Back on top: Resuspended by dredging and other environmental disturbances, organochlorine compounds may affect the health of a dolphin population in a tropical estuary, Sepetiba Bay.

Organochlorine compounds (OCs) are persistent organic pollutants linked to damaging the immune and endocrine systems, leading to a greater susceptibility to infectious diseases at high concentrations. Sepetiba Bay, in the Southeastern Brazilian coast, historically presents anthropogenic activities and environmental contamination that could negatively impact resident populations. In this context, this study aimed to investigate the temporal trends in the accumulation of organochlorine compounds over a 12-year database in the Guiana dolphins' (Sotalia guianensis) resident population from Sepetiba Bay, including individuals collected before, during, and after an unusual mortality event triggered by morbillivirus (n = 85). The influence of biological parameters was also evaluated. The OCs concentrations in the blubber ranged from 0.98 to 739 µg/g of ΣPCB; 0.08-130 µg/g of ΣDDT; <0.002-4.56 µg/g of mirex; <0.002-1.84 µg/g of ΣHCH and <0.001-0.16 µg/g of HCB in lipid weight. Increased temporal trends were found for OCs in Guiana dolphins coinciding with periods of large events of dredging in the region. In this way, our findings suggest that the constant high OCs concentrations throughout the years in this Guiana dolphin population are a result of the constant environmental disturbance in the area, such as dredging. These elevated OCs levels, e.g., ΣPCB concentrations found above the known thresholds, may impair the response of the immune system during outbreak periods, which could lead the population to a progressive decline.

Changes in mercury distribution and its body burden in delphinids affected by a morbillivirus infection: Evidences of methylmercury intoxication in Guiana dolphin.

An unusual mortality event (UME) attributed to morbillivirus infection was identified in two Guiana dolphin populations from the Southeastern Brazilian coast. The aim of this study was to characterize total mercury (THg), methylmercury (MeHg) and selenium (Se) bioaccumulation and body burden in Guiana dolphins from Sepetiba Bay (RJ) collected before (n = 61) and during the UME (n = 20). Significantly lower Se concentrations were found in the livers of individuals collected during the UME (Mann-Whitney test; p = 0.03), probably due to impairment of the detoxification process in the liver. There were differences in THg and Se concentrations in the organs and tissues of individuals (Kruskal-Wallis test, p < 0.05), but not MeHg (Kruskal-Wallis test, p = 0.07). For THg, the liver showed the higher concentrations and differed among organs and tissues analyzed such as blubber (Tukey's test for unequal N; p = 0.003). For Se concentrations, the skin and kidney presented the higher concentrations and varied among other tissues/organs, like muscle (Tukey's test for unequal N; p = 0.02). Differences in body burdens were observed among specimens collected previously and during the UME probably due to the remobilization and transport of the muscle-stored MeHg to other tissues/organs. This abrupt input of MeHg into the bloodstream may cause serious health damage. Indeed, evidences of methylmercury intoxication was observed in Guiana dolphins in Sepetiba Bay. In conclusion, bioaccumulation patterns, the detoxification process and body burden were affected by morbillivirus.

Ketonuria is not associated with hyperemesis gravidarum disease severity.

OBJECTIVE: To assess the association between ketonuria and hyperemesis gravidarum (HG) disease severity. STUDY DESIGN: We included pregnant women hospitalised for HG who participated in the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) trial and women who were eligible, chose not to be randomised and agreed to participate in the observational cohort. Between October 2013 and March 2016, in 19 hospitals in the Netherlands, women hospitalised for HG were approached for study participation. The presence of ketonuria was not required for study entry. Ketonuria was measured at hospital admission with a dipstick, which distinguishes 5 categories: negative and 1+ through 4 + . The outcome measures were multiple measures of HG disease severity at different time points: 1) At hospital admission (study entry): severity of nausea and vomiting, quality of life and weight change compared to pre-pregnancy weight, 2) One week after hospital admission: severity of nausea and vomiting, quality of life and weight change compared to admission, 3) Duration of index hospital admission and readmission for HG at any time point RESULTS: 215 women where included. Ketonuria was not associated with severity of nausea and vomiting, quality of life or weight loss at hospital admission, nor was the degree of ketonuria at admission associated with any of the outcomes 1 week after hospital admission. The degree of ketonuria was also not associated with the number of readmissions. However, women with a higher degree of ketonuria had a statistically significant longer duration of hospital stay (per 1+ ketonuria, difference: 0.27 days, 95 % CI: 0.05 to 0.48). CONCLUSIONS: There was no association between the degree of ketonuria at admission and severity of symptoms, quality of life, maternal weight loss, or number of readmissions, suggesting that ketonuria provides no information about disease severity or disease course. Despite this, women with a higher degree of ketonuria at admission were hospitalised for longer. This could suggest that health care professionals base length of hospital stay on the degree of ketonuria. Based on the lack of association between ketonuria and disease severity, we suggest it has no additional value in the clinical management of HG.

Peri-partum reference ranges for ROTEM(R) thromboelastometry.

BACKGROUND: Post-partum haemorrhage (PPH) causes rapidly developing deficiencies in clotting factors and contributes to substantial maternal morbidity and mortality. Rotational thromboelastometry (ROTEM(®)) is increasingly used as a point of care coagulation monitoring device in patients with massive haemorrhage; however, there are limited data on reference ranges in the peri-partum period. These are required due to the haemostatic changes in pregnancy. METHODS: In a Dutch multi-centre trial, 161 subjects were included; blood samples were obtained during labour (T1) and within 1 h of delivery (T2). Reference ranges of ROTEM(®) INTEM, EXTEM, FIBTEM, and APTEM were set and correlation with laboratory results was investigated using the guidelines of the International Federation of Clinical Chemistry. RESULTS: Reference ranges were obtained for clotting time (CT), clot formation time (CFT), α-angle, clot firmness at 10 and 20 min (A10, A20), maximum clot firmness (MCF), and maximum lysis (ML). These were comparable from centre to centre, and between T1 and T2. Reference ranges T1: EXTEM: CT 31-63 s, CFT 41-120 s, and MCF 42-78 mm. INTEM: CT 109-225 s, CFT 40-103, and MCF 63-78 mm. FIBTEM: CT 31-79 s and MCF 13-45 mm. APTEM: CT 33-62 s, CFT 42-118, and MCF 61-79 mm. CONCLUSIONS: Reference values for ROTEM(®) parameters are reported. The previously published correlation between FIBTEM parameters and plasma fibrinogen levels by the Clauss method is confirmed. Further research is needed to define threshold values for haemostatic therapy in the course of PPH. Clinical trial registration NTR 2515 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2515).

Solely inhibin B producing ovarian tumour as a cause of secondary amenorrhoea with hot flushes: case report and review of literature.

In this report, we describe a case of a solely inhibin B producing fibrothecoma presenting with secondary amenorrhoea and hot flushes. Typical laboratory findings were an elevated LH, elevated inhibin B, low FSH and low estrogen. The World Health Organization classification of amenorrhoea was not applicable since the combination of low estrogen and low FSH suggested a central cause, whereas actually there was an ovarian cause. With staging laparotomy, a bilateral borderline tumour was detected in combination with a fibrothecoma. This report underpins the concept of inhibin B being a selective FSH secretion inhibitor of ovarian origin. Furthermore, a literature review on these topics is included.

Whistles emitted by Atlantic spotted dolphins (Stenella frontalis) in Southeastern Brazil.

The whistles of Atlantic spotted dolphins have been studied in a few localities of the North Atlantic Ocean and those studies revealed that the species emits whistles within a broad frequency range, with a high number of inflection points and presence of harmonics. In the South Atlantic Ocean, there is no information about the sounds produced by Atlantic spotted dolphins. A total of 1092 whistles emitted by free-ranging Atlantic spotted dolphins in Southeastern Brazilian coastal waters were analyzed. Whistles recorded in this study had a broad frequency range from 1.15 to 23.44 kHz. Whistles without harmonics were frequently emitted (N=701; 64.2%) and those signals with zero up to two inflection points corresponded to 94% of all whistles. Some differences in whistle characteristics (inflection points and duration) were found in relation to areas in North Atlantic Ocean and whistles were shorter and with a smaller number of inflection points in Brazil. Whistles produced by Atlantic spotted dolphins varied between the two behavioral states in which dolphins were engaged. Whistles were more frequently emitted when dolphins presented behaviors that included fast movement at surface, prey pursuit, aerial behavior, and physical contact. In these situations, whistles were on average longer and had higher frequency parameters than those emitted when animals were engaged in slowly and moderate traveling. The findings presented herewith reveal that dolphins modified whistle structures within behavioral states.