Medicine

[Obituary] Robert Day

Lancet - 14 April 2018 - 12:00am
Public health expert who directed the US Fred Hutchinson Cancer Research Center. Born in Framingham, MA, USA, on Oct 22, 1930, he died from lung cancer on Jan 6, 2018, in Seattle, WA, USA, aged 87 years.
Categories: Medicine

[Correspondence] Protecting health care in armed conflict: action towards accountability

Lancet - 14 April 2018 - 12:00am
Driven by a deplorable trend of unlawful attacks on health-care facilities and workers in armed conflicts throughout the world, on May 3, 2016, the UN Security Council (UNSC) adopted Resolution 2286 calling for an end to such attacks.1 The Secretary-General followed with recommendations of concrete measures for implementation.2 However, unlawful attacks on health care have continued or intensified in many conflicts, notably in Syria. We, academic institutions, civil society, and co-sponsoring Member States, convened a side event during the 72nd UN General Assembly to focus global attention on this issue and the imperative that Resolution 2286 be implemented.
Categories: Medicine

[Correspondence] Post-trial responsibilities beyond post-trial access

Lancet - 14 April 2018 - 12:00am
What happens at the end of a trial when a patient responds to an investigational medication and benefits considerably? Many people believe that this patient should continue to receive the beneficial drug. This belief underlies the idea of post-trial access—providing investigational interventions post-trial to participants who benefited from them—and was formally introduced by the Declaration of Helsinki in 2000. But even if this patient did not benefit from the investigational medication, doing nothing for them at the end of the trial seems ethically problematic.
Categories: Medicine

[Correspondence] mHealth and the legacy of John Snow

Lancet - 14 April 2018 - 12:00am
On Jan 14, 2018, during a tense final touchdown in a US National Football League playoff game, numerous Apple Watch users received an alert from their device telling them that they were having potentially harmful arrhythmias.1 Smartphones and wearable technology are increasingly used as public health tools because billions of people worldwide are digital users. In 2020, more than 6 billion people will have smartphone subscriptions.2 Clinicians and researchers can use these devices to effortlessly monitor patients' health and behaviour indicators in real time.
Categories: Medicine

[Correspondence] Beware the medicalisation of loneliness

Lancet - 14 April 2018 - 12:00am
Loneliness was recently described in The Lancet as a public health problem that needs to be solved by the medical community (Feb 3, p 426).1 We believe that the medicalisation of loneliness in this way is damaging, especially at a time when the issue is making its way into public understanding.
Categories: Medicine

[Correspondence] Mapping and understanding exclusion

Lancet - 14 April 2018 - 12:00am
On behalf of Mental Health Europe I would like to respond to the Lancet's Editorial (Jan 27, p 282)1 written about our Mapping and Understanding Exclusion report.2 Although we welcome the coverage of our report, we were disappointed to see a reference to the need to uphold the status quo on coercive measures, which might lead to confusion regarding the conclusions of our report. The Lancet's Editorial stated that: “Involuntary treatment and detention are a necessary part of mental health care”.1 This statement is contrary to the core message in our report, which recommended that to reduce coercion in mental health services European states should adopt policies and practices that aim to immediately reduce coercion in mental health services and ultimately make such practices by exception only, in line with human rights standards.
Categories: Medicine

[Correspondence] Compulsory admissions in Greece: multifaceted action is required

Lancet - 14 April 2018 - 12:00am
It was with great concern that we read the Editorial in The Lancet (Jan 27, p 282)1 regarding institutional and coercive mental health treatment in Europe, in which Greece was among the countries with substantial shortfalls in mental health services and violations of patients' human rights.
Categories: Medicine

[Correspondence] Clinical disease activity in the CALM study

Lancet - 14 April 2018 - 12:00am
Jean-Frederic Colombel and colleagues' CALM study (Dec 23, 2017, p 2779),1 which investigated the effect of tight control management on Crohn's disease, reported significantly better outcomes with tight control than with clinical medical management. Tight control consisted of prespecified therapy escalation if a patient's Crohn's disease activity index (CDAI) was at least 150, or if they had elevated C-reactive protein or calprotectin, and resulted in significantly better mucosal healing (and clinical remission) than did therapy escalation based on clinical symptoms alone.
Categories: Medicine

[Correspondence] Clinical disease activity in the CALM study – Authors' reply

Lancet - 14 April 2018 - 12:00am
The Correspondence from Hans Herfarth and colleagues raised clinically relevant questions about our study1 of patients with Crohn's disease, whose treatment was adjusted based on stringent criteria for clinical symptoms and biomarkers (tight control) or less stringent clinical criteria alone.
Categories: Medicine

[Articles] Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

Lancet - 14 April 2018 - 12:00am
In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines.
Categories: Medicine

[Comment] Insecticide-resistant malaria vectors must be tackled

Lancet - 12 April 2018 - 12:30am
Vector control with long-lasting insecticidal nets and indoor residual spraying accounts for most of the 1·3 billion fewer malaria cases and 6·8 million fewer malaria-related deaths attributable to declining transmission between 2000 and 2015.1–3 However, because resistance to pyrethroid insecticides has spread through African malaria vector populations, concerns over maintaining these gains have been widely voiced—but these are frequently disputed.4 The findings presented by Natacha Protopopoff and colleagues5 in The Lancet provide rigorous, long overdue, new evidence for those working in the field of malaria vector control.
Categories: Medicine

[Articles] Effectiveness of a long-lasting piperonyl butoxide-treated insecticidal net and indoor residual spray interventions, separately and together, against malaria transmitted by pyrethroid-resistant mosquitoes: a cluster, randomised controlled,...

Lancet - 12 April 2018 - 12:30am
The PBO long-lasting insecticidal net and non-pyrethroid indoor residual spraying interventions showed improved control of malaria transmission compared with standard long-lasting insecticidal nets where pyrethroid resistance is prevalent and either intervention could be deployed to good effect. As a result, WHO has since recommended to increase coverage of PBO long-lasting insecticidal nets. Combining indoor residual spraying with pirimiphos-methyl and PBO long-lasting insecticidal nets provided no additional benefit compared with PBO long-lasting insecticidal nets alone or standard long-lasting insecticidal nets plus indoor residual spraying.
Categories: Medicine

[Department of Error] Department of Error

Lancet - 11 April 2018 - 12:30am
Das P, Horton R. Pollution, health, and the planet: time for decisive action. Lancet 2018; 391: 407–08—In the acknowledgments section of this Comment (published online first on Oct 19, 2017), the Governments of Germany, Norway, and Sweden should have been thanked for their “funding of the report, input, or both”. This correction has been made to the online version as of April 10, 2018.
Categories: Medicine

[Comment] Public Health Science Conference: a call for abstracts

Lancet - 10 April 2018 - 12:30am
We are delighted to invite abstract submissions for Public Health Science: A National Conference Dedicated to New Research in UK Public Health, to be held in Belfast, UK, on Nov 23, 2018. This is our seventh annual conference to showcase the creativity of the public health research community in the UK and Ireland. The conference provides a forum for academics, practitioners, and policy makers to discuss important public health issues, and learn about the latest public health science and its role in advancing and supporting public health practice, policy, and health services.
Categories: Medicine

Corrigendum: Suppression of luteinizing hormone enhances HSC recovery after hematopoietic injury

Nature Medicine - 10 April 2018 - 12:00am

Corrigendum: Suppression of luteinizing hormone enhances HSC recovery after hematopoietic injury

Corrigendum: Suppression of luteinizing hormone enhances HSC recovery after hematopoietic injury, Published online: 10 April 2018; doi:10.1038/nm0418-525b

Corrigendum: Suppression of luteinizing hormone enhances HSC recovery after hematopoietic injury
Categories: Medicine

Corrigendum: Sex-specific transcriptional signatures in human depression

Nature Medicine - 10 April 2018 - 12:00am

Corrigendum: Sex-specific transcriptional signatures in human depression

Corrigendum: Sex-specific transcriptional signatures in human depression, Published online: 10 April 2018; doi:10.1038/nm0418-525d

Corrigendum: Sex-specific transcriptional signatures in human depression
Categories: Medicine

Current understanding of the human microbiome

Nature Medicine - 10 April 2018 - 12:00am

Current understanding of the human microbiome

Current understanding of the human microbiome, Published online: 10 April 2018; doi:10.1038/nm.4517

Current understanding of the human microbiome
Categories: Medicine

Erratum: The molecular landscape of pediatric acute myeloid leukemia reveals recurrent structural alterations and age-specific mutational interactions

Nature Medicine - 10 April 2018 - 12:00am

Erratum: The molecular landscape of pediatric acute myeloid leukemia reveals recurrent structural alterations and age-specific mutational interactions

Erratum: The molecular landscape of pediatric acute myeloid leukemia reveals recurrent structural alterations and age-specific mutational interactions, Published online: 10 April 2018; doi:10.1038/nm0418-526b

Erratum: The molecular landscape of pediatric acute myeloid leukemia reveals recurrent structural alterations and age-specific mutational interactions
Categories: Medicine

Transplanted neural progenitors bridge gaps to benefit cord–injured monkeys

Nature Medicine - 10 April 2018 - 12:00am

Transplanted neural progenitors bridge gaps to benefit cord–injured monkeys

Transplanted neural progenitors bridge gaps to benefit cord–injured monkeys, Published online: 10 April 2018; doi:10.1038/nm.4531

Human neural progenitor cells have been grafted successfully into rhesus monkeys with spinal cord hemisection, resulting in anatomic integration and improved neurological function.
Categories: Medicine

Predicting leukemia relapse

Nature Medicine - 10 April 2018 - 12:00am

Predicting leukemia relapse

Predicting leukemia relapse, Published online: 10 April 2018; doi:10.1038/nm.4529

Mass cytometry of acute B cell lymphoblastic leukemias at diagnosis reveals intrapatient phenotypic heterogeneity and specific signatures that mimic cell developmental stage and predict future relapse.
Categories: Medicine

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