Coralie R Arends, Caitlyn An Haack, Lisette van der Molen, Michiel W M van den Brekel, Martijn M Stuiver
{"title":"Reference Values for Interstitial Tissue Water in the Head and Neck Area: Non-lymphedema Participants.","authors":"Coralie R Arends, Caitlyn An Haack, Lisette van der Molen, Michiel W M van den Brekel, Martijn M Stuiver","doi":"10.1177/15578585251385299","DOIUrl":"https://doi.org/10.1177/15578585251385299","url":null,"abstract":"<p><p><b><i>Background:</i></b> To determine reference values for interstitial percentage water content (PWC) in the head and neck area, in a large and heterogeneous sample of non-lymphedema participants; to determine left-right interchangeability of measurement locations, and to explore to what extent PWC values vary with age, sex, skin type, and body mass index (BMI) at the determined measuring locations. <b><i>Methods and Results:</i></b> In this cross-sectional study, a heterogeneous group of adult non-lymphedema participants was included. PWC was measured according to an earlier developed protocol by seven trained health professionals. Limits of agreement, error correlations, and bias, as determined by Bland and Altman analysis, were used to assess the left-right interchangeability. Mixed effects models were used to explore variables that explain the variety in PWC values. Stratified descriptive reference values were calculated for relevant subgroups. A total of 412 participants were included in the study. The unstratified PWC values ranged from 38.9% to 45.5%. Sex and BMI were statistically significantly correlated with PWC values, while sex is also clinically relevant. <b><i>Conclusion:</i></b> This study resulted in sex-stratified reliable reference PWC values in the head and neck area for healthy adults. A difference of 10 percentage point between the same measurement point on the left and right side of the head or neck can be considered normal. The established reference values for PWC can be used to assist diagnosis and follow-up in patients with lymphedema in the head and neck area.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giovanni Farina, Ilaria Santaniello, Manuela Galli, Antonella LoMauro
{"title":"Modeling of Lymphedema Distribution and Complex Decongestive Therapy Effectiveness.","authors":"Giovanni Farina, Ilaria Santaniello, Manuela Galli, Antonella LoMauro","doi":"10.1177/15578585251387049","DOIUrl":"https://doi.org/10.1177/15578585251387049","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphedema is a potential chronic degenerative secondary condition of oncologic treatments. Complex decongestive therapy (CDT) is the only treatment. Quantitative dimensional characterization of lymphedema is a topic of great clinical interest that has not been sufficiently analyzed yet. We aimed to develop statistical models that evaluate lymphedema's local spatial distribution and the effectiveness of CDT. <b><i>Methods and Results:</i></b> Retrospective observational analysis of 74 individuals (220 medical records) with unilateral upper or lower limb lymphedema who completed at least one cycle of the first phase of CDT. Statistical mixed-effects models were used to quantify the local distribution of lymphedema through the circumference of eight detection points and the efficacy of CDT according to the entity and the etiology of lymphedema. The coefficients of the models considered both fixed (i.e., the effect at the population level) and random (i.e., subject) effects. All points significantly reduced between pre- and posttreatment. Lymph stagnation occurred in the forearm and below the knee. The dimensions and effective treatment were similar between primary and secondary lymphedema and between mild and moderate lymphedema. The median global volume reduction of the upper limb was 55.1%, while it was 55%, 44.8%, and 41.7% in mild, moderate, and severe lymphedema; 50.6% and 49.4% in primary and secondary lymphedema. The median global volume reduction of the lower limb was 49.5%, while it was 64%, 49.4%, and 48.2% in mild, moderate, and severe lymphedema. <b><i>Conclusion:</i></b> A modeling of lymphedema distribution was provided, finding a dysmorphic pattern driven by the gravitation effect, with lymphedema accumulating on the lower part of the limbs, which is also the part that mostly responded to CDT. The response to CDT was assessed locally and not in terms of global volume change. A new segmental proportional technique was proposed that allows making comparisons between and within subjects.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Relationship Between Sleep Quality, Fatigue, and Quality of Life in Women with Lipedema.","authors":"Ayla Cagliyan Turk, Dilek Eker Buyuksireci, Ender Erden, Ebru Erden, Pinar Borman","doi":"10.1177/15578585251387100","DOIUrl":"https://doi.org/10.1177/15578585251387100","url":null,"abstract":"<p><p><b><i>Background:</i></b> We aimed to assess the sleep quality and the relationship between sleep and fatigue and quality of life in female lipedema patients. <b><i>Methods and Results:</i></b> A total of 52 patients with lipedema (Group 1) and 40 healthy control subjects (Group 2) were enrolled. The type and stage of lipedema were recorded for Group 1. The quality of sleep was assessed by using the Pittsburgh Sleep Quality Index (PSQI). The Fatigue Severity Scale (FSS) was used for assessing fatigue. Quality of life was assessed with the World Health Organization Quality of Life. The mean age of the patient group was 45.26 ± 9.81, whereas it was 42.10 ± 6.36 years in the control group (<i>p</i> > 0.05). The mean body mass index was 30.23 ± 4.70 in Group 1 and 28.55 ± 4.14 in Group 2 (<i>p</i> > 0.05). The total PSQI score was 10 (range: 7-12.75) in Group 1 and 8 (range: 5-10) in Group 2 (<i>p</i> < 0.05). There was no difference between the groups in terms of FSS. In the assessment of quality of life, only the physical function domain was significantly poorer in Group 1 than in Group 2 (<i>p</i> < 0.05). Physical function was correlated with subjective sleep quality, sleep disorder, and daytime dysfunction; fatigue was correlated with sleep disorder, daytime dysfunction, and use of sleep medications (<i>p</i> < 0.05). There was a correlation between the total PSQI score and physical functioning and fatigue (<i>p</i> < 0.05). <b><i>Conclusion:</i></b> Female patients with lipedema have poor sleep quality and decreased quality of life. Sleep disturbance is associated with both physical function and fatigue. Quality of sleep should be questioned in every assessment of patients with lipedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Doubblestein, Deanne Fay, Sarah Brunskill, Betty Westbrook, Brittany Williams
{"title":"Effectiveness of Twice-Daily Complete Decongestive Therapy in Reducing Limb Volume in Children with Lymphedema: A Retrospective Study.","authors":"David Doubblestein, Deanne Fay, Sarah Brunskill, Betty Westbrook, Brittany Williams","doi":"10.1177/15578585251367334","DOIUrl":"10.1177/15578585251367334","url":null,"abstract":"<p><p><b><i>Aim:</i></b> To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema. <b><i>Methods:</i></b> A retrospective cohort study was conducted using rehabilitation records of children aged 5-17 years from Camp Watchme, a North American summer camp providing lymphedema interventions. <b><i>Results:</i></b> Over 4 years, 38 unique campers contributed 66 records for analysis. The majority were female (68.42%), with a mean age of 9.30 ± 2.66 years. Lower extremity limb volume demonstrated statistically significant reductions across all 4 years (2021, <i>p</i> = 0.011; 2022, <i>p</i> = 0.030; 2023, <i>p</i> < 0.001; 2024, <i>p</i> < 0.001). Cumulative analysis of upper extremities (<i>n</i> = 16) also showed significant volume reduction (<i>p</i> = 0.042, <i>r</i> = 0.50). Daily measurement tracking (<i>n</i> = 43) indicated consistent percent volume decreases, with confidence intervals supporting a meaningful change for lower extremity limb volume differences across 4 years. <b><i>Conclusion:</i></b> An intensive, short-duration CDT intervention significantly reduces limb volume in pediatric patients with lymphedema. Future research should explore long-term effects, optimize CDT protocols, and assess broader functional and psychosocial outcomes to enhance pediatric lymphedema management.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"283-290"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<i>Letter:</i> Tips for Treatment and Following Secondary Upper Extremity Lymphedema.","authors":"Takahiro Heshiki, Hayahito Sakai","doi":"10.1177/15578585251376743","DOIUrl":"10.1177/15578585251376743","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"309"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association Between Objectively Measured Physical Activity and Lower-Limb Lymphedema Markers in Patients with Lymphedema Secondary to Gynecological Cancer: A Cross-Sectional Study.","authors":"Yuriko Matsunaga-Myoji, Kimie Fujita, Satomi Tanaka, Miyuki Izumi, Urara Hirata, Kiyoko Kato","doi":"10.1177/15578585251376172","DOIUrl":"10.1177/15578585251376172","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lower-limb lymphedema (LLL) secondary to gynecological cancer is a serious health condition that negatively affects physical activity (PA). We investigated the association between objectively measured PA and lymphedema markers in patients with LLL after gynecological cancer treatment. <b><i>Methods and Results:</i></b> This cross-sectional study included 56 patients (mean age: 62.0 years) with LLL attending a lymphedema center. The degree of lymphedema was evaluated based on lower-limb water content (extracellular water content/whole body water content: ECW/TBW). The amount and intensity of PA were measured using an accelerometer. Thirty-three patients (61.1%) with ECW/TBW ≥0.4 were older, had significantly more sedentary time, and spent lesser time on moderate-to-vigorous activity than patients with ECW/TBW <0.4 (<i>p</i> < 0.05). A generalized linear model using the rate of change in ECW/TBW showed an association with older age, longer time since cancer diagnosis, and lower activity level. The severity of subjective symptoms measured using a visual analog scale did not differ between patients with high and low ECW/TBW. <b><i>Conclusions:</i></b> Patients with LLL spent approximately half of the time in sedentary behavior, with more severe cases exhibiting longer sedentary durations. In older patients who have a long-standing cancer diagnosis, medical professionals should evaluate their activity and self-care status in addition to evaluating LLL and use this information to provide individualized interventions.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"298-305"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alejandro Zapata-Ospina, Juan Pablo Zapata-Ospina, Diego Zapata-Ospina, Diana Rincón-Riano
{"title":"Prevalence of Lymphedema in Colombia During 2015-2020: A Population-Based Registry Study.","authors":"Alejandro Zapata-Ospina, Juan Pablo Zapata-Ospina, Diego Zapata-Ospina, Diana Rincón-Riano","doi":"10.1177/15578585251382549","DOIUrl":"https://doi.org/10.1177/15578585251382549","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Lymphedema is a chronic, intractable, and irreversible disease. It consists of insufficiency of the lymphatic vessels to transport lymph, leading to edema and fibrosis. In developing countries and Colombia, the current prevalence of lymphedema is unknown. <b><i>Methods:</i></b> A descriptive cross-sectional study based on population registries. Secondary sources available in Colombia for epidemiological surveillance were revised, and period and point prevalences were calculated. <b><i>Results:</i></b> A total of 49,185 cases with a diagnosis of lymphedema were identified in Colombia between 2015 and 2020, resulting in a prevalence of 96.6 cases per 100,000 inhabitants for this period. An increase in the annual point prevalence was found from 2015 to 2019. Lymphedema is more prevalent in women and in the population over 60 years of age. Postmastectomy lymphedema is more prevalent in people aged 60 years or older, and a differential distribution among the different regions of the country was observed. <b><i>Conclusions:</i></b> It is the first known prevalence study of lymphedema in Colombia. It shows that the frequency of the disease is increasing, mostly secondary lymphedema, which mainly affects women and people over 35 years of age.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Research Matters.","authors":"","doi":"10.1177/15578585251385907","DOIUrl":"10.1177/15578585251385907","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"310"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<i>Response to Letter:</i> Keith et al., Proposed Framework for Research Case Definitions of Lipedema, 22, 2: 93-105.","authors":"Helen E Eason, Elizabeth S Dylke","doi":"10.1177/15578585251362102","DOIUrl":"10.1177/15578585251362102","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"306-308"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Usefulness of Ultrasound Assessment of Breast Cancer-Related Lymphedema.","authors":"Doyoung Yuk, Kyungmin Kim, Kyeong Eun Uhm","doi":"10.1177/15578585251370750","DOIUrl":"10.1177/15578585251370750","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphedema, a common side effect of breast cancer treatments, affects 20%-40% of patients. Ultrasound evaluation measures structural change as well as skin and subcutaneous tissue thicknesses to assess lymphedema severity. This study aimed to investigate the usefulness of ultrasound evaluation as an outcome measure of lymphedema in patients with breast cancer. <b><i>Methods and Results:</i></b> Thirty-one patients with unilateral breast cancer-related lymphedema were enrolled. Arm circumferences were measured at four points, as the Relative Metric Coefficient of Arm Lymphedema (RMCAL). The thickness of the skin and subcutaneous tissue was measured using ultrasound at four points of the upper arm and forearm, comparing both sides. Subcutaneous echogenicity grade (SEG) and subcutaneous echo-free space (SEFS) grade were assessed following the method described by Suehiro et al. Lymphoscintigraphy evaluated axillary lymph node uptake and dermal backflow. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module 23 (EORTC QLQ-BR23). Increase ratios of skin and subcutaneous tissue thickness, SEG, and SEFS were well correlated with RMCAL value. Additionally, the increase ratio of subcutaneous tissue was significantly different according to the abnormality of axillary lymph node uptake on lymphoscintigraphy. However, ultrasound parameters did not significantly associate with functional and symptom scales of EORTC QLQ-BR23. <b><i>Conclusions:</i></b> Ultrasound parameters were well correlated with arm circumferences. Furthermore, subcutaneous tissue thickness on ultrasound was significantly related to lymphatic function assessed by lymphoscintigraphy.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":"291-297"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}