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Uro-Angiographic Contrast Agents—The Holy Grail
Published in Christoph de Haën, X-Ray Contrast Agent Technology, 2019
Despite the difficulties in many parts of the world iopamidol and/or iohexol, in one case even ioversol, are today offered on the market by companies without proper experience in contrast agent innovation, including Agfa HealthCare Imaging Agents GmbH, Cologne, Germany, iMax Diagnostic Imaging, subsidiary of Hovione FarmaCiencia SA, Loures, Portugal, Tae Joon Pharmaceutical Co. Ltd., Seoul, South Korea, Zhejiang Hisin Pharmaceutical Co. Ltd., Taizhou, China, SRS Pharmaceutical Pvd. Ltd., Mumbai, India and Teva Seiyaku K.K., Nagoya, Japan, Sanochemia Pharmazeutika AG, Vienna, Austria. They have to compete with the traditional innovators, which have invested heavily in manufacturing facilities and distribution channels located worldwide. The multitude of newly entering companies should not obscure the fact that so far, their market share has remained small.174 The principle competitors in the field, except for changes in ownership and some acquisitions of companies active in contrast agent related fields, have remained essentially the same few that had developed proprietary third-generation contrast agents. Their revenues allow continued investments in research and development of contrast agents, although mostly outside the field of X-rays.
Nausea and Vomiting in the Clinical Practices of Radiology and Anesthesia
Published in John Kucharczyk, David J. Stewart, Alan D. Miller, Nausea and Vomiting: Recent Research and Clinical Advances, 2017
M. Riding, D. S. Litz, A. Gerber
Vomiting was of two types — immediate and delayed. Immediate onset vomiting occurred primarily following cervical myelography, especially if a patient was kept flat prior to CT. The vomiting was preceded by extreme nausea, was cyclic in nature, and would obviously interfere with the subsequent CT scan because of patient movement. The onset of the emetic episodes appeared to coincide with the arrival of the Metrizamide over the brain stem and the fourth ventricle. If the patient did not vomit immediately, there was a high incidence of nausea and vomiting after 3 to 4 h. These complications were more common in cervical than in lumbar myelography and were also dose dependent. It was found that the concentration and total amount of iodine was correlated with the incidence of postmyelography nausea and vomiting, although mobilization following lumbar myelography reduced the incidence of nausea.57 Direct C1-C2 injection of contrast material led to the highest incidence of nausea and vomiting, possibly because there was little dilution of the contrast before it reached the posterior fossa, a situation not significantly alleviated by mobilizing the patient.58 The removal of Metrizamide following the examination has been shown to reduce the side effects.59 In a double blind trial examining the effect of dexamethasone in preventing the vomiting and nausea associated with metrizamide myelography, older people reported more severe vomiting reactions and women reported worse vomiting than men.60 Some comparative trials between Metrizamide and the newer nonionic contrast materials are summarized in Table 7. The comparison between the principal agents, Iohexol and Iopamidol, shows no significant difference in terms of nausea and vomiting.
Differential renal proteomics analysis in a novel rat model of iodinated contrast-induced acute kidney injury
Published in Renal Failure, 2023
Ying-Hao Deng, Xiu-Fen Wang, Xi Wu, Ping Yan, Qian Liu, Ting Wu, Shao-Bin Duan
Currently, low-osmolality and iso-osmolality contrast agents are commonly used in clinical practice, whereas hypertonic contrast agents are rarely used due to increased nephrotoxicity and high adverse reactions. However, whether iso-osmolality contrast agents are associated with fewer risks for CI-AKI than low-osmolality contrast agents is controversial based on former literature [31–33]. In this study, renal function and pathological alternation caused by iohexol were found to be more severe than those caused by iodixanol in the new model established, suggesting that iohexol is more toxic than iodixanol, which is consistent with other studies [21]. Mitochondria in the iohexol group presented extensive vacuolar degeneration, reduced mitochondrial cristae, and disorganized structure. Mitochondria are intracellular organelles that play key roles in the production of ATP, the primary source and organelle target of ROS, and are of great importance in maintaining cellular homeostasis. Alterations in mitochondrial ultrastructure imply that mitochondrial quality control is involved in the pathogenesis of CI-AKI. Mitochondrial damage and dysfunction can lead to cell death, tissue injury, and possible organ failure [34].
Apelin-13 alleviates contrast-induced acute kidney injury by inhibiting endoplasmic reticulum stress
Published in Renal Failure, 2023
Qian Liu, Shao-Bin Duan, Lin Wang, Xiao-Qin Luo, Hong-Shen Wang, Ying-Hao Deng, Xi Wu, Ting Wu, Ping Yan and, Yi-Xin Kang
We established a CI-AKI rat model as previously reported to determine whether iohexol induced ER stress in renal tissues in vivo. As shown in Figure 1(A–B), both SCr and BUN were significantly increased in rats after iohexol injection (CM group) compared to rats that were injected with saline (control group). The oxidative stress-related indicator GSH was decreased, while MDA was increased in the CM group compared with the control group (Figure 1(C–D)). The protein expression of ER stress indicators (GRP78), ER stress-induced apoptosis indicators (CHOP, caspase-12) and classical apoptosis indicators (Cleaved caspase-3) were all significantly increased compared with the control group (Figure 1(E–F)). These above results demonstrated that iohexol could indeed cause ER stress, oxidative stress and apoptosis in the kidney.
A novel contrast-induced acute kidney injury mouse model based on low-osmolar contrast medium
Published in Renal Failure, 2022
Jiajia Wu, Jianxiao Shen, Wanpeng Wang, Na Jiang, Haijiao Jin, Xiajing Che, Zhaohui Ni, Yan Fang, Shan Mou
When it comes to the reasons for the dose and type selection of iodinated contrast media and four weeks after the UPHT surgery as being the time selection, firstly, LOCM (iohexol, 10 mL/kg) is widely used in the previous study [21,23]. Although one study successfully adopted 15 mL/kg iohexol combined with dehydration plus furosemide (10 mL/kg) to establish CIN rat model [19], based on the principle of emphasizing the importance of minimizing the dose of CM in clinical practice, LOCM (iohexol, 10 mL/kg) combined with the proper pretreatment is enough to construct male mice model with CI-AKI. Besides, although iohexol is widely used in clinic practice, other common types, such as iodixanol[32], need to be also further explored. At last, the time selection after the UPHT has a wide range of options between 2 and 4 weeks [30,33,40], mostly 3 weeks. The main aim is that the mice can recover from the surgery assault, so we choose 4 weeks for making sure their recovery, but we think 3 weeks selection is also ok as our previous team work described [41–44].