Diphyllobothrium, Adenocephalus, and Diplogonoporus
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Gastrografin (diatrizoate meglumine and diatrizoate sodium) is a soluble and iodinated radiopaque contrast medium and is also used as a vermifuge. This solution is administered as an intraduodenal injection and works efficiently in achieving complete expulsion of tapeworms.181,269–272 One major advantage is that gastrografin can completely discharge live tapeworms with intact scolex and can help in visually monitoring the deworming process.109,272 However, the insertion of the duodenal tube may be painful to the recipient, and also the therapy is expensive compared to treatment with PZQ. Considering the painful nature of the procedure, especially the insertion of the duodenal sonde, gastrografin therapy is not recommended for children.273 Nausea, vomiting, dehydration, and allergic reaction against iodine are some possible side effects, but they are generally mild.
Uro-Angiographic Contrast Agents—The Holy Grail
Christoph de Haën in X-Ray Contrast Agent Technology, 2019
In some companies with persisting research on monomeric uro-angiographic contrast agents, attention shifted from novel iodinated moieties to the choice of counter ions. In the late 1950s, the availability of diatrizoic acid formulated with various cations had led to the insight that not only the anionic triiodinated portion of monomeric ionic molecules played a role in intravascular tolerability and pain sensation but also the single cation or cation mixture used for its neutralization (Massell, Greenstone, and Heringman 1957; Sjögren 1957; Fischer and Eckstein 1961). Diatrizoate sodium/meglumine [UROGRAFIN, Schering, RENOGRAFIN, Squibb] was better tolerated and caused less pain than diatrizoate sodium [HYPAQUE, Winthrop]. In the early 1960s, this caused HYPAQUE to significantly lose market share, most strongly in the United States. Therefore, eventually Winthrop Laboratories too formulated its compound with some meglumine as counter ion, giving it the name HYPAQUE M™.
Practice Paper 8: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
Oesophageal rupture is a relatively rare but life-threatening condition. Rupture is usually iatrogenic and occurs during instrumentation of the oesophagus (endoscopy). Rarely, it can occur following severe and prolonged bouts of vomiting (Boerhaave’s syndrome). The initial investigation of choice in suspected oesophageal rupture is a chest X-ray, which may show pneumomediastinum, pleural effusion and subcutaneous emphysema. The next investigation is an oesophageal contrast study to show the size and anatomical location of any perforation. The most commonly used contrast agent in investigating the gastrointestinal tract is barium sulphate. However, barium is contraindicated as a contrast agent in patients with potential perforation, since its leakage outside the tract can result in a severe fibrotic reaction. Gastrografin (diatrizoate meglumine/diatrizoate sodium solution) is an iodine-based water-soluble contrast medium that is used as an alternative when barium is contraindicated. Patients with proven oesophageal rupture often require surgery, as medical management is associated with a poor prognosis.
Effect of Surgical Adhesive on the Uterus of Rabbits Following Occlusion
Published in Journal of Investigative Surgery, 2019
Anran Xu, Tianyu Hao, Xiaoqing Wei, Chuanfen Li, Lihua Niu, Xiaohui Deng
Hysterosalpingography was performed on the experimental rabbits at 1 or 6 months after surgery to evaluate the uterine occlusion. Following anesthesia, the rabbit was fixed on the fluoroscopy stretcher in supine position, followed by disinfection of the vulva and vaginal and abdominal skin by iodine. Next, the outer labia was ventrally pulled, and then an artificial insemination catheter lubricated with a sterile lubricating jelly was inserted through the introitus and into the vagina at a depth of 3–4 cm. The abdominal cavity was subsequently opened in order to observe the catheter through the wall of the vagina and further insert it into the cervix. The distal end of the catheter was then inserted into the uterus. Subsequently, cervical cerclage was performed on the outer edge of the uterus with absorbable suture to prevent catheter shedding. The same procedure was performed on the other uterine cavity. After connecting the proximal end of the catheter to the push and injection device for hysterosalpingography, the operator supervised the injection of the rabbit with 76% meglumine diatrizoate (Hunan Hansen Pharmaceutical Co., Ltd., Yiyang, China) until the uterus image was fully developed. Following video- and photo-recording, the abdominal cavity was closed, and the rabbits were provided with routine postoperative anti-infection treatments.
Cumulative administrations of gadolinium-based contrast agents: risks of accumulation and toxicity of linear vs macrocyclic agents
Published in Critical Reviews in Toxicology, 2019
Lara Chehabeddine, Tala Al Saleh, Marwa Baalbaki, Eman Saleh, Samia J. Khoury, Salem Hannoun
Nonionic contrasts usually have a lower osmolality than ionic ones due to the additional contribution of Na+ and meglumine. Runge et al. performed an experimental study in which they tested the effects of a single high dose GBCA injection of different osmolalities (case of extravasation) compared to saline and an X-ray contrast control (Runge et al. 2002). The tested GBCAs were gadopentetate dimeglumine (1960 mOsm/kg; LD50 = 6–7 mmol/kg), gadodiamide (789 mOsm/kg; LD50 = 14.8 mmol/kg), gadoversetamide (1110 mOsm/kg; LD50 = 30.3 mmol/kg) and gadoteridol (630 mOsm/kg; LD50 = 12 mmol/kg) (Bousquet et al. 1988; Oksendal and Hals 1993). They showed that the extravasation of high osmolality GBCAs can lead to inflammation, edema and cell necrosis. Indeed, the agent with the highest osmolality had the worse consequences; gadopentetate dimeglumine had similar effects to meglumine diatrizoate, a high osmolality and high viscosity iodinated X-ray contrast agent. Gadoversetamide had similar effects to gadopentetate dimeglumine in terms of necrosis and edema but the inflammatory response was less intense. In contrast, agents with the lowest osmolality (i.e. gadodiamide and gadoteridol) caused significantly less cell necrosis and inflammation and were no different than physiological saline. Low osmolality (nonionic) contrast agents therefore have an advantage when the dose needs to be injected fast (using for example a power injector).
An analysis of fatal iatrogenic therapeutic errors reported to United States poison centers
Published in Clinical Toxicology, 2021
James B. Leonard, Faisal S. Minhaj, Wendy Klein-Schwartz
Intrathecal administration of chemotherapy is a well-described potentially fatal medication error. In a systematic review published in 2014, Gilbar identified 32 cases of intrathecal vincristine administration, 25 of which resulted in death [4]. The risk of intrathecal vincristine administration has been described since 1968, but cases continue to occur with the cases in this series in 2002, 2008, and 2009 [18]. Importantly, in our series, other agents involved in intrathecal errors included imaging agents (diatrizoate meglumine and gadolinium), baclofen, and morphine. While baclofen and morphine are frequently used intrathecally, overdose has been described as complications with both, and these procedures are not without risk [19,20].
Related Knowledge Centers
- Arthroscopy
- Rectal Administration
- Spleen
- Venography
- Radiography
- Radiocontrast Agent
- Pyelogram
- CT Scan
- Intravenous Therapy
- Nasogastric Intubation