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[Correspondence] Reporting sex and gender in medical research

Sa, 18/05/2019 - 00:00
We read the theme issue on advancing women in science, medicine, and global health with great enthusiasm, and here we write in response to the Comment by Jocalyn Clark and Richard Horton.1 Although they set clear parameters for improving equity in the academic publishing system across all Lancet journals, it is but a first step. A systematic and mandatory approach to reporting sex and gender, which covers all papers considered for publication, is necessary, unless justified otherwise.

[Department of Error] Department of Error

Sa, 18/05/2019 - 00:00
Malvy D, McElroy AK, de Clerck H, Günther S, van Griensven J. Ebola virus disease. Lancet 2019; 393: 936–48—In this Seminar, the appendix was incomplete; an updated version has been supplied. These corrections have been made to the online version as of May 16, 2019.

[Department of Error] Department of Error

Sa, 18/05/2019 - 00:00
Dransfield M, Stolz D, Kleinert S for the Lancet COPD Commissioners. Towards eradication of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 2019; 393: 1786–88—In this Comment, in the list of Commissioners' names the spelling of Urs Frey has been corrected. This correction has been made to the online version as of May 16, 2019.

[Department of Error] Department of Error

Sa, 18/05/2019 - 00:00
The Lancet. Measles eradication: a goal within reach, slipping away. Lancet 2019; 393: 1669—In this Editorial, it was reported that the combined measles, mumps and rubella vaccine (MMR) was introduced in 1963, when this vaccine was first introduced in 1971. Corrections to that effect have been made to the online version as of May 16, 2019.

[Clinical Picture] A pain in the neck: calcific tendinitis of the longus colli muscle

Sa, 18/05/2019 - 00:00
A 41-year-old man presented to our hospital with a 20-h history of progressively worsening sudden-onset, severe, left-sided neck pain. Additionally, he complained of a headache in the occipital region, odynophagia, and trismus. He reported no medical history of trauma or infection. A physical examination showed he had severely limited neck motion in all directions because of stiffness. Blood tests showed a leucocytosis (13·0 × 109 per L), an elevated serum C-reactive protein concentration (124 mg/L), and a faster erythrocyte sedimentation rate (24 mm/h).

[Review] Mass gatherings medicine: public health issues arising from mass gathering religious and sporting events

Sa, 18/05/2019 - 00:00
Mass gathering events are associated with major public health challenges. The 2014 Lancet Series on the new discipline of mass gatherings medicine was launched at the World Health Assembly of Ministers of Health in Geneva in May, 2014. The Series covered the planning and surveillance systems used to monitor public health risks, public health threats, and experiences of health-care providers from mass gathering events in 2012 and 2013. This follow-up Review focuses on the main public health issues arising from planned mass gathering events held between 2013 and 2018.

[Review] Refractive surgery

Sa, 18/05/2019 - 00:00
Refractive surgery has evolved beyond laser refractive techniques over the past decade. Laser refractive surgery procedures (such as laser in-situ keratomileusis), surface ablation techniques (such as laser epithelial keratomileusis), and photorefractive keratectomy have now been established as fairly safe procedures that produce excellent visual outcomes for patients with low-to-moderate amounts of ametropia. Additionally, a broader selection of options are now available to treat a wider range of refractive errors.

[Editorial] Net zero by 2050 in the UK

Sa, 11/05/2019 - 00:00
The Committee on Climate Change (CCC), an independent body that advises the UK Government, published a report on May 2, Net zero—the UK's contribution to stopping global warming. Stating that net zero is “necessary, feasible, and cost-effective”, the CCC set a target year of 2050 for complete elimination of greenhouse gas (GHG) emissions in the UK. The report provides a comprehensive framework for multiple sectors that the government could feasibly adopt to adhere to the 2015 Paris Agreement and Intergovernmental Panel on Climate Change (IPCC) limits of 1·5–2·0 degrees global warming from pre-industrial levels by 2050.

[Editorial] Malaysia's Pain Free programme

Sa, 11/05/2019 - 00:00
At the Annual Scientific Meeting of the Australia and New Zealand College of Anaesthetists in Kuala Lumpur (Malaysia) last week, Dr Mary Suma Cardosa, pain specialist at Hospital Selayang and President of the Malaysian Association for the Study of Pain, presented over a decade of work in Malaysia addressing pain. Cardosa described how adoption of “pain as the fifth vital sign” in 2008 improved awareness of pain in hospitals but did not lead to significant practice change. The Pain Free Hospital campaign was subsequently initiated in Malaysia's public health system in 2011, and extended to include primary care and dental services in 2017.

[Editorial] Research futures—from 2019 to 2029

Sa, 11/05/2019 - 00:00
What will the world of research look like in 2029? How will research be funded? What are the pathways to open science? How will researchers work, and what will be the role of technology? How will the research information system change, and what will education look like? On May 2, at a conference organised by the European Health Forum Gastein, and hosted by Wellcome in London (UK), possible drivers shaping the future of research were outlined.

[Comment] Offline: Time to radically rethink non-communicable diseases

Sa, 11/05/2019 - 00:00
The strategies that underpin global health orthodoxy today, expressed as an almost exclusive concern with Sustainable Development Goal (SDG) 3, will fail to deliver healthy lives for all. Few global health institutions or initiatives acknowledge this reality. The Global Fund to Fight AIDS, Tuberculosis and Malaria is unlikely to divert from its narrow disease-driven narrative in the run up to its October, 2019, replenishment conference in Lyon. Gavi, The Vaccine Alliance, sees vaccination as an important contributor to the SDGs.

[World Report] Legal battles over abortion heat up in the USA

Sa, 11/05/2019 - 00:00
Changes to Title X, several legal challenges, and a change to the Supreme Court composition could mean drastic changes for access to abortion in the USA. Susan Jaffe reports.

[Perspectives] Body of thought

Sa, 11/05/2019 - 00:00
“It happened quickly, an inverse magician's trick: now you don't see it, now you do.” This is how Sinéad Gleeson's body announced itself to her when she was 13 years old, as she describes in Blue Hills and Chalk Bones, the opening essay in her debut collection of prose and poetry Constellations: Reflections from Life. Her previously normal, active life was consumed by pain emanating from her left hip. The eventual diagnosis was monoarticular arthritis, but getting to that point took some time, and finding actual relief from the condition even longer.

[Perspectives] In pursuit of polymathy

Sa, 11/05/2019 - 00:00
Medicine, despite its penchant for specialism, has always been responsive to polymathy. In ancient Egypt, Imhotep—most famous as the architect of the Step Pyramid—was also a physician, worshipped as the god of medicine and linked with the ancient Greek god of medicine, Asclepius, mentioned in the Hippocratic oath. Imhotep was the real “Father of Medicine”, wrote William Osler in the 19th century, as quoted by Waqās Ahmed in The Polymath: Unlocking the Power of Human Versatility. Other notable historical examples are Avicenna (Ibn Sina), the Persian physician from the 11th-century Islamic golden age, who wrote on astronomy, geography, mathematics, physics, and philosophy, as well as works of poetry, and Leonardo da Vinci, who pursued not only painting but many other disparate subjects, including anatomy.

[Perspectives] Mike Grocott: climbing high in critical care medicine

Sa, 11/05/2019 - 00:00
Besides his clinical and academic roles as Professor of Anaesthesia and Critical Care Medicine at the UK's University of Southampton, Mike Grocott is director of the Xtreme Everest Oxygen Research Consortium, a group of doctors, nurses, and scientists who use research done at high altitude to improve the treatment of critically ill patients. During his childhood, Grocott's family holidays were mostly in Scotland, the Lake District, and north Wales. “Mountains were a part of growing up and family life”, he recalls.

[Perspectives] Eglantyne Jebb and the war against children

Sa, 11/05/2019 - 00:00
This year, on May 16, Save the Children is 100 years old. It is the second oldest humanitarian organisation in the world (the International Committee of the Red Cross is the oldest), and the largest to focus entirely on the welfare of the child. Not only has it saved the lives of millions of children, it has helped transform the way we think about the nature of childhood itself.

[Obituary] James Lance

Sa, 11/05/2019 - 00:00
Neurologist who specialised in headache and motor control. Born in Wollongong, NSW, Australia, on Oct 29, 1926, he died of acute leukaemia in Sydney, NSW, Australia, on Feb 20, 2019, aged 92 years.

[Correspondence] Trend analysis of diabetic mortality

Sa, 11/05/2019 - 00:00
We read with great interest the Article by Edward Gregg and colleagues (June 16, 2018, p 2430).1 Here, we note some of our concerns on the methodology.

[Correspondence] Trend analysis of diabetic mortality – Authors' reply

Sa, 11/05/2019 - 00:00
We appreciate Xiaoling Yuan and colleagues' Correspondence about our Article.1 We used age adjustment instead of age standardisation because we considered it to be more efficient and appropriate to account for the reduced power in younger age strata in the context of discretised Poisson regression models, which we used to transform serial cohorts into nationally representative, year-specific estimates. Our analyses also modelled mortality trends as a continuous variable and evaluated non-linear terms, in addition to presenting point estimates at 10-year intervals.

[Correspondence] Biodegradable-polymer stents versus durable-polymer stents

Sa, 11/05/2019 - 00:00
In their randomised trial, Thomas Pilgrim and colleagues (Aug 28, 2018, p 737)1 assessed the non-inferiority of ultrathin-strut biodegradable-polymer sirolimus-eluting stents to thin-strut durable-polymer erolimus-eluting stents. The rate ratio (RR) for the primary composite outcome of target lesion failure (biodegradable-polymer stents vs durable-polymer stents) was 1·07 (95% CI 0·88–1·31; p=0·487). On the basis of this quantification, the two stents were claimed to be similar. However, the RR does not capture the temporal profile of event occurrences.