RESUMO
We treated three patients with Aspergillus keratomycosis with collagen shields soaked in amphotericin B (0.50%) for 2 hours at 25 degrees C before application. These shields, replaced daily, were used in conjunction with amphotericin B (0.25%) eye drops, which were applied every 2 hours. Cultures from the eyes of all patients became negative within 15 days of treatment. Subsequently, two patients required keratoplasty. The results suggest that collagen shields prepared this way deliver an adequate concentration of amphotericin B to the cornea, aid its tolerance, and improve the prognosis of Aspergillus keratomycosis. Further studies are needed to define the minimum therapeutic concentrations necessary to inhibit the growth of the fungus and to avoid a toxic effect on the cornea.
Assuntos
Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Aspergilose/tratamento farmacológico , Colágeno , Úlcera da Córnea/tratamento farmacológico , Sistemas de Liberação de Medicamentos , Infecções Oculares Fúngicas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Aspergilose/microbiologia , Aspergilose/patologia , Aspergillus fumigatus/isolamento & purificação , Curativos Biológicos , Córnea/efeitos dos fármacos , Córnea/microbiologia , Córnea/cirurgia , Transplante de Córnea , Úlcera da Córnea/microbiologia , Úlcera da Córnea/patologia , Infecções Oculares Fúngicas/microbiologia , Infecções Oculares Fúngicas/patologia , Feminino , Humanos , Masculino , Soluções OftálmicasRESUMO
Iodide secretion across different regions of rat small intestine has been investigated in vitro using the standard Wilson-Wiseman technique. Net I- secretion was observed along the entire small intestine, being significantly higher in the central region. Anaerobic conditions, ouabain (2 mM) and Na+ free Ringer solution prevented net I- secretion, whilst both theophylline (1 mM) and carbachol (0,1 mM) enhanced the observed basal intestinal I- secretion. Furthermore, Ca2+-deprived bathing solutions significantly reduced intestinal I- secretion. Epithelial I- uptake from both mucosal and serosal sides was measured by using a Ussing-type chamber technique. The initial rate of I- uptake across the mucosal membrane was significantly higher in the central region than in the proximal part of rat small intestine. No significant differences were observed in the rate of I- uptake from the serosal side. These studies suggest that mucosal I- permeability might determine the direction of net I- intestinal transport and that cytosolic Ca2+ may be a physiological regulator of intestinal I- transport.
