Pub Date : 2026-01-10DOI: 10.1016/j.lanepe.2025.101584
Daniele De Luca , Luca Bonadies , Costanza Neri , Barbara Loi , Teresa Maria Silva-Garcia , Guillermo Ramos Noguera , Laura Vivalda , Giulia Res , Maria de las Nieves Cidoncha-Fuertes , Carlos Baena-Palomino , Lorenzo Zanetto , Luca Vedovelli , Dario Gregori , Eugenio Baraldi , Almudena Alonso-Ojembarrena
Background
We lack data about the early evolution of lung pathophysiology in infants developing moderate-to-severe broncho-pulmonary dysplasia (msBPD). We aimed to describe lung aeration and gas exchange during the early phase of msBPD development and identify the critical moments at which they change.
Methods
Prospective, multicentre, cohort study performed in three European centres enrolling preterm (≤30 weeks’ gestation) infants evaluated at 10, 21, 28 days (D) of life and 34 and 36 weeks (W) post-menstrual age, while receiving as little invasive ventilation as possible. Lung aeration was assessed with quantitative lung ultrasound. Pulse oximetry and transcutaneous blood gas measurements were used to calculate the SpO2/FiO2 and PtcO2/FiO2 ratios. msBPD was defined using NIH-2001, NICHD-2018 and Jensen definitions.
Findings
347 infants were studied, of which 80, 79 and 89 had msBPD, using the three definitions, respectively. Lung aeration and oxygenation were always poorer, since D10, in patients with msBPD than in those without it. The difference in lung aeration (β ranging from +0.009 (95% CI: 0; 0.01) to +0.012 (95% CI: 0.01; 0.02), depending on the used definition, p < 0.001) and carbon dioxide (β ranging from +0.01 (95% CI: 0; 0.02) to +0.014 (95% CI: 0.01; 0.02), depending on the used definition, p < 0.001) between patients with and without msBPD increased overtime. Results were similar regardless of the BPD definition. The strongest discrimination was obtained by the lung aeration evolution (β(t) = 0.227 (95% CI: 0.152, 0.302), p < 0.001) with a peak at 26 days.
Interpretation
Patients who develop msBPD consistently demonstrate early and typical pathophysiological phenotypes regardless of the BPD definition. These data highlight critical moments in the development of msBPD and are not captured by currently available BPD definitions.
Funding
Only institutional funding to support the author's working time was used.
{"title":"Lung aeration and gas exchange in preterm infants developing moderate-to-severe bronchopulmonary dysplasia: a multicentre prospective study from the PATH-BPD cohort","authors":"Daniele De Luca , Luca Bonadies , Costanza Neri , Barbara Loi , Teresa Maria Silva-Garcia , Guillermo Ramos Noguera , Laura Vivalda , Giulia Res , Maria de las Nieves Cidoncha-Fuertes , Carlos Baena-Palomino , Lorenzo Zanetto , Luca Vedovelli , Dario Gregori , Eugenio Baraldi , Almudena Alonso-Ojembarrena","doi":"10.1016/j.lanepe.2025.101584","DOIUrl":"10.1016/j.lanepe.2025.101584","url":null,"abstract":"<div><h3>Background</h3><div>We lack data about the early evolution of lung pathophysiology in infants developing moderate-to-severe broncho-pulmonary dysplasia (msBPD). We aimed to describe lung aeration and gas exchange during the early phase of msBPD development and identify the critical moments at which they change.</div></div><div><h3>Methods</h3><div>Prospective, multicentre, cohort study performed in three European centres enrolling preterm (≤30 weeks’ gestation) infants evaluated at 10, 21, 28 days (D) of life and 34 and 36 weeks (W) post-menstrual age, while receiving as little invasive ventilation as possible. Lung aeration was assessed with quantitative lung ultrasound. Pulse oximetry and transcutaneous blood gas measurements were used to calculate the SpO<sub>2</sub>/FiO<sub>2</sub> and PtcO<sub>2</sub>/FiO<sub>2</sub> ratios. msBPD was defined using NIH-2001, NICHD-2018 and Jensen definitions.</div></div><div><h3>Findings</h3><div>347 infants were studied, of which 80, 79 and 89 had msBPD, using the three definitions, respectively. Lung aeration and oxygenation were always poorer, since D10, in patients with msBPD than in those without it. The difference in lung aeration (β ranging from +0.009 (95% CI: 0; 0.01) to +0.012 (95% CI: 0.01; 0.02), depending on the used definition, <em>p</em> < 0.001) and carbon dioxide (β ranging from +0.01 (95% CI: 0; 0.02) to +0.014 (95% CI: 0.01; 0.02), depending on the used definition, <em>p</em> < 0.001) between patients with and without msBPD increased overtime. Results were similar regardless of the BPD definition. The strongest discrimination was obtained by the lung aeration evolution (β(t) = 0.227 (95% CI: 0.152, 0.302), <em>p</em> < 0.001) with a peak at 26 days.</div></div><div><h3>Interpretation</h3><div>Patients who develop msBPD consistently demonstrate early and typical pathophysiological phenotypes regardless of the BPD definition. These data highlight critical moments in the development of msBPD and are not captured by currently available BPD definitions.</div></div><div><h3>Funding</h3><div>Only institutional funding to support the author's working time was used.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101584"},"PeriodicalIF":13.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927917","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 : 2026-01-09DOI: 10.1016/j.lanepe.2025.101580
Lotte Werner , Vita W. Jongen , Sylvia M. Bruisten , Maarten F. Schim van der Loeff , Elske Hoornenborg , Henry J.C. de Vries , Janneke C.M. Heijne
{"title":"Prioritising meaningful outcomes in the practice evaluation of new chlamydia testing guidelines—Authors’ reply","authors":"Lotte Werner , Vita W. Jongen , Sylvia M. Bruisten , Maarten F. Schim van der Loeff , Elske Hoornenborg , Henry J.C. de Vries , Janneke C.M. Heijne","doi":"10.1016/j.lanepe.2025.101580","DOIUrl":"10.1016/j.lanepe.2025.101580","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101580"},"PeriodicalIF":13.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938790","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 : 2026-01-08DOI: 10.1016/j.lanepe.2025.101581
Rosalie Lear, Shiranee Sriskandan, Tom Parks
{"title":"Viral infections and invasive group a streptococcal disease incidence during 2022–2023","authors":"Rosalie Lear, Shiranee Sriskandan, Tom Parks","doi":"10.1016/j.lanepe.2025.101581","DOIUrl":"10.1016/j.lanepe.2025.101581","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101581"},"PeriodicalIF":13.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938538","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 : 2026-01-08DOI: 10.1016/j.lanepe.2025.101579
Zoïe W. Alexiou , Nicole H.T.M. Dukers-Muijrers
{"title":"Prioritising meaningful outcomes in the practice evaluation of new chlamydia testing guidelines","authors":"Zoïe W. Alexiou , Nicole H.T.M. Dukers-Muijrers","doi":"10.1016/j.lanepe.2025.101579","DOIUrl":"10.1016/j.lanepe.2025.101579","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101579"},"PeriodicalIF":13.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938537","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 : 2026-01-05DOI: 10.1016/j.lanepe.2025.101569
Walter Pirker , Joaquim J. Ferreira , Olivier Rascol , Werner Poewe
Hallucinations and delusions are among the most disabling long-term complications of Parkinson's disease (PD). Their pathogenesis is based on a complex interaction of neurodegeneration in critical areas for visual and cognitive processing and PD medication effects. Management rests on the identification and treatment of acute triggers, simplification of PD medication and treatment with antipsychotics. Despite the high prevalence of psychosis in advanced PD there is still a lack of familiarity with its manifestations and therapeutic approaches. This gap is further enhanced by recent developments in drug availability and therapeutic monitoring. Pimavanserin is the only approved drug for the treatment of PD psychosis in the U.S., but currently not marketed elsewhere. The aim of this review is to provide an update on the management options for PD psychosis in other regions of the world with a focus on clinical practice in Europe. Quetiapine and clozapine remain cornerstones of treatment of PD psychosis in Europe. Despite limited evidence for efficacy, quetiapine is often used as first-line therapy, whereas severe PD psychosis usually requires treatment with clozapine, with clozapine demonstrating efficacy without worsening of motor symptoms in randomised, controlled trials. Other antipsychotics should be avoided in PD psychosis due to their ineffectiveness or high potential for worsening parkinsonian motor symptoms. Novel drugs with a better risk-benefit ratio in the treatment of PD psychosis are needed. Non-pharmacological treatments should be explored in relation to their potential to prevent or mitigate psychotic reactions in prospective studies.
{"title":"Management of Parkinson's disease psychosis—a European perspective","authors":"Walter Pirker , Joaquim J. Ferreira , Olivier Rascol , Werner Poewe","doi":"10.1016/j.lanepe.2025.101569","DOIUrl":"10.1016/j.lanepe.2025.101569","url":null,"abstract":"<div><div>Hallucinations and delusions are among the most disabling long-term complications of Parkinson's disease (PD). Their pathogenesis is based on a complex interaction of neurodegeneration in critical areas for visual and cognitive processing and PD medication effects. Management rests on the identification and treatment of acute triggers, simplification of PD medication and treatment with antipsychotics. Despite the high prevalence of psychosis in advanced PD there is still a lack of familiarity with its manifestations and therapeutic approaches. This gap is further enhanced by recent developments in drug availability and therapeutic monitoring. Pimavanserin is the only approved drug for the treatment of PD psychosis in the U.S., but currently not marketed elsewhere. The aim of this review is to provide an update on the management options for PD psychosis in other regions of the world with a focus on clinical practice in Europe. Quetiapine and clozapine remain cornerstones of treatment of PD psychosis in Europe. Despite limited evidence for efficacy, quetiapine is often used as first-line therapy, whereas severe PD psychosis usually requires treatment with clozapine, with clozapine demonstrating efficacy without worsening of motor symptoms in randomised, controlled trials. Other antipsychotics should be avoided in PD psychosis due to their ineffectiveness or high potential for worsening parkinsonian motor symptoms. Novel drugs with a better risk-benefit ratio in the treatment of PD psychosis are needed. Non-pharmacological treatments should be explored in relation to their potential to prevent or mitigate psychotic reactions in prospective studies.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"62 ","pages":"Article 101569"},"PeriodicalIF":13.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939121","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 : 2026-01-01DOI: 10.1016/j.lanepe.2025.101588
The Lancet Regional Health – Europe
{"title":"5 years of the Lancet Regional Health – Europe: science, equity, and why Europe must lead","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2025.101588","DOIUrl":"10.1016/j.lanepe.2025.101588","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"60 ","pages":"Article 101588"},"PeriodicalIF":13.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924567","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 : 2025-12-29DOI: 10.1016/j.lanepe.2025.101577
Charalabos-Markos Dintsios
{"title":"Primary endpoint acceptance is strongly associated with a positive benefit assessment: a self-fulfilling prophecy","authors":"Charalabos-Markos Dintsios","doi":"10.1016/j.lanepe.2025.101577","DOIUrl":"10.1016/j.lanepe.2025.101577","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101577"},"PeriodicalIF":13.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883338","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 : 2025-12-29DOI: 10.1016/j.lanepe.2025.101574
Rafael Cardoso , Idris Ola , Lina Jansen , Monika Hackl , Petra Ihle , Julie Francart , Nancy Van Damme , Zdravka Valerianova , Trayan Atanasov , Ondřej Májek , Ondřej Ngo , Kaire Innos , Margit Mägi , Sandrine Dabakuyo Yonli , Anne-Sophie Woronoff , Brigitte Tretarre , Florence Poncet , Alexander Katalinic , Paul M. Walsh , Ieva Vincerževskienė , Hermann Brenner
Background
Mammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of screening implementation and age at diagnosis.
Methods
In this population-based study conducted in 21 European countries, data from cancer registries covering over 3 million female patients diagnosed with breast cancer, along with data from national statistical offices from 1978 to 2019 were analysed. Annual age-standardised breast cancer incidence rates (by stage and age at diagnosis) and age-standardised breast cancer mortality rates were calculated. Average annual percent changes (AAPCs) in these metrics within 10 years before and 10 years after screening implementation were estimated.
Findings
Overall, breast cancer incidence rates increased over the study period, with the largest increases observed in the first two decades (1978–1987 and 1988–1997), and AAPCs of up to 4.55 (95% confidence interval, CI, 2.56–6.57). In contrast, breast cancer mortality rates decreased most predominantly in the last two decades (1998–2007 and 2008–2018/19), with AAPCs down to −5.40 (95% CI, −9.70 to −0.89). The largest increases in incidence were seen for in situ and stage I cancers (AAPCs ranging from non-significant to 12.03 (95% CI, 7.40–16.86) following screening implementation). Incidence of stage IV cancer declined or remained stable in most countries, with AAPCs down to −6.16 (95% CI, −8.28 to −4.00) after screening introduction. These trends were particularly pronounced among age groups targeted by screening (mostly 50–69 years). Breast cancer mortality rates declined by up to 3 percent annually after screening initiation (lowest AAPC estimate −3.29 (95% CI, −6.26 to −0.23); yet, AAPCs as low as −2.54 (95% CI, −3.15 to −1.93) were also observed before introduction of screening programmes in countries where implementation occurred later, in the 2000s.
Interpretation
This study suggests that mammography screening has influenced trends in breast cancer incidence and mortality in European countries. The results point to the contribution of mammography screening, alongside advances in diagnostics and treatment, to the observed reductions in breast cancer mortality.
{"title":"Breast cancer incidence, by stage at diagnosis, and mortality in 21 European countries in the era of mammography screening: an international population-based study","authors":"Rafael Cardoso , Idris Ola , Lina Jansen , Monika Hackl , Petra Ihle , Julie Francart , Nancy Van Damme , Zdravka Valerianova , Trayan Atanasov , Ondřej Májek , Ondřej Ngo , Kaire Innos , Margit Mägi , Sandrine Dabakuyo Yonli , Anne-Sophie Woronoff , Brigitte Tretarre , Florence Poncet , Alexander Katalinic , Paul M. Walsh , Ieva Vincerževskienė , Hermann Brenner","doi":"10.1016/j.lanepe.2025.101574","DOIUrl":"10.1016/j.lanepe.2025.101574","url":null,"abstract":"<div><h3>Background</h3><div>Mammography screening programmes have been widely implemented across European countries over the past 40 years with the main aim to detect breast cancer earlier and thereby reduce breast cancer mortality. This study aimed to analyse and compare changes over time in breast cancer incidence, by stage at diagnosis, and breast cancer mortality across countries in relation to the timing of screening implementation and age at diagnosis.</div></div><div><h3>Methods</h3><div>In this population-based study conducted in 21 European countries, data from cancer registries covering over 3 million female patients diagnosed with breast cancer, along with data from national statistical offices from 1978 to 2019 were analysed. Annual age-standardised breast cancer incidence rates (by stage and age at diagnosis) and age-standardised breast cancer mortality rates were calculated. Average annual percent changes (AAPCs) in these metrics within 10 years before and 10 years after screening implementation were estimated.</div></div><div><h3>Findings</h3><div>Overall, breast cancer incidence rates increased over the study period, with the largest increases observed in the first two decades (1978–1987 and 1988–1997), and AAPCs of up to 4.55 (95% confidence interval, CI, 2.56–6.57). In contrast, breast cancer mortality rates decreased most predominantly in the last two decades (1998–2007 and 2008–2018/19), with AAPCs down to −5.40 (95% CI, −9.70 to −0.89). The largest increases in incidence were seen for in situ and stage I cancers (AAPCs ranging from non-significant to 12.03 (95% CI, 7.40–16.86) following screening implementation). Incidence of stage IV cancer declined or remained stable in most countries, with AAPCs down to −6.16 (95% CI, −8.28 to −4.00) after screening introduction. These trends were particularly pronounced among age groups targeted by screening (mostly 50–69 years). Breast cancer mortality rates declined by up to 3 percent annually after screening initiation (lowest AAPC estimate −3.29 (95% CI, −6.26 to −0.23); yet, AAPCs as low as −2.54 (95% CI, −3.15 to −1.93) were also observed before introduction of screening programmes in countries where implementation occurred later, in the 2000s.</div></div><div><h3>Interpretation</h3><div>This study suggests that mammography screening has influenced trends in breast cancer incidence and mortality in European countries. The results point to the contribution of mammography screening, alongside advances in diagnostics and treatment, to the observed reductions in breast cancer mortality.</div></div><div><h3>Funding</h3><div>There was no funding source for this study.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"62 ","pages":"Article 101574"},"PeriodicalIF":13.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885243","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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