Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101065
Zhiwei Xu
{"title":"Increased risk of cardiopulmonary mortality during hot weather: well-designed health impact assessments to inform heat adaptation strategies","authors":"Zhiwei Xu","doi":"10.1016/j.lanepe.2024.101065","DOIUrl":"10.1016/j.lanepe.2024.101065","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101065"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571598","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}
Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101119
The Lancet Regional Health – Europe
{"title":"Why is alcohol so normalised in Europe?","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2024.101119","DOIUrl":"10.1016/j.lanepe.2024.101119","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101119"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571891","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}
Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101063
Oriol Mirallas , Berta Martin-Cullell , Víctor Navarro , Kreina Sharela Vega , Jordi Recuero-Borau , Diego Gómez-Puerto , Daniel López-Valbuena , Clara Salva de Torres , Laura Andurell , Anna Pedrola , Roger Berché , Fiorella Palmas , José María Ucha , Guillermo Villacampa , Alejandra Rezqallah , Judit Sanz-Beltran , Rafael Bach , Sergio Bueno , Cristina Viaplana , Gaspar Molina , Joan Carles
Background
Prognostic factors for ambulatory oncology patients have been described, including Eastern Cooperative Oncology Group (ECOG), tumor stage and malnutrition. However, there is no firm evidence on which variables best predict mortality in hospitalized patients receiving active systemic treatment. Our main goal was to develop a predictive model for 90-day mortality upon admission.
Methods
Between 2020 and 2022, we prospectively collected data from three sites for cancer patients with hospitalizations. Those with metastatic disease receiving systemic therapy in the 6 months before unplanned admission were eligible to this study. The least absolute shrinkage and selection operator (LASSO) method was used to select the most relevant factors to predict 90-day mortality at admission. A multivariable logistic regression was fitted to create the PROgnostic Score for Hospitalized Cancer Patients (PROMISE) score. The score was developed in a single-center training cohort and externally validated.
Findings
Of 1658 hospitalized patients, 1009 met eligibility criteria. Baseline demographics, patient and disease characteristics were similar across cohorts. Lung cancer was the most common tumor type in both cohorts. Factors associated with higher 90-day mortality included worse ECOG, stable/progressive disease, low levels of albumin, increased absolute neutrophil count, and high lactate dehydrogenase. The c-index after bootstrap correction was 0.79 (95% CI, 0.75–0.82) and 0.74 (95% CI, 0.68–0.80) in the training and validation cohorts, respectively. A web tool (https://promise.vhio.net/) was developed to facilitate the clinical deployment of the model.
Interpretation
The PROMISE tool demonstrated high performance for identifying metastatic cancer patients who are alive 90 days after an unplanned hospitalization. This will facilitate healthcare providers with rational clinical decisions and care planning after discharge.
{"title":"Development of a prognostic model to predict 90-day mortality in hospitalised cancer patients (PROMISE tool): a prospective observational study","authors":"Oriol Mirallas , Berta Martin-Cullell , Víctor Navarro , Kreina Sharela Vega , Jordi Recuero-Borau , Diego Gómez-Puerto , Daniel López-Valbuena , Clara Salva de Torres , Laura Andurell , Anna Pedrola , Roger Berché , Fiorella Palmas , José María Ucha , Guillermo Villacampa , Alejandra Rezqallah , Judit Sanz-Beltran , Rafael Bach , Sergio Bueno , Cristina Viaplana , Gaspar Molina , Joan Carles","doi":"10.1016/j.lanepe.2024.101063","DOIUrl":"10.1016/j.lanepe.2024.101063","url":null,"abstract":"<div><h3>Background</h3><div>Prognostic factors for ambulatory oncology patients have been described, including Eastern Cooperative Oncology Group (ECOG), tumor stage and malnutrition. However, there is no firm evidence on which variables best predict mortality in hospitalized patients receiving active systemic treatment. Our main goal was to develop a predictive model for 90-day mortality upon admission.</div></div><div><h3>Methods</h3><div>Between 2020 and 2022, we prospectively collected data from three sites for cancer patients with hospitalizations. Those with metastatic disease receiving systemic therapy in the 6 months before unplanned admission were eligible to this study. The least absolute shrinkage and selection operator (LASSO) method was used to select the most relevant factors to predict 90-day mortality at admission. A multivariable logistic regression was fitted to create the PROgnostic Score for Hospitalized Cancer Patients (PROMISE) score. The score was developed in a single-center training cohort and externally validated.</div></div><div><h3>Findings</h3><div>Of 1658 hospitalized patients, 1009 met eligibility criteria. Baseline demographics, patient and disease characteristics were similar across cohorts. Lung cancer was the most common tumor type in both cohorts. Factors associated with higher 90-day mortality included worse ECOG, stable/progressive disease, low levels of albumin, increased absolute neutrophil count, and high lactate dehydrogenase. The c-index after bootstrap correction was 0.79 (95% CI, 0.75–0.82) and 0.74 (95% CI, 0.68–0.80) in the training and validation cohorts, respectively. A web tool (<span><span>https://promise.vhio.net/</span><svg><path></path></svg></span>) was developed to facilitate the clinical deployment of the model.</div></div><div><h3>Interpretation</h3><div>The PROMISE tool demonstrated high performance for identifying metastatic cancer patients who are alive 90 days after an unplanned hospitalization. This will facilitate healthcare providers with rational clinical decisions and care planning after discharge.</div></div><div><h3>Funding</h3><div><span>Merck S.L.U.</span>, Spain.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101063"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572318","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}
Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101067
William Bernal , Rhiannon Taylor , Ian A. Rowe , Abhishek Chauhan , Matthew J. Armstrong , Michael E.D. Allison , Gwilym Webb , Tasneem Pirani , Joanna Moore , Laura Burke , Steven Masson , David Cressy , Brian J. Hogan , Rachel Westbrook , Rajiv Jalan , Kenneth J. Simpson , John Isaac , Douglas Thorburn
Background
Acute on Chronic Liver Failure (ACLF) complicates chronic liver disease (CLD) combining rapidly progressive hepatic with extra-hepatic multiple organ failure and high short-term mortality. Effective therapeutic options are very limited, and liver transplantation (LT) seldom utilised through concerns of high recipient mortality and resource use. Retrospective reports suggest recent outcomes may have improved, but use of LT for ACLF has not been prospectively assessed.
Methods
A prospective programme of prioritised liver graft allocation for selected recipients with ACLF through registration on a new national tier, initiated in May 2021 in all 7 United Kingdom LT centres. Candidates were selected by centre multidisciplinary teams, with inclusion criteria mandating cirrhotic CLD with ACLF requiring critical care (CC) organ support and expected 1-month mortality >50%. Exclusion criteria included age ≥60 years, previous LT, comorbidity or substance misuse profile precluding elective LT. A pilot 50 registrations were planned, with pre-specified futility criteria of a 1-year post-LT survival of 60%.
Findings
Fifty-two patients were registered on the ACLF tier, median (IQR) age 46 (39–52) years, ACLF grade 3 (3–3) and Model for End-stage Liver Disease (MELD) 39 (35–40). At registration 32 (62%) required mechanical ventilation, 44 (85%) vasopressors and 46 (89%) renal replacement. Forty-two (81%) underwent LT 2 (2–5) days after registration: 10 (19%) did not. All non-transplanted died at median 7 (4–13) days after registration (p < 0.0001 vs. LT). Post-LT follow-up was 212 (119–530) days and patient survival 81% (95% CI 66–91): 28-, 90-day and 1-year survival after registration 93%, 86% and 77%. Median length of CC and hospital stay in LT recipients was 16 (8–28) and 35 (23–54) days respectively.
Interpretation
We report the first prospective national series of prioritised liver transplantation for critically ill patients with ACLF. For selected recipients LT is a practical and highly effective treatment option where no other similarly effective interventions exist.
{"title":"Liver transplantation for critically ill patients with acute on chronic liver failure: a prospective national programme of waitlist prioritisation","authors":"William Bernal , Rhiannon Taylor , Ian A. Rowe , Abhishek Chauhan , Matthew J. Armstrong , Michael E.D. Allison , Gwilym Webb , Tasneem Pirani , Joanna Moore , Laura Burke , Steven Masson , David Cressy , Brian J. Hogan , Rachel Westbrook , Rajiv Jalan , Kenneth J. Simpson , John Isaac , Douglas Thorburn","doi":"10.1016/j.lanepe.2024.101067","DOIUrl":"10.1016/j.lanepe.2024.101067","url":null,"abstract":"<div><h3>Background</h3><div>Acute on Chronic Liver Failure (ACLF) complicates chronic liver disease (CLD) combining rapidly progressive hepatic with extra-hepatic multiple organ failure and high short-term mortality. Effective therapeutic options are very limited, and liver transplantation (LT) seldom utilised through concerns of high recipient mortality and resource use. Retrospective reports suggest recent outcomes may have improved, but use of LT for ACLF has not been prospectively assessed.</div></div><div><h3>Methods</h3><div>A prospective programme of prioritised liver graft allocation for selected recipients with ACLF through registration on a new national tier, initiated in May 2021 in all 7 United Kingdom LT centres. Candidates were selected by centre multidisciplinary teams, with inclusion criteria mandating cirrhotic CLD with ACLF requiring critical care (CC) organ support and expected 1-month mortality >50%. Exclusion criteria included age ≥60 years, previous LT, comorbidity or substance misuse profile precluding elective LT. A pilot 50 registrations were planned, with pre-specified futility criteria of a 1-year post-LT survival of 60%.</div></div><div><h3>Findings</h3><div>Fifty-two patients were registered on the ACLF tier, median (IQR) age 46 (39–52) years, ACLF grade 3 (3–3) and Model for End-stage Liver Disease (MELD) 39 (35–40). At registration 32 (62%) required mechanical ventilation, 44 (85%) vasopressors and 46 (89%) renal replacement. Forty-two (81%) underwent LT 2 (2–5) days after registration: 10 (19%) did not. All non-transplanted died at median 7 (4–13) days after registration (p < 0.0001 vs. LT). Post-LT follow-up was 212 (119–530) days and patient survival 81% (95% CI 66–91): 28-, 90-day and 1-year survival after registration 93%, 86% and 77%. Median length of CC and hospital stay in LT recipients was 16 (8–28) and 35 (23–54) days respectively.</div></div><div><h3>Interpretation</h3><div>We report the first prospective national series of prioritised liver transplantation for critically ill patients with ACLF. For selected recipients LT is a practical and highly effective treatment option where no other similarly effective interventions exist.</div></div><div><h3>Funding</h3><div>There was no funding for the study.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101067"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572319","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}
Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101059
Andrea Poli, Franca Marangoni
{"title":"Nutri-score and cardiovascular risk: new insights from the EPIC cohorts","authors":"Andrea Poli, Franca Marangoni","doi":"10.1016/j.lanepe.2024.101059","DOIUrl":"10.1016/j.lanepe.2024.101059","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101059"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571600","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}
Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101087
Daniela Marín-Hernández, Ivana Nedic
{"title":"European Society for Medical Oncology (ESMO) congress 2024","authors":"Daniela Marín-Hernández, Ivana Nedic","doi":"10.1016/j.lanepe.2024.101087","DOIUrl":"10.1016/j.lanepe.2024.101087","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101087"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571603","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}
Pub Date : 2024-11-01DOI: 10.1016/j.lanepe.2024.101047
Anniek de Ruijter , Tamara Hervey , Barbara Prainsack
Trust and solidarity are centrally important to the functioning of healthcare systems, and for societal resilience and stability more broadly. The European Union is increasingly shaping governance and norms that affect trust and solidarity in health—a process that has intensified with the announcement of the ‘European Health Union’ in response to the COVID-19 pandemic. In this context, how can the EU ensure solidarity in health while generating public trust as a pre-condition for solidaristic institutions? We propose three strategies to reach this goal. First, both at national and European levels, institutions and mechanisms of solidarity should be strengthened. Second, the Union should boost the resilience and stability of national healthcare systems through mechanisms of risk-sharing. Third, the Union should mandate or encourage its member countries to enhance prevention and other public health policies to strengthen pre-distribution, aimed to ensure a more equal baseline of public health before inequalities arise.
{"title":"Solidarity and trust in European Union health governance: three ways forward","authors":"Anniek de Ruijter , Tamara Hervey , Barbara Prainsack","doi":"10.1016/j.lanepe.2024.101047","DOIUrl":"10.1016/j.lanepe.2024.101047","url":null,"abstract":"<div><div>Trust and solidarity are centrally important to the functioning of healthcare systems, and for societal resilience and stability more broadly. The European Union is increasingly shaping governance and norms that affect trust and solidarity in health—a process that has intensified with the announcement of the ‘European Health Union’ in response to the COVID-19 pandemic. In this context, how can the EU ensure solidarity in health while generating public trust as a pre-condition for solidaristic institutions? We propose three strategies to reach this goal. First, both at national and European levels, institutions and mechanisms of solidarity should be strengthened. Second, the Union should boost the resilience and stability of national healthcare systems through mechanisms of risk-sharing. Third, the Union should mandate or encourage its member countries to enhance prevention and other public health policies to strengthen pre-distribution, aimed to ensure a more equal baseline of public health before inequalities arise.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101047"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572320","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}
Pub Date : 2024-10-31eCollection Date: 2024-12-01DOI: 10.1016/j.lanepe.2024.101111
Friedrich A von Samson-Himmelstjerna, Edgar Steiger, Benedikt Kolbrink, Hauke S Wülfrath, Thomas Czihal, Roland Schmitt, Dominik von Stillfried, Kevin Schulte
Background: Chronic kidney disease (CKD) is one of the most significant drivers of the global burden of disease and an increasing public health issue. Adequate monitoring and referral of high-risk patients to nephrologists are associated with improved management of CKD. We aimed to assess nephrology referral rates, monitoring of kidney function, and factors associated with failure to refer in Germany.
Methods: We retrospectively analyzed ambulatory claims data of 73,675,956 German patients who were covered by statutory health care in 2022, building a cohort of 1,301,122 patients who had at least two diagnoses of CKD stage 3-5 within the calendar year. In our analysis, we focused particularly on patients with CKD stage 4.
Findings: We identified 207,043 patients with CKD stage 4, of which 134,143/207,043 (64.8%) received nephrologist treatment in 2022. The median age of the cohort was 82 years. Failure to quantify proteinuria occurred in 61,991/72,900 (85.0%) non-referred patients compared to 51,382/134,143 (38.3%) referred patients. In a mixed logistic regression model, referral was less likely for women (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.71-0.74), higher age (OR per year 0.97, CI 0.96-0.97), nursing home inhabitants (OR 0.63, CI 0.61-0.65), and those with certain comorbidities. Regional factors (deprivation, population density, nephrologist density) were not associated with referral.
Interpretation: A substantial proportion of patients with late-stage CKD are not receiving guideline-recommended kidney care in the German health care system, with disparities driven primarily by individual patient factors rather than geographical barriers.
Funding: This study was funded by the University Hospital Schleswig-Holstein and the Central Research Institute of Ambulatory Health Care in Germany.
{"title":"Referral, monitoring, and factors associated with non-referral of chronic kidney disease in Germany: a nationwide, retrospective cohort study.","authors":"Friedrich A von Samson-Himmelstjerna, Edgar Steiger, Benedikt Kolbrink, Hauke S Wülfrath, Thomas Czihal, Roland Schmitt, Dominik von Stillfried, Kevin Schulte","doi":"10.1016/j.lanepe.2024.101111","DOIUrl":"10.1016/j.lanepe.2024.101111","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is one of the most significant drivers of the global burden of disease and an increasing public health issue. Adequate monitoring and referral of high-risk patients to nephrologists are associated with improved management of CKD. We aimed to assess nephrology referral rates, monitoring of kidney function, and factors associated with failure to refer in Germany.</p><p><strong>Methods: </strong>We retrospectively analyzed ambulatory claims data of 73,675,956 German patients who were covered by statutory health care in 2022, building a cohort of 1,301,122 patients who had at least two diagnoses of CKD stage 3-5 within the calendar year. In our analysis, we focused particularly on patients with CKD stage 4.</p><p><strong>Findings: </strong>We identified 207,043 patients with CKD stage 4, of which 134,143/207,043 (64.8%) received nephrologist treatment in 2022. The median age of the cohort was 82 years. Failure to quantify proteinuria occurred in 61,991/72,900 (85.0%) non-referred patients compared to 51,382/134,143 (38.3%) referred patients. In a mixed logistic regression model, referral was less likely for women (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.71-0.74), higher age (OR per year 0.97, CI 0.96-0.97), nursing home inhabitants (OR 0.63, CI 0.61-0.65), and those with certain comorbidities. Regional factors (deprivation, population density, nephrologist density) were not associated with referral.</p><p><strong>Interpretation: </strong>A substantial proportion of patients with late-stage CKD are not receiving guideline-recommended kidney care in the German health care system, with disparities driven primarily by individual patient factors rather than geographical barriers.</p><p><strong>Funding: </strong>This study was funded by the University Hospital Schleswig-Holstein and the Central Research Institute of Ambulatory Health Care in Germany.</p>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"101111"},"PeriodicalIF":13.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900412","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}
Pub Date : 2024-10-30DOI: 10.1016/j.lanepe.2024.101117
Margherita Pizzato , Alberto Giovanni Gerli , Carlo La Vecchia , Gianfranco Alicandro
{"title":"Corrigendum to “Impact of COVID-19 on total excess mortality and geographic disparities in Europe, 2020–2023: a spatio-temporal analysis” The Lancet Regional Health – Europe, Vol 44, 100996","authors":"Margherita Pizzato , Alberto Giovanni Gerli , Carlo La Vecchia , Gianfranco Alicandro","doi":"10.1016/j.lanepe.2024.101117","DOIUrl":"10.1016/j.lanepe.2024.101117","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101117"},"PeriodicalIF":13.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537690","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}
Pub Date : 2024-10-30DOI: 10.1016/j.lanepe.2024.101116
Zoïe W. Alexiou , Bernice M. Hoenderboom , Christian J.P.A. Hoebe , Nicole H.T.M. Dukers-Muijrers , Hannelore M. Götz , Marianne A.B. van der Sande , Henry J.C. de Vries , Janneke E. den Hartog , Servaas A. Morré , Birgit H.B. van Benthem
{"title":"The importance of understanding pelvic inflammatory disease as a polymicrobial infection - authors’ reply","authors":"Zoïe W. Alexiou , Bernice M. Hoenderboom , Christian J.P.A. Hoebe , Nicole H.T.M. Dukers-Muijrers , Hannelore M. Götz , Marianne A.B. van der Sande , Henry J.C. de Vries , Janneke E. den Hartog , Servaas A. Morré , Birgit H.B. van Benthem","doi":"10.1016/j.lanepe.2024.101116","DOIUrl":"10.1016/j.lanepe.2024.101116","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101116"},"PeriodicalIF":13.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552519","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}
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