- The Effectiveness of the Sport "Dragon Boat Racing" in Reducing the Risk of Lymphedema Incidence: An Observational Study. [Journal Article]
- CNCancer Nurs 2018 Jun 22
- CONCLUSIONS: The dragon boat sport participants had more positive clinical and QoL outcomes than did the women who did not participate in that sporting activity.It would be important to make women with breast cancer aware of the practice of dragon boat racing.
- Bioelectrical impedance analysis; a new method to evaluate lymphoedema, fluid status, and tissue damage after gynaecological surgery - A systematic review. [Review]
- EJEur J Obstet Gynecol Reprod Biol 2018 Jun 18; 228:111-119
- The aim of this descriptive review is to summarise the current knowledge of non-invasive bioelectrical impedance analysis (BIA) used with gynaecological surgical patients in regard to postoperative d...
The aim of this descriptive review is to summarise the current knowledge of non-invasive bioelectrical impedance analysis (BIA) used with gynaecological surgical patients in regard to postoperative development of lymphoedema and determination of perioperative fluid balance, and as a prognostic factor in cancer mortality and a predictor of postoperative complications. The databases PubMed, MEDLINE, Scopus Web of Science, the Cochrane Library, and reference lists of selected articles were searched for relevant articles published during the period January 2008-April 2018. Only papers published in English were retrieved. Thirty-seven articles were evaluated. Where gynaecological studies were lacking, studies with a study population from neighbouring clinical fields were used instead. Studies on the clinical use of BIA with gynaecological surgical patients were divided into three categories: the postoperative development of lower limb lymphoedema (n = 7), perioperative hydration measuring (n = 3), and the BIA parameter phase angle as a prognostic factor in cancer survival and as predictive for postoperative complications (n = 6). Of these 16 studies only three used a pure gynaecological study population. Three different methods of BIA were used in these articles: single frequency-BIA, multifrequency-BIA and bioimpedance spectroscopy. BIA was found to detect lymphoedema with a sensitivity of 73% and a specificity of 84%. Studies indicated that BIA was able to detect lower limb lymphoedema at an early stage even before it became clinically detectable. During postoperative hydration measurements, an increase in extracellular fluid volume and extracellular fluid volume in relation to total body fluid volume, as well as a decrease in phase angle, were associated with higher frequencies of postoperative complications. Moreover, low values for the phase angle have been associated with increased mortality in cancer patients. However, the number of studies in this field was limited. From our review, BIA seems to be a useful tool for use in the clinical setting of the gynaecological surgical patient. The theoretical approach of using bioelectrical impedance values to measure the fluid distribution in the body compartments offers wide opportunities in the clinical setting. However, so far, all studies have set up cut-off limits within the study population, and reference values for a general population need to be defined. There are also rather few studies on a gynaecological study population. Hence, there is a need for further studies within gynaecological surgery focusing on early detection of lower limb lymphoedema, perioperative fluid balance, and postoperative complications in order to establish the value of BIA in clinical praxis.
- Absence of IL-17A in Litomosoides sigmodontis-infected mice influences worm development and drives elevated filarial-specific IFN-γ. [Journal Article]
- PRParasitol Res 2018 Jun 22
- Lymphatic filariasis, onchocerciasis and loiasis are widespread neglected tropical diseases causing serious public health problems and impacting the socio-economic climate in endemic communities. Mor...
Lymphatic filariasis, onchocerciasis and loiasis are widespread neglected tropical diseases causing serious public health problems and impacting the socio-economic climate in endemic communities. More than 100 million people currently suffer from filarial infections but disease-related symptoms and infection-induced immune mechanisms are still ambiguous. Although most infected individuals have dominant Th2 and regulatory immune responses leading to a homeostatic regulated state, filarial-induced overt pathology like lymphedema, dermal pathologies or blindness can occur. Interestingly, besides dominant Th2 and regulatory T cell activation, increased Th17-induced immune responses were associated with filarial infection and overt helminth-induced pathology in humans. However, the immunological mechanisms of Th17 cells and the release of IL-17A during filarial infections remain unclear. To decipher the role of IL-17A during filarial infection, we naturally infected IL-17A-/- and wildtype C57BL/6 mice with the rodent filariae Litomosoides sigmodontis and analysed parasite development and immune alterations. Our study reveals that infected IL-17A-deficient C57BL/6 mice present reduced worm burden on days 7 and 28 p.i. but had longer adult worms on day 28 p.i. in the thoracic cavity (TC), the site of infection. In addition, infiltration of CD4+ T cells, CD4+Foxp3+ regulatory T and functional CD4+Rorγt+pStat3+ Th17 cells in the TC was reduced in IL-17A-deficient mice accompanied by reduced eotaxin-1 and CCL17 levels. Furthermore, mediastinal lymph node cells isolated from IL-17A-/- mice showed increased filarial-specific IFN-γ but not IL-4, IL-6, or IL-21 secretion. This study shows that Th17 signalling is important for host immune responses against filarial infection but appears to facilitate worm growth in those that reach the TC.
- Critical Ischemia Time, Perfusion and Drainage Function of Vascularized Lymph Nodes. [Journal Article]
- PRPlast Reconstr Surg 2018 Jun 12
- CONCLUSIONS: The critical ischemia time of vascularized lymph nodes is five hours in the rodent animal model, verified by ICG lymphatic fluid uptake, laser Doppler perfusion, and histologic assessments. Interestingly, lymphatic drainage and perfusion of vascularized lymph nodes were improved with an increased ischemia time before the critical five hours was reached.
- Validation of a short form FLQA-LS quality of life instrument for lymphedema. [Journal Article]
- BJBr J Dermatol 2018 Jun 21
- CONCLUSIONS: FLQA-LS is an improved version of the FLQA-L questionnaire for chronic lymphedema. It demonstrated validity and feasibility and can be easily used in clinical practice and research studies. This article is protected by copyright. All rights reserved.
- Combined physiologic and excisional therapies improve cancer-related lymphedema outcomes. [Journal Article]
- CCCA Cancer J Clin 2018 Jun 21
- Enhancement of Lymphatic Vessels in the Superficial Layer in a Rat Model of a Lymphedematous Response. [Journal Article]
- PRPlast Reconstr Surg Glob Open 2018; 6(5):e1770
- CONCLUSIONS: We have obtained solid evidence showing the differential potency of lymphatic vessels between the superficial and the deep layers after temporal lymphedematous induction. Further analysis of lymphedematous responses in animal models could provide new insights into the challenges associated with the clinical treatment of lymphedema.
- The Chimeric Versatility of the Subscapular System Revisited: Backup Options, Coverage for Bone Transplants and Vascularized Lymph Nodes. [Journal Article]
- PRPlast Reconstr Surg Glob Open 2018; 6(5):e1765
- Traumatic soft tissue and bone defects are demanding challenges for the reconstructive microsurgeons. Common and safe workhorses for these reconstructions are free microvascular flaps based on the su...
Traumatic soft tissue and bone defects are demanding challenges for the reconstructive microsurgeons. Common and safe workhorses for these reconstructions are free microvascular flaps based on the subscapular system. In this article, we want to demonstrate the versatility of the serratus anterior muscle combined with other components of the subscapular system for reconstruction of complex lower extremity defects. Three patients with traumatic soft tissue and bone defects of the lower extremity were planned for reconstruction. The defects varied in size and could be covered by 1 or 2 slips of the serratus muscle or split muscle combined with latissimus dorsi muscle flap. In 1 case, the thoracodorsal lymph node package was included for addressing severe posttraumatic lymphedema after burn injury. In another case, the serratus slips served as coverage for a free scapula bone transplant. The chimeric flaps healed without complications; no further operations were needed for reconstruction. By the use of only 1 or 2 slips of the serratus muscle, we could prevent functional impairments for the patients and reduced further scarring compared with classic latissimus dorsi-(para-) scapular combinations.
- Indocyanine green lymphography for diagnosis of lymphedema following thigh lift surgery. [Letter]
- MMicrosurgery 2018 Jun 19
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- The importance of indocyanine green near-infrared fluorescence angiography in perfusion assessment in vascularized omentum lymphatic transplant. [Journal Article]
- JSJ Surg Oncol 2018 Jun 19
- CONCLUSIONS: Normal flap perfusion is a requisite for successful VOLT harvest. However, over half the patients had some degree of abnormal perfusion irrespective of prior abdominal surgery. Indocyanine green angiography is an important tool in ensuring a healthy lymphatic reconstruction.