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Lancet articles

Oral P2Y12 receptor inhibitors are key for secondary prevention of atherothrombotic events in patients with acute coronary syndromes, in particular those undergoing percutaneous coronary intervention (PCI)1. Prasugrel and ticagrelor are more potent than clopidogrel, which is characterised by increased rates of high on-treatment platelet reactivity (HPR), a known marker for recurrent ischaemic events, including stent thrombosis.2 This characteristic could explain the greater reduction in atherothrombotic…

Niemann-Pick C1 disease (NPC1) is a rare autosomal recessive lysosomal storage disease, which was separated from the sphinomyelinase-deficient NPCA and NPCB when cholesterol was found to be stored.1 No drugs for the disease are currently approved in the USA, although miglustat is approved in Europe. In The Lancet, Daniel Ory and colleagues2 report strong evidence that intrathecal delivery of hydroxypropyl-beta-cyclodextrin (HPBCD) slows the progression of NPC1.

Smoking causes more than 7 million deaths each year1 and tobacco companies have known, since at least 1950, that their products are lethal and addictive. Now Philip Morris International (PMI) is committing nearly US$1 billion over 12 years to the Philip Morris Foundation for a Smoke-Free World that will “fund scientific research designed to eliminate the use of smoked tobacco around the globe”.2 In a Lancet Viewpoint in this issue, the Foundation's President Derek Yach argues it will support…

China's medical insurance system has changed dramatically in the past two decades. The country's most established programme, the Urban Employee Basic Medical Insurance, dates back to the mid-1990s and initially covered only 109 million employees of state-owned and collective enterprises.1 In the early 2000s, the Chinese Government established two additional insurance programmes, the New Cooperative Medical Scheme (NCMS) for rural residents and the Urban Resident Medical Insurance (URMI) programme…

The US Centers for Disease Control and Prevention released a new report on cancer and obesity last week, highlighting that cancers associated with overweight and obesity, including thyroid, liver, kidney, and ovarian cancer, constitute 40% of cancers diagnosed in the USA, with over 630 000 diagnoses in 2014 alone. The study looked at data from the United States Cancer Statistics for 2005-2014. Disparities between sexes in the rates of cancers associated with obesity are especially stark, with 55%…

We are living in an era when the science of medicine has never been better. Medical textbooks are regularly being updated and rewritten to accommodate advances. However, scientific advances are often not translated into medical practice or medical education. With a global burden in excess of 30 million people, atrial fibrillation could be considered a modern-day epidemic.1 But evidence shows that physicians considering anticoagulation treatments for patients are more influenced by the events they…

Tobacco smoking is the leading cause of preventable mortality worldwide and is responsible for more than 7 million deaths each year. In today's issue of The Lancet, we publish a Viewpoint describing the mission and goals of the recently established Foundation for a Smoke-Free World, funded by tobacco giant Philip Morris International. Led by former WHO executive director Derek Yach, the Foundation, whose aim is “to eliminate cigarette smoking worldwide”, will receive US$1 billion in funding…

WHO's Director-General, Dr Tedros, last week launched his new cabinet to widespread acclaim. His mix of deputy and assistant director-generals is made up of nine women (two-thirds of his leadership team) with a geographical spread across 14 countries. India, Brazil, Saudi Arabia, South Africa, and Barbados are all newly represented. The announcement also translated Tedros's verbal promises into structural commitments. New priorities include Universal Health Coverage, climate change, and access…

On average older men now spend 2·4 years and women 3·0 years with substantial care needs, and most will live in the community. These findings have considerable implications for families of older people who provide the majority of unpaid care, but the findings also provide valuable new information for governments and care providers planning the resources and funding required for the care of their future ageing populations.

Systemic sclerosis, also called scleroderma, is an immune-mediated rheumatic disease that is characterised by fibrosis of the skin and internal organs and vasculopathy. Although systemic sclerosis is uncommon, it has a high morbidity and mortality. Improved understanding of systemic sclerosis has allowed better management of the disease, including improved classification and more systematic assessment and follow-up. Additionally, treatments for specific complications have emerged and a growing evidence…