Lancet Regional Health-Europe最新文献

{"title":"Sex-specific associations between sleep apnoea and lung cancer risk in patients with COPD: a nationwide prospective cohort study","authors":"Kristiaan Proesmans ,&nbsp;Annemarie I. Luik ,&nbsp;Lies Lahousse","doi":"10.1016/j.lanepe.2025.101269","DOIUrl":"10.1016/j.lanepe.2025.101269","url":null,"abstract":"<div><h3>Background</h3><div>COPD is an established risk factor for lung cancer. Sleep apnoea is prevalent in COPD and the inflammation caused by intermittent hypoxaemia may increase this lung cancer risk. Females have more systemic inflammation for a similar apnoea-hypopnoea index than males. Therefore, this study aims to investigate sex-specific associations between sleep apnoea and lung cancer in COPD.</div></div><div><h3>Methods</h3><div>The sex-specific absolute and relative risk of sleep apnoea on newly diagnosed lung cancer was estimated in a nationwide observational study of Belgian patients with COPD (≥55 years), between 2017 and 2022, using an Aalan-Johanson estimator and a cause-specific Cox regression model adjusted for age, socioeconomic status, smoking status, alcoholism, frailty, comorbidities, and comedication.</div></div><div><h3>Findings</h3><div>The study consisted of 62,903 COPD patients (42·80% female), of whom 2898 (4·60%) developed lung cancer. We found a significant sex interaction of sleep apnoea on lung cancer hazard (<strong><em>χ</em></strong>-squared: 13·239, P-interaction &lt; 0·01). In females, sleep apnoea was associated with a higher lung cancer risk (cumulative incidence: 1545 vs 1350 per 100,000 PY; aHR: 1·31 (95% CI: 1·05–1·63)). For males, sleep apnoea patients had a lower lung cancer risk (cumulative incidence: 1632 and 2305 per 100,000 PY; aHR: 0·82 (95% CI: 0·70–0·95)). The impact of sleep apnoea on lung cancer development was especially strong in female COPD patients with hypoxia-related comorbidities e.g., with a history of emphysema (aHR: 2·65 (95% CI: 1·11–6·34)).</div></div><div><h3>Interpretation</h3><div>Sleep apnoea was associated with a higher risk of lung cancer in female COPD patients while, in males, there was a lower risk. Especially in female COPD patients with hypoxia, sleep apnoea is strongly associated with an increased lung cancer risk.</div></div><div><h3>Funding</h3><div>Emmanuel van der Schueren cancer research fellowship “<span>Kom Op Tegen Kanker</span>”.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101269"},"PeriodicalIF":13.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683329","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":"Evolving antimicrobial resistance of extensively drug-resistant Gram-negative severe infections associated with conflict wounds in Ukraine: an observational study","authors":"Scott J.C. Pallett ,&nbsp;Anna Morkowska ,&nbsp;Stephen D. Woolley ,&nbsp;Viktoria V. Potochilova ,&nbsp;Kateryna L. Rudnieva ,&nbsp;Olga S. Iungin ,&nbsp;Vincenzo Sgro ,&nbsp;Sara E. Boyd ,&nbsp;Nicola Reece ,&nbsp;Zoe L. Lambert ,&nbsp;Ngee Keong Tan ,&nbsp;Nabeela Mughal ,&nbsp;Olena V. Moshynets ,&nbsp;Luke S.P. Moore ,&nbsp;Matthew K. O'Shea","doi":"10.1016/j.lanepe.2025.101274","DOIUrl":"10.1016/j.lanepe.2025.101274","url":null,"abstract":"<div><h3>Background</h3><div>Conflict can have devastating effects on the development and spread of antimicrobial resistance. In Ukraine, early data post-injury are limited. We aim to explore extensively drug-resistant (XDR) Gram negative phenotypes and genotypes for infections arising early following conflict-associated wounds in Ukraine.</div></div><div><h3>Methods</h3><div>Carbapenem-resistant infections following conflict-associated wounds in Ukraine (February–May 2024) underwent extended antimicrobial susceptibility testing (AST) for 19 antimicrobial agents using 2025 European Committee for Antimicrobial Susceptibility Testing breakpoints. Carbapenemase genes were identified using a novel multiplex molecular resistance assay. Infections arising in the first seven days versus those arising after seven days since injury were compared by logistic regression. Significance was set at <em>p</em> &lt; 0.05.</div></div><div><h3>Findings</h3><div>100 isolates were tested (53, 53.0% <em>Klebsiella pneumoniae</em>; 16, 16.0% <em>other</em> Enterobacterales; 18, 18.0% <em>Acinetobacter baumanii</em> and 13; 13.0% <em>Pseudomonas aeruginosa</em>). Gentamicin (<em>p</em> = 0.0046) and colistin (<em>p</em> = 0.049) resistance were higher in infections arising later. Overall, resistance rates for amikacin (74/100, 74.0%), cefiderocol (44/100, 44.0%) and ceftazidime-avibactam (26/79, 67.1%) were observed. Prevalent resistance genes included NDM + OXA-48-like (24/100, 24.0%), NDM-only (24/100, 24.0%) and KPC (9/100, 9%). Others included OXA 23-like/51-like, IMP and/or mcr1. Earlier infection isolates had a higher burden of carbapenemases/isolate (<em>p</em> = 0.006).</div></div><div><h3>Interpretation</h3><div>Extensively drug-resistant infections were observed early post-injury in Ukraine, with some trend to further resistance in those arising later in the patient pathway. A diverse presence of carbapenemase genes amid XDR Gram negative phenotypes highlights the importance of early screening for mechanisms of resistance in this setting.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>Healthcare Infection Society</span> and <span>CW+ Charity</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101274"},"PeriodicalIF":13.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683333","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 rate of infective endocarditis by socioeconomic position: a Danish nationwide cohort study (2000–2022)","authors":"Søren K. Martiny ,&nbsp;Morten Schmidt ,&nbsp;Jonas A. Povlsen ,&nbsp;Kirstine K. Søgaard ,&nbsp;Hans E. Bøtker ,&nbsp;Henrik T. Sørensen","doi":"10.1016/j.lanepe.2025.101267","DOIUrl":"10.1016/j.lanepe.2025.101267","url":null,"abstract":"<div><h3>Background</h3><div>People with lower socioeconomic positions have a higher risk of cardiac and infectious diseases than those with higher socioeconomic positions. However, how the increasing incidence of infective endocarditis among different socioeconomic groups has played out remains unclear. We therefore aimed to investigate nationwide temporal trends in infective endocarditis incidence rate by socioeconomic position in Denmark.</div></div><div><h3>Methods</h3><div>Using nationwide Danish registries, we investigated infective endocarditis incidence rate (2000–2022). As socioeconomic position indicator, we used affluence level (accounting for household-level income and wealth), dividing the population into low, medium, and high affluence. Average annual percentage changes were computed to evaluate temporal trends. Slope index and relative index of inequality were calculated to obtain inequality gradients.</div></div><div><h3>Findings</h3><div>Per 100,000 person-years, the incidence rate increased from 8.7 in 2000 to 21.2 in 2022 among low; from 7.4 to 14.3 among medium; and from 6.2 to 13.1 among high affluence people. The average annual percentage change was 4.3% among low, 3.5% among medium, and 3.7% among high affluence people. The slope index of inequality increased from 3.8 additional cases per 100,000 person years (95% CI: 0.4–7.3) in 2000 to 12.3 (95% CI: 7.4–17.1) in 2022. The relative index of inequality increased from 1.68 (95% CI: 0.90–2.44) to 2.13 (95% CI: 1.49–2.78).</div></div><div><h3>Interpretation</h3><div>The infective endocarditis incidence rates increased in all affluence levels, with highest rates consistently found in the lowest affluence group, indicating that people with lower socioeconomic positions faced a disproportionately higher risk of infective endocarditis. These findings highlight the need to consider socioeconomic factors when addressing modifiable determinants that may curb the rise in infective endocarditis incidence.</div></div><div><h3>Funding</h3><div><span>Independent Research Fund Denmark</span> (grant no. <span><span>3101-00102B</span></span>) and <span>Center for Population Medicine</span>, <span>Department of Clinical Epidemiology</span>, <span>Aarhus University</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101267"},"PeriodicalIF":13.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683361","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":"Laparoscopic vs open surgery in posterosuperior liver resections: a negative trial with positive implications—the real value lies in perioperative management","authors":"Raffaele Brustia ,&nbsp;Daniele Sommacale","doi":"10.1016/j.lanepe.2025.101276","DOIUrl":"10.1016/j.lanepe.2025.101276","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101276"},"PeriodicalIF":13.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643371","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":"Composition of plant-based diets and the incidence and prognosis of inflammatory bowel disease: a multinational retrospective cohort study","authors":"Jie Chen ,&nbsp;Yuhao Sun ,&nbsp;Lintao Dan ,&nbsp;Judith Wellens ,&nbsp;Shuai Yuan ,&nbsp;Hong Yang ,&nbsp;Tammy Y.N. Tong ,&nbsp;Amanda J. Cross ,&nbsp;Nikos Papadimitriou ,&nbsp;Antoine Meyer ,&nbsp;Christina C. Dahm ,&nbsp;Susanna C. Larsson ,&nbsp;Alicja Wolk ,&nbsp;Jonas F. Ludvigsson ,&nbsp;Kostas Tsilidis ,&nbsp;Edward Giovannucci ,&nbsp;Jack Satsangi ,&nbsp;Xiaoyan Wang ,&nbsp;Evropi Theodoratou ,&nbsp;Simon S.M. Chan ,&nbsp;Nick Wareham","doi":"10.1016/j.lanepe.2025.101264","DOIUrl":"10.1016/j.lanepe.2025.101264","url":null,"abstract":"<div><h3>Background</h3><div>Many currently proposed diets for inflammatory bowel disease (IBD) focus on increasing plant-based foods, although a vegetarian diet can still contain products such as emulsifiers and refined grains that are believed to negatively impact IBD incidence and progression. To better inform dietary management in IBD, we investigated the association between plant-based diets and the incidence and complications of IBD.</div></div><div><h3>Methods</h3><div>We leveraged data from the UK Biobank (UKB, 2009–2022) including 187,888 participants free of IBD at baseline and the European Prospective Investigation into Cancer and Nutrition (EPIC, 1991–2010) cohort including 341,539 individuals free of IBD across centres among Denmark, France, Germany, Greece, Italy, the Netherlands, Sweden and UK. Healthy and unhealthy diets were characterised using plant-based diet indexes (PDIs); in individual participants, these were based on the 24-h dietary recalls for UKB and food frequency questionnaires for EPIC. The primary outcome was the incidence of IBD; secondary outcomes evaluated endpoints of disease prognosis (IBD-related surgery, diabetes, cardiovascular diease, and all-cause mortality). Cox regression was applied to estimate hazard ratios (HRs).</div></div><div><h3>Findings</h3><div>In the UKB (925 incident IBD, median follow-up 11.6 years, IQR 1.3 years), higher adherence to healthy PDI was associated with a lower IBD risk (HR 0.75, 95% CI 0.60–0.94), while higher alignment to an unhealthy PDI associated with an increased risk (HR 1.48, 95% CI 1.21–1.82) when comparing extreme quintiles of PDIs. Among individuals with established IBD, healthy PDI was inversely associated (HR 0.50, 95% CI 0.30–0.83) and unhealthy PDI was positively associated (HR 2.12, 95% CI 1.30–3.44) with need for IBD-related surgery. We did not observe significant associations between PDIs and risk of cardiovascular disease, diabetes mellitus or mortality. In the EPIC study (548 incident IBD, median follow-up 14.5 years, IQR 7.0 years), the HR of incident IBD for healthy PDI was 0.71 (95% CI 0.59–0.85) and for unhealthy PDI was 1.54 (95% CI 1.30–1.84).</div></div><div><h3>Interpretation</h3><div>We provide evidence that the composition of a plant-based diet may be an important determinant of the risk of developing IBD, and of disease course after diagnosis. Further research is needed to explore the mechanistic pathways linking plant-based diets and IBD incidence and prognosis.</div></div><div><h3>Funding</h3><div><span>National Natural Science Foundation of China</span>, <span>Natural Science Fund for Distinguished Young Scholars of Zhejiang Province</span>, National Undergraduate Training Program for Innovation and Entrepreneurship, CRUK Career Development Fellowship, The “Co-PI” project, Natural Science Fund for Excellent Young Scholars of Hunan Province.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101264"},"PeriodicalIF":13.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619670","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":"Health outcomes and their association with weight regain after substantial weight loss in Sweden: a prospective cohort study","authors":"Lena M.S. Carlsson ,&nbsp;Ida Arnetorp ,&nbsp;Johanna C. Andersson-Assarsson ,&nbsp;Peter Jacobson ,&nbsp;Per-Arne Svensson ,&nbsp;Magdalena Taube ,&nbsp;Sofie Ahlin ,&nbsp;Felipe M. Kristensson ,&nbsp;Kristjan Karason ,&nbsp;Ingrid Larsson ,&nbsp;Cecilia Karlsson ,&nbsp;Kirsi H. Pietiläinen ,&nbsp;Ingmar Näslund ,&nbsp;Björn Carlsson ,&nbsp;Markku Peltonen ,&nbsp;Kajsa Sjöholm","doi":"10.1016/j.lanepe.2025.101261","DOIUrl":"10.1016/j.lanepe.2025.101261","url":null,"abstract":"<div><h3>Background</h3><div>The clinical implications of weight regain following weight loss remain uncertain. We analysed mortality, cardiovascular events, cancer, and microvascular disease in individuals with significant weight loss, comparing maintainers to regainers.</div></div><div><h3>Methods</h3><div>Using a prospective cohort design, we analysed 1346 participants who underwent bariatric surgery in the Swedish Obese Subjects (SOS) study, aged 37–60 years with BMI ≥34 (men) or ≥38 (women), recruited 1987–2001. Individuals who regained ≥20% of their 1-year weight loss after 4 years (regain group) were compared to those who regained less (maintenance group). The study was closed on December 31, 2020 with median follow-up of 27 years and 99.9% mortality tracking (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT01479452</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Average weight loss after 1 year was 29.3 ± 11.7 kg and 31.9 ± 13.8 kg and average weight change from year 1 to year 4 was +12.7 ± 6.6 kg and −0.6 ± 7.3 kg in the regain and maintenance groups, respectively. During follow-up, regain and maintenance groups showed similar rates of total mortality and cancer, 12.4 (95% CI: 10.9–14.2) vs 12.4 (10.7–14.3), p = 0.740, and 11.3 (95% CI: 9.7–13.0) vs 10.4 (8.8–12.2) per 1000 person-years (p = 0.308), respectively. The regain group had, however, higher incidence of microvascular disease, 11.0 (95% CI: 9.5–12.8) vs 8.7 (7.3–10.4) per 1000 person-years (p = 0.024), and while not statistically significant, also higher incidence of major adverse cardiovascular events (myocardial infarction, stroke, and heart failure) 15.7 (95% CI: 13.8–17.8) vs 13.0 (11.2–15.1) per 1000 person-years (p = 0.055).</div></div><div><h3>Interpretation</h3><div>Weight regain was linked to increased vascular disease risk but we could not demonstrate an association with life expectancy.</div></div><div><h3>Funding</h3><div>The <span>Swedish Research Council</span>, the Swedish State under the agreement between the Swedish Government and the county councils, the <span>Health &amp; Medical Care</span> Committee of the Region Västra Götaland, the Adlerbert Research Foundation, the <span>Wilhelm and Martina Lundgren Foundation</span>, the <span>Royal Society of Arts and Sciences in Gothenburg</span>, <span>Academy of Finland</span>, <span>Finnish Medical Foundation</span>, Gyllenberg Foundation, <span>Novo Nordisk Foundation</span>, <span>Finnish Diabetes Research Foundation</span>, <span>Paulo Foundation</span> and Sigrid Juselius Foundation.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101261"},"PeriodicalIF":13.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610319","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":"Nephrology referral for chronic kidney disease patients–authors’ reply","authors":"Friedrich A. von Samson-Himmelstjerna ,&nbsp;Edgar Steiger ,&nbsp;Benedikt Kolbrink ,&nbsp;Hauke S. Wülfrath ,&nbsp;Thomas Czihal ,&nbsp;Roland Schmitt ,&nbsp;Dominik von Stillfried ,&nbsp;Kevin Schulte","doi":"10.1016/j.lanepe.2025.101266","DOIUrl":"10.1016/j.lanepe.2025.101266","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101266"},"PeriodicalIF":13.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610318","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":"European Association for the Study of the Liver (EASL) Liver Cancer Summit 2025","authors":"Ivana Nedic","doi":"10.1016/j.lanepe.2025.101262","DOIUrl":"10.1016/j.lanepe.2025.101262","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101262"},"PeriodicalIF":13.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577518","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":"Nephrology referral for chronic kidney disease patients","authors":"Yusuke Okabayashi,&nbsp;Takaya Sasaki,&nbsp;Nobuo Tsuboi","doi":"10.1016/j.lanepe.2025.101249","DOIUrl":"10.1016/j.lanepe.2025.101249","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101249"},"PeriodicalIF":13.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562932","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":"Italian health data system: current data interconnection and digital health ecosystem evolution","authors":"Stefano Lorusso,&nbsp;Serena Battilomo,&nbsp;Rosaria Boldrini,&nbsp;Giovanni Paolo Latella","doi":"10.1016/j.lanepe.2025.101259","DOIUrl":"10.1016/j.lanepe.2025.101259","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101259"},"PeriodicalIF":13.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562049","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}