Exogenous lipoid pneumonia is a rare and under recognized pulmonary disorder caused by the inhalation or aspiration of fat-like substances.Nasal decongestants containing mineral oils or paraffin are emerging as overlo...Exogenous lipoid pneumonia is a rare and under recognized pulmonary disorder caused by the inhalation or aspiration of fat-like substances.Nasal decongestants containing mineral oils or paraffin are emerging as overlooked etiological agents.This review consolidates existing literature to delineate the clinical,radiological,and pathological features of exogenous lipoid pneumonia induced by nasal decongestants,highlight diagnostic challenges,and underscore the importance of thorough patient history in early diagnosis and management.This condition,while preventable,can result in serious pulmonary complications if not recog-nized early.It necessitates a multidisciplinary approach that incorporates careful history taking,high-resolution imaging,cytological assessment,and public health vigilance.展开更多
Dear Sir,We hereby report a case of bilateral acute angle closure glaucoma secondary to a systemic decongestant containing pseudoephedrine freely available over the counter.Acute angle closure glaucoma is an ocular em...Dear Sir,We hereby report a case of bilateral acute angle closure glaucoma secondary to a systemic decongestant containing pseudoephedrine freely available over the counter.Acute angle closure glaucoma is an ocular emergency.Delayed recognition and treatment inevitably leads to permanent visual impairment.Acute angle closure occurs as a result of obstruction to aqueous drainage by blockage of the trabecular meshwork by the iris.Typical presenting symptoms include acute onset of ocular pain,headache and blurred vision.On clinical examination,it is characterized by a markedly raised IOP of above 21 mm Hg together with展开更多
This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration. A cohort of 20 patients was assessed for the distribution of nasal spray befo...This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration. A cohort of 20 patients was assessed for the distribution of nasal spray before and after nasal septum surgery. Sprays were dyed and administered one puff per nostril when patients hold their head up in an upright position. Before and after decongestant admini-stration, the intranasal distribution was semi-quantitatively determined by nasal endoscopy. The results showed that the dyed drug was preferentially sprayed onto the nasal vestibule, the head of the inferior turbinate, the anterior part of septum and nasal floor. As far as the anterior-inferior segment of the nasal cavity was concerned, the distribution was found to be influenced neither by the decongestant nor by the surgery （P〉0.05）. However, both the decongestant and surgery expanded the distribution to the anatomical structures in the superior and posterior nasal cavity such as olfactory fissure, middle turbinate head and middle nasal meatus. No distribution was observed in the sphenoethmoidal recess, posterior septum, tail of inferior turbinate and nasopharynx. It was concluded that nasal septum surgery and decongestant administration significantly improves nasal spray distribution in the nasal cavity.展开更多
Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes.This article revie...Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes.This article reviews the findings of Wang et al,regarding the use of lymphovenous anastomosis and complex decongestive therapy in treating severe,deformed stage III lymphedema with recurrent infections.The case report details the promising results achieved through this combined therapy,highlighting substantial reductions in limb volume and the complete resolution of recurrent lymphangitis.The patient experienced notable improvements in weight loss,physical function,and quality of life.Despite its strengths,the study has several limitations.It lacks specific details on the types of lymphovenous anastomoses performed and complex decongestive therapy protocols,such as frequency and adherence,making reproducibility difficult.The short follow-up period of six months limits understanding of long-term efficacy,and more consistent reporting of key metrics such as weight loss and body mass index would enhance outcome assessments.This article emphasizes the importance of integrating minimally invasive surgical techniques with conservative therapies to address both the symptoms and underlying causes of lymphedema.Further research is essential to standardize protocols and refine combined treatment strategies.展开更多
Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in...Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer.Diagnosis relies on clinical evaluation and objective measures,including arm circumference and volumetric assessments,along with lymphoscintigraphy and ultrasonic measurements.Treatment primarily involves complex decongestive physical therapy,comprising manual lymphatic drainage,compression therapy,exercise,and meticulous skin care.These interventions aim to reduce swelling,alleviate discomfort,and prevent further complications.Additionally,lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential.Flavonoids can be used for drug therapy.Despite its prevalence,lymphedema often receives inadequate attention in clinical practice,emphasizing the importance of raising awareness and enhancing medical services for affected individuals.Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention.Overall,a comprehensive approach encompassing early diagnosis,multidisciplinary management,and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.展开更多
BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatm...BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatment centers are scarce,and there is a lack of consensus on treatment approaches.Furthermore,there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations.Effective management of this condition remains a significant challenge for clinicians.CASE SUMMARY A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer.Since August 2018,she experienced>30 episodes of lymphangitis.Upon presentation,she exhibited bilateral leg swelling and deformation,with four large swellings in the posterior thigh that impeded movement,and pain in the limbs.Skin manifestations included lichenoid lesions and features of deep sclerosis.Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema.After 6 mo of complex decongestive therapy(CDT)and three lymphaticovenous anastomosis(LVA)treatments,the patient lost 49 kg in weight.She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb.The leg pain disappeared,her swelling significantly decreased,and she regained the ability to walk,cycle,and run normally.CONCLUSION The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe,deformed stage III lymphedema.展开更多
To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jia...To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jiangsu Province from May to December,2018,were selected and sequenced in class“ABC”in the order of entry.The patients in class“A”were enrolled in“8”shaped bandaging group.The patients in class“B”were enrolled in“5”spiral bandaging group.The patients in class“C”were enrolled in combined bandage group.The primary outcome was the degree of limb swelling used by multiple-frequency bioelectrical impedance analysis.Secondary outcomes were the amount of bandage losses,counting 24-hour bandage loose occurrences and patients satisfaction.All outcomes were evaluated both before and after treatment.Results After treatment,there was a significant difference in the regression of limb swelling in all three groups(P<0.05).However,the largest amplitude of regression was observed in combined bandage group(limb circumference ratio:53%and tissue water ratio:68%).Although“8”bandaging group had large material,bandage cost and minimum comfort,the bandage has good stability and no case of 24-hour bandage loose occurrences was found in this group.The“5”partial binding group had an advantage in the amount of bandage losses and comfort level,but among which 3 patients had the phenomenon of loose bandage at the joint.The combined bandage group had the best therapeutic effect in limb swelling and patients satisfaction(P<0.05).Conclusion The combined bandage group significantly decreased the degree of limb swelling and 24-hour bandage loose occurrences.Importantly,this treatment improved the degree of patients’satisfaction.The treatment of“8”shaped bandaging combined with spiral bandaging is worthy of clinical promotion.展开更多
Vicks VapoRub® (VVR) is a pharmaceutical preparation containing a combination of levomenthol, eucalyptus oil, turpentine oil and camphor as active ingredients, and thymol, cedarwood oil, and white soft paraffin...Vicks VapoRub® (VVR) is a pharmaceutical preparation containing a combination of levomenthol, eucalyptus oil, turpentine oil and camphor as active ingredients, and thymol, cedarwood oil, and white soft paraffin as excipients. VVR is a petrolatum-based ointment to be either applied topically to the chest, throat, and back or added to hot water and the aromatic vapours inhaled. When used topically, the actives are evaporated by body temperature and inspired. The main therapeutic effects are the feeling of relief from nasal congestion and relief from cough. These were primarily experienced by patients as the trigeminal and olfactory impact of the aromatics and were hypothesized to be experienced within minutes. This was a randomized, single-(Investigator) blind, controlled, 2-arm (VVR vs. petrolatum), parallel design pilot study in 50 otherwise healthy adult patients suffering from common cold and experiencing nasal congestion. Speed to detection of a sensation of nasal cooling and nasal decongestion was assessed following application of the recommended amount of product. The time to first experience of a sensation of nasal cooling was significantly (p ® as directed experienced significant differences from control for sensation of nasal cooling in 12 seconds and the sensation of nasal decongestion in 62 seconds.展开更多
Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with ...Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with unilateral arm lymphedema after breast cancer ALND were enrolled.The patients were divided into three groups based on the difference of circumference between the affected and unaffected extremity:group 1,mild lymphedema in circumference difference;group 2,moderate lymphedema,and group 3,severe lymphedema.These patients received four weeks of CDT and self-administered home therapy.Arm circumference was measured before,right after CDT,3 months and 12 months of follow-up.Results:In the first group,the circumference difference was 1.53±0.73 cm prior to CDT,and 0.32±0.59 cm right after CDT,and the difference was statistically significant(P<0.001).At the 1-year-follow-up,we got an even higher value than the pre-CDT one,however,there was no significant difference(P=0.175).At the end of CDT,the circumference difference of the third group was 4.52±2.58 cm,significantly lower than the baseline level(8.76±3.07 cm)(P<0.001).In the third group,the reduction of circumference difference was persisted for 12 months.Conclusion:The effects of CDT were maintained for 12 months,while there were differences in progress of circumference difference among the three groups.The effects of patients with severe initial edema(>5 cm increased)last longer.展开更多
Objective To evaluate the therapeutic efficacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were includ...Objective To evaluate the therapeutic efficacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were included in the study(5 with primary lymphedema and 12 with secondary lymphedema).All patients were treated with one course(4 weeks)of complex decongestive therapy.Changes inextracellular fluid(ECF),BMI,circumferences,and skin properties including skin stiffness(SF),percent water content(PWC),and trans-epidermal water loss(TEWL)were measured before and after treatment.Results The“elephantiasis-like”appearance of the affected limb was greatly improved after treatment.The ECF,BMI,and circumferences were significantly decreased after treatment(P<0.001)with an average ECF of 2.97±1.82 L,BMI of 1.638±2.647 kg/m^2,and circumference of 6.58±2.79 cm.The values of PWC,TEWL,and SFwere 50.5%±10.6%,18.55±10.2 g/m^2 h,and 0.161±0.176 N,respectively,before treatment and 36.05%±7%,8.3±2.07 g/m^2h,and 0.086±0.038 N,respectively,after treatment,there by showing significant decreases(P<0.05).Conclusion Complex decongestive therapy is effective in the treatment of advanced stages of chronic lymphedema.展开更多
Objective: To explore the application effect of manual lymphatic drainage (MLD) combined with adjustable foam particle arm sleeves in patients with stage I upper limb lymphedema following breast cancer surgery. Method...Objective: To explore the application effect of manual lymphatic drainage (MLD) combined with adjustable foam particle arm sleeves in patients with stage I upper limb lymphedema following breast cancer surgery. Methods: A total of 52 patients with stage I upper limb lymphedema, who were treated between January and December 2023 at a tertiary tumor hospital in Guangzhou, Guangdong Province, were enrolled. Patients received MLD combined with adjustable foam particle arm sleeves. Bioelectrical impedance and body composition measurements were taken before and after treatment (one course consisting of 20 sessions) for comparison. Results: After one course of treatment, there was a significant reduction in arm muscle circumference, hydration rate, segmental water analysis, and segmental extracellular water ratio analysis (p Conclusion: MLD combined with adjustable foam particle arm sleeves effectively improves stage I upper limb lymphedema in postoperative breast cancer patients.展开更多
Aim:This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis(LVA)and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy ...Aim:This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis(LVA)and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy for lymphedema.Methods:We conducted a retrospective chart review of 134 consecutive patients with lower extremity lymphedema who were treated with LVA.A total of 116 patients were included,and they were divided into two groups:patients who underwent perioperative reduction treatment(PORT)following LVA surgery(PORT group,51 patients)and patients who underwent no additional perioperative intervention after LVA surgery(control group,65 patients).PORT included compression therapy and remedial exercise.A total of 41 matched pairs were extracted after propensity score matching analysis.The edema reduction effect was compared between the two groups.Results:Patients who underwent PORT had a significantly higher edema reduction than those in the control group(reduction in lower extremity lymphedema index,14.7 vs.6.7;P=0.03).No unfavorable complications related to PORT were observed in our cohort.Conclusion:It would be highly beneficial to combine reduction treatment in the early postoperative period after LVA surgery to maximize treatment outcomes.展开更多
Aim:Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.Conservative and surgical treatments,such as lymphaticovenous anastomosis(LVA),are available;however,the opt...Aim:Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.Conservative and surgical treatments,such as lymphaticovenous anastomosis(LVA),are available;however,the optimal timing for LVA after the initiation of complex decongestive therapy(CDT)remains unclear.This study aimed to evaluate the effect of CDT duration prior to LVA on the treatment outcomes of upper extremity lymphedema.Methods:Fifty patients with stage II upper extremity lymphedema who underwent LVA were retrospectively evaluated.Patients were divided into two groups based on the duration of CDT before LVA:<6 months(early group)and>6 months(non-early group).The primary outcome measures were percent excess volume(PEV)and reduction rate 12 months after LVA.Results:The early group(CDT<6 months)showed significantly better outcomes than the non-early group(CDT>6 months).The early group had a lower PEV(4%)and a higher reduction rate(56%)than the non-early group(PEV of 10%and reduction rate of 25%)at 12 months after LVA.Conclusions:Early indication for LVA(within 6 months of CDT initiation)resulted in better treatment outcomes for stage II upper extremity lymphedema.This study highlights the potential benefits of early surgical intervention for improving the prognosis of lymphedema.展开更多
Aim:To evaluate the effectiveness of lymphovenular anastomosis(LVA)under local anesthesia for patients with high American Society of Anesthesiologists Physical Status(ASA PS)score.Methods:From January 2019 to January ...Aim:To evaluate the effectiveness of lymphovenular anastomosis(LVA)under local anesthesia for patients with high American Society of Anesthesiologists Physical Status(ASA PS)score.Methods:From January 2019 to January 2021,we collected a total of 29 patients with lymphedema stage III and IV,operated upon with LVA by a single surgeon in a medical center.These patients had poor responses to compression therapies.After surgery,the patients underwent complex decongestive therapy consisting of the continuous wearing of an elastic stocking.To examine the effect of LVA,all data were collected,and differences in preoperative and postoperative means were analyzed.Results:Twenty-nine patients with high ASA PS score(>3)were followed after lymphovenular anastomosis and postoperative compression therapies.Twenty-one of 29 patients were survivors of oncological diseases and continued oncological therapies.The average duration of edema of these patients before LVA was 25±5.0 years.The average number of anastomosis for each patient was 6.8±2.2;the methods of anesthesia had no significant influence on these numbers.The average follow-up period was 7.8±0.85 months,and the result was considered effective(26/29 patients;89.7%).The average reduction of the circumference in affected limbs was 4.40%±3.67%of the preoperative excess length.There were no perioperative complications in this study.Conclusion:Lymphovenular anastomosis can be performed under local anesthesia,especially in patients with high risks of general anesthesia(ASA PS score>3).By this way,we could achieve adequate anastomosis and effective treatment of lymphedema in advanced cancer patients as well.展开更多
文摘Exogenous lipoid pneumonia is a rare and under recognized pulmonary disorder caused by the inhalation or aspiration of fat-like substances.Nasal decongestants containing mineral oils or paraffin are emerging as overlooked etiological agents.This review consolidates existing literature to delineate the clinical,radiological,and pathological features of exogenous lipoid pneumonia induced by nasal decongestants,highlight diagnostic challenges,and underscore the importance of thorough patient history in early diagnosis and management.This condition,while preventable,can result in serious pulmonary complications if not recog-nized early.It necessitates a multidisciplinary approach that incorporates careful history taking,high-resolution imaging,cytological assessment,and public health vigilance.
文摘Dear Sir,We hereby report a case of bilateral acute angle closure glaucoma secondary to a systemic decongestant containing pseudoephedrine freely available over the counter.Acute angle closure glaucoma is an ocular emergency.Delayed recognition and treatment inevitably leads to permanent visual impairment.Acute angle closure occurs as a result of obstruction to aqueous drainage by blockage of the trabecular meshwork by the iris.Typical presenting symptoms include acute onset of ocular pain,headache and blurred vision.On clinical examination,it is characterized by a markedly raised IOP of above 21 mm Hg together with
基金supported by a grant from National Natural Science Foundation of China(No.81070772)Zhuhai Medical Scientific Research Fund(No.PC20081046)
文摘This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration. A cohort of 20 patients was assessed for the distribution of nasal spray before and after nasal septum surgery. Sprays were dyed and administered one puff per nostril when patients hold their head up in an upright position. Before and after decongestant admini-stration, the intranasal distribution was semi-quantitatively determined by nasal endoscopy. The results showed that the dyed drug was preferentially sprayed onto the nasal vestibule, the head of the inferior turbinate, the anterior part of septum and nasal floor. As far as the anterior-inferior segment of the nasal cavity was concerned, the distribution was found to be influenced neither by the decongestant nor by the surgery （P〉0.05）. However, both the decongestant and surgery expanded the distribution to the anatomical structures in the superior and posterior nasal cavity such as olfactory fissure, middle turbinate head and middle nasal meatus. No distribution was observed in the sphenoethmoidal recess, posterior septum, tail of inferior turbinate and nasopharynx. It was concluded that nasal septum surgery and decongestant administration significantly improves nasal spray distribution in the nasal cavity.
文摘Lymphedema,particularly in its advanced stages,presents significant challenges in treatment,often necessitating a combination of therapies to manage symptoms effectively and improve patient outcomes.This article reviews the findings of Wang et al,regarding the use of lymphovenous anastomosis and complex decongestive therapy in treating severe,deformed stage III lymphedema with recurrent infections.The case report details the promising results achieved through this combined therapy,highlighting substantial reductions in limb volume and the complete resolution of recurrent lymphangitis.The patient experienced notable improvements in weight loss,physical function,and quality of life.Despite its strengths,the study has several limitations.It lacks specific details on the types of lymphovenous anastomoses performed and complex decongestive therapy protocols,such as frequency and adherence,making reproducibility difficult.The short follow-up period of six months limits understanding of long-term efficacy,and more consistent reporting of key metrics such as weight loss and body mass index would enhance outcome assessments.This article emphasizes the importance of integrating minimally invasive surgical techniques with conservative therapies to address both the symptoms and underlying causes of lymphedema.Further research is essential to standardize protocols and refine combined treatment strategies.
基金Supported by The National Research Foundation of Korea Grant funded by the Korea Government,No.00219725.
文摘Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer.Diagnosis relies on clinical evaluation and objective measures,including arm circumference and volumetric assessments,along with lymphoscintigraphy and ultrasonic measurements.Treatment primarily involves complex decongestive physical therapy,comprising manual lymphatic drainage,compression therapy,exercise,and meticulous skin care.These interventions aim to reduce swelling,alleviate discomfort,and prevent further complications.Additionally,lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential.Flavonoids can be used for drug therapy.Despite its prevalence,lymphedema often receives inadequate attention in clinical practice,emphasizing the importance of raising awareness and enhancing medical services for affected individuals.Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention.Overall,a comprehensive approach encompassing early diagnosis,multidisciplinary management,and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.
文摘BACKGROUND Lower extremity lymphedema is a common complication following treatment for gynecological malignancies.Its incidence rate can reach up to 70%,affecting~20 million people worldwide.However,specialized treatment centers are scarce,and there is a lack of consensus on treatment approaches.Furthermore,there are even fewer reports on the systematic and effective treatment of severe lymphedema with malformations.Effective management of this condition remains a significant challenge for clinicians.CASE SUMMARY A 40-year-old woman developed bilateral leg swelling 6 years after receiving treatment for endometrial cancer.Since August 2018,she experienced>30 episodes of lymphangitis.Upon presentation,she exhibited bilateral leg swelling and deformation,with four large swellings in the posterior thigh that impeded movement,and pain in the limbs.Skin manifestations included lichenoid lesions and features of deep sclerosis.Radionuclide lymphoscintigraphy confirmed the diagnosis of lower limb lymphedema.After 6 mo of complex decongestive therapy(CDT)and three lymphaticovenous anastomosis(LVA)treatments,the patient lost 49 kg in weight.She also experienced a maximum circumference reduction of 35.2 cm in the left lower limb and 37.5 cm in the right lower limb.The leg pain disappeared,her swelling significantly decreased,and she regained the ability to walk,cycle,and run normally.CONCLUSION The combined application of CDT and LVA therapy demonstrates significant positive effects in the treatment of severe,deformed stage III lymphedema.
基金Project of National Clinical Research Base of Traditional Chinese Medicine in Jiangsu Province,China(Jiangsu Province Academy of Traditional Chinese Medicine),Grant Number:JD2019SZXZD05The Third Open Subject of the Superiority of Nursing in Nanjing University of Traditional Chinese Medicine,Grant Number:2019YSHL127.
文摘To explore the effects of bandage technology and pressure therapy in breast cancer with lymphedema.Methods A total of 91 patients,with breast cancer-related lymphedema and hospitalized in a third-class hospital in Jiangsu Province from May to December,2018,were selected and sequenced in class“ABC”in the order of entry.The patients in class“A”were enrolled in“8”shaped bandaging group.The patients in class“B”were enrolled in“5”spiral bandaging group.The patients in class“C”were enrolled in combined bandage group.The primary outcome was the degree of limb swelling used by multiple-frequency bioelectrical impedance analysis.Secondary outcomes were the amount of bandage losses,counting 24-hour bandage loose occurrences and patients satisfaction.All outcomes were evaluated both before and after treatment.Results After treatment,there was a significant difference in the regression of limb swelling in all three groups(P<0.05).However,the largest amplitude of regression was observed in combined bandage group(limb circumference ratio:53%and tissue water ratio:68%).Although“8”bandaging group had large material,bandage cost and minimum comfort,the bandage has good stability and no case of 24-hour bandage loose occurrences was found in this group.The“5”partial binding group had an advantage in the amount of bandage losses and comfort level,but among which 3 patients had the phenomenon of loose bandage at the joint.The combined bandage group had the best therapeutic effect in limb swelling and patients satisfaction(P<0.05).Conclusion The combined bandage group significantly decreased the degree of limb swelling and 24-hour bandage loose occurrences.Importantly,this treatment improved the degree of patients’satisfaction.The treatment of“8”shaped bandaging combined with spiral bandaging is worthy of clinical promotion.
文摘Vicks VapoRub® (VVR) is a pharmaceutical preparation containing a combination of levomenthol, eucalyptus oil, turpentine oil and camphor as active ingredients, and thymol, cedarwood oil, and white soft paraffin as excipients. VVR is a petrolatum-based ointment to be either applied topically to the chest, throat, and back or added to hot water and the aromatic vapours inhaled. When used topically, the actives are evaporated by body temperature and inspired. The main therapeutic effects are the feeling of relief from nasal congestion and relief from cough. These were primarily experienced by patients as the trigeminal and olfactory impact of the aromatics and were hypothesized to be experienced within minutes. This was a randomized, single-(Investigator) blind, controlled, 2-arm (VVR vs. petrolatum), parallel design pilot study in 50 otherwise healthy adult patients suffering from common cold and experiencing nasal congestion. Speed to detection of a sensation of nasal cooling and nasal decongestion was assessed following application of the recommended amount of product. The time to first experience of a sensation of nasal cooling was significantly (p ® as directed experienced significant differences from control for sensation of nasal cooling in 12 seconds and the sensation of nasal decongestion in 62 seconds.
文摘Background:To assess the edema relief effects of complex decongestive therapy(CDT)in patients with breast cancer associated lymphedema after axillary lymph node dissection(ALND).Methods:58 breast cancer patients with unilateral arm lymphedema after breast cancer ALND were enrolled.The patients were divided into three groups based on the difference of circumference between the affected and unaffected extremity:group 1,mild lymphedema in circumference difference;group 2,moderate lymphedema,and group 3,severe lymphedema.These patients received four weeks of CDT and self-administered home therapy.Arm circumference was measured before,right after CDT,3 months and 12 months of follow-up.Results:In the first group,the circumference difference was 1.53±0.73 cm prior to CDT,and 0.32±0.59 cm right after CDT,and the difference was statistically significant(P<0.001).At the 1-year-follow-up,we got an even higher value than the pre-CDT one,however,there was no significant difference(P=0.175).At the end of CDT,the circumference difference of the third group was 4.52±2.58 cm,significantly lower than the baseline level(8.76±3.07 cm)(P<0.001).In the third group,the reduction of circumference difference was persisted for 12 months.Conclusion:The effects of CDT were maintained for 12 months,while there were differences in progress of circumference difference among the three groups.The effects of patients with severe initial edema(>5 cm increased)last longer.
文摘Objective To evaluate the therapeutic efficacy of complex decongestive therapy in the treatment of elephantiasis of the lower extremities.Methods Seventeen patients with unilateral lower limb elephantiasis were included in the study(5 with primary lymphedema and 12 with secondary lymphedema).All patients were treated with one course(4 weeks)of complex decongestive therapy.Changes inextracellular fluid(ECF),BMI,circumferences,and skin properties including skin stiffness(SF),percent water content(PWC),and trans-epidermal water loss(TEWL)were measured before and after treatment.Results The“elephantiasis-like”appearance of the affected limb was greatly improved after treatment.The ECF,BMI,and circumferences were significantly decreased after treatment(P<0.001)with an average ECF of 2.97±1.82 L,BMI of 1.638±2.647 kg/m^2,and circumference of 6.58±2.79 cm.The values of PWC,TEWL,and SFwere 50.5%±10.6%,18.55±10.2 g/m^2 h,and 0.161±0.176 N,respectively,before treatment and 36.05%±7%,8.3±2.07 g/m^2h,and 0.086±0.038 N,respectively,after treatment,there by showing significant decreases(P<0.05).Conclusion Complex decongestive therapy is effective in the treatment of advanced stages of chronic lymphedema.
文摘Objective: To explore the application effect of manual lymphatic drainage (MLD) combined with adjustable foam particle arm sleeves in patients with stage I upper limb lymphedema following breast cancer surgery. Methods: A total of 52 patients with stage I upper limb lymphedema, who were treated between January and December 2023 at a tertiary tumor hospital in Guangzhou, Guangdong Province, were enrolled. Patients received MLD combined with adjustable foam particle arm sleeves. Bioelectrical impedance and body composition measurements were taken before and after treatment (one course consisting of 20 sessions) for comparison. Results: After one course of treatment, there was a significant reduction in arm muscle circumference, hydration rate, segmental water analysis, and segmental extracellular water ratio analysis (p Conclusion: MLD combined with adjustable foam particle arm sleeves effectively improves stage I upper limb lymphedema in postoperative breast cancer patients.
文摘Aim:This study aimed to clarify the efficacy of the integration of lymphaticovenular anastomosis(LVA)and perioperative reduction treatment in the exploration of optimal combination of surgery and conservative therapy for lymphedema.Methods:We conducted a retrospective chart review of 134 consecutive patients with lower extremity lymphedema who were treated with LVA.A total of 116 patients were included,and they were divided into two groups:patients who underwent perioperative reduction treatment(PORT)following LVA surgery(PORT group,51 patients)and patients who underwent no additional perioperative intervention after LVA surgery(control group,65 patients).PORT included compression therapy and remedial exercise.A total of 41 matched pairs were extracted after propensity score matching analysis.The edema reduction effect was compared between the two groups.Results:Patients who underwent PORT had a significantly higher edema reduction than those in the control group(reduction in lower extremity lymphedema index,14.7 vs.6.7;P=0.03).No unfavorable complications related to PORT were observed in our cohort.Conclusion:It would be highly beneficial to combine reduction treatment in the early postoperative period after LVA surgery to maximize treatment outcomes.
文摘Aim:Lymphedema is a progressive degenerative disease that can cause severe swelling and recurrent infections.Conservative and surgical treatments,such as lymphaticovenous anastomosis(LVA),are available;however,the optimal timing for LVA after the initiation of complex decongestive therapy(CDT)remains unclear.This study aimed to evaluate the effect of CDT duration prior to LVA on the treatment outcomes of upper extremity lymphedema.Methods:Fifty patients with stage II upper extremity lymphedema who underwent LVA were retrospectively evaluated.Patients were divided into two groups based on the duration of CDT before LVA:<6 months(early group)and>6 months(non-early group).The primary outcome measures were percent excess volume(PEV)and reduction rate 12 months after LVA.Results:The early group(CDT<6 months)showed significantly better outcomes than the non-early group(CDT>6 months).The early group had a lower PEV(4%)and a higher reduction rate(56%)than the non-early group(PEV of 10%and reduction rate of 25%)at 12 months after LVA.Conclusions:Early indication for LVA(within 6 months of CDT initiation)resulted in better treatment outcomes for stage II upper extremity lymphedema.This study highlights the potential benefits of early surgical intervention for improving the prognosis of lymphedema.
文摘Aim:To evaluate the effectiveness of lymphovenular anastomosis(LVA)under local anesthesia for patients with high American Society of Anesthesiologists Physical Status(ASA PS)score.Methods:From January 2019 to January 2021,we collected a total of 29 patients with lymphedema stage III and IV,operated upon with LVA by a single surgeon in a medical center.These patients had poor responses to compression therapies.After surgery,the patients underwent complex decongestive therapy consisting of the continuous wearing of an elastic stocking.To examine the effect of LVA,all data were collected,and differences in preoperative and postoperative means were analyzed.Results:Twenty-nine patients with high ASA PS score(>3)were followed after lymphovenular anastomosis and postoperative compression therapies.Twenty-one of 29 patients were survivors of oncological diseases and continued oncological therapies.The average duration of edema of these patients before LVA was 25±5.0 years.The average number of anastomosis for each patient was 6.8±2.2;the methods of anesthesia had no significant influence on these numbers.The average follow-up period was 7.8±0.85 months,and the result was considered effective(26/29 patients;89.7%).The average reduction of the circumference in affected limbs was 4.40%±3.67%of the preoperative excess length.There were no perioperative complications in this study.Conclusion:Lymphovenular anastomosis can be performed under local anesthesia,especially in patients with high risks of general anesthesia(ASA PS score>3).By this way,we could achieve adequate anastomosis and effective treatment of lymphedema in advanced cancer patients as well.
