Uptake and transport by the ovine placenta of neutral nonmetabolizable amino acids with different transport system affinities

In 32 published reports in surgical patients, the preponderance of evidence from standard clinical measures of renal function (BUN and Cr) indicates the absence of renal toxicity following sevoflurane anesthesia. Studies of surgical patients receiving intermediate-duration sevoflurane with high or low fresh gas flow and long-duration sevoflurane with high fresh gas flow included sensitive measures of renal function and/or injury, which also indicate the absence of renal toxicity following sevoflurane anesthesia. Studies of surgical patients receiving long-duration sevoflurane with low fresh gas flow did not include sensitive measures. Seven studies in volunteers are not directly relevant to clinical practice but do raise the issue of whether it is important to apply sensitive measures of renal function and/or injury such as urine concentrations and/or excretion of NAG, beta 2M, alpha 1M, AAP, alpha GST, pi GST, gamma GTP, albumin, protein, and glucose and Cr clearance. Two studies of volunteers receiving prolonged sevoflurane anesthesia with fresh gas flow no greater than 2 L/min concluded that the potential for adverse renal effects of sevoflurane may exist. The other studies of volunteers did not. In 14 published reports of surgical patients in special conditions, the preponderance of evidence from standard clinical measures of renal function indicates the absence of renal toxicity. Studies with sensitive measures have been reported for some conditions where the kidney may be at increased risk (e.g., sevoflurane-induced hypotension, advanced age, and renal insufficiency and failure), are incomplete in others (e.g., hypertension and ischemic heart disease), and are missing in others (e.g., morbid obesity). Studies with sensitive measures of renal function and/or injury are also missing in an important group where the kidney may not be at increased risk--pediatric patients. Studies of other risk conditions, such as temporary ischemia, hemorrhagic hypotension, nephrotoxic antibiotics, kidney transplantation, and diabetes may provide additional information about the renal effects of sevoflurane.     

Effects of dietary fiber on inflammatory bowel disease

The chronic idiopathic inflammatory bowel diseases (IBDs), namely Crohn's disease and ulcerative colitis, appear to be derived from an inappropriate reaction towards a luminal agent, most probably driven by the intestinal microflora, which upregulates the synthesis and release of different pro-inflammatory mediators, thus contributing to tissue damage that characterizes these intestinal conditions. Several studies have reported that IBD is associated with impairment in short-chain fatty acid (SCFA) production, mainly acetate, propionate, and butyrate. They are produced in the large bowel by anaerobic bacterial fermentation of undigested dietary carbohydrates and fiber polysaccharides, with butyrate being considered as the major fuel source for colonocytes. These SCFAs have been proposed to play a key role in the maintenance of colonic homeostasis. Therefore, it is reasonable to consider therapeutic approaches that increase colonic SCFA production, as it can be achieved by administration of dietary fiber to IBD patients. Unfortunately, there is quite limited documentation of efficacy of dietary fiber in properly designed trials. This review discusses the rationale, available evidence for the use of dietary fiber and its mechanisms of action in the treatment and prevention of IBDs.     

Monitoring of bacterial and parasitological contamination during various treatment of sludge

Wastewater treatment results in the production of large quantities of sludge. Agricultural use is an interesting alternative provided that the health risks are taken into account. In France, a decree (1998) defines "sanitized" sludge as sludge that has been treated so that pathogens (Salmonella, enteroviruses, viable nematode eggs) are no longer detectable. The aim of this study was to determine the impact of various sludge treatments on 2 types of pathogens (Salmonella and nematode eggs). We also assessed the levels of micro-organisms that indicate faecal contamination (E. coli, Enterococci, sulfite-reducing anaerobes spores). Various treatment processes were analyzed: 4 biological, 3 chemical, 1 heat, 2 storage and 4 sampling campaigns were carried out. Concerning the parasitological contamination of sludge at the entrance of all sites, concentrations of total nematode eggs and viable nematode eggs were highly heterogeneous (respectively, from 2 to 53 eggs/10 g DM and from 2 to 45 eggs/10 g DM) with viable eggs present in all samples. The total concentration of nematode eggs in the sludge was not greatly affected by treatment or storage, and was in the range < 1-66 eggs/10 g DM. However, the situation was different for mean viable egg counts. For four treatments, no viable eggs were detected. Mesophilic processes are inefficient at eliminating viable nematode eggs. Salmonella were systematically detected in all sludge samples at the entry to the station, except for limed sludge intended for storage. At the end of four treatments Salmonella had been totally eliminated. For the fecal contamination indicators, the largest decrease in E. coli contamination was observed following liming and after thermophilic treatment. The mesophilic treatments resulted in very small decreases in contamination. A similar pattern was observed with Enterococci. For the spores of sulfite-reducing anaerobe bacteria, with the exception of heat treatment, which reduced contamination by 3.2 log units, the maximum decrease in contamination was 1.7 log. For storage of sludge, E. coli and Enterococci levels had decreased at first but then increased between 6 and 8 months of storage.