Effect of silver diamine fluoride, potassium iodide, and glutathione on micro-shear bond strength of glass ionomer cement to caries affected dentine

Background: Silver diamine fluoride (SDF, 38%) is an efficient topical fluoride used to arrest dental caries though it causes black staining of both teeth and restoration. The application of potassium iodide (KI) after SDF reduces the stain, but the color change is only temporary. An alternative method suggested is by mixing glutathione (GSH) with SDF, which preserves the silver ions of SDF within the solution. Hence, the purpose of this in vitro study was to evaluate the microshear bond strength (?SBS) of glass ionomer cement (GIC) to caries affected dentin (CAD) pretreated with SDF/KI/GSH. Materials and Methods: Thirty dentine slices of 2 mm thickness from human permanent upper premolars were demineralized using pH cycling method to mimic CAD. They were allocated to three groups of 10 each and treated with SDF, SDF-KI (SDF followed by KI), SDF + GSH (SDF mixed with GSH), respectively. Specimens were bonded with GICs. The ?SBS was assessed using a universal testing machine and the data obtained were analyzed using one-way ANOVA and Tukey's post hoc test. Results: The ?SBS (mean ± standard deviation) values for groups SDF, SDF-KI, and SDF + GSH were 4.81 ± 2.026, 5.78 ± 1.809, 8.18 ± 2.828 megapascal respectively. Group 3 showed significantly better bond strength compared to groups 1 and 2. In group 2, the addition of KI showed better bond strength when compared to group 1, but the difference was not statistically significant. Conclusion: Pretreatment of teeth with GSH along with SDF application showed significantly better bond strength of GIC to CAD compared to SDF and SDF-KI.

Preeclampsia and Gestational Hypertension: Biochemical and Antioxidant Features in Vitro Might Help Understand Different Outcomes / Pré-eclâmpsia e hipertensão gestacional: Fatores bioquímicos e antioxidantes in vitro podem auxiliar no entendimento de resultados clínicos distintos

Abstract Objective Gestational hypertension (GH) is characterized by increased blood pressure after the 20th gestational week; the presence of proteinuria and/or signs of end-organ damage indicate preeclampsia (PE). Heme oxygenase-1 (HO-1) is an antioxidant enzyme with an important role in maintaining endothelial function, and induction of HO-1 by certain molecules shows potential in attenuating the condition's effects over endothelial tissue. HO-1 production can also be stimulated by potassium iodide (KI). Therefore, we evaluated the effects of KI over HO-1 expression in human umbilical vein endothelial cells (HUVECs) incubated with plasma from women diagnosed with GH or PE. Methods Human umbilical vein endothelial cells were incubated with a pool of plasma of healthy pregnant women (n = 12), pregnant women diagnosed with GH (n = 10) or preeclamptic women (n = 11)with or without the addition of KI for 24 hours to evaluate its effect on this enzyme expression. Analysis of variance was performed followed by Dunnet's test for multiple comparisons between groups only or between groups with addition of KI (p ≤ 0.05). Results KI solution (1,000 µM) reduced HO-1 in the gestational hypertension group (p = 0.0018) and cytotoxicity in the preeclamptic group (p = 0.0143); treatment with KI reduced plasma cytotoxicity but did not affect the preeclamptic group's HO-1 expression. Conclusion Our findings suggest that KI alleviates oxidative stress leading to decreased HO-1 expression; plasma from preeclamptic women did not induce the enzyme's expression in HUVECs, and we hypothesize that this is possibly due to inhibitory post-transcriptional mechanisms in response to overexpression of this enzyme during early pregnancy.

Resumo Objetivo A hipertensão gestacional (GH) é caracterizada pelo aumento da pressão sanguínea após a 20ª semana de gestação; a presença de proteinuria e/ou sinais de danos a órgãos como rins, fígado e cérebro indicam pré-eclâmpsia (PE). A heme oxigenase-1 (HO-1) é uma enzima antioxidante com um papel importante na manutenção da função endotelial, e a sua indução por certas moléculas se mostra potencialmente benéfica frente à característica deletéria destas condições sobre o endotélio. Já foi demonstrado anteriormente que a produção de HO-1 pode ser induzida por iodeto de potássio (KI). Portanto, nós avaliamos os efeitos do KI sobre a citotoxicidade e expressão de HO-1 por células de veia de cordão umbilical humano (HUVECs) após incubação com o plasma de mulheres diagnosticadas com GH ou PE. Métodos Células de veia de cordão umbilical humano foram incubadas com pool de plasma de gestantes saudáveis (n = 12), gestantes com GH (n = 10) ou gestantes com PE (n = 11) com ou sem a adição de KI por 24 horas para avaliar a citotoxicidade através da dosagem de lactato desidrogenase e produção de HO-1 por ELISA. Foi realizada ANOVA seguida de teste de Dunnet para múltiplas comparações entre os grupos estudados, considerando significativos valores de p ≤ 0,05. Resultados A solução de KI (1.000 µM) reduziu a produção de HO-1 no grupo GH (p = 0.0018) e a citotoxicidade no grupo PE (p = 0.0143); o tratamento com KI não afetou a produção de HO-1 por HUVECs incubadas com o plasma do grupo PE. Conclusão Nossos achados sugerem que o KI atenua os efeitos do plasma de gestantes com GH ocasionando a diminuição da produção de HO-1; plasma do grupo PE não induziu a produção de HO-1 em HUVECs em comparação ao grupo saudável, e nossa hipótese é a de que tal achado pode ser devido a mecanismos pós-transcricionais em resposta a uma superestimulação da produção de HO-1 nos estágios iniciais da gravidez.

Effect of iodine supplementation in pregnancy on neurocognitive development on offspring in iodine deficiency areas: a systematic review

ABSTRACT Objective: To investigate the effect of iodine supplementation during gestation on the neurocognitive development of children in areas where iodine deficiency is common. Materials and methods: Based on the PRISMA methodology, we conducted the search for articles in the PubMed, LILACS and Scopus databases, between March and April 2020, without limitation of dates. We used descriptors in English, Portuguese, and Spanish, without filters. Four clinical trials and four cohort articles were included in the review. Results: The maximum supplementation was 300 μg of potassium iodide per day. The Bayley scale and Children's Communication Checklist-Short were used to assess neurodevelopment in children. There was no significant improvement in the children's mental development index and behavioural development index in the supplemented group; however, the psychomotor development index (PDI) showed improvement in the poorer gross motor skills. We found differences in the response time to sound in the supplemented group living in mild deficiency areas. Conclusion: Daily supplementation with iodine can improve poor psychomotor development of children living in mild to moderate iodine deficiency areas. Thus, it is necessary to perform further studies to assess the effect of supplementation on neurodevelopment before, during and after gestation in mild to moderate iodine deficiency areas.

Sporotrichosis refractory to conventional treatment: therapeutic success with potassium iodide

Abstract Sporotrichosis is a subcutaneous mycosis caused by dimorphic fungi of the genus Sporothrix. The authors report a case of fixed cutaneous sporotrichosis with therapeutic failure after 18 months of itraconazole and terbinafine associated with cryosurgery. The patient was cured after the introduction of saturated potassium iodide solution. Sporothrix brasiliensis was the identified species, presenting a susceptibility profile to itraconazole and terbinafine. This fact suggests that therapeutic failure is probably related to the host-fungus interaction rather than drug resistance. It is possible that the immunomodulatory action of the saturated potassium iodide solution may have played an important role in curing this patient.

Comparison of staining potential of silver diamine fluoride versus silver diamine fluoride and potassium iodide under tooth-colored restorations

Background: Silver diamine fluoride (SDF) is one of the effectual cariostatic agents widely used in minimal intervention dentistry. However, the major drawback of SDF is dark staining after its application. Aim: In the present study, the staining of 38% SDF alone and 38% SDF and potassium iodide (KI) was compared after restoration with glass-ionomer cement (GIC) and resin composite using ImageJ software. Methods and Material: Forty extracted carious primary teeth were sorted into four groups. In Group I and II, SDF was applied and restored with GIC and composite restorations, respectively. In Group III and IV, SDF application was followed by KI and restored with GIC and composite restorations, respectively. Images were captured after initial applications on day 1 and day 14 after restoration. The captured images were imported to ImageJ software and mean gray values were calculated. Statistical Analysis: The mean gray values obtained were subjected to statistical analysis using paired t-test and independent sample t-test. There was statistically significant if P < 0.05. Results: Following the application of SDF and RIVA STAR, the baseline mean gray values showed no statistical significance. On day 1, the mean gray values were highest in Group IV (208.30) and lowest in Group I (178.51). Similarly, on day 14, the highest mean gray values were observed in Group IV (208.45) and lowest in Group I (147.6) which were statistically significant. Conclusions: The restorations after SDF application attained dark stain eventually, whereas with the application of SDF followed by KI (RIVA STAR), the restorations showed the least staining.

Potassium iodide promotes the pyroptosis of thyroid follicular epithelial cells through the PARP1-NF-κB-NLRP3 inflammasome activation / 中华内分泌代谢杂志

Objective:To explore the mechanism of potassium iodide-induced pyrolysis of thyroid follicular cells.Methods:Thyroid gland tissue was obtained from patients with thyroid cancer (TC) coexisting with Hashimoto′s thyroiditis, and the tumor-adjacent Hashimoto′s thyroiditis tissue was used as the control. ELISA was used to detect the concentration of the pyroptosis inflammatory cytokines interleukin (IL)-1β and IL-18 in the tissues, and Western blotting was used to detect the activation of gasdermin (GSDM) proteins, a biomarker for pyroptosis. Thyroid follicular cells treated with different concentrations of potassium iodide, and IL-1β, IL-18, lactate dehydrogenase (LDH), GSDMD were measured. Transcriptome chip analysis was used to explore the differentially expressed genes involved in pyroptosis of thyroid follicular cells induced by potassium iodide treatment.Results:The levels of IL-1β and IL-18 cytokines in the tissues of patients with Hashimoto′s thyroiditis and thyroid cancer were higher than control tissues ( P<0.01), and the activation of the pyroptosis executive protein GSDMD was significant increased, while GSDME was not activated. IL-1β, IL-18, and LDH secretion were significantly increased in response to potassium iodide stimulation in thyroid follicular cells ( P<0.01) and GSDMD was cleaved, which indicated that potassium iodide induced the pyroptosis of thyroid follicular cells. Moreover, potassium iodide could activate NLRP3 inflammasomes to promotethe pyroptosis of thyroid follicular cells. Transcriptome chip analysis further found that PARP1 protein was highly upregulated by the stimulation of potassium iodide, and then enhanced the activity of nuclear factor-κB (NF-κB) transcription factor to induce pyroptosis. Conclusions:The findings in this study reveal that potassium iodide promotesthe pyroptosis of thyroid follicular cells through activating NF-κB-NLRP3 inflammasome, which may be a novel mechanism that promots the development of Hashimoto′s thyroiditis under the condition of excessive iodine intake. PARP1 is a pivotal protein that mediates the pyroptosis induced by potassium iodide and may be a potential therapeutic target to control Hashimoto′s thyroiditis progression.

Esporotricosis: presentación de un caso inusual / An unusual presentation of sporotrichosis: a case report

La esporotricosis es una micosis subcutánea de evolución crónica que puede afectar a humanos y animales, causada por el complejo Sporothrix schenckii, se considera un padecimiento ocupacional y su vía de entrada es a través de traumatismos, es frecuente en niños y adolescentes. Se comunica el caso de una adolescente de 12 años, con historia clínica de un año de evolución de causas no bien identificadas de dermatosis facial localizada en región pre-auricular izquierda, constituida por una placa eritematosa, escamosa, indurada, de bordes definidos. Se confirmó el diagnóstico de esporotricosis cutánea fija por el aislamiento en el cultivo y biopsia de lesión. La paciente fue dada de alta con tratamiento de yoduro de potasio durante dos meses.

Sporotrichosis is a chronic subcutaneous mycosis that can affect humans and animals caused by Sporothrix schenckii complex, it is considered an occupational disease and its route of entry is through injuries, it is common in children and adolescents. A 12-year-old female patient with a lesion of one year of evolution, not well identified causes of facial dermatosis localized in left preauricular region, consisting of an erythematous, scaly, indurated and defined edges. The diagnosis of fixed cutaneous sporotrichosis by isolation in culture and wound biopsy was confirmed. The patient was discharged with potassium iodide treatment for two months.

Assessment of acid phosphatase enzyme and influence of potassium iodide on its production in the yeast form of Sporothrix schenckii

Background: Sporotrichosis is caused by a dimorphic fungal species, Sporothrix schenckii (S. schenckii). The enzyme acid phosphatase is pervasive among yeast and yeast like fungi. It has been studied in various fungi like Aspergillus oryzae, Candida albicans etc. but in S. schenckii little is known about enzyme acid phosphatase. The present study depicts the in-vitro influence of Potassium Iodide (KI) on the enzyme acid phosphatase produced by the S. schenckii (yeast form).Methods: A master culture was prepared by incorporating the standard strain of S. schenckii in YNB (Yeast Nitrogen Base) medium and was incubated at 37ºC. After preparing the increasing concentrations with KI in YNB medium, 1.0 mL suspension of master culture was inoculated into each bottle and incubated at 37ºC for different time period 6th, 12th, 18th day (early, mid, peak of log period) respectively. After centrifuging, a 5% homogenate was prepared, which was used for acid phosphatase enzyme assay.Results: The mean acid phosphatase level of control specimen was 20.9±2.01, 50.0±2.25, 45.0±5.10 μg and test specimens was ranged from 14.9±4.89 to 20.2±3.49, 10.2±4.19 to 40.0±6.39 and 10.0±1.81 to 34.7±6.08 μg on day 6, 12 and 18 respectively. The mean value was lower significantly for all the test concentrations as compared to control (p<0.05).Conclusions: The low activity of the enzyme acid phosphatase indicates that KI has inhibitory effect on the growth of S. schenckii that has led to decrease in the activity of the enzyme.

Report of 73 cases of cutaneous sporotrichosis in Mexico

Abstract: We report 73 cases of cutaneous sporotrichosis from the Community Dermatology program, at the central and mountain areas of the state of Guerrero, Mexico. A similar number of cases was found between children and adults, mostly peasants and school-age children with rural occupations. Upper limbs were the mostly affected and the predominant clinical form was lymphocutaneous (56.16%). All cultures corresponded to Sporothrix schenckii (sl). Treatment was done with potassium iodide in 54 patients, achieving clinical and mycological cure in all cases.

Stability analysis of iodine content in potassium iodide iodized salt and potassium iodate iodized salt during production / 中华地方病学杂志

Objective To understand the stability of iodine content in potassium iodide iodized salt and potassium iodate iodized salt during production.Methods The sodium sulfate type brine well rock salt and calcium salt brine well rock salt as raw material were used to produce potassium iodide salt and potassium iodate salt by different iodization methods of before and after fluid bed dryer and then the loss of iodine during production was measured,meanwhile iodine content of powder salt was determined.According to the "Belt Delivery Sampling of Sampling Methods of the Main Products in the Salt Industry" (GB/T 8616-2001),25 standard salt samples and 6-24 powder salt samples were collected in the same batch.The salt iodine content was determined by oxidationreduction titration and direct titration of the "General Test Method in Salt Industry-Determination of Iodine" (GB/T 13025.7-2012).Results For the sodium sulfate type brine well rock salt,there was no statistical difference in iodine loss rate between potassium iodide salt and potassium iodate salt (16.55％ vs.19.60％,x2 =0.01,P ＞ 0.05) by iodization of before fluid bed dryer.The iodine loss rate of potassium iodide salt was 2.17％ and the iodine loss of potassium iodate salt was undetectable and there was no statistical difference between the two (x2 =2.19,P ＞ 0.05)by iodization of after fluid bed dryer.For calcium salt brine well rock salt,the iodine loss rate of potassium iodide was less than that of potassium iodate (20.60％ vs.39.75％,x2 =8.70,P ＜ 0.05) by iodization of before fluid bed dryer and neither of them was lost by iodization of after fluid bed dryer.Conclusions For both sodium sulfate type brine well rock salt and calcium salt brine well rock salt,the iodine loss of iodide iodized salt is not higher than that of potassium iodate during iodization of before or after fluid bed dryer.Since the iodine loss during iodization of before fluid bed dryer is significantly higher than that after fluid bed dryer,adopting iodization of after fluid bed dryer to produce iodized salt should be recommended.

Evaluation of microshear bond strength and nanoleakage of etch‑and‑rinse and self‑etch adhesives to dentin pretreated with silver diamine fluoride/potassium iodide: An in vitro study.

Aims: The aim of this in vitro study was to comparatively evaluate the microshear bond strength (MSBS) of etch‑and‑rinse and self‑etch (ER and SE) bonding systems to dentin pretreated with silver diamine fluoride/potassium iodide (SDF/KI) and nanoleakage at the resin‑dentin interface using transmission electron microscope (TEM). Subjects and Methods: Seventy‑two dentin slabs of 3 mm thickness were prepared from extracted human permanent third molars and divided into four groups (n = 18) based on the dentin surface treatment as follows: (1) ER adhesive bonding without dentin pretreatment; (2) SDF/KI pretreatment of dentin followed by ER adhesive bonding; (3) SE adhesive bonding without dentin pretreatment; and (4) SDF/KI pretreatment of dentin followed by SE adhesive bonding. Resin composite was built on the dentin slabs to a height of 4 mm incrementally, and dentin‑composite beams of approximately 1 mm2 cross‑sectional area were prepared. The beams were subjected to MSBS analysis, and the fractured surface was observed under scanning electron microscope to determine the mode of failure. The resin‑dentin interface was examined under TEM for evaluation of nanoleakage. Statistical Analysis Used: One‑way ANOVA followed by Tukey’s post hoc multiple comparison tests. Results: Pretreatment of dentin with SDF/KI increased the MSBS of ER and SE adhesives, though not statistically significant, except between Groups 2 and 3. In all the groups, the predominant mode of failure was adhesive followed by cohesive in resin, mixed and cohesive in dentin. TEM examination of resin‑dentin interface showed that pretreatment with 38% SDF/KI reduced nanoleakage regardless of the type of bonding system used. Conclusions: Pretreatment of dentin with SDF/KI minimized nanoleakage at the resin‑dentin interface without adversely affecting the bond strength of resin composite to dentin.

Esporotricosis cutánea diseminada con compromiso articular en una mujer con diabetes tipo 2 / Disseminated cutaneous sporotrichosis with joint involvement in a woman with type 2 diabetes

La esporotricosis diseminada es una presentación infrecuente de esta micosis. Aunque ha sido descrita en sujetos inmunocompetentes, con frecuencia existe compromiso de la inmunidad mediada por células T. Reportamos el caso de una mujer con diabetes tipo 2 no controlada que desarrolló esporotricosis cutánea diseminada. El curso de la enfermedad presentó varias complicaciones que incluyeron hepatitis secundaria a itraconazol y artritis de la rodilla con cultivo positivo para Sporothrix schenckii durante el tratamiento con solución saturada de ioduro de potasio. La discusión del caso incluye aspectos de la patogénesis de la esporotricosis diseminada y el manejo de la infección y sus complicaciones.

Disseminated sporotrichosis is a rare presentation of this mycosis. Although it has been described in immunocompetent individuals, there is often T cell-mediated immune compromise. We report the case of a woman with uncontrolled Type 2 diabetes who developed disseminated cutaneous sporotrichosis. The course of the disease presented several complications including hepatitis secondary to itraconazole and knee arthritis with culture positive for Sporothrix schenckii during treatment with saturated solution of potassium iodide. The case discussion includes aspects of the pathogenesis of disseminated sporotrichosis and management of the infection and its complications.

A method for fast genomic DNA extraction from saliva saliva and its application / 第二军医大学学报

Objective To explore a fast, effective and noninvasive method of genomic DNA extraction. Methods We compared the genomic DNAs extracted by two DNA extraction methods of potassium iodide (KI) and Kit from saliva (fresh and placed a week at room temperature), and PCR amplifications were done for TP53 and PRB-3 genes from their extracted DNA. Ninety-nine healthy children and adults were recruited and their saliva samples were collected to detect the stability of DNA extracted by KI. Results High quality genomic DNAs were extracted by both methods from the fresh saliva. The DNA yield based on KI was (1.91±0.15) μg, with the D260/D280 being 1.99±0.05, and that of Kit was (2.64±0.34) μg, with the D260/D280 being 1.81±0.02. Although the extracted DNAs had obvious degradation from saliva samples placed for a week at room temperature, the expectant DNA fragments were successfully amplified by PCR for TP53 and PRB-3 genes using these extracted DNAs. Although the genomic DNAs from saliva samples of 99 healthy volunteers by the method of KI showed individual difference (DNA yield was [1.89±0.46] μg), the DNA quality was stable and reliable (D260/D280 was 1.96±0.10). Conclusion KI method for extracting genomic DNA from saliva is not only cheap and highly effective, but also noninvasive, making it suitable for large-scale epidemiological studies.

Effects of short-term potassium iodide treatment for thyrotoxicosis due to Graves disease in children and adolescents

PURPOSE: Graves disease is the most common cause of hyperthyroidism in children. Inorganic iodide has been used in combination with antithyroid drugs for more effective normalization of thyroid hormones in some cases of severe thyrotoxicosis. This study aimed to investigate clinical characteristics of childhood thyrotoxicosis and effectiveness of inorganic iodide in the early phase of treatment. METHODS: Sixty-seven pediatric patients (53 girls/14 boys, 11.1+/-3.4 years of age), with newly diagnosed thyrotoxicosis due to Graves disease were recruited. Forty-nine patients were treated with antithyroid drugs alone, while 18 patients were treated with combination of antithyroid drugs and potassium iodide. Initial thyroid function tests and levels of thyroid antibodies were recorded for all patients. Thyroid function tests were repeated 2 and 8 weeks after the initiation of treatment. Measurement thyroid antibodies were done 8 weeks after the initiation of treatment. RESULTS: Mean triiodothyronine and free thyroxine levels were significantly lower (P<0.05) in the group receiving combined therapy of antithyroid drugs and potassium iodide after 2 weeks of treatment compared to the patients receiving antithyroid drugs alone. Eight weeks after the initiation of treatment, thyroid function tests in the two groups did not show significant differences. CONCLUSION: The use of potassium iodide in combination with antithyroid drug is effective for more rapid normalization of thyroid hormones in the early phase treatment of childhood thyrotoxicosis, but larger studies with adequate power are needed in future.

Tratamento da esporotricose felina refratária com a associação de iodeto de potássio e itraconazol oral / Treatment of refractory feline sporotrichosis with the association of potassium iodide and oral itraconazole

A esporotricose é uma micose causada por espécies do complexo Sporothrix. Apesar do itraconazol ser o fármaco de escolha devido a sua efetividade e segurança, casos de falência terapêutica em gatos com esta micose têm sido descritos. O iodeto de potássio em cápsulas é uma opção terapêutica nos casos felinos. Adicionalmente, este fármaco é uma alternativa em pacientes humanos não responsivos ao itraconazol. A associação do iodeto de potássio e agentes antifúngicos pode apresentar melhores resultados quando comparada à monoterapia com estes fármacos. Foi realizado um estudo de coorte, o qual teve como objetivo descrever a resposta terapêutica ao iodeto de potássio em cápsulas via oral (5 mg/kg a cada 24 horas) associado ao itraconazol via oral (100 mg/gato a cada 24 horas) em gatos com esporotricose refratária ao itraconazol, assistidos no Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos do Instituto de Pesquisa Clínica Evandro Chagas/Fiocruz no período de 2012 a 2013. Foram incluídos no estudo 38 gatos, dos quais foi observado cura clínica em 24, falência terapêutica em cinco e óbito em três gatosEm seis casos houve abandono do tratamento. O tempo mediano de tratamento até a cura clínica foi 20 semanas. Vinte e nove animais apresentaram efeitos adversos clínicos, sendo 26 classificados como grau leve. Emagrecimento, hiporexia e vômitos foram os efeitos adversos clínicos mais observados. Quatro animais apresentaram efeitos adversos laboratoriais, representado pelo aumento dos valores das enzimas hepáticas. A utilização de iodeto de potássio em cápsulas associado ao itraconazol se mostrou um esquema terapêutico efetivo e seguro, sendo uma opção na esporotricose felina refratária ao itraconazol.

Sporotrichosis is a fungal infection caused by Sporothrix species complex.Itraconazol is the drug of choice for the treatment of the disease due to itseffectiveness and safety. However, cases of treatment failure in cats have beenreported. Potassium iodide capsules are an option for the feline cases.Additionally, the drug is an alternative to human patients unresponsive toitraconazole. The association of potassium iodide and antifungal agents mayprovide better results when compared to the mono therapy with these drugs. A cohort study was conducted, which aimed to describe the therapeutic response oforal potassium iodide (5 mg/kg every 24 hours) associated with oral itraconazole(100 mg/cat every 24 hours) in cats with sporotrichosis refractory to itraconazole,followed up at the Laboratório de Pesquisa Clínica em Dermatozoonoses emAnimais Domésticos do Instituto de Pesquisa Clínica Evandro Chagas/Fiocruz between 2012 and 2013. Of the 38 cats included in the study, 24 were cured,treatment failure ocurred in five and death in three cats. In six cases there wasnon-compliance with treatment. The median time from treatment until clinical curewith the combination was 20 weeks. Twenty-nine animals presented clinical adverse effects, which were classified as mild in 26 animals. Weight loss,hiporexia and vomiting were the most frequently observed. Four animals showed laboratory adverse effects represented by an increase in liver enzymes. The useof potassium iodide associated with itraconazole has proved to be an effective andsafe therapeutic regimen and, therefore, represents an option in the treatment offeline sporotrichosis refractory to itraconazol.

Esporotricosis granulomatosa: presentación de dos casos inusuales / Granulomatous sporotrichosis: report of two unusual cases

Sporotrichosis is a subcutaneous mycosis caused by Sporothrix complex, endemic in Abancay, Peru. Is acquired by traumatic inoculation with plant material. Common clinical presentations are lymphatic cutaneous and fixed cutaneous disease. We report 2 cases of fixed cutaneous sporotrichosis with granulomatous appearance. The first case was a patient of 65 years old with no risk factors and the second case was a 67 year old diabetic patient. Subjects underwent mycological culture with Sabouraud agar, with isolation of Sporothrix schenckii and clinical dignosis of fixed cutaneous sporotrichosis with granulomatous appearance. One patient received oral treatment with saturated solution of potassium iodide (SSKI) with a initial dose of 3 drops tid up to a maximum dose of 40 drops tid. Mycological and clinical cure was achieved after 2 months of treatment. We should consider the unusual clinical presentations of fixed cutaneous sporotrichosis with granulomatous appearance that present morphological and clinical features in diabetic and nondiabetic patients older than 60 years from endemic areas and communicate adequate response to treatment with SSKI in one case.

La esporotricosis es una micosis subcutánea ocasionada por el complejo Sporothrix, endémica en Abancay, Perú. Se adquiere por inoculación traumática con material vegetal. Las formas clínicas comúnmente descritas son la cutánea linfática y cutánea fija. Presentamos dos casos de pacientes adultos con una esporotricosis cutánea fija granulomatosa. El primer caso era una paciente de 65 años de edad, sin antecedentes de riesgo y el segundo era una paciente de 67 años, diabética. El diagnóstico se realizó por cultivo micológico aislándose Sporothrix schenckii. Un caso se trató con solución saturada de yoduro de potasio (SSKI), vía oral, alcanzando la cura micológica y clínica tras dos meses de tratamiento. La otra paciente no acudió a tratamiento. Se revisan las presentaciones clínicas inusuales de la esporotricosis cutánea fija y la forma granulomatosa que presenta características morfológicas y clínicas poco habituales en pacientes diabéticos y no diabéticos mayores de 60 años provenientes de zonas endémicas.

Nanoparticles improved drug radio protective activity.

Radioprotective agents are synthetic compounds or natural products that are immediately administrated before irradiation to reduce injuries caused by ionizing radiation. Toxicity, short duration, and the unfavorable routes of administration, have prevented the widespread use of most radioprotective agents in practice. This study aimed to evaluate the use of slowly release- long circulation biodegradable polymer Poly(lactide-co-glycolide) (PLGA) as carrier for certain water-soluble radioprotective agents. Penicillamine and Potassium Iodide (KI) were selected as examples of radioprotectors which can be used to protect against both internal radionuclide (chronic radiation exposure) and external-beam irradiation (acute radiation exposure). Emulsion-solvent evaporation method (ESE) was used to prepare hydrophilic-drug loaded PLGA Nanoparticles (PLGA- NPs) in an efficient and reproducible manner. The radioprotective efficacy was assessed by 30 days-survival percentage, relative body weights, and (liver & spleen) total cell counts. Results revealed that single oral administration of Penicillamine-NPs or KINPs was effective as free drug (for 5 successive days) which indicate that PLGA-NPs could be used to modulate radioprotective drug activity in biological system, and to improve drug efficacy in different body organs for longer duration than the equal dose of free drug.

Use of potassium iodide in Dermatology: updates on an old drug / Uso do iodeto de potássio na Dermatologia: considerações atuais de uma droga antiga

Potassium iodide, as a saturated solution, is a valuable drug in the dermatologist's therapeutic arsenal and is useful for the treatment of different diseases due to its immunomodulatory features. However, its prescription has become increasingly less frequent in dermatology practice. Little knowledge about its exact mechanism of action, lack of interest from the pharmaceutical industry, the advent of new drugs, and the toxicity caused by the use of high doses of the drug are some possible explanations for that. Consequently, there are few scientific studies on the pharmacological aspects, dosage and efficacy of this drug. Also, there is no conventional standard on how to manipulate and prescribe the saturated solution of potassium iodide, which leads to unawareness of the exact amount of the salt being delivered in grams to patients. Considering that dosage is directly related to toxicity and the immunomodulatory features of this drug, it is essential to define the amount to be prescribed and to reduce it to a minimum effective dose in order to minimize the risks of intolerance and thus improve treatment adherence. This review is relevant due to the fact that the saturated solution of potassium iodide is often the only therapeutic choice available for the treatment of some infectious, inflammatory and immune-mediated dermatoses, no matter whether the reason is specific indication, failure of a previous therapy or cost-effectiveness.

Iodeto de potássio, sob a forma de solução saturada, é um valioso medicamento no arsenal terapêutico do dermatologista. É usado há mais de um século e útil para doenças de fisiopatologias diversas em virtude de seu caráter imunomodulador. Prescrevê-lo, entretanto, tem se tornado cada vez menos frequente na prática dermatológica. O pouco conhecimento sobre seu exato mecanismo de ação, o desinteresse da indústria farmacêutica com o advento de novos fármacos, além da toxicidade do medicamento pelas altas doses utilizadas são algumas das possíveis justificativas. Dessa forma, os estudos científicos envolvendo seus aspectos farmacológicos, posológicos e de eficácia são relativamente raros. Consequentemente, não se convencionou uma padronização na forma de manipular e prescrever a solução saturada de iodeto de potássio, o que causa um verdadeiro desconhecimento da dose exata em gramas do sal que está sendo fornecida aos pacientes. Ao considerar que a dose está diretamente relacionada toxicidade e o conhecimento da característica imunomoduladora dessa droga, é importante definir a quantidade a ser fornecida, reduzindo-a até a dose mínima eficaz, de forma a diminuir a intolerância e melhorar a adesão ao tratamento. A relevância do tema se deve ao fato da solução saturada de iodeto de potássio ser, muitas vezes, a única escolha na terapêutica disponível para o tratamento de algumas dermatoses de origem infecciosa, inflamatória ou imunomediada, quer por indicação específica, por falha de outro medicamento ou por seu custo acessível.

Ocorrência familiar de esporotricose zoonótica / Familial occurrence of zoonotic sporotrichosis

A esporotricose é micose subaguda ou crônica, causada pelo fungo dimórfico Sporothrix schenckii, endêmica no Brasil e transmitida principalmente através da inoculação traumática de seu agente causal na pele. A transmissão zoonótica, especialmente por gatos infectados, tem sido demonstrada em diversos relatos e séries de casos. Nós descrevemos a ocorrência simultânea da doença em três membros de uma mesma família através da arranhadura por gato doméstico infectado. Dois pacientes desenvolveram a forma cutânea-linfática e apenas um desenvolveu a forma cutânea fixa. Dois pacientes foram tratados com sucesso, com solução saturada de iodeto de potássio; entretanto, o terceiro caso apresentou efeitos colaterais e teve seu tratamento substituído por itraconazol, com resolução de suas lesões.

Sporotrichosis is a subacute or chronic mycosis caused by the dimorphic fungus Sporothrix schenckii which is endemic in Brazil and is transmitted primarily through traumatic inoculation of its causative agent into the skin. The zoonotic transmission, especially from infected cats, has been demonstrated in several reports and case series. We present simultaneous occurrence of the disease in three members of the same family by scratches from an infected domestic cat. Two patients developed the lymphocutaneous form and one only developed the fixed cutaneous form. Two patients were successfully treated with saturated solution of potassium iodide; however, the third case reported side effects and had his therapy substituted for itraconazole, with resolution of his lesions.

Cutaneous sporotrichosis treatment with potassium iodide: a 24 year experience in São Paulo state, Brazil / Tratamento da esporotricose cutânea com sski: experiência de 24 anos no estado de São Paulo, Brasil.

BACKGROUND: Sporotrichosis is a subacute or chronic disease caused by a dimorphic fungus, Sporothrix schenckii. The first and most traditional treatment is potassium iodide in satured solution (SSKI) used by DE BEURMANN in 1907. For its effectiveness, it is still used for cutaneous sporotrichosis. OBJECTIVE: To evaluate the treatment of cutaneous sporotrichosis with SSKI in relation to clinical cure, side effects, length of treatment and reactivation. METHODS: We conducted a retrospective analysis of medical records over a 24-year period (1981-2005). Patients of all ages who were treated in the hospital´s division of dermatology were included in the study providing that they had a positive culture of S. schenckii. Satured solution of potassium iodide (3 to 6g per day) was the treatment prescribed. For children, half of the dose was prescribed. RESULTS: The lymphocutaneous disease was prevalent, the cure rate was 94.7 percent, side effects were described in 5.5 percent of the cases, mean length of treatment was 3.5 months and possible reactivation was observed in 11.1 percent. CONCLUSION: SSKI is an effective drug, with many side effects, but with low frequency. Resolution was for maximum six months of treatment. SSKI has been found to be a very effective drug in this retrospective study of culture-proven cases of cutaneous and lymphocutaneous sporotrichosis. It should be used as first drug of choice especially in resource-limited settings.

FUNDAMENTOS: Esporotricose é doença subaguda ou crônica causada pelo fungo dimórfico Sporothrix schenckii. O primeiro e mais tradicional tratamento é o iodeto de potássio em solução saturada (SSKI) usado por De Beurmann em 1907. Por ser eficaz,ainda é muito utilizada no nosso meio para o tratamento da esporotricose cutânea. OBJETIVOS: Avaliar o tratamento da esporotricose cutânea com SSKI em relação à cura clínica, efeitos colaterais, tempo de tratamento e recidiva. MÉTODOS: A partir da revisão dos resultados de exames do laboratório de Micologia da Clínica de Dermatologia da Santa Casa de SP, durante 1981 a 2005, foram incluídos pacientes de qualquer idade com lesão cutânea sugestiva de esporotricose e cultura positiva para S. schenckii. Em todos pacientes o tratamento prescrito foi SSKI na dose de 3 a 6g/dia para adultos, por um período de até duas semanas após cura clínica. Em crianças foi utilizada a metade da dose. RESULTADOS: Houve predomínio da forma cutânea localizada, taxa de cura de 94,7 por cento, efeitos colaterais em 5,5 por cento, média de tempo de tratamento de 3,5 meses e 11,1 por cento de provável recidiva. CONCLUSÃO: A SSKI é eficaz, com diversos efeitos colaterais, porém de baixa frequência, permanecendo indicada para as formas cutâneas da esporotricose.