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Pesquisa : Reação and a and Corpo and Estranho [Palavras]
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[PMID]:29203742
[Au] Autor:Faustova MO; Ananieva MM; Basarab YO; Loban' GA
[Ad] Endereço:Higher State Educational Establishment Of Ukraine " Ukrainian Medical Stomatological Academy", Poltava, Ukraine.
[Ti] Título:Neutrophil bactericidal activity through the stages of placement of different dental implants depending on their chemical composition.
[So] Source:Wiad Lek;70(5):921-924, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The analysis of data provided by implant system manufacturers has demonstrated that implants, i.e. parts screwed into the bone, are of different chemical composition of the implant. Sometimes they have little amount of metal contaminants,which are not biologically passive. THE AIM: To explore the effects produced by dental titanium implants containing metal contaminants on the stimulation of antimicrobial properties of neutrophils. MATERIAL AND METHODS: A total of 24 patients who had from 1 to 4 titanium implants with different chemical compositions were subjected to the comprehensive check-up to this end. The functional activity of neutrophils was evaluated by nitroblue tetrazolium (NBT) reduction test. It was dynamically in 5-7 days after the implant fitting into the bone, and in 3 months after the procedure of implant placement. RESULTS: On the 5-7th day following the placement of implants with weight percentage of titanium (Ti) in the composition from 25 to 50%, the share of active neutrophils significantly increased compared with share of active neutrophils prior the surgical procedure. However, after 3 months, this parameter in patients with implants, whose titanium content was low, remained significantly high. CONCLUSIONS: The placement of dental implants systems led to an increase in the share of active neutrophils in the peripheral blood of the patients in 5-7 days following the procedure of implant insertion. However, this indicator for implant systems with a higher content of Ti in the remote period returned to its original value, which indicates their higher biocompatibility with the tissues of the human body.
[Mh] Termos MeSH primário: Reação a Corpo Estranho/metabolismo
Mediadores da Inflamação/metabolismo
Inflamação/metabolismo
Neutrófilos/metabolismo
Titânio
[Mh] Termos MeSH secundário: Implantes Dentários
Materiais Dentários
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dental Implants); 0 (Dental Materials); 0 (Inflammation Mediators); D1JT611TNE (Titanium)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29384602
[Au] Autor:Liu M; Wu K; Zhao L; Zhang Y
[Ti] Título:Foreign Body Reaction to Biomaterial Nanotubular Surface and the Influence of Silver Loading.
[So] Source:J Biomed Nanotechnol;13(4):381-92, 2017 Apr.
[Is] ISSN:1550-7033
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The impacts of biomaterial surface properties (i.e., surface nanotopography) and dopants (i.e., silver (Ag)) on the biomaterial-associated foreign body reaction (FBR) remain unclear. In this study, an in vivo FBR that was induced by a titania nanotube array (NT) on titanium was examined with and without Ag loading. An NT with an 80 nm diameter that was fabricated by anodization, and the NT samples that were loaded with two Ag concentrations (NT-AgH and NT-AgL) and formed by electrodeposition exhibited high hydrophilicities. A relatively rapid initial Ag+ release with a subsequent gradual reduction was observed for NT-AgH and NT-AgL; the Ag+ release was higher for NT-AgH than for NT-AgL. We found that the NT decreased the biomaterial-associated FBR, evidenced by a decreased fibrous capsule thickness and a number of recruited macrophages. The effect of Ag loading on the FBR was considered acceptable because the FBR induced by the NT-Ag samples was still less severe than that of the PT control. Additionally, the temporary increases in the blood, brain, liver and kidney Ag+ concentrations did not produce general side effects and were considered to be in the safe range. This study demonstrates the ability of nanotopography to alleviate the biomaterial-associated FBR and provides further evidence for future clinical applications of biomaterials with nanostructures and Ag loading.
[Mh] Termos MeSH primário: Implantes de Medicamento/administração & dosagem
Reação a Corpo Estranho/induzido quimicamente
Reação a Corpo Estranho/prevenção & controle
Nanopartículas Metálicas/administração & dosagem
Nanotubos/efeitos adversos
Prata/administração & dosagem
Titânio/efeitos adversos
[Mh] Termos MeSH secundário: Animais
Implantes de Medicamento/química
Reação a Corpo Estranho/patologia
Masculino
Nanopartículas Metálicas/química
Nanotubos/química
Ratos
Ratos Sprague-Dawley
Prata/química
Propriedades de Superfície
Titânio/química
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Drug Implants); 3M4G523W1G (Silver); D1JT611TNE (Titanium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE


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[PMID]:29245243
[Au] Autor:He J; Shi W
[Ad] Endereço:aDepartment of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of MedicinebShanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China.
[Ti] Título:Inflammatory foreign body reaction caused by resorbable materials used for orbital fractures repair: A case report.
[So] Source:Medicine (Baltimore);96(49):e8822, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Resorbable materials have been recommended for orbital fractures repair. Many literatures reported the advantages of resorbable materials in clinical applications, but few reports about complications. PATIENT CONCERNS: In this study, we encountered a 14-year-old boy treated for the orbital fracture by using resorbable plate, in whom inflammatory foreign body reaction was detected. In addition, this patient had repeated history of skin allergy and upper respiratory tract infection. DIAGNOSES: Intraoperative observation showed that the resorbable material near the orbital rim was covered by granulation and inflammatory tissues, without purulent secretions. The histological examination revealed inflammatory foreign body reaction to the resorbable plate. INTERVENTIONS: Debridement was taken to remove the mass on the left lower eyelid. At the outpatient examination, a small amount of granulation tissue was found at the incision. Then, secondary surgery for exploration and removal of the resorbable material was carried, 9 months after the first surgery. OUTCOMES: One month after the surgery, the skin retraction, ectropion, and edema gradually improved. LESSONS: Inadequate degradation of resorbable materials and patient's medical history of allergies may cause an inflammatory foreign body reaction. Therefore, it is prudent to choose resorbable materials for patients.
[Mh] Termos MeSH primário: Implantes Absorvíveis/efeitos adversos
Placas Ósseas/efeitos adversos
Reação a Corpo Estranho/etiologia
Complicações Intraoperatórias/etiologia
Fraturas Orbitárias/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008822


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[PMID]:29068919
[Au] Autor:Danino MA; Nizard N; Paek LS; Govshievich A; Giot JP
[Ad] Endereço:Montreal, Quebec, Canada; and Grenoble, France From the Division of Plastic Surgery, Centre Hospitalier de l'Université de Montréal, Université de Montréal; and the Division of Plastic Surgery, Centre Hospitalier Universitaire Grenoble Alpes.
[Ti] Título:Do Bacteria and Biofilm Play a Role in Double-Capsule Formation around Macrotextured Implants?
[So] Source:Plast Reconstr Surg;140(5):878-883, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The double capsule is a complication mostly described in aggressive macrotextured implants. Mechanical shear stress applied onto an immature periprosthetic capsule has been linked to their formation. The authors aim to demonstrate the role of bacterial phenotype and biofilm in the development of the double capsule. METHODS: Seven double capsules formed at the interface of macrotextured breast expander implants were studied using scanning electron microscopy. Two samples for each surface of the inner capsule layer (the prosthesis interface and the intercapsular space) were analyzed for bacteria cell size, bacterial density, and biofilm deposition. RESULTS: Although all routine bacterial cultures were negative, the prosthesis interface had both higher bacteria load and biofilm deposition compared with the intercapsular space (Mann-Whitney U test, p = 0.004 and p = 0.008, respectively). Moreover, bacteria cell sizes were significantly smaller at the prosthesis interface in six of seven samples. Comparison of bacteria density and biofilm dispersion showed an increase of biofilm extracellular matrix deposition over 2000 cells/mm (linear regression, p = 0.0025). These results indicate a common trend among bacteria species. CONCLUSIONS: Bacterial expression between the different surfaces of the double capsule displays significant differences; bacteria at the prosthesis interface are mostly in a biofilm state, whereas they demonstrate a planktonic phenotype at the intercapsular space. When a sufficient amount of bacteria are present at a specific location, quorum sensing may trigger a biofilm phenotypic switch in planktonic bacteria cells. Biofilm formation may alter capsule formation through immune response, thereby weakening capsule strength and facilitating extracellular matrix delamination and double-capsule formation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
[Mh] Termos MeSH primário: Biofilmes
Implantes de Mama/microbiologia
Reação a Corpo Estranho/microbiologia
Complicações Pós-Operatórias/microbiologia
Dispositivos para Expansão de Tecidos/microbiologia
[Mh] Termos MeSH secundário: Adulto
Implante Mamário/instrumentação
Implante Mamário/métodos
Feminino
Reação a Corpo Estranho/patologia
Seres Humanos
Microscopia Eletrônica de Varredura
Meia-Idade
Complicações Pós-Operatórias/patologia
Estudos Prospectivos
Expansão de Tecido/instrumentação
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003767


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[PMID]:28926383
[Au] Autor:Reiner T; Do TD; Klot MC; Hertzsch F; Seelmann K; Gaida MM; Weber MA; Gotterbarm T
[Ad] Endereço:1Center for Orthopedics, Trauma Surgery and Spinal Cord Injury (T.R., M.C.K., F.H., K.S., and T.G.), and Department of Diagnostic and Interventional Radiology (T.D.D. and M.-A.W.), Heidelberg University Hospital, Heidelberg, Germany 2Institute for Pathology, University of Heidelberg, Heidelberg, Germany.
[Ti] Título:MRI Findings in Patients After Small-Head Metal-on-Metal Total Hip Arthroplasty with a Minimum Follow-up of 10 Years.
[So] Source:J Bone Joint Surg Am;99(18):1540-1546, 2017 Sep 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Concern has been raised about the late onset of adverse reactions to metal debris (ARMD) in patients with a small-head metal-on-metal total hip replacement. The aims of this study were to assess the frequency and characteristic appearance of ARMD in patients with a small-head (28-mm) metal-on-metal total hip replacement and elevated blood ion levels (>1 µg/L) after a minimum follow-up of 10 years and to analyze the possible risk factors associated with the prevalence of these lesions. METHODS: In the present study, we used metal artifact reduction sequence magnetic resonance imaging (MARS MRI) to investigate the cases of 53 patients (66 hips) with a small-head (28-mm) metal-on-metal total hip replacement and elevated blood ion levels at a mean follow-up interval of 15.5 years (range, 10.6 to 19.3 years). Whole blood metal ion levels (cobalt and chromium), clinical outcome scores (Harris hip score), and radiographs were obtained for each patient. Tissue samples from patients who had revision surgery were histologically examined. RESULTS: MARS MRI revealed ARMD in 27 hips (41%). Most hips with ARMD (67%) were asymptomatic. ARMD were generally small, with a median lesion size of 2.3 cm (range, 0.3 to 71.4 cm) and predominantly cystic in nature. Multivariate regression analysis revealed positive correlation between cobalt ion levels and the presence of ARMD. In this case series, the risk for the development of ARMD was 2.87 times higher for every 1 µg/L increase of blood cobalt ion concentration (95% confidence interval, 1.01 to 8.17; p = 0.048). CONCLUSIONS: In this case series, ARMD were seen in 41% of the hips following small-head metal-on-metal total hip arthroplasty at long-term follow-up, and most patients with ARMD were asymptomatic. Blood cobalt ion levels could be identified as a risk factor for ARMD. However, ARMD also occurred in patients with low metal ion levels. Further studies are necessary to investigate the role of ARMD in asymptomatic patients with this bearing type. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Reação a Corpo Estranho/epidemiologia
Prótese de Quadril/efeitos adversos
Próteses Articulares Metal-Metal/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Artroplastia de Quadril/métodos
Cromo/efeitos adversos
Cromo/sangue
Cobalto/efeitos adversos
Cobalto/sangue
Feminino
Seguimentos
Corpos Estranhos/sangue
Reação a Corpo Estranho/diagnóstico por imagem
Reação a Corpo Estranho/etiologia
Seres Humanos
Imagem por Ressonância Magnética/métodos
Masculino
Meia-Idade
Análise Multivariada
Prevalência
Desenho de Prótese
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0R0008Q3JB (Chromium); 3G0H8C9362 (Cobalt)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170920
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01021


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[PMID]:28926382
[Au] Autor:Matharu GS; Berryman F; Judge A; Reito A; McConnell J; Lainiala O; Young S; Eskelinen A; Pandit HG; Murray DW
[Ad] Endereço:1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom 2The Royal Orthopaedic Hospital, Birmingham, United Kingdom 3MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, United Kingdom 4Coxa Hospital for Joint Replacement, Tampere, Finland 5Warwick Hospital, Warwick, United Kingdom 6Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), Chapel Allerton Hospital, Leeds, United Kingdom.
[Ti] Título:Blood Metal Ion Thresholds to Identify Patients with Metal-on-Metal Hip Implants at Risk of Adverse Reactions to Metal Debris: An External Multicenter Validation Study of Birmingham Hip Resurfacing and Corail-Pinnacle Implants.
[So] Source:J Bone Joint Surg Am;99(18):1532-1539, 2017 Sep 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The authors of recent studies have reported newly devised implant-specific blood metal ion thresholds to predict adverse reactions to metal debris (ARMD) in patients who have undergone unilateral or bilateral metal-on-metal (MoM) hip arthroplasty. These thresholds were most effective for identifying patients at low risk of ARMD. We investigated whether these newly devised blood metal ion thresholds could effectively identify patients at risk of ARMD after MoM hip arthroplasty in an external cohort of patients. METHODS: We performed a validation study involving 803 MoM hip arthroplasties (323 unilateral Birmingham Hip Resurfacing [BHR], 93 bilateral BHR, and 294 unilateral Corail-Pinnacle implants) performed in 710 patients at 3 European centers. All patients underwent whole-blood metal ion sampling, and were divided into 2 groups: those with ARMD (leading to revision or identified on imaging; n = 75) and those without ARMD (n = 635). Previously devised implant-specific blood metal ion thresholds (2.15 µg/L of cobalt for unilateral BHR; 5.5 µg/L for the maximum of either cobalt or chromium for bilateral BHR; and 3.57 µg/L of cobalt for unilateral Corail-Pinnacle implants) were applied to the validation cohort, and receiver operating characteristic curve analysis was used to establish the discriminatory characteristics of each threshold. RESULTS: The area under the curve, sensitivity, specificity, and positive and negative predictive values for the ability of each implant-specific threshold to distinguish between patients with and without ARMD were, respectively, 89.4% (95% confidence interval [CI] = 82.8% to 96.0%), 78.9%, 86.7%, 44.1%, and 96.9% for unilateral BHR; 89.2% (CI = 81.3% to 97.1%), 70.6%, 86.8%, 54.5%, and 93.0% for bilateral BHR; and 76.9% (CI = 63.9% to 90.0%), 65.0%, 85.4%, 24.5%, and 97.1% for unilateral Corail-Pinnacle implants. Using the implant-specific thresholds, we missed 20 patients with ARMD (2.8% of the patients in this series). We missed more patients with ARMD when we used the fixed thresholds proposed by regulatory authorities: 35 (4.9%) when we used the U.K. threshold of 7 µg/L for both cobalt and chromium (p = 0.0003), 21 (3.0%) when we used the U.S. threshold of 3 µg/L for both cobalt and chromium (p = 1.0), and 46 (6.5%) when we used the U.S. threshold of 10 µg/L for both cobalt and chromium (p < 0.0001). CONCLUSIONS: This external multicenter validation study confirmed that patients with blood metal ion levels below new implant-specific thresholds have a low risk of ARMD after MoM hip arthroplasty. Using these implant-specific thresholds, we missed fewer patients with ARMD compared with when the thresholds currently proposed by regulatory authorities were used. We therefore recommend using implant-specific blood metal ion thresholds when managing patients who have undergone MoM hip arthroplasty. LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Cromo/sangue
Cobalto/sangue
Corpos Estranhos/sangue
Reação a Corpo Estranho/diagnóstico
Prótese de Quadril/efeitos adversos
Próteses Articulares Metal-Metal/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cromo/efeitos adversos
Cobalto/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Desenho de Prótese
Curva ROC
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; VALIDATION STUDIES
[Nm] Nome de substância:
0R0008Q3JB (Chromium); 3G0H8C9362 (Cobalt)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170920
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01568


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[PMID]:28850638
[Au] Autor:Thackaberry EA; Farman C; Zhong F; Lorget F; Staflin K; Cercillieux A; Miller PE; Schuetz C; Chang D; Famili A; Daugherty AL; Rajagopal K; Bantseev V
[Ad] Endereço:Department of Safety Assessment, Genentech Inc. South San Francisco, California, United States.
[Ti] Título:Evaluation of the Toxicity of Intravitreally Injected PLGA Microspheres and Rods in Monkeys and Rabbits: Effects of Depot Size on Inflammatory Response.
[So] Source:Invest Ophthalmol Vis Sci;58(10):4274-4285, 2017 Aug 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: Poly(lactic-co-glycolic) acid (PLGA) inserts have been successfully developed for the treatment of posterior eye disease as a means of reducing injection frequency of intravitreally administered therapeutics. PLGA microspheres are also of interest for the delivery of intravitreal drugs, since they offer the advantage of being easily injected without surgical procedures or large injectors. Methods: In the current study, the toxicity of PLGA microspheres and rods was investigated in nonhuman primates (NHPs) and rabbits. An in vitro assessment of cytokine responses to PLGA in peripheral blood mononuclear cells (PBMCs) and macrophages was also performed. Results: Intravitreal administration of 3, 10, or 12.5 mg/eye of PLGA microspheres in NHPs resulted in a severe immune response characterized by a foreign body response. Follow-up studies in the rabbit confirmed this finding for PLGA microspheres ranging in size from 20 to 100 µm. In contrast, administration of PLGA rod implants with a similar PLGA mass did not elicit a significant immune response. In vitro assays in PBMCs and macrophages confirmed proinflammatory cytokine release upon treatment with PLGA microspheres but not PLGA rods. Conclusions: These data demonstrate a lack of tolerability of PLGA microspheres upon intravitreal injection, and suggest that the size, shape, and/or surface area of PLGA depots are critical attributes in determining ocular toxicity.
[Mh] Termos MeSH primário: Materiais Biocompatíveis/toxicidade
Sistemas de Liberação de Medicamentos/efeitos adversos
Ácido Láctico/toxicidade
Microesferas
Ácido Poliglicólico/toxicidade
[Mh] Termos MeSH secundário: Animais
Materiais Biocompatíveis/administração & dosagem
Citocinas/metabolismo
Modelos Animais de Doenças
Reação a Corpo Estranho/metabolismo
Reação a Corpo Estranho/patologia
Injeções Intravítreas
Ácido Láctico/administração & dosagem
Macrófagos/metabolismo
Ácido Poliglicólico/administração & dosagem
Coelhos
Retina/efeitos dos fármacos
Retina/patologia
Corpo Vítreo/efeitos dos fármacos
Corpo Vítreo/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Cytokines); 0 (polylactic acid-polyglycolic acid copolymer); 26009-03-0 (Polyglycolic Acid); 33X04XA5AT (Lactic Acid)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170830
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.16-21334


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[PMID]:28768778
[Au] Autor:Matharu GS; Judge A; Pandit HG; Murray DW
[Ad] Endereço:University of Oxford, Nuffield Orthopaedic Centre, Oxford OX3 7LD, UK.
[Ti] Título:Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris? an analysis from the National Joint Registry for England and Wales.
[So] Source:Bone Joint J;99-B(8):1020-1027, 2017 Aug.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision. PATIENTS AND METHODS: We performed a retrospective observational study using National Joint Registry (NJR) data on 2535 MoMHAs undergoing revision surgery for ARMD between 2008 and 2014. The outcomes studied following revision were intra-operative complications, mortality and re-revision surgery. Predictors of re-revision were identified using competing-risk regression modelling. RESULTS: Intra-operative complications occurred in 40 revisions (1.6%). The cumulative five-year patient survival rate was 95.9% (95% confidence intervals (CI) 92.3 to 97.8). Re-revision surgery was performed in 192 hips (7.6%). The cumulative five-year implant survival rate was 89.5% (95% CI 87.3 to 91.3). Predictors of re-revision were high body mass index at revision (subhazard ratio (SHR) 1.06 per kg/m increase, 95% CI 1.02 to 1.09), modular component only revisions (head and liner with or without taper adapter; SHR 2.01, 95% CI 1.19 to 3.38), ceramic-on-ceramic revision bearings (SHR 1.86, 95% CI 1.23 to 2.80), and acetabular bone grafting (SHR 2.10, 95% CI 1.43 to 3.07). These four factors remained predictive of re-revision when the missing data were imputed. CONCLUSION: The short-term risk of re-revision following MoMHA revision surgery performed for ARMD was comparable with that reported in the NJR following all-cause non-MoMHA revision surgery. However, the factors predictive of re-revision included those which could be modified by the surgeon, suggesting that rates of failure following ARMD revision may be reduced further. Cite this article: 2017;99-B:1020-7.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Reação a Corpo Estranho/cirurgia
Prótese de Quadril/efeitos adversos
Próteses Articulares Metal-Metal/efeitos adversos
Sistema de Registros
[Mh] Termos MeSH secundário: Inglaterra/epidemiologia
Feminino
Reação a Corpo Estranho/epidemiologia
Reação a Corpo Estranho/etiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Desenho de Prótese
Falha de Prótese
Reoperação
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
País de Gales/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B8.BJJ-2016-0889.R1


  9 / 5221 MEDLINE  
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[PMID]:28367690
[Au] Autor:Schipper ON; Haddad SL; Pytel P; Zhou Y
[Ad] Endereço:1 OrthoCarolina Foot and Ankle Institute, Charlotte, NC, USA.
[Ti] Título:Histological Analysis of Early Osteolysis in Total Ankle Arthroplasty.
[So] Source:Foot Ankle Int;38(4):351-359, 2017 Apr.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The purpose of this study was to perform a histological comparative analysis of tibiotalar joint samples taken from areas of osteolysis adjacent to total ankle arthroplasties vs control synovial specimens to determine the reaction to and presence of polyethylene (PE) particles. METHODS: A total of 57 pathology samples were identified in the osteolysis group, while 11 were identified in the control group. For each sample, hematoxylin and eosin, Oil Red O (ORO), and macrophage marker CD163-stained slides were created. Polarized light and ORO stain were used to identify PE particles. The presence of metal particles and giant cell reaction to PE particles were also scored. RESULTS: Macrophages, PE particles, metallosis, and foreign body giant cell reaction scores were significantly higher in the osteolysis group compared with the control group. In the osteolysis group, ORO staining was positive in 93% (53/57), birefringent material was present in 96.5% (55/57), and macrophage infiltrates were present in 96.5% (55/57). Foreign body giant cell reaction with giant cells surrounding PE particles was present in 49.1% (28/57) of osteolytic specimens. The presence of foreign body giant cell reaction was associated with significantly higher macrophage, ORO, and polarizable material scores. The average time to surgery for osteolysis from the index ankle replacement was 6.0 (range, 0-15) years for the 57 patients in the osteolysis group. CONCLUSION: This study is the largest ankle arthroplasty histological analysis to show that areas of osteolysis consist of abundant polyethylene wear particles, present both intracellularly and extracellularly. Furthermore, these areas were associated with a CD163 macrophage infiltrate and frequently a foreign body reaction with giant cells engulfing PE particles. It is likely that implant wear particles play a significant role in osteolysis based on the histopathology. LEVEL OF EVIDENCE: Level III, retrospective comparative series.
[Mh] Termos MeSH primário: Doenças das Cartilagens/patologia
Osteólise/patologia
Polietileno/química
[Mh] Termos MeSH secundário: Artroplastia de Substituição do Tornozelo
Reação a Corpo Estranho
Seres Humanos
Próteses e Implantes/normas
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9002-88-4 (Polyethylene)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716682333


  10 / 5221 MEDLINE  
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[PMID]:28329506
[Au] Autor:Martinez-Lopez A; Pérez-Lopez I; Sánchez-Cano D; Ruiz-Villaverde R
[Ad] Endereço:Dermatology Department, Dermatologist, Complejo Hospitalario de Granada, Granada, Spain.
[Ti] Título:Nódulos subcutáneos faciales de 3 meses de evolución.
[So] Source:Dermatol Online J;23(2), 2017 Feb 15.
[Is] ISSN:1087-2108
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Siliconomas are subcutaneous nodules that usuallyappear as a consequence of the migration of freesilicon implanted in other locations. They are morefrequent in women with abnormal breast implants,such as poly implant prostheses (PIP), but they may alsoappear after illegal injection of free silicone. We reporta 57-year-old woman who attended our Dermatologyclinic complaining of relapsing facial panniculitis ofunknown origin. After a thorough work-up, thesenodules were determined to be the consequence ofdermal filler made with fluid silicone, which had beeninjected 20 years prior. High frequency skin ultrasoundof one of the nodules showed a hyperechoic image,also known as "snowstorm," which was located in thesubcutaneous tissue. The disposition of silicone in thisplane obscures the view of any sonographic structurein the underlying plane. Cutaneous sonographyhas become one of the most useful non-invasivetechniques in diagnosis of filler complications andother inflammatory diseases. Combined treatmentwith prednisone and allopurinol was successful, withno recurrence after 1 year of follow-up.
[Mh] Termos MeSH primário: Preenchedores Dérmicos/efeitos adversos
Dermatoses Faciais/diagnóstico por imagem
Reação a Corpo Estranho/diagnóstico por imagem
Paniculite/diagnóstico por imagem
Silicones/efeitos adversos
Tela Subcutânea/diagnóstico por imagem
[Mh] Termos MeSH secundário: Alopurinol/uso terapêutico
Dermatoses Faciais/tratamento farmacológico
Dermatoses Faciais/patologia
Feminino
Reação a Corpo Estranho/tratamento farmacológico
Reação a Corpo Estranho/patologia
Depuradores de Radicais Livres/uso terapêutico
Glucocorticoides/uso terapêutico
Seres Humanos
Meia-Idade
Paniculite/tratamento farmacológico
Paniculite/patologia
Prednisona/uso terapêutico
Tela Subcutânea/patologia
Ultrassonografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dermal Fillers); 0 (Free Radical Scavengers); 0 (Glucocorticoids); 0 (Silicones); 63CZ7GJN5I (Allopurinol); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE



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