Long pulse 1,064-nm neodymium-doped yttrium aluminum garnet laser in aesthetic dermatology.

Long pulse 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser is a very versatile laser due to its deep penetration and absorption by hemoglobin, melanin, and water, which has gained increasing popularity over recent years for the treatment of leg veins and permanent hair removal as well as skin rejuvenation. The long-pulse Nd:YAG laser was appointed as treatment of choice for the treatment of 0.5-3.0 mm deoxygenated, unsightly leg veins. Hair removal is another application of long pulse Nd:YAG lasers, and decreased light absorption by melanin at 1,064 nm reduces the risk of pigmentary side effects, which makes long pulse Nd:YAG laser the safest laser in darker skin types. The long pulse Nd:YAG lasers are also being employed for skin rejuvenation based on their ability to heat dermal water and stimulate collagen production. We have reviewed the parameters of Nd:YAG laser and shared our experiences in these indications that may be useful for good clinical response with minimal side effects.

[An Endurance Athlete with Calf Pain - Probably Musculoskeletal?] / Ein Ausdauersportler mit Schmerz in der Wade ­ vermutlich muskuloskeletal?

An Endurance Athlete with Calf Pain - Probably Musculoskeletal? Abstract. Deep vein thromboses are frequent and account for one third of all cardiovascular diseases. But undoubtedly patients often present risk factors. To assume a deep vein thrombosis in an endurance athlete with pain in the calf, therefore seems unreasonable. The positive D-dimer and the side differences of the calf diameter was the key for the correct diagnosis. The treatment with Heparin improved clinical symptoms within 5 days and the patient became free of pain. The additionally conducted ultrasound showed no more hints for a thromboembolic process.

Relationship between medical compression and intramuscular pressure as an explanation of a compression paradox.

BACKGROUND: Using standing magnetic resonance imaging (MRI), we recently showed that medical compression, providing an interface pressure (IP) of 22 mmHg, significantly compressed the deep veins of the leg but not, paradoxically, superficial varicose veins. OBJECTIVE: To provide an explanation for this compression paradox by studying the correlation between the IP exerted by medical compression and intramuscular pressure (IMP). MATERIAL AND METHODS: In 10 legs of five healthy subjects, we studied the effects of different IPs on the IMP of the medial gastrocnemius muscle. The IP produced by a cuff manometer was verified by a Picopress® device. The IMP was measured with a 21G needle connected to a manometer. Pressure data were recorded in the prone and standing positions with cuff manometer pressures from 0 to 50 mmHg. RESULTS: In the prone position, an IP of less than 20 did not significantly change the IMP. On the contrary, a perfect linear correlation with the IMP (r = 0.99) was observed with an IP from 20 to 50 mmHg. We found the same correlation in the standing position. CONCLUSION: We found that an IP of 22 mmHg produced a significant IMP increase from 32 to 54 mmHg, in the standing position. At the same time, the subcutaneous pressure is only provided by the compression device, on healthy subjects. In other words, the subcutaneous pressure plus the IP is only a little higher than 22 mmHg-a pressure which is too low to reduce the caliber of the superficial veins. This is in accordance with our standing MRI 3D anatomical study which showed that, paradoxically, when applying low pressures (IP), the deep veins are compressed while the superficial veins are not.