Fetal intestinal loop dilatation: Follow-up and outcome of a series of 133 consecutive cases (the DILDIG study)

Objectives

To define the prognostic markers of fetal dilated bowel loops.

Methods

National non-interventional study of 133 consecutive prenatal observations of dilated loops including ultrasound examinations, complementary laboratory tests, magnetic resonance imaging (MRI), outcomes, and postnatal diagnosis.

Results

One hundred twenty seven cases were classified according to outcome: Group 1, very severe (n = 43), Group 2, children needing specific care (n = 39), and Group 3, healthy children (n = 45). Prenatal ultrasound scan suggested duodenal obstruction in 30 cases, small bowel obstruction in 81, colonic obstruction in 11, and diffuse dilatation in 5. Diameter of dilated loops did not significantly differ between the groups. A poor prognosis was significantly associated with duodenal obstruction, genetic anomalies (53% vs. 21.8%), including aneuploidies or CFTR gene mutations and abnormal amniotic fluid biochemistry (86.4% vs. 38.7%). A good prognosis was associated with regression of dilatation and normal MRI.

Conclusion

In this study, postnatal outcomes for fetuses with intestinal dilatation were best predicted by assessing the level of obstruction with prenatal ultrasound and MRI, determining the presence of associated malformations, amniotic fluid biochemical and genetic testing, and monitoring for regression of bowel dilatation. These results should help inform future guidelines on the prenatal and neonatal management of congenital intestinal obstruction.     

Survey of Columnar Cacti and Carrying Capacity for Nectar-Feeding Bats on Curaçao

We estimated the population sizes of the three species of columnar cacti that grow on the island of Curaçao using ground and aerial transects, and we examined the island's carrying capacity for two species of nectar-feeding bats that depend on nectar from the flowers of these cacti. We calculated carrying capacity based on the daily availability of mature flowers between January and December 1993 and the field energy requirements of bats as estimated from an equation for eutherian mammals (low estimate) and one for passerine birds (high estimate) based on body mass. Additional energy requirements of pregnancy and lactation were taken into account. We estimated that 461,172 columnar cacti were present on Curaçao (38% Subpilocereus repandus , 51% Stenocereus griseus , and 11% Pilosocereus lanuginosus ). May through September are the critical months when bats rely most heavily on cactus for food. July 1993 was a bottleneck with the smallest number of mature flowers per day. July and August were months of greatest energy demand because females were lactating. We estimate that the carrying capacity for Glossophaga longirostris in July, when the bat ( Leptonycteris curasoae ) population was 900, was near 1200, an estimate that fits the observed population size of nectar-feeding bats on the island. We suggest that the extensive removal of native vegetation occurring on Curaçao be strictly regulated because further destruction of the cacti will result in a decrease and potential loss of the already low populations of nectar-feeding bats.     

Climate change impacts in Central Asia and their implications for development

Regional Environmental Change - This paper synthesizes what is known about the physical and biophysical impacts of climate change and their consequences for societies and development under...     

Production of biofuels from microalgae

The production of biofuels from microalgae, especially biodiesel, has become a topic of great interest in recent years. However, many of the published papers do not consider the question of scale up and the feasibility of the various processes to be operated at the very large scale required if algal biofuels are to make a meaningful contribution to renewable fuels. All the steps in the process must also be very low cost. This paper discusses the unit processes required for algal biofuels production (i.e., growing the algae, harvesting, dewatering, extraction and conversion to biofuel) and their scalability. In many cases, especially in the lipid extraction step, little is known as yet as to the scalability and economic feasibility of the various processes proposed. We also highlight the key engineering and biological issues which must be resolved for the production of biofuels from microalgae to become an economic reality.