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Subcutaneous Fat Necrosis

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841. Adipose Tissue Promotes a Serum Cytokine Profile Related to Lower Insulin Sensitivity after Chronic Central Leptin Infusion (PubMed)

was found in both adipose depots and IFN-γ only in visceral tissue. Activation of leptin signaling was increased and insulin signaling decreased in subcutaneous fat of L. In conclusion, leptin mediates the production of inflammatory cytokines by adipose tissue independent of its effects on food intake, decreasing insulin sensitivity. (...) and protein content as well as with leptin and insulin signaling in subcutaneous and visceral adipose tissues. In addition, we analyzed the possible correlation between circulating levels of cytokines and peripheral insulin resistance. We studied 18 male Wistar rats divided into controls (C), those treated icv for 14 days with a daily dose of 12 μg of leptin (L) and a pair-fed group (PF) that received the same food amount consumed by the leptin group. Serum leptin and insulin were measured by ELISA, mRNA

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2012 PloS one

842. Immune deficiency could be an early risk factor for altered insulin sensitivity in antiretroviral-naive HIV-1-infected patients: the ANRS COPANA cohort. (PubMed)

, immunovirological and inflammatory parameters, glucose/insulin during oral glucose tolerance test (OGTT), adipokines, subcutaneous and visceral fat surfaces (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT], assessed by computed tomography) and the body fat distribution based on dual-energy X-ray absorptiometry (DEXA).Median age was 36 years; 28% of the patients were female and 35% of sub-Saharan origin; 20% had low CD4(+) T-cell counts (≤200/mm(3)). Patients with low CD4(+) T-cell counts (...) Immune deficiency could be an early risk factor for altered insulin sensitivity in antiretroviral-naive HIV-1-infected patients: the ANRS COPANA cohort. The relationships between immunovirological status, inflammatory markers, insulin resistance and fat distribution have not been studied in recently diagnosed (<1 year) antiretroviral-naive HIV-1-infected patients.We studied 214 antiretroviral-naive patients at enrolment in the metabolic substudy of the ANRS COPANA cohort. We measured clinical

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2012 Antiviral Therapy

843. The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation. (PubMed)

. Univariate logistic regression was used to evaluate the association of interfraction interval (IFI) with these outcomes.At a median follow-up time of 32 months, grade 2-4 and grade 3-4 subcutaneous fibrosis occurred in 31% and 7.5% of patients, respectively. Subcutaneous fibrosis improved in 5 patients (6%) with extended follow-up. Fat necrosis developed in 11% of women, and cosmetic outcome was fair/poor in 19%. The relative volume of breast tissue receiving 5%, 20%, 50%, 80%, and 100% (V5-V100 (...) ) of the prescribed dose was associated with risk of subcutaneous fibrosis, and the volume receiving 50%, 80%, and 100% (V50-V100) was associated with fair/poor cosmesis. The mean IFI was 6.9 hours, and the minimum IFI was 6.2 hours. The mean and minimum IFI values were not significantly associated with late toxicity.The incidence of moderate to severe late toxicity, particularly subcutaneous fibrosis and fat necrosis and resulting fair/poor cosmesis, remains high with continued follow-up. These toxicity

2012 Biology and Physics

844. External-Beam Partial-Breast Irradiation for Early Breast Cancer 40 Gy QD Over 2 Weeks

Frame: 2 years ] The safety of external-beam PBI in selected stages 0 and I female breast cancer patients utilizing 40 Gy in ten daily fractions over two weeks. The study will be deemed too toxic if >10% of enrolled patients have at least one of the following outcomes within 24 months of completion of PBI. Grade 3 or 4 skin/subcutaneous or pulmonary toxicity. The development of clinical fat necrosis. The development of rib fracture on the ipsilateral treated side, detected either clinically

2012 Clinical Trials

845. Soy Protein Intake and the Metabolic Syndrome

will evaluate whether reduced low-grade inflammation is a possible mechanism underlying the improvement in insulin resistance and glucose homeostasis. Finally, it will be assessed whether soy protein has beneficial effects on components of the metabolic syndrome, such as cardio-metabolic risk factors, blood lipid profile, blood pressure and endothelial function, fat storage in the liver and gene-expression in subcutaneous abdominal adipose tissue. Study design: Single-blind, cross-over strictly-controlled (...) will be calculated. Inflammation markers and adipokines [ Time Frame: 4 weeks ] For low-grade inflammation interleukins, tumor necrosis factor-α, C-reactive protein and adipokines will be measured in fasting blood samples. Furthermore, peripheral blood mononuclear cells (PBMC's) will be collected to measure expression of genes involved in lipid handling and inflammation. Cardio-metabolic risk factors [ Time Frame: 4 weeks ] Blood pressure and macro vascular regional arterial stiffness will be assessed by Pulse

2012 Clinical Trials

846. Z-Plasty

Betadine or Hibiclens preparation of site anesthesia Using #15 blade, make vertical incision along Z Excise scar Create full thickness skin flaps Undermine skin at subcutaneous fat Flaps should be freely mobile VII. Step 3: Transpose flap tips Flap tip E is transposed to point D (bottom end of Z) Simple interrupted stay s hold sides es used to hold flap tips in place Flap tip F is transposed to point C (top end of Z) Simple interrupted stay s hold sides es used to hold flap tips in place VIII. Step 4 (...) : Final appearance Line 1 is now reoriented by 90 degrees Z shape is a mirror image of incised Z IX. Complications Flap necrosis or sloughing hematoma (consider large bore needle aspiration) X. References Davidson in Cummings (1998) Otolaryngology, p. 440*1 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Z-Plasty." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip

2015 FP Notebook

847. Venous Insufficiency

, nem meghatározott , Venás elégtelenség Norwegian Venøs insuffisiens Derived from the NIH UMLS ( ) Ontology: Lipodermatosclerosis (C0406500) Definition (SCTSPA) Disminución de la circunferencia de la pierna debida a ulceración recurrente y necrosis adiposa que produce pérdida del tejido subcutáneo en un paciente con estasis venosa Definition (SNOMEDCT_US) A decrease in lower leg circumference due to recurrent ulceration and fat necrosis causing loss of subcutaneous tissue in a patient with venous (...) stasis disease Definition (SNOMEDCT_US) A decrease in lower leg circumference due to recurrent ulceration and fat necrosis causing loss of subcutaneous tissue in a patient with venous stasis disease Concepts Disease or Syndrome ( T047 ) MSH SnomedCT 95335006 , 201301003 , 201306008 , 410016009 English Post-phlebitic liposclerosis , Acute lipodermatosclerosis , Lipodermatosclerosis , lipodermatosclerosis , lipodermatosclerosis (diagnosis) , Lipodermatosclerosis, NOS , Lipodermatosclerosis (disorder

2015 FP Notebook

848. Wound Repair

Debridement Recut wound for clean, fresh, surgical-incision edges Undermining May be required to ensure closure and decreased skin tension Best dissection plane is between dermal layer and connective tissue, subcutaneous fat Insert closed scissors on lateral wound margin, and then spread open Repeat for opposite lateral wound margin technique Grasp with needle driver one third of way from attachment (where needle becomes straight) Evert wound edges (do not dig a ditch, build a flask) Everted edges (...) supply to tip of corner) Everts wound edges, but risk of skin necrosis and scar Everts wound edges, but risk of skin necrosis and scar Deep (interrupted dermal s) May use in clean wounds to better approximate wound edges and reduce wound edge tension Fast technique for long Lacerations, but risk of dehiscence if breaks anywhere along its length Subcuticular May use in clean wounds (surgical wounds) for close wound edge apposition (but does not allow drainage) Removal See for timing of removal XVII

2015 FP Notebook

849. Decubitus Ulcer

or Cognitive or (and other causes of excessive moisture) Advanced age V. Signs: Distribution (bony prominences) Common Heel Ischial tuberosity Buttock Other Ear Occiput Greater Trochanter Lateral Malleolus VI. Examination: Ulcer Characterization Basic description Location Size (Length x Width x Depth) Stage (Types 1-4) See Staging precautions Accurate grading requires debridement of necrosis first Use other grading schemes for staging of s and s Macerated skin (moisture induced wounds) are not staged Stage (...) 1: Nonblanchable erythema of intact skin (pink skin, not purple) Stage 2: Superficial or partial thickness skin loss (no slough or eschar) Stage 3: Full thickness skin loss with subcutaneous damage (crater to fascia) Stage 4: Full thickness skin loss with extensive deep damage to muscle, bone, tendon Additional findings Sinus tracts Exudate Necrotic tissue Granulation tissue Discharge and signs of infection VII. Labs culture Typically not indicated except to identify Levine Technique

2015 FP Notebook

850. Acute Pancreatitis

to evaluate for complications) Consider in severe , pancreatic necrosis or when other complications are suspected Acute Pancreatitis typically shows peripancreatic inflammation and fat stranding (but may be absent early in course) Identifies pancreatic edema and necrosis as well as extrapancreatitc changes including fluid accumulation for severe Pancreatitis: 78% (and LR+ 5.57) for severe Pancreatitis: 86% (and LR- 0.26) Predicts and evaluates Pancreatitis complications, length of hospital stay (...) symptoms or Indigestion , distention or fullness Clay-colored stool Other associated symptoms Decreased s Tactile warmth IV. Signs ral Low grade fever (severe cases) Cardiopulmonary Exam (25%) Left basilar rales ( ) Abdominal Exam Abdominal tenderness and guarding in the upper quadrants Peritoneal signs may be present (e.g. abdominal rigidity or sounds decreased Palpable upper abdominal mass (periumbilical discoloration with subcutaneous and edema) (flank discoloration with ) Skin Exam Erythematous

2015 FP Notebook

851. Burn Injury

(lower layers of reticular ) Findings Wet, weaping lesions with clear s White or pale to that when touched does not blanch Course Healing typically takes >21 days Scarring and contractures are common complications (involves stem cells, follicles, glands) Third degree (Full thickness) Pathophysiology Kills all skin layers Also involves underlying subcutaneous fat Findings Waxy, leathery, dark-brown to black, tan or white skin Bright red burns without blanching or sensation are Third Degree Burns (...) , flames, chemicals, electricity, friction or radiant and electromagnetic energy. A first degree burn is associated with redness, a second degree burn with vesication and a third degree burn with necrosis through the entire skin. Definition (MSH) Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Definition (CSP) damage inflicted on any part of an organism as the direct or indirect result of exposure to steam, chemicals, heat

2015 FP Notebook

852. Adjustable Gastric Banding

under fluoroscopy Management Endoscopic port replacement or Intra-abdominal surgical correction XI. Complications: Pouch dilation Causes Band overinflation Presentations Loss of satiety or regurgitation Management: Initial Deflate band Reinforce dietary management Management: Re-evaluate at 4-6 weeks Anticipate pouch size return to normal in 4-6 weeks Consider gastric band replacement or removal XII. Complications: Port site prominence Weight loss results in decreased subcutaneous fat Port rubs (...) Adjustable Gastric Banding Aka: Adjustable Gastric Banding , Laparoscopic Adjustable Gastric Banding , Adjustable Gastric Banding Surgery , Gastric banding II. Indications Morbid III. Epidemiology Most common form of in U.S. IV. Background Introduced in 2006 Band applied around the distal esophagus or proximal e Reversible and tension can be adjusted via subcutaneous port Replaces V. Efficacy Weight loss 21% at 1 year and 13% at 10 years VI. Prognosis: Outcomes Reoperation is required in 50% of cases

2015 FP Notebook

853. Cellulitis

and edematous conditions which are bilateral Abscess (or purulent drainage) Hallmark of Peau d'orange Skin (orange-peel like skin) Cellulitis results in edema including the fat layer s remain anchored to the Results in an indentation or pitting at each in the midst of edema of the surrounding tissue Regional spread Ascending lymphangitis Small patches of necrosis superinfection may also be present Hemorrhagic and necrotic bullae (specific conditions) Pseudomonas Cellulitis ( ) IX. Differential Diagnosis (...) , indurated Typically caused by Although can have a similar appearance on the face Cellulitis (deep, subcutaneous) Abrupt onset of indistinct faint erythema with rapidly advancing border Typically caused by group A. or Group G Although can cause this as well Purulent Cellulitis Cellulitis with pustular drainage or exudate without definitive, drainable abscess Abscess Hallmark of infection Primary management is If antibiotics are needed (Cellulitis with abscess), then cover (see below) Other l s Consider

2015 FP Notebook

854. Pancreatic Panniculitis Associated with Acinar Cell Carcinoma of the Pancreas: A Case Report (PubMed)

was found on the laboratory examinations. The biopsy specimens from the skin lesions showed subcutaneous fat necrosis. Abdominal computed tomography (CT) revealed a large mass with central necrosis in the body and tail of the pancreas. Distal pancreatectomy, splenectomy and partial transverse colectomy were successfully performed on day 17 of the hospitalization. The histopathologic findings supported the diagnosis of acinar cell carcinoma of the pancreas (ACCP). Postoperatively, the level of serum

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2011 Annals of dermatology

855. Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial. (PubMed)

care control (n = 25). The PRT group performed two sets of 10 exercises at high intensity using free-weights, 3 times per week for 12 weeks during dialysis, while the control group did not exercise. Tumor necrosis factor-alpha, interleukin-1b, interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10, and interleukin-12 were measured in serum before and after the intervention period. Muscle cross-sectional area (CSA), intramuscular lipid, intermuscular adipose tissue, and subcutaneous and total (...) thigh fat, evaluated via computed tomography of the non-dominant mid-thigh, were also collected at both time points. All cytokines were significantly elevated in the total cohort at baseline compared with normative data. There were no cytokine changes over time or between groups (p > 0.05). In secondary analyses pooling the groups, changes in logIL-6 and IL-8 were inversely related to changes subcutaneous thigh fat (p < 0.05) while changes in logIL-6 were also inversely related to changes in thigh

2011 European journal of applied physiology

856. No difference in markers of adipose tissue inflammation between overweight women with polycystic ovary syndrome and weight-matched controls. (PubMed)

of inflammatory markers in adipose tissue.Twenty overweight patients with PCOS, 10 lean patients with PCOS and 20 overweight controls had subcutaneous fat biopsies and blood samples taken. Adipose tissue levels of mRNA of inflammatory markers were determined by use of real-time PCR.Overweight patients with PCOS had higher relative adipose tissue chemokine ligand 2 (P < 0.01), and its cognate receptor (P < 0.05), tumour necrosis factor-α (P < 0.001), interleukin (IL)-10 (P < 0.001) and IL-18 (P < 0.001

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2011 Human Reproduction

857. Radial nerve palsy in the newborn: a case series. (PubMed)

of the current literature.During the study period, 953 infants presented to our clinic. Of these patients, 25 were identified as having isolated radial nerve palsy (i.e., a radial nerve palsy in isolation with good shoulder function and intact flexion of the elbow). Seventeen infants (68.0%) had a subcutaneous nodule representing fat necrosis in the inferior posterolateral portion of the affected arm. Full recovery occurred in all patients within a range of one week to six months, and 72.0% of the patients

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2011 Canadian Medical Association Journal

858. Expression and secretion of the novel adipokine tartrate-resistant acid phosphatase from adipose tissues of obese and lean women. (PubMed)

from lean or obese women.TRAP is a novel human adipokine produced by macrophages and secreted from the subcutaneous adipose tissue in vivo and in vitro. Secretion is linked to the size and number of adipocytes, as well as to concomitant secretion of inflammatory mediators, suggesting that TRAP is involved in fat accumulation and adipose inflammation. (...) of 11%. Adipose secretion of total TRAP was linear in vitro with time and was evident in vivo. Total TRAP secretion in vitro was similar in lean and obese women expressed per unit weight of the adipose tissue but correlated positively with the number/size of adipocytes (P ≤ 0.01) and with adipose secretion of tumor necrosis factor-α and interleukin-6 (P<0.01). TRAP 5b was not secreted from the adipose tissue. ATMs displayed highest cellular expression of TRAP mRNA in adipose tissue cells derived

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2011 International Journal of Obesity

859. Adipokines in Hemodialysis Patients

for 24 weeks. Baseline: Participants will have fasting blood drawn for adipokines: Tumor Necrosis Factor-alpha (TNF-alpha), Interleukin-6 (IL-6), high sensitivity C-Reactive Protein (hsCRP), high molecular weight Adiponectin (HMW-A), and leptin. All patients will undergo MRI scans on the mid-week non-dialysis day. Twenty each of overweight/obese patients randomized to pioglitazone or placebo will also undergo subcutaneous fat biopsy on the mid-week non-dialysis day. Study Period: Participants (...) ] The percent difference in hsCRP concentration geometric mean values from baseline to 6 months was calculated for each arm Secondary Outcome Measures : Change in Tumor Necrosis Factor-α (TNF-α) Concentration in Plasma From Baseline to 6 Months [ Time Frame: Baseline and 6 months ] The percent difference in TNF-α concentration geometric mean values from baseline to 6 months was calculated for each arm Change in Interleukin-6 (IL-6) Concentration in Plasma From Baseline to 6 Months [ Time Frame: Baseline

2011 Clinical Trials

860. Exercise For Sub-acute Stroke Patients in Jamaica

diabetes mellitus (T2DM) and recurrent stroke. By the time individuals reach chronic stroke (>6 months), we report hemiparetic body composition abnormalities including paretic leg muscular atrophy, increased intramuscular area fat, and a major shift to fast myosin heavy chain (MHC). All of these factors promote IR, which has been linked to reduced muscle protein synthesis in aging that may be reversible with exercise. We also find elevated tumor necrosis factor alpha (TNFα) in paretic leg muscle (...) and Abdominal muscle and fat [ Time Frame: Baseline and 6 months ] CT scans to determine 1) mid-thigh cross sectional area for muscle area, intramuscular and subcutaneous fat area, and quality of lean tissue mass, 2) abdominal fat area. Whole body protein and skeletal muscle synthesis and breakdown [ Time Frame: Baseline and 6 months ] Serial blood sampling and pre-/post-muscle biopsies in the fasted and fed state Muscle myosin heavy chain isoform (MHC) proportions [ Time Frame: Baseline and 6 months

2011 Clinical Trials

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