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To compare the safety and efficacy of fractional neodymium-doped yttrium aluminum garnet (Nd:YAG) 1064-nm picosecond laser and fractional 1550-nm erbium fiber laser in acne scar treatment and to assess the adverse effects and complications of the two devices. Thirty patients with cosmetically similar acne scars on both sides of the faces were enrolled and treated four times at 4-week intervals. Each side of the face was treated with either fractional 1064-nm Nd:YAG picosecond laser or fractional 1550-nm erbium fiber laser. Efficacy was evaluated using digital photography taken at baseline and 5 months by a blinded dermatologist using the ECCA grading scale (échelle d’évaluation clinique des cicatrices d’acné). Patient overall satisfaction and self-rated improvement scores were recorded at baseline and 5 months. Adverse effects were recorded at every visit. Twenty-seven patients completed the study. Both devices demonstrated significant median ECCA score improvement from baseline ( P  < 0.001). However, there was no significant difference between the two in terms of median ECCA score improvement, patients’ perception of scar improvement, and overall satisfaction. Considering the adverse effects, more pinpoint bleeding was significantly observed with the picosecond laser ( P  = 0.002), whereas more pain was noted with the erbium laser ( P  < 0.001). Both fractional 1064-nm Nd:YAG picosecond laser and fractional 1550-nm erbium fiber laser are safe and effective in the treatment of acne scars. Costs should be taken into consideration when deciding on which device to use to maximize treatment outcomes.

Melasma significantly impacts life quality, and while various laser therapies show promise, rigorous comparative studies, especially between the novel Picosecond Alexandrite Laser (PSAL) and the traditional combined modality of Q-switched and Long-pulse Nd: YAG Lasers (QLNYL), are notably lacking. This study aims to fill this gap by evaluating the efficacy and safety of these modalities, providing insights into their comparative advantages for clinical practice. In a prospective, evaluator-blinded study, 40 participants with Fitzpatrick Skin Types (FST) III and IV underwent three treatment sessions at four-week intervals with either PSAL or QLNYL. Efficacy was primarily assessed by changes in Melasma Area and Severity Index (MASI) scores at baseline, 4, 8, 12, and 24 weeks, along with patient satisfaction evaluations at the 12- and 24-week marks, and safety assessments conducted throughout the study. Both groups experienced significant reductions in MASI scores post-treatment. Overall, the improvement in MASI scores in the QLNYL group significantly surpassed that in the PSAL group ( P  = 0.010). Patient satisfaction was comparably high between groups, and no significant differences were noted in safety profiles. The PSAL group showed a slightly higher incidence of adverse reactions (not significant) and significantly higher pain scores ( P  = 0.018). Recurrence rates at the 24-week follow-up were 10.5% for PSAL and 0% for QLNYL, with no significant difference. Both PSAL and QLNYL proved effective in treating melasma, with the traditional combined modality of QLNYL demonstrating superior efficacy in FST III-IV. Safety profiles were similar comparable.

This study evaluated the efficacy and safety of a non-ablative vaginal Er: YAG laser device in treating stress urinary incontinence (SUI). We conducted a prospective, multicenter, randomized, sham-controlled clinical trial in which women with SUI received either active treatment with Er: YAG laser therapy or sham control with a non-therapeutic handpiece. Patients underwent three treatments spaced one month apart. The primary endpoint measure was the treatment success rate at three months post-treatment. A total of 126 participants with SUI were recruited, with 84 in the active arm and 42 in the sham arm. One participant in the sham arm was excluded due to not using research instruments. The treatment success rate at three months post-treatment was 36.59% in the sham arm and 71.43% in the active arm, with an absolute difference of 34.84% (95% CI: 17.2–52.5%). Incontinence quality of life questionnaire (I-QOL) score and incontinence questionnaire short form (ICIQ-SF) score demonstrated significant improvement in the both arms with no substantial difference between the groups. Non-ablative vaginal ErYAG laser therapy demonstrated a significant improvement in objectively measured SUI symptoms compared to sham treatment. The non-ablative Er: YAG laser therapy seems to be a promising non-surgical treatment option for SUI patients. The limitations of this study are the short follow-up and limited sample size, so additional studies with longer follow-up and larger number of patients are needed to further elucidate the role of this therapy for SUI.

Acne is among most prevalent skin conditions that adversely impacts patients’ quality of life and self-confidence. Conventional treatment methods face issues with high recurrence rates and unwanted side effects, prompting the need to explore new acceptable treatment options. Comparing the safety and clinical efficacy of intralesional tranexamic acid (TXA) versus 1064 nm long pulsed Nd:YAG laser in the treatment of facial inflammatory acne vulgaris. 30 patients with facial acne vulgaris were involved in a prospective randomized split-face comparative study. Each patient was treated with long-pulsed Nd: YAG laser on one side, and intralesional TXA on the other side at 2-week interval for 4 sessions. Cases were assessed through Investigator Global Assessment of acne (IGA) scale, lesions counting, and erythema score at baseline, after end of treatment, and after follow-up for 3 months. A statistically significant reduction in IGA, lesions count, and erythema score was found in both treated sides (p-value < 0.001). Improvement of IGA and non-inflammatory lesions count was better in laser side more than TXA side after end of treatment and follow-up (p-value < 0.05). Improvement of inflammatory lesions count was non-significant in both sides after end of treatment, while after follow-up it was better on laser side. Improvement of erythema score was non-significant between both therapy modalities after end of treatment and follow-up. 1064 nm long-pulsed Nd: YAG laser and intralesional TXA are effective, and safe treatment modalities for acne. However, Nd-YAG laser has prolonged therapeutic effect over intralesional TXA so, TXA can be considered a promising lunch-time procedure enhancing the outcome.

PurposeTo report the results of a randomized controlled trial comparing outcomes between medium power (MP) and high power (HP) laser settings for HoLEPs.MethodsThe primary objective was to compare the enucleation efficiency (EE) of HP- HoLEP (80–100 W) with MP-HoLEP (50 − 60 W). The secondary objectives were to compare treatment efficacy and safety between both groups. To show a 25% difference in EE, a sample size of 45 individuals per treatment arm was required (alpha = 0.05; Beta = 0.80). Patients demographic and perioperative factors were analyzed, including EE, hemoglobin drop, duration of catheterization, and length of hospital stay. The surgical outcome was evaluated with AUA symptom score, maximum flow rate, postvoid residual urine, and complications to assess differences between MP and HP HoLEP at baseline, 3 months, 1, and 5 years. Quantitative outcomes were compared with independent sample t tests (2-tailed) and qualitative outcomes were compared with chi-square tests.ResultsPreoperative data with the exception of indication for surgery were comparable in both treatment arms. There was no statistically significant difference in enucleation efficiency between the HP-HoLEP and MP-HoLEP laser setting (0.97 ± 0.47 vs. 0.85 ± 0.47 gm/min, p = 0.209). MP laser settings did not increase perioperative or postoperative complications and resulted in durable outcome comparable with HP laser settings at 5-year follow-up.ConclusionsMP-HoLEP is safe and efficient and does not compromise the outcome for HoLEPs when compared with HP-HoLEP.

Background Kidney stone disease is a common problem. The holmium: yttrium–aluminum–garnet (HO:YAG) laser is currently the gold standard laser for ureterorenoscopic (URS) lithotripsy. Recently, the superpulse thulium fiber laser (SP TFL) has shown potential as a substitute for the HO:YAG laser. We aim to compare and evaluate the clinical efficacy and safety of the HO:YAG laser and SP TFL in the treatment of upper urinary calculi in this trial. Methods In this randomized, positive control, blinded management, single-center clinical study, patients with upper urinary calculi will be randomized (1:1) to the experimental group (SP TFL group) or the control group (HO:YAG laser group). Patients in both groups will undergo URS lithotripsy under general anesthesia, and according to the results of randomization, the patients will be treated with an SP TFL (trial group) or a holmium laser (control group). The primary outcome is the stone-free rate at 30 ± 7 days after surgery. The secondary outcomes include the duration of surgery, the duration of laser use, the length of postoperative hospital stay, postoperative clinical indicators, total hospitalization costs, the second-stage stone clearance rate, perioperative complications, the average hemoglobin change, and the mean white blood cell count change. Discussion This study aims to evaluate and compare the clinical efficacy and safety of the SP TFL and HO:YAG for URS lithotripsy in the treatment of upper urinary calculi. Trial registration {2a and 2b} chictr.org.cn ChiCTR2300076893. Registered on October 24, 2023, with ChiCTR ( https://www.chictr.org.cn/bin/project/edit?pid=206827 ). Protocol version {3} August 15, 2023 (V.20230815).

Comparative data regarding the effectiveness of the 1064-nm Nd: YAG picosecond laser with fractional micro-lens array (P-MLA) versus traditional electro-optical synergy (ELOS) for treating post-acne erythema (PAE) are limited. Therefore, we aimed to compare the efficacy and safety of P-MLA and ELOS in the treatment of PAE. This prospective, randomized, split-face trial enrolled 20 patients with PAE, primarily of darker skin tones (Fitzpatrick skin types III-VI). Patients were randomly assigned to receive P-MLA treatment on one side of the face, and ELOS treatment on the other side. Three treatments were administered at 4-week intervals, with follow-up conducted at weeks 0, 4, 8, and 12. Standardized photographs were obtained using the VISIA system. Efficacy was assessed based on improvements in PAE lesion counts, clinical erythema assessment, VISIA skin analysis data, and patient-reported satisfaction. Adverse events were recorded. Both the P-MLA and ELOS groups showed significant reductions in erythema, with the P-MLA group demonstrating a notably greater decrease in PAE lesion counts and a higher clinical response rate at week 12 than the ELOS group. VISIA analysis revealed a greater reduction in red zone scores for the P-MLA group, alongside significant improvements in wrinkles and pigmentation. Patient satisfaction scores were comparable between the two groups, with an overall satisfaction rate of 94.74%. Adverse events, including erythema duration, edema, and pain, were similar across both groups, with no serious complications observed. P-MLA demonstrates superior efficacy and lower risk of adverse effects than ELOS in PAE treatment among Asian patients.

Post-acne erythema (PAE) is a bothering skin condition that emerges from inflammatory acne and persists after its resolution. It is characterized by telangiectasia and erythematous macules. the role of 1064-nm Nd: YAG when combined with low-dose isotretinoin in the acne erythema treatment. forty-eight PAE patients were involved in the study. They were divided into two groups; group (A) patients administering a low dose of oral isotretinoin (10 mg/day) and underwent a total of six two-week interval sessions of 1064 ND-YAG laser treatment, group (B) patients administering a low dose of oral isotretinoin (10 mg/day) only. All adverse effects experienced during the course of therapy were documented, and photos were taken before the start of the treatment and following the end of the treatment duration. Following the completion of the therapeutic intervention, a significant improvement in clinical condition was observed in both groups, with more improvement in group (A) compared to group (B) as evidenced by a notable improvement in the score on the Clinician Erythema Assessment Scale (CEAS) and also a significant decrease in the mean value of optical density of the erythema. combined 1064-nm Nd: YAG with low-dose isotretinoin may be an efficient and secure line in the PAE treatment. Also, the combined therapy had superior results when compared to low-dose isotretinoin alone.

The 589/1319 nm solid-state dual-wavelength (SSDW) laser, which does not require consumable dye, has the potential to target inflammation and sebum production in acne vulgaris pathogenesis. To assess the efficacy and safety of 598/1319 nm SSDW laser as an adjunctive treatment to conventional treatment, 18 patients with bilateral facial acne, with inflammatory papules or pustules, were recruited. Patients were instructed to apply 2.5% benozoyl peroxide (BPO), the drug for inflammatory acne, to their entire face throughout the study. One side of the face was randomly assigned to receive 4 sessions of 589/1319 nm SSDW laser treatments, administered every 2 weeks. After the last laser treatment, 3 monthly follow-ups were scheduled. Inflammatory lesion count (ILC) and acne-related skin parameters, including hemoglobin level, melanin level, skin depression, and skin roughness were measured. Adverse events (AEs) and patients’ satisfaction were assessed. At the 3-month follow-up, the ILC reduced by 46% on the adjunctive laser (BPO + laser) side ( p  = 0.0080), compared with a 29% reduction on the BPO monotherapy side ( p  = 0.1875). On the adjunctive laser side, the change in ILC positively correlated with the change in melanin level ( r  = 0.51, p  = 0.0301) and showed a trend towards a positive correlation with the change in depression volume ( r  = 0.45, p  = 0.0606) and roughness level ( r  = 0.42, p  = 0.0806). The patients reported a pain score of 3.4 ± 2.3 on scale of 10. No serious AEs occurred. Patients’ satisfaction scores were higher with the adjunctive laser therapy, although this was not statistically significant ( p  = 0.2758). In conclusion, the 589/1319 nm SSDW laser provided a synergistic effect as an adjunctive treatment to BPO in inflammatory acne in terms of reducing ILC and improving post inflammatory hyperpigmentation without causing discomfort or downtime.

This study aimed to evaluate the clinical efficacy of picosecond laser therapy combined with the Shumin Star in treating melasma and to explore the role of skin barrier function indicators in the assessment of this treatment process. Ninety patients with melasma were randomly divided into a study group and a control group. The study group received picosecond laser therapy combined with the Shumin Star, while the control group received only picosecond laser therapy. The clinical efficacy and adverse reactions of both groups were compared. Changes in skin barrier function before and after treatment were observed. The receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of skin barrier function for treatment outcomes. The clinical efficacy of the study group was significantly superior to that of the control group (95.56% versus 82.22%, P  = 0.044). After 3 months of treatment, the study group showed significant improvements of skin barrier function in TEWL, stratum corneum hydration, and sebum content, with a significantly lower MASI total score compared to the control group. During the treatment course, the incidence of adverse reactions in the study group was lower than that in the control group. Picosecond laser therapy combined with the Shumin Star is effective in treating melasma. Skin barrier function can be used to assess the clinical efficacy of this treatment, providing valuable reference values for clinical application and promotion.