Riviste scientifiche

While many things changed in South Africa's black communities after the loosening of apartheid control in the early 1990s, perhaps none were more germane to the growing HIV epidemic than the free movement of people and the new forms of socialisation that arose at this time. Back then from my veranda in a peri-urban township outside Durban, I had a front-row view of a changing youth culture.

“One of the things that suggested to surgeons that it would be possible to insert a rigid tube down into the throat was the performances of sword swallowers”, Sarah Chaney tells me. We're standing in the North Cloisters of University College London (UCL) in front of the Foreign Bodies display that Chaney has curated.

Christina Davies and colleagues (March 9, p 805) show that extending tamoxifen from 5 to 10 years reduces recurrence and mortality for women with oestrogen receptor-positive breast cancer. They estimate that 10 years of treatment would nearly halve breast cancer mortality. However, this result raises the question of long-term adherence to treatment.

We read with interest the results of the ATLAS trial, and we would like to highlight some shortcomings.

The findings from the ATLAS trial demonstrate that extended use of adjuvant tamoxifen beyond 5 years is beneficial for women with oestrogen receptor (ER)-positive breast cancer.

Key findings from trials of 5 years or 10 years of tamoxifen are summarised in the . They are remarkable.

Richard Burt and colleagues (March 30, p 1116) propose from a retrospective analysis of autologous haemopoietic stem-cell transplantation (HSCT) in 90 patients with systemic sclerosis that comprehensive cardiac screening including fluid challenge improves patient selection. They ascribe the higher treatment-related mortality in the ASTIS trial (10% vs 6% in their study) to less rigorous cardiac screening, which mandated right heart catheterisation only if there was pulmonary arterial hypertension on echo.

Richard Burt and colleagues' study of treatment-related mortality of autologous haemopoietic cell transplantation in progressive autoimmune diseases is promising with an acceptable 5% treatment-related mortality, compared with 10% in the ASTIS trial. However, we believe that some issues need to be further clarified.

We thank Jacob van Laar and colleagues and Ioanna Sakellari and colleagues for their comments.

The Lancet, in its excellent Series, acknowledged the importance of non-communicable diseases (NCDs), particularly in low-income and middle-income countries (LMICs). These Series stress, among many important points, the need for global cooperation and partnership towards addressing NCDs. However, it is surprising to observe the over-representation of researchers based in high-income countries and the limited participation of LMIC-based researchers in all four Lancet Series (); an observation that warrants open criticism and immediate pragmatic action.

We appreciate the positive comments by Rodrigo Carrillo-Larco and colleagues on the four Lancet Series on non-communicable diseases (NCDs). We applaud the reference to the efforts being made to encourage the inclusion of contributors from low-income and middle-income countries into major debates and to remove barriers to publishing.

We welcome The Lancet's stance on open access (April 6, p 1166). We note that you wish to review how you can make all publicly funded research as accessible and usable as possible. However, we also note that even with the announced changes, The Lancet will still have less free access than other key general medical journals. For example, there is free access to all research articles in The Journal of the American Medical Association (JAMA) after 6 months from 1998, in the New England Journal of Medicine after 6 months from 1990, and in The British Medical Journal immediately from 1840 onwards.

Judith Glynn and Sara Thomas raise important questions about our current policy to offer open access publications as outlined in our recent Comment. Our announcement is only a first step in a fast evolving movement towards making publicly funded research as accessible as possible, and we are continuously reviewing our approach. However, many of our research papers—all those reporting global health research—are already routinely made free to access immediately at publication. In addition, we are launching the first open access journal within the Lancet family, The Lancet Global Health, on June 25, this year.

The Lancet. Salt: friend or foe? Lancet 2013;381: 1790—In this Editorial (May 25), the fifth line of the second paragraph should have stated “2300 mg sodium”. The last line of this paragraph should have stated “3400 mg sodium (about 1·5 teaspoons of salt) daily”. The fifth line of the third paragraph should have read “less than 2300 mg sodium”. The last two lines of the fourth paragraph should have read “1500–2300 mg daily sodium intake”. These corrections have been made to the online version as of June 14, 2013.

The Lancet. Towards better health in China. Lancet 2013;381: 1959— In this Editorial (June 8), the following sentence in the second paragraph should have read “Chronic obstructive pulmonary disease remains one of the leading causes of death in China.” This correction has been made to the online version as of June 14, 2013.

In this study, daily oral tenofovir reduced the risk of HIV infection in people who inject drugs. Pre-exposure prophylaxis with tenofovir can now be considered for use as part of an HIV prevention package for people who inject drugs.

The raltegravir regimen was no less efficacious than the standard of care and was safe and well tolerated. This simple NtRTI-free treatment strategy might extend the successful public health approach to management of HIV by providing simple, easy to administer, effective, safe, and tolerable second-line combination antiretroviral therapy.

Our findings suggest that sofosbuvir is well tolerated and that there is no additional benefit of extending treatment beyond 12 weeks, but these finding will have to be substantiated in phase 3 trials. These results lend support to the further assessment of a 12 week sofosbuvir regimen in a broader population of patients with chronic HCV genotype-1 infection, including those with cirrhosis.