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Chest wall deformities
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Michael J Goretsky, Robert Obermeyer
Bar allergy is 3%. Any patient with a history of a metal or jewellery allergy or atopic history should be tested with a TRUE skin test. This tests for multiple allergens including nickel and cobalt that are specific for the Nuss bar. When positive, custom-made titanium bars should be obtained. Any atypical symptoms such as rash, sterile wound infection or skin discolouration should be tested for metal allergy.
Total prosthetic replacement of the temporomandibular joint
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Allergy to the prosthetic material can occur to any of the components of the prosthesis. Prevention by appropriate allergy testing pre-operatively may reduce this phenomenon although there is a suggestion that patients with failing prosthetic hip replacements develop allergy due to sensitization and lymphocyte activation. Whilst most orthopaedic patients are not tested for metal allergy, these findings cannot be confirmed, however, approximately 10% of the population are allergic to one or more component of cobalt– chromium alloy (usually nickel), whilst 20% with a functioning prosthetic hip are and 60% with a failing prosthesis are. Other factors may be involved, however, where allergy is suspected the ongoing swelling may lead to traction facial nerve palsy and the prosthesis requires removal and ultimate revision to an all titanium prosthesis (Figure 64.5).
Patent foramen ovale
Published in Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček, Congenital Heart Disease in Adults, 2008
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček
Antiaggregation therapy is preferred in elderly patients, with concomitant coronary artery disease, if a cause of CVE/TIA other than paradoxical embolism is likely, and when anticoagulation therapy is contraindicated. Anticoagulation therapy is indicated in concomitant thrombophilic states, deep vein thrombosis, pulmonary embolism, and atrial fibrillation. Surgical management of PFO is currently losing ground. It is indicated in serious complications of catheter-based closure if long-term anticoagulation and antiaggregation therapy is contraindicated; or if preferred by the patient as an alternative to transcatheter closure following drug therapy failure. It may be a method of choice for patients with a metal allergy. Thoracoscopic surgical closure is available in some centers.
Suspected allergy to titanium after anterior cervical discectomy and fusion using a Zero-P device: a case report
Published in British Journal of Neurosurgery, 2023
Changgui Shi, Yanhai Xi, Bin Sun, Hailong He, Jiankun Wen, Yushan Ruan, Xiaojian Ye
Metal allergy can lead to adverse reactions (e.g. hypersensitivity or tissue damage). The clinical presentation of metal allergy varies widely, which can be manifested in the extremities, limbs, and even on the skin. On the skin surface, the manifestations may be presented as eczema, contact dermatitis, and plantar palm rash.13,14 In our case, the patient reported allergic symptoms of skin rashes and throat tingling and itches. In several other studies, contact dermatitis around titanium products has been reported.8–10 In one case of suspected titanium allergy, the patient exhibited eczema on the general skin surface after dental implantations using titanium screws.15 Impaired wound healing and local eczema occurred in another case who received treatment of a right metacarpal fracture using a pure titanium miniplate and screws.9
Book Review
Published in Journal of Dermatological Treatment, 2020
A generation ago, metal allergy was thought to be largely related to a very few metals, such as nickel, chromate, and cobalt. Doctors Chen and Thyssen take us from these origins to the current knowledge, a very different clinical and research situation. A stimulus for their volume relates to the large number of patients receiving metal implants into their body, such as to the hip and knee. Today, we recognize not only the allergens of a generation ago, but also aluminum, beryllium, gold, and palladium. An important section, entitled ‘Metal Allergy in Select Patient Populations,’ summarizes our knowledge of metal allergy in hand eczema, atopic dermatitis, and in children, and in addition, a chapter deals with uncommon manifestations of metal allergy such as contact urticaria. This book greatly extends the previous books on detailed metal allergy on nickel and chromium from the late J. Hostynek. The book is recommended for all practitioners dealing with the complexity of metal allergy, which has, in recent years, become a major reason for patient referrals.
COX-2 induces T cell accumulation and IFN-γ production during the development of chromium allergy
Published in Autoimmunity, 2019
Ratri Maya Sitalaksmi, Koyu Ito, Kouetsu Ogasawara, Yoshiko Suto, Madoka Itabashi, Kyosuke Ueda, Noriyasu Hirasawa, Takayuki Narushima, Nike Hendrijantini, Utari Kresnoadi, Keiichi Sasaki
Metal allergy is categorized as allergic contact dermatitis that is caused by metal sensitization [1,2]. In dentistry, many treatments utilize metals including dental restoration, crowns, orthodontics, implants, and dentures [3]. Nickel, cobalt, and chromium (Cr) are often utilized in alloys to increase properties including corrosion resistance, strength, and workability. In fact, Cr is frequently used in alloys found in coins, dental materials, and daily goods. Unfortunately, however, these metals are also known to cause allergic contact dermatitis [4–6].