Maturitas
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Review
Modern surgical management of breast cancer therapy related upper limb and breast lymphoedema.
Breast cancer is the commonest cancer in the UK. Advances in breast cancer treatment means that the sequelae of treatment are affecting more women and for a longer duration. Lymphoedema is one such sequela, with wide-ranging implications, from serious functional and psychological effects at the individual level to wider economic burdens to society. ⋯ Liposuction reduces the volume and symptoms of lymphedema, but requires continual compressive therapy to avoid recurrence. Lymphatic reconstruction or bypass techniques including lymph node transfer (inguinal nodes are transferred to the affected limb), lymphatico-lymphatic bypass (lymphatics bypass the axilla using a lymph vessel graft reconstructing lymphatic flow from arm to neck) and lymphaticovenous anastomoses (lymphatics in the arm are joined to the venous system aiding lymph drainage) show promise in reducing lymphedema significantly. Further research is required, including into the role of primary lymphaticovenous anastomoses in the prevention of lymphedema at the time of axillary dissection.
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Observational Study
Time trends in leisure time physical activity and physical fitness in the elderly: five-year follow-up of the Spanish National Health Survey (2006-2011).
To estimate the trends in the practice of leisure time physical activity, walking up 10 steps, and walking for 1h, during the years 2006-2011, in elderly Spanish people. ⋯ A decrease in the proportion of respondents who self-reported undertaking leisure-time physical activity, walking up 10 steps, and walking for 1h was observed in the Spanish population of over 65 years between 2006 and 2011.