-
PloS One 2022Meconium-related ileus in very low birth weight infants can lead to increased morbidity or mortality and prolonged hospitalization without prompt diagnosis and...
BACKGROUND
Meconium-related ileus in very low birth weight infants can lead to increased morbidity or mortality and prolonged hospitalization without prompt diagnosis and treatment. This study primarily aimed to identify the incidence of and factors associated with meconium-related ileus and secondarily sought to investigate clinical and growth outcomes after water-soluble contrast media (Gastrografin) enema.
METHODS
We retrospectively reviewed medical records of very low birth weight infants born between February 2009 and March 2019 in the neonatal intensive care unit of a single medical center. Perinatal factors, clinical outcomes, and growth outcomes were compared between the group with meconium-related ileus that received Gastrografin enema and the control group.
RESULTS
Twenty-four (6.9%) patients were diagnosed with meconium-related ileus among 347 very low birth weight infants. All achieved successful evacuation of meconium with an average of 2.8 (range: 1-8) Gastrografin enema attempts without procedure-related complications. Initiation of Gastrografin enema was performed at mean 7.0 days (range: 2-16) after birth. Incidences of moderate to severe bronchopulmonary dysplasia were higher and the duration of mechanical ventilation and need for oxygen were longer in the meconium-related ileus group (P = 0.039, 0.046, 0.048, respectively). Meconium-related ileus infants took more time to start enteral feeding and the nothing per oral time was longer (P = 0.001 and 0.018, respectively). However, time to achieve full enteral feeding and Z-scores for weight and height at 37 weeks and at 6 months corrected age did not differ between the two groups.
CONCLUSIONS
Gastrografin enema in very low birth weight infants with meconium-related ileus was an effective and safe medical management. Following Gastrografin enema, very low birth weight infants with meconium-related ileus achieved similar subsequent feeding progress and similar growth levels as the control groups without meconium-related ileus.
Topics: Diatrizoate Meglumine; Enema; Humans; Ileus; Infant, Newborn; Infant, Very Low Birth Weight; Intestinal Obstruction; Meconium; Retrospective Studies
PubMed: 35951504
DOI: 10.1371/journal.pone.0272915 -
Frontiers in Cell and Developmental... 2022The standard treatment for osteosarcoma comprises complete surgical resection and neoadjuvant chemotherapy, which may cause serious side effects and partial or total...
The standard treatment for osteosarcoma comprises complete surgical resection and neoadjuvant chemotherapy, which may cause serious side effects and partial or total limb loss. Therefore, to avoid the disadvantages of traditional treatment, we developed self-assembling imageable silk hydrogels for osteosarcoma. We analysed whether iodine induced apoptosis in MG-63 and Saos-2 cells by using CCK-8 and flow cytometry assays and transmission electron microscopy. Western blotting was used to analyse the pathway of iodine-induced apoptosis in osteosarcoma cells. PEG400, silk fibroin solution, polyvinylpyrrolidone iodine (PVP-I), and meglumine diatrizoate (MD) were mixed to produce an imageable hydrogel. A nude mouse model of osteosarcoma was established, and the hydrogel was injected locally into the interior of the osteosarcoma with X-ray guidance. The therapeutic effect and biosafety of the hydrogel were evaluated. Iodine treatment at 18 and 20 µM for 12 h resulted in cell survival rate reduced to 50 ± 2.1% and 50.5 ± 2.7% for MG-63 and Sao-2 cells, respectively ( < 0.01). The proportion of apoptotic cells was significantly higher in the iodine-treatment group than in the control group ( < 0.05), and apoptotic bodies were observed by transmission electron microscopy. Iodine could regulate the death receptor pathway and induce MG-63 and Saos-2 cell apoptosis. The hydrogels were simple to assemble, and gels could be formed within 38 min. A force of less than 50 N was required to inject the gels with a syringe. The hydrogels were readily loaded and led to sustained iodine release over 1 week. The osteosarcoma volume in the PEG-iodine-silk/MD hydrogel group was significantly smaller than that in the other three groups ( < 0.001). Caspase-3 and poly (ADP-ribose) polymerase (PARP) expression levels were significantly higher in the PEG-iodine-silk/MD hydrogel group than in the other three groups ( < 0.001). Haematoxylin and eosin (H&E) staining showed no abnormalities in the heart, liver, spleen, lung, kidney, pancreas or thyroid in any group. Self-assembling imageable silk hydrogels could be injected locally into osteosarcoma tissues with X-ray assistance. With the advantages of good biosafety, low systemic toxicity and minimal invasiveness, self-assembling imageable silk hydrogels provide a promising approach for improving the locoregional control of osteosarcoma.
PubMed: 35794868
DOI: 10.3389/fcell.2022.698282 -
Modern Rheumatology Case Reports Jan 2023An 86-year-old man who underwent endovascular aortic repair for impending rupture of an abdominal aortic aneurysm a year ago presented to our hospital because of fatigue...
An 86-year-old man who underwent endovascular aortic repair for impending rupture of an abdominal aortic aneurysm a year ago presented to our hospital because of fatigue and black stools. Multiple bacterial specimens were detected in blood cultures, and computed tomography following oral administration of gastrografin demonstrated gastrografin in the abdominal aorta. The diagnosis of aortic duodenal fistula was confirmed and emergency abdominal aortic replacement was performed. The pathological findings of the aorta included a large number of immunoglobulin G4 (IgG4)-positive plasma cells infiltrating all layers of the aortic wall, with particularly marked thickening of the adventitia. The serum IgG4 level was 241 mg/dl and IgG4-related periaortitis was diagnosed. Aortoduodenal fistula is a rare but fatal complication of IgG4-related periaortitis. Patients should be followed carefully after endovascular aortic repair for inflammatory abdominal aortic aneurysms.
Topics: Male; Humans; Aged, 80 and over; Diatrizoate Meglumine; Aortitis; Aortic Aneurysm, Abdominal; Tomography, X-Ray Computed; Immunoglobulin G
PubMed: 35665812
DOI: 10.1093/mrcr/rxac051 -
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 -
Environmental Science and Pollution... Jun 2022As persistent and ubiquitous contaminants in water, iodinated X-ray contrast media (ICM) pose a non-negligible risk to the environment and human health. In this study,...
As persistent and ubiquitous contaminants in water, iodinated X-ray contrast media (ICM) pose a non-negligible risk to the environment and human health. In this study, we investigated the adsorption behavior of two typical ICM compounds, iohexol (IOH) and amidotrizoic acid (DTZ), on magnetic activated carbon. Theoretical investigations, using density functional theory, identified the molecule structures and calculated the molecular diameters of IOH (1.68 nm) and DTZ (1.16 nm), which revealed that ICM could be adsorbed by mesopores and larger micropores. Therefore, magnetic activated carbon with a porous structure was prepared by the co-precipitation method to investigate the adsorption mechanism of IOH and DTZ. MAC--5 (magnetic activated carbon with a theoretical iron oxide content of 37%) showed the best adsorption ability for both IOH and DTZ, with maximum adsorption capacities of 86.05 and 43.00 mg g, respectively. Adsorption kinetics and isotherm models were applied to explore the mechanisms involved, and the effects of solution pH, initial concentration, temperature, ionic strength, and natural organic matter were also investigated. The pore filling effect, π-π stacking, hydrogen bonding, and electrostatic interaction, were found to be the main adsorption mechanisms. The co-adsorption data showed that competition may occur in ICM coexisting environments. Interestingly, the used MAC--5 could be successfully regenerated and its adsorption efficiency did not decrease significantly after five cycles, indicating that it is a promising adsorbent for ICM. The results from this study provide some new insights for the treatment of water containing ICM.
Topics: Adsorption; Charcoal; Contrast Media; Diatrizoate Meglumine; Humans; Hydrogen-Ion Concentration; Iohexol; Kinetics; Water; Water Pollutants, Chemical; X-Rays
PubMed: 35147873
DOI: 10.1007/s11356-022-19127-9 -
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 -
Gastroenterologia Y Hepatologia Oct 2022Achieving adequate bowel cleansing is of utmost importance for the efficiency of colon capsule endoscopy (CCE). However, information about predictive factors is lacking.... (Observational Study)
Observational Study
BACKGROUND AND AIMS
Achieving adequate bowel cleansing is of utmost importance for the efficiency of colon capsule endoscopy (CCE). However, information about predictive factors is lacking. The aim of this study was to assess the predictive factors of poor bowel cleansing in the CCE setting.
METHODS
In this observational study, 126 patients who underwent CCE at two tertiary care hospitals were included between June 2017 and January 2020. Participants prepared for bowel cleansing with a 1-day clear liquid diet, a 4-L split-dose polyethylene glycol regimen and boosters with sodium phosphate, sodium amidotrizoate and meglumine amidotrizoate. Domperidone tablets and bisacodyl suppositories were administered when needed. Overall and per-segment bowel cleansing was evaluated using a CCE cleansing score. Simple and multiple logistic regression analysis were carried out to assess poor bowel cleansing and excretion rate predictors.
RESULTS
Overall bowel cleansing was optimal in 53 patients (50.5%). Optimal per-segment bowel cleansing was achieved as follows: cecum (86 patients; 74.8%), transverse colon (91 patients; 81.3%), distal colon (81 patients; 75%) and rectum (64 patients; 66.7%). In the univariate analysis, elderly (OR, 1.03; 95% CI (1.01-1.076)) and constipation (OR, 3.82; 95% CI (1.50-9.71)) were associated with poor bowel cleansing. In the logistic regression analysis, constipation (OR, 3.77; 95% CI (1.43-10.0)) was associated with poor bowel cleansing. No variables were significantly associated with the CCE device excretion rate.
CONCLUSION
Our results suggest that constipation is the most powerful predictor of poor bowel cleansing in the CCE setting. Tailored cleansing protocols should be recommended for these patients.
Topics: Aged; Bisacodyl; Capsule Endoscopy; Cathartics; Colon; Colonoscopy; Constipation; Diatrizoate Meglumine; Domperidone; Humans; Polyethylene Glycols; Sodium; Suppositories
PubMed: 35065169
DOI: 10.1016/j.gastrohep.2022.01.003 -
BMJ Supportive & Palliative Care Jan 2024Malignant bowel obstruction (MBO) is a common, challenging condition in advanced cancer. Oral water-soluble contrast medium (Gastrografin) has been used in the...
OBJECTIVES
Malignant bowel obstruction (MBO) is a common, challenging condition in advanced cancer. Oral water-soluble contrast medium (Gastrografin) has been used in the management of MBO without quality studies of its effectiveness and safety. The purpose of this study was to evaluate the feasibility, effectiveness and adverse effects of Gastrografin in patients with MBO and to assess feasibility of the study protocol.
METHODS
A prospective, interventional, single-arm, open label study of Gastrografin across two centres. Patients with unresolved inoperable MBO after 24 hours of conservative medical management were given a single dose of 100 mL of oral Gastrografin.
RESULTS
Over 33 months, 69 individual patients were screened. Of the 20 recruited, 17 completed study assessments (85%). MBO resolved in 10 of 17 patients (59%). Gastrografin passed through to the rectum in 14 patients (78%). The most common adverse effects were diarrhoea, vomiting, nausea and abdominal pain.
CONCLUSIONS
Patient recruitment took longer than anticipated, but the study protocol is feasible. Gastrografin was found to be a relatively effective option for the treatment of MBO. An adeqautely powered randomised controlled trial is needed to formally assess the efficacy and safety of Gastrografin© in MBO.
Topics: Humans; Contrast Media; Diatrizoate Meglumine; Intestinal Obstruction; Pilot Projects; Prospective Studies; Water
PubMed: 35045980
DOI: 10.1136/bmjspcare-2021-003444 -
The British Journal of Radiology Feb 2022With optimized technique, the water-soluble contrast challenge is effective at triaging patients for operative non-operative management of suspected small bowel... (Review)
Review
With optimized technique, the water-soluble contrast challenge is effective at triaging patients for operative non-operative management of suspected small bowel obstruction. Standardized study structure and interpretation guidelines aid in clinical efficacy and ease of use. Many tips and tricks exist regarding technique and interpretation, and their understanding may assist the interpreting radiologist. In the future, a CT-based water-soluble contrast challenge, utilizing oral contrast given as part of the initial CT examination, might allow for a more streamlined algorithm and provide more rapid results.
Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Algorithms; Colon; Conservative Treatment; Contrast Media; Diatrizoate Meglumine; Gastrointestinal Transit; Humans; Intestinal Obstruction; Intestine, Small; Intubation, Gastrointestinal; Iohexol; Middle Aged; Radiography, Abdominal; Treatment Outcome; Triage
PubMed: 34826227
DOI: 10.1259/bjr.20210791 -
Surgery Jun 2022Small bowel obstruction management has evolved to incorporate the Gastrografin challenge. We expanded its use to the emergency department observation unit, potentially... (Review)
Review
BACKGROUND
Small bowel obstruction management has evolved to incorporate the Gastrografin challenge. We expanded its use to the emergency department observation unit, potentially avoiding hospital admission for highly select small bowel obstruction patients. We hypothesized that the emergency department observation unit small bowel obstruction protocol would reduce admissions, costs, and the total time spent in the hospital without compromising outcomes.
METHODS
We reviewed patients who presented with small bowel obstruction from January 2015 to December 2018. Patients deemed to require urgent surgical intervention were admitted directly and excluded. The emergency department observation unit small bowel obstruction guidelines were introduced in November 2016. Patients were divided into pre and postintervention groups based on this date. The postintervention group was further subclassified to examine the emergency department observation unit patients. Cost analysis for each patient was performed looking at number of charges, direct costs, indirect cost, and total costs during their admission.
RESULTS
In total, 125 patients were included (mean age 69 ± 14.3 years). The preintervention group (n = 62) and postintervention group (n = 63) had no significant difference in demographics. The postintervention group had a 51% (36.7 hours, P < .001) reduction in median duration of stay and a total cost reduction of 49% (P < .001). The emergency department observation unit subgroup (n = 46) median length of stay was 23.6 hours. The readmission rate was 16% preintervention compared to 8% in the postintervention group (P = .18).
CONCLUSION
Management of highly selected small bowel obstruction patients with the emergency department observation unit small bowel obstruction protocol was associated with decreased length of stay and total cost, without an increase in complications, surgical intervention, or readmissions.
Topics: Aged; Aged, 80 and over; Diatrizoate Meglumine; Emergency Service, Hospital; Hospitals; Humans; Intestinal Obstruction; Length of Stay; Middle Aged; Retrospective Studies
PubMed: 34815095
DOI: 10.1016/j.surg.2021.10.041