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Objective: To compare the efficacy of standard negative pressure wound therapy with combination of negative pressure wound therapy (NPWT) and instillation of normal saline (NS) in acute traumatic wounds. Study Design: Randomized controlled trial. Place and Duration of Study: CMH Rawalpindi from July to September 2017. Material and Methods: Forty patients of both genders with acute traumatic wounds were included in the study after adequate debridement under appropriate anesthesia. They were divided into two groups by lottery method. In first group i.e. group A, standard negative pressure wound therapy was applied whereas in group B negative pressure wound therapy with instillation of NS was used. Mean number of days required for wound to be ready for the final surgical procedure was calculated for both the groups. Results: Mean age of the patients who participated in the study was 37.98 ± 6.275. The mean time required for the final surgical procedure for conventional group A was 27.4 ± 2.2 days and for group B it was 21.92 ± 3.6 days (p-value

The Pantanal is the most conserved biome in Brazil and among the last wild refuges in South America, but intensification of agriculture and other land use changes present challenges for protecting this exceptionally biodiverse wetland ecosystem. Recent studies have shed new light on the origins and biogeochemistry of a suite of >600 small saline-alkaline lakes in Nhecolândia, a floodplain setting located south of the Taquari River in south-central Pantanal. These soda lakes form a unique aquatic environment in Pantanal and nascent research on their geomicrobiology suggests that their biota may be analogous to early life, and extreme life in Earth's deep biosphere. We argue that the conservation of the soda lakes in the lower Nhecolândia region should be an important strategic component of any conservation plan that aims to mitigate the advance of unsustainable land-use change in the Pantanal. Soda lake conservation has important implications for the carbon cycle, as these landforms sequester carbon dioxide and transmit considerably lower concentrations of methane in comparison to macrophyte-rich freshwater lakes in the region. Further, minerals precipitated in the saline-alkaline lakes are leveraged for cattle consumption, and therefore the continued presence of the lakes is critical for allowing pantaneiro ranchers to pursue certified organic, sustainable beef production systems. Beyond protecting soda lakes and their surrounding forests (mata de cordilheiras) for food systems security, the conservation strategy would also allow further research of little studied extremophile biodiversity and biogeochemistry, with potential for biotechnological innovations attendant to UN Sustainable Development Goals.

Context: During endotracheal intubation, as we aim for smooth induction, smooth extubation is also mandatory. During extubation, coughing, sore throat, hoarseness, and laryngospasm are not desired and have to be prevented. Aims: The aim of the study is to study the effects of inflating the endotracheal tube (ETT) cuff with alkalinized lignocaine (Group L) or dexamethasone (Group D) or saline (Group S) on the emergence phenomena of endotracheal extubation. Settings and Design: Tertiary hospital, randomized double-blinded prospective study. Subjects and Methods: A total of 90 patients undergoing surgery under general anesthesia were randomly allotted into three groups, 30 in each group. After endotracheal intubation, the tube cuff was inflated with alkalinized lignocaine (Group L) or dexamethasone (Group D) or saline (Group S) as per the randomization sequence. At emergence and 1 h after surgery for hemodynamic indices and incidence of postextubation, sore throat, cough, hoarseness, and laryngospasm were assessed. Results: With respect to cough and sore throat, Group L and Group D were significantly better than Group S but the hoarseness was the worst in Group D. Conclusions: Inflating the ETT cuff with alkalinized lignocaine or dexamethasone helped in preventing sore throat and cough to a better extent than saline, the hoarseness, however, being the worst in dexamethasone group.

Interaction between groundwaters with different salinities and lakes show seasonal variations driven by changes in precipitation and evapotranspiration. In the vicinity of Villafáfila lakes, local fresh and brackish regional groundwaters feeds the lakes, forming a brine in the lake sediments aquitard. Two TDEM surveys (summer 2019 and winter 2020) were carried out. Five TDEM soundings were acquired at the same location for each survey, forming a profile from the hills to the lake-shore. Simultaneously to the TDEM surveys, electric conductivity of lake water and groundwater was measured. The resistivity boundary between the local fresh (10–35 Ohm/m) and regional brackish groundwater (2–5 Ohm/m) is well marked at 600 m above sea level (masl) below the hills, and at 650 masl below the lowlands surrounding the lakes. During the summer, fresh-brackish groundwater interphase rises due to evaporative pumping occurring in the lowlands. This increases groundwater salinity close to the terrain surface favoring precipitation of halite efflorescences. Annual record of EC in a piezometer confirms the summer ascendant of the brine contained in the lake aquitard. TDEM sounding is fast and simple technique to monitor seasonal variations in fresh-brackish groundwater interphase and to detect possible salinization of consumption wells and environmental changes.

Parylene is used as encapsulating material for medical devices due to its excellent biocompatibility and insulativity. Its performance as the insulating polymer of implantable neural interfaces has been studied in electrolyte solutions and in vivo. Biological tissue in vitro, as a potential environment for characterization and application, is convenient to access in the fabrication lab of polymer and neural electrodes, but there has been little study investigating the behaviors of Parylene in the tissue in vitro. Here, we investigated the electrochemical impedance behaviors of Parylene C polymer coating both in normal saline and in a chilled pig brain in vitro by performing electrochemical impedance spectroscopy (EIS) measurements of platinum (Pt) wire neural electrodes. The electrochemical impedance at the representative frequencies is discussed, which helps to construct the equivalent circuit model. Statistical analysis of fitted parameters of the equivalent circuit model showed good reliability of Parylene C as an insulating polymer in both electrolyte models. The electrochemical impedance measured in pig brain in vitro shows marked differences from that of saline.

Background. Salinity cause reducing the growth and yield of crops. The application of ameliorants was an alternative to reduce salinity stress and increasing the growth and yield of crops. Objective. To evaluate the response of maize crops with ameliorants application on saline soil. Methodology. The research was conducted in Sidomukti Village District, Brondong Lamongan. The research used split-plot designs with main plots were varieties (P-21 and Bisma) and subplots were ameliorant types (without ameliorant, cow manure, gypsum, Sunhemp (Crotalaria juncea) and rice straw). Results. The application of ameliorants at saline soil reducing salinity stress with increasing the growth and yield of maize. Gypsum and cow manure were appropriate to increase growth and yield of both maize varieties P-21 and Bisma. Gypsum and cow were also increasing the content of Nitrogen, Phosphorus and Potassium of plants, as well as reducing the content of proline, Na and Cl shoot root ratio. Implications. Crops production in saline soil can use ameliorants e.g. cow manure and gypsum. Conclusion. The use of ameliorants such as gypsum or cow manure can increase maize growth and yield in saline soil.

The aggregative stability of nanosized particles of aluminum and magnesium oxides is considered, because they are common components of the environment. Air and water are chosen as the most probable contact media, and saline is chosen as a medium that imitates the internal human environment. It is found that, in all media, aluminum oxide particles have a lower aggregative stability and are more likely to form agglomerates than magnesium oxide particles. Nanosized particles of magnesium oxide and aluminum in the internal media of the human body tend to form nanosized clusters connected through liquid bridges; they are not stable; i.e., nanoscale particles can move in the form of a cluster and, in the medium of the target organ, they disintegrate into particles and act as a nanoscale material. The aggregative stability of nanosized particles is determined by the material of the particles, their size, and the distance between them, while it dynamically changes during the transition from the external environment to the internal environments of the body and at different stages of metabolism, which proves the need to take into account the physical interaction of particles in different environments to assess their toxicity. [ABSTRACT FROM AUTHOR]

With the exception of 0.9% saline, little is known about factors that may contribute to increased serum chloride concentration (S Cl −) in patients undergoing cardiac surgery. For the present study, the authors sought to characterize the association between administered chloride load from intravenous fluid and other perioperative variables, with peak perioperative S Cl −. Secondary analysis of data from a previously published controlled clinical trial in which patients were assigned to a chloride-rich or chloride-limited perioperative fluid strategy (NCT02020538). Academic medical center. The study comprised 1,056 adult patients with normal preoperative S Cl − undergoing cardiac surgery. None Peak perioperative S Cl − and hyperchloremia, defined as peak S Cl − >110 mmol/L, were selected as co-primary endpoints. Regression modeling identified factors independently associated with these endpoints. Mean (standard deviation) peak perioperative S Cl − was 114 (5) mmol/L, and hyperchloremia occurred in 824 (78.0%) of the cohort. In addition to administered volume of 0.9% saline, multivariate linear and logistic regression modeling consistently associated preoperative S Cl − (regression coefficient 0.5; 95% confidence interval [CI] 0.4-0.6 mmol/L; odds ratio 1.60; 95% CI 1.41-1.82 per 1 mmol/L increase) and cardiopulmonary bypass duration (regression coefficient 0.1; 95% CI 0.1-0.2 mmol/L; odds ratio 1.12; 95% CI 1.06-1.19 per 10 minutes) with both co-primary outcomes. Multivariate modeling only explained approximately 50% of variability in peak S Cl −. The present study's data identified an association for both 0.9% saline administration and other nonfluid variables with peak perioperative S Cl − and hyperchloremia. Stand-alone strategies to limit administration of chloride-rich intravenous fluid may have limited ability to prevent hyperchloremia in this setting. [ABSTRACT FROM AUTHOR]

Background: Salinization damages the health of soil systems and reduces crop yields. Responses of microbial communities to salinized soils and their functional maintenance under high salt stress are valuable scientific problems. Meanwhile, the microbial community of the salinized soil in the plateau environment is less understood. Here, we applied metagenomics technology to reveal the structure and function of microorganisms in salinized soil of the Tibetan Plateau. Results: The diversity of composition and function of microbial community in saline soil have changed significantly. The abundances of chemoautotrophic and acidophilic bacteria comprising Rhodanobacter, Acidobacterium, Candidatus Nitrosotalea, and Candidatus Koribacter were significantly higher in saline soil. The potential degradation of organic carbon in the saline soil, as well as the production of NO and N2O via denitrification, and the production of sulfate by sulfur oxidation were significantly higher than the non-saline soil. Both types of soils were rich in genes encoding resistance to environmental stresses (i.e., cold, ultraviolet light, and hypoxia in Tibetan Plateau). The resistance of the soil microbial communities to the saline environment is based on the absorption of K+ as the main mechanism, with cross-protection proteins and absorption buffer molecules as auxiliary mechanisms in our study area. Network analysis showed that functional group comprising chemoautotrophic and acidophilic bacteria had significant positive correlations with electrical conductivity and total sulfur, and significant negative correlations with the total organic carbon, pH, and available nitrogen. The soil moisture, pH, and electrical conductivity are likely to affect the bacterial carbon, nitrogen, and sulfur cycles. Conclusions: These results indicate that the specific environment of the Tibetan Plateau and salinization jointly shape the structure and function of the soil bacterial community, and that the bacterial communities respond to complex and harsh living conditions. In addition, environmental feedback probably exacerbates greenhouse gas emissions and accelerates the reduction in the soil pH. This study will provide insights into the microbial responses to soil salinization and the potential ecological risks in the special plateau environment. [ABSTRACT FROM AUTHOR]

Background: Management of open fractures remains a major clinical challenge because of the higher energy involved in the injury, the greater local trauma, tissue necrosis, and extensive contamination. Even though early surgical debridement was thought to be critical, limited available operative techniques have minimized surgery in favor of early antibiotic administration. No clear agreement on the surgical approach, debridement, or irrigation technique exists. Surgeons continue to argue about the use of various fluids, the appropriate pressure of irrigation, antiseptics, and other factors. The current work reviews the available data and summarizes the capabilities of modern orthopedic irrigation solutions. Methods: To delineate available research on the topic, the PubMed database was queried for the most common techniques, fluid variables, and chemical adjuvants utilized in current open fracture and wound irrigation methodologies. Modes of delivery, volume, pressure, temperature, timing, solution type, and additives are evaluated in the context of known outcomes to determine which solutions may be preferable. Results: Various methods have been described with their own advantages as well as limitations. Particular solutions may apply to specific clinical scenarios, presence of implants, and degree of tissue contamination. Desired irrigation solutions are isotonic, non-toxic, non-hemolytic, transparent, sterilizable, efficient in removing debris and pathogens, as well as affordable; however, no current irrigant achieves all these desired characteristics. Conclusions: Despite being crucial for the healing of open fractures, there is no clear gold standard for irrigation. Although there are some novel irrigation solutions, there has been a paucity of research on finding new, safer, and more effective irrigation solutions that will promote wound healing and reduce infection. [ABSTRACT FROM AUTHOR]

Background: Red ginseng is an herb with many medicinal properties and aids as a mouth rinse with fewer side effects than chlorhexidine. Aim: The study aimed to compare the efficacy of red ginseng herbal mouth rinses with those of chlorhexidine and saline in oral cancer patients. Materials and Methods: The present pilot study was a double-blinded randomized control trial with 45 histopathologically diagnosed oral squamous cell carcinoma patients divided into three groups: two intervention groups (herbal and chlorhexidine mouth rinse) and one control group (saline). Saliva samples for each patient were collected at baseline and after 14 days of using the mouth rinses. A microbiological examination of salivary samples was done by analysing total oral bacterial load along with specific counts for Porphyromonas gingivalis and Fusobacterium nucleatum at baseline and after the usage of mouth rinse. Statistical Analysis: The data normality was analysed using the Shapiro–Wilk test, and following the normal distribution of data, parametric tests were employed. Paired t-test and one-way analysis of variance, followed by post hoc Bonferroni test, were used for inter-group and intra-group differences. Result: There was a significant mean difference in total colony count, Fusobacterium nucleatum, and Porphyromonas gingivalis with oral hygiene index and gingival index improvement in the red ginseng herbal mouth rinse group when compared to the chlorhexidine and saline groups. Conclusion: In this study, red ginseng mouth rinse exhibited an increased antibacterial effect compared to chlorhexidine and saline. Hence, red ginseng mouth rinse can be used in oral cancer patients to maintain oral health, thereby improving the prognosis of these patients. [ABSTRACT FROM AUTHOR]

The Niger Delta is one of the most prolific hydrocarbon provinces in the world, but information on basinal hydrogeology is scanty. Oilfield brines from nine producer wells in the Miocene reservoirs (2,472.25–3,532.48 m.b.s.l.), offshore Niger Delta, have been investigated along with two seawater samples to understand their hydrogeochemical characteristics in relation to the host rock mineralogy. Chemical analysis revealed that the waters are slightly alkaline and can be generally classified as saline water of the Na–Cl type based on their total dissolved solids (TDS). On the basis of bicarbonate, chloride, and sulphate ions, they are shown to be of connate origin. Relative abundance of major ions is in the following order: Na > Ca > Mg > K and Cl > HCO3 > SO4. Saturation indices (SI) of selected mineral phases calculated using PHREEQC indicate that the dissolution of iron oxide and carbonate minerals may contribute major ions in the formation water. The preponderance of alkali elements suggests the presence of feldspars, which could have resulted from sediments through which the water flows. An inverse relationship is observed between the resistivity of formation water and its TDS, which could be used to calculate resistivity values of formation waters in the area if the TDS contributions are known. Chemical data suggest that the formation waters were derived from seawater, dominantly altered by reverse ion-exchange processes and subsequently by water-rock interactions. Multivariate statistical analyses (correlation and factor analysis) indicate multiple sources of enrichment of ions in the formation waters.

Revision surgeries several years after the implantation of the prosthesis are unfavorable from the patient’s point of view as they expose him to additional discomfort, to risk of complications and are expensive. One of the factors responsible for the aseptic loosening of the prosthesis is the gradual degradation of the cement material as a result of working under considerable loads, in an aggressive environment of the human body. Contaminants present in the surgical field may significantly affect the durability of the bone cement and, consequently, of the entire bone-cement-prosthesis system. The paper presents the results of an analysis of selected mechanical properties of two medium-viscosity bone cements DePuy CMW3 Gentamicin and Heraeus Palamed, for the samples contaminated with saline and blood in the range of 1–10%. The results obtained for compressive strength and modulus of elasticity were subjected to statistical analysis, which estimated the nature of changes in these parameters depending on the amount and type of contamination and their statistical significance.

Clinical studies have indicated an association between acute hyperglycemia and poor outcomes in patients with traumatic brain injury (TBI), although optimal blood glucose levels needed to maximize outcomes for these patients' remain under investigation. Previous results from experimental animal models suggest that post-TBI hyperglycemia may be harmful, neutral, or beneficial. The current studies determined the effects of single or multiple episodes of acute hyperglycemia on cerebral glucose metabolism and neuronal injury in a rodent model of unilateral controlled cortical impact (CCI) injury. In Experiment 1, a single episode of hyperglycemia (50% glucose at 2 g/kg, i.p.) initiated immediately after CCI was found to significantly attenuate a TBI-induced depression of glucose metabolism in cerebral cortex (4 of 6 regions) and subcortical regions (2 of 7) as well as to significantly reduce the number of dead/dying neurons in cortex and hippocampus at 24 h post-CCI. Experiment 2 examined effects of more prolonged and intermittent hyperglycemia induced by glucose administrations (2 g/kg, i.p.) at 0, 1, 3 and 6h post-CCI. The latter study also found significantly improved cerebral metabolism (in 3 of 6 cortical and 3 of 7 subcortical regions) and significant neuroprotection in cortex and hippocampus 1 day after CCI and glucose administration. These results indicate that acute episodes of post-TBI hyperglycemia can be beneficial and are consistent with other recent studies showing benefits of providing exogenous energy substrates during periods of increased cerebral metabolic demand.

Degradation of Polysorbate 20 (PS20), a commonly used surfactant in drug product (DP) formulations, is a phenomenon of increasing concern to the biopharmaceutical industry. One of the most prevalent modes of PS20 degradation is enzymatic hydrolysis resulting from co-purified hydrolases that make their way into biologic DP formulations at trace levels. Enzymatic PS20 degradation results in generation of free fatty acids (FFAs) that have limited solubility in aqueous formulations and can form visible and/or sub-visible particles which is undesirable for parenteral DP stability and administration. Many therapeutic monoclonal antibodies are administered intravenously after first diluting the DP into an infusion solution (e.g., 0.9% normal saline, 0.45% half normal saline or 5% dextrose). The purpose of this work is to understand if FFA particles in the DP dissolve in intravenous solutions prior to administration. Our assessment indicates that visible and/or sub-visible particles that contain high levels of lauric, myristic and palmitic acids dissolve immediately upon dilution (at or exceeding two fold) regardless of the intravenous bag or solution type. Therefore, the risk is low of visible and/or sub-visible particles, comprised of FFAs in biopharmaceutical DPs, being intravenously administered to a patient. [ABSTRACT FROM AUTHOR]

Salinity is affecting a large area of Pakistan. The country is situated in a semiarid and arid region where the climate is subtropical continental and the process of salinization and sodification is in progress. Excessive salt rates are adversely influencing the biological, chemical, and physical properties of soils. These physical and chemical changes influence the activity of soil microbes and plant roots, and eventually affect the crop growth and yield. Therefore, it is essential from the food security viewpoint to bring these salt-affected lands into agriculture production for the promptly growing population. The paper provides a brief overview of the different aspects of salt-affected soils regarding their extent, origin, existence, nature, types, causes, characteristics, visual diagnosis, effects on soils and plants, salttolerant plant species, management, strategies adopted in Pakistan to overcome salinity, saline, and bio-saline agriculture. Different issues of salinity can be managed by adopting strategies that are helpful in reclamation of such soils. The overview focuses on chemical and biological amendments as they are the most effective implements in improving various soil properties (soil permeability and structural stability) of saline/sodic soils for sustainable food production, thus, authenticating the potential of inorganic and organic amendments to reinstate soil quality. Salinity effects can be reduced to a higher level by the addition of fertilizers and these amendments may also improve nutrient use efficiency. Other sustainable agronomic practices (crop diversifications, leaching by irrigation water, scraping, etc are also pointed out that may inhibit and, in some cases, reverse the conditions of soil salinization. [ABSTRACT FROM AUTHOR]

Background: Previous study drew different conclusions on significant differences between saline and balanced crystalloid solution infused in critical illness but both showed a statistical difference in the sepsis subgroup. Thus, we will specifically focus on septic patients in this study to compare the effects of saline and balanced solution. We hypothesize that effects of saline on renal outcomes are related to the underline acute kidney injury (AKI) severity and total volumes of infusion.Methods/design: The investigators designed a pragmatic, multi-center parallel controlled trial recruiting 312 patients who are diagnosed with sepsis/septic shock in the intensive care unit (ICU) and will be assigned with either acetate Ringer's solution or saline in the corresponding month. Patients with an end-stage renal disease (ESRD) or who need renal replacement therapy (RRT) prior to or at the time of enrolment are excluded. Enrolled patients will be regarded as with mild, moderate, or severe sepsis on the basis of the severity of their illness and will be divided into subgroups according to their initial renal function and various intravenous infusion volumes when being analyzed. The primary outcome is major adverse kidney events within 28 days (MAKE28), including the composite of in-hospital death, receipt of new renal replacement therapy, or persistent renal dysfunction. Secondary outcomes include 28-day mortality, internal environment disturbance, incidence and duration of vasoactive drug treatment, duration of mechanical ventilation, duration of RRT, and ICU and hospital length of stay.Results and Conclusions: To our knowledge, this study will be the first to focus on septic patients and provide credible and evident data on the comparison of outcome between acetate Ringer's solution and saline for intravenous infusion in adult septic patients on the basis of baseline renal function and infusion volumes taken into consideration.Trial Registration: ClinicalTrials.gov NCT03685214 . Registered on August 15, 2018. [ABSTRACT FROM AUTHOR]

The advent of excimer laser coronary atherectomy (ELCA) nearly four decades ago heralded a novel way to treat complex lesions, both coronary and peripheral, which were previously untraversable and thus untreatable. These complex lesions include heavily calcified lesions, ostial lesions, bifurcation lesions, chronic total occlusions, in-stent restenosis (including stent underexpansion), and degenerative saphenous vein grafts. We discuss the technology of ELCA, its indications, applications, and complications, and suggest the "MAXCon ELCA" technique for better outcomes without increased risk. Lastly, we present a case of MAXCon ELCA effectively treating a complex lesion., (© 2024 Wiley Periodicals LLC.)

Objective: In this experimental study, we aimed to determine whether platelet-rich plasma (PRP) is a suitable preservative for dermo-epidermal grafts. An additional objective was to investigate how long grafts can be stored without biological degradation., Methods: We compared pig skin graft preservation using PRP versus saline solution and crystalloid Custodiol ® , which is used for hypothermic preservation of organs for transplantation. Grafts (10 × 10 mm) were placed on gauze impregnated with one of the tested solutions, and stored for 3, 7, 11, and 15 days at a constant temperature of 4°C. We evaluated a total of 240 pig skin samples: 120 by histopathology and 120 by fluorescence optical microscopy., Results: Overall, Custodiol ® solution appeared to be the best medium for preservation of dermo-epidermal grafts, with beneficial properties manifested on days 7 and 11. Although we expected PRP to be a better preservative than saline, this was not confirmed by our results, as we found no significant difference between these two media. In fact, by day 3, the histopathological results were better with standard saline solution than with PRP. On day 15, with each tested solution, some samples showed histological changes that are incompatible with graft viability., Conclusion: Overall, Custodiol ® appears to be the best medium for dermo-epidermal graft preservation. Moreover, the present findings suggest a maximum graft storage time of 11 days in all of the tested solutions. We do not recommend using grafts stored for 15 days, due to isolated signs of graft biodegradation with all solutions., Competing Interests: None., (IJBT Copyright © 2024.)

Objective: To compare the effect of dextrose prolotherapy (DPT) with saline in the treatment of chronic lateral epicondylopathy (LE). Design: Triple-blinded randomized controlled trial. Setting: Physical medicine and rehabilitation outpatient clinic. Subjects: Sixty cases of chronic LE participants were included in the study. Methods: Participants were randomly divided into two groups as DPT and normal saline. Saline or hypertonic dextrose (15%) was injected at the baseline, and at the end of the 4th and 8th week. Assessments were performed at baseline, and at the end of the 4th, 8th, and 12th week. Outcome measures: Primary outcome measures were Visual Analog Scale (VAS) for pain, Patient Rated Tennis Elbow Evaluation (PRTEE-Total [PRTEE-T], PRTEE-Pain, PRTEE-Function); secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand Score (DASH) and pain-free handgrip strength. Results: Intragroup analysis demonstrated that both groups significantly improved in VAS, PRTEE, DASH scores, and handgrip strength during the study period (p < 0.001, for all outcome measurements in both groups). Intergroup analysis showed that PRTEE-T score changes between baseline-4th and -12th week; VASrest change between baseline and 4th week in the DPT group were significantly higher than the saline group (p = 0.041, p = 0.038, p = 0.013 respectively). There was no significant difference between groups in VAS, DASH scores, and handgrip strength between any time points, in terms of improvement (p > 0.05). Conclusion: Our study results showed that DPT outperformed saline in PRTEE-T score. Although saline seems to be a comparable clinical effect with DPT, further studies comparing the effects of saline injection and DPT are necessary, in chronic LE. [ABSTRACT FROM AUTHOR]

Interim analysis of an open-label randomized controlled trial evaluating nasal irrigations in non-hospitalized patients with coronavirus disease 2019 Keywords: saline; coronavirus; COVID-19; irrigation; nasal EN saline coronavirus COVID-19 irrigation nasal 1325 1328 4 12/09/20 20201201 NES 201201 Response to the coronavirus disease 2019 (COVID-19) pandemic has primarily focused on pharmacologic and medical interventions, including antivirals,1 convalescent sera,2 and vaccinations,3 with each potentially critical in the fight against COVID-19, particularly among high-risk and hospitalized populations. Although the current study provides evidence to suggest that topical saline irrigation can reduce symptom burden in patients with COVID-19, we are not yet able to determine whether irrigations affect viral load and/or shedding. [Extracted from the article]

We propose the nasal administration of calcium-enriched physiological salts as a new hygienic intervention with possible therapeutic application as a response to the rapid and tenacious spread of COVID-19. We test the effectiveness of these salts against viral and bacterial pathogens in animals and humans. We find that aerosol administration of these salts to the airways diminishes the exhalation of the small particles that face masks fail to filter and, in the case of an influenza swine model, completely block airborne transmission of disease. In a study of 10 human volunteers (5 less than 65 years and 5 older than 65 years), we show that delivery of a nasal saline comprising calcium and sodium salts quickly (within 15 min) and durably (up to at least 6 h) diminishes exhaled particles from the human airways. Being predominantly smaller than 1 μm, these particles are below the size effectively filtered by conventional masks. The suppression of exhaled droplets by the nasal delivery of calcium-rich saline with aerosol droplet size of around 10 μm suggests the upper airways as a primary source of bioaerosol generation. The suppression effect is especially pronounced (99%) among those who exhale large numbers of particles. In our study, we found this high-particle exhalation group to correlate with advanced age. We argue for a new hygienic practice of nasal cleansing by a calcium-rich saline aerosol, to complement the washing of hands with ordinary soap, use of a face mask, and social distancing.

Therapeutic monoclonal antibodies (mAbs) are commonly administered to patients through intravenous (IV) infusion, which involves diluting the medication into an infusion solution (e.g., saline and 5% dextrose). Using the wrong diluent can cause product aggregation, which may compromise patient safety. We and others have shown that Herceptin® (trastuzumab) and Avastin® (bevacizumab) undergo rapid aggregation upon mixing with dextrose and human plasma in vitro. In this study, we evaluated the compatibility of a panel of 11 therapeutic mAbs with dextrose or saline and human serum. These mAbs were randomly selected for their distinct formulations and IgG isotypes (IgG1, IgG2, IgG4, and Fc-fusion protein). All the mAbs appeared to be compatible with saline and human serum. However, mAbs that were formulated at acidic pH (≤ 6.5) exclusively formed insoluble aggregates upon mixing with dextrose and serum. Such aggregation was not detected for the mAbs that are at neutral pH (7.2–7.5) or in buffers containing sodium chloride. Mass spectrometric analysis revealed that the insoluble aggregates were composed of mAb molecules and several serum proteins (e.g., complement proteins, apolipoprotein, fibronectin) that are characterized by an isoelectric point of pH 5.4–6.7. At proximate pH to the isoelectric point values, those abundant serum proteins appeared to undergo isoelectric precipitation with mAb molecules. Our observations highlight a potential risk of protein aggregation at the blood-IV interface if a diluent is incompatible with a specific mAb formulation. This information has implications in guiding the design of product formulations and the selection of the right diluent for intravenous infusion of therapeutic mAbs.Abbreviations: ADC: antibody-drug conjugate; D5W: 5% dextrose in water; IM: intramuscular; IV: intravenous; LC-MS/MS: liquid chromatography-tandem mass spectrometry; mAb: monoclonal antibody; SC: subcutaneous; pI: isoelectric point

Objectives: To describe detectable and non-detectable naturally occurring cartilage damage of the equine distal interphalangeal (DIP) joint using plain magnetic resonance (MR) imaging and gadolinium and saline MR arthrography. The second objective was to quantify the sensitivity, specificity and accuracy in detection of cartilage damage.Methods: In a pilot study, the distal limbs of two horses with confirmed osteoarthritis of the DIP joint were imaged with low-field MR. Magnetic resonance images were assessed in consensus by three observers and compared to gross pathological findings. Subsequently, a prospective analytical cross-sectional study design was created to compare pre-contrast MR imaging and saline and gadolinium MR arthrography of isolated equine distal limbs to gross observation findings. Hallmarq® low-field MR (0.27T) scans were performed prior to DIP joint injection, saline/gadolinium post-injection scans were performed at 15 min intervals for 2 h. Joints were inspected and the articular cartilage graded subjectively for cartilage damage (0–3). The presence of detectable or non-detectable cartilage damage on MR images was identified, characterized and recorded in consensus by three observers. Sensitivity, specificity and accuracy in detection of cartilage damage related to gross pathology were calculated.Results: The two clinical cases from the pilot study with confirmed osteoarthritis had full thickness cartilage defects; however, only one of these was correctly identified using low-field MRI. In the prospective study, the majority of naturally occurring cartilage damage could not be identified on plain MR or MR arthrography including extensive partial thickness cartilage erosions. Saline and gadolinium MR arthrography did not improve the detection of cartilage damage. The accuracy of cartilage damage detection was 0.63 with a sensitivity of 0.14 and specificity of 0.92.Clinical Relevance: Both, plain low-field MRI and MR arthrography are not sensitive in detection of naturally occurring cartilage damage of the DIP joint. However, if an abnormal contour is seen in the articular cartilage, cartilage damage is likely to be present.

To assess the application potential of novel biomaterials, their behaviour in model media and upon sterilization should be investigated, as well as the stability related to their storage conditions. Such data are lacking for Mg-substituted HAP (Mg-HAP). Therefore, the changes in the local structure of non-substituted and Mg-HAP after irradiation and immersion in corrected simulated fluid and saline solution for 28 days were followed by electron paramagnetic resonance (EPR) spectroscopy for the first time. To better understand the stability of radical species induced by sterilization, EPR spectra of samples kept for 2 h at temperatures up to 373 K were recorded to provide an insight into the stability of the sample storage conditions by the accelerated aging method. Samples were characterized by PXRD, FTIR, SEM, EDS, AAS and TGA. Results confirmed that irradiation does not induce changes in the composition or the structure of any of the investigated materials. Fading or the complete disappearance of radical signals in the EPR spectra after immersion in both media was accompanied by the disappearance of other phases formed as a minor byproduct in the synthesis of substituted HAP, as confirmed by PXRD and FTIR analysis. Obtained results confirm the great potential of Mg-HAPs for biomedical applications, although closer attention should be given to the processes related to sample storage stability at different temperatures.

Abstract Background The management of childhood intussusception in our sub-region is still via surgical intervention. Currently, the gold standard of treatment is non-operative reduction. We sought to assess the suitability of hydrostatic (saline) reduction of intussusception in children in our institution. Materials and methods A prospective study was conducted between January 2016 and June 2017 in all children with ultrasound confirmed intussusception at a tertiary teaching hospital in Nigeria. All children excluding those with signs of peritonitis, bowel gangrene and intestinal prolapse were selected for ultrasound-guided hydrostatic reduction (USGHR). We allowed a maximum of three attempts at reduction. Results The age range was 3 months to 48 months with a mean of 10.8 ± 9.1 months. Forty percent (N = 18) presented after 24 h of onset of symptoms. The success rate of hydrostatic reduction with saline enema was 84.4% (N = 38). Two (4.4%) perforations occurred during the procedure. Three (7.5%) patients had recurrent intussusception within six months. The duration of symptoms greater than 24 h, age and sex of patients did not influence successful reduction p > 0.05. The duration of admission between those who had successful non-operative reduction and those who subsequently had operative reduction and or resection attained statistical significant difference, p = 0.001. There was no mortality. We achieved a 68% decrease in the operative reduction of intussusception using USGHR as the primary modality of treatment. Conclusion Our study found out that USGHR is a suitable alternative for the treatment of childhood intussusception.

Introduction – Edaphic factors influence the structure and composition of plant communities. The main objective is to identify soil properties associated with the presence of different Limonium species. Methods – We conducted a systematic phytocoenological and edaphic survey over 37 locations across the Balearic archipelago. Canonical Correspondence Analysis was applied to the physicochemical characteristics of soils in which 29 species of Limonium grow. Results – The distribution of Limonium species has a high correlation to specific edaphic factors. The species can be clustered into four major groups. The first group represents species with a high edaphic selectivity – soils characterized by having a high proportion of sand, SO42- and Ca2+. The second group is composed of species with high levels of SAR, OM and SO42- /Cl- ratio. The third group includes species present in soils with a loamy texture, low Ca2+ /Mg2+ ratio and high levels of CO32- and Mg2+. The fourth group includes plants which colonize soils that have a sandy texture, low salinity and high proportion of CO32-. Conclusions – A strong correlation between the distribution of Limonium species and soil characteristics exist. The study contributes to the establishment of foundations for habitat conservation, cultivation and recovery projects for endangered species of Limonium.

Abstract Background Knee osteoarthritis (OA) causes substantial pain, physical dysfunction and impaired quality of life. There is no cure for knee OA, and for some people, the disease may involve progressive symptomatic and structural deterioration over time. Platelet-rich plasma (PRP) is a therapeutic agent that aims to address underlying biological processes responsible for OA pathogenesis. As such, it has the potential to improve both symptoms and joint structure. The aim of this clinical trial is to determine whether a series of injections of PRP into the knee joint will lead to a significantly greater reduction in knee pain, and less loss of medial tibial cartilage volume over 12 months when compared to a series of placebo saline injections in people with knee OA. Methods This will be a two-group, superiority, randomised, participant-, interventionist- and assessor-blinded, placebo-controlled trial. Two hundred and eighty-eight participants aged over 50 years with painful knee OA and mild to moderate structural change on x-ray (Kellgren and Lawrence grade 2 and 3) will be randomly allocated to receive either three PRP injections or three normal saline injections into the knee joint at weekly intervals. The primary outcomes will be 12-month change in average overall knee pain severity (numeric rating scale) and medial tibial cartilage volume (magnetic resonance imaging (MRI)). Secondary outcomes include additional measures of knee pain and other symptoms, function in daily living and sport and recreation, quality of life, participant-perceived global ratings of change, and other MRI structural outcomes including meniscal and cartilage morphology, synovitis, effusion, bone marrow lesions and cartilage defects. A range of additional measures will be recorded, and a separate health economic evaluation will be performed. Discussion The findings from this study will help determine whether PRP improves both clinical and structural knee OA outcomes over 12 months when compared to a series of placebo saline injections. Trial registration Australian New Zealand Clinical Trials Registry reference: ACTRN12617000853347. Prospectively registered 9th of June 2017.

Organic-rich sediments (or ‘sapropels’) are complex organo-mineral matrices that form at the O2-depleted bottom of stagnant water basins. Besides geochemical transformations, slow rate microbially-driven processes underpin the early diagenesis of these sediments. The fossil sapropels found in various marine or lacustrine environments are known as proxies for past climate or hydrological fluctuations. Present-day organic-rich sediments have been described both in fresh (‘gyttja’) and brackish or saline waters mostly in the boreal zones. They are currently used for agricultural or therapeutic purposes. Few saline lakes with significant deposits of modern sapropels are known worldwide. On Romanian territory, saline lakes with substantial organic-rich sediments are found in the Transylvanian Basin (e.g. Ursu Lake, Sovata) and in the South-Eastern part (e.g. the inland, athalassohaline Amara, and the coastal, thalassohaline Techirghiol lakes). The exploration of microbial diversity inhabiting the saline sapropels will improve our current understanding on the processes leading to formation and mineralization of organic-rich sediments of economic value.

The waters that were present on early Mars may have been habitable. Characterising environments analogous to these waters and investigating the viability of their microbes under simulated martian chemical conditions is key to developing hypotheses on this habitability and potential biosignature formation. In this study, we examined the viability of microbes from the Anderton Brine Springs (United Kingdom) under simulated martian chemistries designed to simulate the chemical conditions of water that may have existed during the Hesperian. Associated changes in the fluid chemistries were also tested using inductively coupled plasma-optical emission spectroscopy (ICP-OES). The tested Hesperian fluid chemistries were shown to be habitable, supporting the growth of all of the Anderton Brine Spring isolates. However, inter and intra-generic variation was observed both in the ability of the isolates to tolerate more concentrated fluids and in their impact on the fluid chemistry. Therefore, whilst this study shows microbes from fluctuating brines can survive and grow in simulated martian water chemistry, further investigations are required to further define the potential habitability under past martian conditions.

Aims: The aim of this study was to find and use rhizobacteria able to confer plants advantages to deal with saline conditions. Methods and Results: We isolated 24 different bacterial species from the rhizosphere of halophyte plants growing in Santiago del Estero, Argentina salt flat. Four strains were selected upon their ability to grow in salinity and their biochemical traits associated with plant growth promotion. Next, we tested the adhesion on soybean seeds surface and root colonization with the four selected isolates. Isolate 19 stood out from the rest and was selected for further experiments. This strain showed positive chemotaxis towards soybean root exudates and a remarkable ability to form biofilm both in vitro conditions and on soybean roots. Interestingly, this trait was enhanced in high saline conditions, indicating the extremely adapted nature of the bacterium to high salinity. In addition, this strain positively impacted on seed germination, plant growth and general plant health status also under saline stress. Conclusions: A bacterium isolate with outstanding ability to promote seed germination and plant growth under saline conditions was found. Significance and Impact of the Study: The experimental approach allowed us to find a suitable bacterial candidate for a biofertilizer intended to alleviate saline stress on crops. This would allow the use of soil now considered inadequate for agriculture and thus prevent further advancement of agriculture frontiers into areas of environmental value. [ABSTRACT FROM AUTHOR]

Introduction Increasing demand for an international classification system as a unique communication tool in soil science has caused development of different systems. Like many other countries, Soil Taxonomy and WRB are the most popular soil classification systems in Iran. Genetic and morphologic soil properties are used for soil classification in both systems. However, correlation of the two systems and efforts to harmonize them have been a major concern among soil scientists. Comparing Soil Taxonomy and WRB in gypsiferous and calcareous soils of central Iran, Sarmast et al. (13) reported that WRB using various qualifiers is more effective than Soil Taxonomy. Since no study on soils of Iranshahr and Dalghan Regions located in Sistan and Baloochestan Province has performed and/or no reported data is available, the present research was performed to: 1) study morphological, physical, and chemical soil properties in the area, 2) classify soils based on Soil Taxonomy (2014) and WRB (2015) systems, 3) compare the two systems for soil description in Iranshahr and Dalghan regions as a part of Sistan and Baloochestan Province, central Iran. Material and Methods: The study area starts from Iranshahr (590 m asl) in the center of the province and extends to Dalghan (390 m asl) in west. Alluvial fan, pediment, playa, and hill were among different landforms identified using field studies, topography maps (1:50000), and Google Earth image observations. To cover the maximum soil variations in the area, 10 representative pedons were selected, described, and sampled. Results and Discussions: Calcic, gypsic, anhydritic, argillic, natric, and salic horizons identified after field work and laboratory analysis. Results of the study showed that addition of Yermic Torrifluvent, Yermic Torriorthent, Calcic Gypsiargid, Gypsic Natrsalid, Natric Gypsisalid, Anhydritic Gypsisalid, Anhydritic Calcisalid subgroups to Soil Taxonomy system from one hand, and addition of anhydrite and aquic (for Solonchak reference soil group) qualifiers to WRB system from the other hand, causes a higher correlation and more harmonization between the two classification systems. Meanwhile, the minimum percentage of calcium carbonate equivalent necessary for calcic horizon identification in coarse textured soils including gravel in Soil Taxonomy is also suggested to be added to WRB system. Besides, requirements of salic horizon in WRB system is recommended to be added to Soil Taxonomy. At the same time, soil names in WRB system provide more information and data about soil properties and characteristics in young soils (such as yermic qualifier showing desert pavement) compared to Soil Taxonomy. Soil Taxonomy is not able to properly classify saline soils of arid regions down to subgroup level which is a weak point for this system. That is why newly added Gypsic Natrsalids is suggested for soils with natric, gypsic, and salic horizons in the upper 100 cm of the soil. On the other hand, the requirements of salic horizon in WRB system (the minimum EC content of 15 dS/m and the EC multiplied by the horizon thickness of more and/or equal to 450) are also suggested for Soil Taxonomy. Conclusion: Results of the study for both saline and sodic soils show more capability of WRB system compared to Soil Taxonomy to classify soils. From soil management point of view, natric horizon causes more negative effects compared to salic horizon because Na disperses the soil particles and destroys soil structure and sodic soils need more practices to be improved compared to saline soils. Results for gypsiferous soils also show more capability of WRB system compared to Soil Taxonomy because gypsum content which is important for gypsiferous soils management is properly concerned in WRB system. However, lack of anhydritic horizon in WRB seems to be a weak point for this classification system. That is why it is suggested to be added to WRB (13). Since Soil Taxonomy does not use independent abbreviations for anhydritic horizon compared to gypsic horizon, the Ba and Baa abbreviations are also suggested for Soil Taxonomy to be added. [ABSTRACT FROM AUTHOR]

Background: Lateral epicondylitis, or tennis elbow, is a painful degenerative disorder that commonly occurs in adults between 40 and 60 years of age. Normal saline (NS) injections have been used as placebo through a large number of randomized controlled trials (RCTs) focused on the treatment of lateral epicondylitis. Purpose: This meta-analysis of RCTs aimed to assess the therapeutic effect of NS injections on lateral epicondylitis symptoms and compare results with established minimal clinically important difference criteria. Study Design: Systematic review and meta-analysis. Methods: MEDLINE, Embase, Web of Science, and Scopus databases were searched for clinical trials reporting pain and joint function with the visual analog scale, Patient-Rated Tennis Elbow Evaluation, and Disabilities of the Arm, Shoulder and Hand in patients with lateral epicondylitis. The meta-analysis was conducted with a random effects model and generic inverse variance method. Heterogeneity was tested with the I 2 statistic index. Results: A total of 15 RCTs included in this meta-analysis revealed a significant improvement in pain (mean difference, 3.61 cm [95% CI, 2.29-4.92 cm]; P <.00001; I 2 = 88%; visual analog scale) and function (mean difference, 25.65 [95% CI, 13.30-37.99]; P <.0001; I 2 = 82%; Patient-Rated Tennis Elbow Evaluation / Disabilities of the Arm, Shoulder and Hand) after NS injection (≥6 months). Conclusion: NS injections yielded a statistically significant and clinically meaningful improvement in pain and functional outcomes in patients with lateral epicondylitis. New research should focus on better methods to diminish the potential confounders that could lead to this effect because NS injections could mask the real effect of an active therapeutic intervention in RCT. Registration: CRD42019127547 (PROSPERO). [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate effects of different concentrations (0.5-5%) of Sodium Hypochlorite (NaOCl) solution on healthy tissues, and determine the optimal concentration that does not harm to tissue. Materials and Methods: 30 tibias of 15 male Wistar albino rats were used. The tibias were randomly divided into 5 groups (Salin, 0.5%, 1%, 2.5%, and 5% NaOCl). Tibias were reamed intramedullary, and irrigated with 20 ml of saline or increasing concentrations of (0.5-5%) NaOCl. The tibias were embedded in paraffin and the sections were stained with hematoxylin-eosin. All sections were assessed for edema, acute inflammation, or necrosis according to their density, in bone marrow and soft tissues. Results: Pairwise comparisons revealed that irrigation of tibia with saline or 0.5% NaOCl solutions was not statistically significant in terms of necrosis in the bone marrows (p=0.320). However, irrigation of rat tibia with saline caused less necrosis in the bone marrows compared to high concentrations (1%, 2.5%, and 5%) of NaOCl (saline and 1% NaOCl, p=0.017; saline and 2.5% NaOCl, p=0.0007; saline and 5% NaOCl, p=0.001). Conclusion: As an irrigation solution, the effects of 0.5% NaOCl are similar to those of saline in terms of edema, inflammation, and necrosis. There is a need for evaluation of necrosis for extended periods such as one week or one month by immunohistochemical methods and flow cytometry. [ABSTRACT FROM AUTHOR]

Coastal tropical shallow lagoons are located at the Central Pacific Coast, South America. Standard cyanobacterial and microalgae collections at Puerto Viejo wetland (Grande lagoon, north of the wetland), Lima department with physical -chemical parameters were registered irregularly between 2005 -2010. Planktic natural populations of Rhabdoderma lineare Schmidle et Lauterborn from summer and fall seasons showed cell and colonial morphological variations. R.lineare bloomed in eutrophic saline conditions, associated with the unicellular rodophyte Porphyridium purpureum (Bory) Drew &Ross. They colonized habitats with temperature range of 25 - 33 °C, salinity gradients between 13 - 20 ppt (NaCl), pH range from 8 to 9. Cyanobacterial and rodophyte phenotypic plasticity and, its distributional patterns (planktic and benthic) in the shallow lagoon are related for viable life strategy for successful colonization of coastal lagoons exposed to the annual fluctuating hydrological regime with flooding and desiccation periods. Rhabdoderma lineare y Porphyridium purpureum are new records for Peruvian flora. [ABSTRACT FROM AUTHOR]

Background and Aims: Epidural analgesia is widely used for pain relief but confirmation of accurate epidural placement is poorly understood. We proposed that sensory blockade to cold sensation would predict the accurate placement of epidural. The primary outcome was the assessment of sensory blockade at 5 and 10 min with a standard epidural test dose versus test dose with additional saline. We looked at haemodynamic changes following administration as secondary outcomes. Methods: Following Ethics Committee approval, 161 patients presenting for elective abdominal surgery needing epidural analgesia with general anaesthesia were randomly allocated into Group 1 receiving standard test dose (3 ml of 2% lignocaine with 1:2,00,000 adrenaline) or Group 2 (standard test dose with 6 ml of saline) epidurally. The blockade to cold sensation was assessed at 5 and 10 min. The heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure (MAP) were recorded at baseline, 1, 5, and 10 min following epidural dosing. Statistical analysis was performed with Chi-square test for categorical and Student's t-test for continuous variables. Results: The sensory blockade at 5 min was 69.5% versus 82.3% (P = 0.059), and at 10 min 85.4% versus 97.5% (P = 0.01) in Groups 1 and 2, respectively. The MAP at 5 min (P = 0.032) and the HR and MAP at 10 min (P = 0.015, 0.04) were significantly lower in Group 2. Conclusion: An epidural test dose of 3 ml followed by additional 6 ml saline accurately predicted sensory blockade to cold at 10 min in comparison to the standard dose of 3 ml but was associated with a decrease in the HR and MAP. [ABSTRACT FROM AUTHOR]

There has been a significant rise in the incidence of contrast-associated nephropathy caused by administration of contrast media during cardiac interventions. This is one of the major complications of percutaneous coronary interventions, which may proceed to acute renal failure. Risk factors, including pre-existing renal dysfunction, older age and use of high osmolar contrast media, predispose patients to the development of contrast-associated nephropathy. Different risk-reduction strategies have been used to prevent contrast-associated nephropathy, including use of low osmolar contrast media, N-acetylcysteine, alkalisation of tubular fluid with intravenous sodium bicarbonate, and oral and intravenous hydration with isotonic solution. Hydration using intravenous saline is one of the main treatments used to prevent the development of nephropathy in patients receiving contrast media during cardiac interventions. Prehydration, before administering contrast media, seems to be crucial. The results of studies of the relative efficacy of sodium bicarbonate and/or N-acetylcysteine in reducing the development of contrast-associated nephropathy are not consistent and any beneficial effects may depend on the pre-existing state of the kidney. This review discusses hydration of patients who are at risk of developing contrast-associated nephropathy using intravenous fluid. [ABSTRACT FROM AUTHOR]

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Background: Use of catheter lock solutions (CLSs) as a strategy to prevent catheter‐related bloodstream infections (CRBSIs) has been evaluated in recent clinical trials. Our aim was to identify the most effective CLS formulation in patients receiving home parenteral nutrition (HPN). Methods: We conducted a systematic review and individual‐patient data meta‐analysis (IPDMA). Prospective randomized clinical trials in adult HPN patients using CLS were identified from PubMed, EMBASE, Web of Science, CINAHL, Cochrane library, and ClinicalTrials.gov. Primary outcome was the number of CRBSIs per 1000 catheter days for each CLS. Other outcomes included time to CRBSI and identification of patients with a higher risk for CRBSIs. Results: In total, 1107 studies were screened for eligibility, of which three studies comprising 162 HPN patients and 45,695 catheter days were included in the IPDMA. CRBSI rates were significantly decreased in patients using taurolidine (rate 0.13; 95% confidence interval [CI], 0.05–0.32) when compared with saline (rate 0.74; 95% CI, 0.31–1.74; P =.002) or heparin (rate 2.01; 95% CI, 1.03–3.91; P <.001). The cumulative proportion of CRBSI‐free patients using taurolidine, saline, and heparin after 1 year was 88%, 56%, and 14%, respectively. Three risk factors for CRBSIs were identified: type of CLS, intestinal dysmotility as underlying condition, and use of central venous catheters. Conclusions: Taurolidine was the most effective CLS formulation in HPN patients for the prevention of CRBSIs. We suggest discussing with patients the benefits and risks when starting taurolidine, especially in patients who are considered to have a higher risk for CRBSIs. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy of saline nasal irrigation (S‐NI) and xylitol nasal irrigation (X‐NI) for chronic rhinosinusitis in participants with Gulf War illness (GWI). Methods: This 26 week, 3‐arm (1:1:1) randomized controlled trial examined veterans meeting criteria for GWI with moderate‐to‐severe chronic rhinosinusitis and fatigue symptoms. All participants received standard of care for chronic rhinosinusitis (CRS); additionally, S‐NI or X‐NI participants added twice‐daily NI using 2% saline or 5% xylitol solutions. Outcomes included disease‐specific quality of life (primary; sino‐nasal outcome test [SNOT‐20]; 0‐100 points), overall quality of life (Short‐Form 36), and fatigue (Multidimensional Fatigue Index). Outcome assessors were blind to allocation group. Intention‐to‐treat analysis used repeated measures modeling; statistical significance was evaluated at the two‐sided α level of.05. Results: Randomization (N = 40) produced three similar groups regarding sex (male, 80%), age (53.8 ± 7.8 years), duration (19.8 ± 7.7 years), and illness severity (48.5 ± 12.7 SNOT‐20 points). Age‐ and gender‐adjusted between‐group comparison showed that X‐NI participants, compared with control, reported improved SNOT‐20 scores at 8 weeks (13.5 points, 95% confidence interval [CI] −27.9 to 0.9) and at 26 weeks (15.4 points, 95% CI −30.1 to −0.6). S‐NI participants improved by 13.4 points (95% CI −28.8, 2.1) at 26 weeks compared with control. The improvement in both NI groups approached minimal clinical important difference compared to control for the SNOT‐20 in the general population. Secondary outcomes were not different between groups. Satisfaction in both irrigation groups was high. Conclusions: This randomized controlled trial suggests that NI with saline or xylitol improves chronic sinus symptoms among participants with GWI with improvement scores similar to those in the general population. Level of Evidence: 1b, individual randomized controlled trial. [ABSTRACT FROM AUTHOR]

Purpose of Review: Pediatric and adult chronic rhinosinusitis (CRS) have some similarities but a number of differences. This article reviews the similarities and differences between pediatric and adult CRS. Recent Findings: Rhinosinusitis is an inflammatory disease of the nose and the paranasal sinuses. In adults, inflammation in CRS without polyps (CRSsNP) mainly manifests with T-helper 1 lymphocytes while in CRS with polyps (CRSwNP) manifests with T-helper 2 lymphocytes and eosinophilic inflammation. In children, CRS inflammation manifests with neutrophils, macrophages, and lymphocytes. The associations between the ostiomeatal complex occlusion and CRS are revealed in adults but are not so evident in children. Although the relationship between the CRS and allergic rhinitis is still controversial, recent findings have shown an association between allergen sensitization and a specific group of adults with rhinosinusitis. Intranasal corticosteroids and saline constitute the first-line of medical treatment for both pediatric and adult rhinosinusitis. Low-dose macrolides are used for immunomodulatory activities and beneficial effects to adult patients with CRSsNP were demonstrated by recent meta-analyses. For surgical treatment, adenoidectomy is a key strategy to eradicate mature biofilms in pediatric CRS and effective in treating children with CRS regardless of the adenoid size. Although endoscopic sinus surgery has been proven to improve quality of life outcomes in adult CRS, it should be only considered in the pediatric CRS after failure of adenoidectomy. Summary: Pediatric and adult CRS are different in many aspects, including immunopathogenesis and management. Investigations should be considered in specific cases. After failure of medical treatments, endoscopic sinus surgery is recommended for adults, while adenoidectomy is primarily considered for children. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to evaluate the use of irrigants used in the management of immature non vital permanent teeth by dental students. Materials and Methods: The present study was carried out in the Department of Pediatric and Preventive dentistry. Data was retrospectively collected from the case records of patients from June 2019 to March 2020 at Saveetha Dental College and Hospital. Data was statistically analysed using SPSS version 20.0.Results: A total of 19 patients were included in the study which consisted of 16 males (84.21%) and 3 females (15.78%) The most commonly used irrigant was saline (31.58%) as a sole agent followed by chlorhexidine (10.5%) and sodium hypochlorite (5.3%) saline and EDTA (42.11%) was the most commonly used combination of irrigants compared to EDTA and sodium hypochlorite combination (5.3%) and chlorhexidine, EDTA and saline combination(5.3%).Conclusion: Within the limits of study, saline is most commonly used irrigants for the treatment of immature non vital teeth. Students prefer the use of single irrigants over the use of combination of irrigants. [ABSTRACT FROM AUTHOR]

Summary: Fluid media including sodium chloride 0.9% are used during operative hysteroscopy to provide uterine distension and aid visualisation. Volume overload is a known complication of their use but is usually associated with long procedures or uterine tissue dissection. A previously well 40‐year‐old woman presented for hysteroscopy and evacuation of retained products of conception under general anaesthesia. On emergence, she developed respiratory compromise and a hyperchloraemic metabolic acidosis in keeping with acute pulmonary oedema induced by sodium chloride 0.9% fluid overload. Anaesthetists must remain vigilant during operative procedures using distension media. Additionally, they should be familiar with the clinical and metabolic manifestations consistent with systemic transfusion of such media. [ABSTRACT FROM AUTHOR]

Background: During drilling of bone, which is common in clinical surgeries, heat generation increases local temperature in the drilling site. Transmission of excessive heat to the surrounding bone tissue can cause thermal osteonecrosis. Consequently, it may lead to failure of implants and fixation screws or delay in healing process. Using cooling is a method for limiting temperature elevation. Materials and methods: In this study, through comparing three conditions of drilling without cooling, external cooling with normal saline, and external cooling with OpSite spray, the efficiency of OpSite as coolant is studied. In this regard, 2 drill bit diameters, 3 drilling speeds, and 3 drilling feed-rates are considered as drilling variables in the experiments. Results: For the whole experiments, while cooling with normal saline resulted in lower maximum temperatures than without cooling condition, OpSite had even better results and limited the temperature elevation during drilling of bone efficiently. Conclusion: OpSite spray, which has lower infection risks than normal saline on one hand and lower maximum temperature rise with all combinations of drilling parameters on the other hand, can be considered in clinical surgeries for cooling applications. [ABSTRACT FROM AUTHOR]

Status of mineral nutrient in plant body play an important role in improving its response to any environmental hazard like water stress, salt stress and heavy metal stress etc. Along with other mineral nutrients, potassium has an important task regarding plants endurance under salt stress condition. It is very important for maintaining turgor and membrane potential, balancing osmotic potential, controlling stomatal movement and activating enzymes. Addition of potassium in growing medium improved salinity tolerance in rice, wheat and corn. Results of previous research depicted that high concentration of potassium in plant body greatly reduced the production of reactive oxygen species. With the objective to combat salinity stress in maize a pot study to investigate the effect of K application on the growth and Fe/Zn use efficiency of salt-tolerant and sensitive maize genotypes. In this experiment two maize {Zea mays L.) genotypes, one salinity sensitive and one salinity tolerant (on the basis of study I) were used. Seeds of each cultivar were sterilized in HgCb solution (0.1%) for 10 min and after rinsing these seeds with distilled water they were sown in plastic pots containing well washed gravels. The seedlings were allowed to grow for 15 days. Uniform sized seedlings were transferred to a hydroponic system comprising of plastic tubs filled with Hoagland's nutrient solution (half strength). The treatments in this experiment include different levels of NaCl and potassium. The concentrations of potassium were 1 and 1.5 mM of the Hoagland nutrient solution with 0 or 100 mM NaCl. The salinity treatment was developed by adding sodium chloride (NaCl) to the nutrient solution after four days of transplantation to the hydroponic system. There were four replications of each treatment. The plants were allowed to grow in the treatment solutions for 28 days and at harvest the data regarding root/ shoot lengths, root/shoot fresh and dry weights were recorded. The oven dried shoot samples were analyzed for ion contents including Zn, Fe, Na+ and K+. It was concluded that in saline soil maize yield may improve by the application of K and increase of the concentration in maize grains can improve human nourishment. [ABSTRACT FROM AUTHOR]

Purpose: Compare the diagnostic performance of saline and gadolinium shoulder magnetic resonance arthrograms (MRA) in the detection of labral and rotator cuff injury compared to arthroscopy.Materials and Methods: Consecutive patients who underwent a gadolinium or saline MRA followed by arthroscopy were retrospectively reviewed. The reports were reviewed for injuries. A chi square or Fisher's exact test was performed to compare the MRA and surgery. Kappa values were calculated to correlate diagnosis of tear between MRA and arthroscopy.Results: There were a total of 58 patients included, including 34 gadolinium arthrograms and 24 saline arthrograms. The accuracy of saline MRA was similar compared to gadolinium MRA in the diagnosis of tears of the supraspinatus (accuracy 0.88 vs 0.74, respectively) and infraspinatus (accuracy 0.88 vs 0.65, respectively) tendons and tears of the anterior/anterior inferior, posterior, and superior labrum, (accuracy 0.79 vs 0.76, 0.71 vs 0.62, and 0.58 vs 0.56), and saline vs gadolinium, respectively. Although there was a trend toward overall better saline MRA performance, a statistically significant difference in the accuracy to detect tears was only noted for the infraspinatus tendon. Interobserver agreement for rotator cuff tears was higher for saline than gadolinium MRA.Conclusion: Saline MRA was accurate, with no significant differences compared gadolinium arthrograms in the diagnosis of labral and rotator cuff pathology. Given expense, and the potential additional information provided by fluid sensitive sequences over T1 fat-suppressed sequences, consideration should be given to using saline for shoulder MRAs.Level Of Evidence: Level III, Retrospective Cohort Study. [ABSTRACT FROM AUTHOR]

Decline in Agriculture production due to salinity is one of the key problems in many areas around the globe including Pakistan. Around the globe approximately, 800-million-hectare area is salt affected and it is estimated that up to middle of 21st century, 50 % of the arable land all over the world will be destroyed due to salinization problem. Use of canal water is the only strategy where saline and good quality waters are used in a cyclic manner for leaching down the salts that accumulated during irrigation with saline water. In this manner, salt accumulation does not rise beyond tolerance limit of the crop. Current study was conducted at research area Department of Soil Science, College of Agriculture, University of Sargodha, Pakistan during 2018. The experiment consisted of four treatments replicated four times and randomized complete block design (RCBD) was used to make layout. Treatments were; T1 = canal water (control), T2 = water of EC 2.0 dS/m, T3 = water of EC 3.0 dS/m and T4 = water of EC 4.0 dS/m. Maize was sown as test crop. Pre and post-harvest soil analysis was carried out for different physical and chemical characteristics. Maize fodder biomass, plant height, plant diameter and no. of plants/m² were noted. The observed results showed that irrigation with canal water significantly enhanced the maximum height of maize plants, number of plants/m², stem diameter and fresh weight/total biomass of maize plants. The T2 and T3 produced less yield as compared to T1 but significantly higher to T4. Results of the experiment revealed that growth and yield components of maize were impaired in a negative way with the use of saline water as source of irrigation. [ABSTRACT FROM AUTHOR]