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Background: Vulvovaginal atrophy (VVA) includes a wide range of conditions affecting the reproductive and urinary systems, often requiring careful evaluation and management for optimal health. Aims: This study aims to evaluate the symptom management effects of a real time temperature‐monitored non‐ablative RF device for the treatment of postmenopausal Chinese women with VVA symptoms. Methods: This pilot study involved 24 postmenopausal Chinese women with one or more VVA symptoms, who wished to remain sexually active. VHIS, VAS, and FSFI were used to track and evaluate various aspects of the patient's condition. Analyses were conducted at the end of the study to verify the statistical significance of the treatment's results. Results: All patients reported substantial, statistically significant, improvements on every VVA symptom tracked. Approximately 80% of the patients reported total symptom reversal at 12‐week post‐treatment follow‐up. Conclusion: This pilot study demonstrated that non‐ablative, monopolar RF technology equipped with real time temperature monitoring is feasible and safe in the treatment of postmenopausal women with VVA symptoms, and efficacious at up to 12 weeks post‐treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: The development of microfocused ultrasound and fractional radiofrequency-based devices has expanded the range of cosmetic treatment options for patients with skin of color. Fractional non-ablative laser treatments can also be safely performed in skin types III-VI with appropriate settings and adjunctive topical treatments. OBJECTIVE: We sought to review the available literature on the use of energy-based devices for treatment of facial skin conditions in skin types III-VI. METHODS: A PubMed search was performed on studies from 2010-2021 assessing safety and efficacy of fractional ablative and non-ablative lasers, radiofrequency, and microfocused ultrasound-based treatments for conditions such as acne scars, melasma, benign pigmented lesions, rhytids, and skin laxity in skin types III-VI. RESULTS: Seven randomized trials, fourteen prospective cohort studies, and six retrospective reviews were included. Combination treatment with fractional radiofrequency and non-ablative laser has demonstrated efficacy in the treatment of acne scars in skin of color with minimal adverse effects. Laser-assisted drug delivery with low-density 1927-nm thulium or diode lasers has been shown to reduce the number of treatments required for significant clearance of melasma as compared with other modalities. Microfocused ultrasound has been shown to safely treat skin laxity in skin of color. LIMITATIONS: There is a paucity of studies which include patients with skin type VI, limiting our overall understanding of the safety of these treatments in skin of color. CONCLUSION: There are numerous available studies demonstrating safety and efficacy of energy-based devices for the treatment of facial skin conditions in skin types III-VI, but the significant variation among their designs, methods of assessment, and study populations highlights the need for larger meta-analyses to further interpret their results. [ABSTRACT FROM AUTHOR]

To explore the efficacy and safety of fractional micro-needling radiofrequency (FMRF) in the treatment of enlarged pores on the cheek in a Chinese cohort. Patients with enlarged facial pores who underwent FMRF between January 2020 and December 2022 were included in this study. Blinded clinical assessments were performed by two independent dermatologists using a six-grade photographic enlarged pore scale and a quartile grading scale. Patients were asked to rate the degree of pain related to treatment on a visual analog scale (VAS), with scores ranging from 0 (no pain) to 10 (worst pain ever). A paired t-test was used to analyze the six-grade photographic enlarged pore scores. A total of 22 patients received three consecutive sessions of FMRF treatment, with intervals of 1–3 months, and underwent follow-up as scheduled. The mean six-grade photographic enlarged score was 3.55 ± 0.96 at baseline, while the score decreased significantly to 2.59 ± 0.59 after three treatment sessions (P < 0.05). The improvement score of the patients, assessed by two independent dermatologists, was 2.31 ± 0.71, according to the quartile grading scale. The mean VAS score was 6.42 ± 1.44. FMRF is effective and safe for the treatment of enlarged facial pores after three sessions. [ABSTRACT FROM AUTHOR]

Background: Lumbosacral radicular syndrome (LRS) is probably the most frequent neuropathic pain syndrome, exaggerating medical and economy burden on developing countries, such as Vietnam. As a result, the urgence to find an approach which is both affordable and effective always puts great demand on medical researchers. Objectives: Evaluate the effectiveness of transforaminal pulsed radiofrequency (PRF) stimulation on the dorsal root ganglion (DRG) and epidural steroid injection (ESI) in management of chronic lumbosacral radiculopathy. Methods: Seventy-six patients with chronic radicular pain were performed transforaminal PRF + ESI by neurosurgeons. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-month, 3-month, 6-month and 12-month follow-up. Primary outcome was measured by using Visual Analogue Scale (VAS), Oswestry disability index (ODI) and Straight Leg Raising Test (SLRT). Secondary outcome was subjectively collected based on short assessment of patients' satisfaction (SAPS). Results: Patients who received transforaminal PRF and ESI showed significant improvements on all three evaluation tools (VAS, ODI, SLRT), compared to that before treatment (p<0.001). Pain relief was achievable and long-lasting, which met patients' expectation. No significant complications were observed for 12 months follow-up. Conclusion: Transforaminal PRF combined with ESI in management of lumbosacral radiculopathy should be a good method of choice for its effectiveness and safety in management of pain. [ABSTRACT FROM AUTHOR]

A randomized controlled study was conducted to evaluate the safety and efficacy of radiofrequency treatment in postmenopausal women not willing to use or presenting a contraindication for menopause hormone therapy (MHT) and suffering from genitourinary syndrome of menopause (GSM). A prospective randomized open study evaluated the effect of radiofrequency treatment versus a gel (control group) in postmenopausal women suffering from GSM. Patients were assessed at baseline and after 10–12 weeks of treatment for severity of vulvovaginal atrophy, dyspareunia, pH, vaginal smear maturation index, Vaginal Health Index and Female Sexual Function Index. The difference at baseline and after 10–12 weeks of treatment and the difference in improvement were tested between groups by a two-sample t-test and the Mann–Whitney test. Due to the COVID-19 pandemic, we were only able to treat 48 patients (24 patients using radiofrequency and 24 patients using a gel). Globally, at the end of the study, there were no differences in changes of the measured outcomes between the group of women treated with radiofrequency and the control group. Radiofrequency treatment was found to be safe, but was not superior to a gel, although the study lacked power. The study was registered at ClinicalTrials.gov (NCT03857893). [ABSTRACT FROM AUTHOR]

This article discusses the efficacy of high-voltage, long-duration pulsed radiofrequency (PRF) for the treatment of acute herpes zoster-related trigeminal neuralgia in a patient with a permanent pacemaker. The study focuses on the use of PRF as a neuroregulatory approach for managing herpes zoster neuralgia and postherpetic neuralgia. The authors present a case study of an 83-year-old female patient with intractable trigeminal neuralgia who underwent high-voltage, long-duration PRF treatment, which resulted in immediate pain relief and sustained pain reduction for six months. The article emphasizes the need for comprehensive preoperative evaluation and careful surgical planning when considering this treatment option for patients with permanent pacemakers. Further research is needed to establish the safety and efficacy of this treatment on a larger scale. [Extracted from the article]

The use of functional neurosurgical implants has increased over the past 10 years. PlasmaBlade is an innovative electrosurgical appliance harnessing pulsed radiofrequency (RF) energy. Our aim was to assess the risk of damage to neuromodulation hardware during PlasmaBlade dissection. A simulated setting with chicken breast threaded with different hardware and PlasmaBlade used in three configurations.. Post dissection, the wires were inspected naked eye and under an operating microscope. The induced current was assessed contemporaneously using an oscilloscope. Five surgeons tested the PlasmaBlade at different generator settings. Sixty dissections were undertaken. No structural damage or induced current was identified at CUT 3/4, COAG 5. At CUT 6, COAG 5 and during dissection in a perpendicular orientation with prolonged hardware contact, opacification of insulation material occurred in 15/20 dissections. There was no dissolution of insulation even at this setting. On deviation from Medtronic advice, hardware damaged occurred if one was reckless with the PlasmaBlade. When using the recommended settings and operational technique, PlasmaBlade dissection did not cause any damage to implant wiring/tubing in this simulated setting. This report seeks to add to clinical data suggesting PlasmaBlade is safe for dissection around deep brain stimulator (DBS), vagal nerve stimulator (VNS), and spinal cord stimulator (SCS) hardware. [ABSTRACT FROM AUTHOR]

Purpose: With the growing demand for more effective fat reduction techniques, a combination of synchronized radiofrequency (RF) and HIFEM has been introduced. Preceding studies evidenced the ability of RF+HIFEM to maintain the fat tissue temperature at the levels necessary for adipocyte apoptosis while documenting the induced changes to the fat tissue during the several weeks after the treatment. This study aims to demonstrate the induction of apoptosis by RF+HIFEM technology in the early stages through the assessment of caspase‐3 protein, one of the apoptosis‐executing proteases. Design: In this two‐arm, single‐center, randomized trial, nine human subjects were enrolled and assigned into two groups, either the active group (N = 6) treated with both RF+HIFEM set at the highest tolerated levels or the sham group (N = 3) treated with 5% of the maximum RF+HIFEM power, serving as a control. All patients were scheduled to undergo one treatment visit of the abdominal area, two follow‐up visits at 8 and 24 h, and one safety visit 7 days after the treatment. A punch biopsy (5 mm in diameter, approximately 10 mm in depth) was obtained from the abdominal area at the baseline and consecutive follow‐up visits. Samples were fixed, and cut into 5 μm thick slices, and immunohistochemical staining was used to visualize the Caspase‐3, revealing the adipocyte nuclei where apoptosis processes are in progress. Findings: Documented findings suggest that the temperature threshold of 43–45°C is required to initiate fat apoptosis and consequent reduction in adipocyte number was achieved during the combined treatment with RF+HIFEM. The active group showed an elevated ratio of positively stained nuclei versus all adipocyte nuclei found on the evaluated slices—referred to as the apoptotic index (AI). The AI significantly (p < 0.001) increased at both 8 h (47.01 ± 10.56%) and 24 h (43.58 ± 6.35%) posttreatment. The Sham group showed no significant change in the AI (p > 0.05). No adverse events or side effects related to the treatments were observed. Summary: This study supports previously published evidence on fat reduction after RF+HIFEM treatment, documenting the safe initiation of adipocyte programmed cell death posttreatment. [ABSTRACT FROM AUTHOR]

Background: Wrinkle formation is the most visible characteristic of facial aging. Radiofrequency (RF) technology is currently utilized to reduce facial wrinkles and contribute to skin rejuvenation. Objective: To analyze the efficacy and safety of a noninvasive, home‐based RF device applied for facial rejuvenation in Chinese people. Methods: A single‐center, open‐label, intraindividual controlled trial was performed on subjects who received an 8‐week treatment of the RF device. A total of 22 female individuals aged 25–60 years with Fitzpatrick skin type III–IV were enrolled. Efficacy of treatment was subjectively evaluated using the Fitzpatrick Wrinkle Classification Scale (FWCS) assessed by physician or overall satisfaction of subject with a 10‐point VAS, and objectively using the skin ultrasound examination as well as the 3D skin analysis system. Adverse event was recorded at each visit. Results: In comparison with the baseline, evaluator‐assessed FWCS scores showed significant improvement at 4 weeks (p < 0.005) and 8 weeks (p < 0.005) after treatment. All subjects reported different degrees of improvement in facial wrinkles after 8 weeks of treatment. The results of skin ultrasound examination revealed significant increase of the dermal thickness at week 8 (p < 0.05) as compared to the baseline. In addition, a significant decrease in the proportion and density of perioral wrinkles evaluated by the 3D skin analysis system was observed from baseline to week 4. The treatment was well‐tolerated, and no serious adverse event was observed. Conclusion: This noninvasive, home‐based RF device was effective in improving skin texture and elasticity with a safe and well‐tolerated treating procedure. [ABSTRACT FROM AUTHOR]

Background: Thermage is a monopolar radiofrequency (RF). It has become an indispensable part of facial and body youthful methods. Although the current device is constantly improving in epidermal cooling techniques and even automatically measures the local impedance value, applying surface anesthesia can take some of the pain away caused by thermage, and the patient's severe pain in the jaw and neck areas is still difficult to resolve. Methods: The author describes how he uses the combination of the buccal nerve block (BNB) and the superficial cervical plexus block (SCPB) to improve the comfort of the patient's face and neck treatment of patients. It can improve the quality, elasticity, and texture of the skin. Results: According to the author's knowledge of oral and maxillofacial surgery, the combination of BNB and SCPB is applied to the neck and facial analgesia. Combining the BNB and SCPB effectively provides facial and neck anesthesia. The BNB in this technique provides pain relief to the facial skin in the mandibular area and SCPB offers pain relief to the skin of the neck. RF facial rejuvenation treatment often involves the junction of the face and neck to improve the contour of the mandibular margin. Therefore, Whether the RF treatment is aimed at the face or neck, or the treatment is performed simultaneously, we advocate the block both of the buccal nerve and the superficial cervical plexus nerves to achieve perfect analgesia. Still, the dosage of anesthetic medication for the nerve block can be adjusted according to the treatment area. Conclusion: We applied these two nerve blocks and their combination to improve skin laxity with RF therapy for the first time. [ABSTRACT FROM AUTHOR]

Introduction: We investigated the safety and efficacy of percutaneous facial nerve pulsed radiofrequency combined with drug injection for treatment of intractable facial paralysis of herpes zoster. The authors provide a detailed description of percutaneous facial nerve pulsed radiofrequency combined with steroid injection for treatment of intractable facial paralysis after herpes zoster, and they examine its clinical efficacy. This is the first time in the literature to our knowledge that this procedure has been applied in facial paralysis after herpes zoster. Methods: A total of 43 patients with a history of facial paralysis after herpes zoster for > 1 month were enrolled in this retrospective study. The patients were subjected to percutaneous stylomastoid foramen pulsed radiofrequency of the facial nerve under computed tomography (CT) guidance combined with drug injection. The House-Brackmann grades and NRS (Numerical Rating Scale) data collection were performed at different time points (preoperatively, 1 day post-procedure, and 2, 4, and 12 weeks postoperatively). The occurrence of complications was also assessed. Results: The 43 participants successfully completed the CT-guided percutaneous stylomastoid foramen pulsed radiofrequency of the facial nerve combined with drug injection. Both approaches [posterior approach of the ear (7 cases) and anterior approach of the ear (36 cases)] were efficacious and safe. The House-Brackmann grades (I, II, III, IV, V, VI) were 4 (3–4), 2 (2–3), 1 (1–2), and 1 (0–2) at different operation times (T0, T1, T2, T3, T4); patients felt significant recovery at T1 after operation and had gradually recovered at each time point but had no significant recovery after T3. The NRS scores at different operation times were 2.690 ± 2.213, 0.700 ± 0.939, 0.580 ± 1.006, 0.440 ± 0.908, and 0.260 ± 0.759, respectively. Differences in NRS scores between T0 and T1/2/3/4 were significant while differences between T1 and T2/3/4 were not significant. Six patients developed mild numbness, nine patients exhibited muscle tension, while one patient exhibited facial stiffness. During surgery, there was no intravascular injection of drugs, no nerve injury was reported, and there was no local anesthetic poisoning or spinal anesthesia. Conclusions: Percutaneous stylomastoid foramen pulsed radiofrequency combined with drug injection of the facial nerve for treatment of intractable facial paralysis after herpes zoster is a minimally invasive technique with high rates of success, safety, and effective outcomes. It is a potential therapeutic option for cases of facial paralysis of herpes zoster with a > 1 month history even for those with severe facial paralysis and whose treatment has failed after oral medication and physiotherapy. [ABSTRACT FROM AUTHOR]

Radiofrequency thermocoagulation (RFTC) of the peripheral branches of the trigeminal nerve has been used for trigeminal neuralgia. However, the long-term outcomes of radiofrequency thermocoagulation have not been established. To evaluate the long-term efficacy of RFTC of peripheral branches in patients with refractory trigeminal neuralgia. A retrospective cohort study was conducted in a comprehensive medical center in China. Patients who underwent radiofrequency thermocoagulation of peripheral branches for refractory trigeminal neuralgia from May 2014 to March 2021 were included for analysis. A total of 84 patients with refractory trigeminal neuralgia underwent 105 procedures. BNI I–II which represents treatment success was achieved in 76/84 (90%) patients and 93/105 (89%) procedures. During follow-up, BNI I and II were maintained in 64/76 (84%), 40/73 (55%), 20/67 (30%), 17/65 (26%), 12/61 (20%), and 8/58 (14%) of patients at 1, 2, 3, 4, 5, and 6 years, after the first procedure, respectively. For all the 105 procedures, BNI I and II were maintained in 68/93 (73%), 41/89(46%), 22/82(27%), 15/79 (19%), 8/74 (11%), and 3/72 (4%) at 1, 2, 3, 4, 5, and 6 years, respectively. There is no significant difference between the first and repeat thermocoagulation in terms of immediate (90% vs. 81%, P=0.140) and long-term efficacies (24 months vs.18 months, P=0.266). Radiofrequency thermocoagulation resulted in better long-term outcomes in patients with typical purely paroxysmal pain (24 months vs. 11 months, P=0.033). Radiofrequency ablation of the peripheral branches of the trigeminal nerve might be a safe and effective method in the treatment of refractory trigeminal neuralgia. [ABSTRACT FROM AUTHOR]

Pulmonary vein isolation (PVI), as the cornerstone of atrial fibrillation (AF) ablation, has emerged a widely used therapy for patients suffering from AF. To improve PVI efficiency, single-shot catheters (SSCs) have been developed. Regrettably, SSCs are not integrated into 3D-mapping technology. In that regard, a novel radiofrequency balloon catheter (RFBC, Heliostar, Biosense Webster) with full integration into 3D-mapping technology has been developed. The aim of this study was to assess operative and follow-up outcomes of the RFBC in AF patients. In this monocentric prospective registry, patients with a first-time PVI using the RFBC were included. Follow-up visits were scheduled 3, 6, 12 and 24 months after ablation and in case of symptoms. A total of 171 patients (36.8% female) were included, with a mean age of 68.5 ± 10.2 years. Among them, 63 patients (36.8%) presented with persistent AF. Notably, no major periprocedural complications were observed. The mean follow-up period was 287 ± 157 days. In the Kaplan–Meier analysis, the estimated recurrence-free survival after 12 months was 81.8%. Based on our data, PVI with the fully 3D-mapping-integrated RFBC seems to be safe and effective and to have a favorable 12-month outcome in patients with paroxysmal and persistent AF. [ABSTRACT FROM AUTHOR]

BACKGROUND Acne scarring is an unfortunate sequela affecting up to 95% of patients with acne and carries profound psychosocial impact. Both nonablative fractional lasers (NAFL) and microneedling with radiofrequency (MNRF) have demonstrated comparable efficacy in the treatment of atrophic acne scars. OBJECTIVE To determine whether alternating NAFL and MNRF is superior to NAFL alone in the treatment of atrophic acne scars. METHODS AND MATERIALS This was a prospective, single-center, double-blinded, split-face clinical trial. Twenty patients with atrophic acne scars who had their facial halves randomized to receive either NAFL alone or NAFL alternating with MNRF. Patients received 4 total treatments at 4-week intervals. RESULTS Ninety days after the final treatment, both facial halves demonstrated a significant improvement in the mean global échelle d'évaluation clinique des cicatrices d'acné (ECCA) score from baseline (p < .001 for both halves). The average percentage improvement at the final end point was 20% to 30% from baseline. No significant difference was noted between facial halves for mean global ECCA score or percentage improvement at any time point. CONCLUSION Although both NAFL and MNRF are safe and effective in the treatment of atrophic acne scars, alternating NAFL and MNRF does not seem to be superior to NAFL alone. [ABSTRACT FROM AUTHOR]

Background. Zoster-associated pain (ZAP) is often refractory to conventional treatments and can seriously affect patients' physical and mental health. High-voltage pulsed radio frequency (H-PRF) is a new method for treating ZAP with pulse voltages above 60 V or even up to 100 V. The purpose of this paper was to conduct a systematic review and meta-analysis to evaluate the efficacy of H-PRF in the management of ZAP. Methods. PubMed, Embase, and the Cochrane library were searched from their inception to June 2022 to identify controlled trials which evaluated the effectiveness of H-PRF compared with standard PRF and sham operations. The primary outcome was pain scores at different treatment times. The secondary outcomes included SF-36 scores, rescue analgesic dose, and side effects. Results. We reviewed 6 randomized controlled trials involving 428 patients. There was no significant difference between the H-PRF and standard PRF pain scores at 1 week after surgery and the sham operation group at 1 month. At 1, 3, and 6 months, the H-PRF group had better pain score than the standard PRF group, and at 3 months, the pain score was better than the sham operation group. The H-PRF group showed improvement in the SF-36 score, and there were no significant complications in the H-PRF group. Conclusions. H-PRF is an effective and safe treatment method that has better effects in relieving pain and improving the quality of life and physical and mental health. Although H-PRF provides pain relief rates comparable to those of the control group in the early stages, it remains the preferred and alternative treatment for relieving herpes zoster-related pain. [ABSTRACT FROM AUTHOR]

The very high-power short-duration (vHP-SD) ablation strategy is an alternative for pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). However, the acute procedural biophysical behavior of successful lesion creation by means of this technique is still unexplored. We performed a retrospective case–control study aimed at evaluating the behavior of vHP-SD ablation parameters with the QDOT MICRO™ ablation catheter (Biosense Webster) compared with standard radiofrequency (RF) ablation with the THERMOCOOL SMARTTOUCH® ablation catheter. Twenty consecutive cases of symptomatic PAF treated with the QDOT MICRO™ ablation catheter from December 2022 to March 2023 were compared with cases treated with the standard technique. The acute procedural success of PVI was obtained in all cases with 2192 RF applications, and no adverse events occurred. Compared with the controls, vHP-SD cases featured a significant reduction in procedural time (47 ± 10 vs. 56 ± 12 min, p = 0.023), total RF time (3.8 [CI 3.4–4.6] vs. 21.2 [CI 18.4–24.9] min, p < 0.001), ablation phase time (25 ± 5 vs. 39 ± 9 min, p < 0.001), and irrigation volume (165 [CI 139–185] vs. 404 [CI 336–472] ml, p < 0.001). In vHP-SD RF ablation, a contact force of 5 g minimum throughout the 4 s of RF application appeared to be statistically significant in terms of an impedance drop of at least 10 Ohm (OR 2.63 [CI 1.37; 5.07], p = 0.003). In contrast, in the control group, the impedance drop depended linearly on the contact force. This suggests a different biophysical behavior of vHP-SD ablation. A maximum temperature and minimum contact force of >5 g independently predicted an effective impedance drop in vHP-SD. Increasing the contact force over 5 g during 4 s of vHP RF application might not be necessary to achieve a successful lesion. [ABSTRACT FROM AUTHOR]

Objective: With more than 1.5 million performed procedures, liposuction was the second most performed esthetic surgical procedure all over the world in males and in females in the year 2020. The objective of this open‐label, evaluator‐blinded study was to assess the efficacy and safety of an energy‐based device that combines multipolar radiofrequency with pulsed electromagnetic field (PEMF) in patients that underwent liposuction. Materials and Methods: A total of 30 subjects, of whom 24 were females (80%), with a mean age of 48.4 ± 11.0 years (range: 27–69 years) and a mean weight of 69.5 ± 11.7 kg underwent unilateral treatment with radiofrequency and application of PEMF after bilateral liposuction. One month after the last of a total of six weekly treatments, skin elasticity, visco‐elasticity and net elasticity, as well as subject reported satisfaction on a 5‐point scale ranging from −1 (worse) to 3 (very much improved) and esthetic improvement ranging from 0 (very unsatisfied) to 4 (very satisfied) rated by three independent reviewers were assessed. Results: Three independent and blinded reviewers rated the improvement of the treated side on average as 1.17 + 0.07 compared with baseline. Subjects were very satisfied with their treatment, with a mean score of 3.24 (0.03) out of 4 at the 1‐month follow‐up visit. Cutometer measurements showed no significant changes. Conclusion: This study revealed that the subjective satisfaction with the results of the application of RF and PEMF after liposuction is high, while at the same time the esthetic appearance as rated by independent raters improved on the treated side. [ABSTRACT FROM AUTHOR]

Ultrasonography is a well-tolerated procedure that aids in the targeted esthetic therapies of special cutaneous regions, as well as in the prevention (vascular mapping, identification of previous filler, and others) and management of potential complications (vascular occlusion, external vascular compression, product misplacement or migration, inflammatory reactions, and others). It has lately been promoted as the first-line imaging tool to address injectables. In this article, we aim to review the evolving role of ultrasonography in cosmetic filler procedures, from the fundamental ultrasound characterization of cosmetic fillers to the ultrasound-enhanced detection and management of cosmetic filler complications, including ultrasound's role in hyaluronidase-guided injections for cosmetic filler dissolution. Furthermore, the paper explores the integral role played by ultrasound in enhancing the precision, efficacy, and safety of additional minimally invasive aesthetic techniques such as mesotherapy, radiofrequency, cryolipolysis, and polydioxanone procedures. [ABSTRACT FROM AUTHOR]

A 59-year-old woman with prior bilateral lower eyelid autologous fat transfer, subdermal micro-needling and fractional radiofrequency skin resurfacing presented with delayed left-sided preseptal cellulitis with small multinodular abscesses unresponsive to oral outpatient antibiotic regimens and inpatient intravenous antibiotics. Wound culture revealed Mycobacterium chelonae infection treated successfully with a 4-month regimen of clarithromycin and tedizolid without recurrence. This case highlights (1) the need for vigilance and a broad differential in delayed post-operative wound infections including non-tuberculous mycobacterial infections, (2) resolution of infection without recurrence on clarithromycin and novel tedizolid oral antibiotic therapy, and (3) that caution should be exercised when performing combination autologous fat transfers with subdermal micro-needling procedures as the breakdown in skin integrity may potentiate infection. [ABSTRACT FROM AUTHOR]

Monopolar radiofrequency (RF) non-invasively tightens and rejuvenates the skin by stimulating collagen fiber production. Since the introduction of the monopolar RF device in the early 2000's, RF devices have advanced and they can rejuvenate of periorbital and forehead wrinkles, as well as skin laxity of the lower face and neck. We compared the differences in the treatment effects based on the tip size. This randomized split-face study comprised 31 participants aged 29 to 75 years old (three males and 28 females) who underwent one session of monopolar RF; one side of the face was treated with a 3cm2 tip and the other with a 4cm2 tip. Facial wrinkle scores were measured on the upper face and the lower face before and after treatment for up to three months. Significant improvement was observed in the periorbital area (p<0.001), forehead (p=0.72), and glabellar (p=0.63) treated with a smaller tip. However, nasolabial folds (p=0.8) and marionette lines (p=0.13) showed better improvement when treated with a larger tip. [ABSTRACT FROM AUTHOR]

Radiofrequency (RF) catheter ablation is an effective treatment option for targeting the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT). Previous data suggested that using intracardiac echocardiography (ICE) guidance could improve procedural outcomes when compared to using fluoroscopy alone. In this prospective study, we aimed to compare the effectiveness of an electroanatomical mapping system (EAMS)-guided approach with an ICE-guided approach for SP ablation. Eighty patients undergoing SP ablation for AVNRT were randomly assigned to either the ICE-guided or EAMS-guided group. If the procedural endpoint was not achieved after 8 RF applications; patients were allowed to crossover to the ICE-guided group. The ICE-guided approach reduced the total procedure time (61.0 (56.0; 66.8) min vs. 71.5 (61.0; 80.8) min, p < 0.01). However, the total fluoroscopy time was shorter (0 (0–0) s vs. 83.5 (58.5–133.25) s, p < 0.001) and the radiation dose was lower (0 (0–0) mGy vs. 3.3 (2.0–4.7) mGy, p < 0.001) with EAMS-guidance. The ICE-guided group had a lower number of RF applications (4 (3–5) vs. 5 (3.0–7.8), p = 0.03) and total ablation time (98.5 (66.8–186) s vs. 136.5 (100.5–215.8) s, p = 0.02). Nine out of 40 patients (22.5%) in the EAMS-guided group crossed over to the ICE-guided group, and they were successfully treated with similar RF applications in terms of number, time, and energy compared to the ICE-guided group. There were no recurrences during the follow-up period. In conclusion, the utilization of ICE guidance during SP ablation has demonstrated notable reductions in procedural time and RF delivery when compared to procedures guided by EAMS. In challenging cases, an early switch to ICE-guided ablation may be the optimal choice for achieving successful treatment. [ABSTRACT FROM AUTHOR]

Background: Visceral adipose tissue (VAT), present in the abdominal cavity, oftentimes contributes to an unpleasant aesthetic appearance and can be correlated with serious health issues. High‐intensity focused electromagnetic field (HIFEM) technology with synchronized radiofrequency (RF) was recently used for abdominal body shaping through subcutaneous fat reduction and muscle growth. Aim: This study aimed to assess the effect of HIFEM + RF technology on VAT tissue. Methods: Data of 16 men and 24 women (22–62 years, 21.2–34.3 kg/cm2) from the original study were retrospectively reviewed. All subjects received three 30‐min HIFEM + RF abdominal treatments once weekly for three consecutive weeks. The VAT area was measured in the axial plane of MRI scans at two levels: L4–L5 vertebrae and 5 cm above this level. The VAT was identified, segmented, and calculated, yielding total area in square centimeters per scan at both specified levels. Results: By thoughtful review of the subject's post‐treatment MRI scans, no other changes in the abdominal cavity were found except for VAT. The evaluation showed a VAT reduction of 17.8% (p < 0.001) on average at 3‐month follow‐up, maintaining the results up to 6 months (−17.3%). Averaging the values obtained from both measured levels, the VAT, occupied an area of 100.2 ± 73.3 cm2 at the baseline. At the 3‐month follow‐up, the subjects achieved an average reduction of 17.9 cm2, preserving the results at 6 months (−17.6 ± 17.3 cm). Conclusion: This retrospective analysis of MRI images objectively documented the effect of HIFEM + RF abdominal therapy on VAT. The data indicates considerable VAT reduction without serious adverse events following the HIFEM + RF procedure. [ABSTRACT FROM AUTHOR]

Dorsal root entry zone (DREZ) lesioning may be used to treat neuropathic pain in patients with traumatic brachial plexus injuries. The clinical outcome after surgery is variable in the medical literature. We aimed to report the surgical outcome after DREZ lesioning by radiofrequency and to analyze prognostic factors such as the presence of a spinal cord injury identified before surgery. We conducted a retrospective study that included 57 patients who had experienced traumatic brachial plexus injuries and exhibited neuropathic pain that did not respond to conservative treatment methods. They were submitted to DREZ lesioning. We defined the inclusion and exclusion criteria, collected sociodemographic and clinical characteristics, and identified and classified spinal cord lesions based on magnetic resonance imaging. We applied statistical tests to evaluate the association between pain intensity after surgery and the radiological profile and sociodemographic characteristics. Immediately after surgery, the pain outcome was considered good or excellent in 50 patients (89.28%). At the last follow-up, it was good or excellent in 39 patients (68.43%). There was no association (P > 0.05) between the pain outcome and the variables analyzed (time interval between trauma and DREZ lesioning, presence of spinal cord injury, age, the number of avulsed roots, and the type of pain). DREZ lesioning using radiofrequency represents a significant therapeutic approach for managing neuropathic pain after a traumatic brachial plexus injury. Importantly, we found that the presence of a spinal cord injury is not associated with the surgical outcome. [ABSTRACT FROM AUTHOR]

BACKGROUND Lasers and devices are used to enhance transcutaneous delivery of fillers. However, little has been published on the histologic findings of this form of laser/device-assisted delivery to determine the optimal devices and fillers. OBJECTIVE To objectively evaluate the histological effects of laser-assisted and device-assisted filler delivery. METHODS Ex vivo human abdominoplasty skin samples were treated with fractional CO2 laser (ECO2, 120 µm tip, 120 mJ), fractional radiofrequency microneedling (FRMN, Genius, 1.5 mm, 20 mJ/pin), and microneedling (2.0 mm). Immediately after poly-L-lactic acid (PLLA), hyaluronic acid gel, calcium hydroxylapatite, and black tissue marking dye were topically applied. After treatment, biopsies were collected for histologic evaluation. RESULTS Histology revealed that PLLA and black dye were found in greatest abundance, hyaluronic acid was found to a lesser extent, and calcium hydroxylapatite was least found within channels created by fractional CO2 laser. Microneedling was effective only at delivering black dye, whereas FRMN failed to show significant channel formation or delivery of the studied products. CONCLUSION Among the devices and fillers studied, fractional CO2 laser and PLLA proved to be the most effective combination for laser/device-assisted filler delivery. Neither microneedling nor FRMN was effective as devices to enhance filler delivery. [ABSTRACT FROM AUTHOR]

Trigeminal neuralgia has an incidence of 4-13 per 100000 people per year. The incidence of this disease increases in the elderly, and it is known to cause severe shock-like pain. Pharmacological therapy is the first-line treatment of trigeminal neuralgia. If pharmacological therapy fails, then different procedures are available. Pulse-dose radiofrequency is one such procedure. In this study, we evaluated Pulse dose radiofrequency's efficacy as a method in which pulse amplitude and width are considered essential variables. This research was conducted as a cross-sectional study on trigeminal neuralgia patients referred to the pain clinic of Amir A’lam Hospital in 2020. Conservative therapy has failed; therefore, the clinician decided to use pulse dose radiofrequency to reduce their pain. Among the 29 patients registered during this period, 15 (51.8%) were women and 14 (48.3%) were men. The mean (±SD) age of the patient was 57.07(±14.26) years. The tow route was interrupted in 7 (24.1%) patients. A significant difference was observed between the pain scores before and after the operation (P<0.001). Pulse-dose radiofrequency is a safe and effective therapy for treating trigeminal neuralgia and can be considered a new way to develop the pulse radiofrequency method. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of gabapentin combined with pulse radiofrequency and nerve block in the treatment of postherpetic neuralgia. Methods: In this study, 106 patients diagnosed with postherpetic neuralgia were selected and divided into control group A (36 cases), experimental group B (35 cases) and experimental group C (35 cases) by random number table. Group A was treated with oral gabapentin, group B was treated with gabapentin combined with nerve block, and group C was treated with gabapentin combined with pulsed radio frequency therapy. The therapeutic effects of the three groups were observed and compared, and visual alogue scale (VAS), self-rating scale of sleep (SRSS), numeric rating scale (NRS) and adverse reactions were statistically analyzed. Results: After 3 days, 7 days, 14 days and 1 month, compared with control group A, VAS, SRSS and NRS scores in groups B and C were significantly decreased (P<0.05). The incidence of adverse reactions in test group B and C was 8.57% (3/35) and 5.71% (2/35), respectively, and that in control group A was 22.22% (8/36). The incidence of adverse reactions in test group was significantly lower than that in control group, and the difference was statistically significant(P<0.05). Conclusion: Compared with gabapentin and gabapentin combined with nerve block, gabapentin combined with RF pulse and nerve block in the treatment of postherpetic neuralgia can effectively relieve pain and improve sleep status in the short term. [ABSTRACT FROM AUTHOR]

Background: Periorbital hyperpigmentation (POH) is a common disorder in the patients. Women are more upset with POH in compare to males. Several methods have been used to the POH, with different efficacy and adverse reactions. Aim: The aim of the present study is to evaluate the efficacy of microneedle fractional radiofrequency (MRF) in treating POH. Methods: So, nine patients with POH and the age range of 25–57 years, were treated by microneedle fractional radiofrequency (MRF). The outcome was evaluated via biometric assessment. The colorimeter was used to assess the skin lightness. Mexameter was used for evaluated the amount of Melanin in the periorbital skin. Cutometer was used for skin elasticity assessment. The skin ultrasound imaging system was utilized to estimate the epidermis and dermis diameter and density. Furthermore, Visioface was applied to assessed the skin color and wrinkles. Also patient's satisfaction and physician's assessment were evaluated. Results: The results displayed that the periorbital skin lightness 32.38% ± 5.67 and elasticity of the R2: 40.29% ± 8.18, R5: 39.03 ± 5.38 and R7: 42.03% ± 14.16 were significantly improved after treatment (p < 0.05). Also the melanin content of the skin was decreased (49.41% ± 9.12). The skin layers were denser in the dermis and also in the epidermis (skin density: 30.21% ± 10.16 and skin thickness: 41.12% ± 13.21) (p < 0.05). The results revealed the decrease in the percent change of the skin color (30.34% ± 9.30) and wrinkle (area: 25.84% ± 6.43 and volume: 30.66% ± 8.12) (p < 0.05). Similarly, the physician and patient's assessment were confirmed the obtained outcomes. Conclusion: In conclusion, the microneedle RF technique is practicable, effective and safe method for periorbital dark circles treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND High-intensity focused electromagnetic field (HIFEM) and synchronized radiofrequency (RF) technologies have been shown to be safe and effective on multiple body parts OBJECTIVE To determine the plasma lipid levels and liver function tests of consecutive HIFEM + RF procedures delivered on the same day. METHODS Eight women and 2 men (24-59 years, BMI 22.4-30.6 kg/m²) underwent 4 30-minute consecutive HIFEM + RF procedures. The treated area differed according to gender (females: abdomen and lateral and inner thighs; males: abdomen and front and back thighs). Liver function (aspartate aminotransferase [AST], alanine aminotransferase [ALT], gamma-glutamyltransferase [GGT], alkaline phosphatase [ALP]) and lipid profile (cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG]) was monitored from blood samples drawn before the treatment, 1 hour, 24 to 48 hours, and 1 month after treatment. The subject's satisfaction, comfort, abdominal circumference, and digital photographs were also monitored. RESULTS All 10 patients completed planned treatments and follow-up blood draws. No significant fluctuation or notable deviation in the measured blood parameters was observed. The average values during the study were in a range of AST 15.7 to 16.7IU/L, ALT 11.9 to 13.4IU/L, GGT 11.6 to 13.8IU/L, and ALP 71.4 to 77.2IU/L, TG 1.0 mmol/L, HDL 1.7 mmol/L, LDL 3.0 mmol/L, and cholesterol 5.0 to 5.1 mmol/L corresponded to the normal ranges. Subjects reported high comfort during the treatment and satisfaction with their results. No adverse event occurred. CONCLUSION Plasma levels remained stable and normal or lipids and LFTs for multiple same-day treatments of RF plus HIFEM. [ABSTRACT FROM AUTHOR]

Facial erythema is a representative symptom of rosacea patients that greatly impairs quality of life. Recently, the therapeutic effects of intradermal injection of botulinum toxin type-A on erythema have been investigated. Fractional microneedling radiofrequency has been reported to be effective in dermal remodeling and anti-inflammation. To obtain enhanced therapeutic effects with a less painful and easier approach, a treatment regimen using transdermal botulinum toxin delivery with fractional microneedling radiofrequency was developed. We aimed at investigating the efficacy and safety of transdermal botulinum toxin delivery with fractional microneedling radiofrequency in treating the erythema of rosacea. This was a retrospective review of 20 patients with facial erythema associated with rosacea. All patients underwent two sessions of treatment at 4-week intervals. Standardized photographs were taken, and the clinicians' erythema assessment (CEA), erythema index (EI) measured through a spectrophotometer, investigator's global assessment (IGA), and subjective satisfaction and side effects were evaluated at the baseline and 4, 8, and 12 weeks after the baseline. Compared to the baseline, CEA levels significantly decreased after 8 weeks (P = 0.018) and 12 weeks (P = 0.005). As an objective measure, EI was observed to decrease significantly at 4 weeks (P = 0.04) and 8 weeks after the baseline (P = 0.005) compared with the baseline. Ninety-five percent of patients were either very satisfied or satisfied with the treatment. None of the patients experienced remarkable side effects. A novel treatment regimen involving transdermal botulinum toxin delivery and fractional microneedling radiofrequency may be an effective and safe option for reducing the facial erythema of rosacea. [ABSTRACT FROM AUTHOR]

Background/Aims The efficacy and safety of anti-reflux mucosectomy (ARMS) or radiofrequency energy delivery in the treatment of gastroesophageal reflux disease (GERD) have been reported, but the difference between the 2 remains unclear. Methods This was a single center, randomized, comparative clinical study. Patients with symptoms of heartburn and/or regurgitation despite proton pump inhibitor treatment were randomly assigned to either ARMS group (n = 20) or radiofrequency group (n = 20). Primary outcome was the standardized GERD questionnaire (GERDQ) at 2 years after the procedures. Secondary outcomes were the proportions of patients with complete proton pump inhibitor (PPI) cessation and patients satisfied with the treatment. Results A total of 18 patients randomized to ARMS and 16 to radiofrequency were analyzed in this study. The operation success rate of the 2 groups was 100%. In both ARMS and radiofrequency groups, GERDQ scores at 2 years after the procedures were significantly lower than that before operation (P = 0.044 and P = 0.046). At 2 years postoperatively, the scores of GERDQ did not differ between the 2 groups (P = 0.755). There was no significant difference in the rate of discontinuation of PPIs and patient satisfaction in the ARMS and radiofrequency groups (P = 0.642 and P = 0.934). Conclusions The clinical efficacy of ARMS and radiofrequency for the PPI-refractory GERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is promising endoscopic management for the treatment of refractory GERD. [ABSTRACT FROM AUTHOR]

Chronic lumbosacral radicular pain (CLRP) as a possible adverse consequence of lumbar spine surgery represents a serious medical challenge. Pulsed radiofrequency of dorsal root ganglion (PRF–DRG) treatment is known to be effective in alleviating CLRP. This retrospective study compares the efficacy of a single CT-guided PRF–DRG procedure in the treatment of unilateral CLRP between patients without (non-PSS) and with (PSS) previous lumbar spine surgery. Non-PSS and PSS groups included 30 and 20 patients, respectively. Outcomes (pain intensity and disability) were evaluated by means of the visual analog scale (VAS) and Oswestry disability index (ODI) immediately after the procedure (VAS), as well as three and six months after the procedure, respectively. Non-PSS group showed a significant (p ˂ 0.001) decrease of VAS (median) at all follow-up intervals (from 6 to 4; 4; 4.5 points, respectively). The PSS group showed a significant yet transient VAS (median) decrease (from 6 to 5 points) immediately after the procedure only (p < 0.001). The decrease of VAS was more pronounced in the non-PSS group after three and six months (p = 0.0054 and 0.011, respectively) in intergroup comparison. A relative decrease of VAS ≥ 50% during follow-up was achieved in 40%; 43.3%; 26.7% (non-PSS), and 25%; 5%; 0% (PSS) of patients. ODI (median) significantly decreased in the non-PSS group (from 21.5 to 18 points) at three and six months (p = 0.014 and 0.021, respectively). In conclusion, previous lumbar spine surgery decreases the therapeutic efficacy of PRF–DRG procedure in CLRP patients. [ABSTRACT FROM AUTHOR]

Introduction: Stretch marks are common atrophic dermal scars with significant physical and psychological effects. Therefore, there is a need for effective cosmetics and procedures for stretch mark treatment. This study aimed to evaluate the efficacy and safety of a novel treatment for stretch marks that is made up of topical formulations containing beta-glucan combined with nanofractional radiofrequency. Methods: This randomized, blinded control trial enrolled 64 Chinese women aged 20–45 years at > 6 months after delivery with obvious white or silver abdominal stretch marks. Participants were randomly allocated to group A (blank group), group B (topical product group), group C (product combined with nanofractional radiofrequency), and group D (vehicle combined with nanofractional radiofrequency). The stretch mark width, skin elasticity, skin color, skin thickness, and collagen density were noninvasively measured. Two trained assessors evaluated the severity, color, outline, and relaxation of the striae. Results: Group C showed the best treatment efficacy, with no adverse effects observed during the study period. Conclusion: Our findings indicate that stretch mark treatment using topical formulations containing beta-glucan, combined with nanofractional radiofrequency plus magnetic nanofractional radiofrequency, is tolerable and effective. Trial registration: ChiCTR2200056725. [ABSTRACT FROM AUTHOR]

CustomBone® prosthesis is a widely recognized effective and successful technique for the reconstruction of cranial bone defects. Prior the cranioplasty implant, meticulous dissection within thick scar tissue is required. During this delicate surgical manoeuvre is vital to avoid damage to the skin flap itself and to the underlying cerebrovascular structures. We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc). It reduced the incidence of post operativesubgaleal hematoma, the operative times and the intra operative blood loss following cranioplasty compared to the traditional scalpel and scissor dissection. The authors present a one centre case series study to review the indications, safety and efficacy of the PEAK PlasmaBlade™ in adult patientsunderwent cranioplasty. Two surgical techniques for tissue dissection were compared: PEAK PlasmaBlade™ versus scalpel and scissor dissection (SSD). Treatment outcomes following each of these surgical approaches, relative to rate of post-operative subgalealhematoma formation, hospital admission, and operative times were compared. A total of 10 patients that had cranioplasty treatment were evaluated. In patients underwent scalp dissection with the PEAKPlasmaBlade™, we observed a reduction in the operative times, in the subgaleal hematoma formation and then in the hospital stay. PEAK PlasmaBlade™ revealed to be a safe and effective device in tissues dissection for cranioplasty implant. It provided reduction of the rate of subgaleal hematoma formation, operating times and less potential risk to damage cerebrovascular structures. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. BACKGROUND: Recently, it has been reported that a micro-insulated needle radiofrequency (RF) system is effective at achieving subcutaneous fat reduction; however, no study has yet applied this technique to reduce submental fat. OBJECTIVE: To evaluate the efficacy and safety of a fractional RF device with a micro-insulated needle to reduce submental fat. MATERIALS AND METHODS: In this prospective, single-blinded, pre–post comparative study, 24 adults with excess submental fat were treated once using a micro-insulated needle RF device. Outcomes included efficacy (submental fat rating by an independent investigator, fat volume quantified with a 3-dimensional camera, and patient satisfaction), assessed 1 and 2 months after the procedure, and safety (adverse events), assessed throughout the study. RESULTS: The patients' Physician-Assisted Submental Fat Rating Scale score significantly decreased after 1 month and further decreased after 2 months. The average volume of submental fat was significantly decreased after 2 months (20.44 ± 5.53 cc to 16.41 ± 4.58 cc, p <.001). Patient satisfaction was high. Transient and mild local skin reactions without long-term sequelae were observed in 4 patients. CONCLUSION: The micro-insulated needle RF device is beneficial for the reduction of submental fat and has tolerable safety profiles. Trial registration: ClinicalTrials.gov Identifier: NCT05517824. [ABSTRACT FROM AUTHOR]

Background: Hyaluronic acid (HA) filler injections have increased in popularity. They are usually performed in combination with other treatment modalities, including lasers and energy‐based devices, to enhance cosmetic results. Theoretically, HA and other filler injections should be performed after laser‐ or energy‐based device treatments. In some instances, however, practitioners are asked to administer laser‐ or energy‐based device treatment after HA dermal filler injection. There is a concerning possibility of HA filler degradation as a result of bulk heating generated by lasers or energy‐based devices, especially radiofrequency (RF). Aim: To evaluate the effect of RF treatment at different time points on HA degradation in vivo, using clinicohistological analysis. Patients/methods: Fourteen volunteers were recruited and received intradermal HA filler injections in four sites on the abdomen. One site served as the control, and the other three sites were treated with monopolar RF on the same day after injection, at 14 and 28 days post‐injection. Skin biopsies were performed at baseline and 56 days after HA injection. Histopathological sections were reviewed for residual filler in the tissue. Results: The results showed that HA grading scores decreased in five (35.71%), one (7.14%), and one (7.14%) participants when RF was performed immediately, 14 and 28 days after injection, respectively. Conclusion: In conclusion, RF treatment after HA filler injection may affect the integrity of the HA filler in the tissue, especially if RF treatment was performed on the same day after HA injection. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of bipolar radiofrequency therapy in promoting skin contraction in rabbits. Methods From September 2021 to June 2022, 24 New Zealand rabbits were selected to design the abdominal skin radiofrequency treatment area, and take into 12 groups of 2 in different radiofrequency temperature and radiofrequency power arrangements. The skin contraction of the treatment area before and immediately after radiofrequency therapy and 1 month and 3 months after radiofrequency therapy was observed, and the skin contraction range was evaluated by calculating the area of the radiofrequency area. HE staining to assess skin thickness differences; Masson staining to assess changes in collagen content. Results All rabbits in each group experienced different degrees of skin contraction. The temperature was set at 36 t, 38 t and 40 t, after lower power (16~22 W) treatment, significant lateral skin contraction could be seen immediately after surgery, 1 month after surgery and 3 months after surgery compared with preoperative, and there were no complications such as nodules, blister burns and other complications at the treatment site (N0.05) . HE staining showed that the thickness of skin and subcutaneous tissue was significantly reduced immediately after surgery, at 1 month and 3 months after surgery compared with before surgery (N0.05), and there was no significant significance between postoperative time periods (P>0.05). The results of Masson staining showed that after radiofrequency treatment, the skin collagen gap was reduced, the skin contracted, the collagen fibers were restructured, the original arrangement order was broken, the collagen space was compressed, the tissue arrangement was closer than before the operation, and thickened collagen bands and elastic fibers could be seen at the junction between the dermis layer and the subcutaneous layer. Conclusion Bipolar radio frequency has a good function of tightening the skin, and has little tissue damage, quick recovery, safe operation, and the therapeutic effect can last for more than 3 months. [ABSTRACT FROM AUTHOR]

Photobiomodulation therapy (PBMT) can significantly reduce inflammation and relieve pain, including postoperative pain and edema. The study aimed to evaluate the performance of a photobiomodulation-based device that includes a static magnetic field (SMF) to treat laser- or intensive and fractional radiofrequency-related side effects, such as pain, redness, and edema in patients treated for different dermatological conditions. METHODS: The study had a prospective, non-randomized, single-center design. Male and female patients aged 18 years or older underwent one or two PBMT-SMF (anti-inflammatory or anti-edematous) sessions on the same day, once or twice a week, after laser or radiofrequency facial treatments due to various dermatological disorders. Variables and efficacy assessments were pain, redness, edema, and their reduction from baseline to the last visit. RESULTS: Twenty-seven patients were included, seven (25.9%) men and 20 (74.1%) women, with a mean (SD) age of 43.7 (14.1) years. Seven (25.9%) patients were treated with radiofrequency, and 20 (74.1%) patients with a vascular laser (three [15%] for angioma, two [10%] for scars, three [15%] for erythrosis, and 12 [60%] for rosacea). After the PBMT-SMF protocol, overall mean pain reduction was 40 percent, and redness and edema reduction were shown by the pictures taken before and after the PBMT-SMF procedure. LIMITATIONS: The primary limitations were the small number of patients and no quantitative variables for redness and edema. CONCLUSION: PBMT-SMF reduced edema and inflammation after treatment with lasers or intensive or fractional radiofrequency for facial conditions, and probably, analgesic and anti-inflammatory drugs. [ABSTRACT FROM AUTHOR]

Background: Inevitable signs of aging are especially noticeable in middle to elder age when stretch marks, loose skin, cellulite, and body‐contour changes naturally appear. Aims: To verify efficacy of high‐intensity focused electromagnetic field (HIFEM), radiofrequency (RF), and Targeted Pressure Energy (TPE) combination treatment to address unfavorable changes in skin, fat, and muscle tissue. Methods: The device simultaneously emitting monopolar RF and TPE energies was consecutively combined with simultaneous HIFEM+RF procedure in 32 subjects (21–64 years, 17.4–33.5 kg/m2) for treatment of thighs (N = 15; back, inner, or front), buttocks/saddlebags (N = 7), abdomen (N = 8), and upper arms (N = 2). All patients underwent four weekly, combined treatments of 30‐min HIFEM+RF procedure followed by 15–30 min RF+TPE, depending on treatment area. Circumferential measurements, digital photographs, subject satisfaction, and comfort questionnaires were assessed up to 3‐months post‐treatment. Results: Majority of participants found treatments comfortable, no adverse events occurred. Subjects showed substantial improvement in all treated areas from 1‐month follow‐up. Combination of HIFEM+RF, monopolar RF, and TPE resulted in significant circumference decrease. Generally, more pronounced results were seen at 3 months when subjects showed −5.2 cm on abdomen, −3.0 cm on thighs, and −5.5 cm on saddlebags, respectively. Ninety‐four percent of subjects were satisfied with treatment results, most noticed improvement in cellulite, skin laxity, and muscle definition. Conclusions: Results showed high patient satisfaction and efficacy in improving body contour and skin quality. Combining simultaneous HIFEM+RF procedure with simultaneous monopolar RF+TPE treatments considerably enhanced body contour and skin tissue. The procedure proved versatile and may effectively treat multiple body parts. [ABSTRACT FROM AUTHOR]

aims to compare 1-month's efficacy and safety of single-session ethanol ablation and radiofrequency ablation for treating both purely cystic nodules and predominantly cystic thyroid nodules. Materials and methods: This short-term retrospective study was approved by the Ethics Committee of the Institutional Review Board of Danang Family hospital, and written informed consent for procedures was obtained for all patients. Thirty-nine patients who presented with cystic thyroid nodules and met inclusion criteria were extracted from the computerized medical records. The internal fluid of cystic thyroid nodules was aspirated as much as possible. Ethanol ablation was performed using 18-gauge needles with 99.5% ethanol, and RFA used a cooled-electrode RFA system and 18-gauge internally cooled electrodes via the trans-isthmic approach, moving-shot technique. Nodule volume, therapeutic success rate, the largest diameter, thyroid function tests, and complications were evaluated and compared before and after treatment in each group. Results: Among 39 patients, 17 patients were undergone EA (mean age of 47.35 years; the proportion of female of 76.5%; purely thyroid cyst percentage of 41.4%) and 22 patients were undergone RFA (mean age of 46.63 years; the proportion of female of 86.4%; purely thyroid cyst percentage of 54.5%). Both treatment techniques showed a significant reduction of the largest diameter and nodule volume (p< 0.05) without complications. RFA reduced nodule volume and the largest nodule size greater than EA treatment at 1-month post-ablation (p< 0.05). In addition, the therapeutic success rate in the RFA group was higher than in the EA group. Conclusion: Both RFA and EA treatment with single-session confirm the efficacy and safety for cystic thyroid nodules at 1-month follow-up, RFA reduced greater in nodule volume and the largest nodule size than the EA treatment. Thus, the therapeutic success rate in the RFA group was higher than in the EA group. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the clinical performance of the Venclose radiofrequency system for thermal ablation of incompetent great saphenous veins. MATERIALS AND METHODS: Twenty-five patients were enrolled and treated at the Vein Center at Brühl, Leipzig, Germany in a prospective exploratory study. Primary outcome measures were the percentage of limbs with vein occlusion without reflux in the treated vein and the number and type of adverse events through 12 months. RESULTS: Four of 25 patients received bilateral great saphenous vein treatments (29 treated limbs). All patients completed the study through 12 months. Twenty-eight great saphenous veins (97%) were ablated and successfully occluded with no reflux while one vein developed segmental recanalization starting at the 3-month follow up. Six adverse events were reported through 12 months; two were determined by the investigator as probably related to the device or procedure. All adverse events were reported as resolved by 6 months. CONCLUSION: In this exploratory study, use of the Venclose radiofrequency ablation system achieved vein occlusion without reflux in all but one vein with six adverse events treated and resolved. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. BACKGROUND: Aging is a multifactorial response to genetic preprogramming nuances, sun exposure, and ultraviolet radiation. Recently, there has been a paradigm shift toward minimally invasive rejuvenation. OBJECTIVE: This prospective multicenter study aims to evaluate the efficacy and safety of a novel hands-free bipolar bulk radiofrequency (RF) device in terms of improvement in skin appearance. PATIENTS AND METHODS: This multicenter prospective study enrolled subjects aged 35 to 75 years with visible signs of aging. The primary objective was to evaluate skin appearance pretreatment and at 1, 3, and 6 months after the final treatment. Each patient received 3 total treatments to the chin and cheeks using the hands-free RF device spaced 2 weeks apart. RESULTS: In total, data from 87 patients were assessed from 6 treatment sites. The average age was 54 years (range 35–75 years). Most patients were female (97%), and Fitzpatrick skin types I to V were represented. Overall, patients found the procedures to be relatively pain-free, and both patients and investigators felt they noted some improvement in their skin appearance. Histological sections demonstrated an increase in collagen or elastic fibers within the papillary dermis. CONCLUSION: This study supports the use of this novel noninvasive hands-free bipolar facial remodeling device for the improvement of skin appearance. [ABSTRACT FROM AUTHOR]

Chronic rhinitis, cryotherapy, middle turbinate nonallergic rhinitis, radiofrequency therapy, vasomotor rhinitis Keywords: chronic rhinitis; cryotherapy; middle turbinate nonallergic rhinitis; radiofrequency therapy; vasomotor rhinitis EN chronic rhinitis cryotherapy middle turbinate nonallergic rhinitis radiofrequency therapy vasomotor rhinitis 88 91 4 01/06/23 20230101 NES 230101 INTRODUCTION Chronic rhinitis (CR) affects up to 30% of the US adult population.[1] Approximately 10%-20% of patients fail to respond to medical therapies and can benefit from alternative treatment options. Two fellowship-trained rhinologists randomly selected and performed all procedures; three to five treatments on each side with radiofrequency therapy and two treatments with cryotherapy. [Extracted from the article]

Esophageal thermal lesions following pulmonary vein isolation (PVI) for atrial fibrillation (AF) potentially harbor lethal complications. Radiofrequency (RF)-PVI using contact force-technology can reduce collateral damage. We evaluated the incidence of endoscopically detected esophageal lesions (EDEL) and the contribution of contact force to esophageal lesion formation without esophageal temperature monitoring. One hundred and thirty-one AF patients underwent contact force-guided RF-PVI. Contact force, energy, force-time-integral, and force-power-time-integral were adopted. During PVI at the posterior segment of the wide antral circumferential line, limits were set for energy (30 W), duration (30 s) and contact force (40 g). Ablations were analyzed postero-superior and -inferior around PVs. Endoscopy within 120 h identified EDEL in six patients (4.6%). In EDEL(+), obesity was less frequent (17% vs. 68%, p = 0.018), creatinine was higher (1.55 ± 1.18 vs. 1.07 ± 0.42 mg/dL, p = 0.016), and exclusively at the left postero-inferior site, force-time-integral and force-power-time-integral were greater (2973 ± 3267 vs. 1757 ± 1262 g·s, p = 0.042 and 83,547 ± 105,940 vs. 43,556 ± 35,255 g·J, p = 0.022, respectively) as compared to EDEL(−) patients. No major complications occurred. At 12 months, arrhythmia-free survival was 74%. The incidence of EDEL was low after contact force-guided RF-PVI. Implementing combined contact force-indices on the postero-inferior site of left-sided PVs may reduce EDEL. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the clinical results and influencing factors of the fractional microneedle radiofrequency (FMR) treatment for enlarged facial pores on different facial sites. Methods: The clinical data of patients with enlarged facial pores who underwent FMR treatment from January 2019 to December 2020 were collected. The efficacy and complications of FMR for enlarged pores in different facial areas were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to explore the clinical factors related to the efficacy of FMR after the first treatment session. Results: Totally, 75 patients with enlarged facial pores were included (full‐face FMR for 45, nasal FMR for 58, frontal FMR for 45, and cheek FMR for 72 patients). All patients received more than one treatment session, two patients received five treatment sessions, and the mean number of FMR session was 1.7. The moderate to excellent improvement rates in patients with nasal, frontal and cheek enlarged pores after the first session were 13.8%, 8.9%, and 11.1%, respectively. The improvement rate rose with the increasing number of treatment sessions. Multivariate logistic regression analysis revealed that long pulse‐width (300 ms) was positively associated with clinical efficacy after the first session (OR = 22.4, 95% CI [2.0–250.4], p = 0.012), compared with the short pulse‐width group (100–200 ms). The main adverse effects after FMR were transient pain, erythema, and edema. A minority of patients developed acneiform eruption. Conclusion: This study confirms that FMR is safe and effective in improving enlarged facial pores. The pulse width is associated with the improvement of nasal enlarged pores. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Female stress urinary incontinence (SUI) is a prevalent condition, and conservative treatment options are needed. Were evaluated CO2 laser and radiofrequency as treatment for SUI. Methods: One hundred thirty-nine women with SUI were eligible and randomized in a three-arm double-blind randomized controlled trial into radiofrequency (RF), laser (LS) and sham control (SCT) groups, with 3-monthly outpatient treatment sessions. One hundred fourteen women were included, 38 in each group, during a 12-month follow-up. The primary outcomes were: subjective improvement of SUI, evaluated on a Likert scale, and objective cure, which was a composite outcome defined according to negative stress tests, voiding diary and pad test. Questionnaires were also applied. The sample size was calculated to provide 80% power to identify a 20% difference between groups, p < 0.05. Results: Subjective improvement and objective cure of SUI were identified respectively in 72.6% and 45.2% in LS and in 61.7% and 44.7% in RF, both significantly higher than the 30.0% and 14.0% in SCT. Considering only mild cases (pad test < 10 g), objective cure was achieved in 66.7% in LS, 63.6% in RF and 22.2% in SCT. Significant reduction in the number of episodes of urinary incontinence was found according to voiding diaries (p = 0.029) and pad weight (p = 0.021). A significant reduction in urgency and urinary loss during sexual intercourse was observed only with LS and RF. Improvement in quality of life was also verified by the I-QoL and ICIQ-SF in favor of the energy-treated groups. Conclusions: CO2 laser and radiofrequency are outpatient options for SUI treatment, with no major complications. They had similar results and presented better results than in the sham control group. [ABSTRACT FROM AUTHOR]

Background: Sensitive skin is a widespread dermatologic condition, and no optimal treatments have been established so far. Objective: To investigated the efficacy and safety of the combined therapy of short‐wave radiofrequency (SWRF) and intense pulsed light (IPL) in improving transepidermal water loss (TEWL) and facial erythema in sensitive skin patients. Methods: Twenty‐two patients with sensitive skin received the SWRF treatment once per week for 4 weeks and IPL treatment once. Digital photographs and three‐dimensional images were taken at each follow‐up. The clinical efficacy was evaluated by the improvement of sensitive scale‐10 including irritant symptoms and facial erythema. In addition, erythema area and TEWL values were measured. Results: All patients showed subjective and objective improvement in irritant sensations and facial erythema after treatment. The TEWL values decreased from 20.29 ± 5.97 g·h−1·m−2 at baseline to 14.70 ± 6.02 g·h−1·m−2 after SWRF treatment and 13.78 ± 4.70 g·h−1·m−2 after combined therapy (p = 0.000). The clearance of the erythema area was statistically significant, with 14.05% ± 5.71% at baseline, 9.38% ± 4.08% after SWRF treatment, and 5.73% ± 2.79% after combined therapy (p = 0.000). No adverse events were observed. Conclusions: The combination of SWRF with IPL was effective in relieving skin irritant sensations and facial erythema of sensitive skin by repairing skin barrier function. [ABSTRACT FROM AUTHOR]

Non-ablative fractional laser (NAFL) and radiofrequency (RF) are popular for treating periorbital wrinkles owing to short downtime and low risk of side effects. To compare the effectiveness and safety of infrared bipolar radiofrequency (IR-RF) and NAFL, including 1540 nm Er: glass and 1927 nm thulium-doped laser, to determine the better option for clinical treatment of periorbital wrinkles. Twenty-seven patients assigned to 3 groups underwent split-face treatment. Two of the three treatments were randomly selected for patients in each group: IR-RF, 1540 nm Er: glass NAFL, and 1927 nm thulium-doped NAFL. Therapeutic outcomes were subjectively and objectively evaluated six months after the last treatment. Side effects and pain evaluations were conducted. Fitzpatrick wrinkle scores revealed no statistical difference for IR-RF, whereas the NAFL-treated sides exhibited significant improvements (p <.05). VISIA analysis of skin texture showed similar results. In IR-RF-treated sides, patients over 50 years old exhibited significant improvements compared with those below 50 (p <.05). The sample size was small. More objective evaluations like photometer measurements are required. NAFL is effective and safe for improving periorbital wrinkles, but IR-RF might be more suitable for elderly patients, particularly those with low pain tolerance. [ABSTRACT FROM AUTHOR]

Introduction: Monopolar radiofrequency (MRF) is a valuable modality for tightening and contouring mild-to-moderate facial skin laxity. Few studies have evaluated new-generation MRF devices for lower facial laxity in Asians. This study aims to evaluate the efficacy and safety of MRF for treating lower facial laxity in Asians. Methods: This prospective cohort study enrolled 30 volunteers with Fitzpatrick Skin Types III–V and mild-to-moderate skin laxity. Subjects received a single MRF treatment. Self-assessments and adverse events were recorded. Two blinded dermatologists graded improvements (6-point scale) after treatment and 1, 3, and 6 months later. Results: All subjects completed the study. Treatment energy levels ranged from 2 to 4. The average number of shots was 412 ± 49, delivered in 3–4 passes with 15–30% overlap. All patients reported improvement in lower facial laxity immediately after treatment. Most patients had mild-to-moderate improvement over the 6-month follow-up. Continuous improvement was observed at the 1-, 3-, and 6-month follow-ups (P < 0.01). Significant improvement was seen at the 6-month follow-up compared with the 1-month follow-up (P < 0.01). Subjects tolerated the procedure well: the average pain score was 3.13 out of 10, and no serious adverse events were observed. Conclusions: The new-generation MRF device we tested was effective and safe for mild-to-moderate lower facial laxity in Asian skin. The latest MRF technology offers improved safety to prevent complications. Appropriate patient selection, setting, and protocols are mandatory to achieve optimal clinical outcomes. The Trial Registration Number: TCTR20210326002. [ABSTRACT FROM AUTHOR]

This article discusses the treatment procedures for intractable gastroesophageal reflux disease (GERD) after peroral endoscopic myotomy (POEM). The study compares the safety and efficacy of three therapeutic methods: anti-reflux ablation therapy (ARAT), anti-reflux mucosectomy (ARMS), and Stretta radiofrequency (SRF). The data of 22 patients with intractable GERD after POEM were analyzed, and the results showed that the ARMS group had the best improvement in subjective symptoms. However, there were no significant differences in endoscopic esophagitis and EndoFLIP DI improvement among the three methods. The study also found that post-POEM GERD was related to achalasia type, and post-procedural adverse events occurred in the ARAT and ARMS groups. [Extracted from the article]

Purpose: To evaluate the performance of a new, highly flexible radiofrequency (RF) coil system for imaging patients undergoing MR simulation. Methods: Volumetric phantom and in vivo images were acquired with a commercially available and prototype RF coil set. Phantom evaluation was performed using a silicone-filled humanoid phantom of the head and shoulders. In vivo assessment was performed in five healthy and six patient subjects. Phantom data included T1-weighted volumetric imaging, while in vivo acquisitions included both T1- and T2-weighted volumetric imaging. Signal to noise ratio (SNR) and uniformity metrics were calculated in the phantom data, while SNR values were calculated in vivo. Statistical significance was tested by means of a non-parametric analysis of variance test. Results: At a threshold of p = 0.05, differences in measured SNR distributions within the entire phantom volume were statistically different in two of the three paired coil set comparisons. Differences in per slice average SNR between the two coil sets were all statistically significant, as well as differences in per slice image uniformity. For patients, SNRs within the entire imaging volume were statistically significantly different in four of the nine comparisons and seven of the nine comparisons performed on the per slice average SNR values. For healthy subjects, SNRs within the entire imaging volume were statistically significantly different in seven of the nine comparisons and eight of the nine comparisons when per slice average SNR was tested. Conclusions: Phantom and in vivo results demonstrate that image quality obtained from the novel flexible RF coil set was similar or improved over the conventional coil system. The results also demonstrate that image quality is impacted by the specific coil configurations used for imaging and should be matched appropriately to the anatomic site imaged to ensure optimal and reproducible image quality. [ABSTRACT FROM AUTHOR]