Lancet Regional Health-Americas最新文献

英文中文

Mammography does not fit all: the screening controversy in Brazil 乳房x光检查并不适合所有人：巴西的筛查争议

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-08 DOI: 10.1016/j.lana.2025.101367

José Bines , Fabiola Kestelman

引用次数: 0

Incidence rates of twelve chronic diseases/conditions in US adults: findings from a population-based study 美国成年人12种慢性疾病/病症的发病率：一项基于人群的研究结果

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-08 DOI: 10.1016/j.lana.2025.101342

Richard L. Nahin , Termeh Feinberg , Hanna Grol-Prokopczyk , Flavia P. Kapos , Kerri Murray , Remle Scott , Anna Zajacova

Background

There are no contemporary studies simultaneously examining the incidence of multiple chronic diseases/conditions in US adults. We estimated one-year incidence rates for 12 chronic diseases/conditions with high public burden.

Methods

Data were from the nationally representative National Health Interview Survey 2019–2020 Longitudinal Cohort (N = 10,415). We assessed incidence rates for anxiety, arthritis, asthma, cancer, chronic obstructive pulmonary disease (COPD), chronic pain, coronary heart disease (CHD), depression, diabetes, high cholesterol, hypertension, and obesity. We calculated overall and sex-specific age-standardized incidence rates per 1000 person-years (PY) and examined associations with baseline age, sex, race/ethnicity, education, insurance, and smoking status.

Findings

In the sample, 51.7% ([95% CI: 50.3–53.1]; N = 5624, representing 129.7 million adults) were female, 20.5% ([95% CI: 20–22.2]; N = 3405, representing 21.1 million adults) were aged 65+ years, 63.2% ([95% CI: 60.9–65.4]; N = 7495, representing 158.5 million adults) were Non-Hispanic White, 16.5% ([95% CI: 14.7–18.4]; N = 1153, representing 41.5 million adults) were Hispanic/Latino, 28.8% ([95% CI: 27.4–30.2]; N = 4228, representing 72.3 million adults) graduated college, and 72.4 ([95% CI: 70.8–73.9]; N = 7287, representing 167.0 million adults) had private health insurance. One-year incidence rates were lowest for diabetes, COPD and CHD: 13.8/1000 PY (95% CI: 10.8–16.8), 14.4/1000 PY (95% CI: 11.8–17.0), and 14.7/1000 PY (95% CI: 12.7–17.0), respectively. The highest rates were observed for high cholesterol and chronic pain, 85.7/1000 PY (95% CI: 79.4–91.9) and 85.3/1000 PY (95% CI: 78.7–92.0), respectively, while all other rates were between these extremes. Females had higher rates of anxiety (69.6 [95% CI: 60.5–75.7] vs 36.4 [95% CI: 29.8–43.1]) and depression (63.7 [95% CI: 55.1–72.3] vs 34.5 [95% CI: 28.4–40.7]), while males had higher rates of hypertension (77.3 [95% CI: 72.3–82.3] vs 56.5 [95% CI: 48.7–64.3]). Incidence-related risk factors differed across diseases/conditions, with age the most consistent predictor.

Interpretation

This comprehensive assessment documented striking variation in chronic disease/condition incidence. The findings provide essential evidence for prioritizing and coordinating prevention initiatives across the chronic disease/condition spectrum.

Funding

US National Institutes of Health.

背景：目前还没有同时调查美国成人多种慢性疾病/病症发病率的研究。我们估计了12种公共负担高的慢性病/病症的一年发病率。方法数据来自具有全国代表性的《2019-2020年全国健康访谈调查》纵向队列（N = 10,415）。我们评估了焦虑、关节炎、哮喘、癌症、慢性阻塞性肺疾病（COPD）、慢性疼痛、冠心病（CHD）、抑郁、糖尿病、高胆固醇、高血压和肥胖的发病率。我们计算了每1000人年（PY）的总体和性别特异性年龄标准化发病率，并检查了与基线年龄、性别、种族/民族、教育程度、保险和吸烟状况的关系。在样本中，51.7% （[95% CI: 503 - 53.1]; N = 5624，代表1.297亿成年人）为女性，20.5% （[95% CI: 20-22.2]; N = 3405，代表2110万成年人）为65岁以上，63.2% （[95% CI: 60.9-65.4]; N = 7495，代表1.585亿成年人）为非西班牙裔白人，16.5% （[95% CI: 14.7-18.4]; N = 1153，代表4150万成年人）为西班牙裔/拉丁裔，28.8% ([95% CI: 27.4-30.2]；N = 4228，代表7230万成年人)大学毕业，72.4 （[95% CI: 70.8-73.9]; N = 7287，代表1.67亿成年人）拥有私人医疗保险。糖尿病、慢性阻塞性肺病和冠心病的一年发病率最低：分别为13.8/1000 PY （95% CI: 10.8-16.8）、14.4/1000 PY （95% CI: 11.8-17.0）和14.7/1000 PY （95% CI: 12.7-17.0）。高胆固醇和慢性疼痛的发生率最高，分别为85.7/1000 PY （95% CI: 79.4-91.9）和85.3/1000 PY (95% CI: 78.7-92.0)，而所有其他发生率介于这两个极端之间。女性有更高的焦虑率（69.6 [95% CI: 60.5-75.7] vs 36.4 [95% CI: 29.8-43.1]）和抑郁症（63.7 [95% CI: 55.1-72.3] vs 34.5 [95% CI: 28.4-40.7]），而男性有更高的高血压率（77.3 [95% CI: 72.3-82.3] vs 56.5 [95% CI: 48.7-64.3]）。与发病率相关的风险因素因疾病/病症而异，年龄是最一致的预测因素。这项综合评估记录了慢性疾病/病症发生率的显著差异。研究结果为确定慢性病/病症范围内预防措施的优先次序和协调提供了重要证据。资助美国国立卫生研究院。

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引用次数: 0

Prenatal and intrapartum antibiotic exposure and childhood infections: considerations and complexities 产前和产时抗生素暴露和儿童感染：考虑和复杂性

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-07 DOI: 10.1016/j.lana.2025.101368

Isobel M.F. Todd , David P. Burgner , Maria C. Magnus , Lars Henning Pedersen , Jessica E. Miller

引用次数: 0

Impact and scope of Mexican clinical practice guideline for adult overweight and obesity on weight stigma 墨西哥成人超重和肥胖临床实践指南对体重污名的影响和范围

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-07 DOI: 10.1016/j.lana.2025.101366

Emma Chávez-Manzanera , Verónica Vázquez-Velázquez

引用次数: 0

An undeniable public health urgency, but an incomplete response: centering racial and ethnic equity in Canada's “Strategic approaches to reducing the substance use-related burden of disease” 不可否认的公共卫生紧迫性，但不完整的回应：将种族和族裔平等作为加拿大“减少药物使用相关疾病负担的战略方针”的中心

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-07 DOI: 10.1016/j.lana.2025.101370

Jude Mary Cénat , Idrissa Beogo , Monnica Williams , Smita Pakhale

引用次数: 0

US emergency department visits by women due to assault (2018–2021): a retrospective cross-sectional analysis 2018-2021年美国女性因性侵就诊急诊：回顾性横断面分析

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-06 DOI: 10.1016/j.lana.2025.101343

Summer Chavez , Irma Ugalde , Michael Ulrich , Omolola Adepoju , Tonghui Xu , Winston Liaw

Background

Domestic violence has played a key role in linking firearms and homicide amongst female individuals. Combined with the increase of reports of violence against women during the COVID-19 pandemic, a rise in emergency department (ED) visits may be witnessed. Our aim was to estimate the changes in prevalence and risk factors associated with assault and firearm-related emergency department (ED) visits by female patients following the COVID-19 pandemic.

Methods

We performed a retrospective cross-sectional study of female patients presenting to EDs due to assault from the National Emergency Department Sample (NEDS) from 2018 to 2021. Independent variables included age, race, mortality, ED disposition, primary payer, location, mean total ED chargers, quartile ZIP income, and mechanism and intent of injury. The adjusted association between independent variables and ED visits among patients injured by firearms compared to those injured by other assaults was examined.

Findings

The analytic sample represented an estimated 1,575,543 ED weighted records of female assault cases out of a total weighted sample of 537,133,200 observations (0.29%). While year-over-year ED encounters decreased, firearm injuries and the proportion of patients admitted and dying in the hospital increased. Female patients who were injured by firearms had 89 times higher risk of dying in the ED (RR = 88.82; 95% CI 6 = 72.38–97.06) compared to female patients injured by non-firearm injury mechanisms. Racial disparities were prevalent, with Native American women experiencing the greatest risk of being assaulted (RR = 2.81; 95% CI 2.67–2.97). Victims of firearm related assaults had nearly 4.12 times the risk of identifying as Black compared with those assaulted without firearms (95% CI 3.75–4.52). Female patients seeking care for assault had higher risk of being uninsured (95% CI 2.70–2.77).

Interpretation

While year-over-year ED encounters due to assault decreased, lockdowns and restrictions associated with the observed COVID-19 pandemic may not fully reflect changes in abuse rates in this time period. The strong connection between firearm presence and female homicide and continuations of assault and firearm-related ED visits among vulnerable demographic groups highlights the need for effective strategies to reduce violence.

Funding

Unfunded.

家庭暴力在将枪支与女性杀人联系起来方面发挥了关键作用。在2019冠状病毒病大流行期间，暴力侵害妇女行为的报告有所增加，因此急诊就诊人数可能会增加。我们的目的是估计2019冠状病毒病大流行后女性患者攻击和枪支相关急诊科（ED）就诊的患病率和风险因素的变化。方法：我们对2018年至2021年国家急诊科样本（NEDS）中因攻击而就诊的女性患者进行了回顾性横断面研究。独立变量包括年龄、种族、死亡率、急症处置、主要付款人、地点、平均急症总收费人、四分位数ZIP收入、机制和伤害意图。与其他袭击受伤的患者相比，受火器伤害的患者与急诊室就诊之间的调整后的自变量之间的关联进行了检查。分析样本代表了537,133,200个观察的总加权样本（0.29%）中约1,575,543个女性性侵案件的ED加权记录。虽然急诊病例逐年减少，但火器伤害以及住院和死亡的患者比例却有所增加。女性火器伤患者急诊死亡风险是非火器伤女性患者的89倍（RR = 88.82; 95% CI 6 = 72.38 ~ 97.06）。种族差异普遍存在，美洲原住民妇女遭受侵犯的风险最大（RR = 2.81; 95% CI 2.67-2.97）。与没有枪支的受害者相比，枪支相关袭击的受害者被认定为黑人的风险近4.12倍（95% CI 3.75-4.52）。因遭受袭击而寻求治疗的女性患者没有保险的风险更高（95% CI 2.70-2.77）。虽然因袭击而导致的急诊事件逐年减少，但与观察到的COVID-19大流行相关的封锁和限制可能无法完全反映这一时期虐待率的变化。在弱势群体中，枪支的存在与女性杀人、持续的攻击和与枪支有关的急诊科就诊之间存在着密切的联系，这突出表明需要制定有效的战略来减少暴力。

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引用次数: 0

Brazil's health tax at a crossroads: safeguarding the constitutional victory against ultra-processed foods 巴西的健康税正处于十字路口：捍卫反对超加工食品的宪法胜利

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-02 DOI: 10.1016/j.lana.2025.101363

Felipe Silva Neves , Larissa Loures Mendes , Eduardo Augusto Fernandes Nilson , Inês Rugani Ribeiro de Castro , Rafael Moreira Claro , Daniela Silva Canella , Ísis Eloah Machado , Ariene Silva do Carmo , Mariana Carvalho de Menezes , Deborah Carvalho Malta

引用次数: 0

Beyond encampments: an evidence-based path to solving Canada's homelessness crisis 超越营地：解决加拿大无家可归危机的循证之路

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-02 DOI: 10.1016/j.lana.2025.101362

Mohammad Karamouzian , Stephen W. Hwang , Dan Werb

引用次数: 0

E-cigarettes versus combination nicotine replacement therapy following a recent failed quit attempt: a pragmatic randomized trial through state tobacco quitlines 在最近一次戒烟尝试失败后，电子烟与联合尼古丁替代疗法：一项通过州烟草戒烟热线进行的实用随机试验

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-02 DOI: 10.1016/j.lana.2025.101351

Theodore L. Wagener , Alice Hinton , Theodore M. Brasky , Yoo Jin Cho , Laura A. Beebe , Michael S. Businelle , Matthew J. Carpenter , Jonathan Hart , Katrina A. Vickerman

Background

E-cigarettes have emerged as a potentially more effective and satisfying alternative to nicotine replacement therapy (NRT) for smokers who struggle to quit. Although quitlines are effective platforms for tobacco cessation, they have not incorporated e-cigarettes due to regulatory concerns and limited clinical evidence. We evaluated whether quitline-delivered counseling combined with e-cigarettes was more effective than counseling with NRT among adults who recently failed to quit using standard quitline services.

Methods

We conducted a pragmatic, open-label, parallel-group randomised controlled trial with two U.S. state quitlines between October 2020 and January 2023. Adults [N = 350; 212 (61%) female & 248 (72%) white] who were still smoking after a recent quitline enrollment were randomised (1:1) to receive 8 weeks of either JUUL e-cigarettes or a combination of nicotine patch and lozenge, along with three counseling calls. The primary outcome was biochemically verified 7-day point prevalence smoking abstinence (7-day PPA) at 8 weeks. Analyses used an intent-to-treat approach; secondary outcomes included 12-week abstinence, prolonged abstinence, changes in smoking behavior, dependence, and adverse effects.

Findings

At 8 weeks, 7-day PPA did not differ significantly between e-cigarette and NRT groups [25 (14.3%) of 175 and 17 (9.7%) of 175, respectively; OR 1.56; 95% CI 0.80–3.04; p = 0.19]. Both groups showed similar reductions in cigarette use and dependence. Adherence to counseling and assigned products was high. Adverse events were generally mild; cough and breathing difficulties were more frequently reported in the e-cigarette group and NRT participants reported more dizziness, sleeplessness, and allergies.

Interpretation

Among quitline users with a recent failed quit attempt, e-cigarettes combined with quitline counseling were not more effective than combination NRT in increasing smoking abstinence after 8 weeks’ follow-up.

Funding

U.S. National Institute on Drug Abuse.

对于那些努力戒烟的人来说，de -香烟已经成为尼古丁替代疗法（NRT）潜在的更有效、更令人满意的替代品。虽然戒烟热线是戒烟的有效平台，但由于监管方面的考虑和有限的临床证据，它们并没有纳入电子烟。我们评估了在最近使用标准戒烟热线服务戒烟失败的成年人中，戒烟热线提供的咨询与电子烟结合是否比NRT更有效。方法：我们在2020年10月至2023年1月期间对美国两条州戒烟线进行了一项实用、开放标签、平行组随机对照试验。成人[N = 350；在最近的戒烟热线登记后，仍在吸烟的212名（61%）女性（248名（72%）白人）被随机分成（1:1）组，接受8周的JUUL电子烟或尼古丁贴片和锭剂的组合，同时还有3个咨询电话。主要终点是8周时经生化验证的7天点流行戒烟（7天PPA）。分析采用意向治疗法；次要结局包括12周戒烟、长期戒烟、吸烟行为的改变、依赖和不良反应。结果发现，在8周，7天的PPA在电子烟组和NRT组之间没有显著差异[175人中分别有25人（14.3%）和17人（9.7%）；或1.56;95% ci 0.80-3.04；P = 0.19]。两组人在吸烟和对香烟的依赖方面都有相似的减少。对咨询和指定产品的依从性很高。不良事件一般轻微；电子烟组更频繁地报告咳嗽和呼吸困难，NRT参与者报告更多的头晕、失眠和过敏。解释：在最近戒烟失败的戒烟热线使用者中，经过8周的随访，电子烟联合戒烟热线咨询在增加戒烟方面并不比联合NRT更有效。国家药物滥用研究所。

{"title":"E-cigarettes versus combination nicotine replacement therapy following a recent failed quit attempt: a pragmatic randomized trial through state tobacco quitlines","authors":"Theodore L. Wagener , Alice Hinton , Theodore M. Brasky , Yoo Jin Cho , Laura A. Beebe , Michael S. Businelle , Matthew J. Carpenter , Jonathan Hart , Katrina A. Vickerman","doi":"10.1016/j.lana.2025.101351","DOIUrl":"10.1016/j.lana.2025.101351","url":null,"abstract":"<div><h3>Background</h3><div>E-cigarettes have emerged as a potentially more effective and satisfying alternative to nicotine replacement therapy (NRT) for smokers who struggle to quit. Although quitlines are effective platforms for tobacco cessation, they have not incorporated e-cigarettes due to regulatory concerns and limited clinical evidence. We evaluated whether quitline-delivered counseling combined with e-cigarettes was more effective than counseling with NRT among adults who recently failed to quit using standard quitline services.</div></div><div><h3>Methods</h3><div>We conducted a pragmatic, open-label, parallel-group randomised controlled trial with two U.S. state quitlines between October 2020 and January 2023. Adults [N = 350; 212 (61%) female & 248 (72%) white] who were still smoking after a recent quitline enrollment were randomised (1:1) to receive 8 weeks of either JUUL e-cigarettes or a combination of nicotine patch and lozenge, along with three counseling calls. The primary outcome was biochemically verified 7-day point prevalence smoking abstinence (7-day PPA) at 8 weeks. Analyses used an intent-to-treat approach; secondary outcomes included 12-week abstinence, prolonged abstinence, changes in smoking behavior, dependence, and adverse effects.</div></div><div><h3>Findings</h3><div>At 8 weeks, 7-day PPA did not differ significantly between e-cigarette and NRT groups [25 (14.3%) of 175 and 17 (9.7%) of 175, respectively; OR 1.56; 95% CI 0.80–3.04; p = 0.19]. Both groups showed similar reductions in cigarette use and dependence. Adherence to counseling and assigned products was high. Adverse events were generally mild; cough and breathing difficulties were more frequently reported in the e-cigarette group and NRT participants reported more dizziness, sleeplessness, and allergies.</div></div><div><h3>Interpretation</h3><div>Among quitline users with a recent failed quit attempt, e-cigarettes combined with quitline counseling were not more effective than combination NRT in increasing smoking abstinence after 8 weeks’ follow-up.</div></div><div><h3>Funding</h3><div>U.S. <span>National Institute on Drug Abuse</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"54 ","pages":"Article 101351"},"PeriodicalIF":7.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884386","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}

引用次数: 0

Unique role of the prospective cohort incident-tumor biobank method in etiological research 前瞻性队列事件肿瘤生物库方法在病因学研究中的独特作用

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas

Pub Date : 2026-01-01 DOI: 10.1016/j.lana.2025.101290

Shuji Ogino , Alpa V. Patel , Satoko Ugai , Marios Giannakis , Tomotaka Ugai

引用次数: 0

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