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Sakae Y, Takada H, Ichinose S, Nakajima M, Sakai A, Ogawa R. Treatment with YIGSR peptide ameliorates mouse tail lymphedema by 67 kDa laminin receptor (67LR)-dependent cell-cell adhesion. Biochem Biophys Rep 2023; 35:101514. [PMID: 37521371 PMCID: PMC10372372 DOI: 10.1016/j.bbrep.2023.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
Impaired microcirculation can cause lymphatic leakage which leads to a chronic swelling in the tissues of the body. However, no successful treatment gives any protection against lymphedema due to the lack of well-revealed pathophysiology of secondary lymphedema. Binary image of laminin immunohistochemical expression revealed that distribution of laminin expression localized during surgically induced lymphedema. 67 kDa laminin receptor (67LR) mRNA expression showed a peak at during lymphedema exacerbation. Since the response of 67LR molecules may affect the prevention of inflammation and edema, here we have hypothesized that 67LR ligand of YIGSR peptide could permit reconstructive environment for amelioration of lymphedema and evaluated the effect of YIGSR in a mouse tail model of lymphedema. Indeed, intra-abdominal injections of YIGSR for the first 3 days after inducing lymphedema in the mouse tail model reduced the tail lymphedema on day 14 by 27% (P = 0.035). Histology showed that YIGSR treatment protected lymphedema impairment in epidermis and dermis, and it also inhibited the expansion of intercellular spaces and enhanced especially cell adhesion in the basement membrane as revealed by transmission electron microscopy. Interestingly, the treatment also reduced the local expression of transforming growth factor (TGF)β. Further elucidation of the mechanisms of 67LR-facilitated lymphangiogenesis contributes to find potential targets for the treatment of lymphedema.
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Affiliation(s)
- Y. Sakae
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
| | - H. Takada
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
- Department of Anti-Aging and Preventive Medicine, Nippon Medical School, Japan
| | - S. Ichinose
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
| | - M. Nakajima
- Department of Pharmacology, Nippon Medical School, Japan
| | - A. Sakai
- Department of Pharmacology, Nippon Medical School, Japan
| | - R. Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
- Department of Anti-Aging and Preventive Medicine, Nippon Medical School, Japan
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Gao J, McClenaghan C, Christiaans I, Alders M, van Duinen K, van Haelst MM, van Haaften G, Nichols CG. Lymphedema as first clinical presentation of Cantu Syndrome: reversed phenotyping after identification of gain-of-function variant in ABCC9. Eur J Hum Genet 2023; 31:188-194. [PMID: 36336713 PMCID: PMC9905590 DOI: 10.1038/s41431-022-01210-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/16/2022] [Accepted: 09/30/2022] [Indexed: 11/09/2022] Open
Abstract
Cantu Syndrome (CS), [OMIM #239850] is characterized by hypertrichosis, osteochondrodysplasia, and cardiomegaly. CS is caused by gain-of-function (GOF) variants in the KCNJ8 or ABCC9 genes that encode pore-forming Kir6.1 and regulatory SUR2 subunits of ATP-sensitive potassium (KATP) channels. Many subjects with CS also present with the complication of lymphedema. A previously uncharacterized, heterozygous ABCC9 variant, p.(Leu1055_Glu1058delinsPro), termed indel1055, was identified in an individual diagnosed with idiopathic lymphedema. The variant was introduced into the equivalent position of rat SUR2A, and inside-out patches were used to characterize the KATP channels formed by Kir6.2 and WT or mutant SUR2A subunits coexpressed in Cosm6 cells. The indel1055 variant causes gain-of-function of the channel, with an increase of the IC50 for ATP inhibition compared to WT. Retrospective consideration of this individual reveals clear features of Cantu Syndrome. An additional heterozygous ABCC9 variant, p.(Ile419Thr), was identified in a second individual diagnosed with lymphedema. In this case, there were no additional features consistent with CS, and the properties of p.(Ile416Thr) (the corresponding mutation in rat SUR2A)--containing channels were not different from WT. This proof-of-principle study shows that idiopathic lymphedema may actually be a first presentation of otherwise unrecognized Cantu Syndrome, but molecular phenotyping of identified variants is necessary to confirm relevance.
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Affiliation(s)
- Jian Gao
- Department of Cell Biology and Physiology and Center for the Investigation of Membrane Excitability Diseases, Washington University in St. Louis, St. Louis, MO, USA
| | - Conor McClenaghan
- Department of Cell Biology and Physiology and Center for the Investigation of Membrane Excitability Diseases, Washington University in St. Louis, St. Louis, MO, USA
| | - Imke Christiaans
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marielle Alders
- University of Amsterdam, Department of Human Genetics, Meibergdreef 9, Amsterdam, The Netherlands
| | - Kirsten van Duinen
- Department of Dermatology, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - Mieke M van Haelst
- University of Amsterdam, Department of Human Genetics, Meibergdreef 9, Amsterdam, The Netherlands.
- Departments of Pediatrics, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
- Emma Center for Personalized Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
| | - Gijs van Haaften
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Colin G Nichols
- Department of Cell Biology and Physiology and Center for the Investigation of Membrane Excitability Diseases, Washington University in St. Louis, St. Louis, MO, USA.
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Chang YC, Lin GM, Tseng TA, Vitale E, Yang CH, Yang YL. The Experience of Mindfulness-Based Stress Reduction on Menopausal Symptoms, Sleep Disturbance, and Body Image among Patients with Breast Cancer-A Qualitative Study. Curr Oncol 2023; 30:1255-1266. [PMID: 36661746 PMCID: PMC9857969 DOI: 10.3390/curroncol30010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND AIM The objective was to decrease patient menopausal symptoms, sleep disturbance, and body image using a nonpharmacological therapy for cultivating key healthy lifestyle habits in patients with breast cancer. MATERIALS AND METHODS The participants were 26 women with breast cancer who had recently received structured mindfulness-based stress reduction (MBSR) training in a clinical trial. Focus groups and interviews were conducted, during which the participants were asked semistructured, open-ended questions regarding the experiences of MBSR. RESULTS The participants indicated that MBSR helped them to alleviate hot flashes and night sweats, and improve sleep quality and be more at ease with the external aspect of their body. On the other hand, during MBSR intervention in a group manner, the participants felt more psychological support and an outlet for sharing negative emotional experiences. CONCLUSION This study identified the short-term benefits associated with group-based MBSR for women with breast cancer. In addition, our research identified the difficulties of intervention measures and coping methods. The study described the benefits of MBSR for patients with breast cancer. The findings of this study will help nursing staff identify the main coping menopausal symptoms and control negative mental health.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung 40604, Taiwan
- Nursing Department, China Medical University Hospital, Taichung 404327, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien-Armed Forces General Hospital, Hualien 97144, Taiwan
- Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tzuhui Angie Tseng
- Department of Environmental and Cultural Resources, National Tsing Hua University, Hsinchu 30063, Taiwan
| | - Elsa Vitale
- Mental Health Center, ASL (Local Health Authority) Bari, 70026 Bari, Italy
| | - Ching-Hsu Yang
- Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu 30071, Taiwan
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
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Accompagnement des patientes mastectomisées à l’officine. ACTUALITES PHARMACEUTIQUES 2022. [DOI: 10.1016/j.actpha.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Gulati S, Chandrashekhara SH, Bhoriwal S, Kose SI. Chronic lymphoedema: a nidus for squamous cell carcinoma. BMJ Case Rep 2022; 15:e248543. [PMID: 35537771 PMCID: PMC9092127 DOI: 10.1136/bcr-2021-248543] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/03/2022] Open
Abstract
Lymphoedema is a chronic debilitating condition characterised by diffuse swelling caused by lymphatic obstruction. The secondary form of lymphoedema is more common than the primary form. Untreated filariasis remains an important cause of lymphoedema in developing countries. The most common complication of chronic lymphoedema is cellulitis. It is also a risk factor for the development of neoplasms such as lymphangiosarcoma, squamous cell carcinoma, melanoma, lymphoma and malignant fibrous histiocytoma. We report a case of a woman in her 60s who developed squamous cell carcinoma in the background of chronic lymphoedema.
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Affiliation(s)
- Shrea Gulati
- Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | | | | | - Snehal Ishwar Kose
- Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Semkin VA, Vozgoment OV, Nadtochiy AG, Ivanova AA. [Lymphotropic therapy in the treatment of patients with postoperative secondary lymphedema of the maxillofacial region]. STOMATOLOGIIA 2022; 101:47-52. [PMID: 35943500 DOI: 10.17116/stomat202210104147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of study was to improve the effectiveness of treatment of patients with secondary postoperative lymphedema of the maxillofacial region using lymphotropic therapy. MATERIAL AND METHODS During 2020-2021 8 patients aged 40 to 70 years with secondary postoperative lymphedema of the maxillofacial region were treated in the Central Research Institute of Dentistry and Maxillofacial Surgery. The article presents the clinical and ultrasound results of a study of the effectiveness of the lymphotropic therapy in the treatment of patients with secondary lymphedema of the maxillofacial region. RESULTS Six patients with an early stage of lymphedema had a complete regression of edema and normalization of the ultrasound picture of the soft tissues of the maxillofacial region. In 2 patients with late-stage lymphedema there was a regression of edema, but the preservation of residual swelling of soft tissues and signs of fibro-fatty transformation of soft tissues were revealed on ultrasound examination. CONCLUSION Lymphotropic therapy with antifibrotic and anti-inflammatory drugs is one of the effective methods of treating postoperative secondary lymphedema of the maxillofacial region at the early stages of the disease.
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Affiliation(s)
- V A Semkin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O V Vozgoment
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - A G Nadtochiy
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A A Ivanova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Bergmann A, Baiocchi JMT, de Andrade MFC. Conservative treatment of lymphedema: the state of the art. J Vasc Bras 2021; 20:e20200091. [PMID: 34777487 PMCID: PMC8565523 DOI: 10.1590/1677-5449.200091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/08/2020] [Indexed: 11/22/2022] Open
Abstract
This article aims to discuss the possibilities of conservative and non-pharmacological treatments for lymphedema. A non-systematic review of the literature was carried out, including studies involving human subjects with different types of lymphedema. Several approaches to lymphedema treatment have been reported and Complex Decongestive Therapy (CDT) has been considered the most effective treatment for limb lymphedema. Other conservative treatments have been proposed such as Taping, Extracorporeal Shock Wave Therapy, Acupuncture, Photobiomodulation Therapy, Endermologie, Intermittent Pneumatic Compression, and Low-frequency, Low-intensity Electrotherapy. The choice of the therapeutic approach to be employed should consider lymphedema characteristics, the therapist's experience, and the patient's wishes. In addition, since this is a chronic condition, the patient must adhere to the treatment. To this end, the therapeutic proposal may be the key to better control of limb volume.
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Affiliation(s)
- Anke Bergmann
- Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brasil
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Semkin VA, Nadtochiy AG, Vozgoment OV, Ivanova AA. [Head and neck lymphedema. Literature review]. STOMATOLOGII︠A︡ 2021; 100:103-108. [PMID: 34180633 DOI: 10.17116/stomat2021100031103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The article is a review of the latest literature data on lymphedema of the head and neck, its etiology, pathogenesis, classification and main clinical manifestations. The main methods of diagnosis and treatment of this pathology are indicated.
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Affiliation(s)
- V A Semkin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A G Nadtochiy
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O V Vozgoment
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - A A Ivanova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Leray H, Malloizel-Delaunay J, Lusque A, Chantalat E, Bouglon L, Chollet C, Chaput B, Garmy-Susini B, Yannoutsos A, Vaysse C. Body Mass Index as a Major Risk Factor for Severe Breast Cancer-Related Lymphedema. Lymphat Res Biol 2020; 18:510-516. [DOI: 10.1089/lrb.2019.0009] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hélène Leray
- Service de Chirurgie Gynécologique Oncologique, CHU-Toulouse, Institut Universitaire de Toulouse-Oncopole, Toulouse, France
| | | | - Amélie Lusque
- Service de Biostatistique, Institut Claudius Regaud, Institut Universitaire de Toulouse-Oncopole, Toulouse, France
| | - Elodie Chantalat
- Service de Chirurgie Gynécologique Oncologique, CHU-Toulouse, Institut Universitaire de Toulouse-Oncopole, Toulouse, France
| | - Léonard Bouglon
- Service de Médecine Vasculaire, CHU-Toulouse, Toulouse, France
| | - Charlotte Chollet
- Service de Chirurgie Gynécologique Oncologique, CHU-Toulouse, Institut Universitaire de Toulouse-Oncopole, Toulouse, France
| | - Benoit Chaput
- Service de Chirurgie Plastique et des Brûlés, CHU-Toulouse, Toulouse, France
| | | | - Alexandra Yannoutsos
- Service de Médecine Vasculaire, CHU-Toulouse, Toulouse, France
- Service de Médecine Vasculaire, Hôpital Paris Saint-Joseph, Paris, France
| | - Charlotte Vaysse
- Service de Chirurgie Gynécologique Oncologique, CHU-Toulouse, Institut Universitaire de Toulouse-Oncopole, Toulouse, France
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10
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Determination of the Minimum Detectable Change in the Total and Segmental Volumes of the Upper Limb, Evaluated by Perimeter Measurements. Healthcare (Basel) 2020; 8:healthcare8030285. [PMID: 32825744 PMCID: PMC7551255 DOI: 10.3390/healthcare8030285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 01/16/2023] Open
Abstract
Among female breast cancer survivors, there is a high prevalence of lymphedema subsequent to axillary lymph node dissection and axillary radiation therapy. There are many methodologies available for the screening, diagnosis and follow-up of breast cancer survivors with or without lymphedema, the most common of which is the measurement of patients’ arm circumference. The purpose of this study was to determine the intra-rater minimal detectable change (MDC) in the volume of the upper limb, both segmentally and globally, using circumference measurements for the evaluation of upper limb volume. In this study, 25 women who had received a unilateral mastectomy for breast cancer stage II or III participated. On two occasions separated by 15 min, the same researcher determined 11 perimeters for each arm at 4 cm intervals from the distal crease of the wrist in the direction of the armpit. The MDC at the segmental level ranged from 3.37% to 7.57% (2.7 to 14.6 mL, respectively) and was 2.39% (42.9 mL) at the global level of the arm; thus, minor changes in this value result in a high level of uncertainty in the interpretation of the results associated with the diagnosis of lymphedema and follow-up for presenting patients.
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11
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Chantalat L, Simon M, Fourgeaud C, Vignes S. [Puffy hand syndrome: A little-known diagnosis]. Rev Med Interne 2020; 41:700-703. [PMID: 32674894 DOI: 10.1016/j.revmed.2020.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/05/2020] [Accepted: 05/21/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Puffy hand syndrome is a rare complication of intravenous drug addiction. Diagnosis is based on the patient's history and clinical examination. OBSERVATIONS A woman and two men, aged 42, 39 and 36 years old, are described. All had a history of intravenous drug use of heroin and oral buprenorphine misuse. Puffy hand syndrome appeared during drug addiction (n = 2) or after its withdrawal (n = 1). It was associated with acrocyanosis (n = 1) or injection scars (n = 1). Upper limb ultrasonography showed sequelae of venous (n = 3) or arterial (n = 1) thrombosis. An upper limb lymphoscintigraphy in one patient showed decreased radionuclide uptake of axillary lymph node and subdermal reflux tracer in the forearm. Treatment was based on low-stretch bandages to reduce the volume and then elastic compression sleeve for long-term stabilization. CONCLUSION Puffy hand syndrome seen in intravenous drug addicts is poorly understood. It is a chronic complication despite the cessation of drug use. This syndrome has to become more widely known because its management is mandatory, although symptomatic.
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Affiliation(s)
- L Chantalat
- Unité de Lymphologie, Site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 15 rue Eugène Millon, 75015 Paris, France
| | - M Simon
- Unité de Lymphologie, Site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 15 rue Eugène Millon, 75015 Paris, France
| | - C Fourgeaud
- Unité de Lymphologie, Site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 15 rue Eugène Millon, 75015 Paris, France
| | - S Vignes
- Unité de Lymphologie, Site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 15 rue Eugène Millon, 75015 Paris, France.
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Bozon G, Mestre Godin S, Chorron G, Nou Howaldt M, Laroche JP, LeCollen L, Calais C, Quéré I, Galanaud JP. Assessment of primary lymphedema and post-thrombotic lower limb edema patient's pathway. JOURNAL DE MÉDECINE VASCULAIRE 2020; 45:55-61. [PMID: 32265015 DOI: 10.1016/j.jdmv.2020.01.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 12/06/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess: (1) lower limb primary lymphedema or post-thrombotic syndrome patient's pathway in terms of health care professional use and (2) if aetiology of edema has an impact on this pathway. METHODS Ancillary survey of the transversal prospective CHROEDEM pilot study. Forty patients with either lower limb primary lymphedema or post-thrombotic syndrome were invited to participate. RESULTS Seventy-five percent of primary lymphedema patients and 50% of post-thrombotic patients benefited from a multidisciplinary management (P=0.10) including the general practitioner, the vascular medicine physician and either a physiotherapist (particularly in case of primary lymphedema), a registered nurse (particularly in case of post-thrombotic syndrome). Main ambulatory health care professionals' correspondent of hospital-based vascular medicine physicians were general practitioners (80%) in post-thrombotic patients, and general practitioners (60%) and physiotherapists (45%) in primary lymphedema patients. Pharmacists were also involved in patient education. CONCLUSION Management of primary lymphedema and post-thrombotic related chronic edema is usually multidisciplinary. General practitioners and vascular medicine physicians are the cornerstones of this management, that also involves the physiotherapist in case of primary lymphedema and in a lesser extent the registered nurse and the pharmacist. This suggests that these five healthcare professional should play a key role in case of development of standardized patient pathways for primary lymphedema and post-thrombotic syndrome.
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Affiliation(s)
- G Bozon
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France.
| | - S Mestre Godin
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France; EA 2992, Montpellier 1 university, 34000 Montpellier, France
| | - G Chorron
- Département de l'information médicale, CHU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - M Nou Howaldt
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - J P Laroche
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - L LeCollen
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - C Calais
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - I Quéré
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France; EA 2992, Montpellier 1 university, 34000 Montpellier, France
| | - J P Galanaud
- Department of vascular medicine, CHU Montpellier, Saint-Eloi hospital, 80, avenue Augustin-Fliche, 34090 Montpellier, France; EA 2992, Montpellier 1 university, 34000 Montpellier, France; Department of medicine, Sunnybrook Health Sciences Centre, université de Toronto, 2075, Bayview avenue, M4N 3M5 Toronto, ON, Canada
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13
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Malloizel-Delaunay J, Chantalat E, Bongard V, Chaput B, Garmy-Susini B, Yannoutsos A, Vaysse C. Endermology treatment for breast cancer related lymphedema (ELOCS): Protocol for a phase II randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 2019; 241:35-41. [PMID: 31419694 DOI: 10.1016/j.ejogrb.2019.07.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/24/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Secondary lymphedema is a serious and debilitating condition, which may cause a range of cutaneous, infectious and joint complications with major psychological and social consequences. There is no curative treatment available. Initial symptomatic treatment includes Intensive Decongestive Treatment (IDT), which involves the use of multi-layered compression bandages, along with manual lymph drainage, physical exercise and skin care. IDT leads to an average decrease in limb volume of 20-40%, when compared to the contralateral limb. A better reduction may be obtained through the use of new adjuvant techniques, of which endermology is an example. The aim of this phase II study is to validate an IDT protocol combining endermology with standard of care in breast cancer related lymphedema. STUDY DESIGN A standardised care protocol was proposed by the University Hospital of Toulouse's Lymphology team for the treatment of upper limb lymphedema after breast cancer surgery using Cellu M6 (LPG) Endermologie over 30 min. Every patient benefitted from IDT over 5 consecutive days, within the multidisciplinary Lymphology unit. Patients were randomised into three arms as follows: Arm 1: IDT for 5 days with bandages + manual lymphatic drainage. Arm 2: IDT with bandages + manual lymphatic drainage + Cellu M6 for 5 days. Arm 3: bandages + Cellu M6 for 5 days. During the study, patients will be followed-up for a period of 6 months. Use of LPG's Cellu M6 in combination with IDT may improve upper limb volume reduction compared with standard of care. By improving breast cancer related lymphedema, we expect to minimise further fluid build-up and to improve skin care, thus reducing the number of consultations and hospital admissions caused by this condition. The results of the present research protocol are expected to promote evidence supporting the use of endermology in the field of lymphology.
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Affiliation(s)
| | - Elodie Chantalat
- University Hospital Toulouse, Toulouse University Cancer Institute - Oncopole, Department of Oncological Surgery, Toulouse, France
| | - Vanina Bongard
- Toulouse University Hospital, Clinical Research Methodological Support Unit (USMR, Unité de Support Méthodologique à la Recherche), Toulouse, France
| | - Benoit Chaput
- University Hospital Toulouse, Department Plastic Surgery and Burns, Toulouse, France
| | | | - Alexandra Yannoutsos
- Paris Saint-Joseph Hospital, Vascular Medicine Department, Paris, France; Paris Descartes University, INSERM UMR 1153-CRESS, Paris, France
| | - Charlotte Vaysse
- University Hospital Toulouse, Toulouse University Cancer Institute - Oncopole, Department of Oncological Surgery, Toulouse, France.
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Maruccia M, Pezzolla A, Nacchiero E, Dicillo P, Macchia L, Fiore P, Giudice G, Elia R. Efficacy and early results after combining laparoscopic harvest of double gastroepiploic lymph node flap and active physiotherapy for lower extremity lymphedema. Microsurgery 2019; 39:679-687. [DOI: 10.1002/micr.30511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Michele Maruccia
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ TransplantationUniversity of Bari Aldo Moro Bari Italy
| | - Angela Pezzolla
- Division of Videolaparoscopic Surgery, Department of Emergency and Organ TransplantationUniversity of Bari Bari Italy
| | - Eleonora Nacchiero
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ TransplantationUniversity of Bari Aldo Moro Bari Italy
| | - Patrizia Dicillo
- Department of Basic Medical Sciences, Neuroscience and Sensory OrgansUniversity of Bari "Aldo Moro" Bari Italy
| | - Laura Macchia
- Department of Basic Medical Sciences, Neuroscience and Sensory OrgansUniversity of Bari "Aldo Moro" Bari Italy
| | - Piero Fiore
- Department of Basic Medical Sciences, Neuroscience and Sensory OrgansUniversity of Bari "Aldo Moro" Bari Italy
| | - Giuseppe Giudice
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ TransplantationUniversity of Bari Aldo Moro Bari Italy
| | - Rossella Elia
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ TransplantationUniversity of Bari Aldo Moro Bari Italy
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Humbert S, Razanamahery J, Payet-Revest C, Méaux-Ruault N, Gil H, Magy-Bertrand N, London J. Accro à la dispense de sport jusqu’à une certaine séance de natation…. Rev Med Interne 2019; 40:623-625. [DOI: 10.1016/j.revmed.2019.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 11/30/2022]
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Fourgeaud C, Vignes S. [Lower limb lymphedema: A rare manifestation of spondyloarthropathy]. Rev Med Interne 2019; 40:837-840. [PMID: 31279481 DOI: 10.1016/j.revmed.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 06/24/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Spondyloarthritis include articular (axial, peripheral or enthesitic) and extra-articular manifestations. We reported three cases of limb lymphedema associated with a spondyloarthritis. CASE REPORTS We report on two men and one female aged of 75, 52 and 39 years, respectively. The rheumatic disease was an ankylosing spondylitis HLA B27 positive in two patients and a psoriatic arthritis in the remaining one. Lymphedema, always unilateral, confirmed by the Stemmer's sign, involved the whole lower limb (n=2) or only the foot and calf (n=1). Lymphedema occurred 3 months, 40 and 9 years after the onset of spondyloarthritis. Lower limb lymphoscintigraphy was abnormal in all cases: decrease (n=2) or absence (n=1) of inguinal lymph node uptake, and visualization of the popliteal lymph node related to deep lymphatic pathway (n=1). Treatment of the spondyloarthritis did not improve lymphedema. Both the low-stretch bandage and elastic compression treatment allowed its reduction and stabilization. CONCLUSION Limb lymphedema is a rare extra-articular manifestation of spondyloarthritis. Its course appears to be independent of joint disease. Its management is specific and should be associated to that of the rheumatologic disorder.
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Affiliation(s)
- C Fourgeaud
- Unité de Lymphologie, site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
| | - S Vignes
- Unité de Lymphologie, site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France.
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Fourgeaud C, Simon L, Benoughidane B, Vignes S. Lymphœdèmes associés à la prise de sirolimus : à propos de 15 patients. Rev Med Interne 2019; 40:151-157. [DOI: 10.1016/j.revmed.2018.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/08/2018] [Accepted: 04/17/2018] [Indexed: 11/24/2022]
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Vignes S, Bellanger J. Lymphangiectasies intestinales primitives (maladie de Waldmann). Rev Med Interne 2018; 39:580-585. [DOI: 10.1016/j.revmed.2017.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 07/24/2017] [Indexed: 12/17/2022]
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Stepanova AM, Merzlyakova AM, Khulamhanova MM, Trofimova OP. The post-mastectomy syndrome: the secondary lympedema after the combined treatment of breast cancer (the literature review and own results). JOURNAL OF MODERN ONCOLOGY 2018. [DOI: 10.26442/1815-1434_2018.2.45-49] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The post-mastectomy syndrome and lymphedema after the combined treatment of breast cancer, significantly worsen the quality of life of patients, their psycho - emotional state. The treatment of this disease is always combined in nature, and involves elements of the Complex Decongestive Therapy, pneumatic compression, mild electrical stimulation and low-frequency magnetic therapy. The best results of therapy are achieved with early detection and treatment. Complex treatment of lymphedema does not affect the course of cancer.
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Baxter GD, Liu L, Tumilty S, Petrich S, Chapple C, Anders JJ. Low level laser therapy for the management of breast cancer-related lymphedema: A randomized controlled feasibility study. Lasers Surg Med 2018; 50:924-932. [DOI: 10.1002/lsm.22947] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 11/12/2022]
Affiliation(s)
- George David Baxter
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy, University of Otago; Dunedin New Zealand
| | - Lizhou Liu
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy, University of Otago; Dunedin New Zealand
| | - Steve Tumilty
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy, University of Otago; Dunedin New Zealand
| | - Simone Petrich
- Department of Surgical Sciences; Southern District Health Board; Dunedin New Zealand
| | - Cathy Chapple
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy, University of Otago; Dunedin New Zealand
| | - Juanita J. Anders
- Department of Anatomy, Physiology and Genetics; Uniformed Services University of the Health Sciences; Bethesda Maryland
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Vignes S, Simon L, Vidal F, Arrault M. [Abnormal nails and chronic cough]. Rev Med Interne 2017; 39:767-768. [PMID: 28579108 DOI: 10.1016/j.revmed.2017.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/12/2017] [Indexed: 11/25/2022]
Affiliation(s)
- S Vignes
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France.
| | - L Simon
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
| | - F Vidal
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
| | - M Arrault
- Unité de lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), hôpital Cognacq-Jay, 15, rue Eugène-Millon, 75015 Paris, France
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Mousavi SR. Long Term Results of Innovative Procedure in Surgical Management of Chronic Lymphedema. Open Orthop J 2016; 10:543-549. [PMID: 27990192 PMCID: PMC5120377 DOI: 10.2174/1874325001610010543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 04/27/2016] [Accepted: 06/19/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Lymphedema is the result of impaired lymphatic drainage by the affected organ. This abnormality can be primary or secondary. Different operative approaches have been introduced to treat chronic lymphedema. MATERIALS AND METHODS This retrospective study included 816 patients who were diagnosed with chronic lower extremity lymphedema and did not respond to non-operative management for at least six months. Data was collected over 25 years, between March 1987 and March 2013. Doppler ultrasonography of the deep venous system was routinely undertaken in all patients to confirm patency. The patients underwent surgery and their progress was followed for at least one year postoperatively. RESULTS All patients were operated by the suggested technique and long term fallow-up which is a modified form of the Homan's technique. The outcome was excellent, and 89.2% of patients were free of complication and 2% had poor results. The most common complication was wound seroma and wound infection. CONCLUSION The long term results and considering the difficulties associated with the treatment of chronic lymphedema and the variety of surgical options, our method achieved excellent results, and may be proposed for the standard operative procedure for treating intractable forms of this disease.
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Affiliation(s)
- Seyed R. Mousavi
- Shohada Medical Center and Cancer Research Center, Vascular Department, Shahid Beheshti University Medical Sciences, Tehran, Iran
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