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Little information is available about how intravenous bolus injection of iopromide 370 twice in a short time will affect hemodynamics and whether the changes reach clinically relevant levels. In the present study, 31 healthy adult volunteers received abdominal contrast-enhanced CT and coronary CTA sequential examinations. The same dose and rate of normal saline was injected 30 min in advance as self-control. Hemodynamic data were noninvasively collected at selected time points from 1 min prior to injection to 30 min post-injection. The results showed that after iopromide 370 injection, except for stroke volume, all other indicators changed immediately during the first injection, changed most significantly during the second injection (P < 0.05), and returned to baseline within 10 min. Heart rate and cardiac output exhibited the most pronounced changes, with an increasing rate of 33.5% and 33.8%, respectively. For indicators with a change range of > 15% during the second injection, except for mean arterial pressure and total peripheral resistance, the proportions of subjects for the other indicators between the two groups were statistically different (P < 0.05). In conclusion, intravenous bolus injection of iopromide 370 twice in dual-site sequential examinations induced dose-cumulative and time-dependent hemodynamic effects, which all fluctuated within the normal ranges. [ABSTRACT FROM AUTHOR]

The electronic absorption spectra of solutions of aromatic and aliphatic iodine-containing substances in dimethyl sulfoxide, which are components of adhesive compounds for blood vessels, have been studied. It has been shown that, during storage of iodinated fatty acids, iodine is split off from them with the formation of an ion, with the presence of dimethyl sulfoxide and KI accelerating this process. Within 25 days, the concentration of bound iodine in solutions of iodinated fatty acids decreased three times. The stability of solutions of iodinated aromatic substances in dimethyl sulfoxide during storage for at least 6 months has been shown. [ABSTRACT FROM AUTHOR]

The redox-mediating capacity of magnetic reduced graphene oxide nanosacks (MNS) to promote the reductive biodegradation of the halogenated pollutant, iopromide (IOP), was tested. Experiments were performed using glucose as electron donor in an upflow anaerobic sludge blanket (UASB) reactor under methanogenic conditions. Higher removal efficiency of IOP in the UASB reactor supplied with MNS as redox mediator was observed as compared with the control reactor lacking MNS. Results showed 82% of IOP removal efficiency under steady state conditions in the UASB reactor enriched with MNS, while the reactor control showed IOP removal efficiency of 51%. The precise microbial transformation pathway of IOP was elucidated by high-performance liquid chromatography coupled to mass spectroscopy (HPLC-MS) analysis. Biotransformation by-products with lower molecular weight than IOP molecule were identified in the reactor supplied with MNS, which were not detected in the reactor control, indicating the contribution of these magnetic nano-carbon composites in the redox conversion of this halogenated pollutant. Reductive reactions of IOP favored by MNS led to complete dehalogenation of the benzene ring and partial rupture of side chains of this pollutant, which is the first step towards its complete biodegradation. Possible reductive mechanisms that took place in the biodegradation of IOP were stated. Finally, the novel and successful application of magnetic graphene composites in a continuous bioreactor to enhance the microbial transformation of IOP was demonstrated. [ABSTRACT FROM AUTHOR]

A controlled, randomized study using an experimental model of contrast (iopromide)-induced nephropathy (CIN) in normal mongrel rats showed that the combination of treatment by hydration with the nicotinamide adenine dinucleotide (NAD)-containing formulation Nadcin, with cytoprotective and antiischemic actions, decreased the plasma creatinine and urea nitrogen levels 72 h after induction of CIN. Aclose correlational relationship ( r = 0.78, p < 0.001) was found between the blood endothelin-1 (ET-1) level and O generation, while there was no relationship between hydrogen peroxide production and the ET-1 level ( r = 0.13, p > 0.05) or between the ET-1 level and catalase activity ( r = 0.41, p > 0.05). In contrast to monotherapy with hydration, inclusion of Nadcin normalized blood ET-1 and the blood ET-1/creatinine ratio, the blood and renal NAD/NADH and NADP/NADPH redox potentials, and had more marked actions on reversing the overproduction of free radicals and on the antioxidant defense system in the blood and renal tissue. It is suggested that ET-1, the ET-1/creatinine ratio, and the plasma redox potential can be used as early markers for increases in the risk of developing stable impairment of renal function on use of x-ray contract agents. [ABSTRACT FROM AUTHOR]

Background: Several recent studies showed the optimal contrast enhancement with a low-concentration and iso-osmolar contrast media in both adult and pediatric patients. However, low contrast media concentrations are not routinely used due to concerns of suboptimal enhancement of cardiac structures and small vessels. Objective: To evaluate the feasibility of using iso-osmolar contrast media containing a low iodine dose for CT cardiac angiography at 80 kilovolts (kVp) in neonates and infants. Materials and methods: The iodixanol 270 group consisted of 79 CT scans and the iopromide 370 group of 62 CT scans in patients ≤1 year old. Objective measurement of the contrast enhancement was analyzed and contrast-to-noise ratios of the ascending aorta and left ventricle were calculated. Regarding subjective measurement, a four-point scale system was devised to evaluate degrees of contrast enhancement, image noise, motion artifact and overall image quality of each image set. Reader performance for correctly differentiating iodixanol 270 and iopromide 370 by visual assessment was evaluated. Results: Group objective and subjective measurements were nonsignificantly different. Overall sensitivity, specificity and diagnostic accuracy for correctly differentiating iodixanol 270 and iopromide 370 by visual assessment were 42.8%, 59%, and 50%, respectively. Conclusion: The application of iodixanol 270 achieved optimal enhancement for performing pediatric cardiac CT angiography at 80 kVp in neonates and infants. Objective measurements of contrast enhancement and subjective image quality assessments were not statistically different in the iodixanol 270 and iopromide 370 groups. [ABSTRACT FROM AUTHOR]

The potential of granular activated carbon (GAC) to remove iopromide and its intermediates from ozone-treated river water was evaluated. Mass spectrum analysis showed that ozone treatment lead to partial removal of iopromide ( m/z 791.8) with generation of various intermediates. GAC demonstrated a lower iopromide adsorption (1.60 μg/g) in the presence of natural organic matter (NOM) compared to NOM-free water (12.54 μg/g), indicating the inhibitory effect of NOM on iopromide adsorption. Ozone treatment of the influent reduced the inhibitory effect of NOM by altering its composition and inducing polarity shift. GAC post-treatment resulted in improved removal of residual iopromide and its intermediates from the ozone-treated influent. Application of such combined treatment of ozonation followed by GAC adsorption can be an effective strategy for the removal of iopromide and its intermediates from contaminated water streams. [ABSTRACT FROM AUTHOR]

The atropisomer composition of iopromide substance and formulations is discussed. At 120 °C in aqueous iopromide solution, its atropisomers were found to be converted to conformers, which reached equilibrium with each other in 15 min at this temperature. Thus, the atropisomer composition of iopromide substance in solutions prepared using the technical method as described inevitably consists of the equilibrium between conformers formed at 120 °C. The equilibrium composition of these solutions persists after cooling, i.e., after return of conformers to the state of atropisomers. The relative content of the E1 and E2 (USP terminology) atropisomers (Σ E) is an important quality indicator for iopromide formulations; only compliance with the inequality Σ E ≥ 20 % guarantees phase stability of solutions with working concentrations of iopromide ( ≤ 769 mg/ml) over a wide range of temperatures (0 - 120 °C). The inequality Σ E ≥ 20 % is inevitably reached during heat sterilization of iopromide. [ABSTRACT FROM AUTHOR]

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Iopromide has been frequently detected in different environmental compartments. However, the biodegradation of iopromide was limited, and significantly different removal efficiencies by various methods were reported. In this study, a Pseudomonas sp. I-24 isolated from activated sludge in a sewage treatment plant was used to degrade iopromide. Four different cosubstrates were selected as the cometabolic carbon and energy sources. The results showed that cosubstrate starch was able to increase catabolic enzymatic activity and enhance iopromide degradation. The degradation efficiency of iopromide was as high as 88.24 %, which was much higher as compared with other cosubstrates (38.58-51.44 %) and blank sample (2.81 %). Additionally, the highest enzymatic activity of 0.182 mU for iopromide degradation was also obtained when adding starch as a cosubstrate, somehow supporting that higher enzymatic activity resulted in higher degradation efficiency for iopromide. Although little was illuminated about the molecular mechanism during the degradation process of iopromide with starch addition, the two-dimensional gel electrophoresis results indicated that the iopromide-degrading cells growing with cosubstrate starch underwent significant physiological changes. [ABSTRACT FROM AUTHOR]

Background: Intravascular administration of iodinated contrast media continues to be a common cause of hospital-acquired acute kidney injury. Accumulating evidence suggests that radiocontrast agent-induced nephrotoxicity is associated with increased oxidative stress, which leads to renal tissue damage with DNA fragmentation. We therefore tested whether an iso-osmolar contrast medium (iodixanol) causes less oxidative DNA damage to renal tubular cells than a low-osmolar contrast medium (iopromide). Methods: HK-2 cells (human proximal renal tubular cell line) were incubated at different time points (10 min–2 h) with increasing concentrations (20–120 mg/ml iodine) of iodixanol or of iopromide. Oxidative DNA damage to renal tubular cells was measured by alkaline comet assay (single-cell gel electrophoresis). Results: Both iso- and low-osmolar contrast agents induced time- and concentration-dependent DNA fragmentation. DNA fragmentation was maximal at 2 h with 120 mg/ml iodine for iopromide (32 ± 27 tail moments) and iodixanol (46 ± 41 tail moments); both were significantly different from the control value with 3.15 ± 1.6 tail moments (Student’s t test; p < 0.001). After 1 and 2 h and for all concentrations, iodixanol produced significantly higher DNA fragmentation than iopromide (ANOVA for 1 h p = 0.039 and 2 h p = 0.025, respectively). Conclusion: We were able to demonstrate for the first time that an iso-osmolar contrast medium induced even greater oxidative stress and DNA damage than a low-osmolar agent in HK-2 cells. This could provide an explanation for the nephrotoxicity that also is observed with iodixanol in clinical practice. [ABSTRACT FROM AUTHOR]

Non-ionic dimers induce less diuresis than non-ionic monomers, resulting in increased opacification of the urinary tract in intravenous urography. This trial compared the diagnostic efficacy of iodixanol and iopromide in patients with macroscopic haematuria. One hundred consecutive patients with normal renal function and macroscopic haematuria entered a double blind, comparative, randomised, parallel trial. Contrast media were given with bolus injection in doses of 300 mgI/kg b.w. Radiographs were blindly evaluated by three radiologists who analysed different parameters (calyceal density and filling, papillary blush detection, delineation of collecting ducts, renal pelvis opacification, visualisation of ureters, bladder density, bladder distention) and estimated the diagnostic confidence (whether abnormal findings were definitely absent, probably absent, doubtful, probably present or certainly present). Radiological diagnoses were compared with final diagnoses. Results were summarised as the ratio of the odds of having a worse performance of iopromide vs iodixanol. Iodixanol showed a significantly better calyceal density and filling [odds ratio (OR): 1.96; 95% confidence interval (CI): 1.60-2.41], a significantly better pelvis opacification (OR 2.91; CI 2.02-4.18) and a significantly more frequent papillary blush detection (OR 1.95; CI 1.29-2.95). Iopromide showed a significantly better ureteral visualisation (OR 0.67; CI 0.48-0.92) and a significantly higher bladder distention (OR 0.59; CI 0.36-0.99). Iodixanol allowed a significantly higher diagnostic confidence as to calyceal evaluation (OR 1.35; CI 1.01-1.79). No significant differences were found with regard to other parameters. The results confirmed theoretical expectations. The higher opacification provided by iodixanol allowed better results and a higher diagnostic confidence in the upper excretory pathway. [ABSTRACT FROM AUTHOR]

Blood isotone contrast media is considered to be less toxic to vascular and pancreatic duct endothelium than high-osmolar contrast media. In this study we assessed the impact of a low-osmolar contrast agent compared with a blood isotone product on pancreatic damage induced by endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic retrograde sphincterotomy (EST). In a prospective trial 42 consecutive ERCP/EST patients were randomized to receive either iopromid, a low-osmolar non-ionic contrast agent (770 mosmol/kg H2O), or iotrolan, a blood-isotone non-ionic product (320 mosmol/kg H2O). The endoscopies were performed by two experienced endoscopists. Forty patients were included in the study. Blood samples were collected before and 40 min, 2, 4, 6 and 24 h after the endoscopic procedure. Samples were analysed for pancreatic serum enzymes, acute-phase proteins and blood counts. A clinical pain score was investigated. Post-ERCP pancreatitis was diagnosed in 2 patients in the iopromid group and in 5 patients in the iotrolan group. There was no significant difference between groups in the time course of pancreatic serum enzymes, acute-phase proteins or in the pain score. Due to the small number of patients in this study, only stronger differences caused by the two contrast media could have led to statistically significant results. We did not observe statistically significant differences in comparing iotrolan and iopromid concerning ERCP/EST-induced pancreatic damage. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography.Methods: A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography.Results: The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p << 0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19. 8% in the iopromide group (p << 0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p = NS). Overall diagnostic information was optimal for 94.1% in the iodixanol group and 95.3% in the iopromide group (p = NS).Conclusions: Iodixanol 270 mg I/ml causes significantly less injection-associated pain during femoral arteriography and is as safe and efficacious as iopromide 300 mg I/ml. [ABSTRACT FROM AUTHOR]

A rabbit model was used to assess the effects of intracarotid injections of ionic monomer (meglumine iothalamate), non-ionic monomer (iohexol, iopromide), and non-ionic dimer (iotrol) contrast materials on the blood-brain barrier. The degree of blood-brain barrier damage was assessed qualitatively using Evans' blue dye, and quantitatively by calculating the difference in pertechnetate uptake between injected and non-injected hemispheres. The results showed that the non-ionic dimer, iotrol, had the least effect on the blood-brain barrier, and that although iopromide and iohexol produced greater damage than iotrol, the ionic compound, meglumine iothalamate, caused the greatest disruption to the blood-brain barrier. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Iopentol (Imagopaque®, Nycomed Imaging AS, Oslo, Norway) 300 mg I/ml was compared with iopromide (Ultravist®, Schering AG, Berlin, Germany) 300 mg I/ml in pediatric angiocardiography in 97 children (48 and 49 patients, mean age 2.8 and 4.1 years in the respective contrast medium groups). The volume injected was usually 4–6 ml/kg b. w. ECG, blood pressure, heart rate, adverse events and efficacy were evaluated. Five patients in the iopentol group and four in the iopromide group reported adverse events. This difference was not statistically significant. One adverse event in each of the two groups was considered as possibly related to the contrast medium. Only small and transient changes in heart rate, blood pressure and ECG parameters were observed. No difference between the two contrast media was found for efficacy. It can be concluded that iopentol is well suited for angiocardiographic examinations in children. [ABSTRACT FROM AUTHOR]

We report the European experience with iotrolan 280, a new, non-ionic, isotonic, dimeric, iodinated contrast agent in cerebral angiography. Six randomized, double-blind, controlled, interindividual studies took place at four study centers in Germany. All the studies used intra-arterial contrast administration: iotrolan 280 was administered to 186 patients, iopamidol 300 to 127 patients, iohexol 300 tp 30 patients and iopromide 300 to 30 patients. Iotrolan 280 gave impoved contrast quality with improved opacification of small cerebral vessels. LOcal pain and heat sensations were fewer following iotrolan administration. There was a trend towards better neural tolerance of iotrolan 280 as shown by electroencephaplogram. [ABSTRACT FROM AUTHOR]

Clinical data from 14 randomized double-blind studies were reviewed to compare the renatl tolerance of non-ionic monomeric contrast agents (iopamidol 300, iopromide 300, iohexol 300) with the non-ionic dimer iotrolan 280. A prospective study of iotrolan 280 versus iohexol 300 in renally impaired patients was also evaluated. Differences between the contrast agents were investigated using sub-group analysis of patients with an increased risk of contrast-induced nephropathy. Both the prospective study and meta-analysis of previous studies indicate that iotrolan 280 has less influence on renal function than the non-ionic monomeric comparator agents. [ABSTRACT FROM AUTHOR]

Iotrolan (280 mg iodine/ml) a new non ionic, isotonic dimeric, contrast agent, was evaluated in multicenter clinical stidues conducted in Europe between March 1987 and September 1992. The studies compared the efficacy and safety of the agent with the non-ionic monomeric contrast agents available at the time. Iotrolan was given intravenously to patients undergoing urography, head and body computed tomography phlebography and digital subtraction angiography. The agent was also studied after intra-arterial injections in cerebral, visceral and peripheral angiographic procedures as well as digital subtraction angiography. Data from 32 prospective double blind, randomized, controlled clinical studies, were evaluated. A total of 1203 patients received either iopromide, iohexol or iopamidol (all in concentration of 300 mg iodine/ml), and a further 1207 patients received iortrolan. As there were no sognificant differences ( P = 0.0853) in adverse events between the comparative agents, their adverse event data were pooled for evaluation with data from patients receiving iotrolan. Adverse experiences were recorded in two categories - local tolerance (heat and pain) and general tolerance (generalized heat and adverse clinical events). After intra-arterial injection iotrolan had a significantly lower incidence of local heat sensation ( P = 0.0001) and a significantly lower incidence of local pain ( P = 0.0001) compared with comparator agents. Also, after intravenous injection iotrolan had a significantly lower incidence of local heat ( P = 0.0038). In the overall evaluation of general tolerance for all indications, iotrolan was shown to produce significantly less generalized heat ( P = 0.0012) and a lower incidence of adverse events ( P = 0.061) compared with the reference agents. [ABSTRACT FROM AUTHOR]

Twelve healthy male volunteers participated in a single-blind, randomised, placebo-controlled cross-over study of IV iopromide in doses of 15 g iodine or 80 g iodine infused over a period of 15 min. The volunteers were observed for three days during which time blood samples, urine and faeces were collected. The terminal disposition phase half-life of iopromide was 2 h and 1.9 h, and the total clearance was 110 and 103 ml·min at the lower and at the higher dose levels, respectively. The steady state volume of distribution was 16 and 17 l, indicating predominantly extracellular distribution of iopromide. Statistical analysis (one-sided t-test) showed that all the target parameters (AUC, half-life and urinary excretion) were equivalent at both dose levels, indicating dose proportionate, first order kinetics of iopromide over the large dose range tested. Iopromide was well tolerated after both doses. [ABSTRACT FROM AUTHOR]

Unlabelled: We report the presence of iopromide in the bowel and urine of a preterm infant, born 10 days after intravenous administration of the nonionic monomer to his mother. Excessive urinary iodine excretion and borderline hyperthyrotropinaemia were observed in the infant. Moreover, crossing of the fetal blood-brain barrier was demonstrated by detection of the angiographic material in CSF and thus direct fetal neurotoxic effects cannot be excluded.Conclusion: These widely used contrast media may cross the placenta and accumulate in various fetal tissues in significant amounts causing possible neonatal toxicity. Therefore the perinatal safety of these diagnostic agents should at least be questioned. [ABSTRACT FROM AUTHOR]