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Med surg

Imran Rizvi, Girgis Obaid, Shazia Bano, Tayyaba Hasan, David Kessel
OBJECTIVE: A relatively low level of lysosomal photodamage has been shown capable of promoting the efficacy of photodamage simultaneously or subsequently directed to mitochondrial/ER sites. The procedure has hitherto involved the use of two photosensitizing agents that require irradiation at two different wavelengths and different formulation techniques. This, together with different pharmacokinetic profiles of the photosensitizers, adds a layer of complexity to a protocol that we have sought to circumvent...
March 11, 2018: Lasers in Surgery and Medicine
Mladen Korbelik
The insult delivered by photodynamic therapy (PDT) in treated cells is oxidative stress. The main burden threatening survival of PDT-treated cells is proteotoxic damage that jeopardizes proteostasis in these cells. For dealing with this type of proteostasis impairment, cells have developed protection mechanisms operating by signaling networks. This review will outline various components of signaling networks that can be engaged in stressed cells with highlighting the emerging aspects relevant to response to PDT...
March 7, 2018: Lasers in Surgery and Medicine
Albert W Girotti
One of the advantages of PDT is that it can often circumvent tumor resistance to chemotherapeutic agents such as cisplatin and doxorubicin. However, pre-existing and acquired resistance to PDT has also been demonstrated. One type of resistance, which involves nitric oxide (NO) generated by inducible nitric oxide synthase (iNOS/NOS2) in tumor cells, was discovered in the author's laboratory. When subjected to a 5-aminolevulinic acid (ALA)-based photodynamic challenge, several cancer lines, including breast, prostate, and glioma, underwent intrinsic apoptosis that could be substantially enhanced by iNOS enzymatic inhibitors or a NO scavenger, implying iNOS/NO-mediated resistance...
March 5, 2018: Lasers in Surgery and Medicine
Matthew W Semler, Wesley H Self, Jonathan P Wanderer, Jesse M Ehrenfeld, Li Wang, Daniel W Byrne, Joanna L Stollings, Avinash B Kumar, Christopher G Hughes, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Liza Weavind, Jonathan D Casey, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Both balanced crystalloids and saline are used for intravenous fluid administration in critically ill adults, but it is not known which results in better clinical outcomes. METHODS: In a pragmatic, cluster-randomized, multiple-crossover trial conducted in five intensive care units at an academic center, we assigned 15,802 adults to receive saline (0.9% sodium chloride) or balanced crystalloids (lactated Ringer's solution or Plasma-Lyte A) according to the randomization of the unit to which they were admitted...
March 1, 2018: New England Journal of Medicine
Rachel M Peters, Thomas J Hipper, Esther D Chernak
OBJECTIVE: This study seeks to determine the capacity of community primary care practices to meet the needs of patients during public health emergencies and to identify the barriers and resources necessary to participate in a coordinated response with public safety agencies. METHODS: The self-administered web-based survey was distributed in January 2014 via e-mail to primary care providers in Pennsylvania using the listservs of several professional societies. RESULTS: A total of 179 primary care providers participated in the survey...
February 22, 2018: Disaster Medicine and Public Health Preparedness
Albert Brizio, Jean-Christophe Hubert, Brigitte Hennequin, Jeremy Bouchez, Marie-Clément Kouka
In 2016 France hosted the European football championship. In a context of an increased terrorist threat, Chemical, Bacteriological, Radiological, Nuclear (CBRN) attacks were considered possible. Three days prior to the beginning of the event, the Health Authorities required that a medium sized hospital close to a major potential target, prepare a chemical decontamination centre. Despite a low level of preparedness, little external help, and very few extra resources, an efficient decontamination chain (all premises necessary for the management of contaminated victims: from the entrance gate to the post-decontamination dressing cabins) was set up in 15 days (12 days after the unrealistic deadline)...
February 21, 2018: Disaster Medicine and Public Health Preparedness
Christopher J Sardon, Mathew L Resnick
BACKGROUND: Acetabular labral tears in the hip have become an increasingly common finding in active duty members due to improved diagnostic capabilities. This has led to a dramatic increase in operative management despite a lack of evidence to support clear long-term benefits. Literature review demonstrated overwhelmingly positive short-term outcomes for labral repairs; however, scattered case reports exist demonstrating debilitating outcomes in young patients, ultimately resulting in total hip arthroplasty...
February 1, 2018: Aerospace Medicine and Human Performance
Toril Holien, Odrun Arna Gederaas, Sagar Ramesh Darvekar, Eidi Christensen, Qian Peng
BACKGROUND AND OBJECTIVE: Extracorporeal photopheresis (ECP), an established modality for cutaneous T-cell lymphoma (CTCL) and graft-versus-host disease, involves ex vivo treatment of isolated leukocytes of a patient with the photosensitizing drug 8-methoxypsoralen (8-MOP) and ultraviolet-A (UV-A) exposure before reinfusion back to the patient. However, 8-MOP binds to both diseased and normal cells and thus kills both types of the cells after UV-A illumination with little selectivity...
February 20, 2018: Lasers in Surgery and Medicine
M Devadas, D J Ku
BACKGROUND: Bariatric surgery is the most effective treatment for severe obesity, capable of producing more than 50% excess weight loss at 10-year follow-up (James Clin Dermatol 1; 22:276-80; O'Brien Br J Surg 2; 102:611-17; Buchwald et al. Metab Syndr 3; 347-56). The success of bariatric surgery extends far beyond weight loss, with up to 80-90% of patients having improvement or resolution of many of their weight-related co-morbidities including type II diabetes mellitus and hypertension (Puzziferri et al...
February 17, 2018: Obesity Surgery
Arisa E Ortiz, R Rox Anderson, Catherine DiGiorgio, Shang I Brian Jiang, Faiza Shafiq, Mathew M Avram
BACKGROUND AND OBJECTIVE: Basal cell carcinoma (BCC) is an indolent form of skin cancer that is rarely life threatening, but can cause significant cosmetic and functional morbidity. Surgical treatments often result in disfiguring scars, while topical therapies frequently result in recurrence. The need for a more effective nonsurgical alternative has led to the investigation of laser treatment of BCC. We have previously conducted a pilot study which showed 100% histologic clearance at high fluences...
February 13, 2018: Lasers in Surgery and Medicine
Jolien Robijns, Sandrine Censabella, Stefan Claes, Luc Pannekoeke, Lore Bussé, Dora Colson, Iris Kaminski, Paul Bulens, Annelies Maes, Leen Noé, Marc Brosens, An Timmermans, Ivo Lambrichts, Veerle Somers, Jeroen Mebis
OBJECTIVE: Acute radiodermatitis (RD) is a distressing and painful skin reaction that occurs in 95% of the patients undergoing radiotherapy (RT). The aim of this study was to evaluate the effectiveness of photobiomodulation therapy (PBMT) in the prevention of acute RD in breast cancer (BC) patients undergoing RT. METHODS: This study was a randomized, placebo-controlled trial including 120 BC patients that underwent an identical RT regimen post-lumpectomy. Patients were randomly assigned to the laser therapy (LT) or placebo group, with 60 patients in each group...
February 10, 2018: Lasers in Surgery and Medicine
Giovanni Ferrando
OBJECTIVE: To assess the short- and long-term thermal impact of subclinical and clinical regimens of a single, non-invasive uniform ultrasound treatment session on subcutaneous adipose tissue (SAT). STUDY DESIGN: Prospective, open-label, single-arm, split-side study. METHODS: Patients (n = 17) were subjected to uniform ultrasound treatment, delivered in a single session with the SlimME device. The device was set to one of four treatment regimens, which differed in their durations and energy fluences during the raise and maintenance phases...
February 7, 2018: Lasers in Surgery and Medicine
Hidemi Gunji, Ryo Kunimatsu, Yuji Tsuka, Yuki Yoshimi, Keisuke Sumi, Tetsuya Awada, Kengo Nakajima, Aya Kimura, Tomoka Hiraki, Naoto Hirose, Makoto Yanoshita, Kotaro Tanimoto
BACKGROUND AND OBJECTIVES: Tooth movement during orthodontic treatment is associated with bone neoplasticity and bone resorption on the tension and pressure sides. Previous clinical studies have suggested that low-power laser irradiation can accelerate tooth movement during orthodontic treatment, although the underlying mechanism remains unclear. In this study, we used a high-frequency near-infrared diode laser that generates less heat and examined the histologic changes in periodontal tissue during experimental tooth movement with laser irradiation...
February 5, 2018: Lasers in Surgery and Medicine
Seiji Hosokawa, Satoru Takebayashi, Goro Takahashi, Jun Okamura, Hiroyuki Mineta
BACKGROUND: Photodynamic therapy (PDT) is a minimally invasive treatment for malignant tumors. The aim of this study was to determine the efficacy of PDT in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: Thirty-three patients with HNSCC were treated with porfimer sodium-mediated PDT followed by intraoperative light activation at 630 nm via fiber optic microlens delivered after 48 hours of injection. RESULTS: The complete response (CR) rate was 72...
February 5, 2018: Lasers in Surgery and Medicine
Lucas Andreo, Raquel A Mesquita-Ferrari, Beatriz G Ribeiro, Adriana Benitte, Tatiane de Fátima Nogueira, Cristiane M França, Daniela de Fátima Teixeira da Silva, Sandra K Bussadori, Kristianne P S Fernandes, Fernanda I Corrêa, João C F Corrêa
OBJECTIVE: The aim of the present study was to evaluate the effects of myoblast inoculation in combination with photobiomodulation therapy (PBMT) on skeletal muscle tissue following injury. MATERIALS AND METHODS: Sixty-five Wistar rats were divided into five groups: Control-animals not submitted to any procedure; Injury-cryoinjury of the tibialis anterior muscle; HBSS-animals submitted to cryoinjury and intramuscular Hank's Balanced Salt Solution; Injury + Cells-animals submitted to cryoinjury, followed by myogenic precursor cells (C2C12) transplantation; Injury + Cells + LLLT-animals submitted to cryoinjury, followed by myogenic precursor cells (C2C12) transplantation and PBMT (780 nm, 40 mW, 3...
February 5, 2018: Lasers in Surgery and Medicine
Yutong Chen, Zhi Yang, Fan Xia, Hong Ning, Rui Hua
OBJECTIVES: To investigate the blood flow characteristics of polypoidal choroidal vasculopathy (PCV) using optical coherence tomography angiography (OCTA) and to analyse photodynamic therapy (PDT) effects on choroidal remodelling in PCV. MATERIALS AND METHODS: Diagnostic indocyanine green angiography and OCTA were performed. All patients underwent PDT with full-dose verteporfin and were followed up with enhanced-depth imaging optical coherence tomography. RESULTS: At baseline, a branching vascular network (BVN) was clearly demonstrated in all patients with PCV who underwent OCTA examinations as opposed to polyps...
February 5, 2018: Lasers in Surgery and Medicine
Evan Austin, Amy Huang, Tony Adar, Erica Wang, Jared Jagdeo
OBJECTIVES: Our skin is constantly exposed to light from solar radiation and electronic devices, which impact skin physiology and aging. The biological altering properties of ultraviolet (UV) solar radiation on skin have been well established. There is significant scientific and public interest on the effects of electronic device generated light (EDGL) on skin. Currently, the effects of EDGL on skin are largely unknown. EDGL includes UV, visible, and infrared light from consumer electronics such as smartphones, computers, and televisions...
February 5, 2018: Lasers in Surgery and Medicine
Ali I Musani, Julia K Veir, Zheng Huang, Tim Lei, Steve Groshong, Deanna Worley
OBJECTIVE: In the setting of lung cancer, photodynamic therapy (PDT) is typically used to treat centrally located endobronchial tumors. The development of navigational bronchoscopy has opened the potential for using PDT to treat peripheral lung tumors. However, there is limited information about the feasibility of this approach for treating peripheral lung cancers, and about its effects on surrounding healthy lung tissue. We studied the use of PDT delivered by electromagnetic navigational bronchoscopy to treat peripheral lung cancer in dogs...
February 5, 2018: Lasers in Surgery and Medicine
Nicholas J Prindeze, Yvette V L Mann, Tony G Feric, Timothy R Currie, Bonnie C Carney, Lauren T Moffatt, Murray H Loew, Jeffrey W Shupp
OBJECTIVES: Active dynamic thermography (ADT) is a non-contact imaging technique that characterizes non-homogeneities in thermal conductance through objects as a response to applied energy stimulus. The aim of this study was to (i) develop a heat transfer model to define the relationship between thermal stimulation and resolution and (ii) empirically quantify the resolution an ADT imaging system can detect through a range of depths of human skin. MATERIALS AND METHODS: A heat transfer model was developed to describe a thermally non-conductive object below a sheet of skin...
January 25, 2018: Lasers in Surgery and Medicine
Ivan Fistonić, Nikola Fistonić
BACKGROUND AND OBJECTIVE: A growing body of evidence indicates that a non-invasive erbium yttrium-aluminum-garnet (Er:YAG) laser may be an effective and highly tolerable treatment for stress urinary incontinence (SUI) in women. The primary objective was to identify pre-intervention predictors of short-term Er:YAG outcomes. The secondary objective was to identify patient segments with the best Er:YAG laser treatment short-term outcomes. METHODS: A prospective cohort study performed in 2016 at Ob/Gyn Clinic, Zagreb, Croatia, recruited 85 female patients who suffered from SUI...
January 23, 2018: Lasers in Surgery and Medicine
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