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Introduction Multiple studies have shown significant heating of fluid within the urinary collecting system with high-power laser settings. Elevated fluid temperatures may cause thermal injury and tissue damage unless appropriately mitigated. A previous in vitro study demonstrated that chilled (4 °C) irrigation slowed temperature rise, decreased plateau temperature, and lowered thermal dose during laser activation with high-power settings. We sought to evaluate the thermal effects of chilled, room temperature, and warmed irrigation during ureteroscopy with laser activation in an in vivo porcine model. Materials and methods Seven female Yorkshire cross pigs (45-55 kg) were anesthetized and positioned supine. Retrograde ureteroscopy was performed with a thermocouple affixed 5 mm from the distal end of the ureteroscope. In two pigs a holmium:YAG laser was activated for 60 seconds at irrigation rates of 8 ml/min, 12 ml/min, and 15 ml/min with chilled, room temperature, or warmed irrigation. In five pigs core body temperature was recorded for one hour with or without continuous chilled irrigation at 15 ml/min. Results At irrigation rates ≥ 12 ml/min, temperature curves appeared uniformly offset, warmed > room temperature > chilled irrigation. The threshold of thermal tissue injury was reached during laser activation for all irrigation temperatures at 8 ml/min. The threshold was not reached with chilled irrigation at 12 ml/min or 15 ml/min, or with room temperature irrigation at 15 ml/min. The threshold was exceeded at all irrigation rates with warmed irrigation. There was no significant change in core body temperature after delivering chilled irrigation at 15 ml/min compared with no irrigation for 60 minutes. Conclusion Irrigation with chilled saline solution during ureteroscopic laser lithotripsy slows temperature rise, lowers peak temperature, and lengthens the time to thermal injury compared to irrigation with room temperature or warmed saline solutions. Core body temperature was not significantly impacted by chilled irrigation.

Geosynthetic clay liners (GCLs) are used in saline environments but little is known about their soil water characteristic curve (SWCC) when exposed to saline solutions. This paper presents an investigation of the SWCC of three different types of GCLs, which were hydrated with deionised (DI) water and a 0.325 mol/l sodium (Na+) synthetic brine pond solution (NaCl, NaHCO3and Na2CO3). One of the GCLs was made of bentonite modified with polyacrylamide polymer. Higher air-entry values and steeper slopes of SWCCs between the two inflection points were observed in samples hydrated with synthetic brine. Polymer addition increased the water retention of the GCL under both DI and brine hydration. Brine hydration was found to reduce the total mass of liquid absorbed by the bentonite, compared to DI water. Total suction under brine was found to be different from the sum of total suction under DI and osmotic suctions of the brine solution, which may be due to the loss of osmotic swelling and crystallisation of salt in air-filled pores. Compared to the more frequently used Van-Genuchten and Fredlund-Xing models, the three-zone linear Pham-Fredlund model provided better SWCC fit for brine-hydrated GCLs.

The clinical picture of allergic rhinitis includes sneezing, nasal discharge, impaired nasal breathing, and itching of the nose and roof of mouth. Depending on the duration of symptoms, allergic rhinitis is divided into intermittent and persistent forms, and depending on the severity of symptoms, it can be mild, moderate, and severe. Treatment for allergic rhinitis includes elimination of allergic contacts, allergen-specific immunotherapy, and pharmacotherapy. The choice of a treatment regimen is determined by the severity of symptoms, age of a patient and presence of concomitant diseases. The work is aimed to review the most common pharmaceuticals to treat allergic rhinitis. Saline solutions are used as monotherapy when symptoms are mild, or before use of other topical drugs to clean mucous membranes before their application. Intranasal glucocorticosteroids can be used as monotherapy, if symptoms have different levels of severity, and supplemented with other drugs, in case they are not efficient. Intranasal glucocorticosteroids do not have a systemic effect due to minimal bioavailability. The patients with moderate/severe allergic rhinitis are recommended to use them jointly with second generation antihstamines, intranasal cromones, intranasal antihistamines and leukotriene receptor antagonists. The significant side effect of antihistamines, especially of the first generation, are sedative effects on the central nervous system. The side effects of leukotriene receptor antagonists are neuropsychological disorders. Intranasal cromones have a high safety profile, which makes them popular in paediatric practice. However, the dosage regimen up to 3–4 times a day reduces patient adherence to treatment. Decongestants are not indicated as monotherapy for allergic rhinitis but can be used in combination with other drugs in short courses, taking into account the possible side effects.

In many countries, excessive consumption of sodium chloride (salt) has become a serious social problem and reducing salt has been required. Herbs have been reported to enhance the saltiness of food; however, few studies have focused on the numerical evaluation of the degree of saltiness enhancement by herbs. The purpose of this study was to quantify the degree of saltiness enhancement by herbs via human sensory evaluation using a visual analog scale (VAS). The sensory evaluation was conducted on 69 students who were able to arrange the five different saline concentrations in order. The sensory salt concentration of herb-added 0.4 wt% saline solutions were perceived in comparison with the saltiness of 0.2 to 0.6 wt% reference saline solutions. The results were recorded by an arrow on a VAS. Hot-water extracts of the herbs basil, rosemary, parsley, anise, and oregano were used. The sensory salt concentration of a 0.175 wt% herb-added saline was equivalent to the actual salt concentration (0.4 wt%). However, the sensory salt concentrations of salines with 0.35 wt% herb extracts were significantly higher (p

Introducción: La gastroenteritis aguda es una de las principales causas de morbilidad y mortalidad en la infancia. Numerosos estudios han confirmado la seguridad y eficacia de la terapia de rehidratación oral, sin embargo, la rehidratación intravenosa se continúa utilizando en escenarios donde no es posible hidratar al paciente por vía enteral. Durante la última década, se han acumulado pruebas que sugieren que la administración de un líquido de mantenimiento intravenoso hipotónico en niños hospitalizados aumenta el riesgo de hiponatremia. Objetivo general: Determinar la frecuencia de hiponatremia en pacientes con gastroenteritis que reciben soluciones salina hipotónicas en la salas Pediatría del Hospital del Niño Doctor José Renán Esquivel entre enero a diciembre del 2016. Materiales y Métodos: Realizaremos un estudio de cohorte retrospectivo, descriptivo. Examinaremos los expedientes clínicos de niños sin antecedentes patológicos previos de 1 mes a 15 años que habían ingresado a sala de pediatría del Hospital del Niño Doctor José Renán Esquivel de enero a diciembre de 2016, con diagnóstico de gastroenteritis aguda. Para la obtención de la muestra utilizamos un 95% de Confianza, la muestra obtenida fue de 190 pacientes y fue calculada utilizando el programa Epi Info versión 7.0 Resultados: No hubo diferencias significativas en el desarrollo de hiponatremia secundario al uso de soluciones salinas hipotónicas Conclusión: No se registró hiponatremia en pacientes con gastroenteritis aguda que reciben soluciones salinas hipotónicas en la salas de Pediatría del Hospital del Niño Doctor José Renán Esquivel.

Acute respiratory viral infections (ARVI) are the most common diseases among children. The typical and most disturbing symptoms of ARVI are nasal discharge, nasal congestion and difficulty in nasal breathing. Local protective factors of the respiratory mucosa (epithelial barrier, mucociliary clearance, antimicrobial peptides, immunoglobulin A, microbiota) prevent the penetration of respiratory infections. To prevent ARVI in children it is important to maintain the physiological state of the mucous membrane. ARVI treatment in children is based on care and supportive activities. By irrigating nasal cavity with saline one removes mucus, mechanical impurities, stimulates mucociliary clearance, reduces swelling of the mucous membrane and need for decongestants. The new nasal spray Aqualor Protect contains 45% of sea water with a slightly hypertonic concentration of salts (1.5%) and Ascophillum nodosum brown algae extract. The main polysaccharides of brown algae - fucoidan and ascofillan - have a wide range of biological actions, including anti-inflammatory and antiviral properties. The extract of brown algae added to saline helps to increase the effectiveness of irrigation therapy in the treatment and prevention of acute respiratory viral infections in children.

The poultry industry has attempted to improve carcass chilling efficiency, meat quality, and product safety. The purpose of this research was to investigate the effects of subzero saline chilling on carcass chilling time and microbial safety. Eviscerated tom turkeys were randomly picked from a local turkey processing plant and subjected to chilling in one of the 3 chilling solutions: 1) 0% NaCl/0.5°C (ice slurry control), 2) 4% NaCl/−2.41°C, and 3) 8% NaCl/−5.08°C. The turkey carcasses in subzero saline solutions were chilled more efficiently and reduced the chilling time over the carcasses in ice slurry solution. No significant difference was observed for carcass chilling yield and fillet cooking yield regardless of chilling method (P > 0.05). The number of mesophilic aerobic bacteria (MAB), Escherichia coli (E. coli), and total coliform cells were significantly reduced in the carcasses chilled in subzero saline solutions over the icy control, except MAB in 4% NaCl/−2.41°C (P < 0.05). Based on these results, the chilling of turkey carcass in subzero saline solution appears to improve carcass chilling efficiency and bacterial reduction, especially Gram-negative bacteria such as E. coli and total coliforms.

Background Intra-operative bile leakage testing is very important in partial liver resection in living donor liver transplant as it allows detection of bile leaking points on the cut surface and decreases postoperative bile leak which is one of the most dreadful complication following liver transplant surgery. In this study we tried to assess the Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant. Objective In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of biliary leakage in patients who will undergo partial liver resection as living donor liver transplant. Methodology In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of bile leakage in patients who underwent partial liver resection as a living donor liver transplant. This study included 60 patients who received partial liver resection as a living donor liver transplant. The conventional saline test (injecting an isotonic sodium chloride solution through the cystic duct) was carried out in 30 patients and the White test (injecting a fat emulsion solution through the cystic duct) was carried out in 30 patients Results Incidence of postoperative bile leakage was compared between the conventional method and the White test. Bile leakage occurred in 8 patients (26.7%) in the conventional method group and in 2 patients (6.7%) in the White test group. In addition, the White test detected intraoperative a significantly higher number of bile leakage sites compared with the conventional method. The White test is better than the conventional test for the intraoperative detection of bile leakage. Conclusion Based on our study, we recommend that surgeons investigating bile leakage sites during liver resections should use the White test instead of the conventional saline test.

Background Hepatic surgery will be always one of the most challenging surgical procedures due to its anatomical and pathophysiologic varieties. Various problems may complicate the post-operative course. Bile leak remains a serious complication after hepatectomy. Bile leaks can significantly impact morbidity, mortality, and cost of treatment. Bile leak increases risk of sepsis, need for further intervention, either radiological or return to theatre, prolongs duration of intensive care unit and hospital stay, and can precipitate liver failure and death. Objective To assess the post-operative bile leak complication after using white test versus conventional saline test Patients and Methods A prospective study on 50 Hepatectomy cases divided into two groups, the first group consist of 25 cases using white test and the second group consist of 25 cases using conventional saline test from January 2019 to January 2020, at Hepatobiliary unit of the general surgery department of Ain Shams university hospitals. Results The White test has clear advantages in comparison with other bile leakage tests: it precisely detects bile leakages, regardless of size; it does not stain the resection surface, allowing it to be washed off and repeated ad infinitum; and it is safe, quick, and inexpensive. The white test is a feasible and sensitive bile leakage test with no obvious disadvantages. It could be a possible standardized method to prevent bile leakage in major liver resection. Conclusion Now after we discussed our study and reviewed other opinions discussing the optimal methods for intraoperative bile leakage testing, we have now settled on White test using fat emulsion solution to be best of all tests.

Background Nasal skin edema is a common result of soft and bony tissue trauma during rhinoplastic procedures. In a cosmetic surgery like rhinoplasty, skin edema can fade the cosmetic results and can lead to dissatisfaction for both the surgeon and the patient. Local saline /adrenaline injection is claimed to reduce the nasal skin edema intraoperative. Aim of the work To assess effect of injection of saline adrenaline (1/100000) 15ml versus 5ml on the skin oedema and thickness during rhinoplasty through thesis study. Subjects and Methods In this study 30 cases of rhinoplasty will be operated, 15 cases will be injected by saline adrenaline (1/100000) of 5ml and the others 15 cases will be injected by saline adrenaline (1/100000) of 15 ml, then measuring the skin oedema after 10 minutes of saline adrenaline (1/100000) injection, after 30 minutes and after 60 minutes of the injection at three sites; the dorsum, supratip and the tip of the nose by Seal Gouge Caliper (surgical caliber). Results the intraoperative skin edema was significantly decreased with local injection of large amount (15ml) of saline /adrenaline 1/100000 than the usual injected amount (5ml) saline /adrenaline 1/100000 specially at the tip and the supratip of the nose and specially at 30 min and 60 min after injection, but statistically significance difference only at 60min at the dorsum. Conclusion that the skin oedema much less with injection of 15ml of saline adrenaline (1/100000) in comparison to injection of 5ml of saline adrenaline (1/100000).

Background EUS-gastroenterostomy (EUS-GE) is a novel modality in the management of malignant gastric outlet obstruction (MGOO). It is, however, technically challenging limiting its widespread application. To facilitate EUS-GE, a double balloon catheter has been developed in Japan. While this tool is not available outside of Asia, we have conceived a similar device using a widely available vascular balloon catheter. We aim to determine the clinical efficacy and safety of EUS-GE using this double balloon device (DBD). Aims We aim to determine the clinical efficacy and safety of EUS-GE using this double balloon device (DBD). Methods This is a single-centre, retrospective study of consecutive patients who underwent DBD assisted EUS-GE for MGOO from January 2019-June 2020 (IRB approved). The DBD consists of two 60 mm vascular balloons (Coda, Cook Medical, USA) fashioned together with the balloons 10 cm apart (Figure 1). It is inserted across the obstruction over a wire to the ligaments of Treitz. Both balloons are then inflated followed by saline and contrast infusion into the occluded small bowel segment to facilitate EUS-guided insertion of a 15 mm cautery assisted lumen apposing metal stent (AxiosTM, Boston Scientific Inc, USA). The primary endpoint is the rate of technical success defined as adequate deployment of the stent. Secondary endpoints include rate of clinical success and adverse events. Results A total of 11 patients were included in this study. 45% were female with a mean age of 64.9 ± 8.6 years old. The etiology of MGOO was 73% pancreatic cancer, 9% gastric cancer, 9% duodenal cancer, and 9% metastatic cervical cancer. Procedures were performed under general anesthesia and conscious sedation in 82% and 18%, of patients respectively. The mean procedure time was 64.8 ± 25.8 minutes. Technical and clinical success (intention to treat) was 91%. The only technical failure was due to poor patient tolerance of the procedure under conscious sedation. There was one adverse event (9%) due to stent migration rated as severe. Two patients (18%) required re-intervention for stent obstruction secondary to food impaction associated with non-compliance to a low-residue diet. Following re-enforced instructions, no further obstruction occurred. All patients started a clear liquid diet within 1 day of the procedure with a mean time to a low residue diet of 3.25 days ± 2.5. The median length of hospital stay following the procedure was 5 days ± 13. The median follow-up time was 84 days (IQR 152). Conclusions DBD assisted EUS-GE is clinically effective and safe. This balloon device may greatly facilitate the technical aspect of EUS-GE while potential enhancing its safety and clinical use. Larger studies are needed to validate this approach to EUS-GE. Funding Agencies None

Linear and calix[4]arene based star-shaped poly-2-ethyl-2-oxazines have been explored in saline solutions at NaCl concentration of 0.0050 g cm−3. The calix[4]arene core promotes an aggregation in solutions of the star-shaped polymer and a decrease in its phase separation temperature. Poly-2-ethyl-2-oxazine is more sensitive to the presence of NaCl in solution than the known poly-2-isopropyl-2-oxazolines.

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Electrophisiology Section of the Spanish Society of Cardiology Introduction. Lesion Size Index (LSI) and Ablation Index (AI) are markers of lesion quality that incorporate power, contact force (CF), and time in a weighted formula to estimate lesion size. Although accurate predicting lesion depth in-vitro, their precision in lesion size estimation has not been well established for certain power and CF settings. Purpose. We conducted an experimental ex-vivo study to analyse the effect of power and CF in size and morphology of ablation lesions in a porcine heart model. Methods. 24 sets of 10 perpendicular epicardial radiofrequency applications were performed with two commercially available catheters (TactiCath, Sensor Enabled; and SmartTouch) on porcine left ventricle submerged in 37ºC saline, combining different power (25, 30, 35, 40, 50 and 60W) and CF (10 and 20g) settings, and aiming at a lower (LSI/AI of 5/400) or higher (LSI/AI of 6/550) index. After each application, lesions were cross-sectioned and measured. Results. 480 lesions were performed. For a given target index and CF, significant differences in lesion volume and depth with different power settings were observed with both catheters. Regarding lesion volume, statistically significant differences were observed with all CF and LSI targets with TactiCath, except for 10 g and LSI 5 (10 g and LSI 5, p = 0.4134; 10 g and LSI 6, p In a side-by-side comparison, lesions performed with TactiCath were smaller and shallower than those performed with SmartTouch when applying a lower CF of 10g, both when targeting a lower index objective (volume: 41.8 ± 54.3mm3 vs 158.3 ± 33.2mm3, p Conclusions. Size and morphology of index-guided radiofrequency lesions varied significantly with different power and CF settings, highlighting the importance of achieving a good CF in any ablation procedure. Abstract Figure. Box-plot of lesion volume

Funding Acknowledgements Type of funding sources: None. Background Bipolar radiofrequency catheter ablation (BA) is an important therapeutic option for therapy refractory ventricular arrhythmias. BA approaches may frequently include titration of energy from lower to higher levels and target epicardial sites with overlying fat tissue. However, the actual effect on lesion formation has not been evaluated. Purpose Investigating lesion modalities during BA (a) using low-to-high energy titration, (b) conducting prior sequential unipolar ablation additional to BA and (c) in epicardial fat tissue. Methods An ex-vivo model consisting of freshly explanted swine hearts positioned in a circulating temperature-controlled saline bath was established. An irrigated active and ground ablation catheter with a 3.5mm tip connected to a novel single generator capable of performing BA were positioned on both sides of the left ventricular/ventricular septal myocardium orthogonal to respective swine tissue. Radiofrequency energy was applied with a fixed force of 10 g for 60 s using different approaches: (1) Titration group, BA of 30 W following BA of 50W; (2) sequential group, ablating unipolar from both catheters using 30 W; (3) epicardial fat group (fat thickness >1 cm) with BA of 50W; (4) sequential + BA group, applying unipolar energy of 30 W first on both catheters with consecutive BA of 50W; (5) control group, with BA of 30, 40 or 50 W only. Dimensions of set lesion as well as bipolar generator impedance during ablation were assessed. Results A total of 65 ablation lesions were analyzed. The mean tissue thickness was 18 ± 3 mm (range 11-23 mm), with a mean fat thickness of 3.5 ± 1.1 mm in the epicardial fat group. Overall, transmurality was observed in 17 lesions (26%) with the highest rates in the titration and sequential + BA group (75 / 100%), while no difference to the control group applying 50 W was detected (Kruskal-Wallis test, p = 0.30/0.19) and no lesion displaying transmurality in the epicardial fat group (p 0.99), whereas being significantly larger than in the epicardial fat group [median 59 (interquartile range 41-92 mm3), p = 0.02/0.01]. The sequential + BA group showed significantly increased lesion volume compared with both titration and control group [1401 (1093-1728) mm3, p = 0.004, Figure]. Eleven steam pops (17%) were registered with similar distribution between groups (p = 0.24). Conclusion Lesion dimensions were similar between the BA titration approach and BA solely applying 50 W. Prior sequential unipolar ablation may significantly increase ablation lesion volumes during BA. The effect of BA at sites of significant epicardial fat tissue >1 cm may be severely limited, which should be considered during procedure planning. Abstract Figure. Lesion dimensions in BA approaches

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Background Cardiogenic shock (CS) complicates 8% of acute myocardial infarctions and has a short-term mortality approaching 50%. Traditional mechanical circulatory support (MCS) have significant adverse event profiles related to their position within the circulation. PALVAD is an extra circulatory MCS designed to be implanted percutaneously. The dual balloon system provides cardiac support whilst sitting in the space between the pericardium and left ventricular (LV) free wall. The actuator (ACT) balloon augments CO through ECG gated LV systolic compression and the positioning balloon sits against the pericardium dissipating this force. Methodology Non-recovery experiments were conducted in eleven 40k-60g pigs. A percutaneous coronary balloon occlusion model was initially used (n = 3) following which an Esmolol infusion model (n = 8) was used due to increased stability when titrating for a low cardiac output state . A Millar catheter was placed in the LV for simultaneous pressure and volume measurements and a Transonic flow probe was placed around the internal carotid. The device was inserted percutaneously and operated for alternating on/off periods. The device was inserted into a saline perfused cadaver following which CT and MRI imaging was undertaken. CT images were reconstructed three dimensionally and analysed. Results PAL-VAD had a significant impact across all parameters with a mean increase of 42% ± 16.1 in CO, 42% ± 17.3 in stroke volume, 20% ± 15.5 in pressure and a 30% ± 18.5 in flow and a mean device actuation of 48mins. Cadaveric imaging confirmed appropriate device dimensions for human anatomy and a 32% reduction in LV volume was seen with ACT balloon inflation. Conclusions PALVAD performance in during a low CO state is promising. Recovery experiments, including histology assessment, are planned to further evaluate safety and efficacy with longer-term use. % Increase with PALVAD Parameter% IncreaseCardiac Output42Stroke Volume42Pressure20Flow30Abstract Figure.

Carcass chilling in subzero saline solutions has the potential to improve chilling efficiency and meat quality. The purpose of this research was to investigate the effects of subzero saline chilling on broiler carcass for chilling efficiency and breast tenderness. Broiler carcasses were chilled using 2 high saline solutions (4% NaCl/-2.41°C and 8% NaCl/-5.08°C) without (Experiment I) and with (Experiment II) a pre-chilling step, and 3 low saline solutions (1% NaCl/-0.6°C, 2% NaCl/-1.2°C, and 3% NaCl/-1.8°C) in Experiment III. Ice water slurry (0% NaCl/0.5°C) was used as a control. In Experiments I and II, the breast fillets of broilers in subzero saline solutions showed significantly lower shear forces than those in water control, regardless of salt content and temperature level (P < 0.05). In Experiment III, 3% NaCl/-1.8°C solution reduced the broiler chilling time by 22% over the water control, with an intermediated reduction (13 to 17%) observed for 1% NaCl/-0.6°C and 2% NaCl/-1.2°C solutions. Shear force was stepwise reduced as the salt concentration increased from 0 to 3% and the solution temperature decreased from 0.5 to -1.8°C. No significant difference was observed for carcass chilling yield, breast pH/R-value, and breast cooking yield/salt content, regardless of chilling method. Based on these results, chilling of boiler carcass in 3% NaCl/-1.8°C or higher NaCl and lower temperature solutions appears to improve carcass chilling efficiency and meat tenderness over the traditional water immersion chilling.

The aim of the study was to evaluate the analgesic efficacy of tramadol compared to butorphanol administered locally in ventral surface of the hind paw of rats. Prospective, randomized experimental study; twenty-one adult male Wistar rats were selected. Heart rate (beats minute-1), respiratory rate (breaths minute-1), and paw withdrawal latency (onset of radiant heat until paw withdrawal/seconds) were measured prior (T0) and after (T5, T10, T15, T20) intraplantar injection with saline solution 0,9% (group S), butorphanol 1 mg kg-1 (group B), and tramadol 1 mg kg-1 (group T). Shapiro-Wilk normality test and Friedman test were used to analyze the data expressed by median and range. Statistical significance was set at p < 0.05. Statistical analysis of heart rate showed that there were significant differences between groups at different monitoring times. There were no significant differences in respiratory rate after intraplantar injection in any of the treatment groups. The paw withdrawal latency values at T5, T10, and T15 minutes after intraplantar injection in the group B were significantly higher compared to baseline value and to the values of the other groups. The paw withdrawal latency were no significant changes in the measurements of intragroup in S and T. Intraplantar administration of butorphanol provides a good analgesia and significantly increases paw withdrawal latency compared to tramadol. Intraplantar injection of butorphanol could be useful and safe and safe technique to achieve local analgesia for minor surgical procedures in rats.

Radiofrequency ablation (RFA) is a treatment for liver tumors with advantages over the traditional treatment of surgical resection. This procedure has the shortest recovery time in early stage tumors. The objective of this study is to parameterize the impedance curve of the RFA procedure in an ex vivo model by defining seven parameters (t1/2, tminimum, tend, Zinitial, Z1/2, Zminimum and Zend). Based on these parameters, three performance indices are defined: one to identify the magnitude of impedance curve asymmetry (δ), one Drop ratio (DR) describing the percentage of impedance decrease until the minimum impedance point is reached, and Ascent Ratio (AR) describing the magnitude of increase in impedance from the minimum impedance point to its maximum point. Fifty ablations were performed in a bovine ex vivo model to measure and evaluate the proposed parameters and performance index. The results show that the groups had an average δ of 29.02%, DR of 22.41%, and AR of 545.33% for RFA without the use of saline or deionized solutions. The saline solution and deionized water-cooled groups indicated the correlation of performance indices δ, DR, and AR with the obtained final ablation volume. Therefore, by controlling these parameters and indices, lower recurrence is achieved.

Background and Aims: Fluid administration during liver transplant (LT) surgery is controversial. Although adverse outcomes following positive intraoperative fluid balance have been reported, studies presenting the influence of cumulative postoperative fluid balance (CFB) on complications following LT are sparse. Patients with chronic liver disease tend to receive more fluid during and after surgery due to their unique physiological disease state. The aim of this study was to evaluate the influence of 48-hour CFB on the development of acute kidney injury (AKI) and pulmonary complications on day 4 after live donor LT. Methods: This retrospective study included 230 patients undergoing live donor LT. The effect of CFB on day 2 on AKI and pulmonary complications was analysed. Chi-square test, Fisher's exact test, samples t-test, Mann-Whitney U-test were used. Results: Bivariate analysis showed a lower graft vs recipient weight ratio (GRWR), sepsis (P < 0.001) and a higher 48-hour CFB after surgery significantly increased the development of AKI. For pulmonary complications, higher Model for End- stage Liver Disease-Na (MELD-Na) score, higher peak arterial lactate, higher 48-hour CFB (P = 0.016) and sepsis (P = 0.003) were found to be statistically significant. Upon multivariate analysis, CFB at 48 hours was significantly higher in patients suffering from pulmonary complications, and GRWR and sepsis were significant for AKI. For every one litre increase in CFB on day 2, the odds of pulmonary complications increased by 37%. Conclusion: A more positive CFB on day 2 increased the development of pulmonary complications and lower GRWR and sepsis increased the development of AKI.

Background The 2015 cardiopulmonary resuscitation (CPR) guidelines have stressed that high-quality CPR improves survival from cardiac arrest (CA). In particular, the guidelines recommended that it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min in adult CA patients. However, it is unknown whether the 2015 guidelines contributed to favorable neurological outcome in adult CA patients. The present study aimed to clarify the effects of the 2015 guidelines in adult CA patients, using the data of the All-Japan Utstein Registry, a prospective, nationwide, population-based registry of out-of-hospital CA (OHCA). Methods From the data of this registry between 2011 and 2016, we included adult witnessed OHCA patients due to cardiac etiology, who had non-shockable rhythm as an initial rhythm. We excluded patients who received prehospital care in 2015 because it was difficult to distinguish prehospital care based on either 2010 CPR guidelines or 2015 CPR guidelines. We also excluded patients who received bystander CPR by citizens because we cannot assess the quality of bystander CPR in this registry. Study patients were divided into five groups based on different years (figure). The endpoint was the favorable neurological outcome at 30 days after OHCA. Potential confounding factors based on biological plausibility and previous studies were included in the multivariable logistic regression analysis. These variables included the age, sex (male, female), advanced airway or not, the administration of adrenaline or not, the administration of saline or not, instructed by dispatcher or not, and time interval from call EMS to scene. Results The figure showed favorable neurological outcomes at 30 days. In the multivariate analysis, the adjusted odds ratio for 30-day favorable neurological outcome in OHCA patients in 2016 as compared to in 2011 was 1.32 (95% CI: 1.04–1.68, p=0.022). On the other hands, there were no significant differences from 2011 to 2014. Conclusion In the OHCA patients with non-shockable rhythm, the 2015 guidelines were superior to the 2010 guidelines, in terms of neurological benefits. Figure 1 Funding Acknowledgement Type of funding source: None

Background Cardiogenic shock complicates around 8% of acute myocardial infarctions with a significant short term mortality of 35–50%. Traditional mechanical circulatory support can improve cardiac output (CO) however they have significant adverse event profiles related to their position within the circulation, including but not limited to infection, stroke and embolism. PALVAD is an extra circulatory left ventricular assist device, designed to be implanted percutaneously., It provides cardiac support whilst sitting outside the circulatory system in the space between the pericardium and left ventricular (LV) free wall. The dual balloon system connects to an external pumping system via a drive line. The actuator balloon augments CO through ECG gated LV systolic compression and the positioning balloon sits against the pericardial surface dissipating this force across a large surface. Purpose Assess device efficacy in a low CO state in a non-recovery porcine model. Understand device interactions with the left ventricle and pericardium in a cadaveric model. Methodology Non-recovery porcine model experiments were conducted in three 40k-50g pigs at a large animal catheterisation facility. An Esmolol infusion was titrated to create a low output state. A Millar catheter was placed in the LV for simultaneous pressure and volume measurements and a Transonic flow probe was placed around the internal carotid for flow measurements. The device was inserted percutaneously and operated for a total of 4.7 hrs. For cadaveric experiments the device was inserted into a Thiel embalmed saline perfused cadaver following which detailed CT and MRI imaging was undertaken. Results When target reduction in cardiac output was met PALVAD increased systolic pressure by 34%, stroke volume by 54%, CO by 53% and flow by 53%. There was no macroscopic evidence of epicardial or pericardial damage. Cadaveric imaging further informed optimal positioning of the device in relation to the LV free wall. Conclusions PALVAD performance during low CO state in non-recovery porcine experiments is promising. Further recovery experiments, including histology assessment, are planed to evaluate safety and efficacy with longer term use to guide optimisation towards the eventual aim of a first-in-man trial. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Translational Research Grant

Funding Acknowledgements Beca de la Sección de Electrofisiología y Arritmias para formación en investigación post-residencia en centros españoles INTRODUCTION Ablation Index and Lesion Size Index are novel markers of ablation lesion quality that incorporate power (W), contact force (CF), and time (T) in a weighted formula to accurately estimate lesion size. While LSI includes system impedance (I) in the formula, this parameter is not considered for AI calculation. PURPOSE The aim of our study was to analyse the impact of I in lesion formation. METHODS Radiofrequency (RF) lesions were created on porcine myocardial slabs by using an open-tip irrigated catheter with real-time monitoring of CF (a TactiCath™ Quartz Contact Force Ablation Catheter for LSI-guided lesions and a ThermoCool® SmartTouch® Catheter for AI-guided lesions). Catheters were mounted in an articulated arm and manually maneuvered over a platform placed within a tank filled with either a low impedance medium (saline solution) or a high impedance medium (running water) with a heating pump to produce non-pulsatile flow directed perpendicularly to the myocardium surface at a rate of 5 l/min and a temperature of 37ºC. For each catheter and medium, ten lesions were performed with a CF of 20 grams and a W of 25, 30, 35 and 40 watts aiming at a LSI of 5 or a AI of 400 (recommended targets for posterior wall pulmonary vein isolation for each index). After RF delivery, the myocardium was cross-sectioned at the level of each lesion and its blanched zone was measured with a dial calliper with a 0.1 mm resolution (image, panel A). Lesion volume was calculated using width and depth, according to a validated formula (image, panel B). RESULTS No difference in application time was noted in the AI-guided lesions depending on the medium (23.8 ± 1.6s, 17.2 ± 1.4s, 13.7 ± 0.8s and 12.2 ± 0.7s for 25W, 30W, 35W and 40W, respectively) while a significant reduction in application time was noted in the LSI-guided lesions performed in a low I medium (93.8 ± 6.6 ohms; 17.9 ± 1.9s, 11.3 ± 3.7s, 9.1 ± 0.9s and 7.3 ± 0.5s for 25W, 30W, 35W and 40W) compared with those performed in a high impedance medium (132.4 ± 6.6 ohms; 27.3 ± 1.4s, 17.9 ± 2.5s, 15.5 ± 1.4 and 13 ± 1.2 for the same programmed W (p Both catheters showed differences in lesion size according to the I, with lower lesion volumes in the low I medium and higher lesion volumes in the high I medium. Although globally smaller in size, higher lesion volumes were noted in the AI-guided lesions compared to LSI-guided lesions in a low I medium (image, panel C). On the contrary, a better performance of the LSI-guided lesions was observed in the high I medium (image, panel D). CONCLUSIONS System impedance affected lesion size both in LSI-guided an AI-guided ablation lesions, with smaller lesions seen in a lower I medium. Further studies are needed to assess the clinical relevance of this findings in an in-vivo scenario. Abstract Figure.

Polymyxins are a group of antibacterial substances and have remained the drugs of choice for treatment of resistant Gram-negative bacilli. Polymyxin B is administered by intravenous infusion and requires the reconstitution of lyophilized powder with 0.9% saline or 5% glucose solutions. To date, there is little information about polymyxin stability in different infusions solutions, especially at 40 ºC, a temperature that is recommended to study drug stability as it accelerates degradation reactions. Therefore, in this work an analytical method using LC-MS/MS was developed, validated and applied to determine the stability of polymyxin B diluted in 0.9% saline or 5% glucose solutions at 25 ºC and 40 ºC. The stability of polymyxin B solutions was evaluated during 72 hours. Polymyxin B1 and B2 were stable for 24 hours in saline (0.9%) and glucose solution (5%), however a significant degradation of polymyxin B1 and B2 was observed after 48 hours and 72 hours of assay. The reduction of polymyxin content was evidenced in both saline and glucose media, at room temperature as well as at 40 ºC. No significant differences in pH of polymyxin solutions (glucose or saline) were evidenced during stability assay.

Objectives To assess the potential role of prolotherapy in treating the most tender points of FM patients as a trial to improve symptoms. Patients and Methods 20 primary FM Patients were injected with 3 cc of 25 % dextrose with 2 cc of 1 % lidocaine and then filled to 6 cc total volume with saline, making dextrose concentration of 12.5%, with 0.5 ml of the solution prepared per point,with a maximum of 6 points/ session. - Follow up visit were required every two weeks for other injections over a course of six weeks (duration of healing cascade). After 6 weeks, patients were assessed using NRS, FIQ VAS , MFI - 20 , SQS and PHQ-9 scales. Results As regard number of tender points, there was a highly Statistically significant P- value ( Conclusion Prolotherapy may offer great therapeutic advantages for FM patients, as it is well tolerated with minimal or no side effects. Moreover, prolotherapy injection reduces pain intensity and functional disability in daily life activities.

Osmotic suction affects the mechanical properties of the clay and exists as long as the solute is present in pore water of soil. Determination of osmotic suction of pore solution is significant for quantitatively explaining the mechanical behaviors of clay in saline solution. This paper aims to introduce a calculation method to determine the osmotic suction of saline solutions and the application of the osmotic suction to quantify the mechanical behaviors of clay in saline solutions. Osmotic coefficient as the bridge connecting ion concentration and osmotic suction was calculated by a simplified half-empirical equation and verified by published experimental data. Then the osmotic suctions were achieved using the calculated osmotic coefficients, and two filter paper methods were carried out to verify the calculated results. The consistency between the experimental results and the calculated ones proved the correctness of the proposed method for calculating the osmotic suction. A step further, the mechanical behaviors of clay in saline solutions were explained and quantified from the microscopic with the concept of microstructural effective stress and the macroscopic with the concept of modified effective stress, both related to the osmotic suctions.

The incorporation of chlorine in serpentine minerals is crucial for the recycling of chlorine in subduction zones. Fluid inclusions of natural serpentinites have up to 50 wt% Cl, but effect of fluid salinity on chlorine distribution in serpentine minerals is poorly constrained. In this study, natural serpentinites (Lichi Melange, Taiwan) with starting grain sizes of 100–177 μm were equilibrated in saline solutions (2.93 wt%, 8.78 wt%, and 19.30 wt% NaCl) at ambient temperature and pressure for experimental duration from 18 to 43 days. The concentrations of chlorine in serpentine minerals were analyzed using electron microprobe with a detection limit of 33 ppm. Serpentine before experiments has very low chlorine, 0.017 ± 0.009 wt%. In contrast, serpentine equilibrated in saline solutions contains chlorine around three times higher, e.g., serpentine equilibrated in 2.93 wt% NaCl has 0.077 ± 0.033 wt% Cl after 18 days. The serpentine was re-equilibrated in pure water for around 24 h in order to testify chlorine is hosted in a weak-bound or structurally-bound position. For serpentine minerals equilibrated in low-salinity solutions (2.93 wt% and 8.78 wt% NaCl), they lost ∼40% of Cl after re-equilibrated in pure water. Despite such release, chlorine in serpentine minerals is still higher than that of serpentine before experiment, which indicates that saline solutions increase structurally-bound chlorine of serpentine minerals. This is more efficient for high-salinity solution (19.30 wt% NaCl), and chlorine in serpentine re-equilibrated in pure water is essentially the same as that of serpentine equilibrated in the saline solution. Our experimental results suggest that chlorine in serpentine can be greatly modified by saline fluids. The structurally-bound chlorine may not necessarily reflect the T-P information of natural serpentinites.

Brain metastases (BM) are the most common neoplasm to affect the adult central nervous system, occurring ten times more frequently than primary brain tumor. BM develop in 40–50% of advanced lung adenocarcinoma (LUAD), and the lack of durable response to chemotherapy, immunotherapy, or targeted therapy will result in death within a year of BM diagnosis. Despite the high burden of disease, dismal prognosis, and the increase in incidence over time, the biological underpinnings of BM remain poorly understood due to both the difficulty of obtaining a sizable collection of metastatic tissue samples as well as a lack of clinically relevant models. As such, it is possible that the inability to properly study this disease may result in metastasis driver-genes remaining undiscovered. Typical models of BM utilize direct implantation of tumor cells into the mouse brain, or inoculation into the blood via intracardiac/intracarotid injections; these routes are invasive and cannot fully recapitulate the entirety of the metastatic cascade. Here we present a novel, non-invasive method to develop primary lung tumors and brain metastases. A 10µL tumor cell suspension in phosphate-buffered saline was applied to the nostrils of lightly anesthetized mice, allowing direct deposit of cells into the lungs. Mice were monitored with bioluminescence imaging bi-weekly and culled at 2.5–3 months post-inoculation. Lungs and brains were also removed and imaged, where tumors in both organs were observed. Further research is necessary to elucidate either the linear or parallel progression of tumor formation within this model. Nonetheless, our technique presents a novel preclinical tool to interrogate the metastatic process, allowing validation of genetic drivers as well as therapeutic screening.

In aqueous and saline solutions, one or more chloride ions per monomer unit are necessary for evident changes in the self-organization of poly-2-isopropyl-2-oxazoline and solution behavior on heating.

This study investigates freeze desalination achieved through partial freezing of drops of saline solutions. Firstly, a parametric study is performed to determine the ice recovery (%) and salinity reduction (%) for drops of NaCl solutions as a function of drop size, NaCl concentration and freezing temperature. It was shown that desalination can be achieved in millimetric drops at freezing temperatures pertinent to their partial freezing state. Overall, greater supercooling degrees were required for higher salt concentrations, leading to a higher ice recovery (%) in smaller drops for a given salt concentration. The salinity reduction (%), however, reduced linearly as the ice recovery (%) increased, with drops of greater salt concentrations showing the least salinity reduction. The higher ice growth rate experienced by such drops is believed to be responsible for the observed lower salinity reduction (%). A map of freezing state is developed for drops of 1, 3.5 and 6 wt% NaCl solution. The map identifies the drop's state of freezing in terms of unfrozen, partially frozen, and fully frozen state. This map can be employed to identify the temperature range required for achieving partial freezing of saline drops, the pre-requisite for drop-based freeze desalination processes.

Introduction/Objective Histologic frozen section analysis is typically used for parathyroid tissue identification during parathyroidectomy when needed, in conjunction with a rapid intraoperative plasma parathyroid hormone (PTH) assay to confirm falling levels of circulating PTH after parathyroid excision. As an alternative to frozen section consults, we hypothesize that automated analysis of intraoperative fine needle aspiration (ioFNA) tissue samples using a rapid PTH immunoassay can accurately identify parathyroid tissue and reduce the need for frozen section consults. Methods A rapid PTH immunoassay (Elecsys PTH STAT; Roche Diagnostics, Indianapolis, IN), currently used for intraoperative plasma samples, was validated for FNA samples on a Cobas® e411 using tissue aspirates of ex vivo parathyroid and control specimens rinsed in 1mL saline. ioFNA PTH results during parathyroidectomy were then prospectively assessed for accuracy over a 4-month period by comparing values to final histopathologic diagnoses. The number of frozen section consults requested was compared to a 5-month period prior to the availability of the ioFNA PTH assay. Results Ninety patients underwent parathyroidectomy (128 excised parathyroids) during the study period, performed by a single experienced endocrine surgeon. Indications included primary (81/90), tertiary (5/90), and recurrent (4/90) hyperparathyroidism. Thirty-nine cases (55.5 excised parathyroids) were performed after the availability of the ioFNA PTH assay. ioFNA samples were sent for PTH analysis in 7/39 cases (18%; 12 samples total) and had a sensitivity/specificity of 100% (parathyroid [n=7] PTH values 1968 - >5000pg/mL; non-parathyroid [n=5] PTH values Conclusion Analysis of ioFNA tissue samples using an automated rapid PTH immunoassay can accurately identify parathyroid tissue and can be used as an alternative to frozen section consult when needed.

Objectives Saline and Plasma-Lyte have different physiochemical contents; consequently, they may differently affect patients’ renal function. We compared the effects of fluid therapy with 0.9% saline and with Plasma-Lyte 148 on renal function as assessed by creatinine concentration among patients undergoing major surgery. Methods We conducted a prospective, double-blinded cluster crossover trial comparing the effects of the two fluids on major surgery patients. The primary aim was to establish the pilot feasibility, safety and preliminary efficacy evidence base for a large interventional trial to establish whether saline or Plasma-Lyte is the preferred crystalloid fluid for managing major surgery patients. The primary efficacy outcome was the proportion of patients with changes in renal function as assessed by creatinine concentration during their index hospital admission. We used changes in creatinine to define acute kidney injury (AKI) according to the RIFLE criteria. Results The study was feasible with 100% patient and clinician acceptance. There were no deviations from the trial protocol. After screening, we allocated 602 patients to saline and 458 to Plasma-Lyte. The median (IQR) volume of intraoperative fluid received was 2000 mL (1000:2000) in both groups. Forty-nine saline patients (8.1%) and 49 Plasma-Lyte patients (10.7%) developed a postoperative AKI (adjusted incidence rate ratio [aIRR]: 1.34; 95% CI: 0.93–1.95; p = 0.120). No differences were observed in the development of postoperative complications (aIRR: 0.98; 95% CI: 0.89–1.08) or the severity of the worst complication (aIRR: 1.00; 95% CI: 0.78–1.30). The median (IQR) length of hospital stay was six days (3:11) for the saline group and five days (3:10) for the Plasma-Lyte group (aIRR: 0.85; 95% CI: 0.73–0.98). There were no serious adverse events relating to the trial fluids, nor were there fluid crossover or contamination events. Conclusions The study design was feasible to support a future follow-up larger clinical trial. Patients treated with saline did not demonstrate an increased incidence of postoperative AKI (defined as changes in creatinine) compared to those treated with Plasma-Lyte. Our findings imply that clinicians can reasonably use either solution intraoperatively for adult patients undergoing major surgery. Trial registration Registry: Australian New Zealand Clinical Trials Registry; ACTRN12613001042730; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364988.

Introduction: Oral mucositis could affect children’s health status. The purpose of this study was to identify the difference of effectiveness between gargling with povidone iodine 1% and normal saline solutions in 5-15 years old children who received chemotherapy. Method: This study used pre-experiment static group comparison design. There were 18 respondents who divided into 2 treatment groups and 1 control group. The independent variable w as gargling use solutions of povidone iodine 1% and normal saline and the dependent variable was oral mucositis . The level of mucositis measured using multiple variable mucositis rating scales then analyzed by means of statistical test mann whitney u test with significance level of α≤0.05. Result: The result showed that there were no difference between gargling use solutions of povidone iodine 1% and normal saline (p=0.930). Thus normal saline as good as povidone iodine 1% to prevent oral mucositis. It can be concluded that there was no difference between the use of povidone iodine 1% and normal saline as mouthwash to prevent oral mucositis. Discussion: It is recommended that patient with chemotherapy should be gorgled with povidone iodine and normal saline .

The electrooxidation of glucose on a polycrystalline gold electrode from alkaline and saline solutions was investigated. The influence of Nafion on the oxidation of glucose under the same conditions was also studied. The presence of Nafion on the surface of a polycrystalline gold electrode decreased the rate of glucose oxidation in alkaline solution. The sensitivity of glucose determination was diminished. However, processes occurring at the electrode were clearly separated. Stable cyclic voltammogram of a polycrystalline gold electrode was obtained in saline solution. The addition of glucose to saline solution initiated the reaction of gold dissolution. The presence of Nafion on the electrode surface prevented the formation of hydrous gold oxide. The addition of glucose to saline solution led to the passivation of the Nafion-covered gold electrode. The gold electrode pretreated in alkaline solution and covered with Nafion was used for glucose detection in saline solution. The linear behavior was obtained in the concentration range from 2 to 10 mM with the slope of 0.0015 mA/mM and the coefficient of 0.95. The chronoampermetric response of the pretreated gold electrode covered with Nafion was also tested.

cute rhinosinusitis is a common disease among all age groups, which is treated as by general practice doctors so by single-discipline specialists. In the article the issues about the treatment of rhinosinusitis are found. The possibilities of irrigation therapy with saline solutions (isotonic, hypertonic) in children are shown. Key words: children, rhinosinusitis, irrigation therapy, saline solution, Humer.

There are indications that exposing adolescent rodents to oxytocin (OT) promotes social activity and reduces anxiety in adulthood. Adult male gray rats selected for elimination and enhancement of the aggressive response to humans, when exposed to OT, showed divergent changes in the resident behavior towards the intruder. It could be assumed that adolescent administration of both OT and antagonist of OT receptor (OTR) would also have different long-term effects on resident behavior and startle reflex in adult aggressive and tame rats. The aim of this work is to study the long-term effects of adolescent administration of both OT and antagonist of OT receptor (OTR) on resident behavior and startle reflex in adult tame and aggressive male gray rats. Starting at the age of 28 days, the animals received nasal applications of 5 μL of oxytocin solution (1 μg / μL) or saline for 5 days (daily). At the age of two months, the acoustic startle amplitude was assessed in two series of 5 acoustic stimuli. The resident-intruder test was performed one week later. Antagonist of OT receptor l-368,899 was administered intraperitoneally (i.p.) once at a dose of 5 mg/kg at the age of 30-33 days. Subsequent startle reflex tests were performed 20 days later, at the age of 50-53 days. A week later, the resident-intruder test was performed on the same rats. The startle amplitude in aggressive rats of the control group (in two series of acoustic stimuli) and those having received saline (in the first series) was larger than in the corresponding tame groups. Oxytocin and saline solutions did not significantly affect the startle amplitude compared to control animals. After saline administration, the attack latency in tame rats was longer than in aggressive rats (P0.05). Oxytocin treatment caused a prolongation of this period in aggressive males compared with control animals receiving saline solution (P0.01). In addition, oxytocin administration in aggressive males caused an increase in the time of social behavior, which did not include aggressive and same-sex behavior, as compared with the corresponding control animals (P0.05). Exogenous oxytocin receptor antagonist (l-368,899) did not affect the startle amplitude and behavior in the resident-intruder test in aggressive and tame male rats. Adolescent OT treatment causes a prolongation of both the attack latency and social behavior in the resident-intruder test in adult aggressive male rats, but does not affect these parameters in tame rats.

Background: The aim of this study was to compare the efficacies of saline solutions of different concentrations used for the management of infants with mild to moderate bronchiolitis. Methods: A retrospective chart review of 46 children, aged 1-24 months, diagnosed with acute bronchiolitis was performed. The patients were separated into 2 groups: normal saline and 3% hypertonic saline. Length of hospital stay, modified respiratory assessment score (MRAS) at admission, at 48 hours of admission and at discharge were compared. Results: MRAS evaluated at admission, at 48 hours after admission and at discharge and length of hospital stay did not reveal significant difference between the two groups (p>0.05). Conclusions: Comparison of two different treatments, salbutamol applied in combination with either normal saline or 3% hypertonic saline, did not reveal any statistically significant differences with respect to symptomatic improvement or length of hospital stay.

BackgroundCoronary revascularization using imaging guidance is rapidly becoming the standard of care. Intravascular optical coherence tomography uses near-infrared light to obtain high resolution intravascular images. Standard optical coherence tomography imaging technique employs iodinated contrast dye to achieve the required blood clearance during acquisition. We sought to systematically evaluate the technical performance of saline as an alternative to iodinated contrast for intravascular optical coherence tomography assessment.Methods and resultsWe performed bench top optical coherence tomography analysis on nylon tubing with sequential contrast/saline dilutions to empirically derive adjustment coefficients. We then applied these coefficients in vivo in an established rabbit abdominal stenting model with both saline and contrast optical coherence tomography imaging. In this model, we assessed the impact of saline on both quantitative and qualitative vessel assessment. Nylon tubing assessment demonstrated a linear relationship between saline and contrast for both area and diameter. We then derived adjustment coefficients, allowing for accurate calculation of area and diameter when converting saline into both contrast and reference dimensions. In vivo studies confirmed reduced area with saline versus contrast [7.43 (5.67-8.36) mm2 versus 8.2 (6.34-9.39) mm2, p = 0.001] and diameter [3.08 mm versus 3.23 mm, p = 0.001]. Following correction, a strong relationship was achieved in vivo between saline and contrast in both area and diameter without compromising image quality, artefact, or strut assessment.ConclusionSaline generates reduced dimensions compared to contrast during intravascular optical coherence tomography imaging. The relationship across physiologic coronary diameters is linear and can be corrected with high fidelity. Saline does not adversely impact image quality, artefact, or strut assessment.

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This systematic review and meta-analysis (MA) aimed to verify the capacity of different storage media to preserve viability of periodontal ligament cells in comparison to Hank's Balanced Salt Solution. The searches, selection process, data extraction and Risk of Bias control were conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five MA were conducted to compare the cell viability between milk versus Hank's balanced salt solution (HBSS) in a dichotomous (1) or continuous (2) data model; tap water versus HBSS (3); medicinal herbals versus HBSS (4); and saline solution versus HBSS (5). 693 potentially studies were identified, with 18 studies included in the qualitative and 8 studies included in the quantitative analysis. Most of the articles presented a low risk of bias. HBSS medium showed a superior ratio of cell viability compared to tap water (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%) and saline solution (RR 0.76; 95% CI [0.69, 0.84]; p < 0.0001; I2 = 99%). Herbal medicines showed a similar ratio of cell viability when compared to HBSS (RR 0.97; 95% CI [0.94, 1.00]; p = 0.08; I2 = 50%). Mixed results were observed between milk and HBSS: a superior ratio of HBSS was observed in an overall evaluation (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%), and a similar ratio was achieved when periodontal ligament (PDL) cells were removed prior to immersion in the solution (RR 0.94; 95% CI [0.87, 1.01]; p = 0.10; I2 = 0%) or rinsed in tap water or maintained in open air prior to immersion (RR 0.63; 95% CI [0.35, 1.12]; p = 0.11; I2 = not applicable). This systematic review and MA suggests that milk and herbal medicines could represent an alternative to HBSS. However, more studies are necessary to obtain a reliable conclusion.

Previously, dental stone has been utilized in mechanical testing of the periodontal ligament, which connects the tooth to the alveolar bone. This was achieved by casting swine mandibles in dental stone for displacement controlled testing. The stone was used as a riding base to hold the mandible in place. However, this was done in dry, ex vivo conditions, failing to simulate the natural presence of vascular fluid in the periodontal ligament. While this can be simulated with submersion in saline, the mechanical response of dental stone to saline is currently unknown, and thus cannot yet be used to secure the mandible in saline. To identify differences in the strength of dental stone after submersion in saline, Coecal Type III Dental Stone samples were cast in a 3D printed mold, then submerged in 0.9% NaCl solution for varying time periods: 0 hours, 0.5 hours, 1 hour, 4 hours, and 24 hours. Samples were then removed from the solutions, patted dry, and placed in an Instron ElectroPuls E3000 for compression tests. The Instron preloaded samples to 3 N, displaced them to 0.1 mm at 0.025 mm/s, held them for 10 s, then offloaded at 0.025 mm/s. This cycle was repeated five times per test, with each sample undergoing two tests. Results showed that the last three cycles of each test were most consistent, and were the only ones considered in further analysis of results. The average peak force and average force during the 10 s hold of each test were compared across submersion times, and, considering standard deviation, showed no consistent differences. A linear regression was completed to determine statistical differences between the force values. The p-values of the average peak force and average force were 0.624 and 0.892 respectively, approaching the required value of 1, and therefore failed to reject the null hypothesis, representing no significant difference in the average force across submersion times. As a result, it can be assumed that submersion in saline has no effect on the strength of dental stone. These results can be applied to further research on the periodontal ligament, involving submersion of the swine mandible in saline solutions.

The initial degradation of zinc has been investigated through exposures to simulated and real body fluids of increasing complexity: phosphate buffered saline (PBS), Ringer's saline solution, human plasma, and whole blood. Real body fluids were used to close the electrolyte gap between simulated and in vivo environment. Polarization of zinc in whole blood show a passive response not present in other electrolytes. The analysis shows a decrease in corrosion rate with time for plasma and whole blood and an increase for PBS and Ringer's. During exposure to plasma and whole blood a bi-layered corrosion product with poor adherence was formed over a uniformly corroding surface. The corrosion products comprise a mixture of inorganic material and biomolecules. Samples degrading in PBS were prone to localized corrosion and formed thick porous corrosion products of primarily zinc phosphates while in Ringer's solution a gel like layer of zinc carbonate was formed over an interface with shallow pits. The use of whole blood or plasma as electrolytes for short term in vitro evaluation of potential biodegradable metals may provide an improved understanding of the behavior in vivo, while Ringer's solution is preferred over PBS for long term degradation studies of zinc. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1141-1151, 2016.

Rationale and key points This article provides information on nasal douching, which nurses can use to advise patients on how to perform this procedure. It explains how to prepare and use a home-made solution for nasal douching, and discusses the various products available that can assist patients in undertaking this procedure. » Nasal douching, also known as nasal washout, irrigation or lavage, is recommended to clear mucus and allergens from the nose for people with rhinitis or rhinosinusitis. It is also recommended following nasal surgery to cleanse and aid healing inside the nose. » Nasal douching can be used as a baseline preparation treatment or alone to reduce the symptoms of sinonasal disease and/or allergy. It can also be performed 10-20 minutes before using a corticosteroid nasal spray, which increases the efficacy of this treatment. » Saline solutions used for nasal douching can be home-made or ready-mixed products. While it may be easier to use ready-mixed products to perform the procedure, they can be expensive. A balanced isotonic saline solution made at home using common household ingredients is considered equally safe and effective. Reflective activity 'How to' articles can help update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How you could use this article to enable patients to understand the benefits of nasal douching. 2. How you can support patients to perform nasal douching on a daily basis, to maximise the effectiveness of their treatment.

A study was conducted at vegetable seed Laboratory Institute of Horticultural Sciences, University of Agriculture Faisalabad to investigate the effect of halo and hydro-priming on seed germination and seedling growth of cabbage under saline conditions. Cabbage seeds were primed with five different salts i.e. KNO3, KH2PO4, KCl, NaCl, CaNO3, and water (Hydro-priming) for 2 hours in darkness at 24±1oC temperature. Both primed and unprimed seeds were irrigated with five different saline solutions [0 mM, 50 mM, 100 mM, 150 mM and 200 mM NaCl]. Results showed that priming treatments with KCl, KH2PO4 and KNO3 at different concentrations gave best results in terms of final germination percentage (FGP), time taken to 50 % germination (T50), germination index (GI), mean germination time (MGT) and seedling vigour index (SVI) as compared to unprimed seeds. However, enhanced salinity levels had harmful influence on almost all parameters under study. The present study exposed that under normal and saline conditions all priming treatments mainly KNO3 can be used to increase seed enactment in cabbage. However, further studies are needed to investigate the effects of halo priming on growth and yield of cabbage. Keywords: Cabbage; Germination energy; Halo priming; Salinity http://dx.doi.org/10.19045/bspab.2017.60002

Thoracic endovascular aortic repair (TEVAR) has been shown to lead to increased aortic stiffness. The aim of this study was to investigate the effect of stent graft type and stent graft length on aortic stiffness in a controlled, experimental setting. Methods: Twenty porcine thoracic aortas were connected to a pulsatile mock loop system. Intraluminal pressure was recorded at two sites in order to measure pulse wave velocity (PWV) for each aorta: before stent graft deployment (t1); after deployment of a 100-mm long stent graft (t2); and after distal extension through deployment of a second 100-mm long stent graft (t3). Four different types of stent grafts (Conformable Gore® TAG® Device, Bolton Relay® Device, Cook Zenith Alpha(TM), and Medtronic Valiant®) were evaluated. Results: For the total cohort of 20 aortas, PWV increased by a mean 0.6 m/s or 8.9% of baseline PWV after deployment of a 100-mm proximal stent graft (P

Background In 2007, the Saline versus Albumin Fluid Evaluation—Translation of Research Into Practice Study (SAFE-TRIPS) reported that 0.9% sodium chloride (saline) and hydroxyethyl starch (HES) were the most commonly used resuscitation fluids in intensive care unit (ICU) patients. Evidence has emerged since 2007 that these fluids are associated with adverse patient-centred outcomes. Based on the published evidence since 2007, we sought to determine the current type of fluid resuscitation used in clinical practice and the predictors of fluid choice and determine whether these have changed between 2007 and 2014. Methods In 2014, an international, cross-sectional study was conducted (Fluid-TRIPS) to document current patterns of intravenous resuscitation fluid use and determine factors associated with fluid choice. We examined univariate and multivariate associations between patients and prescriber characteristics, geographical region and fluid type. Additionally, we report secular trends of resuscitation fluid use in a cohort of ICUs that participated in both the 2007 and 2014 studies. Regression analysis were conducted to determine changes in the administration of crystalloid or colloid between 2007 and 2014. Findings In 2014, a total of 426 ICUs in 27 countries participated. Over the 24 hour study day, 1456/6707 (21.7%) patients received resuscitation fluid during 2716 resuscitation episodes. Crystalloids were administered to 1227/1456 (84.3%) patients during 2208/2716 (81.3%) episodes and colloids to 394/1456 (27.1%) patients during 581/2716 (21.4%) episodes. In multivariate analyses, practice significantly varied between geographical regions. Additionally, patients with a traumatic brain injury were less likely to receive colloid when compared to patients with no trauma (adjusted OR 0.24; 95% CI 0.1 to 0.62; p = 0.003). Patients in the ICU for one or more days where more likely to receive colloid compared to patients in the ICU on their admission date (adjusted OR 1.75; 95% CI 1.27 to 2.41; p =

In this work, four ultrafiltration (UF) membranes with molecular weight cut-offs (MWCOs) of 5, 15, 30 and 50 kDa, respectively, were fouled with 1% BSA aqueous solutions and cleaned with different saline solutions. The influence of MWCO, membrane material and operating conditions on the cleaning effi- ciency was investigated. Saline solutions were able to clean the 5, 15 and 30 kDa membranes, but not the 50 kDa membrane. NaCl, NaNO3, NH4Cl and KCl were the most effective salts. The cleaning tests demonstrated that the higher the temperature of the saline solution was, the higher the cleaning efficiency was also. In addition, an increase in the crossflow velocity resulted in an increase in the hydraulic cleaning efficiency (HCE). However, there was an optimum value of salt concentration to clean the membrane effectively. Response Surface Methodology was used to investigate the relationship between salt concentration and temperature in the cleaning process., The authors of this work wish to gratefully acknowledge the financial support from the Spanish Ministry of Science and Innovation through the project CTM2010-20186 and the Generalitat Valenciana through the program "Ayudas para la realizacion de proyectos I+D para grupos de investigacion emergentes GV/2013".