1
|
Jaenisch M, Wirtz DC. Titanium - a Cementable Material for Endoarthroplasty. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024; 162:296-302. [PMID: 36720242 DOI: 10.1055/a-1975-0687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
As materials for arthroplasty, titanium alloys exhibit the following advantages over conventional steel, cobalt chromium or chromium nickel alloys - good fatigue strength, excellent biocompatibility, low modulus of elasticity, and high corrosion resistance. The previous worse clinical outcome was most likely caused by crevice corrosion and led to reduced use. To warrant safe use, the design should be optimised (sufficient proximal diameter, proximal collar), in order to reduce unwanted deformation in the proximal part of the prosthesis. Additionally, a rough surface (Ra > 2.5 µm) should not be used. Further research in surface treatments (e. g. silicate-silane) could facilitate additional improvement.
Collapse
Affiliation(s)
- Max Jaenisch
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Dieter Christian Wirtz
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland
| |
Collapse
|
2
|
Leiter V. Signs and symptoms: Adverse events associated with a sterilization device. Soc Sci Med 2024; 351:116963. [PMID: 38759388 DOI: 10.1016/j.socscimed.2024.116963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/26/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
Sterilization is now the most common contraceptive method used by women of in the U.S., and sterilization devices have played an important role in its increased popularity. This mixed methods study examines a random sample of 2500 U.S. Food and Drug Administration (FDA) adverse event reports made between 2006 and 2017 about Essure, a sterilization device. Quantitative coding was used to examine patient problems; pain and bleeding were reported most frequently. Qualitative coding analyzed impacts of symptoms on patients' everyday lives and patients' healthcare experiences, including intimate relationships, mothering, and paid employment. Findings suggest that some patients struggled when their reported "subjective" symptoms didn't result in "objective" clinical signs of problems, and when physicians dismissed or deflected their concerns in diagnostic encounters. This paper raises important issues regarding the symptoms patients associated with Essure, the diagnosis of device-driven disease and injury, and the FDA's regulation of medical devices.
Collapse
Affiliation(s)
- Valerie Leiter
- Department of Public Health, Simmons University, 300 The Fenway, Boston, MA, 02115, USA.
| |
Collapse
|
3
|
Apiamu A, Avwioroko OJ, Evuen UF, Kadiri HE, Kpomah ED, Anigboro AA, Ugbebor G, Asagba SO. Exposure to Nickel-Cadmium Contamination of Drinking Water Culminates in Liver Cirrhosis, Renal Azotemia, and Metabolic Stress in Rats. Biol Trace Elem Res 2024; 202:1628-1643. [PMID: 37468716 DOI: 10.1007/s12011-023-03777-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
Drinking water polluted by heavy metals has the potential to expose delicate biological systems to a range of health issues. This study embraced the health risks that may arise from subchronic exposure of thirty-four male Wistar rats to nickel (Ni)-cadmium (Cd)-contaminated water. It was done by using the Box-Behnken design (BBD) with three treatment factors (Ni and Cd doses at 50-150 mg/L and exposure at 14-21-28 days) at a single alpha level, resulting in seventeen experimental combinations. Responses such as serum creatinine (CREA) level, blood urea nitrogen (BUN) level, BUN/CREA ratio (BCR), aspartate and alanine aminotransferases (AST and ALT) activities, and the De Ritis ratio (DRR), as well as malondialdehyde (MDA) level, catalase (CAT), and superoxide dismutase (SOD) activities, were evaluated. The results revealed that these pollutants jointly caused hepatocellular damage by raising AST and ALT activities and renal dysfunction by increasing CREA and BUN levels in Wistar rats' sera (p < 0.05). These outcomes were further supported by BCR and DRR values beyond 1. In rats' hepatocytes and renal tissues, synergistic interactions of these metals resulted in higher MDA levels and significant impairments of CAT and SOD activities (p < 0.05). In order to accurately forecast the effects on the responses, the study generated seven acceptable regression models (p < 0.05) with r-squared values of > 80% at no discernible lack of fit (p > 0.05). The findings hereby demonstrated that Wistar rats exposed to these pollutants at varied doses had increased risks of developing liver cirrhosis and azotemia marked by metabolic stress.
Collapse
Affiliation(s)
- Augustine Apiamu
- Department of Biochemistry, Faculty of Science, Delta State University, Abraka, Delta State, Nigeria.
| | - Oghenetega J Avwioroko
- Department of Biochemistry, Faculty of Basic Medical Sciences, Redeemer's University, Ede, Osun State, Nigeria
| | - Uduenevwo F Evuen
- Department of Biochemistry, College of Natural and Applied Sciences, Western Delta University, Oghara, Delta State, Nigeria
| | - Helen E Kadiri
- Department of Biochemistry, Faculty of Science, Delta State University, Abraka, Delta State, Nigeria
| | - Enyohwo D Kpomah
- Department of Biochemistry, Federal University, Otuoke, Bayelsa State, Nigeria
| | - Akpovwehwee A Anigboro
- Department of Biochemistry, Faculty of Science, Delta State University, Abraka, Delta State, Nigeria
| | - Gilbert Ugbebor
- Department of Chemical Science, Faculty of Science, University of Delta, Agbor, Delta State, Nigeria
| | - Samuel O Asagba
- Department of Biochemistry, Faculty of Science, Delta State University, Abraka, Delta State, Nigeria
| |
Collapse
|
4
|
Murali N, Gupta R, Desai KR. The role of iliac vein stent placement in pelvic venous disorder management. J Vasc Surg Venous Lymphat Disord 2024; 12:101696. [PMID: 37977520 DOI: 10.1016/j.jvsv.2023.101696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
Pelvic venous disease (PeVD) has historically been challenging to diagnose and treat. This paper describes a comprehensive approach to the diagnosis of PeVD and reviews the role of iliac vein stent placement in treatment. Patient selection is vital for non-thrombotic iliac vein lesions (NIVLs) as only a small subset of patients with an NIVL will benefit from stent placement. There is limited, inconclusive data on optimal treatment for patients with both primary ovarian vein reflux and an NIVL. Patients with chronic post-thrombotic outflow obstruction typically have a more favorable risk/benefit ratio for intervention but require anticoagulation and close follow-up due to poorer long-term stent patency. Intravascular ultrasound is a useful tool for identifying obstructive lesions, sizing stents, and planning landing zones. More research is needed to characterize underlying pathophysiology, validate thresholds for intervention, develop reliable methods for outcomes assessment, and determine treatment response. Until this data is produced, an individualized treatment approach is warranted.
Collapse
Affiliation(s)
- Nikitha Murali
- Section of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, IL
| | - Ramona Gupta
- Section of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, IL
| | - Kush R Desai
- Section of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, IL.
| |
Collapse
|
5
|
Vaishnav D, Essibayi MA, Toma A, Liriano G, Perkash RS, Stock A, Holland R, Dmytriw AA, Wolfe SQ, Al Kasab S, Spiotta A, Haranhalli N, Altschul DJ. Metal allergy and neurovascular stenting: A systematic review. Interv Neuroradiol 2024:15910199231226283. [PMID: 38225179 DOI: 10.1177/15910199231226283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Intracranial stents and flow diverters contain significant amounts of metals, notably nickel, which can cause allergic reactions in a considerable portion of the population. These allergic responses may lead to complications like in-stent stenosis (ISS) and TIA/Stroke in patients receiving stents or flow diverters for intracranial aneurysms. METHODS We conducted a systematic review of studies from inception until July 2023, which reported outcomes of patients with metal allergy undergoing neurovascular stenting. The skin patch test was used to group patients into those with positive, negative, or absent patch test results but with a known history of metal allergy. RESULTS Our review included seven studies with a total of 39 patients. Among them, 87% had a history of metal allergy before treatment. Most aneurysms (89%) were in the anterior circulation and the rest (11%) were in the posterior circulation. Skin patch tests were performed in 59% of patients, with 24% showing positive results and 33% negative. Incidental ISS was observed in 18% of patients, and the rate of TIA/Stroke was reported in 21%. The pooled rates of ISS and TIA/Stroke were higher in the first group (43% and 38%) compared to the second (18% and 9%) and third groups (15% and 15%), but these differences were not statistically significant. CONCLUSIONS The current neurosurgical literature does not provide a conclusive association between metal allergy and increased complications among patients undergoing neurovascular stenting. Further studies are necessary to gain a more comprehensive understanding of this topic.
Collapse
Affiliation(s)
- Dhrumil Vaishnav
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Muhammed Amir Essibayi
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Aureliana Toma
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Genesis Liriano
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Raja Sandeep Perkash
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ariel Stock
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ryan Holland
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adam A Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Stacey Q Wolfe
- Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sami Al Kasab
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Alejandro Spiotta
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Neil Haranhalli
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David J Altschul
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
6
|
Kageyama Y, Aida K, Nishizaki Y, Ebisui T, Akiyama T, Nakamura T. Increased prevalence of zinc hypersensitivity in patients with primary Sjögren syndrome: A case-control study. Int J Rheum Dis 2024; 27:e14861. [PMID: 37574907 DOI: 10.1111/1756-185x.14861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Yasunari Kageyama
- Takanawa Clinic, Minato-ku, Tokyo, Japan
- Tokai University Hospital, Isehara-shi, Japan
| | | | - Yasuhiro Nishizaki
- Tokai University Hospital, Isehara-shi, Japan
- Department of Clinical Health Science, Tokai University Tokyo Hospital, Tokai University School of Medicine, Shibuya-ku, Tokyo, Japan
| | | | - Tetsu Akiyama
- Laboratory of Molecular and Genetic Information, Institute for Quantitative Biosciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- The Social Cooperation Program of Cellular Dynamics, Institute for Quantitative Biosciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | |
Collapse
|
7
|
Tidd JL, Gudapati LS, Simmons HL, Klika AK, Pasqualini I, Piuzzi NS. Do Patients With Hypoallergenic Total Knee Arthroplasty Implants for Metal Allergy Do Worse? An Analysis of Health Care Utilizations and Patient-Reported Outcome Measures. J Arthroplasty 2024; 39:103-110. [PMID: 37454947 DOI: 10.1016/j.arth.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/02/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Metal allergy is a rare and controversial cause of implant failure and poor outcomes following total knee arthroplasty (TKA). Few studies have investigated clinical and patient-reported outcome measures (PROMs) in patients treated with hypoallergenic implants. This investigation aimed to compare: (1) health care utilizations (eg, hospital length of stay, 90-day readmission rate, and incidence of nonhome discharge) and (2) 1-year PROMs between patients who received hypoallergenic and standard TKA implants. METHODS This was a retrospective review of prospectively collected data from patients who underwent primary TKA between 2018 and 2019. Propensity score matching (3:1) was used to compare standard TKA patients with those who received hypoallergenic TKA implants, respectively. Knee injury and Osteoarthritis Outcome Score (KOOS) pain, KOOS Physical function Shortform (PS), and Veterans RAND 12-Item Health Survey Mental Component Score were collected preoperatively and at 1-year. After matching, 190 hypoallergenic and 570 standard TKAs were analyzed. RESULTS No differences were observed in length of stay (P = .98), 90-day readmission (P = .89), and nonhome discharge (P = .82). Additionally, there was no significant difference in change from preoperative to 1-year PROMs (KOOS pain, P = .97; KOOS PS, P = .88; Veterans RAND 12-Item Health Survey Mental Component Score, P = .28). Patient-reported satisfaction was similar at 1-year (P = .23). Patients achieved similar rates of Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for KOOS pain (PASS, P = .77; MCID, P = .33) and KOOS PS (PASS, P = .44; MCID, P = .65). CONCLUSION Patients treated with hypoallergenic TKA implants for suspected metal allergy had similar outcomes compared to patients who had standard implants and no metal allergy.
Collapse
Affiliation(s)
- Joshua L Tidd
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | | | - Hannah L Simmons
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Alison K Klika
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
8
|
Tille E, Beyer F, Lützner C, Postler A, Thomas P, Summer B, Lützner J. No difference in patient reported outcome and inflammatory response after coated and uncoated total knee arthroplasty - a randomized controlled study. BMC Musculoskelet Disord 2023; 24:968. [PMID: 38098024 PMCID: PMC10720193 DOI: 10.1186/s12891-023-07061-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Allergies against implant materials are still not fully understood. Despite controversies about its relevance, some patients need treatment with hypoallergenic implants. This study compared coated and standard total knee arthroplasty (TKA) regarding inflammatory response and patient-reported outcome measures (PROMs). METHODS 76 patients without self-reported allergies against implant materials were included in a RCT and received a coated or standard TKA of the same cemented posterior-stabilized knee system. 73 patients completed the 3-year follow-up. Two patients died and there was one revision surgery. Serum levels of cytokines with a possible role in implant allergy were measured in patient`s serum (IL-1beta, IL-5, IL-6, IL-8, IL-10, IFN γ, TNF α) prior to, one and three years after surgery. Furthermore, PROMs including knee function (Oxford Knee Score, Knee Society Score) and health-related quality of life (QoL, EuroQuol questionnaire) were assessed. Additionally, 8 patients with patch-test proven skin allergy against implant materials who received the coated implant were assessed similarly and compared to a matched-pair group receiving the same implant. RESULTS There were no differences in function and QoL between the assessed groups at any follow-up. The majority of patients demonstrated no elevation of the measured blood cytokines. Cytokine patterns showed no differences between study groups at any follow-up. The allergy patients demonstrated slower functional improvement and minor differences in cytokine pattern. Yet these results were not significant. There were no differences in the matched-pair analysis. CONCLUSION We observed no relevant increase in serum cytokine levels in any group. The inflammatory response measured seems limited, even in allergy patients. Furthermore, there were no differences between coated and standard TKA in non-allergy patients in the 3-year Follow-Up period. TRIAL REGISTRATION The study protocol was registered in the US National Institutes of Health's database ( http://www. CLINICALTRIALS gov ) registry under NCT03424174 on 03/17/2016.
Collapse
Affiliation(s)
- Eric Tille
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherst. 74, 01307, Dresden, Germany.
| | - Franziska Beyer
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherst. 74, 01307, Dresden, Germany
| | - Cornelia Lützner
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherst. 74, 01307, Dresden, Germany
| | - Anne Postler
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherst. 74, 01307, Dresden, Germany
| | - Peter Thomas
- Department of Dermatology und Allergology, Ludwig-Maximilians-University, Munich, Germany
| | - Burkhard Summer
- Department of Dermatology und Allergology, Ludwig-Maximilians-University, Munich, Germany
| | - Jörg Lützner
- University Center of Orthopaedic, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, TU Dresden, Fetscherst. 74, 01307, Dresden, Germany
| |
Collapse
|
9
|
Schuler L, Zust D, Dahm G, Clabots F. Nickel in foodstuffs available on the Luxembourgish market and dietary intake. FOOD ADDITIVES & CONTAMINANTS. PART B, SURVEILLANCE 2023; 16:350-360. [PMID: 37691281 DOI: 10.1080/19393210.2023.2249434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/15/2023] [Indexed: 09/12/2023]
Abstract
Nickel is a food contaminant of natural or anthropogenic origin. Monitoring of contaminants in food in general allows obtaining an overview on the presence of substances that are undesirable to health. The aim of this study was to analyse nickel content in food of non-animal origin and beverages sold in Luxembourg to determine the exposure of the population to this contaminant. In total, 660 samples were analysed in the timeframe from 2017 to 2021. The results demonstrate high concentrations of nickel in cashew nuts, walnuts, hemp and sunflower seeds, dried peas, oregano, and cocoa powder. Surveillance of contaminants in food allows identifying contributors to the chronic and acute exposure of nickel in order to potentially set official maximum levels in European legislation in the future, allowing for better enforcement actions in case of contaminated products and increasing consumer protection.
Collapse
Affiliation(s)
- Luc Schuler
- Ministry of Agriculture, Viticulture and Rural Development, Luxembourg Veterinary and Food Administration, Strassen, Grand Duchy of Luxembourg
| | - Danny Zust
- Ministry of Agriculture, Viticulture and Rural Development, Luxembourg Veterinary and Food Administration, Strassen, Grand Duchy of Luxembourg
| | - Georges Dahm
- Laboratoire National de Sante, Department of Forensic Medecine, Dudelange, Grand Duchy of Luxembourg
| | - Fabienne Clabots
- Ministry of Agriculture, Viticulture and Rural Development, Luxembourg Veterinary and Food Administration, Strassen, Grand Duchy of Luxembourg
| |
Collapse
|
10
|
Murthy MK, Khandayataray P, Padhiary S, Samal D. A review on chromium health hazards and molecular mechanism of chromium bioremediation. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:461-478. [PMID: 35537040 DOI: 10.1515/reveh-2021-0139] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/19/2022] [Indexed: 05/13/2023]
Abstract
Living beings have been devastated by environmental pollution, which has reached its peak. The disastrous pollution of the environment is in large part due to industrial wastes containing toxic pollutants. The widespread use of chromium (Cr (III)/Cr (VI)) in industries, especially tanneries, makes it one of the most dangerous environmental pollutants. Chromium pollution is widespread due to ineffective treatment methods. Bioremediation of chromium (Cr) using bacteria is very thoughtful due to its eco-friendly and cost-effective outcome. In order to counter chromium toxicity, bacteria have numerous mechanisms, such as the ability to absorb, reduce, efflux, or accumulate the metal. In this review article, we focused on chromium toxicity on human and environmental health as well as its bioremediation mechanism.
Collapse
Affiliation(s)
| | | | - Samprit Padhiary
- Department of Biotechnology, Academy of Management and Information Technology, Khordha, India
| | - Dibyaranjan Samal
- Department of Biotechnology, Academy of Management and Information Technology, Khordha, India
| |
Collapse
|
11
|
Baranoski JF, Catapano JS, Rutledge C, Cole TS, Majmundar N, Winkler EA, Srinivasan VM, Jadhav AP, Ducruet AF, Albuquerque FC. Endovascular Treatment of Cerebrovascular Lesions Using Nickel- or Nitinol-Containing Devices in Patients with Nickel Allergies. AJNR Am J Neuroradiol 2023; 44:939-942. [PMID: 37474263 PMCID: PMC10411833 DOI: 10.3174/ajnr.a7936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/11/2023] [Indexed: 07/22/2023]
Abstract
Nickel is used in many cerebral endovascular treatment devices. However, nickel hypersensitivity is the most common metal allergy, and the relative risk of treatment in these patients is unknown. This retrospective analysis identified patients with nickel or metal allergies who underwent cerebral endovascular treatment with nickel-containing devices. Seven patients with nickel and/or other metal allergies underwent treatment with 9 nickel-containing devices. None experienced periprocedural complications. No patient received treatment with corticosteroids or antihistamines. At a mean clinical follow-up for all patients of 22.8 months (range, 10.5-38.0 months), no patients had symptoms attributable to nickel allergic reactions. The mean radiographic follow-up for all patients at 18.4 months (range, 2.5-37.5 months) showed successful treatment of the targeted vascular pathologies, with no evidence of in-stent stenosis or other allergic or hypersensitivity sequelae. The treatment of cerebrovascular lesions with a nickel-containing device resulted in no adverse outcomes among these patients and was safe and effective.
Collapse
Affiliation(s)
- J F Baranoski
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - J S Catapano
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - C Rutledge
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - T S Cole
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - N Majmundar
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - E A Winkler
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - V M Srinivasan
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - A P Jadhav
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - A F Ducruet
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - F C Albuquerque
- From the Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| |
Collapse
|
12
|
Hua Z, Hu M, Chen Y, Huang X, Gao L. Investigation of the Friction Properties of a New Artificial Imitation Cartilage Material: PHEMA/Glycerol Gel. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114023. [PMID: 37297157 DOI: 10.3390/ma16114023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
The absence of artificial articular cartilage could cause the failure of artificial joints due to excessive material wear. There has been limited research on alternative materials for articular cartilage in joint prostheses, with few reducing the friction coefficient of artificial cartilage prostheses to the range of the natural cartilage friction coefficient (0.001-0.03). This work aimed to obtain and characterize mechanically and tribologically a new gel for potential application in articular replacement. Therefore, poly(hydroxyethyl methacrylate) (PHEMA)/glycerol synthetic gel was developed as a new type of artificial joint cartilage with a low friction coefficient, especially in calf serum. This glycerol material was developed via mixing HEMA and glycerin at a mass ratio of 1:1. The mechanical properties were studied, and it was found that the hardness of the synthetic gel was close to that of natural cartilage. The tribological performance of the synthetic gel was investigated using a reciprocating ball-on-plate rig. The ball samples were made of a cobalt-chromium-molybdenum (Co-Cr-Mo) alloy, and the plates were synthetic glycerol gel and two additional materials for comparison, which were ultra-high molecular polyethylene (UHMWPE) and 316L stainless steel. It was found that synthetic gel exhibited the lowest friction coefficient in both calf serum (0.018) and deionized water (0.039) compared to the other two conventional materials for knee prostheses. The surface roughness of the gel was found to be 4-5 μm through morphological analysis of wear. This newly proposed material provided a possible solution as a type of cartilage composite coating with hardness and tribological performance close to the nature of use in wear couples with artificial joints.
Collapse
Affiliation(s)
- Zikai Hua
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Mindie Hu
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Yiwen Chen
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Xiuling Huang
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Leiming Gao
- Department of Engineering, Nottingham Trent University, Nottingham NG1 4FQ, UK
| |
Collapse
|
13
|
Siljander B, Chandi S, Debbi E, McLawhorn A, Sculco PK, Chalmers BP. A comparison of clinical outcomes after total knee arthroplasty (TKA) in patients with preoperative nickel allergy receiving Cobalt-Chromium (CoCr) or Nickel-Free Implant. J Arthroplasty 2023:S0883-5403(23)00403-5. [PMID: 37100098 DOI: 10.1016/j.arth.2023.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
INTRODUCTION The role of metal hypersensitivity reactions in total knee arthroplasty (TKA) failure is debated. There is no consensus on whether use of a more expensive nickel-free implant is indicated for patients who have pre-operative nickel allergy. The purpose of this study was to examine the outcome of patients who have pre-operative nickel allergy receiving nickel-free or cobalt chromium (CoCr) implants. METHODS This was a retrospective review of 17,798 patients who underwent 20,324 unilateral primary TKAs between 2016 and 2020. Presence of pre-operative nickel allergy was determined (n=282). Patients were divided into 2 cohorts: those receiving (1) nickel-free or (2) CoCr implants. Clinical outcome scores and revision rates were assessed. RESULTS 243 received a nickel-free implant and 39 received a CoCr implant. There was no significant difference in revision rate between the cohorts. Survivorship free of revision was 94% in the CoCr implant cohort and 98% in the nickel-free implant cohort (P=0.9). When comparing clinical outcome scores between cohorts, there was no difference in preoperative, 6-week or 1-year Knee Osteoarthritis Outcome Score Joint Replacement (KOOS JR.), Visual Analog Scale (VAS), Lower Extremity Activity Scale (LEAS), Patient-Reported Outcomes Measurement Information System (PROMIS), and Veterans RAND 12-item (VR12) scores between cohorts. CONCLUSIONS In this retrospective cohort study, there was no difference in revision rates or clinical outcomes in patients who had a nickel allergy undergoing primary TKA with CoCr or nickel-free implants. Further studies are needed to determine if nickel allergy is an independent risk factor for worse TKA outcomes in general.
Collapse
|
14
|
Khalaf EM, Taherian M, Almalki SG, Asban P, Kareem AK, Alhachami FR, Almulla AF, Romero-Parra RM, Jawhar ZH, Kiani F, Noroozi Manesh I, Mohammadi MJ. Relationship between exposure to heavy metals on the increased health risk and carcinogenicity of urinary tract (kidney and bladder). REVIEWS ON ENVIRONMENTAL HEALTH 2023:reveh-2022-0245. [PMID: 37076952 DOI: 10.1515/reveh-2022-0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
In today's society, with the continuous development of manufacturing industries and factories related to chemicals, the amount of heavy metals in the inhaled air of humans, water and even food consumption has increased dramatically. The aim of this study was investigation of relationship between exposure to heavy metals on the increased carcinogenicity risk of kidney and bladder. Databases used to for searched were the Springer, Google Scholar, Web of Science, Science Direct (Scopus) and PubMed. At the end after sieve we selected 20 papers. Identify all relevant studies published 2000-2021. The results of this study showed that exposure to heavy metals due to the bio accumulative properties of these metals can cause kidney and bladder abnormalities and provide the basis through various mechanisms for malignant tumors in these organs. Based on result this study, since a limited number of heavy metals including copper, iron, zinc and nickel in very small amounts as micronutrients play a very important role in the function of enzymes and the body cells biological reactions, but exposure to some of them like arsenic, lead, vanadium and mercury will cause irreversible effects on people's health and cause various diseases including cancers of the liver, pancreas, prostate, breast, kidney and bladder. The kidneys, ureter and bladder are the most important organs in the urinary tract on human. According to the result of this study, the duty of this urinary system is to remove toxins, chemicals and heavy metals from the blood, balance electrolytes, excrete excess fluid, produce urine and transfer it to the bladder. This mechanism causes the kidneys and bladder to be highly associated with these toxins and heavy metals, which can lead to various diseases in these two important organs. According to the finding the reducing exposure to heavy metals in various ways can prevent many diseases related to this system and reduce the incidence of kidney and bladder cancers.
Collapse
Affiliation(s)
- Eman M Khalaf
- Department of Pharmacy, Al Maarif University College, Ramadi, Anbar, Iraq
| | - Masoume Taherian
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sami G Almalki
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Parisa Asban
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - A K Kareem
- Biomedical Engineering Department, Al-Mustaqbal University College, Hillah, Iraq
| | - Firas Rahi Alhachami
- Radiology Department, College of Health and Medical Technololgy, Al-Ayen University, Thi-Qar, Iraq
| | - Abbas F Almulla
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | | | - Zanko Hassan Jawhar
- Department of Medical Laboratory Science, College of Health Sciences, Lebanese French University, Erbil, Kurdistan Region, Iraq
| | - Fatemeh Kiani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Iman Noroozi Manesh
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health and Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
15
|
Wu Q, Chen B, Yu X, Wang Z, Sun Z, Duan J, Ding H, Wu W, Bao N, Zhao J. Bone and Soft Tissue Reaction to Co(II)/Cr(III) Ions Stimulation in a Murine Calvaria Model: A Pioneering in vivo Study. Acta Biomater 2023; 164:659-670. [PMID: 37003495 DOI: 10.1016/j.actbio.2023.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/16/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023]
Abstract
Metal ions released during wear and corrosion of the artificial knee/hip joints are considered to contribute to aseptic implant failure. However, there are few convincing in vivo studies that demonstrate the effects of metal ions on bone and soft tissue. This study examined the in vivo effects of Co(II)/Cr(III) ions on mouse calvaria and the supra-calvaria soft tissue in an original mouse model. With the implantation of a helmet-like structure, we set up a subcutaneous cavity on the calvaria in which Co(II) Chloride or Cr(III) Chloride solutions were administered respectively. A layer of interface membrane formed on the calvaria along with the implantation of the helmet. The administered Cr(III) ions accumulated in the interface membranes while Co(II) disseminated into the circulation. Accumulated Cr(III) and related products induced local massive macrophage infiltration and skewed the bone metabolic balance. At last, we revealed that lymphocyte aggregates, which are the pathologic hallmark of human periprosthetic tissue, could be caused by either Co(II) or Cr(III) stimulation. These in vivo results may shed light on the effects and pathogenic mechanism of the Co(II)/Cr(III) ions released from the joint prosthesis. STATEMENT OF SIGNIFICANCE: Macrophage infiltration and lymphocyte aggregates are hallmarks of human joint periprosthetic tissue. We chronically administered Co(II)/Cr(III) ions on mouse calvaria and reproduced these two histopathologic hallmarks on mouse tissue based on an implanted helmet-like structure. Our results reveal that Cr(III) ions are locally accumulated and are effective in inducing macrophage infiltration and they can be phagocytosed and stored. However, the lymphocytes aggregates could be induced by both Co(II), Cr(III) and other unspecific inflammatory stimuli.
Collapse
Affiliation(s)
- Qi Wu
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China
| | - Bin Chen
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China
| | - Xin Yu
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China
| | - Zhen Wang
- Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China
| | - Zhongyang Sun
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China
| | - Jiahua Duan
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China
| | - Hao Ding
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China
| | - Weiwei Wu
- Department of Vascular Surgery, Beijing Tsinghua Changgung Hospital, Tsinghua University Medical Center, Beijing 102218, China
| | - Nirong Bao
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China.
| | - Jianning Zhao
- Department of Orthopaedics, Affiliated Jinling Hospital, Medical School of Nanjing University, 305 Zhongshandonglu Road, Nanjing 210002, China.
| |
Collapse
|
16
|
Lerma M, Cantu J, Banu KS, Gardea-Torresdey JL. Environmental assessment in fine jewelry in the U.S.-Mexico's Paso del Norte region: A qualitative study via X-ray fluorescence spectroscopy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 863:161004. [PMID: 36543270 DOI: 10.1016/j.scitotenv.2022.161004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Heavy metal contamination in raw materials has spread widely in the United States. The high increased number of recalls in consumer products and the lack of stricter regulations in the raw materials to be used in the jewelry industry have raised concerns among consumers. Studies in low-cost jewelry have shown the presence and high content of heavy metals; this environmental problem led to a child's death after swallowing a charm containing elevated levels of lead (Pb). Exposure to heavy metals, through inhalation, mouth, and skin contact, causes adverse health effects in children and adults. Exposure to lead affects mainly the nervous system and brain development; exposure to cadmium (Cd) causes damage to liver, kidneys, and lungs, and potentially leads to cancer; exposure to nickel (Ni) causes severe dermatitis. Thus, the importance and impact of studies of this nature cannot be overstated. As heavy metal contamination has increased in the United States, this research fills an important knowledge gap between previous studies conducted on low-cost jewelry and fine jewelry. In this study, conducted in the Paso del Norte region, one hundred and forty-three pieces of fine jewelry were evaluated for the presence of heavy metals using X-ray fluorescence (XRF) spectroscopy. Our study showed that 61 samples (42.7 %) exhibited the presence of Ni in the metal alloy, prevailing in jewelry pieces with lower percentage of gold. Eighteen samples showed the presence of Pb in gemstones, 11 pieces of these samples (7.7 % total) had <33.3 % gold (≤10 K); however, none of the samples showed the presence of Pb in the metal alloy. Further research is needed to evaluate the bioaccessibility of Pb in these gemstones, which may pose a potential health hazard to children and adults in the US Paso del Norte region and throughout the world.
Collapse
Affiliation(s)
- Maricarmen Lerma
- Environmental Sciences and Engineering, Ph.D. Program, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
| | - Jesús Cantu
- Department of Chemistry and Biochemistry, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
| | - Kazi Saima Banu
- Department of Chemistry and Biochemistry, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA
| | - Jorge L Gardea-Torresdey
- Environmental Sciences and Engineering, Ph.D. Program, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA; Department of Chemistry and Biochemistry, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA.
| |
Collapse
|
17
|
Filliquist B, McKay R, Marcellin-Little DJ, Irvin JJ, Garcia TC, Vernau W, Chou PY, Kapatkin AS, Vapniarsky N. Metal reactivity is present in dogs with tibial plateau leveling osteotomy and total hip replacement implants. Am J Vet Res 2023; 84:ajvr.22.08.0141. [PMID: 36652332 DOI: 10.2460/ajvr.22.08.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/25/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Determine whether dogs with well-functioning orthopedic metal implants can develop metal reactivity. SAMPLE Client-owned dogs that had tibial plateau leveling osteotomy (TPLO) or total hip replacement (THR) implants for 12 months or more and control dogs with no implants. PROCEDURES Lymphocyte transformation testing was performed by exposing peripheral blood lymphocytes to nickel (Ni), chromium (Cr), cobalt (Co), or a combination of these metals. Lymphocyte proliferation was assessed with flow cytometry. Lymphocyte stimulation indexes (SIs) were calculated. A SI > 2 was considered reactive. Median SIs of dogs in response to metal exposure were compared statistically. RESULTS Samples from 10 dogs with TPLO, 12 dogs with THR, and 7 control dogs were analyzed. Six dogs out of 22 with metal implants had a reactive SI to 1 or more metals, while 2 of 7 control dogs had a SI > 2 when exposed to nickel only. When all metals were considered, no differences in metal reactivity were found between TPLO, THR, and control groups. CLINICAL RELEVANCE Metal reactivity is present in dogs and can be identified using lymphocyte transformation testing. Reactivity to Ni is present in dogs with and without metal implants. Reactivity to Co and Cr occurs in some dogs with metal implants.
Collapse
Affiliation(s)
- Barbro Filliquist
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.,JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Rachel McKay
- Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Denis J Marcellin-Little
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.,JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Justine J Irvin
- JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Tanya C Garcia
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.,JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - William Vernau
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Po-Yen Chou
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.,JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Amy S Kapatkin
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.,JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - Natalia Vapniarsky
- JD Wheat Veterinary Orthopedic Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA.,Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA
| |
Collapse
|
18
|
Dadkhahfar S, Chehrassan M, Faldini C. Hypersensitivity reactions to metals in spine surgery. Musculoskelet Surg 2023; 107:29-35. [PMID: 36344900 DOI: 10.1007/s12306-022-00765-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022]
Abstract
Hypersensitivity to orthopedic devices is a rare condition with an underestimated incidence due to the lack of diagnostic guideline and ambiguous clinical manifestations. Although hypersensitivity to metal is common, a few cases of hypersensitivity reactions have been reported after spinal instrumentation. Spinal fusion and stabilization require a wide range of devices such as screws, wires, bands, and artificial disk replacement devices. Spinal instrumented surgeries are different from total joint arthroplasty in several aspects such as degree and pattern of motion, loading environment, and adjacent tissues with distinct characteristics. The interval for hypersensitivity reactions to occur after spinal metallic implantation is usually weeks to months. The present review covers the topic of hypersensitivity reactions that have been reported after spinal surgeries with the focus on cutaneous presentations.
Collapse
Affiliation(s)
- S Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Chehrassan
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - C Faldini
- Istituto Orthopedico Rizzoli, Bologna, Italy
| |
Collapse
|
19
|
Kakşi SA, Kahraman FC, Akdeniz N, Özen T. Results of the patch tests with European baseline series in children: Five years of experience from a single center in Turkey and a review of the literature. J Cosmet Dermatol 2023; 22:1071-1076. [PMID: 36437575 DOI: 10.1111/jocd.15531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis (ACD) is increasingly prevalent. Patch testing is the gold-standard diagnostic method. AIMS Our study aimed to identify common contact-sensitizing allergens in Turkish children. PATIENTS/METHODS We retrospectively analyzed the patch test results and characteristics of 191 pediatric patients [114 (59.7%) females, 77 (40.3%) males], who received the diagnosis of allergic contact dermatitis between 2015 and 2019. RESULTS The mean age of the patients was 12.2 years (range 4-18 years). Thirty-six (18.8%) of the patients in the study group had positive patch test outcomes with 56 positive allergens. Girls had a significantly higher rate of total positive patch test results than boys (75%/25%; p = 0.003, p < 0.05). The most frequent four allergens were nickel sulfate (n = 20, 10.4%), cobalt chloride (n = 6, 3.14%), p-phenylenediamine (n = 5, 2.61%), Methylchloroisothiazolinone/methylisothiazolinone (n = 5, 2.61%), respectively. CONCLUSIONS In our study, we discovered that in addition to the frequently encountered metal allergens such as nickel and cobalt, p-phenylenediamine and Methylchloroisothiazolinone/methylisothiazolinone sensitivities were frequent in the Turkish population. p-phenylenediamine sensitization can cause serious systemic dermatitis during the lifetime of children. We suggest that in Turkey personal care and hygiene products containing Methylchloroisothiazolinone/methylisothiazolinone should be legally regulated. Since childhood contact dermatitis may have an impact on the quality of life by influencing family and social life, suspected allergens should be detected as early as possible.
Collapse
Affiliation(s)
- Sümeyye Altıntaş Kakşi
- Department of Dermatology, İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Filiz Cebeci Kahraman
- Department of Dermatology, İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Necmettin Akdeniz
- Department of Dermatology, İstanbul Şişli Memorial Hospital, İstanbul, Turkey
| | - Tunç Özen
- Department of Dermatology, İstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| |
Collapse
|
20
|
Costa MD, Donner S, Bertrand J, Pop OL, Lohmann CH. Hypersensitivity and lymphocyte activation after total hip arthroplasty. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:214-221. [PMID: 36820851 DOI: 10.1007/s00132-023-04349-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/24/2023]
Abstract
In the last decades total hip arthroplasty (THA) has become a standard procedure with many benefits but also a few still unsolved complications, which can lead to surgical revision in 19-23% of cases. Thus, aseptic loosening and metal hypersensitivity remain challenges. The phenomenon of wear debris causes chronic inflammation, which produces osteolysis and aseptic loosening. Wear debris promotes osteoclast production and inhibits osteoblasts by secretion of pro-inflammatory cytokines. Micro-abrasions can be induced by abrasive, adhesive and fatigue wear and cause a liberation of metal ions, which lead to another immune response elicited mostly by macrophages. Another reaction in the neocapsule can be a type IV hypersensitivity reaction to various alloys, containing metals such as nickel, cobalt and chromium. Patch testing and the lymphocyte transformation test (LTT) are not the best diagnostic possibilities to exclude a postoperative hypersensitivity reaction, because of the different alignment of the epicutaneous cells compared to the periprosthetic deep tissue. This hypersensitivity reaction is mostly induced by cytokines, which are secreted by macrophages rather than lymphocytes. In cell cultures and in animal studies, multipotent mesenchymal stem cells (MSC) have been shown to play a role in improving initial implant integration, to limit periprosthetic osteolysis and also to reconstitute peri-implant bone stock during implant revision. Thus, MSC might be used in the future to prolong the durability of THA. A better understanding of the interactions between primary chronic inflammation, corrosion, osteolysis and hypersensitivity is mandatory to develop new therapeutic strategies, aiming at the reduction of the incidence of implant failures. In this article the underlying immunological mechanisms to aseptic loosening are presented.
Collapse
Affiliation(s)
- Maximilian D Costa
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Stefanie Donner
- Centre for Musculoskeletal Surgery, Charité-University Medicine, Berlin, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Ovidiu-Laurean Pop
- Department of Morphological Sciences, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Christoph H Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
| |
Collapse
|
21
|
Tsuchida D, Matsuki Y, Tsuchida J, Iijima M, Tanaka M. Allergenicity and Bioavailability of Nickel Nanoparticles Compared to Nickel Microparticles in Mice. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1834. [PMID: 36902949 PMCID: PMC10004360 DOI: 10.3390/ma16051834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Metal allergy is a common disease that afflicts many people. Nevertheless, the mechanism underlying metal allergy development has not been completely elucidated. Metal nanoparticles might be involved in the development of a metal allergy, but the associated details are unknown. In this study, we evaluated the pharmacokinetics and allergenicity of nickel nanoparticles (Ni-NPs) compared with those of nickel microparticles (Ni-MPs) and nickel ions. After characterizing each particle, the particles were suspended in phosphate-buffered saline and sonicated to prepare a dispersion. We assumed the presence of nickel ions for each particle dispersion and positive control and orally administered nickel chloride to BALB/c mice repeatedly for 28 days. Results showed that compared with those in the Ni-MP administration group (MP group), the Ni-NP administration group (NP group) showed intestinal epithelial tissue damage, elevated serum interleukin (IL)-17 and IL-1β levels, and higher nickel accumulation in the liver and kidney. Additionally, transmission electron microscopy confirmed the accumulation of Ni-NPs in the livers of both the NP and nickel ion administration groups. Furthermore, we intraperitoneally administered a mixed solution of each particle dispersion and lipopolysaccharide to mice and then intradermally administered nickel chloride solution to the auricle after 7 days. Swelling of the auricle was observed in both the NP and MP groups, and an allergic reaction to nickel was induced. Particularly in the NP group, significant lymphocytic infiltration into the auricular tissue was observed, and serum IL-6 and IL-17 levels were increased. The results of this study showed that in mice, Ni-NP accumulation in each tissue was increased after oral administration and toxicity was enhanced, as compared to those with Ni-MPs. Orally administered nickel ions transformed into nanoparticles with a crystalline structure and accumulated in tissues. Furthermore, Ni-NPs and Ni-MPs induced sensitization and nickel allergy reactions in the same manner as that with nickel ions, but Ni-NPs induced stronger sensitization. Additionally, the involvement of Th17 cells was suspected in Ni-NP-induced toxicity and allergic reactions. In conclusion, oral exposure to Ni-NPs results in more serious biotoxicity and accumulation in tissues than Ni-MPs, suggesting that the probability of developing an allergy might increase.
Collapse
Affiliation(s)
- Dai Tsuchida
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Yuko Matsuki
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Jin Tsuchida
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Masahiro Iijima
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| | - Maki Tanaka
- Department of Clinical Laboratory Science, School of Medical Technology, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan
| |
Collapse
|
22
|
Aljabali AA, Obeid MA, Bashatwah RM, Serrano-Aroca Á, Mishra V, Mishra Y, El-Tanani M, Hromić-Jahjefendić A, Kapoor DN, Goyal R, Naikoo GA, Tambuwala MM. Nanomaterials and Their Impact on the Immune System. Int J Mol Sci 2023; 24:ijms24032008. [PMID: 36768330 PMCID: PMC9917130 DOI: 10.3390/ijms24032008] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
Nanomaterials have been the focus of intensive development and research in the medical and industrial sectors over the past several decades. Some studies have found that these compounds can have a detrimental impact on living organisms, including their cellular components. Despite the obvious advantages of using nanomaterials in a wide range of applications, there is sometimes skepticism caused by the lack of substantial proof that evaluates potential toxicities. The interactions of nanoparticles (NPs) with cells of the immune system and their biomolecule pathways are an area of interest for researchers. It is possible to modify NPs so that they are not recognized by the immune system or so that they suppress or stimulate the immune system in a targeted manner. In this review, we look at the literature on nanomaterials for immunostimulation and immunosuppression and their impact on how changing the physicochemical features of the particles could alter their interactions with immune cells for the better or for the worse (immunotoxicity). We also look into whether the NPs have a unique or unexpected (but desired) effect on the immune system, and whether the surface grafting of polymers or surface coatings makes stealth nanomaterials that the immune system cannot find and get rid of.
Collapse
Affiliation(s)
- Alaa A. Aljabali
- Faculty of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, Yarmouk University, P.O. Box 566, Irbid 21163, Jordan
- Correspondence: (A.A.A.); (M.M.T.)
| | - Mohammad A. Obeid
- Faculty of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, Yarmouk University, P.O. Box 566, Irbid 21163, Jordan
| | - Rasha M. Bashatwah
- Faculty of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, Yarmouk University, P.O. Box 566, Irbid 21163, Jordan
| | - Ángel Serrano-Aroca
- Biomaterials and Bioengineering Lab., Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia, San Vicente Mártir, 46001 Valencia, Spain
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Yachana Mishra
- Department of Zoology, School of Bioengineering and Bioscience, Lovely Professional University, Phagwara 144411, Punjab, India
| | - Mohamed El-Tanani
- Pharmacological and Diagnostic Research Centre, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman 19328, Jordan
| | - Altijana Hromić-Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina
| | - Deepak N. Kapoor
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India
| | - Rohit Goyal
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology and Management Sciences, Solan 173229, Himachal Pradesh, India
| | - Gowhar A. Naikoo
- Department of Mathematics and Sciences, College of Arts and Applied Sciences, Dhofar University, Salalah PC 211, Oman
| | - Murtaza M. Tambuwala
- Lincoln Medical School, University of Lincoln, Brayford Pool Campus, Lincoln LN6 7TS, UK
- Correspondence: (A.A.A.); (M.M.T.)
| |
Collapse
|
23
|
Thienpont E. Titanium niobium nitride knee implants are not inferior to chrome cobalt components for primary total knee arthroplasty at medium-term follow-up. Arch Orthop Trauma Surg 2023:10.1007/s00402-022-04754-1. [PMID: 36595031 DOI: 10.1007/s00402-022-04754-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Oxidized zirconium (Oxinium), titanium nitride (TiN) or titanium niobium nitride (TiNbN) coated implants became in recent years available for an increasing amount of total knee arthroplasty (TKA) systems. The hypothesis of this study was that the use of TiNbN-coated components would not lead to inferior results compared to conventional implants and that none of the metal hypersensitivity patients receiving TiNbN-coated implants would require revision for metal allergy. MATERIALS AND METHODS This retrospective study compared 53 Titanium Niobium Nitride coated TKA with 103 conventional chrome cobalt implants of the same design. Patients were evaluated at a minimal follow-up of 3 years. RESULTS No differences in clinical, radiological or patient-reported outcome measurements were observed between these groups. A survivorship of 96% without differences in revision rates was observed at medium-term follow-up of 6.5 years. DISCUSSION Metal allergy leading to contact or generalized dermatitis after TKA is very rare and usually linked to chrome or cobalt hypersensitivity. Nickel release from knee implants has not been shown to lead to cutaneous symptoms, but unexplained pain and swelling, peri-prosthetic osteolysis and component loosening remain potential issues not fully understood. The use of coated implants eliminates this factor from the diagnostic equation in case of postoperative dissatisfaction. CONCLUSION The use of titanium niobium nitride coated implants for primary knee osteoarthritis in self-reported metal hypersensitivity patients shows similar outcomes and survivorship rates as conventional chrome cobalt TKA, with no revisions for allergy at medium-term follow-up.
Collapse
Affiliation(s)
- Emmanuel Thienpont
- Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.
| |
Collapse
|
24
|
Lamothe PA, Berkowitz DM, Schimmel ME. A Case of Nitinol Airway Stent Placement in a Patient With Known Nickel Skin Sensitivity With No Local or Systemic Reactions After 6 Months of Follow-up. J Bronchology Interv Pulmonol 2023; 30:83-85. [PMID: 35838198 DOI: 10.1097/lbr.0000000000000847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Pedro A Lamothe
- Interventional Pulmonology, Division of Pulmonary, Allergy and Critical Care Medicine Emory University School of Medicine, Atlanta, GA
| | | | | |
Collapse
|
25
|
Anastasio AT, Johnson LG, Willhite JP, Mousallem T, Hendershot EF, Parekh SG. Team Approach: Metal Hypersensitivity in Total Joint Arthroplasty. JBJS Rev 2023; 11:01874474-202301000-00002. [PMID: 36722837 DOI: 10.2106/jbjs.rvw.22.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
» As total joint arthroplasty volume continues to grow nationwide, more uncommon complications such as metal implant hypersensitivity are reported with greater frequency in the literature. » Metal hypersensitivity is a challenging diagnosis given the potentially vague symptomology. It should be considered a diagnosis of exclusion, necessitating careful consideration of other potential etiologies of a failing implant before arriving at the final diagnosis of metal hypersensitivity. » Patients can experience substantial morbidity from implant rejection and in severe, refractory cases may even require revision arthroplasty and conversion to a hypoallergenic implant. » Given the complex nature of the condition, successful treatment of metal hypersensitivity to orthopaedic implants is best achieved through the use of a multidisciplinary, team-based approach. Immunologists, radiologists, and infectious disease physicians as well as orthopaedic surgeons and mechanical engineers are all vital in appropriate diagnosis and treatment of the condition.
Collapse
Affiliation(s)
| | - Lindsey G Johnson
- Campbell University School of Osteopathic Medicine, Lillington, North Carolina
| | | | | | | | | |
Collapse
|
26
|
Muacevic A, Adler JR, Ohri S, Prajwal Mane Manohar M, Tiesenga F. Rare Metallic Allergy Reaction Presentation to Cholecystectomy Surgical Clip. Cureus 2022; 14:e32934. [PMID: 36712743 PMCID: PMC9873387 DOI: 10.7759/cureus.32934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 12/26/2022] Open
Abstract
Metal allergies have been a growing concern in the general population over the past several decades. Laparoscopic cholecystectomy is the standard treatment for gallbladder diseases such as cholelithiasis and cholecystitis, during which surgical clips composed of metals such as nickel or titanium are often used to clamp the arteries and ducts. These metals are documented to produce hypersensitivity reactions. Here, we present the case of a 53-year-old male patient who successfully underwent laparoscopic cholecystectomy and two weeks later reported constant right upper quadrant pain accompanied by nausea that was exacerbated by exercise and food. After several months of severe interference with the patient's lifestyle, we removed the surgical clips after ruling out all possible organic causes of the pain. A total of six surgical clips were removed during surgery, and the patient reported a substantial resolution of symptoms post-operation. Post-cholecystectomy syndrome (PCS), allergy to the metallic surgical clips, and migration or improper clip placement during surgery were all considered possible causes for the pain. Still, the clinical presentation and laboratory studies pulled focus toward metallic surgical clip allergy as the most plausible cause for the presenting symptoms. The metallic haptens released by the surgical clips activate the innate and adaptive immune response cascades and pre-sensitize the CD8 and B cells to the metallic allergens. With reexposure, these pre-sensitized CD8 and B cells trigger a hypersensitivity reaction. Standardizing allergy tests as part of the pre-operation checklist can prove to be an inexpensive way to eliminate such post-surgical complications. Furthermore, alternatives like absorbable sutures or even different hypoallergenic metal or plastic clips can be considered viable options to replace nickel or titanium-made surgical clips during surgery.
Collapse
|
27
|
Rubio L, Barrulas P, Costa M, Garcia-Jares C, Lores M, Barrocas Dias C. The chemistry behind the body art: unveiling the elemental profile and heavy metal content of natural tattoos and dyes by ICP-MS. RSC Adv 2022; 12:34414-34424. [PMID: 36545629 PMCID: PMC9709773 DOI: 10.1039/d2ra06126k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
Temporary tattoos and dyes are increasing popularity as an alternative to permanent ones. However, knowledge on its elementary composition is scarce and, this scientific gap can potentially make them a source of heavy metal exposure on humans. The present research aimed to explore the possibility of using the inorganic chemical signature to characterize natural pigments-based products and to evaluate the heavy metal content in jagua temporary tattoos and henna temporary hair dyes and tattoos. Thirty-four different samples of commercial products were analyzed for the presence and quantity of eleven trace elements (Al, Cr, Mn, Co, Ni, Cu, Zn, As, Cd, Ba, and Pb) by inductively coupled plasma mass spectrometry (ICP-MS). The overall mean concentrations varied between 0.02 and 973 μg g-1 in solid samples or 0.01-1878 μg g-1 for paste ones, wherein potential fake products were uncovered. None of the 34 samples considered comply with the current European Cosmetics Regulation. Samples were differentiated according to their Cr, Zn, Ba, and Pb content. The overall results revealed highly variable levels in the investigated samples, which leads us to suggest detailed quality controls of these materials, due the fact that their continued use can origin potential threat to human health.
Collapse
Affiliation(s)
- Laura Rubio
- CRETUS, Department of Analytical Chemistry, Nutrition and Food Science, Universidade de Santiago de CompostelaE-15782Santiago de CompostelaSpain+34-881-814-379,Laboratory of Research and Development of Analytical Solutions (LIDSA), Department of Analytical Chemistry, Nutrition and Food Science, Universidade de Santiago de CompostelaE-15782Santiago de CompostelaSpain
| | - Pedro Barrulas
- HERCULES Laboratory, University of Évora, Palácio do VimiosoLargo Marquês de Marialva 87000-809ÉvoraPortugal+351-266740800
| | - Mafalda Costa
- HERCULES Laboratory, University of Évora, Palácio do VimiosoLargo Marquês de Marialva 87000-809ÉvoraPortugal+351-266740800
| | - Carmen Garcia-Jares
- CRETUS, Department of Analytical Chemistry, Nutrition and Food Science, Universidade de Santiago de CompostelaE-15782Santiago de CompostelaSpain+34-881-814-379,Laboratory of Research and Development of Analytical Solutions (LIDSA), Department of Analytical Chemistry, Nutrition and Food Science, Universidade de Santiago de CompostelaE-15782Santiago de CompostelaSpain
| | - Marta Lores
- Laboratory of Research and Development of Analytical Solutions (LIDSA), Department of Analytical Chemistry, Nutrition and Food Science, Universidade de Santiago de CompostelaE-15782Santiago de CompostelaSpain
| | - Cristina Barrocas Dias
- HERCULES Laboratory, University of Évora, Palácio do VimiosoLargo Marquês de Marialva 87000-809ÉvoraPortugal+351-266740800,Chemistry and Biochemistry Department, School of Sciences and TechnologyRua Romão Ramalho, 597000-671ÉvoraPortugal
| |
Collapse
|
28
|
Abi El Cheikh T, Vargas IM, Alili E, Tiesenga F. The Improvement of Nonspecific Chronic Symptoms Post-Gallbladder Clip Removal. Cureus 2022; 14:e30625. [DOI: 10.7759/cureus.30625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/05/2022] Open
|
29
|
Risk of Exposure to Trace Elements through the Application of Facial Makeup Powders. J CHEM-NY 2022. [DOI: 10.1155/2022/9229134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The study aimed to ascertain the levels of trace elements present in the face powders marketed in Ghana. Fifteen different brands of facial makeup powders were purchased from a local market in Ghana. The samples were analyzed using an X-ray fluorescence (XRF) analyzer to determine the concentrations of 16 elements (Pb, As, Hg, Zn, Fe, Mn, Cr, Ti, Cu, Ni, Co, Sb, Cd, Ag, Sn, and Au). The contents of the trace elements were ordered in the following descending order according to the maximum concentrations: Fe > Zn > Ti > Mn > Cr > Hg > As > Pb > Cu, Ni, Co, Sb, Cd, Ag, Sn, and Au. Pearson correlation statistics showed strong positive relationships between Pb and Zn (r = 0.71), Pb and Cr (r = 0.57), Hg and Zn (r = 0.63), Hg and Fe (r = 0.73), Hg and Cr (r = 0.61), Zn and Fe (r = 0.69), Zn and Cr (r = 0.88), Fe and Cr (r = 0.67), and Fe and Ti (r = 0.62). Except for Pb and Cr, all the other elements had their margin of safety (MOS) values less than 100. The hazard indices (HIs) for Pb, Mn, Cr, and Ti were less than 1, indicating no risk. However, the HIs for As, Hg, Zn, and Fe were more than 1, indicating a potential risk of usage in adults. As a result, using face powders could put users at risk of exposure to trace elements. Dermal exposure to trace elements from cosmetics resulted in a lifetime cancer risk (LCR) that was higher than what was considered tolerable (LCR >10−6) due to the presence of Pb, As, and Cr. Mercury was identified as a potential skin sensitizer in the cosmetic samples examined by an exposure-based sensitization quantitative risk assessment (SQRA).
Collapse
|
30
|
Roach K, Roberts J. A comprehensive summary of disease variants implicated in metal allergy. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2022; 25:279-341. [PMID: 35975293 PMCID: PMC9968405 DOI: 10.1080/10937404.2022.2104981] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Allergic disease represents one of the most prominent global public health crises of the 21st century. Although many different substances are known to produce hypersensitivity responses, metals constitute one of the major classes of allergens responsible for a disproportionately large segment of the total burden of disease associated with allergy. Some of the most prevalent forms of metal allergy - including allergic contact dermatitis - are well-recognized; however, to our knowledge, a comprehensive review of the many unique disease variants implicated in human cases of metal allergy is not available within the current scientific literature. Consequently, the main goal in composing this review was to (1) generate an up-to-date reference document containing this information to assist in the efforts of lab researchers, clinicians, regulatory toxicologists, industrial hygienists, and other scientists concerned with metal allergy and (2) identify knowledge gaps related to disease. Accordingly, an extensive review of the scientific literature was performed - from which, hundreds of publications describing cases of metal-specific allergic responses in human patients were identified, collected, and analyzed. The information obtained from these articles was then used to compile an exhaustive list of distinctive dermal/ocular, respiratory, gastrointestinal, and systemic hypersensitivity responses associated with metal allergy. Each of these disease variants is discussed briefly within this review, wherein specific metals implicated in each response type are identified, underlying immunological mechanisms are summarized, and major clinical presentations of each reaction are described.Abbreviations: ACD: allergic contact dermatitis, AHR: airway hyperreactivity, ASIA: autoimmune/ autoinflammatory syndrome induced by adjuvants, BAL: bronchoalveolar lavage, CBD: chronic beryllium disease, CTCL: cutaneous T-cell lymphoma, CTL: cytotoxic T-Lymphocyte, DRESS: drug reaction with eosinophilia and systemic symptoms, GERD: gastro-esophageal reflux disease, GI: gastrointestinal, GIP: giant cell interstitial pneumonia, GM-CSF: granulocyte macrophage-colony stimulating factor, HMLD: hard metal lung disease, HMW: high molecular weight, IBS: irritable bowel syndrome, Ig: immunoglobulin, IL: interleukin, LMW: low molecular weight, PAP: pulmonary alveolar proteinosis, PPE: personal protective equipment, PRR: pathogen recognition receptor, SLE: systemic lupus erythematosus, SNAS: systemic nickel allergy syndrome, Th: helper T-cell, UC: ulcerative colitis, UV: ultraviolet.
Collapse
Affiliation(s)
- Ka Roach
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| | - Jr Roberts
- Allergy and Clinical Immunology Branch (ACIB), National Institute of Occupational Safety and Health (NIOSH), Morgantown, WV, USA
| |
Collapse
|
31
|
Knox S, Hagvall L, Malmberg P, O'Boyle NM. Topical Application of Metal Allergens Induces Changes to Lipid Composition of Human Skin. FRONTIERS IN TOXICOLOGY 2022; 4:867163. [PMID: 36004357 PMCID: PMC9393847 DOI: 10.3389/ftox.2022.867163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022] Open
Abstract
Lipids are an important constituent of skin and are known to be modified in many skin diseases including psoriasis and atopic dermatitis. The direct effects of common metallic contact allergens on the lipid composition of skin has never been investigated, to the best of our knowledge. We describe skin lipid profiles in the stratum corneum and viable epidermis of ex vivo human skin from a female donor upon exposure to three metal allergens (nickel, cobalt and chromium) visualised using time-of-flight secondary ion mass spectrometry (ToF-SIMS), which allows for simultaneous visualisation of both the allergen and skin components such as lipids. Multivariate analysis using partial least squares discriminant analysis (PLS-DA) indicated that the lipid profile of metal-treated skin was different to non-treated skin. Analysis of individual ions led to the discovery that cobalt and chromium induced increases in the content of diacylglycerols (DAG) in stratum corneum. Cobalt also induced increases in cholesterol in both the stratum corneum and viable epidermis, as well as monoacylglycerols (MAG) in the viable epidermis. Chromium caused an increase in DAG in viable epidermis in addition to the stratum corneum. In contrast, nickel decreased MAG and DAG levels in viable epidermis. Our results indicate that skin lipid content is likely to be altered upon topical exposure to metals. This discovery has potential implications for the molecular mechanisms by which contact allergens cause skin sensitization.
Collapse
Affiliation(s)
- Sophie Knox
- School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Dublin, Ireland
| | - Lina Hagvall
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per Malmberg
- Chemistry and Chemical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Niamh M. O'Boyle
- School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Dublin, Ireland
- *Correspondence: Niamh M. O'Boyle,
| |
Collapse
|
32
|
Wright A, Laundry-Mottiar L, Hedberg YS. The ability of sweat and buffer solutions to reduce hexavalent chromium of relevance for leather extraction. Regul Toxicol Pharmacol 2022; 133:105222. [PMID: 35817209 DOI: 10.1016/j.yrtph.2022.105222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 05/30/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
The European Union restricted the amount of hexavalent chromium (Cr(VI)) in leather in 2015, but skin allergy cases due to Cr-tanned leather are not declining. Standardized extraction methods have been criticized to both over- and underestimate the expected amount of bioavailable Cr(VI) in leather. This study aims to evaluate the ability of four extraction solutions to reduce or preserve Cr(VI): artificial sweat solutions (ASWs) of pH 4.7, 6.5, and 8.0, and phosphate buffer (PB) of pH 8.0. This was investigated by incubating each solution with added Cr(VI) as a function of time, and then measuring the recovered Cr(VI). All solutions, especially PB, preserved Cr(VI) for 24 h. These solutions were also pre-exposed to Cr-free vegetable-tanned leather (VTL) before incubation with Cr(VI). Released vegetable tannin species strongly reduced Cr(VI), with up to 4000 μg/L added Cr(VI) reduced in all solutions after 24 h. However, after 1 h, Cr(VI) was still detectable in extraction solutions at pH 6.5 and above. The reduction of Cr(VI) in relevant extraction solutions is hence a process dependent on time, pH, and the presence of co-released leather species. All extraction solutions, but least PB, have the potential to underestimate any Cr(VI) present on the surface of leather.
Collapse
Affiliation(s)
- Alexandra Wright
- Dept. of Chemistry, The University of Western Ontario, 1151 Richmond Str., London, Ontario, N6A 5B7, Canada
| | - Lila Laundry-Mottiar
- Dept. of Chemistry, The University of Western Ontario, 1151 Richmond Str., London, Ontario, N6A 5B7, Canada
| | - Yolanda S Hedberg
- Dept. of Chemistry, The University of Western Ontario, 1151 Richmond Str., London, Ontario, N6A 5B7, Canada; Surface Science Western, The University of Western Ontario, 999 Collip Circle, London, Ontario, N6G 0J3, Canada; Lawson Health Research Institute, London, Ontario, N6C 2R5, Canada.
| |
Collapse
|
33
|
Bowers LN, Ranpara AC, Roach KA, Knepp AK, Arnold ED, Stefaniak AB, Virji MA. Comparison of product safety data sheet ingredient lists with skin irritants and sensitizers present in a convenience sample of light-curing resins used in additive manufacturing. Regul Toxicol Pharmacol 2022; 133:105198. [PMID: 35659913 PMCID: PMC9351547 DOI: 10.1016/j.yrtph.2022.105198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022]
Abstract
Material jetting and vat photopolymerization additive manufacturing (AM) processes use liquid resins to build objects. These resins can contain skin irritants and/or sensitizers but product safety data sheets (SDSs) might not declare all ingredients. We characterized elemental and organic skin irritants and sensitizers present in 39 commercial products; evaluated the influence of resin manufacturer, system, color, and AM process type on the presence of irritants and sensitizers; and compared product SDSs to results. Among all products, analyses identified 23 irritant elements, 54 irritant organic substances, 22 sensitizing elements, and 23 sensitizing organic substances; SDSs listed 3, 9, 4, and 6 of these ingredients, respectively. Per product, the number and total mass (an indicator of potential dermal loading) of ingredients varied: five to 17 irritant elements (8.32-4756.65 mg/kg), one to 17 irritant organics (3273 to 356,000 mg/kg), four to 17 sensitizing elements (8.27-4755.63 mg/kg), and one to seven sensitizing organics (15-382,170 mg/kg). Median numbers and concentrations of irritants and sensitizers were significantly influenced by resin system and AM process type. The presence of undeclared irritants and sensitizers in these resins supports the need for more complete information on product SDSs for comprehensive dermal risk assessments.
Collapse
Affiliation(s)
- Lauren N Bowers
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Anand C Ranpara
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Katherine A Roach
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Alycia K Knepp
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Elizabeth D Arnold
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| | - Aleksandr B Stefaniak
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA.
| | - M Abbas Virji
- National Institute for Occupational Safety and Health, 1095 Willowdale Road, Morgantown, WV, 26505, USA
| |
Collapse
|
34
|
Liu Z, Wang J, Yang X, Huang Q, Zhu K, Sun Y, Van Hulle S, Jia H. Generation of environmental persistent free radicals (EPFRs) enhances ecotoxicological effects of the disposable face mask waste with the COVID-19 pandemic. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 301:119019. [PMID: 35189297 PMCID: PMC8854206 DOI: 10.1016/j.envpol.2022.119019] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 05/07/2023]
Abstract
A large amount of disposable plastic face masks (DPFs) is produced and used during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which results in an inevitable consequence of the dramatic increase of DPFs waste. However, the impact of DPFs exposure to the environment on their toxicity is rarely considered. In this study, a range of 76-276 items/L microplastics (MPs) was detected in the DPFs leachates, and fibrous (> 80.3%) and polypropylene (PP, > 89.2%) MPs were dominant. Co, Cu, Ni, Sr, Ti and Zn, were commonly detected in all leachates of the tested DPFs. Organics, such as acetophenone, 2,4-Di-tert-butylphenol, benzothiazole, bisphenol-A and phthalide, were found in the DPFs leachate, which were including organic solvents and plasticizer. Besides, we first found an emerging environmental risk substance, namely environmentally persistent free radicals (EPFRs), was generated in the DPFs leachates. The characteristic g-factors of the EPFRs was in a range of 2.003-2.004, identified as mixture of carbon- and oxygen-centered radicals. By means of in vitro toxicity assay, the DPFs leachate were confirmed to cause cytotoxicity and oxidative stress. Significantly, it is found that the formed EPFRs could contribute more toxic effects. Furthermore, when compared to N95 respirators, the tested surgical masks tend to release more MPs, leach more metals and organics, and generate more EPFRs. Surgical masks were thus showed higher risk than N95 respirators after exposure to water. This work highlights the importance of understanding the chemical complexity and possible toxicity of DPFs for their risk assessment.
Collapse
Affiliation(s)
- Ze Liu
- Key Laboratory of Plant Nutrition and the Agri-Environment in Northwest China, Ministry of Agriculture, College of Natural Resources and Environment, Northwest A & F University, Yangling, 712100, China
| | - Jianqun Wang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuetong Yang
- LIWET, Department of Green Chemistry and Technology, Ghent University, Campus Kortrijk, Graaf Karel De Goedelaan 5, B-8500, Kortrijk, Belgium
| | - Qian'en Huang
- Key Laboratory of Plant Nutrition and the Agri-Environment in Northwest China, Ministry of Agriculture, College of Natural Resources and Environment, Northwest A & F University, Yangling, 712100, China
| | - Kecheng Zhu
- Key Laboratory of Plant Nutrition and the Agri-Environment in Northwest China, Ministry of Agriculture, College of Natural Resources and Environment, Northwest A & F University, Yangling, 712100, China
| | - Yajiao Sun
- Key Laboratory of Plant Nutrition and the Agri-Environment in Northwest China, Ministry of Agriculture, College of Natural Resources and Environment, Northwest A & F University, Yangling, 712100, China
| | - Stijn Van Hulle
- LIWET, Department of Green Chemistry and Technology, Ghent University, Campus Kortrijk, Graaf Karel De Goedelaan 5, B-8500, Kortrijk, Belgium
| | - Hanzhong Jia
- Key Laboratory of Plant Nutrition and the Agri-Environment in Northwest China, Ministry of Agriculture, College of Natural Resources and Environment, Northwest A & F University, Yangling, 712100, China.
| |
Collapse
|
35
|
Montgomery BK, Gamble JG, Kha ST, Hecht GG, Vorhies JS, Lucas JF. Indications for and Risks Associated With Implant Removal After Pediatric Trauma. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202204000-00016. [PMID: 35427259 PMCID: PMC10566936 DOI: 10.5435/jaaosglobal-d-22-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
A wide range of implants are used in the treatment of pediatric fractures, including wires, plates, screws, flexible rods, rigid rods, and external fixation devices. Pediatric bones differ from adult bones both mechanically and biologically, including the potential for remodeling. Implants used in pediatric trauma patients present a unique set of circumstances regarding indications, risks, timing of implant removal, weight-bearing restrictions, and long-term sequelae. Indications for implant removal include wire/pin fixation, when substantial growth remains, and infection. When considering implant removal, the risks and benefits must be assessed. The primary risk of implant removal is refracture. The timing of implant removal varies widely from several weeks to a year or more with the option of retention depending on the fracture, type of implant, and skeletal maturity of the patient.
Collapse
Affiliation(s)
- Blake K. Montgomery
- From the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Dr. Lucas and Dr. Hecht); Stanford Orthopaedics, San Jose, CA (Dr. Lucas and Dr. Hecht); and the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Montgomery, Dr. Gamble, Dr. Kha, and Dr. Vorhies)
| | - James G. Gamble
- From the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Dr. Lucas and Dr. Hecht); Stanford Orthopaedics, San Jose, CA (Dr. Lucas and Dr. Hecht); and the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Montgomery, Dr. Gamble, Dr. Kha, and Dr. Vorhies)
| | - Stephanie T. Kha
- From the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Dr. Lucas and Dr. Hecht); Stanford Orthopaedics, San Jose, CA (Dr. Lucas and Dr. Hecht); and the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Montgomery, Dr. Gamble, Dr. Kha, and Dr. Vorhies)
| | - Garin G. Hecht
- From the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Dr. Lucas and Dr. Hecht); Stanford Orthopaedics, San Jose, CA (Dr. Lucas and Dr. Hecht); and the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Montgomery, Dr. Gamble, Dr. Kha, and Dr. Vorhies)
| | - John S. Vorhies
- From the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Dr. Lucas and Dr. Hecht); Stanford Orthopaedics, San Jose, CA (Dr. Lucas and Dr. Hecht); and the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Montgomery, Dr. Gamble, Dr. Kha, and Dr. Vorhies)
| | - Justin F. Lucas
- From the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Dr. Lucas and Dr. Hecht); Stanford Orthopaedics, San Jose, CA (Dr. Lucas and Dr. Hecht); and the Department of Orthopaedic Surgery, Stanford University, Redwood City, CA (Dr. Montgomery, Dr. Gamble, Dr. Kha, and Dr. Vorhies)
| |
Collapse
|
36
|
Oppel E, Kapp F, Böhm AS, Pohl R, Thomas P, Summer B. Contact sensitization to iron - a potentially underestimated metal allergen and elicitor of complications in patients with metal implants. Contact Dermatitis 2022; 86:531-538. [PMID: 35172024 DOI: 10.1111/cod.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about sensitization to iron (Fe) in private, working and medical settings, particulary implantology. OBJECTIVES To investigate sensitization to metals, particularly to Fe, both in pre-implant individuals with presumed metal allergy and in patients with suspected metal implant allergy. To further characterize Fe-sensitized individuals. METHODS Analysis of patch test reactions to an Fe (II)-sulfate-containing metal series in 183 consecutive patients (41 pre-implant, 142 metal implant-bearers). Test readings on D2, D3 and D6. Evaluation of questionnaire-aided history, of metal reactivity patterns, and demographics of Fe-reactors. RESULTS Metal reactivity in pre-implant/implant/total group was: to nickel 39%/30%/32%; to cobalt 17%/15%/15%; to chromium 7%/13%/11%. Co-sensitizations cobalt/nickel (19/58) and cobalt/chromium (11/21) were significant at P < .001; co-sensitizations Fe/Nickel (4/10) and chromium/knee arthroplasty (11/73) at P = .03. Ten of 183 (5.5%) reacted to Fe (2 of 41 pre-implant patients, 8 of 142 implant-bearers) with 10 only reacting on D6. Fe-reactivity was highest in complicated knee arthroplasty (7/73). Further peculiarities of Fe reactors included frequent isolated Fe reactivity (6/10), occupational metal exposure (7/10), previous (par)enteral Fe-substitution (6/10). CONCLUSIONS The 5.5% prevalence of Fe-reactions suggests a potentially underestimated role of this metal allergen in general and in implant-bearers. The latter also show a distinct metal sensitization pattern. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Eva Oppel
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Florian Kapp
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Ann-Sophie Böhm
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Ralf Pohl
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Peter Thomas
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| | - Burkhard Summer
- Clinic for Dermatology and Allergology, Ludwig-Maximilians-University Munich, Germany
| |
Collapse
|
37
|
Alshafeiy TI, Matich A, Rochman CM, Harvey JA. Advantages and Challenges of Using Breast Biopsy Markers. JOURNAL OF BREAST IMAGING 2022; 4:78-95. [PMID: 38422410 DOI: 10.1093/jbi/wbab052] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Indexed: 03/02/2024]
Abstract
Percutaneous image-guided biopsy procedures are the standard of care for histologic assessment of suspicious breast lesions. Post-biopsy tissue markers (clips) optimize patient management by allowing for assessment on follow-up imaging and precise lesion localization. Markers are used to ensure accurate correlation between imaging modalities, guide preoperative localization for malignant and high-risk lesions, and facilitate accurate identification of benign lesions at follow-up. Local practices differ widely, and there are no data detailing the exact frequency of use of clips for different breast biopsies. There are many indications for biopsy marker deployment, and some difficulties may be encountered after placement. The placement of biopsy markers has many advantages and few disadvantages, such that deployment should be routinely used after percutaneous biopsy procedures with rare exception.
Collapse
Affiliation(s)
| | - Alison Matich
- University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY, USA
| | - Carrie M Rochman
- University of Virginia Medical Center, Department of Radiology and Medical Imaging, Charlottesville, VA, USA
| | - Jennifer A Harvey
- University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY, USA
| |
Collapse
|
38
|
Vanent KN, Federico EM, Bass DI, Barros G, Keen J, Levitt MR. Nickels and tines: the myth of nickel allergy in intracranial stents. J Neurointerv Surg 2022; 14:1244-1247. [PMID: 34987071 DOI: 10.1136/neurintsurg-2021-018365] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/18/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Most intracranial stents contain nickel alloy, and nickel allergy or hypersensitivity is common. Neurological injury following endovascular treatment with a nickel containing intracranial stent has been reported in patients with purported nickel allergy, but it is unclear whether these reactions represent true nickel hypersensitivity. We quantified nickel release from commonly used intracranial stents to investigate whether such stents should be avoided in patients with nickel allergy. METHODS We examined nickel release from seven commonly used intracranial stents: Enterprise, LVIS Jr, Neuroform, Wingspan, Zilver, Pipeline Flex Embolization Device, and Surpass Evolve. We incubated each stent in human plasma-like media for 30 days. Dimethylglyoxime (DMG) spot testing was performed on each stent to detect released nickel at 0 and 30 days. Inductively coupled plasma-optical emission spectroscopy (ICP-OES) was then used to quantify the nickel concentration of the media at 30 days. Nickel currency and nickel standard for atomic absorption spectrometry were used as positive controls. RESULTS DMG spot tests indicated nickel release only from nickel currency at 0 and 30 days of incubation. No nickel release was detected from any stent at 30 days using ICP-OES. CONCLUSIONS Nickel release from commonly used intracranial stents is negligible. These results suggest that previously reported hypersensitivity to these stents may be misattributed to nickel allergy, and that patients with nickel allergy may be safely treated with select nickel-containing stents.
Collapse
Affiliation(s)
- Kevin N Vanent
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Emma M Federico
- Neurological Surgery, University of Washington, Seattle, Washington, USA.,Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA
| | - David I Bass
- Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Guilherme Barros
- Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Jade Keen
- Neurological Surgery, University of Washington, Seattle, Washington, USA.,Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA
| | - Michael R Levitt
- Neurological Surgery, University of Washington, Seattle, Washington, USA .,Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA.,Radiology, University of Washington, Seattle, WA, USA.,Mechanical Engineering, University of Washington, Seattle, WA, USA
| |
Collapse
|
39
|
Magnano GC, Marussi G, Pavoni E, Adami G, Larese Filon F, Crosera M. Percutaneous metals absorption following exposure to road dust powder. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118353. [PMID: 34637821 DOI: 10.1016/j.envpol.2021.118353] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
The skin constitutes a protective barrier to external physical and chemical aggressions. Although it is constantly exposed to various xenobiotics, it is generally considered poorly permeable to them, as for example metal ions, becoming unfortunately an entry route of such substances. Metals may penetrate inside the skin inducing more or less local effects such as skin sensitization and potential metals diffusion into the bloodstream. The objective of the study was to investigate the percutaneous penetration of metals in vitro - ex vivo in Franz cell with intact as well damaged skin applying a road dust powder. Moreover, porcine and human skins were compared. This study demonstrated that, after the application of a road dust powder on the skin, metals can penetrate and permeate this cutaneous membrane. From this experimental analysis, in intact skin lead (Pb) achieved the highest skin absorption in both human and porcine skin, while skin absorption profile of cobalt (Co) was the lowest in human skin than the one in porcine model. The concentrations of Ni present in receiving solution were higher compared to other metals in all experiments performed. The present work, definitely shows that metals permeation through damaged skin is accelerated than intact skin, as a result of the weaker cutaneous barrier function. According to published data, pig skin appeared as a suitable model for human skin. Our results confirmed that skin absorption of metals can be relevant in environmental exposures.
Collapse
Affiliation(s)
| | - Giovanna Marussi
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Italy
| | - Elena Pavoni
- Department of Mathematics and Geosciences, University of Trieste, Italy
| | - Gianpiero Adami
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Italy
| | | | - Matteo Crosera
- Department of Chemical and Pharmaceutical Sciences, University of Trieste, Italy
| |
Collapse
|
40
|
Guéroult AM, Al-Balah A, Davies AH, Shalhoub J. Nickel hypersensitivity and endovascular devices: a systematic review and meta-analysis. Heart 2021; 108:1707-1715. [PMID: 34702756 DOI: 10.1136/heartjnl-2021-319940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/23/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Nickel allergy is common; endovascular specialists are often confronted with nickel allergic patients ahead of the implantation of endovascular devices, many of which are nickel-containing. Our aim was to elucidate whether nickel hypersensitivity is significantly associated with worse or adverse outcomes after placement of a nickel-containing endovascular device. METHODS Inclusion criteria were: endovascular and transcatheter procedures for coronary, structural heart, neurovascular and peripheral vascular pathology involving nickel-allergic patients. All adverse outcomes were included as defined by included studies. A systematic review and meta-analysis were undertaken using a random-effects model. Searches of MEDLINE and EMBASE were conducted for articles published 1947-2019. RESULTS 190 records were identified, 78 articles were included for qualitative synthesis and 15 met criteria for meta-analysis. Patch-test confirmed nickel allergy was associated with an increased risk of adverse outcomes following implantation of a nickel-containing endovascular device (n=14 articles, 1740 patients; OR 2.61, 95% CI 1.41 to 4.85). This finding further was observed in coronary (n=12 articles, 1624 patients; OR 1.94, 95% CI 1.16 to 3.23) and structural heart subgroups (n=2 articles, 83 patients; OR 52.28, 95% CI 1.31 to 2079.14), but not in the neurovascular subgroup (n=1 article, 33 patients; OR 3.04, 95% CI 0.59 to 15.72) or with a patient-reported history of nickel allergy (n=2 articles, 207 patients; OR 2.14, 95% CI 0.23 to 19.70). CONCLUSIONS Patch-tested nickel allergy is associated with an increased risk of adverse outcomes following endovascular device implantation and alternative treatment options should be considered. Specialists faced with patients' self-reporting nickel allergy should consider proceeding to diagnostic patch-testing.
Collapse
Affiliation(s)
- Aurélien M Guéroult
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, London, UK .,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
| | - Amer Al-Balah
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Alun H Davies
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
| | - Joseph Shalhoub
- Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, London, UK.,Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
41
|
Riedel F, Aparicio-Soto M, Curato C, Thierse HJ, Siewert K, Luch A. Immunological Mechanisms of Metal Allergies and the Nickel-Specific TCR-pMHC Interface. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10867. [PMID: 34682608 PMCID: PMC8535423 DOI: 10.3390/ijerph182010867] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 12/19/2022]
Abstract
Besides having physiological functions and general toxic effects, many metal ions can cause allergic reactions in humans. We here review the immune events involved in the mediation of metal allergies. We focus on nickel (Ni), cobalt (Co) and palladium (Pd), because these allergens are among the most prevalent sensitizers (Ni, Co) and immediate neighbors in the periodic table of the chemical elements. Co-sensitization between Ni and the other two metals is frequent while the knowledge on a possible immunological cross-reactivity using in vivo and in vitro approaches remains limited. At the center of an allergic reaction lies the capability of a metal allergen to form T cell epitopes that are recognized by specific T cell receptors (TCR). Technological advances such as activation-induced marker assays and TCR high-throughput sequencing recently provided new insights into the interaction of Ni2+ with the αβ TCR-peptide-major histocompatibility complex (pMHC) interface. Ni2+ functionally binds to the TCR gene segment TRAV9-2 or a histidine in the complementarity determining region 3 (CDR3), the main antigen binding region. Thus, we overview known, newly identified and hypothesized mechanisms of metal-specific T cell activation and discuss current knowledge on cross-reactivity.
Collapse
Affiliation(s)
- Franziska Riedel
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Straße 2, 14195 Berlin, Germany
| | - Marina Aparicio-Soto
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Caterina Curato
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Hermann-Josef Thierse
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Katherina Siewert
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
| | - Andreas Luch
- Department for Chemicals and Product Safety, Federal Institute for Risk Assessment, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; (M.A.-S.); (C.C.); (H.-J.T.); (K.S.); (A.L.)
- Institute of Pharmacy, Freie Universität Berlin, Königin-Luise-Straße 2, 14195 Berlin, Germany
| |
Collapse
|
42
|
Matar HE, Porter PJ, Porter ML. Metal allergy in primary and revision total knee arthroplasty : a scoping review and evidence-based practical approach. Bone Jt Open 2021; 2:785-795. [PMID: 34587776 PMCID: PMC8558451 DOI: 10.1302/2633-1462.210.bjo-2021-0098.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aims Metal allergy in knee arthroplasty patients is a controversial topic. We aimed to conduct a scoping review to clarify the management of metal allergy in primary and revision total knee arthroplasty (TKA). Methods Studies were identified by searching electronic databases: Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Embase, from their inception to November 2020, for studies evaluating TKA patients with metal hypersensitivity/allergy. All studies reporting on diagnosing or managing metal hypersensitivity in TKA were included. Data were extracted and summarized based on study design, study population, interventions and outcomes. A practical guide is then formulated based on the available evidence. Results We included 38 heterogeneous studies (two randomized controlled trials, six comparative studies, 19 case series, and 11 case reports). The evidence indicates that metal hypersensitivity is a rare complication with some histopathological features leading to pain and dissatisfaction with no reliable screening tests preoperatively. Hypoallergenic implants are viable alternatives for patients with self-reported/confirmed metal hypersensitivity if declared preoperatively; however, concerns remain over their long-term outcomes with ceramic implants outperforming titanium nitride-coated implants and informed consent is paramount. For patients presenting with painful TKA, metal hypersensitivity is a diagnosis of exclusion where patch skin testing, lymphocyte transformation test, and synovial biopsies are useful adjuncts before revision surgery is undertaken to hypoallergenic implants with shared decision-making and informed consent. Conclusion Using the limited available evidence in the literature, we provide a practical approach to metal hypersensitivity in TKA patients. Future national/registry-based studies are needed to identify the scale of metal hypersensitivity, agreed diagnostic criteria, and management strategies. Cite this article: Bone Jt Open 2021;2(10):785–795.
Collapse
Affiliation(s)
- Hosam E Matar
- Wrightington Hospital, Wigan, UK.,Nottingham Elective Orthopaedic Services, Nottingham University Hospital NHS Trust, Nottingham, UK
| | | | | |
Collapse
|
43
|
Ashraf T, Taneez M, Kalsoom S, Irfan T, Shafique MA. Experimental Calculations of Metals Content in Skin-Whitening Creams and Theoretical Investigation for Their Biological Effect Against Tyrosinase Enzyme. Biol Trace Elem Res 2021; 199:3562-3569. [PMID: 33079299 DOI: 10.1007/s12011-020-02441-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022]
Abstract
The demand for skin-whitening creams (SWCs) has increased rapidly worldwide due to sharp rise in product advertisements in the media and the growing awareness. Metals are present either as impurities or added intentionally in creams and may have toxic effects on users. The present study was carried out to determine the content of metals such as mercury (Hg), cadmium (Cd), lead (Pb), arsenic (As), chromium (Cr), nickel (Ni), cobalt (Co), copper (Cu), zinc (Zn), and iron (Fe) in fifteen skin-whitening creams marketed at local shops in Islamabad, Pakistan. The concentrations of metals were analyzed by inductive coupled plasma-optical emission spectrometer (ICP-OES) after digestion with a mixture of HNO3, HCl, and H2O2. The skin-whitening creams were found to have metal concentrations in parts per million (ppm) in the following range: Hg (1.0-18,210 ppm), Co (0.1992-1.9931 ppm), Cr (1.0453-2.7455 ppm), Cu (0.6987-0.1997 ppm), Fe (8.8868-28.6213 ppm), Ni (0.7487-1.5958 ppm), Pb (0.2997-4.7287 ppm), and Zn (7819.2-39,696.7 ppm). As and Cd were not detected in any of the fifteen skin-whitening creams. Only one cream (L'Oréal Paris White Perfect) was found in safe limits defined by the Food and Drug Administration for cosmetics. In order to elucidate the mechanism of lower production of melanin in presence of heavy metals, a molecular docking study was carried out by using Molecular Operating Environment (MOE) software. A good correlation was observed between experimental findings and molecular docking studies.
Collapse
Affiliation(s)
- Tanzeela Ashraf
- Sulaiman Bin Abdullah Aba Al-Khail-Center for Interdisciplinary Research in Basic and Applied Sciences (SA-CIRBS), International Islamic University, Islamabad, 44000, Pakistan
| | - Mehwish Taneez
- Sulaiman Bin Abdullah Aba Al-Khail-Center for Interdisciplinary Research in Basic and Applied Sciences (SA-CIRBS), International Islamic University, Islamabad, 44000, Pakistan.
| | - Saima Kalsoom
- Sulaiman Bin Abdullah Aba Al-Khail-Center for Interdisciplinary Research in Basic and Applied Sciences (SA-CIRBS), International Islamic University, Islamabad, 44000, Pakistan
| | - Tahira Irfan
- Department of Environmental Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan
| | - Munib Ahmed Shafique
- Central Analytical Facility Division (CAFD), Pakistan Institute of Nuclear Science and Technology (PINSTECH), Islamabad, Pakistan
| |
Collapse
|
44
|
Skin permeation of nickel, cobalt and chromium salts in ex vivo human skin, visualized using mass spectrometry imaging. Toxicol In Vitro 2021; 76:105232. [PMID: 34365006 DOI: 10.1016/j.tiv.2021.105232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/16/2021] [Accepted: 08/03/2021] [Indexed: 11/20/2022]
Abstract
Skin permeation and distribution of three of the most common skin sensitizers was investigated using a previously developed animal-free exposure method combined with imaging mass spectrometry. Nickel, cobalt, and chromium (III) salts were dissolved in a buffer and exposed to human skin ex vivo, to be analyzed using time of flight secondary ion mass spectrometry (ToF-SIMS). Our findings demonstrate that metal haptens mainly accumulated in the stratum corneum, however all three metal sensitizers could also be detected in the epidermis. Cobalt and chromium (III) species penetrated into the epidermis to a larger extent than nickel species. The degree of penetration into the epidermis is suggested to be affected by the sensitization potency of the metal salts, as well as their speciation, i.e. the amount of the respective metal present in the solution as bioaccessible and solubilised ions. Our method provided permeation profiles in human skin for known sensitizers, on a level of detail that is not possible to achieve by other means. The findings show that the permeation profiles are different, despite these sensitizers being all metal ions and common causes of contact allergy. Studying skin uptake by only considering penetration through the skin might therefore not give accurate results.
Collapse
|
45
|
Pan Z, Yang Y, Zhang L, Zhou X, Zeng Y, Tang R, Chang C, Sun J, Zhang J. Systemic Contact Dermatitis: The Routes of Allergen Entry. Clin Rev Allergy Immunol 2021; 61:339-350. [PMID: 34338976 DOI: 10.1007/s12016-021-08873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 01/19/2023]
Abstract
Systemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis of SCD may be delayed. In this work, we summarized all of the routes through which allergens can enter the body and cause SCD, including oral intake, local contact (through skin, inhalation, nasal spray and anal application), implants, and other iatrogenic or invasive routes (intravenous, intramuscular, intraarticular, and intravesicular). This will provide a comprehensive reference for the clinicians to identify the culprit of SCD.
Collapse
Affiliation(s)
- Zhouxian Pan
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yongshi Yang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Lishan Zhang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Xianjie Zhou
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Yueping Zeng
- Dermatology Department, Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, PekingBeijing, 100730, China
| | - Rui Tang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, 95616, USA. .,Division of Pediatric Immunology and Allergy, Joe DiMaggio Children's Hospital, Hollywood, FL, USA.
| | - Jinlyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
| | - Jing Zhang
- Beijing Synchrotron Radiation Facility, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, 100049, China
| |
Collapse
|
46
|
Luvsannyam E, Jayaraman A, Jain MS, Jagani RP, Velez V, Mirji AS, Tiesenga F, Jorge J. Diffuse Nickel Hypersensitivity Reaction Post-cholecystectomy in a Young Female. Cureus 2021; 13:e17146. [PMID: 34532180 PMCID: PMC8436999 DOI: 10.7759/cureus.17146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Nickel, a silvery-hard metallic element used in corrosion-resistant alloys, is widely used in the medical field. Nickel has aided in medical advancements; however, it has been known to cause hypersensitivity reactions. Retained foreign bodies due to surgical procedures may cause postoperative complications such as allergic reactions. This case involves a 30-year-old female presenting with non-specific symptoms involving multiple organ systems, notably with abdominal pain. Due to chronic symptoms, the patient was tested for metal allergies and diagnosed with hypersensitivity reactions to nickel surgical clips that were previously inserted during cholecystectomy. Subsequently, the patient had surgical removal of the foreign bodies, which led to significant improvement of her symptoms immediately. This case demonstrates a delayed hypersensitivity reaction to a foreign body involving multiple body systems and vague symptoms making the diagnosis challenging. It is important to carefully evaluate the patient's past medical history including history of any allergies. It also brings attention to the necessity of performing metal skin patch tests preoperatively for individuals with a history of any type of allergies.
Collapse
Affiliation(s)
- Enkhmaa Luvsannyam
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Surgery, Avalon University School of Medicine, Youngstown, USA
| | | | - Molly S Jain
- Medicine, Saint James School of Medicine, Park Ridge, USA
| | - Ravi P Jagani
- Medicine, All Saints University College of Medicine, Kingstown, VCT
| | - Veronica Velez
- Medicine, Saint James School of Medicine, Park Ridge, USA
| | - Anushka S Mirji
- Surgery, Metropolitan University College of Medicine, St. John's, ATG
| | | | - Juaquito Jorge
- General and Vascular Surgery, West Suburban Hospital, Oak Park, USA
| |
Collapse
|
47
|
Zhang Y, de Graaf NPJ, Roffel S, Spiekstra SW, Rustemeyer T, Kleverlaan CJ, Feilzer AJ, Bontkes H, Deng D, Gibbs S. Patch test-relevant concentrations of metal salts cause localized cytotoxicity, including apoptosis, in skin ex vivo. Contact Dermatitis 2021; 85:531-542. [PMID: 34268774 PMCID: PMC9291529 DOI: 10.1111/cod.13940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
Background Metal alloys containing contact sensitizers (nickel, palladium, titanium) are extensively used in medical devices, in particular dentistry and orthopaedic surgery. The skin patch test is used to test for metal allergy. Objective To determine whether metal salts, when applied to freshly excised skin at patch test–relevant concentrations and using a method which mimics skin patch testing, cause in changes in the epidermis and dermis. Methods Tissue histology, apoptosis, metabolic activity, and inflammatory cytokine release were determined for two nickel salts, two palladium salts, and four titanium salts. Results Patch test–relevant concentrations of all metal salts caused localized cytotoxicity. This was observed as epidermis separation at the basement membrane zone, formation of vacuoles, apoptotic nuclei, decreased metabolic activity, and (pro)inflammatory cytokine release. Nickel(II) sulfate hexahydrate, nickel(II) chloride hexahydrate, titanium(IV) bis(ammonium lactato)dihydroxide, and calcium titanate were highly cytotoxic. Palladium(II) chloride, sodium tetrachloropalladate(II), titanium(IV) isopropoxide, and titanium(IV) dioxide showed mild cytotoxicity. Conclusion The patch test in itself may be damaging to the skin of the patient being tested. These results need further verification with biopsies obtained during clinical patch testing. The future challenge is to remain above the elicitation threshold at noncytotoxic metal concentrations.
Collapse
Affiliation(s)
- Yan Zhang
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Niels P J de Graaf
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Sanne Roffel
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sander W Spiekstra
- Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Amsterdam University Medical Centre location AMC, Amsterdam, The Netherlands
| | - Cees J Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Albert J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hetty Bontkes
- Unit Medical Immunology, Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands
| | - Dongmei Deng
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Susan Gibbs
- Department of Oral Cell Biology, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Molecular Cell Biology and Immunology, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands
| |
Collapse
|
48
|
Chen D, Wu JY, Kennedy KM, Yeager K, Bernhard JC, Ng JJ, Zimmerman BK, Robinson S, Durney KM, Shaeffer C, Vila OF, Takawira C, Gimble JM, Guo XE, Ateshian GA, Lopez MJ, Eisig SB, Vunjak-Novakovic G. Tissue engineered autologous cartilage-bone grafts for temporomandibular joint regeneration. Sci Transl Med 2021; 12:12/565/eabb6683. [PMID: 33055244 DOI: 10.1126/scitranslmed.abb6683] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022]
Abstract
Joint disorders can be detrimental to quality of life. There is an unmet need for precise functional reconstruction of native-like cartilage and bone tissues in the craniofacial space and particularly for the temporomandibular joint (TMJ). Current surgical methods suffer from lack of precision and comorbidities and frequently involve multiple operations. Studies have sought to improve craniofacial bone grafts without addressing the cartilage, which is essential to TMJ function. For the human-sized TMJ in the Yucatan minipig model, we engineered autologous, biologically, and anatomically matched cartilage-bone grafts for repairing the ramus-condyle unit (RCU), a geometrically intricate structure subjected to complex loading forces. Using image-guided micromilling, anatomically precise scaffolds were created from decellularized bone matrix and infused with autologous adipose-derived chondrogenic and osteogenic progenitor cells. The resulting constructs were cultured in a dual perfusion bioreactor for 5 weeks before implantation. Six months after implantation, the bioengineered RCUs maintained their predefined anatomical structure and regenerated full-thickness, stratified, and mechanically robust cartilage over the underlying bone, to a greater extent than either autologous bone-only engineered grafts or acellular scaffolds. Tracking of implanted cells and parallel bioreactor studies enabled additional insights into the progression of cartilage and bone regeneration. This study demonstrates the feasibility of TMJ regeneration using anatomically precise, autologous, living cartilage-bone grafts for functional, personalized total joint replacement. Inclusion of the adjacent tissues such as soft connective tissues and the TMJ disc could further extend the functional integration of engineered RCUs with the host.
Collapse
Affiliation(s)
- David Chen
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Josephine Y Wu
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Kelsey M Kennedy
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Keith Yeager
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Jonathan C Bernhard
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Johnathan J Ng
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Brandon K Zimmerman
- Department of Mechanical Engineering, Columbia University, New York, NY 10032, USA
| | - Samuel Robinson
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Krista M Durney
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Courtney Shaeffer
- Department of Mechanical Engineering, Columbia University, New York, NY 10032, USA
| | - Olaia F Vila
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Catherine Takawira
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | | | - X Edward Guo
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA
| | - Gerard A Ateshian
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA.,Department of Mechanical Engineering, Columbia University, New York, NY 10032, USA
| | - Mandi J Lopez
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Sidney B Eisig
- College of Dental Medicine, Columbia University, New York, NY 10032, USA
| | - Gordana Vunjak-Novakovic
- Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA. .,College of Dental Medicine, Columbia University, New York, NY 10032, USA.,Department of Medicine, Columbia University, New York, NY 10032, USA
| |
Collapse
|
49
|
Filatova D, Cherpak C. Mechanisms of Nickel-Induced Cell Damage in Allergic Contact Dermatitis and Nutritional Intervention Strategies. Endocr Metab Immune Disord Drug Targets 2021; 20:1010-1014. [PMID: 31969107 DOI: 10.2174/1871530320666200122155804] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/23/2019] [Accepted: 05/31/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hypersensitivity to nickel is a very common cause of allergic contact dermatitis since this metal is largely present in industrial and consumer products as well as in some commonly consumed foods, air, soil, and water. In nickel-sensitized individuals, a cell-mediated delayed hypersensitivity response results in contact to dermatitis due to mucous membranes coming in long-term contact with nickel-containing objects. This process involves the generation of reactive oxidative species and lipid peroxidation-induced oxidative damage. Immunologically, the involvement of T helper (h)-1 and Th-2 cells, as well as the reduced function of T regulatory cells, are of importance. The toxicity, mutagenicity, and carcinogenicity of nickel are attributed to the generation of reactive oxygen species and induction of oxidative damage via lipid peroxidation, which results in DNA damage. OBJECTIVE The aim of this research is to identify nutritionally actionable interventions that can intercept nickel-induced cell damage due to their antioxidant capacities. CONCLUSION Nutritional interventions may be used to modulate immune dysregulation, thereby intercepting nickel-induced cellular damage. Among these nutritional interventions are a low-nickel diet and an antioxidant-rich diet that is sufficient in iron needed to minimize nickel absorption. These dietary approaches not only reduce the likelihood of nickel toxicity by minimizing nickel exposure but also help prevent oxidative damage by supplying the body with antioxidants that neutralize free radicals.
Collapse
Affiliation(s)
- Dana Filatova
- Department of Nutrition and Integrative Health, Maryland University of Integrative Health, Laurel, Maryland, United States
| | - Christine Cherpak
- Department of Nutrition and Integrative Health, Maryland University of Integrative Health, Laurel, Maryland, United States
| |
Collapse
|
50
|
Nickel Hypersensitivity to Atrial Septal Occluders: Smoke Without Fire? Clin Rev Allergy Immunol 2021; 62:476-483. [PMID: 34129170 DOI: 10.1007/s12016-021-08867-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 02/08/2023]
Abstract
Nickel is one of the most common contact allergens worldwide; it is used as the main component of the devices used for atrial septal defects (ASDs) and patent foramen ovale (PFO) closure. Developing nickel hypersensitivity after PFO/ASD occlusion is significantly rarer described in medical literature than typical nickel contact sensitization. The exact pathophysiological mechanism of this "device syndrome" remains unknown, and many question the real incidence or even the existence of this clinical entity. Nevertheless, it has been associated with a wide spectrum of symptoms, including chest pain, migraines, palpitation, and dyspnea. Skin patch tests are the first-line approach to diagnose nickel hypersensitivity. However, diagnostic criteria for the device syndrome have not been developed, and diagnosis in reported cases is established by a process of elimination. Management-drug therapy (corticosteroids, clopidogrel, etc.) or even surgical explantation in severe cases-of patients developing such clinical manifestations after percutaneous PFO/ASD occlusion is empirical. Undoubtedly, endocardiac device-related nickel hypersensitivity requires more focused research to discover the underlying mechanism as well as to develop reliable prognostic tests for detecting high-risk patients and preventing severe nickel hypersensitivity reactions.
Collapse
|