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donderdag 12 oktober 2017

The Lancet: [Comment] Tackling viral haemorrhagic fever in Africa

[Comment] Tackling viral haemorrhagic fever in Africa
Outbreaks of viral haemorrhagic fevers, such as the Ebola virus disease epidemic in west Africa, have caught the attention of the global health community because of perceived and real threats to local, national, and global health security and their economic impact.1 Although viral haemorrhagic fever outbreaks primarily affect settings in which pathogens emerge from animal hosts, they also have the potential to spread worldwide. Consequently, models that accurately predict the emergence and spread of viruses that cause viral haemorrhagic fevers are needed.
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[Clinical Picture] Xanthoma disseminatum
A 20-year-old man presented to the dermatology department of our hospital in November, 2012, with a 5-year history of multiple brownish-yellow xanthoma-like papules and nodules affecting the face, flexures of the trunk, and limbs, with no systemic symptoms. The lesions had initially appeared as discrete or grouped papules, which then coalesced into plaques and nodules, especially in the axillae, over a period of 2 years. They were painless and asymptomatic, and the patient sought medical help only for cosmetic resions, particularly regarding the lesions on his face.
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[Department of Error] Department of Error
GBD 2016 SDG Collaborators. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016. Lancet 2017; 390: 1423–59—The full-text version of this Article has been updated so that the list of authors is displayed in the correct order, in line with the pdf version, rather than in alphabetical order. This correction has been made to the online version as of Oct 12, 2017.
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[Perspectives] Felicia Marie Knaul: advocate for better pain relief and palliative care
The time before her father died of stomach cancer in 1984 had a lasting impact on Felicia Knaul. "Each day brought new and ever-more challenging horrors—bone metastases popping up throughout his body…lungs filling with fluid and agonising, rattling breathing for which for several days I could do little other than keep his head elevated to stop him from drowning", recalls Knaul, who was just 18 years old at the time. Eventually, he was given sufficient opioids to make him more comfortable. Since then, Knaul, a health economist, has devoted herself to tackling neglected aspects of health care and social justice worldwide.
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[The Lancet Commissions] Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Commission report
In agonising, crippling pain from lung cancer, Mr S came to the palliative care service in Calicut, Kerala, from an adjoining district a couple of hours away by bus. His body language revealed the depth of the suffering.We put Mr S on morphine, among other things. A couple of hours later, he surveyed himself with disbelief. He had neither hoped nor conceived of the possibility that this kind of relief was possible.Mr S returned the next month. Yet, common tragedy befell patient and caregivers in the form of a stock-out of morphine.
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