Inhaled Water and Salt Suppress Respiratory Droplet Generation and COVID-19 Incidence and Death on US Coastlines

Dry air alters salt and water balance in the upper airways and increases the risks of COVID-19 among other respiratory diseases. We explored whether such upper airway variations in salt and water balance might alter respiratory droplet generation and potentially contribute to observed impacts of airway hydration on respiratory disease. In a randomized 4-arm study of 21 healthy human subjects we found that the breathing of humid air, the wearing of cotton masks, and the delivery of (sodium, calcium, and magnesium chloride) salt droplets sized to deposit in the nose, trachea, and main bronchi similarly reduce the exhalation of respiratory droplets by approximately 50% ([Formula: see text] ¡ 0.05) within 10 minutes following hydration. Respiratory droplet generation returns to relatively high baseline levels within 60–90 minutes on return to dry air in all cases other than on exposure to divalent (calcium and magnesium) salts, where suppression continues for 4–5 hours. We also found via a preliminary ecological regression analysis of COVID-19 cases in the United States between January 2020 and March 2021 that exposure to elevated airborne salt on (Gulf and Pacific) US coastlines appears to suppress by approximately 25%–30% ([Formula: see text] ¡ 0.05) COVID-19 incidence and deaths per capita relative to inland counties — accounting for ten potential confounding environmental, physiological, and behavioral variables including humidity. We conclude that the hydration of the upper airways by exposure to humidity, the wearing of masks, or the breathing of airborne salts that deposit in the upper airways diminish respiratory droplet generation and may reduce the risks of COVID-19 incidence and symptoms.

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COVID-19 symptoms reduce with targeted hydration of the nose, larynx and trachea

10.21203/rs.3.rs-1089497/v1 ◽

2021 ◽

Author(s):

Carol George ◽

Gerhard Scheuch ◽

Ulf Seifart ◽

Leeberk Inbaraj ◽

Sindhulina Chandrasingh ◽

...

Keyword(s):

Oxygen Saturation ◽

Low Income ◽

Human Subjects ◽

Droplet Generation ◽

Saline Control ◽

Control Group ◽

Upper Airways ◽

Two Phase ◽

Total Body Mass ◽

Tract Infections

Abstract Dirty air and poor access to healthcare threatens the lives of billions of people in low-income regions of the world. We investigated whether upper-airway hydration might alter two-phase flow in the airways on normal tidal breathing and be a useful, safe, easily distributed non-drug intervention for limiting risks of COVID-19. In observational human volunteer studies involving 464 human subjects in Marburg, Germany (357 normal subjects), Boston, US (20 healthy subjects), and Bangalore, India (87 subjects recently tested positive for COVID-19), we find that respiratory droplet generation increases by up to 4 orders of magnitude with up to 1% total body mass dehydration (n=20), and in dehydration-associated states of advanced age (n=357), elevated BMI-age (n=148), and SARS-CoV-2 infection (n=87). Hydration of the nose, larynx and trachea in a protocol of exercise-induced dehydration by the nasal inhalation of calcium-rich hypertonic salt droplets of mean diameter 8-12 μm diminished respiratory droplet numbers and increased oxygenation relative to a non-treatment control (P<0.05). In a randomized double-blinded nasal-saline control study, thrice-a-day delivery of the calcium-rich hypertonic salts (active) over three days suppressed respiratory droplet generation by 51% +/- 11% and increased oxygen saturation by 48.08% ± 9.61% (P<0.001) in COVID-19 positive subjects (n=20), while no changes in exhaled aerosol (P=0.235) or oxygen saturation (P=0.533) were observed in the nasal-saline control group (n=20). In the active group 47% of patients discharged with no self-reported symptoms while all of the subjects in the nasal saline group discharged with lingering symptoms. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of lower respiratory-tract infections such as COVID-19.

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Safety and efficacy update: Alvimopan in postoperative ileus

Clinical Medicine Therapeutics ◽

10.4137/cmt.s2384 ◽

2009 ◽

Vol 1 ◽

pp. CMT.S2384 ◽

Cited By ~ 1

Author(s):

David T. Beattie

Keyword(s):

Postoperative Ileus ◽

Bowel Resection ◽

Human Subjects ◽

The United States ◽

Opioid Agonist ◽

Phase 3 ◽

Healthy Human ◽

Primary Metabolite ◽

Opioid Receptor Antagonists ◽

Multiple Species

Postoperative ileus (POI) in patients undergoing abdominal surgery is associated with significant morbidity. In 2008, alvimopan (Entereg®) was approved by the Food and Drug Administration (FDA), and is the only available POI therapy in the United States for patients undergoing bowel resection. Data from preclinical studies demonstrate that alvimopan and its primary metabolite, ADL 08-0011, behave as potent μ. opioid receptor antagonists. In animals, alvimopan and ADL 08-0011 attenuate opioid agonist-induced reductions in gastrointestinal (GI) transit. Higher doses of alvimopan are required to inhibit opioid-induced analgesia as a result of its inability to penetrate the central nervous system (CNS). ADL 08-0011 is also peripherally selective, although to a lesser degree than alvimopan. In multiple species, including humans, alvimopan has low oral bioavailability, while ADL 08-0011, following its generation by human gut microflora, is more readily absorbed and achieves higher exposures. Three Phase 2 and five Phase 3 clinical trials have been conducted to investigate the efficacy and tolerability of alvimopan in patients undergoing bowel resection. An additional Phase 3 study was conducted in hysterectomy patients. In the majority of the studies, statistically significant, and clinically meaningful, acceleration of GI recovery has been demonstrated. Consistent with animal data, alvimopan has no effect on opioid agonist-induced analgesia in healthy human subjects and POI patients. Clinical experience to date in POI patients indicates that alvimopan is well tolerated when used according to its approved dosing regimen (12 mg b.i.d. for up to 7 days). In this article, the preclinical and clinical properties of alvimopan are reviewed.

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WEARABLE SWEAT SENSING DEVICE FOR DETECTION OF IBD BIOMARKERS

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa347.028 ◽

2021 ◽

Vol 27 (Supplement_1) ◽

pp. S12-S12

Author(s):

Badrinath Jagannath ◽

Sriram Muthukumar ◽

Shalini Prasad

Keyword(s):

Real Time ◽

Dynamic Range ◽

Electrochemical Impedance ◽

Limit Of Detection ◽

Human Subjects ◽

The United States ◽

Healthy Human ◽

Affinity Capture ◽

Specific Affinity ◽

Impedance Spectroscopy Technique

Abstract Introduction Inflammatory Bowel Disease affects 1.2 million in the United States. Flare-up of the disease occurs in a random way and current testing methods lack ability for real-time prediction of a flare up. The levels of cytokines elevate during a flareup. Therefore, we hypothesize that real-time monitoring of cytokine biomarkers can be useful for early detection of flare-ups and provide better patient management. In this context, sweat-based diagnostics can be promising for real-time tracking of IBD biomarkers. Materials and Methods A wearable SWEATSENSER was developed by functionalization of specific affinity capture probes (IL-1β, CRP antibodies) on metal/semiconducting interface deposited on a porous patch substrate. Electrochemical impedance spectroscopy technique was used to detect the interaction between the specific antibody and target analyte. The developed SWEATSENSER was tested on 20 healthy human subjects in compliance with an approved IRB at UT Dallas. Continuous on-body measurements were recorded to report IL-1β, CRP levels in sweat in real-time. Results In this work, a wearable multiplexed sweat sensor for detection of IL-1β, CRP in sweat has been demonstrated. The sensor demonstrates a limit of detection of 1 pg/mL with a dynamic range from 1 pg/mL- 512 pg/mL for both the biomarkers in sweat. The sweat sensor demonstrated excellent correlation with reference ELISA method (Pearson’s r ≥0.95). On-body monitoring using sweat sensor from passively perspired human sweat demonstrated a mean concentration of 28 pg/mL for IL-1β in healthy cohort. Conclusion A wearable sweat sensor was developed to monitor potential IBD markers in sweat. The developed device can be useful in better management of IBD patients.

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Influence of Demographic Factors on Serum Concentrations of Seven Chemical Constituents in Healthy Human Subjects

Clinical Chemistry ◽

10.1093/clinchem/19.4.395 ◽

1973 ◽

Vol 19 (4) ◽

pp. 395-402 ◽

Cited By ~ 12

Author(s):

David M Goldberg ◽

Alan J Handyside ◽

David A Winfield

Keyword(s):

Uric Acid ◽

Human Subjects ◽

Chemical Constituents ◽

Smoking Habit ◽

Blood Chemistry ◽

Regression Equations ◽

Healthy Human ◽

Laboratory Staff ◽

Calcium And Magnesium ◽

Screening Clinic

Abstract Serum from 519 subjects attending a screening clinic and from the laboratory staff was used to study the influence of age, sex, body weight, social class, blood pressure, and smoking habit upon the concentration in serum of urea, uric acid, cholesterol, inorganic phosphate, total protein, calcium, and magnesium. Values for urea, uric acid, calcium, and magnesium were significantly higher in males. Age was a positive determinant of urea and cholesterol in both sexes, and of magnesium in females only. The correlation of uric acid with age was positive in females and negative in males, but in both sexes the correlation between uric acid and weight was strongly positive. Regression equations were developed to express the demographic and nondemographic contributions to the individual's blood chemistry values. From these, a set of demographically-corrected reference values were derived. When applied to a selected group of female hospital outpatients, these seemed to discriminate more accurately between subjects with and without disease than did conventional parametric limits.

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COVID-19 symptoms reduce with targeted hydration of the nose, larynx and trachea

10.21203/rs.3.rs-1089497/v2 ◽

2022 ◽

Author(s):

Carolin Elizabeth George ◽

Gerhard Scheuch ◽

Ulf Seifart ◽

Leeberk Inbaraj ◽

Sindhulina Chandrasingh ◽

...

Keyword(s):

Oxygen Saturation ◽

Low Income ◽

Human Subjects ◽

Droplet Generation ◽

Saline Control ◽

Control Group ◽

Upper Airways ◽

Two Phase ◽

Total Body Mass ◽

Tract Infections

Abstract Dirty air and poor access to healthcare threatens the lives of billions of people in low-income regions of the world. We investigated whether upper-airway hydration might alter two-phase flow in the airways on normal tidal breathing and be a useful, safe, easily distributed non-drug intervention for limiting risks of COVID-19. In observational human volunteer studies involving 464 human subjects in Marburg, Germany (357 normal subjects), Boston, US (20 healthy subjects), and Bangalore, India (87 subjects recently tested positive for COVID-19), we find that respiratory droplet generation increases by up to 4 orders of magnitude with up to 1% total body mass dehydration (n=20), and in dehydration-associated states of advanced age (n=357), elevated BMI-age (n=148), and SARS-CoV-2 infection (n=87). Hydration of the nose, larynx and trachea in a protocol of exercise-induced dehydration by the nasal inhalation of calcium-rich hypertonic salt droplets of mean diameter 8-12 µm diminished respiratory droplet numbers and increased oxygenation relative to a non-treatment control (P<0.05). In a randomized double-blinded nasal-saline control study, thrice-a-day delivery of the calcium-rich hypertonic salts (active) over three days suppressed respiratory droplet generation by 51% +/- 11% and increased oxygen saturation by 48.08% ± 9.61% (P<0.001) in COVID-19 positive subjects (n=20), while no changes in exhaled aerosol (P=0.235) or oxygen saturation (P=0.533) were observed in the nasal-saline control group (n=20). In the active group 47% of patients discharged with no self-reported symptoms while all of the subjects in the nasal saline group discharged with lingering symptoms. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of lower respiratory-tract infections such as COVID-19.

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Minimizing Carry-Over Effects After Treatment Failure and Maximizing Therapeutic Outcome

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000180 ◽

2014 ◽

Vol 222 (3) ◽

pp. 171-178 ◽

Cited By ~ 3

Author(s):

Mareile Hofmann ◽

Nathalie Wrobel ◽

Simon Kessner ◽

Ulrike Bingel

Keyword(s):

Treatment Failure ◽

Human Subjects ◽

Subsequent Treatment ◽

Clinical Samples ◽

Administration Route ◽

Healthy Human ◽

Negative Experiences ◽

Analgesic Treatment ◽

Balanced Design ◽

Carry Over

According to experimental and clinical evidence, the experiences of previous treatments are carried over to different therapeutic approaches and impair the outcome of subsequent treatments. In this behavioral pilot study we used a change in administration route to investigate whether the effect of prior treatment experience on a subsequent treatment depends on the similarity of both treatments. We experimentally induced positive or negative experiences with a topical analgesic treatment in two groups of healthy human subjects. Subsequently, we compared responses to a second, unrelated and systemic analgesic treatment between both the positive and negative group. We found that there was no difference in the analgesic response to the second treatment between the two groups. Our data indicate that a change in administration route might reduce the influence of treatment history and therefore be a way to reduce negative carry-over effects after treatment failure. Future studies will have to validate these findings in a fully balanced design including larger, clinical samples.

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Detection of Soluble Fibrin Monomer Complexes in Blood by Means of Protamine Sulphate Test

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651247 ◽

1968 ◽

Vol 20 (01/02) ◽

pp. 044-049 ◽

Cited By ~ 33

Author(s):

B Lipiński ◽

K Worowski

Keyword(s):

Human Subjects ◽

Coronary Thrombosis ◽

Mean Value ◽

Healthy Human ◽

Protamine Sulphate ◽

Soluble Fibrin ◽

Fibrin Monomer ◽

Dog Plasma ◽

The Mean ◽

Precipitable Protein

SummaryIn the present paper described is a simple test for detecting soluble fibrin monomer complexes (SFMC) in blood. The test consists in mixing 1% protamine sulphate with diluted oxalated plasma or serum and reading the optical density at 6190 Å. In experiments with dog plasma, enriched with soluble fibrin complexes, it was shown that OD read in PS test is proportional to the amount of fibrin recovered from the precipitate. It was found that SFMC level in plasma increases in rabbits infused intravenously with thrombin and decreases after injection of plasmin with streptokinase. In both cases PS precipitable protein in serum is elevated indicating enhanced fibrinolysis. In healthy human subjects the mean value of OD readings in plasma and sera were found to be 0.30 and 0.11, while in patients with coronary thrombosis they are 0.64 and 0.05 respectively. The origin of SFMC in circulation under physiological and pathological conditions is discussed.

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