RESUMO
Allergic contact dermatitis (ACD) is an important diagnosis to consider in patients with dermatitis following specific exposures. Classically, ACD from persulfates is associated with hair-bleaching products and spa water/swimming pool exposure and is most commonly reported in adult men. We report a case of ACD to potassium peroxymonopersulfate (PPMS), a common pool "shocking" chemical, in a 7-year-old boy presenting with recurrent and diffuse dermatitis triggered by swimming pool exposure.
Assuntos
Dermatite Alérgica de Contato , Exantema , Masculino , Adulto , Humanos , Criança , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Exantema/etiologia , Exantema/induzido quimicamente , Compostos de Potássio/efeitos adversosRESUMO
BACKGROUND: Actinic keratosis (AK) is an epithelial carcinoma in situ of the skin. There is a need for early treatment due to the risk of malignant transformation. In addition to being effective, the initial therapy in particular should be well tolerated and user-friendly. Potassium hydroxide (KOH) solution is already established as keratolytic treatment option for hyperkeratotic skin diseases such as mollusca contagiosa. MATERIALS AND METHODS: A prospective single-arm, multicentre medical device study (Treatment of AK with KOH, TAKKOH) was conducted to investigate the efficacy and safety of KOH 5% solution for the treatment of mild to moderate AK. Patients applied KOH solution twice daily for 14 days with a subsequent off-treatment phase of 14 days (â one treatment cycle) for a maximum of three treatment cycles or at least until treatment success was achieved. Treatment success, defined as complete remission (CR) of all AK lesions of a patient, was the primary objective. Secondary objectives included the evaluation of partial remission (PR), the number of AK lesions in remission, efficacy assessment by investigators and patients with a 6point grading system and several safety parameters. RESULT: In all, 73 patients were enrolled in the study. CR was achieved in 54.9% of patients, whereas PR was observed in 64.8% with a 69.9% reduction in lesion numbers. With respect to safety, 46.6% of the patients experienced adverse events. Most of these events (82.6%) were adverse reactions comprising exclusively short-lived and mild local skin reactions. CONCLUSIONS: The study provides an indication of the efficacy and safety of KOH 5% solution for the lesion-directed topical therapy of AK.
Assuntos
Ceratose Actínica , Humanos , Hidróxidos , Ceratose Actínica/diagnóstico , Ceratose Actínica/tratamento farmacológico , Compostos de Potássio/efeitos adversos , Estudos Prospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Bromide is a halide ion of the element bromine usually administered in the form of potassium salt as monotherapy or add-on treatment in epileptic dogs. It is excreted unchanged in the urine and undergoes tubular reabsorption in competition with chloride. Thus, dietary chloride content affects serum bromide concentrations. This is the first published clinical report of bromide toxicosis secondary to a dietary modification of chloride content in an epileptic dog treated with potassium bromide. CASE PRESENTATION: A 3-year-old 55-kg neutered male Tibetan Mastiff was evaluated because of a 1-month history of progressive signs including ataxia, lethargy and behaviour changes. The dog was successfully treated for idiopathic epilepsy since the age of 1-year-old with phenobarbital and potassium bromide. Two months prior to presentation, the owners decided to change the dog's diet without veterinary advice. Physical examination was unremarkable. A 12-kg weight gain was recorded since last follow-up (8 months). Neurological examination revealed severe symmetric 4-limbs ataxia with altered vigilance and intermittent episodes of hyperactivity and aggressive behaviour without significant abnormality of cranial nerves. Serum bromide concentration was high and increased by 103 % since last follow-up. Nutritional evaluation revealed a 53 % decrease of chloride content in the diet before and after dietary transition. Bromide toxicosis was suspected, due to bromide reduced clearance secondary to the decreased dietary chloride content. Potassium bromide treatment was lowered by 15 % without further dietary changes. Neurologic signs progressively improved over the next month, without any seizure. After two months, the serum bromide concentration lowered to the same level measured before dietary modification. After four months, neurological examination was unremarkable. CONCLUSIONS: Dietary chloride content can directly influence serum bromide concentrations, therefore affecting seizure control or contributing to unexpected adverse effects. In the present case, a reduction in chloride intake markedly increased serum bromide concentrations causing bromism. Dietary changes should be avoided in dogs treated with potassium bromide to maintain stable serum bromide levels.
Assuntos
Brometos/efeitos adversos , Brometos/uso terapêutico , Cloretos/administração & dosagem , Dieta/veterinária , Doenças do Cão/induzido quimicamente , Epilepsia/veterinária , Compostos de Potássio/efeitos adversos , Compostos de Potássio/uso terapêutico , Animais , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Doenças do Cão/tratamento farmacológico , Cães , Epilepsia/tratamento farmacológico , MasculinoRESUMO
BACKGROUND: Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is a significant cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to mitigate the risk of CIN, there remains a need for novel effective treatments. Evidence suggests that delivery of nitric oxide (NO) through chemical reduction of inorganic nitrate to NO may offer a novel therapeutic strategy to reduce CIN and thus preserve long term renal function. DESIGN: The NITRATE-CIN trial is a single-center, randomized, double-blind placebo-controlled trial, which plans to recruit 640 patients presenting with acute coronary syndromes (ACS) who are at risk of CIN. Patients will be randomized to either inorganic nitrate therapy (capsules containing 12 mmol KNO3) or placebo capsules containing potassium chloride (KCl) daily for 5 days. The primary endpoint is development of CIN using the Kidney Disease Improving Global Outcomes (KDIGO) criteria. A key secondary endpoint is renal function over a 3-month follow-up period. Additional secondary endpoints include serum renal biomarkers (e.g. neutrophil gelatinase-associated lipocalin) at 6 h, 48 h and 3 months following administration of contrast. Cost-effectiveness of inorganic nitrate therapy will also be evaluated. SUMMARY: This study is designed to investigate the hypothesis that inorganic nitrate treatment decreases the rate of CIN as part of semi-emergent coronary angiography for ACS. Inorganic nitrate is a simple and easy to administer intervention that may prove useful in prevention of CIN in at-risk patients undergoing coronary angiographic procedures.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/prevenção & controle , Meios de Contraste/efeitos adversos , Nitratos/administração & dosagem , Compostos de Potássio/administração & dosagem , Síndrome Coronariana Aguda/diagnóstico por imagem , Angiografia Coronária/efeitos adversos , Angiografia Coronária/métodos , Método Duplo-Cego , Humanos , Testes de Função Renal , Lipocalina-2/sangue , Nitratos/efeitos adversos , Nitratos/economia , Compostos de Potássio/efeitos adversos , Compostos de Potássio/economia , Projetos de Pesquisa , Reino UnidoRESUMO
BACKGROUND: A new prolonged-release formulation of potassium citrate and potassium bicarbonate, ADV7103, has been shown to improve metabolic control, palatability, and gastrointestinal safety in patients with distal renal tubular acidosis (dRTA) when compared to standard of care (SoC) treatments. The present work evaluates safety and efficacy of ADV7103 during 24 months. METHODS: Thirty pediatric and adult patients were included in an open-label extension study after a phase II/III trial. Safety and tolerability were assessed. Plasma bicarbonate and potassium levels, as well as urine parameters, were evaluated over time. Acceptability, adherence, and quality of life were also assessed. The evolution of clinical consequences of dRTA in the cohort was explored. RESULTS: There were 104 adverse events (AEs) reported, but only 9 gastrointestinal events observed in five patients (17%) were considered to be related to ADV7103 treatment. There were no AEs leading to treatment discontinuation. Plasma bicarbonate and potassium levels were in the normal ranges at the different visits, respectively, in 69-86% and 83-93% of patients. Overall adherence rates were ≥ 75% throughout the whole study in 79% patients. An average improvement of quality of life of 89% was reported at 24 months of study. CONCLUSIONS: Common AEs concerned metabolism and gastrointestinal disorders; the former being related to the disease. Less than half of the gastrointestinal AEs were related to ADV7103 treatment and they were mostly mild in severity. Metabolic parameters were maintained in the normal ranges in most patients. Patient satisfaction was high and adherence to treatment was good and remained stable. TRIAL REGISTRATION NUMBER: Registered as EudraCT 2013-003828-36 on the 3rd of September 2013.
Assuntos
Acidose Tubular Renal , Bicarbonatos , Citrato de Potássio , Compostos de Potássio , Acidose Tubular Renal/tratamento farmacológico , Adulto , Bicarbonatos/efeitos adversos , Bicarbonatos/uso terapêutico , Criança , Humanos , Potássio , Citrato de Potássio/efeitos adversos , Citrato de Potássio/uso terapêutico , Compostos de Potássio/efeitos adversos , Compostos de Potássio/uso terapêutico , Qualidade de VidaRESUMO
CO2 absorbents were introduced into anesthesia practice in 1924 and are essential when using a circle system to minimize waste by reducing fresh gas flow to allow exhaled anesthetic agents to be rebreathed. For many years, absorbent formulations consisted of calcium hydroxide combined with strong bases like sodium and potassium hydroxide. When Sevoflurane and Desflurane were introduced, the potential for toxicity (compound A and CO, respectively) due to the interaction of these agents with absorbents became apparent. Studies demonstrated that strong bases added to calcium hydroxide were the cause of the toxicity, but that by eliminating potassium hydroxide and reducing the concentration of sodium hydroxide to <2%, compound A and CO production is no longer a concern. As a result, CO2 absorbents have been developed that contain little or no sodium hydroxide. These CO2 absorbent formulations can be used safely to minimize anesthetic waste by reducing fresh gas flow to approach closed-circuit conditions. Although absorbent formulations have been improved, practices persist that result in unnecessary waste of both anesthetic agents and absorbents. While CO2 absorbents may seem like a commodity item, differences in CO2 absorbent formulations can translate into significant performance differences, and the choice of absorbent should not be based on unit price alone. A modern practice of inhalation anesthesia utilizing a circle system to greatest effect requires reducing fresh gas flow to approach closed-circuit conditions, thoughtful selection of CO2 absorbent, and changing absorbents based on inspired CO2.
Assuntos
Anestesia com Circuito Fechado/instrumentação , Anestesia por Inalação/instrumentação , Anestésicos Inalatórios/administração & dosagem , Hidróxido de Cálcio/química , Dióxido de Carbono/química , Hidróxidos/química , Compostos de Potássio/química , Hidróxido de Sódio/química , Absorção Fisico-Química , Anestesia com Circuito Fechado/efeitos adversos , Anestesia por Inalação/efeitos adversos , Anestésicos Inalatórios/efeitos adversos , Hidróxido de Cálcio/efeitos adversos , Desenho de Equipamento , Humanos , Hidróxidos/efeitos adversos , Segurança do Paciente , Compostos de Potássio/efeitos adversos , Respiração Artificial/efeitos adversos , Respiração Artificial/instrumentação , Medição de Risco , Fatores de Risco , Hidróxido de Sódio/efeitos adversosAssuntos
Carcinoma Basocelular/cirurgia , Reação a Corpo Estranho/induzido quimicamente , Hemostáticos/efeitos adversos , Neoplasias Cutâneas/cirurgia , Biópsia , Carcinoma Basocelular/patologia , Diagnóstico Diferencial , Humanos , Compostos de Ferro/efeitos adversos , Masculino , Pessoa de Meia-Idade , Polímeros/efeitos adversos , Compostos de Potássio/efeitos adversos , Couro Cabeludo , Neoplasias Cutâneas/patologiaRESUMO
Molluscum contagiosum is a common childhood condition, and although it is self-limited, treatments are often prescribed. Several medications are available, but there is no consensus regarding the optimal choice in the pediatric population. We report a child who underwent potassium hydroxide 5% treatment resulting in superficial diffuse erosions caused by the inappropriate application. This underlines the importance of parent education before use of this medication with well-known caustic properties.
Assuntos
Antivirais/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Hidróxidos/efeitos adversos , Molusco Contagioso/tratamento farmacológico , Compostos de Potássio/efeitos adversos , Úlcera Cutânea/induzido quimicamente , Administração Tópica , Antivirais/administração & dosagem , Dorso , Pré-Escolar , Fármacos Dermatológicos/administração & dosagem , Humanos , Hidróxidos/administração & dosagem , Masculino , Adesão à Medicação , Pescoço , Necrose , Compostos de Potássio/administração & dosagem , Ombro , Pele/efeitos dos fármacos , Pele/patologia , Soluções/administração & dosagem , Soluções/efeitos adversos , Resultado do TratamentoAssuntos
Anticonvulsivantes/efeitos adversos , Brometos/efeitos adversos , Dermatite Esfoliativa/diagnóstico , Toxidermias , Compostos de Potássio/efeitos adversos , Adulto , Anticonvulsivantes/uso terapêutico , Brometos/uso terapêutico , Dermatite Esfoliativa/induzido quimicamente , Dermatite Esfoliativa/complicações , Epilepsia/tratamento farmacológico , Feminino , Humanos , Compostos de Potássio/uso terapêuticoAssuntos
Anticonvulsivantes/efeitos adversos , Brometos/efeitos adversos , Toxidermias/diagnóstico , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Compostos de Potássio/efeitos adversos , Anticonvulsivantes/uso terapêutico , Brometos/uso terapêutico , Toxidermias/etiologia , Humanos , Lactente , Masculino , Compostos de Potássio/uso terapêuticoRESUMO
OBJECTIVE: We evaluated potassium bromide's (KBr's) efficacy and tolerability for pediatric refractory epilepsy. METHODS: We retrospectively reviewed the records of 42 patients treated with KBr in our hospital between 2008 and 2016 (age: 4 months to 19 years; mean: 6.2 years). Thirteen of them had 2 seizure types. The treatment durations ranged from 1 month to 6 years (mean: 15.0 months). RESULTS: KBr had an excellent effect (seizure-free status) in 3 patients (7.1%), a moderate effect (>50% reduction in seizure frequency from the pretreatment baseline) in 21 patients (50.0%), and no effect (<50% reduction in seizure frequency from the pretreatment baseline) in 18 patients (42.9%). The effective daily doses ranged from 20 to 80 mg/kg (mean: 50.0 mg/kg). KBr was effective in 59.1% patients with generalized epilepsy (n = 22), 55.6% patients with focal epilepsy (n = 18), and both patients with Dravet syndrome. An excellent or moderate effect was found in 72.2% patients with tonic seizures (n = 18), 66.6% patients with generalized tonic-clonic seizures (n = 6), 75.0% patients with secondary generalized seizures (n = 4), 46.2% patients with focal seizures (n = 13), and 20% patients with infantile spasms (n = 10) but no patients with myoclonic seizures (n = 2). Adverse effects including drowsiness, excitement, and rashes were reported in 13 patients (31.0%). CONCLUSIONS: These findings suggest that KBr is particularly effective for tonic seizures, generalized tonic-clonic seizures, and secondary generalized seizures. Although the adverse effects need further attention, KBr should be considered for pediatric refractory epilepsy.
Assuntos
Anticonvulsivantes/uso terapêutico , Brometos/uso terapêutico , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Compostos de Potássio/uso terapêutico , Adolescente , Anticonvulsivantes/efeitos adversos , Brometos/efeitos adversos , Criança , Pré-Escolar , Epilepsias Parciais/tratamento farmacológico , Epilepsia Generalizada/tratamento farmacológico , Feminino , Humanos , Lactente , Masculino , Compostos de Potássio/efeitos adversos , Estudos Retrospectivos , Convulsões/tratamento farmacológico , Resultado do Tratamento , Adulto JovemRESUMO
Introduction: Our objective was to assess efficacy, safety and tolerance of topical potassium hydroxide (KOH) 10% for treating Molluscum contagiosum (MC) in children. Material and methods: Randomized, double-blind, placebo-controlled clinical trial including all children 2-16 years with MC infection attending pediatrician primary healthcare visits. The treatment was KOH 10% gel applied once daily up to clearing (maximum 30 days). Results: KOH 10% showed superior efficacy to placebo (55.3% vs 16.3%, p < .001). Time until clearing was inferior with KOH 10% (p = .001). MC lesions were reduced with KOH 10%, which also showed higher efficacy when the instructions of use of the device were modified. KOH 10% patients presented more adverse events (AE) than placebo patients (72.3% vs 31.8%, p < .001). Most patients (91.5%) completely recovered. There were no differences in frequency of AE before and after the change of instructions, intolerance was more frequently reported by parents with new instructions. Conclusions: KOH 10% was superior to placebo in the main efficacy outcome and most secondary efficacy outcomes. KOH 10% patients had more AE and intolerance symptoms than placebo, although there were no severe AE and most patients recovered. KOH 10% is an effective and safe topical treatment for MC infection in children.
Assuntos
Hidróxidos/uso terapêutico , Molusco Contagioso/tratamento farmacológico , Compostos de Potássio/uso terapêutico , Administração Tópica , Adolescente , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Hidróxidos/efeitos adversos , Hidróxidos/química , Masculino , Efeito Placebo , Compostos de Potássio/efeitos adversos , Compostos de Potássio/química , Soluções/química , Resultado do TratamentoRESUMO
BACKGROUND: Cardioplegia is an integral part of myocardial protection. The superiority of blood cardioplegia in adult patients has been reported. However, this is yet to be studied in cyanotic pediatric patients. METHODS: A randomized open-label trial was conducted in 70 patients with tetralogy of Fallot. They were divided into two groups: 35 patients had crystalloid cardioplegia (controls), and 35 had blood cardioplegia. Lactate and coronary oxygen extraction in arterial blood and the coronary sinus were measured immediately after cessation of cardiopulmonary bypass, 15 and 30 min later. Postoperative mortality, major adverse cardiac events, mechanical ventilation time, inotrope administration, arrhythmias, right ventricular function, intensive care unit and hospital length of stay were observed. RESULTS: There were no significant differences in clinical outcomes or lactate levels. There was a significant difference in coronary oxygen extraction immediately and 15 min after cessation of cardiopulmonary bypass ( p = 0.038, p = 0.015). CONCLUSION: Blood cardioplegia gave a better postoperative oxygen extraction value but there were no differences in myocardial damage or clinical outcome between the two groups.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Soluções Cardioplégicas/uso terapêutico , Ponte Cardiopulmonar , Parada Cardíaca Induzida/métodos , Compostos de Potássio/uso terapêutico , Tetralogia de Fallot/cirurgia , Adolescente , Adulto , Biomarcadores/sangue , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Soluções Cardioplégicas/efeitos adversos , Ponte Cardiopulmonar/efeitos adversos , Criança , Pré-Escolar , Cianose/sangue , Cianose/etiologia , Feminino , Parada Cardíaca Induzida/efeitos adversos , Humanos , Indonésia , Lactente , Recém-Nascido , Ácido Láctico/sangue , Masculino , Oxigênio/sangue , Complicações Pós-Operatórias/etiologia , Compostos de Potássio/efeitos adversos , Fatores de Risco , Tetralogia de Fallot/sangue , Tetralogia de Fallot/complicações , Tetralogia de Fallot/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Crystalloid priming is a cost-effective, free from immunological reactions, and independent from human plasma delivery. However, there is some debate on the negative impact of low plasma colloid pressure and higher incidence of systemic inflammatory response syndrome (SIRS). The aim of the study was to rule out any adverse effects of crystalloid priming on the postoperative outcome. METHODS: We investigated 520 consecutive patients, including emergencies, who had isolated on-pump coronary artery bypass grafting in 2009 by retrospective analysis in our clinic. Crystalloid priming (n = 294) was introduced as an alternative to albumin (n = 226). Reviewing patient charts and IT-based data generated a dataset of perioperative parameters. RESULTS: There were no differences with respect to demographical data and preexisting comorbidities between both groups. Despite equal perfusion times, more volume had to be substituted during extracorporeal circulation following crystalloid priming. However, this did not influence the inhospital outcomes. According to the definition of the "Sepsis-3 Guidelines," the incidence of SIRS was similar. There was no difference in the need for a vasopressor treatment, and only transient higher serum lactate levels were found in the crystalloid group. The incidence of neurologic and organ-related adverse events, as well as 30-day mortality was comparable. CONCLUSION: The use of crystalloid priming is safe in coronary artery bypass grafting surgery in adults. However, there might be a greater need for crystalloid fluids during surgery.
Assuntos
Albuminas/administração & dosagem , Soluções Cardioplégicas/administração & dosagem , Ponte de Artéria Coronária , Circulação Extracorpórea/instrumentação , Máquina Coração-Pulmão , Compostos de Potássio/administração & dosagem , Idoso , Albuminas/efeitos adversos , Soluções Cardioplégicas/efeitos adversos , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/mortalidade , Circulação Extracorpórea/efeitos adversos , Circulação Extracorpórea/mortalidade , Feminino , Alemanha/epidemiologia , Glucose/administração & dosagem , Glucose/efeitos adversos , Máquina Coração-Pulmão/efeitos adversos , Humanos , Incidência , Masculino , Manitol/administração & dosagem , Manitol/efeitos adversos , Cloreto de Potássio/administração & dosagem , Cloreto de Potássio/efeitos adversos , Compostos de Potássio/efeitos adversos , Procaína/administração & dosagem , Procaína/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
We studied myocardial protection during coronary artery bypass graft surgery using low-volume cardioplegia (Cardioplexol) and minimal extracorporeal circulation (MECC) for different types of coronary artery diseases. In total, 426 consecutive patients were included and divided into four groups: those with left main stem stenosis (n = 45), those with three-vessel disease (n = 200), those with both (n = 141), and those with neither (n = 40). The peak postoperative myocardial markers and 30-day mortality were analyzed. Both myocardial markers and 30-day mortality were significantly elevated in patients with isolated main stem stenosis. We conclude that the use of low-volume cardioplegia and MECC is safe. However, patients with underlying isolated left main stem stenosis might be less protected.
Assuntos
Soluções Cardioplégicas/administração & dosagem , Ponte de Artéria Coronária , Estenose Coronária/cirurgia , Circulação Extracorpórea/métodos , Parada Cardíaca Induzida/métodos , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Compostos de Potássio/administração & dosagem , Biomarcadores/sangue , Soluções Cardioplégicas/efeitos adversos , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/mortalidade , Estenose Coronária/sangue , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/mortalidade , Creatina Quinase Forma MB/sangue , Bases de Dados Factuais , Circulação Extracorpórea/efeitos adversos , Circulação Extracorpórea/mortalidade , Feminino , Parada Cardíaca Induzida/efeitos adversos , Parada Cardíaca Induzida/mortalidade , Humanos , Masculino , Traumatismo por Reperfusão Miocárdica/sangue , Traumatismo por Reperfusão Miocárdica/diagnóstico , Traumatismo por Reperfusão Miocárdica/mortalidade , Compostos de Potássio/efeitos adversos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Troponina T/sangueRESUMO
PURPOSE: The purpose of this study was to evaluate the effect of different cardioplegic solutions on endothelial integrity and oxidative stress in cardiovascular surgery. METHODS: In this randomized prospective study, after ethics approval and informed consent, 60 surgical patients were included. Patients undergoing coronary bypass surgery were randomized into two groups as warm blood cardioplegia (n = 30) and cold crystalloid cardioplegia (n = 30) following the cross-clamping. Measurements were performed at three time points: before induction of anesthesia (T1), at admission to intensive care unit (ICU) (T2) and at the 24th postoperative hour (T3). Besides biochemical routine hemodynamic monitoring, patients were assessed for the sialic acid (SA), ischemic-modified albumin (IMA), advanced oxide protein products (AOPPs), total thiol (SH), and free hemoglobin (fHb) level. RESULTS: Neither crystalloid nor blood cardioplegia led to significant changes in the AOPPs, T-SH, and SA level (p >0.05). Crystalloid cardioplegia, however, increased IMA level compared to both baseline (p <0.01) and blood cardioplegia group (p <0.05). fHb levels were transiently increased in both groups at the second-time point (p <0.001). fHb level was lower in the crystalloid group compared to that in the other group (p <0.05) at T2. CONCLUSION: Cardioplegia type creates similar effects on glycocalyx integrity. However, myocardial protection could be provided with warm blood cardioplegia.
Assuntos
Soluções Cardioplégicas/administração & dosagem , Ponte de Artéria Coronária , Células Endoteliais/efeitos dos fármacos , Glicocálix/efeitos dos fármacos , Parada Cardíaca Induzida/métodos , Estresse Oxidativo/efeitos dos fármacos , Compostos de Potássio/administração & dosagem , Produtos da Oxidação Avançada de Proteínas/sangue , Idoso , Biomarcadores/sangue , Soluções Cardioplégicas/efeitos adversos , Temperatura Baixa , Ponte de Artéria Coronária/efeitos adversos , Creatina Quinase Forma MB/sangue , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Feminino , Glicocálix/metabolismo , Glicocálix/patologia , Parada Cardíaca Induzida/efeitos adversos , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Ácido N-Acetilneuramínico/sangue , Compostos de Potássio/efeitos adversos , Estudos Prospectivos , Albumina Sérica Humana , Compostos de Sulfidrila/sangue , Fatores de Tempo , Resultado do Tratamento , Troponina I/sangue , TurquiaRESUMO
Epidemiological studies indicated that chronic exposure to high water iodine is associated with primary hypothyroidism (PH) and subclinical hypothyroidism (SCH). However, the mechanism is not well understood. In this study, we explored whether chronic exposure to high water iodine from potassium iodate (KIO3) can induce hypothyroidism in addition to determining if nitric oxide (NO) is involved in the pathogenesis. 96 female Wistar rats were divided into six groups: control, I1000µg/L, I3000µg/L, I6000µg/L, N-nitro-L-arginine methylester (L-NAME) and L-NAME+I6000µg/L. After 3 months, urine iodine concentration, thyroid hormone, NO and nitric oxide synthase (NOS) serum levels were determined. Additionally, thyroid expression of inducible nitric oxide synthase (iNOS) was also investigated. Thyroid morphology was observed under light microscopy and transmission electron microscope. SCH as indicated by elevated serum thyrotropin (TSH) was induced among rats exposed to 3000⯵g/L I-, while rats treated with 6000⯵g/L I- presented PH characterized by elevated TSH and lowered total thyroxine in serum. Moreover, serum NO, NOS and iNOS expression in the thyroid were significantly increased in I3000µg/L and I6000µg/L groups. Changes in thyroid function and morphology in the L-NAME+I6000µg/L group were extenuated compared to I6000µg/L group. These findings suggested that chronic exposure to high water iodine from KIO3 likely induces hypothyroidism with significant morphology changes in female Wistar rats and NO appears to be involved in the pathogenesis.