RECORD 4 study A phase III study (RECORD 4) comparing oral rivaroxaban with subcutaneous enoxaparin for prevention of venous thromboembolism after knee replacement surgery. Article The Lancet (online May 5) Full text| PDF

Breast-tissue composition and cancer Breast-tissue composition and other risk factors for breast cancer were examined in a cross-sectional study of women aged 15-30 years. Article The Lancet Oncology (online April 30) Full text| PDF

Cystic fibrosis Review of clinical care for cystic fibrosis and recent advances in the understanding of its pathogenesis, screening of neonates, and development of therapies to treat the basic defect. Seminar The Lancet (online April 28) Full text| PDF

• Charcot-Marie-Tooth syndrome
  Article The Lancet Neurology (online May 7)
  Full text| PDF
• Alteplase for childhood stroke
  Article The Lancet Neurology (online May 6)
  Full text| PDF
• Paternal psychiatric disorders
  Review The Lancet (online May 5)
  Full text| PDF
• NHS Evidence: a new service
  Comment The Lancet (online April 30)
  Full text| PDF
• Multiple sclerosis NORMIMS study
  Article The Lancet Neurology (online April 30)
  Full text| PDF

The US Institute of Medicine's Committee on Conflict of Interest in Medical Research, Education, and Practice has published its final report. It stresses the importance of preventing bias, rather than tackling its consequences, and includes tips for identifying, limiting, and managing conflicts without damaging research collaborations.

Russia is facing human development obstacles that go beyond the economic and social, according to a UNDP report. A demographic challenge has arisen from Russia's low birth rate, ageing population, short life expectancies, and unclear immigration policies. The report cites the need for knowledge, political will, and economic resources in management of this problem.

Drug company Crucell N V and the Aeras Global TB Vaccine Foundation have started a phase I trial to test the safety of their jointly developed tuberculosis vaccine in infants previously immunised with the bacille Calmette-Guérin vaccine. The trial, the first in infants, is being done in South Africa in 54 healthy infants who have not been exposed to tuberculosis or HIV/AIDS.

The incidence of HIV in Taiwan's population of injection-drug users (IDUs) has decreased by almost 50% over 3 years. 3300 new cases were reported in 2005 compared with 1752 in 2008. This success is attributed to the country's harm-reduction programme, launched in 2006, which incorporates screening of IDUs, a needle-exchange scheme, and the use of methadone.

More This Week in Medicine:

• Innovation incentive
• Children in conflict
• Public perceptions
• Island inclusion
• Radiation record
• DNA on the fly
• Over-the-counter analgesia
• Homosexuality illegal
• New face

1.	Effects of a polypill (Polycap) on risk factors in middle-aged individuals without cardiovascular disease (TIPS): a phase II, double-blind, randomised trial Article (2009) Lancet 373 (9672), pp. 1341-1351 Full text| PDF
2.	Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial Article (2009) Lancet 373 (9670), pp. 1175-1182 Full text| PDF
3.	Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies Article (2009) Lancet 373 (9669), pp. 1083-1096 Full text| PDF
4.	Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials Article (2009) Lancet 373 (9670), pp. 1190-1197 Full text| PDF
5.	A girl with episodic abdominal pain Clinical Picture (2007) Lancet 369 (9576), p. 1890 Full text| PDF

1.	Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) Research (1998) Lancet 352 (9131), pp. 837-853 Full text|PDF|Cited 6,869 times
2.	MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: A randomised placebo-controlled trial Research (2002) Lancet 360 (9326), pp. 7-22 Full text|PDF|Cited 3,545 times
3.	Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: Principal results of the Hypertension Optimal Treatment (HOT) randomised trial Research (1998) Lancet 351 (9118), pp. 1755-1762 Full text|PDF|Cited 3,027 times
4.	A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) Research (1996) Lancet 348 (9038), pp. 1329-1339 Full text|PDF|Cited 2,578 times
5.	Peginterferon alfa-2b plus ribavirin compared with interferonalfa-2b plus ribavirin for initial treatment of chronic hepatitis C: A randomised trial Research (2001) Lancet 358 (9286), pp. 958-965 Full text|PDF|Cited 2,390 times

"Whether future trials [of below-knee casts for severe ankle sprains] should be pragmatic or non-pragmatic is likely to be a subject for continued debate, but the benefit of taking a different approach to investigate an old question should not be dismissed."

View full letter