Riviste scientifiche

[Perspectives] Anne Chang: a champion of childhood lung health

The Lancet - Ve, 07/09/2018 - 23:00
At a health centre in Melbourne for Aboriginal and Torres Strait Islanders in the late 1980s, medical student Anne Chang had her eyes opened to Indigenous disadvantage in Australia. “The patients there had diseases not seen in mainstream medicine”, she says. “Pus from the children's ears and chronic cough with purulent nasal discharge were common.” It was one of many experiences of health inequities that helped drive her passion for improving the health of disadvantaged groups. “People who are worse off should be given the best care”, says Chang, now Professor and Head of the Child Health Division at Menzies School of Health Research in Darwin and Consultant Paediatric Respiratory Physician at Children's Health Queensland Hospital in Brisbane.

[Perspectives] Understanding heartbreak: from Takotsubo to Wuthering Heights

The Lancet - Ve, 07/09/2018 - 23:00
Although an enduring subject of art, music, and literature, it was not until the 1990s that medicine concluded that one can succumb to a broken heart. Japanese physician Hikaru Sato characterised the first case reports of Takotsubo cardiomyopathy, a cardiac response to acute emotional stress. The condition was poetically dubbed the “broken heart syndrome”.

[Perspectives] Perpetual change

The Lancet - Ve, 07/09/2018 - 23:00
Transformations large and small are responsible for life and the world around us—from the structural rearrangements of proteins in our bodies, from one millisecond to the next, to the moulding of our Earth's continents, oceans, mountains, and plains over eons. The ability to change and transform is not only needed to instigate and shape, but also to maintain and evolve. Without an ability to change, we could not grow, move, or think. In Shapeshifters: On Medicine & Human Change, Gavin Francis, a writer and general practitioner based in Edinburgh, UK, explores change in the human body and its relation to health and disease.

Denis Anthony Mitchison

The Lancet - Ve, 07/09/2018 - 23:00
Pioneering tuberculosis researcher. He was born in Oxford, UK, on Sept 6, 1919, and died following a bilateral pulmonary embolism in Kingston, UK, on July 2, 2018, aged 98 years.

[Correspondence] Interpretation of results of pooled analysis of individual patient data

The Lancet - Ve, 07/09/2018 - 23:00
The collaborative meta-analysis of individual patient data on percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) by Stuart J Head and colleagues (March 10, p 939)1 is a very welcome addition to the literature, establishing convincingly the superiority of CABG over PCI on the important outcome of all-cause mortality (hazard ratio 1·20, 95% CI 1·06–1·37; p=0·004). However, the conclusions offered by the authors are methodologically incorrect and their publication in a major journal surprising.

[Correspondence] Interpretation of results of pooled analysis of individual patient data

The Lancet - Ve, 07/09/2018 - 23:00
We read with interest the meta-analysis by Stuart J Head and colleagues1 of individual patient data from randomised trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with multivessel or left main disease. The authors found variation in outcomes according to the anatomical complexity of coronary artery disease, as gauged by the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score,2 but reported negative tests for interaction between subgroups of patients in the low (<23), middle (23–32), and high (>32) SYNTAX score tertiles and hazard ratios of death.

[Correspondence] Interpretation of results of pooled analysis of individual patient data – Authors' reply

The Lancet - Ve, 07/09/2018 - 23:00
We thank Nick Freemantle and Domenico Pagano, and Peter Jüni and colleagues for their comments on our Article on mortality after coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI), in which we identified important subgroup differences that might affect the choice of revascularisation modality.1

[Correspondence] Fixed-dose combinations for hypertension

The Lancet - Ve, 07/09/2018 - 23:00
Globally, 1·4 billion people have hypertension, of whom less than 15% have their blood pressure appropriately controlled1 and, as a result, elevated blood pressure is a leading cause of death globally, killing more than 10 million people a year. In low-income and middle-income countries, more than 70% of the treated patients with hypertension have uncontrolled blood pressure. One major reason for low levels of control is that most patients only receive monotherapy,1,2 although evidence suggests that most patients require two drugs or more to achieve optimal and sustained blood pressure control.

[Department of Error] Department of Error

The Lancet - Ve, 07/09/2018 - 23:00
Karthikeyan G, Guilherme L. Acute rheumatic fever. Lancet 2018; 392: 161–74—In panel 3 of this Seminar, the penultimate sentence in the first paragraph should read “A first or recurrent episode of acute rheumatic fever can be diagnosed in the presence of two major criteria, or one major and two minor criteria.” This correction has been made to the online version as of Sept 6, 2018.

[Department of Error] Department of Error

The Lancet - Ve, 07/09/2018 - 23:00
Azizi M, Schmieder RE, Mahfoud F, et al. Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomised, sham-controlled trial. Lancet 2018; 391: 2335–45—For this Article, the author list on PubMed has been updated to include all members of the RADIANCE-HTN Investigators. This change has been made online as of Sept 6, 2018.

[Department of Error] Department of Error

The Lancet - Ve, 07/09/2018 - 23:00
Bandara AN, Mehrnoush V. Electronic cigarettes: adolescent health and wellbeing. Lancet 2018; 392: 473. In this Correspondence, the corresponding author's email address was incorrect. This has been corrected online as of Sept 6, 2018.

[Articles] Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis

The Lancet - Ve, 07/09/2018 - 23:00
Although inferences are limited by the observational nature of these data, treatment outcomes were significantly better with use of linezolid, later generation fluoroquinolones, bedaquiline, clofazimine, and carbapenems for treatment of multidrug-resistant tuberculosis. These findings emphasise the need for trials to ascertain the optimal combination and duration of these drugs for treatment of this condition.

[Clinical Picture] Rhinocerebral aspergillosis

The Lancet - Ve, 07/09/2018 - 23:00
A 27-year-old man presented to our hospital with a 4-month history of bilateral frontal headache, irritability, frontal lobe signs, bilateral proptosis, and nasal obstruction. He had no other signs or symptoms of a systemic illness. Rhinoscopy showed a soft tissue mass obstructing both nasal airways. A CT scan of his head showed hyperdense lesions involving both the paranasal sinuses (figure), with expansions into the frontal interdiploë spaces, and some calcification (figure). An MRI scan of the brain showed a soft tissue mass extending along the anterior cranial fossa floor up to the sellar and parasellar regions (figure).

[Series] Bronchiectasis in children: diagnosis and treatment

The Lancet - Ve, 07/09/2018 - 23:00
Bronchiectasis is conventionally defined as irreversible dilatation of the bronchial tree. Bronchiectasis unrelated to cystic fibrosis is an increasingly appreciated cause of chronic respiratory-related morbidity worldwide. Few randomised controlled trials provide high-level evidence for management strategies to treat the children affected by bronchiectasis. However, both decades-old and more recent studies using technological advances support the notion that prompt diagnosis and optimal management of paediatric bronchiectasis is particularly important in early childhood.

[Series] Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity

The Lancet - Ve, 07/09/2018 - 23:00
Bronchiectasis is characterised by pathological dilation of the airways. More specifically, the radiographic demonstration of airway enlargement is the common feature of a heterogeneous set of conditions and clinical presentations. No approved therapies exist for the condition other than for bronchiectasis caused by cystic fibrosis. The heterogeneity of bronchiectasis is a major challenge in clinical practice and the main reason for difficulty in achieving endpoints in clinical trials. Recent observations of the past 2 years have improved the understanding of physicians regarding bronchiectasis, and have indicated that it might be more effective to classify patients in a different way.

Correction: Suppression of GATA-3 Nuclear Import and Phosphorylation: A Novel Mechanism of Corticosteroid Action in Allergic Disease

PLoS Medicine - Ve, 07/09/2018 - 22:00

by Kittipong Maneechotesuwan, Xin Yao, Kazuhiro Ito, Elen Jazrawi, Omar S. Usmani, Ian M. Adcock, Peter J. Barnes

Google’s AI hate speech detector is easily fooled by a few typos

New Scientist - Ve, 07/09/2018 - 17:01
Demand is growing for tools that automatically flag online hate speech, but the current crop can easily be fooled by adding a few typos or an innocuous word

Japan wants people to virtually embody avatars orbiting in space

New Scientist - Ve, 07/09/2018 - 16:56
The Japanese space programme has partnered with an airline to build humanoid robots to assist astronauts and allow people on the ground to experience space

Novichok attack: Did Russian agents have enough poison to kill 4000?

New Scientist - Ve, 07/09/2018 - 16:23
Media reports say the dose of Novichok nerve agent used in the Salisbury attack was high enough to kill thousands – but this would have been almost impossible

Glass box of atomic vapour could work as a James-Bond-style spy radio

New Scientist - Ve, 07/09/2018 - 11:42
Most radios use antennae to pick up a signal, but this new one uses a glass box full of vapour instead, with lasers to translate the signal into a sound
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