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1.
Rev. Col. Bras. Cir ; 49: e20222981, 2022. tab, graf
Article in English | LILACS | ID: biblio-1365388

ABSTRACT

ABSTRACT Introduction: secondary forms of lymphedema may occur as consequence of tumors, surgeries, radiotherapy, trauma and infections. Degloving injuries are severe and infrequent forms of trauma, with avulsion at the level of muscular fascia, and consequent injury of the lymphatic system. Objective: to evaluate the alterations in lymphatic circulation in patients being victims of circumferential degloving injuries in the lower limbs, using lymphoscintigraphic. Patients and Methods: retrospective analysis of the cases treated in the period from 2010 to 2016. Segmental, circumferential and unilateral injuries with involvement of the lower limbs were included. Lymphoscintigraphy was performed after a minimum interval of 12 months after the end of treatment. The non-injured lower limb was used as control. The Kleinhans Semiquantitative Index (KSI) was used for the semiquantitative evaluation of the lymphoscintigraphic findings. Results: eighteen patients were evaluated, six of whom were female and 12 were male. The mean age was 28.11 years. The average vertical extension of the circumferential traumatized segment was 29.33cm. The injured area presented variations of 5 to 15% of the body surface, with an average of 8.95%. Lymphoscintigraphy was performed after an average interval of 22.55 months. Alterations were observed on the traumatized limb (TL) in 13 patients. All control limbs (CL) were normal. The mean KSI observed in TL was 8.32, while in CL, the average value was 0.58 (p<0.001). Conclusion: patients with circumferential degloving injuries in the lower limbs present compromised lymphatic circulation and high probability to develop lymphedema.


RESUMO Introdução: as formas secundárias de linfedema podem ocorrer em consequência de tumores, cirurgias, radioterapia, traumas e infecções. Os desenluvamentos são formas graves e infrequentes de trauma, sendo observada avulsão no plano da fáscia muscular, com consequente lesão do sistema linfático. Objetivo: avaliar as alterações na circulação linfática nos pacientes vítimas de desenluvamentos circunferenciais nos membros inferiores, a partir da análise linfocintilográfica. Pacientes e Métodos: análise retrospectiva dos casos atendidos no período de 2010 a 2016. Foram incluídos os casos com acometimento segmentar, circunferencial e unilateral em membros inferiores. A linfocintilografia foi realizada após um intervalo mínimo de 12 meses do término do tratamento. O membro inferior não traumatizado foi utilizado como controle. Para a avaliação semiquantitativa dos achados linfocintilográficos, utilizou-se o Índice de Kleinhans (ISQTK). Resultados: foram avaliados 18 pacientes, sendo seis do gênero feminino e 12 do masculino. A média de idade foi de 28,11 anos. A extensão vertical do segmento traumatizado circunferencial foi em média de 29,33cm. O segmento traumatizado apresentou variações de 5 a 15% da superfície corporal, com média de 8,95%. A linfocintilografia foi realizada após intervalo médio de 22,55 meses. Foram observadas alterações no exame linfocintilográfico do membro traumatizado (MT) em 13 pacientes. Todos os exames dos membros controle (MC) foram normais. O ISQTK médio observado no MT foi 8,32 (0,3-20,75). No MC o valor médio foi de 0,58 (0,15-0,75). Conclusão: os pacientes com desenluvamentos circunferenciais nos membros inferiores apresentam circulação linfática comprometida e alta probabilidade para o desenvolvimento de linfedema.


Subject(s)
Humans , Male , Female , Adult , Degloving Injuries , Lymphedema , Retrospective Studies , Lower Extremity/diagnostic imaging , Lymphoscintigraphy
2.
Rev. cuba. angiol. cir. vasc ; 22(2): e222, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289363

ABSTRACT

Introducción: El linfedema es una enfermedad crónica con un impacto negativo sobre la salud de las personas que lo padecen. Este se considera un problema de salud subestimado y subregistrado, por lo que requiere de mayores esfuerzos investigativos y sanitarios. Objetivo: Identificar las características de algunos parámetros de la inmunidad humoral y celular en pacientes con linfedema del municipio El Cerro. Métodos: Se realizó un estudio descriptivo en 48 pacientes residentes en el municipio Cerro, atendidos en consulta externa del Instituto Nacional de Angiología y Cirugía Vascular en el período 2011-2015. El grupo se dividió en 24 pacientes con linfedema y 24 sin la enfermedad. A todos se les cuantificaron las concentraciones de las inmunoglobulinas (A, G y M) y de la proteína C reactiva. También se les hizo la prueba de hipersensibilidad retardada. Se utilizó chi cuadrado no paramétrico para asociar el estado inmunológico con la presencia de linfedema, la etiología y los estadios de este. Se trabajó con una confiabilidad del 95 por ciento (p < 0,05). Resultados: Predominaron los pacientes del sexo femenino (58,3 por ciento) y los de 60 años y más (29,2 por ciento). Hubo mayor frecuencia de linfangitis recurrentes (70,8 por ciento), con predominio del linfedema secundario en estadio IIb (45,8 por ciento); de afectación del miembro inferior derecho (45,8 por ciento), con una diferencia significativa de las inmunoglobulinas (IgA e IgG); y de frecuencia de pacientes anérgicos (91,7 por ciento), con proteína C reactiva positiva (45,8 por ciento). Conclusiones: Los pacientes con linfedema tienen afectados su sistema inmune, con mayor frecuencia de anérgicos, diminución de las inmunoglobulinas IgA e IgG, y positividad de proteína C reactiva(AU)


Introduction: Lymphedema is a chronic disease with a negative impact on the health of patients with lymphedema. It is considered an underestimated and sub-recorded health problem, which requires greater research and health efforts. Objective: Identify the characteristics of some parameters of humoral and cellular immunity in patients with lymphedema from Cerro municipality. Methods: A descriptive study was carried out in 48 patients living in Cerro municipality, who were attended in the external consultation of the National Institute of Angiology and Vascular Surgery in the period 2011-2015. The group was divided into 24 patients with lymphedema and 24 patients without the disease. The concentrations of immunoglobulins (A, G and M) and C-reactive protein were quantified in all of them. The test of delayed hypersensitivity was also perfomed. Non-parametric chi-square was used to associate immune state with the presence of lymphedema, etiology and lymphedema stages. Reliability was of 95 percent (p<0.05). Results: Female patients predominated (58.3 percent) and those of 60 years and older (29.2 percent). There was a higher frequency of recurrent lymphangitis (70.8 percent), predominantly stage II b secondary lymphedema (45.8 percent); lower right limb involvement (45.8 percent), with a significant difference of immunoglobulins (IgA and IgG); and frequency of anergic patients (91.7 percent), with positive C-reactive protein (45.8 percent). Conclusions: Patients with lymphedema have their immune system affected, more frequently the anergic ones, a decrease of IgA and IgG immunoglobulins, and positivity of C-reactive protein(AU)


Subject(s)
Humans , Female , Middle Aged , Immunoglobulin A/adverse effects , Hypersensitivity, Delayed , Immune System , Lymphedema/etiology , Epidemiology, Descriptive
3.
Rev. Pesqui. Fisioter ; 11(2): 368-374, Maio 2021. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1253529

ABSTRACT

INTRODUÇÃO: O câncer de mama é a neoplasia mais incidente na população feminina brasileira, sendo o linfedema uma de suas principais complicações cirúrgicas. OBJETIVO: Verificar a relação do índice de massa corpóreo e o desenvolvimento do linfedema no pós-operatório de câncer de mama, sua relação com o tipo de tratamento e ao tempo pós-cirúrgico. MATERIAIS E MÉTODOS: Foram levantados prontuários de 59 mulheres no período de maio de 2008 a fevereiro de 2009 utilizando dados da anamnese; exame físico; perimetria, volume estimado; relatos, sintomas e dados em prontuário. A análise foi feita por meio de médias e desvios padrões para as variáveis quantitativas e qualitativas (absoluta e relativa) e para verificação dos fatores de risco foi utilizado o Teste t de Student e Teste Qui-quadrado de Pearson com nível de significância de 5%. RESULTADOS: A frequência de linfedema foi de 47,5%, sendo que 40,7% eram obesas. Observou-se diferença significativa entre os grupos de linfedema e IMC (p=0,002). Nota-se ainda diferença significativa entre linfedema no grupo sem radioterapia de axila (p=0,003) e associação entre o tempo pós-cirúrgico e linfedema (p=0,006), sendo maior após 6 meses de cirurgia. CONCLUSÃO: Existe correlação entre obesidade e desenvolvimento do linfedema. Os tipos de tratamento parecem não ter influenciado o seu desenvolvimento e quanto mais tempo decorrido pós- cirurgia, maior o risco do seu aparecimento.


INTRODUCTION: Breast cancer is the most common neoplasm in the Brazilian female population, with lymphedema being one of its main surgical complications. OBJECTIVE: To verify the relationship between the body mass index and the development of lymphedema in the postoperative period of breast cancer, its relationship with the type of treatment received and the time elapsed from the surgery. MATERIALS AND METHODS: Medical records of 59 women were collected from May 2008 to February 2009 using data from anamnesis, physical exam; perimetry, estimated volume; reports, symptoms, and notes in medical records. The analysis was performed using means and standard deviations for the quantitative and qualitative variables (absolute and relative) and to verify the risk factors used, the Student's t-test and Pearson's chi-square test with a 5% significance level (0.05). RESULTS: The frequency of lymphedema was 47.5%, with 40.7% being obese. There was a significant difference between the groups of lymphedema and BMI (p=0.002). There is also a significant difference between lymphedema in the group without axillary radiotherapy (p=0.003) and an association between post-surgical time and lymphedema (p=0.006), being greater after six months of surgery. CONCLUSION: There is a correlation between obesity and the development of lymphedema. The types of treatment do not seem to have influenced their development, and the longer the surgery has elapsed, the greater the risk of their appearance.


Subject(s)
Breast Neoplasms , Lymphedema , Obesity
4.
Fisioter. Bras ; 22(2): 272-289, Maio 25, 2021.
Article in Portuguese | LILACS | ID: biblio-1284188

ABSTRACT

Introdução: O linfedema é a complicação mais frequente no pós-operatório do câncer de mama. Objetivo: Identificar a efetividade do uso da Terapia Complexa Descongestiva (TCD) na redução do volume e no tratamento intensivo do linfedema em pacientes submetidas ao procedimento cirúrgico com esvaziamento axilar devido ao câncer de mama. Métodos: Trata-se de uma revisão sistemática, para o qual foram consultados os bancos de dados Bireme e Pubmed, utilizando artigos científicos em português e inglês de revistas indexadas nas bases de dados Medline, Scielo, Lilacs, Register of Controlled Trials (Cochrane Central) e Physiotherapy Evidence Database (PEDro), publicados entre os anos de 2004 e 2019. Para a construção do trabalho foram incluídos estudos que estivessem disponíveis na íntegra, que a população alvo fosse composta por mulheres submetidas ao procedimento cirúrgico devido ao câncer de mama, com esvaziamento axilar, que apresentassem linfedema e que incluíssem em seus tratamentos, um protocolo fisioterapêutico de TCD. Também de forma independente, foi avaliada a qualidade metodológica dos estudos selecionados com a Escala de Qualidade de JADAD. Resultados: Atualmente, o padrão-ouro dentre as principais técnicas fisioterapêuticas utilizadas para o tratamento do linfedema é a TCD, a qual é composta por drenagem linfática manual, cuidados com a pele e unhas, bandagem de compressão e exercícios terapêuticos. Conclusão: A TCD é considerada o método mais utilizado e eficiente na redução do volume e no tratamento intensivo do linfedema pósmastectomia. (AU)


Introduction: The lymphedema is the most common postoperative complication of breast cancer. Objective: The present study aims to identify the effectiveness of the use of Complex Decongestive Therapy (CDT) in reducing volume and intensive treatment of lymphedema in patients undergoing axillary emptying due to breast cancer. Methods: This was a systematic review, for which Bireme and Pubmed databases were consulted, using scientific articles in Portuguese and English from journals indexed in Medline, Scielo, Lilacs, Register of Controlled Trials (Cochrane Central) databases and Physiotherapy Evidence Database (PEDro), all of them published between the years 2004 to 2019. For the construction of this study, we included articles available in full, with a target population consisting of women undergoing the surgical procedure due to breast cancer, with axillary emptying, who presented lymphedema and who included in their treatments a physical therapy protocol of CDT. Also, independently, the methodological quality of the studies selected was evaluated using the JADAD Quality Scale. Results: Currently, the gold standard among the main physiotherapeutic techniques used for the treatment of lymphedema is CDT, which consists of manual lymphatic drainage, skin and nail care, compression bandaging and therapeutic exercises. Conclusion: The CDT is considered the most used and efficient method for volume reduction and intensive treatment of post-mastectomy lymphedema. (AU)


Subject(s)
Humans , Physical Therapy Modalities , Lymphedema , Mastectomy , Breast Neoplasms , Lymph , Lymphatic System
6.
Rev. Eugenio Espejo ; 15(1): 22-29, 20210102.
Article in Spanish | LILACS | ID: biblio-1145483

ABSTRACT

Se realizó un estudio con diseño cuantitativo, de tipo observacional descriptivo; cuya población de estudio estuvo constituida por 142 pacientes de sexo femenino, diagnosticadas con cáncer de mama en la Unidad Oncológica Solca-Chimborazo, durante el período 2014-2019; con el objeti - vo de describir el tratamiento fisioterapéutico en ese contexto de investigación. Los datos fueron recolectados a partir de las respectivas historias clínicas. A partir de 2015, se observó un predo- minio de pacientes adultos con edades comprendidas entre 36 y 65 años. De las 142 pacientes que conformaron la población estudiada, solo 5 desarrollaron linfedema posquirúrgico. La mayoría de las pacientes incluidas en el estudio fueron intervenidas quirúrgicamente (65); 59 de las cuales recibieron tratamiento de drenaje linfático manual. Entre la población elegida en la Unidad Oncológica de Solca-Chimborazo se evidenció que la aplicación de terapia de rehabili - tación mediante drenaje linfático manual posquirúrgico reduce la posibilidad de aparición de linfedema a largo plazo.


This research aimed to describe the physiotherapeutic treatment in this research context. A study was carried out with a quantitative design, of a descriptive observational type. The study popula- tion consisted of 142 female patients, diagnosed with breast cancer at the Solca-Chimborazo Oncology Unit, during the period 2014-2019. The data were collected from the respective medi- cal records. Since 2015, a predominance of adult patients aged between 36 and 65 years was observed. From the 142 patients that made up the study population, only 5 developed postsurgi- cal lymphedema. Most of the patients included in the study underwent surgery (65); 59 received manual lymphatic drainage treatment. Among the population chosen in the Solca-Chimborazo Oncology Unit, it was evidenced that the application of rehabilitation therapy through postope- rative manual lymphatic drainage reduces the possibility of long-term lymphedema develop - ment.


Subject(s)
Humans , Female , Middle Aged , Breast , Manual Lymphatic Drainage , Lymphedema , Patients , Rehabilitation , Therapeutics
7.
Article in English | WPRIM | ID: wpr-921879

ABSTRACT

Objective To study the reliability and validity of the Chinese version of the Lymphedema Quality of Life Questionnaire (LYMQOL) in lymphedema patients. Methods LYMQOL was translated into Chinese. The Chinese version of the LYMQOL was distributed with the official Wechat account "Lymphedema Channel" to lymphedema patients who were recruited from October 28


Subject(s)
China , Humans , Lymphedema , Quality of Life , Reproducibility of Results , Surveys and Questionnaires
8.
Article in English, Portuguese | LILACS | ID: biblio-1369484

ABSTRACT

Introduction: Breast cancer is one of the most common neoplasms among women in the world, accounting for 29.7% (66,280) of new cases in Brazil, and also corresponding to the main cause of death in this group (16.1%, 16,724). Neoplastic lymphedema is a malignant process of breast carcinoma, not very common but related to the disease progression. The gold standard treatment for lymphedema is the complex decongestive therapy (CDT) in order to reduce and maintain limb volume and increase the patient's quality of life. However, treatment for neoplastic lymphedema is little explored in the literature. The objective of this study was to analyze and report the impact of CDT on the control of neoplastic lymphedema symptoms and volume. Case report: Patient with breast cancer in palliative treatment and neoplastic lymphedema in the homolateral upper limb. The proposed physiotherapeutic treatment for this patient was the adapted CDT, which was split in two phases. The first phase was to reduce the lymphedema volume with skin care orientations, passive exercises (because of monoplegia and joint restriction) and compressive bandaging. Even if the lymphatic drainage was not applied, the treatment brought significant improvement in reducing the left upper limb volume with loss of 1,045,58 mL between the beginning and end of the first phase. The second phase was targeted to maintenance, indicating the use of compressive clamp to control the volume. Conclusion: The adapted CDT may be an option to minimize the volume of neoplastic lymphedema


Introdução: O câncer de mama está entre as neoplasias mais comuns entre as mulheres no mundo, representando 29,7% (66.280) dos casos novos no Brasil. Também corresponde à principal causa de óbitos (16,1%, 16.724) nesse grupo. O linfedema neoplásico é um processo maligno do carcinoma de mama não muito comum, significando progressão da doença. O tratamento padrão-ouro para o linfedema é a terapia complexa descongestiva (TCD) com a finalidade de reduzir e manter o volume do membro, além de aumentar a qualidade de vida do paciente. Entretanto, o tratamento para o linfedema neoplásico é pouco explorado na literatura. O objetivo deste estudo foi analisar e relatar o impacto da TCD no controle da sintomatologia e volume do linfedema neoplásico. Relato do caso: Paciente com câncer de mama em tratamento paliativo com linfedema neoplásico no membro superior homolateral. O tratamento fisioterapêutico proposto para essa paciente foi a TCD adaptada, dividida em duas fases. A primeira consistiu em reduzir o volume do linfedema, por meio de orientações de cuidados com a pele, exercícios passivos (em razão da monoplegia e restrição articular) e enfaixamento compressivo. Apesar de não ter sido realizada drenagem linfática, o tratamento demonstrou melhora significativa na redução do volume no membro superior esquerdo com perda de 1.045,58 ml entre o início e o final da primeira fase. A segunda fase foi dirigida à manutenção, indicando o uso da braçadeira compressiva para controle do volume. Conclusão: A TCD adaptada pode ser uma opção para minimizar o volume do linfedema neoplásico


Introducción: El cáncer de mama se encuentra entre las neoplasias más comunes entre las mujeres en el mundo, representando 29,7% (66.280) de nuevos casos en Brasil y es la principal causa de muerte en este grupo (16,1%, 16.724). La linfedema neoplásica es un proceso maligno de carcinoma mamario que significa progresión de la enfermedad. El tratamiento estándar para la linfedema es la terapia compleja descongestiva (TCD) con el fin de reducir el volumen de las extremidades y aumentar la calidad de vida del paciente, pero es poco explorado en la literatura. El objetivo de este estudio fue evaluar si el rendimiento de la TCD influiría en el volumen de linfedema. Relato del caso: El estudio fue un informe de una paciente con cáncer de mama y linfedema neoplásico en la extremidad superior homolateral. El tratamiento fisioterapéutico propuesto para este paciente fue el TCD adaptado, que se dividió en dos fases. La primera consiste en reducir el volumen de la linfedema mediante pautas de cuidado de la piel, ejercicios pasivos porque el paciente ha presentado plejía, restricción articular del hombro del miembro superior izquierdo y vendaje compresivo. Aunque en el estudio no se realizó drenaje linfático, el tratamiento mostró una mejoría significativa en la reducción de volumen en el miembro superior izquierdo con una pérdida de 1.045,58 ml entre el inicio y el final de la primera fase. La segunda fase dirigida al mantenimiento, en la que se indicó el uso de la pinza compresiva para control de volumen. Conclusión: La TCD adaptada puede ser una opción para minimizar el volumen y las quejas de un paciente con linfedema neoplásico


Subject(s)
Humans , Female , Palliative Care , Breast Neoplasms , Physical Therapy Modalities , Lymphedema/therapy
9.
An. Fac. Cienc. Méd. (Asunción) ; 53(3): 159-164, 20201201.
Article in Spanish | LILACS | ID: biblio-1178006

ABSTRACT

La elefantiasis verrugosa nostra es una patología poco frecuente secundaria a linfedema crónico no filariásico, con la consecuente deformación y aumento de volumen del miembro afecto acompañado de un engrosamiento excesivo de la piel. Presentamos el caso de un paciente de sexo masculino con hiperplasia verrugosa en miembros inferiores secundaria a linfedema crónico por trastornos de la circulación venolinfática.


The elephantiasis nostra verrucosa is a rare pathology secondary to chronic non-filarial lymphedema, with the consequent deformation and volume increase of the affected limb accompanied by excessive thickening of the skin. We present the case of a male patient with verrucous hyperplasia in the lower limbs secondary to chronic lymphedema due to disorders of the venolymphatic circulation.


Subject(s)
Sarcoma, Kaposi , Elephantiasis , Non-Filarial Lymphedema , Hyperplasia , Lymphedema , Pathology , Skin
10.
Rev. enferm. UERJ ; 28: e49435, jan.-dez. 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1146262

ABSTRACT

Objetivo: identificar e mapear estratégias preconizadas para prevenção de linfedema em pacientes submetidas a esvaziamento axilar em tratamento do câncer de mama. Método: revisão de escopo realizada em agosto de 2019 considerando oito bases de dados e oito bases da literatura cinzenta. A amostra final foi composta por 13 artigos, selecionados de acordo com critérios de elegibilidade. Resultados: os estudos foram predominantemente randomizados, com nível de evidência 1a, e realizados na América do Norte. Medidas preventivas tradicionalmente utilizadas, como limitar exercícios com carga ou evitar punção venosa e aferição de pressão arterial, não se demonstraram efetivas em nenhum dos estudos encontrados. Foi evidenciado como medida preventiva o controle dos fatores de risco modificáveis associados ao linfedema: IMC elevado (> 25 kg/m2 ) e quimioterapia administrada no braço ipsilateral. Conclusões: não foram apresentadas evidências significativas para medidas cotidianamente preconizadas na prevenção do linfedema, e fatores de risco modificáveis se destacaram entre os riscos para seu desenvolvimento.


Objective: to identify and map strategies recommended for prevention of lymphedema in patients after axillary dissection during breast cancer treatment. Method: this scoping review was conducted in August 2019 across eight databases and eight gray literature data sources. The final sample comprised 13 journal articles that met eligibility criteria. Results: the studies, most of which were randomized, conducted in North America, and offered Level 1a evidence. None of the studies reviewed found traditionally employed preventive measures, such as limiting weight training or avoiding venipuncture and blood pressure measurements, to be effective. Evidence indicated that controlling modifiable lymphedema-related risk factors ­ namely high BMI (> 25 kg/m²) and chemotherapy administration in the ipsilateral arm ­ was a preventive measure. Conclusion: no significant evidence was reported for traditionally recommended preventive measures against lymphedema, and modifiable factors figured prominently among risk factors for lymphedema.


Objetivo: identificar y mapear las estrategias recomendadas para la prevención del linfedema en pacientes después de una disección axilar durante el tratamiento del cáncer de mama. Método: esta revisión de alcance se realizó en agosto de 2019 en ocho bases de datos y ocho fuentes de datos de literatura gris. La muestra final comprendió 13 artículos de revistas que cumplieron con los criterios de elegibilidad. Resultados: los estudios, la mayoría de los cuales fueron aleatorios, se realizaron en Norteamérica y ofrecieron evidencia de Nivel 1a. Ninguno de los estudios revisados encontró que las medidas preventivas empleadas tradicionalmente, como limitar el entrenamiento con pesas o evitar la punción venosa y las mediciones de la presión arterial, sean efectivas. La evidencia indicó que el control de los factores de riesgo relacionados con el linfedema modificables, a saber, un IMC alto (> 25 kg / m²) y la administración de quimioterapia en el brazo ipsilateral, era una medida preventiva. Conclusión: no se informó evidencia significativa de las medidas preventivas recomendadas tradicionalmente contra el linfedema, y los factores modificables figuraron de manera prominente entre los factores de riesgo para el linfedema.


Subject(s)
Humans , Female , Axilla , Breast Neoplasms/therapy , Lymph Node Excision/adverse effects , Lymphedema/prevention & control , Body Mass Index , Risk Factors , Control , Arterial Pressure
11.
Med. U.P.B ; 39(2): 17-23, 21/10/2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1123561

ABSTRACT

Objetivo: Evaluar la calidad de vida en un grupo de pacientes con linfedema por cáncer de seno en la ciudad de Medellín. Metodología: Se realizó un estudio cuantitativo de tipo descriptivo correlacional, en el que se analizó la relación de la calidad de vida con la sintomatología, tratamientos médicos recibidos y perímetros del brazo en 11 mujeres con linfedema. Se valoró el dolor, perímetros de ambos brazos y se utilizó el cuestionario de calidad de vida FACT B+4. Resultados: A partir de las correlaciones de Spearman se identificó que, para la calidad de vida y los perímetros del brazo afectado, hubo una correlación inversa y no significativa, lo que indica que no existe una percepción negativa frente a la calidad de vida pese al linfedema. Hubo una correlación inversa y significativa entre el número de tratamientos y la calidad de vida (a más número de tratamientos recibidos, menor calidad de vida según la percepción de las participantes). Así mismo, la percepción de calidad de vida se correlacionó de modo inverso con el dolor. Conclusión: La calidad de vida se ve influenciada por la cantidad de tratamientos oncológicos recibidos, dichos tratamientos tienen efectos colaterales e impactan el bienestar. El dolor es una complicación que influye negativamente en la calidad de vida, más aún si se trata no se trata oportunamente.


Objective: This study intends to evaluate the quality of life of a group of patients with lymphedema due to breast cancer in the city of Medellin. Methodology: A descriptive correlational study was carried out with a quantitative approach, with the purpose of evaluating the quality of life in patients with lymphedema due to breast cancer, analyzing its relationship with symptoms; treatments received; and arm circumferences. The analyzed population consisted of 11 women. In which pain, perimeters of both arms were evaluated, and the FACT B + 4 Quality of life questionnaire was also implemented. Results: From Spearman's correlations, it was found that, for the variables of quality of life and perimeters of the affected arm, the correlation was inverse and not significant, indicating that there is no negative perception of quality of life despite the presence of lymphedema, while, for the number of treatments received by the patients and their quality of life, the correlation was inverse and significant, indicating that an increase in the number of treatments received, affects the perception of quality of life. The same analysis was developed for the variables of quality of life and pain, finding a significant and inverse correlation; therefore, as pain increases, the perception of quality of life decreases. Conclusion: The quality of life is an element that is influenced by the amount of cancer treatments received, which increases the side effects, and impacts the well-being of patients including lymphedema, also, pain is a complication that greatly influences the quality of life, even more if it is not timely treated.


Objetivo: Avaliar a qualidade de vida num grupo de pacientes com linfedema por câncer de mama na cidade de Medellín. Metodologia: Se realizou um estudo quantitativo de tipo descritivo de correlação, no qual se analisou a relação da qualidade de vida com a sintomatologia, tratamentos médicos recebidos e perímetros do braço em 11 mulheres com linfedema. Se valorou a dor, perímetros de ambos braços e se utilizou o questionário de qualidade de vida FACT B+4. Resultados: A partir das correlações de Spearman se identificou que, para a qualidade de vida e os perímetros do braço afetado, houve uma correlação inversa e não significativa, o que indica que não existe uma percepção negativa frente à qualidade de vida apesar do linfedema. Houve uma correlação inversa e significativa entre o número de tratamentos e a qualidade de vida (a mais número de tratamentos recebidos, menor qualidade de vida segundo a percepção das participantes). Assim mesmo, a percepção de qualidade de vida se correlacionou de modo inverso com a dor. Conclusão: A qualidade de vida se vê influenciada pela quantidade de tratamentos oncológicos recebidos, ditos tratamentos têm efeitos colaterais e impactam no bem-estar. A dor é uma complicação que influi negativamente na qualidade de vida, mais ainda se não se trata oportunamente.


Subject(s)
Humans , Female , Breast Neoplasms , Pain , Perception , Quality of Life , Women , Lymphedema
12.
Appl. cancer res ; 40: 1-7, Oct. 19, 2020. ilus, tab
Article in English | LILACS, Inca | ID: biblio-1255030

ABSTRACT

Background: Lymphoedema is a common side effect after treatment for head and neck cancer. Our treatment protocol involves staging the degree of lymphoedema and then offering treatment comprising skin care, manual lymphatic drainage, simple lymphatic drainage, compression and elastic therapeutic tape. The Glasgow Benefit Inventory is a validated post-interventional questionnaire applicable to otorhinolaryngology interventions which measures changes in health status. The aim of this study was to quantify the health benefits of lymphoedema treatment using the Glasgow Inventory Benefit questionnaire, in patients with a history of treated head and neck cancer. Methods: Any patient who had undergone treatment with curative intent of a primary head and neck malignancy who had been referred for lymphoedema treatment within a 6 month period was eligible for inclusion. Patients completed a questionnaire after finishing the course of lymphoedema treatment. Results: A total of 15 patients completed the questionnaire. Ten patients (67%) demonstrated some level of improvement in quality of life, while two (13%) reported no benefit and three (20%) reported negative improvements. The average score for the total Glasgow Benefit Inventory scale was + 7.2. The greatest benefit was demonstrated with the physical benefit subscale (+ 13.1). The average general benefit score was + 9.0. Conclusions: Lymphoedema treatment involves techniques which can fairly easily be taught to patients to complete at home. In this study, there were mild improvements in patient reported quality of life using the Glasgow Benefit Inventory in the majority of patients. Clinical interest has increased in lymphoedema recently, but there is still limited information about the effectiveness of treatments and future research should look to address these issues.


Subject(s)
Quality of Life , Head and Neck Neoplasms , Lymphedema , Surveys and Questionnaires
13.
Rev. argent. cir. plást ; 26(2): 88-91, apr-jun 2020. fig, tab
Article in Spanish | LILACS | ID: biblio-1147144

ABSTRACT

El lindefema masivo localizado es una condición rara pero su incidencia se encuentra en aumento. El linfedema puede ser primario o secundario a infecciones, radioterapia, cirugías, cáncer, enfermedades del sistema inmune o a compresión. Algunos autores han sugerido un incremento en su incidencia debido a la epidemia de obesidad. El linfedema escrotal produce una morbilidad importante debido a mala higiene, infecciones, incontinencia urinaria, disfunción sexual, pérdida de la libido e inclusive limitación en la deambulación. Las opciones de tratamiento no quirúrgico de la linfedema incluyen el drenaje linfático manual, prendas de compresión, terapia física y ejercicio. Usualmente, el tratamiento conservador falla debido a la dificultad anatómica que presenta la región genital para la aplicación de dichas terapias. El tratamiento quirúrgico puede ser efectivo en casos graves y moderados. Existen diferentes variantes a la técnica quirúrgica, pero la resección del tejido afectado y la reconstrucción con tejido sano es primordial. El pronóstico de esta patología tiende a ser bueno; sin embargo, se reporta una alta tasa de recidiva.


Massive localized lymphedema is a rare but rising condition that could be primary in nature or secondary to infections, radiation, surgery, malignancies, autoimmune or compression. Some authors have suggested and increased incidence due to the raising epidemic of obesity. Scrotal lymphedema causes significant morbidity such as poor hygiene, infections, urinary incontinence, sexual dysfunction, loss of libido and a limited ambulation. Although non operative treatment options for lymphedema include manual lymph drainage, compression garments, exercises, sequential gradient pump. Usually, non-operative techniques fail due to the difficult in the anatomic area. Surgical treatment can be effective in moderate to severe cases of giant scrotal lymphedema. There are many variations of the surgical technique, however, resection of the affected tissue and reconstruction with healthy skin is primordial. The prognosis tends to be good, although there is reported a significant amount of relapse, mostly dependent on the weight lost and diet of the patients


Subject(s)
Humans , Male , Adult , Scrotum/surgery , Lymphedema/pathology , Elephantiasis , Neoplasms , Obesity
14.
Rev. cir. (Impr.) ; 72(2): 113-117, abr. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1092901

ABSTRACT

Resumen Introducción El linfedema es una enfermedad crónica, progresiva y debilitante, con un impacto significativo en la calidad de vida de los pacientes. Diversos estudios han evaluado instrumentos y cuestionarios enfocados en reportar resultados del tratamiento quirúrgico del linfedema y el impacto en su calidad de vida, desde la perspectiva del paciente. Destaca recientemente el Lymphedema Quality of Life Score (LeQOLiS) , método de aplicación simple en la práctica clínica, con excelente correlación fisiopatológica de la enfermedad. Objetivo Validación lingüística y adaptación transcultural del Lymphedema Quality of Life Score, publicado originalmente en inglés. Materiales y Método Se realizó la validación lingüística siguiendo las guías MAPI/TRUST Research Institute ; traducción inglés-español, contra traducción español-inglés, conciliación inglés-inglés y aplicación de ésta en 6 individuos. Se utilizó estadística descriptiva y analítica en los resultados. Resultados Las 6 pacientes evaluadas, fueron de sexo femenino, edad promedio 49 ± 17 (SD) años, IMC 27 ± 5 kg/m2. Todos los pacientes encuestados presentaron una considerable disminución de la puntuación total en el período postoperatorio (p = 0,027). Conclusión Lymphedema Quality of Life Score es un instrumento válido, confiable y reproducible para la evaluación objetiva del impacto del tratamiento quirúrgico del linfedema en la calidad de vida de los pacientes.


Background Lymphedema is a chronic, progressive and debilitating disease with a significant impact on patients' quality life. Multiple instruments and questionnaires have been carried out focused in results of the surgical treatment of lymphedema and their impact in quality of life, from the perspective of patients. One recently published, "Lymphedema Quality of Life Score (LeQOLiS), is a simple method to use in clinical practice, with an excellent physiopathological correlation of the disease. Aim Linguistic validation and transcultural adaptation of Lymphedema Quality of Life Score, published in English originally. Materials and Method The linguistic validation guidelines of the MAPI/TRUST Research institute were used and the survey was applied to six patients. Descriptive and analytical statistics were used. Results Six female patients surveyed, mean age 49 ± 17 years and the mean body mass index was 27 ± 5 kg/m2.All the patients had a decrease in the total score in the postoperative period. Conclusions The Lymphedema Quality of Life Score is a valid, reliable and reproducible instrument to objectively assess the impact of the surgical treatment of lymphedema in the quality of life.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Quality of Life , Activities of Daily Living/psychology , Lymphedema/psychology , Translating , Adaptation, Psychological , Surveys and Questionnaires , Outcome Assessment, Health Care , Sickness Impact Profile , Lymphedema/surgery
15.
Diagn. tratamento ; 25(1): 4-8, jan.-mar. 2020.
Article in Portuguese | LILACS | ID: biblio-1099499

ABSTRACT

Contexto: O lipedema, apesar de prevalente, é uma condição mórbida subdiagnosticada. Descrição do caso: O presente artigo apresenta o caso de uma paciente de 80 anos com diversas comorbidades que possui episódios álgicos e pruriginosos constantes em membros inferiores, além de alterações dérmicas, associadas a dificuldade de deambulação e flexão de pernas, bem como presença constante de hematomas, equimoses e sensação de peso constante em membros inferiores. Discussão: O lipedema é geralmente confundido com seus principais diagnósticos diferenciais, como, por exemplo, o linfedema e a obesidade. Conclusões: Torna-se, portanto, essencial o conhecimento fisiopatológico e clínico da doença, a fim de que seja feito um diagnóstico preciso e, deste modo, instalada uma terapêutica adequada.


Subject(s)
Humans , Female , Aged, 80 and over , Vascular Diseases , Venous Insufficiency , Epidemiology , Lipedema , Lymphedema , Obesity
16.
Rev. eletrônica enferm ; 22: 1-7, 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1119146

ABSTRACT

Estudo transversal que buscou analisar a ocorrência de erisipela em mulheres com câncer de mama. Foi desenvolvido em um núcleo de reabilitação e incluídas, por conveniência, 84 mulheres com câncer de mama. Observou-se que 19% das participantes apresentaram sinais e sintomas de erisipela. Os sinais mais prevalentes foram hiperemia da pele, calor local e dor (100%). Além disso, observou-se que 75% das participantes com erisipela também apresentavam linfedema (p<0,005). Entre as mulheres com linfedema e erisipela, observou-se que 83,3% apresentavam o linfedema previamente ao primeiro episódio de erisipela. A prevalência de erisipela entre mulheres com câncer de mama em reabilitação, apontou que dentre os fatores predisponentes desta patologia houve associação com a presença de linfedema. Dados que justificam a inclusão de medidas de prevenção do linfedema, como hidratação do membro superior homolateral à cirurgia e evitar traumas nos cuidados prestados às mulheres com câncer de mama, prevenindo também a erisipela.


A cross-sectional study that analyzed the occurence of erysipelas in women with breast cancer. It was conducted in a rehabilitation center, and 84 women with breast cancer were included by convenience. It was observed that 19% of women had signs and symptoms of erysipelas. The most prevalent signs were skin hyperemia, local heat, and pain (100%). Moreover, 75% of participants with erysipelas also had lymphedema (p<0.005). Among women with lymphedema and erysipelas, 83.8% had the lymphedema before erysipelas. The prevalence of erysipelas among women with breast cancer in rehabilitation pointed that within the predisposing factors of this pathology, there was an association with the presence of lymphedema. This data justify the inclusion of prevention measures for lymphedema, such as hydration of the superior limb homolateral to the surgery and to avoid trauma in the care provided to women with breast cancer, also preventing erysipelas.


Subject(s)
Humans , Female , Breast Neoplasms , Erysipelas , Breast Neoplasms/nursing , Disease Prevention , Lymphedema
17.
Fisioter. Mov. (Online) ; 33: e003367, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133916

ABSTRACT

Abstract Introduction: Some health professionals have difficulty treating and preventing upper extremity lymphedema (UEL), demonstrating the need for evidence-based educational technology, such as algorithms. These algorithms should be simple, clear and direct, providing a comprehensive portrait of the care process. Objective: Construct and validate an algorithm to prevent and treat upper extremity lymphedema Method: In order to construct the algorithm, an integrative literature review was conducted in the Health Sciences, SciELO, LILACS and MEDLINE databases. The algorithm was evaluated by 27 physiotherapists and validated using the Delphi method. Statistical analysis was carried out using the content validity index (CVI). Results: In the first assessment, the judges classified the algorithm as "Inadequate" or "Adequate"; following corrections made according to their suggestions, the algorithm was reassessed as "Adequate" or "Completely adequate". The content validity index was 0.95 at the former and 1.0 at the latter. Conclusion: Following an integrative literature review, an algorithm to treat and prevent upper extremity lymphedema was constructed and validated by experienced professionals, exhibiting interrater agreement in the second assessment.


Resumo Introdução: Alguns profissionais apresentam dificuldades para tratar e prevenir o linfedema de membros superiores. Sendo assim, há a necessidade de desenvolver tecnologia educativa desenvolvido com embasamento cientifico, por exemplo, algorítmo. Os algoritmos devem ser simples, claro, diretos e, que conferem uma visão completa do processo de cuidado devem ser desenvolvido. Objetivo: Construir e validar um algoritmo para tratamento e prevenção de linfedema de membros superiores. Método: Para a construção do algoritmo, foi realizada revisão integrativa da literatura nas bases de dados das Ciências da Saúde, SciELO, LILACS, MEDLINE. A avaliação do algoritmo foi feita por 27 fisioterapeutas. Para a validação do algoritmo, recorreu-se à técnica de Delphi. A análise estatística utilizada foi o Índice de Validade de Conteúdo. Resultados: Na primeira avaliação, os juízes avaliaram o algoritmo entre "Inadequado" e "Adequado"; após feitas as correções sugeridas pelos avaliadores, o algoritmo foi reenviado, tendo sido avaliado entre "Adequado" e "Totalmente adequado". Com relação ao índice de validade de conteúdo geral, na primeira avaliação, foi 0,95 e, na segunda avaliação, foi 1,0. Conclusão: Após revisão integrativa da literatura, o algoritmo para tratamento e prevenção de linfedema de membros superiores foi construído e validado por profissional com experiência na área, mostrando concordância entre os juízes na segunda avaliação


Subject(s)
Humans , Algorithms , Lymphedema , Statistical Analysis , Educational Technology , Upper Extremity , Physical Therapists
18.
Article in Chinese | WPRIM | ID: wpr-828307

ABSTRACT

OBJECTIVE@#To analyze FOXC2 gene variant in a family affected with lymphodema-distichiasis syndrome (LDS).@*METHODS@#Peripheral blood samples were collected for the extraction of DNA and protein. Whole-exome sequencing was carried out to detect variants in the proband. Suspected variant was validated by Sanger sequencing. Western blotting was used to detect changes in protein expression.@*RESULTS@#The proband and his mother were both found to carry a heterozygous nonsense variant c.177C>G (p.Tyr59X) of the FOXC2 gene, which was previously unreported. Down-regulated expression of FOXC2 was detected by Western blotting. Prenatal ultrasonography of the fetus indicated increased nuchal thickness. Amniocentesis was performed at 21+1 weeks of pregnancy, genetic testing suggested that the fetus also carried the c.177C>G variant.@*CONCLUSION@#The patients' condition may be attributed to the heterozygous nonsense variant c.177C>G of the FOXC2 gene, which resulted in a significant decrease in FOXC2 expression. Increased nuchal thickness may also be related with decreased FOXC2 expression. Above finding has expanded the variant spectrum of the FOXC2 gene.


Subject(s)
Codon, Nonsense , Eyelashes , Congenital Abnormalities , Female , Forkhead Transcription Factors , Genetics , Metabolism , Gene Expression , Genetic Testing , Genetic Variation , Humans , Lymphedema , Genetics , Pedigree , Pregnancy , Prenatal Diagnosis
19.
Article in Chinese | WPRIM | ID: wpr-879915

ABSTRACT

OBJECTIVE@#To identify the genetic causes of a family with lymphedema-distichiasis syndrome (LDS).@*METHODS@#The whole exome sequencing was performed in a aborted fetus as the proband, and a candidate gene was identified. Peripheral blood of 8 family members were collected. Genotypic-phenotypic analysis were carried out through PCR amplification and Sanger sequencing.@*RESULTS@#The proband, and the mother, grandmother, uncle, granduncle of the proband all had distichiasis or varix of lower limb carried a @*CONCLUSIONS@#The


Subject(s)
Aborted Fetus/physiopathology , Adult , Eyelashes/pathology , Female , Forkhead Transcription Factors/genetics , Frameshift Mutation , Humans , Lymphedema/pathology , Male , Phenotype , Pregnancy , Whole Exome Sequencing
20.
Medisan ; 23(4)jul.-ago. 2019. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1091121

ABSTRACT

Se describe el caso clínico de un paciente que, 7 años después de habérsele realizado una falectomía parcial con linfadenectomía inguinal superficial y quimioterapia (cisplatino 150) por un carcinoma epidermoide del pene, acudió al Servicio de Urología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso en Santiago de Cuba por presentar un linfedema gigantesco de escroto, de origen obstructivo linfático, con marcada repercusión sobre la posición bípeda y la marcha. Se realizó el procedimiento quirúrgico (técnica de Homans con modificaciones) y el paciente evolucionó satisfactoriamente. Luego de 2 años de operado, se le dio el alta de la consulta externa, pues se consideró que había recuperado la capacidad físico-motora y su autoestima.


The case report of a patient is described who, 7 years after carrying out a partial falectomy with inguinal superficial lymphadenectomy and chemotherapy (cisplatin 150) due to an squamous cell carcinoma of the penis, he went to the Urology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba presenting a giant scrotal lymphedema, of lymphatic obstructive origin, with marked repercussion on the biped position and during walking. The surgical procedure (Homans technique with modifications) was carried out and the patient had a satisfactory clinical course. Then after 2 years of surgery, he was discharged from the out-patient service, because it was considered that he had recovered the physical motor skills and his self-esteem.


Subject(s)
Scrotum/surgery , Lymph Node Excision , Lymphedema/surgery
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