Author Topic: In today's news...  (Read 4105 times)

msmaggie

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In today's news...
« on: September 10, 2010, 07:41:48 am »
FYI .... I am quoting from a report in the newspaper this morning.


WASHINGTON – Federal health regulators are warning doctors that a class of injectable drugs used in MRI medical imaging scans can cause a rare and sometimes fatal condition in patients with kidney disease.
The Food and Drug Administration said Thursday it is adding its strongest warning label to imaging agents that contain the chemical gadolinium, highlighting the risks when used in patients with kidney problems.
"These label changes are intended to help ensure these drugs are used appropriately," the FDA said in a posting to its website. The warning language will appear in a bolded box at the top of the drugs' labels.
The agency said in a statement that use of the drugs can lead to a rare syndrome that causes hardening of the skin and tissue growth along joints, eyes and internal organs. The ailment, which is sometimes fatal, is called nephrogenic fibrosing dermopathy and has been reported in patients with weakened kidney function.
There is no known treatment for the condition, though kidney transplant appears to slow disease and even reverse it in some cases.

Known as contrast agents, the products are used to improve clarity in medical scans of the heart and other internal organs. The FDA has approved seven such agents since 1988.
While the nephrogenic syndrome has been reported with all seven drugs, the FDA said three have greater risks than the others: Bayer Healthcare's Magnevist, General Electric Healthcare's Omniscan and Covidien's Optimark. The FDA label stresses that these drugs should not be used in patients with kidney disease.
An agency spokeswoman said those three drugs are "chemically more unstable" than the others in the class and "thus more likely to release gadolinium."
Gadolinium is a metal with distinctive magnetic properties that increase its visibility during MRI scans. It is known to be toxic to the liver.

The four other drugs are Prohance and Multihance from Brocco Diagnostics Inc., Bayer's Eovist and Ablavar from Lantheus Medical Imaging.

The new FDA labels for all seven drugs instruct physicians to screen patients for kidney disease before administering the agents. Doctors should also order lab tests for patients who may be at increased risk of reduced kidney function. The FDA said there haven't been any reports of the syndrome in patients with normal kidney function.

There are two non-gadolinium-based imaging agents on the market, though the FDA has approved them only for liver scans.
GE Healthcare said in a statement that the FDA's labeling reinforces physician guidelines that already stress the importance of screening for patients with kidney problems.

The company said MRI contrast agents "continue to be a valuable diagnostic tool with a proven safety record for the overwhelming majority of patients to whom they are prescribed."
Bayer said it will cooperate with regulators and "will make periodic safety reports to the FDA and other regulators."
Diagnosed  left AN 8/07/08, 1.9 CM
Surgery 12/10/08 at Methodist Hospital w/Vrabec and Trask for what turned out to be a cpa meningioma.

leapyrtwins

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Re: In today's news...
« Reply #1 on: September 10, 2010, 11:51:04 am »
Thanks for the info., Priscilla.

Gadolinium has always been a concern, which is why most hospitals/docs make you have your blood tested prior to an MRI that uses gadolinium.

The blood tests in question are a BUN and creatine.  I've had them prior to all of my post op MRIs - it's policy at the hospital that I go to.

http://www.ehow.com/facts_5728389_bun-creatine-mean_.html

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

msmaggie

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Re: In today's news...
« Reply #2 on: September 10, 2010, 01:33:37 pm »
I think as long as the patient is aware of any known kidney or liver problems, most people do just fine.  The testing is a very good idea. I had not heard of any risks concerning the dye elements, and I honestly don't think I had any testing done before the first one. I did have plenty of testing done before the other two. Thanks for the info on which tests should be given. That is very helpful for anyone who has concerns about their MRI.
Priscilla
Diagnosed  left AN 8/07/08, 1.9 CM
Surgery 12/10/08 at Methodist Hospital w/Vrabec and Trask for what turned out to be a cpa meningioma.

Jim Scott

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Re: In today's news...
« Reply #3 on: September 10, 2010, 03:25:31 pm »
Priscilla ~

Thanks for alerting us to the heretofore lightly-publicized warning about gadolinium and the possible serious consequences resulting from it's use in patients with kidney disease.   Fortunately, my kidneys seem to be in good working order so apparently I'm not at risk, although the tests are still a very sensible precaution.  Now we know why.   

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

tenai98

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Re: In today's news...
« Reply #4 on: September 10, 2010, 03:41:32 pm »
because of such problems, my hospital now screens prior to an MRI.....I sure did ask alot of questions when told I needed bloodwork before my latest MRI whiich I never had to have before
JO
14mmX11mmX11mm left ear
TRANSLAB 04/07/09 2cms at time of surgery
Dr. Benoit and Schramm, Ottawa Civic Campus
SSD ,some facial numbness
Baha surgery sept 22/09
residual tumor 13mmX7mmX8mm
2016 new growth.  25mmX21mmX22mm
cyberknife on June 7

dalern

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Re: In today's news...
« Reply #5 on: September 11, 2010, 02:11:27 am »
Here in California, I have been required to have blood work (BUN and Creatinine) prior to each MRI using contrast.  I am having an MRI on the 20th, and just had my blood work today.  I think it is the safest pre-screening they can do.
~Dale
Dale Barnes, RN, MSN, CLNC
Tarzana, CA
1998 Sudden Onset Idiopathic Sensorineural  hearing loss diagnosed at House Ear Institute, Los Angeles
BAHA June 30, 2010 Dr. Jeffrey Harris UCSD San Diego

ppearl214

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Re: In today's news...
« Reply #6 on: September 11, 2010, 05:48:11 am »
Here in California, I have been required to have blood work (BUN and Creatinine) prior to each MRI using contrast.  I am having an MRI on the 20th, and just had my blood work today.  I think it is the safest pre-screening they can do.
~Dale

Same here Dale. They do Bun/Creatinine to help make sure liver functions are ok to help "pass" the contrast.  Pretty standard across the board (I hope....) and are usually done within 4 wks of the MRI with contrast.

sorry, didn't sleep at a Holiday Inn Express last night.... just spend too much time in blood labs.

Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

tenai98

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Re: In today's news...
« Reply #7 on: September 11, 2010, 07:37:00 am »
four weeks ahead of MRI...wow...I had my bloodwork done in July for my next MRI in March 2011....
JO
14mmX11mmX11mm left ear
TRANSLAB 04/07/09 2cms at time of surgery
Dr. Benoit and Schramm, Ottawa Civic Campus
SSD ,some facial numbness
Baha surgery sept 22/09
residual tumor 13mmX7mmX8mm
2016 new growth.  25mmX21mmX22mm
cyberknife on June 7

opp2

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Re: In today's news...
« Reply #8 on: September 11, 2010, 09:11:37 am »
I was never asked, nor did I have any blood work done before my MRI with contrast. Perhaps I looked healthy? I don't believe my MRI in Oct will be a contrast MRI either. Interesting.
Diagn Apr 14 2009 with 2.5 cm lt AN. - numbness in the face and sudden onset headaches accompanied by balance issues. Consults with Drs in S Ontario, California (House) and Vancouver. Picked Dr. Akagami in BC.
Retrosigmoid July 6, 2010, 3.0cm by then. SSD left, no other significant side effects.

leapyrtwins

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Re: In today's news...
« Reply #9 on: September 11, 2010, 10:53:33 am »
Four weeks? 

I have my blood drawn in the morning and my MRI a few hours later that same afternoon.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

CHD63

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Re: In today's news...
« Reply #10 on: September 11, 2010, 11:55:32 am »
I cannot imagine any value of doing lab work months ahead of the MRI with contrast ..... it seems to me quite a bit could change in that time.  In my case, just taking a normal dose of Tylenol elevates my liver enzymes but quickly returns to normal when I stop taking it for a few days.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

ppearl214

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Re: In today's news...
« Reply #11 on: September 11, 2010, 07:02:44 pm »
Four weeks? 

I have my blood drawn in the morning and my MRI a few hours later that same afternoon.

Jan

you got good connections! :)  My MRI center doesn't do the lab work, so MRI ordering doc (ie: brain surgeon) orders my MRI and coordinates the blood work at my PCP's office (they have a lab).  The lab results are certainly quick to obtain..... the MRI center told me that the labs should be done no later than 4 wks prior to the MRI.... sooner if possible.

Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Kaybo

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Re: In today's news...
« Reply #12 on: September 11, 2010, 07:29:56 pm »
I've never had a blood test for an MRI - I've just had to sign a release that I know it can cause problems!

;D
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!