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Biomedical subjects

Neil S Sadick

Publications and source records attributed to Neil S Sadick.

At least 19 recordsLinked to original sources
PubMed2006

A quality rating scale for aesthetic surgical procedures.

BACKGROUND: Cosmetic dermatologic procedures offer the promise of visible aesthetic enhancement with minimal risk. While in recent years the number of available procedures has proliferated, there are few objective methods for evaluating the relative quality of these procedures for particular indications or specific patients. OBJECTIVE: (A) To develop a simple, easy-to-use numerical rating scale to assess the quality of cosmetic surgical procedures on a range of parameters pertaining to clinical efficacy and patient satisfaction; (B) to statistically validate the discriminative value of this rating scale. METHODS: (A) Patient and physician interviews were performed to elicit a list of factors that may collectively characterize the clinical efficacy and patient tolerability of cosmetic dermatologic procedures. A 0-100 point rating scale was developed based on these factors, with the face-validity of this scale checked by a group of patients and physicians; (B) Statistical analysis of the questionnaire was performed by asking 15 expert cosmetic dermatologic surgeons to use it to rate 23 common cosmetic dermatologic procedures, and analyzing the results. RESULTS: (A) An easy-to-use scale was constructed to assess the quality of cosmetic dermatologic procedures by rating the associated cost, risk, time (procedure and recovery), discomfort, results, and longevity of benefit. A "physician adjustment factor" was used to further increase the relevance of this 0-100 point scale for specific patients; (B) Repeated-measures analysis of variations (ANOVAs) performed on the data from the survey of experts demonstrated that this scale can be used to discriminate between common dermatologic procedures. The differences in mean subscores and total scores among procedures grouped by anatomic site and target lesion-type were significant at the level of P < .05. LIMITATIONS: Patient preferences exogenous to the rating scale may increase or decrease the suitability of specific procedures. CONCLUSIONS: Common cosmetic dermatologic procedures are of uniformly high quality, as per expert ratings on a systematic measure. This quality rating scale appears statistically valid and robust, given that expert raters assigned similar ratings to the same procedures but mean ratings were different across procedures. In the future, this quality rating scale can be used to assess novel interventions, and to help dermatologic surgeons faced with patient concern to optimally select among alternative procedures for a given indication.

Botulinum Toxins, Type A↗
PubMed2006

Laser and light treatments for pilonidal cysts.

Pilonidal (nest of hair) cysts are foreign body reactions accompanied by chronic inflammation. Current accepted treatments include the traditional conservative treatments or aggressive surgery. However, these modalities exhibit a high rate of disease recurrence, especially in patients with hirsutism; therefore, affected patients often are subjected to repeated surgical interventions. This report describes 5 patients treated with either a diode laser or intense pulsed light (IPL), which produced results leaving the patients recurrence free. Four of 5 patients remained recurrence free for 7 months to more than 36 months; one patient experienced a recurrence after 36 months, which was longer than his previous remission. These results suggest laser and IPL technologies are alternatives to traditional surgical intervention, providing potentially longer disease-free intervals and fewer recurrences.

Adult↗
PubMed2006

Hair removal for Fitzpatrick skin types V and VI using light and heat energy technology.

OBJECTIVE: To determine the safety and efficacy of a light and heat energy (LHE)-based system (SkinStaion system; Radiancy Inc, Orangeburg, NY, USA) for hair removal in subjects with skin types V and VI. METHODS: Thirty-one subjects with Fitzpatrick skin types V and VI were consented for treatment with the system. Twenty-six subjects completed the 12-week follow-up. Safety was evaluated at each visit and efficacy was evaluated at both follow-up visits. RESULTS: An average hair clearance of 41.7% from 57 treatment sites was reported at the 6-week follow-up visit and a 35.5% average hair clearance was reported at the 12-week follow-up. Edema was only reported in 2 cases (7.7%) of the study population. Eleven cases of erythema were reported following treatment. CONCLUSION: Treatment with the modified LHE system was safe and effective for hair removal in patients with skin types V and VI.

Adult↗
PubMed2005

A clinical, histological, and computer-based assessment of the Polaris LV, combination diode, and radiofrequency system, for leg vein treatment.

BACKGROUND AND OBJECTIVES: Electro-optical synergy (ELOS) is a novel technology that combines radiofrequency (RF) with optical energy. This study investigated the safety and effectiveness of the Polaris LV system, which is based on combined RF and diode laser (915 nm), for the treatment of leg veins. STUDY DESIGN/MATERIALS AND METHODS: Fifty women (Fitzpatrick II-IV) with red or blue leg veins (1-4 mm in diameter) were treated with the Polaris LV, using a fluence of 60-80 J/cm(2) and conducted RF energy of 100 J/cm(3). Patients received up to three treatment sessions at 2- to 4-week intervals. Both patients and an independent physician graded the level of vessel clearance at 2 months following the last treatment, using pre- and post-treatment photographs. Also, a computer-generated assessment of vessel clearance was done in 40 patients. Twenty patients provided biopsy specimens for histologic assessment. RESULTS: Approximately three-quarters of patients demonstrated >/= 50% vessel clearance, and about 30% had 75%-100% vessel clearance. Computer-generated scores correlated closely with physician scores. Histologic assessment showed signs of coagulation and prominent endothelial degeneration in all treated vessels, but the epidermis remained normal. There were minimal complications. CONCLUSIONS: The Polaris LV is effective and safe in treating red and blue leg veins up to 4 mm in diameter.

Adult↗
PubMed2005

Advances in the treatment of varicose veins: ambulatory phlebectomy, foam sclerotherapy, endovascular laser, and radiofrequency closure.

Several recent advances in the treatment of varicose veins have improved the safety, efficacy, comfort, efficiency, and long-term success of therapy. The advances of ambulatory phlebectomy, foam sclerotherapy, endovascular laser, and radiofrequency ablation with closure have made a significant positive impact on patient satisfaction. Duration of treatment and recovery is shorter, discomfort is minimized, and results are generally excellent. Studies assessing long-term outcomes are ongoing, and treatment modalities are continuing to evolve.

Ambulatory Surgical Procedures↗
PubMed2005

Ablative facial resurfacing.

This article discusses ablative resurfacing, which is a powerful tool for rejuvenation of the aging face and treatment of a wide array of skin lesions. In the proper hands, it is a safe and effective way to treat many of the problems of photodamaged skin that surgery or nonablative methods cannot address.

Chemexfoliation↗
PubMed2005

Evaluation of pulsed light and radiofrequency combined for the treatment of acne vulgaris with histologic analysis of facial skin biopsies.

BACKGROUND: Light and radiofrequency (RF) devices have recently been used to treat acne in selected patients. OBJECTIVE: To investigate the safety and efficacy of a combination of pulsed light and RF energy for the treatment of acne. Materials and methods. Thirty-two patients with moderate acne were treated twice weekly for four weeks with the Aurora AC (Syneron Medical Ltd, Yokneam, Israel), a combination of pulsed light and RF energy. Twenty-five patients completed the study. In four patients, the number of hair follicles showing perifolliculitis, the diameters of hair follicles, the diameters of sebaceous glands, and expressions of heat shock protein 70 and procollagen-1 were evaluated before and after treatment. RESULTS: The mean lesion count was reduced by 47% (p < 0.05) after eight treatments. Adverse effects-erythema, tingling, and burning-were mild and temporary. The percentage of follicles with perifolliculitis decreased from 58% to 33%, sebaceous gland areas decreased from 0.092 mm2 to 0.07 mm2, and heat shock protein 70 and procollagen-1 expressions did not change. CONCLUSION: The combination of optical and RF energies may be an alternative nonablative modality for the treatment of moderate acne. Clinical improvement may be partly due to reductions in both perifollicular inflammation and sebaceous gland areas.

Acne Vulgaris↗
PubMed2005

Randomized, double-blind, placebo-controlled study evaluating the lidocaine/tetracaine patch for induction of local anesthesia prior to minor dermatologic procedures in geriatric patients.

BACKGROUND: Topical anesthetics offer a noninvasive method of anesthesia. OBJECTIVE: To evaluate the efficacy and safety of the lidocaine/tetracaine patch, a 1:1 (wt:wt) eutectic mixture of lidocaine and tetracaine, for local anesthesia before minor dermatologic procedures in geriatric patients. METHODS: In a multicenter, randomized, double-blind, placebo-controlled study, 79 patients over the age of 65 years received a 30-minute application of either the lidocaine/tetracaine patch or placebo immediately before a shave biopsy or superficial excision. The primary measure of efficacy was patient assessment of procedural pain using the visual analog scale (VAS). Secondary efficacy end points included patient, investigator, and independent observer assessments. RESULTS: There was a statistically significant difference (p = .041) in patient ratings of pain by VAS score in the active group (9.5 mm) compared with the placebo group (22.5 mm). None of the secondary end points showed a statistically significant difference between groups. No adverse events were reported. CONCLUSION: The lidocaine/tetracaine patch is a safe and effective method for noninvasive induction of local anesthesia for minor dermatologic procedures in patients over the age of 65 years.

Aged↗
PubMed2005

Effects of intense pulsed light and the 1,064 nm Nd:YAG laser on sun-damaged human skin: histologic and immunohistochemical analysis.

BACKGROUND: Nonablative methods may produce collagen synthesis in sun-damaged skin. OBJECTIVE: To study the effects of intense pulsed light (IPL) and 1,064 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser: a histologic and immunohistochemical analysis of sun-damaged skin. MATERIALS AND METHODS: Nine subjects participated. Five subjects received five-monthly treatments with IPL (560 nm cutoff filter, 8 x 35 mm spot size, pulse duration 2.4/4.2 milliseconds, pulse delay 15 milliseconds, fluence 28-35 J/cm2). Four subjects received treatment with a 1,064 nm Nd:YAG laser (130 J/cm2, triple pulse, 7.0/7.0/7.0-millisecond pulse duration, 75-millisecond delay). Routine histology and immunohistochemistry on 2 mm punch biopsies were taken before treatment and then at 3 and 6 months. We quantified collagen in the upper dermis and expression of heat shock protein 70 and procollagen 1. RESULTS: Pretreatment specimens contained solar damage. After treatment with the 1,064 nm Nd:YAG laser, the amount of collagen in the papillary dermis was slightly thicker than in those subjects treated with the IPL device (nonsignificant differences). Scattered dendritic cells in the papillary and upper reticular dermis expressed heat shock protein 70 and procollagen 1 after treatment with either light device. CONCLUSION: Both the IPL and 1,064 nm Nd:YAG laser-induced heat activation of superficial dermal dendritic cells resulted in deposition of collagen in the papillary dermis without evident morphologic damage to the epidermis or dermis.

Female↗
PubMed2005

Combination radiofrequency and light energies: electro-optical synergy technology in esthetic medicine.

BACKGROUND: In the past decade, there has been an astonishing insurgence in the number and variety of commercially available nonablative resurfacing devices. This is related in part to a continually increasing market demand for noninvasive cosmetic procedures that are associated with minimal recovery time and fewer complications than the traditional carbon dioxide (CO2) laser. OBJECTIVE: The goal of nonablative devices is to selectively heat the target tissues without injuring surrounding tissue. This article reviews the mechanism, results of clinical studies, and treatment parameters for a combination optical and radiofrequency (RF) energies system. METHODS AND MATERIALS: To see modest clinical improvement, the patient often requires a series of treatments over the course of several months (sometimes up to 18 months). RESULTS: Preliminary studies with combination optical and RF energies have shown promising results in different dermatologic applications, including skin rejuvenation, hair removal, and leg vein treatment. CONCLUSION: A new technology that integrates bipolar RF and optical energies, ELOS (Syneron Medical Ltd, Yokneam, Israel), is based on the premise of a synergistic activity between the two forms of energy. The bipolar RF component enables the use of lower levels of the optical component, reducing the risk from optical energy and potentially improving its use across different skin types and hair colors. The optical component is believed to drive the bipolar RF energy to concentrate where the optical energy has selectively heated the target.

Hair Removal↗
PubMed2005

Nonablative wrinkle treatment of the face and neck using a combined diode laser and radiofrequency technology.

BACKGROUND: Nonablative laser systems that integrate optical and conducted radiofrequency (RF) energies are a novel technology for the treatment of wrinkles. OBJECTIVE: This two-center study investigated the safety and effectiveness of combination diode laser (900 nm) and RF for the treatment of wrinkles and skin texture. METHODS: Patients with grade II to IV wrinkling on the face, according to the Glogau classification system, were treated with a combination diode laser and RF using a fluence of 30 to 50 J/cm2 and RF energy of 80 to 100 J/cm3. Patients received up to three treatment sessions at 2- to 3-week time intervals. Wrinkle assessments using the Glogau scale were conducted at baseline and at 3 months following the last treatment. In addition, patients and physicians graded the level of improvement using pre- and post-treatment photographs. RESULTS: Twenty-three subjects completed all three treatment sessions. Of these participants, more than 50% had a greater than 50% improvement in the appearance of wrinkles. All subjects reported a noticeable improvement in skin smoothness and texture. CONCLUSION: This preliminary study demonstrates that the combination of diode laser and RF energies decreases the appearance of wrinkles and improves skin texture.

Adult↗
PubMed2004

Selective electro-thermolysis in aesthetic medicine: a review.

The use of radiofrequency (RF) for selective electro-thermolysis has been found to produce a highly efficient thermal effect on biological tissue. Different from optical energy, RF energy is dependent on the electrical properties of the tissue rather than on concentration of chromophores in the skin for selective thermal destruction of targeted sites. Good results have been obtained with systems that use RF current alone for skin resurfacing, with efficacy comparable to laser resurfacing but with potentially more rapid healing. A related adverse effect is pain accompanying the procedure, due to a high depth of penetration. Another technology integrates RF energy together with optical energy (using lower energies of both forms of energies). These systems have shown efficacy in hair removal for all hair colors and skin types, as well as wrinkle reduction; and may reduce the risk of side effects associated with either RF or optical treatments alone. This article discusses the properties of electrical current in medicine and reviews the studies to date that have evaluated RF energy for dermatological applications.

Electrosurgery↗
PubMed2004

Laser hair removal.

The evolution of new technologies has helped to improve the clinical efficacy of laser hair removal and increase understanding of hair biology and phototrichoregulatory interactions. Long-term hair removal is now a realistic goal in the majority of individuals. Although the optimal schedule for repeat treatments is not known, most laser surgeons report treatments at 4- to 8-week intervals or at the first signs of regrowing hairs. Newer radiofrequency technologies might address the issue of white and light blond hair phenotypes;however, their exact role in the laser hair removal armamentarium remains to be further elucidated by future studies.

Esthetics↗
PubMed2004

Comparison of botulinum toxins A and B in the treatment of facial rhytides.

Facial rhytides of the upper one third of the face are common aesthetic concerns, and are caused principally by overactivity of the underlying facial musculature. Botulinum toxin, which acts by causing flaccid paralysis of facial mimetic muscles, has become a treatment of choice for the management of these hyperfunctional facial lines. Two antigenically distinct serotypes have been developed and are currently available for commercial use in the United States. There are major differences between the two toxins in terms of pharmacology and formulation that account for clinical differences, and precise interconversion is not well-established. Nevertheless, in these preliminary studies, Myobloc seems to have a faster onset of action and potentially a more even and smoother paralysis. The shorter duration of action of Myobloc seems to be dose-related. It is clear that both agents safely and effectively reduce dynamic facial rhytides. Based on individual efficacy, safety, diffusion pattern, onset, and duration, ultimately, with further trials and clinical experience, it is conceivable that each toxin will have its own set of indications.

Anti-Dyskinesia Agents↗
PubMed2004

A prospective clinical study to evaluate the efficacy and safety of cellulite treatment using the combination of optical and RF energies for subcutaneous tissue heating.

BACKGROUND: There have not been any published studies on the use of radiofrequency (RF)-light-based technologies for the treatment of cellulite. Only preliminary results have recently been reported (ASDS Proceedings, September 2004). OBJECTIVE: This two-center study investigated the safety and effectiveness of combined energies for cellulite treatment using the VelaSmoothtrade mark system. METHODS: Thirty-five female subjects with cellulite and/or skin irregularities on the thighs and/or buttocks were treated with the VelaSmooth device. Patients received from eight to 16 treatments twice weekly. All patients maintained their normal lifestyle, and diet and fluid consumption. The circumference of the right and left medial thighs was measured at both baseline and approximately 4 weeks after the last treatment. During the last follow-up visit, the physician graded the level of improvement in skin smoothing and/or cellulite improvement using pre- and post-treatment photographs. Three patients provided biopsy specimens for histological assessment. RESULTS: All study patients showed some level of reduction in thigh circumference after 8 weeks of treatment; indeed, 70% of all patients showed such a reduction after 4 weeks of treatment. Also, 100% of all patients showed some level of improvement in skin texture and cellulite. The mean decrease in circumference was 0.8 inches. Some patients demonstrated reductions of more than 2 inches. There were minimal complications associated with treatment. CONCLUSION: This preliminary study demonstrates that the VelaSmooth system can have a beneficial effect on cellulite appearance. Further studies are needed to better define the mechanisms by which RF and light energies affect subdermal tissues and develop a method of quantified cellulite analysis.

Adipose Tissue↗
PubMed2004

Hair removal using a combination of conducted radiofrequency and optical energies--an 18-month follow-up.

OBJECTIVE: Multiple lasers and intense pulsed light sources have been shown to provide long-term hair removal; however, the management of all dark skin phenotypes and light-colored hair remains problematic. The present study examined the long-term photoepilatory effect of a combined intense pulsed light (IPL) (680-980 nm)/radiofrequency (RF) (10-30 J/cm3) light source and its efficiency for the treatment of multiple skin phenotypes and varied hair colors. METHODS: Forty adult patients (skin phenotypes II-V) with varied facial and non-facial hair colors were treated with a combined IPL/RF technology. Four treatments were carried out over a period of 9-12 months at 8-12-week intervals. Light energy ranged from 15 to 26 J/cm2, while RF energy varied from 10 to 20 J/cm3. Hair counts and photographic evaluation of skin sites were obtained at baseline, and months 1, 3 and 5 after the final treatment session. H&E biopsies were examined at 1 week in five randomly selected study cohorts. RESULTS: Maximum hair reduction was observed at 6-8 weeks after each treatment. An average clearance of 75% was observed in all body locations at 18 months. No significant adverse sequelae were reported. Results showed no significant dependence on skin color: lighter and darker skin types responded similarly to treatment. Histologic evaluation revealed thermal damage to hair follicles with vacuolar degeneration. CONCLUSION: The combined IPL (680-980 nm)/RF light source with contact cooling is a safe and effective method of long-term hair reduction in patients of diversified skin types and varied hair colors and is associated with excellent patient safety.

Follow-Up Studies↗
PubMed2004

Effective epilation of white and blond hair using combined radiofrequency and optical energy.

OBJECTIVE: The present study examined the long-term photoepilatory effect on blond and white hair of a combined intense pulsed light (680-980 nm) device with a bipolar radiofrequency component producing electrical current at a depth of 4 mm. MATERIALS AND METHODS: Thirty-six adult women with white and blond hair (skin phenotypes I-V) were included in the study. The chin and upper lip were treated with four treatment sessions over 9-12 months with long-term follow-up performed at month 18 (6 months after the last treatment). The level of RF energy was 20 J/cm3, while optical fluences varied from 24 to 30 J/cm2. Hair counts and photographic evaluation of some sites were obtained at baseline, months 1, 3 and 5 and the final treatment session. RESULTS: An average hair removal of 48% was observed at month 18 (6 months following the final treatment session). A slightly higher photoepilatory efficiency was noted for blond hair (52%) versus white hair (44%) treatment sites. CONCLUSION: Combined radiofrequency and optical energy technology may produce effective photoepilation of blond and white hair phenotypes.

Adult↗