Environmental pressure from the 2014–15 eruption of Bárðarbunga volcano, Iceland

The effusive six months long 2014-2015 Bárðarbunga eruption (31 August-27 February) was the largest in Iceland for more than 200 years, producing 1.6 ± 0.3 km3 of lava. The total SO2 emission was 11 ± 5 Mt, more than the amount emitted from Europe in 2011. The ground level concentration of SO2 exceeded the 350 μg m−3 hourly average health limit over much of Iceland for days to weeks. Anomalously high SO2 concentrations were also measured at several locations in Europe in September. The lowest pH of fresh snowmelt at the eruption site was 3.3, and 3.2 in precipitation 105 km away from the source. Elevated dissolved H2SO4, HCl, HF, and metal concentrations were measured in snow and precipitation. Environmental pressures from the eruption and impacts on populated areas were reduced by its remoteness, timing, and the weather. The anticipated primary environmental pressure is on the surface waters, soils, and vegetation of Iceland

Cardiovascular safety of celecoxib in acute myocardial infarction patients: a nested case-control study

The objective was to measure the impact of exposure to coxibs and non-steroidal antiinflammatory drugs (NSAID) on morbidity and mortality in older patients with acute myocardial infarction (AMI). A nested case-control study was carried out using an exhaustive population-based cohort of patients aged 66 years and older living in Quebec (Canada) who survived a hospitalization for AMI (ICD-9 410) between 1999 and 2002. The main variables were all-cause and cardiovascular (CV) death, subsequent hospital admission for AMI, and a composite end-point including recurrent AMI or CV death. Conditional logistic regressions were used to estimate the risk of mortality and morbidity. A total of 19,823 patients aged 66 years and older survived hospitalization for AMI in the province of Quebec between 1999 and 2002. After controlling for covariables, the risk of subsequent AMI and the risk of composite end-point were increased by the use of rofecoxib. The risk of subsequent AMI was particularly high for new rofecoxib users (HR 2.47, 95% CI 1.57–3.89). No increased risk was observed for celecoxib users. No increased risk of CV death was observed for patients exposed to coxibs or NSAIDs. Patients newly exposed to NSAIDs were at an increased risk of death (HR 2.22, 95% CI 1.30–3.77) and of composite end-point (HR 2.28, 95% CI 1.35–3.84). Users of rofecoxib and NSAIDs, but not celecoxib, were at an increased risk of recurrent AMI and of composite end-point. Surprisingly, no increased risk of CV death was observed. Further studies are needed to better understand these apparently contradictory results

High-dose nifedipine use is associated with increased risk of out-of-hospital cardiac arrest : Multi-country case-control study

Introduction Drugs that influence cardiac electrophysiological properties by impacting on cardiac ion channels have been associated with an increased risk of out-of-hospital cardiac arrest (OHCA) due to ventricular tachycardia/ventricular fibrillation (VT/VF). It is unknown whether dihydropyridines, which block L-type calcium channels, are associated with increased risk of OHCA. Purpose To determine whether the widely used dihydropyridines nifedipine and amlodipine are associated with increased OHCA risk. Methods We performed a multi-country case-control study using data from the Dutch Amsterdam Resuscitation Studies registry (ARREST, 2005-2011) and the Danish Cardiac Arrest Registry (DANCAR, 2001-2014). Both registries are community-based registries of all-cause OHCA and are part of the ESCAPE-NET consortium that studies OHCA across Europe. Cases were cardiac-caused OHCA patients with VT/VF, and controls (up to 5 per case) were non-OHCA individuals matched on age, sex and index (OHCA) date. Dutch controls were sampled from PHARMO Database Network and Danish controls from the general (Danish) population. We compared current use on the index date of the study drugs (prescription within 90 days before OHCA) to no use of any dihydropyridine, using conditional logistic regression analysis with adjustment for well-known risk factors of OHCA. Results We studied 2,503 cases and 10,543 controls in ARREST (median age 67.0 years, interquartile range [IQR] 57.0-77.0 years; 77.4% male), and 22,208 cases and 111,040 controls in DANCAR (median age 74 years, IQR 64-82 years; 62.9% male). In both registries, current use of high-dose nifedipine (≥60mg/day), but not low-dose nifedipine