Objectives. Lymphedema is neglected in medical education, and a review on healthcare practitioners (HCPs) knowledge is necessary to shed light on gaps and to provide evidence for establishing educational programs on lymphedema. Methods. This systematic review was performed based on the PRISMA guideline in PubMed, Scopus, Web of Science, and Google Scholar databases. There was no limitation on the type of lymphedema or HCPs. The quality assessment was performed based on QATSDD. Data regarding study characteristics, questionnaire context, and findings of the study were summarized from each article. Results. After the screening, 16 articles were included that 12 were cross-sectional, two were qualitative, and two were interventional pilot studies. Breast cancer and other cancer-related lymphedema, lymphatic filariasis, and podoconiosis were included, and the majority of articles were focused on primary HCPs. The overall knowledge was low and average in five and 11 articles, respectively, and prior education was a significant factor related to higher knowledge of lymphedema in two studies. Conclusion. Structured education of lymphedema is needed to increase the knowledge of HCPs and to enhance their collaboration in multidisciplinary care teams. Improvement of HCPs knowledge may lead to better outcomes of lymphedema patients management which are neglected.

Background: This study aimed to compare the gut microbiome (GM) composition, serum inflammatory markers and faecal short‐chain fatty acids among individuals with type 1 and type 2 diabetes mellitus (DM) and healthy controls.Methods: This case–control study examined 49 subjects with type 2 DM, 21 with type 1 DM and 40 healthy controls. Blood and faecal samples were collected. Serum inflammatory markers, including CRP, IL‐1β, IL‐6, TNF‐α and IFN‐γ, were measured using enzyme‐linked immunosorbent assays (ELISA). Bacterial populations were quantified using RT‐qPCR and NGS. Faecal metabolites were analysed using gas chromatography.Results: Simpson's alpha diversity was higher among types 1 and 2 DM than in the control. The frequency of the bacterial genera Gemmiger, Dorea, Collinsella, Escherichia/Shigella, Dialister, Coprococcus, Achromobacter, Intestinimonas and Allisonella in type 2 DM was higher than in the control, and the frequency of the genera Romboutsia and Clostridium was decreased in type 2 DM. The frequency of the Prevotella, Bacteroides and Faecalibacterium genera in type 1 DM was lower than in the other groups. Acetate, propionate and butyrate levels were significantly higher in type 2 DM patients compared to the other groups. Participants with diabetes had significantly higher hs‐CRP, IL1‐β, TNF, IL‐6 and IFG levels compared to the controls. Compared to healthy controls, both T1DM and T2DM patients showed a significant increase in the abundance of the Lactobacillus genus (p = 0.01) and a decrease in Faecalibacterium (p = 0.02). Additionally, serum levels of IL‐6 and TNF‐α were significantly elevated in T2DM patients (p = 0.003 and p = 0.005, respectively). Faecal levels of butyrate were significantly reduced in both diabetic groups compared to the controls (p = 0.004).Conclusion: By determining the GM alterations in patients with diabetes, interventional strategies could be designed to modulate the GM composition as an adjunctive therapy in diabetes.

Breast cancer-related lymphedema (BCRL) is a debilitating condition that affects a significant proportion of breast cancer survivors, profoundly impacting their quality of life. While many studies have investigated the risk factors for BCRL occurrence, the determinants of its severity remain underexplored. This retrospective observational study evaluated the risk factors associated with BCRL severity among patients treated at the Motamed Cancer Institute, Tehran, Iran. Female patients with unilateral BCRL aged 25–75 years were included. Data were collected over a 10-year period and analyzed for demographic, clinical, and pathological variables. Lymphedema severity was assessed using established clinical staging criteria and categorized into early-stage (stages 1 and 2a) and advanced-stage (stages 2b and 3) groups. Also, presence of fibrosis and non-pitting edema were other indicators of BCRL severity. Statistical analyses included univariate and multivariate logistic regression to identify predictors of advanced-stage BCRL. A total of 500 participants were analyzed, with a mean age of 41.16 ± 10.20 years and BMI of 28.72 ± 4.78 kg/m². Advanced-stage BCRL was significantly associated with older age (p = 0.00), higher number of excised lymph nodes (p = 0.04), and radiotherapy (p = 0.00). Multivariate analysis identified radiotherapy as the strongest independent predictor of advanced-stage BCRL (OR: 2.12, 95% CI: 1.22–3.67, p = 0.007). Other variables, including tumor grade, molecular subtypes, and type of surgery, did not independently predict BCRL severity. Advanced-stage BCRL is influenced by multiple factors, particularly radiotherapy and the extent of lymph node dissection. These findings underscore the importance of strategies to mitigate risk among breast cancer survivors, especially those undergoing radiotherapy. Further research is warranted to explore targeted interventions for reducing BCRL severity.