An update on maternal medication-related embryopathies

There is a general perception that any exposure to medication during pregnancy poses a potential risk to the fetus. Most available data about teratogenic drugs is derived from animal studies, case reports, or cohort studies. As a result, counseling women and their partners about the safety of drugs during pregnancy can be difficult due to limited information about efficacy, pharmacokinetics, and teratogenicity of some drugs. However, this should always be done in the context of weighing up potential teratogenic risks with the perinatal risks of an untreated medical or psychiatric condition. Ideally, this counseling should occur prior to a planned pregnancy so that medications and treatment of chronic medical conditions can be optimized. It is important that clinicians providing antenatal care are able to confidently manage women including utilizing appropriate resources. This paper aims at reviewing a selected (non-exhaustive) list of the most commonly prescribed medications considered significant human teratogens and provides recommendations for pre-conception and antenatal counseling.     

Oxygen and carbon stable isotopic profiles of the fan mussel, Pinna nobilis, and reconstruction of sea surface temperatures in the Mediterranean

Stable oxygen and carbon isotope profiles ('¹⁸O_skeletal and '¹³C_skeletal), taken along the direction of growth from the umbo to the shell margin in shells of the pinnid Pinna nobilis, were used to reconstruct sea surface temperatures (SST) in the south-east Mediterranean and ontogenetic records of metabolic CO₂ incorporation. Comparison of the seasonal cycle of SST, predicted from the '¹⁸O_skeletal record of a small (young) rapidly growing pinnid and temperature measured with a continuous in situ recorder showed that P. nobilis calcifies under isotopic equilibrium with surrounding seawater, thus indicating that P. nobilis shells can be used as a reliable predictor of SST. A 10-year SST record for the south-east Mediterranean was reconstructed from the shell profiles of four pinnid shells of different sizes and ages collected in 1995 and 1996. Reliable resolution of the seasonal SST could only be achieved during the first 4 years of shell growth. As the pinnids grew older, the temperature record was poorly resolved because the shell growth had diminished with age, resulting in time-averaging of the record. The amplitude of the generated seasonal temperature cycle compared favourably (DŽ°C) with a long-term temperature record from northern Mediterranean waters. Clear seasonal cycles in '¹³C_skeletal were observed with an amplitude of ~1.0‰, similar to the calculated seasonal changes in '¹³C of seawater (0.6‰) overlying seagrass meadows. An ontogenetic trend towards less positive '¹³C_skeletal values was too large to be attributed to any decrease in '¹³C in seawater resulting from the invasion of anthropogenic CO₂. It is suggested that the temporal changes of '¹³C_skeletal are due to incorporation of respiratory CO₂ into the extrapallial fluid and reflect changes in the metabolic activity of the pinnid rather than changes in the isotopic composition of dissolved inorganic carbon within the surrounding seawater.     

THE EFFECTS OF ARTIFICIAL CIRCULATION ON A SMALL NORTHEASTERN IMPOUNDMENT1

ABSTRACT: Artificial circulation was applied at East Sidney Lake, a small, eutrophic impoundment in New York, to improve the water quality of the reservoir and tailwater. Treatment was successful at both reducing the stability of the reservoir and maintaining higher mean oxygen concentrations in the bottom waters. Discharge waters had lower metals and phosphorus concentrations during treatment years. However, vertical temperature differences, although minimal, were still sufficient to permit chemical stratification and some phosphorus release from the sediments. Frequent mixing events during periods of low stability, and runoff from storm events, also appeared to increase transport of phosphorus into the epilimnion. Overall, treatment did not result in decreases in algal populations or improvements in water clarity.     

CHANGE IN LAKE TROPHIC STATE AND INTERNAL PHOSPHORUS RELEASE AFTER ALUMINUM SULFATE APPLICATION1

ABSTRACT: Recovery of eutrophic lakes after nutrient diversion may be delayed if the lake experiences significant internal phosphorus (p) loading to the water column. A maximum dose of aluminum sulfate, defined herein, was applied to the anaerobic sediments of the hypolimnia of two dimictic Ohio lakes following septic tank diversion, with the objective of attaining long term control of the release of phosphorus to the water column from these sediments. The results were compared to a similar, downstream, untreated lake. Total phosphorus concentration declined sharply after treatment and has remained so through 1980 for both lakes, a period of 5 and 6 years of control, respectively. Internal P loading from anaerobic, hypolimnetic sediments was partially controlled by the treatment but there are other important sources, perhaps in the littoral zone, in these lakes. Algal biomass is Smaller and water transparency has increased. Both lakes became mesotrophic after treatment, as described by the Carlson (1977) trophic state index, and remain in that improved condition to date. No deleterious side effects were observed, although one lake experienced a significant decrease in diversity of planktonic microcrustacea and a lakeward extension of the macrophyte community. This method appears to be an effective and lasting means of accelerating the recovery of a eutrophic lake following nutrient diversion.     

RHODAMINE WT DYE LOSSES IN A MOUNTAIN STREAM ENVIRONMENT1

ABSTRACT: A significant fraction of rhodamine WT dye was lost during a short term multitracer injection experiment in a mountain stream environment. The conservative anion chloride and the sorbing cation lithium were concurrently injected. In-stream rhodamine WT concentrations were as low as 45 percent of that expected, based on chloride data. Concentration data were available from shallow‘wells’dug near the stream course and from a seep of suspected return flow. Both rhodamine WT dye and lithium were nonconservative with respect to the conservative chloride, with rhodamine WT dye closely following the behavior of the sorbing lithium. Nonsorption and sorption mechanisms for rhodamine WT loss in a mountain stream were evaluated in laboratory experiments. Experiments evaluating nonsorption losses indicated minimal losses by such mechanisms. Laboratory experiments using sand and gravel size streambed sediments show an appreciable capacity for rhodamine WT sorption. The detection of tracers in the shallow wells and seep indicates interaction between the stream and the flow in the surrounding subsurface, intergravel water, system. The injected tracers had ample opportunity for intimate contact with materials shown in the laboratory experiments to be potentially sorptive. It is suggested that in the study stream system, interaction with streambed gravel was a significant mechanism for the attenuation of rhodamine WT dye (relative to chloride).     

LAKE SUPERIOR REGULATION EFFECTS

ABSTRACT: The outflows of Lake Superior through the St. Marys River have been modified from natural conditions, initially by the construction of engineering works, such as bridges, and later by the construction of control works and the regulation of the lake. For all practical purposes, the period from 1860 to 1887 represents the natural river conditions. During the period 1888-1900 the regimen was modified by the construction of the International Railroad Bridge and the Chandler-Dunbar Power Canal. In 1901 construction began on the compensating works. Following the completion of the compensating works in August 1921, the Lake Superior outflows were regulated in accordance with the Orders of Approval, 26 and 27 May 1914. A hydrologic response model was developed to simulate the natural Lake Superior regime. The model was run for the 1860–1975 period to simulate natural Lake Superior levels and outflows. The simulated levels were compared with the recorded levels to determine the effect of regulation. It was found that regulation has resulted in a rise in Lake Superior water levels. The simulated natural outflows for the period from 1937 to 1975 were run through the Great Lakes hydrologic response model to analyze the regulation effects on Lakes Michigan-Huron, St. Clair, and Erie. The results show no long-term bias due to regulation.     

Evaluation of Ecologically Relevant Bioassays for a Lotic System impacted by a Coal-mine effluent, using Isonychia

Many studies investigating the ecotoxicological impacts of industrial effluents on fresh-water biota utilize standardized test species such as the daphnids, Ceriodaphnia dubia, Daphnia magna, and the fathead minnow, Pimephales promelas. Such species may not be the most predictive or ecologically relevant gauges of the responses of instream benthic macroinvertebrates to certain stressors, such as total dissolved solids. An indigenous species approach should be adopted, using a sensitive benthic collector-filterer following development of practical laboratory bioassays. In the Leading Creek Watershed (southeast Ohio), an aggregated approximately 99% reduction in mean mayfly abundance for all impacted sites was observed below a coal-mine effluent with mean specific conductivity (SC) of 8,109 (7,750-8,750) microS cm(-1). The mayfly, Isonychia, was exposed for 7-days to a simulation of this effluent, in lotic microcosms. Based on lowest observable adverse effect concentrations, Isonychia survival was a more sensitive endpoint to SC (1,562 microS cm(-1)) than were 7-day C. dubia survival and fecundity (3,730 microS cm(-1)). Isonychia molting, a potentially more sensitive endpoint, was also examined. Using traditional test species to assess discharges to surface water alone may not adequately protect benthic macroinvertebrate assemblages in systems impaired by discharges high in SC.     

CLIMATE CHANGE IMPACTS UNCERTAINTY FOR WATER RESOURCES IN THE SAN JOAQUIN RIVER BASIN,CALIFORNIA1

ABSTRACT: A climate change impacts assessment for water resources in the San Joaquin River region of California is presented. Regional climate projections are based on a 1 percent per year CO₂ increase relative to late 20th Century CO₂ conditions. Two global projections of this CO₂ increase scenario are considered (HadCM2 and PCM) during two future periods (2010 to 2039 and 2050 to 2079). HadCM2 projects faster warming than PCM. HadCM2 and PCM project wetter and drier conditions, respectively, relative to present climate. In the HadCM2 case, there would be increased reservoir inflows, increased storage limited by existing capacity, and increased releases for deliveries and river flows. In the PCM case, there would be decreased reservoir inflows, decreased storage and releases, and decreased deliveries. Impacts under either projection case cannot be regarded as more likely than the other. Most of the impacts uncertainty is attributable to the divergence in the precipitation projections. The range of assessed impacts is too broad to guide selection of mitigation projects. Regional planning agencies can respond by developing contingency strategies for these cases and applying the methodology herein to evaluate a broader set of CO₂ scenarios, land use projections, and operational assumptions. Improved agency access to climate projection information is necessary to support this effort.     

REAL-TIME MANAGEMENT OF WATER QUALITY IN THE SAN JOAQUIN RWER BASIN,CALIFORNIA1

ABSTRACT: In the San Joaquin River Basin, California, a realtime water quality forecasting model was developed to help improve the management of saline agricultural and wetland drainage to meet water quality objectives. Predicted salt loads from the water quality forecasting model, SJRIODAY, were consistently within ± 11 percent of actual, within ± 14 percent for seven-day forecasts, and within ± 26 percent for 14-day forecasts for the 16- month trial period. When the 48 days dominated by rainfall/runoff events were eliminated from the data set, the error bar decreased to ± 9 percent for the model and ± 11 percent and ± 17 percent for the seven-day and 14-day forecasts, respectively. Constraints on the use of the model for salinity management on the San Joaquin River include the number of entities that control or influence water quality and the lack of a centralized authority to direct their activities. The lack of real-time monitoring sensors for other primary constituents of concern, such as selenium and boron, limits the application of the model to salinity at the present time. A case study describes wetland drainage releases scheduled to coincide with high river flows and significant river assimilative capacity for salt loads.     

LAKE ONTARIO REGULATION UNDER TRANSPOSED CLIMATES1

ABSTRACT: The implications of Lake Ontario regulation under transposed climates with changed means and variability are presented for seasonal and annual time scales. The current regulation plan is evaluated with climates other than the climate for which it was developed and tested. This provides insight into potential conflicts and management issues, development of regulation criteria for extreme conditions, and potential modification of the regulation plan. Transposed climates from the southeastern and south central continental United States are applied to thermodynamic models of the Great Lakes and hydrologic models of their watersheds; these climates provide four alternative scenarios of water supplies to Lake Ontario. The scenarios are analyzed with reference to the present Great Lakes climate. The responses of the Lake Ontario regulation plan to the transposed climate scenarios illustrate several key issues: (1) historical water supplies should no longer be the sole basis for testing and developing lake regulation plans; (2) during extreme supply conditions, none of the regulation criteria can be met simultaneously, priority of interests may change, and new interests may need to be considered, potentially requiring substantial revision to the Boundary Waters Treaty of 1909; (3) revised regulation criteria should be based on ecosystem health and socio-economic benefits for a wider spectrum of interests and not on frequencies and ranges of levels and flows of the historical climate; and (4) operational management of the lake should be improved under the present climate, and under any future climate with more variability, through the use of improved water supply forecasts and monitoring of current hydrologic conditions.