The effectiveness of extracorporeal shock wave therapy on breast cancer-related lymphedema: A literature review.

Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast cancer-related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast cancer-related lymphedema.

Usefulness of abdominal ultrasonography with studies of the intestinal loops in Turner syndrome patients.

Turner syndrome, a chromosomal disorder caused by partial or complete absence of one of the two X chromosomes, is characterized by an increased incidence (compared with that in the normal population) of either autoimmune disorders, including chronic inflammatory bowel diseases, or angiodysplasia of the small intestine. Because ultrasonography and color Doppler ultrasound are widely used to investigate gastrointestinal disorders, we decided to carry out an ultrasound-based screening study in patients with Turner syndrome to determine whether this method might be useful in the follow-up of this population.