Mise à jour le : 01-05-2017
Les derniers abstracts de la revue The Lancet : |
Date de mise en ligne : Samedi 29 avril 2017
The Lancet
[Editorial] A hundred days: what is to show for it?
The first 100 days of a presidency are often taken as a measure of initial success and an indicator of the future potential of an administration. By this standard, the first days of President Donald Trump present a bleak outlook. In many respects, the most important features of the Trump Administration so far are the things that have not happened. The repeal of the Affordable Care Act (ACA), a central campaign promise of the Republican Party, collapsed under the weight of logical inconsistencies in the Republican promise: that their plan could provide better health-care coverage, to more people, more cheaply, and cut taxes, all at the same time.
Date de mise en ligne : Samedi 29 avril 2017
The Lancet
[Editorial] Health an afterthought in a single-issue election
“We need a general election and we need one now, because we have at this moment a one-off chance to get this done while the European Union agrees its negotiating position and before the detailed talks begin.†Last week, UK Prime Minister Theresa May set out her case for a general election. One would be forgiven for thinking, reading the transcript of her speech, that May was readying the nation for a second referendum on the political issue of a generation, Britain leaving the European Union (EU).
Date de mise en ligne : Samedi 29 avril 2017
The Lancet
[Editorial] Better understanding of youth mental health
Mental health issues are the leading cause of disability in adolescents aged 15–19 years in all the world's regions, contributing 45% of their overall burden of disease. Early intervention to prevent mental health disorders is crucial to suicide prevention and to improve lifelong wellbeing. On April 18, the charity Mission Australia, in association with the Black Dog Institute, a research institute based in New South Wales, published the 5th Youth Mental Health Report. From a survey of 21 000 Australian adolescents emerges a grim picture of mental health, with 22·8% of young Australians meeting the criteria for probable serious mental illness (PSMI), as assessed by the Kessler 6 measure of non-specific psychological distress.
Date de mise en ligne : Mercredi 12 avril 2017
Stephen B Hanauer
[Comment] Targeting interleukin 23 for Crohn's disease: finding the right drug for the right patient
Brian Feagan and colleagues1 report in The Lancet the short-term (12 weeks) efficacy and safety of risankizumab, a humanised monoclonal antibody targeting the p19 subunit of interleukin 23, in patients with moderate-to-severe Crohn's disease (Crohn's disease activity index [CDAI] score 220–450) and document endoscopically active mucosal lesions. The study enrolled patients who had previously been exposed to one (93%) or more (79%) tumour necrosis factor (TNF) inhibitors and were receiving corticosteroids (27%) or immunomodulators (26%) with an average disease duration of 13 years.
Date de mise en ligne : Mercredi 01 mars 2017
Ingrid Arijs, Isabelle Cleynen
[Comment] RISK stratification in paediatric Crohn's disease
“Speak up. Step up. Stand out.†With this slogan for the fifth annual Crohn's and Colitis Awareness Week, the Crohn's & Colitis Foundation of America was asking everyone to raise awareness of Crohn's disease and ulcerative colitis. Despite the invisible nature of these incurable diseases, patients with inflammatory bowel disease have symptoms including severe abdominal pain, weight loss, and diarrhoea. The onset of Crohn's disease is characterised most often by an inflammatory phenotype; most patients develop stricturing or penetrating complications, or both, over time.
Date de mise en ligne : Mardi 21 mars 2017
Michael A Belfort, Steven L Clark
[Comment] Computerised cardiotocography—study design hampers findings
Cardiotocography is a diagnostic tool, not a therapeutic modality. Diagnostic tests are unlikely to improve outcomes unless followed by specific and effective therapeutic interventions. When the management of highly specific abnormalities is not specified in a study protocol but is instead left to the individual discretion of many providers with very different management approaches, the chance that all of them will react in the same way is small.
Date de mise en ligne : Samedi 29 avril 2017
Jacob J E Koopman, Remko S Kuipers
[Comment] From arterial ageing to cardiovascular disease
Although cardiovascular disease is one of the most prevalent and studied diseases in high-income countries, its aetiology has not been fully unveiled. Study of its pathophysiology in other regions will help develop a greater understanding of the disease.
Date de mise en ligne : Samedi 29 avril 2017
Neil R Poulter, Daniel T Lackland
[Comment] May Measurement Month: a global blood pressure screening campaign
Suboptimal blood pressure is the cause of more death than any other single risk factor1 and is the leading contributor to the global burden of disease. This contribution is expected to grow. Furthermore, hypertension (that level of raised blood pressure for which guidelines usually recommend drug treatment) affects more than 1 billion people globally,2 is the biggest contributor to cardiovascular disease,3 and yet it remains undiagnosed in most of those affected.4
Date de mise en ligne : Samedi 29 avril 2017
Liam J Donaldson, Edward T Kelley, Neelam Dhingra-Kumar, Marie-Paule Kieny, Aziz Sheikh
[Comment] Medication Without Harm: WHO's Third Global Patient Safety Challenge
In 1960, Alphonse Chapanis, turned his attention from engineering to health care. In a study of medication-related errors in a 1100-bed hospital,1 he and his colleague identified seven sources of such errors potentially leading to harm to a patient: medicine omitted, or given to the wrong patient, at the wrong dose, as an unintended extra dose, by the wrong route, at the wrong time, or as the wrong drug entirely. Almost 60 years later, these same types of errors still happen worldwide. Later that year in a follow-up policy paper,2 Chapanis identified four areas of recommendations that could prevent harm and remain relevant today: written communication, medication procedures, the working environment, training, and education.
Date de mise en ligne : Samedi 29 avril 2017
Richard Horton
[Comment] Offline: The new neglected (non-tropical) diseases
Neglected tropical diseases (NTDs) are no longer neglected, according to the WHO. “Record-breaking progress†over the past decade has brought diseases such as African trypanosomiasis and lymphatic filariasis “to their kneesâ€. The campaign to defeat NTDs has been “one of the most effective global partnerships in modern public healthâ€, says WHO Director-General Margaret Chan. WHO calls these successes “a rags-to-riches storyâ€. So if NTDs are no longer neglected, what are today's neglected diseases? One answer must be the non-communicable diseases (NCDs).
Date de mise en ligne : Samedi 29 avril 2017
Susan Jaffe
[World Report] Marching for science as budget cuts threaten US research
Academics push back against President Trump's proposed budget cuts, which give a sobering insight into the future of US research. Susan Jaffe, The Lancet's Washington correspondent, reports.
Date de mise en ligne : Samedi 29 avril 2017
Dinesh C Sharma
[World Report] Rising violence against health workers in India
Health workers in India have reached a breaking point as they face risk of physical attacks while carrying out their work. Dinesh C Sharma reports.
Date de mise en ligne : Samedi 29 avril 2017
Rita Rubin
[World Report] Profile: INS in Bogotá—100 years improving Colombian health
A rabid cat and a case of diphtheria —this is what led to the creation of Colombia's Instituto Nacional de Salud (INS), or National Institute of Health, which celebrates its centenary this year. With now 600 employees in Bogota, the INS is one of the leading public health agencies in Latin America. Its director, Martha Lucia Ospina, is the first woman in its history to hold that position.
Date de mise en ligne : Samedi 29 avril 2017
Georgina Ferry
[Perspectives] Thomas Browne: a rarity among rarities
We are inclined to think of social networks as a modern phenomenon, dependent on the technology of electronic communication. What, then, to make of a 17th-century Norwich doctor, who rarely left his home, but whose prolific writings were admired across Europe? Whose impact was such that writers of the modern era, from Edgar Allan Poe to Jorge Luis Borges (and not forgetting Virginia Woolf) counted him as essential reading? Of whose first book Sir William Osler, the father of modern medical training and practice, declared that no other had had “so enduring an influence on my life�
Date de mise en ligne : Samedi 29 avril 2017
Tony Kirby
[Perspectives] Nelly Mugo—rolling out PrEP in Kenya
Nelly Mugo has happy memories of growing up in a large Kenyan family as one of eight children. They moved to Nairobi when she was a child and she recalls how an early high school interest in plant science and farming switched to medicine as she found herself thinking “what are the most important things I can know to take care of my family?†She began her medical degree at the University of Nairobi in 1981. One of just 16 women in a class of 120, she remembers that “gender became more important as we subspecialised.
Date de mise en ligne : Samedi 29 avril 2017
Dora Vargha, Jeremy A Greene
[Perspectives] Grey-market medicines: diphtheria antitoxin and the decay of biomedical infrastructure
More so than most of its European neighbours, Spain at the turn of the 21st century thought it had relegated diphtheria to the past: the country had not seen a case of diphtheria since 1986. Not, that is, until a 6-year old boy was diagnosed with the disease in May, 2015. Although diphtheria has been a curable disease since the development of diphtheria antitoxin (DAT) in the 1890s and its widespread manufacture in the early 20th century, scarcely a month after his diagnosis, the child succumbed to this disease thought to have been largely tamed by modern medical science.
Date de mise en ligne : Samedi 29 avril 2017
Geoff Watts
[Obituary] Kenneth Joseph Arrow
Nobel Prize winning economist. He was born in New York, USA, on Aug 23, 1921, and died in Palo Alto, USA, on Feb 21, 2017 aged 95 years.
Date de mise en ligne : Samedi 29 avril 2017
Neena Modi, Anne Greenough, Russell Viner, Judith Ellis, Mary Marsh
[Correspondence] Health professional associations and industry funding—reply from Modi et al
We are writing to clarify the position of the UK Royal College of Paediatrics and Child Health (RCPCH) with respect to engagement with industry, including infant formula companies. Revisions to our long-standing policy were agreed by the RCPCH Council in October, 2016, after a detailed membership consultation that provided a strong majority mandate. In brief (full details are available on our website),1 the RCPCH's policy for accepting donations encourages donors, including infant formula manufacturers, subject to due diligence, to contribute to funds that support activities that benefit infants, children, and young people.
Date de mise en ligne : Samedi 29 avril 2017
Declan O'Brien
[Correspondence] Health professional associations and industry funding—reply from O'Brien
I am writing in relation to the letter by Anthony Costello and colleagues,1 who state that they do not represent the views, decisions, or policies of WHO.
Date de mise en ligne : Samedi 29 avril 2017
Stewart Forsyth
[Correspondence] Health professional associations and industry funding—reply from Forsyth
The letter from Anthony Costello and colleagues1 shows the tangled web that has been woven by WHO to prevent food industry involvement in infant feeding policy and practice. This is despite the core statement within the International Code of Marketing of Breast-milk Substitutes, “affirming the need for governments, organisations of the United Nations system, non-governmental organisations, experts in various related disciplines, consumer groups, and industry to cooperate in activities aimed at the improvement of maternal, infant, and young child health and nutritionâ€.
Date de mise en ligne : Samedi 29 avril 2017
Tony Waterston, Anthony Williams, Charlotte Wright, Delan Devakumar, Rosie Kyeremateng
[Correspondence] Health professional associations and industry funding—reply from Waterston et al
We write as sponsors of the motion passed at the UK Royal College of Paediatrics and Child Health (RCPCH) Annual General Meeting (AGM) in April, 2016, opposing acceptance of funding from companies that market products within the scope of the International Code of Marketing of Breast-milk Substitutes (also known as the International Code).1
Date de mise en ligne : Samedi 29 avril 2017
Felicity Savage
[Correspondence] Health professional associations and industry funding—reply from Savage
The World Alliance for Breastfeeding Action (WABA) applauds the letter from Costello and colleagues1 criticising the tragic decision of the UK Royal College of Paediatrics and Child Health (RCPCH) to continue accepting money from the infant formula industry to support their activities. In our work to protect, promote, and support breastfeeding, WABA and its partners all over the world encounter promotional activities of this industry, which undermine mothers' ability to breastfeed, and mislead the health professionals who might support them.
Date de mise en ligne : Samedi 29 avril 2017
Kathleen C Parry, Catherine Sullivan, Alison M Stuebe
[Correspondence] Health professional associations and industry funding—reply from Parry et al
We write to commend Anthony Costello and colleagues1 for their Correspondence regarding the recent decision by the UK Royal College of Paediatrics and Child Health (RCPCH) to continue accepting funds from manufacturers of breast milk substitutes (BMS). This decision violates the World Health Assembly International Code of Marketing of Breast-milk Substitutes (also known as the International Code).
Date de mise en ligne : Samedi 29 avril 2017
Muhammad Qudrat-e-Khuda Talukder, Mohammod Shahidullah, Azad Chowdhury, Soofia Khatoon, Khurshid Talukder
[Correspondence] Health professional associations and industry funding—reply from Talukder et al
A breast milk substitutes (BMS) act has been in existence in Bangladesh since 1984. Even before this BMS act was strengthened in 2013, the Bangladesh Paediatric Association, the Bangladesh Neonatal Forum, the Bangladesh Perinatal Society, as well as the Obstetric Gynaecology Society of Bangladesh had stopped taking financial support from BMS producers. This is despite the fact that Bangladesh is a low-to-middle-income country with a gross domestic product per capita that is 36-times less than that of the UK.
Date de mise en ligne : Samedi 29 avril 2017
José M Belizán, Suellen Miller
[Correspondence] What can WHO do to support research in LMICs?
To achieve improvements in global health, research is necessary to identify novel solutions to major public health issues. Implementation research is particularly relevant in view of the history of evidence-based practices being poorly or never implemented. Efforts spearheaded by The Lancet have demonstrated the potential impact of implementing practices shown to reduce mortality, alleviate and prevent morbidities, and improve quality of life.1–4
Date de mise en ligne : Mardi 21 mars 2017
Robert Keith
[Correspondence] The INFANT study—a flawed design foreseen
During the INFANT Study1 (March 21) application process in 2006–07 and since, concerns were formally raised regarding study design weaknesses by myself and some of the clinical investigators, clinical collaborators, and the National Institute for Health Research (NIHR) referees.2 The source of the concerns were two-fold.
Date de mise en ligne : Samedi 29 avril 2017
[Department of Error] Department of Error
Frank Smithuis, Moe Kyaw Kyaw, Ohn Phe, et al. Efficacy and effectiveness of dihydroartemisinin-piperaquine versus artesunate-mefloquine in falciparum malaria: an open-label randomised comparison. Lancet 2006; 367: 2075–85—In this Article, the name of the fifth author should have been spelled “Linn Htetâ€. This change has been made to the online version as of April 27, 2017.
Date de mise en ligne : Mercredi 12 avril 2017
Brian G Feagan, William J Sandborn, Geert D'Haens, Julián Panés, Arthur Kaser, Marc Ferrante, Edouard Louis, Denis Franchimont, Olivier Dewit, Ursula Seidler, Kyung-Jo Kim, Markus F Neurath, Stefan Schreiber, Paul Scholl, Chandrasena Pamulapati, Bojan Lalovic, Sudha Visvanathan, Steven J Padula, Ivona Herichova, Adina Soaita, David B Hall, Wulf O Böcher
[Articles] Induction therapy with the selective interleukin-23 inhibitor risankizumab in patients with moderate-to-severe Crohn's disease: a randomised, double-blind, placebo-controlled phase 2 study
In this short-term study, risankizumab was more effective than placebo for inducing clinical remission in patients with active Crohn's disease. Therefore, selective blockade of interleukin-23 via inhibition of p19 might be a viable therapeutic approach in Crohn's disease.
Date de mise en ligne : Mercredi 01 mars 2017
Subra Kugathasan, Lee A Denson, Thomas D Walters, Mi-Ok Kim, Urko M Marigorta, Melanie Schirmer, Kajari Mondal, Chunyan Liu, Anne Griffiths, Joshua D Noe, Wallace V Crandall, Scott Snapper, Shervin Rabizadeh, Joel R Rosh, Jason M Shapiro, Stephen Guthery, David R Mack, Richard Kellermayer, Michael D Kappelman, Steven Steiner, Dedrick E Moulton, David Keljo, Stanley Cohen, Maria Oliva-Hemker, Melvin B Heyman, Anthony R Otley, Susan S Baker, Jonathan S Evans, Barbara S Kirschner, Ashish S Patel, David Ziring, Bruce C Trapnell, Francisco A Sylvester, Michael C Stephens, Robert N Baldassano, James F Markowitz, Judy Cho, Ramnik J Xavier, Curtis Huttenhower, Bruce J Aronow, Greg Gibson, Jeffrey S Hyams, Marla C Dubinsky
[Articles] Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study
Our findings support the usefulness of risk stratification of paediatric patients with Crohn's disease at diagnosis, and selection of anti-TNFα therapy.
Date de mise en ligne : Mardi 21 mars 2017
The INFANT Collaborative Group
[Articles] Computerised interpretation of fetal heart rate during labour (INFANT): a randomised controlled trial
Use of computerised interpretation of cardiotocographs in women who have continuous electronic fetal monitoring in labour does not improve clinical outcomes for mothers or babies.
Date de mise en ligne : Vendredi 17 mars 2017
Hillard Kaplan, Randall C Thompson, Benjamin C Trumble, L Samuel Wann, Adel H Allam, Bret Beheim, Bruno Frohlich, M Linda Sutherland, James D Sutherland, Jonathan Stieglitz, Daniel Eid Rodriguez, David E Michalik, Chris J Rowan, Guido P Lombardi, Ram Bedi, Angela R Garcia, James K Min, Jagat Narula, Caleb E Finch, Michael Gurven, Gregory S Thomas
[Articles] Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study
Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined.
Date de mise en ligne : Jeudi 22 décembre 2016
Carolyn Jack, Therese El Helou
[Clinical Picture] Non-healing ulcerative paronychia
A 32-year-old man with a 14-year history of ulcerative colitis presented to our dermatology clinic in December, 2014, with a 2-month history of a mildly tender, purulent paronychial lesion of his right big toe.
Date de mise en ligne : Mercredi 30 novembre 2016
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
[Seminar] Crohn's disease
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions.
Date de mise en ligne : Mercredi 30 novembre 2016
Ryan Ungaro, Saurabh Mehandru, Patrick B Allen, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel
[Seminar] Ulcerative colitis
Ulcerative colitis is a chronic inflammatory disease affecting the colon, and its incidence is rising worldwide. The pathogenesis is multifactorial, involving genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors. Patients with ulcerative colitis have mucosal inflammation starting in the rectum that can extend continuously to proximal segments of the colon. Ulcerative colitis usually presents with bloody diarrhoea and is diagnosed by colonoscopy and histological findings.