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The Journal of Bone and Joint Surgery.... Aug 2012We report a systematic review and meta-analysis of the peer-reviewed literature focusing on metal sensitivity testing in patients undergoing total joint replacement... (Meta-Analysis)
Meta-Analysis Review
We report a systematic review and meta-analysis of the peer-reviewed literature focusing on metal sensitivity testing in patients undergoing total joint replacement (TJR). Our purpose was to assess the risk of developing metal hypersensitivity post-operatively and its relationship with outcome and to investigate the advantages of performing hypersensitivity testing. We undertook a comprehensive search of the citations quoted in PubMed and EMBASE: 22 articles (comprising 3634 patients) met the inclusion criteria. The frequency of positive tests increased after TJR, especially in patients with implant failure or a metal-on-metal coupling. The probability of developing a metal allergy was higher post-operatively (odds ratio (OR) 1.52 (95% confidence interval (CI) 1.06 to 2.31)), and the risk was further increased when failed implants were compared with stable TJRs (OR 2.76 (95% CI 1.14 to 6.70)). Hypersensitivity testing was not able to discriminate between stable and failed TJRs, as its predictive value was not statistically proven. However, it is generally thought that hypersensitivity testing should be performed in patients with a history of metal allergy and in failed TJRs, especially with metal-on-metal implants and when the cause of the loosening is doubtful.
Topics: Arthroplasty, Replacement; Humans; Hypersensitivity; Joint Prosthesis; Metals; Preoperative Period; Prosthesis Failure; Skin Tests
PubMed: 22844057
DOI: 10.1302/0301-620X.94B8.28135 -
The Journal of Prosthetic Dentistry May 2022The marginal and internal adaptation of a fixed dental prosthesis depends on a variety of factors, finish line designs being one of them. A clear consensus as to which... (Meta-Analysis)
Meta-Analysis Review
Effect of different finish line preparations on the marginal and internal adaptation of cobalt-chromium metal alloy copings fabricated by using CAD-CAM technology: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
The marginal and internal adaptation of a fixed dental prosthesis depends on a variety of factors, finish line designs being one of them. A clear consensus as to which finish line design can provide a better marginal and internal adaptation with respect to cobalt-chromium metal alloy copings fabricated by using computer-aided design and computer-aided manufacturing (CAD-CAM) technology is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the effect of different finish line preparations on the marginal and internal adaptation of cobalt-chromium metal alloy copings fabricated by using CAD-CAM technology.
MATERIAL AND METHODS
Electronic (PubMed, Cochrane, EBSCOhost, and Google Scholar) and manual searches were conducted for articles published from January 2010 to December 2020 to identify relevant studies evaluating the effect of different finish line preparations (chamfer, deep chamfer, shoulder, rounded shoulder) on the marginal and internal adaptation of cobalt-chromium metal alloy copings fabricated by using CAD-CAM technology.
RESULTS
A total of 573 articles were obtained via electronic search, and 10 articles were obtained through manual search, of which 24 in vitro studies were selected after title, abstract, and full-text screening and were included for both qualitative and quantitative analyses. The marginal adaptation was evaluated under the parameters of marginal gap, absolute marginal discrepancy, and vertical marginal discrepancy, whereas internal adaptation was evaluated under the parameters of internal gap, cervical discrepancy, axial discrepancy, and occlusal discrepancy. The methods of CAD-CAM fabrication (direct metal laser sintering, hard milling, and soft milling) were considered under the subgroup analysis.
CONCLUSIONS
An overall better marginal and internal adaptation was observed with shoulder and rounded shoulder finish line designs when CAD-CAM methods were used for coping fabrication. Marginal and internal adaptation in chamfer and deep chamfer finish line designs showed better results with soft milling and direct metal laser sintering methods, whereas shoulder finish line showed better results with hard milling.
Topics: Adaptation, Psychological; Chromium; Chromium Alloys; Cobalt; Computer-Aided Design; Crowns; Dental Marginal Adaptation; Dental Prosthesis Design
PubMed: 34716012
DOI: 10.1016/j.prosdent.2021.06.030 -
Biological Trace Element Research Nov 2022It has been reported that heavy metals have adverse effects on the immune system. However, the relationship between heavy metal exposure and allergic outcomes remains... (Meta-Analysis)
Meta-Analysis Review
It has been reported that heavy metals have adverse effects on the immune system. However, the relationship between heavy metal exposure and allergic outcomes remains unclear. This systematic review was conducted to examine whether heavy metal exposure is associated with allergic outcomes during childhood. We performed a systematic search of all relevant articles in Web of Science, EMBASE, and PubMed, from inception through to November 2020. We used odds ratio (OR) and the standard mean differences (SMDs) with 95% confidence intervals (CIs) to present estimates from individual studies. In addition, random-effects meta-analysis was used to pool the data. We also conducted the meta-regression and subgroup analysis to explore potential sources of heterogeneity. After duplicate removal, we finally included 35 articles in the systematic review and meta-analysis from an initial 11,181 articles. The overall results showed that copper (Cu) was associated with asthma (pooled SMD = 1.50, 95% CI = 0.13-2.86); in the subgroup analysis, the results indicated that lead (Pb) was associated with asthma (pooled OR = 6.27, 95% CI = 2.24-17.56), and Cu and Pb were connected with atopic dermatitis (SMD = - 1.05, 95% CI = - 1.45 to - 0.65; SMD = 5.68, 95% CI = 5.05-6.32), respectively. Mercury (Hg) was associated with atopic dermatitis (pooled OR = 1.13, 95% CI = 1.04-1.22) and wheeze (OR = 1.20, 95% CI = 1.05-1.37). The meta-analysis results indicate that Cu might be connected with childhood asthma, but not with other allergic diseases; Hg and Pb may have no association with allergic diseases during childhood. Given some limits observed in the current studies, more prospective cohort studies are still needed to verify our findings. Review registration: PROSPERO CRD42020222167.
Topics: Asthma; Child; Copper; Dermatitis, Atopic; Humans; Lead; Mercury; Metals, Heavy; Prospective Studies
PubMed: 35006554
DOI: 10.1007/s12011-021-03070-w -
Spine Deformity Jan 2021Metallic spinal implants undergo wear and corrosion which liberates ionic or particulate metal debris. The purpose of this study was to identify and review studies that...
PURPOSE
Metallic spinal implants undergo wear and corrosion which liberates ionic or particulate metal debris. The purpose of this study was to identify and review studies that report the concentration of metal ions following multi-level spinal fusion and to evaluate the impact on clinical outcomes.
METHODS
Databases (PubMed, EBSCO MEDLINE) were searched up to August 2019 for studies in English-language assessing metal ion levels [chromium (Cr), titanium (Ti), nickel (Ni)] in whole blood, serum, or plasma after spinal fusion using a specific search string. Study, patient, and implant characteristics, method of analysis, metal ion concentration, as well as clinical and radiographic results was extracted.
RESULTS
The systematic search yielded 18 studies encompassing 653 patients. 9 studies reported Ti ions, eight reported Cr, and six reported Ni. Ti levels were elevated compared to controls/reference range/preoperative baseline in seven studies with the other two reporting no difference. Cr levels were elevated compared to controls/reference range in seven studies with one reporting no difference. Ni levels showed no difference from controls/reference range in four studies with one reporting above normal and another elevated compared to controls. Radiographic evidence of corrosion, implant failure, pseudarthrosis, revision surgery and adverse reaction reporting was highly variable.
CONCLUSION
Metal ions are elevated after instrumented spinal fusion; notably Cr levels from stainless steel implants and Ti from titanium implants. The association between clinical and radiographic outcomes remain uncertain but is concerning. Further research with standardized reporting over longer follow-up periods is indicated to evaluate the clinical impact and minimizing risk.
Topics: Chromium; Humans; Ions; Metals; Spinal Diseases; Spinal Fusion
PubMed: 32780305
DOI: 10.1007/s43390-020-00177-3 -
Biological Trace Element Research May 2023Intake of fruits is important for health. However, it can be a contamination source of potentially toxic elements (PTEs). The present study aimed to investigate the... (Meta-Analysis)
Meta-Analysis Review
Intake of fruits is important for health. However, it can be a contamination source of potentially toxic elements (PTEs). The present study aimed to investigate the concentration of PTEs such as arsenic (As), lead (Pb), cadmium (Cd), copper (Cu), nickel (Ni), and Iron (Fe) in various fresh and processed fruits. All the studies related to the concentration of PTEs in fresh and processed fruits by international databases including were included and non-carcinogenic risks assessment was evaluated based on the total hazard quotient (TTHQ). According to findings highest concentrations of As, Cd and Pb were observed in pineapple, mango, and cherry, while the lowest concentrations of these metals were found in berries, pineapple, and berries. Regarding trace elements, peach and cucumber represented the highest and lowest concentrations of Fe, respectively. Moreover, the highest and lowest concentrations of Cu were related to plum and banana, respectively. Considering the type of continents, the highest concentrations of As, Cd, Pb, Fe, Ni, and Cu among fresh and processed fruits belonged to Pan American Health Organization (EMRO), EMRO, African Region (AFRO), European Region (EURO), AFRO, and Western Pacific Region (SEARO). Eventually, the non-carcinogenic risk assessment of the heavy metal in fresh and processed fruits indicated that the risk pattern was different in various countries and the calculated TTHQ level in infants was below 1. Overall, the consumption of fresh and processed fruits is safe and does not pose a risk to the health of consumers.
Topics: Humans; Arsenic; Cadmium; Environmental Monitoring; Fruit; Lead; Metals, Heavy; Nickel; Risk Assessment; Soil Pollutants
PubMed: 35727404
DOI: 10.1007/s12011-022-03332-1 -
Environmental Toxicology and Chemistry Mar 2023Through a systematic review and a series of meta-analyses, we evaluated the general responsiveness of putative transcriptional biomarkers of general toxicity and... (Meta-Analysis)
Meta-Analysis
Through a systematic review and a series of meta-analyses, we evaluated the general responsiveness of putative transcriptional biomarkers of general toxicity and chemical stress. We targeted metal exposures performed on bivalves under controlled laboratory conditions and selected six transcripts associated with general toxicity for evaluation: catalase, glutathione-S-transferase, heat shock proteins 70 and 90, metallothionein, and superoxide dismutase. Transcriptional responses (n = 396) were extracted from published scientific articles (k = 22) and converted to log response ratios (lnRRs). By estimating toxic units, we normalized different metal exposures to a common scale, as a proxy of concentration. Using Bayesian hierarchical random effect models, we then tested the effects of metal exposure on lnRR, both for metal exposure in general and in meta-regressions using toxic unit and exposure time as independent variables. Corresponding analyses were also repeated with transcript and tissue as additional moderators. Observed patterns were similar for general and for transcript- and tissue-specific responses. The expected overall response to arbitrary metal exposure was an lnRR of 0.50, corresponding to a 65% increase relative to a nonexposed control. However, when accounting for publication bias, the estimated "true" response showed no such effect. Furthermore, expected response magnitude increased slightly with exposure time, but there was little support for general monotonic concentration dependence with regard to toxic unit. Altogether, the present study reveals potential limitations that need consideration prior to applying the selected transcripts as biomarkers in environmental risk assessment. Environ Toxicol Chem 2023;42:628-641. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
Topics: Animals; Bayes Theorem; Bivalvia; Ecotoxicology; Metals; Biomarkers; Water Pollutants, Chemical
PubMed: 36200657
DOI: 10.1002/etc.5494 -
The Journal of Arthroplasty Dec 2012Metal-on-metal (MOM) hip articulations represent a potential alternative to conventional metal-on-polyethylene total hip arthroplasty (THA). We performed a systematic... (Comparative Study)
Comparative Study Meta-Analysis Review
Metal-on-metal (MOM) hip articulations represent a potential alternative to conventional metal-on-polyethylene total hip arthroplasty (THA). We performed a systematic review of the peer-reviewed literature in search of studies comparing MOM with conventional primary THA with regard to functional outcomes, radiographic outcomes, and complication rates. Four Level I randomized controlled trials remained following our screening process. The data published in these studies were extracted and aggregated using a Mantel-Haenszel cumulative fixed effects meta-analysis. We found no significant difference between MOM and conventional THA with regard to functional outcomes as measured by Harris hip scores and radiographic outcomes as measured by radiolucent lines. Patients with MOM THA did however demonstrate a 3.37 times greater complication rate (1.57, 7.26). In light of the lack of superiority, the increased complication rate, the greater cost, and the potential for adverse medical consequences associated with MOM THA, these bearing surfaces should be used with caution.
Topics: Arthroplasty, Replacement, Hip; Hip Joint; Humans; Metals; Postoperative Complications; Radiography; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 22771090
DOI: 10.1016/j.arth.2012.05.023 -
Environmental Science and Pollution... May 2022Heavy metal pollution has increasingly affected human life, and the treatment of heavy metal pollution, especially chromium pollution, is still a major problem in the... (Review)
Review
Heavy metal pollution has increasingly affected human life, and the treatment of heavy metal pollution, especially chromium pollution, is still a major problem in the field of environmental governance. As a commonly used industrial metal, chromium can easily enter the environment with improperly treated industrial waste or wastewater, then pollute soil and water sources, and eventually accumulate in the human body through the food chain. Many countries and regions in the world are threatened by soil chromium pollution, resulting in the occurrence of cancer and a variety of metabolic diseases. However, as a serious threat to agriculture, food, and human health. Notwithstanding, there are limited latest and systematic review on the removal methods, mechanisms, and effects of soil chromium pollution in recent years. Hence, this article outlines some of the methods and mechanisms for the removal of chromium in soil, including physical, chemical, biological, and biochar methods, which provide a reference for the treatment and research on soil chromium pollution drawn from existing publications.
Topics: Biodegradation, Environmental; Chromium; Environmental Policy; Humans; Metals, Heavy; Soil; Soil Pollutants
PubMed: 35226261
DOI: 10.1007/s11356-022-19452-z -
Food and Chemical Toxicology : An... Aug 2018Human consumption of fish protein, including canned tuna fish, is increasing steadily worldwide. However, there are some concerns about the potential exposure to... (Meta-Analysis)
Meta-Analysis Review
Human consumption of fish protein, including canned tuna fish, is increasing steadily worldwide. However, there are some concerns about the potential exposure to elevated concentrations of metals in canned tuna fish. Several studies have been conducted in Iran regarding the concentration of metals in seafood, including copper (Cu), selenium (Se), iron (Fe), zinc (Zn), mercury (Hg), lead (Pb), chromium (Cr), arsenic (As), nickel (Ni), tin (Sn), and cadmium (Cd) in canned tuna fish. The main aim of this study was to gather data from existing papers and to perform a meta-analysis of the pooled concentrations of metals to evaluate their non-carcinogenic and carcinogenic risks in children and adults consumers. Search was conducted retrieving data from the international biomedical databases with highly public access and consultation, e.g., Web of Science, PubMed, Science Direct, and Scopus, and national database (SID and Irandoc) between 1983 and November of 2017. Data from 23 articles and 1295 samples were assessed and extracted. The ranking order of metals based on mean concentrations (μg/g wet weight) were Fe (13.17) > Zn (9.31) > Se (2.23) > Al (1.8) > Cr (1.63) > Cu (1.52) > As (0.38) > Ni (0.33) > Pb (0.24) > Cd (0.14) > Hg (0.11) > Sn (0.1). Except for Cd and Se, concentrations of other metals in the canned tuna fish were lower than the limits recommended by the United States Environmental Protection Agency (USEPA), World Health Organization (WHO), Food and Agriculture Organization (FAO) and Iran National Standards Organization (INSO). The minimum and maximum target hazard quotient (THQ) for adults were 5.55E-5 for Al and 2.23E-08 for Cr. For children, they were 7.23E-05 for Al and 2.91E-08 for Cr. THQ, and total target hazard quotient (TTHQ) were ≤1.0 for adult and children consumers. The Incremental Lifetime Cancer Risk (ILCR) of As was 3.21E-5 in adults and 4.18E-5 in children. Adults and children that consume canned tuna fish in Iran are not at non-carcinogenic risk but have a carcinogenic risk due to As.
Topics: Animals; Carcinogens; Dietary Exposure; Food Handling; Humans; Iran; Metals; Risk Assessment; Seafood; Tuna
PubMed: 29913231
DOI: 10.1016/j.fct.2018.06.023 -
Environmental Pollution (Barking, Essex... May 2024The gut-brain axis is a crucial interface between the central nervous system and the gut microbiota. Recent evidence shows that exposure to environmental contaminants,... (Review)
Review
The gut-brain axis is a crucial interface between the central nervous system and the gut microbiota. Recent evidence shows that exposure to environmental contaminants, such as heavy metals, can cause dysbiosis in gut microbiota, which may affect the gut-brain communication, impacting aspects of brain function and behavior. This systematic review of the literature aims to evaluate whether deleterious effects on brain function due to heavy metal exposure could be mediated by changes in the gut microbiota profile. Animal studies involving exposure to heavy metals and a comparison with a control group that evaluated neuropsychological outcomes and/or molecular outcomes along with the analysis of microbiota composition were reviewed. The authors independently assessed studies for inclusion, extracted data and assessed risk of bias using the protocol of Systematic Review Center for Laboratory Animal Experimentation (SYRCLE) for preclinical studies. A search in 3 databases yielded 16 eligible studies focused on lead (n = 10), cadmium (n = 1), mercury (n = 3), manganese (n = 1), and combined exposure of lead and manganese (n = 1). The animal species were rats (n = 7), mice (n = 4), zebrafish (n = 3), carp (n = 1) and fruit fly (n = 1). Heavy metals were found to adversely affect cognitive function, behavior, and neuronal morphology. Moreover, heavy metal exposure was associated with changes in the abundance of specific bacterial phyla, such as Firmicutes and Proteobacteria, which play crucial roles in gut health. In some studies, these alterations were correlated with learning and memory impairments and mood disorders. The interplay of heavy metals, gut microbiota, and brain suggests that heavy metals can induce direct brain alterations and indirect effects through the microbiota, contributing to neurotoxicity and the development of neuropsychological disorders. However, the small number of papers under review makes it difficult to draw definitive conclusions. Further research is warranted to unravel the underlying mechanisms and evaluate the translational implications for human health.
Topics: Mice; Rats; Animals; Humans; Gastrointestinal Microbiome; Manganese; Zebrafish; Metals, Heavy; Brain
PubMed: 38462196
DOI: 10.1016/j.envpol.2024.123732