The Lancet
Access to antiretroviral therapies for people living with HIV in the developing countries is a major world health priority. One of the strategies adopted consists in utilizing combinations of fixed doses of generic antiretrovirals, involving three medicinal drugs of two different classes in the same tablet. These combinations, however, have never been fully evaluated and therefore raise questions as to their efficacy and safety. A clinical trial, conducted in Cameroon by IRD researchers working with other organizations and supported by the ANRS (1), has demonstrated that one of the most common combinations currently deployed in Africa, using nevirapine, stavudine and lamivudine, satisfies these criteria. The full results, published and discussed in the journal The Lancet, confirmed that this generic tritherapy can be used as a basic treatment in the developing countries.
In a report recently published in the Lancet, physicians have described a new way to preserve the fertility of women who must undergo chemotherapy. This method, which can be done quickly, does not involve surgery or hormonal stimulation of the ovaries.
For the first time, scientists have successfully treated monkeys infected with the deadly Ebola virus. Ebola causes hemorrhagic fever that kills up to 80 percent of humans infected with the virus. These findings, published in the December 13th issue of THE LANCET, represent an important step in the search for a treatment strategy for Ebola. Currently no effective therapies are available.
About 90 percent of child deaths worldwide occur in just 42 countries -- and about one-fourth of these deaths occur before age 5 in the poorest countries, such as Angola and Niger. Yet, 8 million of the 11 million childhood deaths worldwide each year could easily be prevented, says a Cornell University expert, writing in the authoritative medical journal The Lancet . That's because almost 60 percent of deaths of children under 5 in the developing world are due to malnutrition and its interactive effects on preventable diseases.
Police should hand out more traffic tickets. While Robert Tibshirani, PhD, won't win any popularity contests with that sentiment, the Stanford School of Medicine researcher and his colleagues at the University of Toronto report in a paper being published in the June 28 issue of The Lancet that vigilant traffic law enforcement may reduce fatal car crashes.
An international team of researchers has estimated that the fatality rate for SARS is considerably higher than some early estimates. According to a paper published online today in The Lancet, which examines data from the first nine weeks of Hong Kong's epidemic, the case fatality rate, among those admitted to hospital, in patients 60 years of age and older is estimated to be far higher (43.3%, 95% confidence interval 35.2 to 52.4%) than those below 60 (13.2%, 95% confidence interval 9.8 to 16.8%).
A research team led by investigators from Massachusetts General Hospital (MGH) and Brigham and Women's Hospital (BWH) has discovered that amyloid-beta (A-beta), the protein that forms plaques in the brains of people with Alzheimer's disease, can also be detected in the lens of the human eye. The investigators were able to identify A-beta in lens samples from elderly individuals with and without the disorder; however, an unusual pattern of amyloid deposits was found only on the lenses of Alzheimer's patients.
Treating the underlying cause of asthma rather than its symptoms appears to be more effective at reducing severe asthma attacks, according to new research reported in The Lancet. Asthma is known to be associated with increased numbers of microscopic cells called eosinophils, in the airway. These can be detected by a simple sputum test and their numbers rise several weeks before an asthma attack. A study of 74 patients with moderate to severe asthma were randomly placed into two groups. One was treated conventionally, the other using the sputum test with their medication regulated in response to changes in eosinophil numbers. The results showed that the sputum test group had fewer severe attacks and hospitalisations than the conventional treatment group.
A discovery published in the current issue of The Lancet may lead to new treatments for a deadly liver disease of infancy -- dramatically reducing the number of liver transplants in children. A team of researchers at Cincinnati Children's Hospital have revealed a genetic underpinning to biliary atresia, the most common reason for liver transplant in children. Biliary atresia occurs in infants and usually becomes evident two to eight weeks after birth. Its cause has been unknown. Symptoms include unexplained jaundice, dark urine, clay-colored stools and weight loss. The disease destroys bile ducts in the liver, trapping bile, rapidly causing damage to liver cells and severe scarring.
Brain aneurysms, in which an artery wall balloons out abnormally, can lead to death or disability. Inserting small metal coils into burst aneurysms can decrease by 25 percent the risk of patient death and disability during the first year after the procedure, according to preliminary results of a long-term study published in the The Lancet. The coils are like "miniature slinkies that are folded gently into the aneurysm like a ball of yarn one by one to stop the bleeding," said one of the researchers, noting that the procedure also can be used to prevent aneurysms from bursting. "With coiling, we can either help fix the damage or prevent it from occurring." Surgical clipping is currently the most common method of treating brain aneurysms.
