RESUMEN
AIMS: The lack of standardised definitions for heart failure outcome measures limits the ability to reliably assess effectiveness of heart failure therapies. The European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart) aimed to produce a catalogue of internationally endorsed data definitions for heart failure outcome measures. METHODS: Following the EuroHeart methods for the development of cardiovascular data standards, a working group was formed of representatives from the European Society of Cardiology Heart Failure Association and other leading heart failure experts. A systematic review of observational and randomised clinical trials identified current outcome measures, which was supplemented by clinical practice guidelines and existing registries for contemporary definitions. A modified Delphi process was employed to gain consensus for variable inclusion and whether collection should be mandatory (Level 1) or optional (Level 2) within EuroHeart. In addition, a set of complementary outcome measures were identified by the Working Group as of scientific and clinical importance for longitudinal monitoring for people with heart failure. RESULTS: Five Level 1 and two Level 2 outcome measures were selected and defined, alongside five complementary monitoring outcomes for patients with heart failure. CONCLUSION: We present a structured, hierarchical catalogue of internationally endorsed heart failure outcome measures. This will facilitate quality improvement, high quality observational research, registry-based trials, and post market surveillance of medical devices.
RESUMEN
Samples of intestine and hepatopancreas from 65 blue land crabs (Cardisoma guanhumi), a crustacean commonly consumed as a food item in Grenada, were collected from six geographic sites in Grenada and tested for Salmonella by enrichment and selective culture. The individual animal prevalence of Salmonella based on isolation was 17% (11 of 65), and all infected crabs were from three of the six sampled locations. Isolates were identified by serotyping as Salmonella enterica serovars Saintpaul (n = 6), Montevideo (n = 4), and Newport (n = 1). The intestines of all 11 infected crabs were positive for Salmonella, but only 7 of 11 hepatopancreas samples were positive for Salmonella, and these isolates were the same serovar as isolated from the matching intestine. These three Salmonella serovars are known to cause human illness in many countries, and in the Caribbean Salmonella Saintpaul has been frequently isolated from humans. In a disc diffusion assay, all isolates were susceptible to all 11 drugs tested: amoxicillin-clavulanic acid, ampicillin, cephalothin, chloramphenicol, ciprofloxacin, gentamicin, imipenem, neomycin, streptomycin, tetracycline, and trimethoprim-sulfamethoxazole. To our knowledge, this report is the first concerning isolation and antimicrobial susceptibilities of Salmonella serotypes from the blue land crab.