Effect of Thiamine Status on Probability of Lake Ontario Chinook Salmon Spawning in the Upper and Lower Sections of Salmon River, New York

Consumption of thiaminase-containing forage fishes reduces egg and muscle thiamine content and impairs the spawning migration of Cayuga Lake (New York) rainbow trout Oncorhynchus mykiss. Because some Chinook salmon O. tshawytscha from Lake Ontario have been shown to produce eggs low in thiamine, we examined the relationship between the migration of Chinook salmon and the thiamine content of their eggs spawned in the lower and upper sections of the Salmon River, a major tributary to Lake Ontario, in 2003–2006. Eggs from the upper section of the river were collected from 79 salmon returning to the state hatchery 25 river kilometers from the mouth. Eggs from 25 salmon in the lower section were collected from redds or females angled on redds approximately 1–3 km from the mouth. For all years combined, we found the mean thiamine concentration in eggs spawned in the lower section to be significantly lower than that for eggs spawned in the upper section; however, the annual differences in thiamine content of eggs between the upper and lower sections were significant only in 2003 and 2006. Binary logistic regression showed that the odds of spawning in the upper section was increased by 96% (95% confidence interval, 21–217%) for every nanomole of increase in the thiamine content of eggs. Therefore, the migratory achievement of Chinook salmon was significantly dependent on their thiamine status

Effect of Thiamine Status on Probability of Lake Ontario Chinook Salmon Spawning in the Upper or Lower Sections of Salmon River, New York

Consumption of thiaminase‐containing forage fishes reduces egg and muscle thiamine content and impairs the spawning migration of Cayuga Lake (New York) rainbow trout Oncorhynchus mykiss. Because some Chinook salmon O. tshawytscha from Lake Ontario have been shown to produce eggs low in thiamine, we examined the relationship between the migration of Chinook salmon and the thiamine content of their eggs spawned in the lower and upper sections of the Salmon River, a major tributary to Lake Ontario, in 2003–2006. Eggs from the upper section of the river were collected from 79 salmon returning to the state hatchery 25 river kilometers from the mouth. Eggs from 25 salmon in the lower section were collected from redds or females angled on redds approximately 1–3 km from the mouth. For all years combined, we found the mean thiamine concentration in eggs spawned in the lower section to be significantly lower than that for eggs spawned in the upper section; however, the annual differences in thiamine content of eggs between the upper and lower sections were significant only in 2003 and 2006. Binary logistic regression showed that the odds of spawning in the upper section was increased by 96% (95% confidence interval, 21–217%) for every nanomole of increase in the thiamine content of eggs. Therefore, the migratory achievement of Chinook salmon was significantly dependent on their thiamine status.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142217/1/nafm0895.pd

Standardisation of clinical assessment, management and follow-up of acute hospitalised exacerbation of copd: A europe-wide consensus

Background: Despite hospitalization for exacerbation being a high-risk event for morbidity and mortality, there is little consensus globally regarding the assessment and management of hospitalised exacerbations of COPD. We aimed to establish a consensus list of symptoms, physiological measures, clinical scores, patient questionnaires and investigations to be obtained at time of hospitalised COPD exacerbation and follow-up. Methods: A modified Delphi online survey with pre-defined consensus of importance, feasibility and frequency of measures at hospitalisation and follow-up of a COPD exacerbation was undertaken. Findings: A total of 25 COPD experts from 18 countries contributed to all 3 rounds of the survey. Experts agreed that a detailed history and examination were needed. Experts also agreed on which treatments are needed and how soon these should be delivered. Experts recommended that a full blood count, renal function, C-reactive protein and cardiac blood biomarkers (BNP and troponin) should be measured within 4 hours of admission and that the modified Medical Research Council dyspnoea scale (mMRC) and COPD assessment test (CAT) should be performed at time of exacerbation and follow-up. Experts encouraged COPD clinicians to strongly consider discussing palliative care, if indicated, at time of hospitalisation. Interpretation: This Europe-wide consensus document is the first attempt to standardise the assessment and care of patients hospitalised for COPD exacerbations. This should be regarded as the starting point to build knowledge and evidence on patients hospitalised for COPD exacerbations

Prognostic Value of Right Ventricular Function in Patients With Suspected Myocarditis Undergoing Cardiac Magnetic Resonance.

BACKGROUND Risk-stratification of myocarditis is based on functional parameters and tissue characterization of the left ventricle (LV), whereas right ventricular (RV) involvement remains mostly unrecognized. OBJECTIVES In this study, the authors sought to analyze the prognostic value of RV involvement in myocarditis by cardiac magnetic resonance (CMR). METHODS Patients meeting the recommended clinical criteria for suspected myocarditis were enrolled at 2 centers. Exclusion criteria were the evidence of coronary artery disease, pulmonary artery hypertension or structural cardiomyopathy. Biventricular ejection fraction, edema according to T2-weighted images, and late gadolinium enhancement (LGE) were linked to a composite end point of major adverse cardiovascular events (MACE), including heart failure hospitalization, ventricular arrhythmia, recurrent myocarditis, and death. RESULTS Among 1,125 consecutive patients, 736 (mean age: 47.8 ± 16.1 years) met the clinical diagnosis of suspected myocarditis and were followed for 3.7 years. Signs of RV involvement (abnormal right ventricular ejection fraction [RVEF], RV edema, and RV-LGE) were present in 188 (25.6%), 158 (21.5%), and 92 (12.5%) patients, respectively. MACE occurred in 122 patients (16.6%) and was univariably associated with left ventricular ejection fraction (LVEF), LV edema, LV-LGE, RV-LGE, RV edema, and RVEF. In a series of nesting multivariable Cox regression models, the addition of RVEF (HRadj: 0.974 [95% CI: 0.956-0.993]; P = 0.006) improved prognostication (chi-square test = 89.5; P = 0.001 vs model 1; P = 0.006 vs model 2) compared with model 1 including only clinical variables (chi-square test = 28.54) and model 2 based on clinical parameters, LVEF, and LV-LGE extent (chi-square test = 78.93). CONCLUSIONS This study emphasizes the role of RV involvement in myocarditis and demonstrates the independent and incremental prognostic value of RVEF beyond clinical variables, CMR tissue characterization, and LV function. (Inflammatory Cardiomyopathy Bern Registry [FlamBER]; NCT04774549; CMR Features in Patients With Suspected Myocarditis [CMRMyo]; NCT03470571)

Prognostic Value of Right Ventricular Function in Patients With Suspected Myocarditis Undergoing Cardiac Magnetic Resonance

BACKGROUND Risk-stratification of myocarditis is based on functional parameters and tissue characterization of the left ventricle (LV), whereas right ventricular (RV) involvement remains mostly unrecognized. OBJECTIVES In this study, the authors sought to analyze the prognostic value of RV involvement in myocarditis by cardiac magnetic resonance (CMR). METHODS Patients meeting the recommended clinical criteria for suspected myocarditis were enrolled at 2 centers. Exclusion criteria were the evidence of coronary artery disease, pulmonary artery hypertension or structural cardiomyopathy. Biventricular ejection fraction, edema according to T2-weighted images, and late gadolinium enhancement (LGE) were linked to a composite end point of major adverse cardiovascular events (MACE), including heart failure hospitalization, ventricular arrhythmia, recurrent myocarditis, and death. RESULTS Among 1,125 consecutive patients, 736 (mean age: 47.8 ± 16.1 years) met the clinical diagnosis of suspected myocarditis and were followed for 3.7 years. Signs of RV involvement (abnormal right ventricular ejection fraction [RVEF], RV edema, and RV-LGE) were present in 188 (25.6%), 158 (21.5%), and 92 (12.5%) patients, respectively. MACE occurred in 122 patients (16.6%) and was univariably associated with left ventricular ejection fraction (LVEF), LV edema, LV-LGE, RV-LGE, RV edema, and RVEF. In a series of nesting multivariable Cox regression models, the addition of RVEF (HR$_{adj}$: 0.974 [95% CI: 0.956-0.993]; P = 0.006) improved prognostication (chi-square test = 89.5; P = 0.001 vs model 1; P = 0.006 vs model 2) compared with model 1 including only clinical variables (chi-square test = 28.54) and model 2 based on clinical parameters, LVEF, and LV-LGE extent (chi-square test = 78.93). CONCLUSIONS This study emphasizes the role of RV involvement in myocarditis and demonstrates the independent and incremental prognostic value of RVEF beyond clinical variables, CMR tissue characterization, and LV function. (Inflammatory Cardiomyopathy Bern Registry [FlamBER]; NCT04774549; CMR Features in Patients With Suspected Myocarditis [CMRMyo]; NCT03470571)

Estimation of pediatric skeletal age using geometric morphometrics and three-dimensional cranial size changes

International audienc