Feasibility of implementing a remote system for lymphoedema conservative therapy: a case study.

BACKGROUND: Poor access to lymphoedema specialists and communication between them and patients prevents appropriate lymphoedema management. Therefore, development and dissemination of remote systems is necessary to improve care in rural areas with limited medical personnel or access to medical coordination. AIMS: The authors evaluated the elements required for providing patient education on conservative therapy for lymphoedema, to determine the feasibility of remote management. METHODS: The study involved connecting a health professional in a local clinic (point A) treating a patient with lymphoedema, who was present alongside the clinician, with a specialist certified lymphoedema therapist (CLT) located remotely in a university (point B). FINDINGS: The CLT was able to greet, interview and provide guidance to the patient on conservative therapy. Direct contact with the patient was not possible, which limited visualisation, palpation, leg circumference measurement, and lymphatic drainage management. CONCLUSION: The findings suggest that remote a lymphoedema management approach involving conservative therapy benefits both patients and health professionals, particularly in rural regions. Future studies are needed to confirm the effectiveness of this approach to confirm adequate treatment.

Preparation of highly regioselective amphiprotic chitosan derivative via "click chemistry".

Synthesis of a highly regioselective amphiprotic chitosan derivative was achieved by click chemistry. The Huisgen cycloaddition between 6-azido-6-deoxy-N-pthaloyl-chitosan and methyl propiolate was successfully carried out in the presence of Cu(I) catalyst. After the reaction, both the phthaloyl protecting group and methyl group were completely removed by hydrazine. FT-IR and NMR spectroscopy as well as elemental analysis strongly support the structural uniformity of the desired amphiprotic chitosan derivative, which has both a carboxylic group with a 1,4-triazole linker at the C-6 position and an amino group at the C-2 position per repeating unit. The amphiprotic chitosan derivative was soluble under both acidic and basic aqueous conditions. In contrast, it formed nanoparticle under neutral condition due to the interaction between the positive (-NH(3)(+)) and negative (-COO(-)) ions on the chitosan derivative.