Time for a responsible internet age.

Lancet. 2010 Mar 6;375(9717):778

Authors:

PMID: 20206756 [PubMed - in process]

International Women's Day 2010.

Lancet. 2010 Mar 6;375(9717):777

Authors:

PMID: 20206755 [PubMed - in process]

Apixaban to prevent venous thromboembolism after knee replacement.

Lancet. 2010 Mar 6;375(9717):779-80

Authors: Fareed J, Hull R

PMID: 20206758 [PubMed - in process]

Raising awareness of antiphospholipid antibody syndrome.

Lancet. 2010 Mar 6;375(9717):778

Authors:

PMID: 20206757 [PubMed - in process]

Offline: Those who think freely think well.

Lancet. 2010 Mar 6;375(9717):790

Authors: Horton R

PMID: 20206762 [PubMed - in process]

Peer review: what would we do without it?

Lancet. 2010 Mar 6;375(9717):789

Authors: Kleinert S

PMID: 20206761 [PubMed - in process]

Calling young researchers.

Lancet. 2010 Mar 6;375(9717):788-9

Authors: Samarasekera U, Jupp S

PMID: 20206760 [PubMed - in process]

Radiotherapy for endometrial cancer: a key piece in the jigsaw.

Lancet. 2010 Mar 6;375(9717):781-2

Authors: Kitchener H, Powell M

PMID: 20206759 [PubMed - in process]

Seasonal vaccine effectiveness against pandemic A/H1N1.

Lancet. 2010 Mar 6;375(9717):801-2; author reply 802-3

Authors: Janjua NZ, Skowronski DM, Hottes TS, De Serres G, Crowcroft NS, Rosella LC

PMID: 20206765 [PubMed - in process]

Agnes Moses: preventing maternal transmission of HIV in Malawi.

Lancet. 2010 Mar 6;375(9717):797

Authors: Shetty P

PMID: 20206763 [PubMed - in process]

Colombia's health reform: false debates, real imperatives.

Lancet. 2010 Mar 6;375(9717):803

Authors: Yamin AE

PMID: 20206768 [PubMed - in process]

White blood.

Lancet. 2010 Mar 6;375(9717):801; author reply 801

Authors: Lommerse K, Mwagomba B, van den Akker T

PMID: 20206766 [PubMed - in process]

Abortion in Australia: still to emerge from the 19th century.

Lancet. 2010 Mar 6;375(9717):804-5

Authors: de Costa CM, Russell DB, Carrette M

PMID: 20206770 [PubMed - in process]

Colombia's health reform: false debates, real imperatives.

Lancet. 2010 Mar 6;375(9717):803

Authors: Londoño E, Dario-Gómez R, de Vos P

PMID: 20206769 [PubMed - in process]

Snake bite: simple steps to prevention and reduction of morbidity.

Lancet. 2010 Mar 6;375(9717):805

Authors: Bawaskar HS, Bawaskar PH

PMID: 20206773 [PubMed - in process]

Health benefits of interventions to reduce greenhouse gases.

Lancet. 2010 Mar 6;375(9717):804; author reply 804

Authors: Ezzati M, Lin HH

PMID: 20206772 [PubMed - in process]

Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial.

Lancet. 2010 Mar 6;375(9717):807-15

Authors: Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Hornick P,

BACKGROUND: Low-molecular-weight heparins such as enoxaparin are preferred for prevention of venous thromboembolism after major joint replacement. Apixaban, an orally active factor Xa inhibitor, might be as effective, have lower bleeding risk, and be easier to use than is enoxaparin. We assessed efficacy and safety of these drugs after elective total knee replacement. METHODS: In ADVANCE-2, a multicentre, randomised, double-blind phase 3 study, patients undergoing elective unilateral or bilateral total knee replacement were randomly allocated through an interactive central telephone system to receive oral apixaban 2.5 mg twice daily (n=1528) or subcutaneous enoxaparin 40 mg once daily (1529). The randomisation schedule was generated by the Bristol-Myers Squibb randomisation centre and stratified by study site and by unilateral or bilateral surgery with a block size of four. Investigators, patients, statisticians, adjudicators, and steering committee were masked to allocation. Apixaban was started 12-24 h after wound closure and enoxaparin 12 h before surgery; both drugs were continued for 10-14 days, when bilateral ascending venography was scheduled. Primary outcome was the composite of asymptomatic and symptomatic deep vein thrombosis, non-fatal pulmonary embolism, and all-cause death during treatment. The statistical plan required non-inferiority of apixaban before testing for superiority; analysis was by intention to treat for non-inferiority testing. The study is registered at ClinicalTrials.gov, number NCT00452530. FINDINGS: 1973 of 3057 patients allocated to treatment (1528 apixaban, 1529 enoxaparin) were eligible for primary efficacy analysis. The primary outcome was reported in 147 (15%) of 976 apixaban patients and 243 (24%) of 997 enoxaparin patients (relative risk 0.62 [95% CI 0.51-0.74]; p<0.0001; absolute risk reduction 9.3% [5.8-12.7]). Major or clinically relevant non-major bleeding occurred in 53 (4%) of 1501 patients receiving apixaban and 72 (5%) of 1508 treated with enoxaparin (p=0.09). INTERPRETATION: Apixaban 2.5 mg twice daily, starting on the morning after total knee replacement, offers a convenient and more effective orally administered alternative to 40 mg per day enoxaparin, without increased bleeding. FUNDING: Bristol-Myers Squibb; Pfizer.

PMID: 20206776 [PubMed - in process]

Governments should reduce prices before rationing care.

Lancet. 2010 Mar 6;375(9717):806

Authors: Ford N, Berman D

PMID: 20206775 [PubMed - in process]

The post-Darwinist concept of species: a place for Lamarck?

Lancet. 2010 Mar 6;375(9717):806

Authors: Landires I

PMID: 20206774 [PubMed - in process]

Bacterial septic arthritis in adults.

Lancet. 2010 Mar 6;375(9717):846-55

Authors: Mathews CJ, Weston VC, Jones A, Field M, Coakley G

Symptoms and signs of septic arthritis are an important medical emergency, with high morbidity and mortality. We review the changing epidemiology of septic arthritis of native joints in adults, encompassing the increasing frequency of the disorder and its evolving antibiotic resistance. We discuss various risk factors for development of septic arthritis and examine host factors (tumour necrosis factor alpha, interleukins 1 and 10) and bacterial proteins, toxins, and enzymes reported to be important determinants of pathogenesis in mouse models. Diagnosis of disease is largely clinical, guided by investigations and the opinion of skilled clinicians. We emphasise the need for timely medical and surgical intervention-most importantly, through diagnostic aspiration of relevant joints, choice of suitable antibiotic, and appropriate supportive measures. Management is growing in complexity with the advent of novel and antibiotic-resistant causative microorganisms and within the current climate of increased immunosuppression. Findings from animal models and patients are shedding light on disease pathogenesis and the possibility of novel adjunctive treatments, including systemic corticosteroids, cytokines and anticytokines, and bisphosphonates.

PMID: 20206778 [PubMed - in process]

Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial.

Lancet. 2010 Mar 6;375(9717):816-23

Authors: Nout RA, Smit VT, Putter H, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Kroese MC, van Bunningen BN, Ansink AC, van Putten WL, Creutzberg CL,

BACKGROUND: After surgery for intermediate-risk endometrial carcinoma, the vagina is the most frequent site of recurrence. This study established whether vaginal brachytherapy (VBT) is as effective as pelvic external beam radiotherapy (EBRT) in prevention of vaginal recurrence, with fewer adverse effects and improved quality of life. METHODS: In this open-label, non-inferiority, randomised trial undertaken in 19 Dutch radiation oncology centres, 427 patients with stage I or IIA endometrial carcinoma with features of high-intermediate risk were randomly assigned by a computer-generated, biased coin minimisation procedure to pelvic EBRT (46 Gy in 23 fractions; n=214) or VBT (21 Gy high-dose rate in three fractions, or 30 Gy low-dose rate; n=213). All investigators were masked to the assignment of treatment group. The primary endpoint was vaginal recurrence. The predefined non-inferiority margin was an absolute difference of 6% in vaginal recurrence. Analysis was by intention to treat, with competing risk methods. The study is registered, number ISRCTN16228756. FINDINGS: At median follow-up of 45 months (range 18-78), three vaginal recurrences had been diagnosed after VBT and four after EBRT. Estimated 5-year rates of vaginal recurrence were 1.8% (95% CI 0.6-5.9) for VBT and 1.6% (0.5-4.9) for EBRT (hazard ratio [HR] 0.78, 95% CI 0.17-3.49; p=0.74). 5-year rates of locoregional relapse (vaginal or pelvic recurrence, or both) were 5.1% (2.8-9.6) for VBT and 2.1% (0.8-5.8) for EBRT (HR 2.08, 0.71-6.09; p=0.17). 1.5% (0.5-4.5) versus 0.5% (0.1-3.4) of patients presented with isolated pelvic recurrence (HR 3.10, 0.32-29.9; p=0.30), and rates of distant metastases were similar (8.3% [5.1-13.4] vs 5.7% [3.3-9.9]; HR 1.32, 0.63-2.74; p=0.46). We recorded no differences in overall (84.8% [95% CI 79.3-90.3] vs 79.6% [71.2-88.0]; HR 1.17, 0.69-1.98; p=0.57) or disease-free survival (82.7% [76.9-88.6] vs 78.1% [69.7-86.5]; HR 1.09, 0.66-1.78; p=0.74). Rates of acute grade 1-2 gastrointestinal toxicity were significantly lower in the VBT group than in the EBRT group at completion of radiotherapy (12.6% [27/215] vs 53.8% [112/208]). INTERPRETATION: VBT is effective in ensuring vaginal control, with fewer gastrointestinal toxic effects than with EBRT. VBT should be the adjuvant treatment of choice for patients with endometrial carcinoma of high-intermediate risk. FUNDING: Dutch Cancer Society.

PMID: 20206777 [PubMed - in process]

Community-associated meticillin-resistant Staphylococcus aureus.

Lancet. 2010 Mar 4;

Authors: Deleo FR, Otto M, Kreiswirth BN, Chambers HF

Meticillin-resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide, and causes substantial morbidity and mortality. Health-care-associated MRSA infections arise in individuals with predisposing risk factors, such as surgery or presence of an indwelling medical device. By contrast, many community-associated MRSA (CA-MRSA) infections arise in otherwise healthy individuals who do not have such risk factors. Additionally, CA-MRSA infections are epidemic in some countries. These features suggest that CA-MRSA strains are more virulent and transmissible than are traditional hospital-associated MRSA strains. The restricted treatment options for CA-MRSA infections compound the effect of enhanced virulence and transmission. Although progress has been made towards understanding emergence of CA-MRSA, virulence, and treatment of infections, our knowledge remains incomplete. Here we review the most up-to-date knowledge and provide a perspective for the future prophylaxis or new treatments for CA-MRSA infections.

PMID: 20206987 [PubMed - as supplied by publisher]

Altered pain perception in schizophrenia.

Lancet. 2010 Mar 6;375(9717):864

Authors: Murakami H, Tamasawa N, Yamashita M, Takayasu S, Nigawara T, Matsui J, Suda T

PMID: 20206779 [PubMed - in process]

Effect of scaling up women's groups on birth outcomes in three rural districts in Bangladesh: a cluster-randomised controlled trial.

Lancet. 2010 Mar 5;

Authors: Azad K, Barnett S, Banerjee B, Shaha S, Khan K, Rego AR, Barua S, Flatman D, Pagel C, Prost A, Ellis M, Costello A

BACKGROUND: Two recent trials have shown that women's groups can reduce neonatal mortality in poor communities. We assessed the effectiveness of a scaled-up development programme with women's groups to address maternal and neonatal care in three rural districts of Bangladesh. METHODS: 18 clusters (with a mean population of 27 953 [SD 5953]) in three districts were randomly assigned to either intervention or control (nine clusters each) by use of stratified randomisation. For each district, cluster names were written on pieces of paper, which were folded and placed in a bottle. The first three cluster names drawn from the bottle were allocated to the intervention group and the remaining three to control. All clusters received health services strengthening and basic training of traditional birth attendants. In intervention clusters, a facilitator convened 18 groups every month to support participatory action and learning for women, and to develop and implement strategies to address maternal and neonatal health problems. Women were eligible to participate if they were aged 15-49 years, residing in the project area, and had given birth during the study period (Feb 1, 2005, to Dec 31, 2007). Neither study investigators nor participants were masked to treatment assignment. In a population of 229 195 people (intervention clusters only), 162 women's groups provided coverage of one group per 1414 population. The primary outcome was neonatal mortality rate (NMR). Analysis was by intention to treat. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN54792066. FINDINGS: We monitored outcomes for 36 113 births (intervention clusters, n=17 514; control clusters, n=18 599) in a population of 503 163 over 3 years. From 2005 to 2007, there were 570 neonatal deaths in the intervention clusters and 656 in the control clusters. Cluster-level mean NMR (adjusted for stratification and clustering) was 33.9 deaths per 1000 livebirths in the intervention clusters compared with 36.5 per 1000 in the control clusters (risk ratio 0.93, 95% CI 0.80-1.09). INTERPRETATION: For participatory women's groups to have a significant effect on neonatal mortality in rural Bangladesh, detailed attention to programme design and contextual factors, enhanced population coverage, and increased enrolment of newly pregnant women might be needed. FUNDING: Women and Children First, the UK Big Lottery Fund, Saving Newborn Lives, and the UK Department for International Development.

PMID: 20207412 [PubMed - as supplied by publisher]

Effect of a participatory intervention with women's groups on birth outcomes and maternal depression in Jharkhand and Orissa, India: a cluster-randomised controlled trial.

Lancet. 2010 Mar 5;

Authors: Tripathy P, Nair N, Barnett S, Mahapatra R, Borghi J, Rath S, Rath S, Gope R, Mahto D, Sinha R, Lakshminarayana R, Patel V, Pagel C, Prost A, Costello A

BACKGROUND: Community mobilisation through participatory women's groups might improve birth outcomes in poor rural communities. We therefore assessed this approach in a largely tribal and rural population in three districts in eastern India. METHODS: From 36 clusters in Jharkhand and Orissa, with an estimated population of 228 186, we assigned 18 clusters to intervention or control using stratified randomisation. Women were eligible to participate if they were aged 15-49 years, residing in the project area, and had given birth during the study. In intervention clusters, a facilitator convened 13 groups every month to support participatory action and learning for women, and facilitated the development and implementation of strategies to address maternal and newborn health problems. The primary outcomes were reductions in neonatal mortality rate (NMR) and maternal depression scores. Analysis was by intention to treat. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN21817853. FINDINGS: After baseline surveillance of 4692 births, we monitored outcomes for 19 030 births during 3 years (2005-08). NMRs per 1000 were 55.6, 37.1, and 36.3 during the first, second, and third years, respectively, in intervention clusters, and 53.4, 59.6, and 64.3, respectively, in control clusters. NMR was 32% lower in intervention clusters adjusted for clustering, stratification, and baseline differences (odds ratio 0.68, 95% CI 0.59-0.78) during the 3 years, and 45% lower in years 2 and 3 (0.55, 0.46-0.66). Although we did not note a significant effect on maternal depression overall, reduction in moderate depression was 57% in year 3 (0.43, 0.23-0.80). INTERPRETATION: This intervention could be used with or as a potential alternative to health-worker-led interventions, and presents new opportunities for policy makers to improve maternal and newborn health outcomes in poor populations. FUNDING: Health Foundation, UK Department for International Development, Wellcome Trust, and the Big Lottery Fund (UK).

PMID: 20207411 [PubMed - as supplied by publisher]

Bystander CPR for paediatric out-of-hospital cardiac arrest.

Lancet. 2010 Mar 2;

Authors: López-Herce J, Alvarez AC

PMID: 20202678 [PubMed - as supplied by publisher]

Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study.

Lancet. 2010 Mar 2;

Authors: Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM, Berg RA, Hiraide A,

BACKGROUND: The American Heart Association recommends cardiopulmonary resuscitation (CPR) by bystanders with chest compression only for adults who have cardiac arrests, but not for children. We assessed the effect of CPR (conventional with rescue breathing or chest compression only) by bystanders on outcomes after out-of-hospital cardiac arrests in children. METHODS: In a nationwide, prospective, population-based, observational study, we enrolled 5170 children aged 17 years and younger who had an out-of-hospital cardiac arrest from Jan 1, 2005, to Dec 31, 2007. Data collected included age, cause, and presence and type of CPR by bystander. The primary endpoint was favourable neurological outcome 1 month after an out-of-hospital cardiac arrest, defined as Glasgow-Pittsburgh cerebral performance category 1 or 2. FINDINGS: 3675 (71%) children had arrests of non-cardiac causes and 1495 (29%) cardiac causes. 1551 (30%) received conventional CPR and 888 (17%) compression-only CPR. Data for type of CPR by bystander were not available for 12 children. Children who were given CPR by a bystander had a significantly higher rate of favourable neurological outcome than did those not given CPR (4.5% [110/2439] vs 1.9% [53/2719]; adjusted odds ratio [OR] 2.59, 95% CI 1.81-3.71). In children aged 1-17 years who had arrests of non-cardiac causes, favourable neurological outcome was more common after bystander CPR than no CPR (5.1% [51/1004] vs 1.5% [20/1293]; OR 4.17, 2.37-7.32). However, conventional CPR produced more favourable neurological outcome than did compression-only CPR (7.2% [45/624] vs 1.6% [six of 380]; OR 5.54, 2.52-16.99). In children aged 1-17 years who had arrests of cardiac causes, favourable neurological outcome was more common after bystander CPR than no CPR (9.5% [42/440] vs 4.1% [14/339]; OR 2.21, 1.08-4.54), and did not differ between conventional and compression-only CPR (9.9% [28/282] vs 8.9% [14/158]; OR 1.20, 0.55-2.66). In infants (aged <1 year), outcomes were uniformly poor (1.7% [36/2082] with favourable neurological outcome). INTERPRETATION: For children who have out-of-hospital cardiac arrests from non-cardiac causes, conventional CPR (with rescue breathing) by bystander is the preferable approach to resuscitation. For arrests of cardiac causes, either conventional or compression-only CPR is similarly effective. FUNDING: Fire and Disaster Management Agency and the Ministry of Education, Culture, Sports, Science and Technology (Japan).

PMID: 20202679 [PubMed - as supplied by publisher]

Reforms on the horizon for Australia's health system.

Lancet. 2010 Feb 27;375(9716):712-3

Authors: McLachlan G

PMID: 20201133 [PubMed - in process]

China boosts medical research.

Lancet. 2010 Feb 27;375(9716):711

Authors: Guo L

PMID: 20201132 [PubMed - in process]

Institute to investigate cancer hotspot in Czech Republic.

Lancet. 2010 Feb 27;375(9716):714

Authors: Holt E

PMID: 20201134 [PubMed - in process]

Atherosclerosis and diet in ancient Egypt.

Lancet. 2010 Feb 27;375(9716):718-9

Authors: David AR, Kershaw A, Heagerty A

PMID: 20201135 [PubMed - in process]

Health workers detained in the Philippines.

Lancet. 2010 Feb 20;375(9715):628

Authors: Cheng MH

PMID: 20198724 [PubMed - in process]

Health experts concerned over India's asbestos industry.

Lancet. 2010 Feb 20;375(9715):626-7

Authors: Burki T

PMID: 20198723 [PubMed - in process]

US region to model health service on Iranian system.

Lancet. 2010 Feb 20;375(9715):625

Authors: Bristol N

PMID: 20198722 [PubMed - in process]

Enrolling pregnant women in biomedical research.

Lancet. 2010 Feb 20;375(9715):632-3

Authors: Macklin R

PMID: 20198725 [PubMed - in process]

How would you spend pound1 million to tackle ageing?

Lancet. 2010 Feb 27;375(9716):698

Authors: The Lancet

PMID: 20189008 [PubMed - in process]

State of the heart in the USA.

Lancet. 2010 Feb 27;375(9716):697

Authors: The Lancet

PMID: 20189007 [PubMed - in process]

Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis.

Lancet. 2010 Feb 24;

Authors: Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N

BACKGROUND: In response to findings that pelvic lymphadenectomy does not have any therapeutic benefit for endometrial cancer, we aimed to establish whether complete, systematic lymphadenectomy, including the para-aortic lymph nodes, should be part of surgical therapy for patients at intermediate and high risk of recurrence. METHODS: We selected 671 patients with endometrial carcinoma who had been treated with complete, systematic pelvic lymphadenectomy (n=325 patients) or combined pelvic and para-aortic lymphadenectomy (n=346) at two tertiary centres in Japan (January, 1986-June, 2004). Patients at intermediate or high risk of recurrence were offered adjuvant radiotherapy or chemotherapy. The primary outcome measure was overall survival. FINDINGS: Overall survival was significantly longer in the pelvic and para-aortic lymphadenectomy group than in the pelvic lymphadenectomy group (HR 0.53, 95% CI 0.38-0.76; p=0.0005). This association was also recorded in 407 patients at intermediate or high risk (p=0.0009), but overall survival was not related to lymphadenectomy type in low-risk patients. Multivariate analysis of prognostic factors showed that in patients with intermediate or high risk of recurrence, pelvic and para-aortic lymphadenectomy reduced the risk of death compared with pelvic lymphadenectomy (0.44, 0.30-0.64; p<0.0001). Analysis of 328 patients with intermediate or high risk who were treated with adjuvant radiotherapy or chemotherapy showed that patient survival improved with pelvic and para-aortic lymphadenectomy (0.48, 0.29-0.83; p=0.0049) and with adjuvant chemotherapy (0.59, 0.37-1.00; p=0.0465) independently of one another. INTERPRETATION: Combined pelvic and para-aortic lymphadenectomy is recommended as treatment for patients with endometrial carcinoma of intermediate or high risk of recurrence. If a prospective randomised or comparative cohort study is planned to validate the therapeutic effect of lymphadenectomy, it should include both pelvic and para-aortic lymphadenectomy in patients of intermediate or high risk of recurrence. FUNDING: Japanese Foundation for Multidisciplinary Treatment of Cancer, and the Japan Society for the Promotion of Science.

PMID: 20188410 [PubMed - as supplied by publisher]

Lymphadenectomy in endometrial cancer: when, not if.

Lancet. 2010 Feb 24;

Authors: Dowdy SC, Mariani A

PMID: 20188409 [PubMed - as supplied by publisher]

Respiratory administration of measles vaccine.

Lancet. 2010 Feb 27;375(9716):706-8

Authors: Omer SB, Hiremath GS, Halsey NA

PMID: 20189011 [PubMed - in process]

Giving the ischaemic heart a shot in the arm.

Lancet. 2010 Feb 27;375(9716):699-700

Authors: Ovize M, Bonnefoy E

PMID: 20189010 [PubMed - in process]

Moving towards a world without cluster bombs.

Lancet. 2010 Feb 27;375(9716):698

Authors: The Lancet

PMID: 20189009 [PubMed - in process]

Low-level laser therapy for neck pain.

Lancet. 2010 Feb 27;375(9716):721-2

Authors: Shiri R, Viikari-Juntura E

PMID: 20189015 [PubMed - in process]

Terje Pedersen: a pioneer trialist in preventive cardiology.

Lancet. 2010 Feb 27;375(9716):717

Authors: Morris K

PMID: 20189014 [PubMed - in process]

Offline: History lessons.

Lancet. 2010 Feb 27;375(9716):710

Authors: Horton R

PMID: 20189013 [PubMed - in process]

Rare diseases and legislation in China.

Lancet. 2010 Feb 27;375(9716):708-9

Authors: Wang JB, Guo JJ, Yang L, Zhang YD, Sun ZQ, Zhang YJ

PMID: 20189012 [PubMed - in process]

Effectiveness of intensive autism programmes.

Lancet. 2010 Feb 27;375(9716):722-3

Authors: Dawson M, Gernsbacher MA

PMID: 20189018 [PubMed - in process]

Low-level laser therapy for neck pain - Authors' reply.

Lancet. 2010 Feb 27;375(9716):722

Authors: Chow R, Johnson M, Bjordal J, Lopes-Martins R

PMID: 20189017 [PubMed - in process]

Low-level laser therapy for neck pain.

Lancet. 2010 Feb 27;375(9716):721

Authors: Verhagen AP, Schellingerhout JM

PMID: 20189016 [PubMed - in process]

ADRB2 Arg16Gly polymorphism in the LARGE trial.

Lancet. 2010 Feb 27;375(9716):724-5

Authors: Manolopoulos KN, Karpe F

PMID: 20189021 [PubMed - in process]

Effectiveness of intensive autism programmes - Authors' reply.

Lancet. 2010 Feb 27;375(9716):723

Authors: Mandell DS, Levy SE, Schultz RT

PMID: 20189020 [PubMed - in process]

Nutt damage.

Lancet. 2010 Feb 27;375(9716):723-4

Authors: Bown WC

PMID: 20189019 [PubMed - in process]

ADRB2 Arg16Gly polymorphism in the LARGE trial - Authors' reply.

Lancet. 2010 Feb 27;375(9716):725

Authors: Wechsler ME, Israel E,

PMID: 20189024 [PubMed - as supplied by publisher]

Drug development for neglected diseases.

Lancet. 2010 Feb 27;375(9716):725-6

Authors: Alleyne G

PMID: 20189023 [PubMed - in process]

Nutt damage - Author's reply.

Lancet. 2010 Feb 27;375(9716):724

Authors: Nutt D

PMID: 20189022 [PubMed - in process]

Remote ischaemic conditioning before hospital admission, as a complement to angioplasty, and effect on myocardial salvage in patients with acute myocardial infarction: a randomised trial.

Lancet. 2010 Feb 27;375(9716):727-734

Authors: Bøtker HE, Kharbanda R, Schmidt MR, Bøttcher M, Kaltoft AK, Terkelsen CJ, Munk K, Andersen NH, Hansen TM, Trautner S, Lassen JF, Christiansen EH, Krusell LR, Kristensen SD, Thuesen L, Nielsen SS, Rehling M, Sørensen HT, Redington AN, Nielsen TT

BACKGROUND: Remote ischaemic preconditioning attenuates cardiac injury at elective surgery and angioplasty. We tested the hypothesis that remote ischaemic conditioning during evolving ST-elevation myocardial infarction, and done before primary percutaneous coronary intervention, increases myocardial salvage. METHODS: 333 consecutive adult patients with a suspected first acute myocardial infarction were randomly assigned in a 1:1 ratio by computerised block randomisation to receive primary percutaneous coronary intervention with (n=166 patients) versus without (n=167) remote conditioning (intermittent arm ischaemia through four cycles of 5-min inflation and 5-min deflation of a blood-pressure cuff). Allocation was concealed with opaque sealed envelopes. Patients received remote conditioning during transport to hospital, and primary percutaneous coronary intervention in hospital. The primary endpoint was myocardial salvage index at 30 days after primary percutaneous coronary intervention, measured by myocardial perfusion imaging as the proportion of the area at risk salvaged by treatment; analysis was per protocol. This study is registered with ClinicalTrials.gov, number NCT00435266. FINDINGS: 82 patients were excluded on arrival at hospital because they did not meet inclusion criteria, 32 were lost to follow-up, and 77 did not complete the follow-up with data for salvage index. Median salvage index was 0.75 (IQR 0.50-0.93, n=73) in the remote conditioning group versus 0.55 (0.35-0.88, n=69) in the control group, with median difference of 0.10 (95% CI 0.01-0.22; p=0.0333); mean salvage index was 0.69 (SD 0.27) versus 0.57 (0.26), with mean difference of 0.12 (95% CI 0.01-0.21; p=0.0333). Major adverse coronary events were death (n=3 per group), reinfarction (n=1 per group), and heart failure (n=3 per group). INTERPRETATION: Remote ischaemic conditioning before hospital admission increases myocardial salvage, and has a favourable safety profile. Our findings merit a larger trial to establish the effect of remote conditioning on clinical outcomes. FUNDING: Fondation Leducq.

PMID: 20189026 [PubMed - as supplied by publisher]

China's irrational medical pricing scheme.

Lancet. 2010 Feb 27;375(9716):726

Authors: Zhang H

PMID: 20189025 [PubMed - in process]

Systemic infection and delirium: when cytokines and acetylcholine collide.

Lancet. 2010 Feb 27;375(9716):773-775

Authors: van Gool WA, van de Beek D, Eikelenboom P

Systemic infection and drugs with anticholinergic effects are well-recognised and prevalent risk factors for delirium in elderly people. Experimental findings and neuropathological observations suggest that activation of microglia is pivotal for mediation of the behavioural effects of systemic infections. The microglial response is usually regulated tightly, but defensive features could turn neurotoxic once microglial cells escape from cholinergic inhibition. A self-propelling neuroinflammatory reaction might follow, and this cascade could account for the strong association between delirium and long-term cognitive impairment and even dementia. Here, we propose a hypothetical model, suggesting that poor outcome after delirium can be averted in vulnerable elderly people by use of readily available drugs. Agents that either restore cholinergic control of microglia or directly inhibit neuroinflammation warrant testing in clinical trials.

PMID: 20189029 [PubMed - as supplied by publisher]

Management of stable coronary artery disease.

Lancet. 2010 Feb 27;375(9716):763-772

Authors: Pfisterer ME, Zellweger MJ, Gersh BJ

Results of two randomised controlled trials for the management of mild-to-moderate chronic stable coronary artery disease (Clinical Outcomes Utilizing Revascularization and Aggressive drug Evaluation [COURAGE] and Bypass Angioplasty Revascularization Investigation type-2 Diabetes [BARI-2D]) have stimulated a vigorous debate about whether an initial strategy of revascularisation or a conservative approach with drugs is most effective. The conclusions of these two trials were clear: for some patients randomly assigned after angiography to revascularisation or pharmacological therapy, rates of death and myocardial infarction did not differ between the two strategies. What remains unresolved is how to generalise these data to patients without angiography, the role of stress testing, and the preferred approach to patients with relevant ischaemia on stress testing. This Review draws attention to the controversial issues in both management approaches, analyses the strengths and limitations of recent trials, and proposes a treatment algorithm that is applicable to daily clinical practice. Findings suggest that the severity of anginal symptoms and the extent of ischaemia in stress testing could help to identify patients who are at increased risk and who might benefit from an early invasive strategy. On the basis of the data and considerations presented, a strategy of initial optimum pharmacological therapy or direct invasive management can be tailored to an individual's circumstances and preferences.

PMID: 20189028 [PubMed - as supplied by publisher]

Dilated cardiomyopathy.

Lancet. 2010 Feb 27;375(9716):752-762

Authors: Jefferies JL, Towbin JA

Dilated cardiomyopathy is characterised by left ventricular dilation that is associated with systolic dysfunction. Diastolic dysfunction and impaired right ventricular function can develop. Affected individuals are at risk of left or right ventricular failure, or both. Heart failure symptoms can be exercise-induced or persistent at rest. Many patients are asymptomatic. Chronically treated patients sometimes present acutely with decompensated heart failure. Other life-threatening risks are ventricular arrhythmias and atrioventricular block, syncope, and sudden death. Genetic inheritance arises in 30-48% of patients, and inflammatory disorders such as myocarditis or toxic effects from medications, alcohol, or illicit drugs also result in dilated cardiomyopathy. Genes that cause dilated cardiomyopathy generally encode cytoskeletal and sarcomeric (contractile apparatus) proteins, although disturbance of calcium homeostasis also seems to be important. In children, disrupted mitochondrial function and metabolic abnormalities have a causal role. Treatments focus on improvement of cardiac efficiency and reduction of mechanical stress. Arrhythmia therapy and prevention of sudden death continue to be mainstays of treatment. Despite progress over the past 10 years, outcomes need to be improved.

PMID: 20189027 [PubMed - as supplied by publisher]

Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis.

Lancet. 2010 Feb 25;

Authors: Lamb SE, Hansen Z, Lall R, Castelnuovo E, Withers EJ, Nichols V, Potter R, Underwood MR,

BACKGROUND: Low-back pain is a common and costly problem. We estimated the effectiveness of a group cognitive behavioural intervention in addition to best practice advice in people with low-back pain in primary care. METHODS: In this pragmatic, multicentre, randomised controlled trial with parallel cost-effectiveness analysis undertaken in England, 701 adults with troublesome subacute or chronic low-back pain were recruited from 56 general practices and received an active management advisory consultation. Participants were randomly assigned by computer-generated block randomisation to receive an additional assessment and up to six sessions of a group cognitive behavioural intervention (n=468) or no further intervention (control; n=233). Primary outcomes were the change from baseline in Roland Morris disability questionnaire and modified Von Korff scores at 12 months. Assessment of outcomes was blinded and followed the intention-to-treat principle, including all randomised participants who provided follow-up data. This study is registered, number ISRCTN54717854. FINDINGS: 399 (85%) participants in the cognitive behavioural intervention group and 199 (85%) participants in the control group were included in the primary analysis at 12 months. The most frequent reason for participant withdrawal was unwillingness to complete questionnaires. At 12 months, mean change from baseline in the Roland Morris questionnaire score was 1.1 points (95% CI 0.39-1.72) in the control group and 2.4 points (1.89-2.84) in the cognitive behavioural intervention group (difference between groups 1.3 points, 0.56-2.06; p=0.0008). The modified Von Korff disability score changed by 5.4% (1.99-8.90) and 13.8% (11.39-16.28), respectively (difference between groups 8.4%, 4.47-12.32; p<0.0001). The modified Von Korff pain score changed by 6.4% (3.14-9.66) and 13.4% (10.77-15.96), respectively (difference between groups 7.0%, 3.12-10.81; p<0.0001). The additional quality-adjusted life-year (QALY) gained from cognitive behavioural intervention was 0.099; the incremental cost per QALY was pound1786, and the probability of cost-effectiveness was greater than 90% at a threshold of pound3000 per QALY. There were no serious adverse events attributable to either treatment. INTERPRETATION: Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider. FUNDING: National Institute for Health Research Health Technology Assessment Programme.

PMID: 20189241 [PubMed - as supplied by publisher]

CBT for low-back pain in primary care.

Lancet. 2010 Feb 25;

Authors: Manchikanti L

PMID: 20189240 [PubMed - as supplied by publisher]

Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.

Lancet. 2010 Feb 25;

Authors:

BACKGROUND: Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. METHODS: The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. FINDINGS: The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006). Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). INTERPRETATION: Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery. FUNDING: Medical Research Council, the Stroke Association, Sanofi-Synthélabo, European Union.

PMID: 20189239 [PubMed - as supplied by publisher]

Horner's syndrome-not to be sneezed at.

Lancet. 2010 Feb 27;375(9716):776

Authors: Bazari F, Hind M, Ong YE

PMID: 20189030 [PubMed - in process]

Relief agencies prepare for long haul in Haiti.

Lancet. 2010 Feb 13;375(9714):539

Authors: Adams P

PMID: 20191672 [PubMed - in process]

Increasing HIV prevention and care for injecting drug users.

Lancet. 2010 Feb 26;

Authors: Jarlais DC, Arasteh K, Gwadz M

PMID: 20189639 [PubMed - as supplied by publisher]

HIV prevention, treatment, and care services for people who inject drugs: a systematic review of global, regional, and national coverage.

Lancet. 2010 Feb 26;

Authors: Mathers BM, Degenhardt L, Ali H, Wiessing L, Hickman M, Mattick RP, Myers B, Ambekar A, Strathdee SA,

BACKGROUND: Previous reviews have examined the existence of HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide, but they did not quantify the scale of coverage. We undertook a systematic review to estimate national, regional, and global coverage of HIV services in IDUs. METHODS: We did a systematic search of peer-reviewed (Medline, BioMed Central), internet, and grey-literature databases for data published in 2004 or later. A multistage process of data requests and verification was undertaken, involving UN agencies and national experts. National data were obtained for the extent of provision of the following core interventions for IDUs: needle and syringe programmes (NSPs), opioid substitution therapy (OST) and other drug treatment, HIV testing and counselling, antiretroviral therapy (ART), and condom programmes. We calculated national, regional, and global coverage of NSPs, OST, and ART on the basis of available estimates of IDU population sizes. FINDINGS: By 2009, NSPs had been implemented in 82 countries and OST in 70 countries; both interventions were available in 66 countries. Regional and national coverage varied substantially. Australasia (202 needle-syringes per IDU per year) had by far the greatest rate of needle-syringe distribution; Latin America and the Caribbean (0.3 needle-syringes per IDU per year), Middle East and north Africa (0.5 needle-syringes per IDU per year), and sub-Saharan Africa (0.1 needle-syringes per IDU per year) had the lowest rates. OST coverage varied from less than or equal to one recipient per 100 IDUs in central Asia, Latin America, and sub-Saharan Africa, to very high levels in western Europe (61 recipients per 100 IDUs). The number of IDUs receiving ART varied from less than one per 100 HIV-positive IDUs (Chile, Kenya, Pakistan, Russia, and Uzbekistan) to more than 100 per 100 HIV-positive IDUs in six European countries. Worldwide, an estimated two needle-syringes (range 1-4) were distributed per IDU per month, there were eight recipients (6-12) of OST per 100 IDUs, and four IDUs (range 2-18) received ART per 100 HIV-positive IDUs. INTERPRETATION: Worldwide coverage of HIV prevention, treatment, and care services in IDU populations is very low. There is an urgent need to improve coverage of these services in this at-risk population. FUNDING: UN Office on Drugs and Crime; Australian National Drug and Alcohol Research Centre, University of New South Wales; and Australian National Health and Medical Research Council.

PMID: 20189638 [PubMed - as supplied by publisher]

Head of German cost-effectiveness institute forced to quit.

Lancet. 2010 Feb 13;375(9714):540-1

Authors: Hyde R

PMID: 20191677 [PubMed - in process]

Health equity--an election manifesto?

Lancet. 2010 Feb 13;375(9714):525

Authors:

PMID: 20191676 [PubMed - in process]

India combats confusion over counterfeit drugs.

Lancet. 2010 Feb 13;375(9714):542

Authors: Chatterjee P

PMID: 20191673 [PubMed - in process]

Medicine and the human story.

Lancet. 2010 Feb 13;375(9714):546-7

Authors: Yawar A

PMID: 20191678 [PubMed - in process]

Protests highlight plight of Chile's Mapuche Indians.

Lancet. 2010 Feb 6;375(9713):449-50

Authors: Moloney A

PMID: 20183895 [PubMed - in process]

New hope for prison health in the UK.

Lancet. 2010 Feb 6;375(9713):447-8

Authors: Siva N

PMID: 20183894 [PubMed - in process]

Questions of identity.

Lancet. 2010 Feb 6;375(9713):451

Authors: Shetty P

PMID: 20183896 [PubMed - in process]

Too tall, too small? The temptation to tinker with a child's height.

Lancet. 2010 Feb 6;375(9713):454-5

Authors: Cohen S, Cosgrove C

PMID: 20183897 [PubMed - in process]

Deafness.

Lancet. 2009 Dec 19;374(9707):2126-7

Authors: Levine JA

PMID: 20109836 [PubMed - indexed for MEDLINE]

Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial.

Lancet. 2010 Feb 17;

Authors: Bakris GL, Sarafidis PA, Weir MR, Dahlöf B, Pitt B, Jamerson K, Velazquez EJ, Staikos-Byrne L, Kelly RY, Shi V, Chiang YT, Weber MA,

BACKGROUND: The Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial showed that initial antihypertensive therapy with benazepril plus amlodipine was superior to benazepril plus hydrochlorothiazide in reducing cardiovascular morbidity and mortality. We assessed the effects of these drug combinations on progression of chronic kidney disease. METHODS: ACCOMPLISH was a double-blind, randomised trial undertaken in five countries (USA, Sweden, Norway, Denmark, and Finland). 11 506 patients with hypertension who were at high risk for cardiovascular events were randomly assigned via a central, telephone-based interactive voice response system in a 1:1 ratio to receive benazepril (20 mg) plus amlodipine (5 mg; n=5744) or benazepril (20 mg) plus hydrochlorothiazide (12.5 mg; n=5762), orally once daily. Drug doses were force-titrated for patients to attain recommended blood pressure goals. Progression of chronic kidney disease, a prespecified endpoint, was defined as doubling of serum creatinine concentration or end-stage renal disease (estimated glomerular filtration rate <15 mL/min/1.73 m(2) or need for dialysis). Analysis was by intention to treat (ITT). This trial is registered with ClinicalTrials.gov, number NCT00170950. FINDINGS: The trial was terminated early (mean follow-up 2.9 years [SD 0.4]) because of superior efficacy of benazepril plus amlodipine compared with benazepril plus hydrochlorothiazide. At trial completion, vital status was not known for 143 (1%) patients who were lost to follow-up (benazepril plus amlodipine, n=70; benazepril plus hydrochlorothiazide, n=73). All randomised patients were included in the ITT analysis. There were 113 (2.0%) events of chronic kidney disease progression in the benazepril plus amlodipine group compared with 215 (3.7%) in the benazepril plus hydrochlorothiazide group (HR 0.52, 0.41-0.65, p<0.0001). The most frequent adverse event in patients with chronic kidney disease was peripheral oedema (benazepril plus amlodipine, 189 of 561, 33.7%; benazepril plus hydrochlorothiazide, 85 of 532, 16.0%). In patients with chronic kidney disease, angio-oedema was more frequent in the benazepril plus amlodipine group than in the benazepril plus hydrochlorothiazide group. In patients without chronic kidney disease, dizziness, hypokalaemia, and hypotension were more frequent in the benazepril plus hydrochlorothiazide group than in the benazepril plus amlodipine group. INTERPRETATION: Initial antihypertensive treatment with benazepril plus amlodipine should be considered in preference to benazepril plus hydrochlorothiazide since it slows progression of nephropathy to a greater extent. FUNDING: Novartis.

PMID: 20170948 [PubMed - as supplied by publisher]

Chemo-immunotherapy in RCC: the end of a story.

Lancet. 2010 Feb 20;375(9715):613-4

Authors: Escudier B

PMID: 20171385 [PubMed - in process]

Advising the UK Government.

Lancet. 2010 Feb 20;375(9715):612

Authors: The Lancet

PMID: 20171384 [PubMed - in process]

Bodies revealed, but whose?

Lancet. 2010 Feb 20;375(9715):612

Authors: The Lancet

PMID: 20171383 [PubMed - in process]

Childhood obesity: affecting choices.

Lancet. 2010 Feb 20;375(9715):611

Authors: The Lancet

PMID: 20171382 [PubMed - in process]

Composite renal endpoints: was ACCOMPLISH accomplished?

Lancet. 2010 Feb 17;

Authors: Heerspink HL, de Zeeuw D

PMID: 20170949 [PubMed - as supplied by publisher]

An endothelin antagonist for resistant hypertension.

Lancet. 2010 Feb 20;375(9715):635

Authors: Bharti B, Bharti S

PMID: 20171391 [PubMed - in process]

An endothelin antagonist for resistant hypertension.

Lancet. 2010 Feb 20;375(9715):635

Authors: Dhaun N, Goddard J, Webb DJ

PMID: 20171390 [PubMed - in process]

Elisabeth potts dellon.

Lancet. 2010 Feb 20;375(9715):631

Authors:

PMID: 20171389 [PubMed - in process]

The Beckham test.

Lancet. 2010 Feb 20;375(9715):631

Authors: Laurance J

PMID: 20171388 [PubMed - in process]

Offline: AIDS is not zero sum.

Lancet. 2010 Feb 20;375(9715):624

Authors: Horton R

PMID: 20171387 [PubMed - in process]

Paper of the year 2009: results.

Lancet. 2010 Feb 20;375(9715):622-3

Authors: Summerskill W

PMID: 20171386 [PubMed - in process]

The need for new antibiotics.

Lancet. 2010 Feb 20;375(9715):637

Authors: Vento S, Cainelli F

PMID: 20171395 [PubMed - in process]

An endothelin antagonist for resistant hypertension.

Lancet. 2010 Feb 20;375(9715):636

Authors: O'Brien E

PMID: 20171394 [PubMed - in process]

An endothelin antagonist for resistant hypertension.

Lancet. 2010 Feb 20;375(9715):636

Authors: Naunton M

PMID: 20171393 [PubMed - in process]

An endothelin antagonist for resistant hypertension - Authors' reply.

Lancet. 2010 Feb 20;375(9715):636-637

Authors: Weber MA, Linseman JV, Lindholm LH,

PMID: 20171392 [PubMed - as supplied by publisher]

The need for new antibiotics.

Lancet. 2010 Feb 20;375(9715):638

Authors: Wise R, Piddock L

PMID: 20171399 [PubMed - in process]

GAVI's Advance Market Commitment.

Lancet. 2010 Feb 20;375(9715):638-9

Authors: Schwalbe N, El-Ziq I

PMID: 20171398 [PubMed - in process]

GAVI's Advance Market Commitment.

Lancet. 2010 Feb 20;375(9715):638

Authors: Light DW

PMID: 20171397 [PubMed - in process]

The need for new antibiotics.

Lancet. 2010 Feb 20;375(9715):637-8

Authors: Baiden F, Owusu-Agyei S, Webster J, Chandramohan D

PMID: 20171396 [PubMed - in process]

The internet and informed dissent.

Lancet. 2010 Feb 20;375(9715):640

Authors: Maskell S, Cross G, Gluckman P

PMID: 20171402 [PubMed - in process]

HPV vaccination: waiting for evidence of effectiveness.

Lancet. 2010 Feb 20;375(9715):639-640

Authors: Suba EJ, Raab SS,

PMID: 20171401 [PubMed - as supplied by publisher]

Early initiation of treatment for HIV infection.

Lancet. 2010 Feb 20;375(9715):639

Authors: Phillips A, Costagliola D, Sabin C, Sterne J

PMID: 20171400 [PubMed - in process]

A "fussy eater" with renal failure.

Lancet. 2010 Feb 20;375(9715):696

Authors: Archer L, Kilburn-Toppin F, Sneddon K, Kemp H, Smith R, Toth T, Tomson C

PMID: 20171405 [PubMed - in process]