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the symposium
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06/01/2010 14:57
lori 
06/01/2010 14:57
lori 
the symposium

Wolfgang,

I too am interested in what happened at the symposium in May. Could you recap it? I am interested in how many attended, their profession, etc.. Their thoughts about treatment, etc..

Thanks,

Lori

06/01/2010 19:42
cindy850 
06/01/2010 19:42
cindy850 
Re: the symposium

I am very interested also. Would love to know all about it. Please tell us what the news.

06/02/2010 01:10
flojo 
06/02/2010 01:10
flojo 
Re: the symposium

So would I. Thanks.

06/02/2010 08:03
wach 

Administrator

06/02/2010 08:03
wach 

Administrator

Re: the symposium

Not easy to summarize two days packed with presentations and discussions in just a few words ... I will try and if you are interested in further details you might can read abstracts on http://dupuytrensymposium.com/program.html.

First of all, there was no glorious breakthrough and Dupuytren's disease remains a mystery. But that was to be expected. The prime goal of this conference was bringing together physicians from research and clinics who usually publish on spezialized conferences and get them into a dialogue. I believe that worked quite well and kicked off joint projects. To continue this synergy Charles Eaton proposed and established a common Internet platform for Dupuytren research and we will further look into a central database merging patients data for research purposes.

It was amazing how many research is on-going all over the world and it is high quality research. To fuel this flame Dupuytren Society announced the Dupuytren Award that will be awarded annually to honour excellent research on Dupuytren's and Ledderhose disease.

Some specific points (just a personal selection)

Basics: the genome and genetics research will still take a while. Results are still contradictionary. - Meinel proposed that the contracture is not an active process with consequences for the surgical strategy. - High incidence rates in Belgium and Bosnia show that Dupuytren's is more frequent than previously thought.

Surgical techniques: 36 years of dermofasciectomy prove this is a reliable technique if applied properly (Ketchum). A cellular implant and adjuvant tamoxifen improve surgical outcome dramatically for severe cases (better results and much lower recurrence; papers by Degreef). Segmental fsaciectomy minimizes the surgical damage and has no higher recurrence than wider fasciectomy (Degreef).

NA and Xiaflex: NA becomes an established technique but suffers from high recurrence as compared to fasciectomy (NA: 85% recurrence after 5 years with an average recurrence period of 2.3 years, paper by van Rijssen). NA even without contracture to relieve tightness (Gan). Xiaflex seems to have more immediate side effects than NA but might be doing better on recurrence (Badalamente). Lipografting after a specific extensive NA seems to reduce the recurrence and soften the palm but requires larger damage (Khouri).

RT and Cryo: Seegenschmiedt showed promising long term RT results of treatment of Dupuytren's and Ledderhose disease. Cryo becomes established (FDA approved) as treatment for Ledderhose; it reduces the nodule size and improves the use of the foot but cannot avoid recurrence (Spilken).

Splinting: a British multicenter study (Larson) did not find any benefit of splinting after surgery. Meinel showed how contracture still improved after NA due to splinting. This seems to be contradictonary and may need further investigation.


Wolfgang

06/02/2010 17:49
lori 
06/02/2010 17:49
lori 
Re: the symposium

Thanks Wolfgang. Thanks for the updated research and the link.

Lori

06/02/2010 21:23
LubaM. 
06/02/2010 21:23
LubaM. 
Re: the symposium

thanks Wolfgang.... the link you provided is very informative. It will take me weeks to go through all the papers I'm interested in. Your continued support is always appreciated.

06/02/2010 23:47
flojo 
06/02/2010 23:47
flojo 
Re: the symposium

Thanks, Wolfgang, for your take on selected presentations. The ones you selected are in areas very important to me.

Thanks for the link, too.

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dupuytrensymposium   contradictionary   symposium   dramatically   dermofasciectomy   Seegenschmiedt   contradictonary   Wolfgang   Lipografting   research   fasciectomy   established   Dupuytren   Ledderhose   consequences   contracture   investigation   interested   presentations   recurrence