RESUMO
BACKGROUND AND OBJECTIVES: We previously described the association of pancreatitis with the use of iodixanol radiocontrast in two patients on hemodialysis. This study was designed to determine whether there might be a causal link. DESIGN: 30 consecutive hemodialysis patients without predisposition for pancreatitis who were undergoing de-clotting and angioplasty of their arteriovenous access were randomly assigned to either iodixanol or iohexol radiocontrast. RESULTS: The demographics and volume of contrast used were similar between the groups. 2 of the 15 patients who received iodixanol developed elevations in serum amylase and lipase as well as signs and symptoms of pancreatitis. No patient who received iohexol developed pancreatitis. CONCLUSION: The use of iodixanol appears to be associated with pancreatitis in a small population of hemodialysis patients. Although the pathogenesis of iodixanol-induced pancreatitis is unclear, we speculate that it is possibly related to the hyperviscosity of this agent, which may decrease pancreatic blood flow. Larger studies are needed to verify these findings.
Assuntos
Meios de Contraste/efeitos adversos , Falência Renal Crônica/enzimologia , Falência Renal Crônica/terapia , Pancreatite/epidemiologia , Diálise Renal , Ácidos Tri-Iodobenzoicos/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Amilases/metabolismo , Feminino , Humanos , Iohexol/efeitos adversos , Falência Renal Crônica/diagnóstico por imagem , Lipase/metabolismo , Masculino , Pessoa de Meia-Idade , Pancreatite/induzido quimicamente , Pancreatite/diagnóstico , Projetos Piloto , RadiografiaRESUMO
Recognition of interosseous membrane disruption associated with radial head injury and Essex-Lopresti injury is important, especially if radial head excision is contemplated. Because a widely accepted method to diagnose interosseous membrane disruption does not exist, we evaluated the accuracy of ultrasonography to diagnose this injury in a cadaver model. Nine pairs of cadaver forearms were randomized into 2 groups. The central third of the interosseous membrane of forearms of group 1 was cut, whereas it was visualized but not cut in group 2. A dynamic ultrasound examination was performed to determine interosseous membrane integrity, and static images were made. The static images were evaluated by 2 other radiologists and interpretations were recorded. One radiologist incorrectly interpreted 1 pair of forearms; the other 2 radiologists were 100% accurate. The accuracy of ultrasonography in detecting interosseous injuries was 96% with our methods.