1.Symptom Relief for Lymphedema-caused Malignant Soft Tissue Tumors in Two Patients with Advanced Stage Disease
Kenichiro HAMADA ; Seiji IKEDA ; Masaki YOSHIKAWA ; Masaharu SHIMA ; Susumu JOYAMA ; Nobuhito ARAKI
The Japanese Journal of Rehabilitation Medicine 2013;50(6):448-452
Limb lymphedema is a serious complication following surgery or radiation therapy for malignant soft tissue tumors. We have recently experienced two cases where we provided symptomatic relief for lymphedema as part of palliative care for patients with sarcoma in the advanced stage. For the treatment of lymphedema, complex physical therapy (manual lymphatic drainage, compression, and exercise therapy), elevation of the affected limb, and skin care were carried out after ruling out the presence of deep venous thrombosis. Inelastic bandaging provides containment and effectively arrests the progression of swelling that stretches the skin. Since obstructive masses interrupt the entire lymphatic quadrants, lymphatic drainage is focused on creating a collateral flow in the truncal territories and in the limb. No complications associated with treatment were observed. In spite of refractory edema due to disease progression in both cases, the swelling of the affected limb or patients' subjective symptoms were temporarily improved by the treatment. While aiming to reduce swelling, the provision of comfort, relief from pain or other swelling-related symptoms, and maintenance or restoration of function are desirable and beneficial outcomes. Palliative therapy for lymphedema may lead to an improvement of the quality of life (QOL) of patients with sarcoma in the advanced stage.
2.Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients
Kota HORI ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Yoshifumi KIDO ; Takahiro BISE ; Aomi KUZUHARA ; Takenori HAMADA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2024;28(4):388-394
Background:
Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.
Methods:
This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1–2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.
Results:
Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1–3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.
Conclusions
Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.
3.Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients
Kota HORI ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Yoshifumi KIDO ; Takahiro BISE ; Aomi KUZUHARA ; Takenori HAMADA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2024;28(4):388-394
Background:
Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.
Methods:
This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1–2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.
Results:
Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1–3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.
Conclusions
Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.
4.Improved Systemic Inflammation is Associated with Functional Prognosis in Post-Stroke Patients
Kota HORI ; Yoshihiro YOSHIMURA ; Hidetaka WAKABAYASHI ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Sayuri SHIMAZU ; Ai SHIRAISHI ; Yoshifumi KIDO ; Takahiro BISE ; Aomi KUZUHARA ; Takenori HAMADA ; Kouki YONEDA ; Kenichiro MAEKAWA
Annals of Geriatric Medicine and Research 2024;28(4):388-394
Background:
Systemic inflammation is associated with poor functional outcomes. However, the effects of improved inflammation on functional indicators remain unclear. This study aimed to clarify the relationship between improvements in systemic inflammation and activities of daily living in patients after stroke.
Methods:
This retrospective cohort study included patients post stroke with systemic inflammation upon admission. Systemic inflammation was defined as a modified Glasgow Prognostic Score (mGPS) score of 1–2. Improvement in systemic inflammation was defined as a reduction in mGPS score or blood C-reactive protein (CRP) levels during hospitalization. The primary outcomes were the motor items of the Functional Independence Measure (FIM-motor) at discharge. We applied multiple linear regression analysis to examine whether reduced systemic inflammation was associated with outcomes after adjusting for confounding factors.
Results:
Of the 1,490 patients recruited, 158 (median age of 79 years; 88 men) had systemic inflammation on admission and were included in the study. Among these patients, 131 (82.9%) and 147 (93.0%) exhibited reduced mGPS and CRP levels, respectively. The median change in CRP was 2.1 mg/dL (interquartile range, 1.1–3.8). Multivariate analysis revealed that improvements in mGPS (β=0.125, p=0.012) and CRP levels (β=0.108, p=0.108) were independently and positively associated with FIM-motor at discharge.
Conclusions
Improvement in systemic inflammation was positively associated with functional outcomes in patients post stroke. Early detection and therapeutic intervention for systemic inflammation may further improve outcomes in these patients.