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1.
Stud Health Technol Inform ; 290: 1134-1135, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673242

RESUMO

Lymphoedema is a chronic disease affecting millions. Standard treatment is Complex Decongestive Therapy (CDT) which entails physical interaction with a therapist to imitate the drainage of the edematous fluid along with training to continue self-care at home. We present a case study of initiating CDT totally online. The result showed that, though totally online lymphoedema care is possible, hurdles do exist. It can be an option to exercise even after the COVID period.


Assuntos
COVID-19 , Linfedema , Drenagem , Exercício Físico , Humanos , Linfedema/terapia , Resultado do Tratamento
2.
Ned Tijdschr Geneeskd ; 1662022 03 24.
Artigo em Holandês | MEDLINE | ID: mdl-35499753

RESUMO

Chronic edema is caused by lymphatic impairment due to either overload of interstitial fluid or anatomic/functional lymphatic failure in any part of the body. Lymphatics play a crucial role in interstitial homeostasis, immune surveillance and fat absorption in the gut. Lymphedema is a clinical sign with swelling and not a diagnosis. In the latter stages inflammatory processes lead to fat formation and fibrosis. Untreated lymphedema has an increased risk for erysipelas, physical dysfunction and tends to worsen. Obesity and reduced physical activity are the main influenceable risk factors after oncological treatments in patients with impaired lymphatics. Prior to a multidisciplinary treatment program, a proper diagnosis with health profile is made. Treatment exists of two phases: an initial treatment phase and a maintenance phase in which the focus is on compression, self-management, exercise, minimizing risk factors and creating a healthy lifestyle. Clinimetrics are important for monitoring in both phases.


Assuntos
Vasos Linfáticos , Linfedema , Doença Crônica , Edema/complicações , Fibrose , Humanos , Linfedema/diagnóstico , Linfedema/etiologia , Linfedema/terapia
3.
PLoS Negl Trop Dis ; 16(5): e0010057, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35604949

RESUMO

BACKGROUND: Podoconiosis is a skin Neglected Tropical Disease (skin NTD) that causes lymphoedema, and affects barefooted subsistence farmers in some tropical countries. The clinical presentation and histopathologic correlates of podoconiosis have been understudied. Here, we systematically document the clinical and histopathologic spectrum of podoconiosis. METHODS: This is a cross-sectional study in Durbete, Ethiopia from February 2018 to October 2019. Dermatologists performed a patient history, physical examination, filariasis test strip, and skin biopsy for histopathologic examination. The results were summarised and a descriptive statistical analysis and Wilcoxon rank sum test with continuity correction was done. RESULTS: We recruited 289 patients for the study, 178 (61.6%) had stage 1 or 2 podoconiosis, and 111(38.4%) stage 3 to 5 podoconiosis. 188 (64.1%) had a family history of podoconiosis. In 251 (86.9%) patients, both legs were affected by podoconiosis and in 38 (13.1%) only one leg was affected. 220 (77.5%) patients had warty lesions, 114 (39.4%) had nodules. The median number of episodes of Acute Dermato-Lymphangio-Adenitis (ADLA) reported by the patients in the last three months was 2 (interquartile range (IQR) 1-4). Increased episodes of ADLA were significantly associated with stage 3-5 podoconiosis (P = 0.002), while burning pain in the feet was more common in stage 1 or 2 podoconiosis. Stage 3-5 disease was histopathologically characterised by epidermal and dermal thickening, verrucous acanthosis, inflammatory cell infiltrates (predominantly lymphoplasmacytic), dilated and ectatic and a reduced number of lymphatic vessels, eccrine ductal hyperplasia, and sclerosis such as thickened collagen bundles. CONCLUSION: We provide a detailed description of the different clinical patterns, associated clinical findings and the histopathologic spectrum of podoconiosis at different stages of the disease. Our observations should serve as a guide to classifying patients with podoconiosis for prognostic assessment and treatment decision.


Assuntos
Elefantíase , Linfedema , Doença Aguda , Estudos Transversais , Elefantíase/diagnóstico , Elefantíase/epidemiologia , Elefantíase/patologia , Etiópia/epidemiologia , Humanos , Perna (Membro) , Linfedema/terapia
4.
BMJ Open ; 12(4): e053165, 2022 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-35379618

RESUMO

INTRODUCTION: Breast cancer-related lymphoedema (BCRL) is a chronic swelling in the arm on the side of the breast cancer surgery, affecting one in five women. Recent studies in BCRL have demonstrated that resistance exercise can improve symptoms and quality of life without worsening lymphoedema. No studies have explored whether combining the principles of progressive resistance exercise training with therapeutic strategies of compression therapy and the decongestive lymphatic exercise sequence are beneficial in reducing arm lymphoedema volume. The aim of this three-arm, provincial randomised controlled trial is to determine the efficacy of a 12-week decongestive progressive resistance exercise (DRE) programme in combination with the one of two types of compression garments compared with standard care. METHODS AND ANALYSIS: Sixty women with BCRL will be recruited and randomly assigned to one of the following three groups: (1) Standard care, (2) DRE with use of a daytime compression garment during exercise and (3) DRE with use of an adjustable compression wrap during exercise. The primary outcome is the percentage reduction in arm lymphoedema volume. Secondary outcomes include bioimpedance analysis, muscular strength, shoulder range of motion, physical activity level and health-related quality of life. Exploratory outcomes include evaluating changes in arm tissue composition using MRI and examining outcomes between the two DRE experimental groups. The primary analysis will compare changes between the groups from baseline to week 12 reflecting the end of the randomised control trial period. ETHICS AND DISSEMINATION: The trial has received ethics approval from the Health Research Ethics Board of Alberta: Cancer Committee. The study results will be disseminated through scientific peer-reviewed publications, and presented at national and international conferences, and other media portals. The programme protocol will be shared with healthcare professionals and patient groups through clinical workshops and webinars. TRIAL REGISTRATION NUMBER: NCT05022823. PROTOCOL VERSION: 12 November 2021. ISSUE DATE: 26 April 2021.


Assuntos
Neoplasias da Mama , Linfedema , Treinamento de Força , Neoplasias da Mama/complicações , Neoplasias da Mama/cirurgia , Bandagens Compressivas , Exercício Físico , Feminino , Humanos , Linfedema/complicações , Linfedema/terapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
J Physiother ; 68(2): 110-122, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35428594

RESUMO

QUESTIONS: When added to decongestive lymphatic therapy (DLT), what is the effect of fluoroscopy-guided manual lymphatic drainage (MLD) versus traditional MLD or placebo MLD for the treatment of breast cancer-related lymphoedema (BCRL)? DESIGN: Multicentre, three-arm, randomised controlled trial with concealed allocation, intention-to-treat analysis and blinding of assessors and participants. PARTICIPANTS: At five hospitals in Belgium, 194 participants with unilateral chronic BCRL were recruited. INTERVENTION: All participants received standard DLT (education, skin care, compression therapy and exercises). Participants were randomised to also receive fluoroscopy-guided MLD (n = 65), traditional MLD (n = 64) or placebo MLD (n = 65). Participants received 14 sessions of physiotherapy during the 3-week intensive phase and 17 sessions during the 6-month maintenance phase. Participants performed self-management on the other days. OUTCOME MEASURES: All outcomes were measured: at baseline; after the intensive phase; after 1, 3 and 6 months of maintenance phase; and after 6 months of follow-up. The primary outcomes were reduction in excess volume of the arm/hand and accumulation of excess volume at the shoulder/trunk, with the end of the intensive phase as the primary endpoint. Secondary outcomes included daily functioning, quality of life, erysipelas and satisfaction. RESULTS: Excess lymphoedema volume decreased after 3 weeks of intensive treatment in each group: 5.3 percentage points of percent excessive volume (representing a relative reduction of 23.3%) in the fluoroscopy-guided MLD group, 5.2% (relative reduction 20.9%) in the traditional MLD group and 5.4% (relative reduction 24.8%) in the placebo MLD group. The effect of fluoroscopy-guided MLD was very similar to traditional MLD (between-group difference 0.0 percentage points, 95% CI -2.0 to 2.1) and placebo MLD (-0.2 percentage points, 95% CI -2.1 to 1.8). Fluid accumulated at the shoulder/trunk in all groups. The average accumulation with fluoroscopy-guided MLD was negligibly less than with traditional MLD (-3.6 percentage points, 95% CI -6.4 to -0.8) and placebo MLD (-2.4 percentage points, 95% CI -5.2 to 0.4). The secondary outcomes also showed no clinically important between-group differences. CONCLUSION: In patients with chronic BCRL, MLD did not provide clinically important additional benefit when added to other components of DLT. REGISTRATION: NCT02609724.


Assuntos
Neoplasias da Mama , Linfedema , Neoplasias da Mama/complicações , Feminino , Fluoroscopia , Humanos , Linfedema/etiologia , Linfedema/terapia , Drenagem Linfática Manual , Qualidade de Vida
6.
BMC Health Serv Res ; 22(1): 461, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35395942

RESUMO

BACKGROUND: Lymphoedema is a common, distressing and debilitating condition that can be related to cancer and its treatment or other conditions. Little is known about current practices in the diagnosis, assessment and management of lymphoedema in low- and middle-income countries (LMIC). AIM: To describe current practices in diagnosing, assessing and managing cancer-related and other forms of lymphoedema in LMIC, and related barriers and facilitators. METHODS: An exploratory-descriptive qualitative study. Participants were lymphoedema experts or health care professionals identified via published lymphoedema papers and professional organizations respectively. Sampling was purposive to ensure a diversity of perspectives and experience. Data collection was via semi-structured telephone/video interviews, and questions canvassed participants' experiences and perceptions of lymphoedema care in LMIC. Interviews were audio-recorded and transcribed verbatim. Analysis proceeded via inductive coding before mapping codes to the World Health Organization's (WHO) Innovative Care for Chronic Conditions Framework. RESULTS: Nineteen participants were interviewed, most of whom were physiotherapists (n = 11). Ten participants worked permanently in a LMIC, while the remainder were based in a high-income country (HIC) and had been involved in initiatives to improve lymphoedema care across multiple LMIC. Participants indicated that management of cancer versus non-cancer related lymphoedema was similar, but that pathways to care were more straight-forward for those receiving cancer care, leading to earlier diagnosis. Key facilitators to optimizing lymphoedema care in LMIC included: 1) joining forces to overcome lymphoedema-related stigma; 2) building workforce capabilities; and 3) partnering with patients and families to support self-management. Ideas for building workforce included developing health professional knowledge, supporting a commitment to multidisciplinary team care, and adapting HIC guidelines for lymphoedema care to LMIC. Partnering with patients and families to support self-management involved following the person-centred approach, establishing clear communication, promoting adherence to management, adapting management to available resources, and involving patient family and friends in lymphoedema care. CONCLUSION: Raising community and health professional awareness regarding lymphoedema and its management is a key first step to improving care outcomes. Resources for clinicians and patients/families developed for lymphoedema care in HIC need to be adapted for low resource settings.


Assuntos
Linfedema , Neoplasias , Países em Desenvolvimento , Humanos , Linfedema/diagnóstico , Linfedema/terapia , Neoplasias/complicações , Neoplasias/terapia , Pobreza , Pesquisa Qualitativa , Melhoria de Qualidade
7.
Br J Community Nurs ; 27(Sup4): S40-S42, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35373615

RESUMO

Massive localised lymphoedema (MLL) is an issue that affects patients with obesity. Much of the literature surrounding MLL focuses upon surgical management. This case study will explore the conservative management of a patient with MLL of the distal thighs. MLL of the legs negatively impacts patients' mobility, which, in turn, affects their ability to undertake physical activity. Encouraging exercise and activity forms part of conventional lymphoedema treatment, as well as compression garments (in this case, compression wraps), good skin care and weight management. The impact of the COVID-19 pandemic on this patient's lymphoedema treatment will also be considered. The treatment of not just MLL, but lymphoedema in general, requires commitment from patients, their carers and staff. This case study illustrates what can be achieved, despite a pandemic, when a patient, their carers and lymphoedema therapists fully commit to a treatment regimen that is manageable and well-supported. The patient's MLL has shrunk significantly, and her weight continues to reduce. Informed consent was gained from the patient concerned in this case study.


Assuntos
COVID-19 , Linfedema , Bandagens Compressivas , Tratamento Conservador , Feminino , Humanos , Linfedema/terapia , Pandemias
8.
Br J Community Nurs ; 27(Sup4): S20-S22, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35373618

RESUMO

Healthcare professionals need adequate preparatory education to treat children and young people with lymphoedema confidently and competently. This collaborative international project, based on existing literature and expert focus groups, seeks to identify the nature of that education need and in what format it could be addressed.


Assuntos
Pessoal de Saúde , Linfedema , Adolescente , Criança , Atenção à Saúde , Grupos Focais , Pessoal de Saúde/educação , Humanos , Linfedema/terapia , Inquéritos e Questionários
9.
Br J Community Nurs ; 27(Sup4): S24-S26, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35373619

RESUMO

There is some confusion surrounding the management of people with lymphoedema in the presence of deep vein thrombosis (DVT). This may be in relation to the suitability of commencing compression therapy or regarding the continuation of compression therapy in those who develop DVT. The purpose of this British Lymphology Society position paper is to support evidence-based practice and debunk the myths surrounding the management of DVT and lymphoedema.


Assuntos
Linfedema , Trombose Venosa , Humanos , Linfedema/terapia , Trombose Venosa/terapia
10.
Br J Community Nurs ; 27(Sup4): S13-S14, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35373620

RESUMO

Lower extremity lymphoedema is common after many cancers. Nevertheless, epidemiological estimates of the prevalence of lower extremity lymphoedema vary widely. A recent study, however, clarified the rates in women with colorectal, endometrial and ovarian malignancies: about one third self-reported lower extremity lymphoedema. The study also confirmed that lower extremity lymphoedema can markedly undermine physical functioning. Some patients, however, seem to be at especially high-risk of developing lower extremity lymphoedema, such as those who undergo extensive lymphadenectomy. Moreover, until recently, few clinical trials assessed treatment benefits from the patient's perspective. A recent study explored the goals and benefits that matter most to patients, which may help healthcare professionals individualise management.


Assuntos
Linfedema , Feminino , Humanos , Extremidade Inferior , Linfedema/epidemiologia , Linfedema/terapia , Prevalência
11.
J Vasc Surg Venous Lymphat Disord ; 10(4): 929-936, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35364303

RESUMO

OBJECTIVE: Lymphedema affects >1 in 1000 Americans, most often resulting from breast cancer surgery. Conservative treatment, such as compression garments, combined decongestive therapy (CDT), and pneumatic compression pumps, is the current standard of care. Despite the wide availability of these therapies, lymphedema has remained undertreated worldwide. We investigated whether third-party insurance coverage might be a barrier to obtaining conservative treatment in the United States. METHODS: We conducted a cross-sectional analysis of publicly accessible insurance policies. A total of 58 insurers were included in accordance with their state enrollment data and market share. The analysis was conducted using a web-based search and individual telephone interviews. For those policies that extended coverage, the medical necessity criteria were abstracted. RESULTS: A total of 50 insurance companies (86%) had a policy in place addressing conservative management. Included in 37 policies (64%), compression garments were covered the least often (n = 33; 89%). Although CDT was included in only 22 policies (38%), it was universally covered. Noncalibrated pneumatic compression pumps were the most frequently addressed intervention (n = 46; 79%), significantly more often than CDT (P < .01) and were universally covered, significantly more often than were compression garments (P < .04). Criteria for reimbursement were present for more than one half of the policies that provided coverage. CONCLUSIONS: A large proportion of U.S. insurers provided coverage for conservative treatment of lymphedema. However, only 38% of the policies included a statement of coverage for CDT. Most of the policies that did provide coverage for these four therapies also had multiple criteria that were required to be met before considering reimbursement. These requirements could create barriers to the receipt of treatment.


Assuntos
Tratamento Conservador , Linfedema , Tratamento Conservador/efeitos adversos , Estudos Transversais , Humanos , Cobertura do Seguro , Linfedema/diagnóstico , Linfedema/terapia , Mastectomia , Estados Unidos
12.
CMAJ Open ; 10(2): E338-E347, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35414596

RESUMO

BACKGROUND: One of the more frequent complications following treatment for breast cancer, lymphedema is a substantial swelling of the arm, breast and chest wall that occurs on the side where lymph nodes were removed. The aim of this work is to update recommendations on the prevention, diagnosis and management of lymphedema related to breast cancer. METHODS: We present the protocol for an update of the 2001 clinical practice guideline on lymphedema from the Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. We will use a patient-oriented research approach with a focus on self-management and the positive health model to inform the updated guideline development. The methods proposed will be undertaken with consideration of the standards outlined in the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. The literature will be appraised by evaluating existing guidelines from other countries, the evidence from systematic reviews and meta-analyses and direct evidence from clinical studies. We will manage competing interests according to Guidelines International Network principles. Recommendations will be presented using an actionable statement format and will be linked to the level of evidence along with any relevant considerations used in formulation. A draft of the guideline will be produced by the steering committee then sent out to international experts and stakeholder groups for feedback. INTERPRETATION: The primary benefit of this clinical guideline will be to improve the quality of care of women with breast cancer-related lymphedema. Findings will be disseminated at national and international conferences and through webinars and educational videos hosted on the websites of the supporting organizations.


Assuntos
Neoplasias da Mama , Linfedema , Gerenciamento da Prática Profissional , Neoplasias da Mama/complicações , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Canadá/epidemiologia , Feminino , Humanos , Linfedema/diagnóstico , Linfedema/etiologia , Linfedema/terapia , Guias de Prática Clínica como Assunto
13.
Phlebology ; 37(4): 252-266, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35258350

RESUMO

BACKGROUND: Lymphedema imposes a significant economic and social burden in modern societies. Controversies about its risk factors, diagnosis, and treatment permeate the literature. The goal of this study was to assess experts' opinions on the available literature on lymphedema while following the Delphi methodology. METHODS: In December of 2019, the American Venous Forum created a working group tasked to develop a consensus statement regarding current practices for the diagnosis and treatment of lymphedema. A panel of experts was identified by the working group. The working group then compiled a list of clinical questions, risk factors, diagnosis and evaluation, and treatment of lymphedema. Fifteen questions that met the criteria for consensus were included in the list. Using a modified Delphi methodology, six questions that received between 60% and 80% of the votes were included in the list for the second round of analysis. Consensus was reached whenever >70% agreement was achieved. RESULTS: The panel of experts reached consensus that cancer, infection, chronic venous disease, and surgery are risk factors for secondary lymphedema. Consensus was also reached that clinical examination is adequate for diagnosing lymphedema and that all patients with chronic venous insufficiency (C3-C6) should be treated as lymphedema patients. No consensus was reached regarding routine clinical practice use of radionuclide lymphoscintigraphy as a mandatory diagnostic tool. However, the panel came to consensus regarding the importance of quantifying edema in all patients (93.6% in favor). In terms of treatment, consensus was reached favoring the regular use of compression garments to reduce lymphedema progression (89.4% in favor, 10.6% against; mean score of 79), but the use of Velcro devices as the first line of compression therapy did not reach consensus (59.6% in favor vs 40.4% against; total score of 15). There was agreement that sequential pneumatic compression should be considered as adjuvant therapy in the maintenance phase of treatment (91.5% in favor vs. 8.5% against; mean score of 85), but less so in its initial phases (61.7% in favor vs. 38.3% against; mean score of 27). Most of the panel agreed that manual lymphatic drainage should be a mandatory treatment modality (70.2% in favor), but the panel was split in half regarding the proposal that reductive surgery should be considered for patients with failed conservative treatment. CONCLUSION: This consensus process demonstrated that lymphedema experts agree on the majority of the statements related to risk factors for lymphedema, and the diagnostic workup for lymphedema patients. Less agreement was demonstrated on statements related to treatment of lymphedema. This consensus suggests that variability in lymphedema care is high even among the experts. Developers of future practice guidelines for lymphedema should consider this information, especially in cases of low-level evidence that supports practice patterns with which the majority of experts disagree.


Assuntos
Cardiologia , Linfedema , Consenso , Técnica Delfos , Prova Pericial , Humanos , Linfedema/diagnóstico , Linfedema/terapia , Estados Unidos
14.
J Vasc Nurs ; 40(1): 59-65, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35287836

RESUMO

PURPOSE: Lymphedema is characterized by swelling and fibroadipose tissue deposition that is a physically, psychologically, and socially debilitating condition due to chronic and progressive nature of the disease. Treatment benefit evaluation from the patient's perspective is important for medical decision-making. The aim of this study is to investigate important treatment goals and benefits of treatment from the patients' perspective. METHOD: Eighty-one patients with lymphedema, lipoedema, or lipolymphoedema who are currenlty treated or who underwent previous treatment were included in the study. Socio-demographic data was recorded. Important goals and benefit from treatment were assessed with Patients Needs Questionnaire and Patient Benefit Questionnaire which are sub-questionnaires of Patient Benefit Index-Lymphedema. RESULTS: The most important expectation and needed item was "To find a clear diagnosis and therapy" (n:59, 72%). The least important item for the lymphedema patients was "To feel more attractive" (n:9, 11%). Most beneficial effect of treatment was "To have no fear that the disease will become worse" (n:37, 45.7%). "To have fewer out of pocket treatment expenses" was rated as the least beneficial effect of treatment (n:24, 29.6%). CONCLUSIONS: It is important to identify patients' needs and expectations. Patients should be referred for treatment according to their needs. The effectiveness of the treatment should be evaluated objectively. Patient education should be considered as a part of the effective treatment to teach patients how to control their lymphedema. A clear diagnosis and access to treatment should be ensured for lymphedema patients. Regulations for health insurance benefit coverage are needed to cover cost of compression garments.


Assuntos
Lipedema , Linfedema , Humanos , Lipedema/terapia , Linfedema/terapia , Inquéritos e Questionários , Resultado do Tratamento
15.
Wound Manag Prev ; 68(1): 8-15, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35263273

RESUMO

BACKGROUND: Chronic edema affects millions of people in the United States and worldwide. Edema can result from a variety of diseases, trauma, medications, and other contributing factors; however, all edema is related to lymphatic fluid dysregulation. Additionally, lymphatic impairment and integumentary dysfunction are interrelated, leading to complex clinical presentations that require an integrated medical model of care to maximize outcomes. PURPOSE: This narrative review article will highlight the current evidence that details lymphatic physiology, fluid regulation by the endothelial glycocalyx layer, and the interconnectedness of the vascular and integumentary systems leading to a paradigm shift in our understanding of edema, lymphedema, and chronic wounds. Traditional pedagogy remains siloed with respect to the body systems, whereas current evidence indicates a certain interdependence, particularly between and among the venous, lymphatic, and integumentary systems. METHODS: Comprehensive narrative review of the current and past literature (2010-2021 through PubMed, Google Scholar, MEDLINE Complete, UpToDate) focusing on lymphatic physiology, fluid regulation, the endothelial glycocalyx layer, lymphedema, and venous insufficiency. Review focuses on new evidence supporting the interconnectedness of the systems to support a unified medical management approach. RESULTS: All edema is related to lymphatic dysfunction, whether transient or permanent, thereby creating a lymphedema continuum. Further, lymphatic impairment creates cutaneous regions of skin barrier failure, rendering the skin more susceptible to breakdown and chronic wounds. CONCLUSION: A synthesis of the current evidence suggests an interconnected relationship of the lymphatic, venous, and integumentary systems, highlighting the need for a more integrated medical model of care to provide efficient and comprehensive care and improve patient outcomes.


Assuntos
Vasos Linfáticos , Linfedema , Edema/etiologia , Edema/terapia , Humanos , Linfa , Sistema Linfático/fisiologia , Linfedema/etiologia , Linfedema/terapia
16.
Curr Pediatr Rev ; 18(3): 179-181, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35232363

RESUMO

The Godoy Method of cervical lymphatic therapy is the first treatment option as monotherapy for children which facilitates achieving normalization or near normalization of the affected limb as well as the maintenance of the results, which could assist millions of children throughout the world.


Assuntos
Linfedema , Criança , Humanos , Linfedema/terapia
17.
Br J Community Nurs ; 27(3): 128-134, 2022 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-35274974

RESUMO

The completion of a scoping review within the area of compression therapy and heart failure offers an insight into the present literature in this area, alongside offering the ability to connect this existing knowledge to chronic oedema/lymphoedema when both conditions co-exist. The evidence obtained included national agreed guidelines, consensus documents and existing primary/secondary research. The review identified existing evidence that suggests that the application of compression therapy in those with heart failure may be appropriate, but is dependent upon staging and stability. However, this needs to be contextualised against other co-morbidities, such as lymphoedema, which may impact upon the exact compression therapy and level applied. Further research within the area of heart failure in combination with chronic oedema/lymphoedema would expand the existing evidence base. This is set against a need for further consensus guidance to bridge the gap that exists within the literature.


Assuntos
Insuficiência Cardíaca , Linfedema , Doença Crônica , Consenso , Edema/terapia , Insuficiência Cardíaca/terapia , Humanos , Linfedema/terapia
18.
J Wound Care ; 31(3): 218-223, 2022 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-35199599

RESUMO

OBJECTIVE: The aim of this case series was to retrospectively assess the impact on volume control and patients' quality of life (QOL) when a night-time garment was added to their previous compression regimen for a full 24-hour interval compression plan. METHOD: Patients who had a history of chronic oedema presented to one of two oedema management centres in the US for treatment for oedema exacerbation and/or suboptimal performance of their current garments. Objective data examined were circumferential limb volume (cm3) measurements and QOL measured with the Lymphoedema QOL Tool (LYMQOL-Leg and LYMQOL-Arm). Subjective comments on functional abilities and perception of improvement with a compression plan that comprised a 24-hour interval were documented. RESULTS: All three patients presented in this case series had a reduction in limb volume and improvement in QOL when their daytime regimen of garments was updated and new night-time garments were added. Their subjective comments indicated improvement in activities of daily living and ease of controlling daytime oedema with a 24-hour interval compression plan. CONCLUSION: This case series illustrates the need for clinicians to create a partnership with the patient to promote concordance and adherence as part of their individual 24-hour interval compression plan. This partnership allows the plan to be uniquely changed and adjusted to allow each patient to feel in control of refreshing their mood, their skin and their garments.


Assuntos
Linfedema , Qualidade de Vida , Atividades Cotidianas , Bandagens Compressivas , Edema/terapia , Humanos , Estilo de Vida , Linfedema/terapia , Estudos Retrospectivos
19.
Biomark Med ; 16(4): 303-316, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35176878

RESUMO

Lymphedema is defined as a dysfunction of the lymphatic system producing an accumulation of lymphatic fluid in the surrounding tissue, as well as edema and fibrosis. A total of 250 million people worldwide are affected by this condition. Greater than 99% of these cases are related to a secondary cause. As there is a lack of curative therapy, the goal involves early diagnosis, in order to prevent the progression of the disease. Additionally, early diagnosis can aid in decreasing the demand for more complex surgical procedures. Currently, there is an impressive breadth of diagnostic tests available for these patients. We aimed to review the available literature in relation to the utilization of imaging biomarkers for the early diagnosis and treatment response in lymphedema.


Assuntos
Linfedema , Linfocintigrafia , Biomarcadores , Humanos , Linfedema/diagnóstico por imagem , Linfedema/terapia , Linfocintigrafia/efeitos adversos , Linfocintigrafia/métodos
20.
Phlebology ; 37(3): 200-205, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35220827

RESUMO

OBJECTIVES: This study aims to investigate the impact of change in limb volume on the levels of functional mobility, health-related quality of life, social appearance anxiety, and depression before and after complex decongestive physiotherapy in patients with lower extremity lymphedema. METHOD: Twenty-seven patients with unilateral lower extremity lymphedema were included. The treatment period was 20 sessions. The outcome measures were the limb volume, the Timed Up and Go test, the Short Form-36, the Social Appearance Anxiety Scale, and the Beck Depression Inventory. RESULTS: A statistically significant decrease in the limb volume (p < 0.001) and statistically significant improvements in the Timed Up and Go test performance (p < 0.001), the Short Form-36 Physical Component Summary score (p < 0.01), the Social Appearance Anxiety Scale score (p < 0.001), and the Beck Depression Inventory score (p < 0.001) were found. No statistically significant difference was found on the Short Form-36 Mental Component Summary score (p > 0.05). CONCLUSION: The decrease in the limb volume improves the functional mobility, physical health-related quality of life, social appearance anxiety, and depression in patients with lower extremity lymphedema, but not the mental health-related quality of life.


Assuntos
Linfedema , Qualidade de Vida , Ansiedade/terapia , Depressão/terapia , Humanos , Extremidade Inferior , Linfedema/terapia , Equilíbrio Postural , Estudos de Tempo e Movimento , Resultado do Tratamento
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