Infection is an important cause of stillbirths worldwide: in low-income and middle-income countries, 50% of stillbirths or more are probably caused by infection. By contrast, in high-income countries only 10–25% of stillbirths are caused by infection. Syphilis, where prevalent, causes most infectious stillbirths, and is the infection most amenable to screening and treatment. Ascending bacterial infection is a common cause of stillbirths, but prevention has proven elusive. Many viral infections cause stillbirths but aside from vaccination for common childhood diseases, we do not have a clear prevention strategy.

This intervention could be used with or as a potential alternative to health-worker-led interventions, and presents new opportunities for policy makers to improve maternal and newborn health outcomes in poor populations.

For participatory women's groups to have a significant effect on neonatal mortality in rural Bangladesh, detailed attention to programme design and contextual factors, enhanced population coverage, and increased enrolment of newly pregnant women might be needed.

Meticillin-resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide, and causes substantial morbidity and mortality. Health-care-associated MRSA infections arise in individuals with predisposing risk factors, such as surgery or presence of an indwelling medical device. By contrast, many community-associated MRSA (CA-MRSA) infections arise in otherwise healthy individuals who do not have such risk factors. Additionally, CA-MRSA infections are epidemic in some countries. These features suggest that CA-MRSA strains are more virulent and transmissible than are traditional hospital-associated MRSA strains.

For children who have out-of-hospital cardiac arrests from non-cardiac causes, conventional CPR (with rescue breathing) by bystander is the preferable approach to resuscitation. For arrests of cardiac causes, either conventional or compression-only CPR is similarly effective.

Tetsuhisa Kitamura and colleagues' study1 in The Lancet today is the largest that has analysed out-of-hospital cardiac arrest in children. Overall survival was 9% and only 3% of children had a good neurological outcome, as has been reported before.2–5 The prognosis does not seem to have improved much despite advances in cardiopulmonary resuscitation (CPR).

Worldwide coverage of HIV prevention, treatment, and care services in IDU populations is very low. There is an urgent need to improve coverage of these services in this at-risk population.

In The Lancet today, Bradley Mathers and colleagues1 make a heroic effort—in fact, a systematic review—to document the coverage (services provided per individual in need of services) for HIV prevention and care for injecting drug users (IDUs) throughout the world. Whilst the problems in obtaining data and in assessing the quality of data that could be obtained were formidable, two conclusions can be safely drawn. First, there is great variation in coverage of HIV-related services for IDUs across different countries; and second, in much of the world, coverage is clearly inadequate.

Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider.

Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.

Chronic low-back pain is becoming increasingly common. Freburger and colleagues1 showed an increase in the prevalence of debilitating chronic low-back pain over 14 years. In 1992, the prevalence was 3·9%, and in 2006, it was 10·2%. The overall prevalence increase was 161%, with an increase of 11·4% per year. Low-back pain is a major concern to all when the rapid increase in health-care expenditures worldwide is taken into consideration.

Combined pelvic and para-aortic lymphadenectomy is recommended as treatment for patients with endometrial carcinoma of intermediate or high risk of recurrence. If a prospective randomised or comparative cohort study is planned to validate the therapeutic effect of lymphadenectomy, it should include both pelvic and para-aortic lymphadenectomy in patients of intermediate or high risk of recurrence.

The lack of consensus for primary surgical treatment of endometrial cancer, the most common gynaecological cancer, is deplorable. Whether lymphadenectomy should be done together with hysterectomy has been debated at length and passionately. Resolution of this problem has been confounded by several issues, such as selection of patients, the perceived goals of lymphadenectomy, and clinicians' failure to recognise the known routes of lymphatic spread from the uterus.1 In practice, lymphadenectomy varies from complete omission, to various iterations of lymph-node sampling, to systematic lymphadenectomy.

Medical complicity in torture is not new. Evidence of medical involvement dates back to the 16th century,1 and the participation of medical personnel in torture under military and other dictatorships throughout the 20th century is well documented. Should we then be so surprised to learn, as we have done most recently from Physicians for Human Rights,2 that US military medical personnel have been working closely alongside interrogation teams in the war on terror, devising and monitoring techniques some of which, such as waterboarding, have been condemned by the Attorney General of the USA as torture.

Initial antihypertensive treatment with benazepril plus amlodipine should be considered in preference to benazepril plus hydrochlorothiazide since it slows progression of nephropathy to a greater extent.

Currently, the best treatment for renal protection in hypertension titrates drugs to the level of blood pressure wanted by inhibiting the renin–angiotensin–aldosterone system (RAASi).1,2 Combination therapy is usually needed and, although many combinations with RAASi have been tested for blood pressure lowering, whether such combinations are equally effective for the most important goal—renal protection—is rarely comparatively studied.

Walley T, Davidson P. Research funding in a pandemic. Lancet 2010; published online Jan 21. DOI:10.1016/S0140-6736(10)60068-2—In this Comment, the second author's name had been incorrectly spelled as Davison; his correct surname is Davidson. This correction has been made to the online version as of Feb 8, 2010.

Following the judgment of the UK General Medical Council's Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al1 are incorrect, contrary to the findings of an earlier investigation.2 In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

Around one child in every three was infected with 2009 pandemic H1N1 in the first wave of infection in regions with a high incidence, ten times more than estimated from clinical surveillance. Pre-existing antibody in older age groups protects against infection. Children have an important role in transmission of influenza and would be a key target group for vaccination both for their protection and for the protection of others through herd immunity.

Since 2009 pandemic influenza A H1N1 was first identified in April, 2009,1 the virus has caused widespread illness worldwide. In The Lancet today, Elizabeth Miller and colleagues2 from the UK Health Protection Agency report a pair of cross-sectional serological surveys in which they address the level of pre-existing immunity to 2009 pandemic H1N1 in the population and, more importantly, estimate the proportion of the population infected during the first pandemic wave in the UK.

The influenza A H1N1 pandemic posed opportunities and challenges to researchers and research funders, not only to study the nature of the disease but also to do projects that would bring benefit to patients in as short a time as possible.1 The UK's National Health Service (NHS) was well placed to do such research: its National Institute for Health Research (NIHR) was created in 2006 from the previous Department of Health Research and Development Programme, as a health-research system.2 This novel concept called for a coordinated health-research system with interacting programmes, infrastructure, and development of researchers.

In view of the global shortage of transplantable organs,1 does an individual's willingness to accept an organ transplant create a responsibility to agree to organ donation? In The Lancet today, Jacob Lavee and colleagues2 describe an Israeli initiative which aims to increase rates of organ donation, which are presently low,3 and address the challenge of free riders (ie, people who are willing to take but not to give) by bestowing privileges on individuals who are willing to donate in preference to those who are not.

In The Lancet today, Jacob Lavee and colleagues1 describe a new law recently approved by Israel's Parliament. The law will become effective in January, 2010, and will grant donor-card holders priority in organ allocation, with the aim of increasing the number of organ donations and reducing the length of transplantation waiting lists.

Israel's system for organ donation has been based, since its inception in 1968, on a model in which organs for transplantation are retrieved from brain-dead donors only after consent has been obtained from the appropriate first-degree relatives. This consent is needed even if the potential donor has expressed a wish for posthumous organ donation by signing a donor card, which is a government form that allows people to voluntarily indicate their wish to donate specified organs after their death.1 The consent rate for organ donation in Israel, defined as the proportion of actual donors of total number of medically eligible brain-dead donors, has consistently been 45% during the past decade, much lower than in most western countries.

On Nov 30, WHO released rapid advice summaries of revised recommendations on antiretroviral therapy, on antiretrovirals for the prevention of mother-to-child transmission of HIV, and on infant feeding in the context of HIV.1 WHO followed the GRADE approach2 to develop and update these recommendations.

Since its emergence early this year, the H1N1 2009 influenza A virus has achieved pandemic proportions. Vaccines have been produced by several manufacturers and mass-vaccination campaigns are underway in the USA and several other countries. Scrutiny of the safety of H1N1 vaccines is expected to be intense. With potentially hundreds of millions of people being vaccinated, adverse events will inevitably occur in some recently vaccinated people and the question will arise as to whether the vaccine was causative.

Just under 9 million children aged under 5 years died in 2008 and nearly 40% of these deaths were due to two diseases: pneumonia and diarrhoea.1 Diarrhoea remains the second leading cause of death in children younger than 5 years globally. Nearly one in every five child deaths—around 1·5 million a year—is due to diarrhoea, which kills more children than AIDS, malaria, and measles combined.2

The challenges facing the health of communities around the world are unprecedented, and the data are all too familiar. For 5 billion people living in developing countries, environmental factors and inadequacies in hygiene, economic development, and health-care access are the main causes of shortened life expectancies. Improvements in health status, including reductions in infant mortality and declining incidence of infectious diseases, are being met by the new epidemics of obesity, diabetes mellitus, and cardiovascular disease.