Riviste scientifiche

[Comment] Maternal mortality in Afghanistan: setting achievable targets

The Lancet - Sa, 20/05/2017 - 00:00
In 2002, soon after the NATO-led overthrow of the Taliban regime, a survey of maternal mortality in Afghanistan was done, commissioned by the Afghan Ministry of Public Health, the US Centers for Disease Control and Prevention, and UNICEF. The results were published in The Lancet in 2005 and estimated the maternal mortality ratio (MMR) to be 1600 deaths per 100 000 livebirths (95% CI 1100–2000),1,2 among the highest in the world and consistent with the UN estimates.1 In the most remote rural district, Ragh, in mountainous Badakhshan Province, the estimate was 6507 per 100 000 livebirths,1 among the highest MMRs recorded globally.

[Comment] Computer-assisted diagnosis for skin cancer: have we been outsmarted?

The Lancet - Sa, 20/05/2017 - 00:00
Skin cancer is the most common malignancy in fair-skinned populations, with melanoma incidence the highest in New Zealand and Australia (50 and 48 per 100 000 population, respectively) and projected to increase in the UK (from 17 to 36 per 100 000 population) and in the USA (from 29 to 32 per 100 000 population) between 2007–11 and 2022–26.1 Non-melanoma skin cancer is up to 20 times more common than melanoma worldwide.2 For every melanoma diagnosed, there are from three to 40 benign lesions biopsied; the proportion of biopsied lesions that are benign is generally greater in primary care than in specialist settings.

[Comment] Arab youth respond to the Lancet Commission on adolescent health and wellbeing

The Lancet - Sa, 20/05/2017 - 00:00
The Lancet Commission on adolescent health and wellbeing1 is a rich compendium of evidence on adolescent health globally, and highlights the importance of youth engagement. Such engagement is vital in the Arab region where youth (15–29 years) comprise about 30% of the population.2 Young people in this region are exposed to structural violence and conflict that affect every aspect of their lives2—a situation that exacerbates the uncertainties of an already tumultuous life stage. Yet young people in the region have used their voices constructively to push for equity and justice.

[Comment] Offline: Israel and Palestine—a joint search for the truth

The Lancet - Sa, 20/05/2017 - 00:00
In July, 2014, amid the tragedy of a war between Israel and Hamas-controlled Gaza—a conflict in which thousands of rockets and missiles were fired, leaving hundreds of children and women dead—The Lancet published a letter by Paola Manduca and colleagues. We had been working with Palestinian health professionals since 2007 to help advance their health and health care through research collaboration. The intention of publishing the letter from Manduca et al was to signal a cry of anguish for a people we had come to know well.

[Special Report] Famine in South Sudan

The Lancet - Sa, 20/05/2017 - 00:00
Famine affects over 100 000 individuals in a country struggling through a violent civil war, where aid workers risk their lives to provide support, hindered by denial of access. Sharmila Devi reports.

[Perspectives] Epilepsy

The Lancet - Sa, 20/05/2017 - 00:00
Whoever wrote the Hippocratic treatise On the Sacred Disease—almost certainly not the historical Hippocrates— had an eye for an ironic title. This short text is a manifesto for the secular, materialistic medicine we associate with the Hippocratics, and a blistering attack on the claims of ancient Greek folk healers and “temple medicine”. The sacred disease—a condition characterised by fits, foaming lips, and loss of consciousness—was not, the author argued, caused by a demon or a heavenly thunderbolt, but was the result of a blockage in the flow of chilly phlegm around the body.

[Perspectives] Instinct versus science

The Lancet - Sa, 20/05/2017 - 00:00
The Essex Serpent is Sarah Perry's second novel and it is doing very well indeed. A plot summary sounds both worthy and complicated, but the reason for its success is plain within a few pages: it is great fun. Perry is playing with and rejoicing in her neo-Victorian Gothic, teasing the reader with a monster that can't really (can it?) be creeping out of the dark water to terrorise an Essex village where the inhabitants are still open to medieval ideas about sin and supernatural beings while down-from-London visitors have digested Charles Darwin and are moving towards the ideas of Sigmund Freud.

[Perspectives] Brain Diaries: two hemispheres of interest

The Lancet - Sa, 20/05/2017 - 00:00
“Understanding the brain and its diseases is one of the key challenges of the 21st century”, said Professor of Clinical Neurology Christopher Kennard at the launch of Oxford University Museum of Natural History's Brain Diaries. “I've said that is like climbing Everest, but I don't even think we've got to base camp”, Kennard explained, citing the growing “problem of dementia: the longer we live, the more likely we are to develop Alzheimer's”. Incorporating research from more than 50 neuroscientists, Brain Diaries explores the passage of a healthy brain from conception to old age.

[Perspectives] Julie Moore: NHS leader who walks the wards

The Lancet - Sa, 20/05/2017 - 00:00
When asked what makes a good manager in the UK's National Health Service (NHS), it's not the obvious core skills—leadership, willingness to delegate, critical thinking—that Dame Julie Moore chooses to emphasise. Moore, Chief Executive of University Hospitals Birmingham (UHB) NHS Foundation Trust, is eager to talk of values: in essence, the determination to make things better for patients. Indeed the words “values” and “patient care” form a kind of leitmotif to her discourse; she returns to them time and time again.

[Perspectives] John Elliotson, Thomas Wakley, and the mesmerism feud

The Lancet - Sa, 20/05/2017 - 00:00
From the first edition of The Lancet in 1823, the journal's founder and editor Thomas Wakley vowed to expose and denounce quackery. In his first leading article—an innovation borrowed from the radical journalist William Cobbett—Wakley pledged that he would seek to end “mystery and concealment” in medicine in order to “detect and expose the impositions of ignorant practitioners”. This, however, was rather easier said than done in the dimly lit world of early 19th-century science.

[Correspondence] Involving adolescents in the discussion about SDGs

The Lancet - Sa, 20/05/2017 - 00:00
How are we to move forward to meet the Sustainable Development Goals (SDGs), set by the UN, without the involvement of adolescents? The Lancet Commission on adolescent health and wellbeing (May 11, p 2423)1 demonstrates a zealous stance towards betterment of the world through improvement of the quality of life of adolescents. Our future: a Lancet commission on adolescent health and wellbeing is a commendable initiative involving a network of academics, policy makers, practitioners, and young health advocates with broad expertise in adolescent health.

[Correspondence] Addressing underlying causes of violence against doctors in India

The Lancet - Sa, 20/05/2017 - 00:00
The Lancet has helped bring global attention to the problem of violence against doctors in China through its Editorials in 2012 (May 12, p 1764)1 and 2014 (March 22, p 1013),2 and has stimulated local discussion on potential solutions. India's health system faces a similar crisis and the magnitude of the Indian problem is, perhaps, greater. More than 2000 junior doctors from 17 government-run hospitals in India's largest city, Mumbai, went on strike for 4 days in March, 2017, to protest a recent spate of violence against doctors.

[Department of Error] Department of Error

The Lancet - Sa, 20/05/2017 - 00:00
Aletaha D, Bingham CO 3rd, Tanaka Y, et al. Efficacy and safety of sirukumab in patients with active rheumatoid arthritis refractory to anti-TNF therapy (SIRROUND-T): a randomised, double-blind, placebo-controlled, parallel-group, multinational, phase 3 study. Lancet 2017; 389: 1206–17—In table 1 of this Article, the n (%) of female patients in the group assigned to 100 mg sirukumab every 2 weeks should be 240 (82%), the mean BMI for placebo should be 28·72, and the units for C-reactive protein should be mg/L.

[Department of Error] Department of Error

The Lancet - Sa, 20/05/2017 - 00:00
Global Burden of Disease Health Financing Collaborator Network. Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet 2017; 389: 1981–2004—The collaborators for this Article also include Lalit Dandona (Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA and Public Health Foundation of India, New Delhi, India), Rakhi Dandona (Public Health Foundation of India, New Delhi, India and Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA), and G Anil Kumar (Public Health Foundation of India, New Delhi, India).

[Department of Error] Department of Error

The Lancet - Sa, 20/05/2017 - 00:00
Global Burden of Disease Health Financing Collaborator Network. Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet 2017; 389: 2005–30 —The collaborators for this Article also include Lalit Dandona (Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA and Public Health Foundation of India, New Delhi, India), Rakhi Dandona (Public Health Foundation of India, New Delhi, India and Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA), and G Anil Kumar (Public Health Foundation of India, New Delhi, India).

Our brains prefer invented visual information to the real thing

New Scientist - Ve, 19/05/2017 - 19:51
When making sense of a visual blind spot, our brains fill in the gaps. We’re more likely to believe its version of what’s in front of us than a real image

Hopping miniature parrots suggest how birds first got airborne

New Scientist - Ve, 19/05/2017 - 19:15
Parrotlets save energy when foraging by jumping from perch to perch with a few wingbeats, a technique that might have predated true flight

Call obesity a disease and food a pathological agent? No thanks

New Scientist - Ve, 19/05/2017 - 18:15
There is a rising trend to label obesity as a disease and even to liken tempting food to a pathogen. That's very unhelpful, says Lara Williams

LIGO could detect gravitational waves’ permanent space-time warp

New Scientist - Ve, 19/05/2017 - 17:33
When gravitational waves permanently distort space-time, it causes a “memory” signal – which may help LIGO find some of the universe’s most exotic objects

Brain stent to let five paralysed people control exoskeleton

New Scientist - Ve, 19/05/2017 - 16:50
The implant travels to the brain via the blood and could provide a permanent way of recording signals used to direct an exoskeleton that helps paralysed people walk
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