RESUMO
Postmastectomy syndrome (PMS) is a complex neurovascular set of symptoms that develops in most patients after breast cancer (BC) treatment and significantly reduces the quality of life. One of the potential mechanisms of its occurrence is considered to be an endothelial dysfunction. The possible method of reducing manifestation of endothelial dysfunction is systematic aerobic dynamic training. OBJECTIVE: To evaluate the influence of 12-week aerobic dynamic training program of moderate intensity on the endothelial dysfunction laboratory markers and life quality in patients with PMS. MATERIAL AND METHODS: Single-center prospective randomized trial included 40 patients with PMS divided into study (20 patients) and comparative (20 patients) groups, as well as 20 healthy female volunteers. The expression level of soluble intercellular adhesion molecule-1 (ICAM-1) and platelet endothelial cell adhesion molecule-1 (PECAM-1) were evaluated in all participants at baseline by enzyme-linked immunosorbent assay method, and additionally psychological and physical component of health by SF-36 questionnaire were assessed in patients with PMS.Patients of study group received a course of 12-week partially controlled aerobic dynamic training of moderate intensity lasting 45 minutes with frequency equal 5 times per week. Patients with PMS were re-evaluated for ICAM-1 and PECAM-1, as well as for life quality. RESULTS: The group of patients with PMS after BC treatment had increased level of ICAM-1 in long-term period, that may indicate endothelial dysfunction. Statistically significant decrease of endothelial dysfunction laboratory markers was revealed in patients with PMS, who underwent the course of cardiorespiratory training. In the same time, the dynamics of changes in ICAM-1 was higher in the study group than in comparative group. Further, improvement of physical and psychological components of health by SF-36 questionnaire was found. CONCLUSIONS: The program of cardiorespiratory trainings of moderate intensity in patients, who had BC treatment a year ago, decreases intercellular adhesion molecules level that may show an improvement of endothelial dysfunction.
Assuntos
Molécula 1 de Adesão Intercelular , Mastectomia , Humanos , Feminino , Molécula 1 de Adesão Intercelular/sangue , Pessoa de Meia-Idade , Adulto , Molécula-1 de Adesão Celular Endotelial a Plaquetas/sangue , Qualidade de Vida , Estudos Prospectivos , Terapia por Exercício/métodos , Neoplasias da Mama/cirurgia , Neoplasias da Mama/reabilitaçãoRESUMO
The article deals with immediate and medium-term results of hybrid and endovascular treatment of 74 patients with various pathologies of the thoracic and thoracoabdominal aorta (31 with aneurysms, 43 with thoracic and thoracoabdominal aortic dissections). Elective and emergency interventions were performed in 49 and 25 patients, respectively. Endoprosthetic repair of the arch, descending thoracic and thoracoabdominal aorta was performed in 25 patients, hybrid operations in 47 subjects (open switch of brachiocephalic, visceral and renal arteries followed by aortic endoprosthetic repair - 37, endovascular methods of making a landing zone - 12). The duration of the follow-up period after discharge from hospital amounted to 24.9±16.3 months. The technical success level was 98.6%. The overall hospital mortality rate was 11% (n=8), elective - 4% (n=2), emergency - 24% (n=6). Eight patients underwent repeat interventions on the thoracic and thoracoabdominal aorta. The 5-year cumulative survival rate was 82.3%, with freedom from repeat interventions amounting to 51.3%. Hybrid operations on the arch and descending thoracic aorta are considered to be a relatively safe and effective method of treatment. Follow-up and timely treatment of remote complications after hybrid or endovascular operations are obligatory for improving the results.
Assuntos
Aneurisma da Aorta Torácica , Implante de Prótese Vascular , Procedimentos Endovasculares , Aorta Torácica/cirurgia , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Dissecação , Procedimentos Endovasculares/efeitos adversos , Humanos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Presented herein is a brief review of the materials of the Saint Petersburg Lymphology Forum, describing the main results of scientific studies in biology of lymphatic cells, genetic studies in lymphology, modern methods of diagnosis and treatment of lower-limb lymphedema, post-mastectomy syndrome. This is followed by discussion of the prospects of the development of new technologies in diagnosis and treatment of lymphedema.
Assuntos
Doenças Linfáticas/terapia , Sociedades Médicas , Congressos como Assunto , Humanos , Federação RussaRESUMO
Investigations of the lymphatic bed of lower extremities by the method of rentgen-contrast lymphography were performed in 64 patients with trophic ulcers of lower extremities and postthrombotic disease. The data obtained by lymphography allowed formation of a group of patients perspective for treatment by lymphotropic antibacterial therapy. The lymphotropic therapy using Gentamycin and Cefazolin resulted in a more rapid arresting of local inflammatory alterations and development of reparative processes in the trophic ulcer area and in normalization of the main clinico-laboratory parameters.