This prospective study investigates whether amino terminal proB-type natriuretic peptide (NT-proBNP) levels are elevated in neonates with congenital heart defect (CHD). NT-proBNP levels in the umbilical cord blood of 60 neonates with prenatally diagnosed CHD, in the cord blood of 200 control subjects, and in the plasma of the respective mothers were analyzed using an automated enzyme immunoassay. NT-proBNP concentrations in the cord blood of the CHD group were significantly elevated compared with controls [median (range): 158 pg/mL (378 -3631 pg/mL) and 626 pg/mL (153-2518 pg/mL); p value Ͻ0.001]. The NT-proBNP concentrations of the newborns and their mothers did correlate neither in the CHD nor in the control group. In 54 patients with CHD, NT-proBNP levels were measured on the median 5th day of life. They showed a significant increase (median 1665 pg/mL and 19222 pg/mL; p Ͻ 0.001). NT-proBNP levels in the cord blood of neonates with CHD are significantly elevated and show a marked increase in the first week of life. Furthermore, this study confirms previously published reference intervals of NT-proBNP in the cord blood of healthy neonates as well as the finding that there is no exchange of NTproBNP across the placenta. (Pediatr Res 66: 466-469, 2009) B rain-type natriuretic peptide (BNP) is a natriuretic hormone secreted from the cardiac ventricular myocytes in response to an increase in ventricular wall stretch and filling pressures (1). Furthermore, hypoxia has been shown to be a direct stimulus for secretion of BNP in human cardiac myocytes (2). On secretion from the cardiac myocyte, pro-BNP, the inactive precursor, is cleaved into the biologically active BNP and the amino terminal fragment (NT-proBNP). Several studies have shown an excellent correlation between BNP and NT-proBNP plasma levels of adults, children, and in umbilical cord blood (3-5).Concentrations of BNP and its biologically inactive fragment NT-proBNP are of high relevance in the diagnosis and treatment management of congestive heart failure in adults and children (3,6 -11). Both peptides are useful markers in a variety of cardiac diseases in children and adolescents (11)(12)(13)(14)(15)(16)(17)(18). It is well imaginable that also premature and newborn patients could benefit from the use of natriuretic peptide levels for diagnosis and treatment guidance of cardiac diseases.However, data on the usefulness of natriuretic peptides for diagnosis and management of congenital heart disease in this age group are limited. Even the published neonatal reference values show a variation depending on the kits used, the age at blood sampling, and the population studied (19 -25). There are several studies published on the role of natriuretic peptides in the management of patent ductus arteriosus (26 -30), persistent pulmonary hypertension of the newborn (31), as a marker of neonatal sepsis (32,33), and of left ventricular function (32,34). Previous investigations did neither show differences of NT-proBNP levels between arterial and venous cord b...

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In the dialogue between Timothy F. Murphy and Cristina Richie about queer bioethics and queer reproduction in this journal, significant points of the emergent and extremely important discussions on lesbian, gay, bisexual, transgender (LGBT) and queer bioethics are raised. Richie specifies correctly that queer bioethics can either complement or contradict LGBT bioethics and the queer standpoint against heteroconformity and heterofuturity is decisive here. As the field of queer bioethics is such a recent and essential part of consideration for bioethics and as it is still evolving, the objective of this intervention is to provide both an overview of important milestones of queer bioethics and to highlight that queer bioethics is not mono-logic and monolithic. To exemplify queer bioethic's 'many-headed monsters', queer reproduction is revisited and complemented by a European viewpoint. It is central to my argument and here I disagree with Richie that to be against heterofuturity does not necessarily mean to be against queer reproduction. However, I also argue that there are other reasons why queer reproduction should not be pursued at all costs. Finally, I discuss the most recent debates on race, class and citizenship, for example, queer necropolitics. These points still need to be addressed in queer bioethical agendas.

Achieving parenthood with the help of assisted reproductive technologies (ART) remains a fraught business, particularly for queer and trans people who want to use sperm donation, egg donation, procedures involving surrogates, or other ARTs. This is because the regulation of fertility treatment and associated issues such as the documentation of parenthood in birth certificates and passports varies across countries including European jurisdictions. These variations include who is considered an appropriate prospective parent, what kind of treatment they should be allowed, and to what documented parent status they are entitled. Elaborating a continuum model of classifying countries according to their relatively permissive or restrictive ART regulations, we argue that other criteria of assessment need to be used to acknowledge queer and trans people. We compare Estonia, Austria and the UK in terms of LGBTIQ people's opportunities to access ART and the documentation of parenthood. The concept of 'ontological surgery' regarding the regulation of biotechnology in different states suggests ways of thinking about differences in access to ART and parenthood status both within and across countries for LGBTQI people seeking to form families and to create new kinds of kinship. ARTICLE HISTORY

Transnational research funders such as the European Commission and NordForsk increasingly require researchers to conduct transnational research. Yet, there is little research on what this means for seeking ethics approval, not least for qualitative researchers. Much work on ethics approval comes from Canada, the United States, and other Anglophone countries, often in a health-related context, and centers on issues between researchers and research ethics boards (REBs), or on inconsistent or inappropriate decision-making by REBs. Ethical conduct within research has, of course, generated a rich literature but not on gaining ethics approval when conducting qualitative transnational research. Rather, the underlying situation usually is that the research is conducted in the same geopolitical space as where the REB is located. Drawing on two cases studies, in which researchers located in one country, Sweden, sought ethics approval to conduct research in other European countries, we explore some of the challenges that we faced in gaining such approval and provide some suggestions how this process might be made both more efficient and more productive for researchers and research funders alike.