Radial artery patency outcomes with saline flushing of the radial sheath after coronary intervention: A prospective cohort study.

OBJECTIVE: The implications of saline flushing of the radial sheath have not been studied in terms of radial artery occlusion. We aimed to investigate radial artery patency outcomes after the saline flush of the radial sheath. METHODS: In this prospective observational study, patients were selected to receive either radial sheath flushing with 10 mL of saline after pulling the sheath to one-third of its length (Group 1) or standard care (Group 2) after removal of the catheter sheath as per physician discretion. Radial artery patency was assessed by Doppler ultrasound at 24 h and 30 days after the procedure. RESULTS: A total of 2877 patients were enrolled in the study, with 1340 receiving radial sheath flushing and 1537 receiving standard care. At 24 h after the procedure, the incidence of radial artery occlusion was significantly lower in the radial sheath flushing group compared to the standard care group (4.4% vs 12.6%, p = 0.027). This difference persisted 30 days after the procedure (6.1% vs 15.8%, p = 0.015). Radial sheath flushing was independently associated with a lower risk of radial artery occlusion 30 days after the procedure, after adjusting for potential confounders (OR 0.375, 95% CI 0.18-0.77, p = 0.008). CONCLUSION: In conclusion, this prospective study provides evidence to support the use of radial sheath flushing after coronary intervention via the radial artery as a simple and effective strategy for reducing the risk of radial artery occlusion without increasing the risk of other adverse outcomes.

Sodium in the skin: a summary of the physiology and a scoping review of disease associations.

A large and growing body of research suggests that the skin plays an important role in regulating total body sodium, challenging traditional models of sodium homeostasis that focused exclusively on blood pressure and the kidney. In addition, skin sodium may help to prevent water loss and facilitate macrophage-driven antimicrobial host defence, but may also trigger immune dysregulation via upregulation of proinflammatory markers and downregulation of anti-inflammatory processes. We performed a systematic search of PubMed for published literature on skin sodium and disease outcomes and found that skin sodium concentration is increased in patients with cardiometabolic conditions including hypertension, diabetes and end-stage renal disease; autoimmune conditions including multiple sclerosis and systemic sclerosis; and dermatological conditions including atopic dermatitis, psoriasis and lipoedema. Several patient characteristics are associated with increased skin sodium concentration including older age and male sex. Animal evidence suggests that increased salt intake results in higher skin sodium levels; however, there are conflicting results from small trials in humans. Additionally, limited data suggest that pharmaceuticals such as diuretics and sodium-glucose co-transporter-2 inhibitors approved for diabetes, as well as haemodialysis may reduce skin sodium levels. In summary, emerging research supports an important role for skin sodium in physiological processes related to osmoregulation and immunity. With the advent of new noninvasive magnetic resonance imaging measurement techniques and continued research on skin sodium, it may emerge as a marker of immune-mediated disease activity or a potential therapeutic target.

Health related quality of life in pregnant women: a comparison between urban and rural populations.

OBJECTIVE: To study mental and physical health of pregnant women and compare the differences between those residing in urban and rural settings. METHODS: A Cross-Sectional Survey was conducted on pregnant women (n=179) in urban and rural areas of Islamabad in January 2009. SF-12, a validated instrument for mental and physical health assessment was used and translated into Urdu. Responses were decoded as per SF-12 analysis protocol. Independent sample t-test was done to compare the quantitative variables. The level of statistical significance was p<0.05. The survey was filled either by the participant or the research team and was anonymous. All the researchers were trained in the interview technique in order to make sure that each question carried the same meaning during the actual survey. This was done to standardize the survey methodology. RESULTS: A total of 179 survey forms were collected, 83 and 96 from both rural and urban areas respectively. Role Limitations because of Physical Problems (p=0.020), General Health Perceptions (p=0.001) and Role Limitations because of Emotional Problems (p=0.023) had statistically significantly lower scores in rural women as compared to urban women. CONCLUSION: Self-perceived mental and physical health was better in urban pregnant women than in rural women.