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Dupuytren contracture in diabetic hand  [cached]
Alessandro Geraci,Renzo Bianchi,Antonio Sanfilippo,Michele D'Arienzo
Endocrinology Studies , 2011, DOI: 10.4081/es.2011.e2
Abstract: Dupuytren's disease (DD) is a fibroproliferative disorder of unknown origin causing palmar nodules and flexion contracture of the digits. About 5% of individuals with DD are diabetic, with an increased prevalence that is proportional to the duration of the diabetes. The association with diabetes mellitus is well recorded, with a reported prevalence of between 3% and 32%. This review considers the evidence behind the association between DD and diabetes mellitus, considering the pathogenesis, clinical manifestations and therapies that can be found in the literature.
Epidermolytic Hyperkeratosis With Digital Contracture
Bhat M Ramesh,Mathew Deepa,Martis Jacintha
Indian Journal of Dermatology , 2002,
Abstract: We report a case of epidermolytic hyperkeratosis with digital contracture. The patients had hyperkeratotic lichenfified lesions over extensive areas on the body.
The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions  [PDF]
Hyunjic Lee,Surak Eo,Sanghun Cho,Neil F. Jones
Archives of Plastic Surgery , 2012, DOI: http://dx.doi.org/10.5999/aps.2012.39.4.426
Abstract: Dupuytren’s contracture is a condition commonly encountered by hand surgeons, although itis rare in the Asian population. Various surgical procedures for Dupuytren’s contracture havebeen reported, and the outcomes vary according to the treatment modalities. We report thetreatment results of segmental fasciectomies with multiple transverse incisions for patientswith Dupuytren’s contracture. The cases of seven patients who underwent multiple segmentalfasciectomies with multiple transverse incisions for Dupuytren’s contracture from 2006 to 2011were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites wereperformed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and theproximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomiesby removing the fibromatous nodules or cords between the incision lines were performed andthe wound margins were approximated. The mean range of motion of the involved MCP jointsand PIP joints was fully recovered. During the follow-up periods, there was no evidence ofrecurrence or progression of disease. Multiple transverse incisions for Dupuytren’s contractureare technically challenging, and require a high skill level of hand surgeons. However, weachieved excellent correction of contractures with no associated complications. Therefore,segmental fasciectomies with multiple transverse incisions can be a good treatment option forDupuytren’s contracture.
ISCHAEMIC STROKE
MOAZZAM ALI ATIF
The Professional Medical Journal , 2007,
Abstract: Objective: To determine the frequency of carotid atherosclerosis inischaemic stroke patients in our population using color Doppler ultrasound. Design: Observational. Place and Durationof study: This study was conducted in Medical Unit II of Jinnah Postgraduate Medical Centre, Karachi from Oct 2002to Feb 2003. Subjects and Methods: All the patients admitted in our ward during this duration with CT scan proof ofstroke were included in the study. Risk factors in all these patients were stratified. Complete history and examinationwas done and carotid Doppler ultrasound was performed on all patients with ischaemic stroke according to the studyprotocol. Results: A total of 100 patients were included in this study following the above-mentioned protocol over aperiod of five months. 66% of these were having cerebral infarction. Hypertension (72%), diabetes (35%), smoking(29%) and obesity (20%) were the common risk factors in these patients. The frequency of significant carotidatherosclerosis in acute ischaemic stroke patients was 21%. Conclusion: Doppler ultrasound is non-invasive, safe andcost-effective modality for evaluation of carotid vessels. In symptomatic and high-risk group, it should be used as firstdiagnostic modality for management or selecting patients for further investigation.
Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO  [PDF]
Veejay Bagga,Marion Palmer,Ramesh Sadasivan,Govindan Raghuraman
Case Reports in Critical Care , 2013, DOI: 10.1155/2013/474358
Abstract: We report a case of a 64-year-old woman who was admitted to intensive care unit with multiorgan failure secondary to Plasmodium falciparum malaria. Haemodynamic monitoring using the transpulmonary thermodilution with pulse contour analysis system (PiCCO) was achieved via the left brachial artery. Two days later, a flexion deformity of the left hand was noted, and examination revealed left lower arm ischaemia. Removal of the catheter resulted in an immediate improvement of the contracture. However, distal pulses were still absent, and the arm remained ischaemic resulting in a below elbow amputation. This is the first documented case of a persistent limb ischaemia following the insertion of an arterial catheter for haemodynamic monitoring with PiCCO. We therefore highlight the need for regular assessment of limb perfusion after arterial catheterisation for haemodynamic monitoring with PiCCO. In addition, the brachial artery should be avoided, and femoral artery catheterisation is recommended. 1. Introduction Advanced haemodynamic monitoring is used extensively in intensive care to help assist with cardiovascular management of critically ill patients. Traditionally, advanced haemodynamic management involved the use of pulmonary artery catheters (PAC); however, this method is becoming less popular as the benefits of using this technique remain controversial [1, 2]. In addition, its use has been associated with complications such as arrhythmias, infection, thrombotic complications [3], and, rarely, rupture of the pulmonary artery [4, 5]. Transpulmonary thermodilution monitoring using the PiCCO system (PULSION Medical System, Munich, Germany) is being used as a popular alternative to PAC. It’s claimed benefits include minimal side effects, less invasiveness and is well validated against PAC. Data on the complications associated with this monitoring technique is limited; however, a recent prospective study which included over 500 patients in 14 different European intensive care units has shown that haemodynamic monitoring with PiCCO is safe, and serious complications are rare [6]. 2. Case Report A 64-year-old lady with recent history of traveling to Uganda was admitted to the hospital with Plasmodium falciparum malaria. Her comorbidities included hypertension and morbid obesity. The initial parasite count was 14%. Soon after her admission, her clinical condition deteriorated, and she developed multiple organ failure requiring ventilatory, renal supports, and advanced haemodynamic management. To help assist with cardiovascular and circulatory management,
Ischaemic colitis - review  [PDF]
Dimitrijevi? I.,Micev M.,?aranovi? ?.,Markovi? V.
Acta Chirurgica Iugoslavica , 2008, DOI: 10.2298/aci0803089d
Abstract: Colonic ischaemia, commonly referred to as ischaemic colitis, is the most common type of intestinal ischaemia. The term "ischaemic colitis" was used by Marston (1966) with three typical patterns of injury described: transient reversible ischaemia, ischaemic ulcers with stricturing, and gangrenous ischaemic colitis. Dominant presenting symptoms were colicky abdominal pain, vomiting, bloody diarrhea, and hematochezia. Patients often have minimal signs on clinical examination. Most patients were diagnosed at colonoscopy. Two regions that are believed to be anatomically vulnerable to ischemic disease are "Griffith’s point", at the splenic flexure and "Sudeck’s critical point", of the Drummond marginal artery. Clinically, ischaemic colitis is classified as non-gangrenous or gangrenous. Non-gangrenous ischaemic colitis involves the mucosa and submucosa and accounts for 80-85 percent of all cases of ischaemic colitis. Non-gangrenous ischaemic colitis is further subclassified into transient, reversible ischaemic colitis with a less severe form of injury and chronic, non-reversible ischaemic colitis, which includes chronic colitis and stricture and has a more severe form of injury. Gangrenous ischaemic colitis accounts for the remaining 15-20 percent of cases and manifests as the most severe form of injury. It includes acute fulminant ischaemia with transmural infarction that may progress to necrosis and death. Specific indications for operation include peritonitis, perforation, recurrent fever or sepsis, clinical deterioration in patients refractory to medical management. Relative indications include fulminant colitis, massive hemorrhage, chronic protein losing colopathy, and symptomatic ischemic structure.
Update on the management of Dupuytren’s contracture
Linda Vi, David B O’Gorman, Bing Siang Gan
Orthopedic Research and Reviews , 2010, DOI: http://dx.doi.org/10.2147/ORR.S8592
Abstract: ate on the management of Dupuytren’s contracture Review (4979) Total Article Views Authors: Linda Vi, David B O’Gorman, Bing Siang Gan Published Date August 2010 Volume 2010:2 Pages 35 - 43 DOI: http://dx.doi.org/10.2147/ORR.S8592 Linda Vi1, David B O’Gorman2, Bing Siang Gan3 1Department of Physiology and Pharmacology, 2Hand and Upper Limb Centre, Lawson Health Research Institute, Departments of Surgery and Biochemistry, 3Hand and Upper Limb Centre, Lawson Health Research Institute, Departments of Surgery and Medical Biophysics, University of Western Ontario, London, Ontario, Canada Abstract: Dupuytren’s disease (DD) is a pathological condition of the palmar fascia that is characterized by the formation of tight collagenous disease cords leading to permanent finger contractures. The disease is most prevalent in Caucasian men, and its incidence increases with age advancement. The most common complaint from patients having DD is the impairment of normal hand function. At present, the disease is incurable and the pathophysiology of DD is unknown. The most common treatment for DD is surgery; however, this treatment is associated with a high rate of recurrence. More recently, researchers have begun to explore the molecular basis of DD in the hopes of developing new, more effective treatment for DD. This review will summarize the history and clinical presentation of the disease, highlight current and emerging molecular treatments, and explore the implications of these advancements for future work.
Experimental model of capsular contracture in silicone implants
Bastos, érika Malheiros;Sabino Neto, Miguel;Ferreira, Lydia Masako;Garcia, élvio Bueno;Liebano, Richard Eloin;Han, Yuri Anna;
Acta Cirurgica Brasileira , 2003, DOI: 10.1590/S0102-86502003001100004
Abstract: the breast implant procedure is one of the most performed into plastic surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. we describe here one experimental model of capsule contracture in rats.
Experimental model of capsular contracture in silicone implants
Bastos érika Malheiros,Sabino Neto Miguel,Ferreira Lydia Masako,Garcia élvio Bueno
Acta Cirurgica Brasileira , 2003,
Abstract: The breast implant procedure is one of the most performed into Plastic Surgery and the contracture that occurs the capsule formed around the breast implants one of most frequent complication. We describe here one experimental model of capsule contracture in rats.
Plantar fibromatosis and Dupuytren’s contracture in an adolescent  [PDF]
Nikoli? Jelena,Janji? Zlata,Mom?ilovi? Dragan,Ninkovi? Sr?an
Vojnosanitetski Pregled , 2011, DOI: 10.2298/vsp1110886n
Abstract: Background. Fibromatosis represents a wide group of benign, locally proliferative disorders of fibroblasts. Dupuytren` s disease is a benign proliferative disease of palmar aponeurosis which usually affects adults between 40 and 60 years of age. Ledderhose`s disease or plantar fibromatosis is plantar equivalent of Dupuyten`s disease most often affecting middle- aged and older men, usually bilateral, represented with painless nodule in the medial division of plantar fascia. Case report. We presented a 19-year old adolescent that turned to a plastic surgeon complaining to his small finger contracture. He noticed palmar thickening with nodule over the metacarpophalangeal joint of small finger of his right hand when he was 16 years old. A year later a finger started to band. During physical checkup we noticed plantar nodule that also had his father and grandmother. Magnetic resonance and tumor biopsy confirmed a suspicion on plantar fibromatosis - Ledderhose`s disease. Clinical exam of the hand clearly led to a conclusion that the patient had Dupuytren`s contracture with pretendinous cord over the small finger flexor tendons and lack of extension of proximal interphalangeal (PIP) joint. On the extensor side of the PIP joints there were Garrod`s nodes. The patient refused surgical treatment of plantar tumor, but agreed to surgical correction of finger contracture. Conclusion. Despite the fact that Dupuytren`s disease and plantar fibromatosis are diseases of adults, the possibility of conjoint appearance of these forms of fibromatosis in adolescent period of life should be kept in mind especially in patients with strong genetic predisposition.
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