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Mohammad A Hossain, Eric Costanzo, James Cosentino, Chirag Patel, Huzaif Qaisar, Vikas Singh, Taimoor Khan, Jennifer S Cheng, Arif Asif, Tushar J Vachharajani
Contrast-induced acute kidney injury is a common iatrogenic complication associated with increased health resource utilization and adverse outcomes, including short- and long-term mortality and accelerated progression of preexisting renal insufficiency. The incidence of contrast-induced nephropathy (CIN) has been reported to range from 0% to 24%. This wide range reported by the studies is due to differences in definition, background risk factors, type and dose of contrast medium used, and the frequency of other coexisting potential causes of acute renal failure...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Min Suk Yang, Sang Il Choi, Woo Jung Song, Sae Hoon Kim, Sang Heon Cho, Kyung Up Min, Jae Hyoung Kim, Yoon Seok Chang
PURPOSE: Patients with a history of radiocontrast media (RCM) hypersensitivity can be overlooked, resulting in repeated reactions. Therefore, a consultation support system for RCM hypersensitivity has been in operation at Seoul National University Bundang Hospital since December 2011. We analyzed the effect of this system on physicians' practice. METHODS: A retrospective study was conducted on patients with previous RCM reactions (December 1, 2010 to November 30, 2012)...
March 2018: Allergy, Asthma & Immunology Research
Alicia M Gehling, Kyle Kuszpit, Emily J Bailey, Krystal H Allen-Worthington, David P Fetterer, Pedro J Rico, Thomas M Bocan, Christian C Hofer
This study presents recommendations for intramuscular injection into the caudal thigh muscle of mice according to analysis of in vivo imaging of intramuscularly injected iohexol, a radiocontrast agent commonly used in CT imaging. An experienced laboratory animal technician using a Hamilton syringe intramuscularly injected iohexol into isoflurane-anesthetized female and male BALB/c mice. Injected volumes (25, 50, 100, and 200 μL) underwent CT scanning at 9 time points over a 3-h period. The distribution of the injectate in the muscles of the rear leg was examined over time for each volume group...
January 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Christopher Dang, Eitan Dickman, Mark O Tessaro, Pranjal Patel, Maxim Dzeba, Antonios Likourezos, Illya Pushkar, Peter Homel, Lawrence E Haines
OBJECTIVE: Emergency Department patients with abdominal pain may require both an ultrasound (US) and computed tomography (CT) for an accurate diagnosis. Patients are often asked to drink oral radiocontrast while awaiting ultrasound, in order to better expedite a CT in the case of a non-diagnostic US. The impact of oral radiocontrast on US image quality has not been studied. We compared the quality of US images obtained before and after the ingestion of oral radiocontrast in healthy adult volunteers...
November 20, 2017: American Journal of Emergency Medicine
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Stefan Herget-Rosenthal
PURPOSE: Acute kidney injury (AKI) is a severe complication after infrarenal abdominal aortic aneurysm (iAAA) repair. Little data are available whether endovascular aneurysm (EVAR) or open aortic repair (OAR) differs with respect to AKI frequency and severity, consecutive development of chronic kidney disease (CKD) and potentially preventable and modifiable risk factors of AKI. PATIENTS AND METHODS: We assessed AKI rates, AKI stages and CKD applying current, complete definitions from the kidney disease improving global outcomes initiative in propensity-score-matched cohorts of all patients with elective and urgent iAAA repair at our institution from 2007 to 2011...
February 2018: International Urology and Nephrology
Mihwa Park, Minjeong Kim, Jisun Park, Jinhyun Cho
Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/μL to 2000/μL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days...
January 2018: Yonsei Medical Journal
Marlies Ostermann, Peter A McCullough, Lui G Forni, Sean M Bagshaw, Michael Joannidis, Jing Shi, Kianoush Kashani, Patrick M Honore, Lakhmir S Chawla, John A Kellum
OBJECTIVES: Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 predict the development of acute kidney injury following renal insults of varied aetiology. To aid clinical interpretation, we describe the kinetics of biomarker elevations around an exposure. DESIGN: In an ancillary analysis of the multicenter SAPPHIRE study, we examined the kinetics of the urinary [tissue inhibitor of metalloproteinase-2]•[insulin-like growth factor binding protein 7] in association with exposure to common renal insults (major surgery, IV radiocontrast, vancomycin, nonsteroidal anti-inflammatory drugs, and piperacillin/tazobactam)...
March 2018: Critical Care Medicine
Yub Raj Sedhai, Reshma Golamari, Santosh Timalsina, Soney Basnyat, Ajay Koirala, Ankush Asija, Tatvam Choksi, Akanksha Kushwah, David Geovorgyan, Tawseef Dar, Madhura Borikar, Waseem Ahangar, Joseph Alukal, Subtain Zia, Jose Missri
BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded...
November 2017: American Journal of the Medical Sciences
Mauricio Forero, Manikandan Rajarathinam, Sanjib Das Adhikary, Ki Jinn Chin
PURPOSE: The erector spinae plane (ESP) block has been described in the successful management of both thoracic and abdominal pain. Since the erector spinae muscle extends to the cervical spine, the ESP block may be potentially useful in painful conditions of the shoulder girdle. CLINICAL FEATURES: We performed a series of ESP blocks at the T2/T3 level in an elderly male patient with chronic shoulder pain. Immediate and profound analgesia with improved range of motion was consistently observed following the block...
November 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Benjamin Struecker, Andreas Andreou, Sascha Chopra, Ann-Christin Heilmann, Johanna Spenke, Christian Denecke, Igor Maximilian Sauer, Marcus Bahra, Johann Pratschke, Matthias Biebl
BACKGROUND: Data on the typical time point of occurrence of anastomotic leak (AL) after esophagectomy for esophageal cancer are currently scarce. Therefore, the usefulness of routine radiocontrast agent studies (RRCS) for testing proper healing of the anastomosis after esophagectomy remains unclear. Furthermore, preferred available tools to diagnose postoperative AL and therapeutic options are still under debate. METHODS: We present a retrospective analysis of 328 consecutive patients who underwent esophagectomy for esophageal cancer between 2005 and 2015...
November 7, 2017: Digestive Surgery
Eleni Palli, Demosthenes Makris, John Papanikolaou, Grigorios Garoufalis, Irini Tsilioni, Paris Zygoulis, Epaminondas Zakynthinos
BACKGROUND: The aim was to investigate whether the use of N-acetylcysteine and ascorbic acid reduce contrast-induced nephropathy incidence in critical care patients. METHODS: This was a one-center, two-arm, prospective, randomized, open-label, controlled trial in the Intensive Care Unit of the University Hospital of Larissa, Greece. Patients with stable renal function, who underwent non urgent contrast-enhanced computed tomography for diagnostic purposes, were included in the study...
October 31, 2017: Critical Care: the Official Journal of the Critical Care Forum
Michele Andreucci, Teresa Faga, Antonio Pisani, Raffaele Serra, Domenico Russo, Giovambattista De Sarro, Ashour Michael
Radiocontrast media (RCM)-induced acute kidney injury (CI-AKI) is a major clinical problem whose pathophysiology is not well understood. Direct toxic effects on renal cells, possibly mediated by reactive oxygen species, have been postulated as contributing to CI-AKI. We investigated the effect of quercetin on human renal proximal tubular (HK-2) cells treated with the radiocontrast medium (RCM) sodium diatrizoate. Quercetin is the most widely studied flavonoid, and the most abundant flavonol present in foods...
May 2018: Journal of Cellular Physiology
Farhala Mari Baloch, Javed Majid Tai, Aamir Hameed Khan, Abdul Baqi
A 50-year-old man presented to the emergency department with interscapular pain, diaphoresis and restlessness. Initial examination raised the possibility of aortic dissection; however, the CT scan did not concur with the diagnosis. An ECG showed ST segment elevation in leads V1-V6 and echocardiography showed severe left ventricular systolic dysfunction. Coronary angiography through the right femoral artery was attempted but the diagnostic catheter could not be advanced to the ascending aorta. Radiocontrast injection showed complete obstruction of the descending aorta...
October 9, 2017: BMJ Case Reports
Auryan Szalat, Amichai Perlman, Mordechai Muszkat, Mogher Khamaisi, Zaid Abassi, Samuel N Heyman
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) provide outstanding long-term cardiovascular and renal protection in high-risk patients with type 2 diabetes mellitus. Yet, despite encouraging renal safety outcomes reported in the EMPA-REG study, scattered reports suggest that there might be a risk for acute kidney injury (AKI), which may occasionally be fatal or might require renal replacement therapy. Reduced trans-glomerular pressure with a modest decline in kidney function, an inherent characteristic of SGLT2i therapy, conceivably forms the basis for the long-term renal protection, resembling agents that block the renin-angiotensin-aldosterone (RAAS) axis...
March 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Gai-Ling Liu, Rong Lei, Shao-Bin Duan, Mi-Mi Tang, Min Luo, Qian Xu
Contrast media (CM)-induced nephropathy (CIN) is a serious complication of intravascularly applied radiocontrast media. At present, no drugs have been approved for the prevention of CIN. The present study aimed to explore the effects and potential mechanisms of atorvastatin on iodinated CM-induced cytotoxicity in the human proximal renal tubular epithelial cells. The cytotoxic effect of iohexol (50, 100 and 200 mg I/ml) and the protective effect of atorvastatin pretreatment (1, 20 and 40 µM) were assessed...
October 2017: Experimental and Therapeutic Medicine
Paul J Turner, Elina Jerschow, Thisanayagam Umasunthar, Robert Lin, Dianne E Campbell, Robert J Boyle
Up to 5% of the US population has suffered anaphylaxis. Fatal outcome is rare, such that even for people with known venom or food allergy, fatal anaphylaxis constitutes less than 1% of total mortality risk. The incidence of fatal anaphylaxis has not increased in line with hospital admissions for anaphylaxis. Fatal drug anaphylaxis may be increasing, but rates of fatal anaphylaxis to venom and food are stable. Risk factors for fatal anaphylaxis vary according to cause. For fatal drug anaphylaxis, previous cardiovascular morbidity and older age are risk factors, with beta-lactam antibiotics, general anesthetic agents, and radiocontrast injections the commonest triggers...
September 2017: Journal of Allergy and Clinical Immunology in Practice
Edmilson Leal Bastos de Moura, Fábio Ferreira Amorim, William Huang, Marcelo de Oliveira Maia
OBJECTIVE: To establish whether there is superiority between contrast-induced acute kidney injury and contrast-induced nephropathy criteria as predictors of unfavorable clinical outcomes. METHODS: Retrospective study carried out in a tertiary hospital with 157 patients undergoing radiocontrast infusion for propaedeutic purposes. RESULTS: One hundred forty patients fulfilled the inclusion criteria: patients who met the criteria for contrast-induced acute kidney injury (59) also met the criteria for contrast-induced nephropathy (76), 44...
July 2017: Revista Brasileira de Terapia Intensiva
Melissa Hershman, Ahmadreza Alizadeh, Arun Swaminath
No abstract text is available yet for this article.
September 2017: American Journal of Gastroenterology
Maud A W Hermans, Nicolette J T Arends, Roy Gerth van Wijk, P Martin van Hagen, Hanneke C Kluin-Nelemans, Hanneke N G Oude Elberink, Suzanne G M A Pasmans, Paul L A van Daele
OBJECTIVE: Mastocytosis is a chronic hematologic disorder that is characterized by the accumulation of aberrant mast cells and typically involves the skin and/or bone marrow. Patients with mastocytosis are at increased risk of anaphylaxis. Based on theoretical assumptions, medical procedures requiring general anesthesia or radiocontrast media are deemed hazardous for patients with mastocytosis. The objective of this article is to provide a comprehensive overview of the actual risk of iatrogenic anaphylaxis and provide recommendations for daily practice...
October 2017: Annals of Allergy, Asthma & Immunology
Christopher R McCudden, Joannes F M Jacobs, David Keren, Hélène Caillon, Thomas Dejoie, Kristian Andersen
Protein electrophoresis and immunofixation are subject to a variety of analytical interferences that may affect monoclonal protein diagnostics performed in the context of monoclonal gammopathies. Interferences include endogenous substances, such as hemoglobin and fibrinogen, and exogenous compounds, such as radiocontrast dyes, antibiotics, and monoclonal antibody therapies. General approaches to managing interferences begin with recognition of the problem. Provided herein are examples of common, rare, and novel interferences with the goal of providing a comprehensive overview...
August 24, 2017: Clinical Biochemistry
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