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Effective Modality (effective + modality)
Selected AbstractsIdiopathic myelofibrosis: pathogenesis to treatmentHEMATOLOGICAL ONCOLOGY, Issue 2 2006John T Reilly Abstract Idiopathic myelofibrosis (IMF) is the least common of the chronic myeloproliferative disorders and carries the worst prognosis with a median survival of 4 years. It is a clonal haematopoietic stem-cell disorder and, although the pathogenesis remains unclear, approximately 50% of cases are known to possess an activating JAK2 V617F mutation. In contrast, the characteristic stromal proliferation is a reactive, or secondary, event that results from the aberrant release of a variety of growth factors from megakaryocytes and monocytes. Treatment for most cases is supportive, although androgens, recombinant erythropoietin, steroids and thalidomide are effective modalities for the amelioration of anaemia. Myelosuppression, splenectomy and irradiation are valuable therapeutic modalities for specific clinical situations. Prognostic scores are available to aid the identification of cases for whom bone marrow transplantation should be considered. Recently, the use of reduced intensity conditioning has resulted in prolonged survival and lower transplant-related mortality. This review summarises the recent advances in the disease's pathogenesis and discusses the role of the various therapeutic options. Copyright © 2006 John Wiley & Sons, Ltd. [source] Cardiovascular Events in Hypertension Trials of Angiotensin-Converting Enzyme InhibitorsJOURNAL OF CLINICAL HYPERTENSION, Issue 2005William J. Elliott MD Angiotensin-converting enzyme inhibitors are widely-prescribed drugs for hypertension and are supported by clinical trials in which they reduce cardiovascular events. In the high-risk patients in the Heart Outcomes Prevention Evaluation, the Perindopril Protection Against Recurrent Stroke Study, and European Trial of Reduction of Cardiac Events With Perindopril in Stable Coronary Artery Disease, ramipril and perindopril showed impressive benefits. One reason trandolapril did somewhat less well in the Prevention of Events With Angiotensin-Converting Enzyme Inhibition trial may be that its patients were very well treated with other effective modalities. In the Antihypertensive and Lipid Lowering to Prevent Heart Attack Trial, lisinopril-treated patients had a slightly lower incidence of myocardial infarction, despite much poorer control of blood pressure, perhaps because a second-line diuretic was prohibited by protocol. Although angiotensin-converting enzyme inhibitors can cause cough and angioedema (more common among blacks), angiotensin receptor blockers are currently more expensive and have fewer outcome trials to support their use. [source] Management of hyperfunctioning single thyroid nodules in the era of minimally invasive thyroid surgeryANZ JOURNAL OF SURGERY, Issue 5 2009Charles Tan Both surgical excision and radioiodine ablation are effective modalities in the management of hyperfunctioning thyroid nodules. Minimally invasive thyroid surgery (MITS) using the lateral mini-incision approach has previously been demonstrated to be a safe and effective technique for thyroid lobectomy. As such MITS may offer advantages as a surgical approach to hyperfunctioning thyroid nodules without the need for a long cervical incision or extensive dissection associated with formal open hemithyroidectomy. The aim of the present study was to assess the safety and efficacy of MITS for the treatment of hyperfunctioning thyroid nodules. This is a retrospective case study. Data were obtained from the University of Sydney Endocrine Surgical Unit Database from 2002 to 2007. There were 86 cases of hyperfunctioning thyroid nodules surgically removed during the study period, of which 10 (12%) were managed using the MITS approach. The ipsilateral recurrent laryngeal nerve was identified and preserved in all cases with no incidence of temporary or permanent nerve palsy. The external branch of the superior laryngeal nerve was visualized and preserved in eight cases (80%). There were no cases of postoperative bleeding. There was one clinically significant follicular thyroid carcinoma in the series (10%). In nine of 10 cases (90%) normalization of thyroid function followed surgery. MITS is a safe and effective procedure, achieving the benefits of a minimally invasive procedure with minimal morbidity. As such it now presents an attractive alternative to radioiodine ablation for the management of small hyperfunctioning thyroid nodules. [source] Utility of Intralesional Sclerotherapy with 3% Sodium Tetradecyl Sulphate in Cutaneous Vascular MalformationsDERMATOLOGIC SURGERY, Issue 3 2010MNAMS, SUJAY KHANDPUR MBBS BACKGROUND Vascular malformations have devastating cosmetic effects in addition to being associated with pain and bleeding. Sclerotherapy has been successfully used in treating complicated hemangiomas and vascular malformations. OBJECTIVES To assess the efficacy of sclerotherapy with 3% sodium tetradecyl sulphate (STS) in venous and lymphatic malformations. MATERIALS AND METHOD We performed sclerotherapy with 3% STS in 13 patients with venous malformations and microcystic lymphatic malformation, all low-flow malformations and with extent predominantly to the subcutis, confirmed using Doppler ultrasound. Lesions were located on the face, lower lip, flanks, buttocks, and extremities. Patients presented for cosmetic reasons, pain, or bleeding. Sclerotherapy was undertaken as an office procedure without any radiological guidance and therapy repeated every 3 weeks. Therapeutic efficacy was assessed subjectively clinically and photographically. RESULTS The lesions regressed by 90% to 100% in 11 cases after a mean of four injections, with no improvement in two cases (one each of venous malformation and lymphatic malformation). Complications included cutaneous blister formation, erosions, and crusting at injection site in seven cases and atrophic scarring in four patients. CONCLUSIONS Sclerotherapy with 3% STS is a simple, safe, and effective modality for venous malformations and can be undertaken as an office procedure in lesions limited to the subcutis. The authors have indicated no significant interest with commercial supporters. [source] Photodynamic Therapy of Cutaneous Lymphoma Using 5-Aminolevulinic Acid Topical ApplicationDERMATOLOGIC SURGERY, Issue 8 2000Arie Orenstein MD Background. Photodynamic therapy (PDT) with topical application of 5-aminolevulinic acid (ALA) is a new and effective modality for treatment of superficial basal and squamous cell carcinomas. Objective. We present the kinetics of ALA-induced protoporphyrin IX (PP) accumulation and the results of ALA PDT treatment on two patients with different stages (stage I and stage III) of mycosis fungoides (MF)-type cutaneous T-cell lymphoma (CTCL). Methods. ALA-Decoderm cream was applied to the lesions for 16 hours. Spectrofluorescence measurements of PP accumulation were carried out before, during, and 1 hour after photoirradiation (580,720 nm) using the VersaLight system. Results. Different patterns of PP fluorescence kinetics were observed in patients with early and advanced stages of the disease. During photoirradiation the intensity of fluorescence decreased depending on the lesion thickness. One hour after the photoirradiation procedure no PP fluorescence was observed in the stage I MF lesion, while in the thick stage III MF lesions, PP fluorescence reappeared; after an additional 10,15 minutes of irradiation PP fluorescence disappeared. Complete response with excellent cosmetic results was observed in the stage I lesion after a single irradiation with a light dose of 170 J/cm2; in five stage III lesions, complete response was achieved after fractionated irradiation with a total light dose of 380 J/cm2 (follow-up at 27 and 24 months, respectively). Conclusion. The results showed a high response of both stage I and stage III MF lesions to ALA PDT. This modality appears to be very effective and can be used successfully for MF treatment. [source] Plasmapheresis as rescue therapy in accelerated acute humoral rejection,JOURNAL OF CLINICAL APHERESIS, Issue 3 2003Kottarathil A. Abraham Abstract Accelerated acute humoral rejection (AHR) continues to occur in renal transplantation despite improved crossmatching, with potentially devastating consequences. Between 1 June 1998 and 31 December 2000, 440 renal transplants were performed in our center. AHR was diagnosed by the demonstration of typical pathological features on renal histology and positive direct immunofluorescence or detection of anti-HLA antibodies in serum. AHR developed in 20 (4.5%) of our renal transplant recipients, nine male and eleven female at an average of 16.3 days post transplantation. All of these patients had a negative current cytotoxic crossmatch prior to transplantation. The median serum creatinine at diagnosis was 5.96 mg/dL, and 83% of these individuals developed oliguric renal failure requiring dialysis after having initially attained good graft function (median of best serum creatinine before AHR was 2.64 mg/dL). The 18 recipients who had not infarcted their grafts at the time of diagnosis of AHR received plasmapheresis in conjunction with intensification of their immunosuppressive regimen. This regimen was successful in reversing AHR in 78% of those treated with apheresis. In the 14 responders, graft survival at 6 months was 100% and at 12 months was 91%. Median serum creatinine at 6 and 12 months was 1.26 and 1.33 mg/dL, respectively. Patients received an average of 8.1 plasma exchanges. However, responders received a significantly higher frequency of plasmapheresis (P = .0053), despite undergoing a similar number of exchanges overall. Plasmapheresis appears to be an effective modality for reversing AHR and maintaining graft function. J. Clin. Apheresis 18:103,110, 2003. © 2003 Wiley-Liss, Inc. [source] Effectiveness of a combination of platelet-rich plasma, bovine porous bone mineral and guided tissue regeneration in the treatment of mandibular grade II molar furcations in humansJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2003Vojislav Lekovic Abstract Objective: A combination of platelet-rich plasma (PRP), bovine porous bone mineral (BPBM) and guided tissue regeneration (GTR) has been shown to be effective as regenerative treatment for intrabony periodontal defects. The purpose of this study was to evaluate the effectiveness of PRP, BPBM and GTR used in combination as regenerative treatment for grade II molar furcation defects in humans. Material and methods: Using a split-mouth design, a total of 52 grade II mandibular molar furcation defects were treated either with PRP/BPBM/GTR (experimental group, n=26) or with an open flap debridement (control group, n=26). The primary outcomes evaluated in this study included changes in pocket depth, attachment level and re-entry bone levels (horizontal and vertical) between baseline and 6 months postoperatively. Results: The results showed that the experimental group presented with significantly greater pocket reduction (4.07±0.33 mm for experimental and 2.49±0.38 mm for control sites), gain in clinical attachment (3.29 ± 0.42 mm for experimental and 1.68±0.31 mm for control sites), vertical defect fill (2.56± 0.36 mm for experimental and ,0.19±0.02 for control sites) and horizontal defect fill (2.28±0.33 mm for experimental and 0.08±0.02 mm for control sites) than the control group. Conclusions: It was concluded that the PRP/BPBM/GTR combined technique is an effective modality of regenerative treatment for mandibular grade II furcation defects. Further studies are necessary to elucidate the role played by each component of the combined therapy in achieving these results. Zusammenfassung Ziel: Eine Kombination von plättchemreichen Plasma (PRP), bovinem porösem Knochenmineral (BPBM) und gesteuerter Geweberegeneration (GTR) wurde als effektiv bei der regenerativen Behandlung von intraalveolären parodontalen Knochendefekten gezeigt. Der Zweck dieser Studie war die Evaluation der Effektivität von PRP, BPBM und GTR in der Kombination als regenerative Behandlung für Grad II Furkationsdefekte bei menschlichen Molaren. Material und Methoden: Unter Nutzung eines split-mouth Design wurden 52 Grad II Unterkiefermolaren Furkationsdefekte entweder mit PRP/BPBM/GTR (experimentelle Gruppe, n=26) oder mit einer offenen Reinigung (Lappenoperation) (Kontrollgruppe, n=26) behandelt. Die primären Ergebnisse die in dieser Studie evaluiert wurden, bezogen die Veränderung der Sondierungstiefen, des Stützgewebeniveaus und des Knochenniveaus bei reentry-Operationen (horizontal und vertikal) zwischen Basis und 6 Monate post operationem ein. Ergebnisse: Die Ergebnisse zeigten, dass die experimentelle Gruppe eine höhere Reduktion der Sondierungstiefen (4.07±0.33 mm für experimentelle und 2.49±0.38 mm für Kontrollflächen), einen höheren Stützgewebegewinn (3.29±0.42 mm für experimentelle und 1.68± 0.31 mm für Kontrollflächen), eine größere vertikale Defektfüllung (2.56±0.36 mm für experimentelle und ,0.19±0.02 für Kontrollflächen) sowie horizontale Defektfüllung (2.28± 0.33 mm für experimentelle und 0.08±0.02 mm für Kontrollflächen) verglichen mit den Kontrollen zeigte. Schlussfolgerungen: Es wird gefolgert, dass die Kombination von PRB/BPBM/GTR eine effektive Modifikation der regenerativen Behandlung bei Grad II Furkationsdefekten bei unteren Molaren ist. Weitere Studien sind notwendig, um die Rolle jeder Komponente dieser kombinierten Therapie in der Erzielung dieser Ergebnisse zu erfassen. Résumé Objectif: Une combinaison de plasma riche en plaquette (PRP), de minéral d'os bovin poreux (BPBM) et de régénération tissulaire guidée (GTR) a prouvé son efficacité en tant que traitement régénératif pour les lésions intra-osseuses parodontales. Cette étude se propose d'évaluer l'intérêt de l'utilisation en combinaison de PRP, BPBM et GTR comme traitement de régénération des lésions furcatoires molaires de classe II chez l'homme. Matériels et Méthodes: Par une étude conçue en bouche croisée, 52 lésions furcatoires molaires mandibullaires ont été traitées soit avec PRP/BPBM/GTR (groupe expérimental, n=26) ou par simple lambeau d'accès (groupe contrôle, n=26). Les objectifs primaires évalués dans cette étude étaient la modification de la profondeur de poche, le niveau d'attache et les niveaux osseux lors de la réentrée (en horizontal et en vertical) mesurés six mois post-op. Résultats: les résultats montrent que le groupe expérimental présentait significativement une plus importante réduction de poche (4.07±0.33 mm contre 2.49±0.38 mm pour les sites contrôles), un gain d'attache clinique plus important (3.29± 0.42 mm contre 1.68±0.31 mm pour les sites contrôles), un comblement vertical des lésions(2.56±0.36 mm contre ,0.19±0.02 pour les sites contrôles) et un comblement horizontal des lésions (2.28±0.33 mm contre 0.08± 0.02 mm pour les sites contrôles). Conclusions: Nous en concluons que la technique combinant PRP/BPBM/GTR est un traitement régénératif efficace pour les lésions de furcation molaire mandibulaire de classe II. Des études complémentaires sont nécessaires pour élucider le rôle joué par chaque élément de cette combinaison dans l'obtention de ces résultats. [source] Argon plasma coagulation as first-line treatment for chronic radiation proctopathyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2004SHAJI SEBASTIAN Abstract Background and Aim:, Chronic radiation proctopathy is a troublesome complication of radiotherapy to the pelvis, for which current treatment modalities are unsatisfactory. The present prospective study was designed to determine the usefulness and safety of argon plasma coagulation in the management of chronic radiation proctopathy. Methods:, Twenty-five consecutive patients (M:F 24:1, mean age: 69 years) with radiation proctopathy were prospectively included. All patients received argon plasma coagulation by a standard protocol. Response to treatment was assessed by symptom response, bleeding severity score, hematological parameters and transfusion requirements over a median 14-month follow up. Results:, Patients received a median of one treatment session with argon plasma coagulation. There was significant improvement in rectal bleeding in all patients, with complete cessation of bleeding in 21 (81%) of the patients. The median bleeding severity score fell from 3 to 0 (P < 0.0005). The mean hemoglobin level rose from 10.05 ± 2.21 g/dL before treatment to 12.44 ± 1.09 g/dL at 6 months following treatment (P < 0.002). There was also improvement in other symptoms such as urgency and diarrhea. Over the period of follow up, there was no recurrence of anemia and no complications were noted. Conclusion:, These results suggest that argon plasma coagulation is a safe and effective modality in the treatment of chronic radiation proctopathy. © 2004 Blackwell Publishing Asia Pty Ltd [source] A New Stent Design for the Treatment of True Bifurcation Lesions: H-Side Branch StentsJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2010MYEONG-KI HONG M.D. Background:There has been much debate for the adequate treatment strategies for true bifurcation lesions. The purpose of this study is to introduce and test a novel stent design for the treatment of true bifurcation lesions. Methods:This side branch stent is composed of three parts: proximal, connecting, and distal parts. The distal part for the side branch vessel has a slope-side stent margin for circumferential coverage of the ostium and one radio-opaque marker for targeting the carina. The proximal part with two radio-opaque markers operates for safe stent delivery and useful guidance for a more precise placement of the distal part on the side branch ostium. Results of the in vitro test in the acrylic resin-made bifurcation phantom model were evaluated with microcomputer tomography. Animal experiments with this new stent platform were also performed in five pigs. Results:In vitro test and microcomputer tomography showed complete coverage of the side branch ostium circumferentially with stent struts, and the absence of stent struts in the main vessel above the side branch ostium level. This side branch stents were successfully deployed in all 5 pigs. The results of animal experiments were also similar to those of in vitro tests. Conclusions:In vivo and vitro tests demonstrated the effective modality of this side branch stent for the treatment of true bifurcation lesions. (J Interven Cardiol 2010;23:54,59) [source] Reduction in parafunctional activity: a potential mechanism for the effectiveness of splint therapyJOURNAL OF ORAL REHABILITATION, Issue 2 2007A. G. GLAROS summary, Interocclusal splints may be an effective modality in the management of temporomandibular disorders (TMD), but there is little evidence regarding the mechanism by which splints work. This study tested the hypothesis that pain reduction produced by splints is associated with reduction in parafunctional activity. In a two-group, single-blinded randomized clinical trial, patients diagnosed with myofascial pain received full coverage hard maxillary stabilization splints. Patients were instructed to maintain or avoid contact with the splint for the 6 weeks of active treatment. Patients who decreased the intensity of tooth contact were expected to show the greatest alleviation of pain, and those who maintained or increased contact were expected to report lesser reductions in pain. Experience-sampling methodology was used to collect data on pain and parafunctional behaviours at pre-treatment and during the final week of treatment. Patients were reminded approximately every 2 h by pagers to maintain/avoid contact with the splint. The amount of change in intensity of tooth contact accounted for a significant proportion of the variance in pain change scores. Patients who reduced tooth contact intensity the most reported greater relief from pain. Splints may produce therapeutic effects by reducing parafunctional activities associated with TMD pain. [source] The efficacy of excimer laser (308 nm) for vitiligo at different body sitesJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2006A Hofer Abstract Background, The treatment with XeCl-excimer laser generated 308-nm UVB radiation has shown promising results in patients with vitiligo. Objective, In this controlled, prospective trial we studied the primary efficacy (start and grade of repigmentation) and patient's satisfaction of XeCl-excimer laser for treatment of vitiligo patches at different body sites and re-evaluated the achieved repigmentation 12 months after the end of therapy. Methods, Twenty-five patients with generalized or localized vitiligo with a total of 85 lesions at different body sites were enrolled in this study. Vitiligo patches were treated with 308-nm XeCl-excimer laser 3 times a week for 6 to 10 weeks. The overall repigmentation grade of each treated lesion was evaluated once a week on a 5 point scale rating from 0 (no repigmentation), 1 (1,5%), 2 (6,25%), 3 (26,50%), 4 (51,75%), to 5 (76,100%). Results, Twenty-four patients completed the study. Within 6 to 10 weeks of treatment 67% of the patients (16/24) developed follicular repigmentation of at least one of their vitiligo lesions. Lesion repigmentation started after a mean of 13 treatments in lesions located on the face, trunk, arm, and/or leg (high-responder location), and after a mean of 22 treatments in lesions located on the elbow, wrist, dorsum of the hand, knee, and/or dorsum of the foot (low-responder location). Untreated control lesions and lesions located on the fingers did not achieve any repigmentation. After 10 weeks of treatment repigmentation of more than 75% was found in 25% (7/28) of lesions of the high-responder location group versus 2% (1/43) of lesions of the low-responder location group. In most cases, laser-induced repigmentation was persistent, as determined 12 months after the end of treatment. Conclusions, 308-nm excimer laser is an effective modality for the treatment of vitiligo. However, similar to other non-surgical treatment modalities, the therapeutic effect is mainly dependent on the location of vitiligo lesions. [source] Evaluation of metaflumizone granular fly bait for management of housefliesMEDICAL AND VETERINARY ENTOMOLOGY, Issue 2 2009A. AHMAD Abstract The housefly, Musca domestica L. (Diptera: Muscidae), is a pest of great veterinary and public health importance. In this study, the efficacy of metaflumizone granular fly bait was assessed on first generation (F1) housefly adults raised from flies collected at a cattle feedlot in Kansas. All bioassays were conducted as choice tests, with flies having ad libitum access to water, granular sugar and bait. A commercial methomyl-based bait (Golden MalrinTM) was used as positive control; no bait (water and granular sugar only) was used as negative control. Fly mortality was recorded on days 2, 7 and 14. The metaflumizone bait was significantly more slow-acting than the methomyl bait (mortality rates after 2 days of exposure were 49.9% and 57.9%, respectively). However, there were no significant differences in cumulative mortality later in the bioassays. Cumulative mortality rates on days 7 and 14 were 96.1% (metaflumizone), 91.4% (methomyl) and 99.0% (metaflumizone), 97.6% (methomyl), respectively. Our results demonstrate that the metaflumizone granular fly bait may be an effective modality for incorporation into management programmes for houseflies in and around livestock production facilities as well as in residential settings. [source] Determination of the Minimum Temperature Required for Selective Photothermal Destruction of Cancer Cells with the Use of Immunotargeted Gold NanoparticlesPHOTOCHEMISTRY & PHOTOBIOLOGY, Issue 2 2006Xiaohua Huang ABSTRACT Laser photothermal therapy of cancer with the use of gold nanoparticles immunotargeted to molecular markers on the cell surface has been shown to he an effective modality to selectively kill cancer cells at much lower laser powers than those needed for healthy cells. To elucidate the minimum light dosimetry required to induce cell death, photothermal destruction of two cancerous cell lines and a noncancerous cell line treated with antiepidermal growth factor receptor (anti-EGFR) antibody-conjugated gold nanoparticles is studied, and a numerical heat transport model is used to estimate the local temperature rise within the cells as a result of the laser heating of the gold nanoparticles. It is found that cell samples with higher nanoparticle loading require a lower incident laser power to achieve a certain temperature rise. Numerically estimated temperatures of 70,80°C achieved by heating the gold particles agree well with the measured threshold temperature for destruction of the cell lines by oven heating and those measured in an earlier nanoshell method. Specific binding of anti-EGFR antibody to cancerous cells overexpressing EGFR selectively increases the gold nanoparticle loading within cancerous cells, thus allowing the cancerous cells to be destroyed at lower laser power thresholds than needed for the noncancerous cells. in addition, photothermal therapy using gold nanoparticles requires lower laser power thresholds than therapies using conventional dyes due to the much higher absorption coefficient of the gold nanoparticles. [source] Short-wave diathermy: current clinical and safety practicesPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2002Nora Shields MISCP Abstract Background and Purpose Short-wave diathermy (SWD) is widely available, yet a comprehensive examination of current clinical practice remains absent from the literature. The present paper aims to assess clinical and safety issues in continuous (CSWD) and pulsed (PSWD) short-wave diathermy application and subsequently indicate areas for future research. Method A postal survey was carried out among 116 senior physiotherapists in 41 Irish hospital-based physiotherapy departments. Results The response rate to the study was 75%. Analysis found that PSWD was the preferred mode of treatment with 27% of respondents using it more than once daily. Respondents considered both modes of treatment indicated for a variety of conditions. CSWD was rated as an effective treatment for chronic osteoarthritis, polyarthritis, non-specific arthrosis and haematomas. PSWD was reported an effective modality for acute soft tissue injury, haematomas, acute osteoarthritis, sinusitis and rheumatoid arthritis. Dose selection varied greatly but tended to be based on the type, nature and duration of the condition. Analysis of safety practices uncovered concerning findings. Although a high level of agreement was found on measures for patient safety, 30% of respondents reported that no measures for operator safety were taken and only five respondents stated they remained a specified distance from SWD equipment. Measures to ensure the safety of other personnel in the physiotherapy department were also lacking. Conclusions Given the availability of SWD equipment and its apparent efficacy in certain conditions, future research should aim to establish this by means of controlled clinical trials. The findings on safety practices underline the urgent need for comprehensive guidelines to ensure the safety of operators, patients and the general public during SWD application. Copyright © 2002 Whurr Publishers Ltd. [source] Pulsed dye laser treatment for viral warts: A study of 120 patientsTHE JOURNAL OF DERMATOLOGY, Issue 8 2008Hyun Su PARK ABSTRACT A prospective, non-blinded, non-randomized study on 120 wart patients treated with pulsed dye laser was performed to evaluate the efficacy and safety of pulsed dye laser treatment for viral warts and to demonstrate the proper application and effective technique of this method. The overall clearance rate was 49.5%. The clearance rates of flat warts, periungual warts, plantar warts and common warts were 67.6%, 51.1%, 47.6% and 44.3%, respectively. Overall, the response rates of pediatric warts, recalcitrant warts and old warts were superior to those of adult warts, simple warts and non-old warts, respectively; however, those trends were not statistically significant. We concluded that pulsed dye laser treatment is a safe, tolerable and relatively effective treatment method for viral warts. Pulsed dye laser treatment may be a more efficacious method for flat warts and recalcitrant periungual warts, and it can be an effective modality for newly-developed warts. The highest clearance rate was noted at a fluence of 9.5 J/cm2 (P , 0.05) and it is recommended that practitioners perform pulsed dye laser treatments for viral warts at the fluences of 9.0,9.5 J/cm2. A replacement of pulsed dye laser treatment should be considered unless prominent improvement is observed after three treatment sessions. [source] |