Lipedema is a chronic progressive disease characterized by abnormal fat distribution resulting in disproportionate, painful limbs. It almost exclusively affects women, leading to considerable disability, daily functioning impairment, and psychosocial distress. Literature shows both scarce and conflicting data regarding its prevalence. Lipedema has been considered a rare entity by several authors, though it may be a far more frequent condition than thought. Despite the clinical impact on women's health, lipedema is in fact mostly unknown, underdiagnosed, and too often misdiagnosed with other similarly presenting diseases. Polygenic susceptibility combined with hormonal, microvascular, and lymphatic disorders may be partly responsible for its development. Furthermore, consistent information on lipedema pathophysiology is still lacking, and an etiological treatment is not yet available. Weight loss measures exhibit minimal effect on the abnormal body fat distribution, resulting in eating disorders, increased obesity risk, depression, and other psychological complaints. Surgical techniques, such as liposuction and excisional lipectomy, represent therapeutic options in selected cases. This review aims to outline current evidence regarding lipedema epidemiology, pathophysiology, clinical presentation, differential diagnosis, and management. Increased awareness and a better understanding of its clinical presentation and pathophysiology are warranted to enable clinicians to diagnose and treat affected patients at an earlier stage.
No abstract
Zusammenfassung. Lipödem-Patienten leiden an der weit verbreiteten Unkenntnis ihrer Pathologie. Angesichts ihres chronischen, fortschreitenden und invalidierenden Charakters muss die frühe Diagnose der Krankheit ZIel der Bezugspersonen sein, um medizinische Wanderungen und das Auftreten komplexer Krankheitsbilder zu begrenzen. Behandlungen ermöglichen die Reduzierung von Lipödemen und deren Langzeitkontrolle. Das Management muss entsprechend dem Krankheitsstadium individualisiert werden. Die Compliance des Patienten, die Überwachung und die Unterstützung durch den Arzt sind für das Erreichen der besten Ergebnisse unerlässlich.
Computed tomography in childhood epilepsy Sir, Children attending the school at the David Lewis Centre for Epilepsy are a selected group, as with few exceptions they are residential pupils from various parts of the United Kingdom and therefore are likely to have severe and often multiple handicaps. It seemed probable that a group of such children might show a high incidence of significant abnormalities on computed tomography. The children attending the school at the David Lewis Centre and examined by computed tomography over several years numbered 222; there were 154 boys and 68 girls, aged 7 to 19 years. The results showed that 152 were normal. There were 28 with evidence of some degree of generalised atrophy and 30 with focal atrophy. Nine showed calcification and in three the findings were compatible with a cerebral tumour. Abnormalities in a third of the children is in agreement with the findings of Bachman et a1' and Yang et al.2 Bachman et al studied 98
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