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The dechlorination effect of sodium thiosulfate and the DCM model for wastewater dechlorination were investigated in order to achieve the automatic control of the dosage of dechlorination agent. Meanwhile，the model calibration was carried out by the nonlinear fitting. The automatic control system of the dosage of dechlorination agent was also developed. The results showed that sodium thiosulfate could be used for dechlorination in the influent of a waste water treatment plant （WWTP），and 90% of residual chlorine in the sewage could be removed within one minute of the dechlorination reaction. The dichlorination efficiencies were mainly determined by the dosage of sodium thiosulfate. The DCM model could be described by CtC0=k21+k1CR+k3. The DCM model curves had a good correlation with the test data. The square values of the fitting correlation coefficients were greater than 0.99，and the residual sums of square were less than 0.000 5. The imitative effect of the DCM model was best while the dechlorination time was one minute. Meanwhile，according to the DCM model，the automatic control of the dosage of dechlorination agent was described with programmable logic controller（PLC） as the main controller，with the on-line monitoring instrument of residual chlorine as the measuring element and with diaphragm pump as the executive equipment. The dosing point was set at the water-collecting well of influent pump station of the WWTP. The residual chlorine values of the influent in biological treatment unit were used for real-time feedback to determine whether the automatic control system of wastewater dechlorination was running correctly or not.

Abstract Background Up to now, there is no unequivocal intervention to mitigate vascular calcification (VC) in patients with hemodialysis. This network meta-analysis aimed to systematically evaluate the clinical efficacy of sodium thiosulfate, bisphosphonates, and cinacalcet in treating vascular calcification. Methods A comprehensive study search was performed using PubMed, Web of Science, the Cochrane Library, EMBASE and China National Knowledge Internet (CNKI) to collect randomized controlled trials (RCTs) of sodium thiosulfate, bisphosphonates, and cinacalcet for vascular calcification among hemodialysis patients. Then, network meta-analysis was conducted using Stata 17.0 software. Results In total, eleven RCTs including 1083 patients were qualified for this meta-analysis. We found that cinacalcet (SMD − 0.59; 95% CI [–0.95, -0.24]) had significant benefit on vascular calcification compared with conventional therapy, while sodium thiosulfate or bisphosphonates did not show such efficiency. Furthermore, as for ranking the efficacy assessment, cinacalcet possessed the highest surface under the cumulative ranking curve (SUCRA) value (88.5%) of lessening vascular calcification and was superior to sodium thiosulfate (50.4%) and bisphosphonates (55.4%). Thus, above results suggested that cinacalcet might be the most promising drug for vascular calcification treatment in hemodialysis patients. Mechanistically, our findings illustrated that cinacalcet reduced serum calcium (SMD − 1.20; 95% CI [–2.08, − 0.33]) and showed the tendency in maintaining the balance of intact Parathyroid Hormone (iPTH) level. Conclusions This network meta-analysis indicated that cinacalcet appear to be more effective than sodium thiosulfate and bisphosphonates in mitigating vascular calcification through decreasing serum calcium and iPTH. And cinacalcet might be a reasonable option for hemodialysis patients with VC in clinical practice. Systematic Review Registration [ http://www.crd.york.ac.uk/PROSPERO ], identifier [CRD42022379965].

One of the more common dechlorinated agents is Sodium thiosulfate. However, the toxicity on the aquatic animals was unknown, this study aims to determine the adverse effects of random usage and high sodium thiosulfate concentration in carp fish rearing in an earthen pond in Hawy -Al-Kanesa in Mosul city. The sodium thiosulfate used at 10 gm /L led to fish mortality of 80% through 96 days of exposure. The semi-quantities score analysis of histopathological alteration of gill represented a biological indicator for toxicity estimation, which reveals the significant alteration index (P≤0.05) in the vacuolar degeneration and hemorrhage while highly significant alteration index (P≤0.01) represented in the other vascular disturbances (edema, congestion, and aneurysm), hyperplasia, hyper trophy of cells, shortening, loss and fusion of secondary gills lamellae with abnormal cartilage morphology. Chloride and mucus cells were ++ and +++ for Periodic acid Schefft and Masson Trichrome, respectively, and apoptotic cells have been detected via caspase-3 activation, which was prominently detected mainly in the cells structure of the secondary gill lamella rather than primary filaments. This study concluded that sodium thiosulfate is toxic in high concentration to fish and leads to a pathological alteration in the vital organs such as gills. The semi-quantitative analysis is one of the modern techniques through which significant pathological changes are determined in histological sections of the gills and immunohistochemically and technique to determine programmed cell death.

Ototoxicity is a devastating direct, irreversible side effect of platinum use in children with cancer, with its consequent effect on speech, language and social development, quality of life and adult productivity. Cisplatin, an essential chemotherapeutic agent for the treatment of solid tumors in children, is a DNA cross-linking agent. Which causes hearing loss in 50-70% of cisplatin treated children. Fortunately, to prevent hearing loss, sodium thiosulfate (STS), which binds to cisplatin, and reduces the superoxides in both tumor and outer hair cells of the cochlea has now been discovered to be an effective and safe otoprotectant if administered correctly. The aim of this perspective paper is to explore the key safety issues and challenges important for pediatric oncologists and pharmacists when considering the clinical use of STS as an otoprotectant for children and adolescents receiving cisplatin. These include: the choice of the formulation; the timing, both that of the STS in relation to cisplatin as well as the timing of the cisplatin infusion itself; the dosing; the challenge left by the definition of localized versus disseminated disease and the difference in indication for STS, between cisplatin treated patients and those receiving another platinum chemotherapeutic agent, carboplatin.

A Hypo helmet is a fabric hood soaked with an aqueous solution of two sodium salts for the detoxication of chlorine that was developed during the First World War. Herein, we report on a lecture, developed for non-chemistry majors that used the Hypo helmet to highlight the physical and chemical properties of chlorine. The lecture consisted of the following three components: (1) a brief introduction to the First World War (the Chemists’ War), (2) video demonstrations of the generation of chlorine by mixing bleaching powder and hydrochloric acid and the detoxication of chlorine using a dummy Hypo helmet, and (3) students’ written impressions of the lecture. The students’ written impressions revealed two things: the lecture on chlorine and the Hypo helmet was well received, and most of the students (71 %, N = 82) did not know that chlorine was used as a poisonous gas during the First World War.

The modern period in the development of the world community and the Russian Federation in particular is characterized by the globalization of chemical danger. The increase of chemical hazards is determined by the growing potential of the chemical industry in developed countries, widespread use of highly toxic substances in industry, presence of not destroyed stockpiles of chemical weapons abroad, bolstering terrorist manifestations etc. In these circumstances one of the components of the concept of medical support for chemical safety is the existence of a scientifically based system for the development and application of medical technologies for the treatment and prophylaxis of chemical poisoning. The system of emergency specialized toxicological assistance that exists in the Russian Federation suggests the use of means of antidote therapy. However, the analysis of the reports of centers / departments of acute poisoning indicates the lack of significant means of specific pharmacotherapy there. Also there are no important antidotes to cyanides, irritants or alcohol substitutes on Russia's pharmaceutical market. After the analysis of the state of the scientific, technological and industrial base, as well as the analysis of the potential hazards of a chemical nature, it is necessary to underline, that the main directions for the optimization of the antidote therapy system in the Russian Federation should include experimental and clinical studies aimed at the development and creation of innovative antidotes (or adaptation and licensing of various pharmacopeial drugs). The short-term tasks of research, production and regulatory development of the antidote therapy system in the Russian Federation are connected with the completion of the development, registration and acceptance of domestic means of antidote therapy (antidotes to cyanides, combustion products, irritants, psychodisleptics), improvement of technical means of applying existing antidotes, legal regulations in the sphere of providing access to antidotes for medical units and organizations.

Sulfur mustard was widely used during the Iran-Iraq war (1980–1988) and in other conflicts in the Middle East. Due to its availability, it can be used by terrorist organizations on the territory of the Russian Federation. Iran is the only country, against which mustard gas was used in modern warfare. The aim of this work is to analyze and summarize the experience of treating of sulfur mustard exposure, accumulated by Iranian specialists during the Iran-Iraq war (1980–1988). The UN official documents and materials, declassified CIA documents, articles of Iranian authors as well as other open sources have been used during its preparation. The Iraqi army used mustard gas in two aggregate states: liquid and dry. Dry mustard gas was a novelty of that war. It was a powdered silica steeped in mustard gas, with a particle size of less than 5 μm. The first signs and symptoms of poisoning could appear after 15 minutes, while acute poisoning effects of exposure to mustard gas vapour or liquid were typically delayed for several hours. The reasons for the severe mustard lesions of the servicemen were the lack of personal protective equipment, untimely evacuation from the mustard gas contamination zone, and the absence of mobile reserves of clean water and degassing installations in battle formations. Iranian experts consider 0.5% sodium hypochlorite solution to be the most effective decontaminant. The only safe antidote is sodium thiosulfate, administered within 60 minutes after exposure to mustard gas. During the evacuation of victims and their treatment in hospitals it is necessary, in severe cases, to insert an intravenous catheter, carry out a tracheotomy with the installation of a tracheotomy tube, and use bronchoscopy as early as possible to flush the bronchi. The treatment of skin and eye lesions should be conservative. In case of a corneal perforation, if its diameter is more than 2 mm – keratoplasty, if it is less – cyanoacrylate glue. Treatment of respiratory lesions aims to relieve symptoms and reduce the severity of complications. For this, bronchodilators, antitussives, mucolytics and, if necessary, antibiotics are used. The use of corticosteroids should be limited to the treatment of those patients with bronchospasm, who can not be treated by bronchodilators. The Iranians also consider gene therapy and treatment with mesenchymal stem cells to be the promising method used in the treatment of lung lesions.

Calciphylaxis is a rare and life-threatening condition in patients with end-stage kidney disease (ESKD). In this case report, we reported a 72-year-old female who had undergone aortic and mitral mechanical valve replacement 22 years ago due to rheumatic aortic and mitral stenosis. Following the valve replacement, she initiated warfarin treatment. Five years ago, she received a diagnosis of uremia and has since been undergoing regular hemodialysis. Ten months prior to her current admission, she experienced excruciating pain and was diagnosed with calciphylaxis. Additionally, an electrocardiogram revealed atrial fibrillation, while echocardiography indicated that the aortic and mitral mechanical valves were appropriately positioned, with normal perivalvular surroundings and good valve leaflet activity. No noticeable thrombosis was observed in the left atrium or left atrial appendage. Color Doppler imaging showed moderate stenosis in the lower extremity arteries, with no venous thromboembolism present. Extensive eggshell-like calcification within the arterial media was detected. The patient was managed with regular hemodialysis, symptomatic treatments (including anticoagulation and analgesia), and sodium thiosulfate. Unfortunately, symptomatic management provided limited relief, and during the one-month follow-up period, the patient passed away due to septic shock. Currently, there is insufficient conclusive evidence regarding alternative influential anticoagulants or appropriate prosthetic valve selection. For individuals with ESKD receiving maintenance hemodialysis, early identification, diagnosis, and treatment of calciphylaxis are of paramount importance.

Coronary artery calcification (CAC) is common in dialysis patients and is associated with a higher risk of future cardiovascular events. Sodium thiosulfate (STS) is effective for calciphylaxis in dialysis patients; however, the influence of STS on CAC in dialysis patients remains unclear. This systematic review and meta-analysis were conducted to evaluate the effects of STS on CAC in patients undergoing dialysis. PubMed, Embase, Cochrane Library, CNKI, and Wanfang databases were searched from inception to 22 March 2023 for controlled studies comparing the influence of STS versus usual care without STS on CAC scores in dialysis patients. A random effects model incorporating the potential influence of heterogeneity was used to pool the results. Nine studies, including two non-randomized studies and seven randomized controlled trials, were included in the meta-analysis. Among these, 365 patients on dialysis were included in the study. Compared with usual care without STS, intravenous STS for 3–6 months was associated with significantly reduced CAC scores (mean difference [MD] = −180.17, 95% confidence interval [CI]: −276.64 to −83.70, p 0.05). In conclusion, intravenous STS may be effective in attenuating CAC in dialysis patients.

A multimodality approach has been proposed as an effective treatment for calciphylaxis in patients with end-stage kidney disease. In this retrospective study, we report the cases of 12 end-stage kidney disease patients from l’Hôtel-Dieu de Québec hospital (Canada) who were diagnosed with calciphylaxis between 2004 and 2012 and treated with a multimodality clinical approach including sodium thiosulfate (STS). Statistical analyses were performed to evaluate the impacts of patients characteristics, the different interventions as well as therapy regimen on the therapeutic response. The majority of patients (n = 9) were hemodialyzed. The patients-associated comorbidities were consistent with previously reported risk factors for calciphylaxis: Diabetes (n = 11), calcium-based phosphate binders use (n = 10), warfarin use (n = 9), obesity (n = 7), female gender (n = 8) and intravenous iron use (n = 8). STS was given for a median duration of 81 days. 75% of the patients had a response (total or partial) including a complete response in 42% of patients. One-year mortality rate was low (25%). STS was used during a mean duration of 83.33 ± 41.52 days and with a total cumulating dose of 1129.00 ± 490.58 g. The recorded mean time before a complete response was 102.20 days (51–143). Pain improvement occurred after a mean time of 8.67 ± 10.06 days. None of the studied factors was statistically associated with a complete or a partial response to the multimodality approach. Although our data have a limited statistical power, they support treating calciphylaxis with a multimodality approach including STS as its effects are independent from important clinical variables.

Background Sodium thiosulfate (STS) can be used to treat patients diagnosed with calciphylaxis, which is a rare life-threatening syndrome. However, our patients treated with the recommended STS regimen presented with serious adverse events, resulting in treatment withdrawal. Then an optimized STS regimen was used to increase the tolerance of patients to STS and improve treatment continuation. The curative effect of the new regimen is not yet definite. Therefore, this study aimed to evaluate the response to the use of the optimized STS regimen for the treatment of calciphylaxis in Chinese patients during the first three courses of treatment.Methods Demographic, clinical, and laboratory data were retrospectively collected on 31 calciphylaxis patients with chronic kidney disease (CKD) or end-stage kidney disease (ESKD) treated with the optimized STS regimen. The primary outcome was a clinical improvement. The secondary outcomes included survival rate and adverse events.Results Twenty-five patients (over 80%) achieved clinical improvement considering improvement or nonspecific changes of skin lesions (80.65%) and pain relief (100%). Furthermore, 54.84% of patients did not experience any adverse events and none died from complications. During a median follow-up of 9 months (interquartile range 4‒19), 27 patients (87.10%) survived; additionally, 13 patients (41.94%) survived after a one-year follow-up period.Conclusion The optimized STS regimen is relatively safe, associated with satisfactory outcomes, and well tolerated by patients for short to medium treatment duration. Hence, it is a promising approach for the treatment of patients diagnosed with calciphylaxis.

One of the most critical tasks of modern energy is accumulating thermal energy due to the inefficient use of thermal energy during the underloading of power systems in which heat-accumulating materials are used. Therefore the paper studies the effect of alternating electric current on the heat-accumulating properties in a mixture based on Na2SO4·10H2O. It is established that the AC effect leads to an increase in the melt crystallization temperature of Na2SO4·10H2O and Na2S2O3·5H2O and also contributes to the return of heat. The selection of the treatment mode of the Na2SO4·10H2O–Na2S2O3·5H2O (50: 1 wt.) mixture by the AC was carried out. It was shown that the latent heat of melting of 329 kJ/kg is achieved at 500000 Hz frequency.

Calciphylaxis is a rare and potentially life-threatening disease which occurs most frequently in end-stage renal disease. Here, we describe a 69-year-old male patient who presented to the clinic with extremely painful necrotic ulcers of the right lower extremity. His risk factors included hypertension, diabetes mellitus type II, steatosis hepatis, and chronic hepatitis B. Laboratory studies revealed no signs for uremia, hyperparathyroidism, and normal phosphorus as well as calcium levels. A diagnosis of nonuremic calciphylaxis was made in correlation with clinical and histological features. A novel therapeutic approach combining sodium thiosulfate and iloprost showed remarkable improvement of the wound-associated pain and healing of the ulcers within 3 months. Due to its high mortality rate, an early diagnosis and initiation of treatment are crucial to be beneficial for patient outcomes.

Abstract Case Description A 9‐year‐old Quarter Horse gelding was presented for lethargy, decreased appetite, polyuria and polydipsia (PU/PD), and severe muscle wasting suggestive of immune‐mediated myositis. Clinical Findings The horse displayed lethargy, fever, tachyarrhythmia, inappetence, PU/PD, and severe epaxial and gluteal muscle wasting. Clinicopathologic findings were consistent with previously reported cases of systemic calcinosis in horses, including increased muscle enzyme activity, hyperphosphatemia, increased calcium‐phosphorus product, hypoproteinemia, and an inflammatory leukogram. A diagnosis of systemic calcinosis was established by histopathologic evaluation of biopsy specimens from skeletal muscle, lung, and kidney. Treatment and Outcome Symptomatic treatment was complemented by IV treatment with sodium thiosulfate to reverse calcium‐phosphate precipitation in soft tissue and PO aluminum hydroxide to decrease intestinal phosphorus absorption and serum phosphorus concentration. Clinical Relevance This is the first report in the veterinary literature of an antemortem diagnosis of systemic calcinosis in the horse that was successfully treated and had favorable long‐term outcome.

Abstract Background Doxorubicin (DOX) is an effective antitumor agent, but its clinical usage is limited due to adverse cardiotoxic effects. Several compounds have been studied to reduce DOX cardiotoxicity to improve its therapeutic index. This study was aimed to investigate the protective effects of sodium thiosulfate (STS) pre-treatment against DOX-induced cardiomyopathy in rats. Methods Male Wistar rats were randomized into 4 groups: control (saline), DOX (2.5 mg/kg, 3 times per week, intraperitoneal [i.p.]), STS (300 mg/kg, 3 times per week, i.p), and DOX + STS (30 min prior to DOX injection, 3 times per week, i.p.) over a period of 2 weeks. The body weight, electrocardiography, histopathology, papillary muscle contractility, and oxidative stress biomarkers in heart tissues were assessed. Results The results indicated that STS significantly improved the body weight (P

Cisplatin is commonly used during intraperitoneal chemotherapy however has well-established nephrotoxic side-effects. Sodium thiosulfate is often added to cisplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) protocols to mitigate this, however evidence regarding risk of hypernatraemia is scarce as of yet.

Objectives The objective of this study was to find a promising dechlorination chemical which can replace sodium bisulfite (SBS), which is mainly used as a dechlorination agent in reverse osmosis processes but can cause odor issues. Methods Candidate chemicals were selected in consideration of economic feasibility, ease of use, and toxicity. These included sodium metabisulfite (SM), sodium thiosulfate (ST), and sodium sulfite (SS). We investigated the effect of organic matters in water on residual chlorine decomposition and compared the appropriate injection amounts for each dechlorination chemicals. Also, the effect of the pH of treated water upon dechlorination was assessed. Results and Discussion Upon injection of dechlorination chemicals at the theoretical chlorine removal point, the chlorine was not completely removed but 10% to 40% remained. In ultrapure water, it was possible to completely dechlorinate by injecting 1.6 to 2.6 times more than the theoretical injection amount: 1.8, 2.2, and 3.1 times more for ST, SM, and SS, respectively. Considering only the injection amount, ST is an efficient dechlorination chemical for water with pH 9 or higher, and SM is for pH 9 or less Conclusion Considering the product price and user convenience, it is feasible to use ST, which can resolve the odor problem.

Cu and other elements in waste acid from copper smelting flue gas sulphuric acid system have high extraction value. In this paper aiming at the precipitation reaction process of Cu2+ with S2O32-, through experiments, thermodynamic calculation, and product characterization, the precipitation reaction way of Cu2+ was systematically investigated and analyzed. The kinetic parameters of the main reaction and the side reaction in the vulcanization system were determined experimentally to clarify the law of factors which affect the reaction rate. The experimental results show that: S2O32- and Cu2+ directly participate in the reaction to produce CuS, and the reaction process is accompanied by the disproportionation side reaction of S2O32- and H+. The reaction order of S2O32-+Cu2+ is higher than that of S2O32-+H+, and the reaction activation energy of the former is greater than that of the latter. Therefore, increasing the concentration of the vulcanizing agent and increasing the reaction temperature can significantly increase the main reaction selectivity. When the reaction temperature is 80 ℃, the molar ratio of S2O32- to Cu2+ is 2∶1, and the reaction time is 120 min, the removal rate of Cu2+ reaches 99.45%.

Abstract Background Calciphylaxis, or calcific uremic arteriolopathy (CUA), is a rare, fatal disorder of microvascular calcification and thrombosis that typically affects patients with end-stage renal disease (ESRD) receiving long-term dialysis. Fewer reports describe calciphylaxis in peritoneal dialysis patients than hemodialysis patients as per a literature review. To date, there are no clear guidelines for CUA diagnosis and treatment. While sodium thiosulfate (STS) has been increasingly used for treatment in recent years, there have also been reports of severe side effects. There is no uniform standard for its usage and dosage, especially for peritoneal dialysis patients. Case presentation We present a case of a 40-year-old Chinese male patient with ESRD on peritoneal dialysis who developed calciphylaxis with severe painful cutaneous ulcers on the fingers and toes that were managed successfully for 6 months with comprehensive treatment composed mainly of small-dose fractionated sodium thiosulfate. Conclusions Our experience suggests that the treatment of calciphylaxis requires timely and multi-angle intervention. Treatment with small-dose fractionated sodium thiosulfate has proven effective and tolerated in this patient.

Abstract Background Calciphylaxis is a rare, often fatal disease resulting from calcification of dermal arterioles and capillaries. Usually diagnosed in patients with end-stage renal disease, this disorder typically presents as necrotic, nonhealing ulcers in acral or adipose areas. Here we report the case of an elderly man who was found to have calciphylaxis of the distal digits and penis, the latter of which is an uncommon site of disease that carries a particularly poor prognosis. Case presentation A 73-year-old African American man with multiple medical comorbidities including dialysis-dependent end-stage renal disease presented with worsening painful, necrotic lesions on his glans penis and several distal digits over the last 2 months. The wound on the glans was foul smelling with overlying purulence and had been unsuccessfully treated with amoxicillin–clavulanic acid. Discovery of diffuse intravascular calcification on computed tomography, in addition to a markedly elevated calcium–phosphate product immediately prior to the onset of his ulcers, led to the diagnosis of calciphylaxis. The patient was initiated on sodium thiosulfate without improvement in his lesions, and he died 3 months later after another prolonged hospitalization. Conclusions While calciphylaxis is a rare disease, involvement of the distal digits and especially the penis is even more uncommon and portends a particularly poor prognosis: 6-month mortality rates are reportedly as high as 70%. This suggests that prompt recognition and management of the disease is required; however, despite receiving standard therapy, our patient failed to experience improvement in his disease and instead developed several more fingertip ulcers at blood glucose sample points during his hospitalization. A corollary of the case presented here is the need for more effective management of calciphylaxis, especially for patients in whom uncommon sites, such as the penis, are involved.

Introduction: This study compared influence of various irrigation protocols on vertical root fracture resistance of root canal treated teeth. Methods: Forty-eight extracted mandibular premolars were included in the study. The root canals of teeth were instrumented and specimens were allocated into 4 (n = 12) groups according to the irrigation solutions: Group 1: 5% EDTA, 2.5% NaOCl and DW; Group 2: 5% EDTA, 2.5% NaOCl, DW and 2% CHX; Group 3: 5% EDTA, 2.5% NaOCl and 5% Na2S2O3; Group 4: 5% EDTA, 2.5% NaOCl, 5% Na2S2O3 and 2% CHX. Root canals were filled and a load in a vertical direction was applied a week later to specimens. The data were analysed using two-way ANOVA test (P < 0.05). Results: Interaction between using DW or Na2S2O3 and using or not using CHX had a significant effect on fracture resistance to vertical forces (P < 0.001). Irrigation with Na2S2O3 improves fracture resistance to vertical forces when compared to irrigation with DW (P < 0.001). Irrigation with CHX did not affect fracture resistance to vertical forces (P = 0.759). Conclusion: The irrigation solutions statistically affect resistance of root canal treated teeth to vertical fracture forces.

Dewatering of sludge is a key problem that must be solved in the sewage sludge disposal industry. In this study, a series of process optimization tests were conducted to learn how to improve sludge treatment. The optimum process of sludge leaching treatment was studied in a specially designed 100-L reactor system. Four factors were investigated and nine batches of bioleaching tests were run at three levels of these factors. Orthogonal experiments showed that the effect of sludge return ratio and aeration rate on the sludge moisture content was significant and hydraulic retention time (HRT) had a clear effect, but nutrient types had a reduced effect on the moisture content of sludge. The primary and secondary order of each factor is reflux ratio > aeration rate > HRT > nutrient type. Under the optimal process, three batches of sludge were processed and the moisture content of the filter press cake was reduced to less than 60%, the organic matter content reduced to below 5%, and the concentration of heavy metals (Cu, Zn, Pb, and Cr) was much lower than the agricultural standard limit, which is suitable for landscaping, composting, and incineration power generation and other resource applications.

Wojciech Danysz,1 Bartosch Nowag,1 Thomas Hengl,1 Peter Kreymerman,2 Céline Furne,3 Elise Madeuf,4 Christoph Höennscheidt,1 Deanne Mraz Robinson5,6 1R&D, Merz Pharmaceuticals GmbH, Frankfurt am Main, Germany; 2Medical Affairs, Merz North America, Raleigh, NC, USA; 3NAMSA, Chasse sur Rhône, France; 4Preclinical Studies, Voxcan, Marcy L´Etoile, France; 5Modern Dermatology of Connecticut, Westport, CT, USA; 6Yale-New Haven Hospital, New Haven, CT, USACorrespondence: Wojciech DanyszMerz Pharmaceuticals GmbH, Eckenheimer Landstrasse 100, Frankfurt am Main 60318, GermanyEmail Wojciech.danysz@merz.deIntroduction: Calcium hydroxylapatite microspheres suspended in a gel carrier of sodium carboxymethylcellulose (CaHA; Radiesse®) has demonstrated safe and effective restoration of facial volume in clinical trials, as well as collagen biostimulation leading to skin quality improvement. The potential with CaHA, as with any filler, to produce overcorrection and subsequent complications has led to the search for a reversal agent. Sodium thiosulfate (STS) was proposed based on experience with it as a chelating agent to treat calciphylaxis. Previous pilot studies with small sample sizes have suggested its efficacy in the reduction of CaHA volume and nodule formation. The present study focuses on the verification of this effect using various readout methods in preclinical experiments.Methods: We use both in vitro (co-incubation of STS with CaHA) and in vivo (injections in farm pig) methods with readout techniques such as 3D camera analysis, micro-computed tomography ex vivo (μCT), computed tomography in vivo (CT), histopathology and scanning electron microscopy.Results: We did not obtain any indications of CaHA degradation by STS, either in vitro or in vivo. 3D-camera analysis also did not show any decreasing effect of STS on CaHA. However, histology, μCT ex vivo, and CT in vivo indicated a decrease of Radiesse amount/volume after STS treatment, which could be attributed to dispersion effect. It should be noted that necrosis and haemorrhages were observed after STS treatment.Discussion: Results suggest no indication of CaHA microspheres degradation with STS and that the STS mechanism of action on CaHA is consistent with a dispersion effect. Observed necrosis is a further obstacle in the use of STS.Keywords: calcium hydroxylapatite, sodium thiosulfate, dispersion effect, computed tomography, histology, 3D camera

Background/Aims: Arterial stenosis activates the renin-angiotensin-aldosterone system subsequently resulting in renovascular hypertension (RVHT) and renal oxidative injury. We explored the effect of sodium thiosulfate (STS, Na2S2O3), a developed antioxidant in clinical trial, on RVHT-induced hypertension and renal oxidative injury in rats. Methods: We induced RVHT in male Wistar rats with bilaterally partial ligation of renal arteries in the 2-kidney 2-clip model. We evaluated the STS effect on RVHT-induced oxidative injury and apoptosis by a chemiluminescence amplification method, Western blot, and immunohistochemistry. Results: We found STS displayed a dose-dependent antioxidant H2O2 activity and adapted the maximal scavenging H2O2 activity of STS at the dosage of 0.1 g/kg intraperitoneally 3 times/week for 4 weeks in RVHT rats. RVHT induced a significant elevation of arterial blood pressure, blood reactive oxygen species amount, neutrophil infiltration, 4-HNE and NADPH oxidase gp91 expression, Bax/Bcl-2/poly(ADP-ribose) polymerase (PARP)-mediated apoptosis formation, blue Masson-stained fibrosis, and urinary protein level. STS treatment significantly reduced hypertension, oxidative stress, neutrophil infiltration, fibrosis, and Bax/Bcl-2/PARP-mediated apoptosis formation and depressed the urinary protein level in the RVHT models. Conclusion: Our results suggest that STS treatment could ameliorate RVHT hypertension and renal oxidative injury through antioxidant, antifibrotic, and antiapoptotic mechanisms.

Background: Intralesional injection of sodium thiosulfate has emerged as a promising therapy for calcinosis cutis, but to our knowledge there are no randomized controlled trials evaluating its efficacy as a treatment. Objective: Conduct a prospective, double-blinded investigation of intralesional sodium thiosulfate versus normal saline in the treatment of dystrophic calcinosis cutis. Methods: This prospective pilot study injected normal saline or sodium thiosulfate at 0.1 mL/cm2 into lesions at baseline and at 1- and 2-month follow-up. Subjects were followed for a total of 12 weeks. An in-person Physician Global Assessment score was assigned by the injecting physician at each visit and was repeated by an independent observer. Results: Of 4 subjects who completed the study, only 1 experienced improvement in the size and Physician Global Assessment score of the lesion. By 3-month follow-up, there was no difference between the average size of the treatment and control lesions (P = .39). Limitations: This was a small single-center study with limited demographic diversity and a short follow-up period. Only dystrophic calcinosis cutis subjects were included, and subjects received only 3 monthly injections of sodium thiosulfate. Conclusions: With only 1 positive response, our results highlight the need for further study of sodium thiosulfate treatment for dystrophic calcinosis.

Summary: Background: Intimal hyperplasia (IH) remains a major limitation in the long-term success of any type of revascularisation. IH is due to vascular smooth muscle cell (VSMC) dedifferentiation, proliferation and migration. The gasotransmitter Hydrogen Sulfide (H2S), mainly produced in blood vessels by the enzyme cystathionine- γ-lyase (CSE), inhibits IH in pre-clinical models. However, there is currently no H2S donor available to treat patients. Here we used sodium thiosulfate (STS), a clinically-approved source of sulfur, to limit IH. Methods: Low density lipoprotein receptor deleted (LDLR−/−), WT or Cse-deleted (Cse−/−) male mice randomly treated with 4 g/L STS in the water bottle were submitted to focal carotid artery stenosis to induce IH. Human vein segments were maintained in culture for 7 days to induce IH. Further in vitro studies were conducted in primary human vascular smooth muscle cells (VSMCs). Findings: STS inhibited IH in WT mice, as well as in LDLR−/− and Cse−/− mice, and in human vein segments. STS inhibited cell proliferation in the carotid artery wall and in human vein segments. STS increased polysulfides in vivo and protein persulfidation in vitro, which correlated with microtubule depolymerisation, cell cycle arrest and reduced VSMC migration and proliferation. Interpretation: STS, a drug used for the treatment of cyanide poisoning and calciphylaxis, protects against IH in a mouse model of arterial restenosis and in human vein segments. STS acts as an H2S donor to limit VSMC migration and proliferation via microtubule depolymerisation. Funding: This work was supported by the Swiss National Science Foundation (grant FN-310030_176158 to FA and SD and PZ00P3-185927 to AL); the Novartis Foundation to FA; and the Union des Sociétés Suisses des Maladies Vasculaires to SD, and the Fondation pour la recherche en chirurgie vasculaire et thoracique.

Abstract Background This study aims to evaluate the ability of sodium thiosulfate (STS) to neutralize the adverse effect of sodium hypochlorite (NaOCl) on dentin micro-hardness. Methods Fifty single-rooted teeth were longitudinally sectioned. The samples divided into a control and four sample groups (n = 20). All the samples were immersed in different solutions as follows, Control: Normal saline for 15 min, G1and G2: 2.5% NaOCl for 15 min, G3: 2.5% NaOCl for 15 min, followed by 5% STS for 10 min, G4: Normal saline for 15 min followed by 5% STS for 10 min. All groups except G1 incubated for one week before the test. The micro-hardness of samples was measured. Data were analyzed using the Kruskal–Wallis test for pairwise comparisons. A p value

Sarju Panchal,1 Kirstie Holtermann,2 Namrita Trivedi,1 Hariharan Regunath,3 Preethi Yerram4 1Department of Internal Medicine, Hospital of University of Pennsylvania, Philadelphia, PA 19146, USA; 2Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA; 3Department of Medicine – Divisions of Pulmonary, Critical Care and Infectious Diseases, University of Missouri School of Medicine, Columbia, MO 65212, USA; 4Department of Medicine – Division of Nephrology, University of Missouri School of Medicine, Columbia, MO 65212, USACorrespondence: Preethi YerramDepartment of Medicine - Division of Nephrology, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USATel +1 573 882 7992Email yerramp@umsystem.eduBackground: Calciphylaxis is a rare but severe complication mostly affecting patients with end-stage renal disease (ESRD) and is associated with high morbidity and mortality. The natural history, concomitant factors, pathogenesis, and treatment for calciphylaxis remain equivocal.Methods: We conducted a retrospective study on patients diagnosed with calciphylaxis in a tertiary care center between January 1, 2012, and December 31, 2017. We describe demographics, co-morbidities, laboratory parameters, effectiveness of sodium thiosulfate treatment and outcomes.Results: Of the 30 patients (age 65.6 ± 12.79 years, male:female = 8:22), 23 (76.67%) had ESRD and were either on hemodialysis (15 [65.22%], median duration 22.5 months [range 0.2– 96 months]) or peritoneal dialysis (8 [34.78%], duration 29± 10 months). Predisposing home medications: 8 (28%) had calcium supplements, 10 (36%) had warfarin, 16 (57%) had vitamin D and 5 (18%) had iron supplements. The median parathyroid hormone (PTH) level was 239.8 pg/mL (range 4.7– 2922). Calciphylaxis was found on extremities in 21 (70%) and on torso in 6 (20%) patients. Sodium thiosulfate (STS) was given for treatment in 20 (67%) patients and 3 were cured in < 2.25 months. One-year survival for all patients with calciphylaxis was 26% (29% for STS group and 20% for those that did not receive STS) and following any surgical treatment regardless of STS use was 14%.Limitations: Retrospective design, absence of a control group and low power.Conclusion: Calciphylaxis was more common among females with a predilection for extremities over the torso. Elevations in PTH and inflammatory markers were common. Treatment with STS did not show a statistically significant improvement in survival. Those who were cured, were treated with STS up to three months.Keywords: calciphylaxis, sodium thiosulfate, calcific uremic arteriolopathy, calcification, non-uremic calciphylaxis

Objective: To compare the anti-proliferative effect of sodium thiosulfate on human colorectal cancer cells (HT-29) and normal small intestine cells (IEC6). Methods: Cells (HT-29 and IEC6) were treated with different concentrations of sodium thiosulfate ranging from 0.5 mM to 80 mM for 24 h. Cell viability was measured via crystal violet and MTT assays. HT-29 cells were further treated in the presence and absence of mitochondrial electron transport chain (ETC) inhibitors, KATP channel opener and closer and H2S inhibitors for 24 h followed by sodium thiosulfate in order to study their respective roles in the anti-proliferative activity of sodium thiosulfate. Results: The IC50 values of sodium thiosulfate on HT-29 cells were 40.93 mM and 42.45 mM by crystal violet and MTT assay whereas, in the case of IEC6 cells, the values were 45.17 mM and 47.22 mM. The inhibition of endogenous H2S enzymes and KATP channel induced no change in the anti-proliferative capacity of sodium thiosulfate. However, the anti-proliferative activity of sodium thiosulfate was enhanced in the presence of mitochondrial ETC inhibitors. Conclusions: HT-29 cell growth is effectively attenuated by sodium thiosulfate and the anti-proliferative activity of sodium thiosulfate is enhanced in the presence of mitochondrial ETC inhibitors.

Abstract Hydrogen sulfide (H2S) has long been known as a toxic environmental hazard. Discovery of physiological roles of H2S as a neurotransmitter by Kimura and colleagues triggered an intensive research in the biological roles of H2S in the past decades. Manipulation of H2S levels by inhibiting H2S synthesis or administration of H2S-releasing molecules revealed beneficial as well as harmful effects of H2S. As a result, it is now established that H2S levels are tightly controlled and too much or too little H2S levels cause harm. Nonetheless, translation of sulfide-based therapy to clinical practice has been stymied due to the very low therapeutic index of sulfide and the incomplete understanding of endogenous sulfide metabolism. One potential strategy to circumvent this problem is to use a safe and stable sulfide metabolite that may mediate effects of H2S. Alternatively, endogenous sulfide levels may be controlled using specific sulfide scavengers. In this review article, the role of endogenous H2S production and catabolism will be briefly reviewed followed by an introduction of thiosulfate and H2S scavengers as novel pharmacological tools to control H2S-dependent signaling.

Objectives This study aimed to compare the efficacy of intravenous sodium thiosulfate (IV STS) with that of loratadine in the treatment of uremic pruritus in hemodialysis (HD) patients. Methods This retrospective study included 44 HD patients with pruritus aged over 18 years between June 2018 and January 2020 at the Aerospace Center Hospital of China. Twenty-four HD patients received 3.2 g IV STS treatment three times per week at the end of each HD session for 8 weeks. Twenty HD patients received loratadine (10 mg/day) for 8 weeks. Pruritus intensity was measured using a visual analog scale (VAS) and the detailed pruritus score (DPS) at three time points. The safety of STS was evaluated according to adverse event symptoms and biological variable changes. Results There was no significant difference between the STS and loratadine groups in age, sex, characteristics of pruritus, or other clinical variables before treatment. After 8 weeks of treatment, the VAS score (7.07 ± 2.56 and 2.67 ± 2.01) and DPS (30.72 ± 4.81 and 8.04 ± 2.86) decreased significantly in the STS group (p 0.05). There were no morbidities or mortalities associated with the use of either drug. All biological variables remained stable after therapy. Conclusions STS can improve uremic pruritus in HD patients. However, literature on the subject remains lacking. Close monitoring for adverse effects is advised.

Background Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to provide benefits in the management of peritoneal metastasis. Cisplatin (CDDP) is one of the most frequently used drugs for peritoneal infusion. A major restriction is that CDDP causes renal toxicity and acute renal failure, sometimes leading to chronic renal failure. The aim of the present study was to assess the impact of sodium thiosulfate (ST) in preventing renal impairment (RI) following HIPEC with CDDP. Methods This prospective study assessed the RI rates for all patients who underwent HIPEC with CDDP during two successive periods: without ST (nST Period; from November 2016 to September 2017) and with ST (ST Period; from October 2017 to March 2018). During the ST Period, patients received an ST infusion at 9 mg/m2 prior to HIPEC and at 12 mg/m2 at the end of the procedure. RI was defined by postoperative serum creatinine >1.6 times elevation of baseline value. The impact of ST treatment was evaluated by comparison of the RI rates between the two periods. Results During ST Period, none of 38 patients (0%) developed RI versus 11/35 patients (31.4%) during the nST Period (p

The ongoing epidemic caused by SARS-CoV-2 infection led to the search for fundamentally new ways and means to combat inflammation and other pathologies caused by this virus. Using a cellular model of lipopolysaccharide (LPS)-induced sepsis (human promonocytes), we showed that both a hydrogen sulfide donor (sodium thiosulfate, STS) and a recombinant Heat shock protein 70 (rHsp70) effectively block all major inflammatory mediators when administrated before and after LPS challenge. The protective anti-inflammatory effect of rHsp70 and H2S was also confirmed in vivo using various animal models of pneumonia. Specifically, it was found that rHsp70 injections prevented the development of the acute respiratory distress syndrome in highly pathogenic pneumonia in mice, increased animal survival, and reduced the number of Programmed death-1 (PD-1)-positive T-lymphocytes in peripheral blood. Based on our model experiments we developed a combined two-phase therapeutic approach for the treatment of COVID-19 patients. This procedure includes the inhalation of hot helium–oxygen mixtures for induction of endogenous Hsp70 in the first phase and STS inhalation in the second phase. The use of this approach has yielded positive results in COVID-19 patients, reducing the area of lung lesions, restoring parameters of innate immunity and T-cell immune response against coronavirus infection, and preventing the development of pulmonary fibrosis and immune exhaustion syndrome.

IntroductionIn the immunology of sepsis microcirculatory and mitochondrial dysfunction in the gastrointestinal system are important contributors to mortality. Hydrogen sulfide (H2S) optimizes gastrointestinal oxygen supply and mitochondrial respiration predominantly via K(ATP)-channels. Therefore, we tested the hypothesis that sodium thiosulfate (STS), an inducer of endogenous H2S, improves intestinal and hepatic microcirculation and mitochondrial function via K(ATP)-channels in sepsis.MethodsIn 40 male Wistar rats colon ascendens stent peritonitis (CASP) surgery was performed to establish sepsis. Animals were randomized into 4 groups (1: STS 1 g • kg-1 i.p., 2: glibenclamide (GL) 5 mg • kg-1 i.p., 3: STS + GL, 4: vehicle (VE) i.p.). Treatment was given directly after CASP-surgery and 24 hours later. Microcirculatory oxygenation (µHBO2) and flow (µflow) of the colon and the liver were continuously recorded over 90 min using tissue reflectance spectrophotometry. Mitochondrial oxygen consumption in tissue homogenates was determined with respirometry. Statistic: two-way ANOVA + Dunnett´s and Tukey post - hoc test (microcirculation) and Kruskal-Wallis test + Dunn’s multiple comparison test (mitochondria). p < 0.05 was considered significant.ResultsSTS increased µHbO2 (colon: 90 min: + 10.4 ± 18.3%; liver: 90 min: + 5.8 ± 9.1%; p < 0.05 vs. baseline). Furthermore, STS ameliorated µflow (colon: 60 min: + 51.9 ± 71.1 aU; liver: 90 min: + 22.5 ± 20.0 aU; p < 0.05 vs. baseline). In both organs, µHbO2 and µflow were significantly higher after STS compared to VE. The combination of STS and GL increased colonic µHbO2 and µflow (µHbO2 90 min: + 8.7 ± 11.5%; µflow: 90 min: + 41.8 ± 63.3 aU; p < 0.05 vs. baseline), with significantly higher values compared to VE. Liver µHbO2 and µflow did not change after STS and GL. GL alone did not change colonic or hepatic µHbO2 or µflow. Mitochondrial oxygen consumption and macrohemodynamic remained unaltered.ConclusionThe beneficial effect of STS on intestinal and hepatic microcirculatory oxygenation in sepsis seems to be mediated by an increased microcirculatory perfusion and not by mitochondrial respiratory or macrohemodynamic changes. Furthermore, the effect of STS on hepatic but not on intestinal microcirculation seems to be K(ATP)-channel-dependent.

Laterite ore is one of the important sources of nickel (Ni). However, it is difficult to liberate Ni from ore structure during reduction roasting. This paper provided an effective way for a robust recovery of Ni from laterite ore by H2 reduction using sodium thiosulfate (Na2S2O3) as a promoter. . It was found that a Ni content of 9.97% and a Ni recovery of 99.24% were achieved with 20 wt% Na2S2O3 at 1,100°C. The promoting mechanism of Na2S2O3 in laterite ore reduction by H2 was also investigated. The thermogravimetric results suggested the formation of Na2Mg2SiO7, Na2SO3, Na2SO4, and S during the pyrolysis of laterite with Na2S2O3, among which the alkali metal salts could destroy the structures of nickel-bearing silicate minerals and hence release Ni, while S could participate in the formation of the low-melting-point eutectic phase of FeS-Fe. The formation of low-melting-point phases were further verified by the morphology analysis, which could improve the aggregation of Ni-Fe particles due to the capillary forces of FeS-Fe as well as the enhanced element migration by the liquid phase of sodium silicates during reduction.

Cornelia Erfurt-Berge, Regina Renner Department of Dermatology, University Hospital Erlangen, Erlangen 91054, GermanyCorrespondence: Cornelia Erfurt-BergeDepartment of Dermatology, University Hospital Erlangen, Ulmenweg 18, Erlangen 91054, GermanyTel + 49 9 131 853 5000Email Cornelia.Erfurt-Berge@uk-erlangen.deAbstract: Calciphylaxis (CP) is a rare disorder presenting with painful ischemic skin ulcerations. Its association with end-stage renal disease, but also non-uremic cases have been described. Several risk factors, like metabolic syndrome, calcium-phosphate imbalance, anticoagulative medication and female gender have been discussed. Multidisciplinary therapeutic approaches are necessary since evidence-based guidelines are missing due to lack of pathophysiological understanding of the disease and the absence of studies with large patient cohorts. However, strategies for local wound therapy, reduction of risk factors and systemic therapies are being developed. Changes in duration, frequency and method of hemodialysis and specific medication to lower the calcium upload can be effective in uremic CP cases. Systemic treatments with cinacalcet, sodium thiosulfate or bisphosphonates have been applied successfully in CP patients, but large placebo-controlled randomized trials are still needed to gather better insight into this fatal disease.Keywords: calciphylaxis, calcific uremic arteriolopathy, non-uremic calciphylaxis, calcification, treatment, sodium thiosulfate

Abstract Background Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity. Methods Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR). Patients with asymmetric hearing were not eligible. The planed treatment included cisplatin 100 mg/m2 at days 1, 22 and 43. A baseline pre-treatment complete audiometric evaluation (pure tone at frequencies ranging from 0.5 to 14 kHz, bone conduction at 0.5–4 kHz and DPOAEs) was performed. Adverse effects were noted according to CTCAE. On the day before the beginning of CCR, eligible and consenting patients were randomized to receive a trans-tympanic injection of the gel either in the left ear or in the right ear. A final post-treatment complete audiometric evaluation was scheduled to be performed 1 month after the end of CCR by audiologists kept blind to the ear assignment. For the main outcome, the permanent threshold shift (PTS) in decibel (dB) was calculated as the difference between the final and baseline measures at all pure tone frequencies at 0.5–14 kHz for each patient and for each ear. The main outcome was assessed blindly in a mixed linear model with the PTS as the dependent variable and intervention, frequency, their interaction and radiation dose to the cochlea as independent variables. Results Between January 2015 and April 2016, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.3 dB less for treated ears compared to control ears. Although not statistically (p = 0.61) nor clinically significant, the difference was in favor of the treated ears for all frequencies between 3 and 10 kHz. Conclusions Our trial suggests that STS deposited on the round window was safe for the middle and inner ears. More work is needed to improve the efficacy of trans-tympanic injections of cisplatin antidotes. Trial registration ClinicalTrials.gov, NTC02281006, Registered 3 November 2014.

Introduction: The use of Sodium Hypochlorite (NaOCl) as an endodontic irrigant changes the properties of dentine and lowers the bond strength of resin cements to dentine. But it can be reversed by the use of antioxidants. Aim: To evaluate the effect of different antioxidants for restoring adhesion potential/reversal of microtensile bond strength of dentin of the pulp chamber treated with NaOCl and Ethylenediaminetetracetic Acid (EDTA). Materials and Methods: It was a laboratory based experimentalinvitro study in which 40 freshly extracted human incisors were selected and cut to expose the pulp chamber dentin. The specimens were distributed into five groups: Group I samples were irrigated with 5.25% NaOCl for 30 minutes followed by 17% EDTA for 3 minutes and final rinse was done with 5.25% NaOCl (Positive control). Group II samples were treated with distilled water only (Negative control). In Group III, samples were treated same as in group I followed by 10% Sodium Ascorbate (SA) for 10 minute. Samples of group IV samples were also treated as in group I followed by application of 5% solution of Alpha tocopherol with for 10 minutes. Group V samples were treated same as in group I followed by rinse with 5% solution of Sodium Thiosulphate (Na2 S2 O3 ) for 10 minutes. Composite resin build up was performed and interface was tested by using Universal testing machine for Microtensile bond strength. The resulting data was analysed by one-way Analysis of Variance (ANOVA) and Mann-Whitney U test (p

Abstract Existing reducing agents for cross-linking polymers are expensive and toxic and mostly limited for water shut off applications. A gelation study was performed on a safer, cheaper, more soluble, and short-lived gel by cross-linking polyacrylamide and chromium as a cross-linking agent using a rheometer and bead-pack porous media. The effect of concentration of sodium thiosulfate as the reducing agent was investigated to determine conditions for optimum yield strength and the gelation time and behavior which has never been published before. For a fixed minimum concentration (for the gel to form) of polyacrylamide and sodium dichromate, the gel yield strength vs. sodium thiosulfate concentration showed a somewhat bell-shaped curve initially increasing, reaching a peak at 2000 ppm, and then starting to decrease. The gelation formed by sodium thiosulfate was comparatively weak and short lived as compared to the ones formed by other reducing agents. Gel started to form instantaneously, reached a peak in 2 h, began to decrease, and then stabilized at 40 cp. The mobility reduction trends were similar to the yield strength curve. The short-lived gel could be useful to improve the waterflood mobility ratio far away from the wellbore without compromising on ease of injectivity.

Calciphylaxis is a life threatening disease for which patients with chronic kidney disease, particular those on dialysis, are at increased risk. As it is a rare condition, treatment options are limited and duration of treatment is not clear, especially when it comes to patients on renal replacement treatment with peritoneal dialysis. We report a case of a 55 year-old woman with end stage renal disease on renal replacement treatment with peritoneal dialysis for five months that presented with severe calciphylaxis of both legs. She had started haemodialysis at the age of 31 and 3 later she received a cadaveric renal transplant that lasted for 20 years. She was treated with warfarin due to atrial fibrillation diagnosis. The treatment approach was multimodal and multidisciplinary and included treatment with sodium thiosulfate and hyperbaric oxygen, warfarin suspension and maintenance of optimized peritoneal dialysis prescription. Additionally, wound dressings were done every other day and antibiotics started whenever there were signs of infection and pain was managed with high doses of opiates and pain adjuvants. There was significant improvement and the patient kept peritoneal dialysis treatment with preserved residual renal function. This raises the question, if there is a need to transition calciphylaxis patients on peritoneal dialysis to haemodialysis, as it is possible to ensure a high efficiency dialysis program with automated peritoneal dialysis.

Many publications described sodium thiosulfate used to prevent the renal toxicity induced by cisplatin hyperthermic intraperitoneal chemotherapy. After around 60 or 90 minutes of hyperthermic chemotherapy, cisplatin was drained and then, sodium thiosulfate was infused by intravenous route. Sodium thiosulfate is used in two steps: a first step, at 9 g/m2 in 250 mL of 0.9 % sodium chloride over 10 minutes followed by a second step, at 12 g/m2 in 1000 mL of 0.9 % sodium chloride over 6 hours. The purpose of this work was to study the stability of sodium thiosulfate at 16 mg/mL in 0.9 % sodium chloride polyolefin bags 1000 mL and at 72 mg/mL in 0.9 % sodium chloride polyolefin bags 250 mL, at 25 °C, protected or unprotected from light.

Calciphylaxis is commonly associated with end-stage renal disease patients on haemodialysis. We present a rare case of calciphylaxis in a non-uremic patient. The diagnosis was made clinically and confirmed with skin biopsy showing calcification of the dermal and subcutaneous tissues in the von Kossa stain. We believe that the combination of uncontrolled diabetes mellitus, a non-functioning paraganglioma and vitamin D deficiency in a susceptible female patient was responsible for causing calciphylaxis in our patient. An index of suspicion should be maintained by clinicians for calciphylaxis even in patients without uremia.

Uremic pruritus is a distressful complication of chronic kidney disease and results in impaired quality of life and higher mortality rates. Intravenous sodium thiosulfate has been reported to alleviate pruritus in hemodialysis patients. We performed a systematic review and meta-analysis to estimate the efficacy of intravenous sodium thiosulfate in patients with uremic pruritus. A systematic search of electronic databases up to June 2021 was conducted for randomized controlled trials that evaluated the clinical effects of sodium thiosulfate in the management of patients with uremic pruritus. Two reviewers selected eligible articles and evaluated the risk of bias; the results of pruritus assessment and uremic pruritus-related laboratory parameters in selected studies were analyzed. There are four trials published between 2018 and 2021, which include 222 participants. The sodium thiosulfate group displayed significant decrease in the pruritus score (standardized mean difference = −3.52, 95% confidence interval = −5.63 to −1.41, p = 0.001), without a significant increase in the adverse effects (risk ratio = 2.44, 95% confidence interval = 0.37 to 15.99, p = 0.35) compared to the control group. Administration of sodium thiosulfate is found to be a safe and efficacious complementary therapy in improving uremic pruritus in patients with chronic kidney disease.

This article covers the patterns of oxidation of sulfide and thiosulfate ions by bacteria Rhodopseudomonas yavorovii Ya-2016 under different cultivation conditions. In the environments with 1.4–5.6 мМ Na2S2O3, R. yavorovii Ya-2016 bacteria accumulated biomass of 1.4–1.6 g/l, which was higher than biomass (1.2-0.6 g/l) accumulated by the bacteria with the same concentrations of Na2S × 9H2O. The efficiency of oxidation of 1.4, 2.8, 5.6 мМ sulfide- and thiosulfate-ions as donors of electrons by the bacteria equaled 97.4, 42.6, 18.7 and 68.8, 28.0, 3.7%, respectively. As a result of bacterial oxidation of 1.4 мМ hydrogen sulfide and sodium thiosulphate in the environment accumulation of 0.13–1.30 мМ sulfate-ions occurs, and the element sulfur becomes an intermediate metabolite in the environment with Na2S×9H2O. R. yavorovii Ya-2016 bacteria are capable of using sulfate-ions as a single source of sulfate at increase in photptrophs. In the environment with 2.5 мМ sulfate-ions concentration the bacteria biomass was 1.4 g/l, the bacteria assimilated 17.7% of sulfates. Because purple non-sulfur bacteria R. yavorovii Ya-2016 are capable of using sulfide-ions as donors of electrons of anoxygenic photosynthesis and using sulfate-ions as a single source of sulfate, they could be successfully used in the technologies of remediating the environment from compounds of sulfur.