First Report of a Successful Pregnancy in an Everolimus-Treated Heart-Transplanted Patient: Neonatal Disappearance of Immunosuppressive Drugs.

The use of everolimus (EVL) as primary immunosuppression is steadily increasing in heart transplantation (HTx) patients. Limited data currently exist in kidney transplantation, but there is no report of EVL use during pregnancy after HTx and its pharmacokinetics in the newborn. We report a case of an unplanned pregnancy discovered at 21 weeks of gestation in a female HTx patient aged 40 years treated with EVL and cyclosporine (CyA). Because pregnancy was advanced, immunosuppression therapy was left unchanged. At 36 weeks, a healthy infant was delivered. At birth, CyA blood levels were lower in the neonate, but EVL concentrations in maternal and neonatal umbilical blood were similar. Amniotic fluid concentrations were undetectable for both drugs. In the newborn, EVL was measurable at 5 days after birth, whereas CyA disappeared within 2 days. Cord blood displayed a normal count of B and T cells and CD4, CD8 and natural killer cell populations. At birth, both mother and newborn displayed the same blood levels of EVL; therefore, a filter effect of the placenta may be hypothesized for CyA but not for EVL. No immediate complications were observed with this pregnancy.

High resolution gamma-ray spectrometry for routine measurements of environmental samples.

A practical and comprehensive experimental approach for radioactivity measurements of voluminous environmental samples using high-resolution gamma-ray spectrometry with High Purity Germanium (HPGe) detector is presented. The radioanalytical procedure includes sample preparation, detector calibration, implemented corrections, quality control and assurance; and it is demonstrated with the determination of natural and anthropogenic radionuclides in water and soil standard samples. The methodology is verified, and the results are validated by intercomparison with the refence values provided as part of a worldwide proficiency test.

Pregnancy outcome following maternal exposure to statins: a multicentre prospective study.

OBJECTIVE: This contribution addresses the risk associated with exposure to statins during pregnancy. DESIGN: Multicentre observational prospective controlled study. SETTING: European Network of Teratology Information Services. POPULATION: Pregnant women who contacted one of 11 participating centres, seeking advice about exposure to statins during pregnancy, or to agents known to be nonteratogenic. METHODS: Pregnancies exposed during first trimester to statins were followed up prospectively, and their outcomes were compared with a matched control group. MAIN OUTCOME MEASURES: Rates of major birth defects, live births, miscarriages, elective terminations, preterm deliveries and gestational age and birthweight at delivery. RESULTS: We collected observations from 249 exposed pregnancies and 249 controls. The difference in the rate of major birth defects between the statin-exposed and the control groups was small and statistically nonsignificant (4.1% versus 2.7% odds ratio [OR] 1.5; 95% confidence interval [95% CI] 0.5-4.5, P = 0.43). In an adjusted Cox model, the difference between miscarriage rates was also small and not significant (hazard ratio 1.36, 95% CI 0.63-2.93, P = 0.43). Premature birth was more frequent in exposed pregnancies (16.1% versus 8.5%; OR 2.1, 95% CI 1.1-3.8, P = 0.019). Nonetheless, median gestational age at birth (39 weeks, interquartile range [IQR] 37-40 versus 39 weeks, IQR 38-40, P = 0.27) and birth weight (3280 g, IQR 2835-3590 versus 3250 g, IQR 2880-3630, P = 0.95) did not differ between exposed and non-exposed pregnancies. CONCLUSIONS: This study did not detect a teratogenic effect of statins. Its statistical power remains insufficient to challenge current recommendations of treatment discontinuation during pregnancy.

Holoprosencephaly in clomiphene-induced pregnancy: a possible association? A case report and literature review.

Clomiphene is widely used for inducing ovulation. Evidence for congenital abnormalities, in particular central nervous system defects (CNS-D) and in babies born from clomiphene-induced pregnancies is conflicting. The authors report a case of holoprosencephalia (HPE) in a fetus delivered from a mother receiving clomiphene.

Distribution of dissolved 137Cs, 131I and 238Pu at Eastern Mediterranean Sea in case of hypothetical accident at the Akkuyu Nuclear Power Plant.

A coupled hydrodynamic/lagrangian particle drift model was applied to obtain the distribution of key radionuclides that are dispersed at the surface water (upper 100 m) of Eastern Mediterranean Sea, in case of an accident of Nuclear Power Plant at Akkuyu. The model was applied to simulate the dispersion of key artificial radionuclide concentration, in case of a hypothetical accident to assess issues related to sea health and potential hazards. The released radionuclide was found to have a favorable westward direction, following the prevailing currents. The variability of the predicted pattern is interpreted according to the near surface circulation patterns in the study area. The dispersion of key radionuclides (137Cs, 238Pu and 131I) was studied in a spatial and temporal manner at the neighboring coasts of the location of the NPP. Furthermore, the fate of the plume was predicted for each month after the accident date close to the areas of Akkuyu, namely Cyprus, Rhodes Island, North Cretan coast, Cyclades and Syrian Coast. The annual study revealed that the radioactive plume is present with high concentration (maximum values of 1200 Bq m-3 for the long lived isotopes and 600 Bq m-3 for 131I) in the location of the plant for short period of time (1-2 months), while the other areas are affected during the whole year with low level of activity concentration (20-50 Bqm-3). The ERICA Assessment Tool was also used to evaluate dose rates to common marine biota at the studied areas.

Calibration of a CeBr3 based γ-spectrometer for onsite and laboratory radioactivity measurements in sediment samples.

The calibration of an underwater spectrometer, consisting of a CeBr3 crystal, is performed for sediment sample measurements, via experimental data and Monte Carlo simulations. The system was implemented for activity concentration measurements in marine sediment samples in the laboratory. The results were compared with corresponding high resolution measurements and showed that the system provides accurate results, but relatively high uncertainties. Different measurement geometries are theoretically studied via Monte Carlo simulations in order to improve the system performance for such measurements.

Dispersion pattern of 226Ra and 235U using the ERICA Tool in the coastal mining area, Ierissos Gulf, Greece.

Natural radionuclides, present in mining materials, can exhibit elevated values, thus it is of great interest to study their dispersion in mining areas. Radionuclide spatial variations were determined in coastal surface sediments near the mining area of Ierissos Gulf in northern Greece. 226Ra and 235U measured concentrations were compared with the estimations of ERICA Tool, the dispersion patterns were derived and the affected region around the load-out pier area was calculated to be approximately 21 km2.

Radioactivity levels of recent sediments in the Butrint Lagoon and the adjacent coast of Albania.

Sediment samples have been collected in the Butrint area, located in the south-west Albania to determine the radioactivity levels of (40)K, (137)Cs, (212)Bi, (212)Pb, (214)Bi, (214)Pb, (226)Ra and (228)Ac on the bed of the lagoon and adjacent sea, using direct counting gamma spectroscopy. The concentration of (137)Cs and (40)K varied from 2.8 to 37.5 Bq/kg and from 266 to 675 Bq/kg dry weight (dw), respectively (central values). The average concentrations of (238)U and (232)Th daughter products varied from 8 to 27 Bq/kg and from 13 to 40 Bq/kg dw, respectively. The measured (235)U activity ranged from 0.7 to 2.5 Bq/kg dw. Samples of different sedimentary properties, studied for the radioactivity concentration, revealed an inversely proportional relation between grain size and a linear combination of measured specific activities of (226)Ra, (232)Th ((228)Ac, (212)Bi and (212)Pb), (40)K and (137)Cs.