Riviste scientifiche

[Editorial] We need a global conversation on the 2020 Olympic Games

The Lancet - Sa, 12/06/2021 - 00:00
With 6 weeks until the Tokyo 2020 Olympic Games begin, concerns over the safety of the Games amid the COVID-19 pandemic are intensifying. Public health experts have expressed strong reservations about how well the risks are being mitigated in articles and before parliamentary committees. The Olympic and Paralympic Games are now deeply unpopular in Japan: lengthy petitions have been signed, 10 000 volunteers have resigned, and several opinion polls have shown that most respondents thought the Games should be postponed or cancelled.

[Comment] Anticoagulation in COVID-19: reaction to the ACTION trial

The Lancet - Sa, 12/06/2021 - 00:00
Early in the COVID-19 pandemic, it became clear that coagulopathy leading to macrovascular and microvascular thrombotic events was a considerable potential complication for patients with COVID-19.1 Increased inflammation and coagulopathy were independently associated with critical illness and all-cause mortality and had a synergistic role in the pathogenesis of COVID-19.2 Early observations of a benefit from heparin3 in a selected cohort of severely ill patients with COVID-19 in China, followed by reports of increased thromboembolic events in patients with COVID-19 (both in and outside of intensive care units [ICUs]) despite the use of standard-dose venous thromboembolism prophylaxis,4,5 led many physicians to use increased anticoagulant doses, even without robust data available.

[World Report] Political change in Israel and the effects on health

The Lancet - Sa, 12/06/2021 - 00:00
Benjamin Netanyahu's 12-year premiership might be coming to an end. What will it mean for health? Sharmila Devi reports.

[World Report] China's three-child policy

The Lancet - Sa, 12/06/2021 - 00:00
News that the Chinese Government will allow up to three children per couple will do little to boost startlingly low fertility rates, predict experts. Megan Tatum reports.

[World Report] Southern Madagascar faces “shocking” lack of food

The Lancet - Sa, 12/06/2021 - 00:00
The worst drought in 30 years has created a nutritional crisis of exceptional gravity according to aid organisations. Munyaradzi Makoni reports.

[World Report] US drug importation plan hits snag

The Lancet - Sa, 12/06/2021 - 00:00
The Biden administration says it has “no timeline” for deciding if states can import cheap drugs from Canada. Susan Jaffe reports.

[Perspectives] The public health approach to paediatric firearm injury

The Lancet - Sa, 12/06/2021 - 00:00
Here is where most Americans agree: we want to keep ourselves and our families and communities safe from firearm injury. But beyond that, the USA is rife with disagreement about firearm injury. We argue about what causes it, how to prevent it, and even how common it is.

[Perspectives] Kirsten Ostherr: mobilising the translational humanities

The Lancet - Sa, 12/06/2021 - 00:00
As the myriad lessons of the COVID-19 pandemic begin to emerge, one is evident: disciplines beyond science and medicine are essential to improve the handling of health crises. Even the most effective COVID-19 vaccines, therapeutics, and public health strategies are likely to falter unless their deployment is informed by behavioural, historical, and cultural insights, trustworthy communication, and the effective use of technology. One scholar seeking to advance these insights is Kirsten Ostherr, the Gladys Louise Fox Professor of English, Director of the Medical Humanities Program, and Director of the Medical Futures Lab at Rice University in Houston, TX, USA.

[Perspectives] Narrative complexity in the time of COVID-19

The Lancet - Sa, 12/06/2021 - 00:00
During the COVID-19 pandemic, medicine and public health have grappled with challenges related to individual behaviour and decision making, both in terms of infection and more recently concerning the uptake of COVID-19 vaccines. Social theory has long pointed to the role of narrative when trying to grasp the complexity of understanding and decision making in times of crisis. Such theory has underscored the importance of context to the ways that people understand specific experiences or phenomena, and, consequently, to the understandings that they relay to others.

[Obituary] José Baselga

The Lancet - Sa, 12/06/2021 - 00:00
Eminent oncologist who contributed to breast cancer treatments. He was born in Barcelona, Spain, on July 3, 1959, and died of Creutzfeldt-Jakob disease in Cerdanya, Spain, on March 21, 2021, aged 61 years.

[Correspondence] A strategy for SARS-CoV-2 vaccination in Yemen

The Lancet - Sa, 12/06/2021 - 00:00
Yemen has one of the most fragile health-care systems and is currently experiencing war and famine. Since 2015, the country's humanitarian crisis has resulted in the emergence and re-emergence of debilitating infectious diseases and severely weakened the country's health infrastructure.

[Correspondence] ChAdOx1 nCoV-19 vaccine: asymptomatic efficacy estimates

The Lancet - Sa, 12/06/2021 - 00:00
Merryn Voysey and colleagues1 provide some of the first evidence of the effectiveness of ChAdOx1 nCoV-19 vaccine (AZD1222) against asymptomatic infections. However, readers might be surprised by the non-intuitive results reported in the tables, where vaccine efficacy estimates for asymptomatic infections are close to the null or even negative.

[Correspondence] ChAdOx1 nCoV-19 vaccine: asymptomatic efficacy estimates – Authors' reply

The Lancet - Sa, 12/06/2021 - 00:00
It is well established that randomised controlled trials are the gold standard for estimating the effect of interventions. In such studies, outcomes in participants randomised to receive the new intervention are compared with those randomised to the control product, to produce unbiased estimates of the effect of the intervention.

[Correspondence] COVID-19 vaccine efficacy data: solid enough to delay second dose?

The Lancet - Sa, 12/06/2021 - 00:00
Sharon Amit and colleagues1 suggest that after a first dose of BNT162b2 vaccine, there was an adjusted rate reduction of COVID-19 disease of 85% (71–92) for days 15–28 in vaccinated compared with unvaccinated health-care workers (HCWs).1 We think this Correspondence has fundamental flaws and address them here.

[Correspondence] COVID-19 vaccine efficacy data: solid enough to delay second dose? – Authors' reply

The Lancet - Sa, 12/06/2021 - 00:00
We thank John Robertson and Herb Sewell for their interest in our Correspondence.1 We reported early rate reductions in SARS-CoV-2 infections and COVID-19 disease in health-care workers (HCWs) working at the Sheba Medical Center, Israel, receiving the BNT162b2 mRNA vaccine.1

[Correspondence] Vaccines can save children with non-preventable diseases

The Lancet - Sa, 12/06/2021 - 00:00
Xiang Li and colleagues1 modelled the health impact of vaccination programmes in low-income and middle-income countries and predicted that approximately 120 million deaths will be averted in children born between 2000 and 2030. They took into consideration both the direct effect of vaccination on vaccinated cohorts and the indirect effects in the population through herd immunity. Although these data are immensely helpful for policy makers, we believe that the indirect impacts of vaccination go even further than suggested.

[Correspondence] Vaccines can save children with non-preventable diseases – Authors' reply

The Lancet - Sa, 12/06/2021 - 00:00
Senjuti Saha and Samir Saha make the excellent point that the scope of vaccine impact goes beyond the deaths that are directly averted by immunisation activities. In this we agree. We aimed to quantify the deaths averted by vaccination for ten diseases in 98 low-income and middle-income countries.1 However, there are wider benefits of vaccination—for example, in reducing the burden on health-care services. With many low-income and middle-income countries having minimal health-care capacity, the impact of vaccination might far outstrip the current best estimates.

[Correspondence] Inclusion and diversity in the PRINCIPLE trial

The Lancet - Sa, 12/06/2021 - 00:00
We welcome the call from Paramjit Gill and colleagues1 for diverse participation in clinical trials like PRINCIPLE.2We initiated many inclusive recruitment strategies, including the appointment of a leading and national pharmacist expert working with minority ethnic communities who was tasked with targeting socioeconomically deprived areas, minority ethnic communities, and people with learning difficulties; developing UK-wide relationships with community and religious organisations (including places of worship); collaborating with universities and national and regional health-care institutions; and gathering nationwide support from minority ethnic leaders, health professionals, and their organisations (appendix).

[Correspondence] Intersectionality in UHC: from blue-sky to day-to-day practice

The Lancet - Sa, 12/06/2021 - 00:00
Rajvinder Samra and Olena Hankivsky1 rightly address intersectionality in analysing inequalities and the intersection of social identities in power structures in medical education and its negative consequences on the future of health-care providers.

[Department of Error] Department of Error

The Lancet - Sa, 12/06/2021 - 00:00
Burtness B, Harrington KJ, Greil R, et al. Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. Lancet 2019; 394: 1915–28—In this Article, the overall survival at 24 months in patients receiving cetuximab with chemotherapy (shown in figure S3C) should have been 18%. The appendix has been corrected as of June 10, 2021.
Condividi contenuti