Ultrasound-assisted liposuction (UAL). This type of liposuction is sometimes used in conjunction with traditional liposuction. During UAL, the surgeon inserts a metal rod that emits ultrasonic energy under your skin. This ruptures the fat-cell walls and breaks down the fat for easier removal. A new generation of UAL called VASER-assisted liposuction uses a device that may improve skin contouring and reduce the chance of skin injuries.
1000 to 1500 ml crystalloids administered pre operatively as a priming solution and another 2000 ml of crystalloids given at the time of SA. Here again, depending on the clinical parameters, the rate of the fluid is adjusted accordingly. Overall, the patient, under Spinal Anaesthesia, will need about 1500 ml of crystalloids and 500 ml of colloid more than required under general anaesthesia.
The goal of metabolic syndrome treatment is to reduce the risk of heart disease and diabetes by controlling the associated problematic health conditions (high blood pressure, high cholesterol, diabetes, insulin resistance). “A study in which 53 percent of people had metabolic syndrome at the start found that over three years, intensive lifestyle changes—mainly diet and exercise—resulted in the lowest risk of developing diabetes and the lowest risk of developing metabolic syndrome in those who didn’t have it,” Ndumele says. Recommended changes include:
Because the population of the U.S. is aging, and because metabolic syndrome is more likely the older you are, the American Heart Association (AHA) has estimated that metabolic syndrome soon will become the main risk factor for cardiovascular disease, ahead of cigarette smoking. Experts also think that increasing rates of obesity are related to the increasing rates of metabolic syndrome.
Ultrasonic techniques are available as an internal, canula based, as well as an external one, with paddle application. The high ultrasonic energy produced by passing electrical energy to a piezoelectric crystal creates micro cavities in a liquid or semi liquid medium during the expansion cycle of the sound wave. This property of microcavitation is used in UAL.
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[Guideline] Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120(16):1640-5. [Medline].
A recent systemic review and meta-analysis of randomized controlled trials comparing the long-term effects (greater than 1 year) of dietary interventions on weight loss showed no sound evidence for recommending low-fat diets. In fact, low-carbohydrate diets led to significantly greater weight loss compared to low-fat interventions. It was observed that a carbohydrate-restricted diet is better than a low-fat diet for retaining an individual’s BMR. In other words, the quality of calories consumed may affect the number of calories burned. BMR dropped by more than 400 kcal/day on a low-fat diet when compared to a very low-carb diet.
Suction lipectomy was initially advocated for the treatment of localized collections of fat and for the removal of less than 1500 ml of fat material. However, many patients wish to have multiple areas treated or have diffuse collections of fat. In such instances, the removal of over 1500 ml of material and circumferential lipectomy are necessary to present optimal aesthetic results. However, when over 1500 ml of material is removed, anaesthetic requirements, fluid replacement, and treatment of blood loss become important if the procedure is to be performed safely.
What should I expect during open heart surgery? Open heart surgery is an operation to repair a fault or damage in the heart. It is a major operation during which the surgeon will open the chest to access the heart. This surgery will require a hospital stay of at least one week. Read on to learn more about the procedure, including preparation and recovery. Read now

First, I want to thank you for all of your dedication and work in providing this site. The difficulty of maintaining a healthy weight is a big problem for so many people. My personal question & issue in staying on Keto is my craving for fresh fruit. This a.m I had a large fresh peach along with my “Bullet Proof” coffee. Have I now sabotaged today’s Keto eating?


The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]

Because the population of the U.S. is aging, and because metabolic syndrome is more likely the older you are, the American Heart Association (AHA) has estimated that metabolic syndrome soon will become the main risk factor for cardiovascular disease, ahead of cigarette smoking. Experts also think that increasing rates of obesity are related to the increasing rates of metabolic syndrome.
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]

The first modern study of fasting as a treatment for epilepsy was in France in 1911.[12] Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.[13]


If you've tried exercise and dieting and still have areas on your body that won't respond, you should consider the newest method of liposuction, SmartLipo, which is performed by Dr. Schlessinger along with tumescent liposuction, which was invented by a dermatologist. Before you select a physician and undergo the procedure, it's important for you to know that all liposuction - even tumescent liposuction - is not alike.
The surgeons who perform liposuction must understand the physiology and differences between smaller volume and large volume liposuction. The anaesthesiologist is an integral member of the team and must have a complete understanding of the procedure and be well trained to handle preoperative, peri-operative, or post-operative problems of fluid shits and drug toxicity. The patient's core body temperature must be maintained using heating blanket systems on the table, minimizing body exposure and using warmed wetting solution.
Eat more protein. Protein is required by the body to repair damaged cells and plays a vital role in growth and development.[3] But it can also play a role in weight loss. Diets high in protein tend to make people feel fuller, and when paired with a reduction in carbohydrate intake these diets can help with weight loss.[4] However, it's important to remember that not all sources of protein are good for you: red meat and full-fat dairy products, though high in protein, can also increase the risk of heart disease.[5] Good sources of protein include:[6]
Snack on portion-controlled fruit, seeds and nuts. One study found that snacking on 42g of almonds per day (instead of munching on something high-carb with equal calories) helped to reduce belly fat and improved cholesterol levels. “The high levels of fibre are proven to combat excess calorie consumption later in the day,” says registered dietitian Lucy Jones.
Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
Dr. Schlessinger does not recommend tumescent liposuction for skin tightening. Tumescent liposuction is useful for removing fat, but it does not help improve the appearance of loose skin. If you are truly looking for only skin tightening, it won't be that impressive. Many other options for skin tightening work better, are less expensive and have shorter recovery times, such as laser procedures.
Any guess at what disorder affects 40 percent of people over the age of 60? It’s called metabolic syndrome, which unfortunately does not simply mean that your metabolism is slow or out of whack. Metabolic syndrome is a metabolic disorder that involves not one, but a combination of three or more of the following health issues: abdominal obesity, high blood sugar, high triglyceride levels, high blood pressure or low HDL (“good”) cholesterol.
You’re transitioning. Your body is equipped to process a high intake of carbs and a lower intake of fat. Your body needs to create enzymes to be able to do this. In the transitional period, the brain may run low on energy which can lead to grogginess, nausea, and headaches. If you’re having a large problem with this, you can choose to reduce carb intake gradually.

There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. A number of markers of systemic inflammation, including C-reactive protein, are often increased, as are fibrinogen, interleukin 6, tumor necrosis factor-alpha (TNF-α), and others. Some have pointed to a variety of causes, including increased uric acid levels caused by dietary fructose.[18][19][20]
2No interest will be charged on the promotional purchase if you pay the promotional purchase amount in full within the 6 or 12 month promotional period. If you do not, interest will be charged on the promotional purchase from the purchase date. For new accounts, Purchase APR (interest rate) is 26.99%. For example, a 12 month promotional period on a $10,000 purchase will have a deferred interest rate of 26.99%. If monthly payments of $834 are made for 12 months, there would be no interest charged and the total cost of the loan would be $10,000. Regular minimum monthly payment terms of the account will apply. There is no prepayment penalty. Terms offered are based on income, credit score and history, and other factors. Financing provided by Synchrony Bank, a consumer financial services company headquartered in Stamford, Connecticut.

In general, a person with metabolic syndrome is twice as likely to develop IHD and five times as likely to develop diabetes as someone without it. The probability of developing metabolic syndrome is also closely linked to a lack of physical activity and the fact of being overweight/obese. Other causes include insulin resistance, ethnicity (often Asian), family history, older age and other factors (Box 23.1). Associated diseases and signs may be raised uric acid levels, hepatic steatosis, haemochromatosis and acanthosis nigricans. Metabolic syndrome may be associated with inflammatory periodontal disease.

Liposuction for fat removal is similar to Phaco-emulsification of the ocular lens for cataracts. It permits elimination of localized fat deposits through miniature incisions that leave an inconspicuous scar. Principal indications are fat deposits in the gluteo-crural areas, hips and the abdomen. While the ideal body shape is trim and athletic, a well contoured shoulder and chest, a flat abdomen and a narrow hip and thigh area are sought-after and lipo-sculpturing is anticipated to bestow these expectations.
The Modified Atkins diet and modified ketogenic diet (sometimes called 'modified ketogenic therapy') use a high proportion of fats and a strict control of carbohydrates. These are often considered more flexible than the classical or MCT ketogenic diets, as more protein can be eaten, and approximate portion sizes may be used in place of weighed recipes.
Localized fat accumulation patterns also vary by race and age. A decrease in the subcutaneous fatty layer and elevations in intra-abdominal fat contents are seen with increasing age. Women have a proportionately higher percentage of body fat than men and have a gynaecoid pattern of fat deposition characterized by increased deposits over the lateral thigh, buttock, hips, and truncal region, while men show an android pattern that centres on the truncal and abdominal regions.
This is a wealth of information. My husband and I are starting the keto diet tomorrow and I knew nothing about it. When I sat down to look up information about it, I found this. Thank you! This is everything I need to know in one place. We are not as healthy as we’d like to be and I am optimistic this will help us obtain our goals, along with an exercise plan.
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).[19]
^ Jump up to: a b Gatta-Cherifi, Blandine; Cota, Daniela (2015). "Endocannabinoids and Metabolic Disorders". Endocannabinoids. Handbook of Experimental Pharmacology. 231. pp. 367–91. doi:10.1007/978-3-319-20825-1_13. ISBN 978-3-319-20824-4. PMID 26408168. The endocannabinoid system (ECS) is known to exert regulatory control on essentially every aspect related to the search for, and the intake, metabolism and storage of calories, and consequently it represents a potential pharmacotherapeutic target for obesity, diabetes and eating disorders. ... recent research in animals and humans has provided new knowledge on the mechanisms of actions of the ECS in the regulation of eating behavior, energy balance, and metabolism. In this review, we discuss these recent advances and how they may allow targeting the ECS in a more specific and selective manner for the future development of therapies against obesity, metabolic syndrome, and eating disorders.
In order to transition and remain in this state, aiming for about 30–50 net grams is typically the recommended amount of total carbs to start with. This is considered a more moderate or flexible approach but can be less overwhelming to begin with. Once you’re more accustomed to “eating keto,” you can choose to lower carbs even more if you’d like (perhaps only from time to time), down to about 20 grams of net carbs daily. This is considered the standard, “strict” amount that many keto dieters aim to adhere to for best results, but remember that everyone is a bit different.
Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.
Liposuction is performed under general anesthesia in an accredited surgical facility. It is considered an outpatient procedure. On average, each body part (i.e. tummy, thighs, etc.) will take approximately 30 minutes to complete. After surgery, patients will wear a compression garment on the treated areas. It takes about a full week for the bruising and swelling to dissipate, and can take several months for the final results to appear. Liposuction will produce scars where the cannula incision was made, but these are usually small and will fade over time.
People who have metabolic syndrome or are at risk for it may need to take medicine as treatment. This is especially true if diet and other lifestyle changes have not made a difference. Your doctor may prescribe medicine to help lower blood pressure, improve insulin metabolism, lower LDL cholesterol and raise HDL cholesterol, increase weight loss, or some combination of these.
Blood pressure goals are generally set lower than 130/80. Some blood pressure medications offer more benefits than simply lowering blood pressure. For example, a class of blood pressure drugs called ACE inhibitors has been found to also reduce the levels of insulin resistance and actually deter the development of type 2 diabetes. This is an important consideration when discussing the choice blood pressure drugs in the metabolic syndrome.
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