scholarly journals Lipedema and lipedematous scalp: An overview

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Lulua Safar ◽  
Sandhya George
Keyword(s):  
Progressive Disease ◽  
Subcutaneous Tissue ◽  
Treatment Options ◽  
Fat Distribution ◽  
Tissue Thickness ◽  
Diagnostic Features ◽  
Dermatological Condition ◽  
Chronic Progressive Disease ◽  
Significant Disability ◽  
Therapeutic Alternatives

Lipedema is a chronic, progressive disease marked by abnormal fat distribution in the limbs, resulting in disproportionately sized and painful limbs. It primarily affects women and causes significant disability, functional impairment, and psychological distress. Despite its clinical significance in women’s health, lipedema is largely unknown, underdiagnosed, and misdiagnosed with other diseases with similar symptoms including obesity. It is difficult to distinguish between obesity and lipedema since these two conditions often coexist. Since the precise etiology of lipedema is yet to be determined, there is no treatment that targets the underlying cause. The most basic conservative treatment is decongestive physical therapy, which is normally needed life-long. In some cases, surgical procedures such as liposuction and excisional lipectomy are the therapeutic alternatives. Lipedematous scalp is a rare, dermatological condition with no known cause, characterized by increased subcutaneous tissue thickness and a smooth and boggy scalp. When it occurs in conjunction with alopecia, it is known as lipedematous alopecia, often mistaken as androgenetic alopecia. The goals of this article are to explain the etiology, clinical features, and treatment options for lipedema and lipedematous scalp (two relatively less known conditions), as well as to highlight their diagnostic features.

Features of the course and treatment of glaucoma during pregnancy

2020 ◽  
Vol 98 (3) ◽  
pp. 178-184
Author(s):  
T. V. Chernyakova ◽  
A. Yu. Brezhnev ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev
Keyword(s):  
Pregnant Women ◽  
Laser Treatment ◽  
Progressive Disease ◽  
Clinical Course ◽  
The Other ◽  
Third Trimester ◽  
The Third ◽  
Chronic Progressive Disease ◽  
Hypotensive Therapy ◽  
Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

scholarly journals Emergent Polymyxin Resistance: End of an Era?

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Zekun Li ◽  
Yuping Cao ◽  
Lingxian Yi ◽  
Jian-Hua Liu ◽  
Qiwen Yang
Keyword(s):  
Susceptibility Testing ◽  
Treatment Options ◽  
Effective Control ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Poor Clinical Outcome ◽  
Ventilator Support ◽  
Multiple Risk Factors ◽  
Chromogenic Agar ◽  
Therapeutic Alternatives

Abstract Until recently, the polymyxin antibiotics were used sparingly due to dose limiting toxicities. However, the lack of therapeutic alternatives for infections caused by highly resistant Gram-negative bacteria has led to the increased use of the polymyxins. Unfortunately, the world has witnessed increased rates of polymyxin resistance in the last decade, which is likely in part due to its irrational use in human and veterinary medicine. The spread of polymyxin resistance has been aided by the dissemination of the transferable polymyxin-resistance gene, mcr, in humans and the environment. The mortality of colistin-resistant bacteria (CoRB) infections varies in different reports. However, poor clinical outcome was associated with prior colistin treatment, illness severity, complications, and multidrug resistance. Detection of polymyxin resistance in the clinic is possible through multiple robust and practical tests, including broth microdilution susceptibility testing, chromogenic agar testing, and molecular biology assays. There are multiple risk factors that increase a person’s risk for infection with a polymyxin-resistant bacteria, including age, prior colistin treatment, hospitalization, and ventilator support. For patients that are determined to be infected by polymyxin-resistant bacteria, various antibiotic treatment options currently exist. The rising trend of polymyxin resistance threatens patient care and warrants effective control.

scholarly journals LINEA ALBA COLLAGEN ASSESSMENT IN MORBIDLY OBESE PATIENTS

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 8-11
Author(s):  
João Vicente Machado GROSSI ◽  
Felipe Fernandes NICOLA ◽  
Ivan Alberto ZEPEDA ◽  
Martina BECKER ◽  
Eduardo Neubarth TRINDADE ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Healing Process ◽  
Age Groups ◽  
Immunohistochemical Analysis ◽  
Control Group ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Age Group ◽  
Tissue Thickness ◽  
Linea Alba

ABSTRACT Background: The evaluation of collagen in the abdominal wall has been increasingly studied because of the relevance on collagen in the healing process after laparotomy. Aim: To evaluate the amount of collagen in the linea alba of patients undergoing laparotomic bariatric surgery and comparing with non-obese cadavers. Methods: Were evaluated 88 samples of aponeurosis from abdominal linea alba of 44 obese patients (obesity group) and 44 non-obese cadavers (control group). The samples were collected in 2013 and 2104, and were sorted according to age (18-30, 31-45 and 46-60), gender, BMI, waist and cervical circumference, and subcutaneous tissue thickness. Material for biopsy was collected from the supraumbilical region of the linea alba for immunohistochemical analysis differentiating collagen type 1 and type 3 and the 1/3 ratio. Image-Pro Plus pixel counting software was used to measure the amount of collagen. Results: The obesity group evidenced mean age 44.11±9.90 years; 18-30 age group had three (6.8%) obese individuals; 31-45 had 22 (50%) and 46-60 had 19 (43.1%). Females were present in 81.8% (n=36); BMI (kg/m²) was 48.81±6.5; waist circumference (cm) was 136.761±13.55; subcutaneous tissue thickness (cm) 4.873±0.916. Considering age groups, gender and BMI, there were statistical differences in all tests when compared with the cadavers. Conclusion: The amount of collagen in the linea alba above the umbilical region in the morbidly obese patients was smaller than in the non-obese cadavers in the same age group.

Suboptimal clinician awareness of appropriate NTRK fusion testing and TRK inhibitor use in solid tumors.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 229-229
Author(s):  
Ryan P. Topping ◽  
Krista Marcello ◽  
Terrence Fagan ◽  
Timothy A. Quill ◽  
Todd Michael Bauer ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Progressive Disease ◽  
Inhibitor Therapy ◽  
Tumor Type ◽  
Advanced Solid Tumors ◽  
Educational Activities ◽  
Time Period ◽  
Trk Inhibitors ◽  
Therapeutic Alternatives ◽  
Selection Of

229 Background: Since late 2018, 2 TRK inhibitors—larotrectinib and entrectinib—have been approved by the EMA and FDA for treating patients with advanced solid tumors harboring an NTRK fusion and progressive disease or no therapeutic alternatives. It is recommended that testing for NTRK fusions occur as early as possible after a diagnosis of advanced disease in patients with solid tumors to inform potential use of TRK inhibitors. Methods: Between April 2018 and April 2021, we conducted multiple live and online educational activities for oncology healthcare professionals (HCPs) on NTRK fusion testing and/or TRK inhibitor treatment for varied solid tumors. Each activity included polling questions designed to assess HCP knowledge and practice patterns. In this analysis, we assessed HCP responses to these questions to evaluate awareness of expert recommendations on NTRK fusion testing and the selection of TRK inhibitor therapy for appropriate patients. Results: In 6 live and online activities with data from April 2018 to April 2021, 29% of HCPs (n = 844) indicated that they ordered molecular profiling to test for NTRK fusions in all solid tumors in their current practice. Of note, low rates of testing were reported in TRK inhibitor/ NTRK testing-focused activities throughout this time period, with no significant increase over time. In assessing different patient cases across 8 activities where experts recommended TRK inhibitor therapy as optimal, many HCPs did not select a TRK inhibitor, with considerable variance by tumor type (Table). *For all cases, experts selected larotrectinib and/or entrectinib as optimal treatment. †HCP respondents. GBM, glioblastoma; GI, gastrointestinal; MSI-H, microsatellite instability-high; PD, progressive disease; PTC, papillary thyroid cancer.Conclusions: The rate of broad testing for NTRK fusions across patients with solid tumors remains low, and many HCPs lack awareness of when to consider a TRK inhibitor. Educational activities designed to address these deficiencies would be of clear benefit to HCPs treating patients with advanced solid tumors. A detailed analysis of HCP trends will be presented.[Table: see text]

scholarly journals Induction of WNT16 via Peptide-mRNA Nanoparticle-Based Delivery Maintains Cartilage Homeostasis

Pharmaceutics ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 73
Author(s):  
Huimin Yan ◽  
Ying Hu ◽  
Antonina Akk ◽  
Muhammad Farooq Rai ◽  
Hua Pan ◽  
...  
Keyword(s):  
Messenger Rna ◽  
Treatment Options ◽  
Cartilage Explants ◽  
Joint Disease ◽  
Chondrocyte Apoptosis ◽  
Proof Of Concept ◽  
Human Cartilage ◽  
Cartilage Homeostasis ◽  
Wide Range ◽  
Significant Disability

Osteoarthritis (OA) is a progressive joint disease that causes significant disability and pain and for which there are limited treatment options. We posit that delivery of anabolic factors that protect and maintain cartilage homeostasis will halt or retard OA progression. We employ a peptide-based nanoplatform to deliver Wingless and the name Int-1 (WNT) 16 messenger RNA (mRNA) to human cartilage explants. The peptide forms a self-assembled nanocomplex of approximately 65 nm in size when incubated with WNT16 mRNA. The complex is further stabilized with hyaluronic acid (HA) for enhanced cellular uptake. Delivery of peptide-WNT16 mRNA nanocomplex to human cartilage explants antagonizes canonical β-catenin/WNT3a signaling, leading to increased lubricin production and decreased chondrocyte apoptosis. This is a proof-of-concept study showing that mRNA can be efficiently delivered to articular cartilage, an avascular tissue that is poorly accessible even when drugs are intra-articularly (IA) administered. The ability to accommodate a wide range of oligonucleotides suggests that this platform may find use in a broad range of clinical applications.

scholarly journals Pulmonary hypertension: From an orphan disease to a global epidemic

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
Ghazwan Butrous
Keyword(s):  
Pulmonary Hypertension ◽  
Vascular Resistance ◽  
Progressive Disease ◽  
Right Ventricular Failure ◽  
Medical Community ◽  
Pulmonary Vasculature ◽  
Current Interest ◽  
Ventricular Failure ◽  
Global Epidemic ◽  
Chronic Progressive Disease

[No abstract. Showing first paragraph of article]Pulmonary hypertension is a progressive disease characterized by an elevation of pulmonary artery pressure and pulmonary vascular resistance, leading to right ventricular failure and death. It remains a challenging chronic progressive disease, but the current interest and advent of medical therapy in the last 20 years has significantly changed the perception of medical community in this disease. Pulmonary hypertension is not a specific disease; the majority of cases present with other diseases and various pathological processes that affect the pulmonary vasculature, and consequently increase pulmonary pressure and vascular resistance.

scholarly journals Anthropometric Measurements Of The Ventrogluteal İnjectıon Area: A Cross-sectional Study

2020 ◽  
Vol 17 (3) ◽  
pp. 900-910
Author(s):  
Emel Tuğrul ◽  
Leyla Khorshıd ◽  
Özüm Tunçyürek
Keyword(s):  
Muscle Tissue ◽  
Subcutaneous Tissue ◽  
Research Problem ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Anthropometric Measurements ◽  
Sectional Study ◽  
Tissue Thickness ◽  
Cross Sectional ◽  
Crista Iliaca

Research Problem / Aim: The ventrogluteal injection area is one of the areas most frequently used by nurses in intramuscular injection applications. The thicknesses of the subcutaneous tissue and the muscle tissue in this area are important for a safe injection. The aim of this study is the determination of the subcutaneous and muscle tissue thicknesses on the ventrogluteal injection area and the anthropometric data about it. Method: The study has designed a cross-sectional study. 150 individuals who applied to the ultrasound unit of the hospital and accepted to participate in the study were included in the study. The ventrogluteal injection area was determined with the ‘’V’’ method by the researcher. The subcutaneous and muscle tissue thicknesses from the areas on the injection area and the areas 2 and 4 cm around the injection area were determined using the ultrasound device. Moreover, the relation between the anthropometric measurements of the individuals (height, weight, waist, hip and crista iliaca circumferences, distance between the large trochanter and crista iliaca and crista iliaca anterior) and the tissue thicknesses on the injection area were evaluated. The data of the research were evaluated with definitive statistics, ANOVA test and posthoc Tukey test, t test and correlation analysis. The p<0.05 value was accepted as statistically significant for all results. Findings: The average subcutaneous tissue thickness in the injection area was determined as 15.44±8.01 mm and the average tissue thickness there was determined as 31.75±11.86 mm. The subcutaneous tissue thickness in women was found more than the subcutaneous tissue thickness in men. When the tissue thicknesses 2 and 4 cm around the injection area were analyzed, it was found that the area where the total tissue thickness was the least was over 2 cm (41.67±14.83) and over 4 cm (35.79±15.55) of the injection area. It was determined that the average total thickness 4 cm around the injection area was less than 38 mm in underwight individuals. Conclusions: According to the results obtained from the study, the weight and body mass index of the individual should be considered in the choice of the injection area and the length of the needle to be used when the ventrogluteal injection area was used in intramuscular injections. Especially in obese individuals, longer needles can be preferred. Besides, it must be thought that there may be the risk of bone injury 4 cm around the injection area in asthenic individuals and individuals with normal weight. Moreover, since the individuals’ having a large waist and hip circumference is related to their subcutaneous tissue thickness, it is recommended that long needles should be chosen in these individuals.

Sensorineural hearing loss in neurobrucellosis

1993 ◽  
Vol 107 (11) ◽  
pp. 1034-1036 ◽  
Author(s):  
Ratna Thomas ◽  
Mohan Kameswaran ◽  
Vel Murugan ◽  
B. C. Okafor
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Combination Treatment ◽  
Incidental Finding ◽  
Treatment Options ◽  
Sensorineural Hearing ◽  
Clinical Feature ◽  
Diagnostic Features ◽  
Diagnostic Screening

AbstractA case of neurobrucellosis presenting to the otologist with sensorineural hearing loss (SNHL) as the predominant clinical feature is reported. The diagnostic features and treatment options are discussed and the need for prolonged combination treatment to prevent relapse and further deterioration of hearing stressed. SNHL in neurobrucellosis has hitherto been reported principally in neurology literature as something of an incidental finding and so escapes the attention of otologists. It is hoped that this report will alert otologists in areas where brucellosis is endemic to the need to include tests for brucellosis in the routine diagnostic screening for SNHL. Practitioners in other locations should also consider this possibility when dealing with patients who have visited or lived in endemic regions.

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