Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.671
Filtrar
1.
Cell Prolif ; 53(7): e12813, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32515860

RESUMO

OBJECTIVES: Accumulating studies have investigated the PM2.5-induced pulmonary toxicity, while gaps still remain in understanding its toxic mechanism. Due to its high specific surface area and adsorption capacity similar to nanoparticles, PM2.5 acts as a significant carrier of metals in air and then leads to altered toxic effects. In this study, we aimed to use CBs and Ni as model materials to investigate the autophagy changes and pulmonary toxic effects at 30 days following intratracheal instillation of CBs-Ni mixture. MATERIALS AND METHODS: Groups of mice were instilled with 100 µL normal saline (NS), 20 µg CBs, and 4 µg Ni or CBs-Ni mixture, respectively. At 7 and 30 days post-instillation, all the mice were weighed and then sacrificed. The evaluation system was composed of the following: (a) autophagy and lysosomal function assessment, (b) trace element biodistribution observation in lungs, (c) pulmonary lavage biomedical analysis, (d) lung histopathological evaluation, (e) coefficient analysis of major organs and (f) CBs-Ni interaction and cell proliferation assessment. RESULTS: We found that after CBs-Ni co-exposure, no obvious autophagy and lysosomal dysfunction or pulmonary toxicity was detected, along with complete clearance of Ni from lung tissues as well as recovery of biochemical indexes to normal range. CONCLUSIONS: We conclude that the damaged autophagy and lysosomal function, as well as physiological function, was repaired at 30 days after exposure of CBs-Ni. Our findings provide a new idea for scientific assessment of the impact of fine particles on environment and human health, and useful information for the comprehensive treatment of air pollution.


Assuntos
Autofagia/efeitos dos fármacos , Carbono/efeitos adversos , Pneumopatias/induzido quimicamente , Pulmão/efeitos dos fármacos , Metais/efeitos adversos , Animais , Linhagem Celular , Pulmão/metabolismo , Pneumopatias/metabolismo , Lisossomos/efeitos dos fármacos , Lisossomos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Tamanho da Partícula , Células RAW 264.7 , Distribuição Tecidual
2.
World Neurosurg ; 139: 471-477, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32339728

RESUMO

BACKGROUND: Metal hypersensitivity is a rare complication after spinal implant placement but is related to significant clinical challenges including implant failure and poor wound healing. The incidence is likely underreported secondary to challenges with diagnosis and retreatment options. CASE DESCRIPTION: We present the case of a 41-year-old woman with metal hypersensitivity 6 years status post anterior lumbar interbody fusion after a previously failed revision procedure who presented with low back pain and abdominal pain with food intolerance. Diagnostics revealed presacral fluid collection, which was negative for infection. A detailed workup ruled out other possible differential diagnoses and confirmed hypersensitivity to nickel. Intraoperatively, the interbody was loose but difficult to remove secondary to scar tissue. Ultimately, it was successfully replaced with a polyetheretherketone interbody, which did not contain nickel. CONCLUSIONS: Metal hypersensitivity is likely an underreported complication in spine literature that is associated with poor outcomes. Further research to create evidence-based guidelines on diagnosis and retreatment options will facilitate diagnosis, reduce time to revision surgery, and ultimately decrease patient suffering.


Assuntos
Hipersensibilidade/diagnóstico por imagem , Níquel/efeitos adversos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Dispositivos de Fixação Cirúrgica/efeitos adversos , Adulto , Feminino , Humanos , Hipersensibilidade/etiologia , Metais/efeitos adversos , Resultado do Tratamento
3.
J Comput Assist Tomogr ; 44(3): 443-449, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32217899

RESUMO

OBJECTIVE: To assess impact of single-energy metal artifact reduction (SEMAR) algorithm utilizing retrospective adaptive thresholding in reducing metal artifacts in the abdomen and pelvis. METHODS: In this prospective institutional review board-approved, Health Insurance Portability and Accountability Act-compliant study, 90 patients with various metals (n = 97) on computed tomography of abdomen and pelvis (Canon Medical, Aquilion ONE and PRIME) scanned 07/2017-09/2018 with SEMAR retrospectively applied were included. Density was measured in the near and far field to the metals. Density standard deviation (SD), representing artifact severity, was compared with and without SEMAR applied. Two trained human observers independently evaluated severity of artifacts on a five-point scale (0, no artifact; 5, severe artifact). RESULTS: The SEMAR significantly decreased artifact severity in the near field of high-density metal implants (SD of 204 ± 101HU without vs. 66 ± 40HU with SEMAR, P < 0.001). In the far field, the artifact severity was similar (40 ± 31HU without vs. 36 ± 27HU with SEMAR, P = 0.41). Artifact severity was decreased adjacent to low-density metal in the near field (SD of 86 ± 56HU without vs 49 ± 30HU with SEMAR, P < 0.001). In the far field to the low-density metals artifact severity was similar (33 ± 29HU without vs. 31 ± 27HU with SEMAR, P = 0.79). Subjectively, artifacts severity decreased for high-density metals in near field by 1.3 ± 1.0, and in far field by 0.7 ± 0.7 and for low-density metals in the near field by 0.7 ± 1.0, far field 0.4 ± 0.5, all P < 0.05. CONCLUSIONS: The SEMAR retrospective algorithm with adaptive thresholding subjectively and objectively reduced near-field artifacts generated by high- and low-density metals.


Assuntos
Abdome/diagnóstico por imagem , Artefatos , Processamento de Imagem Assistida por Computador/métodos , Metais/efeitos adversos , Tomografia Computadorizada por Raios X , Idoso , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/normas
5.
Biomed Res Int ; 2019: 3649838, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781613

RESUMO

Metal wear debris and released ions (CoCrMo), which are widely generated in metal-on-metal bearings of hip implants, are also found in patients with metal-on-polyethylene bearings due to the mechanically assisted crevice corrosion of modular taper junctions, including head-neck and neck-stem taper interfaces. The resulting adverse reactions to metal debris and metal ions frequently lead to early arthroplasty revision surgery. National guidelines have since been published where the blood metal ion concentration of patients must consistently be monitored after joint replacement to prevent serious complications from developing after surgery. However, to date, the effect of metal particles and metal ions on local biological reactions is complex and still not understood in detail; the present study sought to elucidate the complex mechanism of metal wear-associated inflammation reactions. The knee joints in 4 groups each consisting of 10 female BALB/c mice received injections with cobalt chrome ions, cobalt chrome particles, and ultra-high-molecular-weight polyethylene (UHMWPE) particles or PBS (control). Seven days after injection, the synovial microcirculation and knee joint diameter were assessed via intravital fluorescence microscopy followed by histological evaluation of the synovial layer. Enlarged knee diameter, enhanced leukocyte to endothelial cell interactions, and an increase in functional capillary density within cobalt chrome particle-treated animals were significantly greater than those in the other treatment groups. Subsequently, pseudotumor-like tissue formations were observed only in the synovial tissue layer of the cobalt chrome particle-treated animals. Therefore, these findings strongly suggest that the cobalt chrome particles and not metal ions are the cause for in vivo postsurgery implantation inflammation.


Assuntos
Artroplastia de Quadril/efeitos adversos , Ligas de Cromo/efeitos adversos , Prótese de Quadril/efeitos adversos , Metais/efeitos adversos , Animais , Ligas de Cromo/farmacologia , Corrosão , Modelos Animais de Doenças , Humanos , Inflamação/sangue , Inflamação/induzido quimicamente , Articulação do Joelho/cirurgia , Metais/uso terapêutico , Camundongos , Polietileno/farmacologia , Falha de Prótese/efeitos adversos , Reoperação , Líquido Sinovial/efeitos dos fármacos
6.
Medicine (Baltimore) ; 98(45): e17914, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702670

RESUMO

There are very few reports of eczema and other prosthetic-related allergic skin complications following arthroplasty. We aimed to assess the risk of eczema after joint replacement.We performed a retrospective population-based cohort study in 2024 joint replacement patients using the Longitudinal Health Insurance Database. For comparison, 8096 controls were selected, with 4 control subjects for each joint replacement patient matched for age, sex, and index year, to assess eczema risk. We examined 14-year cumulative eczema incidence associated with age, sex, immunity, disease history, and joint replacement location.Eczema rates in the joint replacement patients were 38% higher than in the control group (57.90 vs 41.84 per 1000 person-years, respectively). Compared with the control group, joint replacement patients showed a 1.35-fold increased risk of eczema according to the multivariable Cox model (95% Confidence interval [CI] = 1.23-1.49). Knee replacement patients had higher eczema risk compared with the control group (Hazard ratio [HR] = 1.45, 95% CI = 1.33-1.70). Stratified by study period, the joint replacement cohort had a higher eczema risk after the 3-month follow-up.Our study revealed that joint arthroplasty increased risk of eczema in this 14-year follow-up study, and this was not related to personal atopic history or gender.


Assuntos
Artroplastia de Substituição/efeitos adversos , Eczema/epidemiologia , Prótese Articular/efeitos adversos , Idoso , Artroplastia de Substituição/estatística & dados numéricos , Estudos de Casos e Controles , Comorbidade , Dermatite Alérgica de Contato/epidemiologia , Eczema/etiologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco
7.
Artigo em Inglês | MEDLINE | ID: mdl-31605583

RESUMO

Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. This study analyzes and compares the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution. In the period 2015-2017, 36 patients with 37 large acetabular defects were treated with porous metal augments in cemented and uncemented acetabular revisions. Postoperatively, patients were monitored for two years on average period of 24-36 months. Acetabular augments were used when preoperative and intraoperative findings indicated the presence of large acetabular defects that can hinder the stability of the revision implants. We used lateral approach, 36 mm femoral head, and cementless or cemented acetabular cup depending on local bone quality. Postoperatively, all patients followed total hip arthroplasty precautions, with weight bearing as tolerated regimen with use of crutches during 6 weeks after surgery. The follow-up was radiological and clinical. We used HHS. At a mean follow-up of two years (range 24-36 months) one patient had reinfection and one patient had infection. None of the patients shown signs of aseptic augment or acetabular cup loosening. Porous metal augments show comparable excellent radiographic and clinical short-term outcomes, when combined with cemented or uncemented cups in revision hip arthroplasty. They allow good bone ingrowth, adequate implant contact and good stability. Complications were related to infection and not related to the augments itself.


Assuntos
Acetábulo/anormalidades , Acetábulo/cirurgia , Artroplastia de Quadril/instrumentação , Reoperação/métodos , Acetábulo/diagnóstico por imagem , Assistência ao Convalescente , Idoso , Artroplastia de Quadril/métodos , Cimentos para Ossos/efeitos adversos , Cimentação/tendências , Feminino , Prótese de Quadril , Humanos , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Porosidade , Complicações Pós-Operatórias/epidemiologia , Desenho de Prótese , Radiografia/métodos , Reoperação/instrumentação , Resultado do Tratamento
8.
BMC Musculoskelet Disord ; 20(1): 415, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31488129

RESUMO

BACKGROUND: The aim of this study was to review the long-term results of the instrumented Bone Preserving (iBP) elbow prosthesis. METHODS: Thirty-one patients (10 M, 21F, 28-77 year) were retrospectively evaluated using the Oxford Elbow Score (OES), Disabilities of Arm, Shoulder and Hand Outcome Measure (DASH), Mayo Elbow Performance (MEPS), physical examination and standard radiographs. Kaplan-Meier survival analysis was used. RESULTS: Thirty-seven primary iBPs have been placed in 31 patients between 2000 and 2007. Six patients (8 prostheses) had died, 10 elbows had been revised and three patients (4 prostheses) were lost to follow-up. Fourteen patients (15 prostheses) were available for follow-up. The main indication for surgery was rheumatoid arthritis. Mean follow-up was 11 years (8-15). Kaplan-Meier survival analysis showed a survival of 81% at 10 years after surgery. Main reason for revision was particle disease and loosening due to instability and malalignment. Eleven of 14 patients were satisfied, although radiographs showed radiolucencies in 11 patients. CONCLUSION: The iBP elbow prosthesis gives a survival rate of 81% 10 years after surgery with a progressive decline beyond 10 years. However, many patients have radiolucencies. Discrepancy between clinical signs and radiological results warrants structural follow-up, to assure quality of bone stock in case revision surgery is indicated. The study was reviewed and approved by the Medical Ethical Committee of University Medical Center Groningen (METc2016/038). LEVEL OF EVIDENCE: Level IV, Case series.


Assuntos
Artroplastia de Substituição do Cotovelo/instrumentação , Prótese de Cotovelo/efeitos adversos , Próteses Articulares Metal-Metal/efeitos adversos , Metais/efeitos adversos , Falha de Prótese , Adulto , Idoso , Artrite Reumatoide/cirurgia , Artroplastia de Substituição do Cotovelo/efeitos adversos , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/efeitos adversos , Tratamentos com Preservação do Órgão/instrumentação , Osteoartrite/cirurgia , Satisfação do Paciente , Desenho de Prótese/efeitos adversos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
9.
J Med Case Rep ; 13(1): 255, 2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31420009

RESUMO

BACKGROUND: Penetrating neck and chest trauma is a very common entity in emergency medicine that usually requires surgical treatment. Our case report illustrates the case of a 27-year-old Arabian man with hemopneumothorax associated with pneumomediastinum due to an unusual occupational injury. CASE PRESENTATION: A metal sliver, coming from an axe using for wood chopping, penetrated the neck of a 27-year-old Arabian man in the left supraclavicular region mimicking a gun bullet; the entrance hole was at the left pleural dome where the sliver had just penetrated the apex of the lung passing through the upper lobe of his left lung creating an exit wound in the dorsal segment of the same lobe arriving in the posterior thoracic wall. Biportal video-assisted thoracic surgery was performed to remove blood clots and the unusual foreign body.  CONCLUSION: In the literature, there are several case series about this topic, with some of them reporting unusual foreign bodies that lead to penetrating trauma. However, to the best of our knowledge, no cases like the one we have reported are described in the current literature.


Assuntos
Corpos Estranhos/cirurgia , Lesão Pulmonar/cirurgia , Lesões do Pescoço/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Ferimentos Penetrantes/cirurgia , Adulto , Corpos Estranhos/diagnóstico por imagem , Hemopneumotórax/etiologia , Humanos , Masculino , Metais/efeitos adversos , Traumatismos Ocupacionais/cirurgia , Ferimentos Penetrantes/diagnóstico por imagem
10.
PLoS One ; 14(8): e0221692, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31442288

RESUMO

Metal implants not only deteriorate image quality, but also increase radiation exposure. The purpose of this study was to evaluate the effect of metal hip prosthesis on absorbed radiation dose and assess the efficacy of organ dose modulation (ODM) and metal artifact reduction (MAR) protocols on dose reduction. An anthropomorphic phantom was scanned with and without bilateral metal hip prostheses, and surface and deep level radiation doses were measured at the abdomen and pelvis. Finally, the absorbed radiation doses at pelvic and abdominal cavities in the reference, ODM, and two MAR scans (Gemstone spectral imaging, GE) were compared. The Mann Whitney-U test and Kruskal-Wallis test were performed to compare the volume CT dose index (CTDIvol) and mean absorbed radiation doses. Unilateral and bilateral metal hip prostheses increased CTDIVOL by 14.4% and 30.5%, respectively. MAR protocols decreased absorbed radiation doses in the pelvis. MAR showed the most significant dose reduction in the deep pelvic cavity followed by ODM. However, MAR protocols increased absorbed radiation doses in the upper abdomen. ODM significantly reduced absorbed radiation in the pelvis and abdomen. In conclusion, metal hip implants increased radiation doses in abdominopelvic CT scans. MAR and ODM techniques reduced absorbed radiation dose in abdominopelvic CT scans with metal hip prostheses.


Assuntos
Prótese de Quadril , Metais/efeitos adversos , Exposição à Radiação , Tomografia Computadorizada por Raios X , Absorção de Radiação , Artefatos , Humanos , Especificidade de Órgãos/efeitos da radiação , Doses de Radiação
11.
Biomed Res Int ; 2019: 2519205, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360706

RESUMO

Dental implants are often made of titanium alloys. Implant therapy currently promises a good long-term result without impacting health; however, its success depends on many factors. In this article, the authors focus on the most common risk factors associated with metallic surgical implants. Titanium-induced hypersensitivity can lead to symptoms of implant rejection. Corrosion and biofilm formation are additional situations in which these symptoms may occur. For medical purposes, it is important to define and discuss the characteristics of metals used in implantable devices and to ensure their biocompatibility. To avoid hypersensitivity reactions to metallic dental implants, precautionary principles for primary prevention should be established.


Assuntos
Materiais Biocompatíveis/efeitos adversos , Implantes Dentários/efeitos adversos , Metais/efeitos adversos , Materiais Biocompatíveis/uso terapêutico , Corrosão , Ligas Dentárias/efeitos adversos , Ligas Dentárias/uso terapêutico , Humanos , Metais/uso terapêutico , Fatores de Risco , Titânio/efeitos adversos , Titânio/uso terapêutico
12.
Methods Mol Biol ; 2011: 133-142, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31273698

RESUMO

Well-functioning of fundamental life processes and human body required metal elements especially essential elements like copper, zinc, magnesium, etc. However, other elements are very toxic for physiological functions including lead (Pb) and cadmium (Cd). Recently, cumulative investigations have interested in the role of metal elements in neurodegenerative diseases and psychiatric disorders especially anxiety and depression. Models of intoxication have been established to evaluate the neurobehavioral effects of metal element exposure via acute and chronic intoxication by metals levels in rats. This method makes available a means to recognize the association between the element level in water, diet, or serum and psychiatric dysfunctions. It allows also to assess the neurobehavioral injuries of metals in animal models and may provide a new window to understand the role metals play in the development of mood and psychiatric disorders.the role metals play in the development of mood and psychiatric disorders.


Assuntos
Transtornos Mentais/etiologia , Metais/efeitos adversos , Doenças do Sistema Nervoso/etiologia , Oligoelementos/efeitos adversos , Doença Aguda , Animais , Comportamento Animal , Biomarcadores , Cádmio , Doença Crônica , Cobre/efeitos adversos , Cobre/metabolismo , Modelos Animais de Doenças , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/metabolismo , Transtornos Mentais/psicologia , Metais/metabolismo , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/metabolismo , Doenças do Sistema Nervoso/fisiopatologia , Fenótipo , Ratos , Avaliação de Sintomas , Oligoelementos/metabolismo , Zinco/efeitos adversos , Zinco/metabolismo
14.
Knee ; 26(4): 941-950, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255527

RESUMO

Aseptic loosening and wear is second to only infection as the most common cause of arthroplasty failure. Degeneration of the polyethylene and metal arthroplasty components can lead to metallosis, which can cause a combination of direct cytotoxic effects and an inflammatory response within the synovial and periarticular tissues. This can result in bone resorption and secondary arthroplasty component loosening as well as a metal containing joint effusion and metal-induced synovitis. Little literature exists as to the ultrasonographic findings of metal-induced synovitis and polyethylene component displacement. As the use of musculoskeletal ultrasound significantly increases, being aware of these findings is important. The most important ultrasonographic findings include differentiating a joint effusion from synovitis utilizing dynamic compression, identifying areas of echogenic shadowing related to metal deposition and visualizing displaced arthroplasty components. The following is a case report that demonstrates the ultrasonographic imaging findings of metallosis, metal-induced synovitis and polyethylene component displacement. We will also demonstrate the ultrasound-guided aspiration findings as well as radiographic and gross pathologic correlations.


Assuntos
Articulação do Joelho/diagnóstico por imagem , Prótese do Joelho/efeitos adversos , Metais/efeitos adversos , Falha de Prótese , Sinovite/etiologia , Artroplastia do Joelho/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Polietileno , Radiografia , Ultrassonografia
15.
Environ Int ; 131: 104985, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31319292

RESUMO

BACKGROUND: Production of crystal glass and colored art glassware have been going on in the south-eastern part of Sweden since the 1700s, at over 100 glassworks and smaller glass blowing facilities, resulting in environmental contamination with mainly arsenic (As), cadmium (Cd), lead (Pb) and polycyclic hydrocarbons (PAH). High levels of metals have been found in soil, and moderately elevated levels in vegetables, mushrooms and berries collected around the glassworks sites compared with reference areas. Food in general, is the major exposure source to metals, such as Cd and Pb, and PAHs. Exposure to these toxic metals and PAH has been associated with a variety of adverse health effects in humans including cancer. OBJECTIVE: The aim of the present study was to evaluate the occurrence of cancer in a cohort from the contaminated glasswork area in relation to long-term dietary intake of locally produced foods, while taking into account residential, occupational and life styles factors. METHODS: The study population was extracted from a population cohort of 34,266 individuals who, at some time between the years 1979-2004, lived within a 2 km radius of a glassworks or glass landfill. Register information on cancer incidence and questionnaire information on consumption of local foods (reflecting 30 years general eating habits), life-time residence in the area, life style factors and occupational exposure was collected. Furthermore, blood (n = 660) and urine (n = 400) samples were collected in a subsample of the population to explore associations between local food consumption frequencies, biomarker concentrations in blood (Cd, Pb, As) and urine (PAH metabolite 1-OHPy) as well as environmental and lifestyle factors. The concurrent exposure to persistent organic pollutants (POPs) from food was also considered. A case-control study was performed for evaluation of associations between intakes of local food and risk of cancer. RESULTS: Despite high environmental levels of Cd, Pb and As at glasswork sites and landfills, current metal exposure in the population living in the surrounding areas was similar or only moderately higher in our study population compared to the general population. Reported high consumption of certain local foods was associated with higher Cd and Pb, but not As, concentrations in blood, and 1-OHPy in urine. An increased risk of cancer was associated with smoking, family history of cancer, obesity, and residence in glasswork area before age 5 years. Also, a long-term high consumption of local foods (reflecting 30 years general eating habits), i.e. fish and meat (game, chicken, lamb), was associated with increased risk of various cancer forms. CONCLUSIONS: The associations between consumption of local food and different types of cancer may reflect a higher contaminant exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than before. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.


Assuntos
Dieta , Exposição Ambiental/efeitos adversos , Resíduos Industriais/efeitos adversos , Metais/efeitos adversos , Neoplasias/epidemiologia , Hidrocarbonetos Policíclicos Aromáticos/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Vidro , Humanos , Incidência , Masculino , Indústria Manufatureira , Pessoa de Meia-Idade , Neoplasias/induzido quimicamente , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
16.
BMC Musculoskelet Disord ; 20(1): 332, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315587

RESUMO

BACKGROUND: Head breakage is a serious complication following total hip arthroplasty when using Ceramic on Ceramic bearings surfaces. There is still in controversy about the selection of bearing surfaces when conducting revision surgery. CASE PRESENTATION: We describe the case of a fifty-year-old man who had undergone right total hip arthroplasty (THA) with ceramic-on-ceramic prostheses in 2011. After a fall 6 years after the primary procedures, radiographs suggested a ceramic head breakage for revision THA with exchange of metal-on-polyethylene bearing. However, 8 months later, severe metallosis and multiple pseudotumor was confirmed in pelvis and surrounding hip after re-revision THA with ceramic-on-polyethylene prostheses. Analysis of the serum metal ion indicated massive wear of the metal head and erosion of the stem neck and taper. CONCLUSIONS: This case vividly demonstrates metal bearings should be avoided and revision with complete synovectomy and thorough debridement should be performed whenever possible for a fractured ceramic bearing.


Assuntos
Artroplastia de Quadril/efeitos adversos , Prótese de Quadril/efeitos adversos , Falha de Prótese/efeitos adversos , Reoperação/efeitos adversos , Artroplastia de Quadril/instrumentação , Cerâmica/efeitos adversos , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Articulação do Quadril/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/patologia , Cintilografia , Reoperação/instrumentação , Fatores de Risco , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Chemosphere ; 236: 124332, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31323547

RESUMO

In previous studies, we have shown that copper (Cu) is significantly accumulated in various tissues of killifish Poecilia vivipara following chronic exposure. Also, we showed that chronic metal exposure disrupted energy production and growth in this species. In the present study, we aimed to evaluate if chronic exposure to this metal could also affect reproductive parameters of P. vivipara males (sperm quality). In order to test that, newborn (<24 h-old) fish were exposed to two concentrations of waterborne Cu (5 and 9 µg/L) for 345 days. After exposure, fish were euthanized and the testes were collected for sperm analysis. We could observe that exposed animals had reduced sperm motility and period of motility. Also, the sperm of exposed fish had reduced plasma membrane integrity, mitochondrial functionality and DNA integrity when compared to sperm of control animals. It is suggested that the well-known association of Cu with elevated oxidative damage, endocrine disruption and energetic disturbance are involved with the observed outcomes. The results obtained in the present study show that chronic exposure to environmentally relevant concentrations of waterborne Cu caused reductions in all parameters used to evaluate sperm quality. Therefore, it is concluded that life-time exposure to this metal may disrupt fish reproduction and negatively affect the maintenance of its populations.


Assuntos
Cobre/efeitos adversos , Cobre/química , Fundulidae/crescimento & desenvolvimento , Metais/efeitos adversos , Motilidade Espermática/imunologia , Poluentes Químicos da Água/efeitos adversos , Poluentes Químicos da Água/química , Animais , Humanos , Masculino , Metais/química
18.
J Orthop Surg Res ; 14(1): 182, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208448

RESUMO

BACKGROUND: Metal sensitivity as a cause for painful joint replacement has become increasingly prevalent; however, there is a lack of reported clinical outcome data from total knee arthroplasty patients with metal allergies. The purpose of this study was to determine whether patients presenting with a painful total knee arthroplasty with a positive metal sensitivity have improved outcomes following revision to a hypoallergenic implant. METHODS: A retrospective review was conducted for patients that underwent a revision total knee arthroplasty after metal sensitivity testing over a 3-year period from January 1, 2015, to December 31, 2017. Based on the results of sensitivity testing, patients underwent revision total knee arthroplasty to a hypoallergenic component or a standard component. Following revision, patients returned to the clinic at an interval of 6 weeks, 5 months, and 12 months for functional, pain, and satisfaction assessment. Outcomes were compared within and between sensitivity groups. RESULTS: Of the included patients, 78.3% (39/46) were positive for metal sensitivity. The most common metal sensitivity was to nickel (79.5%, 32/39). Both non-reactive and reactive patients significantly improved in range of motion after revision arthroplasty. The reactive group saw a 37.8% decrease in pain at 6 weeks post-revision (p < 0.001) Whereas, the non-reactive group only saw a moderate, non-significant improvement in pain reduction at 6 weeks post-revision (27.0%; p = 0.29). Frequency of pain experienced did not vary significantly between groups. Maximum metal lymphocyte transformation test (LTT) sensitivity score did not correlate with pain level at the time of revision (R2 = 0.02, p = 0.38) or percent improvement after revision (R2 = 0.001, p = 0.81). Overall, all patients reported being very satisfied after revision total knee arthroplasty; there was no difference between positive and negative sensitivity groups (W = 62, p = 0.89). CONCLUSIONS: Patients presenting with a painful knee arthroplasty and positive metal LTT have improved pain scores, walking function, and range of motion following revision to a hypoallergenic component. This study also provides a treatment algorithm for patients presenting with a painful knee replacement, in order to provide effective and timely diagnosis and management.


Assuntos
Artroplastia do Joelho/efeitos adversos , Hipersensibilidade/complicações , Prótese do Joelho/efeitos adversos , Metais/efeitos adversos , Reoperação , Artroplastia do Joelho/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
19.
BMC Musculoskelet Disord ; 20(1): 195, 2019 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-31054584

RESUMO

BACKGROUND: Adverse Reaction to Metal Debris (ARMD) is a major reason for revision surgeries in patients with metal-on-metal (MoM) hip replacements. Most failures are related to excessively wearing implant producing harmful metal debris (extrinsic factor). As ARMD may also occur in patients with low-wearing implants, it has been suggested that there are differences in host-specific intrinsic factors contributing to the development of ARMD. However, there are no studies that have directly assessed whether the development of ARMD is actually affected by these intrinsic factors. METHODS: We included all 29 patients (out of 33 patients) with sufficient data who had undergone bilateral revision of ASR MoM hips (58 hips) at our institution. Samples of the inflamed synovia and/or pseudotumour were obtained perioperatively and sent to histopathological analysis. Total wear volumes of the implants were assessed. Patients underwent MARS-MRI imaging of the hips preoperatively. Histological findings, imaging findings and total wear volumes between the hips of each patient were compared. RESULTS: The difference in wear volume between the hips was clinically and statistically significant (median difference 15.35 mm3, range 1 to 39 mm3, IQR 6 to 23 mm3) (p < 0.001). The median ratio of total wear volume between the hips was 2.0 (range 1.09 to 10.0, IQR 1.67 to 3.72). In majority of the histological features and in presence of pseudotumour, there were no differences between the left and right hip of each patient (p > 0.05 for all comparisons). These features included macrophage sheet thickness, perivascular lymphocyte cuff thickness, presence of plasma cells, presence of diffuse lymphocytic infiltration and presence of germinal centers. CONCLUSIONS: Despite the significantly differing amounts of wear (extrinsic factor) seen between the sides, majority of the histological findings were similar in both hips and the presence of pseudotumour was symmetrical in most hips. As a direct consequence, it follows that there must be intrinsic factors which contribute to the symmetry of the findings, ie. the pathogenesis of ARMD, on individual level. This has been hypothesized in the literature but no studies have been conducted to confirm the hypothesis. Further, as the threshold of metal debris needed to develop ARMD appears to be largely variable based on the previous literature, it is likely that there are between-patient differences in these intrinsic factors, ie. the host response to metal debris is individual.


Assuntos
Artroplastia de Quadril/instrumentação , Reação a Corpo Estranho/imunologia , Prótese de Quadril/efeitos adversos , Próteses Articulares Metal-Metal/efeitos adversos , Metais/imunologia , Falha de Prótese/etiologia , Idoso , Artroplastia de Quadril/efeitos adversos , Feminino , Reação a Corpo Estranho/induzido quimicamente , Reação a Corpo Estranho/patologia , Reação a Corpo Estranho/cirurgia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Articulação do Quadril/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Metais/efeitos adversos , Pessoa de Meia-Idade , Reoperação/estatística & dados numéricos
20.
Environ Geochem Health ; 41(6): 2473-2489, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31037580

RESUMO

This case study was performed to determine whether the pollutants in water of urban park could bring health risk to human engaging in water-related activities such as swimming and provide evidence demonstrating the critical need for strengthened recreational water resources management of urban park. TN, NH4+-N, TP, Cu, Mn, Zn, Se, Pb, As, Cd and Cr(VI) contents were determined to describe the spatial distribution of contaminations; sources apportionment with the method of correlation analysis, factor analysis and cluster analysis were followed by health risk assessment for swimmers of different age groups. The results reveal that element contents in all sites do not exceed Chinese standard for swimming area and European Commission standard for surface water; all detected elements except Cr(VI) have a tendency to accumulate in the location of lake crossing bridge; Mn and Zn are considered to have the same pollution source including geogenic and anthropogenic sources by multivariable analysis. Carcinogenic risks of different age groups descend in the same order with non-carcinogenic risks. Among all elements, Zn and Mn contribute the lowest non-carcinogenic risk (5.1940E-06) and the highest non-carcinogenic risk (7.9921E-04) through skin contact pathway, respectively. The total average personal risk for swimmers in swimming area is 1.9693E-03, and this site is not suitable for swimming. Overall, it is possible that swimmers are exposed to risk via the dermal route when carrying out water-related activities, it is recommended that necessary precautions and management should be taken in other similar locations around the world.


Assuntos
Exposição Ambiental/análise , Metais/análise , Parques Recreativos , Poluentes Químicos da Água/análise , Adolescente , Amônia/análise , Carcinógenos/toxicidade , Criança , Pré-Escolar , China , Cidades , Exposição Ambiental/efeitos adversos , Monitoramento Ambiental , Humanos , Lactente , Recém-Nascido , Lagos , Metais/efeitos adversos , Nitrogênio/análise , Medição de Risco , Natação
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA