We bring you the latest news from the healthcare about the health care in the United Kingdom.

donderdag 12 juli 2018

The Lancet: [Comment] Improving management of neonatal infections

[Comment] Improving management of neonatal infections
Infections causing sepsis, meningitis, or pneumonia contributed directly to around 0·6 million neonatal deaths worldwide in 2016,1 and indirectly to many more through pathways leading to preterm birth and neonatal encephalopathy. Despite this knowledge, understanding of the causes of neonatal infection, particularly in resource-poor settings, is limited. Treatment in these settings usually relies on the sensitive but non-specific clinical diagnosis of possible serious bacterial infection (pSBI),2 made by front-line health-care workers and defined according to set criteria.
Read more

[Comment] A new step towards an HIV/AIDS vaccine
A preventive vaccine is an essential part of the strategy to eradicate the HIV pandemic.1 Although the search for an AIDS vaccine has led to many scientific advances, a vaccine remains out of reach. Major impediments include the protean ability of HIV to mutate rapidly and the lack of definitive correlates of vaccine protection. Over the years, a multitude of vaccine methodologies have been tested, but few have progressed to efficacy trials2–7 and only one provided evidence for protection.7 Current HIV vaccine efficacy trials aim to improve on the success of the RV144 trial7 in Thailand, which showed a modest 31·2% protection.
Read more

[Articles] Evaluation of a mosaic HIV-1 vaccine in a multicentre, randomised, double-blind, placebo-controlled, phase 1/2a clinical trial (APPROACH) and in rhesus monkeys (NHP 13-19)
The mosaic Ad26/Ad26 plus gp140 HIV-1 vaccine induced comparable and robust immune responses in humans and rhesus monkeys, and it provided significant protection against repetitive heterologous SHIV challenges in rhesus monkeys. This vaccine concept is currently being evaluated in a phase 2b clinical efficacy study in sub-Saharan Africa (NCT03060629).
Read more

[Comment] Addressing the global challenge of snake envenoming
Joshua Longbottom and colleagues1 highlight once again that snake envenoming is a major health issue affecting remote and rural regions of the tropics. They use information about venomous snake distribution, health-care access, and availability of antivenom to identify the most vulnerable populations to snakebite. This modelling study1 reported in The Lancet identified about 92·66 million people living in regions vulnerable to snakebite, including sub-Saharan Africa, southeast Asia, and Indonesia.
Read more

[Comment] Weight-adjusted aspirin for cardiovascular prevention
Understanding the sources of variability in patients' responses to medicines has the potential to improve efficacy and safety through personalisation of treatment. Individual factors—ie, a patient's risk of cardiovascular events—are already considered when deciding who is prescribed low-dose aspirin for cardiovascular prevention. However, aspirin inhibits just one of several pathways of platelet activation, so it is not surprising that many patients still experience cardiovascular events.1 Factors that potentially contribute to these treatment failures, sometimes named as aspirin resistance, have been studied extensively, and several plausible mechanisms have been suggested, including non-adherence,2 accelerated platelet turnover in patients with diabetes,3 drug interactions with non-steroidal anti-inflammatory drugs,4 reduced bioavailability due to enteric coating,5,6 and bodyweight.
Read more