Adverse reactions to contrast agents. Scope of problem
About: This article is published in Investigative Radiology.The article was published on 1970-11-01. It has received 243 citations till now. The article focuses on the topics: Scope (project management).
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TL;DR: Urine histamine was increased in direct proportion to the histamine infusions, and because of stability, accessibility, and the capacity for retrospective diagnosis, urine is the suggested fluid to employ to measure histamine release in humans.
Abstract: Plasma and urine histamine levels were measured during sequential infusions of histamine (0.05, 0.1, 0.25, 0.5, and 1.0 microgram/kg/min histamine base for 30 min each) to determine the plasma level required to elicit flushing, headaches, tachycardia, and diastolic hypotension. Each study was performed with subjects on no medications or after pretreatment with hydroxyzine and/or cimetidine in order to confirm the receptor subtype involved in each of the responses. Resting plasma histamine levels were 0.62 +/- 0.12 ng/ml, and levels rose progressively indirect proportion to the concentration of infused histamine. Plasma levels of histamine required to elicit symptoms were as follows: 1.61 +/- 0.30 ng/ml = 30% increase in heart rate, 2.39 +/- 0.52 ng/ml = significant flush and headache, and 2.45 +/- 0.13 ng/ml = 30% increase in pulse pressure. Cimetidine pretreatment failed to influence the histamine level required to elicit symptoms, hydroxyzine pretreatment significantly raised the level required to increase heart rat by 30%, and the combination of antihistamines significantly raised the threshold for histamine to elicit all the response. Urine histamine was increased in direct proportion to the histamine infusions, and because of stability, accessibility, and the capacity for retrospective diagnosis, urine is the suggested fluid to employ to measure histamine release in humans.
149 citations
TL;DR: The natural history of bile duct stones is reviewed and the different ways in which they may now be treated are detailed.
Abstract: The introduction of laparoscopic cholecystectomy has resulted in increased options for the management of bile duct stones and has stimulated a fundamental reappraisal of the situation before the laparoscopic era. This article reviews the natural history of bile duct stones and details the different ways in which they may now be treated. New areas of controversy are highlighted and the need for further studies is emphasized.
132 citations
TL;DR: The radioopaque compounds used in diagnostic radiology are variously referred to as dyes, agents, media, or materials, but by all criteria they are actually drugs and resemble other drugs as far as untoward side reactions are concerned.
109 citations
Cites background from "Adverse reactions to contrast agent..."
...For other adverse reactions to Uro-RCD, there was no detectable sex difference [7]....
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TL;DR: There seems to be no valid reason to depend upon intravenous pretesting in the hope of avoiding serious reactions and a comparison of death rates between pretested patients and those who were not pretested revealed no statistically significant differences.
Abstract: A nationwide survey of 10 years of teaching hospital experience covering 3.8 million excretory urograms revealed an overall death rate of 19 per million. A total of 75% of the radiologists questioned employed a pretest before excretory urography, either routinely or in selected cases. Of these, 96% used an intravenous route. A comparison of death rates between pretested patients and those who were not pretested revealed no statistically significant differences. Thus there seems to be no valid reason to depend upon intravenous pretesting in the hope of avoiding serious reactions.
108 citations
TL;DR: The suggested future line of investigation concerns the physicochemical interaction of CM and targeted biological systems which may allow the analysis and predictivity of these interactions at the molecular level.
105 citations