Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone.
Identifieur interne : 005671 ( PubMed/Corpus ); précédent : 005670; suivant : 005672Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone.
Auteurs : J R Casley-Smith ; R G Morgan ; N B PillerSource :
- The New England journal of medicine [ 0028-4793 ] ; 1993.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Coumarins.
- drug therapy : Lymphedema.
- pathology : Arm, Leg, Lymphedema.
- physiopathology : Lymphedema.
- chemical , therapeutic use : Coumarins.
- Chronic Disease, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Skin Temperature.
Abstract
Benzopyrones can reduce the volume of high-protein edema fluid by stimulating proteolysis. These compounds provide a method for removing excess protein and its consequent edema and reduce its clinical sequelae, such as chronic inflammation and secondary infections.
DOI: 10.1056/NEJM199310143291604
PubMed: 8377779
Links to Exploration step
pubmed:8377779Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone.</title>
<author><name sortKey="Casley Smith, J R" sort="Casley Smith, J R" uniqKey="Casley Smith J" first="J R" last="Casley-Smith">J R Casley-Smith</name>
<affiliation><nlm:affiliation>Henry Thomas Laboratory (Microcirculation Research), University of Adelaide, S.A., Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Morgan, R G" sort="Morgan, R G" uniqKey="Morgan R" first="R G" last="Morgan">R G Morgan</name>
</author>
<author><name sortKey="Piller, N B" sort="Piller, N B" uniqKey="Piller N" first="N B" last="Piller">N B Piller</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="1993">1993</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone.</title>
<author><name sortKey="Casley Smith, J R" sort="Casley Smith, J R" uniqKey="Casley Smith J" first="J R" last="Casley-Smith">J R Casley-Smith</name>
<affiliation><nlm:affiliation>Henry Thomas Laboratory (Microcirculation Research), University of Adelaide, S.A., Australia.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Morgan, R G" sort="Morgan, R G" uniqKey="Morgan R" first="R G" last="Morgan">R G Morgan</name>
</author>
<author><name sortKey="Piller, N B" sort="Piller, N B" uniqKey="Piller N" first="N B" last="Piller">N B Piller</name>
</author>
</analytic>
<series><title level="j">The New England journal of medicine</title>
<idno type="ISSN">0028-4793</idno>
<imprint><date when="1993" type="published">1993</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm (pathology)</term>
<term>Chronic Disease</term>
<term>Coumarins (adverse effects)</term>
<term>Coumarins (therapeutic use)</term>
<term>Double-Blind Method</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Leg (pathology)</term>
<term>Lymphedema (drug therapy)</term>
<term>Lymphedema (pathology)</term>
<term>Lymphedema (physiopathology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Skin Temperature</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Coumarins</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Arm</term>
<term>Leg</term>
<term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Coumarins</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Chronic Disease</term>
<term>Double-Blind Method</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Skin Temperature</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Benzopyrones can reduce the volume of high-protein edema fluid by stimulating proteolysis. These compounds provide a method for removing excess protein and its consequent edema and reduce its clinical sequelae, such as chronic inflammation and secondary infections.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">8377779</PMID>
<DateCreated><Year>1993</Year>
<Month>10</Month>
<Day>21</Day>
</DateCreated>
<DateCompleted><Year>1993</Year>
<Month>10</Month>
<Day>21</Day>
</DateCompleted>
<DateRevised><Year>2012</Year>
<Month>11</Month>
<Day>15</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Print">0028-4793</ISSN>
<JournalIssue CitedMedium="Print"><Volume>329</Volume>
<Issue>16</Issue>
<PubDate><Year>1993</Year>
<Month>Oct</Month>
<Day>14</Day>
</PubDate>
</JournalIssue>
<Title>The New England journal of medicine</Title>
<ISOAbbreviation>N. Engl. J. Med.</ISOAbbreviation>
</Journal>
<ArticleTitle>Treatment of lymphedema of the arms and legs with 5,6-benzo-[alpha]-pyrone.</ArticleTitle>
<Pagination><MedlinePgn>1158-63</MedlinePgn>
</Pagination>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Benzopyrones can reduce the volume of high-protein edema fluid by stimulating proteolysis. These compounds provide a method for removing excess protein and its consequent edema and reduce its clinical sequelae, such as chronic inflammation and secondary infections.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a randomized, double-blind, placebo-controlled, crossover trial of 5,6-benzo-[alpha]-pyrone in 31 patients with postmastectomy lymphedema of the arm and 21 patients with lymphedema of the leg of various causes (this agent, also known as 56 BaP, 1,2-benzopyrone, or coumarin, is not an anticoagulant). The patients received 400 mg of the active drug or placebo, each for six months.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">During the placebo period, lymphedema often worsened, especially in the arms. Measurements of limb volume showed that the active drug reduced the mean amount of edema fluid in the arms from 46 percent above normal to 26 percent above normal (P < 0.001) and the amount in the legs from 25 percent to 17 percent above normal (P < 0.001). The circumference of the arms was reduced from 17 percent to 13 percent above normal, and the circumference of the legs from 11 percent to 7 percent above normal (P < 0.001). The softness of the limb tissue was increased (P < 0.001), and elevated skin temperatures were reduced (P < 0.001). There were fewer attacks of secondary acute inflammation (P = 0.01). Bursting pains and feelings of hardness were decreased, as were feelings of tightness, tension, swelling, and heaviness; limb mobility also improved. The active drug was preferred to the placebo by 93 percent of the patients (P < 0.001). Side effects--mild nausea or diarrhea--occurred in seven patients taking the active drug. None withdrew from the trial, and the side effects disappeared after the first month of therapy.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">5,6-Benzo-[alpha]-pyrone results in slow but safe reduction of lymphedema of the extremities.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Casley-Smith</LastName>
<ForeName>J R</ForeName>
<Initials>JR</Initials>
<AffiliationInfo><Affiliation>Henry Thomas Laboratory (Microcirculation Research), University of Adelaide, S.A., Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Morgan</LastName>
<ForeName>R G</ForeName>
<Initials>RG</Initials>
</Author>
<Author ValidYN="Y"><LastName>Piller</LastName>
<ForeName>N B</ForeName>
<Initials>NB</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016449">Randomized Controlled Trial</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
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<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>N Engl J Med</MedlineTA>
<NlmUniqueID>0255562</NlmUniqueID>
<ISSNLinking>0028-4793</ISSNLinking>
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<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D003374">Coumarins</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>A4VZ22K1WT</RegistryNumber>
<NameOfSubstance UI="C030123">coumarin</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D001132" MajorTopicYN="N">Arm</DescriptorName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002908" MajorTopicYN="N">Chronic Disease</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003374" MajorTopicYN="N">Coumarins</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004311" MajorTopicYN="N">Double-Blind Method</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007866" MajorTopicYN="N">Leg</DescriptorName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012881" MajorTopicYN="N">Skin Temperature</DescriptorName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1993</Year>
<Month>10</Month>
<Day>14</Day>
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<ArticleId IdType="doi">10.1056/NEJM199310143291604</ArticleId>
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