Treatment with both the 1540-nm and the 1410-nm NAFL was shown to improve SD clinically and histopathologically. Further studies are needed to optimize treatment parameters.
Radiofrequency (RF) was first applied to aesthetic uses as monopolar RF. In its monopolar form, RF is applied to the target area by means of a dedicated handpiece, while a grounding pad is applied to the body at a distance. This differs from the mode of unipolar RF, in which a single electrode with no return is applied to the skin; the distinction between these two modalities is discussed in detail in the chapter 'Unipolar Radiofrequency'. The entry of RF into the body at the site of contact with the active electrode leads to bulk tissue heating, which can be provided at a depth. This ability to heat a volume of tissue noninvasively is applied to skin tightening on the face and body, as the heat induces both immediate collagen contraction and delayed collagen synthesis, by thermal induction of fibroblasts. Cumulative experience with monopolar RF has led to better, more reproducible, and better-tolerated results as treatment protocols and devices have evolved. Monopolar RF has a firm place as a safe and popular technology in the aesthetic armamentarium.Nonablative radiofrequency (NARF) devices find their place in dermatology for the purpose of skin tightening as they readily target the deeper tissues of the dermis and induce collagen remodeling. They have gained particular popularity because of their ability to offer improvement of lax and/or photodamaged skin without the postoperative morbidity and financial burden of surgical procedures. Compared to more invasive alternatives, the results of NARF are modest; however, it remains in demand secondary to its lower side effect profile and remarkably short postprocedural downtime. This continuing shift away from ablative and invasive aesthetic procedures continues to be driven largely by patient and clinician preferences [1].Monopolar radiofrequency (RF) is a nonsurgical approach to skin tightening and photorejuvenation. The FDA first cleared its use for treatment of periorbital rhytids in 2002. Additional clearances were given for tightening of the lower face in 2004 and for skin tightening on the body in 2005. The first device, Thermage ThermaCool (Sol-
A 75-year-old male, with a medical history of diabetes, hypertension, coronary artery disease, status post coronary artery bypass graft, and left-sided breast cancer, status post left breast mastectomy, was transferred from an outside hospital with complaints of a month of constipation, nausea and vomiting. The patient presented to an OSH a month prior with recent onset of constipation, with no bowel movements for 10 days, changed from his usual habit of daily bowel movements. He initially responded to lactulose with a bowel movement and was discharged on a regimen of stool softeners and laxatives; however, upon returning home, he was again unable to move his bowels despite his bowel regimen and developed diffuse abdominal pain, nausea and vomiting secondary to distension. An outpatient esophagogastroduodenoscopy (EGD) showed that the patient had a normal esophagus and a large amount of retained food in the stomach, concerning for gastroparesis. This finding was thought to be secondary to his diabetes, despite his well-controlled blood sugars and a hemoglobin A1c of 7.0 %. After two further weeks of constipation, the patient was readmitted to the OSH with abdominal pain, intractable nausea and vomiting, as well as a 20-25 lbs weight loss since his symptoms began. Imaging showed colonic gaseous distention, with the cecum dilated to 9.5 cm, and an un-prepped sigmoidoscopy was performed, showing no inflammation, polyps or masses; of note, a screening colonoscopy done 4 months prior identified and removed multiple benign polyps. A CT scan of his abdomen and pelvis also did not show any obstructing colonic masses. He was presumed to have colonic pseudo-obstruction, or Ogilvie Syndrome. Erythromycin was started without effect. He was subsequently given neostigmine, which was also unsuccessful in relieving his symptoms. The patient was then referred to another OSH for further workup. A 4-day gut motility study showed a pan-GI dysmotility disorder. Furthermore, a gastric emptying study revealed markedly delayed gastric emptying of both solid and liquid foods, but defecography was entirely normal. Non-contrast CTs of the chest, abdomen and pelvis again did not identify any masses or bowel obstruction, but did show enlarged precarinal lymph nodes and prostatomegaly, as well as small thyroid nodules bilaterally. As the patient continued to fail to have a bowel movement and could not tolerate a diet, he was started on total parenteral nutrition and was transferred to Thomas Jefferson University Hospital (TJUH) for further evaluation.On presentation to TJUH, the patient complained of occasional diffuse abdominal pain and distention, as well as nausea. He had not had any vomiting since he stopped eating when he was started on TPN. He denied any swallowing difficulty but did complain of constantly spitting up clear sputum. He had not had a bowel movement in more than 4 weeks since his initial response to lactulose at the first OSH. He had lost 30 lbs in the 4 weeks since his symptoms began. His review of systems was other wise...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.