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Les derniers abstracts de la revue The Lancet :


    Date de mise en ligne : Mercredi 26 avril 2017
    The Lancet
    [Editorial] WOMAN: reducing maternal deaths with tranexamic acid
    Over 200 million women become pregnant each year. Despite great progress during the past three decades, deaths during pregnancy and childbirth remain a serious (and largely preventable) risk for women in around 75 countries where 98% of maternal mortality occurs. The UN estimates that 532 000 maternal deaths took place in 1990. That number had fallen to 303 000 by the end of the Millennium Development Goal (MDG) era in 2015. Haemorrhage accounts for 18% of these deaths, and is a particularly important cause of maternal mortality in Africa and Asia.


    Date de mise en ligne : Samedi 27 mai 2017
    The Lancet
    [Editorial] Purdah and the gagging of science
    The UK's National Institute for Health Research (NIHR) has issued guidance discouraging publication of—and commentary on—NIHR-funded research for the remainder of the country's General Election purdah. Purdah is a controlled period restricting public-facing activity, intended to prevent influence on election outcomes (currently enforced from April 22 to June 8). Using purdah to control science communication is an abuse of its intended purpose, and is not part of the original code. The guidance prevents dissemination and commentary on all NIHR-funded research covering public health, social care, health-system finance and workforce, and “any other areas where there is a risk of political interpretation”.


    Date de mise en ligne : Samedi 27 mai 2017
    The Lancet
    [Editorial] National progress on antimicrobial resistance
    On May 22, in the shadow of WHO Director-General elections, WHO, the Food and Agriculture Organization of the UN, and the World Organisation for Animal Health presented progress on the first open survey of countries' national action plan preparedness on Antimicrobial Resistance (AMR) at the 70th World Health Assembly.


    Date de mise en ligne : Mardi 28 mars 2017
    Robert J Wyatt
    [Comment] Are we ready for targeted therapy for IgA nephropathy?
    Almost 50 years have passed since the initial description of IgA nephropathy by Berger and Hinglais.1 IgA nephropathy is the most common chronic glomerulonephritis in the world.2 A renal biopsy is required for diagnosis but not regularly performed early in the course of the disease in some regions.3 Clearly, many people with this disease go undiagnosed, as shown by marked differences in population-based incidences for European and North American cohorts.4 Variation exists even within a single country, as evidenced by 70% more kidney biopsies being performed in the Tayside region of Scotland compared with Greater Glasgow.


    Date de mise en ligne : Lundi 20 mars 2017
    Fergus J Caskey, Rachael L Morton
    [Comment] Optimising care for children with kidney disease
    The theme for World Kidney Day in 2016 was “kidney disease and children: act early to prevent it”. Given the adverse effect of renal replacement therapy—dialysis and transplantation—on quality of life and health care resources, few would disagree with this ambition. For some children, however, end-stage kidney disease cannot be avoided and its effects have to be managed and outcomes optimised. With increasing fiscal pressures on health services in many settings around the world, the Article in The Lancet by Nicholas Chesnaye and colleagues looking at macroeconomics and survival on renal replacement therapy in Europe is timely.


    Date de mise en ligne : Samedi 27 mai 2017
    Peter Sands, Mukesh Chawla
    [Comment] Financing preparedness at a national level
    For far too long, the approach to pandemics has been one of panic and neglect: throwing money and resources at the problem when a serious outbreak occurs; then neglecting to sustain funding of preparedness when the news headlines move on. The result has been far too many lives lost and too much damage to human livelihoods. As news of new cases of Ebola virus disease in the DR Congo1 shows, the threat of deadly pathogens is ever present. New outbreaks will occur, but by investing in preparedness—in prevention, detection, containment, and control—their frequency and impact can be reduced.


    Date de mise en ligne : Lundi 22 mai 2017
    Tarja Halonen, Hina Jilani, Kate Gilmore, Flavia Bustreo
    [Comment] Realisation of human rights to health and through health
    The powerful interplay between health and the human rights of women, children, and adolescents forms the cornerstone of the global development agenda. When their right to health is upheld, their access to all other human rights is enhanced.1 The corollary holds true. When their right to health is denied, the impacts inhibit their exercise of other human rights, undermining their potential and undoing realisation of the promise of the Sustainable Development Goals and Agenda 2030. That is why whole-of-government leadership is needed to fulfil the potential of the powerful nexus of intersecting, interdependent rights.


    Date de mise en ligne : Samedi 27 mai 2017
    Katie Dain
    [Comment] A new chapter for the NCD Alliance: stronger together
    The 70th World Health Assembly (WHA) coincides with a milestone in the history and development of the NCD Alliance (NCDA), and a new chapter for non-communicable disease (NCD) advocacy.


    Date de mise en ligne : Samedi 27 mai 2017
    Laura Feetham, Sabine Kleinert
    [Comment] Respiratory medicine and critical care: a call for papers for ERS
    The Lancet and The Lancet Respiratory Medicine would like to hear from authors of research papers in the fields of respiratory medicine and critical care, as the two journals are planning special issues to coincide with the 2017 European Respiratory Society (ERS) International Congress that will take place in Milan, Italy, on Sept 9–13, 2017.


    Date de mise en ligne : Samedi 27 mai 2017
    Richard Horton
    [Comment] Offline: B-day—time to get real
    It wasn't 9/11. But it felt like it. The shock of waking up on June 24, 2016, was palpable. Bewilderment and bereavement. Those of us who believed in the UK as an outward-looking European nation couldn't accept the fact that by the slimmest of majorities (51·9% vs 48·1%), Britain had voted to leave the European Union (EU). Even today, that sense of incomprehension, even trauma, is still felt by many. The Liberal Democrats have promised a final public vote on a Brexit settlement, together with an option to vote to stay in the EU.


    Date de mise en ligne : Mardi 23 mai 2017
    Andrew Green
    [World Report] Ebola outbreak in the DR Congo
    International agencies are implementing response protocols after an Ebola virus disease outbreak was confirmed in the DR Congo. Andrew Green reports.


    Date de mise en ligne : Samedi 27 mai 2017
    Susan Jaffe
    [World Report] Scott Gottlieb sworn in to head the FDA
    Scott Gottlieb becomes commissioner of the FDA, as the agency's role is threatened by an administration adverse to regulation. Susan Jaffe, The Lancet's Washington correspondent, reports.


    Date de mise en ligne : Samedi 27 mai 2017
    Barbara Fraser
    [World Report] Data reveal state of Venezuelan health system
    Epidemiological data released by the Government of Venezuela after 2 years of silence betrays how the political and economic crisis has taken a toll on the health system. Barbara Fraser reports.


    Date de mise en ligne : Samedi 27 mai 2017
    Laurie Garrett
    [Perspectives] When Big Men ruled global health: a cautionary tale
    There was a time in world health efforts when Big Men (yes, all men, European and North American) had Big Ideas, backed by money and power. They had offices in places like the World Bank, UNICEF, and the Rockefeller Foundation. And they made scientific and programmatic decisions, financing and executing schemes that affected the survival and lives of hundreds of millions of people. When their decisions were sagacious and well executed the results could be breathtaking. Millions of children might in a single year be spared death from measles, for example, thanks to a targeted immunisation campaign.


    Date de mise en ligne : Samedi 27 mai 2017
    Brian Hurwitz
    [Perspectives] Parkinson's disease: what's in the name
    It is 200 years since James Parkinson (1755–1824) published his observations on slowly and differentially developing involuntary movements, which he contended constituted “the same species” of disease. In An Essay on the Shaking Palsy, first published in May, 1817, Parkinson argued that specific forms of shaking, weakness, and altered posture and gait, together amounted to a previously uncharacterised “highly afflictive” malady. He called it “the Shaking Palsy” and rendered it in the Essay once only—and pointedly in brackets—as “(Paralysis Agitans)”.


    Date de mise en ligne : Samedi 27 mai 2017
    Geoff Watts
    [Obituary] Helen Carty
    Leading paediatric radiologist. Born in Dungarvan, Ireland, on May 12, 1944, she died in Liverpool, UK, on April 23, 2017, aged 72 years.


    Date de mise en ligne : Lundi 15 mai 2017
    Francesco Della Corte, Frederick M Burkle, Alba Ripoll Gallardo, Luca Ragazzoni
    [Correspondence] Ahmadreza Djalali: questions everyone must ask
    Dr Ahmadreza Djalali is hovering near death in an Iranian jail.1 The efforts of the international community in securing his release, as extensive as we can muster, seem increasingly ineffective, in great part due to the fact that all international petitions appear to have been ignored by the Iranian Government. Strong positions from the international community—ranging from Physicians for Human Rights,2 Amnesty International,3 the Swedish,1 Belgian,4 and Italian5 Governments, and multiple academic institutions worldwide—have fallen on deaf ears.


    Date de mise en ligne : Samedi 27 mai 2017
    Anne Baber Wallis, Edrisa Sanyang
    [Correspondence] New era for health in The Gambia?
    We appreciate Andrew Green's timely World Report (Feb 18, p 684)1 on The Gambia. At this crucial moment, The Gambia and west Africa face serious public health challenges. During the recent leadership change, the Economic Community of West African States (ECOWAS) gave vital diplomatic and military support to The Gambia. Continued ECOWAS-wide collaboration could improve overall public health, particularly in response to regional issues such as climate change. Gambian leaders must repair infrastructure corroded by decades of misgovernance that has left a depleted treasury and staggering debt load.


    Date de mise en ligne : Samedi 27 mai 2017
    Paul W Armstrong, Frans Van de Werf
    [Correspondence] STREAM characterisation correction
    In their discussion of modern management of acute myocardial infarction, Reed and colleagues (Jan 14, p 197)1 incorrectly assign our Strategic Reperfusion Early after Myocardial Infarction (STREAM) study to their section on rescue and facilitated percutaneous coronary intervention (PCI) and assert it “is not recommended”.2 STREAM was designed to address the needs of the large proportion of patients worldwide who present within 3 h of symptom onset and cannot undergo timely PCI within 1 h of first medical contact.


    Date de mise en ligne : Samedi 27 mai 2017
    Grant W Reed, Christopher P Cannon
    [Correspondence] STREAM characterisation correction – Authors' reply
    We greatly appreciate the thoughtful response to our Seminar by Paul Armstrong and Frans Van de Werf. In our Seminar (Jan 14, p 197),1 we cite the Strategic Reperfusion Early after Myocardial Infarction (STREAM) study to support the statement that immediate or very early percutaneous coronary intervention (PCI) after fibrinolytic therapy has no ischaemic benefit and might cause harm by increasing bleeding.2 We feel that this is a justified application of this reference, because in STREAM, a greater proportion of patients who had intracranial haemorrhage in the fibrinolysis group was recorded compared with the proportion in the primary PCI only group (1·0% vs 0·2%; p=0·04), particularly in patients older than 75 years of age.


    Date de mise en ligne : Samedi 27 mai 2017
    Dario Paladini, Gustavo Malinger, Gianluigi Pilu, Ilan Timor-Trisch, Paolo Volpe
    [Correspondence] The MERIDIAN trial: caution is needed
    We congratulate Paul Griffiths and colleagues (Feb 4, p 538)1 for their Article showing that in-utero MRI changed prognostic information in at least 20% of cases of fetal brain abnormalities, and led to changes in clinical management in over a third of cases compared with ultrasound. However, we have several concerns about this Article.


    Date de mise en ligne : Samedi 27 mai 2017
    Melvin Samsom
    [Correspondence] Artificial trachea transplantation is not ready for patients
    Although one assignment of a university hospital is to develop health care, the safety of each and every patient treated can never be challenged. Therefore, I, as the Chief Executive Officer of Karolinska University Hospital, feel the urge to share the lessons learned from the world's first artificial trachea transplantations in patients.


    Date de mise en ligne : Samedi 27 mai 2017
    Donatella Lippi, Philippe Charlier, Paola Romagnani
    [Correspondence] Acromegaly in Lorenzo the Magnificent, father of the Renaissance
    Lorenzo de' Medici (1449–92), also known as the Magnificent, was a statesman, patron of arts, and a key supporter of the Renaissance, a cultural movement in Italy that spread throughout Europe, marking the beginning of the Early Modern Age (from the 14th to the 17th century).


    Date de mise en ligne : Mercredi 17 mai 2017
    Peter Byass
    [Correspondence] Dr Tedros Adhanom Ghebreyesus is the best candidate for WHO DG
    As Sally Davies has already pointed out,1 the World Health Assembly will shortly meet to elect the next Director-General (DG) of WHO. Three candidates (Tedros Adhanom Ghebreyesus [Ethiopia], Sania Nishtar [Pakistan], and David Nabarro [UK]) were selected by the WHO Executive Board in January, 2017, for the final stage of the election. All three are well qualified and experienced in their own ways and all fulfil WHO's established criteria.1 So the important issue for the world's ministers of health, meeting in Geneva, Switzerland, will be deciding which of the three candidates could best lead the needed reforms at WHO while also protecting and enhancing the health of the world's people.


    Date de mise en ligne : Jeudi 18 mai 2017
    George Alleyne, Cary Cooper, Pekka Puska, Robert Beaglehole, Ruth Bonita, Alexandre Kalache, Mohamed Abdi Jama, Fareed Minhas, Samad Shera
    [Correspondence] Sania Nishtar is the health leader that the world needs
    Dr Sania Nishtar is the ideal person to lead WHO and we urge the world's 194 health ministers to elect her as the next Director–General (DG) in the coming World Health Assembly. Every health minister at the World Health Assembly will be aware of the wide and deep challenges facing WHO and global public health, and will be cognisant of the need to find the best leader. This is not a claim we make lightly. Many of the arguments for our claim are set out in detail in Nishtar's published manifesto,1 but some of the more important points bear repeating.


    Date de mise en ligne : Jeudi 18 mai 2017
    David Nabarro
    [Correspondence] Open letter to WHO DG candidates: reply from David Nabarro
    I thank Katherine Brown and colleagues for their letter (May 13, p 1879).1


    Date de mise en ligne : Lundi 22 mai 2017
    Scott Weathers, Sophie Hermanns
    [Correspondence] Open letter urges WHO to take action on industrial animal farming
    Margaret Chan, the Director-General of WHO, spoke at last year's World Health Assembly (WHA) to call for action from the international community on three “slow motion disasters” that she expected would soon “reach a tipping point where the harm done is irreversible.”1 These issues are climate change, antibiotic resistance, and the rise of non-communicable diseases. The election of a new Director-General at WHO this May brings an opportunity to set a new agenda. WHO has already taken leadership on the crises outlined by Chan, especially on antibiotic resistance.


    Date de mise en ligne : Vendredi 19 mai 2017
    Frank Ashall
    [Correspondence] Questions around the candidacy of Dr Tedros Adhanom Ghebreyesus for WHO DG
    With the final vote for the next WHO Director-General (DG) close upon us, I wish to raise concerns regarding the candidature of Dr Tedros Adhanom Ghebreyesus.


    Date de mise en ligne : Vendredi 05 mai 2017
    [Department of Error] Department of Error
    WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet 2017; 389: 2105–16—In the procedures section of this Article, “10 mg/mL” of tranexamic acid should have been “100 mg/mL”. This correction has been made to the online version as of May 5, 2017, and the printed version is correct.


    Date de mise en ligne : Mercredi 26 avril 2017
    WOMAN Trial Collaborators
    [Articles] Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial
    Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset.


    Date de mise en ligne : Mardi 28 mars 2017
    Bengt C Fellström, Jonathan Barratt, Heather Cook, Rosanna Coppo, John Feehally, Johan W de Fijter, JĂŒrgen Floege, Gerd Hetzel, Alan G Jardine, Francesco Locatelli, Bart D Maes, Alex Mercer, Fernanda Ortiz, Manuel Praga, SĂžren S SĂžrensen, Vladimir Tesar, Lucia Del Vecchio, NEFIGAN Trial Investigators
    [Articles] Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial
    TRF-budesonide 16 mg/day, added to optimised RAS blockade, reduced proteinuria in patients with IgA nephropathy. This effect is indicative of a reduced risk of future progression to end-stage renal disease. TRF-budesonide could become the first specific treatment for IgA nephropathy targeting intestinal mucosal immunity upstream of disease manifestation.


    Date de mise en ligne : Lundi 20 mars 2017
    Nicholas C Chesnaye, Franz Schaefer, Marjolein Bonthuis, Rebecca Holman, Sergey Baiko, Esra Baskın, Anna Bjerre, Sylvie Cloarec, Elisabeth A M Cornelissen, Laura Espinosa, James Heaf, Rosårio Stone, Diamant Shtiza, Ilona Zagozdzon, JérÎme Harambat, Kitty J Jager, Jaap W Groothoff, Karlijn J van Stralen, ESPN/ERA-EDTA Registry Committee
    [Articles] Mortality risk disparities in children receiving chronic renal replacement therapy for the treatment of end-stage renal disease across Europe: an ESPN-ERA/EDTA registry analysis
    Substantial international variation exists in paediatric renal replacement therapy mortality rates across Europe, most of which was explained by disparities in public health expenditure, which seems to limit the availability and quality of paediatric renal care. Differences between countries in their ability to accept and treat the youngest patients, who are the most complex and costly to treat, form an important source of disparity within this population. Our findings can be used by policy makers and health-care providers to explore potential strategies to help reduce these health disparities.


    Date de mise en ligne : Jeudi 19 janvier 2017
    Enrico Maria Trecarichi, Angelico Spagnolo, Fabio De-Giorgio, Tommaso Pirronti, Frediano Inzani, Giuseppe Vetrugno
    [Clinical Picture] Excavated pulmonary lesions: differential diagnosis in a health-care worker
    A healthy 55-year-old Italian nurse, with a history of bilateral nasal polyposis, had occupational screening after contact with a patient diagnosed with pulmonary tuberculosis. She had no other medical history of note (including diabetes or gastro-oesophageal reflux disease) and reported no other contact with tuberculosis. She could not recall having had previous BCG vaccination. A Mantoux skin test was positive (about 10 mm). Chest radiograph showed two lesions in the left lower lobe: an air-filled nodule with slightly thickened walls of about 2 cm diameter, and another solid nodule about 1 cm diameter (appendix).


    Date de mise en ligne : Samedi 27 mai 2017
    Jill Vanmassenhove, Jan Kielstein, Achim Jörres, Wim Van Biesen
    [Series] Management of patients at risk of acute kidney injury
    Acute kidney injury (AKI) is a multifaceted syndrome that occurs in different settings. The course of AKI can be variable, from single hit and complete recovery, to multiple hits resulting in end-stage renal disease. No interventions to improve outcomes of established AKI have yet been developed, so prevention and early diagnosis are key. Awareness campaigns and education for health-care professionals on diagnosis and management of AKI—with attention to avoidance of volume depletion, hypotension, and nephrotoxic interventions—coupled with electronic early warning systems where available can improve outcomes.


    Date de mise en ligne : Samedi 27 mai 2017
    Thomas Wekerle, Dorry Segev, Robert Lechler, Rainer Oberbauer
    [Series] Strategies for long-term preservation of kidney graft function
    Kidney transplantation has become a routine procedure in the treatment of patients with kidney failure, and requires collaboration of experts from different disciplines, such as nephrology, surgery, immunology, pathology, infectious disease medicine, cardiology, and oncology. Grafts can be obtained from deceased or living donors, with different logistical requirements and implications for long-term graft patency. 1-year graft survival rates are greater than 95% in many centres but improvement of long-term function remains a challenge.