Is there a role for fetal interventions in gastroschisis management? – An updated comprehensive review

We conducted a comprehensive evidence-based review on the epidemiology and current standard of care of gastroschisis management as well as the pathophysiology, rationale and feasibility of fetal therapy as a viable alternative. Gastroschisis is a periumbilical abdominal wall defect characterized by abdominal viscera herniation in utero. It affects 4 in 10 000 live births, but the prevalence has steadily increased in recent years. Gastroschisis is typically diagnosed on routine second-trimester ultrasound. The overall prognosis is favorable, but complex gastroschisis, which accounts for about 10% to 15% of cases, is associated with a higher mortality, significant disease burden and higher healthcare costs due to long- and short-term complications. The current standard of care has yet to be established but generally involves continued fetal surveillance and multidisciplinary perinatal care. Postnatal surgical repair is achieved with primary closure, staged silo closure or sutureless repair. Experimental animal studies have demonstrated the feasibility of in utero closure, antiinflammatory therapy and prenatal regenerative therapy. However, reports of early preterm delivery and amnioinfusion trials have failed to show any benefit in humans. Further experimental studies and human trials are necessary to demonstrate the potential benefit of fetal therapy in gastroschisis.     

Environmental quality assessment combining sediment metal levels, biomarkers and macrobenthic communities: application to the óbidos coastal lagoon (Portugal)

Macroinvertebrate benthic communities are one of the key biological components considered for the assessment of benthic integrity in the context of the Water Framework Directive (WFD). However, under moderate contamination scenarios, the assessment of macrobenthic alterations at community level alone could be insufficient to discriminate the environmental quality of coastal and transitional waters. Keeping this in view, sediment quality of moderately contaminated sites in a coastal lagoon (óbidos lagoon, Portugal) was assessed by the combination of sediment metal levels, Carcinus maenas biomarkers (accumulated metals and oxidative stress responses) and macrobenthic communities. Two sites were selected in confined inner branches (BS and BB) and a third one in the middle lagoon (ML). The site BB presented slightly higher levels of metals in sediment but biological variables calculated for macrobenthic data were not significantly different between sites. The biotic index M-AMBI that is being applied to assess environmental quality of transitional waters in the scope of the WFD pointed either to high (site ML) or good quality status (BS and BB) in the selected sites. However, crabs from BB site presented significantly higher levels of Ni in hepatopancreas than those from ML and macrobenthic community structure was significantly different between BB and ML. Additionally, spatial differences were obtained for oxidative stress parameters suggesting that BB site presented stressors for crabs (higher GST and lower GSH_t at BB site). Factor analysis (PCA) integrating sediment contamination, biomarkers in crabs and macrobenthic data also distinguished BB site as the most environmentally disturbed. On the other hand, at ML site, some macrobenthic variables (equitability and polychaetes’ diversity) were found to be enhanced by current environmental conditions, suggesting the existence of a better sediment quality. Current results pointed to the usefulness of integrating macrobenthic community alterations with responses at organism level (bioaccumulation and biochemical endpoints) in order to increase the accuracy of environmental quality assessment in lagoon systems. Moreover, the application of different statistical methods was also found to be recommendable.     

Does ISO 14001 work in Brazil?

As a result of increasing global awareness about the importance of the environment, depletion of natural resources and legal pressures for companies to manage their processes in a sustainable manner, ISO 14001 systems have been gaining increasingly more importance in the organizational scenario. These elements are even more critical in emerging nations due to less awareness and fewer demands by governments and the population in relation to environmental issues. Therefore, the main objective of this study is to verify the benefits and difficulties of Environmental Management Systems based on ISO 14001 at industries in the state of São Paulo – Brazil (an emerging country) by conducting a survey to subsidize the proposal for actions in the public, academic and private sectors to promote the use of this standard of reference and strengthen its results in Brazil. A questionnaire was sent to 194 companies from the National Institute of Metrology, Standardization and Industrial Quality database. 69 answered, representing a return rate of 35.36%. The main benefits identified are related to the development of preventive environmental actions, reduction in the consumption of power, water, gas and fuel oil, and a positive influence on other internal management processes. The main difficulties are related to cost increases from ISO 14001 management systems and the constant changes in environmental legislation in Brazil. Some actions are proposed at the end of the analyses to intensify the use and improve the results of this standard, such as changes in government legislation and its collective development and implementation in industries.