ABSTRACT
OBJECTIVES: Chemical pleurodesis is an important therapeutic tool to control recurrent malignant pleural effusion. Among the various sclerosing agents, iodopovidone is considered effective and safe. However, in a recent study, ocular changes were described after iodopovidone was used in recurrent pneumothorax. The aim of the study was to evaluate the efficacy and morbidity of iodopovidone pleurodesis in an experimental model. METHODS: New Zealand rabbits were submitted to intrapleural injection of iodopovidone at concentrations of 2%, 4% and 10%. Biochemical (lactic dehydrogenase, proteins, triiodothyronine, free thyroxine, urea and creatinine) and immunological (Interleukin-8 [IL-8], VEGF and TGFβ) parameters were measured in the pleural fluid and blood. After 1, 3, 7, 14 and 28 days, groups of animals were euthanized, and macro- (pleura) and microscopic (pleura and retina) analyses were performed. RESULTS: An early pleural inflammatory response with low systemic repercussion was observed without corresponding changes in thyroid or renal function. The higher concentrations (4% and 10%) correlated with greater initial exudation, and maximum pleural thickening was observed after 28 days. No changes were observed in the retinal pigment epithelium of the rabbits. CONCLUSION: Iodopovidone is considered to be an effective and safe sclerosing agent in this animal model. However, its efficacy, tolerance and safety in humans should be further evaluated. .
Subject(s)
Animals , Rabbits , Pleural Effusion, Malignant/therapy , Pleurodesis/methods , Povidone-Iodine/administration & dosage , Sclerosing Solutions/administration & dosage , Cytokines/blood , Enzyme-Linked Immunosorbent Assay , Models, Animal , Pleura/drug effects , Povidone-Iodine/adverse effects , Retinal Pigment Epithelium/drug effects , Sclerosing Solutions/adverse effects , Time FactorsABSTRACT
Background & objectives: Chemical pleurodesis is an accepted therapy for patients with recurrent pleural effusions and pneumothorax. Iodopovidone has been shown to be safe and effective for chemical pleurodesis in several studies. The aim of this systematic review was to update a previously reported meta-analysis on the efficacy and safety of iodopovidone pleurodesis. Methods: Two databases MEDLINE and EMBASE were searched for a period (1952-2010), and studies that have reported success rates with iodopovidone pleurodesis were selected. The proportions with 95 per cent confidence interval (CI) were calculated to assess the outcomes in the individual studies and the results were pooled using a random effects model. Results: Thirteen eligible studies with 499 patients were included in the mata-analysis. The success rates varied from 70 to 100 per cent in different studies with the pooled success rate being 88.7 per cent (95% CI, 84.1 to 92.1). The success rate was not affected by the method (tube thoracostomy vs. thoracoscopy, 89.6 vs. 94.2%) or the indication of pleurodesis (pleural effusion vs. pneumothorax, 89.2 vs. 94.9%). The only significant complication reported was chest pain of varying degree. Systemic hypotension was reported in six patients across the studies. There were no deaths associated with iodopovidone pleurodesis. Statistical heterogeneity and publication bias were found. Interpretation & conclusions: Iodopovidone may be considered a safe and effective agent for chemical pleurodesis in patients with pleural effusions and recurrent pneumothoraces.
Subject(s)
Chest Pain/chemically induced , Humans , Pleural Effusion/pathology , Pleural Effusion/therapy , Pleurodesis/methods , Pneumothorax/pathology , Pneumothorax/therapy , Povidone-Iodine/administration & dosage , Povidone-Iodine/adverse effects , Talc/administration & dosageABSTRACT
An open prospective trial was undertaken among 50 patients to evaluate the efficacy and safety of metronidazole and povidone iodine in comparison to povidone iodine alone in pre- and postoperative sterilisation and surgical wound healing. It was found that the combination of metronidazole and povidone iodine is superior to povidone iodine alone in respect to efficacy, in the study.
Subject(s)
Adult , Anti-Infective Agents/adverse effects , Anti-Infective Agents, Local/therapeutic use , Drug Therapy, Combination , Female , Humans , Male , Metronidazole/adverse effects , Postoperative Care , Povidone-Iodine/adverse effects , Preoperative Care , Prospective Studies , Surgical Wound Infection/drug therapy , Treatment OutcomeABSTRACT
Trata-se de um ensaio clínico randomizado em 27 pacientes cardiopatas (clínicos e cirúrgicos) com o objetivo de testar a efetividade do TCM (triglicerídeos de cadéia média) com AGE (ácidos graxos essenciais) como modalidade terapêutica de úlceras de decúbito. O estudo foi efetuado em dois grupos de pacientes cardiopatas utilizando-se para o primeiro grupo soluçäo de TCM com AGE e o segundo grupo PVPI (polivinilpirrolidona-iodo) tópico no tratamento das úlceras. Observou-se que com a soluçäo de TCM com AGE houve uma reduçäo na área total das úlceras de 8 cm2 na primeira semana e com PVPI houve um aumento de 1 cm2 na primeira semana. Da primeira semana à terceira semana a reduçäo da área com TCM com AGE foi de 22,7 cm2 e com PVPI houve um aumento de 7 cm2. Comprovou-se a efetividade da soluçäo de TCM com AGE comparado com a soluçäo convencional que após a sua aplicaçäo aumentou o tamanho da escara.
Subject(s)
Humans , Adult , Middle Aged , Povidone-Iodine/adverse effects , Fatty Acids, Essential/therapeutic use , Triglycerides/therapeutic use , Pressure Ulcer , Heart DiseasesABSTRACT
Se instiló una solución al 10% de yodo-povidona en la cavidad abdominal de diversas especies de animales. En todas se demostró un efecto letal en breve plazo con dosis entre 10 y 40 cc/kg. Se obtuvo dosis letal-50 en ratones C57-CFW que correspondió a 5 cc/kg. Se concluye que la yodo-povidona por vía intraperitoneal es tóxica y que su uso debe ser limitado a cavidades bloqueadas. Se requerirán más estudios para determinar su utilidad e inocuidad en lavados peritoneales de toda la cavidad