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Sample records for basic lymphedema management

  1. Feasibility and effectiveness of basic lymphedema management in Leogane, Haiti, an area endemic for bancroftian filariasis.

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    David G Addiss

    Full Text Available BACKGROUND: Approximately 14 million persons living in areas endemic for lymphatic filariasis have lymphedema of the leg. Clinical studies indicate that repeated episodes of bacterial acute dermatolymphangioadenitis (ADLA lead to progression of lymphedema and that basic lymphedema management, which emphasizes hygiene, skin care, exercise, and leg elevation, can reduce ADLA frequency. However, few studies have prospectively evaluated the effectiveness of basic lymphedema management or assessed the role of compressive bandaging for lymphedema in resource-poor settings. METHODOLOGY/PRINCIPAL FINDINGS: Between 1995 and 1998, we prospectively monitored ADLA incidence and leg volume in 175 persons with lymphedema of the leg who enrolled in a lymphedema clinic in Leogane, Haiti, an area endemic for Wuchereria bancrofti. During the first phase of the study, when a major focus of the program was to reduce leg volume using compression bandages, ADLA incidence was 1.56 episodes per person-year. After March 1997, when hygiene and skin care were systematically emphasized and bandaging discouraged, ADLA incidence decreased to 0.48 episodes per person-year (P<0.0001. ADLA incidence was significantly associated with leg volume, stage of lymphedema, illiteracy, and use of compression bandages. Leg volume decreased in 78% of patients; over the entire study period, this reduction was statistically significant only for legs with stage 2 lymphedema (P = 0.01. CONCLUSIONS/SIGNIFICANCE: Basic lymphedema management, which emphasized hygiene and self-care, was associated with a 69% reduction in ADLA incidence. Use of compression bandages in this setting was associated with an increased risk of ADLA. Basic lymphedema management is feasible and effective in resource-limited areas that are endemic for lymphatic filariasis.

  2. Lymphedema

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    ... risk of developing lymphedema after cancer, from cancer treatment or from other secondary causes include: Older age Excess weight or obesity Rheumatoid or psoriatic arthritis Complications Lymphedema in your ...

  3. THE REHABILITATION MANAGEMENT OF LYMPHEDEMA

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    OJOGA Florina

    2015-05-01

    Full Text Available Lymphedema is an important pathology for rehabilitation medecine, especially for the patients who underwent a mastectomy for breast cancer. His frequency is higher when mastectomy is combined with lymph node disection and irradiation of the lymph nodes. Symptoms include heaviness, numbness, pain, stiffness and weakness in the affected limb. Complications of lymphedema include infections such as cellulitis, erysipelas and lymphangitis. Treatment must be instituted as soon as possible and preventive measures are essential. The rehabilitation treatment consists of skin care measures, manual lymphatic massage, elastic compression of the affected limb and kinetotherapy.

  4. [Management of secondary lymphedema in patients with cancer].

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    Wenczl, Enikő

    2016-03-27

    Due to the increased number of cancer patients and the progress in cancer treatment, there are more cases with cancer-related lymphedema. Lymphedema treatment became part of oncological patients' care. Basic therapy for lymphedema is the complex decongestive therapy, which should be embedded into the patient's comprehensive medical care and should always be determined individually. Results of therapy are influenced by the experience of the doctor and the physiotherapist in lymphedema care, patient's complience, tumor behavior and the accompanying diseases. Lymphedema is a chronic disease, requires lifelong follow-up and treatment. For prevention and better care, it would be important to inform patients about lymphedema risk and appropriate life-style (e.g. weight control) preoperatively and during oncological follow-up. Early diagnosis is important. Lymphedema treatment should be integrated into palliative programmes. If therapy is started in time, complications may be avoided, healthcare costs may be reduced and better quality of life may be achieved.

  5. Lymphedema

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    ... arm (or leg) for everyday activities? Yes, absolutely. Bear in mind, however, that physical activity increases blood ... observed. When you go outside, put on a sun block, because sunburn can aggravate lymphedema. When you ...

  6. Successful management of persistent lower extremity lymphedema with suction-assisted lipectomy

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    John P. Micha

    2018-02-01

    Conclusion: Since lymphedema often remains disabling and incurable following traditional therapy, suction-assisted lipectomy should be considered as an alternative when endeavoring to optimally manage this complication.

  7. Self-Care for Management of Secondary Lymphedema: A Systematic Review

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    Graves, Patricia; Gordon, Susan

    2016-01-01

    Background Lymphedema is a debilitating and disfiguring sequela of an overwhelmed lymphatic system. The most common causes of secondary lymphedema are lymphatic filariasis (LF), a vector-borne, parasitic disease endemic in 73 tropical countries, and treatment for cancer in developed countries. Lymphedema is incurable and requires life-long care so identification of effective lymphedema management is imperative to improve quality of life, reduce the burden on family resources and benefit the local community. This review was conducted to evaluate the evidence for effective lymphedema self-care strategies that might be applicable to management of all types of secondary lymphedema. Methodology/Principal Findings Searches were conducted in Medline, CINAHL and Scopus databases in March 2015. Included studies reported before and after measures of lymphedema status or frequency of acute infections. The methodological quality was assessed using the appropriate Critical Appraisal Skills Program checklist. Descriptive synthesis and meta-analysis were used to evaluate effectiveness of the outcomes reported. Twenty-eight papers were included; two RCTs were found to have strong methodology, and overall 57% of studies were rated as methodologically weak. Evidence from filariasis-related lymphedema (FR-LE) studies indicated that hygiene-centred self-care reduced the frequency and duration of acute episodes by 54%, and in cancer-related lymphedema (CR-LE) home-based exercise including deep breathing delivered significant volume reductions over standard self-care alone. Intensity of training in self-care practices and frequency of monitoring improved outcomes. Cultural and economic factors and access to health care services influenced the type of intervention delivered and how outcomes were measured. Conclusions/Significance There is evidence to support the adoption of remedial exercises in the management of FR-LE and for a greater emphasis on self-treatment practices for people

  8. Multidisciplinary Approaches to the Management of Breast-Cancer-Related Lymphedema

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    Solmaz Fakhari

    2013-07-01

    Full Text Available Breast-cancer-related lymphedema is a significant morbidity mostly observed following primary treatments for breast cancer (surgery, radiation, and chemotherapy (1. Multiple complications might accompany lymphedema including cosmetic deformity, psychological disorders, consistent pain, and consequently decreased quality of life. Treatment  mostly focuses on reducing edema and its subsequent pain; however, no definite treatment has been hitherto introduced (2. Surgical approaches in the management of lymphedema are efficient including physiologic methods (e.g. flap interposition, lymph transfer, and lymphatic bypass and reductive techniques (e.g. liposuction (3. While the former mostly targets at reducing lymphedema through restoring lymphatic drainage, the latter aims at removing fibrofatty tissues which contribute to lymph stasis. Microsurgical variation of lymphatic bypass has gained popularity, in which the accumulated lymph in the lymphedematous limb is redirected. Non-surgical approaches are also practiced in most cases. Comprehensive decongestive therapy, consisting of skin care, exercise, special bandaging and massage, is the most frequently used non-surgical approach efficacy of which could be enhanced in combination with self-management strategies (4. Recently newer techniques have been introduced to tackle lymphedema and its associated pain. Manual lymph drainage, stellate ganglion block, acupuncture, deep oscillation, and pneumatic compression have been efficiently used in several studies. Moreover, significant short-term progress has been reported following other modalities such as low-level laser therapy (5. The complexity of breast-cancer-related lymphedema and its complications necessitates a multidisciplinary approach with the primary goal of easing the burden of the disease on the breast cancer patients. In addition, developing special guidelines encompassing these multidisciplinary approaches and providing educational and

  9. Usability and feasibility of health IT interventions to enhance Self-Care for Lymphedema Symptom Management in breast cancer survivors

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    Mei R. Fu, PhD, RN, FAAN

    2016-09-01

    Conclusions: This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.

  10. Impact of community-based lymphedema management on perceived disability among patients with lymphatic filariasis in Orissa State, India.

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    Philip J Budge

    Full Text Available Lymphatic filariasis (LF infects approximately 120 million people worldwide. As many as 40 million have symptoms of LF disease, including lymphedema, elephantiasis, and hydrocele. India constitutes approximately 45% of the world's burden of LF. The Indian NGO Church's Auxiliary for Social Action (CASA has been conducting a community-based lymphedema management program in Orissa State since 2007 that aims to reduce the morbidity associated with lymphedema and elephantiasis. The objective of this analysis is to evaluate the effects of this program on lymphedema patients' perceived disability.For this prospective cohort study, 370 patients ≥14 years of age, who reported lymphedema lasting more than three months in one or both legs, were recruited from villages in the Bolagarh sub-district, Khurda District, Orissa, India. The World Health Organization Disability Assessment Schedule II was administered to participants at baseline (July, 2009, and then at regular intervals through 24 months (July, 2011, to assess patients' perceived disability. Disability scores decreased significantly (p<0.0001 from baseline to 24 months. Multivariable analysis using mixed effects modeling found that employment and time in the program were significantly associated with lower disability scores after two years of program involvement. Older age, female gender, the presence of other chronic health conditions, moderate (Stage 3 or advanced (Stage 4-7 lymphedema, reporting an adenolymphangitis (ADL episode during the previous 30 days, and the presence of inter-digital lesions were associated with higher disability scores. Patients with moderate or advanced lymphedema experienced greater improvements in perceived disability over time. Patients participating in the program for at least 12 months also reported losing 2.5 fewer work days per month (p<0.001 due to their lymphedema, compared to baseline.These results indicate that community-based lymphedema management programs

  11. The role of operative management of varicose veins in patients with lymphedema and/or lipedema of the legs.

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    Földi, M; Idiazabal, G

    2000-12-01

    The role of operative management of "symptomatic" varicose veins in patients with lower extremity lymphedema or lipedema is controversial. We reviewed the clinical outcome of 261 patients between 1989-1997 at the Földiclinic with lower extremity lymphedema (68 patients), lipo-lymphedema or lympho-lipedema (103 patients) or lipedema (90 patients) who had undergone operation for varicose veins. In each group, the results were dismal as leg swelling worsened or was unchanged in greater than 90% whereas symptoms such as heaviness, fatigue, cramps (termed varicogenic symptomatology) were improved in less than 10%. These findings support that operations for varicose veins in the legs of patients with lymphedema, lipedema, or combinations of these disorders should be undertaken only if there is an absolute indication present (ascending phlebitis and/or bleeding). Otherwise, complete decongestive physiotherapy is still the best treatment approach for these groups of patients.

  12. Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

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    2013-01-01

    Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical treatment modalities that are under active investigation. PMID:24053624

  13. Integrated management of filarial lymphedema for rural communities.

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    Narahari, S R; Ryan, T J; Mahadevan, P E; Bose, K S; Prasanna, K S

    2007-03-01

    The Global Alliance for the Elimination of Lymphatic Filariasis (GAELF) has recommended exploring local health traditions of skin care and a low cost treatment paradigm for rural communities has been proposed by Vaqas and Ryan. Our case study incorporates these promising treatments for use in treating filariasis in rural communities. Patients having lymphedema of one or both lower limbs (skin: normal, thickened or with trophic/warty changes) received treatment components from ayurveda, yoga and biomedicine simultaneously: including soap wash, phanta soaking, Indian manual lymph drainage (IMLD), pre- and post-IMLD yoga exercises, and compression using bandages for 194 days, along with diet restrictions and oral herbal medicines indicated for "elephantiasis" in Ayurveda. Entry points when infected were treated with biomedical drugs. The study was conducted in the reverse pharmacology design. 112 patients and 149 lower limbs completed 194 days of treatment during 2003-2006. Significant improvements were observed in the limb circumference measurements and the frequency of acute dermatolymphangioadenitis, use of preventive antibiotics, and reduction in the number of entry points were also improved. The objective to obtain significant benefit for a common problem using locally available, sustainable and affordable means has been achieved. It has not been our purpose to show that the regimen employed is better than another but the results do pose the question--"Are there components of Ayurvedic medicine that deserve further study?" It is important to understand that the regimen has been delivered mostly at home and that participants we have treated, representing a population suffering from a common problem, have not had access to effective conservative therapy that is culturally acceptable, safe, and efficacious.

  14. Psychosocial factors associated with adherence for self-management behaviors in women with breast cancer-related lymphedema.

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    Alcorso, Jessica; Sherman, Kerry A; Koelmeyer, Louise; Mackie, Helen; Boyages, John

    2016-01-01

    Cognitive and affective psychosocial factors have been found to underlie adherence to preventive behaviors in women at risk of developing lymphedema following treatment for breast cancer. The aim of this study was to determine if these factors are associated with adherence to self-management behaviors for women diagnosed with breast cancer-related lymphedema (BCRL). Women with BCRL were recruited through a community-based breast cancer organization and three Australian lymphedema treatment clinics. Participants completed an online questionnaire assessing demographics, medical history, adherence to self-management behaviors, psychosocial variables (personal control, treatment control, consequences, distress, and self-regulation of affect), and knowledge about lymphedema self-management. A total of 166 women participated in the study. Participants reported adhering to a mean of five out of seven behaviors, with 19.5% of participants adhering to all seven behaviors. Adherence to individual behaviors ranged from 65% (self-lymphatic drainage) to 98.2% (skin care). Greater knowledge about lymphedema was significantly correlated with higher adherence. Hierarchical multiple linear regression analysis indicated that only medical history factors (time since diagnosis and having undergone hormone replacement therapy) predicted a significant amount of the variance in adherence. These findings highlight the importance of patient knowledge for optimal adherence to a self-management regimen. In addition, medical history factors may identify if a patient is at risk of nonadherence. The lack of association of adherence with other psychosocial factors considered in this study indicates that factors underlying adherence in affected women differ considerably from those factors prompting preventive behavior adherence in the at-risk population.

  15. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  16. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  17. Evidence-based practice in the management of lower limb lymphedema after gynecological cancer.

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    Iwersen, Lisandra Fossari; Sperandio, Fabiana Flores; Toriy, Ariana Machado; Palú, Marina; Medeiros da Luz, Clarissa

    2017-01-01

    Lower limb lymphedema (LLL) is characterized as a physical-functional chronic complication that impacts the quality of life of women who have gone through treatment for gynecological cancer. The present study aims to check the conservative treatments available for lymphedema after gynecological cancer in the context of evidence-based practice. The selection criteria included papers from May 1993 discussing treatment protocols used in LLL after treatment for gynecological cancer. The search was performed until October 2014 in MEDLINE, SciVerse, and PEDro using "rehabilitation," "treatment outcome," "therapeutics," "clinical protocol," "gynecologic surgery," "lower extremity," "lower limb," and "lymphedema" as keywords, focused on women with a previous diagnosis of gynecological cancer who received radiation and/or chemotherapy and/or surgery and/or lymphadenectomy as part of their treatment. From 110 studies found, 3 articles that used the complex decongestive therapy (CDT) as a treatment protocol were selected. There were no randomized clinical trials associated with the conservative treatment of LLL post-treatment of gynecological cancer. The three selected articles are retrospective, and had the same outcome - decreased volume of the affected limb lymphedema. Although LLL is more or as frequent and detrimental as upper limb lymphedema post-cancer treatment, there are only a few studies about this subject. Publications are even scarcer when considering studies with interventional approach. Randomized controlled trials are necessary to support rehabilitation resources on lymphedema post-gynecological cancer treatment.

  18. A multimodal physical therapy approach to the management of a patient with temporomandibular dysfunction and head and neck lymphedema: a case report.

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    Crane, Patricia; Feinberg, Lauren; Morris, John

    2015-02-01

    There is a paucity of research that investigates therapeutic interventions of patients with concurrent head and neck lymphedema and temporomandibular dysfunction (TMD). The purpose of this case report is to describe the management and outcomes of a patient with head and neck lymphedema and TMD using a multimodal physical therapy approach. A 74-year-old male with a past medical history of head and neck lymphedema and TMD was referred to physical therapy with chief complaints of inability to open his mouth in order to eat solid food, increased neck lymphedema, temporomadibular joint pain, and inability to speak for prolonged periods of time. The patient was treated for three visits over 4 weeks. Treatment included complete decongestive therapy (CDT), manual therapy, therapeutic exercise, and a home exercise program. Upon discharge, the patient had improved mandibular depression, decreased head and neck lymphedema, improved deep neck flexor endurance, decreased pain, and improved function on the Patient Specific Functional Scale (PSFS). Utilization of a multimodal physical therapy approach to treat a patient with a complex presentation yielded positive outcomes. Further research on outcomes and treatment approaches in patients with TMD and head and neck lymphedema is warranted.

  19. Arm lymphedema after treatment of breast cancer: Etiology, diagnosis, and management

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    Ashish Goel

    2015-01-01

    Full Text Available Breast cancer related lymphedema (BCRL is a chronic debilitating condition seen after treatment of breast cancer. The overall incidence varies from 20% to 56% in all patients treated for breast cancer. Every patient is at a lifelong risk for BCRL and the risk goes on increasing as the followup period increases. Locoregional treatment including surgery or radiotherapy is the most common risk factor for development of arm lymphedema. There are two phases of arm lymphedema. There is increased fluid accumulation in the fluid phase of lymphedema which later on goes into the solid phase where fat and fibrotic tissue is deposited in the subcutaneous tissue. The treatment of BCRL is a challenge both for the patient and the treating surgeon and it needs multidisciplinary team work to be successful. Non-surgical treatment modalities include complete decongestive therapy (CDT and pneumatic compression therapy. Surgery for BCRL is usually undertaken as a salvage modality after failure of conservative approaches. The surgical spectrum for BCRL varies from extensive excisional operations which were commonly done in the past to newer methods like suction assisted protein lipectomy, lymphatic reconstruction and vascular lymph node transfer (VLNT using super-microsurgical techniques. There is no consensus regarding the preference of one procedure over other due to lack of randomised control trials. It is however suggested to do lymphovenous anastomosis and complete decongestive therapy for early cases in fluid phase; while patients in the solid phase may be treated with a combination of liposuction with CDT or VLNT alone.

  20. Basic Elements of Knowledge Management

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    Marcin W. Staniewski

    2007-10-01

    Full Text Available The article is a review of basic knowledge management terminology. It presents such a description as: knowledge resources levels (data, information, knowledge, and wisdom, knowledge sources (internal, external, and knowledge typology (implicit, tacit or individual, social. Moreover the article characterizes knowledge management process, knowledge management system and main knowledge management strategies (codification, personalization. At the end of the article there is mentioned the knowledge creating process (the concept of knowledge creation spiral and the role of Intelligence Technology (IT and organizational culture as main elements supporting knowledge management implementation in organizations.

  1. National Lymphedema Network

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    ... Benefits for Professionals Training Programs Helpful Links New CLT Graduate Program Job Postings Get More Involved Donate ... posts job listings for open certified lymphedema therapist (CLT) positions nationwide. Certified Lymphedema Therapist jobs will be ...

  2. Self-reported information sources and perceived knowledge in individuals with lymphedema.

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    Deng, J; Fu, M R; Armer, J M; Cormier, J N; Radina, E; Thiadens, S R J; Dietrich, M S; Weiss, J; Tuppo, C M; Ridner, S H

    2013-12-01

    Currently, a limited number of studies have been conducted that examine sources of information and knowledge level in individuals with lymphedema. This study aimed (1) to examine self-reported information sources and perceived lymphedema knowledge among individuals with lymphedema; and (2) to examine differences in self-reported information sources and perceived lymphedema knowledge among individuals with primary or secondary lymphedema; and with upper or lower extremity lymphedema. The National Lymphedema Network (NLN) conducted a survey to collect self-report data from March 2006 to January 2010. Overall, participants preferred a variety of sources of information. Participants reported low levels of knowledge about the types of lymphedema, treatment approaches and methods, and self-administrated therapies. In comparison to participants with secondary or upper extremity lymphedema, participants with primary or lower extremity lymphedema reported lower knowledge level regarding causes of lymphedema, risks for and complications of lymphedema, treatment approaches and methods for lymphedema, and self-administered therapies. Opportunities exist to expand lymphedema information sources. Healthcare professionals should focus on delivering high quality information about treatment and self-care management to individuals with lymphedema.

  3. Association between lymphedema self-care adherence and lymphedema outcomes among women with breast cancer-related lymphedema.

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    Brown, Justin C; Kumar, Anagha; Cheville, Andrea L; Tchou, Julia C; Troxel, Andrea B; Harris, Susan R; Schmitz, Kathryn H

    2015-04-01

    The aim of this study was to determine whether adherence to self-care modalities for breast cancer-related lymphedema (BCRL) predicts BCRL outcomes among 128 breast cancer survivors who participated in the 12-mo physical activity and lymphedema trial. This was a prospective cohort study. Adherence to ten BCRL self-care modalities, as recommended in the clinical practice guidelines for the management of BCRL, was assessed by a questionnaire at baseline. BCRL outcomes assessed at baseline and 12 mos included volumetry, circumferences, bioimpedence spectroscopy, the Norman lymphedema survey, and therapist-defined lymphedema exacerbations requiring treatment. Generalized linear models were used to estimate the relationship between adherence to BCRL self-care modalities and the likelihood of experiencing a BCRL outcome. Adherence to BCRL self-care activities did not predict experiencing any BCRL outcomes at 12 mos. Levels of adherence to BCRL self-care modalities did not predict a 5% or greater decrease in interlimb volume (Ptrend = 0.79), 5% or greater decrease in the sum of interlimb arm circumferences (Ptrend = 0.47), 10% or greater decrease in bioimpedence spectroscopy (Ptrend = 0.83), 1 or greater decrease in self-reported lymphedema symptoms (Ptrend = 0.91), or therapist-defined lymphedema exacerbation requiring treatment (Ptrend = 0.84). Our findings suggest that levels of BCRL self-care adherence do not predict BCRL outcomes among breast cancer survivors with stable lymphedema who were followed for 12 mos.

  4. [Clinical Management: Basics and organization].

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    Torres, Juan; Mingo, Carlos

    2015-01-01

    Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.

  5. A Survey of the Status of Awareness of Lymphedema in Breast Cancer Patients in Busan-Gyeongnam, Korea.

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    Choi, Jong Kyoung; Kim, Hui Dong; Sim, Young Joo; Kim, Ghi Chan; Kim, Dong Kyu; Yu, Byeng Chul; Park, Si-Sung; Jeong, Ho Joong

    2015-08-01

    To support the establishment of lymphedema education plans and the actual practice of education by investigating the current lymphedema awareness status of Korean breast cancer patients. cross-sectional population survey was conducted in 116 breast cancer patients in the Busan-Gyeongnam area. The survey included questions regarding demographic characteristics, breast cancer-related lymphedema (BCRL) risk factors, and characteristics and treatments of the disease. Some of the items were scored to determine the level of awareness. The items that affect the awareness of lymphedema were investigated by statistical analysis. Eighty-one of the 116 patients answered that they had heard of lymphedema, and 30 of them (25.86%) had received explanations about the possibility of lymphedema before surgery. Only 20 patients (17.25%) knew that lymphedema is not a completely curable disease, 24 patients (20.68%) thought that lymphedema does not require any treatment, and only 56 patients (48.27%) knew that lymphedema is treated in the Department of Rehabilitation Medicine. The main factors that affected patients' awareness of lymphedema were their age, chemotherapy, duration of breast cancer, and lymphedema treatment history. The majority of survey participants who were breast cancer patients either lacked awareness of BCRL or had false ideas about it, indicating the inadequate level of education provided for lymphedema. In the case of breast cancer diagnosis, early and continuous education for future management is essential, and the framework for the provision of education including education protocols related to age, disease duration, and lymphedema treatment is needed.

  6. Complementary, alternative, and other noncomplete decongestive therapy treatment methods in the management of lymphedema: a systematic search and review.

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    Rodrick, Julia R; Poage, Ellen; Wanchai, Ausanee; Stewart, Bob R; Cormier, Janice N; Armer, Jane M

    2014-03-01

    (1) To provide a critical analysis of the contemporary published research that pertains to complementary, alternative, and other noncomplete decongestive therapies for treatment of lymphedema (LE), and (2) to provide practical applications of that evidence to improve care of patients with or at risk for LE. TYPE: This study meets the defining criteria as a systematic search and review because it includes varied study types. All studies that met the inclusion criteria were evaluated for weight of evidence and value. The systematic search and review includes articles published in the contemporary literature (2004-2012). Publications published from 2004-2011 were retrieved from 11 major medical indices by using search terms for LE and management approaches. Literature archives were examined through 2012. Data extraction included study design, objectives pertaining to LE, number and characteristics of participants, interventions, and outcomes. Study strengths and weaknesses were summarized. Study evidence was categorized according to the Oncology Nursing Society Putting Evidence into Practice level-of-evidence guidelines after achieving consensus among the authors. No authors participated in development of nor benefitted from the review of these modality methods or devices. Extracted data from 85 studies were reviewed in 4 subcategories: botanical, pharmaceutical, physical agent modality, and modalities of contemporary value. After review, 47 articles were excluded, which left 16 articles on botanicals and pharmaceuticals and 22 articles for physical agent modality and/or modalities of contemporary value. Pharmaceuticals were later excluded. The authors concluded that botanicals had generated sufficient studies to support a second, more specific systematic review; thus, botanicals are reported elsewhere. It was found that limited high-level evidence was available for all categories. Well-constructed randomized controlled trials related specifically to LE were limited

  7. Lymphedema Risk Reduction Practices

    Science.gov (United States)

    ... Question Corner (68) Research (38) Insurance (46) Inspirational Patients (8) LymphLink Articles (174) FAQ's (6) Position Papers (9) LSAP Perspective (9) FOLLOW US! Sign up for our mailing list. twitter Facebook LinkedIn Copyright ©2018 National Lymphedema Network ...

  8. [Administration of selenium in lymphedema].

    Science.gov (United States)

    Kasseroller, R

    1997-09-15

    To investigate the effectiveness and dosage of selenium in the treatment of lymphedema. Intensive treatment with decongestive physical therapy in combination with sodium selenite shows significant improvement in the reduction of the volume of the limb and in the histophysiology of secondary lymphedema after mastectomy or Wertheim-operation. The incidence of skin infections decreased significantly. The anti-inflammatory effect should be considered in the treatment of lymphedema.

  9. Lymphedema secondary to filariasis

    International Nuclear Information System (INIS)

    Leonard, J.C.; Humphrey, G.B.; Basmadjian, G.

    1985-01-01

    A 1-year-old immunodeficient boy developed brawny edema of the left foot. Lymphoscintigraphy revealed no evidence of left inguinal activity following pedal injection of Tc-99m-Sn phosphate. Over the next two months, the patient developed lymphedema on the right and repeat scintigraphy demonstrated no movement of isotope from the dorsum of either foot. Subsequent studies identified microfilaria in a nocturnal blood smear, which were thought to represent Brugia beaveri acquired by mosquito transmission in Oklahoma

  10. Lymphedema following axillary lymph node dissection for breast cancer.

    Science.gov (United States)

    Sakorafas, George H; Peros, George; Cataliotti, Luigi; Vlastos, George

    2006-11-01

    Lymphedema is a relatively common, potentially serious and unpleased complication after axillary lymph node dissection (ALND) for breast cancer. It may be associated with functional, esthetic, and psychological problems, thereby affecting the quality-of-life (QOL) of breast cancer survivors. Objective measurements (preferentially by measuring arm volumes or arm circumferences at predetermined sites) are required to identify lymphedema, but also subjective assessment can help to determine the clinical significance of any volume/circumference differences. Lymphedema per se predisposes to the development of other secondary complications, such as infections of the upper limb, psychological sequelae, development of malignant tumors, alterations of the QOL, etc. The risk of lymphedema is associated with the extent of ALND and the addition of axillary radiation therapy. Treatment involves the application of therapeutic measures of the so-called decongestive lymphatic therapy. Prevention is of key importance to avoid lymphedema formation. The application of the sentinel lymph node biopsy in the management of breast cancer has been associated with a reduced incidence of lymphedema formation.

  11. How Managers Fail to Meet Basic Employee Needs

    Science.gov (United States)

    College Store Journal, 1978

    1978-01-01

    Too often basic employee needs go unmet due to poor human relations practices and ineffective work management techniques. Managers can avoid the common mistakes listed, and meet the needs identified in this report by restudying basic management concepts. (JMD)

  12. Basic chemistry for radioactive waste management

    International Nuclear Information System (INIS)

    Eom, Tae Yoon; Park, Kyeong Kyun; Kim, Won Ho; Jee, Kwang Yong; Kim, Jong Koo; Park, Young Jae; Yoo, Man Soo; Jee, Chun Suk; Song, Byung Chul; Choi, Kyae Chun

    1992-03-01

    The goal of this study is to obtain the information about the chemical behavior of radionuclides in groundwater for the safety of radioactive waste management. The effect of o-phenanthroline and 2,2'-bipyridine on the adsorption of metal(II) (Mn, Fe, Co, Ni, and Cu) to silica gel surface, computer program for calculation of compound concentrations in multi-composition system, Np-237 reagent purification by anion exchange resin, characterization of installed basic photoacoustic spectrophotometer, and study of pH, ionic strength and metal ion adsorption on humic acid size distribution were described. (Author)

  13. Improving traffic signal management and operations : a basic service model.

    Science.gov (United States)

    2009-12-01

    This report provides a guide for achieving a basic service model for traffic signal management and : operations. The basic service model is based on simply stated and defensible operational objectives : that consider the staffing level, expertise and...

  14. Basics of theory of ecological crisis management

    Directory of Open Access Journals (Sweden)

    Stajić Ljubomir

    2013-01-01

    Full Text Available Today, it is clear that environmental accidents and processes represent, not only potential but also real causes of crises on which states must be aware of. The formation of the ecological crisis is growing exponentially, along with their consequences. The problem with the environmental crisisis lies not in the fact that they exist, but how we treat them. Exploring the causes of the crisis requires an interdisciplinary approach. At the micro level, this approach focuses on the role of individuals. At the middle level of research, focus is on organizational factors and processes that may play important role in causing the crisis. Macro level of approach lists possible causes that seem to make the crisis more or less inevitable and unavoidable features of the modern world. The crisis is also characterized by negative effects (perturbations, deregulation, conflict, confused action, intense stress, which leads to reckless actions and positive effects (mobilization, solidarity, cooperation, improved adaptation to the environment, experiential learning. Furthermore, ecological crisis represents an emergency situation whose beginning and duration are not predetermined. Anti-crisis measures have failed mainly because of the numerous factors influencing on one hand, on a complexity of the crisis and, on the other hand, because of its continuously changing factors throughout the duration of the crisis. Managing ecological crisis occurs, therefore, as a permanently professional inventive and complicated process which aims to prevent the escalation of the crisis, as well as the elimination of the expected and actual negative consequences of the crisis. Mismanagement of such crisis drains system resources, interferes with its function and organization, impacts on the financial opportunities while achieving positive goals. Extreme mismanagement can lead to the entropy of the system itself. The purpose of this paper is to elaborate basic facts of managing

  15. Kaposi sarcoma following postmastectomy lymphedema.

    Science.gov (United States)

    Montero Pérez, Iria; Rodríguez-Pazos, Laura; Álvarez-Pérez, Adriana; Ferreirós, M Mercedes Pereiro; Aliste, Carlos; Suarez-Peñaranda, Jose Manuel; Toribio, Jaime

    2015-11-01

    Classical Kaposi sarcoma (KS) usually appears on lower extremities accompanied or preceded by local lymphedema. However, the development in areas of chronic lymphedema of the arms following mastectomy, mimicking a Stewart-Treves syndrome, has rarely been described. We report an 81-year-old woman who developed multiple, erythematous to purple tumors, located on areas of post mastectomy lymphedema. Histopathological examination evidenced several dermal nodules formed by spindle-shaped cells that delimitated slit-like vascular spaces with some red cell extravasation. Immunohistochemically, the human herpesvirus type 8 (HHV-8) latent nuclear antigen-1 was detected in the nuclei of most tumoral cells confirming the diagnosis of KS. Lymphedema could promote the development of certain tumors by altering immunocompetence. Although angiosarcoma (AS) is the most frequent neoplasia arising in the setting of chronic lymphedema, other tumors such as benign lymphangiomatous papules (BLAP) or KS can also develop in lymphedematous limbs. It is important to establish the difference between AS and KS because their prognosis and treatment are very different. Identification by immunohistochemistry of HHV-8 is useful for the distinction between KS and AS or BLAP. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. [Lymphedema of the head in clinical practice].

    Science.gov (United States)

    Rüger, K

    1993-08-01

    In the Feldberg clinic Dr. Asdonk in St. Blasien we treat primary and secondary lymphedemas of the head with the "Manual lymphdrainage according to Vodder-Asdonk." Secondary lymphedemas are a result of cancer therapy or are caused of tumors or their metastases respectively. A successful therapy is possible at primary lymphedemas of head or lymphedemas following an inflammation or an injury. If the cancer increases unstoppable the so-called "malignant lymphedema" not always decreases. Nevertheless we should treat with manual lymphdrainage therapy because if we do it not the lymphedema increases also unstoppable and it means a disaster for the patient. The manual lymphdrainage therapy is the only treatment we can do. Diuretics are only an indication in the final phase of the malignant lymphedema of the head because they do not take away the protein out of the interstitial tissue and so the edema becomes all the more.

  17. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  18. DOES TREATMENT ALLEVIATE LYMPHEDEMA SYMPTOMS? A CROSS-SECTIONAL STUDY EVALUATING PATIENT PERSPECTIVES.

    Science.gov (United States)

    Finnane, A; Janda, M; Hayes, S C

    2015-09-01

    Most studies evaluating lymphedema treatment effect focus on objective reductions in limb volume, with little attention given to subjective treatment outcomes. The objective of this work was to describe the range of lymphedema symptoms experienced by patients and the importance of symptom improvement following treatment. The second aim was to explore lymphedema treatment use and the effect of individual treatments on symptoms, from the patient's perspective. Australian adults with lymphedema (n = 421) completed a self-administered questionnaire. Information was collected about patients' symptoms, the importance of symptom improvement following treatment, as well as treatment types used and perceived effectiveness of each treatment. In addition to swelling, the vast majority of participants experienced heaviness and tightness in the affected region. Overall, symptoms of lymphedema varied between individuals but the majority considered subjective symptom improvement to be an important outcome of treatment. The most commonly used treatments were compression garments, self- massage, prescribed exercises, and manual lymph drainage, and the majority (95%) of participants had used multiple treatments to manage their lymphedema. The impact of treatments on subjective symptoms varies widely between treatments. Consequently, in addition to objective measures of swelling, it is important to include patient-reported outcomes in future prospective lymphedema treatment studies.

  19. Management of Refractive Errors And Low Vision Among Basic ...

    African Journals Online (AJOL)

    The study sought to discuss the management of refractive errors and low vision among basic school children in the Atwima district. A sample of 1,177 public basic school children aged between 5-19 years was randomly selected from ten basic schools for examination. Thirteen key informants in the district were purposively ...

  20. Prospective Lymphedema Surveillance in a Clinic Setting

    Directory of Open Access Journals (Sweden)

    Janet Chance-Hetzler

    2015-08-01

    Full Text Available The potential impact of breast cancer-related lymphedema (LE is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1 time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ; (2 referral to LE management with limb volume increase (LVI and/or LBCQ symptoms; and (3 cost of LE management at lower LVI (≥5%–≤10% versus traditional (≥10%. Findings revealed a visit timeframe mean of 40.3 min (range = 25–60; 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9. LBCQ symptoms and LVI were significantly (p < 0.001 correlated to LE referral; six of the nine patients referred (67% displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings.

  1. Lipedema complicated by lymphedema of the abdominal wall and lower limbs.

    Science.gov (United States)

    Zelikovski, A; Haddad, M; Koren, A; Avrahami, R; Loewinger, J

    2000-06-01

    We describe a 52 year-old woman in whom lymphedema primarily of the abdominal wall was superimposed on lipedema resulting in an abdomen of enormous dimensions with marked impairment of ambulation. Treatment consisted of preoperative compression of the legs by an external pneumatic device (Lympha-Press) followed by excision of the lymphedematous abdominal fat pad in conjunction with "debulking" of the right leg. The patient illustrates the extremes of lipedema complicated by lymphedema and the technical difficulties associated with its management.

  2. Basic Project Management Methodologies for Survey Researchers.

    Science.gov (United States)

    Beach, Robert H.

    To be effective, project management requires a heavy dependence on the document, list, and computational capability of a computerized environment. Now that microcomputers are readily available, only the rediscovery of classic project management methodology is required for improved resource allocation in small research projects. This paper provides…

  3. Gigantic Suprapubic Lymphedema: A Case Study

    Directory of Open Access Journals (Sweden)

    Roozbeh Tanhaeivash

    2016-08-01

    Full Text Available We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg. Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases.

  4. Teaching Basic Probability in Undergraduate Statistics or Management Science Courses

    Science.gov (United States)

    Naidu, Jaideep T.; Sanford, John F.

    2017-01-01

    Standard textbooks in core Statistics and Management Science classes present various examples to introduce basic probability concepts to undergraduate business students. These include tossing of a coin, throwing a die, and examples of that nature. While these are good examples to introduce basic probability, we use improvised versions of Russian…

  5. Head and neck lymphedema: what is the physical therapy approach? A literature review

    Directory of Open Access Journals (Sweden)

    Lunara Basqueroto Della Justina

    Full Text Available Abstract Introduction: Head and neck lymphedema is considered a chronic and complex complication with potential to cause physical, functional, emotional and social impairment. Objective: To identify the approaches to physical therapy used to treat head and neck cancer-related lymphedema. Method: A bibliographic search was conducted in February and March 2012 in books and electronic databases, LILACS, MEDLINE, SCIELO, Cochrane, PEDro, and BDTD using the following keywords: lymphedema, treatment, head and neck cancer, and physical therapy connected by the Boolean operator AND without a specific time frame. Results and discussion: Early diagnosis and assessment is key to properly managing and effectively treating lymphedema. Diagnosis is reached through clinical history and physical assessment by measuring the distance between two anatomical landmarks, circumference measures, and lymphedema rating scales. Complex decongestive therapy, which includes manual lymph drainage, compressive bandaging, kinesiotherapy and skin care, is the technique most frequently used and currently considered to be the gold standard. Conclusions: No consensus is reported in the literature in regard to a standard procedure to assess and treat head and neck cancer-related lymphedema. Assessments and treatments described in the literature are mainly restricted to the limbs; therefore, further studies are needed to support effective clinical actions in the physical therapy approach to this condition.

  6. Basic elements of a risk management program

    International Nuclear Information System (INIS)

    Ericson, D.M. Jr.; Varnado, G.B.

    1991-01-01

    The modern industrial manger faces the challenge of safely and efficiently operating increasingly complex, sophisticated, and expensive plants in an atmosphere of reduced resources and increased competition, and frequently with heightened political and public oversight. These political and public concerns have become especially significant where the Federal Government regulates and/or funds programs that have a significant potential for adverse public safety or environmental impacts. Under these circumstances, a major accident or environmental insult could translate into major programmatic delay, redirection, or even plant closing. After-the-fact (reactive) resolution of safety and/or environment problems is both costly and time-consuming process. Therefore, it is prudent for managers at all levels to initiate aggressive proactive efforts to identify and control the risks (hazards) associated with their programs. Unfortunately, risk is not a concept with a single, universally accepted definition. It is most often represented as the product of the probability of occurrence of undesired events and the resultant consequences of those events. The consequences of concern may include: loss of human health, reduction in life expectancy, or loss of life; material or financial losses; environmental damage; or even societal disturbances. This paper discusses risk management and systems safety interest in which has intensified over the post decade principally because of public perceptions of the risks associated with nuclear power and the disposal of hazardous chemical wastes

  7. Upper limb lymphedema after breast cancer treatment

    International Nuclear Information System (INIS)

    Ben Salah, H.; Bahri, M.; Jbali, B.; Daoud, J.; Guermazi, M.; Frikha, M.

    2012-01-01

    Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

  8. [Lipedema complicated with lymphedema and chyloderma].

    Science.gov (United States)

    Ignjatović, M; Jevtić, M; Cerović, S

    2000-01-01

    Lipedema never reveals clinical picture of extreme lymphedema-elephantiasis, and skin signs and complications have not been observed. Aim of this paper is to present a case of lipedema with the initial lymphedema in which, after one episode of lymphangiitis and cellulitis, came to the rapid development of lymphedema followed by chyloderma. During the local treatment of extreme chyloderma with excessive exudation, semiocclusive synthetic dressings have been used for moist wound healing. The treatment was completed after 20 weeks with total epithelizsation, without maceration and irritation, without additional spreading of the chyloderma field, without wound infections, with fast and full relief of the pain. Lipedem with extreme lymphedema can be followed by skin complications of lymphedema like chylodermia.

  9. Lipedema: a clinical entity distinct from lymphedema.

    Science.gov (United States)

    Rudkin, G H; Miller, T A

    1994-11-01

    In a review of 250 cases of lymphedema of the lower extremity, 9 patients were noted to share unique similarities in their history and physical findings. Although these patients had mild swelling in their pretibial areas and were all referred with a diagnosis of lymphedema of the legs, their findings differed significantly from the usual patient with either congenital or acquired lymphedema. Notably, the lower extremity swelling was always bilateral and symmetrical in nature and never involved the feet. Skin changes characteristic of lymphedema were not found, and consistent fat pads were present anterior to the lateral malleoli in each patient. These findings are representative of a clinical entity known as lipedema, which is distinct from lymphedema and for which treatment may be different.

  10. Aortic dissection. Basic aspects and endovascular management

    International Nuclear Information System (INIS)

    Jaramillo, Nicolas I; Alviar, Carlos I

    2005-01-01

    elucidated. The clinical, diagnostic and management perspectives on aortic dissection and its variants, aortic intramural hematoma and atherosclerotic aortic ulcer, are reviewed

  11. Basic management of medical emergencies: recognizing a patient's distress.

    Science.gov (United States)

    Reed, Kenneth L

    2010-05-01

    Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

  12. Significant Differences in Nurses’ Knowledge of Basic Wound Management

    DEFF Research Database (Denmark)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B

    2014-01-01

    Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...... of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found...... of wound management in Denmark and suggests how improvements might be achieved....

  13. Basic Graphical Data Management System (BAGDAMS version 1.0)

    International Nuclear Information System (INIS)

    Weindorf, J.W.

    1979-06-01

    BAGDAMS (BAsic Graphical DAta Management System) is a set of FORTRAN callable subroutines which provides mass storage data structuring and manipulation capabilities. Although primarily designed to facilitate the handling of graphical data files (files containing information to be displayed upon graphical hardware devices), BAGDAMS can also be used in many other applications requiring complex mass storage resident data structures. (author)

  14. Predictors of Lymphedema Following Breast Cancer Surgery

    National Research Council Canada - National Science Library

    Swenson, Karen K

    2006-01-01

    .... Cases will be identified in the physical therapy or cancer centers. Controls will be identified using the oncology registry and include patients with breast cancer surgery who have not developed lymphedema...

  15. Treatment of upper limb lymphedema with low-level laser: a systematic review

    Directory of Open Access Journals (Sweden)

    Silvia Elizate Monteiro

    Full Text Available Introduction Low-level lasers have been suggested as a complement to lymphedema treatment. However, this therapy’s mechanism of action and its effects are poorly understood up to the present. Objective To conduct a systematic literature review to analyze the effects of low-level laser in the treatment of upper-limb lymphedema in women submitted to breast cancer surgery. Material and methods Randomized clinical trials were included, in Portuguese, English and Spanish, from January 1990 to July 2013. The article search was carried out in the Pubmed, Lilacs and PEDro electronic databases, with the following descriptors:Terapia a Laser de Baixa Intensidade, Linfedema, Câncer de Mama, Low-level laser therapy, Lymphedema, Breast Neoplasms and also through a manual search. Results and discussion Low-level lasers have been used for treating several acute and chronic conditions. However, its application for managing post breast cancer surgery is still recent, often based on empirical evidence. Treating upper-limb lymphedema with low-level laser presented positive results, with reduction in the circumference or volume of the affected limb. Conclusion More studies of high methodological quality are needed in order to better understand the mechanism of action of low-level laser on the lymphatic system and its effects on lymphedema treatement.

  16. Development of a framework for pneumatic device selection for lymphedema treatment

    Directory of Open Access Journals (Sweden)

    Sonja M Maul

    2009-12-01

    Full Text Available Sonja M Maul1, Julie A Devine2, Carolyn R Wincer31St. Luke’s Idaho Elks Rehabilitative Services, Boise, ID, USA; 2Center for Wound Care, Butler Memorial Hospital, Butler, PA, USA; 3Centers for Rehabilitation Services, Gibsonia, PA, USAAbstract: The results of three patients with difficult to manage leg and trunk lymphedema are reported. Patients were treated with the current standard of care: combined decongestive therapy. All three patients met obstacles in achieving independent self-care, which impeded their discharge to home care. The use of two currently available programmable pneumatic compression devices (PCDs was investigated to determine if these devices could enable these difficult-to-manage patients to meet their discharge goals. Results indicate that programmable PCDs can be effective in managing complicated cases of leg and trunk lymphedema, and that differences may exist between devices. In this trial, the device with lower applied pressures and smaller pneumatic chambers provided better tolerated treatment and overall better patient outcomes. These three case reports show that in-home use of an appropriate PCD can help patients with stage 3 and advanced stage 2 lymphedema achieve stable limb volumes with no exacerbation of lymphedema-related symptoms. Results also demonstrate the ability of patients to consistently use programmable PCDs in a home environment. The results are presented in a structured decision-making framework to aid the therapist and physician in selecting appropriate patients for home PCD lymphedema therapy, and in the selection of an appropriate PCD.Keywords: lymphedema, swelling, pneumatic, compression, flexitouch, lympha press.

  17. Upper extremity lymphedema index: a simple method for severity evaluation of upper extremity lymphedema.

    Science.gov (United States)

    Yamamoto, Takumi; Yamamoto, Nana; Hara, Hisako; Mihara, Makoto; Narushima, Mitsunaga; Koshima, Isao

    2013-01-01

    Measurement of the circumference is the most commonly employed method for evaluating extremity lymphedema. However, comparison between different patients is difficult with this measurement. To resolve this problem, we have formulated a new index, upper extremity lymphedema (UEL) index, which can be easily obtained from measurements of the body. We evaluated correlation between UEL index and clinical stage in patients with UEL. The UEL indices were significantly correlated with clinical stages and could be used as a severity scale. The lower extremity lymphedema index makes objective assessment of the severity of lymphedema through a numerical rating, regardless of the body type. This numerical rating makes the index useful for evaluation of lymphedema severities between different cases.

  18. Heavy resistance training and lymphedema

    DEFF Research Database (Denmark)

    Bloomquist, Kira; Karlsmark, Tonny; Christensen, Karl Bang

    2014-01-01

    , and identify associations between progressive resistance training with heavy loads, and the development of BCRL. MATERIAL AND METHODS: This was a descriptive study. POPULATION: Women treated for breast cancer (n = 149), who had participated in the 'Body and Cancer' exercise intervention between 1 January 2010......BACKGROUND: There is limited knowledge regarding progressive resistance training during adjuvant chemotherapy and the risk of developing breast cancer-related lymphedema (BCRL). Furthermore, no studies have investigated the safety of resistance training with heavy loads (> 80% 1 repetition maximum......) in this population. 'Body and Cancer' is a six-week, nine-hour weekly, supervised, multimodal exercise intervention utilizing progressive resistance training with heavy loads for cancer patients undergoing chemotherapy. The purpose of the present study was to estimate the prevalence of BCRL in former participants...

  19. BASIC

    DEFF Research Database (Denmark)

    Hansen, Pelle Guldborg; Schmidt, Karsten

    2017-01-01

    BPP. Tilgangen består dels af den overordnede proces-model BASIC og dels af et iboende framework, ABCD, der er en model for systematisk adfærdsanalyse, udvikling, test og implementering af adfærdsrettede løsningskoncepter. Den samlede model gør det muligt for forskere såvel som offentligt ansatte...

  20. Management Strategies in Basic Education and Participation of Parents

    Directory of Open Access Journals (Sweden)

    Johel Furguerle-Rangel

    2016-05-01

    Full Text Available In the educational process it is necessary to use management paradigms and active participation of parents. The objective was to determine the use of management strategies by the director of basic education and participation of parents in the educational process. It is a descriptive, transversal and field study, whose instrument was a questionnaire of 26 closed-questions.   The sample comprised 16 directors, 52 teachers and 62 parents. For most managers and faculty the technique of brainstorming, involvement in decision-making, continues knowledge management and radical change are crucial in the educational process of children.   But mothers and fathers believe that managerial groups do not use strategies properly except for reengineering.   The mother and fathers are mainly involved in education management but not in the learning process. It is recommended the deepening of policy management training teaching force, through continuous training provided by the government and the promotion of family participation in the teaching-learning process of children.

  1. Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

    Directory of Open Access Journals (Sweden)

    Kanapathy M

    2015-08-01

    Full Text Available Muholan Kanapathy,1 Mark J Portou,1,2 Janice Tsui,1,2 Toby Richards1,21Division of Surgery and Interventional Science, University College London, 2Department of Vascular Surgery, Royal Free London NHS Foundation Trust Hospital, London, UKAbstract: Diabetic foot ulcers (DFUs are complex, chronic, and progressive wounds, and have a significant impact on morbidity, mortality, and quality of life. A particular aspect of DFU that has not been reviewed extensively thus far is its management in conjunction with peripheral limb edema. Peripheral limb edema is a feature of diabetes that has been identified as a significant risk factor for amputation in patients with DFU. Three major etiological factors in development of lymphedema with concurrent DFU are diabetic microangiopathy, failure of autonomic regulation, and recurrent infection. This review outlines the pathophysiology of lymphedema formation in patients with DFU and highlights the cellular and immune components of impaired wound healing in lymphedematous DFU. We then discuss the principles of management of DFU in conjunction with lymphedema.Keywords: diabetic foot ulcer, lymphedema, chronic wound, wound management

  2. Effects of yoga on arm volume among women with breast cancer related lymphedema: A pilot study.

    Science.gov (United States)

    Fisher, Mary Insana; Donahoe-Fillmore, Betsy; Leach, Laura; O'Malley, Colleen; Paeplow, Cheryl; Prescott, Tess; Merriman, Harold

    2014-10-01

    Lymphedema affects 3-58% of survivors of breast cancer and can result in upper extremity impairments. Exercise can be beneficial in managing lymphedema. Yoga practice has been minimally studied for its effects on breast cancer related lymphedema (BCRL). The purpose of this study was to determine the effect of yoga on arm volume, quality of life (QOL), self-reported arm function, and hand grip strength in women with BCRL. Six women with BCRL participated in modified Hatha yoga 3×/week for 8 weeks. Compression sleeves were worn during yoga sessions. Arm volume, QOL, self-reported arm function, and hand grip strength were measured at baseline, half-way, and at the conclusion of yoga practice. Arm volume significantly decreased from baseline (2423.3 ml ± 597.2) to final measures (2370.8 ml ± 577.2) (p = .02). No significant changes in QOL (p = .12), self-reported arm function (p = .34), or hand grip strength (p = .26) were found. Yoga may be beneficial in the management of lymphedema. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Financial cost of lymphedema borne by women with breast cancer

    Science.gov (United States)

    Xu, Ying; Kalfa, Senia; Koelmeyer, Louise; Parkinson, Bonny; Mackie, Helen; Viveros, Hector; Gollan, Paul; Taksa, Lucy

    2016-01-01

    Abstract Objective Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors. Methods An online national survey was conducted with 361 women who had either breast cancer without lymphedema (BC) (group 1, n = 209) or breast cancer with lymphedema (BC+LE) (group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association. Results Both breast cancer and lymphedema result in significant out‐of‐pocket financial costs borne by women. Of patients with BC+LE, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% in the BC group (P < .020). For patients with lymphedema, over half (56%) indicated that this specific additional diagnosis to their breast cancer affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs (40.1%). The average number of attendances to a therapist each year was 5.8 (range, 0‐45). Twenty‐five patients (16.4%) had an episode of cellulitis in the past year. The incidence of cellulitis was 7.7% in 91 patients with subclinical or mild lymphedema compared with 29.5% of 61 patients with more extensive lymphedema (P < .001). The average out‐of‐pocket financial cost of lymphedema care borne by women was A$977 per annum, ranging from A$207 for subclinical lymphedema to over A$1400 for moderate or severe lymphedema. Conclusions This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs. PMID:27479170

  4. Basic Burns Management E-Learning: A New Teaching Tool.

    Science.gov (United States)

    Egro, Francesco M

    Burns teaching is organized only in a few medical schools in the United Kingdom. An e-learning tutorial was developed with the objective of incorporating burns teaching within the medical school curriculum. A 33-webpage e-learning was created, covering topics such as local and general response to burns, assessment of burns, first aid, primary and secondary survey, and referral guidelines. Medical student satisfaction was then evaluated using a 12-question feedback survey rated based on a Likert scale from 1 (very poor) to 5 (very good). The 12-question survey was completed by a total of 18 medical students ranging from second to fourth years (second = 17%, third = 22%, fourth = 61%). While only a couple of students had received prior burns teaching, 50% of the cohort had an interest to pursue surgery as a career. The majority of students (72%) would be interested to have an e-learning module on basic burns management in their medical curriculum. The means of all domains specific to the e-learning were rated as "good" or "very good." Students' rating for ease of use was 87%, usefulness was 88%, relevance to the medical curriculum was 90%, clarity and quality of content were 78% and 83%, respectively, design was 79%, and the overall satisfaction with this e-learning was 87%. The "Basic Burns Management" e-learning tutorial can provide an efficient and effective means of information delivery to medical students and junior doctors, allowing easy and fast incorporation of burns teaching within the medical curriculum and in other medical teaching settings.

  5. Lymphedema as a Cancer Treatment Side Effect

    Science.gov (United States)

    ... CDT). This is also known as complex decongestive therapy. It combines skin care, manual lymphatic drainage, exercise, and compression. A doctor who specializes in lymphedema or a CLT should perform CDT. The therapist will also tell you how to ... therapy. If you have trouble swallowing or other issues ...

  6. [What physiotherapeutic method for the treatment of post-mastectomy lymphedema is the most effective?

    Science.gov (United States)

    Grushina, T I

    volume of the upper limb decreased on the average for all stages of lymphedema by 37.7±9.3% under effect of pneumatic compression alone, by 49.5±10.7% under the influence of its combination with electrotherapy, by 59.9±5.4% under the action of the combination of pneumatic compression with magnetotherapy, and by 76.3±7.3% after the application of all the three techniques together (p<0.05). Electrical neurostimulation of the blood vessels and skeletal muscles proved especially effective for the treatment of I-II grade lymphedema while magnetic therapy was most efficient for the management of grade III-IV lymphedema. The proposed method of combined physiotherapy looks very encouraging for the treatment of late lymphedema but does not completely solve all problems pertaining to the management of this pathological condition.

  7. Hereditary Lymphedema of the Leg – A Case Report

    Directory of Open Access Journals (Sweden)

    Birgit Heinig

    2017-07-01

    Full Text Available Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist when he was seven years old. He had never been treated for lymphedema but experienced multiple erysipelas during his life. After diagnostic procedures to exclude other causes of leg swelling, the diagnosis of hereditary lymphedema of the leg, stage III was confirmed. We initialized complex decongestive therapy. During two weeks of intensive treatment, the circumference of the left leg could be reduced by 10 cm. This case illustrates the "natural course" hereditary lymphedema. But it raises the hope that even after decades of ignorance, the patients benefits from complex decongestive treatment. Therapeutic nihilism is unnecessary and poses lymphedema patients to risks of infection and secondary malignancies like Stewart-Trewes syndrome.

  8. Lymphedema and employability - Review and results of a survey of Austrian experts.

    Science.gov (United States)

    Neubauer, Markus; Schoberwalter, Dieter; Cenik, Fadime; Keilani, Mohammad; Crevenna, Richard

    2017-03-01

    Literature about lymphedema and its influence on the ability to work and employability is limited. The aim of the present study was to investigate the opinion of Austrian experts on factors influencing the ability to work and employability in patients suffering from lymphedema. A self-administered questionnaire consisting of 6 questions was sent to 12 Austrian lymphedema experts with 6 different specializations from May to August 2016. These experts were asked about suitable and unsuitable professions, the possible influence of lymphedema on the ability to work and employability as well as about existing and additional measures to improve the return to work. The reply rate was 100% (12 out of 12). All experts agreed that lymphedema can restrict the ability to work and employability. The leading reason for limited ability to work and employability was restricted mobility or function of the affected limb along with time-consuming therapeutic modalities, pain and psychological stress. The most suitable job named was teacher and the most unsuitable job named was cook. As easements for return to work, early rehabilitation, self-management, coping strategies, patient education, employer's goodwill and employer's cooperation were reported. Furthermore, experts stressed the need for an adjustment of the legal framework as well as low-barrier and more therapy offers. Adjusted work demands seem to be of greater importance to support the ability to work and employability than recommendations for specific job profiles alone. Experts suggest an adjustment of the legal framework for affected patients, claiming a right for early rehabilitation as well as for life-long therapy. Even though some clinically useful conclusions may be drawn from this article, further research in the field is warranted.

  9. [Secondary lymphedema--the importance of a multidisciplinary team approach].

    Science.gov (United States)

    Heldenberg, Eitan; Bass, Arie

    2013-03-01

    Secondary lymphedema is the most common type of lymphedema. Malignancy, mainly breast carcinoma, is the main cause of upper extremity lymphedema, while groin dissection, irradiation and trauma are the cause of lower extremity lymphedema. Early recognition of the pathology followed by early referral to a vascular surgeon, leading a multidisciplinary team, who takes care of those patients, can prevent a miserable Life from these patients. Lifelong commitment of the patients, prolonged financial support of the health insurance supplier, as well as team work of the group taking care of the patient, is the only way to help these patients.

  10. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency.

    Science.gov (United States)

    Armer, Jane M; Henggeler, Mary H; Brooks, Constance W; Zagar, Eris A; Homan, Sherri; Stewart, Bob R

    2008-01-01

    (38-39% lymphedema occurrence), with symptom report being the earliest predictor of lymphedema occurrence than any other measurement. Findings verify the importance of subjective assessment by symptom report of limb changes and SCD following breast cancer treatment as an essential tool in early detection and treatment of lymphedema. Findings also support the importance of pre-operative baseline measurements, symptom history, and SCA for later post-op comparisons. These preliminary findings underscore the importance of strengthening SCA by educating breast cancer survivors. Self assessment, early detection, and early treatment hold the best promise for optimal management of this chronic condition, limiting detrimental effects on SCA, and improving quality of life and physiological and psychosocial well-being. These findings lay the foundation for a clinical research program in breast cancer lymphedema based on SCDNT in which education in and awareness for self-report of lymphedema-associated symptoms is a first step in screening. Increasing patient knowledge through education will increase SCA by identifying ane providing information to meet self-care requisites (SCR) related to the health deviation of lymphedema. The nurse has the opportunity to assist patients in developing self-care actions as needed to meet universal and health deviation therapeutic requisites to address self-care demands following breast cancer treatment.

  11. 41 CFR 102-74.10 - What is the basic facility management policy?

    Science.gov (United States)

    2010-07-01

    ... facility management policy? 102-74.10 Section 102-74.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT General Provisions § 102-74.10 What is the basic facility management policy? Executive agencies...

  12. Basic Sciences Fertilizing Clinical Microbiology and Infection Management.

    Science.gov (United States)

    Baquero, Fernando

    2017-08-15

    Basic sciences constitute the most abundant sources of creativity and innovation, as they are based on the passion of knowing. Basic knowledge, in close and fertile contact with medical and public health needs, produces distinct advancements in applied sciences. Basic sciences play the role of stem cells, providing material and semantics to construct differentiated tissues and organisms and enabling specialized functions and applications. However, eventually processes of "practice deconstruction" might reveal basic questions, as in de-differentiation of tissue cells. Basic sciences, microbiology, infectious diseases, and public health constitute an epistemological gradient that should also be an investigational continuum. The coexistence of all these interests and their cross-fertilization should be favored by interdisciplinary, integrative research organizations working simultaneously in the analytical and synthetic dimensions of scientific knowledge. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  13. Possible genetic predisposition to lymphedema after breast cancer.

    Science.gov (United States)

    Newman, Beth; Lose, Felicity; Kedda, Mary-Anne; Francois, Mathias; Ferguson, Kaltin; Janda, Monika; Yates, Patsy; Spurdle, Amanda B; Hayes, Sandra C

    2012-03-01

    Known risk factors for secondary lymphedema only partially explain who develops lymphedema following cancer, suggesting that inherited genetic susceptibility may influence risk. Moreover, identification of molecular signatures could facilitate lymphedema risk prediction prior to surgery or lead to effective drug therapies for prevention or treatment. Recent advances in the molecular biology underlying development of the lymphatic system and related congenital disorders implicate a number of potential candidate genes to explore in relation to secondary lymphedema. We undertook a nested case-control study, with participants who had developed lymphedema after surgical intervention within the first 18 months of their breast cancer diagnosis serving as cases (n=22) and those without lymphedema serving as controls (n=98), identified from a prospective, population-based, cohort study in Queensland, Australia. TagSNPs that covered all known genetic variation in the genes SOX18, VEGFC, VEGFD, VEGFR2, VEGFR3, RORC, FOXC2, LYVE1, ADM, and PROX1 were selected for genotyping. Multiple SNPs within three receptor genes, VEGFR2, VEGFR3, and RORC, were associated with lymphedema defined by statistical significance (p2.0). These provocative, albeit preliminary, findings regarding possible genetic predisposition to secondary lymphedema following breast cancer treatment warrant further attention for potential replication using larger datasets.

  14. Twisting Tourniquet© Technique: introducing Schnogh, a novel device and its effectiveness in treating primary and secondary lymphedema of extremities

    International Nuclear Information System (INIS)

    Chanwimalueang, Narumon; Ekataksin, Wichai; Piyaman, Parkpoom; Pattanapen, Gedsuda; Hanboon, Borimas K

    2015-01-01

    Twisting Tourniquet © or in Thai “Schnogh” is a new invention for compression therapy of lymphedema. Twisting Tourniquet © Technique (TTT) is totally noninvasive for lymphedema management. After the amazing successful evidence in the first series of 28 patients, we have conducted preliminary studies in lymphedema clinics. It was found that the combination of gradually increasing constriction force by Schnogh until desired pressure was reached and maintained for 15 min, followed by a 5-min release, doing repeatedly this compression-decompression for at least 10 sessions a day, can generate acceptable results. The aim of the study was to evaluate the scientific effectiveness and establish a treatment protocol of TTT proposed as a therapeutic approach for clinical management of lymphedema. During 2006–2013, from over 3500 patients, 647 with primary/secondary lymphedema passed inclusion criteria, 307 for upper, and 340 for lower extremity. In the 5-day course of TTT, each day patients underwent 10 sessions of a 15-min compression followed by a 5-min decompression. Vegan diet was encouraged as an adjuvant therapy. Among lymphedema patients whose spectrum of edema severity ranged from mild to gigantic, TTT yielded an average volume reduction rate (VR) at 50.2% and 55.6%, making the average edema reduction volume attained at 463 and 1856 mL for upper and lower limb, respectively. The uniformed practice by Schnogh which supports a continual compression–decompression maneuver over 3.5 h daily for five consecutive days could induce an average VR at above half of the swelling in extremities of 647 patients. Schnogh is therefore effective in clinical management of lymphedema under TTT treatment of fibroblastic interstitium

  15. Profile of Knowledge Management, Basic Sanitation and Attitudes towards Clean and Health Community in Kupang City

    Science.gov (United States)

    Nikmah; Ardi, Muhammad; Yahya, Mohamad; Upa, Muhamad D. Pua; Dirawan, Gufran Darma

    2017-01-01

    The objective of research is to describe the knowledge and attitude of basic sanitation management community in Kupang City. This type of research is a survey research using quantitative approach. Data were collected by using the instrument in the form of test knowledge of basic sanitation management and attitude questionnaire. The data was then…

  16. Beckwith-Wiedemann Syndrome and Primary Lymphedema of the Lower Extremity.

    Science.gov (United States)

    Beijnen, Usha E A; Maclellan, Reid A; Goss, Jeremy A; Couto, Javier A; Konczyk, Dennis J; Greene, Arin K

    2017-01-01

    Beckwith-Wiedemann syndrome is the most common genetic overgrowth syndrome. Patients with Beckwith-Wiedemann syndrome may have hemihypertrophy, but their lymphatic vasculature is intact. We present a child with Beckwith-Wiedemann syndrome and lower extremity enlargement thought to be due to hemihypertrophy that was instead diagnosed with primary lymphedema. There are many causes of leg overgrowth in the pediatric population and misdiagnosis is common. While extremity enlargement secondary to hemihypertrophy may occur in 15% of patients with Beckwith-Wiedemann syndrome, progression and pitting edema only occur in primary lymphedema. This report highlights the importance of ensuring an accurate diagnosis so that patients are managed appropriately. © 2016 Wiley Periodicals, Inc.

  17. Development and validation of a self-report lower-extremity lymphedema screening questionnaire in women.

    Science.gov (United States)

    Yost, Kathleen J; Cheville, Andrea L; Weaver, Amy L; Al Hilli, Mariam; Dowdy, Sean C

    2013-05-01

    Patient-reported signs and symptoms are often the first indication of clinically relevant lymphedema. The purpose of this study was to develop and assess the diagnostic accuracy of a screening questionnaire to detect lower-extremity lymphedema (LEL) among normal-weight women and women with obesity. This was a cross-sectional survey study. The authors reviewed existing questionnaires assessing upper-extremity lymphedema (UEL) for potential questions and worked with content experts to generate new items. A draft questionnaire with 59 items was reviewed by 5 physicians and 5 physical therapists who specialized in lymphedema management and 5 female patients with clinically confirmed secondary LEL. A revised questionnaire with 45 items was administered by mail to 186 women with clinically confirmed LEL (n=116) or UEL (n=70). A total of 99 women (53.2% of 186) completed the mailed survey, and 28 women with lymphedema who were recruited directly in a lymphedema clinic waiting area also completed the survey. A parsimonious subset of items that best discriminated patients with and without LEL was identified using chi-square tests and logistic regression. Sensitivity and specificity for detecting LEL and positive and negative likelihood ratios (LR+, LR-) were estimated for the entire sample and for subsamples defined by obesity (body mass index ≥30 versus UEL group, n=39). A sum of 13 items (score range=0-52) was the most discriminating. Using a cutoff score of ≥5 points, the sensitivity and specificity for detecting LEL among all participants were 95.5% and 86.5%, respectively (LR+=7.1, LR-=0.05), and 94.8% and 76.5%, respectively (LR+=4.0, LR-=0.07), for participants who were obese. By enumerating a sample with a high prevalence of LEL, a spectrum bias may have been introduced, which may have affected the accuracy of the screening questionnaire. The brief, 13-item self-report questionnaire is a sensitive and specific tool for detecting clinically relevant LEL among

  18. Database basic design for safe management radioactive waste

    International Nuclear Information System (INIS)

    Son, D. C.; Ahn, K. I.; Jung, D. J.; Cho, Y. B.

    2003-01-01

    As the amount of radioactive waste and related information to be managed are increasing, some organizations are trying or planning to computerize the management on radioactive waste. When we consider that information on safe management of radioactive waste should be used in association with national radioactive waste management project, standardization of data form and its protocol is required, Korea Institute of Nuclear Safety(KINS) will establish and operate nationwide integrated database in order to effectively manage a large amount of information on national radioactive waste. This database allows not only to trace and manage the trend of radioactive waste occurrence and in storage but also to produce reliable analysis results for the quantity accumulated. Consequently, we can provide necessary information for national radioactive waste management policy and related industry's planing. This study explains the database design which is the essential element for information management

  19. Battle Management as a Basic Air Force Doctrine Operational Function

    National Research Council Canada - National Science Library

    Rhone, Jon M

    2008-01-01

    According to JP 1-02, Department of Defense Dictionary of Military and Associated Terms, battle management is "The management of activities within the operational environment, based on the commands...

  20. Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial

    International Nuclear Information System (INIS)

    McNeely, Margaret L.; Campbell, Kristin L.; Webster, Marc; Kuusk, Urve; Tracey, Karen; Mackey, John

    2016-01-01

    Lymphedema is a prevalent long-term effect of breast cancer treatment that is associated with reduced quality of life. More recent observational data suggest that the addition of night-time compression to day-time use of a compression garment results in better long-term control of arm lymphedema. The primary objectives of the randomized controlled phase of the trial are to determine the efficacy of night-time compression on arm lymphedema volume maintenance and quality of life in breast cancer survivors who have completed intensive reduction treatment for their lymphedema. The study will be a parallel 3-arm, multi-centre randomized fast-track trial. A total of 120 women with breast cancer related lymphedema will be recruited from 3 centres in Canada and randomized to group 1: Day-time compression garment alone or Group 2: Day-time compression garment + night-time compression bandaging or Group 3: Day-time compression garment + use of a night-time compression system garment. The duration of the primary intervention period will be 12 weeks. The follow-up period after the intervention (weeks 13 to 24) will follow a longitudinal observational design. The primary outcome variables: differences from baseline to week 12 in arm volume and quality of life (Lymphoedema Functioning, Disability and Health Questionnaire: Lymph-ICF). Secondary outcomes include bioimpedance analysis, sleep disturbance and self-efficacy. All measurements are standardized and will be performed prior to randomization, and at weeks 6, 12, 18 and 24. The use of night-time compression as a self-management strategy for chronic breast cancer related lymphedema is seen as an innovative approach to improve long-term control over the condition. This trial aims to advance the knowledge on self-management strategies for lymphedema

  1. Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer

    International Nuclear Information System (INIS)

    Koul, Rashmi; Dufan, Tarek; Russell, Catherine; Guenther, Wanda; Nugent, Zoan; Sun Xuyan; Cooke, Andrew L.

    2007-01-01

    Objective: To evaluate the results of combined decongestive therapy and manual lymphatic drainage in patients with breast cancer-related lymphedema. Methods and Materials: The data from 250 patients were reviewed. The pre- and posttreatment volumetric measurements were compared, and the correlation with age, body mass index, and type of surgery, chemotherapy, and radiotherapy was determined. The Spearman correlation coefficients and Wilcoxon two-sample test were used for statistical analysis. Results: Of the 250 patients, 138 were included in the final analysis. The mean age at presentation was 54.3 years. Patients were stratified on the basis of the treatment modality used for breast cancer management. Lymphedema was managed with combined decongestive therapy in 55%, manual lymphatic drainage alone in 32%, and the home program in 13%. The mean pretreatment volume of the affected and normal arms was 2929 and 2531 mL. At the end of 1 year, the posttreatment volume of the affected arm was 2741 mL. The absolute volume of the affected arm was reduced by a mean of 188 mL (p < 0.0001). The type of surgery (p = 0.0142), age (p = 0.0354), and body mass index (p < 0.0001) were related to the severity of lymphedema. Conclusion: Combined decongestive therapy and manual lymphatic drainage with exercises were associated with a significant reduction in the lymphedema volume

  2. Basic practice management systems. Part II of the dental management pyramid series.

    Science.gov (United States)

    Levin, Roger P

    2003-08-01

    Mastering basic management systems is the first of six levels in the Dental Management Pyramid that determines the future direction of your practice. It is important to avoid the temptation to move from one level to the next until you have addressed all aspects of the current level. All too often, dentists attempt to move up the pyramid without completing each level, leaving incomplete management in other areas. Business systems allow for the highest level of profitability, the lowest stress, and the most enjoyment for you and your team members. They serve as the very foundation on which you build your successful dental practice. In the next installment of this series, leadership skills and team development will be discussed.

  3. The risk of lymphedema after breast cancer surgical treatment.

    Science.gov (United States)

    Diaconu, C; Livadariu, Roxana-Maria; Dogaru, C

    2012-01-01

    The aim of this study is to emphasize the importance of knowing the predisposing factors of the occurrence of homolateral upper limb lymphedema after breast cancer surgery. The study included 1104 patients with breast cancer, who were hospitalized in the IIIrd Surgical Clinic, lasi, between 2000 and 2010, for surgical treatment followed by oncological adjuvant therapy. The surgical intervention was conservative in 228 cases and modified radical mastectomy - Madden type - in 876 patients. Periodic clinical follow-ups were done every 3 months during the first postoperative year, every 6 months during the second year and annually thereafter. Early lymphedema occurring in the first 14 postoperative days or between day 14 and day 21 was found in 8 patients. Late lymphedema, occurring up to 12 months or more after surgery, was diagnosed in 41 patients. Medium and severe lymphedema occurred at 42 patients. We evaluated the preexisting risk factors, the risk factors related to the type of surgery and those related to the cancer staging. It's ideal to identify predisposing factors of developing lymphedema related to breast cancer surgery before applying any type of treatment, There are therapeutic methods (general, drug therapy, physiotherapy) and methods related to the surgical act that influences the prophylaxis of lymphedema or have an amazing effect on already occurred lymphedema.

  4. Basic concepts of philosophy of management and corporations

    DEFF Research Database (Denmark)

    Rendtorff, Jacob Dahl

    2013-01-01

    This chapter presents some fundamental concepts of the philosophy of management and corporations by addressing the problem of corporate legitimacy and Immanuel Kant’s distinction between theoretical, practical, and aesthetic reason and judgment. This chapter begins with a general definition...... of philosophy of management and corporations and continues by presenting its ontological and epistemological underpinnings. This approach is used to address the relation between economics, business ethics, and philosophy of management. Finally, ethical and aesthetic judgment is presented as the mediator between...

  5. Essentials of Risk Management. Strategic Decisions. Board Basics.

    Science.gov (United States)

    Sonenstein, Burton; Kumin, Laura A.

    1998-01-01

    This booklet, intended for trustees of institutions of higher education, offers some instruction on the principles of risk management. Introductory information provides a definition of risk management, which is seen as a planning and strategic function, not solely as a financial or safety assessment. Individual sections then address the following…

  6. Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong [Samsung Medical Center, Seoul (Korea, Republic of)

    1997-07-01

    An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy.

  7. Evaluation of the effectiveness of kinesio taping application in a patient with secondary lymphedema in breast cancer: a case report

    Directory of Open Access Journals (Sweden)

    Jakub Taradaj

    2014-03-01

    Full Text Available Breast cancer-related lymphedema is one of the complications resulting from treatment. It is defined as arm oedema in the breast cancer patients caused by interruption of the flow of the axillary lymphatic system from surgery or radiation therapy, which results in the accumulation of fluid in the subcutaneous tissue of the arm, with a decrease in tissue distensibility around the joints and an increased weight of the extremity. Decongestive lymphatic therapy is common management for lymphedema. A program combining skin care, manual lymphatic drainage, exercise, and compression therapy (multilayer bandage or garment is recognised as the best practice in lymphedema management. Kinesio taping (KT for lymphatic drainage is a new choice in the field of physical therapy. The material and the original concept of the taping technique were introduced by Dr Kenso Kase in 1973. K-tape had been designed to allow 30-40% longitudinal stretch. It is composed of 100% cotton fibers and acrylic heat sensitive glue. Development of the technique for its administration is still ongoing. The paper discusses the case of a woman with breast cancer, in whom lymphedema occurred. The patient had three weeks of therapy. The treatment consisted of 12 manual lymphatic drainage, 12 pneumatic compressions and 3 applications of the KT method (due to the lack of standard multi-layer bandaging. During the measurement of oedema it was noted that KT had a significant effect on the reduction of lymphedema and accelerates healing effects compared to standard methods.

  8. Cancer pain management: Basic information for the young pain physicians

    Directory of Open Access Journals (Sweden)

    SPS Rana

    2011-01-01

    Full Text Available Cancer pain is multifactorial and complex. The impact of cancer pain is devastating, with increased morbidity and poor quality of life, if not treated adequately. Cancer pain management is a challenging task both due to disease process as well as a consequence of treatment-related side-effects. Optimization of analgesia with oral opioids, adjuvant analgesics, and advanced pain management techniques is the key to success for cancer pain. Early access of oral opioid and interventional pain management techniques can overcome the barriers of cancer pain, with improved quality of life. With timely and proper anticancer therapy, opioids, nerve blocks, and other non-invasive techniques like psychosocial care, satisfactory pain relief can be achieved in most of the patients. Although the WHO Analgesic Ladder is effective for more than 80% cancer pain, addition of appropriate adjuvant drugs along with early intervention is needed for improved Quality of Life. Effective cancer pain treatment requires a holistic approach with timely assessment, measurement of pain, pathophysiology involved in causing particular type of pain, and understanding of drugs to relieve pain with timely inclusion of intervention. Careful evaluation of psychosocial and mental components with good communication is necessary. Barriers to cancer pain management should be overcome with an interdisciplinary approach aiming to provide adequate analgesia with minimal side-effects. Management of cancer pain should comprise not only a physical component but also psychosocial and mental components and social need of the patient. With risk-benefit analysis, interventional techniques should be included in an early stage of pain treatment. This article summarizes the need for early and effective pain management strategies, awareness regarding pain control, and barriers of cancer pain.

  9. [Basic considerations during outsourcing of clinical data management services].

    Science.gov (United States)

    Shen, Tong; Liu, Yan

    2015-11-01

    With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.

  10. Seroma indicates increased risk of lymphedema following breast cancer treatment

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Jørgensen, Mads Gustaf; Haugaard, Karen

    2017-01-01

    Introduction Lymphedema is one of the most serious complications following breast cancer treatment. While many risk factors are well described the role of seroma formation has recently produced mixed results. Therefore, we aimed to evaluate if seroma is a risk factor for development of lymphedema...... in one of the largest retrospective cohort studies. Material and methods We included all patients with unilateral breast cancer treated in the period of 2008-2014. Data regarding treatment and breast cancer characteristics were retrieved from the national breast cancer registry. Data regarding lymphedema...... were lymphadenectomy, radiation therapy, chemotherapy, BMI above 30, total lymph nodes removed above 15 and higher number of metastatic lymph nodes. Conclusions Postoperative seroma doubles the risk of developing lymphedema. Future studies should examine if seroma reducing measures will lead to lower...

  11. Future research priorities for morbidity control of lymphedema

    Directory of Open Access Journals (Sweden)

    S R Narahari

    2017-01-01

    Full Text Available Background: Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP was established to decide on the future priorities in lymphedema research. Methods: A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients' priorities. Results: One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF, and economic benefit of integrative treatments of lymphedema. Conclusion: A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP.

  12. Quality management in radiology: historical aspects and basic definitions.

    Science.gov (United States)

    Erturk, Sukru Mehmet; Ondategui-Parra, Silvia; Ros, Pablo R

    2005-12-01

    In today's extremely competitive economic environment, the quality management processes used by industrial companies have become commonplace at hospitals and are proving successful in improving quality and controlling costs. Continuous quality improvement (CQI) methods provide a relatively new way, compared with quality assurance (QA) and quality control (QC) methods, to improve the quality of health care. Continuous quality improvement should be considered a philosophy rather than simply a methodology; it assumes no endpoints in improvement efforts and does not attempt to replace the older concepts of QA and QC but rather to reap their benefits and take them to a higher conceptual level. Continuous quality improvement has 4 foci: (1) to determine and meet the needs of patients and customers, (2) to approach quality improvement holistically on the basis of the identification of the underlying cause of poor performance, (3) to apply fact-based management and scientific methodology, and (4) to empower its practitioners to improve quality on a daily basis. Health care institutions and radiology departments use a variety of CQI systems or models, including the model of the Joint Commission on Accreditation of Healthcare Organizations, the Six Sigma model, and the Model for Business Excellence of the European Foundation for Quality Management. The International Organization for Standardization 9000, which creates a suitable organizational environment for the implementation of a CQI system, can be considered an effective QA and QC method.

  13. Weight lifting in women with breast-cancer-related lymphedema.

    Science.gov (United States)

    Schmitz, Kathryn H; Ahmed, Rehana L; Troxel, Andrea; Cheville, Andrea; Smith, Rebecca; Lewis-Grant, Lorita; Bryan, Cathy J; Williams-Smith, Catherine T; Greene, Quincy P

    2009-08-13

    Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema, preventing them from obtaining the well-established health benefits of weight lifting, including increases in bone density. We performed a randomized, controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm. The primary outcome was the change in arm and hand swelling at 1 year, as measured through displaced water volume of the affected and unaffected limbs. Secondary outcomes included the incidence of exacerbations of lymphedema, number and severity of lymphedema symptoms, and muscle strength. Participants were required to wear a well-fitted compression garment while weight lifting. The proportion of women who had an increase of 5% or more in limb swelling was similar in the weight-lifting group (11%) and the control group (12%) (cumulative incidence ratio, 1.00; 95% confidence interval, 0.88 to 1.13). As compared with the control group, the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms (P=0.03) and upper- and lower-body strength (Pweight lifting had no significant effect on limb swelling and resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms, and increased strength. (ClinicalTrials.gov number, NCT00194363.) 2009 Massachusetts Medical Society

  14. [Comparative analysis of lymphoscintigraphy between lipedema and lower limb lymphedema].

    Science.gov (United States)

    Boursier, V; Pecking, A; Vignes, S

    2004-12-01

    Lipedema is characterized by bilateral enlargement of the legs due to abnormal deposition of fat tissue from pelvis to ankles. It is seen most frequently in obese women. Lipedema appears to be a distinct clinical entity but may be confounded with lymphedema. To analyze and to compare between lipedema and lymphedema the qualitative and quantitative aspects of lymphoscintigraphy. Fifteen women with lipedema were recruited. Mean age of onset of lipedema was 31.5 +/- 15 years. Body mass index was 35.1 +/- 7.9 kg/m2, 13 women were obese. Lipedema was compared to 15 cases of primary lymphedema (women: 13, men: 2) of the lower limbs (unilateral: 13, bilateral: 2), with a mean age at onset of 28.7 +/- 12.6 years. Lymphoscintigraphy of the lower limbs with morphologic (visualization of inguinal lymph nodes) and kinetic (half-life, lymphatic speed of the colloid) studies was performed in all cases. Absence of visualization of inguinal lymph nodes was observed in 14/15 cases of lymphedema and in 1/15 cases of lipedema (plipedema than in controlateral limbs of lymphedema (154 +/- 23 vs 121 +/- 36 minutes, plipedema (230 +/- 92 vs 154 +/- 23 minutes, plipedema without morphologic abnormality as seen in lymphedema. Lymphoscintigraphy is not indispensable but is a useful tool when diagnosis is doubtful. Treatment is difficult and may include weight loss and possible surgery.

  15. Brand Evaluation - A Basic Feature in Modern Brand Management

    OpenAIRE

    Cosmin IRIMIEŞ

    2012-01-01

    Defined as the sum of features that make a subject unique, the brand has turned into one of the most important characteristics of the way products, services and institutions conduct their public relations or are presented to the contemporary consumer. Taking into consideration that branding is an extremely flexible process and can be applied to a very wide range of subjects, the brand management has become one of the most important instruments of modern marketing and is used in every selling/...

  16. Lymphoscintigraphy in the diagnosis of extremity lymphedema

    International Nuclear Information System (INIS)

    Yang Meifang; Lu Gang; Li Fang; Tian Jian

    1994-01-01

    Lymphoscintigraphy, using 99m Tc labeled antimony sulfur colloid and 99m Tc labeled dextran, was performed on 25 patients with swelling of upper or lower extremities for diagnosis of lymphedema. Five different lymphoscintigraphic patterns were identified, that is normal (4 cases), collaterals (2 cases), mixed (13 cases), dermal backflow (4 cases) and no backflow pattern (2 cases). Eight patients underwent operations for lympho-venous anastomoses on the involved extremity. The results indicate that lymphoscintigraphy has many advantages, such as simplicity and non-invasiveness, safety and reliability, being able to differentiate properties of extremity edema, to provide the information of morphologic changes and dynamically display lymphatic drainage and obstructive extent in the lymphatic system. The procedure is valuable for determination of the treatment modalities and the selection of patient for lymphatic microsurgery

  17. Waste Management Effluent Treatment Facility: Phase I. CAC basic data

    International Nuclear Information System (INIS)

    Gemar, D.W.; O'Leary, C.D.

    1984-01-01

    In order to expedite design and construction of the Waste Management Effluent Treatment Facility (WMETF), the project has been divided into two phases. Phase I consists of four storage basins and the associated transfer lines, diversion boxes, and control rooms. The design data pertaining to Phase I of the WMETF project are presented together with general background information and objectives for both phases. The project will provide means to store and decontaminate wastewater streams that are currently discharged to the seepage basins in F Area and H Area. This currently includes both routine process flows sent directly to the seepage basins and diversions of contaminated cooling water or storm water runoff that are stored in the retention basins before being pumped to the seepage basins

  18. Brand Evaluation - A Basic Feature in Modern Brand Management

    Directory of Open Access Journals (Sweden)

    Cosmin IRIMIEŞ

    2012-10-01

    Full Text Available Defined as the sum of features that make a subject unique, the brand has turned into one of the most important characteristics of the way products, services and institutions conduct their public relations or are presented to the contemporary consumer. Taking into consideration that branding is an extremely flexible process and can be applied to a very wide range of subjects, the brand management has become one of the most important instruments of modern marketing and is used in every selling/buying transaction. The purpose of this article is to make a comprehensive analysis of the evaluation methods of brands, to present the situations that usually need a brand evaluation as well as to see whether Romania has made any progress from this point of view.

  19. Three basic options for the management of PWR waste

    International Nuclear Information System (INIS)

    Malherbe, J.; Saulieu, E. de; Glibert, R.; Alamo Berna, S.; Cecille, L.; Geiser, H.; Kowa, S.; Thiels, G.

    1990-01-01

    Relying on the national practices of France, Germany and Belgium, three reference management routes for PWR wastes were drawn up and subsequently evaluated in terms of costs and radiological impact. It was thus demonstrated that safety regulations and technical redundancies, especially for off-gas treatment, liquid waste processing and dry solid waste treatment, play an important part in the cost associated with each route. The analysis of the different treatment options for mixed solid low level waste highlighted the low cost effectiveness of incineration as compared to compaction. Whatever the scenario investigated, the disposal costs of PWR wastes proved to be quite marginal in the overall cost. The radiological impact associated with each route was assessed through individual doses resulting from liquid and gaseous effluents. This theoretical exercise included some sensitivity studies performed on a selection of important parameters

  20. The Basics of the Money Flow Management of Enterprise

    Directory of Open Access Journals (Sweden)

    Tanklevska Nataliya S.

    2017-06-01

    Full Text Available Essence of the definition of «money flow» of enterprise has been researched. The theoretical basis for the formation of money flows of enterprise, including the developments by mercantilists, marxists, monetarists, and contemporaries has been systematized. Cycles of the money flow and its relationship to the circulation of economic means have been characterized. The money flow discounting factors have been determined, which include inflation, risk, and alternativeness of investment process. The economic, political, social, and techno-economic risks that impact the management of money flows of enterprise have been allocated. The classification of money flows of enterprises by various attributes has been provided. The main sources of formation and modalities of the optimal money flow structure of enterprise have been determined. The advantages and disadvantages of using financial resources to generate money flows of enterprise have been characterized.

  1. [The basic system for the management of a spa and resort facility].

    Science.gov (United States)

    Fedotchenko, A A; Kholmogorov, N A

    2014-01-01

    The authors propose the basic system for the management of a spa and resort facility that ensures functioning of all its divisions as an integrated process. It is maintained that organization of a spa and resort facility must include measures aimed at improving its working structure, material and technical resources, marketing plans, financial management, medical services, informational support, and personnel administration.

  2. Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Deng Jie, E-mail: jie.deng@vanderbilt.edu [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Ridner, Sheila H. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Dietrich, Mary S. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee (United States); Wells, Nancy; Wallston, Kenneth A. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A. [Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States)

    2012-11-01

    Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients {>=}3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

  3. [Survey on the diagnostics and therapy of patients with lymphedema and lipedema].

    Science.gov (United States)

    Reich-Schupke, S; Mohren, E; Stücker, M

    2018-03-12

    Implementation of guideline recommendations for the diagnosis and therapy of lipedema and lymphedema seems to be problematic in daily routine. Systematic data for Germany are missing. The aim of the study was data collection regarding diagnosis and therapy of lymphologic diseases in an outpatient setting. Monocentric, prospective survey of patients from a lymphologic outpatient clinic using a standardized questionnaire focusing on diagnostics and therapy at the initial diagnosis. In all, 72 patients (83.3% women) with lymphedema (n = 26), lipedema (n = 14) or lipolymphedema (n = 32) were included; 44.4% had symptoms more than 5 years before the initial diagnosis. Main symptoms were swelling of the leg and foot (especially lymphedema) and feeling of heaviness (especially lipedema). In 75%, the initial diagnosis was made by a medical specialist. The basic diagnostics recommended by the guidelines-medical history (73.6%) and clinical examination (84.7%)-were done in most of the patients. After the initial diagnosis, 46% of the patients had decongestion therapy of different intensity and quality. A total of 58.3% of the patients were directly provided a prescription for a medical stocking. Only a few patients received instructions for breathing exercises (22.2%), self-performed lymphatic drainage (6.9%) or muscle exercises (8.3%). There are still deficits in the diagnosis and especially in the therapy of patients with lymphologic diseases in an outpatient setting. Further education and training are necessary for physicians, physiotherapists, medical supply businesses, and patients.

  4. 41 CFR 102-80.10 - What are the basic safety and environmental management policies for real property?

    Science.gov (United States)

    2010-07-01

    ... safety and environmental management policies for real property? 102-80.10 Section 102-80.10 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT General Provisions § 102-80.10 What are the basic safety and environmental management policies for real property? The basic safety and...

  5. Lymphatic capillary pressure in patients with primary lymphedema.

    Science.gov (United States)

    Zaugg-Vesti, B; Dörffler-Melly, J; Spiegel, M; Wen, S; Franzeck, U K; Bollinger, A

    1993-09-01

    Flow and pressure dynamics in minute human lymphatics are unexplored. Lymphatic capillary pressure was measured by the servo-nulling technique at the foot dorsum of 14 patients with primary lymphedema and 15 healthy controls. Glass micropipettes (7-9 microns) were inserted under microscopic control into lymphatic microvessels previously stained by fluorescence microlymphography (FITC-Dextran 150,000). Mean lymphatic capillary pressure was 7.9 +/- 3.4 mm Hg in the controls and 15.0 +/- 5.1 mm Hg in the patients. The difference was significant at the P Hamas and H. K. Al Hassan (1985, Microcirc., Endothelium, Lymphatics 2, 267-384) (17.9 mm Hg) in lower leg lymphedema. Microlymphatic hypertension present in patients with primary lymphedema is probably an important factor for edema formation.

  6. [Contribution of lymphoscintigraphy in the exploration of lymphedema in children].

    Science.gov (United States)

    Baulieu, F; Vaillant, L; Gironet, N; Machet, L; Eder, V; Baulieu, J L; Lorette, G

    2003-12-01

    The objectives of this work were a) to assess the feasibility of lymphoscintigraphy in very young children, and b) to assess its usefulness in understanding the underlying pathophysiology. Forty-one children (age range 3 months-16 years) with primary lymphedema of the lower and/or upper limbs underwent lymphosinctigraphy using 99mTC-labeled colloid (Nanocis or Nanocol) injected subcutaneous at the foot and/or hand level. Recording time, which depended on the child's age, included at least static images during the thirty minutes following injection and four hours later. Abnormal activity of the lymph collectors, nodes, and interstitial space were analyzed according to age (> or bride disease (n=1), and hypoplasia revealed by occurrence of a minor factor (n=11). These observations demonstrate the role of lymphoscintigraphy in the diagnosis and prognostic evaluation of lymphedema in children. Lymphoscintigraphy is a useful technique for very young children with lymphedema providing further information contributing to overall exploration.

  7. Effect of physical therapy on breast cancer related lymphedema

    DEFF Research Database (Denmark)

    Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard

    2014-01-01

    BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...... trial. A total of 160 breast cancer patients with arm lymphedema will be recruited from 3 hospitals and randomized into one of two treatment groups A: Complete Decongestive Therapy including manual drainage or B: Complete Decongestive Therapy without manual lymphatic drainage. The intervention period...... type of treatment is most effective is sparse. The objective of this study is to investigate whether CDT is equally effective if it includes manual lymphatic drainage or not in the treatment of arm lymphedema among patients with breast cancer. METHODS/DESIGN: A randomized, single-blind, equivalence...

  8. Lymphedema after upper limb transplantation: scintigraphic study in 3 patients.

    Science.gov (United States)

    Cavadas, Pedro C; Thione, Alessandro; Carballeira, Alexo; Dominguez, Pablo Caro

    2013-07-01

    Lymphatic vasculature is known to spontaneously reconnect after hand replantation. Nonetheless, lymphatic outflow has not been specifically studied in hand transplantation.Lymphedema was studied clinically and scintigraphically in 3 bilateral upper limb transplants performed in Valencia, Spain, since 2006. Case 1 was a radiocarpal level, case 2 midforearm and proximal forearm, and case 3 was a transhumeral transplantation. Follow-up was 5, 4, and 3 years, respectively. Clinically, in case 1, there was a left-sided moderate lymphedema, case 2 was normal, and a right-sided moderate lymphedema was present in case 3. Lymphoscintigraphy results were consistent with the clinical findings. It was normal in the 4 nonedematous limbs. In the 2 affected limbs, there were scintigraphic findings of lymphatic block and lymphangiectasia.The study demonstrates objectively that lymphatic circulation can reconnect spontaneously in hand transplantations, although not in a homogeneously efficient way.

  9. Lymphedema treatment decreases pain intensity in lipedema.

    Science.gov (United States)

    Szolnoky, G; Varga, E; Varga, M; Tuczai, M; Dósa-Rácz, E; Kemény, L

    2011-12-01

    Lipedema is a disproportional obesity featuring light pressure-induced or spontaneous pain. On the basis of our clinical observations, lymphedema therapy, as practiced in our clinic, reduces the perception of pain beyond leg volume reduction. We therefore aimed to measure pain intensity prior and subsequent to treatment. 38 women with lipedema were enrolled in the study with 19 patients undergoing treatment and 19 serving as the control group using exclusively moisturizers. Treatment consisted of once daily manual lymph drainage (MLD), intermittent pneumatic compression (IPC), and multilayered short-stretch bandaging performed throughout a 5-day-course. Pain was evaluated with a 10-item questionnaire, a pain rating scale (PRS), and the Wong-Baker Faces scale. Treatment resulted in a significant reduction of pain with a decrease in mean scores of all three measures. In the control group, only PRS showed significant decrease. Our study results indicate that this treatment regimen not only reduces leg volume and capillary fragility, but also improves pain intensity in patients with lipedema.

  10. An Agent-Based Approach for Evaluating Basic Design Options of Management Accounting Systems

    OpenAIRE

    Friederike Wall

    2013-01-01

    This paper investigates the effectiveness of reducing errors in management accounting systems with respect to organizational performance. In particular, different basic design options of management accounting systems of how to improve the information base by measurements of actual values are analyzed in different organizational contexts. The paper applies an agent-based simulation based on the idea of NK fitness landscapes. The results provide broad, but no universal support for conventional ...

  11. Differences of symptoms in head and neck cancer patients with and without lymphedema.

    Science.gov (United States)

    Deng, Jie; Murphy, Barbara A; Dietrich, Mary S; Sinard, Robert J; Mannion, Kyle; Ridner, Sheila H

    2016-03-01

    Head and neck cancer (HNC) patients are at risk for developing external and internal lymphedema. Currently, no documentation of symptom differences between individuals with and without head and neck lymphedema is available. The purpose of this analysis was to examine symptom differences among HNC patients with and without lymphedema. Data were drawn from three cross-sectional studies of HNC patients >3 months post-cancer treatment (total N = 163; 128 patients with lymphedema, 35 without lymphedema). External lymphedema was evaluated via physical examination; internal lymphedema was identified through endoscopic examination. Participant's head and neck lymphedema status was categorized into two groups: no indication of external or internal lymphedema and at least some indication of external or internal lymphedema. Lymphedema Symptom Intensity and Distress Survey-Head and Neck (LSIDS-H&N) was used to assess symptom burden. Descriptive statistics, McNemar, chi-squared, Wilcoxon signed-ranks, and Mann-Whitney tests were used. Twenty-three pairs of patients were identified and matched on the age, primary tumor site, tumor stage, and time since end of cancer treatment. Relative to patients without lymphedema, matched patients with lymphedema reported either increased symptom prevalence or severity or distress level for the following symptoms (prevalence differences of at least 15 % between the matched groups and p < 0.05): (1) numbness; (2) tightness; (3) heaviness; (4) warmth; (5) pain without head/neck movement; (6) problems swallowing mashed or pureed foods; (7) trouble breathing; (8) blurred vision; (9) feel worse when flying in an airplane; and (10) swelling. Findings suggest that HNC-related lymphedema may be associated with substantial symptom burden. Studies with larger sample sizes are needed to replicate the findings.

  12. Therapeutic importance of manual lymphatic drainage for lymphedema of limbs

    OpenAIRE

    VOTRUBOVÁ, Eva

    2013-01-01

    The importance of lymphatic drainage and other techniques used to cure lymphedema was known as early as around the year 3,000 BC. In the Czech Republic it became quite common after 1992, when the Czech Society of Lymphology was founded. Since the number of professionals in this area has been increasing and so has the number of patients, which makes the cure of lymphedema a very topical question. The first chapter of the theoretical part of my thesis is devoted to the history of the anatomy of...

  13. Lymphedema and lipedema - an overview of conservative treatment.

    Science.gov (United States)

    Wagner, S

    2011-07-01

    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.

  14. Teaching Management and Implementation of Pedagogical Classroom Projects in Basic Education

    Directory of Open Access Journals (Sweden)

    Waldemar Antonio Guerrero Matos

    2006-11-01

    Full Text Available The present article diffuses the results of the oriented study to determine the relationship between the administration of the educational one and the execution of the pedagogic projects of classroom in Basic Education. Theoretically it was based on the constructivismo and the contributions of the National Basic Curriculum. The investigation type was descriptive. The results allowed to corroborate in the teachers, weaknesses in the execution of the Pedagogic Projects of Classroom, evidencing difficulties to the moment to apply the pedagogic abilities. Therefore it is recommended to carry out courses of upgrade to manage with effectiveness this strategy of planning constructivist.

  15. Bioelectrical impedance self-measurement protocol development and daily variation between healthy volunteers and breast cancer survivors with lymphedema.

    Science.gov (United States)

    Ridner, Sheila H; Bonner, Candace M; Doersam, Jennifer K; Rhoten, Bethany A; Schultze, Benjamin; Dietrich, Mary S

    2014-03-01

    A significant percentage of breast cancer survivors are at risk for lymphedema for which lifelong self-care is required. Previous studies suggest that less than 50% of breast cancer survivors with lymphedema (BCS-LE) perform prescribed self-care tasks and that even wearing a compression sleeve, the most commonly reported self-care activity, is done irregularly. Reasons for poor self-care adherence include perceived lack of results from self-care (no available arm volume data) and perceived inability to manage the condition. A two-part pilot study was conducted to: 1) develop and determine the feasibility of a self-measurement protocol using a single frequency bioelectrical impedance device; and 2) examine daily variation in extracellular volume in healthy and lymphedematous limbs. Healthy and BCS-LE volunteers were recruited to refine and test a self-measurement protocol. Volunteers were trained in the use of the device and measured for 5 consecutive days in a laboratory setting. They were then given the device to use at home for an additional 5 consecutive days of self-measurement. All volunteers completed each scheduled home measurement. Daily variability in both groups was noted. Home self-measurement using bioelectrical impedance is feasible, acceptable, and captures change. This has implications for both self-care support and for the possibility of incorporating self-measurement using bioelectrical impedance in future clinical trials examining effectiveness of lymphedema treatment.

  16. Breast Cancer-Related Lymphedema: Implications for Family Leisure Participation

    Science.gov (United States)

    Radina, M. Elise

    2009-01-01

    An estimated 20% of breast cancer survivors face the chronic condition of breast cancer-related lymphedema. This study explored the ways in which women with this condition experienced changes in their participation in family leisure as one indicator of family functioning. Participants (N = 27) were interviewed regarding lifestyles before and after…

  17. Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation

    Directory of Open Access Journals (Sweden)

    Fabio Nicoli

    2014-09-01

    Full Text Available Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF. We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.

  18. Helium Neon laser therapy for post mastectomy lymphedema and ...

    African Journals Online (AJOL)

    The aim of this work was to evaluate the efficacy of Helium Neon (He–Ne) laser therapy on post mastectomy lymphedema and shoulder mobility. Thirty female patients with axillary lymph node dissection (ALND), with or without radiotherapy had been participated in this study. The patients were randomly divided into two ...

  19. Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review

    NARCIS (Netherlands)

    Hidding, J.T.; Viehoff, P.B.; Beurskens, C.H.G.; Laarhoven, H.W. van; Sanden, M.W. van der; Wees, P.J. van der

    2016-01-01

    BACKGROUND: Lymphedema is a common complication of cancer treatment, resulting in swelling and subjective symptoms. Reliable and valid measurement of this side effect of medical treatment is important. PURPOSE: The purpose of this study was to provide best evidence regarding which measurement

  20. Bayesian Evaluation of Lymphoscintigraphy of Secondary Upper Limb Lymphedema. Abstract

    Czech Academy of Sciences Publication Activity Database

    Heřmanská, J.; Křížová, H.; Gebouský, Petr; Wald, M.; Kárný, Miroslav; Adámek, J.; Zimák, J.

    2004-01-01

    Roč. 31, Suppl. 2 (2004), s. 454 ISSN 1619-7070. [Annual Congress of the EANM 2004. Helsinki, 04.09.2004-08.09.2004] R&D Projects: GA MZd NC7601 Institutional research plan: CEZ:AV0Z1075907 Keywords : quantitative lymphoscintigraphy * lymphedema * Bayesian estimation Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 3.935, year: 2004

  1. Shoulder Pain after Fall, Septic Shock, and Pyomyositis Associated with Breast Cancer Chemotherapy and Lymphedema

    Directory of Open Access Journals (Sweden)

    Hiromitsu Kitayama

    2016-11-01

    Full Text Available Background: As a symptom of pyomyositis, sepsis usually follows local inflammation signs. Here, we report pyomyositis with lymphedema of upper extremity in which septic shock and poor local findings initially presented during chemotherapy for breast cancer. Case Report: An 80-year-old woman presented with chronic right shoulder pain during chemotherapy for the recurrent disease. She had a history of postmastectomy lymphedema, diabetes mellitus, and repeated hyaluronic acid injections to the shoulder joint. The pain suddenly worsened with septic shock and no apparent local signs. Magnetic resonance imaging revealed myonecrosis, and no pus was yielded by ultrasound-guided needle aspiration. After 2 weeks of recovery by conservative medical management, surgical drainage was performed. Late formulated massive intramuscular pus showed severe neutrophil infiltration and myonecrosis. Conclusion: Pyomyositis can develop into septic shock with poor local signs. Myelosuppression after chemotherapy can cause myonecrosis without macroabscess, and magnetic resonance imaging was useful for the diagnosis of this condition. When unspecified local pain appears during cancer chemotherapy we should consider this disease, too.

  2. The Records Management Officer in Local Government. Basic Records Management for Local Government, No. 2.

    Science.gov (United States)

    New York State Education Dept., Albany. State Archives and Records Administration.

    This reports provides local governments with guidelines and suggestions for selecting a Records Management Officer to develop, organize, and direct a records management program. Such a program is described as an over-arching, continuing, administrative effort that manages recorded information from its initial creation to its final disposition.…

  3. Managing complex, high risk projects a guide to basic and advanced project management

    CERN Document Server

    Marle, Franck

    2016-01-01

    Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

  4. WATER RESOURCES MANAGEMENT : AN ANALYSIS OF THE MUNICIPAL PLAN OF BASIC SANITATION XANGRILÁ/ RS

    Directory of Open Access Journals (Sweden)

    Mariana Barbosa de Souza

    2016-09-01

    Full Text Available This article seeks to analyze the way how is the regionalization and management of water resources from the Municipal Plan analysis Sewerage Shangri-La (PMSBX, which in itself shows the importance of the subject, even before the outbreak of the recent water crisis in 2014 in São Paulo, at which water management has become widely discussed. The main objective is to study the legislation and documents related to water resources, especially in relation to water regionalization, participation and conflict resolution. Thus, this aims to bring the discussion laws and concepts, considering its importance, especially in times of globalization, as well as answer the question that underlies this study: "What are the interrelationships between the National Basic Sanitation Policy (Law No. 11.445, of January 5, 2007, the National Basic Sanitation Plan and Sanitation Municipal Basic Plan for Xangri-Lá/RS?". The method used in the research is based on analysis of legislation and documents created by civil society, which are important on the subject, checking how the governance, management and water regionalization are given in Brazilian context, gaucho and regional. From a preliminary analysis can point out that the legislation, as well as the documents investigated, even in the solidification phase, run through by several challenges to its effective implementation.

  5. Significant differences in nurses' knowledge of basic wound management - implications for treatment.

    Science.gov (United States)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B; Hjalager, Ida R C; Jemec, Gregor B E

    2014-07-01

    Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found that the length of experience (adjusted for workplace and education) did not have any impact on nurses' knowledge. Nurses' knowledge of clinical investigations was consistently lower than their knowledge of therapy and clinical symptoms. This study provides benchmarking information about the current status of wound management in Denmark and suggests how improvements might be achieved.

  6. Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Deng Jie; Ridner, Sheila H.; Dietrich, Mary S.; Wells, Nancy; Wallston, Kenneth A.; Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A.

    2012-01-01

    Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

  7. Primary lymphedema and other lymphatic anomalies are associated with 22q11.2 deletion syndrome.

    Science.gov (United States)

    Unolt, Marta; Barry, Jessica; Digilio, Maria Cristina; Marino, Bruno; Bassett, Anne; Oechslin, Erwin; Low, David W; Belasco, Jean B; Kallish, Staci; Sullivan, Kathleen; Zackai, Elaine H; McDonald-McGinn, Donna M

    2018-02-12

    Lymphedema is an abnormal accumulation of interstitial fluid within the tissues. Primary lymphedema is caused by aberrant lymphangiogenesis and it has been historically classified based on age at presentation. Although most cases are sporadic, primary lymphedema may be familial or present in association with chromosomal abnormalities and syndromic disorders. To the best of our knowledge, primary lymphedema has never been described in patients with 22q11.2 deletion syndrome. We identified 4 patients with 22q11.2 deletion syndrome and primary lymphedema via our International 22q11.2 Deletion Syndrome Consortium. All patients underwent comprehensive clinical, laboratory and imaging assessments to rule out other causes of lymphedema. All patients had de novo typical deletions and family histories were negative for lymphedema. We report the novel association of primary lymphedema with 22q11.2 deletion syndrome. Importantly, animal models demonstrated Tbx1 playing a critical role in lymphangiogenesis by reducing Vegfr3 expression in lymphatic endothelial cells. Moreover, the VEGFR3 pathway is essential for lymphangiogenesis with mutations identified in hereditary primary lymphedema. Accordingly, our findings provide a new insight into understanding cellular mechanisms of lymphangiogenesis disorders. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  8. Quantitative Lymphoscintigraphy to Predict the Possibility of Lymphedema Development After Breast Cancer Surgery: Retrospective Clinical Study.

    Science.gov (United States)

    Kim, Paul; Lee, Ju Kang; Lim, Oh Kyung; Park, Heung Kyu; Park, Ki Deok

    2017-12-01

    To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment. This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups. Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04-0.46; p=0.001). In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

  9. Mutations in the VEGFR3 signaling pathway explain 36% of familial lymphedema

    DEFF Research Database (Denmark)

    Mendola, A; Schlögel, M J; Ghalamkarpour, A

    2013-01-01

    Lymphedema is caused by dysfunction of lymphatic vessels, leading to disabling swelling that occurs mostly on the extremities. Lymphedema can be either primary (congenital) or secondary (acquired). Familial primary lymphedema commonly segregates in an autosomal dominant or recessive manner. It can......, FOXC2, SOX18, CCBE1, and PTPN14. Twelve mutations were found that explain 8% of the cases. Still unidentified is the genetic cause of primary lymphedema in 64% of patients with a family history and 92% of sporadic cases. Identification of those genes is important for understanding of etiopathogenesis...

  10. Efficient selection of association rules from lymphedema symptoms data using a graph structure.

    Science.gov (United States)

    Xu, Shuyu; Shyu, Chi-Ren

    2010-11-13

    Secondary lymphedema (LE) is a chronic progressive disease often caused by cancer treatment, especially in patients who require surgical removal of or radiation to lymph nodes. While LE is incurable, it can be managed successfully with early detection and appropriate treatment. Detection and prediction of LE is difficult due to the absence of a "gold standard" for diagnosis. Despite this, management of the disease is accomplished through adherence to a set of guidelines developed by experts in the field. Unfortunately, not all the recommendations in such a document are supported by clear research evidence, and most of them are only based on expert judgment with limited evidence. This paper focuses on developing a new algorithm to extract specific association rules from LE survey data and efficiently index the rules for easy knowledge retrieval, with the ultimate goal discovering evidence-based and relevant knowledge for inclusion into the best practice document (BP) for the LE community.

  11. Mapping the geographical distribution of podoconiosis in Cameroon using parasitological, serological, and clinical evidence to exclude other causes of lymphedema.

    Directory of Open Access Journals (Sweden)

    Kebede Deribe

    2018-01-01

    Full Text Available Podoconiosis is a non-filarial elephantiasis, which causes massive swelling of the lower legs. It was identified as a neglected tropical disease by WHO in 2011. Understanding of the geographical distribution of the disease is incomplete. As part of a global mapping of podoconiosis, this study was conducted in Cameroon to map the distribution of the disease. This mapping work will help to generate data on the geographical distribution of podoconiosis in Cameroon and contribute to the global atlas of podoconiosis.We used a multi-stage sampling design with stratification of the country by environmental risk of podoconiosis. We sampled 76 villages from 40 health districts from the ten Regions of Cameroon. All individuals of 15-years old or older in the village were surveyed house-to-house and screened for lymphedema. A clinical algorithm was used to reliably diagnose podoconiosis, excluding filarial-associated lymphedema. Individuals with lymphoedema were tested for circulating Wuchereria bancrofti antigen and specific IgG4 using the Alere Filariasis Test Strips (FTS test and the Standard Diagnostics (SD BIOLINE lymphatic filariasis IgG4 test (Wb123 respectively, in addition to thick blood films. Presence of DNA specific to W. bancrofti was checked on night blood using a qPCR technique.Overall, 10,178 individuals from 4,603 households participated in the study. In total, 83 individuals with lymphedema were identified. Of the 83 individuals with lymphedema, two were found to be FTS positive and all were negative using the Wb123 test. No microfilaria of W. bancrofti were found in the night blood of any individual with clinical lymphedema. None were found to be positive for W. bancrofti using qPCR. Of the two FTS positive cases, one was positive for Mansonella perstans DNA, while the other harbored Loa loa microfilaria. Overall, 52 people with podoconiosis were identified after applying the clinical algorithm. The overall prevalence of podoconiosis was

  12. An Agent-Based Approach for Evaluating Basic Design Options of Management Accounting Systems

    Directory of Open Access Journals (Sweden)

    Friederike Wall

    2013-12-01

    Full Text Available This paper investigates the effectiveness of reducing errors in management accounting systems with respect to organizational performance. In particular, different basic design options of management accounting systems of how to improve the information base by measurements of actual values are analyzed in different organizational contexts. The paper applies an agent-based simulation based on the idea of NK fitness landscapes. The results provide broad, but no universal support for conventional wisdom that lower inaccuracies of accounting information lead to more effective adaptation processes. Furthermore, results indicate that the effectiveness of improving the management accounting system subtly interferes with the complexity of the interactions within the organization and the coordination mode applied

  13. ["Depletion" in the treatment of lymphedema of the lower extremities].

    Science.gov (United States)

    Bilancini, S; Lucchi, M

    1987-01-01

    The treatment of lymphedemas consists of two phases: reduction of the edema-prevention of its recurrence. The second phase is invariably linked to the use of a strong contention by means of a stocking. In order to reduce the edema, opinions do not all occur. Some advocate pressotherapy, manual lymphatic drainage, wrapping and immersion in mercury. The authors propose another form of treatment which has the merit to be simple and well tolerated. Their study is based on 187 cases of moderate lymphedema of the lower extremities and, they observed favorable results in 179 patients. For 8 patients, there were partial results, but the treatment prescribed had not been perfectly followed by the patients.

  14. Basic planning and work performance of Hanford Site environmental management activities

    International Nuclear Information System (INIS)

    Piper, L.L.

    1997-01-01

    This document provides an overview of the basic planning and work of the Department of Energy Richland Operations Office (DOE-RL). It defines key terms, concepts, and processes used in Hanford's Environmental Management (EM) activities. It is not intended to provide complete details on the topics discussed. It does, however, provide a roadmap of the overall process so that opportunities for tribal, regulator, and public involvement can be clearly identified. Many documents are referenced in this plan. Each is described in some detail in Section 5, and cross-references to that section are provided throughout the discussion in Sections 1 through 4

  15. Adaptive Immune Responses Regulate the Pathophysiology of Lymphedema

    Science.gov (United States)

    2012-09-01

    or mice depleted of CD4+ T cells.[33] The finding that the composition of the extracellular matrix (ECM) can directly regulate interstitial fluid...lymphatic vessel staining was performed by injecting tomato lectin (1 mg/ml, Sigma) 20mm to the distal tip of the tail followed by sacrifice 45 minutes...e254. 30. Galkowska H, Olszewski WL (1986) Cellular composition of lymph in experimental lymphedema. Lymphology 19: 139-145. 31. Foldi E, Sauerwald

  16. Ultrasonography as a tool to objectify lymphedema and lipedema

    OpenAIRE

    Tanneberger, Amelie

    2012-01-01

    Introduction We determined the skin thickness of the legs in seventeen healthy subjects and 71 patients with lymph- and lipedema using 20 MHz ultrasonography. The aim was to find out, whether there are any differences in skin thickness in patients with lymph- and lipedema as compared to the healthy subjects. Methods From August 2007 until April 2008 we investigated 71 patients with swelling of the legs due to different causes. The study included patients with primary lymphedema, s...

  17. Staging of upper limb lymphedema from routine lymphoscintigraphic examinations

    Czech Academy of Sciences Publication Activity Database

    Gebouský, Petr; Kárný, Miroslav; Křížová, H.; Wald, M.

    2009-01-01

    Roč. 39, č. 1 (2009), s. 1-7 ISSN 0010-4825 R&D Projects: GA MŠk 1M0572; GA MŠk 2C06001 Institutional research plan: CEZ:AV0Z10750506 Keywords : Quantitative lymphoscintigraphy * Secondary lymphedema of upper limbs * Staging * Bayesian evaluation * Probabilistic mixtures Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.269, year: 2009 http://library.utia.cas.cz/separaty/2009/AS/karny-0320214.pdf

  18. Imaging findings of adiposis dolorosa vs. massive localized lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Petscavage-Thomas, Jonelle M.; Bernard, Stephanie A.; Bennett, Jennifer [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD (United States)

    2015-06-01

    Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa. A 10-year retrospective review of the picture archiving and communications system was performed. Two musculoskeletal radiologists reviewed images to confirm and document imaging features, location, size, and patient demographics. Medical records were reviewed to characterize patients into three groups: one group met at least three of the four criteria of Dercum's syndrome, the second group met less than three criteria, and the third group had clinical diagnosis of cellulitis of the lower extremity. Seventeen cases (25 masses) of adiposis dolorosa were found, nine cases of which met at least three criteria of Dercum's syndrome. All cases in the first two groups demonstrated skin thickening and lymphedema of subcutaneous fat, which was fluid attenuation on CT and low or intermediate T1-weighted and high STIR/T2-weighted MR signal. Two cases with pathology showed mild fatty infiltration with fibrous septa, and the third case showed massive localized lymphedema. The third group of ten cellulitis patients demonstrated non-mass-like subcutaneous edema with similar CT attenuation and MR signal characteristics to the first two groups, but differed by the presence of post-contrast enhancement and non-mass-like appearance in 90 %. Imaging findings of adiposis dolorosa and massive localized lymphedema overlap, as do the symptoms and pathological features. Due to the mass-like engorgement of the soft tissues and pain, patients will often undergo imaging to exclude neoplasm or infection. Knowledge of these

  19. Fourth annual workshop on management in basic and applied research environments

    Energy Technology Data Exchange (ETDEWEB)

    Bodnarczuk, M.W. [ed.

    1993-11-01

    The struggle to develop quality management concepts that ``map`` onto the cultural and work practices found in basic and applied research environments has been (for better or for worse) an attempt to differentiate basic and applied research from the nuclear industry. In the first (1990) edition of this ``Music Book`` proceedings, almost every laboratory that participated had a quality program that was traceable to, based on, influenced by, or in reaction to the nuclear quality standard ASME-NQA-1. This 1993 edition of the ``Music Book`` is very different in that almost every laboratory has developed a quality program that is based on, traceable to, or heavily influenced by DOE 5700.6C (Quality Assurance) and the DOE Standard; Implementation Guide for Quality Assurance Programs for Basic and Applied Research (DOE-ER-STD-6001-92). In order to construct a context for what follows and properly introduce the contents of this book, we want to briefly recount some of the highlights of the events that brought about this change, from the perspective of one who participated in the process.

  20. The use of a basic safety investment model in a practical risk management context

    International Nuclear Information System (INIS)

    Aven, Terje; Hiriart, Yolande

    2011-01-01

    We consider a basic model in economic safety analysis: a firm is willing to invest an amount x in safety measures to avoid an accident A, which in the case of occurrence, leads to a loss of size L. The probability of an accident is a function of x. The optimal value of x is determined by minimizing the expected costs. In the paper, we re-examine this model by adopting a practical risk/safety management perspective. We question how this model can be used for guiding the firm and regulators in determining the proper level of investment in safety. Attention is given to issues like how to determine the probability of an accident and how to take into account uncertainties that extend beyond the expected value. It is concluded that the model, with suitable extensions and if properly implemented, provides a valuable decision support tool. By focusing on investment levels and stimulating thereby the generation of alternative risk-reducing measures, the model is considered particularly useful in risk reduction (ALARP) processes. - Highlights: → It is shown how to use a basic investment model in a practical risk management setting. → The model may be a valuable decision support tool if properly implemented. → It guides decision makers on risk reduction and how to determine what is ALARP. → The model stimulates the generation of alternative risk-reducing measures.

  1. Surgical-site infection following lymph node excision indicates susceptibility for lymphedema

    DEFF Research Database (Denmark)

    Jørgensen, Mads Gustaf; Toyserkani, Navid Mohamadpour; Thomsen, Jørn Bo

    2018-01-01

    BACKGROUND AND OBJECTIVES: Cancer-related lymphedema is a common complication following lymph node excision. Prevention of lymphedema is essential, as treatment options are limited. Known risk factors are firmly anchored to the cancer treatment itself; however potentially preventable factors such...

  2. The effect of prophylactic lymphovenous anastomosis and shunts for preventing cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jørgensen, Mads G; Toyserkani, Navid M; Sørensen, Jens A

    2018-01-01

    BACKGROUND: Lymphedema is one of the most dreaded side effects to any cancer treatment involving lymphadenectomy. Progressed lymphedema is adversely complex and currently there is no widely acknowledged curative treatment. Therefore recent focus has shifted to risk reduction and prevention. It ha...

  3. One-sided limb lymphedema in a liver transplant recipient receiving sirolimus

    NARCIS (Netherlands)

    van Onna, M.; Geerts, A.; van Vlierberghe, H.; Berrevoet, F.; de Hemptinne, B.; Troisi, R.; Colle, I.

    2007-01-01

    Sirolimus (SRL) is associated with many side effects including hypercholesterolemia, anaemia, impaired wound healing and abnormal liver function tests. Limb lymphedema has only been reported several times in renal transplant recipients. We present a case of lower limb lymphedema that occurred in a

  4. The Lymphedema and Gynecologic Cancer (LEG) Study: Incidence, Risk Factors, and | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): The proposed study, Lymphedema and Gynecologic cancer (LEG): Incidence, Risk Factors and Impact, will innovatively utilize the cooperative group setting of the GOG (Gynecologic Oncology Group) to prospectively study 1300 women newly diagnosed with cervical, endometrial, or vulvar cancer to determine the incidence and impact of lower extremity lymphedema following surgical treatment of these diseases. |

  5. Cell therapy for the treatment of lower limb lymphedema. Case report

    International Nuclear Information System (INIS)

    Goicoechea Diaz, Pedro; Hernandez Ramirez, Porfirio; Artaza Sanz, Heriberto

    2010-01-01

    Although lymphedema is a common disabling disease causing significant morbidity for affected patients, treatment for this condition remains limited and largely ineffective. Some reported data suggest that some bone-marrow derived cells may play a role in lymphangiogenesis. It appears that blood vessels and lymphatic vessels might use the same population of cells for vasculogenesis and lymphangiogenesis. Therefore, adult stem cell therapy could be a new useful strategy for the treatment of lymphedema. We report a resolution of a severe lower limb bilateral lymphedema after implantation of autologous adult stem cells derived from bone marrow. As far as we know, this is the first reported case with chronic lower limb lymphedema treated successfully with autologous cell therapy. This procedure is a low-cost, relatively simple and easy to perform option that opens new ways for the treatment of lymphedema

  6. Lymphedema, lipedema, and the open wound: the role of compression therapy.

    Science.gov (United States)

    Macdonald, John M; Sims, Nancy; Mayrovitz, Harvey N

    2003-06-01

    As the science of wound healing has evolved over the past two decades, so has awareness of the "hidden epidemic" of lymphedema. Substantial information has been accumulated regarding the pathophysiology and therapy of lymphedema. Until recently, the relationship between wound healing and the negative effects of associated peri-wound lymphedema has received little attention. Identifying wound-related lymph stasis and safe mobilization of the fluid are fundamentals that must be addressed for proper therapy. Experience gained from the successful treatment of primary and secondary lymphedema has proven very useful in the applications to wound-related lymphedema. The mobilization of lymph fluid from the peri-wound area with the use of reasoned compression is essential for proper therapy of the open wound, as are appropriate bandage selection and safeguards for bandage application.

  7. Basic problems of management in the sphere of forest relations in retrospect of public prosecutor

    Directory of Open Access Journals (Sweden)

    I. A. Kuzmin

    2016-08-01

    Full Text Available Public administration of forests is one of the most important sectors of ecological public administration at the national and local levels. Forest legislation is the legal basis for management, whose quality and regulatory capacity ensure the effectiveness of state power activities aimed at sustainable use, protection and regeneration of forests. The need for reforming and properly updating forest legislation and law enforcement is long overdue, which is confirmed by scientific studies and actual facts. A basic problem of forest management is the absence of an official definition of «forest» and «urban forest». Problems of forest fire protection and management problems in the forest sector (e.g. related to the provision of forest plots and the sale and purchase of forest stands are widespread. Management problems also cover a mismatch of legislative activity of the competent entities regarding the regulation of forestry relations, the one-time combination of regulatory and supervisory functions in the same bodies, as well as the lack of a single current and objective system of state cadastral registration. The paper mentions peculiarities of identifying legal responsibility for forest offenses. It is noted that office of public prosecutor, being a central supervisory agency of the state due to the nature of its job and position in a system of separation of powers, has vast (if compared with other subjects of administrative relations opportunities to identify, overcome and eliminate the problems of management of forests. The paper considers separate case materials that show an active role of the national public prosecutor’s office in supporting law and order in the examined field. Generalized conclusions are drawn based on the results of the study.

  8. Waste management plan for pipeline construction works: basic guideline for its preparation

    Energy Technology Data Exchange (ETDEWEB)

    Serricchio, Claudio; Caldas, Flaviana V. [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil); Souza, Izabel C.A. de; Araujo, Ronaldo G. de [TELSAN, Rio de Janeiro, RJ (Brazil); Souza, Tania Mara [IMC-SASTE, Sao Paulo,SP (Brazil); Veronez, Fernanda A. [Bourscheid, Porto Alegre, RS (Brazil)

    2009-07-01

    During the stage of implementation of the land pipes enterprise, one of the main environmental aspects to be considered was the creation of solid and liquid waste. To mitigate the possible impacts to the environment, the main adopted mitigate measure was the implementation of a Waste Management Plan - WMP. Thus, the management of waste from pipes construction has the challenge of a great variety of stages and phases for the implementation of pipes and the diversity of local situations related to the topographic and hydro-geologic conditions. Considering the peculiarity of the pipes activities, this article proposes the elaboration of a Basic Guide to be used as reference for the creation of WMP's for similar enterprises, using as foundation the data from the three Gas Pipelines: Cabiunas - Vitoria; Vitoria - Cacimbas and Cacimbas - Catu. After the analysis of the three mentioned enterprises, it was verified that the waste management generated on the building and assembling of the land pipes normally occurs in accord with previous planning, but there's no systematization for the waste to be better recycled and reutilized, thus mitigating their creation. (author)

  9. The Basic Framework for Robot Applicability Enhancement of Nuclear Risk Management in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young; Jeong, Kungmin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Inn Seock [bISSA Technology, Inc., Germantown (United States)

    2015-05-15

    Beyond-design-basis external events such as the one having occurred at the Fukushima Daiichi Nuclear Power Plant typically pose considerable challenges to the plant personnel because of the harsh environments caused by the events (e.g., extreme terrains, high radiation, radioactive rubbles, high heat, and explosive environment). Therefore, remote response techniques by use of robotic systems are needed to help the plant personnel cope with the extreme events. In this study the basic framework for enhancing robotic applicability to disaster management was developed using the analytic technique of Master Logic Diagram (MLD) and Goal-Tree Success-Tree (GTST). The users of robots have to devise a sound maintenance program, otherwise their unscheduled downtime may increase beyond limit, consequently defeating the purpose of robot applications. In addition, maintainability could be enhanced by designing for ease of diagnosis, and ease of access and repair. Ways to upgrade maintainability could be devised by evaluating maintainability in the design stage. The basic framework discussed herein shall be used by the KAERI's robotics team as a fundamental framework in enhancing the applicability of disaster robots in the hazardous environment caused by extreme events.

  10. Brain Basics

    Medline Plus

    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... in controlling movement, managing the release of various hormones, and aiding the flow of information to the ...

  11. Complete decongestive physical therapy in a patient with secondary lymphedema due to orthopedic trauma and surgery of the lower extremity.

    Science.gov (United States)

    Cohen, Meryl D

    2011-11-01

    This case report describes a patient who developed lower-extremity lymphedema secondary to orthopedic trauma and surgery and reports the response to complete decongestive physical therapy (CDP), with 8 treatment sessions over 3 months. The patient was a 56-year-old man who sustained a right ankle displaced fibular fracture, underwent open reduction internal fixation surgery 12 days later, and developed lymphedema 4 months postinjury. The patient's impairments of the right lower extremity included increased girth, decreased ankle range of motion, and increased pain. Due to these impairments and the inability to fit into normal footwear, the patient limited activities such as ambulating long distances and climbing stairs. This limited activity restricted him from participating in his normal lifestyle activities such as walking his dog in the community and performing all necessary work duties. Using the truncated cone formula to measure limb volume, the limb volume of the right (involved) lower extremity decreased 368 mL as a result of CDP. The percentage of difference in limb volume between the right and left lower extremities at the initial examination was 9%, and it was reduced to less than 1% at discharge. He was independent with his home program in order to maintain the results of therapy. Physical therapist management of secondary lymphedema due to orthopedic trauma and surgery of the lower extremity was effective in decreasing circumferential girth measurements and decreasing limb volume, thereby improving gait and allowing the patient to fit into his work and leisure shoes. The patient reported improvement in his ability to perform all work activities, and he returned to his prior level of participation in the community.

  12. A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema.

    Science.gov (United States)

    Sohl, Stephanie J; Dietrich, Mary S; Wallston, Kenneth A; Ridner, Sheila H

    2017-07-01

    Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL. Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions. Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy-Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis. There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis. These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.

  13. The needs of basic chemistry studies for nuclear waste management issues

    International Nuclear Information System (INIS)

    Guillaumont, R.

    2004-01-01

    There are several strategies to manage the radioactive matter which has taken the status of 'ultimate radwaste'. They are based on combinations of the three primary strategies: 'Wait for Decay', 'Concentrate and Confine' and 'Disperse and Dilute' the radio-toxic radionuclides and chemo-toxic elements. They are, or will be used for safe storage (interim and long term) or safe disposal of nuclear wastes. The chemical needs to apply these strategies are on materials for isolation, matrices for confinement and on the numerous aspects of the migration of the elements, both in the lithosphere and in the biosphere. According to the ultimate fate of long lived radionuclides which will be finally released into the environment, migration studies of elements are, or should be, the driving force of research in nuclear wastes management. The chemical needs for improving our present basic knowledge related to this field will be reviewed, with emphasis on some new topics and on the effects of concentration of the elements when they migrate. The necessity to open some 'dark boxes' will be outlined. The paper does not intend to give programs of researches but only tracks for future research. (authors)

  14. Treatment of breast cancer-related lymphedema with adipose-derived regenerative cells and fat grafts

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Jensen, Charlotte Harken; Andersen, Ditte Caroline

    2017-01-01

    Breast cancer-related lymphedema (BCRL) is a debilitating late complication with a lack of treatment opportunities. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with freshly isolated adipose-derived...... regenerative cells (ADRC) for treating lymphedema with 6 months follow-up. Ten BCRL patients were included. ADRC was injected directly into the axillary region, which was combined with a scar-releasing fat graft procedure. Primary endpoints were change in arm volume. Secondary endpoints were change in patient...

  15. Tissue dielectric constant and circumference measurement in the follow-up of treatment-related changes in lower-limb lymphedema.

    Science.gov (United States)

    Tugral, Alper; Viren, Tuomas; Bakar, Yesim

    2018-02-01

    Lymphedema of lower limbs is a chronic condition that requires life-long management. Therapeutic effect of complex decongestive physiotherapy (CDP) is most often followed by circumference measurements (CM). However, the CM measurements are not specific to interstitial tissue fluid and have problems in sensitivity and objectivity. The aim of present study was to evaluate the therapeutic effect of CDP with a new tissue water specific measurement technique, in patients with lower limb lymphedema (LLL). A total of 17 patients with unilateral LLL (11 primary, 6 secondary lymphedema) were recruited in this study. CDP was applied for 5 days a week for 4 weeks. CM measurement of both limbs was performed at nine sites along limb by tape measure. Percentage skin water content (PWC) of thigh, calf and ankle was measured in affected lymphedema limb and contralateral limb with MoistureMeterD Compact (MMDC) device. Inter-limb PWC ratio was calculated by dividing affected side's PWC value with PWC of contralateral limb. Patients were asked to fullfill the Lymph Quality of Life Questionnaire. Significant reduction of circumference after CDP was detected at all nine measurement sites along lower limb (Pmeasurements showed a significant decrease of skin tissue water at thigh, calf and ankle measurement sites after CDP (Pmeasurements reflected a positive effect of CDP in patients with LLL. Both absolute PWC values and inter-limb PWC ratios were meaningful tools to follow the effect of therapautic intervention. Compared with CM measurements the TDC technique offered easier, quicker, objective and more practical measurements for routine assessments of LLL.

  16. Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

    International Nuclear Information System (INIS)

    Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min

    2006-01-01

    A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS

  17. Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2006-12-15

    A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

  18. Developmental defects of enamel and dentine: challenges for basic science research and clinical management.

    Science.gov (United States)

    Seow, W K

    2014-06-01

    Abnormalities of enamel and dentine are caused by a variety of interacting factors ranging from genetic defects to environmental insults. The genetic changes associated with some types of enamel and dentine defects have been mapped, and many environmental influences, including medical illnesses that can damage enamel and dentine have been identified. Developmental enamel defects may present as enamel hypoplasia or hypomineralization while dentine defects frequently demonstrate aberrant calcifications and abnormalities of the dentine-pulp complex. Clinically, developmental enamel defects often present with problems of discolouration and aesthetics, tooth sensitivity, and susceptibility to caries, wear and erosion. In contrast, dentine defects are a risk for endodontic complications resulting from dentine hypomineralization and pulpal abnormalities. The main goals of managing developmental abnormalities of enamel and dentine are early diagnosis and improvement of appearance and function by preserving the dentition and preventing complications. However, despite major advances in scientific knowledge regarding the causes of enamel and dentine defects, further research is required in order to translate the knowledge gained in the basic sciences research to accurate clinical diagnosis and successful treatment of the defects. © 2013 Australian Dental Association.

  19. Coding of meaningful concepts in lymphedema-specific questionnaires with the ICF

    NARCIS (Netherlands)

    Viehoff, P.B.; Hidding, J.T.; Heerkens, Y.H.; Ravensberg, C.D. van; Neumann, H.A.

    2013-01-01

    Abstract Purpose: To identify and quantify the meaningful concepts within questionnaires focusing on lymphedema using the International Classification of Functioning, Disability and Health (ICF). Methods: Electronic searches of Medline, EMBASE, CINAHL, CENtral and Pedro (2005-2010) were conducted.

  20. Development of consensus International Classification of Functioning, Disability and Health (ICF) core sets for lymphedema

    NARCIS (Netherlands)

    Viehoff, P.B.; Heerkens, Y.F.; Ravensberg, C.D. van; Hidding, J.; Damstra, R.J.; Napel, H. ten; Neumann, H.A.

    2015-01-01

    To understand the challenges of patients with lymphedema it is important to describe functioning and to measure the effectiveness of treatment in changing functioning. The International Classification of Functioning, Disability and Health (ICF) offers an international framework to classify

  1. MRI and ultrasonographic findings in the investigation of lymphedema and lipedema.

    Science.gov (United States)

    Dimakakos, P B; Stefanopoulos, T; Antoniades, P; Antoniou, A; Gouliamos, A; Rizos, D

    1997-01-01

    Twenty-four healthy subjects and 16 patients with lymphedema and lipedema were studied with MRI and ultratomography. In chronic lymphedema, ultrasonography revealed a statistically significant increase of the subcutaneous fat without difference in skin thickness as compared to the healthy subjects. MRI revealed in lymphedema a statistically significant increase of skin thickness + subcutaneous tissue + muscular mass (p = 0.048); in lipedema, a statistically significant increase of skin thickness and subcutaneous tissue (p < 0.0001) as compared to the healthy controls. MRI offers strong qualitative and quantitative parameters in the diagnosis of lymphedema and lipolymphedema, while ultrasonography is expected to improve its diagnostic efficiency with the aid of high frequency echo with more sophisticated resolution apparatus. Age, weight and height of the patient as well as duration of the disease do not seem to affect the above-mentioned parameters.

  2. Accurate Prediction of Submental Lymph Nodes Using Magnetic Resonance Imaging for Lymphedema Surgery

    Directory of Open Access Journals (Sweden)

    Mora-Ortiz Asuncion, MD

    2018-03-01

    Conclusions:. The preoperative MRI is a useful tool for the detection of mean 7.2 submental lymph nodes. Mean 72.2% of submental lymph nodes can be successfully transferred for extremity lymphedema with optimal functional recovery.

  3. Reforms in Philippine Basic Education Viewed from Key Elements of Successful School-Based Management (SBM) Schools

    Science.gov (United States)

    de Guzman, Allan B.

    2006-01-01

    While it is true that SBM shapes and charts the direction of school operations, it is interesting to discuss how a developing country like the Philippines is influenced by this reform strategy as a structural and procedural framework in managing its system of education, particularly, its basic education sector which through the years has been…

  4. GJA4/connexin 37 mutations correlate with secondary lymphedema following surgery in breast cancer patients

    OpenAIRE

    Hadizadeh, M.; Ardebili, S.M.M.; Salehi, M.; Young, C.; Mokarian, F.; McClellan, J.; Xu, Q.; Kazemi, M.; Moazam, E.; Mahaki, B.; Bonab, Maziar Ashrafian

    2018-01-01

    Open access article Lymphedema is a condition resulting from mutations in various genes essential for lymphatic development and function which leads to obstruction of the lymphatic system. Secondary Lymphedema is a progressive and incurable condition, most often manifesting after surgery for breast cancer. Although its causation appears complex, various lines of evidence indicate genetic predisposition may play a role. Previous studies show that mutations in Connexin 47 are associated with...

  5. MR imaging of the lymphatic system in patients with lipedema and lipo-lymphedema.

    Science.gov (United States)

    Lohrmann, Christian; Foeldi, Etelka; Langer, Mathias

    2009-05-01

    To assess for the first time the morphology of the lymphatic system in patients with lipedema and lipo-lymphedema of the lower extremities by MR lymphangiography. 26 lower extremities in 13 consecutive patients (5 lipedema, 8 lipo-lymphedema) were examined by MR lymphangiography. 18 mL of gadoteridol and 1 mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously in the forefoot. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For MR lymphangiography, a 3D-spoiled gradient-echo sequence was used. For evaluation of the lymphedema a heavily T2-weighted 3D-TSE sequence was performed. In all 16 lower extremities (100%) with lipo-lymphedema, high signal intensity areas in the epifascial region could be detected on the 3D-TSE sequence. In the 16 examined lower extremities with lipo-lymphedema, 8 lower legs and 3 upper legs demonstrated enlarged lymphatic vessels up to a diameter of 3 mm. In two lower legs with lipo-lymphedema, an area of dermal back-flow was seen, indicating lymphatic outflow obstruction. In the 10 examined lower extremities with clinically pure lipedema, 4 lower legs and 2 upper legs demonstrated enlarged lymphatic vessels up to a diameter of 2 mm, indicating a subclinical status of lymphedema. In all examined extremities, the inguinal lymph nodes demonstrated a contrast material enhancement in the first image acquisition 15 min after injection. MR lymphangiography is a safe and accurate minimal-invasive imaging modality for the evaluation of the lymphatic circulation in patients with lipedema and lipo-lymphedema of the lower extremities. If the extent of lymphatic involvement is unclear at the initial clinical examination or requires a better definition for optimal therapeutic planning, MR lymphangiography is able to identify the anatomic and physiological derangements and to establish an objective baseline.

  6. A Pilot Randomized Trial Evaluating Lymphedema Self-Measurement with Bioelectrical Impedance, Self-Care Adherence, and Health Outcomes

    OpenAIRE

    Ridner, Sheila H.; Shih, Ya-Chen Tina; Doersam, Jennifer K.; Rhoten, Bethany Andrews; Schultze, Benjamin S.; Dietrich, Mary S.

    2014-01-01

    Background: Less than half of breast cancer survivors with lymphedema perform self-care as directed. Effective lymphedema self-care is required to obtain acceptable health outcomes. Self-Regulation Theory suggests that objective self-measurement of physiological conditions is necessary to promote self-regulation/self-care. Bioelectric Impedance Spectroscopy (BIS) represents a potential self-measurement method for arm lymphedema. The purpose of this pilot study was to examine the impact of arm...

  7. Mobilization of fluids in large volumetric reductions during intensive treatment of leg lymphedema.

    Science.gov (United States)

    Pereira De Godoy, J M; Franco Brigidio, P A; Salles Cunha, S X; Batigália, F; De Fatima Guerreiro Godoy, M

    2013-10-01

    The aim of the current study was to evaluate fluid mobilization during the intensive treatment of leg lymphedema. The mobilization of intracellular and extracellular fluids in the lower and upper extremities and trunk was evaluated with the intensive treatment of leg lymphedema in a prospective study. Mobilization of fluids was assessed by bioelectrical impedance using the InBody S10 device in ten patients with leg lymphedema, regardless of the cause. Treatment consisted of six to eight hours per day of Manual Lymphatic Therapy (Godoy & Godoy technique), Mechanical Lymphatic Therapy (RAGodoy device®) and a non-elastic cotton-polyester stocking. A significant reduction in total water was observed for the lymphedematous limb, but with an increase in intracellular water of from 59% to 61%. Additionally, total water increases were observed in the limbs without lymphedema and in the trunk. There was an increase in total intracellular water of the extremities and trunk, but without any change in the extracellular water. In high-volume reductions during lymphedema treatment, fluids are displaced from the lymphedematous limb to extremities without lymphedema and to the trunk.

  8. Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis.

    Science.gov (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Feng, Shao Qing; Tong, Yun; Zhang, Ju Fang; Constantinides, Joannis; Lazzeri, Davide; Grassetti, Luca; Nicoli, Fabio; Zhang, Yi Xin

    2017-04-01

    Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence. Although FIR therapy has been applied for several years on thousands of lymphedema patients, there are still few studies that have reported the biological effects of FIR on lymphatic tissue. In this research, we investigate the effects of far infrared rays on the major components of lymphatic tissue. Then, we explore the effectiveness and safety of FIR as a promising treatment modality of lymphedema. A total of 32 patients affected by lymphedema in stage II and III were treated between January 2015 and January 2016 at our department. After therapy, a significant decrease of limb circumference measurements was noted and improving of quality of life was registered. Laboratory examination showed the treatment can also decrease the deposition of fluid, fat, hyaluronan, and protein, improving the swelling condition. We believe FIR treatment could be considered as both an alternative monotherapy and a useful adjunctive to the conservative or surgical lymphedema procedures. Furthermore, the real and significant biological effects of FIR represent possible future applications in wide range of the medical field.

  9. Modified lymph vessel flap transplantation for the treatment of refractory lymphedema: A case report.

    Science.gov (United States)

    Mihara, Makoto; Tange, Shuichi; Hara, Hisako; Han Peng, Zhou; Haragi, Makiko; Muarai, Noriyuki

    2016-11-01

    Lymph vessel flap transplantation (LFT), lymphaticovenous anastomosis (LVA), or lymph node flap transfer are sometimes used to treat lymphedema that is resistant to conservative treatment. LFT harvested from the contralateral limb has been reported for the treatment of lymphedema. Here we report the use of modified LFT from the abdominal wall for the treatment of refractory lymphedema. Our patient was a 57-year-old patient with secondary lower limb lymphedema was previously treated with conservative therapy and lymphaticovenous anastomosis. We first examined the lymphatic function of the lower abdominal region in the patient using indocyanine green (ICG) lymphography. After confirming the good lymphatic function in the right abdominal region, we harvested the pedicled abdominal adiposal flap containing multiple abdominal lymph vessels and transferred it to the left groin region. The flap (20 × 10 cm 2 ) was based on the superficial circumflex iliac artery perforator. We anastomosed one lymph vessel in the flap to that in the recipient site. We also performed multiple fibrotripsy using a 3-mm-diameter stainless steel stick inserted into small incisions. The postoperative course was uneventful. The circumference measurement was decreased by 2.2-13.5 cm at 1 year after the operation. The lower abdominal region has many lymph vessel networks and is thought to be a less risky donor site in patients with lymphedema than the lower limbs. Thus, LFT may be an option for the treatment of chronic lymphedema. © 2015 Wiley Periodicals, Inc. Microsurgery 36:695-699, 2016. © 2015 Wiley Periodicals, Inc.

  10. Basic diagnosis of solid waste generated at Agua Blanca State Park to propose waste management strategies.

    Science.gov (United States)

    Laines Canepa, José Ramón; Zequeira Larios, Carolina; Valadez Treviño, Maria Elena Macías; Garduza Sánchez, Diana Ivett

    2012-03-01

    State parks are highly sensitive areas of great natural importance and tourism value. Herein a case study involving a basic survey of solid waste which was carried out in 2006 in Agua Blanca State Park, Macuspana, Tabasco, Mexico with two sampling periods representing the high and low tourist season is presented. The survey had five objectives: to find out the number of visitors in the different seasons, to consider the daily generation of solid waste from tourist activities, to determine bulk density, to select and quantify sub-products; and to suggest a possible treatment. A daily average of 368 people visited the park: 18,862 people in 14 days during the high season holiday (in just one day, Easter Sunday, up to 4425 visitors) and 2092 visitors in 43 days during the low season. The average weight of the generated solid waste was 61.267 kg day(-1) and the generated solid waste average per person was 0.155 kg person(-1 ) day(-1). During the high season, the average increased to 0.188 kg person(-1 ) day(-1) and during the low season, the average decreased to 0.144 kg person(-1 ) day(-1). The bulk density average was 75.014 kg m(-3), the maximum value was 92.472 kg m(-3) and the minimum was 68.274 kg m(-3). The sub-products comprised 54.52% inorganic matter; 32.03% organic matter, 10.60% non-recyclable and 2.85% others. Based on these results, waste management strategies such as reuse/recycling, aerobic and anaerobic digestion, the construction of a manual landfill and the employment of a specialist firm were suggested.

  11. Profilometry and subsurface imaging in point of care diagnosis in ocular disease and lymphedema after breast cancer treatment

    Science.gov (United States)

    Sayegh, Samir I.; Taghian, Alphonse

    2013-03-01

    Breast cancer-related lymphedema (BCRL) can be irreversible with profound negative impact on patients' quality of life. Programs that provide screening and active surveillance for BCRL are essential to determine whether early detection and intervention influences the course of lymphedema development. Established methods of quantitatively assessing lymphedema at early stages include "volume" methods such as perometry and bioimpedance spectroscopy. Here we demonstrate 1) Use of topographical techniques analogous to those used in corneal topography 2) Development of point-of-care lymphedema detection and characterization based on off-the-shelf hardward 3) The role of subsurface imaging 4) Multimodal diagnostics and integration yielding higher sensitivity/ specificity.

  12. Breast cancer management in a case of hemihypertrophy/lymphedema.

    Science.gov (United States)

    Alipour, Sadaf

    2013-03-01

    Breast cancer can occur in women affected by congenital disorders because of its very high incidence. The circumstances of the underlying disease may affect the treatment plan for the cancer. In our case, breast cancer occurred in a 43-year-old woman with congenital hemihypertrophy and lymphedematous features of the overgrowth. These conditions are described in the article while questions about the best practice for the cancer surgery are mentioned.

  13. [Quality Management for Surgeons: The Knowledge of Basic Contexts and Innovative Strategies Promotes the Competitiveness of Clinical Department].

    Science.gov (United States)

    Hellmann, Wolfgang

    2017-12-01

    Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners. This paper provides basic knowledge on quality management, risk management, and quality assurance in the context of relevant medical terms. It demonstrates new ways for implementation on the level of a surgery department, and introduces a new model of quality. Georg Thieme Verlag KG Stuttgart · New York.

  14. Integrating modern dermatology and Ayurveda in the treatment of vitiligo and lymphedema in India.

    Science.gov (United States)

    Narahari, Saravu R; Ryan, Terence J; Bose, Kuthaje S; Prasanna, Kodimoole S; Aggithaya, Guruprasad M

    2011-03-01

    Globally, governments have recognized the growing popularity of Complementary and Alternative Medicines and the possibility of their combined use with biomedicine. Decisions within the Government of India have led to a conducive environment for conducting clinical studies, to achieve integration of more than one system of medicine, so that their combined benefits can be brought to bear on chronic, difficult-to-treat conditions. To develop integrative dermatology treatment protocols for patients with long-standing skin diseases who have received treatment from many centers. A team of doctors from modern dermatology, Ayurveda, yoga therapy, and homeopathy studied recruited patients to develop mutual orientation on each therapeutic system and a working knowledge of approach to their clinical diagnosis. Six-hundred thirty-eight patients affected by lower limb lymphedema requiring skin care as a major part of treatment were treated integrating modern dermatology and Ayurveda. Three-hundred eighty-one vitiligo patients were examined and treated to understand the clinical presentations and treatment options in Ayurveda. A two-step cluster analysis performed by SPSS Version 16 showed average volume reductions of 13.3% and 23% on day 14, 19.7% and 31.1% on day 45, and 23.4% and 39.7% on day 90 of treatment in small and large lymphedematous limbs. Inflammatory episodes before the onset on this treatment was reported by 79.5% of our lymphedema patients, and 9.4% reported this at the end of three months after our treatment. Among vitiligo patients, we found that 39.6% of patients had kapha, 39.8% pitta, 10.8% had vatha and 0.52% has tridoshaja presentation. There are over 100 treatment options available in Ayurveda to treat vitiligo. Each system of medicine recognizes the same disease albeit with minor difference in description. Skin care procedures like washing and emollients restore the barrier function and skin health. We have converged Ayurvedic skin care with that of

  15. Prescription and adherence to lymphedema self-care modalities among women with breast cancer-related lymphedema.

    Science.gov (United States)

    Brown, Justin C; Cheville, Andrea L; Tchou, Julia C; Harris, Susan R; Schmitz, Kathryn H

    2014-01-01

    To profile the prescription for and adherence to breast cancer-related lymphedema (BCRL) self-care modalities among breast cancer (BrCa) survivors with BCRL in a 12-month randomized weightlifting trial. We developed a questionnaire that assessed prescription for and adherence to 10 BCRL self-care modalities that included physical therapy exercise, pneumatic compression pump, medication, lymphedema bandaging, arm elevation, self-administered lymphatic drainage, therapist-administered lymphatic drainage, compression garments, skin care, and taping. We measured prescription for and adherence to BCRL self-care modalities at baseline, 3, 6, and 12 months. Longitudinal logistic regression was used to estimate the odds ratio (OR) and 95 % confidence interval (95 % CI) associated with prescription for and adherence to BCRL modalities over time. This study included 141 BrCa survivors with BCRL. Women were prescribed an average of 3.6 ± 2.1 BCRL self-care modalities during the study. The prescription for therapist-administered lymphatic drainage (OR = 0.92, 95 % CI 0.88-0.96), pneumatic compression pump use (OR = 0.94, 95 % CI 0.89-0.98), and bandaging (OR = 0.96, 95 % CI 0.93-0.99) decreased over 12 months of follow-up. No other prescribed BCRL self-care modalities changed during the study. Over 12 months, the average adherence to all BCRL self-care modalities varied with 13, 24, 32, and 31 % of women reporting variable. The average adherence to BCRL self-care was non-optimal. Future research is necessary to prepare BrCa survivors with the knowledge, skills, abilities, and resources necessary to care for this lifelong condition.

  16. Virtual patients: an effective educational intervention to improve paediatric basic specialist trainee education in the management of suspected child abuse?

    Science.gov (United States)

    McEvoy, M M; Butler, B; MacCarrick, G; Nicholson, A J

    2011-09-01

    Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.

  17. Virtual patients: an effective educational intervention to improve paediatric basic specialist trainee education in the management of suspected child abuse?

    LENUS (Irish Health Repository)

    McEvoy, M M

    2011-09-01

    Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.

  18. Management of basic education for ethnic groups in highland and border regions of Thailand

    Directory of Open Access Journals (Sweden)

    Phathombut Keawsomnuk

    2017-05-01

    The research findings revealed that the actors for advocacy policy in basic education for ethnic groups consist of: 1 the primary education service area, 2 community, 3 NGOs, 4 scholars, and 5 schools. This study indicated that the provision of basic education policy for ethnic groups must consist of knowledge from communities such as ethnic life styles integrated in the curriculum, and a special education mechanism and process for Thai ethnic groups, including facilitation of ethnic group participation in the abovementioned actors by various means.

  19. Management of the basic characteristic of a supervisor and managerial position

    OpenAIRE

    Stanisław Borkowski

    2015-01-01

    The main focus in this chapter is diversification of the definitions of the following notions: leadership, supervision, management. The existence of various types of leaders, supervisors, managers has been emphasized. The supervisors’ features were assessed based on the rules 4E+1P, which prove their value in revealing the leadership characteristics of the management personnel.

  20. The Dutch lymphedema guidelines based on the International Classification of Functioning, Disability, and Health and the chronic care model

    NARCIS (Netherlands)

    Damstra, R.J.; Halk, A.B.; Born, Y.; Butter, E.S.F.A.; Dorst, E.B.L. van; Everdingen, J.J. van; Feenstra, C.; Gielink, P.D.; Heide-Schoon, G.; Hendrickx, A.; Hidding, J.T.; Storm van Leeuwen, J.B.; Nijland, S.; Oskam, E.; Paulusma, I.; Russell, N.; Rutgers-van Wijlen, K.; Sissingh, I.; Strobbe, L.J.A.; Verhoeff-Braat, C.J.A.; Verwaard, R.; Vleuten, C.J.M. van der; Voesten, H.G.J.M.; Hartog, A.; Urget, M.C.

    2017-01-01

    Lymphedema is a chronic and progressive condition due to an imbalance between lymphatic filtration and transport capacity. A relative overload of fluid is caused by lymphatic impairment (afterload impairment); an absolute overload is caused by increased filtration (preload raised). Lymphedema can

  1. Lesson Plans for Teaching Basic Vocational Agriculture. Section III. Introduction to Soil Management and Classification.

    Science.gov (United States)

    McCully, James S., Jr., Comp.

    This publication, one of five sections, was developed for use in first and second year basic agriculture courses in secondary schools in Mississippi. The five lessons focus on the measurement and description of property and the classification of land. The purposes of the lessons are to (1) introduce the units and methods used to measure distance…

  2. Refractory lymphedema of the hand: an unusual presentation of recurrent herpes simplex virus infection

    Directory of Open Access Journals (Sweden)

    Ali Majdzadeh

    2016-07-01

    Full Text Available Introduction: Herpes Simplex Virus (HSV infection of the hand resulting in lymphatic complications such as lymphangitis and lymphedema is exceedingly uncommon. Although these complications typically resolve in 21 days, they can be persistent and may not resolve even with antiviral use, thereby mimicking dyshidrotic eczema or a bacterial event and often being misdiagnosed and inappropriately treated as such. We report a case of frequently recurring HSV infection of the hand over a long period of time resulting in refractory lymphedema which did not resolve with antiviral treatment. We further endeavor to raise awareness about this highly unusual presentation of HSV infection. A comprehensive review of the literature was conducted for similar cases using PubMed and Medline. Case Report: This is the first reported case with nearly a decade-long interval between the onset of primary HSV infection and the development of chronic lymphedema. Although valacyclovir significantly reduced the episodic aggravation of the lymphedema, it did not entirely resolve it. Similar cases of persistent lymphedema also included a long history of untreated and recurrent HSV infection of the hand, suggesting that this lymphatic outcome may be circumvented by prompt treatment with antivirals. Conclusion: This case report not only presents a highly uncommon lymphatic manifestation and unusual timeline of exacerbation of the very common HSV infection, but also highlights the importance and benefits of early initiation of antiviral therapy and the prevention of reactivation.

  3. The effect of mechanical lymph drainage accompanied with heat on lymphedema.

    Science.gov (United States)

    Mariana, Valente Flávia; de Fátima, Guerreiro Godoy Maria; Maria, Pereira de Godoy José

    2011-11-01

    Thermotherapy has been indicated by some researchers as a treatment for lymphedema. A study comparing temperatures demonstrated that a temperature of 40°C significantly increased the transportation of lymph compared to other temperatures assessed. The aim of this study was to evaluate the possible benefits of mechanical lymph drainage accompanied with heat in the treatment of lymphedema of the lower limbs. In a cross-over randomized study, the effect of heat on lymph drainage was evaluated in the treatment of leg lymphedema. The study, performed in the Godoy Clinic in São Jose do Rio Preto, Brazil, involved seven patients (two males and five females) with leg lymphedema. The patients' ages ranged from 18 to 79 years old with a mean of 48.5 years. The subjects underwent a total of 38 assessments including 19 evaluations of mechanical lymph drainage alone and 19 combined with thermotherapy. Heat was applied using an electric blanket which was wrapped around the legs of the patients. The volume of legs was evaluated by water plethysmography before and after treatment sessions. The paired t-test was used for statistical analysis with an alpha error of p = 0.05 being considered as acceptable. No statistically significant differences were evidenced between mechanical lymph drainage alone and lymph drainage combined with thermotherapy. There was no obvious synergic effect in the immediate post-treatment period when heat was combined with mechanical lymph drainage in the treatment of lymphedema.

  4. Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer.

    Science.gov (United States)

    Teo, Irene; Novy, Diane M; Chang, David W; Cox, Matthew G; Fingeret, Michelle Cororve

    2015-11-01

    Depression and reduced quality of life are often reported in patients with upper-extremity lymphedema secondary to breast cancer treatment. Little is known about how pain and body image influence depression in patients with lymphedema. The current study examined the association of pain intensity and body integrity beliefs with depressive symptoms and the extent to which body image dissatisfaction mediated these associations. A cross-sectional sample of patients with lymphedema secondary to breast cancer treatment completed self-report questionnaires of pain, body image, and depressive symptoms. Hierarchical regression analyses and tests of mediation were conducted to examine the associations among the variables of interest. Pain intensity and body integrity beliefs were positively associated with depressive symptoms. Further, body image dissatisfaction mediated the relationship between pain and depressive symptoms, indicating that higher levels of pain led to higher states of body image dissatisfaction, which, in turn, led to greater depressive symptoms. Body image dissatisfaction also mediated the relationship between body integrity beliefs and depressive symptoms, suggesting that greater body integrity beliefs led to higher dissatisfaction with one's body and subsequently to greater depressive symptoms. Our findings provide preliminary evidence that pain intensity and body image are important factors in understanding depressive symptoms in patients with lymphedema. Clinical implications include screening for pain and body image concerns in this population to identify patients who are in distress. Counseling interventions targeting body image dissatisfaction can also be potentially helpful for patients with lymphedema. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study.

    Science.gov (United States)

    Togawa, Kayo; Ma, Huiyan; Sullivan-Halley, Jane; Neuhouser, Marian L; Imayama, Ikuyo; Baumgartner, Kathy B; Smith, Ashley Wilder; Alfano, Catherine M; McTiernan, Anne; Ballard-Barbash, Rachel; Bernstein, Leslie

    2014-08-22

    Lymphedema is a potentially debilitating condition that occurs among breast cancer survivors. This study examines the incidence of self-reported lymphedema, timing of lymphedema onset, and associations between sociodemographic, clinical and lifestyle factors and lymphedema risk across racial-ethnic groups using data from a multicenter, multiethnic prospective cohort study of breast cancer survivors, the Health, Eating, Activity and Lifestyle Study. A total of 666 women diagnosed with breast cancer staged as in situ, localized or regional disease at ages 35 to 64 years were recruited through the Surveillance, Epidemiology, and End Results registries in New Mexico (non-Hispanic white and Hispanic white), Los Angeles County (black), and Western Washington (non-Hispanic white) and followed for a median of 10.2 years. We evaluated sociodemographic factors, breast cancer- and treatment-related factors, comorbidities, body mass index (BMI), hormonal factors, and lifestyle factors in relation to self-reported lymphedema by fitting Cox proportional hazards models, estimating hazard ratios (HR) and 95% confidence intervals (CI). Over the follow-up period, 190 women (29%) reported lymphedema. The median time from breast cancer diagnosis to onset of lymphedema was 10.5 months (range: 0.5 to 134.9 months). Factors independently associated with lymphedema were total/modified radical mastectomy (versus partial/less than total mastectomy; HR = 1.37, 95% CI: 1.01 to 1.85), chemotherapy (versus no chemotherapy; HR = 1.48, 95% CI: 1.09 to 2.02), no lymph nodes removed (versus ≥10 lymph nodes removed; HR = 0.17, 95% CI: 0.08 to 0.33), pre-diagnostic BMI ≥30 kg/m2 (versus BMI BMI should be closely monitored for detection and treatment of lymphedema. Further studies are needed to understand the roles of chemotherapy and hypertension in the development of lymphedema.

  6. Development and evaluation of the Korean version of the Gynecologic Cancer Lymphedema Questionnaire in gynecologic cancer survivors.

    Science.gov (United States)

    Lim, Myong Cheol; Lee, Jeong Seon; Joo, Jungnam; Park, Kibyung; Yoo, Heon Jong; Seo, Sang-Soo; Kang, Sokbom; Chung, Seung Hyun; Park, Sang-Yoon

    2014-04-01

    The purpose of this study was two-fold: first, to develop a Korean version of the Gynecologic Cancer Lymphedema Questionnaire (GCLQ-K) and evaluate its reliability and reproducibility and second, to examine the diagnostic efficacy of GCLQ-K in predicting lymphedema in gynecologic cancer survivors. We designed a case-control study, and the GCLQ-K was completed by 33 gynecologic cancer survivors with lymphedema and 34 gynecologic cancer survivors without lymphedema. A follow-up GCLQ-K was completed 3weeks after the baseline questionnaire. The GCLQ-K showed high reliability with a Cronbach's α of 0.83 and high reproducibility with an intraclass correlation of 0.96. Of the 7 symptom clusters, 6 identified patients with lymphedema with statistical significance; identification of lymphedema using the physical functioning and infection-related symptom clusters did not reach significance. The area under the receiver operating characteristic curve (AUC) to distinguish patients with and without lymphedema was 0.868 (95% confidence interval [CI], 0.779-0.956). Following the exclusion of the physical functioning and infection-related symptom clusters, which showed poor prediction value for lymphedema, the AUC of the GCLQ-K total score further improved to 0.922 (95% CI, 0.864-0.981). The GCLQ-K was successfully developed with minimal modifications to adapt the original GCLQ to the Korean culture and showed high internal consistency and reproducibility. Moreover, gynecologic cancer survivors with and without lymphedema could be satisfactorily distinguished using the GCLQ-K. Thus, GCLQ-K was proven to be a reliable tool, capable of identifying lymphedema in Korean gynecological cancer survivors. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. A3byComp: A Support tool for Basic Implementation of Competency Management Systems in Social Entities

    Directory of Open Access Journals (Sweden)

    Daniel CLAVERO HERRERO

    2015-12-01

    Full Text Available The importance of managing processes related to people working in institutions within the scope of FEAPS evidenced by the increasing incorporation into the strategy of the organizations policies aimed at improving the working conditions of workers and in the development of competence management systems aimed at promoting professional development, which aims greater effectiveness and efficiency in providing support for improving the quality of life of people with disabilities and their families. At the same time, banks have highlighted the need for specific instruments and tools that facilitate the implementation of these systems. In Extremadura, it has been developed a software tool for the implementation of basic competence management systems called A3byComp that has been freely available to the entire network promoting industry collaboration aimed mutual learning.

  8. Risk terminology primer: Basic principles and a glossary for the wildland fire management community

    Science.gov (United States)

    Matthew P. Thompson; Tom Zimmerman; Dan Mindar; Mary Taber

    2016-01-01

    Risk management is being increasingly promoted as an appropriate method for addressing wildland fire management challenges. However, a lack of a common understanding of risk concepts and terminology is hindering effective application. In response, this General Technical Report provides a set of clear, consistent, understandable, and usable definitions for terms...

  9. Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Jang Eun-ha

    2009-12-01

    Full Text Available Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

  10. Upper extremity function and quality of life in patients with breast cancer related lymphedema.

    Science.gov (United States)

    Bojinović-Rodić, Dragana; Popović-Petrović, Svetlana; Tomić, Sanja; Markez, Stanislava; Živanić, Dobrinka

    2016-09-01

    Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL). The aim of this study was to estimate health-related quality of life (HRQoL) in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36). Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH). The size of lymphedema was determined by the arm circumference. The higher HRQoL score was assessed for mental health (47.0 ± 12.2) than for physical one (42.2 ± 7.5). The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9) and Social Function (70.1 ± 23.1). The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1) and General Health (49.3 ± 20.1). Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05). Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

  11. Upper extremity function and quality of life in patients with breast cancer related lymphedema

    Directory of Open Access Journals (Sweden)

    Bojinović-Rodić Dragana

    2016-01-01

    Full Text Available Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL. The aim of this study was to estimate health-related quality of life (HRQoL in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36. Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH. The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2 than for physical one (42.2 ± 7.5. The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9 and Social Function (70.1 ± 23.1. The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1 and General Health (49.3 ± 20.1. Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05. Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

  12. Basic concepts for crew resource management and non-technical skills.

    Science.gov (United States)

    Flin, Rhona; Maran, Nikki

    2015-03-01

    In this paper, we explain the conceptual background to non-technical skills and show how they can influence job performance in anaesthesia. We then describe the taxonomy of anaesthetists' non-technical skills (ANTS) and related systems, such as ANTS-AP for anaesthetic practitioners. We discuss the training courses that have been designed to teach these non-technical skills, which are called crew resource management (CRM), crisis resource management (CRM) or crisis avoidance resource management (CARMA). Finally, we discuss the application of non-technical skills assessment systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Basic principles and practical steps in the management of fluid balance in the newborn.

    Science.gov (United States)

    Hartnoll, Gary

    2003-08-01

    The fluid management of newborn babies can pose many problems. This article discusses the factors that affect fluid balance in the newborn infant, both term and preterm, and the special circumstances of the surgical neonate. The main determinants of management are: (1) an estimation of transepidermal water losses; (2) an awareness of glomerular filtration rate and how this is influenced by age, respiratory distress and medical intervention; and (3) knowledge of tubular function and its maturation and the processes of postnatal adaptation. This knowledge and appropriate monitoring are the mainstay of management of neonatal fluid balance.

  14. Systematic review of basic oral care for the management of oral mucositis in cancer patients.

    Science.gov (United States)

    McGuire, Deborah B; Fulton, Janet S; Park, Jumin; Brown, Carlton G; Correa, M Elvira P; Eilers, June; Elad, Sharon; Gibson, Faith; Oberle-Edwards, Loree K; Bowen, Joanne; Lalla, Rajesh V

    2013-11-01

    The purpose of this project was to evaluate research in basic oral care interventions to update evidence-based practice guidelines for preventing and treating oral mucositis (OM) in cancer patients undergoing radio- or chemotherapy. A systematic review of available literature was conducted by the Basic Oral Care Section of the Mucositis Study Group of MASCC/ISOO. Seven interventions--oral care protocols, dental care, normal saline, sodium bicarbonate, mixed medication mouthwash, chlorhexidine, and calcium phosphate--were evaluated using the Hadorn (J Clin Epidemiol 49:749-754, 1996) criteria to determine level of evidence, followed by a guideline determination of one of the following: recommendation, suggestion, or no guideline possible, using Somerfield's (Classic Pap Cur Comments 4:881-886, 2000) schema. Fifty-two published papers were examined by treatment population (radiotherapy, chemotherapy, and hematopoietic stem cell transplant) and by whether the intervention aimed to prevent or treat OM. The resulting practice suggestions included using oral care protocols for preventing OM across all treatment modalities and age groups and not using chlorhexidine mouthwash for preventing OM in adults with head and neck cancer undergoing radiotherapy. Considering inadequate and/or conflicting evidence, no guidelines for prevention or treatment of OM were possible for the interventions of dental care, normal saline, sodium bicarbonate, mixed medication mouthwash, chlorhexidine in patients receiving chemotherapy or hematopoietic stem cell transplant, or calcium phosphate. The evidence for basic oral care interventions supports the use of oral care protocols in patient populations receiving radiation and/or chemotherapy and does not support chlorhexidine for prevention of mucositis in head and neck cancer patients receiving radiotherapy. Additional well-designed research is needed for other interventions to improve the amount and quality of evidence guiding future clinical

  15. Basic criteria for a sustainable water management at the U.S.-México border: the case of ambos Nogales

    Directory of Open Access Journals (Sweden)

    Luis Ernesto Cervera Gómez

    2003-01-01

    Full Text Available This article aims to analyze some basic criteria for a sustainable use of water in an international watershed shared by Mexico and the United States. The study area comprises the region of Ambos Nogales, which is located inside the Upper Santa Cruz River Basin. This portion of the watershed represents the main ecosystem and the main source of water for urban and rural populations located in this region. Following criteria of sustainability the authors revise and adapt to the case of Ambos Nogales, a set of guidelines proposed by the Pacific Institute for Studies in Development, Environment, and Security. These guidelines include the following elements: basic water requirements needed to maintain quality of life in the population and the health of ecosystems; water quality that meets certain minimum standards; human actions and their impact on long-term renewability of freshwater stocks and flows; collection of data concerning water resources, use and quality of water; institutional mechanisms to prevent and resolve conflicts; and a democratic process of water-planning and decision-making. These twin cities have a long history of cooperation and conflict linked to water resources, which makes available enough information to create a diagnostic about the water management inside a binational arena, and allowing to explore possibilities for a better water resources management under a sustainable regime and from an international perspective. Keywords: Sustainability, binational water management, ambos Nogales region.

  16. The basic laws and problems of organization of management of transport systems

    International Nuclear Information System (INIS)

    Bochkov, A.A.; Ekshikeev, T.K.; Filenko, S.A.; Tursunov, A.A.

    2005-01-01

    In this clause are given essence and characteristics of existing laws of management of transport systems and specificities of use in market economy. Depending on the accepted decisions for management of transport systems in uncertain conditions and connection with insufficient the information, use the methods of programming is considered as the correct decision for the put tasks. The realization of stochastic programming is shown by an example and note by a level of a stock of spare part in transport systems

  17. Wound management of chronic diabetic foot ulcers: from the basics to regenerative medicine.

    Science.gov (United States)

    Andrews, Karen L; Houdek, Matthew T; Kiemele, Lester J

    2015-02-01

    Hospital-based studies have shown that mortality rates in individuals with diabetic foot ulcers are about twice those observed in individuals with diabetes without foot ulcers. To assess the etiology and management of chronic diabetic foot ulcers. Literature review. Systematic review of the literature discussing management of diabetic foot ulcers. Since there were only a few randomized controlled trials on this topic, articles were selected to attempt to be comprehensive rather than a formal assessment of study quality. Chronic nonhealing foot ulcers occur in approximately 15% of patients with diabetes. Many factors contribute to impaired diabetic wound healing. Risk factors include peripheral neuropathy, peripheral arterial disease, limited joint mobility, foot deformities, abnormal foot pressures, minor trauma, a history of ulceration or amputation, and impaired visual acuity. With the current treatment for nonhealing diabetic foot ulcers, a significant number of patients require amputation. Diabetic foot ulcers are optimally managed by a multidisciplinary integrated team. Offloading and preventative management are important. Dressings play an adjunctive role. There is a critical need to develop novel treatments to improve healing of diabetic foot ulcers. The goal is to have wounds heal and remain healed. Diabetic neuropathy and peripheral arterial disease are major factors involved in a diabetic foot ulcer. Despite current treatment modalities for nonhealing diabetic foot ulcers, there are a significant number of patients who require amputations. No known therapy will be effective without concomitant management of ischemia, infection, and adequate offloading. © The International Society for Prosthetics and Orthotics 2014.

  18. Development of a participatory Management approach of the Committee for Basic Education School under the Nongbualamphu Primary Educational Service Area Office 2

    Directory of Open Access Journals (Sweden)

    Jirayu Prommajak

    2016-10-01

    Full Text Available This study aimed: 1 study the present state and adverse conditions of administration with the participation of the basic education in schools. 2 Development of a participatory Management approach of the Committee for Basic Education school under the Nongbualamphu Primary Educational Service Area Office 2. Split data into 2 phases. Phase 1: The sample used for this research consisted of 128 members of the committee on basic education in school under the Nongbualamphu Primary Educational Service Area Office 2. Selected by using stratified random sampling. Instruments used included a set of rating scale questionnaires. Phase 2: Data from the interviews using a structured questionnaire and focus group discussion. The basic statistics used for analyzing the collected data were percentage, means and standard deviation. The results of this study were as follows: 1. On the present state administration with the participation of the basic education commission in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall participation in management is moderate. Considering the individual aspects, found that the academic administration overall participation in management and budget management were moderate. The personnel management and general and administrative overall participation in management at a high level. 2. Adverse conditions of administration with the participation of the school board for basic education in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall in a high level. Considering the individual aspects, found that the school board in basic education is desirable to participate in the management of all aspects. 3. Development of a participatory management approach of the committee for basic education school under the Nongbualamphu Primary Educational Service Area Office 2 is a developmental process management principles PDCA, 5 steps. Step 1: Creating a common understanding Step

  19. Wilderness Medical Society practice guidelines for basic wound management in the austere environment: 2014 update.

    Science.gov (United States)

    Quinn, Robert H; Wedmore, Ian; Johnson, Eric L; Islas, Arthur A; Anglim, Anne; Zafren, Ken; Bitter, Cindy; Mazzorana, Vicki

    2014-12-01

    In an effort to produce best-practice guidelines for wound management in the austere environment, the Wilderness Medical Society convened an expert panel charged with the development of evidence-based guidelines for the management of wounds sustained in an austere (dangerous or compromised) environment. Recommendations are made about several parameters related to wound management. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. This is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2014;25(3):295-310. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  20. The management of human resources in the Basic Units of Cooperative Production in Cuba: An essential challenge

    Directory of Open Access Journals (Sweden)

    Deysi Alfonso Porraspita

    2018-02-01

    Full Text Available The socioeconomic structure of Cuba has undergone a stage of profound transformation, with various factors that have intervened in this process, where different forms of business structures have converged, one of which has been represented by the cooperative sector, fundamentally developed in agriculture from the country. In this scenario the issue of the effectiveness of these entities has been subject to dissimilar analyzes and debates from different sides, where what is related to the human factor has played an essential role, this implies a detailed observation of the adequate management of human resources in the integral management of these organizations. In this line, the fundamental challenge will be to manage human resources in a way that contributes to the continuous improvement of the Cooperative Production Units as one of the representative structures of the agrarian cooperative sector in Cuba. Carrying out an analysis highlighting the importance of the management of human resources as a contribution to affectivity of the Basic Units of Cooperative production constituted the objective of the work. Through analysis, synthesis and use of the logical historical in the system analysis, the work addressed the theoretical pillars and methodological aspects that support the management of human resources in the cooperative entities analyzed as a tribute to the effectiveness of their results.

  1. Energy management and effective energy use in Ukraine: basic problems and ways to solve them

    International Nuclear Information System (INIS)

    Gnedoy, M.V.

    2003-01-01

    In this paper, barriers in the way of energy efficiency are considered and classified. The classification is made in six blocks: financial, sociological, manufacturing, management-organisational, legal and market. A strategy to overcome these barriers and the achievement of more effective energetics in Ukraine are proposed. On the basis of the strategy, five indissoluble tasks are considered: energy supply reliability, pricing and tariff policy, the legislative and normative base, energy use efficiency, environmental protection and decrease in influence on climate change. Solving these problems will allow the construction of an effective system of energy management in Ukraine. (author)

  2. Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

    Science.gov (United States)

    Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

    2017-01-01

    The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

  3. Creative Management as a Strategy for Breakthrough Innovation. Lessons from Basic Research Projects of Japanese Companies.

    Science.gov (United States)

    Lee, K. T.

    1997-01-01

    Japanese science/technology policies emphasize creative research management for strengthening breakthrough innovation. Key lessons include the following: cultivation of creative researchers, clear strategic directions, systematic teamwork and collaboration, focus on strategic industrial relevance, balance between autonomy and control, and the need…

  4. Animal Science Basic Core Curriculum. Kansas Postsecondary Farm and Ranch Management Project.

    Science.gov (United States)

    Albracht, James, Ed.

    Thirty-six units of instruction are included in this core curriculum in animal science for postsecondary farm and ranch management programs. Units of instruction are divided into seven instructional areas: (1) Livestock Types, (2) Livestock Programs, (3) Nutrition, (4) Animal Health, (5) Animal Breeding, (6) Animal Improvement, and (7) Livestock…

  5. The Impact of Radiation Therapy on the Risk of Lymphedema After Treatment for Breast Cancer: A Prospective Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Laura E.G.; Miller, Cynthia L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Skolny, Melissa N.; Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean A. [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-03-01

    Purpose/Objective: Lymphedema after breast cancer treatment can be an irreversible condition with a negative impact on quality of life. The goal of this study was to identify radiation therapy-related risk factors for lymphedema. Methods and Materials: From 2005 to 2012, we prospectively performed arm volume measurements on 1476 breast cancer patients at our institution using a Perometer. Treating each breast individually, 1099 of 1501 patients (73%) received radiation therapy. Arm measurements were performed preoperatively and postoperatively. Lymphedema was defined as ≥10% arm volume increase occurring >3 months postoperatively. Univariate and multivariate Cox proportional hazard models were used to evaluate risk factors for lymphedema. Results: At a median follow-up time of 25.4 months (range, 3.4-82.6 months), the 2-year cumulative incidence of lymphedema was 6.8%. Cumulative incidence by radiation therapy type was as follows: 3.0% no radiation therapy, 3.1% breast or chest wall alone, 21.9% supraclavicular (SC), and 21.1% SC and posterior axillary boost (PAB). On multivariate analysis, the hazard ratio for regional lymph node radiation (RLNR) (SC ± PAB) was 1.7 (P=.025) compared with breast/chest wall radiation alone. There was no difference in lymphedema risk between SC and SC + PAB (P=.96). Other independent risk factors included early postoperative swelling (P<.0001), higher body mass index (P<.0001), greater number of lymph nodes dissected (P=.018), and axillary lymph node dissection (P=.0001). Conclusions: In a large cohort of breast cancer patients prospectively screened for lymphedema, RLNR significantly increased the risk of lymphedema compared with breast/chest wall radiation alone. When considering use of RLNR, clinicians should weigh the potential benefit of RLNR for control of disease against the increased risk of lymphedema.

  6. MANAGEMENT STYLE AND WORK MOTIVATION IN THE BASIC SCHOOLS IN THE MUNICIPALITY OF MIRANDA

    Directory of Open Access Journals (Sweden)

    Sobeida del Carmen Alvarado Silva

    2016-10-01

    Full Text Available The aim of the study is to determine the relationship between management style and work motivation in national primary schools in the Altagracia Parish at the Municipality of Miranda. It is a descriptive correlational research, framed on the positivist approach. The design is field not experimental and transsectional. The quantitative statistical analysis is used to process the data obtained from subjects surveyed to measure the relationship of the variables. A population census comprised of 99 subjects of whom 09 are managers and 90 teachers was conducted. Two instruments made up of 36 items with Likert response options were designed: always, almost always, sometimes and never. The statistical analysis used to analyze the results was descriptive; with frequency distribution by items. As conclusion, a very low positive and statistically significant correlation between variables was detected.

  7. Genetic tests in lymphatic vascular malformations and lymphedema.

    Science.gov (United States)

    Michelini, Sandro; Paolacci, Stefano; Manara, Elena; Eretta, Costantino; Mattassi, Raul; Lee, Byung-Boong; Bertelli, Matteo

    2018-04-01

    Syndromes with lymphatic malformations show phenotypic variability within the same entity, clinical features that overlap between different conditions and allelic as well as locus heterogeneity. The aim of this review is to provide a comprehensive clinical genetic description of lymphatic malformations and the techniques used for their diagnosis, and to propose a flowchart for genetic testing. Literature and database searches were performed to find conditions characterised by lymphatic malformations or the predisposition to lymphedema after surgery, to identify the associated genes and to find the guidelines and genetic tests currently used for the molecular diagnosis of these disorders. This search allowed us to identify several syndromes with lymphatic malformations that are characterised by a great heterogeneity of phenotypes, alleles and loci , and a high frequency of sporadic cases, which may be associated with somatic mutations. For these disorders, we found many diagnostic tests, an absence of harmonic guidelines for molecular diagnosis and well-established clinical guidelines. Targeted sequencing is the preferred method for the molecular diagnosis of lymphatic malformations. These techniques are easy to implement and have a good diagnostic success rates. In addition, they are relatively inexpensive and permit parallel analysis of all known disease-associated genes. The targeted sequencing approach has improved the diagnostic process, giving patients access to better treatment and, potentially, to therapy personalised to their genetic profiles. These new techniques will also facilitate the prenatal and early postnatal diagnosis of congenital lymphatic conditions and the possibility of early intervention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Stewart-Treves Syndrome on the Lower Extremity Associated to Idiopathic Chronic Lymphedema Visualized on FDG PET/CT

    DEFF Research Database (Denmark)

    Brittain, Jane Maestri; Nymark, Tine; Hildebrandt, Malene Grubbe

    2017-01-01

    Angiosarcomas are highly malignant and rare tumors of vascular or lymphatic endothelial cell origin with a poor prognosis. Lymphangiosarcoma associated with chronic lymphedema is known as Stewart-Treves syndrome. Stewart-Treves syndrome is primarily described in patients with lymphedema of an upper...... extremity occurring after breast cancer surgery including radical axillary lymph node dissection and subsequent radiotherapy. It is rarely described in the presence of idiopathic chronic lymphedema of the lower extremities. We present a case of lymphangiosarcoma visualized on F-FDG PET/CT, where Stewart...

  9. Tc-99m-Human Serum Albumin Transit Time as a Measure of Arm Breast Cancer-Related Lymphedema

    DEFF Research Database (Denmark)

    Toyserkani, Navid M; Hvidsten, Svend; Tabatabaeifar, Siavosh

    2017-01-01

    34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent bilateral lymphoscintigraphy using intradermal injection in both hands of technetium-99m-labeled human serum albumin and sequential 5 min imaging for 5 hours. The mean transit time (MTT) in the arms was calculated...... based on time activity curves generated from injection site and arm regions. Visual lymphedema scoring was performed based on dermal backflow and lymph node presence. Excess arm volume was calculated from circumference measurements. RESULTS: The MTT (mean ± SD) was significantly longer in the lymphedema...

  10. Teaching Styles of the Classroom Managers in one Basic Primary School in the Philippines

    Directory of Open Access Journals (Sweden)

    Marife G.Villena

    2015-05-01

    Full Text Available This study aimed to determine the teaching styles of the classroom managers in Pinamucan Elementary School. Specifically, it identified the demographic profile or the teachers respondents in terms of age, gender, educational qualification, number of seminars attended, assigned level and years of services; and find out which of the teaching styles of the teacher respondents in terms of whole class, individual, and small group activities are practiced. The study used descriptive methods were a standardized questionnaire was utilized as the main instrument in gathering data. Based on the result, Most of the classroom managers belonged to the middle aged bracket; had been working from 20 to 29 years in this institution, and were assigned in different grades / levels, and had attended 7-9 seminars for the length of time they had served there; majority of the respondents often use the question and answer method when doing whole class activities. For individual activities, homework is often used by the classroom managers to get their students’ attention while for small group activities, games were often practiced as means of initiating cooperation among students. The school may be practice the used of LCD. School administrator mat conduct seminars regarding modern classroom methodologies

  11. Development of consensus International Classification of Functioning, Disability and Health (ICF) core sets for lymphedema.

    Science.gov (United States)

    Viehoff, P B; Heerkens, Y F; Van Ravensberg, C D; Hidding, J; Damstra, R J; Ten Napel, H; Neumann, H A M

    2015-03-01

    To understand the challenges of patients with lymphedema it is important to describe functioning and to measure the effectiveness of treatment in changing functioning. The International Classification of Functioning, Disability and Health (ICF) offers an international framework to classify functioning of persons in their personal environment. ICF Core Sets are lists of selected ICF categories concerning those important aspects of functioning that are most likely to be affected by a specific health problem or disease. These Core Sets make it easier and faster to describe and communicate the patient's problems and to define treatment goals. Furthermore, they are available to health care providers of all professions, researchers, health insurance companies and policy-makers. The objective of this document is to present the outcomes of a consensus conference held to determine the first versions of the ICF Core Sets for lymphedema. Frequency rankings were made of the ICF categories derived from four preparatory studies, being: a) a systematic review; b) a qualitative study; c) an expert survey; and d) a cross-sectional study. By means of working group discussions and plenary sessions, a final consensus on ICF categories was achieved and Comprehensive and Brief Core Sets for lymphedema for the upper limb, lower limb, and midline lymphedema were defined. These ICF Core Sets contain different items in each region. Future validation of these Core Sets for health professions and for countries is needed.

  12. Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

    Directory of Open Access Journals (Sweden)

    Sood Suneet

    2010-06-01

    Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

  13. Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer

    Science.gov (United States)

    2017-05-03

    Lymphedema; Stage IA Cervical Cancer; Stage IA Uterine Corpus Cancer; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Uterine Corpus Cancer; Stage IB Vulvar Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer

  14. Autosomal recessive intestinal lymphangiectasia and lymphedema, with facial anomalies and mental retardation

    NARCIS (Netherlands)

    Hennekam, R. C.; Geerdink, R. A.; Hamel, B. C.; Hennekam, F. A.; Kraus, P.; Rammeloo, J. A.; Tillemans, A. A.

    1989-01-01

    We report on two male and two female relatives with intestinal lymphangiectasia; severe lymphedema of limbs, genitalia, and face; facial anomalies; seizures; mild growth retardation; and moderate mental retardation. Main facial anomalies are a flat face, flat nasal bridge, hypertelorism, small

  15. Intermittent Pneumatic Compression Enhances Formation of Edema Tissue Fluid Channels in Lymphedema of Lower Limbs.

    Science.gov (United States)

    Zaleska, Marzanna; Olszewski, Waldemar L; Cakala, Marta; Cwikla, Jaroslaw; Budlewski, Tadeusz

    2015-06-01

    In lymphedema, tissue fluid steadily accumulates in the subcutaneous space containing loose connective tissue. We documented previously that deformation of the structure of subcutaneous collagen bundles and fat by excess fluid leads to formation of "lakes" and interconnected channels with irregular shape. Since there is no force that could mobilize and propel stagnant fluid to the regions where lymphatics absorb and contract, this task should be taken over by external massage. The most effective in this respect seems to be the sequential intermittent pneumatic compression (IPC). The aim of the study was to observe whether IPC would enhance and accelerate formation of tissue fluid channels. Together with the Biocompression Systems (Moonachie, NJ), we designed a high pressure intermittent compression device and used in it our therapy protocol for patients with obstructive lymphedema of lower limbs. The study was carried out on 18 patients with lymphedema stages II-IV. The IPC was applied daily for 1-2 hours. The follow up time was 24-36 months. Lymphoscintigraphy and immunohistopathology of tissue biopsies were used for evaluation of channel formation process. The forced fluid flow brought about increase of the area of fluid channels in the thigh and groin, with a decrease in the calf. Concomitantly, with decrease of channel area in the calf, there was a decrease of calf circumference. No new lymphatic collectors were observed. Compression of limb lymphedema tissues leads to formation of tissue channels as pathways for evacuation of edema fluid.

  16. Treatment of postmastectomy lymphedema by bypassing the armpit with implanted silicone tubings.

    Science.gov (United States)

    Olszewski, Waldemar L; Zaleska, Marzanna

    2017-02-01

    Women treated for breast cancer are facing a life-time risk of developing lymphedema in up to 40% of this population. In advanced cases of lymphedema main lymphatics are obstructed and tissue fluid accumulates in the interstitial spaces forming fluid "lakes"and "channels". The only solution for fluid drainage would be creating artificial channel for flow away to the non-obstructed regions. The aim of this study was to form artificial pathways for edema fluid flow by subcutaneous implantation of silicone tubes into the swollen limb. Implantation was carried out in ten patients with lymphedema after mastectomy, axillary lymphadenectomy and radiotherapy, stage II and III. Tubes were placed from hand dorsum, through forearm and arm to scapular region. Implantation was followed by routine arm sleeve compression. Prophylactic long term penicillin was administered. The follow-up is at present 10 months. We observed: implanted tubes brought about fast evacuation of excess tissue fluid; most decrease in circumference, volume and stiffness occurred within first two weeks; less limb heaviness and easier hand grip; lymphoscintigraphy tracer accumulated in tubes and around them; free fluid was seen on ultrasonography at both ends of tubes and in between; no postoperative complications. We propose a multimodality method including implantation, limb compression to generate fluid pressure gradient for flow and prevention of inflammation by administration of long-term penicillin. Simplicity of surgical procedure and lack of reaction to implant make the method worth applying in advanced stages of lymphedema in large cohorts of patients.

  17. The godoy & godoy cervical stimulation technique in the treatment of primary congenital lymphedema.

    Science.gov (United States)

    de Godoy, José Maria Pereira; de Godoy, Ana Carolina Pereira; Guimarães, Tânia Dias; de Godoy, Maria de Fátima Guerreiro

    2012-07-31

    THE AIM OF THE CURRENT STUDY IS TO REPORT ON THE TREATMENT OF PRIMARY LYMPHEDEMA USING A NEW FORM OF THERAPY: cervical stimulation. In a prospective cohort study, 9 boys and 5 girls with primary congenital lymphedema were evaluated over two years. Age ranged from two months to 8.5 years. After diagnosis, all mothers were trained in the new technique. The Godoy & Godoy cervical stimulation technique consists of between 20 to 30 stimuli per minute using light movements in the cervical region. All the children were submitted to perimetric evaluations of the feet and legs; however, in this study only two points, 3 and 6 cm from the base of the big toe nail, were used. The two-tailed t-test was used for statistical analysis with an alpha error of 5% (P<0.05) considered acceptable. The size of the lymphedematous feet was reduced and even normalized (P<0.0001) for all treated children. Cervical stimulation is a new option in the treatment of primary congenital lymphedema; its association with compression stockings has a synergistic effect in reducing the volume of lymphedema.

  18. The Godoy & Godoy cervical stimulation technique in the treatment of primary congenital lymphedema

    Directory of Open Access Journals (Sweden)

    Jose Maria Pereira de Godoy

    2012-10-01

    Full Text Available The aim of the current study is to report on the treatment of primary lymphedema using a new form of therapy: cervical stimulation. In a prospective cohort study, 9 boys and 5 girls with primary congenital lymphedema were evaluated over two years. Age ranged from two months to 8.5 years. After diagnosis, all mothers were trained in the new technique. The Godoy & Godoy cervical stimulation technique consists of between 20 to 30 stimuli per minute using light movements in the cervical region. All the children were submitted to perimetric evaluations of the feet and legs; however, in this study only two points, 3 and 6 cm from the base of the big toe nail, were used. The two-tailed t-test was used for statistical analysis with an alpha error of 5% (P<0.05 considered acceptable. The size of the lymphedematous feet was reduced and even normalized (P<0.0001 for all treated children. Cervical stimulation is a new option in the treatment of primary congenital lymphedema; its association with compression stockings has a synergistic effect in reducing the volume of lymphedema.

  19. Microzonation in Urban Areas, Basic Element for Land-Use Planning, Risk Management and Sustainable Development

    Science.gov (United States)

    Torres Morales, G. F.; Dávalos Sotelo, R.; Castillo Aguilar, S.; Mora González, I.; Lermo Samaniego, J. F.; Rodriguez, M.; García Martínez, J.; Suárez, M. Leonardo; Hernández Juan, F.

    2013-05-01

    This paper presents the results of microzonification of the natural hazards for different metropolitan areas and highlights the importance of integrating these results in urban planning. The cities that have been covered for the definition of danger in the state of Veracruz are: Orizaba, Veracruz and Xalapa, as part of the production of a Geological and Hydrometeorology Hazards Atlas for the state of Veracruz, financed by the Funds for the Prevention of Natural Disasters FOPREDEN and CONACYT. The general data of each metropolitan area was integrated in a geographic information system (GIS), obtaining different theme maps, and maps of dynamic characteristics of soils in each metropolitan area. For the planning of an urban area to aspire to promote sustainable development, it is essential to have a great deal of the details on the pertinent information and the most important is that that has to do with the degree of exposure to natural phenomena. In general, microzonation investigations consider all natural phenomena that could potentially affect an area of interest and hazard maps for each of potential hazards are prepared. With all the data collected and generated and fed into a SIG, models were generated which define the areas most threatened by earthquake, flood and landslide slopes. These results were compared with maps of the main features in the urban zones and a qualitative classification of areas of high to low hazard was established. It will have the basic elements of information for urban planning and land use. This information will be made available to the authorities and the general public through an Internet portal where people can download and view maps using free software available online.;

  20. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial.

    Science.gov (United States)

    Schmitz, Kathryn H; Ahmed, Rehana L; Troxel, Andrea B; Cheville, Andrea; Lewis-Grant, Lorita; Smith, Rebecca; Bryan, Cathy J; Williams-Smith, Catherine T; Chittams, Jesse

    2010-12-22

    Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise, preventing them from obtaining established health benefits of weight lifting. To evaluate lymphedema onset after a 1-year weight lifting intervention vs no exercise (control) among survivors at risk for breast cancer-related lymphedema (BCRL). A randomized controlled equivalence trial (Physical Activity and Lymphedema trial) in the Philadelphia metropolitan area of 154 breast cancer survivors 1 to 5 years postunilateral breast cancer, with at least 2 lymph nodes removed and without clinical signs of BCRL at study entry. Participants were recruited between October 1, 2005, and February 2007, with data collection ending in August 2008. Weight lifting intervention included a gym membership and 13 weeks of supervised instruction, with the remaining 9 months unsupervised, vs no exercise. Incident BCRL determined by increased arm swelling during 12 months (≥5% increase in interlimb difference). Clinician-defined BCRL onset was also evaluated. Equivalence margin was defined as doubling of lymphedema incidence. A total of 134 participants completed follow-up measures at 1 year. The proportion of women who experienced incident BCRL onset was 11% (8 of 72) in the weight lifting intervention group and 17% (13 of 75) in the control group (cumulative incidence difference [CID], -6.0%; 95% confidence interval [CI], -17.2% to 5.2%; P for equivalence = .04). Among women with 5 or more lymph nodes removed, the proportion who experienced incident BCRL onset was 7% (3 of 45) in the weight lifting intervention group and 22% (11 of 49) in the control group (CID, -15.0%; 95% CI, -18.6% to -11.4%; P for equivalence = .003). Clinician-defined BCRL onset occurred in 1 woman in the weight lifting intervention group and 3 women in the control group (1.5% vs 4.4%, P for equivalence = .12). In breast cancer survivors at risk for lymphedema, a program of slowly progressive weight lifting

  1. Factor VII Deficiency: From Basics to Clinical Laboratory Diagnosis and Patient Management.

    Science.gov (United States)

    Sevenet, Pierre-Olivier; Kaczor, Daniel A; Depasse, Francois

    2017-10-01

    Factor VII (FVII) deficiency is a rare inheritable bleeding disorder affecting 1/500 000 individuals. Clinical manifestations are heterogeneous, from asymptomatic to severe and potentially fatal bleeding. These clinical manifestations do not correlate well with FVII plasma levels. For this reason, FVII-deficient patient management during surgery or for long-term prophylaxis remains challenging. Laboratory testing for FVII activity is, however, the first-line method for FVII deficiency diagnosis and is helpful for managing patients in combination with clinical history. Additional testing consists of FVII immunoassay and genetic testing. Genetic abnormalities on the FVII gene are heterogeneous and can translate into quantitative or qualitative defects. Some of the latter can react differently with different thromboplastins; this can be misleading for the laboratory as no consensus exists at present on an FVII deficiency diagnosis methodology. Indeed, no single test is able to predict accurately the bleeding risk. This review provides a broad picture of inherited and acquired FVII deficiency with a particular focus on laboratory diagnosis.

  2. Hydrocoelom and lymphedema in dendrobatid frogs at National Aquarium, Baltimore: 2003-2011.

    Science.gov (United States)

    Clancy, Meredith M; Clayton, Leigh A; Hadfield, Catherine A

    2015-03-01

    Hydrocoelom and lymphedema are common in amphibians. In the family Dendrobatidae at the National Aquarium, Baltimore, prevalence was 3.19% from 2005 to 2011. Complete review of all cases in dendrobatids from 01 January 2003 to 01 June 2011 at the National Aquarium identified annual incidence rate, associated signs, diagnostic findings, therapeutics, and outcomes using medical record review. Associated etiologies were assessed via available necropsy and histopathology reports. Hydrocoelom was defined as coelomic distention with fluid; lymphedema was defined as fluid accumulation in the lymph spaces. These two syndromes could occur concurrently, and no association between case success (36.5% overall) or etiology was found to contrast hydrocoelom and lymphedema. Species susceptibility varied, with increased prevalence and incidence rate in Adelphobates castaneoticus, Dendrobates auratus, and Phyllobates spp. D. auratus also had reduced case success overall (26.0%). Females experienced hydrocoelom and/or lymphedema at an attack rate more than three times that of males. Fluid aspiration for culture was the most predictive antemortem diagnostic to find infectious etiologies, but antemortem diagnostics were largely noncontributory in identifying other causes of fluid accumulation. Enrofloxacin treatment increased case success more than fivefold when compared to those not treated and was the only treatment positively associated with case success. Infectious etiology, renal disease, and gastrointestinal disease, including parasitism, were seen commonly on postmortem evaluation of cases. These findings underscore the importance of the ability to individually track and treat cases, with fluid culture and initiation of enrofloxacin therapy (10 mg/kg p.o.q. 24 hr) seen as the best first steps after presentation with hydrocoelom or lymphedema.

  3. Heavy-Load Lifting: Acute Response in Breast Cancer Survivors at Risk for Lymphedema.

    Science.gov (United States)

    Bloomquist, Kira; Oturai, Peter; Steele, Megan L; Adamsen, Lis; Møller, Tom; Christensen, Karl Bang; Ejlertsen, Bent; Hayes, Sandra C

    2018-02-01

    Despite a paucity of evidence, prevention guidelines typically advise avoidance of heavy lifting in an effort to protect against breast cancer-related lymphedema. This study compared acute responses in arm swelling and related symptoms after low- and heavy-load resistance exercise among women at risk for lymphedema while receiving adjuvant taxane-based chemotherapy. This is a randomized, crossover equivalence trial. Women receiving adjuvant taxane-based chemotherapy for breast cancer who had undergone axillary lymph node dissection (n = 21) participated in low-load (60%-65% 1-repetition maximum, two sets of 15-20 repetitions) and heavy-load (85%-90% 1-repetition maximum, three sets of 5-8 repetitions) upper-extremity resistance exercise separated by a 1-wk wash-out period. Swelling was determined by bioimpedance spectroscopy and dual-energy x-ray absorptiometry, with breast cancer-related lymphedema symptoms (heaviness, swelling, pain, tightness) reported using a numeric rating scale (0-10). Order of low- versus heavy-load was randomized. All outcomes were assessed before, immediately after, and 24 and 72 h after exercise. Generalized estimating equations were used to evaluate changes over time between groups, with equivalence between resistance exercise loads determined using the principle of confidence interval inclusion. The acute response to resistance exercise was equivalent for all outcomes at all time points irrespective of loads lifted, with the exception of extracellular fluid at 72 h after exercise with less swelling after heavy loads (estimated mean difference, -1.00; 95% confidence interval, -3.17 to 1.17). Low- and heavy-load resistance exercise elicited similar acute responses in arm swelling and breast cancer-related lymphedema symptoms in women at risk for lymphedema receiving adjuvant taxane-based chemotherapy. These represent important preliminary findings, which can be used to inform future prospective evaluation of the long-term effects of

  4. The sentinel lymph node management: basics, techniques, documentation, classification, and recommendations regarding quality assurance

    International Nuclear Information System (INIS)

    Maza, S.; Munz, D.L.

    2006-01-01

    The sentinel lymph node (SLN) management represents one of the most fascinating developments world-wide in oncology during the last 15 years. The N 0 M 0 -situation in the context of pN-staging is the general indication and must be guaranteed before SLN diagnostics. An SLN is defined as one or more lymph node(s) to which lymphatic drainage and metastases from a (solid) primary tumour are most likely to occur. The SLN is visualised by lymphatic mapping using either a radioactive tracer, a vital dye, a lymphotropic MR-contrast agent or a combination of all (if necessary multimodal imaging). SLNs are reliably identified by the visualisation of an ''own'' afferent lymphatic vessel (further criteria are described). Instructions for the SLN diagnostic procedure in selected primary tumours are presented. Finally, suggestions on documentation and classification and also recommendations regarding quality assurance are addressed. (orig.)

  5. Back to Basics: The Effect of Healthy Diet and Exercise on Chronic Disease Management.

    Science.gov (United States)

    Allison, Robert L

    2017-01-01

    The increase in obesity rates in the U.S. and other less developed industrial countries have led to a worldwide epidemic of chronic disease states. Increased obesity rates are implicated in the treatment failures for illnesses such as coronary artery disease, diabetes, heart failure, hypertension and cancer. Effective prevention of obesity through diet and exercise contributes to the successful medical management of multiple chronic disease states. Review the last 10 years of literature (2006-2016) on the effects of diet and exercise as they relate to the prevention of chronic disease. Cochran Database of Systematic Reviews and other original articles using the National Center for Biotechnical Information database. The success in management of chronic disease lies in a physician's ability to educate patients and effective utilization of the resources available to that provider. Patient accountability for their individual chronic disease states is a problem related to patient education, patient participation, access to care, and payment resources. Financial, racial, and socioeconomic barriers must be addressed in the creation of an effective plan. Teaching on the importance of diet and exercise needs to occur early in life and be continually reinforced for successful outcomes. In the last 10 years, there has not been a significant study suggesting a single successful model of diet and exercise that can control chronic diseases. Cardiac, diabetic, and cancer patients have reduced hospital admissions, improved diabetic control, and improved quality of life scores related to coordinated diet and exercise programs, however. Patients may be unwilling or unable to be accountable for health care coordination. The development of exercise and obesity prevention policies and the adjustment in financial rewards to health care organizations will have a major impact in implementing these programs over the next 10 years.

  6. Basic principles

    International Nuclear Information System (INIS)

    Wilson, P.D.

    1996-01-01

    Some basic explanations are given of the principles underlying the nuclear fuel cycle, starting with the physics of atomic and nuclear structure and continuing with nuclear energy and reactors, fuel and waste management and finally a discussion of economics and the future. An important aspect of the fuel cycle concerns the possibility of ''closing the back end'' i.e. reprocessing the waste or unused fuel in order to re-use it in reactors of various kinds. The alternative, the ''oncethrough'' cycle, discards the discharged fuel completely. An interim measure involves the prolonged storage of highly radioactive waste fuel. (UK)

  7. Pilot Study: The Effectiveness of Complex Decongestive Therapy for Lymphedema in Palliative Care Patients with Advanced Cancer.

    LENUS (Irish Health Repository)

    Cobbe, Sinead

    2017-12-05

    Complex decongestive therapy (CDT) is a regimen of physical treatment for lymphedema. Its effectiveness is unknown in advanced cancer patients. This study evaluates effectiveness of CDT in this population.

  8. Systematic Review and Meta-Analysis of the Effects of Exercise for Those With Cancer-Related Lymphedema.

    Science.gov (United States)

    Singh, Ben; Disipio, Tracey; Peake, Jonathan; Hayes, Sandra C

    2016-02-01

    To evaluate the effects of exercise on cancer-related lymphedema and related symptoms, and to determine the need for those with lymphedema to wear compression during exercise. CINAHL, Cochrane, EBSCOhost, MEDLINE, PubMed, ProQuest Health and Medical Complete, ProQuest Nursing and Allied Health Source, ScienceDirect, and SPORTDiscus databases were searched for trials published before January 1, 2015. Randomized and nonrandomized controlled trials and single-group pre-post studies published in English were included. Twenty-one (exercise) and 4 (compression and exercise) studies met inclusion criteria. Data were extracted into tabular format using predefined data fields by 1 reviewer and assessed for accuracy by a second reviewer. Study quality was evaluated using the Effective Public Health Practice Project Quality Assessment Tool. Data were pooled using a random-effects model to assess the effects of acute and long-term exercise on lymphedema and lymphedema-associated symptoms, with subgroup analyses for exercise mode and intervention length. There was no effect of exercise (acute or intervention) on lymphedema or associated symptoms, with standardized mean differences from all analyses ranging between -0.2 and 0.1 (P values ≥.22). Findings from subgroup analyses for exercise mode (aerobic, resistance, mixed, other) and intervention duration (>12wk or ≤12wk) were consistent with these findings-that is, no effect on lymphedema or associated symptoms. There were too few studies evaluating the effect of compression during regular exercise to conduct a meta-analysis. Individuals with secondary lymphedema can safely participate in progressive, regular exercise without experiencing a worsening of lymphedema or related symptoms. However, there is insufficient evidence to support or refute the current clinical recommendation to wear compression garments during regular exercise. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc

  9. Radiation therapy targets and the risk of breast cancer-related lymphedema: a systematic review and network meta-analysis.

    Science.gov (United States)

    Shaitelman, Simona F; Chiang, Yi-Ju; Griffin, Kate D; DeSnyder, Sarah M; Smith, Benjamin D; Schaverien, Mark V; Woodward, Wendy A; Cormier, Janice N

    2017-04-01

    New indications have been found for regional nodal irradiation (RNI) in breast cancer treatment, yet the relationship of RNI and lymphedema risk is uncertain. We sought to determine the association of RNI and lymphedema. We searched MEDLINE, EMBASE, and Scopus for articles in English on humans published from 1995 to 2015, using search terms breast neoplasm, treatment, and morbidity. Two investigators independently selected articles and extracted information, including manuscripts reporting incidence of lymphedema by radiation targets. Meta-analyses, review papers, case-control studies, matched-pair studies, repetitive datasets, and retrospective studies were excluded. A total of 2399 abstracts were identified and 323 corresponding articles reviewed. Twenty-one studies met inclusion criteria. Data were pooled using a random effects mixed model. Network meta-analyses were performed to determine the association of radiation targets alone and radiation targets plus extent of axillary surgery on incidence of lymphedema. The addition of RNI to breast/CW irradiation was associated with an increased incidence of lymphedema (OR 2.85; 95% CI 1.24-6.55). In patients treated with sentinel lymph node biopsy or axillary sampling, there was no association of lymphedema with the addition of RNI to breast/CW irradiation (OR 1.58; 95% CI 0.54-4.66; pooled incidence 5.7 and 4.1%, respectively). Among patients treated with axillary lymph node dissection (ALND), treatment with RNI in addition to breast/CW radiation was associated with a significantly higher risk of lymphedema (OR 2.74; 95% CI 1.38-5.44; pooled incidence 18.2 and 9.4%, respectively). RNI is associated with a significantly higher risk of lymphedema than irradiation of the breast/CW, particularly after ALND.

  10. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients

    OpenAIRE

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks...

  11. Physical activity and lower limb lymphedema among uterine cancer survivors.

    Science.gov (United States)

    Brown, Justin C; John, Gabriella M; Segal, Saya; Chu, Christina S; Schmitz, Kathryn H

    2013-11-01

    Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET · h · wk of PA, participants who reported ≥ 18.0 MET · h · wk of PA had an odds ratio of LLL of 0.32 (95% confidence interval, 0.15-0.69; P trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg · m (P trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥ 12 blocks per day of walking had an odds ratio of LLL of 0.19 (95% confidence interval, 0.09-0.43; P trend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg · m (P trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

  12. Laser CO2 treatment for vulvar lymphedema secondary to gynecological cancer therapy: A report of two cases and review of the literature

    OpenAIRE

    SOPRACORDEVOLE, FRANCESCO; MANCIOLI, FRANCESCA; CANZONIERI, VINCENZO; BUTTIGNOL, MONICA; GIORDA, GIORGIO; CIAVATTINI, ANDREA

    2015-01-01

    Vulvar lymphedema is an uncommon and disabling side-effect of pelvic lymphadenectomy and pelvic radiotherapeutic treatment for invasive genital cancer. Lymphorrhea, a complication of lymphedema, may be extremely distressing for patients due to the requirement to wear sanitary towels and as the pain and loss of elasticity of the vulvar skin and mucosa can cause discomfort during coitus. Surgical treatments of lymphorrhea and vulvar lymphedema secondary to gynecological cancer treatments remain...

  13. Liquid silicone used for esthetic purposes as a potentiator for occurrence of post-radiotherapy genital lymphedema: case report

    Directory of Open Access Journals (Sweden)

    Raíssa Quaiatti Antonelli

    Full Text Available ABSTRACT CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.

  14. Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials.

    Science.gov (United States)

    Kasawara, Karina Tamy; Mapa, Jéssica Monique Rossetti; Ferreira, Vilma; Added, Marco Aurélio Nemitalla; Shiwa, Silvia Regina; Carvas, Nelson; Batista, Patricia Andrade

    2018-05-01

    Lymphedema is known as a secondary complication of breast cancer treatment, caused by reduction on lymphatic flow and lymph accumulation on interstitial space. The Kinesio Taping (KT) has become an alternative treatment for lymphedema volume reduction. The objective of the study was to evaluate the literature through a systematic review on KT effects on lymphedema related to breast cancer. Search strategies were performed by the following keywords: "Kinesio Taping," "Athletic Tape," "Cancer," "Neoplasm," "Lymphedema," and "Mastectomy" with derivations and different combinations. The following databases were accessed: SCIELO, LILACS, MEDLINE via PubMed, and PEDro, between 2009 and 2016. Studies published in English, Portuguese, and Spanish were considered for inclusion. The studies' methodological quality was assessed by the PEDro scale. Seven studies were identified by the search strategy and eligibility. All of them showed positive effect in reducing lymphedema (perimeter or volume) before versus after treatment. However, with no effects comparing the KT versus control group or others treatments (standardized mean difference = 0.04, confidence interval 95%: -0.24; 0.33), the average score of the PEDro scale was 4.71 points. KT was effective on postmastectomy lymphedema related to breast cancer; however, it is not more efficient than other treatments.

  15. Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

    Science.gov (United States)

    Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

    2008-01-01

    The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

  16. Brain Basics

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    Full Text Available ... About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain Brain ... called the hypothalamic-pituitary-adrenal (HPA) axis. Brain Basics in Real Life Brain Basics in Real Life— ...

  17. Brain Basics

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    Full Text Available ... Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video Welcome. Brain Basics provides information on how the brain works, how mental illnesses ...

  18. Proceeding of the Scientific Meeting and Presentation on Basic Research in Nuclear of the Scientific and Technology Part II : Nuclear Chemistry; Process Technology and Radioactive Waste Management; Environment

    International Nuclear Information System (INIS)

    Sudjatmoko; Karmanto, Eko Edy; Endang-Supartini

    1996-04-01

    Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology is a routine activity was held by Yogyakarta Nuclear Research Centre, National Atomic Energy Agency (BATAN) for monitoring the research activity which achieved in BATAN. The Proceeding contains a proposal about basic which has Nuclear Chemistry, Process Technology, Radioactive Waste Management and Environment. This proceeding is the second part from two part which published in series. There are 61 articles which have separated index

  19. Basic serials management handbook

    CERN Document Server

    Szilvássy, Judith

    1996-01-01

    Die International Federation of Library Associations and Institutions (IFLA) ist der führende internationale Dachverband, der die Interessen von Bibliotheken und Informationsdiensten und ihren Nutzern vertritt. Sie ist das weltweite Sprachrohr der Bibliotheks- und Informationsberufe. In der Reihe IFLA Publications wird eine Vielzahl der Möglichkeiten diskutiert, wie Bibliotheken, Informationszentren sowie Angestellte in Informations- und Dokumentationsberufen weltweit ihre Ziele formulieren und ihren Einfluss als Gruppe wahrnehmen, ihre Interessen vertreten sowie Lösungen für globale Probleme entwickeln können.

  20. Brain Basics

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    Full Text Available ... at NIMH News & Events About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain Brain Basics in Real Life Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video ...

  1. [Current wound care in patients with elephantiasis--third-stage lymphedema].

    Science.gov (United States)

    Rucigaj, Tanja Planinsek; Slana, Ana; Leskovec, Nada Kecelj

    2012-10-01

    Lymphedema resulting from fluid accumulation due to impairment in the lymphatic system drainage leads to enlargement of the body part involved. If left untreated, in its third stage it results in elephantiasis. Elephantiasis is frequently accompanied by papillomatosis and lymphocutaneous fistulas with lymphorrhoea, erosions and ulcers, frequently with the loss of function in the respective part of the body. Unlike other chronic wounds, wound healing in lymphedema is highly dependent on the use of combined therapies because local treatment with modern supportive dressings and compression therapy with adhesive and non-adhesive short-stretch systems is only part of the complete treatment. This treatment also includes sub-bandage foamy materials, kinesitherapy with tapes (kinesiotaping), intermittent local application of high-pressure oxygen, breathing exercise, and manual lymph drainage and exercises.

  2. Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema

    Science.gov (United States)

    Armer, Jane M.; Shook, Robin P.; Schneider, Melanie K; Brooks, Constance W.; Peterson, Julie; Stewart, Bob R

    2010-01-01

    This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency. PMID

  3. Role of CT in the diagnosis of primary lymphedema of the lower limb

    International Nuclear Information System (INIS)

    Hadjis, N.S.; Carr, D.H.; Banks, L.; Pflug, J.J.

    1985-01-01

    Twelve patients with primary lymphedema of the lower limb were examined with computed tomography (CT). A characteristic honeycomb pattern of the subcutaneous compartment was seen in 10 of these patients. CT scans in nine other patients with swollen leg secondary to chronic venous disease or lipedema did not show this characteristic pattern. CT may be helpful in the differential diagnosis of a swollen leg, thus obviating venography or lymphangiography

  4. Role of CT in the diagnosis of primary lymphedema of the lower limb

    Energy Technology Data Exchange (ETDEWEB)

    Hadjis, N.S.; Carr, D.H.; Banks, L.; Pflug, J.J.

    1985-02-01

    Twelve patients with primary lymphedema of the lower limb were examined with computed tomography (CT). A characteristic honeycomb pattern of the subcutaneous compartment was seen in 10 of these patients. CT scans in nine other patients with swollen leg secondary to chronic venous disease or lipedema did not show this characteristic pattern. CT may be helpful in the differential diagnosis of a swollen leg, thus obviating venography or lymphangiography.

  5. Lymph Node Transplantation Decreases Swelling and Restores Immune Responses in a Transgenic Model of Lymphedema.

    Directory of Open Access Journals (Sweden)

    Jung-Ju Huang

    Full Text Available Secondary lymphedema is a common complication of cancer treatment and recent studies have demonstrated that lymph node transplantation (LNT can decrease swelling, as well as the incidence of infections. However, although these results are exciting, the mechanisms by which LNT improves these pathologic findings of lymphedema remain unknown. Using a transgenic mouse model of lymphedema, this study sought to analyze the effect of LNT on lymphatic regeneration and T cell-mediated immune responses.We used a mouse model in which the expression of the human diphtheria toxin receptor is driven by the FLT4 promoter to enable the local ablation of the lymphatic system through subdermal hindlimb diphtheria toxin injections. Popliteal lymph node dissection was subsequently performed after a two-week recovery period, followed by either orthotopic LNT or sham surgery after an additional two weeks. Hindlimb swelling, lymphatic vessel regeneration, immune cell trafficking, and T cell-mediated immune responses were analyzed 10 weeks later.LNT resulted in a marked decrease in hindlimb swelling, fibroadipose tissue deposition, and decreased accumulation of perilymphatic inflammatory cells, as compared to controls. In addition, LNT induced a marked lymphangiogenic response in both capillary and collecting lymphatic vessels. Interestingly, the resultant regenerated lymphatics were abnormal in appearance on lymphangiography, but LNT also led to a notable increase in dendritic cell trafficking from the periphery to the inguinal lymph nodes and improved adaptive immune responses.LNT decreases pathological changes of lymphedema and was shown to potently induce lymphangiogenesis. Lymphatic vessels induced by LNT were abnormal in appearance, but were functional and able to transport antigen-presenting cells. Animals treated with LNT have an increased ability to mount T cell-mediated immune responses when sensitized to antigens in the affected hindlimb.

  6. Lymph Node Transplantation Decreases Swelling and Restores Immune Responses in a Transgenic Model of Lymphedema.

    Science.gov (United States)

    Huang, Jung-Ju; Gardenier, Jason C; Hespe, Geoffrey E; García Nores, Gabriela D; Kataru, Raghu P; Ly, Catherine L; Martínez-Corral, Inés; Ortega, Sagrario; Mehrara, Babak J

    2016-01-01

    Secondary lymphedema is a common complication of cancer treatment and recent studies have demonstrated that lymph node transplantation (LNT) can decrease swelling, as well as the incidence of infections. However, although these results are exciting, the mechanisms by which LNT improves these pathologic findings of lymphedema remain unknown. Using a transgenic mouse model of lymphedema, this study sought to analyze the effect of LNT on lymphatic regeneration and T cell-mediated immune responses. We used a mouse model in which the expression of the human diphtheria toxin receptor is driven by the FLT4 promoter to enable the local ablation of the lymphatic system through subdermal hindlimb diphtheria toxin injections. Popliteal lymph node dissection was subsequently performed after a two-week recovery period, followed by either orthotopic LNT or sham surgery after an additional two weeks. Hindlimb swelling, lymphatic vessel regeneration, immune cell trafficking, and T cell-mediated immune responses were analyzed 10 weeks later. LNT resulted in a marked decrease in hindlimb swelling, fibroadipose tissue deposition, and decreased accumulation of perilymphatic inflammatory cells, as compared to controls. In addition, LNT induced a marked lymphangiogenic response in both capillary and collecting lymphatic vessels. Interestingly, the resultant regenerated lymphatics were abnormal in appearance on lymphangiography, but LNT also led to a notable increase in dendritic cell trafficking from the periphery to the inguinal lymph nodes and improved adaptive immune responses. LNT decreases pathological changes of lymphedema and was shown to potently induce lymphangiogenesis. Lymphatic vessels induced by LNT were abnormal in appearance, but were functional and able to transport antigen-presenting cells. Animals treated with LNT have an increased ability to mount T cell-mediated immune responses when sensitized to antigens in the affected hindlimb.

  7. Relevance of quantification in combined lymphoscintigraphy diagnostics of upper limb lymphedema. Abstract

    Czech Academy of Sciences Publication Activity Database

    Heřmanská, J.; Gebouský, Petr; Křížová, H.; Kárný, Miroslav; Wald, M.

    2005-01-01

    Roč. 32, Suppl. 1 (2005), s. 50 ISSN 1619-7070 R&D Projects: GA MZd NC7601; GA ČR GA102/03/0049 Institutional research plan: CEZ:AV0Z10750506 Keywords : quantitative lymphoscintigraphy * secondary lymphedema of upper limbs * dynamic modeling * staging * Bayesian evaluation Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 3.883, year: 2005

  8. Lymphedema in Klippel-Trenaunay Syndrome: Is It Possible to Normalize?

    Directory of Open Access Journals (Sweden)

    Jose Maria Pereira de Godoy

    2016-01-01

    Full Text Available The aim of this study is to report the results of intensive therapy of lymphedema associated with Klippel-Trenaunay syndrome. A 24-year-old female patient reported that her family had observed edema in her right leg and port wine stains from birth. For ten years, they consulted with different specialists in the region but the prognosis did not change and no specific treatment was found. In 2014, at the age of 24, with massive lymphedema, a leg ulcer, and recurrent infections, she started treatment at the Clínica Godoy in São José do Rio Preto. She was evaluated by clinical history, physical examination, water displacement volumetry, and bioimpedance. Intensive therapy (8 hours daily was proposed using Manual Lymphatic Therapy (Godoy & Godoy, Cervical Stimulation Therapy, Mechanical Lymphatic Therapy, a grosgrain stocking adjusted several times a day, and the use of Unna boot in the region of the ulcer. The volume of edema was reduced by about 44% within the first week with further reductions in the following weeks and healing of the ulcer. Subsequently, it was possible to control and maintain the reduction in swelling with less intense treatment. It is possible to reduce and maintain the treatment results of lymphedema associated with Klippel-Trenaunay syndrome.

  9. Utilization of bioimpedance spectroscopy in the prevention of chronic breast cancer-related lymphedema.

    Science.gov (United States)

    Kaufman, David I; Shah, Chirag; Vicini, Frank A; Rizzi, Marisa

    2017-12-01

    This analysis was performed to assess the impact of early intervention following prospective surveillance using bioimpedance spectroscopy (BIS) to detect and manage breast cancer-related lymphedema (BCRL). From 8/2010 to 12/2016, 206 consecutive patients were evaluated with BIS. The protocol included pre-operative assessment with L-Dex as well as post-operative assessments at regular intervals. Patients with L-Dex scores >10 from baseline were considered to have subclinical BCRL and were treated with over-the-counter (OTC) compression sleeve for 4 weeks. High-risk patients were defined as undergoing axillary lymph node dissection (ALND), receiving regional nodal irradiation (RNI), or taxane chemotherapy. Chronic BCRL was defined as the need for complex decongestive physiotherapy (CDP). Median follow-up was 25.9 months. Overall, 17% of patients had one high-risk feature, 8% two, and 7% had three. 9.8% of patients were diagnosed with subclinical BCRL with highest rates seen following ALND (23 vs. 7%, p = 0.01). Development of subclinical BCRL was associated with ALND and receipt of RNI. At last follow-up, no patients (0%) developed chronic, clinically detectable, BCRL. Subset analysis was performed of the 30 patients undergoing ALND. Median number of nodes removed was 18 and median number of positive nodes was 2. 77% received taxane chemotherapy, 62% axillary RT, and 48% had elevated BMI. Overall, 86% of patients had at least one additional high-risk feature, 70% at least two, and 23% had all three. Seven patients (23%) had abnormally elevated L-Dex scores at some point during follow-up. To date, none has required CDP. The results of this study support prospective surveillance utilizing BIS initiated pre-operatively with subsequent post-operative follow-up measurements for the detection of subclinical BCRL. Intervention triggered by subclinical BCRL detection with an elevated L-Dex score was associated with no cases progressing to chronic, clinically detectable

  10. Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

    Science.gov (United States)

    Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

    2016-06-01

    Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, 25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P UEL index between BMI groups [low BMI vs middle BMI vs high BMI, 97.2 (4.2) vs 96.6 (4.6) vs 96.7 (9.9), P > 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

  11. Liposuction for Submental Lymphedema Improves Appearance and Self-Perception in the Head and Neck Cancer Patient.

    Science.gov (United States)

    Brake, Maria K; Jain, Lauren; Hart, Robert D; Trites, Jonathan R B; Rigby, Matthew; Taylor, S Mark

    2014-08-01

    Patients who have undergone treatment for head and neck cancer are at risk for neck lymphedema, which can severely affect quality of life. Liposuction has been used successfully for cancer patients who suffer from posttreatment limb lymphedema. The purpose of our study was to review the outcomes of head and neck cancer patients at our center who have undergone submental liposuction for posttreatment lymphedema. Prospective cohort study. Oncology center in tertiary hospital setting. Head and neck cancer patients who underwent submental liposuction for posttreatment lymphedema were included. Nine patients met the study criteria. Patients completed 2 surveys (Modified Blepharoplasty Outcome Evaluation and the validated Derriford Appearance Scale) pre- and postoperatively to assess satisfaction. Patients' pre- and postoperative photos were graded by independent observers to assess outcomes objectively. Our study demonstrated a statistically significant improvement in patients' self-perception of appearance and statistically significant objective scoring of appearance following submental liposuction. Submental liposuction improves the appearance and quality of life for head and neck cancer patients suffering from posttreatment lymphedema by way of improving their self-perception and self-confidence. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  12. Brain Basics

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    Full Text Available ... as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of the brain ... specialized for the function of conducting messages. A neuron has three basic parts: Cell body which includes ...

  13. Brain Basics

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    Full Text Available ... in Real Life Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video ... and epigenetic changes can be passed on to future generations. Further understanding of genes and epigenetics may ...

  14. Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report.

    Science.gov (United States)

    McKey, Katelyn P; Alappattu, Meryl J

    Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. The patient's smallest upper extremity volumes were documented before the operation after two

  15. Educational Project Management Instructional System. Module Two. Project Management Basic Principles. Volume I--Lessons 1 to 6. Volume II--Lessons 7 to 12. Volume III--Case Simulation.

    Science.gov (United States)

    Cummings, C. Peter; Cook, Desmond L.

    This module is the second in a self-instructional program designed to train public school personnel in how to manage educational projects. The purpose of this module is to provide current or potential project directors with the basic knowledge, skills, abilities, and sensitivities needed to manage a local educational project. In the areas of…

  16. Seawater-flooding events and impact on freshwater lenses of low-lying islands: Controlling factors, basic management and mitigation

    Science.gov (United States)

    Gingerich, Stephen B.; Voss, Clifford I.; Johnson, Adam G.

    2017-01-01

    An unprecedented set of hydrologic observations was collected after the Dec 2008 seawater-flooding event on Roi-Namur, Kwajalein Atoll, Republic of the Marshall Islands. By two days after the seawater flooding that occurred at the beginning of dry season, the observed salinity of water withdrawn by the island’s main skimming well increased to 100% seawater concentration, but by ten days later already decreased to only 10–20% of seawater fraction. However, the damaging impact on the potability of the groundwater supply (when pumped water had concentrations above 1% seawater fraction) lasted 22 months longer. The data collected make possible analyses of the hydrologic factors that control recovery and management of the groundwater-supply quality on Roi-Namur and on similar low-lying islands.With the observed data as a guide, three-dimensional numerical-model simulation analyses reveal how recovery is controlled by the island’s hydrology. These also allow evaluation of the efficacy of basic water-quality management/mitigation alternatives and elucidate how groundwater withdrawal and timing of the seawater-flooding event affect the length of recovery. Simulations show that, as might be expected, by adding surplus captured rainwater as artificial recharge, the freshwater-lens recovery period (after which potable groundwater may again be produced) can be shortened, with groundwater salinity remaining lower even during the dry season, a period during which no artificial recharge is applied. Simulations also show that the recovery period is not lengthened appreciably by groundwater withdrawals during recovery. Simulations further show that had the flooding event occurred at the start of the wet season, the recovery period would have been about 25% (5.5 months) shorter than actually occurred during the monitored flood that occurred at the dry-season start. Finally, analyses show that artificial recharge improves freshwater-lens water quality, making possible longer

  17. Development in self-reported arm-lymphedema in Danish women treated for early-stage breast cancer in 2005 and 2006 – A nationwide follow-up study

    DEFF Research Database (Denmark)

    Gärtner, Rune; Mejdahl, Mathias Kvist; Andersen, Kenneth Geving

    2014-01-01

    The main purpose of this nationwide follow-up study was to examine the development of self-reported lymphedema in the population of women with early-stage breast cancer in Denmark. In 2008 and 2012 two identical questionnaires were sent to the women aged 18-70 years treated for unilateral primary...... in contrast to 30% treated with ALND. However, 19% of women treated with ALND and not reporting lymphedema in 2008 had developed lymphedema by 2012. In conclusion lymphedema remains a frequent problem, years after treatment for breast cancer, though, number of women reporting lymphedema and overall severity...

  18. Intra- and Inter-Rater Reliability of Bioimpedance in the Evaluation of Lymphedema Secondary to Treatment of Breast Cancer.

    Science.gov (United States)

    Ferro, Ana Paula; Ferreira, Vânia Tie Koga; Rezende, Monique Silva; de Souza, Thamires Rodrigues; Almeida, Ana Maria de; Guirro, Rinaldo Roberto de Jesus; Guirro, Elaine Caldeira de Oliveira

    2017-12-18

    The objective of the study was to evaluate the intra- and inter-rater reliability of bioimpedance in determining upper limb volume in women with lymphedema resulting from breast cancer treatment, as well as its correlation with the upper limb volume calculated by circumferential measurement. A blind cross-sectional study was performed in which 27 women (62.59 ± 10.50 years) were evaluated with upper limb lymphedema secondary to breast cancer treatment. Two examiners performed assessments in the same volunteers independently and twice, with an interval of 1 week between assessments. The collections were performed by the direct tetrapolar multifrequency segmental bioimpedance and by the circumference of the upper limb homolateral to the breast cancer. The results of the circumference showed that the homolateral limb had lymphedema. The intra- and inter-rater analysis showed excellent reliability with intraclass correlation coefficient (ICC) values ranging from 0.954 to 0.999 for the amount of liquid and excellent reliability with ICC values ranging from 0.852 to 0.999 for the electrical impedance of the upper limb with lymphedema. The correlation was strong and negative (p < 0.05) between intracellular, extracellular, and total water when associated with electrical impedance and moderate and positive (p < 0.05) when associated with upper limb volume for all frequencies. The correlations between upper limb volume and water quantities were moderate and positive (p < 0.05). The results indicate that bioimpedance is a reliable method for the evaluation of lymphedema, and the volume of the homolateral upper limb is associated with the amount of water in women with lymphedema secondary to the treatment of breast cancer.

  19. Evaluation of inter-rater reliability of subjective and objective criteria for diagnosis of lymphedema in upper and lower limbs

    Directory of Open Access Journals (Sweden)

    Larissa Louise Campanholi

    2015-03-01

    Full Text Available BACKGROUND: The diagnosis of lymphedema can be obtained objectively by measurement methods, and also by subjective methods, based on the patient's complaint. OBJECTIVE: To evaluate inter-rater reliability of objective and subjective criteria used for diagnosis of lymphedema and to propose a lymphedema cut-off for differences in volume between affected and control limbs. METHODS: We studied 84 patients who had undergone lymphadenectomy for treatment of cutaneous melanoma. Physical measures were obtained by manual perimetry (MP. The subjective criteria analyzed were clinical diagnosis of lymphedema in patients' medical records and self-report of feelings of heaviness and/or increase in volume in the affected limb. RESULTS: For upper limbs, the subjective criteria clinical observation (k 0.754, P<0.001 and heaviness and swelling (k 0.689, P<0.001 both exhibited strong agreement with MP results and there was moderate agreement between MP results and swelling (k 0.483 P<0.001, heaviness (k 0.576, P<0.001 and heaviness or swelling (k 0.412, P=0.001. For lower limbs there was moderate agreement between MP results and clinical observation (k 0.423, P=0.003 and regular agreement between MP and self-report of swelling (k 0.383, P=0.003. Cut-off values for diagnosing lymphedema were defined as a 9.7% difference between an affected upper limb and control upper limb and a 5.7% difference between lower limbs. CONCLUSION: Manual perimetry, medical criteria, and self-report of heaviness and/or swelling exhibited better agreement for upper limbs than for lower limbs for diagnosis of lymphedema.

  20. Multiple metastatic basal cell carcinoma with concurrent metastatic pleomorphic sarcoma in chronic lymphedema area--case report.

    Science.gov (United States)

    Oliveira, Giuliano da Paz; Girão, Régio José Santiago; Soares, Cléverson Teixeira; Mello Junior, Edgard Jose Franco

    2012-01-01

    Chronic lymphedema presents as interstitial fluid retention due to a failure in the lymphatic system drainage. The affected region becomes more vulnerable immunologically and predisposed to the onset of neoplasms. Basal Cell Carcinoma is the most common sort of neoplasm, nevertheless it rarely metastisizes. Sarcomas are malignant mesenchymal neoplasms, locally aggressive, which can spread. Here is reported an infrequent case of multiple basal cell carcinoma, synchronous to a poorly differentiated pleomorphic sarcoma, both spreading to lymph nodes and arising from tissue compromised by chronic lymphedema.

  1. Basic electrotechnology

    CERN Document Server

    Ashen, R A

    2013-01-01

    BASIC Electrotechnology discusses the applications of Beginner's All-purpose Symbolic Instruction Code (BASIC) in engineering, particularly in solving electrotechnology-related problems. The book is comprised of six chapters that cover several topics relevant to BASIC and electrotechnology. Chapter 1 provides an introduction to BASIC, and Chapter 2 talks about the use of complex numbers in a.c. circuit analysis. Chapter 3 covers linear circuit analysis with d.c. and sinusoidal a.c. supplies. The book also discusses the elementary magnetic circuit theory. The theory and performance of two windi

  2. A Scintigraphic Method for Quantitation of Lymphatic Function in Arm Lymphedema

    DEFF Research Database (Denmark)

    Hvidsten, Svend; Toyserkani, Navid M; Sørensen, Jens A

    2018-01-01

    ) measure of lymph fluid passing through the arm. METHODS AND RESULTS: Eleven patients, aged 34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent simultaneous bilateral lymphoscintigraphy using intradermal injection of 99mTc-labeled human serum albumin (HSA). Imaging...... was performed at 30-45 minute intervals for 5 hours. Time activity curves from each injection site and each arm region were recorded. The input into the arm region was obtained as the (minus) time derivative of the injection site activity curve. In the proposed model the arm activity curve was considered...

  3. Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2016-07-01

    Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

  4. Proceedings of the Scientific Meeting and Presentation on Basic Researchin Nuclear Science and Technology part II: Nuclear Chemistry, Process Technology, Radioactive Waste Management and Environment

    International Nuclear Information System (INIS)

    Sukarsono, R.; Karmanto, Eko-Edy; Suradjijo, Ganang

    2000-01-01

    Scientific Meeting and Presentation on Basic Research in Nuclear Scienceand Technology is an annual activity held by Centre for Research and Development of Advanced Technology, National Nuclear Energy Agency, for monitoring research activities achieved by the Agency. The papers presented in the meeting were collected into proceedings. These are the second part of the proceedings that contain 71 articles in the fields of nuclear chemistry, process technology, radioactive waste management, and environment (PPIN).

  5. Filarial lymphedema is characterized by antigen-specific Th1 and th17 proinflammatory responses and a lack of regulatory T cells.

    Directory of Open Access Journals (Sweden)

    Subash Babu

    Full Text Available Lymphatic filariasis can be associated with development of serious pathology in the form of lymphedema, hydrocele, and elephantiasis in a subset of infected patients.To elucidate the role of CD4(+ T cell subsets in the development of lymphatic pathology, we examined specific sets of cytokines in individuals with filarial lymphedema in response to parasite antigen (BmA and compared them with responses from asymptomatic infected individuals. We also examined expression patterns of Toll-like receptors (TLR1-10 and Nod-like receptors (Nod1, Nod2, and NALP3 in response to BmA. BmA induced significantly higher production of Th1-type cytokines-IFN-gamma and TNF-alpha-in patients with lymphedema compared with asymptomatic individuals. Notably, expression of the Th17 family of cytokines-IL-17A, IL-17F, IL-21, and IL-23-was also significantly upregulated by BmA stimulation in lymphedema patients. In contrast, expression of Foxp3, GITR, TGFbeta, and CTLA-4, known to be expressed by regulatory T cells, was significantly impaired in patients with lymphedema. BmA also induced significantly higher expression of TLR2, 4, 7, and 9 as well Nod1 and 2 mRNA in patients with lymphedema compared with asymptomatic controls.Our findings implicate increased Th1/Th17 responses and decreased regulatory T cells as well as regulation of Toll- and Nod-like receptors in pathogenesis of filarial lymphedema.

  6. related Factors of complete basic Immunization on children and Vaccine Management at Primary Health care and Health Post in X Subdistrict Depok city

    Directory of Open Access Journals (Sweden)

    Tri Afriani

    2015-01-01

    Full Text Available background:Immunization is an effective primary prevention against infectious diseases on children. The purpose of this study was to determine the related factors to the completeness of basic immunization on children and vaccine management at primary health care and posyandu in X Subdistric, Depok City. Methods:The study used a cross-sectional design with a sample of 140 mothers of children aged at least 11 months, and qualitatif study about vaccines management. Mother and child data collection using questionnaires and child health card (Kartu Menuju Sehat in December 2012–May 2013. Vaccine management data was collected at 2 primary health care and 2 posyandu with interview and observation. Data analysis was performed with Chi-square test. result:The largest percentage of mothers who have children under the age of at least 11 months of age <30 years, at least graduated from junior high school education, no work, have a low knowledge about immunization. Vaccine management in clinics and neighborhood health center for storage after use of vaccines in posyandu not be returned to the community health center, recording and reporting is not done on the book of the records so that the possibility of scattered or lost, and the person in charge of managing the vaccine instead of pharmacy personnel. Residual use of the vaccine in posyandu not directly returned to the health center. Recording the use of vaccines in posyandu not carried on the books, so it is probable scattered or lost. Manager vaccine at primary health care should a technical pharmacy in accordance with Government Regulation No. 51 of 2009 conclusion: Completeness of basic immunization of children under one years old (82,9%, incomplete biggest measles immunization (15,0%. Factors parental characteristics (age, education, occupation, knowledge and the availability of the vaccine were not significantly associated with children complete basic immunization. recommendation: Improving health

  7. Anesthesia Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Anesthesia Basics KidsHealth / For Teens / Anesthesia Basics What's in ... español Conceptos básicos sobre la anestesia What Is Anesthesia? No doubt about it, getting an operation can ...

  8. Brain Basics

    Medline Plus

    Full Text Available ... pituitary-adrenal (HPA) axis. Brain Basics in Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah ... having trouble coping with the stresses in her life. She began to think of suicide because she ...

  9. Classroom Management Issues in Information and Communication Technology (ICT)-Mediated Learning Environments: Back to the Basics

    Science.gov (United States)

    Lim, Cher Ping; Pek, Meow Sien; Chai, Ching Sing

    2005-01-01

    Research studies have shown that effective classroom management is a necessary condition for successful ICT integration in schools. Drawing upon the classroom management practices of teachers in a Singapore primary school, this article describes how the elements of classroom management facilitate the creation of a conducive learning environment to…

  10. Basic hydraulics

    CERN Document Server

    Smith, P D

    1982-01-01

    BASIC Hydraulics aims to help students both to become proficient in the BASIC programming language by actually using the language in an important field of engineering and to use computing as a means of mastering the subject of hydraulics. The book begins with a summary of the technique of computing in BASIC together with comments and listing of the main commands and statements. Subsequent chapters introduce the fundamental concepts and appropriate governing equations. Topics covered include principles of fluid mechanics; flow in pipes, pipe networks and open channels; hydraulic machinery;

  11. Lymphatico-venous anastomosis as treatment for breast cancer-related lymphedema: a prospective study on quality of life.

    Science.gov (United States)

    Cornelissen, Anouk J M; Kool, Melissa; Lopez Penha, Tiara R; Keuter, Xavier H A; Piatkowski, Andrzej A; Heuts, E; van der Hulst, René R W J; Qiu, Shan Shan

    2017-06-01

    Lymphedema is a chronic and disabling sequel of breast cancer treatment that can be treated by lymphatico-venous anastomosis (LVA). Artificial connections between the venous and lymphatic system are performed supermicrosurgically. This prospective study analyses the effect of LVA on quality of life. A prospective study was performed between November 2015 and July 2016 on consecutive patients in the Maastricht University Medical Centre. Quality of life was considered as the primary outcome, and the Lymphedema International Classification of Functioning (Lymph-ICF) questionnaire was used. Discontinuation of compressive stockings and arm volume, using the Upper Extremity Lymphedema index (UEL-index), were the secondary outcomes. Twenty women with early-stage breast cancer-related lymphedema (BCRL) were included. The mean age was 55.9 ± 4 years and the median BMI was 25.1 [21-30] kg/m 2 . The mean follow-up was 7.8 ± 1.5 months. Statistically significant improvement in quality of life was achieved in the total score and for all the quality of life domains after one year of follow-up (p < 0.05). The discontinuation rate in compressive stockings use was 85%. The difference in mean relative volume did not show a statistically significant decrease. LVA for early-stage BCRL resulted in a significant improvement in quality of life and a high rate in stocking discontinuation.

  12. Streptococcal toxic-shock syndrome due to Streptococcus dysgalactiae subspecies equisimilis in breast cancer-related lymphedema: a case report.

    Science.gov (United States)

    Sumazaki, Makoto; Saito, Fumi; Ogata, Hideaki; Yoshida, Miho; Kubota, Yorichika; Magoshi, Syunsuke; Kaneko, Hironori

    2017-07-14

    Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities. An 83-year-old Japanese woman with breast cancer-related lymphedema in her left upper limb was referred to our hospital with high fever and acute pain with erythema in her left arm. She showed septic shock with disseminated intravascular coagulation. Blood culture showed positive results for Streptococcus dysgalactiae subspecies equisimilis, confirming a diagnosis of streptococcal toxic-shock syndrome. She survived after successful intensive care. To the best of our knowledge, this case represents the first report of Streptococcus dysgalactiae subspecies equisimilis-induced streptococcal toxic-shock syndrome in a patient with breast cancer-related lymphedema. Breast cancer-related lymphedema is a common problem, and we must pay attention to invasive streptococcal soft tissue infections, particularly in elderly patients with chronic disease.

  13. Debulking Surgery for Elephantiasis Nostras With Large Ectatic Podoplanin-Negative Lymphatic Vessels in Patients With Lipo-Lymphedema

    Science.gov (United States)

    Wollina, Uwe; Heinig, Birgit; Schönlebe, Jaqueline; Nowak, Andreas

    2014-01-01

    Objective: Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery. Methods: We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. After tumescent microcannular laser-assisted liposuction both patients underwent a debulking surgery with a modification of Auchincloss-Kim's technique. Histologic examination of the tissue specimen was performed. Results: The surgical treatment was well tolerated and primary healing was uneventful. After primary wound healing and ambulation of the patients, a delayed ulceration with lymphorrhea developed. It was treated by surgical necrectomy and vacuum-assisted closure leading to complete healing. Mobility of the leg was much improved. Histologic examination revealed massive ectatic lymphatic vessels nonreactive for podoplanin. Conclusions: Debulking surgery can be an adjuvant technique for elephantiasis nostras in advanced lipo-lymphedema. Although delayed postoperative wound healing problems were observed, necrectomy and vacuum-assisted closure achieved a complete healing. Histologic data suggest that the ectatic lymphatic vessels in these patients resemble finding in podoplanin knockout mice. The findings would explain the limitations of decongestive lymphatic therapy and tumescent liposuction in such patients and their predisposition to relapsing erysipelas. PMID:24741382

  14. Brain Basics

    Medline Plus

    Full Text Available ... normal brain development and function can go awry, leading to mental illnesses. Brain Basics will introduce you ... of DNA. Sometimes this copying process is imperfect, leading to a gene mutation that causes the gene ...

  15. Brain Basics

    Medline Plus

    Full Text Available ... Events About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  16. Basic Finance

    Science.gov (United States)

    Vittek, J. F.

    1972-01-01

    A discussion of the basic measures of corporate financial strength, and the sources of the information is reported. Considered are: balance sheet, income statement, funds and cash flow, and financial ratios.

  17. Brain Basics

    Medline Plus

    Full Text Available ... effectively coordinate the billions of cells in the body, the results can affect many aspects of life. ... messages. A neuron has three basic parts: Cell body which includes the nucleus, cytoplasm, and cell organelles. ...

  18. Brain Basics

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    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... brain. DNA —The "recipe of life," containing inherited genetic information that helps to define physical and some ...

  19. Brain Basics

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    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... learning more about how the brain grows and works in healthy people, and how normal brain development ...

  20. Brain Basics

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    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  1. Brain Basics

    Medline Plus

    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... blues" from time to time. In contrast, major depression is a serious disorder that lasts for weeks. ...

  2. Brain Basics

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    Full Text Available ... How the brain develops How genes and the environment affect the brain The basic structure of the ... inside contents of the cell from its surrounding environment and controls what enters and leaves the cell, ...

  3. Brain Basics

    Medline Plus

    Full Text Available ... depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of ... but sometimes give rise to disabilities or diseases. neural circuit —A network of neurons and their interconnections. ...

  4. Brain Basics

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    Full Text Available ... in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions ... the basic working unit of the brain and nervous system. These cells are highly specialized for the function ...

  5. Brain Basics

    Medline Plus

    Full Text Available ... the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions ... basic working unit of the brain and nervous system. These cells are highly specialized for the function ...

  6. Results of surgical treatment of massive localized lymphedema in severely obese patients

    Directory of Open Access Journals (Sweden)

    Wilson Cintra Júnior

    Full Text Available OBJECTIVE: to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL in the severely obese. METHODS: in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life. RESULTS: all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias. CONCLUSION: surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.

  7. Quality of life of women with lymphedema after surgery for breast cancer

    Directory of Open Access Journals (Sweden)

    Marislei Sanches Panobianco

    2014-06-01

    Full Text Available This study evaluated the quality of life of 20 women with post-mastectomy lymphedema due to breast cancer, using the Flanagan’s Adapted Quality of Life Scale (1 and the Visual Analogue Scale (2, with data collection from July to December 2009 in the countryside of the state of São Paulo. It was observed a lower quality of life concerning participation in recreational and work activities, and better quality of life was related to relationship with friends; listening to music, reading, watching TV and going to the movies. Cronbach's alpha of Scale 1 was 0.86 and the average of Scale 2 was 6.26. Overall, the scales showed satisfactory results of quality of life, but low values showed factors that must be worked out, such as participation in sports, work and learning activities. Thus, lymphedema interferes with the quality of life, indicating a need for early intervention in order to help women achieve better quality of life.

  8. Incidence and Risk Factors of Lower Extremity Lymphedema After Gynecologic Surgery in Ovarian Cancer.

    Science.gov (United States)

    Ki, Eun Young; Park, Jong Sup; Lee, Keun Ho; Hur, Soo Young

    2016-09-01

    There is no standard method to establish an early diagnosis of lower extremity lymphedema (LEL). Lower extremity lymphedema can be diagnosed by physical examination and laboratory tests when patients complain of typical clinical symptoms. The objective of this study was to investigate the incidence and risk factors of LEL in patients with ovarian cancer. The medical records were reviewed retrospectively in patients with ovarian cancer treated at Seoul St. Mary's Hospital from January 2000 to July 2014. A total of 413 patients with epithelial ovarian cancer were analyzed. Forty-six patients (11.1%) developed LEL, and 67.4% of these patients had LEL within 1 year after surgery. The mean number of resected lymph nodes (LNs) was larger in patients with LEL (43.1 ± 16.7; range, 12-80) than in those without (32.3 ± 19.8; range, 0-99) (P < 0.0001). The number of resected LNs was significantly associated with the occurrence of LEL (odds ratio, 1.025; 95% confidence interval, 1.005-1.045; P < 0.05). A significant proportion of patients with ovarian cancer could develop LEL after surgery. This study suggests that the occurrence of LEL is associated with the number of resected LNs.

  9. Lymphatic Drainage of Legs Reduces Edema of the Arms in Children with Lymphedema

    Directory of Open Access Journals (Sweden)

    Lívia Maria Pereira de Godoy

    2018-01-01

    Full Text Available Objective. The aim of the present study is to report on the reduction of edema of lymphedematous arms just by treating the lower limbs. Methods. A 16-year-old girl reported that she has started having right lower limb edema at the age of three. At age 13, she performed a lymphoscintigraphy that confirmed the diagnosis of primary lymphedema of the four limbs. Recently she sought treatment at the Clínica Godoy in São Jose do Rio Preto where she was submitted to intensive treatment for eight hours per day for five days using manual (Godoy & Godoy technique and mechanical lymphatic therapy (RA Godoy® of the lower limbs, cervical lymphatic therapy (cervical stimulation, and the continuous use of a grosgrain stocking. Results. At the end of treatment, reductions in the sizes of both arms and legs were noted even without the use of any specific therapy for the arms. After four years, the size of the arms was normal. Conclusion. Treatment of lymphedema of the legs has systemic repercussions that may lead to the reduction in swelling of other untreated regions of the body.

  10. Synergistic Effects of Proprioceptive Neuromuscular Facilitation and Manual Lymphatic Drainage in Patients with Mastectomy-Related Lymphedema

    Directory of Open Access Journals (Sweden)

    Kyung-Jin Ha

    2017-11-01

    Full Text Available Purpose: Manual lymphatic drainage (MLD and proprioceptive neuromuscular facilitation (PNF are potential therapeutic strategies to reduce mastectomy-induced edema. The purpose of this study was to investigate whether the combination of these therapies would induce synergistic effects to treat lymphedema-related complications and to analyze a possible physiological mechanism involved in the observed effects.Methods: A total of 55 patients diagnosed with mastectomy-induced lymphedema were recruited and randomized into three experimental groups: PNF group (n = 17, MLD group (n = 20, and PNF + MLD group (n = 18. They were subjected to designated rehabilitation program three times a week for 16 weeks. ROM (flexion of the shoulder joint, edema size, arterial blood flow velocity, and degree of pain and depression were measured every 4 weeks over experimental period.Results: Lymphedema volume, VAS pain scale, and Beck depression scale were decreased in PNF and MLD groups for 16 weeks in a time-dependent manner. In combination, a greater reduction of these variables was observed over 16 weeks compared to each PNF and MLD. While axillary arterial blood circulation rate in the affected extremity was increased in both PNF and PNF + MLD groups over 16 weeks, this value was not increased in MLD group throughout the experimental period. A greater reduction of scales of VAS pain and Beck Depression Inventory (BDI was observed in PNF + MLD group after the 16 week-treatment, as compared to each PNF and MLD group. Pearson's coefficients test demonstrated that there are significant correlation of depression against pain (r = 0.616, p < 0.01, ROM (r = −0.478, p < 0.01, and lymphedema size (r = 0.492, p < 0.01.Conclusion: The combination of MLD and PNF induces potent synergistic effects on edema volume, shoulder range of motion (ROM, pain, and depression in patients with lymphedema. In addition, an increased rate of axillary arterial blood flow in PNF

  11. Management of soils polluted by activities of a basic nuclear installations. Guide Nr 24, Release of the 2016/08/30

    International Nuclear Information System (INIS)

    2016-01-01

    After having indicated the relevant regulatory texts and guides related to sanitation and dismantling, and having stated definitions of some important terms, this guide addresses the sanitation or soil management approach to be adopted as soon as a soil pollution requires it. This pollution can be radioactive or chemical, and the case of a pollution going out of the installation is also included. Legal responsibility is outlined. The guide aims then at detailing the articulation between the various concerned and relevant documents for the management of a radioactive or chemical pollution related to the activities of a basic nuclear installation (BNI), and at detailing ASN expectations in this respect. Thus, it recalls the adopted management approach and methodological tools: diagnosis, interpretation of environment condition, management plan. It describes the approach related to soil sanitation: diagnosis, document to be produced, field and additional investigations, implementation of the reference approach for a complete removal of pollution, actions to be undertaken when the application of the reference approach is impossible, end of sanitation works. The third part discusses the methodology of soil sanitation by excavation by distinguishing three defence lines, by discussing the management of excavated soils (management modalities, warehousing within the installation). Administrative procedures to be applied before, during and after sanitation works are then presented. Specific management approaches are indicated for a BNI being operated or being dismantled. Actions of information are also indicated. Finally, requirements in terms of quality assurance are evoked

  12. MANAGERS AND BASIC EDUCATION TEACHERS : THE IMPLICATIONS OF ITS ROLE WITH THE EFFECTIVENESS OF TECHNICAL SCHOOL BOARDS

    Directory of Open Access Journals (Sweden)

    Manuel Ortega Muñoz

    2015-06-01

    Full Text Available This letter is part of a broader investigation that deals with the functioning of the School Technical Councils in the elementary schools in the state of Durango, Mexico. In this part, they were raised the following objectives: a Identify what level of implications of the role of principals and teachers in the effective functioning of the School Technical Councils, b Identify the implications of the role of principals and teachers are regarding compliance with the objectives of the School Technical Councils in schools of basic education in the state of Durango and c Identify the implications of the role of principals and teachers regarding the exercise of the powers of the Technical School Councils in schools are Basic education in the state of Durango, Mexico. To achieve the objectives was carried out an exploratory, descriptive, correlational, cross-sectional non-experimental study. Information gathering was conducted by survey method using a questionnaire applied to 1243 principals, group teachers, support teachers and of basic education in the State of Durango, México. Its main results support the conclusion that the gender implications regarding the effective functioning of the School Technical Councils in the elementary schools in the state of Durango have a low level, analyzing its dimensions: achievement of objectives and exercise of powers.

  13. Changes in arm tissue composition with slowly progressive weight-lifting among women with breast cancer-related lymphedema.

    Science.gov (United States)

    Zhang, Xiaochen; Brown, Justin C; Paskett, Electra D; Zemel, Babette S; Cheville, Andrea L; Schmitz, Kathryn H

    2017-07-01

    Studies in breast cancer-related lymphedema (BRCL) have exclusively examined total arm volume, but not the specific tissue composition that contributes to total volume. We evaluated baseline differences in arm tissue composition [fat mass, lean mass, bone mineral content (BMC), and bone mineral density (BMD)] between the affected and unaffected arms in women with BRCL. We compared changes in arm tissue composition and self-reported lymphedema symptoms after 1 year of weight-lifting versus control. We utilized data from physical activity and lymphedema trial that included 141 women with BRCL. Arm tissue composition was quantified using dual-energy X-ray absorptiometry. The severity of lymphedema was quantified using self-report survey. Weight-lifting was performed at community fitness facilities. At baseline, the affected arm had more fat (∆ = 89.7 g; P arm. After 12 months of weight-lifting, composition of the affected arm was improved: lean mass (71.2 g; P = 0.01) and BMD (14.0 mg/cm 2 ; P = 0.02) increased, arm fat percentage decreased (-1.5%; P = 0.003). Composition of the unaffected arm was only improved in lean mass (65.2 g; P = 0·04). Increases in lean mass were associated with less severe BCRL symptoms. Among women with BRCL, slowly progressive weight-lifting could improve arm tissue composition. Changes in arm tissue composition predict changes in symptom burden. Investigating the combined effects of exercise and weight loss on arm tissue composition and BCRL symptoms may provide additional insight into the benefits of lifestyle modification on lymphedema biology.

  14. Clinical significance of a proposed lymphoscintigrpahic functional grade system in patients with extremity lymphedema of stage i

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Joan Young; Hwang, Ji Hye; Kim, Dong Ik; Cho, Young Seok; Lee, Su Jin; Choi, Yong; Choe, Yeam Seong; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    We proposed a new lymphoscintigrpahic functional grade (LGr) system in extremity lymphedema, and investigated the association between the LGr and a long-term response to physical therapy in patients with extremity lymphedema of stage I. The subjects were 20 patients with unilateral extremity lymphedema of stage I, who underwent pre-treatment extremity lymphoscintigraphy using Tc-99m antimony sulfur colloid, and were treated by complex decongestive physical therapy (CDPT). A proposed lymphoscintigrpahic functional grade system consisted of LGr 0 to LGr 4 according to the ilioinguinal nodal uptake, amount of dermal backflow, and uptake pattern of main and collateral lymphatics : LGr 0 = normal, LGr 1 = decreased lymphatic function without dermal backflow, LGr 2 = decreased lymphatic function with dermal backflow, LGr 3 = non - visualization of main lymphatics with dermal backflow, and LGr 4 = no significant lymphatic transport from injection site. LGr 2 was divided into 2A and 2B based on the amount of dermal backflow. A physician who is a lymphedema specialist determined the long-term outcome to CDPT with normalized response (NR), good response (GR) and poor response (PR) based on the change of edema volume reduction, skin status and occurrence of dermatolymphangioadenitis after the clinical follow-up for more than 1 year. Therapeutic responses were NR in 2 patients. GR in 9 patients and PR in 9 patients. Baseline LGrs were 1 in 7 patients, 2A in 4 patients, 2B in 5 patients, 3 in 2 patients, and 4 in 2 patients. There was a significant relationship between therapeutic response and LGr (p=0.003). In other words, 10 of 11 patients (91%) with LGr 1 or 2A showed NR. or GR. On the contrary, 8 of 9 patients (89%) with LGr 2B, 3 or 4 showed PR. Patients with unilateral extremity lymphedema of stage I had different lymphoscintigrpahic functional grades. This grade system may be useful to predict the response to physical therapy in such patients.

  15. Safety of Weightlifting Among Women with or at Risk for Breast Cancer–Related Lymphedema: Musculoskeletal Injuries and Health Care Use in a Weightlifting Rehabilitation Trial

    OpenAIRE

    Brown, Justin C.; Troxel, Andrea B.; Schmitz, Kathryn H.

    2012-01-01

    Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur.

  16. Managing radioactive waste produced at secret basic nuclear facilities; La gestion des dechets radioactifs issus des installations nucleaires de base secretes

    Energy Technology Data Exchange (ETDEWEB)

    Elluard, M.P. [Chef de projet a l' Autorite de Surete Nucleaire de Defense - Ministere de la Defense, 75 - Paris (France)

    2011-02-15

    The Delegate for Nuclear Safety and Radiation Protection for National Defence Installations and Activities (DSND) is attached to the French Minister of Defence and the Minister for Industry. The DSND's task is to study and propose to the relevant ministers the specific nuclear safety and radiation protection policy applicable to secret basic nuclear installations (SBNI) classified as such by decision of the Prime Minister. He supervises application of this policy. The DSND draws up the regulations relative to managing waste present within the boundaries of SBNIs in accordance with the guidelines set out in the Environmental Code. Thus, the Title VI of the Order of 26 September 2007 setting out the general technical regulations designed to prevent and limit pollution and external risks resulting from the operation of secret basic nuclear installations recalls the requirement for all SBNI operators to take every precaution necessary to reduce the volume and the radiological, chemical and biological toxicity of all waste produced at its installations and to optimise its management, whilst giving priority to recycling and processing rather than final disposal, which is to be reserved for final waste. The DSND supervises and monitors safety at every stage in radioactive waste management: production, processing, storage, transportation and disposal. (author)

  17. Basic electronics

    CERN Document Server

    Holbrook, Harold D

    1971-01-01

    Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t

  18. Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example.

    Science.gov (United States)

    Li, Tongtong; Lei, Trudy; Xie, Zheng; Zhang, Tuohong

    2016-02-04

    To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China. Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.

  19. Proceedings of the Scientific Meeting and Presentation on Basic Research in Nuclear of the Science and Technology part III : Radioactive Waste Management and Environment

    International Nuclear Information System (INIS)

    Kamsul Abraha; Yateman Arryanto; Sri Jauhari S; Agus Taftazani; Kris Tri Basuki; Djoko Sardjono, Ign.; Sukarsono, R.; Samin; Syarip; Suryadi, MS; Sardjono, Y.; Tri Mardji Atmono; Dwiretnani Sudjoko; Tjipto Sujitno, BA.

    2007-08-01

    The Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology is a routine activity held by Centre for Accelerator Technology and Material Process, National Nuclear Energy Agency, for monitoring the research activity which achieved in National Nuclear Energy Agency. The Meeting was held in Yogyakarta on July 10, 2007. The proceedings contains papers presented on the meeting about Radioactive Waste Management and Environment and there are 25 papers which have separated index. The proceedings is the third part of the three parts which published in series. (PPIN)

  20. Laser CO2treatment for vulvar lymphedema secondary to gynecological cancer therapy: A report of two cases and review of the literature.

    Science.gov (United States)

    Sopracordevole, Francesco; Mancioli, Francesca; Canzonieri, Vincenzo; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea

    2015-04-01

    Vulvar lymphedema is an uncommon and disabling side-effect of pelvic lymphadenectomy and pelvic radiotherapeutic treatment for invasive genital cancer. Lymphorrhea, a complication of lymphedema, may be extremely distressing for patients due to the requirement to wear sanitary towels and as the pain and loss of elasticity of the vulvar skin and mucosa can cause discomfort during coitus. Surgical treatments of lymphorrhea and vulvar lymphedema secondary to gynecological cancer treatments remain controversial and are not currently considered to be the standard therapy. The present study reports two cases of vulvar lymphedema complicated by vulvar lymphorrhea in females who had undergone treatment for cervical and endometrial cancer, respectively; a review of the literature is also included. In the two present cases, vulvar lymphedemas were refractory to standard treatments, including decongestive therapy, manual lymph drainage, elastic bandaging, low-stretch bandaging, exercises and skin care. Laser CO 2 excision and vaporization of the whole skin and mucosal tissue of the vulva was successfully performed to treat the lymphorrhea and improve quality of life. Thus, the present two cases indicated that laser CO 2 surgery may present an additional therapy for the treatment of genital lymphedema that is refractory to other treatments.

  1. Basic conceptions

    International Nuclear Information System (INIS)

    Khasanov, A.Kh.

    1988-01-01

    In this part of book author presents the basic conceptions of minerals studying. The course of minerals deposits is the most important branch of geology science and studying the geology, material constitution, formation conditions and regularity of distribution in earth crust different types of mineral raw materials

  2. Brain Basics

    Medline Plus

    Full Text Available ... mental illnesses. Search the NIMH Website: Home Health & Education Mental Health Information Statistics Consumer Health Publications Help for Mental Illnesses Clinical Trials Outreach Research Priorities Funding Labs at ... Health & Education > Educational Resources Brain Basics Introduction The Growing Brain ...

  3. Brain Basics

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    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... MSC 9663 Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS ...

  4. Brain Basics

    Medline Plus

    Full Text Available ... by which the cell sends information to receiving neurons. cell body —Contains the nucleus and cytoplasm of a ... circuit —A network of neurons and their interconnections. neuron —A nerve cell that is the basic, working unit of the ...

  5. Brain Basics

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    Full Text Available ... Join A Study News & Events News & Events Home Science News Events Multimedia Social Media Press Resources Newsletters NIMH News Feeds About Us About Us Home About the Director Advisory Boards and ... Basics will introduce you to some of this science, such as: How the brain develops How genes ...

  6. Ethanol Basics

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-01-30

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  7. Using basic geographic information systems functionality to support sustainable forest management decision making and post-decision assessments

    Science.gov (United States)

    Ronald E. McRoberts; R. James Barbour; Krista M. Gebert; Greg C. Liknes; Mark D. Nelson; Dacia M. Meneguzzo; et al.

    2006-01-01

    Sustainable management of natural resources requires informed decision making and post-decision assessments of the results of those decisions. Increasingly, both activities rely on analyses of spatial data in the forms of maps and digital data layers. Fortunately, a variety of supporting maps and data layers rapidly are becoming available. Unfortunately, however, user-...

  8. Wavelet basics

    CERN Document Server

    Chan, Y T

    1995-01-01

    Since the study of wavelets is a relatively new area, much of the research coming from mathematicians, most of the literature uses terminology, concepts and proofs that may, at times, be difficult and intimidating for the engineer. Wavelet Basics has therefore been written as an introductory book for scientists and engineers. The mathematical presentation has been kept simple, the concepts being presented in elaborate detail in a terminology that engineers will find familiar. Difficult ideas are illustrated with examples which will also aid in the development of an intuitive insight. Chapter 1 reviews the basics of signal transformation and discusses the concepts of duals and frames. Chapter 2 introduces the wavelet transform, contrasts it with the short-time Fourier transform and clarifies the names of the different types of wavelet transforms. Chapter 3 links multiresolution analysis, orthonormal wavelets and the design of digital filters. Chapter 4 gives a tour d'horizon of topics of current interest: wave...

  9. Development of the short version of the Gynecologic Cancer Lymphedema Questionnaire: GCLQ-7.

    Science.gov (United States)

    Kim, Se Ik; Kim, Namjoo; Lee, Seonjoo; Lee, Sujung; Joo, Jungnam; Seo, Sang Soo; Chung, Seung Hyun; Park, Sang Yoon; Lim, Myong Cheol

    2017-03-01

    The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) was designed to identify gynecologic cancer patients with lower limb lymphedema (LLL). The questionnaire consists of 20 items distributed over 7 symptom clusters. The present study aimed to develop an abridged form of the GCLQ for simpler screening and more effective follow-up of LLL. Data that had been collected for the development and validation of the Korean version of the GCLQ (GCLQ-K) were used in this study. Receiver-operating characteristic (ROC) curves were drawn according to the individual items of the GCLQ-K. Based on discrimination ability, the candidate items were selected in each symptom cluster. After combining the items, the best model was identified and named GCLQ-7. The area under the ROC curve (AUC) was compared between the GCLQ-7 and the original GCLQ-K. In total, 11 candidate items were selected from the original GCLQ-K. Among the models made with the candidate items, GCLQ-7, the best model, was constructed with 7 items as follows: 1) limited knee movement, 2) general swelling, 3) redness, 4) firmness/tightness, 5) groin swelling, 6) heaviness, and 7) aching. This model exhibited an AUC of 0.945 (95% confidence interval [CI], 0.900-0.991), which is comparable with that of the original GCLQ-K (AUC, 0.867; 95% CI, 0.779-0.956). The best cutoff value was 2 points, at which the sensitivity and specificity were 97.0% and 76.5%, respectively. The newly developed short version model, GCLQ-7, showed acceptable discrimination ability as compared with the original GCLQ-K. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  10. Comparison of transports expected under different waste management concepts: determination of basic data for application in risk analyses

    International Nuclear Information System (INIS)

    Alter, U.; Mielke, H.G.; Wehner, G.

    1983-01-01

    According to the Atomic Act, article 9a, paragraph 1, the licensees of nuclear power plants in the Federal Republic of Germany are obliged to provide for the management of radioactive wastes resulting from the operation of these plants. Concerning the provisions to be made for the management of such wastes, two concepts are discussed: nuclear reprocessing and final waste disposal center (Nukleares Entsorgungszentrum, NEZ); and the integrated spent fuel and waste management concept (Integriertes Entsorgungskonzept, IEK). Unlike the NEZ, the IEK-concept may have different sites for the following fuel cycle facilities: intermediate spent fuel storage, reprocessing, waste conditioning and final disposal, and uranium and plutonium fuel element fabrication facilities. The fundamental differences of the pertinent transports are presented. Transport scenarios expected under the two alternatives NEZ and IEK have been elaborated for the purpose of a data collection covering the following aspects: materials to be shipped, number of packages shipped, number of packages shipped per transport, transport by rail or by road, transport routes and distances, and duration of transports

  11. Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA.

    Science.gov (United States)

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn; Gilchrist, Laura

    2017-07-01

    The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to make these clinically applicable, recommendations were based on the characteristics as to the location and stage of a patient's upper-quadrant lymphedema.

  12. Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

    Science.gov (United States)

    Traish, Abdulmaged M.; Goldstein, Irwin; Kim, Noel N.

    2007-01-01

    Objectives Androgens are essential for the development and growth of the penis, and they regulate erectile physiology by multiple mechanisms. Our goal is to provide a concise overview of the basic research and how this knowledge can be translated into a new clinical paradigm for patient management. In addition, this new paradigm may serve as a basis for stimulating constructive debate regarding the use of testosterone in men, and to promote new, innovative basic and clinical research to further understand the underlying mechanisms of androgen action in restoring erectile physiology. Methods A literature review was performed utilizing the US National Library of Medicine's PubMed database. Results On the basis of evidence derived from laboratory animal studies and clinical data, we postulate that androgen insufficiency disrupts cellular-signaling pathways and produces pathologic alterations in penile tissues, leading to erectile dysfunction. In this review, we discuss androgen-dependent cellular, molecular, and physiologic mechanisms modulating erectile function in the animal model, and the implication of this knowledge in testosterone use in the clinical setting to treat erectile dysfunction. The new clinical paradigm incorporates many of the consensed points of view discussed in traditional consensed algorithms exclusively designed for men with androgen insufficiency. There are, however, novel and innovative differences with this new clinical paradigm. This paradigm represents a fresh effort to provide mandatory and optional management strategies for men with both androgen insufficiency and erectile dysfunction. Conclusions The new clinical paradigm is evidence-based and represents one of the first attempts to address a logical management plan for men with concomitant hormonal and sexual health concerns. PMID:17329016

  13. Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction.

    Science.gov (United States)

    Traish, Abdulmaged M; Goldstein, Irwin; Kim, Noel N

    2007-07-01

    Androgens are essential for the development and growth of the penis, and they regulate erectile physiology by multiple mechanisms. Our goal is to provide a concise overview of the basic research and how this knowledge can be translated into a new clinical paradigm for patient management. In addition, this new paradigm may serve as a basis for stimulating constructive debate regarding the use of testosterone in men, and to promote new, innovative basic and clinical research to further understand the underlying mechanisms of androgen action in restoring erectile physiology. A literature review was performed utilizing the US National Library of Medicine's PubMed database. On the basis of evidence derived from laboratory animal studies and clinical data, we postulate that androgen insufficiency disrupts cellular-signaling pathways and produces pathologic alterations in penile tissues, leading to erectile dysfunction. In this review, we discuss androgen-dependent cellular, molecular, and physiologic mechanisms modulating erectile function in the animal model, and the implication of this knowledge in testosterone use in the clinical setting to treat erectile dysfunction. The new clinical paradigm incorporates many of the consensed points of view discussed in traditional consensed algorithms exclusively designed for men with androgen insufficiency. There are, however, novel and innovative differences with this new clinical paradigm. This paradigm represents a fresh effort to provide mandatory and optional management strategies for men with both androgen insufficiency and erectile dysfunction. The new clinical paradigm is evidence-based and represents one of the first attempts to address a logical management plan for men with concomitant hormonal and sexual health concerns.

  14. Basic electronics

    CERN Document Server

    Tayal, DC

    2010-01-01

    The second edition of this book incorporates the comments and suggestions of my friends and students who have critically studied the first edition. In this edition the changes and additions have been made and subject matter has been rearranged at some places. The purpose of this text is to provide a comprehensive and up-to-date study of the principles of operation of solid state devices, their basic circuits and application of these circuits to various electronic systems, so that it can serve as a standard text not only for universities and colleges but also for technical institutes. This book

  15. Diagnosis of Upper-Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of APTA

    OpenAIRE

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn; Gilchrist, Laura

    2017-01-01

    Introduction: The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. Methods: Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic ...

  16. [The application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities].

    Science.gov (United States)

    Kulchitskaya, D B; Gerasimenko, M Yu; Aphanova, T V; Konchugova, T V

    The principal objective of the present work was to evaluate the influence of impulse magnetic therapy on the state of the microcirculatory system in the patients presenting with lymphedema of the lower extremities. The study included 59 patients with stage of 1 and 2 lymphedema who were divided into two groups. Those comprising the first group had impulse magnetic therapy applied to their lower extremities while the patients making up the second group served as controls. All the patients were examined with the use of the laser Doppler flowmetry (LDF) that revealed the initially present pathological changes in the microcirculatory system of their lower extremities. The study has demonstrated that the application of impulse magnetic therapy produced a positive effect on all the constituent components of the microcirculatory blood stream of the patients suffering from lymphedema of the lower extremities. Specifically, the initially increased arteriolar tonus was decreased, the blood flow in the capillary vessels was improved, and congestive phenomena in the venular segments of the microcirculation blood stream were markedly reduced. The results of the LDF examination in the control group gave no evidence of significant changes in the patients' microcirculatory system. The results of the LDF examination of the patients of the control group suggested the absence of any appreciable changes in the microcirculatory system. The present study has demonstrated the advisability of the application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities as a minimally invasive technique for the evaluation of the condition of the microcirculatory system and the objective assessment of the effectiveness of the outcomes of physiotherapy in the patients with vascular pathology.

  17. Synergistic Effects of Proprioceptive Neuromuscular Facilitation and Manual Lymphatic Drainage in Patients with Mastectomy-Related Lymphedema.

    Science.gov (United States)

    Ha, Kyung-Jin; Lee, Sang-Yeol; Lee, Hojun; Choi, Seung-Jun

    2017-01-01

    Purpose: Manual lymphatic drainage (MLD) and proprioceptive neuromuscular facilitation (PNF) are potential therapeutic strategies to reduce mastectomy-induced edema. The purpose of this study was to investigate whether the combination of these therapies would induce synergistic effects to treat lymphedema-related complications and to analyze a possible physiological mechanism involved in the observed effects. Methods: A total of 55 patients diagnosed with mastectomy-induced lymphedema were recruited and randomized into three experimental groups: PNF group ( n = 17), MLD group ( n = 20), and PNF + MLD group ( n = 18). They were subjected to designated rehabilitation program three times a week for 16 weeks. ROM (flexion of the shoulder joint), edema size, arterial blood flow velocity, and degree of pain and depression were measured every 4 weeks over experimental period. Results: Lymphedema volume, VAS pain scale, and Beck depression scale were decreased in PNF and MLD groups for 16 weeks in a time-dependent manner. In combination, a greater reduction of these variables was observed over 16 weeks compared to each PNF and MLD. While axillary arterial blood circulation rate in the affected extremity was increased in both PNF and PNF + MLD groups over 16 weeks, this value was not increased in MLD group throughout the experimental period. A greater reduction of scales of VAS pain and Beck Depression Inventory (BDI) was observed in PNF + MLD group after the 16 week-treatment, as compared to each PNF and MLD group. Pearson's coefficients test demonstrated that there are significant correlation of depression against pain ( r = 0.616, p facilitate treatment process for patients with lymphedema.

  18. Pathological Investigation of Acquired Lymphangiectasia Accompanied by Lower Limb Lymphedema: Lymphocyte Infiltration in the Dermis and Epidermis.

    Science.gov (United States)

    Hara, Hisako; Mihara, Makoto; Anan, Takashi; Fukumoto, Takaya; Narushima, Mitsunaga; Iida, Takuya; Koshima, Isao

    2016-09-01

    Sometimes acquired lymphangiectasia (lymphangioma circumscriptum), the pathological mechanism of which is unknown, accompanies lymphedema. The purpose of this study was to better understand the pathological changes present in acquired lymphangiectasia. We examined the pathological characteristics of acquired lymphangiectasia with lymphedema among patients treated at the University of Tokyo Hospital from March 2008 to December 2015. In total, 16 biopsies from 10 patients were investigated. The average age of the patients was 57.2 years (range 43-69), and all were female with secondary lymphedema. Surgical specimens were fixed in formalin, and tissue sections were stained with hematoxylin-eosin. Additional immunostaining (podoplanin, lymphatic vessel endothelial hyaluronan receptor [LYVE] -1, CD4, CD8, CD20, and CD31) was performed in cases 1-3 and 8-10. Dilation of lymphatic vessels in the papillary dermis was present in all 10 cases. Infiltration of inflammatory cells, most of which were lymphocytes, was also observed in the dermis and the epidermis in all cases, even though there were no clinical signs of inflammation. The infiltrating lymphocytes were mainly CD4+ T cells, and less commonly, CD8+ T cells and CD20+ B cells. The number of three types of lymphocytes was significantly larger in the superficial layer of the dermis than in the deep layer, which may indicate that they oozed out from the dilated lymphatic vessels located in the superficial dermis. CD8+ T cells infiltrated the epidermis in seven of eight specimens. In case 4, coagulated lymphatic fluid inside the lymphatic vessel was observed. Proliferation of collagenous fiber in the dermis and acanthosis were observed. Lymphatic dilation and proliferation of collagenous fiber in the dermis were seen in cases of acquired lymphangiectasia (lymphangioma circumscriptum). Constant infiltration of lymphocytes in the dermis and the epidermis may have a relation to frequent cellulitis, which is often seen in

  19. Brain Basics

    Medline Plus

    Full Text Available ... Criteria (RDoC) Funding Funding Home Opportunities & Announcements Funding Strategy for Grants Application Process Managing Grants Clinical Research ... occur when this process does not work correctly. Communication between neurons can also be electrical, such as ...

  20. Brain Basics

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    Full Text Available ... Home Opportunities & Announcements Funding Strategy for Grants Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs at NIMH Home Research Areas Principal Investigators Administrative Oversight & Support Collaborations & Partnerships Join A Study News & ...

  1. Brain Basics

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    Full Text Available ... Grants Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs at NIMH ... needed for the cell to work properly including small structures called cell organelles. Dendrites branch off from ...

  2. Brain Basics

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    Full Text Available ... Criteria (RDoC) Funding Funding Home Opportunities & Announcements Funding Strategy for Grants Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs at NIMH Home ...

  3. Brain Basics

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    Full Text Available ... Funding Home Opportunities & Announcements Funding Strategy for Grants Application Process Managing Grants Clinical Research Training Small Business ... works in healthy people, and how normal brain development and function can go awry, leading to mental ...

  4. Asthma Basics

    Science.gov (United States)

    ... asthma diary is another way to help manage asthma. Tracking your child's symptoms and medicines will help you know when ... When to Go to the ER if Your Child Has Asthma Do Allergies Cause Asthma? Allergy Shots Asthma Center ...

  5. Brain Basics

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    Full Text Available ... Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs at NIMH Home ... all. She was happily married and successful in business. Then, after a serious setback at work, she ...

  6. Brain Basics

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    Full Text Available ... Criteria (RDoC) Funding Funding Home Opportunities & Announcements Funding Strategy for Grants Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs ...

  7. Brain Basics

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    Full Text Available ... the brain, which is linked to thought and emotion. It is also linked to reward systems in ... stay focused on a task, and managing proper emotional reactions. Reduced ACC activity or damage to this ...

  8. Brain Basics

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    Full Text Available ... the Brain Meet Sarah Sarah is a middle-aged woman who seemed to have it all. She ... body. dopamine —A neurotransmitter mainly involved in controlling movement, managing the release of various hormones, and aiding ...

  9. A plant resource and experiment management system based on the Golm Plant Database as a basic tool for omics research

    Directory of Open Access Journals (Sweden)

    Selbig Joachim

    2008-05-01

    Full Text Available Abstract Background For omics experiments, detailed characterisation of experimental material with respect to its genetic features, its cultivation history and its treatment history is a requirement for analyses by bioinformatics tools and for publication needs. Furthermore, meta-analysis of several experiments in systems biology based approaches make it necessary to store this information in a standardised manner, preferentially in relational databases. In the Golm Plant Database System, we devised a data management system based on a classical Laboratory Information Management System combined with web-based user interfaces for data entry and retrieval to collect this information in an academic environment. Results The database system contains modules representing the genetic features of the germplasm, the experimental conditions and the sampling details. In the germplasm module, genetically identical lines of biological material are generated by defined workflows, starting with the import workflow, followed by further workflows like genetic modification (transformation, vegetative or sexual reproduction. The latter workflows link lines and thus create pedigrees. For experiments, plant objects are generated from plant lines and united in so-called cultures, to which the cultivation conditions are linked. Materials and methods for each cultivation step are stored in a separate ACCESS database of the plant cultivation unit. For all cultures and thus every plant object, each cultivation site and the culture's arrival time at a site are logged by a barcode-scanner based system. Thus, for each plant object, all site-related parameters, e.g. automatically logged climate data, are available. These life history data and genetic information for the plant objects are linked to analytical results by the sampling module, which links sample components to plant object identifiers. This workflow uses controlled vocabulary for organs and treatments. Unique

  10. Effects of proprioceptive neuromuscular facilitation stretching and deep-breathing exercises on upper extremity lymphedema in stroke patients.

    Science.gov (United States)

    Hwang, Woon Taek; Jeong, Yeon-Jae; Kim, Seong-Yeol; Jeong, Yeon-Gyu

    2016-12-01

    [Purpose] The purpose of this study was to determine the effects of deep-breathing and proprioceptive neuromuscular facilitation stretching exercises on upper limb lymphedema in stroke patients. [Subjects and Methods] The study consisted of 10 patients with lymphedema that had occurred after stroke. Neurodevelopmental treatment was applied in the same manner as that used for the existing treatment. The subjects performed deep-breathing and stretching exercises three times per week for 4 weeks (12 sessions total). Body water volume in the upper limbs was measured before and after exercise by using an InBody S10 analyzer. [Results] Performance of deep-breathing and stretching exercises significantly reduced body water volume in both the affected and unaffected arms. The extracellular-to-total cellular fluid volume ratio in the affected arm improved to 0.379 after exercise, although this change was not significant. [Conclusion] The results of the present study show that deep-breathing and proprioceptive neuromuscular facilitation stretching exercises reduce upper extremity lymphedema in stroke patients.

  11. Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.

    Science.gov (United States)

    Matsumoto, Andrew; Al-Rohil, Rami N; Bravin, Marina; Anderson, Lori; Wroblewski, Danielle; Carlson, John A

    2017-02-01

    Cutaneous polyarteritis nodosa (CPAN) is a chronic, indolent, single organ arteritis that generally presents with lower extremity nodules and/or livedo racemosa, accompanied by malaise and arthralgias. CPAN is often triggered by infection, commonly Group A streptococcal species, and is considered an autoimmune reaction. Scarring from surgery and obliterative lymphangiitis from bacterial cellulitis are the causes of lymphedema. Lymphedematous skin is predisposed to autoimmune disorders. Herein we report a 53-year-old woman who developed CPAN restricted to a localized area of the right upper arm-shoulder that had undergone multiple surgeries, complicated by episodes of Streptococcus viridans cellulitis. Clinically, a 15 cm diameter plaque exhibited violaceous, reticulate margins, subtle papules and nodules and central livedo racemosa. Biopsy showed numerous foci of arteritis in active, subacute and reparative stages. In addition, a broad zone of fibrosis replaced the deep dermis-subcutis zone and harbored numerous dilated lymphatic vessels scar lymphedema. Treatment consisted of high potency topical corticosteroids under occlusion; remission after 3 months therapy and follow-up. CPAN primarily affects the lower legs, a region of frequently affected by phlebolymphedema. This report of CPAN localized to an area of scar lymphedema underscores the importance of lymphatic function in the pathogenesis of CPAN. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Lymphedema (PDQ)

    Science.gov (United States)

    ... goes back into the bloodstream. The rest of the fluid enters the lymph system through tiny lymph vessels. ... and dry and wear cotton socks. Avoid blocking the flow of fluids through the body. It is important to keep ...

  13. Lymphedema: etiopathogenesis

    International Nuclear Information System (INIS)

    Fossum, T.W.; Miller, M.W.

    1992-01-01

    Two main factors have impeded the progress of work on the lymphatic vessels…, namely lack of methods of investigation and lack of interest. The latter has been partly due to the paucity of effective therapeutic methods to deal with lymphatic vessel disorders

  14. Brain Basics

    Medline Plus

    Full Text Available ... different roles, from controlling blood pressure and heart rate to responding when we sense a mistake, helping us feel motivated and stay focused on a task, and managing proper emotional reactions. Reduced ACC activity or damage to this brain ...

  15. Brain Basics

    Medline Plus

    Full Text Available ... Funding Strategy for Grants Application Process Managing Grants Clinical Research Training Small Business Research Labs at NIMH Labs ... Statistics Consumer Health Publications Help for Mental Illnesses Clinical Trials Outreach Research Priorities Funding Labs at NIMH News & Events About ...

  16. Basic principles of knowledge management and its application to the industrial company in tactical operations of maintenance and operational exploitation: A qualitative study

    Directory of Open Access Journals (Sweden)

    Francisco Javier Cárcel Carrasco

    2013-01-01

    Full Text Available Purpose: Although knowledge and its management is, and has been, studied in depth, particularly since the 90’s decade of the past century, especially for the strategic management, innovation, trade, or business administration, there are still many questions on how it articulates or transfers and the barriers to its management, especially when we talk about internal tactical activities that affect staff that we could call "offices", such as maintenance and industrial assembly or exploitation and conduction of the facilities. Because of the peculiarities normally seen in this kind of activity in the industrial companies, the knowledge of these people is strongly based on their experience (strong tacit component, difficult to measure and articulate, and on many occasions, however, this rupture of information-knowledge, can represent a high cost for the company (often assumed to be something inevitable due to the increase in production and service downtime, loss of efficiency, or tuning time of new staff to these areas.Design/methodology/approach: After a description of the State of the art and the basic principles of knowledge management, a qualitative study in an industrial company has been carried out, within the areas of operation and maintenance, in order to know the barriers and facilitators that such involved personnel finds in order to achieve an adequate transmission and use of that knowledge.Findings and Originality/value: Learn about barriers, facilitators and impact that offers the knowledge management in the areas of industrial maintenance, especially among professionals in offices which operate with a high degree of tacit knowledge and with a heavy dependence on the company on these professionals.Research limitations/implications: Those characteristics of a qualitative study in a particular area and within a geographical area, although it can be extrapolated to other types of companies and regional areas.Practical implications: Learn

  17. Case report: Manual lymphatic drainage and kinesio taping in the secondary malignant breast cancer-related lymphedema in an arm with arteriovenous (A-V) fistula for hemodialysis.

    Science.gov (United States)

    Chou, Ya-Hui; Li, Shu-Hua; Liao, Su-Fen; Tang, Hao-Wei

    2013-08-01

    Lymphedema is a dreaded complication of breast cancer treatment. The standard care for lymphedema is complex decongestive physiotherapy, which includes manual lymphatic drainage (MLD), short stretch bandaging, exercise, and skin care. The Kinesio Taping could help to improve lymphatic uptake. We reported a patient with unilateral secondary malignant breast cancer-related lymphedema and arteriovenous (A-V) fistula for hemodialysis happened in the same arm, and used kinesio taping, MLD, and exercise to treat this patient because no pressure could be applied to the A-V fistula. The 12-session therapy created an excellent effect. We do not think the kinesio taping could replace short stretch bandaging, but it could be another choice for contraindicating pressure therapy patients, and we should pay attention to wounds induced by kinesio tape.

  18. The effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema: a single-blind, randomized controlled trial.

    Science.gov (United States)

    Park, Jin-Hyuck

    2017-07-01

    This study was to investigate the effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema. 69 women participated in this study and then they were randomly allocated to complex exercise group (n = 35) or the conventional decongestive therapy group (n = 34). All subjects received 8 sessions for 4 weeks. To identify the effects on shoulder range of motion and pain, goniometer and visual analog scale were used, respectively. The outcome measurements were performed before and after the 4 week intervention. After 4 weeks, complex exercise group had greater improvements in shoulder range of motion and pain compared with the conventional decongestive therapy group (p women with breast cancer-related lymphedema. Complex exercise would be useful to improve shoulder range of motion and pain of the women with breast cancer-related lymphedema.

  19. Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study.

    Science.gov (United States)

    Kwan, Marilyn L; Yao, Song; Lee, Valerie S; Roh, Janise M; Zhu, Qianqian; Ergas, Isaac J; Liu, Qian; Zhang, Yali; Kutner, Susan E; Quesenberry, Charles P; Ambrosone, Christine B; Kushi, Lawrence H

    2016-08-01

    Breast cancer-related lymphedema (BCRL) is a serious chronic condition after breast cancer (BC) surgery and treatment. It is unclear if BCRL risk varies by race/ethnicity. In a multiethnic prospective cohort study of 2953 BC patients, we examined the association of self-reported BCRL status with self-reported race/ethnicity and estimated genetic ancestry. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated by multivariable Cox proportional hazards models, with follow-up starting 6 months post-BC diagnosis. Estimates were further stratified by body mass index (BMI). By 48 months of follow-up, 342 (11.6 %) women reported having BCRL. Younger age at BC diagnosis, higher BMI at baseline, and lower physical activity were associated with greater BCRL risk. African American (AA) women had a 2-fold increased risk of BCRL compared with White women (HR = 2.04; 95 % CI 1.35-3.08). African genetic ancestry was also associated with an increased risk (HR = 2.50; 95 % CI 1.43, 4.36). Both risks were attenuated but remained elevated after adjusting for known risk factors and became more pronounced when restricted to the nonobese women (adjusted HR = 2.31 for AA and HR = 3.70 for African ancestry, both p ancestry data, with a potential ancestry-obesity interaction.

  20. Illustrating the (invisible: Understanding the impact of loss in adults living with secondary lymphedema after cancer

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2014-08-01

    Full Text Available Life with a disability is often riddled with paradoxes, one of which is being visibly marked, while personal experiences, losses, and challenges remain hidden. Our article draws attention to this paradox among people who live with secondary lymphedema after cancer (SLC. SLC is a relatively unfamiliar chronic condition within medical and lay discourses of cancer, which proves challenging for the many cancer survivors who are in search of information and understanding. Thirteen men and women with SLC were recruited from two research sites (Fredericton, NB, and Ottawa, ON, Canada to participate in semi-structured interviews about the physical and psychosocial aspects of SLC. Using a methodology of interpretive description, our analysis of participant interviews reveals the complex ways in which men and women felt both visible and invisible within various contexts. We discuss three majors themes: (invisibility and appearance related to material losses; (invisibility and action connected to visible losses in function, as well as invisible struggles to care for oneself; and the loss of present and future well-being, as SLC renders some limitations visible while potentially obscuring a hopeful future indefinitely. Our research indicates that timely diagnosis of SLC would be an immediate first step in recognizing the physical and emotional dimensions of the condition. To accomplish this, increased awareness is needed. To enhance quality of life for those living with SLC, the development of new resources and psychosocial supports is also required.

  1. Fuel management inside the reactor. Impact of the substitution of the basic libraries of the Eclipse and Record codes of the FMS system of fuel management

    International Nuclear Information System (INIS)

    Alonso V, G.; Hernandez L, H.

    1992-12-01

    The present work is given to know the repercussions in the obtained results by the ECLIPSE-RECORD system of the package of fuel management FMS of SCANDPOWER, with the use of the libraries of effective sections of neutrons, for both codes, generated starting from the ENDF-B/IV database. Inside of the Institute it doesn't have any version of the ECLIPSE code it which drove us to make use of the versions of the THERMOS and GADPOL codes. The obtained results with the libraries generated were compared against those that are obtained making use of the libraries that it possesses the code, generated starting from the ENDF-B/III database, and the data that General Electric Co. reports for the cells that were used for this work. The calculations with the THERMOS-GADPOL-RECORD system, installed in 830 CDC machine of the Institute, its were carried out following the calculation sequence that it is continued during the generation of nuclear databases proposed by CFE only for the series 1 and 2. The obtained results are reported in the Appendixes B and C as well as some of the enter files for the codes used in the Appendix D, which are specified for those installed versions. (Author)

  2. Effects of qigong exercise on upper limb lymphedema and blood flow in survivors of breast cancer: a pilot study.

    Science.gov (United States)

    Fong, Shirley S M; Ng, Shamay S M; Luk, W S; Chung, Joanne W Y; Ho, Jacqueline S C; Ying, Michael; Ma, Ada W W

    2014-01-01

    Qigong exercise is a popular method for relieving the side effects of conventional cancer treatments in survivors of breast cancer, yet its effects are not empirically assessed. This study aimed to investigate the effects of qigong exercise on upper limb lymphedema, arterial resistance, and blood flow velocity in survivors with breast cancer and mastectomy. This study was conducted as a prospective clinical trial. Eleven survivors of breast cancer with qigong experience (mean age = 58.3 ± 10.1 years) were assigned to the experimental group and 12 survivors of breast cancer without qigong experience (mean age = 53.8 ± 4.2 years) were assigned to the control group. They all had breast cancer-related lymphedema. All procedures were completed within one session. After baseline measurements were taken, the experimental group performed 18 Forms Tai Chi Internal Qigong for approximately 6 minutes while the control group rested for similar duration in a sitting position. Both groups were then reassessed. All participants were measured on their affected upper limb circumference (by using tape measures), peripheral arterial resistance, and blood flow velocities (using a Doppler ultrasound machine). The between-group differences were not significant for all outcome measures at baseline (P > .05). The circumferences of the affected upper arm, elbow, forearm and wrist decreased after qigong exercise (P .0125). In terms of vascular outcomes, the resistance index decreased and the maximum systolic arterial blood flow velocity (SV) and minimum diastolic arterial blood flow velocity (DV) increased significantly after qigong exercise (P Qigong exercise could reduce conventional cancer therapy side effects such as upper limb lymphedema and poor circulatory status in survivors of breast cancer. However, such effects may be temporary, and further studies must be conducted to explore longer term effects.

  3. Development of a Tissue-Engineered Lymphatic Graft Using Nanocomposite Polymer for the Treatment of Secondary Lymphedema.

    Science.gov (United States)

    Kanapathy, Muholan; Kalaskar, Deepak; Mosahebi, Afshin; Seifalian, Alexander M

    2016-03-01

    Damage of the lymphatic vessels, commonly due to surgical resection for cancer treatment, leads to secondary lymphedema. Tissue engineering approach offers a possible solution to reconstruct this damage with the use of lymphatic graft to re-establish the lymphatic flow, hence preventing lymphedema. The aim of this study is to develop a tissue-engineered lymphatic graft using nanocomposite polymer and human dermal lymphatic endothelial cells (HDLECs). A nanocomposite polymer, the polyhedral oligomeric silsequioxane-poly(carbonate-urea)urethane (POSS-PCU), which has enhanced mechanical, chemical, and physical characteristics, was used to develop the lymphatic graft. POSS-PCU has been used clinically for the world's first synthetic trachea, lacrimal duct, and is currently undergoing clinical trial for coronary artery bypass graft. Two designs and fabrication methods were used to manufacture the conduits. The fabrication method, the mechanical and physical properties, as well as the hydraulic conductivity were tested. This is followed by in vitro cell culture analysis to test the cytocompatibility of HDLEC with the polymer surface. Using the casted extrusion method, the nanocomposite lymphatic graft demonstrates desirable mechanical property and hydraulic conductivity to re-establish the lymphatic flow. The conduit has high tensile strength (casted: 74.86 ± 5.74 MPa vs. coagulated: 31.33 ± 3.71 MPa; P nanocomposite polymer. It displays excellent mechanical property and cytocompatibility to HDLECs, offering much promise for clinical applications and as a new treatment option for secondary lymphedema. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Could Kinesio tape replace the bandage in decongestive lymphatic therapy for breast-cancer-related lymphedema? A pilot study.

    Science.gov (United States)

    Tsai, Han-Ju; Hung, Hsiu-Chuan; Yang, Jing-Lan; Huang, Chiun-Sheng; Tsauo, Jau-Yih

    2009-11-01

    The purpose of this study is to compare the treatment and retention effects between standard decongestive lymphatic therapy (DLT) combined with pneumatic compression (PC) and modified DLT, in which the use of a short-stretch bandage is replaced with the use of Kinesio tape (K-tape) combined with PC. Forty-one patients with unilateral breast-cancer-related lymphedema for at least 3 months were randomly grouped into the DLT group (bandage group, N = 21) or the modified DLT group (K-tape group, N = 20). Skin care, 30-min manual lymphatic drainage, 1-h pneumatic compression therapy, application of a short-stretch bandage or K-tape for each group, and a 20-min physical therapy exercise were given during every treatment session. Patient evaluation items included physical therapy assessment, limb size, water composition of the upper extremity, lymphedema-related symptoms, quality of life, and patients' acceptance to the bandage or tape. There was no significant difference between groups in all outcome variables (P > 0.05) through the whole study period. Excess limb size (circumference and water displacement) and excess water composition were reduced significantly in the bandage group; excess circumference and excess water composition were reduced significantly in the tape group. The acceptance of K-tape was better than the bandage, and benefits included longer wearing time, less difficulty in usage, and increased comfort and convenience (P tape could replace the bandage in DLT, and it could be an alternative choice for the breast-cancer-related lymphedema patient with poor short-stretch bandage compliance after 1-month intervention. If the intervention period was prolonged, we might get different conclusion. Moreover, these two treatment protocols are inefficient and cost time in application. More efficient treatment protocol is needed for clinical practice.

  5. Changes in Antibody Levels during and following an Episode of Acute Adenolymphangitis (ADL among Lymphedema Patients in Leogane, Haiti.

    Directory of Open Access Journals (Sweden)

    Katherine E Mues

    Full Text Available Episodes of acute adenolymphangitis (ADL are often the first clinical sign of lymphatic filariasis (LF. They are often accompanied by swelling of the affected limb, inflammation, fever, and general malaise and lead to the progression of lymphedema. Although ADL episodes have been studied for a century or more, questions still remain as to their etiology. We quantified antibody levels to pathogens that potentially contribute to ADL episodes during and after an episode among lymphedema patients in Léogâne, Haiti. We estimated the proportion of ADL episodes hypothesized to be attributed to specific pathogens.We measured antibody levels to specific pathogens during and following an ADL episode among 41 lymphedema patients enrolled in a cohort study in Léogâne, Haiti. We calculated the absolute and relative changes in antibody levels between the ADL and convalescent time points. We calculated the proportion of episodes that demonstrated a two-fold increase in antibody level for several bacterial, fungal, and filarial pathogens.Our results showed the greatest proportion of two-fold changes in antibody levels for the carbohydrate antigen Streptococcus group A, followed by IgG2 responses to a soluble filarial antigen (BpG2, Streptococcal Pyrogenic Exotoxin B, and an antigen for the fungal pathogen Candida. When comparing the median antibody level during the ADL episode to the median antibody level at the convalescent time point, only the antigens for Pseudomonas species (P-value = 0.0351 and Streptolysin O (P-value = 0.0074 showed a significant result.Although our results are limited by the lack of a control group and few antibody responses, they provide some evidence for infection with Streptococcus A as a potential contributing factor to ADL episodes. Our results add to the current evidence and illustrate the importance of determining the causal role of bacterial and fungal pathogens and immunological antifilarial response in ADL episodes.

  6. An interval-possibilistic basic-flexible programming method for air quality management of municipal energy system through introducing electric vehicles.

    Science.gov (United States)

    Yu, L; Li, Y P; Huang, G H; Shan, B G

    2017-09-01

    Contradictions of sustainable transportation development and environmental issues have been aggravated significantly and been one of the major concerns for energy systems planning and management. A heavy emphasis is placed on stimulation of electric vehicles (EVs) to handle these problems associated with various complexities and uncertainties in municipal energy system (MES). In this study, an interval-possibilistic basic-flexible programming (IPBFP) method is proposed for planning MES of Qingdao, where uncertainties expressed as interval-flexible variables and interval-possibilistic parameters can be effectively reflected. Support vector regression (SVR) is used for predicting electricity demand of the city under various scenarios. Solutions of EVs stimulation levels and satisfaction levels in association with flexible constraints and predetermined necessity degrees are analyzed, which can help identify the optimized energy-supply patterns that could plunk for improvement of air quality and hedge against violation of soft constraints. Results disclose that largely developing EVs can help facilitate the city's energy system with an environment-effective way. However, compared to the rapid growth of transportation, the EVs' contribution of improving the city's air quality is limited. It is desired that, to achieve an environmentally sustainable MES, more concerns should be focused on the integration of increasing renewable energy resources, stimulating EVs as well as improving energy transmission, transport and storage. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Lettuce Production Hydroponics (Lactuca Sativa L. for the Promotion of Self-Management in Basic School Bolivariana “Los Naranjos”

    Directory of Open Access Journals (Sweden)

    Luis Alfredo Díaz

    2017-05-01

    Full Text Available The present research aims at the promotion of the Hydroponic Lettuce Cultivation (Lactuca Sativa L. as a self - management alternative in the Bolivarian Basic School “Los Naranjos”, Calderas parish, Bolívar municipality of Barinas state. The nature of the study is framed under the modality of the qualitative paradigm, adopting the method of Participatory Action Research. On the other hand, the research will be conducted in (4 four phases: Phase I. Diagnosis, Phase II. Elaboration of the action plan, Phase III. Implementation of the action plan, Phase IV. Reflection, interpretation and integration of results. Information triangulation was used to analyze the information in order to cross-check information from key informants. For all of the above, this study constitutes a significant contribution to the teaching and learning process as it is the responsibility of the family and teachers as promoters and agents of dissemination of knowledge, accept the responsibility in this process of placing children in contact And girls with new techniques of cultivation, in this case with the hydroponic technique, since its early years, so that this is a pleasurable, pleasant and encouraging experience that accompanies him for the rest of his life.

  8. Accounting & Finance; a Basic Introduction

    NARCIS (Netherlands)

    drs. Ewoud Jansen

    2011-01-01

    The book is about finance and accounting, subjects widely discussed in many other books. What sets this book apart from most others is that it discusses all the basic aspects of finance and accounting in one single textbook. Three areas of interest are discussed: Financial Management; Management

  9. Far infrared ray (FIR) therapy: An effective and oncological safe treatment modality for breast cancer related lymphedema.

    Science.gov (United States)

    Li, Ke; Xia, Liang; Liu, Ning Fei; Nicoli, Fabio; Constantinides, Joannis; D'Ambrosia, Christopher; Lazzeri, Davide; Tremp, Mathias; Zhang, Ju Fang; Zhang, Yi Xin

    2017-07-01

    The incidence of breast cancer related lymphedema is approximately 5%. Far infrared ray (FIR) treatment can potentially reduce fluid volume and extremity circumference as well as the frequency of dermato-lymphangitis (DLA). However, there is no published data on the oncological safety of FIR and the potential for activation of any residual breast cancer cells. The aim of this study is to investigate the safety of far infrared ray (FIR) treatment of postmastectomy lymphedema, clinically and in vitro. Patients who underwent mastectomy more than 5years ago complicated by upper extremity lymphedema for more than 1year were included. The enrolled patients were divided into an FIR treatment group and a control group (conservative treatment using bandage compression). Outcome measures included tumor markers (CA153, CA125), ultrasonography of relevant structures and monitoring for adverse reactions 1year after treatment. For the in vitro part of the study, the effects of FIR on human breast adenocarcinoma cell lines (MCF7, MDA-MB231) compared to the effects of FIR on human dermal fibroblasts as a control were considered. The viability, proliferation, cell cycle and apoptotic statistics of the adenocarcinoma and human dermal fibroblast cell lines were analyzed and compared. Results demonstrated that after treatment with FIR, tumor marker (CA153, CA125) concentrations in both the FIR and control groups were not elevated. There was no statistically significant difference between FIR and control group marker expression (p>0.05). Furthermore, no patients were diagnosed with lymphadenectasis or newly enlarged lymph nodes in these two groups. Importantly, there were no adverse events in either group. The in vitro experiment indicated that FIR radiation does not affect viability, proliferation, cell cycle and apoptosis of fibroblasts, MCF-7 and MDA-MB-231 cells. FIR should be considered as feasible and safe for the treatment of breast cancer related lymphedema patients 5years

  10. Causes of Shoulder Pain in Women with Breast Cancer-Related Lymphedema: A Pilot Study

    Science.gov (United States)

    Jeong, Ho Joong; Hwang, Ki Hun; Kim, Ghi Chan

    2011-01-01

    Purpose To inform on shoulder pathology and to identify the disabilities and level of quality of life (QOL) associated with shoulder pain in patients with breast cancer-related lymphedema (BCRL). Materials and Methods Using patient history, physical examination, and ultrasound (US), we classified patients with BCRL into the following three groups: no pain with normal ultrasound (US), pain with normal US, and pain with abnormal US. We evaluated shoulder pathology using US, pain intensity using a visual analogue scale (VAS), and functional disability using the Korean version of the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire. For assessment of QOL, we used the Korean version of the brief form of the World Health Organization Quality of Life Assessment Instrument (WHOQOL-BREF). Results 28.9% of patients had no pain and normal US, 31.6% had pain with normal US, and 39.5% had pain with abnormal US. The US findings for those with pain and abnormal US revealed the following: 53.3% had a supraspinatus tear, 13.3% had biceps tenosynovitis, 13.3% had acromioclavicular arthritis, 13.3% had subdeltoid bursitis, and 53.3% had adhesive capsulitis. Patients with shoulder pain and abnormal US findings had significantly higher mean DASH and pain scores. Pain scores were positively correlated with DASH scores and negatively correlated with QOL. Conclusion We found that BCRL with shoulder pain and evidence of shoulder pathology on US was associated with reduced QOL and increased disability. Proper diagnosis and treatment of shoulder pain are necessary to improve QOL and decrease disability in patients with BCRL. PMID:21623610

  11. Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  12. Physical activity, daily walking, and lower limb lymphedema associate with physical function among uterine cancer survivors.

    Science.gov (United States)

    Brown, Justin C; Lin, Lilie L; Segal, Saya; Chu, Christina S; Haggerty, Ashley E; Ko, Emily M; Schmitz, Kathryn H

    2014-11-01

    We sought to quantify the proportion of uterine cancer survivors who self-report poor physical function. We then sought to quantify the association of poor physical function with physical activity (PA), walking, and lower limb lymphedema (LLL), among women with a history of uterine cancer. Physical function was quantified using the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) questionnaire. PA, walking, and LLL were measured using self-report questionnaire. PA was calculated using metabolic equivalent hours per week (MET-h week(-1)), and walking was calculated using blocks per day (blocks day(-1)). Logistic regression estimated odds ratios (OR) and 95 % confidence intervals (95 % CI). Among the 213 uterine cancer survivors in our survey (43 % response rate), 35 % self-reported poor physical function. Compared to participants who reported <3.0 MET-h week(-1) of PA, participants who reported ≥18.0 MET-h week(-1) of PA were less likely to have poor physical function (OR 0.03, 95 % CI 0.01-0.10; P trend  < 0.0001). Compared to participants who reported <4.0 blocks day(-1) of walking, participants who reported ≥12.0 blocks day(-1) of walking were less likely to have poor physical function (OR 0.07, 95 % CI 0.03-0.19; P trend  < 0.0001). Compared to participants who did not have LLL, participants with LLL were more likely to have poor physical function (OR 5.25, 95 % CI 2.41-11.41; P < 0.0001). Higher levels of PA and walking associate with a lower likelihood of reporting poor physical function. The presence of LLL associates with a higher likelihood of reporting poor physical function. These findings are hypothesis-generating and should be evaluated in future prospective studies.

  13. Factors Associated With the Development of Breast Cancer–Related Lymphedema After Whole-Breast Irradiation

    International Nuclear Information System (INIS)

    Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew; Ghilezan, Mihai; Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha; Mitchell, Christina; Wallace, Michelle; Vicini, Frank

    2012-01-01

    Purpose: To determine the rates of breast cancer–related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

  14. Does Axillary Boost Increase Lymphedema Compared With Supraclavicular Radiation Alone After Breast Conservation?

    International Nuclear Information System (INIS)

    Hayes, Shelly B.; Freedman, Gary M.; Li Tianyu; Anderson, Penny R.; Ross, Eric

    2008-01-01

    Purpose: To determine independent predictors of lymphedema (LE) after breast radiotherapy and to quantify added risks of LE from regional node irradiation (RNI). Materials and Methods: A total of 2,579 women with T1-2, N 0-3, M0 breast cancer treated with breast conservation between 1970 and 2005 were studied. A total of 2,169 patients (84%) received radiation to the breast (B), 226 (8.8%) to the breast and supraclavicular LNs (B+SC), and 184 (7.1%) to the breast, supraclavicular LNs, and a posterior axillary boost (B+SC+PAB). Median follow-up was 81 months (range, 3-271). Results: Eighteen percent of patients developed LE. LE risks were as follows: 16% (B), 23% (B+SC), and 31% (B+SC+PAB) (p < 0.0001). LE severity was greater in patients who had RNI (p = 0.0002). On multivariate analysis, RT field (p < 0.0001), obesity index (p = 0.0157), systemic therapy (p = 0.0013), and number of LNs dissected (p < 0.0001) independently predicted for LE. In N1 patients, the addition of a SC to tangents (p < 0.0001) and the addition of a PAB to tangents (p = 0.0017) conferred greater risks of LE, but adding a PAB to B+SC RT did not (p = 0.8002). In the N2 patients, adding a PAB increased the risk of LE 4.5-fold over B+SC RT (p = 0.0011). Conclusions: LE predictors included number of LNs dissected, RNI, obesity index, and systemic therapy. LE risk increased when a SC or PAB were added in the N1 subgroup. In the N2 patients, a PAB increased the risk over B+SC. The decision to boost the axilla must be weighed against the increased risk of LE that it imposes

  15. Effects of warm acupuncture on breast cancer–related chronic lymphedema: a randomized controlled trial

    Science.gov (United States)

    Yao, C.; Xu, Y.; Chen, L.; Jiang, H.; Ki, C.S.; Byun, J.S.; Bian, W.

    2016-01-01

    Background Effective treatment for breast cancer–related chronic lymphedema (bcrl) remains a clinical challenge. Acupuncture and moxibustion treatments have been shown to be beneficial and safe for treating bcrl. In the present randomized controlled trial, we compared the effectiveness of combined acupuncture and moxibustion (“warm acupuncture”) with that of diosmin in bcrl. Methods Breast cancer patients who met the inclusion and exclusion criteria (n = 30) were randomized to experimental and control groups (15 per group). On alternate days, patients in the experimental group received 30 minutes of acupuncture at 6 acupoints, with 3 of the needles each being topped by a 3-cm moxa stick. The control treatment was diosmin 900 mg 3 times daily. The control and experimental treatments were administered for 30 days. Outcome measures included arm circumferences (index of effectiveness), range of motion [rom (shoulder joint function)], quality of life, clinical safety, and adverse events. Results Measured by the index of effectiveness, bcrl improved by 51.46% in the experimental group and by 26.27% in the control group (p extorsion in the experimental group improved significantly; they did not change in the control group. Self-reported quality of life was significantly better with warm acupuncture than with diosmin. No adverse effects were reported during the treatment period, and laboratory examinations for clinical safety fell within the normal ranges. Conclusions Compared with diosmin, warm acupuncture treatment can effectively reduce the degree of bcrl at the specific acupoints treated and can promote quality of life. Warm acupuncture showed good clinical safety, without any adverse effects on blood or the cardiovascular system. PMID:26966410

  16. Effects of warm acupuncture on breast cancer-related chronic lymphedema: a randomized controlled trial.

    Science.gov (United States)

    Yao, C; Xu, Y; Chen, L; Jiang, H; Ki, C S; Byun, J S; Bian, W

    2016-02-01

    Effective treatment for breast cancer-related chronic lymphedema (bcrl) remains a clinical challenge. Acupuncture and moxibustion treatments have been shown to be beneficial and safe for treating bcrl. In the present randomized controlled trial, we compared the effectiveness of combined acupuncture and moxibustion ("warm acupuncture") with that of diosmin in bcrl. Breast cancer patients who met the inclusion and exclusion criteria (n = 30) were randomized to experimental and control groups (15 per group). On alternate days, patients in the experimental group received 30 minutes of acupuncture at 6 acupoints, with 3 of the needles each being topped by a 3-cm moxa stick. The control treatment was diosmin 900 mg 3 times daily. The control and experimental treatments were administered for 30 days. Outcome measures included arm circumferences (index of effectiveness), range of motion [rom (shoulder joint function)], quality of life, clinical safety, and adverse events. Measured by the index of effectiveness, bcrl improved by 51.46% in the experimental group and by 26.27% in the control group (p extorsion in the experimental group improved significantly; they did not change in the control group. Self-reported quality of life was significantly better with warm acupuncture than with diosmin. No adverse effects were reported during the treatment period, and laboratory examinations for clinical safety fell within the normal ranges. Compared with diosmin, warm acupuncture treatment can effectively reduce the degree of bcrl at the specific acupoints treated and can promote quality of life. Warm acupuncture showed good clinical safety, without any adverse effects on blood or the cardiovascular system.

  17. Role of lymphoscintigraphy in diagnosis and management of patients with leg swelling of unclear etiology

    International Nuclear Information System (INIS)

    Kalawat, Tek Chand; Chittoria, Ravi Kumar; Reddy, Praveen Kumar; Suneetha, Batchu; Narayan, Ravishwar; Ravi, Parthsarthi

    2012-01-01

    To study the utility of lymphoscintigraphy in detection of lymphatic obstruction in patients with leg swelling of unclear etiology, selection of site for nodo venous shunt procedure, and follow-up lymphoscintigraphic documentation of improved lymph flow in surgically treated limb. Twenty four consecutive patients with leg swelling, 10 male, 14 female with mean age 47 years, range from 13 years to 74 years underwent lymphoscintigraphy. All patients were referred from Department of Plastic Surgery, after initial work-up, and routine investigations to rule out the other causes of leg swelling. Both clinical and scintigraphic staging performed for all patients. All clinically and scintigraphically positive patients treated with decongestive lymphatic therapy (DLT). In addition to the DLT, those patients positive for unilateral or bilateral lymphedema, consented for surgical intervention, nodo venous shunt (NVS) in their only affected or one of the two affected lower limbs. Follow-up lymphoscintigraphy performed in operated cases after 3 months to 6 months of surgery, lymphoscintigraphy images of each patient in pre and post-surgery compared. In 20/24 cases (83%) of clinically positive leg swelling were found to be positive for lymphedema on lymphoscintigraphy and remaining, 4/24 were scintigraphically normal. Based on the clinical and lymphoscintigraphy staging, 03/20 cases (15%) had Grade I lymphedema, 01/20 (5%) Grade II lymphedema, 06/20 (30%) Grade III and remaining 10/20 (50%) had Grade IV lymphedema. 11/20 cases of Lymphedema (55%) were managed conservatively by only DLT and in remaining 09/20 cases (45%), who were case of Grade IV, lymphedema (five patients with unilateral and four patients with bilateral disease) initially treated with DLT, and on completion of DLT, undergone for NVS procedure, in their unilaterally affected lower limb or one of the two diseased lower limbs. All nine patients showed remarkable clinical improvement in leg swelling and their

  18. Assessment of Volume Measurement of Breast Cancer-Related Lymphedema by Three Methods: Circumference Measurement, Water Displacement, and Dual Energy X-Ray Absorptiometry

    DEFF Research Database (Denmark)

    Gjørup, Caroline; Zerahn, B.; Hendel, Helle Westergren

    2010-01-01

    Background: Following treatment for breast cancer 12%-60% develop breast cancer-related lymphedema (BCRL). There are several ways of assessing BCRL. Circumference measurement (CM) and water displacement (WD) for volume measurements (VM) are frequently used methods in practice and research...

  19. Therapeutic Effects of Saireito (Chai-Ling-Tang, a Traditional Japanese Herbal Medicine, on Lymphedema Caused by Radiotherapy: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Aiko Nagai

    2013-01-01

    Full Text Available Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50% showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

  20. The RSZ BASIC programming language manual

    Science.gov (United States)

    Stattel, R. J.; Niswander, J. K.; Kochhar, A. K.

    1980-01-01

    The RSZ BASIC interactive language is described. The RSZ BASIC interpreter is resident in the Telemetry Data Processor, a system dedicated to the processing and displaying of PCM telemetry data. A series of working examples teaches the fundamentals of RSZ BASIC and shows how to construct, edit, and manage storage of programs.

  1. THEORETICAL ASPECTS OF BASIC PROVISIONS OF THE ENERGY SAVING MANAGEMENT SYSTEM IN THE FIELD OF HOUSING AND PUBLIC UTILITIES THROUGH INTRODUCTION OF SMALL INNOVATIVE ENTERPRISES

    Directory of Open Access Journals (Sweden)

    Kiseleva Ekaterina Alexandrovna

    2012-10-01

    Full Text Available The author addresses solutions to problems of the housing and utilities sector (including a substantial depreciation of fixed assets of the municipal infrastructure, a gap between domestic utilities management technologies and those employed worldwide, and the fund raising problem through power saving actions to be facilitated by small innovative enterprises. The proposed solutions contribute to formation of new jobs in the regions, reduction of power consumption and higher efficiency of regional economies due to reduced costs and rates (prices set for utilities-related services, and improvement of the standard and quality of living. The principal objective is to develop a set of procedures and criteria to serve as the basis for the selection of tools of power saving innovations in the housing and utilities sector of regions and municipalities. The above actions are to be implemented through the involvement of small innovative enterprises. The basic tools (instruments of the state social and economic (including innovation-related policy, that are to stimulate subjects of innovative activities to implement innovative projects in this sector stimulate energy efficiency innovations in the housing and utilities sector. The proposed set of tools includes tax holidays, subsidies, grants, soft loans, concessional loans, state and municipal orders, etc. The procedure of selection of instruments of state-initiated innovations designated for the improvement of the power efficiency of the housing and public utilities sector to be implemented by regional and municipal authorities is proposed by the author. The author identifies several types of energy saving innovations in the housing and utilities sector, based on their systemic effects. Upon identification of the top-priority recipients of state support, financial resources are to be distributed. Advantages of innovative energy saving projects in the housing and utilities sector, developed and implemented

  2. The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema.

    Science.gov (United States)

    Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

    2014-08-01

    The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images 'spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research.

  3. The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema

    Science.gov (United States)

    Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

    2014-01-01

    The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images ‘spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research. PMID:25197263

  4. Incidence and risk factors for lower limb lymphedema after gynecologic cancer surgery with initiation of periodic complex decongestive physiotherapy.

    Science.gov (United States)

    Deura, Imari; Shimada, Muneaki; Hirashita, Keiko; Sugimura, Maki; Sato, Seiya; Sato, Shinya; Oishi, Tetsuro; Itamochi, Hiroaki; Harada, Tasuku; Kigawa, Junzo

    2015-06-01

    Lower limb lymphedema (LLL) is one of the most frequent postoperative complications of retroperitoneal lymphadenectomy for gynecologic cancer. LLL often impairs quality of life, activities of daily living, sleep, and sex in patients with gynecologic cancer. We conducted this study to evaluate the incidence and risk factors for LLL after gynecologic cancer surgery in patients who received assessment and periodic complex decongestive physiotherapy (CDP). We retrospectively reviewed 126 cases of gynecologic cancer that underwent surgery involving retroperitoneal lymphadenectomy at Tottori University Hospital between 2009 and 2012. All patients received physical examinations to detect LLL and underwent CDP by nurse specialists within several months after surgery. The International Society of Lymphology staging of lymphedema severity was used as the diagnostic criteria. Of 126 patients, 57 (45.2%) had LLL, comprising 45 and 12 patients with stage 1 and stage 2 LLL, respectively. No patient had stage 3 LLL. LLL was present in 37 (29.4%) patients at the initial physical examination. Multivariate analysis revealed that adjuvant concurrent chemoradiotherapy and age ≥ 55 years were independent risk factors for ≥ stage 2 LLL. To minimize the incidence of ≥ stage 2 LLL, gynecologic oncologists should be vigilant for this condition in patients who are ≥ 55 years and in those who undergo adjuvant chemoradiotherapy. Patients should be advised to have a physical assessment for LLL and to receive education about CDP immediately after surgery involving retroperitoneal lymphadenectomy for gynecologic cancer.

  5. The articulated action plan (par in municipalities in Mato Grosso do Sul State and its implications for the democratic management of basic education - doi: 10.4025/actascieduc.v34i2.17546

    Directory of Open Access Journals (Sweden)

    Regina Tereza Cestari de Oliveira

    2012-11-01

    Full Text Available The paper analyzes the implications of the Articulated Action Plan (PAR, a component of the Education Development Plan (PDE, to the democratic management of basic education, within the context of the educational policy, during President Luiz Inácio Lula da Silva’s second government term (2007-2010. It presents research findings through the examination of documentary sources, focusing on the actions defined by the municipalities in the state of Mato Grosso do Sul, within PAR’s Educational Management Dimension. These actions, in alignment with the guidelines of the plan called All for Education, indicate the limits and possibilities of building a democratic management of basic education, depending on the implementation by the municipalities, as they exercise their autonomy.  

  6. Surgical treatment of lymphedema of the penis and scrotum Tratamento cirúrgico do linfedema peno-escrotal

    Directory of Open Access Journals (Sweden)

    Miguel Modolin

    2006-08-01

    Full Text Available PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. MATERIALS AND METHODS: Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. RESULTS: Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. CONCLUSIONS: The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.INTRODUÇÃO: O linfedema peno-escrotal, independentemente da etiologia, é determinado pela redução do fluxo linfático com conseqüente aumento do volume do escroto e pênis. A evolução clínica da doença é caracterizada com extremo desconforto ao paciente, limitando a higiene local, a deambulação, o intercurso sexual e a micção em posição ortostática. OBJETIVO: Apresentar a experiência e resultados no tratamento da patologia com

  7. Proceeding of the Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology part II : Nuclear Chemistry, Process Technology, Radioactive Waste Management and Environment

    International Nuclear Information System (INIS)

    Sukarsono, R.; Ganang Suradjijo

    2002-01-01

    Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology is a routine activity held by Centre for Research and Development of Advanced Technology, National Nuclear Energy Agency, for monitoring the research activity which achieved in National Nuclear Energy Agency. This proceedings contains a proposal about basic research in nuclear technology which has environment. This proceedings is the second part of the two parts which published in series. There are 57 articles which have separated index. (PPIN)

  8. Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

    Directory of Open Access Journals (Sweden)

    Roberta Maria Dalia

    2005-10-01

    Full Text Available The purpose of this study was to prove the efficiency of qualitative and quantitative lymphoscintigraphy in the diagnosis of the lower extremity lymphedema. Seventy-seven patients had been studied, most of then (85.7% were female. Patients’ ages ranged from 18 to 82 years. All patients underwent a bilateral lymphoscintigraphy. Images were recorded with a dual-detector instrument in the whole-body scanning mode. Feet and inguinal static views were acquired within 15 minutes and three hours after radiopharmaceutical injection. Two nuclear doctors evaluated the lymphoscintigrams qualitatively. Quantitative studies of the radiopharmaceutical absorption and the lymph node chain uptake were also obtained. Of the 154 evaluated members, 21.44% (n = 33 were classified as normal, 61.68% (n = 95 as mildly altered and 16.88% (n = 26 much altered. Quantitation of lymphatic chain uptake may be a more sensitive approach to the diagnosis of lymphatic impairment than the qualitative analysis.O objetivo do estudo foi comprovar a eficiência da linfocintilografia qualitativa e quantitativa no diagnóstico e na classificação da gravidade do linfedema de membros inferiores. Foram estudados 77 pacientes, sendo 66 (85,7% do sexo feminino, na faixa etária entre 18 e 82 anos. Todos os pacientes foram submetidos a uma linfocintilografia bilateral, com um equipamento de dois detectores, na qual se adquiriu imagens dos pés, da região inguinal e uma varredura dos membros, após 15 minutos e três horas da injeção do radiofármaco. Os exames foram avaliados qualitativamente por 2 médicos nucleares. Também foram feitos estudos quantitativos da absorção do radiofármaco e da captação em cadeia inguinal. Dos 154 membros avaliados classificaram-se como normais 21,44% (n=33, pouco alterados 61,68% (n=95 e muito alterados 16,88% (n=26. A quantificação da captação da cadeia linfática pode ser um método mais sensível para o diagnóstico do linfedema em rela

  9. Role of MR imaging in the differential diagnosis of lymphedema, phlebedema, and lipedema of the lower extremity

    International Nuclear Information System (INIS)

    Hagspiel, K.D.; Duewell, S.; Frick, E.; Bollinger, A.; Schulthess, G.K. von.

    1990-01-01

    The distinction between the different forms of leg edema is usually based on clinical findings and findings of venography, lymphography, and scintigraphy. This paper assesses the usefulness of MR imaging in differentiating these diseases. Twenty-four patients with lipedema, lymphedema, or phlebedema were investigated with our 1.5-T system. In each patient, transaxial T1- and T2- weighted spin-echo (SE) sequences were performed. After the application of Gd-DOTA, dynamic gradient-echo scans were performed, and the T1- weighted SE sequence was repeated. Lipedema was easy to differentiate from the other two types of edema because of its homogeneously enlarged subcutaneous layer that showed no signal increase on T2-weighted sequences or after Gd-DOTA enhancement

  10. The potential role of angiogenesis in the development of shoulder pain, shoulder dysfunction, and lymphedema after breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Mafu TS

    2018-01-01

    Full Text Available Trevor S Mafu,1 Alison V September,1 Delva Shamley2 1Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, 2Clinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Abstract: Shoulder morbidity is a well-documented sequela of breast cancer treatment, which includes various manifestations such as pain, reduced range of motion, and lymphedema, among others. The multifactorial nature of such morbidities has long been appreciated, and research on reliable risk predictors of development thereof still continues. Previous studies have demonstrated the potential of different types of physical therapy to treat such shoulder problems, and the integration of such interventions into routine care for breast cancer survivors is a requirement in most high-income countries. Although patients at risk for developing shoulder problems would most likely benefit from posttreatment physical therapy, currently, there is no gold standard for identifying this patient group. This is particularly important in low- and middle-income countries where scarce monetary resources need to be directed specifically to those most in need. Modulators of the angiogenesis pathway have been implicated in noncancer shoulder conditions such as rotator cuff disease, adhesive capsulitis, and tendon injuries. The present review summarizes the role of angiogenesis in the development of shoulder morbidity among breast cancer survivors and sets forth the rationale for our belief that angiogenesis signaling may help explain a proportion of the reported clinical variability noted in the development of shoulder pain and dysfunction and upper-limb lymphedema after breast cancer treatment. Keywords: angiogenesis, shoulder dysfunction, cytokines, polymorphism, breast cancer therapy

  11. Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association.

    Science.gov (United States)

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn; Gilchrist, Laura

    2017-07-01

    The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to maximize clinical applicability, recommendations were based on the characteristics as to the location and stage of a patient's upper quadrant lymphedema. © American Physical Therapy Association 2017. Published by Oxford University Press [on behalf of the American Physical Therapy Association].

  12. Self-reported arm-lymphedema and functional impairment after breast cancer treatment--a nationwide study of prevalence and associated factors

    DEFF Research Database (Denmark)

    Gärtner, Rune; Jensen, Maj-Britt; Kronborg, Lise

    2010-01-01

    Lymphedema and impairment of function are well-established sequelae to breast cancer treatment and affect an increasing number of women due to continually improved survival. The aim of the present nationwide questionnaire study was to examine the impact of breast cancer treatment on perceived....../heaviness varied from 13 to 65%. Associated factors were young age, axillary lymph node dissection (ALND) and radiotherapy but not type of breast surgery or use of chemotherapy. Depending on treatment group 11-44% had to give up activities. Giving up activities was associated with pain and swelling...... swelling/sensation of heaviness (lymphedema) and on function, reporting prevalence in 12 subgroups of modern treatment and offering estimates for treatment-related associated factors. 3253 Women (87%) returned the study questionnaire. Depending on treatment group prevalence of perceived swelling...

  13. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast

    DEFF Research Database (Denmark)

    Ryttov, N; Holm, N V; Qvist, N

    1988-01-01

    The influence of postoperative radiation therapy on development of late arm lymphedema and shoulder joint disability following mastectomy was evaluated from a series of 57 women with operable carcinoma of the breast. The patients were divided into three groups. Common for all three groups...... was mastectomy and partial axillary dissection. In addition one group received postoperative irradiation plus systemic therapy and another group systemic therapy alone. The incidence of late arm lymphedema/impaired shoulder mobility was 11%/4% in the group of patients undergoing surgery alone, 46......%/38% in the group of patients receiving adjuvant irradiation and 6%/12% in the group of patients receiving adjuvant systemic therapy. It is concluded that adjuvant irradiation to the axilla in patients with metastatic lymph nodes highly increases the risk of late physical sequelae following modified radical...

  14. [Primary congenital lymphedema: Milroy disease: the first case observed in the Department of Pediatrics at the University Hospital Yalgado Ouedraogo, Ouagadougou].

    Science.gov (United States)

    Ouattara, Chantal Zoungrana; Kalmogho, Angèle; Yonaba, Caroline; Bouda, Chantal Gabrielle; Yaméogo, Ghislaine; Kam, Ludovic

    2017-01-01

    Congenital lymphedema is the accumulation of lymphatic fluid in the child's interstitial spaces. Milroy disease is a rare, hereditary, autosomal dominant condition showing incomplete penetrance. We report the case of a 7-year old little girl with Milroy disease examined for erysipelas on congenital big right leg. A family history of large congenital member existed. Physical examination showed big oedematous right leg painful to palpation, with skin lichenification and erysipelas. Paraclinical assessment objectified cutaneous lymphedema with vascular involvement suggestive of ectasia of the right saphenous vein. Female karyotype showed no abnormalities, despite the small chromosomal rearrangements. Treatment was based on physiotherapy, bandages, compression stockings and psychotherapy. This first case in Burkina Faso testifies to the rarity of the pathology but especially to the diagnostic difficulties related to the inadequacy of paraclinical investigations.

  15. Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association

    OpenAIRE

    Levenhagen, Kimberly; Davies, Claire; Perdomo, Marisa; Ryans, Kathryn; Gilchrist, Laura

    2017-01-01

    Abstract The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence ...

  16. Are compression corsets beneficial for the treatment of breast cancer-related lymphedema? New opportunities in physiotherapy treatment – a preliminary report

    Directory of Open Access Journals (Sweden)

    Hansdorfer-Korzon R

    2016-04-01

    Full Text Available Rita Hansdorfer-Korzon,1 Jacek Teodorczyk,2 Agnieszka Gruszecka,3 Piotr Lass2,4 1Department of Physiotherapy, 2Department of Nuclear Medicine, 3Department of Informatics and Statistics, 4Department of Molecular Spectroscopy, Institute of Experimental Physics, Gdansk, Poland Introduction: Treatment of secondary lymphedema still remains an important medical issue. Treatment response is characterized by periodic remission rather than complete recovery. Compression methods currently used as part of complete decongestive therapy vary considerably in efficacy. Manual drainage, bandaging, and compression pumps are ineffective in everyday practice. Positive results have increasingly been reported where compression garments have been used as part of the treatment. This pilot study demonstrates a beneficial effect following the use of compression corsets in the treatment of edema in breast cancer-related lymphedema (BCRL. Material: A total of 35 women with BCRL were enrolled. Of these, 29 patients completed the study. Methods: Ultrasound (B-mode was used to evaluate lymphedema in the side of the chest after mastectomy. This test was performed three times at a specific site on the operated side and symmetrically on the opposite side. Subsequently, patients were fit with an appropriate compression corset. The data were then statistically analyzed. Conclusion: After the surgical treatment of breast cancer, lymphatic fluid reservoirs may form at the side of the chest. The use of carefully selected compression corsets is an effective treatment for BCRL. Corsets are an important item, which we recommend should be included in compression clothing sets. We anticipate this finding will form the foundation for further work on the use of modern compression garments for the treatment of BCRL as well as contribute to the limited number of published reports that exist on the subject. Keywords: lymphedema, breast cancer, physical therapy

  17. Results of emergency management of acute abdomen in adults based on clinical assessment and basic imaging investigations: are advanced imaging techniques always necessary for successful treatment?

    OpenAIRE

    Sangram Karandikar

    2016-01-01

    Background: The term acute abdomen refers to signs and symptoms of abdominal pain and tenderness, a clinical presentation that may require emergency surgical treatment. Patients suffering from both, surgical as well as medical diseases may present with acute abdomen. The main objectives of the study are to identify common causes of acute abdomen, to assess the need for urgent surgical intervention in these patients and to evaluate role of basic diagnostic techniques and need of advanced imagi...

  18. Verrucous lesions arising in lymphedema and diabetic neuropathy: Elephantiasis nostras verrucosa or verrucous skin lesions on the feet of patients with diabetic neuropathy?

    Science.gov (United States)

    Hotta, Eri; Asai, Jun; Okuzawa, Yasutaro; Hanada, Keiji; Nomiyama, Tomoko; Takenaka, Hideya; Katoh, Norito

    2016-03-01

    Verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) develop in areas with sensory loss in diabetic patients. Although various types of chronic stimulation, such as pressure or friction, are considered an important factor in the development of such lesions, the precise pathogenesis of VSLDN remains obscure, and there is currently no established treatment for this disease. Here, we present a case of VSLDN on the dorsum of the right foot. However, because lymphedema was also observed at the same site, this lesion could also be diagnosed as elephantiasis nostras verrucosa arising in diabetic neuropathy. The lesion was successfully treated with a combination of elastic stocking and mixed killed bacterial suspension and hydrocortisone ointment, which suggested that VSLDN might have been exacerbated by the pre-existing lymphedema. Because various types of chronic stimulation can trigger VSLDN, treatment plans should be devised on a case-by-case basis. Therefore, it is important to investigate the presence of factors that can induce or exacerbate chronic inflammatory stimulation, such as lymphedema in our case, in each patient with VSLDN. © 2015 Japanese Dermatological Association.

  19. Safety of weightlifting among women with or at risk for breast cancer-related lymphedema: musculoskeletal injuries and health care use in a weightlifting rehabilitation trial.

    Science.gov (United States)

    Brown, Justin C; Troxel, Andrea B; Schmitz, Kathryn H

    2012-01-01

    It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs.

  20. Health Insurance Basics

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

  1. PASCAL vs BASIC

    Science.gov (United States)

    Mundie, David A.

    1978-01-01

    A comparison between PASCAL and BASIC as general purpose microprocessor languages rates PASCAL above BASIC in such points as program structure, data types, structuring methods, control structures, procedures and functions, and ease in learning. (CMV)

  2. Basic Research Firing Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Basic Research Firing Facility is an indoor ballistic test facility that has recently transitioned from a customer-based facility to a dedicated basic research...

  3. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions ...

  4. Basic research for environmental restoration

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-01

    The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs.

  5. Basic research for environmental restoration

    International Nuclear Information System (INIS)

    1990-12-01

    The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs

  6. 49 CFR 633.21 - Basic requirement.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

  7. Basic Cake Decorating Workbook.

    Science.gov (United States)

    Bogdany, Mel

    Included in this student workbook for basic cake decorating are the following: (1) Drawings of steps in a basic way to ice a layer cake, how to make a paper cone, various sizes of flower nails, various sizes and types of tin pastry tubes, and special rose tubes; (2) recipes for basic decorating icings (buttercream, rose paste, and royal icing);…

  8. Programming Visual Basic 2005

    CERN Document Server

    Liberty, Jesse

    2005-01-01

    This information-packed guide helps you understand Visual Basic 2005, the next-generation release of the popular Visual Basic programming language. This book aims to make you immediately productive in creating Windows and web applications using Visual Basic 2005 and all of its tools. Perfect for experienced VB6 and novice programmers

  9. 5 CFR 551.401 - Basic principles.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...

  10. Microsurgery guided by sequential preoperative lymphography using {sup 68}Ga-NEB PET and MRI in patients with lower-limb lymphedema

    Energy Technology Data Exchange (ETDEWEB)

    Long, Xiao; Gao, Chao; Yang, Elan [Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Plastic Surgery, Beijing (China); Zhang, Jingjing [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Beijing (China); National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine LOMIN, Bethesda, MD (United States); Zhang, Daming; Xue, Huadan [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiology, Beijing (China); Chi, Chongwei [Institute of Automation Chinese Academy of Sciences Beijing, Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Beijing (China); Lang, Lixin; Niu, Gang; Chen, Xiaoyuan [National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine LOMIN, Bethesda, MD (United States); Zhu, Zhaohui; Li, Fang [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Beijing (China)

    2017-08-15

    The popularity of contemporary microsurgical techniques in treatment of lower-limb lymphedema calls for better visualization of the lymphatic system, both preoperatively and intra-operatively. The aim of this prospective study was to investigate the feasibility of a novel combination of {sup 68}Ga-NEB positron emission tomography (PET) with magnetic resonance lymphography (MRL) in evaluating lymphedema and guiding surgical intervention. A total of 11 patients (F 9, M 2, age range 29-69 y) with lower-limb lymphedema classified into stage I to III were recruited. PET acquisition was performed at 30, 60 and 90 min after subcutaneous injection of the albumin-binding radiotracer {sup 68}Ga-NEB into the bilateral first web spaces of the feet. All the patients were also subjected to {sup 99m}Tc-sulfur colloid (SC) lymphoscintigraphy for comparison. Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed using sequences specialized for lymphatic vessel scans. All the patients underwent surgical interventions within a week. The surgical approach includes the use of a linear marker for edema localization and indocyanine green (ICG) lymphography with a near-infrared surgical navigation system intra-operatively. Lymph transport in lymphatic channels was clearly observed by visualization of {sup 68}Ga-NEB activity in the lymphatic vessels and within lymph nodes for all 11 patients as well as the visualization of the edema section plane with dermal backflow (DB), abnormally increased and disconnected uptake along the lymphatic channels. Preoperative {sup 68}Ga-NEB PET combined with MRL provides advantageous three-dimensional images, higher temporal resolution, significantly shorter time lapse before image acquisition after tracer injection and more accurate pathological lymphatic vessel distribution than {sup 99m}Tc-SC lymphoscintigraphy combined with MRI. This study documented an effective imaging pattern to combine {sup 68}Ga-NEB PET and MRL in patients with lower

  11. Microsurgery guided by sequential preoperative lymphography using 68Ga-NEB PET and MRI in patients with lower-limb lymphedema

    International Nuclear Information System (INIS)

    Long, Xiao; Gao, Chao; Yang, Elan; Zhang, Jingjing; Zhang, Daming; Xue, Huadan; Chi, Chongwei; Lang, Lixin; Niu, Gang; Chen, Xiaoyuan; Zhu, Zhaohui; Li, Fang

    2017-01-01

    The popularity of contemporary microsurgical techniques in treatment of lower-limb lymphedema calls for better visualization of the lymphatic system, both preoperatively and intra-operatively. The aim of this prospective study was to investigate the feasibility of a novel combination of 68 Ga-NEB positron emission tomography (PET) with magnetic resonance lymphography (MRL) in evaluating lymphedema and guiding surgical intervention. A total of 11 patients (F 9, M 2, age range 29-69 y) with lower-limb lymphedema classified into stage I to III were recruited. PET acquisition was performed at 30, 60 and 90 min after subcutaneous injection of the albumin-binding radiotracer 68 Ga-NEB into the bilateral first web spaces of the feet. All the patients were also subjected to 99m Tc-sulfur colloid (SC) lymphoscintigraphy for comparison. Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed using sequences specialized for lymphatic vessel scans. All the patients underwent surgical interventions within a week. The surgical approach includes the use of a linear marker for edema localization and indocyanine green (ICG) lymphography with a near-infrared surgical navigation system intra-operatively. Lymph transport in lymphatic channels was clearly observed by visualization of 68 Ga-NEB activity in the lymphatic vessels and within lymph nodes for all 11 patients as well as the visualization of the edema section plane with dermal backflow (DB), abnormally increased and disconnected uptake along the lymphatic channels. Preoperative 68 Ga-NEB PET combined with MRL provides advantageous three-dimensional images, higher temporal resolution, significantly shorter time lapse before image acquisition after tracer injection and more accurate pathological lymphatic vessel distribution than 99m Tc-SC lymphoscintigraphy combined with MRI. This study documented an effective imaging pattern to combine 68 Ga-NEB PET and MRL in patients with lower-limb lymphedema. This strategy

  12. Fatores associados ao linfedema em pacientes com câncer de mama Associated factors of lymphedema in breast cancer patients

    Directory of Open Access Journals (Sweden)

    Daniella Marta Ferreira de Paiva

    2011-02-01

    Full Text Available OBJETIVO: determinar a prevalência e os fatores associados ao linfedema em pacientes com câncer de mama. MÉTODOS: este estudo de corte transversal incluiu 250 mulheres com mais de seis meses de tratamento para o câncer de mama, que compareceram ao Ambulatório de Mastologia e Oncologia para consulta de seguimento em um Centro de Referência em Oncologia, em Juiz de Fora, Minas Gerais. Elas foram entrevistadas e submetidas à avaliação física. Foram colhidos dados de prontuário relacionados ao tratamento da neoplasia, à intervenção axilar e ao tumor. Diagnosticou-se linfedema quando a diferença entre os membros superiores foi maior ou igual a 2 cm pela perimetria. Os grupos de mulheres com e sem linfedema foram comparados em relação aos possíveis fatores de risco, e as medidas de tendência central, dispersão e prevalência foram obtidas admitindo o nível de significância de 95%. RESULTADOS: Cento e doze mulheres (44,8% apresentaram linfedema. Foi encontrada diferença significativa entre os grupos de mulheres com e sem linfedema em relação à mediana de linfonodos retirados (p=0,02; apresentação de trombose linfática superficial no braço homolateral à cirurgia (pPURPOSE: 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

  13. Importance of basic therapy in psoriasis.

    Science.gov (United States)

    Thaçi, Diamant; Augustin, Matthias; Krutmann, Jean; Luger, Thomas

    2015-05-01

    Basic therapy plays an important role in the management of psoriasis, regardless of disease severity or the therapeutic concept used. It helps reduce symptoms such as pruritus and scaling, decreases exacerbations, and may therefore prolong the remission period after successful antipsoriatic treatment. Accordingly, adequate basic therapy can also have a positive effect on patients' severely impaired quality of life. Unfortunately, the importance of basic therapy in psoriasis is still underestimated. Based on clinical trial data, the present review highlights the efficacy and potential of basic therapy, and focuses on new data and developments in this field.

  14. Information management in the Basic Services to the Urban Poor (BUSP) scheme in Kalyan Dombivili (Maharashtra, India) and implications for Geographic Information System (GIS) development

    NARCIS (Netherlands)

    Richter, C.

    2014-01-01

    Urban poverty alleviation schemes in India continue to target mainly slum areas. An important aspect in the planning, implementation, and monitoring of such government schemes pertains to the procedure and practices of spatial and socio-spatial information management in municipal administration.

  15. Basic digital signal processing

    CERN Document Server

    Lockhart, Gordon B

    1985-01-01

    Basic Digital Signal Processing describes the principles of digital signal processing and experiments with BASIC programs involving the fast Fourier theorem (FFT). The book reviews the fundamentals of the BASIC program, continuous and discrete time signals including analog signals, Fourier analysis, discrete Fourier transform, signal energy, power. The text also explains digital signal processing involving digital filters, linear time-variant systems, discrete time unit impulse, discrete-time convolution, and the alternative structure for second order infinite impulse response (IIR) sections.

  16. Basic algebraic topology

    CERN Document Server

    Shastri, Anant R

    2013-01-01

    Introduction The Basic Problem Fundamental Group Function Spaces and Quotient Spaces Relative Homotopy Some Typical Constructions Cofibrations Fibrations Categories and Functors Cell Complexes and Simplicial Complexes Basics of Convex Polytopes Cell Complexes Product of Cell Complexes Homotopical Aspects Cellular Maps Abstract Simplicial Complexes Geometric Realization of Simplicial Complexes Barycentric Subdivision Simplicial Approximation Links and Stars Covering Spaces and Fundamental Group Basic Definitions Lifting Properties Relation with the Fundamental Group Classification of Covering P

  17. Hydromechanics - basic properties

    International Nuclear Information System (INIS)

    Lee, Sung Tak; Lee, Je Geun

    1987-03-01

    This book tells of hydromechanics, which is about basic properties of hydromechanics such as conception, definition, mass, power and weight, and perfect fluid and perfect gas, hydrostatics with summary, basic equation of hydrostatics, relative balance of hydrostatics, and kinematics of hydromechanics, description method of floating, hydromechanics about basic knowledge, equation of moment, energy equation and application of Bernoulli equation, application of momentum theory, inviscid flow and fluid measuring.

  18. Basic molecular spectroscopy

    CERN Document Server

    Gorry, PA

    1985-01-01

    BASIC Molecular Spectroscopy discusses the utilization of the Beginner's All-purpose Symbolic Instruction Code (BASIC) programming language in molecular spectroscopy. The book is comprised of five chapters that provide an introduction to molecular spectroscopy through programs written in BASIC. The coverage of the text includes rotational spectra, vibrational spectra, and Raman and electronic spectra. The book will be of great use to students who are currently taking a course in molecular spectroscopy.

  19. Physical Activity Basics

    Science.gov (United States)

    ... Weight Breastfeeding Micronutrient Malnutrition State and Local Programs Physical Activity Basics Recommend on Facebook Tweet Share Compartir How much physical activity do you need? Regular physical activity helps ...

  20. Effect of proprioceptive neuromuscular facilitation D2 flexion and breathing exercises on lymphedema without a short stretch compression bandage.

    Science.gov (United States)

    Hwang, Woon Taek; Chung, Sin Ho; Chung, Min Sung; Lee, Kyu Hoon; Kim, Taikon

    2015-10-01

    [Purpose] The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation (PNF) D2 flexion and breathing exercises in a patient with lymphedema (LE). [Subject] This report describes a 57-year-old woman with LE in whom a short-stretch compression bandage (SSCB) could not be used for treatment because of skin itching and redness. [Methods] The patient received complex decongestive therapy without a SSCB. Next, PNF D2 flexion and breathing exercises were conducted three times per week for 14 weeks (36 times). [Results] As a result, the circumference of the armpit was reduced by 0.5 cm; that of 10 cm above the elbow, by 1 cm; that of the elbow, by 0.5 cm; that of 10 cm below the elbow, by 1 cm; and that of the back of the hand, by 0.5 cm. A total of 100 mL (9.4%) of body water was eliminated from the right upper extremity, and moisture ratio was reduced by 0.005%. Finally, range of motion was improved to 20° flexion, 60° abduction, 40° external rotation, and 10° internal rotation. [Conclusion] This study showed that PNF D2 flexion and breathing exercises were effective in reducing LE and improving range of motion.

  1. Evaluation of patient-relevant outcomes of lymphedema and lipedema treatment: development and validation of a new benefit tool.

    Science.gov (United States)

    Blome, C; Augustin, M; Heyer, K; Knöfel, J; Cornelsen, H; Purwins, S; Herberger, K

    2014-01-01

    Patient-relevant treatment benefit is traditionally measured with health-related quality of life (HRQoL) instruments. The Patient Benefit Index (PBI) methodology allows for a more direct measurement, with the patients rating both importance and achievement of treatment goals. Here, we developed and validated a PBI version specific for the assessment of benefit in lymphedema and lipedema treatment (PBI-L). The development included five steps: (1) open item collection; (2) consensus of items in a multidisciplinary expert panel; (3) application of the German PBI-L in a cross-sectional study (n = 301); (4) translation into English; (5) application of the English PBI-L in a randomized clinical trial (n = 82). Subscales were developed using factor analysis. Construct validity was analyzed by correlating PBI-L and convergent criteria such as HRQoL and quality of care. To test for responsiveness, the association to change in HRQoL measures was computed. Floor and ceiling effects were low. There were few missing values. Two well-interpretable subscales were found with Cronbach's alpha >0.8 each. Global and subscale scores correlated with convergent criteria and with change in disease-specific HRQoL, but not with change in generic HRQoL. The PBI-L is an internally consistent, valid, and responsive instrument for the assessment of patient-relevant benefit of edema treatment. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

    Directory of Open Access Journals (Sweden)

    Moris Topaz

    2012-01-01

    Full Text Available Regulated negative pressure-assisted wound therapy (RNPT should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

  3. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment.

    Science.gov (United States)

    Topaz, Moris

    2012-05-01

    Regulated negative pressure-assisted wound therapy (RNPT) should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound's environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT) is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

  4. Basic standards for radiation protection

    International Nuclear Information System (INIS)

    Webb, G.A.M.

    1982-01-01

    The basic standards for radiation protection have been based, for many years, on the recommendations of the International Commission of Radiological Protection. The three basic standards recommended by the Commission may be summarized as ''justification, optimization of protection and adherence to dose limitations. The applications of these basic principles to different aspects of protection are briefly summarized and the particular ways in which they have been applied to waste described in more detail. The application of dose limits, both in the control of occupational exposure and in regulating routine discharges of radioactive effluents is straight forward in principle although the measurement and calculational requirements may be substantial. Secondary standards such as derived limits may be extremely useful and the principles underlying their derivation will be described. Optimization of protection is inherently a more difficult concept to apply in protection and the various techniques used will be outlined by with particular emphasis on the use of cost benefit analysis are recommended by the ICRP. A review will be given of the problems involved in extending these basic concepts of the ICRP to probabilistic analyses such as those required for assessing the consequences of accidents or disruptive events in long term repositories. The particular difficulties posed by the very long timescales involved in the assessment of waste management practices will be discussed in some detail. (orig./RW)

  5. BASIC Beats PASCAL.

    Science.gov (United States)

    Ever, Jacob

    1981-01-01

    Features of two versions of the BASIC programing language are compared with the features of the PASCAL programing language. The application chosen for comparison was a word processor. The conclusion was that PASCAL had the best language features, but BASIC had better systems capabilities. (MP)

  6. Basic Electronics I.

    Science.gov (United States)

    Robertson, L. Paul

    Designed for use in basic electronics programs, this curriculum guide is comprised of twenty-nine units of instruction in five major content areas: Orientation, Basic Principles of Electricity/Electronics, Fundamentals of Direct Current, Fundamentals of Alternating Current, and Applying for a Job. Each instructional unit includes some or all of…

  7. Finding Basic Writing's Place.

    Science.gov (United States)

    Sheridan-Rabideau, Mary P.; Brossell, Gordon

    1995-01-01

    Posits that basic writing serves a vital function by providing writing support for at-risk students and serves the needs of a growing student population that universities accept yet feel needs additional writing instruction. Concludes that the basic writing classroom is the most effective educational support for at-risk students and their writing.…

  8. Basic Cancer Terms

    Science.gov (United States)

    ... basics of cancer . Carcinoma Cancer that starts in skin or tissues that line the inside or cover the outside of internal organs. Cells The basic units that make up the human body. Chemoprevention The use of natural, synthetic (made in a laboratory), or biologic (from a ...

  9. Nuclear multifragmentation: Basic concepts

    Indian Academy of Sciences (India)

    2014-05-02

    May 2, 2014 ... Abstract. We present a brief overview of nuclear multifragmentation reaction. Basic formalism of canonical thermodynamical model based on equilibrium statistical mechanics is described. This model is used to calculate basic observables of nuclear multifragmentation like mass distribution, fragment ...

  10. PRINCIPLES OF HYDROGEOMORPHOLOGY AS A BASIC PRECONDITION FOR SOLUTION OF TERRITORIAL STRUCTURE OF UNITARY SYSTEM OF AGRICULTURAL, FOREST AND WATER MANAGEMENT

    Directory of Open Access Journals (Sweden)

    K KUDRNA

    2007-07-01

    Full Text Available In the presented work, the laws of hydrogeomorfhology have been defi ned on the principle of symmetry and invariance, which are to be respected at solution of territorial structure of Unitary System of Agricultural, Forest and Water Management (USAFWM. The principle of the solution is a dominant position of the geomorphologic formation Gh of a given sea-level altitude in the analyzed part of territory, which determines control and regulation of all components of water balance. The newly formed territory unit, delimited around the geomorphologic formation by water streams, was called a hydrogeomorphologic region of the third order (HGR-3.

  11. Positron emission tomography basic sciences

    CERN Document Server

    Townsend, D W; Valk, P E; Maisey, M N

    2003-01-01

    Essential for students, science and medical graduates who want to understand the basic science of Positron Emission Tomography (PET), this book describes the physics, chemistry, technology and overview of the clinical uses behind the science of PET and the imaging techniques it uses. In recent years, PET has moved from high-end research imaging tool used by the highly specialized to an essential component of clinical evaluation in the clinic, especially in cancer management. Previously being the realm of scientists, this book explains PET instrumentation, radiochemistry, PET data acquisition and image formation, integration of structural and functional images, radiation dosimetry and protection, and applications in dedicated areas such as drug development, oncology, and gene expression imaging. The technologist, the science, engineering or chemistry graduate seeking further detailed information about PET, or the medical advanced trainee wishing to gain insight into the basic science of PET will find this book...

  12. Health insurance basic actuarial models

    CERN Document Server

    Pitacco, Ermanno

    2014-01-01

    Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

  13. The Impact of L-Dex® Measurements in Assessing Breast Cancer Related Lymphedema (BCRL as Part of Routine Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alison L. Laidley, MD

    2016-09-01

    Full Text Available Purpose: With improved survivorship, the prevalence of breast cancer related lymphedema (BCRL continues to increase, leading to impairment of a patients’ quality of life. While traditional diagnostic methods are limited by an inability to detect BCRL until clinically apparent, bioimpedance spectroscopy (BIS has been shown to detect subclinical BCRL. The purpose of this study is to evaluate the role of BIS in the early detection of BCRL as well as assessment of response to BCRL treatment. Methods: A retrospective review of 1,133 patients treated between November 2008 and July 2013 at two surgical practices was performed. Eligible patients (n=326 underwent pre-operative and post-operative L-Dex measurements. Patients were identified as having subclinical lymphedema if they were asymptomatic and the L-Dex score increased > 10 units above baseline and were monitored following treatment. Patients were stratified by lymph node dissection technique (SLNB vs. ALND and receipt of BCRL treatment.Results: The average age of the cohort was 56.2 years old and mean follow-up was 21.7 months. Of the 326 patients, 210 underwent SLNB and 116 underwent ALND. BCRL was identified by L-Dex in 40 patients (12.3%. The cumulative incidence rate of subclinical lymphedema was 4.3% for SLNB (n=9 and 26.7% for ALND (n=31. Of those diagnosed with BCRL, 50% resolved following treatment, 27.5% underwent treatment without resolution, and 22.5% had resolution without treatment. The prevalence of persistent, clinical BCRL was 0.5% for SLNB and 8.6% for ALND.Conclusions: This study demonstrates both the feasibility and clinical utility of implementing L-Dex measurements in routine breast cancer care. L-Dex identified patients with possible subclinical BCRL and allowed for assessment of response to therapy.

  14. Dynamic analysis of muscular lymphokinetic activities in the treatment of lymphedema of the upper limbs - doi:10.5020/18061230.2007.p233

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Guerreiro Godoy

    2012-01-01

    Full Text Available The aim of the present study was to evaluate the resting and working pressures associated to a restrain mechanism, in patients suffering from lymphedema of the upper limbs, postbreast cancer treatment, whilst performing occupational and day-to-day self-care activities. Six female patients under treatment of lymphedema due to surgical, radiotherapeutic and chemotherapeutic treatment of breast cancer, in the age group between 32 and 76 years (mean 54 years old, ± 31.11 were selected. A compression sleeve of “gorgurão” (cotton-polyester material was applied as a restrain mechanism. The occupational and daily personal care activities evaluated were those common to all participants. These activities included washingup, cooking in a small pan, sweeping the floor using the affected arm, brushing the teeth, brushing the hair, washing small items of clothes, ironing clothes and making the bed. For statistical analysis, mean and standard deviation between resting pressures and minimum and maximum working pressures were determined. The two-tailed student t-test and variance analysis were used for repeated measurements. The Bonferroni limit was used in the analysis of the variables to calculate the alpha error, with a value of 5%, considered statistically significant. All of the analyzed activities associated to the “gorgurão” compression sleeve generated both resting and working pressures (p <0.005. In conclusion, the occupational daily life tasks used in the present study generate resting and working pressures and can be used as a form of treatment of the lymphedema.

  15. Safety of Weightlifting Among Women with or at Risk for Breast Cancer–Related Lymphedema: Musculoskeletal Injuries and Health Care Use in a Weightlifting Rehabilitation Trial

    Science.gov (United States)

    Brown, Justin C.; Troxel, Andrea B.

    2012-01-01

    Introduction. It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Methods. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. Results. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Conclusion. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs. PMID:22752068

  16. Basic rocks in Finland

    International Nuclear Information System (INIS)

    Piirainen, T.; Gehoer, S.; Iljina, M.; Kaerki, A.; Paakkola, J.; Vuollo, J.

    1992-10-01

    Basic igneous rocks, containing less than 52% SiO 2 , constitute an important part of the Finnish Archaean and Proterozoic crust. In the Archaean crust exist two units which contain the majority of the basic rocks. The Arcaean basic rocks are metavolcanics and situated in the Greenstone Belts of Eastern Finland. They are divided into two units. The greenstones of the lower one are tholeiites, komatiites and basaltic komatiites. The upper consists of bimodal series of volcanics and the basic rocks of which are Fe-tholeiites, basaltic komatiites and komatiites. Proterozoic basic rocks are divided into seven groups according to their ages. The Proterozoic igneous activity started by the volominous basic magmatism 2.44 Ga ago. During this stage formed the layered intrusions and related dykes in the Northern Finland. 2.2 Ga old basic rocks are situated at the margins of Karelian formations. 2.1 Ga aged Fe-tholeiitic magmatic activity is widespread in Eastern and Northern Finland. The basic rocks of 1.97 Ga age group are met within the Karelian Schist Belts as obducted ophiolite complexes but they occur also as tholeiitic diabase dykes cutting the Karelian schists and Archean basement. The intrusions and the volcanics of the 1.9 Ga old basic igneous activity are mostly encountered around the Granitoid Complex of Central Finland. Subjotnian, 1.6 Ga aged tholeiitic diabases are situated around the Rapakivi massifs of Southern Finland, and postjotnian, 1.2 Ga diabases in Western Finland where they form dykes cutting Svecofennian rocks

  17. From basic needs to basic rights.

    Science.gov (United States)

    Facio, A

    1995-06-01

    After arriving at an understanding that basic rights refer to all human needs, it is clear that a recognition of the basic needs of female humans must precede the realization of their rights. The old Women in Development (WID) framework only understood women's needs from an androcentric perspective which was limited to practical interests. Instead, women's primary need is to be free from their subordination to men. Such an understanding places all of women's immediate needs in a new light. A human rights approach to development would see women not as beneficiaries but as people entitled to enjoy the benefits of development. Discussion of what equality before the law should mean to women began at the Third World Conference on Women in Nairobi where the issue of violence against women was first linked to development. While debate continues about the distinction between civil and political rights and economic, social, and cultural rights, the realities of women's lives do not permit such a distinction. The concept of the universality of human rights did not become codified until the UN proclaimed the Universal Declaration of Human Rights in 1948. The declaration has been criticized by feminists because the view of human rights it embodies has been too strongly influenced by a liberal Western philosophy which stresses individual rights and because it is ambiguous on the distinction between human rights and the rights of a citizen. The protection of rights afforded by the Declaration, however, should not be viewed as a final achievement but as an ongoing struggle. International conferences have led to an analysis of the human-rights approach to sustainable development which concludes that women continue to face the routine denial of their rights. Each human right must be redefined from the perspective of women's needs, which must also be redefined. Women must forego challenging the concept of the universality of human rights in order to overcome the argument of cultural

  18. Basic stress analysis

    CERN Document Server

    Iremonger, M J

    1982-01-01

    BASIC Stress Analysis aims to help students to become proficient at BASIC programming by actually using it in an important engineering subject. It also enables the student to use computing as a means of learning stress analysis because writing a program is analogous to teaching-it is necessary to understand the subject matter. The book begins by introducing the BASIC approach and the concept of stress analysis at first- and second-year undergraduate level. Subsequent chapters contain a summary of relevant theory, worked examples containing computer programs, and a set of problems. Topics c

  19. Quantum electronics basic theory

    CERN Document Server

    Fain, V M; Sanders, J H

    1969-01-01

    Quantum Electronics, Volume 1: Basic Theory is a condensed and generalized description of the many research and rapid progress done on the subject. It is translated from the Russian language. The volume describes the basic theory of quantum electronics, and shows how the concepts and equations followed in quantum electronics arise from the basic principles of theoretical physics. The book then briefly discusses the interaction of an electromagnetic field with matter. The text also covers the quantum theory of relaxation process when a quantum system approaches an equilibrium state, and explai

  20. Impacto dos marcadores socioeconômicos na gravidade do linfedema das extremidades inferiores Impact of socioeconomic markers in severity of lower extremity lymphedema

    Directory of Open Access Journals (Sweden)

    Aquiles Tadashi Ywata de Carvalho

    2011-12-01

    Full Text Available No Brasil, a incidência do linfedema é pouco conhecida e poucas são as documentações científicas reportando a associação do linfedema com os fatores sociais e econômicos na nossa região. O objetivo do estudo foi analisar o impacto dos marcadores socioeconômicos na gravidade do linfedema das extremidades inferiores conforme a classificação de Mowlem, na região metropolitana de Salvador (BA. Dos 324 pacientes estudados, 200 (62% eram do gênero feminino. A idade variou entre 14 e 69 anos, com mediana de 48 anos. Analisando comparativamente as variáveis: gravidade do linfedema versus grau de escolaridade e gravidade versus renda familiar, observou-se que 93,8% dos pacientes classificados como Mowlem III estavam incluídos no grupo dos pacientes sem escolaridade e/ou com renda familiar de até três salários-mínimos. Não houve registro de doença avançada em pacientes com renda familiar acima de sete salários-mínimos e/ou com terceiro grau completo.In Brazil, the incidence of lymphedema is poorly known, and there is little scientific documentation reporting the association of lymphedema with the social and economic factors in our region. The objective was to analyze the impact of socioeconomic markers on the severity of lymphedema of the lower extremities according to the classification of Mowlem in the metropolitan region of Salvador (BA, Brazil. Of the 324 patients studied, 200 (62% were female. The age ranged between 14 and 69 years, median 48 years. Comparatively analyzing the varying severity of lymphedema versus education level and severity versus family income, it showed that 93.8% of patients classified as Mowlem III were included in the group of patients without education and/or with income up to three minimum wages. There was no record of advanced disease in patients with family incomes greater than seven minimum wages and/or graduate.

  1. Higher vascular endothelial growth factor-C concentration in plasma is associated with increased forearm capillary filtration capacity in breast cancer-related lymphedema

    DEFF Research Database (Denmark)

    Jensen, Mads Radmer; Simonsen, Lene; Karlsmark, Tonny

    2015-01-01

    shown that the forearm capillary filtration coefficient (CFC) is increased bilaterally in BCRL. In this study, we aimed to elucidate if increased CFC is associated with low-grade inflammation and/or vascular endothelial growth factor-c (VEGF-C) signaling. Fourteen patients with unilateral BCRL and nine......Breast cancer-related lymphedema (BCRL) is a frequent, chronic and debilitating swelling that mainly affects the ipsilateral arm and develops as a complication to breast cancer treatment. The pathophysiology is elusive opposing development of means for prediction and treatment. We have earlier...... increased forearm CFC in BCRL subjects. Interstitially increased MCP-1 levels may augment local microvascular protein permeability in BCRL....

  2. HIV Treatment: The Basics

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Treatment: The Basics Last Reviewed: March 22, 2018 ...

  3. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David ...

  4. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David ...

  5. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord ... LLC Understanding Spinal Cord Injury About Us Expert Videos Contact Us Personal Experience Videos Blog Videos By ...

  6. Noise Radar Technology Basics

    National Research Council Canada - National Science Library

    Thayaparan, T; Wernik, C

    2006-01-01

    .... In this report, the basic theory of noise radar design is treated. The theory supports the use of noise waveforms for radar detection and imaging in such applications as covert military surveillance and reconnaissance...

  7. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of ... injury? What is a Spinal Cord Injury? SCI Medical Experts People Living With SCI Personal Experiences By ...

  8. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 ...

  9. Video Screen Capture Basics

    Science.gov (United States)

    Dunbar, Laura

    2014-01-01

    This article is an introduction to video screen capture. Basic information of two software programs, QuickTime for Mac and BlueBerry Flashback Express for PC, are also discussed. Practical applications for video screen capture are given.

  10. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD Kristine Cichowski, MS Read Bio Founding ...

  11. Basic Information about Mercury

    Science.gov (United States)

    ... Your Environment Contact Us Share Basic Information about Mercury On this page: What is mercury? Emissions of ... Consumer products that traditionally contain mercury What is Mercury? Mercury is a naturally-occurring chemical element found ...

  12. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children ...

  13. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  14. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries ... Therapy-Lokomat T. George Hornby, PhD, PT Empowering the Patient After Spinal Cord Injury Guy W. Fried, ...

  15. Radionuclide Basics: Iodine

    Science.gov (United States)

    ... Search Radiation Protection Contact Us Share Radionuclide Basics: Iodine Iodine (chemical symbol I) is a chemical element. ... in the environment Iodine sources Iodine and health Iodine in the Environment All 37 isotopes of iodine ...

  16. Basic Concurrency Theory

    DEFF Research Database (Denmark)

    Løvengreen, Hans Henrik

    2002-01-01

    In this set of notes, we present some of the basic theory underlying the discipline of programming with concurrent processes/threads. The notes are intended to supplement a standard textbook on concurrent programming.......In this set of notes, we present some of the basic theory underlying the discipline of programming with concurrent processes/threads. The notes are intended to supplement a standard textbook on concurrent programming....

  17. Transportation Emissions: some basics

    DEFF Research Database (Denmark)

    Kontovas, Christos A.; Psaraftis, Harilaos N.

    2016-01-01

    . The main purpose of this chapter is to introduce some basic concepts that are relevant in the quest of green transportation logistics. First, we present the basics of estimating emissions from transportation activities, the current statistics and future trends, as well as the total impact of air emissions...... of the energy efficiency gap and examines why governments and companies may forego cost-effective investments in energy efficiency, even though they could significantly reduce energy consumption at a lower cost....

  18. Basic Finite Element Method

    International Nuclear Information System (INIS)

    Lee, Byeong Hae

    1992-02-01

    This book gives descriptions of basic finite element method, which includes basic finite element method and data, black box, writing of data, definition of VECTOR, definition of matrix, matrix and multiplication of matrix, addition of matrix, and unit matrix, conception of hardness matrix like spring power and displacement, governed equation of an elastic body, finite element method, Fortran method and programming such as composition of computer, order of programming and data card and Fortran card, finite element program and application of nonelastic problem.

  19. Basic Monetary Economics

    OpenAIRE

    Farm, Ante

    2017-01-01

    This is an introduction to money and the workings of the financial system. The creation of money is discussed in detail in Chapter 1. Chapter 2 explains how international payments can add to money creation but also generate a new type of money, usually called Eurodollars. Basic securities are defined and characterized in Chapter 3, namely bills, bonds and shares, but basic derivatives, like futures, swaps, and options, are also discussed. Chapter 4 deals with pricing by banks when extending l...

  20. Catalyst in Basic Oleochemicals

    OpenAIRE

    Eva Suyenty; Herlina Sentosa; Mariani Agustine; Sandy Anwar; Abun Lie; Erwin Sutanto

    2007-01-01

    Currently Indonesia is the world largest palm oil producer with production volume reaching 16 million tones per annum. The high crude oil and ethylene prices in the last 3 – 4 years contribute to the healthy demand growth for basic oleochemicals: fatty acids and fatty alcohols. Oleochemicals are starting to replace crude oil derived products in various applications. As widely practiced in petrochemical industry, catalyst plays a very important role in the production of basic oleochemic...

  1. Design and Development of a Telerehabilitation Self-Management Program for Persons with Chronic Lower Limb Swelling and Mobility Limitations: Preliminary Evidence

    Directory of Open Access Journals (Sweden)

    Becky L. Faett

    2012-01-01

    Full Text Available This paper describes design and development of a self-management program, delivered by telerehabilitation (TR, to address the problem of chronic lower limb swelling in persons with limited mobility. The 18.6 million persons with limited mobility in the USA are at increased risk for chronic lower limb swelling and related secondary complications, including cellulitis and skin ulcers. Over time, chronic swelling often progresses to lymphedema, an incurable condition requiring lifelong care. Without successful self-management, lymphedema and its related complications inevitably worsen. Access and adherence to appropriate treatment are challenging for persons with limited mobility. Program development involved a structured process to establish content validity (videos and manuals, readability, suitability, and selection of a TR platform to deliver the educational program. Our goal was to develop a program that would engage patients in self-management skills. The TR software platform chosen, Versatile and Integrated System for Telerehabilitation (VISYTER was designed to facilitate face-to-face delivery of an interactive home-based self-management program via the internet in real time. Results demonstrated validity of the educational program and ease of use with TR. Future plans are to evaluate ability of this approach to promote self-management skills, home monitoring, and improved management of persons with lymphedema and limited mobility.

  2. Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study.

    Science.gov (United States)

    Kuroda, Kenji; Yamamoto, Yasuhiro; Yanagisawa, Manami; Kawata, Akira; Akiba, Naoya; Suzuki, Kensuke; Naritaka, Kazutoshi

    2017-07-25

    Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence. Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk. The cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m 2 (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030-2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126-4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148-5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120-2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3-6) and low-risk (scores 0-2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440-3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9-62.1%] for the high-risk group and 28.9% [95% CI, 21.1-38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0

  3. What is the effect of treating secondary lymphedema after breast cancer with complete decongestive physiotherapy when the bandage is replaced with Kinesio Textape? - A pilot study.

    Science.gov (United States)

    Melgaard, Dorte

    2016-08-01

    Secondary lymphedema (SL) following breast cancer is a well-known complication following surgery or radiation. SL may result in loss of functional ability, cosmetic deformities, physical discomfort, recurrent episodes of erysipelas, and psychological distress. There is no evidence as to what is the most effective treatment for SL. This randomized controlled pilot study included 10 patients treated for SL following breast cancer. The patients were included and screened for SL by a physiotherapist. They were randomized to treatment with CDP with Kinesio Textape or bandage for 4 weeks. Endpoints were quality of life, circumference of the arm, costs, and working environment for the physiotherapist. The two groups were comparable according to baseline data. Outcomes on quality of life, costs, and working environment for the physiotherapist; the treatment with CDP with tape was superior to the CDP with bandage treatment. In regard to reducing the circumference there was no difference. This randomized controlled pilot study shows that CDP with tape can be an alternative to CDP with bandage. The quality of life is higher, the economy and working environment is better, and the effect measured by circumference is comparable. More RCTs are required to increase the evidence for CDP with tape. Treating lymphedema with CDP with tape after breast cancer is a good alternative to CDP with bandage and makes it possible to treat more patients with less resources.

  4. Disección de aorta: Aspectos básicos y manejo endovascular Aortic dissection: Basic aspects and endovascular management

    Directory of Open Access Journals (Sweden)

    Nicolás I Jaramillo

    2005-08-01

    theoretically high risk of complications should render the surgeon extremely cautious especially with young patients. Conceptually, the endoluminal treatment in the acute phase seems to be the solution and will probably become a preferred therapy while technical refinement is under way. Worldwide experience is growing and with this a better understanding of the indications and limitations of this innovative therapy will be elucidated. The clinical, diagnostic and management perspectives on aortic dissection and its variants, aortic intramural hematoma and atherosclerotic aortic ulcer, are reviewed.

  5. Gestão da educação básica e o fortalecimento dos Conselhos Escolares Management of the basic education and the empowerment of the School Councils

    Directory of Open Access Journals (Sweden)

    Márcia Angela da S. Aguiar

    2008-01-01

    Full Text Available Examina-se a estratégia de implementação do Programa Nacional de Fortalecimento dos Conselhos Escolares adotada pela Secretaria de Educação Básica do Ministério da Educação com o objetivo de identificar os mecanismos utilizados para a inscrição da temática da gestão democrática na agenda das secretarias de educação e das escolas, bem como o envolvimento dos gestores e conselheiros escolares nos processos de formação promovidos pelo MEC, no período de 2004 a 2006.The strategy of implementation of the Programa Nacional de Fortalecimento dos Conselhos Escolares has been examined and adopted by the Secretary of Basic Education of the Department of Education (MEC with the objective to identify the mechanisms used for the registration of the themes - democratic management - in the agenda of the secretaries of education and the schools, as per the involvement of the managers and the school council members in the processes of formation promoted by the MEC, during the period of 2004 to 2006.

  6. Softver za proračun uzdužne statičke stabilnosti i upravljivosti aviona za osnovnu obuku pilota / Software for calculation of an axial static stability and management of airplanes for basic pilot training

    Directory of Open Access Journals (Sweden)

    Dalibor Petrović

    2006-07-01

    Full Text Available U ovom radu opisan je softver za proračun uzdužne statičke stabilnosti i upravljivosti aviona za osnovnu obuku pilota. Softver je urađen sa numerom da konstruktorima omogući brzo i lako dobijanje potrebnih rezultata vezanih za stabilnost i upravljivost kod preliminarnih proračuna vezanih za ovu vrstu aviona. Program je urađen na osnovu analize velikog broja aviona iz ove klase, a njegova tačnost je testirana na avionu "Lasta". Rezultati koji su dobijeni ovim softverom bili su više od zadovoljavajućih, s obzirom na to da se radi o programu koji bi se koristio za preliminarni proračun. / This document introduced software for calculation of an axial static stability and management of airplanes for basic pilot training. The purpose of this software is to provide a quicker and an easier way of getting results regarding preliminary calculation of stability and management for these types of airplanes. The program is based upon analysis of data gathered from a large number of tested airplanes of this class. The accuracy of the program has been tested on the airplane type 'Lasta' and results were more than satisfying, especially regarding the fact that the program is meant to be used for preliminary calculation.

  7. Basic Electromagnetism and Materials

    CERN Document Server

    Moliton, André

    2007-01-01

    Basic Electromagnetism and Materials is the product of many years of teaching basic and applied electromagnetism. This textbook can be used to teach electromagnetism to a wide range of undergraduate science majors in physics, electrical engineering or materials science. However, by making lesser demands on mathematical knowledge than competing texts, and by emphasizing electromagnetic properties of materials and their applications, this textbook is uniquely suited to students of materials science. Many competing texts focus on the study of propagation waves either in the microwave or optical domain, whereas Basic Electromagnetism and Materials covers the entire electromagnetic domain and the physical response of materials to these waves. Professor André Moliton is Director of the Unité de Microélectronique, Optoélectronique et Polymères (Université de Limoges, France), which brings together three groups studying the optoelectronics of molecular and polymer layers, micro-optoelectronic systems for teleco...

  8. Comprehensive basic mathematics

    CERN Document Server

    Veena, GR

    2005-01-01

    Salient Features As per II PUC Basic Mathematics syllabus of Karnataka. Provides an introduction to various basic mathematical techniques and the situations where these could be usefully employed. The language is simple and the material is self-explanatory with a large number of illustrations. Assists the reader in gaining proficiency to solve diverse variety of problems. A special capsule containing a gist and list of formulae titled ''REMEMBER! Additional chapterwise arranged question bank and 3 model papers in a separate section---''EXAMINATION CORNER''.

  9. Basic Financial Accounting

    DEFF Research Database (Denmark)

    Wiborg, Karsten

    This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects: busin......: business entities, the transformation process, types of businesses, stakeholders, legislation, the annual report, the VAT system, double-entry bookkeeping, inventories, and year-end cast flow analysis.......This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects...

  10. Ecology and basic laws

    International Nuclear Information System (INIS)

    Mayer-Tasch, P.C.

    1980-01-01

    The author sketches the critical relation between ecology and basic law - critical in more than one sense. He points out the incompatibility of constitutional states and atomic states which is due to constitutional order being jeopardised by nuclear policy. He traces back the continuously rising awareness of pollution and the modern youth movement to their common root i.e. the awakening, the youth movement of the turn of the century. Eventually, he considers an economical, political, and social decentralization as a feasible alternative which would considerably relieve our basic living conditions from the threatening forms of civilization prevailing. (HSCH) [de

  11. Basic set theory

    CERN Document Server

    Levy, Azriel

    2002-01-01

    An advanced-level treatment of the basics of set theory, this text offers students a firm foundation, stopping just short of the areas employing model-theoretic methods. Geared toward upper-level undergraduate and graduate students, it consists of two parts: the first covers pure set theory, including the basic motions, order and well-foundedness, cardinal numbers, the ordinals, and the axiom of choice and some of it consequences; the second deals with applications and advanced topics such as point set topology, real spaces, Boolean algebras, and infinite combinatorics and large cardinals. An

  12. Basic properties of semiconductors

    CERN Document Server

    Landsberg, PT

    2013-01-01

    Since Volume 1 was published in 1982, the centres of interest in the basic physics of semiconductors have shifted. Volume 1 was called Band Theory and Transport Properties in the first edition, but the subject has broadened to such an extent that Basic Properties is now a more suitable title. Seven chapters have been rewritten by the original authors. However, twelve chapters are essentially new, with the bulk of this work being devoted to important current topics which give this volume an almost encyclopaedic form. The first three chapters discuss various aspects of modern band theory and the

  13. Foundation of Basic Arithmetic

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 2. Foundation of Basic Arithmetic. Jasbir S Chahal. General Article Volume 11 Issue 2 February 2006 pp 6-16. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/011/02/0006-0016. Keywords. Different ...

  14. Basic Tuberculosis Facts

    Centers for Disease Control (CDC) Podcasts

    2012-03-12

    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses basic TB prevention, testing, and treatment information.  Created: 3/12/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/12/2012.

  15. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Heather Taylor, PhD Michelle Meade, PhD Jonathon Rose, PhD The Basics of Spinal Cord Injury Rehabilitation Kristine Cichowski, ... Cord Injury Katie Powell, OT Mary Jane Mulcahey, PhD, OTR/L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord ...

  16. Basic radiation oncology

    International Nuclear Information System (INIS)

    Beyzadeoglu, M. M.; Ebruli, C.

    2008-01-01

    Basic Radiation Oncology is an all-in-one book. It is an up-to-date bedside oriented book integrating the radiation physics, radiobiology and clinical radiation oncology. It includes the essentials of all aspects of radiation oncology with more than 300 practical illustrations, black and white and color figures. The layout and presentation is very practical and enriched with many pearl boxes. Key studies particularly randomized ones are also included at the end of each clinical chapter. Basic knowledge of all high-tech radiation teletherapy units such as tomotherapy, cyberknife, and proton therapy are also given. The first 2 sections review concepts that are crucial in radiation physics and radiobiology. The remaining 11 chapters describe treatment regimens for main cancer sites and tumor types. Basic Radiation Oncology will greatly help meeting the needs for a practical and bedside oriented oncology book for residents, fellows, and clinicians of Radiation, Medical and Surgical Oncology as well as medical students, physicians and medical physicists interested in Clinical Oncology. English Edition of the book Temel Radyasyon Onkolojisi is being published by Springer Heidelberg this year with updated 2009 AJCC Staging as Basic Radiation Oncology

  17. Basic physics for all

    CERN Document Server

    Kumar, B N

    2012-01-01

    This is a simple, concise book for both student and non-physics students, presenting basic facts in straightforward form and conveying fundamental principles and theories of physics. This book will be helpful as a supplement to class teaching and to aid those who have difficulty in mastering concepts and principles.

  18. Basic Electronics II.

    Science.gov (United States)

    Willison, Neal A.; Shelton, James K.

    Designed for use in basic electronics programs, this curriculum guide is comprised of 15 units of instruction. Unit titles are Review of the Nature of Matter and the P-N Junction, Rectifiers, Filters, Special Semiconductor Diodes, Bipolar-Junction Diodes, Bipolar Transistor Circuits, Transistor Amplifiers, Operational Amplifiers, Logic Devices,…

  19. Greek Basic Course.

    Science.gov (United States)

    Defense Language Inst., Washington, DC.

    This course in Modern Greek, consisting of 100 lesson units in 13 volumes, is one of the Defense Language Institute's Basic Course Series. The course is designed to train native English language speakers to Level 3 proficiency in comprehension, speaking, reading, and writing Modern Greek. (Level 5 is native-speaker proficiency.) Lesson units…

  20. Basic Self-Esteem.

    Science.gov (United States)

    Kaeter, Margaret

    1993-01-01

    Training employees in basic skills necessitates sensitivity to their self-esteem. This can be achieved if the organizational culture supports training, the program is voluntary, it uses the group's strengths, it challenges them on an adult level, it does not resemble traditional schooling, and it builds in quick success. (SK)

  1. Basic Exchange Rate Theories

    NARCIS (Netherlands)

    J.G.M. van Marrewijk (Charles)

    2005-01-01

    textabstractThis four-chapter overview of basic exchange rate theories discusses (i) the elasticity and absorption approach, (ii) the (long-run) implications of the monetary approach, (iii) the short-run effects of monetary and fiscal policy under various economic conditions, and (iv) the transition

  2. Ethanol Basics (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2015-01-01

    Ethanol is a widely-used, domestically-produced renewable fuel made from corn and other plant materials. More than 96% of gasoline sold in the United States contains ethanol. Learn more about this alternative fuel in the Ethanol Basics Fact Sheet, produced by the U.S. Department of Energy's Clean Cities program.

  3. Basic Soils. Revision.

    Science.gov (United States)

    Montana State Univ., Bozeman. Dept. of Agricultural and Industrial Education.

    This curriculum guide is designed for use in teaching a course in basic soils that is intended for college freshmen. Addressed in the individual lessons of the unit are the following topics: the way in which soil is formed, the physical properties of soil, the chemical properties of soil, the biotic properties of soil, plant-soil-water…

  4. Basic chemistry for radioactive waste management

    International Nuclear Information System (INIS)

    Eom, Tae Yoon; Suh, Moo Yul; Joe, Kih Soo; Chung, Yong Sam; Kim, Jung Suk; Sohn, Se Chul; Han, Sun Ho; Jee, Kwang Yong; Choi, Kwang Soon; Lee, Chang Heon

    1991-03-01

    Chemical analysis methods on geological materials were investigated for the evaluation of radioactive waste disposal site, and the scope and contents weer as follows: -Determination of the major and trace elements in granite rocks by ICP-AES and INAA: Experimental conditions of ICP-AES and INAA were established with geological standard rock, USGS-G2. The ICP-AES was found to be better both in precision and in accuracy than the INAA for major elements. The precision and the accuracy of the ICP-AES method were about 6% and +/- 10%, respectively. -Determination of inorganic and organic anions by ion chromatography and prediction of retention times : Analytical methods for inorganic anions was established with NaOH eluents by ion chromatography. Studies on the prediction of retention times of the anions for gradient elution was carried out using the stepwise elution equation. The slope from the plot of log K' against log [OH - ] was obtained by a linear regression, and a good agreement was obtained between the experimental and the calculated values. -Development of analytical methods for the determination of Co, Ni and In by differential-pulse adsorptive stripping voltametry and ferrous and ferric ions by spectrometry : Detection limits of Co, Ni and In were 0.02, 0.05 and 0.2 ppb, respectively, and the content of ferrous and ferric ion in KAERI ground water were 0.12 and 0.08 ppm respectively. -Determination of trace uranium in groundwaters by neutron activation analysis : Uranium in KAERI groundwater was preconcentrated on the chelating resin, Chelex-100 and the uranium content was measured by neutron activation analysis. The analytical result was 4.5 ppb with standard deviation of 0.049. (Author)

  5. Radiation Therapy Risk Factors for Development of Lymphedema in Patients Treated With Regional Lymph Node Irradiation for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, Ravi A. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Miller, Cynthia L. [Harvard Medical School, Boston, Massachusetts (United States); Skolny, Melissa N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-03-15

    Purpose: We previously evaluated the risk of breast cancer-related lymphedema (LE) with the addition of regional lymph node irradiation (RLNR) and found an increased risk when RLNR is used. Here we analyze the association of technical radiation therapy (RT) factors in RLNR patients with the risk of LE development. Methods and Materials: From 2005 to 2012, we prospectively screened 1476 women for LE who underwent surgery for breast cancer. Among 1507 breasts treated, 172 received RLNR and had complete technical data for analysis. RLNR was delivered as supraclavicular (SC) irradiation (69% [118 of 172 patients]) or SC plus posterior axillary boost (PAB) (31% [54 of 172]). Bilateral arm volume measurements were performed pre- and postoperatively. Patients' RT plans were analyzed for SC field lateral border (relative to the humeral head), total dose to SC, RT fraction size, beam energy, and type of tangent (normal vs wide). Cox proportional hazards models were used to analyze associated risk factors for LE. Results: Median postoperative follow-up was 29.3 months (range: 4.9-74.1 months). The 2-year cumulative incidence of LE was 22% (95% confidence interval [CI]: 15%-32%) for SC and 20% (95% CI: 11%-37%) for SC plus PAB (SC+PAB). None of the analyzed variables was significantly associated with LE risk (extent of humeral head: P=.74 for <1/3 vs >2/3, P=.41 for 1/3 to 2/3 vs >2/3; P=.40 for fraction size of 1.8 Gy vs 2.0 Gy; P=.57 for beam energy 6 MV vs 10 MV; P=.74 for tangent type wide vs regular; P=.66 for SC vs SC+PAB). Only pretreatment body mass index (hazard ratio [HR]: 1.09; 95% CI: 1.04-1.15, P=.0007) and the use of axillary lymph node dissection (HR: 7.08, 95% CI: 0.98-51.40, P=.05) were associated with risk of subsequent LE development. Conclusions: Of the RT parameters tested, none was associated with an increased risk of LE development. This study underscores the need for future work investigating alternative RLNR risk factors for LE.

  6. Basics of statistical physics

    CERN Document Server

    Müller-Kirsten, Harald J W

    2013-01-01

    Statistics links microscopic and macroscopic phenomena, and requires for this reason a large number of microscopic elements like atoms. The results are values of maximum probability or of averaging. This introduction to statistical physics concentrates on the basic principles, and attempts to explain these in simple terms supplemented by numerous examples. These basic principles include the difference between classical and quantum statistics, a priori probabilities as related to degeneracies, the vital aspect of indistinguishability as compared with distinguishability in classical physics, the differences between conserved and non-conserved elements, the different ways of counting arrangements in the three statistics (Maxwell-Boltzmann, Fermi-Dirac, Bose-Einstein), the difference between maximization of the number of arrangements of elements, and averaging in the Darwin-Fowler method. Significant applications to solids, radiation and electrons in metals are treated in separate chapters, as well as Bose-Eins...

  7. Basics of RF electronics

    CERN Document Server

    Gallo, A

    2011-01-01

    RF electronics deals with the generation, acquisition and manipulation of high-frequency signals. In particle accelerators signals of this kind are abundant, especially in the RF and beam diagnostics systems. In modern machines the complexity of the electronics assemblies dedicated to RF manipulation, beam diagnostics, and feedbacks is continuously increasing, following the demands for improvement of accelerator performance. However, these systems, and in particular their front-ends and back-ends, still rely on well-established basic hardware components and techniques, while down-converted and acquired signals are digitally processed exploiting the rapidly growing computational capability offered by the available technology. This lecture reviews the operational principles of the basic building blocks used for the treatment of high-frequency signals. Devices such as mixers, phase and amplitude detectors, modulators, filters, switches, directional couplers, oscillators, amplifiers, attenuators, and others are d...

  8. Basic electronic circuits

    CERN Document Server

    Buckley, P M

    1980-01-01

    In the past, the teaching of electricity and electronics has more often than not been carried out from a theoretical and often highly academic standpoint. Fundamentals and basic concepts have often been presented with no indication of their practical appli­ cations, and all too frequently they have been illustrated by artificially contrived laboratory experiments bearing little relationship to the outside world. The course comes in the form of fourteen fairly open-ended constructional experiments or projects. Each experiment has associated with it a construction exercise and an explanation. The basic idea behind this dual presentation is that the student can embark on each circuit following only the briefest possible instructions and that an open-ended approach is thereby not prejudiced by an initial lengthy encounter with the theory behind the project; this being a sure way to dampen enthusiasm at the outset. As the investigation progresses, questions inevitably arise. Descriptions of the phenomena encounte...

  9. Basic linear algebra

    CERN Document Server

    Blyth, T S

    2002-01-01

    Basic Linear Algebra is a text for first year students leading from concrete examples to abstract theorems, via tutorial-type exercises. More exercises (of the kind a student may expect in examination papers) are grouped at the end of each section. The book covers the most important basics of any first course on linear algebra, explaining the algebra of matrices with applications to analytic geometry, systems of linear equations, difference equations and complex numbers. Linear equations are treated via Hermite normal forms which provides a successful and concrete explanation of the notion of linear independence. Another important highlight is the connection between linear mappings and matrices leading to the change of basis theorem which opens the door to the notion of similarity. This new and revised edition features additional exercises and coverage of Cramer's rule (omitted from the first edition). However, it is the new, extra chapter on computer assistance that will be of particular interest to readers:...

  10. Basic ergodic theory

    CERN Document Server

    Nadkarni, M G

    2013-01-01

    This is an introductory book on Ergodic Theory. The presentation has a slow pace and the book can be read by any person with a background in basic measure theory and metric topology. A new feature of the book is that the basic topics of Ergodic Theory such as the Poincare recurrence lemma, induced automorphisms and Kakutani towers, compressibility and E. Hopf's theorem, the theorem of Ambrose on representation of flows are treated at the descriptive set-theoretic level before their measure-theoretic or topological versions are presented. In addition, topics around the Glimm-Effros theorem are discussed. In the third edition a chapter entitled 'Additional Topics' has been added. It gives Liouville's Theorem on the existence of invariant measure, entropy theory leading up to Kolmogorov-Sinai Theorem, and the topological dynamics proof of van der Waerden's theorem on arithmetical progressions.

  11. Basic Emotions: A Reconstruction

    Science.gov (United States)

    Mason, William A.; Capitanio, John P.

    2016-01-01

    Emotionality is a basic feature of behavior. The argument over whether the expression of emotions is based primarily on culture (constructivism, nurture) or biology (natural forms, nature) will never be resolved because both alternatives are untenable. The evidence is overwhelming that at all ages and all levels of organization, the development of emotionality is epigenetic: The organism is an active participant in its own development. To ascribe these effects to “experience” was the best that could be done for many years. With the rapid acceleration of information on how changes in organization are actually brought about, it is a good time to review, update, and revitalize our views of experience in relation to the concept of basic emotion. PMID:27110280

  12. Emulsion Science Basic Principles

    CERN Document Server

    Leal-Calderon, Fernando; Schmitt, Véronique

    2007-01-01

    Emulsions are generally made out of two immiscible fluids like oil and water, one being dispersed in the second in the presence of surface-active compounds.They are used as intermediate or end products in a huge range of areas including the food, chemical, cosmetic, pharmaceutical, paint, and coating industries. Besides the broad domain of technological interest, emulsions are raising a variety of fundamental questions at the frontier between physics and chemistry. This book aims to give an overview of the most recent advances in emulsion science. The basic principles, covering aspects of emulsions from their preparation to their destruction, are presented in close relation to both the fundamental physics and the applications of these materials. The book is intended to help scientists and engineers in formulating new materials by giving them the basics of emulsion science.

  13. Basic Semiconductor Physics

    CERN Document Server

    Hamaguchi, Chihiro

    2010-01-01

    This book presents a detailed description of the basic semiconductor physics. The reader is assumed to have a basic command of mathematics and some elementary knowledge of solid state physics. The text covers a wide range of important phenomena in semiconductors, from the simple to the advanced. The reader can understand three different methods of energy band calculations, empirical pseudo-potential, k.p perturbation and tight-binding methods. The effective mass approximation and electron motion in a periodic potential, Boltzmann transport equation and deformation potentials used for full band Monte Carlo simulation are discussed. Experiments and theoretical analysis of cyclotron resonance are discussed in detail because the results are essential to the understanding of semiconductor physics. Optical and transport properties, magneto-transport, two dimensional electron gas transport (HEMT and MOSFET), and quantum transport are reviewed, explaining optical transition, electron phonon interactions, electron mob...

  14. Catalog of State Basic Skills Products.

    Science.gov (United States)

    CEMREL, Inc., St. Louis, MO.

    Listed in this catalog are 122 product descriptions from 34 states identified by state coordinators of basic skills instruction as the best developed in their states. Products include books, pamphlets, videotapes, booklets, checklists, guides, handbooks, anthologies, and computer programs. Each product was developed to improve the management, the…

  15. Collections Care: A Basic Reference Shelflist.

    Science.gov (United States)

    de Torres, Amparo R., Ed.

    This is an extensive bibliography of reference sources--i.e., books and articles--that relate to the care and conservation of library, archival, and museum collections. Bibliographies are presented under the following headings: (1) General Information; (2) Basic Collections Care; (3) Architectural Conservation; (4) Collections Management: Law,…

  16. Workplace Basics: The Skills Employers Want.

    Science.gov (United States)

    Carnevale, Anthony P.; And Others

    1989-01-01

    Identifies the basic skills needed by workers to function in today's high technology workplace. Examines ways of training employees in learning and communication skills, adaptability, personal management, group effectiveness, and organizational leadership. Describes the eight-step training approach used by Mazda Motor Manufacturing Corporation.…

  17. Problems associated with basic oral surgical techniques

    International Nuclear Information System (INIS)

    Kapatkin, A.S.; Marretta, S.M.; Schloss, A.J.

    1990-01-01

    The veterinarian must be able to diagnose several types of dental problems. History, physical examination, clinical pathology, and radiography are important in making an accurate diagnosis. Basic oral surgery includes various extraction techniques and management of their associated complications. Knowledge of dental anatomy and proper surgical technique can make an extraction curative rather than a frustrating procedure with multiple complications

  18. Design and Development of a Telerehabilitation Self-Management Program for Persons with Chronic Lower Limb Swelling and Mobility Limitations: Preliminary Evidence

    OpenAIRE

    Faett, Becky L.; Geyer, Mary Jo; Hoffman, Leslie A.; Brienza, David M.

    2012-01-01

    This paper describes design and development of a self-management program, delivered by telerehabilitation (TR), to address the problem of chronic lower limb swelling in persons with limited mobility. The 18.6 million persons with limited mobility in the USA are at increased risk for chronic lower limb swelling and related secondary complications, including cellulitis and skin ulcers. Over time, chronic swelling often progresses to lymphedema, an incurable condition requiring lifelong care. Wi...

  19. Basic Financial Accounting

    DEFF Research Database (Denmark)

    Wiborg, Karsten

    This textbook on Basic Financial Accounting is targeted students in the economics studies at universities and business colleges having an introductory subject in the external dimension of the company's economic reporting, including bookkeeping, etc. The book includes the following subjects......: business entities, the transformation process, types of businesses, stakeholders, legislation, the annual report, the VAT system, double-entry bookkeeping, inventories, and year-end cast flow analysis....

  20. Basic of Neutron NDA

    Energy Technology Data Exchange (ETDEWEB)

    Trahan, Alexis Chanel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-09-15

    The objectives of this presentation are to introduce the basic physics of neutron production, interactions and detection; identify the processes that generate neutrons; explain the most common neutron mechanism, spontaneous and induced fission and (a,n) reactions; describe the properties of neutron from different sources; recognize advantages of neutron measurements techniques; recognize common neutrons interactions; explain neutron cross section measurements; describe the fundamental of 3He detector function and designs; and differentiate between passive and active assay techniques.

  1. Basic concepts in oceanography

    International Nuclear Information System (INIS)

    Small, L.F.

    1997-01-01

    Basic concepts in oceanography include major wind patterns that drive ocean currents, and the effects that the earth's rotation, positions of land masses, and temperature and salinity have on oceanic circulation and hence global distribution of radioactivity. Special attention is given to coastal and near-coastal processes such as upwelling, tidal effects, and small-scale processes, as radionuclide distributions are currently most associated with coastal regions. (author)

  2. Basics of Computer Networking

    CERN Document Server

    Robertazzi, Thomas

    2012-01-01

    Springer Brief Basics of Computer Networking provides a non-mathematical introduction to the world of networks. This book covers both technology for wired and wireless networks. Coverage includes transmission media, local area networks, wide area networks, and network security. Written in a very accessible style for the interested layman by the author of a widely used textbook with many years of experience explaining concepts to the beginner.

  3. Risk communication basics

    Energy Technology Data Exchange (ETDEWEB)

    Corrado, P.G. [Lawrence Livermore National Laboratory, CA (United States)

    1995-12-31

    In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information.

  4. Risk communication basics

    International Nuclear Information System (INIS)

    Corrado, P.G.

    1995-01-01

    In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information

  5. Basic nucleonics. 2. ed.

    International Nuclear Information System (INIS)

    Guzman, M.E.

    1989-01-01

    This book is oriented mainly towards professionals who are not physicists or experts in nuclear sciences, physicians planning to specialize in nuclear medicine or radiotherapy and technicians involved in nuclear applications. The book covers the fundamental concepts of nuclear science and technology in a simple and ordered fashion. Theory is illustrated with appropriate exercises and answers. With 17 chapters plus 3 appendices on mathematics, basic concepts are covered in: nuclear science, radioactivity, radiation and matter, nuclear reactions, X rays, shielding and radioprotection

  6. Basic Microfluidics Theory

    DEFF Research Database (Denmark)

    Svendsen, Winnie Edith

    2015-01-01

    ,000 m−1, which is a huge difference and has a large impact on flow behavior. In this chapter the basic microfluidic theory will be presented, enabling the reader to gain a comprehensive understanding of how liquids behave at the microscale, enough to be able to engage in design of micro systems...... and to support the theory used in other chapters in the book, but without going into the deep underlying theoretical approach....

  7. Reconstrucción en linfedema peneano y escrotal secundario a hernia inguinal bilateral gigante Reconstruction in penile and scrotal lymphedema secondary to billateral giant inguinal hernia

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-12-01

    Full Text Available El linfedema peneano y escrotal tiene consecuencias funcionales, estéticas, sociales y psicológicas significativas para el paciente que lo padece. Es una enfermedad infrecuente en los países desarrollados, aunque relativamente prevalente en los países tropicales. Su causa más común es la filariasis, aunque en nuestra práctica diaria se asocia más frecuentemente a cirugía, radioterapia, procesos inflamatorios y neoplásicos. Presentamos un caso singular de linfedema penoescrotal secundario a cirugía por hernia inguinal gigante bilateral que persistía un año después de la intervención. El tratamiento quirúrgico consistió en la exéresis de toda la piel linfedematosa del escroto involucrada y el uso de colgajos de piel escrotal posterior para la cobertura testicular. En un segundo tiempo quirúrgico se llevó a cabo una extirpación total de la piel del pene y del tejido subcutáneo superficial a la fascia de Buck. Empleamos injertos de piel de grosor parcial para cubrir el pene denudado. El resultado estético postoperatorio fue aceptable y los resultados funcionales y psicológicos son satisfactorios para el paciente 3 años después de la cirugía.Lymphedema of the penis and scrotum has important functional, cosmetic, social, psychological consequences for the affected patient. It is a rare disease in the developed countries, although it is relatively frequent in tropical countries. Globally, the most common cause is filariasis, although in our practice it is most frecuently associated to surgery, radiotherapy, inflammatory and neoplasic diseases. We report one rare case of penoscrotal lymphedema due to billateral giant inguinal hernia reconstrction. The lymphedema was persistent one year after the repair of the billateral hernia. The technique of reconstruction consisted of excision of all involved lymphedematous skin of the scrotum, and use of posterior scrotal flaps for testicular coverage. In a second surgical time, a total

  8. Classifying basic research designs.

    Science.gov (United States)

    Burkett, G L

    1990-01-01

    Considerable confusion over terminology for classifying basic types of research design in family medicine stems from the rich variety of substantive topics studied by family medicine researchers, differences in research terminology among the disciplines that family medicine research draws from, and lack of uniform research design terminology within these disciplines themselves. Many research design textbooks themselves fail to specify the dimensions on which research designs are classified or the logic underlying the classification systems proposed. This paper describes a typology based on three dimensions that may be used to characterize the basic design qualities of any study. These dimensions are: 1) the nature of the research objective (exploratory, descriptive, or analytic); 2) the time frame under investigation (retrospective, cross-sectional, or prospective); and 3) whether the investigator intervenes in the events under study (observational or interventional). This three-dimensional typology may be helpful for teaching basic research design concepts, for contemplating research design decisions in planning a study, and as a basis for further consideration of a more detailed, uniform research design classification system.

  9. Veinte principios básicos para el tratamiento de los problemas de salud en la APS Twenty basic principles for the management of the heatlh problems in PHC

    Directory of Open Access Journals (Sweden)

    José Díaz Novás

    2005-04-01

    Full Text Available Se enfatiza en la importancia del tratamiento de los problemas de salud en la atención primaria, analizándose las variables a considerar. Se exponen 20 principios básicos para ello, y se insiste en el diagnóstico correcto, la relación médico-paciente, la relación riesgo-beneficio, el tratamiento integral de los pacientes, los nuevos medicamentos, los objetivos e individualización del tratamiento, el manejo de los múltiples problemas, la terapéutica en los ancianos, la familia como unidad de atención, el cumplimiento de las indicaciones médicas, los fracasos terapéuticos y los efectos adversos del tratamiento. Se brindan elementos a considerar para una buena prescripción.Emphasis is made on the importance of the treatment of the health problems at the primary health care level and different variables are analysed. Twenty basic principles are exposed to this end and it is insisted on the correct diagnosis, the doctor-patient relation, the risk-benefit relation, the comprehensive treatment to patients, the new drugs, the objectives and individualization of the treatment, the management of the multiple problems, the therapeutics in the elderly, the family as a unit of attention, the fulfillment of the medical indications, the therapeutic failures and the adverse effects of the treatment. Some elements to be taken into account for a right prescription are given.

  10. Basic research on maxillofacial implants

    Energy Technology Data Exchange (ETDEWEB)

    Matsui, Yoshiro [Showa Univ., Tokyo (Japan). School of Dentistry

    2001-11-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  11. Basic research on maxillofacial implants

    International Nuclear Information System (INIS)

    Matsui, Yoshiro

    2001-01-01

    Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

  12. Stress Management

    Science.gov (United States)

    Healthy Lifestyle Stress management By Mayo Clinic Staff Stress basics Stress is a normal psychological and physical ... of life. Start practicing stress management techniques today. Stress relief The pace and challenges of modern life ...

  13. Manage Stress

    Science.gov (United States)

    ... Manage Stress Print This Topic En español Manage Stress Browse Sections The Basics Overview Signs and Health ... and Health Effects What are the signs of stress? When people are under stress, they may feel: ...

  14. Catalyst in Basic Oleochemicals

    Directory of Open Access Journals (Sweden)

    Eva Suyenty

    2007-10-01

    Full Text Available Currently Indonesia is the world largest palm oil producer with production volume reaching 16 million tones per annum. The high crude oil and ethylene prices in the last 3 – 4 years contribute to the healthy demand growth for basic oleochemicals: fatty acids and fatty alcohols. Oleochemicals are starting to replace crude oil derived products in various applications. As widely practiced in petrochemical industry, catalyst plays a very important role in the production of basic oleochemicals. Catalytic reactions are abound in the production of oleochemicals: Nickel based catalysts are used in the hydrogenation of unsaturated fatty acids; sodium methylate catalyst in the transesterification of triglycerides; sulfonic based polystyrene resin catalyst in esterification of fatty acids; and copper chromite/copper zinc catalyst in the high pressure hydrogenation of methyl esters or fatty acids to produce fatty alcohols. To maintain long catalyst life, it is crucial to ensure the absence of catalyst poisons and inhibitors in the feed. The preparation methods of nickel and copper chromite catalysts are as follows: precipitation, filtration, drying, and calcinations. Sodium methylate is derived from direct reaction of sodium metal and methanol under inert gas. The sulfonic based polystyrene resin is derived from sulfonation of polystyrene crosslinked with di-vinyl-benzene. © 2007 BCREC UNDIP. All rights reserved.[Presented at Symposium and Congress of MKICS 2007, 18-19 April 2007, Semarang, Indonesia][How to Cite: E. Suyenty, H. Sentosa, M. Agustine, S. Anwar, A. Lie, E. Sutanto. (2007. Catalyst in Basic Oleochemicals. Bulletin of Chemical Reaction Engineering and Catalysis, 2 (2-3: 22-31.  doi:10.9767/bcrec.2.2-3.6.22-31][How to Link/DOI: http://dx.doi.org/10.9767/bcrec.2.2-3.6.22-31 || or local: http://ejournal.undip.ac.id/index.php/bcrec/article/view/6

  15. Electrical installation calculations basic

    CERN Document Server

    Kitcher, Christopher

    2013-01-01

    All the essential calculations required for basic electrical installation workThe Electrical Installation Calculations series has proved an invaluable reference for over forty years, for both apprentices and professional electrical installation engineers alike. The book provides a step-by-step guide to the successful application of electrical installation calculations required in day-to-day electrical engineering practice. A step-by-step guide to everyday calculations used on the job An essential aid to the City & Guilds certificates at Levels 2 and 3Fo

  16. Machine shop basics

    CERN Document Server

    Miller, Rex

    2004-01-01

    Use the right tool the right wayHere, fully updated to include new machines and electronic/digital controls, is the ultimate guide to basic machine shop equipment and how to use it. Whether you're a professional machinist, an apprentice, a trade student, or a handy homeowner, this fully illustrated volume helps you define tools and use them properly and safely. It's packed with review questions for students, and loaded with answers you need on the job.Mark Richard Miller is a Professor and Chairman of the Industrial Technology Department at Texas A&M University in Kingsville, T

  17. Back to basics audio

    CERN Document Server

    Nathan, Julian

    1998-01-01

    Back to Basics Audio is a thorough, yet approachable handbook on audio electronics theory and equipment. The first part of the book discusses electrical and audio principles. Those principles form a basis for understanding the operation of equipment and systems, covered in the second section. Finally, the author addresses planning and installation of a home audio system.Julian Nathan joined the audio service and manufacturing industry in 1954 and moved into motion picture engineering and production in 1960. He installed and operated recording theaters in Sydney, Austra

  18. C# Database Basics

    CERN Document Server

    Schmalz, Michael

    2012-01-01

    Working with data and databases in C# certainly can be daunting if you're coming from VB6, VBA, or Access. With this hands-on guide, you'll shorten the learning curve considerably as you master accessing, adding, updating, and deleting data with C#-basic skills you need if you intend to program with this language. No previous knowledge of C# is necessary. By following the examples in this book, you'll learn how to tackle several database tasks in C#, such as working with SQL Server, building data entry forms, and using data in a web service. The book's code samples will help you get started

  19. Basic heat transfer

    CERN Document Server

    Bacon, D H

    2013-01-01

    Basic Heat Transfer aims to help readers use a computer to solve heat transfer problems and to promote greater understanding by changing data values and observing the effects, which are necessary in design and optimization calculations.The book is concerned with applications including insulation and heating in buildings and pipes, temperature distributions in solids for steady state and transient conditions, the determination of surface heat transfer coefficients for convection in various situations, radiation heat transfer in grey body problems, the use of finned surfaces, and simple heat exc

  20. Basic bladder neurophysiology.

    Science.gov (United States)

    Clemens, J Quentin

    2010-11-01

    Maintenance of normal lower urinary tract function is a complex process that requires coordination between the central nervous system and the autonomic and somatic components of the peripheral nervous system. This article provides an overview of the basic principles that are recognized to regulate normal urine storage and micturition, including bladder biomechanics, relevant neuroanatomy, neural control of lower urinary tract function, and the pharmacologic processes that translate the neural signals into functional results. Finally, the emerging role of the urothelium as a sensory structure is discussed. Copyright © 2010 Elsevier Inc. All rights reserved.