title: Intensive outpatient treatment of elephantiasis.
abstract: OBJECTIVE
  The aim of this paper was to report on a novel approach to the intensive outpatient treatment of elephantiasis of an underprivileged population.
  
  
  METHODS
  Prospective, random study, the diagnosis of lymphedema was clinical and the inclusion of patients was by order of arrival in the treatment center where all were invited to participate in the study. Intensive outpatient therapy was performed for 6 to 8 hours daily over a period of four weeks. Eleven legs with grade III elephantiasis of 8 patients were evaluated in a random prospective study. Three patients were men and five were women with ages ranging between 28 and 66 years old. Treatment included mechanical lymph drainage using the RAGodoy® apparatus for a period of 6 to 8 hours daily and the Godoy & Godoy cervical stimulation technique for 20 minutes per day, both associated to the use of a home-made medical compression stocking using a low-stretch cotton-polyester material. Additionally, manual lymph drainage using the Godoy & Godoy technique was performed for one hour. Perimetry was used to compare measurements made before and after treatment, of the three points of the limb with the largest circumferences. The paired t-test was utilized for statistical analysis with an alpha error greater than 5% (P-value <0.05).
  
  
  RESULTS
  Reductions in the perimeter of affected limbs were significant over this 4-week treatment program (P-value=0.001).
  
  
  CONCLUSIONS
  Intensive outpatient treatment is an option for all types of lymphedema with large volumetric reductions being possible in a short period when treating elephantiasis.
authors.affiliation: Department of Cardiology and Cardiovascular Surgery, Medicine School of São Jose do Rio Preto-FAMERP and Research CNPq (National Council for Research and Development), Brazil. godoyjmp@riopreto.com.br
authors.forename: J M
authors.initials: JM
authors.lastname: Pereira De Godoy
authors.forename: P
authors.initials: P
authors.lastname: Amador Franco Brigidio
authors.forename: E
authors.initials: E
authors.lastname: Buzato
authors.forename: M
authors.initials: M
authors.lastname: Fátima Guerreiro De Godoy
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001938:Brazil; D004322:Drainage / Q000379:methods*; D004604:Elephantiasis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D053828:Stockings, Compression; D013997:Time Factors; D016896:Treatment Outcome; D035862:Vulnerable Populations