How renal toxins respond to renal function deterioration and oral toxic adsorbent in pH-controlled releasing capsule.

The number of patients with chronic kidney disease (CKD) is increasing. Oral toxin adsorbents may provide some value. Several uremic toxins, including indoxyl sulfate (IS), p-cresol (PCS), acrolein, per- and poly-fluoroalkyl substances (PFAS), and inflammation markers (interleukin 6 [IL-6] and tumor necrosis factor [TNF]-alpha) have been shown to be related to CKD progression. A total of 81 patients taking oral activated charcoal toxin adsorbents (AC-134), which were embedded in capsules that dissolved in the terminal ileum, three times a day for 1 month, were recruited. The renal function, hemoglobulin (Hb), inflammation markers, three PFAS (PFOA, PFOS, and PFNA), and acrolein were quantified. Compared with the baseline, an improved glomerular filtration rate (GFR) and significantly lower acrolein were noted. Furthermore, the CKD stage 4 and 5 group had significantly higher concentrations of IS, PCS, IL-6, and TNF but lower levels of Hb and PFAS compared with the CKD Stage 3 group at baseline and after the intervention. Hb was increased only in the CKD Stage 3 group after the trial (p = .032). Acrolein did not differ between the different CKD stage groups. Patients with improved GFR (responders) (about 77%) and nonresponders had similar baseline GFR. Responders had higher acrolein and PFOA levels throughout the study and a more significant reduction in acrolein, indicating a better digestion function. Both the higher PFOA and lower acrolein may be related to improved eGFR (and possibly to improvements in proteinuria, which we did not measure. Proteinuria is associated with PFAS loss in the urine), AC-134 showed the potential to improve the GFR and decrease acrolein, which might better indicate renal function change. Future studies are needed with longer follow-ups.

Activated carbon cloth versus silver-based dressings in a population with diabetic foot ulcer: a randomised controlled trial.

OBJECTIVE: Activated carbon cloth (ACC), known as Zorflex dressing, has emerged as an innovative approach in managing bacterial infection in diabetic foot ulcer (DFU) treatment. This pilot study was undertaken to determine the efficacy of Zorflex ACC dressing (Chemviron Carbon Cloth Division, UK) compared to standard silver-based dressing on DFUs. METHOD: An open label, comparative, randomised controlled trial enrolling patients who attended the diabetic foot clinic was conducted between August 2022 and August 2023. The primary endpoint was a difference of 20% in wound area reduction with the ACC dressing compared to silver-based dressing within eight weeks. The secondary endpoints were proportion of complete healing, time to healing and adverse events. RESULTS: The cohort comprised 40 patients. The mean wound reduction percentage at 8 weeks for patients in the ACC arm was 85.40±16.00% compared with 65.08±16.36% in the silver-based dressing arm. Complete healing was observed in six of 20 patients in the ACC arm compared to two of 20 in the silver-based dressing arm. CONCLUSION: These data suggest that the ACC dressing promotes better ulcer healing in DFU patients than the silver-based dressing.

Impact of feeding biochar sources in rohu (Labeo rohita): Evaluating the growth, nutrient absorption, carcass composition, haematology and mineral status.

Biochar, an organic carbonaceous matter, is a unique feed additive that is now being used in aquaculture industry to formulate a cost-effective and eco-friendly diet. This experiment (in door) was conducted over course of 90 days to determine the most effective form of biochar, produced from various sources, for supplementation in Moringa oleifera seed meal-based diet. These sources were: farmyard manure biochar, parthenium biochar (PB), vegetable waste biochar, poultry waste biochar (PWB) and corncob waste biochar, added at 2 g/kg concentration to determine the effect of supplementation on the growth indices, nutrient absorption, carcass composition, haematology and mineral status of Labeo rohita (rohu) fingerlings. The research design consisted of six test diets with three replications (6 × 3) of each. Total of 270 fingerlings (6.30 ± 0.020 g) were fed at 5% body weight and 15 of them were kept in separate steel tanks. The results indicated that PWB was most effective in improving weight gain (285.58 ± 4.54%) and feed conversion ratio (1.060 ± 0.040) compared to control diet and other test diets. The same type of biochar (PWB) produced the best results for nutrient digestibility, that is, crude protein, crude fat and gross energy and carcass composition. In terms of haematology and mineral status, PWB showed the best results. In conclusion, it was found that PWB significantly enhanced (p < 0.05) L. rohita fingerling's growth, carcass composition, nutrient digestibility, haematological parameters (red blood cells, white blood cells, platelets and haemoglobin) and mineral composition (Ca, Na, P, Mg, Fe, Mn, Zn, K and Cu) whereas PB negatively affected all parameters. It is anticipated that the potential use of biochar will increase in aquaculture industry, as research on its incorporation in fish feeds is still limited.

Effects of bamboo charcoal powder, bamboo vinegar, and their combination in laying hens on performance, egg quality, relative organ weights, and intestinal bacterial populations.

This experiment examines the effects of bamboo charcoal (BC) powder, bamboo vinegar (BV), and their combination (BCV) in the diet of laying hens on performance, egg quality, relative organ weights, and intestinal bacterial populations. A total of 320 laying hens (36 weeks of age) were divided into 4 treatment groups, with 10 replicates per treatment and 8 hens per replicate. They were fed on a control diet, the control diet supplemented with 0.8% BC, the control diet supplemented with 0.4% BV, or the control diet supplemented with a combination of BC (0.8%) and BV (0.4%) from 36 to 51 weeks of age. Egg production increased in the hens fed the BV and BCV diets during 48 to 51 weeks of age (P < 0.05). Damaged egg rate decreased in the hens fed the BV and BCV diets for the whole experiment (P < 0.05). Shell thickness was highest in the BCV-fed group at week 43, and shell strength was higher in the BV-fed group at week 51 (P < 0.05). Supplementation of BC or BCV in the diet resulted in a decreased abdominal fat pad (P < 0.05). In the ileal content, the population of Salmonella spp. decreased in the BV and BCV groups and the population of Lactobacillus spp. increased in the BV group (P < 0.05). The present results indicate that feeding BV or BCV alleviates damaged egg rate and decreases intestinal pathogenic bacteria, while feeding BC benefits by reducing abdominal fat. These results suggest that the effect of BCV seems to be induced by the synergistic effect of BC and BV, and that the BCV contributes to the effective use of bamboo on the laying hen's production.

The role of biochars in sustainable crop production and soil resiliency.

Biochar is a promising soil additive for use in support of sustainable crop production. However, the high level of heterogeneity in biochar properties and the variations in soil composition present significant challenges to the successful uptake of biochar technologies in diverse agricultural soils. An improved understanding of the mechanisms that contribute to biochar-soil interactions is required to address issues related to climate change and cultivation practices. This review summarizes biochar modification approaches (physical, chemical, and biochar-based organic composites) and discusses the potential role of biochar in sustainable crop production and soil resiliency, including the degradation of soil organic matter, the improvement of soil quality, and reductions in greenhouse gas emissions. Biochar design is crucial to successful soil remediation, particularly with regard to issues arising from soil structure and composition related to crop production. Given the wide variety of feedstocks for biochar production and the resultant high surface heterogeneity, greater efforts are required to optimize biochar surface functionality and porosity through appropriate modifications. The design and establishment of these approaches and methods are essential for the future utilization of biochar as an effective soil additive to promote sustainable crop production.

Novel method to estimate the appropriate dosing interval for activated charcoal to avoid interaction with other drugs.

PURPOSE: Activated charcoal is known to adsorb a variety of drugs concomitantly administered and reduce their intestinal absorption, and separating the dosing is considered a practical approach to avoid this drug interaction. The aim of the present study was to develop and validate a simple method to estimate the sufficient dosing interval to avoid drug interaction using the pharmacokinetic profile of the subject drugs administered alone and the amplitude of interaction upon simultaneous administration with activated charcoal. METHODS: For each subject drug, the pharmacokinetic profile and the amplitude of interaction, as assessed by AUCR (the ratio of area under the plasma concentration-time curve (AUC) in the presence of activated charcoal to that in its absence), were collected from previous reports. The AUCR value was estimated based on the compartment model under the assumption that the subject drug in the first gastrointestinal compartment is immediately adsorbed to a certain extent upon the administration of activated charcoal. The estimated AUCR (AUCRe) for each drug with certain dosing interval was compared with the respective AUCR value reported previously (AUCRobs). RESULTS: Among twenty concentration profiles for 14 subject drugs obtained from previous reports, 15 AUCRe values fell in the range of 80-120% of the respective AUCRobs values. CONCLUSION: The developed method enabled estimation of the amplitude of DDI by activated charcoal administered in a certain dosing interval, whereas overestimation of AUCRe was observed for drugs that undergo extensive enterohepatic circulation.

Utility of Activated Carbon Nanoparticle (CNP) During total Thyroidectomy for Clinically Nodal Positive Papillary Thyroid Carcinoma (PTC).

BACKGROUND: Activated carbon nanoparticle (CNP) is a novel tracer that may facilitate nodal dissection in clinically nodal positive (cN1) papillary thyroid carcinoma (PTC). The present study compared the nodal yield and surgical outcomes between surgery with CNP and without CNP. METHODS: Patients who underwent total thyroidectomy with therapeutic nodal dissection for cN1 PTC were given the option of intraoperative CNP injection. Among those who received CNP, 0.2 mL CNP suspension was injected in both thyroid lobes before dissection. Study endpoints included number of total and metastatic lymph nodes, inadvertently removed parathyroid glands (PGs), postoperative parathyroid hormone, calcium, and post-6-month thyroglobulin (Tg). Biochemical complete response (BCR) was defined as Tg ≤ 1 ng/mL and/or stimulated Tg ≤ 2 ng/mL. RESULTS: One-hundred and twenty patients (58.3%) received CNP, while 86 (41.7%) had surgery without CNP. Demographics, tumor characteristics, and operative time were comparable between the two groups. However, total mean number of normal and metastatic lymph nodes retrieved were significantly greater in CNP group (10.0 vs. 8.1, p = 0.032 and 4.5 vs. 2.7, p = 0.002, respectively). Rate of inadvertently removed PG was significantly less in CNP group (13.3% vs. 23.3%, p = 0.042). Postoperative Tg level and BCR were significantly lower in CNP group (9.9 ng/mL vs. 14.7 ng/mL, p = 0.297 and 82.4% vs. 72.9%, p = 0.002, respectively). However, large-sized ( ≥ 3 cm) PTCs had a significantly lower nodal staining rate than smaller-sized PTCs (10.3% vs. 69.4%, p < 0.001). CONCLUSIONS: CNP injection can facilitate therapeutic central nodal dissection by increasing the nodal yield rates and reducing inadvertent PG removal. To enhance its utility, a greater volume of CNP might be necessary in larger-sized (> 3 cm) PTCs.

Treatment of ibuprofen intoxication with charcoal haemoperfusion in two dogs.

Case history: Two dogs presented separately to the Small Animal Hospital, University of Florida (Gainsville, FL, USA) for ingestion of ibuprofen. The first dog ingested 561.8 mg/kg ibuprofen in addition to paracetamol and caffeine and vomited prior to admission. This patient also received fluid therapy for 8 hours prior to charcoal haemoperfusion. The second dog ingested 500 mg/kg of ibuprofen and the owners induced vomiting with hydrogen peroxide prior to presentation. Due to the severity of clinical signs, both patients were treated with charcoal haemoperfusion.Clinical findings: The concentrations of ibuprofen in the blood of the dogs prior to treatment were 478 and 301 mg/L. During the treatment ibuprofen concentrations were reduced by 95.8% and 45.5%, respectively, with no treatment side effects and minimal clinical signs after treatment.Diagnosis: Toxicity due to ingestion of ibuprofen toxicity that was successfully treated with charcoal haemoperfusion.Clinical relevance: In the cases described here minimal benefit was seen after 3 hours of treatment using one haemoperfusion cartridge. This is in contrast to a previously published report in which dogs were treated for 6 hours with two charcoal haemoperfusion cartridges. This suggests that one cartridge may be sufficient. The amount of ibuprofen ingested was not a reliable predictor of the concentration in blood at the initiation of treatment. Charcoal haemoperfusion is an effective means of reducing plasma concentrations of ibuprofen, however, its use may be limited by its cost and availability.

DAV131A Protects Hamsters from Lethal Clostridioides difficile Infection Induced by Fluoroquinolones.

Fluoroquinolone treatments induce dysbiosis of the intestinal microbiota, resulting in loss of resistance to colonization by exogenous bacteria such as Clostridioides difficile that may cause severe diarrhea in humans and lethal infection in hamsters. We show here that DAV131A, a charcoal-based adsorbent, decreases the intestinal levels of the fluoroquinolone antibiotics levofloxacin and ciprofloxacin in hamsters, protects their intestinal microbiota, and prevents lethal infection by C. difficile.

Ultrasound-guided dual-localization for axillary nodes before and after neoadjuvant chemotherapy with clip and activated charcoal in breast cancer patients: a feasibility study.

BACKGROUND: We report on our experience of ultrasound (US)-guided dual-localization for axillary nodes before and after neoadjuvant chemotherapy (NAC) with clip and activated charcoal to guide axillary surgery in breast cancer patients. METHODS: Between November 2017 and May 2018, a dual-localization procedure was performed under US guidance for the most suspicious axillary nodes noted at initial staging (before NAC, with clip) and restaging (after NAC, with activated charcoal) in 28 cytologically proven node-positive breast cancer patients. Patients underwent axillary sampling or dissection, which involved removing not only the sentinel nodes (SNs), but also clipped nodes (CNs) and tattooed nodes (TNs). Success (or failure) rates of biopsies of SNs, CNs, and TNs and inter-nodal concordance rates were determined. Sensitivities for the individual and combined biopsies were calculated. RESULTS: SN biopsy failed in four patients (14%), whereas the CN biopsy failed in one patient (4%). All TNs were identified in the surgical field. Concordance rates were 79% for CNs-TNs, 63% for CNs-SNs, and 58% for TNs-SNs. Sensitivity for SN, CN, and TN biopsy was 73%, 67%, and 67%, respectively. Sensitivity was 80% for any combination of biopsies (SN plus CN, SN plus TN, SN plus CN plus TN). CONCLUSIONS: US-guided dual-localization of axillary nodes before and after NAC with clip and activated charcoal was a feasible approach that might facilitate more reliable nodal staging with less-invasive strategies in node-positive breast cancer patients.

Characterization of a clinically used charcoal suspension for in vivo EPR oximetry.

OBJECTIVES: Electron paramagnetic resonance (EPR) oximetry using particulate materials allows repeatable measurements of oxygen in tissues. However, the materials identified so far are not medical devices, thus precluding their immediate use in clinical studies. The aim of this study was to assess the magnetic properties of Carbo-Rep®, a charcoal suspension used as a liquid marker for preoperative tumor localization. MATERIALS AND METHODS: Calibration curves (EPR linewidth as a function of pO2) were built using 9-GHz EPR spectrometry. The feasibility of performing oxygen measurements was examined in vivo by using a low-frequency (1 GHz) EPR spectrometer and by inducing ischemia in the gastrocnemius muscle of mice or by submitting rats bearing tumors to different oxygen-breathing challenges. RESULTS: Paramagnetic centers presenting a high oxygen sensitivity were identified in Carbo-Rep®. At 1 GHz, the EPR linewidth varied from 98 to 426 µT in L-band in nitrogen and air, respectively. The sensor allowed repeated measurements of oxygen over 6 months in muscles of mice. Subtle variations of tumor oxygenation were monitored in rats when switching gas breathing from air to carbogen. DISCUSSION: The magnetic properties of Carbo-Rep® are promising for its future use as oxygen sensor in clinical EPR oximetry.

Rice busk biochar treatment to cobalt-polluted fluvo-aquic soil: speciation and enzyme activities.

Rice busk biochar was mixed with cobalt (Co)-polluted soil to examine the efficacy of biochar for Co immobilization and detoxification in fluvo-aquic soil. The Co speciation (modified BCR sequential extraction), fluorescein diacetate (FDA) hydrolysis and soil enzyme activities were investigated. In soil, the Co ions (acid-soluble fraction) could be uptake by biochar due to the microporous structure on the surface, as well as the oxygen-containing functional groups and conjugated structure in the molecular structure. Therefore, when the biochar concentration was lower than the optimum concentration (~6 g·kg-1), there was transformation of Co from the acid-soluble fraction to the oxidizable fraction, resulting in lower environmental risk. However, if the biochar concentration continued increasing, the distribution coefficient of Co in the acid-soluble fraction increased (P < 0.05). The biochar could also reduce the toxicity of Co, resulting in the negative correlations between soil enzyme activities (FDA hydrolysis, urease and alkaline phosphatases) and Co in the acid-soluble fraction (r = -0.816, -0.928 and -0.908, respectively, P < 0.01). When the biochar concentration ranged from 5.83 to 6.76 g·kg-1, the efficacy for Co immobilization and detoxification reached the maxima. To conclude, in fluvo-aquic soil, rice busk biochar is an effective amendment for immobilizing Co ions and reducing the toxicity of Co. The biochar concentration in soil should range from 5.83 to 6.76 g·kg-1 to reach the optimum efficacy.

Reversing anticoagulation in the hemorrhaging patient.

PURPOSE OF REVIEW: Anticoagulants in general, but especially the relatively new direct oral anticoagulants and platelet inhibitors, pose a great challenge for physicians in the hemorrhaging patient. The aim of the present review is to provide an overview on recent studies dealing with the reversal of anticoagulation in the hemorrhaging patient and to describe our therapeutic emergency strategy for those patients. RECENT FINDINGS: A specific antidote for dabigatran is already on the market and antidotes for the direct and indirect factor Xa inhibitors are in development. Moreover, bleeding under platelet inhibitors remains critical with very little evidence on effective reversal strategies. SUMMARY: To reverse anticoagulation in the hemorrhaging patient, specific antidotes should be the first option if available, followed by four-factor prothrombin complex concentrate (PCC), activated PCC and recombinant activated factor seven as the emergency strategy. Fibrinogen concentrate, antifibrinolytics and oral charcoal, respectively, can be considered as an additional measure. Massive blood loss and thrombocytopenia should be treated independently according to the respective, local guidelines for (massive) transfusion of blood and blood products.

Effects of walnut shell and chicken manure biochar on in vitro fermentation and in vivo nutrient digestibility and performance of dairy ewes.

Two experiments were conducted to investigate the effects of addition of walnut shell biochar (WSB) and chicken manure biochar (CMB) to dairy ewes' diet. In in vitro experiment, the effects of different levels of WSB and CMB (0.5, 1, and 1.5% diet dry matter (DM)) on rumen fermentation characteristics were assessed in a completely randomized design with seven treatments and three replicates. Treatments were as follows: basal diet without biochar (control), basal diet with 0.5, 1, and 1.5% WSB, and basal diet with 0.5, 1, and 1.5% CMB. Addition of 1% WSB and 1.5% CMB to the diet linearly decreased methane production and ammonia-N concentrations and increased pH compared to control (P < 0.001). Inclusion of WSB and CMB to the diet did not change volume of gas production and total volatile fatty acids (VFA) and proportion of acetate, propionate, and butyrate. In the second experiment, six milking Kermanian ewes were used in a replicated Latin square design with three treatments and three 21-day periods to evaluate the effects of 1% WSB and 1.5% CMB (based on results obtained from in vitro trial) on intake, digestibility, and milk yield and composition. Dietary inclusion of 1% WSB and 1.5% CMB resulted in more milk yield (P < 0.01), milk protein (P < 0.05), and solids not fat (SNF) (P < 0.001). Blood glucose and total protein increased (P < 0.01) in ewes fed 1% WSB and 1.5% CMB in comparison to ewes fed control diet. Apparent digestibility coefficients of DM (P < 0.01) and OM (P < 0.10) were increased with inclusion of 1% WSB and 1.5% CMB in diet. Neutral detergent fiber (NDF) digestibility was also increased in WSB-fed ewes (P < 0.01). The lack of negative effects of 1% WSB and 1.5% CMB coupled with the observed reduction in methane emission and ammonia concentration and also improvement in milk production suggested that biochars can be beneficially incorporated in dairy ewes' ration as a low-cost feed additive.

Protection of the Human Gut Microbiome From Antibiotics.

Background: Antibiotics are life-saving drugs but severely affect the gut microbiome with short-term consequences including diarrhea and selection of antibiotic-resistant bacteria. Long-term links to allergy and obesity are also suggested. We devised a product, DAV132, and previously showed its ability to deliver a powerful adsorbent, activated charcoal, in the late ileum of human volunteers. Methods: We performed a randomized controlled trial in 28 human volunteers treated with a 5-day clinical regimen of the fluoroquinolone antibiotic moxifloxacin in 2 parallel groups, with or without DAV132 coadministration. Two control goups of 8 volunteers each receiving DAV132 alone, or a nonactive substitute, were added. Results: The coadministration of DAV132 decreased free moxifloxacin fecal concentrations by 99%, while plasmatic levels were unaffected. Shotgun quantitative metagenomics showed that the richness and composition of the intestinal microbiota were largely preserved in subjects co-treated with DAV132 in addition to moxifloxacin. No adverse effect was observed. In addition, DAV132 efficiently adsorbed a wide range of clinically relevant antibiotics ex vivo. Conclusions: DAV132 was highly effective to protect the gut microbiome of moxifloxacin-treated healthy volunteers and may constitute a clinical breakthrough by preventing adverse health consequences of a wide range of antibiotic treatments. Clinical Trials Registration: NCT02176005.

[Una mezcla de manzanilla y anís estrella con actividad antimotilidad y antidiarreica en ratones].

INTRODUCTION: Diarrhea is a serious public health problem in Mexico and other countries. An alternative widely used in the treatment of diarrhea is the use of medicinal herbs. Infusions of chamomile and star anise, which have anti-inflammatory and antimotility properties, could help alleviate gastrointestinal disorders. OBJECTIVE: The objective of this study was to determine the effect of the mixture of infusions of star anise and chamomile on the gastrointestinal activity in mice. MATERIAL AND METHOD: Ten groups were formed with 10 mice per group. The percentage of advance of the activated charcoal administered through the intestine of the animals was evaluated. The model of diarrhea was induced with castor oil. The infusions were prepared using a mixture with a 50:50 ratio of the herbs, and were administered in a mixture of 10, 20, 40 and 80 mg/kg orally. RESULTS: The results indicate that mixtures 40 and 80 decreased the percentage of advance of activated charcoal, delayed the onset of diarrhea and decreased the number of evacuations compared to the control group. CONCLUSIONS: The study suggests that the combination of chamomile and star anise can be used as an alternative antidiarrheal treatment.

INTRODUCCIÓN: La diarrea es un serio problema de salud pública en México y otros países. Una alternativa ampliamente utilizada en el tratamiento de la diarrea es el uso de hierbas medicinales. Infusiones de manzanilla y anís estrella, que poseen propiedades antiinflamatorias y antimotilidad, podrían ayudar a aliviar los trastornos gastrointestinales. OBJETIVO: El objetivo de este estudio fue determinar el efecto de la mezcla de infusiones de anís estrella y manzanilla en la actividad gastrointestinal en ratones. MATERIAL Y MÉTODO: Se formaron 10 grupos con 10 ratones por grupo. Se evaluó el porcentaje de avance del carbón activado administrado a través del intestino de los animales. El modelo de diarrea fue inducido con aceite de ricino. Las infusiones se prepararon usando una mezcla con una relación 50:50 de las hierbas, y se administraron en una mezcla de 10, 20, 40 y 80 mg/kg por vía oral. RESULTADOS: Los resultados indican que las mezclas 40 y 80 disminuyeron el porcentaje de avance del carbón activado, retrasaron la aparición de diarrea y disminuyeron el número de evacuaciones en comparación con el grupo control. CONCLUSIONES: El estudio sugiere que la combinación de manzanilla y anís estrella se puede usar como un tratamiento antidiarreico alternativo.

An open prospective study evaluating efficacy and safety of a new medical device for rectal application of activated carbon in the treatment of chronic, uncomplicated perianal fistulas.

PURPOSE: It has been proposed that biological/chemical substances in the intestine might play a role in the occurrence and deterioration of perianal fistulas. Elimination of such unidentified factors from the lower gastrointestinal tract might offer a new strategy for the management of anal fistulas. The aim of this study was to evaluate the clinical effects on non-Crohn's disease perianal fistula healing, and the safety and tolerability of a new medical device that applies high-purity, high-activity granular activated carbon locally into the rectum twice daily of patients with perianal fistulas without any concomitant medication. METHODS: An open, single-arm, prospective study with active treatment for 8 weeks and an optional follow-up until week 24 ( ClinicalTrial.gov identifier NCT01462747) among patients with chronic, uncomplicated perianal fistulas scheduled for surgery was conducted. RESULTS: Of 28 patients included, 10 patients (35.7%) showed complete fistula healing (closed, no discharge on palpation) after 8 weeks; seven of these patients, corresponding to 25% of the enrolled patients, remained in remission for up to 31 weeks. At week 8, there was a statistically significant reduction in the discharge visual analog scale (p = 0.04), a significant improvement in the patient-perceived quality of life for the category of embarrassment (p = 0.002), and a trend toward improvement in the other assessment categories. CONCLUSIONS: The treatment was well tolerated, and patient acceptance was high. The results support the efficacy and safety of locally administered activated carbon for the treatment of patients with chronic uncomplicated perianal fistulas not receiving any other medication for fistula problems.

TCDD administered on activated carbon eliminates bioavailability and subsequent shifts to a key murine gut commensal.

Activated carbon (AC) is an increasingly attractive remediation alternative for the sequestration of dioxins at contaminated sites globally. However, the potential for AC to reduce the bioavailability of dioxins in mammals and the residing gut microbiota has received less attention. This question was partially answered in a recent study examining 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced hallmark toxic responses in mice administered with TCDD sequestered by AC or freely available in corn oil by oral gavage. Results from that study support the use of AC to significantly reduce the bioavailability of TCDD to the host. Herein, we examined the bioavailability of TCDD sequestered to AC on a key murine gut commensal and the influence of AC on the community structure of the gut microbiota. The analysis included qPCR to quantify the expression of segmented filamentous bacteria (SFB) in the mouse ileum, which has responded to TCDD-induced host toxicity in previous studies and community structure via sequencing the 16S ribosomal RNA (rRNA) gene. The expression of SFB 16S rRNA gene and functional genes significantly increased with TCDD administered with corn oil vehicle. Such a response was absent when TCDD was sequestered by AC. In addition, AC appeared to have a minimal influence on murine gut community structure and diversity, affecting only the relative abundance of Lactobacillaceae and two other groups. Results of this study further support the remedial use of AC for eliminating bioavailability of TCDD to host and subsequent influence on the gut microbiome.

Effect of biochar addition on short-term N2O and CO2 emissions during repeated drying and wetting of an anthropogenic alluvial soil.

Agricultural soils are an important source of greenhouse gases (GHG). Biochar application to such soils has the potential of mitigating global anthropogenic GHG emissions. Under irrigation, the topsoils in arid regions experience repeated drying and wetting during the crop growing season. Biochar incorporation into these soils would change the soil microbial environment and hence affect GHG emissions. Little information, however, is available regarding the effect of biochar addition on carbon dioxide (CO2) and nitrous oxide (N2O) emissions from agricultural soils undergoing repeated drying and wetting. Here, we report the results of a 49-day aerobic incubation experiment, incorporating biochar into an anthropogenic alluvial soil in an arid region of Xinjiang Province, China, and measuring CO2 and N2O emissions. Under both drying-wetting and constantly moist conditions, biochar amendment significantly increased cumulative CO2 emission. At the same time, there was a significant reduction (up to ~20 %) in cumulative N2O emission, indicating that the addition of biochar to irrigated agricultural soils may effectively slow down global warming in arid regions of China.

Activated Charcoal Does Not Reduce Duration of Phenytoin Toxicity in Hospitalized Patients.

Phenytoin toxicity frequently results in a prolonged inpatient admission. Several publications avow multidose activated charcoal (MDAC) will enhance the elimination of phenytoin. However, these claims are not consistent, and the mechanism of enhanced eliminaiton is unproven. The aim of this investigation is to compare the time to reach a clinical composite end point in phenytoin overdose patients treated with no activated charcoal (NoAC), single-dose activated charcoal (SDAC), and MDAC. This was a retrospective study using electronic poison center data. Patients treated in a health care facility with phenytoin concentrations >20 mg/L were included. Patients were grouped by use of SDAC, MDAC, and NoAC. The primary end points were either time to resolution of symptoms, hospital discharge, or the case was closed by a toxicologist. After applying inclusion and exclusion criteria, 132 cases were included for analysis. There were 88 NoAC, 13 SDAC, and 31 MDAC cases. The groups were similar in symptomatology, age, and chronicity of expsoure. Mean peak phenytoin concentrations (SD) were 42 mg/L (12), 41 mg/L (11), and 42 mg/L (11) for NoAC, SDAC, and MDAC, respectively. Mean time to reach the study end point was 39 hours [95% confidence interval (CI), 31-48], 52 hours (95% CI, 36-68), and 60 hours (95% CI, 45-75) for NoAC, SDAC, and MDAC, respectively. The groups appeared similar with respect to peak phenytoin concentrations and prevalence of signs and symptoms. In this observational series, the use of activated charcoal was associated with increased time to reach the composite end point of clinical improvement.