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ABSTRACT BACKGROUND AND OBJECTIVES: Osteoarthritis is an inflammatory and degenerative joint disease, causing pain, musculoskeletal disorders and impact on functionality, daily life activities and quality of life. The action of physical agents by means of deep heating seems to be an alternative to treat such disease. This study aimed at verifying the effects of deep heating on osteoarthritis patients. CONTENTS: A systematic review was carried out in Medline, Scielo and LILACS databases as from keywords "Osteoarthritis", "Induced Hyperthermia", "Physiotherapy" and "Ultrasound", and other keywords such as "Deep heat", "Microwaves" and Short-waves", in Portuguese, English and Spanish, in the period from January 2005 to January 2016, and 986 articles were found. Initially, 16 potentially relevant articles were selected for the study and, after a judicious qualitative analysis, nine complete articles meeting inclusion criteria were selected. CONCLUSION: Physical deep heating physical agents (ultrasound, short-waves diathermy and microwaves) were beneficial to manage pain and other variables in individuals with osteoarthritis in different levels of severity, especially in the long term. However, these effects are better observed when applied simultaneously with kinesiotherapy.
RESUMO JUSTIFICATIVA E OBJETIVOS: A osteoartrite é uma doença articular inflamatória e degenerativa, que provoca dor, agravos osteoarticulares e impacto na funcionalidade, nas atividades de vida diária e na qualidade de vida. A ação de agentes físicos por meio do calor profundo parece ser uma alternativa no tratamento dessa doença. O objetivo deste estudo foi verificar os efeitos do calor profundo em indivíduos com osteoartrite. CONTEÚDO: Realizou-se uma revisão sistemática nas bases de dados Medline, Scielo e LILACS, a partir dos descritores "Osteoartrite", "Hipertermia Induzida", "Fisioterapia" e "Ultrassom" e outras palavras-chaves como "Calor profundo", "Micro-ondas" e "Ondas curtas", nas línguas portuguesa, inglesa e espanhola, no período de janeiro de 2005 a janeiro de 2016. Encontraram-se 986 artigos. Inicialmente, 16 artigos potencialmente relevantes foram selecionados para o estudo, e, após uma análise qualitativa criteriosa, selecionaram-se 9 artigos completos que preencheram os critérios de inclusão exigidos. CONCLUSÃO: Os agentes físicos em forma de calor profundo (ultrassom, diatermia por ondas curtas e micro-ondas) ofertam benefícios no manuseio da dor e outras variáveis em indivíduos com osteoartrite em diferentes graus de acometimento, especialmente no longo prazo. Contudo, esses efeitos são mais bem observados quando aplicados em concomitância à cinesioterapia.
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PURPOSE: A prospective phase II trial was conducted to evaluate the effectiveness and toxicity of regional hyperthermia and whole liver irradiation (WLI) for numerous chemorefractory liver metastases from colorectal cancer. MATERIALS AND METHODS: Enrolled patients had numerous chemorefractory hepatic metastases from colorectal cancer. Five sessions of hyperthermia and seven fractions of 3-gray WLI were planned. Health-related quality of life (HRQoL) was determined using the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire C-30 and the Functional Assessment of Cancer Therapy-Hepatobiliary version 4.0. Objective and pain response was evaluated. RESULTS: A total of 12 patients consented to the study and the 10 who received WLI and hyperthermia were analyzed. WLI was completed as planned in nine patients and hyperthermia in eight. Pain response was partial in four patients and stable in four. Partial objective response was achieved in three patients (30.0%) and stable disease was seen in four patients at the 1-month follow-up. One patient died 1 month after treatment because of respiratory failure related to pleural metastasis progression. Other grade III or higher toxicities were detected in three patients; however, all severe toxicities were related to disease progression rather than treatment. No significant difference in HRQoL was noted at the time of assessment for patients who were available for questionnaires. CONCLUSION: Combined WLI and hyperthermia were well tolerated without severe treatment-related toxicity with a promising response from numerous chemorefractory hepatic metastases from colorectal cancer.
Subject(s)
Humans , Colorectal Neoplasms , Disease Progression , Fever , Follow-Up Studies , Hyperthermia, Induced , Liver , Neoplasm Metastasis , Prospective Studies , Quality of Life , Radiotherapy , Respiratory InsufficiencyABSTRACT
A healthy 48 year-old man became unconscious suddenly, with a corporal temperature of 43ºC when participating in a strenuous motorcycle off-road competition in the last 2 days in southeastern Brazil on a very hot and humid summer. Once the first 6 hours of in-hospital he had dysfunction of several organ and systems. During the following days, he developed fulminant hepatic failure (FHF), disseminated intravascular coagulation, rhabdomyolysis and multiple organ failure. Despite the use of immediate conventional core body temperature control methods and support of organsystem function, the patient died on 11th day. Autopsy findings: there was significant jaundice impregnation, petechial and hemorrhagic suffusions in the skin and in visceral organs as well as generalized edema. The microscopic exam showed cytotoxic and vasogenic brain edema and encephalic death. The liver and the pancreas were diffusely necrotic and hemorrhagic, besides rhabdomyolysis, cardiac failure and acute tubular necrosis in the kidneys. The immunohistochemistry exam showed diffuse liberation in the lung and other viscera tissue of tumor necrosis factor- (TNF). In spite of being a rare occurrence, FHF should be included in the complications induced by exertion and commonly progresses to death.
ABSTRACT
La hipertermia hídrica se ha utilizado para tratamientos de diversas formas de cáncer, en hueso aún no se ha determinado cuál es su efecto; se realizó este estudio prospectivo para demostrar los cambios estructurales y metabólicos y los efectos en la consolidación de hueso expuesto a hipertermia hídrica. Se utilizaron 30 conejos de raza New-Zealand. Con peso entre 2.8 y 3.2 kg divididos en 9 grupos y 3 subgrupos, se realizó osteotomía en el tercio medio del fémur derecho; este segmento fue expuesto a hipertermia a 15, 20 y 25 grados centígrados, durante 50, 60 y 70 minutos, gammagrafía ósea cada cuatro semanas y radiográficos cada semana hasta la semana 13. Para el análisis estadístico se utilizó la prueba de post-hoc y test de Tukey, encontrando diferencias en las concentraciones de elementos químicos a temperaturas superiores a 60 grados durante 20 minutos con significancia estadística, retardo en la consolidación y evidencia de actividad metabólica. Se concluye que con la exposición a temperaturas de 60 grados durante 20 minutos se presentaron alteraciones morfológicas en potasio, magnesio, azufre y fósforo y retardo en la consolidación ósea. Estos resultados son usados como parámetros para el tratamiento con hipertermia hídrica controlada en tumores óseos.
Fluid hyperthermia has been used to treat various types of cancers, but its effects on bone have not been determined. The purpose of this prospective study was to show the structural and metabolic changes of bone exposed to fluid hyperthermia and the effects of the latter on bone healing. Thirty New Zealand rabbits were used, weighting 2.8-3.2 kg; they were divided into 9 groups and 3 subgroups. An osteotomy was performed in the mid third of the right femur and this segment was exposed to hyperthermia at 15, 20 and 25 degrees centigrade for 50, 60 and 70 minutes. A bone scan was performed every 4 weeks and X-rays were taken every week up to week 13. The post-hoc Tukey test was used for the statistical analysis. Differences were found in the concentration of chemicals at temperatures above 60 degrees for 20 minutes with statistical significance; bone healing was delayed and there was evidence of metabolic activity. We conclude that exposure to temperatures above 60 degrees for 20 minutes resulted in morphologic alterations in potassium, magnesium, sulfur and phosphorus, and delayed bone healing. These results are used as parameters for the treatment of bone tumors with fluid hyperthermia.
Subject(s)
Animals , Rabbits , Bone and Bones/metabolism , Hyperthermia, Induced/methods , Bone and Bones/chemistryABSTRACT
É relatado um caso de retinoblastoma de aparecimento tardio, com características pouco freqüentes, com o objetivo de melhorar o controle da afecção. Em 1993, SJMMF, nove meses, masculino, leucodermo, apresentou tumor na retina esquerda. O paciente tinha história familiar de retinoblastoma. A enucleação foi realizada, comprovando-se retinoblastoma. Os exames para estadiamento sistêmico foram normais. O olho direito evoluiu normal por dez anos. Em exame de rotina, foram constatadas três lesões de retinoblastoma na retina nasal. Foi feita termoterapia transpupilar, com laser de diodo de 810 nm. Após 30 dias, as lesões regrediram. Após 60 dias houve recidiva na borda da lesão, onde foi realizada crioterapia transescleral, com regressão do tumor por seis meses. Durante o controle, observaram-se condensações próximas à lesão tumoral atrófica (sementes vítreas). Foi feito braquiterapia com Iodo125, havendo desaparecimento das mesmas após 30 dias. Novas sementes surgiram três meses pós-braquiterapia, depositadas na superfície retiniana, sendo tratadas com crioterapia transescleral e termoterapia transpupilar, havendo regressão. O paciente evoluiu com nova semente vítrea após seis meses, a qual, após depositar-se na superfície da retina, foi tratada com termoterapia transpupilar. Está em seguimento há 38 meses desde o aparecimento do tumor bilateral, mantendo acuidade visual de 20/20 e exames clínicos normais. Considera-se importante este caso pela pouca freqüência de aparecimento da doença nesta idade. Julga-se necessário o alerta para os casos de retinoblastoma já considerados curados.
A case of retinoblastoma with uncommon features is reported, aiming at improving follow-up. In 1993, SJMMF, 9-month-old white boy, presented a squint in the left eye. A retinal tumor was detected. The patient had a family history of retinoblastoma. Enucleation was performed and retinoblastoma was proved. The patient underwent examination for staging, all were normal. The fellow eye remained normal for 10 years. During routine examination the retina map revealed three retinoblastoma white lesions in the nasal retina. The patient underwent transpupillary thermotherapy with diode laser. After 30 days, the lesions became atrophic. After 60 days there was tumor recurrence on the border of the lesion. Sclera cryotherapy was performed. There was tumor regression for six months. During follow-up, condensations next to the atrophic tumor lesions were discovered, which were vitreous seeds. Brachitherapy with 125 iodine was done. The lesions disappeared after 30 days. New vitreous seeds appeared 3 months later, set on the retina surface. They were blocked with sclera cryotherapy and transpupillary thermotherapy. The patient presented with new vitreous seeds after six months, which adhered to the retina. They were blocked with transpupillary thermotherapy. Follow-up was for 38 months since the appearance of the bilateral tumor. The patient presents normal visual acuity and clinical examination. This case is important considering the low frequency of the disease at this age. It is essential to maintain alertness when cases of retinoblastoma are seen as cured.
Subject(s)
Humans , Infant , Male , Neoplasm Recurrence, Local , Retinal Neoplasms , Retinoblastoma , Brachytherapy , Cryotherapy , Eye Enucleation , Laser Therapy , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/therapy , Retreatment , Retinal Neoplasms/diagnosis , Retinal Neoplasms/surgery , Retinal Neoplasms/therapy , Retinoblastoma/diagnosis , Retinoblastoma/surgery , Retinoblastoma/therapyABSTRACT
OBJECTIVE: To evaluate the recovery of semen quality in a cohort of infertile men after known hyperthermic exposure to hot tubs, hot baths or whirlpool baths. MATERIALS AND METHODS: A consecutive cohort of infertile men had a history remarkable for wet heat exposure in the forms of hot tubs, Jacuzzi or hot baths. Clinical characteristics and exposure parameters were assessed before exposure was discontinued, and semen parameters analyzed before and after discontinuation of hyperthermic exposure. A significant seminal response to withdrawal of hyperthermia was defined as > 200 percent increase in the total motile sperm count (TMC = volume x concentration x motile fraction) during follow-up after cessation of wet heat exposure. RESULTS: Eleven infertile men (mean age 36.5 years, range 31-44) exposed to hyperthermia were evaluated pre and post-exposure. Five patients (45 percent) responded favorably to cessation of heat exposure and had a mean increase in total motile sperm counts of 491 percent. This increase was largely the result of a statistically significant increase in sperm motility from a mean of 12 percent at baseline to 34 percent post-intervention (p = 0.02). Among non-responders, a smoking history revealed a mean of 5.6 pack-years, compared to 0.11 pack-years among responders. The prevalence of varicoceles was similar in both cohorts. CONCLUSIONS: The toxic effect of hyperthermia on semen quality may be reversible in some infertile men. We observed that the seminal response to exposure elimination varies biologically among individuals and can be profound in magnitude. Among non-responders, other risk factors that could explain a lack of response to elimination of hyperthermia should be considered.
Subject(s)
Humans , Male , Adult , Baths/adverse effects , Hot Temperature/adverse effects , Infertility, Male/etiology , Semen/physiology , Sperm Motility/physiology , Cohort Studies , Retrospective Studies , Sperm CountABSTRACT
Objective To explore the inhibition effects and mechanics of nano-magnetoliposomes containing As_2O_3 (NMLA) combined with magnetic fluid hyperthermia on xenograft cervical carcinoma in nude mice. Methods After establishment of xenograft cervical carcinoma models in nude mice, nano-liposomes containing As_2O (NLA group), nano-magnetoliposomes (NML group) and NMLA (NMLA group) were injected into the xnograft cervical carcinoma, respectively, and all nude mice were exposed to AMF for three times. The inhibitive ratios (IR) of the tumors, apoptosis index (AI), proliferation index (PI) and the expression of Bcl-2 and Bax proteins were measured, as well as the function of liver and kidney. Results IRs in NLA, NML and NMLA groups were 57.06% (P0.05). The obvious necrosis was observed in the tumor tissues in NLA, NML and NMLA groups, but not in the peripheral tissues of the tumors and the visceras. Conclusion NMLA, without toxicity of liver and kidney, might be a desirable composite carrier of targeted treatment with chemotherapy and thermotherapy simultaneously.
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Objective To study the in vitro heating ability of Ni-Cu thermoseeds and their effect on the rabbit liver cells and tissues. Methods The temperature of rabbit liver tissues were monitored under an alternating magnetic field.MTT assay was used to evaluate the in vitro cytotoxicity of the extra-liquid of the Ni-Cu thermoseeds;Hemolytic test was carried out to estimate its blood toxicity;and muscular implantation test was employed to determine the levels of its tissue toxicity.Results The thermoseeds used in this experiment showed a high heating ability in alternating magnetic field in vitro.MTT assay showed that the toxicity of the material on mouse fibroblast(L-929) cell lines was 1 degree,which means non-cytotoxic.Hemolytic test revealed a hemolysis rate(HR) of 3.25%(less than 5%),showing that the thermoseeds had no hemolytic reaction.Muscular implantation test showed different levels of inflammatory reaction in the muscle tissues.Conclusion Thermoseeds induced heating in alternating magnetic field can achieve an appropriate temperature,and the gilded thermoseeds have a high biocompatibility with 1 degree cytotoxicity without leading to hemolytic reaction.