The decline in Zimbabwe's health indicators over the past three decades is attributed to high HIV/AIDS prevalence, poor governance, and economic policies. To address this, the authors propose a new healthcare recovery plan prioritizing essential services like emergency obstetric care and training specialist mid-level workers.
A cheap, locally produced oral cholera vaccine has been proven safe and effective in preventing clinically significant cholera cases in young children and older individuals. The vaccine demonstrated nearly 70% protection against cholera for at least 2 years after vaccination.
The Russian government should continue funding harm reduction programs for injecting drug users, as they are crucial for tackling the HIV epidemic. These programs have been instrumental in reducing deaths and improving health outcomes among this vulnerable population.
A study published in The Lancet Oncology found that immunodeficiency increases the risk of multiple cancers in HIV patients. Lower CD4 counts were linked to higher risks of certain cancers, while antiretroviral therapy reduced this risk. Effective cancer screening programs are recommended for HIV-positive individuals.
A new study published in The Lancet found that early treatment with glatiramer acetate can reduce the risk of progressing to 'full-blown' multiple sclerosis by almost half. The medication also showed efficacy in reducing MRI measures of disease activity and cumulative number of new lesions.
Patients with brain tumors treated with WBRT plus SRS experience significant decline in learning and memory function compared to those receiving SRS alone. The study concludes that SRS alone combined with close clinical monitoring is the preferred treatment strategy for patients newly diagnosed with one to three brain metastases.
Studies suggest that routine stroke prevention therapies could be highly effective in the very elderly population. Meanwhile, research on epilepsy in later life is needed to improve treatment and prognosis for this growing demographic.
The study, involving over 14,656 patients, found that two-thirds of heroin users stopped or reduced their use, while a similar proportion of crack cocaine users did the same. Heroin use decreased by an average of 15 days per month, and crack cocaine use by eight days.
Preliminary evidence suggests that shortened working weeks may further extend increases in life expectancy and health. Disability prevalence has been falling, with increasing evidence suggesting that people are living better despite an increase in chronic diseases.
A new study published in The Lancet found that combining gabapentin and nortriptyline is more effective than using either drug alone in reducing neuropathic pain. The treatment resulted in a significant reduction in pain scores, with patients experiencing relief from their symptoms.
A new nomogram developed by Ronald DeMatteo and colleagues predicts a patient's risk of cancer recurrence after surgery to remove primary GIST. The tool uses tumour size, location, and mitotic index as established prognostic criteria.
A study of young women with antiphospholipid syndrome reveals a significantly increased risk of stroke and heart attack, particularly when combined with smoking and oral contraceptive use. The findings emphasize the need for screening and warning young women about these cardiovascular risks.
The Lancet publishes a landmark Series on the current state of surgical research, highlighting its problems and proposed solutions. A framework called IDEAL is introduced to guide surgeons in evaluating new innovations, aiming to identify beneficial procedures at an earlier stage.
A randomized controlled trial found that surgery provides a modest benefit over nonsurgical treatment for patients with carpal tunnel syndrome, with improvements in hand function and symptoms lasting up to 1 year. However, some patients reported persistent symptoms after surgery.
A recent study published in The Lancet found that using a drain after surgery to release a chronic subdural hematoma significantly reduces both mortality and hematoma recurrence. The study assessed 215 patients with chronic SDH who underwent burr-hole surgery, with a significant benefit observed in the group using a drain.
A systematic review found that post-stroke dementia rates varied greatly, but were closely related to stroke characteristics and complications. The authors suggest that optimum acute stroke care and secondary prevention measures could reduce the burden of dementia. Further studies are needed to identify independent predictive factors.
Canada faces a pressing challenge to address the deteriorating progress towards Millennium Development Goals (MDGs). The Lancet urges Canada to make significant contributions in five key areas: health system strengthening, climate change, peace through health, Indigenous Health, and establishing a Canadian Health Action Network for Glo...
A mathematical model suggests that improved community-based access to life-saving drugs like misoprostol and antibiotics can prevent up to 59,000 maternal deaths across sub-Saharan Africa per year. The study found that the poorest women would benefit most from these interventions.
A systematic review of evidence found that flu can trigger heart attacks and cause cardiovascular death, but the influenza vaccine may reduce this risk. The review suggests that vaccination should be encouraged in people with existing cardiovascular disease, particularly during seasonal flu outbreaks.
Cancer experts are developing a tool to work out the percentage risk a woman has of developing cervical cancer. The tool uses cervical precancer, defined as histological cervical intraepithelial neoplasia grade 3 (CIN3) or more severe, as a surrogate for cervical cancer.
A large trial found that hormone replacement therapy (HRT) increases the risk of death from lung cancer, especially non-small-cell lung cancer. Women taking HRT were 71% more likely to die from lung cancer than those on placebo, with higher risks also seen in current and long-term past smokers.
Researchers found that adding high-dose cytarabine to methotrexate therapy improved complete remission rates (46%) and overall response rates (69%) in patients with primary central nervous system lymphoma. The combination also resulted in a lower risk of relapse and improved progression-free survival.
A phase III randomised controlled trial found that dose-dense weekly paclitaxel plus carboplatin improved survival in women with advanced epithelial ovarian cancer, with a median progression-free survival of 28 months compared to 17 months. Overall survival at 3 years was also higher in the dose-dense regimen group.
A randomized phase III study found that pemetrexed significantly improved progression-free survival (4.3 months vs 2.6 months) and overall survival (13.4 months vs 10.6 months) compared to placebo in patients with advanced non-squamous NSCLC who did not progress after initial platinum-based chemotherapy.
A recent Editorial in The Lancet emphasizes the connection between family planning, climate change, and women's health. Implementing contraception can help reduce unintended pregnancies and slow population growth, thereby alleviating demographic pressure on the environment.
Improving toilets and hand hygiene can reduce tropical enteropathy and lead to substantial decreases in stunting among children. Dr Jean Humphrey hypothesises that preventing faecal-oral transmission by providing safe disposal of stools and promoting handwashing with soap can normalise child growth.
A recent study found that intermittent preventive malaria treatment in African infants is both safe and effective, with sulfadoxine-pyrimethamine providing protection for up to 6 weeks. However, the use of this drug is limited by potential resistance and its risks. New long-acting antimalarial drugs are urgently needed for this strategy.
A study found that extracorporeal membrane oxygenation (ECMO) significantly improves survival rates and reduces disability in adults with severe acute respiratory failure. The treatment, which uses heart-lung bypass technology, was shown to be cost-effective compared to conventional ventilation.
The authors emphasize the need for radical reductions in CO2 emissions to prevent catastrophic climate change, highlighting its impact on global health and human well-being. They advocate for a low-carbon diet, clean power, and sustainable agriculture to achieve a healthier and more equal society.
Using validated prediction rules, researchers found that 1 in 4 children under 2 years and 1 in 5 older than 2 years could avoid CT scans without increasing the risk of clinically-important traumatic brain injuries. The study analyzed over 42,000 children and identified accurate prediction rules for low-risk patients.
A new endothelin type A antagonist, darusentan, provides significant reduction in blood pressure for patients with treatment-resistant hypertension. The study shows that darusentan is generally well-tolerated, but fluid retention is a main adverse effect.
Studies estimate that pneumococcal disease caused about 826,000 deaths in children aged 1-59 months, while Hib disease caused around 371,000 deaths. These figures highlight the importance of effective interventions and vaccines to reduce child mortality and attain Millennium Development Goal 4
The study reveals that nearly two-thirds of adolescent deaths in sub-Saharan Africa and Southeast Asia occurred, despite these regions containing only 42% of the global 10—24-year-old population. Traffic accidents and violence were among the leading causes of death, with more than half of all deaths due to injuries or violence.
The global average annual rate of reduction in under-5 mortality has increased from 2000-2008 compared to 1990-2000. However, the world is still far from achieving Millennium Development Goal 4, with many regions not on track to meet the target.
A new treatment protocol using dexamethasone instead of prednisone and less intensive chemotherapy showed similar event-free survival in non-high risk patients but better results in high-risk patients, reducing the risk of side effects. Overall, the treatment strategy improved survival rates for children with acute lymphoblastic leukemia.
A study published in The Lancet found that vaccination against bacterial infections, such as Streptococcus pneumoniae and Haemophilus influenzae type b, can substantially improve survival rates in African children with sickle-cell anaemia. The researchers also found that these bacteria are the same cause of infection in both developed ...
A 22-year-old woman, recently undergoing chemotherapy for Hodgkin's disease, survives severe swine-flu infection after receiving unlicensed intravenous Relenza treatment in combination with corticosteroids. Her condition improved significantly within 48 hours, and she was discharged after 24 days in ICU.
A controversy surrounds Sweden's promotion of low-carb high-fat (LCHF) diets, sparking concern over national public health and individual well-being. Despite scientific evidence, a group of experts was removed from the Swedish National Board of Health and Welfare due to perceived conflicts of interest.
Researchers found that house screening reduced mosquito numbers by 49-59% and malaria-related anaemia in children by half. The authors suggest integrating house screening into vector management programs to combat malaria.
A new study published in The Lancet found that proton pump inhibitors do not negate the clinical benefit of clopidogrel or prasugrel in patients after a heart attack. The TRITON-TIMI 38 trial showed that PPIs can be safely used with these antiplatelet drugs to reduce gastrointestinal bleeding.
Researchers found that nadroparin almost halves the risk of developing blood clots in ambulatory cancer patients receiving chemotherapy. The study, published in The Lancet Oncology, showed a significant reduction in thromboembolic events in patients treated with nadroparin compared to those receiving placebo.
A new study published in The Lancet found that otamixaban significantly reduces the risk of death and second heart attacks in patients with non-ST-elevation acute coronary syndromes. The drug, which inhibits factor Xa, shows promise as an alternative to current standard treatments.
The HORIZONS-AMI study found that bivalirudin reduced clinical events and major bleeding in heart attack patients undergoing angioplasty. This is a significant finding with important clinical implications for the selection of treatment strategies for high-risk patients.
The CAVATAS study found that surgery reduces the risk of both short-term and long-term stroke, as well as repeat stenosis. Patients who underwent endovascular treatment had a higher incidence of restenosis and subsequent stroke compared to those who received surgery.
The UPLIFT study found that starting COPD treatment with inhaled tiotropium at an earlier stage reduces decline of lung function and risk of exacerbations. Treatment should begin in patients with moderate disease to improve health status.
A new study published in The Lancet found that using inhaled corticosteroid budesonide to treat Chronic Obstructive Pulmonary Disease (COPD) does not significantly increase the risk of pneumonia. Data from over 7,000 patients showed a low incidence of pneumonia and no significant difference between treatment groups.
A new class of anti-inflammatory drugs called phosphodiesterase 4 (PDE4) inhibitors shows promise for improving lung function and reducing exacerbations in moderate-to-severe COPD patients. Roflumilast improved lung function by 48mL and reduced exacerbations by 17% compared to placebo, with more adverse events reported.
A new predictive tool, ADO index, improves upon the existing BODE index by providing a more accurate estimate of mortality risk. The updated index is easier to use and can help clinicians identify patients at moderate or high risk of mortality, guiding targeted treatment options.
A new treatment involving AVI-4658 has shown promising results in patients with Duchenne muscular dystrophy (DMD), increasing dystrophin production by skipping exon 51. The treatment was found to be safe and effective, with increased dystrophin expression observed in treated muscles.
Despite notable achievements in disease management, South Africa faces a severe HIV and tuberculosis crisis, with 17% of the global burden. The country needs to escalate its public health response to tackle rising drug resistance and improve treatment outcomes.