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1. Lipoedema is described with an illustration of a recent case. 2. This condition should be distinguished from lymphoedema of the legs. 3. The differential diagnosis is discussed. 4. Comment is made on treatment.
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En último término, el edema de los miembros se produce siempre a través de perturbaciones circulatorias. Estas alteraciones pueden tener un origen central o sistémico: afecciones cardiovasculares, renales, tiroideas o humorales (hipoproteinemia) y pueden también tener un origen periférico: insuficiencia venosa, linfoedema, etc. Uno de los problemas más difíciles de controlar para el médico es el edema de las piernas, de origen periférico, esto es sin relación con alteraciones cardiorrenales, tiroideas o humorales,. en otras palabras el edema consecutivo a la insuficiencia venosa que sucede como grave secuela a las flebotrombosis o flebitis, al linfoedema, etc. En los últimos años se ha avanzado bastante, sin embargo, en la prevención y en el tratamiento de estos edemas de origen periférico merced al mejor conocimiento de la fisiopatología, lo que supone un perfeccionamiento diagnóstico y a favor del uso de nuevos medios de tratamiento como ,los anticoagulantes y las vendas elásticas. Uno de los aportes más interesantes que se han hecho en el diagnóstico y diferenciación de estos sindromes es la descripción de una entidad clínica, hecha en Marzo de 1940 por dos investigadores de la Clínica Mayo: Allen y Hines que denominaron lipoedema de las piernas. Se trata de un aumento de volumen simétrico y generalizado de las piernas por aumento de los depósitos adiposos subcutáneos y por edema, que afecta casi exclusivameñte a las mujeres. A la descripción del cuadro clínico hecha en 1940 hemos sumado como antecedente bibliográfico un trabajo de conjunto que nos ha enviado directamente el Dr. Edgar v. Allen desde la Clínica Mayo, que no se ha publicado aún, y que reúne la experiencia de dicho servicio desde 1937 hasta 1946 .
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Introduction. Personal observations (20 cases, 19 photographs). Consideration of special clinical varieties or syndromes—groups of cases. Group I. Adiposis dolorosa. Group II. Obesity. Group III. Nodular circumscribed lipomatosis. Group IV. Diffuse symmetrical lipomatosis (Fetthals, Madelung; adéno-lipomatose symétrique à prédominance cervicale, Launois and Bensaude). Group V. Neuropathic edema, pseudoedema, pseudolipoma and lipoma. Group VI. Adipositas cerebralis (Fröhlich, Madelung and others). Consideration of the combined groups. General summary (including special subjects, arthritism, heredity, etc.). Etiology (including glands of internal secretion). Treatment. Conclusions. Bibliography.The object of this study is to simplify or unify the clinical classification of abnormal subcutaneous fat deposits by correlating the symptomatology and constitutional relations common to the several varieties or clinical groups that have been separated under descriptive designations according to their predominant characteristics. It is with special reference to Dercum's ``adiposis dolorosa'' that this study is undertaken. I shall
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Lipedema is a chronic, predominantly female disorder characterized by disproportionate regional expansion of subcutaneous adipose tissue, pain, tenderness and easy bruising. Although adipocyte hypertrophy, altered progenitor-cell behavior, microvascular dysfunction, extracellular-matrix remodeling, immune-cell alterations and variable lymphatic abnormalities have been reported, their causal and temporal relationships remain unresolved. Here, we propose that these findings may represent interacting manifestations of dysregulation within an adipovascular unit (AVU) rather than independent pathological processes.
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Software engineering plays a key role in developing high-quality healthcare systems, particularly in Precision Medicine, where advanced systems are required to tailor clinical interventions based on individual genetic, environmental, and lifestyle factors. Therefore, it is necessary to rethink software engineering methods to address the significant challenges in healthcare systems, especially in system design, complex data analysis, traceability, and AI explainability. This paper presents the MATIIGEN project, which aims to address these challenges. MATIIGEN introduces an intelligent system for automated DNA variant interpretation. The project combines Model-Driven Software Engineering (MDSE) principles with Explainable Artificial Intelligence (XAI) to support the transition of genomic tools from laboratory validation environments (TRL4) to operational clinical settings (TRL6). MDSE provides the structural and methodological basis for building robust, traceable, and interoperable software systems, and XAI provides mechanisms to make the system’s outputs more transparent and understandable to clinicians. The applicability of MATIIGEN platform is demonstrated through a historically overlooked chronic disease: Lipedema. By focusing on a condition that is under-researched in clinical settings, we can demonstrate that the MATTIGEN platform can generate insights in areas of medicine where data is scarce and complex. Our work demonstrates that adopting MDSE principles provides a systematic methodology for transforming multifaceted clinical data into actionable medical insights and establishes a scalable architecture for high-quality, software-intensive systems in the healthcare domain.
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Lipedema is a chronic and progressive disorder, a primary lipotrophy characterized by abnormal fat deposition, primarily in the buttocks and legs bilaterally. It is symmetrical and disproportionate. It is estimated to affect 10 to 18% of women in Europe and approximately 12.3% of the Brazilian female population.
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