Acute non-renal adverse events after unenhanced and enhanced computed tomography and magnetic resonance imaging

Aim: Investigating the incidence of non-renal acute adverse events (AAEs) in patients undergoing unenhanced or enhanced computed tomography (CT) or magnetic resonance (MR) (four groups) using the ac- tive interview-method. Methods: The imaging procedure followed the standards of the department. Furthermore, the iodine-based (nonionic monomer) and gadolinium-based (cyclic) contrast agent was the same as used for all other examinations in the department. All patients were interviewed for 72 hours after the MR or CT examination regarding occurrence of AAEs using a structured questionnaire. Results: A total of 1358 patients (259 with enhanced MR, 434 with unenhanced MR, 450 with enhanced CT and 215 with unenhanced CT) were enrolled. AAEs were significantly higher (P unenhanced MR [39 (9.0%)] and CT [5 (2.3%)] groups. Dizziness was significantly [19 (7.3%), (P frequent in the enhanced MR. The same AAEs were reported in both contrast groups and control groups. Conclusion: AAEs which are mainly considered to be caused by the contrast medium are also experienced by patients undergoing CT or MR without contrast. Enhanced MR is correlated with more reactions than unenhanced MR and enhanced CT. Dizziness was reported more frequently after MR than CT, both with and without contrast;more patients were CNS examined with MR and with CT.

Animal models applied to acute-on-chronic liver failure:Are new models required to understand the human condition?

The liver is a multifaceted organ;its location and detoxifying function expose this organ to countless injuries.Acute-on-chronic failure liver(ACLF)is a severe syndrome that affects the liver due to acute decompensation in patients with chronic liver disease.An infection environment,ascites,increased liver enzymes and prothrombin time,encephalopathy and fast-evolving multiorgan failure,leading to death,usually accompany this.The pathophysiology remains poorly understand.In this context,animal models become a very useful tool in this regard,as understanding;the disease may be helpful in developing novel therapeutic methodologies for ACLF.However,although animal models display several similarities to the human condition,they do not represent all ACLF manifestations,resulting in significant challenges.An initial liver cirrhosis framework followed by the induction of an acute decompensation by administering lipopolysaccharide and D-Ga IN,potentiating liver damage supports the methodologies applied to induce experimental ACLF.The entire methodology has been described mostly for rats.Nevertheless,a quick Pub Med database search indicates about 30 studies concerning ACFL models and over 1000 regarding acute liver failure models.These findings demonstrate the clear need to establish easily reproducible ACFL models to elucidate questions about this quickly established and often fatal syndrome.

Clinical characteristics,GRACE score,TIMI score and prognosis of patients with type 2 diabetes mellitus complicated with acute coronary syndrome

Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardial infarction(TIMI)score and clinical prognosis.Method:The study was a retrospective one-center observational study,continuous inclusion of 600 ACS patients diagnosed by coronary angiography in our hospital from October 2018 to July 2019.Collect general clinical data,laboratory examination results,imaging data and interventional treatment data of all patients.Were divided into:T2DM with ACS group(group DA)and non-T2DM with ACS(group NDA)according to whether or not they were associated with T2DM.According to the GRACE、TIMI score,the two groups were divided into high risk group,middle risk group and low risk group.All patients underwent coronary angiography to calculate the number of vascular lesions and Gensini scores.Design questionnaire,after discharge to 2 groups of patients by telephone or outpatient follow-up average of 10 months,statistics of the occurrence of MACE events.Result:Among the 600 patients included in the study,362 were male(60.3%)and 238 were female(39.7%)with mean age(64.7±10.3)years.The baseline data showed that the G、TG、UA、CR levels were higher in the DA group than in the NDA group;the proportion of men was lower than in the NDA group.The results of coronary angiography showed that the Gensini score of DA group was higher than that of NDA group,and the proportion of single lesion was lower than that of NDA group.The binary Logistic regression analysis suggested that age and CRP were independent risk factors for MACE events in patients with T2DM.GRACE risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,and there was no significant difference between low and middle risk group.TIMI risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,while the proportion of low and middle risk group was lower than that in NDA group.The ROC curve shows that the area(AUC)below the ROC curve that GRACE、TIMI score predicted the occurrence of MACE events in patients with T2DM and ACS was 0.707 and 0.586.Conclusion:Patients with T2DM and ACS had higher clinical risk stratification than without T2DM.GRACE score compared with the TIMI score had better predictive value for the occurrence of MACE events after discharge of T2DM with ACS patients.