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[Correspondence] Disparity in the selection of patients in clinical trials

Sa, 12/03/2022 - 01:00
Evidence-based medicine is the universally accepted cutting-edge standard of care. The framework heavily relies on protocols typically derived from the systematic reviews of randomised clinical trials (RCTs), the gold standard of research in biomedical sciences. However, the results obtained from RCTs might not be applicable to real-world populations if the study sample was not representative of real populations of patients.

[Department of Error] Department of Error

Sa, 12/03/2022 - 01:00
Osman M, Alassam MN. Military attacks on health workers in Sudan. Lancet 2022; 399: 1045—In this Correspondence, references have been corrected. This correction has been made to the online version as of March 10, 2022 and the print version is correct.

[Department of Error] Department of Error

Sa, 12/03/2022 - 01:00
Shoib S, Essar MY, Mohd Saleem S, Legris Z, Chandradasa M. The children of Afghanistan need urgent mental health support. Lancet 2022; 399: 1045–46—In this Correspondence, a reference to the 2018 cross-sectional survey of children in Afghanistan was missing. This correction has been made to the online version as of March 10, 2022, and the print version is correct.

[Articles] Repeated intravenous cardiosphere-derived cell therapy in late-stage Duchenne muscular dystrophy (HOPE-2): a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial

Sa, 12/03/2022 - 01:00
CAP-1002 cell therapy appears to be safe and effective in reducing deterioration of upper limb function in patients with late-stage Duchenne muscular dystrophy. Various measures of cardiac function and structure were also improved in the CAP-1002 group compared with the placebo group. Longer-term extension studies are needed to confirm the therapeutic durability and safety of CAP-1002 beyond 12 months for the treatment of skeletal myopathy and cardiomyopathy in Duchenne muscular dystrophy.

[Articles] Transmission of SARS-CoV-2 delta variant (AY.127) from pet hamsters to humans, leading to onward human-to-human transmission: a case study

Sa, 12/03/2022 - 01:00
Pet hamsters can be naturally infected with SARS-CoV-2. The virus can circulate among hamsters and lead to human infections. Both genetic and epidemiological results strongly suggest that there was more than one hamster-to-human transmission event in this study. This incident also led to onward human transmission. Importation of SARS-CoV-2-infected hamsters was a likely source of this outbreak.

[Clinical Picture] A girl with unruly locks: molecular genetics makes a diagnosis of uncombable hair syndrome

Sa, 12/03/2022 - 01:00
A 3-year-old girl was referred to the dermatology department with blonde, straw-like, and unruly hair. The child's parents reported that since birth her hair had been sparse and slow growing. And from about one year of age, her parents had difficulty combing her hair.

[Therapeutics] Drug therapy for osteoporosis in older adults

Sa, 12/03/2022 - 01:00
The goal of osteoporosis management is to prevent fractures. Several pharmacological agents are available to lower fracture risk, either by reducing bone resorption or by stimulating bone formation. Bisphosphonates are the most widely used anti-resorptives, reducing bone turnover markers to low premenopausal concentrations and reducing fracture rates (vertebral by 50–70%, non-vertebral by 20–30%, and hip by ~40%). Bisphosphonates bind avidly to bone mineral and have an offset of effect measured in months to years.

[Articles] Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21

Ve, 11/03/2022 - 01:30
The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics. In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic.

[Comment] Reflexivity, Cultural Safety, and improving the health of racially minoritised communities

Gi, 10/03/2022 - 01:30
In February, 2022, the NHS Race and Health Observatory published a robust review of the evidence on health-care inequalities among racially minoritised communities in the UK.1 This review covered mental health care, maternal and neonatal health care, digital inclusion and access to health-care services, genetic testing and genomic services, and inequalities in the UK National Health Service (NHS) workforce. It identified recurring themes, including inadequate ethnicity reporting and data on the experiences of minority ethnic groups and discrimination, and resultant delays in seeking care from health-care institutions due to fear of racism, as well as inadequate service provision and interpreter services.

[Comment] Reducing the risks of nuclear war to humanity

Sa, 05/03/2022 - 01:30
On Feb 27, 2022, Russia's President Vladimir Putin ordered Russian nuclear forces to be placed on “the special regime of combat duty”.1 This decision increased the alert status of Russian nuclear forces from a peacetime status to a pre-combat status, creating the legal conditions for any further instruction to launch missiles. Presumably Putin's move is intended to create fear and uncertainty, intensify pressure on Ukraine and the North Atlantic Treaty Organization (NATO) allies and partners, reduce resistance to Russian attacks in Ukraine, and extract concessions in negotiations.

[Comment] Racism in two UK global health institutions

Sa, 05/03/2022 - 01:30
Many people have been shocked by the racism evidenced in the February, 2022 independent review1,2 of the Liverpool School of Tropical Medicine (LSTM), Liverpool, UK, the oldest institute of global health in the world. The LSTM findings are strikingly similar to those of a 2021 independent review3,4 of the London School of Hygiene & Tropical Medicine (LSHTM), London, UK, a marginally younger, but substantially larger institute of global health. Dedicated almost exclusively to research in low-income and middle-income countries and related teaching, the institutes annually receive about £115 million (LSTM) and £180 million (LSHTM) in research grant income from various funding bodies, including UK Research and Innovation (UKRI), the Bill & Melinda Gates Foundation, and the Wellcome Trust.

[Comment] Gefapixant for chronic cough

Sa, 05/03/2022 - 01:00
Chronic cough is responsible for a decrease in quality of life. Chronic cough affects approximately 5–10% of the global population1,2 and might be complicated by incontinence, cough syncope, and dysphonia, leading to social embarrassment and subsequent social isolation and depression or anxiety.3,4 In some people, cough is associated with a treatable underlying disease such as allergic rhinitis, asthma, or gastro-oesophageal reflux disease. Many of these individuals might respond to treatments targeting the primary cause.

[Comment] Prioritise research on vaccines for pregnant and breastfeeding women

Sa, 05/03/2022 - 01:00
Pregnant women, their fetuses, and infants are at increased risk of severe disease and death from many vaccine-preventable diseases, including COVID-19.1,2 However, they are typically excluded from pre-implementation vaccine research aimed at generating robust data in support of evidence-informed decision making. This was initially the case with COVID-19 vaccines. In 2019, the PREVENT Working Group published 22 recommendations on how to include pregnant and breastfeeding women in vaccine research and implementation for emerging infections.

[Comment] The Lancet journals: our new ombudsperson

Sa, 05/03/2022 - 01:00
We are indebted to Professor Malcolm Molyneux, who served as Ombudsman to the Lancet group of journals from 2015, providing authoritative and wise advice during his tenure. After 6 years of service, Malcolm was to stand down at the end of 2021. On Nov 16, 2021, he died after an illness.1

[Comment] Offline: Ukraine and the lessons of Alexander Herzen

Sa, 05/03/2022 - 01:00
A pandemic. And now war. A war, the UK's Ukraine Ambassador wrote last week “on the whole of the civilised world”. The burden of war falls mostly on women and children. 10 million children younger than 5 years died in conflicts between 1995 and 2015. Women and children will now be dying from preventable causes in Ukraine. The health and humanitarian crisis afflicting Ukraine has received far too little attention. Consider those forcibly displaced. Although hard to predict, as many as 5 million people, up to three-quarters of whom will be women and children, are likely to become refugees.

[World Report] Ukrainian health workers respond to war

Sa, 05/03/2022 - 01:00
Ukraine's civilian health workers are having to postpone usual care and focus instead on treating casualties following Russia's invasion. Salehya Ahsan reports.

[World Report] Humanitarian work in Ukraine disrupted

Sa, 05/03/2022 - 01:00
The UN and aid agencies have halted operations amid worsening conflict, while the region prepares for huge numbers of displaced people. Sharmila Devi reports.

[World Report] International Women's Day: dismay at alcohol and arms ties

Sa, 05/03/2022 - 01:00
Health advocates are concerned at the corporate capture of International Women's Day, with the alcohol industry and arms manufacturers backing a popular website. Sophie Cousins reports.

[World Report] Activists welcome Colombia's decriminalisation of abortion

Sa, 05/03/2022 - 01:00
The ruling consolidates Latin America's swing towards pro-choice, following similar recent decisions in Argentina and Mexico. Amy Booth reports.

[Perspectives] Sally Grantham-McGregor: pioneer in early childhood development

Sa, 05/03/2022 - 01:00
“I can still be horrified by the poverty in the world and how it affects children's development”, says Sally Grantham-McGregor, Emeritus Professor of International Child Health at University College London (UCL), UK, and the doyenne of early childhood development (ECD). In pioneering work in Jamaica, she developed a low-cost early childhood intervention and showed that it can have long-term benefits for children. Now called Reach Up, it has been implemented in 16 countries, with several, including China and Peru, rolling it out as a national programme.