Genetic amniocentesis in biamniotic twin pregnancies by a single transabdominal insertion of the needle

We present a technique to aspirate amniotic fluid from both sacs in biamniotic twin pregnancies using a single abdominal insertion with a spinal needle. It was successful in 48 out of 55 cases of biamniotic twin pregnancies referred to our perinatal unit between 1985 and 1994. The single insertion technique was used when the inter-amniotic membrane was clearly evident and two separate free amniotic fluid pools could be reached by the operator with a single puncture. An adequate amount of amniotic fluid was sampled from both sacs to make a cytogenetic diagnosis in all cases. There were four fetuses with trisomy 21 in three twin pregnancies. In two cases, only one twin was affected whilst the co-twin was normal, so that a selective feticide was performed. No miscarriages due to genetic amniocentesis were reported. After 1990, all genetic amniocenteses in biamniotic twin pregnancies (except for one case due to late booking) were performed between 14 and 15 weeks of gestation and with all cases except one, it was possible to sample both twins by a single puncture. We suggest that early amniocentesis (14–15 weeks) by a single abdominal puncture could be a reliable and safe alternative to first-trimester chorionic villus sampling in twin pregnancies.     

A coastal cliff management district for protection of eroding high relief coasts

Ensuring that new buildings do not interfere with the recreational and protective functions of the natural system and that the buildings will be useful long enough to protect the investment are among long-term solutions to coastal erosion. We propose that coastal cliff management districts be established for management of eroding high relief shorelines. Such districts would include an imminent failure zone, in which bluff retreat is possible at any time; a migration zone, which allows for long-term shoreline retreat; and a stability control zone in which activities affecting bluff erosion are restricted. Procedures are described for delineating these zones based on geomorphic criteria. If these land use controls are implemented, some shorefront development can be accommodated while retaining valuable characteristics of the natural system.     

Exhaled NO in asthmatic children in unpolluted and urban environments.

BACKGROUND: NO production (NOex) in the airway epithelium is increased in asthmatic patients and is potently inhibited by anti-inflammatory treatments. The study was designed to compare the: (i) levels of NOex in two groups of asthmatic children residing in different environments (one in a national park in the mountains and the other in a large city) and (ii) the influence of glucocorticoids on levels of NOex between the children and those without treatment. METHODS: The measurements were performed during the same period in the two locations, 100 km apart. NOex was measured using a chemiluminescence analyzer in controls and two comparable groups of asthmatic children. The first group included 63 children (10+/-3 years) recruited from a specialized institution for asthmatic children, and the second group consisted of 46 asthmatic children (9+/-3 years) living in an urban area. A reference group of 17 healthy children residing in the same city was also studied. MEASUREMENTS AND RESULTS: The concentrations of NOex in children in the specialized institution were significantly lower (P<.001) than those in asthmatic children living in the city (5.1+/-2.4 vs. 13.8+/-9.3 ppb) and comparable to those in healthy controls (5.3+/-4.0 ppb). In the urban area, NOex levels increased when atmospheric pollution recorded on the previous day had increased. In contrast to that observed in the urban children, glucocorticoids had little influence on the levels of NOex in the children living in the specialized institution. CONCLUSIONS: Although these relationships need to be confirmed, our findings show that for the determination of NOex, specifying the quality of the environment, in particular, the purity of the air respired by asthmatic children, not only at the time of measurement but also over the previous days, is important.     

Proposal of Indicators to Assess Urban Sustainability in Brazil

The research related here focuses on municipal situations where problems of sustainability may be defined and tackled on the basis of bottom-up management procedures with the participation of organized society. The aim is to build management models that may be implemented with reasonable administrative effort and cost. Implementation pursues the target of approaching a sustainable situation in the municipality. Environmental parameters for an ideal municipality with undefined geographical location are presented. For each parameter, a set of indicators is developed that can measure the prospect of sustainability. The indicators are defined in terms of numbers or literal concepts according to the possibility of measurement. Examples of management models are presented, which are able to approach the situation defined as sustainable by the indicators. The basic management tool is the learning curve of targeted communities, which is experimentally developed and applied. The indicators are grouped according to their range of applicability.     

Towards a smallholder hydrology for equitable and sustainable water management

Situations of water scarcity challenge sustainability and threaten small users' access to water. In response to this problem, there has been a search for a method of hydrological analysis that can better represent the needs of small water users. While this search is rooted in the debate favouring a more participatory and inclusive allocation of the resource, it also requires a new focus on smallholder hydrology that can confront the gaps and biases found in current hydrological practices in many countries. This article looks at past hydrological practices and also at results of recent studies, highlighting the perspective of smallholder irrigators in surface water planning in Zimbabwe, and groundwater planning in India. These case studies show that wider social forces, not always best science, drive hydrological practices. However, new frameworks focusing on the water user can emerge for more equitable and sustainable water management.