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The sex ratio and rate of reoperation for Dupuytren's contracture in men and women
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
1999 Ingår i: J Hand Surg (Br), Vol. 24, nr 4, s. 456-9Artikel i tidskrift (Refereegranskat) Published
Ort, förlag, år, upplaga, sidor
1999. Vol. 24, nr 4, s. 456-9
Identifikatorer
URN: urn:nbn:se:uu:diva-89700OAI: oai:DiVA.org:uu-89700DiVA, id: diva2:161391
Tillgänglig från: 2002-03-21 Skapad: 2002-03-21 Senast uppdaterad: 2015-03-17Bibliografiskt granskad
Ingår i avhandling
1. Dupuytren´s Contracture: Features and Consequences
Öppna denna publikation i ny flik eller fönster >>Dupuytren´s Contracture: Features and Consequences
2002 (Svenska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Dupuytren's contracture (DC) is a fibromatous disease of the palmar fascia of unknown etiology. The present study was undertaken in order to assess pathophysiological mechanisms and consequences.

In a cohort study of 2,375 patients operated for DC at the Department of Hand Surgery, Uppsala there was a male: female ratio of 5.9:1. Women had a higher mean age at first operation than men. One-third of the men and one-quarter of the women required repeated surgery. Early age at first operation was associated with recurrent disease.

The risk of cancer was determined in 15,212 patients operated on for DC in Sweden. The overall relative risk was increased by 24%. There was a significantly increased risk for buccal, oesophageal, gastric, lung and pancreatic cancers, which indicates that smoking and alcohol abuse are probable risk factors for DC.

Furthermore, there was an increased frequency of fibrosarcoma and malignant fibrous histiocytoma, the cause of which is unexplained

The causes of death were evaluated in a national cohort of 16,517 patients operated for DC. There was an overall increased mortality (SMR=1.06), inversely related to age and significant for both sexes, in patients under 70 years. The risk estimate was highest for endocrine-, gastrointestinal-, and respiratory diseases, and accidents. There was also an increased SMR for cardiovascular diseases in younger patients more than 10 years after surgery. The most probable mechanism is related to smoking and other lifestyle factors.

Outcome after surgery was not related to the immunohistochemical expression of connective tissue activation markers, such as collagen type IV, integrin α5, laminin, smooth muscle α-actin, procollagen type I, and desmin, in surgical specimens in a prospectively investigated group of patients. Furthermore, there were no associations between gender, age at onset of DC, number of operations, heredity, diabetes mellitus, or medication for cardiovascular disease, and the expression of the different markers. The individual characteristics that place a person at high risk are, thus, not obviously related to ongoing connective tissue production at time of surgery or to connective tissue activity in its conventionally used sense.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2002. s. 53
Serie
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1130
Nyckelord
Surgery, Dupuytren´s contracture, epidemiology, outcome study, cohort, prognostic factors, immunohistochemistry, Kirurgi
Nationell ämneskategori
Kirurgi
Forskningsämne
kirurgi
Identifikatorer
urn:nbn:se:uu:diva-1794 (URN)91-554-5262-0 (ISBN)
Disputation
2002-04-19, Skoog salen. ingång 79, Akademiska sjukhuset, Uppsala, 13:15 (Engelska)
Opponent
Tillgänglig från: 2002-03-21 Skapad: 2002-03-21 Senast uppdaterad: 2009-08-10Bibliografiskt granskad

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