How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

1,105 results for

Subcutaneous Fat Necrosis

by
...
Latest & greatest
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

801. Burns, Thermal (Follow-up)

go completely through the eschar. The subcutaneous fat will appear to bubble up into the escharotomy wound. Bleeding is minimal and is easily controlled by pressure. Upon completion of the escharotomy, a dressing with antibiotics is placed on the wound, and the extremity is elevated to help maintain homeostasis. If the chest is involved and the eschar compromises ventilatory motion, perform an escharotomy involving the anterior chest. Incisions are made along the costal margin, along the anterior (...) be debrided (see the image below); the intact skin serves as a hermetic barrier, although the blister fluid can serve as an excellent medium for bacterial growth. Another argument for debridement is that removal of the blister roof allows topical agents to reach burn tissue. Blisters that are intact but are located in areas that have a high likelihood of rupture may be sharply debrided. The World Health Organization (WHO) recommends debridement of all bullae and excision of all adherent necrotic tissue

2014 eMedicine Pediatrics

802. Xenotransplantation (Overview)

) and promote intravascular coagulation. After contact with human/primate blood, clots quickly develop in pECs. The increased clot formation may be immunologically mediated, or may be the result of specific hormone regulators. Lee et al. recently examined this question. [ ] Incubation of pECs with human tumor necrosis factor alpha (TNF-α) or interleukin-1α (IL-1α) caused an increase in porcine tissue factor (TF) activity and mRNA; however, those changes were not seen when these cells were exposed to 20 (...) . [ ] Adult pig islet cells were encapsulated in microcapsules implanted in the kidney or in a subcutaneous macrodevice in streptozocin-treated cynomolgus monkeys; in the latter group, diabetes was controlled for 6 months without immune suppression. This remarkable advance could pave the way for a variety of future human trials. The regulation of T-regulatory cells Still another approach involves inducing host immune tolerance and tissue accommodation; if the host immune system were ‘taught’ to tolerate

2014 eMedicine Pediatrics

803. Weber-Christian Disease (Overview)

: A, ×20; B, ×200.) Histopathologic features of subcutaneous fat necrosis of the newborn. (A) Scanning power shows a mostly lobular panniculitis (arrow indicates area enlarged in B). (B) Higher magnification demonstrated narrow needle-shaped clefts radially arranged and surrounded by histiocytes. (A and B, hematoxylin-eosin stain; original magnifications: A, X 20; B, X 200). Histopathologic features of lipoatrophy secondary to subcutaneous injections of corticosteroids. (A) Low-power view showed small (...) Updated: Aug 28, 2018 Author: Eyal Muscal, MD, MS; Chief Editor: Lawrence K Jung, MD Share Email Print Feedback Close Sections Sections Weber-Christian Disease Overview Background Panniculitis refers to a broad spectrum of diseases that involve inflammation of the subcutaneous fat layer of the skin. Weber-Christian disease is an eponym for a form of panniculitis, idiopathic nodular panniculitis, which is characterized by subcutaneous nodules, inflammatory cells in the fat lobules, and systemic

2014 eMedicine Pediatrics

804. Sickle Cell Anemia (Treatment)

for the treatment of severe pain associated with a vasoocclusive crisis Use of analgesics and physical therapy for the treatment of avascular necrosis In July 2017, the US Food & Drug Administration (FDA) approved L-glutamine oral powder (Endari) for patients age 5 years and older to reduce severe complications of SCD. [ , ] L-glutamine increases the proportion of the reduced form of nicotinamide adenine dinucleotides in sickle cell erythrocytes; this probably reduces oxidative stress, which contributes (...) is an efficient iron chelator. It is administered as a prolonged infusion intravenously or subcutaneously for 5-7 days a week. Although effective, there are significant challenges associated with its use that can result in non-compliance. [ ] Deferiprone and deferasirox, oral iron chelators, are effective for iron overload treatment and have differences (eg, different pharmacokinetics and adverse effect profiles). Deferasirox has a capacity similar to deferoxamine in chelating iron, but it is administered

2014 eMedicine Pediatrics

805. Birth Trauma (Follow-up)

below): Abrasions Erythema petechia Ecchymosis Lacerations Subcutaneous fat necrosis Location of injury in soft tissue planes on the scalp and head. Skull injuries with a favorable long-term prognosis include the following: Caput succedaneum Cephalhematoma Linear fractures Facial injuries with a favorable long-term prognosis include the following: Subconjunctival hemorrhage Retinal hemorrhage Musculoskeletal injuries with a favorable long-term prognosis include the following: Clavicular fractures (...) sometimes may occur as scalpel cuts during cesarean delivery or during instrumental delivery (ie, vacuum, forceps). Infection remains a risk, but most of these lesions uneventfully heal. Management consists of careful cleaning, application of antibiotic ointment, and observation. Bring edges together using Steri-Strips. Lacerations occasionally require suturing. Subcutaneous fat necrosis Subcutaneous fat necrosis is not usually detected at birth. Irregular, hard, nonpitting, subcutaneous plaques

2014 eMedicine Pediatrics

806. White Blood Cell Function (Treatment)

, differentiation, activation and apoptosis of the cells of the immune system. Some ILs, including IL2, also have antiviral and antitumoral functions. Interferons (-a, -b, -g) are involved in the regulation of immune responses and promote the activation and differentiation of the cells of the immune system. Interferons also possess antiviral and antitumoral properties. Tumor necrosis factor (TNF)-a and TNF-b have proinflammatory properties as well as antitumoral functions. Hematopoietic growth and survival (...) and severe immunopathologic conditions. Most parenchymal cells express IL-17 receptors; signaling through these receptors induces the target cells to produce proinflammatory factors, such as IL-6, IL-1, tumor necrosis (TNF), IL-8, and matrix metalloproteinases. [ ] Most cytotoxic T lymphocytes express CD8 and recognize endogenously derived antigens in the context of MHC class I molecules. They are critical in mediating allograft rejection, tumor surveillance, and destruction of intracellular pathogens

2014 eMedicine Pediatrics

807. Weber-Christian Disease (Treatment)

histiocytes. (A and B, hematoxylin-eosin stain; original magnifications: A, ×20; B, ×200.) Histopathologic features of subcutaneous fat necrosis of the newborn. (A) Scanning power shows a mostly lobular panniculitis (arrow indicates area enlarged in B). (B) Higher magnification demonstrated narrow needle-shaped clefts radially arranged and surrounded by histiocytes. (A and B, hematoxylin-eosin stain; original magnifications: A, X 20; B, X 200). Histopathologic features of lipoatrophy secondary (...) References Lazarus GS. Panniculitis and Disorders of the Subcutaneous Fat. . Weber EP. A case or relapsing nonsuppurative nodular panniculitis. Brit J Derm . 1925. 37:301. Christian HA. Relapsing febrile nodular nonsuppurative panniculitis. Arch Intern Med . 1928. 41:338. Haubrich WS. Weber and Christian of Weber-Christian disease. Gastroenterology . 2008 Apr. 134(4):912. . Valverde R, Rosales B, Ortiz-de Frutos FJ, Rodriguez-Peralto JL, Ortiz-Romero PL. Alpha-1-antitrypsin deficiency panniculitis

2014 eMedicine Pediatrics

808. Xenotransplantation (Treatment)

endothelial cells (pECs) and promote intravascular coagulation. After contact with human/primate blood, clots quickly develop in pECs. The increased clot formation may be immunologically mediated, or may be the result of specific hormone regulators. Lee et al. recently examined this question. [ ] Incubation of pECs with human tumor necrosis factor alpha (TNF-α) or interleukin-1α (IL-1α) caused an increase in porcine tissue factor (TF) activity and mRNA; however, those changes were not seen when (...) alginate macroencapsulation devices. [ ] Adult pig islet cells were encapsulated in microcapsules implanted in the kidney or in a subcutaneous macrodevice in streptozocin-treated cynomolgus monkeys; in the latter group, diabetes was controlled for 6 months without immune suppression. This remarkable advance could pave the way for a variety of future human trials. The regulation of T-regulatory cells Still another approach involves inducing host immune tolerance and tissue accommodation; if the host

2014 eMedicine Pediatrics

809. Amenorrhea (Diagnosis)

. Kallmann syndrome most commonly occurs as an X-linked recessive disorder caused by a KAL1 defect. Autosomal dominant and autosomal recessive inheritances are less common. [ , ] For detailed information, see . Evidence suggests a negative correlation between body fat levels and menstrual abnormalities. A critical body fat level must be present for the reproductive system to function normally. In some female athletes, the synergistic effects of excessive exercise and disordered eating cause severe (...) Gynecol Reprod Biol . 2016 Mar. 198:131-7. . Jayasena CN, Nijher GM, Chaudhri OB, Murphy KG, Ranger A, Lim A, et al. Subcutaneous injection of kisspeptin-54 acutely stimulates gonadotropin secretion in women with hypothalamic amenorrhea, but chronic administration causes tachyphylaxis. J Clin Endocrinol Metab . 2009 Nov. 94(11):4315-23. . Erb TM, Gerschultz K, Gold MA, Sanfilippo JS. Primary amenorrhea in a young adult with sickle cell disease: a case report and brief literature review on adolescent

2014 eMedicine Pediatrics

810. Acute Respiratory Distress Syndrome (Diagnosis)

permeability, influx of protein rich edema fluid into the alveolar sacs, dysfunction of surfactant production, and defective ion transport leading to impaired fluid clearance from alveolar cells. These changes are the hallmark of ARDS pathophysiology and are accompanied by dysregulated inflammation from dysfunctional leukocytes and influx of pro-inflammatory cytokines like interleukins and tumor-necrosis factor. The role of neutrophils in this mechanism is controversial. Animal models have favored both (...) , if they are associated with shock and thrombocytopenia. [ ] Other more common etiologies include bronchiolitis, aspiration pneumonia, aspiration of gastric contents, major trauma, pulmonary contusion, burns, inhalational injury, massive transfusions or transfusion-related acute lung injury (TRALI). [ , , , , , ] Transfusion of all type of blood products including packed red blood cells, fresh frozen plasma and platelets has been associated with development of ARDS. [ , ] Other causes include acute pancreatitis, fat

2014 eMedicine Pediatrics

811. Burns, Thermal (Diagnosis)

go completely through the eschar. The subcutaneous fat will appear to bubble up into the escharotomy wound. Bleeding is minimal and is easily controlled by pressure. Upon completion of the escharotomy, a dressing with antibiotics is placed on the wound, and the extremity is elevated to help maintain homeostasis. If the chest is involved and the eschar compromises ventilatory motion, perform an escharotomy involving the anterior chest. Incisions are made along the costal margin, along the anterior (...) be debrided (see the image below); the intact skin serves as a hermetic barrier, although the blister fluid can serve as an excellent medium for bacterial growth. Another argument for debridement is that removal of the blister roof allows topical agents to reach burn tissue. Blisters that are intact but are located in areas that have a high likelihood of rupture may be sharply debrided. The World Health Organization (WHO) recommends debridement of all bullae and excision of all adherent necrotic tissue

2014 eMedicine Pediatrics

812. Birth Trauma (Diagnosis)

below): Abrasions Erythema petechia Ecchymosis Lacerations Subcutaneous fat necrosis Location of injury in soft tissue planes on the scalp and head. Skull injuries with a favorable long-term prognosis include the following: Caput succedaneum Cephalhematoma Linear fractures Facial injuries with a favorable long-term prognosis include the following: Subconjunctival hemorrhage Retinal hemorrhage Musculoskeletal injuries with a favorable long-term prognosis include the following: Clavicular fractures (...) sometimes may occur as scalpel cuts during cesarean delivery or during instrumental delivery (ie, vacuum, forceps). Infection remains a risk, but most of these lesions uneventfully heal. Management consists of careful cleaning, application of antibiotic ointment, and observation. Bring edges together using Steri-Strips. Lacerations occasionally require suturing. Subcutaneous fat necrosis Subcutaneous fat necrosis is not usually detected at birth. Irregular, hard, nonpitting, subcutaneous plaques

2014 eMedicine Pediatrics

813. Plantar Fasciitis (Treatment)

the superficial layers of the subcutaneous tissue, because corticosteroid injection into the superficial fat pad can cause fat necrosis and atrophy, which reduce the shock-absorbing capacity of the plantar heel Studies have reported success rates of 70% or better. [ , ] Corticosteroid injections have been shown to improve symptoms at 1 month but not at 6 months. It is recommended not to give more than 3 steroid injections within a year. A randomized, controlled study demonstrated that intralesional (...) corticosteroids. [ ] Potential risks of corticosteroid injection include plantar fascia rupture, which was found in almost 10% of patients after plantar fascia injection in one case series, [ ] and fat pad atrophy. [ , ] Long-term sequelae were found in approximately 50% of patients with plantar fascia rupture. [ ] Improper placement of a corticosteroid injection for plantar fasciitis can result in necrosis and atrophy of the plantar fat pad at the heel. This complication may result in significant pain

2014 eMedicine Surgery

814. Morton Neuroma (Treatment)

obtain either total resolution of symptoms or improvement to a satisfactory level with footwear modifications and restrictions. [ ] Corticosteroid or local anesthetic injections may be helpful, especially when coupled with the aforementioned shoe modifications. A dorsal injection is administered with 40 mg of methylprednisolone or a similar corticosteroid and 1% plain lidocaine or 0.5% plain bupivacaine in the same syringe. To avoid steroid-induced skin necrosis, do not inject into the superficial (...) subcutaneous tissue. Injections should not be used indiscriminately, because the injection itself is associated with mild risk. High-quality evidence supports the use of corticosteroid injections for short-term (3-month) symptom relief. [ , ] Symptom relief may last longer in smaller neuromas (<5 mm). [ ] Alcohol sclerosing injections should be used with caution, in that they have not been shown to be reliably effective. [ , , ] Nonsteroidal anti-inflammatory drugs (NSAIDs) or antiseizure medications

2014 eMedicine Surgery

815. Hidradenitis Suppurativa (Treatment)

recurrence. The block of tissue excised should be adequately wide and sufficiently deep. To ensure that the deep coils of the apocrine gland are removed, the subcutaneous tissue down to the deep fascia, or at least 5 mm of subcutaneous fat, should be excised. The extent of the sinus tracts is intraoperatively marked by injecting 3-5 mL of a methyl-violet solution. Complete surgical excision is achieved when all color-coded areas are fully removed. In cases where blue-stained areas occurred (...) was developed. Wide excisions reach into the healthy deep subcutaneous fat, but the STEEP procedure with its successive tangential transsections leaves the epithelialized bottoms of the sinus tracts and a large extent of the subcutaneous fat intact, leading to more superficial and smaller defects. STEEP is done with the patient under general anesthesia. For the performance of the multiple transversal sections, electrosurgery has some important advantages over the carbon dioxide laser, since transversal

2014 eMedicine Surgery

816. Foot Infections (Treatment)

and aggressive treatment to preserve a limb or a life. Necrotizing fasciitis and gas gangrene are the two most common pedal surgical emergencies. Local tissue damage, progressive gangrene, and potential systemic toxemia and/or death can result from these infections. [ ] Necrotizing fasciitis Necrotizing fasciitis is characterized by widespread necrosis of fascia and deeper subcutaneous tissues, with initial sparing of skin and muscle. Eventually, skin involvement is noted, with cellulitis evolving (...) be unpredictable and are typically polymicrobial. Soft-tissue infections in the foot consist of any infectious process affecting the skin, subcutaneous tissue, adipose tissue, superficial or deep fascia, ligaments, tendons, tendon sheaths, joints, or joint capsules. Considering that there are more than 20 joints, 44 tendons, approximately 100 ligaments, four major compartments, and numerous fascial planes in the normal foot, one can readily appreciate the potential for complex problems. Many events can

2014 eMedicine Surgery

817. Intersection Syndrome (Treatment)

occupations. The goals of therapy are strengthening, full ROM, and modification of equipment. The rehabilitation period may last 4-6 weeks. Previous Next: Complications Cortisone injections near the skin may cause depigmentation in patients who are dark skinned. These injections also may lead to subcutaneous fat atrophy or necrosis, infection, and tendon rupture, although, fortunately, these complications are rare. Theoretically, surgical release of the extensor retinaculum could lead to bowstringing

2014 eMedicine Surgery

818. Intestinal and Multivisceral Transplantation (Treatment)

perforation is warranted in any intestinal transplant recipient with unexplained fever, diarrhea, or gastrointestinal bleeding. Enteral nutrition is provided as soon as intestinal function returns. In the absence of other clinical complications, enteral feedings are started on the third-to-fifth postoperative day. The concentration and type of enteral nourishment are tailored to the patient's clinical response. A low-fat diet is used in the early posttransplant period. On average, recipients of ISB (...) supplements (gluconate forms) Rice starch products Medium chain triglycerides Fat restriction Restrict fat to around 30% of daily intake if colon is in continuity (combined with soluble fibers and complex starches). If the patient has no colon, fat restriction may not be necessary, as fat is felt to be a good energy source in these patients. Glutamine Lactose avoidance Oxalate avoidance Jejunostomies isotonic high sodium (encouraged target is 90 mmol/L) Fiber Clinical trial data suggest that fiber assists

2014 eMedicine Surgery

819. Bariatric Surgery (Treatment)

and seromas, as well as fat necrosis, skin slough, infection, and deep vein thrombosis (DVT). In addition, the patient should be involved with a team that assesses nutritional and psychological issues as needed. [ ] Previous Next: Complications Early complications of Roux-en-Y gastric bypass are as follows: Anastomotic leak (1-3%) Pulmonary embolism, DVT (< 1%) Wound infection (more common with open approach) Gastrointestinal hemorrhage, bleeding (0.5-2%) Respiratory insufficiency, pneumonia Acute (...) and accessible through a port, which is attached by a catheter to the band. The port is placed subcutaneously in the anterior abdominal wall after the band is secured around the stomach. Adjustment of the band through the access port is an essential part of laparoscopic adjustable gastric banding therapy. Appropriate adjustments, performed as often as six times annually, are critical for successful outcomes. Patients must chew food thoroughly to allow food to pass through the band. Adjusting the inflation

2014 eMedicine Surgery

820. Blunt Chest Trauma (Treatment)

or is associated with severe pain due to proximal brachial plexus injury. An above-elbow amputation may be the best approach for these patients. Chest-wall defects The management of large open chest-wall defects initially requires irrigation and debridement of devitalized tissue to prevent progression into a necrotizing wound infection. Once the infection is under control, subsequent treatment depends on the severity and level of defect. Reconstructive options range from skin grafting to well-vascularized (...) . Patients are in respiratory distress. They typically cannot phonate and frequently present with stridor. Other physical signs include an associated pneumothorax and massive subcutaneous emphysema. Blunt tracheal injuries are immediately life-threatening and require surgical repair. Bronchoscopy is required to make the definitive diagnosis. The first therapeutic maneuver is the establishment of an adequate airway. If airway compromise is present or probable, a definitive airway is established

2014 eMedicine Surgery

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>