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Evaluation of continuous constant current and continuous pulsed current in sweat induction for cystic fibrosis diagnosis.
Gomez, CCS, Marson, FAL, Servidoni, MF, Ribeiro, AF, Ribeiro, MÂGO, Gama, VAL, Costa, ET, Ribeiro, JD, Vieira Junior, FU
BMC pulmonary medicine. 2018;(1):153
Abstract
BACKGROUND The sweat test (ST) is the gold standard for the diagnosis of cystic fibrosis (CF). However, little is known about sweat induction using different types of currents and waves. In this context, our objective was to develop a device to induce sweat and compare the use of continuous constant current (CCC) and continuous pulsed current (CPC) in individuals with CF and healthy controls. METHODS A prospective cross-sectional study with experimental intervention. The variables of gender, ethnicity, age, and body mass index (BMI) were considered. The method of Gibson and Cooke was used, and the following markers were evaluated: sweat weight, electrical impedance, sufficient sweat amount, and CF diagnosis. Triangular (TPC) or sinusoidal (SPC) pulsed current was applied to the right arm, and CCC was applied to the left arm. RESULTS The study analyzed 260 individuals, 141/213 (54.2%) were female participants, 135/260 (51.9%) were Caucasians. The distribution of individuals by concentration of chloride at the ST was: (CF) 26/260 (10%); (borderlines) 109/260 (41.9%); (healthy) 97/260 (37.3%); (insufficient weight in sweat) 28/260 (10.8%). No association was observed between the sufficient sweat amount to perform the ST when we compared the currents. However, the SPC showed a higher amount of sweat weight. Using Bland and Altman plot considering the agreement between the sweat chloride values achieved from CPC [SPC and TPC] and CCC, there was no proportional bias and mean values are unrelated and only explain less than 8% of the variation. Moreover, TPC presented higher electrical impedance when compared with SPC and CCC. SPC presented lower electrical impedance and higher sweat weight than CCC. Male participants presented lower electrical impedance and higher sweat weight with CCC and TPC, and higher sweat weight with SPC. CONCLUSIONS The evaluated currents are safe and able to induce and produce sweat in sufficient quantities for the ST. SPC presented lower electrical impedance when compared with other currents. The use of SPC is recommended to induce sweat in patients with sweat problems. Finally, ethnicity, gender, age and BMI did not influence sweat induction at the ST, and no side effect was observed in our study.
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Does saline resuscitation affect mechanisms of coagulopathy in critically ill trauma patients? An exploratory analysis.
Smith, CA, Gosselin, RC, Utter, GH, Galante, JM, Young, JB, Scherer, LA, Schermer, CR
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2015;(3):250-4
Abstract
Metabolic acidosis has been implicated in the development of coagulopathy, although the specific mechanisms have not been well characterized. We sought to explore whether resuscitation of injured patients with a balanced crystalloid solution affects coagulation, as measured by endogenous thrombin potential (ETP) and thromboelastography (TEG). We performed an exploratory analysis of a subset of subjects enrolled in a randomized trial comparing the effect of resuscitation with isotonic saline versus Plasma-Lyte A (PLA) on acidosis and electrolyte abnormalities. We collected plasma at admission and 6 h later for subsequent ETP and TEG analysis and compared subjects receiving isotonic saline to those receiving PLA. Among 18 evaluated subjects, baseline characteristics, including ETP and TEG parameters, were similar between the two arms. At 6 h, subjects receiving isotonic saline were more acidemic. At 6 h, there were no differences in ETP parameters between groups; however, TEG results showed the time from initial clot formation to an amplitude of 20 mm (K) was shorter (3.8 ± 2.1 vs. 7.2 ± 2.8 s) and the rapidity of fibrin build-up and cross-linking (α angle) was significantly greater (41 ± 8 vs. 24 ± 15 deg) for the PLA group than in the isotonic saline group. Relative to PLA, isotonic saline does not alter thrombin generation, but isotonic saline and PLA may differentially impact clotting factor availability. The shorter time to reach prespecified clot amplitude and the increased rate of fibrin generation imply faster amplification of clotting factors with PLA without effect on latency time or clot strength.
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Effect of three different contamination removal methods on bond strength of a self-etching adhesive to dentin contaminated with an aluminum chloride hemostatic agent.
Ajami, AA, Kahnamoii, MA, Kimyai, S, Oskoee, SS, Pournaghi-Azar, F, Bahari, M, Firouzmandi, M
The journal of contemporary dental practice. 2013;(1):26-33
Abstract
AIM: This study evaluated the effect of three different contamination removal methods on bond strength of one-step self-etching adhesive to dentin contaminated with an aluminum chloride hemostatic agent. MATERIALS AND METHODS One hundred noncarious adult molars were used in this study; 2-mm-thick dentin disks were prepared and randomly assigned to 5 groups (n = 20). Group I: control; group II: hemostatic agent-contaminated; group III: hemostatic agent-contaminated and rinsing with water; group IV: hemostatic agent-contaminated and ethylene diamine tetraacetic acid (EDTA) application; and group V: hemostatic agent-contaminated and phosphoric acid application. Clearfil S3 Bond was used to bond composite to dentin surfaces. Subsequent to adding composite cylinders the shear bond strength test was performed. Data were analyzed by one-way ANOVA and Tukey test. Two additional specimens from each group were prepared and evaluated under scanning electron microscope (SEM). RESULTS There were statistically significant differences in bond strength among the groups (p < 0.001). In two-by-two comparisons statistically significant differences were observed in bond strength values between all the groups (p < 0.001) except for groups I and IV (p = 0.933). CONCLUSION Aluminum chloride hemostatic agent adversely affected the bond strength of self-etch adhesive to dentin. However, application of EDTA increased the bond strength to the level of normal dentin. CLINICAL SIGNIFICANCE EDTA and phosphoric acid removed aluminum chloride hemostatic agent contamination of dentin surfaces. However, unlike EDTA phosphoric acid failed to increase the bond strength of self-etch adhesive to dentin to the level of the control group.
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Effect of experimental acid/base conditioner on microtensile bond strength of 4-META/MMA-TBB resin to dentin after long-term water immersion.
Soeno, K, Taira, Y, Ito, S
Dental materials journal. 2012;(5):851-5
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Abstract
An experimental conditioner (Exp), which was an aqueous solution of 10% ascorbic acid and 5% ferric chloride, was prepared in this study. This study evaluated the effect of Exp on the microtensile bond strength between a self-curing resin and dentin after long-term water immersion. Flat human dentin surfaces were sequentially pretreated with 40% phosphoric acid, 10% sodium hypochlorite, and Exp. Surface pretreatment with an aqueous solution of 10% citric and 3% ferric chloride (10-3) was used as a control. Composite resin rods were bonded to pretreated dentin surfaces using 4-META/MMA-TBB resin. Microtensile bond strengths were evaluated after water immersion at 24 h, 12 months, 24 months, and 36 months. At each immersion period, the bond strength of Exp was significantly higher than that of 10-3. After 36 months, Exp showed no significant decrease in microtensile bond strength, but 10-3 showed significant reductions. Pretreatment with experimental acid/base conditioner markedly improved the bonding durability of 4-META/MMA-TBB resin to human dentin when compared against the conventional 10-3 treatment.
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A randomised clinical trial to assess maintenance of gingival health by a novel dentifrice containing 0.1%w/w o-cymen-5-ol and 0.6%w/w zinc chloride.
Kakar, A, Newby, EE, Kakar, K, Ghosh, S, Targett, D, Bosma, ML
International dental journal. 2011;(Suppl 3):13-20
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OBJECTIVES To assess the ability of 0.1%w/w o-cymen-5-ol/ 0.6%w/w zinc chloride dentifrice to maintain gingival health compared to a sodium fluoride control dentifrice. DESIGN Following a baseline examination, subjects went through a regimen to bring them to a high level of gingival health. This included a professional prophylaxis supported by oral hygiene instruction prior to commencing study treatment. Subjects brushed twice daily for 12 weeks with either the test or control dentifrice. Examinations for gingival inflammation (MGI), bleeding and plaque were performed after 6 and 12 weeks. RESULTS 224 subjects were included in the efficacy analysis. Relative to the sodium fluoride/ silica control dentifrice group the o-cymen-5-ol/ zinc chloride dentifrice exhibited statistically significant reductions (p<0.0001) in MGI, bleeding and plaque of 12.3%, 18.5% and 13.2% respectively after six weeks and 38.1%, 37.8% and 24.2% after 12 weeks. CONCLUSION The results of the present clinical study demonstrate that the use of the 0.1%w/w o-cymen-5-ol/ 0.6%w/w zinc chloride dentifrice over a 12 week period provides a statistically significant benefit in maintaining gingival health compared to a sodium fluoride control dentifrice.
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A randomised clinical trial to assess maintenance of gingival health by a novel gel to foam dentifrice containing 0.1%w/w o-cymen-5-ol, 0.6%w/w zinc chloride.
Kakar, A, Newby, EE, Ghosh, S, Butler, A, Bosma, ML
International dental journal. 2011;(Suppl 3):21-7
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OBJECTIVES To assess the ability of 0.1%w/w o-cymen-5-ol/ 0.6%w/w zinc chloride gel to foam dentifrice to maintain gingival health compared to a sodium fluoride control dentifrice. DESIGN Following a baseline examination, subjects went through a regimen to bring them to a high level of gingival health. This involved a professional dental prophylaxis supported by oral hygiene instruction prior to commencing study treatment. Subjects brushed twice daily for 12 weeks with either the test or control dentifrice. Examinations for gingival inflammation (MGI), bleeding and plaque were performed after 12 weeks. RESULTS 205 subjects were included in the efficacy analysis. Relative to the sodium fluoride/ silica control dentifrice group the o-cymen-5-ol/ zinc chloride gel to foam dentifrice exhibited statistically significant reductions (p<0.0001) in MGI, bleeding and plaque of 32.2%, 26.3% and 20.7% respectively after 12 weeks. CONCLUSION The results of the present clinical study demonstrate that the use of the 0.1%w/w o-cymen-5-ol/ 0.6%w/w zinc chloride gel to foam dentifrice over a 12 week period provides a statistically significant benefit in maintaining gingival health compared to a sodium fluoride control dentifrice.
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Investigation of the redox interaction between Mn-bicarbonate complexes and reaction centers from Rhodobacter sphaeroides R-26, Chromatium minutissimum, and Chloroflexus aurantiacus.
Terentyev, VV, Shkuropatov, AY, Shkuropatova, VA, Shuvalov, VA, Klimov, VV
Biochemistry. Biokhimiia. 2011;(12):1360-6
Abstract
The change in the dark reduction rate of photooxidized reaction centers (RC) of type II from three anoxygenic bacteria (Rhodobacter sphaeroides R-26, Chromatium minutissimum, and Chloroflexus aurantiacus) having different redox potentials of the P(+)/P pair and availability of RC for exogenous electron donors was investigated upon the addition of Mn(2+) and HCO(3)(-). It was found that the dark reduction of P(870)(+) from Rb. sphaeroides R-26 is considerably accelerated upon the combined addition of 0.5 mM MnCl(2) and 30-75 mM NaHCO(3) (as a result of formation of "low-potential" complexes [Mn(HCO(3))(2)]), while MnCl(2) and NaHCO(3) added separately had no such effect. The effect is not observed either in RC from Cf. aurantiacus (probably due to the low oxidation potential of the primary electron donor, P(865), which results in thermodynamic difficulties of the redox interaction between P(865)(+) and Mn(2+)) or in RC from Ch. minutissimum (apparently due to the presence of the RC-bound cytochrome preventing the direct interaction between P(870)(+) and Mn(2+)). The absence of acceleration of the dark reduction of P(870)(+) in the RC of Rb. sphaeroides R-26 when Mn(2+) and HCO(3)(-) were replaced by Mg(2+) or Ca(2+) and by formate, oxalate, or acetate, respectively, reveals the specificity of the Mn2+-bicarbonate complexes for the redox interaction with P(+). The results of this work might be considered as experimental evidence for the hypothesis of the participation of Mn(2+) complexes in the evolutionary origin of the inorganic core of the water oxidizing complex of photosystem II.
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Comparison of parenteral iron sucrose and ferric chloride during erythropoietin therapy of haemodialysis patients.
Wu, CJ, Lin, HC, Lee, KF, Chuang, CK, Chen, YC, Chen, HH
Nephrology (Carlton, Vic.). 2010;(1):42-7
Abstract
AIM: To compare the effects of i.v. iron sucrose and Fe chloride on the iron indices of haemodialysis patients with anaemia. METHODS One hundred and eight haemodialysis patients receiving recombinant human erythropoiesis-stimulating agent (ESA) (mean age 59.37 years) were enrolled and randomly assigned to an iron sucrose or an Fe chloride group. Iron supplements were administered at 100 mg/week during the first 4 weeks (loading dose). Ferritin and transferrin saturation (TSAT) were then measured and dose adjusted. Ninety-eight subjects completed treatment; 51 in the iron sucrose group and 47 in the Fe chloride group. Ferritin, TSAT, haematocrit (Hct), reticulocyte count, serum albumin, fractional clearance of urea (Kt/V) and intact parathyroid hormone (iPTH) were measured. RESULTS There was no significant difference in baseline characteristics between the groups. Significant differences between the groups were observed in both iron indices and ESA dosage. Hct at week 24 (31.1% vs 29.7%, P = 0.006) and ferritin at week 20 (731.3 vs 631.7 ng/mL, P = 0.006) in the iron sucrose group were significantly higher than in the Fe chloride group. ESA dosage used in the iron sucrose group at week 8 was significantly lower than in the Fe chloride group (244.9 vs 322.6 U/kg per month, P = 0.003), and iron sucrose group received significantly lower iron dose than the Fe chloride group at week 8 (P = 0.005). CONCLUSION Although the differences in ESA dosage, ferritin and iron dosage between two groups were found during the study period while similar results were shown at the end of 24 week study. Thus, iron sucrose and Fe chloride are safe and work equally well for haemodialysis patients.
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Discrete-state representation of ion permeation coupled to fast gating in a model of ClC chloride channels: comparison to multi-ion continuous space Brownian dynamics simulations.
Coalson, RD, Cheng, MH
The journal of physical chemistry. B. 2010;(3):1424-33
Abstract
A discrete-state model of chloride ion motion in a ClC chloride channel is constructed, following a previously developed multi-ion continuous space model of the same system (Cheng, M. H.; Mamonov, A. B.; Dukes, J. W.; Coalson, R. D. J. Phys. Chem. B 2007, 111, 5956) that included a simplistic representation of the fast gate in this channel. The reducibility of the many-body continuous space to the eight discrete-state model considered in the present work is examined in detail by performing three-dimensional Brownian dynamics simulations of each allowed state-to-state transition in order to extract the appropriate rate constant for this process, and then inserting the pairwise rate constants thereby obtained into an appropriate set of kinetic master equations. Experimental properties of interest, including the rate of Cl(-) ion permeation through the open channel and the average rate of closing of the fast gate as a function of bulk Cl(-) ion concentrations in the intracellular and extracellular electrolyte reservoirs are computed. Good agreement is found between the results obtained via the eight discrete-state model versus the multi-ion continuous space model, thereby encouraging continued development of the discrete-state model to include more complex behaviors observed experimentally in these channels.
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New method to compute mixed water and electrolyte changes in hyponatremia: a preliminary report.
Bartoli, E, Castello, L, Bergamasco, L, Sainaghi, PP
Journal of nephrology. 2009;(2):273-80
Abstract
BACKGROUND We developed a new method that diagnoses when either Na or water alone are altered during electrolyte abnormalities. The aim of this study is to describe the preliminary report of an original method which can give exact or useful calculations even in mixed disorders. METHODS when NaCl is lost, the plasma Cl (PCl) to plasma Na (PNa) ratio falls from 0.75 (the normal value) toward zero, the ratio of plasma anions other than Cl (POAN) to PNa rises toward unity and POAN/PPCl toward infinity. With subscript 0 or normal values and subscript 1 for those during derangement, PCl1/PCl0 falls below unity, while POAN 1 /POAN 0 rises above unity in these hyponatremic disorders. Based on these changes, we developed exact mathematical formulas to compute alterations in solvent and solutes. The boundary conditions of applicability were computer modeled. RESULTS regression coefficients between true data fed oo the computer and those calculated with our formulas were 1.00 when the boundary conditions were entirely met (R2=1.00, <0.0001) and 0.93-0.96 (R2>0.94<0.99, <0.001) when the boundary conditions were allowed to extend beyond their limits of exclusive mathematical validity. The method was extended to patients whose data satisfied the boundary conditions. The results show that the computations satisfactorily predict the exact measurements obtained by the change in body weight (R2=0.61, <0.001). CONCLUSIONS This new method represents useful adjunct in evaluating and treating hyponatremias. Although its validity is limited to rather strict boundary conditions, it represents an original way to evaluate mixed solvent/solute derangements.