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[Perspectives] WHOse health agenda? 70 years of struggle over WHO's mandate

Sáb, 07/04/2018 - 00:00
Like any milestone, WHO's 70th anniversary offers an opportunity to reflect on its past trajectory and chart the challenges ahead. WHO's promising mandate for health cooperation, forged amid a short-lived post-war optimism, mapped out a world of possibilities. Yet its realisation has been limited across distinct eras by complex geopolitical, economic, and institutional pressures, ranging from the Cold War rivalry between US and Soviet blocs to contemporary assaults on WHO's independence by powerful private actors.

[Obituary] John Sulston

Sáb, 07/04/2018 - 00:00
Nobel Prize winner for work on Caenorhabditis elegans and a leader in human genome research. Born in Fulmer, UK, on March 27, 1942, he died on March 6, 2018, from complications of stomach cancer, aged 75 years.

[Correspondence] Polio transition: overlooked challenges

Sáb, 07/04/2018 - 00:00
The reduction in the number of poliomyelitis cases by more than 99% is an extraordinary success of the global community. In their Comment, Michel Zaffran and colleagues (Jan 6, p 11)1 assume that eradication will be achieved soon and focus on strategies to ensure that poliovirus will not be reintroduced into a polio-free world.2

[Correspondence] On the misuses of medical history

Sáb, 07/04/2018 - 00:00
A surprising amount of bad history passes peer review in the sciences and medicine. What do we mean by bad history? One example would be the misuse of historical images. Many images of so-called plague used in scientific publications depict patients suffering from leprosy.1 Another example is when commonly repeated claims about historical people or events are lifted from earlier scientific or medical writings, without checking whether professional historical scholarship has revised earlier interpretations.

[Correspondence] C1 esterase inhibitor concentrates and attenuated androgens

Sáb, 07/04/2018 - 00:00
Marc A Riedl and colleagues (July 25, 2017, p 1595)1 conducted a phase 2, multicentre, randomised, double-blind, placebo-controlled crossover trial in 32 patients to test the prophylactic efficacy of recombinant human C1 esterase inhibitor for hereditary angio-oedema. Once or twice weekly administration of recombinant human C1 esterase inhibitor (50 IU/kg) reached the primary endpoint (reduced number of attacks) in an intention-to-treat analysis.

[Correspondence] C1 esterase inhibitor concentrates and attenuated androgens – Authors' reply

Sáb, 07/04/2018 - 00:00
We thank Yannick D Muller and colleagues for their interest in our Article1 describing results from a randomised, double-blind, placebo-controlled study with the use of recombinant human C1 esterase inhibitor for prophylaxis of hereditary angio-oedema.

[Department of Error] Department of Error

Sáb, 07/04/2018 - 00:00
Khanna D, Denton CP, Angelika Jahreis A, et al. Safety and efficacy of subcutaneous tocilizumab in adults with systemic sclerosis (faSScinate): a phase 2, randomised, controlled trial. Lancet 2016; 387: 2630–40—In table 3 of this Article (published online first on May 5, 2016), the p value (placebo vs tocilizumab) for a decrease of 4·7 units or more at 48 weeks should have been 0·25. The interpretation of these data remains unchanged. This correction has been made online as of April 5, 2018.

[Department of Error] Department of Error

Vie, 06/04/2018 - 00:30
The Lancet. Dementia in the UK: preparing the NHS for new treatments. Lancet 2018; 391: 1237— In the second sentence of this Editorial, the cost of dementia to the National Health Service in the UK should have been £26 billion. This correction has been made to the online version as of April 5, 2018.

[Editorial] Dementia in the UK: preparing the NHS for new treatments

Sáb, 31/03/2018 - 00:00
Dementia is a devastating disease that brings fear, confusion, and loneliness to the lives of patients and their families. Today, around 850?000 people in the UK are living with dementia, costing the National Health Service (NHS) and UK society more than £26 million annually. By 2025, it is estimated that over 1 million people in the UK will be affected, with the prevalence and costs of care for these patients expected to double by 2050. These are worrisome figures given the absence of any safe, clinically effective, disease-modifying therapy for Alzheimer's disease or other forms of dementia.

[Editorial] Good news for the world's newest nation

Sáb, 31/03/2018 - 00:00
Despite South Sudan's crippling civil war, the country has interrupted the transmission of Guinea worm disease, announced the Carter Center on March 21. This disease is now on the edge of eradication, with only six countries reporting low rates of infection.

[Editorial] Cybersecurity and patient protection

Sáb, 31/03/2018 - 00:00
Network-connected devices and data are vulnerable to attack, exploitation, and unintended loss. The alleged harvesting of profiles from 50 million people by Cambridge Analytica through friend networks on Facebook is the most recent and egregious example. In May, 2017, the WannaCry ransomware that infected more than 200?000 computers across 100 countries also infiltrated a third of National Health Service trusts, and brought some services to a standstill. Yet, despite agreement on the need for better cyber hygiene (risk management and online health), there is no consensus on what form it should take.

[Comment] Transparency of retracting and replacing articles

Sáb, 31/03/2018 - 00:00
Journal editors are responsible for the integrity of the published record and must correct it when necessary. They are getting better at this job, as evidenced by journal retraction policies1 and numbers of article retractions.2 Most retractions are due to misconduct, but about 20% are retracted because of an unintentional error or methodological flaw.2 To credit the correction of an honest error and avoid stigmatisation of authors, journals have begun a practice of retraction with republication of a corrected article.

[Comment] Offline: The Palestinian health predicament worsens

Sáb, 31/03/2018 - 00:00
The United Nations Relief and Works Agency (UNRWA), which administers health services to 5·3 million Palestinian refugees through 143 primary health facilities, is in acute crisis. After President Trump cut almost US$300 million from UNRWA's 2018 budget, services will run out of money by the end of May. Irrespective of one's views about the complex politics of the Middle East, America's decision to threaten the provision of basic health care to millions of dependent people seems utterly cruel. This emergency was a major theme of last week's annual Lancet Palestinian Health Alliance (LPHA) scientific meeting, held in Beirut, Lebanon.

[World Report] Gairdner Awards 2018 honour GBD studies

Sáb, 31/03/2018 - 00:00
Creators of the GBD studies look back at almost two decades since the first iteration. Other awards recognised the fields of optogenetics, epigenetics, and lung cancer research. Brian Owens reports.

[World Report] What does the GDPR mean for the medical community?

Sáb, 31/03/2018 - 00:00
The General Data Protection Regulation will start in May across the European Union, but doubts are being cast on how prepared researchers and clinicians are. Becky McCall reports.

[Perspectives] Jan Egeland: humanitarian who gives a voice to the displaced

Sáb, 31/03/2018 - 00:00
“The major challenge of our time is to fight social injustice, and to promote human rights and humanitarian principles through action and not just words”, says Jan Egeland. “We must stand up for our values, even in extraordinary times.” As Secretary-General of the Norwegian Refugee Council (NRC) and Special Adviser to the UN Special Envoy for Syria, he speaks forcefully about the crises in Syria, Yemen, Nigeria, and elsewhere, “where millions of civilians are displaced and attacked, and there is no protection at all”.

[Perspectives] Rethinking cures in Jesse Ball's A Cure for Suicide

Sáb, 31/03/2018 - 00:00
In January, 2018, UK Prime Minister Theresa May appointed a ministerial lead on loneliness “to address the loneliness endured by the elderly, by carers, by those who have lost loved ones—people who have no one to talk to or share their thoughts and experiences with”. Social psychologist Jean Twenge offers a different perspective on modern loneliness for a generation that has grown up staring at digital screens. This generation, she argues, is “on the brink of the worst mental-health crisis in decades [and] much of this deterioration can be traced to their phones”.

[Perspectives] Moments on the margins

Sáb, 31/03/2018 - 00:00
Once upon a time it must have seemed exciting to be photographed, as if you were going to become part of history. Now that everyone with a smartphone can post selfies all day, what does it really mean to make images of someone else? Photographers who are trying to capture marginalised or misunderstood cultures are in an increasingly difficult position if they are not from the same background or culture as their subjects. They risk being accused of objectification in the name of art at best, and exploitation at worst.

[Perspectives] Bridging magic and medicine

Sáb, 31/03/2018 - 00:00
12-year-old Tommy lay listlessly in his hospital bed. I noticed, however, that his eyes were becoming a bit brighter since I had bounded into the room a moment earlier with my satchel of magic paraphernalia and made three red foam balls disappear into thin air.

[Perspectives] The girl who died in the fire

Sáb, 31/03/2018 - 00:00
A warm light suffuses an empty stage surrounded by nine pianos. A young woman walks to the front and she is caught by a panic attack. Thus the new production of Tennessee Williams' Summer and Smoke, directed by Rebecca Frecknall at London's Almeida Theatre, begins. Written in 1948, just after the success of A Streetcar Named Desire, the play, in its deceptive simplicity, touches some of the key themes of Williams' early works: the marginalisation of women in the southern states of the USA, the dichotomy between spirituality and carnality, and the lability of mental health.