Trace element concentrations, including Cd and Hg, in long-finned pilot whales (Globicephala melas edwardii) mass stranded on the New Zealand coast.

The Southern Hemisphere long-finned pilot whale (Globicephala melas edwardii) is a top predator in the New Zealand pelagic food web, feeding predominantly on arrow squids. This study quantified trace element concentrations (Al, As, Cd, Co, Cr, Cu, Fe, Hg, Ni, Mn, Pb, Se, V, Zn) in four tissues (blubber, kidney, liver, muscle) from 21 individuals from stranding sites in New Zealand. Maximum Cd and Hg concentrations were measured in liver and kidney, respectively. Selenium had a positive correlation with Cd and Hg, suggesting the involvement of Se in Cd and Hg detoxification. Arrow squids from the whales' stomach contents were DNA barcoded and identified as Nototodarus sloanii. Trace element concentrations were measured in squid samples from the whale stomach contents. The significant correlation for Hg between the squid tissue and the whale tissue suggests that arrow squids play a major role in trace element uptake by G. m. edwardii.

Trophic ecology drives trace element concentrations in the Antarctic octopod community.

Despite the Antarctic Ocean being considered a pristine environment, elevated trace element concentrations have been reported in many marine organisms. The Antarctic Ocean is particularly vulnerable to climate change, which can also affect the bioaccumulation of trace element concentrations in biota. While Antarctic octopods are key components of the regional food webs as prey for a variety of predators (e.g., seals, fish, and seabirds), their contamination state by trace elements remains largely unknown. This study investigated the trace element concentrations in relation to the trophic ecology in Antarctic octopods. Stable isotope values (δ13C and δ15N) and trace element concentrations (Ag, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, V, and Zn) were measured in eight different species (Adelieledone polymorpha, Pareledone aequipapillae, P. albimaculata, P. aurata, P. charcoti, P. cornuta, P. felix, and P. turqueti) sampled near Elephant Island, close to the Antarctic Peninsula. Stable isotopes of δ15N varied among species, with significant differences between A. polymorpha and P. aurata suggesting potential niche segregation. Trace element concentrations also differed among species and with sampling depth, which likely reflects their trophic ecology. The data presented in this study provides the first insight into the trace element concentrations for these endemic octopods in this vulnerable habitat and their stable isotope values.

Influence of sexual dimorphism on stable isotopes and trace element concentrations in the greater hooked squid Moroteuthopsis ingens from New Zealand waters.

The Chatham Rise, one of the highest offshore-primary production regions in New Zealand waters, hosts a great abundance and diversity of deep-sea cephalopods including the greater hooked squid, Moroteuthopsis ingens. Stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) and trace element concentrations (Ag, As, Cd, Co, Cr, Cu, Fe, Hg, Ni, Pb, Se, V, and Zn) were assessed in female and male specimens of different size classes (89-563 mm mantle length). Values of δ13C and δ15N were overall higher in females and δ13C was further influenced by size and sex. Both muscular mantle (the largest fraction of the total body mass) and digestive gland (the known main storage organ for Ag, Cd, Cu and Zn in many cephalopods) tissues were analysed. Higher levels of Cd were observed in males than in females. A positive effect was found between size and Hg concentrations, which could be related to the ontogenetic descent of larger specimens into deeper waters, where they are exposed to higher Hg concentrations, and/or dietary shifts toward Hg-enriched prey with increasing size. This study provides trace element data for this abundant and ecologically important species, and further reveals higher trace element concentrations (especially Hg) in M. ingens from the Chatham Rise, compared to specimens from the sub-Antarctic zone.

Regional assessment of trace element concentrations in arrow squids (Nototodarus gouldi, N. sloanii) from New Zealand waters: Bioaccessibility and impact on food web and human consumers.

The New Zealand arrow squids, Nototodarus gouldi and N. sloanii, play an important role in the marine food web, and are both economically important fishery species. This study compares trace element concentrations (As, Cd, Co, Cr, Cu, Fe, Hg, Ni, Mn, Pb, U, and Zn) in these animals from different fishing locations within New Zealand's Exclusive Economic Zone (Auckland Islands, Chatham Rise, Dunedin, Golden Bay, Taranaki, and West Coast of the South Island). Muscular mantle (the tissue usually consumed by humans) and digestive gland tissue (the primary organ for trace element accumulation) concentrations were compared among regions, revealing size, species, and sampling location effects. Overall, N. gouldi had higher concentrations of As and Zn. The Taranaki region had the highest concentrations for Cd, Co, Cu, and Zn in both tissues analysed. To assess the bioaccessibility of these trace elements to humans, an in-vitro digestion simulation experiment was conducted, revealing bioavailable concentrations overall below the maximum levels presently considered tolerable for human consumption. However, the in-vitro digestion had no observable effect upon Cd concentrations in arrow squid mantle tissue (implying that the measured concentrations are bioaccessible to humans), and revealed that Cd had the highest potential impact on marine food webs and human health. Digestive gland concentrations in particular indicate that arrow squids can be considered important vectors for trace element transfer to top predators (mean concentration for Cd: 123 ± 148 µg g-1 dw), with region-specific differences.

Trace element analysis reveals bioaccumulation in the squid Gonatus fabricii from polar regions of the Atlantic Ocean.

The boreoatlantic gonate squid (Gonatus fabricii) represents important prey for top predators-such as marine mammals, seabirds and fish-and is also an efficient predator of crustaceans and fish. Gonatus fabricii is the most abundant cephalopod in the northern Atlantic and Arctic Ocean but the trace element accumulation of this ecologically important species is unknown. In this study, trace element concentrations (Ag, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, and Zn) were analysed from the mantle muscle and the digestive gland tissue of juveniles, adult females, and adult males that were captured south of Disko Island off West-Greenland. To assess the feeding habitat and trophic position of this species, stable isotopes of carbon (δ13C) and nitrogen (δ15N) were measured in their muscle tissue. Mercury concentrations were positively correlated with size (mantle length) and trophic position. The Hg/Se ratio was assessed because Se has been suggested to play a protective role against Hg toxicity and showed a molar surplus of Se relative to Hg. Cadmium concentrations in the digestive gland were negatively correlated with size and trophic position (δ15N), which suggested a dietary shift from Cd-rich crustaceans towards Cd-poor fish during ontogeny. This study provides trace element concentration data for G. fabricii from Greenlandic waters, which represents baseline data for a northern cephalopod species. Within West-Greenland waters, G. fabricii appears to be an important vector for the transfer of Cd in the Arctic pelagic food web.

High cadmium and mercury concentrations in the tissues of the orange-back flying squid, Sthenoteuthis pteropus, from the tropical Eastern Atlantic.

The orange-back flying squid, Sthenoteuthis pteropus, plays an important role in the eastern tropical Atlantic Ocean (ETA) pelagic food web, as both predator and prey. Specimens of S. pteropus were caught off the Cape Verde Islands and concentrations of Ag, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, V, and Zn were measured in the digestive gland. Among the analysed elements, Cd showed the highest average concentration with values among the highest ever recorded in cephalopods. In addition to the digestive gland, Hg concentrations were also analysed in the buccal mass and mantle tissue. Among the three tissues, buccal mass showed the highest Hg concentrations. In females, Hg concentrations in the buccal mass were positively correlated with stable isotope ratios (δ13C and δ15N) and mantle length, showing both bioaccumulation with age and bioamplification along the trophic levels. High Cd and Hg concentrations in the digestive gland and muscle respectively would lead to elevated exposure of squid-eating top predators such as yellowfin tuna, swordfish or dolphinfish, which are commercially harvested for human consumption. This study provides a deeper understanding of the trace element contamination in an abundant and ecologically important, but poorly studied pelagic squid in the ETA.

[Austrian interdisciplinary recommendations on pediatric perioperative pain management: background, aims, methods and key messages]. / Österreichische interdisziplinäre Handlungsempfehlungen zum perioperativen Schmerzmanagement bei Kindern : Hintergrund, Ziel, Methodik und Kernaussagen.

These recommendations were originally commissioned by the"Österreichische Gesellschaft für Anästhesiologie, Reanimation und Intensivmedizin" (ÖGARI, Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine). Against this background, Austrian experts from the disciplines anesthesiology, pain management, pediatrics and the "Berufsverband Kinderkrankenpflege" (Professional Association of Pediatric Nursing) have with legal support developed evidence-based and consensus recommendations for the clinical practice. The recommendations include key messages which cover the most important recommendations for the individual topics. The complete recommendations on pediatric perioperative pain management consist of seven separate articles which each deal with special sub-topics with comments on and explanations of the key messages. The target groups of the recommendations are all medical personnel of the individual disciplines involved in the treatment of perioperative and posttraumatic pain for neonates, infants and children up to 18 years old.

[Pharmacodynamic and pharmacokinetic characteristics of pain therapy in neonates: Austrian interdisciplinary recommendations on pediatric perioperative pain management]. / Pharmakodynamische und pharmakokinetische Besonderheiten der Schmerztherapie bei Neugeborenen : Österreichische interdisziplinäre Handlungsempfehlungen zum perioperativen Schmerzmanagement bei Kindern.

The false assumption that neonates are less sensitive to pain than adults led to a long delay in the introduction of a reasonable pain therapy for children. Even if the basic principles of the development, transmission and perception of pain in premature infants and neonates are not completely understood, the results of studies have clearly shown that pain can be perceived from 22 weeks of gestation onwards. This knowledge results in the necessity to also administer an adequate pain therapy to premature and newly born infants. However, for the use of pharmaceuticals in neonates and infants the pharmacodynamic and pharmacokinetic characteristics must also be considered. The immaturity of the organs liver and kidneys limits the metabolism and also excretion processes. The different physical proportions also modify the dosing of pharmaceuticals. Children in the first year of life differ substantially from adults in physiology, pharmacodynamics and pharmacokinetics. The care of neonates and infants requires specialist knowledge which is described in this article.

Preterm infants with low immunoglobulin G levels have increased risk of neonatal sepsis but do not benefit from prophylactic immunoglobulin G.

OBJECTIVE: In a prospective, randomized, placebo-controlled, multicenter study, we evaluated the prevention of neonatal infections with intravenous immunoglobulin G (IVIgG) prophylaxis for preterm infants (gestational age <33 weeks) with umbilical cord blood IgG levels < or =4 g/L. STUDY DESIGN: Intravenous IgG or placebo (albumin), 1 g/kg body weight, was given on days 0, 3, 7, 14, and 21 to 81 infants with umbilical cord blood IgG levels < or =4 g/L: (1) IVIgG group, n = 40, mean (SD) gestational age 27.5 (2.2) weeks and birth weight 1.06 (0.39) kg; (2) placebo group, n = 41, mean (SD) gestational age 27.7 (2.5) weeks and birth weight 1.13 (0.38) kg. Infants with umbilical cord blood IgG levels >4 g/L (n = 238) served as a separate comparison group. Neonatal infections according to European Society of Pediatric Infectious Disease criteria were monitored until 28 days of life. RESULTS: Infants with IgG levels < or =4 g/L at birth who received IVIgG had no significant reduction in infectious episodes or mortality rate when compared with those given placebo. However, infants with a serum concentration of IgG >4 g/L at birth had significantly fewer infectious episodes (culture-proven sepsis) than infants with low serum concentrations of IgG (< or =4 g/L) when compared at the same gestational ages (26 to 29 weeks, P <.003). CONCLUSIONS: Prophylactic immunotherapy with IVIgG did not improve the immune competence in preterm infants with low serum IgG concentrations at birth. We speculate that a spontaneously high serum IgG concentration at birth reflects placenta function and is an indicator of a more mature immune system capable of protecting the preterm infant against severe neonatal infections.

Factor V Leiden and prothrombin gene G 20210 A variant in children with ischemic stroke.

OBJECTIVE: To investigate if the factor V Leiden mutation (F-V-LM) and/or the prothrombin gene G 20210 A variant (P-G20210A-V) are risk factors for acute stroke in Austrian children. PATIENTS: 33 children with acute ischemic stroke documented by computer tomography and/or magnetic resonance imaging of the brain were enrolled in an open multicenter survey. RESULTS: 6/33 children had F-V-LM (5 heterozygous, 1 homozygous). This represents 18% (95% CI: 6.7-39.9%) of our pediatric stroke population and thus exceeds the expected prevalence in the Austrian population of 4,6% (Fischer's exact test, p = 0.01). F-V-LM was not found in 11 children with neonatal stroke but in 6/22 children with stroke after the neonatal period. 5/6 children with F-V-LM had an underlying disorder that is a risk factor for stroke in children. The P-G20210A-V was detected in 1/26 (3.85%; 95% CI: 0.1-21.4%) patients. Comparison of the prevalence of P-G20210A-V in our study with that in the general population of Austria of 1% revealed no statistical significance (Fischer's exact test, p = 0.38). CONCLUSION: Our data suggest that the F-V-LM is a risk factor for acute stroke in Austrian children beyond the neonatal period. The P-G20210A-V apparently does not represent a risk factor for stroke in Austrian children.

Decreasing reticulocyte counts associated with declining post-dose erythropoietin plasma levels in anaemia of prematurity.

UNLABELLED: A prospective sequential, multicentre trial was conducted to determine the association between erythropoietin (EPO) plasma levels and the erythropoietic response to recombinant human erythropoietin (r-HuEPO) during long-term treatment of premature infants. Twenty-nine infants, gestational ages 26-34 weeks and postnatal ages more than 14 days, received 600 IU r-HuEPO per kg per week divided into three doses subcutaneously for haemoglobin levels less than 120 g/l or haematocrit less than 36% over a period of 4 weeks. Eight additional patients were studied for a total of 10 weeks. EPO plasma concentrations and haematologic parameters were measured prior to the onset of treatment and at 2-weekly intervals thereafter. Treatment with r-HuEPO resulted in a median increase in corrected reticulocyte counts of 2.5% (range 0.2-4.6%) above patient's baseline, thereafter a decrease was observed. In the 8 patients followed for 10 weeks reticulocyte counts declined significantly during weeks 6-10 when compared with the first 4 weeks (p < 0.005). Median 72-hour post-dose EPO plasma levels increased significantly (p < 0.0001) to 57.3 mU/ml (range 5.0-160) above patient's baseline after the first injection, but declined progressively thereafter until they approached baseline values at week 10. CONCLUSION: R-HuEPO treatment after the first month was associated with a decrease in post-injection plasma levels and a decrease in erythropoietic response. This decrease in erythropoietin's efficacy and the decline observed in post-dose EPO plasma levels may be causally related.

Topographical EEG analysis of rolandic spikes.

We performed topographic EEG investigation with instant voltage mapping in 57 patients with a Rolandic spike focus including 35 patients with benign Rolandic epilepsy. A pronounced maximal negativity of "Rolandic" spikes could be demonstrated over central or mid-temporal electrodes, with a spread to parietal or upper frontal areas with a dipole formation (centrotemporal negativity, frontal positivity) and involvement of midline. There was a moderate correlation between spike amplitude or duration with spread to adjacent areas. No other focal abnormalities such as focal slowing could be revealed by visual or FFT EEG analysis. During light sleep spike activity was pronounced and often associated with generalized spike wave activity. Thus, a functional disturbance rather than a structural lesion can be assumed.

The functional organization of the interictal spike complex in benign rolandic epilepsy.

PURPOSE: We studied the functional organization of the interictal epileptic spike complex in patients with benign rolandic epilepsy of childhood (BREC). METHODS: We recorded interictal epileptiform spikes and somatosensory evoked potentials after median nerve stimulation, providing a biologic marker for the location of the central sulcus in 12 patients with BREC. We used multiple dipole modeling to assess the number, the three-dimensional intracerebral location, and the time activity of the underlying neuronal sources. RESULTS: Although the interictal spike complex could be modeled by a single tangential dipolar source in seven patients (group 1), in the remaining five patients, two sources-a radial and a tangential dipole-were necessary adequately to explain the interictal spikes (group 2). The tangential source was located deeper than the radial source and was characterized by a frontal positivity and a centroparietal negativity with a phase reversal across the central sulcus, suggesting that the interictal spikes originated in the anterior wall of the central sulcus. The radial source showed a single electronegativity over the ipsilateral central region, which would be compatible with involvement of the top of either the pre- or postcentral gyrus. Both sources showed biphasic time patterns with an average latency difference of 30 ms. CONCLUSIONS: Our results indicate that in some patients with typical BREC, the interictal epileptiform spike complex is generated by multiple, simultaneously active neuronal populations within the central region and that epileptiform activity is propagated between these two adjacent cortical areas.

Diaphragmatic paresis in newborns due to phrenic nerve injury.

Phrenic nerve lesions as a result of birth trauma have been reported as a cause of acute respiratory distress infrequently. We report recent diagnostic and therapeutic experiences in four newborns with birth-traumatic phrenic nerve injury: one bilaterally, and three unilaterally, all right-sided. In each case, mechanical ventilation was required for at least 16 days. Ultrasound examination of the diaphragm and phrenic nerve conduction studies turned out to be the diagnostic methods of choice. Spontaneous recovery occurred in two children and two became asymptomatic after operative treatment. One improved after plication of diaphragm and one after autologous nerve transplantation.

Quantitative EEG in young diabetics.

The aim of this study was to investigate the influence of metabolic control on quantitative electroencephalographic (EEG) abnormalities in young diabetic patients. We compared quantitative EEGs of 44 insulin-dependent diabetic patients with age-matched controls. Furthermore, differences in EEG variables of diabetic patients and controls were correlated with the age of onset and duration of diabetes, hemoglobin A1c concentrations, and episodes with severe hypoglycemia. We found a correlation between high values of hemoglobin A1c and decreased relative power of the alpha band. Patients with previous ketoacidotic episodes had increased relative power of the delta/theta band and decreased relative power of the alpha band. Patients with hemoglobin A1c values less than 8.5% exhibited slowing of background activity compared with normal controls. We conclude that metabolic control influences the EEG and that improvement of glucose metabolism is an important factor in avoiding EEG abnormalities in young diabetic patients.