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- ItemAcesso aberto (Open Access)Avaliação da voz em pacientes submetidos à cordectomia com laser de CO2(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-06-01) Haddad, Leonardo [UNIFESP]; Abrahão, Márcio [UNIFESP]; Cervantes, Onivaldo [UNIFESP]; Ceccon, Fabio Pupo [UNIFESP]; Gielow, Ingrid [UNIFESP]; Carvalho, Jomar Rezende [UNIFESP]; Leonhardt, Fernando Danelon [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)AIM: To evaluate voice outcomes in patients with early glottic carcinoma treated by CO2 laser cordectomy. METHOD: 15 patients with glottic Tis and T1 squamous cell carcinoma treated with CO2 laser were analyzed. The assessment consisted of perceptual voice analysis, objective voice evaluation and video-laryngo-stroboscopic exam. In addition, patients rated their voices and completed the Voice related Quality of Life (VR-QOL) questionnaire. The results were compared with those obtained in a matched control group. RESULTS: Most of the patients presented some degree of hoarseness on perceptual voice analysis, mainly rough and breathy voices. Their acoustic evaluation compared with the control group showed a small increase in fundamental frequency, but with no statistically significant difference, and the values of jitter, shimmer and noise to harmonic ratio were worse and statistically significant. As regards to videolaryngo- stroboscopic findings, better results were achieved in the less extensive resection group. Patients have had minimal repercussion in their life quality in respect to voice. CONCLUSIONS: In spite of voice alterations in patients submitted to cordectomy by CO2 laser, functional results are acceptable, with minimal repercussion in their quality of life. Avaliação da voz em pacientes submetidos à cordectomia com laser de CO2.
- ItemAcesso aberto (Open Access)Desmineralização dentária de pacientes respiradores orais submetidos à expansão maxilar(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2010-12-01) Bakor, Silvia Fuerte [UNIFESP]; Pereira, Julio Cesar Mota [UNIFESP]; Frascino, Silvana [UNIFESP]; Ladalardo, Thereza Christinna Cellos Gonçalves Pinheiro [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; FAPI Curso de Especialização em Ortodontia; Universidade Estadual de Feira de Santana Curso de Odontologia; Universidade Federal de São Paulo (UNIFESP); APCDMouth breathing may cause deformities on the dental arch and be a risk factor for caries and periodontal disease; fixed orthodontic appliances compound the problem. AIM: to evaluate mineralization of tooth enamel and the oral cariogenic microbiota of mouth breathers that are using maxillary expanders. MATERIAL AND METHOD: a prospective study of 20 mouth-breathing patients with maxillary atresia, aged from 09 to 13 years. Enamel mineralization was measured using a fluorescence technique, before installing the expander and after its removal. The cariogenic microbiota was evaluated by the No Caries®. The t test (p<0.05) was applied for the statistical analysis, and the oral microbiota was analyzed by incidence. RESULTS: there was a statistically significant difference in the enamel mineralization level after maxillary expansion; the mean value was 3.08. The colorimetric test showed that the caries development potential was reduced in 45%, increased in 15%, and unaltered in 40% after maxillary expander use. CONCLUSION: there was a statistically significant difference in enamel mineralization after maxillary expansion; this difference was within the clinically normal range; the cariogenic potential increased in a small number of patients during orthodontic treatment.
- ItemSomente MetadadadosEfeito da terapia laser em baixa intensidade em lesões mamilares durante a amamentação(Universidade Federal de São Paulo (UNIFESP), 2013-06-26) Coca, Kelly Pereira [UNIFESP]; Abrao, Ana Cristina Freitas de Vilhena Abrao [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Pain and nipple trauma are common problems and an important obstacle to successful breastfeeding, occurring on the first days after birth and considered as the main causes of early weaning. Objective: Analyze the effect of low-level laser therapy on pain and tissue repair of nipples during breastfeeding. Method: Randomized double-blind controlled clinical trial with 59 women with nipple trauma hospitalized at a university hospital in São Paulo, 29 of them belonging to the Control group and 30 to the Intervention group. The independent variable was low-level laser (InGaAIP, 660nm, red, visible, 40 mW) at the fluency of 5J/cm2, 3 irradiations (ETotal= 0.6 J/) every 24 hours from inclusion to hospital discharge. The outcome variables were: pain, evaluated through the Visual Analog Scale, and tissue repair, assessed according to clinical parameters of tissue repair: healthy nipple, tissue color, presence of hyperemia, exudate, border condition and area in cm2. The project was approved by the Research Ethics Committee of the Federal University of São Paulo. For data analysis, mean, median and standard deviation at 95% confidence interval were calculated for numerical variables, using chi-squared test, Fisher’s exact test and Student’s t-test; paired t-test was used in the comparison of groups between the periods, and the analysis of variance was used in the repeated measurement. All statistical analyses considered the level of significance was 0.05, using SPSS version 17.0. Results: Regarding the feed observation variables, both Control and Intervention groups were similar. The use of lowlevel laser, InGAlP 660nm, 40mW, with irradiation of 3 points of 5 J/cm2 5 seconds (ETotal = 0.6 J) at the nipple trauma, reduced the pain by 2.0 scores while feeding, immediately after the intervention, within the first 24 hours. In the qualitative evaluation, mild pain was more frequent in the Intervention group. The proposed dose was not effective to reduce pain in 12-hour intervals between irradiations. Regarding tissue repair, the clinical parameters analyzed (tissue color, presence of edema, exudate, border condition and trauma area) did not show any statistical difference between the groups, although the Intervention group presented a more favorable behavior than the Control group. Conclusion: The results obtained in the trial allowed to conclude that a woman with nipple trauma treated with low-level laser presents reduced nipple pain and no alteration to nipple tissue repair of breastfeeding mothers. Laser may be a great ally in therapy to 125 breastfeeding mothers, who have nipple pain in this period, providing relief and extended exclusive breastfeeding. Descriptors: Nipples/trauma. Breastfeeding. Lasers. Clinical Trial. Obstetrical Nursing.
- ItemSomente MetadadadosLaser de diodo 975 (nm) no tratamento fototermico da flacidez cervicofacial(Universidade Federal de São Paulo (UNIFESP), 2016-10-31) Wolfenson, Moises [UNIFESP]; Ferreira, Lydia Masako Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction:.New devices have been developed to repair deformities in cervicofacial region by means of photothermal effect of laser radiation. Objective: To evaluate the fototermólise laser therapy 975 ? (nm) on sagging skin on the face and neck. Methods: This is a prospective interventional only center study. Forty two postmenopausal women were included, submitted to photo-thermal diode laser therapy to correct sagging on cervical-facial region. The laser fluency was 3 kj/100 cm² in skin used as security parameter to calculate the ideal cumulative energy for the regions treated. Direct antropometry was performed as: four cervico-facial lines were measured before, immediately after and after three months, with a caliper. The measurements were compared through Wilcoxon test. Fifteen patients underwent biopsies by needling of regions with sagging, before and 90 days after the laser. These tissue was subjected to morphometry and compared by Wilcoxon test. Results: A significant retraction of the skin was observed in all patients three months after the procedure, with reduction of length of four cervical-facial lines (p<0.001). The results of the morphometries indicated quantitative increase of collagens I and III in the treated regions (p<0.001). Conclusion: The use of a laser diode ?975 resulted in reduction of sagging skin.
- ItemAcesso aberto (Open Access)Laser e luz pulsada de alta energia: indução e tratamento de reações alérgicas relacionadas a tatuagens(Sociedade Brasileira de Dermatologia, 2004-12-01) Sacks, Tatiana; Barcaui, Carlos [UNIFESP]; Sociedade Brasileira de Dermatologia; Universidade Federal de São Paulo (UNIFESP)The authors describe two cases of allergic reactions related to tattoos, in which laser and intense pulsed light had an important role in inducing and treating these allergic reactions. In the first case, the patient developed eczematous lesions at the site of the red pigment used in tattooing. After several unsuccessful therapeutic attempts, intense pulsed light was used. It successfully removed the red pigment and treated the allergy symptoms. In the second case, the authors describe a case of anaphylactic reaction precipitated by the long pulse Nd:YAD laser.
- ItemSomente MetadadadosPhotodynamic therapy for acne vulgaris: A critical review from basics to clinical practice Part I. Acne vulgaris: When and why consider photodynamic therapy?(Elsevier B.V., 2010-08-01) Sakamoto, Fernanda H. [UNIFESP]; Lopes, Jose Daniel [UNIFESP]; Anderson, R. Rox; Harvard Univ; Universidade Federal de São Paulo (UNIFESP)The first-line treatments for acne vulgaris are conventional topical and/or oral medications. However, many patients have contraindications, only partial response, significant adverse effects, or recurrence. Light-based treatments and photodynamic therapy (PDT) using topical precursors of porphyrins are off-label alternative treatments for acne vulgaris, with their own advantages and disadvantages. To date, there is no consensus on PDT methodology and parameters. An understanding of pathophysiology of acne, light tissue interactions, and PDT mechanisms of action is helpful whenever PDT is considered as an alternative treatment. in general, blue light alone improves acne because of its antiinflammatory effects. PDT using 5-aminolevulenic acid (ALA) or ALA derivatives induces transient antimicrobial and antiinflammatory effects. At high doses, red light PDT may induce inhibition or destruction of sebaceous glands, resulting in clinical improvement. (J Am Acad Dermatol 2010;63:183-93.)
- ItemSomente MetadadadosPhotodynamic therapy for acne vulgaris: A critical review from basics to clinical practice Part II. Understanding parameters for acne treatment with photodynamic therapy(Elsevier B.V., 2010-08-01) Sakamoto, Fernanda H. [UNIFESP]; Torezan, Luis; Anderson, R. Rox; Harvard Univ; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Photodynamic therapy requires a photosensitizer, oxygen, and activating light. for acne, pilosebaceous units are target structures. Porphyrins are synthesized in vivo from 5-aminolevulinic acid (ALA), particularly in pilosebaceous units. Different photosensitizers and drug delivery methods have been reported for acne treatment. There are a variety of porphyrin precursors with different pharmacokinetic properties. Among them, ALA and methyl-ester of ALA (MAT.) are available for possible off-label treatment of acne vulgaris. in addition, various light sources, light dosimetry, drug incubation time, and pre- and posttreatment care also change efficacy and side effects. None of these variables has been optimized for acne treatment, but a number of clinical trials provide helpful guidance. in this paper, we critically analyze clinical trials, case reports, and series of cases published through 2009. (J Am Acad Dermatol 2010;63:195-211.)
- ItemSomente MetadadadosUpdate on Laser Photochemotherapy: An Alternative for Cancer Treatment(Bentham Science Publ Ltd, 2011-10-01) Paiva, Marcos Bandiera [UNIFESP]; Joo, Jayne; Abrahão, Márcio [UNIFESP]; Ribeiro, Joao Carlos [UNIFESP]; Cervantes, Onivaldo [UNIFESP]; Sercarz, Joel A.; Univ Calif Los Angeles; Universidade Federal de São Paulo (UNIFESP); Univ Calif DavisAlthough major progress has been made in surgery, radiation, and chemotherapy for the treatment of malignancy during the last 20 years, there has been little improvement in the survival of patients with recurrent or advanced head and neck cancer. Because of the ease and accessibility for surgery and their loco-regional biological behavior, head and neck cancers serve as an ideal model to test combined laser energy delivered via interstitial fiberoptics and chemotherapeutic agents activated by photo-thermal energy as an alternative, less invasive treatment for cancer. A number of investigators have shown that anthracyclines and cisplatin are likely candidates for light or heat activation in cancer cells. Maximum tolerated dose followed by photochemical and thermal activation via laser fiberoptics can improve treatment by sensitizing tumor response. The higher intratumor drug levels compared to systemic drug administration along with laser activation should also reduce systemic toxicity. In this article the authors analyze the concept of combining anti-cancer drugs and laser therapy and review the clinical application. In summary, the literature available suggests photochemotherapy with currently approved drugs and lasers may soon become an attractive alternative for cancer treatment.