Lancet (London, England)最新文献

{"title":"Reactions to START:REACTS - Authors' reply.","authors":"Andrew Metcalfe, Helen Parsons, Tom Lawrence, Stephen Drew, Martin Underwood","doi":"10.1016/S0140-6736(22)01799-8","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01799-8","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1583-1584"},"PeriodicalIF":168.9,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin and Helicobacter pylori interaction.","authors":"Angel Lanas, Francesca Santilli","doi":"10.1016/S0140-6736(22)02000-1","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)02000-1","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1560-1561"},"PeriodicalIF":168.9,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40455742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solving endgame problems for 1·4 billion people in India.","authors":"Siddhesh Zadey, Sweta Dubey","doi":"10.1016/S0140-6736(22)01800-1","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01800-1","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1581-1583"},"PeriodicalIF":168.9,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial.","authors":"Pengfei Yang, Lili Song, Yongwei Zhang, Xiaoxi Zhang, Xiaoying Chen, Yunke Li, Lingli Sun, Yingfeng Wan, Laurent Billot, Qiang Li, Xinwen Ren, Hongjian Shen, Lei Zhang, Zifu Li, Pengfei Xing, Yongxin Zhang, Ping Zhang, Weilong Hua, Fang Shen, Yihan Zhou, Bing Tian, Wenhuo Chen, Hongxing Han, Liyong Zhang, Chenghua Xu, Tong Li, Ya Peng, Xincan Yue, Shengli Chen, Changming Wen, Shu Wan, Congguo Yin, Ming Wei, Hansheng Shu, Guangxian Nan, Sheng Liu, Wenhua Liu, Yiling Cai, Yi Sui, Maohua Chen, Yu Zhou, Qiao Zuo, Dongwei Dai, Rui Zhao, Qiang Li, Qinghai Huang, Yi Xu, Benqiang Deng, Tao Wu, Jianping Lu, Xia Wang, Mark W Parsons, Ken Butcher, Bruce Campbell, Thompson G Robinson, Mayank Goyal, Diederik Dippel, Yvo Roos, Charles Majoie, Longde Wang, Yongjun Wang, Jianmin Liu, Craig S Anderson","doi":"10.1016/S0140-6736(22)01882-7","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01882-7","url":null,"abstract":"<p><strong>Background: </strong>The optimum systolic blood pressure after endovascular thrombectomy for acute ischaemic stroke is uncertain. We aimed to compare the safety and efficacy of blood pressure lowering treatment according to more intensive versus less intensive treatment targets in patients with elevated blood pressure after reperfusion with endovascular treatment.</p><p><strong>Methods: </strong>We conducted an open-label, blinded-endpoint, randomised controlled trial at 44 tertiary-level hospitals in China. Eligible patients (aged ≥18 years) had persistently elevated systolic blood pressure (≥140 mm Hg for >10 min) following successful reperfusion with endovascular thrombectomy for acute ischaemic stroke from any intracranial large-vessel occlusion. Patients were randomly assigned (1:1, by a central, web-based program with a minimisation algorithm) to more intensive treatment (systolic blood pressure target <120 mm Hg) or less intensive treatment (target 140-180 mm Hg) to be achieved within 1 h and sustained for 72 h. The primary efficacy outcome was functional recovery, assessed according to the distribution in scores on the modified Rankin scale (range 0 [no symptoms] to 6 [death]) at 90 days. Analyses were done according to the modified intention-to-treat principle. Efficacy analyses were performed with proportional odds logistic regression with adjustment for treatment allocation as a fixed effect, site as a random effect, and baseline prognostic factors, and included all randomly assigned patients who provided consent and had available data for the primary outcome. The safety analysis included all randomly assigned patients. The treatment effects were expressed as odds ratios (ORs). This trial is registered at ClinicalTrials.gov, NCT04140110, and the Chinese Clinical Trial Registry, 1900027785; recruitment has stopped at all participating centres.</p><p><strong>Findings: </strong>Between July 20, 2020, and March 7, 2022, 821 patients were randomly assigned. The trial was stopped after review of the outcome data on June 22, 2022, due to persistent efficacy and safety concerns. 407 participants were assigned to the more intensive treatment group and 409 to the less intensive treatment group, of whom 404 patients in the more intensive treatment group and 406 patients in the less intensive treatment group had primary outcome data available. The likelihood of poor functional outcome was greater in the more intensive treatment group than the less intensive treatment group (common OR 1·37 [95% CI 1·07-1·76]). Compared with the less intensive treatment group, the more intensive treatment group had more early neurological deterioration (common OR 1·53 [95% 1·18-1·97]) and major disability at 90 days (OR 2·07 [95% CI 1·47-2·93]) but there were no significant differences in symptomatic intracerebral haemorrhage. There were no significant differences in serious adverse events or mortality between groups.</p><p><strong>Interpretation: <","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1585-1596"},"PeriodicalIF":168.9,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language changes for Indian medical education.","authors":"Dinesh C Sharma","doi":"10.1016/S0140-6736(22)02158-4","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)02158-4","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1575"},"PeriodicalIF":168.9,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The North American opioid crisis: draw on the expertise of people who use drugs.","authors":"Alex K Gertner, Nabarun Dasgupta, Louise Vincent","doi":"10.1016/S0140-6736(22)01590-2","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01590-2","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1401-1402"},"PeriodicalIF":168.9,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monofilament suture versus braided suture thread to improve pregnancy outcomes after vaginal cervical cerclage (C-STICH): a pragmatic randomised, controlled, phase 3, superiority trial.","authors":"Victoria Hodgetts Morton,&nbsp;Philip Toozs-Hobson,&nbsp;Catherine A Moakes,&nbsp;Lee Middleton,&nbsp;Jane Daniels,&nbsp;Nigel A B Simpson,&nbsp;Andrew Shennan,&nbsp;Fidan Israfil-Bayli,&nbsp;Andrew K Ewer,&nbsp;Jim Gray,&nbsp;Mark Slack,&nbsp;Jane E Norman,&nbsp;Christoph Lees,&nbsp;Konstantinos Tryposkiadis,&nbsp;Max Hughes,&nbsp;Peter Brocklehurst,&nbsp;R Katie Morris","doi":"10.1016/S0140-6736(22)01808-6","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01808-6","url":null,"abstract":"<p><strong>Background: </strong>Miscarriage in the second trimester and preterm birth are significant global problems. Vaginal cervical cerclage is performed to prevent pregnancy loss and preterm birth. We aimed to determine the effectiveness of a monofilament suture thread compared with braided suture thread on pregnancy loss rates in women undergoing a cervical cerclage.</p><p><strong>Methods: </strong>C-STICH was a pragmatic, randomised, controlled, superiority trial done at 75 obstetric units in the UK. Women with a singleton pregnancy who received a vaginal cervical cerclage due to a history of pregnancy loss or premature birth, or if indicated by ultrasound, were centrally randomised (1:1) using minimisation to receive a monofilament suture or braided suture thread for their cervical cerclage. Women and outcome assessors were masked to allocation as far as possible. The primary outcome was pregnancy loss, defined as miscarriage, stillbirth, or neonatal death in the first week of life, analysed in the intention-to-treat population (ie, all women who were randomly assigned). Safety was also assessed in the intention-to-treat population. The trial was registered with ISRCTN, ISRCTN15373349.</p><p><strong>Findings: </strong>Between Aug 21, 2015, and Jan 28, 2021, 2049 women were randomly assigned to receive a monofilament suture (n=1025) or braided suture (n=1024). The primary outcome was ascertained in 1003 women in the monofilament suture group and 993 women in the braided suture group. Pregnancy loss occurred in 80 (8·0%) of 1003 women in the monofilament suture group and 75 (7·6%) of 993 women in the braided suture group (adjusted risk ratio 1·05 [95% CI 0·79 to 1·40]; adjusted risk difference 0·002 [95% CI -0·02 to 0·03]).</p><p><strong>Interpretation: </strong>Monofilament suture did not reduce rate of pregnancy loss when compared with a braided suture. Clinicians should use the results of this trial to facilitate discussions around the choice of suture thread to optimise outcomes.</p><p><strong>Funding: </strong>National Institute of Health Research Health Technology Assessment Programme.</p>","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1426-1436"},"PeriodicalIF":168.9,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we end stigma and discrimination in mental health?","authors":"The Lancet","doi":"10.1016/S0140-6736(22)01937-7","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01937-7","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1381"},"PeriodicalIF":168.9,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33501397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The North American opioid crisis: how effective are supervised consumption sites?","authors":"Mary Clare Kennedy,&nbsp;Mohammad Karamouzian,&nbsp;Brandon D L Marshall","doi":"10.1016/S0140-6736(22)01593-8","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01593-8","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1403-1404"},"PeriodicalIF":168.9,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Error.","authors":"","doi":"10.1016/S0140-6736(22)01696-8","DOIUrl":"https://doi.org/10.1016/S0140-6736(22)01696-8","url":null,"abstract":"","PeriodicalId":251261,"journal":{"name":"Lancet (London, England)","volume":" ","pages":"1404"},"PeriodicalIF":168.9,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}