Résumé
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. .
Sujets)
Animaux , Lapins , Épanchement pleural malin/thérapie , Pleurodèse/méthodes , Povidone iodée/administration et posologie , Solutions sclérosantes/administration et posologie , Cytokines/sang , Test ELISA , Modèles animaux , Plèvre/effets des médicaments et des substances chimiques , Povidone iodée/effets indésirables , Épithélium pigmentaire de la rétine/effets des médicaments et des substances chimiques , Solutions sclérosantes/effets indésirables , Facteurs tempsRésumé
Introduçäo: os pacientes de tumores oculares podem ter pior prognóstico visual e sistêmico na ocorrência de atraso diagnóstico e tratamento empreendida por esses pacientes e descrever as características demográficas e clínicas dos mesmos. Material e métodos: entrevista com pacientes portadores de tumores oculares de diagnóstico recente atendidos em hospital universitário no período de maio/95 a maio/96. Resultados: foram avaliados 37 pacientes. Os tumores malignos encontrados com maior frequência foram retinoblastoma, carcinoma epidermoide de conjuntiva e melanoma de coróide. A trajetória desde o início do quadro ocular até a terapêutica desenvolveu-se em quatro etapas principais, com problemas diferentes relatados em cada uma delas. As etapas de 1 a 3, relacionadas ..