Artigos

Life (Basel). 2025 Sep 3;15(9):1397. doi: 10.3390/life15091397.ABSTRACTLipedema is a chronic, progressive adipose connective tissue disorder characterized by symmetrical, disproportionate fat accumulation, typically affecting the lower extremities and arms, accompanied by pain, swelling, and a sensation of heaviness. This study introduces intermediate Stages 1.5 and 2.5 to the established lipedema classification (Stages 1, 2 and 3), and other affected areas, based on physical examination, a questionnaire, and photographic documentation. Bioelectrical Impedance Spectroscopy (BIS) was employed to quantify total body water (TBW) across stages. A significant and linear increase in BMI was observed from Stage 1 to 3, correlating with increased reported pain and heaviness in the thighs, calves, and upper arms. Systemic symptoms of brain fog, debilitating fatigue, and hypothermia were significantly prevalent. TBW demonstrated a significant, stage-dependent increase in the lower extremities. Adipose tissue accumulation over the knees and feet significantly increased with lipedema stage. In contrast, shin involvement was evident in early stages and remained consistently elevated throughout later stages. Skeletal Muscle Mass (SMM) exhibited a significant increase across lipedema stages, positively correlating with fat mass (FM) in Stage 3. This study elucidates previously underrecognized clinical features and distribution patterns of lipedema, offering a refined staging system to improve understanding of its progression and burden.PMID:41010339 | DOI:10.3390/life15091397

Nutrients. 2025 Sep 20;17(18):3014. doi: 10.3390/nu17183014.ABSTRACTBackground/Objectives: Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation and inflammation, predominantly affecting women. While recent evidence suggests a systemic pro-inflammatory state in lipedema, the role of diet in modulating inflammation remains underexplored. This study assessed the anti-inflammatory potential of a Mediterranean-style ketogenic diet and its effects after 7 months of adherence on systemic inflammation markers (CRP and IL-6) in women with lipedema (n = 24) and a control group with overweight/obesity (n = 24). Methods: The Dietary Inflammatory Index (DII) was used to characterize the inflammatory potential of the diet throughout the intervention. Dietary intake was analyzed pre- and post-intervention, and anthropometric, body composition, and biochemical parameters were measured. Results: Beyond its beneficial effects on body composition (significant reductions in body weight, fat, leg circumferences, and visceral fat), the intervention diet also demonstrated anti-inflammatory potential. In lipedema, baseline diet showed a pro-inflammatory DII profile (DII/day = 3.04), which was reduced by about 1.5 points after the intervention (p = 0.008). When expressed per 1000 kcal, the DII values were markedly lower for both baseline (DII = 0.22) and intervention diet (DII = ~0.01). Following the intervention diet, reduction in CRP (-0.39, p = 0.016) and IL-6 levels (-0.33, p = 0.034) in lipedema were observed. A significant positive association was observed between the intervention diet’s DII and CRP (r = 0.55, p = 0.005), and between the baseline diet’s DII and IL-6 (r = 0.50, p = 0.013) in lipedema group. Conclusions: These findings suggest that ketogenic diet rich in anti-inflammatory and antioxidant nutrients can reduce systemic inflammation in lipedema patients, independently of caloric restriction.PMID:41010539 | DOI:10.3390/nu17183014

Lymphat Res Biol. 2025 Sep 25. doi: 10.1177/15578585251382110. Online ahead of print.ABSTRACTBackground: Lipedema, a chronic condition affecting mostly women, involves painful bilateral increase of subcutaneous adipose tissue. The societal impact of this disease is still poorly understood. This study aimed to validate the Lymphedema Quality-of-Life Questionnaire (LYMQOL) for lipedema patients in Germany, assessing its feasibility, reliability, and validity. Methods and Results: A total of 81 German-speaking stage II lipedema patients were asked to complete both the LYMQOL (arm and leg versions) and the Short Form Health Survey (SF-36) questionnaires twice, and this was 2 weeks apart. Feasibility was evaluated through response rates, scale structure via factor analysis, validity through SF-36 correlations, and reliability through internal consistency and test-retest reliability analysis. A valid 68% response rate was achieved. Both arm and leg versions demonstrated construct validity with significant correlations to SF-36 subscales. Internal consistency for the leg version was acceptable to excellent, and good to excellent for the arm version. Test-retest reliability was very good for both versions. Conclusions: This study validates the LYMQOL as a robust tool for assessing lipedema patients’ quality of life, and also validates the German translation contained in this article. We hope to fill a critical research gap and support future clinical studies aiming at enhancing patient care.PMID:40996112 | DOI:10.1177/15578585251382110

Cureus. 2025 Sep 14;17(9):e92331. doi: 10.7759/cureus.92331. eCollection 2025 Sep.ABSTRACTBACKGROUND: Lipedema is a chronic disorder characterized by symmetrical and disproportionate fat accumulation, pain, and easy bruising, often resistant to conventional treatments. Functional dysmetria (FD), a maladaptive neuromotor response linked to epigenetic stress, has been proposed as a relevant contributor to pain in lipedema.OBJECTIVE: This retrospective observational study aimed to evaluate whether correcting FD through the radioelectric asymmetric conveyer (REAC) technology Neuropostural Optimization (NPO) protocol can reduce pain in patients with lipedema, using a sham-controlled design.METHODS: In this retrospective observational study, 83 consecutive women with stage 2-5 lipedema underwent both sham and real NPO procedures during a single session. Pain intensity was measured using the visual analog scale (VAS) immediately after each procedure. Statistical analyses were performed using paired t-tests with effect sizes (Cohen’s dz) and 95% confidence intervals.RESULTS: Baseline pain was uniformly high (mean 7.41 ± 0.53), with some pre-sham values reaching 10/10. Pain reduction was observed exclusively after real NPO and not after sham. Sham NPO induced no significant changes, whereas real NPO yielded a mean pain reduction exceeding 3.5 VAS points across all stages (mean change -3.65 ± 0.62; 95% CI: -3.79 to -3.51; Cohen’s dz = 5.88, 95% CI: 4.85-6.92; p < 0.0001).CONCLUSIONS: These findings suggest that correction of FD by REAC NPO provides rapid and clinically meaningful analgesic effects in lipedema patients, addressing an upstream neuropsychomotor dysfunction that may contribute to disease progression. However, given the retrospective single-center design and absence of long-term follow-up, these conclusions are limited to the short-term effects observed. Further multicenter and longitudinal studies are warranted to confirm these results and evaluate long-term outcomes.PMID:40970229 | PMC:PMC12441218 | DOI:10.7759/cureus.92331

Aesthetic Plast Surg. 2025 Sep 12. doi: 10.1007/s00266-025-05192-1. Online ahead of print.ABSTRACTBACKGROUND: Lipedema is a chronic disorder of adipose tissue that predominantly affects women and is frequently misdiagnosed as obesity or lymphedema. Traditionally associated with the lower extremities, lipedema can also involve the abdominal region, although there are currently no established diagnostic criteria for abdominal lipedema. This study aims to propose a diagnostic algorithm for abdominal lipedema based on clinical features, macroscopic observations, and ultrasound findings.METHODS: This retrospective study analyzed data from 327 patients treated between March 2018 and March 2024 for lipedema, including those with abdominal involvement. Clinical evaluations, ultrasound imaging, and surgical outcomes were examined to assess the prevalence and characteristics of abdominal lipedema. Patients were classified based on lipedema severity, and criteria for abdominal lipedema diagnosis were established through clinical and imaging data.RESULTS: The study identified that abdominal involvement increases with the severity of lipedema, with 31% of patients with stage II lipedema and 70% of those with stage III lipedema exhibiting abdominal manifestations. The proposed diagnostic algorithm includes maximum, major, and minor criteria, such as symmetrical fat deposition, pain, and non-responsiveness to diet and exercise. Specific threshold values for each category were defined to establish the diagnosis. The findings highlight the existence of both ascending (from legs to abdomen) and descending (from arms to abdomen) centripetal progression patterns, challenging traditional notions that limit lipedema to the extremities CONCLUSION: Abdominal lipedema is a significant and underrecognized manifestation of the condition, requiring specific diagnostic criteria to ensure accurate diagnosis and appropriate treatment. The study proposes a diagnostic framework based on clinical and imaging features that can improve the recognition and management of abdominal lipedema. Multidisciplinary treatment approaches, including both conservative measures and surgical interventions such as abdominoplasty and liposuction, are recommended to improve patient outcomes.LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .PMID:40938408 | DOI:10.1007/s00266-025-05192-1

Maturitas. 2025 Sep 5;202:108716. doi: 10.1016/j.maturitas.2025.108716. Online ahead of print.ABSTRACTBACKGROUND: Lipedema is a chronic, progressive condition characterized by symmetrical accumulation of adipose tissue, predominantly in women’s lower extremities. It is frequently associated with pain, reduced mobility, and psychological distress. Dietary interventions have become central to conservative management of the condition, yet their clinical efficacy remains unclear.METHODS: This systematic review included peer-reviewed studies assessing dietary strategies in individuals with clinically diagnosed lipedema. Searches were conducted in four databases in July 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies applied dietary interventions and reported clinical or psychosocial outcomes, and the risk of bias was subsequently assessed.RESULTS: Nine studies involving 269 women met the inclusion criteria. The majority applied hypocaloric dietary protocols, particularly ketogenic, low-carbohydrate high-fat, or ketogenic modified Mediterranean diets. Across studies, weight loss and reduction in fat mass were consistently reported. Some studies also observed improvements in pain, inflammation, and quality of life, though these outcomes were not uniformly assessed. Few studies used advanced measures of body composition such as dual-energy X-ray absorptiometry or magnetic resonance imaging; most relied on bioelectrical impedance analysis. Only one study evaluated emotional dysregulation and only one assessed food addiction, but no study systematically measured eating behavior traits, or current or past eating disorders. Intervention durations ranged from four to twenty-eight weeks, and adherence strategies varied. The risk of bias was moderate to high in most studies. Two trials (conducted by Lundanes and Jeziorek et al.) were randomized controlled trials, whereas the remaining studies used non-randomized designs despite including control and intervention groups. Due to the high heterogeneity in study design, outcomes, and measurement tools, combined with the small sample sizes and risk of bias, it was not possible to conduct a meta-analysis.CONCLUSION: The effects of dietary approaches on lipedema remain unclear. Future studies should adopt robust methodological designs, include larger and stratified samples based on disease stage, use accurate assessments of body composition (including muscle mass and strength), evaluate mental health and eating behaviors, and investigate the long-term sustainability of interventions. The literature lacks standardized methodologies and comprehensive evaluation of psychosocial and eating behavior, highlighting the need for stronger evidence to inform clinical practice.PMID:40939491 | DOI:10.1016/j.maturitas.2025.108716

Aesthetic Plast Surg. 2025 Sep 8. doi: 10.1007/s00266-025-05260-6. Online ahead of print.NO ABSTRACTPMID:40921780 | DOI:10.1007/s00266-025-05260-6

Aesthetic Plast Surg. 2025 Sep 8. doi: 10.1007/s00266-025-05260-6. Online ahead of print.NO ABSTRACTPMID:40921780 | DOI:10.1007/s00266-025-05260-6

Microsurgery. 2025 Sep;45(6):e70115. doi: 10.1002/micr.70115.ABSTRACTBACKGROUND: When indocyanine green lymphography (ICG-L) fails to display a linear pattern, preoperative planning for lymphovenous anastomosis (LVA) becomes challenging. Given the anatomical symmetry of lymphatics in extremities, the healthy limb can serve as a template for the affected one. This study introduces an accessible technique that uses augmented reality (AR) to mirror the lymphatic anatomy of the unaffected limb onto the affected side to assist in surgical planning.METHODS: Twelve patients with unilateral secondary lymphedema of the upper or lower extremity (Stage II or less) were included. After standard ICG-L mapping, the unaffected limb was photographed when it showed a linear lymphatic pattern. The image was mirrored and superimposed onto the affected limb using an AR smartphone app to guide incision planning for LVA. Volume reduction and clinical outcomes were measured postoperatively.RESULTS: A total of 39 LVAs were successfully performed at the planned locations, with 100% intraoperative accuracy. No modifications or extensions of incisions were needed. Patients experienced an average operative time of 142.5 min. Volume excess was reduced by 47% over a follow-up period of 3-24 months, with a notable reduction in episodes of cellulitis and improvements in symptoms and quality of life.CONCLUSIONS: “Mirror the lymph” is a reliable, low-cost AR-based planning method for identifying lymphatic vessels in patients with unilateral lymphedema when ICG-L mapping shows early dermal backflow. This technique improves surgical precision and efficiency and offers an innovative tool for resource-limited settings.PMID:40904036 | DOI:10.1002/micr.70115

Phlebology. 2025 Sep 3:2683555251377228. doi: 10.1177/02683555251377228. Online ahead of print.ABSTRACTBackgroundCompression therapy (CT) is widely prescribed for chronic venous disease (CVD), lymphedema, and lipedema despite robust evidence supporting its effectiveness only in a minority of clinical scenarios.AimProvide an overview of the methodological parameters essential for obtaining a high-quality scientific trial.MethodsThe International Compression Club (ICC) chairman prepared a preliminary list of the main methodological flaws in publications on CT, and a list of parameters to be included in high-quality randomized controlled trials (RCTs). This list was circulated among ICC board members, who provided their comments and suggestions. The document was then presented and discussed at an ICC consensus meeting with various professionals in May 2024 in London. Meeting minutes were distributed to ICC members, and the final document reflecting all additional comments and suggestions was compiled. In summary, the following recommendations represent the consensus of the ICC members.ResultsThe ICC recommends that the following parameters be reported in randomized clinical trials (RCTs): appropriate patient selection, adequate sample size, detailed classification of venous and lymphatic diseases, detailed description of CT modality, adherence to CT, and reasons for non-adherence. Tailored recommendations for specific scenarios and the use of standardized quality-of-life (QoL) tools are emphasized. Despite their value, RCTs face limitations and do not reflect real-world clinical practice. Real-world evidence (RWE) can complement RCTs by providing insights into routine applications, safety, compliance, and cost-effectiveness across diverse patient populations by standardized methodologies, large cohorts, and reliable validated registries to ensure validity.ConclusionsCombining data from RCTs and RWS allows for a comprehensive understanding of CT. RCTs provide evidence of effectiveness in a controlled scenario, while RWE offers real-world perspectives on compliance and economic outcomes in clinical practice. Together, these approaches enable a more holistic evaluation of CT, addressing current gaps in knowledge and guiding its optimal use.PMID:40899334 | DOI:10.1177/02683555251377228

Vasa. 2025 Sep 2. doi: 10.1024/0301-1526/a001224. Online ahead of print.NO ABSTRACTPMID:40891600 | DOI:10.1024/0301-1526/a001224

Vasa. 2025 Sep 2. doi: 10.1024/0301-1526/a001224. Online ahead of print.NO ABSTRACTPMID:40891600 | DOI:10.1024/0301-1526/a001224

BMJ Open. 2025 Aug 28;15(8):e086869. doi: 10.1136/bmjopen-2024-086869.ABSTRACTOBJECTIVES: To identify research priorities related to the diagnosis, treatment and management of lipoedema.DESIGN: This was a research question priority-setting that ensured the involvement of patients, relatives and healthcare professionals in all parts. It consisted of the following steps: identifying research questions through an open survey, seeking input from patients, patient relatives and healthcare professionals. Prioritisation, including a Delphi exercise and a final priority-setting meeting.SETTING: Swedish healthcare and community.PARTICIPANTS: A total of 255 participants submitted research questions. 130 participated in the prioritisation of the submitted questions. Of these, 89 were patients, 10 were relatives, 19 were healthcare professionals and 12 were representatives of patient organisations.RESULTS: 1314 potential research questions were submitted; 62 unique questions remained after analysis. 130 and 123 people answered the first and second Delphi surveys, respectively. 20 questions were discussed by 13 participants at the final priority-setting meeting. The following five research questions were selected as a top priority: (1) what criteria should apply for a diagnosis of lipoedema? (2) What outcomes are important in lipoedema research? (3) What effect does manual treatment, such as manual lymphatic drainage have on lipoedema? (4) What effect does liposuction have on lipoedema? (5) What are the effects of hormonal treatment on lipoedema?CONCLUSIONS: We found a consensus between patients and healthcare professionals on topics that warrant priority in future research into lipoedema. The questions reflect both the diagnosis of the condition and research on treatment effects. We hope the results will inform researchers and research funders, and direct future studies towards important research questions.PMID:40876880 | PMC:PMC12406854 | DOI:10.1136/bmjopen-2024-086869

Cureus. 2025 Jul 26;17(7):e88809. doi: 10.7759/cureus.88809. eCollection 2025 Jul.ABSTRACTLipedema, characterized by the disproportionate accumulation of fat in the lower extremities, pain, and tenderness, is frequently misdiagnosed and underestimated. This evolutionary perspective reframes lipedema as an ancestral adaptive mechanism for energy storage, crucial in prehistory for female survival during periods of food scarcity. Subcutaneous fat, predominant in lipedema, conferred energetic, thermoregulatory, and cardioprotective advantages – especially for women during pregnancy and lactation – unlike men’s visceral fat, which is geared toward rapid mobilization. In the modern context, inflammatory triggers such as pollution, stress, and gluten-rich diets exacerbate chronic inflammation, turning lipedema into a clinical challenge. Inflammation acts as a warning signal, and its management – rather than indiscriminate surgical removal of adipose tissue, an essential endocrine organ – is fundamental. Extensive liposuction may lead to postoperative adipose endocrine insufficiency, with metabolic and hormonal imbalances. Conservative strategies, such as ketogenic or gluten-free diets, moderate exercise, and stress management, foster a favorable metabolic environment, allowing mobilization of stored fat. This editorial advocates for a holistic and individualized approach, highlighting the connection between lipedema and conditions such as attention-deficit/hyperactivity disorder (ADHD), calls for further research into the interaction between genetics, inflammation, and environmental factors, and urges increased awareness of lipedema as a legitimate medical condition.PMID:40861617 | PMC:PMC12377255 | DOI:10.7759/cureus.88809

Phlebology. 2025 Aug 25:2683555251372218. doi: 10.1177/02683555251372218. Online ahead of print.ABSTRACTObjectiveThe incidence of lipedema is poorly described due to its confusion with lymphedema. Patient education is crucial for treatment and prevention strategies but also for improving healthcare outcomes. This study assessed and compared the quality of English and Spanish online resources for patients suffering from lipedema using a multimetric approach.MethodsA deidentified Google search using the terms “lipedema” and “lipedema español” was conducted. The first 10 academic/organizational websites in each language were selected. Quality assessment was performed using the Patient Education and Materials Assessment Tool (PEMAT), Cultural Sensitivity Assessment Tool (CSAT), Simple Measure of Gobbledygook (SMOG), and facticity criteria to evaluate understandability and actionability, cultural sensitivity, readability, and factual quality, respectively.ResultsEnglish webpages scored 73.70% for understandability and 35.0% for actionability, while Spanish webpages scored 75.05% and 21.0%, respectively; no significant differences were found between languages in understandability (p = .970) and actionability (p = .895). A significantly higher proportion of Spanish resources was found to be culturally sensible than English resources (90% vs 70%; p < .001). However, no significant differences were found in the cultural sensitivity score (English 2.87 vs Spanish 3.01; p = .677). The grade reading level for Spanish materials was significantly lower compared to English materials (11.08 vs 13.45; p = .006). Factual quality was low across both languages according to the facticity framework, though English materials scored higher than Spanish (2.20 vs 1.00; p = .051).ConclusionOur results suggest that online English and Spanish materials on lipedema have inadequate actionability, facticity, and reading grade levels for patients. Nonetheless, the levels of understandability and cultural sensitivity are acceptable. Enhancing the quality of online health literature for lipedema patients presents an opportunity to alleviate psychosocial burdens and address misconceptions.PMID:40851549 | DOI:10.1177/02683555251372218

Br J Nurs. 2025 Aug 7;34(12):S12-S18. doi: 10.12968/bjon.2024.0495.ABSTRACTLipoedema (lipalgia) is a condition that is often underdiagnosed or misdiagnosed as obesity or lymphoedema, which can result in mismanagement of treatment leading to poor mental and physical outcomes. It is a condition that is predominately seen in those assigned female at birth and rarely identified at an early age. Inconsistencies regarding criteria used for diagnosis and staging has led to challenges in the reliability of treatment options available for people with the condition. Poor diagnosis can substantially impact on a person’s quality of life in terms of mental health, physical health and finances. Lipoedema has different stages and classifications according to visual characteristics. Recommended developments of practice include the setting up of a diagnostic criteria to identify key symptoms of lipoedema, which can help practitioners consider effective treatment options alongside diet, exercise, compression therapy and skin care as part of the overall treatment plan.PMID:40818035 | DOI:10.12968/bjon.2024.0495

Int J Mol Sci. 2025 Jul 23;26(15):7074. doi: 10.3390/ijms26157074.ABSTRACTLipedema is a chronic, estrogen-sensitive adipose tissue disorder characterized by disproportionate subcutaneous fat accumulation, fibrosis, inflammation, and resistance to fat mobilization. Despite its high prevalence, lipedema remains poorly understood and frequently misdiagnosed. This narrative review proposes a novel pathophysiological model in which menopause acts as a critical turning point in the progression of lipedema, driven by estrogen receptor imbalance (ERβ predominance over ERα), intracrine estrogen excess, and adipose tissue dysfunction. We demonstrate how menopause amplifies adipose tissue dysfunction by suppressing ERα signaling; enhancing ERβ activity; and disrupting mitochondrial function, insulin sensitivity, and lipid oxidation. Concurrently, the upregulation of aromatase and 17β-HSD1, combined with the suppression of 17β-HSD2, sustains localized estradiol excess, perpetuating inflammation, fibrosis, and immune dysregulation. The molecular signature observed in lipedema closely mirrors that of other estrogen-driven gynecological disorders, such as endometriosis, adenomyosis, and uterine fibroids. Understanding these molecular mechanisms highlights the pivotal role of menopause as a catalyst for disease progression and provides a rationale for targeted therapeutic strategies, including hormonal modulation and metabolic interventions. This review reframes lipedema as an estrogen receptor-driven gynecological disorder, offering a new perspective to improve clinical recognition, diagnosis, and management of this neglected condition.PMID:40806207 | PMC:PMC12346519 | DOI:10.3390/ijms26157074

Lymphology. 2025;58(2):46-55.ABSTRACTThe lymphatic system, a complex physiological network of lymphatic organs and vessels, is essential for maintaining fluid homeostasis. Dysfunction of lymphatic system can lead to lymphedema, a pathology characterized by the accumulation of interstitial fluid in peripheral tissues. This study aimed to identify novel genetic variants in genes within the RAS/ MAPK pathway and assess their potential association with lymphedema onset. We conducted a retrospective analysis of the genetic and clinical data from 408 patients diagnosed with primary lymphedema. These patients were previously tested using a next-generation sequencing panel that included 28 diagnostic genes and 71 candidate genes. The analysis revealed five genetic variants in the genes LZTR1, RAF1 and MAP2K1. Among the identified variants, four of them have never been reported in the literature. In silico analysis and molecular modelling supported the possible pathogenicity of one missense variant in RAF1 (c.1344T>G; p.Ile448Met), which could affect protein activation by phosphorylation. The results of this study highlight the genes involved in the RAS/MAPK signaling pathway as potential diagnostic targets for primary lymphedema.PMID:40803040

Ir J Med Sci. 2025 Aug 11. doi: 10.1007/s11845-025-04024-0. Online ahead of print.ABSTRACTOBJECTIVES: To determine the frequency of neuropathic pain in patients with lipedema and to assess the impact of neuropathic pain on quality of life and its correlation with clinical variables.METHOD: The prospective, descriptive study included 150 patients diagnosed with lipedema. The demographic characteristics, pain intensity, lipedema type, lipedema stage, and quality of life of the patients were evaluated. The during activity pain intensity was evaluated using the Visual Analogue Scale (VAS), and neuropathic pain was evaluated with the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale. Quality of life was assessed using the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF).RESULTS: This mean age of the patients was 42.63 ± 10.03 years, and the mean body mass index was 33.07 ± 5.67 kg/m2. Type 2 and stage 2 lipedema were present in 96% and 51.3% of the patients, respectively. The mean VAS score for pain in lipedema patients was 6.38 ± 1.71, and the mean LANSS score was 11.57 ± 7.11. The prevalence of neuropathic pain was 43.3%. Patients with neuropathic pain had statistically significantly higher VAS and LANSS scores (p = 0.001 and p < 0.001, respectively). The neuropathic pain group, scores for the physical and psychological domains of the WHOQOL-BREF were statistically significantly lower (p = 0.001 and p < 0.001, respectively).CONCLUSIONS: Nearly half of the patients with lipedema have neuropathic pain, and neuropathic pain, which adversely affects the quality of life. Treatment should be planned in the presence of neuropathic pain in this patient group, in whom the etiopathogenesis of pain is not yet clearly known.PMID:40788448 | DOI:10.1007/s11845-025-04024-0

Phlebology. 2025 Aug 10:2683555251369082. doi: 10.1177/02683555251369082. Online ahead of print.NO ABSTRACTPMID:40785137 | DOI:10.1177/02683555251369082

Ir J Med Sci. 2025 Aug 11. doi: 10.1007/s11845-025-04024-0. Online ahead of print.ABSTRACTOBJECTIVES: To determine the frequency of neuropathic pain in patients with lipedema and to assess the impact of neuropathic pain on quality of life and its correlation with clinical variables.METHOD: The prospective, descriptive study included 150 patients diagnosed with lipedema. The demographic characteristics, pain intensity, lipedema type, lipedema stage, and quality of life of the patients were evaluated. The during activity pain intensity was evaluated using the Visual Analogue Scale (VAS), and neuropathic pain was evaluated with the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale. Quality of life was assessed using the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF).RESULTS: This mean age of the patients was 42.63 ± 10.03 years, and the mean body mass index was 33.07 ± 5.67 kg/m2. Type 2 and stage 2 lipedema were present in 96% and 51.3% of the patients, respectively. The mean VAS score for pain in lipedema patients was 6.38 ± 1.71, and the mean LANSS score was 11.57 ± 7.11. The prevalence of neuropathic pain was 43.3%. Patients with neuropathic pain had statistically significantly higher VAS and LANSS scores (p = 0.001 and p < 0.001, respectively). The neuropathic pain group, scores for the physical and psychological domains of the WHOQOL-BREF were statistically significantly lower (p = 0.001 and p < 0.001, respectively).CONCLUSIONS: Nearly half of the patients with lipedema have neuropathic pain, and neuropathic pain, which adversely affects the quality of life. Treatment should be planned in the presence of neuropathic pain in this patient group, in whom the etiopathogenesis of pain is not yet clearly known.PMID:40788448 | DOI:10.1007/s11845-025-04024-0

Phlebology. 2025 Aug 10:2683555251369082. doi: 10.1177/02683555251369082. Online ahead of print.NO ABSTRACTPMID:40785137 | DOI:10.1177/02683555251369082

Cancer Chemother Pharmacol. 2025 Aug 9;95(1):80. doi: 10.1007/s00280-025-04802-8.ABSTRACTBACKGROUND: Patients with KRAS wild-type (wt) metastatic colorectal cancer (mCRC) treated with single-agent cetuximab (C) or panitumumab (P), have improved progression-free survival (PFS) and overall survival (OS) compared to best supportive care but an objective response rate (ORR) of only 13-17%. Preclinical and clinical data suggest that dual targeted therapy (e.g., neratinib [N] + C) may improve overall response rates in tumors that are wt for KRAS, NRAS, BRAF, and PIK3CA (quadruple-wt).METHODS: NSABP FC-11 is a multi-center, two-arm, phase II study in patients with quadruple-wt mCRC who had prior oxaliplatin and irinotecan treatment. Arm 1 treated patients with HER2 mutation, with or without prior C or P. Arm 2 treated HER2 non-amplified (14 evaluable) and HER2-amplified (1 evaluable) patients with N + C. The primary aim was PFS at cycle 6 (PFS6). Secondary aims included ORR, objective response, clinical benefit, and safety. Exploratory aims included molecular profiling for mutations, copy number, and RNA expression.RESULTS: Arm 1 closed early due to low accrual (n = 4) and is not reported. Arm 2 enrolled 21 patients; six discontinued treatment before first scan. Fifteen patients were evaluable with at least one follow-up scan with six demonstrating PFS6. With intention-to-treat (ITT) analysis, this cohort demonstrated an ORR/PFS6 of 28% (6/21). No grade 5 or otherwise unexpected adverse events were noted. Correlative molecular studies did not definitively define responders.CONCLUSION: Arm 2 of FC-11 demonstrated an ORR/PFS6 of 28%, which compares favorably to single-agent treatment in this subset of patients.CLINICAL TRIALS REGISTRATION: NCT03457896.PMID:40782152 | DOI:10.1007/s00280-025-04802-8

Front Glob Womens Health. 2025 Jul 24;6:1629077. doi: 10.3389/fgwh.2025.1629077. eCollection 2025.ABSTRACTBACKGROUND: Lipedema is a chronic condition characterized by excessive fat deposition in the hips, buttocks, and lower legs, significantly impacting quality of life. In Czechia, limited research exists on the relationship between lipedema symptoms and depressive symptoms, despite the condition’s prevalence and its impact on mental health.AIM: This study aims to investigate the relationship between lipedema symptoms and the severity of depressive symptoms among Czech women and assess their quality of life.METHODS: We administered an online survey to 43 women with lipedema. Participants completed questionnaires on quality of life (WHOQOL-BREF), sociodemographic and clinical characteristics, and depressive symptoms severity, evaluated using the PHQ-9 tool.RESULTS: PHQ-9 results showed that 50.9% of participants exhibited moderate to severe depressive symptoms. Quality of life ratings varied, with 27.9% of participants rating their health as poor or very poor. Significant correlations were found between lipedema symptoms, such as shortness of breath, muscle stiffness, and depression severity, indicating a complex relationship between physical symptoms and mental health.CONCLUSION: These findings highlight the significant mental health burden faced by individuals with lipedema. The association between physical and depressive symptoms emphasizes the need for comprehensive, tailored interventions, especially integrated mental and physical healthcare approaches, aimed at improving overall well-being in this population.PMID:40778367 | PMC:PMC12328370 | DOI:10.3389/fgwh.2025.1629077

Lymphat Res Biol. 2025 Aug 4. doi: 10.1177/15578585251362102. Online ahead of print.NO ABSTRACTPMID:40763111 | DOI:10.1177/15578585251362102