Carbon footprint of a laser unit: a study of two centres in the UK.

PURPOSE: Climate change has serious consequences for our wellbeing. Healthcare systems themselves contribute significantly to our total carbon footprint, of which emissions from surgical practice are a major component. The primary sources of emissions identified are anaesthetic gases, disposal of single-use equipment, energy usage, and travel to and from clinical areas. We sought to quantify the waste generated by laser surgery which, to our knowledge, has not been previously reported. METHODS: The carbon footprint of two laser centres operating within the United Kingdom were measured. The internationally recognised Greenhouse Gas Protocol was used as a guiding framework to classify sources of waste and conversion factors issued by the UK government were used to quantify emissions. RESULTS: The total carbon footprints per day at each unit were 299.181 carbon dioxide equivalents (kgCo2eq) and 121.512 kgCO2eq, respectively. We found the carbon footprint of individual laser treatments to be approximately 15 kgCO2eq per procedure. The biggest overall contributor to the carbon footprint was found to be the emissions generated from staff, patient and visitor travel. This was followed by electricity usage, and indirect emissions from physical waste and laundry. CONCLUSIONS: The carbon footprint of laser procedures was considerably less than the average surgical operation in the UK. This initial study measures the carbon footprint of a laser center in a clinical setting and allows us to identify where improvements can be made to eventually achieve a net carbon zero health care system.

A comparative study of hair removal at an NHS hospital: Luminette intense pulsed light versus electrolysis.

Twenty-five women, referred for hair removal by electrolysis, were enrolled in a split face study to treat facial hirsutism. Each patient was treated on six occasions: one-half of the face with electrolysis and the other side with an intense pulsed light source. Patients were evaluated with respect to reduction in hair counts, side effects and discomfort during treatment. Re-growth was assessed at 3, 6 and 9 months following treatment. All patients, except one with very sparse, fair hair growth, preferred treatment with the Intense Pulsed Light and rated their average hair reduction with this method as 77% after five treatments. The overall patient satisfaction rates as determined by visual analogue scales were 8.3 out of 10 for IPL and 5.4 out of 10 for electrolysis.

A retrospective study of the efficacy of intense pulsed light for the treatment of dermatologic disorders presenting to a cosmetic skin clinic.

BACKGROUND: One hundred seven patients presenting to a cosmetic skin clinic were treated with intense pulsed light (IPL) over a 12-month period. The main categories of patients offered treatment were those with vascular problems such as rosacea, facial telangiectasia, and spider nevi; pigmentation disorders such as solar damage, lentigines, and hyperpigmentation; and assorted problems such as scarring and poikiloderma. METHODS: Each patient who entered into the study had the full medical history taken and a dermatologic assessment. Polaroid photographs were taken and the images used for comparison before and after treatment. Outcomes were assessed by physicians' global assessment and a patients' postal questionnaire. Patients were treated with a Lumina IPL (Lynton Lasers Ltd) using a multiple pulsing facility with variable interpulse spacing, incorporating a 585-nm head. Fluence levels varied between 10 and 40 J/cm(2), although the average fluence over all patients was 25 J/cm(2). The delay was set between 10 and 30 ms and two to four pulses were used. Results Excellent results were seen in 80% of patients treated. There was a high patient satisfaction rate and low prevalence of side effects. CONCLUSIONS: IPL has been shown to provide a safe and effective noninvasive treatment for a wide range of dermatologic disorders and is suitable for wider use in primary care.

The impact of clozapine on electrophysiological features: how can we utilize the findings?

INTRODUCTION: There is a large body of findings on the impact of clozapine upon electrophysiological features. This study repeats several of these earlier studies and reports on whether, and how, these findings can be utilized in our particular research/clinical situation. METHODS: Neurophysiological investigations were carried out on 37 schizophrenia patients, before and after commencing a clinically indicated trial of clozapine. Data from three areas of investigation-EEG, quantitative EEG (QEEG), and evoked response potential (ERP)-were compared with findings from earlier studies. Analysis was also extended to include clinical indicators, dosages, and several novel combinations of features. RESULTS: Our local population has a higher incidence of baseline abnormalities than that found in earlier investigations. Even with this difference, clozapine still leads to an increase in EEG slow-wave activity. The slow-wave increase is significantly correlated with an increase in P3 amplitude of the ERP. While QEEG changes were correlated with clinical changes, the ERP correlation did not reach significance levels. CONCLUSIONS: Electrophysiological findings, particularly from small numbers of studies, may not be generalizable to all populations. Findings which were replicated, however, support the potential use of slow wave changes in the EEG in clinical management. (Int J Psych Clin Pract 2002; 6: 95-102).