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A Short History of NSF and GDD

The reader should note that in this blog I will not use either old terminology or incorrectly described GBCAs to avoid perpetuating outdated or incorrect information. In the late 1990's, Shawn Cowper, a dermatopathologist from Yale, identified a skin disease in patients with chronic renal failure that exhibited exuberant fibrosis but he was able to distinguish from other entities such as scleromyxedema, because the newly described disease exhibited CD 34+ circulating fibrocytes as a distinctive feature. This disease came to be known as Nephrogenic Systemic Fibrosis (NSF). It was not until approximately 7 years later that a dialysis unit nephrologist from Austria, Grobner, observed that a ser

Stability of Gadolinium Based Contrast Agents (GBCAs)

There are two stability properties of GBCAs that are important to be familiar with as they relate to how well the GBCA stays intact: thermodynamic stability and kinetic stability. Thermodynamic stability refers to the proportion of GBCA that remains intact (chelated) versus dissociated in equilibrium. Kinetic stability refers to the rate or speed at which this equilibrium is reached. In classic chemistry, thermodynamic stability is measured at a ph of 1 (extremely acidic), which does not reflect what happens in humans where the physiologic ph is 7.4. When thermodynamic stability is measured at physiologic ph this has been called conditional stability. Kinetic stability is generally reported

Gadolinium Storage Condition (GSC): What Does the Future Hold?

Gadolinium Storage Condition is the term for individuals have have undergone GBCA administration, and are not sick from the Gd. There are at least 10 million individuals with meaningful GSC, but in essence everyone who has received a GBCA and does not have either NSF or GDD has some gadolinium (the great majority miniscule amounts) retained in their body. But by the same token everyone also has some lead, some mercury, some chromium, and some arsenic, etc - a function of living in the modern age. So meaningful refers to readily detectable by modern techniques in organ systems, especially the bone. This is especially true if the individuals have undergone administration of linear GBCAs. Studi

Doc Strauss: It is Time to Combat Systemic Abuse

The article highlights key components of systemic change to combat abuse of power through addressing Doc Strauss and sexual abuse of male wrestling students at Ohio State University: Yet another report on gross misconduct by a physician against students at a university, as part of a larger picture of general serious misconducts at major universities: Penn State and Sandusky, Michigan State and Nassar and Strampel, University of North Carolina and academic misconduct in the athletics department and 5 UNC women suffering sexual assault/ rape with institution minimization, and now Ohio State University and Doc Strauss. What all of these institutions have in common is that they are state un

Radiology Contrast Agents: Who's Minding the Contrast Mint?

It was something like 15 years ago that the Radiology community had imposed upon them, by some combination of hospital administration, hospital pharmacy, and maybe initiated by the FDA, that radiology contrast agents were actually drugs, and as such had to be prescribed by physicians. I am speaking for myself, but I think my views in this piece reflected the general views of radiologists. Drugs.... we thought they were just one time use contrast agents to allow us to see diseases better on images. It was also decided at the time, that since they had to prescribed, that the ordering physician was to decide if the imaging study required contrast or not. So, radiologists, who knew imaging and t

Primer on Safety of Imaging Studies: There may be scarier things under the imaging bed than GDD

Many sufferers have called for informed consent prior to administering GBCAs for MRI studies. This may not be an unreasonable request at all. In my opinion, at the least the patient should leave with an information sheet, as happens after surgical procedures, which describes adverse events, with a focus on the symptoms of GDD (1,2), and to call the imaging facility if they have problems. Ideally in the near future I would like MRI facilities equipped with chelating agents so the patient can return to the center and be chelated for the Gd. Essentially it is not much different than the original GBCA administration in the first place. Some sufferers vigorously claim that all GBCAs should be tak

 
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