment. We did analysis by modified intention to treat. This study is registered with ClinicalTrials.gov, number NCT01783678. Findings Between Feb 7, 2013, and July 29, 2013, we enrolled 275 eligible patients, of whom 262 (95%) completed treatment; 274 patients were included in the final analysis. Overall rates of sustained virological response 12 weeks after treatment were 85% (95% CI 77–91) in patients with genotype-1 HCV, 88% (69–98) in patients with genotype-2 HCV, 89% (81–94) in patients with genotype-3 HCV, and 84% (66–95) in patients with genotype-4 HCV. Response rates in treatment-naive patients with HCV genotypes 2 or 3 (89% [95% CI 67–99] and 91% [81–97], respectively) were similar to those in treatment-experienced patients infected with those genotypes (83% [36–100] and 86% [73–94], respectively). There was no emergence of sofosbuvir-resistance mutations in patients with HCV viral relapse. Six (2%) patients discontinued treatment because of adverse events. The most common adverse events were fatigue, insomnia, asthenia, and headache. Four (1%) patients had serious adverse events regarded as related to study treatment. Additionally, four (1%) patients receiving antiretroviral treatment had a transient HIV viral breakthrough; however, none required changes in antiretroviral regimen. Interpretation Sofosbuvir and ribavirin provided high rates of sustained virological response after 12 weeks of treatment in treatment-naive and treatment-experienced patients co-infected with HIV and HCV genotypes 1–4. The characteristics of this interferon-free combination regimen make sofosbuvir plus ribavirin a useful treatment option for this patient population. Funding Gilead Sciences.


      PubDate: 2015-02-05T07:00:16Z
       
  • Socioeconomic inequalities in adolescent health 2002–2010: a
           time-series analysis of 34 countries participating in the Health Behaviour
           in School-aged Children study
    • Abstract: Publication date: Available online 4 February 2015
      Source:The Lancet
      Author(s): Frank J Elgar , Timo-Kolja Pförtner , Irene Moor , Bart De Clercq , Gonneke W J M Stevens , Candace Currie
      Background Information about trends in adolescent health inequalities is scarce, especially at an international level. We examined secular trends in socioeconomic inequality in five domains of adolescent health and the association of socioeconomic inequality with national wealth and income inequality. Methods We undertook a time-series analysis of data from the Health Behaviour in School-aged Children study, in which cross-sectional surveys were done in 34 North American and European countries in 2002, 2006, and 2010 (pooled n 492 788). We used individual data for socioeconomic status (Health Behaviour in School-aged Children Family Affluence Scale) and health (days of physical activity per week, body-mass index Z score [zBMI], frequency of psychological and physical symptoms on 0–5 scale, and life satisfaction scored 0–10 on the Cantril ladder) to examine trends in health and socioeconomic inequalities in health. We also investigated whether international differences in health and health inequalities were associated with per person income and income inequality. Findings From 2002 to 2010, average levels of physical activity (3·90 to 4·08 days per week; p<0·0001), body mass (zBMI −0·08 to 0·03; p<0·0001), and physical symptoms (3·06 to 3·20, p<0·0001), and life satisfaction (7·58 to 7·61; p=0·0034) slightly increased. Inequalities between socioeconomic groups increased in physical activity (−0·79 to −0·83 days per week difference between most and least affluent groups; p=0·0008), zBMI (0·15 to 0·18; p<0·0001), and psychological (0·58 to 0·67; p=0·0360) and physical (0·21 to 0·26; p=0·0018) symptoms. Only in life satisfaction did health inequality fall during this period (−0·98 to −0·95; p=0·0198). Internationally, the higher the per person income, the better and more equal health was in terms of physical activity (0·06 days per SD increase in income; p<0·0001), psychological symptoms (−0·09; p<0·0001), and life satisfaction (0·08; p<0·0001). However, higher income inequality uniquely related to fewer days of physical activity (−0·05 days; p=0·0295), higher zBMI (0·06; p<0·0001), more psychological (0·18; p<0·0001) and physical (0·16; p<0·0001) symptoms, and larger health inequalities between socioeconomic groups in psychological (0·13; p=0·0080) and physical (0·07; p=0·0022) symptoms, and life satisfaction (−0·10; p=0·0092). Interpretation Socioeconomic inequality has increased in many domains of adolescent health. These trends coincide with unequal distribution of income between rich and poor people. Widening gaps in adolescent health could predict future inequalities in adult health and need urgent policy action. Funding Canadian Institutes of Health Research.


      PubDate: 2015-02-05T07:00:16Z
       
  • Political factors behind US global AIDS programmes slow-down
    • Abstract: Publication date: Available online 21 January 2015
      Source:The Lancet
      Author(s): Matthew M Kavanagh , Jamila Headley , Asia Russell



      PubDate: 2015-01-26T06:54:39Z
       
  • Blood as medicine: social meanings of blood and the success of Ebola
           trials
    • Abstract: Publication date: Available online 19 January 2015
      Source:The Lancet
      Author(s): Melanie Bannister-Tyrrell , Charlotte Gryseels , Alexandre Delamou , Umberto D'Alessandro , Johan van Griensven , Koen Peeters Grietens



      PubDate: 2015-01-21T06:52:10Z
       
 
 
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