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In this study, we studied the degradation kinetics of a common iodine contrast agent, diatrizoate, by ozone and the formation of disinfection by-products (DBPs) in the sequential chlorination. Effects of ozone concentration, solution pH, and bromide concentration on diatrizoate degradation were evaluated. The results indicate that diatrizoate can be effectively degraded (over 80% within 1 h) by ozone, and the degradation kinetics can be well described using the pseudo-first-order kinetic model. The pseudo-first-order rate constant (kobs) of diatrizoate degradation significantly increased with increasing ozone concentration and decreasing bromide concentration. The kobs kept increasing with the increase of pH value and reached a maximum of 6.5 (±0.05) × 10−2 min−1 at pH 9. As the ozone concentration gradually increased from 0.342 to 1.316 mg/L, the corresponding kobs of diatrizoate degradation increased from 1.76 (±0.20) × 10−3 to 4.22 (±0.3) × 10−2 min−1. The bromide concentration exhibited a strong inhibitory effect on diatrizoate degradation because of the competition for ozone with diatrizoate. Trichloromethane was the only detected DBP in the subsequent chlorination in the absence of bromide. However, in the presence of bromide, six other DBPs were detected, and bromochloroiodomethane and tribromomethane became the major products with concentrations 1–2 orders higher than those of the other DBPs. In order to provide safe drinking water to the public, water should be maintained at circumneutral pH values and low bromine concentrations ( 7.; •OH played a major role in diatrizoate degradation during ozonation.; Bromide can strongly inhibit diatrizoate degradation because of the competition for ozone with diatrizoate.; The formation of DBPs can be controlled at circumneutral pH and low bromine concentrations (

Introduction The advent of the Gastrograffin® small bowel follow through (G-SBFT) has resulted in a decreased rate of operative intervention of small bowel obstructions (SBO); however, there is no data to suggest when G-SBFT should be performed. Methods We retrospectively reviewed 548 patients, admitted to 1 of 9 hospitals with a diagnosis of SBO. Patients were divided into two categories with regards to timing of G-SBFT: before (early) or after (late) 48 hours from admission. Primary outcomes were length of stay (LOS) and total cost. Secondary outcomes were operative interventions and mortality. Results Of the reviewed patients, 71% had the G-SBFT ordered early. Comparing early versus late, there were no differences in patient characteristics with regards to age, sex, or BMI. There was a significant difference between LOS (4 vs 8 days, P < 0.05) and total cost ($17,056.19 vs $33,292.00, P < 0.05). There was no difference in mortality (1.3% vs 2.6%, P = 0.239) or 30-day readmission rates (15.6% vs 15.9%, P = 0.509). Patients in the early group underwent fewer operations (20.7% vs 31.9%, P = 0.05). Discussion Patients that had a G-SBFT ordered early had a decreased LOS, total cost, and operative intervention. This suggests there is a benefit to ordering G-SBFT earlier in the hospital stay to reduce the overall disease burden, and that it is safe to do so with regards to mortality and readmissions. We therefore recommend ordering a G-SBFT within 48 hours to reduce LOS, cost, and need for an operation

Mollusks are very sensitive to aquatic environmental alterations and then, are important bio-indicators for monitoring the contamination of water bodies. Iodinated X-ray contrast media (ICMs) are ubiquitously present in the aquatic environment, primarily due to their high consumption for diagnosis purposes, high injection levels, low biodegradability, and low removal rates by wastewater treatment plants. Although these compounds are assumed to be of low toxicity, aquatic organisms are continuously exposed to these agents, which may result in adverse effects as ICMs can act as iodine source and disrupt the endocrine system. Thus, the evaluation of their environmental risk, especially on aquatic fauna is of great interest. To this end, we first compared the accumulation behavior, based on iodine analysis, of two ICM exhibiting different osmolality, diatrizoic acid and iohexol in Dreissena polymorpha bivalves exposed under laboratory conditions at concentrations of 0, 100, and 1000 μg/L during 4 and 7 days. This study was the first to provide information on iodine concentration in whole soft tissues and several organs in control zebra mussels. Moreover, it showed, after exposure, an increase of iodine content mainly in the digestive glands, followed by gills and gonads, highlighting that ICMs actually enter the organisms. Thus, bioaccumulation of ICMs studies were then performed, by liquid chromatography coupled to tandem mass spectrometry, on entire mollusks and digestive glands of organisms exposed at 0, 10, 100, and 1000 μg/L of both ICMs during 21 days, followed by 4 days of depuration. These first data on ICMs concentrations in zebra mussels, showed a clear accumulation of ICMs in mussels as a function of relative exposure level, as well as a rapid depuration. Osmolality did not seem to have a significant impact on the accumulation level, but a slight difference was observed on the accumulation pattern between both ICMs.

Background The aim of this study was to determine an effective dose of the contrast agent diatrizoate in healthy rabbits. Methods This study included 14 rabbits receiving three different dosages of a solution containing 300 mg iodine/mL and 600 mg diatrizoate/mL (Dose 1, 2 mL/kg; Dose 2, 7 mL/kg; Dose 3, 10 mL/kg). Full body radiographs were obtained at 0, 15, 30, 45 and 60 minutes, and 12 and 24 hours after oral administration. Blood samples 60 minutes and 24 hours after administration and fecal dry matter after 24 hours were compared to preliminary samples. Results Recommended doses and times for radiography for luminal patency and visualization of each gastrointestinal segment are given. The evaluated blood parameters were within their respective reference intervals throughout this study. However, significant changes (P < 0.05) could be observed. A decrease in hematocrit at all three doses administered, an increase in urea that persisted for more than 24 hours after administration of 2 mL/kg and 10 mL/kg, and a short-term increase in creatinine after administration of 7 mL/kg could be observed. Glucose and sodium were still increased after administration of 10 mL/kg after 24 hours, while potassium decreased after administration of all three doses. The chloride concentration was still increased after 24 hours after administration of 7 mL/kg. Administration of 7 mL/kg and 10 mL/kg resulted in a significant decrease in the dry matter of feces. Five rabbits developed self-limiting diarrhea after administration of 10 mL/kg. Conclusion and clinical relevance Diatrizoate is a useful contrast agent in order to assess the passage through the intestine and achieve a good visualization of the gastrointestinal system.

The use of the iodine-containing contrast agent diatrizoate was investigated in healthy rabbits and in rabbits with gastric dilatation and intestinal obstruction. For this purpose, transit times through the gastrointestinal tract and clinical use were investigated during a one year period. In addition, a possible influence on thyroid hormone levels was evaluated.Transit times of contrast agent through the different intestinal sections were examined radiographically in 14 healthy rabbits. For this purpose, 7 ml/kg of a 300 mg iodine/ml and 600 mg diatrizoate/ml containing solution were administered. Radiographs were obtained at different time intervals. Three different doses (D1 2 ml/kg, D2 7 ml/kg, D3 10 ml/kg) were administered, and blood samples were collected at two time points (60 min, 24 h) to analyze thyroid hormone levels (TT4, fT4, TSH). In addition, 70 rabbits that had received the contrast agent diatrizoate because of gastric dilatation and suspected intestinal obstruction were retrospectively evaluated during a period of one year. Focus was placed on arrival of the contrast agent in the cecum, laboratory changes, and mortalities.In all healthy rabbits, contrast medium was detectable in the cecum after a mean of 45-60 min. In the animals suffering from gastrointestinal obstruction, this was delayed to a mean of 121.2 min. These animals showed hypothermia in 92.4 % and hyperglycemia in 45.9 %. 56.1 % exhibited an increase in urea and 33.9 % an increase in creatinine. In 71.4 % of cases, medical treatment was possible, however 12 % of these individuals succumbed to the disease. 28.6 % of the cases were managed surgically which was associated with a mortality of 50 %. TT4, fT4, and TSH levels displayed significant alterations among the three contrast agent doses (p0.05). These changes were found to be transient when follow-up was performed two weeks later.When ileus is suspected in rabbits, diatrizoate may be helpful in evaluating the progression of the disease in addition to the use of native radiographs. Sufficient hydration and monitoring of renal function are advisable. Transient changes in thyroid hormones were evident but lacked clinical relevance.In dieser Studie wurde der Einsatz des jodhaltigen Kontrastmittels (KM) Amidotrizoat an gesunden und an Kaninchen mit einer Magendilatation und einem Verdacht auf eine intestinale Obstruktion untersucht. Dazu wurden die Passagezeiten durch den Magendarmtrakt und der klinische Einsatz innerhalb eines Jahres untersucht. Außerdem wurde ein möglicher Einfluss auf Schilddrüsenhormone evaluiert.Die KM-Passagezeiten durch die einzelnen Darmabschnitte wurden an 14 gesunden Kaninchen röntgenologisch untersucht. Dazu wurden 7 ml/kg einer Lösung mit 300 mg Iod/ml und 600 mg Amidotrizoat/ml verabreicht und die Tiere in zeitlichen Abständen erneut geröntgt. Zur Untersuchung der Schilddrüsenhormone (TTBei Verdacht eines Ileus beim Kaninchen kann neben dem Einsatz von nativen Röntgenaufnahmen Amidotrizoat für die Bewertung des Krankheitsverlaufs hilfreich sein. Eine Kontrolle der Nierenfunktion und eine Hydrierung des Tieres sind anzuraten. Es konnten transiente Veränderungen der Schilddrüsenhormone nachgewiesen werden, die aber ohne klinische Relevanz blieben.

Adverse reactions after intravascular administration of iodine-based contrast media are well-known. Nevertheless the same type of contrast media is also used for endoscopic retrograde cholangiopancreatography and systemic absorption of contrast media after mentioned procedure routinely occurs, not much is known about effects of widely used diatrizoates (Triombrast) on the hepato-pancreato-biliary system in case of cholelithiasis treatment.The aim of the present study was to determine the effectiveness and biosafety of diatrizoate contrast media in terms of complicated cholelithiasis healing using conventional and improved surgery treatment protocols based on set of biochemical markers.The paper presents materials of clinical observation and biochemical analysis of 122 patients have been diagnosed with gallstone disease complicated by choledocholithiasis and cholangitis and biliary pancreatitis. Biochemical liver tests before and after surgery treatment using conventional and improved protocols were determined.Biochemical manifestations of hepatocellular injury included exceeded activity of γ-glutamyltranspeptidase and aminotrasferases as well as level of liver fatty acid-binding protein and bilirubin which were different between groups of patients with cholelithiasis who suffered from concomitant cholangitis and pancreatitis. Proposed management algorithm for patients with gallstone disease with concomitant cholangitis and pancreatitis links to get rid of endoscopic retrograde cholangiography with contrast agent from the conventional surgery treatment protocols because its most obvious downside.Patients with gallstone diseases revealed significant biochemical changes that should be successfully resolved after surgery treatment without endoscopic retrograde cholangio- pancreatography with contrast media because its hepatotoxic effect.

International audience; The occurrence of iodine X-ray contrast media (ICM) in the environment is a global concern since they can be transformed into toxic compounds during water disinfection process. Among the different approaches that have been tested to degrade them, electroreduction offers the advantages to be selective, targeting in a cost-effective way the functional groups responsible for ICM biorecalcitrance and allowing the recovery of iodide ions. We have previously shown that total deiodination of diatrizoate, a highly biorecalcitrant ICM, did not lead to a significant enhancement of its biodegradability. In this work, the electroreduction of amido groups of diatrizoate was attempted to further improve its biodegradability. Electrolyses of diatrizoate and its deiodinated derivative, were investigated in neutral and acidic medium. A total deiodination of diatrizoate was rapidly achieved in both media along with a slower reduction of the amido groups, as shown by LC-MS/MS analysis of by-products. The biodegradability of the solutions was estimated by the evaluation of the BOD5/COD ratio. Results show that it was improved after the electroreduction performed in acidic medium. This result was confirmed by a biological treatment on activated sludge over a 21 days period, leading to mineralization yields of 46% and 68% for diatrizoate and 3,5-diacetamidobenzoic acid, respectively, after the electroreduction process. © 2021 Elsevier B.V.

Chemical disinfection of water provides significant public health benefits. However, disinfectants like chlorine can react with naturally occurring materials in the water to form disinfection byproducts (DBPs). Natural levels of iodine have been reported to be too low in some source waters to account for the levels of iodinated DBPs detected. Iodinated X-ray contrast media (ICM) have been identified as a potential source of iodine. The toxicological impact of ICM present in source water at the time of disinfection has not been fully investigated. Iopamidol, iohexol, iopromide, and diatrizoate are among the ICM most frequently detected in water. In this study, source water containing one of these four ICM was chlorinated; non-chlorinated ICM-containing water samples served as controls. Reactions were conducted at an ICM concentration of 5 µM and a chlorine dose of 100 µM over 72 hr. Water concentrates (20,000-fold) were prepared by XAD-resin/ethyl acetate extraction and DMSO solvent exchange. We used the MatTek® reconstituted human epithelial skin irritation model to evaluate the water concentrates and also assessed the dermal irritation and sensitization potential of these concentrates using the LLNA:BrdU ELISA in BALB/c mice. None of the water concentrates tested (2500X) resulted in a skin irritant response in the MatTek® skin irritation model. Likewise, none of the concentrates (2500X, 1250X, 625X, 312.5X, 156.25X) produced a skin irritation response in mice: erythema was minimal; the maximum increase in ear thickness was less than 25%. Importantly, none of the concentrates produced a positive threshold response for allergic skin sensitization at any concentration tested in the LLNA:BrdU ELISA. We conclude that concentrates of water disinfected in the presence of four different ICM did not cause significant skin irritation or effects consistent with skin sensitization at the concentrations tested., The authors thank Mr. Carey Copeland, Ms. Debbie Andrews, Mr. Tony McDonald, and Mr. Yusupha M. Sey for expert technical support. C.P. acknowledges support of Marie Curie IOF grant agreement 274379 funded by the European Union 7th R&D Framework Programme (FP7/2007-2013) and grant RYC2020-028901-I funded by MCIN/AEI/10.13039/501100011033 and “ESF investing in your future” . Drs. C. Weitekamp and YH Kim are acknowledged for their thoughtful and critical review of this manuscript.

BACKGROUND Iodinated contrast media (ICM) is a frequently used compound in radiology. Non-immediate hypersensitivity reactions (HSR) appear when a patient leaves the department and usually are undocumented. True hypersensitivity in this group is rarely proved. METHODS Single-centre 2014-2018 data were retrospectively analysed. HSR to ICM were classified and investigated according to the time of occurrence (immediate 1 hour). ENDA questionnaire and skin tests (prick or intradermal test) were performed according to ENDA/EAACI recommendations. RESULTS 69 patients with a clinical history of HSR to ICM were identified, 72.46% were females (n = 50). The average age was 56 (SD ± 13.16) years. Non-immediate HSR occurred in 28.99% (n = 20) patients. The suspected culprit drugs were: iodixanol 20% (n = 4), iopromide 5% (n = 1), diatrizoate 10% (n = 2) and iohexol 10% (n = 2). Among non-immediate HSR 96.00% (n = 19) of patients had skin rashes. A statistically significant correlation was found between the clinical symptoms and the type of reaction (p-value

Diatrizoate, a refractory ionic iodinated X-ray contrast media (ICM) compound, cannot be efficiently degraded in a complex wastewater matrix even by advanced oxidation processes. We report in this research that a homogeneous process, thiourea dioxide (TDO) coupled with trace Cu(II) (several micromoles, ubiquitous in some wastewater), is effective for reductive deiodination and degradation of diatrizoate at neutral pH values. Specifically, the molar ratio of iodide released to TDO consumed reached 2 under ideal experimental conditions. TDO eventually decomposed into urea and sulfite/sulfate. Based on the results of diatrizoate degradation, TDO decomposition, and Cu(I) generation and consumption during the TDO-Cu(II) reaction, we confirmed that Cu(I) is responsible for diatrizoate degradation. However, free Cu(I) alone did not work. It was proposed that Cu(I) complexes are actual reactive species toward diatrizoate. Inorganic anions and effluent organic matter negatively influence diatrizoate degradation, but by increasing the TDO dosage, as well as extending the reaction time, its degradation efficiency can still be guaranteed for real hospital wastewater. This reduction reaction could be potentially useful for in situ deiodination and degradation of diatrizoate in hospital wastewater before discharge into municipal sewage networks.

The development of new capsules now allows endoscopic diagnosis in all segments of the gastrointestinal tract and comes with new needs for differentiated preparation regimens. Although the literature is steadily increasing, the results of the conducted trials on preparation are sometimes conflicting. The ingestion of simethicone before gastric and small bowel capsule endoscopy for prevention of air bubbles is established. The value of a lavage before small bowel capsule endoscopy (SBCE) is recommended, although not supported by all studies. Ingestion in the morning before the procedure seems useful for the improvement of mucosa visualization. Lavage after swallowing of the capsule seems to improve image quality, and in some studies also diagnostic yield. Prokinetics has been used with first generation capsules to shorten gastric transit time and increase the rate of complete small bowel visualization. With the massively prolonged battery capacity of the new generation small bowel capsules, prokinetics are only necessary in significantly delayed gastric emptying as documented by a real-time viewer. Lavage is crucial for an effective colon capsule or pan-intestinal capsule endoscopy. Mainly high or low volume polyethylene glycol (PEG) is used. Apart from achieving optimal cleanliness, propulsion of the capsule by ingested boosts is required to obtain a complete passage through the colon within the battery lifetime. Boosts with low volume sodium picosulfate (NaP) or diatrizoate (gastrografin) seem most effective, but potentially have more side effects than PEG. Future research is needed for more patient friendly but effective preparations, especially for colon capsule and pan-intestinal capsule endoscopy.

OBJECTIVE. The purpose of this study was to assess the rate of appendiceal filling with a positive oral contrast solution at MDCT performed for suspected acute appendicitis in adults. MATERIALS AND METHODS. We performed a retrospective review of MDCT in 684 consecutive adult patients with suspected acute appendicitis in a 19-month period. Patients were excluded if no positive oral contrast solution (500 mL each of water and polyethylene glycol and 30 mL diatrizoate) was given or if the appendix was not visible or absent. After exclusion, images of 519 patients (mean age ± SD, 37.4 ± 16.0 years; 335 women, 184 men) were reviewed for cecal contrast opacification and appendiceal filling. Imaging findings were recorded as positive or negative for acute appendicitis using all available clinical and pathologic data as a reference standard. A control series of CT colonography (CTC) screening examinations (overnight preparation with universal cecal opacification) in 2552 adults without symptoms of appendicitis was also reviewed. RESULTS. Cecal opacification was confirmed in 313/519 (60.3%) patients, with no difference between those considered to be positive (68/107, 63.6%) or negative (245/412, 59.5%) for appendicitis (p = 0.506). When positive oral contrast solution reached the cecum, appendiceal filling was seen in none of the 68 (0%) with appendicitis and in 205 of the 245 (83.7%) without appendicitis (p < 0.0001). Among CTC control subjects, appendiceal filling was similar to the cohort considered to be without appendicitis (2240/2552 [87.8%], p = 0.070). CONCLUSION. In MDCT for suspected acute appendicitis, luminal filling of the noninflamed appendix exceeds 80% when positive oral contrast solution reaches the cecum, indicating results similar to screening CTC. The appendix did not fill in proven acute appendicitis, indicating appendiceal filling may allow exclusion of appendicitis with high certainty. These results suggest positive oral contrast solution may augment diagnostic accuracy and confidence in cases of suspected acute appendicitis.

The objective of our study was to compare the quality of bowel opacification from three different positive oral contrast agents-barium sulfate, diatrizoate, and iohexol-at abdominopelvic CT.Abdominopelvic CT examinations with three different oral contrast agents (each contrast agent: n = 300 patients) of 900 patients were retrospectively evaluated by two independent readers. For four segments of the gastrointestinal tract (i.e., the stomach, jejunum, ileum, and colon), readers recorded qualitative data (grade of nonuniform lumen opacification, types of inhomogeneous opacifications, presence of artifacts, and distribution of contrast agent) and quantitative data (CT attenuation of lumen [in Hounsfield units]). The results were compared among the three contrast agents using the Mann-Whitney U test and repeated-measures ANOVA with a post hoc Bonferroni correction.Fewer artifacts were detected with iohexol (4.3%) as the oral contrast agent than with diatrizoate (13.0%) and barium sulfate (14.3%) (each, p0.05). Barium showed a greater frequency of bowel lumen heterogeneity (388/831 segments, 47%) than iohexol (155/679, 23%) and diatrizoate (185/763, 24% segments) (p0.001). Barium showed higher CT attenuation than iohexol and diatrizoate in the stomach but lower CT attenuation in the ileum (each, p0.05).The frequency of inhomogeneous bowel opacification was lower for iohexol than for diatrizoate or barium sulfate. Barium showed the highest frequency of bowel lumen heterogeneity. The iodinated agents showed greater increases in mean CT attenuation from the proximal bowel segments to the distal bowel segments than barium sulfate.

Amyloid-beta 42 (Aβ42), the key biomarker of Alzheimer’s disease (AD), aggregates to form neurotoxic amyloid plaques. In this work, we modified two fluorescein isothiocyanate-labeled Aβ42-targeting peptides and designed an Aβ42-specific ultrasensitive polyvalent-directed peptide polymer (PDPP) to enhance AD diagnosis sensitivity. The dissociation constant of Aβ42 by PDPP was 103-fold higher than the single-site-directed peptide. The improved binding was due to the ability of PDPP to detect multiple receptors on the target. The power of the PDPP diagnostic probe was verified in its application to detect Aβ42 in cerebrospinal fluid (CSF), which showed a lower limit of detection (LOD) in the fg mL–1 range that is more sensitive than detection by antibodies or single peptides. In addition, we present a novel ultrasensitive diagnostic system using an array of nanoporous ZnO nanoparticles, which play a role in fluorescence signal amplification, to further improve AD diagnosis sensitivity. We enhanced the signal...

As a type of iodinated contrast medium (ICM), the diatrizoate (DTZ) found in aquatic systems has posed a serious threat to the ecosystem and to human health. In this study, Fe(II)-activated persulfate (Fe2+/PS) oxidation was employed to degrade DTZ, and the optimal operating conditions were determined. Electron paramagnetic resonance (EPR) spectra and density functional theory (DFT) calculations were adopted to determine the dominant radicals and analyze the degradation paths, respectively. It was found that a PS concentration of 10 mmol/L, an n(Fe2+)/n(PS) ratio of 1:10, an initial pH of 3.0, and a high temperature increased the degradation efficiency of DTZ. After suppression of the oxidation process by tertiary butyl alcohol (TBA) and methanol (MtOH), the EPR spectra demonstrated that DTZ degradation was attributed to the combined effects of SO4− and OH and that OH played a more important role. Based on the theoretical calculation and comparison of the reduction energies of possible degradation products, the path from DTZ to TP630 and then to TP628 and finally to TP602 was recognized as the main DTZ degradation pathway during the Fe2+/PS oxidation process. These findings validated and demonstrated that DTZ could be effectively degraded by Fe2+/PS oxidation, which is a promising approach to remove DTZ from water.

The detection of wastewater impact on stream chemistry is often hindered by high background concentrations of ubiquitous solutes. In the present study we tested the applicability of artificial sweeteners (AS) and iodinated X-ray contrast media (ICM) as tracers to detect this impact by examining wastewater treatment plant (WWTP) effluents and surface water samples. The developed direct injection LC-MS/MS method enabled the detection of these anthropogenic micropollutants in aqueous samples down to trace level concentrations. The 2-h-composite sampling of WWTP effluent revealed fluctuating ICM concentrations between and within days with highest concentrations at the end of the week. Diatrizoic acid (DTZ) and iopromide (IOP) were the predominant ICM with concentrations up to 7 μg/L. Concentrations of the AS acesulfame (ACE) fluctuated between 0.5 μg/L and 1 μg/L. Concentrations of AS and ICM in surface water were both associated with wastewater impact. DTZ contamination was more widespread whereas some sampling points exhibited a more pronounced contamination with non-ionic ICM. Surface water was frequently contaminated with AS. Particularly ACE was detected in every surface water sample indicating that it is chemically stable and that inputs to the aquatic environment via WWTP effluents are widespread. The broad application of ACE as food additive enables its application as a tracer throughout Germany. Furthermore, the developed LC-MS/MS method enables rapid detection of ACE down to the low ng/L-range. Nonetheless, DTZ or IOP could be used in addition to ACE to verify anthropogenic influences on natural waters.

The degradation kinetics of the widely used iodinated X-ray contrast medium, namely diatrizoate, was investigated during ultraviolet (UV) photolysis and UV/chlorination. Factors influencing diatrizoate degradation, such as pH, chlorine dosage, and bromide concentration, were also evaluated. Diatrizoate was not degraded during chlorination. However, the degradation of diatrizoate during UV photolysis and UV/chlorination complied with the pseudo-first-order kinetics. At pH 7, the pseudo-first-order rate constant during UV/chlorination was 9.3 times higher than that during UV photolysis. The results of a radical quenching test using excessive tert-butanol suggested that the contribution of Cl, a type of reactive chlorine species (RCS), was limited. The contributions of UV direct photolysis, hydroxyl radicals ( OH), and RCS to diatrizoate degradation during UV/chlorination at pH 7 were estimated to be 12.8%, 1.2%, and 85.9%, respectively. Results of further experiment suggested that OCl primarily caused diatrizoate degradation. As the chlorine concentration gradually increased from 25 to 150 μM, the corresponding pseudo-first-order rate constant of UV/chlorination increased from 8.37 (±0.42) × 10−3 to 5.52 (±0.28) × 10−2 s−1. When the pH value was increased from 5 to 9, the rate of diatrizoate degradation reached the maximum at pH 7 and gradually decreased during UV/chlorination; however, the rate of diatrizoate degradation remained stable during UV photolysis. The degradation of diatrizoate was inhibited when the bromide concentration was increased due to the competition for chlorine between bromide and diatrizoate; thus, the generation of OCl was limited. Compared with UV irradiation, UV/chlorination could reduce the formation of iodinated trihalomethanes (I-THM) after chlorination. However, dichloroacetonitrile (C2HCl2N), which is carcinogenic, was generated during UV/chlorination.

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.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.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 (P0.01), six cases in this group (29%), showed free air on X-ray images (P0.01). The median hospital stay in groups A and B were 89.0 and 136.5 days, respectively (P0.05). Overall mortality was 2.4%.early therapeutic diagnosis by GaE followed by early surgery is suggested as the optimum strategy for MRI in VLBWs.

Introduction: Post-contrast acute kidney injury (PC-AKI) develops in a significant proportion of patients with CKD after invasive cardiology procedures and is strongly associated with adverse outcomes. Objective: We sought to determine whether increased intrarenal nitric oxide (NO) would prevent PC-AKI. Methods: To create a large animal model of CKD, we infused 250 micron particles into the renal arteries in 56 ± 8 kg pigs. We used a low-frequency therapeutic ultrasound device (LOTUS – 29 kHz, 0.4 W/cm2) to induce NO release. NO and laser Doppler probes were used to assess changes in NO content and blood flow. Glomerular filtration rate (GFR) was measured by technetium-diethylene-triamine-pentaacetic acid (Tc-99m-DTPA) radionuclide imaging. PC-AKI was induced by intravenous infusion of 7 cm3/kg diatrizoate. In patients with CKD, we measured GFR at baseline and during LOTUS using Tc-99m--DTPA radionuclide imaging. Results: In the pig model, CKD developed over 4 weeks (serum creatinine [Cr], mg/dL, 1.0 ± 0.2–2.6 ± 0.9, p < 0.01, n = 12). NO and renal blood flow (RBF) increased in cortex and medulla during LOTUS. GFR increased 75 ± 24% (p = 0.016, n = 3). PC-AKI developed following diatrizoate i.v. infusion (Cr 2.6 ± 0.7 baseline to 3.4 ± 0.6 at 24 h, p < 0.01, n = 3). LOTUS (starting 15 min prior to contrast and lasting for 90 min) prevented PC-AKI in the same animals 1 week later (Cr 2.5 ± 0.4 baseline to 2.6 ± 0.7 at 24 h, p = ns, n = 3). In patients with CKD (n = 10), there was an overall 25% increase in GFR in response to LOTUS (p < 0.01). Conclusions: LOTUS increased intrarenal NO, RBF, and GFR and prevented PC-AKI in a large animal model of CKD, and significantly increased GFR in patients with CKD. This novel approach may provide a noninvasive nonpharmacological means to prevent PC-AKI in high-risk patients.

Iodinated contrast media (ICMs) are a class of X-ray contrast media worldwide utilized for radiographic procedures. Since they cannot be removed efficiently during water treatment, they can be found in surface and groundwater. In this work, a rapid and sensitive direct injection liquid chromatography-tandem (LC-MS/MS) method for the simultaneous analysis of seven ICMs media (iopamidol, ioxitalamic acid, diatrizoic acid, iothalamic acid, iohexol, iomeprol and iopromide) in complex aqueous matrices has been developed and validated. The MDLs for the analytes ranged from 0.7 to 21 ng L-1 in ultrapure water, and recoveries ranged from 86 to 100% in drinking water, 85-103% in groundwater and 84-105% in WWTP effluent. A stereo-isomer for iopromide was separated. This analytic method was applied to investigate the removal of target ICMs by low pressure ultra violet light (LPUV) advanced oxidation processes with three oxidants, hydrogen peroxide, free chlorine and monochloramine in groundwater. Results showed that the addition of oxidants did not enhance attenuation of ICMs, since fluence-based decay apparent rate constants were similar (KUV = 3.2 × 10-3, KUV-Cl2 = 3.6 × 10-3 and KUV-NH2 = 3.4 × 10-3 10-3 cm2 mJ-1). This yielded direct photolysis is the main mechanism to attenuate target ICMs. Accepted version

BACKGROUND Intestinal disorders are common in very low-birthweight infants. The purpose of this study was to evaluate the impact of prophylactic oral Gastrografin® (diatrizoate acid) on meconium-related ileus (MRI) in extremely preterm infants. METHODS This was a retrospective case-control study of infants born extremely preterm at

This study examined the electrochemical (EC) reduction of iodinated contrast media (ICM) exemplified by iopamidol and diatrizoate. The method of rotating ring-disc electrode (RRDE) was used to elucidate rates and mechanisms of the EC reactions of the selected ICMs. Experiments were carried at varying hydrodynamic conditions, concentrations of iopamidol, diatrizoate, natural organic matter (NOM) and model compounds (resorcinol, catechol, guaiacol) which were used to examine interactions between products of the EC reduction of ICMs and halogenation-active species. The data showed that iopamidol and diatrizoate were EC-reduced at potentials -0.45 V vs. s.c.e. In the range of potentials -0.65 to -0.85 V their reduction was mass transfer-controlled. The presence of NOM and model compounds did not affect the EC reduction of iopamidol and diatrizoate but active iodine species formed as a result of the EC-induced transformations of these ICMs reacted readily with NOM and model compounds. These data provide more insight into the nature of generation of iodine-containing by-products in the case of reductive degradation of ICMs.

Although the ultimate goal of administering active pharmaceutical ingredients (APIs) is to save countless lives, the presence of impurities and/or degradation products in APIs or formulations may cause harmful physiological effects. Today, impurity profiling (i.e., the identity as well as the quantity of impurity in a pharmaceutical) is receiving critical attention from regulatory authorities. Despite the predominant use of spectroscopic and chromatographic methods over electrochemical methods for impurity profiling of APIs, this work investigates the opportunities offered by electroanalytical methods, particularly, ion-selective electrodes (ISEs), for profiling degradation-related impurities (DRIs) compared with conventional spectroscopic and chromatographic methods. For a meaningful comparison, diatrizoate sodium (DTA) was chosen as the anionic X-ray contrast agent based on its susceptibility to deacetylation into its cytotoxic and mutagenic degradation product, 3,5-diamino-2,4,6 triiodobenzoic acid (DTB). This cationic diamino compound can be also detected as an impurity in the final product because it is used as a synthetic precursor for the synthesis of DTA. In this study, four novel sensitive and selective sensors for the determination of both DTA and its cytotoxic degradation products are presented. Sensors I and II were developed for the determination of the anionic drug, DTA, and sensors III and IV were developed for the determination of the cationic cytotoxic impurity. The use of these novel sensors not only provides a stability-indicating method for the selective determination of DTA in the presence of its degradation product, but also permits DRI profiling. Moreover, a great advantage of these proposed ISE systems is their higher sensitivity for the quantification of DTB relative to other spectroscopic and chromatographic methods, so it can measure trace amounts of DTB impurities in DTA bulk powder and pharmaceutical formulation without a need for preliminary separation.

This study investigates the sustained oxidation performance of sulfate-based electrooxidation at a boron-doped diamond anode; more specifically, the continued oxidation of a model compound, diatrizoate, in the absence of applied current (i.e., off-grid oxidation). Two approaches were taken: delayed sample quenching with methanol, and application of intermittent current supply. For samples electrooxidized in Na2SO4 anolyte for 10–15 min, a delay of 60 min in sample quenching yielded an additional diatrizoate removal of 53%. This impact of sample quenching delay was observed at both pH 2 and pH 7, indicating that the source of sulfate and hydroxyl radicals was present at both pH values. Intermittent current supply (cycles of 5 min ON/15 min OFF) enabled a saving in electrical energy consumption by ~35% compared to constant current, due to continued removal of diatrizoate during the OFF periods. Electrooxidation in NaNO3 anolyte did not show any off-grid oxidation of diatrizoate, confirming the crucial role of electrochemically activated sulfate. Given that the sulfate concentration was only 150 mg L−1, the results presented herein may have significant implications in the electrochemical treatment of various types of contaminated water, from groundwater to sulfate-rich wastewater. Keywords: Electrooxidation, Sulfate radicals, Sustained oxidation performance, Radical chain propagation