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- ItemAcesso aberto (Open Access)Análise dos efeitos da fotobiomodulação na desmielinização aguda em camundongos idosos(Universidade Federal de São Paulo, 2021-02-25) Aigner, Gabrielle Paranhos [UNIFESP]; Castro, Glaucia Monteiro de [UNIFESP]; Renno, Ana Claudia Muniz [UNIFESP]; http://lattes.cnpq.br/4106611304688552; http://lattes.cnpq.br/2727707909050870; http://lattes.cnpq.br/5761398819067390; Universidade Federal de São Paulo (UNIFESP)Multiple sclerosis is a chronic inflammatory disease of the central nervous system, which leads to demyelination of neurons and, subsequently, to axonal degradation. This demyelination causes symptoms of the disease such as fatigue, ataxia, muscle weakness and spasticity. This clinical picture when combined with the aging process of the human body implies specific physiological changes, such as the phenomenon of immunosenescence and impairment of neuroplasticity, further worsening the disease's prognosis. We hypothesized that treatment with low-intensity therapeutic photobiomodulation may promote the reversion of acute demyelination induced by cuprizone, through the proliferation and differentiation of oligodendrocyte precursor cells. The present study aimed to evaluate the efficacy of treatment with therapeutic photobiomodulation in acute demyelination induced in elderly mice. Then, 20 male C57Bl / 6 mice, aged between 8 and 9 months old, were distributed in the groups: Control (CTL), Laser Control (CTLL), Cuprizona (CPZ) and Cuprizona Laser (CPZL). Demyelination was induced by the addition of 0.2% cuprizone to the ground diet for 5 weeks for the CPZ and CPZL groups. Therapeutic photobiomodulation was applied in a transcranial manner in the CTLL and CPZL groups. The Rotarod and NOR tests were performed to assess the animals' motor and cognitive performance, in addition to the analyzes of the lipid profile present in the blood serum and the myelin density by Luxol Fast Blue staining. We verified by means of these tests that the animals in the cuprizone group that underwent acute demyelination demonstrated a worse motor and cognitive performance in addition to having a lower myelin density value compared to animals in the cuprizone laser and laser control groups that received the therapeutic photobiomodulation. Our results, then, allow us to infer that the treatment of acute demyelination in elderly mice with photobiomodulation was able to reverse the clinical signs characteristic of myelin loss.
- ItemAcesso aberto (Open Access)Comparação entre as técnicas de panfotocoagulação utilizando laser 577 nm de multidisparos versus panfotocoagulação convencional no tratamento da retinopatia diabética(Universidade Federal de São Paulo (UNIFESP), 2021) Passos, Renato Magalhaes [UNIFESP]; Farah Neto, Michel Eid [UNIFESP]; Universidade Federal de São PauloPurpose: To compare the outcomes after panretinal photocoagulation (PRP) with two different strategies for treating diabetic retinopathy (DR), based in criteria such as laser parameters, therapeutic response, and patient tolerance. Methods: This single-center, randomized clinical study included 41 eyes with proliferative or severe non-proliferative DR. They were treated in group 1 with 577 nanometer (nm) multispot laser and 20 milliseconds (ms) pulse duration, while in group 2 they were treated with so-called conventional PRP with 532 nm single-spot laser and 100 ms pulse duration. The outcomes included functional evaluation with best-corrected visual acuity (BCVA) and structural evaluation with imaging methods (OCT and fluorescein angiogram) at baseline, 6 and 12 months. Other variables included laser parameters, number of PRP applications required, and results of a subjective pain analysis. Results: The multispot laser (group 1) required fewer PRP applications and more laser spots delivered (P<0.001) to compensate for lower fluence/pulse duration and provided a similar pain sensibility compared with single-spot laser. Both groups maintained the initial VAs and CRTs; about 50% of cases had vitreomacular interface changes and improved macular edema, with similar angiographic improvements after 12 months. New vessels regression was seen less frequently in both groups, possibly because of baseline disease severity rather than the treatment modality. Conclusions: Multispot laser demonstrated to be equivalent and non-inferior to conventional treatment with single spot laser for diabetic retinopathy, offering some advantages such as smaller number of sessions to finish PRP and a lower fluence to obtain the desired results, producing less retinal iatrogenic damage.
- ItemEmbargoDiferentes energias (6J E 12J) da fotobiomodulação na intensidade da dor em pacientes com osteoartrite de joelho(Universidade Federal de São Paulo, 2023-11-30) Nogueira, Tatiane Diehl Vaz [UNIFESP]; Pinfildi, Carlos Eduardo [UNIFESP]; http://lattes.cnpq.br/6370481853776867; http://lattes.cnpq.br/9494527320839762; Universidade Federal de São Paulo (UNIFESP)Introdução: Osteoartrite (OA) é uma doença degenerativa crônica que no mundo afeta, aproximadamente, 250 milhões de pessoas, sendo que 83% é referente ao joelho (KOHN et al., 2016), que tem a dor como principal sintoma afetando tanto a funcionalidade da articulação quanto a qualidade de vida do indivíduo (NEOGI et al.,(2013). A fotobiomodulação é um recurso eficaz para o tratamento da OA por consequência do seu efeito analgésico, além do seu resultado de redução da inflamação e aceleração da regeneração tecidual (COTLER et al., 2015). Desta forma, deve-se pesquisar sobre tratamentos eficazes, como a fotobiomodulação, na qual diferentes energias devem ser analisadas a fim de obter um efeito analgésico esperado no tratamento. Objetivo: A pesquisa tem como objetivo primário avaliar o efeito da Fotobiomodulação com diferentes energias de 6J e 12J, na intensidade da dor de pacientes com osteoartrite de joelho. Método: Foram selecionados 20 participantes de ambos os sexos que possui osteoartrite de joelho unilateral ou bilateral grau I ao IV, com pontuação acima de 4 pontos (moderada) na Escala Numérica de Dor (END) no momento da avaliação e apresentar dor em pelo menos três tipos de atividades de vida diária (AVDs) como subir ou descer escadas, sentar e levantar, ajoelhar, correr e agachar, no qual foram submetidos a um estudo transversal em que todos os participantes realizaram duas sessões com diferentes grupos de dosimetrias. Desta forma, na primeira semana foi realizado no indivíduo os testes Sit To Stand (STS) e Time Up and Go (TUG), um treino de propriocepção e aplicado parâmetros da dosimetria 1 (6J, contínuo, comprimento de onda de 808 nm, potência de 100mW, área do feixe de 0,12cm², irradiância de 0.83W/cm², tempo por ponto de 60 segundos e fluência de 50J/cm²). Na segunda sessão, ou seja, na semana seguinte, foi aplicado no mesmo indivíduo a laserterapia com parâmetros da dosimetria 2 (12J, contínuo, comprimento de onda de 808 nm, potência de 100mW, área do feixe de 0,12cm², irradiância de 0.83W/cm², tempo por ponto de 120 segundos e fluência de 100J/cm²) além do treino de propriocepção. A dor, nas duas sessões, foi avaliada por meio da END, após as duas intervenções (laserterapia e treino de propriocepção) e depois de 24 horas por intermédio da rede social Whatsapp. Resultado: Os resultados sugerem que a dosagem mais alta (12J) proporcionou uma redução mais significativa em comparação com a dosagem mais baixa (6J). Conclusão: Este estudo sugere que a FBM com uma dosagem de energia de 12J é mais eficaz na redução da dor de pacientes com osteoartrite de joelho grau I ao IV em comparação com uma dosagem de 6J em uma intervenção a curto prazo. Entretanto, mostra-se necessário um maior tamanho amostral a fim de adquirir resultados mais robustos e com maior relevância.
- ItemSomente MetadadadosEfeitos da fotobiomodulação no desempenho físico em atletas: revisão sistemática com metanálise(Universidade Federal de São Paulo (UNIFESP), 2021) Guedes, Priscilla Silva [UNIFESP]; Guerra, Ricardo Luís Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Context and Objective: Photobiomodulation (FBM) has been studied for many years in various effects, such as: analgesia, tissue repair and tissue healing. Recently, studies have been exploring fatigue recovery and performance in athletes. This study aimed to conduct a systematic review and meta-analysis to analyze the effect of photobiomodulation on performance in athletes. Methods: A literature search was performed in the databases: MEDLINE (via PubMed), LILACS, PEDro, EMBASE and SPORTSDiscus. The studies were considered eligible when they performed Photobiomodulation with a control or placebo group, in order to assess performance in athletes. Articles in duplicates, reviews, experimental studies in animals, non-athlete and sick individuals were excluded. Searches were not limited by language of publication. The articles were filtered by title and summary using the Rayyan® online collaborative platform. The platform allowed the process to be carried out blindly in the extraction and resolution of duplicates. Two authors worked independently on data extraction (PSG and YLM) and when necessary a third author broke the tie. The articles were read in full when there was not enough information in the summary that could indicate the presence of the required criteria (eg: control group, placebo group or evaluated population). The randomized clinical trials that were included in the review had the risk of bias assessment performed by the Cochrane collaboration tool for risk of bias assessment and the quality of the evidence performed by the GRADE - Grading of Recommendatios Assessment, Development and Evaluation. Results: Of the 53 randomized clinical trials (RTC's) found, 12 criteria were selected for qualitative analysis and 10 RTC's for quantitative analysis (meta-analysis). Regarding the risk of bias, studies show a greater tendency to low risk of bias and in relation to the quality of evidence, the research showed a trend of “moderate” quality of studies. The studies proved to be quite heterogeneous and well diversified in relation to the applicability of the Laser. Meta-analysis showed that: on the strength outcome the effect of Photobiomodulation is no different from the effect of the intervention with Placebo [DMP = 0.13; 95% CI = -0.42; 0.68; p = 0.6405];in power, there were no differences in effects between Photobiomodulation and Placebo interventions [DMP = 0.07; 95% CI = -0.27; 0.41; p = 0.6808]; in velocity, there was no difference when comparing the effect sizes of Photobiomodulation vs Placebo [DMP = -0.15; 95% CI = -0.89; 0.60; p = 0.7001]; and in the and in the resistance outcome, there was no effect of photobiomodulation on this parameter when compared to Placebo [DMP = 0.40; 95% CI = - 0.07; 0.87]. Conclusion: we conclude that although the literature demonstrates positivity in the treatment with photobiomodulation in athletes, in the outcomes researched in this review with meta-analysis there was no difference in the comparison of the effect sizes of Photobiomodulation vs Placebo.
- ItemSomente MetadadadosInovação tecnológica para termoablação de tumores de cabeça e pescoço com terapia termica de laser indução associada à cisplatina CDDP-LITT(Universidade Federal de São Paulo (UNIFESP), 2021) Palumbo, Marcel Das Neves [UNIFESP]; Paiva, Marcos Bandiera [UNIFESP]; Universidade Federal de São PauloThe thermal ablation of tumors by laser has been growing as a multidisciplinary subspecialty defined as LITT, mainly due to high demand of less invasive procedures to patients in palliative care. In this therapy, high doses of thermal energy are directed to the central area of the tumor, causing irreversible damage to tumor cells, but smaller doses are directed to outlying areas, causing reversible changes, maintaining the tumor viability, consequentially with high risk of recurrence. The association with chemotherapeutic drugs, mainly cisplatin (CDDP), has been studied with satisfactory results, decreasing the possibility of recurrence. Since the first studies of cisplatin, the local effect can be strengthened by LITT( LITT-CDDP procedure), since the heat increases intracellular uptake and the susceptibility of the cell to cytotoxicity. In this study, we developed new prototype with dual Laser 1470nm + 450nm and intratumoral cisplatin. Further studies are required to assess the security in higher doses, the increase in number of applications, especially important in high-volume tumors.