A new study published in The Lancet shows that there is no definitive difference in outcomes between using general or local anaesthetic for carotid surgery. The randomised controlled trial analysed over 3,500 patients and found similar incidence rates of stroke, heart attack, and death in both groups.
A WHO study suggests that universal voluntary HIV testing combined with immediate treatment after diagnosis could significantly reduce HIV cases in a severe epidemic. The strategy aims to accelerate the transition from an endemic phase to an elimination phase, reducing HIV cases to 1 per 1000 people within 10 years.
Telcagepant has shown efficacy in treating moderate to severe migraines, offering a safer alternative to triptans with fewer side effects. The study analyzed 1380 patients and found telcagepant 300mg to be more effective than placebo for freedom from pain and other symptoms.
The UK Home Office is responsible for the health care of children in detention centres, where many receive inadequate education and healthcare. The Lancet Editorial highlights the appalling failures in care, including missed childhood immunisations and inadequate treatment for illnesses like malaria and sickle-cell disease.
The INTEREST study found oral gefitinib comparable to injected docetaxel in non-small cell lung cancer patients, with better quality of life. Common side effects included rash and diarrhoea with gefitinib, while neutropenia and asthenic disorders were more common with docetaxel.
A 30-year-old Colombian woman has undergone successful transplantation of a tissue-engineered airway, showing improved quality of life with normal functioning and no rejection. The graft developed its own blood supply and the patient was discharged without complications.
The Lancet Infectious Diseases review highlights the growing concern of Acinetobacter baumannii infections, which can be caused by environmental exposure, skin colonization, or hospital-acquired conditions. Researchers emphasize the need for strict hygiene compliance and further research on antibiotic treatment options to prevent major...
Insecticide-treated bednet coverage increased from 1.8% in 2000 to 18.5% by 2007, leaving 89.6 million children unprotected, with 25% in Nigeria alone.
The article reveals substantial inequalities in healthy life years (HLYs) from the age of 50 across EU countries, with GDP and spending on elderly care being key factors. HLYs at 50 are highest in Denmark and Malta for men, and France, Italy, and Spain for women, while lowest in Estonia and Hungary.
The Lancet Editorial suggests that President-elect Barack Obama's administration should prioritize health system strengthening to address the uninsured US residents. The plan includes payment choices, universal children's health insurance, and pre-existing condition coverage.
A recent study published in The Lancet found that the MRKAd5 HIV-1 gag/pol/nef vaccine failed to provide any protection against HIV infection. However, immune responses mounted by T-cell-based vaccines alone may not be sufficient to protect against HIV infection or disease.
A meta-analysis of 33 trials found no significant reduction in mortality risk with beta-blockers in non-cardiac surgery patients, but did reduce heart attack and vessel blockage risk; however, it also increased stroke risk. The authors call for reevaluation of guidelines until conclusive evidence is available.
A new study by Professor Olle Lundberg and colleagues found that policies supporting dual-earner families decrease infant mortality rates, while those supporting traditional male earner/female stay-at-home families do not. Increased generosity in basic state pensions also reduces excess mortality in old age.
A study by The Lancet found that Sure Start programs in England boost children's social skills and parental involvement, creating better home-learning environments. The research also revealed that families in SSLP areas use more services to support child development.
A recent study found that exposure to green spaces significantly narrowed the health gap between rich and poor populations. In England, areas with more green space had half as large a difference in mortality rates between the richest and poorest individuals compared to those in less green areas.
The study found that population-wide best-practice interventions could reduce coronary heart disease mortality by 57% and the difference between socioeconomic groups by 69%. Primordial prevention strategies could achieve even greater reductions, up to 86%.
A study of 110 patients found that brain edema, known as perilesional oedema (PO), is common and associated with seizures in patients with calcified neurocysticercosis. PO may be a preventable cause of seizures in endemic countries, suggesting a unique treatment target.
The US desperately needs more family doctors to address healthcare access disparities and improve patients' outcomes. Incentives are needed to encourage medical students to specialize in general primary care, rather than lucrative but limited specialty options.
A review of commonly used C. difficile test kits found inaccurate results, leading to misdiagnosis and severe consequences. A new two-stage testing system is proposed to improve diagnostic accuracy and reduce false positives and negatives.
Data from Kenya shows a delay between decreased malaria transmission and mortality rates. The study found that when transmission is high, the disease burden falls mainly on small children, but when transmission decreases, the burden spreads throughout childhood, leading to an increased proportion of children with severe cerebral malaria.
A study found that the World Health Organization's (WHO) budget allocations do not align with global disease burdens. The WHO allocated 87% of its budget to infectious diseases, while non-communicable diseases received only 12%. This disparity in funding is concerning, particularly for injuries and violence, which are largely underfunded.
Between 1999-2007, malaria incidence and mortality declined significantly in The Gambia thanks to increased funding and targeted interventions for pregnant women and young children. Proportions of malaria-positive slides decreased by up to 82% and deaths attributed to malaria fell by 100% in some hospitals.
The occurrence of hot flushes and joint symptoms during endocrine treatment for breast cancer can indicate a reduced chance of cancer recurrence, suggesting treatment success. Women with hormone-receptor-positive tumours who reported these symptoms had lower recurrence rates compared to those without symptoms.
A review found that off-label use of anticancer drugs ranged from 6.7% to 33.2% between 1990 and 2002, primarily used in palliative care. The study highlights the need for accurate data on off-label use to inform decision-making by health professionals.
The Lancet Editorial highlights China's health system reform as a starting point for broader dialogue on wellbeing. Key challenges include human rights, freedom of expression, Tibet, and Taiwan.
A study published in The Lancet predicts John McCain's mortality rate due to melanoma, with a 10-year survival rate of 24%. The author suggests that McCain's risk improves if his cancer has not spread, reducing the annual mortality rate to 6% per year.
A phase II trial of oral fumarate (BG00012) showed a 69% reduction in new gadolinium enhancing lesions and a 32% decrease in annual relapse rate. Longer-term studies are underway to confirm these findings and establish its place in multiple sclerosis treatment.
A new study published in The Lancet found that tesofensine can produce weight loss up to twice that of current medications, with the lowest dose showing promising results. Researchers believe this could be a game-changer for treating obesity, but larger trials are needed to confirm.
Experts warn that both John McCain's and Barack Obama's healthcare plans will be significantly impacted by the $700 billion bailout. McCain's plan would cut federal insurance for the poor, while Obama's plan proposes expanded coverage with standard benefits. The bailout is expected to diminish prospects for health reform.
China faces a significant health and economic challenge due to rising chronic diseases, including high blood pressure and smoking. The country has an ageing population and increasing rates of obesity, diabetes, and cardiovascular disease, with tobacco use being a major factor in these trends.
The Lancet Series on Health System Reform in China discusses the need for an efficacy-driven approach in traditional Chinese medicine (TCM) research. Poor people rely heavily on herbal medicine, but many treatments lack reliable evidence of efficacy, exacerbating healthcare inequity.
The Chinese early detection system for infectious diseases has identified clusters of bird-flu in humans in real time, providing authorities with early warning of the start of a pandemic. The system has been instrumental in reducing the impact of infectious diseases, with significant gains in life expectancy and infant mortality rates.
Despite having more doctors than nurses, China struggles with uneven distribution and lack of employment for medical graduates. This maldistribution can be corrected through national policies that incentivize health professionals to work in rural areas.
The report aims to initiate collaboration between The Lancet, China Medical Board, and WHO to strengthen China's health system. Key findings include improved translational research capacity and increased international collaboration.
China's high out-of-pocket medical expenses hinder its progress in providing adequate health insurance coverage. The country needs to improve health insurance coverage and quality by tackling rising costs and the distribution of funds. Implementing a per-patient-episode system, like South Korea, may help reduce costs.
China has introduced new regulations for organ transplantation that ban financial rewards for donors and establish safeguards to prevent exploitation. The changes have led to a significant decrease in transplants from dead donors and an increase in living donor transplants.
China is facing significant challenges to health equity, with rural infant mortality rates nearly five times higher than in urban areas. The country has established health insurance schemes, but faces issues with market failures, inadequate government investment, and inequity in social determinants of health.
Injury-related deaths account for over 10% of all Chinese deaths, mainly due to traffic accidents, drowning, and pesticide poisoning. The authors suggest implementing low-cost prevention measures such as stricter driving laws, pesticide restrictions, and swimming education to reduce injury mortality rates.
China has made significant strides in providing maternal and newborn health services, with coverage increasing from 20% in rural areas to 62% in 2003. However, the country still struggles with non-communicable diseases, smoking cessation, and affordability of healthcare, with 438 million people facing difficulties accessing care in 2003.
The Lancet Series on Health System Reform in China brings together scientific evidence on China's major health challenges and its health strategies. The series aims to foster collaboration between China, the World Health Organization, and international partners to strengthen the Chinese people's healthcare.
Recent studies confirm the prevalence of migraine remains stable, with aura doubling heart attack risk and increasing cardiovascular disease mortality. New treatments targeting calcitonin gene-related peptide (CGRP) show promise, with olcegepant and telcagepant demonstrating effective pain relief.
The Lancet Editorial recommends four top candidates - Tim Barnett, Stefano Bertozzi, Michel Sidibé and Debrework Zewdie - to succeed outgoing Executive Director Peter Piot. The selected candidates will be evaluated on their vision and plans for the new role.
A new dispersible antimalarial tablet is as effective as crushed tablets, improving adherence and cure rates in children. The study found a higher day-28 cure rate and lower adverse events with the new tablet.
Long-term follow-up data from the APPROVe trial confirm that rofecoxib substantially increases the risk of stroke, heart attack, and death compared to placebo. The relative risk of reaching cardiovascular events was increased by 79% in the rofecoxib group.
The Movement for Global Mental Health aims to scale up mental health services globally through citizen advocacy and action. Key findings include the establishment of national taskforces in Vietnam and Indonesia, as well as progress in Brazil.
A new drug class, ranolazine, has been approved for the treatment of chronic stable angina, providing a safe and effective alternative to existing treatments. Ranolazine has been shown to reduce anginal episodes by one attack per week and extend exercise time before an angina attack develops, with benefits seen in men more than women.
A case report highlights the risk of thiamine deficiency disease after gastric bypass surgery for obesity, which can lead to severe neurological symptoms. Patients are advised to take multivitamins and monitor their thiamine levels to prevent this condition.
A study published in The Lancet Neurology found that patients in a minimally conscious state may experience pain perception similar to healthy individuals. This suggests that these patients could benefit from painkilling treatment, which is currently challenging due to limited awareness of their condition.
A genetic association with SERPING1 has been found to be strongly linked to age-related macular degeneration, a leading cause of visual impairment and blindness. The study's findings have significant implications for the development of novel treatments for this devastating disease.
A substudy of the Physician's Health Study found that overweight men with high plasma concentrations of C-peptide, a protein reflecting insulin secretion, had significantly higher prostate-cancer mortality rates. Men with both high C-peptide and BMI prior to diagnosis had a four times higher risk of disease-specific mortality.