ORTHOPEDICS THIS WEEK VOLUME 14 , ISSUE 23 | JULY 17 , 2018 24
EXTREMITIES
Drug Proves Successful in Treating Dupuytren ’ s Disease
Dupuytren ’ s disease is a condition of the hand that causes the fingers to curl irreversibly into the palm . There is currently no treatment for early Dupuytren ’ s disease . And , typically , patient ’ s fingers become so bent that their hand function is impaired . About 4 % of the population of the UK are affected by this ailment .
Researchers at the Kennedy Institute and Nuffield Department of Orthopaedics , Rheumatology and Musculoskeletal Sciences , University of Oxford , working with clinicians at NHS Lothian , have found that injection of the anti-TNF drug adalimumab into Dupuytren ’ s disease nodules results in the reduction of the cell characteristics responsible for progression of the disease .
Based on their laboratory data that tumor necrosis factor ( TNF ) drives the development of the cell type that causes Dupuytren ’ s disease , the research team explored the effect of an anti-TNF drug injected directly into the Dupuytren ’ s nodule tissue . The results so far , they report , are promising .
“ Our data have shown that a concentrated formulation of adalimumab injected directly into the diseased tissue may be effective in targeting the cells responsible for Dupuytren ’ s disease ,” said study leader Jagdeep Nanchahal , M . D ., Ph . D ., University of Oxford Professor of Hand , Plastic and Reconstructive Surgery .
“ This brings new hope to people who suffer from this disabling condition , who currently have to wait for their situation to deteriorate , watching their hand lose function until it is bad enough for surgery .”
This randomized trial ( phase 2a ) recruited 28 patients with Dupuytren ’ s disease who were scheduled to have surgery to remove diseased tissue in their hands . Two weeks prior to surgery they received a single injection of varying doses of the anti-TNF drug , or a placebo . The tissue removed during surgery , which is usually discarded , was then analyzed . The team found that adalimumab reduces expression of the fibrotic markers , at two weeks post injection , suggesting this drug could be used to stop the growth of disease causing myofibroblast cells . They also found the drug to be safe and well tolerated .
The anti-TNF drug adalimumab ( Humira ) is currently licensed in the EU for the treatment of a number of conditions including rheumatoid arthritis , Crohn ’ s disease and ulcerative colitis .
SPORTS MEDICINE
Concussive Impact May Not Be Worse for Kids
At the recent National Athletic Trainers ’ Association ’ s ( NATA ) 69th Clinical Symposia & AT Expo , held in New Orleans between June 26 and June 28 , 2018 , one of the new studies presented — from the Cincinnati Children ’ s Hospital — suggests that younger children are not more susceptible to the negatives effects of repetitive head impacts than older adolescents , as currently hypothesized .
Wikimedia Commons and Lance Cpl . David Flynn
In their study , “ Brain white matter alterations associated with a single season of competitive football : A comparison of youth and high school football ,” Kim Barber Foss , MS , ATC , LAT , certified athletic trainer and faculty member in the Master of Science in Health Science program at the Rocky Mountain University of Health Professions in Provo , Utah , and her colleagues compared the white matter ( WM ) integrity and total head impacts of a cohort of youth football players ( YFB ) relative to varsity high school football players ( HS ) over the course of one competitive season .
Wikipedia . org
The findings are published on line in the journal EBio- Medicine , published by The Lancet . — BY
A total of 12 YFB ( 13.08 ± 0.64 years ) and 21 HS ( 17.5 ± 0.78 years ) participated in the study . Magnetic resonance imaging sessions were completed pre-
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