Lasers in Medical Science最新文献

The aim of this study was to compare the effects of laser systems and cold atmospheric plasma (CAP) on the surface roughness (Ra) and shear bond strength (SBS) of flexible hybrid ceramics (FHCs). Eighty FHC samples were divided into 5 groups to be subjected to surface treatments (hydrofluoric acid (HFA), HFA + 5 W Er: YAG laser (HFA + 5WE), HFA + 3 W Er: YAG laser (HFA + 3WE), HFA + ultrafast fiber laser (HFA + FL), and CAP). The Er: YAG laser (AT Fidelis Plus III, Fotona, Slovenia) was operated with a 0.9 mm diameter tip, delivering 250 mJ and 150 mJ per pulse, with output powers of 5 W and 3 W, and fluences of 23,623 J/cm² and 14,157 J/cm², respectively, at a frequency of 20 Hz and a pulse duration of 600 µs for 30 s. The FL (FiberLAST Inc., Turkey) was applied with a 7 mm spot size, 1 mJ pulse energy, 20 W output power, 100 kHz repetition rate, ultrashort pulse length (100 ns), and the fluence of 1,820 J/cm² for 7 s. The CAP (PiezoBrush PZ3, Relyon Plasma, Germany) applied to the surfaces for 80 s at a treatment speed of 5 cm²/s and 100% plasma power. After the Ra values were measured, each group was divided into 2 subgroups to be cemented with total-etch (TE) and self-adhesive (SA) resin cements. The SBS of all the samples was measured. One sample was randomly selected from each group, and the fractured surfaces were examined by SEM analysis. The significance level was at P < 0.05. HFA + FL had the highest Ra values, and there was no significant difference between HFA + FL and HFA + 5WE (P > 0.05). There was no difference in Ra between CAP and HFA (P > 0.05). The highest SBS values were observed for the samples cemented with TE after HFA + FL. The difference between the SBS values of the groups cemented with TE after CAP, HFA + 5WE, HFA + 3WE, and HFA + FL was not significant (P < 0.05). The use of FL may be a promising method to improve SBS without causing thermal damage when using TE or SA cements. CAP can be recommended as a practical and safe treatment with SA cement because it is suitable for chairside use with a handheld device and does not change the physical properties of the material.

Cellulite is a skin condition that significantly affects women, characterized by "holes" or depressions in the skin, affecting approximately 95% of women at some point in their lives. Cellulite often presents inflammatory symptoms such as increased skin temperature and hyperalgesia. Photobiomodulation, whether applied locally or systemically, has demonstrated important anti-inflammatory effects in various conditions. This study investigates the effects of local and systemic photobiomodulation on hip culottes temperature increases and hyperalgesia in patients with grades 2 to 4 cellulite. Cellulite assessment was carried out using detailed anamnesis, photographic records, algometry, and infrared thermography. Participants received randomized bilateral treatment with or without systemic irradiation using LED photobiomodulation on the hip culottes for four weeks, three times a week. This study aimed to evaluate the effect of photobiomodulation, especially locally applied, together or not with systemic irradiation, on cellulite hyperalgesia and skin temperature among 25 female participants. The group that received only LED treatment showed an increase in pain threshold of 8% and 20% on the right and left sides, respectively, while the group treated with LED + ILIB showed an increase in pain threshold of 32% on both sides. Local photobiomodulation produced a skin temperature decrease of 0.4 °C, while the combination of local and systemic irradiation produced an average skin temperature decrease of 1.2 °C. Our results clearly demonstrate a significantly beneficial effect of LED therapy for cellulite treatment, especially when administered in combination with mILIB, leading to a significant reduction of pain hypersensitivity and skin temperature, indicating a regional subcutaneous improvement of the inflammatory status.

Treatment of onychomycosis includes topical and systemic agents. However, prolonged use of oral treatment could cause adverse effects and topical antifungal agents have limited penetration. To compare the clinical efficacy and the safety of fractional CO₂ laser combined with topical tioconazole nail solution versus Q-switched 1064 Nd: YAG laser in the treatment of fingernail onychomycosis. This randomized comparative clinical trial was conducted on 13 patients (47 nails) with fingernail onychomycosis. Patients were randomized to receive either fractional CO2 laser combined with topical tioconazole or Q-Switched Nd: YAG 1064 nm laser every 2 weeks for 3 months followed by a 1-month follow up assessment. Onychomycosis severity index (OSI) score, Dermatology life Quality Index (DLQI) score, patient satisfaction score, dermoscopic evaluation and KOH examination were used for assessment of improvement. OSI showed improvement after treatment in both arms (from 16.17 to 10.92 in fractional CO2 arm (p = 0.026) and 23.13 to 22.43 (p = 0.92)). When comparing both groups OSI score significantly reduced in the fractional CO2 laser combined with tioconazole more than the Q-switched laser group (p = 0.002). The mean DLQI score significantly improved in both groups but no statistically significant difference between the two groups. Significant improvement in patient satisfaction score was noted in both groups. Mycological cure using KOH examination was detected in both groups (44.4% in the CO2 group and 56.5% in the Q-switched group) with no significant difference (P value < 0.05). Ruin pattern keratosis found to be the most dermoscopic pattern to be associated with poor OSI score improvement. Fractional CO2 laser combined with topical tioconazole is more efficient in treatment of onychomycosis than Q-Switched Nd: YAG 1064 nm laser group as regards clinical improvement but both have comparable effect on mycological cure. Their use as adjuvant treatment rather than alone is recommended to ensure mycological cure in onychomycosis.

In this research, women were diagnosed as pregnant based on blood serum samples Raman spectroscopy. Raman spectroscopy is a vibrational technique that provides information on the chemical composition of samples. The Raman techniques have significantly impacted the study of various degenerative diseases, particularly cancer detection, using less invasive methods such as the analysis of blood serum samples. Additionally, these techniques have been used to study the health status of patients, which is often difficult to monitor using conventional techniques. This study obtained serum samples from 12 women diagnosed as pregnant and 11 non-pregnant volunteers (controls). Spectra were collected using a LabRAM HR800 Raman Spectrometer (Horiba Jobin-Yvon) with an 830 nm wavelength laser. For each serum sample, 10 Raman spectra were obtained by focusing the laser, using a $100\times$ microscope objective, on different points of the sample with an exposure time of 40 seconds and an irradiation power of 17 mW. The raw spectra were processed using baseline correction and smoothing to remove noise, fluorescence, and shot noise. Subsequently, the spectra were normalized and analyzed using the multivariate statistical method of Principal Component Analysis (PCA). In these spectra, the characteristic bands of main blood serum biomolecules such as phenylalanine (Phe), tyrosine (Tyr), glutathione, amide III, phospholipid, carotene, and tryptophan (Trp) can be observed. Nevertheless, when analyzing the average spectra of pregnant and non-pregnant women, the main spectral differences were associated with variations in molecules like glutathione, tryptophan (Trp), tyrosine, and phenylalanine, which occur during the first trimesters of pregnancy. This aligns with findings previously reported by other studies. Furthermore, the serum samples from pregnant and non-pregnant patients can be effectively discriminated using PCA applied to the Raman spectra, revealing two distinct clusters in the PCA plot corresponding to each group's status. The results demonstrate that pregnancy can be determined based on blood serum samples Raman spectroscopy with $92.5\%$ sensitivity and $97.3\%$ specificity. Although there are very effective devices on the market to determine pregnancy based on the Human Chorionic Gonadotropin (HCG) hormone detection in urine samples, these preliminary results indicate an alternative method known as Raman spectroscopy. On the other hand, the results could also suggest the possibility of carrying out other gynecological or fetal-related studies in women using these Raman techniques.

This review aimed to determine whether photobiomodulation therapy (PBMT) is a safe and effective alternative for treating and preventing OM in children. The database search was carried out on PubMed, Embase, and Cochrane. Gray literature was also consulted through Google Scholar. Among 20 studies included, no adverse effect was reported, and only one study did not show any evidence of benefit from the use of PBMT. The analgesic effect of PBMT was emphasized and its action in accelerating the healing process and reducing the severity, duration and even incidence of OM was also noted. Evidence was found to encourage the use of PBMT to treat OM in pediatric patients. Higher quality studies must be developed in order to clarify the PBMT prophylactic effect and the best protocols for each clinical situation.The protocol of this review was registered on PROSPERO (CRD42023418109).

Striae distensae (SD) are a prevalent dermatological concern of women and approximately 90% of pregnant women experience these stretch marks. Fractional microneedle radiofrequency (FMR) and fractional CO2 laser (FCL) have gained substantial attention in the treatment of SD. In clinical studies, a clear superiority between FMR and FCL treatments is not found due to limited studies and sample sizes. In this systematic review and meta-analysis, a search of English-language articles was performed on PubMed, employing various combinations of keywords "fractional CO2 laser," "microneedle radiofrequency," and "striae". Studies that compared the treatments of FMR and FCL for SD and provided data regarding professional evaluation of improvement, patient self-assessment, and/or the presence of post-inflammatory hyperpigmentation (PIH) were included. We analyzed the incorporated studies utilizing both random and fixed-effects models to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Professional assessments of improvement showed no statistically significant difference between the FMR and FCL groups (OR: 1.27; 95% CI: 0.49-3.31). Similarly, patient self-assessments of improvement did not exhibit a significant difference (OR: 0.72; 95% CI: 0.13-3.90). However, the development of PIH was significantly less frequent in the FMR group when compared to the FCL group (OR: 0.24; 95% CI: 0.08-0.70). Both FMR and FCL demonstrate comparable performance in terms of improving lesions, as assessed by both healthcare professionals and patients. However, FCL is associated with a higher risk of developing PIH. This finding can guide clinicians especially who prefer a single treatment.

This study aims to evaluate and compare the short-term efficacies of high-intensity laser therapy (HILT) and ESWT(focused) on pain, sensitivity, handgrip strength and functions, in the treatment of lateral epicondylitis (LE). Fourty seven patients (age range, 18 to 65 years) with unilateral elbow pain were randomized into two groups. HILT group (n = 24) and ESWT group(n = 23). The HILT and ESWT were administered three times a week for three weeks, and each treatment was combined with exercises. All paticipant in both of two groups were evaluated with ultrasonography for common extansor tendon thickness. A visual analog scale (VAS), quick Disabilities of the Arm, Shoulder, and Hand (QDASH), hand grip strength test were used to evaluate the patients before, one and six weeks after treatment. There were significant improvement in VAS, hand grip strength, QuickDASH scores and CET thickness before and after treatment in both group(p < 0,05). But there were no significant differences between the groups pre-treatment, at the 1st week, and 6th week after treatment (p > 0.05). Only hand grip strength was smilar to the pretreatment outcomes in HILT group. Both treatment methods were found to be effective and safe in the short-term treatment of LE. Consequently, these non-invasive, effective and safe techniques can be successfully used in the treatment of common pathology of the elbow.

The aim of this study was to investigate the bond strength between PEEK/PEKK and composite resins after various laser treatments and to compare the effectiveness of lasers on these polymers. 130 disc-shaped PEEK and PEKK blocks were obtained (10 mm diameter-4 mm height). One sample from each group (10 in total) was selected for scanning electron microscopy (SEM) analysis. The samples were randomly divided into 5 different surface treatment groups for each material (PEEK and PEKK): Er: YAG laser, Nd: YAG laser, diode laser, femtosecond laser and control (no surface treatment) (n = 12). Baseline and post-treatment surface roughness measurements were performed using a profilometer. The composite resin was bonded and SBS was measured. Comparisons among the groups were conducted via Kruskal-Wallis, one-way ANOVA; Tukey and Dunn tests were used as a post hoc test (p ≤ 0.05). All lasers significantly increased the roughness values of the PEEK and PEKK samples. In terms of shear bond strength; the Er: YAG and femtosecond laser groups had the highest values and the Nd: YAG, diode and control groups had the lowest values of the PEEK samples (p ≤ 0.05). The control group had the highest bond strength values and the femtosecond group had the lowest values for PEKK samples (p ≤ 0.05). All laser treatments increased the surface roughness of the PEEK and PEKK. Lasers increased the bond strength of PEEK to the veneering composite resin and decreased the bond strength values of PEKK. This shows that lasers behave differently in PEEK and PEKK materials.

Photodynamic therapy (PDT) is an alternative to cancer treatment, demonstrating selectivity and significant cytotoxicity on malignant tissues. Such therapy involves two nontoxic components: photosensitizer (PS) and non-ionizing radiation. In optimal dosage combinations, PDT causes cellular and tissue effects by oxygen-dependent processes, leading tumor cells to regulated cell death pathways. Regulated necrosis, called necroptosis, can be triggered by PDT and is characterized by caspase-8 inhibition and RIPK1, RIPK3, and MLKL activities, leading to plasma membrane pores formation with subsequent cellular content release into the extracellular space. For this review, studies accessed by PubMed describing the relation between necroptosis and PDT were summarized. The results showed that PDT can trigger necroptosis mechanisms in different tumor cells. Moreover, a mix of different cell death types can co-occur. It is also important to highlight that necroptosis triggered by PDT is related to damage-associated molecular patterns (DAMPs) release, involving immunogenic cell death and vaccination. The cell death response is directly related to the photosensitizer chemical characteristics, concentration, incubation time, cellular location, and irradiation parameters. The synergism among all cell death types is an excellent advantage for avowing tumor resistance mechanisms and developing new solutions.