Lymphedema duration as a predictive factor of efficacy of complete decongestive therapy.

Lymphedema is a common condition with global impact and a multitude of complications, however, only a few professionals specialize in its management. A retrospective analysis of 105 subjects with unilateral lymphedema upper or lower limb was performed to investigate whether the duration of lymphedema constitutes an important factor associated with the efficacy of complete decongestive therapy (CDT). Subjects were classified into two groups according to the duration of lymphedema, prior to CDT: group A (≤1 year) and group B (>1 year). Both groups were treated daily according to the same CDT protocol for four weeks. The CDT efficacy was determined based on the percent reduction of excess volume (PREV) measurements. Lymphedema was significantly reduced in both groups of subjects, but significantly more in group A (p<0.001). In subjects with upper limb lymphedema, median value of PREV was 80.8% (interquartile range, 79.1-105.0%) in group A and 62.0% (interquartile range, 56.7-66.5%) in group B (p<0.001). In subjects with lower limb lymphedema PREV was 80.7% (interquartile range, 74.9-85.2%) and 64.5% (interquartile range, 56.0-68.1%) for groups A and B, respectively (p<0.001). Duration of lymphedema was found to be a strong predictive factor that may significantly impact CDT efficacy. Therapeutic effects were increased in subjects who were detected and treated earlier for lymphedema.

All-Order Amplitudes at any Multiplicity in the Multi-Regge Limit.

We propose an all-loop expression for scattering amplitudes in planar N=4 super Yang-Mills theory in multi-Regge kinematics valid for all multiplicities, all helicity configurations, and arbitrary logarithmic accuracy. Our expression is arrived at from comparing explicit perturbative results with general expectations from the integrable structure of a closely related collinear limit. A crucial ingredient of the analysis is an all-order extension for the central emission vertex that we recently computed at next-to-leading logarithmic accuracy. As an application, we use our all-order formula to prove that all amplitudes in this theory in multi-Regge kinematics are single-valued multiple polylogarithms of uniform transcendental weight.

Physiotherapeutic rehabilitation of lymphedema: state-of-the-art.

Lymphatic diseases, especially lymphedema, represent a serious problem in the health community. We investigated strategies and methods for physiotherapeutic rehabilitation of lymphedema by carrying out a comprehensive search of the Medline and Embase databases from 1990 to 2016 to identify relevant published studies, articles, and reviews. Approaches for conservative management of lymphedema include the following: manual lymphatic drainage, lymphedema rehabilitation exercises, compression therapy, skin care, pneumatic compression, elevation of the extremities, thermal therapy, complete decongestive physiotherapy (CDT), taping, and aqua lymphatic therapy. Treatment of lymphedema with CDT, which is a combination of four methods (manual lymphatic drainage, lymphedema rehabilitation exercises, compression therapy, skin care), can achieve a 45-70% reduction in lymphedema volume. Prerequisites for successful physiotherapy are the availability of physicians, nurses and therapists who are specifically trained, educated, and experienced in each method. CDT is the most effective treatment as it reduces the symptoms of lymphedema and improves patients' functionality, mobility, and quality of life. Although other therapeutic techniques have demonstrated positive results, these surveys are limited and more studies are needed to confirm findings.

Sex differences in the effects of two stress paradigms on dopaminergic neurotransmission.

Sex differences in behavioral and neurobiological responses to stress are considered to modulate the prevalence of some psychiatric disorders, including major depression. In the present study, we compared dopaminergic neurotransmission and behavior in response to two different stress paradigms, the Forced Swim Test (FST) and the Chronic Mild Stress (CMS). Male and female rats were subjected to one session of swim stress for two consecutive days (FST) or to a variety of mild stressors alternating for six weeks (CMS). Subsequently, the tissue levels of dopamine (DA) and its metabolites (HVA and DOPAC) in the hippocampus, the hypothalamus, the prefrontal cortex and the striatum were measured using high-performance liquid chromatography (HPLC). The ratios HVA/DA and DOPAC/DA were also calculated as indices of the dopaminergic activity. Results from the FST determined that males exhibited lower immobility, higher climbing duration and increased dopaminergic activity in the prefrontal cortex and the hippocampus compared to females. CMS induced alterations in sucrose intake in both sexes, while it only decreased dopaminergic activity in the prefrontal cortex of females. These findings show that FST and CMS have different effects on the dopaminergic activity of discrete brain regions depending on the sex of the animal. These data support the growing evidence that females display a differential response and adaptation to stress than males.

Individual responses to novelty are associated with differences in behavioral and neurochemical profiles.

Experimental animals can be differentiated on the basis of their horizontal or vertical activity to high responders (HR) and low responders (LR) upon exposure to a novel environment. These individual differences have been associated with behavioral and neurobiological differences in a number of experimental procedures used for studying sensitivity to psychostimulants, anxiety, depression, and cognitive function. In the present study, we differentiated the rats to HR and LR based on their vertical activity upon exposure to a novel environment. Additionally, we ascertained whether HR and LR rats differ in a battery of tests such as passive avoidance (PA), object recognition (OR), and the water-maze (WM) that provide indices for cognitive function and the forced swim test (FST), an animal model of affective responsivity and antidepressant-like activity. Potential differences in neurochemical indices between the two phenotypes were also examined. HR rats displayed impaired non-spatial object recognition memory, but enhanced spatial performance, as compared to LR rats. FST induced "depressive-like" symptoms in both phenotypes that were differently manifested in HR versus LR rats. Neurochemical findings revealed distinct differences in serotonergic and dopaminergic activity in the striatum and the prefrontal cortex of HR as compared to LR rats. The above results show that HR and LR rats exhibit important differences in a battery of tests related to cognitive performance or affective responsivity, which may be associated with differences in certain neurobiological parameters.

Sex differences in behavioral, neurochemical and neuroendocrine effects induced by the forced swim test in rats.

The forced swim test (FST) has been considered as a pharmacologically valid test of the depressive syndrome in rodents. However, few studies have focused on neurochemical and behavioral responses during FST in both male and female rats. Thus, we investigated certain behavioral and neuroendocrine responses as well as the serotonergic activity after the application of FST in both sexes. Our data show that the duration of immobility was increased in both male and female rats during the 2nd session of the FST. Sex differences are observed in some behavioral responses, such as head swinging that is mostly present in male rats. In female rats FST induced a decrease in serotonergic activity in hippocampus and hypothalamus while in male rats it induced an increase in serotonergic activity in hypothalamus. Corticosterone serum levels were elevated in both sexes. However, hippocampal GR mRNA levels tended to be increased in males and females respectively. Moreover, hypothalamic serotonin (5-HT)1A mRNA levels were decreased in female rats while in male rats hippocampal 5-HT1A mRNA levels were increased. These data have shown that FST induces "depressive like symptoms" in both sexes and provide evidence that sex differences characterize certain behavioral aspects in the FST. Notably, hippocampal and hypothalamic serotonergic activity has been differentially modified in male rats compared with female rats and these neurochemical findings could be relevant to the differentiated expression of 5-HT1A receptor. Hypothalamic-pituitary-adrenal axis activity was also affected by FST application in a sex specific manner. The present results support that FST induced behavioral, neurochemical and neurobiological alterations, which are sex dependent.

Individual responses to novelty predict qualitative differences in d-amphetamine-induced open field but not reward-related behaviors in rats.

Differences in the locomotor response of rats to a novel environment (high responders [HR] versus low responders [LR]) have been associated with differences in vulnerability to psychostimulants. In the present study we profiled extensively the behavioral repertoire of HR and LR rats (differentiated on the basis of vertical activity) during exposure to a novel environment and in response to d-amphetamine (d-amp; 1.5 mg/kg, i.p.). Moreover, we ascertained whether HR and LR rats differ in the rewarding effects of medial forebrain bundle electrical self-stimulation and in the ability of d-amp to increase the reinforcing efficacy of self-stimulation. Apart from rearing, HR animals displayed increased moving, sniffing, but decreased standing and yawning compared with LR. Factor analysis revealed a more complex behavioral structure consisting of locomotion, exploration, vertical activity and self-directed behavior for HR compared with LR rats. Qualitative, but not quantitative differences, between the two groups of rats in their behavioral responses to d-amp were found. In particular, a more complex profile mainly characterized by self-directed behavior, locomotion and vertical activity was manifested for HR as compared with LR rats. Baseline brain stimulation reward thresholds did not differ between the two groups of rats. Additionally, brain stimulation reward thresholds for the two groups were not differentially affected by d-amp. The above results suggest that HR and LR can be further differentiated upon exposure to a novel environment and in response to d-amp. This differentiation is primarily based on qualitative cohorts of their behavioral structure, but not on deviations in the reward processes as assessed by intracranial self-stimulation.