Lancet Regional Health-Europe最新文献

{"title":"Bridging the gap: advancing health equity and eliminating HBV and HCV among marginalized populations","authors":"Loreta A. Kondili , Maria Giovanna Quaranta , Massimo Andreoni","doi":"10.1016/j.lanepe.2025.101222","DOIUrl":"10.1016/j.lanepe.2025.101222","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101222"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We need evidence-based futility thresholds to transplant grade-3 acute on chronic liver failure patients with poor respiratory, hemodynamic, and metabolic parameters—authors’ reply","authors":"William Bernal , Douglas Thorburn","doi":"10.1016/j.lanepe.2024.101198","DOIUrl":"10.1016/j.lanepe.2024.101198","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101198"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between HPV vaccination and cervical screening policy changes and cervical cancer incidence and grade-3 cervical intraepithelial neoplasia incidence in England, 2006–2020: a population-based trends analysis","authors":"Milena Falcaro ,&nbsp;Alejandra Castañón ,&nbsp;Busani Ndlela ,&nbsp;Peter Sasieni","doi":"10.1016/j.lanepe.2024.101157","DOIUrl":"10.1016/j.lanepe.2024.101157","url":null,"abstract":"<div><h3>Background</h3><div>Monitoring trends in diseases after the implementation of new public health interventions or policy changes is crucial for public health planning and surveillance. In this study we look at variations in rates of cervical cancer and grade-3 cervical intraepithelial neoplasia (CIN3) incidence between 2006 and 2020 in England and relate them to predictions based on the changes in HPV vaccination and cervical screening policy.</div></div><div><h3>Methods</h3><div>Using population-based registry data, we estimated incidence rates and their 95% confidence intervals for cervical cancer and CIN3 by age group and by either year of diagnosis or 1-year birth cohort. Trends were compared over time and across birth cohorts by calculating relative changes with respect to reference time points. We also tested if trends in women offered HPV vaccination were significantly different across outcomes (cervical cancer and CIN3) and age groups. To do this, we used Poisson regression with adjustments for interval censoring, overdispersion and correlation between observations.</div></div><div><h3>Findings</h3><div>There were 5558 cancers and 164,682 cases of CIN3 from 53.4 million women-years of observation in the age group 20–29.99 years. We found no evidence of increased cervical cancer rates over the age of 26 in cohorts not offered cervical screening until age 24.5 or 25 years. Substantial and increasing reductions in CIN3s and cervical cancers were observed in the cohorts offered HPV vaccination and were consistent with an 80% (95% CI: 72.9%–87.1%) decrease in cervical neoplasia in the routine vaccination group.</div></div><div><h3>Interpretation</h3><div>Plots against different time scales (e.g., calendar year and date of birth) may provide important insights that could otherwise be missed. Our findings are consistent with a sustained high effectiveness of the HPV immunization programme as the catch-up vaccination cohorts age.</div></div><div><h3>Funding</h3><div><span>Cancer Research UK</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101157"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HBV and HCV testing outcomes among marginalized communities in Italy, 2019–2024: a prospective study","authors":"Monica Monti ,&nbsp;Teresita Caruso ,&nbsp;Alice Castellaccio ,&nbsp;Irene De Giorgi ,&nbsp;Gabriella Cavallini ,&nbsp;Maria Laura Manca ,&nbsp;Serena Lorini ,&nbsp;Silvia Marri ,&nbsp;Luisa Petraccia ,&nbsp;Francesco Madia ,&nbsp;Cristina Stasi ,&nbsp;Laura Carraresi ,&nbsp;Elisabetta Lorefice ,&nbsp;Sara Irene Bonelli ,&nbsp;Alessandro Nerli ,&nbsp;Mouheb M.A. Mudalal ,&nbsp;Lorenzo Martini ,&nbsp;Stefano Gitto ,&nbsp;Eleonora Carradori ,&nbsp;Adela Xheka ,&nbsp;Laura Gragnani","doi":"10.1016/j.lanepe.2024.101172","DOIUrl":"10.1016/j.lanepe.2024.101172","url":null,"abstract":"<div><h3>Background</h3><div>The health of the marginalized populations is crucial for public health and inequalities. The World Health Organization (WHO) Global Hepatitis Report 2024 stated that over 304 million people were living with Hepatitis B Virus (HBV)/Hepatitis C Virus (HCV) infection in 2022. We performed HBV/HCV screenings among marginalized communities to reveal hidden infections and link-to-care positive participants.</div></div><div><h3>Methods</h3><div>From January 2019 to May 2024, finger-prick tests were used to conduct on-site screenings at non-profit organizations in Tuscany, Italy. Positive participants were referred to the closest outpatient clinic.</div></div><div><h3>Findings</h3><div>Eighty/1812 (4.4%) participants were Hepatitis B surface Antigen (HBsAg)+, mostly men (<em>p</em> &lt; <em>0.001</em>) and non-Italian natives compared to those HBsAg- (<em>p</em> &lt; <em>0.001</em>). Fifty-two/1812 (2.9%) were anti-HCV+ with a higher proportion of Italians (<em>p</em> &lt; <em>0.001</em>) and lower education level (<em>p</em> &lt; 0.01) compared to the anti-HCV-. Intravenous drug use was an independent factor for being anti-HCV+ (<em>p</em> &lt; <em>0.0001</em>). Among the HBsAg + individuals, 66.3% (53/80) were linked and 90.4% (48/53) retained in care (treated/monitored). Of the anti-HCV participants requiring clinical evaluation, 37.8% (14/37) were linked to care, and all the 11/14 (88.6%) viremic patients were successfully treated.</div></div><div><h3>Interpretation</h3><div>We found higher HBV/HCV positivity compared to national prevalences. Participation and linkage to care were successful. The young mean age (33.6 yrs) of HBsAg + individuals, primarily from regions with low vaccinal adherence, indicated geographical origin as a key risk factor. HCV positivity was associated with extreme marginality. The results stress the need to implement marginalized groups screening to target HBV/HCV hidden infections, reducing disparities in healthcare and advancing towards the WHO 2030 elimination goal.</div></div><div><h3>Funding</h3><div><span>Gilead Sciences</span>; <span>Fondazione Cassa di Risparmio di Pistoia e Pescia</span>; <span>Regione Toscana</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101172"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling Clostridioides difficile (CD): current evidences and future directions in the treatment of CD infections","authors":"Guido Granata ,&nbsp;Nicola Petrosillo","doi":"10.1016/j.lanepe.2024.101174","DOIUrl":"10.1016/j.lanepe.2024.101174","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101174"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to The Lancet Regional Health – Europe's clinical and statistical peer reviewers in 2024","authors":"Pooja Jha,&nbsp;Rafael Cardoso,&nbsp;Ivana Nedic,&nbsp;Stephanie Becker,&nbsp;Heather Brown","doi":"10.1016/j.lanepe.2025.101232","DOIUrl":"10.1016/j.lanepe.2025.101232","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101232"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining child maltreatment for research and surveillance: an international, multi-sectoral, Delphi consensus study in 34 countries in Europe and surrounding regions","authors":"Laura Elizabeth Cowley ,&nbsp;Diogo Lamela ,&nbsp;Katarzyna Drabarek ,&nbsp;Leonor Bettencourt Rodrigues ,&nbsp;Athanasios Ntinapogias ,&nbsp;Aideen Naughton ,&nbsp;Geoff Debelle ,&nbsp;Ravit Alfandari ,&nbsp;Andreas Jud ,&nbsp;Gabriel Otterman ,&nbsp;Taina Laajasalo ,&nbsp;Cindy W. Christian ,&nbsp;Vaska Stancheva-Popkostadinova ,&nbsp;Luciana Caenazzo ,&nbsp;Virginia Soldino ,&nbsp;Rachael Vaughan ,&nbsp;Alison Kemp ,&nbsp;Ulugbek Nurmatov ,&nbsp;Lisa Hurt","doi":"10.1016/j.lanepe.2024.101196","DOIUrl":"10.1016/j.lanepe.2024.101196","url":null,"abstract":"<div><div>Child maltreatment is a complex public health issue that has consequences across the life-course. Studies to quantify child maltreatment and identify interventions and services are constrained by a lack of uniform definitions. We conducted a European Delphi study to reach consensus on types and characteristics of child maltreatment for use in surveillance and research. Statements were developed following a scoping review and identification of key concepts by an international expert team (n = 19). A multidisciplinary expert panel (n = 70) from 34 countries completed three rounds of an online survey. We defined consensus as ≥70% agreement or disagreement with each statement after the final round. Consensus was reached on 26/31 statements (participant retention rate 94%). From the statements, we propose a unified definition of child maltreatment to improve measurement and surveillance in Europe. Concerted efforts are now required to test and refine the definition further prior to real-world operationalisation.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101196"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring equity in access to liver transplant for patients with acute-on-chronic liver failure across the UK","authors":"Oliver D. Tavabie ,&nbsp;Paul N. Brennan","doi":"10.1016/j.lanepe.2024.101193","DOIUrl":"10.1016/j.lanepe.2024.101193","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101193"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Romania's health workforce: leading by example","authors":"Rosemary James ,&nbsp;Cris Scotter ,&nbsp;Alexandru Florin Rogobete ,&nbsp;Teodor Cristian Blidaru ,&nbsp;Alexandru Rafila ,&nbsp;Gareth Rees ,&nbsp;Ioana Novac ,&nbsp;Daphne Kaiteladou ,&nbsp;Yanina Andersen ,&nbsp;Khamis Al-alawy ,&nbsp;Olympia Konstantakopoulou ,&nbsp;Natasha Azzopardi Muscat ,&nbsp;Tomas Zapata ,&nbsp;Nicolae Dragoș Garofil","doi":"10.1016/j.lanepe.2024.101191","DOIUrl":"10.1016/j.lanepe.2024.101191","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101191"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, case fatality, and functional outcome of intracerebral haemorrhage, according to age, sex, and country income level: a systematic review and meta-analysis","authors":"Axel Wolsink ,&nbsp;Maaike P. Cliteur ,&nbsp;Charlotte J. van Asch ,&nbsp;Hieronymus D. Boogaarts ,&nbsp;Ruben Dammers ,&nbsp;Gerjon Hannink ,&nbsp;Floris H.B.M. Schreuder ,&nbsp;Catharina J.M. Klijn","doi":"10.1016/j.lanepe.2024.101180","DOIUrl":"10.1016/j.lanepe.2024.101180","url":null,"abstract":"<div><h3>Background</h3><div>Intracerebral haemorrhage (ICH) accounts for approximately 28% of all strokes worldwide. ICH has a high case fatality, and only few survivors recover to independent living. Over the past decades, demographic changes, and changes in prevalence and management of risk factors may have influenced incidence. Widespread implementation of stroke units and improved care in general may have affected case fatality and outcome. We aimed to update the evidence on incidence, case fatality, and functional outcome of ICH, according to age, sex, and country income level.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed and Embase from 2008 to April 2023 for prospective population-based studies on incidence, case fatality, or functional outcome of first-ever ICH. We excluded studies in which less than 80% of cases was confirmed with imaging or autopsy. Quality of the studies was assessed based on the used case finding methods. We used inverse variance-based random-effects meta-analyses to pool the crude incidence, case fatality at 1 month, and the percentage of patients with good functional outcome after 3, 6, or 12 months, as defined by the authors of the individual studies. Time trends were assessed using weighted linear meta-regression. Funnel plots were constructed to study publication bias. The review was registered on PROSPERO (CRD42023413314).</div></div><div><h3>Findings</h3><div>We identified 70 eligible studies, describing 19,470 ICH patients from 26 different countries. Of these, 62 studies reported on crude incidence, 41 on case fatality, and 10 on functional outcome. Overall crude incidence was 29.2 per 100,000 person-years (95% CI 23.3–36.4; I² = 100%). Incidence was lower in women than in men and increased with age. Incidence was highest in lower-middle income countries, followed by high and upper-middle income countries. Case fatality at 1 month was 35.5% (95% CI 32.3–38.9; I² = 90%). The percentage of patients with good functional outcome (mRS 0–2 in nine studies, mRS 0–3 in one) after 3–12 months was 31.2% (95% CI 24.7–38.6; I² = 76%). We found no time trends in incidence, case fatality, or functional outcome.</div></div><div><h3>Interpretation</h3><div>Our results demonstrate the persistently high burden and devastating consequences of ICH, stressing the need for better preventive strategies and acute treatments.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101180"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}