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Abstract: Osmotic dehydration of banana (Musa sapientum, shum.) was optimized with respect to temperature (25–55 °C), salt (0–10 g/100 g) and sucrose (30–60 g/100 g) concentrations through response surface methodology. The solution of Fick’s law for unsteady-state mass transfer in a cylindrical configuration was used to calculate the effective diffusivities of water, sucrose and NaCl. Analyses were conducted in triplicate for moisture, sugar and salt contents. Peleg’s model was used to predict the equilibrium condition, which was shown to be appropriate for water loss and solute uptake. For the above conditions of osmotic dehydration, the effective diffusivity of water was found to be in the range of 5.19–6.47 × 10−10 m2 s−1, the sucrose effective diffusivity between 4.27–6.01 × 10−10 m2 s−1 and that of NaCl between 4.32–5.42 × 10−10 m2 s−1. The working conditions that simultaneously optimize these 3 variables were the temperature of 25 °C with a solution composed of 30 g/100 g of sucrose and 10 g/100 g of sodium chloride. This condition provided values of 4.80 × 10−10 m2 s−1 for effective diffusivity of water, of 3.21 × 10−10 m2 s−1 for effective diffusivity of sucrose and 4.49 × 10−10 m2 s−1 for effective diffusivity of sodium chloride. [ABSTRACT FROM AUTHOR]

False oxygen consumption effect characterized by a decrease of the polarographic sensor readings by the introduction of neutral microadditives into the incubation medium was modeled and tested. These neutral microadditives neither consume oxygen nor cause its consumption by other components of the medium. It is shown that microadditives less than 3% of the volume of incubation medium can cause statistically significant effect of false oxygen consumption more than 4% of the initial oxygen content. The effect can reachmore than 15% at higher volumes of additives. The most important properties of additives enhancing the effect are low oxygen content, low temperature, and low concentration of oxygen salting out components. [ABSTRACT FROM AUTHOR]

Abstract: The interaction between Rnc1, an RNA interactive protein, and a Pmp1 mRNA was investigated by affinity capillary electrophoresis (ACE). Prior to the ACE experiments, the column performances of three capillaries (an untreated fused silica capillary, a polybrene–polyacrylic acid (PB–PAA) double layer coating capillary, and a carboxylated capillary with a covalent modification) were studied with model proteins including ribonuclease B (RNase B) and bovine serum albumin (BSA). Using an untreated fused silica and a PB–PAA double layer coating capillaries, both of the protein peaks were broad and tailing. However, using a carboxylated capillary, the protein peaks were sharp and symmetric, and migration times were repeatable (RSD<0.4%). Further, the proteins in human serum also gave sharp peaks and its repeatability was kept at a high level by pre-treatment of a capillary inner wall with 1M sodium chloride solution before each run. An Rnc1 protein was analyzed by ACE with background electrolytes containing various concentrations of Pmp1 sense mRNA using a carboxylated capillary. Increase in the concentration of the mRNA was found to delay the migration time of the protein. But the migration time of the protein was kept constant with increasing Pmp1 anti-sense mRNA instead of Pmp1 sense mRNA. A straight line (r =0.987) was obtained by plotting 1/(migration time shift) versus 1/(Pmp1 sense mRNA concentration) and the association constant of Rnc1 protein with Pmp1 sense mRNA could be estimated to be 4.15×106 M−1. These results suggest that the association constants of proteins with mRNAs as ligands were easily determined by the proposed method. [ABSTRACT FROM AUTHOR]

The distal convoluted tubule (DCT) reabsorbs 5-10% of filtered Na, and is an important site for regulation of Na balance. Additionally, the amount and composition of the tubular fluid that leaves the DCT affects H and K secretion in more distal nephrin segments. Mutations in five genes whose products are expressed in the DCT demonstrate these points and help to define the mechanisms by which the DCT contributes to control of electrolyte balance and volume. Loss of function mutations in the apical thiazide-sensitive NaCl cotransporter and the basolateral K channel Kir4.1, and activating mutations in the Ca-sensing receptor cause a phenotypically similar salt wasting syndrome. Mutation in two recently identified kinases, WNK1 and WNK4 cause a salt-retaining syndrome through increased apical expression of NaCl cotransporter. Recent studies indicate that these genes are important not only for understanding the physiology of the distal nephron, but that they and others may also contribute to blood pressure variation in the general population. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives:To evaluate total salt intake in the adult population through an analysis of sodium in 24-h urine samples in two regions of Belgium.Methods:Urine samples were collected over 24 h from participants and they had to complete a specific questionnaire about salt intake afterwards. Sodium and creatinine concentrations were analysed in these samples.Subjects:The target population comprised adults aged 45-65 years in the region of Ghent and Liege. A total of 123 and 157 volunteers from Ghent and Liege, respectively, were included in the study.Results:The mean creatinine level in Flanders (n=114) amounted to 0.173±0.035 mmol/kg/day, whereas in the Walloon region (n=135) it amounted to 0.161±0.036 mmol/kg/day, after the exclusion of subjects with incomplete urine collection. Intake of sodium in Flanders (n=114) was 4.29±1.29 g/day, whereas in the Walloon region (n=135) it was 3.94±1.44 g/day. In both regions, sodium intake in men was higher than in women.Conclusion:Salt intake was more or less twice as high as the recommended intake. Salt intake as estimated from 24-h urine collections is substantially higher than that previously calculated on the basis of food consumption data. A salt reduction programme for Belgium is primordial. [ABSTRACT FROM AUTHOR]

Hypertension and type 2 diabetes mellitus (T2DM) are powerful risk factors for cardiovascular disease (CVD) and chronic kidney disease (CKD), both of which are leading causes of morbidity and mortality worldwide. Research into the pathophysiology of CVD and CKD risk factors has identified salt sensitivity and insulin resistance as key elements underlying the relationship between hypertension and T2DM. Excess dietary salt and caloric intake, as commonly found in westernized diets, is linked not only to increased blood pressure, but also to defective insulin sensitivity and impaired glucose homeostasis. In this setting, activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS), as well as increased signaling through the mineralocorticoid receptor (MR), result in increased production of reactive oxygen species and oxidative stress, which in turn contribute to insulin resistance and impaired vascular function. In addition, insulin resistance is not limited to classic insulin-sensitive tissues such as skeletal muscle, but it also affects the cardiovascular system, where it participates in the development of CVD and CKD. Current clinical knowledge points towards an impact of salt restriction, RAAS blockade, and MR antagonism on cardiovascular and renal protection, but also on improved insulin sensitivity and glucose homeostasis. [ABSTRACT FROM AUTHOR]

Objective: Although goitre and cretinism were brought under control in Kyrgyzstan during the 1960s by centrally directed iodized salt supplies, iodine-deficiency disorders (IDD) had made a comeback when the USSR broke up in 1991. Upon independence, Kyrgyzstan started developing its own salt processing industry and by 2001 the Government enacted a law on IDD elimination, mandating universal salt iodization (USI) at 25-55 mg/kg. The present study aimed to evaluate the effectiveness of the USI strategy on the iodine consumption, iodine status and burden of IDD in the population of Kyrgyzstan. Design: A national, population-representative survey during autumn 2007 collected household salt and urine samples of school-age children and pregnant women for quantitative iodine measurements. Thyroid volume was measured by ultrasound. Results: The median iodine content in household salt was 11∙2 mg/kg; 97∙9% of salt samples were iodized, but only 39∙5% had ≥15 mg iodine/kg. The median urinary iodine concentration (UIC) of 114μg/l in children did not differ from the UIC of 111μg/l in pregnant women. Thyroid volume in pregnant women increased with the duration of pregnancy. Strong relationships existed between salt iodine levels and the UIC values in children and women. Conclusions: The iodine nutrition status of the Kyrgyz population is highly responsive to household salt iodization. Although the results in children suggest adequate iodine nutrition, the iodine consumption among pregnant women did not assure their dietary requirements. In-depth analysis of the survey data suggest that excess iodine intake is not likely to become a public health concern in Kyrgyzstan when the salt supply meets agreed standards. [ABSTRACT FROM AUTHOR]

Objective: Evaluation of a dietary Na reduction trial in a community setting. Design: Community-based randomized trial. Ten-week nutrition intervention activities focused on lifestyle modification to decrease dietary Na intake, under the supervision of a registered dietitian. Twenty-four hour urine specimens were collected at baseline and follow-up visits to determine 24 h urinary Na excretion. Setting: The University of Pittsburgh Center for Healthy Aging, Key to Life Nutrition Program. Subjects: Hypertensive adults at least 65 years of age. Results: Mean age of participants was 75 years. Twenty-four hour mean urinary Na excretion at baseline was 3174 mg/d. This reduced to 2944 mg/d (P=0∙30) and 2875 mg/d (P≤0≤03) at 6- and 12-month follow-ups, respectively. In a subsample (urine volume of ≤1000 ml, baseline to 12 months), mean urinary Na excretion decreased from 3220 mg/d to 2875 mg/d (P≤0∙02). Conclusions: Significant reductions in mean 24 h urinary Na were reported, but results fell short of the recommended guidelines of 1500 mg/d for at-risk individuals. Our results reiterate the difficulty in implementing these guidelines in community-based programmes. More aggressive public health efforts, food industry support and health policy changes are needed to decrease Na levels in older adults to the recommended guidelines. [ABSTRACT FROM AUTHOR]

Objective: To measure dietary salt intake in a Swedish population. Design: A cross-sectional study with measured 24 h urinary excretion of Na and K. Completeness of urine collection was assessed using p-aminobenzoic acid. The subjects were interviewed on their habitual food intake. Setting: Sahlgrenska University Hospital, Gothenburg, Sweden. Subjects: Eighty-six young men (age 18-20 years), randomly selected from the population of Gothenburg. Seven men were excluded due to incomplete urine collection. Results: The mean excretion of Na and K over 24 h was 198 and 84 mmol, respectively (corresponding to 11∙5 g NaCl and 3∙3 g K). The mean 24 h excretion in the highest quartile of Na excretion was 297 mmol Na and 105 mmol K, and in the lowest quartile, 100 mmol Na and 68 mmol K. The mean Na:K ratio was 2∙3, and respectively 3∙2 and 1∙8 in the highest and lowest Na excretion quartiles. Calculated energy intake did not differ between the highest and lowest quartiles of Na excretion, but body weight, BMI and the intake of certain foods known to be Na-rich did. Conclusions: Salt intake in young men was alarming high and even subjects in the lowest quartile of Na excretion did not meet present recommendations to limit salt intake to 5-6 g/d. At this point we can only speculate what the consequences of the high salt intake may be for CVD and stroke later in life. Regulation of the salt content in processed and fast food and in snacks is advocated, to curtail the salt burden on society imposed by the food industry. [ABSTRACT FROM AUTHOR]

Low birth weight humans often exhibit hypertension during adulthood. Studying the offspring of rat dams fed a maternal low-protein diet is one model frequently used to study the mechanisms of low birth weight-related hypertension. It remains unclear whether this model replicates key clinical findings of hypertension and increased blood pressure responsiveness to stress or high-salt diet. We measured blood pressure via radiotelemetry in 13-wk-old male offspring of maternal normal- and low-protein dams. Neither group exhibited hypertension at baseline; however, 1 h of restraint was accompanied by a significantly greater blood pressure response in low-protein compared with normal-protein offspring. To enhance the effect of a high-salt diet on blood pressure, normal- and low-protein offspring underwent right uninephrectomy, while controls underwent sham surgery. After 5 weeks on a high-salt diet (4% NaCI), mean arterial pressure in the Low-Protein+Sham offspring was elevated by 6 ± 2 mmHg (P < 0.05 vs. baseline), while it remained unchanged in the normal-protein offspring. In the two uninephrectomized groups, blood pressure increased further, but was of similar magnitude. Glomerular filtration rate in the low-protein uninephrectomized offspring was 50% less than that in normal-protein offspring with intact kidneys. These data indicate that, while male low-protein offspring are not hypertensive during young adulthood, their blood pressure is hyperresponsive to restraint stress and is salt sensitive, and their glomerular filtration rate is more sensitive to hypertension-causing insults. Collectively, these may predispose for the development of hypertension later in life. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Low volume sweat samples are considered unreliable for the diagnosis of cystic fibrosis, based on the assertion that sweat conductivity and chloride are reduced at lower sweating rates. We aimed to re-evaluate the relationship between sweat volume and test results. DESIGN: We reviewed all sweat tests performed in our institution to assess the relationship between sweat volume and conductivity, and between sweat volume and sweat chloride. We also compared results between pairs of sweat tests taken simultaneously from a single patient, one with sweat volume below and the other above the currently accepted minimum volume (15 µl). RESULTS: A weak inverse relationship between sweat volume and sweat conductivity was found (n=1500, R2=0.105, p0.05). In discordant pairs (one below and one exceeding the accepted minimum volume), the mean test result in the low volume sample was slightly higher than its counterpart. In 76 such pairs, mean conductivity was 41.1±14.6 mmol/l in the lower volume sample, compared with 36.8±16.0 mmol/l in the higher volume sample (p<0.001). Similarly, in 33 of the pairs, mean sweat chloride was 28.4±15.7 mmol/l in the lower volume sample compared with 25.1±15.2 mmol/l in the higher volume sample (p=0.004). CONCLUSION: A normal sweat conductivity and/or chloride value from a sweat volume <15 µl in a patient whose clinical symptoms are not very suggestive of cystic fibrosis, renders this diagnosis unlikely. In contrast, elevated sweat chloride or conductivity measured from a sample whose volume is <15 µl may represent an artefact related to the low volume. [ABSTRACT FROM AUTHOR]

The article presents a study that assesses the effect of salt preference on the incidence of gastric cancer in Korean adults through a population-based, prospective cohort study. The study included Korean government employees, school faculty members, and their unemployed dependents. It suggests that salt preference has a marginal positive association with a risk of gastric cancer.

A new, region-based mathematical model of the urine concentrating mechanism of the rat renal inner medulla (IM) was used to investigate the significance of transport and structural properties revealed in recent studies that employed immunohistochemical methods combined with three-dimensional computerized reconstruction. The model simulates preferential interactions among tubules and vessels by representing two concentric regions. The inner region, which represents a collecting duct (CD) cluster, contains CDs, some ascending thin limbs (ATLs), and some ascending vasa recta; the outer region, which represents the intercluster region, contains descending thin limbs, descending vasa recta, remaining ATLs, and additional ascending vasa recta. In the upper portion of the IM, the model predicts that interstitial Na+ and urea concentrations (and osmolality) in the CD clusters differ significantly from those in the intercluster regions: model calculations predict that those CD clusters have higher urea concentrations than the intercluster regions, a finding that is consistent with a concentrating mechanism that depends principally on the mixing of NaCl from ATLs and urea from CDs. In the lower IM, the model predicts that limited or nearly zero water permeability in descending thin limb segments will increase concentrating effectiveness by increasing the rate of solute-free water absorption. The model predicts that high urea permeabilities in the upper portions of ATLs and increased contact areas of longest loop bends with CDs both modestly increase concentrating capability. A surprising finding is that the concentrating capability of this region-based model falls short of the capability of a model IM that has radially homogeneous interstitial fluid at each level but is otherwise analogous to the region-based model. [ABSTRACT FROM AUTHOR]

Simulations conducted in a mathematical model were used to exemplify the hypothesis that elevated solute concentrations and tubular flows at the boundary of the renal outer and inner medullas of rats may contribute to increased urine osmolalities and urine flow rates. Such elevated quantities at that boundary may arise from hyperfiltration and from inner stripe hypertrophy, which are correlated with increased concentrating activity (Bankir L, Kriz W. Kidney mt. 47: 7-24, 1995). The simulations used the region-based model for the rat inner medulla that was presented in the companion study (Layton AT, Pannabecker TL, Dantzler WH, Layton HE. Am J Physiol Renal Physiol 298: F000-F000, 2010). The simulations were suggested by experiments which were conducted in rat by Gamble et al. (Gamble JL, McKhann CF, Butler AM, Tuthill E. Am J Physiol 109: 139-154, 1934) in which the ratio of NaCl to urea in the diet was systematically varied in eight successive 5-day intervals. The simulations predict that changes in boundary conditions at the boundary of the outer and inner medulla, accompanied by plausible modifications in transport properties of the collecting duct system, can significantly increase urine osmolality and flow rate. This hyperfiltration-hypertrophy hypothesis may explain the finding by Gamble et al. that the maximum urine osmolality attained from supplemental feeding of urea and NaCl in the eight intervals depends on NaCl being the initial predominant solute and on urea being the final predominant solute, because urea in sufficient quantity appears to stimulate concentrating activity. More generally, the hypothesis suggests that high osmolalities and urine flow rates may depend, in large part, on adaptive modifications of cortical hemodynamics and on outer medullary structure and not entirely on an extraordinary concentrating capability that is intrinsic to the inner medulla. [ABSTRACT FROM AUTHOR]

Previous studies have shown that in proximal and distal tubule nephron segments, peritubular ANG II stimulates sodium chloride transport. However, ANG II inhibits chloride transport in the medullary thick ascending limb (mTAL). Because ANG II and catecholamines are both stimulated by a decrease in extracellular fluid volume, the purpose of this study was to examine whether there was an interaction between ANG II and catecholamines to mitigate the inhibition in chloride transport by ANG II. In isolated perfused rat mTAL, 10-8 M bath ANG II inhibited transport (from a basal transport rate of 165.6 ± 58.8 to 58.8 ± 29.4 pmol∙mm-1∙min-1 P <0.01). Bath norepinephrine stimulated chloride transport (from a basal transport rate of 298.1 ± 31.7 to 425.2 ± 45.8 pmol∙mm-1∙min-1 P < 0.05) and completely prevented the inhibition in chloride transport by ANG II. The stimulation of chloride transport by norepinephnne was mediated entirely by its β-adrenergic effect; however, both the β- and α-adrenergic agonists isoproterenol and phenylephrine prevent the ANG II-mediated inhibition in chloride transport. In the presence of 10-5 M propranolol, the effect of norepinephrine to prevent the inhibition of chloride transport by ANG II was still present. These data are consistent with an interaction of both α- and β-catecholamines and ANG II on net chloride transport in the mTAL. [ABSTRACT FROM AUTHOR]

Adult Cancer magister make forays into hyposaline estuarine habitats during times of high food abundance. However, as weak osmoregulators, they are poorly equipped to deal with the concurrent demands of osmoregulation and digestion. Therefore, the potential interaction between nutritional status and feeding in a physiologically challenging environment was investigated. Changes in the proportion of crabs feeding, the amount of food consumed, the time spent feeding, and the efficiency with which a meal was consumed were examined in response to the length and severity of hyposaline exposure, and the duration of starvation. Reductions in the (a) number of animals feeding, (b) the amount of food consumed, and (c) the time spent feeding were observed in salinities where C. magister actively osmoregulates the concentration of its internal fluids. Although this reduction in feeding was likely a stress response, the crabs were able evaluate the level of salinity stress: there was a dose-dependent reduction in feeding, and they were able to discriminate between salinities separated by as little as 3.5‰. The likelihood that animals would feed in low salinity increased with starvation. Thus, the aversion to food uptake in physiologically stressful conditions may be overridden by the need to procure nutrients. In the natural environment, we suggest that C. magister are employing an ‘eat and run’ strategy, moving into the estuary, consuming a meal, and retreating to higher salinities to digest. [ABSTRACT FROM AUTHOR]

The article presents a study on the effects of a low-salt diet on urinary calcium excretion in patients with idiopathic calcium nephrolithiasis. Information about the subjects and methods used are offered, along with a discussion on hypercalciura as an important risk factor for the crystallization of calcium oxalate and kidney stones formation. Result of the study reveals that calcium excretion is reduced by a low-salt diet in hypercalciuric stone patients.

The article presents a study which examines the effects of intake of dietary salt on vascular function and blood pressure. Information about the subjects and methods used are offered, along with a discussion on the causal link between excess dietary salt, high blood pressure, and cardiovascular disease. Result of the study reveals a significant increase in vascular function and BP from dietary salt loading in hypertensive people.

Abstract: Successful breastfeeding is predicated on its initial success. Salt appetite during lactation may be relevant to breastfeeding success because sodium is essential for development of foetus and neonate. Here we examined whether maternal salt preference might facilitate breastfeeding. Nursing mothers (n =327) were categorized as high, medium or low salt preferring, and the relationship to persistence of exclusive breastfeeding during the first 25 days postnatal was evaluated. Contrary to expectation, we find that mothers with low salt preference persisted in breastfeeding beyond day 7 postnatal in comparison to mothers with high salt preference, and mothers with high salt preference had the shortest exclusive breastfeeding duration up to postnatal day 25. Awareness of this among health workers and nursing mothers could contribute to successful breastfeeding. [Copyright &y& Elsevier]

Background: This study was developed to establish whether betaine was present in the sweat of females and to determine any correlations with other sweat components. Methods: Sweat patches were placed on eight trained adolescent Highland dancers (age = 13.6 ± 2.3 yr), who then participated in a dance class for 2 hours. Patches were removed, and the sweat recovered via centrifugation. The sweat was subsequently analyzed for betaine, choline, sodium, potassium, chloride, lactate, glucose, urea and ammonia. Results: Betaine was present in the sweat of all subjects (232 ± 84 μmol̇L-1), which is higher than typically found in plasma. The concentration of several sweat components were correlated, in particular betaine with most other measured components. Conclusion: Betaine, an osmoprotectant and methyl donor, is a component of sweat that may be lost from the body in significant amounts. [ABSTRACT FROM AUTHOR]

Background/Aims: Congenital adrenal hyperplasia (CAH) is characterized by adrenal insufficiency with or without salt wasting. It is also accompanied by adrenomedullary hypofunction. The aim of the present study was to investigate adrenomedullary function in patients with CAH due to 21-hydroxylase and 11β-hydroxylase deficiencies and in age-matched normal subjects. Methods: We measured plasma catecholamines (epinephrine and norepinephrine) and urine metanephrine in 44 patients with CAH, 32 due to 21-hydroxylase deficiency (17 patients with the salt-wasting form and 15 patients with the simple virilizing form), and 12 due to 11β-hydroxylase deficiency, and in 25 healthy controls. Results: Plasma epinephrine and urine metanephrine levels were significantly higher in the controls than in patients with CAH (p = 0.02 and p < 0.001, respectively). Plasma norepinephrine levels were significantly lower in the controls than in patients with CAH (p < 0.001). Interestingly, patients with the salt-wasting form had lower norepinephrine levels in comparison to the other subgroups of CAH. Conclusion: Despite the fact that CAH patients have insufficient epinephrine secretion, these patients have the ability to increase compensatory norepinephrine. However, this increase is much lower in patients with the salt-wasting form. These findings need to be confirmed by other studies. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This study examined the association between cigarette smoking and dieting behaviors and trends in that association among US adolescents in grades 9–12 between 1999 and 2007. Youth Risk Behavior Survey datasets were analyzed using the multivariable logistic regression method. The sample size of each survey year ranged from 13,554 to 15,273 with girls representing 49–51% of the sample ( N = 71,854). About 62% of the entire study participants were whites and 14% were blacks. Prevalence estimates of current smoking and corresponding 95% confidence intervals were computed across four comparison groups formed by gender and body weight. Extreme dieting was an independent predictor of smoking. Extreme dieters showed a higher variability of smoking behavior than their peers. The magnitude of the association between smoking and extreme dieting became smaller in recent years among adolescents but remained unchanged among non-overweight girls over that same time period. When adolescent smoking behavior is examined, the intensity of dieting behavior should be considered within its association with other co-occurring unhealthy behaviors. [ABSTRACT FROM AUTHOR]

Although the global incidence of gastric cancer has been decreased dramatically in recent decades, it is the most common cancer in north and northwest Iran. The wide variation in incidence across different geographical areas and higher proportion of cardia cancer are two main characteristics of gastric cancer in Iran. Current investigations indicate that a high prevalence of H.pylori infection, high dietary intake of salt and smoking are the main environmental factors of gastric cancer in Iran. Gastroesophageal reflux disease is another contributing factor in populations with a higher incidence of gastric cardia cancer. While interventions on modifiable environmental risk factors should be considered as the main modality to reduce gastric cancer development, surveillance programs for early detection of cancer in highly selected groups may increase overall survival rates in potential patients in this country. [ABSTRACT FROM AUTHOR]

Excess dietary salt is a well established cause of high blood pressure and vascular disease. National and international bodies recommend a significant reduction in population salt intakes on the basis of strong evidence for health gains that population salt reduction strategies could achieve. The Australian Division of World Action on Salt and Health (AWASH) coordinates the Drop the Salt! campaign in Australia. This aims to reduce the average amount of salt consumed by Australians to six grams per day over five years through three main implementation strategies targeting the food industry, the media and government. This strategy has the potential to achieve a rapid and significant reduction in dietary salt consumption in Australia. With industry and government engagement, this promises to be a highly effective, low cost option for preventing chronic disease. [ABSTRACT FROM AUTHOR]

BackgroundSalt restriction, an important approach for primary and secondary prevention of hypertension, is undermined by unsatisfactory adherence. A salt-restriction study tested the efficacy and safety of a compound ion salt (CISalt) with low sodium content in an animal model and in a community-based population.MethodsIn part 1, 8-week-old male spontaneously hypertensive rats (SHRs) were fed 1% CISalt in the study group and 8% or 1% normal salt (NSalt) in controls (n = 10 each) for 12 weeks. Blood pressure (BP) and urinary electrolytes were measured every 3 weeks. After 12 weeks, collagen deposition in the heart and kidney and the levels of angiotensin II (Ang II) and nitric oxide (NO) in plasma and renal cortex were measured. In part 2, a single-blind, randomized, 6-month controlled trial with CISalt was conducted in 248 persons (age ≥65 years) in 10 rural communities. Plasma renin activity and Ang II were included in blood and urinary measures at baseline and 6 months.ResultsReduced BP urinary protein excretion and reduced collagen in the heart and kidneys were significantly different in animals fed CISalt compared to controls. In human studies, at 6 months, mean systolic BP (SBP) was decreased by 9.6 mm Hg (95% confidence interval (CI): 13.1 to 6.1, P < 0.001) and diastolic BP (DBP) by 5.3 mm Hg (95% CI: 7.9 to 2.6, P < 0.001), respectively, compared to controls; urinary sodium excretion also decreased by 67.4 mmol/24 h (95% CI: 84.8 to 50.0, P < 0.001), and plasma renin activity was slightly increased by 0.19 ng/ml/h (95% CI: 0.04–0.33, P = 0.013). No adverse cardiovascular events were reported.ConclusionsIn these studies, CISalt lowered BP and showed end-organ protection in hypertensive animals and BP reduction in humans. CISalt appears to be a safe and acceptable strategy to reduce BP.American Journal of Hypertension 2009; doi 10.1038/ajh.2009.135American Journal of Hypertension 2009; 22, 9, 934–942. doi:10.1038/ajh.2009.135 [ABSTRACT FROM AUTHOR]

BACKGROUND: Primary aldosteronism (PA) is the most common form of secondary hypertension, while Gitelman's syndrome (GS) is the most common inherited renal tubular disease. However, coexistence of these two diseases has never been previously reported. AIM AND SUBJECTS: The aim of our study was to describe the association of GS and PA in two unrelated patients and compare their clinical presentation with a group of patients with GS. METHODS: Ten subjects suspected to have only GS were assigned to the control group. Saline infusion test was used to confirm the diagnosis of PA. GS was confirmed by sequencing of the causal genes (SLC12A3 and CLCNKB) and functional analyses in Xenopus laevis oocytes. RESULTS: Confirmatory tests, gene analysis, and functional studies demonstrated the coexistence of GS and PA in both patients. In total, nine novel SLC12A3 gene variants, including seven missense mutations, one splice mutation, and one frameshift deletion, were found in 12 subjects. Four mutations (p.T60M, p.T304M, p.T465P, and p.N611T) harbored by the two patients with both PA and GS were revealed to be loss-of-function variants. Although both patients were normotensive, neither of them had normal nocturnal dip. CONCLUSIONS: Two rare diseases GS and PA may occasionally coexist in one subject. In these patients, salt depletion and volume constriction might explain the absence of hypertension normally seen in PA patients. However, the protective mechanism against hypertension via down-regulation of renal sodium handling was probably not sufficient in those patients, since their normal circadian rhythm of blood pressure was disrupted. [ABSTRACT FROM AUTHOR]

The article focuses on the efficacy of decreasing salt intake to prevent high blood pressure. It mentions that there will be an increase in the prevalence of coronary heart disease, heart failure, kidney failure and strokes should there be a neglect for hypertension treatment. Several adverse effects of salt are cited which include the elevation of blood pressure and the development of left ventricular hypertrophy. Several strategies in educating the public about the benefits of salt-restricted diet are discussed, one of which is counselling.

Abstract: Proteins aggregated into spherulite structures of amyloid fibrils have been observed in patients with certain brain diseases such as Alzheimer''s and Parkinson''s. The conditions under which these protein spherulites form and grow are not currently known. In order to illuminate the role of environmental factors on protein spherulites, this research aims to explore the kinetics and mechanisms of spherulite formation and growth, as monitored by optical microscopy, in a range of salt concentrations, and initial protein concentrations for two model proteins: bovine β-lactoglobulin and insulin. These two proteins are significantly different in their size and fibril growth rate, but both of these proteins have been shown previously to form amyloid fibrils and spherulites under low pH conditions. The growth pattern of spherulites in each protein solution was monitored and quantified using a linear polymerisation reaction model which allowed for quantification of formation and growth rates across experiments. Two themes were found in the experimental results of spherulite formation and growth: the two model protein systems behaved very similarly to one another when viewed on relative scales, and the spherulites in these systems followed trends seen in some of the previous research of amyloid fibril growth. Specifically, in the presence of salt, both β-lactoglobulin and insulin systems demonstrated maximum growth rates at the same salt concentration, possibly suggesting the role that salt plays in altering rates may not be protein specific (e.g. anion binding to aid unfolding), but may be generic (e.g. electrostatic shielding of repelling charges). Specifically, with variations in the initial protein concentrations, spherulite trends across both model systems were a decrease in appearance time (faster appearance) and an increased growth rate as concentration increased. The appearance time decreased at a diminishing rate towards a limiting shortest appearance time. A limiting shortest appearance time suggests that, in the higher concentrations of protein tested, spherulite formation is not dependent upon the spatial concentration of protein but on the preparedness of the protein to form or join the spherulite. [Copyright &y& Elsevier]

There is a 1-4 mmol/L rise in plasma sodium concentrations in individuals with high salt intake and in patients with essential hypertension. In this study, we used 3 independent assays to determine whether such a small increase in sodium concentrations per so alters endothelial nitric oxide synthase (eNOS) function and contributes to hypertension. By directly measuring NOS activity in living bovine aortic endothelial cells, we demonstrated that a 5-mmol/L increase in salt concentration (from 137 to 142 mmol/L) caused a 25% decrease in NOS activity. Importantly, the decrease in NOS activity was in a salt concentration-dependent manner. The NOS activity was decreased by 25, 45, and 70%, with the increase of 5, 10, and 20 mmol/L of NaCI, respectively. Using Chinese hamster ovary cells stably expressing eNOS, we confirmed the inhibitory effects of salt on eNOS activity. The eNOS activity was unaffected in the presence of equal milliosmol of mannitol, which excludes an osmotic effect. Using an ex vivo aortic angiogenesis assay, we demonstrated that salt attenuated the nitric oxide (NO)-dependent proliferation of endothelial cells. By directly monitoring blood pressure changes in response to salt infusion, we found that in vivo infusion of salt induced an acute increase in blood pressure in a salt concentration-dependent manner. In conclusion, our findings demonstrated that eNOS is sensitive to changes in salt concentration. A 5-mmol/L rise in salt concentration, within the range observed in essential hypertension patients or in individuals with high salt intake, could significantly suppress eNOS activity. This salt-induced reduction in NO generation in endothelial cells may contribute to the development of hypertension. [ABSTRACT FROM AUTHOR]

The article discusses the impact of salt reduction on vascular function that measure by brachial artery flow-mediated dilatation (FMD) in human. It highlights the benefit of salt reduction which help improve endothelium-dependant vasodilation in resting clinic blood pressure. It cites the comparison between low-salt diet and usual-salt diet for a weight-stable setting in FMD.

Total body sodium and arterial blood pressure (ABP) are mutually dependent variables regulated by complex control systems. This review addresses the role of ABP in the normal control of sodium excretion (NaEx), and the physiological control of renin secretion. NaEx is a pivotal determinant of ABP, and under experimental conditions, ABP is a powerful, independent controller of NaEx. Blood volume is a function of dietary salt intake; however, ABP is not, at least not in steady states. A transient increase in ABP after a step-up in sodium intake could provide a causal relationship between ABP and the regulation of NaEx via a hypothetical integrative control system. However, recent data show that subtle sodium loading (simulating salty meals) causes robust natriuresis without changes in ABP. Changes in ABP are not necessary for natriuresis. Normal sodium excretion is not regulated by pressure. Plasma renin is log-linearly related to salt intake, and normally, decreases in renin secretion are a precondition of natriuresis after increases in total body sodium. Renin secretion is controlled by renal ABP, renal nerve activity and the tubular chloride concentrations at the macula densa (MD). Renal nerve activity is related to blood volume, also at constant ABP, and elevates renin secretion by means of β1-adrenoceptors. Recent results indicate that renal denervation reduces ABP and renin activity, and that sodium loading may decrease renin without changes in ABP, glomerular filtration rate or β1-mediated nerve activity. The latter indicates an essential role of the MD mechanism and/or a fourth mediator of the physiological control of renin secretion. [ABSTRACT FROM AUTHOR]

Prescribing "salt restriction" for patients with salt-related health problems--using diets measuring sodium content and portion sizes--has been notoriously unpopular and unreliable, and the only therapeutic alternative has been to prescribe diuretics. This article reports a new observation that total salt intake is low enough (sodium < 5 0 mmol/day) to be more effective and less troublesome than diuretics in people who follow the Australian dietary guideline to choose foods low in salt while using the definition of low salt foods in the Australia New Zealand Food Standards Code (Na ≤120 mg/100g). Low salt foods--eaten exclusively during human evolution--can usually abolish the severe vertigo of Meniere's disorder as the sole treatment, and reverse the universal rise of blood pressure with age, preventing hypertension. This simple prescription for better food (a healthier salt intake) enables health professionals to obtain measurable and permanent clinical improvement in motivated patients. The full public health potential of better food will require a long period of gradual reform in food processing and the evolution of a new cuisine. Shoppers must know what they are buying, and Australia needs Britain's traffic light labels that identify low salt foods at a glance with green lights for salt. [ABSTRACT FROM AUTHOR]

The article presents a randomized, double-blind, controlled trial of the efficacy of dual fortification of salt with iodine and iron. Subjects and methods used are offered, highlights the two contrasting formulas proposed to measure the efficacy of dual-fortified salt (DFS). Result of the trial reveals that the prevalence of anemia and iron deficiency in school-age children can be reduced by DFS, suggesting to take into consideration local salt characteristics when choosing an iron fortificant.

Abstract  Progressive familial intrahepatic cholestasis (PFIC) is a cholestatic liver disease of childhood. Pruritus secondary to increased bile salts in the serum may not respond to medical treatment. Partial external biliary diversion (PEBD), which reduces the serum bile salt level in the enterohepatic cycle, is used in the treatment of this symptom. In this study, our experience in performing this technique and the early promising results of PEBD in two children with PFIC are reported along with a review of the current literature. Partial external biliary diversion was performed by interposing a 15-cm jejunum between the gallbladder and abdominal wall. Biliary drainage through a stoma began in the fi rst postoperative day and reached 120–200 ml/day. Pruritus improved and then stopped on the 15th postoperative day, while the serum bile acid concentration also decreased. Partial external biliary diversion by jejunal interposition provides an excellent control of pruritus in children with PFIC with no adverse effects. A cholecystectomy should therefore be avoided in patients with PFIC. [ABSTRACT FROM AUTHOR]

An increase in angiotensin II (ANG II) under conditions of high salt intake can result in renal damage. The extent to which ANG II does this directly or by way of stimulating aldosterone (Aldo) secretion is a subject of some debate. In the present study, we sought to determine the separate effects of Aldo and ANG II on the expression of plasminogen activator inhibitor-1 (PAI-1) and other factors related to renal fibrosis in the stroke-prone spontaneously hypertensive rat (SHRSP). Saline-drinking male SHRSPs underwent adrenalectomy (ADX) or sham operation (Sham). Treatment groups consisted of ADX + ANG II (25 ng/min sc) and ADX + Aldo (40 µg·kg-1µday-1 sc). After 2 wk of treatment, circulating Aldo levels were reduced to the limit of detection, renal PAT-1, transforming growth factor-β1 (TGF-β1), and osteopontin expression, and phospho-Smad2 (p-Smad2) level were decreased severalfold, and Smad7 (an inhibitory regulator of TGF-β1 action) expression was increased in ADX compared with Sham rats. Infusion of Aldo into ADX SHRSPs restored the renal mRNA expression of PAI-1, TGF-β1 (along with restored p-Smad2 level), and osteopontin and reduced that of Smad7, whereas ANG II had no or a lesser effect. The findings were confirmed by histological examination of renal tissue. In summary, in the saline-drinking SHRSP, Aldo increased renal profibrotic factors and produced renal injury whereas ANG II in the absence of the adrenals had no effect. [ABSTRACT FROM AUTHOR]

Objective: High dietary salt has been demonstrated to inhibit angiogenesis in skeletal muscle. The purpose of this study was to determine whether high salt impairs steady state muscle performance following a chronic stimulation protocol. Methods: Sprague-Dawley rats were placed on a control diet (CD, 0.4% NaCl) or high salt diet (HSD, 4.0% NaCl) prior to implantation of an electrical muscle stimulator. In chronically stimulated animals, hind limb muscles were stimulated to contract eight hours daily for seven days. Sham animals received a stimulator that was never activated. Results: Following chronic stimulation, tibialis anterior (TA) muscles of animals on CD demonstrated an 84.6% increase in force of contraction at the end of an acute stimulation bout relative to sham animals fed CD. Decreased muscle fatigue was associated with an increase in capillaries per TA fiber (C:F). Chronic stimulation in HSD rats induced a smaller improvement (52.2%) in final force compared to HSD sham rats. This impairment of muscle performance in high salt-fed rats correlated with inhibited angiogenesis. Infusion of angiotensin II in HSD animals restored angiogenesis and muscle fatigue to CD levels. Conclusions: This study suggests that angiogenic inhibition by high salt is associated with impaired skeletal muscle performance following chronic stimulation. [ABSTRACT FROM AUTHOR]

This study examined the responses of Eucalyptus camaldulensis seedlings to water stress and fertilization. To assess the effects of fertilization on osmotic adjustment under water stress conditions, 4-month-old E. camaldulensis plants were raised in pots and fertilized with either nitrogen (2 g of urea) or phosphorus (12 g of triple superphosphate). The soil was watered to attain one of the two conditions: field capacity and osmotic potential. Solute accumulation increased under the influence of P fertilizer in well-watered conditions, which indicates better performance under water stress. However, under water-stress conditions, control plants increased dry mass allocation to leaves but decreased allocation to roots. Water use efficiency, i.e. the grams of water transpired per gram of dry mass accumulated, was not altered by fertilization or water stress. N-fertilized plants increased allocation to roots and maintained allocation to leaves under water-stress conditions in comparison with control plants. They were not affected by water stress as much as P-fertilized plants. Osmotic adjustment was observed only in P-fertilized and control plants. Osmotic adjustment in water-stressed plants was associated with increased stomatal conductance. Water stress strategies were altered by fertilization and water availability. [ABSTRACT FROM AUTHOR]

Adult rats submitted to perinatal salt overload presented renin-angiotensin system (RAS) functional disturbances. The RAS contributes to the renal development and renal damage in a 5/6 nephrectomy model. The aim of the present study was to analyze the renal structure and function of offspring from dams that received a high-salt intake during pregnancy and lactation. We also evaluated the influence of the prenatal high-salt intake on the evolution of 5/6 nephrectomy in adult rats. A total of 111 sixty-day-old rat pups from dams that received saline or water during pregnancy and lactation were submitted to 5/6 nephrectomy (nephrectomized) or to a sham operation (sham). The animals were killed 120 days after surgery, and the kidneys were removed for immunohistochemical and histological analysis. Systolic blood pressure (SBP), albuminuria, and glomerular filtration rate (GFR) were evaluated. Increased SBP, albuminuria, and decreased GFR were observed in the rats from dams submitted to high-sodium intake before surgery. However, there was no difference in these parameters between the groups after the 5/6 nephrectomy. The scores for tubulointerstitial lesions and glomerulosclerosis were higher in the rats from the sham saline group compared to the same age control rats, but there was no difference in the histological findings between the groups of nephrectomized rats. In conclusion, our data showed that the high-salt intake during pregnancy and lactation in rats leads to structural changes in the kidney of adult offspring. However, the progression of the renal lesions after 5/6 nephrectomy was similar in both groups. [ABSTRACT FROM AUTHOR]

Many regulatory and professional organizations are calling for strict new regulations to reduce sodium consumption on a population basis. New regulations on sodium may have significant public health and economic impacts. This article explores five regulatory options to reduce sodium consumption: 1) maintaining the status quo, 2) improving risk communication and information, 3) revoking generally regarded as safe status of sodium and regulating its use in food products, 4) establishing a sodium tax, and 5) establishing a market-based, cap-and-trade system for sodium that builds on similar approaches in environmental regulatory policy. Cap-and-trade may be a promising regulatory option for sodium and other ingredients. [ABSTRACT FROM AUTHOR]

This paper provides a review of the mid-term evaluation of "Health Japan 21" and discusses the status of progress towards the goals of items within the "Nutrition and diet" area. Among 14 items investigated, an improving trend was observed in eight items, though there was no improvement in five items. Whilst the percentage of obese individuals significantly increased during the 25 years from 1976 to 1999, secular trend showed that it has become unchanged since 2000, when "Health Japan 21" was enacted, regardless of gender and age. Another favorable finding was a decreasing trend of salt intake especially in the age group of 50-59 years. Besides, the analyses of the proportion of the persons "who have interest in dietary improvement" among the ones "who believe there are problems in their diet" showed that an increased awareness of inappropriate diet and also in the motivation to improve it, especially among males aged 50-59 years. On the other hand, some items showed worsening trend; e.g. decrease in vegetable intake, decrease of persons who are aware of their own optimal weight and practice weight control. Thus, the progress within Health Japan 21 was assessed as not necessarily satisfactory. In order to ensure the progress of "Health Japan 21" towards 2010, it is now crucial to effectively incorporate "Japanese Food Guide Spinning Top" and a new strategy of non-communicable diseases prevention focusing on the control of metabolic syndrome, which will be launched in April 2008, into the national health promotion program. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that the airways of cystic fibrosis (CF) patients have elevated sodium chloride (NaCl) levels due to the malfunctioning of the CF transmembrane conductance regulator protein. For bacteria to survive in this high-salt environment, they must adjust by altering the regulation of gene expression. Among the different bacteria inhabiting the airways of CF patients is the opportunistic pathogen Burkholderia cenocepacia. Previous studies have indicated that B. cenocepacia produces a toxin and cable pili under high osmolar conditions. We used transposon mutagenesis to identify NaCl-regulated genes in the clinical strain B. cenocepacia K56-2. Six transconjugants were induced with increasing NaCl concentration. The DNA flanking the transposon was sequenced and five distinct open reading frames were identified encoding the following putative proteins: an integrase, an NAD-dependent deacetylase, TolB, an oxidoreductase, and a novel hypothetical protein. The collective results of this study provide important information about the physiology of B. cenocepacia when faced with osmotic stress and suggest the identity of significant virulence mechanisms in this opportunistic pathogen. [ABSTRACT FROM AUTHOR]

Background: In Rajasthan, an Indian State with significant salt production, the sale of non-iodized salt for human consumption was banned in 1992. This study explored the relationships between the use of iodized salt in Rajasthan and the iodine status of children and pregnant women living in the area. Methods: In a State-wide survey, 30 clusters were selected proportionate-to-population-size and 40 school children, 6 -12 years old, were enrolled by random house-to-house visits in each cluster. Twelve pregnant women from the same households were also sampled. Salt used for cooking and a casual urine sample from each child and pregnant woman were collected. The salt iodine content was measured by titration and the urinary iodine concentration (UIC) by a quality-assured colorimetric method. Results: Salt iodine content was ≥15mg/kg in 41.9% of the households, and 23.0% used non-iodized salt. Median UIC was 139μg/L in children and 127μg/L in pregnant women. In households using non-iodized salt, the median UIC's were 96μg/L and 100μg/L in children and women, respectively. Disaggregating the UIC distributions by salt iodine levels revealed a consistent, step-wise pattern of UIC in children with increasing salt iodine content. A similar but less steep pattern was observed in pregnant women. The iodine status of both children and pregnant women attained the optimal range only when the salt iodine content was close to 30mg/kg. Conclusion: For optimum iodine status in the population of Rajasthan, the iodization of household salt should be mandated at a higher level than what is practiced at present. [ABSTRACT FROM AUTHOR]

The proximal tubule reabsorbs two thirds of the filtered NaCl in an isoosmotic fashion. In the adult proximal tubule, active NaCl transport is mediated by the parallel operation of Na+/H+ and Cl−/base exchangers, and a substantive amount of chloride transport occurs passively across the paracellular pathway. Studies in the neonatal proximal tubule have resulted in unexpected results. The isoform of the Na+/H+ exchanger mediating proximal tubule sodium absorption, NHE3, is virtually absent in the neonatal rat kidney. NHE8, an isoform of the Na+/H+ exchange, in low abundance on the apical membrane of the adult proximal tubule, is present in high abundance in the neonatal segment. Whereas chloride permeability is high in the adult, favoring passive paracellular chloride flux, the neonatal proximal tubule is virtually impermeable to chloride ions. This is again due to a developmental change in isoforms of proteins forming the tight junction. The permeability properties of epithelia are due to a family of tight junction proteins called claudins. Claudins 6 and 9 are expressed in the neonatal proximal tubule at a time when chloride permeability is low, but these claudin isoforms are virtually absent in the adult segment. The causes for these postnatal changes in proximal tubular transport and developmental isoform changes are also discussed in this review. [ABSTRACT FROM AUTHOR]

Research Question: What is the situation of iodine deficiency disorder (IDD) and salt consumption in Jammu region? Hypothesis: The prevalence of IDD has decreased markedly as a result of medical as well as socio-economic factors. Objective: To assess the magnitude of IDD in Jammu region and also assess the salt consumption patterns in the region. Design: Cross-sectional study. Setting: Primary schools in both urban and rural areas. Study Tools: Clinical examination of study population for goiter, laboratory assessment of casual urine sample for urinary iodine estimation of I2 content of salt samples collected from sub-samples of study population. Participants: School children in the age group of 6-12 years were selected for study using WHO 30-cluster methodology, urine samples were collected from 15% of selected children and salt samples from 5% of sub-sample. Ethical Concern: No ethical issues were involved. Results: An overall goiter prevalence of 11.98% was observed in the region. Females had a prevalence of 16.1% and males 10.1%. The median urinary iodine excretion in the region was 96.5 µg/l (range: 29.0-190.0 µg/l). Forty-nine percent of subjects had biochemical iodine deficiency with 6.7% having moderate and 42.53% mild iodine deficiency. In Jammu region, 74.47% of households consume powdered salt with 98.17% powdered salt samples having an I2 content of greater than 15 ppm. Conclusion: Iodine deficiency remains a public health problem in the region, though the region seems to be in a state of nutritional transition from iodine deficiency to iodine sufficiency. [ABSTRACT FROM AUTHOR]

This study determined the contribution of chronic salt loading and early loss of ovarian hormones on diastolic function in the hypertensive female mRen(2).Lewis rat, a monogenetic strain that expresses the mouse renin-2 gene in various tissues. Estrogen-intact mRen2 rats fed a high salt (HS) (8% sodium chloride) diet exhibited early diastolic dysfunction when compared to normal salt-fed (NS) (1% sodium chloride) rats. In contrast, ovariectomized (OVX) rats on either NS or HS diets showed impaired relaxation with evidence of elevated left ventricular filling pressures (E/e') or pseudonormalization. This more advanced stage of diastolic dysfunction was associated with increases in interstitial cardiac fibrosis and high circulating levels of aldosterone, two factors leading to reduced ventricular compliance. These findings may explain the preponderance of diastolic dysfunction and diastolic heart failure in postmenopausal women and provide a potential animal model for evaluating prevention and treatment interventions for this disorder. [ABSTRACT FROM AUTHOR]

Background: Postoperative deaths and neurological injury have resulted from hyponatraemia associated with the use of hypotonic saline solutions following surgery. We aimed to determine the rates and types of intravenous fluids being prescribed postoperatively for children in the UK. Methods: A questionnaire was sent to members of the British Association of Paediatric Surgeons (BAPS) and Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) based at UK paediatric centres. Respondents were asked to prescribe postoperative fluids for scenarios involving children of different ages. The study period was between May 2006 and November 2006. Results: The most frequently used solution was sodium chloride 0.45% with glucose 5% although one quarter of respondents still used sodium chloride 0.18% with glucose 4%. Isotonic fluids were used by 41% of anaesthetists and 9.8% of surgeons for the older child, but fewer for infants. Standard maintenance rates or greater were prescribed by over 80% of respondents. Conclusion: Most doctors said they would prescribe hypotonic fluids at volumes equal to or greater than traditional maintenance rates at the time of the survey. A survey to describe practice since publication of National Patient Safety Agency (NPSA) recommendations is required. [ABSTRACT FROM AUTHOR]