Clinical applications 4 miscellaneous

Dupuytren s disease is characterized by progressive contractures in the palm of the hand and fingers secondary to the formation of contracting bands or cords of collagen laid down by myofibroblasts. It occurs predominately in 40-year-old white men of Northern European decent. The pathogenic tissue is composed of collagen [3]. 

Historically, treatment has been surgical, including percutaneous fasciotomy or open fasciectomy [103]. Surgical complications occur in about 18% of cases (nerve injury 2.3%, arterial injury 0.4%, digital hematoma 2%, wound infection 9.5%, skin slough 2.4%, and sympathetic dystrophy 2.4%) [19]. Recurrence ranges from 27% to 80% [73, 74, 89, 107]. Numerous non-surgical modalities have been tried with limited success [52]. 

Agolini, S.F., Shah, K., Jaffe, J., Newcomb, J., Rhodes, M., Reed, J.F. 1997. Arterial embolization is a rapid and effective technique for controlling pelvic fracture hemorrhage. J Trauma 43, 395-399. 

Fleissel, A. 2006. Economic considerations for the use of recombinant human bone morphogenetic protein-2 in open tibial fractures in Europe the German model. Curr Med Res Opin 22 Suppl 1, SI9-22. 

Arezzo, J.C. 2009. Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins, NeuroBloc /Myobloc Unique features and findings, Toxicon 54(5), 690-696. 

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Several clinical trails are reported with curcumin in cancer patients around the world. Some of our recent review [Anand et al., 2008 Goel et al., 2007 Kunnumakkara et al., 2008] gives a detailed description of the clinical trials with curcumin, which are summarized in Table 16.2. An early clinical trial evaluated the effectiveness of topical application of a curcumin ointment in patients with external cancerous lesions. Patients with cancers of oral cavity (37 patients), breast (7 patients), vulva (4 patients), skin (3 patients), and miscellaneous unspecified sites (11 patients) were enrolled in this study. Remarkable symptomatic relief was observed in this study with the reduction in smell in 90% of the cases, reduction in itching in almost all cases, and reduction in exudates in 70% of cases. Reduction in lesion size and pain was observed in about 10% of the cases and only one melanoma (scalp) patient showed an adverse effect of local itching, which may be due to the allergic reaction to curcumin. 

Table 12 lists a number of miscellaneous applications of GLC which are of interest to clinical chemists. 

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