28 research outputs found
Preoperative assessment enables the early diagnosis and successful treatment of lymphedema.
BACKGROUND The incidence of breast cancer (BC)-related lymphedema (LE) ranges from 7% to 47%. Successful management of LE relies on early diagnosis using sensitive measurement techniques. In the current study, the authors demonstrated the effectiveness of a surveillance program that included preoperative limb volume measurement and interval postoperative follow-up to detect and treat subclinical LE. METHODS LE was identified in 43 of 196 women who participated in a prospective BC morbidity trial. Limb volume was measured preoperatively and at 3-month intervals after surgery. If an increase >3% in upper limb (UL) volume developed compared with the preoperative volume, then a diagnosis of LE was made, and a compression garment intervention was prescribed for 4 weeks. Upon reduction of LE, garment wear was continued only during strenuous activity, with symptoms of heaviness, or with visible swelling. Women returned to the 3-month interval surveillance pathway. Statistical analysis was a repeated-measures analysis of variance by time and limb ( P ≤ .001) comparing the LE cohort with an age-matched control group. RESULTS The time to onset of LE averaged 6.9 months postoperatively. The mean (±standard deviation) affected limb volume increase was 83 mL (±119 mL; 6.5% ± 9.9%) at LE onset ( P = .005) compared with baseline. After the intervention, a statistically significant mean 48 mL (±103 mL; 4.1% ± 8.8%) volume decrease was realized ( P < .0001). The mean duration of the intervention was 4.4 weeks (±2.9 weeks). Volume reduction was maintained at an average follow-up of 4.8 months (±4.1 months) after the intervention. CONCLUSIONS A short trial of compression garments effectively treated subclinical LE. Cancer 2008. Published 2008 by the American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60215/1/23494_ftp.pd
World unmaking in the fiction of Delany, VanderMeer, and Jemisin
This dissertation examines end-of-world and posthumanist themes in speculative fiction and theory through the concept of “world unmaking.” Reading for world unmaking in three popular U.S. works of speculative fiction — Samuel R. Delany’s Dhalgren (1974), Jeff VanderMeer’s Annihilation (2014), and N. K. Jemisin’s the Broken Earth Trilogy (2015-17) — it explores how varying representations of “the end” are deployed to destabilize normative ideals of the human and the world that undergird conventional notions of the subject under late liberal humanism. While much attention has been paid to world building and how inherent logics cohere within fictional worlds, world unmaking asks how representations of world disorder, instability, and breakdown might hold important insights for narrating and navigating disordered worlds. Contemporary posthumanist critical theorists increasingly vie for speculative practices that disrupt the inherited onto-epistemologies of liberal humanisms and settler colonialisms. In particular, new materialists and speculative realists argue urgent work must be done to expand thought beyond naturalized and neutralized discourses that subtend conventional versions of reality, especially as the pressures of multiple ecological and geopolitical crises bear down unequally upon the lives of both humans and nonhumans on a shared planet Earth. The rise in popularity of post-apocalyptic, eco-catastrophe, and survival narratives in recent decades suggests a growing appetite for speculative imaginings of the end. While some representations of the end of the world serve as an escape from the intersecting crises of the environment, the resurgence of right-wing politics and white supremacy, and the ongoing violence of settler colonialism, this dissertation illustrates the importance of attending to speculative imaginings that use the end-of-the-world conceit to destabilize dominant culture and pose more expansive questions about what it means to be human.Graduat
Tips for getting compression garments on and off
Compression hosiery can be difficult to put on by hand, this is especially true for the older person. This article identifies ways of putting garments on without causing distress to the wearer. </jats:p
