Lancet Regional Health-Europe最新文献

{"title":"Efficacy of repeated immunoadsorption in patients with post-COVID myalgic encephalomyelitis/chronic fatigue syndrome and elevated β2-adrenergic receptor autoantibodies: a prospective cohort study","authors":"Elisa Stein ,&nbsp;Cornelia Heindrich ,&nbsp;Kirsten Wittke ,&nbsp;Claudia Kedor ,&nbsp;Rebekka Rust ,&nbsp;Helma Freitag ,&nbsp;Franziska Sotzny ,&nbsp;Anne Krüger ,&nbsp;Markus Tölle ,&nbsp;Patricia Grabowski ,&nbsp;Carmen Scheibenbogen ,&nbsp;Laura Kim","doi":"10.1016/j.lanepe.2024.101161","DOIUrl":"10.1016/j.lanepe.2024.101161","url":null,"abstract":"<div><h3>Background</h3><div>Since the pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the leading trigger for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Evidence indicates that autoimmunity plays an important pathophysiological role. We aimed to evaluate the effectiveness of IA treatment in post-COVID ME/CFS patients.</div></div><div><h3>Methods</h3><div>This pre-post study included 20 post-coronavirus disease 2019 (COVID) ME/CFS patients found to have elevated β2 adrenergic autoantibodies (β2 AR-AB) between October 2022 and October 2023. Patients, with a median disease duration of 22 months (IQR: 15–31), were treated with five immunoadsorption sessions at Charité - Universitätsmedizin Berlin, Germany. Seven were male and 13 female, with a median age of 40 years (IQR: 36–51). The primary end point was the change in the Short Form (36) Health Survey physical functioning domain (SF36 PF) from baseline to four weeks post immunoadsorption. Key symptoms were assessed via questionnaires over six months. Handgrip strength and EndoPAT® measurements were used to evaluate muscle fatigue and vascular dysfunction. Seven patients who worsened after an initial response received a second cycle.</div></div><div><h3>Findings</h3><div>The treatment was generally well tolerated, reducing total immunoglobulin G by 79% (<em>CI</em>: 73–84%) and β2 AR-AB by 77% (<em>CI</em>: 58–95%). Patients demonstrated a mean increase in the SF36 PF of 17.75 points (<em>CI</em>: 13.41–26.16), with the greatest improvement occurring between months two and three, and significant gains maintained through month six. 14/20 (70%) patients were categorized as responders with an increase in the SF36 PF of ≥ ten points. Further lasting improvements were reported in fatigue, post-exertional malaise, pain, cognitive, autonomic, and immunological symptoms. Female patients had increased repeat handgrip strength at month six.</div></div><div><h3>Interpretation</h3><div>Immunoadsorption may improve symptoms in post-COVID ME/CFS patients. The beneficial effects of IgG depletion suggest a significant role for autoantibodies and disturbed B-cell function in the condition's pathophysiology.</div></div><div><h3>Funding</h3><div>Funded by The <span>Federal Ministry of Education and Research</span> and the <span>Weidenhammer Zöbele Research Foundation</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101161"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933458","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, haemodynamic, and metabolic parameters","authors":"Alfonso W. Avolio ,&nbsp;Massimo Antonelli ,&nbsp;Lucio Caccamo ,&nbsp;Francesco Frongillo ,&nbsp;Luca Del Prete ,&nbsp;Alberto Ferrarese ,&nbsp;Massimo Iavarone ,&nbsp;Patrizia Burra","doi":"10.1016/j.lanepe.2024.101194","DOIUrl":"10.1016/j.lanepe.2024.101194","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101194"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029863","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":"Effectiveness of quadrivalent human papillomavirus vaccination against high-grade cervical lesions by age and doses: a population-based cohort study","authors":"Shiqiang Wu ,&nbsp;Alexander Ploner ,&nbsp;Ana Martina Astorga Alsina ,&nbsp;Yunyang Deng ,&nbsp;Lina Ask Schollin ,&nbsp;Jiayao Lei","doi":"10.1016/j.lanepe.2024.101178","DOIUrl":"10.1016/j.lanepe.2024.101178","url":null,"abstract":"<div><h3>Background</h3><div>One or two-dose schedule for human papillomavirus (HPV) vaccination has been recommended by the World Health Organization and used in many vaccination programs. We aimed to comprehensively evaluate the effectiveness of quadrivalent HPV vaccine against high-grade cervical lesions by age at vaccination and number of doses received.</div></div><div><h3>Methods</h3><div>This cohort study included 2,200,495 females aged 10–35 years old who were residents of Sweden between 2006 and 2022, with 584,676 (26.6%) receiving at least one dose of quadrivalent HPV vaccine. We used Poisson regression models to estimate the incidence rate ratios (IRR) comparing the incidence rate of high-grade cervical lesions in relation to age at vaccination and doses.</div></div><div><h3>Findings</h3><div>In girls initiating vaccination before age 15, we observed IRRs of 0.42 (95% CI 0.33–0.52) after one-dose, 0.54 (0.47–0.63) after two-dose, and 0.50 (0.47–0.53) after three-dose. The IRRs were 0.60 (95% CI 0.52–0.70), 0.55 (0.49–0.62), and 0.54 (0.52–0.56) after one, two or three doses for girls who initiated vaccination age 15–17. For women who initiated vaccination after age 20, higher doses may be needed to achieve a statistically significant risk reduction.</div></div><div><h3>Interpretation</h3><div>Receiving one or two doses of HPV vaccines prior to age 17, especially for those initiating before age 15, has comparable effectiveness against high-grade cervical lesions with those who received three doses.</div></div><div><h3>Funding</h3><div><span>Swedish Research Council</span>, <span>Swedish Research Council for Health, Working Life and Welfare</span>, and <span>Karolinska Institutet</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101178"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162763","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":"Call me by MY name: the PassepartouT∗, a new tool to prevent misgendering and outing","authors":"Alberto Scala ,&nbsp;Marina Bonato ,&nbsp;Camillo Barbisan ,&nbsp;Marina Miscioscia ,&nbsp;Andrea Garolla","doi":"10.1016/j.lanepe.2024.101202","DOIUrl":"10.1016/j.lanepe.2024.101202","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"49 ","pages":"Article 101202"},"PeriodicalIF":13.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016128","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 the gap: advancing health equity and eliminating HBV and HCV among marginalized populations","authors":"Loreta A. Kondili ,&nbsp;Maria Giovanna Quaranta ,&nbsp;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 ,&nbsp;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}