Mise à jour le : 07-02-2012
Les derniers abstracts de la revue The Lancet : |
Date de mise en ligne : Samedi 04 février 2012
The Lancet
[This Week in Medicine] February 4?10, 2012
Leading influenza researchers have agreed to a voluntary 60-day pause on controversial research involving mutant H5N1 virus strains that are transmissible in mammals. In an announcement on Jan 20, the scientists said the hiatus will allow time for governments, organisations, and the scientific community to discuss potential safety concerns.
Date de mise en ligne : Samedi 04 février 2012
The Lancet
[Editorial] New estimates of malaria deaths: concern and opportunity
This week we publish surprising and, on the face of it, disturbing findings. According to Christopher Murray and colleagues at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, there were 1·24 million deaths (95% uncertainty interval 0·93?1·69 million) from malaria worldwide in 2010?around twice the figure of 655?000 estimated by WHO for the same year. How should the malaria community interpret this finding? Before we answer that question, we need to look beneath the surface of this striking overall mortality figure.
Date de mise en ligne : Samedi 04 février 2012
The Lancet
[Editorial] Genomic medicine and the NHS: it is possible
An independent advisory group has urged the UK Government to integrate genomic medicine into the National Health Service (NHS). The Human Genomics Strategy Group (HGSG), established in 2010 after a House of Lords inquiry into genomic medicine, set out their recommendations in a report published on Jan 25. First, the group proposed that the government outline a policy for expansion of genomic technology in the NHS; HGSG emphasised that commissioning of cost-effectiveness studies will be a necessary step.
Date de mise en ligne : Samedi 04 février 2012
The Lancet
[Editorial] Keeping patients safe
In July, 2011, the UK's medical regulator, the General Medical Council (GMC), was told by the Commons Health Select Committee to send a ?clear signal? to doctors that they were failing in their duties if they did not report concerns about patients' safety. That signal has now come in Raising and acting on concerns about patient safety?new GMC guidance published on Jan 26, which advises doctors about the best ways to alert employers and health-care regulators about poor quality care.
Date de mise en ligne : Samedi 04 février 2012
Allyson M Pollock, David Price, Peter Roderick, Tim Treuherz, David McCoy, Martin McKee, Lucy Reynolds
[Comment] How the Health and Social Care Bill 2011 would end entitlement to comprehensive health care in England
The National Health Service (NHS) in England has been a leading international model of tax-financed, universal health care. Legal analysis shows that the Health and Social Care Bill currently making its way through the UK Parliament would abolish that model and pave the way for the introduction of a US-style health system by eroding entitlement to equality of health-care provision. The Bill severs the duty of the Secretary of State for Health to secure comprehensive health care throughout England and introduces competitive markets and structures consistent with greater inequality of provision, mixed funding, and widespread provision by private health corporations.
Date de mise en ligne : Samedi 04 février 2012
Carlo Palmieri, Alison Jones
[Comment] The 2011 EBCTCG polychemotherapy overview
In The Lancet, the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) report meta-analyses of outcomes in 100?000 women with early breast cancer in more than 100 trials of adjuvant chemotherapy, which include the first EBCTCG meta-analyses of adjuvant taxane treatment. This study comes 35 years after the first report of the benefit of adjuvant chemotherapy, and is the 16th publication in the group's 28-year history of bringing together individual patient data from all randomised trials worldwide.
Date de mise en ligne : Samedi 04 février 2012
Lucy C Thompson, Christopher Gillberg
[Comment] Behavioural problems from perinatal and neonatal insults
The nature, scale, and interactions of behavioural disorders after neonatal and perinatal insults, including preterm birth and infectious diseases, are not well understood. In The Lancet, Michael Mwaniki and colleagues present a broad systematic review of the type and probability of development of a range of neurodevelopmental sequelae, in which they have included 153 research studies and 22?161 liveborn children. The authors report a very high overall prevalence of at least one deficit in any domain (median risk 39·4%, IQR 20·0?54·8%).
Date de mise en ligne : Samedi 04 février 2012
Robert O Bonow
[Comment] What's past is prologue: advances in cardiovascular imaging
?The rapid advances in cardiology during the first half of the 20th century may be fairly ascribed to the introduction of new techniques.?Paul Wood, 1951
Date de mise en ligne : Samedi 04 février 2012
Thomas Fletcher
[Comment] Born to be wild?
Antisocial behaviour in adolescence can be associated with ill health in the form of self-harm, drug abuse, and mental disorders, and may presage criminal activity later in life. This is a worldwide problem with far-reaching social and economic implications, for individuals as well as for society as a whole.
Date de mise en ligne : Samedi 04 février 2012
Richard Horton
[Comment] Offline: Small acts of kindness
Seen on a plate somewhere in Italy. Brains. Quite a delicacy. Not a chance.
Date de mise en ligne : Samedi 04 février 2012
Frank JM van Kuppeveld, Jos WM van der Meer
[Comment] XMRV and CFS?the sad end of a story
Scientific papers on chronic fatigue syndrome (CFS) often evoke much debate and emotional reaction, as exemplified by the recent discussions in The Lancet on the PACE trial. Also, the potential role of a retrovirus in CFS kindled a fierce controversy which has recently culminated. In 2009, in Science, Lombardi and colleagues described the occurrence of the xenotropic murine leukaemia virus (MLV)-related virus (XMRV), a gammaretrovirus, in white blood cells in 67% of patients with CFS and in 3·7% of healthy controls.
Date de mise en ligne : Samedi 04 février 2012
Shu-Yu Lyu, Lien-Wen Su, Yi-Ming Arthur Chen
[Comment] Effects of education on harm-reduction programmes
Harm-reduction programmes are remarkably successful in controlling HIV in injecting drug users worldwide, but more effort is needed to prevent even more HIV infections in this group. Recent reviews individual behavioural approaches, and medical treatment and care. Still, little is known about evidence-based educational intervention effects of harm-reduction programmes for injecting drug users.
Date de mise en ligne : Samedi 04 février 2012
Amy Yee
[World Report] Regulation failing to keep up with India's trials boom
Ethical violations in clinical trials in India have exposed gaping holes in the country's regulatory system, which has struggled to oversee the booming industry. Amy Yee reports from New Delhi.
Date de mise en ligne : Samedi 04 février 2012
David Holmes
[World Report] NICE epilepsy guidance ?may be detrimental to patient care?
New NICE guidelines on epilepsies have come under fire by several experts who say that they do not reflect clinical experience and focus too much on drug cost effectiveness. David Holmes reports.
Date de mise en ligne : Samedi 04 février 2012
Gonçalo Figueiredo Augusto
[World Report] Cuts in Portugal's NHS could compromise care
Portugal's debt crisis is forcing hospital closures and hasty reform of the National Health Service, causing some observers to raise concerns about patient care. Gonçalo Figueiredo Augusto reports.
Date de mise en ligne : Samedi 04 février 2012
George J Annas
[Perspectives] America's plague of incarceration
Arriving at Washington DC's Reagan National airport last year, I, like other visitors, was greeted with large signs featuring the Statue of Liberty and the words: ?Welcome to America, home to 5% of the world's people and 25% of the world's prisoners.? The posters were produced by the National Association for the Advancement of Colored People (NAACP) to help publicise their ?Misplaced Priority: Over Incarcerate, Under Educate? campaign.
Date de mise en ligne : Samedi 04 février 2012
Desmond O'Neill
[Perspectives] The sound of silence
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60176-7/fulltext?rss=yes
Date de mise en ligne : Samedi 04 février 2012
Tony Kirby
[Perspectives] Joseph Lau: mastering the meta-analysis
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60177-9/fulltext?rss=yes
Date de mise en ligne : Samedi 04 février 2012
Ruth Richardson
[Perspectives] Charles Dickens, The Lancet, and Oliver Twist
The place that for many years served London's Middlesex Hospital as its Outpatient Department is not a beautiful building. Yet it's the oldest element of that great London hospital still standing on Cleveland Street, diagonally across from the vast field the institution used to fill, now sadly strewn with dust and broken bricks. This building has recently been the subject of a very public tussle: the owner intent on its replacement by a huge apartment block; locals and others (myself among them) equally determined to preserve it.
Date de mise en ligne : Samedi 04 février 2012
Alison Snyder
[Obituary] Thomas E Bryant
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60179-2/fulltext?rss=yes
Date de mise en ligne : Samedi 04 février 2012
Claire M Slater, Alexander C Ford
[Correspondence] Treatment of Helicobacter pylori in Latin America
Robert Greenberg and colleagues (Aug 6, p 507) are to be commended for doing a mass screening and treatment trial for Helicobacter pylori in the general population of Latin America. There is evidence to suggest that population screening and treatment can reduce the incidence of gastric cancer and lessen the economic burden from dyspepsia. However, we are not sure that Greenberg and colleagues' conclusion that 14-day triple therapy is preferable to 5-day concomitant therapy in this setting is warranted.
Date de mise en ligne : Samedi 04 février 2012
Luigi Gatta, Nimish Vakil, Dino Vaira
[Correspondence] Treatment of Helicobacter pylori in Latin America
Robert Greenberg and colleagues found that, in seven Latin American sites, the probability of Helicobacter pylori eradication with triple therapy lasting 14 days (TT-14) was 82·2%, which was 8·6% higher than with concomitant therapy lasting 5 days (CT-5) and 5·6% higher than with sequential therapy (ST). However, these data deserve further analysis.
Date de mise en ligne : Samedi 04 février 2012
David Y Graham, Alba A Trespalacios
[Correspondence] Treatment of Helicobacter pylori in Latin America
In their multisite study, Robert Greenberg and colleagues attempted to identify a reliably effective treatment for Helicobacter pylori for use in Latin America. Each study site used locally available drugs and the regimens all contained clarithromycin or clarithromycin?metronidazole, despite the unacceptably low success of triple therapies elsewhere and a high expected prevalence of metronidazole resistance. The success of treatments for infectious diseases is mainly related to the absence of antimicrobial resistance and is predictable if one knows the pattern of resistance and the effect of resistance on the regimens tested.
Date de mise en ligne : Samedi 04 février 2012
E Robert Greenberg, Garnet L Anderson, Douglas R Morgan, Javier Torres, William D Chey, for the SWOG H pylori Eradication Trial investigators
[Correspondence] Treatment of Helicobacter pylori in Latin America ? Authors' reply
Claire Slater and Alexander Ford note that all three treatments compared in our trial achieved eradication probabilities similar to those reported from previous community-based programmes of Helicobacter pylori screening and treatment and that the less-expensive concomitant regimen might be preferable to the more effective, but more costly, triple therapy regimen in a low-resource environment. We agree with both of these points and said as much in our report. The purchase price of the three regimens varied widely between the seven study sites, with a range of US$12?120 for 14-day triple therapy, $7?56 for 10-day sequential therapy, and $6?44 for 5-day concomitant therapy.
Date de mise en ligne : Samedi 04 février 2012
Asmat Ullah Malik, Moazzam Khalil, Anar Ulikpan, Ahsan Maqbool Ahmad
[Correspondence] A tale of devolution, abolition, and performance
Sania Nishtar and Ahmed Mehboob (Aug 20, p 648) make a convincing case for retaining a federal institution to take care of national responsibilities in health in Pakistan. Despite the technical appeal of alternative options, the most striking feature of this debate is the low level of response from stakeholders to the threatened abolition of the Ministry of Health, compared with the vigorous backlash against the proposed devolution of the Higher Education Commission.
Date de mise en ligne : Samedi 04 février 2012
Sunita Dodani, Rashid A Chotani
[Correspondence] A tale of devolution, abolition, and performance
Sania Nishtar and Ahmed Mehboob's discussion of the abolition of the Health Ministry in Pakistan raises the question of whether the health care problems in Pakistan could be solved by such a move.
Date de mise en ligne : Samedi 04 février 2012
Sabeena Jalal
[Correspondence] Improving health: can Pakistan prioritise?
Pakistan lags far behind in meeting the Millennium Development Goals. Neonatal mortality is responsible for 57% of all deaths in children younger than 5 years in the country, and Pakistan has the highest neonatal mortality rate in the region. The under-5 mortality rate has decreased by 24% since 1990. However, both rates have remained more or less static in the poorest income quintile. With the devolution of the Ministry of Health last year, Pakistan faces the challenge of developing the much needed provincial infrastructure that would integrate the comprehensive efforts of various stakeholders in promoting better health outcomes.
Date de mise en ligne : Samedi 04 février 2012
Janet Voûte, Anne Heughan, Jorge Casimiro
[Correspondence] Non-communicable diseases and the food and beverage industry
The International Food & Beverage Alliance (IFBA) includes ten global food and non-alcoholic beverage manufacturers (Coca-Cola Company, Ferrero, General Mills, Grupo Bimbo, Kellogg's, Kraft Foods, Mars, Nestlé, PepsiCo, and Unilever). Although we cannot speak for the entire food and non-alcoholic beverage industry, nor any other industry, our member companies support initiatives to address the global non-communicable disease (NCD) problem and commend the UN for bringing global attention to this issue, particularly in developing countries.
Date de mise en ligne : Samedi 04 février 2012
Kenneth A Fleming, Denise Best
[Correspondence] The Integrated Academic Training programme at Oxford
In 2006, the Integrated Academic Training programme was initiated in the UK as a result of the Walport report on the crisis of decreasing clinical academic numbers. In Oxford, we decided that the most effective way to manage the programme would be to create a dedicated Oxford University Clinical Academic Graduate School ( OUCAGS). We wish to highlight both some advantages of this approach and challenges within the overall programme.
Date de mise en ligne : Samedi 04 février 2012
Sai Kit Lam, Donald Burke, Duane Gubler, Jorge Méndez-Gálvan, Laurent Thomas
[Correspondence] Call for a World Dengue Day
Dengue fever is a mosquito-borne disease caused by dengue viruses?members of the family Flaviviridae. Severe forms of dengue infection can be fatal and are a leading cause of hospital admission in many parts of the world, placing tremendous pressure on medical resources and having a heavy economic and societal effect. There has been a 30-fold increase in the number of dengue cases over the past 50 years. Recent studies estimate 50?100 million infections each year, although, owing to under-reporting, this figure could be even higher.
Date de mise en ligne : Samedi 04 février 2012
Francois G Brivet
[Correspondence] Editorial code of conduct
In his Correspondence (Nov 5, p 1626), Syed Wamique Yusuf reports the fact that, after acceptance and revision of the proofs, one of his case reports was deemed no longer suitable for publication when he did not comply with the obligatory subscription to the journal.
Date de mise en ligne : Samedi 04 février 2012
Elizabeth Wager
[Correspondence] Editorial code of conduct
I fully agree with Syed Wamique Yusuf that the governance of journals should be taken seriously. This is one of the functions of the Committee on Publication Ethics ( COPE). Since 2003, COPE has promoted a Code of Conduct among our members (which now number almost 7000 journal editors worldwide). If anybody feels that a member has not followed this code, they can bring a complaint against them which COPE will consider. The code states that journals should ?preclude business needs from compromising intellectual standards? and goes on to state that ?editors should make decisions on which articles to publish based on quality and suitability for readers rather than for immediate financial or political gain?.
Date de mise en ligne : Samedi 04 février 2012
Dev Kevat, Fiona Lander, Bebe Loff
[Correspondence] The growing threat to medical independence in conflict zones
Your Editorial ?Torture in Syria's hospitals? (Nov 5, p 1606) relays the allegation of Amnesty International's report that patients in state-run hospitals were being targeted and tortured by authorities to ?quell dissent?. The undermining of the independence and work of medical personnel has unfortunately been a theme of recent conflicts.
Date de mise en ligne : Samedi 04 février 2012
José Baddini Martinez, Adriana Ignacio de Padua
[Correspondence] McCoy's syndrome: a new medical entity
A 40-year-old woman was sent to our service for a bronchoscopy owing to multiple interstitial pulmonary infiltrates. She complained of a dry cough, dyspnoea, and wheezing of 4 months' duration. She also reported bronchospasm episodes in childhood. The patient had already been seen by three different clinicians and brought with her several test results, including a thorax CT. She had been treated with antibiotics, bronchodilators, and steroids, without improvement.
Date de mise en ligne : Samedi 04 février 2012
The Lancet
[Department of Error] Department of Error
Abraham WT, Adamson PB, Bourge RC, et al. Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial. Lancet 2011; 377: 658?66?In this Article (Feb 19), the first sentence of the fifth paragraph in the Statistical analysis section on page 661 should have started: ?Prespecified supplementary analyses were heart-failure-related hospitalisations during the entire randomised follow-up (Andersen-Gill model)?? Additionally, during internal auditing of this study in preparation for data presentation to regulatory authorities, a small number of unreported events were uncovered.
Date de mise en ligne : Samedi 04 février 2012
The Lancet
[Department of Error] Department of Error
Glazener C, Boachie C, Buckley B, et al. Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trials. Lancet 2011; 378: 328?37?This Article (July 23) should have contained the following conflicts of interest statement: ?BB has received travel expenses from Astellas, Medtronic, and Pfizer. All other authors declare no conflicts of interest?. This correction has been made to the online version as of Feb 3, 2012.
Date de mise en ligne : Samedi 04 février 2012
Christopher JL Murray, Lisa C Rosenfeld, Stephen S Lim, Kathryn G Andrews, Kyle J Foreman, Diana Haring, Nancy Fullman, Mohsen Naghavi, Rafael Lozano, Alan D Lopez
[Articles] Global malaria mortality between 1980 and 2010: a systematic analysis
Our findings show that the malaria mortality burden is larger than previously estimated, especially in adults. There has been a rapid decrease in malaria mortality in Africa because of the scaling up of control activities supported by international donors. Donor support, however, needs to be increased if malaria elimination and eradication and broader health and development goals are to be met.
Date de mise en ligne : Samedi 04 février 2012
Early Breast Cancer Trialists' Collaborative Group (EBCTCG)
[Articles] Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100?000 women in 123 randomised trials
10-year gains from a one-third breast cancer mortality reduction depend on absolute risks without chemotherapy (which, for oestrogen-receptor-positive disease, are the risks remaining with appropriate endocrine therapy). Low absolute risk implies low absolute benefit, but information was lacking about tumour gene expression markers or quantitative immunohistochemistry that might help to predict risk, chemosensitivity, or both.
Date de mise en ligne : Samedi 04 février 2012
Michael K Mwaniki, Maurine Atieno, Joy E Lawn, Charles RJC Newton
[Articles] Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic review
Intrauterine and neonatal insults have a high risk of causing substantial long-term neurological morbidity. Comparable cohort studies in resource-poor regions should be done to properly assess the burden of these conditions, and long-term outcomes, such as chronic disease, and to inform policy and programme investments.
Date de mise en ligne : Samedi 04 février 2012
John P Greenwood, Neil Maredia, John F Younger, Julia M Brown, Jane Nixon, Colin C Everett, Petra Bijsterveld, John P Ridgway, Aleksandra Radjenovic, Catherine J Dickinson, Stephen G Ball, Sven Plein
[Articles] Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial
CE-MARC is the largest, prospective, real world evaluation of CMR and has established CMR's high diagnostic accuracy in coronary heart disease and CMR's superiority over SPECT. It should be adopted more widely than at present for the investigation of coronary heart disease.
Date de mise en ligne : Samedi 04 février 2012
Gerold Stanek, Gary P Wormser, Jeremy Gray, Franc Strle
[Seminar] Lyme borreliosis
Lyme borreliosis (Lyme disease) is caused by spirochaetes of the Borrelia burgdorferi sensu lato species complex, which are transmitted by ticks. The most common clinical manifestation is erythema migrans, which eventually resolves, even without antibiotic treatment. However, the infecting pathogen can spread to other tissues and organs, causing more severe manifestations that can involve a patient's skin, nervous system, joints, or heart. The incidence of this disease is increasing in many countries.
Date de mise en ligne : Samedi 04 février 2012
Hilary Longhurst, Marco Cicardi
[Seminar] Hereditary angio-oedema
Hereditary angio-oedema is caused by a heterozygous deficiency of C1 inhibitor. This inhibitor regulates several inflammatory pathways, and patients with hereditary angio-oedema have intermittent cutaneous or mucosal swellings because of a failure to control local production of bradykinin. Swellings typically evolve in several hours and persist for a few days. In addition to orofacial angio-oedema, painless swellings affect peripheries, which causes disfigurement or interference with work and other activities of daily living.
Date de mise en ligne : Samedi 04 février 2012
Federico Balagué, Anne F Mannion, Ferran Pellisé, Christine Cedraschi
[Seminar] Non-specific low back pain
Non-specific low back pain has become a major public health problem worldwide. The lifetime prevalence of low back pain is reported to be as high as 84%, and the prevalence of chronic low back pain is about 23%, with 11?12% of the population being disabled by low back pain. Mechanical factors, such as lifting and carrying, probably do not have a major pathogenic role, but genetic constitution is important. History taking and clinical examination are included in most diagnostic guidelines, but the use of clinical imaging for diagnosis should be restricted.
Date de mise en ligne : Samedi 04 février 2012
Deepak Arumugam, John J Atherton, Paul T Martin
[Case Report] A lethal injection?
In October, 2010, a 29-year-old man initially presented to a primary care clinic with fevers, sore throat, and odynophagia, and was treated with oral phenoxymethylpenicillin 250 mg four times daily for tonsillitis. He re-presented 72 h later with persisting symptoms and fever of 38·4°C, and was administered 1?000?000 units of intramuscular procaine benzylpenicillin. 4?5 min later, he collapsed with no cardiac output, and cardiopulmonary resuscitation was commenced. Paramedic staff arrived within 20 min and monitoring showed ventricular fibrillation.