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Sulfurous-arsenical-ferruginous thermal water nasal inhalation and irrigation in children with recurrent upper respiratory tract infections: Clinical outcomes and predictive factors.
Franz, L, Manica, P, Claudatus, J, Frigo, AC, Marioni, G, Staffieri, A
American journal of otolaryngology. 2021;(6):103083
Abstract
PURPOSE Recurrent upper respiratory disorders (RURD) are among the most common problems diagnosed in pediatric otolaryngology practice. Although several preliminary studies have demonstrated beneficial effects of thermal water inhalations for RURD, inhalation of thermal water has not been included among validated management protocols. The effects of sulfurous-arsenical-ferruginous thermal water nasal irrigations have been confirmed also in prospective, randomized studies. The main aim of this explorative, retrospective, observational study has been to compare the clinical outcome in pediatric patients with RURD treated with sulfurous-arsenical-ferruginous thermal water inhalation versus combined inhalation and nasal irrigation. METHODS Two hundred and fifty-three pediatric patients with RURD were considered; 231 underwent thermal water inhalations (inhalation of hot humid air and aerosol) only, while 22 underwent nasal irrigations combined with inhalations. Subjective overall efficacy perception and treatment tolerability were scored as categorical variables (from 0 = no efficacy/worst tolerability to 3 = maximal efficacy/best tolerability). RESULTS Nasal obstruction, sneezing, serous, mucous, and purulent rhinorrhea, cough, and snoring improved respectively in 80.2%, 72.9%, 79.0%, 93.8%, 92.3%, 64.8%, and 60.4% of patients referring these symptoms at presentation, respectively. No statistically significant differences between inhalations alone and combined inhalations and irrigations emerged. The median overall efficacy perception score was 2 while the median treatment tolerability score was 3. CONCLUSIONS This investigation found that sulfurous-arsenical-ferruginous water treatment was a well-tolerated therapeutic option for selected pediatric patients with RURD. These promising preliminary results should be confirmed in prospective, randomized, double-blind settings, also using minimally invasive but objective and quantitative evaluation methods.
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Water only fasting and its effect on chemotherapy administration in gynecologic malignancies.
Riedinger, CJ, Kimball, KJ, Kilgore, LC, Bell, CW, Heidel, RE, Boone, JD
Gynecologic oncology. 2020;(3):799-803
Abstract
OBJECTIVE As a protective response, during starvation organisms withdraw energy from growth and reproduction to focus on cellular maintenance. Cancer cells cannot undergo this differential response which has been theorized as an adjunct to improve both the effect of chemotherapy treatment and reduce treatment side effects. We sought to investigate the feasibility and effect of short-term fasting in patients receiving chemotherapy for gynecologic malignancy. METHODS A randomized control trial was conducted of women with gynecologic malignancies receiving at least 6 planned chemotherapy cycles. Fasting patients maintaining a water-only fast for 24 h before and 24 h following each chemotherapy cycle were compared to nonfasting patients. Treatment related side effects and quality of life (QOL) was assessed using NCCN-FACT FOSI-18 questionnaire. RESULTS Analysis included data from 120 cycles of chemotherapy. The majority of patients had stage 3 and 4 malignancy requiring multi-agent chemotherapy. Eleven patients had ovarian, 8 had uterine, and 1 had cervical cancer. Ninety percent received taxane and platinum-based doublet therapy. Weight loss and unanticipated hospitalizations were similar between treatment groups. Fewer dose reductions or delays were seen in the fasting group. There was no significant difference in mean QOL scores, but fasting group QOL scores improved over the course of treatment to a level that reached the minimal clinically important difference. CONCLUSION A 48-h fast is well tolerated without increasing weight loss, hospital admissions, or chemotherapy dose reduction/delays. Fasting resulted in fewer treatment modifications and improved quality of life scores over the course of treatment.
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Growth, Yield and Biochemical Impact of Anti-transpirants on Sunflower Plant Grown under Water Deficit.
Abdallah, MMS, Bakry, BA, El-Bassiouny, HMS, El-Monem, AAA
Pakistan journal of biological sciences : PJBS. 2020;(4):454-466
Abstract
BACKGROUND AND OBJECTIVE Climate change affecting on weather in many different ways especially drought and temperature rise. This will drastically down plant production, if not start looking for another source to increase water productivity to cope up with water stress conditions. In this study efforts were conducted to interpret the use of anti-transpirants to conserving irrigation water, aiding plant survival under dry conditions and protecting plant against drought stress. MATERIALS AND METHODS Two field experiments were carried out during 2017 and 2018 successive growing summer seasons at the experimental farm of National Research Centre, Nubaria, El-Beheira Governorate, Egypt. Anti-transparent ,i.e., chitosan (100 and 150 mg L-1), calcium carbonate (5 and 10 g L-1), salicylic acid (200 and 300 mg L-1) were foliar sprayed on sunflower plants grown under two water levels (normal 100% and deficit 50%). RESULTS The results showed that water stress decreased growth criteria, photosynthetic pigments, osmoprotectants, yield components, oil and carbohydrate (%) as compared to 100% of irrigation requirements. Meanwhile, water deficit induced significant increases in (proline). Foliar treatments of sunflower plant with chitosan, calcium carbonate, salicylic acid increased growth criteria, yield components, photosynthetic pigments, total soluble sugars, proline and free amino acid as compared to control plant. Data also illustrated that, all used treatment improved seed yield, oil and carbohydrate% of sunflower plants. CONCLUSION Generally, it could be concluded that 10 g L-1 CaCO3 and 300 mg L-1 SA at 50% level of water irrigation could be recommended for sunflower plant grown under similar field conditions in order to get optimum yield and to save irrigation water.
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Comparing Intradermal Sterile Water with Intravenous Morphine in Reducing Pain in Patients with Renal Colic: A Double-Blind Randomized Clinical Trial.
Mozafari, J, Verki, MM, Tirandaz, F, Mahjouri, R
Reviews on recent clinical trials. 2020;(1):76-82
Abstract
OBJECTIVE The present study was conducted to investigate the effect of intradermal administration of sterile water compared to intravenous morphine on patients with renal colic. METHODS This double-blind, randomized clinical trial study was conducted in 2017 to compare the therapeutic effects of intradermal sterile water with those of intravenous morphine on patients with renal colic presenting to the emergency departments (ED) of Imam Khomeini and Golestan Hospitals in Ahvaz, Iran. The first group received 0.5 ml of intradermal sterile water, and the second group 0.1mg/kg of intravenous morphine plus 0.5 ml of intradermal sterile water in the most painful area or the center of the painful area in the flank. The pain severity was measured using a visual analogue scale (VAS), and the medication side-effects were recorded at the beginning of the study and minutes 15, 30,45 and 60. RESULTS A total of 94 patients were studied in two groups. The mean severity of pain was 2.97 ± 1.51 in the sterile water group and 2.34 ± 1.89 in the morphine group at minute 30 (P=0.042), 2.58 ± 1.43 in the sterile water group and 1 ± 1.23 in the morphine group at minute 45 (P<0.001), and 1.89 ± 1.7 in the sterile water group and 0.52 ± 0.79 in the morphine group at minute 60 (P<0.001). CONCLUSION Morphine reduces pain faster and more effectively than intradermal sterile water; nevertheless, treatment with intradermal sterile water can be used as an appropriate surrogate or adjunct therapy for pain control, particularly in special patients or in case of medication scarcity.
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Is water exchange superior to water immersion for colonoscopy? A systematic review and meta-analysis.
Chen, Z, Li, Z, Yu, X, Wang, G
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association. 2018;(5):259-267
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Abstract
BACKGROUND/AIMS: Recently, water exchange (WE) instead of water immersion (WI) for colonoscopy has been proposed to decrease pain and improve adenoma detection rate (ADR). This systematic review and meta-analysis is conducted to assess whether WE is superior to WI based on the published randomized controlled trials (RCTs). MATERIALS AND METHODS We searched studies from PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE. Only RCTs were eligible for our study. The pooled risk ratios (RRs), pooled mean difference (MD), and pooled 95% confidence intervals (CIs) were calculated by using the fixed-effects model or random-effects model based on heterogeneity. RESULTS Five RCTs consisting of 2229 colonoscopies were included in this study. WE was associated with a significantly higher ADR than WI (RR = 1.18; CI = 1.05-1.32; P = 0.004), especially in right colon (RR = 1.31; CI = 1.07-1.61; P = 0.01). Compared with WI, WE was confirmed with lower pain score, higher Boston Bowel Preparation Scale score, but more infused water during insertion. There was no statistical difference between WE and WI in cecal intubation rate and the number of patients who had willingness to repeat the examination. Furthermore, both total procedure time and cecal intubation time in WE were significantly longer than that in WI (MD = 2.66; CI = 1.42-3.90; P < 0.0001; vs MD = 4.58; CI = 4.01-5.15; P < 0.0001). CONCLUSIONS This meta-analysis supports the hypothesis that WE is superior to WI in improving ADR, attenuating insertion pain and providing better bowel cleansing, but inferior in time and consumption of infused water consumption during insertion.
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Moisture Adsorption Isotherm and Storability of Hazelnut Inshells and Kernels Produced in Oregon, USA.
Jung, J, Wang, W, McGorrin, RJ, Zhao, Y
Journal of food science. 2018;(2):340-348
Abstract
UNLABELLED Moisture adsorption isotherms and storability of dried hazelnut inshells and kernels produced in Oregon were evaluated and compared among cultivars, including Barcelona, Yamhill, and Jefferson. Experimental moisture adsorption data fitted to Guggenheim-Anderson-de Boer (GAB) model, showing less hygroscopic properties in Yamhill than other cultivars of inshells and kernels due to lower content of carbohydrate and protein, but higher content of fat. The safe levels of moisture content (MC, dry basis) of dried inshells and kernels for reaching kernel water activity (aw ) ≤0.65 were estimated using the GAB model as 11.3% and 5.0% for Barcelona, 9.4% and 4.2% for Yamhill, and 10.7% and 4.9% for Jefferson, respectively. Storage conditions (2 °C at 85% to 95% relative humidity [RH], 10 °C at 65% to 75% RH, and 27 °C at 35% to 45% RH), times (0, 4, 8, or 12 mo), and packaging methods (atmosphere vs. vacuum) affected MC, aw , bioactive compounds, lipid oxidation, and enzyme activity of dried hazelnut inshells or kernels. For inshells packaged at woven polypropylene bag, MC and aw of inshells and kernels (inside shells) increased at 2 and 10 °C, but decreased at 27 °C during storage. For kernels, lipid oxidation and polyphenol oxidase activity also increased with extended storage time (P < 0.05), and MC and aw of vacuum packaged samples were more stable during storage than those atmospherically packaged ones. Principal component analysis showed correlation of kernel qualities with storage condition, time, and packaging method. This study demonstrated that the ideal storage condition or packaging method varied among cultivars due to their different moisture adsorption and physicochemical and enzymatic stability during storage. PRACTICAL APPLICATION Moisture adsorption isotherm of hazelnut inshells and kernels is useful for predicting the storability of nuts. This study found that water adsorption and storability varied among the different cultivars of nuts, in which Yamhill was less hygroscopic than Barcelona and Jefferson, thus more stable during storage. For ensuring food safety and quality of nuts during storage, each cultivar of kernels should be dried to a certain level of MC. Lipid oxidation and enzyme activity of kernel could be increased with extended storage time. Vacuum packaging was recommended to kernels for reducing moisture adsorption during storage.
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Comparative evaluation of chlorhexidine and cinnamon extract used in dental unit waterlines to reduce bacterial load in aerosols during ultrasonic scaling.
Mamajiwala, AS, Sethi, KS, Raut, CP, Karde, PA, Khedkar, SU
Indian journal of dental research : official publication of Indian Society for Dental Research. 2018;(6):749-754
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Abstract
BACKGROUND Dental unit waterlines (DUWL) are believed to be a source of infection. Ultrasonic instruments generate aerosols with significantly greater numbers of bacteria. Chlorhexidine (CHX) exhibits significant antiseptic effect. Recently, cinnamon (CIN) has been displayed to have antibacterial and anti-inflammatory properties in vivo. AIM: The aim of this study is to compare and evaluate the efficacy of CHX versus CIN extract in the reduction of bacterial count in dental aerosols when used as an irrigant through DUWL during ultrasonic scaling. MATERIALS AND METHODS Sixty patients with moderate-to-severe gingivitis were randomly divided into 3 groups of 20 patients each undergoing ultrasonic scaling. For experimental group I, CHX was added in dental unit reservoir before ultrasonic scaling. Similarly, in group II, CIN extract was used and group III served as control where distilled water (DW) was used. The aerosols from ultrasonic units were collected on two blood agar plates at three different positions. One plate from each position was incubated aerobically for 48 h and other plate anaerobically for 72 h. The total number of colony forming units (CFUs) was then calculated and statistically interpreted. RESULTS CHX and CIN both were equally effective (P > 0.05) in reducing the bacterial count in aerosols as compared to DW (P < 0.05) when used through DUWL. Maximum contamination was seen on the agar plate placed at the chest of the patient. CONCLUSION Both CIN and CHX used as an irrigant through DUWL effectively helped in the reduction of bacterial count in dental aerosols.
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Water exchange versus air insufflation for colonoscopy: A meta-analysis.
Liu, Y, Huang, QK, Dong, XL, Jin, PP
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association. 2018;(6):311-316
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BACKGROUND/AIMS: To compare water exchange (WE) method with conventional air insufflation (AI) method for colonoscopy, evaluating the technical quality, screening efficacy, and patients' acceptance. MATERIALS AND METHODS Electronic databases were systematically searched for randomized controlled trials comparing WE colonoscopy with AI colonoscopy. The pooled data of procedure-associated and patient-related outcomes were assessed, using the weighted mean difference (WMD) with 95% confidence interval (CI) for continuous variables and relative risk (RR) with 95% CI for dichotomous variables, respectively. RESULTS A total of 13 studies involving 7056 patients were included. The cecum intubation rate was similar between WE and AI methods (RR = 1.01, 95% CI = 0.99-1.02,P = 0.37); however, a significantly longer cecum intubation time was shown in WE group (WMD = 1.56, 95% CI = 0.75-2.37,P = 0.002). Compared with AI, WE was associated with a higher risk of adenoma detection rate (ADR) (RR = 1.28, 95% CI = 1.18-1.38,P < 0.00001) and polyp detection rate (PDR) (RR = 1.30, 95% CI = 1.21-1.39,P < 0.00001). Patients in WE group experienced significantly less maximum pain score (WMD = -1.99, 95% CI = -2.68 to -1.30,P < 0.00001) and less requested on-demand sedation (RR = 0.58, 95% CI = 0.44-0.77,P = 0.0002). Likewise, they also experienced less abdominal compression (RR = 0.62, 95% CI = 0.51-0.74,P < 0.00001) and reposition (RR = 0.74, 95% CI = 0.63-0.86,P = 0.0001). Moreover, patients' willingness to repeat colonoscopy was significantly greater for WE (RR = 1.14, 95% CI = 1.07-1.21,P < 0.0001). CONCLUSION This meta-analysis confirmed that WE method could significantly increase ADR/PDR and improve patients' acceptance of colonoscopy, while reducing the degree of pain and minimize the need for on-demand sedation and adjunct maneuvers, despite requiring more cecal intubation time.
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Effect of Coaching to Increase Water Intake on Kidney Function Decline in Adults With Chronic Kidney Disease: The CKD WIT Randomized Clinical Trial.
Clark, WF, Sontrop, JM, Huang, SH, Gallo, K, Moist, L, House, AA, Cuerden, MS, Weir, MA, Bagga, A, Brimble, S, et al
JAMA. 2018;(18):1870-1879
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IMPORTANCE In observational studies, increased water intake is associated with better kidney function. OBJECTIVE To determine the effect of coaching to increase water intake on kidney function in adults with chronic kidney disease. DESIGN, SETTING, AND PARTICIPANTS The CKD WIT (Chronic Kidney Disease Water Intake Trial) randomized clinical trial was conducted in 9 centers in Ontario, Canada, from 2013 until 2017 (last day of follow-up, May 25, 2017). Patients had stage 3 chronic kidney disease (estimated glomerular filtration rate [eGFR] 30-60 mL/min/1.73 m2 and microalbuminuria or macroalbuminuria) and a 24-hour urine volume of less than 3.0 L. INTERVENTIONS Patients in the hydration group (n = 316) were coached to drink more water, and those in the control group (n = 315) were coached to maintain usual intake. MAIN OUTCOMES AND MEASURES The primary outcome was change in kidney function (eGFR from baseline to 12 months). Secondary outcomes included 1-year change in plasma copeptin concentration, creatinine clearance, 24-hour urine albumin, and patient-reported overall quality of health (0 [worst possible] to 10 [best possible]). RESULTS Of 631 randomized patients (mean age, 65.0 years; men, 63.4%; mean eGFR, 43 mL/min/1.73 m2; median urine albumin, 123 mg/d), 12 died (hydration group [n = 5]; control group [n = 7]). Among 590 survivors with 1-year follow-up measurements (95% of 619), the mean change in 24-hour urine volume was 0.6 L per day higher in the hydration group (95% CI, 0.5 to 0.7; P < .001). The mean change in eGFR was -2.2 mL/min/1.73 m2 in the hydration group and -1.9 mL/min/1.73 m2 in the control group (adjusted between-group difference, -0.3 mL/min/1.73 m2 [95% CI, -1.8 to 1.2; P = .74]). The mean between-group differences (hydration vs control) in secondary outcomes were as follows: plasma copeptin, -2.2 pmol/L (95% CI, -3.9 to -0.5; P = .01); creatinine clearance, 3.6 mL/min/1.73 m2 (95% CI, 0.8 to 6.4; P = .01); urine albumin, 7 mg per day (95% CI, -4 to 51; P = .11); and quality of health, 0.2 points (95% CI, -0.3 to 0.3; P = .22). CONCLUSIONS AND RELEVANCE Among adults with chronic kidney disease, coaching to increase water intake compared with coaching to maintain the same water intake did not significantly slow the decline in kidney function after 1 year. However, the study may have been underpowered to detect a clinically important difference. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01766687.
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Peritoneal Water Transport Characteristics of Diabetic Patients Undergoing Peritoneal Dialysis: A Longitudinal Study.
Fernandes, A, Ribera-Sanchez, R, Rodríguez-Carmona, A, López-Iglesias, A, Leite-Costa, N, Pérez Fontán, M
American journal of nephrology. 2017;(1):47-54
Abstract
BACKGROUND Volume overload is frequent in diabetics undergoing peritoneal dialysis (PD), and may play a significant role in the excess mortality observed in these patients. The characteristics of peritoneal water transport in this population have not been studied sufficiently. METHOD Following a prospective, single-center design we made cross-sectional and longitudinal comparisons of peritoneal water transport in 2 relatively large samples of diabetic and nondiabetic PD patients. We used 3.86/4.25% glucose-based peritoneal equilibration tests (PET) with complete drainage at 60 min, for these purposes. MAIN RESULTS We scrutinized 59 diabetic and 120 nondiabetic PD patients. Both samples showed relatively similar characteristics, although diabetics were significantly more overhydrated than nondiabetics. The baseline PET disclosed lower ultrafiltration (mean 439 mL diabetics vs. 532 mL nondiabetics, p = 0.033) and sodium removal (41 vs. 53 mM, p = 0.014) rates in diabetics. One hundred and nine patients (36 diabetics) underwent a second PET after 12 months, and 45 (14 diabetics) underwent a third one after 24 months. Longitudinal analyses disclosed an essential stability of water transport in both groups, although nondiabetic patients showed a trend where an increase in free water transport (p = 0.033) was observed, which was not the case in diabetics. CONCLUSIONS Diabetic patients undergoing PD present lower capacities of ultrafiltration and sodium removal than their nondiabetic counterparts. Longitudinal analyses disclose an essential stability of water transport capacities, both in diabetics and nondiabetics. The clinical significance of these differences deserves further analysis.