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The Lancet
Journal Prestige (SJR): 14.934
Citation Impact (citeScore): 9
Number of Followers: 2420  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0140-6736 - ISSN (Online) 1474-547X
Published by Elsevier Homepage  [3161 journals]
  • Cochrane review methods called into question
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Talha Burki
       
  • Melanoma
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Dirk Schadendorf, Alexander C J van Akkooi, Carola Berking, Klaus G Griewank, Ralf Gutzmer, Axel Hauschild, Andreas Stang, Alexander Roesch, Selma UgurelSummaryCutaneous melanoma causes 55 500 deaths annually. The incidence and mortality rates of the disease differ widely across the globe depending on access to early detection and primary care. Once melanoma has spread, this type of cancer rapidly becomes life-threatening. For more than 40 years, few treatment options were available, and clinical trials during that time were all unsuccessful. Over the past 10 years, increased biological understanding and access to innovative therapeutic substances have transformed advanced melanoma into a new oncological model for treating solid cancers. Treatments that target B-Raf proto-oncogene serine/threonine-kinase (BRAF)V600 (Val600) mutations using selected BRAF inhibitors combined with mitogen-activated protein kinase inhibitors have significantly improved response and overall survival. Furthermore, advanced cutaneous melanoma has developed into a prototype for testing checkpoint-modulating agents, which has increased hope for long-term tumour containment and a potential cure. These expectations have been sustained by clinical success with targeted agents and antibodies that block programmed cell-death protein 1 in locoregional disease, which induces prolongation of relapse-free, distant-metastasis-free, and overall survival times.
       
  • What must be the role of INSERM in French biomedical research'
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Gilles Mercier
       
  • Health of Hungarians: worsens or improves'
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Zoltán Rihmer
       
  • Coeliac disease and dermatitis herpetiformis – Authors' reply
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Benjamin Lebwohl, David S Sanders, Peter HR Green
       
  • Coeliac disease and dermatitis herpetiformis
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Giacomo Caio, Roberto De Giorgio, Umberto Volta
       
  • Coeliac disease and dermatitis herpetiformis
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): François Rodrigues, Claude Bachmeyer
       
  • The future of end-of-life care
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Anna E Bone, Catherine J Evans, Irene J Higginson
       
  • Datafication of medical device use for training and device design
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): George Shorten
       
  • It is time for universal HPV vaccination
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Gilliam Prue, Peter Baker, Donna Graham, Chris Nutting, Peter Greenhouse, Mark Lawler
       
  • Longevity in elite athletes: the first 4-min milers
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Barry J Maron, Paul D Thompson
       
  • Rwanda: not the official narrative
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Laurie Garrett
       
  • Prostate cancer
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Richard Barnett
       
  • Louise Kenny: pioneer in maternal and perinatal health
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Rachael Davies
       
  • Aortic calcification in longstanding, undiagnosed Takayasu arteritis
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Mahesh Janarthanan, Jebaraj Rathinasamy
       
  • Crisis in the Chad Basin
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Sharmila Devi
       
  • Funds cut for aid in the occupied Palestinian territory
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Sharmila Devi
       
  • When no guideline recommendation is the best recommendation
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): Michael Bretthauer, Mette Kalager
       
  • Patient letters: improving an outdated system
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): The Lancet
       
  • Mismanaged expectations—maternal morbidity in the USA
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): The Lancet
       
  • Health in the European region: time to act on the evidence
    • Abstract: Publication date: 15–21 September 2018Source: The Lancet, Volume 392, Issue 10151Author(s): The Lancet
       
  • Support for UNRWA's survival
    • Abstract: Publication date: Available online 12 September 2018Source: The LancetAuthor(s): Karl Blanchet, Abbas El-Zein, Ana Langer, Miho Sato, Sawsan Abdulrahim, Kim Abouchacra, Rima Afifi, Vittorio Agnoletto, Hidechika Akashi, Mohamad Alameddine, Éimhín Ansbro, Vera Araújo-Soares, Nassim Assefi, Matt Baillie Smith, Marco Bardus, Jacqueline Bhabha, Espen Bjertness, Karl Blanchet, Josephine Borghi, Joanna Busza
       
  • Offline: The new politics of health in India
    • Abstract: Publication date: Available online 12 September 2018Source: The LancetAuthor(s): Richard Horton
       
  • Informing NCD control efforts in India on the eve of Ayushman Bharat
    • Abstract: Publication date: Available online 12 September 2018Source: The LancetAuthor(s): Balram Bhargava, Vinod K Paul
       
  • No need to change dairy food dietary guidelines yet
    • Abstract: Publication date: Available online 11 September 2018Source: The LancetAuthor(s): Jimmy Chun Yu Louie, Anna M Rangan
       
  • Association of dairy intake with cardiovascular disease and mortality in
           21 countries from five continents (PURE): a prospective cohort study
    • Abstract: Publication date: Available online 11 September 2018Source: The LancetAuthor(s): Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Patrick Sheridan, Viswanathan Mohan, Romaina Iqbal, Rajeev Gupta, Scott Lear, Edelweiss Wentzel-Viljoen, Alvaro Avezum, Patricio Lopez-Jaramillo, Prem Mony, Ravi Prasad Varma, Rajesh Kumar, Jephat Chifamba, Khalid F Alhabib, Noushin Mohammadifard, Aytekin Oguz, Fernando Lanas, Dorota RozanskaSummaryBackgroundDietary guidelines recommend minimising consumption of whole-fat dairy products, as they are a source of saturated fats and presumed to adversely affect blood lipids and increase cardiovascular disease and mortality. Evidence for this contention is sparse and few data for the effects of dairy consumption on health are available from low-income and middle-income countries. Therefore, we aimed to assess the associations between total dairy and specific types of dairy products with mortality and major cardiovascular disease.MethodsThe Prospective Urban Rural Epidemiology (PURE) study is a large multinational cohort study of individuals aged 35–70 years enrolled from 21 countries in five continents. Dietary intakes of dairy products for 136 384 individuals were recorded using country-specific validated food frequency questionnaires. Dairy products comprised milk, yoghurt, and cheese. We further grouped these foods into whole-fat and low-fat dairy. The primary outcome was the composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure). Hazard ratios (HRs) were calculated using multivariable Cox frailty models with random intercepts to account for clustering of participants by centre.FindingsBetween Jan 1, 2003, and July 14, 2018, we recorded 10 567 composite events (deaths [n=6796] or major cardiovascular events [n=5855]) during the 9·1 years of follow-up. Higher intake of total dairy (>2 servings per day compared with no intake) was associated with a lower risk of the composite outcome (HR 0·84, 95% CI 0·75–0·94; ptrend=0·0004), total mortality (0·83, 0·72–0·96; ptrend=0·0052), non-cardiovascular mortality (0·86, 0·72–1·02; ptrend=0·046), cardiovascular mortality (0·77, 0·58–1·01; ptrend=0·029), major cardiovascular disease (0·78, 0·67–0·90; ptrend=0·0001), and stroke (0·66, 0·53–0·82; ptrend=0·0003). No significant association with myocardial infarction was observed (HR 0·89, 95% CI 0·71–1·11; ptrend=0·163). Higher intake (>1 serving vs no intake) of milk (HR 0·90, 95% CI 0·82–0·99; ptrend=0·0529) and yogurt (0·86, 0·75–0·99; ptrend=0·0051) was associated with lower risk of the composite outcome, whereas cheese intake was not significantly associated with the composite outcome (0·88, 0·76–1·02; ptrend=0·1399). Butter intake was low and was not significantly associated with clinical outcomes (HR 1·09, 95% CI 0·90–1·33; ptrend=0·4113).InterpretationDairy consumption was associated with lower risk of mortality and major cardiovascular disease events in a diverse multinational cohort.FundingFull funding sources are listed at the end of the paper (see Acknowledgments).
       
  • Understanding heartbreak: from Takotsubo to Wuthering Heights
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Lakshmi Krishnan, Daniel Marchalik
       
  • Advances in bronchiectasis: endotyping, genetics, microbiome, and disease
           heterogeneity
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Patrick A Flume, James D Chalmers, Kenneth N OlivierSummaryBronchiectasis is characterised by pathological dilation of the airways. More specifically, the radiographic demonstration of airway enlargement is the common feature of a heterogeneous set of conditions and clinical presentations. No approved therapies exist for the condition other than for bronchiectasis caused by cystic fibrosis. The heterogeneity of bronchiectasis is a major challenge in clinical practice and the main reason for difficulty in achieving endpoints in clinical trials. Recent observations of the past 2 years have improved the understanding of physicians regarding bronchiectasis, and have indicated that it might be more effective to classify patients in a different way. Patients could be categorised according to a heterogeneous group of endotypes (defined by a distinct functional or pathobiological mechanism) or by clinical phenotypes (defined by relevant and common features of the disease). In doing so, more specific therapies needed to effectively treat patients might finally be developed. Here, we describe some of the recent advances in endotyping, genetics, and disease heterogeneity of bronchiectasis including observations related to the microbiome.
       
  • Department of Error
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s):
       
  • Department of Error
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s):
       
  • Department of Error
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s):
       
  • Fixed-dose combinations for hypertension
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Sandeep P Kishore, Abdul Salam, Anthony Rodgers, Marc G Jaffe, Tom Frieden
       
  • Interpretation of results of pooled analysis of individual patient data
           – Authors' reply
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Stuart J Head, Grigorios Papageorgiou, Milan Milojevic, Gregg W Stone, A Pieter Kappetein
       
  • Interpretation of results of pooled analysis of individual patient data
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Peter Jüni, Stephan Windecker, Franz-Josef Neumann
       
  • Interpretation of results of pooled analysis of individual patient data
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Nick Freemantle, Domenico Pagano
       
  • Denis Anthony Mitchison
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Geoff Watts
       
  • Shapeshifters: On Medicine & Human Change, Gavin Francis. Profile Books in
           association with Wellcome Collection (2018), 304, £16·99., ISBN:
           9781781257739
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Fiona Mitchell
       
  • Rhinocerebral aspergillosis
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Manjul Tripathi, Sandeep Mohindra
       
  • Anne Chang: a champion of childhood lung health
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Rachael Davies
       
  • Greece's health after the “day of liberation”
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Sharmila Devi
       
  • India advises against electronic nicotine delivery systems
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Sophie Cousins
       
  • Criminalisation of health care in Nicaragua's political crisis
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): David Agren
       
  • Offline: Why has global health forgotten cancer'
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Richard Horton
       
  • Better and safer treatment for multidrug-resistant tuberculosis
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Paul E Farmer
       
  • Reducing harm in the treatment of multidrug-resistant tuberculosis
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Anja Reuter, Jennifer Furin
       
  • Slow burn: tobacco control in the Americas
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): The Lancet
       
  • Are we ready for universal genomic sequencing for newborns'
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): The Lancet
       
  • Bronchiectasis in children: diagnosis and treatment
    • Abstract: Publication date: 8–14 September 2018Source: The Lancet, Volume 392, Issue 10150Author(s): Anne B Chang, Andrew Bush, Keith GrimwoodSummaryBronchiectasis is conventionally defined as irreversible dilatation of the bronchial tree. Bronchiectasis unrelated to cystic fibrosis is an increasingly appreciated cause of chronic respiratory-related morbidity worldwide. Few randomised controlled trials provide high-level evidence for management strategies to treat the children affected by bronchiectasis. However, both decades-old and more recent studies using technological advances support the notion that prompt diagnosis and optimal management of paediatric bronchiectasis is particularly important in early childhood. Although considered to be of a non-reversible nature, mild bronchiectasis determined by radiography might be reversible at any age if treated early, and the lung function decline associated with disease progression could then be halted. Although some management strategies are extrapolated from cystic fibrosis or adult-based studies, or both, non-cystic fibrosis paediatric-specific data to help diagnose and manage these children still need to be generated. We present current knowledge and an updated definition of bronchiectasis, and review controversies relating to the management of children with bronchiectasis, including applying the concept of so-called treatable traits.
       
  • Addressing the fragmentation of global health: the Lancet Commission on
           synergies between universal health coverage, health security, and health
           promotion
    • Abstract: Publication date: Available online 7 September 2018Source: The LancetAuthor(s): Gorik Ooms, Trygve Ottersen, Albrecht Jahn, Irene Akua Agyepong
       
  • Strengthening oral health for universal health coverage
    • Abstract: Publication date: Available online 25 July 2018Source: The LancetAuthor(s): Julian Fisher, Harry-Sam Selikowitz, Manu Mathur, Benoit Varenne
       
  • Viroj Tangcharoensathien: master carpenter of Thai health care
    • Abstract: Publication date: Available online 1 February 2018Source: The LancetAuthor(s): Geoff Watts
       
  • Single dose moxidectin versus ivermectin for Onchocerca volvulus infection
           in Ghana, Liberia, and the Democratic Republic of the Congo: a randomised,
           controlled, double-blind phase 3 trial
    • Abstract: Publication date: Available online 18 January 2018Source: The LancetAuthor(s): Nicholas O Opoku, Didier K Bakajika, Eric M Kanza, Hayford Howard, Germain L Mambandu, Amos Nyathirombo, Maurice M Nigo, Kambale Kasonia, Safari L Masembe, Mupenzi Mumbere, Kambale Kataliko, Jemmah P Larbelee, Mawolo Kpawor, Kpehe M Bolay, Fatorma Bolay, Simon K Attah, Michel Vaillant, Christine M Halleux, Annette C KueselSummaryBackgroundThe morbidity and socioeconomic effects of onchocerciasis, a parasitic disease that is primarily endemic in sub-Saharan Africa, have motivated large morbidity and transmission control programmes. Annual community-directed ivermectin treatment has substantially reduced prevalence. Elimination requires intensified efforts, including more efficacious treatments. We compared parasitological efficacy and safety of moxidectin and ivermectin.MethodsThis double-blind, parallel group, superiority trial was done in four sites in Ghana, Liberia, and the Democratic Republic of the Congo. We enrolled participants (aged ≥12 years) with at least 10 Onchocerca volvulus microfilariae per mg skin who were not co-infected with Loa loa or lymphatic filariasis microfilaraemic. Participants were randomly allocated, stratified by sex and level of infection, to receive a single oral dose of 8 mg moxidectin or 150 μg/kg ivermectin as overencapsulated oral tablets. The primary efficacy outcome was skin microfilariae density 12 months post treatment. We used a mixed-effects model to test the hypothesis that the primary efficacy outcome in the moxidectin group was 50% or less than that in the ivermectin group. The primary efficacy analysis population were all participants who received the study drug and completed 12-month follow-up (modified intention to treat). This study is registered with ClinicalTrials.gov, number NCT00790998.FindingsBetween April 22, 2009, and Jan 23, 2011, we enrolled and allocated 998 participants to moxidectin and 501 participants to ivermectin. 978 received moxidectin and 494 ivermectin, of which 947 and 480 were included in primary efficacy outcome analyses. At 12 months, skin microfilarial density (microfilariae per mg of skin) was lower in the moxidectin group (adjusted geometric mean 0·6 [95% CI 0·3–1·0]) than in the ivermectin group (4·5 [3·5–5·9]; difference 3·9 [3·2–4·9], p
       
  • A new powerful drug to combat river blindness
    • Abstract: Publication date: Available online 18 January 2018Source: The LancetAuthor(s): Michel Boussinesq
       
  • Political and technical barriers to improving quality of health care
    • Abstract: Publication date: Available online 5 September 2018Source: The LancetAuthor(s): Mishal S Khan, Farah N Hashmani
       
  • Putting quality and people at the centre of health systems
    • Abstract: Publication date: Available online 5 September 2018Source: The LancetAuthor(s): The Lancet
       
  • How far will the FIREHAWK stent fly'
    • Abstract: Publication date: Available online 3 September 2018Source: The LancetAuthor(s): Stefan James
       
  • Repositioning Africa in global knowledge production
    • Abstract: Publication date: Available online 30 August 2018Source: The LancetAuthor(s): Sharon Fonn, Laban Peter Ayiro, Philip Cotton, Adam Habib, Peter Mulwa Felix Mbithi, Alfred Mtenje, Barnabas Nawangwe, Eyitope O Ogunbodede, Idowu Olayinka, Frederick Golooba-Mutebi, Alex Ezeh
       
  • Childhood mortality during conflicts in Africa
    • Abstract: Publication date: Available online 30 August 2018Source: The LancetAuthor(s): Emelda A Okiro, Philip Ayieko
       
  • Risk factor policies, morbidity, and mortality in Russia
    • Abstract: Publication date: Available online 30 August 2018Source: The LancetAuthor(s): Jürgen Rehm, Carina Ferreira-Borges
       
  • Diagnosing myocardial infarction: a highly sensitive issue
    • Abstract: Publication date: Available online 28 August 2018Source: The LancetAuthor(s): Stefan Blankenberg, Johannes Tobias Neumann, Dirk Westermann
       
  • Imaging of coronary inflammation for cardiovascular risk prediction
    • Abstract: Publication date: Available online 28 August 2018Source: The LancetAuthor(s): Amir A Mahabadi, Tienush Rassaf
       
  • BASKET-SMALL 2: advancing DCB beyond in-stent restenosis
    • Abstract: Publication date: Available online 28 August 2018Source: The LancetAuthor(s): Hee Hwa Ho, Paul Jau Lueng Ong
       
  • Aspirin—still the GLOBAL LEADER in antiplatelet therapy
    • Abstract: Publication date: Available online 27 August 2018Source: The LancetAuthor(s): Deepak L Bhatt
       
  • Aspirin for primary prevention of cardiovascular disease
    • Abstract: Publication date: Available online 26 August 2018Source: The LancetAuthor(s): Davide Capodanno, Dominick J Angiolillo
       
  • Revisiting ASCOT 16 years later
    • Abstract: Publication date: Available online 26 August 2018Source: The LancetAuthor(s): Suzanne Oparil, Richard H Fu
       
  • Long-term mortality after blood pressure-lowering and lipid-lowering
           treatment in patients with hypertension in the Anglo-Scandinavian Cardiac
           Outcomes Trial (ASCOT) Legacy study: 16-year follow-up results of a
           randomised factorial trial
    • Abstract: Publication date: Available online 26 August 2018Source: The LancetAuthor(s): Ajay Gupta, Judith Mackay, Andrew Whitehouse, Thomas Godec, Tim Collier, Stuart Pocock, Neil Poulter, Peter SeverSummaryBackgroundIn patients with hypertension, the long-term cardiovascular and all-cause mortality effects of different blood pressure-lowering regimens and lipid-lowering treatment are not well documented, particularly in clinical trial settings. The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study reports mortality outcomes after 16 years of follow-up of the UK participants in the original ASCOT trial.MethodsASCOT was a multicentre randomised trial with a 2 × 2 factorial design. UK-based patients with hypertension were followed up for all-cause and cardiovascular mortality for a median of 15·7 years (IQR 9·7–16·4 years). At baseline, all patients enrolled into the blood pressure-lowering arm (BPLA) of ASCOT were randomly assigned to receive either amlodipine-based or atenolol-based blood pressure-lowering treatment. Of these patients, those who had total cholesterol of 6·5 mmol/L or lower and no previous lipid-lowering treatment underwent further randomisation to receive either atorvastatin or placebo as part of the lipid-lowering arm (LLA) of ASCOT. The remaining patients formed the non-LLA group. A team of two physicians independently adjudicated all causes of death.FindingsOf 8580 UK-based patients in ASCOT, 3282 (38·3%) died, including 1640 (38·4%) of 4275 assigned to atenolol-based treatment and 1642 (38·1%) of 4305 assigned to amlodipine-based treatment. 1768 of the 4605 patients in the LLA died, including 903 (39·5%) of 2288 assigned placebo and 865 (37·3%) of 2317 assigned atorvastatin. Of all deaths, 1210 (36·9%) were from cardiovascular-related causes. Among patients in the BPLA, there was no overall difference in all-cause mortality between treatments (adjusted hazard ratio [HR] 0·90, 95% CI 0·81–1·01, p=0·0776]), although significantly fewer deaths from stroke (adjusted HR 0·71, 0·53–0·97, p=0·0305) occurred in the amlodipine-based treatment group than in the atenolol-based treatment group. There was no interaction between treatment allocation in the BPLA and in the LLA. However, in the 3975 patients in the non-LLA group, there were fewer cardiovascular deaths (adjusted HR 0·79, 0·67–0·93, p=0·0046) among those assigned to amlodipine-based treatment compared with atenolol-based treatment (p=0·022 for the test for interaction between the two blood pressure treatments and allocation to LLA or not). In the LLA, significantly fewer cardiovascular deaths (HR 0·85, 0·72–0·99, p=0·0395) occurred among patients assigned to statin than among those assigned placebo.InterpretationOur findings show the long-term beneficial effects on mortality of antihypertensive treatment with a calcium channel blocker-based treatment regimen and lipid-lowering with a statin: patients on amlodipine-based treatment had fewer stroke deaths and patients on atorvastatin had fewer cardiovascular deaths more than 10 years after trial closure. Overall, the ASCOT Legacy study supports the notion that interventions for blood pressure and cholesterol are associated with long-term benefits on cardiovascular outcomes.FundingPfizer.
       
  • Telehealth: delivering high-quality care for heart failure
    • Abstract: Publication date: Available online 25 August 2018Source: The LancetAuthor(s): John F G Cleland, Robin A Clark
       
  • Vascular access and antithrombotic therapy in patients with acute coronary
           syndrome
    • Abstract: Publication date: Available online 25 August 2018Source: The LancetAuthor(s): Dominick J Angiolillo
       
  • No level of alcohol consumption improves health
    • Abstract: Publication date: Available online 23 August 2018Source: The LancetAuthor(s): Robyn Burton, Nick Sheron
       
  • Updated Zika virus recommendations are needed
    • Abstract: Publication date: Available online 23 August 2018Source: The LancetAuthor(s): Manon Vouga, Didier Musso, Abraham Goorhuis, David O Freedman, David Baud
       
  • Economic sanction: a weapon of mass destruction
    • Abstract: Publication date: Available online 20 August 2018Source: The LancetAuthor(s): Farrokh Habibzadeh
       
  • Saudi visa trainees called home from Canada in diplomatic dispute
    • Abstract: Publication date: Available online 20 August 2018Source: The LancetAuthor(s): Maria Mathews, Ivy Bourgeault
       
  • Department of Error
    • Abstract: Publication date: Available online 17 August 2018Source: The LancetAuthor(s):
       
  • Leishmaniasis
    • Abstract: Publication date: Available online 17 August 2018Source: The LancetAuthor(s): Sakib Burza, Simon L Croft, Marleen BoelaertSummaryLeishmaniasis is a poverty-related disease with two main clinical forms: visceral leishmaniasis and cutaneous leishmaniasis. An estimated 0·7–1 million new cases of leishmaniasis per year are reported from nearly 100 endemic countries. The number of reported visceral leishmaniasis cases has decreased substantially in the past decade as a result of better access to diagnosis and treatment and more intense vector control within an elimination initiative in Asia, although natural cycles in transmission intensity might play a role. In east Africa however, the case numbers of this fatal disease continue to be sustained. Increased conflict in endemic areas of cutaneous leishmaniasis and forced displacement has resulted in a surge in these endemic areas as well as clinics across the world. WHO lists leishmaniasis as one of the neglected tropical diseases for which the development of new treatments is a priority. Major evidence gaps remain, and new tools are needed before leishmaniasis can be definitively controlled.
       
 
 
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