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1.
Niger J Clin Pract ; 23(1): 110-115, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31929216

RESUMO

Objective: The aim of this study was to compare to effect of phototherapy and surface flattening after immediately bleaching on the shear bond strength to bleached enamel. Methods: Ninety-six human upper incisors were divided into 4 groups (n = 24). Group NB: no bleached, group P: phototherapy with YSGG laser, group F: 0.5 mm surface flattening, group PF: 0.5 mm surface flattening and phototherapy with Er;Cr:YSGG laser. Then, each group was assigned to 2 subgroups according to adhesive mode (n = 12) as; subgroup S (self-etching mode), subgroup T (total-etching mode) which are universal adhesives. All surface conditionings and restorations were performed with composite resin materials immediately after bleaching. Shear bond strength test was performed by using universal testing machine. The surfaces were also evaluated with SEM. The data were statistically analyzed with one-way ANOVA post-hoc Tukey tests. Results: The lowest SBS values were achieved in FS (13.72 ± 2.29) while the highest ones in PT (28.01 ± 6.81). However, the differences were not significant (P > 0.05). All surface conditioning methods provided SBS values similar to the control (P > 0.05). All subgroups of self-etching mode were significantly lower than their total-etching counterparts (P < 0.05). Conclusions: The present study showed that surface removal and phototherapy have a potential clinical application for eliminate to undesirable effect of bleaching treatment. Surface conditioning with either flattening and/or phototherapy may provide clinicians to restore bleached teeth at the same visit with bleaching and reduce chair-time.


Assuntos
Adesivos/farmacologia , Colagem Dentária/métodos , Esmalte Dentário/efeitos dos fármacos , Corrosão Dentária/métodos , Lasers de Estado Sólido/uso terapêutico , Fototerapia , Resistência ao Cisalhamento , Clareamento Dental , Ataque Ácido Dentário/métodos , Resinas Compostas/química , Materiais Dentários/química , Humanos , Teste de Materiais , Clareamento Dental/métodos
3.
J Urol ; 203(2): 309, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31661373
4.
J Urol ; 203(2): 309-310, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31661376
5.
Urology ; 136: 19-34, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31726185

RESUMO

Tm:YAG laser operates at a wavelength of 1940-2013 nm in a continuous wave mode, which enables smooth incision and rapid vaporization of prostatic tissue, with a shallow penetration of only 0.2 mm. These characteristics make Tm:YAG a versatile laser, allowing the surgeon to perform resection, vaporization, and vapoenucleation. This systematic review aims to summarize the current evidence of safety and efficacy, long-term durability, impact on sexual function following Tm:YAG laser enucleation and vapoenucleation of the prostate and to compare the outcomes of these procedures vs other surgical treatments of benign prostatic hyperplasia.


Assuntos
Terapia a Laser , Lasers de Estado Sólido/uso terapêutico , Prostatectomia/métodos , Túlio , Humanos , Masculino
6.
Urology ; 136: 196-201, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31790785

RESUMO

OBJECTIVE: To compare outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) for lower urinary tract symptoms secondary to benign prostate hyperplasia using 3 different laser fibers and 2 different laser energy modes. MATERIALS AND METHODS: This is a review of a clinic registry of men with lower urinary tract symptoms secondary to benign prostate hyperplasia who underwent HoLEP between August 2018 and January 2019. Patients were assigned to group 1 (50 patients), group 2 (50 patients), and group 3 (50 patients) based on the HoLEP being completed with either a Slimline 550µm, Slimline 1000µm, or MOSES 550 µm laser, respectively. The groups were compared using SSPS for ANOVA comparison of means and multivariate logistic regression. RESULTS: Ten patients who underwent concomitant stone surgery (2 PCNL, 8 ureteroscopy , 3 bilateral cases) and 11 patients had bladder stones removed; ancillary procedures did not significantly differ between groups(P = .2). Prostate enucleation times differed significantly (22.5 + 7.3, 16.4 + 6.9, 18.1 + 8.6 minutes P ≤.001) between groups. However, statistical significance was lost once enucleation time was indexed against enucleated tissue weight. Time to achieve hemostasis (minutes) was statistically different between groups (10.6 + 6.1, 7.7 + 5.2, 6.3 + 4.8 P <.001). This difference in hemostatic time was maintained on multilogistic regression demonstrating that MOSES laser enucleation was associated with a 3.9-minute decrease time to achieve hemostasis after enucleation compared to Slimline 550 HoLEP (P <.001). CONCLUSION: Our findings suggest that modulated pulsed laser energy can improve hemostasis during the enucleation phase of a HoLEP resulting in shorter Operating Room times.


Assuntos
Terapia a Laser/instrumentação , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Sintomas do Trato Urinário Inferior/cirurgia , Prostatectomia/métodos , Hiperplasia Prostática/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/complicações , Estudos Retrospectivos
7.
Urology ; 135: 171-172, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31589882

RESUMO

OBJECTIVE: To demonstrate how bladder ultrasound can be useful in completing morcellation during difficult Holmium Laser Enucleation of the Prostate (HoLEP). As HoLEP has emerged as a standard of care for the treatment of benign prostatic hyperplasia, multiple studies have reported the potentially catastrophic complication of bladder injury during morcellation. This video aims to assist any urologist performing HoLEP by providing step-by-step instruction for using ultrasound to complete morcellation safely. METHODS: Enucleation is performed using a 26-French continuous flow scope, off-set laser bridge with a laser stabilization catheter, and a 550 µm holmium laser fiber. Once the median and lateral lobes have been enucleated, the outer sheath is removed and the nephroscope is inserted to facilitate morcellation. Under dual inflow irrigation, the Piranha morcellator (Richard Wolf, Knittlingen, Germany) is introduced and set to the manufacturer's recommended settings of 1500 rpm. A 3.5-MHz convex abdominal ultrasound transducer (Hitachi Prosound Alpha 7; Hitachi Aloka Medical America, Wallingford, CT) under B-mode is used to visualize the bladder, predominantly in the sagittal orientation. Morcellation proceeds under simultaneous ultrasound and direct cystoscopic guidance. RESULTS: The distended bladder is visualized concurrently with the ultrasound and via the nephroscope as the Piranha engages the adenoma and begins morcellation. Once the adenoma is engaged, the operator then drops their hands to place the morcellator in the center of the bladder. Ultrasound provides real-time feedback as to the location of the morcellator in relation to the adenoma and bladder. CONCLUSION: This video highlights the use of intraoperative bladder ultrasound as a visual aid to assist during the morcellation portion of HoLEP. This proof of concept demonstrates that ultrasound can be an additional tool to utilize during difficult cases when cystoscopic visualization during morcellation is limited.


Assuntos
Complicações Intraoperatórias/prevenção & controle , Terapia a Laser/métodos , Morcelação/métodos , Prostatectomia/métodos , Bexiga Urinária/diagnóstico por imagem , Humanos , Complicações Intraoperatórias/etiologia , Terapia a Laser/efeitos adversos , Terapia a Laser/instrumentação , Lasers de Estado Sólido/efeitos adversos , Lasers de Estado Sólido/uso terapêutico , Masculino , Morcelação/efeitos adversos , Morcelação/instrumentação , Estudo de Prova de Conceito , Próstata/diagnóstico por imagem , Próstata/cirurgia , Prostatectomia/efeitos adversos , Prostatectomia/instrumentação , Hiperplasia Prostática/cirurgia , Ultrassonografia , Bexiga Urinária/lesões
8.
Int J Oral Maxillofac Surg ; 49(1): 99-106, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31230766

RESUMO

This randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT03001791) compared excisional biopsies of fibrous hyperplasia performed using a CO2 laser (140Hz, 400µs, 33mJ), Er:YAG laser (35Hz, 297µs, 200mJ, air-water cooling), or scalpel (15c blade). Clinical parameters recorded were duration of the intervention, intraoperative bleeding, need for electrocauterization and/or suturing, postoperative side effects, complications, pain, and intake of analgesics. Histopathological linear measurements of the thermal damage zone were performed on the laser biopsies. Results showed that the duration of the intervention was significantly shorter for both lasers compared to the scalpel (P<0.001). Intraoperative bleeding occurred less frequently with the CO2 laser (P<0.001). Additional electrocautery was used in 92% of Er:YAG laser interventions (P<0.001). Postsurgical complications, pain, and the intake of analgesics did not differ between the groups. The measured thermal damage zones differed significantly between the CO2 laser (median of 72.6µm) and Er:YAG laser (30.9µm) (P<0.001). This RCT showed that CO2 laser, Er:YAG laser, and scalpel are all adequate for excisional biopsies of small lesions in the oral mucosa. While patient postoperative morbidity is similar, the ideal instrument can be selected according to the surgical advantages preferred for the individual situation.


Assuntos
Terapia a Laser , Lasers de Gás , Lasers de Estado Sólido , Biópsia , Dióxido de Carbono , Humanos , Instrumentos Cirúrgicos
9.
Clin Oral Investig ; 24(1): 357-368, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31102045

RESUMO

OBJECTIVE: The aim of this study was to compare the clinical performances of two low-shrinkage composite resins (silorane-based and methacrylate-based) in class I cavities prepared by Er,Cr:YSGG laser or conventional diamond bur over 60 months. MATERIALS AND METHOD: Eighteen patients with four similar-sized occlusal lesions in molar teeth were included to the study. A total of 72 class I cavities were prepared either by Er,Cr:YSGG laser or conventional diamond bur. Cavities were restored with Filtek Silorane (3M-ESPE) (silorane-based) or Kalore (GC) (methacrylate-based) according to the manufacturers' instructions. All restorative procedures were performed by one operator, and the restorations were examined by two evaluators according to the FDI criteria at baseline and at 6, 12, 24, 36, 48, and 60 months. Patients' satisfaction about the preparation methods was also evaluated with a questionnaire. Pearson chi-square test was used for statistical analysis (p = 0.05). RESULTS: The 60-month recall rate was 88.8% and the retention rates for experimental groups were 100%. After 60 months, no significant differences were detected among groups, regarding marginal adaptation, marginal staining, surface staining, color match, and translucency. None of the restorations exhibited postoperative sensitivity or recurrence of caries. CONCLUSION: Different preparation techniques had no effect on the longevity of restorations. The two low-shrinkage composite systems tested were both clinically acceptable after 60 months. CLINICAL RELEVANCE: Low-shrinkage composites showed similar clinical performance in class I cavities prepared with a laser or conventional bur after a 60-month observation period.


Assuntos
Resinas Compostas , Cárie Dentária , Preparo da Cavidade Dentária , Lasers de Estado Sólido , Cárie Dentária/terapia , Restauração Dentária Permanente , Humanos , Resinas de Silorano
10.
J Urol ; 203(2): 304-310, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31487219

RESUMO

PURPOSE: Prostate specific antigen screening for prostate cancer has recently been challenged due to poor sensitivity. In addition to prostate cancer, a number of conditions elevate prostate specific antigen, of which benign prostatic hyperplasia is most common. The objective of this study was to assess the positive predictive value of prostate specific antigen and prostate specific antigen density for prostate cancer risk following holmium laser enucleation of the prostate. MATERIALS AND METHODS: We queried an institutional review board approved database of holmium laser enucleation of the prostate performed at Indiana University from 1999 to 2018 to identify 1,147 patients with prostate specific antigen data available after holmium laser enucleation. A total of 55 biopsies after enucleation were recorded. Demographics, prostate specific antigen, prostate volume and oncologic details were analyzed. The primary outcome was biopsy proven prostate cancer. RESULTS: A total of 55 patients underwent transrectal ultrasound prostate biopsy for cause after holmium laser enucleation of the prostate. Cancer was identified in more than 90% of biopsied cases. Men with prostate specific antigen above 1 ng/ml at biopsy had a 94% probability of cancer detection and an 80% risk of clinically significant disease. Prostate specific antigen density above 0.1 ng/ml2 was associated with a 95% risk of cancer and an 88% risk of clinically significant cancer. Prostate specific antigen greater than 5.8 ng/ml or prostate specific antigen density greater than 0.17 ng/ml2 was universally associated with biopsy proven cancer. CONCLUSIONS: Prostate specific antigen and prostate specific antigen density have high positive predictive value for prostate cancer risk after holmium laser enucleation of the prostate. Thresholds for biopsy should be lower than in patients who do not undergo holmium laser enucleation. Those who undergo that procedure and have prostate specific antigen above 1 ng/ml or prostate specific antigen density above 0.1 ng/ml2 are at higher risk for harboring clinically significant disease and should undergo biopsy. Referring physicians should be aware of these significant risk shifts.


Assuntos
Calicreínas/sangue , Lasers de Estado Sólido , Antígeno Prostático Específico/sangue , Próstata/patologia , Prostatectomia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/cirurgia , Idoso , Humanos , Masculino , Monitorização Fisiológica , Tamanho do Órgão , Valor Preditivo dos Testes , Prostatectomia/métodos , Neoplasias da Próstata/patologia , Estudos Retrospectivos
11.
Clin Oral Investig ; 24(2): 711-718, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31127428

RESUMO

OBJECTIVE: To evaluate the effect of Er:YAG etching on topography, microstructure, compressive strength, and shear bond strength (SBS) of All-Bond Universal adhesive to mineral trioxide aggregate-Angelus (AMTA) and Biodentine (BD). METHODS AND MATERIALS: Sixty cylindrical specimens of each cement (AMTA and BD) in five groups were prepared and stored for 72 h. The control groups were non-etched, and four other groups were acid-etched and laser-etched with a pulse energy of 60, 80, or 100 mJ, followed by compressive strength testing. Surface micromorphology and topography were evaluated. Similar groups were bonded using All-Bond Universal with self-etch and etch-and-rinse (acid-etch) approaches, and laser-etch 60, 80, and 100 mJ, and SBS was tested. Data were analyzed using two-way and one-way ANOVA and the Bonferroni post hoc tests (α = 0.05). RESULTS: BD had a significantly higher compressive strength and SBS (except for laser-etch 100) compared to AMTA, regardless of the etching method (p < 0.001). Acid etching and laser etching 100 of both cements and laser etching 80 of BD alone produced a significantly lower compressive strength than that for the other groups. Contrary to BD, for AMTA, all the treatments significantly increased SBS compared to that of the self-etch group. CONCLUSIONS: Etching of AMTA was needed for stronger bonding; laser etching with 60 or 80 mJ without compromising compressive strength was recommended. Etching not only did not improve bonding ability of BD, but it also negatively affected the strength of BD. CLINICAL RELEVANCE: To achieve successful combined calcium silicate cement-resin material restoration, an adequate bond between the materials is mandatory. This might be provided with the ultramild adhesive through laser etching without compromising compressive strength, depending on cement composition and laser energy level used.


Assuntos
Força Compressiva , Colagem Dentária , Lasers de Estado Sólido , Ataque Ácido Dentário , Compostos de Cálcio , Cimentos Dentários , Teste de Materiais , Resistência ao Cisalhamento , Silicatos , Propriedades de Superfície
12.
Food Chem ; 309: 125754, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-31734006

RESUMO

The present work illustrates the potential of laser-induced breakdown spectroscopy (LIBS) for the direct analysis of liquid food products. The aim of the experiment was to predict calcium content in ready-to-feed infant formula. The analysis was performed by a LIBS system coupled to a liquid sample chamber with a rotatory wheel that presents the liquid to the laser beam as a thin film. Multivariate analysis with partial least squares regression (PLSR) was performed to correlate LIBS spectral data to reference calcium contents. The obtained PLSR model exhibited a good fit and linearity, as indicated by the coefficients of determination for calibration (Rc2) and cross-validation (Rcv2), with values of 0.96 and 0.89, respectively. The robustness of the calibration model was assessed by external validation showing a root-mean-square error of prediction of 6.45 mg 100 mL-1. These results demonstrated the potential of LIBS for real-time analysis of liquid food products.


Assuntos
Cálcio/análise , Fórmulas Infantis/análise , Lasers de Estado Sólido , Espectrofotometria Atômica/métodos , Cálcio/normas , Calibragem , Humanos , Lactente , Análise dos Mínimos Quadrados , Modelos Lineares , Reprodutibilidade dos Testes , Espectrofotometria Atômica/normas
13.
Quintessence Int ; 51(1): 8-16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31781691

RESUMO

OBJECTIVES: Tooth preparation is one of the factors that affect the bond strength of composite to teeth, and the method of preparation affects dentin morphology. Several disadvantages have been observed for the conventional technique. Currently, Er:YAG laser is a good treatment option and has been used to prepare hard dental tissue; it enables conservative preparation without damage to the pulp. Though Er:YAG laser is a promising alternative for preparation of the dentin surface, the bond strengths of Er:YAG-lased tooth substrates to composite reported in the literature have been confusing and even contradictory. The aim of the present study was to investigate the effect of Er:YAG laser irradiation, compared with conventional methods, on the shear bond strength of enamel and dentin. METHOD AND MATERIALS: The databases PubMed, EMBASE, Springer, Wiley-Blackwell, EBSCO, and the China Academic Journals Full-text Database were searched for relevant studies in English or Chinese. Full-text articles were selected that involved shear bond strength after using the Er:YAG laser and conventional methods. Review Manager 5.0 was used to estimate the effects of the results among selected articles. Forest plots, sensitivity analyses, and bias analyses were also conducted for the articles. RESULTS: Both in dentin and in enamel, the shear bond strength after using Er:YAG laser was significantly higher than that of the blank control (conventionally treated) group. Differences were not significant between studies that used burs in comparison with phosphoric acid. There was high heterogeneity of shear bond strength between different groups, and low numbers of studies and contradictory results may be the main reasons for this. A funnel plot indicated that some publication bias existed. CONCLUSION: The shear bond strength after Er:YAG laser preparation was significantly higher than that of the blank control (conventionally treated) group. Er:YAG laser is a safe and convenient alternative procedure, and has some advantages over traditional methods.


Assuntos
Colagem Dentária , Lasers de Estado Sólido , China , Esmalte Dentário , Dentina , Resistência ao Cisalhamento
14.
Maturitas ; 132: 1-6, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31883657

RESUMO

OBJECTIVES: To determine the efficacy and predictive factors for the success of Er:YAG laser treatment in patients with urinary incontinence (UI). METHODS: Eighty-two patients with UI were treated by Er:YAG laser in this cohort study. The patients were evaluated by ICIQ-SF and KHQ-UI before and after the procedure. Improvement was categorized as: none (0-25%), mild (26-50%), moderate (51-75%), or high (76-100%). The duration of the treatment effect was evaluated at follow-up in relation to maximum improvement time (MIT) and total improvement time (TIT). RESULTS: Forty-two patients were determined to have SUI and 40 patients MUI. The mean ISIQ-SF and KHQ-UI scores significantly improved after the procedure (p<0.0001). The SUI patients responded to the laser treatment significantly better (p<0.008). Younger women had significantly better results (p<0.008), while premenopausal women (p<0.032) and women in the early postmenopausal years (p<0.032) also saw a positive response to the Er:YAG laser treatment. Women with a lower BMI had greater improvement (p<0.011). The total laser energy expenditure during the sessions may also be a predictive parameter for the success of Er:YAG laser treatment of UI (p = 0.059). MIT and TIT were significantly longer among the patients in the high-improvement group. CONCLUSION: Er:YAG laser treatment of the symptoms of UI, especially SUI, is more efficacious and of longer duration for younger, premenopausal or early postmenopausal women with normal BMI.


Assuntos
Lasers de Estado Sólido/uso terapêutico , Incontinência Urinária por Estresse/terapia , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários , Fatores de Tempo
15.
J Photochem Photobiol B ; 203: 111740, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31887638

RESUMO

PURPOSE: The aims of this ex vivo study were to evaluate the effectiveness of the Nd:YAP laser in the treatment of dentin hypersensitivity, to compare the temperature rise during laser irradiation at three different dentine thicknesses, and to analyse the composition of the dentine-lased surface. METHODS: A total of 33 teeth were used in this study. For scanning electron microscopy (SEM) observation, 24 teeth were transversely sectioned and divided into 4 groups: group A was irrigated with EDTA; group B was irradiated by Nd:YAP laser with 180 mJ energy/per pulse, 0.9 W average power, and 5 Hz frequency (power density [PD] = 229 W/cm2); group C was irradiated by Nd:YAP laser with 280 mJ energy/pulse, 1.4 W average power, and 5 Hz frequency (PD = 356 W/cm2); and group D was irradiated by Nd:YAP with 360 mJ energy/pulse, 1.8 W average power, and 5 Hz frequency (PD = 458 W/cm2). Energy-dispersive spectroscopy (EDS) analysis was performed on the same teeth evaluated for SEM observations. For temperature increase evaluation performed with thermocouples, 9 teeth were transversely sectioned at 3 different thicknesses (3 for each group) of 1, 2, and 3 mm. RESULTS: Statistical analysis showed significant changes in the diameter of the dentinal tubule orifices among all groups; EDS did not show modification of the Ca/P ratio. Temperature increase under irradiation exceeded 5.5 °C only in the group D samples. CONCLUSIONS: This ex vivo study, based on temperature recording, SEM observation, and EDS analysis, demonstrated that Nd:YAP laser at a PD of 356 W/cm2, corresponding to an average power of 1.4 W, defines the best treatment for dentine hypersensitivity in terms of compromise between efficacy of the treatment and safety of the pulp.


Assuntos
Sensibilidade da Dentina/radioterapia , Lasers de Estado Sólido/uso terapêutico , Dentina/fisiologia , Dentina/efeitos da radiação , Humanos , Microscopia Eletrônica de Varredura , Espectrometria por Raios X , Temperatura Ambiente
16.
J Contemp Dent Pract ; 20(9): 1014-1018, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31797821

RESUMO

AIM OF STUDY: Evaluation of the bond strength of the resin cement after enamel conditioning with erbium-doped yttrium aluminum garnet laser compared to other four different techniques. MATERIALS AND METHODS: The study consisted of 50 enamel specimens excluded from the smooth surfaces of newly extracted human 3rd molars. The specimens were randomly divided into five groups in terms of the enamel treatment technique. Each group (n = 10) was conditioned differently by bevel and acid etching group (I), acid etching technique group (II), double acid etching technique group (III), air abrasion followed by acid etching group (IV), and Er:YAG laser followed by acid etching group (V). After enamel treatment, a resin cylinder was installed using split Teflon matrix on each enamel specimen. Then the specimens were exposed to a shear strength device, and shear force was applied. The results were recorded with Newton. The required data were collected and statistically analyzed. A one-way ANOVA test was conducted to compare the five study groups using SPSS version 21 (p < 0.05). RESULTS: All groups showed high shear bond strength values ranging from 19.26 MPa (for group III) to 27.05 MPa (for group V). The enamel treatment with Er:YAG laser followed by acid etching gave the best results with significant differences compared to the other groups. CONCLUSION: Within the limitations of the present study, it can be concluded that the combination between the Er:YAG laser and the acid etching enhances the bond strength of resin cement with the enamel. CLINICAL SIGNIFICANCE: The use of Er:YAG laser followed by acid etching can be a successful technique for enamel conditioning and the results showed their superiority over the other groups.


Assuntos
Colagem Dentária , Lasers de Estado Sólido , Ataque Ácido Dentário , Esmalte Dentário , Humanos , Cimentos de Resina , Resistência ao Cisalhamento
17.
Rev Assoc Med Bras (1992) ; 65(11): 1329-1335, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31800891

RESUMO

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Assuntos
Litotripsia/métodos , Urolitíase/terapia , Medicina Baseada em Evidências , Humanos , Lasers de Estado Sólido , Litotripsia a Laser , Fatores de Tempo
18.
Int Braz J Urol ; 45(6): 1161-1166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808404

RESUMO

PURPOSE: To compare two-shift operation mode and single player mode different impact on surgical results and operator comfort in flexible ureteroscopic holmium laser lithotripsy for renal calculi larger than 1.5cm. MATERIALS AND METHODS: From december 2017 to december 2018, 92 patients with renal calculi admitted to Qilu Hospital and were treated through fl exible ureteroscopy. They were randomized in two-shift group (n=50) and single player group (n=42). The operative time, blood loss, hospitalization stay after operation, residual fragments (≥4mm) rate, fragmentation speed, postoperative complications and operator's fatigue score were compared. RESULTS: There was no significant difference between two groups regarding age, gender, illness side, stone size, blood loss, operative time, postoperative hospitalization stay, complications, etc (p >0.05). The fragmentation speed was 44.5±20.0mm3/min in two-shift group compared with 34.2±17.3mm3/min in single player group (p=0.037). Residual fragments (≥4mm) rate after fi rst surgery was 18% in two-shift group, while the residual fragments (≥4mm) rate was 40.5% after first surgery in single player group (p=0.017). The total fatigue score of two-shift group was 8.4 compared to 29.9 in single player group (p <0.001). CONCLUSION: In flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm, two-shift operation mode can raise the fragmentation speed and stone clearance rate, as well as signifi cantly lower operator's fatigue level and improve operator's comfort.


Assuntos
Cálculos Renais/cirurgia , Lasers de Estado Sólido/uso terapêutico , Litotripsia a Laser/métodos , Ureteroscopia/métodos , Adulto , Desenho de Equipamento , Ergonomia , Feminino , Humanos , Cálculos Renais/patologia , Tempo de Internação , Litotripsia a Laser/instrumentação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias , Reprodutibilidade dos Testes , Resultado do Tratamento , Ureteroscopia/instrumentação
19.
20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(6): 1159-1164, 2019 Dec 18.
Artigo em Chinês | MEDLINE | ID: mdl-31848522

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of the seven-step two-lobe holmium laser enucleation of the prostate (HoLEP) technique with low power laser device, and to introduce the detailed operating procedures, key points, short-term outcomes of this modified HoLEP technique. METHODS: From March 2016 to November 2017, 90 patients underwent HoLEP in Peking University Third Hospital. The patients were divided into two groups: high-power group (32 patients) were performed with traditional Gilling's three-lobe enucleation using high power (90 W) laser; Low-power group (58 patients) were performed with seven-step two-lobe enucleation using low power (40 W) laser. The main steps of the low power seven-step two-lobe HoLEP phase included: (1) The identification of the correct plane between adenoma and capsule at 5 and 7 o'clock laterally to the veru montanum; (2) The connection of the bilateral plane by making a adenoma incision at the proximal point of veru montanum; (3) The extension of the dorsal plane under the whole three lobes between adenoma and capsule towards the bladder neck; (4) The separation of the middle lobe from two lateral lobes by making two retrograde incisions separately from apex 5 and 7 o'clock towards the bladder neck; (5) The enucleation of the middle lobe adenoma by extending the dorsal plane through into the bladder; (6) The prevention of the apex mucosa by making a circle incision at the apex of the prostate; (7) The en-bloc enucleation of the two lateral lobe adenomas by extending the lateral and ventral plane between adenoma and capsule from 5 and 7 o'clock to 12 o'clock conjunction and through into the bladder. RESULTS: The mean patient age was (66.25±5.37) years vs. (68.00±5.18) years; The mean body mass indexes were (24.13±4.06) kg/m2 vs. (24.57±3.50) kg/m2; The mean prostate specific antigen values were (3.23±2.47) µg/L vs. (6.00±6.09) µg/L; The average prostatic volumes evaluated by ultrasound was (49.03±20.63) mL vs. (67.55±36.97) mL. There was no significant difference between the two groups. Furthermore, there were no significant differences in terms of perioperative and follow up data, including operative time; enucleation efficiencies; hemoglobin decrease; blood sodium and potassiumthe change postoperatively; catheterization duration and hospital stay; the international prostate symptom scores and quality of life scores pre- and post-operatively. There was 1 transurethral resection of the prostate (TURP) conversion in high-power group and 1 transfusion in low-power group during the operations. The follow-up one month after operation showed no severe stress incontinence in both the groups, whereas 3 cases ejaculatory dysfunctions in high-power group versus 1 case in low-power group were observed; Other surgeryrelated complications included: 2 cases postoperative hemorrhage (Clavien II and Clavien IIIb) in high-power group, 2 cases postoperative temperature more than 38 °C (Clavien I) and 1 case dysuria following catheter removal (Clavien I) in low-power group. CONCLUSION: Low power laser device can be applied safe and effectively for HoLEP procedure using the seven-step two-lobe HoLEP technique. The outcomes comparable with high power laser HoLEP can be achieved.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Hólmio , Humanos , Masculino , Hiperplasia Prostática/cirurgia , Qualidade de Vida , Resultado do Tratamento
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