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Subcutaneous Fat Necrosis

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121. Hepatic Issues and Complications Associated With Inflammatory Bowel Disease: A Clinical Report From the NASPGHAN Inflammatory Bowel Disease and Hepatology Committees

: Cholelithiasis Viral Hepatitis Transplant issues IgG4 cholangiopathy Granulomatous hepatitis Primary biliary cirrhosis Hepatic amyloidosis Nonalcoholic fatty liver disease/steatohepatitis TNF ¼ tumor necrosis factor. Saubermann et al JPGN Volume 64, Number 4, April 2017 640 Copyright © ESPGHAL and NASPGHAN. All rights reserved. improve patient survival with the native liver (35). ERCP should be performed by interventional endoscopists with experience in PSC management. Perioperative antibiotics (...) , a persistent antiphospholipid antibody, oral contraceptive use, smoking, obesity, thalidomide, or having a central venous catheter (65). If thromboprophylaxis is planned, then low-molecular-weight heparin is recommended. The dosing of enoxaparin is weight based with patients>60 kg receiving either 30 mg subcutaneous twice daily, or 40 mg once daily, and patients 30 cm are associated with an odds ratio of 7 (95% confidence interval, 2.6–19.3] for the development of gallstones (70). Similarly, another study

2017 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

122. Recommendation on Design, Execution, and Reporting of Animal Atherosclerosis Studies: A Scientific Statement From the American Heart Association

ranging from 300 to 500 mg/dL. , Although the rate of atherosclerotic lesion development varies greatly between facilities, macrophage foam cells can be present in the aortic root within a month. At later stages, there are complex lesions containing spindle-shaped smooth muscle cells, increased extracellular matrix, and overlying fibrous caps. The addition of a saturated fat-enriched diet (21% wt/wt saturated fat, 0.2% wt/wt cholesterol; commonly referred to as Western diet) accelerates (...) atherosclerosis and results in elevated total plasma cholesterol concentrations of >1000 mg/dL. Western diet feeding results in a more foam cell–rich atherosclerosis, with lesions containing cholesterol crystals, necrotic cores, and calcifications. However, a fat-enriched diet can alter the outcomes of atherosclerosis because of the induction of pronounced hypercholesterolemia. For example, recombination-activating gene 1–deficient (Rag1 −/− ) mice on an apoE −/− background have attenuated atherosclerosis

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2017 American Heart Association

126. Dyslipidaemias

acid ER extended release ESC European Society of Cardiology ESRD end-stage renal disease EU European Union FACE-BD Fondamental Academic Centers of Expertise in Bipolar Disorders FATS Familial Atherosclerosis Treatment Study FCH familial combined hyperlipidaemia FDA US Food and Drug Administration FDC fixed-dose combination FH familial hypercholesterolaemia FIELD Fenofibrate Intervention and Event Lowering in Diabetes FOCUS Fixed-Dose Combination Drug for Secondary Cardiovascular Prevention GFR

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2016 European Society of Cardiology

127. Diarrhoea in Adult Cancer Patients: ESMO Clinical Practice Guidelines

Consider Clostridium dif?cile, Salmonella, Campylobacter and other causes of infectious colitis. CBC, complete blood count; i.v., intravenous; s.c., subcutaneous; tid, three times a day. Annals of Oncology Clinical Practice Guidelines Volume 29 | Supplement 4 | October 2018 doi:10.1093/annonc/mdy145 | iv135 Downloaded from by guest on 27 March 2019sepsis, neutropaenia, bleeding or dehydration, and patients with severe (...) the diarrhoea is often bloody [V, A]. Anticholinergic, antidiarrhoeal and opioid agents should be avoided since they may aggravate ileus [V, A]. The indications for and timing of surgical intervention are controversial. The mortality rate of patients who fail to respond to medical interventions is high and many patients may not be salvageable. Nonetheless, in selected patients, surgery may be helpful to avoid progressive bowel necrosis, perforation and to help control sepsis. Commonly cited indications

2018 European Society for Medical Oncology

128. The Association of Coloproctology of Great Britain and Ireland Consensus Guidelines in Surgery for Inflammatory Bowel Disease

, the underlying principle has to be bowel sparing . Unfortunately, there are few high‐quality randomized controlled trials to assess different surgical techniques for surgery in small bowel Crohn's disease and much of the evidence is from small studies and historic data . Indications for surgery Failure of medical treatment Crohn's disease is a lifelong chronic inflammatory disease which is mainly treated medically. Biological therapies, including anti‐tumour necrosis factor α (TNFα) agents, are very (...) bowel can be differentiated from the normal one by palpating the mesenteric border of the bowel wall, where it is usually thickened with fat wrapped on the sides of the wall . Some older studies were in favour of extended resection for the involved bowel , . However, a RCT of 152 patients comparing a macroscopically limited resection margin of 2 cm with an extended resection margin of 12 cm, found that the width of the excised margin did not affect recurrence. More significantly, recurrence rates

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2018 Association of Coloproctology of Great Britain and Ireland

129. Renal Cell Carcinoma

size of papillary adenoma was 5 mm. From now, papillary adenoma is de?ned as a papillary renal tumour =15 mm in itslargestdimension. - The main prognostic factors in chromophobe RCC are tumour stage, the presence of necrosis, a sarcomatoid and/or rhabdoidcomponentandsmallvesselinvasion. - Hybrid tumours present overlapping features of oncocyto- mas and chromophobe RCC. They have indolent behaviour andareusuallyobservedinBirt–Hogg–Dubésyndrome. - The diagnosisof the highlyaggressive collecting duct (...) is 31 years. The diagnosis is based on a strong nuclear TFE3/TFEB immunoreactivity and the presence of a translocation involving TFE3 or TFEB genes:t(X;1)(p11.2;q21)andt(6,11)(p21;q12),respectively. - Among angiomyolipomas (AMLs), epithelioid AML is now recognised as a separate entity with a risk of progression or metastasis. The prognostic factors for the risk of progression are association with tuberous sclerosis, multiple AML, the presence of necrosis, tumour size >7 cm, extrarenal extension

2017 European Society for Medical Oncology

131. Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

formation can be detected by ultrasonography. Ultrasonography can also identify a subcutaneous or perigraft fluid collection that could be aspirated for analysis, culture, cell count, and other studies used to differentiate a noninfected seroma from bleeding. A sinogram can demonstrate extension of a sinus tract to the graft, which might involve an anastomotic site. A potential risk of sinograms is that an infection can be introduced during the procedure by the high-pressure instillation of contrast (...) manipulations, the presence of perigraft air is highly suggestive of VGI. CT findings often suggestive of infection include perigraft fluid with fat stranding, lack of fat plane between graft and bowel, and anastomotic leakage or aneurysm. Perigraft fluid is usually reabsorbed within 3 months postoperatively, and perigraft air is usually absorbed within the first week or so, although it can persist for as long as 2 months postoperatively. , , Intra-abdominal VGI can occur many months to years after surgery

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2016 American Heart Association

132. Practice Guidelines for the Diagnosis and Management of Aspergillosis

). Prophylaxis with itraconazole is limited by tolerability and absorption ( strong recommendation; high-quality evidence ). 68. We recommend continuation of antifungal prophylaxis throughout the duration of immunosuppression in patients with chronic immunosuppression associated with GVHD (corticosteroid equivalent of >1 mg/kg/day of prednisone for >2 weeks and/or the use of other anti-GVHD therapies, such as lymphocyte-depleting agents, or tumor necrosis factor α (TNF-α) inhibition, for refractory GVHD

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2016 Infectious Diseases Society of America

133. Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae

There is limited evidence on the utility of ultrasound in diagnosing stress fractures. Ultrasound is a first-line imaging modality in assessing muscles, tendons, joints, and nerves in the extremities [33], so the radiologist should know the typical sonographic appearance of stress fractures. Sonographic findings of stress fractures include subcutaneous edema, periosteal thickening, cortical bone irregularity, local hyperemia [33-35], and periosteal callus. Overall, ultrasound appears to be more sensitive than (...) of delayed union, nonunion, displacement, and avascular necrosis [17]. Given the importance of recognizing these high-risk fractures in the femoral head and neck, MRI is the preferred second-line study after initial negative radiographs to prevent delayed diagnosis. Variant 3: Suspected stress (fatigue) fracture, excluding hip and vertebrae. Negative radiographs. Next imaging study. See variant 2. Certain stress fractures are considered high risk based on a tendency for nonunion or delayed union. High

2016 American College of Radiology

134. Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot)

-tissue or juxta-articular swelling. Suspected soft-tissue infection. Additional imaging following radiographs. Radiologic Procedure Rating Comments RRL* MRI area of interest without and with IV contrast 9 Radiographs and MRI are both indicated and complementary. This procedure provides better delineation of fluid collection and areas of necrosis with contrast. O MRI area of interest without IV contrast 7 This procedure is an alternative to MRI without and with contrast if contrast is contraindicated (...) on fluid-sensitive sequences such as T2-weighted fat- saturated and short tau inversion recovery. Studies have confirmed both high sensitivity and high specificity of T1-weighted signal abnormalities for assigning true positive and true negative in suspected osteomyelitis [10,11]. 1 Principal Author and Panel Vice-chair, University of Kentucky, Lexington, Kentucky. 2 Research Author, University of Kentucky, Lexington, Kentucky. 3 Panel Chair, Mayo Clinic, Phoenix, Arizona. 4 NYU Center

2016 American College of Radiology

135. Liposuction for chronic lymphoedema

Recommendations 1.1 Current evidence on the safety and efficacy of liposuction for chronic lymphoedema is adequate to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 Patient selection should only be done by a multidisciplinary team as part of a lymphoedema service. 2 2 Indications and current treatments Indications and current treatments 2.1 Lymphoedema is the abnormal accumulation of subcutaneous fat and fluid in body tissue (...) are stopped the patient is fitted with a custom- made compression garment, which is worn every day. These techniques aim to reduce the pain and discomfort associated with lymphoedema. In very severe cases, surgical treatment can be used to reduce the size of the limb or to restore lymphatic flow. Repeated debulking procedures to excise skin and subcutaneous tissue may be needed. Procedures to restore lymphatic flow from the limb include constructing an alternative lymph drainage pathway via lymphovenous

2017 National Institute for Health and Clinical Excellence - Interventional Procedures

136. Childhood Vascular Tumors Treatment (PDQ®): Health Professional Version

on the right depict the hemangioma after proliferation (slightly raised with a brighter central color). Credit: Israel Fernandez-Pineda, M.D. Infantile hemangiomas can be superficial in the dermis, deep in the subcutaneous tissue, combined, or in the viscera. Combined lesions are common. They are most common in the head and neck but can be anywhere on the body. They can be localized, segmental, or multiple in nature. The cutaneous appearance of infantile hemangiomas is usually red to crimson, firm (...) of the upper medial eyelid but any hemangioma around the eye that is large enough can obstruct the visual axis. The clinician should be aware of subcutaneous periocular hemangiomas, as these lesions can extend into the orbit, causing exophthalmos or globe displacement with only limited cutaneous manifestations. Issues with these lesions include astigmatism from direct pressure of the growing hemangioma, ptosis, proptosis, and strabismus. One of the leading causes of preventable blindness in children

2018 PDQ - NCI's Comprehensive Cancer Database

137. Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®): Health Professional Version

or MRI of the total spine and pelvis appears equally efficacious in the detection of bone lesions.[ ] If amyloidosis is suspected, perform a needle aspiration of subcutaneous abdominal fat and stain the bone marrow biopsy for amyloid as the easiest and safest way to confirm the diagnosis.[ ] Measure serum albumin and beta-2-microglobulin as independent prognostic factors.[ , ] The presence of circulating myeloma cells is considered a poor prognostic factor.[ ] Primary plasma cell leukemia has (...) of the IMAJEM Study. J Clin Oncol 35 (25): 2911-2918, 2017. [ ] [ ] Gertz MA, Li CY, Shirahama T, et al.: Utility of subcutaneous fat aspiration for the diagnosis of systemic amyloidosis (immunoglobulin light chain). Arch Intern Med 148 (4): 929-33, 1988. [ ] Greipp PR: Advances in the diagnosis and management of myeloma. Semin Hematol 29 (3 Suppl 2): 24-45, 1992. [ ] Durie BG, Stock-Novack D, Salmon SE, et al.: Prognostic value of pretreatment serum beta 2 microglobulin in myeloma: a Southwest Oncology

2018 PDQ - NCI's Comprehensive Cancer Database

139. Gastrointestinal Complications (PDQ®): Health Professional Version

glycol (227.1 g), sodium chloride (5.53 g), potassium chloride (2.82 g), sodium bicarbonate (6.36 g), and sodium sulfate (anhydrous, 21.5 g). Do not add flavorings. Serve chilled to improve palatability. Can be stored up to 48 hours in the refrigerator. Use: To clear bowel with minimal water and sodium loss or gain. Opioid antagonists (naloxone, methylnaltrexone, naldemedine) Caution: Administer only if other drugs have failed. Subcutaneous methylnaltrexone, 0.15 mg per kilogram of body weight, can (...) incontinence. Dis Colon Rectum 52 (2): 286-92, 2009. [ ] Memon S, Bissett IP: Rectal perforation following transanal irrigation. ANZ J Surg : , 2014. [ ] Thomas J, Karver S, Cooney GA, et al.: Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med 358 (22): 2332-43, 2008. [ ] Portenoy RK, Thomas J, Moehl Boatwright ML, et al.: Subcutaneous methylnaltrexone for the treatment of opioid-induced constipation in patients with advanced illness: a double-blind, randomized, parallel

2018 PDQ - NCI's Comprehensive Cancer Database

140. Intraocular (Uveal) Melanoma Treatment (PDQ®): Health Professional Version

or more in thickness can be demonstrated provided it is located behind the equator where the intraocular tumor, sclera, and adjacent orbital fat are readily imaged.[ ] Orbital extraocular extension of choroidal melanoma may be found in eyes with medium and large tumors, but it is very rare in eyes with small melanomas. Metastatic Disease Systemic metastases are evident in only 1% to 4% of patients at the time of diagnosis of the primary ocular melanoma.[ ] Because the uveal tract is a vascular (...) , and subcutaneous sites are also common.[ ] In the COMS trials, the liver was the only site of detectable metastasis in 46% of patients with metastases reported during follow-up or at the time of death; 43% had metastases diagnosed in the liver and other sites.[ ] In patients with a history of ocular melanoma who present with hepatic metastases of unknown origin, metastatic melanoma is considered in the differential diagnosis. It is particularly unusual for choroidal melanomas of any size to invade the optic

2018 PDQ - NCI's Comprehensive Cancer Database

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