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Hyperphosphatemic familial tumoral calcinosis (HFTC) is a rare autosomal recessive disorder. Topical sodium thiosulfate (STS) and acetazolamide can be a safe and effective treatment for the patients who do not respond to conventional therapy for ectopic calcifications. We report the successful treatment of deep soft-tissue calcifications with topical STS and acetazolamide in a boy diagnosed with HFTC due to a novel homozygous mutation of FGF23.

Oxidation of sulfite and competitive absorption existed in Na2SO3 solution for simultaneous removal of NOx and SO2, inhibited the long-term high-efficiency when used for practical applications. A matching strategy was developed to solve these problems. Antioxidants combination was used to retard the oxidation of antioxidant and enhance inhibition of S(IV) (tetravalent sulfur) oxidation. Hydroquinone (HQ) and sodium thiosulfate (ST) showed a positive synergistic effect on inhibition of S(IV) oxidation. When SO2 concentration was 500 and 2000 ppmV, the addition of 0.1 wt.% HQ and 1 wt.% ST decreased the percentage of S(IV) oxidized by oxygen by over 30% and 40%, respectively. Alkali (Na2CO3) alleviated the competitive absorption between NOx and SO2. Moreover, Na2CO3 exhibited an enhancement effect on the absorption of NOx and SO2 when coupled with anti-oxidants. While the increase of oxygen pressure accelerated the oxidation of S(IV), the anti-oxidants can retard the oxidation. The measurement of pH suggested the removal efficiency of NOx highly depended on SO32⁻ concentration rather than pH. The further investigation of the mechanism suggested the match effect was related to the interaction between ST and the intermediate product of HQ. The match strategy holds a potential for application of SO32⁻ to denitration.

GOAL: The purpose of this study was to evaluate the effectiveness of vitamin C solution (VCS) in reducing adverse reactions caused by painless Lugol chromoendoscopy. BACKGROUND: Lugol chromoendoscopy is an effective method for screening superficial esophageal squamous cell carcinoma, although Lugol iodine solution (LIS) causes mucosal irritation. STUDY: In 4 hospitals in China, patients were randomized and divided into a distilled water (DW) group, an sodium thiosulfate solution (STS) group and a VCS group. Patients' esophageal mucosal surfaces were stained with either 1.2% or 0.5% LIS and then sprayed with DW, STS, or VCS at various concentrations. For the current randomized study, 1610 patients were enrolled in the 1.2% LIS group and 1355 patients were enrolled in the 0.5% LIS group. In addition, 150 patients were enrolled to assess the discoloration effect. The primary outcome for evaluation was the incidence of acute or late adverse reactions after Lugol iodine staining. The secondary outcome for evaluation was the discoloration effect on esophageal iodine-stained mucosa. RESULTS: VCS significantly reduced the occurrence of acute adverse reactions due to staining from 1.2% LIS. The effect of VCS was similar to that of STS but better than that of DW (P

Calcinosis cutis is a deposition of calcium in the skin and subcutaneous tissue, often accompanied by pain, reduced mobility, and chronic infections. Limited evidence is available about the feasibility and efficacy of therapies alternative to systemic treatment and surgical excision, both of which often lead to unsatisfactory results or complications. We conducted a systematic review to evaluate the efficacy and safety of topical and intralesional sodium thiosulfate, extracorporeal shock-wave lithotripsy (ESWL), and laser for calcinosis cutis. PubMed, Embase, and Web of Science were searched. Reports of calciphylaxis and treatment combined with systemic medications were excluded. A total of 40 studies including 136 patients were analysed. Partial or complete remission after monotherapy was observed in 64% to 81% of cases. Self-applied topical sodium thiosulfate required patient’s adherence (mean treatment duration, 4.9 months; range 2–24). Laser therapy enabled complete remission of microcalcifications after a single procedure (57%; 12/21). ESWL and intralesional sodium thiosulfate injections decreased calcinosis-associated pain (median reduction in VAS score, 3; range 0–9 and 1; range 0–5, respectively). The most common adverse event was scarring and hyperkeratosis, observed after CO2 laser (56%; 10/18). Intralesional sodium thiosulfate injections caused transient pain in over 11% of patients. Recurrences within the follow-up were rare (2%; 3/136). This study provides an overview of minimally invasive and local therapies that in selected cases might transcend conventional treatment. The limitation of this study is the poor level of evidence, which emerges mainly from non-randomized studies at high risk of bias.

Objectives: To determine safety, feasibility, and preliminary activity of transtympanic injection of sodium thiosulfate (STS) against cisplatin-induced hearing loss (CIHL). DESIGN Randomized controlled trial. SETTING Tertiary cancer hospital. PATIENTS Adults to be treated with high-dose cisplatin (>= 75 mg/m(2)). INTERVENTION Selected by randomization, 0.1 M STS gel on one side and placebo gel on the other side was transtympanically applied to the middle ear 3 hours before cisplatin administration. After amendment, the placebo ear was left untreated. Main Outcome Measure: Primary outcome was safety and feasibility. Secondary outcomes included pharmacokinetic analysis of systemic cisplatin and preliminary activity of STS. Clinically relevant CIHL was defined as a >= 10 dB threshold shift at pure-tone average 8-10-12.5 kHz (PTA(8-12.5)). Response to STS was defined as a threshold shift at PTA(8-12.5) in the STS-treated ear of >= 10 dB smaller than the untreated ear. Results: Twelve patients were treated. Average CIHL at PTA(8-12.5) was 12.7 dB in untreated ears and 8.8 dB SPL in STS-treated ears (p = 0.403). Four patients did not develop CIHL. Four out of eight patients with CIHL responded to STS: CIHL at PTA(8-12.5) in STS-treated ears was 18.4 dB less compared to untreated ears (p = 0.068). Grade 1 adverse events were reported. Pharmacokinetic results were available for 11 patients. Conclusion: Transtympanic application of STS was safe and feasible. Based on our pharmacokinetic analysis, we postulate that transtympanic STS does not interfere with the systemically available cisplatin. Our results provide a preliminary proof of concept for transtympanic application of STS in preventing CIHL and warrants further evaluation on a larger scale.

Objectives Familial hyperphosphatemic tumoral calcinosis is a rare disorder characterized by hyperphosphatemia with recurrent ectopic periarticular calcifications, in addition to other visceral and vascular manifestations, without any inflammatory or neoplastic disorder. The available treatment strategies are limited. Here we report an eight year old female patient with recurrent lesions under the chin, and bilateral hips which are painful and improving of the size of the lesions and hyperphosphatemia. Case presentation The patient was started to the treatment with peroral acetazolamide however the lesion did not regress but a new lesion appeared then we added sevelamer and topical sodium thiosulfate treatment for three months. After the three months of the combination treatment the lesions, there were no pain, no hyperphospahtemia regression/disappearance of the lesions. Conclusions This combination treatment or topical sodium thiosulfate use only may be a novel treatment strategy for the patients prospective controlled trials are needed.

Background The most severe complications following soft tissue filler injections result from the intraarterial administration of the filler product. Although hyaluronic acid–based filler can be trans-arterially dissolved with hyaluronidase, no information is available on calcium hydroxylapatite (CaHA)-based fillers. Objective The authors sought to test whether CaHA-based fillers can be trans-arterially dissolved by sodium thiosulfate (STS) when evaluated in cadaveric and in vitro models. Methods Human cadaveric facial arterial segments were each filled with 0.2 cc of commercially available CaHA product and submerged for 24 hours in 4 different STS-containing solutions: 10 cc STS (300 mg/cc) (pure, 1:1 dilution, 1:2 dilution), 0.9% saline and 10 cc STS (300 mg/cc), and 300 IU (bovine) hyaluronidase in a 1:1 ratio. Results Intraarterial CaHA was detected in human facial artery segments after 24 hours independent of the STS concentration employed. Submerging the arterial segments in STS (300 mg/cc) and 300 IU (bovine) hyaluronidase (1:1 ratio) also did not dissolve the intraarterial CaHA product. Gray scale analyses did show, however, that increasing concentrations of STS resulted in increased disintegration of CaHA in an in vitro experimental setting. Conclusions The results of this study indicate that STS is limited in its potential to dissolve intraarterial CaHA of cadaveric human facial arteries, despite the fact that it appears effective when in direct contact with the CaHA. Adverse events caused by intraarterial administration of CaHA-based fillers still lack a suitable antidote.

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.

Calciphylaxis is a rare and severe condition, characterized by calcification and thrombosis of small vessels, mainly affecting the skin. It is most often described in patients with end-stage renal disease on dialysis. Rarer cases of non-uremic calciphylaxis are reported. The prognosis is grim and the treatment is not well codified. Sodium thiosulfate has been used for more than a decade in the treatment of uremic calciphylaxis and has been shown to be effective. Its use in non-uremic cases has been reported in a few rare observations. Rheopheresis is a technique very recently used as an adjuvant treatment in uremic calciphylaxis. We describe a case of non-uremic calciphylaxis in a patient with normal renal function and with calcium supplementation. Sodium thiosulfate was introduced, then discontinued due to the patient's poor tolerance for this treatment. Rheopheresis was then used and allowed the acceleration of healing process and a significant reduction in pain. These two treatments are promising, larger studies are needed to establish their effectiveness in non-uremic calciphylaxis.

Calcinosis cutis (CC) is defined as the deposition of calcium salts on the skin and subcutaneous tissue. It is associated with different conditions, including some autoimmune diseases, and it can generate significant inflammation, pain, and functional impairment. Different therapies have been tried with limited results. Intralesional sodium thiosulfate seems a promising therapeutic option. We report a patient with diffuse systemic sclerosis who presented with two symmetrical plaques on both axillae, which caused pain and skin retraction. The clinical diagnosis was consistent with CC, which was confirmed by skin biopsy and ultrasound. The patient was treated with a 250 mg/ml solution of sodium thiosulfate injected into the plaques. Complete resolution was achieved after three monthly sessions. The only reported adverse effect was a transient burning sensation during the injections. Given its effectiveness and safety, we believe that intralesional sodium thiosulfate could become a valid first-line option for the treatment of CC.

Calciphylaxis, a rare disease mainly seen in patients with chronic kidney disease, is characterised by ischaemic skin damages and excruciating pain. Calciphylaxis has poor prognosis which often results in amputation and high mortality. Although guidelines for the management of calciphylaxis are not available, sodium thiosulfate has showed efficacy in many clinical reports. We report the case of a 64-year-old advanced calciphylaxis male patient who had two amputations due to intolerable pain manifested as deteriorating ulcer. After he was treated with intravenous sodium thiosulfate (STS), his pain was significantly relieved with a healing trend of the big wound. One more amputation for the remission of intractable pain was avoided. The treatment experience indicates that sodium thiosulfate is of great value in quick pain relief and reducing suffering of calciphylaxis patients. Keywords: Calciphylaxis, Calcific uremic arteriolopathy, Painful skin ulcer, Maintenance haemodialysis, Continuous....

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.

AIM: The aim of the present study was to evaluate the effect of various intermediate irrigating solutions in the removal of orange-brown precipitate formed due to alternative use of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) root canal irrigants. METHODS: The root canals of 50 mandibular premolars were prepared using ProTaper Universal Rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland) up to size F3. The roots were randomly divided into five experimental groups specified by the intermediate irrigant used; Group 1: No intermediate irrigant used (control), Group 2: Saline, Group 3: 7% maleic acid (MA), Group 4: 4% sodium thiosulfate, and Group 5: 70% isopropyl alcohol (n = 10). After final irrigation with CHX, the specimens were evaluated for the presence/absence of orange-brown precipitate under stereomicroscope. RESULTS: Mean precipitate for all experimental groups was calculated using ANOVA F test which showed orange-brown precipitate (parachloroanaline) in all groups except Group 4 and Group 5 which were highly significant (p < 0.001) at all the levels of root canal. Intergroup pairwise comparison was done using Tukey’s post hoc test. CONCLUSION: About 7% MA is effective in minimizing the formation of orange-brown precipitate when used as intermediate irrigant between NaOCl and CHX. However, the precipitate was not observed with 4% sodium thiosulfate and 70% isopropyl alcohol.

SummaryCisplatin is a widely used chemotherapy for the treatment of certain solid tumors. Ototoxicity and subsequent permanent hearing loss remain a serious dose-limiting side effect associated with cisplatin treatment. To date, no therapies have been approved to prevent or treat cisplatin-induced hearing loss (CIHL). Sodium thiosulfate effectively inactivates cisplatin through covalent binding and may provide protection against cisplatin-induced ototoxicity. DB-020 is being developed as a novel formulation of sodium thiosulfate pentahydrate in 1% sodium hyaluronate for intratympanic injection (IT), enabling the delivery of high concentrations of thiosulfate into the cochlea prior to cisplatin administration. In the DB-020-002 phase 1a single-ascending dose study, healthy volunteers were enrolled into 5 cohorts to receive different doses of DB-020 via IT injection. Cohorts 1–4 received unilateral injections while Cohort 5 received bilateral injections. Plasma thiosulfate pharmacokinetics was measured, and safety and audiometric data were collected throughout the study. This study has demonstrated that intratympanic administration of DB-020 results in nominal systemic increases in thiosulfate levels, hence it should not compromise cisplatin anti-tumor efficacy. Furthermore, DB-020 was safe and well tolerated with most adverse events reported as transient, of mild-to-moderate severity and related to the IT administration procedure. These results support the design and execution of the ongoing proof-of-concept study, DB-020-002, to assess otoprotection using DB-020 in cancer patients receiving cisplatin without negatively impacting cisplatin anti-tumor efficacy.

Calciphylaxis, also known as calcific uremic arteriolopathy, is a devastating systemic disease most commonly associated with chronic kidney failure. Its hallmark histopathologic features of small-vessel calcification, intimal hyperplasia, and microthrombi lead to microvascular occlusion and tissue necrosis. Clinically, it typically presents with painful cutaneous lesions that may be distal or proximal, with proximal lesions associated with higher mortality. Visceral involvement in this disease process is rare and in such case reports, all patients have coincident active cutaneous lesions. We present a case of a man in his 40s receiving hemodialysis presenting with mesenteric calciphylaxis complicated by ischemic colitis without active cutaneous lesions. Treatment consisted of sodium thiosulfate, vitamin K, and surgical resection. He previously had penile calciphylaxis treated with 3 months of sodium thiosulfate therapy and optimization of his serum calcium, phosphate, and parathyroid hormone levels. His penile calciphylaxis healed 12 months before his presentation with mesenteric calciphylaxis. This is the first known case report of isolated mesenteric calciphylaxis. It raises a number of clinical dilemmas, including duration of sodium thiosulfate use, monitoring for disease activity, and suitability for future kidney transplantation. Index Words: Mesenteric calciphylaxis, calcific uremic arteriolopathy, ischemic colitis, hemodialysis, sodium thiosulfate, vitamin K

The increasing consumption of wakame algae (Undaria pinnatifida) and kombu (Laminaria ochroleuca) because of their culinary appeal and beneficial properties means there is a need to study the composition of these new foods. Algae stand out for their high iodine content, this being an essential element whenever it is ingested at recommended levels but which, ingested in high quantities, can cause harmful effects to health such as hyperthyroidism and even goiter. The iodine content in 30 samples of algae from different geographical origins (Asia and Europe) has been determined by oxidation-reduction titration with sodium thiosulfate. European kombu algae (27.7 ± 5.4 mg/kg dry weight) have the highest mean average iodine concentrations. European algae have higher iodine content than Asian algae. Significant differences (p

Calciphylaxis is a potencially disorder in patients with hyperphosphatemic familial tumoral calcinosis (HFTC). Patients commonly present livedo racemosa and retiform purpura, which may progress to necrosis and very painful ulcers. Treatment with sodium thiosulfate provides good results; however, intralesional and intravenous treatment can be limited by its adverse effects. Topical sodium thiosulfate has been successfully reported for cutaneous calcification associated with connective tissue diseases and calciphylaxis in patients with chronic kidney disease. We provide a case report of a patient with HFTC and calciphylaxis who was treated with topical sodium thiosulfate with a rapid and complete response with no side effects.

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.

Highlights • Penile gangrene is a presentation of calciphylaxis and is associated with high mortality rate. Calcium level may be normal at presentation. • Superficial biopsy of the penis should only be considered if diagnosis is equivocal. Punch biopsy is preferred over excision biopsy. • Overly aggressive surgical treatment of penile gangrene is associated to poor outcomes. Sodium thiosulfate may be effective in treating penile gangrene due to calciphylaxis. • Mechanism of sodium thiosulfate is unknown but may be related to improvement in blood flow in calcified blood vessels •Further studies are required., Penile gangrene is a rare but fatal complication of calciphylaxis in end-stage renal disease (ESRD). To date, there are no guidelines on its management, and outcomes are generally poor with high mortality rate. We present a case of a diabetic patient with ESRD presenting with dry gangrene of the glans penis due to calciphylaxis and successfully treated with intravenous sodium thiosulfate (STS) and early total parathyroidectomy. We further analysed existing literatures on cases that utilized STS in the treatment of penile calciphylaxis.

Sodium Thiosulfate (STS) is already reported as an antioxidant, anti-inflammatory agent with antiseptic, antifungal properties. The search for an ideal antiseptic still continues, which is lethal to all types of bacteria and their spores and sustain the activity for a longer time without any harm to the host tissue. The aim of the present study is to evaluate the effect of STS on curing of wounds in rats when compared to Betadine. We developed topical gels having 6% and 12% STS. The effects of STS on wound healing rate of Rats were evaluated against Betadine as positive control. Wounds of control group, selected as Group 1 was treated with normal saline (0.2 ml), twice a day. Reference standard control, designated as Group 2 rats were given with 0.2 ml Betadine twice a day. Rats in Groups 3 and 4 were treated with 0.2 ml of STS gel (6% or 12% respectively) twice a day. In our study, STS formulation has proved to be a safe and efficient wound healing product. It has a neutral pH and longer half life (>12 months). Higher STS dose of 12% proved to have a wound curing rate equivalent to that of Betadine. On 11th Day, 97 ± 0.79% healing was achieved with Betadine and 98 ± 0.67% with 12% STS Gel (∗P

This study aimed to effectively control the disease process of hemodialysis outpatients. Hemodialysis secondary hyperparathyroidism patients were randomly divided into the control group and treatment group. The control group was treated with routine treatment, and the treatment group was treated with sodium thiosulfate based on the control group. The changes of serum calcium, phosphorus, whole parathyroid hormone, calcium-phosphorus product and coronary artery calcification (CAC) score, as well as the relief of clinical symptoms, postoperative complications and recurrence in the preoperative and postoperative periods were observed. The levels of C-reactive protein and CAC scores were significantly decreased in the treatment group after treatment. While there was no significant difference in blood calcium, blood phosphorus, PTH, calcium-phosphorus product, and CAC score in the control group after treatment. And after treatment, the proportion of skin pruritus, myasthenia, bone pain, insomnia, restless legs syndrome, and other symptoms in the treatment group was significantly decreased compared with those before treatment, but there was no significant change in the control group before and after treatment. Sodium thiosulfate can reduce the high level of CAC in hemodialysis patients obviously.

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.

Background and Aims Lugol’s iodine chromoendoscopy is an important method to detect esophageal squamous cell carcinoma. Sodium thiosulfate solution (STS) has been used to neutralize iodine after Lugol’s chromoendoscopy; however, it is not available in many medical centers. The aim of the current study was to assess the efficacy of N-acetylcysteine solution (NAC) for relieving symptoms caused by Lugol’s iodine chromoendoscopy. Methods Patients were randomized to receive either STS or NAC after spraying Lugol’s iodine solution on the esophagus. The neutralizing effects for residual iodine in the esophagus and gastric mucous pool were observed. The primary endpoint was the intensity of retrosternal pain and/or heartburn measured by a visual analog scale (VAS) score 30 minutes after chromoendoscopy. Secondary endpoints were the rate of patients with any adverse symptom, rate of moderate to severe retrosternal discomfort occurring, and heart rate variability between time points before and after chromoendoscopy. Results The neutralization rates for residual iodine between the NAC and STS groups were not significantly different (P > .999). The difference of median VAS scores between the NAC and STS groups 30 minutes after chromoendoscopy was .0 (P = .719; 95% confidence interval, .0-.0), and the 95% confidence interval higher limit was .0, which was less than our prespecified margin of .5, concluding an noninferiority of NAC with regard to STS. There was no significant difference between the 2 groups regarding the rate of patients with any adverse symptom, rate of moderate to severe retrosternal discomfort, or heart rate variability at 5 minutes or 30 minutes after chromoendoscopy. Conclusion As a very easily accessible reagent in clinical circumstances, NAC can also alleviate mucosal irritation symptoms induced by Lugol’s chromoendoscopy at similar efficacy as STS and can be routinely recommended. (Clinical trial registration number: NCT04764643 .)

Thiosulfate in the form of sodium thiosulfate (STS) is a major oxidation product of hydrogen sulfide (H2S), an endogenous signaling molecule and the third member of the gasotransmitter family. STS is currently used in the clinical treatment of acute cyanide poisoning, cisplatin toxicities in cancer therapy, and calciphylaxis in dialysis patients. Burgeoning evidence show that STS has antioxidant and anti-inflammatory properties, making it a potential therapeutic candidate molecule that can target multiple molecular pathways in various diseases and drug-induced toxicities. This review discusses the biochemical and molecular pathways in the generation of STS from H2S, its clinical usefulness, and potential clinical applications, as well as the molecular mechanisms underlying these clinical applications and a future perspective in kidney transplantation.

The Oceanographic Museum offers interesting exhibits of several marine lives for tourist sightseeing and entertainment. These sea water ornamental fish are all caught in the wild. However, its health can be affected by cyanide poisoning during human fishing. Depending on the level of cyanide poisoning, fish can die after one and two weeks that caused economic damages for the museum. The present study is concerned with results of cyanide detoxification by using direct injection into cinnamon clownfish or soak of hydroxocobalamin, sodium nitrite and sodium thiosulfate with the aim of improving the health, survival and life time for fish, contributing to increasing economic efficiency for the Oceanographic Museum.

The effectiveness of formation of biofilms or "biofilm" by strains of Pseudomonas and their capacity to reduce chlorine and antagonistic to coliform bacteria, allows to a large extent, study the ability of P. aeruginosa and P. fluorencens to form biofilm. For the experimental design four tanks with drinking water were used, to which sodium thiosulfate was added to eliminate chlorine concentrations. To make the formation of Biofilms, four PVC "T" structures were placed, supported with sweet wire. Three treatments were used, one with P. aeruginosa, another with P. fluorencens and the mixture (combination of both strains). Counting, characterization and quantification of bacterial colonies were carried out for each treatment. In order to determine the effectiveness of biofilm formation by strains of P. aeruginosa and P. fluorescens, as well as their capacity to reduce chlorine and antagonistic tocoliform bacteria. Our results indicate that P. aeruginosa showed a greater capacity to form biofilms, in comparison with the other treatments. The strains showed effectiveness in decreasing the concentrations of chlorine used, as well as, great power of antagonism against Escherichia coli. P. aeruginosa showed greater antagonism capacity with a 1mm diameter halo. We have found that the strains of Pseudomonas used produce biofilms efficiently, which reduces chlorine., La efectividad de formación de biofilms o “biopelícula” por cepas de Pseudomona y su capacidad de disminución del cloro y antagónica para bacterias coliformes, permite en gran medida, estudiar la capacidad de P. aeruginosa y P. fluorencens para formar biopelícula. Para el diseño experimental se utilizaron cuatro tanques con agua potable, a la cual se le adicionó Tiosulfato de sodio para eliminar las concentraciones de cloro. Para efectuar la formación de biofilms se colocaron cuatro estructuras en forma de“T” de PVC, sostenidas con alambre dulce. Se utilizaron tres tratamientos, uno con P. aeruginosa, otro con P. fluorencens y la mixtura (combinación de ambas cepas). Para cada tratamiento se realizaron conteos, caracterización y cuantificación de colonias bacterianas. Con el objetivo de determinar la efectividad de formación de biofilms por cepas de P. aeruginosa y P. fluorescens, así como también su capacidad de disminución del cloro y antagónica para bacterias coliformes. Nuestros Resultados indican que P. aeruginosa presentó una mayor capacidad para formar biofilms, en comparación con los demás tratamientos. El biofilms formado mostró efectividad en disminuir las concentraciones de cloro utilizadas, así como también, gran poder de antagonismo contra Escherichia coli. P. aeruginosa mostró mayor capacidad de antagonismo con un halo de 1mm de diámetro. Hemos encontrado que las cepas de Pseudomona utilizadas producen biofilms eficientemente, el cual reduce las concentraciones de cloro.

Study objective Cyanide is a deadly poison, particularly with oral exposure, in which larger doses can occur before any symptoms develop. Multiple governmental agencies highlight oral cyanide as an agent that can be used in a terrorist attack because it can be easily weaponized and is readily available. Currently, there are no Food and Drug Administration–approved antidotes specifically for oral cyanide. An oral countermeasure that can neutralize and prevent absorption of cyanide from the gastrointestinal tract after oral exposure is needed. The objective of this study is to determine if the combination of glycine and sodium thiosulfate administered orally is effective in reducing mortality in a large, swine model of oral cyanide toxicity. Methods Nine swine (45 to 55 kg) were instrumented, sedated, and stabilized. Potassium cyanide (at 8 mg/kg) in saline solution was delivered as a onetime bolus through an orogastric tube. Three minutes after cyanide administration, animals that were randomized to the treatment group received sodium thiosulfate (508.2 mg/kg, 3.25-M solution) and glycine (30 mg/kg, 3.5-M solution) through an orogastric tube. Survival at 60 minutes was the primary outcome. We compared survival between groups by log-rank Mantel-Cox analysis and trended laboratory results and vital signs. Results At baseline and treatment, all animals were similar. Survival at 60 minutes was 100% in treated animals compared with 0% in the control group (P=.003). By the study end, defined as death or 60 minutes after cyanide administration, there was a significant difference in the lactate concentration between the treatment and control groups (control 9.43 mmol/L [SD 4.08]; treatment 1.66 mmol/L [SD 0.82]; difference between means 7.69 mmol/L [SD 2.07]; 95% confidence interval difference –14.05 to –1.32). Mean arterial pressure was significantly different between the treatment and control groups at study end (control 26 mm Hg [SD 6.7]; treatment 81 mm Hg [SD 14]; difference between means 55.2 mm Hg [SD 7.1]; 95% confidence interval difference 37.8 to 72.6). pH and oxygen saturation were also significantly different between the treatment and control groups at study end. Conclusion The combination of oral sodium thiosulfate and glycine significantly improved survival and physiologic parameters in a large-animal model of oral cyanide toxicity.

There are several limitations of thiosulfate leaching methods in its industrial application. The main limitation is the addition of copper and ammonia which act as catalysts in the thiosulfate leaching process. The introduction of cupric ions can accelerate the rate of gold leaching but cause massive oxidation of thiosulfate, and cupric ions in the leachates are also adverse to gold recovery. Moreover, the presence of ammonia must be taken into account due to the increasing environment concerns. In this paper, a systematic investigation was carried out during oxygen pressure thiosulfate leaching (OPTL) without adding copper and ammonia at elevated temperature and oxygen pressure. Thermodynamic calculations showed that the improvement of temperature and pressure was favorable to gold leaching by thiosulfate. However, high temperature and pressure also caused high thiosulfate consumption (55.3 kg/t-ore of sodium thiosulfate) and relatively low gold extraction (87.6%) without additives. Addition of ammonium alcohol polyvinyl phosphate (AAPP) in the tests could reduce thiosulfate consumption to 45.7 kg/t-ore, whilst 90.2% of gold extraction can be achieved. XPS and SEM studies indicated that AAPP could also hinder the deposition of some passivation species including FeOOH, Fe2O3, Al2O3, S0, etc. on the ore surface. The gold recovery from oxygen pressure thiosulfate leach solution was conducted by the method of resin adsorption. Over 98% of gold can be loaded at 1 g/L strong base anion exchange resin of Tulsion A-21S and almost 100% of gold on the loaded resin can be stripped with a two component eluent solution comprising chloride and sulfite.

The aim of the research was to study the dependence of the severity on the degree of endogenous intoxication and the effectiveness of complex treatment of calves using sodium thiosulfate-based drugs for gastrointestinal diseases. Studies were carried out under production conditions in cattle farms of the Vitebsk, Liozno and Gorodok districts. As preparations based on sodium thiosulfate, the veterinary drug "Averon" produced by LLC Belekotekhnika RB and the veterinary preparation Antitox manufactured by ImmCont GmbH, Germany, were used. These drugs as an antitoxic agent, were administered once a day, intravenously, slowly at a dose of 25 ml, until the clinical signs of the disease disappeared in addition to the basic treatment taken in the farms with gastrointestinal diseases. The data obtained as a result of the analysis of the literature and the conduct of our own research showed that in the pathogenesis of gastrointestinal diseases of the calves, the link to the pathogenesis, which significantly determines the severity of their course and prognosis, is endogenous intoxication. It was found that in patients with calves, the MW content was higher at the height of the disease – 1.75–2 times with moderate severity and 1.94 and 2.47 times with severe. Laboratory criteria were established for predicting the severity of dyspepsia and abomasoenteritis in calves of 14 to 30 days of age. So, at a level higher than 0,120 conv. units in 100% of such calves, dyspepsia or gastroenteritis proceeded in a severe (toxic) form. The significant direct correlations between the concentration of MWS and LPO products (r ≥ 0.650) revealed at the height of the disease indicate the significance of LPO as a source in the development of endotoxication in gastrointestinal diseases in calves. It has been established that the use of drugs with antitoxic action based on sodium thiosulphate in the complex therapy of calves of patients with dyspepsia and abomasoenteritis can reduce the severity and lethality of calves with dyspepsia by 5% to 10%. Key words: calves, blood, endogenous intoxication, abomazoenteritis, dyspepsia, therapeutic efficacy, treatment.

In pilot-scale testing, dead-end ultrafiltration concentration (DEUF-C) sampling increased detection of pathogens in lettuce wash water. This study investigated DEUF-C performance when scaled up to commercial processing levels. Two sets of experiments were done to: 1) compare pathogen detection probability in lettuce wash water generated from commercial pilot-scale processing using DEUF-C versus standard grab sampling, and 2) evaluate DEUF-C to concentrate pathogens inoculated into commercially-generated flume and centrifuge lettuce wash water. In pilot-scale runs, one lettuce head inoculated to contain 2–8 × 104 CFU of Escherichia coli O157:H7 and 3–10 × 105 CFU of Listeria monocytogenes was processed along with 907 kg of uninoculated lettuce using sanitizer-free tap water. Two to four 40-L volumes of the wash water were concentrated to 400 mL by DEUF-C, and pathogen detection probability in these samples was compared to standard grab samples after 24 h–48 h of enrichment using qPCR. In the second set of trials, chlorine in flume and centrifuge water from a local commercial processing facility was neutralized with sodium thiosulfate (100 mg/L), spiked with both E. coli O157:H7 and L. monocytogenes at 102 CFU/mL, and processed by DEUF-C. Total filterable volume was determined for DEUF-C samples, and detection (qPCR) probabilities in unenriched DEUF-C and grab samples were determined. E. coli O157:H7 and L. monocytogenes were detected in 100% of the DEUF-C samples from pilot-scale water samples. Comparable grab samples yielded 6.7% detection for E. coli O157:H7, and 20 and 60% for 24 h- and 48 h-enriched L. monocytogenes samples, respectively. The total filterable volume in commercially-generated waters was significantly higher for flume than for centrifuge water. All unenriched DEUF-C samples yielded E. coli O157:H7 and L. monocytogenes compared to 11.1 and 22.2%, respectively, for the unenriched grab samples. These findings indicate DEUF-C can improve the probability of detecting E. coli and Listeria in commercial wash water. However, filtration of commercial lettuce wash water remains challenging, with more work needed to ensure DEUF-C is feasible for commercial use.

Sodium thiosulfate preconditioning (SIPC) was recently reported to be cardioprotective due to its ability to inhibit caspase-3 activation, chelate calcium ions and scavenge free radicals. However, the rationale behind its ability to improve the contractility of isolated rat heart challenged with ischemia-reperfusion injury (IR) is not well understood. As mitochondrial preservation is implicated in cardioprotection against IR, the present study was conceived to identify whether the cardioprotective effects of SIPC is associated with mitochondrial preservation. Using the isolated Langendorff rat heart model, 1 mM sodium thiosulfate (STS) was used to precondition the rat heart before IR and was used to study its effect on cardiac mitochondria. The IR heart experienced a ventricular contractile dysfunction that was improved by SIPC. Upon assessing in-gel the ATP synthetic capacity of mitochondria from IR heart, there was a significant decline, while in SIPC it was well preserved close to sham. As a sustained flow of electrons through the ETC and well-integrated mitochondria are the prerequisites for ATP synthesis, SIPC improved the activities of ETC complex enzymes (I-IV), which was reflected from the preserved ultrastructure of the mitochondria as analyzed from electron-microscopy in the treated rat hearts. This observation was coherent with the elevated expression of PGC1α (20%), a critical regulator of ATP production, which increased the mitochondrial copy number as well in the STS treated heart compared to IR. In conclusion, mitochondria might be a critical target for SIPC mediated cardioprotection against IR.

Sulfur mustard (SM) is a blistering chemical warfare agent that was used during the World War I and in the Iraq-Iran conflict. The aim of this paper is to discuss and critically review the published results of experiments on the treatment of SM poisoning based on our clinical and research experience. The victims must remove from the contaminated zone immediately. The best solution for decontamination is large amounts of water, using neutral soap and 0.5% sodium hypochlorite. Severely intoxicated patients should be treated according to advanced life support protocols and intensive care therapy for respiratory disorders and the chemical burn. Sodium thiosulfate infusion (100-500 mg/kg/min) should be started up to 60 min after SM exposure. However, N-acetyle cysteine (NAC) is recommended, none of them acts as specific or effective antidote. The important protective and conservative treatment of SM-induced pulmonary injuries include humidified oxygen, bronchodilators, NAC as muculytic, rehydration, mechanical ventilation, appropriate antibiotics and respiratory physiotherapy as clinically indicated. Treatment of acute SM ocular lesions start with topical antibiotics; preferably sulfacetamide eye drop, continue with lubricants, and artificial tears. Treatment for cutaneous injuries include: moist dressing; preferably with silver sulfadiazine cream, analgesic, anti-pruritic, physically debridement, debridase, Laser debridement, followed by skin autologous split-thickness therapy as clinically indicated. The new suggested medications and therapeutic approaches include: anti-inflammatory agents, Niacinamide, Silibinin, Calmodulin antagonists, Clobetasol, full-thickness skin grafting for skin injuries; Doxycycline; Bevacizumab, and Colchicine for ocular injuries. Recommended compounds based on animal studies include Niacinamide, Aprotinin, des-aspartate-angiotensin-I, Gamma-glutamyltransferase, vitamin E, and vitamin D.

Inhalation injury is often associated with burns and significantly increases morbidity and mortality. The main toxic components of fire smoke are carbon monoxide, hydrogen cyanide, and irritants. In the case of an incident at a nuclear power plant or recycling facility associated with fire, smoke may also contain radioactive material. Medical treatments may vary in different countries, and in this paper, we discuss the similarities and differences in the treatments between China and Germany. Carbon monoxide poisoning is treated by 100% oxygen administration and, if available, hyperbaric oxygenation in China as well as in Germany. In addition, antidotes binding the cyanide ions and relieving the respiratory chain are important. Methemoglobin-forming agents (e.g., nitrites, dimethylaminophenol) or hydroxocobalamin (Vitamin B12) are options. The metabolic elimination of cyanide may be enhanced by sodium thiosulfate. In China, sodium nitrite with sodium thiosulfate is the most common combination. The use of dimethylaminophenol instead of sodium nitrite is typical for Germany, and hydroxocobalamin is considered the antidote of choice if available in cases of cyanide intoxications by fire smoke inhalation as it does not further reduce oxygen transport capacity. Systematic prophylactic use of corticosteroids to prevent toxic pulmonary edema is not recommended in China or Germany. Stable iodine is indicated in the case of radioiodine exposure and must be administered within several hours to be effective. The decorporation of metal radionuclides is possible with Ca (DTPA) or Prussian blue that should be given as soon as possible. These medications are used in both countries, but it seems that Ca (DTPA) is administered at lower dosages in China. Although the details of the treatment of inhalation injury and radionuclide(s) decorporation may vary, the general therapeutic strategy is very similar in China and Germany.

Background Calciphylaxis is a form of vascular calcification more commonly associated with renal disease. While the exact mechanism of calciphylaxis is poorly understood, most cases are due to end stage kidney disease. However, it can also be found in patients without kidney disease and in such cases is termed non-uremic calciphylaxis for which have multiple proposed etiologies. Case summary We describe a case of a thirty-year-old morbidly obese Caucasian female who had a positive history of alcoholic hepatitis and presented with painful calciphylaxis wounds of the abdomen, hips, and thighs. The hypercoagulability panel showed low levels of Protein C and normal Protein S, low Antithrombin III and positive lupus anticoagulant and negative anticardiolipin. Wound biopsy confirmed the diagnosis of non-uremic calciphylaxis in the setting of alcoholic liver disease. The calciphylaxis wounds did not improve when Sodium Thiosulfate was used alone. The patient underwent a series of bedside and surgical debridement. Broad spectrum antibiotics were also used for secondary wound bacterial infections. The patient passed away shortly after due to sepsis and multiorgan failure. Conclusion Non-uremic Calciphylaxis can occur in the setting of alcoholic liver disease. The treatment of choice is still unknown.