scholarly journals Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Masato Yoshihara ◽  
Kaoru Kitamura ◽  
Satoko Tsuru ◽  
Ryoko Shimono ◽  
Hiromi Sakuda ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Study ◽  
Physical Therapy ◽  
Cancer Treatment ◽  
Lower Limb ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Analysis Of Covariance ◽  
Multivariate Linear Regression Analysis ◽  
Factors Associated

Abstract Background Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment. Methods We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined. Results In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2 or higher and receiving radiation rarely responded to CPT. Conclusions Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.

The Effect of Lumbar Sympathetic Ganglion Block on Gynecologic Cancer-Related Lymphedema

2013 ◽  
Vol 4;16 (4;7) ◽  
pp. 345-352
Author(s):  
Hahck Soo Park
Keyword(s):  
Quality Of Life ◽  
Conservative Treatment ◽  
Cancer Treatment ◽  
Pain Score ◽  
Lower Limb ◽  
Sympathetic Ganglion ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Ganglion Block

Background: Eighteen to 25% of patients after gynecological cancer treatment suffer from lower limb lymphedema (LLL) that decreases the quality of life of gynecological cancer survivors. Lumbar sympathetic ganglion block (LSGB) is widely used in practice for the evaluation and management of sympathetically mediated pain in the lower limbs. Several articles have suggested that sympathetic ganglion block could be an effective treatment for lymphedema. Objectives: To investigate the effect of LSGB on patients with secondary lymphedema related to the treatment of gynecologic cancer, who do not respond to a conservative treatment. Study Design: Prospective clinical study. Setting: A single academic medical center, outpatient setting. Methods: Eighteen patients with stage II lower limb lymphedema who did not response to the conservative treatment were recruited. The patients underwent fluoroscopy-guided LSGB 3 times at 2-week intervals. The circumference of the thigh and calf was measured in the upright position at the first visit and 2 weeks after each session of LSGB. The pain score of the lower limb was checked at the same time by a numeric rating scale (NRS) from 0 to 10. The patients were asked about their satisfaction with the procedure at the last follow-up visit. The Wilcoxon signed rank test was used for data analysis. Significance was accepted at a P-value less than 0.05/3. Results: The circumferences of affected thighs and calves decreased from 56.38 ± 4.77 and 35.33 ± 3.51cm to 54.42 ± 5.27 and 34.41 ± 3.35cm, respectively, in a significant manner after 3 consecutive LSGBs (P < 0.05/3). The maximal decrease after the third LSGB was 4 cm in the thigh and 2cm in the calf. The pain score also showed a significant decrease after 3 consecutive LSGBs from 2.17 to 1.28. The tightness and heaviness of the affected limb decreased after the first LSGB in 15 patients (83.3%) and after the second LSGB in 2 patients (11.1%). Five of 18 patients (27.8%) answered that the result of the LSGB met their expectations, 10 (55.6%) answered they would undergo the same treatment for the same outcome, 2 (11.1%) answered they did not improve as much as they had hoped, and they would not undergo the same treatment for the same outcome, and only one patient (5.6%) answered the LSGB showed no effect. Limitations: This study lacks a placebo control group and has only 18 patients. We did not evaluate the quality of life of the patients. Conclusion: We suggest that LSGB can be one of the treatment options for patients suffering from LLL after gynecologic cancer treatment. Our result could provide a basis for a randomized controlled trial in future investigations. The pain physicians can play an important role as one of the multidisciplinary team for a comprehensive treatment of LLL. Key words: Lumbar sympathetic ganglion block;gynecologic cancer;lymphedema

scholarly journals Risk factors for late-onset lower limb lymphedema after gynecological cancer treatment: A multi-institutional retrospective study

2020 ◽  
Vol 46 (7) ◽  
pp. 1334-1338 ◽  
Author(s):  
Masato Yoshihara ◽  
Ryoko Shimono ◽  
Satoko Tsuru ◽  
Kaoru Kitamura ◽  
Hiromi Sakuda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Cancer Treatment ◽  
Lower Limb ◽  
Late Onset ◽  
Gynecological Cancer

scholarly journals Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Baobao Feng ◽  
Xiao Fei ◽  
Ying Sun ◽  
Xingguo Zhang ◽  
Deya Shang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Tuberculous Meningitis ◽  
Adult Patients ◽  
Apache Ii ◽  
Cox Regression Analysis ◽  
Factors Associated

Abstract Background Tuberculous meningitis (TBM) is the most lethal form of tuberculosis worldwide. Data on critically ill TBM patients in the intensive care unit (ICU) of China are lacking. We tried to identify prognostic factors of adult TBM patients admitted to ICU in China. Methods We conducted a retrospective study on adult TBM in ICU between January 2008 and April 2018. Factors associated with unfavorable outcomes at 28 days were identified by logistic regression. Factors associated with 1-year mortality were studied by Cox proportional hazards modeling. Results Eighty adult patients diagnosed with TBM (age 38.5 (18–79) years, 45 (56 %) males) were included in the study. An unfavorable outcome was observed in 39 (49 %) patients and were independently associated with Acute Physiology and Chronic Health Evaluation (APACHE) II > 23 (adjusted odds ratio (aOR) 5.57, 95 % confidence interval (CI) 1.55–19.97), Sequential Organ Failure Assessment (SOFA) > 8 (aOR 9.74, 95 % CI 1.46–64.88), and mechanical ventilation (aOR 18.33, 95 % CI 3.15–106.80). Multivariate Cox regression analysis identified two factors associated with 1-year mortality: APACHE II > 23 (adjusted hazard ratio (aHR) 4.83; 95 % CI 2.21–10.55), and mechanical ventilation (aHR 9.71; 95 % CI 2.31–40.87). Conclusions For the most severe adult TBM patients of Medical Research Council (MRC) stage III, common clinical factors aren’t effective enough to predict outcomes. Our study demonstrates that the widely used APACHE II and SOFA scores on admission can be used to predict short-term outcomes, while APACHE II could also be used to predict long-term outcomes of adult patients with TBM in ICU.

Risk factors for cellulitis in patients with secondary lower limb lymphedema associated with gynecological cancer treatment

2016 ◽  
Vol 206 ◽  
pp. e113-e114
Author(s):  
Sho Tano ◽  
Takehiko Takeda ◽  
Kaname Uno ◽  
Masato Yoshihara ◽  
Michinori Mayama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Treatment ◽  
Lower Limb ◽  
Gynecological Cancer

scholarly journals Prognostic Factors Associated with Survival in Patients Infected with COVID-19: A Retrospective Study on 214 Patients from Iran

2021 ◽  
Vol 24 (4) ◽  
pp. 333-338
Author(s):  
Amir Sadeghi ◽  
Pegah Eslami ◽  
Arash Dooghaie Moghadam ◽  
Bobak Moazzami ◽  
Ali Pirsalehi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Study ◽  
Factors Associated

scholarly journals Prognostic factors associated with the survival of patients with gastric adenocarcinoma: A retrospective study

2020 ◽  
Vol 7 (2) ◽  
pp. 68-76
Author(s):  
Cheng‐Kuo Chen ◽  
Chun‐Lung Feng ◽  
Cheng‐Ju Yu ◽  
Cheng‐Yuan Peng ◽  
Hsueh‐Chou Lai ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Study ◽  
Gastric Adenocarcinoma ◽  
Factors Associated

scholarly journals Factors Associated With Utilization of Preoperative and Postoperative Rehabilitation Services by Patients With Amputation in the VA System: An Observational Study

2013 ◽  
Vol 93 (9) ◽  
pp. 1197-1210 ◽  
Author(s):  
Linda J. Resnik ◽  
Matthew L. Borgia
Keyword(s):  
Physical Therapy ◽  
Occupational Therapy ◽  
Lower Limb ◽  
Care Setting ◽  
Guideline Implementation ◽  
Rehabilitation Services ◽  
Postoperative Rehabilitation ◽  
Factors Associated ◽  
The Impact ◽  
To Receive

Background The Department of Veterans Affairs (VA) and the Department of Defense published evidence-based guidelines to standardize and improve rehabilitation of veterans with lower limb amputations; however, no studies have examined the guidelines' impact. Objectives The purposes of this study were: (1) to describe the utilization of rehabilitative services in the acute care setting by people who underwent major lower limb amputation in the VA from 2005 to 2010, (2) to identify factors associated with receipt of rehabilitation services, and (3) to examine the impact of the guidelines on service receipt. Design A cross-sectional study of 12,599 patients, who underwent major surgical amputation of the lower limb at a VA medical center from January 1, 2005, to December 31, 2010, was conducted. Data were obtained from main and surgical inpatient datasets and the inpatient encounters files of the Veterans Health Administration databases. Methods Rehabilitation services were categorized as physical therapy, occupational therapy, and either (any therapy), before or after amputation. Separate multivariate logistic regressions examined the impact of guideline implementation and identified factors associated with service receipt. Results Patients were 1.45 and 1.73 times more likely to receive preoperative physical therapy and occupational therapy and 1.68 and 1.79 times more likely to receive postoperative physical therapy and occupational therapy after guideline implementation. Patients in the Northeast had the lowest likelihood of receiving preoperative and postoperative rehabilitation services, whereas patients in the West had the highest likelihood. Other patient characteristics associated with service receipt were identified. Limitations The sample included only veterans who had surgeries at VA Medical Centers and cannot be generalized to veterans with surgeries outside the VA or to nonveteran patients and settings. Conclusions Further quality improvement efforts are needed to standardize delivery of rehabilitation services for veterans with amputations in the acute care setting.

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