Hot off the presses! Dec 31 LANCET

The Dec 31 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:

• Crunch time for heart failure care in England and Wales
  - LANCET 376(9758):2041 (2010)
  
• New obesity pill: new hopes, old fears
  - LANCET 376(9758):2042 (2010)
  
• Tackling loneliness in the holidays
  - LANCET 376(9758):2042 (2010)
  
• A new standard of care in newly diagnosed multiple myeloma
  - LANCET 376(9758):2043-2044 (2010)
  
• Management of mental disorders: lessons from India
  - LANCET 376(9758):2045-2046 (2010)
  
• Proteinuria and risk of acute kidney injury
  - LANCET 376(9758):2046-2048 (2010)
  
• Five complementary interventions to slow cholera: Haiti
  - LANCET 376(9758):2048-2051 (2010)
  
• Artemisinin resistance—the clock is ticking
  - LANCET 376(9758):2051-2052 (2010)
  
• Winner of the Wakley prize 2010
  - LANCET 376(9758):2053 (2010)
  
• Nominations for The Lancet paper of the year 2010
  - LANCET 376(9758):2053 (2010)
  
• Offline: The God of Carnage
  - LANCET 376(9758):2054 (2010)
  
• Tackling tuberculosis in London's homeless population
  - LANCET 376(9758):2055-2056 (2010)
  
• Stopping traffic
  - LANCET 376(9758):2057-2058 (2010)
  
• Highlights 2010
  - LANCET 376(9758):2059-2068 (2010)
  
• Ivabradine and outcomes in chronic heart failure
  - LANCET 376(9758):2069 (2010)
  
• Ivabradine and outcomes in chronic heart failure
  - LANCET 376(9758):2069 (2010)
  
• Ivabradine and outcomes in chronic heart failure – Authors' reply
  - LANCET 376(9758):2069-2070 (2010)
  
• Vertebroplasty versus conservative treatment for vertebral fractures
  - LANCET 376(9758):2070-2071 (2010)
  
• Vertebroplasty versus conservative treatment for vertebral fractures
  - LANCET 376(9758):2071 (2010)
  
• Vertebroplasty versus conservative treatment for vertebral fractures – Authors' reply
  - LANCET 376(9758):2071-2072 (2010)
  
• Under-reporting of progressive supranuclear palsy
  - LANCET 376(9758):2072 (2010)
  
• Moral algorithm versus human rights law; philosophy versus ethos
  - LANCET 376(9758):2072-2073 (2010)
  
• A plea for investment in district hospitals
  - LANCET 376(9758):2073 (2010)
  
• Breaking away from the disease-focused paradigm
  - LANCET 376(9758):2073-2074 (2010)
  
• Music of the heart
  - LANCET 376(9758):2074 (2010)
  
• Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma: a randomised phase 3 study
  - LANCET 376(9758):2075-2085 (2010)
  Background Thalidomide plus dexamethasone (TD) is a standard induction therapy for myeloma. We aimed to assess the efficacy and safety of addition of bortezomib to TD (VTD) versus TD alone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma. Methods Patients (aged 18–65 years) with previously untreated symptomatic myeloma were enrolled from 73 sites in Italy between May, 2006, and April, 2008, and data collection continued until June 30, 2010. Patients were randomly allocated (1:1 ratio) by a web-based system to receive three 21-day cycles of thalidomide (100 mg daily for the first 14 days and 200 mg daily thereafter) plus dexamethasone (40 mg daily on 8 of the first 12 days, but not consecutively; total of 320 mg per cycle), either alone or with bortezomib (1·3 mg/m2 on days 1, 4, 8, and 11). The randomisation sequence was computer generated by the study coordinating team and was stratified by disease stage. After double autologous stem-cell transplantation, patients received two 35-day cycles of their assigned drug regimen, VTD or TD, as consolidation therapy. The primary endpoint was the rate of complete or near complete response to induction therapy. Analysis was by intention to treat. Patients and treating physi! cians were not masked to treatment allocation. This study is still underway but is not recruiting participants, and is registered with ClinicalTrials.gov, number NCT01134484, and with EudraCT, number 2005-003723-39. Findings 480 patients were enrolled and randomly assigned to receive VTD (n=241 patients) or TD (n=239). Six patients withdrew consent before start of treatment, and 236 on VTD and 238 on TD were included in the intention-to-treat analysis. After induction therapy, complete or near complete response was achieved in 73 patients (31%, 95% CI 25·0–36·8) receiving VTD, and 27 (11%, 7·3–15·4) on TD (p<0·0001). Grade 3 or 4 adverse events were recorded in a significantly higher number of patients on VTD (n=132, 56%) than in those on TD (n=79, 33%; p<0·0001), with a higher occurrence of peripheral neuropathy in patients on VTD (n=23, 10%) than in those on TD (n=5, 2%; p=0·0004). Resolution or improvement of severe peripheral neuropathy was recorded in 18 of 23 patients on VTD, and in three of five patients on TD. Interpretation VTD induction therapy before double autologous stem-cell transplantation significantly improves rate of complete or near complete response, and represents a new standard of care for patients with multiple myeloma who are eligible for transplant. Funding Seràgnoli Institute of Haematology at the University of Bologna, Bologna, Italy.
• Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial
  - LANCET 376(9758):2086-2095 (2010)
  Background Depression and anxiety disorders are common mental disorders worldwide. The MANAS trial aimed to test the effectiveness of an intervention led by lay health counsellors in primary care settings to improve outcomes of people with these disorders. Methods In this cluster randomised trial, primary care facilities in Goa, India, were assigned (1:1) by computer-generated randomised sequence to intervention or control (enhanced usual care) groups. All adults who screened positive for common mental disorders were eligible. The collaborative stepped-care intervention offered case management and psychosocial interventions, provided by a trained lay health counsellor, supplemented by antidepressant drugs by the primary care physician and supervision by a mental health specialist. The research assessor was masked. The primary outcome was recovery from common mental disorders as defined by the International Statistical Classification of Diseases and Related Health Problems—10th revision (ICD-10) at 6 months. This study is registered with ClinicalTrials.gov, number NCT00446407. Findings 24 study clusters, with an equal proportion of public and private facilities, were randomised equally between groups. 1160 of 1360 (85%) patients in the intervention group and 1269 of 1436 (88%) in the control group completed the outcome assessment. Patients with ICD-10-confirmed common mental disorders in the intervention group were more likely to have recovered at 6 months than were those in the control group (n=620 [65·0%] vs 553 [52·9%]; risk ratio 1·22, 95% CI 1·00–1·47; risk difference=12·1%, 95% CI 1·6%–22·5%). The intervention had strong evidence of an effect in public facility attenders (369 [65·9%] vs 267 [42·5%], risk ratio 1·55, 95% CI 1·02–2·35) but no evidence for an effect in private facility attenders (251 [64·1%] vs 286 [65·9%], risk ratio 0·95, 0·74–1·22). There were three deaths and four suicide attempts in the collaborative stepped-care group and six deaths and six suicide attempts in the enhanced usual care group. None of the de! aths were from suicide. Interpretation A trained lay counsellor-led collaborative care intervention can lead to an improvement in recovery from CMD among patients attending public primary care facilities. Funding The Wellcome Trust.
• Glomerular filtration rate, proteinuria, and the incidence and consequences of acute kidney injury: a cohort study
  - LANCET 376(9758):2096-2103 (2010)
  Background Low values of estimated glomerular filtration rate (eGFR) predispose to acute kidney injury, and proteinuria is a marker of kidney disease. We aimed to investigate how eGFR and proteinuria jointly modified the risks of acute kidney injury and subsequent adverse clinical outcomes. Methods We did a cohort study of 920 985 adults residing in Alberta, Canada, between 2002 and 2007. Participants not needing chronic dialysis at baseline and with at least one outpatient measurement of both serum creatinine concentration and proteinuria (urine dipstick or albumin-creatinine ratio) were included. We assessed hospital admission with acute kidney injury with validated administrative codes; other outcomes were all-cause mortality and a composite renal outcome of end-stage renal disease or doubling of serum creatinine concentration. Findings During median follow-up of 35 months (range 0–59 months), 6520 (0·7%) participants were admitted with acute kidney injury. In those with eGFR 60 mL/min per 1·73 m2 or greater, the adjusted risk of admission with this disorder was about 4 times higher in those with heavy proteinuria measured by dipstick (rate ratio 4·4 vs no proteinuria, 95% CI 3·7–5·2). The adjusted rates of admission with acute kidney injury and kidney injury needing dialysis remained high in participants with heavy dipstick proteinuria for all values of eGFR. The adjusted rates of death and the composite renal outcome were also high in participants admitted with acute kidney injury, although the rise associated with this injury was attenuated in those with low baseline eGFR and heavy proteinuria. Interpretation These findings suggest that information on proteinuria and eGFR should be used together when identifying people at risk of acute kidney injury, and that an episode of acute kidney injury provides further long-term prognostic information in addition to eGFR and proteinuria. Funding The study was funded by an interdisciplinary team grant from Alberta Heritage Foundation for Medical Research.
• Omsk haemorrhagic fever
  - LANCET 376(9758):2104-2113 (2010)
  Omsk haemorrhagic fever is an acute viral disease prevalent in some regions of western Siberia in Russia. The symptoms of this disease include fever, headache, nausea, severe muscle pain, cough, and moderately severe haemorrhagic manifestations. A third of patients develop pneumonia, nephrosis, meningitis, or a combination of these complications. The only treatments available are for control of symptoms. No specific vaccine has been developed, although the vaccine against tick-borne encephalitis might provide a degree of protection against Omsk haemorrhagic fever virus. The virus is transmitted mainly by Dermacentor reticulatus ticks, but people are mainly infected after contact with infected muskrats (Ondatra zibethicus). Muskrats are very sensitive to Omsk haemorrhagic fever virus. The introduction of this species to Siberia in the 1930s probably led to viral emergence in this area, which had previously seemed free from the disease. Omsk haemorrhagic fever is, theref! ore, an example of a human disease that emerged owing to human-mediated disturbance of an ecological niche. We review the biological properties of the virus, and the epidemiological and clinical characteristics of Omsk haemorrhagic fever.
• An epidemic of loneliness
  - LANCET 376(9758):2114-2115 (2010)
  
• Cytotoxic therapy for severe swine flu A/H1N1
  - LANCET 376(9758):2116 (2010)