Assessment of low-level laser therapy effects after extraction of impacted lower third molar surgery

Introduction: The aim of this study was to assess the effect of low-level laser therapy [LLLT] on pain, swelling and maximum mouth opening in patients undergoing third molar surgery

Methods: A prospective, randomized double-blind study was undertaken on 44 patients at the Dental School, Ahvaz Jundishapur University of Medical Sciences, in 2015. A low-level laser was randomly applied on one of the two sides after surgery of 15 patients. The experimental side received 18 J/cm2 of energy density, wavelength of 980 nm, and output power of 1.8 W. On the control side, a hand-piece was applied intra-orally, but laser was not activated. In addition, in order to evaluate trismus, 13 patients were treated by unilateral laser therapy and 16 patients did not receive laser therapy at all. The laser was administered intraorally on two points of vestibular and lingual sides at 1 cm from the surgery site, and extraorally at the emergence of the masseter muscle, immediately after surgery, and repeated 24 hours later. The pain, swelling and maximum mouth opening [MMO] were compared between the two groups at 24 hours and a week after surgery

Results: The mean score of pain 24 hours after surgery in the laser therapy group [2.3 +/- 3.5] was significantly lower than the mean score of pain in the drug therapy [4.19 +/- 3.09] [P = 0.036]. Moreover, the mean score of pain at one week after surgery in the laser therapy group [0.13 +/- 2.33] was significantly lower than the drug therapy group [1.43 +/- 2.45] [P = 0.046]. The amount of swelling according to different measurements did not significantly differ between the two groups neither at 24 hours nor at 1 week after surgery

Conclusion: Our findings showed that LLLT was useful in reducing pain and could slightly reduce swelling compared to drug therapy in impacted third molar surgery

Complicaciones tardías de la radioterapia ocular / Late complications of the ocular radiotherapy

La radioterapia es uno de los pilares terapéuticos utilizados en la oncología, no exenta de producir daño ocular, lo que constituye un fenómeno bien establecido. La aparición de complicaciones continúa siendo la principal preocupación de la aplicación de la radioterapia, a pesar del empleo de nuevas estrategias que buscan reducir las complicaciones y mejorar el índice terapéutico. Se presenta una paciente femenina de 63 años con diagnóstico de carcinoma epidermoide de la conjuntiva, moderadamente diferenciado G-II, invasor (T3N0M0) en ojo izquierdo, que llevó tratamiento quirúrgico y radioterapia superficial complementaria. Como complicación tardía, la paciente presentó catarata radiógena, que recibió tratamiento quirúrgico, además de aneurismas conjuntivales en el área tratada(AU)

Radiotherapy is one of the therapeutic pillars used in oncology, but ocular damage may occur and this is a well-established phenomenon. The occurrence of complications remains the main concern for the application of radiotherapy, despite the use of new strategies to reduce complications and to improve the therapeutic rate. Here is a 63 years old female patient, who was diagnosed with epidermoid carcinoma of the conjunctiva, moderately differentiated G-II invader (T3N0M0) in the left eye. She was surgically treated and received supplementary superficial radiotherapy As a late complication, the patient presented with radiogenic cataract treated by surgery, in addition to conjunctival aneurysms in the treated area as well(AU)

Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM / Impact of adjuvant radiotherapy on the cosmetic outcome of immediate breast reconstruction performed using a transverse rectus abdominis myocutaneous flap

INTRODUÇÃO: O efeito da radioterapia adjuvante após a reconstrução mamária com retalhos autólogos é controverso. O objetivo deste estudo é analisar se a radioterapia pós-operatória causa alterações volumétricas e cosméticas após a reconstrução mamária imediata com retalho do músculo reto abdominal (TRAM, do inglês transverse rectus abdominis myocutaneous). MÉTODO: No total, foram avaliadas 25 pacientes submetidas a reconstrução autóloga com retalho TRAM pediculado pós-mastectomia por câncer de mama e radioterapia adjuvante. Os resultados estéticos tardios foram coletados após o intervalo mínimo de 6 meses posteriormente ao esquema completo da radioterapia. RESULTADOS: A média de idade das pacientes foi de 42,2 anos, variando de 30 anos a 53 anos. Duas (8%) perdas completas do retalho ocorreram por necrose gordurosa maciça, duas (8%) pacientes evoluíram com contratura do retalho e perda volumétrica, e 52% das pacientes apresentaram alterações cutâneas. Entretanto, a maioria das pacientes (84%) não evoluiu com perda significativa do volume inicial do retalho ou com distorção do contorno e contração do retalho. CONCLUSÕES: O resultado cosmético após a reconstrução mamária imediata com retalho TRAM irradiado foi aceitável, comparativamente aos dados descritos na literatura. Esses achados indicam que os retalhos podem sofrer distorções de contorno pela contração, além de perda volumétrica significativa em pacientes candidatas à reconstrução com TRAM e necessidade de radioterapia adjuvante pós-mastectomia. Assim, as complicações tardias da irradiação pós-operatória devem ser consideradas nesse contexto.

BACKGROUND: The outcome of adjuvant radiotherapy performed after breast reconstruction using autologous flaps is controversial. In this study, we aimed to assess whether postoperative radiotherapy would induce volumetric and cosmetic changes after immediate breast reconstruction performed using a transverse rectus abdominis myocutaneous (TRAM) flap. METHODS: We evaluated 25 patients who were previously diagnosed with breast cancer and underwent post-mastectomy autologous reconstruction with a pedicled TRAM flap followed by adjuvant radiotherapy. Late aesthetic results were recorded starting 6 months after the completion of a full course of radiotherapy. RESULTS: The average patient age was 42.2 years (range, 30-53 years). Two (8%) complete flap losses occurred due to massive fat necrosis. Two (8%) patients exhibited flap contracture and volume loss, whereas skin changes were observed in 52% of patients. Most of the patients (84%), however, had no significant initial flap volume loss, contour distortion, or flap contraction . CONCLUSIONS: The cosmetic result obtained in the present study by immediate breast reconstruction performed using an irradiated TRAM flap was satisfactory compared to the data described in the literature. These findings suggest that the flap contours may be distorted by contraction and that significant volume losses can be observed in patients who may be candidates for TRAM flap reconstruction and require post-mastectomy adjuvant radiotherapy. Thus, in these circumstances, late complications due to postoperative irradiation should be considered.

Prostatectomía radical: seguimiento a largo plazo / Radical prostatectomy: long term follow-up

Presentamos la experiencia de nuestro Servicio en el tratamiento del cáncer prostático clínicamente órgano-confinado, mediante prostatectomía radical, en la perspectiva de un análisis de largo plazo. Se efectuó una revisión retrospectiva sobre un universo de 227 pacientes, cumpliendo los datos exigidos 164, que representan el 72,2 por ciento de la serie original. El tiempo máximo de seguimiento fue de 11 años 6 meses, exigiéndose un mínimo de 3 años, resultando una media de seguimiento de 6,66 años. La edad promedio fue 64 años. Los estadios órgano-confinados se mantuvieron libres de progresión en 72 por ciento, lo que se invierte en estadios como pT3C, 96 por ciento de progresión, y 7 casos, N1 y N2 que progresaron todos. Radioterapia complementaria se aplicó en 50 pacientes, exclusiva en 39 con 71,7 por ciento de remisión. La sobrevida global fue de 86,5 por ciento y cáncer específica de 95 por ciento.