Lasers in Medical Science最新文献

Purpose: RVVC is defined as four or more episodes of candidiasis in a 12-month period. Conventional treatment is complex and often involves long-term medication use or multiple treatments. ABL therapy is a promising treatment option as it is acceptable to women and has only rare side effects. We conducted a prospective study with the objective of assessing the effects of antimicrobial blue light (ABL) therapy for recurrent vulvovaginal candidiasis (RVVC) in drug-resistant women.

Methods: Our study enrolled RVVC drug-resistant women (defined based on clinical non-response to standard azole therapies confirmed through culture or persistence of VVC symptoms (oedema, erythema, pruritus, burning, dysuria and leucorrhea)), who received ABL through 10 sessions for 20 min once a week from January 2023 to January 2024. The symptoms of Recurent VVC were assessed after 10 treatment sections and after 6 months.

Results: We included 62 patients. The overall symptoms improvement were 79% immediately after treatment and 58% after 6 months, respectively. There was an improvement in the symptoms of pruritus, burning, oedema, erythema and leucorrhoea.

Conclusion: ABL was an effective therapy to be employed in drug-resistant women suffering from RVVC.

Since the introduction of CO₂ fractional laser in dermatology, multiple clinical evidences have shown its effectiveness in treating alopecia areata(AA). However, the extent of efficacy remains under-researched, with a lack of extensive and large-scale comparisons, which is a topic of global discussion. We present a case of a 13-year-old male child with AA. After taking '10 mg oral prednisone acetate' three times daily, applying' compound Siyadan ointment' twice daily, and receiving CO₂ fractional laser treatment with different parameters on different area once a month. After three months of treatment, the patient's lesions had fully resolved. It was observed that hair growth varied among different parameter regions.

The Endolift® technique, introduced in 2005, gained popularity among medical and non-medical professionals as a non-surgical approach using subdermal laser devices. However, its widespread adoption lacked a thorough understanding of its physiological interaction, resulting in controversies over its effectiveness and safety. This study aimed to assess the evidence of Endolift® efficacy, parametrization, and safety by analyzing adverse events. A systematic literature review was conducted by searching the following databases: NCBI/PubMed, Medline, Embase, CINAHL, and the Cochrane Central Library. These searches resulted in 111 articles. Seven articles were selected after removing duplicates and screening titles, abstracts, and full texts. These articles exhibited a high risk of bias, a lack of standardization in treatment parameters, and reports of adverse events that did not align with clinical reality, often occurring with off-label use.In conclusion, due to insufficient high-quality research and inconsistent indications and parameter adjustments, asserting the efficacy and safety of Endolift® is challenging. Randomized studies are recommended to curb indiscriminate use, which may compromise patient safety. This analysis underscores the importance of evidence-based clinical practices for patient safety and ethical treatment.

Vitiligo is a chronic depigmenting condition that causes amelanotic macules and patches on the skin. Despite various treatment options, treating vitiligo is a challenge. This study aimed to evaluate the combination of laser CO₂ fractional and narrow-band ultraviolet B (NB-UVB) versus NB-UVB monotherapy in vitiligo patients. This was a prospective, self-controlled, and randomized trial. Ten patients with symmetrical vitiligo lesions on both sides of their body and who had a history of insufficient response to conventional therapies were included in this trial. Group A received three sessions of fractional CO₂ laser at 1-month intervals during NB-UVB phototherapy which was performed three times a week for three months. Patients in group B only received phototherapy same as group A. The primary endpoint was the repigmentation rate. The mean age was 34.40 ± 11.93 years (range of 19-63). After the intervention, repigmentation was better in group A and the difference was statistically significant (P = 0.025). Patients in group A showed a better reduction of VASI score than group B (39.12 ± 27.81 Vs. 44.45 ± 30.77), although it was not statistically significant (P = 0.518). VETF and VIDA outcomes were slightly better in Group A than B, but it was not statistically significant (P = 0.317 and P = 0.180, respectively). The results of this study indicated that combining fractional CO₂ laser with NB-UVB is superior to NB-UVB monotherapy, providing a promising modality in vitiligo patients.

Numerous research studies have delved into the potential effect of LASER therapy on alleviating pain associated with plantar fasciitis. However, the distinct effects of both High Intensity and Low Intensity LASER therapy (HILT/LILT) on addressing plantar fasciitis pain have not been thoroughly investigated. This systematic review seeks to provide a comprehensive summary of the present body of literature regarding the use of LASER therapy in managing pain related to plantar fasciitis. A conscientious search across four databases namely Google Scholar, PubMed, PEDro and The Cochrane Library was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, which yielded five pertinent studies out of 21,034 studies that met the predefined inclusion criteria and underwent rigorous evaluation. The assessment tools such as PEDro were employed on these studies for critical review. Although some variations persisted among the research outcomes, a predominant trend highlighted a notable decrease in pain severity on Visual Analogue Scale (VAS)/Numeric Rating Scale-pain (NRS-p) with the adoption of diverse LASER therapy methodologies. Notably, no adverse repercussions were reported across any of the studies, emphasizing the safety profile of these LASER interventions for plantar fasciitis patients. In summation, integrating these LASER therapy approaches alongside conventional therapeutic strategies appears promising for enhancing the efficacy and sustainability of plantar fasciitis pain management. The study protocol has been registered with PROSPERO (CRD42023453098) (International Prospective Register of Systematic Reviews).

Background: Post-inflammatory hyperpigmentation (PIH) is a common cosmetic concern, often leading to significant psychological distress for the patients. With the widespread application of lasers including ablative fractional resurfacing (AFR) with a 10,600 nm CO₂ laser, PIH caused by lasers is becoming increasingly common. But due to the absence of an appropriate animal research model, our understanding of pathophysiological mechanisms and preventive strategies for PIH remains limited.

Methods: This study aimed to establish an animal model to investigate PIH following AFR CO₂ laser application, focusing on the dynamic changes in melanin, inflammatory cytokines, growth factors, and skin structures as PIH developed. We employed pigmented guinea pigs as our experimental subjects and conducted our research in two phases. In the first phase, we utilized three modes of AFR CO₂ laser to identify which laser mode could induce PIH by monitoring dynamic melanin changes. In the second phase, the laser mode that most reliably induced PIH was applied to re-establish the PIH model. Pathophysiological changes during PIH progression were investigated through histopathological observations, real-time quantitative polymerase chain reaction, and two-photon microscopy.

Results: We successfully established a replicable animal model for PIH following AFR CO₂ laser application. We observed a significant increase in inflammatory cytokines and growth factors within the skin tissue by the second week, with stable pigmentation becoming apparent by the third week.

Conclusions: Our research provides a promising animal model for understanding and further investigating the mechanisms of PIH after laser procedures.

Ebm level: V (animal study).

Androgenic alopecia (AGA) is the most common form of non-scarring hair loss, characterized by marked hair follicle miniaturization. AGA is a challenging skin condition with limited treatment results. Laser light can promote hair growth at specific wavelengths. The efficacy of fractional CO2 laser in scalp AGA treatment was reported in a few studies. We aimed to compare the efficacy of fractional CO2 laser alone versus the combination of fractional CO2 laser with topical dutasteride in the treatment of male AGA. 30 male patients with AGA were enrolled in the study; they were divided into two groups. All patients received three sessions of ablative fractional CO2 laser one month apart on the scalp, where group (I) patients were subjected to laser sessions only, and group (II) patients were subjected to topical dutasteride, first immediately after each session and secondly fifteen days after each session. The evaluation was done according to dermoscopy (DermLite^® DL4) and photographic assessment. Patient satisfaction and side effects were reported. According to the global photo assessment, the combination of fractional CO2 laser with topical dutasteride showed a statistically significant improvement compared to the fractional CO2 laser alone group. The combination of fractional CO2 laser with topical dutasteride is more efficient in improving male androgenic alopecia than fractional CO2 laser alone according to the investigator's global assessment. There was a significant improvement in all dermoscopic parameters in both groups.

Objective: This study evaluated dentin morphology and pulp cavity temperature changes during nanosecond‑ and microsecond‑pulse Er, Cr: YSGG laser debonding restoration and residual adhesive.

Materials and methods: Ten caries-free teeth had their enamel removed perpendicular to the long axis, followed by bonding of glass ceramic restorations. The samples were randomly divided into two groups and subjected to Er, Cr: YSGG laser (3 mJ, 100 Hz, 100 ns), (3 mJ, 100 Hz, 150 µs) for debonding of restoration and residual adhesive on dentin surfaces. Thermocouples and scanning electron microscopy were used to monitor pulp cavity temperature and dentin surface morphology during debonding.

Results: Both nanosecond- and microsecond-pulse lasers effectively debonding restorations, leaving residual adhesive on dentin surfaces that required further treatment. The temperature change of pulp cavity with nanosecond pulses laser was 1.8 ℃ and 2.8 ℃ during debonding of restoration and residual adhesive, and with microsecond pulses were also 3.4 ℃ and 5.8 ℃, respectively. The dentinal tubules in the nanosecond pulses laser group were completely opening, while those in the microsecond pulses laser group were partially opening.

Conclusions: Nanosecond pulses of Er, Cr: YSGG laser are preferable over microsecond pulses for debonding restoration and residual adhesive on dentin surfaces. Nanosecond pulses induce smaller temperature changes in the pulp cavity and more pronounced opening of dentinal tubules, facilitating subsequent bonding processes.