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https://www.readbyqxmd.com/read/28761034/successful-desensitization-to-radiocontrast-media-in-two-high-risk-cardiac-patients
#1
Mona Al-Ahmad, Tito Rodriguez Bouza
Hypersensitivity reactions to radiocontrast media (RCM) are common and in severe cases may present a challenge for treating physician in cases when premedication fails or the patient presents with severe comorbidities. We describe two cases in need of radiocontrast media after a severe reaction on previous exposure to iohexol. One presented anaphylactic reaction to RCM despite premedication and another presented with angina. Both cases were treated with a desensitization protocol to iodixanol. In conclusion, desensitization to radiocontrast media may be considered in patients with previously unsuccessful premedication and/or severe acute comorbidities...
July 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28750665/renal-damage-induced-by-pemetrexed-causing-drug-discontinuation-a-case-report-and-review-of-the-literature
#2
Yassir Sbitti, Hafsa Chahdi, Khaoula Slimani, Adil Debbagh, Anouar Mokhlis, Abderrahmane Albouzidi, Fahd Bennani, Hassan Errihani, Mohamed Ichou
BACKGROUND: Pemetrexed maintenance therapy holds tremendous potential in improving the survival of patients with advanced pulmonary adenocarcinoma. Major side effects include myelosuppression and cutaneous reactions. However, little data are available on pemetrexed nephrotoxicity. Our case describes clinically relevant renal events leading to treatment discontinuation in routine practice. CASE PRESENTATION: We report a case of a 69-year-old Moroccan man treated for metastatic non-small cell lung cancer...
July 28, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28748118/serum-uric-acid-and-acute-kidney-injury-a-mini-review
#3
REVIEW
Kai Hahn, Mehmet Kanbay, Miguel A Lanaspa, Richard J Johnson, A Ahsan Ejaz
Acute kidney injury causes great morbidity and mortality in both the community and hospital settings. Understanding the etiological factors and the pathophysiological principles resulting in acute kidney injury is essential in prompting appropriate therapies. Recently hyperuricemia has been recognized as a potentially modifiable risk factor for acute kidney injury, including that associated with cardiovascular surgery, radiocontrast administration, rhabdomyolysis, and associated with heat stress. This review discussed the evidence that repeated episodes of acute kidney injury from heat stress and dehydration may also underlie the pathogenesis of the chronic kidney disease epidemic that is occurring in Central America (Mesoamerican nephropathy)...
September 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#4
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28575877/drug-induced-nephrotoxicity-and-medicinal-plants
#5
Abolfazl Khajavi Rad, Reza Mohebbati, Sara Hosseinian
Drug-induced nephrotoxicity is one of the most common causes of acute kidney injury. There are various agents that exert nephrotoxic effects through different pathogenic mechanisms. Aminoglycoside antibiotics, chemotherapeutic agents, radiocontrast media, and nonsteroidal anti-inflammatory drugs are among common nephrotoxic agents. In recent years, natural compounds are being increasingly used in the treatment of kidney diseases. Given many reports available on the curative effects of a variety of medicinal plants against drug-associated nephrotoxicity, we aimed to review the protective effects of medicinal plants on certain nephrotoxic drugs...
May 2017: Iranian Journal of Kidney Diseases
https://www.readbyqxmd.com/read/28552379/are-ace-inhibitors-and-beta-blockers-dangerous-in-patients-at-risk-for-anaphylaxis
#6
Christopher A Coop, Rebecca S Schapira, Theodore M Freeman
The objective of this article is to review the available studies regarding angiotensin converting enzyme (ACE) inhibitors and beta-blockers and their effect on patients at risk for anaphylaxis. A literature search was conducted in PUBMED to identify peer-reviewed articles using the following keywords: anaphylaxis, ACE inhibitor, beta-blocker, food allergy, radiocontrast media, venom allergy, skin testing, and immunotherapy. Some studies show an increased risk of anaphylaxis in patients who are taking ACE inhibitors and beta-blockers, whereas others studies do not show an increased risk...
May 25, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28543761/experimental-characterization-of-a-direct-conversion-amorphous-selenium-detector-with-thicker-conversion-layer-for-dual-energy-contrast-enhanced-breast-imaging
#7
David A Scaduto, Olivier Tousignant, Wei Zhao
PURPOSE: Dual-energy contrast-enhanced imaging is being investigated as a tool to identify and localize angiogenesis in the breast, a possible indicator of malignant tumors. This imaging technique requires that x-ray images are acquired at energies above the k-shell binding energy of an appropriate radiocontrast agent. Iodinated contrast agents are commonly used for vascular imaging, and require x-ray energies greater than 33 keV. Conventional direct conversion amorphous selenium (a-Se) flat-panel imagers for digital mammography show suboptimal absorption efficiencies at these higher energies...
August 2017: Medical Physics
https://www.readbyqxmd.com/read/28505618/use-of-epinephrine-in-patients-with-drug-induced-anaphylaxis-an-analysis-of-the-beijing-pharmacovigilance-database
#8
Tiansheng Wang, Xiang Ma, Yan Xing, Shusen Sun, Hua Zhang, Til Stürmer, Bin Wang, Xiaotong Li, Huilin Tang, Ligong Jiao, Suodi Zhai
BACKGROUND: Few studies assessing the use of epinephrine in drug-induced anaphylaxis (DIA) in the hospital setting are available. We utilized the Beijing Pharmacovigilance Database (BPD) to evaluate the appropriateness of epinephrine for DIA management. METHODS: DIA cases collected in the BPD from January 2004 to December 2014 were adjudicated and analyzed for demographics, causative drugs, clinical signs, outcomes, initial treatment, route, dosing, and cardiovascular adverse events (CAE) of epinephrine...
2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28497630/acute-generalized-exanthematous-pustulosis-caused-by-an-iodinated-contrast-radiocontrast-medium-for-computed-tomography-arthrography-of-the-knee
#9
Charles Velter, Catherine Schissler, Chloé Moulinas, Martine Tebacher-Alt, Jean-Marie Siedel, Bernard Cribier, Dan Lipsker
No abstract text is available yet for this article.
June 2017: Contact Dermatitis
https://www.readbyqxmd.com/read/28490883/retrospective-analysis-of-non-laboratory-based-adverse-drug-reactions-induced-by-intravenous-radiocontrast-agents-in-a-joint-commission-international-accredited-academic-medical-center-hospital-in-china
#10
Qin-Lan Chen, Xiao-Ying Zhao, Xiao-Mi Wang, Na Lv, Ling-Ling Zhu, Hui-Min Xu, Quan Zhou
The authors retrospectively analyzed the pattern and characteristics of non-laboratory-based adverse drug reactions (ADRs) induced by intravenous radiocontrast agents in a large-scale hospital in China during 2014-2015. There were 314 ADR cases among 118,208 patients receiving enhanced CT or MRI examinations. The frequency of moderate/severe ADRs defined by Chinese Society of Radiology (ie, severe vomiting, systematic urticaria, facial swelling, dyspnea, vasovagal reaction, laryngeal edema, seizure, trembling, convulsions, unconsciousness, shock, death, and other unexpected adverse reactions) was rare (0...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28489466/intrathecal-injection-of-gadobutrol-a-tale-of-caution
#11
Corey Reeves, Enrique Galang, Raj Padalia, Nam Tran, Devang Padalia
In the field of interventional pain medicine a radiocontrast agent is commonly used in conjunction with fluoroscopy. Limited work has been published regarding the use of gadolium based contrast agents (GBCA) in the intrathecal space. We report a case of an intrathecal gadobutrol injection resulting in neurotoxic manifestations.A 60-year-old female with a history significant for lumbar post-laminectomy syndrome and intrathecal drug delivery implantation was admitted for lumbar fusion and kyphoplasty. Postoperatively, the patient had escalating pain medication requirements...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28488055/-choosing-wisely-recommendations-in-nephrology
#12
REVIEW
J Galle, J Floege
The German Society of Internal Medicine ("Deutsche Gesellschaft für Innere Medizin", DGIM) founded the Choosing wisely initiative in order to address diagnostic and therapeutic procedures that are frequently inappropriately applied, whether this be in terms of over-, under-, or misuse of health services. The German Society of Nephrology ("Deutsche Gesellschaft für Nephrologie," DGfN) strongly supports the initiative and has contributed five positive and five negative recommendations. These ten recommendations are discussed in the current publication...
May 9, 2017: Der Internist
https://www.readbyqxmd.com/read/28483312/current-knowledge-and-management-of-hypersensitivity-to-perioperative-drugs-and-radiocontrast-media
#13
Karen S Hsu Blatman, David L Hepner
Perioperative anaphylaxis is an iatrogenic clinical condition, most often after anesthetic induction. Several mechanisms are implicated, including IgE- and non-IgE-mediated mechanisms. Perioperative anaphylaxis tends to be severe and has a higher mortality rate than anaphylaxis in other settings. This is partly due to factors that impair early recognition of anaphylaxis. Neuromuscular blocking agents, latex containing products, and antibiotics are the most common etiology. Chlorhexidine and dyes are increasingly culprits...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28382626/use-of-radiocontrast-agents-in-ckd-and-esrd
#14
Jehan Z Bahrainwala, Amanda K Leonberg-Yoo, Michael R Rudnick
Contrast exposure in a population with chronic kidney disease (CKD) requires additional consideration given the risk of contrast-induced nephropathy (CIN) after exposure to iodinated contrast as well as systemic injury with exposure to gadolinium-based contrast agents (GBCA). Strategies to avoid CIN, and manage patients after exposure, including extracorporeal removal of contrast media, may differ among an advanced CKD population as compared to a general population. There is strong evidence to support the use of isotonic volume expansion and the lowest dose of low-osmolar or iso-osmolar contrast media possible to decrease CIN...
April 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28352014/risk-factors-for-contrast-induced-nephropathy-after-coronary-angiography
#15
Sandeep Kumar, Ranjith K Nair, Naveen Aggarwal, A K Abbot, J Muthukrishnan, K V S Hari Kumar
Contrast-induced nephropathy (CIN) is of concern after the use of radiocontrast media for coronary angiography (CAG) and percutaneous coronary intervention (PCI). We studied the incidence of CIN and its risk factors in patients undergoing CAG. In this prospective study, we included all patients with normal renal parameters undergoing CAG with nonionic radiocontrast media. We excluded patients with known chronic kidney disease, baseline creatinine more than 1.5 mg/dL, significant hypotension, anemia, and patients with acute myocardial infarction undergoing emergency PCI...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28281738/efficacy-of-nicorandil-treatment-for-prevention-of-contrast-induced-nephropathy-in-high-risk-patients-undergoing-cardiac-catheterization-a-prospective-randomized-controlled-trial
#16
Leili Iranirad, Seyed Fakhreddin Hejazi, Mohammad Saleh Sadeghi, Shahram Arsang Jang
BACKGROUND: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures and is the third leading cause of the acute kidney injury (AKI) among hospitalized patients. This clinical trial was performed to assess the preventive effect of oral nicorandil on CIN in high-risk patients undergoing cardiac catheterization. METHODS: In this prospective, randomized, controlled trial, 128 patients with at least two risk factors for CIN undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to either the nicorandil group or the control group...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28258478/in-vitro-diagnosis-of-immediate-drug-hypersensitivity-anno-2017-potentials-and-limitations
#17
REVIEW
I I Decuyper, E A Mangodt, A L Van Gasse, K Claesen, A Uyttebroek, M Faber, V Sabato, C H Bridts, C Mertens, M M Hagendorens, L S De Clerck, Didier G Ebo
BACKGROUND: For most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT)...
June 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28248433/application-of-bold-mri-and-dti-for-the-evaluation-of-renal-effect-related-to-viscosity-of-iodinated-contrast-agent-in-a-rat-model
#18
Yi Wang, Ke Ren, Yi Liu, Wen-Ge Sun, Jia-Huan Wang, Xin Zhang, Cheng-Hua Wu
PURPOSE: To evaluate the effects of viscosity of contrast agent (CA) on intrarenal oxygenation and diffusion as measured by blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) in a rat model. MATERIALS AND METHODS: Radiocontrast iodixanol formulated in three viscosities were designated 270, 320, and 350 (mg iodine/mL). Sixty-three male Wistar rats were divided into four groups. Saline and iodixanol (4 g iodine/kg) were administered...
March 1, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28128875/an-ultrasound-guided-tendon-sparing-lateral-approach-to-injection-of-the-navicular-bursa
#19
K Nottrott, C De Guio, A Khairoun, M Schramme
BACKGROUND: Navicular disease in the horse often requires injection of the navicular bursa. We have developed an ultrasound-guided, lateral needle approach to navicular bursocentesis, which avoids penetration of the deep digital flexor tendon (DDFT) and the need for radiographic control. OBJECTIVES: To describe and evaluate the feasibility and efficacy of an ultrasound-guided, lateral bursocentesis technique. STUDY DESIGN: Cadaveric and in vivo experiments...
January 27, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28100100/a-new-update-for-radiocontrast-induced-nephropathy-aggravated-with-glycerol-in-rats-the-protective-potential-of-epigallocatechin-3-gallate
#20
Saziye Sezin Palabiyik, Busra Dincer, Elif Cadirci, Irfan Cinar, Cemal Gundogdu, Beyzagul Polat, Muhammed Yayla, Zekai Halici
Contrast media (CM) is known to have nephrotoxic adverse effects. Epigallocatechin-3-gallate (EGCG) is the most abundant and active catechin in green tea, and has strong antioxidant and anti-inflammatory properties. This study investigated whether EGCG can reduce contrast-induced nephrotoxicity (CIN), alone or with glycerol (GLY)-induced renal damage, and to understand its mechanisms of protection against toxicity, using models of GLY and CIN in rats. The rats were separated into eight groups (n = 6 in each), as follows: Healthy, GLY, CM, GLY + CM, CM + EGCG 50 mg/kg (po), GLY + CM + EGCG 50 mg/kg (po), CM + EGCG 100 mg/kg (po), and GLY + CM + EGCG 100 mg/kg (po)...
November 2017: Renal Failure
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