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Review: cobalt toxicity and artificial metal hips

4.5 out of 5 stars Systemic toxicity related to metal hip prostheses. Bradberry SM et al. Clin Toxicol 2014;52:837-847. Abstract As TPR has reported before, cobalt poisoning can cause hypothyroidism, cardiomyopathy, and neurotoxicity. Neurological manifestations include: optic nerve damage and retinopathy with reduced visual acuity bilateral nerve deafness and tinnitus polyneuropathy (sensory and motor) cognitive impairment and memory loss A number of papers and case reports have described clinical cobalt toxicity related to metal-on-metal hip prostheses or revision of a failed ceramic prosthesis with metal parts. Although these cases are somewhat rare, missing the association can be catastrophic. Recently, a report in theNew England Journal of Medicine described a 59-year-old woman with bilateral metal-on-metal hip prostheses who received a heart transplant for severe progressive cardiomyopathy. She also developed hypothyroidism, initially attributed to previous treatment with amiodarone. Cobalt toxicity was not diagnosed until months after transplant surgery. This superb paper describes and critically reviews that 18 cases in the medical literature of systemic toxicity in patients with metal hip prostheses. The authors — using somewhat vague criteria — determined that i 10 of these cases the systemic manifestations were probably related to cobalt exposure. Some key take-home points from the paper. metal ions released from hip prostheses im...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical cardiomyopathy cobalt toxicity hip replacement hypothyroidism neurotoxicity prosthesis Source Type: news

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Authors: Guedes AF, Sargento L, Braz-Nogueira J, Lousada N, Moreira C, Carvalho FA, Santos NC Abstract Erythrocyte aggregation is an indicator of cardiovascular risk, which is influenced by plasma fibrinogen concentration. Fibrinogen levels are elevated during cardiovascular diseases. Our main goals were to understand how fibrinogen-erythrocyte binding influences erythrocyte aggregation and how it constitutes a cardiovascular risk factor in essential arterial hypertension (EAH) and chronic heart failure (CHF). Fibrinogen-erythrocyte and erythrocyte-erythrocyte adhesion measurements were conducted by atomic force mi...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
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Source: Scandinavian Journal of Occupational Therapy - Category: Occupational Health Tags: Scand J Occup Ther Source Type: research
CONCLUSIONS: We report a rare case of TERT, HRAS, and EIF1AX mutations in a patient with follicular adenoma. TERT promoter mutations may be an early genetic event in the molecular pathogenesis of follicular thyroid carcinoma. PMID: 29669480 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
CONCLUSIONS: The rate of mental health presentations to EDs increased significantly in NSW between 2010 and 2014, particularly presentations by adolescents. Urgent action is needed to provide better access to adolescent mental health services in the community and to enhance ED models of mental health care. The underlying drivers of this trend should be investigated to improve mental health care. PMID: 29669496 [PubMed - as supplied by publisher]
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
CONCLUSIONS: Accidental rectus muscle disinsertion after pterygium excision surgery is a serious but rare postoperative complication of pterygium surgery. Great care should be taken intraoperatively to avoid this complication. Reattachment of the disinserted medial rectus will produce a satisfactory resolution of the problem. PMID: 29672190 [PubMed - as supplied by publisher]
Source: Strabismus - Category: Research Tags: Strabismus Source Type: research
Authors: Bea JW, Wassertheil-Smoller S, Wertheim BC, Klimentidis Y, Chen Z, Zaslavsky O, Manini TM, Womack CR, Kroenke CH, LaCroix AZ, Thomson CA Abstract Studies suggest that ACE-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) may preserve skeletal muscle with aging. We evaluated longitudinal differences in lean body mass (LBM) among women diagnosed with hypertension and classified as ACE-I/ARB users and nonusers among Women's Health Initiative participants that received dual energy X-ray absorptiometry scans to estimate body composition (n=10,635) at baseline and at years 3 and 6 of follow-up. Of thos...
Source: Journal of Aging Research - Category: Geriatrics Tags: J Aging Res Source Type: research
Authors: Kwak KA, Cho HJ, Yang JY, Park YS Abstract Liver cirrhosis is a major cause of mortality and a common end of various progressive liver diseases. Since the effective treatment is currently limited to liver transplantation, stem cell-based therapy as an alternative has attracted interest due to promising results from preclinical and clinical studies. However, there is still much to be understood regarding the precise mechanisms of action. A number of stem cells from different origins have been employed for hepatic regeneration with different degrees of success. The present review presents a synopsis of stem ...
Source: Canadian Journal of Gastroenterology - Category: Gastroenterology Tags: Can J Gastroenterol Hepatol Source Type: research
We report a rare occurrence of incisional hernia attributable to internal wound dehiscence after PD catheter placement in a patient on sirolimus.A 34-year-old Latino American man was started on PD training 4 weeks after placement of a PD catheter. Soon after completing training, he developed a large soft bulge close to the PD catheter, with expansile cough impulse suggestive of an incisional hernia filled with peritoneal dialysate. The size of the bulge would decrease after the dialysate was drained. No external leak of dialysate was evident along the exit site.Because of the size of the hernia and the history of it fillin...
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research
Level at which left ventricular outflow gradient becomes hemodynamically significant: Cardiology MCQs from Cardiophile MD Click here for Volume 2! Volume 3 to be published soon! Correct answer: b) 50 mm Hg. But for defining left ventricular outflow tract obstruction (LVOTO), a peak left ventricular outflow tract (LVOT) pressure gradient of 30 mm Hg or more at rest or during physiological provocative measures like Valsalva manoeuvre, standing or exercise is enough. Symptomatic patients with LVOTO gradient 50 mm Hg or above in spite of maximally tolerated medications will be considered for septal reduction therapies like s...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
ConclusionThese results suggest prophylactic catheter ablation decreases ICD therapies, including shocks and electrical storm with no improvement in overall mortality. There is a need for future carefully designed randomized clinical trials.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
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