ABSTRACT
Objective: Analysis of data collected in routine clinical practice of the combined impact of both physical activity and decrease in body mass index (BMI) on a minor prevalence of lymphedema in post-breast cancer patients. Methods: Analysis of data obtained by the specialized rehabilitation unit, from 99 female patients for 18 months, after a specific diet, sports program and complete decongestive therapy (CDT) was indicated. Personal data, affected organ volume, weight, physical activity level and Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer (FACT-B+4) were collected in follow-up visits. Results: Although the average of body-mass index showed no change during the assessment period, about 13% of patients in the second follow-up visit and 30% in the third one had lost weight. Women experiencing weight-loss in the third follow-up visit presented a reduced volume of the affected organ [−50 (−248 to 141) ml vs. 130 (−148 to 355) ml, p<0.05] as compared to weight-gaining patients. No relationship was established between physical activity and lymphedema volume changes. Conclusions: Apart from the conventional treatment with orthotics and manual lymph drainage, BCRL prevention and treatment needs to focus right from the start on weight management or weight-loss in obese patients.(AU)
Objetivo: Analizar los datos recopilados en la práctica clínica rutinaria sobre el impacto combinado de la actividad física y la reducción del índice de masa corporal (IMC) en la reducción de la prevalencia de linfedema secundario a cáncer de mama (BCRL). Métodos: Análisis de los datos obtenidos por la unidad de rehabilitación especializada, de 99 pacientes durante 18 meses, tras prescribirse una dieta específica, un programa deportivo y una terapia descongestiva completa (TDC). En las visitas de seguimiento se recopilaron datos personales, volumen del órgano afectado, peso, nivel de actividad física y FACT-B+4 (Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer). Resultados: Aunque el índice de masa corporal medio no reflejó cambios durante el periodo de evaluación, cerca del 13% de las pacientes habían perdido peso en la segunda semana de seguimiento, incrementándose este porcentaje al 30% en la tercera semana. Las mujeres que experimentaron pérdida de peso durante la tercera visita de seguimiento presentaron una reducción del volumen del órgano afectado [-50 (-248-141)ml vs. 130 (-148-355)ml, p<0,05] en comparación con las pacientes que habían ganado peso. No se estableció relación alguna entre la actividad física y los cambios de volumen de linfedema. Conclusiones: Aparte del tratamiento convencional con ortésicos y drenaje linfático manual, la prevención y tratamiento de BCRL debe centrarse, desde el inicio, en la gestión del peso o la pérdida de peso en las pacientes obesas.(AU)
Subject(s)
Humans , Female , Middle Aged , Aged , Breast Neoplasms , Weight Loss , Body Mass Index , Breast Cancer Lymphedema , Motor Activity , Rehabilitation , SportsABSTRACT
OBJECTIVE: Analysis of data collected in routine clinical practice of the combined impact of both physical activity and decrease in body mass index (BMI) on a minor prevalence of lymphedema in post-breast cancer patients. METHODS: Analysis of data obtained by the specialized rehabilitation unit, from 99 female patients for 18 months, after a specific diet, sports program and complete decongestive therapy (CDT) was indicated. Personal data, affected organ volume, weight, physical activity level and Functional Assessment of Cancer Therapy Questionnaire for Breast Cancer (FACT-B+4) were collected in follow-up visits. RESULTS: Although the average of body-mass index showed no change during the assessment period, about 13% of patients in the second follow-up visit and 30% in the third one had lost weight. Women experiencing weight-loss in the third follow-up visit presented a reduced volume of the affected organ [-50 (-248 to 141) ml vs. 130 (-148 to 355) ml, p<0.05] as compared to weight-gaining patients. No relationship was established between physical activity and lymphedema volume changes. CONCLUSIONS: Apart from the conventional treatment with orthotics and manual lymph drainage, BCRL prevention and treatment needs to focus - right from the start - on weight management or weight-loss in obese patients.
Subject(s)
Breast Neoplasms , Lymphedema , Female , Humans , Breast Neoplasms/complications , Breast Neoplasms/therapy , Drainage , Lymphedema/etiology , Lymphedema/therapy , Physical Therapy Modalities , Manual Lymphatic DrainageABSTRACT
Los tumores del glomus carotídeo son lesiones de crecimiento lento e infrecuentes. Por la localización anatómica se recomienda su extirpación. Se presenta un paciente de 35 años con tumor del glomus carotídeo derecho agresivo. Se realizó embolización prequirúrgica; 24 horas después presentó ictus en territorio de la arteria cerebral media derecha, objetivándose en resonancia magnética nuclear material de embolización, apareciendo paresia facial izquierda leve. Se interviene tras 5 meses, presenta postcirugía: parálisis facial izquierda central, voz bitonal, disfagia leve, hemiparesia izquierda espástica de predominio braquial. Recibió tratamiento con toxina botulínica tipo A (TboA) en miembros izquierdos, seguido de estiramientos de la musculatura afectada. Objetivando en revisiones seriadas: mejoría en el dolor, patrón de marcha, posición del miembro superior y mejoría funcional. El tratamiento con TboA producirá mejoría global en patrones distónicos si se selecciona la musculatura y la dosis de forma correcta, obteniendo mejoras en funcionalidad y calidad de vida (AU)
Carotid glomus tumor are uncommon and slow growing lesions. Removal is recommended due to their anatomical localization. The case of a 35-year old patient with aggressive right carotid glomus tumor is presented. Presurgery embolization was performed. At 24 hour, the patient suffered stroke in the right middle cerebral artery territory, observing embolization material with the MRI, mild left facial paresis appearing. Surgery was performed 5 months later. Post-surgery, the patient has left central facial paralysis, bitonal voice, mild dysphagia, left spastic hemiparesis with brachial predominance. The patient was treated with botulinum toxin type A (TboA) in left limbs, followed by stretchings of the affected muscles. The seriated check-up studies showed improvement in pain, gait pattern, position of the upper limb as well as functional improvement. Treatment with TboA would produce an overall improvement in dystonic patterns, if the muscles and the dose are correctly selected, obtaining improvements in functionality and quality of life (AU)
