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China Medicine News Science

Worldwide Shortage of Barium 270

New submitter redhat_redneck writes "The U.S. and Canada has been experiencing a shortage of barium sulfate, which is used as contrast for upper and lower GI studies. It has reached the point where doctors are being asked not to order these exams except in emergencies, and some exams are being cancelled. Here's the letter that's been put out by the manufacturer. The longer this drags on, the more serious this issue becomes, eventually impacting patients and healthcare providers in both cost and quality of care. Some sources point to a dramatic drop in Chinese production. In their defense, it seems China is changing safety regulations. Medical use only make a fraction of the uses of barium sulfate, but it's going to be disproportionately affected by this shortage. We can't go back to our old contrast Thorotrast; it causes cancer. Does anyone know of alternatives to barium?"
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Worldwide Shortage of Barium

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  • by Anonymous Coward on Wednesday January 09, 2013 @04:47AM (#42529499)

    which is used as contrast for upper and lower GI studies

    What the hell are these studies and why is it assumed Slashdot readers would know what they are? What's a "contrast" in this context?

    Is the submitter seriously asking us to suggest alternatives to barium? Worst submission ever. It could have explained what this bullshit means, and why China needed to improve safety?

  • by gweihir ( 88907 ) on Wednesday January 09, 2013 @04:54AM (#42529549)

    The icky-factor aside, Barium is an element does not vanish and can certainly be sterilized to any degree desired. So, why do they apparently not recycle the stuff?

  • by White Flame ( 1074973 ) on Wednesday January 09, 2013 @05:59AM (#42529903)

    This is a problem with more than Barium. Tons of nutritionally beneficial trace minerals and other such things are all being flushed into the oceans via sewage treatment & disposal, as our stool doesn't return to local soil.

  • by jo_ham ( 604554 ) <joham999NO@SPAMgmail.com> on Wednesday January 09, 2013 @07:39AM (#42530329)

    Was being brief and assumed the implications were obvious...... guess not

    1. Just because a few geeks are certain re-use is ok and might be willing to do it, the general public would not be

    2. Even if you are a geek, there's no guarantee some minimum-wage flunky at a re-processing company (or some unionized hospital worker who is mad and in the middle of some "labor action") is gonna do a perfect job and the stuff YOU end up drinking will be properly re-processed. A bit like drinking re-cycled urine .... fine if you are a geek and the processing is being done by the rocket scientists at NASA for the space station, but are you still willing if it's being done by the guy who's only other career option included saying "want fries with that?"

    3. A good lawyer will easily convince a typical jury (possibly with members who are anti-science lefties who reject nuclear stuff) that there was some bad thing in the re-processing process (probably done by evil "big hospital" or "big pharma") i.e. it's just another level of "doubt" ....

    Think some more and you can imagine many other reasons that each just make the business case a little bit harder to close. No single cut might kill the patient (in this case: re-use of Barium), but lots of little cuts and he bleeds-out

    You assume, naively, that the hospital does the recycling and just makes up fresh suspensions. Of course, if any recycling was done it would be to recover the pure BaSO4, which would be the domain of a chemical supplier; who then supplies the material to a pharma company, who then makes the thing you drink, who sells it to the hospital.

    Recovering the material from shit is no different to recovering it from the ore it originally came from in the ground. Medical-purity BaSO4 is likely to be a further cut above the lab-grade stuff you can buy from any number of common chemical suppliers - purifying it is trivial - they do it all the time to make the stuff in the first place. What we're discussing here is the economic viability of recovering it from sewage waste. The source is ultimately unimportant. If it ends up in a drug it has to come from a very specific, well monitored source. There's no chance some "flunky" is going to affect the dose of contrast agent you drink. (Oh, and nice, unnecessary jab at union workers and "lefties" there - given your level of discourse and opinion of union labour I'll try and keep my words to fewer than four syllables so you can follow along).

    It seems you live in a world full of conspiracies and hidden enemies in the shadows at every turn trying to get one over on you. You might want to just relax a bit. You can log in too; the government is not tracking your slashdot account.

  • by Stolpskott ( 2422670 ) on Wednesday January 09, 2013 @08:03AM (#42530447)

    Quoting from the Wikipedia article for Iodine,
    "Iodine sensitivity is rare but has a considerable effect given the extremely widespread use of iodine-based contrast media".

    So I would say that using Diatrizoic acid/diatrizoate as a Barium replacement (Hypaque, Gastrografin and Ultravist are the trade names) in cases where there is no flagged Iodine sensitivity in the patient is viable, with Barium being used in those rare cases (if in doubt, do a quick Iodine test, as far as I can recall the results are pretty quick - a drop of iodine on the inside of the wrist or elbow, a small rash will form if the recipient is sensitive, and the rash can be treated with standard rash creams (if the recipient is REALLY sensitive, anaphylactic shock is a possibility if a large amount of Ioidine is applied - you dip the person's arm in it - but if the sensitivity is that bad, it should already be flagged). This also has a positive effect for most people, who are generally short of the daily Iodine intake levels they should have.

    Disclaimer, my medical knowledge is limited by the fact that I dated and lived with a med student for 7 years, helping her study and revise for exams. Talk to your doctor if you have concerns about your own potential Iodine sensitivity or Gastro-intestinal issues. Do not come to /. and expect sane medical opinions here...

  • by Goaway ( 82658 ) on Wednesday January 09, 2013 @10:09AM (#42531379) Homepage

    Maybe if you were born without a nose.

  • by ultranova ( 717540 ) on Wednesday January 09, 2013 @01:06PM (#42533685)

    Can someone point me to a REAL nerd site where the above aliterate Anonymous Jock who doesn't give two shits about learning doesn't go?

    You wouldn't be welcome on such a site, given your attitude to questions - which, after all, are a prerequisite to learning.

    WE'RE NERDS. We understand most scientific and medical terms. When you say "LEO" we don't think "cop" we think "low Earth orbit."

    First, medicine is a science, thus the expression "most scientific and medical terms" is redundant. Second, no one understands most scientific terms. "Science" refers to the entire body of human knowledge, which not only is far too vast for any one person to know most of, but also grows faster than you can learn it - even if your learning capacity was unlimited, the bandwidth of your senses is simply not enough.

    Finally, "nerd" doesn't necessarily refer to someone interested in either science in general or medicine in specific. People who are enthusiastic about programming, or matemathics, or 19th century French poetry could all be called nerds without necessarily knowing what "GI" refers to in a medical context - assuming it actually refers to just one thing and isn't reused anywhere. On the other hand, "LEO" is usually used with sufficient context to conclude that we are talking about some kind of satellite orbit or at the very least a space trajectory.

    If you don't understand scientific or medical terminology, maybe you should just stay away from slashdot?

    Perhaps you wouldn't have such issues with jocks if you changed your attitude a little? Because I can certainly see why a jock - or, really, anyone - might not like you.

    They don't like you because you're an arrogant twat, just in case you didn't get that already.

"Remember, extremism in the nondefense of moderation is not a virtue." -- Peter Neumann, about usenet