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Sample records for intravenous contrast media

  1. Safety of approved MR contrast media for intravenous injection.

    PubMed

    Runge, V M

    2000-08-01

    In the last 10 years, the use of intravenous contrast media in magnetic resonance (MR) has become well-established clinical practice. Contrast media provide critical additional diagnostic information in many instances. The gadolinium chelates constitute the largest group of MR contrast media and are considered to be very safe. These agents are thought to be safer than nonionic iodinated contrast agents. Unlike x-ray agents, the gadolinium chelates are not nephrotoxic. Minor adverse reactions, including nausea (1%-2% for all agents) and hives (<1% for all agents), occur in a very low percent of cases. Health care personnel should be aware of the (extremely uncommon) potential for severe anaphylactoid reactions in association with the use of MR contrast media and be prepared should complications arise. The four gadolinium chelates currently available worldwide, gadopentetate dimeglumine, gadoteridol, gadodiamide, and gadoterate meglumine, cannot be differentiated on the basis of adverse reactions. Far fewer patients have been examined to date with the two other agents that have widespread approval, mangafodipir trisodium and ferumoxides. These latter two agents are considered to be very safe but have a higher percentage of associated adverse reactions (7%-17% with mangafodipir trisodium and 15% with ferumoxides). This review discusses the safety issues involved with administration of intravenous contrast media in MR imaging, focusing on the six agents (four gadolinium chelates, one manganese chelate, and the last a large iron particle) with widespread use world-wide. PMID:10931582

  2. Adverse reactions to intravenous iodinated contrast media: a primer for radiologists.

    PubMed

    Namasivayam, Saravanan; Kalra, Mannudeep K; Torres, William E; Small, William C

    2006-07-01

    Adverse reactions to intravenous iodinated contrast media may be classified as general and organ-specific, such as contrast-induced nephrotoxicity. General adverse reactions may be subclassified into acute and delayed types. Acute general adverse reactions can range from transient minor reactions to life-threatening severe reactions. Non-ionic contrast media have lower risk of mild and moderate adverse reactions. However, the risk of fatal reactions is similar for ionic and non-ionic contrast media. Adequate preprocedure evaluation should be performed to identify predisposing risk factors. Prompt recognition and treatment of acute adverse reactions is crucial. Risk of contrast induced nephrotoxicity can be reduced by use of non-ionic contrast media, less volume of contrast, and adequate hydration. The radiologist can play a pivotal role by being aware of predisposing factors, clinical presentation, and management of adverse reactions to contrast media. PMID:16688432

  3. Contrast Induced Nephropathy with Intravenous Iodinated Contrast Media in Routine Diagnostic Imaging: An Initial Experience in a Tertiary Care Hospital

    PubMed Central

    Bhatt, Shuchi; Rajpal, Nipun; Rathi, Vineeta; Avasthi, Rajneesh

    2016-01-01

    Background. Contrast induced nephropathy (CIN) is common cause of hospital acquired renal failure, defined as iatrogenic deterioration of renal function following intravascular contrast administration in the absence of another nephrotoxic event. Objectives. Objectives were to calculate incidence of CIN with routine IV contrast usage and to identify its risk factors. Materials and Methods. Study was conducted on 250 patients (having eGFR ≥ 45 mL/min/1.73 m2) receiving intravenous contrast. Various clinical risk factors and details of contrast media were recorded. Patients showing 25% increase in postprocedural serum creatinine value or an absolute increase of 0.5 mg/dL (44.2 mmol/L) were diagnosed as having CIN. Results and Conclusions. Postprocedural serum creatinine showed significant increase from baseline levels. 25 patients (10%) developed CIN. CIN was transient in 21 (84%) patients developing CIN. One patient (4%) developed renal failure and another died due to unknown cause. Dehydration, preexisting renal disease, cardiac failure, previous contrast administration, and volume of contrast had significant correlation with development of CIN (p < 0.05); whereas demographic variables, baseline serum creatinine/eGFR, previous renal surgery, diabetes mellitus, hypertension, nephrotoxic drug intake, abnormal routine hematology, and contrast characteristics had no correlation with CIN. CIN is a matter of concern even in routine imaging requiring intravenous contrast media, in our set-up. PMID:27069686

  4. Intravenous Imaging Contrast Media Complications: The Basics That Every Clinician Needs to Know.

    PubMed

    Rose, Trevor A; Choi, Jung W

    2015-09-01

    Intravenous contrast is commonly used in noninvasive imaging procedures such as magnetic resonance imaging and computed tomography and can evaluate blood vessels and better characterize soft-tissue lesions. Although the incidence of adverse events after administration of contrast is low, it is important that clinicians and radiologists minimize risks and respond quickly and effectively when reactions occur. We will discuss a range of adverse events to iodinated and gadolinium-based contrast agents, including allergic-like reactions, nephrotoxicity, extravasation, and nephrogenic systemic fibrosis. We will review risk stratification for patients, as well as premedication and treatment of adverse events. PMID:25820169

  5. Intravenous contrast media application using cone-beam computed tomography in a rabbit model

    PubMed Central

    Kim, Min-Sung; Kim, Bok-Yeol; Choi, Hwa-Young; Choi, Yoon-Joo; Oh, Song-Hee; Kang, Ju-Hee; Lee, Sae-Rom; Kang, Ju-Han; Kim, Gyu-Tae; Choi, Yong-Suk

    2015-01-01

    Purpose This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. Materials and Methods CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. Results The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Conclusion Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography. PMID:25793181

  6. Renal-related adverse effects of intravenous contrast media in computed tomography

    PubMed Central

    Leow, Kheng Song; Wu, Yi Wei; Tan, Cher Heng

    2015-01-01

    Renal-related adverse effects of intravascular contrast media (CM) include contrast-induced nephropathy in computed tomography and angiography. While large retrospective studies have been published, the exact pathogenesis of this condition is still unknown. We review the main international guidelines, including the American College of Radiology white paper and the guidelines of European Society of Urogenital Radiology, Royal College of Radiologists and Canadian Association of Radiologists, as well as their references, regarding this subject. We present a simplified, concise approach to renal-related adverse effects of CM, taking into consideration the basis for each recommendation in these published guidelines. This will allow the reader to better understand the rationale behind appropriate patient preparation for cross-sectional imaging. PMID:25917468

  7. Contrast agent choice for intravenous coronary angiography

    SciTech Connect

    Zeman, H.D.; Siddons, D.P.

    1989-01-01

    The screening of the general population for coronary artery disease would be practical if a method existed for visualizing the extent of occlusion after an intravenous injection of contrast agent. Measurements performed with monochromatic synchrotron radiation x-rays and an iodine containing contrast agent at the Stanford Synchrotron Radiation Laboratory have shown that such an intravenous angiography procedure would be possible with an adequately intense monochromatic x-ray source. Because of the size and cost of synchrotron radiation facilities it would be desirable to make the most efficient use of the intensity available, while reducing as much as possible the radiation dose experienced by the patient. By choosing contrast agents containing elements with a higher atomic number than iodine, it is possible to both improve the image quality and reduce the patient radiation dose, while using the same synchrotron source. By using Si monochromator crystals with a small mosaic spread, it is possible to increase the x-ray flux available for imaging by over an order of magnitude, without any changes in the storage ring or wiggler magnet. The most critical imaging task for intravenous coronary angiography utilizing synchrotron radiation x-rays is visualizing a coronary artery through the left ventricle or aorta which also contains a contrast agent. Calculations have been made of the signal to noise ratio expected for this imaging task for various contrast agents with atomic numbers between that of iodine and bismuth.

  8. Contrast agent choice for intravenous coronary angiography

    NASA Astrophysics Data System (ADS)

    Zeman, H. D.; Siddons, D. P.

    1990-05-01

    The screening of the general population for coronary artery disease would be practical if a method existed for visualizing the extent of occlusion after an intravenous injection of contrast agent. Measurements performed with monochromatic synchrotron radiation X-rays and an iodine-containing contrast agent at the Stanford Synchrotron Radiation Laboratory have shown that such an intravenous angiography procedure would be possible with an adequately intense monochromatic X-ray source. Because of the size and cost of synchrotron radiation facilities it would be desirable to make the most efficient use of the intensity available, while reducing as much as possible the radiation dose experienced by the patient. By choosing contrast agents containing elements with a higher atomic number than iodine, it is possible to both improve the image quality and reduce the patient radiation dose, while using the same synchrotron radiation source. By using Si monochromator crystals with a small mosaic spread, it is possible to increase the X-ray flux available for imaging by over an order of magnitude, without any changes in the storage ring or wiggler magnet. The most critical imaging task for intravenous coronary angiography utilizing synchrotron radiation X-rays is visualizing a coronary artery through the left ventricle or aorta which also contain contrast agent. Calculations have been made of the signal to noise ratio expected for this imaging task for various contrast agents with atomic numbers between that of iodine and bismuth. The X-ray energy spectrum of the X-17 superconduction wiggler beam line at the National Synchrotron Light Source at Brookhaven National Laboratory has been used for these calculations. Both perfect Si crystals and Si crystals with a small mosaic spread are considered as monochromators. Contrast agents containing Gd or Yb seem to have about the optimal calculated signal to noise ratio. Gd-DTPA is already approved for use as a contrast agent for

  9. Safety of magnetic resonance contrast media.

    PubMed

    Runge, V M

    2001-08-01

    Intravenous contrast media, specifically the gadolinium chelates, are well accepted for use in the clinical practice of magnetic resonance imaging. The gadolinium chelates are considered to be very safe and lack (in intravenous use) the nephrotoxicity found with iodinated contrast media. Minor adverse reactions, including nausea and hives, occur in a low percentage of cases. The four agents currently available in the United States cannot be differentiated on the basis of these adverse reactions. Severe anaphylactoid reactions are also known to occur with all agents, although these are uncommon. This review discusses the safety issues involved with intravenous administration of the gadolinium chelates and off-label use. The latter is common in clinical practice and permits broader application of these agents. PMID:11687717

  10. [Allergy to radiographic contrast media].

    PubMed

    Vionnet, Julien; Petitpierre, Stéphanie; Fumeaux, Alexandre; Meuli, Reto; Spertini, Francois; Comte, Denis

    2013-04-17

    Allergy to radiographic contrast media Hypersensitivity reactions to radio-contrast media are common in the daily practice. These products are responsible for immediate (< or = 1 hour after administration) and non immediate (> 1 hour after administration) hypersensitivity reactions. A diagnostic work-up by an allergologist with skin tests and in some cases provocation tests is of value in reducing the risk of recurrent hypersensitivity reactions to iodinated contrast media. A careful selection of the patients is required because the incidence of breakthrough reactions is still concerning, even with proper premedication. Practical recommendations are presented in this article. For gadolinium-based contrast agents, data in the literature is not sufficient for suggesting guidelines. PMID:23667970

  11. Cardiopulmonary arrest induced by anaphylactoid reaction with contrast media.

    PubMed

    Nakamura, Iwao; Hori, Shingo; Funabiki, Tomohiro; Sekine, Kazuhiko; Kimura, Hiroyuki; Fujishima, Seitaro; Aoki, Katsunori; Kuribayashi, Sachio; Aikawa, Naoki

    2002-05-01

    Anaphylactoid reactions to iodinated contrast media can cause life-threatening events and even death. A 44-year-old woman presented with cardiopulmonary arrest (CPA) immediately following the administration of nonionic iodinated contrast media for an intravenous pyelography. Her cardiac rhythm during CPA was asystole. She was successfully resuscitated by the radiologists supported by paged emergency physicians using the prompt intravenous administration of 1 mg of epinephrine. Neither laryngeal edema nor bronchial spasm was observed during the course of treatment, and she was discharged on the 4th day without any complications. The patient did not have a history of allergy, but had experienced a myocardial infarction and aortitis. She had undergone 11 angiographies and had been taking a beta-adrenergic receptor antagonist. Planned emergency medical backup is advisable to ensure resuscitation in the event of an anaphylactoid reaction to the use of contrast media in-hospital settings. PMID:12009227

  12. Renal Safety of Iodinated Contrast Media Depending on Their Osmolarity – Current Outlooks

    PubMed Central

    Mruk, Bartosz

    2016-01-01

    Summary Iodinated contrast media (ICM) are commonly administered pharmaceutical agents. Most often they are used intravenously and intraarterially. Although iodinated contrast agents are relatively safe and widely used, adverse events occur and questions remain about their use, safety, and interactions. The most important adverse effects of contrast media include hypersensitivity reactions, thyroid dysfunction, and contrast-induced nephropathy. Radiologists must be aware of the risk factors for reactions to contrast media. Nonionic iodinated contrast agents can be divided into monomeric, low-osmolar, and dimeric, iso-osmolar classes. The osmotic characteristics of contrast media have been a significant focus in many investigations of contrast-induced nephropathy. PMID:27141236

  13. Anaphylactoid reactions with gastrointestinal contrast media.

    PubMed

    Skucas, J

    1997-04-01

    Significant anaphylactoid reactions to gastrointestinal contrast media are rare. Whether a patient who is atopic or has asthma is predisposed to these reactions is speculative. The rare patient who previously had a severe allergic reaction to such a product probably should not undergo a subsequent examination with a similar agent. The American College of Radiology classification of contrast media side effects can also be applied to the gastrointestinal contrast media. PMID:9124150

  14. Anaphylactoid reaction to intravenous contrast in patient with systemic mastocytosis.

    PubMed

    Weingarten, T N; Volcheck, G W; Sprung, J

    2009-07-01

    Systemic mastocytosis is a rare disorder characterised by tissue infiltration of morphologically abnormal mast cells and has been associated with severe anaphylactoid reactions during general anaesthesia. We report the case of a 43-year-old woman who developed a severe anaphylactoid reaction to iodinated contrast media. Persistently elevated serum tryptase levels led to further evaluation and the eventual diagnosis of systemic mastocytosis. This case highlights the importance of repeated measurements of serum tryptase levels following severe anaphylactoid reactions. The anaesthetist should also be aware of the propensity of these patients to develop severe anaphylactoid reactions during general anaesthesia and use treatment strategies to minimise this risk. PMID:19681427

  15. Nanosized Ultrasound Enhanced-Contrast Agent for in Vivo Tumor Imaging via Intravenous Injection.

    PubMed

    Kim, Manse; Lee, Jong Hyun; Kim, Se Eun; Kang, Seong Soo; Tae, Giyoong

    2016-04-01

    To enhance the detection limit of ultrasound (US) imaging, ultrasound enhanced-contrast agents (UECAs) that can go preferentially to the target tissue such as a tumor and amplify the US signal have been developed. However, nanosized UECAs among various UECAs developed are very limited to clearly demonstrate proper ability for selective tumor detection by US imaging upon their intravenous injection. In this study, we prepared CaCO3 nanoparticles that were formed inside a flexible and biocompatible pluronic-based nanocarrier. This nanosized UECA was stable in serum-containing media and generated CO2, more preferentially at low pH; thus, it could be detected by US imaging. After intravenous injection into tumor-bearing mice, this nanosized UECA showed a significant US contrast enhancement at the tumor site in 1 h, in contrast to no change in the liver, followed by a rapid clearance from the body in 24 h. Therefore, the present nanosized UECA could be applied as an effective diagnostic modality for in vivo tumor imaging by ultrasonography. PMID:27010717

  16. Renal stones on portal venous phase contrast-enhanced CT: does intravenous contrast interfere with detection?

    PubMed Central

    Dym, R. Joshua; Duncan, Dameon R.; Spektor, Michael; Cohen, Hillel W.; Scheinfeld, Meir H.

    2015-01-01

    Purpose To determine the sensitivity of portal venous phase contrast-enhanced CT for the detection of renal stones. Methods This retrospective study included 97 CT examinations of the abdomen without and with intravenous contrast, including 85 (87.6%) examinations with at least one renal stone on the “gold standard” noncontrast images, as scored by a single radiologist. Three other radiologists each independently reviewed only the contrast-enhanced images from all 97 examinations and recorded all renal stones. Reviewer sensitivity for stones was categorized by stone diameter. Reviewer sensitivity and specificity for stone disease were also calculated on a per-kidney basis. Results The 97 cases included a total of 238 stones ≥1 mm, with a mean (±SD) of 1.2 ± 1.9 stones per kidney and a stone diameter of 3.5 ± 3.0 mm. Pooling data for the three reviewers, sensitivity for all stones was 81%; sensitivity for stones ≥2, ≥3, ≥4, and ≥5 mm was 88%, 95%, 99%, and 98%, respectively. Sensitivity for stone disease on a per-kidney basis was 94% when considering all stones; when considering only stones ≥2, ≥3, and ≥4 mm, sensitivity was 96%, 99%, and 100%, respectively. Specificity for stone disease on a per-kidney basis was 98% overall, 99% when considering only stones ≥2 mm, and 100% when considering only stones ≥3 mm. Conclusion: Contrast-enhanced CT is highly sensitive for the detection of renal stones ≥3 mm in diameter and less sensitive for smaller stones. In cases where the clinical diagnosis is uncertain and performance of a CT examination is being contemplated, intravenous contrast utilization would allow assessment for stone disease while also optimizing evaluation for other conditions. PMID:24504541

  17. Contrast media use in the operating room.

    PubMed

    Bickham, Peggy; Golembiewski, Julie

    2010-04-01

    Iodinated contrast media is frequently used in the OR, but often is not well understood by health care providers who are administering it. Although used for diagnosis rather than treatment, contrast media is classified as a drug by the FDA, and has indications, contraindications, adverse effects, drug interactions, disease interactions, and laboratory interference issues related to its use. Iodinated contrast media is classified according to osmolarity and ionicity, and these characteristics contribute to potential for adverse effects and choice of agent. Financial and safety concerns are factors to be considered when selecting an appropriate agent. Adverse effects can range from mild and self-limited to severe and life threatening; potentially the most serious of these are anaphylactoid reactions and contrast-induced acute renal failure. Knowledge of risk factors and preventive strategies is vital, as are issues related to substitution of gadolinium-based contrast, an off-label use. It is important for the perianesthesia nurse to become familiar with these commonly used imaging medications. PMID:20359644

  18. Contrast Media Extravasation of Computed Tomography and Magnetic Resonance Imaging: Management Guidelines for the Radiologist.

    PubMed

    Nicola, Refky; Shaqdan, Khalid Wael; Aran, Shima; Prabhakar, Anand M; Singh, Ajay Kumar; Abujudeh, Hani H

    2016-01-01

    Intravenous contrast administration has been of great importance in diagnostic radiology, but it is not without risks either due to the local, systemic allergic reactions or due to subcutaneous extravasation of contrast media. Subcutaneous contrast medium extravasationis an infrequent, yet a well-recognized complication. However, most incidents are minor and can be managed conservatively, but there are a few cases that require immediate surgical intervention. This article discusses the risks factors, clinical manifestations, and conservative and surgical approaches of subcutaneous contrast media extravasation for both computed tomography and magnetic resonance imaging. PMID:26477550

  19. Hypersensitivity to contrast media and dyes.

    PubMed

    Brockow, Knut; Sánchez-Borges, Mario

    2014-08-01

    This article updates current knowledge on hypersensitivity reactions to diagnostic contrast media and dyes. After application of a single iodinated radiocontrast medium (RCM), gadolinium-based contrast medium, fluorescein, or a blue dye, a hypersensitivity reaction is not a common finding; however, because of the high and still increasing frequency of those procedures, patients who have experienced severe reactions are nevertheless frequently encountered in allergy departments. Evidence on allergologic testing and management is best for iodinated RCM, limited for blue dyes, and insufficient for fluorescein. Skin tests can be helpful in the diagnosis of patients with hypersensitivity reactions to these compounds. PMID:25017677

  20. Acute adverse reactions to magnetic resonance contrast media--gadolinium chelates.

    PubMed

    Li, A; Wong, C S; Wong, M K; Lee, C M; Au Yeung, M C

    2006-05-01

    The objective of this study was to evaluate the clinical safety of intravenous gadolinium-based contrast media used in patients who underwent MRI at a single institution. Acute adverse reactions to intravenous gadolinium-based contrast media used for MRI at the Princess Margaret Hospital, Hong Kong, SAR, from January 1999 to November 2004 were recorded in an incidence log book. The medical records of patients' demographics were retrospectively reviewed and the nature, frequency and severity of the adverse reactions were investigated and documented. The incidence of acute adverse reactions to intravenous gadolinium-based contrast media was 0.48% (45 patients with 46 adverse reactions). The severity of these adverse reactions were 96% mild, 2% moderate (one patient developed shortness of breath that required oxygen supplementation and intravenous steroidal management) and 2% severe (one patient developed an anaphylactoid reaction, but successfully recovered through timely resuscitation). No patients were recorded as having contrast extravasation and none died as a result of any adverse reaction. Among the 45 patients who developed adverse reactions, three patients (6.7%) had prior adverse reactions to iodinated contrast media, three (6.7%) had prior reactions to a different gadolinium-based contrast agent, one (2%) had asthma and nine (20%) had a history of drug/food allergy. Overall, 41% of the adverse reactions were not documented in the final MRI report or the clinical medical records. Gadolinium-based contrast media are safe and well tolerated by the vast majority of patients. In our study, the adverse reaction rate (0.48%) and the incidence of severe anaphylactoid reaction (0.01%) concur with those reported in the literature. Although most of the symptoms are mild and transient, these adverse reactions must be accurately documented and managed. PMID:16632615

  1. Safety of intravenous application of second-generation ultrasound contrast agent in children: prospective analysis.

    PubMed

    Piskunowicz, Maciej; Kosiak, Wojciech; Batko, Tomasz; Piankowski, Arkadiusz; Połczyńska, Katarzyna; Adamkiewicz-Drożyńska, Elżbieta

    2015-04-01

    The goal of the work described here was to assess the safety profile of intravenous second-generation ultrasound contrast agents (UCAs) containing sulfur hexafluoride in pediatric contrast-enhanced ultrasound. Between 2010 and 2013, a total of 167 examinations were performed in 137 children referred by the Oncology Department. Approval by an Independent Ethical Review Board on Scientific Research for the intravenous use of an UCA containing sulfur hexafluoride in children with oncologic diseases was obtained. Consent for UCA administration was acquired from the parents or legal guardians. Severe anaphylactic reaction was observed in 0.6% (n = 1). No other adverse events during or after intravenous administration of contrast were observed in the examined group (no changes in heart rate and rhythm, blood pressure, oxygen saturation or respiratory rate). There were no reports of subjective flushing, nausea, transient headaches or altered taste. Although second-generation ultrasound contrast agents are considered potentially safe, all investigators should be prepared for the development of adverse reactions and have provisions in place for all pediatric intravenous contrast-enhanced ultrasound examinations. More multicenter studies are essential to determination of an accurate UCA safety profile. PMID:25701526

  2. Contrast media in cardiovascular magnetic resonance.

    PubMed

    Lombardi, Massimo; Aquaro, Giovanni; Favilli, Brunella

    2005-01-01

    Among the available imaging techniques, Magnetic Resonance Imaging (MRI) is gaining an increasing role in the cardiologic setting because its specific properties such as the use of non ionising energies, the natural strong contrast between different tissues, the absence of spatial limitations, the good spatial and temporal resolution, the reduced operator dependency. To further improve the images quality and the histopathologic characterisation of tissues the use of contrast media (molecules containing gadolinium, manganese, iron, dysprosium ions) has been proposed both in the experimental and in the clinical settings. Among these ions gadolinium, which having 7 odd electrons in the external orbit has a strong magnetic momentum, is the most used. Gadolinium by itself is extremely toxic but once it is linked with a chelanting agent such as DTPA (Dietilen-Triamin-Penta-Acetic acid) the resulting complex shows a very low toxicity. The number of Gadolinium based compound is growing together with the use of contrast agents in MRI. These contrast agents are routinely used to perform Magnetic Resonance Angiography (MRA) and to a better definition of several cardiac diseases such as the presence of a intra- or paracardiac mass, the evaluation of myocardial perfusion and the evaluation of viability. Both the latter applications have relevant clinical implications. In fact the assessment of myocardial perfusion is one of the most used approach for detecting inducible myocardial ischemia due to major coronary artery disease or to assess the presence of a microvascular disease. The presence and the extent of viable myocardium is deeply modifying the clinical decision making as this viable tissue can recruit a normal function spontaneously or after revascularisation. Furthermore, the extent of viable myocardium has a strong correlation with negative prognosis. Clinical events are also time related to the detection of viable tissue. These evidences imply that the diagnostic

  3. Survey of contrast media used in coronary angiograph

    SciTech Connect

    Weikl, A.; Hubmann, M.

    1982-01-01

    In recent years, various contrast media have been developed for use in coronary angiography. These contrast media may be divided into ionic contrast media of high osmolality, those of low osmolality, and nonionic contrast materials. We conducted our own clinical studies with 40 patients. In random succession a standard contrast medium (ionic, of high osmolality) and a new-generation contrast medium (either nonionic or ionic with low osmolality) were injected into the right and left coronary arteries. After each injection we measured the systolic and diastolic blood pressure using a liquid-filled coronary catheter. In addition, the change in the length of the cardiac cycle was registered in terms of the R-R interval (in ms) and at the same time, leads I, II, and III of the ECG were recorded. We studied the influence of the various contrast media on the activity of ATPase in in vitro experiments, using Lasser and Lang's. When ionic contrast media of low osmolality and nonionic contrast media were utilized the heart rate showed no change. Disturbances of rhythm such as ventricular tachycardia or fibrillation were not observed. All of the contrast media used produced the same ECG changes. These changes can be ascribed to the inhibition of ATPase. The arterial blood pressure was lowered significantly only by ionic contrast media of high osmolality only.

  4. Intravascular iodinated contrast media and the anaesthetist.

    PubMed

    Dickinson, M C; Kam, P C A

    2008-06-01

    The use of intravascular iodinated contrast media (ICM) in radiological investigations is common. Increasingly, anaesthetists and intensivists are involved in the care of patients undergoing these investigations. Whilst the use of ICM is generally safe there are important adverse effects that need to be recognised and measures instigated to prevent or treat these effects. In patients at risk of developing adverse reactions it is important to consider alternative modes of imaging so that ICM can be avoided. Strategies for the prevention of ICM nephropathy should be considered in all patients receiving ICM. Currently intravascular volume expansion with 0.9% saline has the strongest evidence base. The use of isotonic sodium bicarbonate combined with N-acetylcysteine appears promising in providing further benefits. Although the use of N-acetylcysteine alone has not been shown to significantly reduce the incidence of ICM nephropathy it is cheap, has few adverse effects and it would seem reasonable to continue its use in conjunction with intravascular volume expansion. The routine use of corticosteroid and antihistamine premedication is not always effective in preventing general adverse reactions. PMID:18477275

  5. Intravenous contrast medium aggravates the impairment of pancreatic microcirculation in necrotizing pancreatitis in the rat.

    PubMed Central

    Schmidt, J; Hotz, H G; Foitzik, T; Ryschich, E; Buhr, H J; Warshaw, A L; Herfarth, C; Klar, E

    1995-01-01

    BACKGROUND: Previous reports demonstrated that radiographic contrast medium, as used in contrast-enhanced computed tomography, increases acinar necrosis and mortality in experimental pancreatitis. The authors studied the possibility that these changes may be related to an additional impairment of pancreatic microcirculation. METHODS: Fifty Wistar rats had acute pancreatitis induced by intraductal glycodeoxycholic acid (10 mmol/L for 10 min) and intravenous cerulein (5 micrograms/kg/hr for 6 hrs). After rehydration (16 mL/kg), pancreatic capillary perfusion was quantified by means of intravital microscopy at baseline before intravenous infusion of contrast medium (n = 25) or saline (n = 25), and 30 and 60 minutes thereafter. In addition to total capillary flow, capillaries were categorized as high- or low-flow (> or < 1.6 nL/min). RESULTS: Pancreatic capillary flow did not change in either high- or low-flow capillaries after saline infusion. However, contrast medium infusion induced a significant decrease of total capillary flow (p < 0.001). Analysis according to the relative flow rate revealed that this was primarily because of a significant additional reduction of perfusion in low-flow capillaries (p < 0.0001). Furthermore, complete capillary stasis was observed in 15.9 +/- 3.4% after contrast medium as compared with 3.2 +/- 1.2% after saline infusion (p < 0.006). CONCLUSION: Radiographic contrast medium aggravates the impairment of pancreatic microcirculation in experimental necrotizing pancreatitis. PMID:7717779

  6. Hemodynamic and Tubular Changes Induced by Contrast Media

    PubMed Central

    Caiazza, Antonella; Russo, Luigi; Russo, Domenico

    2014-01-01

    The incidence of acute kidney injury induced by contrast media (CI-AKI) is the third cause of AKI in hospitalized patients. Contrast media cause relevant alterations both in renal hemodynamics and in renal tubular cell function that lead to CI-AKI. The vasoconstriction of intrarenal vasculature is the main hemodynamic change induced by contrast media; the vasoconstriction is accompanied by a cascade of events leading to ischemia and reduction of glomerular filtration rate. Cytotoxicity of contrast media causes apoptosis of tubular cells with consequent formation of casts and worsening of ischemia. There is an interplay between the negative effects of contrast media on renal hemodynamics and on tubular cell function that leads to activation of renin-angiotensin system and increased production of reactive oxygen species (ROS) within the kidney. Production of ROS intensifies cellular hypoxia through endothelial dysfunction and alteration of mechanisms regulating tubular cells transport. The physiochemical characteristics of contrast media play a critical role in the incidence of CI-AKI. Guidelines suggest the use of either isoosmolar or low-osmolar contrast media rather than high-osmolar contrast media particularly in patients at increased risk of CI-AKI. Older age, presence of atherosclerosis, congestive heart failure, chronic renal disease, nephrotoxic drugs, and diuretics may multiply the risk of CI-AKI. PMID:24678510

  7. Hemodynamic and tubular changes induced by contrast media.

    PubMed

    Caiazza, Antonella; Russo, Luigi; Sabbatini, Massimo; Russo, Domenico

    2014-01-01

    The incidence of acute kidney injury induced by contrast media (CI-AKI) is the third cause of AKI in hospitalized patients. Contrast media cause relevant alterations both in renal hemodynamics and in renal tubular cell function that lead to CI-AKI. The vasoconstriction of intrarenal vasculature is the main hemodynamic change induced by contrast media; the vasoconstriction is accompanied by a cascade of events leading to ischemia and reduction of glomerular filtration rate. Cytotoxicity of contrast media causes apoptosis of tubular cells with consequent formation of casts and worsening of ischemia. There is an interplay between the negative effects of contrast media on renal hemodynamics and on tubular cell function that leads to activation of renin-angiotensin system and increased production of reactive oxygen species (ROS) within the kidney. Production of ROS intensifies cellular hypoxia through endothelial dysfunction and alteration of mechanisms regulating tubular cells transport. The physiochemical characteristics of contrast media play a critical role in the incidence of CI-AKI. Guidelines suggest the use of either isoosmolar or low-osmolar contrast media rather than high-osmolar contrast media particularly in patients at increased risk of CI-AKI. Older age, presence of atherosclerosis, congestive heart failure, chronic renal disease, nephrotoxic drugs, and diuretics may multiply the risk of CI-AKI. PMID:24678510

  8. Safe Use of Contrast Media: What the Radiologist Needs to Know.

    PubMed

    Beckett, Katrina R; Moriarity, Andrew K; Langer, Jessica M

    2015-10-01

    Iodinated and gadolinium-based contrast media are used on a daily basis in most radiology practices. These agents often are essential to providing accurate diagnoses, and are nearly always safe and effective when administered correctly. However, reactions to contrast media do occur and can be life threatening. Therefore, it is critical for faculty and staff to know how reactions to contrast agents manifest and how to treat them promptly. The decline in renal function seen occasionally after intravenous administration of iodinated contrast agents is poorly understood and likely multifactorial, and its association with the contrast medium may be overemphasized. However, it is important that radiologists be aware of current understanding and strategies to decrease the incidence of renal dysfunction. Nephrogenic systemic fibrosis, a skin disease, is an adverse reaction related to use of some gadolinium-based contrast agents in patients with chronic renal failure. The types of gadolinium most often associated with this condition and the indications for withholding gadolinium are important and are discussed in this article. The use of enteric contrast agents and contrast agents during pregnancy and nursing are reviewed briefly. Current knowledge for safe use of contrast media and key concepts that all radiologists should know are summarized in this review. PMID:26466182

  9. Management of acute adverse reactions to contrast media.

    PubMed

    Thomsen, Henrik S; Morcos, Sameh K

    2004-03-01

    When anaphylactoid and other severe adverse reactions to contrast media occur, prompt recognition and immediate treatment are essential. Simple guidelines for treatment have been requested by many radiologists, and therefore the Contrast Media Safety Committee has produced guidelines for treatment of acute adverse reactions to contrast media. The committee made an extensive review of the literature on treatment of adverse reactions to contrast media. Based on this, a report and guidelines were prepared. The resulting report was discussed at the 10th European Symposium on Urogenital Radiology in Uppsala. Sweden, September 2003. Guidelines for treatment of acute adverse reactions and a list of first-line drugs and equipment that should be available in the room where contrast medium is given are provided. PMID:14740165

  10. A discriminative-generative model for detecting intravenous contrast in CT images.

    PubMed

    Criminisi, Antonio; Juluru, Krishna; Pathak, Sayan

    2011-01-01

    This paper presents an algorithm for the automatic detection of intravenous contrast in CT scans. This is useful e.g. for quality control, given the unreliability of the existing DICOM contrast metadata. The algorithm is based on a hybrid discriminative-generative probabilistic model. A discriminative detector localizes enhancing regions of interest in the scan. Then a generative classifier optimally fuses evidence gathered from those regions into an efficient, probabilistic prediction. The main contribution is in the generative part. It assigns optimal weights to the detected organs based on their learned degree of enhancement under contrast material. The model is robust with respect to missing organs, patients geometry, pathology and settings. Validation is performed on a database of 400 highly variable patients CT scans. Results indicate detection accuracy greater than 91% at approximately 1 second per scan. PMID:22003683

  11. Safety profile and protocol prevention of adverse reactions to uroangiographic contrast media in diagnostic imaging.

    PubMed

    Rossi, C; Reginelli, A; D'Amora, M; Di Grezia, G; Mandato, Y; D'Andrea, A; Brunese, L; Grassi, R; Rotondi, A

    2014-01-01

    The purpose of the study is to examine the incidence of adverse reactions caused by non-ionic contrast media in selected patients after desensitization treatment and to evaluate the safety profile of organ iodine contrast media (i.c.m.) in a multistep prevention protocol. In a population of 2000 patients that had received a CT scan, 100 patients with moderate/high risk for adverse reactions against iodinated contrast agents followed a premedication protocol and all adverse reactions are reported and classified as mild, moderate or severe. 1.7 percent of the pre-treated patients reported a mild, immediate type reaction to iodine contrast; of these five patients with allergy 0.71 percent had received iomeprol, 0.35 percent received ioversol and 0.71 percent received iopromide. The incidence of adverse reactions was reported to be higher (4 out of 5 patients) among those that referred a history of hypersensitivity against iodinated i.c.m. Although intravenous contrast materials have greatly improved, especially in terms of their safety profile, they should not be administered if there isn't a clear or justified indication. In conclusion, even if we know that the majority of these reactions are idiosyncratic and unpredictable we propose, with the aim of improving our knowledge on this subject, a multicenter study, based on skin allergy tests (prick test, patch test, intradermal reaction) in selected patients that have had previous experiences of hypersensitivity against parenteral organ iodine contrast media. PMID:24750802

  12. First Bloch eigenvalue in high contrast media

    NASA Astrophysics Data System (ADS)

    Briane, Marc; Vanninathan, Muthusamy

    2014-01-01

    This paper deals with the asymptotic behavior of the first Bloch eigenvalue in a heterogeneous medium with a high contrast ɛY-periodic conductivity. When the conductivity is bounded in L1 and the constant of the Poincaré-Wirtinger weighted by the conductivity is very small with respect to ɛ-2, the first Bloch eigenvalue converges as ɛ → 0 to a limit which preserves the second-order expansion with respect to the Bloch parameter. In dimension two the expansion of the limit can be improved until the fourth-order under the same hypotheses. On the contrary, in dimension three a fibers reinforced medium combined with a L1-unbounded conductivity leads us to a discontinuity of the limit first Bloch eigenvalue as the Bloch parameter tends to zero but remains not orthogonal to the direction of the fibers. Therefore, the high contrast conductivity of the microstructure induces an anomalous effect, since for a given low-contrast conductivity the first Bloch eigenvalue is known to be analytic with respect to the Bloch parameter around zero.

  13. In vivo comparison of tantalum, tungsten, and bismuth enteric contrast agents to complement intravenous iodine for double-contrast dual-energy CT of the bowel.

    PubMed

    Rathnayake, Samira; Mongan, John; Torres, Andrew S; Colborn, Robert; Gao, Dong-Wei; Yeh, Benjamin M; Fu, Yanjun

    2016-07-01

    To assess the ability of dual-energy CT (DECT) to separate intravenous contrast of bowel wall from intraluminal contrast, we scanned 16 rabbits on a clinical DECT scanner: n = 3 using only iodinated intravenous contrast, and n = 13 double-contrast enhanced scans using iodinated intravenous contrast and experimental enteric non-iodinated contrast agents in the bowel lumen (five bismuth, four tungsten, and four tantalum based). Representative image pairs from conventional CT images and DECT iodine density maps of small bowel (116 pairs from 232 images) were viewed by four abdominal imaging attending radiologists to independently score each comparison pair on a visual analog scale (-100 to +100%) for (1) preference in small bowel wall visualization and (2) preference in completeness of intraluminal enteric contrast subtraction. Median small bowel wall visualization was scored 39 and 42 percentage points (95% CI 30-44% and 36-45%, both p < 0.001) higher for double-contrast DECT than for conventional CT with enteric tungsten and tantalum contrast, respectively. Median small bowel wall visualization for double-contrast DECT was scored 29 and 35 percentage points (95% CI 20-35% and 33-39%, both p < 0.001) higher with enteric tungsten and tantalum, respectively, than with bismuth contrast. Median completeness of intraluminal enteric contrast subtraction in double-contrast DECT iodine density maps was scored 28 and 29 percentage points (95% CI 15-31% and 28-33%, both p < 0.001) higher with enteric tungsten and tantalum, respectively, than with bismuth contrast. Results suggest that in vivo double-contrast DECT with iodinated intravenous and either tantalum- or tungsten-based enteric contrast provides better visualization of small bowel than conventional CT. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26892945

  14. Paraplegia after contrast media application: a transient or devastating rare complication? Case report.

    PubMed

    Mielke, Dorothee; Kallenberg, Kai; Hartmann, Marius; Rohde, Veit

    2016-05-01

    The authors report the case of a 76-year-old man with a spinal dural arteriovenous fistula. The patient suffered from sudden repeated reversible paraplegia after spinal digital subtraction angiography as well as CT angiography. Neurotoxicity of contrast media (CM) is the most probable cause for this repeated short-lasting paraplegia. Intolerance to toxicity of CM to the vulnerable spinal cord is rare, and probably depends on the individual patient. This phenomenon is transient and can occur after both intraarterial and intravenous CM application. PMID:26544597

  15. Changes in transmural distribution of myocardial perfusion assessed by quantitative intravenous myocardial contrast echocardiography in humans

    PubMed Central

    Fukuda, S; Muro, T; Hozumi, T; Watanabe, H; Shimada, K; Yoshiyama, M; Takeuchi, K; Yoshikawa, J

    2002-01-01

    Objective: To clarify whether changes in transmural distribution of myocardial perfusion under significant coronary artery stenosis can be assessed by quantitative intravenous myocardial contrast echocardiography (MCE) in humans. Methods: 31 patients underwent dipyridamole stress MCE and quantitative coronary angiography. Intravenous MCE was performed by continuous infusion of Levovist. Images were obtained from the apical four chamber view with alternating pulsing intervals both at rest and after dipyridamole infusion. Images were analysed offline by placing regions of interest over both endocardial and epicardial sides of the mid-septum. The background subtracted intensity versus pulsing interval plots were fitted to an exponential function, y = A (1 − e−βt), where A is plateau level and β is rate of rise. Results: Of the 31 patients, 16 had significant stenosis (> 70%) in the left anterior descending artery (group A) and 15 did not (group B). At rest, there were no differences in the A endocardial to epicardial ratio (A-EER) and β-EER between the two groups (mean (SD) 1.2 (0.6) v 1.2 (0.8) and 1.2 (0.7) v 1.1 (0.6), respectively, NS). During hyperaemia, β-EER in group A was significantly lower than that in group B (1.0 (0.5) v 1.4 (0.5), p < 0.05) and A-EER did not differ between the two groups (1.0 (0.5) v 1.2 (0.4), NS). Conclusions: Changes in transmural distribution of myocardial perfusion under significant coronary artery stenosis can be assessed by quantitative intravenous MCE in humans. PMID:12231594

  16. Intravenous contrast-enhanced CT of the postoperative lumbar spine: improved identification of recurrent disk herniation, scar, arachnoiditis, and diskitis

    SciTech Connect

    Teplick, J.G.; Haskin, M.E.

    1984-10-01

    Unsuccessful relief of symptoms after back surgery is usually attributable to hypertrophic extradural scar or recurrent herniated disk. Their clinical and myelographic differentiation is difficult, yet important because reoperation is not always beneficial for scar removal. This article examines the usefulness of intravenous contrast-enhanced computed tomography for this problem. Forty-five postsurgical patients were studied; eight had subsequent surgery. In the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with hypertrophic scars, intravenous contrast enhancement of the scar allowed its recognition in each case; in the four with recurrent disk herniation, nonenhancement of the extruded disk allowed its recognition in three. In the other 37 patients who were not reoperated, 33 were believed to have scar on the basis of contrast enhancement. The method seems promising for more accurate evaluation of failed back surgery, including the recognition of diskitis.

  17. Extracellular gadolinium-based contrast media: an overview.

    PubMed

    Bellin, Marie-France; Van Der Molen, Aart J

    2008-05-01

    Increasing use is made of extracellular MRI contrast agents that alter the image contrast following intravenous administration; they predominantly shorten the T1 relaxation time of tissues. The degree and location of these changes provide substantial diagnostic information. However gadolinium-based contrast agents (Gd-CA) are not inert drugs. They may cause acute non-renal adverse reactions (e.g. anaphylactoid reactions), acute renal adverse reactions (e.g. contrast induced nephropathy), delayed adverse reactions (nephrogenic systemic fibrosis) and problems at the site of injection (e.g. local necrosis). This review describes the current status of Gd-CA, their mechanism of action, chemical structure, pharmacokinetics, dosage, elimination, nephrotoxicity and adverse events. PMID:18358659

  18. [Adverse reactions to iodinated contrast media: how to prevent them?].

    PubMed

    Berner, Jeanne; Poletti, Pierre-Alexandre; Becker, Christoph D; Nendaz, Mathieu

    2009-10-14

    The incidence of acute iodine contrast media reactions, appearing within the first hour after the procedure, is low but clinically important due to their daily use. Previous adverse reactions to iodinated contrast media, asthma and a history of allergic reaction are the most recognized risk factors, but the identification of patients at risk remains difficult. The efficacy of preventive measures such as corticosteroid and/or antihistaminic administration rests on low-level evidence. Practical recommendations are presented in this article. Rather than relying on the sole administration of a premedication, the importance of other measures must be stressed: assessing the relevance of the indication to the radiologic exam, use of low osmolarity contrast media, and ensuring a proper monitoring of the patient during and after the procedure. PMID:19911686

  19. Contrast Media Injector Technology - Renal Safety During Coronarography

    PubMed Central

    Mujicic, Ermina; Kevric, Ekrem; Rasic, Senija; Selimovic, Amina; Granov, Nermir; Music, Dinka

    2015-01-01

    Aim: This study sought to assess whether the volume and osmolarity of contrast media (CM) influences the occurrence of contrast induced nephropathy (CIN) following coronarography procedure. CIN can be defined as an increase in the serum concentration of creatinine greater than a 25% from baseline during the period of 12 to 48 hours after the administration of radiocontrast media. Material and methods: We examined 100 patients without diabetes with serum creatinine concentration from 45 mmol/l to 141 mmol/l and 100 patients with diabetes with serum creatinine concentration from 46 mmol/l to 161 mmol/l who underwent coronary angiography. During procedure they received iso-osmolar contrast medium, Visipaque 320 (iodixanol-320), for group without diabetes from 40 to 340 ml and for group with diabetes from 49 to 310 ml. Results: CIN occurred in 27 (13,5%) of the 200 study patients. There was a trend toward higher prevalence of CIN (16% vs.11%, p = 0.086) in the diabetic group compared with the non-diabetic group. Patient with diabetes received less contrast media, they are younger but number patients with CIN are higher. Conclusion: Increasing contrast media dose is associated with the occurrence of CIN following coronarography. But, another risk factors like diabetes mellitus, old age, male sex and preexisting kidney disease have influence of developing CIN after coronarography. PMID:26635433

  20. Acute kidney injury by radiographic contrast media: pathogenesis and prevention.

    PubMed

    Andreucci, Michele; Faga, Teresa; Pisani, Antonio; Sabbatini, Massimo; Michael, Ashour

    2014-01-01

    It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24-72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both. PMID:25197639

  1. Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

    PubMed Central

    Faga, Teresa; Pisani, Antonio; Michael, Ashour

    2014-01-01

    It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24–72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both. PMID:25197639

  2. Ionic versus nonionic MR imaging contrast media: operational definitions.

    PubMed

    Chang, C A; Sieving, P F; Watson, A D; Dewey, T M; Karpishin, T B; Raymond, K N

    1992-01-01

    An experimental rationale is provided to differentiate between the terms ionic and nonionic for magnetic resonance (MR) imaging contrast media such as gadodiamide and gadopentetate dimeglumine. Four independent types of physical measurements (electric conductivity, osmolality, electrophoresis, and ion exchange) were performed on a range of test compounds, including D-glucose, iohexol, gadopentetate dimeglumine, and gadodiamide. Iohexol, D-glucose, and gadodiamide are shown to be nonionic species at physiologic pH (7.4), not measurably dissociating in solution. A range of gadopentetate salts behave as electrolytes, dissociating into constituent charged ions in aqueous media. Operational definitions for the terms ionic and nonionic are provided, and the terms neutral and net zero charge are compared with nonionic for accuracy. The nomenclature nonionic and ionic is deemed appropriate for differentiating MR imaging contrast media. PMID:1623289

  3. Interference of medical contrast media on laboratory testing

    PubMed Central

    Lippi, Giuseppe; Daves, Massimo; Mattiuzzi, Camilla

    2014-01-01

    The use of contrast media such as organic iodine molecules and gadolinium contrast agents is commonplace in diagnostic imaging. Although there is widespread perception that side effects and drug interactions may be the leading problems caused by these compounds, various degrees of interference with some laboratory tests have been clearly demonstrated. Overall, the described interference for iodinate contrast media include inappropriate gel barrier formation in blood tubes, the appearance of abnormal peaks in capillary zone electrophoresis of serum proteins, and a positive bias in assessment of cardiac troponin I with one immunoassay. The interference for gadolinium contrast agents include negative bias in calcium assessment with ortho-cresolphthalein colorimetric assays and occasional positive bias using some Arsenazo reagents, negative bias in measurement of angiotensin converting enzyme (ACE) and zinc (colorimetric assay), as well as positive bias in creatinine (Jaffe reaction), total iron binding capacity (TIBC, ferrozine method), magnesium (calmagite reagent) and selenium (mass spectrometry) measurement. Interference has also been reported in assessment of serum indices, pulse oximetry and methaemoglobin in samples of patients receiving Patent Blue V. Under several circumstances the interference was absent from manufacturer-supplied information and limited to certain type of reagents and/or analytes, so that local verification may be advisable to establish whether or not the test in use may be biased. Since the elimination half-life of these compounds is typically lower than 2 h, blood collection after this period may be a safer alternative in patients who have received contrast media for diagnostic purposes. PMID:24627717

  4. [Uroangiographic contrast media, today. Elements of interest for the urologist].

    PubMed

    Alberti, C

    1997-03-01

    Uroangiographic contrast media, as well as magnetic resonance or ultrasound contrast agents, are substances which are able to artificially enhance the contrast between different tissues, or between normal tissue and pathological areas. The design of ionic and nonionic, monomeric or dimeric, iodobenzene derivatives is outlined with attention given to historical developments and breakthroughs. Relationships between physicochemical properties (osmolality, viscosity, molecular structure, etc.) and pharmacological profile are described. Nonionic compounds display favourable physicochemical characteristics: high water solubility, low osmolality and viscosity and good systemic tolerability. Recent surveys on adverse reactions to uroangiographic iodinated contrast media have shown that the risk of severe reactions is about six times lower with nonionic than ionic X-ray contrast agents. The pathogenetic mechanisms of adverse reactions, generally classified as either anaphylactoid or osmotoxic and chemotoxic, are still not well understood. It has been proposed that leukotrienes, prostaglandins, kinins, etc., may be involved. Nitric oxide appears to play a crucial role in the final common pathway by which anaphylaxis-like reactions occur in response to contrast agent administration. The margin of safety (median lethal dose/diagnostic dose) for nonionic compounds is two- to three-fold greater than for ionic compounds. As a look at the future, an approach to molecules potentially useful as "blood pool X-ray contrast agents" is based on iodinated dendrimeric macromolecules, in which the core is triazacyclononane and branches are represented by trioodobenzene derivatives. PMID:9198904

  5. 3D diffraction tomography for visualization of contrast media

    NASA Astrophysics Data System (ADS)

    Pai, Vinay M.; Stein, Ashley; Kozlowski, Megan; George, Ashvin; Kopace, Rael; Bennett, Eric; Auxier, Julie A.; Wen, Han

    2011-03-01

    In x-ray CT, the ability to selectively isolate a contrast agent signal from the surrounding soft tissue and bone can greatly enhance contrast visibility and enable quantification of contrast concentration. We present here a 3D diffraction tomography implementation for selectively retaining volumetric diffraction signal from contrast agent particles that are within a banded size range while suppressing the background signal from soft tissue and bone. For this purpose, we developed a CT implementation of a single-shot x-ray diffraction imaging technique utilizing gratings. This technique yields both diffraction and absorption images from a single grating-modulated projection image through analysis in the spatial frequency domain. A solution of iron oxide nano-particles, having very different x-ray diffraction properties from tissue, was injected into ex vivo chicken wing and in vivo rat specimens respectively and imaged in a 3D diffraction CT setup. Following parallel beam reconstruction, it is noted that while the soft tissue, bone and contrast media are observed in the absorption volume reconstruction, only the contrast media is observed in the diffraction volume reconstruction. This 3D diffraction tomographic reconstruction permits the visualization and quantification of the contrast agent isolated from the soft tissue and bone background.

  6. A Review: Radiographic Iodinated Contrast Media-Induced Thyroid Dysfunction

    PubMed Central

    Leung, Angela M.; Braverman, Lewis E.; Brent, Gregory A.; Pearce, Elizabeth N.

    2015-01-01

    Context: Thyroid hormone production is dependent on adequate iodine intake. Excess iodine is generally well-tolerated, but thyroid dysfunction can occur in susceptible individuals after excess iodine exposure. Radiological iodinated contrast media represent an increasingly common source of excess iodine. Objective: This review will discuss the thyroidal response after acute exposure to excess iodine; contrast iodine-induced thyroid dysfunction; risks of iodine-induced thyroid dysfunction in vulnerable populations, such as the fetus, neonate, and patients with impaired renal function; and recommendations for the assessment and treatment of contrast iodine-induced thyroid dysfunction. Methods: Data for this review were identified by searching PubMed, Google Scholar, and references from relevant articles from 1948 to 2014. Conclusions: With the increase in the use of computed tomography scans in the United States, there is increasing risk of contrast-induced thyroid dysfunction. Patients at risk of developing iodine-induced thyroid dysfunction should be closely monitored after receiving iodinated contrast media and should be treated as needed. PMID:25375985

  7. [Complications related to the administration of iodinated contrast media].

    PubMed

    Cappeliez, O; Lemort, M; Dagnelie, J

    1997-12-01

    Improvement brought to iodinated molecules aims to obtain an optimal enhancement effect together with a lower toxicity. However, benign adverse events remain a common risk, and anaphylactoid reactions from the intravascular administration of iodinated contrast media may occur at random and are unpredictable. Although most contrast reactions are mild and self-limited, severe and even life-threatening reactions can occur at any time and for any kind of agent. Physicians must be aware of possible complications related to administration of this kind of agents and must be able to identify patients at risk, to care for prevention and prescribe an appropriate premedication regimen. PMID:9481156

  8. Self-expandable CoreValve implantation without contrast media.

    PubMed

    Bruschi, Giuseppe; Colombo, Paola; De Marco, Federico; Barosi, Alberto; Mauri, Silvia; Klugmann, Silvio

    2016-09-01

    Transcatheter aortic valve implantation has been designed to treat high-risk surgical patients affected by severe aortic stenosis, many of whom are affected by chronic kidney disease. To perform transcatheter self-expandable valve implantation, multiple contrast injections are required to monitor the procedure, so these patients are at increased risk of acute kidney injury. We described self-expandable transcatheter aortic valve implantation without contrast media in an 80-year-old man affected by severe aortic stenosis and endstage chronic kidney disease. PMID:26068936

  9. On Burnett coefficients in periodic media in low contrast regime

    NASA Astrophysics Data System (ADS)

    Conca, C.; San Martín, J.; Smaranda, L.; Vanninathan, M.

    2008-05-01

    In this work, we consider low contrast periodic media and we study the dependence of the effective or homogenized tensor and the dispersion tensor in terms of the microstructure. We treat both one-dimensional structures and some laminated structures in higher dimension. Interesting properties of the sign of these coefficients are found. Surprisingly, these depend on the microstructure only through the local proportion parameter, and in some cases, they do not depend on the microstructure at all.

  10. [SAFETY PATIENT. USE AND MANAGEMENT OF CONTRAST MEDIA].

    PubMed

    Lozano Gragera, Isabel María; Postigo Mota, Salvador

    2015-01-01

    This article tries to point out the patient safety and the fundamental rol of nursing in the management of contrast media in the Imaging Diagnostic Services, two aspects of vital importance in the nurse practique. We will look at what the contrast agents are, how we can use them, what the routes of administration are, their adverse reactions and everything related to the patient safety that we, as professional, should do in our daily performance. And, of course, the process must include the information we need to give to the patient, verbally and written (informed consent) in the current legal framework. The aim of this work is to provide the nurse with updated knowledge that is necessary to carry out safety nursing care interventions within the context of the performance of diagnosis techniques using contrast agents. PMID:26448999

  11. Intravenous ultrasound contrast agents versus other imaging methods in pediatric patients with neoplastic diseases – a comparison

    PubMed Central

    Kosiak, Wojciech; Batko, Tomasz; Adamkiewicz-Drożyńska, Elżbieta; Szarmach, Arkadiusz

    2013-01-01

    The lack of registration of ultrasound contrast agents for use in patients below the age of 18 is a significant limitation of their usage. Despite this, examinations with the use of contrast agents are conducted in numerous centers, mainly as part of the diagnostic process of vesicoureteral reflux. Examinations after an intravenous administration of contrast agents are conducted rarely. The reason for this is not only the lack of registration, but also the lack of studies on their safety profile in paediatric patients or no guidelines concerning the dosage. It seems that imaging with the use of such agents could help solve certain clinical problems when other diagnostic methods fail. The paper presents selected cases of pediatric patients treated in oncological departments, in whom the examination with the use of ultrasound contrast agents had a considerable influence on the diagnostic and therapeutic process. PMID:26675552

  12. Drying patterns of porous media containing wettability contrasts.

    PubMed

    Shokri, N; Or, D

    2013-02-01

    Porous media containing sharp wettability discontinuities may occur in natural systems due to depositional processes, accumulation of organic layers or modification of soil wettability following intense forest fires all of which are known to significantly modify water flow and transport processes. We studied evaporation from sand columns containing hydraulically-interacting domains with sharp wettability contrasts. We employed neutron transmission technique to map liquid phase dynamics during evaporation, and conducted laboratory experiments to evaluate evaporative fluxes affected by interactions across wettability contrast. We explained the preferential drying front displacement in the hydrophobic domain and the spatial extent of capillary flow supporting the vaporization plane using a physically-based model. The model provides description of observed liquid phase patterns and dynamics observed in neutron radiography measurements and evaporative fluxes from laboratory experiments. Our results provide new insights into evaporation induced capillary exchange and preferential liquid phase distribution during evaporation from hydraulically interacting vertical porous domains with differing wettability properties and offer opportunities for design of selectively drying of porous media in natural and engineered systems. PMID:23123032

  13. Shellfish allergy and relation to iodinated contrast media: United Kingdom survey

    PubMed Central

    Baig, Mudassar; Farag, Ahmad; Sajid, Jamal; Potluri, Rahul; Irwin, R Bruce; Khalid, Hafiz Mohammed Idrees

    2014-01-01

    AIM: To assess current practice of United Kingdom cardiologists with respect to patients with reported shellfish/iodine allergy, and in particular the use of iodinated contrast for elective coronary angiography. Moreover we have reviewed the current evidence-base and guidelines available in this area. METHODS: A questionnaire survey was send to 500 senior United Kingdom cardiologists (almost 50% cardiologists registered with British Cardiovascular Society) using email and first 100 responses used to analyze practise. We involved cardiologists performing coronary angiograms routinely both at secondary and tertiary centres. Three specific questions relating to allergy were asked: (1) History of shellfish/iodine allergy in pre-angiography assessment; (2) Treatments offered for shellfish/iodine allergy individuals; and (3) Any specific treatment protocol for shellfish/iodine allergy cases. We aimed to establish routine practice in United Kingdom for patients undergoing elective coronary angiography. We also performed comprehensive PubMed search for the available evidence of relationship between shellfish/iodine allergy and contrast media. RESULTS: A total of 100 responses were received, representing 20% of all United Kingdom cardiologists. Ninety-three replies were received from consultant cardiologists, 4 from non-consultant grades and 3 from cardiology specialist nurses. Amongst the respondents, 66% routinely asked about a previous history of shellfish/iodine allergy. Fifty-six percent would pre-treat these patients with steroids and anti-histamines. The other 44% do nothing, or do nonspecific testing based on their personal experience as following: (1) Skin test with 1 mL of subcutaneous contrast before intravenous contrast; (2) Test dose 2 mL contrast before coronary injection; (3) Close observation for shellfish allergy patients; and (4) Minimal evidence that the steroid and anti-histamine regime is effective but it makes us feel better. CONCLUSION: There is no

  14. Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

    PubMed Central

    Tasanarong, Adis

    2014-01-01

    Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given. PMID:24895606

  15. Neurotolerability of nonionic x-ray contrast media: The role of chemotoxicity

    SciTech Connect

    Luzzani, F.; Morisetti, A.; Bussi, S.

    1996-06-01

    Because small quantities of x-ray contrast agents can cross the blood-brain barrier, the authors evaluate the properties that contribute to neurotoxicity. The acute toxicity of various monomer and dimer contrast media was assessed after intracerebroventricular (ICV) injection to mice and intracisternal (ICI) injection to rats. In mice, median lethal dose (LD{sub 50}) values for monomer contrast media apart from iohexol were higher than those for dimer contrast media. In rats, iopentol and iopromide were more neurotoxic than all other contrast media. The signs of toxicity for all contrast media included convulsions, dyspnea, hypoactivity, and sedation. Hypertonic D-mannitol solution was tolerated as well as artificial cerebrospinal fluid. Neither the hydrophilicity of the molecules nor the physicochemical properties of their solutions explain the toxicities satisfactorily. Neurotoxicity of monomer or dimer contrast media depends more on chemical structure characteristics other than hydrophilicity than on the physicochemical characteristics of their solutions. 34 refs., 3 tabs.

  16. Visualization of Noncalcified Gallstones on CT Due to Vicarious Excretion of Intravenous Contrast

    PubMed Central

    Krauthamer, Andres; Maldjian, Pierre D.

    2008-01-01

    We present a case where low attenuation gallstones are visible on CT only on delayed imaging secondary to gallbladder opacification from vicarious excretion of contrast. We discuss heterotopic accumulation of contrast in the gallbladder and its potential diagnostic utilization in the detection of occult pathology. PMID:22470586

  17. Do Intravenous N-Acetylcysteine and Sodium Bicarbonate Prevent High Osmolal Contrast-Induced Acute Kidney Injury? A Randomized Controlled Trial

    PubMed Central

    Inda-Filho, Antonio Jose; Caixeta, Adriano; Manggini, Marcia; Schor, Nestor

    2014-01-01

    Background N-acetylcysteine (NAC) or sodium bicarbonate (NaHCO3), singly or combined, inconsistently prevent patients exposed to radiographic contrast media from developing contrast-induced acute kidney injury (CI-AKI). Objective We asked whether intravenous isotonic saline and either NaHCO3 in 5% dextrose or else a high dose of NAC in 5% dextrose prevent CI-AKI in outpatients exposed to high-osmolal iodinated contrast medium more than does saline alone. Methods This completed prospective, parallel, superiority, open-label, controlled, computer-randomized, single-center, Brazilian trial (NCT01612013) hydrated 500 adult outpatients (214 at high risk of developing CI-AKI) exposed to ioxitalamate during elective coronary angiography and ventriculography. From 1 hour before through 6 hours after exposure, 126 patients (group 1) received a high dose of NAC and saline, 125 (group 2) received NaHCO3 and saline, 124 (group 3) received both treatments, and 125 (group 4) received only saline. Results Groups were similar with respect to age, gender, weight, pre-existing renal dysfunction, hypertension, medication, and baseline serum creatinine and serum cystatin C, but diabetes mellitus was significantly less prevalent in group 1. CI-AKI incidence 72 hours after exposure to contrast medium was 51.4% (257/500), measured as serum creatinine > (baseline+0.3 mg/dL) and/or serum cystatin C > (1.1· baseline), and 7.6% (38/500), measured as both serum creatinine and serum cystatin C > (baseline+0.3 mg/dL) or > (1.25 · baseline). CI-AKI incidence measured less sensitively was similar among groups. Measured more sensitively, incidence in group 1 was significantly (p<0.05) lower than in groups 2 and 3 but not group 4; adjustment for confounding by infused volume equalized incidence in groups 1 and 3. Conclusion: We found no evidence that intravenous isotonic saline and either NaHCO3 or else a high dose of NAC prevent CI-AKI in outpatients exposed to high osmolal iodinated contrast

  18. Contrast Media for X-ray and Magnetic Resonance Imaging: Development, Current Status and Future Perspectives.

    PubMed

    Frenzel, Thomas; Lawaczeck, Rüdiger; Taupitz, Matthias; Jost, Gregor; Lohrke, Jessica; Sieber, Martin A; Pietsch, Hubertus

    2015-09-01

    Over the last 120 years, the extensive advances in medical imaging allowed enhanced diagnosis and therapy of many diseases and thereby improved the quality of life of many patient generations. From the beginning, all technical solutions and imaging procedures were combined with dedicated pharmaceutical developments of contrast media, to further enhance the visualization of morphology and physiology. This symbiosis of imaging hardware and contrast media development was of high importance for the development of modern clinical radiology. Today, all available clinically approved contrast media fulfill the highest requirements for clinical safety and efficacy. All new concepts to increase the efficacy of contrast media have also to consider the high clinical safety standards and cost of goods of current marketed contrast media. Nevertheless, diagnostic imaging will contribute significantly to the progresses in medicine, and new contrast media developments are mandatory to address the medical needs of the future. PMID:26207928

  19. Contrast media hypersensitivity--scope of the problem.

    PubMed

    Brockow, Knut

    2005-04-15

    Hypersensitivity reactions to contrast media (CM) are frequent causes of anaphylactically induced fatalities. Adverse events after CM exposure are classified into immediate and non-immediate reactions, with differing pathomechanisms. In the majority of patients with immediate reactions, IgE-mediated allergy can not be demonstrated and the underlying mechanism remains unknown. However, recent data has provided evidence for skin test positivity and/or specific IgE in some patients with severe reactions. Cell-mediated hypersensitivity is the responsible mechanism for the majority of non-immediate skin eruptions. Skin tests have been employed to confirm this hypersensitivity. Previous reactors have an increased risk to develop new reactions upon repeated exposure, however, other risk factors are poorly defined. The use of skin tests for the selection of a "safe" CM is controversially discussed; information on sensitivity and specificity is lacking. New in-vitro assays have to be developed and/or validated. Premedication of previous reactors is common practice among radiologists, however, its precise role in the prevention of severe CM reactions to lower-osmolality CM has not been demonstrated. Thus, the main future tasks are to develop and validate allergic tests procedures, which may identify patients at risk and/or may confirm CM tolerance, and to reassess the value of different premedications in the prevention of hypersensitivity reactions. PMID:15767034

  20. Adverse reactions to iodinated contrast media administered at the time of endoscopic retrograde cholangiopancreatography (ERCP).

    PubMed

    Pan, Jen-Jung; Draganov, Peter V

    2009-03-01

    Adverse reactions after intravascular administration of iodine contrast media are common and prophylactic regiments consisting of the use of steroids and low osmolality contrast media are highly effective in significantly decreasing the adverse reactions rate. The same type of contrast media are also used for opacification of the biliary tree and the pancreatic duct at the time of endoscopic retrograde cholangiopancreatography (ERCP). Systemic absorption of contrast media after ERCP routinely occurs. Although the adverse reaction rate appears to be very low the exact incidence remains unknown due to the retrospective nature of all reports. Despite the lack of formal recommendations, numerous prophylactic regiments are routinely used prior to ERCP in patients with history of prior reaction to intravascular contrast media. Moreover, the use of prophylaxis has even expanded to patients with no prior reaction to intravascular contrast media who are somehow perceived to be at increase risk (e.g. shellfish allergy). Recently, the first large scale prospective study reported exceedingly low incidence of adverse reaction to high oslmolality iodine-containing contrast media administered at the time of ERCP done without prophylactic premedication even in patients considered to be at the highest risk (prior severe reaction to intravascular contrast media administration). These data suggest that the use of prophylactic regiments prior to ERCP appears to be unnecessary. PMID:19275689

  1. Effect of X-ray Contrast Media, Chlorination, and Chloramination on Zebrafish Development

    EPA Science Inventory

    Effect of X-ray Contrast Media, Chlorination, and Chloramination on Zebrafish Development Little is known about the vertebrate developmental toxicity of chlorinated or chloraminated drinking water (DW), iodinated X-ray contrast media (ICM, a common contaminate of DW) or how the c...

  2. Diagnostic image quality of hysterosalpingography: ionic versus non ionic water soluble iodinated contrast media

    PubMed Central

    Mohd Nor, H; Jayapragasam, KJ; Abdullah, BJJ

    2009-01-01

    Objective To compare the diagnostic image quality between three different water soluble iodinated contrast media in hysterosalpingography (HSG). Material and method In a prospective randomised study of 204 patients, the diagnostic quality of images obtained after hysterosalpingography were evaluated using Iopramide (106 patients) and Ioxaglate (98 patients). 114 patients who had undergone HSG examination using Iodamide were analysed retrospectively. Image quality was assessed by three radiologists independently based on an objective set of criteria. The obtained results were statistically analysed using Kruskal-Wallis and Mann-Whitney U test. Results Visualisation of fimbrial rugae was significantly better with Iopramide and Ioxaglate than Iodamide. All contrast media provided acceptable diagnostic image quality with regard to uterine, fallopian tubes outline and peritoneal spill. Uterine opacification was noted to be too dense in all three contrast media and not optimal for the assessment of intrauterine pathology. Higher incidence of contrast intravasation was noted in the Iodamide group. Similarly, the numbers of patients diagnosed with bilateral blocked fallopian tubes were also higher in the Iodamide group. Conclusion HSG using low osmolar contrast media (Iopramide and Ioxaglate) demonstrated diagnostic image qualities similar to HSG using conventional high osmolar contrast media (Iodamide). However, all three contrast media were found to be too dense for the detection of intrauterine pathology. Better visualisation of the fimbrial outline using Ioxaglate and Iopramide were attributed to their low contrast viscosity. The increased incidence of contrast media intravasation and bilateral tubal blockage using Iodamide are probably related to the high viscosity. PMID:21611058

  3. The use of iodinated and gadolinium contrast media during pregnancy and lactation.

    PubMed

    Webb, Judith A W; Thomsen, Henrik S; Morcos, Sameh K

    2005-06-01

    The use of iodinated or gadolinium-based contrast media in pregnant or lactating women often causes concerns in the radiology department because of the principle of not exposing a fetus or neonate to any drugs. Because of the uncertainty about the use of contrast media during pregnancy and lactation, the Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines. An extensive literature search was carried out and summarized in a report. Based on the limited information available, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. Mutagenic and teratogenic effects have not been described after administration of gadolinium or iodinated contrast media. Free iodide in radiographic contrast medium given to the mother has the potential to depress fetal/neonatal thyroid function. Neonatal thyroid function should be checked during the 1st week if iodinated contrast media have been given during pregnancy. No effect on the fetus has been seen after gadolinium contrast media. Only tiny amounts of iodinated or gadolinium-based contrast medium given to a lactating mother reach the milk, and only a minute proportion entering the baby's gut is absorbed. The very small potential risk associated with absorption of contrast medium may be considered insufficient to warrant stopping breast-feeding for 24 h following either iodinated or gadolinium contrast agents. PMID:15609057

  4. Taxanes as a Risk Factor for Acute Adverse Reactions to Iodinated Contrast Media in Cancer Patients

    PubMed Central

    Farolfi, Alberto; Della Luna, Corradina; Ragazzini, Angela; Carretta, Elisa; Gentili, Nicola; Casadei, Carla; Aquilina, Michele; Barone, Domenico; Minguzzi, Martina; Amadori, Dino; Nanni, Oriana

    2014-01-01

    Background. The impact of cytotoxic agents on the risk of acute allergy-like adverse reactions (ARs) to intravenous iodinated contrast media (ICM) injections is unknown. Methods. We retrospectively reviewed 13,565 computed tomography (CT) scans performed in a consecutive cohort of cancer patients from January 1, 2010 to December 31, 2012. Episodes of acute ICM-related ARs were reported to the pharmacovigilance officer. The following matched comparisons were made: tax code, gender, primary tumor, antineoplastic therapy, and date of last cycle. Concomitant antineoplastic treatment was classified into five groups: platinum, taxane, platinum plus taxane, other, and no treatment group (no therapy had been administered in the previous 24 months). Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (CI) to evaluate the risk of acute ICM-related ARs. Results. Of 10,472 contrast-enhanced CT scans, 97 (0.93%; 95% CI: 0.74–1.11) ICM-related ARs were reported, 11 of which (0.1%) were severe, including one fatality. The overall incidence was significantly higher in patients aged <65 years (p = .0062) and in the platinum plus taxane and taxane groups (p = .007), whereas no correlation was found with gender, number of previous CT scans, site of disease, or treatment setting. Multivariate analysis confirmed an increased risk for patients aged <65 years (OR: 1.73; 95% CI: 1.14–2.63) and for the taxane group (in comparison with the no treatment group; OR: 2.06; 95% CI: 1.02–4.16). Conclusion. Among cancer patients, concomitant treatment with taxanes and younger age would seem to be risk factors for ICM-related ARs. PMID:25063226

  5. Defining the Modalities of Intravenous Contrast Application During the Diagnostics of Hepatic Metastases with Computerized Tomography

    PubMed Central

    Kutllovci, Arben; Ymeri, Halit; Zogaj, Drita; Kutllovci, Skender; Zogaj, Dukagjin

    2016-01-01

    Introduction: The liver is the biggest human abdominal parenchymal organ; it weights approximately 1500 grams and is located in the right hypochondrium, under the diaphragm. Liver is able to perform multiple functions also by means of the rich dual vascularization: hepatic arterial system and the portal vein system, between which exists a short circuit (shunt) and free mixture inside the sinusoid, whilst the two flows drain in the same vein system. The discovery of CT and its application in practice fundamentally changes the importance of diagnostic methods for hepatobiliary lesions. Patients and methods: During a 4-year period, 984 patients suspected with liver or biliary tract disease were explored with CT. 117 of these patients were analyzed with liver metastases. Examinations of the liver was performed in dorsal decubitus and in absolute apnea with spiral movement of the table and in denominations of 1and 5 mm. Siemens MSCT 64 and 6 tier apparatuses enable short scanning time with almost immediate reconstruction, which offers all the necessary elements required for carrying out certain protocols. Results: The average density of metastatic lesions is about 20 HU smaller than normal liver parenchyma. Metastasis with necrosis are more hypodense (30-50 HU smaller than normal liver parenchyma), whilst necrotic metastases with smaller dimensions are almost isodense with normal parenchyma. However, metastases with diameter between 4 to 6 cm are completely isodense and will remain so even after the application of I.V. contrast. The average more frequent size according to most authors, as well as according to our material (148 patients or 90%) was 2-3 cm in transversal diameter. PMID:27041807

  6. Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol

    PubMed Central

    2014-01-01

    Background Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR). The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. Methods All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. Results The protocol was applied to a total of 252 examinations (153 patients, ages 15–87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Conclusion Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma. PMID:25287952

  7. Allergic reactions to iodinated contrast media: premedication considerations for patients at risk.

    PubMed

    Schopp, Jennifer G; Iyer, Ramesh S; Wang, Carolyn L; Petscavage, Jonelle M; Paladin, Angelisa M; Bush, William H; Dighe, Manjiri K

    2013-08-01

    The objectives of this article are to review allergy-type reactions to iodinated contrast media and the protocols utilized to prevent or reduce the occurrence of these adverse reactions in high-risk patients. We will begin by discussing the types or classifications of the adverse reactions to iodinated contrast media. We will then discuss reaction mechanisms, identify the patients at highest risk for adverse reactions, and clarify common misperceptions about the risk. Finally, we will discuss the actions of the medications used to help reduce or prevent allergy-type reactions to iodinated contrast media, the protocols used to help reduce or prevent contrast reactions in high-risk patients, and the potential side effects of these medications. We will also discuss the high-risk patient who has received premedication due to a prior index reaction and discuss the risk of having a subsequent reaction, termed "breakthrough reaction." Identifying patient at high risk for an "allergy-type" reaction to contrast media is an essential task of the radiologist. Prevention of or reduction of the risk of an adverse reaction is critical to patient safety. If an examination can be performed without contrast in a patient at high risk for an allergy-type reaction, it may be appropriate to avoid contrast. However, there are situations where contrast media is necessary, and the radiologist plays a vital role in preventing or mitigating an allergy-type reaction. PMID:23430296

  8. [Prophylaxis and treatment of side effects due to iodinated contrast media relevant to radiological practice].

    PubMed

    Becker, C

    2007-09-01

    Increased utilization of iodinated contrast media may be associated with increased incidence of adverse events. The most important side effects include contrast-induced nephropathy, anaphylactoid reaction, thyrotoxicosis, and extravasation. In patients with moderate renal dysfunction, saline hydration and reduction of contrast media volume are recommended. No regime to prevent anaphylactoid reactions has yet proven to be efficient. If subclinical hyperthyroidism has been determined, prophylaxis with sodium perchlorate is advised. Contrast-induced nephropathy is commonly transient and needs to be followed over time. Mild general anaphylactoid reactions may be treated with antihistaminic drugs and corticosteroids. Furthermore the choice of the X-ray contrast media might influence the risk of any adverse effects. PMID:17768601

  9. Determination of contrast media administration to achieve a targeted contrast enhancement in CT

    NASA Astrophysics Data System (ADS)

    Sahbaee, Pooyan; Li, Yuan; Segars, Paul; Marin, Daniele; Nelson, Rendon; Samei, Ehsan

    2015-03-01

    Contrast enhancement is a key component of CT imaging and offer opportunities for optimization. The design and optimization of new techniques however requires orchestration with the scan parameters and further a methodology to relate contrast enhancement and injection function. In this study, we used such a methodology to develop a method, analytical inverse method, to predict the required injection function to achieve a desired contrast enhancement in a given organ by incorporation of a physiologically based compartmental model. The method was evaluated across 32 different target contrast enhancement functions for aorta, kidney, stomach, small intestine, and liver. The results exhibited that the analytical inverse method offers accurate performance with error in the range of 10% deviation between the predicted and desired organ enhancement curves. However, this method is incapable of predicting the injection function based on the liver enhancement. The findings of this study can be useful in optimizing contrast medium injection function as well as the scan timing to provide more consistency in the way that the contrast enhanced CT examinations are performed. To our knowledge, this work is one of the first attempts to predict the contrast material injection function for a desired organ enhancement curve.

  10. [Radiographic, MR or ultrasound contrast media in pregnant or breast-feeding women: what are the key issues?].

    PubMed

    Fröhlich, J M; Kubik-Huch, R A

    2013-01-01

    The use and the safety of radiographic, MR- or ultrasound contrast media in the diagnostic work-up of pregnant or lactating patients is a frequently discussed question. As only sparse clinical data is available, a careful benefit-risk assessment must contain physico-chemical properties, preclinical data including teratogeneity and embryotoxicity, as well as maternal and foetal exposure. With consideration to the individual risks, iodinated contrast media, macrocyclic MR contrast media with increased stability or sulphur hexafluoride ultrasound contrast media may, if clinically justified, be administered in the smallest possible doses throughout pregnancy. After parental administration of an iodinated contrast medium after the 12th week of pregnancy, the neonate's thyroidal function should be checked during the first week after birth. After parental administration of iodinated, stable macrocyclic, gadolinium or ultrasound contrast media, lactation can be continued normally. In any case, contrast media should be used with caution and only if the benefits outweigh the risk. PMID:23108903

  11. [Suggestions for prevention of adverse reactions after intravasal administration of iodinated contrast media].

    PubMed

    Kuefner, Michael A; Heinrich, Marc; Bautz, Werner; Uder, Michael

    2008-01-01

    Iodinated contrast media are widely used in computed tomography and angiography. Adverse reactions such as contrast-medium induced nephropathy (CIN), anaphylactoid reactions and iodine-induced thyrotoxicosis are associated with intravasal administration of contrast agents. Iodinated contrast agents are generally considered to be safe, but in rare cases they can cause severe life threatening situations. In this review we present an overview about the incidence, pathways, and risk factors of adverse reactions. Simple schemes including hydration protocols for prevention of CIN, medication for prophylaxis of iodine-induced thyrotoxicosis with thyreostatics and anaphylactoid reactions with histamine antagonists and corticosteroids are suggested. PMID:19294866

  12. Quantitative dosimetric assessment for effect of gold nanoparticles as contrast media on radiotherapy planning

    NASA Astrophysics Data System (ADS)

    Tu, Shu-Ju; Yang, Pei-Ying; Hong, Ji-Hong; Lo, Ching-Jung

    2013-07-01

    In CT planning for radiation therapy, patients may be asked to have a medical procedure of contrast agent (CA) administration as required by their physicians. CA media improve quality of CT images and assist radiation oncologists in delineation of the target or organs with accuracy. However, dosimetric discrepancy may occur between scenarios in which CA media are present in CT planning and absent in treatment delivery. In recent preclinical experiments of small animals, gold nanoparticles (AuNPs) have been identified as an excellent contrast material of x-ray imaging. In this work, we quantitatively evaluate the effect of AuNPs to be used as a potential material of contrast enhancement in radiotherapy planning with an analytical phantom and clinical case. Conray 60, an iodine-based product for contrast enhancement in clinical uses, is included as a comparison. Other additional variables such as different concentrations of CA media, radiation delivery techniques and dose calculation algorithms are included. We consider 1-field AP, 4-field box, 7-field intensity modulated radiation therapy (IMRT) and a recent technique of volumetric modulated arc therapy (VMAT). CA media of AuNPs (Conray 60) with concentrations of 10%, 20%, 30%, 40% and 50% containing 28.2, 56.4, 84.6, 112.8 and 141.0 mg of gold (iodine) per mL were prepared prior to CT scanning. A virtual phantom with a target where nanoparticle media are loaded and clinical case of gastric lymphoma in which the Conray 60 media were given to the patient prior to the CT planning are included for the study. Compared to Conray 60 media with concentration of 10%/50%, Hounsfield units for AuNP media of 10%/50% are 322/1608 higher due to the fact that atomic number of Au (Z=79) is larger than I (Z=53). In consequence, dosimetric discrepancy of AuNPs is magnified between presence and absence of contrast media. It was found in the phantom study that percent dose differences between presence and absence of CA media may be

  13. [Selection of contrast media for hemodynamic studies and limitation of the associated risk].

    PubMed

    Baralis, Giorgio; Steffenino, Giuseppe; Dellavalle, Antonio; La Scala, Eugenio; Uslenghi, Eugenio

    2004-02-01

    Both the choice of contrast media for use in the cardiac catheterization laboratory, and the practice for limiting patient damage, are relevant to the quality of health care. As part of our quality assurance program, and as a preliminary step to a critical reappraisal of our current protocols, an updated review has been made of existing evidence about contrast media for this use, and about measures to prevent adverse events. Consideration was also given to evidence-based measures or drug treatment in patients at risk for anaphylactoid reactions or with renal failure, as well as to the recommended course of action in diabetic patients receiving oral biguanide agents. PMID:15080534

  14. Avoidable errors in dealing with anaphylactoid reactions to iodinated contrast media.

    PubMed

    Segal, Arthur J; Bush, William H

    2011-03-01

    Contrast reactions are much less common today than in the past. This is principally because of the current and predominant use of low and iso-osmolar contrast media compared with the prior use of high osmolality contrast media. As a result of the significantly diminished frequency, there are now fewer opportunities for physicians to recognize and appropriately treat such adverse reactions. In review of the literature combined with our own clinical and legal experience, 12 potential errors were identified and these are reviewed in detail so that they can be avoided by the physician-in-charge. Basic treatment considerations are presented along with a plan to systematize an approach to contrast reactions, simplify treatment options and plans, and schedule periodic drills. PMID:21150793

  15. Technology consumption and cognitive control: Contrasting action video game experience with media multitasking.

    PubMed

    Cardoso-Leite, Pedro; Kludt, Rachel; Vignola, Gianluca; Ma, Wei Ji; Green, C Shawn; Bavelier, Daphne

    2016-01-01

    Technology has the potential to impact cognition in many ways. Here we contrast two forms of technology usage: (1) media multitasking (i.e., the simultaneous consumption of multiple streams of media, such a texting while watching TV) and (2) playing action video games (a particular subtype of video games). Previous work has outlined an association between high levels of media multitasking and specific deficits in handling distracting information, whereas playing action video games has been associated with enhanced attentional control. Because these two factors are linked with reasonably opposing effects, failing to take them jointly into account may result in inappropriate conclusions as to the impacts of technology use on attention. Across four tasks (AX-continuous performance, N-back, task-switching, and filter tasks), testing different aspects of attention and cognition, we showed that heavy media multitaskers perform worse than light media multitaskers. Contrary to previous reports, though, the performance deficit was not specifically tied to distractors, but was instead more global in nature. Interestingly, participants with intermediate levels of media multitasking sometimes performed better than both light and heavy media multitaskers, suggesting that the effects of increasing media multitasking are not monotonic. Action video game players, as expected, outperformed non-video-game players on all tasks. However, surprisingly, this was true only for participants with intermediate levels of media multitasking, suggesting that playing action video games does not protect against the deleterious effect of heavy media multitasking. Taken together, these findings show that media consumption can have complex and counterintuitive effects on attentional control. PMID:26474982

  16. Prevention and Management of Adverse Reactions Induced by Iodinated Contrast Media.

    PubMed

    Wu, Yi Wei; Leow, Kheng Song; Zhu, Yujin; Tan, Cher Heng

    2016-04-01

    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. Current premedication prophylaxis in at-risk patients may reduce the risk of ADRs. However, there is still a lack of consensus on the prophylactic role of premedication. Contrast-induced nephropathy (CIN) is another component of IRCM-related ADRs. Hydration remains the mainstay of CIN prophylaxis in at-risk patients. Despite several preventive measures, ADRs may still occur. Treatment strategies for potential contrast reactions are also summarised in this article. This article summarises the pathophysiology, epidemiology and risk factors of ADRs with emphasis on prevention and treatment strategies. This will allow readers to understand the rationale behind appropriate patient preparation for diagnostic imaging involving IRCM. PMID:27292007

  17. Acute Respiratory Distress Syndrome after the Use of Gadolinium Contrast Media

    PubMed Central

    Park, Jihye; Byun, Il Hwan; Park, Kyung Hee; Lee, Jae-Hyun; Nam, Eun Ji

    2015-01-01

    Acute respiratory distress syndrome (ARDS) is a medical emergency that threatens life. To this day, ARDS is very rarely reported by iodine contrast media, and there is no reported case of ARDS induced by gadolinium contrast media. Here, we present a case with ARDS after the use of gadobutrol (Gadovist) as a magnetic resonance imaging (MRI) contrast medium. A 26 years old female without any medical history, including allergic diseases and without current use of drugs, visited the emergency room for abdominal pain. Her abdominopelvic computed tomography with iodine contrast media showed a right ovarian cyst and possible infective colitis. Eighty-three hours later, she underwent pelvis MRI after injection of 7.5 mL (0.1 mL/kg body weight) of gadobutrol (Gadovist) to evaluate the ovarian cyst. She soon presented respiratory difficulty, edema of the lips, nausea, and vomiting, and we could hear wheezing upon auscultation. She was treated with dexamethasone, epinephrine, and norepinephrine. Her chest X-ray showed bilateral central bat-wing consolidative appearance. Managed with mechanical ventilation, she was extubated 3 days later and discharged without complications. PMID:26069143

  18. Complementary contrast media for metal artifact reduction in dual-energy computed tomography.

    PubMed

    Lambert, Jack W; Edic, Peter M; FitzGerald, Paul F; Torres, Andrew S; Yeh, Benjamin M

    2015-07-01

    Metal artifacts have been a problem associated with computed tomography (CT) since its introduction. Recent techniques to mitigate this problem have included utilization of high-energy (keV) virtual monochromatic spectral (VMS) images, produced via dual-energy CT (DECT). A problem with these high-keV images is that contrast enhancement provided by all commercially available contrast media is severely reduced. Contrast agents based on higher atomic number elements can maintain contrast at the higher energy levels where artifacts are reduced. This study evaluated three such candidate elements: bismuth, tantalum, and tungsten, as well as two conventional contrast elements: iodine and barium. A water-based phantom with vials containing these five elements in solution, as well as different artifact-producing metal structures, was scanned with a DECT scanner capable of rapid operating voltage switching. In the VMS datasets, substantial reductions in the contrast were observed for iodine and barium, which suffered from contrast reductions of 97% and 91%, respectively, at 140 versus 40 keV. In comparison under the same conditions, the candidate agents demonstrated contrast enhancement reductions of only 20%, 29%, and 32% for tungsten, tantalum, and bismuth, respectively. At 140 versus 40 keV, metal artifact severity was reduced by 57% to 85% depending on the phantom configuration. PMID:26839905

  19. Radiographic Contrast-Media-Induced Acute Kidney Injury: Pathophysiology and Prophylactic Strategies

    PubMed Central

    2013-01-01

    Contrast-induced acute kidney injury (CI-AKI) is one of the most widely discussed and debated topics in cardiovascular medicine. With increasing number of contrast-media- (CM-) enhanced imaging studies being performed and growing octogenarian population with significant comorbidities, incidence of CI-AKI remains high. In this review, pathophysiology of CI-AKI, its relationship with different types of CM, role of serum and urinary biomarkers for diagnosing CI-AKI, and various prophylactic strategies used for nephroprotection against CI-AKI are discussed in detail. PMID:24967281

  20. The Incidence, Classification, and Management of Acute Adverse Reactions to the Low-Osmolar Iodinated Contrast Media Isovue and Ultravist in Contrast-Enhanced Computed Tomography Scanning.

    PubMed

    Zhang, Bin; Dong, Yuhao; Liang, Long; Lian, Zhouyang; Liu, Jing; Luo, Xiaoning; Chen, Wenbo; Li, Xinyu; Liang, Changhong; Zhang, Shuixing

    2016-03-01

    Some epidemiologic surveillance studies have recorded adverse drug reactions to radiocontrast agents. We aimed to investigate the incidence and management of acute adverse reactions (AARs) to Ultravist-370 and Isovue-370 in patients who underwent contrast-enhanced computed tomography (CT) scanning.Data from 137,473 patients were analyzed. They had undergone enhanced CT scanning with intravenous injection of Ultravist-370 or Isovue-370 during the period of January 1, 2006 to December 31, 2012 in our hospital. We investigated and classified AARs according to the American College of Radiology and the Chinese Society of Radiology (CSR) guidelines for iodinated contrast media. We analyzed risk factors for AARs and compared the AARs induced by Ultravist-370 and Isovue-370.Four hundred and twenty-eight (0.31%) patients experienced AARs, which included 330 (0.24%) patients with mild AARs, 82 (0.06%) patients with moderate AARs, and 16 (0.01%) patients with severe AARs (including 3 cases of cardiac arrest and one case of death). The incidence of AARs was higher with Ultravist-370 than with Isovue-370 (0.38% vs 0.24%, P < 0.001), but only for mild AARs (0.32% vs 0.16%, P < 0.001). Analyses on risk factors indicated that female patients (n = 221, 0.43%, P < 0.001), emergency patients (n = 11, 0.51%, P < 0.001), elderly patients aged 50 to 60 years (n = 135, 0.43%, P < 0.001), and patients who underwent coronary computed tomography angiography (CTA) (n = 55, 0.51%, P < 0.001) had a higher risk of AARs. Cutaneous manifestations (50.52%)-especially rash (59.74%)-were the most frequent mild AARs. Cardiovascular manifestations accounted for most moderate and severe AARs (62.91% and 48.28%, respectively). After proper management, the symptoms and signs of 96.5% of the AARs resolved within 24 hours without sequelae.Ultravist-370 and Isovue-370 are safe for patients undergoing enhanced CT scanning. The incidence of AARs is higher with Ultravist

  1. The Incidence, Classification, and Management of Acute Adverse Reactions to the Low-Osmolar Iodinated Contrast Media Isovue and Ultravist in Contrast-Enhanced Computed Tomography Scanning

    PubMed Central

    Zhang, Bin; Dong, Yuhao; Liang, Long; Lian, Zhouyang; Liu, Jing; Luo, Xiaoning; Chen, Wenbo; Li, Xinyu; Liang, Changhong; Zhang, Shuixing

    2016-01-01

    Abstract Some epidemiologic surveillance studies have recorded adverse drug reactions to radiocontrast agents. We aimed to investigate the incidence and management of acute adverse reactions (AARs) to Ultravist-370 and Isovue-370 in patients who underwent contrast-enhanced computed tomography (CT) scanning. Data from 137,473 patients were analyzed. They had undergone enhanced CT scanning with intravenous injection of Ultravist-370 or Isovue-370 during the period of January 1, 2006 to December 31, 2012 in our hospital. We investigated and classified AARs according to the American College of Radiology and the Chinese Society of Radiology (CSR) guidelines for iodinated contrast media. We analyzed risk factors for AARs and compared the AARs induced by Ultravist-370 and Isovue-370. Four hundred and twenty-eight (0.31%) patients experienced AARs, which included 330 (0.24%) patients with mild AARs, 82 (0.06%) patients with moderate AARs, and 16 (0.01%) patients with severe AARs (including 3 cases of cardiac arrest and one case of death). The incidence of AARs was higher with Ultravist-370 than with Isovue-370 (0.38% vs 0.24%, P < 0.001), but only for mild AARs (0.32% vs 0.16%, P < 0.001). Analyses on risk factors indicated that female patients (n = 221, 0.43%, P < 0.001), emergency patients (n = 11, 0.51%, P < 0.001), elderly patients aged 50 to 60 years (n = 135, 0.43%, P < 0.001), and patients who underwent coronary computed tomography angiography (CTA) (n = 55, 0.51%, P < 0.001) had a higher risk of AARs. Cutaneous manifestations (50.52%)—especially rash (59.74%)—were the most frequent mild AARs. Cardiovascular manifestations accounted for most moderate and severe AARs (62.91% and 48.28%, respectively). After proper management, the symptoms and signs of 96.5% of the AARs resolved within 24 hours without sequelae. Ultravist-370 and Isovue-370 are safe for patients undergoing enhanced CT scanning. The incidence of AARs is

  2. In vivo X-Ray Computed Tomographic Imaging of Soft Tissue with Native, Intravenous, or Oral Contrast

    PubMed Central

    Wathen, Connor A.; Foje, Nathan; van Avermaete, Tony; Miramontes, Bernadette; Chapaman, Sarah E.; Sasser, Todd A.; Kannan, Raghuraman; Gerstler, Steven; Leevy, W. Matthew

    2013-01-01

    X-ray Computed Tomography (CT) is one of the most commonly utilized anatomical imaging modalities for both research and clinical purposes. CT combines high-resolution, three-dimensional data with relatively fast acquisition to provide a solid platform for non-invasive human or specimen imaging. The primary limitation of CT is its inability to distinguish many soft tissues based on native contrast. While bone has high contrast within a CT image due to its material density from calcium phosphate, soft tissue is less dense and many are homogenous in density. This presents a challenge in distinguishing one type of soft tissue from another. A couple exceptions include the lungs as well as fat, both of which have unique densities owing to the presence of air or bulk hydrocarbons, respectively. In order to facilitate X-ray CT imaging of other structures, a range of contrast agents have been developed to selectively identify and visualize the anatomical properties of individual tissues. Most agents incorporate atoms like iodine, gold, or barium because of their ability to absorb X-rays, and thus impart contrast to a given organ system. Here we review the strategies available to visualize lung, fat, brain, kidney, liver, spleen, vasculature, gastrointestinal tract, and liver tissues of living mice using either innate contrast, or commercial injectable or ingestible agents with selective perfusion. Further, we demonstrate how each of these approaches will facilitate the non-invasive, longitudinal, in vivo imaging of pre-clinical disease models at each anatomical site. PMID:23711461

  3. Evaluation of the protective effect of N-acetylcysteine on contrast media nephropathy

    PubMed Central

    Pezeshgi, Aiyoub; Parsamanesh, Negin; Farhood, Goodarz; Mahmoodi, Khalil

    2015-01-01

    Introduction: Intravenous contrast agents can cause acute decline in kidney function, especially in patients with risk factors. Objectives: In this study, we aimed to examine the ameliorative effect N-acetylcysteine (NAC) to reduce the incidence of contrast nephropathy. Patients and Methods: This study was a prospective, randomized, double-blind clinical trial on 150 patients who underwent coronary angiography. The study was carried out on patients undergoing coronary angiography. Patients were randomly assigned into 2 groups of intervention group and control subjects. Intervention group took NAC 600 mg orally twice a day. It was administered one day before angiography and continued until the second day after angiography. Control subjects received saline only. Serum creatinine was measured before and three days after coronary angiography. Results: There was no significant difference between intervention and control groups at baseline (P > 0.05). However, there was a significant decline in creatinine level among NAC patients (P = 0.001). Saline group had significantly higher proportion of nephropathy cases than NAC patients Conclusion: We found that the consumption of NAC is useful for contrast induced nephropathy (CIN) prevention. PMID:26693496

  4. Iodinated contrast media electro-degradation: process performance and degradation pathways.

    PubMed

    Del Moro, Guido; Pastore, Carlo; Di Iaconi, Claudio; Mascolo, Giuseppe

    2015-02-15

    The electrochemical degradation of six of the most widely used iodinated contrast media was investigated. Batch experiments were performed under constant current conditions using two DSA® electrodes (titanium coated with a proprietary and patented mixed metal oxide solution of precious metals such as iridium, ruthenium, platinum, rhodium and tantalum). The degradation removal never fell below 85% (at a current density of 64 mA/cm(2) with a reaction time of 150 min) when perchlorate was used as the supporting electrolyte; however, when sulphate was used, the degradation performance was above 80% (at a current density of 64 mA/cm(2) with a reaction time of 150 min) for all of the compounds studied. Three main degradation pathways were identified, namely, the reductive de-iodination of the aromatic ring, the reduction of alkyl aromatic amides to simple amides and the de-acylation of N-aromatic amides to produce aromatic amines. However, as amidotrizoate is an aromatic carboxylate, this is added via the decarboxylation reaction. The investigation did not reveal toxicity except for the lower current density used, which has shown a modest toxicity, most likely for some reaction intermediates that are not further degraded. In order to obtain total removal of the contrast media, it was necessary to employ a current intensity between 118 and 182 mA/cm(2) with energy consumption higher than 370 kWh/m(3). Overall, the electrochemical degradation was revealed to be a reliable process for the treatment of iodinated contrast media that can be found in contaminated waters such as hospital wastewater or pharmaceutical waste-contaminated streams. PMID:25433384

  5. Evaporation and capillary coupling across vertical textural contrasts in porous media.

    PubMed

    Lehmann, Peter; Or, Dani

    2009-10-01

    High and nearly constant evaporation rates from initially saturated porous media are sustained by capillary-driven flow from receding drying front below the evaporating surface. The spatial extent of continuous liquid pathways in homogeneous porous medium is defined by its hydraulically connected pore size distribution. We consider here evaporative losses from porous media consisting of two hydraulically coupled dissimilar domains each with own pore and particle size distributions separated by sharp vertical textural contrast. Evaporation experiments from texturally dissimilar media were monitored using neutron transmission and dye pattern imaging to quantify water distribution and drying front dynamics. Drying front invades exclusively coarse-textured domain while fine-textured domain remains saturated and its surface continuously coupled with the atmosphere. Results show that evaporation from fine-textured surface was supplied by liquid flow from adjacent coarse domain driven by capillary pressure differences between the porous media. A first characteristic length defining limiting drying front depth during which fine sand region remains saturated is deduced from difference in air-entry pressures of the two porous media. A second characteristic length defining the end of high evaporation rate includes the extent of continuous liquid films pinned in the crevices of the pore space and between particle contacts in the fine medium. We established numerically the lateral extent of evaporation-induced hydraulic coupling that is limited by viscous losses and gravity. For certain combinations of soil types the lateral extent of hydraulic coupling may exceed distances of 10 m. Results suggest that evaporative water losses from heterogeneous and coupled system are larger compared with uncoupled or homogenized equivalent systems. PMID:19905447

  6. Case Report: Atrial Fibrillation After Intravenous Administration of Iodinated Contrast Medium in a Patient With Hepatocellular Carcinoma.

    PubMed

    Maimone, Sergio; Filomia, Roberto; Saitta, Carlo; Raimondo, Giovanni; Squadrito, Giovanni

    2015-09-01

    We describe the case of a 73-year-old woman with liver cirrhosis and hepatocellular carcinoma (HCC) who developed 2 distinct episodes of paroxystic atrial fibrillation (AF) each of which occurred 1 to 4 hours after iodine medium contrast-enhanced computed tomography. Sinus rhythm was restored by amiodarone therapy after the first AF episode and by electrical cardioversion after the second one. A careful clinical, biochemical, and instrumental examination showed that the patient had subclinical hyperthyroidism and moderate mitral insufficiency with mild atrial enlargement.Thus, the coexistence of both subclinical disthyroidism and of cardiac anatomical alterations may have predisposed the patient to AF that in fact occurred when exogenous iodine administration triggered a hyperthyroidism status. PMID:26334896

  7. Case Report: Atrial Fibrillation After Intravenous Administration of Iodinated Contrast Medium in a Patient With Hepatocellular Carcinoma

    PubMed Central

    Maimone, Sergio; Filomia, Roberto; Saitta, Carlo; Raimondo, Giovanni; Squadrito, Giovanni

    2015-01-01

    Abstract We describe the case of a 73-year-old woman with liver cirrhosis and hepatocellular carcinoma (HCC) who developed 2 distinct episodes of paroxystic atrial fibrillation (AF) each of which occurred 1 to 4 hours after iodine medium contrast-enhanced computed tomography. Sinus rhythm was restored by amiodarone therapy after the first AF episode and by electrical cardioversion after the second one. A careful clinical, biochemical, and instrumental examination showed that the patient had subclinical hyperthyroidism and moderate mitral insufficiency with mild atrial enlargement. Thus, the coexistence of both subclinical disthyroidism and of cardiac anatomical alterations may have predisposed the patient to AF that in fact occurred when exogenous iodine administration triggered a hyperthyroidism status. PMID:26334896

  8. Ventriculography and cisternography with water-soluble contrast media in infants with myelomeningocele

    SciTech Connect

    Yamada, H.; Nakamura, S.; Tanaka, Y.; Tajima, M.; Kageyama, N.

    1982-04-01

    Fifty-four newborn infants with myelomeningocele and hydrocephalus were studied by ventriculography using water-soluble contrast media; 20 were also studied by metrizamide myeloencephalography and computerized tomographic (CT) cisternography. Ventriculography suggested that the aqueduct was patent in all cases. Outflow of contrast medium from the fourth ventricle was slow in most cases, complete obstruction was seen in 15%, communication was delayed at the outlet in 54%, and rather free communication was observedin 31%. Metrizamide myeloencephalography and CT cisternography suggested a partial block at the level of the ambient cisterns in approximately one-third of infants. These findings support the concept that flow of cerebrospinal fluid is reduced in several areas. Aqueductal stenosis was not considered an important factor in hydrocephalus, while the most important site of obstruction was felt to be the lowest portion of the fourth ventricle.

  9. Bounds and Estimates for Transport Coefficients of Random and Porous Media with High Contrasts

    SciTech Connect

    Berryman, J G

    2004-09-24

    Bounds on transport coefficients of random polycrystals of laminates are presented, including the well-known Hashin-Shtrikman bounds and some newly formulated bounds involving two formation factors for a two-component porous medium. Some new types of self-consistent estimates are then formulated based on the observed analytical structure both of these bounds and also of earlier self-consistent estimates (of the CPA or coherent potential approximation type). A numerical study is made, assuming first that the internal structure (i.e., the laminated grain structure) is not known, and then that it is known. The purpose of this aspect of the study is to attempt to quantify the differences in the predictions of properties of a system being modeled when such organized internal structure is present in the medium but detailed spatial correlation information may or (more commonly) may not be available. Some methods of estimating formation factors from data are also presented and then applied to a high-contrast fluid-permeability data set. Hashin-Shtrikman bounds are found to be very accurate estimates for low contrast heterogeneous media. But formation factor lower bounds are superior estimates for high contrast situations. The new self-consistent estimators also tend to agree better with data than either the bounds or the CPA estimates, which themselves tend to overestimate values for high contrast conducting composites.

  10. Pathogenesis of Renal Failure in Multiple Myeloma: Any Role of Contrast Media?

    PubMed Central

    Mussap, Michele; Merlini, Giampaolo

    2014-01-01

    The spectrum of kidney disease-associated monoclonal immunoglobulin and plasma cell malignancies is remarkably broad and encompasses nearly all nephropathologic entities. Multiple myeloma with kidney impairment at presentation is a medical emergency since the recovery of kidney function is associated with survival benefits. In most cases, kidney impairment may be the first clinical manifestation of malignant plasma cell dyscrasias like multiple myeloma and light chain amyloidosis. Multiple myeloma per se cannot be considered a main risk factor for developing acute kidney injury following intravascular administration of iodinated contrast media. The risk is increased by comorbidities such as chronic kidney disease, diabetes, hypercalcemia, dehydration, and use of nephrotoxic drugs. Before the administration of contrast media, the current recommended laboratory tests for assessing kidney function are serum creatinine measurement and the estimation of glomerular filtration rate by using the CKD-EPI equation. The assessment of Bence Jones proteinuria is unnecessary for evaluating the risk of kidney failure in patients with multiple myeloma, since this test cannot be considered a surrogate biomarker of kidney function. PMID:24877060

  11. Classification of structurally related commercial contrast media by near infrared spectroscopy.

    PubMed

    Yip, Wai Lam; Soosainather, Tom Collin; Dyrstad, Knut; Sande, Sverre Arne

    2014-03-01

    Near infrared spectroscopy (NIRS) is a non-destructive measurement technique with broad application in pharmaceutical industry. Correct identification of pharmaceutical ingredients is an important task for quality control. Failure in this step can result in several adverse consequences, varied from economic loss to negative impact on patient safety. We have compared different methods in classification of a set of commercially available structurally related contrast media, Iodixanol (Visipaque(®)), Iohexol (Omnipaque(®)), Caldiamide Sodium and Gadodiamide (Omniscan(®)), by using NIR spectroscopy. The performance of classification models developed by soft independent modelling of class analogy (SIMCA), partial least squares discriminant analysis (PLS-DA) and Main and Interactions of Individual Principal Components Regression (MIPCR) were compared. Different variable selection methods were applied to optimize the classification models. Models developed by backward variable elimination partial least squares regression (BVE-PLS) and MIPCR were found to be most effective for classification of the set of contrast media. Below 1.5% of samples from the independent test set were not recognized by the BVE-PLS and MIPCR models, compared to up to 15% when models developed by other techniques were applied. PMID:24374816

  12. [Allergy to drugs and contrast media--recommendations of the Israeli Allergy and Clinical Immunology Association].

    PubMed

    Agmon-Levin, Nancy; Tal, Yuval; Broides, Arnon; Asher, Ilan; Hersheko, Alon; Staubers, Tali; Confino-Cohen, Ronit

    2013-09-01

    Drug hypersensitivity is an adverse reaction that was brought about by a specific immunologic response, not related to the pharmacological components of the drug. Additionally, drug related pseudoallergic and anaphylactoid reactions have been encompassed under the umbrella of hypersensitivity. Some of these reactions are linked with significant morbidity and mortality. Nowadays, the hypersensitivity reactions of most drugs can be well defined and recurrence risk following exposure to the culprit drug and/or related drugs can be assessed. Medical history skin, blood and challenge tests, conducted in an allergy clinic, enable prediction and prevention of repeated events as well as unnecessary avoidance of certain compounds. For instance, most patients who report a prior reaction to penicillin are not allergic to beta-lactams upon allergic evaluation, while avoidance of penicillin based on self-reporting alone often leads to the use of an alternate antibiotic with greater cost or side effect profile. On the other hand, for patients who previously exhibited hypersensitivity to a compound which is currently required, premedication or a desensitization protocol can be recommended to allow the use of this compound. Drug hypersensitivity is most commonly attributed to beta-lactams antibiotics, contrast media reagents and non-steroidal anti-inflammatory drugs (NSAID). Hence, in the current review the recommendations of the Israeli Association for Allergy and Clinical Immunology for the evaluation and treatment of patients suspected to have hypersensitivity to beta-lactams and contrast media reagents are detailed. Recommendations regarding the evaluation of NSAID hypersensitivity will be published on the IMA website, together with those explicated herein. PMID:24364087

  13. Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media.

    PubMed

    Rosado Ingelmo, A; Doña Diaz, I; Cabañas Moreno, R; Moya Quesada, M C; García-Avilés, C; García Nuñez, I; Martínez Tadeo, J I; Mielgo Ballesteros, R; Ortega-Rodríguez, N; Padial Vilchez, M A; Sánchez-Morillas, L; Vila Albelda, C; Moreno Rodilla, E; Torres Jaén, M J

    2016-01-01

    The objective of these guidelines is to ensure efficient and effective clinical practice. The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging. Although rare, IgE-mediated reactions to gadolinium derivatives have been reported. PMID:27326981

  14. Differences between Drug-Induced and Contrast Media-Induced Adverse Reactions Based on Spontaneously Reported Adverse Drug Reactions

    PubMed Central

    Suh, JinUk; Yang, MyungSuk; Kang, WonKu; Kim, EunYoung

    2015-01-01

    Objective We analyzed differences between spontaneously reported drug-induced (not including contrast media) and contrast media-induced adverse reactions. Methods Adverse drug reactions reported by an in-hospital pharmacovigilance center (St. Mary’s teaching hospital, Daejeon, Korea) from 2010–2012 were classified as drug-induced or contrast media-induced. Clinical patterns, frequency, causality, severity, Schumock and Thornton’s preventability, and type A/B reactions were recorded. The trends among causality tools measuring drug and contrast-induced adverse reactions were analyzed. Results Of 1,335 reports, 636 drug-induced and contrast media-induced adverse reactions were identified. The prevalence of spontaneously reported adverse drug reaction-related admissions revealed a suspected adverse drug reaction-reporting rate of 20.9/100,000 (inpatient, 0.021%) and 3.9/100,000 (outpatients, 0.004%). The most common adverse drug reaction-associated drug classes included nervous system agents and anti-infectives. Dermatological and gastrointestinal adverse drug reactions were most frequently and similarly reported between drug and contrast media-induced adverse reactions. Compared to contrast media-induced adverse reactions, drug-induced adverse reactions were milder, more likely to be preventable (9.8% vs. 1.1%, p < 0.001), and more likely to be type A reactions (73.5% vs. 18.8%, p < 0.001). Females were over-represented among drug-induced adverse reactions (68.1%, p < 0.001) but not among contrast media-induced adverse reactions (56.6%, p = 0.066). Causality patterns differed between the two adverse reaction classes. The World Health Organization–Uppsala Monitoring Centre causality evaluation and Naranjo algorithm results significantly differed from those of the Korean algorithm version II (p < 0.001). Conclusions We found differences in sex, preventability, severity, and type A/B reactions between spontaneously reported drug and contrast media-induced adverse

  15. Protective Effects of Repetitive Injections of Radiographic Contrast Media on the Subsequent Tolerance to Ischemia in the Isolated Rat Heart

    SciTech Connect

    Falck, Geir; Bruvold, Morten; Schjott, Jan; Jynge, Per

    2000-11-15

    Purpose: Despite detailed knowledge of the effects of X-ray contrast media on cardiac function, no studies have examined the effect of contrast media injections on the subsequent tolerance to ischemia in the heart.Methods: Isolated perfused rat hearts were exposed to repetitive injections of iohexol, iodixanol, or ioxaglate before 30 min of global ischemia and 120 min of reperfusion. These groups were compared with control (no pretreatment) and ischemic preconditioning known to reduce infarct size. Physiologic variables and infarct size were measured. Results: Pretreatment with iodixanol reduced infarct size significantly compared with control and thus afforded protection against ischemia. Injections with iohexol and ioxaglate reduced infarct size, although not significantly, compared with control.Conclusion: Pretreatment of the isolated rat heart with commonly used contrast media enhances the cardiac tolerance to subsequent ischemia. The mechanism behind this protective effect could not be determined, but could involve stretching of the heart and/or generation of nitric oxide.

  16. Salvianolic Acid B Prevents Iodinated Contrast Media-Induced Acute Renal Injury in Rats via the PI3K/Akt/Nrf2 Pathway

    PubMed Central

    Tongqiang, Liu; Shaopeng, Liu; Xiaofang, Yu; Nana, Song; Xialian, Xu; Jiachang, Hu; Ting, Zhang; Xiaoqiang, Ding

    2016-01-01

    Contrast-induced acute renal injury (CI-AKI) has become a common cause of hospital-acquired renal failure. However, the development of prophylaxis strategies and approved therapies for CI-AKI is limited. Salvianolic acid B (SB) can treat cardiovascular-related diseases. The aim of the present study was to assess the effect of SB on prevention of CI-AKI and explore its underlying mechanisms. We examined its effectiveness of preventing renal injury in a novel CI-AKI rat model. Compared with saline, intravenous SB pretreatment significantly attenuated elevations in serum creatinine and the histological changes of renal tubular injuries, reduced the number of apoptosis-positive tubular cells, activated Nrf2, and lowered the levels of renal oxidative stress induced by iodinated contrast media. The above renoprotection of SB was abolished by the PI3K inhibitor (wortmannin). In HK-2 cells, SB activated Nrf2 and decreased the levels of oxidative stress induced by hydrogen peroxide and subsequently improved cell viability. The above cytoprotection of SB was blocked by the PI3K inhibitor (wortmannin) or siNrf2. Thus, our results demonstrate that, due to its antioxidant properties, SB has the potential to effectively prevent CI-AKI via the PI3K/Akt/Nrf2 pathway. PMID:27382429

  17. Torsten Almén (1931-2016): the father of non-ionic iodine contrast media.

    PubMed

    Nyman, Ulf; Ekberg, Olle; Aspelin, Peter

    2016-09-01

    The Swedish radiologist Torsten Almén is the first clinical radiologist ever to have made a fundamental contribution to intravascular contrast medium design, the development of non-ionic contrast media. He became emotionally triggered by the patients' severe pain each time he injected the ionic "high-osmolar" contrast media when performing peripheral arteriographies in the early 1960s. One day he got a flash of genius that combined the observation of pain, a pathophysiological theory and how to eliminate it with suitable contrast media chemistry. After self-studies in chemistry he developed the concept of iodine contrast media not dissociating into ions in solution to reduce their osmolality and even reach plasma isotonicity. He offered several pharmaceutical companies his concept of mono- and polymeric non-ionic agents but without response, since it was considered against the chemical laws of that time. Contrast media constructed as salts and dissociating into ions in solution was regarded an absolute necessity to achieve high enough water solubility and concentration for diagnostic purposes. Finally a small Norwegian company, Nyegaard & Co., took up his idea 1968 and together they developed the essentially painless "low-osmolar" monomeric non-ionic metrizamide (Amipaque) released in 1974 and iohexol (Omipaque) in 1982 followed by the "iso-osmolar" dimeric non-ionic iodixanol (Visipaque) released in 1993. This has implied a profound paradigm shift with regard to reduction of both hypertonic and chemotoxic side effects, which have been a prerequisite for the today's widespread use of contrast medium-enhanced CT and advanced endovascular interventional techniques even in fragile patients. PMID:27225455

  18. Intravenous myocardial contrast echocardiography predicts regional and global left ventricular remodelling after acute myocardial infarction: comparison with low dose dobutamine stress echocardiography

    PubMed Central

    Abe, Y; Muro, T; Sakanoue, Y; Komatsu, R; Otsuka, M; Naruko, T; Itoh, A; Yoshiyama, M; Haze, K; Yoshikawa, J

    2005-01-01

    Objective: To assess the role of intravenous myocardial contrast echocardiography (MCE) in predicting functional recovery and regional or global left ventricular (LV) remodelling after acute myocardial infarction (AMI) compared with low dose dobutamine stress echocardiography (LDSE). Methods: 21 patients with anterior AMI and successful primary angioplasty underwent MCE and LDSE during the subacute stage (2–4 weeks after AMI). Myocardial perfusion and contractile reserve were assessed in each segment (12 segment model) with MCE and LDSE. The 118 dyssynergic segments in the subacute stage were classified as recovered, unchanged, or remodelled according to wall motion at six months’ follow up. Percentage increase in LV end diastolic volume (%ΔEDV) was also calculated. Results: The presence of perfusion was less accurate than the presence of contractile reserve in predicting regional recovery (55% v 81%, p < 0.0001). However, the absence of perfusion was more accurate than the absence of contractile reserve in predicting regional remodelling (83% v 48%, p < 0.0001). The number of segments without perfusion was an independent predictor of %ΔEDV, whereas the number of segments without contractile reserve was not. The area under the receiver operating characteristic curve showed that the number of segments without perfusion predicted substantial LV dilatation (%ΔEDV > 20%) more accurately than did the number of segments without contractile reserve (0.88 v 0.72). Conclusion: In successfully revascularised patients with AMI, myocardial perfusion assessed by MCE is predictive of regional and global LV remodelling rather than of functional recovery, whereas contractile reserve assessed by LDSE is predictive of functional recovery rather than of LV remodelling. PMID:15797931

  19. Successful transfemoral aortic Edwards(®) SAPIEN(®) bioprosthesis implantation without using iodinated contrast media in a woman with severe allergy to contrast agent.

    PubMed

    Leroux, Lionel; Dijos, Marina; Dos Santos, Pierre

    2013-12-01

    Severe anaphylactoid reaction after the use of iodinated contrast media are rare but can contraindicate the use of contrast agent. It was the case of a 53-year-old woman suffering from symptomatic severe aortic stenosis, recused for cardiac surgery because of deleterious effects of chest-wall irradiation, with porcelain aorta. We decided to implant a 23-mm Edwards(®) SAPIEN(®) transcatheter aortic valve via a femoral route without using any contrast media. The implantation was successful after surgical approach of the femoral artery, transesophageal echocardiography guiding, and localization of native leaflets and coronary trunk with catheters. Immediate and one month post-interventional follow-up was favorable and echocardiography showed a good functioning of the aortic bioprosthesis. Although conventional angiography is the best way to visualize the good positioning of the valve before deployment, our case suggests that, in special situations, transfemoral implantation of an Edwards(®) SAPIEN(®) aortic bioprosthesis is feasible without any contrast injection. PMID:23197475

  20. Taming the non-linearity problem in GPR full-waveform inversion for high contrast media

    NASA Astrophysics Data System (ADS)

    Meles, Giovanni; Greenhalgh, Stewart; van der Kruk, Jan; Green, Alan; Maurer, Hansruedi

    2012-03-01

    We present a new algorithm for the inversion of full-waveform ground-penetrating radar (GPR) data. It is designed to tame the non-linearity issue that afflicts inverse scattering problems, especially in high contrast media. We first investigate the limitations of current full-waveform time-domain inversion schemes for GPR data and then introduce a much-improved approach based on a combined frequency-time-domain analysis. We show by means of several synthetic tests and theoretical considerations that local minima trapping (common in full bandwidth time-domain inversion) can be avoided by starting the inversion with only the low frequency content of the data. Resolution associated with the high frequencies can then be achieved by progressively expanding to wider bandwidths as the iterations proceed. Although based on a frequency analysis of the data, the new method is entirely implemented by means of a time-domain forward solver, thus combining the benefits of both frequency-domain (low frequency inversion conveys stability and avoids convergence to a local minimum; whereas high frequency inversion conveys resolution) and time-domain methods (simplicity of interpretation and recognition of events; ready availability of FDTD simulation tools).

  1. Taming the non-linearity problem in GPR full-waveform inversion for high contrast media

    NASA Astrophysics Data System (ADS)

    Meles, Giovanni; Greenhalgh, Stewart; van der Kruk, Jan; Green, Alan; Maurer, Hansruedi

    2011-02-01

    We present a new algorithm for the inversion of full-waveform ground-penetrating radar (GPR) data. It is designed to tame the non-linearity issue that afflicts inverse scattering problems, especially in high contrast media. We first investigate the limitations of current full-waveform time-domain inversion schemes for GPR data and then introduce a much-improved approach based on a combined frequency-time-domain analysis. We show by means of several synthetic tests and theoretical considerations that local minima trapping (common in full bandwidth time-domain inversion) can be avoided by starting the inversion with only the low frequency content of the data. Resolution associated with the high frequencies can then be achieved by progressively expanding to wider bandwidths as the iterations proceed. Although based on a frequency analysis of the data, the new method is entirely implemented by means of a time-domain forward solver, thus combining the benefits of both frequency-domain (low frequency inversion conveys stability and avoids convergence to a local minimum; whereas high frequency inversion conveys resolution) and time-domain methods (simplicity of interpretation and recognition of events; ready availability of FDTD simulation tools).

  2. Contrast Media Viscosity versus Osmolality in Kidney Injury: Lessons from Animal Studies

    PubMed Central

    Seeliger, Erdmann; Lenhard, Diana C.; Persson, Pontus B.

    2014-01-01

    Iodinated contrast media (CM) can induce acute kidney injury (AKI). CM share common iodine-related cytotoxic features but differ considerably with regard to osmolality and viscosity. Meta-analyses of clinical trials generally failed to reveal renal safety differences of modern CM with regard to these physicochemical properties. While most trials' reliance on serum creatinine as outcome measure contributes to this lack of clinical evidence, it largely relies on the nature of prospective clinical trials: effective prophylaxis by ample hydration must be employed. In everyday life, patients are often not well hydrated; here we lack clinical data. However, preclinical studies that directly measured glomerular filtration rate, intrarenal perfusion and oxygenation, and various markers of AKI have shown that the viscosity of CM is of vast importance. In the renal tubules, CM become enriched, as water is reabsorbed, but CM are not. In consequence, tubular fluid viscosity increases exponentially. This hinders glomerular filtration and tubular flow and, thereby, prolongs intrarenal retention of cytotoxic CM. Renal cells become injured, which triggers hypoperfusion and hypoxia, finally leading to AKI. Comparisons between modern CM reveal that moderately elevated osmolality has a renoprotective effect, in particular, in the dehydrated state, because it prevents excessive tubular fluid viscosity. PMID:24707482

  3. Computed tomography and magnetic resonance imaging contrast media injectors: technical feature review - what is really needed?

    PubMed

    Friebe, Michael

    2016-01-01

    There has been little technical innovation over the last few years for contrast media (CM) injectors that are used for diagnostic imaging (computed tomography [CT], magnetic resonance imaging [MRI], and hybrid imaging systems, such as positron emission tomography-CT or magnetic resonance-positron emission tomography) examinations. The medical need of CM for the enhancement of diagnostic images has been around for a long time, but the application of the CM into the blood stream comes with potential medical complications for the patient and requires a lot of operator experience and training. Most power injector systems that are currently used can do significantly more than what is typically required; this complexity however, adds error potential and cost. This paper focuses on the main features that CM injector systems should have and highlights the technical developments that are useful to have but which add complexity and cost, increase setup time, and require intensive training for safe use. CM injection protocols are very different between CT and MRI, with CT requiring many more variances, has a need for multiphase protocols, and requires a higher timing accuracy. A CM injector used in the MRI suite, on the other-hand, could only need a relatively time insensitive injection with a standard injection flow rate and a volume that is dependent on the patients' weight. This would make easy and lightweight systems possible, which are able to safely and accurately perform the injection task, while allowing full MRI compatibility with relatively low cost investment and consumable costs. PMID:27486345

  4. Contrast venography of the leg: diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast media

    SciTech Connect

    Bettmann, M.A.; Robbins, A.; Braun, S.D.; Wetzner, S.; Dunnick, N.R.; Finkelstein, J.

    1987-10-01

    A prospective, three-center study of two contrast agents for leg venography was performed to evaluate both the relative frequency of adverse effects and whether low-osmolality agents provided significant advantages for this procedure. Fifty-four patients were studied with the standard preparation (iothalamate meglumine) and 57 with a nonionic agent (iopamidol). Both were used at an iodine concentration of 200 mg/mL, and there were no differences in volume of contrast material, duration of infusion, percentage of positive studies, or overall diagnostic adequacy. Patient discomfort was less with iopamidol than with iothalamate (18% vs. 44%), although discomfort was generally mild in both groups. By objective follow-up studies, the frequency of postvenographic thrombosis was not significantly different in the two groups (8% vs. 9%). Contrast venography, then, had a low frequency of complications when either a dilute conventional or a low-osmolality agent was employed. Although the frequency of postvenographic thrombosis was low with both agents, patient discomfort was less with the low-osmolality formulation.

  5. A multiscale restriction-smoothed basis method for high contrast porous media represented on unstructured grids

    NASA Astrophysics Data System (ADS)

    Møyner, Olav; Lie, Knut-Andreas

    2016-01-01

    A wide variety of multiscale methods have been proposed in the literature to reduce runtime and provide better scaling for the solution of Poisson-type equations modeling flow in porous media. We present a new multiscale restricted-smoothed basis (MsRSB) method that is designed to be applicable to both rectilinear grids and unstructured grids. Like many other multiscale methods, MsRSB relies on a coarse partition of the underlying fine grid and a set of local prolongation operators (multiscale basis functions) that map unknowns associated with the fine grid cells to unknowns associated with blocks in the coarse partition. These mappings are constructed by restricted smoothing: Starting from a constant, a localized iterative scheme is applied directly to the fine-scale discretization to compute prolongation operators that are consistent with the local properties of the differential operators. The resulting method has three main advantages: First of all, both the coarse and the fine grid can have general polyhedral geometry and unstructured topology. This means that partitions and good prolongation operators can easily be constructed for complex models involving high media contrasts and unstructured cell connections introduced by faults, pinch-outs, erosion, local grid refinement, etc. In particular, the coarse partition can be adapted to geological or flow-field properties represented on cells or faces to improve accuracy. Secondly, the method is accurate and robust when compared to existing multiscale methods and does not need expensive recomputation of local basis functions to account for transient behavior: Dynamic mobility changes are incorporated by continuing to iterate a few extra steps on existing basis functions. This way, the cost of updating the prolongation operators becomes proportional to the amount of change in fluid mobility and one reduces the need for expensive, tolerance-based updates. Finally, since the MsRSB method is formulated on top of a cell

  6. Intravenous Therapy.

    ERIC Educational Resources Information Center

    Galliart, Barbara

    Intended for teaching licensed practical nurses, this curriculum guide provides information related to the equipment and skills required for nursing care of patients needing intravenous (IV) therapy. It also explains the roles and responsibilities of the licensed practical nurse with regard to intravenous therapy. Each of the 15 instructional…

  7. CT Angiography of the Aorta: Prospective Evaluation of Individualized Low-Volume Contrast Media Protocols.

    PubMed

    Higashigaito, Kai; Schmid, Tabea; Puippe, Gilbert; Morsbach, Fabian; Lachat, Mario; Seifert, Burkhardt; Pfammatter, Thomas; Alkadhi, Hatem; Husarik, Daniela B

    2016-09-01

    Purpose To prospectively develop individualized low-volume contrast media (CM) protocols adapted to tube voltage in patients undergoing computed tomographic (CT) angiography of the aorta. Materials and Methods The study was approved by the institutional review board and local ethics committee. All patients provided written informed consent. CT angiography was performed by using automated attenuation-based tube voltage selection (ATVS) (range, 70-150 kVp; 10-kVp increments). Iodine attenuation curves from an ex vivo experiment in a phantom were used to design CM protocols for CT angiography of the thoracoabdominal aorta in 129 consecutive patients (hereafter, cohort A). Further modified CM protocols based on results in cohort A were designed with the aim of homogeneous vascular attenuation of 300-350 HU across tube voltages and were applied to another 61 consecutive patients (cohort B). Three independent blinded radiologists assessed subjective image quality, and one reader determined objective image quality. The Kruskal-Wallis test was performed to test for differences in subjective image quality, and linear regression was performed to test for differences in objective image quality between the automatically selected tube voltages. Results Experiments revealed tube voltage-dependent iodine attenuation curves, which were used to determine the CM protocols in cohort A; these ranged from 68 mL at 110 kVp to 45 mL at 80 kVp. In both cohorts, ATVS selected 80 kVp in 62 patients, 90 kVp in 84, 100 kVp in 33, and 110 kVp in 11. In cohort A, image quality that was satisfactory or better was attained in 126 (98%) of 129 patients who had no significant differences in subjective image quality between tube voltages (P = .106) but who did have significant differences in attenuation and contrast-to-noise ratio (CNR) (P < .001 for both). In cohort B, the further-modified CM protocol (from 33 mL at 80 kVp to 68 mL at 110 kVp) yielded image quality that was satisfactory or better

  8. Is Non-Contrast CT Adequate for the Evaluation of Hepatic Metastasis in Patients Who Cannot Receive Iodinated Contrast Media?

    PubMed Central

    Jee, Han Bum; Park, Min Jung; Lee, Hye Sun; Park, Mi-Suk; Kim, Myeong-Jin; Chung, Yong Eun

    2015-01-01

    Objective To evaluate the appropriateness of follow-up with only non-enhanced CT (NECT) in patients with gastrointestinal cancer. Subjects and Methods This retrospective study included 323 patients with colorectal and gastric cancer who underwent two consecutive CT examinations (CT1 and CT2), including non-contrast and portal venous phase CT images, with an interval of 1 year. Patients were divided into 2 groups: Group A included patients with no hepatic metastasis on CT1 and with or without newly developed metastasis on CT2 to evaluate the diagnostic performance of NECT for detecting newly developed hepatic metastasis; Group B included patients with known hepatic metastasis both on CT1 and CT2 to evaluate the accuracy of NECT for the assessment of hepatic metastasis based on RECIST criteria (version 1.1). Contrast-enhanced CT (CECT) images were considered as reference standards. Results Group A included 172 patients (M:F = 107:65; mean age, 62.6 years). Among them, 57 patients had 95 metastases (mean size, 2.2 ± 1.3 cm). Per patient and per lesion sensitivity for diagnosing newly developed hepatic metastasis was 56.1–66.7% and 52.6–56.8%, respectively. In terms of small metastases (<1.5 cm), per lesion sensitivity was significantly decreased to 28.1–34.4% (P < 0.05). Metastasis size measurements were significantly smaller on NECT (P < 0.001) compared with reference standards. In Group B, the accuracy of response evaluation based on RECIST criteria was 65.6–72.2%. Conclusions NECT showed inadequate diagnostic performances in both detecting newly developed hepatic metastasis and evaluating the response of hepatic metastasis based on RECIST criteria. PMID:26218533

  9. Current understanding of contrast media reactions and implications for clinical management.

    PubMed

    Meth, Marc J; Maibach, Howard I

    2006-01-01

    Iodinated contrast media (CM) are an integral part of modern diagnostic medicine. Although these agents are considered to be relatively safe, adverse effects in the form of allergy-like reactions occur in a significant number of exposed patients. These reactions may be divided into immediate and delayed responses. Immediate (within 1 hour of administration) anaphylactic reactions range from urticaria and angioedema to laryngeal oedema, hypotension and even death. Delayed reactions to CM occur from 1 hour to 1 week after administration and usually have mostly cutaneous manifestations. History of prior CM reactions and atopy predispose patients to CM reactions. Despite intense research into the pathogenesis of the immediate anaphylactoid responses, new evidence shows that true IgE type I hypersensitivity mediation occurs only in rare, severe cases. The aetiology appears to be multifactorial in most individuals. There is strong evidence to conclude that type IV hypersensitivity is responsible for the delayed reactions to CM. Although switching to non-ionic agents significantly reduces the incidence of immediate reactions to CM, there is little consensus regarding corticosteroid prophylaxis in high-risk individuals. Skin testing and provocative challenges also provide little security. Therefore, physicians must be better prepared to treat immediate anaphylactoid responses. Preventing delayed CM reactions is best performed with patch and delayed intradermal testing in those with a history of prior reactions, although false-negative results have been reported. Corticosteroids and antihistamines may be required for treatment. Until newer agents are developed that negate these issues, healthcare providers must strive to better understand the risk factors associated with CM reactions, as well as the available prophylactic and treatment options. PMID:16454540

  10. Sulfate-mediated electrooxidation of X-ray contrast media on boron-doped diamond anode.

    PubMed

    Radjenovic, Jelena; Petrovic, Mira

    2016-05-01

    Recently, electrochemical activation of sulfate ions to sulfate radical species and nonradically activated persulfate has been demonstrated at boron-doped diamond (BDD) anode, which enhanced the electrooxidation kinetics of several persistent contaminants. In this study, we investigated the transformation pathways of two X-ray contrast media (ICM), diatrizoate and iopromide, in electrooxidation at BDD anode using sulfate and inert nitrate anolyte. Sulfate anolyte yielded a seven-fold increase in apparent rate constants for ICM oxidation compared to inert nitrate anolyte, and a two-fold increase for the removal of organic carbon. Higher iodine release was observed in electrooxidation of diatrizoate compared to iopromide. In the case of diatrizoate, around 80% of deiodination efficiency was achieved in both anolytes. Deiodination efficiency of iopromide was somewhat lower in nitrate anolyte (≤75%) and significantly reduced in sulfate anolyte (≤46%) due to a larger steric hindrance of alkyl side chains. Moreover, a considerable lag phase of iopromide deiodination was observed in sulfate anolyte, indicating that initial oxidation reactions took place almost exclusively at the alkyl side chains. Several transformation products (TPs) of ICM were identified in electrooxidation in sulfate anolyte, and only three TPs in the case of nitrate anolyte. The main mechanistic steps in the oxidation of iopromide were H-abstraction and bond cleavage in the alkyl side chains. Diatrizoate was mainly transformed through oxidative cleavage of iodine substituent and inter-molecular cyclization. Two hydroxylamine derivatives of iopromide and a nitro-derivative of diatrizoate were observed in sulfate anolyte. These products have not been reported previously for hydroxyl radical-mediated oxidation of ICM. Given that electron-transfer mechanism is more typical for sulfate than for hydroxyl radicals, formation of hydroxylamine and nitro-derivatives of ICM was assigned to one

  11. ASCI 2010 contrast media guideline for cardiac imaging: a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group

    PubMed Central

    Kitagawa, Kakuya; Tsai, I-Chen; Chan, Carmen; Yu, Wei; Yong, Hwan Seok; Choi, Byoung Wook

    2010-01-01

    The use of contrast media for cardiac imaging becomes increasing as the widespread of cardiac CT and cardiac MR. A radiologist needs to carefully consider the indication and the injection protocol of contrast media to be used as well as the possibility of adverse effect. There are several guidelines for contrast media in western countries. However, these are focusing the adverse effect of contrast media. The Asian Society of Cardiovascular Imaging, the only society dedicated to cardiovascular imaging in Asia, formed a Working Group and created a guideline, which summarizes the integrated knowledge of contrast media for cardiac imaging. In cardiac imaging, coronary artery evaluation is feasible by non-contrast MR angiography, which can be an alternative examination in high risk patients for the use of iodine contrast media. Furthermore, the body habitus of Asian patients is usually smaller than that of their western counterparts. This necessitates modifications in the injection protocol and in the formula for calculation of estimated glomerular filtration rate. This guideline provided fundamental information for the use of contrast media for Asian patients in cardiac imaging. PMID:20931289

  12. Intravenous conivaptan.

    PubMed

    Moen, Marit D; Keating, Gillian M

    2008-01-01

    *Conivaptan is an arginine vasopressin V1A and V2 receptor antagonist. The intravenous formulation is approved in the US for use in the treatment of euvolemic and hypervolemic hyponatremia. Conivaptan produces a dose-dependent electrolyte-sparing aquaresis (solute-free water excretion), increasing serum sodium levels. *In a randomized, double-blind, parallel-group, placebo-controlled, multicenter trial in adults with euvolemic or hypervolemic hyponatremia, the area under the serum sodium concentration-time curve over a 4-day treatment duration (primary endpoint) was significantly greater in intravenous conivaptan 40 mg/day recipients than in placebo recipients. *The total time during treatment that patients had serum sodium levels > or = 4 mEq/L above baseline was significantly longer in intravenous conivaptan than placebo recipients. In conivaptan recipients, an increase in serum sodium levels of > or = 4 mEq/L above baseline was achieved approximately 1 day after the first dose of the drug. *In addition, the mean change from baseline in free water clearance and effective water clearance over the first day of treatment was significantly greater with intravenous conivaptan than with placebo. *Given the nature of the treatment, the tolerability profile for intravenous conivaptan was generally acceptable in patients with hyponatremia. The most common adverse events were injection related (e.g. injection-site phlebitis), hypotension, and pyrexia. PMID:18828645

  13. Usage of CO2 microbubbles as flow-tracing contrast media in X-ray dynamic imaging of blood flows.

    PubMed

    Lee, Sang Joon; Park, Han Wook; Jung, Sung Yong

    2014-09-01

    X-ray imaging techniques have been employed to visualize various biofluid flow phenomena in a non-destructive manner. X-ray particle image velocimetry (PIV) was developed to measure velocity fields of blood flows to obtain hemodynamic information. A time-resolved X-ray PIV technique that is capable of measuring the velocity fields of blood flows under real physiological conditions was recently developed. However, technical limitations still remained in the measurement of blood flows with high image contrast and sufficient biocapability. In this study, CO2 microbubbles as flow-tracing contrast media for X-ray PIV measurements of biofluid flows was developed. Human serum albumin and CO2 gas were mechanically agitated to fabricate CO2 microbubbles. The optimal fabricating conditions of CO2 microbubbles were found by comparing the size and amount of microbubbles fabricated under various operating conditions. The average size and quantity of CO2 microbubbles were measured by using a synchrotron X-ray imaging technique with a high spatial resolution. The quantity and size of the fabricated microbubbles decrease with increasing speed and operation time of the mechanical agitation. The feasibility of CO2 microbubbles as a flow-tracing contrast media was checked for a 40% hematocrit blood flow. Particle images of the blood flow were consecutively captured by the time-resolved X-ray PIV system to obtain velocity field information of the flow. The experimental results were compared with a theoretically amassed velocity profile. Results show that the CO2 microbubbles can be used as effective flow-tracing contrast media in X-ray PIV experiments. PMID:25178007

  14. On the differences between the BaSO4 particles and additives in media for the double contrast examination of the stomach.

    PubMed

    Virkkunen, P; Lounatmaa, K

    1980-11-01

    Sizes and shapes of the particles in double contrast media for the stomach have been studied with scanning electron microscope. EZ-HD deviated most from the other media because of its large particles (even 70 micrometers in diameter) which were also variable in shape. The additives soluble in water or methanol raise the viscosity of the media considerably (with the exception of EZ-HD) thus lowering their greatest possible densities. The observations explain the differences in the results obtained with patients in clinical examinations with various contrast media. PMID:6456201

  15. Contrast studies.

    PubMed

    Anderson, Susan M

    2006-01-01

    Contrast media plays an important role in imaging soft tissues and organs. Though contrast imaging is considered safe, radiologic technologists can improve the safety of contrast examinations by reviewing institutional safety procedures, safe practices for different methods of contrast administration and possible complications. The need for efficient communication and attention to detail during contrast procedures is essential for patient safety. PMID:16998193

  16. Image contrast enhancement in angular domain optical imaging of turbid media.

    PubMed

    Vasefi, Fartash; Kaminska, Bozena; Chapman, Glenn H; Carson, Jeffrey J L

    2008-12-22

    Imaging structures within a turbid medium using Angular Domain Imaging (ADI) employs an angular filter array to separate weakly scattered photons from those that are highly scattered. At high scattering coefficients, ADI contrast declines due to the large fraction of non-uniform background scattered light still within the acceptance angle. This paper demonstrates various methods to enhance the image contrast in ADI. Experiments where a wedge prism was used to deviate the laser source so that scattered photons could be imaged and subtracted from the image obtained by standard ADI provided the greatest improvement in image contrast. PMID:19104579

  17. [Contrast media: present status and future of their production and use].

    PubMed

    Tsyb, A F; Sergeev, P V; Amosov, I S; Nikitina, R G; Shanazarov, K S; Shimanovskiĭ, N L; Degtiarev, V A

    1989-01-01

    Analysis of the problems involving the design and application of Soviet-made radiocontrast agents showed that the synthesis of such drugs as Iodamid, Triombrast, Etiotrast, Bilimin, and Bilignost in this country made it possible to eliminate the arrears in this field. Together with the elaboration of topics concerning the pharmacokinetics and adverse effects of the above contrast agents, this helped to create a sound scientific base for further work on the unsolved problems, primarily, (1) to synthesize Soviet non-ionogenic radiocontrast agents; (2) to prepare and introduce Soviet ultrasonographic contrast agents into practice; (3) to prepare and introduce magnetic resonance contrast ones into practice; and (4) to introduce unique radiocontrast agents such as triombrast as oil emulsion, oleoferrotrast, fine-dispersion barium sulphate, and chromoetiotrast into clinical practice and to set up their production. PMID:2683464

  18. Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media.

    PubMed

    Della-Torre, E; Berti, A; Yacoub, M R; Guglielmi, B; Tombetti, E; Sabbadini, M G; Voltolini, S; Colombo, G

    2015-05-01

    The purpose of the present work is to evaluate the efficacy of an approach that combines clinical history, skin tests results, and premedication, in preventing recurrent hypersensitivity reactions to iodinated contrast media (ICM). Skin Prick tests, Intradermal tests, and Patch tests were performed in 36 patients with a previous reaction to ICM. All patients underwent a second contrast enhanced radiological procedure with an alternative ICM selected on the basis of the proposed approach. After alternative ICM re-injection, only one patient presented a mild NIR. The proposed algorithm, validated in clinical settings where repeated radiological exams are needed, offers a safe and practical approach for protecting patients from recurrent hypersensitivity reactions to ICM. PMID:25951145

  19. An update on clinical applications of hepatospecific contrast media in magnetic resonance imaging of liver parenchyma.

    PubMed

    Giuga, M; De Gaetano, A M; Guerra, A; Infante, A; Iezzi, R; Spinelli, I; Siciliano, M; Grieco, A; Rapaccini, G L; Gasbarrini, A; Pompili, M; Bonomo, L

    2016-06-01

    Hepatobiliary-specific contrast agents are now widely used in magnetic resonance imaging (MRI) of liver parenchyma. As extracellular fluid agents, they provide informations regarding lesion vascularity and their use in the hepatobiliary or delayed phase (DPI), and give additional data regarding hepatocyte presence and function. The aim of this article is to review the recent literature about MRI using hepatobiliary-specific contrast agents and to discuss benefits and limits of their clinical applications. Since November 2008, hepatobiliary contrast agents were routinely employed in our Institution for the characterization of equivocal liver lesions detected by other imaging modalities, and for the evaluation of hepatic nodules in liver cirrhosis. The informations provided are particularly relevant for the detection of metastases, for the differentiation between focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA), and for the detection and differentiation between dysplastic nodules (DNs) and hepatocellular carcinoma (HCC) in the cirrhotic liver. The role in the cirrhosis grading and the quantification of liver function is still controversial. Finally, their biliary excretion allows evaluation of anatomy and function of the biliary tree. According to our and reported data, hepatobiliary contrast agents are able to improve liver lesions detection and characterization; their introduction in clinical practice has improved MRI diagnostic efficacy/accuracy, allowing to decrease the number of invasive diagnostic procedures. PMID:27383300

  20. A monte carlo comparison of three different media for contrast enhanced radiotherapy of the prostate.

    PubMed

    Garnica-Garza, H M

    2010-06-01

    Contrast-enhanced radiotherapy makes use of a kilovoltage X-ray beam, either from a diagnostic X-ray tube or modified megavoltage linear accelerator, in conjunction with a high-Z contrast medium deposited into the target volume to enhance the absorption of radiation. In this work, using the Monte Carlo code PENELOPE and the voxelized Zubal phantom to model a prostate radiotherapy treatment, a comparison between the physical absorbed dose distributions rendered by three different enhancing agents namely bismuth, gadolinium, and iodine is performed. It is assumed that there exists a concentration of 10 mg of enhancing agent per 1 g of tissue in the target volume while in the background a concentration of 1.5 mg per 1 g of tissue is present. The X-ray beam energy spectrum was obtained by means of Monte Carlo simulation of a tungsten target upon which a 220 keV mono-energetic electron pencil beam is made to impinge, and the resultant photon beam is heavily filtrated by 0.2 cm of copper. The treatment delivery is simulated as a 3608 arc collimated to conform to the target from every direction. Cumulative dose-volume histograms and isodose curves are presented for the target as well as five organs-at-risk, namely rectal wall, bladder, femoral heads, skin, and bone marrow. It is shown that under these conditions clinically acceptable treatment plans are obtained for all three contrast agents. A 72 Gy dose to 100% of the target volume results in maximum absorbed doses to the above mentioned organs-at-risk of 65, 56, 44, 32 and 65 Gy respectively when bismuth is used as the contrast agent, but the results obtained with gadolinium follow closely. PMID:20441237

  1. Interactive neonatal gastrointestinal magnetic resonance imaging using fruit juice as an oral contrast media

    PubMed Central

    2014-01-01

    Background The objective was to evaluate the use of fruit juice with an interactive inversion recovery (IR) MR pulse sequence to visualise the gastrointestinal tract. Methods We investigated the relaxation properties of 12 different natural fruit juices in vitro, to identify which could be used as oral contrast. We then describe our initial experience using an interactive MR pulse sequence to allow optimal visualisation after administering pineapple juice orally, and suppressing pre-existing bowel fluid contents, with variable TI in three adult and one child volunteer. Results Pineapple juice (PJ) had both the shortest T1 (243 ms) and shortest T2 (48 ms) of the fruit juices tested. Optimal signal differentiation between pre-existing bowel contents and oral PJ administration was obtained with TIs of between 900 and 1100 ms. Conclusion The use of an inversion recovery preparation allowed long T1 pre-existing bowel contents to be suppressed whilst the short T1 of fruit juice acts as a positive contrast medium. Pineapple juice could be used as oral contrast agent for neonatal gastrointestinal magnetic resonance imaging. PMID:25245815

  2. Enhanced K-edge plasma angiography achieved with tungsten Kα rays utilizing gadolinium-based contrast media

    NASA Astrophysics Data System (ADS)

    Sato, Eiichi; Hayasi, Yasuomi; Germer, Rudolf; Kimura, Koji; Tanaka, Etsuro; Mori, Hidezo; Kawai, Toshiaki; Inoue, Takashi; Ogawa, Akira; Sato, Shigehiro; Takayama, Kazuyoshi; Ido, Hideaki

    2005-08-01

    The tungsten plasma flash x-ray generator is useful in order to perform high-speed enhanced K-edge angiography using cone beams because Kα rays from the tungsten target are absorbed effectively by gadolinium-based contrast media. In the flash x-ray generator, a 150 nF condenser is charged up to 80 kV by a power supply, and flash x-rays are produced by the discharging. The x-ray tube is a demountable diode, and the turbomolecular pump evacuates air from the tube with a pressure of approximately 1 mPa. Since the electric circuit of the high-voltage pulse generator employs a cable transmission line, the high-voltage pulse generator produces twice the potential of the condenser charging voltage. At a charging voltage of 80 kV, the estimated maximum tube voltage and current were approximately 160 kV and 40 kA, respectively. When the charging voltage was increased, the characteristic x-ray intensities of tungsten Kα lines increased. Using an ytterbium oxide filter, the Kα lines were clean, and hardly any Kβ lines and bremsstrahlung rays were detected. The x-ray pulse widths were approximately 60 ns, and the time-integrated x-ray intensity had a value of approximately 50 μGy at 1.0 m from the x-ray source with a charging voltage of 80 kV. Angiography was performed using a film-less computed radiography system and gadolinium-based contrast media. In angiography of non-living animals, we observed fine blood vessels of approximately 100 μm with high contrasts.

  3. K-edge angiography utilizing a tungsten plasma X-ray generator in conjunction with gadolinium-based contrast media

    NASA Astrophysics Data System (ADS)

    Sato, Eiichi; Hayasi, Yasuomi; Tanaka, Etsuro; Mori, Hidezo; Kawai, Toshiaki; Inoue, Takashi; Ogawa, Akira; Sato, Shigehiro; Takayama, Kazuyoshi; Onagawa, Jun; Ido, Hideaki

    2006-11-01

    The tungsten plasma flash X-ray generator is useful in order to perform high-speed enhanced K-edge angiography using cone beams because K-series characteristic X-rays from the tungsten target are absorbed effectively by gadolinium-based contrast media. In the flash X-ray generator, a 150 nF condenser is charged up to 80 kV by a power supply, and flash X-rays are produced by the discharging. The X-ray tube is a demountable diode, and the turbomolecular pump evacuates air from the tube with a pressure of approximately 1 mPa. Since the electric circuit of the high-voltage pulse generator employs a cable transmission line, the high-voltage pulse generator produces twice the potential of the condenser charging voltage. At a charging voltage of 80 kV, the estimated maximum tube voltage and current were approximately 160 kV and 40 kA, respectively. When the charging voltage was increased, the characteristic X-ray intensities of tungsten K α lines increased. The K α lines were clean, and hardly any bremsstrahlung rays were detected. The X-ray pulse widths were approximately 110 ns, and the time-integrated X-ray intensity had a value of approximately 0.35 mGy at 1.0 m from the X-ray source with a charging voltage of 80 kV. Angiography was performed using a film-less computed radiography (CR) system and gadolinium-based contrast media. In angiography of non-living animals, we observed fine blood vessels of approximately 100 μm with high contrasts.

  4. Enhanced K-edge Angiography Utilizing Tantalum Plasma X-ray Generator in Conjunction with Gadolinium-Based Contrast Media

    NASA Astrophysics Data System (ADS)

    Sato, Eiichi; Hayasi, Yasuomi; Kimura, Koji; Tanaka, Etsuro; Mori, Hidezo; Kawai, Toshiaki; Inoue, Takashi; Ogawa, Akira; Sato, Shigehiro; Takayama, Kazuyoshi; Onagawa, Jun; Ido, Hideaki

    2005-12-01

    The tantalum plasma flash X-ray generator is useful for performing high-speed enhanced K-edge angiography using cone beams because K-series characteristic X-rays from the tantalum target are absorbed effectively by gadolinium-based contrast media. In the flash X-ray generator, a 150 nF condenser is charged up to 80 kV by a power supply, and flash X-rays are produced by the discharging. The X-ray tube is a demountable cold-cathode diode, and the turbomolecular pump evacuates air from the tube with a pressure of approximately 1 mPa. Since the electric circuit of the high-voltage pulse generator employs a cable transmission line, the high-voltage pulse generator produces twice the potential of the condenser charging voltage. At a charging voltage of 80 kV, the estimated maximum tube voltage and current were approximately 160 kV and 40 kA, respectively. When the charging voltage was increased, the K-series characteristic X-ray intensities of cerium increased. The K lines were clean and intense, and hardly any bremsstrahlung rays were detected. The X-ray pulse widths were approximately 100 ns, and the time-integrated X-ray intensity had a value of approximately 300 μGy at 1.0 m from the X-ray source with a charging voltage of 80 kV. Angiography was performed using a filmless computed radiography (CR) system and gadolinium-based contrast media. In the angiography of nonliving animals, we observed fine blood vessels of approximately 100 μm with high contrasts.

  5. Imaging single metal nanoparticles in scattering media by photothermal interference contrast

    NASA Astrophysics Data System (ADS)

    Boyer, David; Tamarat, Philippe; Maali, Abdelhamid; Orrit, Michel; Lounis, Brahim

    2003-04-01

    We have developed a photothermal method for far-field optical detection of nanometer-sized metal particles, combining high-frequency modulation and polarization interference contrast. We can image gold colloids down to 5 nm in diameter, with a signal-to-noise ratio higher than 10. This is a considerable improvement over commonly used optical methods based on resonance plasmon scattering which, for background reasons, are limited to particles of more than about 40 nm in diameter. By adding 300 nm latex spheres in the sample, we also show that in addition to its intrinsic sensitivity, our photothermal method is totally insensitive to non-absorbing scatterers.

  6. Strategies for the prevention of asthmatic, anaphylactic and anaphylactoid reactions during the administration of anesthetics and/or contrast media.

    PubMed

    Liccardi, G; Lobefalo, G; Di Florio, E; Di Iorio, C; Occhiochiuso, L; Romano, L; Savoia, G; Massa, R M; D'Amato, G

    2008-01-01

    General anesthetics and contrast media can cause anaphylactic as well as anaphylactoid reactions. These events are of great concern to radiologists and anesthesiologists because of their relatively high prevalence, possible threat to life, and medical-legal consequences. Points discussed in this review are the critical evaluation of risk factors affecting prevention strategies, the need to be aware of pathogenic mechanisms relevant to prevention strategies, the use of alternative products if a culprit agent is known, the recognition of early signs of a reaction, the need to keep records of reactions on a patient's medical chart, the planning of prophylactic therapy, recommended actions after a reaction to an anesthetic or contrast medium, and the suggested establishment of allergy-anesthesiology centers to improve cooperation, and medical-legal issues. As any drug or contrast medium administered during general anesthesia or a diagnostic procedure can induce a potentially life-threatening or fatal event even in the absence of any evident risk factor in the patient's medical history or clinical status, we usually premedicate susceptible individuals at least to attenuate the severity of an unpredictable reaction, although we cannot rely on the efficacy of premedication to completely prevent a severe event. These recommendations, which are based on the literature and on the experience of our working group, aim to provide useful information for physicians and other specialists who operate in the absence of an allergy consultant. PMID:18361095

  7. Successful balloon pulmonary angioplasty with gadolinium contrast media for a patient with chronic thromboembolic pulmonary hypertension and iodine allergy

    PubMed Central

    Nakamura, Tomohisa; Ogo, Takeshi; Tsuji, Akihiro; Fukui, Shigefumi; Fukuda, Tetsuya; Tahara, Nobuhiro; Fukumoto, Yoshihiro; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi

    2016-01-01

    A 28-year-old male was referred to our hospital with dyspnea. He was diagnosed as having chronic thromboembolic pulmonary hypertension, and a pulmonary endarterectomy (PEA) was performed. However, exertional dyspnea remained because of residual pulmonary hypertension; therefore, the patient was re-admitted to our hospital 1 year after PEA. We performed computed tomography and pulmonary angiography and found web and band lesions in the distal pulmonary artery with a high pulmonary artery pressure. Although further management was complicated because the patient had an anaphylactic shock to iodine-based contrast media, we eventually completed five sessions of balloon pulmonary angioplasty (BPA) using gadolinium contrast medium. His symptoms and hemodynamics dramatically improved after a series of BPA. After 15 months, mean pulmonary arterial pressure reduced from 67 mmHg to 20 mmHg, and subjective symptoms improved from stage Ⅳ to I as per the WHO classification system. BPA is a potential procedure for residual pulmonary hypertension after PEA and could be safely performed using gadolinium contrast medium for patients with iodine allergy. PMID:27141436

  8. Superparamagnetic iron oxide nanoparticles for MRI: contrast media pharmaceutical company R&D perspective.

    PubMed

    Corot, Claire; Warlin, David

    2013-01-01

    Superparamagnetic iron oxide (SPIO) nanoparticles are a relatively large class of contrast agents for magnetic resonance imaging. According to their biodistribution, distinct classes of SPIO nanoparticles have been investigated for clinical applications either as macrophage imaging agents or blood pool agents. Contrast agents which are pharmaceutics followed the same development rules as therapeutic drugs. Several drawbacks such as clinical development difficulties, organization of market access and imaging technological developments have limited the widespread use of these products. SPIO nanoparticles that are composed of thousands iron atoms providing large T2* effects are particularly suitable for theranostic. Stem cell migration and immune cell trafficking, as well as targeted SPIO nanoparticles for molecular imaging studies are mainly at the stage of proof of concept. A major economic challenge in the development of molecular imaging associated with a therapeutic treatment/procedure is to define innovative business models compatible with the needs of all players taking into account that theranostic solutions are promising to optimize resource allocation and ensure that expensive treatments are prescribed to responding patients. PMID:23633290

  9. Photonic crystal slab waveguides in moderate index contrast media: Generalized transverse Bragg waveguides

    NASA Astrophysics Data System (ADS)

    Burckel, David Bruce

    One of the anticipated advantages of photonic crystal waveguides is the ability to tune waveguide dispersion and propagation characteristics to achieve desired properties. The majority of research into photonic crystal waveguides centers around high index contrast photonic crystal waveguides with complete in-plane bandgaps in the photonic crystal cladding. This work focuses on linear photonic crystal waveguides in moderate index materials, with insufficient index contrast to guarantee a complete in-plane bandgap. Using a technique called Interferometric Lithography (IL) as well as standard semiconductor processing steps, a process flow for creating large area (˜cm 2), linear photonic crystal waveguides in a spin-deposited photocurable polymer is outlined. The study of such low index contrast photonic crystal waveguides offers a unique opportunity to explore the mechanisms governing waveguide confinement and photonic crystal behavior in general. Results from two optical characterization experiments are provided. In the first set of experiments, rhodamine 590 organic laser dye was incorporated into the polymer prior to fabrication of the photonic crystal slab. Emission spectra from waveguide core modes exhibit no obvious spectral selectivity owing to variation in the periodicity or geometry of the photonic crystal. In addition, grating coupled waveguides were fabricated, and a single frequency diode laser was coupled into the waveguide in order to study the transverse mode structure. To this author's knowledge, the optical mode profile images are the first taken of photonic crystal slab waveguides, exhibiting both simple low order mode structure as well as complex high order mode structure inconsistent with effective index theory. However, no obvious correlation between the mode structure and photonic crystal period or geometry was evident. Furthermore, in both the laser dye-doped and grating coupled waveguides, low loss waveguiding was observed regardless of

  10. Quantitative measurements of injections into porous media with contrast based MRI

    NASA Astrophysics Data System (ADS)

    Paulsen, J. L.; Donaldson, M. H.; Betancourt, S. S.; Song, Y.-Q.

    2011-09-01

    Porous flow occurs in a wide range of materials and applies to many commercially relevant applications such as oil recovery, chemical reactors and contaminant transport in soils. Typically, breakthrough and pressure curves of column floods are used in the laboratory characterization of these materials. These characterization methods lack the detail to easily and unambiguously resolve flow mechanisms with similar effects at the core scale that can dominate at the aquifer or oil field scale, as well as the effects of geometry that control the flow at interfaces as in a perforated well or the inlet of an improperly designed column. Non-invasive imaging techniques such as MRI have been shown to provide a far more detailed characterization of the properties of the solid matrix and flow, but usually focus on the intrinsic flow properties of porous media or matching a numerical model to a complex flow system. We show that these MRI techniques, utilizing paramagnetic tagging in combination with a carefully controlled and ideal flow system, can quantitatively characterize the effects of geometry and intrinsic flow properties for a point injection into a core. The use of a carefully controlled and 'idealized' system is essential to be able to isolate and match predicted effects from geometry and extract subtle flow processes omitted in the model that would be hidden in a more heterogeneous system. This approach provides not only a tool to understand the behavior of intentional boundary effects, but also one to diagnose the unintentional ones that often degrade the data from routine column flood measurements.

  11. Effects of Contrast Media on Blood Rheology: Comparison in Humans, Pigs, and Sheep

    SciTech Connect

    Laurent, Alexandre; Durussel, Jean Jacques; Dufaux, Jacques; Penhouet, Laurence; Bailly, Anne Laure; Bonneau, Michel

    1999-01-15

    Purpose: To compare whole blood viscosity and erythrocyte aggregation in humans, pigs, and sheep, before and after adding water-soluble iodinated contrast medium (CM). Methods: Two CMs were studied: iopromide (nonionic) and ioxaglate (ionic). The blood-CM viscosity was measured with a Couette viscometer. Erythrocyte aggregation was measured with an erythroaggregometer. Results: The blood-CM viscosity was increased up to +20% (relative to pure blood) with a CM concentration of 0%-10%. At CM concentrations from 10% to 50%, the viscosity decreased. The disaggregation shear stress was increased (relative to pure blood) at low CM concentration (0%-10%). When the CM concentration increased from 10% to 20%, the disaggregation shear stress was decreased, except with the pig blood-ioxaglate mixture. Conclusion: At low CM concentration the blood viscosity was increased in pig, sheep, and humans and the disaggregation shear stress was increased in pig and humans. The aggregation of sheep blood was too low to be detected by the erythroaggregometer. This rise can be explained by the formation of poorly deformable echinocytes. At higher CM concentration, the viscosity and the disaggregation shear stress decreased in relation to the blood dilution. We conclude that pig blood and sheep blood can both be used to study the effect of CM injection on blood viscosity. Nevertheless, the rheologic behavior of pig blood in terms of erythrocyte aggregation is closer to that of human blood than is sheep blood when mixed with CM. Pigs could thus be more suitable than sheep for in vivo studies of CM miscibility with blood during selective cannulation procedures.

  12. Intravenous low-grade endometrial stromal sarcoma with intracardiac extension: A CASE OF inaccurate tumor location on contrast-enhanced computed tomography

    PubMed Central

    NOGAMI, YUYA; YAMAGAMI, WATARU; MAKI, JUNKO; BANNO, KOUJI; SUSUMU, NOBUYUKI; TOMITA, KOICHI; MATSUBARA, KENTARO; OBARA, HIDEAKI; KITAGAWA, YUKO; AOKI, DAISUKE

    2016-01-01

    We herein report a case of low-grade endometrial stromal sarcoma with intracardiac extension in a 58-year-old woman with a uterine tumor with intravascular involvement. The tumor was suspected preoperatively to be an endometrial stromal sarcoma by magnetic resonance imaging. The extent of intravascular involvement was determined to be below the level of the renal veins on preoperative contrast-enhanced computed tomography (CT). However, perioperative echography revealed that the tumor extended to the right atrium. An emergency cardiotomy with extracorporeal circulation was required. The risk of tumor embolism was reduced through transection of the inferior vena cava, but the tumor was difficult to remove completely. Postoperative hormonal therapy reduced the size of the residual tumor and no recurrence was detected for 1 year. The preoperative contrast-enhanced CT was unable to detect the free-floating intravascular tumor. This case illustrates a limitation of CT and indicates that accurate determination of the tumor extent for planning a surgical strategy in similar cases should be performed using multiple imaging methods. PMID:26893856

  13. In vitro assessment of the antibiotic efficacy of contrast media and antibiotics and their combinations at various dilutions.

    PubMed

    Langer, R D; Usmani, A; van Gorkom, K N; Lorke, D E; Petroianu, G; Azimullah, S; Nurulain, S M

    2010-05-01

    Discography is a controversial diagnostic procedure involving the injection of radiographic contrast medium (RCM) into the intervertebral disc. Iatrogenic bacterial discitis is a rare but serious complication. The intervention has been increasingly performed in our patients here in the United Arab Emirates. Prophylactic intravenous antibiotic administration can reduce post-interventional discitis; however, this may favour the development of bacterial resistance. Direct intradiscal injection of an antibiotic together with the RCM is a potential alternative. To date, there has been only one study on the efficacy of antibiotics added to an RCM. Equally, there are only limited data regarding the potential direct effect of RCM on bacterial growth. The purpose of this study was to determine whether the efficacy of antibiotics is affected when RCM are added. In an in vitro study, the effect of non-ionic RCM on the growth of five laboratory bacterial strains, alone and in combination with three broad-spectrum antimicrobials, was tested. Bacterial growth was assessed in the absence and the presence of RCM, antibiotics and their combinations. All three RCM alone demonstrated some inhibition of bacterial growth at high concentrations. In the presence of the RCM, all three antibiotics retained their inhibitory effect on bacterial growth. In conclusion, our in vitro experiments did not reveal any changes in the antimicrobial efficacy of the three antibiotics in the presence of the three tested RCM. Subsequent clinical trials will need to assess whether intradiscal antibiotic administration may be a suitable substitute for, or a supplement to, prophylactic systemic antibiotics before discography. PMID:19690074

  14. Iodinated contrast media cause direct tubular cell damage, leading to oxidative stress, low nitric oxide, and impairment of tubuloglomerular feedback

    PubMed Central

    Liu, Zhi Zhao; Schmerbach, Kristin; Lu, Yuan; Perlewitz, Andrea; Nikitina, Tatiana; Cantow, Kathleen; Seeliger, Erdmann; Persson, Pontus B.; Liu, Ruisheng; Sendeski, Mauricio M.

    2014-01-01

    Iodinated contrast media (CM) have adverse effects that may result in contrast-induced acute kidney injury. Oxidative stress is believed to play a role in CM-induced kidney injury. We test the hypothesis that oxidative stress and reduced nitric oxide in tubules are consequences of CM-induced direct cell damage and that increased local oxidative stress may increase tubuloglomerular feedback. Rat thick ascending limbs (TAL) were isolated and perfused. Superoxide and nitric oxide were quantified using fluorescence techniques. Cell death rate was estimated using propidium iodide and trypan blue. The function of macula densa and tubuloglomerular feedback responsiveness were measured in isolated, perfused juxtaglomerular apparatuses (JGA) of rabbits. The expression of genes related to oxidative stress and the activity of superoxide dismutase (SOD) were investigated in the renal medulla of rats that received CM. CM increased superoxide concentration and reduced nitric oxide bioavailability in TAL. Propidium iodide fluorescence and trypan blue uptake increased more in CM-perfused TAL than in controls, indicating increased rate of cell death. There were no marked acute changes in the expression of genes related to oxidative stress in medullary segments of Henle's loop. SOD activity did not differ between CM and control groups. The tubuloglomerular feedback in isolated JGA was increased by CM. Tubular cell damage and accompanying oxidative stress in our model are consequences of CM-induced direct cell damage, which also modifies the tubulovascular interaction at the macula densa, and may therefore contribute to disturbances of renal perfusion and filtration. PMID:24431205

  15. Borate complexes of x-ray iodinated contrast agents: characterization and sorption studies for their removal from aqueous media.

    PubMed

    Rustighi, Isabella; Donati, Ivan; Ferluga, Matteo; Campa, Cristiana; Pasqua, Adele E; Rossi, Marco; Paoletti, Sergio

    2012-02-29

    Iodinated contrast media (ICM) are persistent and ubiquitous water pollutants. Because of their high water solubility and biochemical stability, their phase-separation and recovery from the aquatic environment is very difficult. Here, borate was chosen as a complexing agent of the two diagnostic aids iomeprol and iopamidol in order to provide them with a negative charge and to fix the resulting adducts on Dowex 1X4 ion exchangers. A systematic characterization study of the complex by means of capillary zone electrophoresis and 11B NMR revealed that iomeprol and iopamidol interact with borate anions in aqueous solutions giving a 1:1 single-charged adduct and that the association constant at 25 °C for both contrast agents is highest at pH 10.5. These findings allowed the proper calibration of experimental parameters for further batch adsorption-desorption trials, where the two ICM were shown to be almost completely removed from the water phase and released from the solid sorbents in mild conditions, enabling the recovery of functional resin. PMID:22245510

  16. Assessment of DNA double-strand breaks induced by intravascular iodinated contrast media following in vitro irradiation and in vivo, during paediatric cardiac catheterization.

    PubMed

    Gould, Richard; McFadden, Sonyia L; Horn, Simon; Prise, Kevin M; Doyle, Philip; Hughes, Ciara M

    2016-01-01

    Paediatric cardiac catheterizations may result in the administration of substantial amounts of iodinated contrast media and ionizing radiation. The aim of this work was to investigate the effect of iodinated contrast media in combination with in vitro and in vivo X-ray radiation on lymphocyte DNA. Six concentrations of iodine (15, 17.5, 30, 35, 45, and 52.5 mg of iodine per mL blood) represented volumes of iodinated contrast media used in the clinical setting. Blood obtained from healthy volunteers was mixed with iodinated contrast media and exposed to radiation doses commonly used in paediatric cardiac catheterizations (0 mGy, 70 mGy, 140 mGy, 250 mGy and 450 mGy). Control samples contained no iodine. For in vivo experimentation, pre and post blood samples were collected from children undergoing cardiac catheterization, receiving iodine concentrations of up to 51 mg of iodine per mL blood and radiation doses of up to 400 mGy. Fluorescence microscopy was performed to assess γH2AX-foci induction, which corresponded to the number of DNA double-strand breaks. The presence of iodine in vitro resulted in significant increases of DNA double-strand breaks beyond that induced by radiation for ≥ 17.5 mg/mL iodine to blood. The in vivo effects of contrast media on children undergoing cardiac catheterization resulted in a 19% increase in DNA double-strand breaks in children receiving an average concentration of 19 mg/mL iodine to blood. A larger investigation is required to provide further information of the potential benefit of lowering the amount of iodinated contrast media received during X-ray radiation investigations. PMID:26549792

  17. Media.

    ERIC Educational Resources Information Center

    Allen, Lee E., Ed.

    1974-01-01

    Intended for secondary English teachers, the materials and ideas presented here suggest ways to use media in the classroom in teaching visual and auditory discrimination while enlivening classes and motivating students. Contents include "Media Specialists Need Not Apply," which discusses the need for preparation of media educators with…

  18. Successful stent implantation guided by intravascular ultrasound and a Doppler guidewire without contrast injection in a patient with allergy to iodinated contrast media.

    PubMed

    Okura, Hiroyuki; Nezuo, Shintaro; Yoshida, Kiyoshi

    2011-07-01

    Presence of allergy to iodinated contrast may prevent percutaneous coronary intervention (PCI) to be performed. We present a 76-year-old male with a history of allergic reaction to iodinated contrast who successfully underwent intravascular ultrasound (IVUS) and a Doppler guidewire-guided PCI. Stent size was determined based on IVUS. After PCI, stent expansion and a lack of edge dissection or incomplete apposition were confirmed by IVUS and a good antegrade coronary flow was confirmed by a Doppler guidewire. Thus, PCI without contrast injection under IVUS and a Doppler guidewire-guidance may be feasible in selected patients with allergy to iodinated contrast. PMID:21725127

  19. Roles of intracellular Ca2+ and cyclic AMP in mast cell histamine release induced by radiographic contrast media.

    PubMed

    Saito, Mami; Itoh, Yoshinori; Yano, Takahisa; Sendo, Toshiaki; Goromaru, Takeshi; Sakai, Naoko; Oishi, Ryozo

    2003-04-01

    Mast cell histamine release is considered to be associated with the etiology of anaphylactoid reactions to iodinated radiographic contrast media (RCM). In the present study, the effects of various ionic and non-ionic RCM on histamine release from mast cells were compared, and the possible mechanisms of the histamine release were subsequently determined. Both ionic (ioxaglate and amidotrizoate) and non-ionic (iohexol, ioversol, iomeprol, iopamidol and iotrolan) RCM increased histamine release from the dissociated rat pulmonary cells, whereby ionic materials were more potent than non-ionic agents. There was no significant correlation between the extent of histamine release and the osmolarity of each RCM solution. In addition, hyperosmotic mannitol solution (1000 mOsm/kg) caused no marked histamine release. Thus, it is unlikely that the hyperosmolarity of RCM solutions contributes to the histamine release. RCM also stimulated, but to a lesser extent, the histamine release from rat peritoneal cells. The RCM-induced histamine release from both types of cells was inhibited by dibutyl cyclic AMP or combined treatment with forskolin and 3-isobutyl-1-methylxanthine. Corresponding to these results, RCM markedly reduced the cellular cyclic AMP content. On the other hand, the removal of intracellular but not the extracellular Ca2+ attenuated the RCM-induced mast cell histamine release. From these findings, it is suggested that the decrease in cellular cyclic AMP content and an increase in intracellular Ca2+ contribute at least in part to the RCM-induced mast cell histamine release. PMID:12690428

  20. Effect of Radiographic Contrast Media on the Spectrin/Band3-Network of the Membrane Skeleton of Erythrocytes

    PubMed Central

    Franke, Ralf-Peter; Scharnweber, Tim; Fuhrmann, Rosemarie; Wenzel, Folker; Krüger, Anne; Mrowietz, Christof; Jung, Friedrich

    2014-01-01

    The membrane of red blood cells consists of a phospholipid bilayer with embedded membrane proteins and is associated on the cytoplasmatic side with a network of proteins, the membrane skeleton. Band3 has an important role as centre of the functional complexes e.g. gas exchange complex and as element of attachment for the membrane skeleton maintaining membrane stability and flexibility. Up to now it is unclear if band3 is involved in the morphology change of red blood cells after contact with radiographic contrast media. The study revealed for the first time that Iopromide induced markedly more severe alterations of the membrane skeleton compared to Iodixanol whose effects were similar to erythrocytes suspended in autologous plasma. A remarkable clustering of band3 was found associated with an accumulation of band3 in spicules and also a sequestration of band3 to the extracellular space. This was evidently accompanied by a gross reduction of functional band3 complexes combined with a dissociation of spectrin from band3 leading to a loss of homogeneity of the spectrin network. It could be demonstrated for the first time that RCM not only induced echinocyte formation but also exocytosis of particles at least coated with band3. PMID:24586837

  1. Computed tomography and magnetic resonance imaging contrast media injectors: technical feature review – what is really needed?

    PubMed Central

    Friebe, Michael

    2016-01-01

    There has been little technical innovation over the last few years for contrast media (CM) injectors that are used for diagnostic imaging (computed tomography [CT], magnetic resonance imaging [MRI], and hybrid imaging systems, such as positron emission tomography–CT or magnetic resonance–positron emission tomography) examinations. The medical need of CM for the enhancement of diagnostic images has been around for a long time, but the application of the CM into the blood stream comes with potential medical complications for the patient and requires a lot of operator experience and training. Most power injector systems that are currently used can do significantly more than what is typically required; this complexity however, adds error potential and cost. This paper focuses on the main features that CM injector systems should have and highlights the technical developments that are useful to have but which add complexity and cost, increase setup time, and require intensive training for safe use. CM injection protocols are very different between CT and MRI, with CT requiring many more variances, has a need for multiphase protocols, and requires a higher timing accuracy. A CM injector used in the MRI suite, on the other-hand, could only need a relatively time insensitive injection with a standard injection flow rate and a volume that is dependent on the patients’ weight. This would make easy and lightweight systems possible, which are able to safely and accurately perform the injection task, while allowing full MRI compatibility with relatively low cost investment and consumable costs. PMID:27486345

  2. Comparison of the effects of radiographic contrast media on dehydration and filterability of red blood cells from donors homozygous for hemoglobin A or hemoglobin S.

    PubMed

    Losco, P; Nash, G; Stone, P; Ventre, J

    2001-11-01

    Iodinated radiographic contrast media have traditionally been contraindicated in patients with sickle cell disease because their high osmolality may induce osmotic shrinkage of red blood cells, impair blood flow through the microcirculation, and precipitate or exacerbate a sickle cell crisis. This study investigated that concept by comparing the hematological and rheological effects in vitro of four X-ray contrast media of differing osmolalities: Visipaque (290 mOsm/kg), Hexabrix (600 mOsm/kg), Omnipaque (844 mOsm/kg), and RenoCal-76 (1940 mOsm/kg). Blood was tested from 10 normal and 10 sickle cell donors at drug concentrations of 0, 1, 10, and 30% w/v in an attempt to approximate the relative concentrations of contrast medium to blood that might occur during the bolus-injection and circulation-diluted phases of drug administration. Parameters evaluated included hematology, red cell morphology, and red cell flow resistance through a micropore filter to approximate the microcirculatory effects. Significant hematological effects for both normal and sickle cell donors included a concentration dependent decrease in hematocrit and MCV, and increase in MCHC, all of which varied directly with the osmolality of the contrast media in the order of RenoCal-76 > Omnipaque > Hexabrix > Visipaque. The contrast media had minor effects on red blood cell morphology except for RenoCal-76, 10-30% in which marked echinocytosis was observed. There was no significant increase in the number of irreversibly sickled cells in donors with hemoglobin S. Filterability of red cell suspensions through capillary size pores was impaired in both normal and sickle cell samples in direct proportion to the osmolality of the contrast media, as listed above. Filterability effects were greater for sickle cells than for normal red cells. Visipaque, which was closest to isotonicity, had little effect on red cell volume and had no significant effect on filterability of normal or sickle cells. These results

  3. Non-ionic contrast media induces oxidative stress and apoptosis through Ca²⁺ influx in human neutrophils.

    PubMed

    Kayan, Mustafa; Nazıroğlu, Mustafa; Ovey, Ishak Suat; Aykur, Mehmet; Uğuz, Abdülhadi Cihangir; Yürekli, Vedat Ali

    2012-12-01

    Non-ionic contrast media (CM) can induce tissue kidney injury via activation of phagocytosis and oxidative stress, although the mechanisms of injury via neutrophils are not clear. We investigated the effects of CM on oxidative stress and Ca²⁺ concentrations in serum and neutrophils of humans. Ten migraine patients were used in the study. Serum and neutrophil samples from patients' peripheral blood were obtained before (control) and 30 min after non-ionic (iopromide) CM injection. The neutrophils were incubated with non specific transient receptor potential 2 (TRPM2) channel blocker, 2-aminoethoxydiphenyl borate (2-APB), and voltage gated Ca²⁺ channel blockers, verapamil plus diltiazem. Serum and neutrophil lipid peroxidation, apoptosis and intracellular Ca²⁺ concentrations levels were higher in the CM group than in controls. The neutrophilic reduced glutathione (GSH) and glutathione peroxidase (GSH-Px) levels as well as serum vitamin E and β-carotene concentrations were lower in the CM group than in controls. Neutrophil lipid peroxidation levels were lower in the CM+2-APB and CM+verapamil-diltiazem groups than in the CM group, although GSH, GSH-Px and intracellular Ca²⁺ values increased in the CM+2-APB and CM+verapamil-diltiazem groups. However, caspase-3, caspase-9, vitamin A and vitamin C values were unaltered by CM treatment. In conclusion, we observed that CM induced oxidative stress and Ca²⁺ influx by decreasing vitamin E, β-carotene and Ca²⁺ release levels in human serum and neutrophils. However, we observed protective effects of Ca²⁺ channel blockers on Ca²⁺ influx in neutrophils. PMID:22903554

  4. Photodecomposition of iodinated contrast media and subsequent formation of toxic iodinated moieties during final disinfection with chlorinated oxidants.

    PubMed

    Allard, Sébastien; Criquet, Justine; Prunier, Anaïs; Falantin, Cécilia; Le Person, Annaïg; Yat-Man Tang, Janet; Croué, Jean-Philippe

    2016-10-15

    Large amount of iodinated contrast media (ICM) are found in natural waters (up to μg.L(-)(1) levels) due to their worldwide use in medical imaging and their poor removal by conventional wastewater treatment. Synthetic water samples containing different ICM and natural organic matter (NOM) extracts were subjected to UV254 irradiation followed by the addition of chlorine (HOCl) or chloramine (NH2Cl) to simulate final disinfection. In this study, two new quantum yields were determined for diatrizoic acid (0.071 mol.Einstein(-1)) and iotalamic acid (0.038 mol.Einstein(-1)) while values for iopromide (IOP) (0.039 mol.Einstein(-1)), iopamidol (0.034 mol.Einstein(-1)) and iohexol (0.041 mol.Einstein(-1)) were consistent with published data. The photodegradation of IOP led to an increasing release of iodide with increasing UV doses. Iodide is oxidized to hypoiodous acid (HOI) either by HOCl or NH2Cl. In presence of NOM, the addition of oxidant increased the formation of iodinated disinfection by-products (I-DBPs). On one hand, when the concentration of HOCl was increased, the formation of I-DBPs decreased since HOI was converted to iodate. On the other hand, when NH2Cl was used the formation of I-DBPs was constant for all concentration since HOI reacted only with NOM to form I-DBPs. Increasing the NOM concentration has two effects, it decreased the photodegradation of IOP by screening effect but it increased the number of reactive sites available for reaction with HOI. For experiments carried out with HOCl, increasing the NOM concentration led to a lower formation of I-DBPs since less IOP are photodegraded and iodate are formed. For NH2Cl the lower photodegradation of IOP is compensated by the higher amount of NOM reactive sites, therefore, I-DBPs concentrations were constant for all NOM concentrations. 7 different NOM extracts were tested and almost no differences in IOP degradation and I-DBPs formation was observed. Similar behaviour was observed for the 5 ICM

  5. Contrast media are incomplete secretagogues acting on human basophils and mast cells isolated from heart and lung, but not skin tissue.

    PubMed

    Genovese, A; Stellato, C; Patella, V; Lamparter-Schummert, B; de Crescenzo, G; Adt, M; Marone, G

    1996-01-01

    To investigate the mechanisms of anaphylactoid reactions to radiocontrast media, in vitro mediator release induced by three iodinated contrast agents was examined using peripheral blood basophils and mast cells purified from human lung parenchyma, heart, and skin tissues. Three iodinated contrast agents, sodium and meglumine salts of ioxaglic acid, sodium and meglumine salts of ioxithalamic acid, and ioversol, were incubated with basophils purified from peripheral blood and human mast cells isolated and purified from different anatomical sites. Release of preformed (histamine and tryptase) and de novo synthesized mediators (prostaglandin D2 and leukotriene C4) into the supernatans was determined at various contrast medium concentrations after incubation for 60 min. Ioxaglate (0.2-0.3 M), ioxithalamate (0.3-0.5 M), and to a lesser extent ioversol (0.3-0.5 M) induced histamine release from basophils in a concentration-dependent manner. All three induced the release of preformed mediators (histamine and tryptase) from human lung, but not from skin mast cells. They also induced histamine and tryptase release from human heart mast cells. However, they did not induce the de novo synthesis of leukotriene C1 or prostaglandin D2 from human basophils or any type of mast cell examined. Cross-linking of IgE by anti-IgE induced the release of leukotriene C4 or prostaglandin D2 from human basophils or mast cells. Mannitol, an osmotic stimulus, induced the release of histamine from human basophils, but to a lesser extent from mast cells. These results show that different contrast media can differ in their ability to release mediators from enriched preparations of human basophils and mast cells. The three contrast agents examined act on basophils and mast cells as incomplete secretagogues, causing the release of preformed mediators, but not these novo synthesis of chemical mediators. It may be useful to measure plasma tryptase levels to detect adverse reactions caused by iodinated

  6. A sensitive multi-residue method for the determination of 35 micropollutants including pharmaceuticals, iodinated contrast media and pesticides in water.

    PubMed

    Valls-Cantenys, Carme; Scheurer, Marco; Iglesias, Mònica; Sacher, Frank; Brauch, Heinz-Jürgen; Salvadó, Victoria

    2016-09-01

    A sensitive, multi-residue method using solid-phase extraction followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed to determine a representative group of 35 analytes, including corrosion inhibitors, pesticides and pharmaceuticals such as analgesic and anti-inflammatory drugs, five iodinated contrast media, β-blockers and some of their metabolites and transformation products in water samples. Few other methods are capable of determining such a broad range of contrast media together with other analytes. We studied the parameters affecting the extraction of the target analytes, including sorbent selection and extraction conditions, their chromatographic separation (mobile phase composition and column) and detection conditions using two ionisation sources: electrospray ionisation (ESI) and atmospheric pressure chemical ionisation (APCI). In order to correct matrix effects, a total of 20 surrogate/internal standards were used. ESI was found to have better sensitivity than APCI. Recoveries ranging from 79 to 134 % for tap water and 66 to 144 % for surface water were obtained. Intra-day precision, calculated as relative standard deviation, was below 34 % for tap water and below 21 % for surface water, groundwater and effluent wastewater. Method quantification limits (MQL) were in the low ng L(-1) range, except for the contrast agents iomeprol, amidotrizoic acid and iohexol (22, 25.5 and 17.9 ng L(-1), respectively). Finally, the method was applied to the analysis of 56 real water samples as part of the validation procedure. All of the compounds were detected in at least some of the water samples analysed. Graphical Abstract Multi-residue method for the determination of micropollutants including pharmaceuticals, iodinated contrast media and pesticides in waters by LC-MS/MS. PMID:27382969

  7. Acute adverse reactions to radiographic iodinated and gadolinium-based contrast media: incidence, risk factors and premedication: from published evidence to a practical approach.

    PubMed

    Tonolini, M; Bianco, R

    2011-01-01

    Although relatively uncommon especially in their severe manifestations, adverse reactions (ARs) to radiographic contrast media (CM) may represent a source of concern to both physicians and patients because of the large number of CT and MR imaging procedures daily performed. In this paper the current literature is reviewed regarding incidence and risk factors for acute ARs to both iodinated and gadolinium-based CM, and about the usefulness of pharmacological premedication to reduce risk. A practical approach for everyday clinical practice is proposed. PMID:22262334

  8. Response to Intravenous Allogeneic Equine Cord Blood-Derived Mesenchymal Stromal Cells Administered from Chilled or Frozen State in Serum and Protein-Free Media

    PubMed Central

    Williams, Lynn B.; Co, Carmon; Koenig, Judith B.; Tse, Crystal; Lindsay, Emily; Koch, Thomas G.

    2016-01-01

    Equine mesenchymal stromal cells (MSC) are commonly transported, chilled or frozen, to veterinary clinics. These MSC must remain viable and minimally affected by culture, transport, or injection processes. The safety of two carrier solutions developed for optimal viability and excipient use were evaluated in ponies, with and without allogeneic cord blood-derived (CB) MSC. We hypothesized that neither the carrier solutions nor CB-MSC would elicit measurable changes in clinical, hematological, or biochemical parameters. In nine ponies (study 1), a bolus of HypoThermosol® FRS (HTS-FRS), CryoStor® CS10 (CS10), or saline was injected IV (n = 3/treatment). Study 2, following a 1-week washout period, 5 × 107 pooled allogeneic CB-MSCs were administered IV in HTS-FRS following 24 h simulated chilled transport. Study 3, following another 1-week washout period 5 × 107 pooled allogeneic CB-MSCs were administered IV in CS10 immediately after thawing. Nine ponies received CB-MSCs in study 2 and 3, and three ponies received the cell carrier media without cells. CB-MSCs were pooled in equal numbers from five unrelated donors. In all studies, ponies were monitored with physical examination, and blood collection for 7 days following injection. CD4 and CD8 lymphocyte populations were also evaluated in each blood sample. In all three studies, physical exam, complete blood cell count, serum biochemistry, and coagulation panel did not deviate from established normal ranges. Proportions of CD4+ and CD8+ lymphocytes increased at 168 h postinjection in CB-MSC treatment groups regardless of the carrier solution. Decreases in CD4+/CD8+ double positive populations were observed at 24 and 72 h in CB-MSC-treated animals. There was no difference in viability between CB-MSCs suspended in HTS-FRS and CS10. HTS-FRS and CS10 used for low volume excipient injection of MSC suspensions were not associated with short-term adverse reactions. HTS-FRS and CS10 both adequately

  9. Tracking changing X-ray contrast media application to an urban-influenced karst aquifer in the Wadi Shueib, Jordan.

    PubMed

    Zemann, Moritz; Wolf, Leif; Grimmeisen, Felix; Tiehm, Andreas; Klinger, Jochen; Hötzl, Heinz; Goldscheider, Nico

    2015-03-01

    Sewage input into a karst aquifer via leaking sewers and cesspits was investigated over five years in an urbanized catchment. Of 66 samples, analyzed for 25 pharmaceuticals, 91% indicated detectable concentrations. The former standard iodinated X-ray contrast medium (ICM) diatrizoic acid was detected most frequently. Remarkably, it was found more frequently in groundwater (79%, median: 54 ng/l) than in wastewater (21%, 120 ng/l), which is supposed to be the only source in this area. In contrast, iopamidol, a possible substitute, spread over the aquifer during the investigation period whereas concentrations were two orders of magnitude higher in wastewater than in groundwater. Knowledge about changing application of pharmaceuticals thus is essential to assess urban impacts on aquifers, especially when applying mass balances. Since correlated concentrations provide conclusive evidence that, for this catchment, nitrate in groundwater rather comes from urban than from rural sources, ICM are considered useful tracers. PMID:25594842

  10. Myocardial ischemia during intravenous DSA in patients with cardiac disease

    SciTech Connect

    Hesselink, J.R.; Hayman, L.A.; Chung, K.J.; McGinnis, B.D.; Davis, K.R.; Taveras, J.M.

    1984-12-01

    A prospective study was performed for 48 patients who had histories of angina and were referred for digital subtraction angiography (DSA). Cardiac disease was graded according to the American Heart Association (AHA) functional classification system. Each patient received 2-5 injections of 40-ml diatrizoate meglumine and diatrizoate sodium at 15 ml per second in the superior vena cava. Of the 28 patients in functional Classes I or II, 11% had angina and 32% had definite ischemic ECG changes after the DSA injections. Of the patients in functional Class III 63% had angina, and 58% had definite ischemic ECG changes after the injections. These observed cardiac effects following bolus injections of hypertonic ionic contrast media indicate that special precautions are necessary when performing intravenous DSA examinations on this group of high risk patients.

  11. Intravenous paracetamol (acetaminophen).

    PubMed

    Duggan, Sean T; Scott, Lesley J

    2009-01-01

    Intravenous paracetamol (rINN)/intravenous acetaminophen (USAN) is an analgesic and antipyretic agent, recommended worldwide as a first-line agent for the treatment of pain and fever in adults and children. In double-blind clinical trials, single or multiple doses of intravenous paracetamol 1 g generally provided significantly better analgesic efficacy than placebo treatment (as determined by primary efficacy endpoints) in adult patients who had undergone dental, orthopaedic or gynaecological surgery. Furthermore, where evaluated, intravenous paracetamol 1 g generally showed similar analgesic efficacy to a bioequivalent dose of propacetamol, and a reduced need for opioid rescue medication. In paediatric surgical patients, recommended doses of intravenous paracetamol 15 mg/kg were not significantly different from propacetamol 30 mg/kg for the treatment of pain, and showed equivocal analgesic efficacy compared with intramuscular pethidine 1 mg/kg in several randomized, active comparator-controlled studies. In a randomized, noninferiority study in paediatric patients with an infection-induced fever, intravenous paracetamol 15 mg/kg treatment was shown to be no less effective than propacetamol 30 mg/kg in terms of antipyretic efficacy. Intravenous paracetamol was well tolerated in clinical trials, having a tolerability profile similar to placebo. Additionally, adverse reactions emerging from the use of the intravenous formulation of paracetamol are extremely rare (<1/10 000). [table: see text]. PMID:19192939

  12. Feasibility of kilovoltage x-ray energy modulation by gaseous media and its application in contrast-enhanced radiotherapy

    SciTech Connect

    Facundo-Flores, E. L.; Garnica-Garza, H. M.

    2013-09-15

    Purpose: To present a method to modulate the energy contents of a kilovoltage x-ray beam that makes use of a gas as the modulating medium. The method is capable of producing arbitrary x-ray spectra by varying the pressure of the modulating gas and the peak kilovoltage (kVp) of the x-ray beams whose energy is being modulated.Methods: An aluminum chamber was machined with a 0.5 cm wall thickness, designed to withstand pressures of more than 80 atm. A pressure sensor and electrovalves were used to monitor and regulate the gas pressure. Argon was used as the modulating gas. A CdTe spectrometer was used to measure x-ray spectra for different combinations of kVp and gas pressure, thus obtaining a set of basis x-ray functions. An arbitrary x-ray spectrum can then be formed by the linear combination of such basis functions. In order to show one possible application of the modulation method, a contrast-enhanced radiotherapy prostate treatment was optimized with respect to the x-ray beam energy, without restrictions on the possible shape of the resultant x-ray spectra.Results: The x-ray spectra basis functions obtained display a smooth and gradual variation of their average energy as a function of the gas pressure for a given kVp, sometimes in the order of 1 or 2 keV. This gradual variation would be difficult to obtain with a conventional aluminum or copper filters, as the change in thickness necessary to reproduce the data presented would be in the order of micrometers, making necessary the use of a large number of such filters. Using the modulation method presented here, the authors were able to reconstruct the optimized x-ray spectra from the measured basis functions, for different optimization objectives.Conclusions: A method has been developed that allows for the controlled modulation of the energy contents of kilovoltage x-ray spectra. The method has been shown to be able to reproduce spectra of arbitrary shape, such as those obtained from the optimization of contrast

  13. Possible Contrast Media Reduction with Low keV Monoenergetic Images in the Detection of Focal Liver Lesions: A Dual-Energy CT Animal Study

    PubMed Central

    Chung, Yong Eun; You, Je Sung; Lee, Hye-Jeong; Lim, Joon Seok; Lee, Hye Sun; Baek, Song-Ee; Kim, Myeong-Jin

    2015-01-01

    Objective To investigate the feasibility of dual-energy CT for contrast media (CM) reduction in the diagnosis of hypervascular and hypovascular focal liver lesions (FLL). Subjects and Methods The Institutional Animal Care and Use Committee approved this study. VX2 tumors were implanted in two different segments of the liver in 13 rabbits. After 2 weeks, two phase contrast enhanced CT scans including the arterial phase (AP) and portal-venous phase (PVP) were performed three times with 24-hour intervals with three different concentrations of iodine, 300 (I300), 150 (I150) and 75 mg I/mL (I75). The mean HU and standard deviation (SD) were measured in the liver, the hypervascular portion of the VX2 tumor which represented hypervascular tumors, and the central necrotic area of the VX2 tumor which represented hypovascular tumors in 140kVp images with I300 as a reference standard and in monoenergetic images (between 40keV and 140keV) with I150 and I75. The contrast-to-noise ratio (CNR) for FLLs and the ratio of the CNRs (CNRratio) between monoenergetic image sets with I150 and I75, and the reference standard were calculated. Results For hypervascular lesions, the CNRratio was not statistically different from 1.0 between 40keV and 70keV images with I150, whereas the CNRratio was significantly lower than 1.0 in all keV images with I75. For hypovascular lesions, the CNRratio was similar to or higher than 1.0 between 40keV and 80keV with I150 and between 40keV and 70keV with I75. Conclusions With dual-energy CT, the total amount of CM might be halved in the diagnosis of hypervascular FLLs and reduced to one-fourth in the diagnosis of hypovascular FLLs, while still preserving CNRs. PMID:26203652

  14. Assessment of the Early Effects of 5,6-Dimethylxanthenone-4-Acetic Acid Using Macromolecular Contrast Media-Enhanced Magnetic Resonance Imaging: Ectopic Versus Orthotopic Tumors

    SciTech Connect

    Seshadri, Mukund Bellnier, David A.; Cheney, Richard T.

    2008-11-15

    Purpose: To investigate the early effects of a vascular disrupting agent (VDA) in ectopic and orthotopic tumors by using macromolecular contrast media (MMCM)-enhanced magnetic resonance imaging (MMCM-MRI). Methods and Materials: The MMCM-MRI of ectopic and orthotopic MCA205 murine fibrosarcomas was performed using the intravascular contrast agent albumin-(gadopentetate dimeglumine){sub 35}. Change in longitudinal relaxation rate ({delta}R1) was measured 24 hours after treatment with 5,6-dimethylxanthenone-4-acetic acid (DMXAA; 30 mg/kg) and used to compute tumor vascular volume and permeability. Correlative histologic and immunohistochemical evaluation was carried out, along with measurement of tumor necrosis factor {alpha} and vascular endothelial growth factor levels in whole tumor extracts using the enzyme-linked immunosorbent assay. Results: Orthotopic tumors showed higher vascular volume (p < 0.05) than ectopic tumors before treatment. Twenty-four hours after DMXAA treatment, a significant (p < 0.0001), but differential, decrease in {delta}R1 (70% in ectopic and 50% in orthotopic tumors) was observed compared with baseline estimates. Consistent with this observation, greater levels of tumor necrosis factor {alpha}, an important mediator of the antivascular activity of DMXAA, were measured in ectopic tumors 3 hours posttreatment compared with orthotopic tumors (p < 0.05). Immunohistochemical (CD31) and histologic (hematoxylin and eosin) sections of ectopic and orthotopic tumors showed highly tumor-selective vascular damage after treatment with the presence of viable surrounding normal tissue. Conclusions: The MMCM-MRI provided early quantitative estimates of change in tumor perfusion after VDA treatment that showed good correlation with cytokine induction. Differences in the response of ectopic and orthotopic tumors highlight the influence of the host microenvironment in modulating the activity of VDAs.

  15. Diagnostic accuracy of MR imaging to identify and characterize focal liver lesions: comparison between gadolinium and superparamagnetic iron oxide contrast media.

    PubMed

    Maurea, Simone; Mainenti, Pier Paolo; Tambasco, Annamaria; Imbriaco, Massimo; Mollica, Carmine; Laccetti, Ettore; Camera, Luigi; Liuzzi, Raffaele; Salvatore, Marco

    2014-06-01

    To compare the diagnostic value of gadolinium (Gd) and ultrasmall superparamagnetic iron oxide (SPIO) contrast media for characterization of focal liver lesions (FLL), we retrospectively evaluated the results of magnetic resonance (MR) imaging in 68 patients (40 M, 28 F, age from 22 to 81 yrs) of which 36 with diagnosis of colo-rectal cancer, 26 with hepatic cirrhosis and 6 with incidental imaging detection of FLL. MR (Gyroscan Intera 1.5 T, Philips Medical Systems) study was performed using T1 and T2 fast-field-echo (FFE) and T2 turbo-spin-echo (TSE) sequences in axial and coronal views. Dynamic multi-phases gadolinium Gd-enhanced T1-FFE-Bh images were obtained in arterial, portal and equilibrium phases, followed by SPIO-enhanced T2-FFE scans. A qualitative analysis of pre- and post-contrast MR images to classify FLL as benign or malignant was performed using a 3-point scoring system: 0= benign; 1= suspicious for malignancy; 2= malignant. A total of 118 lesions were evaluated. In particular, histology (n=18), cytology (n=14) or clinical-imaging follow-up data (n=86) demonstrated 4 adenomas, 29 cysts, 3 focal steatosis, 25 hemangiomas, 1 focal vascular abnormality, 5 fibrotic lesions as well as 13 regenerative nodules, 6 dysplastic, 14 hepatocellular carcinomas (HCC), 17 metastasis and 1 cholangiocarcinoma. For MR imaging, diagnostic accuracy, sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of Gd vs. SPIO images were respectively 83% vs. 92%, 79% vs. 74%, 85% vs. 99% (P=0.002), 68% vs. 96% (P=0.005) and 91% vs. 90%, respectively. The results suggest that SPIO-MR provides a diagnostic incremental value, as specificity and PPV, particularly to characterize FLL compared to Gd-MR; thus, we strongly recommend the use of SPIO when liver lesion characterization is requested and Gd images are uncertain. PMID:24914419

  16. Diagnostic accuracy of MR imaging to identify and characterize focal liver lesions: comparison between gadolinium and superparamagnetic iron oxide contrast media

    PubMed Central

    Mainenti, Pier Paolo; Tambasco, Annamaria; Imbriaco, Massimo; Mollica, Carmine; Laccetti, Ettore; Camera, Luigi; Liuzzi, Raffaele; Salvatore, Marco

    2014-01-01

    To compare the diagnostic value of gadolinium (Gd) and ultrasmall superparamagnetic iron oxide (SPIO) contrast media for characterization of focal liver lesions (FLL), we retrospectively evaluated the results of magnetic resonance (MR) imaging in 68 patients (40 M, 28 F, age from 22 to 81 yrs) of which 36 with diagnosis of colo-rectal cancer, 26 with hepatic cirrhosis and 6 with incidental imaging detection of FLL. MR (Gyroscan Intera 1.5 T, Philips Medical Systems) study was performed using T1 and T2 fast-field-echo (FFE) and T2 turbo-spin-echo (TSE) sequences in axial and coronal views. Dynamic multi-phases gadolinium Gd-enhanced T1-FFE-Bh images were obtained in arterial, portal and equilibrium phases, followed by SPIO-enhanced T2-FFE scans. A qualitative analysis of pre- and post-contrast MR images to classify FLL as benign or malignant was performed using a 3-point scoring system: 0= benign; 1= suspicious for malignancy; 2= malignant. A total of 118 lesions were evaluated. In particular, histology (n=18), cytology (n=14) or clinical-imaging follow-up data (n=86) demonstrated 4 adenomas, 29 cysts, 3 focal steatosis, 25 hemangiomas, 1 focal vascular abnormality, 5 fibrotic lesions as well as 13 regenerative nodules, 6 dysplastic, 14 hepatocellular carcinomas (HCC), 17 metastasis and 1 cholangiocarcinoma. For MR imaging, diagnostic accuracy, sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of Gd vs. SPIO images were respectively 83% vs. 92%, 79% vs. 74%, 85% vs. 99% (P=0.002), 68% vs. 96% (P=0.005) and 91% vs. 90%, respectively. The results suggest that SPIO-MR provides a diagnostic incremental value, as specificity and PPV, particularly to characterize FLL compared to Gd-MR; thus, we strongly recommend the use of SPIO when liver lesion characterization is requested and Gd images are uncertain. PMID:24914419

  17. Zero-dark-counting X-ray photon detection using a YAP(Ce)-MPPC detector and its application to computed tomography using gadolinium contrast media

    NASA Astrophysics Data System (ADS)

    Kami, Syouta; Sato, Eiichi; Kogita, Hayato; Numahata, Wataru; Hamaya, Tatsuki; Nihei, Shinichi; Arakawa, Yumeka; Oda, Yasuyuki; Kodama, Hajime; Hagiwara, Osahiko; Matsukiyo, Hiroshi; Osawa, Akihiro; Enomoto, Toshiyuki; Watanabe, Manabu; Kusachi, Shinya; Sato, Shigehiro; Ogawa, Akira

    2014-07-01

    To measure X-ray spectra and to perform photon-counting computed tomography (PC-CT) with high count rates, we developed a zero-dark-counting spectrometer using a short-decay-time scintillator. A method exploiting a YAP(Ce) [cerium-doped yttrium aluminum perovskite] single crystal scintillator with a decay time of 30 ns and an MPPC (multipixel photon counter) has been developed to count X-ray photons. The photocurrent from the MPPC was amplified by a high-speed current-voltage amplifier, and the event pulse was sent to a multichannel analyzer (MCA) to measure X-ray spectra. The MPPC was driven under pre-Geiger mode at a bias voltage of the MPPC of 70.7 V and a temperature of 23 °C. The PC-CT was accomplished by repeated linear scans and rotations of an object, and projection curves of the object were obtained by the linear scan at a tube current of 1.0 mA. The exposure time for obtaining a tomogram was 10 min at a scan step of 0.5 mm and a rotation step of 1.0°. At a tube voltage of 100 kV, the maximum count rate was 200 kcps. In the PC-CT using gadolinium media, we observed image-contrast variations with changes in lower-level discrimination voltage of the event pulse using a comparator.

  18. Intravenous smart pumps.

    PubMed

    Harding, Andrew D

    2013-01-01

    Intravenous (IV) smart pumps provide substantial safety features during infusion. However, nurses need to understand the requisite education necessary to fully benefit from and improve IV smart pump use and clinical integration. Failure to use IV smart pumps places the nurse and patient at increased risk. PMID:23558918

  19. Ubiquitous Detection of Artificial Sweeteners and Iodinated X-ray Contrast Media in Aquatic Environmental and Wastewater Treatment Plant Samples from Vietnam, The Philippines, and Myanmar.

    PubMed

    Watanabe, Yuta; Bach, Leu Tho; Van Dinh, Pham; Prudente, Maricar; Aguja, Socorro; Phay, Nyunt; Nakata, Haruhiko

    2016-05-01

    Water samples from Vietnam, The Philippines, and Myanmar were analyzed for artificial sweeteners (ASs) and iodinated X-ray contrast media (ICMs). High concentrations (low micrograms per liter) of ASs, including aspartame, saccharin, and sucralose, were found in wastewater treatment plant (WWTP) influents from Vietnam. Three ICMs, iohexol, iopamidol, and iopromide were detected in Vietnamese WWTP influents and effluents, suggesting that these ICMs are frequently used in Vietnam. ASs and ICMs were found in river water from downtown Hanoi at concentrations comparable to or lower than the concentrations in WWTP influents. The ASs and ICMs concentrations in WWTP influents and adjacent surface water significantly correlated (r (2) = 0.99, p < 0.001), suggesting that household wastewater is discharged directly into rivers in Vietnam. Acesulfame was frequently detected in northern Vietnamese groundwater, but the concentrations varied spatially by one order of magnitude even though the sampling points were very close together. This implies that poorly performing domestic septic tanks sporadically leak household wastewater into groundwater. High acesulfame, cyclamate, saccharin, and sucralose concentrations were found in surface water from Manila, The Philippines. The sucralose concentrations were one order of magnitude higher in the Manila samples than in the Vietnamese samples, indicating that more sucralose is used in The Philippines than in Vietnam. Acesulfame and cyclamate were found in surface water from Pathein (rural) and Yangon (urban) in Myanmar, but no ICMs were found in the samples. The ASs concentrations were two-three orders of magnitude lower in the samples from Myanmar than in the samples from Vietnam and The Philippines, suggesting that different amounts of ASs are used in these countries. We believe this is the first report of persistent ASs and ICMs having ubiquitous distributions in economically emerging South Asian countries. PMID:26304512

  20. Reductive and oxidative degradation of iopamidol, iodinated X-ray contrast media, by Fe(III)-oxalate under UV and visible light treatment.

    PubMed

    Zhao, Cen; Arroyo-Mora, Luis E; DeCaprio, Anthony P; Sharma, Virender K; Dionysiou, Dionysios D; O'Shea, Kevin E

    2014-12-15

    Iopamidol, widely employed as iodinated X-ray contrast media (ICM), is readily degraded in a Fe(III)-oxalate photochemical system under UV (350 nm) and visible light (450 nm) irradiation. The degradation is nicely modeled by pseudo first order kinetics. The rates of hydroxyl radical (OH) production for Fe(III)-oxalate/H2O2/UV (350 nm) and Fe(III)-oxalate/H2O2/visible (450 nm) systems were 1.19 ± 0.12 and 0.30 ± 0.01 μM/min, respectively. The steady-state concentration of hydroxyl radical (OH) for the Fe(III)-oxalate/H2O2/UV (350 nm) conditions was 10.88 ± 1.13 × 10(-14) M and 2.7 ± 0.1 × 10(-14) M for the Fe(III)-oxalate/H2O2/visible (450 nm). The rate of superoxide anion radical (O2(-)) production under Fe(III)-oxalate/H2O2/UV (350 nm) was 0.19 ± 0.02 μM/min with a steady-state concentration of 5.43 ± 0.473 × 10(-10) M. Detailed product studies using liquid chromatography coupled to Q-TOF/MS demonstrate both reduction (multiple dehalogenations) and oxidation (aromatic ring and side chains) contribute to the degradation pathways. The reduction processes appear to be initiated by the carbon dioxide anion radical (CO2(-)) while oxidation processes are consistent with OH initiated reaction pathways. Unlike most advanced oxidation processes the Fe(III)-oxalate/H2O2/photochemical system can initiate to both reductive and oxidative degradation processes. The observed reductive dehalogenation is an attractive remediation strategy for halogenated organic compounds as the process can dramatically reduce the formation of the problematic disinfection by-products often associated with oxidative treatment processes. PMID:25269106

  1. Comparison of iodinated trihalomethanes formation during aqueous chlor(am)ination of different iodinated X-ray contrast media compounds in the presence of natural organic matter.

    PubMed

    Ye, Tao; Xu, Bin; Wang, Zhen; Zhang, Tian-Yang; Hu, Chen-Yan; Lin, Lin; Xia, Sheng-Ji; Gao, Nai-Yun

    2014-12-01

    Iodinated trihalomethanes (I-THMs) formation during chlorination and chloramination of five iodinated X-ray contrast media (ICM) compounds (iopamidol, iopromide, iodixanol, histodenz, and diatrizoate) in the presence of natural organic matter (NOM) was evaluated and compared. Chlorination and chloramination of ICM in the absence of NOM yielded only a trace amount of I-THMs, while levels of I-THMs were enhanced substantially in raw water samples. With the presence of NOM, the order with respect to the maximum yield of I-THMs observed during chlorination was iopamidol > histodenz > iodixanol > diatrizoate > iopromide. During chloramination, I-THM formation was enhanced for hisodenz, iodixanol, diatrizoate, and iopromide. The order with respect to the maximum yield of I-THMs observed during chloramination was iopamidol > diatrizoate > iodixanol > histodenz > iopromide. With the exception of iopamidol, I-THM formation was favored at relatively low chlorine doses (≤100 μM) during ICM chlorination, and significant suppression was observed with high chlorine doses applied (>100 μM). However, during chloramination, increasing monochloramine dose monotonously increased the yield of I-THMs for the five ICM. During chlorination of iodixanol, histodenz, and diatrizoate, the yields of I-THMs exhibited three distinct trends as the pH increased from 5 to 9, while peak I-THM formation was found at circumneutral pH for chloramination. Increasing bromide concentration not only considerably enhanced the yield of I-THMs but also shifted the I-THMs towards bromine-containing ones and increased the formation of higher bromine-incorporated species (e.g., CHBrClI and CHBr2I), especially in chloramination. These results are of particular interest to understand I-THM formation mechanisms during chlorination and chloramination of waters containing ICM. PMID:25240119

  2. Contrast echocardiography 1996. A review.

    PubMed Central

    Villarraga, H R; Foley, D A; Mulvagh, S L

    1996-01-01

    Remarkable advances in the field of contrast echocardiography have been made during the last decade. Interest in ultrasound contrast agents that strengthen the backscattered ultrasound signal and improve image display has stimulated further research. Echocardiographic contrast agents providing left ventricular cavity image enhancement after intravenous injection are now available. A role for contrast echocardiography in the assessment of myocardial perfusion has been established within the invasive clinical setting. With the development of newer contrast agents and new ultrasound technology, myocardial perfusion imaging using contrast echocardiography after venous injection is no longer the unattainable "holy grail," but is fast approaching clinical applicability. Images PMID:8792539

  3. INTRAVENOUS ETHER ANESTHESIA

    PubMed Central

    Eger, Edmond I.; Johnson, Edward A.

    1963-01-01

    From a study of intravenous ether anesthesia, it was concluded that ether diluted to a 5 per cent solution in 5 per cent dextrose and water may be used to induce and maintain a smooth and easily controlled anesthetic state similar to that obtained with inhalation ether but without the dependence of the latter technique on ventilation. Cough and laryngospasm were absent. Adequate spontaneous respiration can be maintained with this technique. The technique is particularly useful in endoscopy during which the airway is often not available for anesthetic administration. PMID:14051486

  4. Promoting Media Literacy.

    ERIC Educational Resources Information Center

    Lee, Alice Yuet Lin

    1997-01-01

    The "critical viewing" model for teaching media studies is based on the assumptions that mass media spread evil influences and viewers are mindless and passive media consumers. In contrast, a "cultural reflective" model of media studies would enhance cultural understanding by enabling students to seek alternative ways to think about culture and…

  5. Intravenous Fluid Generation System

    NASA Technical Reports Server (NTRS)

    McQuillen, John; McKay, Terri; Brown, Daniel; Zoldak, John

    2013-01-01

    The ability to stabilize and treat patients on exploration missions will depend on access to needed consumables. Intravenous (IV) fluids have been identified as required consumables. A review of the Space Medicine Exploration Medical Condition List (SMEMCL) lists over 400 medical conditions that could present and require treatment during ISS missions. The Intravenous Fluid Generation System (IVGEN) technology provides the scalable capability to generate IV fluids from indigenous water supplies. It meets USP (U.S. Pharmacopeia) standards. This capability was performed using potable water from the ISS; water from more extreme environments would need preconditioning. The key advantage is the ability to filter mass and volume, providing the equivalent amount of IV fluid: this is critical for remote operations or resource- poor environments. The IVGEN technology purifies drinking water, mixes it with salt, and transfers it to a suitable bag to deliver a sterile normal saline solution. Operational constraints such as mass limitations and lack of refrigeration may limit the type and volume of such fluids that can be carried onboard the spacecraft. In addition, most medical fluids have a shelf life that is shorter than some mission durations. Consequently, the objective of the IVGEN experiment was to develop, design, and validate the necessary methodology to purify spacecraft potable water into a normal saline solution, thus reducing the amount of IV fluids that are included in the launch manifest. As currently conceived, an IVGEN system for a space exploration mission would consist of an accumulator, a purifier, a mixing assembly, a salt bag, and a sterile bag. The accumulator is used to transfer a measured amount of drinking water from the spacecraft to the purifier. The purifier uses filters to separate any air bubbles that may have gotten trapped during the drinking water transfer from flowing through a high-quality deionizing cartridge that removes the impurities in

  6. Pharmaceuticals and iodinated contrast media in a hospital wastewater: A case study to analyse their presence and characterise their environmental risk and hazard.

    PubMed

    Mendoza, A; Aceña, J; Pérez, S; López de Alda, M; Barceló, D; Gil, A; Valcárcel, Y

    2015-07-01

    This work analyses the presence of twenty-five pharmaceutical compounds belonging to seven different therapeutic groups and one iodinated contrast media (ICM) in a Spanish medium-size hospital located in the Valencia Region. Analysis of the target compounds in the hospital wastewater was performed by means of solid phase extraction (SPE) followed by liquid chromatography-tandem mass spectrometry analysis (HPLC-MS/MS). A screening level risk assessment combining the measured environmental concentrations (MECs) with dose-response data based on Predicted No Effect Concentration (PNEC) was also applied to estimate Hazard Quotients (HQs) for the compounds investigated. Additionally, the environmental hazard associated to the various compounds measured was assessed through the calculation of the Persistence, Bioaccumulation and Toxicity (PBT) Index, which categorizes compounds according to their environmentally damaging characteristics. The results of the study showed the presence of twenty-four out of the twenty-six compounds analysed at individual concentrations ranging from 5 ng L(-1) to 2 mg L(-1). The highest concentrations corresponded to the ICM iomeprol, found at levels between 424 and 2093 μg L(-1), the analgesic acetaminophen (15-44 μg L(-1)), the diuretic (DIU) furosemide (6-15 μg L(-1)), and the antibiotics (ABIs) ofloxacin and trimethoprim (2-5 μg L(-1)). The lowest levels corresponded to the anti-inflammatory propyphenazone, found at concentrations between 5 and 44 ng L(-1). Differences in terms of concentrations of the analysed compounds have been observed in all the therapeutic groups when comparing the results obtained in this and other recent studies carried out in hospitals with different characteristics from different geographical areas and in different seasons. The screening level risk assessment performed in raw water from the hospital effluent showed that the analgesics and anti-inflammatories (AAFs) acetaminophen, diclofenac, ibuprofen and

  7. Intravenous acetaminophen use in pediatrics.

    PubMed

    Shastri, Nirav

    2015-06-01

    Acetaminophen is a commonly used pediatric medication that has recently been approved for intravenous use in the United States. The purpose of this article was to review the pharmacodynamics, indications, contraindications, and precautions for the use of intravenous acetaminophen in pediatrics. PMID:26035501

  8. Clinical observation of the adverse drug reactions caused by non-ionic iodinated contrast media: results from 109,255 cases who underwent enhanced CT examination in Chongqing, China

    PubMed Central

    Li, X; Chen, J; Zhang, L; Liu, H; Wang, S; Chen, X; Fang, J; Wang, S

    2015-01-01

    Objective: To analyse the pattern and factors that influence the incidence of adverse drug reactions (ADRs) induced by non-ionic iodinated contrast media and to evaluate their safety profiles. Methods: Data from 109,255 cases who underwent enhanced CT examination from 1 January 2008 to 31 August 2013 were analysed. ADRs were classified according to the criteria issued by the American College of Radiology and the Chinese Society of Radiology. Results: A total of 375 (0.34%) patients had ADRs, including 281 mild (0.26%); 80 moderate (0.07%); and 14 severe (0.01%) ADRs; no death was found. 302 (80.53%) of the ADRs occurred within 15 min after examination. Patients aged 40–49 years (204 cases, 0.43%; p < 0.01) or who underwent coronary CT angiography (93 cases, 0.61%; p < 0.01) were at a higher risk of ADRs. Female patients (180 cases, 0.40%; p < 0.01) or outpatients had significantly higher incidence rates of ADRs. The symptoms and signs of most of the ADRs were resolved spontaneously within 24 h after appropriate treatment without sequelae. Conclusion: The occurrence of ADRs is caused by the combined effects of multiple factors. The ADRs induced by non-ionic iodinated contrast media are mainly mild ones, while moderate or severe ADRs are relatively rare, suggesting that enhanced CT examination with non-ionic iodinated contrast media is highly safe, and severe adverse events will seldom occur under appropriate care. Advances in knowledge: The study included 109,255 patients enrolled in various types of enhanced CT examinations, which could reflect ADR conditions and regulations in Chinese population accurately and reliably. PMID:25582519

  9. Effect of Intravascular Iodinated Contrast Media on Natural Course of End-Stage Renal Disease Progression in Hemodialysis Patients: A Prospective Study

    SciTech Connect

    Janousek, Radim; Krajina, Antonin; Peregrin, Jan H.; Dusilova-Sulkova, Sylvie; Renc, Ondrej; Hajek, Jan; Dvorak, Kamil; Fixa, Petr; Cermakova, Eva

    2010-02-15

    We evaluated the impact of intravascular iodinated contrast medium on residual diuresis in hemodialyzed patients. Two groups of clinically stable hemodialyzed patients with residual diuresis minimally 500 ml of urine per day were studied. The patients from the first group were given iso-osmolal contrast agent iodixanol (Visipaque, GE Healthcare, United Kingdom) in concentration of iodine 320 mg/ml with osmolality 290 mOsm/kg of water during the endovascular procedure. The second control group was followed without contrast medium administered. Residual diuresis and residual renal excretory capacity expressed as 24-h calculated creatinine clearance were evaluated in the both groups after 6 months. The evaluated group included 42 patients who were given 99.3 ml of iodixanol in average (range, 60-180 ml). The control group included 45 patients. There was no statistically significant difference found between both groups in daily volume of urine (P = 0.855) and calculated clearance of creatinine (P = 0.573). We can conclude that residual diuresis is not significantly influenced by intravascular administration of iso-osmolal iodinated contrast agent (iodixanol) in range of volume from 60 to 180 ml in comparison to natural course of urinary output and residual renal function during end-stage renal disease. This result can help the nephrologist to decide which imaging method/contrast medium to use in dialyzed patients in current practice.

  10. Orthostatic stability with intravenous levodopa

    PubMed Central

    Siddiqi, Shan H.; Creech, Mary L.

    2015-01-01

    Intravenous levodopa has been used in a multitude of research studies due to its more predictable pharmacokinetics compared to the oral form, which is used frequently as a treatment for Parkinson’s disease (PD). Levodopa is the precursor for dopamine, and intravenous dopamine would strongly affect vascular tone, but peripheral decarboxylase inhibitors are intended to block such effects. Pulse and blood pressure, with orthostatic changes, were recorded before and after intravenous levodopa or placebo—after oral carbidopa—in 13 adults with a chronic tic disorder and 16 tic-free adult control subjects. Levodopa caused no statistically or clinically significant changes in blood pressure or pulse. These data add to previous data that support the safety of i.v. levodopa when given with adequate peripheral inhibition of DOPA decarboxylase. PMID:26336641

  11. Drugs of abuse, cytostatic drugs and iodinated contrast media in tap water from the Madrid region (central Spain):A case study to analyse their occurrence and human health risk characterization.

    PubMed

    Mendoza, A; Zonja, B; Mastroianni, N; Negreira, N; López de Alda, M; Pérez, S; Barceló, D; Gil, A; Valcárcel, Y

    2016-01-01

    This work analyses the presence of forty-eight emerging pollutants, including twenty-five drugs of abuse and metabolites, seventeen cytostatic drugs and six iodinated contrast media, in tap water from the Madrid Region. Analysis of the target compounds in the tap water was performed by means of (on-line or off-line) solid-phase extraction followed by analysis by liquid chromatography-tandem mass spectrometry. A preliminary human health risk characterization was undertaken for each individual compound and for different groups of compounds with a common mechanism of action found in tap water. The results of the study showed the presence of eight out of the twenty-five drugs of abuse and metabolites analysed, namely, the cocainics cocaine and benzoylecgonine, the amphetamine-type stimulants ephedrine, 3,4-methylenedioxymethamphetamine and methamphetamine, the opioid methadone and its metabolite 2-ethylene-1,5-dimethyl-3,3-diphenylpyrrolidine and, finally caffeine at concentrations ranging from 0.11 to 502 ng L(-1). Four out of the six analysed iodinated contrast media, namely, diatrizoate, iohexol, iomeprol and iopromide, were detected in at least one sample, with concentration values varying between 0.4 and 5 ng L(-1). Cytostatic compounds were not detected in any sample. Caffeine was the substance showing the highest concentrations, up to 502 ng L(-1), mainly in the drinking water sampling point located in Madrid city. Among the other drugs of abuse, the most abundant compounds were cocaine and benzoylecgonine, detected at concentrations ranging from 0.11 to 86 ng L(-1) and from 0.11 to 53 ng L(-1), respectively. Regarding iodinated contrast media, iohexol was the most ubiquitous and abundant compound, with a frequency of detection of 100% and concentrations from 0.5 to 5.0 ng L(-1) in basically the same range in all sampling points. Taking into account the results and types of treatment applied, ozonisation plus granular activated carbon filtration appears to be

  12. Methylprednisolone pharmacokinetics after intravenous and oral administration.

    PubMed Central

    Al-Habet, S M; Rogers, H J

    1989-01-01

    1. The pharmacokinetics of methylprednisolone (MP) were studied in five normal subjects following intravenous doses of 20, 40 and 80 mg methylprednisolone sodium succinate (MPSS) and an oral dose of 20 mg methylprednisolone as 4 x 5 mg tablets. Plasma concentrations of MP and MPSS were measured by both high performance thin layer (h.p.t.l.c.) and high pressure liquid chromatography (h.p.l.c.). 2. The mean values (+/- s.d.) of half-life, mean residence time (MRT), systemic clearance (CL) and volume of distribution at steady state (Vss) of MP following intravenous administration were 1.93 +/- 0.35 h, 3.50 +/- 1.01 h, 0.45 +/- 0.12 lh-1 kg-1 and 1.5 +/- 0.63 1 kg-1, respectively. There was no evidence of dose-related changes in these values. The plasma MP concentration-time curves were superimposable when normalized for dose. 3. The bioavailability of methylprednisolone from the 20 mg tablet was 0.82 +/- 0.11 (s.d.). 4. In vivo hydrolysis of MPSS was rapid with a half-life of 4.14 +/- 1.62 (s.d.) min, and was independent of dose. In contrast, in vitro hydrolysis in plasma, whole blood and red blood cells was slow; the process continuing for more than 7 days. Sodium fluoride did not prevent the hydrolysis of MPSS. PMID:2655680

  13. Culture et medias (Culture and the Media).

    ERIC Educational Resources Information Center

    Abastado, Claude

    1982-01-01

    The traditional conception of pluralistic culture is contrasted with a new, separate form of culture: mass media culture. Its components are noted: medium, message, "mosaic," and strategy, and methodology for its study is discussed. (MSE)

  14. Successful management of contrast medium extravasation injury through stellate ganglion block and intra-arterial nitroglycerin.

    PubMed

    Lee, Chien-Ching; Chuang, Chia-Chun; Liou, Jing-Yang; Hsieh, Ying-Chou; Tsou, Mei-Yung; Chen, Kwok-Hon

    2011-09-01

    We describe the successful management of extravasation injury to the left hand by contrast medium with stellate ganglion block and intra-arterial nitroglycerin in a patient which befell during contrast-enhanced imaging. The incidence of contrast-medium extravasation injury is increasing because of the convenience and availability of contrast-enhanced imaging and ease of injection access. Extravasation of contrast medium may results in severe pain, erythema, cyanosis, and edema or even skin necrosis, which is largely related to the ionization, osmolarity, and volume of the contrast medium. The conservative treatment is often adequate in small amount extravasation, but if the extravasation is overwhelming further energetic management is mandatory. A 29-year-old man was brought to our emergency because of diffuse abdominal pain and he was arranged to receive intravenous contrast media enhanced abdominal computed tomography for diagnosis. Ruptured appendicitis with abscess formation was suspected; then the patient underwent emergent appendectomy and drainage of the abscess. However, severe swelling and cyanotic change that radiated from the intravenous catheter insertion site in every direction over the entire dorsum of the left hand were noted after the surgery. Contrast-medium extravasation injury was highly contemplated and a left stellate ganglion block was performed immediately for relief of symptoms. The consulting surgeon ruled out compartment syndrome, but advised emergent left upper limb arteriography, which revealed signs of vasospasm with high intravascular pressure of the left distal ulnar and radial arteries; thus nitroglycerin was injected into left distal ulnar and radial arteries for relief of vasospasm. The clinical symptoms were improved after the above managements and the patient was discharged 7 days later without any sequela. PMID:21982175

  15. [Lethal intravenous injection of benzine].

    PubMed

    Zirwes, Christian; Ritz-Timme, Stefanie; Hinsch, Nora; Kardel, Bernd; Hartung, Benno

    2015-01-01

    A man who suffered from chronic pain syndrome died two days after intravenous injection of 2 ml benzine. Previous suicide attempts by drug intoxication and strangulation had failed. Death occurred due to multi-organ failure. We present the results of the clinical, morphological and toxicological examinations performed. PMID:26548034

  16. X-ray contrast media mechanisms in the release of mast cell contents: understanding these leads to a treatment for allergies.

    PubMed

    Lasser, Elliott C

    2011-01-01

    A long history of searching for the etiology of X-ray contrast material (CM) reactions has led to the understanding that the CM do not produce anti-CM antigens. Since CM reactions are anaphylactoid in nature, however, a source for mast cell activation was sought. This resulted in the finding that concentrated CM could suppress mast cell activation by attachment to the Fc portion of IgE and IgG. This is presumed to be a steric hindrance effect. In a study of the effects of CM on BP and a study of the effects of CM in sensitized rats, it was concluded that less concentrated CM activated mast cells and that this mechanism was best explained by bridging of adjacent IgE molecules via attachment to their Fc segments. The mast cell release of heparin activating the contact system, as well as the release of histamine, is believed to be responsible for CM reactions and allergic diatheses. PMID:21941574

  17. Iodinated contrast media inhibit oxygen consumption in freshly isolated proximal tubular cells from elderly humans and diabetic rats: Influence of nitric oxide

    PubMed Central

    Liss, Per; Hansell, Peter; Fasching, Angelica; Palm, Fredrik

    2016-01-01

    Objectives Mechanisms underlying contrast medium (CM)-induced nephropathy remain elusive, but recent attention has been directed to oxygen availability. The purpose of this study was to evaluate the effect of the low-osmolar CM iopromide and the iso-osmolar CM iodixanol on oxygen consumption (QO2) in freshly isolated proximal tubular cells (PTC) from kidneys ablated from elderly humans undergoing nephrectomy for renal carcinomas and from normoglycemic or streptozotocin-diabetic rats. Materials PTC were isolated from human kidneys, or kidneys of normoglycemic or streptozotocin-diabetic rats. QO2 was measured with Clark-type microelectrodes in a gas-tight chamber with and without each CM (10 mg I/mL medium). L-NAME was used to inhibit nitric oxide (NO) production caused by nitric oxide synthase. Results Both CM reduced QO2 in human PTC (about –35%) which was prevented by L-NAME. PTC from normoglycemic rats were unaffected by iopromide, whereas iodixanol decreased QO2 (–34%). Both CM decreased QO2 in PTC from diabetic rats (–38% and –36%, respectively). L-NAME only prevented the effect of iopromide in the diabetic rat PTC. Conclusions These observations demonstrate that CM can induce NO release from isolated PTC in vitro, which affects QO2. Our results suggest that the induction of NO release and subsequent effect on the cellular oxygen metabolism are dependent on several factors, including CM type and pre-existing risk factors for the development of CM-induced nephropathy. PMID:26933994

  18. INTRAARTERIAL INJECTION OF IODINATED CONTRAST MEDIUM FOR CONTRAST ENHANCED COMPUTED TOMOGRAPHY OF THE EQUINE HEAD.

    PubMed

    Carmalt, James L; Montgomery, James

    2015-01-01

    Minimizing the volume of contrast administered for contrast-enhanced computed tomography (CT) of the equine head is desirable for reducing costs and risks of adverse reactions, however evidence-based studies on the effects of varying volumes on image quality are currently lacking. The objective of the current study was to determine whether low-volume intraarterial administration of contrast medium would result in an equivalent image quality and tissue attenuation vs. high-volume intravenous bolus administration. A prospective cross-over experimental design was used in a sample of six horses. After anesthetic induction, the right carotid artery was exposed surgically and catheterized. Four CT scans of the cranium were performed for each horse: baseline, immediately following intraarterial contrast injection, five-min postinjection (return to baseline) and a final scan after intravenous contrast administration. Soft tissue attenuation in predetermined regions of interest (ROI); and length, width, and height measurements of the pituitary gland were recorded at each time point. Horses were euthanized and measurements of the pituitary gland were repeated postmortem. No adverse reactions to contrast administration were observed. Intraarterial and intravenous administration of contrast medium resulted in significantly greater soft tissue enhancement of some brain ROI's and the pituitary gland vs. baseline values. Pituitary gland measurements made on postcontrast CT images did not differ from those obtained during postmortem examination. Findings indicated that low-dose intraarterial administration of contrast material in the equine head resulted in comparable soft tissue enhancement vs. high volume intravenous administration. PMID:25782997

  19. Effect of CT contrast on volumetric arc therapy planning (RapidArc and helical tomotherapy) for head and neck cancer

    SciTech Connect

    Liu, Alan J.; Vora, Nayana; Suh, Steve; Liu, An; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.

    2015-04-01

    The objectives of the study were to evaluate the effect of intravenous contrast in the dosimetry of helical tomotherapy and RapidArc treatment for head and neck cancer and determine if it is acceptable during the computed tomography (CT) simulation to acquire only CT with contrast for treatment planning of head and neck cancer. Overall, 5 patients with head and neck cancer (4 men and 1 woman) treated on helical tomotherapy were analyzed retrospectively. For each patient, 2 consecutive CT scans were performed. The first CT set was scanned before the contrast injection and secondary study set was scanned 45 seconds after contrast. The 2 CTs were autoregistered using the same Digital Imaging and Communications in Medicine coordinates. Tomotherapy and RapidArc plans were generated on 1 CT data set and subsequently copied to the second CT set. Dose calculation was performed, and dose difference was analyzed to evaluate the influence of intravenous contrast media. The dose matrix used for comparison included mean, minimum and maximum doses of planning target volume (PTV), PTV dose coverage, and V{sub 45} {sub Gy}, V{sub 30} {sub Gy}, and V{sub 20} {sub Gy} organ doses. Treatment planning on contrasted images generally showed a lower dose to both organs and target than plans on noncontrasted images. The doses for the points of interest placed in the organs and target rarely changed more than 2% in any patient. In conclusion, treatment planning using a contrasted image had insignificant effect on the dose to the organs and targets. In our opinion, only CT with contrast needs to be acquired during the CT simulation for head and neck cancer. Dose calculations performed on contrasted images can potentially underestimate the delivery dose slightly. However, the errors of planning on a contrasted image should not affect the result in clinically significant way.

  20. Contrastive Lexicology.

    ERIC Educational Resources Information Center

    Hartmann, R. R. K.

    This paper deals with the relation between etymologically related words in different languages. A survey is made of seven stages in the development of contrastive lexicology. These are: prelinguistic word studies, semantics, lexicography, translation, foreign language learning, bilingualism, and finally contrastive analysis. Concerning contrastive…

  1. Pre-existing oral contrast from lanthanum carbonate: a confounding factor in CT mesenteric angiography

    PubMed Central

    Bull, M D; Shrimanker, R; Thomas, M R M; Mulgrew, C J

    2012-01-01

    A 69-year-old male was referred from the renal unit to radiology for investigation of bleeding per rectum. A CT mesenteric angiogram was performed. However, it was noted on the pre-contrast images that the large bowel contained positive oral contrast media. The procedure was abandoned as it would have been difficult to see extravasation of intravenous contrast from a bleeding point in the large bowel. The initial belief was that either the patient had been given oral contrast by ward staff on the assumption that it would be needed, or had had a recent radiological study requiring contrast, which was still present. Neither was the case; it emerged that the patient was taking Fosrenol (Shire Pharmaceuticals, Wayne, PA), a lanthanum carbonate medication used in the treatment of hyperphosphataemia. Lanthanum is densely radio-opaque and appears as positive bowel contrast on CT and plain radiography studies. When considering radiological studies specifically requiring the absence of oral contrast, it is important to be aware of the patient's drug history to avoid non-diagnostic scans with the associated radiation exposure. PMID:22457410

  2. Intravenous magnetic nanoparticle cancer hyperthermia

    PubMed Central

    Huang, Hui S; Hainfeld, James F

    2013-01-01

    Magnetic nanoparticles heated by an alternating magnetic field could be used to treat cancers, either alone or in combination with radiotherapy or chemotherapy. However, direct intratumoral injections suffer from tumor incongruence and invasiveness, typically leaving undertreated regions, which lead to cancer regrowth. Intravenous injection more faithfully loads tumors, but, so far, it has been difficult achieving the necessary concentration in tumors before systemic toxicity occurs. Here, we describe use of a magnetic nanoparticle that, with a well-tolerated intravenous dose, achieved a tumor concentration of 1.9 mg Fe/g tumor in a subcutaneous squamous cell carcinoma mouse model, with a tumor to non-tumor ratio > 16. With an applied field of 38 kA/m at 980 kHz, tumors could be heated to 60°C in 2 minutes, durably ablating them with millimeter (mm) precision, leaving surrounding tissue intact. PMID:23901270

  3. Intravenous Solutions for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Miller, Fletcher J.; Niederhaus, Charles; Barlow, Karen; Griffin, DeVon

    2007-01-01

    This paper describes the intravenous (IV) fluids requirements being developed for medical care during NASA s future exploration class missions. Previous research on IV solution generation and mixing in space is summarized. The current exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. We briefly introduce potential methods for generating IV fluids in microgravity. Conclusions on the recommended fluid volume requirements are presented.

  4. Anaphylactic reaction to intravenous diclofenac.

    PubMed

    Singh, Ranju; Bansal, Deepak; Baduni, Neha; Vajifdar, Homay

    2011-01-01

    Diclofenac sodium is a non-steroidal anti-inflammatory drug widely used as an opioid sparing agent for postoperative analgesia. Anaphylaxis due to intravenous diclofenac sodium is very rare. We report a case of anaphylactic reaction to IV diclofenac sodium, occurring postoperatively in a 25-year-old primigravida, the clinical features of which mimicked pulmonary embolism. The rarity, clinical importance and the diagnostic dilemma associated prompted us to report this case. PMID:21633544

  5. Contrast Materials

    MedlinePlus

    ... or other reactions to contrast materials are rare, radiology departments are well-equipped to deal with them. ... is given. However, both the American College of Radiology (ACR) and the European Society of Urogenital Radiology ...

  6. Contrast lipocryolysis

    PubMed Central

    Pinto, Hernán; Melamed, Graciela

    2014-01-01

    Alternative crystal structures are possible for all lipids and each different crystal structure is called a polymorphic form. Inter-conversion between polymorphisms would imply the possibility of leaning crystal formation toward the most effective polymorphism for adipocyte destruction. Food industry has been tempering lipids for decades. Tempering technology applied to lipocryolysis gave birth to “contrast lipocryolysis”, which involves pre- and post-lipocryolysis fat layer heating as part of a specific tempering protocol. In this study, we evaluated the skinfold thickness of 10 subjects after a single contrast lipocryolysis session and witnessed important and fast reductions. PMID:25068088

  7. [Intravenous and subcutaneous immunoglobulin therapy].

    PubMed

    Thon, Vojtěch

    2013-07-01

    Patients with agammaglobulinaemia and hypogammaglobulinaemia require immunoglobulin G (IgG) replacement therapy to prevent serious infections. Since the 1950s, therapy with human immune globulin products has been the standard of treatment. Currently, the most common routes of administration of IgG replacement therapy are intravenous (IVIG) or subcutaneous (SCIG). The home therapy may improve the quality of life in patients who require lifelong IgG replacement. The -anti-IgA antibody test identifies the patients with the risk of anaphylactoid reactions in IVIG replacement. The SCIG delivery may be used in patients with anti-IgA antibodies and previous systemic reactions to IVIG. PMID:23964967

  8. Hypersensitivity from intravenous iron products.

    PubMed

    Bircher, Andreas J; Auerbach, Michael

    2014-08-01

    In the last several years, intravenous therapy with iron products has been more widely used. Although it has been a standard procedure in dialysis-associated anemia since the early 1990s, its use is expanding to a host of conditions associated with iron deficiency, especially young women with heavy uterine bleeding and pregnancy. Free iron is associated with unacceptable high toxicity inducing severe, hemodynamically significant symptoms. Subsequently, formulations that contain the iron as an iron carbohydrate nanoparticle have been designed. With newer formulations, including low-molecular-weight iron dextran, iron sucrose, ferric gluconate, ferumoxytol, iron isomaltoside, and ferric carboxymaltose, serious adverse events are rare. PMID:25017687

  9. Solid-phase extraction coupled with ultra high performance liquid chromatography and electrospray tandem mass spectrometry for the highly sensitive determination of five iodinated X-ray contrast media in environmental water samples.

    PubMed

    Li, Xia; Hu, Junjian; Yin, Daqiang; Hu, Xialin

    2015-06-01

    A highly sensitive method based on solid-phase extraction and ultra high performance liquid chromatography with electrospray tandem mass spectrometry has been developed for simultaneous determination of five iodinated X-ray contrast media in environmental water samples. Various solid-phase extraction cartridges have been evaluated and a combination of LiChrolute EN and ENVI-Carb solid phase extraction cartridges was selected for sample enrichment. The method was comprehensively validated on ground water, tap water, surface water, drinking water, and waste water by the conventional procedures: linearity, method detection limits, accuracy and precision, matrix effects. Good linearity (R(2) > 0.999), low detection limits (0.4-8.1 ng/L), satisfactory recoveries (55.1-109.5%) and precision (0.8-10.0% for intra-day precisions and 0.6-16.5% for inter-day precisions) were obtained for all the target compounds. Iopamidol, iohexol, and diatrizoate in some matrices were affected by matrix effects, which were slightly eased by using the isotope-labeled internal standard. The developed method was successfully applied for real samples collected in Shanghai, China, with detected concentrations up to 2200 ± 200 and 9000 ± 1000 ng/L for iohexol and iopamidol, respectively. PMID:25832295

  10. Pancreatic enzyme secretion during intravenous fat infusion.

    PubMed

    Burns, G P; Stein, T A

    1987-01-01

    The nutritional support of patients with pancreatic and high gastrointestinal fistulas and severe pancreatitis frequently involves intravenous fat infusion. There are conflicting reports on the effect of intravenous fat on pancreatic exocrine secretion. In 10 dogs with chronic pancreatic fistulas, pancreatic juice was collected during secretin (n = 10) or secretin + cholecystokinin (n = 4) stimulation, with and without intravenous fat infusion (5 g/hr). The hormonal-stimulated secretion of lipase, amylase, trypsin, total protein, bicarbonate, and water was unchanged during fat infusion. This study supports the use of intravenous fat as a nutritional source when it is desirable to avoid stimulation of the pancreas. PMID:2434670

  11. Energy sources for intravenous nutrition

    PubMed Central

    Rowlands, B J

    1987-01-01

    Controversy exists concerning the appropriate use of carbohydrate solutions and fat emulsions as energy sources in intravenous nutritional regimens. Current evidence suggests that glucose is the carbohydrate energy source of choice and that when infused with appropriate quantities of protein it provides cheap and effective nutritional support in the majority of patients and clinical circumstances. During glucose infusion, blood glucose and acid-base balance should be closely monitored and, when indicated, exogenous insulin should be added to the regimen to combat hyperglycaemia and improve protein anabolism. Fat emulsions, although expensive, may justifiably be used in patients with moderate or severe stress to provide up to 50% of non-protein energy, especially in circumstances where attempts to satisfy energy requirements exclusively with glucose would impose an additional metabolic stress. PMID:3109093

  12. Intravenous Iron Carboxymaltose as a Potential Therapeutic in Anemia of Inflammation

    PubMed Central

    Traeger, Lisa; Bäumer, Nicole; Schulze, Isabell; Kuhlmann, Tanja; Müller-Tidow, Carsten

    2016-01-01

    Intravenous iron supplementation is an effective therapy in iron deficiency anemia (IDA), but controversial in anemia of inflammation (AI). Unbound iron can be used by bacteria and viruses for their replication and enhance the inflammatory response. Nowadays available high molecular weight iron complexes for intravenous iron substitution, such as ferric carboxymaltose, might be useful in AI, as these pharmaceuticals deliver low doses of free iron over a prolonged period of time. We tested the effects of intravenous iron carboxymaltose in murine AI: Wild-type mice were exposed to the heat-killed Brucella abortus (BA) model and treated with or without high molecular weight intravenous iron. 4h after BA injection followed by 2h after intravenous iron treatment, inflammatory cytokines were upregulated by BA, but not enhanced by iron treatment. In long term experiments, mice were fed a regular or an iron deficient diet and then treated with intravenous iron or saline 14 days after BA injection. Iron treatment in mice with BA-induced AI was effective 24h after iron administration. In contrast, mice with IDA (on iron deficiency diet) prior to BA-IA required 7d to recover from AI. In these experiments, inflammatory markers were not further induced in iron-treated compared to vehicle-treated BA-injected mice. These results demonstrate that intravenous iron supplementation effectively treated the murine BA-induced AI without further enhancement of the inflammatory response. Studies in humans have to reveal treatment options for AI in patients. PMID:27404499

  13. Prevention of Contrast-Induced Nephropathy (CIN) in Interventional Radiology Practice

    PubMed Central

    Gupta, Rajan K.; Bang, Tami J.

    2010-01-01

    Contrast-induced nephropathy (CIN) is a widely recognized and clinically significant problem in patients undergoing an increasing number of minimally invasive procedures that require contrast administration. Contrast-induced nephropathy is the third most common cause of hospital-acquired renal failure and has significant prognostic implications on patient outcomes. Interventional practitioners are faced with challenging decisions regarding prophylaxis and patient management. The major risk factor for developing CIN is preexisting renal dysfunction, particularly in association with diabetes. Patients are considered to be at risk when estimated glomerular filtration rate (eGFR) or estimated creatinine clearance (eCCr) is less than 60. The cornerstone of prevention of CIN is appropriate risk stratification, intravenous hydration with normal saline or sodium bicarbonate, appropriate withholding of nephrotoxic medications, use of low or iso-osmolar contrast media, and various intraprocedural methods for iodinated contrast dose reduction. Although N-acetylcysteine administration is popular, it remains unproven. Practitioners must be familiar with prevention strategies and diagnosis of CIN to minimize its clinical impact. PMID:22550376

  14. Development, validation, and application of a novel LC-MS/MS trace analysis method for the simultaneous quantification of seven iodinated X-ray contrast media and three artificial sweeteners in surface, ground, and drinking water.

    PubMed

    Ens, Waldemar; Senner, Frank; Gygax, Benjamin; Schlotterbeck, Götz

    2014-05-01

    A new method for the simultaneous determination of iodated X-ray contrast media (ICM) and artificial sweeteners (AS) by liquid chromatography-tandem mass spectrometry (LC-MS/MS) operated in positive and negative ionization switching mode was developed. The method was validated for surface, ground, and drinking water samples. In order to gain higher sensitivities, a 10-fold sample enrichment step using a Genevac EZ-2 plus centrifugal vacuum evaporator that provided excellent recoveries (90 ± 6 %) was selected for sample preparation. Limits of quantification below 10 ng/L were obtained for all compounds. Furthermore, sample preparation recoveries and matrix effects were investigated thoroughly for all matrix types. Considerable matrix effects were observed in surface water and could be compensated by the use of four stable isotope-labeled internal standards. Due to their persistence, fractions of diatrizoic acid, iopamidol, and acesulfame could pass the whole drinking water production process and were observed also in drinking water. To monitor the fate and occurrence of these compounds, the validated method was applied to samples from different stages of the drinking water production process of the Industrial Works of Basel (IWB). Diatrizoic acid was found as the most persistent compound which was eliminated by just 40 % during the whole drinking water treatment process, followed by iopamidol (80 % elimination) and acesulfame (85 % elimination). All other compounds were completely restrained and/or degraded by the soil and thus were not detected in groundwater. Additionally, a direct injection method without sample preparation achieving 3-20 ng/L limits of quantification was compared to the developed method. PMID:24590107

  15. A prototype space flight intravenous injection system

    NASA Technical Reports Server (NTRS)

    Colombo, G. V.

    1985-01-01

    Medical emergencies, especially those resulting from accidents, frequently require the administration of intravenous fluids to replace lost body liquids. The development of a prototype space flight intravenous injection system is presented. The definition of requirements, injectable concentrates development, water polisher, reconstitution hardware development, administration hardware development, and prototype fabrication and testing are discussed.

  16. "Basic MR Relaxation Mechanisms & Contrast Agent Design"

    PubMed Central

    De León-Rodríguez, Luis M.; Martins, André F.; Pinho, Marco; Rofsky, Neil; Sherry, A. Dean

    2015-01-01

    The diagnostic capabilities of magnetic resonance imaging (MRI) have undergone continuous and substantial evolution by virtue of hardware and software innovations and the development and implementation of exogenous contrast media. Thirty years since the first MRI contrast agent was approved for clinical use, a reliance on MR contrast media persists largely to improve image quality with higher contrast resolution and to provide additional functional characterization of normal and abnormal tissues. Further development of MR contrast media is an important component in the quest for continued augmentation of diagnostic capabilities. In this review we will detail the many important considerations when pursuing the design and use of MR contrast media. We will offer a perspective on the importance of chemical stability, particularly kinetic stability, and how this influences one's thinking about the safety of metal-ligand based contrast agents. We will discuss the mechanisms involved in magnetic resonance relaxation in the context of probe design strategies. A brief description of currently available contrast agents will be accompanied by an in-depth discussion that highlights promising MRI contrast agents in development for future clinical and research applications. Our intention is to give a diverse audience an improved understanding of the factors involved in developing new types of safe and highly efficient MR contrast agents and, at the same time, provide an appreciation of the insights into physiology and disease that newer types of responsive agents can provide. PMID:25975847

  17. Intravenous thrombolytics for ischemic stroke.

    PubMed

    Barreto, Andrew D

    2011-07-01

    For many decades, intravenous (IV) thrombolytics have been delivered to treat acute thrombosis. Although these medications were originally effective for coronary thrombosis, their mechanisms have proven beneficial for many other disease processes, including ischemic stroke. Treatment paradigms for acute ischemic stroke have largely followed those of cardiology. Specifically, the aim has been to recanalize the occluded artery and to restore perfusion to the brain that remains salvageable. To that end, rapid clot lysis was sought using thrombolytic medicines already proven effective in the coronary arteries. IV-thrombolysis for ischemic stroke began its widespread adoption in the late 1990s after the publication of the National Institute of Neurological Disorders and Stroke study. Since that time, other promising IV-thrombolytics have been developed and tested in human trials, but as of yet, none have been proven better than a placebo. Adjunctive treatments are also being evaluated. The challenge remains balancing reperfusion and salvaging brain tissue with the potential risks of brain hemorrhage. PMID:21638138

  18. Disposition of intravenous radioactive acyclovir

    SciTech Connect

    de Miranda, P.; Good, S.S.; Laskin, O.L.; Krasny, H.C.; Connor, J.D.; Lietman, P.S.

    1981-11-01

    The kinetic and metabolic disposition of (8-14C)acyclovir (ACV) was investigated in five subjects with advanced malignancy. The drug was administered by 1-hr intravenous infusion at doses of 0.5 and 2.5 mg/kg. Plasma and blood radioactivity-time, and plasma concentration-time data were defined by a two-compartment open kinetic model. There was nearly equivalent distribution of radioactivity in blood and plasma. The overall mean plasma half-life and total body clearance +/- SD of ACV were 2.1 +/- 0.5 hr and 297 +/- 53 ml/min/1.73 m2. Binding of ACV to plasma proteins was 15.4 +/- 4.4%. Most of the radioactive dose excreted was recovered in the urine (71% to 99%) with less than 2% excretion in the feces and only trace amounts in the expired Co2. Analyses by reverse-phase high-performance liquid chromatography indicated that 9-(carboxymethoxymethyl)guanine was the only significant urinary metabolite of ACV, accounting for 8.5% to 14.1% of the dose. A minor metabolite (less than 0.2% of dose) had the retention time of 8-hydroxy-9-((2-hydroxyethoxy)methyl)guanine. Unchanged urinary ACV ranged from 62% to 91% of the dose. There was no indication of ACV cleavage to guanine. Renal clearance of ACV was approximately three times the corresponding creatinine clearances.

  19. Intravenous iron-containing products: EMA procrastination.

    PubMed

    2014-07-01

    A European reassessment has led to identical changes in the summaries of product characteristics (SPCs) for all intravenous iron-containing products: the risk of serious adverse effects is now highlighted, underlining the fact that intravenous iron-containing products should only be used when the benefits clearly outweigh the harms. Unfortunately, iron dextran still remains on the market despite a higher risk of hypersensitivity reactions than with iron sucrose. PMID:25162093

  20. Media Clips

    ERIC Educational Resources Information Center

    Vennebush, G. Patrick

    2004-01-01

    Media Clips aims to offer readers contemporary, authentic applications of quantitative reasoning based on print or electronic media. Clips may be in text or graphic format, and clip sources may be either print or electronic media.

  1. Generation of superparamagnetic liposomes revealed as highly efficient MRI contrast agents for in vivo imaging.

    PubMed

    Martina, Marie-Sophie; Fortin, Jean-Paul; Ménager, Christine; Clément, Olivier; Barratt, Gillian; Grabielle-Madelmont, Cécile; Gazeau, Florence; Cabuil, Valérie; Lesieur, Sylviane

    2005-08-01

    Maghemite (gamma-Fe2O3) nanocrystals stable at neutral pH and in isotonic aqueous media were synthesized and encapsulated within large unilamellar vesicles of egg phosphatidylcholine (EPC) and distearoyl-SN-glycero-3-phosphoethanolamine-N-[methoxy(poly(ethylene glycol))-2000] (DSPE-PEG(2000), 5 mol %), formed by film hydration coupled with sequential extrusion. The nonentrapped particles were removed by flash gel exclusion chromatography. The magnetic-fluid-loaded liposomes (MFLs) were homogeneous in size (195 +/- 33 hydrodynamic diameters from quasi-elastic light scattering). Iron loading was varied from 35 up to 167 Fe(III)/lipid mol %. Physical and superparamagnetic characteristics of the iron oxide particles were preserved after liposome encapsulation as shown by cryogenic transmission electron microscopy and magnetization curve recording. In biological media, MFLs were highly stable and avoided ferrofluid flocculation while being nontoxic toward the J774 macrophage cell line. Moreover, steric stabilization ensured by PEG-surface-grafting significantly reduced liposome association with the macrophages. The ratios of the transversal (r2) and longitudinal (r1) magnetic resonance (MR) relaxivities of water protons in MFL dispersions (6 < r2/r1 < 18) ranked them among the best T2 contrast agents, the higher iron loading the better the T2 contrast enhancement. Magnetophoresis demonstrated the possible guidance of MFLs by applying a magnetic field gradient. Mouse MR imaging assessed MFLs efficiency as contrast agents in vivo: MR angiography performed 24 h after intravenous injection of the contrast agent provided the first direct evidence of the stealthiness of PEG-ylated magnetic-fluid-loaded liposomes. PMID:16045355

  2. Treatment of serious infections with intravenous ciprofloxacin.

    PubMed

    Scully, B E; Neu, H C

    1987-04-27

    Thirty-four patients were treated with intravenous ciprofloxacin. Thirty infections occurring in 28 patients were assessable for the efficacy analysis. The drug dosage was 300 mg every 12 hours in 19 patients and 200 mg intravenously every 12 hours in nine patients. Twelve patients were also given ciprofloxacin orally after initial intravenous therapy. The mean duration of total therapy was 31 days. The overall clinical response rate was 87 percent, and the bacteriologic response rate was 70 percent. Favorable responses were observed in 10 of 12 patients with osteomyelitis/septic arthritis; seven of eight with soft tissue infection; four of four with pneumonitis; one of two with cystic fibrosis; and four of four with urinary tract infections. Resistance to ciprofloxacin developed in three Pseudomonas aeruginosa isolates. Toxicity was minor: phlebitis occurred in six patients, nausea in six, and rash in one. Intravenously administered ciprofloxacin or intravenous ciprofloxacin followed by oral ciprofloxacin is a safe and effective therapy for serious infections. PMID:3555062

  3. Intravenous access during pre-hospital emergency care of non-injured patients: a population-based outcome study

    PubMed Central

    Seymour, Christopher W.; Cooke, Colin R.; Hebert, Paul L.; Rea, Thomas D.

    2011-01-01

    Study objective Advanced, pre-hospital procedures such as intravenous access are commonly performed by emergency medical services (EMS) personnel, yet little evidence supports their use among non-injured patients. We evaluated the association between pre-hospital, intravenous access and mortality among non-injured, non-arrest patients. Methods We analyzed a population-based cohort of adult (aged ≥18 years) non-injured, non-arrest patients transported by four advanced life support agencies to one of 16 hospitals from January 1, 2002 until December 31, 2006. We linked eligible EMS records to hospital administrative data, and used multivariable logistic regression to determine the risk-adjusted association between pre-hospital, intravenous access and hospital mortality. We also tested whether this association differed by patient acuity using a previously published, out-of-hospital triage score. Results Among 56,332 eligible patients, one half (N=28,978, 50%) received pre-hospital intravenous access from EMS personnel. Overall hospital mortality in patients who did and did not receive intravenous access was 3%. However, in multivariable analyses, the placement of pre-hospital, intravenous access was associated with an overall reduction in odds of hospital mortality (OR=0.68, 95%CI: 0.56, 0.81). The beneficial association of intravenous access appeared to depend on patient acuity (p=0.13 for interaction). For example, the OR of mortality associated with intravenous access was 1.38 (95%CI: 0.28, 7.0) among those with lowest acuity (score = 0). In contrast, the OR of mortality associated with intravenous access was 0.38 (95%CI: 0.17, 0.9) among patients with highest acuity (score ≥ 6). Conclusions In this population-based cohort, pre-hospital, intravenous access was associated with a reduction in hospital mortality among non-injured, non-arrest patients with the highest acuity. PMID:21872970

  4. Media education.

    PubMed

    Strasburger, Victor C

    2010-11-01

    The American Academy of Pediatrics recognizes that exposure to mass media (eg, television, movies, video and computer games, the Internet, music lyrics and videos, newspapers, magazines, books, advertising) presents health risks for children and adolescents but can provide benefits as well. Media education has the potential to reduce the harmful effects of media and accentuate the positive effects. By understanding and supporting media education, pediatricians can play an important role in reducing harmful effects of media on children and adolescents. PMID:20876180

  5. Particulate contaminants of intravenous medications and infusions.

    PubMed

    Backhouse, C M; Ball, P R; Booth, S; Kelshaw, M A; Potter, S R; McCollum, C N

    1987-04-01

    Particulate contamination in small volume parenteral medications has been studied and compared with that found in a selection of large volume infusions. Particle counts in 39 commonly used small volume medications and 7 large volume infusions were performed by an automated light blockage method (HIAC) or by optical microscopy. Based on these results and a random survey of drug therapy of intensive care patients, it is concluded that the contribution of intravenous medications to the total particle load received by such patients is likely to be many times greater than from infusion fluids. Until firm evidence regarding the harmful systemic effects of drug particles is available and the manufacturing regulations adjusted appropriately, final in-line filtration of infusions immediately proximal to the intravenous cannula should be considered when drugs are being given intravenously. PMID:2884285

  6. Clinical and economic evidence for intravenous acetaminophen.

    PubMed

    Yeh, Yu-Chen; Reddy, Prabashni

    2012-06-01

    Intravenous acetaminophen received United States Food and Drug Administration approval in November 2010 for the management of mild-to-moderate pain, management of moderate-to-severe pain with adjunctive opioid analgesics, and reduction of fever. Although intravenous acetaminophen generally improved pain relief and demonstrated opioid-sparing effects compared with placebo, it did not consistently reduce the frequency of opioid-related adverse events (e.g., postoperative nausea and vomiting). The safety and efficacy of intravenous acetaminophen as an antipyretic agent have been documented in adults and children; however, its cost is several-fold higher than that of the oral and rectal formulations. Although use of intravenous acetaminophen has reduced other postoperative resource utilization (e.g., hospital length of stay) in some studies outside the United States in patients undergoing abdominal surgery, a full economic evaluation in the United States has yet to be undertaken. In addition, its administration time (15-min infusion) and packaging (glass, single-use vial) have the potential to adversely affect patient flow in the postanesthesia care unit, create burden on patient care units, and lead to drug waste. Furthermore, 1 g of intravenous acetaminophen is formulated in 100 ml of solution, which may be an issue for patients with fluid restrictions. Given the clinical and economic evidence currently available, intravenous acetaminophen should not replace oral or rectal acetaminophen, but its use may be considered in a limited number of patients who cannot receive drugs orally and rectally and who cannot tolerate other parenteral nonopioid analgesic or antipyretic agents. PMID:22570116

  7. Precocious emphysema in intravenous drug abusers.

    PubMed

    Weisbrod, G L; Rahman, M; Chamberlain, D; Herman, S J

    1993-01-01

    It is becoming increasingly clear that obstructive airway disease and early emphysema occur in some drug addicts who intravenously abuse drugs intended for oral use. We report four patients with such a history who had clinical, pathophysiologic, and radiologic evidence of severe obstructive airway disease with hyperinflation. Three patients had bullae. All had radiologic changes of intravenous talc granulomatosis. One patient had moderately severe emphysema at autopsy. The pathogenesis of this disease is uncertain but may involve synergism with cigarette smoke, direct toxic effects of the drug, or induced intravascular leukocyte sequestration causing proteolytic pulmonary injury. PMID:8320766

  8. Eastern Equine Encephalitis Treated With Intravenous Immunoglobulins

    PubMed Central

    Mukerji, Shibani S.; Lam, Alice D.

    2016-01-01

    We report the case of a 68-year-old man from southeastern Massachusetts presenting with encephalitis due to eastern equine encephalitis (EEE) virus. Despite the high morbidity and mortality rate of EEE, the patient made a near complete recovery in the setting of receiving early intravenous immunoglobulins. PMID:26740855

  9. Health Instruction Packages: Venipuncture and Intravenous Therapy.

    ERIC Educational Resources Information Center

    Gray, P. Allen, Jr.; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nursing students in techniques for initiating intravenous (I.V.) therapy. The first module, "Selection of a Venipuncture Site: Arm" by P. Allen Gray, Jr., describes the utilization of a tourniquet in locating filled veins in the arm. The second module,…

  10. [Lethal reaction after contrast medium administration].

    PubMed

    Risgaard, Ole; Søe, Charlotte Krabbe; Zejden, Anna

    2008-04-21

    A 49-year-old healthy woman was admitted after a horse-riding accident. On arrival to the emergency department she complained of lower abdominal pain. A CT-scan of the abdomen with non ionic contrast media (iomeprol, 150 ml 4 ml/s) was conducted. The patient died nine hours later due to an anaphylactoid reaction to radio contrast media. The autopsy showed pulmonary oedema and pleural effusion, but did not show any sign of trauma. Early interventions with appropriate therapy had no effect on the fatal outcome. PMID:18462629

  11. New Media.

    ERIC Educational Resources Information Center

    Downtown Business Quarterly, 1998

    1998-01-01

    This theme issue explores lower Manhattan's burgeoning "New Media" industry, a growing source of jobs in lower Manhattan. The first article, "New Media Manpower Issues" (Rodney Alexander), addresses manpower, training, and workforce demands faced by new media companies in New York City. The second article, "Case Study: Hiring @ Dynamid" (John…

  12. Media Panel.

    ERIC Educational Resources Information Center

    Marklund, Inger, Ed.; Hanse, Mona-Britt, Ed.

    1984-01-01

    The Swedish Media Panel is a research program about children and young persons and their use of mass media. The aim of the ten-year (1975-1985) project is to explain how media habits originate, how they change as children grow older, what factors on the part of children themselves and in their surroundings may be connected with a certain use of…

  13. Intravenous/oral ciprofloxacin therapy versus intravenous ceftazidime therapy for selected bacterial infections.

    PubMed

    Gaut, P L; Carron, W C; Ching, W T; Meyer, R D

    1989-11-30

    The efficacy and toxicity of sequential intravenous and oral ciprofloxacin therapy was compared with intravenously administered ceftazidime in a prospective, randomized, controlled, non-blinded trial. Thirty-two patients (16 patients receiving ciprofloxacin and 16 patients receiving ceftazidime) with 38 infections caused by susceptible Pseudomonas aeruginosa, enteric gram-negative rods, Salmonella group B, Serratia marcescens, Pseudomonas cepacia, and Xanthomonas maltophilia at various sites were evaluable for determination of efficacy. Length of therapy varied from seven to 25 days. Concomitant antimicrobials included intravenously administered beta-lactams for gram-positive organisms, intravenous/oral metronidazole and clindamycin for anaerobes, and intravenous/local amphotericin B for Candida albicans. Intravenous administration of 200 mg ciprofloxacin every 12 hours to 11 patients produced peak serum levels between 1.15 and 3.12 micrograms/ml; trough levels ranged between 0.08 and 0.86 micrograms/ml. Overall response rates were similar for patients receiving ciprofloxacin and ceftazidime. Emergence of resistance was similar in both groups--one Enterobacter cloacae and two P. aeruginosa became resistant after ciprofloxacin therapy and two P. aeruginosa became resistant after ceftazidime therapy. The frequency of superinfection with a variety of organisms was also similar in both groups. Adverse events related to ciprofloxacin included transient pruritus at the infusion site and generalized rash leading to drug discontinuation (one patient each), and with ceftazidime adverse effects included pain at the site of infusion and the development of allergic interstitial nephritis (one patient each). Overall, intravenous/oral ciprofloxin therapy appears to be as safe and effective as intravenous ceftazidime therapy in the treatment of a variety of infections due to susceptible aerobic gram-negative organisms. PMID:2686417

  14. Efficacy of Intravenous Paracetamol Versus Intravenous Morphine in Acute Limb Trauma

    PubMed Central

    Jalili, Mohammad; Mozaffarpour Noori, Ali; Sedaghat, Mojtaba; Safaie, Arash

    2016-01-01

    Background: Efficient pain management is one of the most important components of care in the field of emergency medicine. Objectives: This study was conducted to compare intravenous paracetamol and intravenous morphine sulfate for acute pain reduction in patients with limb trauma. Patients and Methods: In a randomized double-blinded clinical trial, all patients (aged 18 years and older) with acute limb trauma and a pain score of greater than 3/10 in the emergency department were recruited; they received either 1 g intravenous paracetamol or 0.1 mg/kg intravenous morphine sulfate over 15 minutes. The primary outcome was the pain score measured on a numerical rating scale at 0, 15 and 30 minutes after commencing drug administration. The requirement for rescue analgesia and the frequency of adverse reactions were also recorded. Results: Sixty patients randomly received either IV paracetamol (n = 30) or IV morphine (n = 30). The mean reduction in numerical rating scale pain intensity scores at 30 minutes was 3.86 (± 1.61) for paracetamol, and 2.16 (± 1.39) for morphine. However, pain relief was significantly higher in the paracetamol group compared to the morphine group (P < 0.001). Four patients in the paracetamol group and 15 patients in the morphine group needed rescue analgesia and the difference was significant (P = 0.05). Conclusions: Intravenous paracetamol appears to provide better analgesia than intravenous morphine in acute limb trauma. Further larger studies are required. PMID:27218042

  15. Hydrothorax, hydromediastinum and pericardial effusion: a complication of intravenous alimentation.

    PubMed

    Damtew, B; Lewandowski, B

    1984-06-15

    Complications secondary to intravenous alimentation are rare but potentially lethal. Massive bilateral pleural effusions and a pericardial effusion developed in a patient receiving prolonged intravenous alimentation. Severe respiratory distress and renal failure ensued. He recovered with appropriate treatment. PMID:6428731

  16. Acute contrast reaction management by radiologists: a local audit study.

    PubMed

    Bartlett, Murray J; Bynevelt, Michael

    2003-12-01

    Consultant radiologists and trainees must possess knowledge of optimal acute management of anaphylactic/anaphylactoid contrast reactions because patient survival depends upon prompt initial management. The aim of the present study is to assess the knowledge of first-line management of these reactions among radiologists. Within one working day, and without prior knowledge, radiology consultants and trainees within four teaching hospitals in a major Australian capital city were asked to complete a confidential questionnaire regarding acute resuscitation management. Scenarios were presented of an adult who developed life-threatening symptoms of anaphylaxis immediately after intravenous contrast administration, ventricular fibrillation and profound bradycardia. Questions were asked with regards to adrenaline, corticosteroid, antihistamines, intravenous volume expansion, cardio-pulmonary rescuscitation and knowledge of the emergency telephone number. Sites were assessed for presence of an anaphylaxis management chart and also when each participant last completed a resuscitation course. Forty-two participants were recruited. Overall, 53% of questions were answered correctly. Only 43% knew the adrenaline dose and if an incorrect dose was administered it was more likely to be an overdose. Notable inadequacies were also discovered with corticosteroid, atropine, antihistamine doses and intravenous fluid use. Only 26% had completed a resuscitation course in the past 2 years. Forty-five percent knew the emergency telephone number and 55% of rooms using intravenous contrast contained an immediately visible chart for contrast reaction management. Radiologist and trainee knowledge of immediate life-threatening contrast reaction management is deficient. Severe contrast reactions are uncommon with today's use of non-ionic contrast, but they still occur. Experience in the management of anaphylaxis can only come from regular, compulsory training. PMID:14641186

  17. Diurnal Variation in Response to Intravenous Glucose*

    PubMed Central

    Whichelow, Margaret J.; Sturge, R. A.; Keen, H.; Jarrett, R. J.; Stimmler, L.; Grainger, Susan

    1974-01-01

    Intravenous glucose tolerance tests (25 g) were performed in the morning and afternoon on 13 apparently normal persons. The individual K values (rate of decline of blood sugar) were all higher in the morning tests, and the mean values were significantly higher in the morning. Fasting blood sugar levels were slightly lower in the afternoon. There was no difference between the fasting morning and afternoon plasma insulin levels, but the levels after glucose were lower in the afternoon. Growth hormone levels were low at all times in non-apprehensive subjects and unaffected by glucose. The results suggest that the impaired afternoon intravenous glucose tolerance, like oral glucose tolerance, is associated with impaired insulin release and insulin resistance. PMID:4817160

  18. [How to control postoperative pain: intravenous route].

    PubMed

    Occella, P; Vivaldi, F

    2003-12-01

    Intravenous administration of analgesic drugs is one of the most common ways to control post-operative pain. It can be used in almost all kinds of surgical interventions and particularly those of medium and high complexity. Besides, when other techniques are contraindicated because of clinical and/or managing problems, intravenous way finds its best application. Among analgesic drugs NSAID (ketorolac) and opioids (tramadol, morphine, buprenorphine) are most frequently used. As to administration techniques, elastomeric pump is, according to personal experience, a simple-to-manage, practical and precise device with lower cost respect to other administration set. Elastomeric pump is a single use reservoir that allows continuous administration of drugs with a uniform pre-set infusion speed. Finally, guide-lines, showing pre-load and infusion doses of analgesic drugs, based on pain intensity, are presented. PMID:14663417

  19. Visualization of Coronary Arteries from Intravenous Angiograms

    NASA Technical Reports Server (NTRS)

    Selzer, Robert H.

    1985-01-01

    Under most circumstances, the coronary arteries are not satisfactorily visualized in intravenous angiograms. The objective of this study is to develop computer image enhancement methods that will improve the quality of the latent coronary images to a degree sufficient to detect an obstructive lesion. Such a technique, if successful, could be used as a first step alternative to conventional coronary angiography for individuals with ambiguous noninvasive cardiac tests. The determination of no lesion from the intravenous procedure would relieve the need for the conventional angiogram, while verification of an obstructive lesion could be followed by a conventional angiogram. The nature of the imaging problem and a description of the methods and initial processing results are described in this paper.

  20. Intravenous immunoglobulin in pediatrics: A review

    PubMed Central

    Prasad, A.N.; Chaudhary, Sanjay

    2013-01-01

    There has been a rapid expansion of the use of intravenous immunoglobulin (IVIG) for an ever-growing number of conditions. IVIG is used at a ‘replacement dose’ (400–600 mg/kg/month) in antibody deficiencies and is used at a high dose (2 g/kg) as an ‘immunomodulatory’ agent in an increasing number of immune and inflammatory disorders.1 The limitations for IVIG are the cost of the preparation and the need for intravenous infusions. Due to the cost, shortages and growing use of IVIG there have been attempts to develop evidence-based guidelines for the use of IVIG in a wide variety of immune disorders in children and neonates. This commentary provides the recommendations and recent publication regarding the use of IVIG in various conditions in children. PMID:25378784

  1. [High-dose intravenous immunoglobulin treatment].

    PubMed

    Taneichi, Hiromichi; Miyawaki, Toshio

    2011-03-01

    Intravenous immunoglobulin treatment was introduced as replacement therapy for patients with congenital agammaglobulinemia. For the last three decades, high-dose intravenous immunoglobulin (HD-IVIg) has been used for autoimmune diseases and systemic inflammatory diseases, such as idiopathic thrombocytopenic purpura, Kawasaki disease, myasthenia gravis and Guillain-Barré/syndrome. Although the immunomodulatory mechanisms of HD-IVIg remains unclear. Its use in many other diseases have been expected. Acute encephalitis/encephalopathy is a complex neurological syndrome associated with significant morbidity and mortality. The pathogenicity of brain dysfunction is still unknown. This review provides an overview and discussion of mechanisms that may be responsible for HD-IVIg effects in acute encephalitis/encephalopathy. PMID:21400848

  2. Intravenous Lipid Emulsions in Parenteral Nutrition.

    PubMed

    Fell, Gillian L; Nandivada, Prathima; Gura, Kathleen M; Puder, Mark

    2015-09-01

    Fat is an important macronutrient in the human diet. For patients with intestinal failure who are unable to absorb nutrients via the enteral route, intravenous lipid emulsions play a critical role in providing an energy-dense source of calories and supplying the essential fatty acids that cannot be endogenously synthesized. Over the last 50 y, lipid emulsions have been an important component of parenteral nutrition (PN), and over the last 10-15 y many new lipid emulsions have been manufactured with the goal of improving safety and efficacy profiles and achieving physiologically optimal formulations. The purpose of this review is to provide a background on the components of lipid emulsions, their role in PN, and to discuss the lipid emulsions available for intravenous use. Finally, the role of parenteral fat emulsions in the pathogenesis and management of PN-associated liver disease in PN-dependent pediatric patients is reviewed. PMID:26374182

  3. Safety of the Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging, Focusing in Part on Their Accumulation in the Brain and Especially the Dentate Nucleus.

    PubMed

    Runge, Val M

    2016-05-01

    The established class of intravenous contrast media for magnetic resonance imaging is the gadolinium chelates, more generally referred to as the gadolinium-based contrast agents (GBCAs). These can be differentiated on the basis of stability in vivo, with safety and tolerability of the GBCAs dependent upon chemical and biologic inertness. This review discusses first the background in terms of development of these agents and safety discussions therein, and second their relative stability based both on in vitro studies and clinical observations before and including the advent of nephrogenic systemic fibrosis. This sets the stage for the subsequent focus of the review, the current knowledge regarding accumulation of gadolinium in the brain and specifically the dentate nucleus after intravenous administration of the GBCAs and differentiation among agents on this basis. The information available to date, from the initial conception of these agents in 1981 to the latest reports concerning safety, demonstrates a significant difference between the macrocyclic and linear chelates. The review concludes with a discussion of the predictable future, which includes, importantly, a reassessment of the use of the linear GBCAs or a subset thereof. PMID:26945278

  4. Effect of contrast agent administration on consequences of dosimetry and biology in radiotherapy planning

    NASA Astrophysics Data System (ADS)

    Lo, Ching-Jung; Yang, Pei-Ying; Chao, Tsi-Chian; Tu, Shu-Ju

    2015-06-01

    In the treatment planning of radiation therapy, patients may be administrated with contrast media in CT scanning to assist physicians for accurate delineation of the target or organs. However, contrast media are not used in patients during the treatment delivery. In particular, contrast media contain materials with high atomic numbers and dosimetric variations may occur between scenarios where contrast media are present in treatment planning and absent in treatment delivery. In this study we evaluate the effect of contrast media on the dosimetry and biological consequence. An analytical phantom based on AAPM TG 119 and five sets of CT images from clinical patients are included. Different techniques of treatment planning are considered, including 1-field AP, 2-field AP+PA, 4-field box, 7-field IMRT, and RapidArc. RapidArc is a recent technique of volumetric modulated arc therapy and is used in our study of contrast media in clinical scenarios. The effect of RapidArc on dosimetry and biological consequence for administration of contrast media in radiotherapy is not discussed previously in literature. It is shown that dose difference is reduced as the number of external beams is increased, suggesting RapidArc may be favored to be used in the treatment planning enhanced by contrast media. Linear trend lines are fitted for assessment of percent dose differences in the planning target volume versus concentrations of contrast media between plans where contrast media are present and absent, respectively.

  5. Intravenous access: a comparison of two methods.

    PubMed

    Duffy, B L; Lee, J S

    1983-05-01

    The reliability in providing a continued venous route to the circulation is compared between a winged needle (Abbott "Butterfly--23 INT") and a plastic catheter (Jelco Teflon "Catheter Placement Unit", 22 gauge). The catheter remained within the vein in all cases and had a much lower incidence of total obstruction during the study period. Where an intravenous infusion is not in place, a plastic catheter provides a more reliable access route to the circulation than does a winged needle. PMID:6869776

  6. Disinfection practices in intravenous drug administration.

    PubMed

    Helder, Onno K; Kornelisse, René F; Reiss, Irwin K M; Ista, Erwin

    2016-06-01

    The aim of the study was to determine the effectiveness of a feedback intervention on adherence to disinfection procedures during intravenous medication preparation and administration. We found that full adherence to the protocols significantly improved from 7.3% to 21.5% (P < .001) regarding medication preparation and from 7.9% to 15.5% (P = .012) regarding medication administration. However, disinfection practices still need improvement. PMID:26899528

  7. Role of Contrast in MR Imaging.

    PubMed

    Chandra, Tushar; Mohan, Suyash

    2016-08-01

    Magnetic resonance (MR) contrast agents have been widely used over the last 3 decades in routine clinical practice. Paul Lauterbur recognized the presence of these contrast agents, which act as paramagnetic catalysts that accelerate the T1 relaxation process. The first MR contrast agent to be approved for clinical use was in 1988, and since then, it is estimated that 200 million doses have been administered worldwide. These contrast agents have diverse clinical as well as research applications, involving almost all the body organs. This review will cover some existing as well as many new applications that have emerged over the last few decades. MR imaging now has the potential of being used to monitor enzymatic activity, gene expression, metal ion homeostasis, and cell death in vivo. In future, newer contrast agents will develop and become commercially available, expanding the current clinical applications of MR contrast media. PMID:27367311

  8. The Variable Rate Intravenous Insulin Infusion Protocol.

    PubMed

    Collard, Benjamin; Sturgeon, Jonathan; Patel, Natasha; Asharia, Shabbar

    2014-01-01

    Insulin use among inpatients is high and associated with severe and regular medication errors. An initial baseline audit showed a wide variation in the prescription of intravenous insulin within the trust. These included variation in the choice of fluid prescribed, electrolyte levels not consistently checked, handwritten illegible prescriptions, and varying parameters set for adjustment of the prescription. A Variable Rate Intravenous Insulin Infusion protocol (VRIII)) was introduced to standardize intravenous insulin prescription throughout the trust by all members of the clinical team. We looked at and measured uptake and effects of the VRIII protocol in improving standardization of insulin prescription for inpatients on insulin at St George's NHS trust. The protocol was uploaded to the intranet to allow access 24 hours a day and the staff educated about it. The VRIII protocol was routinely used successfully throughout the trust. Any initial problems were addressed through education of clinical staff. The protocol has shown decreased prescribing and administrative errors, whilst demonstrating good glucose and electrolyte control. Use of a standardized protocol helps reduce medication errors and demonstrates good glycaemic control. Regular and continued education of clinical staff is necessary to maintain its efficacy. PMID:26734228

  9. Intravenous Lipids for Preterm Infants: A Review

    PubMed Central

    Salama, Ghassan SA; Kaabneh, Mahmmoud AF; Almasaeed, Mai N; Alquran, Mohammad IA

    2015-01-01

    Extremely low birth weight infants (ELBW) are born at a time when the fetus is undergoing rapid intrauterine brain and body growth. Continuation of this growth in the first several weeks postnatally during the time these infants are on ventilator support and receiving critical care is often a challenge. These infants are usually highly stressed and at risk for catabolism. Parenteral nutrition is needed in these infants because most cannot meet the majority of their nutritional needs using the enteral route. Despite adoption of a more aggressive approach with amino acid infusions, there still appears to be a reluctance to use early intravenous lipids. This is based on several dogmas that suggest that lipid infusions may be associated with the development or exacerbation of lung disease, displace bilirubin from albumin, exacerbate sepsis, and cause CNS injury and thrombocytopena. Several recent reviews have focused on intravenous nutrition for premature neonate, but very little exists that provides a comprehensive review of intravenous lipid for very low birth and other critically ill neonates. Here, we would like to provide a brief basic overview, of lipid biochemistry and metabolism of lipids, especially as they pertain to the preterm infant, discuss the origin of some of the current clinical practices, and provide a review of the literature, that can be used as a basis for revising clinical care, and provide some clarity in this controversial area, where clinical care is often based more on tradition and dogma than science. PMID:25698888

  10. Comparing the Efficacy of Intravenous Acetaminophen and Intravenous Meperidine in Pain Relief After Outpatient Urological Surgery

    PubMed Central

    Kolahdouzan, Khosro; Eydi, Mahmood; Mohammadipour Anvari, Hassan; Golzari, Samad EJ; Abri, Reyhaneh; Ghojazadeh, Morteza; Ojaghihaghighi, Seyed Hossein

    2014-01-01

    Background: Pain relief after surgery is an essential component of postoperative care. Objectives: The purpose of this study was to compare the efficacy of intravenous acetaminophen and intravenous meperidine in pain relief after outpatient urological surgery. Patients and Methods: In a prospective, randomized, double-blind clinical trial, 100 outpatients of urological surgery were studied in two groups of acetaminophen (A) and meperidine (M). Patients in group A received 1g of acetaminophen in 100 mL saline within 15 minutes and patients in group M received a single intravenous injection of meperidine 0.5 mg/kg, 15 minutes prior to the end of operation. Postoperative pain was recorded using visual analog scale (VAS). Vital signs, nausea, vomiting, dizziness and respiratory depressions were compared between the two groups. Results: Pain severity in patients treated with intravenous acetaminophen six hours after the operation within one-hour interval was significantly lower than meperidine group (P < 0.0001). Ninety patients in the meperidine group and five patients in the acetaminophen group required additional doses of analgesics. Nausea was significantly lower in acetaminophen group than meperidine group. Conclusions: Intravenous acetaminophen reduced pain following outpatient urological surgery more significantly than meperidine. PMID:25798377

  11. [Iodinated contrast agents used in Radiology].

    PubMed

    Ramírez Ribelles, C; Sánchez Fuster, M A; Pamies Guilabert, J

    2014-06-01

    Iodinated contrast media are widely used in Radiology practices with a very low rate of adverse effects, being contrast-induced nephropathy the most serious one. In the majority of cases it is temporary and reversible, even though it can increase the inhospital morbidity and mortality in patients with risk factors. We will describe the various measures of prevention, being hydration and use of non-ionic contrast low osmolality those which have demonstrated greater effectiveness. Precautions to be taken in some risk situations, as patients treated with metformin or with impaired renal function, are also discussed. PMID:25267147

  12. Contrast enhanced ultrasound of breast cancer

    PubMed Central

    Cassano, E; Rizzo, S; Bozzini, A; Menna, S; Bellomi, M

    2006-01-01

    The importance of ultrasound examination in the diagnosis of breast cancer has been widely demonstrated. During the last few years, the introduction of ultrasound contrast media has been considered a promising tool for studying the vascular pattern of focal lesions within the breast. Our purpose was to assess whether contrast-enhanced (CE) ultrasound examination, performed using specific contrast imaging modes, can be helpful for detection and characterization of breast lesions, and for prediction of the response of breast cancer to therapy. PMID:16478698

  13. Contrast enhanced ultrasound of breast cancer.

    PubMed

    Cassano, E; Rizzo, S; Bozzini, A; Menna, S; Bellomi, M

    2006-01-01

    The importance of ultrasound examination in the diagnosis of breast cancer has been widely demonstrated. During the last few years, the introduction of ultrasound contrast media has been considered a promising tool for studying the vascular pattern of focal lesions within the breast. Our purpose was to assess whether contrast-enhanced (CE) ultrasound examination, performed using specific contrast imaging modes, can be helpful for detection and characterization of breast lesions, and for prediction of the response of breast cancer to therapy. PMID:16478698

  14. Antioxidant effect of Phyllanthus emblica extract prevents contrast-induced acute kidney injury

    PubMed Central

    2014-01-01

    Background Contrast-induced acute kidney injury (CI-AKI) occurs after the administration of intravenous iodinated contrast agents. Oxidative stress has been proposed as one of the most important mechanisms in the pathogenesis of CI-AKI. The objective of this study was to investigate the antioxidant effect of the extract from Phyllanthus emblica (PE) in preventing CI-AKI. Methods Male Sprague Dawley rats were subjected into eight groups, were given water (control) or PE extract (125 or 250 or 500 mg/kg/day) for 5 days before the induction of CI-AKI. Renal function and oxidative stress markers; malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD) and catalase (CAT) activity were determined in plasma and renal tissue. Kidney sections were performed for histopathological examination. Results In the contrast media (CM) group, increases in blood urea nitrogen and serum creatinine were demonstrated which correlated with severity of tubular necrosis, peritubular capillary congestion and interstitial edema. Moreover, an increase in MDA and a decrease in TAC SOD and CAT activity in CM group were significantly changed when compared with the control (P < 0.05). In contrast, CI-AKI-induced rats administrated with PE extract 250 and 500 mg/kg/day significantly preserved renal function and attenuated the severity of pathological damage (P < 0.05) as well as significantly lower MDA and higher TAC, SOD and CAT than the CM group (P < 0.05). Conclusions This study demonstrated the protective role of PE extract against CI-AKI. PMID:24755233

  15. Preventive effect of pentoxifylline on contrast-induced acute kidney injury in hypercholesterolemic rats

    PubMed Central

    YANG, SHI-KUN; DUAN, SHAO-BIN; PAN, PENG; XU, XIANG-QING; LIU, NA; XU, JUN

    2015-01-01

    Oxidative stress is an important mechanism of contrast-induced acute kidney injury (CIAKI). The optimal strategy to prevent CIAKI remains unclear. The aim of the present study was to assess the effect of pentoxifylline, a nonspecific phosphodiesterase inhibitor, on the prevention of CIAKI. A total of 32 healthy male Sprague-Dawley rats were randomly divided into normal dietary group (NN; n=8) and a high cholesterol-supplemented dietary group (HN; 4% cholesterol and 1% cholic acid; n=24). At the end of eight weeks, the rats in the high cholesterol diet group were randomly divided into three subgroups (n=8 in each group). CIAKI was induced in two of the subgroups via intravenous injection of the radiocontrast media iohexol (10 ml/kg). Pentoxifylline (50 mg/kg) was administered to one of the iohexol-treated groups via intraperitoneal injection 12 h prior to and following contrast media (CM) injection. Kidney function parameters and oxidative stress markers were then measured. The renal pathological changes were evaluated using hematoxylin and eosin staining and scored semi-quantitatively. In iohexol-injected rats, serum creatinine (Scr), renal pathological scores, renal malondialdehyde (MDA) content, renal NADPH oxidase activity, fractional excretion of sodium (FENa%) and fractional excretion of potassium (FEK%) were significantly increased (P<0.01). The Scr, histologic scores, renal MDA content, NADPH oxidase activity, FENa% and FEK% in the rats treated with pentoxifylline prior to iohexol were observed to be reduced compared with those in rats treated with iohexol alone (P<0.01). This suggests that pentoxifylline significantly attenuates renal injuries, including tubular necrosis and proteinaceous casts induced by CM. It may be concluded that pentoxifylline protected the renal tissue from the nephrotoxicity induced by low-osmolar CM via an antioxidant effect. PMID:25574202

  16. Basic MR relaxation mechanisms and contrast agent design.

    PubMed

    De León-Rodríguez, Luis M; Martins, André F; Pinho, Marco C; Rofsky, Neil M; Sherry, A Dean

    2015-09-01

    The diagnostic capabilities of magnetic resonance imaging (MRI) have undergone continuous and substantial evolution by virtue of hardware and software innovations and the development and implementation of exogenous contrast media. Thirty years since the first MRI contrast agent was approved for clinical use, a reliance on MR contrast media persists, largely to improve image quality with higher contrast resolution and to provide additional functional characterization of normal and abnormal tissues. Further development of MR contrast media is an important component in the quest for continued augmentation of diagnostic capabilities. In this review we detail the many important considerations when pursuing the design and use of MR contrast media. We offer a perspective on the importance of chemical stability, particularly kinetic stability, and how this influences one's thinking about the safety of metal-ligand-based contrast agents. We discuss the mechanisms involved in MR relaxation in the context of probe design strategies. A brief description of currently available contrast agents is accompanied by an in-depth discussion that highlights promising MRI contrast agents in the development of future clinical and research applications. Our intention is to give a diverse audience an improved understanding of the factors involved in developing new types of safe and highly efficient MR contrast agents and, at the same time, provide an appreciation of the insights into physiology and disease that newer types of responsive agents can provide. PMID:25975847

  17. Media Now.

    ERIC Educational Resources Information Center

    Curtis, Ron

    Developed by the Southwest Iowa Learning Resources Center, Media Now is a course for secondary students in media studies. Curriculum concentration is on television, film, radio, and recorded sound. Individualization of instruction, behavioral science, and mediated learning packages are employed with each module interrelated through printed…

  18. Earned Media

    ERIC Educational Resources Information Center

    Sunshine, Alice

    2011-01-01

    "Earned media" is exactly what one thinks it is. The people who do the necessary work to earn coverage of their issue or battle are the ones who will get their story out to the public. Earning media coverage involves giving careful attention to the mechanics of reaching out to news outlets. Most people can learn the mechanics through workshops,…

  19. Mixed Media

    ERIC Educational Resources Information Center

    Peterson, Erin

    2010-01-01

    While institutions do not often have a hook as compelling as an eagerly awaited movie, great content is critical for media relations success--and coupling it with the right distribution channel can ensure the story finds the right audience. Even better, retooling it for several media platforms can extend the life and reach of a story. The changes…

  20. Media Literacy.

    ERIC Educational Resources Information Center

    Potter, W. James

    Written to appeal to a general audience that wants to think more deeply about the nature of the media, their messages, and their effects on both individuals and society, this book serves as a broad introduction to the thinking that ties educators together in the common goal of educating a media literate generation. It is written from a critical…

  1. Intravenous infusions in chronic pain management.

    PubMed

    Kosharskyy, Boleslav; Almonte, Wilson; Shaparin, Naum; Pappagallo, Marco; Smith, Howard

    2013-01-01

    In the United States, millions of Americans are affected by chronic pain, which adds heavily to national rates of morbidity, mortality, and disability, with an ever-increasing prevalence. According to a 2011 report titled Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research by the Institute of Medicine of the National Academies, pain not only exacts its toll on people's lives but also on the economy with an estimated annual economic cost of at least $560 - 635 billion in health care costs and the cost of lost productivity attributed to chronic pain. Intravenous infusions of certain pharmacologic agents have been known to provide substantial pain relief in patients with various chronic painful conditions. Some of these infusions are better, and although not necessarily the first therapeutic choice, have been widely used and extensively studied. The others show promise, however are in need of further investigations. This article will focus on non-opiate intravenous infusions that have been utilized for chronic painful disorders such as fibromyalgia, neuropathic pain, phantom limb pain, post-herpetic neuralgia, complex regional pain syndromes (CRPS), diabetic neuropathy, and central pain related to stroke or spinal cord injuries. The management of patients with chronic pain conditions is challenging and continues to evolve as new treatment modalities are explored and tested. The following intravenous infusions used to treat the aforementioned chronic pain conditions will be reviewed: lidocaine, ketamine, phentolamine, dexmedetomidine, and bisphosphonates. This overview is intended to familiarize the practitioner with the variety of infusions for patients with chronic pain. It will not, however, be able to provide guidelines for their use due to the lack of sufficient evidence. PMID:23703410

  2. Contrasting effects of G1.2/G2.2 and SOF1/SOF2 embryo culture media on pre- and post-implantation development of non-transgenic and transgenic cloned goat embryos.

    PubMed

    Hosseini, Sayed Morteza; Hajian, Mehdi; Ostadhosseini, Somayyeh; Forouzanfar, Mohsen; Abedi, Parvaneh; Jafarpour, Farnoosh; Gourabi, Hamid; Shahverdi, Abdol Hossein; Vosough, Ahmad; Ghanaie, Hamid Reza; Nasr-Esfahani, Mohammad Hossein

    2015-09-01

    This study compared the efficiency of two embryo culture media (SOF1/SOF2 and G1.2/G2.2) for pre- and post-implantation development of somatic cell nuclear transfer goat embryos derived from non-transgenic and transgenic (for htPA and hrcfIX genes) fibroblasts. Despite similar cleavage rates, G1.2/G2.2 supported significantly higher blastocyst development than SOF1/SOF2 (30-35% versus 21%; P < 0.05), irrespective of cell transgenesis. However, following embryo transfer, pregnancy outcomes (establishment, full-term development and live birth) were all significantly higher (P < 0.05) for embryos developed in SOF1/SOF2 versus G1.2/G2.2. Gene expression profiling of 17 developmentally important genes revealed that: (i) SOX2, FOXD3, IFNT, FZD, FGFR4, ERK1, GCN5, PCAF, BMPR1, SMAD5, ALK4, CDC25 and LIFR were significantly induced in blastocysts developed in SOF1/SOF2 but not G1.2/G2.2; (ii) OCT4, CTNNB and CDX2 were similarly expressed in both groups; and (iii) AKT was significantly higher in G1.2/G2.2 than SOF1/SOF2 (P < 0.05). Following IVF, although blastocyst development in G1.2/G2.2 was significantly higher than SOF1/SOF2 counterparts, the majority of assessed genes were similarly expressed in blastocysts developed in both groups. It was concluded that the long-term programming effects of embryo culture medium and/or embryo production method may irreversibly affect post-implantation development of cloned embryos through defined molecular pathways. PMID:26194883

  3. Cystic fibrosis, intravenous antibiotics, and home therapy.

    PubMed

    Hammond, L J; Caldwell, S; Campbell, P W

    1991-01-01

    The survival rate of patients with cystic fibrosis has improved considerably in the last 20 years. Although not all of the factors accounting for this change are understood, aggressive nutritional management and treatment of pulmonary exacerbations certainly play a role. Home intravenous (IV) antibiotic delivery for pulmonary exacerbation has proved to be as effective as hospital treatment and offers significant advantages to the patient and family. This article examines the microbiology of pulmonary infections in patients with cystic fibrosis, as well as antimicrobial therapy, methods of IV administration, home IV therapy, and the nurse practitioner's role in this home program in the future. PMID:1990112

  4. Intravenous paracetamol in patients with renal colic.

    PubMed

    Morgan, Sara

    2011-02-01

    Non-steroidal anti-inflammatory drugs and opioids have been the mainstay of pain relief in patients with renal colic, but both have side effects. Research on the efficacy of intravenous (IV) paracetamol shows that it is comparable to morphine, diclofenac and ketoralac. This article discusses the role of IV paracetamol for patients with this condition. It examines the effectiveness, mechanism of action and pharmacokinetics of IV paracetamol, and suggests that non-clinical prescribers can use the method to relieve patients' pain quickly. PMID:21384782

  5. Intravenous immune globulin in chronic lymphocytic leukaemia.

    PubMed Central

    Gamm, H; Huber, C; Chapel, H; Lee, M; Ries, F; Dicato, M A

    1994-01-01

    The most common complication of chronic lymphocytic leukaemia (CLL) is infection, which occurs mainly in advanced stages of disease or in those patients with hypogammaglobulinaemia. Intravenous immune globulin (IVIG) has been shown to be a useful prophylactic therapy against infections in such patients. A randomized, double-blind study on 36 patients receiving either 500 mg/kg or 250 mg/kg IVIG every 4 weeks was undertaken to determine the dose regimen required. There was no significant difference in the two treatment groups and we found that CLL patients were equally protected with low-dose IVIG. PMID:8033428

  6. Advances in Pediatric Intravenous Iron Therapy.

    PubMed

    Mantadakis, Elpis

    2016-01-01

    Iron deficiency anemia (IDA) continues to be very common worldwide. Intravenous (IV) iron is an infrequently used therapeutic option in children with IDA despite numerous studies in adults and several small but notable pediatric studies showing efficacy and safety. Presently, the availability of newer IV iron products allows for replacement of the total iron deficit at a single setting. These products appear safer compared to the high molecular weight iron dextrans of the past. Herein, we review the medical literature and suggest that front line use of IV iron should be strongly considered in diseases associated with IDA in children. PMID:26376214

  7. Contrast-Enhanced Digital Mammography and Angiogenesis

    SciTech Connect

    Rosado-Mendez, I.; Palma, B. A.; Villasenor, Y.; Benitez-Bribiesca, L.; Brandan, M. E.

    2007-11-26

    Angiogenesis could be a means for pouring contrast media around tumors. In this work, optimization of radiological parameters for contrast-enhanced subtraction techniques in mammography has been performed. A modification of Lemacks' analytical formalism was implemented to model the X-ray absorption in the breast with contrast medium and detection by a digital image receptor. Preliminary results of signal-to-noise ratio analysis show the advantage of subtracting two images taken at different energies, one prior and one posterior to the injection of contrast medium. Preliminary experimental results using a custom-made phantom have shown good agreement with calculations. A proposal is presented for the clinical application of the optimized technique, which aims at finding correlations between angiogenesis indicators and dynamic variables of contrast medium uptake.

  8. Media Publics and Media Trust.

    ERIC Educational Resources Information Center

    Gaziano, Cecilie; McGrath, Kristin

    To gain a perspective on the kinds of people who find newspapers and television to be high or low in credibility, a two-phase study combined demographic and other characteristics, media behavior, and attitudes toward the media. The first phase involved a series of focused group discussions, while the second was a national, representative sampling…

  9. Efficacy of Intravenous Immunoglobulin in Neurological Diseases.

    PubMed

    Lünemann, Jan D; Quast, Isaak; Dalakas, Marinos C

    2016-01-01

    Owing to its anti-inflammatory efficacy in various autoimmune disease conditions, intravenous immunoglobulin (IVIG)-pooled IgG obtained from the plasma of several thousands individuals-has been used for nearly three decades and is proving to be efficient in a growing number of neurological diseases. IVIG therapy has been firmly established for the treatment of Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy, either as first-line therapy or adjunctive treatment. IVIG is also recommended as rescue therapy in patients with worsening myasthenia gravis and is beneficial as a second-line therapy for dermatomyositis and stiff-person syndrome. Subcutaneous rather than intravenous administration of IgG is gaining momentum because of its effectiveness in patients with primary immunodeficiency and the ease with which it can be administered independently from hospital-based infusions. The demand for IVIG therapy is growing, resulting in rising costs and supply shortages. Strategies to replace IVIG with recombinant products have been developed based on proposed mechanisms that confer the anti-inflammatory activity of IVIG, but their efficacy has not been tested in clinical trials. This review covers new developments in the immunobiology and clinical applications of IVIG in neurological diseases. PMID:26400261

  10. The Human Experience with Intravenous Levodopa

    PubMed Central

    Siddiqi, Shan H.; Abraham, Natalia K.; Geiger, Christopher L.; Karimi, Morvarid; Perlmutter, Joel S.; Black, Kevin J.

    2016-01-01

    Objective: To compile a comprehensive summary of published human experience with levodopa given intravenously, with a focus on information required by regulatory agencies. Background: While safe intravenous (IV) use of levodopa has been documented for over 50 years, regulatory supervision for pharmaceuticals given by a route other than that approved by the U.S. Food and Drug Administration (FDA) has become increasingly cautious. If delivering a drug by an alternate route raises the risk of adverse events, an investigational new drug (IND) application is required, including a comprehensive review of toxicity data. Methods: Over 200 articles referring to IV levodopa were examined for details of administration, pharmacokinetics, benefit, and side effects. Results: We identified 142 original reports describing IVLD use in humans, beginning with psychiatric research in 1959–1960 before the development of peripheral decarboxylase inhibitors. At least 2760 subjects have received IV levodopa, and reported outcomes include parkinsonian signs, sleep variables, hormone levels, hemodynamics, CSF amino acid composition, regional cerebral blood flow, cognition, perception and complex behavior. Mean pharmacokinetic variables were summarized for 49 healthy subjects and 190 with Parkinson's disease. Side effects were those expected from clinical experience with oral levodopa and dopamine agonists. No articles reported deaths or induction of psychosis. Conclusion: At least 2760 patients have received IV levodopa with a safety profile comparable to that seen with oral administration. PMID:26779024