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Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis
摘要： Bactericidal and detoxification effects of diode laser (DL) have been reported in periodontal treatment. The objective of this study was investigating the additional effect of DL with nonsurgical periodontal treatment on the red complex bacteria in type 2 diabetes mellitus (DM) patients with chronic periodontitis (CP). Sixty type 2 DM patients with chronic periodontitis (CP) were randomly assigned in two parallel groups to receive scaling root planning (SRP, n = 30) or SRP followed by DL periodontal pocket irradiation (SRP + DL, n = 30). Recording of clinical parameters and subgingival plaque sampling were performed at baseline, and post therapy (1 and 3 months after treatment). Amounts of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia were evaluated with quantitative RT-PCR. Significant reductions for numbers of all three bacterial species were observed at 1 and 3 months compared with baseline for both treatments (p < 0.001), but no significant differences were found between two groups regarding bacterial reductions at these follow-up time points. No additional benefit of DL as an adjunct to nonsurgical periodontal therapy was recognized in the reduction of P. gingivalis, T. denticola, and T. forsythia for type 2 DM patients with CP. Further studies are required to clarify the effects of diode laser on the other periodontopathogens.
关键词： Nonsurgical periodontal treatment,Periodontopathogens,Diabetes mellitus,Diode lasers,Chronic periodontitis
更新于2025-09-23 15:19:57
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Effect of Modified Laser Transcutaneous Irradiation on Pain and Quality of Life in Patients with Diabetic Neuropathy
摘要： Background: Diabetic neuropathy (DN) is one of the major complications developed by individuals with diabetes mellitus. DN is responsible for a high morbidity and mortality rate and impacts the public health and medical assistance resources. Intradermic laser irradiation on blood (ILIB) consists of the application of light beams on the radial arterial, providing anti-inflammatory and vasodilator effects, antiarrhythmic action, reduction of glucose, and stabilization of the hormonal and immunological systems. These effects help to maintain the physiological dynamics of the body. Objective: The goal of this research was to evaluate the effects of ILIB to relieve pain and improve the quality of life in DN patients. The sample comprised 30 diabetic volunteers with DN, randomly distributed into 3 groups: Control—conventional treatment; ILIB—100 mW, 660 – 10 nm, 30 applications in total, divided into 3 stages of 10 applications, 30 min each, daily, with a 20-day interval between each stage; SILIB—same protocol described for ILIB, with the equipment switched off. Before and after the application of the therapeutic protocols, all volunteers were evaluated by the following instruments: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), visual analog scale, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and PAIN DETECT scale. Collected data were statistically analyzed with a 95% confidence interval, p < 0.05. Results: The ILIB group presented significantly lower pain levels and a better quality of life compared with the control and SILIB groups. Conclusions: This study demonstrated that ILIB therapy was effective in reducing pain and improving quality of life in patients with DN.
关键词： photobiomodulation,diabetes mellitus,diabetic neuropathies,pain
更新于2025-09-23 15:19:57
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A fully automated pipeline of extracting biomarkers to quantify vascular changes in retina-related diseases
摘要： This paper presents an automated system for extracting retinal vascular biomarkers for early detection of diabetes. The proposed retinal vessel enhancement, segmentation, optic disc (OD) and fovea detection algorithms provide fundamental tools for extracting the vascular network within the pre-defined region of interest. Based on that, the artery/vein classification, vessel width, tortuosity and fractal dimension measurement tools are used to assess a large number of quantitative vascular biomarkers. We evaluate our pipeline module by module against human annotations. The results indicate that our automated system is robust to the localisation of OD and fovea, segmentation of vessels and classification of arteries/veins. The proposed pipeline helps to increase the effectiveness of the biomarkers extraction and analysis for the early diabetes, and therefore, has the large potential of being further incorporated into a computer-aided diagnosis system.
关键词： diabetes,Retinal image analysis,vessel biomarkers,computer-aided diagnosis
更新于2025-09-19 17:15:36
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Validation of low-cost smartphone-based thermal camera for diabetic foot assessment
摘要： Infrared thermal imaging (IR) is not yet routinely implemented for early detection of diabetic foot ulcers (DFU), despite proven clinical effectiveness. Low-cost, smartphone-based IR-cameras are now available and may lower the threshold for implementation, but the quality of these cameras is unknown. We aim to validate a smartphone-based IR-camera against a high-end IR-camera for diabetic foot assessment. Methods: We acquired plantar IR images of feet of 32 participants with a current or recently healed DFU with the smartphone-based FLIR-One and the high-end FLIR-SC305. Contralateral temperature differences of the entire plantar foot and nine pre-specified regions were compared for validation. Intra-class correlations coefficient (ICC(3,1)) and Bland-Altman plots were used to test agreement. Clinical validity was assessed by calculating statistical measures of diagnostic performance. Results: Almost perfect agreement was found for temperature measurements in both the entire plantar foot and the combined pre-specified regions, respectively, with ICC values of 0.987 and 0.981, Bland-Altman plots’ mean Δ=-0.14 and Δ=-0.06. Diagnostic accuracy showed 94% and 93% sensitivity, and 86% and 91% specificity. Conclusions: The smartphone-based IR-camera shows excellent validity for diabetic foot assessment.
关键词： Smartphone,Thermal Infrared,Diabetes Mellitus,Diabetic Foot,Foot Ulcer,Temperature
更新于2025-09-19 17:15:36
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A predictive screening tool to detect diabetic retinopathy or macular edema in primary health care: construction, validation and implementation on a mobile application
摘要： The most described techniques used to detect diabetic retinopathy and diabetic macular edema have to be interpreted correctly, such that a person not specialized in ophthalmology, as is usually the case of a primary care physician, may experience difficulties with their interpretation; therefore we constructed, validated and implemented as a mobile app a new tool to detect diabetic retinopathy or diabetic macular edema (DRDME) using simple objective variables. We undertook a cross-sectional, observational study of a sample of 142 eyes from Spanish diabetic patients suspected of having DRDME in 2012–2013. Our outcome was DRDME and the secondary variables were: type of diabetes, gender, age, glycated hemoglobin (HbA1c), foveal thickness and visual acuity (best corrected). The sample was divided into two parts: 80% to construct the tool and 20% to validate it. A binary logistic regression model was used to predict DRDME. The resulting model was transformed into a scoring system. The area under the ROC curve (AUC) was calculated and risk groups established. The tool was validated by calculating the AUC and comparing expected events with observed events. The construction sample (n = 106) had 35 DRDME (95% CI [24.1–42.0]), and the validation sample (n = 36) had 12 DRDME (95% CI [17.9–48.7]). Factors associated with DRDME were: HbA1c (per 1%) (OR = 1.36, 95% CI [0.93–1.98], p = 0.113), foveal thickness (per 1 μm) (OR = 1.03, 95% CI [1.01–1.04], p < 0.001) and visual acuity (per unit) (OR = 0.14, 95% CI [0.00–0.16], p < 0.001). AUC for the validation: 0.90 (95% CI [0.75–1.00], p < 0.001). No significant differences were found between the expected and the observed outcomes (p = 0.422). In conclusion, we constructed and validated a simple rapid tool to determine whether a diabetic patient suspected of having DRDME really has it. This tool has been implemented on a mobile app. Further validation studies are required in the general diabetic population.
关键词： Diabetes mellitus,Macular edema,Diagnostic tests,Statistical models,Diabetic retinopathy,Optical coherence tomography
更新于2025-09-19 17:15:36
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Wearable-band Type Visible-Near Infrared Optical Biosensor for Non-invasive Blood Glucose Monitoring
摘要： Diabetes is a worldwide-serious problem that can only be delayed or prevented by a regular monitoring of blood glucose (BG) concentration level. Continuous monitoring systems allow subjects to prepare the diabetes management strategy and prevent the long-term complications diseases. Until now, most studies utilize various biofluids such as sweat, tears and saliva that have serious unresolved setback such as expensive material, sensor stability, sensor calibration and long-settling time. Therefore, we developed a novel BG sensor which is cost efficient and highly wearable with a small data acquisition time window that allow a non-invasive, long-term continuous blood glucose monitoring (CGM) system. The novel biosensor exploits a unique information of the pulsatile to continuous components of the arterial blood volume pulsation during the change of blood glucose (BG) concentration at the wrist tissue. The reflected optical signal was measured in the combine visible-near infrared (Vis-NIR) spectroscopy. An in-vivo experiment which enclosed 12 volunteers in a two-hour modified carbohydrate-rich meals reached the average correlation coefficient (????) between the estimated and reference BG concentration of 0.86, with the standard prediction error (SPE) of 6.16 mg/dl. Moreover, the full-day experiment was also conducted to test the reliability of the proposed sensor. Results showed that the created model in the previous day, may estimate a full-day BG concentration which was done in next day with an adequate performance.
关键词： Wearable Sensor,Optical Biosensor,Noninvasive Measurement,Visible-Near Infrared Spectroscopy,Diabetes,Continuous Blood Glucose Monitoring
更新于2025-09-19 17:15:36
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Multiple renal ruptures after flexible ureteroscopic lithotripsy with holmium laser
摘要： The authors present a case report of multiple renal ruptures after flexible ureteroscopic lithotripsy (FURL) with holmium laser. Multiple renal ruptures following flexible ureterorenoscopy have not been reported so far. The etiology remains unclear. We like to share this case to make urologists aware of this unusual complication and discuss possible causes and therapeutic approaches.
关键词： urolithiasis,flexible ureteroscopy,infection,Renal rupture,diabetes mellitus
更新于2025-09-19 17:13:59
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Evaluation of the Effects of Low-Level Laser Therapy on Diabetic Bone Healing
摘要： The aim of the present study was to evaluate the effects of low-level laser therapy (LLLT) and biphasic alloplastic bone graft material on diabetic bone healing. Induction of diabetes was performed in 14 male Sprague-Dawley rats by intraperitoneal injection of a 50 mg/kg dose of streptozotocin. Two bilaterally symmetrical non-critical-sized bone defects were created in the parietal bones in each rat. Right defects were filled with biphasic alloplastic bone graft. Rats were randomly divided into 2 groups, with 1 group receiving 10 sessions of LLLT (GaAlAs, 78.5 J/cm2, 100mW, 0.028 cm2 beam). The LLLT was started immediately after surgery and once every 3 days during postoperative period. At the end of treatment period, new bone formation and osteoblast density were determined using histomorphometry. Empty (control), graft-filled, LLLT-treated and both graft-filled and LLLT-treated bone defects were compared. New bone formation was higher in the graft treatment samples compared with the control (P ? 0.009) and laser samples (P ? 0.029). In addition, graft–laser combination treatment samples revealed higher bone formation than control (P ? 0.008) and laser (P ? 0.026) samples. Osteoblast density was significantly higher in the laser treatment (P <0.001), graft treatment (P ? 0.001) and graft–laser combination treatment (P <0.001) samples than control samples. In addition, significantly higher osteoblast density was observed in the graft-laser combination treatment samples compared to the graft treatment samples (P ? 0.005). The LLLT was effective to stimulate osteoblastogenesis but failed to increase bone formation. Graft augmentation for treatment of bone defects seems essential for proper bone healing in diabetes, regeneration may be supported by the LLLT to enhance osteoblastogenesis.
关键词： Bone healing,diabetes,low-level laser therapy
更新于2025-09-12 10:27:22
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Quantitative Analysis of Heel Skin Microcirculation Using Laser Doppler Flowmetry and Tissue Spectrophotometry
摘要： OBJECTIVE: To examine perfusion changes in the heel skin of individuals with and without diabetes mellitus to understand how skin is pathologically affected by diabetes mellitus. METHODS: This case-control study was conducted at an academic hospital in Tuebingen, Germany. A total of 30 subjects were enrolled in the study: 15 with known type 2 diabetes mellitus and 15 without. Each subject was asked to lie in a supine position on a hard lateral transfer mat for 10 minutes. MAIN OUTCOME MEASURES: Heel perfusion was quantitatively assessed directly after relief of pressure and after 3 and 6 minutes after relief of pressure using laser Doppler flowmetry and tissue spectrophotometry. MAIN RESULTS: Directly after relief of pressure, blood flow increased in the superficial skin layers (2 mm below the surface of the skin) in both groups. However, in deep skin layers (8 mm below the surface of the skin), blood flow increased in patients with diabetes mellitus and decreased in healthy patients. Oxygen saturation (SO2) was higher in healthy subjects directly after pressure relief. CONCLUSIONS: The increase in blood flow in superficial skin layers indicates reactive hyperemia after exposure in both groups. The prolonged hyperemia in deep skin layers in patients with diabetes indicates increased tissue vulnerability. Despite the increase in blood flow in deep skin layers, the SO2 and thus supply of tissue in patients with diabetes were reduced.
关键词： diabetes mellitus,pressure injury,oxygen saturation,blood flow,perfusion,diabetic foot ulcers,laser Doppler flowmetry,pressure ulcer,microcirculation
更新于2025-09-12 10:27:22
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QUALITY IMPROVEMENT OF LASER TREATMENT (QUILT)A New Retinal Laser Simulation System for Training in Resource-Poor Countries
摘要： In resource-poor countries, there is a reported lack of quality and structured retinal laser training in residency and hospital eye programs. This unmet training need has been validated in current international diabetic retinopathy screening centers. Quality Improvement of Laser Treatment (QUILT) is a novel laser photocoagulation simulator that contains modules for laser treatment of PDR, diabetic macular edema (DME), retinal vein occlusion, and laser retinopexy. The primary objective of the QUILT simulation is to introduce a new bespoke application to support practical skills training in retinal laser treatment in countries where laser training is suboptimal for ophthalmologists and trainees/residents. The application was first developed as an online application but has subsequently been developed as a standalone application that can be downloaded or copied onto individual laptops or computers, so that the training is not dependent on a good internet connection.
关键词： diabetes,simulator,proliferative diabetic retinopathy,laser training,simulation,pattern scan laser,retinopexy,macular edema
更新于2025-09-11 14:15:04