-
Photodiagnosis and Photodynamic Therapy Sep 2023To systematically review the efficacy of photodynamic therapy (PDT) in the treatment of cutaneous leishmaniasis (CL). (Review)
Review
OBJECTIVE
To systematically review the efficacy of photodynamic therapy (PDT) in the treatment of cutaneous leishmaniasis (CL).
METHODS
PubMed, Embase and Cochrane Library databases were searched for articles published by November 16, 2022, with no time restrictions. 'Cutaneous leishmaniasis' and 'photodynamic therapy' were searched using predefined search strings.
INCLUSION CRITERIA
(i) Randomized control trials; (ii) controlled clinical trials; (iii) case series; (iv) case reports; (v) participants were humans; (vi) clinical diagnosis was CL; (vii) treatment method used was PDT; and (viii) articles published in English.
RESULTS
In total, 303 articles were identified, including 14 papers meeting the criteria. The number of patients in each study ranged from 1 to 60 and the age ranged from 1 to 82 years. Aminolevulinic acid and methyl aminolevulinate were used as photosensitizers. Red light and sunlight were used as light sources. All reported satisfactory clinical effects. Side effects of treatment included burning sensation, pain and pigmentation after treatment. However, they were tolerable and temporary. The follow-up time ranged between 9 weeks and 24 months. A total of two patients recurred, but one did not recur after another round of PDT during the follow-up period.
CONCLUSIONS
The present study suggests that PDT is a safe and effective method for the treatment of CL, with tolerable side effects and good efficacy. As an alternative treatment method of CL, PDT has great potential. However, to verify the efficacy and specific mechanism of PDT for the optimal treatment strategy of CL, further research with larger sample sizes and longer follow-up times are needed.
Topics: Humans; Infant; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Photosensitizing Agents; Photochemotherapy; Aminolevulinic Acid; Leishmaniasis, Cutaneous; Randomized Controlled Trials as Topic
PubMed: 37245683
DOI: 10.1016/j.pdpdt.2023.103627 -
Ultrasound in Obstetrics & Gynecology :... Mar 2024Large-for-gestational-age (LGA) is associated with several adverse maternal and neonatal outcomes. Although many studies have found that early induction of labor (eIOL)... (Review)
Review
OBJECTIVE
Large-for-gestational-age (LGA) is associated with several adverse maternal and neonatal outcomes. Although many studies have found that early induction of labor (eIOL) in LGA reduces the incidence of shoulder dystocia (SD), no current guidelines recommend this particular strategy, due to concerns about increased rates of cesarean delivery (CD) and neonatal complications. The purpose of this study was to assess whether the timing of IOL in LGA fetuses affects maternal and neonatal outcomes in a single center; and to combine these results with the evidence reported in the literature.
METHODS
This study comprised two parts. The first was a retrospective cohort study that included: consecutive patients with singleton pregnancy, an estimated fetal weight (EFW) ≥90 percentile on ultrasound (US) between 35+0 and 39+0 weeks of gestation (WG), who were eligible for normal vaginal delivery. The second part was a systematic review of literature and meta-analysis that included the results of the first part as well as all previously reported studies that have compared IOL to expectant management in patients with LGA. The perinatal outcomes were CD, operative vaginal delivery (OVD), SD, brachial plexus palsy, anal sphincter injury, postpartum hemorrhage (PPH), APGAR score, umbilical arterial pH, neonatal intensive care unit (NICU) admission, use of continuous positive airway pressure (CPAP), intracranial hemorrhage (ICH), phototherapy, and bone fracture.
RESULTS
Retrospective cohort: of the 547 patients, 329 (60.1%) were induced and 218 (39.9%) entered spontaneous labor. Following covariate balancing, CD was significantly higher in the IOL group in comparison to the spontaneous labor group. This difference only became apparent beyond 40WG (hazard ratio: 1.9, p=0.030). The difference between both groups for shoulder dystocia was not statistically significant. Systematic review and metanalysis: 17 studies were included in addition to our own results giving a total sample size of 111,300 participants. When IOL was performed <40+0WG, the risk for SD was significantly lower in the IOL group (OR: 0.64, 95%CI: 0.42-0.98, I =19%). There was no significant difference in CD rate between IOL and expectant management after pooling the results of these 17 studies. However, when removing the studies in which IOL was done exclusively before 40+0WG, the risk for CD in the remaining studies (IOL not exclusively <40+0WG) was significantly higher in the IOL group (odds ratio [OR]: 1.46, 95% confidence interval [95%CI]: 1.02-2.09, I =56%). There were no statistically significant differences between IOL and expectant management for the remaining perinatal outcomes. Nulliparity, history of CD, and low Bishop score but not methods of induction were independent risk factors for intrapartum CD in patients who were induced for LGA.
CONCLUSION
Timing of IOL in patients with suspected macrosomia significantly impacts perinatal adverse outcomes. IOL has no impact on rates of SD but does increase CD when considered irrespective of gestational age, but it may decrease the risk of SD without increasing the risk of other adverse maternal outcomes, in particular cesarean section when performed before 40+0 WG. (GRADE: Low/Very low). This article is protected by copyright. All rights reserved.
PubMed: 38477187
DOI: 10.1002/uog.27643 -
Photodiagnosis and Photodynamic Therapy Dec 2023Pseudomonas aeruginosa is a Gram-negative bacillus that causes superficial and deep infections, which can be minor to life-threatening. Recently, P. aeruginosa has... (Review)
Review
BACKGROUND
Pseudomonas aeruginosa is a Gram-negative bacillus that causes superficial and deep infections, which can be minor to life-threatening. Recently, P. aeruginosa has gained significant relevance due to the increased incidence of multidrug-resistant (MDR) strains that complicate antibiotic treatment. Due to MDR strains, alternative therapies, such as antimicrobial photodynamic therapy (PDT), are presented as a good option to treat nonsystemic infections. PDT combines a photosensitizer agent (PS), light, and oxygen to generate free radicals that destroy bacterial structures such as the envelope, matrix, and genetic material. This work aimed to identify the development stage of the PDT applied to P. aeruginosa to conclude which research stage should be emphasized more.
METHODS
Systematic bibliographic search in various public databases was performed. Related articles were identified using keywords, and relevant ones were selected using inclusion and exclusion criteria according to the PRISMA protocol.
RESULTS
We found 29 articles that meet the criteria, constituting a good body of evidence associated with using PDT against P. aeruginosa in vitro and less developed for in vivo research.
CONCLUSIONS
We conclude that PDT could become an effective adjunct to antimicrobial therapy against P. aeruginosa. This effectiveness depends on the PS used and the location of the infection. Many PS already demonstrated efficacy in PDT, but the evidence is supported significantly by in vitro and very few in vivo studies. Therefore, we conclude that further research efforts should focus on demonstrating the safety and efficacy of these PSs in vivo in animal infection models.
Topics: Animals; Pseudomonas Infections; Photosensitizing Agents; Photochemotherapy; Anti-Bacterial Agents; Gram-Negative Bacteria; Pseudomonas aeruginosa
PubMed: 37709240
DOI: 10.1016/j.pdpdt.2023.103803 -
Photobiomodulation, Photomedicine, and... Aug 2023This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical... (Meta-Analysis)
Meta-Analysis Review
Clinical and Radiographic Outcomes of Adjunctive Photodynamic Therapy for Treating Peri-Implant Mucositis Among Cigarette Smokers and Diabetics: A Systematic Review and Meta-Analysis.
This systematic review aimed to assess the influence of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement (MD) on peri-implant clinical and radiographic outcomes among cigarette smokers and diabetics with peri-implant mucositis (piM). Randomized controlled trials, assessing the clinical and radiographic parameters of aPDT versus MD alone among smokers and diabetics with piM, were included in the study. Meta-analyses were conducted to calculate the standard mean difference with a 95% confidence interval. The methodological quality of the included studies was assessed utilizing the modified Jadad quality scale. The meta-analyses found statistically significant differences between the impact of adjunct aPDT and MD alone on the peri-implant plaque index (PI), probing depth (PD), and bleeding on probing among smokers and diabetics with piM at the final follow-up visit. However, no significant differences were found between the impact of adjunct aPDT and MD alone on the peri-implant crestal bone loss among smokers and diabetics with piM at the final follow-up. The application of aPDT as an adjunctive to MD demonstrated improved scores of the peri-implant clinical parameters among smokers and diabetics with piM in comparison with MD alone.
Topics: Humans; Smokers; Combined Modality Therapy; Mucositis; Debridement; Photochemotherapy; Peri-Implantitis; Anti-Infective Agents; Tobacco Products; Diabetes Mellitus
PubMed: 37506360
DOI: 10.1089/photob.2023.0046 -
Photodiagnosis and Photodynamic Therapy Apr 2024The application of photodynamic therapy (PDT) is pivotal in the management of diverse dermatologic conditions. Microneedling (MN) is a minimally invasive tool that is... (Review)
Review
BACKGROUND
The application of photodynamic therapy (PDT) is pivotal in the management of diverse dermatologic conditions. Microneedling (MN) is a minimally invasive tool that is capable of inducing transient pores on the skin to facilitate transdermal drug delivery. Several studies have reported augmentation of PDT combined with MN. This systematic review analyzes the current studies on the efficacy and safety of MN-assisted PDT for skin diseases.
METHODS
The literature search using the PRISMA standard was completed through PubMed, Embase, Web of Science and CENTRAL from the establishment of the databases to November 2023. Two independent researchers finished the procedure.
RESULTS
A total of 12 articles and 413 subjects met our study criteria. This systematic review suggests that MN-assisted PDT can decrease the incubation time required for the photosensitizer and reduce skin lesions of actinic keratosis (AK) . The common side effect is pain and no serious adverse events were reported.
CONCLUSIONS
MN is an effective method to increase the transdermal delivery rate of photosensitizers. For different photosensitizers and disease, MN may show different clinical effects.
Topics: Photochemotherapy; Humans; Photosensitizing Agents; Needles; Administration, Cutaneous; Keratosis, Actinic; Skin Diseases; Drug Delivery Systems; Percutaneous Collagen Induction
PubMed: 38367923
DOI: 10.1016/j.pdpdt.2024.104016 -
Journal of Cataract and Refractive... May 2024Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with... (Meta-Analysis)
Meta-Analysis Comparative Study
Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with prophylactic CXL. Therefore, we performed a meta-analysis comparing outcomes of refractive surgeries with vs without prophylactic CXL. We systematically searched databases for studies comparing refractive surgeries for myopic correction with vs without prophylactic corneal crosslinking. Review Manager 5.4.1 was used to perform statistical analysis. We included 2820 eyes from 28 studies. Compared with refractive surgery alone, surgery with prophylactic CXL resulted in decreased central corneal thickness, corrected distance visual acuity logMAR, and safety and efficacy indices. There were no significant differences in postoperative uncorrected distance visual acuity of 20/20 or better at ≥12 months and other visual outcomes among both groups. More randomized controlled trials with standard crosslinking protocols are needed to analyze the prophylactic use of crosslinking with refractive surgeries.
Topics: Humans; Cross-Linking Reagents; Photosensitizing Agents; Keratomileusis, Laser In Situ; Riboflavin; Collagen; Visual Acuity; Myopia; Photorefractive Keratectomy; Photochemotherapy; Lasers, Excimer; Corneal Stroma; Ultraviolet Rays; Keratoconus; Corneal Surgery, Laser; Refraction, Ocular
PubMed: 38288954
DOI: 10.1097/j.jcrs.0000000000001405 -
PloS One 2023The aim of this META-analysis was to evaluate the efficacy of photobiomodulation (PBM) therapy in the treatment of inferior alveolar nerve (IAN) injury due to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this META-analysis was to evaluate the efficacy of photobiomodulation (PBM) therapy in the treatment of inferior alveolar nerve (IAN) injury due to orthognathic surgeries, extraction of impacted third molars and mandibular fractures.
METHODS AND MATERIALS
A electric search was conducted by a combination of manual search and four electric databases including Pubmed, Embase, Cochrane library and Web of Science, with no limitation on language and publication date. Gray literature was searched in ClinicalTrials.gov and googlescholar. All retrieved articles were imported into ENDNOTE software (version X9) and screened by two independent reviewers. All analysis was performed using the REVMAN software (version 5.3).
RESULTS
Finally, 15 randomized controlled trials met the inclusion criteria for qualitative analysis and 14 for META-analysis from 219 articles. The results showed that PBM therapy had no effect on nerve injury in a short period of time (0-48h, 14 days), but had significant effect over 30 days. However, the effect of photobiomodulation therapy on thermal discrimination was still controversial, most authors supported no significant improvement. By calculating the effective rate of PBM, it was found that there was no significant difference in the onset time of treatment, whether within or over 6 months.
CONCLUSIONS
The results of this META-analysis show that PBM therapy is effective in the treatment of IAN injures no matter it begins early or later. However, due to the limited number of well-designed RCTs and small number of patients in each study, it would be necessary to conduct randomized controlled trials with large sample size, long follow-up time and more standardized treatment and evaluation methods in the future to provide more accurate and clinically meaningful results.
Topics: Humans; Low-Level Light Therapy; Tooth Extraction; Mandibular Nerve; Mandibular Fractures
PubMed: 37561792
DOI: 10.1371/journal.pone.0287833 -
Journal of Cosmetic Dermatology Sep 2023In cosmetic dermatology, lasers and lights treat a variety of hair and skin conditions, including some that disproportionately affect people of color. (Review)
Review
BACKGROUND
In cosmetic dermatology, lasers and lights treat a variety of hair and skin conditions, including some that disproportionately affect people of color.
AIMS
Our systematic review aims to understand the representation of participants with skin phototypes 4-6 in cosmetic dermatologic trials studying laser and light devices.
METHODS
A systematic literature search was conducted using search terms "laser," "light," and multiple laser and light subtypes in the PubMed and Web of Science databases. All randomized controlled trials (RCTs) published between January 1, 2010 and October 14, 2021 that studied laser or light devices for cosmetic dermatologic conditions were eligible for inclusion.
RESULTS
Our systematic review included 461 RCTs representing 14 763 participants. Of 345 studies that reported skin phototype, 81.7% (n = 282) included participants of skin phototypes 4-6, but only 27.5% (n = 95) included participants of skin phototypes 5 or 6. This trend of excluding darker skin phototypes persisted when results were stratified by condition, laser of study, study location, journal type, and funding source.
CONCLUSIONS
Trials studying lasers and lights for the treatment of cosmetic dermatologic conditions need better representation of skin phototypes 5 and 6.
Topics: Humans; Laser Therapy; Lasers; Phototherapy; Cosmetic Techniques
PubMed: 36977196
DOI: 10.1111/jocd.15739 -
Acta Ophthalmologica May 2024Central serous chorioretinopathy (CSC) is a prevalent exudative maculopathy and the ongoing verteporfin shortage restricts current treatment possibilities. Topical... (Meta-Analysis)
Meta-Analysis Review
Central serous chorioretinopathy (CSC) is a prevalent exudative maculopathy and the ongoing verteporfin shortage restricts current treatment possibilities. Topical non-steroidal anti-inflammatory drugs (NSAID) have previously been proposed as a treatment for CSC, although its exact efficacy remains unclear. In this systematic review and meta-analysis, we outlined the efficacy of topical NSAIDs for the treatment of CSC. We searched 11 literature databases on 13 December 2022, for any study describing topical NSAID treatment for CSC. Thirteen eligible studies were included with a total of 1001 eyes of 994 patients with CSC. Six studies were case reports, two were cohort studies and five were non-randomized comparative studies. Where specified, topical NSAIDs used were bromfenac 0.09%, diclofenac 0.1%, ketorolac 0.4% and 0.5%, pranoprofen 0.1%, and nepafenac 0.1% and 0.3%. Studies were predominantly of cases with acute CSC and several case studies reported treatment outcomes simultaneously with discontinuation of corticosteroid use, which complicated treatment evaluation. Meta-analyses of comparative studies revealed a statistically significant but clinically irrelevant best-corrected visual acuity improvement of -0.04 logMAR (95% CI: -0.07 to -0.01 logMAR; p = 0.01) at 1-month follow-up, which became statistically insignificant at 3-month follow-up (-0.03 logMAR; 95% CI: -0.06 to 0.003 logMAR; p = 0.08). Further, we found no benefit in complete subretinal fluid resolution at 1-month follow-up (OR: 1.20; 95% CI: 0.81-1.76; p = 0.37) or 3-month follow-up (OR: 1.17; 95% CI: 0.86 to 1.59; p = 0.33). Taken together, available evidence does not support the use of topical NSAIDs for the treatment of CSC.
Topics: Humans; Central Serous Chorioretinopathy; Treatment Outcome; Verteporfin; Photochemotherapy; Anti-Inflammatory Agents, Non-Steroidal; Tomography, Optical Coherence; Fluorescein Angiography
PubMed: 37551858
DOI: 10.1111/aos.15743 -
Lasers in Medical Science Sep 2023Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such... (Meta-Analysis)
Meta-Analysis
Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: a systematic review and meta-analysis of split-mouth randomised clinical trials.
Although several studies have evaluated the effect of low-level laser therapy (LLLT) on orthodontic movement acceleration, results are still inconsistent. Such inconsistencies may be attributed to the differences in the LLLT application protocols, especially in terms of wavelength ranges. Objective: (i) to assess the clinical effects of LLLT on the acceleration of orthodontic movement and (ii) to establish the most effective LLLT wavelength to accelerate tooth movement during orthodontic treatments. MEDLINE (PubMed), Scopus, ScienceDirect, and LILACS were searched from inception to October 2022. Inclusion criteria: Split-mouth randomised clinical trials (RCTs) on systemically healthy patients reporting the effect of LLLT in accelerating orthodontic movements, specifically retraction of canines. The risk of bias was assessed using RoB-2. A random effect model was applied. Nineteen RCTs met the inclusion criteria for qualitative synthesis, and eighteen RCTs were included in the quantitative synthesis. Seventeen studies were rated as at some concerns of bias and two studies were classified as having a low risk of bias. In general terms, this systematic review and meta-analysis presents a moderate risk of bias. Findings of this systematic review and meta-analysis point to a tendency for faster orthodontic dental movement in the groups receiving LLLT treatment during the first (OR of 0.28 95% CI (0.07 to 0.48)), second (OR of 0.52 95% CI (0.31 to 0.73)), and third (OR of 0.41 95% CI (0.03 to 0.79)) month follow-up. Wavelengths ≤ 810 nm and energy density values ≤ 5.3 J/cm were associated with faster orthodontic tooth movement.
Topics: Acceleration; Tooth Movement Techniques; Randomized Controlled Trials as Topic; Low-Level Light Therapy; Treatment Outcome
PubMed: 37667064
DOI: 10.1007/s10103-023-03870-7