Increased harbor porpoise mortality in the Pacific Northwest, USA: understanding when higher levels may be normal

In 2006, a marked increase in harbor porpoise Phocoena phocoena strandings were reported in the Pacific Northwest of the USA, resulting in the declaration of an unusual mortality event (UME) for Washington and Oregon to facilitate investigation into potential causes. The UME was in place during all of 2006 and 2007, and a total of 114 porpoises stranded during this period. Responders examined 95 porpoises; of these, detailed necropsies were conducted on 75 animals. Here we review the findings related to this event and how these compared to the years immediately before and after the UME. Relatively equal numbers among sexes and age classes were represented, and mortalities were attributed to a variety of specific causes, most of which were categorized as trauma or infectious disease. Continued monitoring of strandings during 4 yr following the UME showed no decrease in occurrence. The lack of a single major cause of mortality or evidence of a significant change or event, combined with high levels of strandings over several post-UME years, demonstrated that this was not an actual mortality event but was likely the result of a combination of factors, including: (1) a growing population of harbor porpoises; (2) expansion of harbor porpoises into previously sparsely populated areas in Washington’s inland waters; and (3) a more well established stranding network that resulted in better reporting and response. This finding would not have been possible without the integrated response and investigation undertaken by the stranding network.Keywords: Unusual mortality event, Pacific Northwest, Phocoena phocoena, StrandingKeywords: Unusual mortality event, Pacific Northwest, Phocoena phocoena, Strandin

Alcohol consumption and the prevalence of metabolic syndrome: A meta-analysis of observational studies

Background: In the past two decades, the metabolic syndrome has given rise to much clinical and research interest. The broad overlap of alcohol consumption with different components of metabolic syndrome makes alcohol-metabolic syndrome relationship a controversial topic. Objectives: To support the evidence available about the relationship between alcohol consumption and metabolic syndrome as a comprehensive clinical entity, as well as to identify the gender-specific dose-response, by performing a meta-analysis based on information from published data. Methods: Manual and computer searches in different bibliographic databases were performed to identify the relevant scientific publications, on the relation between alcohol consumption and metabolic syndrome. Alcohol intake was converted into a same unit (g/day) and then categorized using standard classification in order to provide relevant comparisons. Fixed and random effects models were used to aggregate individual odds ratios and to derive pooled estimates and 95% confidence intervals. Results: Fourteen relevant publications were identified on the relation between alcohol consumption and the prevalence of metabolic syndrome. 7 studies were included in the meta-analysis. The results showed that alcohol consumption of less than 40 g/day in men and 20 g/day in women significantly reduced the prevalence of metabolic syndrome. Conclusion: "Responsible alcohol intake" appears to be associated with a reduced prevalence of metabolic syndrome. Favorable metabolic effect seemed to be restricted to alcohol consumption of less than 20 g/day among women, and of less than 40 g/day among men. These findings support the actual recommendations regarding alcohol consumption among apparently healthy people. © 2008 Elsevier Ireland Ltd. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Increased Harbor Porpoise Mortality in the Pacific Northwest, USA: Understanding When Higher Levels May be Normal

In 2006, a marked increase in harbor porpoise Phocoena phocoena strandings were reported in the Pacific Northwest of the USA, resulting in the declaration of an unusual mortality event (UME) for Washington and Oregon to facilitate investigation into potential causes. The UME was in place during all of 2006 and 2007, and a total of 114 porpoises stranded during this period. Responders examined 95 porpoises; of these, detailed necropsies were conducted on 75 animals. Here we review the findings related to this event and how these compared to the years immediately before and after the UME. Relatively equal numbers among sexes and age classes were represented, and mortalities were attributed to a variety of specific causes, most of which were categorized as trauma or infectious disease. Continued monitoring of strandings during 4 yr following the UME showed no decrease in occurrence. The lack of a single major cause of mortality or evidence of a significant change or event, combined with high levels of strandings over several post- UME years, demonstrated that this was not an actual mortality event but was likely the result of a combination of factors, including: (1) a growing population of harbor porpoises; (2) expansion of harbor porpoises into previously sparsely populated areas in Washington’s inland waters; and (3) a more well established stranding network that resulted in better reporting and response. This finding would not have been possible without the integrated response and investigation undertaken by the stranding network

Contaminant and health monitoring of endangered Southern Resident killer whales

The Environmental Chemistry Program at NOAA’s Northwest Fisheries Science Center has been analyzing chemical tracers, including environmental pollutants, stable isotope ratios and fatty acids, in support of studies related to NOAA trust resources for more than 40 years. These analyses are conducted for a range of NOAA mission-critical projects such as: ensuring the safety of seafood in response to natural and anthropogenic disasters and providing scientific support on NOAA Natural Resource Damage Assessment litigation-sensitive studies on protected species such as Chinook salmon, marine mammals and sea turtles, and providing data that help describe the population age structure and foraging ecology (including marine distribution) of populations of ESA-listed marine mammals and salmonids. Southern Resident killer whales were listed as endangered in the United States and Canada as a result of the population declining. Since the early 1990s, US and Canadian studies have characterized toxic persistent organic pollutants (POPs) as a threat to this population. As long-lived top predators, Southern Residents are vulnerable to contaminants that occur in urban and industrial areas with high shipping and vessel activities such as Puget Sound where they reside and feed. Studies to date have shown that Southern Residents contain higher POPs concentrations than those in northern residents and other northeastern Pacific killer whale populations, and that contaminant burden and exposure are strongly associated with sex and age. Data have largely been derived from non-lethal remote biopsy samples and analyses conducted on blubber and skin. In addition to POPs, measurements of petroleum related hydrocarbons and total mercury have also been conducted to characterize baseline levels. More recently, investigations have been conducted on feces to investigate POPs as well as reproductive and stress steroids, and on breath samples to investigate pathogenic microbes and antibiotic resistant bacteria, to increase our knowledge on the health of this population

Lower HCV treatment uptake in women who have received opioid agonist therapy before and during the DAA era: The ANRS FANTASIO project

International audienceBACKGROUND:In the era of direct-acting antivirals (DAA) for the treatment of hepatitis C virus (HCV) infection, HCV treatment uptake remains insufficiently documented in key populations such as people with opioid dependence. Access to opioid agonist therapy (OAT) is facilitated in France through delivery in primary care, and individuals with opioid dependence can be identified as those receiving OAT. Women with opioid dependence are especially vulnerable because of associated sex-related stigma, discrimination, and marginalization, all of which negatively interfere with access to HCV prevention and care. This study, based on data collected between 2012 and 2016 in France, aimed to assess whether (i) chronically HCV-infected women with opioid dependence had lower rates of HCV treatment uptake than their male counterparts during the same period (i.e., study period), and (ii) the advent of DAA resulted in increased treatment uptake rates in these women.METHODS:Individuals with opioid dependence were identified as those receiving OAT at least once during the study period. Analyses were based on exhaustive anonymous care delivery data from the French national healthcare reimbursement database. We used multinomial logistic regression to estimate sex-based disparities in HCV treatment uptake (DAA or pegylated-interferon (Peg-IFN)-based treatment versus no treatment) while accounting for potential confounders.RESULTS:The study sample comprised 27,127 individuals, including 5640 (20.8%) women. Median [interquartile range] age was 45 [40-49] years. Between 2012 and 2016, 70.9 (women: 77.2; men: 69.3), 17.3 (14.2; 18.2) and 11.7% (8.6%; 12.5%) of the study sample received, respectively, no HCV treatment, DAA and Peg-IFN-based treatment only. After multiple adjustment for potential confounders, women were 41% (adjusted odds-ratio (AOR) [95% confidence interval (CI]): 0.59[0.53-0.65]) and 28% (0.72[0.66-0.78]) less likely than men to have had Peg-IFN-based and DAA treatment, respectively.CONCLUSION:Despite increased HCV treatment uptake in women with opioid dependence in the DAA era, rates remain lower than for men. In the coming years, access to DAA treatment will continue to increase in France thanks to a forthcoming simplified model of HCV care which includes primary care as an entry point. Nevertheless, a greater understanding of sex-specific barriers to HCV care and the implementation of appropriate sex-specific measures remain a priority

Untreated alcohol use disorder in people who inject drugs (PWID) in France: a major barrier to HCV treatment uptake (the ANRS-FANTASIO study)

International audienceBackground and AimsAlthough people who inject drugs (PWID) are the core at‐risk population in the hepatitis C virus (HCV) epidemic in industrialized countries, few initiate treatment. Alcohol use disorder (AUD), common within this population, has been identified as a barrier to HCV treatment uptake in the general population. We investigated whether the arrival of new and well‐tolerated HCV treatments (direct‐acting antivirals: DAA) has improved HCV treatment uptake in French PWID compared with former treatments (pegylated interferon‐based treatments: Peg‐IFN).DesignUsing discrete‐time Cox proportional hazards models based on exhaustive care delivery data, we tested for associations between AUD (defined by AUD‐related long‐term illness status, diagnosis coding during hospitalization and/or AUD pharmacological treatment) and first HCV treatment delivery, after adjusting for gender, age, complementary universal health cover, liver disease severity and type of opioid agonist therapy (OAT) received. Separate analyses were performed for 2012–13 (Peg‐IFN era) and 2014–16 (DAA era).SettingFrance.ParticipantsAll French people chronically HCV‐infected who received OAT at least once during 2012–16 and were covered by the national health insurance (n = 24 831).MeasurementsIncidence rate of HCV treatment uptake, hazard ratios associated with AUD and other covariates.FindingsIncidence rate (IR) of HCV treatment uptake per 100 person‐years was 6.56, confidence interval (CI) = 6.30–6.84; and IR = 5.70, 95% CI = 5.51–5.89 for Peg‐IFN‐based treatment (2012–13) and DAA (2014–16), respectively. After multiple adjustment, people with AUD not receiving related medication had 30 and 14% lower Peg‐IFN‐based treatment and DAA uptake, respectively, than those without AUD [hazard ratio (HR) = 0.70, 95% CI = 0.62–0.80 and HR = 0.86, 95% CI = 0.78–0.94]. No difference was observed between those treated for AUD and those without AUD.ConclusionsDespite the benefits of direct‐acting antiviral treatment, untreated alcohol use disorder appears to remain a major barrier to hepatitis C virus treatment access for people who inject drugs in France

Headache yesterday in Europe

Background Surveys enquiring about burden of headache over a prior period of time (eg, 3 months) are subject to recall bias. To eliminate this as far as possible, we focused on presence and impact of headache on the preceding day (“headache yesterday”). Methods Adults (18-65 years) were surveyed from the general populations of Germany, Italy, Lithuania, Luxembourg and the Netherlands, from a work-force population in Spain and from mostly non-headache patient populations of Austria, France and UK. A study of non-responders in some countries allowed detection of potential participation bias where initial participation rates were low. Results Participation rates varied between 11% and 59% (mean 27%). Non-responder studies suggested that, because of participation bias, headache prevalence might be overestimated in initial responders by up to 2% (absolute). Across all countries, 1,422 of 8,271 participants (15-17%, depending on correction for participation bias) had headache yesterday lasting on average for 6 hours. It was bad or very bad in 56% of cases and caused absence from work or school in 6%. Among those who worked despite headache, 20% reported productivity reduced by >50%. Social activities were lost by 24%. Women (21%) were more likely than men (12%) to have headache yesterday, but impact was similar in the two genders. Conclusions With recall biases avoided, our findings indicate that headache costs at least 0.7% of working capacity in Europe. This calculation takes into account that most of those who missed work could make up for this later, which, however, means that leisure and social activities are even more influenced by headache

The impact of headache in Europe: principal results of the Eurolight project

Background European data, at least from Western Europe, are relatively good on migraine prevalence but less sound for tension-type headache (TTH) and medication-overuse headache (MOH). Evidence on impact of headache disorders is very limited. Eurolight was a data-gathering exercise primarily to inform health policy in the European Union (EU). This manuscript reports personal impact. Methods The study was cross-sectional with modified cluster sampling. Surveys were conducted by structured questionnaire, including diagnostic questions based on ICHD-II and various measures of impact, and are reported from Austria, France, Germany, Italy, Lithuania, Luxembourg, Netherlands, Spain and United Kingdom. Different methods of sampling were used in each. The full methodology is described elsewhere. Results Questionnaires were analysed from 8,271 participants (58% female, mean age 43.4 y). Participation-rates, where calculable, varied from 10.6% to 58.8%. Moderate interest-bias was detected. Unadjusted lifetime prevalence of any headache was 91.3%. Gender-adjusted 1-year prevalences were: any headache 78.6%; migraine 35.3%; TTH 38.2%, headache on ≥15 d/mo 7.2%; probable MOH 3.1%. Personal impact was high, and included ictal symptom burden, interictal burden, cumulative burden and impact on others (partners and children). There was a general gradient of probable MOH > migraine > TTH, and most measures indicated higher impact among females. Lost useful time was substantial: 17.7% of males and 28.0% of females with migraine lost >10% of days; 44.7% of males and 53.7% of females with probable MOH lost >20%. Conclusions The common headache disorders have very high personal impact in the EU, with important implications for health policy