July - 2019

RICHARD SEMELKA, MD. CONSULTING

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How much Gd is retained and how long will it take to get it all out?

How much Gd is retained and how long will it take to get it all out?

This is my response to a question sent to me (see at bottom) I have heard from another patient the description of the amount 1% of Gd being retained... which I believe some quasi-expert once blew out that number off the top of their head with no science behind it. The story of retention actually is remarkably complex. In someone with normal renal function there is constant elimination of Gd from the body, so the amount retained naturally is always on the decline - so the time

Similarities between the Influenza Pandemic and GDD

Similarities between the Influenza Pandemic and GDD

For many reasons the Influenza Pandemic of 1918-1920 (an H1N1 strain), known colloquially as the Spanish Flu, is a remarkably fascinating disease for many reasons. I will touch only a few of them, which offer similarities to GDD: 1. One of the most remarkable unique aspects of this flu in relation to other flus is its propensity to infect and kill young adults. Most flus tend to kill the very young and very old, but many of the deaths of the Spanish Flu were young adults in t

What is the Importance of Gadolinium Observed in the Brain on MRI?

What is the Importance of Gadolinium Observed in the Brain on MRI?

The short answer - it is of no value and may be problematic if no Gd is seen on MRI. Gd has been shown in the Globus Pallidus (GP) and Dentate Nucleus (DN) on T1-weighted MR images. It is not clear what speciation (what Gd is attached to) to be shown on MRI. Since it is essentially only shown with prior administration of linear agents, and not with macrocyclics, it should reflect Gd dissociated from its ligand. In my opinion, since Gd associated with protein tends to have hig