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Subcutaneous Fat Necrosis

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161. Eponymythology: Atraumatic Abdominal Ecchymosis

associated with retroperitoneal haemorrhage, originally described in acute pancreatitis – Original publication: (n=1) 1919 – George Grey Turner submitted his article for publication as following a “…cursory examination of the voluminous literature on pancreatitis”, where he was unable to “…observe any mention of this sign” 1920 – George Grey Turner published ‘ Local discoloration of the abdominal wall as a sign of acute pancreatitis ‘ citing two cases of acute pancreatitis with fat necrosis (...) and retroperitoneal haemorrhage [ ] Case 1 [1912] 54 year old female with three days of abdominal pain presenting with an area of discoloration (a bluish colour), about 6 inches in diameter involving the abdominal wall surrounding the umbilicus (see …). … the patient suffered from acute pancreatitis, with much effusion into the peritoneal cavity. She lived nine days after operation, and the post-mortem examination disclosed a sloughing pancreas with much fat necrosis Case 2 [1917] 53 year old male soldier

2018 Life in the Fast Lane Blog

162. Semaglutide (Ozempic) - Diabetes Mellitus

4.4, 4.5 and 5.1. Pharmaceutical form: solution for injection Strength: 1.34 mg/ml Route of administration: subcutaneous use Packaging: cartridge (glass) in pre-filled pen Package size: 1 pre-filled pen + 6 needles Ozempic Assessment report EMA/CHMP/715701/2017 Page 3/156 Table of contents 1. Background information on the procedure 7 1.1. Submission of the dossier 7 1.2. Steps taken for the assessment of the product 8 2. Scientific discussion 9 2.1. Problem statement 9 2.1.1. Disease or condition (...) of exposure PYO patient year of observation RMP risk management plan RR rate ratio SAE serious adverse event SAP statistical analysis plan SBP systolic blood pressure s.c. sub cutaneous sema semaglutide SGLT-2 sodium-dependent glucose transporter two SMQ standardised MedDRA query SOC system organ class SU sulfonylurea SUSTAIN Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes T2D type 2 diabetes mellitus TNF-alpha tumour necrosis factor alpha TZD thiazolidinediones UACR urinary albumin

2018 European Medicines Agency - EPARs

163. Tissue Engineered Soft Tissue Reconstruction Using Non-invasive Mechanical Preconditioning and a Shelf-ready Allograft Adipose Matrix. (PubMed)

Tissue Engineered Soft Tissue Reconstruction Using Non-invasive Mechanical Preconditioning and a Shelf-ready Allograft Adipose Matrix. Adipose tissue defects leading to severe functional (disability) and morphological (disfigurement) morbidity are often treated in plastic surgery with fat grafting, which can be limited by resorption, necrosis, and cyst formation. Our study aimed to assess whether adipose scaffolds could provide an environment for in situ autologous fat grafting, and to study (...) whether adipose cell migration and proliferation (adipogenesis) within scaffolds could be enhanced by preliminarily increasing the vascularity (preconditioning) of the surrounding tissues recipient of the scaffolds.Using an established rodent model of subcutaneous tissue/scaffold grafting, we tested the potential of a human-derived, shelf-ready, injectable, decellularized allograft adipose matrix (AAM) to reconstruct soft tissue defects when used in combination with non-invasive mechanical (suction

2019 Plastic and reconstructive surgery

164. Tissue-Engineered Soft-Tissue Reconstruction Using Noninvasive Mechanical Preconditioning and a Shelf-Ready Allograft Adipose Matrix. (PubMed)

Tissue-Engineered Soft-Tissue Reconstruction Using Noninvasive Mechanical Preconditioning and a Shelf-Ready Allograft Adipose Matrix. Adipose tissue defects leading to severe functional (disability) and morphologic (disfigurement) morbidity are often treated in plastic surgery with fat grafting, which can be limited by resorption, necrosis, and cyst formation. This study aimed to assess whether adipose scaffolds could provide an environment for in situ autologous fat grafting, and to study (...) whether adipose cell migration and proliferation (adipogenesis) within scaffolds could be enhanced by preliminarily increasing the vascularity (preconditioning) of the surrounding tissue receiving the scaffolds.Using an established rodent model of subcutaneous tissue/scaffold grafting, the authors tested the potential of a human-derived, shelf-ready, injectable, decellularized allograft adipose matrix to reconstruct soft-tissue defects when used in combination with noninvasive mechanical (suction

2019 Plastic and reconstructive surgery

165. Molecular Characterization of Lipoaspirates Used in Regenerative Head and Neck Surgery. (PubMed)

of lipoaspirates from subcutaneous abdominal fatty tissue was examined. Cellular composition was analyzed using immunohistochemistry (IHC) and flow cytometry, and functionality was assessed through adipose, osteous, and chondral differentiation in vitro. Supernatants were tested for paracrine ASC functions in fibroblast wound-healing assays. Enzyme-linked immunosorbent assay measurement of tumor necrosis factor (TNF), vascular endothelial growth factor (VEGF), stromal-derived factor 1α (SDF-1α (...) healing have not been explored for this method to our knowledge.To evaluate the characteristics of lipoaspirates used in reconstructive head and neck surgical procedures with respect to wound healing.This case series study included 15 patients who received autologous fat injections in the head and neck during surgical procedures at a tertiary referral center. The study was performed from October 2017 to November 2018, and data were analyzed from October 2017 to February 2019.Excessive material

2019 JAMA facial plastic surgery

166. Review of obesity and periodontitis: an epidemiological view. (PubMed)

Review of obesity and periodontitis: an epidemiological view. Obesity and periodontitis are among the most common non-communicable diseases, and epidemiological studies report the influence of obesity in the onset and progression of periodontitis. Data indicate that increased body mass index, waist circumference, percentage of subcutaneous body fat, and serum lipid levels are associated with increased risk to develop periodontitis. The underlying biological mechanisms of this association (...) involve adipose tissue-derived cytokines, such as tumour necrosis factor-α and interleukin-6, which affect whole-body metabolism and contribute to the development of a low-grade systemic inflammation. Multiple studies report a positive association between these two diseases across diverse populations. Obesity does not appear to impair the success of periodontal therapy. However, currently available evidence is variable and therefore inconclusive. Despite the limited evidence about recommendations

2019 British Dental Journal

167. Skin Cancer Treatment (PDQ®): Health Professional Version

. b Deep invasion is defined as invasion beyond the subcutaneous fat or >6 mm (as measured from the granular layer of adjacent normal epidermis to the base of the tumor); perineural invasion for T3 classification is defined as tumor cells within the nerve sheath of a nerve lying deeper than the dermis or measuring ≥0.1 mm in caliber, or presenting with clinical or radiographic involvement of named nerves without skull base invasion or transgression. Table 2. Definitions of Pathological Regional (...) (including the squamous cell and basal cell layers), dermis, subcutaneous tissue, and other parts of the skin. Risk Factors Risk factors for nonmelanoma skin cancer include the following: Sun and UV radiation exposure (including tanning beds). Epidemiologic evidence suggests that cumulative exposure to UV radiation and the sensitivity of an individual’s skin to UV radiation are risk factors for skin cancer, though the type of exposure (i.e., high-intensity exposure and short-duration exposure vs. chronic

2017 PDQ - NCI's Comprehensive Cancer Database

168. Nutrition in Cancer Care (PDQ®): Health Professional Version

into consideration that obesity may mask malnutrition and that weight and BMI alone are not good surrogates for nutrition status.[ ] The consensus statement provides the criteria for evaluating each of the following six potential indicators of malnutrition, with the recommendation that if two or more characteristics are present, the diagnosis of malnutrition is warranted. Insufficient energy intake. Weight loss. Loss of muscle mass. Loss of subcutaneous fat. Localized or generalized fluid accumulation that may (...) components: Food- and nutrition-related history. Anthropometric measurements. Biochemical data, medical tests, and procedures. Nutrition-focused physical assessment. Medical history. Treatment plan. Within the nutrition assessment, the following factors are considered in making a diagnosis of malnutrition:[ ] Insufficient energy intake. Weight loss. Loss of muscle mass. Loss of subcutaneous fat. Localized or generalized fluid accumulation. Diminished functional status (e.g., grip strength

2017 PDQ - NCI's Comprehensive Cancer Database

169. Cancer Pain (PDQ®): Health Professional Version

the treatment dose. Supportive care therapies and pain Supportive care therapies can cause pain, as typified by bisphosphonate-associated osteonecrosis of the jaw.[ ] Corticosteroid use has also been associated with the development of avascular necrosis.[ ] Radiation-induced pain Radiation is associated with several distinct pain syndromes. First, patients may experience pain from brachytherapy and from positioning during treatment (i.e., placement on a radiation treatment table). Second, delayed tissue

2017 PDQ - NCI's Comprehensive Cancer Database

171. Palliative care - constipation

for occasional use only. Peripheral opioid–receptor antagonists Methylnaltrexone bromide(subcutaneous injection) 30 minutes – 4 hours Useful for opioid-induced constipation in terminally ill people, when response to other laxatives is inadequate. Contraindicated in known or suspected bowel obstruction. Use with caution in people with conditions which may predispose to perforation (e.g. gastrointestinal cancer, peptic ulcer, colonic pseudo-obstruction, nonsteroidal anti-inflammatory drugs, steroids (...) ). Not recommended Liquid paraffin(softener) 1–3 days Adverse effects include anal seepage and irritation, malabsorption of fat-soluble vitamins, and (rarely) lipoid pneumonia. Magnesium salts(osmotic) 1–6 hours Not routinely recommended because their purgative action can be undesirably strong. Data from the Electronic Medicines Compendium and from [ ; ; ; ; ; ; ] Time to wait for laxative effect How long is it before different laxative preparations take effect? For information on times for different laxative

2017 NICE Clinical Knowledge Summaries

172. Vyndaqel (tafamidis meglumine)

/animal) (vehicle, 7.5% VE TPGS) to male and female albino rats, radioactivity levels peaked within 2 hours post-dose in the majority of tissues and then declined gradually, but radioactivity was still present at 168 hours post-dose. The organ/plasma ratio was >1 at 0.5 hours post-dose for the liver and stomach and at ?1 hour post-dose for the harderian glands (at all time points after 6 hours post-dose), liver (at all timepoints), and perirenal fat and skin (at 168 hours post-dose). The blood/plasma

2013 Pharmaceuticals and Medical Devices Agency, Japan

173. Lyxumia (lixisenatide)

infusion to ZDF rats (4.2.1.1-13) Continuous subcutaneous infusion of lixisenatide (0.486, 4.86, 48.6 µg/kg/day), exendin-4 (4.187 µg/kg/day), or vehicle 16 was given to male obese ZDF rats (8 weeks of age, 8 rats/group) for 12 weeks and continuous subcutaneous infusion of lixisenatide (48.6 µg/kg/day) or vehicle was given to male lean ZDF rats (8 weeks of age, 8 rats/group) for 12 weeks. For obese rat groups, standard diet was switched to high-fat diet at 5.5 weeks after initiation of administration (...) Lyxumia (lixisenatide) Report on the Deliberation Results May 31, 2013 Evaluation and Licensing Division, Pharmaceutical and Food Safety Bureau Ministry of Health, Labour and Welfare [Brand name] Lyxumia Subcutaneous Injection 300 µg [Non-proprietary name] Lixisenatide (JAN*) [Name of applicant] Sanofi K.K. [Date of application] June 11, 2012 [Results of deliberation] In the meeting held on May 24, 2013, the First Committee on New Drugs concluded that the product may be approved

2013 Pharmaceuticals and Medical Devices Agency, Japan

174. Stivarga (regorafenib hydrate)

inhibitory effect of regorafenib was evaluated in athymic mice ("nude mice") by subcutaneous implantation of human colorectal cancer cell lines, Colo-205, HT-29, and HCT-15. After the implanted tumor weight reached 75 to 144 mg (5-7 days after implantation), regorafenib was orally administered once daily (QD) at the doses of 3, 10, 29, and 96 mg/kg for 9 days, and the tumor weight was measured (the figure below). In nude mice with Colo-205 and HT-29 cell lines, 10 and 29 mg/kg of regorafenib inhibited (...) ovary cell line with TIE2 forcedly expressed, *2: Human megakaryoblastic leukemic cell line, *3: Rat fibroblast cell line with BRAF V600E forcedly expressed In addition, the 28-day once-daily repeated oral administration of regorafenib as well as M-2 and M-5 (3 and 10 mg/kg QD, respectively) suppressed the tumor growth in nude mice subcutaneously implanted with human breast cancer-derived cell lines, MDA-MB-231 and HT-29. Based on the above data, the applicant explained that M-2 and M-5 contribute

2013 Pharmaceuticals and Medical Devices Agency, Japan

175. Xeljanz (tofacitinib citrate)

for treatment of rheumatoid arthritis (RA), nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids etc. have been utilized for symptomatic relief. In recent years, disease-modifying anti- rheumatic drugs (DMARDs), primarily methotrexate (MTX), are introduced early in the course of the disease and furthermore, biologics such as anti-human tumor necrosis factor (TNF) agents are used in RA patients who have had an inadequate response to these conventional treatments. The JAK family of intracellular (...) after the first dose, and the expression of macrophage-, B cell-, T-cell-, and osteoclast-related genes by the last day of dosing, compared with the vehicle group. 3.(i).A.(1).5).(d) Pharmacokinetic/pharmacodynamic modeling in CIA model (4.2.1.1.19) A pharmacokinetic/pharmacodynamic modeling study was conducted using data from prophylactic tofacitinib studies of oral administration (QD and BID) and subcutaneous infusion using an osmotic pump in the CIA model (4.2.1.1.14). When tofacitinib

2013 Pharmaceuticals and Medical Devices Agency, Japan

176. Richard Lehman’s journal review—23 October 2017

, but most of its inflammatory pathways are shared with commoner conditions such as rheumatoid arthritis and the inflammatory bowel diseases. There are actually not that many known pathways, and the summarizes them as: tumour necrosis factor interleukins 12, 17 and 23 Janus kinase pathways. The complexity comes when you get to all the drugs which have been developed to modulate these pathways: inibs and mabs in profusion, typically costing £690/month (tofacitinib) or £704/month (adalimumab). Methotrexate (...) 47) patients who received tofacitinib during the trial.” That seems an awfully high incidence for a trial lasting a few months. Sitting down with a patient who has psoriatic arthritis and a bang up-to-date decision tool, I’d be surprised if she opted to take tofacitinib. JAMA 17 Oct 2017 Vol 318 Oral v subcutaneous semaglutide of semaglutide there was a remarkable 1.9%* lowering of HbA 1c , made even more remarkable by the fact that it was achieved by a peptide travelling through the stomach

2017 The BMJ Blog

177. Diagnosis and Management of Aplastic Anaemia

(Kelsey, ), even in severe thrombocytopenia. Difficulty obtaining fragments may indicate marrow fibrosis or infiltration and should raise the suspicion of a diagnosis other than AA. In AA, fragments and trails are hypocellular with prominent fat spaces and variable numbers of residual haemopoietic cells. Erythropoiesis is reduced or absent; dyserythropoiesis is very common, often marked and does not distinguish MDS from AA. Megakaryocytes and granulocytic cells are markedly reduced or absent (...) myelofibrosis Primary myelofibrosis is usually accompanied by abnormal blood film (teardrop poikilocytosis, leucoerythroblastic) changes and splenomegaly. The absence of an enlarged spleen in the presence of marrow fibrosis suggests a secondary malignancy Mycobacterial infections Sometimes present with pancytopenia and a hypocellular bone marrow. This is seen more commonly with atypical mycobacteria. Other bone marrow abnormalities include granulomas, fibrosis, marrow necrosis and haemophagocytosis

2015 British Committee for Standards in Haematology

179. Inflammatory Bowel Disease (IBD)

Gastroenterology Organization, 2015 Distal UC Extensive UC CD Quiescent Oral or rectal 5-ASA Oral 5-ASA AZA or 6-MP or MTX Oral AZA or 6-MP Oral AZA or 6-MP Perianal Oral antibiotics AZA or 6-MP I.v. infliximab S.c. adalimumab 5-ASA, 5-aminosalicylic acid; 6-MP, 6-mercaptopurine; AZA, azathioprine; BUD, budesonide; CSA, cyclosporine A; CS, corticosteroid; i.m., intramuscular; i.v., intravenous; MTX, methotrexate; s.c., subcutaneous; TNF, tumor necrosis factor. Note: budesonide only for mild to moderate ileal (...) > ileum ? ICV involved (gaping) ? May appear similar to changes in TB ? TB features less common in intestinal TB (favoring CD): — Longitudinal ulceration — Cobblestoning — Aphthous ulceration — Ileum > cecum — ICV may be stenosed or ulcerated WGO Global Guidelines IBD 18 © World Gastroenterology Organization, 2015 Features TB CD Histopathological ? Large, dense, confluent granulomas ? Submucosal granulomas ? Caseous necrosis and submucosal stenosis ? Caseating changes in intestinal wall and mesenteric

2015 World Gastroenterology Organisation

180. Acute Pain Management: Scientific Evidence

medicine 143 References 144 5. ADMINISTRATION OF ANALGESIC MEDICINES 179 5.1 Oral route 179 5.1.1 Opioids and tramadol 182 5.1.2 Paracetamol 184 5.1.3 Nonselective NSAIDs and coxibs 184 5.2 Intravenous route 185 5.2.1 Opioids and tramadol 185 5.2.2 Paracetamol 186 5.2.3 Nonselective NSAIDs and coxibs 186 5.3 Intramuscular and subcutaneous routes 187 5.3.1 Opioids and tramadol 187 5.3.2 Nonselective NSAIDs and coxibs 188 5.4 Transdermal route 188 5.4.1 Opioids 188 5.4.2 Other medicines 189 5.5 (...) , patient preference and outcomes 241 6.2 Cost of PCA 242 6.3 Medicines used for parenteral PCA 242 6.3.1 Opioids 242 6.3.2 Adjuvant medicines 245 6.4 Program parameters for IV PCA 246 6.4.1 Bolus dose 246 6.4.2 Lockout interval 247 6.4.3 Concurrent background (continuous) infusions 247 6.4.4 Dose limits 247 6.4.5 Loading dose 247 6.5 Efficacy of PCA using other systemic routes of administration 247 6.5.1 Subcutaneous PCA 247 6.5.2 Oral PCA 248 6.5.3 Intranasal PCA 248 6.5.4 Transdermal PCA 248 6.6

2015 Clinical Practice Guidelines Portal

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