Effective management of insomnia begins with recognition and adequate assessment by healthcare providers. Non-pharmacological treatments like stimulus control and sleep restriction are effective for conditioned aspects of insomnia, leading to durable long-term improvement in sleep.
The Joint Learning Initiative proposes that strengthening human resources for health is crucial in combating health crises and building sustainable health systems. To achieve the required health improvements and millennium goals, an estimated 4 million extra health workers worldwide are needed, with a focus on tripling human resources ...
A Ugandan clinical trial has identified the most effective drug combinations for treating malaria in Africa, with amodiaquine+sulfadoxine-pyrimethamine proving to be a highly efficacious and economical option. The findings highlight the need for continued research into artemisinin-combination therapies in African field conditions.
Key findings highlight the need for renewed public health strategies, especially in high-risk groups, to prevent sexually transmitted HIV. Experts emphasize the importance of abstinence, fidelity, and condom use, as well as providing contraception to women on antiretroviral drugs, particularly in Africa.
Researchers suggest that skeletal-muscle satellite cells can differentiate into neural cell lineages, potentially repairing damaged muscle or nerve tissue. These stem cells were shown to organise skeletal-muscle fibres in rats with spinal-cord injury and differentiate into astrocytes and neurons.
Up to 70% of spina bifida cases can be prevented by maternal folic acid supplementation around the time of conception. Individuals with spina bifida require both surgical and medical management throughout their lives.
A randomized trial found that daily doses of cheap antibiotic co-trimoxazole nearly halved the mortality rate compared to placebo among HIV-infected children in Zambia. The study suggests that all children with clinical features of HIV infection in Africa should receive co-trimoxazole prophylaxis, regardless of age or CD4 count.
A randomized trial has demonstrated that a HPV vaccine is effective in preventing persistent HPV infections, abnormal Pap tests, and precancerous lesions. The vaccine's efficacy rate is up to 95%, suggesting a substantial reduction in cervical cancer rates globally.
Researchers found increased levels of uncoupling proteins (UCP2 and UCP3) in the hearts of patients with coronary artery bypass graft surgery. This suggests a possible mechanism linking heart failure to energetic abnormalities. The study's findings may lead to new treatment approaches to correct these energy defects.
The Lancet publishes a series of articles on public health in complex emergencies, highlighting progress made in responding to health consequences of such events. Despite improvements, renewed focus is required on major causes of death in conflict-affected societies, including acute respiratory infections and malnutrition.
Researchers found that Philip Morris used a German-based research facility to study the health effects of tobacco smoke in the early 1970s. The company allegedly concealed this information from the public and even within its own executives, publishing only selective results that supported the industry's interests.
A large UK trial found no significant improvements in survival, hospital admissions, or quality of life from comprehensive assessment and management of elderly patients. However, social functioning showed a small benefit from hospital-based outpatient geriatric care.
A systematic review of studies found that atenolol had no significant effect on reducing death from all causes, cardiovascular causes, or incidence of heart attack. However, it showed a trend towards reduced stroke incidence and increased mortality compared to other antihypertensive drugs.
The Vioxx drug was found to increase the risk of heart attacks in patients, with a doubling of risk compared to placebo or other non-steroidal anti-inflammatory drugs. The data showed that adverse cardiovascular effects were evident earlier than September 2004.
A US study found that most low-grade cervical lesions (LSIL) in young women will regress spontaneously, lending support for monitoring these cytological lesions. Follow-up HPV status was a strong predictor of regression, but persistent multiple HPV types slowed rates of regression.
The SARS outbreak highlighted the importance of preparedness and response in hospitals. Quarantine strategies proved ineffective as most cases were acquired in hospital settings. In contrast, Taiwan successfully replaced quarantine with better preparedness for future pandemics.
A study in Kenya found that pediatric admission rates varied significantly among hospitals, with basic resources available in only 12 of 14 first-referral level hospitals. Strengthening district hospital infrastructure is crucial for achieving the Millennium Development Goal for child survival.
Two studies on the Integrated Management of Childhood Illness (IMCI) strategy found that it can lead to significant reductions in child mortality rates, particularly in developing countries. In Tanzania and Bangladesh, IMCI implementation resulted in lower child mortality rates compared to areas without the program.
Researchers found that routine screening of blood samples to detect viral RNA in organ and tissue donors could reduce disease transmission among transplant recipients. The study suggests that nucleic acid testing (NAT) may be used to improve viral safety of grafts.
A study by Les Roberts and colleagues found that the risk of death was 2.5 times greater after the invasion, with violence accounting for most excess deaths. The researchers estimate that 100,000 excess civilian deaths may have occurred since the 2003 invasion.
Research suggests that teenage hormone therapy to reduce adult height in tall girls is linked to impaired fertility later in life. Women who received oestrogen therapy were more likely to experience difficulty becoming pregnant and had a lower per cycle rate of conception.
A recent study reports four cases of angiographically-confirmed stent thrombosis after elective implantation of drug-eluting stents, resulting in myocardial infarction. The authors emphasize the need for careful long-term follow-up to assess late thrombosis risk
The Lancet editorial emphasizes the need for a more compassionate approach to end-of-life medical decisions, particularly in cases where parents and doctors disagree. The article advocates for arbitration as an alternative to court proceedings, citing its potential to resolve conflicts in a more constructive manner.
Researchers found that beta interferon significantly reduced brain tissue loss and slowed MS progression, with around a third of patients showing improved outcomes. The study's results suggest that beta interferon may be an effective treatment for delaying the progression of multiple sclerosis.
The Lancet article advocates for randomized criminal-justice trials to improve evidence-based decision-making in the UK. The proposed approach would involve randomizing offenders between drug treatment and testing order, or alternative sentence, to inform judicial decisions.
A malaria vaccine trial has shown encouraging phase II results, demonstrating a 30% reduction in clinical episodes of malaria among young children. The RTS,S/AS02A vaccine has also shown effectiveness in preventing subsequent new infections and severe malaria cases.
The influenza vaccine faces production challenges, with Chiron's manufacturing troubles affecting UK and US supplies. To mitigate this, manufacturers are diversifying their output to ensure vaccination for high-risk groups is maintained.
A study found that 31% of acute medical inpatients lack mental capacity, but recognition by clinical staff is low. Increasing age and cognitive impairment are key factors associated with a lack of mental capacity.
The US-led humanitarian relief effort in Iraq was plagued by mismanagement, with the Department of Defense dominating the effort. The Office of Foreign Disaster Assistance and other agencies had more experience handling crises, but were overlooked. The study highlights the importance of separating military and humanitarian assistance.
The article discusses the importance of rigorous data collection and review in drug development, citing the Vioxx case as a prime example. Pharmaceutical companies must also learn from their mistakes, and regulatory agencies must reassess safety and efficacy thresholds to prevent patient harm.
A large international study has found that anti-inflammatory drugs commonly used to treat severe head injuries can increase the risk of death by up to 20% within two weeks. The CRASH trial recruited over 20,000 patients from 49 countries and concluded that these drugs should not be used routinely to treat head injury
A Dutch study found over 5% of parents reported smothering, slapping, or shaking their baby due to crying. The risk was highest for parents from non-industrialized countries and those with limited work hours.
A new study suggests that providing air rather than 100% oxygen for newborn babies requiring ventilation after delivery can reduce infant mortality. The findings are based on a systematic review and meta-analysis of five trials, which found that 5% fewer babies given air died compared to those given 100% oxygen.
A recent study found that more than a million people have become internally displaced in Darfur, Sudan, with extremely high death rates due to violence and insecurity. The research confirmed the serious nature of the crisis, highlighting the need for humanitarian aid and accountability.
The Lancet article highlights the under-reported issue of elder abuse, affecting 2-10% of elderly people and increasing mortality risk by three times. A multidisciplinary approach involving family physicians, nursing, social workers, advocacy organisations, and law enforcement is crucial for accurate diagnosis and management.
A systematic review and meta-analysis found that antioxidant supplements do not prevent gastrointestinal cancers and may actually increase mortality risk. The study analyzed data from 14 randomized trials involving over 170,000 participants.
Researchers screened 2000 anonymous surgical tonsillectomy specimens for the presence of rogue prion protein causing vCJD. No positive cases were identified, but a national large-scale prospective prevalence study is necessary to determine true community infection rates.
A European study found that shorter chemotherapy courses for children with Wilms' tumour are as effective as traditional treatment, but with reduced side effects and healthcare costs. The two-year survival rate was around 90% in both groups.
A randomized controlled trial found that patients referred to an alcohol-health worker after visiting the emergency department consumed significantly less alcohol over six months. This intervention reduced reattendance at emergency departments by 0.5 visits on average per year.
A 39-year-old woman gave birth to a healthy baby girl after undergoing orthotopic autotransplantation of cryopreserved ovarian tissue. This procedure bypasses the need for in-vitro fertilization, offering new hope for young cancer patients facing premature ovarian failure.
The Lancet editorial advocates for free access to genome data, highlighting its benefits in accelerating research on diseases such as SARS. This open-access policy promotes international cooperation, trust, and altruism, offering a compelling alternative to bioweapons.
A study found that oral amoxicillin was as effective as injectable penicillin in treating severe pneumonia in young children. The treatment has the potential to reduce referral, admission, and treatment costs in developing countries.
A Swedish study of over 700,000 young adults found that low birthweight and being born to a teenage mother are independent risk factors for increased suicide risk. The study also showed that individuals born fourth or more in sibling order and those from poor maternal socio-economic backgrounds are at higher risk of attempted suicide.
A randomised trial found that doubling the daily dose of imatinib improves progression-free survival by 12% compared to a single daily dose. The study also showed no significant difference in treatment side-effects between the two groups.
A study finds that 50% of patients with Crohn's disease have viable MAP in their blood, suggesting a systemic infection. The findings raise questions about the role of MAP in IBD and highlight the need for further research to clarify its significance.
A randomized trial found that coronary angioplasty within 24 hours of medical therapy for heart-attack patients can significantly improve outcomes. The study, GRACIA-1, showed a halved rate of death, reinfarction, or revascularisation at 12 months compared to conservative treatment.
A recent study found that people with schizophrenia in China are 24 times more likely to die by suicide than those without the condition. The research suggests a possible link between the prevalence of schizophrenia and suicide in women, who make up a larger proportion of those affected.
The Lancet task force outlines a research agenda to strengthen health systems and deliver effective interventions in an equitable manner. The proposal aims to enhance capacity for delivering life-saving interventions, particularly in the developing world.
A recent UK study published in The Lancet has found no association between the MMR vaccine and the development of autism or pervasive developmental disorders. Researchers analyzed data from over 1,300 cases and 4,469 controls, concluding that vaccination did not increase the risk of these conditions.
Primary-care research is criticized for its weakness, but experts argue that reliable evidence is needed to support clinical practice. Effective primary care research influences clinical practice and improves healthcare. Improved investment in high-quality research is necessary to attract top researchers.