radiocontrast

PURPOSE OF REVIEW: Anaphylaxis is a common phenomenon that has been studied for many decades. Despite this, there is still disagreement among organizations regarding the precise definition for anaphylaxis. This article discusses the difference between the proposed definitions of anaphylaxis. Furthermore, the most up-to-date literature on specific subtypes of anaphylaxis is reviewed, and implications for clinical practice are discussed. RECENT FINDINGS: Recent literature on various subtypes of anaphylaxis has been conducted...

BACKGROUND: Sepsis remains the leading cause of mortality in critically ill patients, and mortality is increased when acute kidney injury (AKI) occurs. The Kidney Disease: Improving Global Outcomes (KDIGO) guideline recommends the implementation of supportive measures in patients at high risk for AKI. However, it remains unclear to what extent these nephroprotective measures are implemented in daily clinical practice in critically ill patients, especially those with high-risk exposures such as sepsis...

PURPOSE: To measure and investigate the relationship of three-dimensional gingival morphology on the labial side of the maxillary anterior teeth by using cone-beam CT(CBCT) in conjunction with a novel radiocontrast agent. METHODS: Thirty periodontal healthy subjects were enrolled. The composition of light-cured gingival barrier resin and iohexol injection was applied to the measurement area, then a positioning wire was set up, and CBCT was used to assess supracrestal gingiva tissue (SGT), gingiva thickness (GT) and width of keratinized gingiva (KGW)...

BACKGROUND: Coronary artery disease (CAD) is the leading cause of mortality and morbidity globally. Percutaneous coronary intervention (PCI) is a minimally-invasive lifesaving intervention for these patients; however, acute kidney injury (AKI) is a serious complication of the procedure commonly occurring due to radiocontrast-induced nephropathy. METHODS: A retrospective cross-sectional analytical study was carried out at the Aga Khan Hospital, Dar es Salaam (AKH,D), Tanzania...

BACKGROUND: Increasing evidence from randomised controlled trials supports the implementation of a six-measure care bundle proposed by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines in patients at high risk for acute kidney injury (AKI) to reduce its incidence after cardiac surgery. OBJECTIVE: To assess compliance with the KDIGO bundle in clinical practice. DESIGN: Prospective observational multinational study. SETTING: Six international tertiary care centres, from February 2021 to November 2021...

UNLABELLED: Sweet's syndrome or acute febrile neutrophilic dermatosis is characterized by an acute inflammatory skin eruption of oedematous and erythematous papules, plaques or nodules, accompanied by fever, and leucocytosis with possible extracutaneous involvement. Aetiologies include infections, inflammatory bowel disease, pregnancy or malignancy, or the syndrome may be drug-induced by many classes of medications or very rarely, radiocontrast exposure. Herein, the authors report a case of radiocontrast-induced bullous Sweet's syndrome and contrast-induced acute kidney injury in a woman in her 60s with a complex medical history...

OBJECTIVE: There is an urgent need for safe and targeted interventions to mitigate post-ERCP pancreatitis (PEP). Calcineurin inhibitors (CnIs) offer therapeutic promise as calcineurin signaling within acinar cells is a key initiating event in PEP. In previous proof-of-concept studies using experimental models, we showed that concurrent intra-pancreatic ductal administration of the CnIs, tacrolimus (Tac) or cyclosporine A (CsA) with the ERCP radiocontrast agent (RC) prevented PEP. To translate this finding clinically, we investigated potential toxic effects of intraductal delivery of a single-dose RC-CnI formulation on endocrine pancreas function and systemic toxicities in a preclinical PEP model...

Background. Drug hypersensitivity reactions are presumably immune-mediated reactions that cause reproducible signs and/or symptoms. Overdiagnosis of drug allergy, frequently self-reported, is common and carries significant limitations. We intended to analyze the frequency and impact of drug allergy in hospitalized patients. Methods. A retrospective study was conducted in an Internal Medicine ward at a tertiary hospital in Portugal. All patients with a drug allergy report admitted within a 3-year period were included...

BACKGROUND: Patients with diabetic kidney disease (DKD) are at increased risk to develop post-contrast acute kidney injury (AKI). Diabetic patients under dipeptidyl peptidase 4 inhibitors (DPP4Is) experience a lower propensity to develop AKI. We speculated that linagliptin as a single agent or in combination with allopurinol may reduce the incidence of post-contrast AKI in stage 3-5 chronic kidney disease (CKD) patients with underlying DKD. METHODS: Out of 951 DKD patients eligible for this study, 800 accepted to sign informed consent...

UNLABELLED: Acute contrast-induced thrombocytopenia is an unusual complication, and it is a rare event with the use of modern low-osmolarity iodinated contrast medium. There are only a few reports that exist in English literature. CASE PRESENTATION: The authors report the case of a 79-year-old male patient with severe, life-threatening thrombocytopenia after administration of intravenous nonionic low-osmolarity contrast medium. His platelet count dropped from 179×109 /l to 2×109 /l after 1 h of radiocontrast infusion...

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is commonly used to treat patients with stenosed aortic valves. CT is one of the crucial steps in planning TAVI to obtain measurements of the aortic annulus to choose an appropriately sized prosthesis. Incorrect measurements can lead to patient-prosthesis mismatch and other complications. However, some patients cannot undergo ECG-gated CT with radiocontrast because of the presence of radiopaque objects in the thorax, arrhythmia, renal failure, etc...

BACKGROUND: Acute kidney injury (AKI) following severe trauma is common. However, the requirement of renal replacement therapy (RRT) in these patients is rare and is associated with high morbidity and mortality. The primary objective of this study was to identify odds of risk factors, in particular, hypotension at presentation, for the requirement of RRT in patients with AKI following trauma. METHODS: We performed a case-control study involving patients who were admitted to the intensive care unit (ICU) at a level I trauma center for at least 24 hours...

Endovascular embolization is a minimally invasive procedure during which blood flow to targeted tissues is selectively occluded. The list of clinical indications for embolization continues to expand. Liquid embolic agents are injectable compositions that transition into a solid or semi-solid form when introduced into blood vessels. The mechanism that triggers the liquid-to-solid transition is a key distinguishing feature of liquid embolic agents. GPX is a waterborne liquid embolic agent comprising oppositely charged polyelectrolytes: polyguanidinum and inorganic polyphoshate...

BACKGROUND: Iodixanol-induced anaphylactic reaction is a well-known adverse event of contrast agents, which are generally well-tolerated and reversible. Serious and fatal reactions such as anaphylactic shock after computed tomography (CT) enhancement have been described. However, there is no data on these events in the literature. OBJECTIVE: This report describes a case of a serious anaphylactic reaction, possibly related to iodixanol and provides an overview of case reports...

BACKGROUND Positron emission tomography/computed tomography (PET/CT) has become one of the most prominent modalities worldwide for the diagnosis and surveillance of malignancies. Current clinical imaging guidelines report adverse reactions following PET/CT, especially due to contrast-induced toxicities, such as contrast-induced nephropathy and other rare reactions attributed to a hypersensitivity immune response, such as bronchospasm. Other rare lung toxicities were reported in a few case reports. Herein, we report repeated episodes of alveolar hemorrhage, a novel adverse response to PET/CT, occurring on 2 separate occasions 5 months apart...

Adverse reactions to radiocontrast media (RCM) are rare and occur predominantly in association with intravenous administration but may also occur with intra-arterial and nonvascular injections (e.g., retrograde pyelography, intra-articular injections) of RCM. This article reports the case of a 52-year-old lady who was known to have amyloidosis secondary to rheumatoid arthritis and was on regular renal replacement therapy. She was under follow-up for regular angioplasties to manage the central vein stenosis that was affecting her right brachiocephalic arteriovenous fistula (AVF) and was referred to our Immunology service when she developed an allergic reaction after her AVF angioplasty (central venoplasty)...

Contrast-induced encephalopathy (CIE) is a rare complication that occurs after exposure to contrast media, and it usually manifests with transient neurological deficits that include cortical blindness, altered mental status, and paralysis. It is self-limited, and symptoms usually resolve within 48-72 hours. It requires a high index of suspicion and must be taken into consideration in every patient developing a neurological manifestation after the administration of radiocontrast media. We report a case of post-coronary angiography contrast-induced encephalopathy with low-grade fever and negative imaging...

Over the last decade there have been key advances in understanding mechanisms, risk, and consequences of both true immunological drug hypersensitivity and unverified drug allergy labels that have changed clinical practice. This has been facilitated by the widespread adoption of electronic health records (EHRs). The vast majority of EHR drug allergy labels are unverified and cause significant morbidity from unnecessary avoidance of optimal drug therapy. There has also been significant movement in our understanding of mechanisms of drug hypersensitivity that, in addition to advancing our understanding of the pathogenesis of immediate and delayed reactions, have guided preventive efforts, diagnostic procedures, and clinical management...

The role of contrast-induced nephropathy (CIN) remains controversial. Many experts contend that CIN does not exist or is extremely rare. The diagnosis was previously made too frequently and inappropriately in the presence of coexisting and confounding comorbidities and risk factors making it difficult to singularly isolate the etiologic role of intravenous contrast media in acute kidney injury (AKI). It is probable that many patients were denied important diagnostic information from radiocontrast studies for fear of CIN...

Peritoneal dialysis (PD) patients have higher hospitalisation rates than the general population. The hospitalisations are not always related to dialysis issues, and physicians with little or no experience with PD may be responsible for the care of these hospitalised patients. Furthermore, the hospital may not be familiar with or equipped to manage these patients. This review highlights barriers, knowledge gaps and management strategies to guide the care of hospitalised PD patients.