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1.
J Immunol ; 211(11): 1736-1746, 2023 12 01.
Article in English | MEDLINE | ID: mdl-37861348

ABSTRACT

Cancer chemotherapy-induced neuropathic pain is a devastating pain syndrome without effective therapies. We previously reported that rats deficient in complement C3, the central component of complement activation cascade, showed a reduced degree of paclitaxel-induced mechanical allodynia (PIMA), suggesting that complement is integrally involved in the pathogenesis of this model. However, the underlying mechanism was unclear. Complement activation leads to the production of C3a, which mediates inflammation through its receptor C3aR1. In this article, we report that the administration of paclitaxel induced a significantly higher expression level of C3aR1 on dorsal root ganglion (DRG) macrophages and expansion of these macrophages in DRGs in wild-type (WT) compared with in C3aR1 knockout (KO) mice. We also found that paclitaxel induced less severe PIMA, along with a reduced DRG expression of transient receptor potential channels of the vanilloid subtype 4 (TRPV4), an essential mediator for PIMA, in C3aR1 KO than in WT mice. Treating WT mice or rats with a C3aR1 antagonist markedly attenuated PIMA in association with downregulated DRG TRPV4 expression, reduced DRG macrophages expansion, suppressed DRG neuron hyperexcitability, and alleviated peripheral intraepidermal nerve fiber loss. Administration of C3aR1 antagonist to TRPV4 KO mice further protected them from PIMA. These results suggest that complement regulates PIMA development through C3aR1 to upregulate TRPV4 on DRG neurons and promote DRG macrophage expansion. Targeting C3aR1 could be a novel therapeutic approach to alleviate this debilitating pain syndrome.


Subject(s)
Neuralgia , Paclitaxel , Rats , Mice , Animals , Paclitaxel/adverse effects , TRPV Cation Channels/genetics , Potassium Iodide/adverse effects , Potassium Iodide/metabolism , Rats, Sprague-Dawley , Neuralgia/chemically induced , Hyperalgesia/chemically induced , Hyperalgesia/metabolism , Complement System Proteins/metabolism , Receptors, Complement/genetics , Receptors, Complement/metabolism
2.
Rev Alerg Mex ; 69(2): 98-100, 2023 Jan 04.
Article in Spanish | MEDLINE | ID: mdl-36928251

ABSTRACT

INTRODUCTION: Lugol is a solution composed of elemental iodine (5%) and potassium iodide (10%) together with distilled water, used during colposcopic assessment to identify possible cervical cell alterations. CASE REPORT: A 31-year-old female who presents an episode suggestive of anaphylaxis ninety minutes after a colposcopy exploration, successfully treated with intramuscular hydrocortisone and desclorfeniramine. During colposcopy Lugol solution and acetic acid was applied. Skin prick test (SPT) with Lugol solution was positive (papule 9x7 mm). Four control tests were negative. Intradermal tests (IDT) were positive with Lugol and elemental iodine, the last one turned-out irritant. It was ruled out possible cross-reactivity with other iodine preparations (Betadine®) and potassium iodide (Yoduk®). CONCLUSIONS: Our report demonstrates a rare case of allergy to Lugol solution with positive SPT and a clinical suggestive reaction, with tolerance to other iodine preparations and potassium iodide.


INTRODUCCIÓN: El lugol es una solución compuesta por yodo elemental (5%), yoduro de potasio (10%) y agua destilada, utilizada durante las colposcopias para detectar alteraciones celulares en el cérvix. REPORTE DE CASO: Paciente femenina de 31 años, que tuvo un evento de anafilaxia noventa minutos después de la colposcopia, tratada exitosamente con hidrocortisona por vía intramuscular y desclorfeniramina. Durante la colposcopia se aplicó lugol y ácido acético. La prueba de prick con lugol resultó positiva, con formación de una pápula de 9 x 7 mm, al igual que las pruebas intradérmicas para lugol y yodo elemental. Cuatro controles fueron negativos, excepto para yodo elemental, que resultó irritante en intradermorreacción. Se descartó reactividad cruzada con otras soluciones yodadas (Betadine®) y (Yoduk®). CONCLUSIONES: Reportamos un caso raro de alergia a lugol con prick positivo y una reacción clínica sugerente, con tolerancia a otras preparaciones yodadas y a yoduro de potasio.


Subject(s)
Anaphylaxis , Iodine , Pregnancy , Female , Humans , Adult , Anaphylaxis/chemically induced , Colposcopy , Potassium Iodide/adverse effects , Skin Tests
3.
Nutrients ; 14(24)2022 Dec 09.
Article in English | MEDLINE | ID: mdl-36558407

ABSTRACT

Vitamin C was reported to be able to protect against oxidative damage due to its reducibility. 120 Wistar rats were randomly divided into 4 × 2 groups, including normal iodine (NI), high iodine (HI), low vitamin C (HI + LC), and high vitamin C (HI + HC); potassium iodide (KI) and potassium iodate (KIO3) were commonly used as additives for iodized salt, so every group was also divided into KI and KIO3 groups. After 6 months' feed, the activities of antioxidant enzymes and Lipid Peroxide (MDA) content in serum, liver, kidney, brain, thyroid and lens were determined. In serum, for males, long-term excess iodine intake caused oxidative damage; in the liver, male rats in the HI + LC group had the highest MDA content, which showed that low-dose vitamin C might promote oxidative damage; in kidneys, the MDA content in the HI and HI + LC groups of females was higher; in the brain, high-dose vitamin C could increase the activity of superoxide dismutase (SOD), which was decreased by high iodine intake, and it also decreased MDA content; in the thyroid, for KIO3, the activity of SOD in the HI group was lower than NI and HI + LC; in the lens, the MDA content in females was lower than males. Long-term excess iodine exposure caused oxidative damage and showed sex difference, and vitamin C had a protective effect on it, especially for high-dose vitamin C.


Subject(s)
Ascorbic Acid , Iodine , Vitamins , Animals , Female , Male , Rats , Antioxidants/metabolism , Ascorbic Acid/pharmacology , Iodine/adverse effects , Oxidative Stress , Potassium Iodide/adverse effects , Rats, Wistar , Superoxide Dismutase/metabolism , Vitamins/pharmacology
4.
Intern Med ; 60(11): 1675-1680, 2021 Jun 01.
Article in English | MEDLINE | ID: mdl-33431733

ABSTRACT

Objective Painless thyroiditis (PT) is characterized by transient hyperthyroidism with a low 99mTc uptake. We herein describe 11 cases of PT that occurred during treatment with potassium iodide (KI) for Graves' disease (GD). Methods From August 2016 to December 2018, 11 women with GD who developed PT during treatment with KI were enrolled. Of these patients, 10 discontinued antithyroid drug (ATD) because of side effects and began KI, and 1 patient switched from thiamazole to KI because she was planning a pregnancy. The mean patient age was 40.1 years old. Thyroid function tests, thyroid autoantibodies including anti thyroglobulin antibody (TgAb), anti-thyroperoxidase antibody (TPOAb), and M22-TRAb, and the 99mTc uptake were evaluated at the time of PT. Results All 11 women patients presented with transient thyrotoxicosis in which 99mTc scans revealed a low uptake of 0.34±0.15% (normal 0.70-1.02%). M22-TRAb was absent in all cases except for one (2.4 IU/L), whereas TgAb and TPOAb were present in 10 and 6 cases, respectively. Ten patients returned to a euthyroid status without passing through the post-hypothyroid phase, and one patient underwent total thyroidectomy during the euthyroid phase of PT. Only four patients require beta-blocker therapy. All patients with KI-induced PT except 1 displayed GD remission during a mean observation period of 23.3 months, and 1 patient had recurrence of GD after PT. Conclusion We encountered 11 GD patients who developed PT during treatment with KI, which was initiated after ATD had been discontinued due to side effects.


Subject(s)
Graves Disease , Thyroiditis , Thyrotoxicosis , Adult , Antithyroid Agents/adverse effects , Autoantibodies , Female , Graves Disease/diagnosis , Graves Disease/drug therapy , Humans , Potassium Iodide/adverse effects , Thyroiditis/chemically induced , Thyrotoxicosis/chemically induced , Thyrotoxicosis/diagnosis
5.
Int J Dermatol ; 60(1): 99-106, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33166092

ABSTRACT

BACKGROUND: Cutaneous sporotrichosis, a subcutaneous mycosis because of Sporothrix schenckii, is sporadic worldwide with local hyperendemic pockets. OBJECTIVES: To study clinico-epidemiological and therapeutic aspects of sporotrichosis in our clinic. METHODS: We retrospectively analyzed medical records of 152 (M:F 52:100) patients with cutaneous sporotrichosis managed during 2010-2019. RESULTS: All patients were involved in agricultural activities, and 63.2% were aged 21-60 years. Women outnumbered men by nearly two times. Fixed and lymphocutaneous sporotrichosis occurred in 54.6% and 43.4% patients, respectively. Only 2% of patients had multifocal sporotrichosis. Only 48% of patients imputed their disease to prior injuries. Extremities, upper in 53.9% and lower in 21% of patients, were mostly involved. Scrotum involvement in one patient was unusual. A mixed inflammatory infiltrate in 38.7%, chronic granuloma formation in 35%, and presence of spores in 48.9% biopsies was noted. S. schenckii grew on Sabouraud's dextrose agar in 40.2% of cases. Treatment with saturated solution of potassium iodide was curative in 76.8% patients, and lesions healed in 2-9 months (average 5.2 months). Metallic taste was experienced by 42.9% of patients. Itraconazole therapy was safe and effective in seven patients, and the response was better when combined with SSKI compared to either drug used alone. CONCLUSION: Cutaneous sporotrichosis mostly affects persons during active years of life. The injuries predisposing to infection are mostly forgotten. Both fixed and lymphocutaneous sporotrichosis involving extremities remain common forms. SSKI alone or in combination with itraconazole is safe and effective treatment. Itraconazole is preferable in patients having preexisting hypothyroidism or intolerance to SSKI.


Subject(s)
Agriculture , Antifungal Agents/therapeutic use , Granuloma/microbiology , Occupational Diseases/drug therapy , Potassium Iodide/therapeutic use , Sporotrichosis/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Antifungal Agents/adverse effects , Child , Drug Therapy , Extremities , Female , Humans , India/epidemiology , Itraconazole/therapeutic use , Male , Middle Aged , Occupational Diseases/epidemiology , Occupational Diseases/etiology , Occupational Diseases/pathology , Potassium Iodide/adverse effects , Retrospective Studies , Spores, Fungal , Sporotrichosis/epidemiology , Sporotrichosis/etiology , Sporotrichosis/pathology , Wounds and Injuries/complications , Young Adult
6.
Thyroid ; 31(3): 439-445, 2021 03.
Article in English | MEDLINE | ID: mdl-32729394

ABSTRACT

Background: Several studies have investigated the factors affecting the effects of radioactive iodine (131I) treatment (RAIT) in patients with Graves' disease. However, the influence of dietary or therapeutic iodine on the effect of RAIT has not been fully elucidated yet. The aim of this study was to investigate whether dietary or therapeutic iodine before RAIT influences the therapeutic effects of RAIT with a fixed-dose regimen and a short-term restriction of iodine intake in an iodine-sufficient area. Materials and Methods: We retrospectively analyzed 81 Japanese patients with Graves' disease treated with the following RAIT regimen: dietary iodine restriction for 7 days as well as discontinuation of antithyroid drugs (ATDs), potassium iodine (KI), or both for 5 days before RAIT. On the day of RAIT, we measured urinary iodine content to estimate daily iodine intake. After RAIT, we adjusted the dose of ATDs, KI, or both according to serum thyroid hormone levels every 1-2 months. Using the data from these patients, we investigated the effect of dietary and therapeutic iodine on the therapeutic effects of RAIT. The therapeutic effects at 1 year after RAIT were evaluated based on the necessity of ATDs, KI, or both. Results: Dietary iodine intake was weakly correlated with 131I uptake (RAIU), but the dose of therapeutic iodine was not correlated with RAIU. The therapeutic effects of RAIT were strongly negatively associated with estimated thyroid volume before RAIT. Neither dietary iodine intake nor therapeutic iodine before RAIT affected this association. Conclusion: This study did not find an association between short-term dietary or therapeutic iodine restriction before RAIT and the therapeutic effects of RAIT in an iodine-sufficient area.


Subject(s)
Graves Disease/radiotherapy , Iodine Radioisotopes/therapeutic use , Radiopharmaceuticals/therapeutic use , Adult , Antithyroid Agents/administration & dosage , Antithyroid Agents/adverse effects , Diet/adverse effects , Drug Administration Schedule , Female , Graves Disease/diagnosis , Humans , Iodine Radioisotopes/adverse effects , Male , Middle Aged , Potassium Iodide/administration & dosage , Potassium Iodide/adverse effects , Radiopharmaceuticals/adverse effects , Retrospective Studies , Risk Factors , Time Factors , Tokyo , Treatment Outcome
7.
World J Surg ; 44(10): 3405-3409, 2020 10.
Article in English | MEDLINE | ID: mdl-32447416

ABSTRACT

BACKGROUND: Potassium iodide (KI) treatment affects the vascularity of the thyroid gland and therefore may improve intraoperative visualization of essential structures. However, clear evidence for its usage is lacking, and its implementation in patients suffering from Graves' disease is becoming rare. The objective of this retrospective study was to assess the impact of KI treatment on the intraoperative course and the outcome of patients undergoing thyroidectomy for Graves' diseases. METHODS: The study included 442 patients: 125 patients (28.3%) who received a preoperative treatment with KI ("Group KI") and 317 patients (71.7%) without a KI therapy ("Group No-KI"). Indication for KI treatment was a thyroid bruit (82.5%), as well as hyperthyroidism refractive to medical treatment with antithyroid drugs (17.4%). RESULTS: All patients underwent total thyroidectomy. Permanent vocal cord paresis and permanent hypoparathyroidism were similar in both groups. KI treatment was associated with a significantly longer operative time (142 vs. 128 min, p < 0.001) and a significant higher weight of the thyroid gland. KI treatment did not impact duration of hospital stay or occurrence of secondary hemorrhage. CONCLUSIONS: The complication rate of this study population with clinically severe GD was very low-which may be caused by pre-treatment of patients. The complementary option of a potassium iodide treatment before surgery remains a possibility and should be implemented individually.


Subject(s)
Graves Disease/surgery , Potassium Iodide/administration & dosage , Thyroidectomy , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Female , Graves Disease/drug therapy , Humans , Hypoparathyroidism/etiology , Male , Middle Aged , Operative Time , Postoperative Complications , Potassium Iodide/adverse effects , Preoperative Care , Retrospective Studies , Thyroidectomy/adverse effects , Treatment Outcome , Vocal Cord Paralysis/etiology , Young Adult
8.
Intern Med ; 59(3): 383-388, 2020 Feb 01.
Article in English | MEDLINE | ID: mdl-31554750

ABSTRACT

A patient with underlying Hashimoto's thyroiditis developed amiodarone-induced thyrotoxicosis type 1 that was successfully treated using methimazole in combination with potassium iodide. A 35-year-old woman admitted for perinatal care of twin-to-twin transfusion syndrome was given amiodarone for 7 days for paroxysmal ventricular contraction following pulseless ventricular tachycardia 1 day after delivery. She developed thyrotoxicosis one month after the discontinuation of amiodarone therapy and was negative for thyroid-stimulating hormone receptor antibody. An increased peak velocity of the superior thyroid artery suggested amiodarone-induced thyrotoxicosis type 1. Her thyroid function recovered after combination therapy with methimazole and potassium iodide.


Subject(s)
Amiodarone/adverse effects , Anti-Arrhythmia Agents/adverse effects , Antithyroid Agents/adverse effects , Hashimoto Disease/drug therapy , Methimazole/adverse effects , Potassium Iodide/adverse effects , Thyrotoxicosis/chemically induced , Adult , Amiodarone/therapeutic use , Anti-Arrhythmia Agents/therapeutic use , Antithyroid Agents/therapeutic use , Female , Humans , Methimazole/therapeutic use , Potassium Iodide/therapeutic use , Treatment Outcome
9.
J Toxicol Environ Health A ; 82(10): 603-615, 2019.
Article in English | MEDLINE | ID: mdl-31179882

ABSTRACT

Preparedness for nuclear accident responsiveness includes interventions to protect pregnancies against prolonged exposure to radioactive iodine. The aim of this study was to investigate a new design consisting of repeated administration of potassium iodide (KI, 1 mg/kg) for 8 days in late pregnancy gestational day 9-16 (GD9-GD16) in rats. The later-life effects of this early-life iodine thyroid blocking (ITB) strategy were assessed in offspring two months afterbirth. Functional behavioral tests including forced swimming test (FST) and rotarod test (RRT) in rats of both genders showed lower FST performance in KI-treated females and lower RRT performance in KI-treated male pups. This performance decline was associated with metabolic disruptions in cortex involving amino acid metabolism, tyrosine metabolism, as well as docosahexaenoic acid (DHA) lipids and signaling lipids in males and females. Beyond these behavior-associated metabolic changes, a portion of the captured metabolome (17-25%) and lipidome (3.7-7.35%) remained sensitive to in utero KI prophylactic treatment in both cortex and plasma of post-weaning rats, with some gender-related variance. Only part of these disruptions was attributed to lower levels of TSH and T4 (males only). The KI-induced metabolic shifts involved a broad spectrum of functions encompassing metabolic and cell homeostasis and cell signaling functions. Irrespective Regardless of gender and tissues, the predominant effects of KI affected neurotransmitters, amino acid metabolism, and omega-3 DHA metabolism. Taken together, data demonstrated that repeated daily KI administration at 1 mg/kg/day for 8 days during late pregnancy failed to protect the mother-fetus against nuclear accident radiation. Abbreviations: CV-ANOVA: Cross-validation analysis of variance; DHA: Docosahexaenoic acid; FST: Forced swimming test; FT3: plasma free triiodothyronine; FT4: plasma free thyroxine; GD: Gestational day; ITB: Iodine thyroid blocking; KI: potassium iodide; LC/MS: Liquid chromatography coupled with mass spectrometry; MTBE: Methyl tert-butyl ether; m/z: mass-to-charge ratio; PLS-DA: Partial least squares-discriminant analysis; PRIODAC: Repeated stable iodide prophylaxis in accidental radioactive releases; RRT: Rotarod test; TSH: Thyroid-stimulating hormone; VIP: Variable importance in projection.


Subject(s)
Lipidomics/methods , Metabolomics/methods , Potassium Iodide/adverse effects , Potassium Iodide/therapeutic use , Radiation Exposure/prevention & control , Radioisotopes/toxicity , Thyroid Gland/drug effects , Animals , Female , Male , Models, Animal , Pregnancy , Radioactive Hazard Release , Rats , Rats, Wistar
11.
Med Mycol ; 54(7): 684-90, 2016 Oct 01.
Article in English | MEDLINE | ID: mdl-27207412

ABSTRACT

Feline sporotrichosis is an endemic disease in Rio de Janeiro, Brazil, where zoonotic transmission of Sporothrix spp. has been reported since 1998. Itraconazole (ITZ) remains the first choice for treating this disease in cats. However, there have been reports of therapeutic failure and a long-term endeavor. Potassium iodide (KI), considered in the past as a drug with variable effectiveness in cats with sporotrichosis, arises as an important option in the treatment of cats from the endemic area of Rio de Janeiro. In order to evaluate the effectiveness of the association of ITZ and KI in naive cats with sporotrichosis, a prospective cohort study was conducted on 30 cats receiving ITZ 100 mg/day and KI 2.5 mg-20 mg/kg/day. Clinical and laboratory adverse effects were assessed once a month according to the standard care protocol. The cure rate was 96.15% within a median of 14 weeks of treatment. Adverse effects were observed in 50% of cats and were managed with a temporary drug suspension and/or a hepatoprotective therapy. The association of ITZ and KI emerges as an effective option for the treatment of feline sporotrichosis.


Subject(s)
Antifungal Agents/administration & dosage , Cat Diseases/drug therapy , Itraconazole/administration & dosage , Potassium Iodide/administration & dosage , Sporotrichosis/veterinary , Animals , Antifungal Agents/adverse effects , Brazil , Cats , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/pathology , Female , Itraconazole/adverse effects , Male , Potassium Iodide/adverse effects , Prospective Studies , Sporotrichosis/drug therapy , Treatment Outcome
12.
Ann Endocrinol (Paris) ; 77(1): 1-6, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26830953

ABSTRACT

The better knowledge of the mechanisms of nuclear incidents and lessons learned from accidents in the recent past to improve the effectiveness of measures taken following a nuclear accident exposure to fallout of radioactive iodine isotopes. Thus, immediate, passive measures, such as containment, and stopping consumption of contaminated products are paramount. The earliest possible administration of stable iodine as potassium iodide (KI) reduces significantly (up to 90% if taken at the same time of the accident) thyroid radioactive contamination. These tablets should be given in priority to children and pregnant women. The side effects are minor. KI is not recommended for persons aged over 60 years, or for adults suffering from cardiovascular disorders.


Subject(s)
Iodine Radioisotopes/adverse effects , Nuclear Power Plants , Radioactive Hazard Release , Thyroid Diseases/etiology , Thyroid Diseases/prevention & control , Chernobyl Nuclear Accident , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Potassium Iodide/administration & dosage , Potassium Iodide/adverse effects , Potassium Iodide/therapeutic use , Pregnancy , Radioactive Fallout/adverse effects , Thyroid Neoplasms/etiology , Thyroid Neoplasms/prevention & control
13.
Int J Dermatol ; 55(2): 208-14, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26234812

ABSTRACT

BACKGROUND: Rhinofacial conidiobolomycosis (RFC) is an uncommon subcutaneous fungal infection producing painless swelling with grotesque deformity of the face. Although there are case reports and small case series; there are very few prospective studies evaluating treatment outcome and long-term follow-up. OBJECTIVE: To evaluate the safety and efficacy of combination of itraconazole (200 mg twice daily) and saturated solution of potassium iodide (SSKI) in patients with RFC. METHODS: Ten patients of RFC were studied over a period of 5 years. Diagnosis was confirmed by clinical, histopathological, and microbiological evaluation. Conidiobolus was cultured in four cases and in the rest of the cases, the histopathology was suggestive of RFC. They were treated with itraconazole (200 mg twice daily) and SSKI and followed up for a minimum of 1 year after stopping treatment. RESULTS: The mean age was 38.7 years and the mean duration of symptoms was 22.4 months. Males were predominantly involved (9 : 1). Seven patients responded to the combination treatment, five had complete resolution and two had good improvement (50-75%); however, in two patients the response was minimal (<25% regression of the swelling) and one patient did not show any improvement after 6 months of treatment. CONCLUSION: Combination of itraconazole and SSKI is an effective treatment modality for RFC with relatively faster onset of action, low relapse rates, and minimal adverse effects. It can be considered as first-line treatment in patients with RFC.


Subject(s)
Antifungal Agents/therapeutic use , Conidiobolus , Facial Dermatoses/drug therapy , Itraconazole/therapeutic use , Potassium Iodide/therapeutic use , Zygomycosis/drug therapy , Adult , Aged , Antifungal Agents/adverse effects , Drug Therapy, Combination , Facial Dermatoses/microbiology , Female , Follow-Up Studies , Humans , Itraconazole/adverse effects , Male , Middle Aged , Nose Diseases/drug therapy , Nose Diseases/microbiology , Potassium Iodide/adverse effects , Prospective Studies , Treatment Outcome , Young Adult , Zygomycosis/microbiology
14.
Trials ; 16: 563, 2015 Dec 10.
Article in English | MEDLINE | ID: mdl-26654905

ABSTRACT

BACKGROUND: Concern that mild iodine deficiency in pregnancy may adversely affect neurodevelopment of offspring has led to recommendations for iodine supplementation in the absence of evidence from randomised controlled trials. The primary objective of the study was to investigate the effect of iodine supplementation during pregnancy on childhood neurodevelopment. Secondary outcomes included pregnancy outcomes, maternal thyroid function and general health. METHODS: Women with a singleton pregnancy of fewer than 20 weeks were randomly assigned to iodine (150 µg/d) or placebo from trial entry to birth. Childhood neurodevelopment was assessed at 18 months by using Bayley Scales of Infant and Toddler Development (Bayley-III). Iodine status and thyroid function were assessed at baseline and at 36 weeks' gestation. Pregnancy outcomes were collected from medical records. RESULTS: The trial was stopped after 59 women were randomly assigned following withdrawal of support by the funding body. There were no differences in childhood neurodevelopmental scores between the iodine treated and placebo groups. The mean cognitive, language and motor scores on the Bayley-III (iodine versus placebo, respectively) were 99.4 ± 12.2 versus 101.7 ± 8.2 (mean difference (MD) -2.3, 95 % confidence interval (CI) -7.8, 3.2; P = 0.42), 97.2 ± 12.2 versus 97.9 ± 11.5 (MD -0.7, 95 % CI -7.0, 5.6; P = 0.83) and 93.9 ± 10.8 versus 92.4 ± 9.7 (MD 1.4, 95 % CI -4.0, 6.9; P = 0.61), respectively. No differences were identified between groups in any secondary outcomes. CONCLUSIONS: Iodine supplementation in pregnancy did not result in better childhood neurodevelopment in this small trial. Adequately powered randomised controlled trials are needed to provide conclusive evidence regarding the effect of iodine supplementation in pregnancy. TRIALS REGISTRATION: The trial was registered with the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au . The registration number of this trial is ACTRN12610000411044 . The trial was registered on 21 May 2010.


Subject(s)
Child Development/drug effects , Dietary Supplements , Maternal Health , Nervous System/drug effects , Potassium Iodide/administration & dosage , Pregnancy Complications/prevention & control , Prenatal Care/methods , Thyroid Gland/drug effects , Adult , Age Factors , Australia , Child Language , Cognition/drug effects , Dietary Supplements/adverse effects , Double-Blind Method , Early Termination of Clinical Trials , Female , Humans , Infant , Male , Motor Activity/drug effects , Nervous System/growth & development , Neuropsychological Tests , New Zealand , Potassium Iodide/adverse effects , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/physiopathology , Research Design , Thyroid Function Tests , Thyroid Gland/physiopathology , Time Factors , Treatment Outcome , Young Adult
15.
Presse Med ; 44(11): 1136-45, 2015 Nov.
Article in French | MEDLINE | ID: mdl-26387623

ABSTRACT

"Iodine allergy" does not exist. The concept of "iodine allergy" should be abandoned since it may result in inappropriate measures such as drug, food or environmental eviction. Immediate or non-immediate allergic hypersensitivity to iodinated contrast media is not infrequent. The corresponding allergens have not been identified. Iodine is not involved. Immediate or non-immediate allergic hypersensitivity to povidone iodine is rare. The corresponding allergen is povidone in case of immediate hypersensitivity while nonoxynol might be involved during non-immediate hypersensitivity. Seafood allergens belong to a group of muscle proteins. Immediate drug hypersensitivity or food hypersensitivity is assessed by immediate-reading skin tests while non-immediate drug hypersensitivity is investigated by delayed-reading skin testing. Combined histamine and tryptase measurement is invaluable during the diagnostic approach of immediate hypersensitivity. Other biological tests are being evaluated. Allergic hypersensitivity to iodinated contrast agents does not contraindicate the use of other iodinated drugs.


Subject(s)
Allergens/adverse effects , Contrast Media/adverse effects , Drug Hypersensitivity/etiology , Food Hypersensitivity/etiology , Iodine Compounds/adverse effects , Seafood/adverse effects , Allergens/immunology , Allergens/isolation & purification , Amiodarone/adverse effects , Anaphylaxis/etiology , Animals , Anti-Infective Agents, Local/adverse effects , Anti-Infective Agents, Local/chemistry , Biomarkers , Contrast Media/chemistry , Dermatitis, Contact/etiology , Dietary Proteins/adverse effects , Dietary Proteins/immunology , Drug Hypersensitivity/diagnosis , Food Hypersensitivity/diagnosis , Histamine Release , Humans , Hypersensitivity, Immediate/diagnosis , Hypersensitivity, Immediate/etiology , Iodine/analysis , Iodine/physiology , Muscle Proteins/adverse effects , Muscle Proteins/immunology , Potassium Iodide/adverse effects , Povidone-Iodine/adverse effects , Skin Tests , Thyroxine/adverse effects , Tryptases/blood
16.
Thyroid ; 25(10): 1155-61, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26222916

ABSTRACT

BACKGROUND: To control hyperthyroidism due to Graves' disease, antithyroid drugs should be administered. Several studies have shown that exposure to methimazole (MMI) during the first trimester of pregnancy increases the incidence of specific congenital anomalies that are collectively referred to as MMI embryopathy. Congenital anomalies associated with exposure to propylthiouracil (PTU) have also recently been reported. METHODS: This study investigated whether substituting potassium iodide (KI) for MMI in the first trimester would result in a lower incidence of major congenital anomalies than continuing treatment with MMI alone. The cases of 283 women with Graves' disease (GD) were reviewed whose treatment was switched from MMI to KI in the first trimester (iodine group), as well as the cases of 1333 patients treated with MMI alone (MMI group) for comparison. Another major outcome of interest was the incidence of neonatal thyroid dysfunction. The subjects of the analysis of major congenital anomalies and neonatal thyroid dysfunction were live-born infants. RESULTS: The incidence of major anomalies was 4/260 (1.53%) in the iodine group, which was significantly lower than the incidence of 47/1134 (4.14%) in the MMI group. Two neonates in the iodine group had anomalies consistent with MMI embryopathy (0.8%), as opposed to 18 neonates in the MMI group (1.6%). None of the neonates exposed to KI had thyroid dysfunction or goiter. CONCLUSIONS: Substituting KI for MMI as a means of controlling hyperthyroidism in GD patients during the first trimester may reduce the incidence of congenital anomalies, at least in iodine-sufficient regions.


Subject(s)
Abnormalities, Drug-Induced/epidemiology , Antithyroid Agents/therapeutic use , Graves Disease/drug therapy , Methimazole/therapeutic use , Potassium Iodide/therapeutic use , Pregnancy Complications/drug therapy , Adult , Antithyroid Agents/adverse effects , Drug Substitution , Female , Graves Disease/blood , Humans , Incidence , Japan/epidemiology , Methimazole/adverse effects , Potassium Iodide/adverse effects , Pregnancy , Pregnancy Trimester, First , Retrospective Studies , Thyrotropin/blood , Thyroxine/blood , Treatment Outcome , Triiodothyronine/blood
18.
Thyroid ; 25(1): 43-50, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25178068

ABSTRACT

BACKGROUND: Methimazole (MMI) is usually used at an initial dose of 30 mg/day for severe Graves' disease (GD) hyperthyroidism, but adverse effects are more frequent at this dose than at MMI 15 mg/day. OBJECTIVES: We designed a regimen to address the lack of a primary therapeutic effect of the MMI 15 mg/day by combining it with inorganic iodine at 38.2 mg/day. Our aim was to compare the two regimens (MMI 15 mg+inorganic iodine at 38.2 mg/day (M15+I) vs. MMI 30 mg/day (M30)) in terms of therapeutic effect, adverse effects, and remission rate. DESIGN AND PATIENTS: In a prospective study, 310 patients with untreated GD (serum free thyroxine (fT4) ≥5 ng/dL) were assigned to one of the two regimens. Potassium iodide was discontinued in the M15+I group as soon as the serum fT4 level was within the reference range (0.8-1.6 ng/dL). RESULTS: Percentages of patients achieving an fT4 level within reference range in ≤30, ≤60, or 90 days on the study treatment regimens were 45.3%, 73.9%, and 82.0% respectively for the M15+I group, and 24.8%, 63.1%, and 75.2% respectively for the M30 group. Hence, the proportions of patients achieving this goal in ≤30 or ≤60 days were significantly larger in the M15+I group. Adverse effects that required discontinuation of MMI were more frequent in the M30-treated than in the M15+I-treated group (14.8% vs. 7.5%; p=0.0387). The remission rates in the M15+I and M30 groups were 19.9% and 14.8%-higher in the former, but the difference did not reach statistical significance. CONCLUSION: The results of this study raise the possibility that M15+I is superior to M30 as a primary treatment for moderate to severe hyperthyroidism caused by GD.


Subject(s)
Antithyroid Agents/therapeutic use , Graves Disease/drug therapy , Methimazole/therapeutic use , Potassium Iodide/therapeutic use , Adolescent , Adult , Aged , Antithyroid Agents/administration & dosage , Antithyroid Agents/adverse effects , Child , Drug Administration Schedule , Drug Therapy, Combination , Female , Graves Disease/blood , Humans , Male , Methimazole/administration & dosage , Methimazole/adverse effects , Middle Aged , Potassium Iodide/adverse effects , Thyroid Function Tests , Thyroxine/blood , Treatment Outcome , Triiodothyronine/blood , Young Adult
19.
Eur J Nutr ; 54(2): 319-23, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25381633

ABSTRACT

PURPOSE: Iodine, bivalent iron (Fe²âº), and hydrogen peroxide (H2O2), all significantly affecting the red-ox balance, are required for thyroid hormone synthesis. Intracellular iodine excess (≥10⁻³ M) transiently blocks thyroid hormonogenesis (an adaptive mechanism called Wolff-Chaikoff effect). The aim of the study was to evaluate the effects of iodine, used as potassium iodide (KI) or potassium iodate (KIO3), in concentrations corresponding to those typical for Wolff-Chaikoff effect, on the level of oxidative damage to nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) isolated from porcine thyroid under basal conditions and in the presence of Fenton reaction (Fe²âº+H2O2 → Fe³âº+(·)OH + OH⁻) substrates. METHODS: Thyroid nDNA and mtDNA were incubated in the presence of either KI or KIO3 (2.5-50 mM), without/with FeSO4 (30 µM) + H2O2 (0.5 mM). Index of DNA damage, i.e., 8-oxo-7,8-dihydro-2'-deoxyguanosine, was measured by HPLC. RESULTS: Neither KI nor KIO3 increased the basal level of 8-oxodG in both nDNA and mtDNA. KI-in all used concentrations-completely prevented the damaging effect of Fenton reaction substrates in mtDNA, and it partially prevented this damage in nDNA. KIO3 partially prevented Fe²âº+H2O2-induced oxidative damage in both DNA only in its highest used concentrations (≥25 mM). CONCLUSIONS: Without additional prooxidative abuse, both iodine compounds, i.e., KI and KIO3, seem to be safe in terms of their potential oxidative damage to DNA in the thyroid. The superiority of KI over KIO3 relies on its stronger protective effects against oxidative damage to mtDNA, which constitutes an argument for its preferential utility in iodine prophylaxis.


Subject(s)
DNA Damage , DNA, Mitochondrial/chemistry , Dietary Supplements , Oxidants/antagonists & inhibitors , Potassium Iodide/chemistry , Protective Agents/chemistry , 8-Hydroxy-2'-Deoxyguanosine , Abattoirs , Animals , DNA/chemistry , DNA/drug effects , DNA/isolation & purification , DNA, Mitochondrial/drug effects , DNA, Mitochondrial/isolation & purification , Deoxyguanosine/analogs & derivatives , Deoxyguanosine/analysis , Dietary Supplements/adverse effects , Food, Fortified , Hydrogen Peroxide/antagonists & inhibitors , Hydrogen Peroxide/toxicity , Iodates/adverse effects , Iodates/chemistry , Iron/toxicity , Osmolar Concentration , Oxidants/toxicity , Oxidation-Reduction , Potassium Compounds/adverse effects , Potassium Compounds/chemistry , Potassium Iodide/adverse effects , Protective Agents/adverse effects , Sus scrofa , Thyroid Gland/chemistry
20.
J Eur Acad Dermatol Venereol ; 29(4): 719-24, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25229626

ABSTRACT

BACKGROUND: The first therapeutic choice for the treatment of cutaneous sporotrichosis is oral itraconazole; however, the increase in cases of zoonotic transmission outbreak necessitates a search for effective and safe treatment alternatives. OBJECTIVE: To evaluate a new potassium iodide (KI) posology as an alternative for the treatment of limited cutaneous forms of sporotrichosis. METHODS: One hundred and two patients with sporotrichosis diagnosed by isolation of Sporothrix sp. were included and were divided into 2 groups that received different doses of KI: group A received the conventional dose, and group B received the reduced dose. The cure criteria were based on clinical and serological data. RESULTS: Seventy-nine patients (77.4%) reached clinical cure: 70.6% and 84.3% of groups A and B respectively. Sixteen patients (15.6%) were lost during follow-up, and seven changed drug therapy: five in group A and two in group B. The incidence of adverse events was similar for both groups (64.7%): predominantly metallic taste (44%), followed by mild gastrointestinal intolerance and acneiform eruption (10.7% each). No serious adverse events occurred, and there were no recurrences. Analysis of the results showed no statistically significant difference between groups (P = 0.9255). The improvement in serologic titres was significant in both treatment groups. CONCLUSION: Through statistical analysis, the usual posology was not shown to be superior to the one proposed in this study. Serology for sporotrichosis may be used as a valuable tool in the clinical monitoring of these patients.


Subject(s)
Antifungal Agents/administration & dosage , Potassium Iodide/administration & dosage , Sporotrichosis/drug therapy , Acneiform Eruptions/chemically induced , Adolescent , Adult , Antifungal Agents/adverse effects , Child , Child, Preschool , Drug Eruptions/etiology , Female , Humans , Male , Nausea/chemically induced , Potassium Iodide/adverse effects , Serologic Tests , Sporothrix/immunology , Taste Disorders/chemically induced , Treatment Outcome
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