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Orthopedic implants heal well without complications in most patients but fail for unclear reasons in some individuals. This study determined the relevance of metal hypersensitivity in patients with failed orthopedic implants and those requiring orthopedic implant surgery. The study included 35 patients with failed orthopedic implants and 15 subjects scheduled for orthopedic implant surgery. The production of selected pro-inflammatory cytokines was measured in patients with failed orthopedic implants. Metal hypersensitivity was measured in all subjects using the MELISA® test. Of common metals in orthopedic alloys, the patients with failed orthopedic implants responded most frequently to nickel, chromium, titanium, iron, and molybdenum. Hypersensitivity to metals found in implants was measured in 40% of patients with failed implants. The study also showed that titanium exposure in patients with titanium hypersensitivity might lead to implant failure. Metal hypersensitivity testing should be offered to patients before surgery to minimize the risk of implant failure.

Objective: The aim of the present study was the comparison of the known chronological age of the studied subjects by dental age evaluated according to the developmental stages of seven permanent teeth in the lower left dental quadrant and to determine how much the child's dental age differs from its chronological age. Methods: Radiographs of 579 patients (288 boys and 291 girls), aged 3-16 years, from the database of the Radiological Clinic of the Second Medical Faculty of Charles University and the Motol University Hospital in Prague were reviewed. The patients were examined for different indications by cone beam computed tomography (CBCT). The evaluation of the developmental stages of the teeth was performed from generated panoramic images and reconstructed three-dimensional (3D) images. The developmental stages of the teeth were evaluated by Demirjian's method for dental maturity based on seven teeth of the lower left dental quadrant (Demirjian et al. 1973). The evaluated variables were mineralization and development of the dental crown, length of the root, and closure of the apical foramen. Results: The difference between chronological and dental age was -0.16 (standard deviation (SD) 1.68, p-value 0.7) in boys and -0.10 (SD 1.65, p-value 0.27) in girls, on average. These results confirm that the method is accurate. Low SD values express the precision of the evaluation. Conclusion: Use of reconstructed 3D images makes the evaluation of the maturation of teeth more accurate in comparison to the use of generated panoramic images. The development of teeth (with exception of third molars) was complete at the age of 16 in 97.3% of the studied subjects.

This study is aimed at proving the clinical benefit of the MELISA® test in the minimization or complete elimination of health problems in patients with confirmed hypersensitivity to metals used for tissue replacements. A group of 305 patients aged 20-75 years with previously proven metal hypersensitivity (initial MELISA® test), mainly to titanium and then to another fifteen metals, was chosen from the database at the Institute of Dental Medicine. From these patients, a final group of 42 patients agreed to participate in the study, 35 of which were female and 7 were male. The patients completed a special questionnaire aimed at information regarding change of health status from their last visit and determining whether the results of the initial MELISA® test and recommendations based on it were beneficial for patients or not. They were clinically examined, and peripheral blood samples were taken to perform follow-up MELISA® tests. Questionnaire data was processed, and the follow-up MELISA® test results were compared with the results of the initial MELISA® tests. For statistical analysis, the Fisher’s exact test and paired T -test were used. Thirty-two patients reported that they followed the recommendations based on the results of the initial MELISA® tests, and of these, 30 patients (94%) confirmed significant health improvement. Six patients did not follow the recommendation, and from these, only one patient reported an improvement in his health problems. By comparison of the initial and follow-up MELISA® test results, it can be stated that the hypersensitivity to the given metal decreased or disappeared after the therapeutic interventions performed based on the initial MELISA® test results. The evaluation of the data obtained from patients in this study confirmed a significant clinical benefit of MELISA® test.

Incident High Energy Lasers have shown to cause damages at gross cellular and organelle levels and also at the level of DNA. In this study, the effect of high energy 532 nm short YAG Lasers at 10 p...

Objectives: This prospective study was undertaken to evaluate nuclear matrix protein (NMP22) compared to urine cytology in the detection of bladder cancer and also to determine whether indexing suspicious cytology to NMP22 could enhance the clinical utility of cytology. Methods: Cytological findings of voided urine collected prior to a cystoscopic biopsy were correlated with urine NMP22 assay in 46 patients attending the urology clinic in Mubarak Al-Kabeer Hospital. The patients were clinically categorized into newly diagnosed cases of transitional cell carcinoma (TCC), recurrent TCC, TCC in remission and controls. Results: Using histological diagnosis as the gold standard the sensitivity and specificity of NMP22 were 78% and 43% respectively and of cases with malignant urine cytology were 30% and 87% respectively. If suspicious and malignant cytology were combined as positive results the sensitivity increased significantly to 87% while the specificity decreased but not significantly to 74%. Suspicious or malignant cytology enhanced by positive NMP22 gave a sensitivity of 70% and specificity of 87% neither of which was significantly different from cytology alone. There were three false positive cases on cytology and 13 false positive cases on NMP22 assay. There were three false negative cytology and five false negative NMP22 cases but only one was false negative for both, resulting in a high sensitivity (96%) but low specificity (30%) if either positive NMP22 or malignant or suspicious cytology was taken as a positive result. Conclusion: Combining NMP22 with malignant or suspicious cytological result improved sensitivity for the detection of bladder cancer but with a major decrease in specificity, suggesting a potential role in screening rather than diagnosis.