Risk of amniocentesis in women screened positive for Down syndrome with second trimester maternal serum markers

In routine obstetrical practice, prior to offering invasive prenatal diagnosis, it is crucial to weigh the risks attendant on amniocentesis against the individual's risk of aneuploidy. We took advantage of a policy of follow-up of patients undergoing Down syndrome maternal serum screening to compare the rates of fetal loss before 24 weeks and of early premature delivery at 24–28 weeks between women who underwent amniocentesis and women who did not. A total of 54 902 patients entered the study, of whom 4039 (7.35%) were lost to follow-up and 387 were excluded because of a severe fetal abnormality. Of the 50 476 remaining patients, 3472 had an amniocentesis whereas 47 004 had not and served as controls. In the amniocentesis group, the fetal loss rate before 24 weeks was 1.12% (95% CI=1.08–1.15) and the 24–28 weeks premature delivery rate was 0.40% (95% CI=0.39–0.41) which was significantly higher than in controls (0.42% with 95% CI 0.41–0.43 and 0.24% with 95% CI 0.23–0.25, respectively). The 0.86% difference in adverse outcome rates between the amniocentesis and control groups may be attributable to amniocentesis and compares favourably with the positive predictive value of maternal serum markers (1.70%) observed in the present study. Copyright © 2002 John Wiley & Sons, Ltd.     

A Review of Known and Hypothetical Transmission Routes for Noroviruses

Human noroviruses (NoVs) are considered a worldwide leading cause of acute non-bacterial gastroenteritis. Due to a combination of prolonged shedding of high virus levels in feces, virus particle shedding during asymptomatic infections, and a high environmental persistence, NoVs are easily transmitted pathogens. Norovirus (NoV) outbreaks have often been reported and tend to affect a lot of people. NoV is spread via feces and vomit, but this NoV spread can occur through several transmission routes. While person-to-person transmission is without a doubt the dominant transmission route, human infective NoV outbreaks are often initiated by contaminated food or water. Zoonotic transmission of NoV has been investigated, but has thus far not been demonstrated. The presented review aims to give an overview of these NoV transmission routes. Regarding NoV person-to-person transmission, the NoV GII.4 genotype is discussed in the current review as it has been very successful for several decades but reasons for its success have only recently been suggested. Both pre-harvest and post-harvest contamination of food products can lead to NoV food borne illness. Pre-harvest contamination of food products mainly occurs via contact with polluted irrigation water in case of fresh produce or with contaminated harvesting water in case of bivalve molluscan shellfish. On the other hand, an infected food handler is considered as a major cause of post-harvest contamination of food products. Both transmission routes are reviewed by a summary of described NoV food borne outbreaks between 2000 and 2010. A third NoV transmission route occurs via water and the spread of NoV via river water, ground water, and surface water is reviewed. Finally, although zoonotic transmission remains hypothetical, a summary on the bovine and porcine NoV presence observed in animals is given and the presence of human infective NoV in animals is discussed.     

Risks and benefits of lethal male fighting in the colonial,polygynous thrips Hoplothrips karnyi (Insecta: Thysanoptera)

Summary Males of Hoplothrips karnyi (Hood) (Insecta: Thysanoptera), a colonial fungus-feeding thrips, fight each other in defense of communal egg mass sites, where they mate with females that come to oviposit. Fighting males stab each other with their enlarged, armed forelegs and hit each other with their abdomens. Escalated fights occur between large males of similar size. Fights are often lethal; males that died during observations fought more frequently than other males, were stabbed more often and more severely than other males, and were relatively large, but somewhat smaller than their opponents. Large males tend to win fights and guard egg masses, and they secure about 80% of last matings before ovipositions. Guarding males apparently assess female reproductive condition by putting their forelegs partially around females' abdomens; guarding males, but not nonguarding males, mate preferentially with females that have yet to oviposit. Non-guarding males mate with females away from egg masses, sneak matings at egg masses, and occasionally challenge guarding males. Challenges tend to follow matings by non-guarding males at egg masses. Each of four observed or inferred takeovers was followed by the death of the guarding male that lost. Male fighting strategies are discussed in terms of the consistency of lethal fighting with game theory models. Guardin males appear to pursue a classical hawk strategy of escalate until injured or victorious. This strategy may be advantageous because only large males become guarders, the mating success of guarders greatly exceeds that of non-guarders, and high population viscosity ensures that benefits from killing an opponent accrue directly to gaurders. The occurrence of challenges by large non-guarders implies that fighting ability and resource value asymmetries between males change over time; such changes may result from the energetic costs of guarding, injury to guarding males, or depletion of guarding males' supply of sperm.     

Advances in the Analysis of Air Contaminants Comments

Abstract

Methylcyclopentadienyl manganese tricarbonyl (MMT) is an organometallic compound used as an octane improver in unleaded gasoline. The combustion of MMT leads to the formation of manganese (Mn) oxides, mainly Mn₃O₄. The objective of this study is to assess the variations over time and space of respirable (Mn_R) and total (Mn_T) Mn in the urban atmosphere and to evaluate human exposure by inhalation. Two sampling sites were selected on the island of Montreal based on their local traffic density (municipal botanical garden, C^-= 10,000–15,000 vehicles d^-1; Montreal Waterworks, C⁺= 100,000–130,000 vehicles d^-1). Air samplings were made during the day at stations located 10 m from the road using portable pumps, some of which were equipped with a cyclone. Mn_R and Mn_T and other metals were measured on Teflon filters by neutron activation. Mn exposure doses by inhalation were calculated using Monte–Carlo simulations. Mn_R and Mn_T average concentrations were significantly higher at site C⁺ (Mn_R = 0.024 µg m^-3; Mn_T = 0.050 µg m^-3) than at site C^- (Mn_R= 0.015 µg m^-3; Mn_T= 0.027 µg m^-3). Temporal profiles at sites C⁺ and site C^-were similar, with a coefficient of correlation of 0.24 for Mn_R and 0.26 for Mn_T. Trend analyses (ARIMA) also showed that the period of the week (work days vs. off days) was significantly related to Mn_R and Mn_T variations at both sites. The average exposure dose by inhalation to Mn_R and Mn_T ranged from 0.001 to 0.030 µg kg^-1 day^-1 and 0.001 to 0.05 µg kg^-1 day^-1. Mn_R and Mn_T concentrations reflected a positive relationship with traffic density. However, it remains difficult to attribute these results directly to the combustion of MMT in unleaded gasoline. On average, the Mn_R and Mn_T inhalation doses were 2 to 15 times lower than the reference dose (RfC) proposed by the U.S. Environmental Protection Agency (EPA) for the general population.     

Cerebro-costo-mandibular syndrome in a father and a female fetus: early prenatal ultrasonographic diagnosis and autosomal dominant transmission

Ultrasonography in a female fetus revealed cystic cervical hygroma, severe micrognathia, and vertebral and upper limb anomalies suggestive of cerebro-costo-mandibular syndrome (CCMS) which was diagnosed ultrasonographically at 16 weeks' gestation. The father is affected and presents with a Pierre Robin sequence, short stature and typical costovertebral anomalies. CCMS is a rare and severe disorder. The high frequency of sporadic cases, vertical transmission, and the excess of sibs affected via horizontal transmission suggest dominant autosomal mutation with possible germinal mosaicism. The vertical familial case detailed in the present report is a reminder of the high risk when one parent or one sibling is affected and the extreme variability of phenotype and costal ossification. Early prenatal ultrasound diagnosis is possible in a severely affected fetus. Copyright © 2001 John Wiley & Sons, Ltd.