RESUMO
Background: Povidone, a synthetic polymer commonly used in various products such as antiseptics, cosmetics, and medications, has been associated with allergic reactions, including anaphylaxis. Despite its widespread use, cases of povidone-induced anaphylaxis, especially in children, are under-recognized. This case report aims to highlight the importance of considering povidone allergy in pediatric patients presenting with anaphylaxis. Case Presentation: We describe a 3-year-old boy who experienced anaphylaxis following the application of povidone-iodine antiseptic solution to a leg wound. He presented with generalized urticaria, angioedema, dyspnea, and cough. Prompt diagnosis and management were initiated in the emergency department. He experienced the second anaphylaxis with povidone-containing eye drops prescribed during an ophthalmology visit. Conclusions: Povidone allergy should be considered in pediatric patients presenting with anaphylaxis, especially those with idiopathic reactions or multiple drug allergies. Clinicians should emphasize patient education on label reading and the provision of adrenaline autoinjectors to prevent life-threatening reactions associated with povidone exposure.
Assuntos
Anafilaxia , Anti-Infecciosos Locais , Povidona-Iodo , Humanos , Anafilaxia/induzido quimicamente , Anafilaxia/diagnóstico , Masculino , Pré-Escolar , Povidona-Iodo/efeitos adversos , Povidona-Iodo/administração & dosagem , Anti-Infecciosos Locais/efeitos adversos , Anti-Infecciosos Locais/administração & dosagem , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/etiologia , Epinefrina/administração & dosagem , Epinefrina/efeitos adversos , Soluções Oftálmicas/efeitos adversosRESUMO
PURPOSE: To evaluate the peri- and post-intravitreal injection (IVI) symptoms reported by patients who have been repeatedly injected for age-related macular degeneration (AMD) and to analyze these according to the protocols of the injector. MATERIALS AND METHODS: Multi-center, cross-sectional, consecutive, analytical survey. RESULTS: The IVI protocols of 106 injectors differed in terms of the number of instillations of povidone-iodine, its contact time, and rinsing of the ocular surface post-injection. In total, 3,738 patients responded to the survey, 60.1% of whom were women; 36.4% had received more than 20 IVIs; 50.7% of patients reported irritation upon application of povidone-iodine. Post-IVI, depending on the symptom in question, between 44.8% and 57.4% of patients reported symptoms of ocular surface change. The number of instillations of povidone-iodine, its contact time with the ocular surface, and abundant rinsing post-IVI increased the immediate symptoms. Patients who received more IVIs were more prone to experiencing gritty eyes, and the incidence of acute pain increased in patients who had previously received over 20 IVIs. Women and patients previously treated for dry eye or glaucoma were at greater risk of worse symptoms. CONCLUSION: Comparing injecting centers' practices with patients' self-assessments showed an aggravation of symptoms of ocular surface changes related to povidone-iodine. This survey contributes to providing data for the implementation of a protocol to improve the quality of life of patients injected repeatedly for AMD.
Assuntos
Degeneração Macular , Qualidade de Vida , Humanos , Feminino , Masculino , Injeções Intravítreas , Estudos Transversais , Povidona-Iodo/efeitos adversos , Degeneração Macular/tratamento farmacológico , Degeneração Macular/epidemiologiaRESUMO
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. .
Assuntos
Animais , Coelhos , Derrame Pleural Maligno/terapia , Pleurodese/métodos , Povidona-Iodo/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Citocinas/sangue , Ensaio de Imunoadsorção Enzimática , Modelos Animais , Pleura/efeitos dos fármacos , Povidona-Iodo/efeitos adversos , Epitélio Pigmentado da Retina/efeitos dos fármacos , Soluções Esclerosantes/efeitos adversos , Fatores de TempoRESUMO
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.
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Povidona-Iodo/efeitos adversos , Ácidos Graxos Essenciais/uso terapêutico , Triglicerídeos/uso terapêutico , Úlcera por Pressão , CardiopatiasRESUMO
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