Pub Date : 2024-09-03DOI: 10.1016/S0140-6736(24)01697-0
Adnan A Hyder, Lorena Barberia
{"title":"Addressing global gun violence: a Lancet Commission on Global Gun Violence and Health.","authors":"Adnan A Hyder, Lorena Barberia","doi":"10.1016/S0140-6736(24)01697-0","DOIUrl":"https://doi.org/10.1016/S0140-6736(24)01697-0","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/S0140-6736(24)01609-X
Samuel Kizito, Josephine Nabayinda, Proscovia Nabunya, Fred M Ssewamala
{"title":"HIV and tuberculosis in Uganda: are we neglecting poverty?","authors":"Samuel Kizito, Josephine Nabayinda, Proscovia Nabunya, Fred M Ssewamala","doi":"10.1016/S0140-6736(24)01609-X","DOIUrl":"10.1016/S0140-6736(24)01609-X","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/S0140-6736(24)01778-1
Sharmila Devi
{"title":"Nicaragua bans more than 1650 NGOs.","authors":"Sharmila Devi","doi":"10.1016/S0140-6736(24)01778-1","DOIUrl":"10.1016/S0140-6736(24)01778-1","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/S0140-6736(24)01170-X
Khaled Alser, Saad I Mallah, Yehya Rami Abu El-Oun, Mohammed Ghayada, Abd Al-Karim Sammour, Mads Gilbert, Simon Fitzgerald, Zarina Shaikh, Osaid Alser
<p><strong>Background: </strong>Hospitals, patients, and health-care workers are legally protected by international humanitarian law and the Geneva Convention. However, since Oct 7, 2023, the health-care system in the Gaza Strip, occupied Palestinian territory, has been under unprecedented direct military attacks by Israel, with support for patients proving to be challenging for the remaining health-care workers. Peer-to-peer telemedicine holds promise for assisting surgeons in high-risk, low-resource environments, but might be of reduced utility in extremely austere settings.</p><p><strong>Methods: </strong>We present a patient case series of traumatic injuries shared in an international telemedicine group by the surgical team at Nasser Medical Complex, also known as Nasser Hospital, the largest remaining partially functioning hospital in Gaza. WhatsApp (Meta; Menlo Park, CA, USA), a widely available and user-friendly end-to-end encrypted smartphone application, was used to facilitate consultations for weapon-inflicted injuries. All the presented patient cases were shared after obtaining verbal consent from the patients and discussed through a multidisciplinary team approach. The group was developed into a community with more than 15 specialty and injury-oriented subgroups and over 1000 members who joined through non-targeted social media outreach followed by snowball recruitment. Prospective registration and formal ethics approval in Gaza was impossible because the Ministry of Health, including the local Helsinki Committee, had suspended all operations. In June, 2024, we obtained ethics approval from the local Helsinki committee in Gaza.</p><p><strong>Findings: </strong>We present 12 select patient case studies from a pool of hundreds of patients admitted to Nasser Hospital between Jan 28 and Feb 12, 2024. Four (33%) of the 12 patients were female and eight (67%) were male, with four patients (33%) being children (younger than 18 years). The age range was between 3 years and 70 years, with a median age of 25 years. Most patients presented with penetrating injuries (11 [92%] of 12), with six patients presenting with wounds secondary to fragment injury, and five patients presenting with wounds due to gunshots. One patient presented with a direct blast injury. The site of reported injuries included head and neck areas (four [33%] of 12), abdomen (four [33%] of 12), chest (three [25%] of 12), pelvis (two [17%] of 12), and limbs (one [8%] of 12). Most patients were lost to follow-up (11 [92%] of 12) and were affected by the invasion of the hospital by the Israeli Defense Forces, which subsequently rendered the hospital non-functional. One patient died following their injury.</p><p><strong>Interpretation: </strong>The health-care team at the now non-functioning Nasser Hospital in southern Gaza adapted their allocation and distribution of extremely low resources and relied on smartphones for specialised telemedicine outreach purposes. This enhanced th
{"title":"Trauma care supported through a global telemedicine initiative during the 2023-24 military assault on the Gaza Strip, occupied Palestinian territory: a case series.","authors":"Khaled Alser, Saad I Mallah, Yehya Rami Abu El-Oun, Mohammed Ghayada, Abd Al-Karim Sammour, Mads Gilbert, Simon Fitzgerald, Zarina Shaikh, Osaid Alser","doi":"10.1016/S0140-6736(24)01170-X","DOIUrl":"10.1016/S0140-6736(24)01170-X","url":null,"abstract":"<p><strong>Background: </strong>Hospitals, patients, and health-care workers are legally protected by international humanitarian law and the Geneva Convention. However, since Oct 7, 2023, the health-care system in the Gaza Strip, occupied Palestinian territory, has been under unprecedented direct military attacks by Israel, with support for patients proving to be challenging for the remaining health-care workers. Peer-to-peer telemedicine holds promise for assisting surgeons in high-risk, low-resource environments, but might be of reduced utility in extremely austere settings.</p><p><strong>Methods: </strong>We present a patient case series of traumatic injuries shared in an international telemedicine group by the surgical team at Nasser Medical Complex, also known as Nasser Hospital, the largest remaining partially functioning hospital in Gaza. WhatsApp (Meta; Menlo Park, CA, USA), a widely available and user-friendly end-to-end encrypted smartphone application, was used to facilitate consultations for weapon-inflicted injuries. All the presented patient cases were shared after obtaining verbal consent from the patients and discussed through a multidisciplinary team approach. The group was developed into a community with more than 15 specialty and injury-oriented subgroups and over 1000 members who joined through non-targeted social media outreach followed by snowball recruitment. Prospective registration and formal ethics approval in Gaza was impossible because the Ministry of Health, including the local Helsinki Committee, had suspended all operations. In June, 2024, we obtained ethics approval from the local Helsinki committee in Gaza.</p><p><strong>Findings: </strong>We present 12 select patient case studies from a pool of hundreds of patients admitted to Nasser Hospital between Jan 28 and Feb 12, 2024. Four (33%) of the 12 patients were female and eight (67%) were male, with four patients (33%) being children (younger than 18 years). The age range was between 3 years and 70 years, with a median age of 25 years. Most patients presented with penetrating injuries (11 [92%] of 12), with six patients presenting with wounds secondary to fragment injury, and five patients presenting with wounds due to gunshots. One patient presented with a direct blast injury. The site of reported injuries included head and neck areas (four [33%] of 12), abdomen (four [33%] of 12), chest (three [25%] of 12), pelvis (two [17%] of 12), and limbs (one [8%] of 12). Most patients were lost to follow-up (11 [92%] of 12) and were affected by the invasion of the hospital by the Israeli Defense Forces, which subsequently rendered the hospital non-functional. One patient died following their injury.</p><p><strong>Interpretation: </strong>The health-care team at the now non-functioning Nasser Hospital in southern Gaza adapted their allocation and distribution of extremely low resources and relied on smartphones for specialised telemedicine outreach purposes. This enhanced th","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/S0140-6736(24)01776-8
Sharmila Devi
{"title":"Calls for Gaza ceasefire to tackle poliovirus.","authors":"Sharmila Devi","doi":"10.1016/S0140-6736(24)01776-8","DOIUrl":"10.1016/S0140-6736(24)01776-8","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31DOI: 10.1016/S0140-6736(24)01760-4
Jane Macnaughton, Kristin Zeiler
{"title":"Reimagining illness through post-COVID-19 condition: the need for radically interdisciplinary health research.","authors":"Jane Macnaughton, Kristin Zeiler","doi":"10.1016/S0140-6736(24)01760-4","DOIUrl":"10.1016/S0140-6736(24)01760-4","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31Epub Date: 2024-08-16DOI: 10.1016/S0140-6736(24)01684-2
Kemish Kenneth Alier
{"title":"Transforming humanitarian aid through lived experience.","authors":"Kemish Kenneth Alier","doi":"10.1016/S0140-6736(24)01684-2","DOIUrl":"10.1016/S0140-6736(24)01684-2","url":null,"abstract":"","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-31Epub Date: 2024-08-21DOI: 10.1016/S0140-6736(24)01305-9
Peter Kamenický, Karine Briot, Craig F Munns, Agnès Linglart
X-linked hypophosphataemia is a genetic disease caused by defects in the phosphate regulating endopeptidase homolog X-linked (PHEX) gene and is characterised by X-linked dominant inheritance. The main consequence of PHEX deficiency is increased production of the phosphaturic hormone fibroblast growth factor 23 (FGF23) in osteoblasts and osteocytes. Chronic exposure to circulating FGF23 is responsible for renal phosphate wasting and decreased synthesis of calcitriol, which decreases intestinal phosphate absorption. These mechanisms result in lifelong hypophosphataemia, impaired growth plate and bone matrix mineralisation, and diverse manifestations in affected children and adults, including some debilitating morbidities and possibly increased mortality. Important progress has been made in disease knowledge and management over the past decade; in particular, targeting FGF23 is a therapeutic approach that has substantially improved outcomes. However, patients affected by this complex disease need lifelong care and innovative treatment strategies, such as gene repair of PHEX, are necessary to further limit the disease burden.
X 连锁低磷血症是一种由磷酸调节内肽酶同源物 X 连锁（PHEX）基因缺陷引起的遗传病，具有 X 连锁显性遗传的特点。PHEX 缺乏症的主要后果是成骨细胞和骨细胞中磷酸化激素成纤维细胞生长因子 23（FGF23）的生成增加。长期暴露于循环中的 FGF23 会导致肾磷酸盐消耗和降钙素三醇合成减少，从而降低肠道对磷酸盐的吸收。这些机制导致终生低磷血症、生长板和骨基质矿化受损以及受影响儿童和成人的各种表现，包括一些使人衰弱的病症和可能增加的死亡率。过去十年中，在疾病知识和管理方面取得了重要进展；特别是，以 FGF23 为靶点的治疗方法大大改善了治疗效果。然而，受这种复杂疾病影响的患者需要终生护理，并且需要创新的治疗策略，如 PHEX 基因修复，以进一步减轻疾病负担。
{"title":"X-linked hypophosphataemia.","authors":"Peter Kamenický, Karine Briot, Craig F Munns, Agnès Linglart","doi":"10.1016/S0140-6736(24)01305-9","DOIUrl":"10.1016/S0140-6736(24)01305-9","url":null,"abstract":"<p><p>X-linked hypophosphataemia is a genetic disease caused by defects in the phosphate regulating endopeptidase homolog X-linked (PHEX) gene and is characterised by X-linked dominant inheritance. The main consequence of PHEX deficiency is increased production of the phosphaturic hormone fibroblast growth factor 23 (FGF23) in osteoblasts and osteocytes. Chronic exposure to circulating FGF23 is responsible for renal phosphate wasting and decreased synthesis of calcitriol, which decreases intestinal phosphate absorption. These mechanisms result in lifelong hypophosphataemia, impaired growth plate and bone matrix mineralisation, and diverse manifestations in affected children and adults, including some debilitating morbidities and possibly increased mortality. Important progress has been made in disease knowledge and management over the past decade; in particular, targeting FGF23 is a therapeutic approach that has substantially improved outcomes. However, patients affected by this complex disease need lifelong care and innovative treatment strategies, such as gene repair of PHEX, are necessary to further limit the disease burden.</p>","PeriodicalId":18014,"journal":{"name":"Lancet","volume":null,"pages":null},"PeriodicalIF":98.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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