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American Journal of Surgery Jun 2016Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in predicting the need for surgery, but there is no consensus.
METHODS
A systematic review and meta-analysis was done of studies on diagnostic and therapeutic role of oral WSCA.
RESULTS
WSCA had a sensitivity of 92% and a specificity of 93% in predicting resolution of obstruction without surgery; diagnostic accuracy increased significantly if abdominal X-rays were taken after 8 hours. The administration of oral WSCA reduced the need for surgery (odds ratio .55, P = .003), length of stay (weighted mean difference -2.18 days, P < .00001), and time to resolution (weighted mean difference -28.25 hours, P < .00001). No differences in terms of morbidity or mortality were recorded.
CONCLUSIONS
The administration of WSCA is accurate in predicting the need for surgery; the test should be taken after at least 8 hours from administration. WSCA is a proven safe and effective treatment, correlated with a significant reduction in the need for surgery and in the length of hospital stay.
Topics: Conservative Treatment; Contrast Media; Diatrizoate Meglumine; Digestive System Surgical Procedures; Female; Hospital Mortality; Humans; Intestinal Obstruction; Male; Prognosis; Risk Assessment; Severity of Illness Index; Survival Analysis; Tissue Adhesions; Treatment Outcome
PubMed: 26329902
DOI: 10.1016/j.amjsurg.2015.06.012 -
Arab Journal of Gastroenterology : the... Feb 2022Gastrografin administration (GA) is performed for adhesive small bowel obstruction (ASBO) in cases when decompression therapy using an ileus tube fails to relieve the...
BACKGROUND AND STUDY AIMS
Gastrografin administration (GA) is performed for adhesive small bowel obstruction (ASBO) in cases when decompression therapy using an ileus tube fails to relieve the obstruction. This study evaluated the efficacy of GA and optimized its timing after ileus tube insertion.
PATIENTS AND METHODS
In this retrospective study, we evaluated data from patients with ASBO admitted between January 2014 and August 2018 and included patients who underwent ileus tube intubation and GA. The patients were classified as those treated with GA within 48 h after admission (early GA [EGA]) and those treated later with GA (delayed GA [DGA]). Propensity score matching was performed to compensate for differences between the groups. Short-term outcomes were compared between the two groups.
RESULTS
We included 67 and 80 patients in the EGA and DGA groups, respectively, and 55 pairs with similar background characteristics were matched. The rates of successful conservative management were 87.3% (48/55) in the EGA group, 96.4% (53/55) in the DGA group, and 91.8% (101/110) in the entire sample. The median period of ileus tube insertion in the DGA group was significantly lower than that in the EGA group, whereas other outcomes did not significantly differ between the groups. Aspiration pneumonia occurred in one patient in the EGA group.
CONCLUSIONS
GA with an ileus tube achieved a high rate of successful conservative management. Follow-up using decompression with an ileus tube for at least 48 h after admission is recommended in patients with ASBO.
Topics: Adhesives; Diatrizoate Meglumine; Humans; Ileus; Intestinal Obstruction; Retrospective Studies; Tissue Adhesions; Treatment Outcome
PubMed: 35120840
DOI: 10.1016/j.ajg.2021.12.004 -
Journal of Pediatric Surgery Jul 2021therapeutic strategy for meconium-related ileus (MRI) in very-low-birth-weight infants (VLBWs) has not been established. This study aims to clarify the optimum...
BACKGROUND/PURPOSE
therapeutic strategy for meconium-related ileus (MRI) in very-low-birth-weight infants (VLBWs) has not been established. This study aims to clarify the optimum therapeutic strategy for MRI in VLBWs.
METHODS
MRI was defined as delayed meconium excretion and microcolon on contrast enema with Gastrografin (diatrizoate acid). Forty-two infants with MRI were treated at our institution between 2009 and 2019, and are reviewed here. They were classified into two groups: in group A (n=21), Gastrografin regurgitated into the dilated intestine during the first or second round of Gastrografin enema (GaE), while in group B (N = 21), Gastrografin did not regurgitate. Laparotomy was indicated if the intestine was perforated, or if abdominal distention was not relieved by two rounds of GaE.
RESULTS
in group A, meconium was excreted in all cases within 24 h after GaE, and no cases required laparotomy. In group B, twelve cases (57%) underwent laparotomy (P < 0.01), six cases in this group (29%), showed free air on X-ray images (P < 0.01). The median hospital stay in groups A and B were 89.0 and 136.5 days, respectively (P < 0.05). Overall mortality was 2.4%.
CONCLUSIONS
early therapeutic diagnosis by GaE followed by early surgery is suggested as the optimum strategy for MRI in VLBWs.
Topics: Diatrizoate Meglumine; Enema; Humans; Ileus; Infant, Newborn; Infant, Very Low Birth Weight; Intestinal Obstruction; Meconium; Meconium Ileus
PubMed: 33896618
DOI: 10.1016/j.jpedsurg.2021.03.029 -
Dento Maxillo Facial Radiology Oct 2021To evaluate the diagnostic accuracy using sodium iodide (NaI) and dimethyl sulfoxide (DMSO) as contrast agent in cone beam computed tomography (CBCT) scanning, and...
OBJECTIVES
To evaluate the diagnostic accuracy using sodium iodide (NaI) and dimethyl sulfoxide (DMSO) as contrast agent in cone beam computed tomography (CBCT) scanning, and compare this with micro-CT.
METHODS
18 teeth were cracked artificially by soaking them cyclically in liquid nitrogen and hot water. After pre-treatment with artificial saliva, the teeth were scanned in four modes: CBCT routine scanning without contrast agent (RS); CBCT with meglumine diatrizoate (MD) as contrast agent (ES1); CBCT with NaI + DMSO as contrast agent (ES2); and micro-CT (mCT). The number of crack lines was evaluated in all four modes. Depth of crack lines and number of cracks presented from the occlusal surface to the pulp cavity (Np) in ES2 and micro-CT images were evaluated.
RESULTS
There were 63 crack lines in all 18 teeth. 45 crack lines were visible on ES2 images as against four on the RS and ES1 images (0.05) and 37 on micro-CT images (0.05). Further, 34 crack lines could be observed on both ES2 and micro-CT images, and the average depth presented on ES2 images was 4.56 ± 0.88 mm and 3.89 ± 1.08 mm on micro-CT images (0.05). More crack lines could be detected from the occlusal surface to the pulp cavity on ES2 images than on micro-CT images (22 11).
CONCLUSION
CBCT with NaI +DMSO as the contrast agent was equivalent to micro-CT for number of crack lines and better for depth of crack lines. NaI + DMSO could be a potential CBCT contrast agent to improve diagnostic accuracy for cracked tooth.
Topics: Cone-Beam Computed Tomography; Cracked Tooth Syndrome; Humans; Spiral Cone-Beam Computed Tomography; Tooth Fractures; X-Ray Microtomography
PubMed: 33877874
DOI: 10.1259/dmfr.20210003 -
Experimental and Therapeutic Medicine Jun 2018The aim of the present study was to evaluate the prevalence and causes of spontaneous remission of obstructive jaundice in rats. Healthy male and female Wistar rats...
The aim of the present study was to evaluate the prevalence and causes of spontaneous remission of obstructive jaundice in rats. Healthy male and female Wistar rats (180-220 g) were randomly assigned to receive common bile duct ligation (CBDL) and transection (group A), CBDL only (group B), or CBD dissection without ligation or transection (control group C; n=36 in each group). There was a difference in eye and skin jaundice prevalence between groups A and B from 14 days after surgery. The level of total bilirubin (TB) did not continue to increase in group A and began to decrease in the majority of rats in group B (P<0.05 vs. group B). At day 21 after surgery, the TB level returned to normal in group B and no significant difference was observed compared with group C. At day 21 after surgery, significant dilatation of bile ducts above the ligature was observed in group A following cholangiography with 38% meglumine diatrizoate and this contrast agent did not spread to other sites. Slight dilatation of the proximal bile ducts was observed in group B and the contrast agent entered the intestinal lumen through the omental ducts adhering to the porta hepatis. After 14 days of surgery, there were 36 rats in group A and B, and 17 rats exhibited spontaneous regression of jaundice. Overall, 47.2% (17/36) of rats experienced spontaneous remission of obstructive jaundice, 82.4% (14/17) of which underwent ligation only. The spontaneous remission of jaundice may have been caused by shunting through very small bile ducts or omental ducts adhering to the porta hepatis. If a model of biliary obstruction is to be established in future research, a model of CBDL and transection is preferable. In this case, jaundice reduction surgery should be performed 14 days after establishment of the model.
PubMed: 29904412
DOI: 10.3892/etm.2018.6119 -
Journal of the Mechanical Behavior of... Jun 2022To explore the feasibility of using sodium iodide (NaI)+dimethyl sulfoxide (DMSO)+ethyl alcohol+ethyl acetate as a cone-beam CT (CBCT) contrast agent in the diagnosis of...
OBJECTIVES
To explore the feasibility of using sodium iodide (NaI)+dimethyl sulfoxide (DMSO)+ethyl alcohol+ethyl acetate as a cone-beam CT (CBCT) contrast agent in the diagnosis of vertical root fracture (VRF).
METHODS
21 endodontically treated VRF teeth of 21 patients were collected in this study. All these 21 teeth were confirmed subtle fracture lines under transillumination, the number and position of fracture lines were recorded. All these patients had CBCT routine scanning (RS1) before extraction. After extraction, the teeth was performed micro-CT scanning and 3 in vitro CBCT scanning: CBCT routine scanning in vitro(RS2), CBCT enhanced scanning using meglumine diatrizoate (MD) as contrast agent(ES1); and CBCT enhanced scanning using NaI+DMSO+ethyl alcohol+ethyl acetate as contrast agent(ES2). The number of fracture lines was evaluated on all the 5 scanning modes and the accuracy of diagnosis was calculated.
RESULTS
In all, there were 43 fracture lines on the 21 teeth. The accuracy of detection of fracture lines of CBCT RS1, RS2, ES1, ES2 and micro-CT was 0%, 20.9% (9/43), 11.6% (5/43), 93% (40/43) and 95.3% (41/43) respectively. Significant differences were found between ES2 vs. RS2, ES2 vs. ES1 (p < 0.01); however, no significant difference was found between ES2 vs. micro-CT (p > 0.05).
CONCLUSION
CBCT enhanced scanning using NaI+DMSO+ethyl alcohol+ethyl acetate as contrast agent could be a prospective technique in the diagnosis of VRF.
Topics: Cone-Beam Computed Tomography; Contrast Media; Dimethyl Sulfoxide; Ethanol; Fractures, Bone; Humans; Prospective Studies; Tooth Fractures; Tooth Root
PubMed: 35320764
DOI: 10.1016/j.jmbbm.2022.105175 -
World Journal of Gastroenterology Feb 2015To determine the efficacy and safety benefits of performing intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) to treat symptomatic... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To determine the efficacy and safety benefits of performing intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) to treat symptomatic cholelithiasis.
METHODS
Patients admitted to the Minimally Invasive Surgery Center of Tianjin Nankai Hospital between January 2012 and January 2014 for management of symptomatic cholelithiasis were recruited for this prospective randomized trial. Study enrollment was offered to patients with clinical presentation of biliary colic symptoms, radiological findings suggestive of gallstones, and normal serum biochemistry results. Study participants were randomized to receive either routine LC treatment or LC+IOC treatment. The routine LC procedure was carried out using the standard four-port technique; the LC+IOC procedure was carried out with the addition of meglumine diatrizoate (1:1 dilution with normal saline) injection via a catheter introduced through a small incision in the cystic duct made by laparoscopic scissors. Operative data and postoperative outcomes, including operative time, retained common bile duct (CBD) stones, CBD injury, other complications and length of hospital stay, were recorded for comparative analysis. Inter-group differences were statistically assessed by the χ2 test (categorical variables) and Fisher's exact test (binary variables), with the threshold for statistical significance set at P<0.05.
RESULTS
A total of 371 patients were enrolled in the trial (late-adolescent to adult, age range: 16-70 years), with 185 assigned to the routine LC group and 186 to the LC+IOC group. The two treatment groups were similar in age, sex, body mass index, duration of symptomology, number and size of gallstones, and clinical symptoms. The two treatment groups also showed no significant differences in the rates of successful LC (98.38% vs 97.85%), CBD stone retainment (0.54% vs 0.00%), CBD injury (0.54% vs 0.53%) and other complications (2.16% vs 2.15%), as well as in duration of hospital stay (5.10±1.41 d vs 4.99±1.53 d). However, the LC+IOC treatment group showed significantly longer mean operative time (routine LC group: 43.00±4.15 min vs 52.86±4.47 min, P<0.01). There were no cases of fatal complications in either group. At the one-year follow-up assessment, one patient in the routine LC group reported experiencing diarrhea for three months after the LC and one patient in the LC+IOC group reported on-going intermittent epigastric discomfort, but radiological examination provided no abnormal findings.
CONCLUSION
IOC addition to the routine LC treatment of symptomatic cholelithiasis does not improve rates of CBD stone retainment or bile duct injury but lengthens operative time.
Topics: Adolescent; Adult; Aged; Chi-Square Distribution; China; Cholangiography; Cholecystectomy, Laparoscopic; Cholelithiasis; Female; Humans; Intraoperative Care; Length of Stay; Male; Middle Aged; Operative Time; Postoperative Complications; Predictive Value of Tests; Prospective Studies; Risk Factors; Time Factors; Treatment Outcome; Young Adult
PubMed: 25717250
DOI: 10.3748/wjg.v21.i7.2147 -
Bio-protocol Dec 2019) is an obligate intracellular pathogen that cannot be cultured axenically and must be propagated within eukaryotic host cells. There are at least 15 distinct chlamydial...
) is an obligate intracellular pathogen that cannot be cultured axenically and must be propagated within eukaryotic host cells. There are at least 15 distinct chlamydial serovariants that belong to 2 major biovars commonly referred to as trachoma and lymphogranuloma venereum (LGV). The invasive chlamydia LGV serovar L2 is the most widely used experimental model for studying biology and infection and is the only strain with reliable genetic tools available. New techniques to genetically manipulate L2 have provided opportunities to make mutants using TargeTron and allelic exchange as well as strains overexpressing epitope-tagged proteins, in turn necessitating the regular purification of transformant and mutant clones. Purification of is a labor-intensive exercise and one of the most common reagents classically used in the purification process, Renografin, is no longer commercially available. A similar formulation of diatrizoate meglumine called Gastrografin is readily available and we as well as others have had great success using this in place of Renografin for chlamydial purifications. Here, we provide a detailed general protocol for infection, propagation, purification, and titering of serovar L2 with additional notes specifically pertaining to mutants or recombinant DNA carrying clones.
PubMed: 33654954
DOI: 10.21769/BioProtoc.3459 -
World Journal of Urology Jul 2019Radiotherapy to the bladder has a risk of toxicity to pelvic structures, which can be reduced by using fiducial markers for targeting. Injectable contrast offers an...
INTRODUCTION
Radiotherapy to the bladder has a risk of toxicity to pelvic structures, which can be reduced by using fiducial markers for targeting. Injectable contrast offers an alternative marker to gold seeds, which may fall out or exacerbate scarring. Combining contrast agents with tissue glue can minimize dispersion through tissue, enhancing its utility. We evaluated combinations of contrast agents and tissue glue using porcine bladder, for feasibility and utility as fiducial markers to aid image-guided radiotherapy.
METHODS
Different contrast agents (Lipiodol ultra or Urografin) were combined with different tissue glues (Histoacryl, Tisseal or Glubran2). The mixtures were endoscopically injected into porcine bladder submucosa to identify the area of interest with multiple fiducial markers. The porcine bladders were imaged within a phantom porcine pelvis using standard radiation therapy imaging modalities. The feasibility as an injectable fiducial marker and visibility of each fiducial marker on imaging were scored as binary outcomes by two proceduralists and two radiation therapists, respectively.
RESULTS
Lipiodol-glue combinations were successfully administered as multiple fiducials that were evident on CT and CBCT. Lipiodol with Histoacryl or Glubran2 was visible on kV imaging. The Lipiodol Glubran2 combination was deemed subjectively easiest to use at delivery, and a better fiducial on KV imaging.
CONCLUSION
This study demonstrates the feasibility of mixing contrast medium Lipiodol with Histoacryl or Glubran2 tissue glue, which, injected endoscopically, provides discrete and visible fiducial markers to aid image-guided radiotherapy. Although promising, further study is required to assess the durability of these markers through a course of radiotherapy.
Topics: Animals; Cone-Beam Computed Tomography; Cyanoacrylates; Cystoscopy; Diatrizoate Meglumine; Enbucrilate; Ethiodized Oil; Feasibility Studies; Fibrin Tissue Adhesive; Fiducial Markers; Radiotherapy, Image-Guided; Swine; Tissue Adhesives; Tomography, X-Ray Computed; Urinary Bladder Neoplasms
PubMed: 30288597
DOI: 10.1007/s00345-018-2515-0 -
Cell Biology International Dec 2015Contrast-induced acute kidney injury (CI-AKI) is associated with increasing in-hospital and long-term adverse clinical outcomes in high-risk patients undergoing...
Contrast-induced acute kidney injury (CI-AKI) is associated with increasing in-hospital and long-term adverse clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI). Contrast media (CM)-induced renal tubular cell apoptosis is reported to participate in this process by activating endoplasmic reticulum (ER) stress. An angiotensin II type 1 receptor (AT1R) antagonist can alleviate ER stress-induced renal apoptosis in streptozotocin (STZ)-induced diabetic mice and can reduce CM-induced renal apoptosis by reducing oxidative stress and reversing the enhancement of bax mRNA and the reduction of bcl-2 mRNA, but the effect of the AT1R blocker on ER stress in the pathogenesis of CI-AKI is still unknown. In this study, we explored the effect of valsartan on meglumine diatrizoate-induced human renal tubular cell apoptosis by measuring changes in ER stress-related biomarkers. The results showed that meglumine diatrizoate caused significant cell apoptosis by up-regulating the expression of ER stress markers, including glucose-regulated protein 78 (GRP78), activating transcription factor 4 (ATF4), CCAAT/enhancer-binding protein-homologous protein (CHOP) and caspase 12, in a time- and dose-dependent manner, which could be alleviated by preincubation with valsartan. In conclusion, valsartan had a potential nephroprotective effect on meglumine diatrizoate-induced renal cell apoptosis by inhibiting ER stress.
Topics: Animals; Apoptosis; Cell Survival; Contrast Media; Dose-Response Relationship, Drug; Endoplasmic Reticulum Chaperone BiP; Endoplasmic Reticulum Stress; Humans; Kidney Tubules; Mice; Protective Agents; Valsartan
PubMed: 26248489
DOI: 10.1002/cbin.10521