sábado, 22 de febrero de 2020

WORLD ELEPHANTIASIS DAY 2020 – Lymphostatic Elephantiasis - Lymphatic Filariasis & Podoconiosis - Pediatric & Primary Lymphoedema - Secondary Lymphoedema - Rare Disease - Awareness Day Campaign

A DAY FOR VINDICATION, MARCH 12, WORLD ELEPHANTIASIS DAY

March is recognized worldwide, as the month to highlight lymphedema, its most severe late-stage is known as “elephantiasis”. The Elephantiasis stage is not only located in poor developing countries but also can be found in European and high-tech Western nations. The medical term elephantiasis is used to identify a part of the body, which has undergone progressive deformity and trophic skin changes as a result of chronic lymphatic dysfunction. Throughout the world, the lack of treatment or under-treatment of lymphedema makes the elephantiasis stage a condition that is still present today.

Lymphatic dysfunction (Organic Disability) is not a rare disease but a major public health problem, and it is necessary to sensitize governments and international health organizations, that access to treatment for lymphedema and lymphatic diseases should be a global priority. Up to 10 million Americans may be affected by lymphoedema, and it's estimated that over 250 million people worldwide suffer from the disease, creating pain, swelling, disability, and suffering for patients of all ages, including children. The only way to avoid elephantiasis (Stage III lymphedema) is to provide early compression therapy and compression garments necessary for lymphatic disorders. Read more about why the world is not treating a treatable disease like elephantiasis HERE.
Lymphatic Elephantiasis is one of the world's most disfiguring, disabling, and life-threatening conditions, and is nearly always the result of non-treatment or undertreatment of lymphedema. There is a safe and effective treatment for lymphatic dysfunction, which helps to retain and maintain the progression of the disease towards its severe late stages. The best treatment for lymphedema is COMPLETE DECONGESTIVE THERAPY (CDT), which is considered the “Gold Standard” conservative treatment. This specialized treatment consists of Manual Lymphatic Drainage (MLD) and multi-layered bandage wrapping conducted by specialized lymphedema therapists, as well as other components such as skin care, diet, and exercises. 
The conservative treatment is indicated for all edema stages including Stage III, and as a preventive treatment that will avoid the initial progression toward the elephantiasis stage. Radical reductive ablative surgery, aimed to remove subcutaneous tissue, should always be the last option, for it is associated with possible significant blood loss, morbidity, infections, permanent disfigurement, and recurrence of symptoms.

The elephantiasis stage is preventable in the majority of cases, if the underlying cause which is lymphedema, is treated in its initial stages. In the case of lymphatic filariasis (Secondary Lymphedema), it is recognized that in many cases it is first acquired in childhood, often as many as one-third of children are infected before age 5. This fact needs urgent implications by international health organizations and public health systems, for prevention campaigns and management of this likewise childhood illness. The cornerstone for the PREVENTION of the elephantiasis stage is compression treatment of initial mild lymphedema, which will reduce the incidence of dermatolymphangioadenitis (infectious cellulitis) and Lymphangitis, which are the cause of the subsequent worsening of the condition. Read more about dermatolymphangioadentitis (DLA) in lymphedema HERE.


Apart from the patient daily basic self-care needed, consisting of washing limbs and skin moisturizing, they also need to wear compression garments throughout the day. Without compression garments, it is impossible to retain the progression of lymphatic edema. The daily use of standard bandages is not practical, for they tend to loosen and slip off when undertaking work that requires continuous physical activity, and likewise, soiled bandages can also be an important source of infection. Wearable compression garments are the only means by which a person can carry out their daily activities. Basic self-care alone without compression is not enough by itself to control the disease, and will not stop the progression towards the elephantiasis stage. Read more about the best treatment for elephantiasis HERE

International awareness campaigns are needed for access to compression therapy and compression garments for patients diagnosed with chronic lymphedema, many of them children, since this is the only possible way to stop the progression of the disease. The elephantiasis stage is a treatable condition, but it will never be eradicated from the world as long as there is non-treatment or under-treatment of lymphatic dysfunction (lymphedema).



IMPORTANT NOTICE 

Lymphedema is a serious chronic and progressive disease due to an organic disability. The clinical treatment of lymphedema is neither a cosmetic nor an aesthetic treatment. The treatment of lymphedema is to control its progression and alleviate the symptoms related to dysfunction of the lymphatic circulatory system. To prevent and avoid serious complications associated with treatment, such as the possible displacement of edema to previously unaffected areas when compression therapy is applied for volume reduction, patients should use highly specialized and experienced therapists. 

Professional qualification and instruction delivered remotely online are not the same as live hands-on practical instruction in the clinical training and certification of lymphedema therapists, similar to all other rehabilitation, medical, and surgical training programs, and especially for developing the necessary manual skills to treat a disease as complex as lymphedema. 

Patients should also take special care when choosing a "Multidisciplinary Center of Reference for Lymphedema", as not all countries and centers provide the same treatment options. The best choice is a center of reference that provides Complete Decongestive Therapy (CDT), which is recognized as the “Gold Standard” treatment for lymphedema.

  • Read more about what is the best treatment option for Lymphedema HERE.
  • Read about what are the principal functions of Manual Lymphatic Drainage HERE.
  • Read about what are the main differences between the two principal lymphedema treatment protocols HERE. 
  • Read about what are the strategies for the implementation of low-cost treatment options for Lymphedema HERE.

REFERENCES

(Click on the texts to read the research articles)

SCIENTIFIC SOCIETIES

PATHOPHYSIOLOGY

CUTANEOUS COMPLICATIONS
INFECTIOUS COMPLICATIONS
CELLULITIS / DERMATOLYMPHANGIOADENITIS
TUMOURS

TREATMENT

COMPRESSION GARMENTS

DISABILITY

DISFIGUREMENT

PSYCHOSOCIAL IMPACT

PEDIATRIC LYMPHEDEMA

LYMPHATIC FILARIASIS / PODOCONIOSIS



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