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[Comment] Women making medical history: introducing A Woman's Place

Sa, 04/08/2018 - 00:00
In December, 2017, The Lancet issued a call for papers for its special theme issue on women in science, medicine, and global health.1 The Comment outlined the gender inequalities in medicine that still persist, long after many overt barriers to women's participation have fallen. While that theme issue will be forward-looking, I believe we can also gain insights from looking to the past for examples of women who have made their mark against the odds, and by asking what it was about their particular circumstances that enabled them to do so.

[World Report] China's vaccine production scare

Sa, 04/08/2018 - 00:00
In China, a recent series of scandals involving rabies and DPT vaccines are affecting confidence in the country's vaccination management system. Xun Yuan reports.

[World Report] Opt-out digital health records cause debate in Australia

Sa, 04/08/2018 - 00:00
A move for Australian citizens to have to opt out of digital health records has stirred debate over the balance between data security and the need to access patient information. Chris McCall reports.

[World Report] Measles outbreak in the Americas

Sa, 04/08/2018 - 00:00
A measles outbreak is spreading throughout the Americas, threatening local and indigenous populations that have not been vaccinated. Barbara Fraser reports.

[World Report] HPV vaccine to be offered to boys in England

Sa, 04/08/2018 - 00:00
Following new recommendations, England will join the ranks of countries prescribing human papillomavirus vaccines to boys as well as girls and adults. Andrew Green reports.

[Perspectives] Anna Morandi: anatomist of Enlightenment Bologna

Sa, 04/08/2018 - 00:00
It is a surprise to find that one of the few women celebrated for her medical expertise before the modern era was not a midwife or a herbalist but an anatomist, used to rolling up her sleeves in the stench and gore of the dissecting room and calmly demonstrating to medical students. The status of Anna Morandi (1714–74) is complicated by her concurrent role as an artist: she was one of the pre-eminent creators of accurate wax models of tissues and organs.

[Perspectives] In search of lost time

Sa, 04/08/2018 - 00:00
How does it feel to lose your mind? It would seem that I, Barbara Lipska, would be eminently qualified to answer this question. I've been a neuroscientist for over 30 years, first in my native Poland, and, since 1989, at the National Institute of Mental Health (NIMH) in the USA, where I study mental disorders, especially schizophrenia. Yet I didn't understand mental illness all that much—until it happened to me.

[Obituary] Gustav Victor Rudolf Born

Sa, 04/08/2018 - 00:00
Pharmacologist who illuminated the role of platelets in blood clotting. Born in Göttingen, Germany, on July 29, 1921, he died in London, UK, on April 16, 2018, aged 96 years.

[Correspondence] Providing quality care on the border with Haiti

Sa, 04/08/2018 - 00:00
We read with great interest the World Report by Joe Parkin Daniels (March 17, p 1012)1 about a safe hospital on the border with Haiti. While we applaud the efforts of the hospital to bring care to a vulnerable population, we were disturbed by the tone and factual errors in The Lancet's coverage.

[Correspondence] Reporting of immune checkpoint inhibitor-associated myocarditis

Sa, 04/08/2018 - 00:00
We read with interest the Correspondence by Javid J Moslehi and colleagues (March 10, p 933),1 in which they reported an increase in reporting incidence of myocarditis associated with immune checkpoint inhibitors in WHO's VigiBase database and shed insight on patient outcomes.

[Correspondence] Reporting of immune checkpoint inhibitor-associated myocarditis

Sa, 04/08/2018 - 00:00
We read with interest the Correspondence by Javid J Moslehi and colleagues,1 who used the WHO Vigibase reporting system, to describe the first case series of severe myocarditis after treatment with immune checkpoint inhibitors—an emerging clinical entity.2 They noted that fatality was increased with combination therapy and saw substantial increases in reporting over time (especially in 2017).

[Correspondence] Reporting of immune checkpoint inhibitor-associated myocarditis

Sa, 04/08/2018 - 00:00
We read with great interest the Correspondence by Javid J Moslehi and colleagues,1 on immune checkpoint inhibitor-associated myocarditis.

[Correspondence] Reporting of immune checkpoint inhibitor-associated myocarditis – Authors' reply

Sa, 04/08/2018 - 00:00
We thank Sadeer G Al-Kindi and Guilherme H Oliveira for their Correspondence, and we completely agree with the use of multiple databases to verify and validate our findings on fatalities linked with immune checkpoint inhibitor-associated myocarditis. Their use of the large US Food and Drug Administration database and incorporation of demographic features is commendable and provides additional evidence showing the fulminant and unpredictable nature of immune checkpoint inhibitor-associated myocarditis.

[Correspondence] Strategies to correct the shortage of paediatricians in China

Sa, 04/08/2018 - 00:00
The shortage of paediatricians in China is alarming.1 According to the basic data presented in a white paper about China's current paediatric resources,2 there are around 100 000 paediatricians in China but more than 200 000 additional paediatricians are needed. With a population of 260 million children aged 0–14 years, this means that, on average, each paediatrician cares for 2000 children.

[Correspondence] Post-publication peer review and evidence appraisals in primary care

Sa, 04/08/2018 - 00:00
Although the traditional picture of a general practitioner (GP) could omit the contribution of scholarship decades ago,1 there has been a rising need to build research capacity and make it an integral component of the physician's competencies,2 and to provide crucial frontline feedback as part of the “learning healthcare system”.3 The insights of GPs are pivotal to research, notably for determining the applicability of findings and interventions in clinical settings, identifying future research needs, and closing the feedback loop from evidence generation to application and generalisation.

[Department of Error] Department of Error

Sa, 04/08/2018 - 00:00
Caraceni P, Riggio O, Angeli P, et al. Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial. Lancet 2018; 391: 2417–29—In figure 3 of this Article (published Online First on May 31, 2018), the hazard ratio should read as, “HR 0·62 (95% CI 0·40–0·95)”. This correction has been made to the online version as of Aug 2, 2018.

[Articles] Peer-supported self-management for people discharged from a mental health crisis team: a randomised controlled trial

Sa, 04/08/2018 - 00:00
Our findings suggest that peer-delivered self-management reduces readmission to acute care, although admission rates were lower than anticipated and confidence intervals were relatively wide. The complexity of the study intervention limits interpretability, but assessment is warranted of whether implementing this intervention in routine settings reduces acute care readmission.

[Clinical Picture] A classic case of scurvy

Sa, 04/08/2018 - 00:00
A 40-year-old woman with a history of chronic pancreatitis and gastro-oesophageal reflux disease presented with fatigue, malaise, dizziness, difficulty ambulating, diarrhoea, easy bruising, and a diffuse rash involving her extremities and trunk that had been present for several days. She explained that she had limited her diet to consist mostly of bread, rice, dumplings, and the occasional egg white to reduce the symptoms she suffered from her gastro-oesophageal reflux disease. Her diet was also devoid of red meat, fish, chicken, fruits, and vegetables.

[Seminar] Acute myeloid leukaemia

Ve, 03/08/2018 - 00:30
For several decades, few substantial therapeutic advances have been made for patients with acute myeloid leukaemia. However, since 2017 unprecedented growth has been seen in the number of drugs available for the treatment of acute myeloid leukaemia, with several new drugs receiving regulatory approval. In addition to advancing our therapeutic armamentarium, an increased understanding of the biology and genomic architecture of acute myeloid leukaemia has led to refined risk assessment of this disease, with consensus risk stratification guidelines now incorporating a growing number of recurrent molecular aberrations that aid in the selection of risk-adapted management strategies.

[Seminar] Autism spectrum disorder

Ve, 03/08/2018 - 00:30
Autism spectrum disorder is a term used to describe a constellation of early-appearing social communication deficits and repetitive sensory–motor behaviours associated with a strong genetic component as well as other causes. The outlook for many individuals with autism spectrum disorder today is brighter than it was 50 years ago; more people with the condition are able to speak, read, and live in the community rather than in institutions, and some will be largely free from symptoms of the disorder by adulthood.