scholarly journals Nd:YAG Laser in the Treatment of Nail Psoriasis: Clinical and Dermoscopic Assessment

2021 ◽  
pp. e2021140
Author(s):  
Yasmin Hesham Ali Elwan ◽  
Amira Azim ◽  
Michela Starace ◽  
Hala Shawky Abd Elhafiz

Background: The Nd:YAG laser has emerged as a promising modality for the management of nail psoriasis owing to its ability for deep penetration of the skin surface, which has the advantage of destroying deep vessels. Objective: To assess the efficacy and safety of Nd:YAG laser in treating nail psoriasis. Methods: The present study was a randomized controlled study, conducted on 20 patients of both sexes (age older than 12 years) with mild to moderate psoriasis with nail involvement. We utilized facial telangiectasia parameters of Nd:YAG laser and beam diameter of 2.5 mm. Laser energy started with 110 J/cm2 in the first session and 130 J/cm2 in the rest of the sessions. Sessions were performed once monthly for up to 6 sessions. Results: We found no statistically significant difference in total Nail Psoriasis Severity Index (NAPSI) and nail bed scores before and after treatment among the treated group. However, there was statistically significant improvement in nail matrix score after treatment. On the other hand, the control group did not show any statistically significant changes for all scores throughout the study, except for the nail matrix score mean difference (0.35 ± 1.23 vs -1.00 ± 1.86 in the treated group). The degree of dermoscopic improvement was evident in the treated group (45% vs 25% in the control group). However, it was not statistically significant because of small sample size. The patients’ satisfaction and the external investigator’s assessment showed statistically significant negative correlation with total NAPSI mean difference in the treated group. Conclusion: The role of Nd:YAG laser in nail psoriasis is still controversial.

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 148-149
Author(s):  
James W. Bass

In 1975 Taussig and associates1 evaluated the use of intermittent positive-pressure breathing (IPPB) with racemic epinephrine in the treatment of croup. Apparently their untreated control group received neither racemic epinephrine nor IPPB although all patients received mist tent therapy with 30% to 40% oxygen. A statistically significant benefit was observed in the treated group. A previous controlled study evaluating the effectiveness of aerosol racemic epinephrine alone, without IPPB, failed to show a significant difference between treated patients and placebo (aerosolized saline)-treated controls.2


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1833.2-1833
Author(s):  
B. C. Detlef ◽  
S. El-Nawab-Becker ◽  
M. Toellner ◽  
A. Kleinheinz ◽  
T. Witte

Background:Nail psoriasis is an extreme diagnostic and therapeutic challenge and represents an enormous physical and psychological burden for affected patients.50% of patients with psoriasis vulgaris develop nail involvement (NailPso)during the course of their disease. NailPso is the strongest predictor of psoriatic arthritis (PsA). Through the synovio-enthesial concept we have learned that there is an anatomical-pathophysiological relationship between DIP joint, extensor tendon and nail matrix. We have observed in daily practice that hypervascularization (HV) in ultrasound Power Doppler (US-PD)the nail matrix may be a pathognomonic element in its own right. There are no data on this in the literature.Objectives:Is there a difference in the ultrasound PD examination of the DIP joint and nail area and in the capillary microscopy of the corresponding nail fold in patients with psoriasis vulgaris and nail psoriasis versus patients with psoriasis vulgaris without nail psoriasis.Methods:Monocentric prospective study of all consecutive patients with psoriasis vulgaris who have come to a rheumatic practice to clarify a PsA. Inaddition to demographic data, assessments (PASI,DLQI,CASPAR,GEPARD, DAS28, SJ,TJ,FFBH), clinical examination, a standardized ultrasound PD examination and capillary microscopy of the affected fingertips in PsO patients suffering from nail psoriasis was performed as well as corresponding examinations of the 2nd and 3rd finger right in PsO patients without nail involvement.Results:79 patients could be included during the study period. Thereof 25 PsO patients without nail involvement and 44 PsO patients with nail involvement. Since the patients were examined consecutively, the difference results. There was no difference in age, BMI and sex in both groups (Pso and NailPso). The Caspar criteria as classification criteria for a PsA were positive in 65% of the NailPso patients and positive in 50% of all PsO patients without nail infestation. Hypervascularization in the US-PD examination in the area of the nail matrix could be seen significantly more frequently in NailPso compared to non-NagelPso patients. Such a difference did not exist in the HV of the extensor tendons.Capillary microscopy showed a significant difference in the number of torsions/twist capillaries in NailPso compared to Pso patients without NailPso.Hypervascularization of the nail matrix is seen significantly more frequently in patients with psoriasis of the nail than in patients without psoriasis of the nail. Such a difference does not exist in DIP joint -extensor tendon- enthesitis. At the same time, torsions are significantly more frequently seen in capillary microscopy in NailPso than in patients without NailPso.Conclusion:The US-PD examination is a simple and non-invasive procedure which can be performed routinely in daily practice. The hypervascularization of the nail matrix should also make one think of nail psoriasis in the early stage of PsO, in order to be able to start early an appropriate therapy for this very stigmatizing and therapeutically extremely difficult manifestation of PsO. It seems to occur independently of extensor tendon synovitis as an independent manifestation phenomenon.The occurrence of torsions in capillary microscopy >50 % also seems to be groundbreaking for a NagelPso, whereby capillary microscopy is a temporal challenge in daily routine.References:§ The present study (7734-BO-S2018 Ethics Commission of the MHH, Medical School Hannover, Germany) contains parts of the PhD thesis of M.TöllnerDisclosure of Interests:Becker-Capeller Detlef Grant/research support from: Novartis, Speakers bureau: Pfizer, Soham El-Nawab-Becker: None declared, Malo Toellner: None declared, Andreas Kleinheinz: None declared, Torsten Witte: None declared


2021 ◽  
Vol 10 (12) ◽  
pp. 2637
Author(s):  
Mª. Ángeles del Buey-Sayas ◽  
Elena Lanchares-Sancho ◽  
Pilar Campins-Falcó ◽  
María Dolores Pinazo-Durán ◽  
Cristina Peris-Martínez

Purpose: To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. Methods: In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent variables according to the different diagnostic categories with multiple comparisons to identify the differences between the diagnostic categories, deeming p < 0.05 as statistically significant. Results: The mean CH in the DG group (9.69 mmHg) was significantly lower compared to controls (10.75 mmHg; mean difference 1.05, p < 0.001), FHG (10.70 mmHg; mean difference 1.00, p < 0.05), GLD (10.63 mmHg; mean difference 0.93, p < 0.05) and OHT (10.54 mmHg; mean difference 0.84, p < 0.05). No glaucoma suspects (FHG, GLD, OHT groups) presented significant differences between themselves and the control group (p = 1.00). No statistically significant differences were found in the mean CRF between DG (11.18 mmHg) and the control group (10.75 mmHg; mean difference 0.42, p = 0.40). The FHG and OHT groups showed significantly higher mean CRF values (12.32 and 12.41 mmHg, respectively) than the DG group (11.18 mmHg), with mean differences of 1.13 (p < 0.05) and 1.22 (p < 0.001), respectively. No statistically significant differences were found in CCT in the analysis between DG (562 μ) and the other groups (control = 556 μ, FHG = 576 μ, GLD = 569 μ, OHT = 570 μ). The means of IOPg and IOPcc values were higher in the DG patient and suspect groups than in the control group, with statistically significant differences in all groups (p < 0.001). Conclusion: This study presents corneal biomechanical values (CH, CRF), CCT, IOPg, and IOPcc for diagnosed glaucoma patients, three suspected glaucoma groups, and a healthy population, using the ORA. Mean CH values were markedly lower in the DG group (diagnosed with glaucoma damage) compared to the other groups. No significant difference was found in CCT between the DG and control groups. Unexpectedly, CRF showed higher values in all groups than in the control group, but the difference was only statistically significant in the suspect groups (FHG, GLD, and OHT), not in the DG group.


2000 ◽  
Vol 68 (6) ◽  
pp. 3153-3157 ◽  
Author(s):  
Christian Østergaard ◽  
Runa Vavia Yieng-Kow ◽  
Thomas Benfield ◽  
Niels Frimodt-Møller ◽  
Frank Espersen ◽  
...  

ABSTRACT The polysaccharide fucoidin is a selectin blocker that inhibits leukocyte recruitment into the cerebrospinal fluid (CSF) during experimental pneumococcal meningitis. In the present study, the effect of fucoidin treatment on the release of the proinflammatory cytokines tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), and IL-8 into the CSF was investigated. Rabbits (n = 7) were treated intravenously with 10 mg of fucoidin/kg of body weight every second hour starting 4 h after intracisternal inoculation of ∼106 CFU of Streptococcus pneumoniae type 3 (untreated control group, n = 7). CSF samples were obtained every second hour during a 16-h study period. Treatment with fucoidin caused a consistent and significant decrease in CSF IL-1 levels (in picograms per milliliter) between 12 and 16 h (0 versus 170, 0 versus 526, and 60 versus 1,467, respectively;P < 0.02). A less consistent decrease in CSF TNF-α levels was observed in the fucoidin-treated group, but with no significant difference between the two groups (P > 0.05). In contrast, there was no attenuation in CSF IL-8 levels. Indeed, there was a significant increase in CSF IL-8 levels (in picograms per milliliter) in the fucoidin-treated group at 10 and 12 h (921 versus 574 and 1,397 versus 569, respectively;P < 0.09). In conclusion, our results suggest that blood-derived leukocytes mainly are responsible for the release of IL-1 and to some degree TNF-α into the CSF during pneumococcal meningitis, whereas IL-8 may be produced by local cells within the brain.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaochen Wang ◽  
Guiqiu Zhao ◽  
Jing Lin ◽  
Nan Jiang ◽  
Qian Wang ◽  
...  

Aims. The aim of this study was to assess the efficacy and safety of timolol in the treatment of myopic regression after laser in situ keratomileusis (LASIK).Methods. We searched MEDLINE, CENTRAL, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese Biological Medicine (CBM) from the inception to July 2015 for relevant randomized controlled trials that examined timolol therapy for myopic regression. The methodological quality of the studies included was assessed using the Revman 5.3 software.Results. We included six clinical trials involving 483 eyes in this review, including 246 eyes in treated group and 237 eyes in controlled group. We observed statistically significant improvements on the postoperative SE in the 3 months. However, the change of CCT was not statistically different between the control group and the experimental group. There were fewer cases of IOP, UDVA, and CDVA in treated group having significant difference from the controlled group.Conclusions. Topical timolol could be an effective treatment for reduction of myopic regression especially the spherical errors after myopic LASIK. Further RCTs with larger sample sizes for these trials are warranted to determine the efficacy and limitation for myopic regression after LASIK.


2017 ◽  
Vol 16 ◽  
pp. 1-11
Author(s):  
Shahin Kasraei ◽  
Ebrahim Yarmohammadi ◽  
Maryam Farhadian ◽  
Mona Malek

Objective: this study aimed to assess the effect of treatment of phosphoric acid etched dentin surface with 5% bromelain enzyme and Nd:YAG laser prior to the use of etch and rinse adhesive systems on microleakage margins of class V composite restorations. Materials and Methods: sixty sound premolar teeth were selected. Standard class V cavities were prepared in the buccal and lingual surfaces of each teeth. Preparation in that way 1 mm of the cavity was above and 1 mm of it was below the cementoenamel junction. The teeth were then randomly divided into three groups including 20 teeth(40cavities  in each gorup). Two ethanol base etch and rinse system (Adper Single Bond and OptiBond Solo) was applied in each group. In the control group, cavities were etched with 37% phosphoric acid. Adper Single Bond was applied to 20 and OptiBond Solo was applied to the remaining 20 cavities and they were restored with Z250 composite (n=40). The same procedures were performed in bromelain and Nd:YAG laser groups with the difference that prior to the application of adhesive, aqueous 5% bromelain was applied in bromelain group while Nd:YAG laser was irradiated in laser group. All teeth were thermocycled and their apices were sealed with sticky wax. The tooth surfaces were coated with nail varnish except for 1 mm around the restoration margins, and the teeth were then immersed in fuchsine and sectioned by a diamond disc into mesial and distal halves. Marginal microleakage at both sides was determined and scored under a stereomicroscope at x40 magnification. Then data were analyzed using the Kruskal Wallis and Mann Whitney tests (α=0.05). Results: according the result of Mann Whitney test, Cervical margins showed significantly higher microleakage than the occlusal margins (P=0.000) but no significant difference was noted in microleakage of occlusal (P=0.362) or gingival (P=0.147) margins among the three groups by Kruskal Wallis test. Conclusion: in conclusion, application of proteolytic agents(5% bromelain solution and Nd:YAG laser)  on acid-etched dentin surface prior to the application of adhesive has no significant effect on marginal microleakage of class V composite restorations. 


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ali Ahmed Naga ◽  
Mohammed Ismaeil Abdel Fattah ◽  
Walid Hamed Nofal ◽  
Mohammed Abd-elsalam AlMenshawe

Abstract Background Challenges of diagnosing and treating sepsis only seem more difficult as incidence increases, patients become older and sicker, and pathogenic organisms evolve. New understanding of inflammatory mediators and pathways, immunity, and genetic variability in this disease state suggests that the current definitions of SIRS, sepsis, severe sepsis, and septic shock are oversimplified. Objective The aim of our study is to evaluate the level of RDW, CRP and clinical scores "SOFA and APACHI" as markers in patients with sepsis and their levels on the outcome and resolution of sepsis in ICU. Methodology We conducted a prospective observational controlled study on 90 adult persons of both sex, 45 of them are adult patients and served as the study group (Group I), and the other 45 are healthy adult volunteers and served as the control group (Group II). The study group represented patients admitted to the ICU of Intensive Care Unit at Damanhour Medical National Institute who fulfilled the diagnostic criteria for sepsis, severe sepsis and septic shock on arrival to ICU according to the SCCM/ ESICM/ ACCP/ ATS/SIS International Sepsis Definitions Conference. Results. In the present study we found that CRP measured on admission was not a predictor of mortality, while that measured at day 5 and day 10 predicted mortality, where there was no statistically significant difference in CRP levels between survivors and non-survivors at the day of admission while there were statistically significant differences between survivors and non survivors according to CRP levels at day 5 (p = 0.001*) and at day 10 (p = 0.001*). It was found also that there were statistically significant differences between survivors and non-survivors according to RDW at day 1(p = 0.011*) and at day 5(p = 0.009*), at day 10 was found there was no statistically significant difference between survivors and non-survivors (p = 0.338). Conclusion RDW is a new promising cheap and readily available biomarker that can be able to diagnose patients with sepsis with accuracy comparable to CRP. Also, RDW at admission is able to predict mortality.


2021 ◽  
pp. 1-9
Author(s):  
Nazlı Baltacı ◽  
Mürüvvet Başer

<b><i>Background:</i></b> Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. <b><i>Materials and Methods:</i></b> This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. <b><i>Results:</i></b> Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], <i>p</i> = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], <i>p</i> &#x3c; 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], <i>p</i> = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], <i>p</i> &#x3c; 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (<i>p</i> &#x3c; 0.01), but not in the control group (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.


2010 ◽  
Vol 76 (10) ◽  
pp. 1112-1114 ◽  
Author(s):  
Bonnie R. Wang ◽  
Vincent L. Rowe ◽  
Sung Wan Ham ◽  
Sukgu Han ◽  
Kaushal Patel ◽  
...  

No standard presently exists for the use of systemic heparin during angioaccess surgery to decrease the incidence of postoperative thrombotic complications. Our objective was to study the effects of intraoperatively administered heparin on 30-day patency and postoperative bleeding complications in patients undergoing autogenous arteriovenous (AV) fistula surgery. A prospective, double-blinded, randomized controlled study was performed on 48 patients undergoing AV fistula creation from April 2007 through November 2009. Of the 48 patients, 22 were randomized to the control group and received no heparin. Twenty-six were randomized to receive heparin (75 units/kg intravenously) before clamping of the artery. There was no significant difference in 30-day patency between the heparin and control groups (92% vs 86%, P = 0.65), respectively. Three patients (12%) developed hematomas in the heparin group compared with one (5%) in the control group; however the difference was not statistically significant ( P = 0.61). The results suggest that intraoperative administration of heparin has no statistically significant effect on 30-day patency rates or postoperative bleeding complications. Larger trials with longer term follow-up and assessment of maturation rates are needed to determine the effect of intraoperative anticoagulation on these outcomes of arteriovenous fistula surgery.


1996 ◽  
Vol 24 (6) ◽  
pp. 674-677 ◽  
Author(s):  
K. L. Schwager ◽  
D. B. Baines ◽  
R. J. Meyer

The stimulation of the acupuncture point P6 has been used to prevent nausea and vomiting in the adult population. It has, however, been subject to limited comparative evaluation in children. We proposed that stimulation of P6 and the analgesic point Li4 would reduce the incidence of postoperative vomiting. Eighty-four unpremedicated paediatric patients having day-stay surgery (circumcision or herniotomy/orchidopexy) were included in a randomized, double-blind, placebo-controlled study of transcutaneous stimulation of P6 and Li4 or no stimulation. The incidence of vomiting was recorded for 24 hours postoperatively. There was no statistically significant difference in total postoperative vomiting in those patients who were stimulated, compared with the control group (P=0.909), or between any group for postoperative vomiting in the recovery ward, day-stay ward or at home. For all groups, vomiting was more common within the first four hours and more likely to occur in the day-stay ward.


Sign in / Sign up

Export Citation Format

Share Document