Pub Date : 2025-02-14DOI: 10.1016/s0140-6736(25)00267-3
Rowalt Alibudbud
No Abstract
无摘要
{"title":"LGBTQ+ rights and health: a shifting landscape","authors":"Rowalt Alibudbud","doi":"10.1016/s0140-6736(25)00267-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00267-3","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-14DOI: 10.1016/s0140-6736(25)00264-8
Mika O Salminen, Otto Helve, Henrik Ullum, Herwig Ostermann, Claudia Habl, Guri Rørtveit, Maria do Rosário O Martins, Caroline Semaille
No Abstract
无摘要
{"title":"The urgent need to protect WHO is also an opportunity","authors":"Mika O Salminen, Otto Helve, Henrik Ullum, Herwig Ostermann, Claudia Habl, Guri Rørtveit, Maria do Rosário O Martins, Caroline Semaille","doi":"10.1016/s0140-6736(25)00264-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00264-8","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-13DOI: 10.1016/s0140-6736(25)00164-3
Ava L Liberman, Steven R Levine
No Abstract
{"title":"Ischaemic brain neuroprotection: a true therapeutic frontier?","authors":"Ava L Liberman, Steven R Levine","doi":"10.1016/s0140-6736(25)00164-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00164-3","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"146 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-13DOI: 10.1016/s0140-6736(25)00210-7
Vasee Moorthy, Jeremy Farrar
No Abstract
{"title":"Identifying key randomised clinical trials that could transform clinical care and public health","authors":"Vasee Moorthy, Jeremy Farrar","doi":"10.1016/s0140-6736(25)00210-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00210-7","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Generation C: the scope and effects of paediatric long COVID","authors":"Naomi Ketharanathan, Karolijn Dulfer, Matthijs de Hoog, Marieke Otten, Corinne Buysse","doi":"10.1016/s0140-6736(24)02622-9","DOIUrl":"https://doi.org/10.1016/s0140-6736(24)02622-9","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-13DOI: 10.1016/s0140-6736(25)00193-x
Jim Christenson, Michael D Hill, Richard H Swartz, Corey Adams, Oscar Benavente, Leanne K Casaubon, Sheldon Cheskes, Aravind Ganesh, Jonathan Dave Garman, Cameron Harris, Devin R Harris, Kathy Heard, Sandra Jenneson, Yatika Kohli, Michelle Leroux, Diana Mayor-Nunez, George Medvedev, Manu Mehdiratta, Laurie J Morrison, Johanna Maria Ospel, Michael Tymianski
<h3>Background</h3>Nerinetide is a neuroprotectant effective in preclinical models of acute ischaemic stroke when administered within 3 h of onset. However, the clinical evaluation of neuroprotectants in this short timeframe is challenging. We sought to establish the feasibility, safety, and effectiveness of nerinetide when given before hospital arrival within 3 h of symptom onset of suspected stroke.<h3>Methods</h3>In this multicentre, randomised, double-blind, placebo-controlled study, paramedics enrolled participants aged 40–95 years within 3 h of suspected severe stroke onset, who were previously independent, and were being taken to one of seven stroke centres in Ontario or British Columbia, Canada. The primary hypothesis was that the administration of nerinetide would result in a higher rate of good functional outcomes. Participants were randomly assigned 1:1 to intravenous nerinetide (2·6 mg/kg) or placebo, each in visually identical vials. Paramedics, hospital care providers, and outcome evaluators were masked to treatment assignment. The primary outcome was good functional outcome on a sliding dichotomy of the modified Rankin Scale at 90 days. Participants were assessed on day 4, 30, and 90 by the stroke center research team, in person or over the telephone. Outcomes, adjusted for age and stroke severity, were evaluated in the modified intention-to-treat (mITT) population, and in the target population of those with acute ischaemic stroke. The safety population included all participants who received the study drug. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span> (<span><span>NCT02315443</span><svg aria-label="Opens in new window" focusable="false" height="20" viewbox="0 0 8 8"><path d="M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z"></path></svg></span>), and trial enrolment has concluded.<h3>Findings</h3>Between March 26, 2015, and March 27, 2023, 532 participants received nerinetide (n=265) or placebo (n=267). The mITT population of suspected stroke (n=507; 254 nerinetide and 253 placebo) included 321 (63%) with acute ischaemic stroke, 93 (18%) with intracranial haemorrhage, 44 (9%) with transient ischaemic attack, and 49 (10%) with stroke-mimicking conditions. Treatment began a median of 64 min (IQR 47–100) from symptom onset. Participants randomly assigned to nerinetide had more severe strokes compared with those receiving placebo (median National Institutes of Health Stroke Scale (NIHSS) 12, IQR 5–19 <em>vs</em> 10, 4–18 in mITT, and 14, 7–19 <em>vs</em> 10, 4–18 in the acute ischaemic stroke subgroup). Overall, 145 (57%) of 254 participants in the nerinetide group and 147 (58%) of 253 in the placebo group had the primary outcome of a favourable functional outcome using th
{"title":"Efficacy and safety of intravenous nerinetide initiated by paramedics in the field for acute cerebral ischaemia within 3 h of symptom onset (FRONTIER): a phase 2, multicentre, randomised, double-blind, placebo-controlled study","authors":"Jim Christenson, Michael D Hill, Richard H Swartz, Corey Adams, Oscar Benavente, Leanne K Casaubon, Sheldon Cheskes, Aravind Ganesh, Jonathan Dave Garman, Cameron Harris, Devin R Harris, Kathy Heard, Sandra Jenneson, Yatika Kohli, Michelle Leroux, Diana Mayor-Nunez, George Medvedev, Manu Mehdiratta, Laurie J Morrison, Johanna Maria Ospel, Michael Tymianski","doi":"10.1016/s0140-6736(25)00193-x","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00193-x","url":null,"abstract":"<h3>Background</h3>Nerinetide is a neuroprotectant effective in preclinical models of acute ischaemic stroke when administered within 3 h of onset. However, the clinical evaluation of neuroprotectants in this short timeframe is challenging. We sought to establish the feasibility, safety, and effectiveness of nerinetide when given before hospital arrival within 3 h of symptom onset of suspected stroke.<h3>Methods</h3>In this multicentre, randomised, double-blind, placebo-controlled study, paramedics enrolled participants aged 40–95 years within 3 h of suspected severe stroke onset, who were previously independent, and were being taken to one of seven stroke centres in Ontario or British Columbia, Canada. The primary hypothesis was that the administration of nerinetide would result in a higher rate of good functional outcomes. Participants were randomly assigned 1:1 to intravenous nerinetide (2·6 mg/kg) or placebo, each in visually identical vials. Paramedics, hospital care providers, and outcome evaluators were masked to treatment assignment. The primary outcome was good functional outcome on a sliding dichotomy of the modified Rankin Scale at 90 days. Participants were assessed on day 4, 30, and 90 by the stroke center research team, in person or over the telephone. Outcomes, adjusted for age and stroke severity, were evaluated in the modified intention-to-treat (mITT) population, and in the target population of those with acute ischaemic stroke. The safety population included all participants who received the study drug. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> (<span><span>NCT02315443</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>), and trial enrolment has concluded.<h3>Findings</h3>Between March 26, 2015, and March 27, 2023, 532 participants received nerinetide (n=265) or placebo (n=267). The mITT population of suspected stroke (n=507; 254 nerinetide and 253 placebo) included 321 (63%) with acute ischaemic stroke, 93 (18%) with intracranial haemorrhage, 44 (9%) with transient ischaemic attack, and 49 (10%) with stroke-mimicking conditions. Treatment began a median of 64 min (IQR 47–100) from symptom onset. Participants randomly assigned to nerinetide had more severe strokes compared with those receiving placebo (median National Institutes of Health Stroke Scale (NIHSS) 12, IQR 5–19 <em>vs</em> 10, 4–18 in mITT, and 14, 7–19 <em>vs</em> 10, 4–18 in the acute ischaemic stroke subgroup). Overall, 145 (57%) of 254 participants in the nerinetide group and 147 (58%) of 253 in the placebo group had the primary outcome of a favourable functional outcome using th","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-13DOI: 10.1016/s0140-6736(25)00287-9
Richard Horton
No Abstract
{"title":"Offline: Telling the truth about WHO","authors":"Richard Horton","doi":"10.1016/s0140-6736(25)00287-9","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)00287-9","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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