Rende-Cosenza Course Report and Sorrento Congress.
The training activities in the territory continue. After Milan (as usual, at the Institute of Osteopathy on two weekends in February and March) with participants from the northern regions, the event was repeated (as last year) in Rende (Cosenza) with participants convened from various Calabrian Centers, on two weekends in March and April for an event also this time organized by Provider GECO Formazione.
The opportunities have enabled the training of new health professionals who have approached the problems related to peripheral edema sustained by vascular causes (mainly lymphatic and venous). Interest in this discipline is undoubtedly growing, thanks in part to the opportunities for reception in the area that the ministerial document on the Guidelines on Lymphedema and Related Pathologies is generating and steadily increasing, both in public and private contracted settings.
The Theoretical-Practical Course on Rehabilitation of Phlebolymphedema aims to provide the clinical and practical tools that enable practitioners to discriminate the various forms of edema according to their etiology (local and/or systemic) highlighting all the most appropriate therapeutic indications in individual cases and possible partial indications or, even contraindications. From primary edema to secondary and syndromic forms, post-flebothrombotic forms, ulcerative, venous and lymphatic lesions, possible complications (pulmonary thromboembolic disease, verrucosis, mycosis, erysipelas, lymphangites of various nature, lymphocele), not leaving out those particular pictures that require a targeted and particularly competent type of therapeutic support (Web Axillary Syndrom, bimastectomized, 4-limb lymphedema, external genital lymphedema, head and neck lymphedema, etc. ).
Special attention is paid to the theoretical description of the prerequisites of individual pharmacological, physical rehabilitative, and, when indicated, surgical treatments that aim to reverse the pathophysiological processes leading from the overt clinical pictures to the patho-physiological ones of restoring the most compliant clinical conditions.
The Theoretical-Practical Course on Rehabilitation of Phlebolymphedema aims to provide the clinical and practical tools that enable practitioners to discriminate the various forms of edema according to their etiology (local and/or systemic) highlighting all the most appropriate therapeutic indications in individual cases and possible partial indications or, even contraindications. From primary edema to secondary and syndromic forms, post-flebothrombotic forms, ulcerative, venous and lymphatic lesions, possible complications (pulmonary thromboembolic disease, verrucosis, mycosis, erysipelas, lymphangites of various nature, lymphocele), not leaving out those particular pictures that require a targeted and particularly competent type of therapeutic support (Web Axillary Syndrom, bimastectomized, 4-limb lymphedema, external genital lymphedema, head and neck lymphedema, etc. ).
Special attention is paid to the theoretical description of the prerequisites of individual pharmacological, physical rehabilitative, and, when indicated, surgical treatments that aim to reverse the pathophysiological processes leading from the overt clinical pictures to the patho-physiological ones of restoring the most compliant clinical conditions.
With this in mind, the description of the potential of lymphatic drainage (manual or mechanical ‘operator dependent’) and practical applications constitutes one of the salient aspects of the Course, on which the greatest emphasis is placed with the participants, who are continually corrected, so that they acquire an adequate skill that allows them proper autonomy aimed at the well-being of the patient following the therapeutic act.
In addition to the other various techniques with which to intervene on fibrotic areas of edema (Ultrasound, radial shockwaves, Lymphotaping) and on inflamed or ulcerated areas (Laserdiode, radial shockwaves, magnetotherapy with appropriate programs), the approach to elastocompressive treatment is fundamental, which starts from the theoretical assumptions (cornerstone of the treatment) that a bandage, given the same pathology and evolutionary clinical stage, must be tailored to the type of patient in need of treatment. The difference between the physical expressive capacity, in fact, of a patient who is ‘bedridden’ or forced during the various hours of the day to maintain a semi-orthopnogic posture (sitting in an armchair or wheelchair) and a patient with intense daily physical activity (work and non-work) is fundamental to the choice of materials with which to pack the bandage itself in the affected anatomical areas and to the very choice of application techniques with which the bandage itself is packaged (depending on whether the friction between the various layers of the bandage itself should need to be greater or lesser).
After a description of the various clinical aspects that characterize the systemic pathologies that cause peripheral edema (first and foremost, labile cardiac compensation), a differential diagnosis between the various forms and the consequent therapeutic approach, differentiated in individual cases, is described.
In addition to the other various techniques with which to intervene on fibrotic areas of edema (Ultrasound, radial shockwaves, Lymphotaping) and on inflamed or ulcerated areas (Laserdiode, radial shockwaves, magnetotherapy with appropriate programs), the approach to elastocompressive treatment is fundamental, which starts from the theoretical assumptions (cornerstone of the treatment) that a bandage, given the same pathology and evolutionary clinical stage, must be tailored to the type of patient in need of treatment. The difference between the physical expressive capacity, in fact, of a patient who is ‘bedridden’ or forced during the various hours of the day to maintain a semi-orthopnogic posture (sitting in an armchair or wheelchair) and a patient with intense daily physical activity (work and non-work) is fundamental to the choice of materials with which to pack the bandage itself in the affected anatomical areas and to the very choice of application techniques with which the bandage itself is packaged (depending on whether the friction between the various layers of the bandage itself should need to be greater or lesser).
After a description of the various clinical aspects that characterize the systemic pathologies that cause peripheral edema (first and foremost, labile cardiac compensation), a differential diagnosis between the various forms and the consequent therapeutic approach, differentiated in individual cases, is described.
But also the collateral aspects of the treated pathologies are adequately described, first of all the involvement of the osteo-muscular-ligamentous components (with repercussions on the strength and ‘Range of motion’ of the joints) for which the description of the differential diagnoses with other common pathologies is also operated.
The Course also includes an extensive treatment of Lipedema, in the light of continuing new scientific evidence to better target treatments (for many years ineffective and frustrating for patients) and, above all, to more adequately frame affected individuals from the perspective that individual pictures require an appropriate and personalized multiprofessional and multidisciplinary approach.
A number of videos complete a training course that is rich in iconography, continually updated, which contributes to greater clarity of exposition and is supported by educational material in the form of handouts that contain all the images and diagrams that are proposed during the days.
But this year in Rende there occurred what had happened two months earlier in Grado: the coexistence, on the same day and at the same times, of two scientific events of phlebolymphological interest. In Grado, the event had developed at the same time as the National Congress of the Polish Society of Lymphology and had required (thanks to the wonders of technology that make such occurrences possible today) a live connection to Krakow for scientific presentations and a live discussion with those present.
The Course also includes an extensive treatment of Lipedema, in the light of continuing new scientific evidence to better target treatments (for many years ineffective and frustrating for patients) and, above all, to more adequately frame affected individuals from the perspective that individual pictures require an appropriate and personalized multiprofessional and multidisciplinary approach.
A number of videos complete a training course that is rich in iconography, continually updated, which contributes to greater clarity of exposition and is supported by educational material in the form of handouts that contain all the images and diagrams that are proposed during the days.
But this year in Rende there occurred what had happened two months earlier in Grado: the coexistence, on the same day and at the same times, of two scientific events of phlebolymphological interest. In Grado, the event had developed at the same time as the National Congress of the Polish Society of Lymphology and had required (thanks to the wonders of technology that make such occurrences possible today) a live connection to Krakow for scientific presentations and a live discussion with those present.
At the same time as the Rende Course (scheduled a year earlier), the Conference ‘Venous and Lymphatic Edema: Updates and Innovation in Clinical-Diagnostic and Therapeutic Framing’ organized by Angela Piantadosi was taking place in Sorrento during the second ‘weekend’. The Event was well attended by healthcare professionals, including those from outside the region, and featured distinguished speakers taking turns in presentations. The Conference opened with a Magisterial Reading by Dr. Michelini, who (precisely in direct connection from Rende, in the midst of the active Course and with the participation of the Corsicans themselves) illustrated the ‘State of the Art’ at the national level of Lymphedema and Lipedema, with continuous normative and continuously improving references that the numerous patients suffering from these pathologies, today, compared to years ago, can enjoy regarding their specific care needs. Regulations that many other countries today envy us (in the coming weeks they will also be illustrated at the ILF International Congress in Nottingham), which today allow a more adequate care of patients capillary throughout the territory.
There is still much to be done, but the groundwork has been laid and interest in these issues is always growing for the benefit of the many patients who demand increasingly effective answers to their care needs.
Appointment for the next meetings, as always in the forefront.
Appointment for the next meetings, as always in the forefront.
Dr. Sandro Michelini – FT Fabio Romaldini
