Láser de baja potencia como alternativa terapéutica al eritema multiforme idiopático. Informe de caso

El eritema multiforme es una enfermedad aguda de la piel y/o de las mucosas de naturaleza inmunológica, siendo está de etiología desconocida. Solo el 20% de los casos se dan en niños. El diagnóstico se basa en la historia clínica y el examen físico y el tratamiento no está sistematizado. La terapia con láser de baja potencia está siendo cada vez más utilizada en el campo estomatológico. El objetivo fue evidenciar los beneficios del láser de baja potencia como alternativa terapéutica. Este caso corresponde a un paciente de 10 años de edad, que acudió a la cátedra de Patología Bucal de la Facultad de Odontología de la Universidad Nacional de Asunción (UNA), derivado del Hospital General de Barrio Obrero con antecedentes de internación por presentar lesiones erosivas en labios, boca y máculas en toráx, abdomen, orejas y miembros. En el examen intraoral costras serohemáticas negruzcas en labios, lesiones ulceradas en lengua, piso de boca, paladar duro y mucosa yugal. Se procedió a hacer una lavado de la zona con agua oxigenada, en las áreas afectadas se colocó azul de metileno al 0,01% por 5 minutos, y para la aplicación de laserterapia se realizó una única sesión. El paciente mostró gran evolución a las 24 horas de la aplicación del tratamiento. A los 8 días estaba sin lesiones y asintomático. La fotobioestimulación a nivel celular que ofrece el láser de baja potencia es una herramienta verosímil que se suma a nuevas opciones terapéuticas.

Erythema multiforme is an acute disease of the skin and/or mucous membranes of an immunologic nature, the etiology of which is unknown. Only 20% of cases occur in children. Diagnosis is based on clinical history and physical examination and treatment is not systematized. Low power laser therapy is being increasingly used in the stomatological field. The objective was to demonstrate the benefits of low power laser as a therapeutic alternative. This case corresponds to a 10-year-old patient, who came to the Department of Oral Pathology of the Faculty of Dentistry of the National University of Asuncion (UNA), referred from the General Hospital of Barrio Obrero with a history of hospitalization for presenting erosive lesions on the lips, mouth and macules on the thorax, abdomen, ears and limbs. In the intraoral examination, blackish serohematic crusts on the lips, ulcerated lesions on the tongue, floor of the mouth, hard palate and jugal mucosa. The area was washed with hydrogen peroxide, methylene blue 0.01% was applied to the affected areas for 5 minutes, and only a single session was performed for the application of the laser therapy. The patient showed great evolution 24 hours after the application of the treatment. After 8 days he was completely free of lesions and asymptomatic. The photo-biostimulation at the cellular level offered by the low power laser is a credible tool that adds to new therapeutic options.

O eritema multiforme é uma doença aguda da pele e/ou mucosas de natureza imunológica, cuja etiologia é desconhecida. Apenas 20% dos casos ocorrem em crianças. O diagnóstico é baseado na história clínica e no exame físico. O tratamento não é sistematizado. A terapia laser de baixa potência é cada vez mais utilizada no campo estomatológico. O objectivo foi demonstrar os benefícios do laser de baixa potência como uma alternativa terapêutica. Este caso corresponde a um paciente de 10 anos de idade que veio ao Departamento de Patologia Oral da Faculdade de Odontologia da Universidade Nacional de Asunción (UNA) e foi encaminhado do Hospital Geral do Bairro Obrero com um historial de hospitalização por apresentar lesões erosivas nos lábios, boca e máculas no tórax, abdómen, orelhas e membros. No exame intraoral, crostas serohaemáticas negras nos lábios, lesões ulceradas na língua, chão da boca, palato duro e mucosa jugal. A área foi lavada com peróxido de hidrogénio, azul de metileno 0,01% foi aplicado nas áreas afectadas durante 5 minutos, e foi realizada uma única sessão de laserterapia. O paciente mostrou uma grande evolução 24 horas após a aplicação do tratamento. Após 8 dias, estava completamente livre de lesões e assintomático. A foto-biostimulação a nível celular oferecida pelo laser de baixa potência é uma ferramenta credível que se soma a novas opções terapêuticas.

Láser de baja potencia como alternativa terapéutica al eritema multiforme idiopático. Informe de caso

El eritema multiforme es una enfermedad aguda de la piel y/o de las mucosas de naturaleza inmunológica, siendo está de etiología desconocida. Solo el 20% de los casos se dan en niños. El diagnóstico se basa en la historia clínica y el examen físico y el tratamiento no está sistematizado. La terapia con láser de baja potencia está siendo cada vez más utilizada en el campo estomatológico. El objetivo fue evidenciar los beneficios del láser de baja potencia como alternativa terapéutica. Este caso corresponde a un paciente de 10 años de edad, que acudió a la cátedra de Patología Bucal de la Facultad de Odontología de la Universidad Nacional de Asunción (UNA), derivado del Hospital General de Barrio Obrero con antecedentes de internación por presentar lesiones erosivas en labios, boca y máculas en toráx, abdomen, orejas y miembros. En el examen intraoral costras serohemáticas negruzcas en labios, lesiones ulceradas en lengua, piso de boca, paladar duro y mucosa yugal. Se procedió a hacer una lavado de la zona con agua oxigenada, en las áreas afectadas se colocó azul de metileno al 0,01% por 5 minutos, y para la aplicación de laserterapia se realizó una única sesión. El paciente mostró gran evolución a las 24 horas de la aplicación del tratamiento. A los 8 días estaba sin lesiones y asintomático. La fotobioestimulación a nivel celular que ofrece el láser de baja potencia es una herramienta verosímil que se suma a nuevas opciones terapéuticas.

Erythema multiforme is an acute disease of the skin and/or mucous membranes of an immunologic nature, the etiology of which is unknown. Only 20% of cases occur in children. Diagnosis is based on clinical history and physical examination and treatment is not systematized. Low power laser therapy is being increasingly used in the stomatological field. The objective was to demonstrate the benefits of low power laser as a therapeutic alternative. This case corresponds to a 10-year-old patient, who came to the Department of Oral Pathology of the Faculty of Dentistry of the National University of Asuncion (UNA), referred from the General Hospital of Barrio Obrero with a history of hospitalization for presenting erosive lesions on the lips, mouth and macules on the thorax, abdomen, ears and limbs. In the intraoral examination, blackish serohematic crusts on the lips, ulcerated lesions on the tongue, floor of the mouth, hard palate and jugal mucosa. The area was washed with hydrogen peroxide, methylene blue 0.01% was applied to the affected areas for 5 minutes, and only a single session was performed for the application of the laser therapy. The patient showed great evolution 24 hours after the application of the treatment. After 8 days he was completely free of lesions and asymptomatic. The photo-biostimulation at the cellular level offered by the low power laser is a credible tool that adds to new therapeutic options.

O eritema multiforme é uma doença aguda da pele e/ou mucosas de natureza imunológica, cuja etiologia é desconhecida. Apenas 20% dos casos ocorrem em crianças. O diagnóstico é baseado na história clínica e no exame físico. O tratamento não é sistematizado. A terapia laser de baixa potência é cada vez mais utilizada no campo estomatológico. O objectivo foi demonstrar os benefícios do laser de baixa potência como uma alternativa terapêutica. Este caso corresponde a um paciente de 10 anos de idade que veio ao Departamento de Patologia Oral da Faculdade de Odontologia da Universidade Nacional de Asunción (UNA) e foi encaminhado do Hospital Geral do Bairro Obrero com um historial de hospitalização por apresentar lesões erosivas nos lábios, boca e máculas no tórax, abdómen, orelhas e membros. No exame intraoral, crostas serohaemáticas negras nos lábios, lesões ulceradas na língua, chão da boca, palato duro e mucosa jugal. A área foi lavada com peróxido de hidrogénio, azul de metileno 0,01% foi aplicado nas áreas afectadas durante 5 minutos, e foi realizada uma única sessão de laserterapia. O paciente mostrou uma grande evolução 24 horas após a aplicação do tratamento. Após 8 dias, estava completamente livre de lesões e assintomático. A foto-biostimulação a nível celular oferecida pelo laser de baixa potência é uma ferramenta credível que se soma a novas opções terapêuticas.

Efectividad del láser de baja potencia como terapia adyuvante en pacientes con herpes zóster / Effectiveness of the low power laser as adjuvant therapy in patients with zoster herpes

Introducción: El láser de baja potencia tiene un amplio uso en la práctica médica actual. Existe un gran número de pacientes con afecciones agudas o crónicas que pueden ser tratados con esta terapia, con resultados alentadores, muy superiores a los obtenidos con el uso de la terapéutica convencional. Objetivo: Evaluar la efectividad del láser de baja potencia como terapia adyuvante para reducir el tiempo de respuesta al alivio del dolor en pacientes con herpes zóster. Métodos: Se realizó un estudio cuasiexperimental, de intervención terapéutica, en 21 pacientes con herpes zóster, atendidos en el Servicio de Fisiatría del Policlínico del MININT de Santiago de Cuba, desde enero de 2016 hasta junio de 2017. Se conformaron 2 grupos de forma aleatoria: los integrantes del primero recibieron el tratamiento habitual con aciclovir, vitaminas y analgésico (control); los del segundo, aciclovir, vitaminas y laserterapia (intervención). Resultados: Se observó que en el grupo de intervención la intensidad del dolor fue disminuyendo en relación con la evaluación inicial. Así, en la quinta sesión se apreció mayor porcentaje de pacientes con alivio del dolor que en el grupo control, al igual que en la décima sesión y 21 días después, de ahí la efectividad del tratamiento. Conclusiones: Con el empleo del láser de baja potencia los pacientes con herpes zóster presentaron una mejoría del dolor en menor tiempo, con una respuesta satisfactoria expresada en la totalidad de ellos, por lo que se recomienda su utilización como terapia adyuvante.

Introduction: The low power laser has a wide use in the current medical practice. There is a great number of patients with acute or chronic conditions that can be treated with this therapy, with encouraging results, far better than those obtained with the use of conventional therapy. Objective: To evaluate the effectiveness of low power laser as adjuvant therapy to reduce the response time to pain relief in patients with zoster herpes. Methods: A quasi-experiment study of therapeutic intervention was carried out in 21 patients with zoster herpes. They were assisted in the Physical Medicine Service of the MININT Polyclinic in Santiago de Cuba, from January, 2016 to June, 2017. Two groups were conformed at random: the members of the first one received acyclovir, vitamins and lasertherapy (intervention); those of the second group received acyclovir, vitamins and analgesic (control). Results: It was observed that in the intervention group the intensity of the pain was diminishing in connection with the initial evaluation. This way, in the fifth session it was appreciated a higher percentage of patients with pain relief that in the control group, the same as in the tenth session and 21 days later, hence the effectiveness of the treatment. Conclusions: With the use of low power laser the patients with zoster herpes presented an improvement of the pain in less time, with a satisfactory response expressed in all of them, reason why its use is recommended as adjuvant therapy.

Aplicación del láser de baja potencia para el alivio del dolor en pacientes con tratamiento ortodóncico / Application of low power laser for pain relief in patients with orthodontic treatment

Introducción: El dolor es el principal síntoma que refieren los pacientes después de la colocación y activación de los aparatos ortodóncicos. Objetivo: Evaluar la efectividad del láser de baja potencia en el alivio del dolor en pacientes con tratamiento de ortodoncia. Métodos: Se realizó un estudio cuasiexperimental de intervención terapéutica en 30 pacientes que se encontraban en los inicios de la fase de distalización de los caninos superiores (previa extracción de los primeros premolares de la misma arcada), los cuales fueron atendidos en el Servicio de Ortodoncia del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, de enero a diciembre de 2020. A tal efecto, se conformaron 2 grupos de forma aleatoria, por el orden de llegada, de 15 integrantes cada uno: el de estudio, que fue tratado con láser de baja potencia, y el de control, que recibió paracetamol como analgésico habitual. Para la validación estadística de la información se emplearon el porcentaje y la prueba de la T de Student para muestras independientes, con 95 % de confiabilidad. Resultados: Existieron diferencias significativas en cuanto a la remisión de la intensidad del dolor, pues el síntoma estuvo ausente o en grado leve en todos los integrantes del grupo de estudio luego de tres sesiones terapéuticas (p=0,00), mientras que solo 13,3 % de los pacientes del grupo de control se ubicaron en estas dos categorías. Conclusiones: Se demostró que la terapia alternativa con láser fue más efectiva para paliar el dolor que el paracetamol.

Introduction: The pain is the main symptom that patients refer after placing and activation of the orthodontic appliances. Objective: To evaluate the effectiveness of the low power laser for pain relief in patients with orthodontics treatment. Methods: A quasi-experiment study of therapeutic intervention was carried out in 30 patients that were in the beginnings of the distancing phase of the upper canine teeth (previous extraction of the same arch first premolars), who were assisted in the Orthodontics Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from January to December, 2020. To such an effect, 2 groups were conformed at random, by arrival order, of 15 members each one: the study group that was treated with low power laser, and the control group that received paracetamol as usual analgesic. For the statistical validation of the information the percentage and the Student´s t test were used for independent samples, with 95% of confidence. Results: There were significant differences as for the remission of pain intensity, because absence of this symptom or light pain was observed in all the members of the study group after three therapeutic sessions (p=0.00) while just 13.3 % of the control group patients was located in these two categories. Conclusions: It was demonstrated that the alternative therapy with laser was more effective to palliate the pain than the paracetamol.

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.

The efficacy of ranibizumab combined with 532 laser for treating retinal vein with macular edema complication / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy of intravitreal injection of ranibizumab plus low power 532 laser versus 532 laser alone for treating retinal vein occlusion(RVO)with macular edema complication.<p>METHODS: Retrospective study of 48 patients diagnosed RVO complicated with macular edema from June 2017 to March 2018. Group A of 31 eyes(31 patients)were treated with intravitreal injection of ranibizumab plus low power 532 laser(the power is about 2/3 of the power of group B, about 100-130mw), and group B of 17 eyes(17 patients)were treated with 532 laser(the power is 150-200mw)alone. The best corrected visual acuity(BCVA), foveal retinal thickness(CMT), FFA and fundus were observed both before and after treatment at timepoint of 1mo, 2mo and 3mo between the two groups.<p>RESULTS: In group A, BCVA was 0.84±0.02, 0.49±0.04, 0.29±0.04, 0.26±0.04 before and the 1, 2, 3mo after treatment. In group B, BCVA was 0.85±0.04, 0.58±0.01, 0.53±0.01, 0.53±0.02. The CMT value of group A before and after treatment was 527.5±17.59, 371±17.36, 298.5±32.87, 257.75±17.30μm, respectively. Group B was 535±16.36, 425±24.44, 420.25±17.70, 427.75±17.89μm. Intra-group comparison show statistical differences, group A had lower BCVA and CMT value than group B at the same time point(<i>P</i><0.05). Inter-group comparison with pre-treatment, there was significant difference in BCVA between 1mo, 2mo and 3mo after treatment(<i>P</i><0.05). The CMT and BCVA value from group A are the lowest.<p>CONCLUSION: Both methods are effective in treating RVO with macular edema, improving vision, alleviating ME, and effectively controlling the disease.However, combined treatment can significantly reduce macular edema, improve vision, and be more stable than laser treatment alone.

Analysis of laser therapy effects in Sporothrix schenckii inactivation in vivo

Abstract Introduction Sporotrichosis is a common disease in tropical regions, caused by the fungus Sporothrix schenckii, affecting mainly rural workers and in direct contact with animals. Although treatment by indiscriminate use of oral antifungal drugs gives rise resistant isolates, leading to therapeutic failures and no remission of the disease. To evaluate the effectiveness of red low-power laser photobiomodulation in inactivation of S. schenckii infection induced in rodents. Methods Subcutaneously inoculation (2x103 S. schenckii/ml, 0.2 ml suspension) in the left footpad, in 27 mice divided into: control (n = 6, inoculated, without irradiation): early stage (not inoculated) = 1th biopsy; intermediate (9 weeks of evolution) = 2nd biopsy; final (21 weeks of evolution) = 3th biopsy. Treated (n = 21, inoculated and irradiated): early (13 weeks of evolution, 4 weeks after first irradiation) = 4th biopsy, intermediate (17 weeks of evolution, 8 weeks after first irradiation) = 5th biopsy, final (21 weeks of evolution, 12 weeks after first irradiation) = 6th biopsy. Serial irradiation with biopsies occurred every 30 days during each month, for three months. At the end of testing, the mice were euthanized, and histological analyzes of biopsies were performed. Results Each laser treatment session showed an inactivation of S. schenckii in treated animals compared to controls, with a regression of pseudoepitheliomatous hyperplasia, chronic inflammation, neutrophils, granulomas, giant mononuclear cells and steroid corpuscles. Conclusion The laser photobiomodulation was effective on S. schenckii inactivation, appearing to be an interesting therapeutic option in infections caused by this organism.

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.

Low laser therapy (photobiomodulation) on bacteria of pressure ulcers: in vitro studies / Laser de baixa potência (fotobiomodulação) sobre bacterias de úlceras de pressão: estudos in vitro

Os efeitos biológicos promovidos pelo laser de baixa potência resultam em cicatrização mais rápida das feridas. No entanto, as feridas são sistemas muito complexos, tanto do ponto de vista microbiano quanto do hospedeiro. Como a infecção é uma causa comum de cicatrização retardada, é importante entender o efeito da terapia com laser de baixa intensidade no crescimento bacteriano. Esta mini-revisão resume as evidências atuais sobre os efeitos do laser de baixa intensidade em estudos de bactérias in vitro. (AU)

The biological effects promoted by low power laser result in faster wound healing. However, wounds are very complex systems from both host and microbial point of view. Since infection is a common cause of delayed wound healing, it is important to understand the effect of low-level laser therapy in bacterial growth. This mini-review summaries the current evidence about effects of low level laser on bacteria vitro studies. (AU)

Interações do laser de baixa potência sobre as peroxirredoxinas no processo de reparo: revisão de literatura / Low-power laser interactions on peroxyredoxins in the repair process: literature review

Introdução: uma variedade de estudos vem demonstrando que o laser de baixa potência estimula a osteogênese. Os mecanismos propostos para o efeito bioestimulador do laser envolvem aumento da síntese de ATP e formação de espécies reativas de oxigênio (EROs) pelas mitocôndrias. Estas EROs, incluindo peróxido de hidrogênio, atuam na sinalização celular e influenciam a regulação da expressão gênica, conduzindo a respostas celulares horas ou até mesmo dias após a irradiação. As Peroxirredoxinas (Prxs) constituem uma família de enzimas abundantes capazes de decompor peróxido de hidrogênio. Objetivo: foi realizada uma revisão de literatura acerca dos efeitos bioestimulantes do laser de baixa potência sobre o extresse oxidativo durante o processo de cicatrização. Material e Métodos: foi realizada uma busca nas bases de dados Pubmed e Scielo nos últimos anos, seguindo critérios de inclusão e exclusão pré-determinados, utilizando os termos peroxirredoxina, laser de baixa potência e osteoblastos. Resultados: foram identificados cinquenta artigos com texto completo que se enquadravam nos critérios de inclusão e exclusão. Quanto aos tipos de Peroxirredoxinas, se destacaram as Prxs I e IV. Conclusão: diante das informações colhidas na literatura, concluímos que o mecanismos de ação do laser, induz a formação de EROs, e ainda ressaltamos a importância do estabelecimento de parâmetros seguros na aplicação do laser para que os efeitos desejados, de bioestimulação, sejam alcançados e que sejam evitados os efeitos tóxicos.

Introduction: a variety of studies has shown that low-power laser stimulates osteogenesis. The mechanisms proposed for the biostimulating effect of the laser involve increased ATP synthesis and formation of reactive oxygen species (ROS) by mitochondria. These EROs, including hydrogen peroxide, act on cell signaling and influence the regulation of gene expression, leading to cellular responses at hours or even days after irradiation. Peroxiredoxins (Prxs) constitute a family of abundant enzymes capable of breaking down hydrogen peroxide. Objective: a literature review was carried out on the biostimulating effects of low power laser on oxidative stress during the cicatrization process. Material and Methods: a search of the PubMed and Scielo databases was carried out in recent years, following inclusion and exclusion criteria, using as descriptors peroxirredoxin, low power laser and osteoblasts. Results: fifty full-text articles were identified that fit the inclusion and exclusion criteria. As for the types of Peroxirredoxins, Prxs I and IV were highlighted. Conclusion: In light of the information gathered in the literature, we conclude that the mechanisms of action of the laser induce the formation of EROs, and we also stress the importance of establishing safe parameters in the laser application so that the desired effects of biostimulation are achieved and that toxic effects are avoided.

Laser de baixa potência na periodontia: uma revisão do estado atual do conhecimento / Low power laser in periodontics: a review of knowledge of the current state of knowledge

O uso do laser de baixa potência como instrumento terapêutico vem sendo amplamente incorporado na Medicina e na Odontologia, pois este tem se mostrado um importante auxiliar em tratamento de processos inflamatórios devido à capacidade de imunomodulação dos tecidos. A irradiação com laser excita uma série de moléculas presentes nas mitocôndrias, principalmente os: citocromo c oxidase e superóxido dismutase (NADH), responsáveis pela absorção da luz vermelha e infravermelha. Essas moléculas absorvem a luz e aceleram a transferência de elétrons na cadeia respiratória mitocondrial, aumentando a produção de trifosfato de adenosina (ATP). Devido a essa propriedade, o laser de baixa potência na odontologia é muito bem indicado para as mais diversas especialidades, principalmente na periodontia. Diversos estudos clínicos comprovam que o uso do laser atua como coadjuvante na melhora da resposta inflamatória em diversas situações clínicas como na raspagem subgengival e na reparação de cirurgias periodontais...

The use of low power laser as a therapeutic tool has been widely incorporated in medicine and dentistry, because it has been an important aid in the treatment of inflammatory processes due to its ability of immuno - modulation of tissues . The laser irradiation excites a number of molecules present in the mitochondria especially : cytochrome c oxidase and superoxide dismutase (NADH) responsible for absorption of red and infrared light. These molecules absorb light and accelerate the transfer of electrons in the mitochondrial respiratory chain increasing the production of adenosine triphosphate (ATP). Due to this property, the low-power laser in dentistry is well suited to the most diverse specialties especially in periodontics . Several clinical studies have shown that the use of laser acts as an adjuvant to improve the inflammatory response in many clinical situations such as subgingival scaling and repair of periodontal surgery...

Efeito da laserterapia de baixa potência na inflamação pulmonar em rattus novergicus / Effect of low level laser therapy on lung inflammation in rattus norvegicus

Introdução. A doença pulmonar obstrutiva crônica é uma enfermidade respiratória caracterizada pela presença de obstrução crônica do fluxo aéreo e manifestação inflamatória. Objetivo. Verificar o efeito da laserterapia de baixa potência no tratamento da inflamação pulmonar. Metodologia. Utilizou-se 30 ratos, divididos em três grupos de dez animais: grupo controle (recebeu apenas ar ambiente); grupo DPOC e grupo DPOC+laser (expostos à fumaça de cigarro durante 45 dias, sendo o grupo DPOC+laser tratado durante 12 dias com laser 904nm). Para análise dos resultados foi realizada histopatologia. Resultados. O grupo controle apresentou espaços aéreos normais com distorção arquitetural periférica do pulmão, o grupo DPOC demonstrou um enfisema acentuado, áreas de atelectasias e destruição das paredes alveolares. O grupo tratado houve uma regressão de enfisema acentuado para discreto. Conclusão. Na análise realizada, a inflamação pulmonar induzida pelo cigarro pode ser comprovada e a laserterapia de baixa potência mostrou-se eficaz na atenuação da inflamação.

Introduction. The chronic obstructive pulmonary disease is a respiratory disease characterized by chronic airflow obstruction and inflammatory manifestation. Objective. To investigate the effect of low level laser therapy in the treatment of pulmonary inflammation. Methodology. We used 30 rats divided into three groups of ten animals: control group (received only room air), group COPD and COPD + laser (exposed to cigarette smoke for 45 days with group COPD + laser treated for 12 days with 904nm laser). For data analysis was performed histopathology. Results. The control group had normal air spaces with architectural distortion of the peripheral lung, COPD group showed a marked emphysema, areas of atelectasis and destruction of alveolar walls in the treated group there was a regression from mild to severe emphysema. Conclusion. Through the analysis performed pulmonary inflammation induced by cigarette can be proved, and the low level laser therapy was effective in reducing inflammation.

Aplicação do laser 808nm na dor articular crônica de ratos Wistar / Aplication of 808nm laser in chronic joint pain in Wistar rats

Durante o processo inflamatório, alguns tipos de células predominam e estão envolvidos com a produção de dor. O laser de baixa potência mostra-se útil no controle de mediadores inflamatórios, mas a ampla divergência nos parâmetros dosimétricos, conduz a variações nos resultados positivos. O objetivo deste estudo foi analisar o uso do laser 808nm, na dor articular crônica e edema de ratos Wistar submetidos a sinovite. Foram utilizados 10 ratos Wistar, divididos em dois grupos: GC - indução de sinovite em joelho direito e tratamento placebo; GT - indução de sinovite e irradiado com laser 10J/cm². Para a produção de sinovite foram injetados 100µl de formalina a 5 por cento, no espaço articular tibiofemoral direito. A avaliação da dor ocorreu pelo tempo de elevação da pata (TEP). No 10º dia após a indução de sinovite, iniciou-se o tratamento com laser sobre a face articular medial do joelho, procedimento mantido no decorrer de 10 dias. Os resultados mostraram que o laser apresentou efeitos analgésicos, visto que, para o grupo tratado, houve redução significativa nos valores de TEP, indicando redução da dor, quando comparados os valores pós-tratamento com os pré-tratamento, o que não ocorreu para o grupo que recebeu tratamento placebo; para o edema, o laser também mostrou redução significativa do mesmo. Concluiu-se que o laser 808nm, com 10J/cm², é eficaz na redução da dor articular crônica e edema, em animais submetidos a sinovite experimental.

During the inflammatory process some kinds of cells are predominant and are involved with pain production. Low power laser seems to be useful in the control of inflammatory mediators, but wide divergence in the dosemetric parameters leads to variations in its positive results. The aim of this study was to assess the use of the 808nm laser in the chronic joint pain and edema of Wistar rats submitted to synovitis. Sample was composed of 10 Wistar rats divided in two groups: CG - synovitis induction on right knee and placebo treatment; TG - synovitis induction and irradiated with 10J/cm² laser. 100µl of 5 percent phormaline were injected in the right tibiofemoral joint space. Pain assessment occurred by the time of paw elevation (TPE). On the 10th day after synovitis induction, laser treatment began on the knee medial joint surface and this procedure was kept for 10 days. The outcomes showed that laser presented analgesic effects, since significant reduction of the TPE values was observed for the treated group, hence indicating pain reduction when compared with the pre-treatment values; the same situation did not occur to the group which received the placebo treatment. Concerning edema, laser has also shown significant reduction. It can be concluded that laser 808nm with 10J/cm² is efficient in reduction of chronic joint pain and edema in animals submitted to experimental synovitis.

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.

The Effect of Different Wavelength of Low Power Laser on Fracture Healing / 대한정형외과연구학회지

PURPOSE: The purpose of this study is to evaluate the effect of different wave length of low power laser on early fracture healing. METHODS AND MATERIALS: Nine week old female English Hartley guinea pigs were used for this experiment. Sixty guinea pigs were divided into three groups, and then right femur was fractured and fixed with an intramedullary nail. The frequency of 632 nm and 830 nm semi-conductor laser machines were used. Finally, 46 guinea pigs were survived (including 14 cases in control group, 16 cases in 632 nm group and 16 cases in 830 nm group). Guinea pigs were sacrificed at 3 and 6 weeks separately. The gross, radiologic and histologic findings were assessed by the Modified Zorlu Scoring System. The statistical evaluation was done by repetitive measured ANOVA test. RESULTS: In the gross findings and radiologic findings, both of 632 nm and 830 nm radiation groups showed a greater amount of callus formation at postoperative 3 weeks with statistical significance (P0.05). The result of histological findings showed that an increase of osteoblastic proliferation in two radiation groups was greater than that in the control group at 3 and 6 weeks (P<0.01). Enhancement of osteoblastic proliferation was greater in 830 nm group compared to in 632 nm group at 3 weeks (P<0.05). The comparison between the experimental groups for wave length of 632 nm and 830 nm at 6 weeks showed significant difference (P<0.05). CONCLUSION: In this study, it became known that applying 632 nm and 830 nm wavelength laser to the fracture site accelerate bony union, and 830 nm wavelength laser showed earlier bony union than 630 nm wavelength laser.

Effect of Low Power Laser Irradiation on the Proliferation and Differentiation of PC12 Nerve Cells

OBJECTIVE: We examined the effect of low power laser irradiation (LPLI) on the proliferation and differentiation of PC12 nerve cells. METHOD: After seeding 4x10(5) PC12 nerve cells each in the 24 well-culture dishes, we cultured them for 6 days with RPMI1640 media. LPLI (650 nm, 5 mW, 5 sec) was applied for 1 day, 2 days and 3 days (1, 2 and 3-day-LPLI groups) consecutively. For the degree of proliferation of PC12 nerve cells, we compared the total cell number at 6th day after LPLI by MTT cell proliferation assay. For the degree of differentiation, we compared the length of neurite out-growth and the expression of RT97 at 6th day after adding nerve growth factor on each group. RESULTS: The total cell numbers were increased significantly after LPLI, but those increments were not significant among 1, 2, and 3-day-LPLI groups. The numbers of the differentiated PC12 nerve cells and the expressions of RT97 were diminished serially according to the number of days of LPLI. CONCLUSION: We conclude that LPLI increased the proliferation and decreased the differentiation of PC12 nerve cells. We could suggest that single or short-term use of LPLI on the injured nerve should be helpful for enhancing the neural regeneration in vivo.

The Effect of Low-power Laser on the Murine Hair Growth

Low-power laser(LPL) delivers a small amount of energy without elevation of tissue temperature. LPL has been reported to have biostimulation effects including anti-inflammatory, analgesic, regenerative, immunocorrective, and vasodilative effects. However, the effect of LPL on hair growth has rarely been studied. We investigated the effect of LPL on hair growth in the mouse. After depilation of back skin of mice, we classified the mice into 4 groups: control, laser irradiated group, MoandMore(R) applied group, and Spella 707(R) applied group. Laser irradiation or application of these drugs were performed on the back skin of the mice for 30 days. The results are summarized as follows. Hair growth of control was first observed at 13 days after depilation, and complete hair regrowth was observed at 25 days. Hair growth of both laser irradiation group and MoandMore(R) applied group was first observed at 9 days after depilation, and complete hair regrowth was observed at 20 days. Hair growth of Spella 707(R) applied group was firstly observed at the 9 days after depilation, and complete hair regrowth was observed at the 15 days. Hair growth started at the irradiation site in the laser irradiation group, but it started at the random sites in other groups. In conclusion LPL irradiation have a stimulating effect on the hair growth in the mouse.

Effects of low power laser irradiation in nasal cavity on cerebral blood flow perfusion of patients with brain infarction / 中华物理医学与康复杂志

Objective To study the effects of low power laser irradiation in nasal cavity on cerebral blood flow and cerebral function in patients with brain infarction. Methods Thirty-nine patients with cerebral infarction were divided into a intravenous laser irradiation group and a laser irradiation in nasal cavity group. For the group of intravenous irradiation (ILIB group,18 cases), the patients lay on the bed with their heads fixed and were treated with intravenous laser irradiation for 30 min. Both before and after the therapy they received a SPECT cerebral perfusion imaging separately. For the group of laser irradiation in nasal cavity (LINC group,21 cases), the patients received laser irradiation in nasal cavity for 30 min and also SPECT cerebral perfusion imaging tests both before and after therapy. BFCR% model was used to quantify the blood flow of the focal and mirror regions. Results SPECT showed that there was significant improvement in perfusion of the entire brain and cerebral function in both ILIB and LINC groups after 30 minutes of treatment,each compared to those before treatment; the changes in the focal rCBF and cerebral function were much more obvious (P0.05). BFCR% in focal region was significantly higher than that in mirror region (P0.05). Conclusion Low power laser irradiation in nasal cavity can improve the focal rCBF and cerebral function of the patients with brain infarction, which is similar to that of the ILIB.

Therapeutic effectiveness of low-power Nd:YAG laser on myofascial pain syndrome:73 cases report / 中国康复理论与实践

@#ObjectiveTo investigate the therapeutic effectiveness of low-power laser on myofascial pain syndrome. Methods73 self-controlled patients with myofascial pain syndrome were irradiated on myofascial trigger points with Nd:YAG laser in wavelength 830nm, power 500mW, 20 minutes per day for 5 times. At pre-and post-treatment,pain intensity and pressure pain of myofascial trigger points were checked. ResultsAfter treatment, score of pain intensity was reduced signficantly from (7.24±2.41) to (2.21±1.22) (P<0.001). The pressure pain of myofascial trigger points were improved . Conclusions Low-power laser can reduce the pain intensity and increase the pressure pain threshold of myoficial trigger points.

Wound Healing Effects of Low-Power Laser and Hydrocellular Dressing

There are many methods known to improve the effect of wound healing. Among them, low-power laser light have been used on the basis that it cause increase of new capillary formation, fibroblast, collagen synthesis, and blood flow. But there are some controversies, so the authors tried to prove the efficacy of low-power laser for wound healing on donor sites of skin graft. Performing this study, we also used hydrocelulla dressingr(Allevyn(R)), which is known to accelerate wound healing via providing a clean moist environment with its high absorption capacity, to compare the efficacy with that of low-power laser. We evaluated the wound healing results of fifty patients who underwent split-thickness skin graft for various reasons in Pusan National University Hospital from July 2000 to March 2001. Donor site wounds were formularized with the extent of 7 x 10cm2 width and 13/1000 inch depth on patients' thigh for accurate collection of data. Fifty patients were divided into five groups(n = 10 in each group) according to the method of treatment; Group I: hydrocellular drssing only, Group II: hydrocellular dressing and He-Ne laser, Group III: hydrocellular dressing, He-Ne and infrared (IR) laser, Group IV: hydrocellular dressing, He-Ne, infrared, and CO2 laser, and Group V: adaptive gauze dressing as a conventional method. All groups excluding group V were treated every other day. In laser treated groups, donor site wounds were subjected to irradiation with 500 Hz and 1 J/cm2. In assessing the efficacy of each treatmnet, time for complete epithelialization was assessed in all groups and all groups except for group V were examined every other day by questioning the patients about degree of pain according to the visual analogue pain scale(VAS) and calculated VAS improvement rate after treatment. As a result, laser treated groups(II, III and IV) were superior to hydroclullar dressing treated group(I), although the latter was more effective than the conventional group(V), in aspects of wound healing and pain relief. In conclusion, although hydrocellular dressing promotes wound healing in some aspects, low-power laser was more effective in wound healing and pain relief especially on donor site wounds after partial-thickness skin graft. We think that these low-power lasers with or without hydrocellualr dressing will be helpful in various fields of wound treatment as an adjunctive method.