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Perdomo M, Davies C, Levenhagen K, Ryans K, Gilchrist L. Patient education for breast cancer-related lymphedema: a systematic review. J Cancer Surviv 2023; 17:384-398. [PMID: 36207626 PMCID: PMC9546750 DOI: 10.1007/s11764-022-01262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim was to identify the impact of the (a) components of breast cancer-related lymphedema (BCRL) educational content, (b) modes of education, and (c) timing of education on arm volume, quality of life, function, complications associated with BCRL, adherence to interventions, and knowledge acquisition in individuals diagnosed with breast cancer (BC). METHODS This review followed the Preferred Reported Items for Systematic Review and Meta-analysis (PRISMA) guidelines (PROSPERO CRD42021253084). Databases searched included PubMed, CINAHL, Web of Science, Google Scholar, and Scopus from January 2010 to December 2021. Study quality and bias were assessed using the American Physical Therapy Association's Critical Appraisal Tool for Experimental Intervention Studies. RESULTS Forty-five studies were eligible, and 15 met the inclusion criteria (4 acceptable and 11 low quality). This review was unable to determine the optimal content, mode, and timing for BCRL education across survivorship. Content included a brief overview of BCRL, early signs and symptoms, risk reduction practices, and a point of contact. Delivery was multi-modal, and knowledge acquisition was rarely assessed. Education was provided pre/post operatively and after BCRL developed. CONCLUSIONS Individualized BCRL education via a multi-modal approach, repeated at multiple time points, and assessment of survivors' knowledge acquisition is recommended. Consideration of the survivors' phase of treatment, content volume, and time required to complete the program is advised when developing the educational intervention. IMPLICATIONS FOR CANCER SURVIVORS Survivors of BC may need to advocate for BCRL education based on their individual risk and needs, request a point of contact for questions/follow up, and express their preferred style of learning.
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Affiliation(s)
- Marisa Perdomo
- Division of Biokinesiology and Physical Therapy @ the Ostrow School of Dentistry, University of Southern California, 1540 Alcazar Street CHP 155, Los Angeles, CA, 90089, USA.
| | - Claire Davies
- Nursing and Allied Health Research Office, Baptist Health Lexington, 1740 Nicholasville Road, Lexington, KY, 40503, USA
| | - Kimberly Levenhagen
- Saint Louis University Program in Physical Therapy, 3437 Caroline Street Suite 1026, St Louis, MO, 63104, USA
| | - Kathryn Ryans
- Mercy College Doctor of Physical Therapy Program, 555 Broadway, , Dobbs Ferry, NY, 10522, USA
| | - Laura Gilchrist
- St. Catherine Univeristy, Doctor of Physical Therapy Program, 2004 Randolph Ave, St. Paul, MN, 55105, USA
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Ryans K, Perdomo M, Davies CC, Levenhagen K, Gilchrist L. Rehabilitation interventions for the management of breast cancer-related lymphedema: developing a patient-centered, evidence-based plan of care throughout survivorship. J Cancer Surviv 2023; 17:237-245. [PMID: 33481161 DOI: 10.1007/s11764-021-00991-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE A work group from the American Physical Therapy Association Academy of Oncologic Physical Therapy developed and published a clinical practice guideline (CPG) to aid clinicians in identifying interventions for individuals with breast cancer-related lymphedema (BCRL). This guideline reviewed the evidence for risk mitigation and volume reduction beginning at cancer diagnosis and continuing through survivorship. Application of CPGs can be challenging due to the variability of clinical settings, heterogeneous patient populations, and range of rehabilitation clinician expertise. The purpose of this paper is to assist these clinicians in implementing the recommendations from the CPG to develop a patient-centered, evidence-based plan of care. METHODS/RESULTS This publication presents important considerations for the implementation of recommended rehabilitation interventions across the trajectory of BCRL. CONCLUSION Current evidence supports specific interventions to treat or mitigate the risk for the various stages of BCRL. As clinicians implement these recommendations into practice, they also need to address other impairments that may exist in every individual. Continued collaboration between clinicians and researchers is necessary to further develop optimal treatment modalities and parameters. IMPLICATIONS FOR CANCER SURVIVORS By implementing evidence-based interventions as outlined in the CPG, clinicians can improve the quality of care for survivors of breast cancer.
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Weigensberg MJ, Àvila Q, Spruijt-Metz D, Davis JN, Wen CKF, Goodman K, Perdomo M, Wadé NB, Ding L, Lane CJ. Imagine HEALTH: Randomized Controlled Trial of a Guided Imagery Lifestyle Intervention to Improve Obesity-Related Lifestyle Behaviors in Predominantly Latinx Adolescents. J Altern Complement Med 2021; 27:738-749. [PMID: 34037459 DOI: 10.1089/acm.2020.0515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction: To determine the effects of a novel lifestyle intervention combining lifestyle behavioral education with the complementary-integrative health modality of guided imagery (GI) on dietary and physical activity behaviors in adolescents. The primary aim of this study was to determine the incremental effects of the lifestyle education, stress reduction GI (SRGI), and lifestyle behavior GI (LBGI) components of the intervention on the primary outcome of physical activity lifestyle behaviors (sedentary behavior, light, moderate, and vigorous physical activity), as well as dietary intake behaviors, at the completion of the 12-week intervention. The authors hypothesized that the intervention would improve obesity-related lifestyle behaviors. Materials and Methods: Two hundred and thirty-two adolescent participants (aged 14-17 years, sophomore or junior year of high school) were cluster randomized by school into one of four intervention arms: nonintervention Control (C), Lifestyle education (LS), SRGI, and LBGI. After-school intervention sessions were held two (LS) or three (SRGI, LBGI) times weekly for 12 weeks. Physical activity (accelerometry) and dietary intake (multiple diet recalls) outcomes were assessed pre- and postintervention. Primary analysis: intention-to-treat (ITT) mixed-effects modeling with diagonal covariance matrices; secondary analysis: ad hoc subgroup sensitivity analysis using only those participants adherent to protocol. Results: ITT analysis showed that the Healthy Eating Index (HEI) increased in the LS group compared with C (p = 0.02), but there was no additional effect of GI. Among adherent participants, sedentary behavior was decreased stepwise relative to C in SRGI (d = -0.73, p = 0.004) > LBGI (d = -0.59, p = 0.04) > LS (d = -0.41, p = 0.07), and moderate + vigorous physical activity was increased in SRGI (d = 0.58, p = 0.001). Among adherent participants, the HEI was increased in LS and SRGI, and glycemic index reduced in LBGI. Conclusions: While ITT analysis was negative, among adherent participants, the Imagine HEALTH lifestyle intervention improved eating habits, reduced sedentary activity, and increased physical activity, suggesting that GI may amplify the role of lifestyle education alone for some key outcomes. CTR #NCT02088294.
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Affiliation(s)
- Marc J Weigensberg
- Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Quintila Àvila
- Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Donna Spruijt-Metz
- Department of Psychology, USC Dornsife Center for Economic and Social Research, Los Angeles, CA, USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Cheng K F Wen
- USC Center for Self-Report Science, Los Angeles, CA, USA
| | - Kim Goodman
- Department of Adult Mental Health and Wellness, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Marisa Perdomo
- Division of Biokinesiology and Physical Therapy, USC Ostrow School of Dentistry, Los Angeles, CA, USA
| | - Niquelle Brown Wadé
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Li Ding
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Christianne J Lane
- Division of Biostatistics, Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, CA, USA
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Lima do Nascimento J, Rivero J, Frutuoso e Melo P, Perdomo M. Component unavailability model for PSA Level I applications considering aging and startup degradation: An Application to an Emergency Diesel Generator System. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2020.108000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Davies C, Levenhagen K, Ryans K, Perdomo M, Gilchrist L. Interventions for Breast Cancer-Related Lymphedema: Clinical Practice Guideline From the Academy of Oncologic Physical Therapy of APTA. Phys Ther 2020; 100:1163-1179. [PMID: 32589208 PMCID: PMC7412854 DOI: 10.1093/ptj/pzaa087] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 12/22/2019] [Accepted: 03/01/2020] [Indexed: 12/22/2022]
Abstract
A work group from the American Physical Therapy Association (APTA) Academy of Oncologic Physical Therapy developed a clinical practice guideline to aid clinicians in identifying interventions for people with breast cancer-related lymphedema, targeting volume reduction, beginning at breast cancer diagnosis and continuing through cancer treatments and survivorship. Following a systematic review of published studies and a structured appraisal process, recommendations were developed to guide physical therapists and other health care clinicians in their intervention selection. Overall, clinical practice recommendations were formulated based on the evidence for each intervention and were assigned a grade based on the strength of the evidence. The evidence for each specific intervention was synthesized and appraised by lymphedema stage, when the information was available. In an effort to make recommendations clinically applicable, they were presented by modality throughout the care trajectory. Methodology and research populations varied significantly across studies, and it will be important for future research to use standardized definitions for participant characteristics, diagnostic criteria, and interventions.
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Affiliation(s)
| | - Kimberly Levenhagen
- K. Levenhagen, PT, DPT, Department of Physical Therapy & Athletic Training, Saint Louis University, St Louis, Missouri. Dr Levenhagen is a certified lymphedema therapist
| | - Kathryn Ryans
- K. Ryans, PT, DPT, Doctor of Physical Therapy Program, Mercy College, Dobbs Ferry, New York. Dr Ryans is a board-certified clinical specialist in oncologic physical therapy and a certified lymphedema therapist-Lymphology Association of North America
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Weigensberg MJ, Provisor J, Spruijt-Metz D, Lane CJ, Florindez D, Wen C, Perdomo M, Goodman K. Guided Imagery Council: Feasibility, Acceptability, and Preliminary Effects of a Novel Group-Based Lifestyle Intervention in Predominantly Latino Adolescents. Glob Adv Health Med 2019; 8:2164956119844477. [PMID: 31106035 PMCID: PMC6505239 DOI: 10.1177/2164956119844477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/09/2019] [Accepted: 02/26/2019] [Indexed: 12/27/2022] Open
Abstract
Background The combination of higher stress and higher obesity rates suggests that
Latino youth in the United States may be a population at particular risk for
obesity-related adverse health outcomes. The objective of this article is to
describe the feasibility, acceptability, and quantitative stress-related
outcomes of a 6-week pilot lifestyle intervention using guided imagery (GI)
council in order to reduce risk factors for obesity-related disease. Methods Seventeen urban, adolescents (12 females/5 males, 16 Latino, age 17 ± 1
years, grades 9–12, body mass index 22 ± 4) participated in the 6-week,
after-school pilot intervention. The intervention consisted of three,
75-minute after-school sessions delivered weekly for 6 weeks. The 3 weekly
sessions included 1 session each of nutrition education, physical activity
education and practice, and GI delivered in council, a facilitated group
process based on indigenous practices. Feasibility and acceptability were
assessed by attendance and qualitative exit interview. Stress outcomes
included salivary cortisol and perceived stress. Results The pilot intervention was found to be feasible to deliver in an after-school
setting. The GI and council group format were well liked. A 31% reduction in
salivary cortisol was observed following the stress-reduction GI sessions.
Diurnal cortisol patterns did not change across the intervention, but change
in perceived stress was correlated with change in cortisol awakening
response. Conclusions The intervention was feasible to deliver and highly acceptable. Acute
reduction in salivary cortisol was seen following group GI, while no change
was seen in daily cortisol patterns. These results support the development
of a full 12-week intervention using GI council to reduce obesity-related
disease risk.
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Affiliation(s)
- Marc J Weigensberg
- Department of Pediatrics, University of Southern California (USC) Keck School of Medicine, Los Angeles, California
| | - Joseph Provisor
- Department of Pediatrics, University of Southern California (USC) Keck School of Medicine, Los Angeles, California
| | - Donna Spruijt-Metz
- Department of Psychology, USC Dornsife Center for Economic and Social Research, Los Angeles, California.,Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, California
| | - Christianne J Lane
- Department of Preventive Medicine, Division of Biostatistics, USC Keck School of Medicine, Los Angeles, California
| | - Daniella Florindez
- Department of Pediatrics, University of Southern California (USC) Keck School of Medicine, Los Angeles, California
| | - Cheng Wen
- Department of Preventive Medicine, USC Keck School of Medicine, Los Angeles, California
| | - Marisa Perdomo
- USC Division of Physical Therapy and Biokinesiology, Ostrow School of Dentistry, Los Angeles, California
| | - Kim Goodman
- Department of Adult Mental Health and Wellness, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, California
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Gilchrist L, Levenhagen K, Davies C, Ryans K, Perdomo M. Author Response. Phys Ther 2018; 98:281-283. [PMID: 29319816 DOI: 10.1093/ptj/pzy005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Laura Gilchrist
- Doctor of Physical Therapy Program, St Catherine University, Minneapolis, Minnesota
| | - Kimberly Levenhagen
- Department of Physical Therapy and Athletic Training, St. Louis University, Saint Louis, Missouri
| | - Claire Davies
- Physical Therapy Department, Baptist Health Lexington, Lexington, Kentucky
| | - Kathryn Ryans
- Doctor of Physical Therapy Program, Mercy College, Dobbs Ferry, New York
| | - Marisa Perdomo
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California
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Levenhagen K, Davies C, Perdomo M, Ryans K, Gilchrist L. Diagnosis of Upper Quadrant Lymphedema Secondary to Cancer: Clinical Practice Guideline From the Oncology Section of the American Physical Therapy Association. Phys Ther 2017; 97:729-745. [PMID: 28838217 PMCID: PMC5803775 DOI: 10.1093/ptj/pzx050] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 05/01/2017] [Indexed: 01/20/2023]
Abstract
The Oncology Section of the American Physical Therapy Association (APTA) developed a clinical practice guideline to aid the clinician in diagnosing secondary upper quadrant cancer-related lymphedema. Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in the diagnostic process. Overall clinical practice recommendations were formulated based on the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility. In an effort to maximize clinical applicability, recommendations were based on the characteristics as to the location and stage of a patient's upper quadrant lymphedema.
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Affiliation(s)
- Kimberly Levenhagen
- Saint Louis University, Doisy College of Health Sciences, Department of Physical Therapy & Athletic Training, St Louis, Missouri
| | - Claire Davies
- Rehabilitation Services Baptist Health Lexington, Lexington, Kentucky
| | - Marisa Perdomo
- University of Southern California, Division of Biokinesiology and Physical Therapy, Los Angeles, California
| | - Kathryn Ryans
- Doctor of Physical Therapy Program, Mercy College, Dobbs Ferry, New York
| | - Laura Gilchrist
- St Catherine University, Doctor of Physical Therapy Program, 601 25th Avenue South, Minneapolis, MN 55454
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Perdomo M, Sebelski CA, Davies C. Oncology Section Task Force on Breast Cancer Outcomes: Shoulder and Glenohumeral Outcome Measures. Rehabilitation Oncology 2013. [DOI: 10.1097/01893697-201331010-00005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Gamboa F, Aldana J, Saavedra L, Tellez M, Perdomo M, Tellez N. Antimicrobial activity of active fractions from Eleagia utilis and Isertia laevis against S. mutans and S. sobrinus. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Fernandez A, Guindeo MC, Molero T, Dominguez C, Hortal L, Perez-Borges P, Jimenez S, Navarro M, Perdomo M, Vega N, Palop L. Anaemia of renal failure: Differences between continuous ambulatory peritoneal dialysis and haemodialysis. Nephrology (Carlton) 2000. [DOI: 10.1046/j.1440-1797.2000.00506.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Campos-Herrero MI, Rodríguez H, Lluch J, Perdomo M, Pérez MC, Gómez E. [Disseminated infection by Mycobacterium scrofulaceum: apropos of 3 cases]. Enferm Infecc Microbiol Clin 1996; 14:258-60. [PMID: 9044643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mycobacterium avium-M. Intracellulare complex and Mycobacterium kansasii cause most of nontuberculous mycobacteria infections in AIDS patients in Spain. Mycobacterium scrofulaceum is rarely isolated as a cause of disseminated disease and most of case have been reported before the AIDS occurrence. METHODS Three clinical cases of patients with disseminated disease caused by M.scrofulaceum and AIDS are reviewed. RESULTS Clinical presentation in all cases was similar to those of other disseminated mycobacterial infection, and was also linked to severe immunosuppression (CD4 cell count < 100 CD4/mm3). CONCLUSIONS In our area, M. scrofulaceum is the second species of nontuberculous mycobacteria causing disseminated disease in AIDS patients. The most frequent species is M. avium-M. intracellulare complex. For diagnosis an AIDS patient complaining of febrile syndrome without foci and severe immunosuppression, is mandatory to obtain blood cultures and biopsy or adenopathy aspirates if present. To our knowledge, these are the first reports in our country.
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Affiliation(s)
- M I Campos-Herrero
- Unidad de Microbiología, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria
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Suárez L, Perdomo M, Escobar H. [Bacterial microflora and intestinal ecosystem. Physiopathology of the contaminated small bowel. Acute diarrhea. Environment in Spain]. G E N 1994; 48:61-4. [PMID: 7774785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
Intestinal permeability was investigated in 16 children with cystic fibrosis and 14 age-matched controls, making use of 51Cr-EDTA as probe molecule. Orocecal transit time was also evaluated using the lactulose/hydrogen breath test. There was an increase in permeability to 51Cr-EDTA in patients with cystic fibrosis (mean 13.62%) compared with the control group (mean 1.08%). The orocecal transit time was prolonged in patients with cystic fibrosis compared with controls. Mean fasting breath hydrogen concentration was significantly greater in cystic fibrosis patients (13 ppm) compared with control patients (3 ppm). There was no correlation between the percentage of 51Cr-EDTA excreted and the orocecal transit time in either control or cystic fibrosis patients.
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Affiliation(s)
- H Escobar
- Department of Pediatrics, Ramón y Cajal Hospital, University of Alcalá de Henares, Madrid, Spain
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Fernández A, Vega N, Hortal L, Jimenez F, Laraudogoitía E, Macía M, Plaza C, Perdomo M, Palop L. Could CAPD modulate the hemodynamic changes induced by rHuEPO treatment? Adv Perit Dial 1992; 8:435-9. [PMID: 1361842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Hemodynamic response to treatment with erythropoietin has been analyzed on two different groups of patients. The first group of 25 patients was treated with hemodialysis. The second group of 27 was treated with peritoneal dialysis. Both groups were studied before starting the treatment with erythropoietin, after reaching the hemoglobin target point, and after one year of treatment. The following parameters were recorded: basal and hemoglobin target point, time and dosage of response, incidence of arterial hypertension, diastolic and systolic left ventricular diameters, interventricular septum and posterior wall thickness, ejection fraction, fractional fiber shortening, left ventricular mass index, cardiac output index and peripheral resistance index. The incidence of hypertension was 28.8% and, in both techniques, stabilization of left ventricular mass index occurred a year later. When the hemoglobin target point was reached, a decrease in cardiac output and an increase in peripheral resistance was found. These changes were more evident in the group of patients treated with HD. After a year of treatment, both peripheral resistance and cardiac output were similar to basal values in both groups of patients.
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Affiliation(s)
- A Fernández
- Nephrology Service, Hospital Nuestra Señora del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain
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Vega N, Fernandez A, Hortal L, Macias M, Rodriguez JC, Plaza C, Perdomo M, Vega R, Palop L. Peritoneal dialysis efficiency in CAPD patients in treatment with rHuEPO. Adv Perit Dial 1992; 8:467-70. [PMID: 1361850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Possible modifications in peritoneal behaviour that can be caused by erythropoietin (EPO) treatment and/or correction of anemia in the ultrafiltration and peritoneal diffusion were studied in 24 CAPD patients. The evolution of the patients on the medium run was also studied. The dialysate to plasma ratio, the peritoneal clearance and the mass transfer coefficient of urea and creatinine and the ultrafiltration volume were studied, baseline, after reaching the hemoglobin target, and after eight months of treatment. The group of patients developed a decrease in the dialysate to plasma ratio and in the peritoneal clearance of creatinine. After evaluating the effects of the hemoglobin and the hematocrit, we found a decrease in the dialysate to plasma ratio of urea and creatinine, and in the peritoneal clearance of creatinine. A decrease was also found in the mass transfer coefficients of urea and creatinine. An increase in the ultrafiltration was also found in the patients with hemoglobin levels higher or equal to 11 g/dl. Those changes are reversible after turning the hemoglobin levels back to levels lower than 11 g/dl.
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Affiliation(s)
- N Vega
- Hospital Ntra. Sra. del Pino, Las Palmas de Gran Canaria, Canary Islands, Spain
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Fernández A, Vega N, Jiménez F, Macía M, Laraudiogoitía E, Hortal L, Perdomo M, Plaza C, Rodríguez JC, Palop L. Effect of recombinant human erythropoietin treatment on hemodynamic parameters in continuous ambulatory peritoneal dialysis and hemodialysis patients. Am J Nephrol 1992; 12:207-11. [PMID: 1481867 DOI: 10.1159/000168448] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We studied the hemodynamic changes and the incidence of hypertension after correction of anemia with recombinant human erythropoietin (rhEPO) in 25 hemodialysis (HD) and in 27 continuous ambulatory peritoneal dialysis (CAPD) patients with a mean age of 44.6 years and a mean time on dialysis of 43.6 months. We analyzed basal and final hemoglobin concentrations, time elapsed to reach target hemoglobin, rhEPO dosage, and the following echocardiographic parameters: left ventricular end-systolic and end-diastolic diameters and volumes, posterior wall thickness, interventricular septum, ejection fraction, fractional fiber shortening, cardiac output index, and peripheral vascular resistance index. We did not find any significant difference between HD and CAPD patients in basal and final hemoglobin, concentrations, time elapsed to reach target hemoglobin, dose of rhEPO received for response, and incidence of hypertension. Changes were more evident in HD patients, with a decrease of 15% in cardiac output index and an equal increase of peripheral vascular resistance,. In the patients on CAPD, these variations were less important, with a decrease in cardiac output index of 10% and no significant change in peripheral vascular resistance. Despite both techniques showing the occurrence of hypertension, the left ventricular mass stabilized during the study time. We conclude that CAPD seems to modulate the changes observed in hemodynamic parameters after rhEPO treatment.
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Affiliation(s)
- A Fernández
- Department of Nephrology, Hospital Ntra Sra del Pino, Las Palmas de Gran Canaria, Spain
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