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Interesting
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11/05/03 01:07
Sean 
11/05/03 01:07
Sean 
Interesting

Dupuytren contracture in North Germany. Epidemiological study of 500 cases]

[Article in German]

Brenner P, Krause-Bergmann A, Van VH.

Department fur Plastische, Rekonstruktive und Asthetische Chirurgie, Universitat Leuven, Belgien.

Dupuytren's disease is the "classical" hand illness of the north: it affects people of Celtic or Viking descent throughout the whole of northern Europe, whereas it is an unknown disease in the Mediterranean region. Dupuytren's contracture appears to be an extremity-related disease. Owing to the unclear etiology and a lack of up-to-date demographic data for northern Germany this study aims--together with the literature--to elucidate the role of associated illnesses in an attempt to discover pathogenic explanations. 566 patients suffering from Dupuytren's disease in the area around Hanover were analysed with respect to epidemiological features and their Tubiana contracture stage. 91.2% were of pure northern German stock, 12.5% had a family predisposition. The male-to-female ratio was 7:1. Men were afflicted on average at the age of 56 years. Intellectuals were scored 3.17, while manual workers scored 4.21. There were pre-existing ipsilateral lesions in 15% of cases. 55.1% had bilateral contracture. Ectopic penile and plantar fibrosis or knuckle pads were found in 6.7% of cases. The distribution of stages I-IV decreased by 2.4% from 59.1% among the 1,808 afflicted finger rays. With a score of 3.7-3.72, drinkers and smokers presented significantly more severe contractures, while the 8.2% of diabetics displayed a milder form. Among the epileptics--all of whom were affected bilaterally--the Tubiana stage of 3.71 exceeded the median manual score of 3.63 for the group as a whole. Thus Dupuytren's disease is a general but not an exclusively extremity-related sickness. The androtropy is pathognomic. Women develop the disease one decade later than men. In old age the male-to-female ratio equalizes. Drinkers, smokers and heavy manual workers present a more severe affliction, while diabetics suffer from a significantly less severe form. Although the ulnar type dominates, the radial type accounts for 14.4% of cases. 1.9 million Germans are chronically ill because of Dupuytren's disease. Despite a trauma history, Dupuytren's disease is not recognized as an occupational disease.

11/05/03 01:28
Sean 
11/05/03 01:28
Sean 
information

Dupuytren's disease--the influence of occupation and previous hand injuries.

Mikkelsen OA.

The influence of handedness, work and previous hand trauma is studied in 901 persons with Dupuytren's disease, collected in an epidemiological study of 15,950 citizens in a small, Norwegian town. Dupuytren's disease occurred in all occupational groups, but the prevalence was higher and the contracture more severe in people doing hard manual work than in people doing light or non manual work. Persons with Dupuytren's disease has sustained previous hand trauma more frequently than the general population, and the interval between trauma and first sign of disease was usually a few years. Previous hand injuries were definitely more common among people doing hard manual work, but even when these were excluded from the work material, Dupuytren's disease was still more common among people doing hard manual work, than in people doing light or non manual work. The study has indicated that Dupuytren's disease in certain cases is precipitated and/or aggravated by both work and definite hand injury.

11/05/03 01:37
Sean 
11/05/03 01:37
Sean 
information

Increased mortality in Dupuytren's disease.

Mikkelsen OA, Hoyeraal HM, Sandvik L.

Hospital for Rheumatic Diseases, Haugesund and Medstat, Lillestrom, Norway.

A previous study showed a dip in the prevalence curve of Dupuytren's disease in men over 79 years of age. This may indicate increased mortality. The aim of the present investigation was to study this hypothesis. Four hundred and twenty-six men with Dupuytren's disease, born between 1900 and 1924 were followed for 26 years (1969-1996). Their mortality was compared with that of an age-matched control group of 426 men. In 1996, 361 with Dupuytren's disease and 336 in the control group had died. Overall, patients with Dupuytren's disease had a significantly increased mortality of 22%. The mortality was highest among those with onset of disease before the age of 60. In this age group men with Dupuytren's disease had 70% higher mortality than that of the control group. Disease duration did not seem to influence the mortality.

11/07/03 01:24
Sean 
11/07/03 01:24
Sean 
information

Dupuytren's disease--initial symptoms, age of onset and spontaneous course.

Mikkelsen OA.

647 men and 254 women with Dupuytren's disease of the hands were questioned about how, where and when the disease had started. Usually the disease started in the right hand, and nodules in the ulnar part of the palm were the first symptom in 90%. In 10% of the cases with bilateral disease, it started simultaneously in both hands. One woman and two men noticed the first symptom before 10 years of age. In about 50% of the men, the disease started between 40-59 years of age (women 40-69 years). In men the contracture increased rather constantly during the first twenty years, followed by a stationary phase from about 20 to thirty-five years of duration, whereafter it definitely decreased. In women the disease increased gradually with the duration of the disease.

11/07/03 01:36
????

not registered

11/07/03 01:36
????

not registered

??

A lot of self serving BUNK.

11/07/03 01:42
relevent to??

not registered

11/07/03 01:42
relevent to??

not registered

??

Am I the only one who sees no relevance to any prior
discussions here?

11/07/03 01:47
Mort

not registered

11/07/03 01:47
Mort

not registered

??

Can't quite figure out what the posts by Sean are about unless it's to establish his credentials and give him influence over others naive enough to believe his tiresome rants against all alternatives to surgery.

As Anon said, if he didn't care what treatment others chose, why hasn't the drivel dried up?

11/07/03 01:29
jim h

not registered

11/07/03 01:29
jim h

not registered

the metabolic angle

Some interesting data there. One of the studies seems to say that after about 20 years it's more or less run its course and stops progressing - either that or some side effect of aging shuts it off. So if I can make it through the next 10-15 years, I may not need further treatment from that point on.


11/07/03 01:43
Randy H.

not registered

11/07/03 01:43
Randy H.

not registered

the metabolic angle

"The study has indicated that Dupuytren's disease in certain cases is precipitated and/or aggravated by both work and definite hand injury." (from previous post)

Dups hand surgery, as precise, exacting, and intentional as it may be, is not going to be experienced by the body as any less traumatic than a similarly invasive unintentional "injury". If the initial statement from the study is true, it must follow that the very surgery used to correct the problem has a chance to aggravate more. Like cancer surgery, it is important for the doc to "get it all". I believe this is one good reason. A far less invasive procedure like NA may not "get it all", in fact, it's only goal is to rupture the cord and free the finger. However, as such, it also doesn't stir up the dragon.

And those who have had NA, correct me if I'm wrong, but don't the untreated bumps and nodules tend to recede somewhat after NA all by themselves?

11/07/03 01:17
Mr. X

not registered

11/07/03 01:17
Mr. X

not registered

the metabolic angle

You know, you people need to concentrate on the metabolic standpoint. There are things you can do to slow it down. Quit arguing over what Stupid says. He feeds on negativity. Just research what you can do, and do it. Many good advice has been given in the last year thru out these posts. DC is not only 'will i have this or that procedure/surgery someday', it's also about what can one do to help the liver make the enzyme collagenase.

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