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logo 220 Winter Newsletter 2018/19
Our conference Systemic Effects of Metal Exposure in Clinical Practice was a fascinating, thought-provoking day. It was an opportunity for professionals from disparate fields to come together to discuss how to improve patient outcomes. Co-organised with the British Society for Ecological Medicine as a memorial conference for Prof Vera Stejskal, you can watch the trailer and have the opportunity to purchase the conference video by clicking below. Read the summary here

Metal allergic patient wins €2.5 million case against her dentist
Prior to her treatment, a Spanish patient warned her Barcelona dentist that she was allergic to metals, showing evidence of testing. Her dentist ignored her concerns and placed a chrome/cobalt prosthesis. The patient developed headaches, mouth inflammation and problems with speaking, chewing and swallowing. The dentist did not perform any testing that would allow materials that were "personalised" and bio-compatible to be used for this allergic patient. The dentist was deemed to have acted without due academic and professional diligence and was fined accordingly. 
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BBC Panorama - The Great Implant Scandal

Deborah Cohen presents an investigative documentary about the lack of regulation around medical devices. Technology in the field of medical devices is advancing rapidly. New devices; from contraceptive implants to pacemakers and hip and spinal implants: are being used in patients after failing in trials, causing untold suffering to affected patients. The programme also uncovered a standardised treatment for children with scoliosis, which was established after only being trialled on pigs and cadavers. Rebecca Dutton discussed scoliosis treatment at our recent conference and gave some examples of non-surgical treatments.
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Oral allergies to dental materials produce systemic symptoms
An interesting abstract entitled Oral allergies from Dr Evrard suggests that metal allergy from dental restorations manifest with systemic symptoms including: weakness and lack of energy and joint and muscle pain. He mentions that oral allergies to dental materials are a growing problem and remain poorly diagnosed by health professionals. Dr Evrard had previously written articles on titanium allergy. In earlier articles he mentioned only localised oral symptoms of allergy: cheilitis, gingivitis, redness and swelling etc. It is of great significance that the systemic symptoms reported by metal allergic people are becoming more widely recognised.
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Obese, nickel allergic patients have poorer metabolic profile than obese controls
Previous studies have found a link between nickel allergy and obesity in women. This new study of 1128 overweight and obese patients found 784 were suspected of having nickel allergy. This confirms that nickel allergy appears to be very common in obese patients. It also reports that nickel allergy is associated with impaired glucose homeostasis and increased inflammation.  Evidence has shown that low grade inflammation plays an important part in the development of metabolic syndrome. Interestingly, obese male subjects were more likely to be nickel allergic than female - at odds with what is observed in the general population.
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Hypersensitivity of growing concern in surgical implants

In this article, Dr Pachecho  takes a mainstream viewpoint of allergic response, describing only local symptoms: pain, swelling, inflammation and decreased range of motion. Even though allergic responses to metals are relatively unusual, given the huge numbers of joint replacements (2.5 million in the UK alone in 13 years) they are of growing significance. The author suggests that appropriate patients for pre-surgical testing (by patch testing) are those with dermal reactions to metal jewellery, spectacle frames etc. Metals considered most allergenic for spinal surgery are nickel, chromium and cobalt, but as we have seen titanium is becoming an important allergen with rates as high as 6.3% reported.

 
Nickel allergy and the need for total knee arthroplasty revision

This recently published article looked at knee replacements and nickel allergy and noted the manufacturers' effort to offer bio-compatible, coated implants to help reduce allergic sensitisation. It concludes that LTT testing may be of value in high risk patients and those who consider that they have allergy to metals. The authors used both LTT and sinovial cell counts prior to revision with non-nickel containing implants which were coated in zirconium nitride. They disagree with Pachecho (see previous story) and use LTT testing (rather than patch testing) as a "more direct and objective" form of allergy testing.

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MELISA Diagnostics
Email info@melisa.org
Phone +44 20 8133 5166
Web www.melisa.org
MELISA Testing
Exposure to metals through dental fillings and implants, joint prostheses, environmental pollutants and medication can create health problems in hypersensitive individuals. Metals may trigger Type IV cell mediated allergies. MELISA is a blood test which can identify which metals, that person is exposed to, can cause health problems. MELISA testing has been developed to test for Lyme disease and for allergy to a small number of foods.

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