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JAMA Dec 2015Graves disease is the most common cause of persistent hyperthyroidism in adults. Approximately 3% of women and 0.5% of men will develop Graves disease during their... (Review)
Review
IMPORTANCE
Graves disease is the most common cause of persistent hyperthyroidism in adults. Approximately 3% of women and 0.5% of men will develop Graves disease during their lifetime.
OBSERVATIONS
We searched PubMed and the Cochrane database for English-language studies published from June 2000 through October 5, 2015. Thirteen randomized clinical trials, 5 systematic reviews and meta-analyses, and 52 observational studies were included in this review. Patients with Graves disease may be treated with antithyroid drugs, radioactive iodine (RAI), or surgery (near-total thyroidectomy). The optimal approach depends on patient preference, geography, and clinical factors. A 12- to 18-month course of antithyroid drugs may lead to a remission in approximately 50% of patients but can cause potentially significant (albeit rare) adverse reactions, including agranulocytosis and hepatotoxicity. Adverse reactions typically occur within the first 90 days of therapy. Treating Graves disease with RAI and surgery result in gland destruction or removal, necessitating life-long levothyroxine replacement. Use of RAI has also been associated with the development or worsening of thyroid eye disease in approximately 15% to 20% of patients. Surgery is favored in patients with concomitant suspicious or malignant thyroid nodules, coexisting hyperparathyroidism, and in patients with large goiters or moderate to severe thyroid eye disease who cannot be treated using antithyroid drugs. However, surgery is associated with potential complications such as hypoparathyroidism and vocal cord paralysis in a small proportion of patients. In pregnancy, antithyroid drugs are the primary therapy, but some women with Graves disease opt to receive definitive therapy with RAI or surgery prior to becoming pregnant to avoid potential teratogenic effects of antithyroid drugs during pregnancy.
CONCLUSIONS AND RELEVANCE
Management of Graves disease includes treatment with antithyroid drugs, RAI, or thyroidectomy. The optimal approach depends on patient preference and specific patient clinical features such as age, history of arrhythmia or ischemic heart disease, size of goiter, and severity of thyrotoxicosis. Physicians should be familiar with the advantages and disadvantages of each therapy to best counsel their patients.
Topics: Adrenergic beta-Antagonists; Adult; Antithyroid Agents; Disease Management; Female; Graves Disease; Humans; Iodine Radioisotopes; Male; Potassium Iodide; Pregnancy; Pregnancy Complications; Thyroidectomy
PubMed: 26670972
DOI: 10.1001/jama.2015.16535 -
Future Medicinal Chemistry Sep 2019Tetracyclines are well established antibiotics but show phototoxicity as a side effect. Antimicrobial photodynamic inactivation uses nontoxic dyes combined with harmless... (Review)
Review
Tetracyclines are well established antibiotics but show phototoxicity as a side effect. Antimicrobial photodynamic inactivation uses nontoxic dyes combined with harmless light to destroy microbial cells by reactive oxygen species. Tetracyclines (demeclocycline and doxycycline) can act as light-activated antibiotics by binding to bacterial cells and killing them only upon illumination. The remaining tetracyclines can prevent bacterial regrowth after illumination has ceased. Antimicrobial photodynamic inactivation can be potentiated by potassium iodide. Azide quenched the formation of iodine, but not hydrogen peroxide. Demeclotetracycline (but not doxycycline) iodinated tyrosine after light activation in the presence of potassium iodide. Bacteria are killed by photoactivation of tetracyclines in the absence of oxygen. Since topical tetracyclines are already used clinically, blue light activation may increase the bactericidal effect.
Topics: Anti-Bacterial Agents; Bacteria; Light; Photochemotherapy; Photosensitizing Agents; Tetracyclines
PubMed: 31544504
DOI: 10.4155/fmc-2018-0513 -
Decorporation dilemma: Interplay of prussian blue and potassium iodide in radioactive contamination.Journal of Environmental Radioactivity Jul 2024The expansion of the nuclear industry has led to various radioactive effluents, originating from routine operations or catastrophic incidents such as those at Three Mile... (Review)
Review
The expansion of the nuclear industry has led to various radioactive effluents, originating from routine operations or catastrophic incidents such as those at Three Mile Island (USA), Chernobyl (Ukraine), and Fukushima (Japan). Research conducted after these events emphasizes Cesium-137 (137Cs) and iodine 131 (131I) as major contributors to harmful airborne dispersion and fallout. These isotopes infiltrate the human body via inhalation, ingestion, or wounds, posing significant health risks. Understanding contamination mechanisms and devising effective countermeasures are crucial in mitigating nuclear incident consequences. We propose that concurrent administration of Pru-Decorp™/Pru-Decorp-MG and potassium iodide (KI) could synergistically reduce the levels of 137Cs and block uptake of 131I, respectively, in nuclear incident scenarios. Pru-Decorp™ capsules contain insoluble ferric hexacyanoferrate(II) and are equivalent to USFDA-approved Radiogardase®-Cs, offering radiation exposure mitigation for Cs and Tl contamination. Pru-Decorp-MG capsules consist of insoluble PB and magnesium hydroxide, serving as a prophylactic measure to reduce the risk of internal Cs and Tl contamination for rescue responders. Pru-Decorp™/Pru-Decorp-MG binds Cs/Tl ions in the gastrointestinal tract, hindering absorption and promoting excretion, while KI saturates the thyroid gland with stable iodine, decreasing the uptake of radioactive iodine isotopes. Our hypothesis is supported by studies demonstrating the effectiveness of combination therapies, such as calcium alginate, iron(III) ferrocyanide, and KI, in decreasing the retention of radioisotopes in vital organs. To test this hypothesis, we propose a comprehensive research plan, including in vitro studies simulating gastrointestinal conditions, animal studies to evaluate the efficacy of both drugs simultaneously, and safety clinical trials comparing Pru-Decorp™/Pru-Decorp-MG alone, KI alone, and their combination. Expected outcomes include insights into the synergistic effects of Pru-Decorp™/Pru-Decorp-MG and KI, guiding the development of optimized treatment protocols for simultaneous administration during radioactive contamination incidents. This research aims to address significant critical gaps in nuclear incident preparedness by providing evidence-based recommendations for concurrent antidote use in scenarios involving multiple isotope contamination. Ultimately, this will enhance public health and safety during nuclear emergencies.
Topics: Potassium Iodide; Ferrocyanides; Cesium Radioisotopes; Iodine Radioisotopes; Humans; Radiation Monitoring; Fukushima Nuclear Accident; Radioactive Hazard Release
PubMed: 38781769
DOI: 10.1016/j.jenvrad.2024.107458 -
Drug Development Research Feb 2019The relentless rise of antibiotic resistance is considered one of the most serious problems facing mankind. This mini-review will cover three cutting-edge approaches... (Review)
Review
The relentless rise of antibiotic resistance is considered one of the most serious problems facing mankind. This mini-review will cover three cutting-edge approaches that use light-based techniques to kill antibiotic-resistant microbial species, and treat localized infections. First, we will discuss antimicrobial photodynamic inactivation using rationally designed photosensitizes combined with visible light, with the added possibility of strong potentiation by inorganic salts such as potassium iodide. Second, the use of blue and violet light alone that activates endogenous photoactive porphyrins within the microbial cells. Third, it is used for "safe UVC" at wavelengths between 200 nm and 230 nm that can kill microbial cells without damaging host mammalian cells. We have gained evidence that all these approaches can kill multidrug resistant bacteria in vitro, and they do not induce themselves any resistance, and moreover can treat animal models of localized infections caused by resistant species that can be monitored by noninvasive bioluminescence imaging. Light-based antimicrobial approaches are becoming a growing translational part of anti-infective treatments in the current age of resistance.
Topics: Animals; Anti-Bacterial Agents; Drug Resistance, Bacterial; Electromagnetic Fields; Humans; Light; Photochemotherapy; Photosensitizing Agents
PubMed: 30070718
DOI: 10.1002/ddr.21453 -
Heliyon Jul 2023Antimicrobial photodynamic therapy is emerging as a promising way to treat infections with minimal side effects. Typically, a single photosensitizer used in photodynamic...
Antimicrobial photodynamic therapy is emerging as a promising way to treat infections with minimal side effects. Typically, a single photosensitizer used in photodynamic therapy is capable of generating only one type of reactive oxygen species, which may have inadequate capability to eradicate certain types of microbes, especially species. Thus, the use of combined photosensitizers is examined as a means of achieving superior antimicrobial results. We postulate that bisdemethoxycurcumin, a type I reactive oxygen species generator, combined with potassium iodide, an antimicrobial iodide molecule, might exhibit superior antimicrobial effects compared to a single photosensitizer-mediated photodynamic therapy. The effects of bisdemethoxycurcumin + potassium iodide + dental blue light on reduction were examined. biofilms were treated with 20, 40 or 80 μM bisdemethoxycurcumin, 100 mM potassium iodide or a combination of these species for 20 min before irradiation with a dental blue light (90 J/cm). The negative and positive controls were phosphate buffer saline and nystatin at 1 : 100,000 units/ml, respectively. Candidal numbers were quantified at 0, 1, 6 and 24 h. Hydroxyl radicals were spectrophotometrically measured using 2-[6-(4'amino phynoxyl-3H-xanthen-3-on-9-yl)] benzoic acid or APF probe-mediated fluorescence intensity (Varioskan) at 490/515 nm (excitation/emission). Candidal counts and hydroxyl radical comparisons were performed using the Kruskal-Wallis test and one-way ANOVA, respectively. Correlations between candidal numbers and hydroxyl radical levels were done with a Pearson correlation test. Forty μM bisdemethoxycurcumin+100 mM KI could provide a 3.5 log CFU/ml reduction after 6 h. Bisdemethoxycurcumin alone generated OH levels that were strongly correlated with candidal reduction. In conclusion, 40 μM bisdemethoxycurcumin+100 mM KI could reduce biofilm.
PubMed: 37455953
DOI: 10.1016/j.heliyon.2023.e17490 -
Maedica Mar 2024This study aimed to evaluate the effect of silver diamine fluoride (SDF) in combination with or without glutathione (Glu) and potassium iodide (KI) on the fluoride...
Evaluating the Effect of Silver Diamine Fluoride, with or without Glutathione and Potassium Iodide, on Fluoride Release, Dentin Microhardness and Surface Properties of Dentin.
This study aimed to evaluate the effect of silver diamine fluoride (SDF) in combination with or without glutathione (Glu) and potassium iodide (KI) on the fluoride release and the enhancement of dentin microhardness. In this study, 90 intact premolar teeth from human subjects were allocated into nine groups, each consisting of ten samples: A) control; B) SDF; C) SDF combined with 5% Glu; D) SDF combined with 10% Glu; E) SDF combined with 20% Glu; F) KI after SDF; G) 5% Glu after SDF; H) 10% Glu after SDF; and I) 20% Glu after SDF. Data were analyzed using SPSS version 22 software and ANOVA and post-hoc and repeated measure test (P value <0.05). Dentin microhardness exhibited variations across different treatments, with the highest value being observed in the SDF-5% Glu group and the lowest in the control group. However, there was a significant difference between the mean values of SDF-5% Glu group and the SDF group. Significant increases in microhardness were observed when comparing SDF-5% Glu to SDF+5% Glu and SDF-10% Glu to SDF+10% Glu in peer groups (P value <0.05). Over time, there was a significant increase in the amount of fluoride released as compared to the initial day. The utilization of SDF-5% Glu group exhibited the most favorable effect on improving dentin hardness. Additionally, utilizing Glu in concentrations of 5% and 10% after SDF application proved more effective in increasing dentin microhardness than combining it with SDF. Moreover, in all three fluoride measurement periods, adding 5% Glu to SDF and using 20% Glu following SDF administration led to a significant increase in fluoride release compared to the application of SDF alone.
PubMed: 38736910
DOI: 10.26574/maedica.2024.19.11.48 -
Clinics in Dermatology 2019Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon... (Review)
Review
Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted.
Topics: Adolescent; Adrenal Cortex Hormones; Adult; Antitubercular Agents; Child; Dapsone; Diagnosis, Differential; Diagnostic Errors; Doxycycline; Drug Therapy, Combination; Female; HIV Infections; Humans; Male; Mycobacterium tuberculosis; Potassium Iodide; Skin; Tuberculosis, Cutaneous; Young Adult
PubMed: 31178102
DOI: 10.1016/j.clindermatol.2019.01.008 -
Journal of Dentistry May 2024This study aims to evaluate antibacterial effects of silver diamine fluoride (SDF), SDF/potassium iodide (KI), and nanosilver fluoride (NSF).
OBJECTIVES
This study aims to evaluate antibacterial effects of silver diamine fluoride (SDF), SDF/potassium iodide (KI), and nanosilver fluoride (NSF).
METHODS
Antimicrobial activity of sterile saline, 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), SDF, SDF/KI, NSF, and KI solutions against Streptococcus mutans and Lactobacillus casei was assessed through disc diffusion tests. A dual-species biofilm of S. mutans-L. casei was formed on 48 enamel samples, divided into six groups (n = 8). Group 1 was treated with sterile saline, Group 2 with 5% NaOCl, Group 3 with 2% CHX, Group 4 with SDF, Group 5 with SDF/KI, and Group 6 with NSF. The samples were analysed using confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Statistical analysis utilized Shapiro-Wilk and Kruskal-Wallis tests and multiple comparisons were conducted using Dunn test.
RESULTS
SDF, SDF/KI, and NaOCl displayed significantly higher antibacterial activity against dual-species biofilm compared to NSF and CHX (p < 0.050).
CONCLUSIONS
In conclusion, SDF and SDF/KI demonstrated greater antibacterial activity than NSF. SDF's antibacterial activity was unaffected by KI. Further research is needed to determine the appropriate content and concentration for achieving effective antibacterial activity with NSF.
CLINICAL SIGNIFICANCE
The use of silver-containing materials is increasing in popularity within pediatric dentistry. In this study, an endeavor has been made to assist pediatric dentists in determining which solution might be more advantageous for preventing caries.
PubMed: 38810833
DOI: 10.1016/j.jdent.2024.105097