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1.
Estima (Online) ; 18(1)jan.-dez. 2020. ilus
Artigo em Português | BDENF - Enfermagem | ID: biblio-1096464

RESUMO

Objetivo: Identificar os efeitos da laserterapia de baixa intensidade na cicatrização do pé diabético. Método: Revisão sistemática nas bases de dados PubMed, LILACS, SciELO, CINAHL, Cochrane, Web of Science e Scopus, em que foram identificados 73 artigos, dos quais seis foram incluídos na amostra final, após verificação dos critérios de elegibilidade. Resultados: Os artigos apontaram como efeitos da laserterapia a efetividade na progressão do processo de reparo tecidual do pé diabético, alívio da dor, ação antiinflamatória, aumento da perfusão tecidual da lesão e melhora da resposta vascular e do sistema nervoso. Conclusão: O laser é uma terapia adjuvante que pode acelerar o processo de cicatrização da lesão, diminuir a dor, melhorar a neovascularização e, assim, minimizar o risco de complicações, como amputação do membro inferior e melhora da qualidade de vida de pessoas com diabetes e integridade da pele prejudicada.


Assuntos
Terapia a Laser , Cicatrização , Pé Diabético
2.
Mar Pollut Bull ; 160: 111716, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33181971

RESUMO

Due to the dramatic quantity of plastic debris released into our environment, one of the biggest challenges of the next decades is to trace and quantify microplastics (MPs) in our environments, especially to better evaluate their capacity to transport other contaminants such as trace metals. In this study, trace elements (Fe, Cu, Zn, As, Cd, Sn, Sb, Pb, and U) were analyzed in the microplastic subsurface (200 µm) using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). Microplastics subjected to the marine environment were collected on beaches (Guadeloupe) exposed to the north Atlantic gyre. We established a strategy to discriminate sorbed contaminants from additives based on the metal concentration profiles in MP subsurface using qualitative and quantitative approaches. A spatiotemporal correlation of the sorption pattern was proposed to compare MPs in terms of relative exposure time and time-weighted average concentrations in the exposure media.


Assuntos
Terapia a Laser , Oligoelementos , Guadalupe , Microplásticos , Plásticos , Oligoelementos/análise
3.
Arch Esp Urol ; 73(8): 675-681, 2020 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-33025912

RESUMO

Greenlight laser prostate vaporization is considered a valid alternative to transurethral prostate resection (TURP) for patient with LUTS due to BPH. The current review highlights the current evidence on greenlight technique and current state of-the-art. We will review clinically relevant concerns such as size limitation, economic issues and same-day surgery options. We will also describe technological improvements overtime and its relationship with current vaporization practices.CURRENT SITUATION: Based on clinical trial Goliath, Greenlight 180W vaporization showed non-inferiority to TURP and similar mid-term functional outcomes. A benefit towards length of hospital stay, similar complication rate (below 80% at 2 years). The current laser generators (higher potency) are able to provide an ablative effect on tissue that is associated to a shorter operative time. The major advantage of greenlight laser is the same day discharge, with a low readmission rates. Greenlightlaser is more cost-effective than TURP. CONCLUSIONS: Green light laser remains as an alternativevalid option despite the technological improvementsin the field.


Assuntos
Terapia a Laser , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Humanos , Masculino , Duração da Cirurgia , Hiperplasia Prostática/cirurgia
4.
Arch Esp Urol ; 73(8): 682-688, 2020 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33025913

RESUMO

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.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Litotripsia a Laser , Hiperplasia Prostática , Humanos , Lasers de Estado Sólido/uso terapêutico , Masculino , Hiperplasia Prostática/cirurgia , Túlio
5.
Arch Esp Urol ; 73(8): 699-708, 2020 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-33025915

RESUMO

OBJECTIVE: Prostate enucleation is becoming more relevant within BPH treatment. Nowadays is probably the gold standard for enucleation. Several studies have shown holmium laser as the most frequently used safe and efficient energy source. The long learning curve remains as its major drawback. The current review aims to describe step to step technique at our institutionand describing the rational for its use. METHODS: A detailed description on our  step-to-step Holep technique is provided. We focused on the main differences with other techniques already described highlighting the largest experience reported. RESULTS: None of the published series has shown better results in terms of functional, safety and less complications outcomes on the short and long term. No differences are shown in terms of intraoperative/postoperative blood loss, reoperations, capsular perforations or urethral strictures. Our techniques provides shorter surgical length and improved efficiency than blocking and trilobular techniques. The rates of early continence are 4% vs5-40%. Lastly, improvement in morcellator devices delivered no complications related to that part of the surgery. CONCLUSIONS: Holep is the gold standard technique for prostate enucleation. It provides improved functional and safety outcomes than with other techniques. A standardized and optimized technique is mandatory.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Hiperplasia Prostática , Estreitamento Uretral , Humanos , Lasers de Estado Sólido/uso terapêutico , Masculino , Hiperplasia Prostática/cirurgia
6.
Arch Esp Urol ; 73(8): 745-752, 2020 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33025919

RESUMO

OBJECTIVE: To assess current efficacyand safety of low power HoLEP (Holmium Laser Enucleationof the Prostate) for the treatment of obstructingand symptomatic prostatic adenomas and to identify themechanisms supporting the related clinical advantages. METHODS: A systematic review was conducted usingrelevant databases (Ovid Medline, PubMed, Scopusand Web of Sciences), employing ("low power" OR"high power") AND ("HoLEP" OR "holmium laser enucleationof the prostate") as search terms. Inherent publicationswere selected according to the Preferred ReportingItems for Systematic Reviews and Meta-analyses (PRISMA)guidelines. Additionally, the reference lists of theselected papers were checked manually. RESULTS: We included any kind of study (n=15) dealingwith low power HoLEP because of the scarcity of the resultsobtained with the bibliographic search. Low powerHoLEP seems to be fully comparable to the traditionalhigh power HoLEP in terms of feasibility, efficacy andsafety. An additional clinical advantage of the low powerapproach might be the reduced incidence of postoperativedysuria, with limited intensity and duration, possiblydue to the decreased amount of energy delivered tothe capsular plane with a less aggressive modality, conjugatedwith appropriate technical enucleative choices.The physical rationale of low power HoLEP is discussed. CONCLUSIONS: Low power HoLEP is feasible, safeand effective, and might play a not exclusive role in thereduction of incidence, intensity and duration of postoperative dysuria.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Hiperplasia Prostática , Humanos , Lasers de Estado Sólido/uso terapêutico , Masculino , Hiperplasia Prostática/cirurgia , Resultado do Tratamento
7.
Arch Esp Urol ; 73(8): 767-776, 2020 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33025921

RESUMO

The SuperPulsed Thulium fiber laser has recently become available to the urologist. It can be safely and efficiently applied to humans for the purposes of laser lithotripsy. Particularly, this innovative technology overcomes the main limitations of Holmium:YAG lasers, which had been the principal source of energy for lithotripsy over the past decades. The SuperPulsed Thulium fiber laser allows a broader range of pulse energy (0.025 to 6.0 J), pulse frequency (up to 2000 Hz) and pulse duration (0.05 to 12 ms), as well as smaller operating laser fibers (50-150 µm core), compared to Holmium:YAG lasers. The laser emission at 1940 nm leads to a four-fold higher energy absorption in water, which ensures precise lithotripsy and a high degree of safety. Multiple comparative in vitro studies suggest a 1.5 to 4 times faster stone ablation rate in favor of the SuperPulsed Thulium fiber laser, when compared to Holmium:YAG lasers. It has also been shown to generate particularly fine stone dust, and electronic pulse modulation allows superior stone stabilization. The SuperPulsed Thulium fiber laser, like the Holmium:YAG laser, has been repeatedly reported thermodynamically safe, provided that a minimal irrigation flow (10-15 ml/min) and relatively low average power (≤ 25 W) is maintaining throughout the lithotripsy process. These new standards are particularly advantageous for fine and rapid ureteroscopic stone dusting, and open paths that were not been amenable to the Holmium:YAG laser.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Litotripsia a Laser , Cálculos Urinários , Humanos , Túlio , Cálculos Urinários/cirurgia
8.
Arch Esp Urol ; 73(8): 665-674, 2020 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33025911

RESUMO

"Theatre acting is the operation with ascalpel, movie acting is an operation with a laser". Michael Caine. Being the instrument in hands of urologist laser is much more than a single-application device. Its applicability is deeply dependent on physical properties, settings, and environment. With knowledge of how the device work, why it affects the tissue, and how this laser-tissue interaction goes surgeon can shape further clinical work to choose the best devices or techniques of surgery. Tailoring the laser effects on the needs of the patient. In this paper, we tried to briefly describe what a laser device consists of, the most important laser-tissue interactions that are necessary for understanding the operation of the laser, and the main laser systems that are used in urology.


Assuntos
Terapia a Laser , Urologia , Humanos
9.
Arch Esp Urol ; 73(8): 709-723, 2020 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-33025916

RESUMO

OBJECTIVE:  LASER (Light Amplification by Stimulated Emission of Radiation) technology consists of the emission of a high-energy light beam. In medicine, it is used to cut, coagulate, fragment and evaporate biological or synthetic tissues. In the field of Functional Urology and Urogynecology its use has been widely explored. This article tries to give an overview of its applications in this subspecialty. MATERIAL AND METHOD: A non-systematic free search was performed in Pubmed, Embase and Google Scholar,combining the terms "laser", "laser technology", "interstitial cystitis", "trigonitis", "urinary tract infections","mesh", "mesh complications", "microbiome", "menopause genitourinary syndrome", "vulvovaginal atrophy", "urinary incontinence", "pelvic organ prolapse", "lichensclerosus", "complications" and "vaginal laxity". All relevant studies were retrieved in full text, in order to prepare a summary of each of the pathologies in which laser therapy has been used in Functional Urology and Urogynecology over time. RESULTS: There are different types of lasers and different application modalities to treat a wide variety of functional pathologies, including interstitial cystitis, trigonitis, mesh complications, urinary incontinence or pelvic organ prolapse. In some of them its use has been abandoned, despite the fact that, theoretically, they offer advantages over other therapies, such as in the case of interstitial cystitis. In others there is still not enough evidence in terms of safety and efficacy to be an alternativeto other conventional treatments. CONCLUSIONS: Although laser therapy offers certain advantages over other treatments, its use has not been generalized in the subspecialty of Functional Urology and Urogynecology. More evidence is needed to demonstrate its efficacy and safety.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Prolapso de Órgão Pélvico , Incontinência Urinária , Urologia , Feminino , Humanos , Prolapso de Órgão Pélvico/cirurgia , Incontinência Urinária/cirurgia
10.
Arch Esp Urol ; 73(8): 724-734, 2020 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-33025917

RESUMO

OBJECTIVES: In recent years, there has been a rise concerning the research and development of focal prostate cancer therapies as a consequence of the high percentage of low-risk and localized prostate cancers. These focal therapies aim at preserving the gland in selected patients to avoid overtreatment. The application of lasers for focal ablation and photodynamic therapy has shown promising results in exchange for a minimal rate of adverse events compared to radical treatments. MATERIAL AND METHODS: An extensive review of the available literature on focal laser treatments for localized prostate cancer was conducted. A search in PubMed and Embase was carried out by the following keywords: "Localised prostate cancer", "Low-risk prostate cancer", "Focal therapy", "Magnetic Resonance in localized prostate cancer", "Focal laser ablation" , "Photodynamic therapy" and "TOOKAD". RESULTS: Photodynamic therapy with TOOKAD is the only focal therapy evaluated in a phase III clinical trial,showing a lower rate of progression and a longer time to progression compared to active surveillance. Other studies carried out have revealed a percentage up to 80% of negative biopsies 6 months after TOOKAD. Likewise, the quality of life of patients treated using focal laser ablation techniques and photodynamic therapy has been minimally altered, as most adverse effects have been shown to be mild and transient, with dysuria and hematuria being the most frequent. CONCLUSIONS: Despite the fact that focal therapies are still not recommended outside the context of clinical trials and the lack of comparative studies between the different techniques, laser focal therapies seem to havea future within the new approaches for localized prostate cancer.


Assuntos
Terapia a Laser , Fotoquimioterapia , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/cirurgia , Qualidade de Vida
11.
Artigo em Chinês | MEDLINE | ID: mdl-33040496

RESUMO

Objective:Analyze the relationship between the change of mucosal wave and the infiltrating level of early laryngeal carcinoma so as to guide the cordectomy. Method:Retrospective research on patients of 1a stage without anterior commissure invasion who received simple CO2 laser therapy because of primary glottic laryngeal squamous cell carcinoma. Result:Records of 320 patients including 22 patients who have slightly reduced according to the mucosal wave prompts before operation, 49 patients mucosal wave moderately reduced, 151 patients mucosal wave severely reduced, and 98 patients have mucosal wave disappeared according to stroboscopic assessment. Post-pathological evidence shows that 16 patients had their tumor infiltration into the epithelial layer, of which, 15 received the Ⅲ type laser surgery, 1 patient received the Ⅳ type laser surgery; 189 patients had their tumor infiltration into the lamina propria, of which, 148 received the Ⅲ type laser surgery, 41 received the Ⅳ type laser surgery; and 115 patients had their tumor infiltration into the vocal cord muscle layer, of which, 77 received the Ⅲ type laser surgery, 38 received the Ⅳ type laser surgery. Analyzed according to the Kaplan-Meier method, it shows that their five-year overall survival rate was 94.0%, the five-year disease-specific survival rate was 98.4%; and five-year local-region control rate was 91.2%. Change of the mucosal wave and the tumor infiltrating level have significant correlation; patients whose tumor infiltration had reached the lamina propria received the Ⅲ and Ⅳ type laser surgical treatment, their five-year overall survival rate and their five-year local-region area control rate have no obvious difference; patients whose tumor infiltration have reached the muscular layer received the Ⅲ and Ⅳ type laser surgical treatment, their five-year overall survival rate and their five-year local-region area control rate have no significant difference. Conclusion:This research shows that, change of the mucosal wave can, to a certain extent, prompt the tumor infiltration degree and guide in operation; for patients who are suspected of laryngeal carcinoma, when mucosal wave before operation prompts moderate-sever reduction or disappearance, to ensure bottom incisal margin clean, it should be cut at least to the muscular layer; for laryngeal cancer patients whose infiltrating mucosal wave disappears, it prompts that the tumor may have infiltrated to the muscular layer, and the Ⅲ and Ⅳ type laser surgery will have no significant prognostic influence.


Assuntos
Neoplasias Laríngeas , Terapia a Laser , Glote , Humanos , Neoplasias Laríngeas/cirurgia , Membrana Mucosa , Estudos Retrospectivos
12.
Vestn Oftalmol ; 136(6): 113-120, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33084288

RESUMO

Nowadays glaucoma is one of the leading causes of irreversible blindness worldwide. The main goal in preservation of vision in glaucoma patients is reducing intraocular pressure (IOP), which is considered the main controlled risk factor for progression of glaucomatous optic neuropathy. The article discusses the effectiveness and safety of various transscleral laser technologies in the treatment of glaucoma. Modern transscleral laser technologies that affect the uveoscleral drainage and scleral hydro-permeability are less traumatic and more gentle making them promising in the treatment of patients with early stages of glaucoma, and not only in terminal glaucoma with pain syndrome resistant to conventional treatment ("last resort surgery").


Assuntos
Glaucoma , Terapia a Laser , Terapia com Luz de Baixa Intensidade , Glaucoma/diagnóstico , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Tonometria Ocular
13.
BMC Infect Dis ; 20(1): 801, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33121447

RESUMO

BACKGROUND: According to the 2006 American Society for Colposcopy and Cervical Pathology guidelines, positive CIN2 p16 in women over the age of 25 should be managed with excisional treatment. However, excisional treatment is associated with physical, psychological and obstetric morbidity and can have a negative impact on sexual function. In our study we sought to identify a clear management strategy, addressing the impact of routine use of p16 immunohistochemistry in this population and identify appropriate criteria for patient selection with the aim of reducing over-treatment. METHOD: We studied the medical records of 130 patients who had undergone laser therapy for CIN2. Each patient underwent colposcopy, biopsy and HPV test and were tested for p16 protein,. Patients were divided based on HPV infection into: single infections, multiple infections. All patients underwent ZTA laser therapy with follow-up (2-year follow-up). STATISTICAL ANALYSIS: Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p < 0.05 were considered statistically significant. RESULTS: Single infections had a histological regression of 61.8% (21/34) and a histological persistence rate of 35.3% (12/34), which was greater than the multiple infection rate. The common characteristic that the women with persistence and progression had was the dimension of the lesion and the genotype 16. Ten cases of histological persistence and the only case of progression had one lesion greater than three quarters of the cervix. CONCLUSIONS: With the progress of our understanding of the natural history of infection from human papillomavirus and the increasing use of colposcopy, thanks to the addition of HPV genotyping and the technique of immunohistochemistry, conservative management of these lesions is now possible.


Assuntos
Neoplasia Intraepitelial Cervical/complicações , Neoplasia Intraepitelial Cervical/terapia , Tratamento Conservador/métodos , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Neoplasias do Colo do Útero/complicações , Neoplasias do Colo do Útero/terapia , Adulto , Neoplasia Intraepitelial Cervical/virologia , Colposcopia , Inibidor p16 de Quinase Dependente de Ciclina/imunologia , Progressão da Doença , Feminino , Seguimentos , Genótipo , Humanos , Imuno-Histoquímica , Terapia a Laser , Infecções por Papillomavirus/virologia , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias do Colo do Útero/virologia
14.
Medicine (Baltimore) ; 99(41): e22520, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031293

RESUMO

BACKGROUND: There is no consensus in existing literature on the pulse power, application time, frequency and the dose of energy of laser therapy for the patients. Therefore, we conducted this research for the assessment of safety and efficiency of ultrasound and high-intensity laser therapy (HILT) in the lumbar disc herniation (LDH) patients. METHODS: Our present research was approved by the institutional review board in the West China-Guangan Hospital. All the participants would acquire the written informed consent. From December 2020 to December 2021, we will conduct a prospective evaluation via a senior surgeon for 1 hundred LDH patients who plan to undergo the conservative treatment at our hospital. In this research, the inclusion criteria contained: the patients with lumbar disc herniation diagnosed by lumbar MRI; the patients with no history of trauma or congenital abnormalities; and the patients with sufficient psychological ability to understand and then answer the questions raised in assessment scale. The participants were randomly divided into the control group or HILT group after performing the examination of baseline. The main outcome was the pain score of visual analog scale. The other results contained the adverse effects, back range of motion as well as functional scores. CONCLUSIONS: We assumed that the HILT is as effective as the ultrasound therapy in treating pain for LDH. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry5975).


Assuntos
Deslocamento do Disco Intervertebral/cirurgia , Terapia a Laser/métodos , Humanos , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/terapia , Terapia a Laser/efeitos adversos , Dor Lombar/etiologia , Vértebras Lombares , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Terapia por Ultrassom/efeitos adversos
16.
Rozhl Chir ; 99(7): 299-303, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32972147

RESUMO

INTRODUCTION: Endovenous Laser Ablation (EVLA) is a common alternative to surgical treatment of varicose veins. The aim of our study was to demonstrate that laser occlusion is durable, that we can treat all patients in a one day setting, even with veins >10mm in diameter, and that multiple EVLAs can be done at the same time. METHODS: In the period from 1/2017 to 12/2019 EVLA was performed in a total of 1551 consecutive patients with varicose veins and ultrasonographically documented venous reflux. The mid-term results were evaluated in a group of patients operated from 1/2017 to 6/2017 (316 pts.). We compared a risk group that consisted of patients with veins >10mm in diameter (40 pts.) with a control group (the remaining 276 pts.). Patients with veins >10mm are traditionally considered as candidates for conventional surgery. RESULTS: The catheter-based method enabled us to perform more ablations in one procedure. In 2019 we performed 1.44 EVLA procedures per patient. There was only one postoperative follow-up visit, indicating an uncomplicated postoperative course, in 87.5% of patients of the risk group. In the control group 100% of patients had only one follow-up visit including ultrasound examination, showing an uncomplicated postoperative course (p.


Assuntos
Terapia a Laser , Varizes/diagnóstico por imagem , Varizes/cirurgia , Insuficiência Venosa , Humanos , Veia Safena/diagnóstico por imagem , Veia Safena/cirurgia , Resultado do Tratamento
17.
Lakartidningen ; 1172020 09 14.
Artigo em Sueco | MEDLINE | ID: mdl-32926397

RESUMO

Laser Interstitial Thermal Therapy (LITT) is used to treat patients with intracranial lesions such as epileptogenic foci, radiation necrosis, cavernomas and brain tumors in the United States. The approval for this treatment in Europe has first been granted in 2018, with the first treatment(s) in the Nordic countries - in the form of 3 brain tumor patients - performed at the Karolinska University Hospital in 2019. In this article we briefly describe our initial experience in the context of current literature.


Assuntos
Neoplasias Encefálicas , Terapia a Laser , Lesões por Radiação , Neoplasias Encefálicas/terapia , Europa (Continente) , Humanos , Países Escandinavos e Nórdicos
18.
Lancet ; 396(10253): 754, 2020 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-32919505
19.
PLoS One ; 15(9): e0238659, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941479

RESUMO

Adjunctive use of laser devices as high reactive-level laser/light therapy (HLLT) or photobiomodulation therapy (PBMT) for periodontal therapy is known to be more effective on suppressing pain than conventional therapy, however, there are no systematic reviews addressed its effectiveness. This systematic review and meta-analysis aim to investigate the following clinical question (CQ): does adjunctive use of lasers with conventional therapy suppress the pain associated with periodontal treatment? A systematic and extensive literature search was performed to summarize the currently available knowledge to answer the CQ using the PubMed, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs) conducted before June 2020. Bias risk was assessed using the Cochrane tool for the risk of bias evaluation. A meta-analysis was performed on quantitative evaluation of pain control based on patient-reported outcomes. After an independent screening of 165 initial records, ten RCTs were included. Six of them focused on surgical procedures and the others on non-surgical periodontal pocket therapy. The protocols of HLLT, PBMT, and combination with HLLT and PBMT were employed in five, four and one RCTs, respectively. Following the assessment of bias risk, it is revealed that all RCTs had methodological weaknesses regarding the blinding of key personnel, although other bias risk factors were not evident. Meta-analysis showed that HLLT using erbium lasers significantly reduced the patient-reported pain immediately after treatment (two RCTs, p < 0.0001), while PBMT using diode lasers significantly reduced pain 2-7 days after treatment (two RCTs, p < 0.0001 to p = 0.03). The presented systematic review and meta-analysis suggest that the alternative use of HLLT using erbium lasers to conventional instrumentation can significantly suppress postoperative pain and that intraoperative or postoperative PBMT using diode lasers combined with periodontal surgery can significantly reduce postoperative pain. However, the evidence is still insufficient and more well-designed RCTs are required.


Assuntos
Terapia a Laser , Manejo da Dor , Medidas de Resultados Relatados pelo Paciente , Periodonto/cirurgia , Humanos , Julgamento , Terapia com Luz de Baixa Intensidade , Viés de Publicação , Risco , Escala Visual Analógica
20.
PLoS One ; 15(9): e0238394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970691

RESUMO

PURPOSE: To investigate the outcome of phacoemulsification in selective laser trabeculoplasty (SLT)-treated eyes. METHODS: This retrospective study included patients who had open angle glaucoma (OAG) with previous SLT who underwent phacoemulsification. We evaluated intraocular pressure (IOP), length of glaucoma control without treatment, and antiglaucoma medication or surgery. SLT-treated eyes that did not receive phacoemulsification were retrospectively chosen as a control. We investigated factors related to outcome of phacoemulsification by multivariate analysis. RESULTS: 42 eyes with previous SLT that underwent phacoemulsification and 40 controls were retrospectively evaluated. Phacoemulsification was performed 52 ± 15 months after SLT. After a mean follow-up of 74 ± 21 months, mean IOP was significantly decreased in the phaco group by 2.2 ± 2.7 mmHg (p < 0.001). In the SLT group, mean IOP was decreased by 0.8 ± 2.8 mmHg (p < 0.001). 9 eyes (16.7%) in the phaco group and 11 eyes (19.0%) of the SLT group needed topical treatment, and no eye needed glaucoma surgery in both groups. The factor related to success was higher baseline IOP (p = 0.002). CONCLUSION: Prior SLT didn't negatively influence phacoemulsification in patients with OAG. Phacoemulsification lowered IOP effectively and safely in OAG patients who were treated with SLT.


Assuntos
Glaucoma de Ângulo Aberto/cirurgia , Facoemulsificação , Trabeculectomia/métodos , Idoso , Terapia Combinada , Feminino , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular , Terapia a Laser/métodos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Facoemulsificação/efeitos adversos , Estudos Retrospectivos , Segurança , Resultado do Tratamento
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