Description: Lateral fluxes (i.e., outwelling) of dissolved organic (DOC) and inorganic (DIC) carbon and total alkalinity were estimated using radium isotopes at the groundwater, mangrove creek, and continental shelf scales in the Amazon region. Observations of salinity and radium isotopes in the creek indicated tidally driven groundwater exchange as the main source of carbon. Radium-derived transport rates indicate that mangrove carbon is exported out of the continental shelf on timescales of 22 ± 7 d. Bicarbonate was the main form (82% ± 11%) of total dissolved carbon in all samples, followed by DOC (13% ± 12%) and CO2 (5% ± 4%). DIC (18.7 ± 15.7 mmol m−2 d−1) exceeded DOC (3.0 ± 4.1 mmol m−2 d−1) outwelling at all spatial scales. The interpretation of outwelling across the mangrove-ocean continuum is related to the spatial and temporal scales investigated. At all scales, outwelling represented a major coastal carbon pathway driving bicarbonate storage in the ocean.

Description: Background: A high complication rate of Q fever in pregnancy is described on the basis of a limited number of cases. All pregnant women with proven Q fever regardless of clinical symptoms should therefore receive long-term cotrimoxazole therapy. But cotrimoxazole as a folic acid antagonist may cause harm to the fetus. We therefore investigated the Q fever outbreaks, Soest in 2003 and Jena in 2005, to determine the maternofetal consequences of Coxiella burnetii infection contracted during pregnancy. Methods: Different outbreak investigation strategies were employed at the two sides. Antibody screening was performed with an indirect immunofluorescence test. Medical history and clinical data were obtained and serological follow up performed at delivery. Available placental tissue, amniotic fluid and colostrum/milk were further investigated by polymerase chain reaction and by culture. Results: 11 pregnant women from Soest (screening rate: 49%) and 82 pregnant women from Jena (screening rate: 27%) participated in the outbreak investigation. 11 pregnant women with an acute C. burnetii infection were diagnosed. Three women had symptomatic disease.Three women, who were infected in the first trimester, were put on long-term therapy. The remaining women received cotrimoxazole to a lesser extent (n=3), were treated with macrolides for three weeks (n=1) or after delivery (n=1), were given no treatment at all (n=2) or received antibiotics ineffective for Q fever (n=1). One woman and her foetus died of an underlying disease not related to Q fever. One woman delivered prematurely (35th week) and one child was born with syndactyly. We found no obvious association between C. burnetii infection and negative pregnancy outcome. Conclusions: Our data do not support the general recommendation of long-term cotrimoxazole treatment for Q fever infection in pregnancy. Pregnant women with symptomatic C. burnetii infections and with chronic Q fever should be treated. The risk-benefit ratio of treatment in these patients, however, remains uncertain. If cotrimoxazole is administered, folinic acid has to be added.