This article was designed to describe the main pathogenetic factors underlying the development of lymphedema of the lower extremities, the social implications of this condition, its prevalence throughout the world, and the impact of this disease on the quality of life of patients. In addition, the review presents the modern data on the management of patients with chronic lymphatic edema of the lower extremities. Special attention is given to the principles and methods of its combined conservative treatment, including the use of medications, compression therapy, physiotherapy, thalassotherapy, and balneotherapy. Moreover, the results of the analysis of the effectiveness of the treatment as a whole and of the individual methods, such as intermittent pneumatic compression (SPC), electrical myostimulation, laser therapy, magnetic-laser therapy (MLT) are reported with special reference to their outcomes when applied as isolated interventions and the components of the combined therapy. The review is devoted to the systematization of information about the currently available methods for the prevention and treatment of lymphadema of the lower extremities and the evaluation of the treatment regimens applied in this country and leading foreign clinical centres. Also considered are both the classical scheme of the combined treatment of lymphedema of the lower extremities and the schemes including novel therapeutic modalities. The most promising methods for the treatment of this condition including those proposed during a few recent years (such as kinesiotaping, LPG-engineering, and gravity therapy) are highlighted, and their influence on the generally accepted schemes of the combined treatment of lymphedema of the lower extremities is evaluated. The basic principles of modern pharmacotherapy and its role in the system of methods for the treatment of lymphedema of the lower extremities including phlebotomies, lymphokinesia, antibacterial drugs are considered.

BackgroundThe exact pathogenesis of fibromyalgia (FM) syndrome is unclear. However, different infections including hepatitis C virus, Human immunodeficiency virus and Lyme disease have already been implicated with the development of FM after their acute phase[1]. Imbalance between pro-inflammatory and anti-inflammatory cytokines has been suggested as a possible mechanism that facilitates the neuropathic pain[2].ObjectivesTo investigate the incidence of FM syndrome among convalesced individuals following hospitalization for Acute Coronavirus Disease-2019 (COVID-19) and to identify possible risk factors.MethodsWe performed a cross-sectional study on patients who were discharged after COVID-19 hospitalization from the Sheba Medical Center, Israel, between July 2020 to November 2020. A phone interview was performed consisting of the following questionnaires: the Fibromyalgia Survey Diagnostic Criteria Questionnaire, Sense of Coherence Questionnaire to evaluate resilience, and the Subjective Traumatic Outlook Questionnaire to assess the associated psychological aspects of the trauma. The incidence of post-COVID FM was calculated and regression models were performed to identify predictors.ResultsThe study population consisted of 198 eligible patients who completed the phone interview. The median age was 64 (52-72) and 37% were women. The median follow-up was 5.2 months (IQR 4.4-5.8). The incidence of FM was 15% (30 patients) and 87% (172 patients) had at least one FM-related symptom. Female gender was significantly associated with post-COVID FM (OR 3.65, p=0.002). In addition, high median Subjective Traumatic Outlook scores and low median Sense of Coherence scores were both significantly associated with post-COVID FM (OR 1.19, p<0.001 and OR 0.92, p<0.001, respectively).ConclusionFM is highly prevalent among COVID-19 convalescent patients. Our finding suggests that a significant subjective traumatic experience and a low resilience are highly associated with post-COVID FM.References[1]Buskila D, Atzeni F, Sarzi-Puttini P. Etiology of fibromyalgia: the possible role of infection and vaccination. Autoimmun Rev. 2008;8: 41-43.https://doi.org/10.1016/j.autrev.2008.07.023[2]Amital M, Ben-Shabat N, Amital H, Buskila D, Cohen AD, Amital D. COVID-19 associated hospitalization in 571 patients with fibromyalgia—A population-based study. PLoS ONE. 2021:16: e0261772.https://doi.org/10.1371/journal.pone.0261772Acknowledgements:NIL.Disclosure of InterestsNone Declared.

No abstract

No abstract