2010 Jul 17 - Case Report: Iatrogenic asystole on the ITU

Vinit Sawhney MRCP a, Dr Vivienne A Ezzat PhD a , Andrew SP Sharp MD b, Richard J Schilling MD a. The Lancet, Volume 376, Issue 9736, Page 204, 17 July 2010
In November, 2009, a 61-year-old man was admitted to our intensive therapy unit (ITU) after extensive abdominal surgery to treat multiple gunshot wounds. Two days into his stay in ITU, he developed septicaemia, which necessitated treatment with antibiotics and ventilatory and inotropic support.

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2010 Jul 17 - Acute liver failure

Dr William Bernal MD a , Georg Auzinger EDIC a, Prof Anil Dhawan MD b, Julia Wendon MD a. The Lancet, Volume 376, Issue 9736, Pages 190 - 201, 17 July 2010
Acute liver failure is a rare disorder with high mortality and resource cost. In the developing world, viral causes predominate, with hepatitis E infection recognised as a common cause in many countries.

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2010 Jul 9 - Outcomes from pandemic influenza A H1N1 infection in recipients of solid-organ transplants: a multicentre cohort study

Dr Deepali Kumar MD a , Prof Marian G Michaels MD b, Michele I Morris MD c, Prof Michael Green MD b, Prof Robin K Avery MD d, Catherine Liu MD e, Lara Danziger-Isakov MD d, Valentina Stosor MD f, Prof Michele Estabrook MD g, Soren Gantt MD h, Prof Kieren A Marr MD i, Stanley Martin MD j, Fernanda P Silveira MD k, Raymund R Razonable MD l, Prof Upton D Allen MBBS m, Marilyn E Levi MD n, G Marshall Lyon MD o, Lorraine E Bell MD p, Shirish Huprikar MD q, Gopi Patel MD q, Kevin S Gregg MD r, Prof Kenneth Pursell MD r, Doug Helmersen MD s, Kathleen G Julian MD t, Kevin Shiley MD u, Bartholomew Bono MD v, Vikas R Dharnidharka MD w, Gelareh Alavi MD x, Jayant S Kalpoe MD y, Shmuel Shoham MD x, Gail E Reid MD z, Atul Humar MD a, on behalf of the American Society of Transplantation H1N1 Collaborative Study Group. The Lancet Infectious Diseases, Early Online Publication, 9 July 2010
Background
There are few data on the epidemiology and outcomes of influenza infection in recipients of solid-organ transplants. We aimed to establish the outcomes of pandemic influenza A H1N1 and factors leading to severe disease in a cohort of patients who had received transplants.

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2010 Jul 10 - Lancet Comment: Monitoring of neuromuscular blockade in general anaesthesia

Andrew Smith. The Lancet, Volume 376, Issue 9735, Pages 77 - 79, 10 July 2010
The use of neuromuscular blocking agents (NMBAs) remains an essential part of general anaesthesia. The muscle relaxation they produce enables interventions both by the anaesthetist and the surgeon. However, an international survey confirmed that there is considerable variation in anaesthetists' understanding of the subject, in their use of objective monitoring of the drugs' effects, and in their use of antagonists to reverse them. 1 Research evidence and advances in monitoring technology and drug ...

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2010 Jul 1 - Pre-eclampsia

Prof Eric AP Steegers MD a , Peter von Dadelszen MBChB b, Johannes J Duvekot MD a, Prof Robert Pijnenborg PhD c. The Lancet, Early Online Publication, 1 July 2010
Pre-eclampsia remains a leading cause of maternal and perinatal mortality and morbidity. It is a pregnancy-specific disease characterised by de-novo development of concurrent hypertension and proteinuria, sometimes progressing into a multiorgan cluster of varying clinical features.

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2010 Jul 1 - Global operating theatre distribution and pulse oximetry supply: an estimation from reported data

Dr Luke M Funk MD a b , Thomas G Weiser MD a b, William R Berry MD a b, Stuart R Lipsitz ScD b, Prof Alan F Merry FANZCA c, Prof Angela C Enright FRCPC d, Iain H Wilson FRCA e, Gerald Dziekan MD f, Atul A Gawande MD a b. The Lancet, Early Online Publication, 1 July 2010
Background
Surgery is an essential part of health care, but resources to ensure the availability of surgical services are often inadequate. We estimated the global distribution of operating theatres and quantified the availability of pulse oximetry, which is an essential monitoring device during surgery and a potential measure of operating theatre resources.

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2010 Jun 15 - Lancet Comment: Antifibrinolytic therapy: new data and new concepts

Jerrold H Levy a b. The Lancet, Early Online Publication, 15 June 2010doi:10.1016/S0140-6736(10)60939-7Cite or Link Using DOI
Activation of the fibrinolytic system is an integral part of vascular haemostatic mechanisms to maintain vascular patency. The basis of fibrinolysis is the conversion of the inactive substrate plasminogen to plasmin, an enzyme that cleaves fibrin but also has pleiotropic effects. 1 , 2

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2010 Jun 15 - Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial

CRASH-2 trial collaborators. The Lancet, Early Online Publication, 15 June 2010. 
CRASH-2 Trial
Background
Tranexamic acid can reduce bleeding in patients undergoing elective surgery. We assessed the effects of early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients.

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2010 Jun 1 - Elective high-frequency oscillatory versus conventional ventilation in preterm infants: a systematic review and meta-analysis of individual patients' data

Dr Filip Cools MD a , Lisa M Askie PhD b, Martin Offringa MD c, Jeanette M Asselin RRT d, Sandra A Calvert MB e, Sherry E Courtney MD f, Carlo Dani MD g, David J Durand MD d, Dale R Gerstmann MD h, Prof David J Henderson-Smart FRACP i, Neil Marlow DM j, Prof Janet L Peacock PhD k, J Jane Pillow FRACP l, Prof Roger F Soll MD m, Ulrich H Thome MD n, Patrick Truffert MD o, Michael D Schreiber MD p, Patrick Van Reempts MD q, Valentina Vendettuoli MD r, Giovanni Vento MD s, on behalf of the PreVILIG collaboration. The Lancet, Early Online Publication, 1 June 2010
Background
Population and study design heterogeneity has confounded previous meta-analyses, leading to uncertainty about effectiveness and safety of elective high-frequency oscillatory ventilation (HFOV) in preterm infants. We assessed effectiveness of elective HFOV versus conventional ventilation in this group.

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2010 Jun 1 - Lancet Comment: HFOV in preterms: an individual patients' data meta-analysis

Richard B Parad. The Lancet, Early Online Publication, 1 June 2010
Despite many randomised trials of high-frequency oscillatory ventilation (HFOV) versus conventional ventilation, 1 neonatologists remain unsure about the potential benefits and harms of HFOV for support of preterm infants with surfactant-deficient lungs.

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2010 Jun - Clostridium difficile PCR ribotype 027: assessing the risks of further worldwide spread

Dr Archie CA Clements PhD a b , Ricardo J Soares Magalhães MSc a, Andrew J Tatem PhD c, David L Paterson FRACP d, Thomas V Riley PhD e. The Lancet Infectious Diseases, Volume 10, Issue 6, Pages 395 - 404, June 2010 
Highly virulent strains of Clostridium difficile have emerged since 2003, causing large outbreaks of severe, often fatal, colitis in North America and Europe.

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2010 May 15 - Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials

Prof Kennedy R Lees FRCP a , Erich Bluhmki PhD b, Prof Rüdiger von Kummer MD c, et al, for the ECASS, ATLANTIS, NINDS and EPITHET rt-PA Study Group Investigators‡ The Lancet, Volume 375, Issue 9727, Pages 1695 - 1703, 15 May 2010
Background
Early administration of intravenous recombinant tissue plasminogen activator (rt-PA) after ischaemic stroke improves outcome.

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2010 Apr 9 - Atheroembolic renal disease

Dr Francesco Scolari MD a b , Pietro Ravani MD c. The Lancet, Early Online Publication, 9 April 2010
Atheroembolic renal disease develops when atheromatous aortic plaques rupture, releasing cholesterol crystals into the small renal arteries. Embolisation often affects other organs, such as the skin, gastrointestinal system, and brain.

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2010 Apr 3 - Lancet Correspondence: Sedation versus no sedation in the intensive-care unit

The Lancet, Volume 375, Issue 9721, Page 1159 to 1160, 3 April 2010.
Correpondence on the article of  Strøm T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 2010; 375: 475-480.

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2010 Mar 23 - New antiarrhythmic drugs for treatment of atrial fibrillation

Prof Dobromir Dobrev MD, Prof Stanley Nattel MD. The Lancet, Early Online Publication, 23 March 2010
Inadequacies in current therapies for atrial fibrillation have made new drug development crucial. Conventional antiarrhythmic drugs increase the risk of ventricular proarrhythmia. In drug development, the focus has been on favourable multichannel-blocking profiles, atrial-specific ion-channels, and novel non-channel targets (upstream therapy).

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2010 Mar 12 - Towards a modern classification of the epilepsies?

Anne T Berg a, J Helen Cross b. The Lancet Neurology, Early Online Publication, 12 March 2010
The original international classifications of seizures and epilepsies began with proposals by Henri Gastaut in 1969. The accepted classifications were published in 1970. 1 , 2 They were last updated for seizures in 1981 3 and syndromes in 1989, 4 although changes were minimal.

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2010 Mar 12 - Porphyrias

Prof Hervé Puy MD a b, Prof Laurent Gouya MD a b c, Prof Jean-Charles Deybach MD a b The Lancet, Volume 375, Issue 9718, Pages 924 - 937, 13 March 2010
Hereditary porphyrias are a group of eight metabolic disorders of the haem biosynthesis pathway that are characterised by acute neurovisceral symptoms, skin lesions, or both. Every porphyria is caused by abnormal function of a separate enzymatic step, resulting in a specific accumulation of haem precursors.

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2010 Mar 5 - Community-associated meticillin-resistant Staphylococcus aureus

Dr Frank R DeLeo PhD a , Michael Otto PhD a, Prof Barry N Kreiswirth PhD b, Prof Henry F Chambers MD c. The Lancet, Early Online Publication, 5 March 2010
Meticillin-resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide, and causes substantial morbidity and mortality. Health-care-associated MRSA infections arise in individuals with predisposing risk factors, such as surgery or presence of an indwelling medical device.

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2010 Mar 3 - Lancet Comment: Bystander CPR for paediatric out-of-hospital cardiac arrest

Jesús López-Herce a, Angel Carrillo Álvarez a. The Lancet, Early Online Publication, 3 March 2010doi:10.1016/S0140-6736(10)60316-9
Tetsuhisa Kitamura and colleagues' study1 in The Lancet today is the largest that has analysed out-of-hospital cardiac arrest in children. Overall survival was 9% and only 3% of children had a good neurological outcome, as has been reported before.2—5 The prognosis does not seem to have improved much despite advances in cardiopulmonary resuscitation (CPR).

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2010 Mar 3 - Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study

Tetsuhisa Kitamura MD a, Dr Taku Iwami MD a , Takashi Kawamura MD a, Ken Nagao MD b, Hideharu Tanaka MD c, Vinay M Nadkarni MD d, Robert A Berg MD d, Atsushi Hiraide MD e, for the implementation working group for All-Japan Utstein Registry of the Fire and Disaster Management Agency. The Lancet, Early Online Publication, 3 March 2010
Background
The American Heart Association recommends cardiopulmonary resuscitation (CPR) by bystanders with chest compression only for adults who have cardiac arrests, but not for children. We assessed the effect of CPR (conventional with rescue breathing or chest compression only) by bystanders on outcomes after out-of-hospital cardiac arrests in children.

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