Lancet Regional Health-Europe最新文献

{"title":"Biliary tract cancers: addressing healthcare disparities and improving access to innovative treatments in Europe","authors":"Anthony Turpin , Tian V. Tian , Alice Boilève , Cindy Neuzillet","doi":"10.1016/j.lanepe.2025.101215","DOIUrl":"10.1016/j.lanepe.2025.101215","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101215"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529092","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":"Long-term risk of chronic liver disease in patients with celiac disease: a nationwide population-based, sibling-controlled cohort study","authors":"Jialu Yao ,&nbsp;Jiangwei Sun ,&nbsp;Fahim Ebrahimi ,&nbsp;David Bergman ,&nbsp;Peter H.R. Green ,&nbsp;Hannes Hagström ,&nbsp;Benjamin Lebwohl ,&nbsp;Daniel A. Leffler ,&nbsp;Jonas F. Ludvigsson","doi":"10.1016/j.lanepe.2024.101201","DOIUrl":"10.1016/j.lanepe.2024.101201","url":null,"abstract":"<div><h3>Background</h3><div>Celiac disease (CeD) may be associated with elevated liver enzymes. However, little is known about the risk of chronic liver disease (CLD) of various etiologies or major adverse liver outcomes (MALO) in CeD. We aimed to investigate the long-term risk of CLD in patients with CeD.</div></div><div><h3>Methods</h3><div>Swedish nationwide cohort study. We identified 48,027 patients with biopsy-confirmed CeD between 1969 and 2017. Each patient was exactly matched with ≤5 general population reference individuals (n = 231,909) and followed through 2021. Flexible parametric survival models estimated adjusted hazard ratios (aHRs) of any and specific CLD (i.e., viral hepatitis, metabolic dysfunction-associated steatotic liver disease [MASLD], alcohol-related liver disease, and autoimmune liver disease) and MALO (compensated/decompensated cirrhosis, hepatocellular carcinoma, liver transplantation, and liver-related death).</div></div><div><h3>Findings</h3><div>During a median follow-up of 16.0 years, 649 patients with CeD and 1571 reference individuals developed any CLD (incidence rate: 79.4 vs. 39.5/100,000 person-years). CeD patients had a higher risk of developing any CLD than reference individuals (aHR = 2.01, 95%CI:1.82−2.22). This risk remained elevated ≥25 years after diagnosis, giving one extra CLD case per 110 CeD patients until then. Positive associations were present for autoimmune liver disease (aHR = 4.86), MASLD (aHR = 2.54), and alcohol-related liver disease (aHR = 1.51). Individuals with CeD were at significantly higher risk of incident MALO (aHR = 1.54). Sibling comparisons and sensitivity analyses confirmed the main findings.</div></div><div><h3>Interpretation</h3><div>CeD is associated with a persistently increased risk of any incident CLD, although the absolute risk is low. Physicians should be vigilant to early signs of liver dysfunction in patients with CeD.</div></div><div><h3>Funding</h3><div><span>European Crohn's and Colitis Organisation</span>, the <span>Swedish Society for Medical Research</span> (project#: <span><span>PG-23-0315-H-02</span></span>), <span>FORTE</span> (project#: <span><span>2016-00424</span></span>), <span>Takeda</span>, and the <span>Swiss National Science Foundation</span> (project#: <span><span>P500PM_210866</span></span>).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101201"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529561","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":"The Italian hospital medical profession is broken too","authors":"Sebastiano Buti ,&nbsp;Giuseppe Fornarini","doi":"10.1016/j.lanepe.2025.101254","DOIUrl":"10.1016/j.lanepe.2025.101254","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101254"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520497","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":"Ireland: Europe's outlier in primary health care","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2025.101253","DOIUrl":"10.1016/j.lanepe.2025.101253","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101253"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529620","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":"Bridging gaps in migrant health competencies for infectious and tropical diseases specialists: the experience of the University of Bari from Lampedusa to Apulian Ghettos","authors":"Francesco Di Gennaro,&nbsp;Annalisa Saracino","doi":"10.1016/j.lanepe.2025.101252","DOIUrl":"10.1016/j.lanepe.2025.101252","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101252"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520376","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":"Real-world evidence in spinal muscular atrophy: addressing heterogeneity of populations and treatment comparisons","authors":"Juliette Ropars ,&nbsp;Lamiae Grimaldi ,&nbsp;Susana Quijano-Roy","doi":"10.1016/j.lanepe.2025.101248","DOIUrl":"10.1016/j.lanepe.2025.101248","url":null,"abstract":"<div><div>In this short correspondence, we comment the recently published article “Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study” (The Lancet–Global Health Europe, <span><span>https://doi.org/10.1016/j.lanepe.2024.101092</span><svg><path></path></svg></span>). We commend the authors for generating real-world evidence that highlights the importance of rapid access to disease modifying therapy (DMT) for newly diagnosed patients. However, we caution that confirmatory studies are required to better understand the impact of treatment sequences, particularly in the presence of prior DMT exposure. Addressing these issues will ensure that clinical decision-making is based on the most rigorous evidence available.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"52 ","pages":"Article 101248"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521041","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":"PFMG2025–integrating genomic medicine into the national healthcare system in France","authors":"","doi":"10.1016/j.lanepe.2024.101183","DOIUrl":"10.1016/j.lanepe.2024.101183","url":null,"abstract":"<div><div>Integrating genomic medicine into healthcare systems is a health policy challenge that requires continuously transferring scientific advances into clinics and ensuring equal access for patients. France was one of the first countries to integrate genome sequencing into clinical practice at a nationwide level, with the ambition to provide more accurate diagnostics and personalized treatments. Since 2016, the French government has invested €239M in the 2025 French Genomic Medicine Initiative (PFMG2025) which has so far focused on patients with rare diseases (RD), cancer genetic predisposition (CGP) and cancers. PFMG2025 has addressed numerous challenges to set up an operational organizational framework. As of December the 31st 2023, 12,737 results were returned to prescribers for RD/CGP patients (median delivery time: 202 days, diagnostic yield: 30.6%) and 3109 for cancer patients (median delivery time: 45 days). PFMG2025’s future priorities encompass ensuring economic sustainability, strengthening links with research, empowering patients and practitioners, and fostering collaborations with European partners.</div></div><div><h3>Funding</h3><div>As of December the 31st 2023, €239M have been invested by the French government.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101183"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529621","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":"Understanding Cholangiocarcinoma—perspectives from three European advocacy groups","authors":"Elisabeth Baucells ,&nbsp;Helen Morement ,&nbsp;Paolo Leonardi","doi":"10.1016/j.lanepe.2025.101239","DOIUrl":"10.1016/j.lanepe.2025.101239","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101239"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529093","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":"The strength and resilience of Italy’s health data system","authors":"Alessandro Perrella ,&nbsp;Massimo Bisogno","doi":"10.1016/j.lanepe.2025.101255","DOIUrl":"10.1016/j.lanepe.2025.101255","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"51 ","pages":"Article 101255"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520498","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":"Impact of COVID-19 pandemic on elective care backlog trends, recovery efforts, and capacity needs to address backlogs in Scotland (2013–2023): a descriptive analysis and modelling study","authors":"Syed Ahmar Shah ,&nbsp;Karen Jeffrey ,&nbsp;Chris Robertson ,&nbsp;Aziz Sheikh","doi":"10.1016/j.lanepe.2024.101188","DOIUrl":"10.1016/j.lanepe.2024.101188","url":null,"abstract":"<div><h3>Background</h3><div>Prioritisation of COVID-19 care led to widespread cancellations of elective care, creating a substantial backlog for healthcare systems worldwide. While the pandemic's impacts on elective hospital waiting lists during the early phase of the pandemic have been described in multiple countries, there is limited research on longer-term impacts and recovery efforts.</div></div><div><h3>Methods</h3><div>We conducted a country-wide analysis of Scotland's healthcare system over an 11-year period (January 1, 2013–December 31, 2023) to assess the pandemic's impact on the elective care backlog, evaluate recovery efforts, and estimate the capacity increase required to clear the backlog. Our analysis involved assessments at national, elective type, regional, and specialty levels. We used descriptive statistics to compare trends and a statistical modelling approach (Vector Autoregressive model with exogenous variables) to estimate capacity increases needed.</div></div><div><h3>Findings</h3><div>Waiting lists gradually increased before the pandemic (2013: n = 285,149; 2019: n = 385,859; 35.3% increase over six years) and then rose rapidly during the pandemic (2023: n = 667,749; 73.1% increase over four years). Capacity for elective care dropped substantially during the initial lockdown period (April–June 2020) and had not fully recovered by the end of 2023. These patterns were broadly consistent across Scotland and similar trends were observed when stratified by elective type, region, and specialty. The number of referrals waiting over a year increased from 3056 on December 31, 2019, to 78,243 (&gt;2400% increase) by December 31, 2023. To eliminate the backlog created during the pandemic, a gradual increase in capacity, accumulating to 20% over three years is required. This corresponds to an annual increase of approximately 6.67%, translating to an additional 32,302 cases per year.</div></div><div><h3>Interpretation</h3><div>Scotland's healthcare system struggled to meet elective care demand pre-pandemic, and the pandemic has worsened an already difficult situation. Pre-pandemic elective care capacity had not been restored by the end of 2023. While substantial additional capacity is necessary, it is crucial to adopt broader system-level strategies to effectively address waiting list backlogs.</div></div><div><h3>Funding</h3><div><span>University of Edinburgh’s Chancellor Fellowship</span>; <span>Health Data Research UK</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"50 ","pages":"Article 101188"},"PeriodicalIF":13.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529563","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}