Stage-based approach to the management of fetal growth restriction

Fetal growth restriction (FGR) is among the obstetrical entities with the greatest variation in clinical practice. The first clinically relevant step in the management of FGR is the distinction of ‘true’ FGR, associated with signs of abnormal feto-placental function and poorer perinatal outcome, from small for gestational age fetuses, which do not present abnormal Doppler and have near normal perinatal outcome. Such distinction should not be only relied on umbilical artery Doppler, as this parameter identifies only severe, early-onset, forms of placental insufficiency. Instead, FGR should be diagnosed in the presence of any of the factors associated with a poorer perinatal outcome, including Doppler cerebroplacental ratio and uterine artery Doppler, a growth centile below the third centile. Upon diagnosis, differentiating into early-onset and late-onset FGR is useful to distinguish two clear phenotypes, with differences in severity, association with preeclampsia, and sequence of fetal deterioration. Finally, management of FGR aims at an optimal balance between minimizing fetal injury or death versus the risks of iatrogenic preterm delivery. We propose a protocol that integrates current evidence to classify stages of fetal deterioration, and establishes follow-up intervals and optimal delivery timings, which may facilitate decision-making and minimize variability in the clinical management. © 2014 John Wiley & Sons, Ltd.     

Seasonal evolution of beach waste and litter during the bathing season on the Catalan coast

Beach waste and litter composition and evolution on popular urban (located in the main nucleus of the municipality) and urbanized (located in residential areas outside the main nucleus) beaches of the Costa Brava (Catalan coast) were assessed during the bathing season. Waste and litter production (amount and composition) were affected by urbanization and varied during the summer. Urban beaches had higher densities of waste deposition and lower percentages of organic, domestic and other miscellaneous waste than urbanized beaches. Litter characteristics were also influenced by type of beach, and varied during the season as a consequence of beach use and cleaning practices, but not environmental factors. Urbanized beaches obtained higher scores for aesthetic quality of sand than urban beaches, and small-sized litter tended to accumulate during the season in the beach of Lloret Centre. The most important problems are management of recyclable materials, litter left by users on the sand, and separation of sand from litter. In addition, current efficiency of mechanical cleaning is low, especially in the withdrawal of cigarette butts. These analyses highlight problems that should be addressed in future management of area beaches.     

Identification of magnetic particulates in road dust accumulated on roadside snow using magnetic, geochemical and micro-morphological analyses

The aim of this study is to test the applicability of snow surveying in the collection and detailed characterization of vehicle-derived magnetic particles. Road dust extracted from snow, collected near a busy urban highway and a low traffic road in a rural environment (southern Finland), was studied using magnetic, geochemical and micro-morphological analyses. Significant differences in horizontal distribution of mass specific magnetic susceptibility (χ) were noticed for both roads. Multi-domain (MD) magnetite was identified as the primary magnetic mineral. Scanning electron microscope (SEM) analyses of road dust from both roads revealed: (1) angular-shaped particles (diameter ∼1-300 μm) mostly composed of Fe, Cr and Ni, derived from circulation of motor vehicles and (2) iron-rich spherules (d ∼ 2-70 μm). Tungsten-rich particles (d < 2 μm), derived from tyre stud abrasion were also identified. Additionally, a decreasing trend in χ and selected trace elements was observed with increasing distance from the road edge.