A case of generalized argyria presenting with muscle weakness

Blue Nail Discoloration: Literature Review and Diagnostic Algorithms

Blue nail discoloration is a distinctive clinical presentation, and diagnosis is challenging given the broad differential diagnosis. A comprehensive review of the literature describing blue discoloration of one or multiple nails was performed using the PubMed, Embase, Scopus, and Web of Science databases. A total of 245 publications were included and grouped based on involvement of a single nail (monodactylic) or multiple nails (polydactylic). Monodactylic blue discoloration was associated with tumors or benign nevi, most commonly glomus tumors, followed by blue nevi and less commonly melanomas. Polydactylic blue discoloration was frequently associated with medications (such as minocycline, zidovudine, and hydroxyurea), toxic and exogenous exposures (such as silver), and other medical conditions (such as HIV/AIDS and systemic lupus erythematous). Patients presenting with blue nail discoloration warrant a thorough history, physical examination, and workup to rule out malignancy, systemic disease, or toxic exposure. We present diagnostic algorithms for monodactylic and polydactylic blue nail discoloration to guide workup and treatment plans.

Exogenous pigmentation by silver nitrate: Dermatological and toxicological aspects, case report

La pigmentación exógena por nitrato de plata es una enfermedad poco frecuente, cuyas manifestaciones clínicas pueden aparecer años después del contacto, lo que en ocasiones dificulta su diagnóstico. Se caracteriza por la presencia de máculas o placas azul-grisáceas en la piel o las mucosas de la zona de contacto que, en ocasiones, son muy similares a las lesiones melanocíticas y al melanoma, sus principales diagnósticos diferenciales.

Se reporta el caso de un paciente de Medellín, Colombia, con antecedentes familiares de melanoma y presencia de estas lesiones en todo el cuerpo.

Clinical and Forensic Aspects of the Different Subtypes of Argyria

Argyria encompasses the different cosmetic alterations that can develop if enough silver particles deposit in a specific tissue, typically in the skin, ranging from localized dark-blue macules to a generalized slate-gray/bluish tinge following systemic absorption. This work aims to fully review the state of the art regarding pathophysiology, diagnosis, treatment, and relevant clinical and forensic features of argyria. Argyria has been diagnosed in a wide range of ages, both sexes and varied ethnicities, with no known individual predisposing factors. Ultraviolet radiation with subsequence increases of melanin production aggravates the discoloration due to a reduction in the silver deposits. Physical examination and silver exposure in the anamnesis can be highly suggestive of the diagnosis, but a histopathological analysis with Energy-Dispersive X-ray Spectroscopy is required to unequivocally determine the discoloration etiology. Safe and effective treatment has only been accomplished with laser techniques, though only a few cases have been reported and with limited follow-up time. In conclusion, argyria typically has an occupational or iatrogenic etiology. It should be suspected when a patient presents with typical skin or eye lesions. A seemingly viable treatment modality, with laser technology, is finally within the horizon.

The impact of bacterial size on their survival in the presence of cationic particles of nano-silver

BACKGROUND

Microbial surface area is one of the battlegrounds for invading microbes and host defense. Hence, infectious diseases caused by drug resistant microbes with large surface area are more difficult to treat than small size microbes. Nanobiology offers opportunities to re-explore the biological properties of conventional drugs at molecular level to combat these microbes. The purpose of the present study was to examine size depended susceptibility of Gram-positive bacteria towards nano-silver particles.

METHODS

This study investigated the growth, surface charge, and morphology of emerging B. megaterium MTCC 7192 and re-emerging S. aureus MTCC 3160 cells in order to observe the susceptibility of these bacteria towards cationic nano-silver particles. Nano-silver particles were applied into wells formed on the Nutrient agar plates containing 108 CFU/mL of the bacteria. Surface potential of normal and treated cells was measured by Microtrac and the effects of nano-silver particles on bacterial cells were assessed by Scanning Electron Microscopy (SEM).

RESULTS

In this work, synthesized nano-silver particles were found to be more effective against B. megaterium MTCC 7192 than S. aureus MTCC 3160. For B. megaterium MTCC 7192, a 0.30 fold increase in inhibition zone was observed after the addition of nano-silver particles in the wells. From our studies, it is reasonable to state that alternation of zeta potential may affect the cell morphology, which was further confirmed by SEM.

CONCLUSION

The present study concluded that nano-silver particles appears to interact with a larger surface area more effectively.

The Food Matrix and the Gastrointestinal Fluids Alter the Features of Silver Nanoparticles

Silver nanoparticles (AgNPs) are used in the agri-food sector, which can lead to their ingestion. Their interaction with food and their passage through the gastrointestinal tract can alter their properties and influence their fate upon ingestion. Therefore, this study aims at developing an in vitro method to follow the fate of AgNPs in the gastrointestinal tract. After incorporation of AgNPs into a standardized food matrix, a precolonic digestion is simulated and AgNPs are characterized by different techniques. The presence of food influences the AgNPs properties by forming a corona around nanoparticles. Even if the salivary step does not impact significantly the AgNPs, the pH decrease and the digestive enzymes induce the agglomeration of AgNPs during the gastric phase, while the addition of intestinal fluids disintegrates these clusters. AgNPs can thus reach the intestinal cells under nanometric form, although the presence of food and gastrointestinal fluids modifies their properties compared to pristine AgNPs. They can form a corona around the nanoparticles and act as colloidal stabilizer, which can impact the interaction of AgNPs with intestinal epithelium. This study demonstrates the importance of taking the fate of AgNPs in the gastrointestinal tract into account to perform an accurate risk assessment of nanomaterials.

Bacterial membrane destabilization with cationic particles of nano-silver to combat efflux-mediated antibiotic resistance in Gram-negative bacteria

AIMS

With the purpose of exploring combinatorial options that could enhance the bactericide efficacy of linezolid against Gram-negative bacteria, we assessed the extent of combination of nano-silver and linezolid.

MAIN METHODS

In this study, we selected Escherichia coli MTCC 443 as a model to study the combinatorial effect of nano-silver and linezolid to combat efflux-mediated resistance in Gram-negative bacteria. The acting mechanism of nano-silver on E. coli MTCC 443 was investigated by evaluating interaction of nano-silver with bacterial membrane as well as bacterial surface charge, morphology, intracellular leakages and biological activities of membrane bound respiratory chain dehydrogenase and deoxyribonucleic acids (DNA) of the cells following treatment with nano-silver.

KEY FINDINGS

The alternation of zeta potential due to the interaction of nano-silver towards bacterial membrane proteins was correlated with enhancement of membrane permeability, which allows the penetration of linezolid into the cells. In addition, the binding affinity of nano-silver towards bacterial membrane depressed biological activities of membrane bound respiratory chain dehydrogenases and DNA integrity.

SIGNIFICANCE

Our findings suggested that nano-silver could not only obstruct the activities of efflux pumps, but also altered membrane integrity at the same time and thus increased the cytoplasmic concentration of the linezolid to the effective level.

N-Acetylcysteine reverses silver nanoparticle intoxication in rats

The increasing use of silver nanoparticles (AgNPs) in consumer products raises the risk of human toxicity. Currently, there are no therapeutic options or established treatment protocols in cases of AgNPs intoxication. We demonstrated previously that thiol antioxidants compounds can reverse the cytotoxicity induced by AgNPs in Huh-7 hepatocarcinoma cells. Here, we investigated the use of N-acetylcysteine (NAC) against the systemic toxic effects of AgNPs (79.3 nm) in rats. Biochemical, histopathological, hematological, and oxidative parameters showed that a single intravenous injection of AgNPs (5 mg/kg b.w.) induced deleterious effects such as hepatotoxicity, potentially as a result of AgNPs accumulation in the liver. Treatment with a single intraperitoneal injection of NAC (1 g/kg b.w.) one hour after AgNPs exposure significantly attenuated all toxic effects evaluated and altered the bioaccumulation and release patterns of AgNPs in rats. The findings show that NAC may be a promising candidate for clinical management of AgNPs intoxication.