scholarly journals PATHOMORPHOLOGIC CHARACTERISTICS OF PALMAR APONEUROSIS IN PATIENTS WITH DUPUYTREN’S CONTRACTURE AND VIRAL HEPATITIS

2021 ◽  
Vol 29 (4) ◽  
pp. 454-461
Author(s):  
T.A. Stupina ◽  
◽  
T.N. Varsegova ◽  
Keyword(s):  
Hepatitis B ◽  
Connective Tissue ◽  
Viral Hepatitis ◽  
Nerve Fibers ◽  
Control Group ◽  
Dupuytren’S Contracture ◽  
Virus Hepatitis ◽  
Dense Connective Tissue ◽  
Dupuytren's Contracture ◽  
Palmar Aponeurosis

Objective. To establish pathomorphologic peculiarities of palmar aponeurosis in the patients with Dupuytren’s contracture and concomitant virus hepatitis B and C. Methods. The data analysis of histomorphometric studies of the operation samples of 122 patients with Dupuytren’s contracture («Control» group, n=100) and Dupuytren’s contracture with virus hepatitis B and C («Hepatitis» group, n=22) were analyzed. Results. In patients of the «Hepatitis» group, the content of adiposed tissue in the palmar aponeurosis was 40.9% less (p <0.01) than in the «Control» group, and the content of dense connective tissue was 18.9% higher (p <0, 05). In all patients, arteries with the diameter up to 150 µm prevailed in the palmar aponeurosis, but in the «Hepatitis» group their percentage was reduced by 20%, with higher proportions of vessels with the diameter of 150-450 µm and the absence or recalibration of the largest arteries. In the «Control» group, the arteries had diameters from 50 to 660 µm, in the «Hepatitis» group they did not exceed 370 µm. Vessels less than 300 µm in diameter in both groups had comparable values of the Kernogan’s index. Arteries with a diameter of more than 300 microns in the «Hepatitis» group had higher values of the Kernogan’s index, which indicated a low conductance capacity compared to the vessels in the «Control» group. Most of the nerve trunks of the palmar aponeurosis in the patients of «Hepatitis» group showed signs of necrobiotic changes, i.e. fibrotic or swollen perineurium, withinflammatory cell infiltration, sometimes lost lamellar structure, and nerve fibers with signs of Wallerian degeneration. Conclusion. Obtained histomorphometric data of the tissue composition of palmar fascial fibromatosis, less amount of adiposed tissue and higher amount of dense connective one and more pronounced disorder of hemodynamics and innervation of the palmar aponeurosis in the group with concomitant virus hepatitis indicate significant effect of the liver pathology on the progression of the disease. What this paper adds For the first time, the pathomorphological features of the palmar aponeurosis have been studied in 122 patients with Dupuytren’s contracture and concomitant viral hepatitis B and C.It has been found that in patients with Dupuytren’s contracture and hepatitis in the palmar aponeurosis, the amount of adiposed tissue is reduced and the amount of dense connective tissue is increased; hemodynamic and innervation disorders are more pronounced.

Results of minimally invasive treatment of scar degeneration of palmar aponeurosis

2021 ◽  
pp. 31-38
Author(s):  
Natal’ya Fedosova ◽  
Andrey Abramenkov ◽  
Igor Ezhov
Keyword(s):  
Chronic Disease ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Dupuytren’S Contracture ◽  
Working Population ◽  
Duration Of Treatment ◽  
Invasive Treatment ◽  
Dupuytren's Contracture ◽  
Palmar Aponeurosis

An analysis of the results of surgical treatment of patients with Dupuytren’s contracture using tactics of minimally invasive percutaneous aponeurotomy and open aponeurectomy is presented. Dupuytren’s contracture (CD) is a chronic disease characterized by cicatricial degeneration of the palmar aponeurosis with a predominant lesion of the working population. The need to quickly restore the function of the upper limb in the postoperative period in patients with CD leads to the need to develop new and modernize the existing minimally invasive tactics of surgical treatment, allowing to minimize the duration of treatment and the risks of various complications.

scholarly journals Efficacy of a self-management program in patients with chronic viral hepatitis in China

BMC Nursing ◽  
2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ying’ai Cui ◽  
Michiko Moriyama ◽  
Kazuaki Chayama ◽  
Yanhui Liu ◽  
Chunmei Ya ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Chronic Hepatitis B ◽  
Intervention Group ◽  
Chronic Viral Hepatitis ◽  
Management Program ◽  
Behavioral Changes ◽  
Self Management ◽  
Control Group

Abstract Background Chronic hepatitis, mainly B or C, increases the risk of hepatocellular carcinoma and remains an emerging issue in the globe. China has high rates of liver cancer incidence and mortality in the world. To address such challenges, adequate management of chronic hepatitis is required. Self-management education is one alternative for improving the hepatitis patients’ knowledge of the disease, mental health, and clinical management. This study aimed to examine the quality of life (QOL), psychological effects, and behavioral changes of a self-management program which allows continuity of care for chronic hepatitis B and C patients. Method In a six-month, randomized controlled trial, we invited 73 chronic hepatitis B/C inpatients to receive (i) two face-to-face education sessions provided by a nurse during hospitalization, and monthly telephone counseling at home after discharge; (ii) or usual care treatment (control group). The primary endpoint (patients’ QOL) and secondary outcomes (including self-efficacy, depression symptoms, perceived cognition of illness and behavioral changes) were assessed. In addition, we conducted qualitative data analysis to facilitate the evaluation of the interventions. Results Sixty (82.2%) out of 73 eligible patients with chronic hepatitis B/C (aged 34.9 ± 8.9 years) participated in the study. The intervention group (n = 30) significantly improved on outcomes including QOL, self-efficacy, perceived cognition of illness, and behavioral changes, whereas the control group significantly decreased their healthy behaviors. In terms of behavioral changes, alcohol avoidance, dietary adherence, and stress management also improved in the intervention group. However, there were no significant improvements in symptoms of depression. Most participants (80%) in the intervention group stated that they benefited from the program. Conclusions This program contributed to patients’ acquisition of self-management skills to cope with their illnesses, and significantly improved their QOL. This program serves as a reminder for nurses who care for patients with chronic viral hepatitis to acquire these skills as it would help them address the daily needs of their patients. Trial registration UMIN000025378. Registered December 23, 2016.

scholarly journals The efficacies and limitations of fasciectomy and collagenase clostridium histolyticum in Dupuytren’s contracture management: A meta-analysis

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092174 ◽  
Author(s):  
Tokai B Cooper ◽  
Keshav Poonit ◽  
Chenglun Yao ◽  
Zeyuan Jin ◽  
Jingwei Zheng ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Treatment Algorithm ◽  
Cochrane Library ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum ◽  
Palmar Aponeurosis ◽  
The Mean

Background: We intend to assess the efficacies and limitations of collagenase clostridium histolyticum (CCH) and fasciectomy in treating Dupuytren’s contracture, and the associated complications and rate of recurrences aiming to present a treatment algorithm. Methods: A literature search within the PubMed, Web of Sciences, Cochrane Library, and EMBASE databases was performed using the combined key words ‘Dupuytren, palmar aponeurosis contracture, collagenase clostridium histolyticum and fasciectomy’, including all possible studies with a set of predefined inclusion and exclusion criteria. Results: Thirty studies were assessed for eligibility from 215 identified records. Seventeen publications satisfied the inclusion criteria including 2142 joints in 1784 patients. The mean follow-up time was 18.0 months (3–60). Conclusion: Acceptable contractures release was obtained in both techniques. Severe complications associated with fasciectomy outrank those of CCH, whereas the low rate of recurrence favors the fasciectomy technique.

scholarly journals Morphometric Analysis of Connective Tissue Sheaths of Sural Nerve in Diabetic and Nondiabetic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Braca Kundalić ◽  
Slađana Ugrenović ◽  
Ivan Jovanović ◽  
Natalija Stefanović ◽  
Vladimir Petrović ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Sural Nerve ◽  
Nerve Fibers ◽  
Diabetic Group ◽  
Control Group ◽  
Peripheral Vascular ◽  
Disease Group ◽  
Imagej Software

One of the most common complications of diabetes mellitus is diabetic neuropathy. It may be provoked by metabolic and/or vascular factors, and depending on duration of disease, various layers of nerve may be affected. Our aim was to investigate influence of diabetes on the epineurial, perineurial, and endoneurial connective tissue sheaths. The study included 15 samples of sural nerve divided into three groups: diabetic group, peripheral vascular disease group, and control group. After morphological analysis, morphometric parameters were determined for each case using ImageJ software. Compared to the control group, the diabetic cases had significantly higher perineurial index (P<0.05) and endoneurial connective tissue percentage (P<0.01). The diabetic group showed significantly higher epineurial area (P<0.01), as well as percentage of endoneurial connective tissue (P<0.01), in relation to the peripheral vascular disease group. It is obvious that hyperglycemia and ischemia present in diabetes lead to substantial changes in connective tissue sheaths of nerve, particularly in peri- and endoneurium. Perineurial thickening and significant endoneurial fibrosis may impair the balance of endoneurial homeostasis and regenerative ability of the nerve fibers. Future investigations should focus on studying the components of extracellular matrix of connective tissue sheaths in diabetic nerves.

scholarly journals The search for genetic factors of predisposition to the development of liver cirrhosis in the course of viral hepatitis B in patients from the Republic of Bashkortostan

2012 ◽  
Vol 93 (2) ◽  
pp. 197-203 ◽  
Author(s):  
G T Gusmanova ◽  
D Kh Kalimullina ◽  
A B Bakirov ◽  
R I Khusainova
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis B ◽  
Viral Hepatitis ◽  
Control Group ◽  
Genetic Associations ◽  
Glutathione S Transferase ◽  
Increased Risk ◽  
Viral Hepatitis B ◽  
The Republic ◽  
Severity Of The Disease

Aim. To identify the clinical and genetic associations of polymorphisms of the detoxification of xenobiotics genes during liver cirrhosis that developed as a result of viral hepatitis B. Methods. The study randomly included 38 patients with liver cirrhosis at the age of 25 to 54 years. The control group consisted of 147 healthy individuals. Conducted was an analysis of mutations in the deletion polymorphism of gene CYP1A1, leading to the replacement of the amino acid isoleucine with valine (Ile462Val) in position 462 of the cytochrome P-450 CYP1A1 and polymorphism of the gene GSTM1, which codes an enzyme antioxidant enzyme from the family of glutathione-S-transferase in patients with liver cirrhosis, which developed as a result of hepatitis B with the aim to identify possible associations with an increased risk and severity of the disease. Results. Revealed was a statistically significant increase in the proportion of patients with genotype Ile-Val/(+) compared to genotype Ile-Ile/(+), established was an association between the genotype S65C/N with polymorphism S65C of the gene HFE and liver cirrhosis of combined genesis (viral B + toxic). Conclusion. Ile462Val genotype of the CYP1A1 gene of the cytochrome P450, as well as the presence of a deletion of the glutathione-S-transferase M1 gene are risk factors for the development of liver cirrhosis secondary to hepatitis B.

Effect of Oral Prednisolone after Collagenase Injection for Dupuytren’s Contracture: A Randomized, Controlled Trial with a 1-Year Follow-Up

2020 ◽  
Author(s):  
Yoshihiro Abe
Keyword(s):  
Controlled Trial ◽  
Oral Prednisolone ◽  
Metacarpophalangeal Joint ◽  
Control Group ◽  
Dupuytren’S Contracture ◽  
Active Motion ◽  
Dupuytren's Contracture ◽  
Significant Difference ◽  
Total Active Motion

Abstract Introduction This study verified the effectiveness of oral prednisolone after collagenase clostridium histolyticum (CCH) (10 mg/day for 2 weeks) for Dupuytren’s contracture with a 1-year follow-up. Materials and Methods This study included 31 patients with a contracture of the metacarpophalangeal joint of ≥ 30 degrees. A total of 16 patients were allocated randomly to treatment with prednisolone and 15 patients were treated without prednisolone (control group). Results At day 7, mean total active motion (TAM) was 235 degrees in the prednisolone group and 228 degrees in the control group. Mean Visual Analog Scale was 3.3 in the prednisolone group and 4.6 in the control group. There was significant difference between two groups. At day 30, mean TAM was 241 degrees in the prednisolone group and 233 degrees in the control group. There were significant difference between two groups The mean QuickDASH score was significantly higher in the control group (5.8 vs. 3.4). Recurrence was observed in 2/16 patients (13%) in the prednisolone group and 5/15 patients (33%) in the control group; there was no significant difference. Conclusion The administration of prednisolone decreased the likelihood of adverse effects, and also improved finger flexion range of motion and reduced pain after CCH.

Dupuytren's Contracture: Morphological and Biochemical Changes in Palmar Aponeurosis

HAND ◽  
1982 ◽  
Vol os-14 (3) ◽  
pp. 237-247 ◽  
Author(s):  
H. Hamamoto ◽  
Y. Ueba ◽  
Y. Sudo ◽  
H. Sanada ◽  
T. Yamamuro ◽  
...  
Keyword(s):  
Biochemical Changes ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture ◽  
Palmar Aponeurosis

Dupuytren’s contracture in Ethiopia

2016 ◽  
Vol 42 (1) ◽  
pp. 26-28 ◽  
Author(s):  
A. Gebereegziabher ◽  
A. Baraki ◽  
Y. Kebede ◽  
I. Mohammed ◽  
V. Finsen
Keyword(s):  
Risk Factors ◽  
Demographic Data ◽  
Control Group ◽  
Dupuytren’S Contracture ◽  
Level Of Evidence ◽  
Female Ratio ◽  
Left Hand ◽  
Dupuytren's Contracture ◽  
Hand Involvement ◽  
Soles Of The Feet

Dupuytren’s contracture is believed to be rare in Africa. We have observed the disease in many patients coming to our hospital. This study aimed to provide information concerning the occurrence of the disease and risk factors in these patients. All 75 patients who were referred to the hospital during a 2-year period because of a hand problem that was diagnosed as Dupuytren’s contracture were included. The demographic data of the patients and possible risk factors were recorded and compared with a control group. The male to female ratio was 18:1. The little and ring fingers were most commonly affected. A total of 43 had bilateral hand involvement. The condition affected only the left hand in one patient. Six men also had fibromatosis of the soles of the feet and three of the penis. There was a statistically significant association with hypertension and alcohol consumption, but not with diabetes mellitus. We conclude that there are more cases of Dupuytren’s contracture in Ethiopia than previously thought. Level of evidence: III

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