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1.
ANZ J Surg ; 89(4): 345-349, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30706655

RESUMO

BACKGROUND: To determine national trends in the utilization of surgical procedures for the treatment of benign prostatic hyperplasia (BPH) in Australia over the last 20 years. METHODS: The Medicare Australia and Australian Institute of Health and Welfare databases were used to determine the annual number of surgical procedures and hospital admissions for BPH. RESULTS: From 1998 to 2017, surgical procedures for BPH have increased by 79% which is largely commensurate with population growth. From 1998 to 2008, transurethral resection of the prostate (TURP) was the predominant surgical therapy, accounting for 96% of all surgical treatments. From 2008 to 2017, TURP use reduced to 70% and in the last 5 years has been replaced with photoselective vaporization (16%), UroLift (8%) and holmium laser prostatectomy (6%). UroLift is used significantly more in younger men (P < 0.001). CONCLUSION: There has been a substantial increase in surgical treatments for BPH over the last 20 years. In the last 5 years, TURP use has declined due to an increase in laser prostatectomy and UroLift procedures.


Assuntos
Sintomas do Trato Urinário Inferior/etiologia , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Hiperplasia Prostática/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Terapia a Laser/métodos , Terapia a Laser/estatística & dados numéricos , Lasers de Estado Sólido/estatística & dados numéricos , Lasers de Estado Sólido/uso terapêutico , Sintomas do Trato Urinário Inferior/diagnóstico , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Prostatectomia/métodos , Prostatectomia/estatística & dados numéricos , Hiperplasia Prostática/complicações , Ressecção Transuretral da Próstata/métodos , Ressecção Transuretral da Próstata/estatística & dados numéricos
2.
ScientificWorldJournal ; 2015: 650492, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25874251

RESUMO

The use of optical radiation for the activation of bleaching products has not yet been completely elucidated. Laser light is suggested to enhance the oxidizing effect of hydrogen peroxide. Different methods of enhancing hydrogen peroxide based bleaching are possible. They can be classified into six groups: alkaline pH environment, thermal enhancement and photothermal effect, photooxidation effect and direct photobleaching, photolysis effect and photodissociation, Fenton reaction and photocatalysis, and photodynamic effect.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/efeitos da radiação , Lasers de Estado Sólido/estatística & dados numéricos , Terapia com Luz de Baixa Intensidade/métodos , Clareadores Dentários/administração & dosagem , Clareamento Dental/métodos , Animais , Humanos , Peróxido de Hidrogênio/administração & dosagem , Oxidantes/administração & dosagem
3.
BJU Int ; 112 Suppl 2: 61-4, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24127677

RESUMO

OBJECTIVE: To assess whether the penile cuff non-invasive urodynamic test serves as an effective diagnostic tool for predicting outcomes prior to disobstructive surgery for men presenting with voiding lower urinary tract symptoms. Patients with proven urodynamic obstruction do better after surgery. The current gold standard, invasive pressure-flow studies, imposes cost, resource demand, discomfort and inconvenience to patients. PATIENTS AND METHODS: Patients undergoing surgery for prostatic obstruction at Palmerston North Hospital had pre-operative non-invasive urodynamics and completed an International Prostate Symptom Score (IPSS). Catheterised patients were excluded. Two months post-operatively they completed a further IPSS score. An improvement of seven or greater was defined as a clinically successful outcome. Results were compared with the outcome predicted by the nomogram supplied with the urodynamic device. RESULTS: Data was obtained for 62 patients with mean age 70 years (range 49 to 86 years; SD 9 years). Follow-up was complete for all patients. Thirty-eight patients underwent transurethral resection and 24 holmium laser enucleation of the prostate. Mean IPSS score was 21 (range 5 to 35; SD 6) pre-operatively and 11 (range 1 to 31; SD 9) post-operatively. Thirty-five patients were predicted obstructed and 27 not obstructed. 94% of those predicted obstructed had a successful outcome (p < 0.01). 70% predicted as not obstructed did not have a successful outcome after surgery (p < 0.01). CONCLUSION: The penile cuff test is an exciting adjunct in the decision to proceed to surgery for prostatic obstruction. Patients predicted to be obstructed have an excellent likelihood of a good surgical outcome, yet 30% of those shown not to be obstructed will still do well. Whilst numbers in our study are small, outcomes compare favourably with published results on invasive urodynamic methods.


Assuntos
Sintomas do Trato Urinário Inferior/cirurgia , Obstrução Uretral/cirurgia , Idoso , Idoso de 80 Anos ou mais , Hólmio/uso terapêutico , Humanos , Lasers de Estado Sólido/estatística & dados numéricos , Sintomas do Trato Urinário Inferior/diagnóstico , Masculino , Pessoa de Meia-Idade , Nomogramas , Prognóstico , Ressecção Transuretral da Próstata/estatística & dados numéricos , Obstrução Uretral/diagnóstico , Urodinâmica/fisiologia
4.
Int Endod J ; 46(4): 296-307, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23095058

RESUMO

The aim was to evaluate the efficacy of various types of lasers used as an adjunct to chemo-mechanical disinfection of infected root canals with the outcome measures 'normal periapical condition' or 'reduction of microbial load'. PubMed, CENTRAL and ISI Web of Knowledge literature searches with specific indexing terms and a subsequent hand search were made with stated limits and criteria. Relevant publications were retrieved, followed by interpretation. The quality of each included publication was assessed as high, moderate or low. The initial search process yielded 234 publications. All abstracts of these publications were read, and the reference lists of relevant publications were hand-searched. Ten articles were read in full text and interpreted according to a data extraction form. Five were included in the systematic review and were assessed. A meta-analysis was impossible to perform because the included studies were heterogeneous with regard to study design, treatment and outcome measures. Positive effects were reported; however, no concluding evidence grade could be made because each included study was judged to have low quality, primarily due to lack of a power analysis, blinding and reproducibility. The evidence grade for whether lasers can be recommended as an adjunct to chemo-mechanical disinfection of infected root canals was insufficient. This does not necessarily imply that laser should not be used as an adjunct to root canal treatment but instead underscores the need for future high-quality studies.


Assuntos
Doenças da Polpa Dentária/microbiologia , Lasers de Estado Sólido/estatística & dados numéricos , Preparo de Canal Radicular/instrumentação , Doenças da Polpa Dentária/terapia , Desinfecção/métodos , Humanos
5.
J Laryngol Otol ; 124(4): 407-11, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19941682

RESUMO

OBJECTIVES: Recently, the 532 nm pulsed potassium-titanyl-phosphate laser has emerged as an effective angiolytic laser for treating mucosal lesions of the larynx in the operating theatre and clinic. We sought to assess the current impact of potassium-titanyl-phosphate laser on our laryngeal surgery practice. STUDY DESIGN: Retrospective review of 710 patients undergoing endoscopic laryngeal surgery over a one-year period. METHODS: Medical records of the endoscopic laryngeal procedures were reviewed; 386/710 had been performed in the clinic and 324/710 in the operating theatre under general anaesthesia. Indications for the procedures were classified by pathology. RESULTS: Pulsed potassium-titanyl-phosphate laser was used in 209/386 clinic procedures. The indications for these procedures were: dysplasia (114/209 procedures), papillomatosis (89/209), varices or ectasia (three of 209), and 'other' (three of 209). Pulsed potassium-titanyl-phosphate laser was used in 178/324 operating theatre endoscopic laryngeal procedures. The indications for these procedures were: cancer (54/178 procedures), dysplasia (52/178), papillomatosis (38/178), varices or ectasia (13/178), polyps (six of 178), nodules (six of 178), stenosis (five of 178), granulation (three of 178), and amyloid (one of 178). CONCLUSIONS: Due to its versatility, the 532 nm pulsed potassium-titanyl-phosphate laser is our most commonly utilised instrument for performing endoscopic laryngeal surgery.


Assuntos
Doenças da Laringe/cirurgia , Laringoscopia/métodos , Lasers de Estado Sólido/uso terapêutico , Humanos , Lasers de Estado Sólido/estatística & dados numéricos , Estudos Retrospectivos , Qualidade da Voz
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