Hot off the presses! Jan 14 LANCET

The Jan 14 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:

• Where will new drugs come from?
  - LANCET 377(9760):97 (2011)
  
• Two new year resolutions for DFID
  - LANCET 377(9760):98 (2011)
  
• Binayak Sen's conviction: a mockery of justice
  - LANCET 377(9760):98 (2011)
  
• Caution needed for country-specific cancer survival
  - LANCET 377(9760):99-101 (2011)
  
• Second-hand smoke's worldwide disease toll
  - LANCET 377(9760):101-102 (2011)
  
• Household screening and multidrug-resistant tuberculosis
  - LANCET 377(9760):103-104 (2011)
  
• European conference on chronic respiratory disease
  - LANCET 377(9760):104-106 (2011)
  
• Ram Janki Temple: understanding human stampedes
  - LANCET 377(9760):106-107 (2011)
  
• An international registry of systematic-review protocols
  - LANCET 377(9760):108-109 (2011)
  
• Offline: Our antic disposition
  - LANCET 377(9760):110 (2011)
  
• Czech doctors resign en masse
  - LANCET 377(9760):111-112 (2011)
  
• WHO recommends against inaccurate tuberculosis tests
  - LANCET 377(9760):113-114 (2011)
  
• When is research on children ethical?
  - LANCET 377(9760):115-116 (2011)
  
• Healthy schools
  - LANCET 377(9760):116 (2011)
  
• Alan Guttmacher—a visionary leader of developmental research
  - LANCET 377(9760):117 (2011)
  
• Cesare Lombroso and the pathology of left-handedness
  - LANCET 377(9760):118-119 (2011)
  
• Dudley Howard Williams
  - LANCET 377(9760):120 (2011)
  
• The role of business in public health
  - LANCET 377(9760):121 (2011)
  
• Cabazitaxel for castration-resistant prostate cancer
  - LANCET 377(9760):121 (2011)
  
• Cabazitaxel for castration-resistant prostate cancer
  - LANCET 377(9760):121-122 (2011)
  
• Cabazitaxel for castration-resistant prostate cancer – Authors' reply
  - LANCET 377(9760):122-123 (2011)
  
• Best medical treatment for a symptomatic carotid artery stenosis
  - LANCET 377(9760):123 (2011)
  
• Best medical treatment for a symptomatic carotid artery stenosis – Authors' reply
  - LANCET 377(9760):123-124 (2011)
  
• Status of clinical research in China
  - LANCET 377(9760):124-125 (2011)
  
• The "bicycle sign" for atypical parkinsonism
  - LANCET 377(9760):125-126 (2011)
  
• Department of Error
  - LANCET 377(9760):126 (2011)
  
• Department of Error
  - LANCET 377(9760):126 (2011)
  
• Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data
  - LANCET 377(9760):127-138 (2011)
  Background Cancer survival is a key measure of the effectiveness of health-care systems. Persistent regional and international differences in survival represent many avoidable deaths. Differences in survival have prompted or guided cancer control strategies. This is the first study in a programme to investigate international survival disparities, with the aim of informing health policy to raise standards and reduce inequalities in survival. Methods Data from population-based cancer registries in 12 jurisdictions in six countries were provided for 2·4 million adults diagnosed with primary colorectal, lung, breast (women), or ovarian cancer during 1995–2007, with follow-up to Dec 31, 2007. Data quality control and analyses were done centrally with a common protocol, overseen by external experts. We estimated 1-year and 5-year relative survival, constructing 252 complete life tables to control for background mortality by age, sex, and calendar year. We report age-specific and age-standardised relative survival at 1 and 5 years, and 5-year survival conditional on survival to the first anniversary of diagnosis. We also examined incidence and mortality trends during 1985–2005. Findings Relative survival improved during 1995–2007 for all four cancers in all jurisdictions. Survival was persistently higher in Australia, Canada, and Sweden, intermediate in Norway, and lower in Denmark, England, Northern Ireland, and Wales, particularly in the first year after diagnosis and for patients aged 65 years and older. International differences narrowed at all ages for breast cancer, from about 9% to 5% at 1 year and from about 14% to 8% at 5 years, but less or not at all for the other cancers. For colorectal cancer, the international range narrowed only for patients aged 65 years and older, by 2–6% at 1 year and by 2–3% at 5 years. Interpretation Up-to-date survival trends show increases but persistent differences between countries. Trends in cancer incidence and mortality are broadly consistent with these trends in survival. Data quality and changes in classification are not likely explanations. The patterns are consistent with later diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older. Funding Department of Health, England; and Cancer Research UK.
• Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries
  - LANCET 377(9760):139-146 (2011)
  Background Exposure to second-hand smoke is common in many countries but the magnitude of the problem worldwide is poorly described. We aimed to estimate the worldwide exposure to second-hand smoke and its burden of disease in children and adult non-smokers in 2004. Methods The burden of disease from second-hand smoke was estimated as deaths and disability-adjusted life-years (DALYs) for children and adult non-smokers. The calculations were based on disease-specific relative risk estimates and area-specific estimates of the proportion of people exposed to second-hand smoke, by comparative risk assessment methods, with data from 192 countries during 2004. Findings Worldwide, 40% of children, 33% of male non-smokers, and 35% of female non-smokers were exposed to second-hand smoke in 2004. This exposure was estimated to have caused 379 000 deaths from ischaemic heart disease, 165 000 from lower respiratory infections, 36 900 from asthma, and 21 400 from lung cancer. 603 000 deaths were attributable to second-hand smoke in 2004, which was about 1·0% of worldwide mortality. 47% of deaths from second-hand smoke occurred in women, 28% in children, and 26% in men. DALYs lost because of exposure to second-hand smoke amounted to 10·9 million, which was about 0·7% of total worldwide burden of diseases in DALYs in 2004. 61% of DALYs were in children. The largest disease burdens were from lower respiratory infections in children younger than 5 years (5 939 000), ischaemic heart disease in adults (2 836 000), and asthma in adults (1 246 000) and children (651 000). Interpretation These estimates of worldwide burden of disease attributable to second-hand smoke suggest that substantial health gains could be made by extending effective public health and clinical interventions to reduce passive smoking worldwide. Funding Swedish National Board of Health and Welfare and Bloomberg Philanthropies.
• Tuberculosis burden in households of patients with multidrug-resistant and extensively drug-resistant tuberculosis: a retrospective cohort study
  - LANCET 377(9760):147-152 (2011)
  Background Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis have emerged as major global health threats. WHO recommends contact investigation in close contacts of patients with MDR and XDR tuberculosis. We aimed to assess the burden of tuberculosis disease in household contacts of such patients. Methods We undertook a retrospective cohort study of household contacts of patients treated for MDR or XDR tuberculosis in Lima, Peru, in 1996–2003. The primary outcome was active tuberculosis in household contacts at the time the index patient began MDR tuberculosis treatment and during the 4-year follow-up. We examined whether the occurrence of active tuberculosis in the household contacts differed by resistance pattern of the index patient: either MDR or XDR tuberculosis. Findings 693 households of index patients with MDR tuberculosis were enrolled in the study. In 48 households, the Mycobacterium tuberculosis isolate from the index patient was XDR. Of the 4503 household contacts, 117 (2·60%) had active tuberculosis at the time the index patient began MDR tuberculosis treatment—there was no difference in prevalence between XDR and MDR tuberculosis households. During the 4-year follow-up, 242 contacts developed active tuberculosis—the frequency of active tuberculosis was nearly two times higher in contacts of patients with XDR tuberculosis than it was in contacts of patients with MDR tuberculosis (hazard ratio 1·88, 95% CI 1·10–3·21). In the 359 contacts with active tuberculosis, 142 (40%) had had isolates tested for resistance against first-line drugs, of whom 129 (90·9%, 95% CI 85·0–94·6) had MDR tuberculosis. Interpretation In view of the high risk of disease recorded in household contacts of patients with MDR or XDR tuberculosis, tuberculosis programmes should implement systematic household contact investigations for all patients identified as having MDR or XDR tuberculosis. If shown to have active tuberculosis, these household contacts should be suspected as having MDR tuberculosis until proven otherwise. Funding The Charles H Hood Foundation, the David Rockefeller Center for Latin American Studies at Harvard University, and the Bill & Melinda Gates Foundation.
• Decompression illness
  - LANCET 377(9760):153-164 (2011)
  Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression). The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels) are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 100% oxygen and definitive treatment is recompression to increased pressure, breathing 100% oxygen. Adjunctive treatment, including fluid administration and proph! ylaxis against venous thromboembolism in paralysed patients, is also recommended. Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions.
• Gout therapeutics: new drugs for an old disease
  - LANCET 377(9760):165-177 (2011)
  The approval of febuxostat, a non-purine-analogue inhibitor of xanthine oxidase, by the European Medicines Agency and the US Food and Drug Administration heralds a new era in the treatment of gout. The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Additionally, advances in our understanding of the transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals are translating into potential new treatments. In this Review, we focus on the clinical trials of febuxostat. We also review results from studies of pegloticase, a pegylated uricase in development, and we summarise data for several other pipeline drugs for gout, such as the selective uricosuric drug RDEA594 and various interleukin-1 inhibitors. Finally, we issue a word of caution about the proper use of the new drugs and the already available drugs for gout. At a time of important adv! ances, we need to recommit ourselves to a rational approach to the treatment of gout.
• Within European margins
  - LANCET 377(9760):178 (2011)