The Lancet

Condividi contenuti
The Lancet RSS feed.
Aggiornato: 2 giorni 13 ore fa

[Comment] COVID-19: the turning point for gender equality

Sab, 17/07/2021 - 00:30
The impacts of the COVID-19 pandemic have gone far beyond the disease itself. In addition to the increasing number of COVID-19 deaths,1 the pandemic has deepened social and economic inequalities.2 These indirect impacts have been compounded by pervasive gender inequalities, with profound consequences, especially for women, girls, and people of diverse gender identities.2 There has been an escalation in gender-based violence within households,3 increasing risk of child marriages and female genital mutilation,4 and an increased burden of unpaid care work,5 with impacts on mental health.

[Editorial] COVID-19 in Africa: a lesson in solidarity

Sab, 17/07/2021 - 00:00
Many countries in Africa face a serious third wave of COVID-19 that is both larger and more burdensome on health systems than previous waves. This predictable turn of events has been driven by a morally reprehensible lack of vaccine equity (<1% of the population are fully vaccinated), leaving the continent vulnerable to new and more transmissible variants of the virus, behavioural and economic pandemic fatigue, and complacency. A lack of diagnostic capacity in some countries means the epidemiology of this current wave is uncertain, but South Africa, Namibia, and Zambia are reporting the highest numbers of new cases.

[Comment] In-hospital complications associated with COVID-19

Sab, 17/07/2021 - 00:00
As the COVID-19 pandemic persists globally,1 an emerging challenge is the shift from acute infection to the burden of long-term consequences resulting from the disease. Although a consensus terminology has not yet been reached, the post-acute stage of COVID-19 is mostly defined as 3 or 4 weeks after symptom onset, and long or chronic COVID-19 is defined as symptoms and abnormalities persisting or presenting beyond 12 weeks.2,3 Most studies have focused on acute and subacute COVID-19, although evidence-based guidance for the management of long COVID-19 is limited.

[Comment] BMI and diabetes risk in low-income and middle-income countries

Sab, 17/07/2021 - 00:00
Diabetes is a growing public health problem in all countries, but this increase has been much faster in low-income and middle-income countries (LMICs)1,2 than in high income countries (HICs)3 over the past three decades.4 Concomitantly, the paucity of robust and representative data has prevented improved characterisation of the risk factors underlying this sharp increase in the burden in LMICs, which is needed to build more efficient diabetes screening and prevention policies than the current standard.

[World Report] Afghan health at risk as foreign troops withdraw

Sab, 17/07/2021 - 00:00
Experts warn of the health costs of falling donor support and a risk of increased conflict as US and NATO troops withdraw from Afghanistan. Sophie Cousins reports.

[World Report] The final frontier: health in space

Sab, 17/07/2021 - 00:00
The rise of space tourism and plans to send people to Mars are prompting new studies of the health effects of space flight. Talha Burki reports.

[Perspectives] Binita Kane: sharing hidden histories in heritage and health

Sab, 17/07/2021 - 00:00
After violence broke out in his village in what is now Bangladesh, in the years following the 1947 Partition of India, Binita Kane's father Bim Bhowmick left India for the UK. “I saw newspaper articles from the time about how the village was burning and people were being slaughtered. The fact that my Hindu family escaped was just a miracle in itself”, says Kane, “but the circumstances under which a Muslim family risked their own lives to help them was just incredible…I feel the narrative that's been passed down the generations is largely one of hatred.

[Perspectives] When art mirrors planetary health

Sab, 17/07/2021 - 00:00
The future of the arts in many countries has been plunged into uncertainty during the COVID-19 pandemic. Many museums and galleries have been closed for long periods and their funding hangs by a thread. Like other arts organisations, the planned exhibition schedule at Compton Verney in Warwickshire, UK, was thrown into disarray in 2020. It is therefore remarkable that Compton Verney has recently reopened with a poignant and moving exhibition that could not be more pertinent to COVID-19 and the plight of the planet, despite being conceived and commissioned in 2019.

[Perspectives] The Great Gatsby and the challenge of unreliable narrators

Sab, 17/07/2021 - 00:00
An enduring debate in modern literature concerns the reliability of Nick Carraway, the narrator of F Scott Fitzgerald's The Great Gatsby. For much of the novel, he seems to be a trustworthy person. He describes his Midwestern upbringing, his education at Yale University, and his desire to buck family tradition and move east to pursue a career in finance. Soon after his move to New York, however, Carraway learns of a love triangle involving his college friend, Tom Buchanan, Tom's wife, Daisy, and an enigmatic neighbour on Long Island named Jay Gatsby.

[Perspectives] Medicine and the monsoon

Sab, 17/07/2021 - 00:00
The classical Tamil poetry of the Sangam tradition blurs the boundaries between nature and self, between changing seasons and shifting interior states, and between emotional and physical health. “Monsoon rains,/coming with a stormy wind,/pouring down copiously/with roaring thunder/which kills snakes/in the mountains,/have you no mercy?” the poet Avvaiyar demands. The cycle of the south Asian monsoon—the intense heat of May followed by rains in June—structures many of these verses of love and longing.

[Obituary] Smarajit Jana

Sab, 17/07/2021 - 00:00
Physician and public health specialist who championed HIV prevention. Born on July 21, 1952, in rural West Bengal, India, he died from COVID-19 on May 8, 2021, in Kolkata, India, aged 68 years old.

[Correspondence] COVID-19: counting migrants in

Sab, 17/07/2021 - 00:00
Rohini Mathur and colleagues1 present important data highlighting increased SARS-CoV-2 infection rates among minority ethnic people in the UK, including people reporting as South Asian and Black, yet use of these broad ethnic categories consistently fails to capture the dynamics of contemporary migration. These categories include a highly heterogeneous group of settled minority ethnic people born in the UK, alongside more recently arrived migrants, including an increasing proportion of low-skilled labour migrants, refugees, undocumented migrants, and others who have a particular profile of risk factors for SARS-CoV-2 infection.

[Department of Error] Department of Error

Sab, 17/07/2021 - 00:00
Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. Lancet 2021; 397: 1819–29—In table 2 of this Article, the number of cases of SARS-CoV-2 infection in unvaccinated participants aged 45–64 years should have been 19 579; the incidence rates per 100 000 person-days should have been <0·1 for COVID-19-related hospitalisation in fully vaccinated participants aged 16–44 years and for COVID-19-related death in fully vaccinated participants aged 45–64 years; the total person-days for all outcomes in unvaccinated participants (footnote †) should have been 88 938 310 for age 16–44 years, 22 734 104 for age 45–64 years, 8 403 722 for age ≥65 years, and 120 076 136 for all ages; and the total person-days for all outcomes in fully vaccinated participants (footnote ‡) should have been 77 280 829 for age 16–44 years, 67 027 668 for age 45–64 years, 57 573 686 for age ≥65 years, and 201 882 183 for all ages.

[Department of Error] Department of Error

Sab, 17/07/2021 - 00:00
Rosenstock J, Wysham C, Frias JP, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet 2021; 398: 143–55—The appendix of this Article has been corrected. These corrections have been made to the online version as of July 15, 2021.

[Articles] Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study

Sab, 17/07/2021 - 00:00
Complications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause a substantial strain on health and social care in the coming years. These data will help in the design and provision of services aimed at the post-hospitalisation care of patients with COVID-19.

[Articles] Body-mass index and diabetes risk in 57 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 685 616 adults

Sab, 17/07/2021 - 00:00
The association between BMI and diabetes risk in LMICs is subject to substantial regional variability. Diabetes risk is greater at lower BMI thresholds and at younger ages than reflected in currently used BMI cutoffs for assessing diabetes risk. These findings offer an important insight to inform context-specific diabetes screening guidelines.

[Clinical Picture] Autoimmune pulmonary alveolar proteinosis: a discrepancy between symptoms and CT findings

Sab, 17/07/2021 - 00:00
A 50-year-old man with a 2-year history of a dry cough and mild exertional dyspnoea was referred to our lung disease clinic. The patient—who was originally from Turkey—had a significant cigarette smoking history but no relevant occupational exposures.

[Correspondence] Spike-antibody waning after second dose of BNT162b2 or ChAdOx1

Ven, 16/07/2021 - 00:30
Vaccines based on the spike glycoprotein of SARS-CoV-2 are being rolled out globally to control transmission and limit morbidity and mortality due to COVID-19. Current evidence indicates strong immunogenicity and high short-term efficacy for BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca).1–3 Both vaccines are delivered through a prime-boost strategy, and many countries, including the UK, have used dose intervals longer than 3–4 weeks, expecting to maximise first-dose coverage and immunogenicity.

[Comment] Measuring and ensuring routine childhood vaccination coverage

Gio, 15/07/2021 - 01:01
Vaccines have become a daily topic of conversation worldwide as the world grapples with the impact of the COVID-19 pandemic. Taking stock of the progress made with childhood immunisation over the past 40 years is therefore timely and valuable as we embark on implementing the Immunization Agenda 2030 (IA2030).1

[Comment] Disruptions to childhood immunisation due to the COVID-19 pandemic

Gio, 15/07/2021 - 01:01
In The Lancet, Kate Causey and colleagues1 report their estimates of the disruptions to routine childhood immunisation coverage for the third-dose diphtheria-tetanus-pertussis (DTP3) vaccine and first-dose measles-containing vaccine (MCV1) at the global, regional, and national levels due to the COVID-19 pandemic. These modelled estimates are of importance to national immunisation programmes for planning and implementing catch-up vaccination services to close the immunity gaps and prevent vaccine-preventable disease outbreaks.