No description available.

Injection site-pain and bruising are common side effects of subcutaneous heparin injections. These adverse outcomes are problematic for both the patient and the nurse. Specifically, site-pain causes the patient discomfort and bruising limits possible sites for subsequent injections. It is important that nurses use an injection technique that minimises the incidence of adverse outcomes when administering subcutaneous heparin injections. This study examines the effect of duration of subcutaneous heparin injection on site-pain intensity and bruise size experienced by a group of patients being treated with heparin for ischaemic stroke or transient ischaemic attacks.A quasiexperimental design with subjects serving as their own control was used to address the study objectives. The independent variable was the duration of the injection and the dependent variables were site-pain and bruise size. A convenience sample of 34 subjects receiving 5000 units of a subcutaneous Fragmin injection twice a day were recruited from a large teaching hospital. Subjects rated the level of perceived site-pain intensity during injection using the vertical Visual Analogue Scale. Injection-site bruising was measured at 48 and 60 hours after injection. Data were analysed using the Wilcoxon Sign-Rank test. Results indicated that injection technique B (30-second injection duration) resulted in significantly less intense site-pain during administering the injection and fewer and smaller bruises.The findings of this study indicate that injecting subcutaneous heparin over a longer duration may reduce injection site-pain and bruising.

Introduction: Liposuction has undergone several improvements since its first description, including changes in the cannulas, variation in the concentration of the infiltrating solution, and the use of different devices and technologies. The use of laser technology devices for lipolysis and stimulation of skin retraction has contributed to the procedure. This article presents the authors’ experience with laser lipolysis in 400 patients, within a 5-year period, and discusses the principles of the technology and its effect on tissues. Methods: This is a study performed between July 2007 and July 2012 and included 400 patients who underwent laser lipolysis. All procedures were performed following the original protocol – infiltration of cold saline, passage of the cannula with an optic fiber for conducting the energy needed for laser lipolysis, skin retraction, and finally, conventional liposuction. Results: Hospitalization type ranged from outpatient to overnight surgery. Approximately 45% (180 of 400) of patients had minimal bruising, with involvement of 2% or more of the affected body surface. Hematoma, seroma, and dehiscence occurred in a total of 9% (36 of 400) of patients. We did not find any case of thermal burn of the skin. Conclusions: Laser lipolysis performed according to the described technique was safe and reproducible.

Pasture feeding depresses adipose tissue development in beef cattle whereas grain feeding, enhances adipogenesis. Therefore, we hypothesized that specific fatty acids would differentially affect lipogenesis in explants of bovine subcutaneous (SC) and intramuscular (IM) adipose tissues. Angus steers were harvested at 12, 14, and 16 mo of age, and IM and SC adipose tissue explants from the 8-11th thoracic rib region were dissected and cultured in media. Media contained no supplemental fatty acids or 40 microM of five fatty acids, stearic acid (18:0), oleic acid (18:1 n-9), trans-11 vaccenic acid (18:1 trans-11), conjugated linoleic acid (CLA, 18:2 trans-10, cis-12), or alpha-linolenic acid (18:3 n-3). After 48 h of culture, lipogenesis using [U-14C]glucose and [1-14C]acetate was measured. Lipogenesis from glucose decreased between 12 and 16 mo of age in SC adipose tissue (from 8.9 to 4.0 nmol per 2 h per 100 mg; P = 0.001) and IM adipose tissue (from 4.4 to 2.7 nmol per 2 h 100 mg ; P = 0.08). Lipogenesis from acetate did not change over time in SC adipose (approximately 56 nmol per 2 h per 100 mg; P = 0.23), but increased over time in IM adipose tissue (from from 11.3 to 17.1 nmol per 2 h 100 mg; P = 0.02). Oleic acid increased lipid synthesis from glucose 125 percent (P = 0.04) in IM adipose tissue, whereas stearic acid and trans-vaccenic acid increased lipogenesis from glucose in SC adipose tissue by approximately 50 percent (P = 0.04). In SC adipose tissue only, trans-vaccenic and increased, lipogenesis from glucose (P < 0.02). Lipogenesis from acetate was depressed by CLA nearly 50 percent in SC adipose tissue. PPARγ gene expression increased between 14 and 16 mo of age in control IM and SC adipocytes. The increase in activity was also observed in AMPK gene expression. C/EBPβ and SCD gene expression did not increase in control samples until 16 mo of age. SC adipose tissue responded to stearic acid by increased GPR43 and AMPK gene expression at 12 mo of age. We conclude that fatty acids differentially affect lipid synthesis in IM and SC adipose tissues, which may account for the effects of pasture and grain feeding on adiposity.

Measuring human subcutaneous fat is useful for assessing health risks due to obesity and for monitoring athletes’ health status, body shapes and weight for various sports competitions such as gymnastics and wrestling. Our aim is to investigate the use of ultrasound imaging in automatically measuring human subcutaneous fat thickness. We proposed to use the spectrum properties extracted from the raw radio frequency (RF) signals of ultrasound for the purpose of fat boundary detection. Our fat detection framework consists of four main steps. The first step is capturing RF data from 11 beam steering angles and at four focal positions. Secondly, two spectrum properties (spectrum variance and integrated backscatter coefficient) are calculated from the local spectrum of RF data using the short time Fourier transform and moment analysis. The values of the spectrum properties are encoded as gray-scale parametric images. Thirdly, spatial compounding is used to reduce speckle noise in the parametric images and improve the visualization of the subcutaneous fat layer. Finally, we apply Rosin’s thresholding and Random Sample Consensus boundary detection on the parametric images to extract the fat boundary. The detection framework was tested on 36 samples obtained at the suprailiac, thigh and triceps of nine human participants in vivo. When compared to manual boundary detection on ultrasound images, the best result was obtained from segmenting the spatial compounded spectrum variance values averaged over multiple focuses. A reasonable result could also be obtained by using a single focus. Further, our automatic detection results were compared with the results using skinfold caliper measurements. We found that the correlation is high between our automatic detection and skinfold caliper measurement, and is similar to the previous studies which are not automatic. Our work has shown that the spatial compounded spectrum properties of RF data can be used to segment the subcutaneous fat layer. Based on our results, it is feasible to detect fat at the suprailiac, thigh and triceps sites using the spectrum variance. The values of spectrum variance change more rapidly in the fat tissue than the non-fat tissue.

Measuring human subcutaneous fat is useful for assessing health risks due to obesity and for monitoring athletes’ health status, body shapes and weight for various sports competitions such as gymnastics and wrestling. Our aim is to investigate the use of ultrasound imaging in automatically measuring human subcutaneous fat thickness. We proposed to use the spectrum properties extracted from the raw radio frequency (RF) signals of ultrasound for the purpose of fat boundary detection. Our fat detection framework consists of four main steps. The first step is capturing RF data from 11 beam steering angles and at four focal positions. Secondly, two spectrum properties (spectrum variance and integrated backscatter coefficient) are calculated from the local spectrum of RF data using the short time Fourier transform and moment analysis. The values of the spectrum properties are encoded as gray-scale parametric images. Thirdly, spatial compounding is used to reduce speckle noise in the parametric images and improve the visualization of the subcutaneous fat layer. Finally, we apply Rosin’s thresholding and Random Sample Consensus boundary detection on the parametric images to extract the fat boundary. The detection framework was tested on 36 samples obtained at the suprailiac, thigh and triceps of nine human participants in vivo. When compared to manual boundary detection on ultrasound images, the best result was obtained from segmenting the spatial compounded spectrum variance values averaged over multiple focuses. A reasonable result could also be obtained by using a single focus. Further, our automatic detection results were compared with the results using skinfold caliper measurements. We found that the correlation is high between our automatic detection and skinfold caliper measurement, and is similar to the previous studies which are not automatic. Our work has shown that the spatial compounded spectrum properties of RF data can be used to segment the subcutaneous fat layer. Based on our results, it is feasible to detect fat at the suprailiac, thigh and triceps sites using the spectrum variance. The values of spectrum variance change more rapidly in the fat tissue than the non-fat tissue.

Dercum's disease, also known as adiposis dolorosa, is a rare disease characterized by the accumulation of painful subcutaneous deposits of mature adult fatty tissue around the thighs, trunk, and upper arms and usually in a multifocal distribution. We are reporting an unusual presentation of Dercum's disease, presenting as a single painful, erythematous lesion around the left hip in a 71-year old postmenopausal woman. This report emphasizes the unusual presentation of adiposa dolorosa with a new modality for therapy. A summary of the major clinical associations, diagnostic challenges, and treatment modalities are also included in this manuscript. Wiley Periodicals, Inc.

No description available.

Yes / Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing Guidelines on Allergen Immunotherapy (AIT) for Allergic Rhinoconjunctivitis. To inform the development of clinical recommendations, we undertook a systematic review to assess the effectiveness, cost-effectiveness, and safety of AIT in the management of allergic rhinoconjunctivitis. Methods: We searched nine international biomedical databases for published, in-progress, and unpublished evidence. Studies were independently screened by two reviewers against predefined eligibility criteria and critically appraised using established instruments. Our primary outcomes of interest were symptom, medication,and combined symptom and medication scores. Secondary outcomes of interest included cost-effectiveness and safety. Data were descriptively summarized and then quantitatively synthesized using random-effects meta-analyses. Results: We identified 5960 studies of which 160 studies satisfied our eligibility criteria. There was a substantial body of evidence demonstrating significant reductions in standardized mean differences (SMD) of symptom (SMD -0.53, 95% CI -0.63,-0.42), medication (SMD -0.37, 95% CI -0.49, -0.26), and combined symptom and medication (SMD -0.49, 95% CI -0.69, -0.30) scores while on treatment that were robust to prespecified sensitivity analyses. There was in comparison a more modest body of evidence on effectiveness post-discontinuation of AIT, suggesting a benefit in relation to symptom scores.Conclusions: AIT is effective in improving symptom, medication, and combined symptom and medication scores in patients with allergic rhinoconjunctivitis while on treatment, and there is some evidence suggesting that these benefits are maintained in relation to symptom scores after discontinuation of therapy. / EAACI and BM4SIT project (grant number601763) in the European Union’s Seventh Framework Programme FP7.

Given the great promise of High Intensity Focused Ultrasound (HIFU) as a therapeutic modality, the aim of the present study is to develop and optimise a technique that uses externally applied focused ultrasound energy and remote, ultrasound-based treatment monitoring to destroy subcutaneous fat safely, effectively and non-invasively. Based on initial cavitation and temperature measurements performed ex vivo in excised porcine fat at four different frequencies (0.5, 1.1, 1.6 & 3.4MHz) over a range of pressure amplitudes and exposure durations, it was concluded that 0.5MHz is the optimal frequency for this application since it is capable of instigating inertial cavitation at relatively modest pressures while enhancing focal heat deposition. Histological assessment of tissue treated above the cavitation threshold at 0.5MHz both ex vivo and in vivo demonstrated damage to adipocytes and connective tissue. Furthermore, a good correlation was identified between the energy of broadband emissions detected by the passive cavitation detector (PCD) and the focal temperature rise at 0.5MHz during ex vivo experimentation, which could be exploited as a tool for non-invasive monitoring of successful treatment delivery. In addition, localisation of cavitation activity by means of passive cavitation detection was achieved and shown to provide a strong indicator of the location of induced histological damage. Based on the specific requirements identified during initial experimentation, an application-specific HIFU transducer, cavitation detector and real-time treatment monitoring software was developed and tested ex vivo. This treatment system was found capable of producing extensive damage to adipocytes and collagen confined to the subcutaneous fat layer at the desired treatment depth, which coincided with the location of cavitation activity as displayed by the real-time treatment monitoring software.