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vrijdag 8 december 2017

The Lancet: [Articles] Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with...

[Articles] Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study
Short-term exposure to traffic pollution prevents the beneficial cardiopulmonary effects of walking in people with COPD, ischaemic heart disease, and those free from chronic cardiopulmonary diseases. Medication use might reduce the adverse effects of air pollution in individuals with ischaemic heart disease. Policies should aim to control ambient levels of air pollution along busy streets in view of these negative health effects.
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[Comment] Atraumatic lumbar puncture needles: practice needs to change
Lumbar puncture is a procedure used to obtain cerebrospinal fluid for diagnostic or therapeutic purposes and spinal anaesthesia. A retrospective study1 showed that in 2014, lumbar puncture was done in 1·4% of patients admitted to hospital and 0·8% of patients who were admitted to Accident and Emergency departments in France. Extrapolating these figures to the National Health Service Accident and Emergency attendance data indicates that more than 160 000 lumbar punctures are done in the UK annually.
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[Articles] Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis
Among patients who had lumbar puncture, atraumatic needles were associated with a decrease in the incidence of postdural-puncture headache and in the need for patients to return to hospital for additional therapy, and had similar efficacy to conventional needles. These findings offer clinicians and stakeholders a comprehensive assessment and high-quality evidence for the safety and efficacy of atraumatic needles as a superior option for patients who require lumbar puncture.
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[Department of Error] Department of Error
Williams R, Alexander G, Armstrong I, et al. Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK. Lancet 2017; published online Nov 29. http://dx.doi.org/10.1016/S0140-6736(17)32866-0—In this Article, the first sentence in the legend of figure 4 should read "Data are from references 31 and 32 and were categorised into 5 year bands." This correction has been made to the online version as of Dec 7, 2017, and will be made to the printed Article.
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[Comment] Improving access to psychological therapies in England
Most people with mental illness worldwide receive no treatment at all.1 The number benefiting from effective treatment is even fewer—eg, as low as one in six people with major depression receive effective care in high-income countries, and one in 27 people in low-income or middle-income countries.2 For mild-to-moderate depression, the treatments of choice are psychological therapies.3,4 Are there any examples of a health-care system successfully scaling up evidence-based practice for such common mental disorders? Yes: evidence is emerging that the Improving Access to Psychological Therapies (IAPT) programme in England fits this bill as reported by David M Clark and colleagues in The Lancet.
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