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Lancet articles

In The Lancet, Michael Sweeting and colleagues1 report their estimate of the benefits, harms, and cost-effectiveness of screening women for abdominal aortic aneurysm (AAA) based upon their modelling study. A discrete event simulation model was set up and women-specific parameters were obtained from systematic literature reviews, national registry or administrative databases, major AAA surgery trials, and UK National Health Service reference costs. By use of the same screening strategy as used for…

2 years ago, Andrew Mente and colleagues,1 after studying more than 130 000 people from 49 different countries, concluded that salt restriction reduced the risk of heart disease, stroke, or death only in patients who had high blood pressure, and that salt restriction could be harmful if salt intake became too low. The reaction of the scientific community was swift. “Disbelief” was voiced that “such bad science” should be published by The Lancet.2 The American Heart Association (AHA) refuted…

In 1948, as the UK's National Health Service (NHS) was born, “neurological” treatments consisted of antibiotics, B12 injections, and phenobarbital or phenytoin.1 Much has changed. In epilepsy alone, there are now about 26 anti-epileptic drugs (AEDs). Through much of this transformation, an AED has provided both hope and concern: valproate. Initially licensed for epilepsy in France in 1967,2 valproate is an effective AED recommended in England by the National Institute for Health and Care Excellence…

Facing scarcity of medicines and broken-down medical equipment, women diagnosed with breast cancer in Venezuela resort to more radical means of treatment. Hildegard Willer reports.

A 40-year-old woman with a history of chronic pancreatitis and gastro-oesophageal reflux disease presented with fatigue, malaise, dizziness, difficulty ambulating, diarrhoea, easy bruising, and a diffuse rash involving her extremities and trunk that had been present for several days. She explained that she had limited her diet to consist mostly of bread, rice, dumplings, and the occasional egg white to reduce the symptoms she suffered from her gastro-oesophageal reflux disease. Her diet was also…

Primary CNS tumours refer to a heterogeneous group of tumours arising from cells within the CNS, and can be benign or malignant. Malignant primary brain tumours remain among the most difficult cancers to treat, with a 5 year overall survival no greater than 35%. The most common malignant primary brain tumours in adults are gliomas. Recent advances in molecular biology have improved understanding of glioma pathogenesis, and several clinically significant genetic alterations have been described. A…

During Donald Trump's presidential campaign, he promised to stand up to pharmaceutical companies and, once in office, to adopt measures that would reduce drug prices. After inauguration, he repeated these claims. In May, 2018, the US Department of Health and Human Services published American Patients First,1 a blueprint for how President Trump might achieve his goals via a series of regulatory and policy actions.

Imran Khan is expected to take oath as Pakistan's new Prime Minister on Aug 14, after his Tehreek-e-Insaf party swept to victory with widespread support in the country's recent election. Khan inherits a nation riddled with corruption and facing a grave economic crisis, with loan defaults looming and a bailout from the International Monetary Fund looking inevitable. Coupled with the country's dismal performance on key health-related indicators, improving the state of health in Pakistan will be…

Therapeutic options for diabetes have improved, allowing people with type 1 diabetes to live longer and healthier lives. However, life expectancy remains 8–13 years shorter and cardiovascular disease continues to be the leading cause of morbidity and mortality in type 1 diabetes.1,2 Attention has focused appropriately on modifiable cardiovascular disease risk factors such as glucose control, blood pressure, and cholesterol. However, non-modifiable cardiovascular disease risk factors, age at the…

Great strides have been made in decreasing the prevalence of, and mortality from, ischaemic heart disease in the past decade or so. However, the prevalence of heart failure as the end result of many differing assaults on the heart is increasing worldwide. This increased prevalence is due to a mixture of population ageing and prolonged survival of patients with heart failure because of some treatment successes, and also due to the rising prevalence of risk factors, such as hypertension, diabetes,…