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1.
Salivary Nickel and Chromium Levels in Orthodontic Patients with and Without Periodontitis: a Preliminary Historical Cohort Study.
Amini, F, Asadi, E, Hakimpour, D, Rakhshan, A
Biological trace element research. 2019;(1):10-15
Abstract
Many periodontal patients may need orthodontic treatment. Alterations in oral environment particularly the reduction of pH in periodontal patients could affect metal ion release from orthodontic appliances. However, there is no study on metal ion release in periodontal patients. The aim of this preliminary study was to comparatively evaluate, for the first time, salivary levels of nickel and chromium in periodontal patients (versus healthy controls) under orthodontic treatment for 2 months. In this in vivo study, 40 subjects were evaluated. Patient selection and standardization of orthodontic treatment protocols were prospectively designed and performed. Two groups of n = 20 each (control: healthy orthodontic patients, cohort: orthodontic patients with periodontitis) underwent similar protocols of fixed orthodontic treatment for 2 months. After 2 months, salivary nickel and chromium concentrations of the case and cohort groups were measured using inductively coupled plasma mass spectrometry (ICP-MS). The values were compared between the two groups using t test. There were 10 men and 10 women in each group. The mean age of patients was 34.6 ± 3.6 years old. The salivary level of nickel was 338.2 ± 235.5 ng/ml and 182.8 ± 116.5 ng/ml in the cohort and control groups, respectively (P = 0.0118). The salivary level of chromium was 7.4 ± 3.15 ng/ml in the cohort and 6.35 ± 2.39 ng/ml in the control group (P = 0.2214). Salivary level of nickel might be considerably higher in periodontal patients undergoing 2 months of orthodontic treatment compared to orthodontic patients with healthy gingivae.
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2.
All-Pedicle Screw Fixation With 6-mm-Diameter Cobalt-Chromium Rods Provides Optimized Sagittal Correction of Adolescent Idiopathic Scoliosis.
Lamerain, M, Bachy, M, Dubory, A, Kabbaj, R, Scemama, C, Vialle, R
Clinical spine surgery. 2017;(7):E857-E863
Abstract
PURPOSE Recently introduced cobalt-chromium (CoCr) rods that rely solely on pedicle screws produce very good results in correcting scoliotic curves. All-pedicle screws constructs are also suspected of decreasing thoracic kyphosis. The current study was designed to evaluate sagittal correction in adolescent idiopathic scoliosis patients, using 6-mm CoCr rods and all-screw constructs. MATERIALS AND METHODS A total of 61 patients treated by posterior spinal fusion and instrumentation, using all-pedicle screw constructs were included. The mean age at surgery was 15.4 years (range, 12-18 y). Forty-five patients (group A) were diagnosed with decreased thoracic kyphosis, and 16 patients (group B) had normal (35-50 degrees) thoracic kyphosis. RESULTS The preoperative main Cobb angle was 62.93±19.38 degrees in group A and 73.45±22.13 degrees in group B. In group A, the postoperative main Cobb angle was 23.33±12.71 degrees. In group B, the postoperative main Cobb angle was 27.20±10.04 degrees. The T4-T12 thoracic kyphosis improved postoperatively from 18.15±10.29 to 28.18±8.35 degrees in group A. In group B, the postoperative T4-T12 thoracic kyphosis was 40.34±3.13 degrees. Statistical analysis showed a significant improvement between preoperative and postoperative values of T4-T12 thoracic kyphosis in group A. In group B, the differences in T4-T12 thoracic kyphosis values were not statistically significant. CONCLUSIONS Our result demonstrates a significant improvement of T4-T12 thoracic kyphosis in the hypokyphotic group of patients and confirms that CoCr rods can produce sagittal corrections in hypokyphotic adolescent idiopathic scoliosis patients. Our results confirm the benefit of combining all-pedicle screw constructs with a posterolateral translational in situ bending procedure to correct hypokyphosis directly.
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3.
Comparison of Whole-Blood Metal Ion Levels Among Four Types of Large-Head, Metal-on-Metal Total Hip Arthroplasty Implants: A Concise Follow-up, at Five Years, of a Previous Report.
Hutt, J, Lavigne, M, Lungu, E, Belzile, E, Morin, F, Vendittoli, PA
The Journal of bone and joint surgery. American volume. 2016;(4):257-66
Abstract
Few studies of total hip arthroplasty (THA) implants with a large-diameter femoral head and metal-on-metal design have directly compared the progression of metal ion levels over time and the relationship to complications. As we previously reported, 144 patients received one of four types of large-diameter-head, metal-on-metal THA designs (Durom, Birmingham, ASR XL, or Magnum implants). Cobalt, chromium, and titanium ion levels were measured over five years. We compared ion levels and clinical results over time. The Durom group showed the highest levels of cobalt (p ≤ 0.002) and titanium ions (p ≤ 0.03). Both the Durom and Birmingham groups demonstrated significant ongoing cobalt increases up to five years. Eight patients (seven with a Durom implant and one with a Birmingham implant) developed adverse local tissue reaction. Six Durom implants and one Birmingham implant required revision, with one pseudotumor under surveillance at the time of the most recent follow-up. We found that ion generation and related complications varied among designs. More concerning was that, for some designs, ion levels continued to increase. Coupling a cobalt-chromium adapter sleeve to an unmodified titanium femoral trunnion along with a large metal-on-metal bearing may explain the poor performances of two of the designs in the current study.
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4.
The Inflammatory Phenotype in Failed Metal-On-Metal Hip Arthroplasty Correlates with Blood Metal Concentrations.
Paukkeri, EL, Korhonen, R, Hämäläinen, M, Pesu, M, Eskelinen, A, Moilanen, T, Moilanen, E
PloS one. 2016;(5):e0155121
Abstract
INTRODUCTION Hip arthroplasty is the standard treatment of a painful hip destruction. The use of modern metal-on-metal (MOM) bearing surfaces gained popularity in total hip arthroplasties during the last decade. Recently, worrisome failures due to adverse reaction to metal debris (ARMD), including pseudotumor response, have been widely reported. However, the pathogenesis of this reaction remains poorly understood. The aim of the present study was to investigate the ARMD response by flow cytometry approach. METHODS Sixteen patients with a failed Articular Surface Replacement (ASR) hip prosthesis were included in the study. Samples of pseudotumor tissues collected during revision surgery were degraded by enzyme digestion and cells were typed by flow cytometry. Whole blood chromium and cobalt concentrations were analyzed with mass spectrometry before revision surgery. RESULTS Flow cytometry analysis showed that the peri-implant pseudotumor tissue expressed two principal phenotypes, namely macrophage-dominated and T-lymphocyte-dominated response; the average portions being 54% (macrophages) and 25% (T-lymphocytes) in macrophage-dominated inflammation and 20% (macrophages) and 54% (T-lymphocytes) in T-lymphocyte-dominated response. The percentages of B-lymphocytes and granulocytes were lower in both phenotypes. Interestingly, the levels of blood chromium and cobalt were significantly higher in patients with macrophage-dominated response. CONCLUSIONS The results suggest that the adverse tissue reactions induced by MOM wear particles contain heterogeneous pathogeneses and that the metal levels are an important factor in the determination of the inflammatory phenotype. The present results support the hypothesis that higher metal levels cause cytotoxicity and tissue injury and macrophages are recruited to clear the necrotic debris. On the other hand, the adverse response developed in association with lower metal levels is T-lymphocyte-dominated and is likely to reflect hypersensitivity reaction.
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5.
Two-year serum metal ion levels in minimally invasive total conservative hip resurfacing: preliminary results of a prospective study.
Tai, SM, Millard, N, Munir, S, Jenabzadeh, AR, Walter, LR, Walter, WL
ANZ journal of surgery. 2015;(3):164-8
Abstract
BACKGROUND Metal-on-metal (MoM) hip resurfacings have been associated with the potential development of metallic debris and its associated pathology. Serum cobalt and chromium levels are a reliable surrogate marker of wear rates in MoM bearings. The aim of the study was to examine the trend in serum metal ion levels in the initial 2-year post-operative period following implantation of the minimally invasive total conservative hip MoM hip resurfacing and to determine whether head size, acetabular component orientation, clinical outcome scores or post-operative range of movement would affect these levels. METHODS In this prospective cohort study, serum cobalt and chromium ion levels were measured pre- and post-operatively in 25 patients who underwent minimally invasive total conservative hip MoM hip resurfacing. The results were correlated with acetabular component orientation, head size, outcome scores and post-operative range of movement. RESULTS The mean serum cobalt and chromium levels at 2 years were 1.2 ppb (0.4-4.4 ppb) and 2.1 ppb (0.7-5.7 ppb). The mean cup inclination was 43° (30°-60°) and anteversion was 18° (1°-47°). There was no clear relationship between serum ions and acetabular component orientation, outcome scores or range of movement. Patients with a head size ≤52 mm had significantly higher metal ion levels (cobalt P = 0.02, chromium P = 0.045). CONCLUSION Our preliminary results show all patients had cobalt and chromium levels below those indicating a high-risk implant, suggesting successful early outcome from minimally invasive total conservative hip resurfacing surgery.
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6.
Effect of chromium-enriched yeast on fasting plasma glucose, glycated haemoglobin and serum lipid levels in patients with type 2 diabetes mellitus treated with insulin.
Racek, J, Sindberg, CD, Moesgaard, S, Mainz, J, Fabry, J, Müller, L, Rácová, K
Biological trace element research. 2013;(1):1-4
Abstract
Chromium is required for a normal insulin function, and low levels have been linked with insulin resistance. The aim of this study was to follow the effect of chromium supplementation on fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) and serum lipids in patients with type 2 diabetes mellitus (DM2) on insulin therapy. Eleven randomly selected patients with DM2 on insulin therapy were supplemented with a daily dose of 100 μg chromium yeast for the first supplementation period of 2 weeks. In the second supplementation period, the chromium dose was doubled and continued for the next 6 weeks. The third phase was a 6-week washout period. After each period, the levels of FPG and HbA1c were compared with the corresponding values at the end of the previous period. Serum triglycerides, total HDL and LDL cholesterol values after supplementation were compared with the baseline values. FPG decreased significantly after the first period of chromium supplementation (p < 0.001), and a tendency to a further reduction was observed after the second supplementation period. Similarly, HbA1c decreased significantly in both periods (p < 0.02 and p < 0.002, respectively). Eight weeks after withdrawal of chromium supplementation, both FPG and HbA1c levels returned to their pre-intervention values. The serum lipid concentrations were not significantly influenced by chromium supplementation. Chromium supplementation could be beneficial in patients with DM2 treated with insulin, most likely due to lowered insulin resistance leading to improved glucose tolerance. This finding needs to be confirmed in a larger study.
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7.
The effect of stress on salivary metal ion content in orthodontic patients.
Amini, F, Rahimi, H, Morad, G, Mollaei, M
Biological trace element research. 2013;(3):339-43
Abstract
Psychological stress can alter the environment in favor of corrosion of orthodontic alloys by changing the properties of saliva. This study aimed to assess the effect of stress induction on salivary nickel and chromium content in fixed orthodontic patients. Thirty patients were enrolled in this experiment. Saliva sample collection was performed at four time points: T1, before insertion of orthodontic appliances; T2, 3 months after the initiation of orthodontic treatment, before induction of stress; T3, 15 min following the induction of stress by Trier Social Stress Test; and T4, 30 min following the induction of stress. Ion content was measured by atomic absorption spectrophotometry. The obtained data were analyzed by repeated measures analysis of variance (ANOVA) and post hoc Bonferroni test. The mean amount of salivary nickel increased from 11.9 ± 5.1 μg/L at T1 to 14.1 ± 5.3 μg/L at T4. This increase was found significant only at T4 comparing to T1. The average salivary chromium content changed from 4.1 ± 2.3 μg/L at T1 to 5.1 ± 3.3 μg/L at T4. None of the differences were significant for chromium. In conclusion, induction of stress in this study led to a significant increase in nickel release from orthodontic appliances into saliva. The salivary chromium content however was not significantly altered, yet gradually increased.
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8.
Cushion bearings versus large diameter head metal-on-metal bearings in total hip arthroplasty: a short-term metal ion study.
Moroni, A, Nocco, E, Hoque, M, Diremigio, E, Buffoli, D, Cantù, F, Catalani, S, Apostoli, P
Archives of orthopaedic and trauma surgery. 2012;(1):123-9
Abstract
INTRODUCTION Metal-on-metal total hip arthroplasty (MOM THA) has the advantage of replicating the femoral head size, but the postoperative elevation of serum metal ion levels is a cause for concern. Metal-on-polycarbonate-urethane is a new cushion bearing featuring a large diameter metal head coupled with a polycarbonate-urethane liner. AIM: The aim of this study was to assess and compare serum cobalt (Co) and chromium (Cr) levels in a group of 15 patients treated with a cushion bearing THA system (Group A) and a group of 15 patients treated with a MOM THA system (Group B) at short-term. At a mean follow-up of 27.3 months (18-35 months), in Group A the median Cr and Co serum levels were significantly lower than in Group B, measuring 0.24 μg/L (0.1-2.1 μg/L) and 0.6 μg/L (0.29-2.3 μg/L) compared to 1.3 μg/L (0.1-9 μg/L, p < 0.001) and 2.9 μg/L (0.85-13.8 μg/L, p < 0.001) respectively. RESULTS All patients demonstrated an excellent clinical result, as shown by the Harris and Oxford hip scores. The cushion bearing THA studied in this paper showed clinical outcomes similar to the MOM THA bearing, with the advantage of no significant metal ion elevation in the serum. CONCLUSION These findings warrant the continued clinical study of compliant bearing options.
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9.
Chromium, zinc and magnesium concentrations in the pubic hair of obese and overweight women.
Wiechuła, D, Loska, K, Ungier, D, Fischer, A
Biological trace element research. 2012;(1):18-24
Abstract
The study addressed chromium, zinc and magnesium concentrations in the pubic hair of obese and overweight women. It was carried out on hair collected from 85 women at the age of 16-80 living in the Podkarpackie Voivodeship (southern Poland). The experimental and control groups consisted of 39 and 46 females, respectively. The pubic hair was prepared under a procedure established by the International Atomic Energy Agency, followed by wet digestion in a microwave oven. The concentration of the metals in the pubic hair and reference material was assayed with the flame (Mg, Zn) and flameless (Cr) atomic absorption spectrometry. The pubic hair of overweight and obese women from the experimental group revealed significantly higher chromium and magnesium concentrations and significantly lower concentrations of zinc than in the control group. An increase in BMI brought about an increase in chromium and magnesium concentrations while zinc concentration decreased with increasing BMI. The disturbances in the mineral balance of overweight and obese women were also demonstrated by significantly different ratios of the elements compared with the control group.
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10.
Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss.
Preuss, HG, Bagchi, D, Bagchi, M, Rao, CV, Dey, DK, Satyanarayana, S
Diabetes, obesity & metabolism. 2004;(3):171-80
Abstract
AIM: The efficacy of optimal doses of highly bioavailable (-)-hydroxycitric acid (HCA-SX) alone and in combination with niacin-bound chromium (NBC) and a standardized Gymnema sylvestre extract (GSE) on weight loss in moderately obese subjects was evaluated by monitoring changes in body weight, body mass index (BMI), appetite, lipid profiles, serum leptin and excretion of urinary fat metabolites. HCA-SX has been shown to reduce appetite, inhibit fat synthesis and decrease body weight without stimulating the central nervous system. NBC has demonstrated its ability to maintain healthy insulin levels, while GSE has been shown to regulate weight loss and blood sugar levels. METHODS A randomized, double-blind, placebo-controlled human study was conducted in Elluru, India for 8 weeks in 60 moderately obese subjects (ages 21-50, BMI >26 kg/m(2)). Subjects were randomly divided into three groups. Group A was administered HCA-SX 4667 mg, group B was administered a combination of HCA-SX 4667 mg, NBC 4 mg and GSE 400 mg, while group C was given placebo daily in three equally divided doses 30-60 min before meals. All subjects received a 2000 kcal diet/day and participated in supervised walking. RESULTS At the end of 8 weeks, body weight and BMI decreased by 5-6% in both groups A and B. Food intake, total cholesterol, low-density lipoproteins, triglycerides and serum leptin levels were significantly reduced in both groups, while high-density lipoprotein levels and excretion of urinary fat metabolites increased in both groups. A marginal or non-significant effect was observed in all parameters in group C. CONCLUSION The present study shows that optimal doses of HCA-SX and, to a greater degree, the combination of HCA-SX, NBC and GSE can serve as an effective and safe weight-loss formula that can facilitate a reduction in excess body weight and BMI, while promoting healthy blood lipid levels.