The Lancet

Condividi contenuti
The Lancet RSS feed.
Aggiornato: 5 ore 34 sec fa

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
Watts G. Gwynifer Clare Wenger. Lancet 2021; 398: 1562—In this Obituary, Richard Hadley has been corrected to Roger Hadley in the final sentence. This correction has been made to the online version as of Nov 25, 2021.

[Department of Error] Department of Error

Sa, 27/11/2021 - 00:00
Abu Dayyeh BK, Maselli DB, Rapaka B, et al. Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet 2021; 398: 1965–73—In this Article, where missing, 95% CIs, SDs, and n/N have been added. Additionally, findings for alanine aminotransferase concentrations have been added to the Results. These corrections have been made to the online version as of Nov 25, 2021, and the printed version is correct.

[Clinical Picture] Unexplained uterine atrophy following neoadjuvant chemotherapy in fertility sparing management of cervical cancer

Sa, 27/11/2021 - 00:00
A 31-year-old nulliparous woman attended our hospital for treatment of squamous cell carcinoma of the cervix. She had previously presented with vaginal bleeding and a 28 mm lesion had been found on clinical examination and shown on MRI. We aimed to adopt a fertility sparing strategy—neoadjuvant chemotherapy followed by conservative surgery of the body of the uterus—since biopsy samples of both pelvic sentinel lymph nodes showed no signs of metastatic spread.

[Perspectives] 2021 Global Health Film Festival: platform for change

Gi, 25/11/2021 - 00:30
The 20th-century political philosopher Hannah Arendt understood the power of storytelling. “No philosophy, no analysis, no aphorism, be it ever so profound, can compare in intensity and richness of meaning with a properly narrated story”, she wrote in her essay collection Men in Dark Times. Small wonder, Arendt observed, that in totalitarian states, artists, intellectuals, and writers are some of the first individuals to be silenced. For stories that captivate people's hearts and minds may galvanise them into subversive action.

[Editorial] Afghanistan: the international community must act

Sa, 20/11/2021 - 00:00
“It is going to be hell on Earth.” Afghanistan is set to become the world's worst humanitarian crisis according to David Beasley, head of the World Food Programme. Nearly half of Afghans need humanitarian aid. 22·8 million people could face acute hunger this winter, with 8·7 million at emergency levels of food insecurity. A resulting refugee crisis is likely to affect Afghanistan, the region, and the rest of the world. In desperation, people are selling their assets, and some are resorting to child labour and child marriage.

[Comment] Offline: The flies of our remorse

Sa, 20/11/2021 - 00:00
Eugene Richardson's Epidemic Illusions (2020) is subtitled On the Coloniality of Global Public Health. Although listed as the book's author, he prefers to describe himself as “a single node in a vast, interconnected net of support, mentoring, toleration, encouragement, inspiration, and generosity”. He lists over 140 “other nodes”—individuals, organisations, and groups—to whom he owes a debt, with “the twin goals of epistemic reconstitution and improvement of human well-being”. Although not a handbook explaining how to decolonise medicine and global health, Richardson has delivered what may be the first attempt to explore what decolonisation might achieve.

[World Report] Brazilian scientists reject national award

Sa, 20/11/2021 - 00:00
21 scientists have rejected one of Brazil's highest scientific honours, after President Bolsonaro vetoed two recipients. Lise Alves reports from São Paulo.

[World Report] Legal challenges threaten Biden's COVID-19 vaccine rule

Sa, 20/11/2021 - 00:00
Critics want to block a safety rule requiring employees of large companies to get vaccinated or be tested weekly for COVID-19 and wear masks. Susan Jaffe reports from Washington, DC.

[World Report] mRNA discoveries earn the 2021 Prince Mahidol Award

Sa, 20/11/2021 - 00:00
Katalin Karikó, Drew Weissman, and Pieter Cullis have been recognised for their work that led to the development of COVID-19 vaccines. Talha Burki reports.

[Perspectives] Helen Milroy: pioneer in Indigenous and child mental health

Sa, 20/11/2021 - 00:00
In 1983, Helen Milroy became Australia's first Indigenous doctor to qualify medicine—a pivotal moment in the country's history. She never envisioned being a trailblazer, but her list of firsts in Australia includes being the first Indigenous psychiatrist and the first Indigenous Commissioner to the Australian Football League. Reflecting today as the Stan Perron Chair of Child and Adolescent Psychiatry at Perth Children's Hospital and the University of Western Australia (UWA) and the Co-Director of Embrace at Telethon Kids Institute, she says: “My passion is to make sure we get the best wellbeing and mental health outcomes for our kids right across Australia.” Pat Dudgeon, Professor of Indigenous Psychology at UWA, recognises her contribution to strengthening support services for children's mental health, and comments: “Helen has created a bridge between Aboriginal and mainstream mental health and understandings.

[Perspectives] Readiness for mammography and artificial intelligence

Sa, 20/11/2021 - 00:00
One area that has attracted great attention for the use of deep learning artificial intelligence (AI) in health care is medical imaging, especially mammography. Many initial AI studies proclaimed remarkable improvement in accuracy over the performance of radiologists, but a recent systematic review highlighted there is insufficient scientific evidence to support such findings. The UK National Screening Committee commissioned Freeman and colleagues to review the quality and results of studies that assessed the accuracy of AI algorithms, alone or in combination with radiologists, to detect cancer in digital mammograms; 34 of 36 AI systems evaluated were less accurate than a single radiologist, and all were less accurate than the consensus of two or more radiologists.

[Perspectives] Medicine, magic, and online performance

Sa, 20/11/2021 - 00:00
COVID-19 has transformed clinical practice; online consultation has become a daily reality for many doctors and clinicians have had to rethink what it means to perform. Patient-centred consulting requires the integration of knowledge, technical skill, and expert communication. This integration is partly achieved through performance. Yet clinical work is seldom framed in such terms within mainstream clinical curriculums. As part of the Royal College of Music–Imperial College London Centre for Performance Science, UK, our interdisciplinary research group investigates how skilled performers from diverse fields meet the complex challenges of their work, and what they can learn from one another.

[Obituary] Mortimer Mishkin

Sa, 20/11/2021 - 00:00
Pioneer neuroscientist who researched neurobiological mechanisms of perception and memory. He was born in Fitchburg, MA, USA, on Dec 13, 1926, and died in Bethesda, MD, USA, on Oct 2, 2021, aged 94 years.

[Correspondence] COVID-19: stigmatising the unvaccinated is not justified

Sa, 20/11/2021 - 00:00
In the USA and Germany, high-level officials have used the term pandemic of the unvaccinated, suggesting that people who have been vaccinated are not relevant in the epidemiology of COVID-19. Officials’ use of this phrase might have encouraged one scientist to claim that “the unvaccinated threaten the vaccinated for COVID-19”.1 But this view is far too simple.

[Correspondence] Long-term effects on survivors with COVID-19

Sa, 20/11/2021 - 00:00
Lixue Huang and colleagues1 reported that patients discharged from hospital with COVID-19 showed good physical and functional recovery 1 year after symptom onset. Because of several concerns with the methods, we contend that the findings should be interpreted cautiously.

[Correspondence] Long-term effects on survivors with COVID-19

Sa, 20/11/2021 - 00:00
The conditions that linger after recovery from COVID-19 are commonly referred to as the long-term effects of COVID-19 (long COVID). The risk for sequelae varies according to the severity of the initial acute SARS-CoV-2 infection.1

[Correspondence] Long-term effects on survivors with COVID-19 – Authors' reply

Sa, 20/11/2021 - 00:00
Yan-Jie Zhao and colleagues and Chengliang Yang and colleagues all recommend specific questionnaires to evaluate depression and anxiety symptoms in hospital survivors with COVID-19 1 year after onset.1 We agree that the professional questionnaires could provide the actual prevalence of psychiatric symptoms. However, these questionnaires are somewhat complex and time-consuming. It is challenging to integrate all these assessments into our follow-up study.1 The EuroQol five-dimension five-level (EQ-5D-5L) questionnaire is commonly used to assess the quality of life from five domains in clinical studies.

[Correspondence] CoronaVac efficacy data from Turkey

Sa, 20/11/2021 - 00:00
Mine Tanriover and colleagues1 report that the efficacy of CoronaVac against laboratory-confirmed symptomatic COVID-19 in a trial in Turkey is 83·5% (95% CI 65·4–92·1). By contrast, the efficacy of CoronaVac against symptomatic COVID-19 has been estimated at 50·7% (36·0–62·0) in a Brazilian trial and at 65·3% (20·0–85·1) in an Indonesian trial.2,3 Noting that post-vaccination neutralising antibody titres are quite strongly associated with vaccine efficacy against symptomatic infection,4,5 the efficacy estimated from the Turkish dataset is much higher than we would expect given the modest post-vaccination neutralising antibody titres after the second dose of CoronaVac.

[Correspondence] CoronaVac efficacy data from Turkey – Authors' reply

Sa, 20/11/2021 - 00:00
We thank Martina McMenamin and Benjamin Cowling for raising important issues on vaccine trials in the context of our Article.1 The work they refer to by Palacios and colleagues2 has not been published in a peer reviewed journal; thus we cannot comment on the accuracy or the comparability of its methods. The Indonesian trial data have been published,3 and although the main method of this study was similar to ours, the case definition of COVID-19 and the methods used for active surveillance were different.

[Department of Error] Department of Error

Sa, 20/11/2021 - 00:00
Sun J-M, Shen L, Shah MA, et al. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet 2021; 398: 759–71—The appendix of this Article has been corrected as of Nov 18, 2021.