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1.
Arch Esp Urol ; 74(3): 343-349, 2021 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33818431

RESUMEN

OBJECTIVES: With the spread of more powerful lasers and the advent of new technologies, endoscopic interventions for urolithiasis are continuously evolving. The aim of this study is to present our experience and technique regarding Low Energy (LE)/High Frequency (HF) lithotripsy by using a 120-W Holmium laser (Lumenis®). METHODS: We retrospectively analysed our prospectively maintained Retrograde Intra Renal Surgery (RIRS) database. Lithotripsy was performed using LE/HF settings with a Long Pulse Width (LPW) and consisted of the following steps: 1) contact Laser lithotripsy (LE/HF/LPW dusting - 0,5 J/50 Hz or 02 J/70 Hz); 2) extraction ofmain fragments; 3) non-contact Laser lithotripsy (LE/HF/Short Pulse Width Pop Dusting - 0,5 J /80Hz). Pre-operativeand peri-operative outcomes were collected. Post-operative complications were recorded according to Clavien-Dindo Grading System. Finally, all patients under went a CT scan at three months after RIRS to assess the success of procedure, defined as stone-free or presence of ≤4 mm fragments (Clinical Insignificant Residual Fragments - CIRF). RESULTS: Overall, 104 LE/HF/LPW RIRS from December 2017 to January 2019 were performed. Mean operative time was 59 (SD ±23) minutes, median post-operative stay was two days (IQR 2-3). The post-operative complication rate was 4,8%: one patient had nausea and vomiting (Clavien-Dindo I) and four patients developed urosepsis (Clavien-Dindo II). The success rate was 88,5% (71,2% stone-free and 17,3% CIRF). CONCLUSIONS: LE/HF/LPW RIRS seems to be safe and effective in terms of positive success rate, safety and standard operative time. However, randomized clinical trials are needed to compare this technique to standard RIRS.


Asunto(s)
Cálculos Renales , Láseres de Estado Sólido , Litotripsia por Láser , Humanos , Cálculos Renales/cirugía , Láseres de Estado Sólido/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento , Ureteroscopía
2.
Artículo en Inglés | MEDLINE | ID: mdl-33819321

RESUMEN

This paper reports on a study undertaken to ascertain the efficacy of the erbium:YAG laser (EYL) for peri-implantitis treatment. A total of 12 patients with bone loss resulting from peri-implantitis were involved in this study. The treatment protocol consisted of using the EYL for implant surface debridement and deproteinized bovine bone mineral (DBBM) for bone grafting. The following parameters were analyzed: probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), bone levels (BLs), and the lipopolysaccharide levels before and after debridement with the EYL. This study found a statistically significant improvement in PPD, CAL, BOP, and BL at 3 and 12 months postoperative. Furthermore, a statistically significant decrease in implant-surface LPS levels was observed following debridement with the EYL. These findings show that using the EYL for debridement in peri-implantitis cases is effective in decreasing LPS levels. Moreover, after partial reconstruction with DBBM grafting, BLs were restored for at least 12 months. It was shown in one case that BLs had remained stable over 6 years, which also attests to the efficacy of this treatment. The combined use of EYL and DBBM could be effective for regenerative surgical peri-implantitis treatment.


Asunto(s)
Implantes Dentales , Láseres de Estado Sólido , Periimplantitis , Animales , Biomarcadores , Bovinos , Erbio , Humanos , Láseres de Estado Sólido/uso terapéutico , Periimplantitis/cirugía
3.
J Appl Oral Sci ; 29: e20200736, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33825753

RESUMEN

OBJECTIVE: To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges. METHODOLOGY: Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05). RESULTS: G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001). CONCLUSION: All treatments effectively reduced dentin permeability and promoted tubule occlusion after application. COMBINING ND: YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.


Asunto(s)
Desensibilizantes Dentinarios , Láseres de Estado Sólido , Calcio/farmacología , Dentina , Permeabilidad de la Dentina , Láseres de Estado Sólido/uso terapéutico , Microscopía Electrónica de Rastreo
4.
J Appl Oral Sci ; 29: e20200266, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33825761

RESUMEN

OBJECTIVES: We analyzed the effects of the Er:YAG laser used with different parameters on dentinal tubule (DT) occlusion, intrapulpal temperature and pulp tissue morphology in order to determine the optimal parameters for treating dentin hypersensitivity. METHODOLOGY: Dentin specimens prepared from 36 extracted human third molars were randomized into six groups according to the treatment method (n=6 each): control (A); Gluma desensitizer (B); and Er:YAG laser treatment at 0.5 W , 167 J/cm2 (50 mJ, 10 Hz) (C), 1 W , 334 J/cm2 (50 mJ, 20 Hz) (D), 2 W , 668 J/cm2 (100 mJ, 20 Hz) (E), and 4 W and 1336 J/cm2 (200 mJ, 20 Hz) (F). Treatment-induced morphological changes of the dentin surfaces were assessed using scanning electron microscopy (SEM) to find parameters showing optimal dentin tubule occluding efficacy. To further verify the safety of these parameters (0.5 W, 167 J/cm2), intrapulpal temperature changes were recorded during laser irradiation, and morphological alterations of the dental pulp tissue were observed with an upright microscope. RESULTS: Er:YAG laser irradiation at 0.5 W (167 J/cm2) were found to be superior in DT occlusion, with an exposure rate significantly lower than those in the other groups (P<0.05). Intrapulpal temperature changes induced by Er:YAG laser irradiation at 0.5 W (167 J/cm2) with (G) and without (H) water and air cooling were demonstrated to be below the threshold. Also, no significant morphological alterations of the pulp and odontoblasts were observed after irradiation. CONCLUSION: Therefore, 0.5 W (167 J/cm2) is a suitable parameter for Er:YAG laser to occlude DTs, and it is safe to the pulp tissue.


Asunto(s)
Láseres de Estado Sólido , Oclusión Dental , Dentina , Humanos , Láseres de Estado Sólido/uso terapéutico , Microscopía Electrónica de Rastreo
5.
Braz Oral Res ; 35: e29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33605359

RESUMEN

This study evaluated how Er,Cr:YSGG laser, associated or not with 5% fluoride varnish, influences the surface roughness and volume loss of bovine root dentin submitted to erosive and/or abrasive wear. One hundred and twenty dentin specimens were divided into the groups: without preventive treatment (WPT), 5% fluoride varnish (FV); Er,Cr:YSGG laser irradiation (L), and varnish combined with laser (FV + L). The specimens (n = 10) were subdivided into: 1 = erosion (E); 2 = abrasion (A); and 3 = erosion followed by abrasion (E + A). The erosive solution used was a soft-drink (pH = 2.42 at 4ºC) applied in 5-min cycles twice a day for 10d. Abrasive wear involved brushing for 60s with an electric brush (1,600-oscillations/s) at a load of 2.0N. Surface roughness and volume loss were evaluated using a laser scanning confocal microscope. Roughness data were submitted to one-way ANOVA and Tukey post-hoc test. For volume loss, the Kruskal-Wallis and Dunn's post-hoc tests were used (α = 5%). The lowest values of roughness were found in the control areas of all subgroups (p > 0.05). In the experimental area, the [(WPT) + (E+A)] subgroup had a significantly higher roughness (5.712 ± 0.163 µm 2 ) than the other subgroups (p < 0.05). The L and (FV + L) groups had statistically similar roughness, regardless of the type of wear. The (FV + L) group had the lowest volume loss, regardless of the type of wear performed: [(FV + L) + (E)] = 7.5%, [(FV + L) + (A) = 7.3%, and [(FV + L) + (E + A)] = 8.1%. The subgroup [(WPT) + (E + A)] had the highest volume loss (52.3%). The proposed treatments were effective in controlling dentin roughness. Laser irradiation can be an effective method to increase root dentin resistance after challenges and limit problems related to non-carious lesions.


Asunto(s)
Láseres de Estado Sólido , Erosión de los Dientes , Animales , Bovinos , Dentina , Fluoruros , Láseres de Estado Sólido/uso terapéutico , Erosión de los Dientes/etiología , Raíz del Diente , Cepillado Dental
7.
Curr Opin Ophthalmol ; 32(2): 141-147, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33470670

RESUMEN

PURPOSE OF REVIEW: For decades, laser trabeculoplasty has been a well-proven therapeutic option in glaucoma management, and more recently, it has only gained in popularity. One reason for such popularity is that selective laser trabeculoplasty (SLT) is a therapy independent of patient adherence, which is typically low among glaucoma patients. Consequently, the number of studies on SLT has multiplied throughout the past years. This review provides an overview of studies on SLT from the last 12 months. RECENT FINDINGS: The studies on treatment outcome show a wide range of success rates of SLT reaching between 18 and 88%; however, study designs differ and many studies are not directly comparable. The prospective laser trabeculoplasty for open-angle glaucoma and ocular hypertension (LiGHT) trial has demonstrated good efficacy of SLT - 75% of the eyes achieved their target pressure without drops and 58% after a single SLT. SUMMARY: SLT has proven to be effective in lowering IOP with satisfactory success rates even after single SLT. SLT is repeatable independent of patient's adherence.


Asunto(s)
Glaucoma de Ángulo Abierto/cirugía , Terapia por Láser/métodos , Láseres de Estado Sólido/uso terapéutico , Malla Trabecular/cirugía , Trabeculectomía/métodos , Glaucoma de Ángulo Abierto/fisiopatología , Humanos , Presión Intraocular/fisiología , Hipertensión Ocular/fisiopatología , Hipertensión Ocular/cirugía
8.
Int J Pharm ; 595: 120242, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33484919

RESUMEN

Platelet-rich plasma (PRP) is rich in cytokines and growth factors and is a novel approach for tissue regeneration. It can be used for skin rejuvenation but the large molecular size of the actives limits its topical application. In this study, low-fluence laser-facilitated PRP was delivered to evaluate its effect on absorption through the skin, infection-induced wound, and photoaging. The PRP permeation enhancement was compared for two ablative lasers: fractional (CO2) laser and fully-ablative (Er:YAG) laser. In the Franz cell experiment, pig skin was treated with lasers with superficial ablation followed by the application of recombinant cytokines, growth factors, or PRP. The transport of interferon (IFN)-γ and tumor necrosis factor (TNF)-α was negligible in intact skin and stratum corneum (SC)-stripped skin. Both lasers significantly elevated skin deposition of IFN-γ and TNF-α from PRP, and fully-ablative laser showed a higher penetration enhancement. A similar tendency was found for vascular endothelial growth factor and epidermal growth factor. Er:YAG laser-exposed skin displayed 1.8- and 3.9-fold higher skin deposition of platelet-derived growth factor (PDGF)-BB and transforming growth factor (TGF)-ß1 from PRP, respectively. According to the confocal images, both laser interventions led to an extensive and deep distribution of IFN-γ and PDGF-BB in the skin. In the in vivo methicillin-resistant Staphylococcus aureus (MRSA) infection model, CO2 laser- and Er:YAG laser-assisted PRP delivery reduced bacterial load from 1.8 × 106 to 5.9 × 105 and 1.4 × 104 colony-forming units, respectively. The open wound induced by MRSA was closed by the laser-assisted PRP penetration. In the mouse photoaging model, elastin and collagen deposition were fully restored by combined PRP and full-ablative laser but not by PRP alone and PRP combined with fractional laser. Laser-facilitated PRP delivery even with a low fluence setting can be considered a promising strategy for treating some dermatological disorders.


Asunto(s)
Terapia por Luz de Baja Intensidad/métodos , Staphylococcus aureus Resistente a Meticilina/efectos de la radiación , Plasma Rico en Plaquetas/metabolismo , Envejecimiento de la Piel/efectos de la radiación , Enfermedades de la Piel/terapia , Piel/efectos de la radiación , Infecciones Cutáneas Estafilocócicas/terapia , Administración Cutánea , Animales , Terapia Combinada , Citocinas/farmacocinética , Humanos , Péptidos y Proteínas de Señalización Intercelular/farmacocinética , Láseres de Gas/uso terapéutico , Láseres de Estado Sólido/uso terapéutico , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Piel/diagnóstico por imagen , Piel/efectos de los fármacos , Piel/metabolismo , Absorción Cutánea/efectos de la radiación , Envejecimiento de la Piel/efectos de los fármacos , Porcinos , Cicatrización de Heridas/efectos de los fármacos , Cicatrización de Heridas/efectos de la radiación
9.
Int J Urol ; 28(3): 333-338, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33327043

RESUMEN

OBJECTIVE: To evaluate the safety, efficacy and cost-effectiveness of holmium enucleation of the prostate and bipolar transurethral enucleation of the prostate. METHODS: In our randomized controlled trial, 120 patients were allocated into two equal groups representing holmium enucleation of the prostate and bipolar enucleation of the prostate. Operative parameters were recorded according to operative, enucleation and resection time in addition to the intraoperative complications. Patients were followed up at 1, 3 and 12 months postoperative to assess the prostate size, post-voiding residual urine, International Prostate Symptom Score, peak urine flow rate and quality of life, and compared with the preoperative parameters. Cost analysis was evaluated for both procedures. RESULTS: We evaluated 107 patients who finished our follow up and their data were analyzed. The prostate size was 135.2 ± 34.8 mL and 125 ± 26.9 mL for holmium enucleation of the prostate and bipolar enucleation of the prostate, respectively. Holmium enucleation of the prostate was associated with a shorter operative time of 83.43 ± 6.92 min compared with 94.7 ± 12.2 min in bipolar enucleation of the prostate groups. Holmium enucleation of the prostate was associated with an earlier catheter removal time and shorter hospital stay compared with bipolar enucleation of the prostate. Postoperative International Prostate Symptom Score, quality of life, post-voiding residual urine, peak urine flow rate, prostate-specific antigen and prostate volume reduction were comparable between both groups, and they both showed statistically significant improvement compared with their preoperative parameters. In the cost analysis, holmium enucleation of the prostate was more cost-effective than bipolar enucleation of the prostate. CONCLUSION: Both holmium enucleation of the prostate and bipolar enucleation of the prostate are safe and effective in the surgical management of large prostatic adenomas. Holmium enucleation of the prostate has a shorter operative time and hospital stay with earlier catheter removal time, and is more cost-effective than bipolar enucleation of the prostate.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Hiperplasia Prostática , Resección Transuretral de la Próstata , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Hiperplasia Prostática/cirugía , Calidad de Vida , Resección Transuretral de la Próstata/efectos adversos
10.
Urologe A ; 60(1): 19-26, 2021 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-33315134

RESUMEN

Management of urolithiasis has undergone fundamental changes with the introduction of extracorporeal shock wave lithotripsy (ESWL) and percutaneous and ureterorenoscopic techniques in the 1980s. Since then, these minimally invasive techniques have been continuously optimized and specific laser techniques for stone disintegration have emerged. Besides the established holmium laser, other types of lasers are also emerging. Especially the thulium fiber laser is the subject of promising research due to its variable adjustment options. In terms of patient safety, both holmium and thulium techniques seem to be similar . While serious direct physical lesions are rare, there is increasing evidence of clinically relevant secondary thermal injury due to increased temperatures in the upper urinary tract during treatment. Our research group has recently demonstrated in both in vitro and in vivo (porcine animal model) experiments that monitoring the fluorescence spectra of calculi allows precise target differentiation between stone, tissue, and endoscope components. Consequently, pulse emissions were only emitted when stone material was detected. We believe that target monitoring will minimize the risk of laser-induced urothelial damage and decrease energy release into the upper urinary tract allowing adequate temperature management.


Asunto(s)
Láseres de Estado Sólido , Litotripsia por Láser , Litotricia , Urolitiasis , Animales , Humanos , Láseres de Estado Sólido/uso terapéutico , Seguridad del Paciente , Porcinos , Ureteroscopía/efectos adversos , Urolitiasis/terapia
11.
Int. j. med. surg. sci. (Print) ; 7(4): 1-20, dic. 2020. tab, ilus
Artículo en Español | LILACS | ID: biblio-1151709

RESUMEN

El propósito de este artículo es mejorar nuestro conocimiento sobre las estructuras y función de los diferentes elementos presentes en la boca del recién nacido, ya que en ocasiones los odontólogos no recuerdan la importancia de la boca en el desarrollo general del lactante y la necesidad de una intervención temprana con láseres para ayudarles a obtener un buen estado de su sistema oral. Realizamos una exploración clínica integral del paciente con el fin de realizar un diagnóstico más preciso. Cuando la cirugía sea necesaria, recomendamos utilizar láseres de Erbio siempre que sea posible (láser de 2780nm Er, Cr: YSGG o un Er: YAG de 2940nm), ya que es una opción rápida y eficaz para tratar estas lesiones orales, especialmente los frenillos labiales o linguales que pueden poner en riesgo el acto de amamantar; Asimismo podemos utilizar láseres de diodo (810nm, 940nm, 980 nm o un láser Nd: YAG de 1064nm o de CO2 10.600- 9600 nm) con sus gafas de seguridad específicas. Estos sistemas láser utilizados por un profesional certificado, en colaboración con un personal debidamente entrenado, son un factor muy importante durante la cirugía. Al tener un conocimiento adecuado de las estructuras orales y sus patologías, podemos diagnosticar si esos trastornos deben tratarse quirúrgicamente y, de ser así, cómo proceder con los sistemas láser, ya que son procedimientos mínimamente invasivos; o si debiésemos recomendar a los padres que visiten a un terapeuta miofuncional para ayudar a recuperar la función normal. La comprensión de las estructuras orales de los recién nacidos es muy importante para promover el desarrollo del crecimiento craneofacial y para brindar un servicio importante a las madres, dándoles a sus bebés un buen comienzo en la vida desde una etapa muy temprana. Necesitamos mejorar la colaboración entre profesionales de diferentes disciplinas con el fin de mejorar nuestro conocimiento.


The purpose of this article is to improve our knowledge about the structures and function of the different elements present in the mouth of newborns since dentists sometimes do not remember the importance of the mouth in the general development of infants and the need for an early intervention with lasers to help them obtain a good state of their Oral System. We performed a comprehensive clinical exploration of the patient in order to make a more accurate diagnosis. When surgery is necessary, we recommend to use erbium lasers when possible (2780nm Er, Cr: YSGG laser or a 2940nm Er: YAG), as they are a quick and effective option to treat these oral lesions, especially lip or tongue ties which can risk the act of breastfeeding; moreover, we can also use diode lasers (810nm, 940nm, 980nm or a 1064nm Nd:YAG laser or CO2 10.600-9600 nm.) al lof them with their specifical safety goggles. These laser systems used by a certified professional, in collaboration with a properly trained staff, are a very important factor during the surgery.By having proper knowledge of the oral structures and their pathologies, we are able to diagnose whether those disorders should be surgically treated and if so, how to proceed with laser systems as they are minimally invasive procedures; or if we should recommend parents to visit a myofunctional therapist in order to help recover the normal function.The understanding of oral structures of newborns is very important in order to improve the development of craniofacial growth and provide an important service to mothers by giving their babies a right start in life from a very early stage. We need to improve collaboration between professionals from different disciplines in order to enhance our knowledge.


Asunto(s)
Humanos , Recién Nacido , Láseres de Semiconductores/uso terapéutico , Láseres de Estado Sólido/uso terapéutico , Boca/cirugía , Procedimientos Quirúrgicos Orales , Anquiloglosia/cirugía , Frenillo Labial/cirugía
12.
Zhonghua Nan Ke Xue ; 26(8): 731-735, 2020 Aug.
Artículo en Chino | MEDLINE | ID: mdl-33377736

RESUMEN

Objective: To investigate the clinical effect and safety of transurethral decompression and drainage with holmium laser in the treatment of prostatic abscess. METHODS: We retrospectively analyzed the clinical data on 13 cases of prostatic abscess treated in our hospital from January 2015 to May 2019. One of the patients was cured by drug therapy while the other 12 underwent transurethral decompression and drainage with holmium laser after failure in medication. We recorded such postoperative symptoms as fever, frequent urination, urgent urination, painful urination, tenteria, dysuria and abdominal distension, obtained the dynamical indices of blood and urine routine and culture after surgery, and performed MRI during the follow-up for possible recurrence and complications. Those with disappearance of the clinical symptoms, negative results of urine leukocyte and pathogen examinations, and no recurrence revealed by MRI were considered to be cured. RESULTS: After operation, the clinical symptoms were improved significantly and the urinary catheters removed within 5-10 days in all the cases. At 3-5 days after removal of the catheters, all the patients experienced smooth urination, with no urinary retention or urethral stricture. The patients were followed up for 3-16 months, during which no recurrence was observed. CONCLUSIONS: Transurethral decompression and drainage with holmium laser can achieve a definite clinical effect in the treatment of prostatic abscess and therefore deserves to be promoted in clinical practice.


Asunto(s)
Absceso/cirugía , Descompresión Quirúrgica , Drenaje , Terapia por Láser , Láseres de Estado Sólido , Hiperplasia Prostática , Holmio , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Hiperplasia Prostática/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
13.
Angle Orthod ; 90(3): 369-375, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378425

RESUMEN

OBJECTIVES: To compare the effect of use of laser, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and their combination on prevention of enamel demineralization using polarized light microscopy to assess lesion depth. MATERIALS AND METHODS: Eighty premolars were randomly allocated to four equal groups (n = 20): Group I: Control group, no preventive measures. Group II: CPP-ACP. Group III: Er,Cr:YSGG laser. Group IV: Er,Cr:YSGG laser followed by CPP-ACP. Specimens were subjected to thermocycling and brushing protocols equivalent to 1 year intraorally. Then, all teeth were subjected to acid challenge. Teeth were then sectioned longitudinally and examined under a polarized light microscope and lesion depth was measured. RESULTS: Group IV resulted in the least lesion depth with a significant difference between it and all other groups. CPP-ACP alone and laser alone also showed a significant difference in white spot lesion (WSL) depth compared to the control group; however, no significant difference was found between them. CONCLUSIONS: The combined use of laser and CPP-ACP showed the best prevention against WSL development. The use of CPP-ACP or laser alone also resulted in a significant reduction in lesion depth but was significantly less than their combined use, with no significant difference between them.


Asunto(s)
Láseres de Estado Sólido , Desmineralización Dental , Fosfatos de Calcio , Caseínas/uso terapéutico , Esmalte Dental , Humanos , Láseres de Estado Sólido/uso terapéutico , Fosfopéptidos , Desmineralización Dental/prevención & control , Remineralización Dental
14.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-33370935

RESUMEN

We report the case of a 35-year-old woman who presented with recurrent macroscopic haematuria and known diagnosis of Klippel-Trenaunay syndrome. Imaging and cystoscopy identified an extensive venous malformation involving a large area of the bladder wall. Holmium laser therapy was ineffective at obtaining symptom control. Following a multidisciplinary team meeting, transvenous sclerotherapy with sodium tetradecyl sulphate was performed under image guidance. A reduction in venous density was observed on cystoscopy and the patient has had complete resolution of symptoms within 6 weeks and continued to be asymptomatic up to 24-month follow-up. We propose that transvenous sclerotherapy is considered first-line treatment in this clinical setting.


Asunto(s)
Hematuria/terapia , Síndrome de Klippel-Trenaunay-Weber/complicaciones , Escleroterapia/métodos , Malformaciones Vasculares/terapia , Venas/patología , Administración Intravenosa , Adulto , Cistoscopía , Femenino , Hematuria/etiología , Humanos , Síndrome de Klippel-Trenaunay-Weber/terapia , Láseres de Estado Sólido/uso terapéutico , Angiografía por Resonancia Magnética , Soluciones Esclerosantes/administración & dosificación , Tetradecil Sulfato de Sodio/administración & dosificación , Resultado del Tratamiento , Vejiga Urinaria/irrigación sanguínea , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/patología , Malformaciones Vasculares/diagnóstico , Malformaciones Vasculares/etiología , Malformaciones Vasculares/patología , Venas/diagnóstico por imagen , Venas/efectos de los fármacos
15.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-33370975

RESUMEN

A 52-year-old man presented with lower urinary tract symptoms and intermittent haematuria for the last 6 months. He had undergone totally extraperitoneal right inguinal hernia repair a decade ago. The ultrasonography and an X-ray of the pelvis suggested a large radio-opaque shadow in the bladder. However, CT revealed an encrusted intravesical extension of the migrated mesh along the right anterolateral wall. The entire intravesical part of the migrated mesh with encrustations was successfully retrieved by endourological approach using holmium laser. The patient symptomatically improved and at follow-up, cystoscopy showed a complete re-epithelisation of the bladder mucosa. The intravesical extension of migrated mesh is a rare but challenging complication following mesh hernioplasty and can be successfully managed with a complete endoscopic approach.


Asunto(s)
Remoción de Dispositivos/métodos , Migración de Cuerpo Extraño/cirugía , Herniorrafia/efectos adversos , Láseres de Estado Sólido/uso terapéutico , Falla de Prótesis , Mallas Quirúrgicas/efectos adversos , Cistoscopía , Remoción de Dispositivos/instrumentación , Migración de Cuerpo Extraño/complicaciones , Migración de Cuerpo Extraño/diagnóstico , Hematuria/diagnóstico , Hematuria/etiología , Hematuria/cirugía , Hernia Inguinal/cirugía , Herniorrafia/instrumentación , Humanos , Síntomas del Sistema Urinario Inferior/diagnóstico , Síntomas del Sistema Urinario Inferior/etiología , Síntomas del Sistema Urinario Inferior/cirugía , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Ultrasonografía , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/cirugía
16.
Zhonghua Nan Ke Xue ; 26(10): 888-894, 2020 Nov.
Artículo en Chino | MEDLINE | ID: mdl-33382219

RESUMEN

Objective: To investigate the advantages and disadvantages of point electro-cauterization (PEC) and holmium laser cauterization (HLC) in the treatment of post-ejaculation hematuria. METHODS: From January 2015 to December 2018, 73 patients with post-ejaculation hematuria, aged 24-63 (36.8 ± 4.2) years, underwent PEC (n = 35) or HLC (n = 38) after failure to respond to 3 months of conservative treatment. We compared the hospital days, total hospitalization expenses, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Anxiety Rating Scale (HAMA) score, postoperative duration of hematuria, and recurrence rate at 3 and 6 months after surgery. RESULTS: All the patients experienced first ejaculation but no post-ejaculation hematuria at 1 month after operation. The recurrence rates were lower in the PEC than in the HLC group at 3 months (5.71% vs 2.63%, P > 0.05) and 6 months postoperatively (8.57% vs 5.26%, P > 0.05). Compared with the baseline, the Qmax was decreased from (18.56 ± 2.53) ml/s to (13.68 ± 3.31) ml/s (P < 0.05) and the Qavg from (14.35 ± 2.26) ml/s to (9.69±1.84) ml/s in the PEC group at 1 month after surgery (P < 0.01), but neither showed any statistically significant difference in the HLC group. Mild to moderate anxiety was prevalent in the patients preoperatively, particularly in those without job or regular income and those with a long disease course or frequent onset, the severity of which was not correlated with age, education or marital status. The HAMA score was decreased from18.65 ± 4.33 before to 12.35 ± 3.63 after surgery in the PEC group (P < 0.01), and from 16.88 ± 2.11 to 6.87 ± 4.36 in the HLC group (P < 0.01). The mean hospital stay was significantly longer in the former than in the latter group (ï¼»5.2 + 1.3ï¼½ vs ï¼»3.4 ± 0.5ï¼½ d, P < 0.01), while the total cost markedly lower (ï¼»6.35 ± 1.20ï¼½ vs ï¼»12.72 ± 2.15ï¼½ thousand RMB ¥, P < 0.05). CONCLUSIONS: Both PEC and HLC are safe and effective for the treatment of post-ejaculation hematuria, with no significant difference in the recurrence rate at 3 and 6 months after operation, but their long-term effect needs further follow-up studies. PEC may increase the risk of negative outcomes of the postoperative urinary flow rate, while HLC has the advantages of better relieving the patient's anxiety, sooner discharge from hospital and earlier recovery from postoperative hematuria, though with a higher total cost than the former.


Asunto(s)
Cauterización , Eyaculación , Hematuria/cirugía , Terapia por Láser , Láseres de Estado Sólido , Adulto , Hematuria/etiología , Holmio , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
17.
Arch Esp Urol ; 73(9): 803-812, 2020 Nov.
Artículo en Español | MEDLINE | ID: mdl-33144534

RESUMEN

INTRODUCTION: The Holmium laser is the most used energy source in flexible ureterrenoscopy (URSf). The Lumenis Pulse 120H® laser has a higher system energy, a higher energy per pulse and a higher repetition frequency in relation to other types of lasers, which offers advantages in the treatment of lithiasis. OBJECTIVE: To analyze the results that we have obtained with the use of the Lumenis Pulse120H® laser in patients treated by intrarenal retrograde surgery (RIRS). As secondary objectives there are: the study of the demographic variables of the patients, the characteristics of the stones and the complications associated with the procedure. MATERIAL AND METHODS: An observational, retrospective study of the first 26 patients treated by RIRS and Lumenis Pulse 120H® laser has been performed in our Service between August 2018 and February 2019. The size of the lithiasis was measured on the simple radiography and the CT, in addition, the volume of the lithiasis was calculated. For the realization of RIRS, 8.5Fr digital flexible ureterorenoscope (Olympus®) and the Holmium Lumenis 120H® laser with 200 micron laser fibers from Lumenis® were used. Statistical analysis was performed with the SPSSv21 system. RESULTS: A total of 26 patients with renal lithiasis have been analyzed. The median age was 55.15 years (40.67-67.05). 57.7% of the patients had prior surgical treatment of lithiasis. Thirteen patients presented the litiasis in the renal pelvis, ten in the Upper Calicial Group (GCS), fifteen in the Middle Calicial Group (GCM) and eighteen in the Lower Calicial Group (GCI). The median of the lithiasic volume was 1826.41 mm3. Our overall success rate was 80.8% (100% success in lithiasis less than 2 cm and 85.7% in lithiasis between 2-3 cm). Five patients presented complications, of which 4 were ClavienII and 1 Clavien IIIb. No significant results were found between the lithiasic size and the presence of complications (p = 0.128). CONCLUSIONS: The use of the Lumenis Pulse 120H®laser is an useful tool for the treatment of kidney stones by RIRS, due to his efficiency in the fragmentation and dusting, taking into account that very large lithiasic masses require, in a high percentage of cases, more than one treatment session.


Asunto(s)
Cálculos Renales , Láseres de Estado Sólido , Litiasis , Holmio , Humanos , Cálculos Renales/cirugía , Láseres de Estado Sólido/uso terapéutico , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
18.
Artículo en Inglés | MEDLINE | ID: mdl-33151184

RESUMEN

This investigation was designed to evaluate the reestablishment of bone-to-implant contact on infected dental implant surfaces following decontamination with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser and reconstructive therapy. Three patients presenting with at least one failing implant each were enrolled and consented to treatment with the Er,Cr:YSGG laser surface decontamination and reconstruction with a bone replacement allograft and a collagen membrane. The laser treatment was carried out at a setting of 1.5 W, air/water of 40%/50%, and pulse rate of 30 Hz. At 6 months, all three patients returned for the study. En bloc biopsy samples of four implants were obtained and analyzed. Two patients had excellent clinical outcomes, while one patient with two adjacent failing implants experienced an early implant exposure during the follow-up period. There was histologic evidence of new bone formation with two implant specimens and less bone gain with the others. Despite the small sample size, these were optimistic findings that suggested a positive role of Er,Cr:YSGG laser in debridement of a titanium implant surface to facilitate subsequent regenerative treatment. This investigation provides histologic evidence as well as encouraging clinical results that use of the Er,Cr:YSGG laser can be beneficial for treatment of peri-implantitis, but further long-term clinical studies are needed to investigate the treatment outcome obtained.


Asunto(s)
Implantes Dentales , Láseres de Estado Sólido , Implantes Dentales/efectos adversos , Erbio , Humanos , Láseres de Estado Sólido/uso terapéutico , Titanio , Itrio
19.
Shanghai Kou Qiang Yi Xue ; 29(3): 308-311, 2020 Jun.
Artículo en Chino | MEDLINE | ID: mdl-33043350

RESUMEN

PURPOSE: To evaluate the clinical efficacy of erbium-doped yttrium aluminium garnet (Er: YAG) laser in the treatment of degree II bifurcation periodontitis. METHODS: Thirty patients(60 teeth) with grade II bifurcation lesions of chronic periodontitis were enrolled in this study. One week after supergingival scaling with ultrasound, the patients were randomly divided into experimental group: subgingival scaling with ultrasound and hand instruments + Er: YAG laser irradiation in periodontal pocket; control group: the contralateral homonymous teeth were treated with subgingival scaling with ultrasound and hand instruments alone. The changes of gingival index(GI), pocket depth(PD), horizontal probing depth (HPD) and attachment loss(AL) were compared between the two groups 12 and 20 weeks after treatment. SPSS 20.0 software package was used for statistical analysis. RESULTS: Periodontal clinical indexes(GI, PD, HPD, AL) of the experimental group and control group were significantly reduced compared with baseline at 12 and 20 weeks after treatment(P<0.05). At 12 and 20 weeks after treatment, PD in the experimental group was (4.03±0.48) mm and (3.43±0.45) mm, (4.82±0.55) mm and (4.27±0.36) mm in the control group, respectively. The reduction of PD in the experimental group was significantly greater than that in the control group (P<0.05). There was no significant difference in HPD between the two groups at 12 weeks after treatment. Twenty weeks after operation, HPD in the experimental group was found to be (3.01±0.34) mm and (3.78±0.29) mm in the control group. The decrease of HPD in the experimental group was significantly greater than that in the control group (P<0.05). GI and AL of the experimental group at 12 and 20 weeks were lower than those of the control group, but the difference was not statistically significant. CONCLUSIONS: Er: YAG laser is safe and effective in the treatment of chronic periodontitis patients with grade II root bifurcation lesions with significant clinical value.


Asunto(s)
Periodontitis Crónica , Láseres de Estado Sólido , Periodontitis Crónica/terapia , Raspado Dental , Humanos , Láseres de Estado Sólido/uso terapéutico , Índice Periodontal , Bolsa Periodontal
20.
Arch Esp Urol ; 73(8): 682-688, 2020 Oct.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33025913

RESUMEN

Thulium lasers operate at wavelengths between1940-2013 nm either in a continuous wave or in a pulsed mode, which enables smooth incisions with fast vaporization or effective laser lithotripsy for urolithiasis. Thulium laser enucleation is a minimally invasive and size-independent treatment for benign prostatic hyperplasia (BPH) with excellent long-term results. Since its introduction, several modifications in the technology and surgical techniques have been proposed such as vaporesection, vaporization and enucleation with regard to BPH treatment. Recent developments in the thulium laser technology include the introduction of a super pulsed thulium fiberlaser.  This technique delivers the laser energy through anactive fiber with an absorption maximum in water at awavelength of 1940 µm. Preclinical studies showed asignificantly higher stone fragmentation rate in differentex vivo models compared to the Ho:YAG laser. Another innovative thulium laser that works, as a hybrid laser has yet not been tested clinically, however, will soon be introduced. With the introduction of both new thulium lasers as novel devices, the armamentarium in the field of endourology for lithotripsy and enucleation increases. We here present different thulium lasers and surgical techniques that are possible to perform with each device including the reasons and advantages of each modification.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Litotripsia por Láser , Hiperplasia Prostática , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Hiperplasia Prostática/cirugía , Tulio
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