Zeitschrift fur Lymphologie. Journal of lymphology最新文献

Adding to the existing literature three cases of Stewart-Treves-syndrome in a secondary lymphedema of the leg, a postmastectomy lymphedema with progressing mamma-ca and an uncomplicated postmastectomy lymphedema are described and compared with former observation. Thanks to the physical therapy of edema the frequency of Stewart-Treves-syndrome seems to be lowered compared to former statistics.

Lymph flux disturbance lead to social changes in the life of the patient. In crafts and administration there are numerous occupations which interfere with the pathophysiological conditions of the lymphedema patient. This is being discussed in patients with breast cancer who underwent axillary dissection. Matters of legislation in retirement and handicap have to be reflected. In addition, current problems in the prescription of physical theory in lymphedema patient are reviewed.

On top of one comprehensive English accident statistics of head injuries in sports there is riding, followed by rugby and football. In Germany there is not very little of head and brain damage due to football as wide spread sports, followed by riding, athletics and gymnastics, whereas in boxing recurring head injuries of dosage underlaying concussion of the brain do play a part even in spite of wearing boxing caps. Anyway, damage of the brain will always be the most heavy complication. Besides uncomplicated wounds of the soft parts such as wounds of the scalp or contusion of the face the closed skull and brain damage will be the most generally form of head injury in sports, followed by fractures of the skull with contusion of the brain and intracranial hemorrhage. In the treatment of the post-concussion and post-contusion syndrome manual lymph drainage will achieve more importance by its anti-edematous and therefore depressant and also sedative effects.

Malignant diseases and the resulting disorders may lead to the prescription of physical therapy. In addition, cancer patients may suffer from orthopaedic diseases which are treated by physical therapy, e.g. low back pain. In this review, cancer epidemiology, the prevailing forms of physical therapies, their applications in cancer patients, and possible cautions are being discussed.

In 1991 group meetings have been established in the REHA-Klinik Damp to improve the coping ability of breast cancer patients. Information about the medical treatment was given to reduce uncertainty and anxiety. The psychical and social consequences, for instance, changes in self-consciousness and family life were discussed in their positive and negative aspects. Talking about their personal concerns and getting support by other women was a new experience for those who had not been in a self-help group before. Many breast cancer patients took the opportunity to reflect their needs and wishes to increase contentment in their lives. The following article describes the most important subjects being discussed in the group meetings and their significance for the coping ability of women with breast carcinoma.

Lymphodemas need treatment not only for the complaints they cause but also for their possible complications. Either complaints and complications can be eliminated or at least decreased by consistent physical therapy of edemas according to Asdonk.

The incidence of lymphodemas after vascular surgical reconstructions is underestimated. In stage III and IV of PAOD 80% of our patients are suffering from lymphodemas, in stage II about 30%. In stage III and IV a postreconstructive edema occurs more often, in stage II the incidence of both, secondary lymphedema and postreconstructive edema is similar. A complex physical therapy (CPT) after a successful surgical reconstruction decreases the swelling of the legs by special lymphatic massage and the patients are earlier rehabilitated. The lymphatic massage should be applied only in patients with high degree lymphedematous legs. Because of the improvement of microcirculation a benefit for the healing of trophic lesions could be considered.

Two case reports are presented. A ten year-old boy is impeded in his social activities as sports and a seventeen year-old girl in uptaking the normal activities of a young woman. Both are threatened by the "lymphologic rules" and possibly overprotective mothers, in consequence adverse psychic structures may develop. Physiotherapist and physicians are requested to give advice to the young patients and their parents.

The carcinoma of the breast is considered a very stressing life event for the women and is often followed by depressive reactions, fears and doubts in the worth of the individual self. Aside of the medical treatment psychosocial support of the carcinoma patients is important for a successful coping strategy. At home many women have founded self-guided groups to give this support to each other. The official rehabilitation-concepts of the social insurances in Germany also consider psychosocial support a very important factor for an adequate treatment of the breast carcinoma. The Reha-Klinik Damp has established group meetings for women suffering of breast carcinoma to give them the opportunity of support in coping with the physical and psychosocial changes that follow their disease. The underlying concept of these group meetings is being described and explained in the text.