Comparison of safety and effectiveness of micropulse transscleral cyclophotocoagulation and "slow cook" diode laser transscleral cyclophotocoagulation in patients with refractory open-angle glaucoma

ABSTRACT Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and "slow cook" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was −0.10 ± 0.35 and −0.074 ± 0.16 in the micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the "slow cook" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the "slow cook" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively.

The effectiveness of high-power diode laser as an adjunct to mechanical instrumentation of deep pockets in a patient with generalized, stage III, grade C periodontitis / Eficácia do laser de diodo de alta potência como coadjuvante à instrumentação mecânica de bolsa profunda em paciente com periodontite estádio III, grau C e generalizada

ABSTRACT Periodontitis is an inflammatory clinical condition caused by dysbiotic biofilm that results in progressive destruction of periodontal attachment and can lead to tooth loss if left untreated. Objective: To evaluate the clinical efficacy of high-power diode laser as an adjunct to mechanical instrumentation in periodontal pockets of a patient with generalized, stage III, grade C periodontitis. Methods: 126 sites of a patient were examined at the Clinical Research Laboratory (LabClin) of the Federal University of Campina Grande (UFCG), where the parameters of probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BoP) were evaluated at the beginning of the study and after 3 and 6 months of basic therapy. All sites received non-surgical periodontal treatment which corresponds to scaling and root planing (SRP) and coronary polishing. The deep periodontal pockets with PD ≥ 5 mm, received the adjuvant therapy with diode laser light. Results: There was a significant improvement of periodontal parameters of PD, CAL and BoP in all treated sites. In those with PD ≥ 5 mm, the results were similar, with statistically significant reduction of PD, CAL and BoP before and after treatment. After 6 months, all periodontal pockets with PD ≥ 5mm were reduced to values lower than 3. Conclusion: The irradiation of deep pockets with high-power diode laser proved to be effective as adjuvant therapy to SRP in patients with generalized, stage III, degree C periodontitis.

RESUMO A periodontite é uma condição clínica inflamatória causada por biofilme disbiótico que resulta em destruição progressiva da inserção periodontal e pode levar a perda do dente caso não seja tratada. Objetivo: Avaliar a eficácia clínica do laser de diodo de alta potência como coadjuvante à instrumentação mecânica em bolsas periodontais de um paciente com periodontite, estádio III, grau C e generalizada. Métodos: Foram examinados 126 sítios de uma paciente, no Laboratório de Pesquisas Clínicas (LabClin) da Universidade Federal de Campina Grande (UFCG) onde foram avaliados os parâmetros de profundidade de sondagem (PS), nível de inserção clínica (NIC) e sangramento à sondagem (SS) no início do estudo e após 3 e 6 meses da terapia básica. Todos os sítios receberam tratamento periodontal não cirúrgico o que corresponde a raspagem e alisamento coronorradicular (RACR) e polimento coronário. As bolsas periodontais profundas com PS ≥ 5 mm, receberam a terapia coadjuvante com luz laser de diodo. Resultados: Houve uma melhora significativa dos parâmetros periodontais de PS, NIC e SS em todos os sítios tratados. Nos que apresentavam PS ≥ 5 mm, os resultados foram similares, com redução estatisticamente significativa PS, PIC e SS antes e após a realização do tratamento. Após 6 meses, todas as bolsas periodontais com PS ≥ 5mm foram reduzidas a valores menores que 3. Conclusão: A irradiação de bolsas profundas, com laser de diodo de alta potência, mostrou-se eficaz como terapia coadjuvante à RACR em paciente com periodontite estádio III, grau C, generalizada.

Histological artifacts associated with laser and electroscalpel gingivectomy: Case series / Artefactos histológicos asociados a gingivectomía con láser y electrobisturí: serie de casos

Introduction. Over time, efforts have been invested in the design of new instruments that overcome the disadvantages of the gold standard instrument in surgery, the scalpel. As a result, electronic equipment has emerged such as the electric scalpel and laser devices. The available evidence on these instruments suggests that the tissue response is related to each instrument's physical and biological cutting principles. Objective. To compare the histological changes in gingiva samples associated with surgical cutting performed with a 940 nm diode laser, a 2780 nm erbium, chromium: yttriumscandium-gallium-garnet (Er,Cr:YSGG) laser, and an electric scalpel, by presenting a series of cases. Case presentation. We present three cases of healthy patients undergoing cosmetic surgery. The clinical examination revealed exposure of a keratinized gingiva band greater than 4 mm, normal color and texture in gingival tissue, with a firm consistency and no bleeding on periodontal probing. Gingivectomy was indicated with the following protocols: Diode laser of 940 nm at 1 W, in continuous mode; Er,Cr:YSGG laser of 2780 nm at 2.5 W, 75 Hz, H mode, air 20, water 40, gold tip MT4); and electric scalpel in cutting mode at power level four. Gingival tissue samples were taken and stored in 10% formaldehyde for histological analysis. Conclusion. All the evaluated cutting instruments generated histological changes produced by the thermal effect, the main ones being collagen coagulation and carbonization. The depth of thermal damage caused by the 2780 nm Er,Cr:YSGG laser was much lesser than that induced by the electric scalpel and the 940 nm diode laser.

Introducción. Históricamente se ha invertido esfuerzo en el diseño de nuevos instrumentos que superen las desventajas del estándar de referencia en cirugía, el bisturí. Como consecuencia de esto, han surgido equipos electrónicos como el electrobisturí y los diferentes dispositivos de tecnología láser. La información disponible sobre estos instrumentos sugiere que la respuesta del tejido intervenido está influenciada por los principios físicos y biológicos de corte del instrumento. Objetivo. Comparar los cambios histológicos en muestras de encía asociados al corte quirúrgico realizado con láser de diodo de 940 nm, láser de erbio, cromo: itrio-escandio-galio-granate (Er,Cr:YSGG) (2780nm) y electrobisturí mediante una presentación de serie de casos. Presentación de los casos. Se presentan tres casos de pacientes sanos sometidos a cirugía estética. El examen clínico reveló la exposición de una banda gingival queratinizada mayor de 4 mm, tejido gingival de color y textura normales, de consistencia firme y sin sangrado al sondaje periodontal. Se indicó gingivectomía con los siguientes protocolos: láser de diodo de 940 nm a 1 W, en modo continuo; láser de Er,Cr:YSGG de 2780 nm a 2,5 W, 75 Hz, modo H, aire 20, agua 40, punta de oro MT4; y bisturí eléctrico en modo de corte, a nivel de potencia cuatro. Se tomaron muestras de tejido gingival y se almacenaron en formaldehído al 10 % para su análisis histológico. Conclusión. Los tres instrumentos de corte generaron cambios histológicos producidos por el efecto térmico; los principales fueron coagulación del colágeno y carbonización. La profundización del daño térmico causada por el láser de Er,Cr:YSGG de 2780 nm fue mucho menor que la generada por el electrobisturí y por el láser de diodo de 940 nm.

Effect of conventional and power office bleaching with diode laser and led light on enamel microhardness

Aim: The present study aimed to asses enamel microhardness after office bleaching with diode laser and LED light compared to the conventional bleaching procedure. Methods: Thirty-nine human premolar teeth were collected and randomly divided into three groups regarding of the bleaching technique. Group 1: Snow O bleaching gel with LED light-curing unit; Group 2: Snow L bleaching gel with diode laser irradiation; and Group 3: Opalescence Boost bleaching gel with no light source in group 3. Enamel surface changes were evaluated in one tooth in each study group and one intact tooth as a reference under a scanning electron microscope (SEM). In the remaining samples (n=12), enamel microhardness was determined by Vickers microhardness test before and after bleaching. Data were analyzed with repeated-measures ANOVA to compare microhardness changes, followed by post hoc Tukey tests at the 0.05 significance level. Results: Enamel microhardness decreased in all the groups after bleaching, with the maximum decrease in microhardness in the Snow O bleaching group with LED light, which was significantly higher than the other groups (P=0.002). The two other groups did not exhibit any significant difference in microhardness decrease (P>0.05). Conclusion:Based on the limitations of this study, it can be concluded power bleaching with 980nm diode laser was less time-consuming compare to conventional bleaching procedure and yielded better outcomes in terms of enamel surface microhardness compared to the use of an LED light-curing unit

Tratamiento de la estomatitis aftosa recurrente en pacientes inmunocomprometidos. Revisión sistemática / Treatment of recurrent aphthous stomatitis in immunocompromised patients. Systematic review

RESUMEN Fundamento: Aunque la estomatitis aftosa recurrente no tiene una etiología bien definida porque es una enfermedad multicausal, se ha reconocido que las interacciones o el debilitamiento del sistema inmunitario, contribuyen principalmente a la magnitud del proceso patológico. Las propuestas de tratamiento en pacientes inmunocomprometidos son diversas y por lo general se centran en alteraciones inmunológicas específicas. Objetivo: Evaluar el efecto clínico de los tratamientos propuestos para la estomatitis aftosa recurrente en pacientes inmunocomprometidos. Metodología: La búsqueda se realizó en las bases de datos PubMed/Medline y Cochrane. Se incluyeron ensayos clínicos que tuviesen entre sus variables de respuesta principales: Cicatrización de la úlcera aftosa, tiempo de cicatrización, de recurrencia e intensidad del dolor y entre las variables secundarias: Los efectos adversos y los síntomas. La extracción de datos se realizó de manera independiente por los autores. Se aplicó la metodología por la colaboración Cochrane para evaluar el riesgo de sesgo en cada uno de los estudios. Resultados: Se incluyeron 11 ensayos clínicos (8 controlados) publicados entre 1995 y 2020 y que aportan resultados de la eficacia de varias intervenciones terapéuticas: talidomida (4), irsogladine (2), rebamipida (1), láser de diodo (1), cápsulas de Omega-3 (1), vitamina B 12 (1), Complejo B (1). Seis de estos estudios incluyeron pacientes con la forma menor de estomatitis aftosa recurrente. El periodo de seguimiento estuvo entre los 14 y 360 días. Conclusiones: La talidomida puede ser eficaz en el alivio de los síntomas, la cicatrización y remisión de las lesiones, el diodo de láser y vitamina B12 en la disminución de la intensidad del dolor.

ABSTRACT Background: Although recurrent aphthous stomatitis does not have a well-defined etiology due to it is a multicausal disease, it has been recognized that the interactions or the weakening of the immune system, contribute mainly to the magnitude of the process pathological. Treatment proposals in immune compromised patients are diverse and they usually focus on specific immunological alterations. Objective: To evaluate the clinical effect of the proposed treatments for recurrent aphthous stomatitis in immunocompromised patients. Methodology: The search was performed in the PubMed/Medline and Cochrane databases. Clinical trials were included that could have among their main response variables: Aphthous ulcer healing, healing time, recurrence and pain intensity and among the secondary variables: Adverse effects and symptoms. data extraction was done independently by the authors. The methodology was applied by Cochrane collaboration to assess the risk of bias in each of the studies. Results: 11 clinical trials (8 controlled) published between 1995 and 2020 and that provided the results of the efficacy of various therapeutic interventions: thalidomide (4), irsogladine (2), rebamipide (1), diode laser (1), Omega-3 capsules (1), vitamin B 12 (1), Complex B (1). Six of these studies included patients with the minor form of stomatitis recurrent aphthous. The follow-up period was between 14 and 360 days. Conclusions: Thalidomide may be effective in relieving symptoms, healing and remission of the lesions, the laser diode and vitamin B12 in the decrease of the intensity of the pain.

Efficacy of low-energy laser in the treatment of erosive oral lichen planus in 43 patients / 中国基层医药

Objective:To investigate the clinical efficacy of low-energy laser in the treatment of erosive oral lichen planus (OLP) and its effect on patients' pain.Methods:Eighty-six patients with erosive OLP who were treated in Shanxian Central Hospital from February 2018 to January 2020 were included in this study. They were randomly divided into control and observation groups ( n = 43/group). The control group was treated by local injection of dexamethasone, and the observation group was treated with semiconductor low-energy laser irradiation. All patients were treated for 8 weeks. Pain scores and physical sign score before and after treatment were evaluated in each group. Therapeutic effects were compared between the two groups. Area of lesion was measured in each group. Recurrence of erosive OLP was calculated at 3 and 6 months after surgery. Results:Before treatment, there were no significant differences in visual analogue scale (VAS) score and physical sign score between the two groups (both P > 0.05). At 7, 14, 28 and 56 days after treatment, VAS score and physical sign score were significantly decreased in each group compared with those before treatment, and VAS score and physical sign score in the observation group were significantly lower than those in the control group (all P < 0.05). Total response rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 83.72% (36/43), χ2 = 1.81, P > 0.05). Before and 1 month after treatment, there was no significant difference in area of lesion between control and observation groups (both P > 0.05). At 3 and 6 months after surgery, area of lesion in the observation group was (0.31 ± 0.14) cm 2 and (0.32 ± 0.12) cm 2, respectively, which were significantly smaller than those in the control group [(0.42 ± 0.18) cm 2, (0.48 ± 0.19) cm 2, t = 3.16, 4.67, both P < 0.05). At 3 and 6 months after treatment, recurrence of erosive OLP in the observation group was 2.33% (1/43) and 13.95% (6/43), respectively, which were significantly lower than those in the control group [13.95% (6/43), 37.21% (16/43), χ2 = 3.89, 6.11, both P < 0.05]. Conclusion:There is no significant difference in the short-term efficacy of low-energy laser versus conventional corticosteroids in the treatment of erosive OLP. However, low-energy laser has a more obvious short-term pain relief effect than conventional corticosteroids. It can accelerate the healing of injured tissue and decrease the recurrence rate of erosive OLP.

Reliability of endoscopic dye transit test for prediction of functional success after diode laser and external dacryocystorhinostomy / Confiabilidade do teste endoscópico do corante na predição do sucesso funcional após dacriocistorinostomia com laser diodo e externa

ABSTRACT Purpose: To determine the reliability of the endoscopic dye transit test for the prediction of functional success after dacryocystorhinostomy. Methods: A cross-sectional study was conducted with 50 patients who underwent external dacryocystorhinostomy Group or transcanalicular dacryocystorhinostomy Group and had anatomically patent ducts during irrigation, with a minimum 6-month follow-up. The external dacryocystorhinostomy, defined as the time from instillation of the dye into the conjunctival sac until its flow from the rhinostomy site, was performed in all patients. Positive predictive value of the endoscopic dye transit test to assess functional success was analyzed. The cutoff point was determined using a receiver operating characteristic curve. Results: Of the 50 patients, 44 (88%) exhibited subjective improvement or complete resolution of epiphora (functional success). The best cutoff point for the endoscopic dye transit test was 60 s. Of 39 patients with endoscopic dye transit test £60 s, 38 (97.4%) exhibited functional success, demonstrating a 97.4% positive predictive value. Conclusion: The endoscopic dye transit test £60 s is a reliable tool to predict functional success and good prognosis after external or laser transcanalicular dacryocystorhinostomy.

RESUMO Objetivo: Determinar a confiabilidade do teste endoscópico do corante na predição do sucesso funcional após dacriocistorrinostomia. Métodos: Estudo transversal com 50 pacientes submetidos ao grupo de dacriocistorrinostomia externa ou grupo dacriocistorrinostomia transcanalicular e que possuíam dutos anatomicamente patentes pela irrigação, com seguimento mínimo de 6 meses. A dacriocistorrinostomia externa, definida como o tempo desde a instilação do corante no saco conjuntival até o fluxo do local da rinostomia, foi realizada em todos os pacientes. O valor preditivo positivo do teste endoscópico do corante para avaliar o sucesso funcional foi analisado. O ponto de corte foi determinado usando uma curva característica de operação do receptor. Resultados: Dos 50 pacientes, 44 (88%) apresentaram melhora subjetiva ou resolução completa da epífora (sucesso funcional). O melhor ponto de corte para o teste endoscópico do corante foi de 60 s. Dos 39 pacientes com teste endoscópico do corante £60 s, 38 (97,4%) apresentaram sucesso funcional, demonstrando um valor preditivo positivo de 97,4%. Conclusão: O teste en­doscópico do corante £60 s é uma ferramenta confiável para predizer o sucesso funcional e o bom prognóstico após dacriocistorrinostomia transcanalicular externa ou a laser.

Effect of Qishen-Xiaodian Decoction combined with laser acupoint irradiation on recurrence oxidative stress and renal function oin children with henoch schonlein purpura / 国际中医中药杂志

Objective@#To explore the effect of Qishen-Xiaodian Decoction combined with laser acupoint irradiation on oxidative stress and renal function on children with recurrent henoch schonlein purpura (HSP).@*Methods@#A total of 120 children with recurrent HSP in the dermatology department clinic of Hospital of Xinle City from January 2015 to November 2017 were divided into two groups according to the random number table method, with 60 cases in each group. The control group took loratadine, Troxerutin and vitamin C orally, while the treatment group took Chinese medicine combined with laser acupoint irradiation based onthe control group. Drugs were taken orally for 4 weeks, laser acupoint irradiation treatment for 2 weeks. The level of glutathione peroxidase (GSH-Px) in plasma was detected by ELISA, the levels of MDA and SOD in plasma were detected by thiobarbituric acid colorimetry and hydroxylamine method, the level of IgG, micro albumin (Alb), β2-microglobulin (β2-MG) in urine were detected by radioimmunoassay, and the clinical effect was evaluated. The recurrence was recorded.@*Results@#After treatment, the plasma GSH-Px (90.45 ± 15.36 μmol/L vs. 81.62 ± 13.68 μmol/L, t=3.318), SOD (99.64 ± 18.66 IU/ml vs. 84.21 ± 16.73 IU/ml, t=4.769) in the treatment group were significantly higher than the control group (P<0.01); the MDA (5.58 ± 1.31 μmol/L vs. 4.37 ± 1.36 μmol/L, t=4.964) was significantly lower than the control group (P<0.01); the ratio of urine IgG (3.48 ± 0.95 mg/L vs. 6.56 ± 1.47 mg/L, t=13.630), Alb (7.80 ± 2.94 mg/L vs. 12.73 ± 4.26 mg/L, t=7.378), β2-MG (4.02 ± 1.61 mg/L vs. 6.95 ± 2.10 mg/L, t=8.577) were significantly lower than those of the control group (P<0.01). The total effective rate was 95.0% (57/60) in the treatment group and 80.0% (48/60) in the control group. There was statistically significant difference between two groups (χ2=6.171, P=0.013). Follow-up of 6 and 12 months, the recurrence rate of the treatment group were significantly lower than that of the control group (χ2 value were 4.931, 4.574, P<0.05).@*Conclusions@#Qishen-Xiaodian Decoction combined with laser acupoint irradiation can improve the oxidative stress of children with recurrent HSP, protect the renal function, improve the clinical efficacy and reduce the recurrence rate.

A prospective, comparative evaluation of axillary hair removal with an 808-nm diode laser at different fluences

BACKGROUND: Diode lasers are the gold standard for removing unwanted hair. Lowering the energy should result in less pain and could theoretically affect therapeutic efficacy. This study evaluated the efficacy of an 808-nm diode laser at different fluences for permanent axillary hair removal in Korean women. METHODS: Twenty-four Korean women were divided into two groups. Each patient received laser treatment at both axillae, which were divided into upper and lower parts. Each part received different fluence from an HR808 prototype diode at 1-month intervals: 8, 10, 12, and 14 J/cm². Hair count and thickness were recorded at each follow-up visit and at a 3-month follow-up after the final laser treatment by photography and using a folliscope. At the final visit, pain and patient satisfaction were surveyed. Three plastic surgeons assessed the results on photographs. RESULTS: The mean hair follicle density reduction was 62.18%, 65.28%, 73.08%, and 78.29% on the right upper side, right lower side, left upper side, and left lower side, respectively. The mean hair follicle thickness reduction was 45%, 48%, 54%, and 59% on the right upper side, right lower side, left upper side, and left lower side, respectively. In the plastic surgeons' assessment, the left upper and lower sides scored 2.71. The right upper and lower sides scored 2.38 and 2.04, respectively. CONCLUSIONS: High-fluence (14 J/cm²) treatment with an HR 808 prototype diode laser efficiently removed unwanted hair. No significant difference in comfort was reported compared to the low-fluence mode (8–10 J/cm²).

Micropulse laser trabeculoplasty for uncontrolled open angle glaucoma in Peruvian patients / Trabeculoplastia a laser Micropulso para glaucoma de ângulo aberto não controlado em pacientes peruanos

ABSTRACT Objective: We describe the pressure lowering effect of micropulse laser trabeculoplasty (MLT) in patients with uncontrolled open angle glaucoma (OAG). Design: Retrospective case series. Methods: We retrospective reviewed 30 eyes with Open angle Glaucoma (OAG) at the Vista Clinic in Lima, Peru. A single session of MLT treatment was delivered using a 532 nm Frequency doubled Nd. YAG laser to 360º of the trabecular meshwork with a power of 1000 mW, 25 % of duty cycle, and 300 ms. of exposure. The intraocular pressure (IOP) was measured at baseline and at 1 day, 1 week, 3, 6 months post-treatment and were followed up for one last control. Results: The mean baseline IOP was 15.6 mmHg and in the last control was12.8 mmHg, mean follow up time of 19 months (+/- 10 SD). The mean reduction of IOP in the first day was 1.6 mmHg (± 2.6 SD) and 1.2 mmHg (± 3.3 SD) in the last follow up. The mean percentage of IOP reduction was 17.9% and 7 eyes (40%) had IOP reduction greater than 20%. No statistical difference in relation to demographics characteristics of the patients. The greatest reduction was achieved in the first day with a median of 2.00 (P 0.001). A tendency to achieve higher reduction of IOP in patients with higher baseline IOP was found, but was not statistical significant. No adverse reactions occurred. Conclusions: Micropulse laser trabeculoplasty can temporarily be effective in reducing the IOP in some patients with uncontrolled Open angle glaucoma and appears to be safe.

RESUMO Objetivo: Descrevemos o efeito redutor de pressão da trabeculoplastia com laser de micropulso (MLT) em pacientes com glaucoma de ângulo aberto (OAG) descontrolado. Design: Série de casos retrospectiva. Métodos: Foram revisados retrospectivamente 30 olhos com glaucoma de ângulo aberto (OAG) na Clínica Vista em Lima, Peru. Uma única sessão de tratamento com MLT foi administrada usando uma Nd de frequência duplicada de 532 nm. Laser YAG a 360 º da malha trabecular com uma potência de 1000 mW, 25% do ciclo de trabalho e 300 ms. de exposição. A pressão intra-ocular (PIO) foi medida no início e em 1 dia, 1 semana, 3, 6 meses após o tratamento e foram seguidos por um último controle. Resultados: A média da PIO basal foi de 15,6 mmHg e no último controle foi de 12,8 mmHg, com tempo médio de seguimento de 19 meses (+/- 10 DP). A redução média da PIO no primeiro dia foi de 1,6 mmHg (± 2,6 DP) e 1,2 mmHg (± 3,3 DP) no último seguimento. A porcentagem média de redução da PIO foi de 17,9% e 7 olhos (40%) tiveram redução da PIO superior a 20%. Nenhuma diferença estatística em relação às características demográficas dos pacientes. A maior redução foi obtida no primeiro dia com mediana de 2,00 (P 0,001). A tendência de atingir uma redução maior da PIO em pacientes com PIO basal mais alta foi encontrada, mas não foi estatisticamente significativa. Nenhuma reação adversa ocorreu. Conclusões: A trabeculoplastia a laser Micropulse pode ser temporariamente eficaz na redução da PIO em alguns pacientes com glaucoma de ângulo aberto descontrolado e parece ser segura.

Short term histopathological effects of GaAlAs laser on experimentally induced TMJ osteoarthritis in rabbits

Abstract The aim of this study was to evaluate the biostimulation (BS) effect of the gallium-aluminum-arsenide (GaAlAs) diode laser by histopathology with an experimental osteoarthritis (OA) model in the temporomandibular joints (TMJ) of rabbits, in the early period. GaAlAs diode laser is used for pain reduction in TMJ disorders. Twenty-four adult male New Zealand white rabbits were randomly divided into three equal groups: Control Group (CG), Study Group 1 (SG-1), and Study Group 2 (SG-2). Mono-iodoacetate (MIA) was administered to the right TMJs of all rabbits. The rabbits did not undergo any treatment for four weeks to allow the development of osteoarthritis. In SG-1, laser BS was applied to the rabbits at 940 nm, 5 W, and 15 J/cm2 in continuous wave mode at 48-hour intervals for 14 sessions; and in SG-2, laser BS was applied with the same parameters at 24-hour intervals for 28 sessions. Laser BS was not applied to the rabbits in CG. All rabbits were sacrificed simultaneously. The TMJ cartilage, osteochondral junction, chondrocyte appearance, and subchondral ossification were evaluated histopathologically. There was no statistically significant difference between the groups in terms of cartilage, osteochondral junction, chondrocyte appearance, and subchondral ossification values (p > 0.05). The laser BS protocol used in the study had no positive histopathological effects on TMJ OA in the early period.

Low-level laser therapy for the prevention of low salivary flow rate after radiotherapy and chemotherapy in patients with head and neck cancer / Laser de baixa potência para prevenção de hipofluxo salivar em pacientes portadores de câncer de cabeça e pescoço após radioterapia e quimioterapia

Abstract Objective: To determine whether low-level laser therapy can prevent salivary hypofunction after radiotherapy and chemotherapy in head and neck cancer patients. Materials and Methods: We evaluated 23 head and neck cancer patients, of whom 13 received laser therapy and 10 received clinical care only. An InGaAlP laser was used intra-orally (at 660 nm and 40 mW) at a mean dose of 10.0 J/cm2 and extra-orally (at 780 nm and 15 mW) at a mean dose of 3.7 J/cm2, three times per week, on alternate days. Stimulated and unstimulated sialometry tests were performed before the first radiotherapy and chemotherapy sessions (N0) and at 30 days after the end of treatment (N30). Results: At N30, the mean salivary flow rates were significantly higher among the laser therapy patients than among the patients who received clinical care only, in the stimulated and unstimulated sialometry tests (p = 0.0131 and p = 0.0143, respectively). Conclusion: Low-level laser therapy, administered concomitantly with radiotherapy and chemotherapy, appears to mitigate treatment-induced salivary hypofunction in patients with head and neck cancer.

Resumo Objetivo: Avaliar o impacto do laser de baixa potência na prevenção de hipofluxo salivar em pacientes portadores de câncer de cabeça e pescoço após radioterapia e quimioterapia. Materiais e Métodos: Treze pacientes receberam laserterapia e dez receberam cuidados clínicos. Utilizou-se um InGaAlP laser diodo para aplicação intraoral (comprimento de onda de 660 nm, 40 mW de potência e dose média de 10 J/cm2) e extraoral (comprimento de onda de 780 nm, 15 mW de potência e dose média de 3,7 J/cm2), três vezes por semana, em dias alternados. Sialometrias estimulada e não estimulada foram realizadas antes da primeira sessão de radioterapia e quimioterapia (N0) e 30 dias após o final do tratamento (N30). Resultados: Em N30, os pacientes submetidos à laserterapia apresentaram médias estatisticamente maiores de fluxo salivar estimulado (p = 0,0131) e não estimulado (p = 0,0143), em comparação com os pacientes que receberam apenas cuidados clínicos. Conclusão: A laserterapia de baixa potência realizada concomitantemente a radioterapia e quimioterapia foi capaz de mitigar a hipofunção das glândulas salivares em pacientes portadores de câncer de cabeça e pescoço após o tratamento oncológico.

Diode laser-assisted transcanalicular dacryocystorhinostomy: the effect of age on the results / Dacriocistorrinostomia transcanalicular auxiliada por laser de diodo: o efeito da idade sobre os resultados

ABSTRACT Purpose: The aim of this study was to explore the effect of age on the success of transcanalicular diode laser-assisted dacryocystorhinostomy (TCDCR). Methods: Seventy patients (70 eyes) who underwent transcanalicular diode laser-assisted dacryocystorhinostomy for the treatment of nasolacrimal duct obstruction as a primary surgery were included in this retrospective, nonrandomized study. The patients were divided into two groups according to age. Mean ages were 21.3 ± 3.3 in group 1 and 60.3 ± 7.3 in group 2. The records of the 3-, 6-, and 12-month follow-up examinations were evaluated, and the anatomical and functional outcomes were noted. Functional success was defined as the absence of epiphora as indicated by the patient. Anatomical success was determined as patency of the neo-ostium with irrigation. Results: At the 3-month follow-up, 67% cases in group 1 showed anatomical success and 52% showed functional success; in group 2, the rates were 100% and 92%, respectively. Functional and anatomical success rates were the same for both the 6- and 12-month visits; 46% in group 1 and 76% in group 2. The results in group 2 were significantly better at all three follow-up visits (p<0.05). Conclusions: This study clearly showed that the older patients experienced better transcanalicular diode laser-assisted dacryocystorhinostomy results than the younger patients. The diminished inflammatory response in the older population may be a possible contributing factor to these results. .

RESUMO Objetivo: O objetivo deste estudo foi explorar o efeito da idade sobre o sucesso de dacriocistorrinostomia transcanalicular auxiliada por laser de diodo (TCDCR). Método: Setenta olhos de setenta pacientes submetidos dacriocistorrinostomia transcanalicular auxiliada por laser de diodo para o tratamento da obstrução nasolacrimal como cirurgia primária foram incluídos neste estudo retrospectivo, não randomizado. Os pacientes foram divididos em dois grupos segundo a idade. As idades médias foram 21,3 ± 3,3 no grupo 1 e 60,3 ± 7,3 no grupo 2. Os registros do acompanhamento pós-operatório aos três, seis e 12 meses, foram avaliados, observando resultados anatômicos e funcionais. Sucesso funcional foi definido como a ausência de lacrimejamento, conforme informado pelo paciente. Sucesso anatômico foi determinado como a permeabilidade do novo óstio à irrigação. Resultados: Nos três meses de acompanhamento, 67% dos casos no grupo 1 apresentou sucesso anatômico, e 52% mostraram sucesso funcional. No grupo 2, as taxas foram de 100% e 92%, respectivamente. Taxas de sucesso funcionais e anatômicas foram as mesmas para ambos os seis e 12 meses de visitas: 46% no grupo 1 e 76% no grupo 2. Os resultados do grupo 2 foram significativamente melhores em todas as três visitas pós-operatorias (p<0,05). Conclusões: Este estudo mostra claramente que os pacientes mais idosos apresentam melhores resultados à dacriocistorrinostomia transcanalicular auxiliada por laser de diodo comparados aos mais jovens. A resposta inflamatória diminuída na população mais velha é um possível fator que contribuiu para estes resultados. .

Lipólisis láser y liposucción en ginecomastia: retracción cutánea eficaz y segura / Laser-assisted lipolysis for gynecomastia: safe and effective skin retraction

OBJETIVO: Valorar la eficacia de la lipólisis-láser para corregir el volumen, flacidez y excedente cutáneo sin escisión. MÉTODOS: Prospectivamente, en 32 pacientes con ginecomastia, bajo anestesia tumescente y sedación se realizó lipólisis con láser de diodo 980nm, 15W en emisión continua, 8kJ a 12kJ de energía por mama. Externamente se utilizó aire frío para protección de la piel. Después se utilizó lipoaspiración convencional. No se emplearon drenajes pero si vendaje compresivo. Los pacientes evaluaron los resultados en una escala visual analógica. Dos médicos evaluaron los resultados por fotografías de antes y seis meses después, y midieron las areolas y contorno torácico. RESULTADOS: Veintitrés pacientes consideraron los resultados como Muy Bueno, siete Bueno y dos Regular. La retracción cutánea en la areola fue notable un mes después de la intervención y fue máxima a los seis meses. La valoración de los médicos fue 26 Muy Bueno, cinco Bueno y un Regular. No existieron quemaduras, isquemia, ni lesiones en areolas o pezón. CONCLUSIÓN: La liposucción asistida por láser es eficaz y de ejecución sencilla, poco traumática y permite una temprana reintegración a las actividades.

OBJECTIVES: To evaluate efficacy of laser lipolysis in the treatment of gynecomastia to correct breast volume, flaccidity and excess skin without its excision. METHODS: Prospectively, 32 patients with gynecomastia under tumescent anaesthesia and sedation underwent laser lipolysis with 980nm diode laser, 15W continuous emission and 8 to 12 kJ energy per breast. Externally cold air was used to protect the skin. No drainages were used but a compressive bandage. Patients evaluated results on a VAS scale. Two doctors evaluated results comparing before and 6 month after photographs and also measured the areola and chest diameter. RESULTS: Twenty three patients considered results as Very Good, 7 Good and 2 Fair Cutaneous retraction of the areola was noticeable one month after the surgery and was maximum 6 months after. Evaluation by doctors was 26 Very Good, 5 Good and 1 Fair. There were no burns, ischemia or lesions in areolas or nipples. CONCLUSION: Laser assisted liposuction is a simple and efficacious technique, barely traumatic and permits a rapid reincorporation to normal activitie.

The effects of different doses of 670 nm diode laser on skin flap survival in rats / O efeito de diferentes doses de laser de diodo 670 nm na viabilidade de retalho cutâneo randômico em ratos

PURPOSE: To investigate the effects of different low-level laser therapy (LLLT) doses on random skin flap rats. METHODS: Forty Wistar rats were randomly divided in four groups. The control group (CG) was not irradiated. The experimental groups were irradiated with a diode laser 670 nm with different energies per point: group 2 (G2) with 0.06 J; group 3 (G3) 0.15 J and group 4 (G4) 0.57 J. The three groups were irradiated in 12 equally distributed points in the cranial skin flap portion. They were submitted to the irradiation during the immediate, first and second postoperative days. The necrosis area was evaluated in the seventh postoperative day. RESULTS: The CG shows 49.35 percent of necrosis area in the skin flap; G2, 39.14 percent; G3, 47.01 percent and G4, 29.17 percent respectively. There was a significantly difference when G4 was compared with CG`s skin flap necrosis area. CONCLUSION: The low-level laser therapy diode 670 nm with 0.57 J energy per point increases the survival in randomic skin flap rats.

OBJETIVO: Investigar os efeitos de diferentes doses de laserterapia de baixa intensidade na viabilidade de retalhos cutâneos randômicos em ratos. MÉTODOS: Quarenta ratos Wistar foram randomizadamente distribuídos em quatro grupos. O grupo controle (GC) não foi irradiado. Os animais dos grupos experimentais foram irradiados por laser de diodo (670 nm) com as seguintes energias ofertadas por ponto: grupo 2 (G2) 0,06J; grupo 3 (G3) 0,15 J e grupo 4 (G4) 0,57 J. Os três grupos foram irradiados em 12 pontos igualmente distribuídos na porção cranial do retalho cutâneo. Todos os animais dos grupos 2, 3 e 4 foram submetidos ao protocolo de irradiação por três dias consecutivos, iniciando no pós-operatório imediato. A área necrótica foi avaliada no sétimo dia pós-operatório. RESULTADOS: A porcentagem de área necrótica apresentou-se da seguinte forma, nos diferentes grupos: GC= 49,35 por cento, G2= 39,14 por cento, G3= 47,01 e G4= 29,17 por cento. Foi encontrada diferença estatisticamente significante quando se compararam os dados entre GC e G4. CONCLUSÃO: A irradiação com laser de diodo (670 nm) de baixa intensidade, com oferta de 0,57 J de energia por ponto influenciou positivamente a viabilidade de retalhos cutâneos randômicos em ratos.

Efeito do laser de baixa potência na cicatrização de ferida cirúrgica em ratos / Effect of low level laser on sutured wound healing in rats

PURPOSE: To evaluate the effect of low-level laser therapy (LLLT) ë904 nm on healing of surgical wounds in rats. METHODS: Forty male Wistar rats were used, divided into four groups, underwent incision along the lines Alba covering skin, subcutaneous and muscle abdominal, sutured continuously for nylon 5-0. Eight and fifteen days after the surgery process, the repairing area was removed and histological sections were stained with hematoxylin-eosin to assess cellularity inflammatory, Masson's Trichrome and Picrossirus to quantify the collagen fibers and immunohistochemical technique for counting newly formed vessels. The data were compared statistically using analysis of variance ANOVA, with a "post-hoc Tukey test, p <0.05. RESULTS: Low-level laser therapy reduced the intensity of the inflammatory reaction and influenced the dynamic of the immunoinflammatory response by inducing switching of the leukocyte infiltration pattern (neutrophilic to lymphoplasmacytic infiltration). Also stimulate the deposition and enhance the organization of collagen fibers, featuring a delicate collagen type III. Furthermore, it appeared to a significant increase in the average number of newly formed vessels (p = 0.00 and p = 0.02, respectively). CONCLUSION: Low-level laser therapy resulted in modulate of the inflammatory response, enhanced deposition of collagen fibers and increase in the average number of newly formed vessels.

OBJETIVO: Avaliar o efeito da terapia laser de baixa potência (TLBP) ë904 nm na cicatrização de feridas cirúrgicas em ratos. MÉTODOS: Foram utilizados 40 ratos Wistar, machos, divididos em quatro grupos, submetidos à incisão na linha Alba abrangendo pele, subcutâneo e musculatura abdominal, suturados continuamente por fios de nylon 5-0. Oito e quinze dias após o procedimento cirúrgico, a área de reparo foi removida e os cortes histológicos foram corados com hematoxilina-eosina para avaliar celularidade do infiltrado inflamatório, Tricrômico de Masson e Picrosirius para quantificar as fibras de colágeno e técnica imuno-histoquímica para a contagem de vasos neoformados. Os dados foram comparados estatisticamente pela análise de variância ANOVA, com "teste de Tukey post-hoc, p <0,05. RESULTADOS: A terapia laser de baixa potência reduziu a intensidade da reação inflamatória e influenciou a dinâmica da resposta imuno por induzir a mudança do padrão de infiltração de leucócitos (neutrófilos a infiltração mononuclear). Como também estimula a deposição e melhora padrão organizacional das fibras colágenas, apresentando um delicado colágeno tipo III. Além disso, verificou-se um aumento significativo no número médio de vasos neoformados (p = 0,00 e p = 0,02, respectivamente). CONCLUSÃO: A terapia laser de baixa potência modula a resposta inflamatória, com melhor deposição de fibras colágenas e aumento do número médio de vasos neoformados.

Complicações na dacriocistorrinostomia transcanalicular com laser diodo: complications / Transcanalicular dacryocystorhinostomy with diode laser: complications

OBJETIVO: Analisar as complicações da aplicação do laser de diodo para o tratamento da obstrução nasolacrimal adquirida. MÉTODOS: Foram realizados 44 procedimentos (dacriocistorrinostomia transcanalicular com laser de diodo com intubação bicanalicular de silicone sob anestesia local) entre fevereiro de 2002 a novembro de 2007 em 41 pacientes (3 bilateralmente), sendo 32 mulheres e 9 homens. RESULTADOS: As complicações mais frequentes no intraoperatório foram: dificuldade de passar a sonda de Crawford (13,6 por cento) e passagem da fibra óptica dificultada (11,3 por cento). No pós-operatório, a epífora foi a ocorrência mais frequente (15,9 por cento), seguida pela retirada acidental do silastic (11,3 por cento). CONCLUSÃO: Os índices de complicações intra e pós-operatórias se equivalem aos artigos publicados com a mesma técnica cirúrgica (e mesmo tipo de laser).

PURPOSE: To evaluate the complications of the use of diode laser in the treatment of acquired nasolacrimal obstruction. METHODS: Forty four procedures (transcanalicular dacryocystorhinostomy with diode laser with bicanalicular silicone tube intubation and local anesthesia) where performed from February 2002 to November 2007 in 41 patients (3 bilaterally), 32 women and 9 men. RESULTS: The most common intraoperative complications were disability to pass the Crawford probe (13.6 percent) and the laser probe (11.3 percent). Regarding postoperative complications, epiphora was the event of higher frequency (15.9 percent) followed by the non-intentional silastic extrusion by the patient (11.3 percent). CONCLUSION: Intraoperative and postoperative complications rate were similar of others articles that demonstrated the same surgical technique (with same laser).