scholarly journals Use of Technologies to Improve the Liposuction Outcome Including Skin Texture and Form

2021 ◽  
Author(s):  
Mohan Thomas ◽  
James D’silva ◽  
Amal Abraham

Liposuction as the word suggests involves sucking out fat from the subcutaneous layers. In many parts of the world it is used interchangeably with weight loss and non-surgical fat reduction procedures. The gold standard for liposuction for many decades has been the “Suction assisted Liposuction’ also called SAL. Newer technologies have been introduced with varied claims about skin retraction, painless and complete evacuation of fat as well as a faster recovery. This chapter elaborates the personal experience of the Authors with regards to the discussed newer technologies bringing into perspective their indications, mechanism of action as well as clinical outcomes. At the outset the Authors would like to state emphatically that technologies are as good as the surgeon holding them and that somewhat same result can be achieved through a traditional liposuction in most of the cases. A surgeon looking to incorporate these technologies in practice should first achieve a mastery of traditional SAL for the best outcomes.

Author(s):  
Ruihai Zhou ◽  
George A. Stouffer ◽  
Sidney C. Smith

Hypercholesterolemia is a well-established risk factor for atherosclerotic cardiovascular disease (ASCVD). Low-density lipoprotein cholesterol (LDL-C) has been labeled as “bad” cholesterol and high-density lipoprotein cholesterol (HDL-C) as “good” cholesterol. The prevailing hypothesis is that lowering blood cholesterol levels, especially LDL-C, reduces vascular deposition and retention of cholesterol or apolipoprotein B (apoB)-containing lipoproteins which are atherogenic. We review herein the clinical trial data on different pharmacological approaches to lowering blood cholesterol and propose that the mechanism of action of cholesterol lowering, as well as the amplitude of cholesterol reduction, are critically important in leading to improved clinical outcomes in ASCVD. The effects of bile acid sequestrants, fibrates, niacin, cholesteryl ester transfer protein (CETP) inhibitors, apolipoprotein A-I and HDL mimetics, apoB regulators, acyl coenzyme A: cholesterol acyltransferase (ACAT) inhibitors, cholesterol absorption inhibitors, statins, and proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors, among other strategies are reviewed. Clinical evidence supports that different classes of cholesterol lowering or lipoprotein regulating approaches yielded variable effects on ASCVD outcomes, especially in cardiovascular and all-cause mortality. Statins are the most widely used cholesterol lowering agents and have the best proven cardiovascular event and survival benefits. Manipulating cholesterol levels by specific targeting of apoproteins or lipoproteins has not yielded clinical benefit. Understanding why lowering LDL-C by different approaches varies in clinical outcomes of ASCVD, especially in survival benefit, may shed further light on our evolving understanding of how cholesterol and its carrier lipoproteins are involved in ASCVD and aid in developing effective pharmacological strategies to improve the clinical outcomes of ASCVD.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2228
Author(s):  
Martin Hrubisko ◽  
Radoslav Danis ◽  
Martin Huorka ◽  
Martin Wawruch

The intake of food may be an initiator of adverse reactions. Food intolerance is an abnormal non-immunological response of the organism to the ingestion of food or its components in a dosage normally tolerated. Despite the fact that food intolerance is spread throughout the world, its diagnosing is still difficult. Histamine intolerance (HIT) is the term for that type of food intolerance which includes a set of undesirable reactions as a result of accumulated or ingested histamine. Manifestations may be caused by various pathophysiological mechanisms or a combination of them. The problem with a “diagnosis” of HIT is precisely the inconstancy and variety of the manifestations in the same individual following similar stimuli. The diagnosing of HIT therefore requires a complex time-demanding multidisciplinary approach, including the systematic elimination of disorders with a similar manifestation of symptoms. Among therapeutic approaches, the gold standard is a low-histamine diet. A good response to such a diet is considered to be confirmation of HIT. Alongside the dietary measures, DAO supplementation supporting the degradation of ingested histamine may be considered as subsidiary treatment for individuals with intestinal DAO deficiency. If antihistamines are indicated, the treatment should be conscious and time-limited, while 2nd or 3rd generation of H1 antihistamines should take precedence.


2021 ◽  
Vol 11 (6) ◽  
pp. 2849
Author(s):  
Lilla Pawlik-Sobecka ◽  
Joanna Górka-Dynysiewicz ◽  
Jadwiga Kuciel-Lewandowska

Despite its enormous therapeutic potential, spa treatment is not always properly perceived, hence the numerous attempts to assess its effectiveness. In the world literature, there are few reports on therapy using sulphur- and radon-containing therapeutic waters. In countries with a long tradition of balneotherapy, activity in this field of medicine is evident. Undoubtedly, the interest in balneotherapy results also from natural resources used in spa medicine, which, as geological and balneochemical research shows, are enormous in Poland. A particular example of the occurrence of radon–sulphide waters, rare on the European scale, is the Przerzeczyn-Zdrój health resort. The mechanism of action of therapeutic waters is not fully explored, but their effectiveness in therapy is confirmed by many authors. It is believed to be an effect of combined action of many factors, the most important of which are thermal, mechanical, and chemical.


2017 ◽  
Vol 133 (1) ◽  
pp. 295-355 ◽  
Author(s):  
Emmanuel Farhi ◽  
Matteo Maggiori

AbstractWe propose a simple model of the international monetary system. We study the world supply and demand for reserve assets denominated in different currencies under a variety of scenarios: a hegemon versus a multipolar world; abundant versus scarce reserve assets; and a gold exchange standard versus a floating rate system. We rationalize the Triffin dilemma, which posits the fundamental instability of the system, as well as the common prediction regarding the natural and beneficial emergence of a multipolar world, the Nurkse warning that a multipolar world is more unstable than a hegemon world, and the Keynesian argument that a scarcity of reserve assets under a gold standard or at the zero lower bound is recessionary. Our analysis is both positive and normative.


PEDIATRICS ◽  
1970 ◽  
Vol 46 (5) ◽  
pp. 821-822
Author(s):  
George M. Johnson

Considering that the article "Rabies: Rare Disease, Serious Problem" in the May 1970 Pediatrics1 was published under "Diagnosis and Treatment," it was disappointing that the importance of passive immunization or use of antirabies horse serum was mentioned only briefly in passing. The Sixth Technical Report of the World Health Organization emphasizes the importance of antirabies horse serum for potential human exposure to wildlife rabies, particularly involving bats and carnivorous animals. Personal experience pertaining to treatment of children bitten by wild animals and participation in the care of the child who died following a skunk bite2 have convinced me that the use of antirabies horse serum is not well understood or even known to many.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Win Hlaing Than ◽  
Jack K C Ng ◽  
Gordon C K Chan ◽  
Winston Fung ◽  
Cheuk Chun Szeto

Abstract Background and Aims The prevalence of obesity has increased over the past decade in patients with End Stage Kidney Disease (ESKD). Obesity at the initiation of peritoneal dialysis (PD) was reported to adversely affect clinical outcomes. However, there are few studies on the prognostic relevance of weight gain after PD. Method We reviewed the change in body weight of 954 consecutive PD patients from the initiation of dialysis to 2 years after they remained on PD. Clinical outcomes including patient survival, technique survival, and peritonitis rate in the subsequent two years were reviewed. Results The mean age was 60.3 ± 12.2 years; 535 patients (56.1%) were men and 504 (52.8%) had diabetes. After the first 2 years on PD, the average change in body weight was 1.2± 5.1 kg; their body weight was 63.0 ± 13.3 kg; body mass index (BMI) 24.4 ± 4.4 kg/m2. The patient survival rates in the subsequent two years were 64.9%, 75.0%, and 78.9% (log rank test, p = 0.008) for patients with weight loss ≥3 kg during the first 2 years of PD weight change between -3 and +3 kg, and weight gain ≥3 kg, respectively. The corresponding technique survival rates in the subsequent two years were 93.1%, 90.1%, 91.3%, respectively (p = 0.110), and the peritonitis rates were 0.7±1.5, 0.6±1.7, and 0.6±1.1 episodes per patient-year, respectively (p = 0.3). When the actual BMI after the first 2 years of PD was categorized into underweight, normal weight, marginal overweight, overweight, and obesity groups, the patient survival rates in the subsequent two years were 77.3%, 75.2%, 73.3%, 74.3%, and 75.9%, respectively (p= 0.005), and technique survival 98.0%, 91.9%, 88.0%, 92.8%, and 81.0%, respectively (p= 0.001). After adjusting for confounding clinical factors by multivariate Cox regression models, weight gain ≥ 3kg during the first 2 years of PD was an independent protective factor for technique failure (adjusted hazard ratio [AHR] 0.049; 95% confidence interval [CI] 0.004-0.554, p = 0.015), but was an adverse predictor of patient survival (AHR 2.338, 95%CI 1.149-4.757, p = 0.019). In contrast, weight loss ≥ 3kg during the first 2 years of PD did not predict subsequent patient or technique survival. Conclusion Weight gain during the first 2 years of PD confers a significant risk of subsequent mortality but appears to be associated with a lower risk of technique failure. The mechanism of this discordant risk prediction deserves further study.


2020 ◽  
Author(s):  
Richard Gombrich

The Buddha’s Path of Peace sets out the basic instructions for the life-changing way of the Buddha (the so-called “Noble Eightfold Path”) wholly in the context of contemporary and everyday life, personal experience, human relationships, work, environmental concern and the human wish for peace. In this book, the core of the Buddha’s teaching is comprehensively cast in modern models of thought—borrowed from science and philosophy—and informed by contemporary concerns. The reader, who may be completely new to Buddhism, is accompanied along the Path with practical exercises that are fully explained. The Path begins with an introductory overview and then proceeds through Right Speech, Right Acting, Right Livelihood, Right Effort, Right Concentration, Right Mindfulness, Right Understanding and Right Resolve, and concludes with a short chapter on the relevance of the Path to the multiple crises facing the world today. The reader is mentored throughout by practical meditational and contemplative exercises, with tables, diagrams, analogies and stories. Gradually the reader who has followed this handbook with commitment will feel the benefits of growing peacefulness, wisdom and compassion.


1908 ◽  
Vol 54 (227) ◽  
pp. 704-718
Author(s):  
Lady Henry Somerset

I fully appreciate the very great honour which has been done to me this afternoon in asking me to speak of the experience which I have had in nearly twenty years of work amongst those who are suffering from alcoholism. Of courseyou will forgive me if I speak in an altogether unscientific way. I can only say exactly the experiences I have met with, and as I now live, summer and winter, in their midst, I can give you at any rate the result of my personal experience among such people. Thirteen years ago, when we first started the colony which we have for inebriate women at Duxhurst, the Amendment to the present Inebriate Act was not in existence, that is to say, there was no means of dealing with such people other than by sending them to prison. The physical side of drunkenness was then almost entirely overlooked, and the whole question was dealt with more or less as a moral evil. When the Amendment to the Act was passed it was recognised, at any rate, that prison had proved to be a failure for these cases, and this was quite obvious, because such women were consigned for short sentences to prison, and then turnedback on the world, at the end of six weeks or a month, as the case might be, probably at the time when the craving for drink was at its height, and therefore when they had every opportunity for satisfying it outside the prison gate they did so at once. It is nowonder therefore that women were committed again and again, even to hundreds of times. When I first realised this two cases came distinctly and prominently under my notice. One was that of a woman whose name has become almost notorious in England, Miss Jane Cakebread. She had been committed to prison over 300 times. I felt certain when I first saw her in gaol that she was not in the ordinary sense an inebriate; she was an insane woman who became violent after she had given way to inebriety. She spent three months with us, and I do not think that I ever passed a more unpleasant three months in my life, because when she was sober she was as difficult to deal with-although not so violent-aswhen she was drunk. I tried to represent this to the authorities at the time, but I wassupposed to know very little on the subject, and was told that I was very certainly mistaken. I let her go for the reasons, firstly that we could not benefit her, and secondly that I wanted to prove my point. At the end of two days she was again committed to prison, and after being in prison with abstention from alcohol, which had rendered her more dangerous (hear, hear), she kicked one of the officials, and was accordingly committed to a lunatic asylum. Thus the point had been proved that a woman had been kept in prison over 300 times at the public expense during the last twenty years before being committed to a lunatic asylum. The other case, which proved to me the variations there arein the classifications of those who are dubbed “inebriates,” was a woman named Annie Adams, who was sent to me by the authorities at Holloway, and I was told she enjoyed thename of “The Terror of Holloway.” She had been over 200 times in prison, but directly she was sober a more tractable person could not be imagined. She was quite sane, but she was a true inebriate. She had spent her life in drifting in and out of prison, from prison to the street, and from the street to the prison, but when she was under the bestconditions I do not think I ever came across a more amiable woman. About that time the Amendment to the Inebriates Act was passed, and there were provisions made by which such women could be consigned to homes instead of being sent to prison. The London County Council had not then opened homes, and they asked us to take charge of their first cases. They were sent to us haphazard, without classification. There were women who were habitual inebriates, there were those who were imbecile or insane; every conceivable woman was regarded as suitable, and all were sent together. At that time I saw clearly that there would be a great failure (as was afterwards proved) in the reformatory system in this country unless there were means of separating the women who came from the same localities. That point I would like to emphasise to-day. We hear a great deal nowadays about the failure of reformatories, but unless you classify this will continue to be so.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Dong-Woo Shim ◽  
Yeokgu Hwang ◽  
Yoo Jung Park ◽  
Jin Woo Lee

Category: Ankle, Arthroscopy Introduction/Purpose: The gold standard for the surgical treatment of chronic lateral ankle instability is the modified Brostrom procedure. Surgery aims to re-establish ankle stability and function, without compromising ankle motion. Recently introduced all inside arthroscopic modified Brostrom procedure coincide with the goal on that aspect. The purpose of this study was to investigate the early outcomes of all inside arthroscopic modified Brostrom operation for chronic ankle instability. Methods: From January 2015 to August 2016, 30 patients were included. The visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) ankle–hindfoot score, Foot and Ankle Outcome Score (FAOS), and Karlsson score were used to evaluate clinical outcomes. Anterior talar translation and talar tilt were used to evaluate radiologic outcomes. All patients had lateral ankle instability. All patients had giving way, persistent pain, and an inability to resume their preinjury activity level for more than 6 months. Clinical outcome evaluations were performed preoperatively, at 3 months and 6 months postoperatively, and at a final follow-up using the VAS score, the AOFAS ankle-hindfoot score, FAOS, and Karlsson score. Radiologic outcome evaluations were performed preoperatively and at 1 year postoperatively at final follow-up using anterior talar translation, and talar tilt angle. Results: Thirty patients (19 males and 11 females) were followed up for a mean of 11.0 (range 4 – 23) months. The VAS, AOFAS, 1 FAOS subscale (Quality-of-life) and the Karlsson scores were improved significantly at the each follow-up period of 3 month, 6 month and 1 year postoperatively. Other 4 subscales of FAOS showed no significant outcomes (Table 1). The mean anterior talar translation and talar tilt showed significant improvements from 5.8 mm (SD = 0.4) and 7.9° (SD = 1.0) to 5.3 mm (SD = 0.3) and 5.7° (SD = 0.6) at the final follow-up each (p = 0.034, p=0.034). Conclusion: The arthroscopic modified Brostrom technique could be a viable alternative to the gold-standard open modified Brostrom procedure for anatomic repair of chronic lateral ankle instability. It can yield outstanding functional and clinical outcomes without adverse effects in terms of pain.


2020 ◽  
Vol 5 (4) ◽  
pp. 324
Author(s):  
Zheming Zhang

<p>With the continuous development and evolution of the United States, especially the economic center shift after World War II, the United States become the economic hegemon instead of the UK and thus it seized the economic initiative of the world. After the World War I, the European countries gradually withdraw from the gold standard. In order to stabilize the world economy development and the international economic order, the United States prepared to build the economic system related with its own interests so as to force the UK to return to the gold standard. The game between the United States and the UK shows the significance of economic initiative. Among them, the outcome of the two countries in the fight of the financial system also demonstrates a significant change in the world economic system.</p>


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