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  1. Hamzaini AH, Helmee MN, Masoud S, Suraya A, Nazri MS, Das S
    Clin Ter, 2009;160(6):473-5.
    PMID: 20198290
    BACKGROUND AND AIMS: Many patients who presented to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with signs and symptoms of urolithiasis had mild hydronephrosis with non visualization of calculus on ultrasound examination. These patients underwent an intravenous urogram (IVU) in order to determine the presence of urolithiasis and most of them had normal IVU. The main aim of this study was to determine the predictive value of urinalysis in this group of patients in determining the need for IVU examinations.
    MATERIALS AND METHODS: Retrospectively the ultrasound, urinalysis and intravenous urography reports of 53 patients were reviewed and evaluated.
    RESULTS: The positive predictive and negative predictive value of urinalysis was found to be 68% and 96.4%, respectively. CONCLUSIONS; The results indicate that the urinalysis was an excellent negative predictor for IVU. In view of high radiation dose, risk of contrast reaction and contrast induced nephropathy of IVU, we suggest that it should not be performed in patient with non visualization of calculus mild hydronephrosis when the urinalysis is negative for blood.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Contrast Media/administration & dosage
  2. Haque ST, Chowdhury EH
    Curr Drug Deliv, 2018;15(4):485-496.
    PMID: 29165073 DOI: 10.2174/1567201814666171120114034
    BACKGROUND: Delivery of conventional small molecule drugs and currently evolving nucleic acid-based therapeutics, such as small interfering RNAs (siRNAs) and genes, and contrast agents for high resolution imaging, to the target site of action is highly demanding to increase the therapeutic and imaging efficacy while minimizing the off-target effects of the delivered molecules, as well as develop novel therapeutic and imaging approaches.

    METHODS: We have undertaken a structured search for peer-reviewed research and review articles predominantly indexed in PubMed focusing on the organic-inorganic hybrid nanoparticles with evidence of their potent roles in intracellular delivery of therapeutic and imaging agents in different animal models.

    RESULTS: Organic-inorganic hybrid nanoparticles offer a number of advantages by combining the unique properties of the organic and inorganic counterparts, thus improving the pharmacokinetic behavior and targetability of drugs and contrast agents, and conferring the exclusive optical and magnetic properties for both therapeutic and imaging purposes. Different polymers, lipids, dendrimers, peptides, cell membranes, and small organic molecules are attached via covalent or non-covalent interactions with diverse inorganic nanoparticles of gold, mesoporous silica, magnetic iron oxide, carbon nanotubes and quantum dots for efficient drug delivery and imaging purposes.

    CONCLUSION: We have thus highlighted here the progress made so far in utilizing different organicinorganic hybrid nanoparticles for in vivo delivery of anti-cancer drugs, siRNA, genes and imaging agents.

    Matched MeSH terms: Contrast Media/administration & dosage*
  3. Morishita K, Hiramoto A, Michishita A, Takagi S, Osuga T, Lim SY, et al.
    J. Vet. Intern. Med., 2017 May;31(3):770-777.
    PMID: 28382699 DOI: 10.1111/jvim.14685
    BACKGROUND: Perflubutane microbubbles, a second-generation ultrasound contrast agent, are phagocytized by Kupffer cells. This characteristic may be useful to differentiate diffuse hepatic diseases in dogs.

    HYPOTHESIS/OBJECTIVES: To determine whether the washout ratio in the hepatic vein (HV) measured by contrast-enhanced ultrasonography (CEUS) can distinguish between inflammatory and noninflammatory hepatic disorders in dogs.

    ANIMALS: Forty-one client-owned dogs with hepatic disorders including 14 with hepatitis, 7 with primary hypoplasia of the portal vein (PHPV), 9 with congenital portosystemic shunt (cPSS), and 11 with other hepatopathy were enrolled. Six dogs without hepatic disease also were evaluated as healthy controls.

    METHODS: Dogs with hepatic disorders were prospectively included. Contrast-enhanced ultrasonography of the HV was performed for 2 minutes. Washout ratio was defined as the attenuation rate from peak intensity to the intensity at the end of the CEUS study.

    RESULTS: Washout ratio in the hepatitis group (median, 18.0%; range, 2.0-37.0%) was significantly lower than that of the PHPV (median, 52.2%; range, 11.5-86.3%), cPSS (median, 60.0%; range, 28.6-77.4%), other hepatopathy (median, 70.5%; range, 26.6-88.4%), and normal (median, 78.0%; range, 60.7-91.7%) groups. The area under the receiver operating characteristic curve for hepatitis was 0.960, with a 95% confidence interval (CI) of 0.853-0.990. Washout ratio ≤37.1% resulted in a sensitivity of 100% (95% CI, 78.5-100%) and specificity of 85.2% (95% CI, 67.5-94.1%) for the prediction of hepatitis.

    CONCLUSIONS AND CLINICAL IMPORTANCE: Washout ratio can distinguish hepatitis from the other noninflammatory disorders with high accuracy. This result might reflect impaired Kupffer cell phagocytosis in dogs with hepatitis.

    Matched MeSH terms: Contrast Media/administration & dosage*
  4. Chainchel Singh MK, Abdul Rashid SN, Abdul Hamid S, Mahmood MS, Feng SS, Mohd Nawawi H, et al.
    Forensic Sci Int, 2020 Mar;308:110171.
    PMID: 32032870 DOI: 10.1016/j.forsciint.2020.110171
    BACKGROUND: Post-mortem Computed Tomography (PMCT) allows non-invasive or minimally invasive detection of findings that may or may not be visible during conventional autopsy, however, it does not allow the investigator to draw any conclusions regarding patency of the vessel's lumen. To address this deficiency, Post-mortem Computed Tomography Angiography (PMCTA) utilizing different contrast media and techniques have been introduced with various studies looking at the correlation between PMCTA, autopsy (gross) findings and coronary artery histology in diagnosing coronary artery disease.

    OBJECTIVES: The aim of this study is to investigate the sensitivity and specificity of PMCTA in diagnosing coronary artery stenosis using water-based contrast media introduced though the vessels of the neck, compared to the gold standard of diagnosis i.e. gross and histological evaluation of the coronary artery.

    METHOD: This was a cross sectional study of 158 arterial sections involving 37 subjects recruited from the National Institute of Forensic Medicine (IPFN), Hospital Kuala Lumpur (HKL). An unenhanced PMCT was performed followed by PMCTA using water-based contrast media introduced though the vessels of the neck. Coronary artery stenosis was determined using multiplanar reconstructionD while the degree of stenosis was determined by calculating the percentage of luminal diameter divided by the diameter of the vessel internal elastic.

    RESULTS: The analysis of PMCTA and histopathology examinations revealed a sensitivity of 61.5%, specificity of 91.7%; positive predictive value (PPV) of 40.0% and negative predictive value (NPV) of 96.4%.

    CONCLUSION: PMCTA utilizing water-based contrast introduced though the vessels of the neck yielded similar results as other methods and techniques of PMCTA. We would therefore conclude that PMCTA utilizing this technique could be used to assess the degree of calcification and the presence of significant stenosis.

    Matched MeSH terms: Contrast Media/administration & dosage*
  5. Baradaran H, Ng CR, Gupta A, Noor NM, Al-Dasuqi KW, Mtui EE, et al.
    Int Angiol, 2017 Oct;36(5):445-461.
    PMID: 28541017 DOI: 10.23736/S0392-9590.17.03811-1
    BACKGROUND: The extent of calcium volume in the carotid arteries of contrast-based computer tomography (CT) is a valuable indicator of stroke risk. This study presents an automated, simple and fast calcium volume computation system. Since the high contrast agent can sometimes obscure the presence of calcium in the CT slices, it is therefore necessary to identify these slices before the corrected volume can be estimated.

    METHODS: The system typically consists of segmenting the calcium region from the CT scan into slices based on Hounsfield Unit-based threshold, and subsequently computing the summation of the calcium areas in each slice. However, when the carotid volume has intermittently higher concentration of contrast agent, a dependable approach is adapted to correct the calcium region using the neighboring slices, thereby estimating the correct volume. Furthermore, mitigation is provided following the regulatory constraints by changing the system to semi-automated criteria as a fall back solution. We evaluate the automated and semi-automated techniques using completely manual calcium volumes computed based on the manual tracings by the neuroradiologist.

    RESULTS: A total of 64 patients with calcified plaque in the internal carotid artery were analyzed. Using the above algorithm, our automated and semi-automated system yields correlation coefficients (CC) of 0.89 and 0.96 against first manual readings and 0.90 and 0.96 against second manual readings, respectively. Using the t-test, there was no significant difference between the automated and semi-automated methods against manual. The intra-observer reliability was excellent with CC 0.98.

    CONCLUSIONS: Compared to automated method, the semi-automated method for calcium volume is acceptable and closer to manual strategy for calcium volume. Further work evaluating and confirming the performance of our semi-automated protocol is now warranted.

    Matched MeSH terms: Contrast Media/administration & dosage
  6. Balasingam S, Azman RR, Nazri M
    QJM, 2016 Feb;109(2):121-2.
    PMID: 26101228 DOI: 10.1093/qjmed/hcv121
    Matched MeSH terms: Contrast Media/administration & dosage
  7. Zulkifle AM, Faisal M
    BMJ Case Rep, 2019 Aug 28;12(8).
    PMID: 31466969 DOI: 10.1136/bcr-2018-229169
    Vascular air embolism (VAE) is a known complication of contrast-enhanced CT (CECT) scan occurring in venous or arterial circulation with a wide spectrum of presentations. We report a case of a 44-year-old woman with endometrial adenocarcinoma stage IVB complicated with liver abscess and pulmonary embolism who developed VAE following a routine CECT scan after the sixth cycle of chemotherapy. This was an incidental finding and the patient remained asymptomatic throughout. As such, she was treated conservatively and gradually recovered. This case report serves as a reminder that VAE should be considered in patients presenting with unexplained symptoms following this procedure.
    Matched MeSH terms: Contrast Media/administration & dosage
  8. Lim LY, Mohd Firdaus CA, Fam XI, Goh EH
    J Comput Assist Tomogr, 2017 Jan;41(1):65-66.
    PMID: 27680416 DOI: 10.1097/RCT.0000000000000487
    Computed tomography (CT) is a widely used imaging modality. Although hyponatremia after CT imaging is rare, its effects can be devastating. Hyperosmolar radiocontrast acts as effective osmoles and causes fluid migration from intracellular into extracellular compartment. Dilutional hyponatremia will ensue if translocation of fluid is in excess of diuresis. This case report detailed an unusual case of acute symptomatic hyponatremia after CT renal protocol and the treatments given after its recognition.
    Matched MeSH terms: Contrast Media/administration & dosage
  9. Garcia S, Bhatt DL, Gallagher M, Jneid H, Kaufman J, Palevsky PM, et al.
    JACC Cardiovasc Interv, 2018 11 26;11(22):2254-2261.
    PMID: 30466822 DOI: 10.1016/j.jcin.2018.07.044
    OBJECTIVES: The aim of this study was to compare intravenous (IV) sodium bicarbonate with IV sodium chloride and oral acetylcysteine with placebo for the prevention of contrast-associated acute kidney injury (CAAKI) and intermediate-term adverse outcomes.

    BACKGROUND: Data are conflicting on the optimal strategy to reduce CAAKI and related complications after percutaneous coronary intervention (PCI).

    METHODS: The PRESERVE (Prevention of Serious Adverse Events Following Angiography) trial used a 2 × 2 factorial design to randomize 5,177 patients with stage III or IV chronic kidney disease undergoing angiography to IV 1.26% sodium bicarbonate or IV 0.9% sodium chloride and 5 days of oral acetylcysteine or placebo. A subgroup analysis was conducted of the efficacy of these interventions in patients who underwent PCI during the study angiographic examination. The primary endpoint was a composite of death, need for dialysis, or persistent kidney impairment at 90 days; CAAKI was a secondary endpoint.

    RESULTS: A total of 1,161 PRESERVE patients (mean age 69 ± 8 years) underwent PCI. The median estimated glomerular filtration rate was 50.7 ml/min/1.73 m2 (interquartile range: 41.7 to 60.1 ml/min/1.73 m2), and 952 patients (82%) had diabetes mellitus. The primary endpoint occurred in 15 of 568 patients (2.6%) in the IV sodium bicarbonate group and 24 of 593 patients (4.0%) in the IV sodium chloride group (odds ratio: 0.64; 95% confidence interval: 0.33 to 1.24; p for interaction = 0.41) and in 23 of 598 patients (3.8%) in the acetylcysteine group and 16 of 563 patients (2.8%) in the placebo group (odds ratio: 1.37; 95% confidence interval: 0.71 to 2.62; p for interaction = 0.29). There were no significant between-group differences in the rates of CAAKI.

    CONCLUSIONS: Among patients with CKD undergoing PCI, there was no benefit of IV sodium bicarbonate over IV sodium chloride or of acetylcysteine over placebo for the prevention of CAAKI or intermediate-term adverse outcomes.

    Matched MeSH terms: Contrast Media/administration & dosage
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