Interim 2017/18 influenza seasonal vaccine effectiveness: Combined results from five European studies

Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, -42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Total mercury in the night shark, Carcharhinus signatus in the western equatorial Atlantic Ocean

Mercury is the only element capable to biomagnificate along the food chain, and carnivorous fish tend to accumulate high concentrations of this element. Total mercury in muscle tissue of Carcharhinus signatus sampled along the western equatorial Atlantic Ocean was measured by atomic emission spectrophotometry with ICP/AES. The average total mercury concentrations were consistently greater than the maximum limit for human consumption established by the Brazilian Health Ministry for carnivorous fishes (1000 µg. kg-1 w.w.). Therefore, an average consumption of 0.1 kg/day of C. signatus would result in an average daily ingestion of 174.2 µg of Hg, more than five times the 30 µg/day intake established by the World Health Organization. In the range of lengths studied, body length could not be used as an indicator of the Hg contamination degree for C. signatus. Also, sex cannot be considered a determining factor in the total mercury accumulation in C. signatus.<br>O mercúrio (Hg) é o único metal que comprovadamente biomagnifica através da cadeia alimentar, e sendo assim, espécies de peixes predadores tendem a apresentar altas concentrações deste metal. Porções de tecido muscular de C. signatus coletados na região oeste equatorial do oceano Atlântico foram submetidas a extração ácida e tiveram a concentração de mercúrio determinada com acessório gerador de vapor a frio acoplado a um ICP-AES. A concentração média de Hg apresentou valores acima do limite máximo permissível para consumo humano estabelecido pela legislação brasileira (1000 µg.kg-1 de peso úmido). Conseqüentemente, um consumo médio de 0,1 kg.dia-1 de C. signatus resultaria numa ingestão media de 174,2 µg de Hg, mais de cinco vezes o consumo máximo de 30 µg.dia-1 estabelecido pela Organizacao Munidal da Saúde. Dentro das classes de tamanho analisadas, o comprimento total não pode ser utilizado como indicador do grau de contaminação por mercúrio em C. signatus. Ainda, o sexo não pode ser considerado um fator determinante na acumulação total de mercúrio em C. signatus

Interim 2017/18 influenza seasonal vaccine effectiveness:Combined results from five European studies

Between September 2017 and February 2018, influenza A(H1N1)pdm09, A(H3N2) and B viruses (mainly B/Yamagata, not included in 2017/18 trivalent vaccines) co-circulated in Europe. Interim results from five European studies indicate that, in all age groups, 2017/18 influenza vaccine effectiveness was 25 to 52% against any influenza, 55 to 68% against influenza A(H1N1)pdm09, -42 to 7% against influenza A(H3N2) and 36 to 54% against influenza B. 2017/18 influenza vaccine should be promoted where influenza still circulates

The Gulf of Nicoya (Costa Rica) Fisheries System: Two Decades of Change

In the early 1990s, ecological and fishery data from the Gulf of Nicoya (Pacific Ocean) were holistically analyzed, and a trophic model was constructed using the Ecopath modeling approach. The results indicated that this tropical estuary, which is a Costa Rican fishery hot spot, was already overexploited by shrimp trawlers and the longline fleet, and recent observations suggest further deteriorations in this system. To evaluate the ecosystem and socioeconomic changes in the Gulf of Nicoya over the last 20 years, the 1993 model was reconstructed with data from 2013 to compare both system states. Although the summary statistics of both states (i.e., 1993 and 2013) suggested that the system maintained its general functionality and even enabled the total harvest to increase by approximately 20%, a more detailed analysis of the levels of the functional groups suggested that the system was further degraded as follows: (1) most shrimp, eel, and catfish species decreased their share in the catches, with severe economic losses for the fishery; (2) of the species that substantially increased their share in the catches, most were short‐lived, low‐value species, such as small pelagic and small demersal fishes; and (3) catches of long‐lived, high‐trophic‐level fish, such as rays, sharks, mackerels, and barracudas, decreased. A picture emerged in which the advancing fishery of low‐trophic‐level species with low economic value enabled the total harvest to increase, while valuable shrimp resources and higher‐trophic‐level species were depleted. These developments caused a tremendous economic loss of approximately 50%

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted