Riviste scientifiche

[Perspectives] Making peace with our faulty hearts

The Lancet - Sa, 11/08/2018 - 00:00
In Margaret Atwood's Two Headed Poems (1978), two contrasting voices are heard. “The Woman Who Could Not Live With Her Faulty Heart” focuses on a woman who describes her own heart as a flawed and arrhythmic fish mouth yet speaks of tenderly singing to it. “The Woman Makes Peace With Her Faulty Heart” ends with a description of a precarious truce—a conciliation of sorts, as the woman imagines herself and her heart as distrustful co-conspirators.

[Perspectives] Home truths

The Lancet - Sa, 11/08/2018 - 00:00
Fun Home is a real treat, and one that holds great sadness within it. One friend was so moved by this groundbreaking musical that she got a tattoo to mark the experience. This production at the Young Vic in London, UK, is based on Fun Home (2006), an autobiographical graphic novel by Alison Bechdel, cartoonist and creator of the comic strip Dykes to Watch Out For, which ran from 1983 to 2008. It covers her childhood, her coming out as a lesbian, and her father's death by likely suicide not long after.

[Perspectives] Beyond precision: embracing the politics of global health numbers

The Lancet - Sa, 11/08/2018 - 00:00
“If you cannot measure it, you cannot manage it.” If you attended a global health conference in the past decade, you probably heard a version of this truism at some point. Since the seminal work in 1987 that led to the Global Burden of Disease (GBD) Study, a lot of energy and resources have been spent on getting the global health numbers right. Precision in measurement is perceived as a necessity for the global health agenda.

[Obituary] Arthur Jay Moss

The Lancet - Sa, 11/08/2018 - 00:00
Cardiologist and authority on cardiac arrhythmias. Born in White Plains, NY, USA, on June 21, 1931, he died of cancer in Brighton, NY, USA, on Feb 14, 2018, aged 86 years.

[Correspondence] A Brexit miscalculation

The Lancet - Sa, 11/08/2018 - 00:00
I read with concern Nick Fahy and colleagues' Health Policy (Nov 4, p 2110)1 about how Brexit might affect health and health-care services in the UK. I argue that their Health Policy has a logical flaw and a potential miscalculation (appendix). Fahy and colleagues' key anti-Brexit argument is that EU membership, protective legalities from the Court of Justice of the EU (CJEU), and free movement, tax, and childcare rights are essential to attract and retain much of the UK's National Health Service (NHS) workforce.

[Correspondence] Palliative care and the endless cycle of serious health-related suffering

The Lancet - Sa, 11/08/2018 - 00:00
As Richard Horton pointed out (April 14, p 1465),1 obstacles to accessing palliative care affecting those living with serious health-related suffering are, without any doubt, “the most disfiguring inequity in health care today”.

[Correspondence] The future of radiology: adding value to clinical care

The Lancet - Sa, 11/08/2018 - 00:00
The practice of radiology needs to change for three reasons: subjective decisions about tests are a major contributor to the overuse of services, images are often inconsistently obtained and analysed, and radiology reports often include vague descriptions.

[Correspondence] Electronic cigarettes: adolescent health and wellbeing

The Lancet - Sa, 11/08/2018 - 00:00
We read with interest John N Newton and colleagues' Comment (Feb 6, p 639),1 in which they incorrectly state that “experimentation with ECs [electronic cigarettes] has had no detectable effect on youth smoking rates and increased availability of ECs has not interrupted declining trends in youth smoking in many countries”. We believe that this statement is incorrect and is not supported by evidence in the literature.

[Correspondence] Electronic cigarettes: adolescent health and wellbeing

The Lancet - Sa, 11/08/2018 - 00:00
The Comment by John N Newton and colleagues1 would have been more credible if it had been consistently based on evidence. The authors claim that the findings of the National Academies of Sciences, Engineering, and Medicine report2 are generally in line with the Public Health England evidence review,3 but differences of emphasis exist.

[Correspondence] Electronic cigarettes: adolescent health and wellbeing – Authors' reply

The Lancet - Sa, 11/08/2018 - 00:00
We thank all correspondents for their interest in our Comment.1

[Correspondence] The increase of suicide rates: the need for a paradigm shift

The Lancet - Sa, 11/08/2018 - 00:00
Suicide was highlighted as a major public health issue in a recent release of data by the US Centers for Disease Control and Prevention (CDC).1 The CDC reported a 30% increase (1999–2016) in suicide across all age groups up to age 75 years (in half of all US states), and in 2016, 54% of people in 27 US states who died by suicide had no mental health diagnosis.1 Yet most papers and reports on suicide stress that up to 90% of people who die by suicide had a psychiatric disorder. Despite innovative approaches in both psychiatric treatments and suicide prevention, some important shortcomings seem to have a role in impairing effective progress in reducing deaths by suicide.

[Correspondence] A century ago: Carlo Forlanini and the first successful treatment of tuberculosis

The Lancet - Sa, 11/08/2018 - 00:00
“They have formed a group, for of course a thing like the pneumothorax brings people together. They call themselves the Half-Lung Club.”1Thomas Mann

[Correspondence] Zero tolerance on claims of harassment at UN agency

The Lancet - Sa, 11/08/2018 - 00:00
I read with interest and concern the Special Report by John Zarocostas (April 21, pp 1561–65).1 It is essential that UN agencies provide a safe and secure working environment for their staff, and that all incidents of sexual harassment or abuse are addressed immediately and dealt with appropriately.

[Correspondence] Reducing child mortality in England

The Lancet - Sa, 11/08/2018 - 00:00
Improving the health of women before and during pregnancy and reducing socioeconomic disadvantages could improve infant outcomes in England.1

[Department of Error] Department of Error

The Lancet - Sa, 11/08/2018 - 00:00
Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. Lancet 2018; 391: 939–48—In this Article, percentage symbols have been removed from the mean SYNTAX scores in table 1. Additionally, the data in the last row of the second column in table 2 should have been 11·6% (83/927). These corrections have been made to the online version as of Aug 9, 2018.

[Department of Error] Department of Error

The Lancet - Sa, 11/08/2018 - 00:00
Wallace DJ, Furie RA, Tanaka Y, et al. Baricitinib for systemic lupus erythematosus: a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet 2018; 392: 222–31—The appendix of this Article has been corrected as of Aug 9, 2018.

[Department of Error] Department of Error

The Lancet - Sa, 11/08/2018 - 00:00
Watts G. George F Gao: head of China CDC signals a more global outlook. Lancet 2018; 392: 274—In this Profile, the penultimate sentence of the first paragraph should read “….Director General of the Institute of Microbiology of the Chinese Academy of Sciences”, the second paragraph should begin “Most of Gao's time abroad…”, and the second sentence of the second paragraph should say “spent 3 years at Harvard University”. These corrections have been made to the online version as of Aug 9, 2018

[Articles] Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study

The Lancet - Sa, 11/08/2018 - 00:00
Age at onset of type 1 diabetes is an important determinant of survival, as well as all cardiovascular outcomes, with highest excess risk in women. Greater focus on cardioprotection might be warranted in people with early-onset type 1 diabetes.

[Articles] Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study

The Lancet - Sa, 11/08/2018 - 00:00
Sodium intake was associated with cardiovascular disease and strokes only in communities where mean intake was greater than 5 g/day. A strategy of sodium reduction in these communities and countries but not in others might be appropriate.

[Clinical Picture] Re-expansion pulmonary oedema

The Lancet - Sa, 11/08/2018 - 00:00
A 46-year-old man presented to the emergency department with moderate dyspnoea and a 4-day history of cough. His medical history also included alcoholic cirrhosis with portal hypertension and ascites. On admission, a chest x-ray showed complete white-out of the right hemithorax with contralateral mediastinal deviation compatible with a large pleural effusion—presumed to be hepatic hydrothorax (figure). A chest drain was inserted into the right pleural cavity under ultrasound guidance and 2 L of clear fluid were rapidly drained over approximately 2 min.
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