Pub Date : 2026-02-05DOI: 10.1016/s0140-6736(26)00251-5
Susan Jaffe
{"title":"Millions of Americans lose health insurance as COVID-19 era subsidies end","authors":"Susan Jaffe","doi":"10.1016/s0140-6736(26)00251-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00251-5","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134575","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 : 2026-02-05DOI: 10.1016/s0140-6736(26)00249-7
{"title":"Venezuela: health beyond the political turmoil","authors":"","doi":"10.1016/s0140-6736(26)00249-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00249-7","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134313","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 : 2026-02-05DOI: 10.1016/s0140-6736(26)00203-5
Sammer Marzouk, Alaha Nasari, Antonio Trujillo, Paul B Spiegel
{"title":"Venezuela's health system: when force meets fragility","authors":"Sammer Marzouk, Alaha Nasari, Antonio Trujillo, Paul B Spiegel","doi":"10.1016/s0140-6736(26)00203-5","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00203-5","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134309","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 : 2026-02-05DOI: 10.1016/s0140-6736(25)02504-8
Nicholas J Wald, Aroon D Hingorani, Joan K Morris
{"title":"Simplifying and improving heart attack and stroke prevention","authors":"Nicholas J Wald, Aroon D Hingorani, Joan K Morris","doi":"10.1016/s0140-6736(25)02504-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)02504-8","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134311","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 : 2026-02-05DOI: 10.1016/s0140-6736(25)02506-1
Hady Ghanem, Michele Cherfane
No Abstract
没有抽象的
{"title":"Improving cancer surveillance and global cancer burden estimates","authors":"Hady Ghanem, Michele Cherfane","doi":"10.1016/s0140-6736(25)02506-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)02506-1","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129487","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 : 2026-02-05DOI: 10.1016/s0140-6736(26)00026-7
Nelson Wang, Abdul Salam, Anthony Rodgers
No Abstract
没有抽象的
{"title":"Simplifying and improving heart attack and stroke prevention – Authors' reply","authors":"Nelson Wang, Abdul Salam, Anthony Rodgers","doi":"10.1016/s0140-6736(26)00026-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00026-7","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129509","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 : 2026-02-05DOI: 10.1016/s0140-6736(25)02167-1
Vicente Estrada, Noemi Cabello-Clotet
{"title":"Beyond integrase: the rise of doravirine and islatravir in HIV management","authors":"Vicente Estrada, Noemi Cabello-Clotet","doi":"10.1016/s0140-6736(25)02167-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)02167-1","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134314","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 : 2026-02-04DOI: 10.1016/s0140-6736(26)00097-8
Joseph P Broderick, Andrew M Naidech, Jordan J Elm, Kazunori Toyoda, Dar Dowlatshahi, Andrew M Demchuk, Pooja Khatri, Thorsten Steiner, Philip M Bath, Heinrich J Audebert, Achala Vagal, Sohei Yoshimura, Stephan A Mayer, Lily L Wang, Noor Sabagha, J D Mocco, Carlos Molina, Richard Aviv, Emily Stinson, Syed A Quadri, Francisco Purroy
<h3>Background</h3>Recombinant factor VIIa has been shown to slow bleeding in patients with intracerebral haemorrhage (ICH), but no haemostatic agent has been shown to improve clinical outcomes. We aimed to evaluate the safety, clinical efficacy, and effect on growth of ICH and intraventricular haemorrhage (IVH) of recombinant factor VIIa in patients with acute spontaneous ICH who were most likely to benefit from treatment with this agent.<h3>Methods</h3>We conducted a multicentre, prospective, double-blind, randomised, placebo-controlled, adaptive, phase 3 trial (FASTEST) at 93 sites across the USA, Japan, Canada, Spain, Germany, and the UK. Adults aged 18–80 years with a spontaneous ICH of 2–60 mL, IVH in less than two-thirds of one lateral ventricle or in less than a third of both lateral ventricles, a Glasgow Coma Scale score of at least 8, no evidence of recent ischaemic stroke or myocardial infarction, no recent use of anticoagulation medication or other structural cause of ICH, and who had been treated with study medication within 2 h of stroke onset or last known well were eligible for inclusion. Patients were randomly assigned (1:1) by a simple randomisation scheme to either 80 μg/kg recombinant factor VIIa (intervention group) or an identical placebo (placebo group), administered intravenously over 2 min. All investigators and participants were masked to allocated group assignment. The primary outcome was functional outcome at 180 days, measured by modified Rankin Scale (mRS; score 0–2, 3, and 4–6) and analysed by intention to treat in all randomly assigned patients. The primary safety outcome was life-threatening thromboembolic events during the first 4 days, assessed in all randomly assigned participants. The secondary aim was change in ICH volume and ICH plus IVH volume between baseline and 24 h of treatment administration. We performed an ordinal logistic regression, adjusted for age, baseline ICH volume, baseline IVH volume, and pre-stroke mRS. Preplanned interim analyses, including adaptive sample size re-estimation and enrichment to a younger subgroup (aged ≤70 years), were also conducted. This trial 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>NCT03496883</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 is closed to new participants.<h3>Findings</h3>Between Dec 3, 2021, and Oct 1, 2025, we screened 3288 patients, of whom 626 participants were randomly assigned and included in the intention-to-treat analyses: 298 (48%) in the placebo group and 328 (52%) in the intervention group. 216 (35%) participants were female and 410 (65%) were male,
合并因子VIIa已被证明可以减缓脑出血（ICH）患者的出血，但没有止血药物被证明可以改善临床结果。我们的目的是评估重组VIIa因子在急性自发性脑出血患者中的安全性、临床疗效和对脑出血生长和脑室内出血（IVH）的影响，这些患者最有可能从该药物的治疗中获益。方法：我们在美国、日本、加拿大、西班牙、德国和英国的93个地点进行了一项多中心、前瞻性、双盲、随机、安慰剂对照、适应性的3期试验（FASTEST）。18 - 80岁的成年人的自发我2-60 mL, IVH不到三分之二的一个侧脑室或不到三分之一的两个侧脑室,格拉斯哥昏迷评分分数至少8,没有证据表明最近的缺血性中风或心肌梗塞,最近没有使用抗凝药物或其他我的结构性原因,曾接受研究药物发病2 h内的或最后都有资格列入。采用简单随机方案，将患者按1:1的比例随机分配至80 μg/kg重组VIIa（干预组）或相同的安慰剂（安慰剂组），静脉注射2分钟以上。所有的调查人员和参与者都被蒙面进行分组分配。在所有随机分配的患者中，主要结局是180天的功能结局，采用改良Rankin量表（mRS评分0-2、3和4-6）测量，并通过治疗意向进行分析。在所有随机分配的参与者中，主要的安全性结果是头4天危及生命的血栓栓塞事件。次要目的是在基线和治疗24小时之间脑出血体积和脑出血加IVH体积的变化。我们进行了有序逻辑回归，调整了年龄、基线ICH体积、基线IVH体积和卒中前mRS.，并进行了预先计划的中期分析，包括适应性样本量重新估计和充实到更年轻的亚组（年龄≤70岁）。该试验已在ClinicalTrials.gov注册（NCT03496883），并对新参与者关闭。在2021年12月3日至2025年10月1日期间，我们筛选了3288名患者，其中626名参与者被随机分配并纳入意向治疗分析：安慰剂组298名（48%），干预组328名（52%）。216名（35%）参与者为女性，410名（65%）参与者为男性，平均年龄为61岁（SD 12）。从中风发作到给药的平均时间为100分钟（SD 22）。在第二次中期分析中，该试验符合预先规定的无效停止标准。干预组和安慰剂组在180天mRS的主要临床结局指标上没有差异（校正共同优势比1.09 [95% CI 0.79 - 1.51]; p= 0.61）。干预组15例（5%）和安慰剂组4例（1%）发生了4天内危及生命的血栓栓塞并发症（相对危险度3.41 [95% CI 1.14 - 10.15]; p= 0.020）。与安慰剂相比，重组VIIa因子与基线和24小时CT扫描期间脑出血（- 3.7 mL [95% CI - 5.4至- 1.9]）和脑出血合并IVH生长（- 5.2 mL[- 7.6至- 2.8]）的减少有关。解释在脑出血发病后2小时内给予重组VIIa因子减缓了血肿的生长，但没有改善功能结局，并显示危及生命的血栓栓塞并发症的风险略有增加。重组VIIa因子在持续出血风险最大的患者中的进一步检测正在进行中。资助：国家神经疾病和中风研究所、日本医学研究与开发机构和诺和诺德。
{"title":"Recombinant factor VIIa versus placebo for spontaneous intracerebral haemorrhage within 2 h of symptom onset (FASTEST): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial","authors":"Joseph P Broderick, Andrew M Naidech, Jordan J Elm, Kazunori Toyoda, Dar Dowlatshahi, Andrew M Demchuk, Pooja Khatri, Thorsten Steiner, Philip M Bath, Heinrich J Audebert, Achala Vagal, Sohei Yoshimura, Stephan A Mayer, Lily L Wang, Noor Sabagha, J D Mocco, Carlos Molina, Richard Aviv, Emily Stinson, Syed A Quadri, Francisco Purroy","doi":"10.1016/s0140-6736(26)00097-8","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00097-8","url":null,"abstract":"<h3>Background</h3>Recombinant factor VIIa has been shown to slow bleeding in patients with intracerebral haemorrhage (ICH), but no haemostatic agent has been shown to improve clinical outcomes. We aimed to evaluate the safety, clinical efficacy, and effect on growth of ICH and intraventricular haemorrhage (IVH) of recombinant factor VIIa in patients with acute spontaneous ICH who were most likely to benefit from treatment with this agent.<h3>Methods</h3>We conducted a multicentre, prospective, double-blind, randomised, placebo-controlled, adaptive, phase 3 trial (FASTEST) at 93 sites across the USA, Japan, Canada, Spain, Germany, and the UK. Adults aged 18–80 years with a spontaneous ICH of 2–60 mL, IVH in less than two-thirds of one lateral ventricle or in less than a third of both lateral ventricles, a Glasgow Coma Scale score of at least 8, no evidence of recent ischaemic stroke or myocardial infarction, no recent use of anticoagulation medication or other structural cause of ICH, and who had been treated with study medication within 2 h of stroke onset or last known well were eligible for inclusion. Patients were randomly assigned (1:1) by a simple randomisation scheme to either 80 μg/kg recombinant factor VIIa (intervention group) or an identical placebo (placebo group), administered intravenously over 2 min. All investigators and participants were masked to allocated group assignment. The primary outcome was functional outcome at 180 days, measured by modified Rankin Scale (mRS; score 0–2, 3, and 4–6) and analysed by intention to treat in all randomly assigned patients. The primary safety outcome was life-threatening thromboembolic events during the first 4 days, assessed in all randomly assigned participants. The secondary aim was change in ICH volume and ICH plus IVH volume between baseline and 24 h of treatment administration. We performed an ordinal logistic regression, adjusted for age, baseline ICH volume, baseline IVH volume, and pre-stroke mRS. Preplanned interim analyses, including adaptive sample size re-estimation and enrichment to a younger subgroup (aged ≤70 years), were also conducted. This trial 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>NCT03496883</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 is closed to new participants.<h3>Findings</h3>Between Dec 3, 2021, and Oct 1, 2025, we screened 3288 patients, of whom 626 participants were randomly assigned and included in the intention-to-treat analyses: 298 (48%) in the placebo group and 328 (52%) in the intervention group. 216 (35%) participants were female and 410 (65%) were male, ","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129482","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 : 2026-02-03DOI: 10.1016/s0140-6736(26)00245-x
{"title":"Expression of Concern: Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother","authors":"","doi":"10.1016/s0140-6736(26)00245-x","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00245-x","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146110023","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：