Second-trimester maternal serum alpha-fetoprotein (MSAFP) iselevated in women with adverse pregnancy outcome associated with inherited thrombophilias

Obstetric complications, such as severe pre-eclampsia, fetal growth restriction, abruptio placentae, or stillbirth are associated with abnormally elevated second-trimester maternal serum alpha-fetoprotein (MSAFP) and β subunit of human chorionic gonadotrophin (βhCG). This has been attributed to placental abnormalities. Women with thrombophilias have been shown to have abnormalities of the placenta resulting in adverse pregnancy outcome in these patients. The purpose of the present study was to evaluate whether women with pregnancy complications and inherited thrombophilias have abnormally elevated second-trimester MSAFP or βhCG. Sixty-two women with pregnancy complications were tested for inherited thrombophilias several months after delivery. The thrombophilia group included 29 women with pregnancy complications and an inherited thrombophilia and the control group included 33 other patients without thrombophilia. Patients in the thrombophilia group had a higher median MoM MSAFP compared to the controls (1.337 vs 1.086, p=0.0516). The incidence of abnormally elevated MSAFP (>2.5 MoM) was also significantly higher in the thrombophilia group compared to controls (21% vs 3%, p=0.04). Neither the median MoM βhCG nor the incidence of abnormally elevated βhCG were significantly different between the groups. We conclude that second trimester MSAFP, but not βhCG, is abnormally elevated in patients with thrombophilia and obstetric complications. Copyright © 2001 John Wiley & Sons, Ltd.     

INTERNATIONAL CONFERENCE ON WATER AND HUMAN HEALTH1

The following paper was presented by Dr. Abel Wolman at the Plenary Session of the 22nd Annual Conference of the American Water Resources Association in Atlanta, Georgia, November 10, 1986. Dr. Wolman is Professor Emeritus of Sanitary Engineering at The Johns Hopkins University. He was educated at Johns Hopkins and has received an Honorary Doctor of Engineering (1937) and Honorary Doctor of Laws (1969) from his alma mater. Dr. Wolman held a number of positions before joing the faculty of The Johns Hopkins University as Professor and Chairman of the Department of Sanitary Engineering (1937–1959). He has served as consultant for many studies and projects, in the United States and overseas, and has a long-term record of service to communities, states and governments. A long list of awards and honors include the Sedgwick Memorial Award, APHA; Arthur Sidney Bedell Award, WPCF; Hemisphere Award, inter-American Association of Sanitary Engineers; U.S. Award of the National Medal of Science; Tyler Award, Ecological Society of America; Ben Gurion Award from the State of israel; and the Gordon Maskew Fair Award, WPCA. He is author, co-author or editor of four books and over 3000 technical publications, most in refereed journals.     

WATER RESOURCES MANAGEMENT: INTERNATIONAL CHALLENGE AND OPPORTUNITIES1

The entire water resources field is not contemplated, although reference thereto will be registered. Water supply for potable and hygienic purposes will be presented as symbolic of the global issues confronting 4.8 billion people. Some two billion of these live in the so-called developing or less favored countries. They are either underserved or not served at all by utility systems of whatever grade. Targets for meeting their needs were exemplified by the international agencies in the International Water and Sanitation Decade of 1980-1990. Some successes are apparent, but, in general, hopes are not fulfilled. The pace of accomplishment is very slow. Constraints will be reviewed in some detail. Challenges for reducing these and increasing pace of installations are presented. The potential for a global public works program unprecedented in history is reviewed. Several issues will not be discussed in this paper. Their omission rests primarily upon the fact that their resolution is improbable for decades ahead, if ever. Economists have categorized water as any other economic commodity - and should always be subject to benefit-cost scrutiny. I do not share that view. People could well live without the telephone or the automobile, a destroyer. Without water, their survival is a matter of days. Cost-benefit seems unreal and singularly inappropriate under such circumstances. Secondly, the search for quantifying the health impact of safe water goes on forever. My view is that the results speak for themselves - while sturdy souls continue to seek out the exact correlation figure. Thirdly, the population explosion, although softened a bit, proceeds apace while I write. Lastly, the exposition herein is restricted to potable water and its associated sanitation aspects. Other major uses of water, obviously highly important, are not addressed.     

Soil intervention as a strategy for lead exposure prevention: the New Orleans lead-safe childcare playground project

The feasibility of reducing children's exposure to lead (Pb) polluted soil in New Orleans is tested. Childcare centers (median = 48 children) are often located in former residences. The extent of soil Pb was determined by selecting centers in both the core and outlying areas. The initial 558 mg/kg median soil Pb (range 14-3692 mg/kg) decreased to median 4.1 mg/kg (range 2.2-26.1 mg/kg) after intervention with geotextile covered by 15 cm of river alluvium. Pb loading decreased from a median of 4887 μg/m(2) (454 μg/ft(2)) range 603-56650 μg/m(2) (56-5263 μg/ft(2)) to a median of 398 μg/m(2) (37 μg/ft(2)) range 86-980 μg/m(2) (8-91 μg/ft(2)). Multi-Response Permutation Procedures indicate similar (P-values = 0.160-0.231) soil Pb at childcare centers compared to soil Pb of nearby residential communities. At ～$100 per child, soil Pb and surface loading were reduced within hours, advancing an upstream intervention conceptualization about Pb exposure prevention.