Digital Commons Network^™

Social Return On Investment: A Cost-Benefit Analysis Of The Hiv Integrated Care And Prevention Programs In Cambodia, Sovannary Tuot, Liza Tong, Sopheab Heng, Minh-Anh Luong, Khuondyla Pal, Pheak Chhoun, Siyan Yi

Background: KHANA’s HIV Integrated Care and Prevention (ICP) project provided comprehensive care and support to HIV-affected communities through home and community-based care teams from 2007 to 2011. The aim of this study was to use Social Return on Investment (SROI) methodology to evaluate the social, health, and economic impacts of the ICP project, enabling the calculation of a ratio cost-to-benefit for the community in terms of HIV care, support, and treatment. Methods: The SROI methodology is a social cost-benefit analysis framework that measures and accounts for the values created by a program or series of initiatives. Values were mapped to …

Improving Prevention And Care For Hiv And Sexually Transmitted Infections Among Men Who Have Sex With Men In Cambodia: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Sok Chamreun Choub, Carinne M. Brody

Background: The prevalence of HIV and sexually transmitted infections (STIs) among key populations in Cambodia continues to rise. To address this issue, KHANA, the largest national HIV organization in the country developed and implemented the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project. This study aims to determine the impacts of the SAHACOM on sexual behaviors and the uptake of HIV/STI services among men who have sex with men (MSM) in Cambodia.

Methods: We compared outcome indicators at midterm (n = 352) and endline (n = 394). Surveys were conducted in 2012 and 2014 in Battambang …

Acceptability Study On Hiv Self-Testing Among Transgender Women, Men Who Have Sex With Men, And Female Entertainment Workers In Cambodia: A Qualitative Analysis, Khuondyla Pal, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Cheaty Ly, Srean Chhim, Siyan Yi

Background: In Cambodia, HIV prevalence is high while HIV testing rates remain low among transgender women (TG women), men who have sex with men (MSM), and female entertainment workers (FEW). Introducing self-testing for HIV to these key populations (KPs) could potentially overcome the under-diagnosis of HIV and significantly increase testing rates and receipt of the results, and thus could decrease transmission. Therefore, this study aimed to determine the acceptability of HIV self-testing (HIVST) among these three categories of KPs.

Methods: This study was conducted through focus group discussions (FGDs) with TG women, MSM, and FEW in Phnom Penh …

Men Who Have Sex With Men In Cambodia: Population Size, Hiv Risky Behaviors, And Hiv Prevalence, Siyan Yi, Srean Chhim, Pheak Chhoun, Sovannary Tuot, Cheaty Ly, Phalkun Mun, Chanrith Ngin

Background: Men who have sex with men (MSM) constitute a significant proportion of HIV key populations in Cambodia. We conducted this study to estimate the national population size, assess HIV-related risk behaviors, and determine HIV prevalence among MSM in Cambodia. Methods: This research was conducted in 2014 in 12 study sites in Cambodia. MSM size estimation was performed using capture-recapture method with data collected in two time points within an 18-day interval. To assess HIV risk behaviors, a total of 838 MSM were randomly selected for face-to-face interviews during the capture round. A separate survey using a time …

Short Message Service (Sms) Reminders And Real-Time Adherence Monitoring Improve Antiretroviral Therapy Adherence In Rural Uganda, Jessica E. Haberer, Angella Musimenta, Esther Atukunda, Nicholas Musinguzi, Monique A. Wyatt, Norma C. Ware, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To explore the effects of four types of short message service (SMS) plus realtime adherence monitoring on antiretroviral therapy (ART) adherence: daily reminders, weekly reminders, reminders triggered after a late or missed dose (delivered to patients), and notifications triggered by sustained adherence lapses (delivered to patient-nominated social supporters).

Design: Pilot randomized controlled trial.

Methods: Sixty-three individuals initiating ART received a real-time adherence monitor and were randomized (1 : 1 : 1): (1) Scheduled SMS reminders (daily for 1 month, weekly for 2 months), then SMS reminders triggered by a late or missed dose (no monitoring signal within 2 h …

Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire-Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric Van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as …

"I Always Worry About What Might Happen Ahead" : Implementing Safer Conception Services In The Current Environment Of Reproductive Counseling For Hiv-Affected Men And Women In Uganda, Lynn T. Matthews, Francis Bajunirwe, Jasmine Kastner, Naomi Sanyu, Cecilia Akatukwasa, Courtney Ng, Rachel Rifkin, Cecilia Milford, Lizzie Moore, Ira B. Wilson, David Bangsberg, Jennifer A. Smit, Angela Kaida

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background. We explored healthcare provider perspectives and practices regarding safer conception counseling for HIV-affected clients. Methods.We conducted semistructured interviews with 38 providers (medical and clinical officers, nurses, peer counselors, and village health workers) delivering care to HIV-infected clients across 5 healthcare centres in Mbarara District, Uganda. Interview transcripts were analyzed using content analysis. Results. Of 38 providers, 76% were women with median age 34 years (range 24–57). First, we discuss providers’ reproductive counseling practices. Emergent themes include that providers (1) assess reproductive goals of HIV-infected female clients frequently, but infrequently for male clients; (2) offer counseling focused on “family planning” …

Magnesium Deficiency Results In Oxidation And Fragmentation Of Dna, Down Regulation Of Telomerase Activity, And Ceramide Release In Cardiovascular Tissues And Cells: Potential Relationship To Atherogenesis, Cardiovascular Diseases And Aging, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

The School of Health Sciences Publications and Research

The authors discuss the potential relationship between magnesium, cardiovascular diseases, and aging.

Sudden Cardiac Death In Infants, Children And Young Adults: Possible Roles Of Dietary Magnesium Intake And Generation Of Platelet-Activating Factor In Coronary Arteries, Burton M. Altura, Wenyan Li, Aimin Zhang, Tao Zheng, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

Magnesium (Mg) is a co-factor for more than 500 enzymes, and is the second most abundant intracellular cation after potassium. It is vital in numerous physiological, cellular and biochemical functions and systems necessary for life. Approximately 35 years ago, our laboratory suggested that a progressive, dietary deficiency and/or metabolic induced loss of Mg from the body, beginning early in life, particularly during development of the coronary arteries, could lead to coronary arterial vasospasm, ischemic heart disease, and sudden-cardiac death (SCD). Herein, we review evidence for a brand-new, novel hypothesis which combines knowledge suggesting a combined role for hypomagnesemia and platelet-activating …

Mechanism Of Fecal Bacteriotherapy In Treating Clostridium Difficile Infection And Gi Tract Disorders, Rivka Steinberg

The Science Journal of the Lander College of Arts and Sciences

Clostridium difficile infection, an increasingly prevalent and virulent condition, is often resistant to treatment. Standard antibiotic therapy is rarely efficient when used to treat recurrent C. difficile infection. Fecal microbiota transplantation (FMT) is a safe, effective and inexpensive treatment that has a cure rate of about 90%, according to clinical trials and reports. This approach may also be applicable in treating ulcerative colitis, a type of inflammatory bowel disease, on the basis of the restoration of flora imbalances. Additionally, recent data suggests that a disproportion in composition of the gut microbiome may contribute to obesity. FMT, may restore a healthy …

Effects Of Moderate Intake Of Alcohol On Coronary Heart Disease, Eli Derdik

The Science Journal of the Lander College of Arts and Sciences

The french paradox is caused by an inconsistency with scientific experimentation: The French have a very high intake of saturated fat and cholesterol, which is associated with coronary heart disease, yet they have un-commensurately low levels of deaths due to this disease. It has been proposed that alcohol, as a part of the French diet, is the factor that helps decrease the risk of heart disease in the French population by 20-30%. Research has been gathered from many medical journals to create a larger and more accurate perspective to determine if alcohol has any effect on coronary heart disease. Experiments …

A Single Dose Tmv-Ha Vaccine Protects Mice From H5n1 Influenza Challenge, Jyothi K. Mallajosyula, Trushar Jeevan, Rachel Chikwamba, Richard J. Webby, Alison A. Mccormick

Faculty Publications & Research of the TUC College of Pharmacy

Recombinant subunit vaccines are an efficient strategy to meet the demands of a possible influenza pandemic, because of rapid and scalable production. However, vaccines made from recombinant Hemagglutinin (HA) subunit protein are often of low potency, requiring repeated boosting to generate a sustained immune response. Previously, we demonstrated improved immunogenicity of a plant-made H1 Hemagglutinin (HA) vaccine by chemical conjugation to the surface of the Tobacco Mosaic Virus (TMV) which is non infectious in mammals. Antigen coated TMV is taken up by mammalian dendritic cells and is a highly effective antigen carrier for subunit protein vaccines. In this work, we …

The Influence Of Solid Microneedles On The Transdermal Delivery Of Selected Antiepileptic Drugs, Julia Nguyen, Kevin B. Ita, Matthew J. Morra, Inna E. Popova

Faculty Publications & Research of the TUC College of Pharmacy

The aim of this project was to examine the effect of microneedle rollers on the percutaneous penetration of tiagabine hydrochloride and carbamazepine across porcine skin in vitro. Liquid chromatography-mass spectrometric analysis was carried out using an Agilent 1200 Series HPLC system coupled to an Agilent G1969A TOF-MS system. Transdermal flux values of the drugs were determined from the steady-state portion of the cumulative amount versus time curves. Following twelve hours of microneedle roller application, there was a 6.74-fold increase in the percutaneous penetration of tiagabine hydrochloride (86.42 ± 25.66 µg/cm²/h) compared to passive delivery (12.83 ± 6.30 µg/cm …

The Meanings In The Messages: How Sms Reminders And Real-Time Adherence Monitoring Improve Antiretroviral Therapy Adherence In Rural Uganda, Norma C. Ware, Emily A. Pisarski, Melanie Tam, Monique A. Wyatt, Esther Atukunda, Angella Musimenta, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

To understand how a pilot intervention combining SMS reminders with real-time adherence monitoring improved adherence to HIV antiretroviral therapy (ART) for adults initiating treatment in rural Uganda.

Design: Qualitative study, conducted with a pilot randomized controlled trial.

Methods: Sixty-two pilot intervention study participants took part in qualitative interviews on: preferences for content; frequency and timing of SMS adherence reminders; understandings and experiences of SMS reminders; and understandings and experiences of real-time adherence monitoring. Analysis of interview data was inductive and derived categories describing how participants experienced the intervention, and what it meant to them.

Results: SMS reminders prompted taking individual …

In Vitro Modeling Of The Interaction Between Human Epithelial Cells And Lymphocytes Upon Influenza Infection, Natalia A. Ilyushina, Pete F. Wright

Dartmouth Scholarship

Influenza viruses are a continuous threat to humans because of their ability to cross species barriers and adapt to new hosts. Data from murine studies, along with limited human data, suggest that CD8(+) cytotoxic T lymphocytes (CTL) that recognize conserved epitopes of structural influenza proteins are the main mediators of influenza virus clearance. Additionally, the fact that many CTLs recognize epitopes shared between different influenza strains offers the potential for broad cross-strain immunity. However, the mechanisms of cellular immunity against influenza viruses are poorly defined in humans, where the CTL response has been hard to measure and interpret. We developed …

Sepsis-Review Of Screening For Sepsis By Nursing, Nurse Driven Sepsis Protocols And Development Of Sepsis Hospital Policy/Protocols, Matthew Mccaffery, Omobola Onikoyi, Dilisha Rodrigopulle, Ali Syed, Suzanne Jones, Laura Mansfield, Murali G. Krishna

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Sepsis is one of the leading causes of death in the United States. In order to decrease the morbidity and mortality associated with sepsis in patients, early detection is vital, and so screening protocols have been developed. The Surviving Sepsis Campaign has developed an evidence based screening guideline that has been adapted by various institutions. Having specific criteria in detecting a septic patient is the defining factor in screening for sepsis by nursing staff. In order for the sepsis protocol to be effective, it is necessary that nursing and other front line staff be educated. Institutional barriers regarding implementation of …

Why Is Postoperative Atrial Fibrillation Difficult To Prevent And Treat: Potential Roles Of Unrecognized Magnesium Deficiency And Release Of Ceramide And Platelet-Activating Factor, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Heart failure is a major cause of morbidity and mortality whose costs impose staggering health-care costs and often lengthy hospitalizations. Post-operative atrial fibrillation (POAF) represents a leading cause for heart failure, particularly after cardiac and lung surgeries. Although PAOF is a common cardiac arrhythmia, it is impossible to predict. As the worldwide population is aging, the incidence and prevalence of PAOF is growing. Identifying mechanisms for PAOF is attracting a considerable amount of research with no agreement on the mechanism(s). Our research on the heart and cardiovascular system, over the past 50-plus years, leads us to believe that major causes …

Treatment Of Pasireotide Lar-Associated Hyperglycemia In A Patient With Acromegaly, Cheryl Rosenfeld

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Objective: Hyperglycemia was noted in pasireotide long-acting release (PAS LAR}-treated patients with acromegaly during clinical trials. We describe a clinical approach to hyperglycemia in a patient with acromegaly and diabetes mellitus type 2 (DM2) during PAS LAR initiation and treatment.

Methods: Clinical response to PAS LAR, including self­ monitored blood glucose (SMBG) levels, HbA1c, IGF-1, and adverse effects, was reported. Case Presentation: A 44-year-old male was referred for consultation in 2007 owing to uncontrolled DM2 despite maximum metformin (MET) dose. Testing led to a biochemical diagnosis of acromegaly. An 8-mm pituitary adenoma was seen on MRI. Transsphenoidal pituitary adenoma …

Central Neural Mechanisms Of Salt-Sensitive Hypertension, Robert Larson

Dissertations, Master's Theses and Master's Reports

Hypertension (HTN) is a major risk factor for the development of cardiovascular disease, and it’s estimated that over 80 million adults in the United States have HTN. Essential HTN often demonstrates sensitivity to salt, and reductions in dietary salt attenuate high blood pressure in this population. Evidence indicates that the paraventricular nucleus (PVN) of the hypothalamus is a key driver of HTN due to excess salt intake. The cellular mechanisms whereby PVN neuronal activity is augmented in response to salt are largely unknown. Previous work from our lab has demonstrated that small conductance calcium activated potassium (SK) channel function is …

Sglt2 Inhibitor Therapy Improves Blood Glucose But Does Not Prevent Diabetic Bone Disease In Diabetic Dba/2j Male Mice, Kathryn M. Thrailkill, R. Clay Bunn, Jeffry S. Nyman, Mallikarjuna R. Rettiganti, Gael E. Cockrell, Elizabeth C. Wahl, Sasidhar Uppuganti, Charles K. Lumpkin, John L. Fowlkes

Barnstable Brown Diabetes Center Faculty Publications

Persons with type 1 and type 2 diabetes have increased fracture risk, attributed to deficits in the microarchitecture and strength of diabetic bone, thought to be mediated, in part, by the consequences of chronic hyperglycemia. Therefore, to examine the effects of a glucose-lowering SGLT2 inhibitor on blood glucose (BG) and bone homeostasis in a model of diabetic bone disease, male DBA/2J mice with or without streptozotocin (STZ)-induced hyperglycemia were fed chow containing the SGLT2 inhibitor, canagliflozin (CANA), or chow without drug, for 10 weeks of therapy. Thereafter, serum bone biomarkers were measured, fracture resistance of cortical bone was assessed by …

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

Análisis De Las Políticas Públicas De Prevención Del Cáncer De Cuello Uterino Vinculadas Al Control Del Virus Del Papiloma Humano (Vph) En Argentina / An Analysis Of Argentina’S Public Health Prevention Strategies Of Cervical Cancer Related To The Control Of The Human Papiloma Virus (Hpv), Caroline Seman

Independent Study Project (ISP) Collection

El objetivo general de este estudio es analizar las políticas públicas de prevención del cáncer de cuello uterino (CCU) basadas en la incorporación de nuevas tecnologías como el test de VPH (Virus del Papiloma Humano) y la vacuna contra el VPH en Argentina. Los objetivos específicos son 1) describir la implementación del test de VPH y la campaña de vacunación obligatoria contra el VPH como estrategias de prevención primaria del CCU a nivel nacional: 2) identificar los factores que las facilitan y las obstaculizan. El CCU es el segundo cáncer más diagnosticado en las mujeres de Argentina. Desde el año …

Is Acupuncture, Including Electroacupuncture, Effective In Treating Pain In Plantar Fasciitis?, Alicia Campiglia

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether the use of acupuncture, including electroacupuncture, is effective in treating pain in patients with plantar fasciitis.

STUDY DESIGN: Review of 3 RCTs published between 2011-current, all in the English language.

DATA SOURCES: Three RCTs analyzed the effectiveness of acupuncture therapy compared to a control group using alternate analgesic therapies. All studies were found using EBSCOhost and PubMed and were selected based on relevance to the proposed clinical question.

OUTCOMES MEASURED: Each of the 3 articles analyzed the effectiveness of treating pain with acupuncture treatment in patients diagnosed with …

Are Statins An Effective Treatment In Men With Erectile Dysfunction?, Kelsey Caton

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not HMG-CoA Inhibitors (Statins) are an effective treatment for erectile dysfunction (ED).

STUDY DESIGN: Systematic review of three English language randomized controlled trials published between 2011-2013.

DATA SOURCES: Three randomized controlled trials published in peer-reviewed journals comparing the effects of statins on erectile function found using the PubMed database.

OUTCOMES MEASURED: The outcomes measured included erectile function, assessed using the International Index of Erectile Dysfunction Questionnaire (IIEF) in all three studies and Nocturnal Penile Tumescence (NPT) in one study, and male ED-quality of life using the MED-QoL …

Does Ivabradine Improve Quality Of Life In Cardiovascular Disease Patients?, Daniel E. Lynch

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this review is to determine whether ivabradine therapy can improve the quality of life in cardiovascular disease patients.

Study Design: The studies included in this review are one randomized control study and two double blind randomized control studies from 2008, 2010, and 2012.

Data Source: The three studies in this review were obtained by performing a PubMed search using the keywords “ivabradine” and random control trial.” All articles were published in English and in peer-reviewed journals.

Outcomes Measured: The three studies ascertained whether there was a decrease in hospitalization events within coronary artery disease and heart …

Does Hyperbaric Oxygen Therapy Relieve Post-Concussion Symptoms And Improve Quality Of Life?, Kevin (Sung Min) Lee

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not hyperbaric oxygen therapy relieves post-concussion symptoms and improve quality of life.

Study Design: Review of three randomized controlled trials published in English in peer review journals.

Data Sources: Three randomized controlled trials which evaluated the therapeutic benefits of hyperbaric oxygen therapy compared to control group that did not receive any treatment. All studies were found in PubMed database.

Outcomes Measured: All three studies analyzed the effect of hyperbaric oxygen therapy on quality of life. Rivermead Postconcussion Symptoms Questionnaire (RPQ) and EQ-VAS questionnaire were used to measure …

Does Music Therapy Reduce Anxiety Levels In End-Stage Renal Disease Patients Undergoing Hemodialysis?, Andrew C. Konopacki

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy reduces anxiety levels in end-stage renal disease patients undergoing hemodialysis.

STUDY DESIGN: Systematic Review of two randomized controlled trials and one crossover study published in English in 2008, 2012 and 2013, respectively.

DATA SOURCES: Two non-blind randomized controlled trials and one cross-over study were found via PubMed and EBSCOhost databases.

OUTCOMES MEASURED: Subjective Anxiety Levels were measured in ESRD patients undergoing hemodialysis pre and posttest via patient self-reporting. An anxiety level survey graded on a scale of 1-10 was used in the study by …

Is Safinamide Effective As An Add-On Medication In Treating Parkinson's Disease Motor Symptoms?, Erin E. Kilonsky

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not “Is safinamide effective as an add-on medication in treating Parkinson's disease motor symptoms?”

Study Design: Review of three randomized, controlled studies published in peer reviewed journals in English between 2012-2014.

Data Sources: The three randomized, double-blind clinical trials were found via PubMed and EBSCOhost Web. Articles were selected based on relevance, the date of publication, and whether or not they included patient outcomes.

Outcomes Measured: Among other measures, each trial measured improvement in motor symptoms using the Unified Parkinson’s Disease Rating Scale (UPDRS) Part III (motor) scores, …

How Effective Is Acupuncture In Treating Cancer-Related Fatigue In Adult Cancer Patients?, Anita Elizabeth Kurian

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is an effective course of treatment for improving cancer-related fatigue in adult cancer patients.

DESIGN: Review of three English language primary randomized controlled studies published from 2006-2012.

DATA SOURCES: Three randomized controlled trials studying the effects of acupuncture therapy on cancer-related fatigue were found using PubMed and Cochrane databases.

OUTCOMES MEASURED: Each of the three trials assessed the efficacy and clinical improvement of cancer-related fatigue after acupuncture therapy. Results were measured on the Functional Assessment of Chronic-Illness Therapy-Fatigue Subscale (FACIT-F) or the Multidimensional Fatigue Inventory …

Is Laser Therapy Effective At Relieving Pain In Adult Patients With Recurrent Aphthous Stomatitis?, Kevin Jackson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not laser therapy is effective at relieving pain in adult patients with recurrent aphthous stomatitis.

STUDY DESIGN: Systematic review of three randomized controlled trials published in 2009, 2009, and 2013.

DATA SOURCES: Three randomized controlled trials were obtained using PubMed.

OUTCOMES MEASURED: The symptom of pain was measured for improvement by patient survey of visual analog pain scales.

RESULTS: Prasad et al. (2013), Tezel et al. (2009), and Zand et al. (2009) all demonstrated improvement in a majority of the subjects’ pain relief from treatment with laser …