October, 2006

October, 2006

Perspectives Ten Most Wanted October, 2006 Lunch with The Lancet Gilbert Burnham 1 Rosiglitazone and diabetes (Article, Sept 23) The DREAM Trial I...

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Perspectives

Ten Most Wanted October, 2006

Lunch with The Lancet Gilbert Burnham

1

Rosiglitazone and diabetes (Article, Sept 23) The DREAM Trial Investigators. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. DOI: 10.1016/S01406736(06)69420-8. Lancet 2006; 368: 1096–105.

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The SPACE trial (Article, Oct 7) The SPACE Collaborative Group. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. DOI: 10.1016/S01406736(06)69122-8. Lancet 2006; 368: 1239–47.

Gilbert Burnham, lead author of the much-discussed Lancet Iraq mortality study, doesn’t look like a man whose work was recently discounted by several world leaders. With a friendly face and easy smile, Burnham discussed his career and passion for population-based studies at a casual lunch in the Johns Hopkins Hospital restaurant in Baltimore, MD, USA. “I try my best to be non-political about it and try to keep the attention on the key message—how do we protect people caught up in conflict situations”, he said. The mortality survey was a lightening rod for passions about the war in Iraq, with the authors accused of everything from bad science to politically motivated timing of the study release. Much of the uproar seems to have passed over Burnham, although he has spent hours calmly explaining sampling techniques and survey sizes in various media forums. He said that what is unappreciated by the general public is that scientists are accustomed to putting aside their own views during research. “You look at it from a solid scientific basis”, he said. Nonetheless, some of the criticisms raised his ire slightly. “Somebody found out I had contributed to the Democratic National Committee—you know, $125 or whatever it was. Then the question that comes out of that is does this mean you can only study these things if you happen to be a Republican?” he asks. The Iraq study attracted far more political attention than any of Burnham’s other work. As co-director of Johns Hopkins Center for Refugee and Disaster Response, he has long had a fascination with field studies and community health care. His first involvement was in Korea during the 1970s. Drafted as a conscientious objector, Burnham and like-minded medical colleagues spent their off hours treating local burn victims. Later, while overseeing a hospital in Malawi, he became active in onchocerciasis field research after his wife suggested he find a hobby to get out of the hospital more. That activity has come full circle for him as he now chairs the Mectizan Expert Committee. Although the bulk of Burnham’s work is in Afghanistan, East Africa, and China, the Iraq survey gives him a more public platform to address the public-health implications of war. “Warfare is the ultimate disaster. Conflict is a condition that breaks out many times without warning, has epidemic proportions, and is every bit like the tsunami”. He urges improved and independent epidemiological studies of civilian health during conflict, even though the work is difficult and dangerous. Burnham hopes such data will better inform those who decide where the next epidemic of warfare will break out.

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Alzheimer’s disease (Seminar, July 29) Blennow K, et al. Alzheimer’s disease. DOI: 10.1016/ S0140-6736(06)69113-7. Lancet 2006; 368: 387–403.

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The MEGA trial (Article, Sept 30) The MEGA Study Group. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. DOI: 10.1016/ S0140-6736(06)69472-5. Lancet 2006; 368: 1155–63.

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Mortality in Iraq (Article, Oct 21) Burnham G, et al. Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. DOI: 10.1016/S0140-6736(06)69491-9. Lancet 2006; 368: 1421–28.

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Varicella (Seminar, Oct 14) Heininger U, Seward JF. Varicella. DOI: 10.1016/S01406736(06)69561-5. Lancet 2006; 368: 1365–76.

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Oral renin inhibitors (Review, Oct 21) Staessen JA, et al. Oral renin inhibitors. DOI: 10.1016/ S0140-6736(06)69442-7. Lancet 2006; 368: 1449–56.

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Mandatory HPV vaccines? (Editorial, Oct 7) The Lancet. Should HPV vaccines be mandatory for all adolescents? DOI: 10.1016/S0140-6736(06)69494-4. Lancet 2006; 368: 1212.

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Necrotising enterocolitis (Seminar, Oct 7) Lin PW, Stoll BJ. Necrotising enterocolitis. DOI: 10.1016/ S0140-6736(06)69525-1. Lancet 2006; 368: 1271–83.

10 Glucose and diabetes (Comment, Oct 7) Tuomilehto J, Wareham N. Glucose lowering and diabetes prevention: are they the same? DOI: 10.1016/ S0140-6736(06)69421-X. Lancet 2006; 368: 1218–19. The ten most wanted Lancet articles downloaded from ScienceDirect (see Lancet 2003; 361: 1265. DOI:10.1016/S0140-6736(03)12982-0) in October, 2006.

See Correspondence page 101

Nellie Bristol [email protected]

www.thelancet.com Vol 369 January 13, 2007

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