A varied issue this week. The long Editorial calls for urgent concerted action among the global health community to act on the appalling state of access to water and sanitation in many countries of the world. An incredible 2.6 billion people do not have access to a toilet, and 1.5 million people die every year from diarrhoeal disease related to poor or non-existent sanitation. It does seem incredible early in the 21^st century that this most basic/fundamental issue remains out of the reach to such a vast proportion of the world’s population. There is some hope of change though - read the Editorial! Or why not listen to TLS’s very own Rhona MacDonald discussing the Editorial in this week’s Lancet podcast.

Appalling sanitation is mentioned in a must-read World Report about the crumbling health-care system in Zimbabwe. That country is about to go to an election, and it is hard to believe how life expectancy among women in Zimbabwe is the lowest in the world-just 34 years.

Also of interest should be a detailed Seminar about a much ignored mental health problem: social anxiety disorder. Authors of this Seminar (Murray Stein from University of California San Diego you can hear in this week’s Lancet podcast) point out how 5% of people probably suffer from the disorder. And it is more than mere shyness - people with social anxiety disorder go out of their way to avoid contact with people, avoid eye contact when they are with other people, and even avoid toileting if others are present. The root causes are not clear, but diagnosis and treatment (including cognitive behavioural therapy and pharmacological therapy including the use of SSRI antidepressants) is relatively straightforward. The main problem is that the disorder is not widely recognised-either by sufferers or by physicians. Authors of the Seminar hope for improved awareness to help treat this debilitating form of social phobia.

Some research highlights: the use of insulin glargine-a single injection of daily insulin-is as effective at controlling blood sugar for people with diabetes as insulin lispro, which has to be injected up to three times a day.

Also in research, Dutch authors report how second-generation drugs for schizophrenia are not necessarily more effective than older first generation drugs.

We publish in print the START trial, in collaboration with our sister publication The Lancet Oncology, highlighting how hypofractionation of radiotherapy could revolutionise treatment for early breast cancer. For more information listen to The Lancet Oncology April podcast.

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This entry was posted on Friday, March 28th, 2008 at 5:28 pm and is filed under The Lancet Digest. You can follow any responses to this entry through the RSS 2.0 feed. You can trackback from your own site.