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  • Schwahn-Schreiber, C., Breu, F. X., Rabe, E., Buschmann, I., Döller, W., Lulay, G. R., Miller, A., Valesky, E., & Reich-Schupke, S. (2018). [S1 guideline on intermittent pneumatic compression (IPC)]. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 69(8), 662–673. https://doi.org/10.1007/s00105-018-4219-1

    Under the direction of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and in cooperation with other specialist associations, the S1 guideline on intermittent pneumatic compression (IPC) was adopted in January 2018. It replaces the previous guideline from March 2005. The aim of the guideline is to optimize the indication and therapeutic use of IPC in vascular diseases and edema. An extensive literature search of MEDLINE, existing guidelines, and work relevant to the topic was performed. In view of the often methodologically weak study quality with often small numbers of cases and heterogeneous treatment protocols, recommendations can often only be derived from the available data using good clinical practice/expert consensus. Intermittent pneumatic compression is used for thromboembolism prophylaxis, decongestive therapy for edema, and to positively influence arterial and venous circulation to improve clinical symptoms and accelerate ulcer healing in both the outpatient and inpatient care setting. The therapy regimens and devices used depend on the indication and target location. They can be used as outpatient and inpatient devices as well as at home for long-term indications. A target indication is thrombosis prophylaxis. IPC should be used in severe chronic venous insufficiency (stages C4b to C6), in extremity lymphedema as an add-on therapy and in peripheral arterial occlusive disease (PAOD) with stable intermittent claudication or critical ischemia. IPC can be used in post-traumatic edema, therapy-resistant venous edema, lipedema and hemiplegia with sensory deficits and edema. Absolute and relative contraindications to IPC must be taken into account and risks considered and avoided as far as possible. Adverse events are extremely rare if IPC is used correctly. If the indication and application are correct-also as an add-on therapy-it is a safe and effective treatment method, especially for the treatment of the described vascular diseases and edema as well as thrombosis prophylaxis.

  • Jaldin-Fincati, J. R., Pereira, R. V. S., Bilan, P. J., & Klip, A. (2018). Insulin uptake and action in microvascular endothelial cells of lymphatic and blood origin. American Journal of Physiology. Endocrinology and Metabolism, 315(2), E204–E217. https://doi.org/10.1152/ajpendo.00008.2018

    Whereas the blood microvasculature constitutes a biological barrier to the action of blood-borne insulin on target tissues, the lymphatic microvasculature might act as a barrier to subcutaneously administrated insulin reaching the circulation. Here, we evaluate the interaction of insulin with primary microvascular endothelial cells of lymphatic [human dermal lymphatic endothelial cells (HDLEC)] and blood [human adipose microvascular endothelial cells (HAMEC)] origin, derived from human dermal and adipose tissues, respectively. HDLEC express higher levels of insulin receptor and signal in response to insulin as low as 2.5 nM, while HAMEC only activate signaling at 100 nM (a dose that blood vessels do not normally encounter). Low insulin acts specifically through the insulin receptor, while supraphysiological insulin acts through both the IR and insulin growth factor-1 receptor. At supraphysiological or injection site-compatible doses pertinent to lymphatic microvessels, insulin enters HAMEC and HDLEC via fluid-phase endocytosis. Conversely, at physiologically circulating doses (0.2 nM) pertinent to blood microvessels, insulin enters HAMEC through a receptor-mediated process requiring IR autophosphorylation but not downstream insulin signaling. At physiological doses, internalized insulin is barely degraded and is instead released intact to the extracellular medium. In conclusion, we document for the first time the mechanism of interaction of insulin with lymphatic endothelial cells, which may be relevant to insulin absorption during therapeutic injections. Furthermore, we describe distinct action and uptake routes for insulin at physiological and supraphysiological doses in blood microvascular endothelial cells, providing a potential explanation for previously conflicting studies on endothelial insulin uptake.

  • Nemes, A., Kormanyos, A., Domsik, P., Kalapos, A., Kemeny, L., Forster, T., & Szolnoky, G. (2018). Left ventricular rotational mechanics differ between lipedema and lymphedema:  Insights from the three-dimensional speckle tracking echocardiographic MAGYAR-path  study. Lymphology, 51(3), 102–108.

    The present study aimed to assess LV rotational mechanics by three-dimensional speckle-tracking echocardiography (3DSTE) in lipedema (n=25), lymphedema (n=26) patient groups with age- and gender-matched healthy controls (n=54). 3 lipedema and 4 lymphedema patients were excluded due to insufficient image quality for 3DSTE analysis. LV apical rotation (9.61 ± 4.25 degree vs. 6.40 ± 2.63 degree, p <0.05) and LV twist (13.83 ± 4.89 degree vs. 10.04 ± 3.56 degree, p <0.05) are impaired in lipedema patients as compared to matched controls; similar alterations in lymphedema were not found. Moreover, in some lipedema and lymphedema patients severe LV rotational abnormalities could be detected. Our results suggest that lipedema-associated impaired LV apical rotation and twist assessed by 3DSTE could be a novel differential diagnostic point between lipedema and lymphedema.

  • Rey, L.-E., Koch, N., & Raffoul, W. (2018). [Surgical Treatment for Lipedema]. Praxis, 107(20), 1081–1084. https://doi.org/10.1024/1661-8157/a003091

    Surgical Treatment for Lipedema Abstract. Lipedema is a progressive disease that occurs in adolescence and affects one in nine women. The signs are limited to the lower limbs. Early signs are nonspecific, which is why the diagnosis is often ignored. Later, pain and heaviness of lower limbs become predominant. Finally, at an advanced stage, tissue fibrosis is associated with significant edema. At this stage, patients become severely disabled and bedridden. At the early stage, the treatment is conservative. Liposuction is indicated at the onset of pain. Its effectiveness pain and long-term control has been demonstrated on. Finally, late stages require heavy and complex surgeries combining dermolipectomy and liposuction.

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Last update from database: 3/12/25, 8:25 AM (UTC)