Dose and gender dependence of chlorine inhalation in a conscious ovine model.

Characterization of the pathophysiology of ARDS following chlorine gas inhalation in clinically relevant translational large animal models is essential, as the opportunity for clinical trials in this type of trauma is extremely limited. To investigate Cl2 concentration and gender-dependent ARDS severity. Sheep (n = 54) were exposed to air or Cl2 premixed in air at a concentration of 50, 100, 200, and 300 ppm for 30 min under anesthesia/analgesia and monitored for an additional 48 h in a conscious state. Cardiopulmonary variables and survival endpoints were compared between male and female sheep. Overall there were no significant differences in the responses of female and male sheep except pulmonary oxygenation tended to be better in the male sheep (300 ppm group), and the pulmonary arterial pressure was lower (200 ppm group). The onset of mild ARDS (200 < PaO2/FiO2 ≤ 300) was observed at 36 h post exposure in the 50 ppm group, whereas the 100 ppm group developed mild and moderate (100 ≤ PaO2/FiO2 ≤ 200) ARDS by 12 and 36 h after injury, respectively. The 200 ppm and 300 ppm groups developed moderate ARDS within 6 and 3 h after injury, respectively. The 300 ppm group progressed to severe (PaO2/FiO2 ≤ 100) ARDS at 18 h after injury. Increases in pPeak and pPlateau were noted in all injured animals. Compared to sham, inhalation of 200 ppm and 300 ppm Cl2 significantly increased lung extravascular water content. The thoracic cavity fluid accumulation dose-dependently increased with the severity of trauma as compared to sham. At necropsy, the lungs were red, heavy, solidified, and fluid filled; the injury severity grew with increasing Cl2 concentration. The severity of ARDS and mortality rate directly correlated to inhaled Cl2 concentrations. No significant sex-dependent differences were found in measured endpoint variables.

Assessing the effectiveness of two intervention methods for stony coral tissue loss disease on Montastraea cavernosa.

Stony coral tissue loss disease (SCTLD) was first observed in Florida in 2014 and has since spread to multiple coral reefs across the wider Caribbean. The northern section of Florida's Coral Reef has been heavily impacted by this outbreak, with some reefs experiencing as much as a 60% loss of living coral tissue area. We experimentally assessed the effectiveness of two intervention treatments on SCTLD-affected Montastraea cavernosa colonies in situ. Colonies were tagged and divided into three treatment groups: (1) chlorinated epoxy, (2) amoxicillin combined with CoreRx/Ocean Alchemists Base 2B, and (3) untreated controls. The experimental colonies were monitored periodically over 11 months to assess treatment effectiveness by tracking lesion development and overall disease status. The Base 2B plus amoxicillin treatment had a 95% success rate at healing individual disease lesions but did not necessarily prevent treated colonies from developing new lesions over time. Chlorinated epoxy treatments were not significantly different from untreated control colonies, suggesting that chlorinated epoxy treatments are an ineffective intervention technique for SCTLD. The results of this experiment expand management options during coral disease outbreaks and contribute to overall knowledge regarding coral health and disease.

Effect of household water treatment with chlorine on diarrhea among children under the age of five years in rural areas of Dire Dawa, eastern Ethiopia: a cluster randomized controlled trial.

BACKGROUND: Diarrheal disease is a leading cause of child mortality and morbidity worldwide. Household water treatment with chlorine significantly reduces morbidity due to waterborne diseases. However, the effect of point-of-use (POU) water treatment in improving the quality of water in areas where POU is not provided free of charge and the effectiveness of home visits in inspiring household members to use POU regularly have not been studied. The objective of this study was to evaluate the effectiveness of drinking water disinfection by chlorination on diarrheal disease reduction among children under the age of 5 years in rural eastern Ethiopia. METHODS: A cluster randomized controlled trial was carried out in rural Dire Dawa from October 2018 through January 2019. The 405 households were randomized to intervention and control arms and intervention materials were distributed after conducting a baseline survey. This trial evaluated the effectiveness of household drinking water disinfection by chlorination in reducing incidence of diarrhea among children under the age of 5 years. Intervention households received 1.2% sodium hypochlorite with demonstration of its proper use. Participants in the control households continued with their usual habits of water collection and water storage. Generalized estimation equation (GEE) with log link Poisson distribution family and exchangeable correlation matrix was used to compute crude incidence rate ratio (IRR), adjusted IRR and the corresponding 95% confidence intervals. RESULTS: In the intervention households, in total, 281 cases of diarrhea were documented (8.7 cases per 100 person-weeks observation); in the control households, in total 446 cases of diarrhea were documented (13.8 cases per 100 person-weeks observation). A 36.0% (adjusted IRR = 0.64, 95% CI: 0.57-0.73) reduction in incidence of diarrhea was observed in the intervention arm when compared with the control arm. The highest and the lowest reductions were obtained in children of age ranges 1 to 2 years and 3 to 4 years, 42.7 and 30.4%, respectively. Adherence to the intervention was 81.3% as measured by free residual chlorine test. CONCLUSIONS: In rural areas where diarrhea is the second leading cause of morbidity, water chlorination at the household level using liquid bleach considerably reduced episodes of diarrhea among children under the age of 5 years. Therefore, chlorinating drinking water at the household level may be a valuable interim solution for reducing the incidence of diarrheal diseases until potable water is made accessible to the majority of the population in Dire Dawa Administration and other Ethiopian communities. TRIAL REGISTRATION: PACTR, PACTR201807815961394. Registered 16 July 2018, www.pactr.org.

Can neutral dietary cation-anion difference (DCAD) decrease occurrence of clinical periparturient hypocalcaemia in dairy cattle?

BACKGROUND: Adjusting the dietary cation-anion difference (DCAD) is one of the most efficient ways to stimulate calcium homeostasis in periparturient dairy cattle. However, adjusting DCAD to the recommended negative values (-100 to -150 mEq/kg) is associated with decreased food intake and metabolic acidosis. The critical conditions of the animals at peripartum (i.e. drastic hormonal changes, decreased appetite and negative energy balance) can be detrimental to the health, productivity and welfare of the animals if combined with decreased feed intake caused by unpalatable acidogenic salts. METHODS: In a cross-sectional study, we analysed the ration of eight small to large dairy herds with intensive husbandry systems, including 6949 dry cows. Sodium, potassium, chlorine and sulfur concentrations in the feed were determined and DCAD was calculated. The DCAD of the ration of the farms ranged from -33.5 to +24.7 mEq/kg. Parturient paresis (PP, or milk fever) prevalence was investigated and correlated to DCAD values. RESULTS: Clinical PP occurrence in the dairies of this investigation on average declined by 87% (ranging from a 97% decline to 5% increase). This indicates that adjusting DCAD at neutral values (0 ± 30 mEq/kg range) may both lower the PP prevalence and increase ration palatability by lowering acidogenic salts in the ration. CONCLUSIONS: Further research is recommended to investigate the effects of neutral DCAD on subclinical hypocalcaemia and food intake of the cattle.

What happened at Vienna's Allgemeines Krankenhaus after Semmelweis's contract as Assistant in the First Maternity Division was terminated?

Ignác Fülöp Semmelweis is famous for dramatically reducing puerperal mortality while he was an Assistant in Vienna's largest hospital, the Allgemeines Krankenhaus; he did this, mainly, by requiring medical personnel to disinfect their hands by washing in a chlorine solution. But Semmelweis was soon removed from his post as assistant. The conventional view, which is suggested by Semmelweis's own account, is that his contemporaries were skeptical of his results, that he was marginalized and that once he was no longer directly responsible for caring for maternity patients, puerperal mortality returned to its former high levels. In fact, the situation appears to have been quite different. In this paper, we calculate and discuss the number of deaths at the Allgemeines maternity clinic after Semmelweis was removed from his position. As we will see, his successors maintained a relatively low mortality rate roughly consistent with the rate Semmelweis himself achieved. This suggests that the chlorine washings were probably still used conscientiously after he left and that the opposition he encountered had other sources than doubts about the effectiveness of the chlorine washings.

[The multifunctional therapy of various forms of irritable bowel syndrome]. / Mnogofunktsional'naya terapiya pri razlichnykh formakh sindroma razdrazhennogo kishechnika.

Irritable bowel syndrome (IBS) is a pathological condition characterized by heterogeneous etiology, pathogenesis, and clinical symptoms. These characteristics dictate the necessity of prescribing multiple medications for the treatment of IBS. Such compulsory polypharmacy inadvertently enhances the risk of adverse reactions to the treatment, increases its cost, and impairs compliance on the part of the patients. The objective of the present study was to evaluate the effectiveness of the administration of the clorine-bromine brine with the use of sinusoidal modulated current electrophoresis (SMC-phoresis) for the treatment of different forms of IBS. THE PATIENTS AND METHODS: We examined and treated 80 patients with different forms of IBS. The patients were divided into two equal groups comprised of 40 patients each. The patients of the study group were treated with the use of SMС-phoresis of the bromine-chlorine brine based at the «Varzi-yatchi¼ spa and health resort (the Udmurt Republic) making use of the sparing or stimulating techniques depending on the type of IBS. Each therapeutic course consisted of 10-12 sessions. The patients in the group of comparison received the standard pharmaceutical treatment for IBS (myotropic anti-spasmodics and lactulose). The emphasis was laid on the evaluation of dynamics of the intestinal motor function in different variants of IBS with the use of the EGS-4M apparatus based on the GSRS questionnaire (Gastrointestinal Symptom Rating Scale). Special attention was given to the interpretation of the main gastrointestinal syndromes and the evaluation of the quality of life of the patients in the course of the treatment and after its completion. RESULTS: Тhe main symptoms of IBS after a course of SMC-phoresis with the natural brine were significantly less pronounced compared to those in the patients managed by means of standard pharmacotherapy. Positive dynamics in the clinical picture of the disease had beneficial influence on the quality of life of the patients which approached that of the healthy subjects in the group of comparison. The results of colonography suggested the presence of various types of disturbances of motor function of the intestines. SMC-phoresis of the natural chlorine-bromine brine had a positive influence on dyskinesia associated with diarrhea and constipation associated with IBS, while the effect of the standard pharmaceutical treatment was unidirectional and significantly inferior to it in terms of efficiency. CONCLUSION: The use of complementary therapy can provide a better clinical outcome of IBS and to a greater extent improve the quality of life of the patients presenting with various forms of this pathology.

Quantification of pathogen inactivation efficacy by free chlorine disinfection of drinking water for QMRA.

To support the implementation of quantitative microbial risk assessment (QMRA) for managing infectious risks associated with drinking water systems, a simple modeling approach for quantifying Log10 reduction across a free chlorine disinfection contactor was developed. The study was undertaken in three stages: firstly, review of the laboratory studies published in the literature; secondly, development of a conceptual approach to apply the laboratory studies to full-scale conditions; and finally implementation of the calculations for a hypothetical case study system. The developed model explicitly accounted for variability in residence time and pathogen specific chlorine sensitivity. Survival functions were constructed for a range of pathogens relying on the upper bound of the reported data transformed to a common metric. The application of the model within a hypothetical case study demonstrated the importance of accounting for variable residence time in QMRA. While the overall Log10 reduction may appear high, small parcels of water with short residence time can compromise the overall performance of the barrier. While theoretically simple, the approach presented is of great value for undertaking an initial assessment of a full-scale disinfection contactor based on limited site-specific information.

Determinants of Caregivers' Use and Adoption of Household Water Chlorination: A Qualitative Study with Peri-Urban Communities in the Peruvian Amazon.

The gap between the efficacy and the effectiveness of household water treatment in reducing diarrhea-related morbidity indicates the need for a better understanding of the determinants of long-term behavior change. To explore the barriers to drinking water chlorination in the Peruvian Amazon, where diarrhea is endemic among under-5 children, we conducted qualitative research with 23 caregivers from peri-urban communities of Iquitos, Peru. Our inquiry drew on the Transtheoretical Model of behavior change and the Integrated Behavioral Model for Water, Sanitation, and Hygiene to identify the most relevant contextual, psychosocial, and technological determinants of initial action and long-term adoption of chlorination. Our findings suggest that the decision to try out this practice resulted from the combined effect of knowledge of chlorination benefits and product availability and affordability. Progress from action to adoption was influenced by caretakers' understanding of dosage, the packaging of chlorine products, knowledge and skills for multipurpose laundry bleach, the taste of treated water, and reinforcement. This analysis suggests that a focus on these determinants and the household domain may help to improve the sustainability of future intervention efforts.

Effectiveness of chlorine dispensers in emergencies: case study results from Haiti, Sierra Leone, Democratic Republic of Congo, and Senegal.

Dispensers are a source-based water quality intervention with promising uptake results in development contexts. Dispenser programs include a tank of chlorine with a dosing valve that is installed next to a water source, a local Promoter who conducts community education and refills the Dispenser, and chlorine refills. In collaboration with response organizations, we assessed the effectiveness of Dispensers in four emergency situations. In the three initial and four sustained response phase evaluations, 70 Dispenser sites were visited, 2057 household surveys were conducted, and 1676 water samples were analyzed. Across the evaluations, reported Dispenser use ranged from 9 to 97%, confirmed Dispenser use (as measured by free chlorine residual) ranged from 5 to 87%, and effective use (as measured by improvement in household water quality to meet international standards) ranged from 0 to 81%. More effective Dispenser interventions installed Dispensers at point-sources, maintained a high-quality chlorine solution manufacturing and distribution chain, maintained Dispenser hardware, integrated Dispensers projects within larger water programs, remunerated Promoters, had experienced project staff, worked with local partners to implement the project, conducted ongoing monitoring, and had a project sustainability plan. Our results indicate that Dispensers can be, but are not always, an appropriate strategy to reduce the risk of waterborne diseases in emergencies.

Use of household bleach for emergency disinfection of drinking water.

Household bleach is typically used as a disinfectant for water in times of emergencies and by those engaging in recreational activities such as camping or rafting. The Centers for Disease Control and Prevention recommend a concentration of free chlorine of 1 mg/L for 30 minutes, or about 0.75 mL (1/8 teaspoon) of household bleach per gallon of water. The goal of the study described in this article was to assess two household bleach products to kill waterborne bacteria and viruses using the test procedures in the U.S. Environmental Protection Agency's Guide Standard and Protocol for Testing Microbiological Purifiers. Bleach was found to meet these requirements in waters of low turbidity and organic matter. While the test bacterium was reduced by six logs in high turbid and organic-laden waters, the test viruses were reduced only by one-half to one log. In such waters greater chlorine doses or contact times are needed to achieve greater reduction of viruses.

Photodynamic therapy for pythiosis.

BACKGROUND: Pythiosis is a life-threatening disease caused by Pythium insidiosum. Photodynamic therapy (PDT) is an alternative treatment to surgery that uses the interaction of a photosensitizer, light and molecular oxygen to cause cell death. OBJECTIVES: To evaluate the effect of PDT on the in vitro growth of P. insidiosum and in an in vivo model of pythiosis. METHODS: For in vitro studies, two photosensitizers were evaluated: a haematoporphyrin derivative (Photogem(®)) and a chlorine (Photodithazine(®)). Amphotericin B was also evaluated, and the control group was treated with sterile saline solution. All experiments (PDT, porphyrin, chlorine and light alone, amphotericin B and saline solution) were performed as five replicates. For in vivo studies, six rabbits were inoculated with 20,000 zoospores of P. insidiosum, and an area of 1 cm(3) was treated using the same sensitizers. The PDT irradiation was performed using a laser emitting at 660 nm and a fluence of 200 J/cm(2) . Rabbits were clinically evaluated daily and histopathological analysis was performed 72 h after PDT. RESULTS: For in vitro assays, inhibition rates for PDT ranged from 60 to 100% and showed better results in comparison to amphotericin B. For the in vivo assays, after PDT, histological analysis of lesions showed a lack of infection up to 1 cm in depth. CONCLUSIONS AND CLINICAL IMPORTANCE: In vitro and in vivo studies showed that PDT was effective in the inactivation of P. insidiosum and may represent a new approach to treating pythiosis.

Prevalence of dental erosion in adolescent competitive swimmers exposed to gas-chlorinated swimming pool water.

OBJECTIVES: The purpose of this study was to analyze the prevalence of dental erosion among competitive swimmers of the local swimming club in Szczecin, Poland, who train in closely monitored gas-chlorinated swimming pool water. MATERIALS AND METHODS: The population for this survey consisted of a group of junior competitive swimmers who had been training for an average of 7 years, a group of senior competitive swimmers who had been training for an average of 10 years, and a group of recreational swimmers. All subjects underwent a clinical dental examination and responded to a questionnaire regarding aspects of dental erosion. In pool water samples, the concentration of calcium, magnesium, phosphate, sodium, and potassium ions and pH were determined. The degree of hydroxyapatite saturation was also calculated. RESULTS: Dental erosion was found in more than 26 % of the competitive swimmers and 10 % of the recreational swimmers. The lesions in competitive swimmers were on both the labial and palatal surfaces of the anterior teeth, whereas erosions in recreational swimmers developed exclusively on the palatal surfaces. Although the pH of the pool water was neutral, it was undersaturated with respect to hydroxyapatite. CONCLUSION: The factors that increase the risk of dental erosion include the duration of swimming and the amount of training. An increased risk of erosion may be related to undersaturation of pool water with hydroxyapatite components. CLINICAL RELEVANCE: To decrease the risk of erosion in competitive swimmers, the degree of dental hydroxyapatite saturation should be a controlled parameter in pool water.

Eficácia in vitro de desinfetantes utilizados na anti-sepsia dos tetos frente a leveduras isoladas do leite de vaca com mastite / In vitro efficacy of disinfectants used for antisepsis of teats against yeasts isolated from milk of dairy cows with mastitis

Objetivou-se com este estudo avaliar a sensibilidade in vitro de leveduras isoladas do leite de vaca com mastite frente a alguns desinfetantes comerciais utilizados no pré e pós-dipping em propriedades leiteiras do Estado de Pernambuco. Após a identificação, 12 isolados de leveduras foram submetidos aos testes com os seguintes princípios ativos: iodo (0,57 por cento), cloro (2,5 por cento), clorexidine (2,0 por cento), ácido láctico (2,0 por cento) e amônia quaternária (2,0 por cento) em cinco tempos distintos (15", 30", 60", 300" e 600"). Observou-se que 100 por cento dos isolados mostraram-se sensíveis ao clorexidine, em todos os tempos de exposição. O iodo obteve o segundo melhor resultado com os seguintes percentuais: 83,33 por cento foram sensíveis em 15" de exposição, 91,67 por cento em 30" e 100 por cento foram sensíveis nos tempos 60", 300" e 600". Para o ácido láctico, os resultados foram: 41,67 por cento sensíveis em 15" de exposição, 58,33 por cento em 30", 66,67 por cento em 60" e 300" e 75 por cento em 600". Na Análise dos resultados para amônia quaternária, observou-se que 66,67 por cento foram sensíveis nos tempos 15" e 30", e 91,67 por cento em 60", 300" e 600". Em relação ao princípio ativo cloro apenas 16,67 por cento foram sensíveis no tempo de 15" e 30", e 25 por cento em 60", 300" e 600". Conclui-se que o clorexidine e o iodo apresentam atividade desinfetante significativamente superior ao cloro, frente a leveduras envolvidas nos processos infecciosos da glândula mamária em bovinos. É necessário realizar uma avaliação periódica da atividade desinfetante dos produtos utilizados na rotina do pré e pós-dipping nas propriedades leiteiras frente aos microrganismos mais comumente envolvidos nos casos de mastite (micótica ou bacteriana), pois esta é uma medida eficaz para reduzir a frequência de casos de mastite nos rebanhos.

The aim of this study was to evaluate in vitro sensibility of yeast isolated from milk of dairy cows with mastitis against some commercial disinfectants used in pre and post-dipping in dairy farms of the State of Pernambuco. After identification, 12 yeast isolates were tested with the following disinfectants: iodine at 0,57 percent, chlorine at 2,5 percent, chlorhexidine, lactic acid and quaternary ammonium at 2,0 percent, at different exposure times. It was observed that 100 percent of the isolates were sensitive to chlorhexidine at all exposure times. Iodine has obtained the second best result with the following percentages: 83,33 percent were susceptible at 15'' exposure, 91,7 percent in 30'' and 100 percent were sensitive at 60'' 300'' and 600'' times. For lactic acid, the results were 41,67 percent sensitive at 15'' of exposure, 58,33 percent at 30'', 66,7 percent at 60'' and 300'' and 75 percent at 600''. In the analysis of the results for quaternary ammonium, it was observed that 66,67 percent were sensitive in 15''and 30'' times and 91,67 percent at 60'', 300'' and 600''. Regarding the chlorine activity, only 16,67 percent were sensitive at the 15'' and 30'' times, and 25 percent at 60'', 300'' and 600''. It was concluded that chlorhexidine and iodine have disinfectant activity significantly superior to chlorine, against to yeast involved in infectious processes of the mammary gland in cattle. It is necessary to perform a periodic assessment of the disinfectant activity from products used in the pre and post-dipping routine against dairy farms microorganisms most commonly involved in cases of mastitis (bacterial or fungal) which is an effective alternative to reduce the frequency of mastitis in cattle.

Analysis of the effectiveness of different hygiene procedures used in dental prostheses.

PURPOSE: To compare the effectiveness of bacterial plaque removal of six denture hygiene procedures used by patients to clean their dentures. MATERIALS AND METHODS: Fifteen students randomly divided into groups G1, G2, G3, G4, G5 and G6 used maxillary intraoral appliances for 24 h without cleaning them. Afterwards, the appliances were submitted to the following procedures: P1: washing under running water for 20 s; P2 and P3: cleaning with alkaline peroxide (Corega Tabs®) for 5 and 30 min, respectively; P4: brushing with water and liquid soap for 40 s; P5: alkaline hypochlorite for 10 minutes; P6: home use chlorine solution (Q'boa® at 0.45% for 10 min), throughout a period of 6 consecutive weeks. The procedures followed a circulating scheme, so that all the appliances were submitted to all the hygiene methods studied. After the hygiene procedures, the appliances were stained, photographed and submitted to the weighing method. RESULTS: After ANOVA and Tukey's test, differences were observed: P5 = 0.73 ± 0.3 (b), P6 = 1.27 ± 0.4(b,c), P4 = 1.92 ± 0.5 (b,c), P3 = 2.24 ± 1.0 (b,c), P2 = 7.53 ± 2.5 (c) and P1 = 26.86 ± 15. 3 (a). CONCLUSION: From the results of the study, it could be concluded that the use of alkaline hypochlorite is the best way to remove bacterial plaque, followed by the home-use chlorine solution and brushing with water and liquid soap. Corega Tabs® must be used for 30 min of immersion to have a cleaning effectiveness similar to that of alkaline hypochlorite.

Effect of WF10 (immunokine) on diabetic foot ulcer therapy: a double-blind, randomized, placebo-controlled trial.

This randomized controlled trial was undertaken to evaluate the effect of WF10 (Immunokine) as an adjunct to the standard treatment of diabetic foot ulcer. A total of 40 participants were randomized into 2 groups of 20. One group underwent standard therapy combined with infusions of WF10, and 1 underwent standard therapy combined with placebo. The wound severity scores, which vary with the severity of infection and inflammation, necrotic and granulation tissues, and wound depth and area, were assessed weekly for 9 weeks. Before treatment, the wound severity scores were not significantly different statistically between the 2 groups (13.7 ± 2.8 and 12.9 ± 3.2). After 9 weeks, the WF10 group had a statistically significant decreased wound severity score compared with that of the placebo group (1.8 ± 1.9 versus 4.4 ± 5.3, respectively, p < .05). Subgroup analyses comparing the WF10 and placebo groups showed statistically significant decreases of infection and inflammation (0.0 ± 0.0 versus 0.8 ± 0.9, respectively, p < .01), necrotic tissue (0.0 ± 0.0 versus 0.8 ± 1.1, respectively, p < .01), and an increase of the amount of granulation tissue (0.1 ± 0.3 versus 0.8 ± 1.2, respectively, p < .05). The wound depth and wound area also decreased more in the WF10 group; however, these decreases were not statistically significant. No severe adverse events were observed throughout the observation period. We concluded that the addition of WF10 to standard wound care statistically significantly reduced the wound severity score, infection and inflammation, and necrotic tissue and enhanced the formation of granulation tissue.

Effectiveness of different footbath solutions in the treatment of digital dermatitis in dairy cows.

Three experiments were conducted to test the effectiveness of different footbath solutions and regimens in the treatment of digital dermatitis (DD) in dairy cows. During the study, groups of cows walked through allocated footbath solutions after milking on 4 consecutive occasions. All cows were scored weekly for DD lesion stage on the hind feet during milking. A "transition grade" was assigned on the basis of whether the DD lesions improved (1) or deteriorated or did not improve (0) from week to week. This grade per cow was averaged for all cows in the group. In experiment 1, 118 cows were allocated to 1 of 3 footbath treatments for 5 wk: (1) 5% CuSO(4) each week, (2) 2% ClO(-) each week, or (3) no footbath (control). The mean transition grade, and proportion of cows without DD lesions at the end of the trial were significantly higher for treatment 1 above (0.36, 0.13, and 0.11, respectively; standard error of the difference, SED = 0.057). In experiment 2, 117 cows were allocated to 1 of 4 footbath treatment regimens for 8 wk: (1) 5% CuSO(4) each week, (2) 2% CuSO(4) each week, (3) 5% CuSO(4) each fortnight, or (4) 2% CuSO(4) each fortnight. For welfare reasons, cows allocated to the weekly and fortnightly footbath regimens had an average prevalence of >60% and ≤25% active DD at the start of the trial, respectively. Significantly more cows had no DD lesions (0.53 vs. 0.36, respectively; SED = 0.049), and the mean transition grade of DD lesions was higher in the 5% compared with the 2% weekly CuSO(4) treatment (0.52 vs. 0.38, respectively; SED = 0.066). Similarly, significantly more cows had no DD lesions in the 5% compared with the 2% fortnightly CuSO(4) treatments (0.64 vs. 0.47, respectively; SED = 0.049). In experiment 3, 95 cows were allocated to 1 of 3 footbath treatments: (1) each week alternating 5% CuSO(4) with 10% salt water, (2) each week alternating 5% CuSO(4) with water, or (3) 5% CuSO(4) each fortnight (control). After 10 wk, more cows had no DD in the salt water treatment than in the control treatment (0.35 vs. 0.26, respectively; SED = 0.038), but levels of active lesions were higher for this treatment than in the other 2 treatments (0.17, 0.00, and 0.13, respectively; SED = 0.029). Treatment did not affect mean transition grade of DD lesions. In conclusion, CuSO(4) was the only footbath solution that was consistently effective for treatment of DD. In cases when DD prevalence was high, a footbath each week using 5% CuSO(4) was the most effective treatment.

Possible antioxidant role of SPA therapy with chlorine-sulphur-bicarbonate mineral water.

The aim of our research was to analyze the antioxidant role and efficacy of thermal or salus per aquam (spa) therapy with chlorine-sulphur-bicarbonate mineral water. The study has been performed on 30 rats. The animals were randomized in three groups, each of them composed by ten animals, denominated A, B and C. The A group was the control group and was not subjected to any specific treatment (placebo); the B group has been treated with a standard cycle of hydropinics treatment with mineral water of Therme of Stabia in Castellammare (Naples, Italy) denominated STABIA; the C group was treated with a standard cycle of hydropinic treatment with mineral water of Therme of Stabia in Castellammare (Naples, Italy) denominated SULFUREA. After two weeks of treatment all the rats were sacrificed and blood was collected for the plasmatic determination of reactive oxygen species (ROS). The results demonstrated a significant (P < 0.05) reduction of ROS in B (374 Carr. U. +/-73) and C group (399 carr. U. +/-62) treated with mineral waters if compared with control group (571 + 69 Carr. U.). In conclusion this study suggests a possible antioxidant effect of chlorine-sulphur-bicarbonate spa hydropinic treatment with a consequent suitable intestinal physiology, with reduction of the functional and organic modifications that can lead to pathological disorders of the gastroenteric diseases in whose pathogenesis the oxidative stress can develop an important role.

[Effect of chlorine-sodium hydrocarbonate mineral water on the gastric secretory function in subjects with various daily motor activity patterns].

Effect of Shadrinskaya ID mineral water on the gastric secretory function was evaluated in wrestlers and subjects unengaged in sports activities. Characteristics of the observed functional response of the digestive system provided a deeper insight into the mechanisms by which mineral water along with the controlled muscular load acts on the secretory performance of the stomach. Specific changes of the gastric secretory function at rest and in the veloergometer test were documented in subjects with different patterns of daily motor activity. The knowledge of mechanisms of muscular tension and optimal ways to use mineral water may help to prevent negative manifestations of emotional and physical stress in athletes.

A phase II study to evaluate WF10 in patients with late hemorrhagic radiation cystitis and proctitis.

OBJECTIVE: To evaluate efficacy and safety of WF10 (TCDO iv solution) therapy in patients with late hemorrhagic radiation cystitis and proctitis in a long-term follow up. MATERIAL AND METHODS: From February 1999 to July 2001, 30 symptomatic patients with endoscopically confirmed grade 2 and 3 late hemorrhagic cystitis (n = 16) and proctitis (n = 14) were treated with WF10. The dose was 0.5 ml/kg BW, diluted in 250 ml 5%D/W, administered by intravenous infusion over 2 h, 5 consecutive days, every 3 weeks for 2-4 cycles, combined with standard therapy. The patients were clinically followed up every 3 weeks for 3 months, then every 3 months for 1 year and then every 3-6 months. The study endpoints were immediate response with improvement to Grade 0-1 within 3 months and the incidence of recurrence to Grade > or =2 during the follow up time. RESULTS: After completion of the WF10 therapy, 14 cystitis patients (88%) had improved to grade 0-1 hematuria, and 14 proctitis patients (100%) had improved in bleeding per rectum to grade 0-1 within 3 months. The median follow up time was 51 months. During the follow up period, among the responders, 4 cystitis patients (28%) had recurrent hematuria of grade 2 and two proctitis patients (14%) had recurrent bleeding per rectum of grade 2 and 3. No treatment toxicity was observed. CONCLUSION: The WF10 therapy combined with conventional treatment is simple and safe with long-term efficacy in the treatment of late hemorrhagic radiation cystitis and proctitis.

Reduced recurrence of late hemorrhagic radiation cystitis by WF10 therapy in cervical cancer patients: a multicenter, randomized, two-arm, open-label trial.

BACKGROUND AND PURPOSE: To evaluate the efficacy and the safety of WF10 as adjunct to standard treatment in the management of late hemorrhagic radiation cystitis compared to standard treatment alone. PATIENTS AND METHODS: Cervical cancer patients with Grade 2 or 3 late hemorrhagic radiation cystitis, were randomized and treated with WF10 0.5 ml/kg body weight, diluted in physiological saline or 5% dextrose water 250 ml, intravenous infusions over 2 h on 5 consecutive days, every 3 weeks for 2 cycles plus standard treatment (WF10 group) or standard treatment alone (control group). Fifty patients in each group were evaluated by questioning; urinalysis and cystoscopy during a 1 year follow up. RESULTS: At week 7, 37 patients (74%) in the WF10 group and 32 patients (64%) in the control group showed complete resolution in objective hematuria (P = 0.28). Significantly lower use of antibiotics (P = 0.002) and antispasmodics (P < 0.001) was found in the WF10 group. Among the responders, 24 patients (77%) in the control group experienced recurrent objective hematuria, whereas in the WF10 group only 17 patients (47%) experienced a recurrence (P = 0.01). Recurrence of objective hematuria occurred significantly faster in the control group as evidenced by Kaplan-Meier and log-rank statistics (P = 0.004), suggesting a long-term effect of WF10. Cystoscopy, at the end of the treatment period and after the one year follow up showed overall improvement without significant difference between two groups. No severe toxicity was monitored. CONCLUSIONS: WF10 therapy is a safe, non-invasive and convenient method in the management of late hemorrhagic radiation cystitis. WF10 therapy, as adjunct to standard treatment, has significantly reduced recurrence of objective hematuria, compared to standard treatment alone, during a one year follow up.