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[Correspondence] Vitamin A distribution in danger: should we worry?

Ve, 24/08/2018 - 23:00
In an editorial,1 the Editors lament the fact that vitamin A distribution has reached a 6-year low, according to a UNICEF report. However, vitamin A supplementation was never intended to be a long-term sustainable strategy, as reminded by Michael Latham,2 who called attention to the “great vitamin A fiasco” in 2010.

[Correspondence] Did Cro-Magnon 1 have neurofibromatosis type 2?

Ve, 24/08/2018 - 23:00
In their Correspondence to The Lancet (March 31, p1259),1 Philippe Charlier and colleagues infer that the Cro-Magnon 1 skull (Les Eyzies, France) had neurofibromatosis type 1 (NF1). Their diagnosis was based on a micro-CT scan examination and three-dimensional reconstruction of the skull, which permitted a detailed analysis of the cranial fossil remains, including, in particular, the exact bone aspect of a round polycyclic osteolytic lesion on the right frontal bone (attributed to a progressive bone erosion secondary to a subcutaneous schwannoma) and the aspect and size of the cranial nerve foramina (showing “asymmetry of the size of the internal auditory meatus” secondary to an acoustic schwannoma without ad-ditional foramina anomalies).

[Correspondence] Did Cro-Magnon 1 have neurofibromatosis type 2? – Authors' reply

Ve, 24/08/2018 - 23:00
We read with interest the letter by Martino Ruggieri and colleagues about our retrospective diagnosis of the Cro-Magnon 1 skull.1 We are pleased that the diagnosis of neurofibromatosis is not in question but rather its subclassification and clinical presentation.

[Correspondence] Subject of The Vaccine Race offers perspective on errors

Ve, 24/08/2018 - 23:00
I am the “Flawed hero” described by Mark Honigsbaum in his review of The Vaccine Race by Meredith Wadman (May 13, 2017, p1874),1 who he writes is now “enjoying a rehabilitation”.

[Correspondence] Selected and non-selected non-communicable diseases

Ve, 24/08/2018 - 23:00
I was delighted to see the excellent Series paper by Melanie Y Bertram and colleagues (May 19, p 2071)1 dealing with economic issues related to non-communicable diseases, and read the Comments by Richard Horton and Jennifer Sargent2 and by the WHO Director General, Tedros Adhanom Ghebreyesus,3 with much admiration.

[Correspondence] On Hume and planetary health

Ve, 24/08/2018 - 23:00
In a plea for justice in planetary health, Richard Horton (June 9, p 2307)1 cited philosopher David Hume to argue that humans have the ability to choose their own path. Hume, however, is a source of discourse in planetary health for entirely different reasons. His bigotry, racism, and references to savages2 are, ironically, representative of the complex issues of power, elitism, racism, xenophobia, and lack of choice that Horton outlined. Hume wrote for the elites;3 his appalling beliefs about the indigenous people of the circumpolar regions and tropics as “inferior to the rest of the species” and non-whites as “naturally inferior to the whites”4 are indicative of systems of thought persistent today, built on racial and ethnic hierarchy.

[Correspondence] MacArthur Foundation's investment in education: model for the future

Ve, 24/08/2018 - 23:00
In mid-December, 2017, the US-based MacArthur Foundation announced the long-anticipated winner of their highly coveted, and largest ever, grant, a US$100 million competition—100&Change—to fund a single proposal “promising real and measurable progress toward solving a critical problem of our time in any field and from any location”. Almost 2000 programmes worldwide submitted proposals calling for “solving society's biggest problems with bold yet meaningful, verifiable, durable and feasible solutions” with an emphasis on people with disabilities, gender equity, and communities of interest, including potential beneficiaries who might suffer harm if their problems were not addressed immediately.

[Correspondence] The new face of China's foreign aid: where do we go from here?

Ve, 24/08/2018 - 23:00
China's recent constitutional changes have led to international headlines and debate. However, the founding of a new ministry-level agency—the China International Development Cooperation Agency (CIDCA)—has attracted little attention, despite the effect it might have on China's foreign aid policy and global health strategy.

[Department of Error] Department of Error

Ve, 24/08/2018 - 23:00
Tiono AB, Ouédraogo A, Ouattara D, et al. Efficacy of Olyset Duo, a bednet containing pyriproxyfen and permethrin, versus a permethrin-only net against clinical malaria in an area with highly pyrethroid-resistant vectors in rural Burkina Faso: a cluster-randomised controlled trial. Lancet 2018; https://doi.org/10.1016/S0140-6736(18)31711-2—The webappendix of this Article has been corrected as of Aug 23, 2018.

[Clinical Picture] Lipaemia retinalis in familial chylomicronaemia syndrome

Ve, 24/08/2018 - 23:00
A 5-year-old boy presented to our department with a 2-day history of acute febrile illness. During evaluation, his blood samples were found to be so lipaemic (figure) that it caused interference in analyte measurements. The child was born of a non-consanguineous marriage, there was no history of failure to thrive or developmental delay, and there were no reports of any previous episodes of acute pancreatitis. Neither xanthomata nor hepatosplenomegaly was found at clinical examination. Laboratory test results found a normal fasting blood glucose concentration (4·5 mmol/L).

[Comment] No level of alcohol consumption improves health

Gi, 23/08/2018 - 23:30
By use of methodological enhancements of previous iterations,1 the systematic analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 for 195 countries and territories, 1990–2016,2 is the most comprehensive estimate of the global burden of alcohol use to date. The GBD 2016 Alcohol Collaborators clearly demonstrate the substantial, and larger than previously estimated, contribution of alcohol to death, disability, and ill health, globally. In 2016, alcohol use was the seventh leading risk factor for both deaths and disability-adjusted life-years (DALYs), accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of female deaths and 6·8% (5·8–8·0) of male deaths.

[Articles] Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Gi, 23/08/2018 - 23:30
Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

[Correspondence] Updated Zika virus recommendations are needed

Gi, 23/08/2018 - 23:30
Although many questions remain unanswered about Zika virus, lessons can be taken from the recent epidemics, as emphasised during the second international conference on Zika virus and Aedes aegypti-related infections that took place in June, 2018, in Tallinn, Estonia. Zika virus circulation has decreased but the Zika virus story is probably not over.1 The possibility of Zika virus emergence or re-emergence and circulation should be considered in all areas in which the competent mosquito vectors (ie, Aedes spp and particularly A aegypti) are present.

[Correspondence] Economic sanction: a weapon of mass destruction

Lu, 20/08/2018 - 23:30
In ancient era, an army that could not conquer a city embraced by defensive walls would lay siege to the city to block the provision of necessary supplies to people residing therein. This strategy has not changed markedly since then.

[Correspondence] Saudi visa trainees called home from Canada in diplomatic dispute

Lu, 20/08/2018 - 23:30
Saudi Arabia's decision to recall its students in response to the Canadian Minister of Foreign Affairs' tweet1 about two women's rights activists has sparked a crisis in hospitals and communities that rely on Saudi visa trainees. Canada is the third most popular destination for Saudi-sponsored medical trainees in resi-dences and fellowships, after the USA and the UK.2

[Seminar] Leishmaniasis

Ve, 17/08/2018 - 23:30
Leishmaniasis is a poverty-related disease with two main clinical forms: visceral leishmaniasis and cutaneous leishmaniasis. An estimated 0·7–1 million new cases of leishmaniasis per year are reported from nearly 100 endemic countries. The number of reported visceral leishmaniasis cases has decreased substantially in the past decade as a result of better access to diagnosis and treatment and more intense vector control within an elimination initiative in Asia, although natural cycles in transmission intensity might play a role.

[Department of Error] Department of Error

Ve, 17/08/2018 - 23:30
Willer H. Breast cancer in Venezuela: back to the 20th century. Lancet 2018; 392: 461–62—In this World Report, a procedure incorrectly reported as being radiology should have been radiotherapy. This has been corrected online as of Aug 17, 2018.

[Editorial] The wrong kind of enforcement in Bangladesh

Ve, 17/08/2018 - 23:00
Following an incident in Bangladesh on July 29, in which two students were hit by a speeding bus and killed, protests were launched in Dhaka against the current state of road safety in the country. The spontaneous direct action involved high-school and college-age students standing in the roads of Dhaka, directing traffic and policing behaviour.

[Editorial] Catholic Church v women's rights in Argentina

Ve, 17/08/2018 - 23:00
In disappointing news last week, senators in Argentina voted against legislation to allow elective abortion up to 14 weeks of pregnancy. Public support and the passing of the bill in a lower congressional body had brought the right to choose the farthest in the country's legislative history, only to fall short on Aug 8.

[Editorial] Zika-associated health and development problems in children

Ve, 17/08/2018 - 23:00
Zika virus infection during pregnancy can cause infants to be born with microcephaly and other congenital abnormalities, with further possible adverse developmental outcomes later in life. Last week, the US Centers for Disease Control and Prevention published the first and largest study to assess health and development problems in children aged 1 year or older in Puerto Rico and other US territories who were born to mothers with laboratory-confirmed or possible Zika infection during pregnancy and had received some follow-up care.