The Lancet

Editorial COVID-19: fighting panic with information

22-02-2020 – The Lancet

As governments and health officials worldwide grapple with the epidemic of severe acute respiratory syndrome coronavirus 2, new developments in the accounting of and response to cases are occurring as part of a swiftly evolving crisis. On Feb 11, 2020, WHO announced an official name for the novel coronavirus disease: coronavirus disease 2019 (COVID-19). After a stabilisation in the number of new cases, on Feb 13, 2020, China reported nearly 15 000 new COVID-19 cases and 242 deaths in a single day in Hubei province.

Editorial Childbirth settings in the US

22-02-2020 – The Lancet

Despite spending more than many comparable countries, the US has the highest incidence of maternal and neonatal mortality and morbidity of any high-resource country, particularly among black and Native American women. A report published by the National Academies of Sciences, Engineering, and Medicine (NASEM) shows that although most US births take place in hospitals, a growing proportion occurs in birth centres or at home. Based on the available data, there is a statistically significant increase in the relative risk of neonatal death in the homebirth setting, but also a consistently lower risk of medical intervention during labour and resulting maternal morbidity.

Comment Offline: Facts are not enough

22-02-2020 – Richard Horton

We are in the midst of a struggle. A struggle for the soul of global health. On one side, the intelligent idealists. Those who sincerely believe that by describing the world in ever more refined and precise ways we will advance closer to an elusive truth. A truth that will unlock the extraordinary potential that is global health. The Global Burden of Disease is the divine apotheosis of intelligent idealists. And universal health coverage their Garden of Eden. On the other side of this struggle, the innocent cynics.

World Report Locust swarms in east Africa could be “a catastrophe”

22-02-2020 – Sharmila Devi

The destruction of crops is threatening food security for millions of people. Sharmila Devi reports.

World Report Economic crisis hits Lebanese health care

22-02-2020 – Sharmila Devi

As Lebanons economic crisis deepens, many health workers are unpaid, medical equipment runs short, and hospitals might even face closure. Sharmila Devi reports.

World Report Farewell Seguro Popular

22-02-2020 – David Agren

Mexico has scrapped its Seguro Popular health-care programme, and its replacement is drawing criticism. David Agren reports from Mexico City.

Correspondence Dulaglutide slows kidney disease in type 2 diabetes

22-02-2020 – Nestor Oliva-Damaso, Elena Oliva-Damaso, Juan Payan, Esteban Porrini

Hertzel Gerstein and colleagues1 reported the renal outcomes of the REWIND study, a randomised, placebo-controlled trial of dulaglutide in type 2 diabetes. We would like to make some comments on this study.

“Correspondence Dulaglutide slows kidney disease in type 2 diabetes − Authors reply”

22-02-2020 – Hertzel C Gerstein

Nestor Oliva-Damaso and colleagues questioned the accuracy of the estimated glomerular filtration rate as a measure of renal function. Although it is a derived measure of renal function, large epidemiological studies have clearly shown that estimated glomerular filtration rate decline is strongly correlated with the occurrence of end-stage renal disease.1 This association is seen using different ways to calculate the estimated glomerular filtration rate, including the modification of diet in renal disease equation,2 which we used in the REWIND trial.

Correspondence Conditional power analysis of the DEBUT trial

22-02-2020 – Yang Wang, Tao Chen, Sidong Li, Yanyan Zhao, Wei Li

Tuomas Rissanen and colleagues1 reported a statistically significantly reduced incidence of major adverse cardiac events in patients with de-novo coronary artery lesions at a high risk of bleeding treated with a drug-coated balloon compared with those treated with a bare-metal stent.1 In this study, the absolute difference in major adverse cardiac events at 9 months was reported as −13·2 percentage points (95% CI −6·2 to −21·1). Therefore, the authors claimed that percutaneous coronary intervention with drug-coated balloon was superior to bare-metal stent in patients at risk of bleeding.

“Correspondence Conditional power analysis of the DEBUT trial – Authors reply”

22-02-2020 – Tuomas T Rissanen, Jussi M Kärkkäinen

We thank Yang Wang and colleagues for their interest in our study.1 Our primary intention was to show the non-inferiority of treament with drug-coated balloon in comparison with bare-metal stent in patients with coronary lesions who are at a high risk of bleeding. Instead of assuming a flat event rate in our initial power calculation, we anticipated a 3% treatment benefit for the drug-coated balloon group, on the basis of available data in 2013, when the study was started.2,3 Furthermore, recruiting 2500 patients would have been unrealistic given the low number of percutaneous coronary intervention centres using drug-coated balloon for de-novo lesions in 2013 (because of the absence of randomised controlled trial data at the time).

Correspondence Plasma-first resuscitation to treat haemorrhagic shock in urban areas

22-02-2020 – Sef J A van Bilsen, Lucas T van Eijk, Cornelis Slagt

With great interest we have read the Article by Hunter B Moore and colleagues,1 in which they investigated the effect of early treatment of trauma patients in haemorrhagic shock with thawed plasma. We congratulate the authors for their findings, as doing research in the prehospital setting is very difficult. Inclusion of patients with suspected bleeding was based on clinical parameters which were hypotension and tachycardia, or hypotension by itself (systolic blood pressure ≤70 mm Hg or 71–90 mm Hg plus heart rate ≥108 beats per min).

Correspondence Plasma-first resuscitation to treat haemorrhagic shock in urban areas

22-02-2020 – Mario Chico-Fernández, Jesús A Barea-Mendoza, Jon Pérez-Bárcena, Juan A Llompart-Pou

In the Control of Massive Bleeding After Trauma trial, Hunter B Moore and colleagues1 observed no survival benefit of using prehospital plasma as a first resuscitation method in patients with suspected haemorrhagic shock, during rapid emergency ground rescue to an urban level 1 trauma centre. Their findings are contrary to the recently published Prehospital Air Medical Plasma trial,2 suggesting that the reduced transport time to hospital from the scene plays a major role in the negative results observed by Moore and colleagues.

“Correspondence Plasma-first resuscitation to treat haemorrhagic shock in urban areas – Authors reply”

22-02-2020 – Michael P Chapman, Ernest E Moore, Hunter B Moore, Angela Sauaia

Since the publication of our Control of Massive Bleeding After Trauma (COMBAT) trial results,1 we have received extensive constructive feedback on the outcome and design of this study, and on the utility of blood plasma as the initial resuscitation fluid in a prehospital setting. The particularly insightful Correspondence by Sef J A van Bilsen and colleagues and by Mario Chico-Fernández and colleagues typify this feedback.

Correspondence IADR and AADR applaud the Lancet Oral Health Series

22-02-2020 – Paula Moynihan, J Timothy Wright, William V Giannobile, A Seun Ajiboye, Christopher H Fox

The International Association for Dental Research (IADR) and the American Association for Dental Research (AADR) applaud the authors of the Oral Health Series from The Lancet.1,2 This Series is an excellent compilation of global epidemiological data on the health and economic burden of oral diseases, the social and commercial determinants of oral diseases, and the neglect of oral diseases in global health policies.

“Correspondence IADR and AADR applaud the Lancet Oral Health Series – Authors reply”

22-02-2020 – Cristin E Kearns, Richard G Watt, Lisa A Bero, Habib Benzian

On behalf of all coauthors of the Lancet Oral Health Series1,2 and the accompanying Comment,3 we welcome the Correspondence from the leadership of the International Association for Dental Research (IADR) and the American Association for Dental Research (AADR). We are all proud IADR members and appreciate that the leadership of these organisations highly values the advancement of dental public health research. The new policies of the IADR and AADR, including divestment of sugar-sweetened beverage companies from their investment portfolios, are indeed important models for other institutions and associations.

Department of Error Department of Error

22-02-2020 –

Burtness B, Harrington KJ, Greil R, et al. Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. Lancet 2019; 394: 1915–28—In figure 2 of this Article, the data curves in panel G were mistakenly copied from panel F. The milestone percentages, numbers at risk, and the interpretation of the figure remain unchanged. In table 1, the number of female participants in the cetuximab with chemotherapy group was corrected from “93 (17%)” to “36 (13%)”.

Clinical Picture Immunosuppressed gardener pricked by roses grows Legionella longbeachae

22-02-2020 – Florian Desgranges, Alix T Coste, Diane Wernly, Justine Dufour, Onya Opota, Sylvain Meylan

A 78-year-old gardener presented to our hospital with a fever and a painful swollen right hand. She had started to feel pain in both her ring and little finger 4 days earlier, which spread to her wrist. She also said she had been feverish but did not report having rigors. Notably, she said she frequently handled manure and had puncture wounds from repeatedly pricking herself on the thorns on her rosebushes. She had a history of temporal arteritis and was being treated with prednisolone 40 mg daily.