Lancet Regional Health-Europe最新文献

{"title":"Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study","authors":"Claudia Weiß ,&nbsp;Lena-Luise Becker ,&nbsp;Johannes Friese ,&nbsp;Astrid Blaschek ,&nbsp;Andreas Hahn ,&nbsp;Sabine Illsinger ,&nbsp;Oliver Schwartz ,&nbsp;Günther Bernert ,&nbsp;Maja von der Hagen ,&nbsp;Ralf A. Husain ,&nbsp;Klaus Goldhahn ,&nbsp;Janbernd Kirschner ,&nbsp;Astrid Pechmann ,&nbsp;Marina Flotats-Bastardas ,&nbsp;Gudrun Schreiber ,&nbsp;Ulrike Schara ,&nbsp;Barbara Plecko ,&nbsp;Regina Trollmann ,&nbsp;Veronka Horber ,&nbsp;Ekkehard Wilichowski ,&nbsp;Kristina Probst-Schendzielorz","doi":"10.1016/j.lanepe.2024.101092","DOIUrl":"10.1016/j.lanepe.2024.101092","url":null,"abstract":"<div><h3>Background</h3><div>Real-world data on gene addition therapy (GAT) with onasemnogene abeparvovec (OA), including all age groups and with or without symptoms of the disease before treatment are needed to provide families with evidence-based advice and realistic therapeutic goals. Aim of this study is therefore a population-based analysis of all patients with SMA treated with OA across Germany, Austria and Switzerland (D-A-CH).</div></div><div><h3>Methods</h3><div>This observational study included individuals with Spinal Muscular Atrophy (SMA) treated with OA in 29 specialized neuromuscular centers in the D-A-CH-region. A standardized data set including WHO gross motor milestones, SMA validated motor assessments, need for nutritional and respiratory support, and adverse events was collected using the SMArtCARE registry and the Swiss-Reg-NMD. Outcome data were analyzed using a prespecified statistical analysis plan including potential predictors such as age at GAT, <em>SMN2</em> copy number, past treatment, and symptom status.</div></div><div><h3>Findings</h3><div>343 individuals with SMA (46% male, 54% female) with a mean age at OA of 14.0 months (range 0–90, IQR 20.0 months) were included in the analysis. 79 (23%) patients were clinically presymptomatic at the time of treatment. 172 (50%) patients received <em>SMN2</em> splice-modifying drugs prior to GAT (risdiplam: n = 16, nusinersen: n = 154, both: n = 2). Functional motor improvement correlated with lower age at GAT, with the best motor outcome in those younger than 6 weeks, carrying 3 <em>SMN2</em> copies, and being clinically presymptomatic at time of treatment. The likelihood of requiring ventilation or nutritional support showed a significantly increase with older age at the time of GAT and remained stable thereafter. Pre-treatment had no effect on disease trajectories. Liver-related adverse events occurred significantly less frequently up to 8 months of age. All other adverse events showed an even distribution across all age and weight groups.</div></div><div><h3>Interpretation</h3><div>Overall, motor, respiratory, and nutritional outcome were dependent on timing of GAT and initial symptom status. It was best in presymptomatic children treated within the first six weeks of life, but functional motor scores also increased significantly after treatment in all age groups up to 24 months. Additionally, OA was best tolerated when administered at a young age. Our study therefore highlights the need for SMA newborn screening and immediate treatment to achieve the best possible benefit-risk ratio.</div></div><div><h3>Funding</h3><div>The SMArtCARE and Swiss-Reg-NMD registries are funded by different sources (see acknowledgements).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101092"},"PeriodicalIF":13.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425744","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}

{"title":"Risk of recurrence in early-onset versus late-onset non-metastatic colorectal cancer, 2004–2019: a nationwide cohort study","authors":"Jesper Nors ,&nbsp;Kåre Andersson Gotschalck ,&nbsp;Rune Erichsen ,&nbsp;Claus Lindbjerg Andersen","doi":"10.1016/j.lanepe.2024.101093","DOIUrl":"10.1016/j.lanepe.2024.101093","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of colorectal cancer (CRC) in individuals younger than 50 years of age (early-onset CRC) is increasing. Early-onset CRC often present at advanced stage, suggesting a more aggressive cancer course compared to late-onset CRC (age 50–79). This nationwide cohort study estimates the incidence of recurrence following early-onset CRC and late-onset CRC.</div></div><div><h3>Methods</h3><div>The study included all Danish patients &lt;80 years old operated for first-time Union for International Cancer Control (UICC) stage I–III CRC between January 2004 and December 2019. Recurrence status was determined by applying a validated algorithm to individual-level data from nationwide health registries. The 5-year cumulative incidence functions (CIF) of recurrence were reported for early-onset versus late-onset CRC. The difference in time to recurrence was estimated as a time ratio (TR) using an accelerated failure time model.</div></div><div><h3>Findings</h3><div>Among 25,729 CRC patients, 1441 (5.6%) had early-onset CRC. Compared to late-onset CRC, early-onset was associated with advanced disease stages and higher treatment intensity. The 5-year CIF of recurrence was 29% (95% CI: 26%–31%) in early-onset versus 21% (95% CI: 21%–22%) in late-onset CRC. The higher CIF of recurrence for early-onset patients persisted in stage-stratified analysis. Time to recurrence was shorter in early-onset versus late-onset patients with TR = 0.76 (95% CI: 0.67–0.85). The 5-year CIF of recurrence decreased from 2004 to 2019 for both early- and late-onset patients–most prominent for early-onset patients.</div></div><div><h3>Interpretation</h3><div>Early-onset CRC was associated with higher incidence of recurrence at all disease stages. Indicating that the increased risk is not explained by delayed diagnosis. The excess risk diminished from 2004 to 2019, suggesting that early-onset CRC may achieve a similar recurrence risk as late-onset CRC in a contemporary setting.</div></div><div><h3>Funding</h3><div><span>Aarhus University</span>, <span>Novo Nordisk Foundation</span>, <span>Innovation Fund Denmark</span>, and the <span>Danish Cancer Society</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101093"},"PeriodicalIF":13.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425743","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}

{"title":"Residential exposure to transportation noise and risk of incident atrial fibrillation: a pooled study of 11 prospective Nordic cohorts","authors":"Jesse D. Thacher ,&nbsp;Nina Roswall ,&nbsp;Mikael Ögren ,&nbsp;Andrei Pyko ,&nbsp;Agneta Åkesson ,&nbsp;Anna Oudin ,&nbsp;Annika Rosengren ,&nbsp;Aslak H. Poulsen ,&nbsp;Charlotta Eriksson ,&nbsp;David Segersson ,&nbsp;Debora Rizzuto ,&nbsp;Emilie Helte ,&nbsp;Eva M. Andersson ,&nbsp;Gunn Marit Aasvang ,&nbsp;Gunnar Engström ,&nbsp;Hrafnhildur Gudjonsdottir ,&nbsp;Jenny Selander ,&nbsp;Jesper H. Christensen ,&nbsp;Jørgen Brandt ,&nbsp;Karin Leander ,&nbsp;Mette Sørensen","doi":"10.1016/j.lanepe.2024.101091","DOIUrl":"10.1016/j.lanepe.2024.101091","url":null,"abstract":"<div><h3>Background</h3><div>Transportation noise has been linked with cardiometabolic outcomes, yet whether it is a risk factor for atrial fibrillation (AF) remains inconclusive. We aimed to assess whether transportation noise was associated with AF in a large, pooled Nordic cohort.</div></div><div><h3>Methods</h3><div>We pooled data from 11 Nordic cohorts, totaling 161,115 participants. Based on address history from five years before baseline until end of follow-up, road, railway, and aircraft noise was estimated at a residential level. Incident AF was ascertained via linkage to nationwide patient registries. Cox proportional hazards models were utilized to estimate associations between running 5-year time-weighted mean transportation noise (L_den) and AF after adjusting for sociodemographics, lifestyle, and air pollution.</div></div><div><h3>Findings</h3><div>We identified 18,939 incident AF cases over a median follow-up of 19.6 years. Road traffic noise was associated with AF, with a hazard ratio (HR) and 95% confidence interval (CI) of 1.02 (1.00–1.04) per 10-dB of 5-year mean time-weighted exposure, which changed to 1.03 (1.01–1.06) when implementing a 53-dB cut-off. In effect modification analyses, the association for road traffic noise and AF appeared strongest in women and overweight and obese participants. Compared to exposures ≤40 dB, aircraft noise of 40.1–50 and &gt; 50 dB were associated with HRs of 1.04 (0.93–1.16) and 1.12 (0.98–1.27), respectively. Railway noise was not associated with AF. We found a HR of 1.19 (1.02–1.40) among people exposed to noise from road (≥45 dB), railway (&gt;40 dB), and aircraft (&gt;40 dB) combined.</div></div><div><h3>Interpretation</h3><div>Road traffic noise, and possibly aircraft noise, may be associated with elevated risk of AF.</div></div><div><h3>Funding</h3><div><span>NordForsk</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101091"},"PeriodicalIF":13.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427241","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}

{"title":"Modest versus significant excess mortality due to COVID-19 deaths in Europe – authors' reply","authors":"Margherita Pizzato ,&nbsp;Alberto Giovanni Gerli ,&nbsp;Carlo La Vecchia ,&nbsp;Gianfranco Alicandro","doi":"10.1016/j.lanepe.2024.101061","DOIUrl":"10.1016/j.lanepe.2024.101061","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"45 ","pages":"Article 101061"},"PeriodicalIF":13.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422183","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}

{"title":"COVID-19 vaccination and birth outcomes of 186,990 women vaccinated before pregnancy: an England-wide cohort study","authors":"Arun K. Suseeladevi ,&nbsp;Rachel Denholm ,&nbsp;Matthew Retford ,&nbsp;Elena Raffetti ,&nbsp;Christy Burden ,&nbsp;Katherine Birchenall ,&nbsp;Victoria Male ,&nbsp;Venetia Walker ,&nbsp;Christopher Tomlinson ,&nbsp;Angela M. Wood ,&nbsp;Luisa Zuccolo ,&nbsp;CVD-COVID-UK/COVID-IMPACT Consortium","doi":"10.1016/j.lanepe.2024.101025","DOIUrl":"10.1016/j.lanepe.2024.101025","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 vaccination in pregnancy is recommended by the World Health Organisation as effective and safe. However, there remains a lack of robust evidence to inform vaccination choices for women of childbearing potential in relation to their future pregnancies. Here we investigated the association between starting a course of COVID-19 vaccination before pregnancy and birth outcomes.</div></div><div><h3>Methods</h3><div>We analysed England-wide linked electronic health records for all pregnancies reaching at least 24 weeks gestation between 25th May 2021 and 28th October 2022. We estimated incidence rates and hazard ratios for birth and pregnancy outcomes by pre-pregnancy COVID-19 vaccination status.</div></div><div><h3>Findings</h3><div>Based on 186,990 women, compared to starting a pregnancy unvaccinated, receiving COVID-19 vaccination within 12 months before pregnancy was associated with lower risks of very and extremely preterm birth and small-for-gestational age in term babies for any vaccine type (adjusted hazard ratio and 95% confidence interval: 0.74 [0.63, 0.88] and 0.94 [0.88, 1.00], respectively), and lower stillbirth risk in those receiving an mRNA vaccine (0.72 [0.52, 1.00]). Incidence of venous thromboembolism during pregnancy was higher amongst women receiving a viral-vector, but not an mRNA vaccine (1.54 [1.10, 2.16] and 1.02 [0.70, 1.50], respectively). Results were generally consistent for different dose regimens and across sensitivity analyses.</div></div><div><h3>Interpretation</h3><div>We found evidence that pregnancies starting within 12 months from a first COVID-19 vaccination, compared to those in unvaccinated women, experienced fewer adverse birth outcomes, overall or in selected subgroups of the general population, accounting for potential confounders. An mRNA vaccine should be preferred to a viral-vector vaccine, to minimise safety issues, but where the latter is the only choice, it is still to be preferred to starting a pregnancy unvaccinated. The venous thromboembolism risk of the viral-vector vaccine was substantially lower compared to that attributable to SARS-CoV-2 infection in pregnancy or to commonly used medications such as hormone replacement therapy and oral contraceptives in the non-pregnant population.</div></div><div><h3>Funding</h3><div>UK <span>National Institute for Health and Care Research</span> (NIHR), <span>UKRI</span> <span>Medical Research Council, UK Research and Innovation</span>, <span>The Alan Turing Institute</span>, <span>Health Data Research UK</span>, the <span>Department of Health and Social Care</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"45 ","pages":"Article 101025"},"PeriodicalIF":13.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422184","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}

{"title":"Striking a balance: Europe's green energy ambitions and the environmental impact of lithium","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2024.101090","DOIUrl":"10.1016/j.lanepe.2024.101090","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"45 ","pages":"Article 101090"},"PeriodicalIF":13.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422182","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}

{"title":"Maternal and pregnancy factors contributing to the association between area deprivation and infant mortality in England: a retrospective cohort study.","authors":"Frederick K Ho, Max Allan, Hui Shao, Kenneth K C Man, Bhautesh D Jani, Donald Lyall, Claire Hastie, Michael Fleming, Daniel Mackay, John G F Cleland, Christian Delles, Ruth Dundas, Jim Lewsey, Patrick Ip, Ian Wong, Paul Welsh, Anna Pearce, Charlotte M Wright, Helen Minnis, S Vittal Katikireddi, Jill P Pell","doi":"10.1016/j.lanepe.2024.101075","DOIUrl":"10.1016/j.lanepe.2024.101075","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic inequality in infant mortality in the UK is rising. This study aims to identify contributory maternal and pregnancy factors that can explain the known association between area deprivation and infant mortality.</p><p><strong>Methods: </strong>A cohort study was conducted using Clinical Practice Research Datalink (CPRD) primary care data between 2004 and 2019 linked to the Index of Multiple Deprivation (IMD), and infant mortality from the Office for National Statistics death data. Potential maternal and pregnancy contributory factors included: maternal age, prior maternal health conditions, pregnancy lifestyle factors and complications, use of medications during pregnancy, and characteristics of birth. Counterfactual-based decomposition analysis was used to quantify the relative importance of equalising these factors to reduce inequalities in infant mortality.</p><p><strong>Findings: </strong>A total of 392,606 mother-child dyads were included in this study. The overall risk of infant mortality was greatest for individuals in the most deprived quintile (risk ratio 2.13 [95% CI 1.58-2.90]; risk difference 6.6 [3.8-8.8] per 10,000 live births) compared with the least deprived. Four contributory factors were identified as potentially important: preterm birth (Proportion eliminated [PE] 15.25% [95% CI 9.44-24.12%]), smoking during pregnancy (PE 13.61% [95% CI 3.96-80.97%]), maternal age <20 years at childbirth (PE 10.52% [95% CI 2.93-21.35%]) and maternal depression (PE 9.13% [95% CI 4.47-14.93%]). These collectively accounted for more than one-third of the socioeconomic inequality in mortality.</p><p><strong>Interpretation: </strong>Multifactorial interventions targeting maternal mental health, smoking, teenage pregnancy and preterm birth may mitigate a proportion of the effects of socioeconomic inequality but targeting these, alone, will not stem the rise in infant mortality. Structural efforts to reduce socioeconomic inequalities will also be required to prevent these excess infant deaths.</p><p><strong>Funding: </strong>UK Medical Research Council, Scottish Chief Scientist Office, Wellcome Trust.</p>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"101075"},"PeriodicalIF":13.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900410","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}

{"title":"Salpingectomy versus tubal occlusion in laparoscopic sterilisation (SALSTER): a national register-based randomised non-inferiority trial","authors":"Annika Strandell ,&nbsp;Leonidas Magarakis ,&nbsp;Karin Sundfeldt ,&nbsp;Mathias Pålsson ,&nbsp;Per Liv ,&nbsp;Annika Idahl","doi":"10.1016/j.lanepe.2024.101026","DOIUrl":"10.1016/j.lanepe.2024.101026","url":null,"abstract":"<div><h3>Background</h3><div>Opportunistic salpingectomy to reduce ovarian cancer incidence has become increasingly common despite the lack of randomised trials investigating its safety. In SALSTER, we tested whether salpingectomy for laparoscopic sterilisation is non-inferior to tubal occlusion regarding complications up to eight weeks postoperatively.</div></div><div><h3>Methods</h3><div>SALSTER is a register-based randomised non-inferiority trial in which 41 gynaecological departments in Sweden participated. After being reported to The Swedish National Quality Register of Gynaecological Surgery (GynOp) for laparoscopic sterilisation, women aged &lt;50 years received study information and could consent to participation online. If eligible, randomisation was performed by the examining/operating gynaecologist before surgery, with stratification for centre, and allocation 1:1 to salpingectomy or tubal occlusion. Blinding was attempted for patients but was impossible for surgeons. The first primary outcome, any complication up to eight weeks postoperatively, was routinely reported in GynOp through physician assessment of patient questionnaires, medical records and personal contact. Complications up to eight weeks postoperatively, a primary safety outcome, were analysed in the per-protocol population. The non-inferiority margin for the difference in the absolute risk of complications was defined as ten percentage points. Missing data were handled using multiple imputation. SALSTER was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT03860805</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between April 4, 2019, and March 31, 2023, 539 women were randomised to salpingectomy and 527 to tubal occlusion. In the salpingectomy and tubal occlusion arms, 40 and 18 women discontinued their participation in the trial and another 26 and 10 did not receive the allocated surgery, respectively. Calculated on imputed data, any complication up to eight weeks postoperatively occurred in 8.1% (38.5/473) of patients after salpingectomy and in 6.2% (31.0/499) of patients after tubal occlusion. The risk difference was 1.9 percentage points (95% confidence interval −1.4 to 5.3).</div></div><div><h3>Interpretation</h3><div>Laparoscopic salpingectomy is non-inferior to tubal occlusion regarding complication rates up to eight weeks postoperatively.</div></div><div><h3>Funding</h3><div>This research was funded by the <span>Swedish Cancer Society</span>, the <span>Lena Wäppling foundation</span>, the Swedish state under the <span>ALF-agreement</span>, <span>Umeå University</span>, <span>County of Värmland</span>, and <span>Gothenburg Society of Medicine</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"45 ","pages":"Article 101026"},"PeriodicalIF":13.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422185","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}

{"title":"Trends in avoidable mortality from cardiovascular diseases in the European Union, 1995–2020: a retrospective secondary data analysis","authors":"Avi Cherla ,&nbsp;Ilias Kyriopoulos ,&nbsp;Pauline Pearcy ,&nbsp;Zoi Tsangalidou ,&nbsp;Haris Hajrulahovic ,&nbsp;Pavlos Theodorakis ,&nbsp;Charlotte E. Andersson ,&nbsp;Mandeep R. Mehra ,&nbsp;Elias Mossialos","doi":"10.1016/j.lanepe.2024.101079","DOIUrl":"10.1016/j.lanepe.2024.101079","url":null,"abstract":"<div><h3>Background</h3><div>Certain causes of death can be avoided with access to timely prevention and treatment. We quantified trends in avoidable deaths from cardiovascular diseases for European Union (EU) countries from 1995 to 2020 and examined variations by demographics, disease characteristics, and geography.</div></div><div><h3>Methods</h3><div>Retrospective secondary data analysis of avoidable cardiovascular mortality using the WHO Mortality Database. Avoidable causes of death were identified from the OECD and Eurostat list (which uses an age threshold of 75 years). Regression models were used to identify changes in the trends of age-standardized mortality rates and potential years of life lost.</div></div><div><h3>Findings</h3><div>From 1995 to 2020, 11.4 million deaths from cardiovascular diseases in Europe were avoidable, resulting in 213.1 million potential life years lost. Avoidable deaths were highest among males (7.5 million), adults 65–74 years (6.8 million), and with the leading cause of death being ischemic heart disease (6.1 million). From its peak in 1995 until 2020, avoidable mortality from cardiovascular diseases has decreased by 57% across the EU. The difference in avoidable cardiovascular diseases mortality between females and males, and between Eastern and Western Europe has reduced greatly, however gaps continue to persist.</div></div><div><h3>Interpretation</h3><div>Avoidable mortality from cardiovascular diseases has decreased substantially among EU countries, although improvement has not been uniform across diseases, demographic groups or regions. These trends suggest additional policy interventions are needed to ensure that improvements in mortality are continued.</div></div><div><h3>Funding</h3><div><span>World Health Organization</span>, Regional Office for Europe.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101079"},"PeriodicalIF":13.6,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328311","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}

{"title":"Trends in the incidence of newly diagnosed cerebral cavernous malformations in Finland: a population-based retrospective cohort study","authors":"Aleksi Halmela ,&nbsp;Emilia Saari ,&nbsp;Jani Raitanen ,&nbsp;Timo Koivisto ,&nbsp;Anssi Auvinen ,&nbsp;Juhana Frösen","doi":"10.1016/j.lanepe.2024.101072","DOIUrl":"10.1016/j.lanepe.2024.101072","url":null,"abstract":"<div><h3>Background</h3><div>The few previous studies that have estimated the incidence of cerebral cavernous malformations (cavernomas) have reported incidence rates of 0.2–1.9/100,000 for diagnosed cavernomas. Our aim was to describe incidence trends of cavernomas by clinical presentation.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of cavernomas diagnosed at two university hospitals in Finland (Kuopio University Hospital, KUH and Tampere University Hospital, TAUH). Cavernoma diagnoses during 2004–2020 were identified from the KUH and TAUH Care registry databases and verified from medical records and diagnostic imaging studies. We calculated the age-standardized incidence rates using the European standard population and analysed incidence trend and changes in trend by sex, age group, and calendar year using Poisson regression.</div></div><div><h3>Findings</h3><div>A total of 669 cavernoma diagnoses were identified during 2004–2020 in the combined KUH and TAUH population. The age-standardized incidence rate was 2.01/100,000 (95% confidence interval (CI) 1.85–2.16) for all cavernoma diagnoses, 1.25/100,000 (1.13–1.37) for asymptomatic, 0.75/100,000 (0.66–0.85) for symptomatic, and 0.46/100,000 (0.39–0.53) for ruptured cavernomas. No significant difference in the incidence of cavernoma diagnoses was seen between the KUH and TAUH populations or between the sexes. Incidence of cavernomas was highest at ages 40–59 years and low in those under 20 or over 80 years of age. Incidence of diagnosed cavernomas, especially asymptomatic, increased during the study period.</div></div><div><h3>Interpretation</h3><div>In our population-based study, incidence of cavernomas was higher than previously reported and increased during the study period. The burden imposed by cavernomas on healthcare system is considerable and increasing.</div></div><div><h3>Funding</h3><div>The <span>Research Council of Finland</span>, <span>Kuopio University Hospital</span>, <span>Tampere University Hospital</span>, and <span>Wellbeing services county of Pirkanmaa</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101072"},"PeriodicalIF":13.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323672","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}