Pneumococcal Serotypes and Mortality following Invasive Pneumococcal Disease: A Population-Based Cohort Study

Analyzing population-based data collected over 30 years in more than 18,000 patients with invasive pneumococcal infection, Zitta Harboe and colleagues find specific pneumococcal serotypes to be associated with increased mortality

Safety and efficacy of thrombectomy in patients undergoing primary percutaneous coronary intervention for Acute ST elevation MI: A Meta-Analysis of Randomized Controlled Trials

Clinical trials comparing thrombectomy devices with conventional percutaneous coronary interventions (PCI) in patients with acute ST elevation myocardial infarction (STEMI) have produced conflicting results. The objective of our study was to systematically evaluate currently available data comparing thrombectomy followed by PCI with conventional PCI alone in patients with acute STEMI

Is there an association between liraglutide use and female breast cancer in a real-world setting?

Donnie Funch,1 Kathleen Mortimer,1 Ling Li,1 Heather Norman,1 Atheline Major-Pedersen,2 Anne Helene Olsen,3 Margit S Kaltoft,4 David D Dore1,5 1Optum Epidemiology, Boston, MA, USA; 2Global Safety, Novo Nordisk A/S, Copenhagen, Denmark; 3Epidemiology, Novo Nordisk A/S, Copenhagen, Denmark; 4Global Development, Novo Nordisk A/S, Copenhagen, Denmark; 5Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA Background: Liraglutide is a human glucagon-like peptide-1 receptor agonist approved for treatment of adults with type 2 diabetes mellitus at a maximum dose of 1.8 mg/day (Victoza®) and more recently at 3.0 mg/day for weight management (Saxenda®). During the evaluation of liraglutide for approval in weight management, a minor imbalance in the numbers of reported breast neoplasms was observed, motivating the present study. Our objective was to quantify the association between liraglutide and incidence of breast cancer (BC) among women in a real-world setting. Patients and methods: Women initiating liraglutide or other antidiabetic therapies and who were enrolled in a large US health plan (2010–2014) were included. Comparisons of BC incidence rates were made between matched cohorts of initiators of liraglutide and cohorts of initiators of exenatide, metformin, pioglitazone, sulfonylureas, and dipeptidyl peptidase-4 inhibitors separately and as two “all comparators” groupings: with or without exenatide. Women with two or more claims with BC diagnosis codes within 61days of each other were identified as possible cases, with additional confirmation by clinician review of comprehensive claims listings. Propensity score matched intention-to-treat (ITT) and time-on-drug (TOD) analyses were completed via Poisson regression. A latency analysis was performed. Results: Relative risks for BC for liraglutide vs comparators from the ITT analyses ranged from 0.90 (95% CI: 0.67–1.22) for both the “all comparator” and “all comparator except exenatide” cohorts to 1.46 (95% CI: 0.96–2.22) relative to exenatide. Latency analyses excluding the first year of follow-up yielded slightly attenuated point estimates. The TOD analyses of cumulative use of liraglutide suggested no increased risk of BC. Conclusion: Neither the ITT (overall or latency analysis) nor cumulative TOD analyses suggested an elevated risk of BC among liraglutide initiators. Short length of follow-up and the potential for confounding by unmeasured factors limit the full assessment of long-term risk. Keywords: glucagon-like peptide-1 receptor agonist, type 2 diabetes, administrative claims, intention-to-treat, time-on-dru

Comparative analysis of Streptococcus pneumoniae transmission in Portuguese and Finnish day-care centres

Day-care centre (DCC) attendees play a central role in maintaining the circulation of Streptococcus pneumoniae (pneumococcus) in the population. The prevalence of pneumococcal carriage is highest in DCC attendees but varies across countries and is found to be consistently lower in Finland than in Portugal. We compared key parameters underlying pneumococcal transmission in DCCs to understand which of these contributed to the observed differences in carriage prevalence.PneumoCarr Consortium, Bill and Melinda Gates Foundation grant

Orogenic gold mineralization hosted by Archaean basement rocks at Sortekap, Kangerlussuaq area, east Greenland

A gold-bearing quartz vein system has been identified in Archaean basement rocks at Sortekap in the Kangerlussuaq region of east Greenland, 35 km north–northeast of the Skaergaard Intrusion. This constitutes the first recorded occurrence of Au mineralisation in the metamorphic basement rocks of east Greenland. The mineralisation can be classified as orogenic style, quartz vein-hosted Au mineralisation. Two vein types have been identified based on their alteration styles and the presence of Au mineralisation. Mineralised type 1 veins occur within sheared supracrustal units and are hosted by garnet-bearing amphibolites, with associated felsic and ultramafic intrusions. Gold is present as native Au and Au-rich electrum together with arsenopyrite and minor pyrite and chalcopyrite in thin alteration selvages in the immediate wall rocks. The alteration assemblage of actinolite-clinozoisite-muscovite-titanite-scheelite-arsenopyrite-pyrite is considered to be a greenschist facies assemblage. The timing of mineralisation is therefore interpreted as being later and separate event to the peak amphibolite facies metamorphism of the host rocks. Type 2 quartz veins are barren of mineralisation, lack significant alteration of the wall rocks and are considered to be later stage. Fluid inclusion microthermometry of the quartz reveals three separate fluids, including a high temperature (T <sub>h</sub>  = 300–350 °C), H<sub>2</sub>O–CO<sub>2</sub>–CH<sub>4</sub> fluid present only in type 1 veins that in interpreted to be responsible for the main stage of Au deposition and sulphidic wall rock alteration. It is likely that the carbonic fluids were actually trapped at temperatures closer to 400 °C. Two other fluids were identified within both vein types, which comprise low temperature (100–200 °C) brines, with salinities of 13–25 wt% eq. NaCl and at least one generation of low salinity aqueous fluids. The sources and timings of the secondary fluids are currently equivocal but they may be related to the emplacement of Paleogene mafic intrusions. The identification of this occurrence of orogenic-style Au mineralisation has implications for exploration in the underexplored area of east Greenland between 62 and 69° N, where other, similar supracrustal units are known to be present.<p></p&gt