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Breast Cancer Research and Treatment Oct 2023Male breast cancer accounts for approximately 1% of all breast cancer diagnoses. Unfortunately, a lack of information exists regarding late effects of breast cancer...
PURPOSE
Male breast cancer accounts for approximately 1% of all breast cancer diagnoses. Unfortunately, a lack of information exists regarding late effects of breast cancer treatment in men.
METHODS
An online survey directed towards male breast cancer patients was distributed via social medial and emails from June to July 2022. Participants were asked about their disease characteristics, treatments and side effects from the disease or treatment. Patients and treatment variables were reported via descriptive statistics. Univariate logistic regression was performed to evaluate associations between different treatment variables and outcomes expressed by odds ratio.
RESULTS
A total of 127 responses were analyzed. Median age of the participants was 64 years (range 56-71 years). A total of 91 participants (71.7%) revealed they experienced late effects secondary to their cancer or cancer treatment. The most concerning physical and psychological symptoms reported were fatigue and fear of recurrence respectively. Axillary lymph node dissection was associated with swollen arm and with difficulty in arm or shoulder movement. Systemic chemotherapy was related to bothersome hair loss and changes on interest in sex; and endocrine therapy was associated with feeling less masculine.
CONCLUSION
Our study showed that men suffer several late effects from treatments for breast cancer. Lymphedema, difficulty with arm and shoulder movement, sexual dysfunction and hair loss should be discussed with males as it can be distressing for some patients and decrease their quality of life.
Topics: Humans; Male; Middle Aged; Aged; Breast Neoplasms; Breast Neoplasms, Male; Quality of Life; Axilla; Lymph Node Excision; Lymphedema
PubMed: 37418032
DOI: 10.1007/s10549-023-07027-6 -
Frontiers in Immunology 2023Creeping fat (CrF) is an extraintestinal manifestation observed in patients with Crohn's disease (CD). It is characterized by the accumulation of mesenteric adipose...
Creeping fat (CrF) is an extraintestinal manifestation observed in patients with Crohn's disease (CD). It is characterized by the accumulation of mesenteric adipose tissue (MAT) that wraps around the intestinal wall. Although the role of CrF in CD is still debated, multiple studies have highlighted a correlation between CrF and inflammation, as well as fibrostenosais of the intestine, which contributes to the worsening of CD symptoms. However, the mechanism underlying the potential role of CrF in the development of Crohn's fibrosis remains an enigma. This study aimed to analyze CrF comprehensively using single-cell RNA sequencing analysis. The data was compared with transcriptomic data from adipose tissue in other disease conditions, such as ulcerative colitis, lymphedema, and obesity. Our analysis classified two lineages of preadipocyte (PAC) clusters responsible for adipogenesis and fibrosis in CrF. Committed PACs in CrF showed increased cytokine expression in response to bacterial stimuli, potentially worsening inflammation in patients with CD. We also observed an increase in fibrotic activity in PAC clusters in CrF. Co-analyzing the data from patients with lymphedema, we found that pro-fibrotic PACs featured upregulated pentraxin-3 expression, suggesting a potential target for the treatment of fibrosis in CrF. Furthermore, PACs in CrF exhibited a distinct increase in cell-to-cell communication via cytokines related to inflammation and fibrosis, such as CCL, LIGHT, PDGF, MIF, and SEMA3. Interestingly, these interactions also increased in PACs of the lymphedema, whereas the increased MIF signal of PACs was found to be a distinct characteristic of CrF. In immune cell clusters in CrF, we observed high immune activity of pro-inflammatory macrophages, antigen-presenting macrophages, B cells, and IgG plasma cells. Finally, we have demonstrated elevated IgG plasma cell infiltration and increased pentraxin-3 protein levels in the fibrotic regions of CrF in CD patients when compared to MAT from both UC patients and healthy individuals. These findings provide new insights into the transcriptomic features related to the inflammation of cells in CrF and suggest potential targets for attenuating fibrosis in CD.
Topics: Humans; Crohn Disease; Adipogenesis; Adipose Tissue; Inflammation; Cytokines; Fibrosis; Lymphedema; Immunoglobulin G
PubMed: 38111581
DOI: 10.3389/fimmu.2023.1198905 -
Dermatologie (Heidelberg, Germany) Aug 2023Primary lymphoedema is a hereditary genetic disorder of the lymphatic system. These genetic disorders can result in malformation or dysfunction of the lymphatic system,... (Review)
Review
Primary lymphoedema is a hereditary genetic disorder of the lymphatic system. These genetic disorders can result in malformation or dysfunction of the lymphatic system, which leads to an accumulation of fluid in the tissue and, thus to the formation of oedema. The most common form is peripheral lymphoedema of the lower limbs, but systemic manifestations such as intestinal lymphangiectasia, ascites, chylothorax or hydrops fetalis may also occur. The clinical presentation and the degree of lymphoedema varies depending on the causative gene and the specific gene alteration. Primary lymphoedema is divided into five categories: (1) disorders with somatic mosaicism and segmental growth abnormality, (2a) syndromal disorders, (2b) disorders with systemic involvement, (2c) congenital lymphoedema and (2d) disorders that occur after the first year of life (late onset lymphoedema). Targeted genetic diagnosis is based on the patient's clinical presentation and classification into one of the five categories. In general, the diagnosis usually starts with basic diagnostics, which include cytogenetic and molecular genetic testing. Subsequently, a molecular genetic diagnosis is made by performing single-gene analyses, gene panel examinations, exome sequencing or whole genome sequencing. This allows the identification of genetic variants or mutations that are considered to be causative for the presenting symptoms. Combined with human genetic counselling, the genetic diagnosis allows for conclusions about inheritance, the risk of recurrence and potential concomitant symptoms. In many cases, only this approach allows the definite form of primary lymphoedema to be described.
Topics: Humans; Lymphedema; Lymphatic System; Lymphangiectasis, Intestinal; Genetic Testing; Syndrome
PubMed: 37402871
DOI: 10.1007/s00105-023-05183-w -
Journal of Advanced Nursing Dec 2023To explore predictors of lymphedema self-management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to... (Observational Study)
Observational Study
AIMS
To explore predictors of lymphedema self-management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables.
DESIGN
Further analysis of a multicentre cross-sectional and survey-based study.
METHODS
A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self-reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed.
RESULTS
The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self-management behaviours. The final structural model showed good model fit. Social support, self-efficacy and lymphedema knowledge positively affected lymphedema self-management behaviours, directly and indirectly. Self-regulation acted as a crucial mediator between these variables and self-management. The direct path between social support and self-regulation was not significant. Lymphedema knowledge and social support also influenced self-management via illness perception, self-efficacy and self-regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self-management behaviours.
CONCLUSIONS
The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self-management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self-efficacy, social support and self-regulation directly and indirectly influenced lymphedema self-management behaviours.
IMPACT
This study provides a theoretical basis for the assessment and interventions of lymphedema self-management behaviours in breast cancer patients. Lymphedema self-management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors.
REPORTING METHOD
This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This study focused on identifying and predicting mechanism of self-management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high-risk populations, and inspire the assessment and interventions facilitating self-management behaviours.
STUDY REGISTRATION
This study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084).
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE
For breast cancer patients with poor lymphedema self-management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self-management is multi-faced. Strategies targeted at improving social support, self-regulation, knowledge, self-efficacy and illness perception should be also addressed in lymphedema self-management programs, to facilitate more effective improvement of lymphedema self-management behaviours.
Topics: Humans; Female; Breast Neoplasms; Self-Management; Cross-Sectional Studies; Life Course Perspective; Health Behavior; Lymphedema
PubMed: 37358074
DOI: 10.1111/jan.15759 -
British Journal of Community Nursing Apr 2024The 11th annual National Lymphoedema Conference, organised by the in association with the British Lymphology Society and Lipoedema UK, was hosted at the America Square...
The 11th annual National Lymphoedema Conference, organised by the in association with the British Lymphology Society and Lipoedema UK, was hosted at the America Square Conference Centre, London, on 22 February 2024. The conference, which aims to provide new insights into the latests developments in lymphoedema care and management through talks by leading experts in the field, was attended by an impressive number of delegates and exhibitors. The sessions were Chaired by BLS Trustee Rebecca Elwell, and are summarised below.
Topics: Humans; Lymphedema; Lipedema; London
PubMed: 38578923
DOI: 10.12968/bjcn.2024.29.Sup4.S37 -
The Pan African Medical Journal 2024Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti,... (Review)
Review Meta-Analysis
Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti, but Brugia malayi and Brugia timoriare sometimes encountered as causative agents. Mosquitoes are the vectors while humans the definitive hosts respectively. The burden of the disease is heavier in Nigeria than in other endemic countries in Africa. This occurs with increasing morbidity and mortality at different locations within the country, the World Health Organization recommended treatments for lymphatic filariasis include the use of Albendazole (400mg) twice per year in co-endemic areas with loa loa, Ivermectin (200mcg/kg) in combination with Albendazole (400mg) in areas that are co-endemic with onchocerciasis, ivermectin (200mcg/kg) with diethylcarbamazine citrate (DEC) (6mg/kg) and albendazole (400mg) in areas without onchocerciasis. This paper covered a systematic review, meta-analysis, and scoping review on lymphatic filariasis in the respective geopolitical zones within the country. The literature used was obtained through online search engines including PubMed and Google Scholar with the heading "lymphatic filariasis in the name of the state", Nigeria. This review revealed an overall prevalence of 11.18% with regional spread of Northwest (1.59%), North Central and North East, (4.52%), South West (1.26%), and South-South with South East (3.81%) prevalence. The disease has been successfully eliminated in Argungu local government areas (LGAs) of Kebbi State, Plateau, and Nasarawa States respectively. Most clinical manifestations (31.12%) include hydrocele, lymphedema, elephantiasis, hernia, and dermatitis. Night blood samples are appropriate for microfilaria investigation. Sustained MDAs, the right testing methods, early treatment of infected cases, and vector control are useful for the elimination of lymphatic filariasis for morbidity management and disability prevention in the country. Regional control strategies, improved quality monitoring of surveys and intervention programs with proper records of morbidity and disability requiring intervention are important approaches for the timely elimination of the disease in Nigeria.
Topics: Elephantiasis, Filarial; Humans; Nigeria; Animals; Wuchereria bancrofti; Filaricides; Albendazole; Neglected Diseases; Ivermectin; Brugia malayi
PubMed: 38933431
DOI: 10.11604/pamj.2024.47.142.39746 -
Phlebology Sep 2023Lymphedema is a chronic progressive disease that results in interstitial edema in the limbs, and to a lesser extent in the genitals and face, due to damage to the... (Review)
Review
BACKGROUND
Lymphedema is a chronic progressive disease that results in interstitial edema in the limbs, and to a lesser extent in the genitals and face, due to damage to the lymphatic system.
METHODS
Research was conducted between July 2022 and September 2022 in biomedical databases: PubMed, Cochrane Central Register of Controlled Trials (Cochrane Library), and PEDro.
RESULTS
Two studies showed that lymphedema alters gait parameters by affecting mainly kinematic parameters, although kinetic parameters were found to be significantly altered, especially in patients with severe lymphedema. In other studies, using methods such as videos and questionnaires, difficulties in walking were found in the presence of lymphedema. The most common abnormality was antalgic gait.
CONCLUSIONS
Poor mobility can worsen the edema, which, in turn, can compromise joint range of motion. Gait analysis is an essential tool to evaluate and follow.
Topics: Humans; Gait; Walking; Exercise Therapy; Lymphedema; Biomechanical Phenomena; Lower Extremity
PubMed: 37413662
DOI: 10.1177/02683555231188236 -
The Lancet. Infectious Diseases Jan 2024
Topics: Humans; Elephantiasis, Filarial; Laos
PubMed: 38141647
DOI: 10.1016/S1473-3099(23)00770-3 -
Annals of Surgical Oncology Dec 2023We aimed to examine potential associations between post-surgical upper limb morbidity and demographic, medical, surgical, and health-related fitness variables in newly...
PURPOSE
We aimed to examine potential associations between post-surgical upper limb morbidity and demographic, medical, surgical, and health-related fitness variables in newly diagnosed individuals with breast cancer.
METHODS
Participants were recruited between 2012 and 2019. Objective measures of health-related fitness, body composition, shoulder range of motion, axillary web syndrome, and lymphedema were performed within 3 months of breast cancer surgery, and prior to or at the start of adjuvant cancer treatment.
RESULTS
Upper limb morbidity was identified in 54% of participants and was associated with poorer upper limb function and higher pain. Multivariable logistic regression analysis identified mastectomy versus breast-conserving surgery (odds ratio [OR] 3.51, 95% confidence interval [CI] 2.65-4.65), axillary lymph node dissection versus sentinel lymph node dissection (OR 2.67, 95% CI 1.73-4.10), earlier versus later time from surgery (OR 1.58, 95% CI 1.15-2.18), and younger versus older age (OR 1.01, 95% CI 1.00-1.03) as significantly associated with a higher odds of upper limb morbidity, while mastectomy (OR 1.57, 95% CI 1.10-2.25), axillary lymph node dissection (OR 2.20, 95% CI 1.34-3.60), lower muscular endurance (OR 1.10, 95% CI 1.01-1.16) and higher percentage body fat (OR 1.04, 95% CI 1.00-1.07) were significantly associated with higher odds of moderate or greater morbidity severity.
CONCLUSIONS
Upper limb morbidity is common in individuals after breast cancer surgery prior to adjuvant cancer treatment. Health-related fitness variables were associated with severity of upper limb morbidity. Findings may facilitate prospective surveillance of individuals at higher risk of developing upper limb morbidity.
Topics: Humans; Female; Breast Neoplasms; Mastectomy; Cohort Studies; Prospective Studies; Axilla; Upper Extremity; Lymphedema; Lymph Node Excision; Morbidity; Sentinel Lymph Node Biopsy
PubMed: 37755568
DOI: 10.1245/s10434-023-14316-3 -
Extracellular Vesicles from Adipose-Derived Stem Cells Relieve Extremity Lymphedema in Mouse Models.Plastic and Reconstructive Surgery Nov 2023Transplantation of adipose-derived mesenchymal stem cells (ADSCs) has been reported to improve the severity of chronic lymphedema. Extracellular vesicles (EVs) derived...
BACKGROUND
Transplantation of adipose-derived mesenchymal stem cells (ADSCs) has been reported to improve the severity of chronic lymphedema. Extracellular vesicles (EVs) derived from mesenchymal stem cells have been reported to exert effects such as the promotion of angiogenesis, suppression of inflammation, and regeneration of damaged organs. In this study, the authors show that lymphangiogenesis was induced by EVs derived from ADSCs and reveal the therapeutic potential of these EVs for the treatment of lymphedema.
METHODS
The authors examined the in vitro effects of ADSC-EVs to lymphatic endothelial cells (LECs). Next, they conducted an in vivo analysis of ADSC-EVs to mouse lymphedema models. Bioinformatics analysis was also performed to evaluate the implications of the altered microRNA expression.
RESULTS
The authors showed that ADSC-EVs promoted the proliferation, migration, and tube formation of LECs, and the gene expression of lymphatic markers was elevated in the ADSC-EV-treated group. Notably, a mouse lymphedema model revealed that legs treated with ADSC-EVs had markedly improved edema, with increased numbers of capillary vessels and lymphatic channels. Bioinformatics analysis revealed that ADSC-EV-associated microRNAs, such as miR-199a-3p, miR-145-5p, miR-143-3p, miR-377-3p, miR-100-3p, miR-29a-3p, miR-495-3p, and miR-29c-3p, targeted mouse double minute 2 homolog, which contributed to the stability of hypoxia-inducible factor 1α and resulted in angiogenesis and lymphangiogenesis in LECs.
CONCLUSIONS
The present study showed lymphangiogenic effects of ADSC-EVs, which will lead to new treatment options for chronic lymphedema. Cell-free therapy with EVs has fewer potential risks, such as poor engraftment efficiency and potential tumor formation, than stem cell transplantation and could be a promising tool for patients with lymphedema.
CLINICAL RELEVANCE STATEMENT
This study may open up new possibilities for novel therapies for lymphedema.
Topics: Animals; Mice; Humans; Endothelial Cells; MicroRNAs; Mesenchymal Stem Cells; Extremities; Extracellular Vesicles; Lymphedema
PubMed: 36877751
DOI: 10.1097/PRS.0000000000010388