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Mise jour le : 30-03-2017




Les derniers abstracts de la revue The Lancet :


    Date de mise en ligne : Samedi 25 mars 2017
    The Lancet
    [Editorial] What has Europe ever done for health?
    March 25, 2017, marks the 60th anniversary of the signing of the Treaties of Rome—two treaties that gave birth to the European Economic Community (EEC) and to the European Atomic Energy Community (EURATOM). The treaty establishing the EEC affirmed in its preamble that signatory states were “determined to lay the foundations of an ever closer union among the peoples of Europe”. Security, solidarity, and freedom are protected in the Charter of Fundamental Rights of the European Union (EU). The 1992 Maastricht Treaty placed the health mandate of the EU centre stage and although delivery of health care remains a national competence, EU law governs many areas, such as medicines regulation.


    Date de mise en ligne : Samedi 25 mars 2017
    The Lancet
    [Editorial] Trauma for migrant children stranded in Greece
    A Save the Children report released on March 16 raises alarm about the dire consequences of the deal made between the European Union (EU) and Turkey that limits the number of migrants and refugees entering Europe via Greece. 1 year after the agreement, thousands of people, many escaping Syria or Iraq, are now stranded on Greek islands. They are living in limbo waiting for asylum or passage, prohibited from leaving, and effectively imprisoned. Conditions are said to be appalling with limited infrastructure and facilities.


    Date de mise en ligne : Samedi 25 mars 2017
    The Lancet
    [Editorial] Preparing for future global health emergencies
    On March 13–14, Chatham House and the Graduate Institute Geneva-Global Health Centre hosted a roundtable meeting on preparedness for global health crises. Representatives from WHO and the UN, including member states, global health and development agencies, foundations, academia, and non-profit initiatives shared their work and experiences on monitoring preparedness for outbreaks and other public health emergencies.


    Date de mise en ligne : Jeudi 16 fvrier 2017
    Jennifer M Specht, Nancy E Davidson
    [Comment] Optimal duration of trastuzumab for early HER2-positive breast cancer
    Four pivotal randomised trials1–3 have shown that the addition of trastuzumab, a monoclonal antibody targeting the HER2 receptor, to adjuvant chemotherapy results in significant improvements in disease-free survival and overall survival for patients with early stage HER2-positive breast cancer. The HERA trial1,4 differed from the North American NSABP B-31 and NCCTG 9831 trials3 because it mandated completion of all adjuvant chemotherapy before administration of trastuzumab, and randomly assigned patients to none, or 1 or 2 years of trastuzumab.


    Date de mise en ligne : Mercredi 15 fvrier 2017
    Roy Fleischmann
    [Comment] Interleukin-6 inhibition for rheumatoid arthritis
    In The Lancet, Daniel Aletaha and colleagues1 report the results of their phase 3, double-blind, placebo-controlled study (SIRROUND-T) of two doses of sirukumab, a human monoclonal antibody that binds to the interleukin 6 cytokine, compared with placebo in patients with active rheumatoid arthritis who were refractory or intolerant to anti-tumour necrosis factor (TNF) agents. The patient population was unusual; approximately 20% of the participants were not receiving concomitant conventional disease modifying antirheumatic drugs (DMARDs) at baseline, and participants could have been refractory to several biological DMARDs including tocilizumab.


    Date de mise en ligne : Mardi 14 fvrier 2017
    Britta Siegmund
    [Comment] Is intensity the solution for FMT in ulcerative colitis?
    Inflammatory bowel diseases have been associated with a profound decrease in microbial diversity.1 Since the report by Turnbaugh and colleagues,2 in which the phenotype of a mouse was changed by faecal microbiota transfer (FMT), it became tempting to speculate that intestinal inflammation might be cured by this strategy. This idea has been proved by findings of a randomised trial in patients with Clostridium difficile colitis,3 whereby one FMT enema induced resolution of C difficile-associated diarrhoea in 81% (13 of 16) of patients.


    Date de mise en ligne : Mardi 31 janvier 2017
    Martin Tobias
    [Comment] Social rank: a risk factor whose time has come?
    56 million people died in 2015, many prematurely and most (71%) from non-communicable diseases (NCDs).1 Yet NCDs were absent from the UN Millennium Development Goals (MDGs), which expired in 2015.2 Recognising this absence, WHO has set member states a goal to reduce premature mortality from the major NCDs by 25% by 2025 (the 25 × 25 goal).3 To achieve this goal, WHO urges action on seven established NCD risk factors.3 In The Lancet Silvia Stringhini and colleagues4 argue that these risk factors are not enough.


    Date de mise en ligne : Samedi 25 mars 2017
    Madhukar Pai, Natasha Correa, Nerges Mistry, Prabhat Jha
    [Comment] Reducing global tuberculosis deaths—time for India to step up
    As another World Tuberculosis Day passes by the outlook for tuberculosis control is far from optimistic, especially for India, the ground zero for the global epidemic. Last year, WHO declared that the tuberculosis epidemic was worse than previously thought, with an estimated 10·4 million new tuberculosis cases worldwide in 2015.1 WHO estimated that globally 1·8 million people died from tuberculosis in 2015, of whom 0·4 million were also infected with HIV.1 Although global tuberculosis deaths declined by 22% between 2000 and 2015, it is remarkable that tuberculosis today is responsible for more deaths than HIV and malaria combined, and continues to rank among the top ten causes of deaths worldwide.


    Date de mise en ligne : Samedi 25 mars 2017
    Bilaal U Adam, Paul Cosford, Sarah R Anderson, Ibrahim Abubakar
    [Comment] Sustaining tuberculosis decline in the UK
    The re-emergence of tuberculosis in England began in the late 1980s increasing to a peak in 2011; since then incidence has fallen throughout the UK, in both the UK and non-UK born population, including in children.1 After 4 consecutive years of declining incidence of tuberculosis, sustained progress is finally being made with a 30% decline between 2011 and 2015.1 However, tuberculosis incidence in the UK remains higher than in most other high-income European countries and more than four times higher than in the USA.


    Date de mise en ligne : Samedi 25 mars 2017
    Deborah Padfield, Joanna M Zakrzewska
    [Comment] Encountering pain
    In her keynote lecture at the Encountering Pain conference at University College London (UCL) last year, Rita Charon argued that “unremitting pain is, I believe, our contemporary central dilemma”. Pain, particularly chronic pain, is common and remains difficult to fully capture in the verbal or numerical scales commonly used in clinical practice.1,2 Recognised as a major cause of disability globally, chronic pain affects about 20% of the adult European population with 28 million sufferers in the UK alone.


    Date de mise en ligne : Samedi 25 mars 2017
    Richard Horton
    [Comment] Offline: The dark heart of the wood
    “A family reunion that keeps us connected to the outside world.” So said Mamdouh Aker, a Trustee of Birzeit University, as he opened the annual scientific gathering of The Lancet Palestinian Health Alliance (LPHA), which last week returned in its eighth year to the home of its birth. Birzeit is one of the State of Palestine's most prestigious global universities. The LPHA is a loose network of Palestinian, regional, and international researchers committed to the highest scientific standards in describing, analysing, and evaluating the health and health care of Palestinians—contributing to the global scientific literature and developing local evidence-based policy and practice.


    Date de mise en ligne : Samedi 25 mars 2017
    Susan Jaffe
    [World Report] US health and science advocates gear up for battle over EPA
    The Trump administration's proposed budget makes large cuts to the US Environmental Protection Agency. Susan Jaffe, The Lancet's Washington correspondent, reports.


    Date de mise en ligne : Samedi 25 mars 2017
    John Zarocostas
    [World Report] Iraq's health system under pressure as fighting escalates
    Iraq's war-torn health system is being stretched by an escalation in casualties as military hostilities to retake the northern city of Mosul escalate. John Zarocostas reports.


    Date de mise en ligne : Samedi 25 mars 2017
    Dinesh C Sharma
    [World Report] New plan to end tuberculosis in south and southeast Asia
    Health ministers from south and southeast Asia agreed to fast-track strategies to eliminate tuberculosis by 2030 at a WHO regional meeting in Delhi last week. Dinesh C Sharma reports.


    Date de mise en ligne : Samedi 25 mars 2017
    Tania Glyde
    [Perspectives] Triumph over adversity
    Steve Gleason was a star American football player for the New Orleans Saints. He was smaller than average for the sport so he had to work harder, and gained a reputation as a maverick. After Hurricane Katrina, the disaster that devastated New Orleans, his performance at the Louisiana Superdome amazed audiences and became a symbol of the city's regeneration.


    Date de mise en ligne : Samedi 25 mars 2017
    Richard Lane
    [Perspectives] Ana Mari Cauce: leader of a new initiative in population health
    Until recently, Ana Mari Cauce, President of the University of Washington (UW), based in Seattle, WA, USA, considered herself to be somewhat of an accidental administrator. “I used to be a real hothead, with an intrinsic distrust of authority, distaste for bureaucracy, and disdain for process, not exactly the trifecta of traits that prepares one for academic leadership”, she says. And while Cauce has spent three decades at UW in a variety of progressively senior administrative roles, she sees herself as first and foremost a faculty member.


    Date de mise en ligne : Samedi 25 mars 2017
    Elena Semino, Joanna M Zakrzewska, Amanda Williams
    [Perspectives] Images and the dynamics of pain consultations
    In a London National Health Service pain clinic, a patient (whom we will call Sarah) gave the clinician a series of cards, one by one. On each card is an image that was co-created by artist Deborah Padfield and patients with chronic pain to help represent patients' experiences of pain (figure 1). When she was waiting for her consultation, Sarah had looked through a large pack of these pain cards and selected a few cards to take into the consultation with her. As Sarah handed one of the pain cards (figure 2) to the clinician, the following interaction took place:


    Date de mise en ligne : Samedi 25 mars 2017
    Andrew Green
    [Obituary] Margaret Mungherera
    Leading Ugandan psychiatrist and advocate for health professionals. Born in Jinja, Uganda, on Oct 25, 1957, she died from colon cancer in Chennai, India, on Feb 4, 2017, aged 59 years.


    Date de mise en ligne : Samedi 25 mars 2017
    Bernice Dahn, Mosoka P Fallah, James Platts, Suerie Moon, Ann M Kimball
    [Correspondence] Getting pandemic prevention right
    The voices of the countries most affected by Ebola have not been at the forefront of the numerous global commissions convened to review the crisis. The history of the HIV pandemic suggests that nuances of managing such a response need to come from those who managed the response and were most affected by it. One review1 suggests that the global response to Ebola remains inadequate. This Correspondence is a regional perspective from west Africa, the community most affected by the Ebola epidemic and by infectious-disease outbreaks in general.


    Date de mise en ligne : Vendredi 10 mars 2017
    Leonard Rubenstein, Paul Spiegel
    [Correspondence] The revised US refugee ban, health, and security
    President Trump issued a revised travel and refugee ban on March 6, 2017, in the wake of judicial orders preventing implementation of his previous ban.1,2 The new order discontinues the bar on entry into the USA for permanent residents, reduces from seven to six the number of predominantly Muslim countries whose nationals are suspended from entry for at least 90 days, ends the indefinite bar on entry of Syrian refugees, and eliminates a preference for religious minorities in refugee resettlement.


    Date de mise en ligne : Samedi 25 mars 2017
    Kjell Asplund, Göran Hermerén
    [Correspondence] The need to revise the Helsinki Declaration
    In 2011, The Lancet published an Article (Dec 10, p 1997)1 on the first case of a transplant using a synthetic trachea seeded with the patient's own stem cells. The senior author was Paolo Macchiarini, a thoracic surgeon working at the Karolinska University Hospital, Stockholm. Macchiarini performed another three transplantations with the same technique at the Karolinska. Since research misconduct was suspected and several of the authors of the 2011 article retracted their authorships, The Lancet added an expression of concern to the article in April, 2016.


    Date de mise en ligne : Samedi 25 mars 2017
    Claes Frostell, Gunilla Björling, Emma Strömberg, Sigbritt Karlsson, Ragnhild E Aune
    [Correspondence] Tracheal implants revisited
    An Article in The Lancet by Philipp Jungebluth and colleagues published in 2011 (Dec 10, p 1997),1 can now be found online with four of the original authors having since withdrawn their authorship. That alone is certainly a rare development. The authors described how a seriously ill 36-year-old male patient, with recurrent primary cancer of the distal trachea and main bronchi after complete tumour resection, received a tracheal implant made of polyhedral oligomeric silsesquioxane poly(carbonate-urea) urethane (POSS-PCU).


    Date de mise en ligne : Samedi 25 mars 2017
    Andrew J Beamish, Katherine J Gash, Thomas H Inge
    [Correspondence] Feedback of results to trial participants: be upfront or risk affront
    We commend Erik Stenberg and colleagues for their well designed and delivered large randomised trial (April 2, p 1397),1 which investigated the utility of mesenteric defect closure in reducing the incidence of internal hernia after laparoscopic gastric bypass surgery. The study robustly answers the authors' research question and a plenary audience at the European Obesity Summit in Gothenburg, Sweden, agreed almost unanimously that closure of mesenteric defects should now be standard practice.


    Date de mise en ligne : Samedi 25 mars 2017
    Alexandre Hideo-Kajita, Ron Waksman, Hector M Garcia-Garcia
    [Correspondence] ANTARCTIC: platelet function testing to adjust therapy
    We carefully read the ANTARCTIC study by Guillaume Cayla and colleagues (Oct 22, p 2015),1 and would like to suggest a different interpretation of the results. The trial studied the utility of platelet function reactivity (assessed by VerifyNow) guidance in elderly patients (aged ≥75 years) with acute coronary syndrome and ST-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention and were treated with prasugrel 5 mg daily. For power calculations, the investigators used a combined endpoint of ischaemic and bleeding events, and bleeding events drove the overall event rates.


    Date de mise en ligne : Samedi 25 mars 2017
    Paul A Gurbel, Matthew J Price, Jeffrey R Dahlen, Udaya S Tantry
    [Correspondence] ANTARCTIC: platelet function testing to adjust therapy
    We read the ANTARCTIC study by Guillaume Cayla and colleagues1 with interest. The authors interpreted that platelet function monitoring with treatment adjustment did not improve the clinical outcome of elderly patients treated with coronary stenting for an acute coronary syndrome. We think that the following granular conclusion is more appropriate: elderly patients with acute coronary syndrome given low-dose prasugrel who had low on-treatment reactivity identified by platelet function testing did not have reduced bleeding after switching to clopidogrel therapy.


    Date de mise en ligne : Samedi 25 mars 2017
    Gilles Montalescot, Guillaume Cayla, ANTARCTIC Investigators
    [Correspondence] ANTARCTIC: platelet function testing to adjust therapy – Authors' reply
    We thank Paul Gurbel and colleagues for their interest in our randomised ANTARCTIC study,1 but we think they have wrongly interpreted both the design and the results of the study. Their statement corresponds neither to the hypothesis nor to the primary endpoint of the study. We wish to underscore that the ANTARCTIC study was not a comparison between prasugrel and clopidogrel, that bleeding was not the primary endpoint, that the study never tested switching from prasugrel to clopidogrel, and that 5 mg is not a low dose but the approved dose of prasugrel for the elderly.


    Date de mise en ligne : Mardi 07 fvrier 2017
    [Department of Error] Department of Error
    Stringhini S, Carmeli C, Jokela M, et al. Socioeconomic status and the 25 × 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1·7 million men and women. Lancet 2017; 389: 1229–37—In the supplementary appendix for this Article, some forest plots were omitted for all-cause mortality that have now been added. This correction has been made to the online version as of Feb 7, 2017, and the printed Article is correct.


    Date de mise en ligne : Lundi 27 fvrier 2017
    [Department of Error] Department of Error
    Stringhini S, Carmeli C, Jokela M, et al. Socioeconomic status and the 25 × 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1·7 million men and women. Lancet 2017; 389: 1229–37—the declaration of interests for this Article had stated “PV reports grants from GlaxoSmithKline.” Two authors have the initials PV, Peter Vollenweider, to whom the interest refers, and Paolo Vineis, a last author of the paper. This has been amended to “PVo reports grants from GlaxoSmithKline.” This correction has been made online as of Feb 27, 2017, and the printed Article is correct.


    Date de mise en ligne : Lundi 12 dcembre 2016
    [Department of Error] Department of Error
    Veselka J, Anavekar NS, Charron P. Hypertrophic obstructive cardiomyopathy. Lancet 2016; 389: 1253–67—In table 1 of this Seminar the entry for lysosome-associated membrane glycoprotein 2, under the gene frequency (%) or inheritance heading, states “Dominant; rare”. It should have stated “X-linked; rare.” This correction has been made to the online version as of Dec 12, 2016, and the printed Seminar is correct.


    Date de mise en ligne : Samedi 25 mars 2017
    [Department of Error] Department of Error
    McKee M, Stuckler D. The changing role of the British state and its citizens. Lancet 2014; 384: 1643–44—In this Comment, the declaration of interests should have stated “We declare no competing interests. DS is supported by a Wellcome Trust Investigator Award, and is funded by ERC HRES 313590.” This correction has been made to the online version as of March 23, 2017.


    Date de mise en ligne : Samedi 25 mars 2017
    [Department of Error] Department of Error
    McNeill D, Deere Birkbeck C, Fukada-Parr S, Grover A, Schrecker T, Stuckler D. Political origins of health inequities: trade and investment agreements. Lancet 2017; 389: 760–62—In this Viewpoint, the declaration of interests should have stated “DS is supported by a Wellcome Trust Investigator Award, and is funded by ERC HRES 313590”. This correction has been made to the online version as of March 23, 2017.


    Date de mise en ligne : Samedi 25 mars 2017
    [Department of Error] Department of Error
    Crisp N, Stuckler D, Horton R, et al. Manifesto for a healthy and health-creating society. Lancet 2016; 388: e24–27—In this NHS Manifesto, the declaration of interests should have stated “DS is supported by a Wellcome Trust Investigator Award, and is funded by ERC HRES 313590”. This correction has been made to the online version as of March 23, 2017.


    Date de mise en ligne : Jeudi 16 fvrier 2017
    David Cameron, Martine J Piccart-Gebhart, Richard D Gelber, Marion Procter, Aron Goldhirsch, Evandro de Azambuja, Gilberto Castro, Michael Untch, Ian Smith, Luca Gianni, Jose Baselga, Nedal Al-Sakaff, Sabine Lauer, Eleanor McFadden, Brian Leyland-Jones, Richard Bell, Mitch Dowsett, Christian Jackisch, Herceptin Adjuvant (HERA) Trial Study Team
    [Articles] 11 years' follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial
    1 year of adjuvant trastuzumab after chemotherapy for patients with HER2-positive early breast cancer significantly improves long-term disease-free survival, compared with observation. 2 years of trastuzumab had no additional benefit.


    Date de mise en ligne : Mercredi 15 fvrier 2017
    Daniel Aletaha, Clifton O Bingham, Yoshiya Tanaka, Prasheen Agarwal, Regina Kurrasch, Paul P Tak, Sharon Popik
    [Articles] Efficacy and safety of sirukumab in patients with active rheumatoid arthritis refractory to anti-TNF therapy (SIRROUND-T): a randomised, double-blind, placebo-controlled, parallel-group, multinational, phase 3 study
    In patients with active rheumatoid arthritis who were refractory or intolerant to anti-TNF drugs and other biological treatments, both dosing regimens of sirukumab were well tolerated and significantly improved signs and symptoms of the disease, compared with placebo, in this difficult-to-treat population.


    Date de mise en ligne : Mercredi 15 fvrier 2017
    Sudarshan Paramsothy, Michael A Kamm, Nadeem O Kaakoush, Alissa J Walsh, Johan van den Bogaerde, Douglas Samuel, Rupert W L Leong, Susan Connor, Watson Ng, Ramesh Paramsothy, Wei Xuan, Enmoore Lin, Hazel M Mitchell, Thomas J Borody
    [Articles] Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial
    Intensive-dosing, multidonor, faecal microbiota transplantation induces clinical remission and endoscopic improvement in active ulcerative colitis and is associated with distinct microbial changes that relate to outcome. Faecal microbiota transplantation is, thus, a promising new therapeutic option for ulcerative colitis. Future work should focus on precisely defining the optimum treatment intensity and the role of donor–recipient matching based on microbial profiles.


    Date de mise en ligne : Mardi 31 janvier 2017
    Silvia Stringhini, Cristian Carmeli, Markus Jokela, Mauricio Avendaño, Peter Muennig, Florence Guida, Fulvio Ricceri, Angelo d'Errico, Henrique Barros, Murielle Bochud, Marc Chadeau-Hyam, Françoise Clavel-Chapelon, Giuseppe Costa, Cyrille Delpierre, Silvia Fraga, Marcel Goldberg, Graham G Giles, Vittorio Krogh, Michelle Kelly-Irving, Richard Layte, Aurélie M Lasserre, Michael G Marmot, Martin Preisig, Martin J Shipley, Peter Vollenweider, Marie Zins, Ichiro Kawachi, Andrew Steptoe, Johan P Mackenbach, Paolo Vineis, Mika Kivimäki, LIFEPATH consortium
    [Articles] Socioeconomic status and the 25 × 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1·7 million men and women
    Socioeconomic circumstances, in addition to the 25 × 25 factors, should be targeted by local and global health strategies and health risk surveillance to reduce mortality.


    Date de mise en ligne : Mardi 22 novembre 2016
    Angela C Webster, Evi V Nagler, Rachael L Morton, Philip Masson
    [Seminar] Chronic Kidney Disease
    The definition and classification of chronic kidney disease (CKD) have evolved over time, but current international guidelines define this condition as decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m2, or markers of kidney damage, or both, of at least 3 months duration, regardless of the underlying cause. Diabetes and hypertension are the main causes of CKD in all high-income and middle-income countries, and also in many low-income countries.


    Date de mise en ligne : Mardi 29 novembre 2016
    Josef Veselka, Nandan S Anavekar, Philippe Charron
    [Seminar] Hypertrophic obstructive cardiomyopathy
    Hypertrophic obstructive cardiomyopathy is an inherited myocardial disease defined by cardiac hypertrophy (wall thickness ≥15 mm) that is not explained by abnormal loading conditions, and left ventricular obstruction greater than or equal to 30 mm Hg. Typical symptoms include dyspnoea, chest pain, palpitations, and syncope. The diagnosis is usually suspected on clinical examination and confirmed by imaging. Some patients are at increased risk of sudden cardiac death, heart failure, and atrial fibrillation.


    Date de mise en ligne : Lundi 07 novembre 2016
    Narcyz Ghinea, Wendy Lipworth, Richard Day, Andrew Hill, Gregory J Dore, Mark Danta
    [Viewpoint] Importation of generic hepatitis C therapies: bridging the gap between price and access in high-income countries
    An estimated 80–150 million people are infected with hepatitis C virus (HCV) worldwide, with the highest prevalence in low-income and medium-income countries of Africa and Asia. HCV-related liver disease mortality is estimated to be half a million per annum.1,2