- MR lymphography in patients with upper limb lymphedema: The GPS for feasibility and surgical planning for lympho-venous bypass. [Journal Article]
- JSJ Surg Oncol 2018 Aug 16
- CONCLUSIONS: MR lymphangiography is an accurate and reproducible method for imaging and mapping of lymphatic channels in the lymphedemateous limb.
- Upper Extremity Subcutaneous Lymphatic Drainage "Lymphocentesis" for Symptom Relief in End-Stage Breast Cancer. [Journal Article]
- AJAm J Hosp Palliat Care 2018 Aug 13; :1049909118792179
- Lymphedema is a challenging condition that occurs as a complication to many life-limiting medical conditions. It has a number of associated symptoms including pain, functional impairments, and emotio...
Lymphedema is a challenging condition that occurs as a complication to many life-limiting medical conditions. It has a number of associated symptoms including pain, functional impairments, and emotional distress. Majority of treatment interventions have been studied and applied outside of the palliative care context. Subcutaneous drainage is a technique that has been used in some case reports for the lower extremity and sacrum with good results. This report describes an adapted technique of subcutaneous drainage for treating upper extremity lymphedema in the palliative setting.
- Assessment of limb edema in pediatric post-thrombotic syndrome. [Journal Article]
- RPRes Pract Thromb Haemost 2018; 2(3):591-595
- CONCLUSIONS: Our findings suggest that patient/proxy-reported and clinician-assessed limb edema measure slightly different aspects of PTS, justifying their inclusion in pediatric PTS tools. In addition, proxy-reported swelling was in closer agreement with clinician-assessed total limb size (ie, observed edema), and patient-reported swelling in the LE seemed to reflect limb fluid content (ie, perceived edema).
- Characteristics of pain, other symptoms and function in pediatric post-thrombotic syndrome. [Journal Article]
- RPRes Pract Thromb Haemost 2018; 2(2):334-338
- CONCLUSIONS: Tired limb, heaviness, pain, and impaired endurance were the most frequent clinical findings in pediatric PTS. Frequency of symptoms and pain intensity did not differ between upper and lower extremities. Pain was associated with the presence of other symptoms and impaired function, but not with activity limitation and participation restriction. Better tools are needed to measure these two latter aspects of health.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Kwashiorkor is a disease marked by severe protein malnutrition and bilateral extremity swelling. It usually affects infants and children, most often around the age of weaning through age 5. The disea...
Kwashiorkor is a disease marked by severe protein malnutrition and bilateral extremity swelling. It usually affects infants and children, most often around the age of weaning through age 5. The disease is seen in very severe cases of starvation and poverty-stricken regions worldwide. In the 1950s, it was recognized as a public health crisis by the World Health Organization. However, there was a delay in its recognition, because most cases of childhood death were reported as being from diseases of the digestive system or infectious etiology. Since then, various relief efforts were aimed at eradicating it. As scientists continued to investigate the natural history of the disease in children, they discovered something very striking. Children who were dying from "digestive system diseases" and presenting with diarrhea, cough, coryza, and shortness of breath also were having symptoms of kwashiorkor during this time (pitting edema, anorexia, skin changes, etc.). This finding led to the medical conundrum of whether kwashiorkor was the primary or the secondary cause of death. It was concluded to be the secondary cause of death because many cases of the disease would not have developed without the precipitating stress of diarrhea, dehydration and other infectious diseases such as HIV and measles. While kwashiorkor is a disease of edematous malnutrition, marasmus is similar in appearance. Marasmus is known as the wasting syndrome (malnutrition without edema). Children typically have a depletion of body fat stores, low weight for height, and reduced mid-upper arm circumference. Other features of the disease can include thin, dry skin; a head that appears large relative to the body; an emaciated, weak appearance; bradycardia; hypotension; hypothermia; and thin, shrunken arms, thighs, and buttocks with redundant skin folds.
- A Modified String Technique for Atraumatic Ring Removal. [Journal Article]
- JEJ Emerg Med 2018; 55(2):240-243
- CONCLUSIONS: This multisuture technique adds to the armamentarium of methods for ring removal in the setting of upper-extremity trauma without reverting to alternate techniques for cutting or shattering the ring.
- An Assessment of the Relationship Between Abdominal Obesity and the Severity of Upper Extremity Lymphedema. [Journal Article]
- LRLymphat Res Biol 2018 Jun 05
- CONCLUSIONS: Abdominal obesity was significantly correlated with increased MCD and should be considered along with obesity as an aggravating factor for lymphedema severity.
- Subcutaneous oedema of upper limbs heralding an aggressive form of dermatomyositis. [Journal Article]
- BCBMJ Case Rep 2018 May 30; 2018
- Subcutaneous oedema is a rare presenting clinical manifestation of dermatomyositis. In this case, we report a 44-year-old man presenting with bilateral upper extremity predominant swelling and weakne...
Subcutaneous oedema is a rare presenting clinical manifestation of dermatomyositis. In this case, we report a 44-year-old man presenting with bilateral upper extremity predominant swelling and weakness. The proximal muscle weakness, dysphagia and presence of Gottron's papules as well poikiloderma like skin changes led to the clinical diagnosis of dermatomyositis. He received aggressive treatment with high-dose glucocorticoids and required intravenous immunoglobulin with improvement in his symptoms.
- Reduction mammoplasty as a treatment for symptomatic central venous stenosis. [Journal Article]
- APArch Plast Surg 2018; 45(2):171-176
- Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to,...
Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.
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- An unusual manifestation of olfactory neuroblastoma. [Journal Article]
- BCBMJ Case Rep 2018 Mar 13; 2018
- A 62-year-old woman presented with an 11-month history of worsening nasal symptoms of rhinorrhoea, anosmia, nasal congestion and intermittent epistaxis. MRI revealed a large mass in the upper nasal v...
A 62-year-old woman presented with an 11-month history of worsening nasal symptoms of rhinorrhoea, anosmia, nasal congestion and intermittent epistaxis. MRI revealed a large mass in the upper nasal vault. Biopsy of the mass revealed an olfactory neuroblastoma. While waiting resection, she acutely developed severe proximal muscle weakness, lethargy and lower extremity oedema. Blood glucose was elevated, and hypokalaemic metabolic alkalosis was noted. Elevated serum cortisol level of 95.7 µg/dL (8.7-22.4 µg/dL) and markedly elevated 24-hour urinary cortisol level of 6962.3 µg/24 hours (4.0-50.0 µg/24 hours) with concurrent adrenocorticotropic hormone (ACTH) level of 171 pg/mL (6-58 pg/mL) were suggestive of an ACTH-dependent source of hypercortisolism. A subsequent positive high-dose dexamethasone suppression test was consistent with ectopic ACTH production. She underwent near-total resection of the right nasal mass followed by radiotherapy, resulting in complete resolution of signs and symptoms of cortisol excess.