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A two-year-old neutered male Turkish Angora cat presented with respiratory signs, including chronic snoring sounds and dyspnea with open-mouth breathing. Nasopharyngeal stenosis (NPS) was diagnosed based on endoscopy and computed tomography (CT). An attempt was made to break down the membrane, causing stenosis in the nasopharynx through balloon dilation using a valvuloplasty balloon dilation catheter (12 mm × 3 cm) and retroflexed endoscope. The balloon size was selected according to the identified diameter of the stenotic site on nasopharyngeal CT images. The balloon was inflated with radiographic contrast medium and maintained for 2 min; the similar procedure was repeated four additional times. The stenotic membrane was excised after balloon dilation. Topical Mitomycin C (MMC) was then administered to the stenotic region. After 2 weeks, an additional MMC application was repeated to prevent recurrence. The cat remained free of clinical signs without recurrence for 12 months after the most recent procedure. In this study, effective treatment results were obtained using a combination of balloon dilation, membrane excision, and topical MMC for membranous nasopharyngeal stenosis in a cat. [ABSTRACT FROM AUTHOR]

Within the field of radiology, safeguarding against radiation is crucial, particularly in diagnostic procedures like X-rays, as radiation exposure holds the potential to harm cellular DNA. Presently, lead serves as the predominant material for radiation shielding. However, its usage raises environmental concerns owing to its toxic properties. The objective of this study is to investigate a radiation shielding alternative to lead and assess its efficacy in protecting against radiation. We examined the radiation absorption properties of material made from a composite of PBS and iodine contrast media in various proportions. Our findings indicate that the shielding material containing 75% iodine have the greatest ability to reduce radiation dose from X-rays but are still less than lead. Moreover, the PBS composite with iodine contrast media proved to be environmentally friendly, flexible, and exhibited excellent shielding performance in mitigating exposure during diagnostic X-ray procedures. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) as a result of iodinated contrast media (CM) has been linked to CM-induced renal ischemia and toxic effects on endothelial cells (EC). The recombinant human C1 inhibitor (rhC1INH) has been shown to influence EC activation. Methods: Secondary analysis of 74/77 (96%) participants of a double-blind, randomized, and placebo-controlled study that assessed the effect of rhC1INH on AKI. E-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule (VCAM-1), and CC-chemokin-ligand-5 (CCL5) were determined in frozen blood samples over 48 h and analyzed according to the treatment group and renal outcomes. Results: The mean age was 76.7 years, and 37 patients each received rhC1INH and placebo, respectively. In the entire study population, minor differences in median EC activation markers/CCL5 concentrations during the first 48 h compared to baseline were observed (e.g., E-selectin 27.5 ng/mL at baseline vs. 29.7 ng/mL on day 1, CCL5: 17.7 ng/mL at baseline vs. 32.2 ng/mL on day 2). Absolute changes in ICAM-1/E-selectin concentrations correlated with a higher peak change in urinary NGAL concentrations. However, AKI was not associated with significant changes in EC markers/CCL5. Last, no significant differences in serum concentrations of EC activation markers/CCL5 were evident between the placebo and the rhC1INH group. Conclusions: CM administration during coronary angiography only mildly activated ECs within the first 48 h, which does not explain subsequent AKI. The administration of rhC1INH was not associated with a reduction of EC activation or CCL5. [ABSTRACT FROM AUTHOR]

Transcatheter closure of sinus venosus defect (SVD) is an emerging intervention that utilizes a covered stent to redirect the right upper pulmonary vein to the left atrium. Preprocedural computed tomography analysis, as well as the interventional procedure, necessitates the use of radiographic contrast media. Contrast use is prohibited in patients with advanced kidney disease, who also carry high surgical risks of cardiopulmonary bypass. Transesophageal echocardiography-guided catheter intervention with zero contrast use is presented in this report, along with technical details about planning the procedure. Covered stent exclusion of SVD without contrast use has not been reported in the literature so far.

AbstractIn medical practice, iodine contrast media are necessary for diagnostic techniques. However, it comes with a potential risk to the patient in the form of allergic reactions. The aim of this research is to study the effects of iodine contrast media on endothelial cells in an in vitro system at various concentrations, specifically investigating their impact on cell viability, cell cycle, and apoptosis in the treated cells within the field of diagnostic radiology. Our results showed that in iodine contrast media, when the concentration was within the range of 2.5-50 mgI/ml, cell viability decreased by 50%. Conversely, exposure to ioversol at concentrations between 12.5 and 50.0 mgI/ml resulted in a notable increase in the percentage of total apoptotic cells, including both early and late apoptosis. In conclusion, our in vitro investigation sheds light on the effect of iodinated contrast media on endothelial cell viability, cell cycle progression, and apoptosis. These findings contribute valuable insights to ensure the safety of their use, aligning with guidelines in radiological procedures. Further research and adherence to established guidelines are crucial for refining our understanding and promoting the safe application of iodinated contrast media in the field of radiology. [ABSTRACT FROM AUTHOR]

This study aimed to delineate the detailed anatomy of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in healthy horses using cone beam computed tomography (CBCT). The fetlock region of 15 cadaveric forelimbs and 14 cadaveric hindlimbs from nine adult horses without orthopaedic disease underwent CBCT scanning. Additionally, arthrography CBCT scans were conducted following intra‐articular injection of a radiopaque contrast medium containing blue epoxy resin dye. Subsequently, limbs were frozen and sectioned to visualize anatomical structures in sectional planes corresponding to selected CBCT images. CBCT proved suitable for detailed visualization of the bony components of the fetlock region. Furthermore, the common digital extensor tendon, superficial and deep digital flexor tendons, suspensory ligament, and straight and oblique sesamoidean ligaments were identifiable on CBCT images. However, certain ligaments, such as the collateral sesamoidean ligaments and intersesamoidean ligaments, were not clearly identified. The hyaline cartilage of the MCP and MTP joint facets was assessable on the post‐contrast sequence. In cases where a radiographic or ultrasound examination cannot provide a definitive diagnosis and determine the extent of disease, CBCT can provide additional valuable data on the equine MCP and MTP joint. The images obtained in this study can serve as a reference for CBCT examination of the equine MCP and MTP joint. [ABSTRACT FROM AUTHOR]

A comprehensive grasp of the myocardial micro-architecture is essential for understanding diverse heart functions. This study aimed to investigate three-dimensional (3D) cardiomyocyte arrangement in the laminar structure using X-ray phase-contrast microtomography. Using the ID-19 beamline at the European Synchrotron Radiation Facility, we imaged human left ventricular (LV) wall transparietal samples and reconstructed them with an isotropic voxel edge length of 3.5 μm. From the reconstructed volumes, we extracted different regions to analyze the orientation distribution of local cardiomyocyte aggregates, presenting findings in terms of helix and intrusion angles. In regions containing one sheetlet population, we observed cardiomyocyte aggregates running along the local LV wall's radial direction at the border of sheetlets, branching and merging into a complex network around connecting points of different sheetlets, and bending to accommodate vessel passages. In regions with two sheetlet populations, the helix angle of local cardiomyocyte aggregates experiences a nonmonotonic change, and some cardiomyocyte aggregates run along the local radial direction. X-ray phase-contrast microtomography is a valuable technique for investigating the 3D local myocardial architecture at microscopic level. The arrangement of local cardiomyocyte aggregates in the LV wall proves to be both regional and complex, intricately linked to the local laminar structure. [ABSTRACT FROM AUTHOR]

The article discusses the challenges of providing quality healthcare in the face of limited resources and increasing demand for radiological tests. It highlights the issue of low-value cranial CT scans, which provide little benefit to patients and contribute to unnecessary costs and risks. The article suggests that a combination of strategies, such as implementing guidelines, providing feedback to physicians, and educating all involved parties, would be the most effective way to reduce the number of low-value cranial CT scans. It emphasizes the importance of local institutions taking responsibility and designing appropriate strategies based on their own performance and feedback. The article concludes that reducing low-value cranial CT scans requires long-term involvement from all stakeholders and monitoring of results. [Extracted from the article]

To compare images using reduced CM, low-kVp scanning and DLR reconstruction with conventional images (no CM reduction, normal tube voltage, reconstructed with HBIR. To compare images using reduced contrast media (CM), low kilovoltage peak (kVp) scanning and deep-learning reconstruction (DLR) with conventional image quality (no CM reduction, normal tube voltage, reconstructed with hybrid-type iterative reconstruction method [HBIR protocol]). A retrospective analysis was performed on 70 patients with liver disease and three-phase dynamic imaging using computed tomography (CT) from April 2020 to March 2022 at Oita University Hospital. Of these cases, 39 were reconstructed using the DLR protocol at a tube voltage of 80 kVp and CM of 300 mg iodine/kg while 31 were imaged at a tube voltage of 120 kVp with CM of 600 mg iodine/kg and were reconstructed by the usual HBIR protocol. Images from the DLR and HBIR protocols were analysed and compared based on the contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), figure-of-merit (FOM), and visual assessment. The CT dose index (CTDI) vol and size-specific dose estimates (SSDE) were compared with respect to radiation dose. The DLR protocol was superior, with significant differences in CNR, SNR, and FOM except hepatic parenchyma in the arterial phase. For visual assessment, the DLR protocol had better values for vascular visualisation for the portal vein, image noise, and contrast enhancement of the hepatic parenchyma. Regarding comparison of the radiation dose, the DLR protocol was superior for all values of CTDI vol and SSDE, with significant differences (p <0.01; max. 52%). Protocols using DLR with reduced CM and low kVp have better image quality and lower radiation dose compared to protocols using conventional HBIR. • Deep learning-based reconstruction (DLR) improved the quality of liver CT imaging. • With DLR, radiation dose can be reduced to 51% of the conventional dose. • DLR images with low-contrast media and low-kilovoltage peaks are feasible clinically. [ABSTRACT FROM AUTHOR]

Transcatheter closure of sinus venosus defect (SVD) is an emerging intervention that utilizes a covered stent to redirect the right upper pulmonary vein to the left atrium. Preprocedural computed tomography analysis, as well as the interventional procedure, necessitates the use of radiographic contrast media. Contrast use is prohibited in patients with advanced kidney disease, who also carry high surgical risks of cardiopulmonary bypass. Transesophageal echocardiography-guided catheter intervention with zero contrast use is presented in this report, along with technical details about planning the procedure. Covered stent exclusion of SVD without contrast use has not been reported in the literature so far. [ABSTRACT FROM AUTHOR]

Abatacept (ABT) is a biological disease-modifying antirheumatic drug (bDMARDs) for rheumatoid arthritis (RA) when conventional synthetic DMARDs are ineffective. We aimed to evaluate the long-term effects of ABT on joint destruction in patients treated for over 2 years. Radiographic progression was evaluated using the van der Heijde-modified Total Sharp Score (mTSS) by two rheumatologists at ABT initiation and after 2 years. Multivariate logistic regression analysis was used to identify factors associated with structural remission, defined as the mean annual change in mTSS ≤0.5. Among the 111 patients included, 48 discontinued, and 63 continued ABT treatment until radiographic evaluation was performed. The rate of patients who achieved estimated TSS REM (yearly progression of van der Heijde modified total Sharp scores ≤0.5) was significantly lower in ABT-dropouts than in the ABT-continued group (69% vs. 48%, p =.0336 by Fisher's exact test). Among the continued ABT cases, concomitant glucocorticoid treatment at ABT initiation was the strongest negative predictive factor of estimated TSS REM in univariate and multivariate logistic regression analyses. Radiographic progression after ABT administration should be evaluated separately for dropout and non-dropout cases. Glucocorticoids at the initiation of ABT may serve as a predictive factor for joint destruction in long-term ABT use. [ABSTRACT FROM AUTHOR]

This article, titled "X-Ray Contrast Media in Interventional Radiology for Scrub Technologists," discusses the use of contrast media (CM) in interventional radiology (IR) procedures. The article highlights the importance of understanding the differences between CM used in diagnostic studies and those used in IR procedures, such as intraarterial administration and mixing with drugs and embolic agents. The article also mentions the various types of CM used in IR, including iodine-based, gadolinium-based, and carbon dioxide-based CM, as well as Lipiodol. The choice of CM depends on factors such as the patient's clinical status, the technical nature of the procedure, and the desired image quality. The article emphasizes the need for scrub technologists to have a thorough understanding of IR procedures and CM characteristics in order to safely handle and administer CM. [Extracted from the article]

• IPM could be effectively degraded by the Mn(VII)/S(IV) process. • SO 4 ·– was the major active oxidant contributing to the degradation of IPM. • I– and IO 3 – were generated during IPM degradation by the Mn(VII)/S(IV) process. • IPM degradation by Mn(VII)/S(IV) caused the I-DBPs generation during chlorination. • More attention should be paid to the toxicity of the generated DBPs in this study. Permanganate/sulfite (Mn(VII)/S(IV)) process is a promising pre-oxidation technology for sequestering the emerging organic contaminants in drinking water treatment plant. Iopamidol (IPM), a representative of iodinated X-ray contrast media, has been widely detected in water sources and has the risk of forming iodinated disinfection byproducts (I-DBPs) in water treatment system. In this study, we investigated the evolution of iodine species during the IPM degradation by the Mn(VII)/S(IV) process and its effect on the subsequent formation of I-DBPs during chlorination at pH 7.0 and 8.0. IPM could be effectively degraded in the Mn(VII)/S(IV) process at environmentally relevant pH (pH 7.0 and 8.0). The results of quenching and competitive oxidation kinetic experiments revealed that SO 4 ·– was the major reactive oxidizing species contributing to the degradation of IPM whereas the contributions of HO· and reactive manganese species were negligible in the Mn(VII)/S(IV) process. I– and IO 3 – were generated while no HOI was detected during the degradation of IPM in the Mn(VII)/S(IV) process. The effects of IPM oxidation by Mn(VII)/S(IV) on the subsequent formation of chlorinated disinfection by-products (Cl-DBPs) during chlorination were related to the category of Cl-DBPs. The pre-oxidation of IPM by Mn(VII)/S(IV) resulted in the generation of I-DBPs during the disinfection process although no I-DBPs were detected if no pre-oxidation was applied. The finding of this study suggested that attention should be paid to the toxicity of DBPs when water containing iodinated organic contaminants is treated by Mn(VII)/S(IV) process or other pre-oxidation technologies. [Display omitted] [ABSTRACT FROM AUTHOR]

Contrast-induced acute kidney injury (CI-AKI) is a severe complication associated with significant morbidity and mortality, and effective therapeutic strategies are still lacking. Apelin is an endogenous physiological regulator with antioxidative, anti-inflammatory and antiapoptotic properties. However, the role of apelin-13 in CI-AKI remains unclear. In our study, we found that the protein expression levels of apelin were significantly downregulated in rat kidney tissues and HK-2 cells during contrast media treatment. Moreover, we explored the protective effect of apelin-13 on renal tubule damage using in vitro and in vivo models of CI-AKI. Exogenous apelin-13 ameliorated endoplasmic reticulum stress, reactive oxygen species and apoptosis protein expression in contrast media-treated cells and rat kidney tissues. Mechanistically, the downregulation of endoplasmic reticulum stress contributed critically to the antiapoptotic effect of apelin-13. Collectively, our findings reveal the inherent mechanisms by which apelin-13 regulates CI-AKI and provide a prospective target for the prevention of CI-AKI. [ABSTRACT FROM AUTHOR]

During videofluoroscopic swallowing study (VFSS), barium sulfate (BaSO4) is commonly added into food samples as a radiopaque contrast media for bolus visualization and examination. Accordingly, the consistency and flow behavior of barium stimuli can differ significantly from their non‐barium counterparts. Such differences may have a subsequent impact on the validity of VFSS. Therefore, in this study, effects of barium sulfate on the shear and extensional rheological properties and IDDSI (International Dysphagia Diet Standardization Initiative) flow consistency of liquids prepared using various commercial thickening powders were investigated. Results showed that all barium stimuli exhibited shear thinning behavior but with significantly higher shear viscosity compared to the non‐barium counterparts. A shift factor of viscosity at shear rate 50 s−1 with values in range of 1.21–1.73 could be used to describe the increase in the viscosity for samples thickened with gum‐based thickeners. However, the change in the viscosity was not invariant for the stimuli prepared starch‐based thickener. The addition of BaSO4 had a negative impact on extensional properties of samples by demonstrating a faster filament rupture. The extent of impact on the decrease in filament breakup time was more pronounced in xanthan > guar gum ≈ tara gum‐based thickeners. Based on the IDDSI flow test, no significant effect of BaSO4 was found on the gum‐based thickeners, whereas there was a marked effect in the starch‐based sample. These results can be used beneficially to assist clinicians in the dysphagia diagnosis for matching rheological properties of the barium stimuli to enhance effectiveness dysphagia interventions. [ABSTRACT FROM AUTHOR]

Simple Summary: Foals are commonly subjected to surgeries related to umbilical pathologies. Due to side effects of systemic analgesics and the immaturity of their organ systems, it is challenging to provide adequate analgesia. It is in this context that the role of regional anaesthesia allows for the provision of good quality analgesic coverage, reducing the potential complications associated with systemic analgesic drugs such as opioids. Ultrasound-guided locoregional techniques are commonly employed in both human and veterinary medicine to provide accurate, safe, and effective analgesia in the regions of interest. The rectus sheath block provides adequate analgesia in procedures involving the umbilical area in humans and has been described in other species, including dogs, pigs, calves, and lately in adult horses. The aim of this study was to describe an ultrasound-guided periumbilical rectus sheath block in foal cadavers and evaluate the spread of the contrast media injected. The results obtained indicated that this approach could provide analgesia around the umbilical area due to the nerves stained. However, further studies evaluating the clinical efficacy of the rectus sheath block are necessary. In neonatal equines, pathologies involving umbilical structures are an important cause of morbidity, and surgical removal of urachal remnants is a common procedure in clinical practice. Surgery involving the ventral abdominal wall can cause substantial pain, leading to complications and prolonged recovery. The objectives of this study were to describe a two-point bilateral ultrasound-guided rectus sheath block at the level of the umbilicus and to evaluate the extent of dye distribution in foal cadavers. Ten foal cadavers were included in the study, in which a bilateral two-point ultrasound-guided rectus sheath block was performed—one injection 5 cm cranially and a second one 5 cm caudally to the umbilicus. The injectate consisted of a mixture of iodinated contrast medium and blue dye at a volume of 0.25 mL kg−1 per injection point (total 1 mL kg−1). After the injection, computer tomography and subsequent dissection of the ventral abdominal wall were performed. The extension of the contrast medium, the number of stained nerves, and contamination of the abdominal cavity were evaluated. The cranio-caudal extension of the contrast ranged from 0.8 to 1.4 cm per milliliter of injectate. The most commonly stained ventral branches of spinal nerves were thoracic (Th) nerves 16, 17, and 18 (95%, 85%, and 80% of the nerves, respectively). Abdominal contamination was found in four animals. The results suggest that the block could provide periumbilical analgesia. Further studies with different volumes of injectate and living animals are warranted. [ABSTRACT FROM AUTHOR]

The development of novel radiocontrast agents, mainly used for the visualization of blood vessels, is still an emerging task due to the variety of side effects of conventional X-ray contrast media. Recently, we have shown that octahedral chalcogenide rhenium clusters with phosphine ligands—Na2H14[{Re6Q8}(P(C2H4COO)3)6] (Q = S, Se)—can be considered as promising X-ray contrast agents if their relatively high toxicity related to the high charge of the complexes can be overcome. To address this issue, we propose one of the most widely used methods for tuning the properties of proteins and peptides—PEGylation (PEG is polyethylene glycol). The reaction between the clusters and PEG-400 was carried out in acidic aqueous media and resulted in the binding of up to five carboxylate groups with PEG. The study of cytotoxicity against Hep-2 cells and acute toxicity in mice showed a twofold reduction in toxicity after PEGylation, demonstrating the success of the strategy chosen. Finally, the compound obtained has been used for the visualization of blood vessels of laboratory rats by angiography and computed tomography. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the proximal diffusion distance of radiopaque contrast medium and mepivacaine/methylene blue solution and incidence of inadvertent intrasynovial and intravascular injections of modified sesamoid nerve block (MASB) when compared with traditional plantar nerve analgesia techniques of the equine distal hind limb. SAMPLE: Ex vivo model: 18 hind limbs; and in vivo model: 5 horses in a crossover study. METHODS: In the ex vivo model, a mepivacaine/methylene blue solution was used to compare the diffusion distance between MASB, basisesamoid block (BSB), and traditional low plantar block (TLPB). Ten minutes after injection, skin was dissected and proximal diffusion distance of the dye patch was measured. In the in vivo model, both hind limbs were injected with radiopaque contrast medium with either MASB or TLPB. Ten minutes after injection, a radiograph was acquired and the proximal diffusion of the contrast medium patch was measured. RESULTS: In the ex vivo model, solution proximal diffusion distance for MASB was significantly longer than BSB (P< .050) and significantly shorter than TLPB (P< .050). Both techniques reached the proximal aspect of DFTS similarly (P=.289), and no difference in the incidence of intrasynovial or intravascular injections was observed (P = .292). In the in vivo model, contrast medium proximal diffusion of MASB was significantly shorter than TLPB (P < .050). The proportion of injections that diffused subcutaneously to the proximal aspect of the proximal pouch of the DFTS was not significantly different between techniques (P = .136). No difference in the incidence of DFTS intrasynovial or intravascular injections was observed (P = .305). CLINICAL RELEVANCE: MASB presented significantly more proximal diffusion than BSB and less proximal diffusion than TLPB, consistently reached the proximal aspect of DFTS, and presented a very low risk of intrasynovial and intravascular injections. [ABSTRACT FROM AUTHOR]

Objective was to explore bone-related outcome and bone turnover markers (BTM) during 2 years of secukinumab treatment in patients with radiographic axial spondyloarthritis (r-axSpA) in daily clinical practice.Methods: Included were consecutive r-axSpA outpatients from the Groningen Leeuwarden axSpA (GLAS) cohort treated with secukinumab for 2 years. At baseline and 2 years, spinal radiographic damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS; 0– 72), cervical facet joint involvement according the "de Vlam" scoring method (0– 15) and radiographic vertebral fractures (VF) using the "Genant" method (grade 0– 3). At all visits, BTM reflecting collagen resorption (serum type I collagen C-telopeptide; sCTX), collagen formation (procollagen type 1 N-terminal peptide; PINP) and bone mineralization (bone-specific alkaline phosphatase; BALP) were measured and expressed in Z-scores to correct for the normal influence of age and gender.Results: 17 r-axSpA patients were included; 53% male, mean age was 47± 15 years, mean Ankylosing Spondylitis Disease Activity Score (ASDAS) 3.9± 1.2, and 53% was biological naïve. The median 2-year progression rates were 1.1 for mSASSS and 0.5 for facet joints, which was less than the smallest detectable change. One traumatic VF (grade 3) occurred. Serum levels of sCTX and PINP remained stable during secukinumab treatment and BALP decreased significantly after 2 years, with median 0– 2 year change in Z-scores of +0.1, − 0.4, and − 1.2, respectively.Conclusion: This explorative study of r-axSpA patients treated with secukinumab in daily clinical practice showed low radiographic spinal progression during 2 years of follow-up. Collagen resorption and formation markers remained stable, whereas mineralization marker BALP decreased significantly after 2 years. Our results are in line with the results of in vitro studies demonstrating that inhibition of IL17-A resulted in suppression of osteogenic differentiation with significant decrease in mineralization. [ABSTRACT FROM AUTHOR]

A new bismuth-based CT agent was synthesized through a facile synthesis strategy. The in vitro stability, toxicity and CT performance were evaluated. The in vivo imaging performance was investigated using three different doses (0.5, 1.2 and 5 mmol/kg) and the result obtained at 1.2 mmol/kg was compared with the clinically approved CT agent iopamidol at the same dosage. [ABSTRACT FROM AUTHOR]

The epidemiology of drug-induced anaphylaxis using the Japanese nationwide database has been not reported, even though drugs are a common trigger of anaphylaxis. The aim of this study was to describe the epidemiological profile of cases of drug-induced anaphylaxis, including fatal cases, using the data from the Japanese Adverse Drug Event Report database (JADER). We extracted data regarding drug-related adverse events, between April 2004 and February 2018, published in JADER by the Pharmaceuticals and Medical Devices Agency. We analyzed cases of anaphylaxis occurring between January 2005 and December 2017. The drug classification was based on the Japanese Standard Commodity Classification. There were 16,916 cases of anaphylaxis reported during the study period. Among them, 418 fatalities were registered. The incidence of drug-induced anaphylaxis and fatal cases was 1.03 cases/year per 100,000 population and 0.03 cases/year, respectively. The most frequent causes of anaphylaxis were diagnostic agents, including X-ray contrast media (20.3%), and biological preparations, such as human blood preparations (20.1%). In fatal cases, diagnostic agents (28.7%) and antibiotic preparations (23.9%) were the most commonly associated types of drugs. The frequency of drug-induced anaphylaxis and fatalities in Japan remained unchanged over the 13-year period analyzed in this study. Diagnostic agents and biological preparations were the most frequent causes of anaphylaxis; however, fatalities were most frequently caused by either diagnostic agents or antibiotic preparations. [ABSTRACT FROM AUTHOR]

The aim of the work was to determine the risk factors of contrast-induced nephropathy in patients with acute coronary syndrome and to evaluate the effectiveness of methods of its prevention. There were examined 62 patients admitted to the interventional cardiology department during 9 months of routine practice with a diagnosis of acute coronary syndrome and concomitant chronic kidney disease. Among them, 56.45% have diabetic nephropathy, 21% – hypertensive nephropathy, 19.35% – chronic pyelonephritis, 3.2% – gouty nephropathy. According to the stages of chronic kidney disease: I stage – 8.1%, II stage – 46.8%, III A stage – 30.6%, III B stage – 14.5% of patients. The control group consisted of 32 patients with acute coronary syndrome without kidney pathology. All patients underwent urgent percutaneous coronary intervention with a water-soluble low-osmolarity radiocontrast medium. The risk of contrast-induced nephropathy was determined according to the Mehran scale. Contrast-induced nephropathy was diagnosed by an increase in serum creatinine by >25% over 24-48 hours. Prevention of contrast-induced nephropathy according to existing recommendations was carried out by prescribing early statin therapy and diuresis-controlled combined hydration in 22 patients with concomitant chronic kidney disease. Mathematical processing was performed using Statistica 8.0 software (StatSoft Inc, USA). Patients with chronic kidney disease had a high and very high risk of contrastinduced nephropathy in 19.4% and 3.2% of cases, among them in 91.6% high, and in 100% – very high-risk contrastinduced nephropathy developed. Patients in the control group had a low to moderate risk, none of them developed contrast-induced nephropathy. It has been shown that the risk of contrast-induced nephropathy depends on the stage of chronic kidney disease and is associated with a decrease in the ejection fraction of the left ventricle (≤40%), acute left ventricle failure of the III and IV classes according to Killip, a decrease in diuresis up to ≤0.6 ml/h/kg in the first 12- 24 hours after urgent percutaneous coronary intervention; taking metformin 6-12 hours before the administration of the X-ray contrast medium and the glomerular filtration rate ≤45 ml/min./1.73 m² . In patients who underwent prevention of contrast-induced nephropathy in its entirety, its development was not registered. [ABSTRACT FROM AUTHOR]

Keywords: allergy; basophil activation test; diagnosis; standardisation EN allergy basophil activation test diagnosis standardisation 1055 1058 4 10/09/23 20231001 NES 231001 Key messages Adherence with guidelines was achieved for sample collection, transport and completion time. Priority needs for improvement are the standardisation of control validation and allergen concentrations tested. As mentioned by Eberlein et al.,[6] combinations of markers are needed for an accurate gating strategy; for example CCR3 SP + sp /CD3 SP neg sp , CRTH2 SP hi sp /CD3 SP neg sp , CD123 SP hi sp /HLA-DR SP neg sp or IgE SP + sp /CD203c SP + sp . ACKNOWLEDGEMENTS We thank the participants who completed the survey and the AllergoBioNet network for supporting the study: Dr Thierry Tabary, Dr Lorna Garnier, Dr Yannick Chantran, Dr Mylene De Saint Jore, Dr Claude Lambert, Dr Stéphanie Rogeau, Dr Moïse Michel, Dr Joana Vitte, Dr Martine Pernollet, Dr Jean Milhes, Dr Céline Beauvillain, Dr Béatrice Uring-Lambert, Dr Delphine Mariotte, Dr Mirjana Radosavljevic and Dr Pol André Apoil. [Extracted from the article]

Background Contrast-enhanced imaging studies are widely used to diagnose and follow up acute cerebrovascular diseases. Exposure to contrast media may lead to nephropathy. This study investigated the incidence of contrast-induced acute kidney injury during intensive care follow-up of patients who underwent aneurysmal subarachnoid haemorrhage surgery and the impact of this condition on patient outcomes. Material and Methods Patients >18 years of age with no known renal injury and admitted to the intensive care unit after Fisher Grade IV aneurysmal subarachnoid haemorrhage and surgery between January 2017 and June 2022 were retrospectively analysed. Renal injury was defined as a renal injury occurring within 48 hours of exposure to contrast media in line with the Kidney Disease Improving Global Outcomes criteria. Results Among the 85 patients with subarachnoid haemorrhage who received at least one contrast medium, the mean age was 55, and 40% were female. 11.8% of the patients were found to have early acute kidney injury and were non-oliguric. At 48 hours, six, three, and one patients had Stage 1, 2, and 3 injuries, respectively. None of the patients required renal replacement therapy. Patients received a mean of 2 mL/kg/h saline infusion after contrast media administration and had a mean arterial pressure of 93.6 mmHg. There was no association between acute kidney injury and comorbidities, Glasgow coma scale, or APACHE II scores. Conclusions The study found that the incidence of contrast-induced acute kidney injury was low and transient in patients followed at the ICU after aneurysmal subarachnoid haemorrhage (Fisher Grade IV) surgery. Adequate hydration and hemodynamic stability were found to be effective in reducing acute kidney injury in these patients. [ABSTRACT FROM AUTHOR]

The presence of pharmaceuticals in hospital wastewaters (HWW) has been a focus of interest for researchers in the last decades. Certain therapeutic classes, such as X-ray contrast media, broad-spectrum antimicrobials and cytotoxics among others, are mainly used in hospitals-health care facilities. This study is focused on available studies monitoring the presence of pharmaceuticals in HWW around the world. To that end, the last available version (v3. 2021) of the "Pharmaceuticals in the Environment" database published by the Federal German Environment Agency (Umweltbundesamt) has been used. Almost half of all studies included (107) have been conducted in Europe. Pharmaceuticals have been monitored in HWW in 38 different countries across all five continents. The country with the greatest number of studies is Brazil (11), followed by Spain (8), China (7), and France (6). Our analysis revealed that 271 different pharmaceuticals have been detected at least once in HWW. The five drugs with more studies showing a positive detection are ciprofloxacin (38), sulfamethoxazole (36), diclofenac (34), ibuprofen (29), and trimethoprim (27). A total of 47 out of 271 drugs are considered in the NIOSH "Hazardous drug" list. However, monitoring data for some widely used drugs in hospital settings such as muscle relaxants, anesthetics, and antidotes is lacking. In conclusion, this study provides the first large-scale metadata analysis for the pharmaceuticals in HWW worldwide. [ABSTRACT FROM AUTHOR]

Objectives: COVID-19 lockdowns resulted in a global shortage of iodinated contrast media. Therefore, alternative imaging protocols were devised to evaluate patients arriving to the emergency department (ED) with suspicion of pulmonary embolism (PE). This quality assurance (QA) aims to compare diagnostic potential between alternative magnetic resonance angiography (MRA) protocol over the gold standard computed tomography angiography (CTA) by evaluating MRA imaging quality, scanner type/imaging sequence, and any risk of misdiagnosis in patients with symptoms of PE. Material and Methods: This retrospective study compromised of 55 patients who arrived to ED and underwent MRA of the chest for suspicion of PE during the months of May to June 2022. Data regarding their chief complaints, imaging sequence, and MRA results were collected. Two fellowship-trained faculty radiologists reviewed the MRA scans of the patients and scored the quality using a Likert scale. Results: Two patients were positive for PE and 53 patients showed negative results. Regarding the scan quality issues, motion was noted in 80% of the 55 studies that we reviewed. Significant associations (P < 0.009) between Likert scale scores and initial complaint category were found. The characteristic symptoms associated with suspicion of PE, namely, shortness of breath, chest pain, and cough were distributed among the 1 and 2 categories, reflecting the most optimal vessel opacification scores. We found no risk of misdiagnosis after reviewing the electronic medical record for follow-up appointments within 6 months of ED visit. Conclusion: Patients were screened for PE with MRA as an alternative imaging tool during times of contrast shortage. Further, evaluation of MRA with CTA, side by side, in a larger patient population is required to increase the validity of our QA study. [ABSTRACT FROM AUTHOR]

The dehydration of clinochlore may supply water for the creation of high‐conductivity anomalies and melting beneath volcanic arc. However, this process has not yet been constrained even though it is critical to understanding water cycling processes during subduction. The electrical conductivity of clinochlore was measured at pressures of 1.0–4.0 GPa and temperatures of up to 1273 K. The pressure weakly affected the electrical conductivity of clinochlore. In contrast, the electrical conductivity was significantly enhanced when the clinochlore was heated to temperatures beyond 1048 K, which was accompanied by decomposition into spinel, forsterite, enstatite and aqueous fluids. The elevated conductivity associated with the high activation energy may reflect the migration of Mg2+ and Al3+ during dehydration. We suggested that the aqueous fluids were released from both talc‐like and brucite‐like layer in the clinochlore, and the volumes of fluids released by samples post mortem determined using X‐ray computed tomography were 7.9–11.5 vol.%. Our results indicate that the dehydration of clinochlore results in a significant increase in conductivity of up to ∼1 S/m due to the interconnected network formed by the fluids. Combined with the geothermal gradient, the experimental data were used to interpret the high‐conductivity anomalies observed at depths of 75–120 km in hot subduction zones and 150–200 km in cold subduction zones. The updip migration of aqueous liquids liberated by clinochlore may act as a major water source for the melting at depths of 110 ± 20 km above the descending slab beneath a volcanic arc. Plain Language Summary: The origin of high‐conductivity anomalies in subduction zones and the water source for melting beneath volcanic arcs remain unknown, despite that they are related to water storage and cycling processes during subduction. Dehydration of hydrous minerals may be one of the causes of high‐conductivity anomalies. Clinochlore, which contains ∼13 wt.% water is the only hydrous mineral after antigorite decomposition in cold subduction zones. To better understand these issues, we first conducted electrical conductivity measurements of clinochlore, which has a high dehydration temperature, at pressures of 1.0–4.0 GPa and temperatures of up to 1273 K. We proposed a new dehydration model for clinochlore under high pressure and temperature. Our results showed the electrical conductivity was significantly elevated during dehydration, and we interpreted the high‐conductivity anomalies at depths as clinochlore dehydration. A large amount of aqueous liquid liberated from the clinochlore may provide additional liquid for melting of the overlying wedge. Therefore, our results provide strong evidence for interpreting of the high‐conductivity anomalies. Key Points: The electrical conductivity of clinochlore was measured at pressures of 1.0–4.0 GPa and temperatures of up to 1273 KThe volumes of fluids released by samples were identified via X‐ray computed tomographyThe dehydration of clinochlore enhances the electrical conductivity and provides a water source for melting beneath volcanic arcs [ABSTRACT FROM AUTHOR]

Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with five centimeters of hydrodissection-mediated needle advancement (S-FICB-H) on ON involvement and cranial injectate spread was studied in this radiological cadaveric study. Results were compared with suprainguinal FICB without additional hydrodissection-mediated needle advancement (S-FICB), infrainguinal FICB (I-FICB), and femoral nerve block (FNB). Seventeen human cadavers were randomized to receive ultrasound-guided nerve block with a 40 mL solution of local anesthetic and contrast medium, on both sides. Injectate spread was objectified using computed tomography. The femoral and lateral femoral cutaneous nerves were consistently covered when S-FICB-H, S-FICB or FNB was applied, while the ON was involved in only one of the 34 nerve blocks. I-FICB failed to provide the same consistency of nerve involvement as S-FICB-H, S-FICB or FNB. Injectate reached most cranial in specimens treated with S-FICB-H. Our results demonstrate that even the technique with the most extensive cranial spread (S-FICB-H) does not lead to ON involvement and as such, the ON seems unrelated to FICB. Separate ON block should be considered when clinically indicated. [ABSTRACT FROM AUTHOR]

Background: Indians do not fit the definition of slow transit constipation (STC) according to Western standards because of their quick gut transit. The colonic transit study (CTS) can discriminate between patients with severe specific motility problems, such as Hirschsprung's disease and chronic intestinal pseudo-obstruction, and healthy participants with optimal sensitivity and specificity when using a new technique in the Indian population. The study's goal was to establish the appropriate cutoff to distinguish between healthy participants and moderate abnormalities such as functional constipation. The study aimed to find out a cutoff value for STC compared to healthy volunteers in the Indian population using the new Indian protocol of CTS. Materials and Methods: This observational study was performed in the department of gastroenterology from August 2014 to February 2015. Twenty-one patients who fulfilled the criteria for Rome III functional constipation and eight healthy sex-matched volunteers were included in the study. Subjects were instructed to take 4, 3, and 3 capsules simultaneously (6 markers in each capsule) at 0, 12, and 24 h, respectively. An abdominal X-ray was taken at 36 h and 60 h. The patient group also underwent a thorough history, a clinical examination, and a balloon expulsion test as a screening test for fecal evacuation disorder. The data were compiled and analyzed. The best cutoff was determined by a receiver operating characteristic curve, and the sensitivity, specificity, and predictive values were determined. Results: There were a total of 21 patients with 14 males and 7 females. The majority (38.1%) had a frequency of 7/week. The predominant symptoms were hard stool (66.7%), sensation of blockage (85.7%), and straining (90.5%). The best cutoff to differentiate between normal and slow transit, in comparison to healthy volunteers, was calculated. Area under curve was computed to be 0.69 (P = 0.001) for 60 h and 0.71 (P = 0.001) for 36 h. When =4 and =1 markers were taken, the sensitivity and specificity were 100% and 25%, respectively. When =20 and =4 markers were taken, the sensitivity and specificity were 52% and 100%, respectively. No significant difference between right, left, or rectosigmoid segmental colonic transit time was found at 36 or 60 h. Conclusion: The new protocol to assess colonic transit in the Indian population with functional constipation may be used as a screening modality to find out the delayed transit constipation. However, this protocol has less sensitivity, specificity, and positive and negative predictive values for functional constipation compared to severe diseases such as Hirschsprung's disease and colonic pseudoobstruction. [ABSTRACT FROM AUTHOR]

The short-term effect of tocilizumab (TCZ) on the radiographic progression of rheumatoid arthritis has been reported; however, reports on its long-term effects are scarce. In this study, we aimed to evaluate its long-term effects on joint destruction in patients who had been treated with TCZ for at least two years and for whom X-rays were available. Radiographic progression was evaluated with modified Total Sharp Score (mTSS), and structural remission was defined as the mean annual change in mTSS ≤0.5. Of the 59 patients included in this study (median age, 62 years; female, 81.4%), 34 patients (57.6%) achieved structural remission. Patients who achieved structural remission were relatively younger (59 years vs. 64 years, p =.06), had relatively higher proportion of anti-citrullinated protein antibody positivity (91.2% vs. 72.0%, p =.08), relatively lower C-reactive protein level (0.6 mg/dL vs. 2.2 mg/dL, p =.05), and significantly lower erythrocyte sedimentation rate (ESR) level (28.0 mm/h vs 65.5 mm/h, p =.003) than those who did not. Multivariate logistic regression analysis demonstrated that the baseline ESR level was significantly associated with structural remission (odds ratio, 0.98; 95% confidence interval: 0.96–0.99, p =.049). The baseline ESR level is a critical determinant of the long-term effect of TCZ on joint destruction. [ABSTRACT FROM AUTHOR]

Summary: Background: An inferior alveolar nerve block is often utilised for anaesthesia of the mandibular arcade of teeth prior to dental procedures. It has been described with multiple approaches and methods; however, at the current time, no direct comparison of percutaneous methods is available. Objectives: To compare the accuracy of percutaneous infiltration of the inferior alveolar nerve with a ventral blind approach (control) to blind caudal approach, ultrasound‐guided and neurostimulator‐guided methods. Study design: Prospective comparison of methods using anaesthetised horses prior to euthanasia or cadavers, being utilised for another study. Methods: An 18 G spinal needle was used to inject a volume of 1 ml, composed of 0.5 ml of methylene blue and 0.5 ml of iodinated CT contrast medium, with placement guided by the aforementioned methods. Following injection the needle was left in place, CT‐imaging was performed and then the skulls were dissected. CT enabled assessment of the coverage of the mandibular foramen with contrast medium and distance of the needle tip from the mandibular foramen and dissection enabled assessment of the staining of the inferior alveolar nerve and lingual nerve. Results: The highest percentage of contrast staining of the inferior alveolar nerve and coverage of the mandibular foramen at CT was achieved with caudal blind and ultrasound‐guided approaches; however, no group reached a significant difference to control (ventral blind approach). Concurrent staining of the lingual nerve (possibly associated with undesired side effects) had high incidence and was similar between groups. Main limitations: Use of horses under anaesthesia/cadavers does not replicate clinical conditions and staining/coverage is assumed to relate to a clinically effective block. Conclusions: Ultrasound‐guided and caudal approaches did have increased percentage of successful staining, but neither reached significance compared to the ventral blind approach. [ABSTRACT FROM AUTHOR]

Monitoring regional blood flow distribution in the lungs appears to be useful for individually optimizing ventilation therapy. Electrical impedance tomography (EIT) can be used at the bedside for indicator-based regional lung perfusion measurement. Hypertonic saline is widely used as a contrast agent but could be problematic for clinical use due to potential side effects. In five ventilated healthy pigs, we investigated the suitability of five different injectable and clinically approved solutions as contrast agents for EIT-based lung perfusion measurement. Signal extraction success rate, signal strength, and image quality were analyzed after repeated 10 mL bolus injections during temporary apnea. The best results were obtained using NaCl 5.85% and sodium-bicarbonate 8.4% with optimal success rates (100%, each), the highest signal strengths (100 ± 25% and 64 ± 17%), and image qualities (r = 0.98 ± 0.02 and 0.95 ± 0.07). Iomeprol 400 mg/mL (non-ionic iodinated X-ray contrast medium) and Glucose 5% (non-ionic glucose solution) resulted in mostly well usable signals with above average success rates (87% and 89%), acceptable signal strength (32 ± 8% and 16 + 3%), and sufficient image qualities (r = 0.80 ± 0.19 and 0.72 ± 0.21). Isotonic balanced crystalloid solution failed due to a poor success rate (42%), low signal strength (10 ± 4%), and image quality (r = 0.43 ± 0.28). While Iomeprol might enable simultaneous EIT and X-ray measurements, glucose might help to avoid sodium and chloride overload. Further research should address optimal doses to balance reliability and potential side effects. [ABSTRACT FROM AUTHOR]

(1) Background: Cell injection therapy is an emerging treatment for bullous keratopathy (BK). Anterior segment optical coherence tomography (AS-OCT) imaging allows the high-resolution assessment of the anterior chamber. Our study aimed to investigate the predictive value of the visibility of cellular aggregates for corneal deturgescence in an animal model of bullous keratopathy. (2) Methods: Cell injections of corneal endothelial cells were performed in 45 eyes in a rabbit model of BK. AS-OCT imaging and central corneal thickness (CCT) measurement were performed at baseline and on day 1, day 4, day 7 and day 14 following cell injection. A logistic regression was modelled to predict successful corneal deturgescence and its failure with cell aggregate visibility and CCT. Receiver-operating characteristic (ROC) curves were plotted, and areas under the curve (AUC) calculated for each time point in these models. (3) Results: Cellular aggregates were identified on days 1, 4, 7 and 14 in 86.7%, 39.5%, 20.0% and 4.4% of eyes, respectively. The positive predictive value of cellular aggregate visibility for successful corneal deturgescence was 71.8%, 64.7%, 66.7% and 100.0% at each time point, respectively. Using logistic regression modelling, the visibility of cellular aggregates on day 1 appeared to increase the likelihood of successful corneal deturgescence, but this did not reach statistical significance. An increase in pachymetry, however, resulted in a small but statistically significant decreased likelihood of success, with an odds ratio of 0.996 for days 1 (95% CI 0.993–1.000), 2 (95% CI 0.993–0.999) and 14 (95% CI 0.994–0.998) and an odds ratio of 0.994 (95% CI 0.991–0.998) for day 7. The ROC curves were plotted, and the AUC values were 0.72 (95% CI 0.55–0.89), 0.80 (95% CI 0. 62–0.98), 0.86 (95% CI 0.71–1.00) and 0.90 (95% CI 0.80–0.99) for days 1, 4, 7 and 14, respectively. (4) Conclusions: Logistic regression modelling of cell aggregate visibility and CCT was predictive of successful corneal endothelial cell injection therapy. [ABSTRACT FROM AUTHOR]

To expand the single-dose duration over which noninvasive clinical and preclinical cancer imaging can be conducted with high sensitivity, and well-defined spatial and temporal resolutions, a facile strategy to prepare ultrasmall nanoparticulate X-ray contrast media (nano-XRCM) as dual-modality imaging agents for positron emission tomography (PET) and computed tomography (CT) has been established. Synthesized from controlled copolymerization of triiodobenzoyl ethyl acrylate and oligo(ethylene oxide) acrylate monomers, the amphiphilic statistical iodocopolymers (ICPs) could directly dissolve in water to afford thermodynamically stable solutions with high aqueous iodine concentrations (>140 mg iodine/mL water) and comparable viscosities to conventional small molecule XRCM. The formation of ultrasmall iodinated nanoparticles with hydrodynamic diameters of ca. 10 nm in water was confirmed by dynamic and static light scattering techniques. In a breast cancer mouse model, in vivo biodistribution studies revealed that the 64Cu-chelator-functionalized iodinated nano-XRCM exhibited extended blood residency and higher tumor accumulation compared to typical small molecule imaging agents. PET/CT imaging of tumor over 3 days showed good correlation between PET and CT signals, while CT imaging allowed continuous observation of tumor retention even after 10 days post-injection, enabling longitudinal monitoring of tumor retention for imaging or potentially therapeutic effect after a single administration of nano-XRCM. 64Cu-Chelator-functionalized amphiphilic statistical iodocopolymer (DOTA-ICP) enabled ultrasmall 64Cu-DOTA-ICP nanoparticulate X-ray contrast media (nano-XRCM). The longitudinal monitoring of tumor retention by noninvasive preclinical PET/CT imaging with high sensitivity, and well-defined spatial and temporal resolutions were realized after a single administration of nano-XRCM at ∼2 mg iodine/kg dose. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction: Evidence‐based practice in radiography is an emerging practice, due to a lack of evidence. Beyond the diagnostic requirements of the examination, imaging technique decisions are guided by the radiographer's tertiary education and clinical experience. Imaging technique decisions should include all aspects of evidence‐based practice: research‐based evidence, patient circumstances and clinical experience. Previous research suggests radiographers do to not fully engage with the latter, which may jeopardise progress in the field and lead to outdated practices and suboptimal outcomes for patients. This study aimed to examine the motivators and influences involved in radiographers' decision‐making when modifying imaging acquisition techniques. Methods: An exploratory descriptive, inductive qualitative interview‐based design was used with a convenience sample of radiographers from three public hospital sites in Queensland. Twelve one‐on‐one semi‐structured interviews were performed via video conference, the data were analysed through thematic analysis. Results: Five themes emerged from the data: advancement of technology; experience rather than evidence; radiology's influence on radiographic practice; information sources; and image quality. The pursuit of image quality was the key motivator and criterion that influenced radiographers' choices in imaging technique modification. Interviewees did not engage routinely with research‐based evidence, preferring to rely on empirical observations and professional experience. Conclusion: The exclusion of research‐based evidence can lead to outdated and ineffective clinical decisions. Further work is needed to promote more research in the field of radiography and increase the willingness and capacity of radiographers to follow the principles of evidence‐based practice. [ABSTRACT FROM AUTHOR]

Background: Dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) could be helpful to separate true disease progression from pseudo-progression in brain metastases when assessing the need for retreatment. However, the selection of arterial input functions (AIFs) is not standardized for analysis, limiting its use for this application. Purpose: To compare population-based AIFs, AIFs specific to each patient, and AIFs specific to every visit in the longitudinal follow-up of brain metastases. Material and Methods: Longitudinal data were collected from eight patients before treatment (6 of 8 patients) and after treatment (6–17 visits). Imaging was performed using a 1.5-T MRI system. Lesions were segmented by subtracting precontrast images from postcontrast images. Cerebral blood volume (rCBV) and cerebral blood flow (rCBF) were computed, and Pearson's product moment correlation coefficients were calculated to evaluate similarity of DSC parameters dependent on various AIF choices across time. AIF shape characteristics were compared. Parameter differences between white matter (WM) and gray matter (GM) were obtained to determine which AIF choice maximizes tissue differentiation. Results: Although DSC parameters follow similar patterns in time, the various AIF selections cause large parameter variations with relative standard deviations of up to ±60%. AIFs sampled in one patient across sessions more similar in shape than AIFs sampled across patients. Estimates of rCBV based on scan-specific AIFs differentiated better between perfusion in WM and GM than patient-specific or population-based AIFs (P ≤ 0.02). Conclusion: Results indicate that scan-specific AIFs are the best choice for DSC-MRI parameter estimations in the longitudinal follow-up of brain metastases. [ABSTRACT FROM AUTHOR]

Background: Contrast-induced nephropathy (CIN) is an adverse reaction associated with the use of intravenous contrast media (CM). Purpose: To investigate the impact of low tube voltage settings on single-energy computed tomography (SECT) and rapid kV switching dual-energy CT (DECT) with reduced concentrations of iodinated CM. Material and Methods: A phantom containing four different concentrations of CM (original concentration CM, 20%, 40%, and 60% reductions) was scanned using SECT mode with varying tube voltages (70, 80, 100, and 120 kVp) and DECT mode through reconstructing monoenergetic energy (50 keV and 70 keV) images. ATCM system with different noise index (NI) settings were set, and the images were reconstructed using ASiR-V. Image quality were measured for individual phantom sizes and protocols and compared to a reference protocol for SECT of 120 kVp, NI = 18, threshold contrast enhancement ≥280 HU, and CNR ≥17. Results: Tube voltage settings of 70 kVp together with 40% reduction in the iodinated CM is suitable for small phantom size, those of 80 kVp and 20% reduction is suitable for the medium and large sizes. This allows radiation doses to be reduced by 12%–30%. Values of CNR and contrast for DECT are better than those for SECT with the same NI setting. Conclusion: Diagnostic reference of image quality can be maintained by using SECT with lower tube voltage and DECT with reductions of iodinated CM concentration and radiation dose. Therefore, the NI setting can be increased when DECT is used to achieve a similar image quality. [ABSTRACT FROM AUTHOR]

Some radiological contrast agents have been shown to have effects on bacterial growth. In this study, the antibacterial effect and mechanism of action of iodinated X-ray contrast agents (Ultravist 370, Iopamiro 300, Telebrix Gastro 300 and Visipaque) and complexed lanthanide MRI contrast solutions (MultiHance and Dotarem) were tested against six different microorganisms. Bacteria with high and low concentrations were exposed to media containing different contrast media for various lengths of time and at pH 7.0 and 5.5. The antibacterial effect of the media was examined in further tests using agar disk diffusion analysis and the microdilution inhibition method. Bactericidal effects were found for microorganisms at low concentrations and low pH. Reductions were confirmed for Staphylococcus aureus and Escherichia coli. [ABSTRACT FROM AUTHOR]

Background: Contrast-induced acute kidney injury (CI-AKI) is the third most common cause of hospital-acquired renal failure. However, there is no effective treatment of CI-AKI, and its mechanism is unknown. Interestingly, atorvastatin has been reported to be effective in renal injury. Therefore, the aim of this study was to explore the effect and possible molecular mechanism of atorvastatin in CI-AKI. Methods: On the CI-AKI in vitro model, rat tubular epithelial cells (NRK-52E) were treated with 18 mg I/ml meglumine diatrizoate (MEG) and then pretreated with atorvastatin. pcDNA3.1-TLR4 treatment was performed to overexpress toll-like receptor 4 (TLR4) in NRK-52E cells. Cell Counting Kit-8 (CCK-8) and lactate dehydrogenase (LDH) kits were used to detect NRK-52E cell viability as well as LDH release in each group, respectively; qRT-PCR to determine mRNA expression of TLR4 in cells; western blot to detect protein expression levels of pyroptosis-related proteins (NLRP3, caspase-1, ASC, and GSDMD) and TLR4/MyD88/NF-κB signaling pathway-related proteins (TLR4, MyD88, NF-κBp65, and p-NF-κB p65) in cells. Results: MEG treatment significantly inhibited the viability of NRK-52E cells, increased pro-inflammatory factor levels and promoted pyroptosis, representing successful establishment of a rat tubular epithelial cell (NRK-52E) CI-AKI in vitro model. Notably, atorvastatin increased the activity of MEG-treated NRK-52E cells and alleviated cell injury in a concentration-dependent manner. In addition, atorvastatin significantly down-regulated the expression of TLR4 in MEG-treated NRK-52E cells. However, overexpression of TLR4 inhibited the effects of atorvastatin on increasing cell viability, alleviating cell injury, reducing pro-inflammatory factors (IL-1β, IL-6, and TNF-α) levels, and inhibiting apoptosis (by down-regulating the expression of NLRP3, caspase-1, ASC, and GSDMD). Furthermore, atorvastatin also inhibited the expression of TLR4/MyD88/NF-κB pathway-related proteins (TLR4, MyD88, and p-NF-κB p65). Conclusion: Atorvastatin can attenuate CI-AKI through increasing the activity of MEG-treated renal tubular epithelial cells, relieving cell injury, as well as inhibiting pyroptosis and inflammation. More importantly, the mechanism was achieved by inhibiting the TLR4//MyD88/NF-κB signaling pathway. [ABSTRACT FROM AUTHOR]

Aim: Tissue hypoxia is an early key feature of acute kidney injury. Assessment of renal oxygenation using magnetic resonance imaging (MRI) markers T2 and T2* enables insights into renal pathophysiology. This assessment can be confounded by changes in the blood and tubular volume fractions, occurring upon pathological insults. These changes are mirrored by changes in kidney size (KS). Here, we used dynamic MRI to monitor KS for physiological interpretation of T2* and T2 changes in acute pathophysiological scenarios. Methods: KS was determined from T2*, T2 mapping in rats. Six interventions that acutely alter renal tissue oxygenation were performed directly within the scanner, including interventions that change the blood and/or tubular volume. A biophysical model was used to estimate changes in O2 saturation of hemoglobin from changes in T2* and KS. Results: Upon aortic occlusion KS decreased; this correlated with a decrease in T2*, T2. Upon renal vein occlusion KS increased; this negatively correlated with a decrease in T2*, T2. Upon simultaneous occlusion of both vessels KS remained unchanged; there was no correlation with decreased T2*, T2. Hypoxemia induced mild reductions in KS and T2*, T2. Administration of an X‐ray contrast medium induced sustained KS increase, with an initial increase in T2*, T2 followed by a decrease. Furosemide caused T2*, T2 elevation and a minor increase in KS. Model calculations yielded physiologically plausible calibration ratios for T2*. Conclusion: Monitoring KS allows physiological interpretation of acute renal oxygenation changes obtained by T2*, T2. KS monitoring should accompany MRI‐oximetry, for new insights into renal pathophysiology and swift translation into human studies. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a chronic joint disease that causes disability and pain. The osteochondral interface is a gradient tissue region that plays a significant role in maintaining joint health. It has been shown that during OA, increased neoangiogenesis creates porous channels at the osteochondral interface allowing the transport of molecules related to OA. Importantly, the connection between these porous channels and the early stages of OA development is still not fully understood. Microcomputed tomography (microCT) offers the ability to image the porous channels at the osteochondral interface, however, a contrast agent is necessary to delineate the different X‐ray attenuations of the tissues. In this study BaYbF5‐SiO2 nanoparticles are synthesized and optimized as a microCT contrast agent to obtain an appropriate contrast attenuation for subsequent segmentation of structures of interest, that is, porous channels, and mouse subchondral bone. For this purpose, BaYbF5 nanoparticles were synthesized and coated with a biocompatible silica shell (SiO2). The optimized BaYbF5‐SiO2 27 nm nanoparticles exhibited the highest average microCT attenuation among the biocompatible nanoparticles tested. The BaYbF5‐SiO2 27 nm nanoparticles increased the mean X‐ray attenuation of structures of interest, for example, porous channel models and mouse subchondral bone. The BaYbF5‐SiO2 contrast attenuation was steady after diffusion into mouse subchondral bone. In this study, we obtained for the first time, the average microCT attenuation of the BaYbF5‐SiO2 nanoparticles into porous channel models and mouse subchondral bone. In conclusion, BaYbF5‐SiO2 nanoparticles are a potential contrast agent for imaging porous channels at the osteochondral interface using microCT. [ABSTRACT FROM AUTHOR]

Acute normoxic exercise impacts the rheological properties of red blood cells (RBC) and their senescence state; however, there is a lack of data on the effects of exercise performed in hypoxia on RBC properties. This crossover study compared the effects of acute hypoxia vs. normoxia on blood rheology, RBC senescence, and coagulation during exercise. Nine trained male cyclists completed both a session in normoxia (FiO2 = 21%) and hypoxia (FiO2 = 15.3% ≈ 2500 m). The two sessions were randomly performed, separated by one week, and consisted of an incremental and maximal exercise followed by a 20 min exercise at the first ventilatory threshold (VT1) on a home-trainer. Blood samples were taken before and after exercise to analyze hematological parameters, blood rheology (hematocrit, blood viscosity, RBC deformability and aggregation), RBC senescence markers (phosphatidylserine (PS) and CD47 exposure, intraerythrocyte reactive oxygen species (ROS), and calcium content), and blood clot viscoelastic properties. Hemoglobin oxygen saturation (SpO2) and blood lactate were also measured. In both conditions, exercise induced an increase in blood viscosity, hematocrit, intraerythrocyte calcium and ROS content, and blood lactate concentration. We also observed an increase in blood clot amplitude, and a significant drop in SpO2 during exercise in the two conditions. RBC aggregation and CD47 exposure were not modified. Exercise in hypoxia induced a slight decrease in RBC deformability which could be related to the slight increase in mean corpuscular hemoglobin concentration (MCHC). However, the values of RBC deformability and MCHC after the exercise performed in hypoxia remained in the normal range of values. In conclusion, acute hypoxia does not amplify the RBC and coagulation changes induced by an exercise bout. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the present study was to determine the presence of radiopaque foreign bodies on oral and maxillofacial radiographs and classify them. Method and Materials: The Study Comment section of the Picture Archiving and Communication System of Chonnam National University Dental Hospital was searched using 30 key words to identify images with radiopaque foreign bodies recorded between November 2008 and March 2017. A total of 503 cases of radiopaque foreign bodies were selected from among the recovered images. The radiopaque foreign bodies were sorted into 19 types, which were subsequently divided into two categories according to whether the foreign bodies were inserted intentionally or unintentionally. The two categories were subdivided into five groups based on the cause of insertion: Treatment, Esthetics, Cultural, Iatrogenesis, and Accident. Results: In this study, the proportions of foreign bodies inserted intentionally (48%) and unintentionally (52%) were similar. When the foreign bodies were grouped based on the cause of insertion, the following frequencies were observed: Treatment, 41%; Esthetics, 7%; Cultural, <1%; Iatrogenesis, 51%; and Accident, 1%. Conclusion: For adequate case management and to avoid unnecessary embarrassment and misinterpretation of unexpected radiopacities, clinicians should be familiar with the various types of foreign bodies and should ensure that detailed patient medical/dental history is obtained. [ABSTRACT FROM AUTHOR]

This document is a response letter to an article titled "Effect of Pericapsular Nerve Group Block with Different Concentrations and Volumes of Ropivacaine on Functional Recovery in Total Hip Arthroplasty: A Randomized, Observer-Masked, Controlled Trial." The authors of the response letter express their interest in the study and acknowledge its limitations. They raise questions about the study's methodology, suggesting that factors such as surgical access and etiology should have been considered. They also recommend using objective measures, such as electromyography, to assess sensory blockages and imaging methods to visualize the diffusion of local anesthetics. The authors conclude by thanking the original authors and offering their reflections to improve future studies. [Extracted from the article]