Complications of Minimally Invasive Treatments for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia
Kevin R. Loughlin in Complications of Urologic Surgery and Practice, 2007
Transurethral resection of the prostate has been associated with a relatively small risk (0–2%) of sustaining a urethral or bladder injury (17,20,31). For example, bladder perforation complicated approximately 1% of cases. Most perforations are extraperitoneal and result in suprapubic, inguinal or periumbilical pain in the awake patient. Intraperitoneal perforation is far less common, but more serious. In these cases, the patient experiences generalized abdominal pain and may complain of radiation to the shoulder. Pallor, sweating, peritoneal signs, nausea, and vomiting may be present. Management consists of immediate laparotomy and correction of the defect. The treatment of urethral perforation includes termination of the procedure if it is noticed intra-operatively. This should be stopped only after hemostasis is achieved and the resected tissue is removed. A urethral catheter should be inserted. Suprapubic drainage of the retroperitoneum may be indicated to minimize further fluid resorption. Prostatic capsule perforation has also been reported in a small percentage of cases (~1–2%) during TURP. The symptoms are similar to extraperitoneal bladder perforation. Similarly, if extravasation is suspected, the operation should be terminated once hemostasis is achieved and a urethral catheter should be placed. Another rare intra-operative complication associated with TURP is damage to the urethral orifices. This usually occurs in the setting of trigonal hypertrophy, as the orifices are displaced toward the prostate, putting them at risk during prostatic resection. To avoid such trauma, indigo carmine may be used to visualize the orifices.
Gastrointestinal Motility Disorders Induced by Ethanol
Victor R. Preedy, Ronald R. Watson in Alcohol and the Gastrointestinal Tract, 2017
Similar to data on acute effects of ethanol on colonic motility, data on the effects of chronic ethanol on colonic motility are sparse. Using a nonabsorbable marker, indigo carmine, Wegener et al.5 demonstrated that whole gut transit which is predominantly influenced by colonic transit is normal in alcoholics that had just recovered from a withdrawal syndrome. But, whole gut transit was significantly more prolonged in alcoholics with constipation (21.9 h) compared to alcoholics without constipation (8.4 h) or normals (11.9 h). However, this abnormality could be more a result of constipation rather than of alcoholism.
Amniocentesis
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Three methods of tapping multiple sacs have been described so far. The first and most common one, initially described by Elias et al. in 1980, involves two or more needle insertions, one for each sac, also called the technique of double amniocentesis (61–63) (Fig. 2). In a twin or higher order multiple pregnancy, two or more 22-gauge 3.5-inch spinal needles are separately and sequentially inserted transabdominally under ultrasound visualization into each sac and about 20 mL of amniotic fluid is readily aspirated and sent for cytogenetic evaluation or fetal karyotyping. A problem not infrequently faced with this technique is erroneously sampling the same amniotic sac twice. In order to eliminate this possibility, the sampled sac is marked with a blue dye ensuring that the sac is tapped only once. For this purpose, indigo carmine has been successfully used without any adverse effects (64), though a mild vasoconstrictive effect following intravenous injection has been described. However, the instillation of a foreign substance into the amniotic cavity is of concern. A technical disadvantage with the instillation of indigo carmine is that the dye tends to concentrate at the bottom of the sac taking some time before the stained fluid surrounds the fetus. Methylene blue used as a marker dye in the past has been linked to certain toxic manifestations such as fetal hemolysis, fetal small bowel atresias, and fetal death (65–70). Nevertheless, the high-resolution ultrasound equipment currently available, in expert hands, may ensure accurate sampling from each sac (71,72), reserving the installation of dye for cases of amniotic volume discordance where detection of the septum is uncertain or high-order pregnancies where documentation and “labeling” of sacs turn out insecure (73).
Accelerated shelf life modeling of appearance change in drug products using ASAPprime ®
Published in Pharmaceutical Development and Technology, 2022
Kristina Flavier, James McLellan, Teslin Botoy, Kenneth C. Waterman
Indigo carmine is a pH-sensitive dye with known incompatibilities with oxidizing and reducing agents (Sheskey et al. 2017). For this study, example tablets were formulated with indigo carmine and lactose to cause reduction of the dye and fading of the tablet color from blue to white (Kuramoto et al. 1958). There exist extensive reports in the literature (Vemuri 1985; Shephard et al. 1999; Hiatt et al. 2010, 2011; Jutkus et al. 2015) documenting the color change of L-ascorbic acid in solution, powder, and tablet forms at high temperature and humidity. The primary mechanism of degradation involves the oxidation of L-ascorbic acid to dehydroascorbic acid, resulting in a color change from white to yellow or brown. For this study, L-ascorbic acid stability was evaluated in powder form below the deliquescence point. As such, critical relative humidity (CRH) measurements were conducted on L-ascorbic acid to determine the deliquescence point over the temperature range used in the study and ensure that targeted stress conditions remained below the CRH at each temperature.
Performance of chromoendoscopy and narrow-band imaging in the diagnosis of gastric intestinal metaplasia
Published in Scandinavian Journal of Gastroenterology, 2022
Nhu Thi Hanh Vu, Duc Trong Quach, Ngoc Le Bich Dang, Quang Dinh Le, Doan Thi Nha Nguyen, Huy Minh Le, Nhan Quang Le, Toru Hiyama
The first group is the group of patients undergoing WLE alone. In the second group, WLE was first performed and later changed to NBI mode combined with chromoendoscopy. Indigo carmine dye was used for staining. All patients in both groups were obtained three mapping biopsies along the small curvature according to the updated Sydney Protocol: one from the antrum 2–3 cm proximally to the pylorus, one from the incisura angularis, and one from the lesser curvature about 4 cm proximally to the incisura angularis. In the group of patients examined with chromoendoscopy and NBI, the intended locations for mapping biopsies were marked using still endoscopic images after WLE examination. And mapping biopsies were only performed after the examination with chromoendoscopy and NBI to avoid poor observation of endoscopic lesions due to possible bleeding from the prior biopsy sites. If local lesions suspected of GIM and/or dysplasia which located outside of mapping biopsy location was detected during chromoendoscopy combined with NBI, further targeted biopsy would be taken. The time duration used for endoscopic evaluation of gastric mucosa with WLE was set at five minutes for all patients in both groups. An additional 5-min examination time was set for chromoendoscopy combined with NBI. The examination time did not include biopsy and dye spraying time. The detailed steps of patient recruitment and endoscopic examination are presented in Figure 1.
Comparison between patch test results of natural dyes and standard allergens in batik workers with occupational contact dermatitis
Published in Cutaneous and Ocular Toxicology, 2022
Eka Devinta Novi Diana, Suci Widhiati, Moerbono Mochtar, Muhammad Eko Irawanto
Several previous studies that discussed research on contact allergy to Indigofera tinctoria, Sappan wood (Caesalpinia sappan), and mahogany (Swietenia mahagoni) also supported this research. Indigofera tinctoria contains several components with small weight mollecule, including phenol (94.11 Da), indigotin (262.26 Da), and indirubin (262.26 Da)7,8. Graziano et al. reported an acute allergic reaction that occurred after intravenous administration of Indigo carmine (indigotin) during cystoscopy9. Besides that, a case report of the occurrence of OCD with a positive patch test for the content of brazilin in sappan wood (Caesalpinia sappan) was reported in a 49-year-old woman in China10. Estlander et al. reported that there were 16 subjects experiencing ACD caused by wood dust at the Finnish Institute of Occupational Health Finland, with a positive patch test for Honduran mahogany (Swietenia macrophylla) found in 2 subjects11. Based on the research that has been done previously, the authors are interested in conducting further research on the effects of these three ingredients when compared to standard allergens that cause ACD.
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