The efficacy of intermittent pneumatic compression as a substitute for manual lymphatic drainage in complete decongestive therapy in the treatment of breast cancer related lymphedema.

The aim of this study is to evaluate the efficacy of intermittent pneumatic compression (IPC) as a substitute for manual lymphatic drainage (MLD) in complete decongestive therapy (CDT) for treatment of advanced stages of breast cancer-related lymphedema. In this randomized, single-blind, controlled study, 46 patients with breast cancer-related lymphedema were divided into 2 groups. Both MLD with compression bandage (CB) group (n=24) and IPC with CB group (n=22) received treatment 3 days a week for 5 weeks. Home exercise program was also given to all patients. At the end of the 5th week, patients were treated with a daily 23-hour compression garment and home exercise routines. Assessments were taken at baseline, the fifth week, and the third month. Arm circumference was measured at 5 different areas, shoulder range of motion (ROM) was evaluated with a goniometer, pain, and tightness, and heaviness sensations were assessed with visual analog scale. Both groups had similar demographic and clinical characteristics (p<0.05). There were no significant differences between groups and both groups showed significant improvement (p<0.05) in the five measurement levels of the arm circumference at the fifth week and third month. Similarly, shoulder ROM, pain, tightness, and heaviness sensations improved in both groups (p<0.05). Both MLD and IPC as a component of CDT were found successful at 5 weeks and 3 months without superiority to each other.

Efficacy of kinesio taping in early stage breast cancer associated lymphedema: A randomized single blinded study.

This study was designed to evaluate the effectiveness of kinesio taping compared to compression garment in treatment of early stage breast cancer-associated lymphedema (BCAL). Patients between 18-70-years old who had unilateral stage 1 BCAL were randomized into group I kinesio taping (KT) and group II compression garment (CG) for this single blinded study. KT was applied with a lymphatic correction technique in three-four day intervals for four weeks. At the end of the fourth week, patients were suggested to wear CGs. Patients in group II were treated daily for 23-hours in CGs. Education, preventive measures, and exercises were given to both groups. All patients were evaluated before the treatment (T0), immediate post treatment (T1), and three months after treatment (T2). Circumference differences were measured between the extremities with a nonelastic tape at five levels. Additionally, shoulder range of motion (ROM) was measured, and pain, heaviness, and sensation of tightness were evaluated with a visual analog scale (VAS). Thirty-five patients with stage 1 BCAL were included and randomized to the KT (n= 16) and CG (n= 19) groups. Demographic data and baseline clinical characteristics were similar. Both groups had reductions in all levels of arm circumference differences at immediate post-treatment and three months after treatment. Pain, tightness, and heaviness scores significantly decreased for both groups at immediate post-treatment and third month. Patients in the KT group had significantly lower pain sores than patients in the CG group. Results demonstrated that both modalities had similar effects in the treatment of early stage BCAL. For patients with early stage BCAL, KT can be an alternative treatment to CG for patients who have difficulties in obtaining and wearing CGs.

The validity and reliability of Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL) in a Turkish population.

Background Systemic lupus erythematosus (SLE) may have a profound impact on quality of life. There is increasing interest in measuring quality of life in lupus patients. The purpose of this study was to investigate the validity and reliability of SLE Quality of Life Questionnaire (L-QoL) in Turkish SLE patients. Methods SLE according to 2012 Systemic Lupus International Collaborating Clinics Classification Criteria were recruited into the study. Demographic data, clinical parameters and disease activity measured with the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K); were noted. Nottingham Health Profile and Health Assessment Questionnaire were filled out in addition to the Turkish L-QoL (LQoL-TR). Internal consistency, test-retest reliability, and convergent and discriminant validity were evaluated. Results The mean age of participants was 43.55 ± 14.33 years and the mean disease duration was 89.8 ± 92.1 months. The patients filled out LQoL-TR in 2.5 min. Strong correlation of LQoL-TR with all subgroups of the Nottingham Health Profile and the Health Assessment Questionnaire were established showing the convergent validity. The highest correlation was demonstrated with emotional reactions (rho = 0.72) and sleep component (rho = 0.65) of the Nottingham Health Profile scale ( p < 0.0001). Its poor and not significant correlation with nonfunctional parameters (age, disease duration, perceived general health, SLEDAI-2K) showed its discriminative properties. LQoL-TR demonstrated good internal reliability with a Cronbach's α of 0.93 and test-retest reliability with intraclass correlation coefficient of 0.87. Conclusion The LQoL-TR is a practical and useful tool which demonstrates good validity and reliability.

Complete A-V block: incidental or a part of cor triatriatum dexter.

Cor triatriatum dexter (CTD) is an extremely rare cardiac anomaly in which the right atrium is divided into two distinct chambers by a membrane. The persistence of the right valve of sinus venosus results in a complete septation of the right atrium. This anomaly is frequently associated with other right-sided cardiac abnormalities. Its clinical manifestation and the need for intervention are determined by the number and the size of the fenestrations on the membrane, associated cardiac anomalies and arrhythmias. We describe a case of CTD in a patient with complete atrioventricular (A-V) block.

Concomitant infection of the tricuspid valve and right ventricle free wall after chest tube insertion in a young patient without predisposing diseases.

Infective endocarditis (IE) is one of the most dreaded complications of healthcare-associated bloodstream infection. It is an important and potentially lethal complication of medical care and there is incidence evidence of it in this population. We describe a case of concomitant infection of the tricuspid valve and right ventricle free wall after chest tube insertion for spontaneous pneumothorax in a young patient without predisposing diseases.

Exploring the relationship between the severity of oligozoospermia and the frequencies of sperm chromosome aneuploidies.

The study was aimed to investigate the association between the degree of oligozoospermia and sperm chromosome aneuploidy frequencies in male infertility and to determine whether chromosomal profiles of sperm nuclei would be used for a supportive test before additive reproduction technics. The meiotic segregation profiles of chromosomes X, Y, 13, 18 and 21 were compared by fluorescent in-situ hybridisation (FISH) on the spermatozoa of 30 normally karyotyped oligozoospermic (10 mild, 11 moderate, nine severe) cases without Y-microdeletions, and 10 normozoospermic cases. The results showed significantly higher frequencies of chromosomes 13, 18, 21 disomies (P < 0.001) in the group of patients with moderate and severe oligozoospermia compared with the disomy frequencies of normozoospermic group. The statistically significant differences were also determined in disomy frequencies of sex chromosomes (XY, XX and YY) in between oligozoospermic and normozoospermic groups (P < 0.001, P < 0.001, P < 0.040, respectively). Because oligozoospermic patients are the ones consulted the most for assisted reproductive techniques, identification of sperm aneuploidy rates in men could be considered as an appropriate supportive test before the reproductive implementations. Furthermore, the patients should be counselled with respect to genetic screening results for the potential risk of aneuploid embryo and pre-implantation genetic diagnosis or prenatal diagnosis.