Objectives This study introduces an initial evaluation of a novel High‐Intensity Focused Electromagnetic (HIFEM) technology. The primary goal is to quantify any effects the treatments may have on abdominal tissues, as well as to establish hypotheses for future research of this technology. Methods Twenty‐two patients received four abdominal treatments using the EMSCULPT device (BTL Industries Inc., Boston, MA). Anthropometric evaluations were recorded and digital photographs were taken at baseline, at 2 months, and at 6 months post‐treatments. The MRI without contrast determined by vertertebras T12 and S1 (FIESTA and FSPRG sequences) was used to measure dimensions in coronal cross‐sectional images of abdominal muscle and fatty tissues, in order to assess any anatomical changes induced by the application. Results Analysis of the same MRI slices verified by tissue artefacts showed a statistically significant (all P < 0.0001) average 18.6% reduction of adipose tissue thickness, 15.4% increase in rectus abdominis muscle thickness, and 10.4% reduction in rectus abdominus separation (diastasis recti) as measured from the medial border of the muscle 2 months post‐treatment. More significant improvements were observed in patients with BMI 18.5–24.9 (classified as “normal”). MRI data from 6‐month follow‐up suggest the changes can be preserved in longer term. Tape measurements showed on average 3.8 cm subumbilical circumference reduction. The weight of the subjects did not change significantly (average −0.5 lb; P > 0.05). No adverse events were reported. Conclusions MRI, considered as a highly precise diagnostic method, revealed simultaneous muscle growth, fat reduction and reduced abdominal separation at 2 months and at 6 months post treatments, unrelated with dieting. Further research should investigate the exact physiological processes which stand behind the tissue changes observed in this study. Lasers Surg. Med. 51:40–46, 2019. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
Summary Background and objective Vaginal childbirth, natural process of aging, congenital factors, and surgical interventions are considered the main causes of vulvo‐vaginal laxity driven by changes in collagen and elastin fibers. This causes a loss of strength and flexibility within the vaginal wall. As a result, women may experience lack of sensation and stress urinary incontinence (SUI)—the condition of involuntary loss of urine associated with activities that cause an increase in intra‐abdominal pressure (eg, sneezing, coughing, and lifting). Both vaginal laxity and urinary incontinence significantly affect patients' quality of life (QoL). The aim of this study was to evaluate efficacy and safety of a noninvasive radiofrequency device when used to treat SUI and vulvo‐vaginal laxity through its heating effect which stimulates collagen and elastin fibers. Methods Twenty‐seven women (average age 44.78±10.04 years) with indications of mild/moderate SUI as well as vulvo‐vaginal laxity were treated with a monopolar radiofrequency device. The treatment course consisted of three once‐a‐week sessions. Each session included intravaginal treatment followed by treatment of labia majora and the perineum. Improvement in the SUI condition was evaluated by applying the International Consultation on Incontinence Questionnaire ‐ Urinary Incontinence Short Form (ICIQ‐UI SF). Data were collected at the baseline, after the last treatment and at 1‐month follow‐up visit. Vaginal laxity was assessed by subjective vulvo‐vaginal laxity questionnaire (VVLQ). Data were collected before the 1st treatment and during the 1‐month follow‐up visit. Patient's satisfaction was recorded using a satisfaction questionnaire. Data were collected after the last treatment and at the 1‐month follow‐up visit. Any adverse events related to the treatments were monitored. Results On a scale of 0 to 5, the average frequency of urine leak improved from “2‐3 times a week” (2.15±1.03 points prior to treatment) to “once a week” (1.00±0.78 points post‐treatment), and on to “never” (0.44±0.51 points at the 1‐month follow‐up visit). Sixteen subjects (59.3%) reported decrease in the amount of leakage, with 15 women (55.6%) becoming completely leak‐free at the 1‐month follow‐up. At the 1‐month follow‐up visit, 24 subjects (88.9%) expressed their condition's interference with everyday life decreased and 17 patients (62.9%) said the condition did not interfere with their everyday life at all as a result of the treatment. All results are statistically significant (P<.05). No adverse events were recorded. All subjects reported improvement in vaginal laxity, from average perception of “very loose” (2.19±1.08 points prior to treatment) to “moderately tight” (5.74±0.76 points at the 1‐month follow‐up visit). During the follow‐up visit, 89% of the patients “agreed” or “strongly agreed” that their SUI condition improved, and 93% of the patients “agreed” or “strongly agreed” that their gratification during intercourse improved. None of the subjects reported dissatisfaction. C...
Perforating necrobiosis lipoidica is a very rare clinical variant which consists of degeneration and transepidermal elimination of the collagen with few cases reported in the literature. In two-thirds of the patients it associates with diabetes, with no relation with the glucose control. We present a 42-year-old female patient with a 7-year history of diabetes on insulin therapy, referred to our clinic with a 3-year history of multiple asymptomatic firm plaques disseminated on the upper and lower extremities. The clinical and histological findings proved the diagnosis of perforating necrobiosis lipoidica.
Lymphangiosarcoma is an uncommon vascular tumor that usually develops in chronic lymphedema. The etiology of lymphangiosarcoma remains unknown. It develops mainly after mastectomy, in association with chronic lymphedema (Stewart-Treves syndrome), or after radiotherapy. The early diagnosis of this aggressive tumor is important, as it has a high risk of local recurrence and metastasis. Stewart-Treves syndrome occurs in 0.5% of patients who survive mastectomy for more than 5 years. The mean age at appearance of the angiosarcoma is 62 years, and the mean interval between mastectomy and the appearance of the tumour is 10.5 years. Only two cases have been reported in men following mastectomy. We present a 70-year old male patient with lymphangiosarcoma which developed three and a half years after the diagnosis of breast carcinoma. The patient underwent mastectomy of the right mammary gland with ipsilateral axillary lymph node dissection and had postoperative chemo-and radiotherapy.
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