Background: Lymphedema may be identified by simpler circumference changes as compared with changes in limb volume.
Methods: Ninety breast cancer patients were prospectively enrolled in an academic trial, and seven upper extremity circumferences were measured quarterly for 3 years. A 10% volume increase or greater than 1 cm increase in arm circumference identified lymphedema with verification by a lymphedema specialist. Sensitivity and specificity of several different criteria for detecting lymphedema were compared using the academic trial as the standard.
Results: Thirty-nine cases of lymphedema were identified by the academic trial. Using a 10% increase in circumference at two sites as the criterion, half the lymphedema cases were detected (sensitivity 37%). When using a 10% increase in circumference at any site, 74.4% of cases were detected (sensitivity 49%). Detection by a 5% increase in circumference at any site was 91% sensitive.
Conclusions: An increase of 5% in circumference measurements identified the most potential lymphedema cases compared with an academic trial.
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http://dx.doi.org/10.1016/j.amjsurg.2003.07.003 | DOI Listing |
BMC Med
January 2025
Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
Background: Pain is a major challenge for patients with rheumatoid arthritis (RA), with many people suffering chronic pain. Current RA management guidelines focus on assessing and reducing disease activity using disease-modifying anti-rheumatic drugs (DMARDs). Consequently, pain care is often suboptimal, with growing evidence that analgesics are widely prescribed to patients with RA, despite potential toxicities and limited evidence for efficacy.
View Article and Find Full Text PDFBMC Med Educ
January 2025
Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
Background: The digital shift in higher education is moving from teacher-focused models to active learning with digital technologies, including the integration of game-based learning strategies. We aim to identify, assess, and summarize the findings of evidence and determine the effectiveness of game-thinking on learning outcomes in nursing education.
Methods: A comprehensive search for relevant literature was conducted between April and May 2022 Seven databases ERIC, Scopus, ProQuest Education Source, MEDLINE, CINAHL, Web of Science, and Embase were utilized to locate original, peer-reviewed papers published in English.
Arch Gynecol Obstet
January 2025
MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
Purpose: Observational studies have suggested negative associations between maternal 25-hydroxyvitamin D (25(OH)D) status and risk of hypertensive disorders of pregnancy [pregnancy-induced hypertension (PIH) and preeclampsia (PET)]. Data from intervention studies are limited. We hypothesised that vitamin D supplementation would lower maternal blood pressure (BP) during pregnancy and reduce the incidence of hypertensive disorders of pregnancy.
View Article and Find Full Text PDFBMJ
January 2025
State Key Laboratory of Reproductive Medicine and Offspring Health, Centre for Reproductive Medicine, Institute of Women, Children and Reproductive Health, Shandong University, Jinan, China
Objective: To test the hypothesis that a freeze-all strategy would increase the chance of live birth compared with fresh embryo transfer in women with low prognosis for in vitro fertilisation (IVF) treatment.
Design: Pragmatic, multicentre, randomised controlled trial.
Setting: Nine academic fertility centres in China.
BMJ Open
January 2025
Cardiac Rehabilitation, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Background: This qualitative evaluation was embedded in the Rehabilitation Exercise and psycholoGical support After COVID-19 InfectioN (REGAIN) study, a randomised controlled trial (RCT) for those with post-COVID-19 condition ('long COVID') after hospital admission for COVID-19, comparing weekly home-based, live online supervised group exercise and psychological support sessions with 'best practice usual care' (a single session of advice).
Objective: To increase our understanding of how and why the REGAIN programme might have worked and what helped or hindered this intervention.
Design: A qualitative evaluation which utilised interviews with participants and practitioners delivering the intervention.
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