Arzneimittel in der aquatischen Umwelt

The German Environmental Advisory Council evaluated German water protection policies in its last environmental report (2004) concluded that despite some great successes in this area there is still considerable need for action. Specifically, diffuse nutrient and chemical substances inputs remain an unsolved problem. The contamination of surface and groundwater with pharmaceuticals has been identified as an environmental risk increasing in pertinence. Pharmaceuticals and their metabolites are being detected in the whole aquatic environment, which they enter through sewage, soil contamination by agriculture, and waste storage facilities. Different pharmaceuticals have been tested for acute toxicity on various aquatic organisms, but almost nothing is known about chronic toxicity of these contaminants. This knowledge, however, is essential for estimating the ecotoxicological potential of pharmaceutical residues. In the opinion of the Environmental Council different strategies are necessary, to reduce the contamination of the environment with pharmaceuticals. Farmers should refrain from using pharmaceuticals for prophylactic purposes or from using hormonally or antibiotically active substances in livestock feed additives, so as to reduce inputs of veterinary drugs. As regards human medications, packaging should better correspond to appropriate dosage amounts, and environmentally responsible disposal measures should be followed. Still under discussion are a programme for the risk evaluation of existing pharmaceuticals and a ban on the use of sewage sludge in agriculture. In the future, improvement of sewage treatment facilities, for instances through membrane technologies, will offer further potential to reduce inputs of hazardous substances.     

The use of fetal MRI for renal and urogenital tract anomalies

Fetal anomalies are detected in approximately 2% of all fetuses and, among these, genitourinary tract abnormalities account for 30% to 50% of all structural anomalies present at birth. Although ultrasound remains the first line diagnostic modality, fetal MRI provides important additional structural and functional information, especially with the development of faster sequences and the use of functional sequences. The added value of MRI-based imaging is three-fold: (a) improvement of diagnostic accuracy by adequate morphological examination, (b) detection of additional anomalies, and (c) in addition, MRI has the potential to provide information regarding renal function. In this review, we describe the role of fetal MRI in the anatomical evaluation of renal and urogenital tract anomalies, and we also touch upon the contribution of functional MRI to the diagnostic workup of these conditions.