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1.
Artigo em Chinês | MEDLINE | ID: mdl-32086924

RESUMO

Objective:The aim of this study is to investigate the effect of CO2 laser cordectomy on the voice of early glottic carcinoma. Method:A retrospective analysis of 40 patients who underwent CO2 laser treatment early glottis preoperative clinical data of postoperative laryngeal cancer patients, patients with postoperative recurrence rate, survival rate, and the postoperative complications of patients with preoperative and postoperative laryngoscopy, voice disorders index(voice handicap index, VHI) simplified Chinese version(VHI 13) rating scale, affecting the stability sound quality postoperatively in patients with laryngeal cancer were discussed. Result:All patients underwent voice reexamination 8-97 months after surgery, and the survival rate was 100%, no local recurrence and no obvious postoperative complications. Compared with the healthy control group, there were statistically significant differences in the four indicators F0(fundamental frequency), Jitter(fundamental frequency perturbation), Shimmer(amplitude perturbation) and MPT(maximum pronunciation time), suggesting that CO2 laser surgery resulted in significant changes in acoustic parameters. Jitter and Shimmer indexes in the pre involved combined group were statistically significant different from those in the non involved combined group, suggesting that the sound quality of the pre involved combined group was worse in the postoperative stability period. The VHI score indicated that most patients with early glottic cancer were in severe voice disorder before operation and most were in moderate voice disorder after operation. Compared with the healthy control group, the VHI score and total score of the healthy control group were lower in terms of physiology, psychology and emotion. Compared with the healthy control group, the VHI score and physiology of the early glottic laryngeal cancer patients were lower in the early glottic laryngeal cancer patients before and after surgery, and they were statistically significant. Conclusion:CO2 laser surgery for early glottic cancer, the overall survival rate of patients, low recurrence rate, fewer complications, CO2 laser surgery led to significant changes in acoustic parameters, postoperative sound quality and whether the involvement of pre-associated factors; The total score of VHI and physiological score of early glottic carcinoma patients after CO2 laser operation were better than those before operation.


Assuntos
Neoplasias Laríngeas/cirurgia , Terapia a Laser , Lasers de Gás , Distúrbios da Voz/etiologia , Qualidade da Voz , Dióxido de Carbono , Glote/cirurgia , Humanos , Recidiva Local de Neoplasia , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
2.
Clin Oral Investig ; 24(1): 37-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31720851

RESUMO

OBJECTIVES: To evaluate therapeutic effects of laser therapy on patients with recurrent aphthous stomatitis assessing evidences from previously published systematic reviews. MATERIALS AND METHODS: An overview of systematic reviews was conducted based on PRISMA checklist. Search strategies were developed and adapted for six different electronic databases and a gray literature search was also performed. The methodology quality of the included systematic reviews was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2 (AMSTAR 2). RESULTS: After a two-step selection, five systematic reviews were included. Methodology quality was considered as a high risk of bias in two systematic reviews, while in the other three were graded as moderate. The systematic reviews' conclusions demonstrated that all included systematics reviews showed positive effects of laser therapy for pain relief, and most of them demonstrated healing improvement. A meta-analysis was not feasible due to heterogeneity in treatments parameters. CONCLUSIONS: Evidence suggested that laser therapy is an effective tool to treat recurrent aphthous stomatitis; nevertheless, more randomized clinical trials should be conducted to compare different lasers parameters. CLINICAL RELEVANCE: The present overview evaluated recent evidence about laser therapy for recurrent aphthous stomatitis management in order to contribute for evidence-based dentistry and decision-making. This overview suggests that laser therapy is a safe and promising alternative to treat recurrent aphthous stomatitis, since it promotes wound healing and pain relief.


Assuntos
Terapia a Laser , Lasers de Gás , Terapia com Luz de Baixa Intensidade , Estomatite Aftosa , Humanos , Dor
3.
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
6.
J Photochem Photobiol B ; 201: 111658, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31710923

RESUMO

The goal of the current experiment is to explore the influence of combined and/or single applications of red and near infrared (NIR) photobiomodulation (PBM) at different wavelengths, energy densities and times on cell viability, population doubling time (PDT), and apoptosis of in vitro cultures of human bone marrow-derived mesenchymal stem cells (hBM-MSCs) and h adipose-derived stem cells (hASCs). Both in vitro hBM-MSCs and hASCs were irradiated with 36 protocols using two different laser types (helium­neon [He-Ne] and diodes), four different laser wavelengths (HeNe laser, 630 nm, 810 nm, 630 + 810 nm); three different energy densities (0.6 J/cm2, 1.2 J/cm2, 2.4 J/cm2); and three different PBM times (1, 2, and 3). One-way ANOVA analysis showed that PBM with the 630 nm red laser significantly stimulated cellular viability of both hBM-MSCs and hASCs. The 630 nm red laser significantly decreased PDT of hBM-MSCs. One-way ANOVA demonstrated that the 630 + 810 laser significantly stimulated cellular viability, and significantly decreased PDT and apoptosis of hBM-MSCs and hASCs. Two-way ANOVA analysis showed that PBM with the 630 nm red laser and 630 + 810 nm laser significantly stimulated cellular viability of hASCs compared to the control hASCs, and experimental and control hBM-MSCs. Our study demonstrated that PBM with the combined 630 + 810 nm lasers significantly stimulated cell viability, and significantly decreased PDT and apoptosis of hBM-MSCs and hASCs in vitro. We reported new in vitro evidence where PBM administered at 630 nm (one and two times, 0.6 and 1.2 J/cm2) and 630 + 810 nm (three times, 2.4 J/cm2) significantly increased hASC cell viability compared to its control and the PBM-treated hBM-MSC groups.


Assuntos
Apoptose/efeitos da radiação , Lasers de Gás , Tecido Adiposo/citologia , Células da Medula Óssea/citologia , Sobrevivência Celular/efeitos da radiação , Células Cultivadas , Humanos , Terapia com Luz de Baixa Intensidade , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/efeitos da radiação , Células-Tronco/citologia , Células-Tronco/metabolismo , Células-Tronco/efeitos da radiação
7.
J Drugs Dermatol ; 18(11): 174-1176, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741362

RESUMO

Porokeratosis is a rare disorder of epidermal keratinization that encompasses several clinical forms, characterized by erythematous, annular plaques with an atrophic center and hyperkeratotic ridge-like border. The histopathological hallmark of porokeratosis is the cornoid lamella, a thin column of parakeratotic corneocytes embedded within the stratum corneum. There is no standard treatment regimen for porokeratosis. Current therapeutic modalities include topical agents, systemic medications, and surgical interventions that have variable efficacy. Here, we report a case of a patient with localized porokeratosis lesions on the face and extremities that resolved after one treatment session with carbon dioxide laser resurfacing combined with topical antioxidant serum containing L-ascorbic acid, alpha tocopherol, and ferulic acid. The diagnosis of porokeratosis was supported by the clinical presentation, dermoscopy, and in vivo skin imaging with optical coherence tomography and reflectance confocal microscopy. This case highlights the utility of using carbon dioxide laser to ablate porokeratosis lesions, as well as the clinical advantages offered by new noninvasive skin imaging modalities to examine, diagnose, and follow up skin pathologies. J Drugs Dermatol. 2019;18(11):1174-1176.


Assuntos
Lasers de Gás/uso terapêutico , Poroceratose/cirurgia , Administração Cutânea , Ácido Ascórbico/administração & dosagem , Terapia Combinada , Ácidos Cumáricos/administração & dosagem , Extremidades , Face , Humanos , Terapia a Laser , Masculino , Pessoa de Meia-Idade , Vitamina A/administração & dosagem
8.
Medicine (Baltimore) ; 98(48): e17948, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770202

RESUMO

BACKGROUND: Laser systems are a common treatment choice for onychomycosis. They exert their effects on inhibiting the growth of the fungus by selective photothermolysis but efficacy is dependent on the specific type of apparatus used. To systematically review the available published literature on the curative effects and safety of laser treatment for onychomycosis. METHODS: Databases including PubMed, web of science, China National Knowledge Internet (CNKI), WanFang Database and VIP were searched systematically to identify relevant articles published up to July 2018. Potentially relevant articles were sourced, assessed against eligibility criteria by 2 researchers independently and data were extracted from included studies. A meta-analysis was performed using R software. RESULTS: Thirty-five articles involving 1723 patients and 4278 infected nails were included. Meta-analysis of data extracted from these studies revealed that: the overall mycological cure rate was 63.0% (95%CI 0.53-0.73); the mycological cure rate associated with the 1064-nm Nd: YAG laser was 63.0% (95%CI 0.51-0.74); and that of CO2 lasers was 74.0% (95%CI 0.37-0.98). The published data indicate that laser treatment is relatively safe, but can cause tolerable pain and occasionally lead to bleeding after treatment. CONCLUSION: Laser treatment of onychomycosis is effective and safe. The cumulative cure rate of laser treatment was significantly higher for CO2 lasers than other types of laser. Laser practitioners should be made aware of potential adverse effects such as pain and bleeding.


Assuntos
Lasers de Gás/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Onicomicose/radioterapia , Humanos , Unhas/efeitos da radiação , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
9.
Laryngorhinootologie ; 98(10): 725-741, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31610600

RESUMO

This article is intended to give an overview of the surgery for laryngeal malignancies and the current state of transoral endoscopic laryngeal surgery. The current therapy concepts in transoral endoscopic laryngeal surgery are presented in combination with the various possibilities of reconstruction. The adequate oncological treatment under functional aspects described plays the decisive role here: treatment goals beyond the cure of the tumor disease are the functional maintenance of the larynx with simultaneous preservation of the voice. In general, the diagnosis and treatment of (pre-) cancerous lesions of the laryngeal mucosa is demanding and requires a great deal of experience of the attending laryngologist. Updated classification systems support level-based categorization. In transoral endoscopic laryngeal surgery, resection using cold instruments and the CO2 laser are currently among the traditional methods, although newer methods such as the angiolytic laser can be used to ablate these lesions. Transoral endoscopic laryngeal surgery is a highly endoscopic-microscopic procedure in (pre-) cancerous lesions, which may presumably continue to evolve from the microlaryngoscopic approach over the next few years due to the introduction of new instruments and high-resolution imaging techniques. Robot-assisted surgery has also found its way into the transoral endoscopic treatment of laryngeal carcinoma. Only in the next few years, however, will it become clear to what extent this technique can supplement, replace or clarify surgical methods, since the individualized surgical strategy currently has a priority position for every single patient.


Assuntos
Neoplasias Laríngeas , Laringe , Lasers de Gás , Humanos , Laringoscopia , Laringe/cirurgia , Terapia a Laser
10.
Orv Hetil ; 160(41): 1617-1622, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31587579

RESUMO

Introduction: Genitourinary syndrome of menopause (GSM) affects up to 40-57% of postmenopausal women. Intravaginal microablative fractional CO2 laser is a new proposal for the management of GSM, although the evidence of safety and efficacy of the procedure appears to be insufficient. Aim: The aim of the study was to assess the efficacy of fractional CO2 laser for the treatment of GSM at the Department of Obstetrics and Gynecology of the University of Debrecen. Method: Postmenopausal women with symptoms of GSM underwent three sessions of microablative fractional rejuvenation CO2 laser therapy at 4-6 weeks intervals. Vaginal health index (VHI) scores were completed before each treatment and at 6 weeks follow-up as an objective measurement and visual analog scale was used to assess subjective complaints. Statistical analysis included Student's paired two-sampling t-test for the measure of statistical significance using the standard cutoff for significance p<0.05. Results: 51 women participated (mean age 57.0 ± 9.9 y). Average VHI score was 14.0 ± 4.9 before treatment, 15.0 ± 4.7 after the first session, 18.2 ± 4.6 after the second treatment and 19.5 ± 4.9 at follow-up. The improvement of VHI score was statistically significant between all sessions. Average VAS score was 15.6 ± 14.1 before treatment, 9.0 ± 10.8 after the first session, 5.9 ± 9.2 after the second treatment and 3.4 ± 7.5 at follow-up. The improvement of VAS score was statistically also significant between all sessions. Conclusions: Our study suggests that the fractional CO2 laser is an effective and safe treatment of symptoms associated with GSM. Orv Hetil. 2019; 160(41): 1617-1622.


Assuntos
Dióxido de Carbono/uso terapêutico , Dispareunia/cirurgia , Doenças Urogenitais Femininas/cirurgia , Terapia a Laser , Lasers de Gás/uso terapêutico , Menopausa , Disfunções Sexuais Fisiológicas/cirurgia , Doenças Vaginais/cirurgia , Idoso , Dispareunia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/etiologia , Síndrome , Resultado do Tratamento
11.
Adv Clin Exp Med ; 28(11): 1513-1517, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31596556

RESUMO

BACKGROUND: The main purpose of a biopsy is microscopic examination and diagnosis. Keeping the margins of specimens safe and readable is always fundamental to detecting marginal infiltrations or malignant transformation. Numerous options and tools have been introduced for biopsy procedures. Lasers are one of these options that provide many enhancements to clinical and surgical biopsy procedures in comparison to scalpels. OBJECTIVES: The aim of the present study is to quantify the thermal artefacts in histological specimens obtained using a CO2 laser from different oral mucosal lesions and to evaluate if the resulting thermal effect hinders the histological examination. This aim is accomplished through quantitatively and qualitatively assessing the thermal effect in both the epithelium and connective tissue. MATERIAL AND METHODS: A super-pulsed CO2 laser (10,600 nm) was used to obtain 10 excision biopsy samples. The parameters were a power of 4.2 W in focused mode and a frequency of 80 Hz in super-pulse mode. The histological analysis was performed with an optical microscope. Computerized imaging software was utilized to quantitatively evaluate the thermal effect in both the epithelium and connective tissue expressed in microns. RESULTS: The thermal effect of the CO2 laser was limited to the surgical resection margins in all the specimens and did not hinder the histological analysis. Thermal artefacts were observed in 3 specimens. The range of thermal effects in the epithelial tissue was between 184 µm and 2,292 µm, while in the connective tissue it was between 133 µm and 2,958 µm. CONCLUSIONS: The resulting thermal effects of using a CO2 laser did not hamper the histological evaluation. Utilizing a laser in biopsy procedures should be tailored. Not only should laser parameters and safety margins be taken into consideration but also the working time, clinical accessibility, and the nature and water content of the tissue.


Assuntos
Biópsia/métodos , Terapia a Laser , Lasers de Gás , Humanos
12.
Medicine (Baltimore) ; 98(42): e16987, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626079

RESUMO

RATIONALE: Oral bleeding is usually diagnosed after by referral to other department for the differential diagnosis of hematemesis or hemoptysis. If a patient presents with blood in the oral cavity with no obvious source, generally upper airway, pulmonary, or gastroesophageal lesions are considered likely bleeding foci. The tongue base is an unusual site for laryngopharyngeal varices and only a few cases have been reported. PATIENT CONCERNS: Although varix at the tongue base in patients with liver cirrhosis has been rarely described, physicians must consider variceal bleeding from the tongue base when presented with oral bleeding. In such cases, bleeding foci can be identified and controlled by laryngoscopy. We describe the case of a 42-year-old woman complaining of small amount of hemoptysis with variceal bleeding at the tongue base controlled by laryngoscopic excision and cauterization. DIAGNOSIS: A diagnosis of tongue base varix was made based on medical history, clinical manifestations, laryngoscopic findings and pathologic features for the patient. INTERVENTIONS: The successful laryngoscopic procedures were performed. OUTCOMES: The patient has shown no recurrent oral bleeding during follow-up. LESSONS: Variceal bleeding in the tongue base is likely to cause serious massive hemorrhage. We need to consider this possibility when presented with a patient with intraoral bleeding but no evidence of hemoptysis or hematemesis.


Assuntos
Hemorragia/etiologia , Língua/irrigação sanguínea , Varizes/complicações , Adulto , Cauterização , Diagnóstico Diferencial , Feminino , Humanos , Laringoscopia/métodos , Lasers de Gás/uso terapêutico , Língua/cirurgia , Resultado do Tratamento , Varizes/patologia
13.
Pak J Pharm Sci ; 32(3 Special): 1387-1393, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31551220

RESUMO

The histological and ultrastructural changes of skin of Wistar rats were compared with 10600nm CO2 dot laser irradiation and external use of A acid preparation. The effects of dot matrix CO2 laser and Nd: YAG laser (quasi long pulse width 10600nm wavelength) on the expression of matrix metalloproteinase -1 (MMP-1) and matrix metalloproteinase inhibitor -1 (TIMP-1) in skin of natural aging mice were investigated, and the skin tender mechanism was further explored. To explore the long-term efficacy and timeliness of 10600nm CO2 dot laser and A acid treatment, so as to provide reference for clinical practice. The skin of hair on the back of mice was irradiated with dot CO2 laser and Nd: YAG laser. They were taken at 2 weeks, 1 month and 3 months after irradiation respectively. The dynamic changes of skin HSP47, HSP70 and TGF - ß 1 were detected by immunohistochemistry, and the difference of two laser irradiation effects was compared. 45 female Wistar rats were randomly divided into 9 groups. The back skin was used as the experimental observation area. After the depilation, the observation was divided into four parts by using the cross shaped marking line: the left side of the proximal end was the normal control group (A area). At the proximal end, the left side was the vitamin A acid group (B area). The right side of the tail was the combined treatment group (C area), and the right side of the proximal end was the dot laser group (D area). The C and D regions irradiated 10600 CO2 dot matrix laser 1 times at the beginning of the experiment. The parameters were: energy 15mJ, energy density 5%, frequency 300Hz. The fig. is square, 10mm * 10mm; after the laser irradiation, the B and C areas begin to wipe the 0.025% dimensional A cream every day for 3 weeks. The positive expression of MMP-1 and TIMP-1 in dot CO2 laser and Nd: YAG laser irradiation area was most obvious at 2 weeks. The MMP-1 gray value (115.14 + 5.23) and TIMP-1 gray value (104.01 + 3.15) of the dot matrix laser irradiated area were lower than the MMP-1 gray value (121.75 + 4.39) and TIMP-1 gray value (109.26 + 3.88) in the Nd: YAG laser irradiation area. That is, the positive expression of CO2 laser irradiation area was higher, and the difference was statistically significant (P < 0.05).


Assuntos
Hidroxiprolina/metabolismo , Lasers de Gás/uso terapêutico , Pele/efeitos da radiação , Envelhecimento , Animais , Feminino , Proteínas de Choque Térmico HSP47/metabolismo , Lasers de Estado Sólido , Metaloproteinase 13 da Matriz/metabolismo , Camundongos , Pele/metabolismo , Pele/ultraestrutura , Inibidor Tecidual de Metaloproteinase-1/metabolismo
14.
Eur Arch Otorhinolaryngol ; 276(12): 3405-3412, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31520161

RESUMO

PURPOSE: An anterior glottic web consists of the formation of a bridge of scar tissue covered by epithelium between the anterior free edges of the true vocal cords and represents one of the most common complications of laryngeal endoscopic surgery for tumors involving the anterior commissure. Endoscopic surgery is the therapy of choice, but simple section of the web is burdened by a high recurrence rate. Topical application of mitomycin C, intracordal stents, and the use of mucosal microflaps have been proposed to improve outcomes. We report our experience with the use of single and double mucosal microflaps (sliding technique) during the management of iatrogenic anterior glottic web (IAGW). METHODS: From November 2010 to December 2018, 30 patients (29 males, 1 female, mean age 65 years, range 47-87 years) were observed for IAGW, and 11 of these patients (36.7%) required surgical treatment. The Voice Handicap Index (VHI) and the GRBAS were used for the perceptive evaluation of pre- and post-operative voice quality. RESULTS: A reduction of the web length was observed in all cases, and we did not observe any residual web at the mid-third of the glottis. The mean post-operative VHI score decreased from 45 to 24, and the mean post-operative GRBAS values were reduced from 2.8, 2.4, 2.3, 2.1, and 1.1 to 1.9, 1.4, 1.3, 1.1, and 0, respectively. CONCLUSIONS: The microflap technique represents an effective and reproducible one-step procedure that, in expert hands, allows to obtain good anatomical and functional results in a high percentage of cases.


Assuntos
Glote/cirurgia , Laringectomia/métodos , Laringoplastia/métodos , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Dióxido de Carbono/uso terapêutico , Avaliação da Deficiência , Disfonia , Endoscopia , Feminino , Glote/patologia , Humanos , Doença Iatrogênica , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Membrana Mucosa , Retalhos Cirúrgicos , Resultado do Tratamento , Prega Vocal/cirurgia , Qualidade da Voz
15.
Pol Merkur Lekarski ; 47(278): 60-64, 2019 Aug 30.
Artigo em Polonês | MEDLINE | ID: mdl-31473753

RESUMO

Endometriosis affects 10-15% of the female population of childbearing potential. Endometrioid lesions of the cervical surface are a rare manifestation of the disease. There are various complaints related to this particular form of endometriosis, making the diagnosis challenging. Treatment also raises problems, as widely available and used therapeutic methods often prove to be ineffective. AIM: The aim of the study was to evaluate the efficacy of CO2 laser beam ablation in a group of patients with cervical endometriosis lesions. MATERIALS AND METHODS: This paper presents a summary of cervical endometriosis treatment efficacy in a group of 15 patients who have undergone CO2 laser ablation between May 2016 and April 2019. The majority of patients have already been treated for cervical endometriosis, using cryotherapy, electrocoagulation, curettage and loop electrosurgical excision procedure (LEEP). All patients, following preliminary colposcopy verification and exclusion of malignancies, have undergone CO2 laser ablation of endometrioid cervical lesions. A visual evaluation of the cervix was performed before treatment, directly after the procedure, as well as 4-6 weeks after the procedure, and subsequently every 6-8 months. RESULTS: This paper presents a summary of cervical endometriosis treatment efficacy in a group of 15 patients who have undergone CO2 laser ablation between May 2016 and April 2019. The majority of patients have already been treated for cervical endometriosis, using cryotherapy, electrocoagulation, curettage and loop electrosurgical excision procedure (LEEP). All patients, following preliminary colposcopy verification and exclusion of malignancies, have undergone CO2 laser ablation of endometrioid cervical lesions. A visual evaluation of the cervix was performed before treatment, directly after the procedure, as well as 4-6 weeks after the procedure, and subsequently every 6-8 months. CONCLUSIONS: Cervical endometriosis is a rare manifestation of the diseases, with variable symptoms. It can become a diagnostic challenge, as endometrioid lesions may be confused with cervical malignancies, as well as a therapeutic one, as many of the methods employed prove unsuccessful. Laser ablation of endometrioid cervical lesions seen to be a minimally invasive, safe and effective treatment method that can be offered in an outpatient setting.


Assuntos
Neoplasia Intraepitelial Cervical , Terapia a Laser , Lasers de Gás , Neoplasias do Colo do Útero , Dióxido de Carbono , Neoplasia Intraepitelial Cervical/terapia , Eletrocirurgia , Feminino , Humanos , Resultado do Tratamento
16.
Int J Pediatr Otorhinolaryngol ; 126: 109604, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31369973

RESUMO

This case series aims to determine the optimal surgical approach for pediatric laryngeal saccular cysts. A retrospective chart review of patients who underwent surgical treatment for laryngeal saccular cysts was completed; 5 patients were diagnosed and surgically treated. Treatment approaches included aspiration, supraglottoplasty, injection of bleomycin, endoscopic subtotal resection (marsupialization with the laser or endoscopic instrumentation of the cyst), endoscopic extended subtotal excision (subtotal resection plus removal of false vocal fold with lasering or coblation of the inner cyst wall), and transcervical approaches for resection. Based on our outcomes, an endoscopic extended subtotal resection of the cyst will achieve the best outcomes for cysts confined to the larynx or for Type 1 cysts. A transcervical approach for resection of the cyst will achieve the best outcomes for Type 2 cysts that extend into the neck or are extralaryngeal.


Assuntos
Cistos/cirurgia , Endoscopia , Doenças da Laringe/cirurgia , Humanos , Lactente , Recém-Nascido , Terapia a Laser , Lasers de Gás , Masculino , Estudos Retrospectivos
17.
Breast Cancer Res Treat ; 178(1): 135-140, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31377895

RESUMO

PURPOSE: Vulvovaginal atrophy (VVA) is a commonly reported issue among breast cancer patients, and its aetiology is multifactorial. Treatment is difficult in these women, particularly because the use of oestrogens has traditionally been discouraged. Vaginal laser treatment has been reported to improve symptoms. We aimed to assess the impact on symptoms and sexual function of vaginal laser in women with early breast cancer (EBC). METHODS: We performed a single-arm investigator initiated pilot study of female EBC patients with symptomatic VVA. A total of 3 vaginal laser treatments were administered 4 weeks apart. Questionnaires were completed at baseline, 4, 8 and 12 weeks. Our primary endpoint was symptomatic improvement of VVA at 12 weeks on 10 cm visual analogue scales. Our secondary endpoints were improvement in sexual function using the Female Sexual Function Index (FSFI) and patient-reported improvements in symptoms, sexual function and quality of life. Statistical analysis was performed with a Wilcoxon Signed Rank test. RESULTS: 26 patients were enrolled between February 2016 and August 2017. All patients were post-menopausal, 25 of whom had received anti-oestrogen therapy for their breast cancer. Questionnaire compliance was high (98%) and all patients received the three pre-planned treatments. There was significant improvement in each of the VVA symptoms: dryness (p < 0.001), itch (p < 0.001), burning (p = 0.003), dysuria (p < 0.001) and dyspareunia (p < 0.001). Patients also reported improvement in sexual function on the FSFI (p ≤ 0.001). CONCLUSIONS: Patients receiving vaginal laser had improvement in VVA symptoms and sexual function. Further randomised sham-controlled trials are needed to further assess this treatment.


Assuntos
Neoplasias da Mama/complicações , Lasers de Gás/uso terapêutico , Disfunções Sexuais Fisiológicas/cirurgia , Vagina/patologia , Vulva/patologia , Administração Intravaginal , Atrofia , Feminino , Humanos , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Projetos Piloto , Resultado do Tratamento , Vagina/cirurgia , Vulva/cirurgia
18.
Eur Arch Otorhinolaryngol ; 276(10): 2857-2864, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31367834

RESUMO

OBJECTIVE: To evaluate the predictive value of preoperative peripheral inflammatory markers in patients with vocal fold leukoplakia. METHODS: A retrospective study was performed of the patients diagnosed with vocal fold leukoplakia and who accepted carbon dioxide (CO2) laser resection in our center in the last 10 years. We calculated the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) after collecting and analyzing the clinical, histopathological and laboratory data. The potential relation between blood indexes and clinical events as recurrence or canceration was evaluated. RESULTS: A total of 589 patients were involved, including 300 cases without recurrence (group A), 198 with recurrence but not canceration (group B) and 91 transformed into squamous cancer (group C). Baseline analysis of NLR, PLR, and MLR showed no difference among the three groups before the first surgery. But all the indexes significantly elevated in groups B (P < 0.001, < 0.001, 0.023, respectively) and C (P = 0.009, 0.004, 0.007, respectively) in the last operation. The receiver-operating curve (ROC) analysis showed NLR as a potential marker of canceration of leukoplakia (AUC = 0.837) and the cutoff value was 2.505. When regrouping with pathological outcomes, severe dysplasia and squamous cell carcinoma (SCC) groups both revealed a higher level of NLR, PLR, and MLR comparing to the no dysplasia, mild dysplasia, and moderate dysplasia groups. NLR, PLR, and MLR in high-risk group (moderate, severe dysplasia and carcinoma) also elevated comparing to low-risk group (no dysplasia, mild dysplasia) (P = 0.039, 0.011, 0.007, respectively). CONCLUSIONS: The peripheral inflammatory markers NLR, PLR, and MLR are closely connected with the development of vocal fold leukoplakia. NLR may be a potential marker to predict the poor outcomes (recurrence or canceration) of patients in first surgery.


Assuntos
Carcinoma de Células Escamosas , Contagem de Leucócitos/métodos , Leucoplasia , Linfócitos/patologia , Neutrófilos/patologia , Prega Vocal/patologia , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/patologia , China , Feminino , Humanos , Inflamação/sangue , Lasers de Gás/uso terapêutico , Leucoplasia/sangue , Leucoplasia/patologia , Leucoplasia/cirurgia , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/sangue , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/cirurgia , Prognóstico , Estudos Retrospectivos , Medição de Risco
19.
Rev. ADM ; 76(4): 214-218, jul.-ago 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1023643

RESUMO

Introducción: El uso de agentes químicos en la superficie radicular durante la fase higiénica periodontal tiene como ventajas eliminar factores irritantes, prevenir la acumulación bacteriana y fomentar la cicatrización de la herida. El objetivo del presente estudio fue evaluar la superficie radicular de órganos dentales con periodontitis crónica avanzada, tratados mediante terapia periodontal no quirúrgica con EDTA y láser CO2. Material y métodos: Se evaluaron 40 órganos dentarios de pacientes con periodontitis crónica avanzada indicados para extracción, a los cuales se les realizó raspado y alisado radicular, con el uso de EDTA al 24%, láser CO2 a energía de 1, 1.5 y 2 Watt, para posteriormente evaluar la superficie radicular mediante un microscopio electrónico de barrido. Resultados: El tratamiento de raspado y alisado radicular mostró una superficie regular, pero con marcas de estrías con una cubierta de escombro dentinario, las muestras tratadas con EDTA al 24% muestran apertura de los túbulos dentinarios, con bordes definidos y un diámetro aparentemente amplio y los órganos dentarios tratados con láser CO2 con diferentes poderes de energía mostraron múltiples cambios en su superficie, con una apertura de túbulos dentinarios en su mayoría. Conclusión: La apertura de los túbulos dentinarios se presentó en los grupos experimentales tratados con biomodificador radicular (AU)


Introduction: The use of chemical agents in the root surface during the periodontal hygienic phase has the advantages of eliminating irritating factors, preventing bacterial accumulation and promoting wound healing. The objective of the present study was to evaluate the radicular surface of dental organs with advanced chronic periodontitis treated by non-surgical periodontal therapy with EDTA and CO2 laser. Material and methods: Forty dental organs of patients with advanced chronic periodontitis indicated for extraction were evaluated, which were performed scraping and root planing, with the use of 24% EDTA, CO2 laser with energy of 1, 1.5 and 2 Watt, to later evaluate the radicular surface by means of a scanning electron microscope. Results: The treatment of scaling and root planing showed a regular surface, but with marks of striae with a covering of dentine rubble, the samples treated with 24% EDTA show opening of the dentinal tubules, with defined edges and a seemingly wide diameter and, the dental organs treated with CO2 laser with different power powers showed multiple changes in their surface, with an opening of dentinal tubules in their majority. Conclusion: The opening of the dentinal tubules was presented in the experimental groups treated with a root biomodifier (AU)


Assuntos
Humanos , Periodontite/terapia , Raiz Dentária/efeitos dos fármacos , Raspagem Dentária , Ácido Edético , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Epidemiologia Descritiva , Estudos Transversais , Estudos Prospectivos , Lasers de Gás
20.
Int J Dermatol ; 58(10): 1212-1222, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31297798

RESUMO

BACKGROUND: Scarring is a distressing outcome of acne, as it causes cosmetic and psychological problems to the patients. Unfortunately no single treatment is satisfactory; instead, employing multiple modalities may have better outcome. Autologous adipose tissue-derived adult stem cells (AT-ASCs) and their secretory factors can stimulate collagen synthesis; angiogenesis and migration of fibroblasts thus regenerate damaged tissues. Also, conventional treatments for acne scarring, such as lasers and topical regimens, induce new collagen synthesis via activation of dermal fibroblasts or growth factors. The aim of the study was to verify the effectiveness of AT-ASCs for the treatment of acne scarring vs. the fractional carbon dioxide laser (FxCR). SUBJECTS AND METHODS: Split face comparative study included 10 adult patients with post-acne scars on both sides of the face. One side received AT-ASCs single injection while the other received three sessions of FxCR. Scars were then assessed using the global scoring system Goodman and Baron, scar area percent using NIH ImageJ software and functional assessment by measuring the transepidermal water loss (TEWL) and skin hydration. Both sides were followed for three months. RESULTS: A significant improvement in the degree of scar severity, scar area percent, skin hydration, and TEWL after 3 months of treatment on both sides of the face with insignificant differences between both treatment modalities, provided that AT-ASCs treatment was employed once vs. three sessions of FxCR. CONCLUSION: One injection of AT-ASCs is as effective as three sessions of FxCR in the treatment of atrophic acne scars.


Assuntos
Acne Vulgar/complicações , Células-Tronco Adultas/transplante , Cicatriz/terapia , Terapia com Luz de Baixa Intensidade/métodos , Transplante de Células-Tronco/métodos , Tecido Adiposo/citologia , Adulto , Cicatriz/diagnóstico , Cicatriz/etiologia , Feminino , Seguimentos , Humanos , Lasers de Gás/efeitos adversos , Lipectomia/métodos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/instrumentação , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Pele/patologia , Pele/efeitos da radiação , Fatores de Tempo , Transplante Autólogo/métodos , Resultado do Tratamento , Perda Insensível de Água/efeitos da radiação , Adulto Jovem
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