mesenteric panniculitis causes

panniculitis causes

lawrence: hello. i am dr. lawrence broder,owner of beleza medical spa with offices in austin and round rock, texas. i'd like totalk to you today about a new procedure we are introducing here at beleza called coolsculpting.coolsculpting is based on the principle of cryolipolysis. cryolipolysis means, basically,freezing fat to reduce the fat. it is fda approved to selectively reduce fat on thebody. the principle on how it works was seen inchildren in a syndrome called popsicle panniculitis. when children were noted to have popsiclesin their mouth for long periods of time, they were noted to get a dent in their cheeks andit was thought the ice, the cold was causing selective fat reduction in their cheeks. someresearchers did some studies at massachusetts

general hospital and were able to safely coolfat without, of course, freezing the skin but cool fat and then they found out theycould reduce it from 20 to sometimes to 80 percent in those studies. the way the machine works is, basically...youhave an area, let's say in your lower abdomen that you want to treat. it has a large applicatorthat goes on your abdomen with a little gel pad and it selectively cools that fat downin that area to a certain temperature, a safe temperature so your skin is protected, andit keeps the fat at that temperature for about an hour. after an hour, we take it off andthe area is kind of red and swollen and hard. it's almost like it's frozen. then whathappens is those fat cells that we froze,

some of them, will start to die. over thenext several months your body will clear those fat cells away and you will get the resultsof fat reduction. there is some temporary redness, swelling and numbness, usually forabout a week after the procedure but that all resolves without any treatment. the safety profile of this machine has beenvery good. i haven't seen any reported side effects yet. over the next several monthsafter the treatment, those fat cells die and then we hope and usually see about a 20 to25 percent reduction in the fat layer. it is a non-invasive method. it's relativelycomfortable. you sit there for about an hour. you can read, watch tv, listen to music, sleep.you get up and you leave. there's no surgery.

there's no anesthesia needed. you're backon your feet, back to work immediately. this is another procedure in our armamentariumthat we can use to reduce fat. the other method that is fda approved for selective fat reductionis zerona. that is the low level laser. we also have that. coolsculpting will fit in nicely with ourother treatments like smart lipo, acg medical weight loss, zerona. now, the coolsculptingwill offer another non-invasive way to reduce the fat layer and this can be combined withthose other treatments so you get the body contouring results that you want. now, we're going to show a little, shortvideo of just how the procedure gets set up.

then, we'll show you some pictures on how...beforeand afters and how it works. thank you. courtney: hi. i'm courtney with beleza medicalspa and we're going to be demonstrating how we do the coolsculpting today. this isjosh, our patient. we're going to be treating his lower abdomen. we're going to use atemplate. we're going to be using the larger head on him. it's called cool max. we'rejust going to use this template and show exactly the area we're going to be treating on hereand go ahead and mark it so we know how the treatment is going to start. i'll go ahead and start and mark this. sincejosh is doing the lower abdomen, we're just going to be going right in the middle. righthere. now, i know where exactly the head is

going to go. next, we will use one of our cool pads whichis a little bit cold when we put it on. let me grab that. this just works as a barrierbetween the machine and the skin. this is the part that can be a little bit cold rightat first. all right. we're just going to place this right in the area being treated.is it a little cold? josh: just a little. courtney: we just place it down so it worksas almost like a second skin onto the patient before we actually start the treatment. oncethe gel pad is in place, i've already put the liner on, and then have the machine readyand set to go with the cool max head on, which

is the larger head. now, we're just goingto place it on to the patient. at first, you will feel a little bit of a suction and thenwe will actually start the treatment once it's in place. do you feel the suction? josh: yeah. courtney: all right. we just make sure we'restill lined up and then we start the treatment. each treatment per area is one hour and sowe just have to put a little bobby on so the patient is comfortable with the treatmentand the patient will just sit here for an hour. you can experience a little bit of coolingand freezing in the area but it's a very comfortable, painless procedure. there'sa pager on with the machine and if you need

anything, we come and bring you something.but, the patient just sits here for an hour. after the procedure, you notice what lookslike, almost, a little, frozen stick where it has been in the machine. afterwards, wejust massage that out and those are actually the frozen fat cells. we massage it out sothat those frozen cells hit other cells and so it's going to also kill the cells surroundingit. with this machine, sometimes men see resultsfaster than women. most of the time it takes about two months to see the full results fromthe treatment for all of the fat cells to die and kill off. it is a one-time treatment,it does take an hour per area. the results are permanent. it actually does kill the fatcell. it's just a one-time treatment and

patients are pretty satisfied with the result.it's just an hour per treatment and...is it comfortable? courtney: that is how the coolsculpting works. [end of audio] duration: 8 minutes and 28 minutes page 2 of 3

panniculitis causes

mesenteric panniculitis causes

causes of mesenteric panniculitis

what causes mesenteric panniculitis

hello everyone! my name is megan, and welcometo another anatomy tutorial. in this tutorial, we will be covering the mesentery which isfound in the abdominal cavity. i'm going to also cover some of the related structuresand organs. before we begin talking about the mesentery,i quickly want to go through a brief overview of the peritoneum. the peritoneum is a doublelayer of serous membrane or mesothelium. it lines the walls of the abdominal cavity andmost of the viscera. throughout the abdominal cavity, there are peritoneal folds that connectorgans together or connect these organs to the abdominal wall. some of these folds alsocontain vessels and nerves that supply the organs. their function is two-fold as theyalso stabilize and help maintain the position

of the organs. the subdivisions of the peritoneum includethe omenta, the mesenteries, and the peritoneal ligaments. in this image, we can see the malepelvis… hi guys, as you can see, this video is a previewwhich is reserved to kenhub premium members. why not become one today? as a premium member,you will get access to this video as well as other videos, quizzes, articles, and ouratlas of human anatomy—everything you need to learn anatomy in the most fun and efficientway. join us and let’s continue learning together! https://www.kenhub.com

what causes panniculitis

causes of panniculitis

causes of panniculitis

hospitalizations for skin andsoft tissue infections, or sstis, are rising in frequency. according to a recent ahrq study,hospital stays with a principal diagnosis of ssti grew75% from 1997 to 2010. there's no clear explanation for this phenomenon although it islikely due in part to the rise in community-acquired methicillin-resistantstaph aureus or mrsa infections. according to the 2014 infectiousdiseases society of america guidelines, the first step in diagnosing andmanaging skin and

soft tissue infections is determining ifthe process is purulent or non purulent. purulent sstis include furuncles, or boils, carbuncles, andcutaneous abscesses. non purulent skin andsoft tissue infections include erysipelas, cellulitis, and necrotizing fasciitis. this clinical distinction iscritical as the management of both groups of infections differs. incision and drainage ori and d is necessary for the resolution of purulent sstis.

and according to the 2014 idsa guidelines,antibiotics, as an adjunct to ind, are only recommended if patients haveseverely impaired immune systems or evidence of a systemicinflammatory response. next, clinicians must determine iftheir patient has mild, moderate or severe disease. patients without signs to suggestsa systemic inflammatory response qualifies having mild infection. the majority of skin andsoft tissues infections in the u.s. are mild, andcan be treated in an out-patient clinic.

purulent sstis can betreated with i & d alone, while patients with non-purulentsstis can be treated with empiric oral antibiotics effectiveagainst the common pathogens, namely group a streptococcus, plus orminus methicillin sensitive staphoreous. patients with typical sstis togetherwith signs to suggest a system inflammatory response haveinfections of moderate severity. the guidelines recommend that patientswith purulent sstis of moderate severity be managed with i & d plus empiric oralantibiotics with activity against mrsa, namely trimethoprim-sulfamethoxazoledoxycycline or clindamycin.

patients with nonpurulent sstis ofmoderate severity should be treated with intravenous antibiotics directedagainst streptococcus and methicillin sensitive staph aureus. as discussed earlier, the patient inthis case had non-purulent cellulitus of moderate severity when she was admitted,and should've been started on antibiotics targeted against streptococcus andmethicilin sensitive staph aureus alone. the idsa guidelines include patients whofail initial management among those with severe infections. they suggest broadening antibiotic therapyin these patients to include anti-mrsa

coverage, as well as coverage directedagainst gram negative organisms in specific situations,like necrotizing fasciitis. so that begs the question, has this patient failed herinitial antimicrobial management? the involved area of her leg has notchanged significantly since admission. and she has received broad spectrumantibiotics for almost 48 hours. most patients treated with the rightantibiotics begin to improve symptomatically by 24 to 48 hoursafter the initiation of therapy, but some do not see improvement for 72 hours.

according to the fda guidelines forssti studies, a clinical response is defined as the cessation of spread orreduction of size of the ssti, plus resolution of fever 48 to 72hours after starting antibiotics. in this patient's case,she meets the general criteria for a positive clinical response. she is afebrile, her tachycardia hasresolved, and the arythema, edema, and tenderness have not spread sincethe initiation of antibiotics. thus her antibiotics have not failed,they've worked. in the absence of specificepidemiologic risk factors

most sstis are caused by streptococcus orstaphylococcus species. as previously discussed,her initial antibiotic regimen was inappropriate because it was overly broad,providing gram negative, and anti mrsa activity when it wasnt needed,and is actually contraindicated now, in the era of rising clostridiumdifficile infection rates, and the emergence of multidrug resistant organisms. for that reason it isappropriate to de-escalate her therapy now to a regiment that wouldhave been appropriate from the start. in this case, cefazolin.

it is important to clarify whatmight already seem obvious to you. you do not have to wait until the 48hour timeout to make this switch. you could have done it assoon as you began to care for the patient based upon her presentationand the likely microbiologic ideology. given her clinical scenario you couldconsider making an iv to po switch during your 48 hour time out. she has improved clinically, although you don't know ifshe's taking oral medications. in this case,the narrowest agent with antistrep and

antiemesis activity as well as goodoral bioavailability is dicloxacillin. other potential optionswith broader coverage but good oral bioavailability includecephalexin, doxycycline, and clindamycin. again, these oral antibiotics can beused from the start in mild cases of nonpurulent cellulitis. if your patient is not responding to, or slowly recovering on antibiotics,it is important to consider non-infectious etiologies thatcan masquerade as cellulitis. stasis dermatitis may be the most common.

stasis dermatitis describes the chronicskin changes associated with chronic venous insufficiency includingerythema and desquamation. it is typically bilateral, which isvery uncommon in acute cellulitis. and stasis dermatitis istypically non-tender. lipodermatosclerosis in its acute formis a common cause of pseudo cellulitis. it is a severe fibrosing panniculitisof the subcutaneous tissue, and is another consequence ofchronic venous insufficiency. this process typically starts nearthe medial region of the ankle and progresses to involvethe leg circumferentially.

the leg then takes on the appearanceof what's called the inverted champagne bottle. in its acute form, the affected region canbe erythematous, tender, and edematous. although these patients maybe at an increased risk for acute cellulitis due to their abnormalskin, the chronicity of their symptoms, which can last for months in the absenceof systemic symptoms can help you make the distinctionfrom acute cellulitis. contact dermatitis, both irritant andallergic, often present with erythematous patches limited for the most partto the area of initial exposure.

the lesions can be warm andpainful, but again, systemic signs of infection are absent. other mimics include thrombophlebitis,drug reactions, radiation recall syndromes,and insect stings or bites. for a more in depth discussion ofnon-infectious etiologies that are often confused with sstis please seethe two articles lifted in the for further reading section of this case.

causes of mesenteric panniculitis

what causes mesenteric panniculitis

what causes panniculitis