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[Obituary] Barbara Murphy

Sab, 31/07/2021 - 00:00
Nephrologist and Chair of the Department of Medicine at the Icahn School of Medicine at Mount Sinai. Born on Oct 15, 1964, in South Dublin, Ireland, she died of glioblastoma on June 30, 2021, in New York, NY, USA, aged 56 years.

[Correspondence] Should global financing be the main priority for pandemic preparedness?

Sab, 31/07/2021 - 00:00
Nicole Lurie and colleagues1 argue that “[m]any gaps…must be bridged to establish a truly efficient and effective end-to-end R&D [research and development] preparedness and response ecosystem. Foremost among them is a global financing system”. While obviously essential, it is unlikely that global financing, in itself, will address the immoral inequity on display in the global distribution of COVID-19 vaccines.2 The R&D systems of low-income and middle-income countries (LMICs) need to be strengthened with equal force and funding for pandemic preparedness to succeed.

[Correspondence] Should global financing be the main priority for pandemic preparedness? – Authors' reply

Sab, 31/07/2021 - 00:00
We agree with Carel IJsselmuiden and colleagues that research and development (R&D) systems of low-income and middle-income countries (LMICs) need to be strengthened for pandemic preparedness and response to succeed. Solving the financing challenge is central to closing what we called “the R&D equity gap”.1 This task includes establishing research hubs on each continent committed “to equity of opportunity” for scientists in LMICs who must be central to all aspects of the R&D ecosystem.1 A global financing system is essential to support the broad components of the R&D ecosystem of the future.

[Correspondence] Ethnic disparities in COVID-19: increased risk of infection or severe disease?

Sab, 31/07/2021 - 00:00
Rohini Mathur and colleagues found that Black and Asian ethnic groups were more likely to have adverse COVID-19 outcomes compared with the White population, even after accounting for differences in sociodemographic, clinical, and household characteristics.1 These findings are timely and striking, in light of the Commission on Race and Ethnic Disparities’ recent report,2 which has been criticised for suggesting that the “claim the country is still institutionally racist is not borne out of evidence”.

[Correspondence] Ethnic disparities in COVID-19: increased risk of infection or severe disease? – Authors' reply

Sab, 31/07/2021 - 00:00
We thank Daniel Pan and colleagues for raising an important point regarding our cohort study.1 We agree that separating the risk of infection from the risk of severe disease among those infected is a key issue in understanding and tackling ethnic disparities in COVID-19.2

[Department of Error] Department of Error

Sab, 31/07/2021 - 00:00
Drake TM, Riad AM, Fairfield CJ, et al. Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre, cohort study. Lancet 2021; 398: 223–37—In the Summary of this Article, the percentage of gastrointestinal or liver complications reported should have been 10·8%. This correction has been made to the online version as of July 29, 2021.

[Clinical Picture] Granulomatosis with polyangiitis presents with skip lesions of the bowel

Sab, 31/07/2021 - 00:00
A 54-year-old man presented to our emergency department reporting several weeks of diffuse abdominal pain. He had no medical history of note.

[Comment] What is the association of COVID-19 with heart attacks and strokes?

Ven, 30/07/2021 - 00:30
It has been known for several decades that there is a transient increase in the risk of myocardial infarction and stroke in association with influenza, pneumonia, acute bronchitis, and other chest infections.1–4 It is against this background that Ioannis Katsoularis and colleagues5 studied a possible association of these conditions with COVID-19 during the first wave of the pandemic in Sweden, between February and September, 2020, which they report in The Lancet. The study linked data from the national registers for outpatient and inpatient clinics and the cause of death register for all 86 742 people (median age 48 years [IQR 31–62]; 37 235 [43%] male, 49 507 [57%] female) with COVID-19 who were reported to SmiNet (Swedish Public Health Agency) and 348 481 matched controls.

[Articles] Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study

Ven, 30/07/2021 - 00:30
Our findings suggest that COVID-19 is a risk factor for acute myocardial infarction and ischaemic stroke. This indicates that acute myocardial infarction and ischaemic stroke represent a part of the clinical picture of COVID-19, and highlights the need for vaccination against COVID-19.

[Comment] Gendered ageism: addressing discrimination based on age and sex

Mer, 28/07/2021 - 00:30
The 2021–30 Decade of Healthy Ageing1 aims to improve our functional wellbeing as we age. The UN and WHO have identified four main action areas to promote healthy ageing; one of these is to combat ageism, which perhaps needs to go further in highlighting the important intersection of age and gender.

[Correspondence] Very rare thrombosis with thrombocytopenia after second AZD1222 dose: a global safety database analysis

Mer, 28/07/2021 - 00:30
Since COVID-19 vaccine roll-out, very rare cases of thrombosis with thrombocytopenia syndrome (TTS), which has been referred to as vaccine-induced immune thrombotic thrombocytopenia, have been reported. Here we describe case details of TTS identified in the AstraZeneca global safety database, which captures all spontaneously reported adverse events from real-world use of its medicines and vaccines worldwide.

[Editorial] A time of crisis for the opioid epidemic in the USA

Sab, 24/07/2021 - 00:00
As the COVID-19 pandemic in the USA has eased, the extent of devastation caused during this period by the opioid epidemic is no longer obscured. Data released by the National Center for Health Statistics on July 14 show a steep rise in overdose deaths. Between December, 2019, and December, 2020—the peak of the pandemic in the USA—more than 93 000 Americans died from drug overdoses, up 29·4% over the previous 12 months. This figure equates to roughly 255 overdose deaths per day; national daily COVID-19 deaths currently hover at around the same number.

[World Report] Social unrest disrupts South African health care

Sab, 24/07/2021 - 00:00
Riots and looting have prevented medical care and cut supply chains of food, medicines, and COVID-19 vaccines. Munyaradzi Makoni reports from Cape Town.

[World Report] Inquest begins over South African mental health failings

Sab, 24/07/2021 - 00:00
An inquest has begun into the deaths of 144 patients deinstitutionalised from Life Esidimeni psychiatric care facilities. Marion Scher reports from Johannesburg.

[World Report] Lack of medicines in Mexico

Sab, 24/07/2021 - 00:00
Many prescriptions are unfilled, driven by shortages of drugs in Mexico. President López Obrador has blamed corruption, but analysts say otherwise. David Agren reports.

[Perspectives] Cheryl Moyer: egalitarian in global health research

Sab, 24/07/2021 - 00:00
When we meet on Zoom, Cheryl Moyer joins from her new office—the home gym above her garage in Ann Arbor, MI, USA. She is used to being on the road for much of the year for global health research, and she misses her African friends and colleagues. But she says that while the COVID-19 pandemic stopped her regular field trips to Ghana, it has empowered her local partners to “grab the ball and run with it. They may not need us high-income country partners after all”, she laughs. “That's how it should be and I feel good about that.”

[Perspectives] Portrait or snapshot?

Sab, 24/07/2021 - 00:00
Brigid Edwards is a leading botanical artist. She creates exquisite paintings on vellum, using watercolours and tiny brushes to create portraits of plants and insects. Her work also includes a series of postage stamps of creatures in danger of extinction. As well as the beauty of these images, her paintings are precise scientific records. One of her biggest challenges is to capture the nuances of colour, the precise green of a leaf, or the speckles on a beetle's back. Edwards combines a naturalist's observation with an artist's sensitivity and a craftsman's precision.

[Perspectives] Past and present women pioneers in biomedical science

Sab, 24/07/2021 - 00:00
COVID-19 has propelled a number of scientific breakthroughs that have only been possible because of unprecedented global research collaborations. These remarkable achievements will have profound implications for the future. Women have been front and centre in many of these developments, notably in the area of COVID-19 vaccines and sequencing of SARS-CoV-2. Yet in this pandemic women's position in biomedicine has not been helped by the fact that many women have been disproportionately affected by increased caring responsibilities during lockdowns, reducing the amount of time they have been able to devote to research and publication—with implications for career advancement.

[Obituary] Helen Mae Murray Free

Sab, 24/07/2021 - 00:00
Chemist and co-inventor of dip-and-read diagnostic testing. She was born on Feb 20, 1923, in Pittsburgh, PA, USA, and died following a stroke in Elkhart, IN, USA, on May 1, 2021, aged 98 years.

[Correspondence] Tocilizumab in COVID-19 therapy: who benefits, and how?

Sab, 24/07/2021 - 00:00
The randomised controlled RECOVERY trial1 has met its primary endpoint of reduced 28-day mortality. We congratulate the RECOVERY Collaborative Group for this excellent study. However, the mortality at day 28 was up to 31% in the tocilizumab group and was higher than the results of other published randomised controlled trials.2 The pathophysiology underlying COVID-19 is characterised by SARS-CoV-2 viral infection-induced inflammatory response, cell death, and microvascular thrombosis. Thrombosis appears to be common in patients with COVID-19 pneumonia and could also be responsible for multiorgan failure in patients who are critically ill.