Lymphedema Surveillance and Prevention.

ABSTRACT: Lymphedema is a chronic condition, which can impact a person's quality of life and function. Identifying lymphedema at an early stage is key to preventing a person from developing chronic lymphedema. Physiatry can play an important role in education, identification of risk factors, performing prospective lymphedema surveillance programs, and prevention/treatment of lymphedema. Incorporating lymphedema surveillance programs into routine cancer care provides physiatry with the opportunity to assess additional rehabilitation and functional needs of a cancer patient.

Translating 2019 ACSM Cancer Exercise Recommendations for a Physiatric Practice: Derived Recommendations from an International Expert Panel.

In 2018, the American College of Sports Medicine (ACSM) reconvened an international, multi-disciplinary group of professionals to review pertinent published literature on exercise for people with cancer. The 2018 roundtable resulted in the publication of three articles in 2019. The three articles serve as an important update to the original ACSM Roundtable on Cancer, which convened in 2010. Although the focus of the three 2019 articles is on exercise, which is only one part of comprehensive cancer rehabilitation, the evidence presented in the 2019 ACSM articles has direct implications for physiatrists and other rehabilitation professionals who care for people with cancer. As such, the narrative review presented here has two primary objectives. First, we summarize the evidence within the three ACSM articles and interpret it within a familiar rehabilitation framework, namely the Dietz model of Cancer Rehabilitation, in order to facilitate implementation broadly within rehabilitation practice. Second, via expert consensus, we have tabulated relevant exercise recommendations for specific cancer populations at different points in the cancer care continuum and translated them into text, tables, and figures for ease of reference. Notably, the authors of this article are members of the Cancer Rehabilitation Physician Consortium (CRPC), a group of physicians who subspecialize in cancer rehabilitation medicine (CRM).

Gas Composition of Developing Pneumatocysts in Bull Kelp Nereocystis luetkeana (Phaeophyceae)1.

The subtidal kelp Nereocystis luetkeana (hereafter Nereocystis) maintains an upright stature by producing a single gas-filled float (pneumatocyst) that provides buoyancy. The ability of Nereocystis pneumatocysts to inflate with gas underwater is peculiar, and the gas composition of pneumatocysts has been the topic of several studies over the last 100 years. Past studies of pneumatocyst gases only examined large sporophytes, leaving open questions about the origins of these gases and how gas composition may change during development. In this study, we use developmental time as a means to understand the origin and physiological mechanisms that give rise to different gases within Nereocystis pneumatocysts. Total gas composition was measured across a range of pneumatocyst sizes (5-725 mL). Contrary to previous studies that documented pneumatocyst gas concentrations to be similar to air, this study found internal gas levels of CO, CO2 , and O2 to be 1.2 ± 0.8%, 0.6 ± 0.2%, and 59.9 ± 13.6%, respectively. Our data suggest that the composition of gases does not change as pneumatocysts grow and that the rate of each gas added is approximately proportional to changes in pneumatocyst volume. Therefore, cells constituting the pneumatocyst wall are likely producing more gas (per surface area) to fill pneumatocysts as they expand, maintaining proportional gas composition and corresponding internal pressure.

The Role of Physiatry Practice in a Multidisciplinary Breast Tumor Board: A Descriptive Study.

BACKGROUND: Cancer rehabilitation medicine is a growing field in physiatry, but more studies are needed to demonstrate how physiatry can contribute to patient care within the cancer care continuum. OBJECTIVE: To quantify and describe physiatric participation during a multidisciplinary tumor board for breast cancer patients. DESIGN: A prospective descriptive study. SETTING: A multidisciplinary breast tumor board at a large academic medical center. PARTICIPANTS: Five hundred thirty-seven breast cancer cases presented at a multidisciplinary breast tumor board. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The number of times physiatry actively participated in a multidisciplinary breast tumor board in the categories of referral to physiatry, referral to rehabilitation services, referral to other services, advice given on patients/symptom management, and discussion of available services. RESULTS: Out of 537 breast cancer cases presented, 221 cases (41.2%) resulted in a physiatry recommendation for referral to either physiatry, rehabilitation services, other services, or advice on patient and symptom management. CONCLUSION: Physiatry can actively participate in the care of cancer patients during a multidisciplinary breast cancer tumor board.