Antoine Louveau of @ClevelandClinic closing out the conference with a presentation on lymphatics of the brain: "We have to start caring about this lymphatic system." #nln2019
Neurological disorders are extremely prevalent, extremely expensive, and there are limited therapies and treatments for what are often lifelong battles with large side effects. #nln2019
The brain is the most metabolically active organ of the body - how does it remove its waste?
A few years ago, evidence was found of the gymphatic system. The glymphatic system is not really a structure but rather a concept. #nln2019
Brain is impacted by blood, immune cells, gut + microbiome, and meninges. Meninges is 3-layer structure surrounding brain and spinal cord, previously believed to be a physical protective barrier - recent research shows its much more complex than that. #nln2019
The concept of there being no lymphatic drainage in the brain began back in 1948, with Sir Peter Medawar. This belief persisted (despite evidence, like molecules injected into brain draining into neck lymph nodes!) until recently. #nln2019
The glowing green bits are lymphatics in the meninges of a mouse 🐭 #nln2019
Louveau explains his team's research on neuroinflammation. #nln2019
By performing meningial lymphatic drainage to help clear accumulated cellular waste, there are potentials to treat aging of the brain. #nln2019
Current approaches in rodent studies aren't translatable to humans. Research needs to identify the molecular mechanisms that pertain to the specific function of the meningial lymphatic vessels in order to translate basic research into therapeutic. #nln2019
Meningial lymphatic vessels are implicated in the development/modulation of neurological disorders. MLV have a unique - environment induce - transcriptomic signature whose analysis might provide therapeutic target to safely manipulate the MLV. #nln2019
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Carmen Recupero begins a presentation on the applications of neuro-lymphatic therpay... 🧠 #nln2019
A link between lymphatics and the brain has been suspected, but now there's research backing it up: "Treating lymphatic health in the body is not an arm and a leg." #nln2019
Recupero coins a new term to describe her enthusiasm with glymphatics: "glymphie" 😅💙 #nln2019
Cheryl Brunelle from @MassGeneralNews is here now to discuss prospective screening for breast cancer-related #lymphedema. Re: establishing new guidelines - "This is just the beginning of a discussion that will progress over the next year or so." #nln2019
Screening for #lymphedema should begin at pre-operative visit, and continues every time they see their oncologist. Patient education is key so they can be vigilant of symptoms themselves: "Changes can be subtle. We want them to call as soon as their arm is 'different.'" #nln2019
When taking objective measurements, whether it's a tape measure or a BIS device, it's important to have protocol: "It's not only a tape measure that has potential for human error." #nln2019
.@DrDhruvSinghal from @BIDMChealth Lymphatic Center is on stage now: multidisciplinary approach to #lymphedema care is a necessity, not a luxury. BIDMC's center includes lymphatic therapy, lymphatic medicine, body imaging, lymphatic surgery, and nuclear medicine. #nln2019
The center runs a patient symposium every year to get the patient perspective, helps make program more patient-centric and really makes them a part of the team. (Love to see this!) #nln2019
Within the center are 3 clinics: lymphatic surgery clinic, lymphedema treatment clinic, and lymphatic medicine clinic. Every week the entire team gets together to discuss cases and make decisions as multidisciplinary team. #nln2019
Amy Rivera of @NinjasFightLE is up!! Her presentation is titled "The Power of Positivity: Learning How to Walk Again" #nln2019
@NinjasFightLE With a dramatic photo of her severely swollen pre-op leg behind, Amy begins: "I had a dream for 20 years that I was 'normal,'" she says. "The biggest dream I had... was to wear jeans." #nln2019
@NinjasFightLE Years of misdiagnosis and lack of answers left her without treatment. Amy's right leg was 200% larger than her left. #nln2019
Open discussion between panelists and audience on updating precautionary guidelines for #lymphedema. #nln2019
"We need to get clear on what the definition of #lymphedema is, otherwise we're going to be over-treating and over-worrying [cancer] patients."
-Nigel Bundred, professor of surgical oncology, Manchester University NHS Foundation Trust #nln2019
Wei Chen, professor & attending surgeon from @ClevelandClinic, offers metaphor as a precautionary note on randomized clinical trials: "We've all had good Chinese food and bad Chinese food. The same recipe by different chefs will taste different. Same goes for trials." #nln2019