[Role of lymphofluoroscopy in the management of lymphedema].

The lymphatic vascular system is essential for maintaining a healthy balance between interstitial fluid production and transport. Dysregulation of this balance can lead to the formation of lymphedema, a pathology that is disabling and bothersome in the daily lives of the patients. Lymphofluoroscopy is an invaluable tool that provides static and dynamic images of the superficial lymphatic vessels, with diagnostic and therapeutic implications.

Inclusion of person-centred care in UK postgraduate medical education curricula: Interviews and documentary analysis.

Background: Person-centred care (PCC) involves placing people at the centre of their healthcare decision making to ensure it meets their needs, values, and personal circumstances. Increasingly, PCC is promoted in healthcare policy and guidance, but little is known about how this is embedded in postgraduate medical training. The aim of this research was to understand how PCC is embedded in UK postgraduate medical training and explore factors influencing inclusion of PCC in curricula content.

Community health workers' critical role in trust building between the medical system and communities of color.

The authors interrogate elements of routine medical practice in New York City to argue for reforms of hospital culture through relational trust-building capabilities of community health workers.

Indocyanine green lymphography as novel tool to assess lymphatics in patients with lipedema.

Objective: Lipedema is a chronic and progressive disease associated with lymphatic impairment at later stages. The aim of our study was to describe the functional status and anatomy of lower limb superficial lymphatic system using indocyanine green (ICG) lymphography in patients with lipedema.

Methods: Following ICG injection at the dorsum of the foot, distance (cm) covered by the dye at 10 (T10') and 25 min (T25') was measured and normalized for limb length.

Inclusion of person-centred care in medical and nursing undergraduate curricula in the UK: Interviews and documentary analysis.

Objective: We aimed to understand how person-centred care (PCC) is represented in UK professional standards for undergraduate medical/nursing education and explored how these are reflected in programme provision.

Methods: We identified PCC components in medical (GMC) and nursing (NMC) professional standards and university curricula documents provided. We also identified themes from interviews with high-level informants for medical/nursing undergraduate programmes using framework analysis.

Lipedema: A Call to Action!

Lipedema is a chronic progressive disease characterized by abnormal fat distribution resulting in disproportionate, painful limbs. It almost exclusively affects women, leading to considerable disability, daily functioning impairment, and psychosocial distress. Literature shows both scarce and conflicting data regarding its prevalence.

[Lipedema, the Unknown].

Lipedema, the Unknown Abstract. Lipoedema patients suffer from the widespread ignorance of their pathology. Considering its chronic, progressive and invalidating character, the early diagnosis of the disease must constitute the challenge of their caregivers in order to limit medical wanderings and the occurrence of complex clinical pictures.

[Primary lymphedema].

Characterized by an aplasia, hypoplasia or dysplasia of the lymphatic network, the primary lymphedema takes part of rare diseases. If 10 % of cases are congenital, the majority of them are detected before 35 years, most of the time due to an intercurrent event suh as a sprain or an infection. Although rarer, some primaries lymphedemas are family forms such the syndromes of Milroy and Meige.

Implementing shared decision making in the NHS: lessons from the MAGIC programme.

Shared decision making requires a shift in attitudes at all levels but can become part of routine practice with the right support, say

[Lymphatic vascular pathologies: contribution of lympho-fluoroscopy].

If clinical examination has an essential importance in lymphology disorders and requires experimented practitioners, lymphoscintigraphy and more recently green indocyanine lympho-fluoroscopy constitute precious complementary investigations in prevention, diagnosis, and treatment of lymphatic vascular pathologies. The lymphoscintigraphy interest lies in qualitative and quantitative analysis of macromolecules migration within lymphatic vessels and the deep lymphatic network. The lympho-fluoroscopy distinguishes itself from lymphoscintigraphy allowing real time superficial lymphatic vessels detailed mapping, gathering important information on their contractility, and the presence of compensatory derivations to be favored during manual lymphatic drainage to angiologist and physiotherapist.

Intervention to reduce excessive alcohol consumption and improve comorbidity outcomes in hypertensive or depressed primary care patients: two parallel cluster randomized feasibility trials.

Background: Many primary care patients with raised blood pressure or depression drink potentially hazardous levels of alcohol. Brief interventions (BI) to reduce alcohol consumption may improve comorbid conditions and reduce the risk of future alcohol problems. However, research has not established their effectiveness in this patient population.

Shared decision making: a model for clinical practice.

The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process.

[Lymphatic disorders and prevention of their complications].

The prevalence of lymphedema is clearly underestimated. Too few patients receive treatment. It requires several specifically trained participants and must be conceived in the long term given the chronic nature and the incurability of this pathology.

[Prevention of post-thrombotic syndrome].

Post-thrombotic syndrome (PTS) is the most frequent chronic complication of deep vein thrombosis (DVT) with an estimated prevalence of 30-50%. PTS is a significant cause of disability, especially when complicated by venous ulcers. Therefore, PTS has important socio-economic consequences for both the patient and the health care system.

Delivering stepped care: an analysis of implementation in routine practice.

Background: In the United Kingdom, clinical guidelines recommend that services for depression and anxiety should be structured around a stepped care model, where patients receive treatment at different 'steps,' with the intensity of treatment (i.e., the amount and type) increasing at each step if they fail to benefit at previous steps.

[3rd degree chronic venous insufficiency: physiotherapy treatment].

A venous ulcer is the end result of a long pathological process where venous hypertension represents the principal cause of a number of complications. The physiotherapist by adapting various different therapeutic approaches improves the vascular, joint and respiratory problems of these patients.

Family systems ideas in the 10-minute consultation: using a reflecting partner or observing team in a surgery.

Background: Family therapy and the ideas that underlie it have not had much impact on general practice, although there is good reason to think this could be a useful approach.

Aim: As a group of general practitioners (and a practice nurse) with experience of family therapy, we were interested in demonstrating whether family therapy methods could usefully inform general practice consultations.

Method: Two surgeries were observed by the general practitioner's colleagues.

[The usefulness of lymphatic drainage].

Management of lymphoedema is extremely variable in the medical profession, ranging from total denial of diagnostic procedures and treatment to excessively aggressive treatments. Between these 2 extremes lies the manual lymphatic drainage technique according to Földi, which is an non-invasive physiological method. In some cases, it may be necessary to associate the use of sequential pneumatic compression or the introduction of medicaments of the benzopyrone family.