Fotobiomodulação associada a cosméticos: percepção de profissionais sobre melhora de flacidez e hiperpigmentação genital / Photobiomodulation associated with cosmetics: perception of professionals on the improvement of flaccidity and genital hyperpigmentation

INTRODUÇÃO: A fotobiomodulação associada a cosméticos despigmentantes e rejuvenescedores tem mostrado benefícios na melhora da flacidez e hiperpigmentação genital em mulheres. OBJETIVO: O objetivo do estudo foi descrever a percepção de profissionais acerca da melhora de flacidez e hiperpigmentação genital tratados por fotobiomodulação associada a cosméticos. MÉTODO: O estudo evidenciou percepção de melhora no aspecto geral, flacidez e pigmentação genital com uso da terapêutica proposta. RESULTADOS: Amostra composta por dez mulheres submetidas a quatro sessões de tratamento. A análise dos profissionais foi mediante a comparação dos registos fotográficos de antes e depois do tratamento da região genital. CONCLUSÃO: No entanto, é necessário que novos modelos de avaliação para evidenciar a efetividade terapêutica para tratamentos de flacidez e discromias na região genital sejam desenvolvidos ampliando assim os métodos de avaliação para além da percepção de melhora do aspecto geral.

INTRODUCTION: Photobiomodulation associated with depigmenting and rejuvenating cosmetics has shown benefits in improving sagging and genital hyperpigmentation in women. OBJECTIVE: The aim of the study was to describe the perception of professionals about the improvement of sagging and genital hyperpigmentation treated by photobiomodulation associated with cosmetics. METHOD: The study showed a perception of improvement in the general appearance, sagging and genital pigmentation with the use of the proposed therapy. RESULTS: Sample composed of ten women submitted to four treatment sessions. The analysis of the professionals was by comparing the photographic records of before and after the treatment of the genital region. CONCLUSION: However, it is necessary that new evaluation models to evidence the therapeutic effectiveness for treatments of flaccidity and dyschromias in the genital region are developed, thus expanding the evaluation methods beyond the perception of improvement in the general aspect.

O efeito do laser de baixa potência no tratamento de úlceras venosas avaliado pela Nursing Outcomes Classification (NOC): ensaio clínico randomizado / The effect of low-power laser in the treatment of venous ulcers evaluated by the Nursing Outcomes Classification (NOC): randomized clinical trial

Introduction: The healing and maintenance of tissue integrity of the venous ulcer (VU) consists of a cascade of cellular and molecular events that interact with each other for tissue regeneration to occur. Its treatment depends on the association of different mechanisms through the application of topical products and the use of compressive therapy. Despite technological advances related to the supply and development of technological coverage, there is still no effective impact on the incidence of these injuries, which has high financial costs and damages to patients. Currently, Low-level Laser Therapy (LLLT) has been used to accelerate the cicatricial process in different lesions thanks to its biostimulatory and anti-inflammatory action, which allows its use in VU. In order to guide the choice of the most appropriate treatment, however, an accurate evaluation of the lesion is essential. Nursing Outcomes Classification (NOC) has the results which allow the evaluation of the effect of treatment through clinical indicators. Objective: To compare the effect of adjunctive treatment of LLLT with the conventional treatment in tissue repair of venous ulcer in patients at the Outpatient Nursing clinic. Method: Randomized clinical trial performed at a Brazilian university hospital. The sample consisted of 40 patients with VU, equally randomized to the Control Group (CG) and Intervention Group (GI). Patients were followed up at a weekly nursing visit for 16 weeks or until the lesion was healed. GC received conventional treatment with topical dressings and compressive therapy, while GI was added to TLBP as an adjuvant. An energy dose of 1 to 3 J / cm 2 was used with an AsGalaser laser, with a wavelength of 660 nm. The application occurred punctually at the edges and scanning method in the lesion bed. The wound healing process was evaluated in both groups by eight clinical indicators of Wound healing: second intention (1103): Decreased wound size, Scar formation, granulation, Exudate, Fow wound odor, Macerated skin, Surrounding skin erythema and Periwound edema. The evaluation also occurred from six outcome indicators Tissue integrity: skin and mucous membranes (1101): Thickness, Hydration / Skin flaking, Abnormal Pigmentation, Pruritus, Pain and Necrosis. The analysis took into account the 5-point Likert scale, in which 1 corresponds to the worst score and 5 to the most desirable, using the Generalized Estimating Equation. The study was approved by the Ethics Committee (15-0634). Results: The mean age was 64.55 ± 11.69 years for GC and 63 ± 12.25 for GI. In the CG, 17 (85%) patients were male, whereas in GI female patients prevailed with 11 (55%) patients, generating the only statistically significant difference (p = 0.019) between the groups. The white color (16-80%) and schooling at the level of functional illiterate (15-75% in CG and 12- 63,2% in IG) prevailed in the groups. Regarding wound time, 40% of patients in both groups have one to five years. Eighty-two wounds were evaluated, 39 of GC and 43 of GI, resulting in 1066 consultations, of which 551 occurred in GC and 515 in GI. Regarding wound healing: second intention (1103), GC started with a mean score of 2.87 ± 0.35 and, at the end of the study, presented 4.21 ± 0.60, while GI started with 2.67 ± 0.46 and reached 4.46 ± 0.47 (p = 0.025). There was a statistically significant difference in the comparison between the groups in four of the eight indicators: Granulation (p = 0.010), Decreased wound size (p = 0.010), Scar formation (p = 0.034) and Exudate (p = 0.011). Regarding the Outcome Tissue integrity: skin and mucous membranes (1101), GC started with a mean score of 3.74 ± 0.38 and reached 4.27 ± 0.46 in the last visit, while the GI started with 3.43 ± 0.42 and reached 4.29 ± 0.44. In 11 the analysis of the six indicators of the NOC result, a statistically significant difference was observed in three of them: Abnormal pigmentation (p = 0.008), Thickness (p = 0.010) and Hydration / Skin flaking (p = 0.015) in the comparison between groups. Regarding the conventional treatment, grouped in action class, the CG prevailed enzymatic debridement (17.8%), dressings for infection control (52.8%) and topical agents for maintenance of the humid environment (52.7%). In the GI, dressings for exudate control (9.0%), topical agents for edge protection (31.3%) and perlesional skin (104.2%) emerged. In LLLT the red laser was used, with the mode of irradiation sweeping predominantly in the ulcer bed (97.7%), with an average time of one minute, in the power of 30mW. The mode of point irradiation was used at the edges of the lesion, with a predominance (61.8%) of 10 points, at a distance of one cm each, with energy of 1J/cm2. This mode was also used in the perilesional area, however, with an energy of 21J / cm2. Conclusion: LLLT is an effective adjuvant treatment for tissue regeneration of VU and confirms the clinical indicators of NOC outcome.

Tratamiento del herpes simple labial con laser de baja potencia / Treatment of herpes simplex labialis with low power laser therapy

Introducción: El herpes simple es causado por Herpes virus hominis, que produce una afección eruptiva aguda de uno o mßs grupos de vesículas sobre una base eritematosa; puede localizarse en cualquier parte del cuerpo preferentemente en la boca y los genitales precedida y acompa±ada de ardor y prurito. Objetivos: Se evaluó la efectividad del tratamiento con lßser de baja potencia en relación al tratamiento convencional según la evolución clínica, desaparición de síntomas y signos en los pacientes con herpes simple labial. Metodología: La muestra comprendió 60 pacientes que asistieron a la consulta de dermatología por dicha entidad, en cuatro policlínicos de la capital cubana en el transcurso del a±o 2006. Se llevó a cabo un estudio explicativo de tipo experimental y prospectivo, donde se aplicaron dos tipos de tratamientos, el convencional con aciclovir por vía oral y tópica y el lßser de baja potencia, como único tratamiento. Resultados: Hubo predominio del sexo femenino con 78.3%; el grupo de edad mßs afectado estaba entre 28 y 37 a±os (45.5%), la media del número de sesiones necesarias para la desaparición de síntomas y signos en el tratamiento convencional fue 7.3 sesiones mientras que en el tratamiento con lßser fue 5.2 sesiones y se pudo evidenciar que sí existen diferencias estadísticamente significativas entre las medias de ambos tratamientos; en cuanto a la evolución clínica ambos tratamientos tuvieron mayor porcentaje de pacientes curados. Se recomienda evaluar a largo plazo la presencia de recidivas y que se utilice esta técnica como una opción de tratamiento para mejorar la calidad de vida de los pacientes afectados.

Introduction: Herpes simplex is caused by Herpes virus hominis, producing an acute eruptive affection marked by groups of vesicles on the skin, often on the borders of the lips or nares (cold sores) or on the genitals (genital herpes); it often accompanies fever (fever blisters, herpes febrilis). Objective: Effectiveness of the treatment with low power laser therapy was evaluated against the conventional treatment in people assisting to the clinical evolution, disappearance of symptoms and signs in patients with herpes simplex labialis. Methods: The sample was constituted by 60 patients attending the consultation of dermatology for this entity, in four policlinics of the Cuban capital during 2006. It was carried out an explanatory study of experimental and prospective type; two types of treatments were applied, the conventional with acyclovir (either oral or topically) and low power laser therapy (unique treatment). Results: Women prevalence was high 78.3%; the affected age group was 28 and 37 years (45.5%); disappearance of symptoms and signs in the conventional treatment needed 7.3 sessions, while laser therapy needed 5.2 sessions. There were statistically significant differences between both treatments; as for the clinical evolution both treatments had higher percentage of cured patients. It is recommended to evaluate in long periods the presence of relapses and that it is used this treatment technique like an option of treatmentÆs alternatives to improve the quality of patientsÆ lives.