Lasers in Medical Science最新文献

This prospective study aimed to investigate the efficacy and safety of fractional CO₂ laser with different parameters, in combination with topical halometason, for the management of chronic eczema. Each lesion of the patients were divided into four groups and given fractional CO₂ laser treatment with different parameter and a negative control. After treatment, all four groups were treated with topical halometasone cream once daily for a week. The modified Eczema Area and Severity Index (mEASI) scores were evaluated before treatment, 1-week post-treatment and 4-weeks post-treatment respectively. Numerical rating scale was used to assess the pain degree during the treatment and other adverse reaction were recored. The results suggest that the efficacy of CO₂ fractional laser combined with halometasone cream in the treatment of chronic eczema is better than that of halometasone treatment alone. The efficacy at 4 weeks after treatment was better than at 1 week after treatment. The efficacy varied depending on the laser parameters used. In group B (30 mJ) and group C (50 mJ) with the same spot spacing (0.6 mm), the higher energy group showed faster onset and better efficacy at 1 week post-treatment. However, at 4 weeks, both groups exhibited similar efficacy but the higher-energy group experienced more pain. In group A (1.0 mm) and group B (0.6 mm) with the same energy parameter (30 mJ), dot spacing had little effect on the efficacy at 1 week after treatment. At 4 weeks, the group with smaller dot spacing (0.6 mm) showed better long-term efficacy. This study suggests that the clinical application of CO₂ fractional laser treatment for chronic eczema requires careful selection of therapeutic parameters, and the recommended parameters from this study are 30 mJ energy, 0.6 mm dot spacing, but further research is warranted to confirm these findings.

In orthopedic surgery, laser-assisted procedures have shown great promise as adjuncts, with the potential to enhance patient outcomes, decrease tissue damage, and increase precision. However, a thorough evaluation of their safety and effectiveness is essential. The purpose of this meta-analysis is to thoroughly assess the data from randomized controlled trials (RCTs) to ascertain the possible dangers and clinical advantages of using laser-assisted techniques during orthopedic procedures. We conducted a comprehensive literature search across PubMed, Cochrane Library, Embase, and Web of Science, covering publications until April 2024. RCTs evaluating laser-assisted techniques in orthopedic surgery were included if they reported on operative time, blood loss, postoperative pain, functional outcomes, complication rates, or patient satisfaction. Data were extracted by two independent reviewers and analyzed using SPSS software. Methodological quality was assessed using the Cochrane Risk of Bias tool. Twenty-three RCTs, involving a total of 2,032 patients, met the inclusion criteria. Laser-assisted techniques significantly reduced operative time (MD - 15.32 min; 95% CI - 22.45 to - 8.19; p < 0.001) and postoperative pain (MD - 1.27; 95% CI - 1.91 to - 0.63; p < 0.001). Although the reduction in blood loss did not reach statistical significance (MD - 52.18 mL; 95% CI - 114.32 to 9.96; p = 0.10), the trend suggested potential benefits. Functional outcomes and patient satisfaction were significantly improved, while complication rates were comparable to conventional methods (RR 0.98; 95% CI 0.82 to 1.17; p = 0.84). Publication bias was assessed and found to be minimal. Significant decreases in operating time and postoperative pain, as well as enhanced patient satisfaction and functional results, are linked to laser-assisted orthopedic surgery procedures. The trend points to a possible benefit even though the decrease in blood loss was not statistically significant. These results demonstrate the advantages and safety of laser technology and justify its use in orthopedic surgery. To standardize procedures and improve these methods in various surgical settings, more study is required.

Purpose: Laser hair removal (LHR) plays a significant role in gender-affirming care of transgender and gender-diverse patients. This systematic review aims to synthesize and critically evaluate the current literature on the utility of LHR in these populations, while addressing limitations and barriers.

Methods: A search of the PubMed, EMBASE and Web of Science databases was conducted according to PRISMA guidelines. Studies were included if they directly discussed the topic, were of the appropriate study type and were published in peer-reviewed journals in English. Our search yielded 10 studies that met our inclusion criteria. From the included studies, data was individually extracted and scrutinized, following formal quality assessment.

Results: In transwomen receiving vaginoplasty, LHR has been established as an effective method for preprocedural hair removal, with preliminary studies comparing its efficacy to electrolysis. In transmen undergoing phalloplasty, early findings suggest LHR as satisfactory in decreasing hair density in the neourethra. While limited, available evidence indicates that adequate hair removal may contribute to improved psychosocial outcomes. Efficacy of LHR prior to gender-affirming surgery may differ based on treatment protocols and patient demographics, potentially contributing to the variability in results included within our review. Moreover, cost, lack of provider expertise, and overall fear and anxiety remain recognized barriers to care for LHR and electrolysis.

Conclusion: These results highlight the significant role of LHR in the gender-affirming care of transgender individuals, by aiding in surgical readiness and facilitating gender congruence. Our review is subject to several limitations including limited sample sizes, underscoring the need for future research.

The formation mechanism of OLP is very complicated, and its treatment has always been a difficult problem. This study was to explore the feasibility of pulsed Er: YAG laser in the treatment of erosive OLP by comparing its effect with that of Triamcinolone Acetonide ointment(TA) of OLP, in order to provide new ideas for the clinical treatment of erosive OLP. Forty patients who were clinically and histopathologically diagnosed as OLP at the Department of Periodontics and Oral Mucosa Disease of Dalian Stomatological Hospital were selected, all lesions accompanied by erosion. The included patients were randomly divided into two groups: Er: YAG group and TA group, with 20 cases in each group. The visual analogue scale (VAS), mean lesion area, clinical sign score, and function score in both groups were evaluated at baseline, 1 week, 2 weeks, 1 month and 3 months after treatment, and the recurrence rate of cured patients in both groups was evaluated at 3 months after treatment. Er: YAG laser was superior to TA in relieving pain at 1 week(1.50 ± 0.946 vs. 2.10 ± 0.912, P < 0.05) and improving function at all stages(P < 0.05). But TA was superior to the pulsed Er: YAG laser in promoting the healing of erosive lesions at 2 weeks(0.07 ± 0.223 vs. 0.31 ± 0.549, P < 0.05). There was no significant difference in recurrence between the two groups(P > 0.05). There is no significant difference between pulsed Er: YAG laser and TA in the treatment of erosive OLP. The use of pulsed Er: YAG laser represents a viable and effective therapeutic option for erosive OLP.

Although topical 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) is an effective treatment for facial acne, many patients report significant pain during the irradiation phase, compromising adherence. Two-step PDT, which modifies irradiance in two phases, has been proposed to reduce pain without compromising treatment efficacy. In this single-center, assessor-blinded randomized trial, 26 patients with facial acne were allocated to either a two-step PDT group (n = 12) or a conventional PDT group (n = 14). After applying 20% 5-ALA for 2 h, both groups received red light (630 ± 5 nm) to deliver a total fluence of 120 J/cm². In the two-step group, treatment began at 40 mW/cm² for 5 min, then increased to 100 mW/cm² for 18 min. In the conventional group, irradiance was set at 100 mW/cm² for 20 min. Pain was measured using the Numerical Rating Scale (NRS) at 6, 12, 18, 24, and 30 min after initiation of irradiation. Clinical efficacy, adverse events, recurrence, and patient satisfaction were also evaluated. All 26 patients completed three PDT sessions. Pain scores were significantly lower in the two-step group at every time point (p < 0.05). Both groups had comparable clinical efficacy, recurrence rates, and satisfaction levels (p > 0.05). Adverse events were less frequent in the two-step group but did not differ statistically from the conventional group. Two-step PDT using 5-ALA and 630 nm red light laser substantially reduces pain during acne treatment while maintaining equivalent clinical efficacy, recurrence rates, and patient satisfaction. This modified protocol may improve patient tolerance and adherence to PDT.

At Great Ormond Street Hospital for Children NHS Trust, Pulsed Dye Laser (PDL) therapy is the first line laser treatment for port wine birthmarks (PWB). For recalcitrant PWB, we use triple wavelength therapy using Multiplex laser which is a combination of PDL 585 nm and Nd: YaG 1064 nm, superimposed by PDL at 595 nm five minutes later. Known complications following laser therapy are pain, redness, and bruising, however, scarring is very rare. In this the study we were keen to determine and publish the incidence and the possible risk factors associated with perioral scarring as a complication of laser therapy. A single centre retrospective observational study was performed amongst children aged 3-18 years with facial and perioral PWB who were treated with laser therapy. Patients who were treated for other facial vascular anomalies were excluded from the study. A total of 139 patients with perioral PWB were treated with laser from January 2019 to January 2022. The incidence of perioral scarring after laser treatment was 4.3% (6 patients) over a 3-year period. We found that the key risk factors for scarring were use of multiplex laser (particularly Nd: YaG), inadequate post-operative nursing care, lack of parental education, abnormal wound healing, and equipment failure with improper delivery of cooling. We concluded that the use multiplex laser (particularly Nd: YaG) entails a higher risk for peri-oral scarring. The perioral area is more vulnerable to complications and scarring from laser treatment, because the dermis in this area is thin and sensitive. The complications from laser therapy can be minimised by early recognition of pre-scarring signs, nursing advice and early treatment.

To evaluate the efficacy of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) for the normal tension glaucoma (NTG) in Chinese. Consecutive patients with NTG treated with monocular SLT for eye with higher IOP were enrolled. IOP was evaluated for each patient before SLT, 1 h, 1 week, 1, 3, 6 months, 1 and 2 years after treatment. The treatment success was defined as IOP reduction from the preoperative IOP by 20%. Thirty-two patients with 18.47 ± 9.98 months follow-up were eligible for analyses. The mean IOP reduction after SLT were 2.80 mmHg (15.76%), 2.60 mmHg (15.57%), 2.51 mmHg (15.06%), 3.42 mmHg (20.51%), and 2.41 mmHg (14.46%) at 1, 3, 6 months, 1 and 2 years post-SLT respectively for the treated eyes. While there were 1.39 mmHg (8.94%) and 2.13 mmHg (13.71%) IOP reduction in the fellow eyes at 1 month and 1 year post-SLT respectively. There was positive correlation of IOP reduction between SLT eyes and the fellow eyes (r = 0.6503, P < 0.0001). The absolute success rate for SLT treated eyes mounted to 41.38% at 6 months and decreased to 18.18% at 2 years post-SLT. The success was associated with the number of medicines, pre-IOP and the IOP reduction at 1 and 3 months after SLT. SLT has an effect on lowering IOP for NTG patients in Chinese in both SLT eyes and the follow eyes with insufficient efficacy of anti-glaucoma medications, although the effect was not sustained with a longer follow-up.

This study aimed to evaluate and compare the effectiveness of transcutaneous electric nerve stimulation (TENS) and photobiostimulation using diode LASER, prior to local anaesthesia administration in children undergoing bilateral orthodontic extractions. A split-mouth, parallel arm, Double blinded, randomized clinical trial was conducted on children (12 - 16 yrs) undergoing bilateral orthodontic extractions. Patients were randomly assigned to receive either TENS or PBST. Subjective and Objective parameters for anxiety and pain were assessed, and evaluated for statistical significance (p < 0.05). In this study with 104 patients (mean age 13.59), the TENS group showed significantly lower mean pain scores (WBPRS) for needle insertion (2.30 ± 2.7) versus PBST (5.03 ± 3.1, p < 0.01), LA administration (2.11 ± 2.8 vs. 4.84 ± 2.7, p < 0.01), and extraction (1.92 ± 2.6 vs. 3.23 ± 5.1, p < 0.01). TENS also led to a faster onset of local anesthesia (96.15 s ± 13.9) compared to PBST (155.38 s ± 91, p < 0.05), indicating enhanced efficacy for pain reduction and anesthesia speed. Physiological parameters like pulse rate and salivary pH also showed significant improvements with TENS. Hence TENS and PBST both came out as effective alternatives for topical anesthesia. Both TENS and PBST proved to be effective alternatives to topical anesthesia, TENS therapy with the Synapse Dental Pain Eraser (DPE) demonstrated greater effectiveness in reducing pain and anxiety, reflecting it as a promising option for pediatric patients. However further research is needed to refine and optimize pain management strategies using these alternatives in pediatric dentistry. CTRI Number- CTRI/2022/09/045460 [Registered on: 13/09/2022] Trial Registered Prospectively.

This study aimed to isolate and identify compounds with photodynamic activity from the ethanolic extract of Cnidoscolus quercifolius leaves, incorporate them into nanostructured lipid carriers (NLCs), evaluate singlet oxygen (¹O₂) generation and cytotoxicity in MCF-7 cells. In silico studies were conducted to elucidate possible molecular targets and mechanisms of action for the compounds. C. quercifolius leaves extract was obtained by percolation in ethanol and partitioned by column chromatography. The isolated P1 and P2 compounds were identified by ¹H and ¹³C NMR and incorporated NLCs by the solvent emulsification-evaporation method. The generation of ¹O₂ was carried out using the SOSG reagent. The MTT assay determined the cell viability of MCF-7 cells. Computational studies were performed with cocrystallized ligands. NLCs had a size between 92 and 93 nm and zeta potential values of -8.2 and - 8.9 mV. The SOSG results showed that NLC-P1 had the highest ¹O₂ generation. MTT assay revealed that NLCs loaded with 3% P1 and P2 reduced cell viability to 37.3% and 45.6%. Computational studies demonstrated that Bcl-2 and Mcl-1 were the main targets involved in the anticancer effects of P1 and P2. These findings point to the potential application of chlorophyll derivatives in photodynamic therapy as an alternative to eliminate cancer while improving patients' quality of life during treatment.

This study examines the effects of 630 nm red-light laser therapy on wound healing, with a focus on VEGF-mediated angiogenesis and collagen production. The effectiveness of red-light therapy is influenced by critical parameters, including treatment duration and distance, which often lack standardization across protocols. To address this, we conducted cell viability and scratch wound assays using NIH/3T3 cells in-vitro to identify optimal treatment conditions. Treatment durations of 10 s, 30 s, 60 s, and 5 min, along with distances of 3 cm and 5 cm, were evaluated. Following parameter optimization, the wound-healing efficacy of red-light therapy was assessed in-vivo using nude mice. Standardized 4 mm wounds were created using a biopsy punch, and healing was evaluated at 7 and 21-days post-intervention. Histological analysis was performed, and gene and protein expression levels of COL1A1, COL2A1, VEGF, and IL-1β, which are implicated in wound healing, were assessed via RT-PCR, western blotting, and immunohistochemistry. Results demonstrated that red-light laser therapy significantly upregulated collagen and VEGF expression while reducing IL-1β levels at the three-week time point (p < 0.05). Notably, these effects were comparable to hydrogel treatment, which served as a positive control to assess the efficacy of light-emitting diode (LED)-based therapy. These findings indicate that red-light therapy effectively promotes wound healing by enhancing collagen synthesis and VEGF-mediated angiogenesis within the wound bed.