The TARGIT-A trial found that targeted intraoperative radiotherapy (TARGIT) is non-inferior to whole breast external beam radiotherapy in reducing local recurrences. Patients who underwent TARGIT had similar recurrence rates to those receiving conventional radiotherapy, with lower rates of radiotherapy toxicity.
Vandetanib significantly prolongs progression-free survival and improves response rates compared to standard chemotherapy alone in previously treated advanced NSCLC patients. The addition of vandetanib also reduces symptoms and increases time to worsening of symptoms.
Despite accelerated progress in reducing child mortality, maternal mortality remains high. Brazil and China are highlighted as countries on track to meet the targets set out in MDG4 and MDG5. The report emphasizes the need for increased investment in health systems, community-based interventions, and social determinants.
The Lancet highlights the 10 reasons why women and children are invisible, including a lack of social mission, poor attitudes, inadequate evaluation, and insufficient leadership. The article emphasizes the need for coordination and empowerment to address these issues.
A study on child survival in rural Bangladesh found that mother's death massively reduces child's chances of survival to age 10 years. The father's death has a negligible effect on child mortality rates, with the greatest impact seen in children aged 2-12 months whose mothers had died.
Despite achieving parity by 2015 in only 18 countries, the MDG 3 target for eliminating gender disparity in primary and secondary education remains unmet. The Editorial emphasizes that political discussions around MDGs 4, 5, and 6 have excluded gender equity.
A study published in The Lancet found that low-dose combination therapy of rosiglitazone and metformin can stop people progressing to type 2 diabetes, with a relative risk reduction of 66% compared to placebo. This strategy could target populations at-risk of diabetes.
A large UK study found that genetic variations associated with an increased risk of breast cancer do not interact with environmental factors such as hormone replacement therapy, age at first birth, or obesity. The study's authors conclude that genetic and environmental risks for breast cancer are independent.
A new meta-analysis of individual patient data found that high-frequency oscillatory ventilation (HFOV) has outcomes comparable to conventional ventilation for preterm infants, without increased risk of bronchopulmonary dysplasia or brain damage. The study included 3229 participants and analyzed 10 randomized controlled trials.
Transcranial doppler ultrasound detects cerebral emboli in asymptomatic carotid stenosis patients, revealing those at high risk of stroke and low risk of benefiting from surgery. The technique identifies a small group with high stroke risk, while others have a low risk that may not warrant intervention.
A new trial found that supervised injectable heroin leads to larger reductions in street heroin use compared to injectable or oral methadone. The RIOTT trial showed that treatment with supervised injectable heroin resulted in significantly lower use of street heroin within six weeks.
A groundbreaking study has shown that a novel treatment using small interfering RNAs can protect monkeys from lethal Ebola virus infection after exposure. The treatment was found to be well-tolerated and offered complete protection in some cases, paving the way for further research and potential human trials.
A recent study found that antiretroviral treatment (ART) significantly reduces the risk of HIV transmission in heterosexual couples, with a 92% lower rate of transmission among those on ART compared to those not on treatment. The greatest benefit was seen in individuals with CD4 counts below 200 cells per μL.
The study reveals that global child under-5 deaths have declined by 60% since 1970, with neonatal mortality dropping by 57%. Many poorer countries are making accelerated progress, while high-income countries like the UK and US are lagging behind. Only 31 developing countries are on track to meet MDG4.
A new autism intervention for preschool children showed improvements in parent-child interaction, but failed to deliver a clinically significant reduction in autism symptoms. The study assessed 152 children aged 2-4 years and found that the PACT intervention led to enhanced communicative and social development.
The US plan prioritizes prevention, treatment, and law enforcement, focusing on reducing youth drug use and prescription abuse. In contrast, the UK is facing criticism for its drug policy, which has been influenced by media pressure and ideological opinions, leading to a lack of evidence-based decision-making.
The European Medicines Agency (EMA) has faced criticism for refusing to release documentation on severe adverse reactions, despite a complaint from a father who lost his son to a drug. The EMA's handling of licensing decisions and transparency is being questioned, with some experts calling for more openness.
A large trial found that adding misoprostol to standard uterotonics did not reduce post-partum blood loss, but was associated with increased shivering and body temperature. WHO's withdrawal of support for misoprostol use in low-income settings has been criticized.
Erlotinib maintenance therapy significantly improves progression-free and overall survival in patients with non-small-cell lung cancer. The treatment is generally well-tolerated, with mild to moderate side effects.
The Lancet series highlights the need to assess interventions for social and economic determinants of TB, including malnutrition, alcohol use, and poor housing. Community engagement is crucial to overcome this community disease, and a progressive model is needed to harness community participation.
The article highlights the growing concern of multidrug-resistant tuberculosis (MDR TB) becoming a dominant strain worldwide. MDR TB poses a major threat to existing TB control programmes due to its association with lower cure rates and higher mortality rates than drug-susceptible TB disease.
Despite progress in curing TB patients, the disease remains a major health threat due to poverty, poor diagnosis, and treatment. The Lancet launches the TB Observatory to monitor progress, increase funding, and promote international cooperation to combat TB.
New drugs, vaccines, biomarkers, and diagnostics could reduce TB incidence by 94% by 2050. Biomarker development is crucial for predicting treatment outcomes, while diagnostics advancements aim to improve case detection.
Implementing the 3Is policy (Intensified tuberculosis case finding, Infection control, and Isoniazid preventive therapy) combined with earlier start of ART can prevent HIV-associated TB. Early diagnosis and treatment, along with a comprehensive package of HIV care, form the basis of prevention and control of HIV-associated TB.
The global burden of tuberculosis remains significant, with 11 million active cases in 2008, despite progress made since the start of DOTS era. Rapid expansion of TB diagnosis and treatment has saved up to six million lives, but further efforts are needed to eliminate the disease by 2050.
Experts warn that weak health systems are impeding global efforts to control tuberculosis, with rapidly introduced suboptimum reforms harming national targets. However, innovative solutions from countries like Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam have shown promise in addressing bottlenecks.
A meta-analysis of over 1 million people found that both low kidney filtration rate (GFR) and high albumin: creatinine ratio independently predict mortality risk in the general population. Low GFRs were associated with increased risks, with those below 60 mL/min/1•73 m² experiencing a 57% increased risk of death.
Treatment with alteplase until 4.5 hours from stroke onset enhances favourable outcome chances, while late treatment is associated with reduced short-term survival and increased mortality risk. Early treatment initiation is crucial to maximize benefit and minimize risks.
A recent study found that age-related cortical bone loss is a significant contributor to osteoporosis, with 80% of fractures in old age occurring at cortical sites. Researchers propose targeting cortical bone loss as a potential strategy for reducing fracture risk and improving treatment outcomes.
According to a recent study, more than two-thirds of child deaths worldwide are caused by infectious diseases, with pneumonia being the leading cause. The UK has the highest number of child deaths in Western Europe, and many deaths in high-income countries can be prevented.
A meta-analysis of fibrate drugs found significant reductions in major cardiovascular events and coronary events. Fibrates also showed a modest risk reduction for albuminuria progression, an early marker of kidney disease.
A randomized trial found that pramipexole significantly improved depressive symptoms and functioning in patients with mild-to-moderate Parkinson's disease. The study also showed that the antidepressant effect of pramipexole was largely independent of its effect on motor symptoms.
Genetic research suggests that elevated triglyceride levels are associated with a higher risk of heart disease. A major international consortium led by Dr Nadeem Sarwar and Professor John Danesh found this link in analysis of 350,000 people from 101 studies.
Childhood obesity is a serious condition that can have severe consequences, including hypertension and psychosocial complications. Lifestyle interventions such as diet and exercise should always be the first-line therapy, with drug treatment used rarely and weight-loss surgery only as a last resort.
A retrospective study found that vaccination is associated with earlier onset of seizures in children with Dravet syndrome, but does not affect the clinical outcome. The study analyzed 40 patients and found no difference in intellectual outcome or subsequent seizure type between vaccinated and unvaccinated groups.
The ObaapaVitA study in Ghana found that vitamin A supplementation had no significant impact on pregnancy-related mortality or female mortality rates. This result contradicts the earlier Nepal trial which showed a 44% decrease in maternal mortality with vitamin A supplementation.
The study reveals that Australia and South Korea have some of the highest annual rates of decline in adult mortality. Iceland and Cyprus rank as the lowest risk countries for men and women, respectively. However, the HIV epidemic and social dysfunction in former Soviet states have contributed to high mortality rates in many countries.
Researchers use whole-genome sequencing to identify increased risk of cardiovascular disease, type 2 diabetes, and certain cancers in a patient. The study also reveals genetic variants associated with good response to statins, resistance to clopidogrel, and lower maintenance dosing of warfarin.
A study of 79,036 participants found that Lp-PLA2 enzyme levels were associated with increased risk of coronary heart disease, stroke, and early death. The magnitude of this risk was comparable to that due to high blood pressure or bad cholesterol.
A recent study published in The Lancet Neurology found that deep brain stimulation improves quality of life, mobility, and activities of daily living in advanced Parkinson's disease patients, while also reducing dyskinesia and off time. However, the procedure carried a higher risk of serious adverse events.
Researchers found that combining regional hyperthermia with chemotherapy increases local progression-free and disease-free survival rates in high-risk sarcoma patients. The treatment has shown promise, but the safety profile remains a concern.
A single sigmoidoscopy examination between ages 55 and 64 significantly reduced colorectal cancer mortality by 43% and incidence by one-third in those screened. The study found a lasting protective effect of screening, with 59% of cases detected during screening and only a few post-screening detections.
The Lancet China special issue was launched at a joint event in Beijing, combining the inauguration of the China Center for Health Development Studies. The issue features various articles on healthcare reform, children's health, air and water quality, and more.
A new study published in The Lancet found that injected liraglutide is more effective than oral sitagliptin at controlling blood glucose levels in people with type 2 diabetes who have inadequate control on standard treatment metformin. Liraglutide was well tolerated with minimal risk of hypoglycaemia.
A new antimalarial combination therapy, pyronaridine-artesunate, has been shown to be as effective as the current gold standard treatment, artemether-lumefantrine, but requires only once-daily dosing. The study found high clinical and parasitological response rates and rapid parasite clearance in patients with uncomplicated malaria.
The Lancet Editorial calls for increased public commitment to combat malaria, citing a 20-year development timeline and £500 million investment. A broader public-private partnership is needed to support the development of an effective vaccine, with $20 billion pledged by Bill Gates.
Telcagepant, a CGRP receptor blocker, provides similar pain relief as triptans but with fewer cardiovascular risks. Topiramate may also prevent migraine attacks in chronic sufferers.
Up to 200,000 children under-5 each year could be dying due to RSV-accelerated acute lower-respiratory tract infections. The Lancet study finds that RSV is the most important viral pathogen causing these infections in young children.
A new Lancet editorial promotes the 'eat 5 fruit and veg a day' message despite recent findings suggesting a lower protective effect against cancer. Four key benefits remain: heart disease prevention, strong protection against specific cancers, weight management, and bowel cancer prevention.
The UK's ACMD faced criticism for banning mephedrone without sufficient evidence, prioritizing politics over science. The council's other report on hazardous drug use was ignored, highlighting a flawed approach to tackling substance abuse.