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Alexander Morzycki, Anuj Bhatia, Kieran Murphy
Imaging techniques frequently employ contrast agents to improve image resolution and enhance pathology detection. These gadolinium- and iodine-based media, although generally considered safe, are associated with a number of adverse effects ranging from mild to severe. Reactions are classified as either anaphylactoid ("anaphylaxis-like") or nonanaphylactoid, depending on a number of elements that will be reviewed. Herein, we have summarized predisposing risk factors for adverse events resulting from the use of contrast, their associated pathophysiological mechanisms as well as known prophylaxis for the antitreatment of high-risk patients...
October 13, 2016: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
K Turgutalp, S Bardak, M Horoz, I Helvacı, S Demir, A A Kiykim
PURPOSE: Although various studies have improved our knowledge about the clinical features and outcomes of acute kidney injury developing in the hospital (AKI-DI) in elderly subjects, data about acute kidney injury developing outside the hospital (AKI-DO) in elderly patients (age ≥ 65 years) are still extremely limited. This study was performed to investigate prevalence, clinical outcomes, hospital cost and related factors of AKI-DO in elderly and very elderly patients. METHODS: We conducted a prospective, observational study in patients (aged ≥ 65 years) who were admitted to our center between May 01, 2012, and May 01, 2013...
October 4, 2016: International Urology and Nephrology
Emilee Wilhelm-Leen, Maria E Montez-Rath, Glenn Chertow
Estimates of the incidence of radiocontrast-associated nephropathy vary widely and suffer from misclassification of the cause of AKI and confounding. Using the Nationwide Inpatient Sample, we created multiple estimates of the risk of radiocontrast-associated nephropathy among adult patients hospitalized in the United States in 2009. First, we stratified patients according to the presence or absence of 12 relatively common diagnoses associated with AKI and evaluated the rate of AKI between strata. Next, we created a logistic regression model, controlling for comorbidity and acuity of illness, to estimate the risk of AKI associated with radiocontrast administration within each stratum...
September 29, 2016: Journal of the American Society of Nephrology: JASN
Li Yi Lim, Che Ani Mohd Firdaus, Xeng Inn Fam, Eng Hong Goh
Computed tomography (CT) is a widely used imaging modality. Although hyponatremia after CT imaging is rare, its effects can be devastating. Hyperosmolar radiocontrast acts as effective osmoles and causes fluid migration from intracellular into extracellular compartment. Dilutional hyponatremia will ensue if translocation of fluid is in excess of diuresis. This case report detailed an unusual case of acute symptomatic hyponatremia after CT renal protocol and the treatments given after its recognition.
September 27, 2016: Journal of Computer Assisted Tomography
Vatsal Ladia, Hemang B Panchal, Terrence J O׳Neil, Puja Sitwala, Samit Bhatheja, Rakeshkumar Patel, Vijay Ramu, Debabrata Mukherjee, Ehtisham Mahmud, Timir K Paul
OBJECTIVE: Studies have shown that iodinated radiocontrast use is associated with acute renal failure especially in the presence of chronic kidney disease and multiple factors modulate this risk. The purpose of this meta-analysis is to compare the incidence of renal failure requiring hemodialysis between transfemoral (TF) and transapical (TA) transcatheter aortic valve replacement using the Edwards valve. METHODS: The PubMed database was searched from January 2000 through December 2014...
September 2016: American Journal of the Medical Sciences
Ada Offurum, Lee-Ann Wagner, Tanisha Gooden
Chronic kidney disease (CKD) confers a higher risk of adverse safety events as a result of many factors including medication dosing errors and use of nephrotoxic drugs, which can cause kidney injury and renal function decline. CKD patients may also have comorbidities such as hypertension and diabetes for which they require more frequent care from different providers, and for which standard, but countervailing treatments, may put them at risk for adverse safety events. Areas covered: In addition to the well-known agents such as iodinated radiocontrast, antimicrobials, diuretics and angiotensin converting enzyme (ACE) inhibitors which can directly affect renal function, safety considerations in the treatment of common CKD complications such as anemia, diabetes, analgesia and thrombosis will also be discussed...
October 12, 2016: Expert Opinion on Drug Safety
S R Kim, J H Lee, K H Park, H J Park, J W Park
BACKGROUND: Low-osmolar non-ionic radiocontrast media (RCMs) are commonly used throughout hospitals. However, the incidence of immediate adverse drug reactions (ADRs) to various low-osmolar non-ionic RCMs is not well studied. We compared the incidence of immediate ADRs among different low-osmolar non-ionic RCMs used in computed tomography (CT). METHODS: Severance Hospital has collected data for adverse reactions occurring in-hospital using an internally developed system...
September 20, 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
T U Krohne, J-P Allam, N Novak, F G Holz
BACKGROUND: Preoperative disinfection with povidone-iodine results in a significant reduction of the risk for postoperative endophthalmitis and secondary irreversible vision loss in intraocular surgeries and intravitreal injections. Nevertheless, this important measure is often omitted if so-called "iodine allergy" is suspected. We analyze the physiological and allergological basis for the construct of "iodine allergy". METHODS: This article is based on a selective literature review using the search term "allergy" in combination with "iodine", "povidone", "indocyanine green", or "seafood"...
September 6, 2016: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
So Yeon Lee, Kangmo Ahn, Jihyun Kim, Gwang Cheon Jang, Taek Ki Min, Hyeon Jong Yang, Bok Yang Pyun, Ji Won Kwon, Myung Hyun Sohn, Kyung Won Kim, Kyu Earn Kim, Jinho Yu, Soo Jong Hong, Jung Hyun Kwon, Sung Won Kim, Tae Won Song, Woo Kyung Kim, Hyung Young Kim, You Hoon Jeon, Yong Ju Lee, Hae Ran Lee, Hye Young Kim, Youngmin Ahn, Hye Yung Yum, Dong In Suh, Hyun Hee Kim, Jin Tack Kim, Jeong Hee Kim, Yong Mean Park, Sooyoung Lee
PURPOSE: Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. METHODS: We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. RESULTS: A total of 991 cases (mean age=5...
November 2016: Allergy, Asthma & Immunology Research
So-Hee Lee, Heung-Woo Park, Sang-Heon Cho, Sun-Sin Kim
BACKGROUND: Single premedication with antihistamines for radiocontrast media (RCM) hypersensitivity is frequently used in real world at the emergent situation although its efficacy is not proven. OBJECTIVE: To evaluate the effect of intravenous antihistamines as a premedication in general population who had experience of mild adverse reactions to iodinated RCM. METHODS: A retrospective observational study on 14,785 subjects who had RCM-enhanced computed tomography scans between January 2014 and December 2015 in Seoul National University Hospital Gangnam Healthcare Center, Seoul, South Korea...
July 2016: Asia Pacific Allergy
Bahram Ranjkesh, Flemming Isidor, Michel Dalstra, Henrik Løvschall
Novel fast-setting calcium silicate cement with fluoride (CSC) has been developed for potential applications in tooth crown. The aim of this study was to test the diametral tensile strength (DTS) of different CSC compositions in humid condition on day1, 28, and 180. We tested 'bond CSC' with 3.5% fluoride and no radiocontrast, 'CSC' with 3.5% fluoride and 10% radiocontrast, 'ultrafast CSC' with 3.5% fluoride and 20% radiocontrast, 'high fluoride CSC' with 15% fluoride and 25% radiocontrast, Biodentine, and MTA...
2016: Dental Materials Journal
C Schyma, K Bauer, J Brünig, N Schwendener, R Müller
The powder pocket or soot cavity is a morphologic characteristic of a close contact shot. In a research project concerning staining inside the barrel, the influence of the powder pocket on these traces was investigated.According to the 'triple contrast method', thin pads containing a mixture of acrylic paint, radiocontrast agent and blood were glued on plastic boxes which were coated with a 3-4-mm-thick silicone layer. The containers filled with 10 % ballistic gelatine, were stored for at least 60 h at 4 °C...
July 28, 2016: International Journal of Legal Medicine
Hayriye Sayarlioglu, Ali Okuyucu, Abdulkerim Bedir, Osman Salis, Eser Yenen, Garip Bekfilavioglu, Coskun Kaya
AIM: Contrast medium-induced nephropathy is one of the major complications of intravenous contrast medium use. But its pathogenesis is unclear. Epithelial mesenchymal transition (EMT) is defined as the transformation of the primer epithelial cells to mesenchymal cells. EMT in tubular cells might cause tubulointerstitial damage. In this study, we investigated whether or not EMT has a role in radiocontrast-induced nephropathy. Radiocontrast medium might be triggering reversible EMT via serum and glucocorticoid-regulated kinase 1 (SGK 1)...
September 2016: Renal Failure
Elvira Bocos, Nihal Oturan, Marta Pazos, M Ángeles Sanromán, Mehmet A Oturan
The removal of radiocontrast agent diatrizoic acid (DIA) from water was performed using photo-Fenton (PF) process. First, the effect of H2O2 dosage on mineralization efficiency was determined using ultraviolet (UV) irradiation. The system reached a maximum mineralization degree of 60 % total organic carbon (TOC) removal at 4 h with 20 mM initial H2O2 concentration while further concentration values led to a decrease in TOC abatement efficiency. Then, the effect of different concentrations of Fenton's reagents was studied for homogeneous Fenton process...
October 2016: Environmental Science and Pollution Research International
Bahram Ranjkesh, Jacques Chevallier, Hamideh Salehi, Frédéric Cuisinier, Flemming Isidor, Henrik Løvschall
Aim: Calcium silicate cements are widely used in endodontics. Novel fast-setting calcium silicate cement with fluoride (Protooth) has been developed for potential applications in teeth crowns including cavity lining and cementation. Objective: To evaluate the surface apatite-forming ability of Protooth compositions as a function of fluoride content and immersion time in phosphate-buffered saline (PBS). Material and methods: Three cement compositions were tested: Protooth (3.5% fluoride and 10% radiocontrast), ultrafast Protooth (3...
January 1, 2016: Acta Biomaterialia Odontologica Scandinavica
Yi Wei Wu, Kheng Song Leow, Yujin Zhu, Cher Heng Tan
Iodinated radiocontrast media (IRCM) is widely used in current clinical practice. Although IRCM is generally safe, serious adverse drug reactions (ADRs) may still occur. IRCM-induced ADRs may be subdivided into chemotoxic and hypersensitivity reactions. Several factors have been shown to be associated with an increased risk of ADRs, including previous contrast media reactions, history of asthma and allergic disease, etc. Contrast media with lower osmolality is generally recommended for at-risk patients to prevent ADRs...
April 2016: Annals of the Academy of Medicine, Singapore
Matthew C Phipps, Felipe Monte, Manav Mehta, Harry K W Kim
Osteonecrosis of the femoral head (ONFH) is a debilitating hip disorder, which often produces a permanent femoral head deformity and osteoarthritis. The local delivery of biological agents capable of stimulating bone healing offer potential new treatment options for patients with ONFH. Previous studies from our laboratory have shown that a local intraosseous infusion of bone morphogenic protein-2 (BMP-2) was effective in stimulating new bone formation in a piglet model of ischemic ONFH. However, infusion of BMP-2 solution was associated with unwanted dissemination of BMP-2 out of the femoral head and produced heterotopic ossification in the hip capsule...
July 11, 2016: Biomacromolecules
Anna T Mathew, Steven Fishbane, Yoshitsugu Obi, Kamyar Kalantar-Zadeh
Residual kidney function (RKF) may confer a variety of benefits to patients on maintenance dialysis. RKF provides continuous clearance of middle molecules and protein-bound solutes. Whereas the definition of RKF varies across studies, interdialytic urine volume may emerge as a pragmatic alternative to more cumbersome calculations. RKF preservation is associated with better patient outcomes including survival and quality of life and is a clinical parameter and research focus in peritoneal dialysis. We propose the following practical considerations to preserve RKF, especially in newly transitioned (incident) hemodialysis patients: (1) periodic monitoring of RKF in hemodialysis patients through urine volume and including residual urea clearance with dialysis adequacy and outcome markers such as anemia, fluid gains, minerals and electrolytes, nutritional, status and quality of life; (2) avoidance of nephrotoxic agents such as radiocontrast dye, nonsteroidal anti-inflammatory drugs, and aminoglycosides; (3) more rigorous hypertension control and minimizing intradialytic hypotensive episodes; (4) individualizing the initial dialysis prescription with consideration of an incremental/infrequent approach to hemodialysis initiation (e...
August 2016: Kidney International
Christina George, Alison Sears, Abdel-Ghani Selim, Sarah Walsh, Daniel Creamer
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed drug reaction defined by physical signs and laboratory parameters. Mini-DRESS is a new entity, in cases that display some but not all features of DRESS. Cases of mini-DRESS have a less protracted course, and respond well to systemic corticosteroid treatment.
April 2016: Clinical Case Reports
E A Mangodt, A L Van Gasse, A Bastiaensen, I I Decuyper, A Uyttebroek, M Faber, V Sabato, C H Bridts, M M Hagendorens, L S De Clerck, D G Ebo
The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of IDHR, with particular focus on allergy to curarising neuromuscular blocking agents, antibiotics (β-lactams and fluoroquinolones), iodinated radiocontrast media and opiates.
February 2016: Acta Clinica Belgica
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