Procedures in Fecal Microbiota Transplantation for Treating Irritable Bowel Syndrome: Systematic Review and Meta-Analysis.

BACKGROUND: Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease with no effective treatment. Altered microbiota composition seems implicated in disease etiology and therefore fecal microbial transplantation (FMT) has emerged as a possible treatment therapy. To clarify the clinical parameters impacting FMT efficacy, we conducted a systematic review with subgroup analysis. METHODS: A literature search was performed identifying randomized controlled trials (RCTs) comparing FMT with placebo in IBS adult patients (8-week follow-up) with a reported improvement in global IBS symptoms. RESULTS: Seven RCTs (489 participants) met the eligibility requirements. Although FMT seems not to be effective in global improvement of IBS symptoms, subgroup analysis shows that FMT through gastroscopy or nasojejunal tube are effective IBS treatments (RR 3.03; 95% CI 1.94-4.73; I2 = 10%, p < 0.00001). When considering non-oral ingestion routes, IBS patients with constipation symptoms are more likely to benefit from FMT administration (p = 0.003 for the difference between IBS subtypes regarding constipation). Fresh fecal transplant and bowel preparation seem also to have impact on FMT efficacy (p = 0.03 and p = 0.01, respectively). CONCLUSION: Our meta-analysis revealed a set of critical steps that could affect the efficacy of FMT as clinical procedure to treat IBS, nevertheless more RCTs are needed.

Integrative toolbox to assess the quality of freshwater sediments contaminated with potentially toxic metals.

The Guadiana Basin is a transnational basin, presenting historical contamination with potentially toxic metals (PTM), which origin can be both natural and anthropogenic. This study explores the use of a set of observational, chemical and ecotoxicological assays with Heterocypris incongruens, Vibrio fischeri, Pseudokirchneriella subcapitata, Thamnocephalus platyurus, identifying the most sensitive to be included in a toolbox to analyze the quality of freshwater sediments related to this type of contamination. The study included the analysis of a reservoir and streams sediments of Guadiana basin, in two consecutive years with different climate conditions 2017 (dry year) and 2018 (normal year). The results showed high chemical variability along the basin, with greater contamination with PTM in the reservoir sediments. The calculated Enrichment Factors (EF) indicated high anthropogenic contamination by Cd, followed by Pb (EF > 1.5). The geoaccumulation index (Igeo) revealed that the sediments were severely polluted with Cd, and slightly polluted with Pb and Cu, inducing a higher sublethal toxicity to Heterocypris incongruens. Among the parameters evaluated, and after the use of multivariate statistical techniques, the toolbox for assessing sediments quality, in similar climate and geological conditions, should include the analysis of: meteorology, land use/cover in the area, granulometry, organic matter content, PTM concentrations, contamination indices (e.g., Igeo and EF), and sublethal bioassays with H. incongruens (total sediment analysis) and Vibrio fisheri luminescence inhibition (pore water analysis).

Spatial and temporal dynamics of irrigation water quality under drought conditions in a large reservoir in Southern Portugal.

Water is a scarce resource in the Mediterranean region where adverse climatic conditions promoting water shortages tend to increase with climate change. Under water scarcity conditions and high atmosphere evaporative demand, the risks of decreased water quality, and land salinization are major threats to the sustainability of irrigated agriculture in this region. The assessment of the quality of irrigation water is increasingly important to ensure the maintenance of long-term salt balance at a crop, farm, and regional scale. This study is focused on the spatial and temporal variability of water quality for irrigation in the Alqueva reservoir (Southern Portugal). The assessment was performed every 2 months during a distinctive drought year (2017) and included inorganic ions (Na+, Ca2+, Mg2+, K+, NH4+, Cl-, F-, SO42-, NO3-, and NO2-), pH, and electric conductivity (ECW) of water. Sodium adsorption ratio (SAR) was calculated, and potential soil permeability problems were estimated. The assessment showed significantly higher values of the physicochemical parameters in the most upstream sites, located near tributaries inflows, and an upward trend in ion concentrations throughout the year, with significantly higher concentrations of Na+, Mg2+, Cl-, and SO42, registered through May to November, reflecting the severe drought felt in the summer, autumn, and winter. The evaluation of water quality for irrigation indicated a slight to moderate risk of reduced infiltration rates, which should be considered whenever sprinkler irrigation is used, mainly in fine-textured soils, which are prevalent in the irrigated area. The multivariate statistical approach, using principal component analysis and factor analysis, identified two principal components related to salinity and nutrient concentrations. The cluster analysis revealed three groups of similarity between samples pointing to a more time- than space-controlled pattern. Overall, the temporal dynamics of the water physicochemical parameters could indicate that an abnormal annual distribution of precipitation and temperature may distort seasonal differences. To prevent water and soil degradation, a more frequent assessment of the water quality should be considered, allowing for the selection of appropriate soil and water management measures in irrigated areas.

Pharmaceuticals in a Mediterranean Basin: The influence of temporal and hydrological patterns in environmental risk assessment.

Occurrence of pharmaceuticals in the aquatic environment is nowadays a well-established issue that has become a matter of both scientific and public concern. Tons of different classes of pharmaceuticals find their way to the environment at variable degrees, after their use and excretion through wastewater and sewage treatment systems. The main goal of this study was to correlate the dynamics and the environmental risk of pharmaceuticals with different temporal and hydrological patterns, at the Guadiana Basin (South of Portugal). Water samples were collected bimonthly during 2017 (classified as a drought year) and 2018 (post-drought year) in: Zebro, Álamos and Amieira (intermittent hydrological streams), and Lucefécit (perennial hydrological stream). The pharmaceuticals quantified in higher concentrations, out of 27 investigated, were diclofenac (up to 4806 ng L-1), ibuprofen (3161 ng L-1), hydrochlorothiazide (2726 ng L-1) and carbamazepine (3223 ng L-1). Zebro and Álamos presented the highest contamination by this group of environmental hazardous substances, which may be correlated with the presence of wastewater treatment plants upstream the sampling point of each stream. Furthermore, the highest concentrations occurred mainly during the dry period (2017), when the flow was nearly inexistent in Zebro, and in Álamos after the first heavy rainfalls. In specific periods, the high concentrations of pharmaceuticals detected may induce risk for the organisms of lowest trophic levels, damaging the balance of the ecosystems at these streams. The risk quotient optimised approach (RQf) integrating exposure, toxicity and persistence factors, ranks the pharmaceuticals investigated in terms of risk for the aquatic ecosystems as follows: diclofenac, ibuprofen and carbamazepine (high risk), clarithromycin (moderate risk), acetaminophen, ofloxacin and bezafibrate (endurable risk), and hydrochlorothiazide (negligible risk).