Riviste scientifiche

Meet the turtles surviving an invasion of enormous tractors

New Scientist - Sa, 19/08/2017 - 12:00
The eastern painted turtles must now live among enormous, noisy machinery – and studying them is offering clues to how animals survive alongside heavy industry

[Editorial] 40 years of percutaneous coronary intervention: where next?

The Lancet - Sa, 19/08/2017 - 00:00
When cardiologists gather in Barcelona, Spain, from Aug 26–31 for the annual European Society of Cardiology meeting, they will celebrate Andreas Grüntzig in a special tribute session. Grüntzig performed the first percutaneous coronary angioplasty on Sept 16, 1977, at the University Hospital Zurich, Switzerland, on a 38-year-old patient with a high-grade discrete stenosis of the proximal left anterior descending coronary artery. He reported the first five patients in The Lancet in 1978. To mark this breakthrough and the birth of interventional cardiology, this year's conference spotlight is on 40 years of percutaneous coronary interventions (PCI).

[Editorial] The rising north–south divide in health in the UK

The Lancet - Sa, 19/08/2017 - 00:00
The north–south divide in the UK, and in England in particular, is made up of economic and health-related disparities, among other socioeconomic factors. An article by Iain Buchan and colleagues, published on Aug 7 in the Journal of Epidemiology and Community Health, reported that in the past 20 years, age- and sex-adjusted excess mortality has increased by as much as 46 percentage points in people aged 35–44 years in the north of England compared with the south, and by 27 percentage points in people aged 25–34 years.

[Editorial] Nicotine addiction, reduction, and smoking cessation

The Lancet - Sa, 19/08/2017 - 00:00
Last week, the US Food and Drug Administration (FDA) announced a multiyear roadmap to begin regulating the amount of nicotine allowed in tobacco products. Researchers, including tobacco control advocates, have proposed nicotine reduction as a way of decreasing levels of tobacco use, and the USA may be the first country to seriously discuss using this form of regulation to produce a potentially less addictive form of tobacco. In the wake of the FDA announcement, it was widely reported that other countries, including the UK, Canada, New Zealand, and Finland, have suggested that they would consider nicotine reduction policies for manufacturers.

[Comment] Intravenous fibrinolytics in STEMI: a 25-year perspective

The Lancet - Sa, 19/08/2017 - 00:00
Heart disease remains the number one cause of mortality and morbidity across most of the world.1 Although rates of acute myocardial infarction have fallen in high-income countries, mostly as a consequence of improved lifestyle modifications and continued evolution of risk factor modification,2 acute myocardial infarction remains the most important driver of cardiac mortality. The cornerstones of therapy for acute myocardial infarction have been based on the open-artery hypothesis.3 Previous experimental animal models have shown the initiation of myocardial cell death early after ligation of an epicardial coronary artery.

[Comment] Expansion of the treatment toolbox for mitral regurgitation

The Lancet - Sa, 19/08/2017 - 00:00
In The Lancet, Fabien Praz and colleagues1 report their preliminary experience with the PASCAL mitral repair device and its success among 23 patients, most of whom were not considered anatomically suitable for conventional percutaneous mitral repair.2 The authors did a multicentre, prospective, observational, first-in-man study, collecting data from seven tertiary care hospitals in five countries. Eligible patients were those with symptomatic, severe functional, degenerative, or mixed mitral regurgitation who were denied other surgical or transcatheter options.

[Comment] Hunting hidden parasites: Trypanosoma cruzi

The Lancet - Sa, 19/08/2017 - 00:00
Pathogens are not aware of international borders, including pathogens that cause emerging and neglected tropical diseases. Although Chagas disease is endemic to Latin America, where it affects around 5·7 million people,1,2 it is now a disease of global concern mainly because of the movement of human populations. After the USA, Spain hosts the highest number (more than 50 000) of migrants infected with Trypanosoma cruzi, the parasite that causes this life-threatening disease.3,4 European countries should therefore adapt their legislation to control the main non-vector modes of T cruzi transmission (blood transfusions and haemoderivatives, and organ transplantation).

[World Report] The cost of complacency—black lung in Australia

The Lancet - Sa, 19/08/2017 - 00:00
Black lung's resurgence in Australia is a wake-up call for the international community.

[Perspectives] Jeroen Bax: inspiring the next generation of cardiologists

The Lancet - Sa, 19/08/2017 - 00:00
A conversation with the eminent cardiologist Eugene Braunwald fuelled Jeroen Bax's interest in nurturing aspiring cardiologists. “Braunwald told me that what really matters is developing the next generation of researchers and clinicians”, he recalls. By 2018, Bax will have mentored 60 international PhD students in his cardiac imaging research centre at Leiden University Medical Center (LUMC) in the Netherlands. “Jeroen's students have achieved prominent positions at medical institutions throughout the world”, says Anthony DeMaria, Professor of Medicine at the University of California, San Diego.

[Perspectives] Fat and heart disease: challenging the dogma

The Lancet - Sa, 19/08/2017 - 00:00
Many readers will be incensed by this book. If you think saturated fats and cholesterol are bad for you, you'll be incensed. If you think the fat story is exaggerated, you'll be incensed. If you trust in the objectivity of science to inform health policy, you'll be incensed. Stories of shocking scientific corruption and culpability by government agencies are all to be found in Nina Teicholz's bestseller The Big Fat Surprise. This is a disquieting book about scientific incompetence, evangelical ambition, and ruthless silencing of dissent that has shaped our lives for decades.

[Obituary] Prudence Mabele

The Lancet - Sa, 19/08/2017 - 00:00
South African HIV and gender rights activist. Born in Wattville, South Africa, on July 21, 1971, she died from pneumonia in Johannesburg, South Africa, on July 10, 2017, aged 45 years.

[Correspondence] Global health: generation men

The Lancet - Sa, 19/08/2017 - 00:00
The Fearless Girl statue that faces down Wall Street's charging bull grabbed international headlines and triggered a debate about the glass ceiling that continues to obstruct women from reaching the higher echelons of the financial sector.

[Correspondence] China, Africa, and US academia join hands to advance global health

The Lancet - Sa, 19/08/2017 - 00:00
In 2016, Chinese President Xi Jinping announced the Healthy China 2030 plan—an ambitious agenda to promote health across China and to strengthen South–South cooperation, including the China–Africa Public Health cooperation plan.1 In 2005, African heads of state championed the Agenda Africa 2063, which had a similar emphasis on population health.2 Ongoing health reforms across both Africa and China offer immense potential for mutual learning.3,4 China's success in the provision of preventive and primary care has the potential to inform health care in Africa, which faces similar challenges today as China did more than three decades ago; however, Chinese academic health experts have been unable to translate Chinese experiences to the African context, and suggest academic institutions in both countries need more capacity building to foster sustainable changes to the local health systems.

[Correspondence] PubMed should raise the bar for journal inclusion

The Lancet - Sa, 19/08/2017 - 00:00
A survey by Manca and colleagues1,2 found that predatory journals active in neuroscience and neurology outnumber those regularly indexed in the main biomedical databases. Furthermore, this analysis of predatory publishing (as of October, 2016) showed that over 10% of predatory journals in three important subdisciplines are indexed in PubMed (12% for rehabilitation, 11·4% for neurosciences, and 20·2% for neurology).1,2

[Correspondence] The BLISTER study: possible overestimation of tetracycline efficacy

The Lancet - Sa, 19/08/2017 - 00:00
The BLISTER study, by Hywell C Williams and colleagues (March 6, p 1630),1 indicated that a 25% decrease in the efficacy of tetracycline in the early control of blisters would be acceptable to most UK dermatologists, if accompanied by a reduction of at least 20% in long-term serious side-effects compared with prednisolone. The efficacy of the tetracycline doxycycline was acceptable according to the study's primary effectiveness measure at 6 weeks (upper limit of 90% CI of adjusted difference between treatments [UB], 26·1%, within the 37% predefined acceptable non-inferiority margin [AM]); however, we question the aspects of the study design that appear to favour doxycycline.

[Correspondence] The BLISTER study: possible overestimation of tetracycline efficacy – Authors' reply

The Lancet - Sa, 19/08/2017 - 00:00
We thank Michael J Sladden and Peter E Hutchinson for their comments, but respectfully disagree that our study design1 favoured doxycycline. BLISTER was not an efficacy study of doxycycline versus prednisolone. We investigated whether a doxycycline-initiated pemphigoid treatment strategy could result in improved safety and acceptable effectiveness, when compared with starting with prednisolone. The doxycycline-initiated strategy was expected to be 25% less effective than prednisolone at 6 weeks.

[Correspondence] Forgotten episodes of euthanasia in the 19th century

The Lancet - Sa, 19/08/2017 - 00:00
Two forgotten episodes of euthanasia occurred in the 19th century. The first was recounted by Giuseppe Bandi,1 an officer of Giuseppe Garibaldi, who was injured during the Battle of Calatafimi in 1860 (Sicily, Italy). Bandi was subsequently admitted to the san Michele Convent (Calatafimi, Italy), where other soldiers who had also been gravely wounded were recovering. Among the soldiers was a young man—the Mantuan—with a broken leg who had gangrene and another—the Maironi from Bergamo—who had been wounded by a bullet to his right arm.

[Articles] Comparative efficacy and safety of reperfusion therapy with fibrinolytic agents in patients with ST-segment elevation myocardial infarction: a systematic review and network meta-analysis

The Lancet - Sa, 19/08/2017 - 00:00
Significant differences exist among various fibrinolytic regimens as reperfusion therapy in STEMI and alteplase (accelerated infusion), tenecteplase, and reteplase should be considered over streptokinase and non-accelerated infusion of alteplase. The addition of glycoprotein IIb or IIIa inhibitors to fibrinolytic therapy should be discouraged.

[Articles] Compassionate use of the PASCAL transcatheter mitral valve repair system for patients with severe mitral regurgitation: a multicentre, prospective, observational, first-in-man study

The Lancet - Sa, 19/08/2017 - 00:00
This study establishes feasibility of the Edwards PASCAL TMVr system with a high rate of technical success and reduction of mitral regurgitation severity. Further research is needed on procedural and long-term clinical outcomes.

[Series] Coronary balloon angioplasty, stents, and scaffolds

The Lancet - Sa, 19/08/2017 - 00:00
Since the first coronary angioplasty on Sept 16, 1977, the field of percutaneous coronary intervention has evolved rapidly. Now marking its 40th anniversary, percutaneous coronary intervention has become one of the most common medical procedures worldwide. Much of this progress has been due to the iteration and improvement of angioplasty technologies. Balloon angioplasty was limited by unpredictable procedural outcomes due to vessel dissection and recoil, and a high rate of restenosis. The introduction of stents resulted in more stable early results and lower rates of restenosis, although early stent thrombosis and neointimal hyperplasia causing vessel renarrowing were key limitations.
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