A prospective study linked both alcohol and tobacco to Dupuytren's disease

Godtfredsen, Nina; Lucht, Hasse; Prescott, Eva; Sørensen, Thorkild I A; Grønbæk, Morten

doi:10.1016/j.jclinepi.2003.11.015

Cited by 90 publications

(69 citation statements)

References 18 publications

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“…All patients were treated according to a standard protocol (Figure 1 Fifteen patients needed more splinting than in the standard treatment: These included dynamic extension splints, dynamic flexion splints, exercise splints and wrist splints. The mean number of days before starting active exercise was 7 (range [5][6][7][8][9][10][11][12][13][14], the mean number of visits to the occupational therapist was 6 (range 2-13), and the mean number of visits to the physician was 3 (range 1-7).…”

Section: Interventionmentioning

confidence: 99%

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Engstrand¹,

Borén²,

Liedberg³

2009

Journal of Hand Therapy

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Section: Interventionmentioning

confidence: 99%

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Engstrand¹,

Borén²,

Liedberg³

2009

Journal of Hand Therapy

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“…18 Smoking has also been associated with an increased risk of the disease, and the combination of smoking and high alcohol intake has been reported to increase the risk further. 19 The earliest signs of Dupuytren's disease are changes in the skin, including loss of normal architecture and development of skin pits, caused by small vertical fibres (known as Grapow fibres) that connect the dermis to the palmar fascia. 1 The intermediate phase of the disease is characterised by an abnormal deposition of collagen.…”

Section: Aetiology Pathophysiology and Clinical Presentationmentioning

confidence: 99%

Collagenase clostridium histolyticum for the treatment of Dupuytren’s contracture: systematic review and economic evaluation

Brazzelli

Cruickshank

Tassie

et al. 2015

Health Technol Assess

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BackgroundDupuytren’s disease is a slowly progressive condition of the hand, characterised by the formation of nodules in the palm that gradually develop into fibrotic cords. Contracture of the cords produces deformities of the fingers. Surgery is recommended for moderate and severe contractures, but complications and/or recurrences are frequent. Collagenase clostridium histolyticum (CCH) has been developed as a minimally invasive alternative to surgery for some patients.ObjectivesTo assess the clinical effectiveness and cost-effectiveness of collagenase as an alternative to surgery for adults with Dupuytren’s contracture with a palpable cord.Data sourcesWe searched all major electronic databases from 1990 to February 2014.Review methodsRandomised controlled trials (RCTs), non-randomised comparative studies and observational studies involving collagenase and/or surgical interventions were considered. Two reviewers independently extracted data and assessed risk of bias of included studies. A de novo Markov model was developed to assess cost-effectiveness of collagenase, percutaneous needle fasciotomy (PNF) and limited fasciectomy (LF). Results were reported as incremental cost per quality-adjusted life-year (QALY) gained. Deterministic and probabilistic sensitivity analyses were undertaken to investigate model and parameter uncertainty.ResultsFive RCTs comparing collagenase with placebo (493 participants), three RCTs comparing surgical techniques (334 participants), two non-randomised studies comparing collagenase and surgery (105 participants), five non-randomised comparative studies assessing various surgical procedures (3571 participants) and 15 collagenase case series (3154 participants) were included. Meta-analyses of RCTs assessing CCH versus placebo were performed. Joints randomised to collagenase were more likely to achieve clinical success. Collagenase-treated participants experienced significant reduction in contracture and an increased range of motion compared with placebo-treated participants. Participants treated with collagenase also experienced significantly more adverse events, most of which were mild or moderate. Four serious adverse events were observed in the collagenase group: two tendon ruptures, one pulley rupture and one complex regional pain syndrome. Two tendon ruptures were also reported in two collagenase case series. Non-randomised studies comparing collagenase with surgery produced variable results and were at high risk of bias. Serious adverse events across surgery studies were low. Recurrence rates ranged from 0% (at 90 days) to 100% (at 8 years) for collagenase and from 0% (at 2.7 years for fasciectomy) to 85% (at 5 years for PNF) for surgery. The results of the de novo economic analysis show that PNF was the cheapest treatment option, whereas LF generated the greatest QALY gains. Collagenase was more costly and generated fewer QALYs compared with LF. LF was £1199 more costly and generated an additional 0.11 QALYs in comparison with PNF. The incremental cost-effectiveness ratio was £10,871 per QALY gained. Two subgroup analyses were conducted for a population of patients with moderate and severe disease and up to two joints affected. In both subgroup analyses, collagenase remained dominated.LimitationsThe main limitation of the review was the lack of head-to-head RCTs comparing collagenase with surgery and the limited evidence base for estimating the effects of specific surgical procedures (fasciectomy and PNF). Substantial differences across studies further limited the comparability of available evidence. The economic model was derived from a naive indirect comparison and was hindered by a lack of suitable data. In addition, there was considerable uncertainty about the appropriateness of many assumptions and parameters used in the model.ConclusionsCollagenase was significantly better than placebo. There was no evidence that collagenase was clinically better or worse than surgical treatments. LF was the most cost-effective choice to treat moderate to severe contractures, whereas collagenase was not. However, the results of the cost–utility analysis are based on a naive indirect comparison of clinical effectiveness, and a RCT is required to confirm or refute these findings.Study registrationThis study is registered as PROSPERO CRD42013006248.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…Smoking consumption as number of years smoked, number of cigarettes smoked daily, age at which patient started smoking and the numbers of years since quitting, were carefully recorded. However, total smokers were divided into light and heavy smoker groups base on the average mean of pack/year value as previously described (Godtfredsen et al, 2004). After completing the questionnaire, patients underwent clinical examination by an oral surgeon (KS) and confirmation of patient histopathology by a pathologist (NK), prior to oral …”

Section: Cohortmentioning

confidence: 99%

Alu Hypomethylation in Smoke-Exposed Epithelia and Oral Squamous Carcinoma

Puttipanyalears

Subbalekha²,

Mutirangura³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Alu elements are one of the most common repetitive sequences that now constitute more than 10% of the human genome and potential targets for epigenetic alterations. Correspondingly, methylation of these elements can result in a genome-wide event that may have an impact in cancer. However, studies investigating the genome-wide status of Alu methylation in cancer remain limited. Objectives: Oral squamous cell carcinoma (OSCC) presents with high incidence in South-East Asia and thus the aim of this study was to evaluate the Alu methylation status in OSCCs and explore with the possibility of using this information for diagnostic screening. We evaluated Alu methylation status in a) normal oral mucosa compared to OSCC; b) peripheral blood mononuclear cells (PBMCs) of normal controls comparing to oral cancer patients; c) among oral epithelium of normal controls, smokers and oral cancer patients. Materials and Methods: Alu methylation was detected by combined bisulfite restriction analysis (COBRA) at 2 CpG sites. The amplified products were classified into three patterns; hypermethylation (

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A prospective study linked both alcohol and tobacco to Dupuytren's disease

Cited by 90 publications

References 18 publications

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Collagenase clostridium histolyticum for the treatment of Dupuytren’s contracture: systematic review and economic evaluation

Alu Hypomethylation in Smoke-Exposed Epithelia and Oral Squamous Carcinoma

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