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      Primary Congenital Lymphedema with More Than 10 Years of Treatment Using the Godoy Method Through to Adolescence

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          Abstract

          Introduction: Lymphedema is a specific type of edema that affects regions of the body in a chronic, progressive manner. Aim: The aim of the present study was to describe the therapeutic evolution of more than ten years of treatment for primary congenital lymphedema using the Godoy and Godoy method. Method: Ten children with primary congenital lymphedema with more than ten years of treatment at the Godoy Clinic were evaluated. Children with a clinical diagnosis of primary congenital lymphedema in treatment for more than 10 years with the Godoy Method. Cervical stimulation is the first treatment option of the method and is performed as monotherapy. The patients were reevaluated with weekly, bi-weekly and monthly frequencies and then every three months or when the family was able to return to the clinic. Results: For cases in which cervical stimulation was not possible, grosgrain stockings as monotherapy was the second therapeutic option. Conclusion: The Godoy and Godoy Method is effective at reducing edema in cases of primary congenital lymphedema, with the maintenance of the results throughout the treatment period.

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          Primary lymphedema in children and adolescents: a follow-up study and review.

          Primary lymphedema, a disorder causing persistent swelling in an extremity, is rare in children and adolescents; it affects 1.15/100,000 persons less than age 20 years. It primarily affects girls near menarche. The records of 125 children and adolescents, aged 0 to 20 years, who were examined at the Mayo Clinic were analyzed; 99 of these patients were contacted to obtain follow-up data. The influences of estrogen and inflammation are thought to be important etiologic factors in primary lymphedema. The diagnosis can be made on the basis of a thorough history and physical examination. Lymphangiograms, venograms, and biopsies add nothing to the diagnosis because of the low incidence of tumor in children and adolescents. Conservative treatment is recommended: a Jobst-type stocking, elevation, and proper foot care. Diuretics are not recommended. Careful psychologic counseling, especially in adolescents, is highly recommended.
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            Lymphoedema: an underestimated health problem.

            Lymphoedema/chronic oedema is an important cause of morbidity in the population, but little is known of its epidemiology and impact on patients or health services. To determine the magnitude of the problem of chronic oedema in the community, and the likely impact of oedema on use of health resources, employment and patient's quality of life. Questionnaire-based survey. Health professionals from dedicated lymphoedema services, specific out-patient clinics, hospital wards and community services (GP clinics and district nurses) were contacted to provide information on patients from within South West London Community Trust. A subset of the identified patients was interviewed. Within the catchment area, 823 patients had chronic oedema (crude prevalence 1.33/1000). Prevalence increased with age (5.4/1000 in those aged > 65 years), and was higher in women (2.15 vs. 0.47/1000). Only 529 (64%) were receiving treatment, despite two specialist lymphoedema clinics within the catchment area. Of 228 patients interviewed, 78% had oedema lasting > 1 year. Over the previous year, 64/218 (29%) had had an acute infection in the affected area, 17/64 (27%) being admitted for intravenous antibiotics. Mean length of stay for this condition was 12 days, estimated mean cost pound 2300. Oedema caused time off work in > 80%, and affected employment status in 9%. Quality of life was below normal, with 50% experiencing pain or discomfort from their oedema. Chronic oedema is a common problem in the community with at least 100 000 patients suffering in the UK alone, a problem poorly recognized by health professionals. Lymphoedema arising for reasons other than cancer treatment is much more prevalent than generally perceived, yet resources for treatment are mainly cancer-based, leading to inequalities of care.
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              Godoy & Godoy technique of cervical stimulation in the reduction of edema of the face after cancer treatment.

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                Author and article information

                Journal
                Pediatr Rep
                Pediatr Rep
                pediatrrep
                Pediatric Reports
                MDPI
                2036-749X
                2036-7503
                20 February 2021
                March 2021
                : 13
                : 1
                : 91-94
                Affiliations
                MD Resident of the Pediatrics Unit Intensive Therapy of Santa Casa de São Paulo, Brazil and Research Group of Clínica Godoy, São Jose do Rio Preto 15025120, Brazil; acp.godoy@ 123456gmail.com (A.C.P.d.G.); mfggodoy@ 123456gmail.com (M.d.F.G.G.)
                Author notes
                [* ]Correspondence: godoyjmp@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-5424-7787
                https://orcid.org/0000-0003-3725-7961
                Article
                pediatrrep-13-00012
                10.3390/pediatric13010012
                8006030
                33672755
                219c612a-c672-4ed2-940a-1e88c4385437
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 October 2020
                : 09 February 2021
                Categories
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                Pediatrics
                lymphedema,treatment,children,monotherapy,congenital
                Pediatrics
                lymphedema, treatment, children, monotherapy, congenital

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