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Biomedical subjects

Neil S Sadick

Publications and source records attributed to Neil S Sadick.

At least 37 records · Page 2Linked to original sources
PubMed2004

Combined endovascular laser with ambulatory phlebectomy for the treatment of superficial venous incompetence: a 2-year perspective.

OBJECTIVE: Non-invasive radiofrequency and endovascular technologies are becoming increasingly popular in the treatment of superficial venous incompetence. In conjunction with stab avulsion of truncal varicosities, these technologies have been able to address functional as well as cosmetic superficial venous incompetence in a non-invasive fashion. The present study presents a 2-year follow-up of 30 patients with combined axial incompetence of the greater saphenous vein (GSV) in conjunction with truncal varicosities treated with combination diode laser technology and ambulatory phlebectomy. METHODS: Thirty patients (mean age 49 years) with Sapheno-Femoral Junction reflux associated with GSV incompetence (mean 9.2 x 8.5 mm) and enlarged branch varicosities, as documented by Duplex ultrasound, were enrolled. Patients were treated with an endovascular diode laser (810 nm, 14 W, continuous mode), followed by ambulatory phlebectomy of residual truncal varicosities. Patients were examined 3, 6, 12 and 24 months following this procedure to determine the long-term efficacy of this procedure. RESULTS: A 2-year closure rate of 96.8% was documented by Duplex evaluation. All 273 ambulatory phlebectomy vein segments were eradicated. Two cases of transient hyperpigmentation and one case of telangiectatic matting were documented. CONCLUSION: The combination of endovascular laser and ambulatory phlebectomy appear to be an effective and safe treatment approach for the management of combined saphenous and truncal varicose vein incompetence.

Adult↗
PubMed2004

A preliminary study of utilization of the 1320-nm Nd:YAG laser for the treatment of acne scarring.

BACKGROUND: Multiple treatment modalities have been used for the revision of acne scarring with varying degrees of success. Nonablative laser resurfacing has recently been shown to improve the appearance of atrophic acne scars. OBJECTIVE: The objective was to determine the efficacy of a 1320-nm Nd:YAG laser for the treatment of acne scars. METHODS: Eight patients with facial acne scars received six monthly treatments with a 1320-nm Nd:YAG laser with built-in cryogen cooling. Results were evaluated by objective and patient assessment using a 6-point improvement scale: 1=no improvement, 6=80% to 100% improvement. RESULTS: Acne scar improvement was statistically significant at both the 5-month and 1-year marks. Mean improvement by objective assessment was 3.9 points (p=0.002) at 5 months and 4.3 points (p=0.011) at 1 years. The mean acne scar improvement by patient assessment was 3.6 points (p=0.002) at 5 months. CONCLUSION: The 1320-nm Nd:YAG laser with cryogen cooling significantly improves the appearance of acne scarring.

Acne Vulgaris↗
PubMed2003

Update on non-ablative light therapy for rejuvenation: a review.

BACKGROUND AND OBJECTIVES: Non-ablative technologies are playing an increasing role in the management of photoaging. Newer radiofrequency technologies have added to this therapeutic armamentarium. Shorter wavelength technologies are more effective in targeting pilosebaceous vascular and pigmentary alterations while longer wavelength technologies are most effective in wrinkle reduction mediated through dermal remodeling. An overview of the various technologies available to the practicing laser surgeon are outlined in the present review.

Humans↗
PubMed2003

Botulinum toxin type B.

BACKGROUND: Botulinum toxin B is an antigenically distinct form of Botulinum toxin which has unique physical and clinical properties that distinguish it from Botulinum toxin A. OBJECTIVE: To describe properties of Botulinum toxin B. METHODS: More rapid onset, greater diffusion characteristics as well as diminished longevity have been identified to date in previous studies. RESULTS: BTX-B is safe and effective. CONCLUSION: The clinical role of this novel neurotoxin in the aesthetic arena is presently evolving.

Botulinum Toxins↗
PubMed2003

The use of a new diode laser for hair removal.

BACKGROUND: Diode and long-pulse 1064 Nd:YAG lasers, because of their long wavelengths and extended pulse durations, have gained popularity over the last several years for photoepilation in individuals with dark skin phenotypes. OBJECTIVE: To analyze the clinical efficacy and histologic features of a new 810-nm diode laser in the treatment of unwanted hair in individuals with Fitzpatrick skin types II-IV. METHODS: Twenty-four female subjects (mean age, 33; range, 17-53) were treated three times at monthly intervals with the MeDioStarâ diode laser (Zeiss-Meditech, Jenna, Germany): wavelength 810 nm, spot size 12 mm, pulse duration 50 msec; fluence 25-35 J. Patients had skin types II-IV and light to dark brown hair. Hair counts were carried out using handheld magnifiers at baseline and at months 1, 2, 3, and 6. Six individuals had biopsies taken after treatment and at 3 and 6 months. RESULTS: A mean hair removal efficiency of 74% and 79% was noted at 3 and 6 months, respectively, and was best in those individuals with skin type III. Hair counts after treatment and at last follow-up were significantly lower when compared with the baseline counts (P<0.0001). Histologic analysis revealed a range from early catagen induction to complete follicular destruction. CONCLUSIONS: This study supports the clinical photoepilatory efficiency of a new 810-nm diode laser in producing 70% clinical hair removal efficiency at 6 months. Histopathologic evaluation suggests that this decrease in hair counts is probably secondary to heat trauma to the follicular epithelium, resulting in complete follicular destruction and stopping of anagen phase.

Adolescent↗
PubMed2003

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

Botulinum toxin injections have become a popular treatment for minimizing or eliminating facial wrinkles. After injection, the toxin acts to paralyze or weaken facial mimetic muscles. Two antigenically distinct serotypes, botulinum toxin type A (BTX-A) and botulinum toxin type B (BTX-B), are currently available. BTX-A is a lyophilized powder preparation requiring reconstitution; BTX-B is a ready-to-use liquid formulation. Both agents produce the same resultant clinical effect (i.e., muscle weakening). However, in addition to differences with respect to formulation, they are pharmacologically distinct in terms of molecular size, cellular mechanism of action, and species sensitivity. BTX-A has been used for aesthetic purposes for more than 10 years. Clinical studies and observations have shown that it is an effective agent for treating hyperkinetic facial lines. BTX-B was approved for use in cervical dystonia in 2000, but it has been used off-label to treat facial wrinkles as reported in several open-label studies. These preliminary dose-ranging studies have demonstrated that BTX-B is also effective. Both agents are extremely safe nonsurgical modalities for hyperkinetic facial lines. This article reviews the pharmacology and molecular features of BTX-A and BTX-B and highlights some of the key clinical studies that have been published to date with these two agents.

Antigen-Antibody Reactions↗
PubMed2003

Prospective open-label study of botulinum toxin type B (Myobloc) at doses of 2,400 and 3,000 U for the treatment of glabellar wrinkles.

BACKGROUND: A previous open-label study evaluated botulinum toxin type B (BTX-B; Myobloc) for the treatment of glabellar wrinkles and showed that it is safe and effective at a dose of 1,800 U. The duration of effect at this dose was approximately 8 weeks, and it was felt that higher doses would result in a longer duration of effect. OBJECTIVE: This is a prospective open-label study to assess the safety, efficacy, and duration of response following BTX-B injection at doses of 2,400 and 3,000 U for the treatment of glabellar frown lines. METHODS: A total of 39 patients were enrolled: 16 patients received 2,400 U. Eighteen patients received 3,000 U, and 5 patients received saline injections (control group). Doses were divided equally among six sites. RESULTS: All subjects had rapid improvement of interglabellar rhytides, with full response seen within 2 to 3 days. The duration of effect was 9.6 and 10.4 weeks with 2,400 and 3,000 U, respectively. Five subjects (two in the 2,400-U group and three in 3,000-U group) reported adverse events related to the BTX-B injection. Three subjects complained of mild pain at the injection site, and two subjects complained about lid droop/ptosis (one with the occurrence of headache). CONCLUSIONS: BTX-B injection is safe and effective for the treatment of glabellar wrinkles. It has a very rapid onset of action, and increasing the dose appears to prolong the duration of response. At 3,000 U, the duration of response was 10.4 weeks and was associated with minimal adverse effects. Adverse events were mild and were similar to those seen in previous studies with BTX-A. Additional studies evaluating BTX-B at higher doses are recommended to prolong the duration of response in the treatment of glabellar wrinkles.

Adult↗
PubMed2003

Laser treatment with a 1064-nm laser for lower extremity class I-III veins employing variable spots and pulse width parameters.

BACKGROUND: The long-pulsed 1064-nm Nd:YAG laser (employing varying spot sizes, pulse widths, and fluences) has gained popularity for treating lower extremity blue and red vessels that are less than 4 mm in diameter. OBJECTIVE: To evaluate the efficacy of high-power 50-ms 1064 Nd:YAG laser in the treatment of class I-III lower extremity vessels. METHODS: Ten female patients (mean age of 39 years) had a 5-cm2 area of veins measuring 0.2 to 3 mm in diameter treated with up to three treatment sessions using a new 1064 Nd:YAG laser, with the end point being 100% vessel clearing after three treatments. Red vessels were treated with a spot size of 1.5 mm, a fluence of 400 to 600 J/cm2, a pulse width of 30 to 50 ms; blue vessels of 1 to 3 mm were treated with a spot size of 3 mm, a fluence of 250 to 370 J/cm2, and a pulse width of 50 to 60 ms. Macrophotographic imaging evaluations by blinded observers using a quartile scale and a patient satisfaction scale were employed to evaluate results. RESULTS: At month 3 after the final treatment session, 20% of all vessel types had 50% to 75% improvement. Equal clearing was noted for blue and red vessels. At month 6, 80% of patients had a greater than 75% clearing. Ninety percent of patients were highly satisfied with the treatment results at 6 months. CONCLUSION: By varying spot size, fluence, and pulse duration, a long-wavelength 1064-nm Nd:YAG laser can achieve excellent results for treating both blue and red lower extremity vessels that are less than 3 mm in diameter.

Adult↗
PubMed2003

Laser and intense pulsed light therapy for the esthetic treatment of lower extremity veins.

The role of lasers and intense pulsed light sources has gained increasing popularity over the last decade. Major advances associated with improved results are the main reasons associated with this increasing popularity. These advances include epidermal cooling technologies, variable spot sizes and pulse durations as well as the ability to deliver high-energy fluences. These advances have allowed the delivery of sufficient energy to cause uniform pan-endothelial necrosis without affecting epidermal structures causing adverse sequelae such as post-inflammatory hyperpigmentation and epidermal surface irregularities. The advent of extended-pulse longer-wavelength technologies such as the 1064 Neodymium : Yttrium Aluminum Garnet (Nd : YAG) laser have allowed the treatment of individuals with darker phenotypic skin types as well as deep blue reticular veins up to 3mm in diameter in a monomodal fashion. Combined approaches of sclerotherapy plus laser treatments performed at the same treatment session may produce synergistic results in selected individuals.

Humans↗
PubMed2002

Effects of intense pulsed light on sun-damaged human skin, routine, and ultrastructural analysis.

BACKGROUND AND OBJECTIVE: New, non-ablative methods can be used in skin rejuvenation. Histologic analysis of non-ablative IPL effects on facial, sun-damaged skin. STUDY DESIGN/MATERIALS AND METHODS: Five female subjects, wrinkle class I or II and Fitzpatrick skin types I, II, and III. IPL treatment: once monthly, 560-nm cut-off filters, spot size 8x35 mm, 28-36 J/cm. Routine histology or electron microscopy on 2-mm punches, before treatment and then 1 week, 3 months, and 12 months. RESULTS: Pre-treatment specimens contained solar elastosis and perifollicular lymphoid infiltrates. Collagen and elastic fibers appeared unaffected by treatment. At 1-week, Demodex organisms appeared coagulated. CONCLUSIONS: Under these conditions, IPL induces minimal morphologic changes in mildly sun-damaged skin. Some esthetic improvement may be secondary to clearing of Demodex organisms and reduction of associated lymphocytic infiltrate.

Collagen↗
PubMed2002

The utilization of a new yellow light laser (578 nm) for the treatment of class I red telangiectasia of the lower extremities.

BACKGROUND: A dual-wavelength approach is necessary in order to achieve consistent results when utilizing lasers and intense pulsed light sources to treat red and blue lower extremity vessels. In this regard, short-wavelength technologies (500-800 nm) may be employed to treat red telangiectasia of less than 2 mm on the lower extremities. OBJECTIVE: To demonstrate a new yellow light laser utilizing a copper bromide medium and its potential efficacy in the treatment of red lower extremity telangiectasia of less than 2 mm. METHODS: Forty-six women (mean age 37 years) were treated in two private practice settings with a 578 nm yellow light laser with a circulating cooling window (1-4 degrees C). Class I red telangiectases of the thighs 1.5 mm or less in diameter were considered for treatment. Patients were treated with up to three treatments at 6-week intervals on a 5 cm2 surgical area of vessels utilizing a fluence of 50-55 J/cm2. Results were analyzed by macrophotographic imaging, double-blinded observer evaluation/optical chromatography, and a patient evaluation scale. RESULTS: An average of 1.7 patient treatment sessions produced significant clearing of 75-100% in 71.8% of patients. The mean erythema index showed significant lightening (51-65a+) in the study population. Finally, 76.1% of patients reported great satisfaction with the results of their treatment session. CONCLUSION: A new 578 nm copper bromide (CuBr) yellow light laser produces excellent results in eradicating red telangiectases of the lower extremities that are less than 2 mm in diameter.

Adult↗
PubMed2002

Multifocal pull-through endovascular cannulation technique of ambulatory phlebectomy.

BACKGROUND: New treatment indications and improved technique modifications have made ambulatory phlebectomy increasingly popular in the management of intermediate and large truncal varicosities. OBJECTIVE: To describe a new technique of ambulatory phlebectomy that combines a multifocal incisional and endovascular cannulation approach. This study compares this newly described technique to the previously described "pulling maneuver." METHODS: A double-blinded study consisting of 50 patients who were treated by the conventional pulling maneuver and 50 patients treated by the multifocal pull-through endovascular cannulation technique was conducted. This newly described technique was compared to the previously described "pulling maneuver" in terms of length of vessel avulsed per puncture site, intraoperative time, and complication profile. An average of 20 cm of diseased venous segment was avulsed in each patient subgroup. Results were analyzed utilizing the paired t test (P < .05). RESULTS: A 36% increase in vessel avulsion length per puncture site was achieved in the endovascular pull-through cannulation subgroup compared to the classic pulling maneuver population. The number of puncture sites in the 20 cm segment of veins in the classic pulling maneuver population was 4.50 versus 3.04 in the multifocal pull-through subgroup. The mean operative time was 20% less in the pull-through cannulation population versus the classic pulling technique. Side effect profiles were similar in the two patient subgroups. CONCLUSION: The multifocal pull-through cannulation technique allows extraction of large segments of diseases varicose veins with fewer puncture sites in a more efficient fashion than previously described techniques.

Adult↗
PubMed2002

Botulinum toxin type B for glabellar wrinkles: a prospective open-label response study.

BACKGROUND: Botulinum toxin type B (BTX-B) is U.S. Food and Drug Administration (FDA)-approved for the treatment of cervical dystonia. There are no published studies investigating its efficacy for treatment of glabellar (frown) wrinkles; however, anecdotal reports of its efficacy are promising. OBJECTIVE: The current pilot study is an initial screening study to assess the safety and efficacy of a single, set dose of BTX-B in the treatment of glabellar (frown) lines and to document current clinical experience with BTX-B. METHODS: Thirty subjects (28 women, 2 men) were injected in six sites with 300 U per site for a total dose of 1800 U. RESULTS: At 2 and 4 weeks, patient and physician assessment scores showed an average score of 2 ("complete disappearance of wrinkles"). Three patients reported mild adverse events. CONCLUSION: Injections of BTX-B proved to be very efficacious, with rapid onset, with all patients responding within 3 days (mean 1.5 days). Adverse events were mild. The mean duration of effect with this low dose of BTX-B was 8 weeks. Since the duration may be dose related and minimal adverse events were observed at 1800 U, further studies are in progress to look at the duration of response resulting from higher doses of BTX-B in the treatment of glabellar wrinkles.

Adult↗
PubMed2002

Intense pulsed-light photorejuvenation.

Intense pulsed light photorejuvenation represents a novel mode of treatment of photodamaged skin. A broad-spectrum flashlamp (500-1200 nm) targets chromophores reversing pigmentation, vascular and pilosebaceous aberrations. Both cytokine mediated as well as thermally induced deep dermal remodeling may be achieved using the varied polychromatic wavelengths associated with this technology. Inflammatory dermatosis such as rosacea may also be addressed as well. A structural approach to non-ablative rejuvenation utilizing intense pulsed light is associated with high patient satisfaction and minimal adverse sequelae.

Facial Dermatoses↗