Cutaneous sporotrichosis treatment with potassium iodide: a 24 year experience in São Paulo state, Brazil

BACKGROUND: Sporotrichosis is a subacute or chronic disease caused by a dimorphic fungus, Sporothrix schenckii. The first and most traditional treatment is potassium iodide in satured solution (SSKI) used by DE BEURMANN in 1907. For its effectiveness, it is still used for cutaneous sporotrichosis. OBJECTIVE: To evaluate the treatment of cutaneous sporotrichosis with SSKI in relation to clinical cure, side effects, length of treatment and reactivation. METHODS: We conducted a retrospective analysis of medical records over a 24-year period (1981-2005). Patients of all ages who were treated in the hospital´s division of dermatology were included in the study providing that they had a positive culture of S. schenckii. Satured solution of potassium iodide (3 to 6g per day) was the treatment prescribed. For children, half of the dose was prescribed. RESULTS: The lymphocutaneous disease was prevalent, the cure rate was 94.7%, side effects were described in 5.5% of the cases, mean length of treatment was 3.5 months and possible reactivation was observed in 11.1%. CONCLUSION: SSKI is an effective drug, with many side effects, but with low frequency. Resolution was for maximum six months of treatment. SSKI has been found to be a very effective drug in this retrospective study of culture-proven cases of cutaneous and lymphocutaneous sporotrichosis. It should be used as first drug of choice especially in resource-limited settings.

Effect of iodide on Fas, Fas-ligand and Bcl-w mRNA expression in thyroid of NOD mice pretreated with methimazole

Nonobese diabetic (NOD) mice and a derived strain, NOD.H.2h4, have been used as a model for experimental spontaneous thyroiditis and thyroiditis induced by iodide excess after a goiter-inducing period. Some authors have proposed that iodide, given after methimazole or propylthiouracil, is capable of inducing apoptosis in thyroid cells and that anti-thyroid drugs can modulate the expression of apoptosis components such as Fas and its ligand (Fas-L). Here we evaluated the effect of potassium iodide (20 µg/animal for 4 days, ip) given to NOD mice at the 10th week of life after exposure to methimazole (1 mg/ml) in drinking water from the 4th to the 10th week of life. Fas, Fas-L and Bcl-w expression were analyzed semiquantitatively by RT-PCR immediately after potassium iodide administration (group MI44D) or at week 32 (MI32S). Control groups were added at 10 (C10) and 32 weeks (C32), as well as a group that received only methimazole (CM10). An increase in the expression of Fas-L and Bcl-w (P<0.01, ANOVA) was observed in animals of group MI44D, while Fas was expressed at higher levels (P = 0.02) in group C32 (72.89 ± 47.09 arbitrary units) when compared to group C10 (10.8 ± 8.55 arbitrary units). Thus, the analysis of Fas-L and Bcl-w expression in the MI44D group and Fas in group C32 allowed us to detect two different patterns of expression of these apoptosis components in thyroid tissue of NOD mice.

Mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome: case report

The first case of mediastinal and pulmonary entomophthoromycosis with supe rior vena cava syndrome is reported. The patient presented with a history of edema of the face, neck and upper limbs as well as collateral circulation in the anterior wall of the chest. Histological examination of tissue from mediastinum revealed a granulomatous reaction with microabscesses surrounded by eosinophilic amorphous material and with broad hyphae in the center. Culture was not performed because a preliminary diagnosis of nonHodgkin's malignant lymphoma was made. Surgical correction of the obstructed area was performed and the patient was sucessfully treated with potassium iodide. The authors propose that mediastinal entomoph thoromycosis must be considered in the differential diagnosis of diseases causing superior vena cava syndrome in tropical and sub-tropical regions. This case enlarges the spectrum of clinical manifestations of the zigomycosis caused by Entomoph-thoraceae.

Entomophthoramycosis by Conidiobolus coronatus. Report of a case successfully treated with the combination of itraconazole and fluconazole

Rhinoentomophthoramycosis caused by Conidiobolus coronatus in a 61-year old woman was unsuccessfully treated during 8 years with all the antifungals available in the Brazilian market, including potassium iodide for 1 month, sulfamethoxazole plus trimethoprim for 2 months, amphotericin B, total dose of 1130 mg, cetoconazole, 400 mg/day for 6 months, fluconazole, 200 mg/day, for at least 2 months and, itraconazole, 400 mg/day for 2 months, followed by 200 mg/day for 4 more months. Complete clinical and mycological cure was achieved using itraconazol 400 mg/day in association with fluconazol 200 mg/day during 24 months. After cure she was submitted to plastic surgery to repair her facial deformation. Today she remains clinically and mycologically cured after 59/60 months (5 years!) without any specific antifungal. We thus suggest the use of the combination of itraconazole and fluconazole as an additional option for the treatment of this mycosis.

Environmental contamination by Toxocara sp. eggs in Ribeirão Preto, São Paulo State, Brazil

Toxocariasis is a zoonosis mainly caused by Toxocara canis, an intestinal nematode of dogs. Man acquires the infection through accidental ingestion of viable eggs, and the toxocariasis clinical manifestations may vary from an asymptomatic infection up to the Visceral Larva Migrans syndrome. Seventy eight public squares of Ribeirão Preto, São Paulo, Brazil, including Bonfim Paulista district were visited aiming to evaluate the soil contamination by Toxocara eggs. The squares were divided in five different areas corresponding to the Sanitary Districts of the city. From May to December 2003, soil samples weighting about 250 g each were collected from five distinct sites of each public square. The laboratorial analysis was done by centrifugal-flotation techniques in magnesium sulphate solutions with 5% of potassium iodide (d = 1.33) and zinc sulphate (d = 1.20), and by the sedimentation- flotation in conic chalices with zinc sulphate (d = 1.20). Toxocara sp. eggs were found on 16 (20.5%) squares, with the lowest prevalence (12%) at the central area. From these results, it is expected that the legal authority will adopt protection measures for the city public areas, reducing thus the contamination risk by Toxocara sp. eggs.

Latex production with depolymerizing compounds of actin cytoskeleton in rubber trees

The objective of this work was to assess stimulated latex flow from rubber trees (Hevea brasiliensis) with saturated macrolide (latrunculin A), 1, 5, and 10% potassium iodide in 2% methylcellulose compared with 0.3% ethylene in 2% methylcellulose (check) and 2% methylcellulose (blank). Latex output and contents of pure rubber, total solid, sucrose, inorganic phosphorus, thiol, and Mg2+ were measured. The treatments containing 1% KI or saturated macrolide increased latex yields compared to the blank with 2% methylcellulose alone. The 1% KI or saturated macrolide treatments were equal to that of 0.3% ethylene check treatment. However, 5 and 10% KI were harmful to bark of rubber trees, even caused prolonged tapping panel dryness.

Effects of levels of potassium and nitrogen on yields and post-harvest conservation of onions in winter

Potassium and nitrogen are the elements present in the highest percentage in the onion dry matter. The objective of this experiment was to evaluate yield and post-harvest conservation of Vale Ouro IPA-11 onion cultivar regarding to nitrogen and potassium levels. The experiment was carried out in Petrolina-PE, Brazil, from June to September 2009. The experimental design was a completely randomized block in a 4 x 3 factorial design, composed of four nitrogen levels (0, 60, 120 and 180 kg ha-1) and three potassium levels (0, 90 and 180 kg ha-1) with three replications. The highest yield of commercial bulbs was achieved at an estimated N level of 172.6 kg ha-1. The lowest yield of noncommercial bulbs was estimated at N level of 147.0 kg ha-1. Lower percentage of smaller bulbs (class 2) were obtained by increasing levels of N x K, with a quadratic effect at the dose of 90 kg ha-1 K2O and minimum production point with 127.6 kg N ha-1 (20.3%). Regarding larger caliber bulbs (class 4), linear effects were found both in the absence and for the level of 90 kg ha-1 of K2O as levels of N were increased. When the highest level of 180 kg ha-1 K2O was applied, the level of 92.8 kg ha-1 of N was estimated as the one that would promote the highest bulb yield of this class (35.4%), and 5.3% was found in the lack of potassium fertilization.

Nitrogen and potassium fertilization on the yield and intensity of the maize white spot

A plant's nutritional balance can influence its resistance to diseases. In order to evaluate the effect of increasing doses of N and K on the yield and severity of the mayze white spot, two experiments were installed in the field, one in the city of Ijaci, Minas Gerais, and the other in the city of Sete Lagoas, Minas Gerais. The experimental delimitation was in randomized blocks with 5 x 5 factorial analysis of variance, and four repetitions. The treatments consisted of five doses of N (20; 40; 80; 150; 190 Kg ha-1of N in the experiments 1 and 2) and five doses of K (15; 30; 60; 120; 180 Kg ha-1of K in experiment 1 and 8.75; 17.5; 35; 50; 100 Kg ha-1of K in experiment 2). The susceptible cultivar 30P70 was planted in both experiments. The plot consisted of four rows 5 meters long, with a useful area consisting of two central rows 3 meters each. Evaluations began 43 days after emergence (DAE) in the first experiment and 56 DAE in the second one. There was no significant interaction between doses of N and K and the disease progress P+. The effect was only observed for N. The K did not influence the yield and the severity of the disease in these experiments. Bigger areas below the severity progress curve of the white spot and better yield were observed with increasing doses of N. Thus, with increasing doses of N, the white spot increased and also did the yield.

Characterization of verdete rock as a potential source of potassium

Potassium is a nutrient found at low levels in Brazilian soils, requiring large inputs of fertilizers to achieve satisfactory crop yields. Brazil has high external dependence and limited reserves of soluble K mineral, which is traditionally exploited for the production of fertilizers. On the other hand, it is common the occurrence in the country of potassium-rich silicate minerals which are not commercially exploited. This study aimed to characterize mineralogically and chemically samples of verdete rock separated into size fractions and evaluate its potential as potassium fertilizer. The mineral composition of verdete rock is based on glauconite, quartz and feldspar. The total K2O content in verdete rock ranged from 5.18 to 9.0 dag/kg. The K content extracted in water or 2% citric acid was 2.4% below the total of K, indicating low reactivity of verdete rock and limitations for direct use as K source. The processes of physical fractionation and sedimentation in water are inefficient to promote the concentration of K in the different verdete rock fractions. The total K content in some samples are considerable and may enable the use of this rock as raw material for production of more reactive potassium fertilizers.

The association between serum potassium at hospital admission and the case-fatality rate of leptospirosis in men

Severe leptospirosis affects predominantly males and presents a high susceptibility to hypokalemic acute renal failure. As hypokalemia and hyperkalemia induce severe complications, it is important to evaluate if the initial serum potassium is an independent risk factor for death in leptospirosis. The medical records of 1016 patients hospitalized with the diagnosis of leptospirosis were reviewed. The analysis was restricted to 442, according to the following criteria: male, 18 years or older, information about death or hospital discharge and recorded values of serum potassium, serum creatinine and duration of symptoms at admission. Potassium values lower than 3.5 mEq/L (hypoK), 3.5-5 mEq/L (normoK) and above 5 mEq/L (hyperK) were detected in 180, 245 and 17 patients, respectively. The death rate increased with serum potassium: 11.1% in the hypoK, 14.7% in the normoK and 47.1% in the hyperK group (p = 0.002). In a logistic regression model (normoK as referent), including age, creatinine and duration of symptoms, hypoK was not associated with increased death rate (odds ratio (OR) = 0.80; p > 0.1). On the other hand, hyperK showed a significant association with increased risk of death (OR = 3.95, p = 0.021). In conclusion, in this sample of men with leptospirosis initial serum potassium was positively and independently correlated with the risk of in-hospital death.

Chemical and physical attributes and calcium, magnesium, potassium, and phosphorus in the soil of murundu fields in Brazil

Fields of murundus (FM) are wetlands that provide numerous ecosystem services. The objectives of this study were to evaluate the chemical [organic carbon (OC), P, K+, Ca2+, Mg2+, Al3+ and H+Al] and physical [texture and bulk density (Bd)] soil attributes and calculate the organic matter (OM) and nutrient stock (P, Ca, Mg, and K) in soils of FM located in the Guapore River basin in Mato Grosso. Thirty-six sampling points were selected, and soil samples were collected from two environments: the murundu and plain area surrounding (PAS). At each sampling point, mini trenches of 0.5 × 0.5 × 0.4 m were opened and disturbed and undisturbed soil samples were collected at depths of 0-0.1, 0.1-0.2, and 0.2-0.4 m. In the Principal Component Analysis the variables H+Al (49%) and OM (4%) were associated with the F1 component and sand content (47%) with the F2 component. The FM had lower pH values and higher concentrations of K+, P, and H+Al than PAS at all depths (p < 0.05). Additionally, FM stocked up to 433, 360, 205, and 11 kg ha-1 of Ca, Mg, K, and P, respectively, for up to a depth of 0.2 m. The murundu stored two times more K and three times more P than that in the PAS. Our results show that the FM has high sand content and Bd greater than 1.5 Mg m-3, high acidity, low OC content, and low nutrient concentrations. Thus, special care must be taken to preserve FM such that human intervention does not trigger environmental imbalances.

Serum Potassium Levels Inversely Correlate with D-Dimer In Patients with Acute-Onset Atrial Fibrillation

Background: D-dimer values are frequently increased in patients with atrial fibrillation (AF) compared to subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. Objective: D-dimer values are frequently increased in patients with atrial fibrillation (AF) compared with subjects in sinus rhythm. Hypokalemia plays a role in several cardiovascular diseases, but little is known about the association with AF. The aim of this study was to investigate correlations between D-dimer and serum potassium in acute-onset AF (AAF). Methods: To investigate the potential correlation between the values of serum potassium and D-dimer in patients with AAF, we retrospectively reviewed clinical and laboratory data of all emergency department visits for AAF in 2013. Results: Among 271 consecutive AAF patients with D-dimer assessments, those with hypokalemia (n = 98) had significantly higher D-dimer values than normokalemic patients (139 versus 114 ng/mL, p = 0.004). The rate of patients with D-dimer values exceeding the diagnostic cut-off was higher in the group of patients with hypokalemia than in those with normal serum potassium (26.5% versus 16.2%; p = 0.029). An inverse and highly significant correlation was found between serum potassium and D-dimer (r = −0.21; p < 0.001), even after adjustments for age and sex (beta coefficient −94.8; p = 0.001). The relative risk for a positive D-dimer value attributed to hypokalemia was 1.64 (95% CI, 1.02 to 2.63; p = 0.040). The correlation remained statistically significant in patients free from antihypertensive drugs (r = −0.25; p = 0.018), but not in those taking angiotensin-receptor blockers, angiotensin-converting enzyme inhibitors, or diuretics. Conclusions: The inverse correlation between values of potassium and D-dimer in patients with AAF provides important and complementary information about the thromboembolic risk of these patients.

Doses and methods of distribution of potassium chloride on soybean crop (Glycine max (L.) Merrill) in a red latosol, affecting soil salinity, grain production and chemical composition of leaves

The present work deal t wi th an experiment under field conditions and a laboratory test of soil incubation the objectives were as follows: a. to study effects on soybean grain product ion and leaf composition of increasing doses of potassium chloride applied into the soil through two methods of distribution; b. to observe chemical modifications in the soils incubated with increasing doses of potassium chloride; and, c. to correlate field effects with chemical alterations observed in the incubation test, The field experiment was carried out in a Red Latosol (Haplustox) with soybean cultivar UFV - 1. Potassium chloride was distributed through two methods: banded (5 cm below and 5 cm aside of the seed line) and broadcasted and plowed-down. Doses used were: 0; 50; 100 and 200 kg/ha of K2O. Foliar samples were taken at flowering stage. Incubation test were made in plastic bags with 2 kg of air dried fine soil, taken from the arable layer of the field experiment, with the following doses of KC1 p,a. : 0; 50; 100; 200; 400; 800; 1,600; 3.200; 6,400 and 12,800 kg/ha of K(2)0. In the conditions observed during the present work, results allowed the following conclusions: A response by soybean grain production for doses of potassium chloride, applied in both ways, banded or broadcasted, was not observed. Leaf analysis did not show treatment influence over the leaf contents for N, P, K, Ca, Mg, and CI, Potassium chloride salinity effects in both methods of distribution for all the tested closes were not observed.

The potassium impermeable apical membrane of insect epithelia: a target for development of safe pesticides

Columnar cell apical membranes (CCAM) in series with goblet cell apical membranes (GCAM) form an electroosmotic barrier separating the midgut lumen from epithelial cell cytoplasm. A unique K+ ATPase in GCAM generates three gradients across this barrier. A greater than 180 mV electrical gradient (lumen positive) drives amino acid uptake through voltage-dependent K+ symports. A greater than 1000-fold [H+] gradient (lumen alkaline) and a greater than 10-fold [K+] gradient (lumen concentrated) are adaptations to the high tannin and high K+ content, respectively, in dietary plant material. Agents which act on the apical membrane and disrupt the PD, H+, or K+ gradients are potential insecticides. Insect sensory epithelia and mammalian stria vascularis maintain similar PD and K+ gradients but would not be exposed to ingested anti-apical membrane insecticides. Following the demonstration by Sacchi et al. that Bacillus thuringiensis delta-endotoxin (Bt) induces specifically a K+ conductance increase in CCAM vesicles, we find that the K+ channel blocking agent, Ba2+, completely reverses Bt inhibition of the K+-carried short circuit current in the isolated midgut of Manduca sexta. Progress in characterizing the apical membrane includes finding that fluorosulfonylbenzoyladenosine binds specifically to certain GCAM polypeptides and that CCAM vesicles can be mass produced by Ca2+ or Mg2+ precipitation from Manduca sexta midgut.

Use of a selective medium with potassium tellurite to follow intestinal colonization of hospitalized patients by drug-resistant Enterobacteriaceae

Nosocomial infections are a relevant factor in complicating the recovery of patients interned for even minor causes. In attempt to determine their origin it is crucial to consider that their origin is of an endogenous nature. Looking for an acessible expression of intestinal colonization we analyzed fecal samples from 3 separate groups of hospital patients collected after different lenghts of time. For practical reasons one group was studied prospectively and two other groups (patients hospitalized for up to 7 days and patients hospitalized for more than 7 days) were compared to one another. We looked for the emergence of tellurite resistance among Enterobacteriaceae using a selective medium. MacConkey potassium tellurite (MCPT). The frequence of prospectively studied patients with tellurite resistant strains was significantly greater after 7 days of hospitalization. For the two other groups, patients with more than 7 days of hospitalization showed a significant increase of bacterial species and of strains with new antimicrobial resistance markers. High molecular weigth plasmids were detected in some of these strains. These data show that the MCPT medium is a useful tool for the investigation of bowel colonization in hospitalized patients by drug-resistant Enterobacteriaceae.