Evaluation of the effectiveness of picosecond KTP and fractional thulium lasers on pigmented-type periorbital dark circles.

OBJECTIVE: To determine the effectiveness of picosecond KTP in reducing peri-ocular dark circles caused mainly by excessive pigmentation and to compare Picosecond KTP with Thulium laser ability in reducing the intensity and extent of peri-ocular dark circles. MATERIALS AND METHODS: This split-face prospective study included twelve women with periorbital dark circles (pigmented or mixed-pigmented type). The left lower eyelid was treated using the PicoHi machine (HIRONIC Ltd), a full beam Q-switched Nd-YAG provided by KTP crystal (523 nm) at settings of 0.3 J/cm2, 5 mm, 5 Hz, and 300 Ps. Whereas the right lower eyelid was treated using the Lavieen machine (WON TECH Co., Ltd), a fractional Thulium laser (1927 nm) at setting 1320 mJ/cm2, 30 × 15 mm, 1500 microseconds. Patients received a series of 3 treatment sessions, given at 4-week intervals. RESULTS: The 532-nm full beam Q-switched KTP and fractional Thulium lasers were more likely to induce post-inflammatory hyperpigmentation rather than decrease the pigmentation. The risk is higher with a Q-switched KTP laser, which may be attributed to the skin tone of the participants. Nonetheless, some improvement in the pigmented type of PDCs, although not detected clinically, was documented by the VISIA software. CONCLUSION: No solid conclusion can be drawn from the results of the study. Picosecond KTP and Thulium lasers may have a role in reducing PDCs yet more studies should be performed in order to determine the exact impact these lasers have.

Serum trace element levels in COPD patient: the relation between trace element supplementation and period of mechanical ventilation in a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Many trace elements play important roles in activating or inhibiting enzymatic reactions, by competing with other elements and metalloproteins for binding sites, by affecting the permeability of cell membranes and by other mechanisms. They play important roles in the oxidant/antioxidant balance. As such, trace elements are thought to be involved directly or indirectly in the pathogenesis of several diseases. The aim of the present study is to investigate the effect trace elements (Se, Mn and Zn) intravenously administered on the period the COPD patients spend on mechanical ventilation. METHODS: In a randomized double-blinded controlled trial a set of 120 subjects (40 normal volunteers and 80 COPD) were recruited. Serum concentration levels of Se, Mn and Zn were determined for all enrolled subjects with Inductively Coupled Plasma spectroscopy. COPD patients received intravenous supplementation of the above trace elements and the period the patients spent on mechanical ventilation was determined. RESULTS: There was a significant reduction (P = 0.013) in the period the patients with COPD spent on the mechanical ventilation when received intravenous supplementation (9.4 +/- 7.3 days) compared with the COPD patients who received placebo (17.8 +/- 7.6 days). CONCLUSIONS: Trace element (Se, Mn and Zn) status is altered in critically ill patients with COPD. The supplementation achieved a reduction in the period those patients spent on the mechanical ventilation. A larger multi-centre trial is required to confirm this preventive effect and to explore its applicability to other critical care conditions.

Pleural fluid IL-8 as an inflammatory mediator for discriminating transudates and exudates.

The differential diagnosis of pleural effusion is a frequent clinical problem. The possible role of pleural fluid cytokines in discriminating transudates from exudates has not been studied adequately. The aim of this study was to evaluate serum and pleural fluid levels of interleukin-8 (IL-8) and compare it with common biochemical parameters such as total protein lactate dehydrogenase (LDH). Forty patients with pleural effusion were studied. IL-8 was measured simultaneously in serum and pleural fluid using a commercially available ELISA kit. Standard laboratory methods were employed for biochemical parameters. Serum IL-8 levels were higher in the exudative group (8.1 +/- 0.2), but without statistical difference, when compared with transudate patients (6.8 +/- 0.1) (p > 0.05). Pleural IL-8 levels were significantly increased in exudate effusion when compared with transudate (26.6 +/- 3.7, 7.1 +/- 0.04 respectively, p < 0.001). In addition, a significant difference was found between pleural IL-8 in the malignant group (28.2 +/- 4.4) in comparison with the tuberculous group (21.1 +/- 2.9) (p < 0.01). Using ROC analysis, a pleural IL-8 cut off level of 19.7 pg/ml was found the best discriminating ratio in distinguishing exudates from transudates, with sensitivity of 100%, low specificity (from 50 to 66.7%) and good PPV (from 94.4 to 94.7%). Regarding pleural protein, the best discriminating value was 3 g/dl, while that for LDH was 200 IU/L. It is concluded that IL-8 could be considered as a sensitive, but not specific marker in differentiating pleural effusion into exudate and transudate, specially when used together with other criteria such as protein and LDH levels.