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All the latest articles published on Lancet Journal Discussion Group https://t.me/Medical_Professionals_Forum Contact us https://t.me/Contact_Updates_in_Medicine_Bot
[Corrigendum] Real-life efficacy of immunotherapy for Sézary syndrome: a multicenter observational cohort study
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00558-3/fulltext?rss=yes
In this article, an error is lying in the legend of Figure 2.
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[Comment] Harnessing faith-based organisations for global health equity
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02614-X/fulltext?rss=yes
The global health landscape spans high-income, middle-income, and low-income and middle-income countries (LMICs) and has pervasive disparities in health outcomes and access to care, particularly among underserved and marginalised populations, including minoritised ethnic groups. The COVID-19 pandemic underscored these inequities, revealing that underserved communities often have high levels of unmet health needs, which are exacerbated by socioeconomic inequalities, cultural barriers, and low access to health-care services.
[Comment] Now is the time to build on CDC's progress, not halt it
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02668-0/fulltext?rss=yes
From preventing the spread of malaria in the USA during the early 1950s1 to protecting the public from avian influenza, the US Centers for Disease Control and Prevention (CDC) has worked for almost 80 years to take care of the US public's health. However, health threats are ever present and ever changing, and CDC has changed over the past 4 years to stay ahead of them. After the COVID-19 pandemic, in which the clarity of the agency's guidance and timeliness of its communications were questioned, CDC listened, learned lessons, and took action—to be more effective, more responsive, and more transparent.
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[Articles] TransCatheter aortic valve implantation and fractional flow reserve-guided percutaneous coronary intervention versus conventional surgical aortic valve replacement and coronary bypass grafting for treatment of patients with aortic valve stenosis and complex or multivessel coronary disease (TCW): an international, multicentre, prospective, open-label, non-inferiority, randomised controlled trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02100-7/fulltext?rss=yes
The TCW trial is the first trial to compare percutaneous treatment versus surgical treatment in patients with severe aortic stenosis and complex coronary artery disease, showing favourable primary endpoint and mortality outcomes with percutaneous treatment.
[Comment] TAVI and PCI: redefining treatment for aortic stenosis and complex coronary artery disease
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02318-3/fulltext?rss=yes
The management of patients with aortic valve stenosis and complex coronary artery disease has been the subject of a long-standing debate, particularly regarding the choice between surgical and percutaneous approaches. The development of transcatheter aortic valve implantation (TAVI) and advances in percutaneous coronary intervention (PCI) have expanded treatment options.1–3 Nonetheless, the European Society of Cardiology (ESC) guidelines emphasise that the combined approach of surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG) is favoured over TAVI in multivessel disease amenable to CABG.
[Comment] Non-toxic curative option for patients with genetic disorders
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02301-8/fulltext?rss=yes
Advances in genetic cell modifications are performed routinely in research laboratories, but clinical translation requires refinements, particularly in the context of human cell administration. Chemotherapy is used to promote engraftment by making space for autologous corrected cells, but it can cause toxic effects and might increase the risk of secondary malignancies.1 The ability to perform genetic corrections without the use of conditioning would be an immense advancement. In The Lancet, the FANCOLEN-1 study by Paula Río and colleagues2 took the approach, and risk, of infusing genetically modified cells into patients with Fanconi anaemia without any previous conditioning.
[Articles] Type I spinal muscular atrophy and disease modifying treatments: a nationwide study in children born since 2016
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00546-7/fulltext?rss=yes
Our study provides a picture of the ‘new natural history’ of type I SMA, confirming the impact of the new therapies on the progression of type I with longer survival r and has better motor, respiratory and nutritional.
[Correspondence] A call for moral clarity in the fight against antisemitism
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00150-8/fulltext?rss=yes
The Lancet is commended for its comprehensive coverage of the atrocities in Israel, perpetrated by Hamas terrorists, and the ensuing humanitarian crisis in Gaza. The Oct 7, 2023, massacre by Hamas was a horrendous act, resulting in the deaths of over 1200 innocent civilians, including families with children who suffered extreme violence.1 This act of terrorism, marked by torture, brutality, and the taking of more than 240 hostages, both Israeli and foreign citizens from across the globe, has been disturbingly met with attempts at rationalisation or contextualisation by some in the academic and health-care sectors.
[Correspondence] GRAIL-Galleri: NHS platform trial needed for fair comparisons
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02477-2/fulltext?rss=yes
Biostatisticians expect the applicable machine learning, artificial intelligence, or statistical algorithm to change when the target set of cancers for early detection is restricted, or the evaluation context shifts from clinical to screening. Hence, sensitivity and specificity are liable to change when the algorithm, target set, or context changes.1
[Correspondence] An urgent call to address the intersection of mpox and HIV in Africa
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02542-X/fulltext?rss=yes
Since the clade 1b mpox epidemic was declared a Public Health Emergency of International Concern (PHEIC) in August, 2024, The Lancet journals have published papers1,2 calling for urgent action and support for African countries facing current or potential mpox outbreaks. However, the effect of mpox on people with HIV in Africa has not been sufficiently highlighted.3,4 Several papers suggest that severe outcomes of clade 1b might be linked to malnutrition rates in children and transmission among sex workers.
[Corrigendum] Corrigendum to “Differential efficacy of medical therapies for ulcerative colitis according to disease extent: patient-level analysis from multiple randomized controlled trials” volume 72, 102621
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00559-5/fulltext?rss=yes
In the manuscript, the acknowledgements section currently reads “none”. The correct acknowledgement should be “this publication was based on research using data from data contributors Pfizer, AbbVie, and Takeda, that has been made available through Vivli, Inc. Vivli has not contributed to or approved, and is not in any way responsible for the contents of this publication.”
[Review] Hand eczema
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01810-5/fulltext?rss=yes
Hand eczema is a highly prevalent skin disease and one of the most common work-related disorders. In up to two-thirds of individuals affected by hand eczema, the disease becomes chronic and results in substantial personal and occupational disability. Manifestations of chronic hand eczema vary in severity and appearance over time, and people with eczema typically experience itch, pain, and a burning sensation. The pathophysiology of chronic hand eczema is multifactorial. Major risk factors are current or past atopic dermatitis and excessive or prolonged exposure to irritants or allergens.
[Correspondence] Urgent call for enhanced flood preparedness and response in Spain
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02506-6/fulltext?rss=yes
We are writing to urgently highlight the unprecedented flooding that has devastated eastern Spain, particularly in the Valencia region, beginning on Oct 29, 2024. As of Nov 25, this catastrophic event has resulted in a tragic toll of 229 confirmed fatalities, with 5 people still reported missing.1
[Articles] Adherence and efficacy outcomes in young Australians with suicidal ideation using a self-management app and digital engagement strategy compared with a sham app: a three-arm randomised controlled trial
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00542-X/fulltext?rss=yes
A third wave CBT app helped to reduce ideation severity, however providing additional online resources to promote therapeutic engagement did not enhance these effects.
[Department of Error] Department of Error
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02667-9/fulltext?rss=yes
Xu R, Ye T, Huang W, et al. Global, regional, and national mortality burden attributable to air pollution from landscape fires: a health impact assessment study. Lancet 2024; published online Nov 27. https://doi.org/10.1016/S0140-6736(24)02251-7—In this Article, Yuming Guo and Shanshan Li should have been marked as Joint senior authors; the third sentence of the Summary Findings section should have read “Over 90% of all attributable deaths were in low-income and middle-income countries, particularly in sub-Saharan Africa (606 769 deaths per year), southeast Asia (206 817 deaths), south Asia (170 762 deaths), and east Asia (147 291 deaths)”; and in figure 2, the title should have read “Global and regional trends of annual ADs attributable to exposure to landscape fire-sourced air pollution from 2000 to 2019” and the y-axes titles should have read “Number of ADs (in 10 000s)”.
[Seminar] Chronic pancreatitis
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02187-1/fulltext?rss=yes
Chronic pancreatitis is a progressive fibroinflammatory disease primarily caused by a complex interplay of environmental and genetic risk factors. It might result in pancreatic exocrine and endocrine insufficiency, chronic pain, reduced quality of life, and increased mortality. The diagnosis is based on the presence of typical symptoms and multiple morphological manifestations of the pancreas, including pancreatic duct stones and strictures, parenchymal calcifications, and pseudocysts. Management of chronic pancreatitis consists of prevention and treatment of complications, requiring a multidisciplinary approach focusing on lifestyle modifications, exocrine insufficiency, nutritional status, bone health, endocrine insufficiency, pain management, and psychological care.
[Articles] Treatable traits in idiopathic pulmonary fibrosis: focus on respiratory tract infections—a systematic review and a meta-analysis
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00545-5/fulltext?rss=yes
RTIs are frequently reported adverse events in IPF patients over a one-year period, with different investigated treatments showing no profound impact compared to placebo. Future clinical trials should focus on targeting treatable traits like RTIs.
[Articles] When to stop immunotherapy for advanced melanoma: the emulated target trials
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00539-X/fulltext?rss=yes
These results suggest that a one-year course of immunotherapy is both necessary and sufficient for patients with advanced melanoma. Prolonged treatment beyond 2 years does not appear to be beneficial in terms of survival and could even be detrimental.
[Obituary] Richard Cash
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02621-7/fulltext?rss=yes
Public health doctor who saved millions of lives with the invention of oral rehydration therapy. He was born in Milwaukee, WI, USA, on June 9, 1941 and died from brain cancer on Oct 22, 2024 in Cambridge, MA, USA.
[Articles] Haematopoietic gene therapy of non-conditioned patients with Fanconi anaemia-A: results from open-label phase 1/2 (FANCOLEN-1) and long-term clinical trials
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01880-4/fulltext?rss=yes
These results show for the first time that haematopoietic gene therapy without genotoxic conditioning enables sustained engraftment and reversal of BMF progression in patients with Fanconi anaemia.
[Articles] Adverse events in clinically complex elderly patients with atrial fibrillation according to oral anticoagulation status
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00553-4/fulltext?rss=yes
AF CC patients who discontinued OAC have a high risk of adverse events. New antithrombotic and integrated care approaches to reduce thrombotic risk without increasing bleeding risk are needed in these patients.
[Articles] Maintenance therapy with trofosfamide, idarubicin and etoposide in patients with rhabdomyosarcoma and other high-risk soft tissue sarcomas (CWS-2007-HR): a multicentre, open-label, randomised controlled phase 3 trial
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00536-4/fulltext?rss=yes
The addition of 25 weeks of oral maintenance therapy with trofosfamide, etoposide and idarubicin after standard therapy does not improve EFS and OS in patients with high-risk rhabdomyosarcoma and other STS.
[Articles] Risk of intraoperative hemorrhage during cesarean scar ectopic pregnancy surgery: development and validation of an interpretable machine learning prediction model
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00548-0/fulltext?rss=yes
The developed prediction model, deployed in the network application, is capable of forecasting the risk of intraoperative hemorrhage during CSEP. This tool can facilitate targeted preoperative assessment and clinical decision-making for clinicians. Prospective data should be utilized in future studies to further validate the extended applicability of the model.
[Correspondence] Lebanon: a humanitarian crisis in a complex geopolitical context
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02432-2/fulltext?rss=yes
The UN has launched an appeal for humanitarian aid to Lebanon following the escalation of the Israeli war on Lebanon since Sept 23, 2024.1 The ongoing humanitarian crisis in Lebanon is reminiscent of the crisis associated with the 2006 Israeli war on Lebanon, but with striking differences in impact, relief efforts, and geopolitical context.
[Articles] A telerehabilitation program to improve visual perception in children and adolescents with hemianopia consecutive to a brain tumor: a single-arm feasibility and proof-of-concept trial
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00534-0/fulltext?rss=yes
Our findings underscore the feasibility and safety of home-based audiovisual stimulation in immersive virtual-reality as a potential intervention for improving visual perception in children/adolescents with hemianopia consecutive to a pediatric brain tumor. These promising results lay a strong foundation for a larger randomized controlled trial, offering hope for a meaningful breakthrough in visual rehabilitation for this vulnerable population.
[Comment] Implementing the Global Action Plan on Biodiversity and Health
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02557-1/fulltext?rss=yes
For the first time in the history of global biodiversity governance and global health governance, countries negotiated and adopted a Global Action Plan on Biodiversity and Health at the 16th Conference of the Parties to the Convention on Biological Diversity (CBD COP16) in 2024.1 The 6-year process to develop and agree to this Plan culminates decades of progress to advance the broad interconnections between biodiversity and health into international decision making.2–6 By adopting the Global Action Plan on Biodiversity and Health, parties acknowledged that biodiversity and health interlinkages encompass physical and mental health, communicable and non-communicable disease, health emergencies, social determinants, and food and water security.
[Articles] Global, regional, and national mortality burden attributable to air pollution from landscape fires: a health impact assessment study
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02251-7/fulltext?rss=yes
LFS air pollution induced a substantial global mortality burden, with notable geographical and socioeconomic disparities. Urgent actions are required to address such substantial health impact and the associated environmental injustice in a warming climate.
[Articles] Performance of clinical decision aids (CDA) for the care of young febrile infants: a multicentre prospective cohort study conducted in the UK and Ireland
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00540-6/fulltext?rss=yes
The AAP and BSAC CDAs are highly sensitive at excluding IBI, with a cost saving to hospital services when compared to a treat all approach. The substitution of CRP for PCT made no difference to the performance of the AAP CDA in this cohort and was more costly.