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[Correspondence] Fetal dysanatrophy—a new discipline?

Sa, 16/04/2022 - 00:00
In response to the report on the Orwellian abuse of fetal imagery in current US legislative abjuration of termination of pregnancy services,1 and due to the increasing concern that we have lost our scientific focus in the understanding and management of fetal growth disorders, I propose a new discipline within that of fetomaternal medicine.

[Department of Error] Department of Error

Sa, 16/04/2022 - 00:00
COVID-19 Excess Mortality Collaborators. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21. Lancet 2022; 399: 1513–36—In this Article, Tanzania and Uganda should have been listed under eastern sub-Saharan Africa in the table. The totals for eastern sub-Saharan Africa correctly included Tanzania and Uganda in the original version and have not been changed. The uncertainty intervals for The Economist estimate of excess deaths in the Research in Context panel and Discussion section have been updated to 18·0 million (95% uncertainty interval 12·9–21·0).

[Department of Error] Department of Error

Sa, 16/04/2022 - 00:00
COVID-19 Forecasting Team. Variation in the COVID-19 infection–fatality ratio by age, time, and geography during the pre-vaccine era: a systematic analysis. Lancet 2022; 399: 1469–88—In this Article, Tanzania and Uganda should have been listed under eastern sub-Saharan Africa in table 2. The totals for eastern sub-Saharan Africa correctly inclxnzania and Uganda in the original version and have not been changed. These corrections have been made to the online version as of April 14, 2022, and the printed version is correct.

[Series] Management of common clinical problems experienced by survivors of cancer

Sa, 16/04/2022 - 00:00
Improvements in early detection and treatment have led to a growing prevalence of survivors of cancer worldwide. Models of care fail to address adequately the breadth of physical, psychosocial, and supportive care needs of those who survive cancer. In this Series paper, we summarise the evidence around the management of common clinical problems experienced by survivors of adult cancers and how to cover these issues in a consultation. Reviewing the patient's history of cancer and treatments highlights potential long-term or late effects to consider, and recommended surveillance for recurrence.

[Series] Improved models of care for cancer survivors

Sa, 16/04/2022 - 00:00
The number of survivors of cancer is increasing substantially. Current models of care are unsustainable and fail to address the many unmet needs of survivors of cancer. Numerous trials have investigated alternate models of care, including models led by primary-care providers, care shared between oncology specialists and primary-care providers, and care led by oncology nurses. These alternate models appear to be at least as effective as specialist-led care and are applicable to many survivors of cancer.

[Series] Long-term care for people treated for cancer during childhood and adolescence

Sa, 16/04/2022 - 00:00
Worldwide advances in treatment and supportive care for children and adolescents with cancer have resulted in a increasing population of survivors growing into adulthood. Yet, this population is at very high risk of late occurring health problems, including significant morbidity and early mortality. Unique barriers to high-quality care for this group include knowledge gaps among both providers and survivors as well as fragmented health-care delivery during the transition from paediatric to adult care settings.

[Comment] Improving diversity in global health governing boards

Ve, 15/04/2022 - 00:30
Using available and openly accessible data, the Global Health 50/50 initiative, a UK-based publicly funded charitable organisation, aims to inform and drive action through regular monitoring of progress towards gender parity. The fifth annual Global Health 50/50 report, Boards for All?, spotlights the diversity—or lack thereof—of 146 governing boards in organisations active in global health.1 The organisations that Global Health 50/50 reviews include UN agencies, bilateral funders, charities, private sector companies, and non-governmental organisations (NGOs).

[Comment] Tranexamic acid for trauma in the USA: is prejudice a barrier to saving lives?

Gi, 14/04/2022 - 00:30
The CRASH-2 clinical trial results were published in June, 2010.1,2 Our global collaboration had randomly allocated 20 211 trauma patients from 274 hospitals in 40 countries to receive tranexamic acid, an antifibrinolytic agent to prevent or reduce bleeding, or placebo. Timely tranexamic acid treatment reduced bleeding deaths by nearly one third and without any side-effects.1,2 We estimated that widespread use of tranexamic acid could prevent more than 120 000 trauma deaths each year worldwide, with 3500 deaths avoided each year in the USA.

[Department of Error] Department of Error

Gi, 14/04/2022 - 00:30
Han X, Li J, Chen Y, Li Y, Xu Y, Ying B, Shang H. SARS-CoV-2 nucleic acid testing is China's key pillar of COVID-19 containment. Lancet 2022; published online April 7. https://doi.org/10.1016/S0140-6736(22)00577-3—In this Correspondence, the authors' competing interests statement should have declared that HS is director of the National Clinical Research Center for Laboratory Medicine, which provides technical support for the national strategy of COVID-19 testing, and that all other authors declare no competing interests.

[Comment] Preventing enterovirus A71 disease: another promising vaccine for children

Me, 13/04/2022 - 00:30
Enterovirus A71 (EV71) is a cause of large outbreaks of hand, foot, and mouth disease (HFMD) in children and is associated with severe neurological manifestations, including brainstem encephalitis, which can lead to fatal non-cardiogenic pulmonary oedema and acute flaccid myelitis with potential permanent paralysis.1 Sporadic outbreaks of EV71 have occurred worldwide since its discovery in 1969, while regular cyclical epidemics have plagued the Asia-Pacific region, including Japan, China, Malaysia, Taiwan, Singapore, South Korea, and Vietnam, over the past several decades.

[Articles] Efficacy, safety, and immunogenicity of an inactivated, adjuvanted enterovirus 71 vaccine in infants and children: a multiregion, double-blind, randomised, placebo-controlled, phase 3 trial

Me, 13/04/2022 - 00:30
EV71vac is safe, well-tolerated, and highly effective in preventing EV71 associated diseases in children aged 2–71 months.

[Correspondence] Caring for Ukrainian refugee children with acute and chronic diseases

Ma, 12/04/2022 - 00:30
Care for the increasing number of refugees from Ukraine is both a priority and a challenge for state authorities, social workers, and private initiatives. By March 29, 2022, more than 2·34 million refugees from Ukraine had crossed into Poland, most of them women and children.1 European countries must help prevent additional human catastrophes.

[Correspondence] What comes next in the COVID-19 pandemic?

Ma, 12/04/2022 - 00:30
The COVID-19 pandemic is not over, but with collaboration and solidarity, we can transition to a manageable endemic disease state sooner and better mitigate the most severe health and socioeconomic impacts. In this third year of pandemic response, society needs to focus on improved implementation of effective interventions to end the acute phase. Governments and health authorities have the necessary knowledge and tools in hand, in the form of vaccines, diagnostics, and therapeutics, but equitable availability of these tools remains a challenge globally.

[Comment] Triplet therapy for prostate cancer

Sa, 09/04/2022 - 00:30
The past 8 years have seen four agents shown to be superior to androgen deprivation therapy (ADT) alone in terms of overall survival when given as doublet therapy with ADT for metastatic castration-sensitive prostate cancer.1–7 In The Lancet, Karim Fizazi and colleagues8 report the findings from the PEACE-1 trial, which provides evidence in support of triplet therapy for metastatic castration-sensitive prostate cancer. The trial enrolled 1173 male patients (aged ≥18 years, across Belgium, France, Ireland, Italy, Romania, Spain, and Switzerland) with synchronous (de novo) metastatic hormone-sensitive prostate cancer who received ADT (plus docetaxel in 60% of patients) as standard of care alone, or standard of care with the addition of abiraterone plus prednisone (hereafter referred to as abiraterone), radiotherapy to the primary tumour, or abiraterone plus radiotherapy, in a randomised 2 × 2 factorial design.

[Articles] Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design

Sa, 09/04/2022 - 00:30
Combining androgen deprivation therapy, docetaxel, and abiraterone in de novo metastatic castration-sensitive prostate cancer improved overall survival and radiographic progression-free survival with a modest increase in toxicity, mostly hypertension. This triplet therapy could become a standard of care for these patients.

[Editorial] The Ockenden review and women's health in the UK

Sa, 09/04/2022 - 00:00
“I had a terrible experience…I felt frightened and not listened to…”

[Comment] Offline: Ukraine—difficult lessons for global health

Sa, 09/04/2022 - 00:00
It is easy to condemn Russia for its criminal war against Ukraine. For its attacks on health workers and hospitals. For its violations of international humanitarian law. For its acts of murderous cruelty against civilians. For increasing the risks of a nuclear conflagration. It is right to call for an immediate ceasefire and the withdrawal of Russian forces from Ukraine. To accelerate the delivery of humanitarian aid. To provide safe haven for refugees. To document atrocities and to counter disinformation.

[World Report] Ockenden report a “watershed moment”

Sa, 09/04/2022 - 00:00
A damning review into maternity services at Shrewsbury and Telford Hospital NHS Trust, calling for immediate essential changes, has been welcomed. Jacqui Thornton reports.

[World Report] WHO sexual abuse allegations: 6 months on

Sa, 09/04/2022 - 00:00
Udani Samarasekera looks at what has been done following a critical report into sexual abuse and exploitation during WHO's response to Ebola in DR Congo.

[World Report] The Canada Gairdner Awards 2022

Sa, 09/04/2022 - 00:00
This year's Gairdner prizes have been earned for work on mRNA vaccines, fetal haemoglobin, leukaemia, critical care medicine, and newborn, child, and maternal health. Talha Burki reports.