Prevalencia, presentación y manejo antitrombótico de la fibrilación auricular en la consulta cardiológica ambulatoria

Antecedentes: la fibrilación auricular (FA) es la arritmia sostenida más frecuente en la clínica. Existen pocos datos en nuestro medio sobre la prevalencia, modo de presentación, perfil de riesgo tromboembólico y tratamiento antitrombótico de los pacientes con FA asistidos en la consulta cardiológica general ambulatoria. Método: se identificaron los casos de FA entre las consultas ambulatorias programadas consecutivas en 30 días (junio-julio de 2015) de diez cardiólogos a través de la historia clínica electrónica. Se estudiaron factores demográficos, score de riesgo tromboembólico, tipo de FA y utilización de medicación antitrombótica. Las variables cualitativas se analizaron mediante test exacto de Fisher y las cuantitativas mediante test t de Student o Mann-Whitney, según correspondiera. Resultados: entre 1.875 consultas analizadas, tenían registros de FA 282 (15%), correspondientes a 272 pacientes. La edad de los que tenían FA fue 78,4 ± 8,3 años, mientras que fue 68,3 ± 14 años en el resto (p<0,001). En el sexo masculino tenían FA 136 de 810 consultas (16,7%) y en el sexo femenino en 136 de 1.065 consultas (12,7%) (p=0,0171). En los 257 pacientes con FA no valvular el score CHA2DS2-VASc promedio fue 3,8 ± 1,4, mientras que el 95,3 % tenía un score ³2. El 70,2% tenía FA permanente/persistente y 29,8% la forma paroxística. En FA permanente/persistente la edad media fue 79,2 ± 7,9 años y en FA paroxística fue 76,5 ± 9 años (p=0,0207), el score CHA2DS2-VASc promedio fue 3,9 ± 1,3 y 3,5 ± 1,6 (p=0,0099) respectivamente. Recibían algún tratamiento antitrombótico 252 (92,6%), un anticoagulante oral (ACO) 207 (76,1%), antiagregantes plaquetarios 55 (20,2%) y ambos 10 (3,7%). En FA permanente/persistente recibían ACO 171 de 191 pacientes (89,5 %) y en FA paroxística 36 de 81 (44,4%) (p< 0,0001). El ACO utilizado fue warfarina en 64 (23,5%) y un anticoagulante directo (NOAC) en 143 (52,6%). Conclusiones: la prevalencia de FA en la consulta cardiológica ambulatoria fue elevada, con mayor frecuencia en el sexo masculino y con una media de edad superior en diez años al resto de la población. El 95,3 % de las FA no valvulares tenía score de riesgo ³2 por lo que eran elegibles para ACO. La utilización de ACO fue elevada, pero fue más del doble en FA permanente/persistente que en FA paroxística, aunque la diferencia en edad o score de riesgo entre ambos tipos fue pequeña. La utilización de NOAC superó a la warfarina por más de 2 a 1.

Benthic response to upwelling events off the SE Brazilian coast

The main aim of the present study was to evaluate and compare temporal responses of the benthos in 2 continental shelf areas (Cabo Frio and Ubatuba) off the SE Brazilian coast. In Cabo Frio (23 degrees S, 42 degrees W), the western boundary coastal upwelling of the South Atlantic Central Water (SACW) enhances primary productivity, potentially increasing food supply to the benthic communities via sinking of particulate organic carbon (POC). In contrast, POC fluxes in Ubatuba (23 degrees S, 45 degrees W) are expected to be comparatively lower because SACW remains subsurface. We analyzed the temporal and spatial input of phytodetritus (concentration of chlorophyll a in sediments) and the benthic microbial biomass (estimated by ATP-based carbon content in sediments). Median surface chlorophyll concentration was computed for all daily available SeaWiFS images (from 2001 and 2002) to follow chlorophyll a inputs. All parameters used to investigate benthic responses in the study areas showed consistently higher values in Cabo Frio than in Ubatuba. The results showed that benthic response to upwelling may last months, fueling the microbial communities in the Cabo Frio region.

Environmental and grazing influence on spatial variability of intertidal biofilm on subtropical rocky shores

Epilithic biofilm on rocky shores is regulated by physico-chemical and biological factors and is important as a source of food for benthic organisms. The influences of environmental and grazing pressure on spatial variability of biomass of biofilm were evaluated on shores on the north coast of São Paulo State (SE Brazil). A general trend of greater abundance of microalgae was observed lower on the shore, but neither of the environmental factors evaluated (wave exposure and shore level) showed consistent effects, and differences were found among specific shores or times (September 2007 and March 2008). The abundance of slow-moving grazers (limpets and littorinids) showed a negative correlation with chlorophyll a concentration on shores. However, experimental exclusion of these grazers failed to show consistent results at small spatial scales. Observations of divergent abundances of the isopod Ligia exotica and biomass of biofilm on isolated boulders on shores led to a short exclusion experiment, where the grazing pressure by L. exotica significantly decreased microalgal biomass. The result suggests that grazing activities of this fast-moving consumer probably mask the influence of slow-moving grazers at small spatial scales, while both have an additive effect at larger scales that masks environmental influences. This is the first evaluation of the impact of the fast-moving herbivore L. exotica on microalgal biomass on rocky shores and opens an interesting discussion about the role of these organisms in subtropical coastal environments.

Novel insights into the dynamics of green turtle fibropapillomatosis

Outbreaks of fibropapillomatosis (FP), a neoplastic infectious disease of marine turtles, have occurred worldwide since the 1980s. Its most likely aetiological agent is a virus, but disease expression depends on external factors, typically associated with altered environments. The scarcity of robust long-term data on disease prevalence has limited interpretations on the impacts of FP on turtle populations. Here we model the dynamics of FP at 2 green turtle foraging aggregations in Puerto Rico, through 18 yr of capture-mark-recapture data (1997−2014). We observed spatiotemporal variation in FP prevalence, potentially modulated via individual site-fidelity. FP ex pression was residency dependent, and FP-free individuals developed tumours after 1.8 ± 0.8 yr (mean ± SD) in the infected area. Recovery from the disease was likely, with complete tumour regression occurring in 2.7 ± 0.7 yr (mean ± SD). FP does not currently seem to be a major threat to marine turtle populations; however, disease prevalence is yet unknown in many areas. Systematic monitoring is highly advisable as human-induced stressors can lead to deviations in host− pathogen relationships and disease virulence. Finally, data collection should be standardized for a global assessment of FP dynamics and impacts.

An experimental study of gill net and trammel net 'ghost fishing' off the Algarve (southern Portugal)

Four 100 m lengths of both monofilament gill nets and trammel nets were deployed at depths between 15 and 18 m off the coast of the Algarve (south of Portugal) between April 1995 and June 1996. The nets were set on a natural rocky bottom with one end cut loose to simulate lost nets. Changes in net structure (net height, effective fishing area, movement, colonisation, wear and tear) and their catches (species, sizes, numbers, and biomass) were monitored by divers. Similar patterns were observed in all the nets, with a sharp decrease in net height and effective fishing area, and an increase in visibility within the first few weeks. Net movement was negligible except in the case of interference from other fishing gears. Catch rates were initially comparable to normally fished gill nets and trammel nets in this area, but decreased steadily over time. No sea birds, reptiles or mammals were caught in any of the 8 nets. Catches were dominated by fish (89 % by number, at least 27 species), in particular by sea breams (Sparidae) and wrasses (Labridae). Under the conditions experienced throughout the study the fishing Lifetime of a 'lost' net is between 15 and 20 wk. Based on an exponential model, we estimated that 100 m lengths of gill net and trammel net will catch 314 and 221 fish respectively over a 17 wk period. However, we consider this to be an underestimate due to high rates of predation and scavenging by octopuses, cuttlefish, moray eels, conger eels, and other fish such as the wrasse Coris julis. When the nets were surveyed in the following spring, 8 to 11 mo after being deployed, they were found to be completely destroyed or heavily colonised by algae and had become incorporated into the reef.

Combining multispecies home range and distribution models aids assessment of MPA effectiveness

Marine protected areas (MPAs) are today's most important tools for the spatial management and conservation of marine species. Yet, the true protection that they provide to individual fish is unknown, leading to uncertainty associated with MPA effectiveness. In this study, conducted in a recently established coastal MPA in Portugal, we combined the results of individual home range estimation and population distribution models for 3 species of commercial importance and contrasting life histories to infer (1) the size of suitable areas where they would be fully protected and (2) the vulnerability to fishing mortality of each species. Results show that the relationship between MPA size and effective protection is strongly modulated by both the species' home range and the distribution of suitable habitat inside and outside the MPA. This approach provides a better insight into the true potential of MPAs in effectively protecting marine species, since it can reveal the size and location of the areas where protection is most effective and a clear, quantitative estimation of the vulnerability to fishing throughout an entire MPA.

Early reserve effects linked to small home ranges of a commercial fish, Diplodus sargus, Sparidae

Studies that combine both the ecological responses of marine species and protection measures with movement patterns and habitat use are of major importance in order to better understand the performance of marine protected areas (MPA) and how species respond to their implementation. However, few studies have assessed MPA performance by relating local individual movement patterns and the observed reserve effects. In this study, we combined acoustic telemetry with abundance estimates to study the early effects of a recently established small coastal MPA on the local populations of white seabream. The results show that even small, recently established coastal MPAs can increase the abundance and biomass of commercial fish species, provided that target species have small home ranges and exhibit high site fidelity.

Fish assemblages of shallow intertidal habitats of the Ria Formosa lagoon (South Portugal): influence of habitat and season

Fish assemblages in seagrass and unvegetated habitats located in shallow intertidal creeks within the saltmarsh area of the Ria Formosa coastal lagoon were sampled with a Riley push net at 3 sites on a monthly basis over a 1 yr period. The objective was to test if both habitats support similar fish assemblages in terms of abundance, diversity, assemblage structure, and size distribution, and to investigate how site and season affect the assemblages. Fish assemblages associated with these habitats were significantly different in terms of diversity, abundance, and assemblage structure. Seagrass supported a larger number of species and greater diversity, while unvegetated habitat supported greater fish numbers but only of a few species. The habitats were dominated by different groups of resident species that were responsible for major differences in fish assemblage structure between habitats. Pomatoschistus microps and young-of-the-year (YOY) Atherina presbyter dominated the unvegetated habitat, while seagrass was dominated by a diverse group of species, in particular syngnathids and small labrids, revealing different habitat preferences. Site and season were determinant factors conditioning the role of habitat in structuring fish assemblages. Distance between habitats, site elevation, and the amount of marsh drained affected fish assemblages in both habitats. Seasonal fluctuations in the presence and abundance of YOY from marine migrant and resident species were responsible for comparable changes in fish assemblage structure in both habitats. Both habitats provide a distinctive nursery area for different species, while common species reveal ontogenic distributional changes between habitats, where smaller fish appear first in unvegetated creeks.

Trophic signatures of small-scale fishing gears: implications for conservation and management

We quantified the ecosystem effects of small-scale gears operating in southern European waters (Portugal, Spain, Greece), based on a widely accepted ecosystem measure and indicator, the trophic level (TL). We used data from experimental fishing trials during 1997 to 2000. We studied a wide range of gear types and sizes: (1) gill nets of 8 mesh sizes, ranging from 44 to 80 mm; (2) trammel nets of 9 inner panel mesh sizes, ranging from 40 to 140 mm; and (3) longlines of 8 hook sizes, ranging from Nos. 15 (small) to 5 (large). We used the number of species caught per TL class for constructing trophic signatures (i.e. cumulative TL distributions), and estimated the TL at 25, 50 and 75% cumulative frequency (TL25, TL50, TL75) and the slopes using the logistic function. We also estimated the mean weighted TL of the catches (TLW). Our analyses showed that the TL characteristics of longlines varied much more than those of gill and trammel nets. The longlines of large hooks (Nos. 10, 9, 7, 5) were very TL selective, and their trophic signatures had very steep slopes, the highest mean TL50 values, very narrow mean TL25 to TL75 ranges and mean TLW > 4. In addition, the mean number of TL classes exploited was smaller and the mean TL50 and TLW were larger for the longlines of small hooks (Nos. 15, 13, 12, 11) in Greek than in Portuguese waters. Trammel and gill nets caught more TL classes, and the mean slopes of their trophic signatures were significantly smaller than those of longlines as a group. In addition, the mean number of TL classes exploited, the mean TL50 and the TLW of gill nets were significantly smaller than those of trammel nets. We attribute the differences between longlines of small hooks to bait type, and the differences between all gear types to their characteristic species and size-selectivity patterns. Finally, we showed how the slope and the TL50 Of the trophic signatures can be used to characterise different gears along the ecologically 'unsustainable-sustainable' continuum.

'Reserve effect' within a temperate marine protected area in the north-eastern Atlantic (Arrabida Marine Park, Portugal)

Benefits of marine protected areas depend on local ecological and socio-cultural aspects which are critical to the success of the protection measures. In particular, before-after comparisons are indispensable to disentangle the effects of protection from those of different physical and ecological characteristics among areas. Using underwater visual surveys, we assessed whether biomass and abundance of temperate reef fish assemblages and target invertebrates increased inside a no-take area in the Arrabida Marine Park (Portugal) 3 to 4 yr after its establishment. Data were compared to a previous study, conducted 10 yr before protection was effective. Control-effect comparisons after reserve establishment showed a positive response of legal-size demersal fish and below legal-size target invertebrates. The first evidence of protection was found in biomass but not in numbers. Non-target groups and below legal-size demersal fish had a significant interaction among reserve and habitat complexity indices for either density or biomass, suggesting a lack of a reserve effect. Before-after comparisons revealed non-significant patterns of increase in numbers of target species compared to non-target ones. The most important commercial species showed the largest increase in density after protection was established. Significantly higher abundances and proportionally heavier individuals of these species were also found inside the reserve in the control-effect comparisons. These findings are reinforced by an increasing trend in landings which are consistent with the early detection of a reserve effect.