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Lymphland International Lymphedema Online
J Am Acad Dermatol. 2011 Aug;65(2):448-9.
Angiosarcoma in an obese woman with worsening lymphedema after weight-loss and skin-reduction
surgeries.
Robinson MR, Honda KS, Bordeaux JS.
Source
Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio.
PMID: 21763582 [PubMed - in process]
July 26, 2011
Vasa. 2011 Jul;40(4):271-9.
Lymphedema and lipedema - an overview of conservative treatment.
Wagner S.
Source
RehaClinic Bad Zurzach, Switzerland.
Abstract
Lymphedema and lipedema are chronic progressive disorders for which no causal therapy exists so far.
Many general practitioners will rarely see these disorders with the consequence that diagnosis is often
delayed. The pathophysiological basis is edematization of the tissues. Lymphedema involves an impairment
of lymph drainage with resultant fluid build-up. Lipedema arises from an orthostatic predisposition to edema
in pathologically increased subcutaneous tissue. Treatment includes complex physical decongestion by
manual lymph drainage and absolutely uncompromising compression therapy whether it is by bandage in the
intensive phase to reduce edema or with a flat knit compression stocking to maintain volume.
PMID: 21780050 [PubMed - in process]
Langenbecks Arch Surg. 2011 Jul 16. [Epub ahead of print]
The versatility of the pedicled vertical rectus abdominis myocutaneous flap in oncologic patients.
Daigeler A, Simidjiiska-Belyaeva M, Drücke D, Goertz O, Hirsch T, Soimaru C, Lehnhardt M, Steinau HU.
Source
Department of Plastic Surgery, Burn Center, Sarcoma Reference Center, BG-University Hospital
Bergmannsheil, Buerkle-de-la-Camp-Place 1, 44789, Bochum, Germany, daigeler@hotmail.com.
Abstract
PURPOSE:
The vertical rectus abdominis muscle (VRAM) flap is considered a safe and simple option to cover defects
of the trunk and proximal thigh. Detailed long-time follow-up studies in oncologic patients including
complications and donor site morbidity are rare. In this study, complications and donor site morbidity were
analysed.
METHODS:
Data of 78 consecutive patients with oncologic disease, having received VRAM flaps, were analysed
retrospectively. Patients with soft tissue sarcomas (n = 38), radiation ulcers (n = 18), carcinoma (n =
10), wound-healing difficulties after tumour resection (n = 8), breast reconstruction after ablation (n =
3) and malignant melanoma (n = 1) were included. Statistics concerning patients' satisfaction, the
occurrence of wound-healing difficulties, incisional herniation, loss of abdominal wall strength in correlation
to operative and (neo)adjuvant treatment and patients' history were performed. The mean follow-up time
was 5.5 years.
RESULTS:
No complete flap loss was observed. A body mass index over 30 was positively correlated with wound-
healing difficulties; radiation had no negative effect. A contralateral cutaneous pedicle could reduce the risk
of lymphoedema in groin defect patients. Incisional hernia was present in 13%. Strength endurance of the
abdominal wall was reduced compared to an age-matched control. Most patients were satisfied with the
postoperative result.
CONCLUSIONS:
VRAM flaps are reliable tools for defect coverage in the oncologic patient to prevent chronic ulceration,
lymphangitis or more severe complications like septic rupture of femoral vessels and hip disarticulation.
Donor site morbidity is tolerable, and patients' satisfaction is high.
PMID: 21779830 [PubMed - as supplied by publisher]
Rev Bras Ginecol Obstet. 2011 Feb;33(2):75-80.
[Associated factors of lymphedema in breast cancer patients].
[Article in Portuguese]
Paiva DM, Leite IC, Rodrigues Vde O, Cesca MG.
Source
Faculdade de Ciências Médicas da Saúde em Juiz de Fora, Juiz de Fora, MG, Brasil.
Abstract
PURPOSE:
to determine the prevalence of lymphedema and its associated factors in breast cancer patients.
METHODS:
Two hundred and fifty women that had undergone more than six months of breast cancer treatment and
were being treated at an oncology reference hospital in Juiz de Fora, Minas Gerais, Brazil. They were
interviewed and submitted to physical evaluation. Data from the patients' medical records regarding the
treatment of breast cancer, the extent of axillary intervention and the tumor were analyzed. Lymphedema
was diagnosed when the difference between both upper limbs was 2 cm or more by perimetry. The groups
of women with and without lymphedema were compared regarding the possible risk factors, and central
tendency, dispersion, and prevalence were measured, with a significance level of 95%.
RESULTS:
One hundred and twelve women (44.8%) presented lymphedema. A significant difference was found
between the groups of women with and without lymphedema regarding the median numbers of removed
lymph nodes (p=0.02); presentation of superficial lymphatic thrombosis in the arm ipsilateral to the surgery
(p<0.01); local application of radiotherapy, use of chemotherapy (p<0.01 for both); removal of the cuticles
of the ipsilateral hand with pliers, and weightlifting after the treatment (p<0.01 and p=0.05, respectively).
CONCLUSIONS:
the association between lymphedema and the mentioned factors requires an interdisciplinary approach to this
condition. It is of paramount importance that health teams and patients become aware of the prevention and
treatment of lymphedema, a condition often undervalued.
PMID: 21779649 [PubMed - in process
Circ Res. 2011 Jul 21. [Epub ahead of print]
CCBE1 Is Essential for Mammalian Lymphatic Vascular Development and Enhances the Lymphangiogenic
Effect of Vascular Endothelial Growth Factor-C In Vivo.
Bos FL, Caunt M, Peterson-Maduro J, Planas-Paz L, Kowalski J, Karpanen T, van Impel A, Tong R,
Ernst JA, Korving J, van Es JH, Lammert E, Duckers HJ, Schulte-Merker S.
Source
Hubrecht Institute, KNAW-UMC Utrecht, Utrecht, The Netherlands.
Abstract
Rationale: Collagen- and calcium-binding EGF domains 1 (CCBE1) has been associated with Hennekam
syndrome, in which patients have lymphedema, lymphangiectasias, and other cardiovascular anomalies.
Insight into the molecular role of CCBE1 is completely lacking, and mouse models for the disease do not
exist. Objective: CCBE1-deficient mice were generated to understand the function of CCBE1 in
cardiovascular development, and CCBE1 recombinant protein was used in both in vivo and in vitro settings
to gain insight into the molecular function of CCBE1. Methods and Results: Phenotypic analysis of murine
Ccbe1 mutant embryos showed a complete lack of definitive lymphatic structures, even though Prox1(+)
lymphatic endothelial cells get specified within the cardinal vein. Mutant mice die prenatally. Proximity
ligation assays indicate that vascular endothelial growth factor receptor 3 activation appears unaltered in
mutants. Human CCBE1 protein binds to components of the extracellular matrix in vitro, and CCBE1
protein strongly enhances vascular endothelial growth factor-C-mediated lymphangiogenesis in a corneal
micropocket assay. Conclusions: Our data identify Ccbe1 as a factor critically required for budding and
migration of Prox1(+) lymphatic endothelial cells from the cardinal vein. Ccbe1 probably exerts these effects
through binding to components of the extracellular matrix. CCBE1 has little lymphangiogenic effect on its
own but dramatically enhances the lymphangiogenic effect of vascular endothelial growth factor-C in vivo.
Thus, our data suggest CCBE1 to be essential but not sufficient for lymphangiogenesis.
PMID: 21778431 [PubMed - as supplied by publisher]
Biostatistics. 2011 Jul 20. [Epub ahead of print]
A joint latent variable model approach to item reduction and validation.
Halberstadt SM, Schmitz KH, Sammel MD.
Source
Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104, USA,.
Abstract
Many applications of biomedical science involve unobservable constructs, from measurement of health states
to severity of complex diseases. The primary aim of measurement is to identify relevant pieces of observable
information that thoroughly describe the construct of interest. Validation of the construct is often performed
separately. Noting the increasing popularity of latent variable methods in biomedical research, we propose a
Multiple Indicator Multiple Cause (MIMIC) latent variable model that combines item reduction and
validation. Our joint latent variable model accounts for the bias that occurs in the traditional 2-stage process.
The methods are motivated by an example from the Physical Activity and Lymphedema clinical trial in which
the objectives were to describe lymphedema severity through self-reported Likert scale symptoms and to
determine the relationship between symptom severity and a "gold standard" diagnostic measure of
lymphedema. The MIMIC model identified 1 symptom as a potential candidate for removal. We present this
paper as an illustration of the advantages of joint latent variable models and as an example of the
applicability of these models for biomedical research.
PMID: 21775486 [PubMed - as supplied by publisher]
July 31, 2011
Arch Sex Behav. 2011 Jul 27. [Epub ahead of print]
Compulsive Masturbation and Chronic Penile Lymphedema.
Calabrò RS, Galì A, Marino S, Bramanti P.
Source
Neurorehabilitation Unit, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, Cda Casazza,
98124, Messina, Italy, salbro77@tiscali.it.
Abstract
Chronic penile lymphedema arises from the abnormal retention of lymphatic fluid in the subcutaneous tissues
and may be secondary to local and systemic medical conditions such as sexually transmitted diseases,
filariasis, malignancy, local radiotherapy, and surgery. This case report aims to consider compulsive
masturbation as a possible cause of chronic penile edema. A 40-year-old man was referred to our institute
for behavioral disturbance, including compulsive masturbation. Neuropsychiatric evaluation showed
moderate mental retardation, mild dysarthria and limb incoordination, anxiety, depressed mood, and impulse
dyscontrol. Brain MRI pointed out diffuse white matter lesions. Urogenital examination revealed an
uncircumcised penis with non-tender edema of the shaft and prepuce with areas of lichenification. Since the
most common local and systemic causes of edema were excluded, chronic penile edema due to compulsive
masturbation was diagnosed and the compulsive behavior treated with an antidepressant and low-dose
neuroleptics. Compulsive masturbation should be taken into account when counselling patients with penile
edema.
PMID: 21792689 [PubMed - as supplied by publisher
Rev Bras Fisioter. 2011 Apr;15(2):146-53.
Functional performance of upper limb and quality of life after sentinel lymph node biopsy of breast cancer.
Velloso FS, Barra AA, Dias RC.
Source
Environmental and Health Department, Centro Universitário de Belo Horizonte, Belo Horizonte, MG, Brazil.
Abstract
BACKGROUND:
Sentinel lymph node biopsy (SLNB) is commonly used for the treatment of breast cancer with minimal
surgical intervention as well as with low morbidity rates of upper limbs.
OBJECTIVES:
The aim of the present study was to investigate possible impairments and functional performance of the
upper limb on activities of daily living (ADL) and health related quality of life (HRQL) among women treated
through SLNB in a Brazilian hospital and to study the association among these variables.
METHODS:
Forty-five women (58.9±9.3 years) participated in this descriptive, cross-sectional and correlational study.
The visual analogue scale (VAS) was used to quantify pain intensity/discomfort, arm circumference and
shoulder range of motion (ROM) measurement were used to measure upper limb impairments. The
Disabilites of Arm Shoulder and Hand questionnaire (DASH) was used to quantify functional performance
of upper limb during ADL and European Organisation for Research and Treatment of Cancer - Quality of
Life Questionnaire - Cancer 30 (EORTC-QLQ-C30) and European Organisation for Research and
Treatment of Cancer Quality of Life Questionnaire - Breast Cancer Module 23 (EORTC-BR23) were used
to characterize HRQL.
RESULTS:
Results revealed a 75% prevalence of symptoms affecting upper limb (pain or discomfort in arm, shoulder)
or breast, although the severity of the symptoms was only mild. Only 4.4% exhibited lymphedema and no
ROM restriction was observed. There was little limitation in functional performance of the upper limb, which
was associated with Arm Symptoms scale (EORTC BR-23). Impairments and functional performance of
upper limb did not interfere on HRQL perception, which was considered to be good.
CONCLUSION:
SLNB caused small impairments and limitation on the functional performance of the upper limb during ADL
and did not influence HRQL in our sample.
PMID: 21789365 [PubMed - in process]
Am J Phys Med Rehabil. 2011 May;90(5 Suppl):S69-75.
Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients.
Korpan MI, Crevenna R, Fialka-Moser V.
Source
From the Department of Physical Medicine and Rehabilitation, General Hospital Vienna, Vienna, Austria.
Abstract
Lymphedema therapy has gone by many names in the recent past, being referred to as complex
decongestive therapy, complex physical therapy, or decongestive lymphatic therapy, among others. There
are two phases of lymphedema treatment: the acute "intensive" phase and the maintenance phase. In the
acute phase of treatment, the individual is typically wrapped with medical short-stretch compression
bandages; receives a therapeutic exercise routine, skin care, and education; and undergoes manual lymphatic
drainage by a specially trained physical therapist or healthcare professional. In the maintenance phase, the
goals are for the individual to be able to wear a well-fitted appropriate gradient pressure garment during the
day and compression bandaging (or a device that serves as an alternative to bandaging) at night, to maintain
good skin care, to continue with therapeutic exercise, and to self-perform manual lymphatic drainage (or use
a mechanical device that can perform manual lymphatic drainage) for the area of the body with impaired
lymphatics. The effectiveness of the various components in each phase, as well as the motivation and
compliance of the patient, differs. Further randomized trials are required to determine which component or
combination of components in complex decongestive therapy works most effectively. It is recommended for
patients not only to maintain physical activity for its many health benefits but also to facilitate muscle pumping
to move lymphatic fluid throughout the body. Knowledge of some of the pathophysiologic mechanisms
involved in the development of lymphedema is increasing, and it is possible that current modes of treatment
of lymphedema will be augmented by molecular therapies in the future.
PMID:
21765266
[PubMed - in process]
Am J Phys Med Rehabil. 2011 May;90(5 Suppl):S5-S15.
Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy
interventions.
Silver JK, Gilchrist LS.
Source
From the Harvard Medical School, Department of Physical Medicine and Rehabilitation, Boston,
Massachusetts (JKS); and St Catherine University, Doctor of Physical Therapy Program, Minneapolis,
Minnesota (LSG).
Abstract
Cancer rehabilitation is an important part of survivorship as a distinct phase of treatment. Although cancer
rehabilitation may involve many disciplines, this article specifically covers evidence-based treatment in
physical and occupational therapy. Patients may need physical and occupational therapy services for a
variety of cancer-related or cancer-treatment-related problems, including pain, fatigue, deconditioning, and
difficulty with gait. They may also have problems resuming their previous level of function, which can impact
on activities of daily living, instrumental activities of daily living, return to previous home and community
activity levels, and return to work. This review discusses the role of physical and occupational therapy in
helping cancer patients improve pain and musculoskeletal issues, deconditioning and endurance effects,
fatigue, balance and falls, and lymphedema and psychosocial problems.
PMID:
21765263
[PubMed - in process]
Vascular. 2011 Jul 22. [Epub ahead of print]
Reconstructive surgery for chronic lymphedema: a viable option, but.
Lee BB, Laredo J, Neville R.
Source
Division of Vascular Surgery, Georgetown University School of Medicine, Washington, DC, USA.
Abstract
The aim of the paper is to assess the efficacy of reconstructive lymphatic surgery in the treatment of chronic
lymphedema via retrospective analysis. Lymphovenous anastomotic surgery (LVAS) or free lymph node
transplant surgery (FLTS) was performed on 32 patients who failed to respond to complex decongestive
therapy (CDT) alone for a minimum of a one-year period. In LVAS, three patients with good compliance
among 19 were able to maintain initial improvement through the four-year follow-up period. All three had
secondary lymphedema in clinical stage II. In FLTS, among 13 patients, three compliant patients with the
secondary lymphedema in clinical stage II kept initial improvement through the four-year follow-up. In
conclusion, reconstructive lymphatic surgery (LVAS and FLTS) appears to be more effective in secondary
lymphedema versus primary lymphedema when performed in the early stages. Patient compliance to
maintain CDT postoperatively remains the most critical factor in maintaining durable long-term results. FLTS
seems to have an additional risk involved to the donor lymph node harvest and a limited role compared to
LVAS. Further extended study on FLTS is required to demonstrate its efficacy compared with LVAS.
PMID:
21784876
[PubMed - as supplied by publisher]
Gynecol Oncol. 2011 Jul 21. [Epub ahead of print]
Tailoring adjuvant radiotherapy for stage IB-IIA node negative cervical carcinoma after radical
hysterectomy and pelvic lymph node dissection using the GOG score.
Yeo RM, Chia YN, Namuduri RP, Yap SP, Soong YL, Yam PK, Lim TY, Khoo-Tan HS.
Source
Department of Radiation Oncology, National Cancer Centre, Singapore.
Abstract
OBJECTIVE:
The use of adjuvant radiotherapy for early stage node negative patients varies for different institutions. The
recognized factors such as deep stromal invasion, lymph vascular space invasion, and size of tumor are the
most common factors cited for adjuvant radiotherapy. Studies done have shown that this increases local
control but may increase chronic toxicity rates. We report on our use of the GOG score to tailor our
treatment decisions.
METHODS:
A review of all patients staged IB-IIA who underwent Type 3 Radical Hysterectomy and pelvic lymph node
dissection (RH) from 1997 to 2007. The GOG score proposed by Delgado et al. was applied, and patients
were stratified into 3 groups; <40: no adjuvant treatment, 40-120: Small Field RT (SmRT), and >120:
Standard Field RT (StRT)
RESULTS:
A total of 126 patients matched these criteria. Sixty one patients underwent either SmRT or StRT. There
were only 2 known relapses and one death due to inter current illness. The median follow up was 57months
and the 5year Disease Free Survival was 98.2%. There were no documented Grade 3 or 4 chronic
toxicities. There were significantly less (p=0.025) patients with lower limb lymphedema in the SmRT group
compared to StRT.
CONCLUSION:
Our study confirms the utility of the GOG score to tailor radiotherapy for this cohort of patients. This has
been proven to be high in efficacy and low in morbidity.
Copyright © 2011 Elsevier Inc. All rights reserved.
PMID: 21782226 [PubMed - as supplied by publisher
Vasa. 2011 Jul;40(4):271-9.
Lymphedema and lipedema - an overview of conservative treatment.
Wagner S.
Source
RehaClinic Bad Zurzach, Switzerland.
Abstract
Lymphedema and lipedema are chronic progressive disorders for which no causal therapy exists so far.
Many general practitioners will rarely see these disorders with the consequence that diagnosis is often
delayed. The pathophysiological basis is edematization of the tissues. Lymphedema involves an impairment
of lymph drainage with resultant fluid build-up. Lipedema arises from an orthostatic predisposition to edema
in pathologically increased subcutaneous tissue. Treatment includes complex physical decongestion by
manual lymph drainage and absolutely uncompromising compression therapy whether it is by bandage in the
intensive phase to reduce edema or with a flat knit compression stocking to maintain volume.
PMID: 21780050 [PubMed - in process]
August 2, 2011
J Eur Acad Dermatol Venereol. 2011 Jul 29. doi: 10.1111/j.1468-3083.2011.04182.x. [Epub ahead of
print]
Do the filarial lymphoedema patients''3 months recall' on acute dermato-lymphangio-adenitis (ADLA)
correlate with streptococcal serology?
De Britto LJ, Das LK.
Source
Unit of Clinical Epidemiology & Chemotherapy, Vector Control Research Centre, Indian Council of
Medical Research, Pondicherry, India.
Abstract
Aim The aim of this study was to know the correlation of patients' 3 months recall on acute dermato-
lymphangio-adenitis (ADLA) with anti-streptolysin O (ASO) serology and its application as a tool to know
the burden of ADLA in the community. Methods Fifty-nine lymphoedema (LE) patients and 27 age
matched controls were clinically assessed for LE and the occurrence of ADLA during the previous 3
months was obtained by recall. After obtaining the informed consent, 2 mL of venous blood sample was
collected and ASO was quantified in Olympus AU400 auto-analyzer. Results When the results were
computed as two groups, controls and LE patients with no reported ADLA and LE patients with reported
ADLA (by 3 months recall), the ASO positivity and ASO titre was significantly higher in the later group
(P < 0.05). When the results were computed as three groups, controls with no reported ADLA, LE
patients with no reported ADLA and LE patients with reported ADLA, the ASO titre was significantly
higher in LE patients reported ADLA (P < 0.05). Conclusion As ASO was measured in post-infection
phase, we relied on the ASO titre for making conclusion. Patients' 3 months recall on ADLA correlates
with the ASO titre and therefore, it could be considered as a tool to measure the burden of ADLA in the
community. Multicentre community-based studies are needed to ascertain the findings.
© 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011
European Academy of Dermatology and Venereology.
PMID: 21797929 [PubMed - as supplied by publisher]
Scanning. 2011 Jul 27. doi: 10.1002/sca.20266. [Epub ahead of print]
August 3, 2011
You're in Control of the Cancer, It's not in Control of You - hcp.obgyn.net – By Janet George –
Name: Janet George
Age at diagnosis: 55
Year diagnosed: 1996
Janet George is a mother of three, grandmother of seven, and a breast cancer survivor. Her story began
after a routine mammogram. Janet's mother died of breast cancer, so regular mammograms have always
been part of her healthcare. Janet was notified that a small tumor had been found during a routine
mammogram, and her cancer was diagnosed after a wire localization biopsy.
That was the day she began her research. Janet called the national, state and local breast cancer
organizations for information about treatment options for her type of breast cancer. Janet is a firm believer
that women should read all the information available about their healthcare. Janet says, " I have to be in
charge of everything in my life, including breast cancer."
Janet consulted three surgeons before deciding on what treatment regimen she wanted. She found it
interesting that two male surgeons recommended mastectomy, while a female surgeon suggested
lumpectomy. Janet did some more research and found that survival rates were equal for the two procedures.
She decided to have a lumpectomy.
Janet then decided to check out the radiation therapy department at her local hospital. She is terribly
claustrophobic, and worried about being placed in a small chamber similar to an MRI machine. Her tour of
the radiation bays and laboratories assured her that claustrophobia would not be on her list of worries. It
was one more piece of information she needed to take control of the cancer and her life.
Janet's pathology report confirmed Ducto Carcinoma In Situ. She had 11 lymph nodes removed with the
cancerous lump and calcifications from her right breast. She then began four months of chemotherapy,
followed by seven weeks of radiation. She says that despite all her research, she still wasn't ready for the
side effects of treatment. Janet says, "It's just like delivery, everyone can explain what will happen and how it
will feel, but you just can not understand until you go through it." Janet says the tremendous support of her
medical team just couldn't prepare her for the loss of her toenails, or extremely painful mouth sores. Her
balance was affected, and the nausea reminded her of morning sickness. She also had strong cravings for
tomato sauce. Since the chemo, her veins have collapsed, and she wishes that a shunt had been used to
administer the treatment. She says these are all things that the nurse oncologists could have told her about,
and she still wouldn't have been prepared.
Janet decided ahead of time that the loss of her hair would not be a long process. As soon as her hair began
to fall out, she called her hairdresser and had her head shaved. Janet said she didn't want to be crying in the
shower, all alone, with clumps of hair in her hands. "I believe in you being in charge, not the cancer being in
charge," she says.
Janet felt the mental fight was just as important as the physical one. Janet would spend her time reading
about current research, talking with friends and family about her cancer, and doing research. That ended at 3
o'clock every day. She put aside the cancer and tried to have a normal evening, free of any discussion or
research. She even refused to answer the phone, in case it was someone calling about her health. Her
husband answered the phone instead.
Janet also made sure she dressed every day. It was important for her to have as normal a life as possible,
and for her to be in charge of her life. The excellent support she received from her family was vital, and she
only now understands how hard it was on her spouse. Her husband, Deryl, went with her to all her
treatments and stayed by her side. She says, at the time, all she could do was heal herself and not worry
about the other family members.
Janet says she often used imagery to help her get through the treatments and side effects. She imagined the
chemo as a pac-man game, with the little pac-man going through her body eating the cancer cells. Since the
radiation looks like a light beam, she imagined it was a fairy in a bubble floating through her body taking care
of the cancer cells. She also kept a journal of her thoughts and feelings, which she used to report to her
doctors.
Janet believes not enough is done to prevent lymphedema from returning. She asked to see a physical
therapist. Physical therapy after breast surgery, especially removal of the lymph glands, is designed to stretch
and strengthen arm muscles, prevent excess scar tissue formation, and reduce swelling and stiffness. Janet
says, "You don't realize how involved lymphedema is, you just don't want to mess with it, you could get it 20
years later." Janet does not like to have any procedures done on her arm where the lymph glands were
removed. She requests that all blood pressure and blood be drawn in her unaffected arm, and wears a
medical bracelet to prevent such procedures from being performed on that arm.
Janet has been taking tamoxifen(Drug information on tamoxifen) for four years now, and continues to have
good reports. She felt that her best information came from the PDQ Report from the National Cancer
Foundation, and encourages others to use the information available on the internet. She says, "Now that
women's illnesses are more researched, by golly do it."
August 3, 2011
BrightLife Direct Offers Allegro Jazz and Rumba Compression Garments - PR Newswire (press release) –
Compression clothing distributor adds microfiber compression stockings and legwear to its line-up of
products.
WASHINGTON, Aug. 3, 2011 /PRNewswire/ -- Brightlife Direct now carries two new lines of Allegro
compression garments. The Rumba and Jazz series both offer the soft comfort and modern technology of
microfiber. The latest styles are available through the Washington, DC-based compression clothing
distributor's website and are made in the USA.
"The microfiber material wicks moisture away from the skin and allows the legs and feet to breathe," said
Kip Bright, president of BrightLife Direct. "This is especially important in warm weather, when heat and
humidity cause those with edema or lymphedema to experience more swelling and discomfort."
The Allegro Jazz compression socks are a microfiber-cotton-spandex blend with the microfiber on the outer
layer and a cotton blend with spandex on the inside. It is available in two compression levels, 15-20 mmHg
and 20-35 mmHg. Similar to a men's dress sock but softer, these ribbed Allegro compression socks come
in black, white, tan and navy blue.
The Rumba series features three different nylon-microfiber-spandex blend compression garments. The 15-
20 mmHg closed toe knee-highs are easy to pull on and feature a reinforced heel and balloon toe. The
reinforced reciprocated heels prevent premature wear. The open toe/heel model, available in sand, provides
20-30 mmHg graduated compression.
Also new from Allegro's Rumba series is a leg sleeve with 18-24 mmHg compression. It is an opaque
microfiber-nylon blend available in beige or black. The leg sleeves resemble support socks without feet and
are growing in popularity among runners.
About BrightLife Direct, Inc.: BrightLife Direct (http://www.brightlifedirect.com/) has been serving those
who wear compression garments for more than 10 years. The Washington, DC-based company offers name
brand products at discounted prices. This includes compression stockings from jobst, Mediven, Sigvaris and
Juzo. The company features a private label brand, Allegro stockings, which meets all rigorous testing
standards and is available at 50% to 60% less than name brands. BrightLife Direct also offers arm
compression sleeves and compression gloves for those with lymphedema, Orthaheel footwear for people
requiring orthotics and products for plantar fasciitis treatment.
August 4, 2011
Lymphedema Framework Conference raises profile of the chronic and debilitating condition - Canada
NewsWire (press release) –
LONDON, ON, Aug. 4, 2011 /CNW/ - Held last month in Toronto, the third International Lymphedema
Framework Conference raised the profile of lymphedema in Canada. Conference attendees - who included
430 delegates from 24 countries - gathered to learn and share from key opinion leaders from around the
world. The event is a tremendous step in educating health professionals who treat lymphedema patients in
their daily practice and need to be better equipped.
The two day conference featured updates on latest research, best practices and suggestions to tackle global
challenges in lymphedema management. The Lymphedema Association of Ontario (LAO), co-organizers of
the conference, hope that the excitement generated at the conference will bring much needed attention to this
important condition.
Anna Kennedy, LAO's Executive Director stated, "This was a unique opportunity for Canadians to
participate in a lymphedema global event; networking and learning from their international colleagues. Being
exposed to the advances in other countries will incentivize us even more to advocate for better treatment of
lymphedema here in our own country. Canadian lymphedema patients deserve no less".
A bustling exhibit hall also displayed the latest in innovations for the diagnosis, measurement and treatment of
lymphedema. Included was the official launch of 3M™ Coban™ 2 Layer Compression System for
Lymphedema Intensive Therapy, a breakthrough in intensive therapy compression bandaging for patients
suffering with lymphedema in Canada. ILF delegates got a hands-on look at this new treatment option in a
workshop setting, where they learned application techniques to provide patients with comfort and improved
mobility, compared to traditional bandaging methods.
For more information about 3M™ Coban™ 2 Layer Compression System visit www.3M.ca/coban2layer.
For more information about the Lymphedema Association of Ontario (LAO), contact Anna Kennedy,
Executive Director by phone (416-410-2250) or by email (anna@lymphontario.ca).
About 3M Canada
Established in 1951, 3M Canada Company was one of the first international subsidiaries opened by 3M and
remains one of the largest. 3M Canada's head office and original manufacturing site is in London, Ontario
where approximately half of the company's 1,800 employees work. Other locations include Toronto,
Brockville, and Perth, Ontario and Morden, Manitoba. Globally, 3M has operations in more than 65
countries and captures the spark of new ideas and transforms them into thousands of ingenious products.
Our culture of creative collaboration inspires a never-ending stream of powerful technologies that make life
better.
About the Lymphedema Association of Ontario
Celebrating its 15th anniversary, the Lymphedema Association of Ontario (LAO) has been supporting,
educating and advocating on behalf of lymphedema patients and their families for a better quality of life
throughout the years. Their commitment remains strong: to raise awareness and promote education through
their support line, website, their publication entitled Lymphedema Matters and an annual conference. The
LAO is proud of its role in co-hosting the recent 2011 3rd International Lymphoedema Conference from
June 16-18, 2011.
Job Fair hosted by mall features 40-plus retailers - nwitimes.com – by Sue Reed –
Westfield Southlake Mall in Hobart is hosting a Job Fair from noon to 7 p.m. Aug. 13.
More than 40 retailers will be on hand for job seekers to meet, apply and interview with. Some of the
retailers planning to participate are Best Buy Mobile, Chipotle, Macy's, Carson Pirie Scott and Radio
Shack. Full-time, part-time, hourly and management positions are available.
For more information, contact the Westfield Concierge at (219) 738-2260 or visit the concierge on the
upper level by Macy's for job postings.
Lymphedema program set
Franciscan St. Anthony Health Crown Point will offer its quarterly program, "Prevention and Management
of Lymphedema," at noon Aug. 23 in the Breast Care Center on the third floor of the Burrell Cancer Center,
next to the hospital at 1201 S. Main St., Crown Point.
Lorraine Skolak, a nationally certified lymphedema therapist, will discuss how lymphedema can occur any
time after lymph node dissection and how simple lifestyle changes can help prevent its onset. She also will
explain self-management techniques. Seating is limited. Call (219) 757-6010.
ATHENA nominations
Crossroads Regional Chamber of Commerce and First Midwest Bank are accepting nominations for the
ATHENA Leadership Award, which will be presented to an exemplary leader who has achieved excellence
in their business or profession, served the community in a meaningful way and, most importantly, actively
assisted women to achieve their full leadership potential.
The award presentation will be held Nov. 19 at the chamber's Annual Gala at the Radisson at Star Plaza
Hotel in Merrillville.
Founded nearly 30 years ago, ATHENA International is a women's leadership organization that supports,
develops and honors women leaders through the programs it administers. ATHENA's flagship program, the
ATHENA Leadership Award Program, has honored more than 6,000 women leaders since 1982.
The program is facilitated locally by the Crossroads Regional Chamber of Commerce, a licensed ATHENA
host organization. Recipients are selected by a diverse group of community leaders based on the criteria
above.
Nomination forms are available at the chamber's Merrillville office, 255 W. 80th Place, and must be
submitted by Aug. 25. Call the office at (219)769-8180.
Fitness expert turns author
Angela Ramos, owner of Inspiration Fitness, recently joined a select group of leading health and fitness
entrepreneurs to co-write the health and fitness book, "3 Steps To Your Best Body In Record Time:
America's Leading Fitness Experts Reveal The Proven 3-Step System To The Body You Always Wanted .
. . In Minimum Time."
Ramos contributed the chapter "Kettlebells For Women's Fat Loss."
On the day of its release, the book skyrocketed to best-seller status on Amazon.com, reaching as high as
No. 69 overall in the Amazon Top 100. The book reached No. 1 in both the Quick Workouts and Weight
Training Categories, No. 3 in the Exercise and Fitness category and No. 24 in Health, Mind and Body
Category.
Sue Reed is executive director of Crossroads Regional Chamber of Commerce. Reach her at (219) 769-
8180 orgeninq@crossroadschamber.org. Opinions expressed are solely those of the writer
August 5, 2011
A New Way to Raise Breast Cancer Awareness - Woman's Day – by Barbara Brody –
Bored of bake sales and 5K walk-a-thons? If you’re looking for a more creative way to raise awareness of
breast cancer, you might want to give dragon boating a dry.
Yes, dragon boating. I recently met with some reps from the Mayo Clinic, who told me about the growing
interest in dragon boating for breast cancer awareness. These teams—including one based at the Mayo
Clinic—are participating in competitions and festivals around the country. Next up: the Badger Lake Dragon
Boat Bash in Fort Dodge, Iowa, which is set for August 26-28.
Dragon boating is an ancient Chinese sport that requires immense teamwork: It usually entails 20 paddlers, a
steerer and a drummer working together to synchronize their motions as they race a painted boat that’s been
decorated with a dragon head and tail.
Of course, it’s great exercise, but it wasn’t always clear that it was great for breast cancer survivors: After
breast surgery there’s an increased risk of lymphedema (a blockage of the lymph system that can cause
major arm swelling), so for years patients were told not to do any strenuous upper body exercise. But a
recent Mayo Clinic study proved that not only is this kind of activity safe for survivors; it’s actually beneficial
because it might reduce the risk of lymphedema (as long as you start slow and work your way up).
Sleep Apnea: A New Use for Compression Stockings - Massage Magazine –
Compression stockings are well-known to massage therapists who also practice lymphedema therapy. New
research shows wearing compression stockings may be a simple, low-tech way to improve obstructive sleep
apnea in patients with chronic venous insufficiency.
"We found that in patients with chronic venous insufficiency, compression stockings reduced daytime fluid
accumulation in the legs, which in turn reduced the amount of fluid flowing into the neck at night, thereby
reducing the number of apneas and hypopnea by more than a third," said Stefania Redolfi, M.D., of the
University of Brescia in Italy, who led the research.
To investigate whether compression stockings could alleviate this problem, the researchers recruited
subjects from the chronic venous insufficiency clinic at La Pitié-Salpêtrière hospital in Paris, according to a
press release from the American Thoracic Society. Twelve patients were randomly assigned to one week of
wearing the compression stockings or to a one-week control period without compression stockings.
At the end of the first week, they crossed over to the other arm of the study. Each subject underwent
polysomnography and overnight changes in leg fluid volume and neck circumference were measured at
baseline and at the end of the compression stockings and control periods.
At the end of the compression-stocking period, subjects had an average of a 62-percent reduction in
overnight leg fluid volume change as compared to when they did not wear the stockings.
Patients also had a 60-percent reduction in neck circumference increase, which the researchers used as a
proxy measurement to estimate fluid shift into the neck, and a 36-percent reduction in the number of apneas
and hypopnea per hour of sleep.
August 12, 2011
Arch Argent Pediatr. 2011 Aug;109(4):e77-81.
[Amniotic band sequence and bilateral choanal atresia: a case report].
[Article in Spanish]
Del Toro-Valero A, Estrada-De la Fuente A, Velázquez Santana H, Glicerio González J, Navarro Meza
MC, Ortega-Hinojosa L, López-Cardona MG.
Source
Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara,
Guadalajara, Jalisco, México.
Abstract
Amniotic band sequence (ABS) is a group malformation that mainly affects limbs; clinically, constriction rings
and lymphedema of the fngers, arms and legs, acrosyndactyly and pseudosyndactyly are observed; also
there is congenital amputation of limbs due to distal swelling. Less frequently, craniofacial and trunk
involvement are reported in some patients. Etiology is still unknow and most cases are isolated. In this report
we present the case of a 45-day-old male with diagnosis of SBA and bilateral choanal atresia as attached
fnding, and review possible causes of SBA and associated alterations.
PMID:
21829862
[PubMed - in process]
Rev Med Liege. 2011 May-Jun;66(5-6):336-40.
[Sentinel lymph node biopsy and axillary reverse mapping: a tailoring axillary staging in breast cancer].
[Article in French]
Cusumano P, Bleret V, Nos C, Hustinx R, Lilet H, Gomez P, Lifrange E.
Source
Service de Sénologie, CHU de Liège, Belgique. gcusumano@chu.ulg.ac.be
Abstract
The status of the axillary lymph nodes is one of the most important prognostic factors in women with early
stage breast cancer. Histologic examination of removed lymph nodes is the most accurate method for
assessing spread of disease to these nodes. Axillary lymph node dissection (ALND) remains the standard
approach for women who have clinically palpable axillary nodes. The benefits of ALND include its impact
on disease control (axillary recurrence and survival), its prognostic value, and its role in treatment selection.
However, the anatomic disruption caused by ALND may result in lymphedema, nerve injury, and shoulder
dysfunction, which compromise functionality and quality of life. For patients who have clinically negative
axillary lymph nodes, sentinel lymph node (SLN) biopsy offers a less morbid method to determine if there
are positive nodes, in which case axillary node dissection would be necessary. Patients who are SLN-
positive should undergo complete ALND. Axillary reverse mapping (ARM) is a recent improvement of
ALND which, like the biopsy of the GS, would reduce morbidity.
PMID:
21826973
[PubMed - in process]
Arch Ital Urol Androl. 2011 Jun;83(2):95-8.
Giant scrotal lymphedema as unique onset sign of muscle-invasive bladder cancer. The risk of a misdiagnosis.
Boscolo-Berto R, Viel G, Lamon C, Agostini A, Vezzaro R, Gardiman M, Montisci M, Raduazzo DI.
Source
Department of Environmental Medicine and Public Health, Section of Legal Medicine and Forensic
Pathology, University of Padova, Italy. rafael.boscoloberto@unipd.it
Abstract
A 78-year-old male presented complaining voiding low urinary tract symptoms associated to genital
weightiness over the past few years. Grossly the lesion was only interesting the scrotum, for an about 7.5 kg
mass. The scrotum was minimally tender, with an intact skin bereft of erythema or inflammation, lower limb
lymphedema, inguinal/crural lymphadenopathy. Despite repeated urinary cytologies were negative, an
abdominal CT and urethrocystoscopy confirmed a muscle-invasive transitional cell carcinoma affecting the
bladder. The surgical strategy included a direct excision of the giant scrotum with local tissue reconstruction
and a radical cystectomy with ileal conduit. This is the first time it's noted a giant scrotal lymphedema as the
unique onset sign of a muscle invasive transitional cell carcinoma of the bladder otherwise clinically silent. In
this clinical setting, a differential diagnosis has always to be carried out, as bladder cancer is a life-threatening
disease requiring an aggressive approach.
PMID:
21826882
[PubMed - in process]
J Surg Oncol. 2011 Aug 8. doi: 10.1002/jso.22058. [Epub ahead of print]
Surgical resection for bulky or recurrent axillary metastatic melanoma.
Shada AL, Walters DM, Tierney SN, Slingluff CL Jr.
Source
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia.
Abstract
INTRODUCTION:
Metastatic melanoma has few FDA approved treatments, and aggressive surgical resection has to be
considered for management of bulky axillary metastases. We hypothesized that axillary resection in this
setting is well tolerated and improves symptoms in the majority of patients.
METHODS:
We reviewed a prospectively collected database and identified 47 stage IIIC and IV patients with axillary
nodal disease greater than 5 cm (68%), recurrent disease (36%), or disease adherent to axillary
neurovascular structures (45%). Paresthesias, pain, and bleeding were present in 40% of patients, and were
stable or improved after surgery in 75%. Most patients were asymptomatic prior to resection, and
underwent resection for prevention of potential symptoms.
RESULTS:
Most patients underwent outpatient surgery. Postoperative complications included lymphedema (34%),
range of motion limitation (23%), wound infection (17%), and neuropathic pain (17%). Among symptomatic
patients, average time to progression was 3 months, compared to 9.5 months in asymptomatic patients (P
= 0.08). Five-year survival was lower (16%) in symptomatic patients than in asymptomatic patients (35%,
P = 0.001).
DISCUSSION:
Surgery for bulky axillary melanoma metastases is well tolerated, and should be considered in the
management of Stage III or IV melanoma. Resection prior to symptoms may improve quality of life and is
associated with longer survival. J. Surg. Oncol. © 2011 Wiley-Liss, Inc.
Copyright © 2011 Wiley-Liss, Inc.
PMID:
21826672
[PubMed - as supplied by publisher]
Cancer Radiother. 2011 Aug 4. [Epub ahead of print]
[Management of inflammatory breast cancer after neo-adjuvant chemotherapy.]
[Article in French]
Abrous-Anane S, Savignoni A, Daveau C, Pierga JY, Gautier C, Reyal F, Dendale R, Campana F, Kirova
Y, Fourquet A, Bollet MA.
Source
Service d'onco-radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris cedex 05, France.
Abstract
PURPOSE:
To assess the benefit of breast surgery for inflammatory breast cancer.
PATIENTS AND METHODS:
This retrospective series was based on 232 patients treated for inflammatory breast cancer. All patients
received primary chemotherapy followed by either exclusive radiotherapy (118 patients, 51%) or surgery
with or without radiotherapy (114 patients, 49%). The median follow-up was 11 years.
RESULTS:
The two groups were comparable apart from fewer tumors smaller than 70mm (43% vs 33%, P=0.003), a
higher rate of clinical stage N2 (15% vs 5%, P=0.04) and fewer histopathological grade 3 tumors (46% vs
61%, P<0.05) in the no-surgery group. The addition of surgery was associated with a significant
improvement in locoregional disease control (P=0.04) but with no significant difference in overall survival
rates or disease-free intervals. Late toxicities were not significantly different between the two treatment
groups except for a higher rate of fibrosis in the no-surgery group (P<0.0001), and more lymphedema in the
surgery group (P=0.002).
CONCLUSION:
Our data suggest an improvement in locoregional control in patients treated by surgery, in conjunction with
chemotherapy and radiotherapy, for inflammatory breast cancer.
Copyright © 2011 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All
rights reserved.
PMID:
21820933
[PubMed - as supplied by publisher]
Physiotherapy. 2011 Sep;97(3):234-43. Epub 2010 Dec 4.
Postmastectomy lymphoedema: different patterns of fluid distribution visualised by ultrasound imaging
compared with magnetic resonance imaging.
Tassenoy A, De Mey J, De Ridder F, Van Schuerbeeck P, Vanderhasselt T, Lamote J, Lievens P.
Source
Department of Rehabilitation Research, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels,
Belgium.
Abstract
OBJECTIVES:
Postmastectomy lymphoedema remains a disabling complication caused by treatment for breast cancer. The
increased thickness of the dermal layer and the increased volume of the subcutis represent the most
important contributions to the total swelling of the arm. Ultrasound imaging of the subcutaneous layer results
in different patterns of reflected ultrasound waves depending on the morphological alternations that occurred
due to impaired lymphatic drainage. The aim of this study was to compare these echographic images with
those obtained using magnetic resonance imaging to explain the nature of the morphological changes.
DESIGN:
Observational study.
SETTING:
Patients were recruited from the Breast Clinic at the University Hospital Brussels.
PARTICIPANTS:
Seven women (mean age 60 years) with unilateral breast cancer who subsequently developed lymphoedema.
MAIN OUTCOME MEASURES:
The water displacement technique was applied to determine arm volumes, and echographic and magnetic
resonance images were used to evaluate changes in tissue structures.
RESULTS:
Volumetric measurements of the arm (mean affected arm 3241ml vs unaffected arm 2538ml) showed a
significant increase in total arm volume of 703ml (95% confidence interval 324 to 1084ml). Using
echography, the thickness of the dermal and subcutaneous layers showed an average increase of 0.2 to 0.8
mm and 3.9 to 7.2mm, respectively. The differences between the affected arm and the unaffected arm for all
upper and lower arm measurements (i.e. volumetry, dermal and subcutaneous thickness) were significant,
but no significant differences were registered for hand measurements. On echography, the dermis showed
uniform changes, with a homogenous hypo-echogenic appearance compared with the contralateral side due
to water influx. Different patterns of structural changes could be visualised within the subcutis: (1) uniformly
hypo-echogenic due to the diffuse spread of water through the subcutis; (2) hyperechogenic areas
surrounded by hypo-echogenic streaks visualised on magnetic resonance imaging as adipose tissue
surrounded by fluid embedded in fibrous tissue; and (3) homogenously hyperechogenic due to the
overgrowth of adipose tissue with a minimal amount of water.
CONCLUSIONS:
Echographic images can help to determine the likelihood that complex physical therapy will reduce
lymphoedema, and evaluate treatment results by measuring tissue thickness and evaluating tissue consistency.
Copyright © 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
PMID:
21820542
[PubMed - in process]
August 16, 2011
Ann Surg Oncol. 2011 Aug 12. [Epub ahead of print]
Reply to Letter to the Editor "Lymphoedema in the Observation and Biopsy Arms of MSLT-1" by Thomas,
J Meirion (ASO-2011-04-0666).
Faries MB, Morton DL, Cochran AJ, Thompson JF.
Source
Department of Surgery, Yale School of Medicine, New Haven, CT, USA, mark.faries@yale.edu.
PMID:
21837533
[PubMed - as supplied by publisher]