Hot off the presses! Jun 27 Lancet

The Jun 27 issue of the Lancet is now up on Pubget (About Lancet): if you're at a subscribing institution, just click the link in the latest link at the home page. (Note you'll only be able to get all the PDFs in the issue if your institution subscribes to Pubget.)

Latest Articles Include:

• Alcohol and harm reduction in Russia
  - Lancet 373(9682):2171 (2009)
  
• Cash transfers for children—investing into the future
  - Lancet 373(9682):2172 (2009)
  
• Moving forward with maternal health and human rights
  - Lancet 373(9682):2172 (2009)
  
• Alcohol: a global health priority
  - Lancet 373(9682):2173-2174 (2009)
  
• Action needed to tackle a global drink problem
  - Lancet 373(9682):2174-2176 (2009)
  
• A case study in how harmful alcohol consumption can be
  - Lancet 373(9682):2176-2177 (2009)
  
• Impending type 2 diabetes
  - Lancet 373(9682):2178-2179 (2009)
  
• Primary immunodeficiency diseases: the J Project
  - Lancet 373(9682):2179-2181 (2009)
  
• Strengthening health systems to promote security
  Frenk J - Lancet 373(9682):2181-2182 (2009)
  
• Judicialisation of the right to health in Brazil
  - Lancet 373(9682):2182-2184 (2009)
  
• Save Somalia!
  - Lancet 373(9682):2184 (2009)
  
• The Obama effect?
  - Lancet 373(9682):2185 (2009)
  
• Russia's health promotion efforts blossom
  - Lancet 373(9682):2186-2187 (2009)
  
• Passengers play a key part in road safety in Kenya
  - Lancet 373(9682):2188 (2009)
  
• Patients versus patents
  - Lancet 373(9682):2189-2190 (2009)
  
• Antoine's world
  - Lancet 373(9682):2190 (2009)
  
• Sally Casswell: champion for communities tackling alcohol
  - Lancet 373(9682):2191 (2009)
  
• Is disease eradication ethical?
  - Lancet 373(9682):2192-2193 (2009)
  
• Robert Francis Furchgott
  - Lancet 373(9682):2194 (2009)
  
• Global health and the Bill & Melinda Gates Foundation
  - Lancet 373(9682):2195 (2009)
  
• Global health and the Bill & Melinda Gates Foundation
  - Lancet 373(9682):2195 (2009)
  
• Global health and the Bill & Melinda Gates Foundation
  - Lancet 373(9682):2195-2196 (2009)
  
• Preserving objectivity in medical education
  - Lancet 373(9682):2196 (2009)
  
• Preserving objectivity in medical education
  - Lancet 373(9682):2196-2197 (2009)
  
• Preserving objectivity in medical education
  - Lancet 373(9682):2197 (2009)
  
• Preserving objectivity in medical education
  - Lancet 373(9682):2197 (2009)
  
• Moxifloxacin versus ethambutol in initial tuberculosis treatment
  - Lancet 373(9682):2197-2198 (2009)
  
• Moxifloxacin versus ethambutol in initial tuberculosis treatment
  - Lancet 373(9682):2198 (2009)
  
• Moxifloxacin versus ethambutol in initial tuberculosis treatment – Authors' reply
  - Lancet 373(9682):2198-2199 (2009)
  
• CABG versus PCI for multivessel coronary artery disease
  - Lancet 373(9682):2199-2200 (2009)
  
• CABG versus PCI for multivessel coronary artery disease – Authors' reply
  - Lancet 373(9682):2200 (2009)
  
• Department of Error
  - Lancet 373(9682):2200 (2009)
  
• Department of Error
  - Lancet 373(9682):2200 (2009)
  
• Alcohol and cause-specific mortality in Russia: a retrospective case–control study of 48 557 adult deaths
  - Lancet 373(9682):2201-2214 (2009)
  Background Alcohol is an important determinant of the high and fluctuating adult mortality rates in Russia, but cause-specific detail is lacking. Our case–control study investigated the effects of alcohol consumption on male and female cause-specific mortality. Methods In three Russian industrial cities with typical 1990s mortality patterns (Tomsk, Barnaul, Biysk), the addresses of 60 416 residents who had died at ages 15–74 years in 1990–2001 were visited in 2001–05. Family members were present for 50 066 decedents; for 48 557 (97%), the family gave proxy information on the decedents' past alcohol use and on potentially confounding factors. Cases (n=43 082) were those certified as dying from causes we judged beforehand might be substantially affected by alcohol or tobacco; controls were the other 5475 decedents. Case versus control relative risks (RRs; calculated as odds ratios by confounder-adjusted logistic regression) were calculated in ever-drinkers, defining the reference category by two criteria: usual weekly consumption always less than 0·5 half-litre bottles of vodka (or equivalent in total alcohol content) and maximum consumption of spirits in 1 day always less than 0·5 half-litre bottles. Other ever-drinkers were classif! ied by usual weekly consumption into three categories: less than one, one to less than three, and three or more (mean 5·4 [SD 1·4]) bottles of vodka or equivalent. Findings In men, the three causes accounting for the most alcohol-associated deaths were accidents and violence (RR 5·94, 95% CI 5·35–6·59, in the highest consumption category), alcohol poisoning (21·68, 17·94–26·20), and acute ischaemic heart disease other than myocardial infarction (3·04, 2·73–3·39), which includes some misclassified alcohol poisoning. There were significant excesses of upper aerodigestive tract cancer (3·48, 2·84–4·27) and liver cancer (2·11, 1·64–2·70). Another five disease groups had RRs of more than 3·00 in the highest alcohol category: tuberculosis (4·14, 3·44–4·98), pneumonia (3·29, 2·83–3·83), liver disease (6·21, 5·16–7·47), pancreatic disease (6·69, 4·98–9·00), and ill-specified conditions (7·74, 6·48–9·25). Although drinking was less common in women, the RRs associated with it were generally more extreme. After correction for reporting errors, alcohol-associated excesses accounted for 52% of all study dea! ths at ages 15–54 years (men 8182 [59%] of 13968, women 1565 [33%] of 4751) and 18% of those at 55–74 years (men 3944 [22%] of 17 536, women 1493 [12%] of 12 302). Allowance for under-representation of extreme drinkers would further increase alcohol-associated proportions. Large fluctuations in mortality from these ten strongly alcohol-associated causes were the main determinants of recent fluctuations in overall mortality in the study region and in Russia as a whole. Interpretation Alcohol-attributable mortality varies by year; in several recent years, alcohol was a cause of more than half of all Russian deaths at ages 15–54 years. Alcohol accounts for most of the large fluctuations in Russian mortality, and alcohol and tobacco account for the large difference in adult mortality between Russia and western Europe. Funding UK Medical Research Council, Cancer Research UK, British Heart Foundation, International Agency for Research on Cancer, and European Commission Directorate-General for Research.
• Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study
  - Lancet 373(9682):2215-2221 (2009)
  Background Little is known about the timing of changes in glucose metabolism before occurrence of type 2 diabetes. We aimed to characterise trajectories of fasting and postload glucose, insulin sensitivity, and insulin secretion in individuals who develop type 2 diabetes. Methods We analysed data from our prospective occupational cohort study (Whitehall II study) of 6538 (71% male and 91% white) British civil servants without diabetes mellitus at baseline. During a median follow-up period of 9·7 years, 505 diabetes cases were diagnosed (49·1% on the basis of oral glucose tolerance test). We assessed retrospective trajectories of fasting and 2-h postload glucose, homoeostasis model assessment (HOMA) insulin sensitivity, and HOMA β-cell function from up to 13 years before diabetes diagnosis (diabetic group) or at the end of follow-up (non-diabetics). Findings Multilevel models adjusted for age, sex, and ethnic origin confirmed that all metabolic measures followed linear trends in the group of non-diabetics (10 989 measurements), except for insulin secretion that did not change during follow-up. In the diabetic group (801 measurements), a linear increase in fasting glucose was followed by a steep quadratic increase (from 5·79 mmol/L to 7·40 mmol/L) starting 3 years before diagnosis of diabetes. 2-h postload glucose showed a rapid increase starting 3 years before diagnosis (from 7·60 mmol/L to 11·90 mmol/L), and HOMA insulin sensitivity decreased steeply during the 5 years before diagnosis (to 86·7%). HOMA β-cell function increased between years 4 and 3 before diagnosis (from 85·0% to 92·6%) and then decreased until diagnosis (to 62·4%). Interpretation In this study, we show changes in glucose concentrations, insulin sensitivity, and insulin secretion as much as 3–6 years before diagnosis of diabetes. The description of biomarker trajectories leading to diabetes diagnosis could contribute to more-accurate risk prediction models that use repeated measures available for patients through regular check-ups. Funding Medical Research Council (UK); Economic and Social Research Council (UK); British Heart Foundation (UK); Health and Safety Executive (UK); Department of Health (UK); National Institute of Health (USA); Agency for Health Care Policy Research (USA); the John D and Catherine T MacArthur Foundation (USA); and Academy of Finland (Finland).
• Status vasovagalis
  - Lancet 373(9682):2222 (2009)
  
• Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders
  - Lancet 373(9682):2223-2233 (2009)
  Alcohol consumption has been identified as an important risk factor for chronic disease and injury. In the first paper in this Series, we quantify the burden of mortality and disease attributable to alcohol, both globally and for ten large countries. We assess alcohol exposure and prevalence of alcohol-use disorders on the basis of reviews of published work. After identification of other major disease categories causally linked to alcohol, we estimate attributable fractions by sex, age, and WHO region. Additionally, we compare social costs of alcohol in selected countries. The net effect of alcohol consumption on health is detrimental, with an estimated 3·8% of all global deaths and 4·6% of global disability-adjusted life-years attributable to alcohol. Disease burden is closely related to average volume of alcohol consumption, and, for every unit of exposure, is strongest in poor people and in those who are marginalised from society. The costs associated with alcohol! amount to more than 1% of the gross national product in high-income and middle-income countries, with the costs of social harm constituting a major proportion in addition to health costs. Overall, we conclude that alcohol consumption is one of the major avoidable risk factors, and actions to reduce burden and costs associated with alcohol should be urgently increased.
• Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol
  - Lancet 373(9682):2234-2246 (2009)
  This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making! alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.
• Reducing harm from alcohol: call to action
  - Lancet 373(9682):2247-2257 (2009)
  Despite clear evidence of the major contribution alcohol makes to the global burden of disease and to substantial economic costs, focus on alcohol control is inadequate internationally and in most countries. Expansion of industrial production and marketing of alcohol is driving alcohol use to rise, both in emerging markets and in young people in mature alcohol markets. Cost-effective and affordable interventions to restrict harm exist, and are in urgent need of scaling up. Most countries do not have adequate policies in place. Factors impeding progress include a failure of political will, unhelpful participation of the alcohol industry in the policy process, and increasing difficulty in free-trade environments to respond adequately at a national level. An effective national and international response will need not only governments, but also non-governmental organisations to support and hold government agencies to account. International health policy, in the form of a F! ramework Convention on Alcohol Control, is needed to counterbalance the global conditions promoting alcohol-related harm and to support and encourage national action.
• Recurrent pneumothoraces, rash, and polyuria
  - Lancet 373(9682):2258 (2009)