IPL

IPL
  • 文章类型: Journal Article
    目的:口内毛发生长是皮瓣或移植口咽重建术的一个令人衰弱的副作用。没有规范的治疗,但是小组已经通过口内激光脱毛成功根除了不必要的毛发生长。本范围审查评估了激光治疗在治疗这种情况中的实用性。
    方法:本范围审查遵循PRISMA-ScR指南。OvidMedline,使用索引术语和关键字查询Embase(Ovid)和Scopus。所得文章由两名独立审稿人根据纳入标准进行审查,并提取相关数据。
    结果:文献检索产生297篇文章,其中22项符合纳入标准。总的来说,77名患者接受了治疗:38名患者接受了Alexandrite激光,19使用Nd:YAG激光器,18与二极管激光器,还有两个用二氧化碳激光。定义为毛发计数减少80%或更多的完全反应在70名患者(90%)和6名患者(8%)中实现部分反应(毛发计数减少10%-79%)。一位头发灰白的患者(1%)的头发数量减少了不到10%。平均而言,需要3.84次治疗,间隔5.4周。治疗耐受性良好,无主要副作用。
    结论:这是首次评估口腔内激光毛发疗法的效用的范围审查,并表明它可能是一种安全有效的治疗方法。然而,在临床上可行的情况下,外科医生应建议术前脱毛,以尽可能减轻这种副作用。
    OBJECTIVE: Intraoral hair growth is a debilitating side effect of flap or graft-based oropharyngeal reconstruction. There is no standardized treatment, but groups have successfully eradicated unwanted hair growth with intraoral laser hair removal. This scoping review assesses the utility of laser therapy in managing this condition.
    METHODS: This scoping review followed PRISMA-ScR guidelines. Ovid Medline, Embase (Ovid) and Scopus were queried using index terms and keywords. Resulting articles were reviewed for inclusion by two independent reviewers against inclusion criteria and relevant data were extracted.
    RESULTS: The literature search yielded 297 articles, 22 of which met inclusion criteria. In total, 77 patients were treated: 38 patients with an Alexandrite laser, 19 with an Nd:YAG laser, 18 with a diode laser, and two with a CO2 laser. Complete response defined as 80% or more reduction in hair count was achieved in 70 patients (90%) and six patients (8%) achieved a partial response (10%-79% reduction in hair count). One patient (1%) with gray hair saw less than a 10% reduction in hair count. On average, 3.84 treatment sessions were needed, spaced 5.4 weeks apart. Treatments were well tolerated without major side effects.
    CONCLUSIONS: This is the first scoping review assessing the utility of intraoral laser hair therapy and suggests it may be a safe and effective treatment. However, surgeons should advise preoperative hair removal when clinically feasible to mitigate this side effect as much as possible.
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  • 文章类型: Systematic Review
    Die Rosazea ist eine häufige chronische Hauterkrankung, die sich hauptsächlich im mittleren Bereich des Gesichtes manifestiert. Die okulären Manifestationen der Rosazea wurden bisher nur unzureichend untersucht und bereits die Schätzungen der Prävalenz schwanken erheblich zwischen 6% und 72% der Gesamtpopulation aller Rosazea-Patienten. Zu den Behandlungsmöglichkeiten der okuläre Rosazea gehören die Lidhygiene, topisch anwendbare antimikrobielle Substanzen, topisch oder oral verabreichte Antibiotika und Vitamin-A-Derivate, Cisclosporin-haltige Emulsionen speziell für das Auge und IPL-Behandlungen (intense pulsed light). Direkte Vergleiche zwischen den verschiedenen Therapieoptionen fehlen jedoch. Ziel dieser Literatur-Übersicht ist es, die Wirksamkeit und Nebenwirkungen der verschiedenen Behandlungsmöglichkeiten der okulären Rosazea zu vergleichen. Dazu wurden systematische Datenbankrecherchen in Cochrane, MEDLINE und Embase durchgeführt. Titel, Abstrakt, Volltext und Daten wurden jeweils doppelt durchgesehen. Insgesamt erfüllten 66 Artikel mit einer kumulierten Patientenzahl von 1275 Patienten die Einschlusskriterien. Zu den wirksamsten Behandlungsoptionen zählten topisch anwendbare antimikrobielle Substanzen und die orale Gabe von Antibiotika. Damit konnte bei 91% (n  =  82/90) bzw. 89% (n  =  525/580) der Patienten ein vollständiges oder partielles Ansprechen erzielt werden. Es folgten die IPL-Behandlung (89%, n  =  97/109 partielles Ansprechen), die Ciclosporin-Augen-Emulsion (87% n  =  40/46) und die Lidhygiene (65%, n  =  67/105). Kombinationsbehandlungen führten in 90% der Fälle (n  =  69/77) zu einem vollständigen bzw. partiellen Ansprechen. Diese Ergebnisse deuten darauf hin, dass eine topische Therapie mit antimikrobiellen Substanzen, Antibiotika per os, IPL und Ciclosporin-haltige Emulsionen die effektivsten Einzelmaßnahmen zur Behandlung der okulären Rosazea darstellen.
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  • 文章类型: Systematic Review
    酒渣鼻是一种常见的慢性皮肤病,主要分布在中央面部。酒渣鼻的眼部表现研究甚少,对患病率的估计差异很大,酒渣鼻人群中的6%到72%不等。眼部酒渣鼻的治疗选择包括眼睑卫生,局部和口服抗生素,环孢菌素眼用乳剂,口服维生素A衍生物,和强烈的脉冲光;然而,缺乏对眼部酒渣鼻治疗方法的直接比较。本文旨在比较不同治疗方式对眼部酒渣鼻的治疗效果和不良事件。我们通过搜索Cochrane进行了系统的审查,MEDLINE和Embase。Title,abstract,全文筛选,和数据提取一式两份。六十六条符合纳入标准,代表总共1,275名患者。最有效的治疗方式是局部抗菌药物和口服抗生素,分别在91%(n=82/90)和89%(n=525/580)的患者中获得完全或部分缓解,其次是强脉冲光(89%,n=97/109部分响应),环孢素眼用乳剂(87%n=40/46),和盖子卫生(65%,n=67/105)。联合治疗实现了90%的完全或部分反应(n=69/77)。结果表明,局部抗菌药物,口服抗生素,强烈的脉冲光。和环孢素是最有效的单一模式治疗。
    Rosacea is a common chronic skin disease distributed primarily around the central face. Ocular manifestations of rosacea are poorly studied, and estimates of prevalence vary widely, ranging from 6% to 72% in the rosacea population. Treatment options for ocular rosacea include lid hygiene, topical and oral antibiotics, cyclosporine ophthalmic emulsion, oral vitamin A derivatives, and intense pulsed light; however, a direct comparison of treatment methods for ocular rosacea is lacking. This review aims to compare treatment efficacy and adverse events for different treatment modalities in ocular rosacea. We performed a systematic review by searching Cochrane, MEDLINE and Embase. Title, abstract, full text screening, and data extraction were done in duplicate. Sixty-six articles met the inclusion criteria, representing a total of 1,275 patients. The most effective treatment modalities were topical antimicrobials and oral antibiotics, which achieved complete or partial response in 91% (n = 82/90) and 89% (n = 525/580) of patients respectively, followed by intense pulsed light (89%, n = 97/109 partial response), cyclosporine ophthalmic emulsion (87% n = 40/46), and lid hygiene (65%, n = 67/105). Combination treatments achieved a complete or partial response in 90% (n = 69/77). Results suggest that topical antimicrobials, oral antibiotics, intense pulsed light. and cyclosporine were the most efficacious single modality treatments.
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  • 文章类型: Journal Article
    基于光的脱毛家庭设备发出强烈的脉冲光(IPL)或二极管激光。虽然美国食品和药物管理局在美国控制着它们,欧洲继续将它们归类为化妆品。新出现的问题是:如果没有保护的眼睛无意中暴露于光发射,该怎么办?或者,如果消费者试图克服保护性安全功能?我们通过搜索Medline进行了系统审查,中部,和谷歌学者数据库调查暴露于IPL脱毛后报告的眼部损伤。我们无法确定暴露于家庭设备后报告的任何病例;然而,共有20名患者被确定为虹膜萎缩,前房炎症,和/或暴露于办公室IPL或二极管光后的视网膜色素上皮损伤。40%的人在光照过程中没有使用任何防护眼镜。所报道的能量密度在20-24J/cm2的范围内。尽管在办公室设备后发现了眼部损伤,报告的流量在家庭设备的限制范围内。为此,制造商应在包装上提供有关眼部危害的明确说明,使用护目镜的重要性,和一个坚定的警告,不要克服接触传感器。家庭设备引起的眼部损伤仍然是一个问题,也许报道不足。
    Light-based hair removal home devices emit intense pulse light (IPL) or Diode laser. While the Food and Drug Administration controls them in the US, Europe continues to classify them as cosmetic products. Emerging concerns are: what if an unprotected eye is inadvertently exposed to light emission? Or if the consumer tries to overcome the protective safety features? We performed this systematic review by searching the Medline, CENTRAL, and Google Scholar databases to investigate the ocular damage reported after exposure to IPL for hair removal. We could not identify any case reported following exposure to home devices; however, a total of 20 patients were identified with iris atrophy, anterior chamber inflammation, and/or retinal pigment epithelium damage following exposure to office IPL or Diode lights. 40% were not using any protective eyewear during the light procedure. The reported fluences were in the range of 20-24 J/cm2. Although the ocular damage was identified following office devices, the reported fluences were within the home device\'s limits. For that, manufacturers should provide clear instructions on the package regarding the ocular hazards, the importance of using protective goggles, and a firm warning not to overcome the contact sensors. Home device-induced ocular damage is still a concern, perhaps under-reported.
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  • 文章类型: Journal Article
    不典型的临床和皮肤镜检查结果,或位于用激光或强脉冲光(IPL)进行脱毛(光脱毛)治疗的身体区域的色素黑素细胞病变的变化,已在文献中描述。共有三项前瞻性研究,共79例,有287个黑素细胞痣,一些病例报告报告了光脱毛后的皮肤镜发现和变化。据报道,20-100%的个体发生了临床变化,而在48%至93%的痣中观察到皮肤镜变化。更频繁的皮肤变化包括漂白,色素球的发育,不规则的色素沉着区域和回归结构,包括灰色地带,灰点/小球,和白色的无结构区域。具有不典型的皮肤镜检查结果和光脱毛后变化的色素性病变的诊断方法包括反射共聚焦显微镜,顺序数字皮肤镜随访,和/或切除和组织病理学。在光脱毛的背景下,与这些诊断步骤有关的挑战包括检测可能需要进行活检以排除黑色素瘤(丑小鸭,不规则的色素沉着区,蓝灰色或白色区域,和色素网络的损失),后续变化的潜在持久性,并且由于黑素细胞的扭曲或病变的完全消退,可能无法进行组织病理学诊断。此外,这些诊断方法可能很耗时,需要医生熟悉皮肤镜特征,可能会给个人带来焦虑,并强调避免激光或IPL设备越过色素病变是关键。
    Atypical clinical and dermoscopic findings, or changes in pigmented melanocytic lesions located on body areas treated with lasers or intense pulsed light (IPL) for hair removal (photoepilation), have been described in the literature. There are three prospective studies in a total of 79 individuals with 287 melanocytic nevi and several case reports reporting the dermoscopic findings and changes after photoepilation. Clinical changes have been reported in 20-100% of individuals, while dermoscopic changes have been observed in 48% to 93% of nevi. More frequent dermoscopic changes included bleaching, the development of pigmented globules, and irregular hyperpigmented areas and regression structures, including gray areas, gray dots/globules, and whitish structureless areas. The diagnostic approach for pigmented lesions with atypical dermoscopic findings and changes after photo-epilation included reflectance confocal microscopy, sequential digital dermoscopy follow-up, and/or excision and histopathology. Challenges pertaining to these diagnostic steps in the context of photoepilation include the detection of findings that may warrant a biopsy to exclude melanoma (ugly duckling, irregular hyperpigmented areas, blue-gray or white areas, and loss of pigment network), the potential persistence of changes at follow-up, and that a histopathologic diagnosis may not be possible due to the distortion of melanocytes or complete regression of the lesion. Furthermore, these diagnostic approaches can be time-consuming, require familiarization of the physician with dermoscopic features, may cause anxiety to the individual, and highlight that avoiding passes of the laser or IPL devices over pigmented lesions is key.
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  • 文章类型: Journal Article
    背景:医学放射教育中的跨专业教育(IPE)旨在提高学生和长期患者的预后。本范围审查旨在提供现有证据的概述,并检查用于增强医学放射科学(MRS)学生发展的IPE策略的有效性。
    方法:Medline,CINAHL,搜索了CochraneLibrary和Emcare的文章,这些文章采用了实验研究设计来定量评估IPE对MRS学生的有效性。两名评审员独立筛选并提取相关数据。关键评估是使用JBI关键评估工具进行的。
    结果:本综述包括18项研究。发现了不同的IPE方法,特别是在交付方法方面,干预措施的设置和持续时间。MRS学生与许多职业互动,尤其是医生和护士。所有采用对照臂的研究都显示出有利于IPE干预的统计学阳性结果。在事后研究中,大多数IPE干预措施在IPE实施后报告了显著的正差异.这需要增强对其他职业的感知知识和理解,以及承担团队角色的能力。
    结论:IPE被证明在提高学生的观念和态度方面是有效的,并且在有限的程度上,提高知识获取。未来的研究应该评估长期影响和患者相关的结果。
    结论:各种形式的IPE对MRS学生显示出积极的结果;但是,长期的干预措施,以小组形式进行,并在教育途径的早期进行,可能表现出更大的效力。
    Interprofessional education (IPE) in medical radiation education is designed to enhance both student and longer-term patient outcomes. This scoping review aims to provide an overview of the available evidence and examine the effectiveness of IPE strategies used to enhance the development of medical radiation science (MRS) students.
    Medline, CINAHL, Cochrane Library and Emcare were searched for articles which employed an experimental study design to quantitatively assess the effectiveness of IPE for MRS students. Two reviewers screened and extracted relevant data independently. Critical appraisal was conducted using the JBI critical appraisal tool.
    Eighteen studies were included in this review. Diverse approaches to IPE were discovered, particularly in terms of the method of delivery, setting and duration of interventions. MRS students interact with many professions, particularly medical doctors and nurses. All studies which employed a control arm demonstrated statistically positive findings favoring IPE intervention(s). In pre-post studies, most IPE interventions reported significant positive differences after IPE was implemented. This entailed an enhanced perceived knowledge and understanding of other professions, and ability to undertake their role in the team.
    IPE was shown to be effective in enhancing students\' perceptions and attitudes and to a limited extent, improve knowledge acquisition. Future research should assess long-term effects and patient-related outcomes.
    IPE in a variety of formats demonstrates positive results for MRS students; however, interventions which are longer-term, conducted in small groups, and performed earlier in the educational pathway, may demonstrate greater effectiveness.
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  • 文章类型: Journal Article
    激光和基于光的设备提供了长期“脱毛”的范围,但是,支持其长期疗效的证据有限.这项研究旨在评估激光和光为基础的“脱毛”装置的长期疗效,考虑到头发生长周期中身体部位特异性变化的变化。对随机对照试验(RCT)进行了系统评价,随访期大于或等于目标身体部位一个完整毛发生长周期的长度。只有五个合格的RCT被确定为适合纳入,其中共有223名患者。据报道,钕:钇-铝-石榴石(Nd:YAG)激光的平均长期毛发减少率为30%至73.61%,翠绿石激光范围为35-84.25%,二极管激光器的范围为32.5%至69.2%。在所有三个设备中,从针对腿毛的试验(1年生长周期)观察到的长期减少最大,从针对面部毛发的试验(6个月生长周期)观察到的长期减少最小.强脉冲光(IPL)导致平均长期毛发减少52.7-27%;从靶向面部区域观察到最小的减少,从靶向腋窝区域观察到最大的减少(7个月的生长周期)。总之,在毛发生长周期较长的身体部位观察到更大的长期毛发减少。未来的试验应考虑身体部位毛发生长周期的变化,以提供有关治疗结果的准确长期数据。
    Laser and light-based devices provide scope for long-term \"hair-removal\" however, there is limited evidence supporting their long-term efficacy. This study aimed to assess the long-term efficacy of laser and light-based \"hair-removal\" devices, taking into account variations in body site-specific variations in hair growthcycles. A systematic review of randomized controlled trials (RCTs) with follow-up periods greater than or equal to the length of one complete hair growth cycle in the body site targeted was conducted. Only five eligible RCTs were identified as suitable for inclusion, and these comprised a total of 223 patients. The average long-term hair reduction reported for neodymium:yttrium-aluminum-garnet (Nd:YAG) laser ranged from 30 to 73.61%, Alexandrite laser ranged from 35 to 84.25%, and Diode laser ranged from 32.5 to 69.2%. In all three devices, the greatest long-term reduction was observed from trials targeting leg hair (1-year growth cycle) and lowest from targeting facial hair (6-month growth cycle). Intense pulsed light (IPL) produced average long-term hair reduction of 52.7-27%; smallest reduction was observed from targeting the face area and greatest from targeting the axillary area (7-month growth cycle). In conclusion, greater long-term hair reduction was observed on body sites with longer hair growth cycles. Future trials should take into account the variation of hair growth cycles across body sites to provide accurate long-term data on treatment outcomes.
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  • 文章类型: Journal Article
    酒渣鼻是一种主要影响面部的慢性皮肤疾病,以红斑为特征,瞬态或持久性,毛细血管扩张症,和炎性病变,包括丘疹-脓疱和肿胀。该疾病的基本组成部分是面部皮肤的持续性红斑。潮红发作(急性-亚急性间歇性血管舒张)很常见。鼻子肿胀和红斑伴随着毛囊皮脂腺孔的扩张,被称为鼻门,可以注意到在慢性病例。酒渣鼻影响了世界人口的10%,尤其是在35-50岁的皮肤白皙的个体中。女性比男性更容易受到影响。几种治疗方式,包括局部用药,全身药物,激光,和基于光的疗法已用于治疗酒渣鼻,结果可变。外用药物如壬二酸,甲硝唑,和硫磺酰胺/硫磺,口服抗生素,如四环素,单独口服类维生素A或,最常见的是,结合形成治疗的主体。诸如强脉冲光和脉冲染料激光之类的光疗法最好用于红斑毛细血管扩张型。局部用溴莫尼定,羟甲唑啉,伊维菌素,他克莫司,吡美莫司,低剂量修饰释放四环素和肉毒杆菌毒素是治疗性军械库的新补充。本文提供了用于酒渣鼻的各种疗法的全面综述。
    Rosacea is a chronic cutaneous disorder affecting primarily the face, characterized by erythema, transient or persistent, telangiectasia, and inflammatory lesions including papulo-pustules and swelling. The essential component of the disease is the persistent erythema of facial skin. Episodes of flushing (acute-subacute intermittent vasodilation) are common. Swelling and erythema of the nose along with dilatation of the pilosebaceous poral orifices, known as rhinophyma, can be noted in chronic cases. Rosacea affects up to 10% of the world population and is especially noted in fair-skinned individuals aged 35-50. Women are affected more often than men. Several treatment modalities including topical medications, systemic drugs, lasers, and light-based therapies have been used for the management of rosacea with variable results. Topical medications such as azelaic acid, metronidazole, and sulfacetamide/sulfur, oral antibiotics such as tetracyclines, and oral retinoids alone or, most commonly, in combination form the mainstay of treatment. Light therapies such as intense pulsed light and pulsed dye laser are best used for the erythemato-telangiectatic type. Topical brimonidine, oxymetazoline, ivermectin, tacrolimus, pimecrolimus, low-dose modified-release tetracyclines and botulinum toxin are the new additions to the therapeutic armamentarium. This article provides a comprehensive review of the various therapies used for rosacea.
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  • 文章类型: Journal Article
    OBJECTIVE: To conduct a systematic review of the effectiveness of various types of lasers (and light based therapies) for the treatment of hidradenitis suppurativa (HS) and to establish recommendations based on our findings.
    METHODS: MEDLINE, Cochrane and PubMed databases.
    METHODS: English language studies describing the use of laser for the treatment of HS.
    METHODS: Multiple reviewers performed independent extraction and identified 22 studies that met the inclusion and exclusion criteria.
    RESULTS: Studies were categorised according to grading recommendations based on evidence quality guidelines for systematic reviews. Only 2 studies met criteria to be assigned the highest grade.
    CONCLUSIONS: Nd:YAG laser has been shown to be effective for the treatment of HS, as is intense pulsed light therapy (IPL) using the same principles of laser hair removal. There is weak evidence to recommend the use of carbon dioxide, diode or alexandrite lasers. The need for larger randomized controlled trials is highlighted.
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