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The Santos and São Vicente Estuarine System (SSVES) is a region with significant economic importance in southeastern Brazil. It contains petrochemical and metallurgical industrial complexes and the largest commercial harbor in South America, which have made the area vulnerable to degradation by chemical pollutants, such as mercury (Hg). This study is the first to evaluate the environmental parameters that control the spatial distribution of Hg in the surface sediments of the SSVES which is influenced mainly by hydrodynamics and total organic carbon. The innermost part of the estuarine system, where weaker currents lead to an environment with more sediment deposition, has anomalous Hg concentrations, reaching values over 7.0 mg kg–1 and enrichment factors of 115, resulting from historical anthropogenic activities. Although there is a low probability of harmful effects of Hg in organisms, this element demonstrates greater mobility and bioavailability in the environment, indicating the need for monitoring Hg for the conservation of this region.

The analysis of hydrocarbons in terms of individual compounds is relevant to understand the origin and source of these substances, as well as its distribution in environmental compartments, including sediments and biota. Hydrocarbons concentrations were determined in sediments and in whole-body soft tissues of the tropical clam Anomalocardia flexuosa in sediment toxicity testing using samples of Mucuripe bay (Ceará State, NE Brazil) collected in 2011 during dredging events [1]. Data of target compounds included aliphatic (AHs) and aromatic hydrocarbons (PAHs), and linear alkylbenzenes (LABs). AHs compounds were determined on gas chromatography with flame ionization detector (GC-FID), while PAHs and LABs were determined on gas chromatography coupled to a mass spectrometer (GC/MS) in a selected ion mode (SIM). The potential of this dataset is baseline information on hydrocarbons contamination in sediments from a semi-arid region and the bioaccumulation of organic contaminants in marine organisms that can be used as models in ecotoxicological studies.

Few test organisms are employed for sediment toxicity assessments in Tropical regions, including Brazil. We assessed the ability of the clam Anomalocardia flexuosa to respond to contamination in sediment bioassays using dredging materials of a semi-arid region (Ceará State, NE Brazil), with attention to sublethal responses. Sediments were collected during and after dredging (survey 1 and 2, respectively) and animals exposed in laboratory over 28 days, with responses measured at 7 days. Bioaccumulation of contaminants was determined in whole-body soft tissues as a metric of bioavailability, and biomarkers' changes were monitored in terms of enzymes of phase I and II metabolism, acetylcholinesterase (AChE), and antioxidant responses, lipid peroxidation (LPO) and DNA damage (strand breaks). Clams accumulated aliphatic (AHs) and aromatic hydrocarbons (PAHs), and linear alkylbenzenes (LABs) compared to control conditions (day 0), with increased amounts of As, Cd, Cu, and Zn observed in some samples. The enzyme glutathione S-transferase was enhanced in animals exposed to samples, indicating activation of phase II metabolism. Changes observed in glutathione peroxidase (GPx), glutathione reductase (GR), LPO and strand breaks were related to oxidative stress. AChE enzymatic activity also changed, as an indicator of neurotoxicity caused by sediment exposure. The computed integrated biomarker response index (IBR) ranked sites according to the contamination status and proximity to its sources. Correlations found for biomarkers and bioaccumulation of hydrocarbons indicated the influence of harbor activities, effluent discharges, and urban runoff on the sediment pollution of Mucuripe Bay. Data also showed that SQGs are unable to predict bioaccumulation and subchronic effects. Based on our results we consider that biomarkers responses in A. flexuosa are important endpoints to be applied in sediment toxicity bioassays in tropical regions.

Preterm birth and stillbirth are among the greatest health burdens associated with pregnancy and childbirth. Fifteen million babies are born preterm each year, causing about 1 million deaths annually and lifelong problems for many survivors; 3 million stillbirths also occur annually. Worldwide, the number of women and children who die during pregnancy and childbirth exceeds the total number of births in the United States. New approaches could provide a greater understanding of prematurity, stillbirth, and maternal complications of pregnancy and childbirth. Integrated multidisciplinary investigations of the mother, fetus, and newborn in different contexts and populations could elucidate the biological pathways that result in adverse outcomes and how to prevent them. Descriptive research can determine the burden of disease, while more mechanistic discovery research could explore the physiology and pathophysiology of pregnancy and childbirth. Together, this research can lead to the development and delivery of new and much more effective interventions, even in low-resource settings. Recent surveys of researchers and funders reveal a striking lack of consensus regarding priority areas for research and the development of interventions. While researchers enumerate unanswered questions about pregnancy and childbirth, they lack consensus on priorities. Funders are equally uncertain about research and development projects that need to be undertaken, and many are hard-pressed to support research on the complex problems of pregnancy and childbirth given competing priorities. This lack of consensus provides an opportunity to engage with funders and researchers to recognize the importance of understanding healthy pregnancies and the consequences of adverse pregnancy outcomes. A strategic alliance of funders, researchers, nongovernmental organizations, the private sector, and others could organize a set of grand challenges centered on pregnancy and childbirth that could yield a substantial improvement in reproductive health., (Copyright © 2012 Mosby, Inc. All rights reserved.)

Stillbirth is a common adverse pregnancy outcome, with nearly 3 million third-trimester stillbirths occurring worldwide each year. 98% occur in low-income and middle-income countries, and more than 1 million stillbirths occur in the intrapartum period, despite many being preventable. Nevertheless, stillbirth is practically unrecognised as a public health issue and few data are reported. In this final paper in the Stillbirths Series, we call for inclusion of stillbirth as a recognised outcome in all relevant international health reports and initiatives. We ask every country to develop and implement a plan to improve maternal and neonatal health that includes a reduction in stillbirths, and to count stillbirths in their vital statistics and other health outcome surveillance systems. We also ask for increased investment in stillbirth-related research, and especially research aimed at identifying and addressing barriers to the aversion of stillbirths within the maternal and neonatal health systems of low-income and middle-income countries. Finally, we ask all those interested in reducing stillbirths to join with advocates for the improvement of other pregnancy-related outcomes, for mothers and their offspring, so that a united front for improved pregnancy and neonatal care for all will become a reality., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Characteristics of gentamicin resistance were studied in gram-negative bacilli from 50 consecutive patients with nosocomial infection, during a time when gentamicin resistance had recently become prevalent at Medical University Hospital. Burns, decubitus ulcers, and cystic fibrosis were common precipitating factors for acquisition of gentamicin-resistant organisms. Pseudomonas aeruginosa accounted for 76% and Enterobacteriaceae for 24% of isolates. There was high prevalence of cross-resistance to amikacin (61%) and tobramycin (58%). Of the P aeruginosa strains 36% possessed plasmids which were rapidly detected by agarose gel electrophoresis. None of the isolates transferred gentamicin resistance. Representative isolates failed to elaborate aminoglycoside-modifying enzymes or to take up labelled amikacin. Multiple immunotypes of P aeruginosa were identified. These data suggest that a nonplasmid mediated resistance mechanism such as impermeability was responsible for the emergence of gentamicin resistance.