Medical Journal News

In the CASTING study,1 the TRiP(cast) score was utilised to identify patients at low risk of venous thromboembolism. The cumulative incidence of venous thromboembolism was estimated to be 2·0%, indicating that most patients, approximately 98%, were at low risk and did not require anticoagulation. Therefore, it was inappropriate to identify low-risk subgroups from a population already consisting mostly of individuals at low risk of developing the condition. In contrast, there was no significant difference in the incidence of venous thromboembolism (1·1% vs 1·0%) between the intervention phase, guided by the TRiP(cast), and the control phase, during which 16% of patients would be classified as high risk but did not receive anticoagulation.

We would like to congratulate Douillet and colleagues1 on their CASTING study, which showed a relevant reduction in prophylactic anticoagulation by using the TRIP(cast) score without an increase in the risk of venous thromboembolism. However, we were surprised by the inclusion of male sex as a risk factor in the TRIP(cast) score. The TRIP(cast) score was developed on the basis of two prior scores. One score was based on expert consensus (TIP score) that did not include male sex as a risk factor.

I read with great interest the CASTING study by Douillet and colleagues.1 I appreciate the authors’ contribution; however, there are several issues I would like to discuss.

We thank Liang V Tang and colleagues, Perrine Truong and Francois-Xavier Ageron, and Wei Xiong for their interest in our CASTING study and their comments.

Veltkamp R, Korompoki E, Harvey KH, et al. Direct oral anticoagulants versus no anticoagulation for the prevention of stroke in survivors of intracerebral haemorrhage with atrial fibrillation (PRESTIGE-AF): a multicentre, open-label, randomised, phase 3 trial. Lancet 2025; 405: 927–36—In this Article, the final sentence of the Findings in the Summary was incorrect and has been deleted. This correction has been made to the online version as of March 13, 2025, and the printed version is correct.

Human African trypanosomiasis or sleeping sickness is caused by infection with Trypanosoma brucei gambiense or Trypanosoma brucei rhodesiense parasites, which are transmitted by tsetse flies in sub-Saharan Africa. Control of human African trypanosomiasis is based on case detection, treatment, and vector control. In the past decade, simple rapid diagnostic tests were introduced for gambiense human African trypanosomiasis, facilitating screening in primary health-care facilities. A new oral drug, fexinidazole, became the first-line treatment for gambiense human African trypanosomiasis without severe meningo-encephalitic disease, as well as for rhodesiense human African trypanosomiasis.

Adding a single sentence suggesting a deadline for FIT return in the invitation letter to FIT colorectal screening resulted in more timely FIT return and reduced the need to issue reminder letters. This is a highly cost-effective intervention that could be easily implemented in routine practice. A planning tool had no positive effect on FIT return.

Hirst JE, Witt A, Mullins E, Womersley K, Muchiri D, Norton R. Delivering the promise of improved health for women and girls in England. Lancet 2024; 404: 11–14—In this Comment, the second sentence and reference 1 to a Manual source have been removed because this reference was found not to be reliable. These changes have been made to the online version as of March 12, 2025.

Colorectal cancer is the second leading cause of cancer-related death globally, accounting for more than 900 000 deaths each year.1 A large share of this burden could be avoided by well-organised screening programmes. In recent years, an increasing number of countries have introduced organised screening programmes with faecal immunochemical tests (FITs) directly sent, along with easy to understand information and instructions for use, to the eligible target population. Such programmes can achieve high adherence rates, well above 60%,2 and their introduction has been shown to be followed (after an initial apparent transient rise in incidence due to early detection of prevalent colorectal cancer) by a major reduction of both colorectal cancer incidence (in particular incidence of late-stage cancer) and mortality.

Like political leaders throughout Europe, US President Donald Trump pledged if elected to detain and deport millions of migrants without legal documentation or with temporary protected status.1 Since Jan 20, 2025, he has moved swiftly to achieve these aims. His administration rescinded guidance that restricted immigration enforce­ment in health-care facilities, religious institutions, and schools.2–4 Military resources have been diverted for deportations, with wrenching images of shackled people directed into military planes, detained at Guantánamo Bay military base, and crowded into militarised camps in Panama.

New England Journal of Medicine, Volume 392, Issue 11, Page 1089-1099, March 13/20, 2025.

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New England Journal of Medicine, Volume 392, Issue 11, March 13/20, 2025.

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New England Journal of Medicine, Volume 392, Issue 11, March 13/20, 2025.

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