Thesis (doctoral)--Universiteit van Amsterdam, 1982. / Vita. "Stellingen" (3 p. inserted) and summary in Dutch. Includes bibliographical references (p. 99-103).

Thesis (doctoral)--Universiteit van Amsterdam, 1982. / Vita. "Stellingen" (3 p. inserted) and summary in Dutch. Includes bibliographical references (p. 99-103).

Thesis (M.A.)--University of South Florida, 2006. / Title from PDF of title page. Document formatted into pages; contains 29 pages. Includes bibliographical references.

Made available in DSpace on 2014-06-11T19:27:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-04-23Bitstream added on 2014-06-13T19:35:40Z : No. of bitstreams: 1 oliveira_j_me_arafcf.pdf: 352998 bytes, checksum: 997166e2dffc2b5acc213ed4bfd5d252 (MD5) / Universidade Estadual Paulista (UNESP) / O linfedema de Membro Superior (MS) e a principal complicacao decorrente da cirurgia e tratamento do cancer (CA) de mama e e causado pela destruicao dos canais de drenagem axilar em virtude da cirurgia, radioterapia ou pela progressao regional da doenca. Esta pesquisa teve o intuito de verificar a influencia da ingestao de triglicerideos de cadeia media (TCM) associada ao tratamento fisioterapeutico em mulheres portadoras de linfedema de MS pos-cirurgia de CA de mama. Para tanto, teve a participacao de 14 mulheres mastectomizadas que apresentavam linfedema de MS homolateral a cirurgia, com idade media de 64}12 anos e Indice de Massa Corporea (IMC) de 27}4,1 kg/m2. Apos avaliacao nutricional foram divididas, aleatoriamente, em dois grupos: Grupo Controle (n=7), submetido ao tratamento fisioterapeutico constando da terapia complexa descongestiva (massagem classica, drenagem linfatica manual, bandagem compressiva e cuidados com a pele), 3 vezes na semana, durante 8 semanas e automassagem nas 2 semanas seguintes; Grupo TCM (n=7), submetido ao mesmo protocolo fisioterapeutico somado ao tratamento dietetico diario com ingestao de TCM, por 10 semanas. O linfedema foi avaliado atraves da cirtometria, da volumetria, das pregas cutaneas e pela quantidade de agua corporal total. As sensacoes de desconforto, peso e dor no MS acometido foram coletadas por escalas visuais analogas (EVA). Ao final da intervencao, a cirtometria, a volumetria e as pregas cutaneas tricipital e bicipital mostraram diferencas significativas entre os grupos (p.0,05), com uma maior reducao do linfedema no grupo TCM. As sensacoes de desconforto e peso no membro foram significativamente menores na comparacao inicial e final no grupo TCM. Nao houve diferencas na quantidade de agua corporal total. / The lymphedema of upper-extremity (UE) is the main complication due to the surgery and treatment of the breast cancer and it is caused by the destruction of the channels of axillary drainage because of the surgery, radiation therapy or by the local progression of the disease. This research had the intention of verifying the influence of the intakes of medium chain triglycerides (MCT) associated to the physiotherapeutic treatment in the lymphedema of the upper-extremity of postmastectomy women. For this research, it counted with the participation of 14 postmastectomy women who presented lymphedema of upper-extremity at the same side to the surgery, with medium age 64}12 years old and Body Mass Index (BMI) of 27}4,1 kg/m2. After nutritional evaluation they were divided, at ramdom, in two groups: Control Group (n=7), submitted to the physiotherapeutic treatment consisting of the complex decongestive therapy (classic massage, manual lymphatic drainage, compression bandage and cares with the skin), three times a week, during eight weeks and self-massage in the two following weeks; MCT Group (n=7), submitted to the same physiotherapeutic protocol in addition to the daily dietotherapy with intakes of MCT, during ten weeks. The lymphedema was evaluated by the circumferential and volumetric measures, by skin folds of arm with lymphedema and by the amount of total body water. The sensations of discomfort, pain and weight in the UE were collected by visual analogue scales (VAS). At the end of the intervention, the circumferential and volumetric measures, and the tricipital and bicipital skin folds showed significant differences among the groups (p.0,05), with a larger reduction of the lymphedema in the MCT Group. The sensations of discomfort and weight in the UE were significantly smaller in the final comparison related to the initial in the MCT Group.

Thesis (MTech (Nursing))--Cape Peninsula University of Technology, 2011. / To determine the incidence, risk factors and the treatment of lymphedema after breast cancer treatment at the oncology unit of KATH, Kumasi, Ghana from 01 January 2005 to 31 December 2008. Descriptive retrospective survey was used. Using a data capture sheet, data was collected from the medical records of the breast cancer patients. Breast cancer and lymphedema-related variables were collected. Data was analyzed as descriptive statistics. Chi-square test was applied to determine whether or not two variables are independent variables. Among 313 patients treated for breast cancer between 2005 and 2008, 31 (9.9%) developed lymphedema after treatment. A chi-square test showed that axillary lymph node dissection was statistically a significant risk factor of lymphedema (Chi-square test value=7.055, P value=0.008). Radiation and late stage of breast cancer diagnosis may have contributed in development of lymphedema despite having P value> 0.05. Age, body mass index (BMI) and hypertension were also not associated with lymphedema.

Uma das principais complicações do tratamento cirúrgico do câncer de mama é o linfedema do membro superior homolateral à linfonodectomia, que pode levar a sérias conseqüências físicas e emocionais às mulheres que o apresentam. O objetivo deste estudo foi avaliar a eficácia de um protocolo que inclui a utilização da estimulação elétrica de alta voltagem, no tratamento do linfedema, em um grupo de mulheres submetidas à cirurgia para o câncer de mama. O protocolo de tratamento constituiu-se de aplicações da estimulação elétrica de altavoltagem, duas vezes por semana, num total de catorze sessões, em dias de atendimento de um núcleo de reabilitação, complementadas por orientações quanto ao autocuidado, automassagem e exercícios físicos, no domicílio. Os instrumentos de avaliação foram: a perimetria em sete pontos; o cálculo da diferença de volume (DV) entre os membros e do percentual de aumento do volume (PAV) do membro com linfedema, em relação ao contralateral; um formulário com dados sociodemográficos e pessoais, acerca do tratamento do câncer de mama, e outro acerca dos sinais e sintomas do linfedema. Participaram 17 voluntárias, com uma diferença de perimetria de 2 a 5 centímetros entre os membros superiores. Os resultados analisados por meio do método estatístico T pareado para variáveis dependentes revelaram redução significativa de 14,13% (p = 0,0067) do PAV e de 13,8% (p = 0,0089) da DV. A perimetria apresentou redução significativa em 3 pontos: sete cm acima do cotovelo (p = 0,0138), sete cm abaixo do cotovelo (p = 0,0282) e no punho (p = 0,0476). A análise das variáveis subjetivas, sobre a avaliação do aspecto do membro com linfedema, por meio do teste de McNemar para dois grupos emparelhados, também revelou melhora significativa de alguns sinais e sintomas. Houve melhora na sensação de membro volumoso (p = 0,0265), na sensação de aumento de temperatura (p = 0,0003), melhora da dor (p = 0,0442), da ADM (p = 0,0098), da consistência do linfedema (p = 0,0002) e do sinal de cacifo (p = 0,0023). Pôde-se concluir que a utilização da estimulação elétrica de alta-voltagem associada a exercícios e orientações foi eficaz na redução do linfedema. / One of the main complications of surgical breast cancer treatment is the lymphedema in the upper limb on the same side where the lymphadenectomy was performed, which can cause severe physical and emotional consequences for women with this complication. This study aimed to assess the efficacy of a lymphedema treatment protocol that includes the use of high voltage electrical stimulation in a group of women submitted to breast cancer surgery. The treatment protocol consisted of high-voltage electrical stimulation applications, twice a week, totaling fourteen sessions, held during meetings of a rehabilitation group, in addition to selfcare, self-massage and physical exercise orientations at home. The assessment instruments were: anthropometrics in seven points; calculation of the volume difference (VD) between the limbs and the volume increase percentage (VIP) of the limb with lymphedema as opposed to the other side; a form with sociodemographic and personal data about the breast cancer treatment, and another about the signs and symptoms of the lymphedema. Participants were 17 volunteers, with a perimeter difference ranging from 2 to 5 centimeters between the upper limbs. The results, analyzed through the statistical paired T method for dependent variables, revealed a significant reduction by 14.13% (p = 0.0067) in VIP and 13.8% (p = 0.0089) in VD. The anthropometrics presented a significant three-point reduction: seven cm above the elbow (p = 0.0138), seven cm below the elbow (p = 0.0282) and at the wrist (p = 0.0476). The analysis of the subjective variables, about the aspect evaluation of the limb with lymphedema, using McNemars test for two paired groups, also revealed a significant improvement in some signs and symptoms. Improvements were found in the feeling of a bulky limb (p = 0.0265), in the feeling of increased temperature (p = 0.0003), pain (p = 0.0442), movement range (p = 0.0098), consistency of the lymphedema (p = 0.0002) and the Godet sign (p = 0.0023). It was concluded that the use of high voltage electrical stimulation in combination with exercises and orientations, was effective to reduce the lymphedema.

Estudo qualitativo que buscou, à luz do Interacionismo Simbólico, compreender o significado do linfedema na vida de mulheres com câncer de mama, na relação consigo mesmas, com os outros e com o mundo. Os dados foram obtidos por meio de entrevistas e prontuários de 14 mulheres com linfedema de braço pós- cirurgia por câncer de mama, que freqüentam um serviço especializado em reabilitação pós-mastectomia. Procurou-se identificar unidades temáticas pela Análise de Conteúdo, nas seguintes categorias: 1- significado do linfedema, na relação consigo mesmas e 2- na relação com os outros e com o mundo. Na relação consigo mesmas, o linfedema significou preocupação com o aumento do volume do braço e complicações, mudança de hábitos, dificuldades diversas, alterações emocionais e busca de justificativas para a presença do linfedema, concluindo que ele é um problema estigmatizante. Na relação com os outros e com o mundo, elas indicaram instituições como a ciência, o trabalho, a família, os serviços de saúde e a sociedade, na construção do significado do linfedema, e reconheceram-se como tendo um corpo diferente pelo aumento do volume do braço, o que as torna pessoas estigmatizadas. Porém, revelam sinalizações de possibilidades de ações dos outros e inscrevem a criação de novos instrumentos sociais, o que evidencia sinais de mobilização para a construção de um mundo simbólico mais positivo e rico em contribuições. / This qualitative study aimed at, in the light of Symbolic Interactionism, understanding the meaning of lymphedema to women with breast cancer, observing their relations with themselves, with others and with the world. Data were obtained through interviews and record analysis with 14 women with lymphedema in the arm after the breast cancer surgery who attended a service specialized in post-mastectomy rehabilitation. The author searched to identify thematic units through Content Analysis in the selected categories: 1- the meaning of lymphedema in relation to themselves and 2- in relation to others and to the world. With respect to themselves, the lymphedema meant concern with the arm increasing volume and complications, habit changes, several difficulties, emotional alterations and the search for justifications about the presence of the lymphedema, concluding that it is a stigmatizing problem. Regarding the others and the world, they indicated institutions such as science, work, family, health services and society, in the construction of knowledge on lymphedema, and recognized themselves as having a different body due to the increase in arm volume, transforming them in stigmatized people. However, they revealed signs for possibilities of others’ actions and for the creation of new social instruments, evidencing signs of mobilization for the construction of a symbolic world more positive and rich in contributions.

The purpose of this literature review is to investigate the most effective forms of self-care that patients can perform to reduce swelling caused by lymphedema. Lymphedema may occur secondary to lymph node trauma, which makes it difficult for lymph fluid to leave an extremity. Even though lymphedema is more recognized as a side effect of breast cancer treatment, it can also be the result of many other ailments or treatments and can be present in any part of the body. By knowing which therapies are most effective, nurses and other health care professionals can educate patients to help ease the burden caused by this debilitating condition. This thesis discusses the results of clinical trials that studied different methods of self-care including exercises, bandaging, compression garments, sequential compression devices, and performing manual lymphatic drainage. The conclusion derived from the review of multiple studies is that participating in a combination of multiple therapies is the most effective means of lymphedema management and should be considered the ideal standard of care.

Yes / Research Question: To assess the feasibility of the MGSIS-5and G3L-20 in a community sample of cisgender men aged 40 years and older Research problem: Psychometric measures can aid urologic practice by prompting patients to talk about aspects of their body that are either too sensitive or a natural part of aging. Importantly, reliable and valid measures can also contribute to a an evidenced-based-practice-based-evidence cycle where they can establish the impact of changes recommended by research while using the results in turn to inform research. In this study, we examine two psychometric measures on the opposite ends of a psychological-physical continuum; the Male Genital Self-Image Scale (MGSIS-5) and the Groin and Lower Limb Lymphedema questionnaire (G3L-20) Methodology: Non-experimental psychometric design administering the questionnaires online to a community sample of cisgender men aged 40 years old and above. Validity and reliability analyses were conducted. Results: 30 men completed the study; 14 aged 40-49, 14 aged 50-59 and 2 aged 60-69. The MGSIS-5 and G3L-20 show acceptable reliability and validity with one- and three-component structures respectively. Conclusions: The MGSIS-5 and G3L-20 show sufficient feasibility to justify the resources for studies with larger community samples and for pilot studies with clinical populations.

Les lymphœdèmes secondaires au traitement du cancer du sein représentent une des comorbidités majeures de l’adénomectomie axillaire. L’exérèse des lymphonœuds axillaires est pointée comme la cause évidente de l’apparition du lymphœdème. Elle semble être une condition nécessaire, mais non suffisante, pour que les patientes développent un lymphœdème secondaire. Les patientes opérées selon la même procédure chirurgicale et affectées d’un lymphœdème secondaire peuvent être catégorisées en deux groupes :l’un présentant un œdème caractérisé par le signe du godet marqué et une réponse rapide aux bandages compressifs, l’autre montrant les signes inverses. Nous posons l’hypothèse que parmi les causes intercurrentes à la genèse du lymphœdème secondaire au traitement du cancer du sein, la procédure chirurgicale du creux axillaire peut induire des perturbations intermittentes de l’hémodynamique de la veine axillaire et provoquer une hyperfiltration d’amont. Notre travail montre que l’exérèse de tout ou partie de la lame cellulo-adipeuse qui contient les lymphonœuds et l’ouverture de la gaine axillaire, modifie les conditions biomécaniques de la veine axillaire, lorsque le bras est ballant le long du corps, ayant pour conséquence une occlusion partielle et intermittente de cette veine, ce qui détermine aux distalités du membre une augmentation de la filtration. Cette occlusion intermittente provoque un épaississement réactionnel local de l’endothélium veineux et induit à terme le développement d’un réseau veineux collatéral superficiel visible sur le thorax à l'aide de l'imagerie par thermographie à infrarouges lointains. Après avoir démontrer l’existence clinique de l'occlusion intermittente par différentes méthodes expérimentales et cliniques, nous avons proposer à la fois des moyens diagnostiques simples et initier une proposition de traitement chirurgical visant à rétablir de meilleures conditions hémodynamiques veineuses qui pourraient contribuer à la décongestion partielle du membre. / Doctorat en Sciences de la motricité / info:eu-repo/semantics/nonPublished