ABSTRACT
Introduction: Upper limbs lymphedema is one of the rather common and debilitating sequels of breast cancer treatment. The incidence of this sequel has been reported in different sources to be from 25% to 38%. The purpose of this study was to evaluate the incidence and the risk factors of lymphedema following invasive breast carcinoma treatment
Materials and Methods: Recorded data of breast cancer patients referred to Mashhad Omid Hospital between 1997 and 2005 were evaluated for the incidence and risk factors of lymphedema. Univariate and multivariate analysis were performed to evaluate the risk factors using a logistic regression model
Results: Out of 312 patients entering the study 101 patients [32.4%, 95% CI: 27.2-37.6] developed lymphedema. Univariate analysis did not show a statistically significant difference between the rates of lymphedema in radical mastectomy when compared to other types of surgery such as lumpectomy with axillary dissection. Obesity according to body mass index significantly affected the development of lymphedema [p=0.03]. The average number of metastatic nodes was 4.56 +/- 4.05 in patients who had and 2.48 +/- 3.19 in patients who did not have lymphedema [p<0.01]. The average percentage of metastatic to excised nodes was%54.59 +/- 37.48 in patients who had and%34.67 +/- 34.84 in patients who did not have lymphedema [p<0.01]. Age, the number of excised nodes, the stage of disease, hormonal therapy, adjuvant radiation therapy and chemotherapy had no correlations with lymphedema
Conclusion: According to our findings, body mass index, the number of metastatic nodes and the percentage of metastatic to excised nodes were correlated with the development of lymphedema
ABSTRACT
In Iran dipyridamole is the main agent used for coronary dilatation before myocardial perfusion SPECT. This study tries to evaluate the side effects after dipyridamole infusion and its relation with hemodynamic changes. We studied 300 patients who referred to myocardial perfusion scan. The exclusion criteria were: 1] AV block degree 2 or more, 2] Asthma 3] Sick sinus syndrome 4] LV EF<25%. Dipyridamole infusion was done with a dose of 0.568 mg/kg of body weight for 4 minutes and blood pressure and pulse rate were measured before infusion of dipyridamole and 2 minutes after termination of infusion. Patients were asked for any side effects and any complaints were recorded. Relationship between these side effects and age and sex of patients as well as hemodynamic changes were studied. 148 female and 152 male patients studied with a mean age of 55.9 years [11.1]. After dipyridamole infusion 79.3% of patients had at least one symptom, with headache [50%] and sweating [3%], the most and the least prevalent symptoms respectively. Mean heart rate increment was 8.8 and 9.2 beat per minute in female and male respectively [P=0.59]. Mean systolic blood pressure decrement was 8.5 [8.6] and 9.6 [7.1] mmHg in male and female respectively [P=0.21]. Diastolic pressure decrement was 4.6 [6.7] and 6.8 [6.3] mmHg in male and female respectively [P=0.003]. Headache and flashing were more frequent in female patients [P=0.004]. Other symptoms like dizziness, dyspnea, chest discomfort and abdominal discomfort were not different between female and male patients [P>0.08]. After dipyridamole infusion, nonspecific side effects are frequent. Headache and flashing is more frequent in female patients. Flashing is related to decrement in diastolic blood pressure