Всем здраствуйте. У меня один важный коммент по поводу влияния гадолиния на почки. На мой взгляд в 2008 году работая на МРТ и не знать о токсическом воздействии гадолиния на почки это нонсенс; коллеги мы что не читаем журналы? Не посещаем сайты? О таком диагнозе как Nephrogenic Systemic Fibrosis слышали? Описано еще лет 5-6 назад.
Читайте ссылки:
http://www.fda.gov/cder/drug/InfoSheets/HCP/gcca_200705.htm
Patients who have developed large areas of hardened skin with slightly raised plaques, papules, or confluent papules; with or without pigmentary alteration and/or with biopsies showing increased numbers of fibroblasts, alteration of the normal pattern of collagen bundles seen in the dermis, and often increased dermal deposits of mucin.
Nephrogenic Systemic Fibrosis (NSF), also known as nephrogenic fibrosing dermopathy (NFD), is a condition that, so far, has occurred only in people with kidney disease. There is no convincing evidence that NSF is caused by a medication, a microorganism, or by dialysis. There have been no cases identified prior to early 1997. At this point it appears NSF is a systemic disorder with its most prominent and visible effects in the skin. For this reason, Nephrogenic Systemic Fibrosis has been suggested as an equivalent terminology in those previously diagnosed with NFD, and is preferred in that it more accurately reflects our current understanding of the disorder.
Neither the duration of kidney disease nor its underlying cause are related to the development of NSF. Some patients with NSF develop skin tightening in the earliest stages of kidney disease, and others may have had kidney disease for years. Specific triggers for the development of NSF are still being investigated. Recent reports have strongly correlated the development of NSF with exposure to gadolinium-containing MRI contrast agents. Further information from the US Food and Drug Administration regarding this observation can be found here: (http://www.fda.gov/cder/drug/advisory/gadolinium_agents.htm). The initial FDA advisory has been recently modified to the statement present at this site: (http://www.fda.gov/cder/drug/advisory/gadolinium_agents_20061222.htm) .
NSF appears to affect males and females in approximately equal numbers. NSF has been confirmed in children and the elderly, but tends to affect the middle-aged most commonly. It has been identified in patients from a variety of ethnic backgrounds and from North America, Europe, and Asia.
Besides kidney disease, conditions that may be associated with NSF include coagulation abnormalities and deep venous thrombosis, recent surgery (particularly vascular surgery), recent failure of a transplanted kidney, and sudden onset kidney disease with severe swelling of the extremities. It is very common for the NSF patient to have undergone a vascular surgical procedure (such as revision of an AV fistula, or angioplasty of a blood vessel) or to have experienced a thrombotic episode (thrombotic loss of a transplant or deep venous thrombosis) approximately two weeks before the onset of the skin changes.
The associated conditions enumerated in the preceding paragraph frequently justify the use of gadolinium-enhanced MRI or MRA studies. Whether the recently announced association of NSF with gadolinium exposure is the common denominator of all NSF cases is still under investigation. A verifiable cause and effect relationship has not yet been established, but active efforts to prove or refute this relationship are underway. Two recent papers have verified the presence of gadolinium in the tissue of some patients with NSF, however, the study designs do not allow for determining whether the gadolinium caused the NSF (free article download #1)(free article download #2).
Top of the page
Symptoms and Signs
Patients with NSF describe swelling and tightening of the skin, usually limited to the extremities (images), but sometimes involving the trunk. The condition may develop over a period of days to several weeks. In many cases, the skin thickening inhibits the flexion and extension of joints, resulting in contractures. Severely affected patients may be unable to walk, or fully extend the joints of their arms, hands, legs, and feet. Complaints of muscle weakness are common. Approximately 5% of patients have a rapidly progressive (fulminant) course.
The skin changes may start as reddened or darkened patches, papules, or plaques. In time, the skin may feel “woody” and the surface may resemble the texture of the peel of an orange. Patients may experience burning, itching, or severe sharp pains in areas of involvement. Radiography may reveal calcifications of the soft tissue. Deep "bone pain" has been described in the hips and in the ribs.
The skin lesions are commonly symmetrical, with zones between the ankles and thighs most commonly involved, followed by involvement between the wrist and upper arms. Hand and foot swelling with blister-like lesions has also been reported. Some patients have reported yellow papules or plaques on or near the eyes. Rapid, new onset fluctuating hypertension of unknown cause has been described prior to the onset of the skin lesions.
На мой взгляд в 2008 году работая на МРТ и не знать о токсическом воздействии гадолиния на почки это нонсенс; коллеги мы что не читаем журналы? Не посещаем сайты? О таком диагнозе как Nephrogenic Systemic Fibrosis слышали? Описано еще лет 5-6 назад.
Даже не читая журналы, не посещая сайты и не слышав о страшном Nephrogenic Systemic Fibrosis любой думающий врач знает о возможности осложнений и побочных действий, аллергических реакций от применения любых препаратов.
Dr.Mario, спасибо за цитаты и ссылки, но менторский тон не совсем уместен. Простите за вынужденное оппонирование, ничего личного
Предлагаю обмен информацией по обслуживанию и эксплуатации томографа Somatom Balance. Могу предложить по Somatom Emotion (почти тоже самое для Balance) на русском языке
Руководство пользователя Руководство пользователя syngo Руководство пользователя опциями syngo
Спасибо Вам за предложение. Любая информация, представляющая интерес для врача лучевого диагноста, весьма полезна и может быть представлена на сайте. Мы может открыть для имеющейся у Вас информации отдельную "ветку". Если Вы не против дайте знать в виде комментария.ниже.
Подскажите,пожалуйста.насколько безопасна для медперсонала установка спирального компьютерног томографа ASTEION VP (TOSHIBA) под кабинетом функциональной диагностики?Нигде не могу найти технические требования безопасности!
предел повысился до 320 срезов =)
Всем здраствуйте. У меня один важный коммент по поводу влияния гадолиния на почки. На мой взгляд в 2008 году работая на МРТ и не знать о токсическом воздействии гадолиния на почки это нонсенс; коллеги мы что не читаем журналы? Не посещаем сайты? О таком диагнозе как Nephrogenic Systemic Fibrosis слышали? Описано еще лет 5-6 назад. Читайте ссылки: http://www.fda.gov/cder/drug/InfoSheets/HCP/gcca_200705.htm
http://www.acr.org/SecondaryMainMenuCategories/quality_safety/MRSafety.aspx
http://www.icnfdr.org/
Original Case Definition
Patients who have developed large areas of hardened skin with slightly raised plaques, papules, or confluent papules; with or without pigmentary alteration and/or with biopsies showing increased numbers of fibroblasts, alteration of the normal pattern of collagen bundles seen in the dermis, and often increased dermal deposits of mucin.
--------------------------------------------------------------------------------
NSF…what is it?
Nephrogenic Systemic Fibrosis (NSF), also known as nephrogenic fibrosing dermopathy (NFD), is a condition that, so far, has occurred only in people with kidney disease. There is no convincing evidence that NSF is caused by a medication, a microorganism, or by dialysis. There have been no cases identified prior to early 1997. At this point it appears NSF is a systemic disorder with its most prominent and visible effects in the skin. For this reason, Nephrogenic Systemic Fibrosis has been suggested as an equivalent terminology in those previously diagnosed with NFD, and is preferred in that it more accurately reflects our current understanding of the disorder.
Neither the duration of kidney disease nor its underlying cause are related to the development of NSF. Some patients with NSF develop skin tightening in the earliest stages of kidney disease, and others may have had kidney disease for years. Specific triggers for the development of NSF are still being investigated. Recent reports have strongly correlated the development of NSF with exposure to gadolinium-containing MRI contrast agents. Further information from the US Food and Drug Administration regarding this observation can be found here: (http://www.fda.gov/cder/drug/advisory/gadolinium_agents.htm). The initial FDA advisory has been recently modified to the statement present at this site: (http://www.fda.gov/cder/drug/advisory/gadolinium_agents_20061222.htm) .
GE healthcare, one manufacturer of gadolinium-containing MRI contrast, has issued an informational announcement at: (http://www.amershamhealth-us.com/omniscan/safety/index.html). This announcement has been updated to include new information as of 12/2006 and is present at this site: (http://www.amershamhealth-us.com/omniscan/safety/safety%20update%202007.html)
NSF appears to affect males and females in approximately equal numbers. NSF has been confirmed in children and the elderly, but tends to affect the middle-aged most commonly. It has been identified in patients from a variety of ethnic backgrounds and from North America, Europe, and Asia.
Besides kidney disease, conditions that may be associated with NSF include coagulation abnormalities and deep venous thrombosis, recent surgery (particularly vascular surgery), recent failure of a transplanted kidney, and sudden onset kidney disease with severe swelling of the extremities. It is very common for the NSF patient to have undergone a vascular surgical procedure (such as revision of an AV fistula, or angioplasty of a blood vessel) or to have experienced a thrombotic episode (thrombotic loss of a transplant or deep venous thrombosis) approximately two weeks before the onset of the skin changes.
The associated conditions enumerated in the preceding paragraph frequently justify the use of gadolinium-enhanced MRI or MRA studies. Whether the recently announced association of NSF with gadolinium exposure is the common denominator of all NSF cases is still under investigation. A verifiable cause and effect relationship has not yet been established, but active efforts to prove or refute this relationship are underway. Two recent papers have verified the presence of gadolinium in the tissue of some patients with NSF, however, the study designs do not allow for determining whether the gadolinium caused the NSF (free article download #1)(free article download #2).
Top of the page
Symptoms and Signs
Patients with NSF describe swelling and tightening of the skin, usually limited to the extremities (images), but sometimes involving the trunk. The condition may develop over a period of days to several weeks. In many cases, the skin thickening inhibits the flexion and extension of joints, resulting in contractures. Severely affected patients may be unable to walk, or fully extend the joints of their arms, hands, legs, and feet. Complaints of muscle weakness are common. Approximately 5% of patients have a rapidly progressive (fulminant) course.
The skin changes may start as reddened or darkened patches, papules, or plaques. In time, the skin may feel “woody” and the surface may resemble the texture of the peel of an orange. Patients may experience burning, itching, or severe sharp pains in areas of involvement. Radiography may reveal calcifications of the soft tissue. Deep "bone pain" has been described in the hips and in the ribs.
The skin lesions are commonly symmetrical, with zones between the ankles and thighs most commonly involved, followed by involvement between the wrist and upper arms. Hand and foot swelling with blister-like lesions has also been reported. Some patients have reported yellow papules or plaques on or near the eyes. Rapid, new onset fluctuating hypertension of unknown cause has been described prior to the onset of the skin lesions.
Let me see...
radiographia.ru
Большое спасибо ДОКТОР МАРИО.
Dr.Mario, спасибо за цитаты и ссылки, но менторский тон не совсем уместен. Простите за вынужденное оппонирование, ничего личного
Зри в корень!
Предлагаю обмен информацией по обслуживанию и эксплуатации томографа Somatom Balance.
Могу предложить по Somatom Emotion (почти тоже самое для Balance) на русском языке
Руководство пользователя
Руководство пользователя syngo
Руководство пользователя опциями syngo
Журналы посвященные Somatom Sessions
на английском языке.
Спасибо Вам за предложение. Любая информация, представляющая интерес для врача лучевого диагноста, весьма полезна и может быть представлена на сайте. Мы может открыть для имеющейся у Вас информации отдельную "ветку". Если Вы не против дайте знать в виде комментария.ниже.
С уважением В. Катенёв
В медицине мало, что понимаю. Я инженер, обслуживаю томограф. С удовольствием поделюсь любой имеющиеся инфомацией.
"Ветка" в этом разделе форума. Название "информация по обслуживанию и эксплуатации аппаратуры".
Назовите ценность хотябы некотрых аппаратов.
Желательно с деталями.
1) Монатж
2) Калибровка
3) Обслуживание
4) Оборудование
Уважаемые специалисты!
Подскажите,пожалуйста.насколько безопасна для медперсонала установка спирального компьютерног томографа ASTEION VP (TOSHIBA) под кабинетом функциональной диагностики?Нигде не могу найти технические требования безопасности!