effect of combined decongestive therapy and pneumatic compression pump on lymphedema indicators in patients with breast cancer related lymphedema

Lymphedema treatment is difficult and there is no consensus on the best treatment. This study evaluated the effect of combined decongestive therapy [CDT] and pneumatic compression pump on lymphedema indicators in patients with breast cancer related lymphedema [BCRL]. Twenty one women with BCRL were enrolled. The volume difference of upper limbs, the circumference at 9 areas and shoulder joint range of motion were measured in all patients. CDT was done by an educated nurse in two phases. In first phase, CDT was accompanied by use of a compression pump for 4 weeks, 3 days per week. In second phase, CDT was performed daily without compression pump for 4 weeks by patients at home. At the end of each phase, the same primary measurements were done for patients. The mean volume difference of the upper limbs and mean difference in circumference in all areas at different phases decreased significantly. Mean flexion, extension, abduction and external rotation [in degrees] at different phases increased significantly. CDT significantly reduced mean volume and mean circumference of the affected limb, and significantly increased shoulder joint range of motion. The findings support the optimal effects of CDT in the treatment of secondary lymphedema of upper extremity

[Glutamate transporters and excitotoxicity in nervous system]

L-glutamate is the major excitatory neurotransmitter in the central nervous system [CNS]. It contribute in various physiological conditions such as brain development, synaptic plasticity, memory and learning. However, increasing of the extracellular glutamate concentration and overactivation of glutamate receptors in particular ionotropic subtypes leads to excitotoxicity which is the fundamental pathological pathway of neuronal injury. Due to lack of extracellular enzymatic destruction, the removal of released glutamate is achieved through the excitatory amino acid transporters [EAATs] which are distributed in glia that tightly surround the synaptic clefts, as well as in neurons. EAATs which known as Na+-dependent high-affinity glutamate transporters are the main responsible for maintaining extracellular glutamate concentration below excitotoxic levels. Moreover another membrane transporters regulating the flux of glutamate in different areas of the CNS. This system is cystine-glutamate exchanger [XCG-] that is Na+-independent system. Dysfunction of EAATs has been implicated in both acute insults e.g. stroke, trauma and chronic neurological and neuropsychiatric disorders e.g. amyotrophic lateral sclerosis, epilepsy, schizophrenia and Alzheimer's disease. Therefore, the purpose of this review article is to explain the pathway of glutamate biosynthesis, its release into CNS, discribing and elaborating Glutamate transporters, activites and their role in excitoxcity in CNS

Differential sensitivity of male and female neuronal cells may play a role in onset of neuronal diseases

Due to the worldwide increase in the number of older people in both developed and developing countries, there is a public health concern for dealing with age related diseases such as neurodegenerative diseases. There is little known about the difference in neuronal cell responses between genders. Our understanding of the neuronal cell response regarding genders, will be useful for developing more efficient therapies for these diseases such as Alzheimer's disease. To investigate gender differences in neuronal cell response against cell death inducers, we examined the percentage of cell death in male and female mouse primary cortical neuronal cultures. Our findings indicate that there is a difference in cellular response to ethanol [a cell death inducer] that may be the basis of how they behave in vivo of what may be seen in adults, as they age. These observation support this idea that genetic factors, most likely governed by X or Y chromosomes

[Evaluation of serum aluminum level before and after [DFO] test in patients of hemodialysis unit of Zahedan]

Background: aluminum accumulation in plasma and tissues is a well-described complication among persons undergoing peritoneal dialysis or hemodialysis. Excess bone aluminum is associated with low bone formation rates and increased risk for fractures. Current recommendations for care of patients with end-stage renal disease include screening for aluminum toxicity with plasma aluminum levels; patients with levels below20 micro g/L are considered to be at low risk for aluminum related bone disease [ARBD]. By attention to some clinical symptoms that maybe related to AL toxicity, we measured serum AL level before and after DFO test

Methods and materials: in this descriptive study the incidence of AL toxicity in patients on hemodialysis in Khatam-Al-Anbia hospital of Zahedan-Iran was measured. In 35 patients on hemodialysis, serum level of AL before and after DFO test was measured. We also measured serum level of Ca, P, ALP, PTH and Ferritin in these groups of patients. To evaluate AL level in water used for hemodialysis it was measured at the same time

Results: in our study serum AL levels in most of patients were high [32 out of 35]. It may be due to high level of AL in dialysate. Dialysate AL level before and after RO [Reverse Osmosis] were 16 microgram/Lit and 19.8 microgram/Lit respectively. In only 3 out of 35 patient's serum AL levels of baseline were less than 20 microgram/Lit and DFO test in one of them was positive. Serums AL level of 16 patients were between 20 to 40 microgram I Lit and in 16 patients were more than 40 microgram/Lit

Conclusions: in conclusion treatment with improperly processed water was the major causes of aluminum toxicity in uremic patients