Riviste scientifiche

Strange illusion makes people forget where their teeth are

New Scientist - %age fa
An illusion can trick people into thinking their teeth are closer to their neck than in reality, showing that our bodily perceptions are easily influenced

[Editorial] Prioritising disability in universal health coverage

The Lancet - %age fa
Current health systems are failing the 1 billion people worldwide living with disabilities. Unless access to health care is dramatically improved for this marginalised group, the goal of universal health coverage will not be achieved. These are the stark conclusions of The Missing Billion, a report from the London School of Hygiene & Tropical Medicine and other partners, published on July 9, which shines a light on the barriers to health care and disparities in outcomes faced by people living with disabilities.

[Editorial] Oral health at a tipping point

The Lancet - %age fa
What comes to mind when you think of dentistry? A luxury, a pain, excessive costs, the quest for straight, white teeth? Any way that dentistry is thought of, it's rarely as a mainstream part of health-care practice and policy, despite the centrality of the mouth and oral cavity to people's wellbeing and identity. The inattention to dental and oral health is concerning given the fact that oral diseases—tooth decay, gum disease, and oral cancers—are exceedingly common, affecting an estimated 3·5 billion people across the world.

[Editorial] A wake up call for the Ebola outbreak response

The Lancet - %age fa
A 46-year-old pastor died from Ebola virus infection in Goma, DR Congo, this week. Nearly a year since the Ebola outbreak began, WHO convened a High-Level meeting to review the response and to call for a more system-wide coordinated approach with UN partners ahead of publication of the fourth strategic response plan (SRP4) by the government. The tone of the meeting was defiant and conveyed a definite change in narrative, at odds with those who claim the Ebola virus outbreak is under control. WHO Director-General, Tedros Adhanom Ghebreyesus, announced that he will reconvene the International Health Regulations Emergency Committee.

[Comment] Sphenopalatine ganglion stimulation after stroke, promising but not yet ready for adoption

The Lancet - %age fa
Despite major advances in treatment of acute ischaemic stroke with reperfusion therapies—intravenous thrombolysis and mechanical thrombectomy1,2—most patients remain ineligible for these treatments. In many centres around the world, neither mechanical thrombectomy nor advanced brain imaging to identify patients who would benefit from reperfusion therapies in a later time window is available.3,4 Alternative treatment options are needed that improve outcome irrespective of time windows and imaging-defined salvageable tissue windows.

[Comment] Conflicts of interest between the sugary food and beverage industry and dental research organisations: time for reform

The Lancet - %age fa
Prevention of dental caries (tooth decay), one of the most common chronic diseases globally,1 requires the global implementation of WHO's guideline on sugars intake.2,3 WHO recommends that individuals consume less than 10% of total energy intake from free sugars and that intake below 5% would be beneficial.3 The global dental research community, as the Lancet oral health Series1,2 argues, has an important role in the implementation of the WHO guideline by promoting research on public health and dietary interventions, among other actions.

[Comment] Promoting radical action for global oral health: integration or independence?

The Lancet - %age fa
Globally, oral health has been neglected. The major global burden of oral health and its social and economic impacts are not disputed,1 and the deficiencies in oral health care and preventive services in all countries are apparent.2 But given that everyone experiences oral health problems at some stage of their life, it is surprising that the neglect of global oral health has not been seriously challenged.

[Comment] Understanding masculinities to improve men's health

The Lancet - %age fa
While women and girls experience more disability in every region of the world, men and boys bear a greater share of the global mortality burden. The 2016 Global Burden of Disease data show age-standardised death rates per 100 000 population of 1002 for men and 690 for women.1 Many of the drivers of men's ill-health are linked to perceptions and attitudes about manhood and the overall structural organisation of men's lives and relationships.2 Furthermore, this public health challenge is intensified by insufficient attention to the intersections between masculine norms and men's health within public health systems.

[Comment] Offline: The ethical darkness of global health

The Lancet - %age fa
Saudi Arabia. A country whose rulers ordered the murder and dismemberment of journalist Jamal Khashoggi. A nation whose armed forces have killed thousands of civilians in Yemen. The Philippines. A country whose President has led a violent “war on drugs”, with over 4000 extrajudicial executions since 2016. Myanmar. A nation whose abuses against the Rohingya people have been globally condemned. International action to hold Saudi Arabia, the Philippines, and Myanmar accountable has been weak. But there has, at least, been some action.

[World Report] Hungarian Government taking over science academy

The Lancet - %age fa
A bill pending approval could allow the Hungarian Government to take over the Hungarian Academy of Sciences. Sharmila Devi reports.

[World Report] Hysterectomies in Beed district raise questions for India

The Lancet - %age fa
An anomalous number of hysterectomies among women working as sugarcane cutters in Beed, Maharashtra, raises suspicion of unscrupulous medical practices. Patralekha Chatterjee reports.

[World Report] The yellow fever vaccination certificate loophole in Nigeria

The Lancet - %age fa
Nigeria has introduced an e-registry to prevent travel with counterfeit certificates. But it is still possible to obtain a government-issued certificate without vaccination. Paul Adepoju reports.

[Perspectives] Moon landing: space medicine and the legacy of Project Apollo

The Lancet - %age fa
On July 20, 1969, after a fraught 13 minutes of final descent, Apollo 11's commander Neil Armstrong and lunar module pilot Edwin “Buzz” Aldrin Jr made their historic first landing on the surface of the Moon. The US National Aeronautics and Space Administration (NASA) estimates that all-told 400 000 people were involved in that effort. The Project Apollo workforce had laboured tirelessly to achieve the goal set by US President John F Kennedy in 1961 of getting a human crew to the surface of the Moon and back before the end of the decade.

[Perspectives] Taxidermy and the clinic

The Lancet - %age fa
Derek Frampton is one of the UK's leading taxidermists. For years he was based at London's Natural History Museum and now he works freelance. Much of his work involves “setting up” animals from zoos or collections when they die. At other times, he works with museum specimens that need conservation or repair. Sometimes he recreates extinct animals, or imaginary creatures like dragons. And sometimes, he works for the sheer joy of his art.

[Perspectives] Richard Watt: time to tackle oral diseases

The Lancet - %age fa
Richard Watt first became aware of the social roots of oral health inequalities more than 30 years ago when he was a dentist at Greaves Hall psychiatric hospital in Merseyside, UK. There, he witnessed “appalling” levels of oral disease. “The mouth really is a marker of people's social position and future disease risk”, he says, “and oral diseases are a canary in the coal mine for inequality”. Today, Watt is Professor and Chair of Dental Public Health at University College London (UCL) in the Department of Epidemiology and Public Health.

[Perspectives] Polished smiles and porcelain teeth

The Lancet - %age fa
Perhaps the most famous set of false teeth in history rest on a brass cradle in a glass case at the Mount Vernon Estate in Virginia. In another setting, they could be a pair of castanets imagined by Francis Bacon—a ghastly, disembodied grin that might pursue you, gnashing, through your dreams. These dentures once belonged to George Washington, first President of the USA, and—as most writers on the subject have observed—they are not made of wood, but a mixture of human teeth, cow or horse teeth, and elephant ivory.

[Obituary] Teruko Ishizaka

The Lancet - %age fa
Immunologist who co-discovered IgE and advanced allergy research. Born in Yamagata, Japan, on Sept 28, 1926, she died with Parkinsonism symptoms in Yamagata, Japan, on June 4, 2019, aged 92 years.

[Correspondence] When can heart failure treatment be stopped safely?

The Lancet - %age fa
We have ethical concerns regarding the study by Brian Halliday and colleagues.1 As active practitioners, we have ample experience treating patients with heart failure with recovered left ventricular ejection fraction. Our experience includes individuals who stopped beta-blockers due to non-compliance or discontinuation by other health-care providers, subsequently deteriorating in their systolic function and clinical status. In the justification of the TRED-HF trial,1 the investigators provide three main arguments.

[Correspondence] When can heart failure treatment be stopped safely?

The Lancet - %age fa
Brian Halliday and colleagues1 showed that the withdrawal of pharmacological treatment in patients with recovered dilated cardiomyopathy was associated with a high rate of relapse. While the study provides support for the ongoing use of medications for these patients,2 it should be noted that the study population consisted of a heterogeneous group, with almost half (48%) on three or more heart failure medications before withdrawal. The cohort included patients with atrial fibrillation, hypertension, diabetes, familial cardiomyopathy, or truncating variant in TTN.

[Correspondence] When can heart failure treatment be stopped safely? – Authors' reply

The Lancet - %age fa
We thank Jennifer Thibodeau and Mark Drazner for their comments. As experienced clinicians, it is probable they have cared for patients with dilated cardiomyopathy who have made a full symptomatic recovery with apparent normalisation of cardiac function. Such patients frequently ask whether heart failure treatments can be stopped. What should we tell such patients? We do not think that anecdotes are the optimal basis for advising on treatment. Data from randomised trials provide objective evidence of risk and facilitate shared decision making.
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