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1.
Chinese Medical Journal ; (24): 598-605, 2022.
Article in English | WPRIM | ID: wpr-927555

ABSTRACT

BACKGROUND@#Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia.@*METHODS@#This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years.@*RESULTS@#A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group.@*CONCLUSIONS@#In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.


Subject(s)
Child, Preschool , Exchange Transfusion, Whole Blood/adverse effects , Humans , Hyperbilirubinemia, Neonatal/therapy , Infant , Infant, Newborn , Kernicterus/therapy , Phototherapy/methods , Retrospective Studies
2.
Dermatol. argent ; 27(1): 34-36, ene.-mar. 2021. il
Article in Spanish | LILACS, BINACIS | ID: biblio-1361760

ABSTRACT

La morfea superficial es una variante rara de morfea que se distingue de la clásica tanto en la clínica como en la histopatología. Se caracteriza por máculas hipopigmentadas o hiperpigmentadas, con mínima o ninguna induración, sin síntomas asociados, contractura ni atrofia. En la histopatología, se observa un compromiso limitado a las fibras colágenas en la dermis reticular superficial. Se comunica el caso de una paciente con diagnóstico de morfea superficial tratada con fototerapia ultravioleta B y metotrexato.


Superficial morphea is a rare variant of morphea that is distinguished from the classic variant both clinically and histopathologically. It is characterized by hypo or hyperpigmented patches with minimal to no induration, without associated symptoms, without contracture or atrophy. At the histopathological level, a limited involvement of collagen fibers is observed at the level of the uperficial reticular dermis. The case of a patient with superficial morphea treated with ultraviolet B phototherapy and methotrexate is presented.


Subject(s)
Humans , Female , Middle Aged , Phototherapy/methods , Scleroderma, Localized/therapy , Scleroderma, Localized/diagnosis , Scleroderma, Localized/drug therapy , Methotrexate/administration & dosage , Dermis/pathology , Folic Acid/administration & dosage
3.
J. appl. oral sci ; 28: e20190720, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134776

ABSTRACT

Abstract Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Phototherapy/methods , Tooth Bleaching/methods , Tooth Bleaching Agents/administration & dosage , Carbamide Peroxide/administration & dosage , Hydrogen Peroxide/administration & dosage , Light , Reference Values , Spectrophotometry , Surface Properties/drug effects , Surface Properties/radiation effects , Risk Factors , Analysis of Variance , Treatment Outcome , Colorimetry , Combined Modality Therapy , Statistics, Nonparametric , Dental Enamel/drug effects , Dental Enamel/radiation effects , Dentin Sensitivity/chemically induced
4.
Int. j. morphol ; 37(4): 1541-1550, Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040167

ABSTRACT

Psoriasis is a chronic inflammatory disease that presents skin rashes which can arise through plaques. The aim of this work was to compare the effectiveness of short-term physical agents treatment on macroscopic morphology (area and erythema) in patients with plaque psoriasis. This prospective randomized experimental study included fourteen subjects, medically diagnosed with psoriasis, with more than one plaque in the skin and voluntarily without topical treatment. All subjects completed the study that consisted of 12 treatment sessions divided in control (C), artificial balneotherapy (AB), phototherapy (PT) or balneophototherapy (BPT) groups. After session 12, there was a significant reduction of the plaque area by all treatments when compared to C group and BPT was the most effective one. However, only AB and PT presented a reduction of erythema. Regarding severity, 9 patients changed to a lower category on the PASI test, and 5 of them maintained a mild psoriasis, but lowered their score. Finally, 13 of 14 subjects improved their quality of life. The physical agents used reduced the severity of psoriasis and improved quality of life of patients after 12 sessions of treatment during a onemonth period. The BPT was the more effective in controlling psoriasis by diminishing its area and PT by attenuating the erythema.


La Psoriasis es una enfermedad inflamatoria crónica que presenta irritación cutánea que puede derivar a placas. El objetivo de este trabajo fue comparar la efectividad del tratamiento a corto plazo con agentes físicos en la morfología macroscópica (área y eritema) en pacientes con placas de psoriasis. Estudio experimental, prospectivo, randomizado. Catorce sujetos participaron con diagnóstico médico de psoriasis, con más de una placa en la piel y sin tener tratamiento tópico de forma voluntaria. Todos los sujetos completaron el estudio, el cual consistió de 12 sesiones de tratamiento dividido en grupo control (C), BA, FT y BFA. Posterior a la sesión 12, se observó una reducción significativa en toda el área de las placas que recibieron tratamiento al compararlas al grupo C y el grupo BFA fue el más efectivo. Sin embargo, solo los grupos BA y FT presentaron una reducción del eritema. Respecto a la severidad, 9 pacientes cambiaron de la baja categoría en el test de PASI y 5 de ellos se mantuvieron en el nivel medio, pero disminuyeron su puntaje. Finalmente, 13 de 14 sujetos mejoraron su calidad de vida. Los agentes físicos usados redujeron la severidad de la psoriasis y mejoraron la calidad de vida de los pacientes después de 12 sesiones de tratamiento durante el período de un mes. La BFA fue la más efectiva en controlar la psoriasis por la disminución en el área y la FT por la atenuación del eritema.


Subject(s)
Humans , Male , Female , Adult , Phototherapy/methods , Psoriasis/therapy , Balneology/methods , Psoriasis/pathology , Psoriasis/psychology , Quality of Life , Time Factors , Severity of Illness Index , Prospective Studies , Surveys and Questionnaires , Treatment Outcome
5.
Säo Paulo med. j ; 137(6): 543-549, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1094517

ABSTRACT

ABSTRACT BACKGROUND: Shoulder pain is considered to be the third largest cause of musculoskeletal functional alterations in individuals presenting pain during movement. OBJECTIVE: The purpose of this synthesis of evidence was to identify the clinical effectiveness of conservative and surgical treatments reported in Cochrane systematic reviews among individuals diagnosed with rotator cuff disease. DESIGNAND SETTING: Review of systematic reviews, conducted in the Federal University of São Paulo (Universidade Federal de São Paulo, UNIFESP). METHODS: This synthesis of evidence included systematic reviews that had been published in the Cochrane database. The inclusion criteria were that these systematic reviews should involve individuals aged ≥ 16 years with rotator cuff disease, comparing surgical procedures with or without associated nonsurgical procedures versus placebo, no treatment or other nonsurgical interventions. RESULTS: Thirty-one systematic reviews were included, involving comparisons between surgical procedures and conservative treatment; procedures either combined or not combined with drugs, versus other procedures; and procedures involving exercises, manual therapy and electrothermal or phototherapeutic resources. CONCLUSIONS: The findings suggest that strengthening exercises, with or without associated manual therapy techniques and other resources, were the interventions with greatest power of treatment over the medium and long terms, for individuals with shoulder pain. These had greater therapeutic power than surgical procedures, electrotherapy or photobiomodulation. Protocol registration number in the PROSPERO database: ID - CRD42018096578.


Subject(s)
Humans , Evidence-Based Medicine , Rotator Cuff Injuries/therapy , Phototherapy/methods , Exercise , Treatment Outcome , Shoulder Pain/therapy , Pain Management/methods , Rotator Cuff Injuries/surgery , Rotator Cuff Injuries/drug therapy , Conservative Treatment/methods , Systematic Reviews as Topic
6.
Gac. méd. Méx ; 155(5): 483-491, Sep.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1286547

ABSTRACT

Morphea, or localized scleroderma, is a rare disease of the connective tissue that manifests itself with localized sclerosis of the skin and, in some cases, with extracutaneous manifestations. Its etiology is not fully understood, but it is believed that there is genetic predisposition, in addition to environmental triggering factors. Classification of the disease is not simple due to its multiple presentations; however, it is useful in order to define the treatment, which should be individualized and started early to avoid cosmetic and functional complications. In this review, we summarize the most important practical aspects of the classification, diagnostic methods and evaluation of morphea activity, as well as available therapeutic options, with an emphasis on existing clinical evidence regarding their efficacy and safety.


Subject(s)
Humans , Male , Female , Scleroderma, Localized/classification , Scleroderma, Localized/diagnosis , Scleroderma, Localized/etiology , Scleroderma, Localized/therapy , Phototherapy/methods , Prognosis , Severity of Illness Index , Sex Factors , Exercise Therapy , Immunosuppressive Agents
7.
An. bras. dermatol ; 94(2,supl.1): 76-107, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011088

ABSTRACT

Abstract: Psoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian population. The most common clinical manifestations are erythematous, scaling lesions that affect both genders and can occur on any anatomical site, preferentially involving the knees, elbows, scalp and genitals. Besides the impact on the quality of life, the systemic nature of the disease makes psoriasis an independent risk factor for cardiovascular disease, especially in young patients with severe disease. By an initiative of the Brazilian Society of Dermatology, dermatologists with renowned clinical experience in the management of psoriasis were invited to form a work group that, in a partnership with the Brazilian Medical Association, dedicated themselves to create the Plaque Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the diagnosis (evaluation of severity and comorbidities) and treatment of plaque psoriasis were defined. The issues generated a search strategy in the Medline-PubMed database up to July 2018. Subsequently, the answers to the questions of the recommendations were devised, and each reference selected presented the respective level of recommendation and strength of scientific evidence. The final recommendations for making up the final text were worded by the coordinators.


Subject(s)
Humans , Male , Female , Psoriasis/diagnosis , Psoriasis/therapy , Phototherapy/methods , Psoriasis/epidemiology , Societies, Medical , Time Factors , Vitamin D/analysis , Severity of Illness Index , Brazil , Comorbidity , Anthralin/therapeutic use , Methotrexate/therapeutic use , Cyclosporine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Dermatologic Agents/therapeutic use , Dermatology , Drug Combinations , Calcineurin Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use
8.
An. bras. dermatol ; 93(1): 33-38, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-887147

ABSTRACT

Abstract: Background: While phototherapy is a well-established treatment for many dermatoses, data from the literature regarding its use in elderly patients are quite limited. Objective: In this study, we aimed to determine the phototherapy indications in geriatric patients and to evaluate the effectiveness and reliability of phototherapy in this group. Methods: This study included 95 patients of 65 years of age and older who were treated in our phototherapy unit between 2006 and 2015. The data for this study were collected retrospectively from patient follow-up forms in the phototherapy unit. Results: Phototherapy was administered to 28 (29.5%) patients for mycosis fungoides, 25 (26.3%) patients foplaque type psoriasis, 12 (12.6%) patients for palmoplantar psoriasis, 12 (12.6%) patients for generalized pruritus, and 18 (19%) for other dermatoses. Of the patients, 64.2% had received a narrowband UVB (NB-UVB), 21.1% oral psoralen UVA (PUVA), and 14.7% local PUVA treatment. A complete response was achieved in 76.9-85.7% of the mycosis fungoides and in 73.71-100% of the psoriasis vulgaris patients treated with NB-UVB and PUVA, respectively. All the patients with generalized pruritus were treated with NB-UVB, and 80% of these patients achieved significant improvement. The erythema rate was found to be 0.43% per session for NB-UVB treatment and 0.46% per session for PUVA treatment as a side effect. Study limitations: The limitations of our study are that it was retrospective and the remission durations of the patients are not known. Conclusion: This study showed that phototherapy is effective and reliable in the elderly population with proper dose increases and close follow-up.


Subject(s)
Humans , Male , Female , Aged , Phototherapy/methods , Pruritus/therapy , Psoriasis/therapy , Skin Neoplasms/therapy , Mycosis Fungoides/therapy , PUVA Therapy/methods , Safety , Reproducibility of Results , Retrospective Studies , Treatment Outcome
9.
Article in Portuguese | LILACS | ID: lil-758418

ABSTRACT

A reparação de feridas constitui um processo complexo, que envolve fatores externos e internos do tecido local, seguindo fases que vão desde a proliferação celular, passando pela angiogênese até o fechamento total da ferida com a reepitelização, A quitosana e a fototerapia por luz emitida por diodo (LED? Light Emiting Diode) são duas terapias que estimulam o reparo tecidual, O presente estudo teve como objetivo realizar revisão bibliográfica acerca dos efeitos cicatricial do LED e da Quitosana de forma isolada e associada, Uma busca na literatura foi realizada utilizando uma variedade de fontes, incluindo base de dados on line, A busca em bancos de dados possibilitou a seleção de 15 artigos sobre o efeito do LED na cicatrização e 17 artigos sobre os efeitos cicatrizantes da quitosana, Não foram encontrados nesta revisão artigos que relatassem a associação dos dois procedimentos na cicatrização, Os artigos analisados mostram os efeitos positivos e isolados do LED e de compostos à base de quitosana na aceleração do processo cicatricial, Observou-se falta de padronização nos estudos quanto as variáveis analisadas, Sugerem-se novos estudos que avaliem a eficácia da associação dos dois procedimentos: LED e Quitosana...


The wound repair is a complex process that involves external and internal factors of the local tissue following phases which goes from cell proliferation, angiogenesis, and complete wound closure with reepithelization. Chitosan and light emitting diode (LED) are two therapies that stimulate tissue repair. The aim of this work was to review the literature on the healing effects of these therapies either together or separately. A search was performed using various sources of information, including online databases. The search allowed the selection of 15 papers about the LED effect in healing and 17 about healing effects of chitosan. It was not found information about the combined effect of the two treatments in healing. The content of the studies confirmed the positive effects of LED and chitosan isolated therapies accelerating the wound healing. It was verified a lack of standardization in the studies and the analyzed variables. It is suggested further studies to evaluate the efficacy of the associating of both LED and Chitosan procedures...


Subject(s)
Biocompatible Materials , Phototherapy/methods , Lasers, Semiconductor , Chitosan/therapeutic use , Wound Healing
10.
Einstein (Säo Paulo) ; 13(3): 430-434, July-Sep. 2015.
Article in English | LILACS | ID: lil-761939

ABSTRACT

Sleep disorders are common in patients with Alzheimer dementia and affect the quality of life of patients and of their caregivers. Despite the rising number of studies in the area, almost all of them are about non-pharmacological treatment. Our objective was to review the literature concerning pharmacological and non-pharmacological approaches to treat sleep disorders of elderly patients with Alzheimer dementia in the ambulatory setting. The treatments revised consisted of sleep hygiene and/or use of intense light coupled or not with use of melatonin, cholinesterase inhibitors, antipsychotics, hypnotics or antidepressants. In addition to the non-pharmacological measures, there is evidence that the use of trazodone may aid the treatment of sleep disorders of older individuals with Alzheimer dementia. More studies are necessary to examine the non-pharmacological and pharmacological treatments revised herein.


Os transtornos do sono são comuns nos pacientes com doença de Alzheimer e interferem na qualidade de vida do paciente e de seu cuidador. Apesar da alta prevalência desses transtornos, existe pouca evidência em relação ao seu tratamento. Nosso objetivo foi revisar a literatura em relação ao tratamento não farmacológico e farmacológico dos transtornos do sono nos idosos com doença de Alzheimer em comunidade. Os tratamentos incluídos consistiram na higiene do sono e/ou no uso da luz intensa, combinados ou não com o uso da melatonina, nos inibidores de acetilcolinesterases, antipsicóticos, hipnóticos ou antidepressivos. Para além das medidas não farmacológicas, há evidência de que o uso da trazodona é efetivo no tratamento dos transtornos do sono de pacientes com doença de Alzheimer. Mais estudos sobre as estratégias farmacológicas e não farmacológicas aqui revisadas ou outras são desejáveis.


Subject(s)
Humans , Alzheimer Disease/complications , Sleep Wake Disorders/therapy , Antidepressive Agents, Second-Generation/therapeutic use , Outpatients , Phototherapy/methods , Sleep Wake Disorders/drug therapy , Sleep Wake Disorders/etiology , Trazodone/therapeutic use
11.
Indian J Dermatol Venereol Leprol ; 2015 Mar-Apr; 81(2): 124-135
Article in English | IMSEAR | ID: sea-158255

ABSTRACT

Background: Both phototherapy and photochemotherapy have been used in all stages of mycosis fungoides since they improve the symptoms and have a favourable adverse effect profi le. Materials and Methods: We performed an extensive search of published literature using keywords like “phototherapy”, “photochemotherapy”, “NBUVB”, “PUVA”, “UVA1”, “mycosis fungoides”, and “Sezary syndrome”, and included systematic reviews, meta-analysis, national guidelines, randomized controlled trials (RCTs), prospective open label studies, and retrospective case series. These were then arranged according to their levels of evidence. Results: Five hundred and forty three studies were evaluated, of which 107 fulfi lled the criteria for inclusion in the guidelines. Conclusions and Recommendations: Photochemotherapy in the form of psoralens with ultraviolet A (PUVA) is a safe, effective, and well tolerated fi rst line therapy for the management of early stage mycosis fungoides (MF), that is, stage IA, IB, and IIA (Level of evidence 1+, Grade of recommendation B). The evidence for phototherapy in the form of narrow-band UVB (NB-UVB) is less robust (Level of evidence 2++, Grade of recommendation B) but may be considered at least as effective as PUVA in the treatment of early-stage MF as an initial therapy. In patients with patches and thin plaques, NB-UVB should be preferentially used. PUVA may be reserved for patients with thick plaques and those who relapse after initial NB-UVB therapy. For inducing remission, three treatment sessions per week of PUVA phototherapy or three sessions per week of NB-UVB phototherapy may be advised till the patient achieves complete remission. In cases of relapse, patients may be started again on PUVA monotherapy or PUVA may be combined with adjuvants like methotrexate and interferon (Level of evidence 2+, Grade of recommendation B). Patients with early-stage MF show good response to combination treatments like PUVA with methotrexate, bexarotene or interferon- α-2b. However, whether these combinations hold a signifi cant advantage over monotherapy is inconclusive. For late stage MF, the above-mentioned combination therapy may be used as fi rst-line treatment (Level of evidence 3, Grade of recommendation C). Currently, there is no consensus regarding maintenance therapy with phototherapy once remission is achieved. Maintenance therapy should not be employed for PUVA routinely and may be reserved for patients who experience an early relapse after an initial course of phototherapy (Level of evidence 2+, Grade of recommendation B). Bath-water PUVA may be tried as an alternative to oral PUVA in case the latter cannot be administered as the former may show similar effi cacy (Level of evidence 2-, Grade of recommendation C). In pediatric MF and in hypopigmented MF, both NB-UVB and PUVA may be tried (Level of evidence 3, Grade of recommendation D).


Subject(s)
Humans , MEDLINE/statistics & numerical data , Mycosis Fungoides/therapy , Photochemotherapy/methods , Photochemotherapy/standards , Phototherapy/methods , Phototherapy/standards , PubMed/statistics & numerical data
12.
São Paulo; s.n; 2015. 101 p. ilus, tab. (BR).
Thesis in Portuguese | LILACS, BBO | ID: biblio-871109

ABSTRACT

Este estudo avaliou a influência da fototerapia a laser (FTL) na proliferação e diferenciação de células-tronco da polpa dentária humana (DPSCs; do inglês, Dental Pulp Stem Cells ) encapsuladas em carreador injetável e termoresponsivo (PL; Pluronic® F-127, Sigma-Aldrich, MO, EUA) com incorporação de proteína morfogenética óssea 4 recombinante humana (rhBMP4) (sistema PL/rhBMP4). O biomaterial foi caracterizado de acordo com seus perfis de embebição e dissolução, liberação de rhBMP4 e sua estrutura morfológica. DPSCs foram isoladas, caracterizadas e encapsuladas em PL para confirmar sua viabilidade e seu potencial de diferenciação (adipo e osteogênico) em comparação com células-tronco mesenquimais de medula óssea (BMMSCs; do inglês, Bone Marrow Mesenchymal Stem Cells). Quando encapsuladas no sistema PL/rhBMP4, DPSCs foram irradiadas com duas densidades de energia diferentes utilizando laser de diodo de fosfeto de índio-gálio-alumínio (InGaAlP), modos contínuo, pontual e em contato [660 nm, 0,028 cm2, 20 mW, 0,71 W/cm2, 3 J/cm2 (4 s) ou 5 J/cm2 (7 s)]. Os ensaios de PKH26 (do inglês, Red Fluorescent Cell Linker), CFU-F (do inglês, Coloning Forming Units - Fibroblastic), e MTT (do inglês, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide)) foram utilizados para avaliar adesão/proliferação, diferenças na capacidade formadora de colônias e viabilidade das DPSCs (neste último caso sob estresse nutricional), respectivamente. Finalmente, a diferenciação odonto/osteogênica foi analisada por qRT-PCR e confirmada por ensaio de vermelho de alizarina. O biomaterial embebeu e dissolveu rapidamente; densa rede tubular e reticular com poros interconectados foi observada. DPSCs e BMMSCs apresentaram alta viabilidade celular quando encapsuladas em PL. Ambas as linhagens celulares tiveram êxito em se diferenciar em tecidos adiposo e ósseo. De acordo com o PKH26, DPSCs puderam aderir e proliferar no sistema PL/rhBMP4. DPSCs irradiadas encapsuladas tanto em PL como em PL/rhBMP4 formaram mais CFU-F que os controles não irradiados. Sob estresse nutricional, DPSCs semeadas no PL e irradiadas com 5 J/cm2 exibiram maior taxa de viabilidade celular em relação aos grupos não irradiados e irradiados com 3 J/cm2. Na presença de rhBMP4, os grupos irradiados tanto com 3 J/cm2 quanto com 5 J/cm2 apresentaram deposição mineral precoce quando comparados aos grupos não irradiados. Ainda, após 21 dias de diferenciação odonto/osteogênica, DPSCs irradiadas produziram maior quantidade de nódulos mineralizados. A irradiação com 5 J/cm2 levou ao aumento significativo da expressão de genes envolvidos na diferenciação odonto/osteogênica, como colágeno tipo I (COL1A1), osteocalcina (OCN), proteína da matriz dentinária 1 (DMP1), sialofosfoproteina dentinária (DSPP) e proteína heat shock 27 kDa (HSPB1). A associação entre rhBMP4 e FTL promove proliferação e diferenciação odonto/osteogênica de DPSCs acelerando e aumentando notavelmente a formação de tecido mineralizado, em especial quando a densidade de energia de 5 J/cm2 é aplicada.


This study evaluated the influence of laser phototherapy (LPT) on dental pulp stem cells (DPSCs) proliferation and differentiation upon encapsulation in an injectable and thermo-responsive cell carrier (PL; Pluronic® F-127, Sigma-Aldrich, MO, USA) loaded with human recombinant bone morphogenetic protein 4 (rhBMP4)(PL/rhBMP4 system). The biomaterial was characterized according to its swelling and dissolution profiles, release of rhBMP4 and morphological structure. DPSCs were isolated, characterized and encapsulated in PL to confirm their viability and multilineage differentiation potential (adipo and osteogenic) in comparison to bone marrow mesenchymal stem cells (BMMSCs). When encapsulated in the PL/rhBMP4 system, DPSCs were irradiated with two different energy densities using a continuous-wave indium-gallium-aluminum-phosphide (InGaAlP) diode laser [660 nm, 0.028 cm2, 20 mW, 0.71 W/cm2, 3 J/cm2 (4 s) or 5 J/cm2 (7 s)] in punctual and contact modes. The PKH26 (Red Fluorescent Cell Linker), the CFU-F (Coloning Forming Units - Fibroblastic), and the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide] assays were used to assess differences in cell adhesion/proliferation, colony forming units formation ability, and cell viability of DPSCs (in this case under nutritional stress), respectively. Then, alizarin red and qRT-PCR analyzes were used to evaluate odonto/osteogenic differentiation. The biomaterial swelled and dissolved rapidly; dense tubular and reticular network morphology with well-interconnected pores was observed. DPSCs and BMMSCs presented high cell viability when encapsulated in PL. Both cell lineages successfully differentiated into bone or adipose tissues. According to PKH26, DPSCs were able to adhere and proliferate in the PL/rhBMP4 system. Irradiated DPSCs encapsulated in either PL or PL/rhBMP4 system formed more CFU-F than non-irradiated controls. Under nutritional stress, DPSCs encapsulated in the hydrogels with no rhBMP4 and irradiated at 5 J/cm2 exhibited higher cell viability than the other groups. In the presence of rhBMP4, the groups irradiated both at 3 and 5 J/cm2 energy densities displayed earlier mineral deposition than the non-irradiated groups. Moreover, after 21 days of odonto/osteogenic differentiation, irradiated DPSCs produced greater nodule formation than the control groups. At the energy density of 5 J/cm2, there were significant upregulation of genes involved in odonto/osteoblast differentiation, such as type I collagen (COL1A1), osteocalcin (OCN), dentin matrix protein 1 (DMP1), dentin sialophosphoprotein (DSPP) and heat shock protein 27 kDa (HSPB1). The association between rhBMP4 and LPT promotes cell proliferation and odonto/osteogenic differentiation of DPSCs accelerating and increasing the formation of mineralized tissue, in particular when the energy density of 5 J/cm2 is applied.


Subject(s)
Stem Cells/cytology , Stem Cells/classification , Stem Cells/physiology , Stem Cells/pathology , Phototherapy/instrumentation , Phototherapy/methods , Phototherapy , Lasers
13.
São Paulo; s.n; 2015. 101 p. ilus, tab. (BR).
Thesis in Portuguese | LILACS, BBO | ID: biblio-867712

ABSTRACT

Este estudo avaliou a influência da fototerapia a laser (FTL) na proliferação e diferenciação de células-tronco da polpa dentária humana (DPSCs; do inglês, Dental Pulp Stem Cells ) encapsuladas em carreador injetável e termoresponsivo (PL; Pluronic® F-127, Sigma-Aldrich, MO, EUA) com incorporação de proteína morfogenética óssea 4 recombinante humana (rhBMP4) (sistema PL/rhBMP4). O biomaterial foi caracterizado de acordo com seus perfis de embebição e dissolução, liberação de rhBMP4 e sua estrutura morfológica. DPSCs foram isoladas, caracterizadas e encapsuladas em PL para confirmar sua viabilidade e seu potencial de diferenciação (adipo e osteogênico) em comparação com células-tronco mesenquimais de medula óssea (BMMSCs; do inglês, Bone Marrow Mesenchymal Stem Cells). Quando encapsuladas no sistema PL/rhBMP4, DPSCs foram irradiadas com duas densidades de energia diferentes utilizando laser de diodo de fosfeto de índio-gálio-alumínio (InGaAlP), modos contínuo, pontual e em contato [660 nm, 0,028 cm2, 20 mW, 0,71 W/cm2, 3 J/cm2 (4 s) ou 5 J/cm2 (7 s)]. Os ensaios de PKH26 (do inglês, Red Fluorescent Cell Linker), CFU-F (do inglês, Coloning Forming Units - Fibroblastic), e MTT (do inglês, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide)) foram utilizados para avaliar adesão/proliferação, diferenças na capacidade formadora de colônias e viabilidade das DPSCs (neste último caso sob estresse nutricional), respectivamente. Finalmente, a diferenciação odonto/osteogênica foi analisada por qRT-PCR e confirmada por ensaio de vermelho de alizarina. O biomaterial embebeu e dissolveu rapidamente; densa rede tubular e reticular com poros interconectados foi observada.


DPSCs e BMMSCs apresentaram alta viabilidade celular quando encapsuladas em PL. Ambas as linhagens celulares tiveram êxito em se diferenciar em tecidos adiposo e ósseo. De acordo com o PKH26, DPSCs puderam aderir e proliferar no sistema PL/rhBMP4. DPSCs irradiadas encapsuladas tanto em PL como em PL/rhBMP4 formaram mais CFU-F que os controles não irradiados. Sob estresse nutricional, DPSCs semeadas no PL e irradiadas com 5 J/cm2 exibiram maior taxa de viabilidade celular em relação aos grupos não irradiados e irradiados com 3 J/cm2. Na presença de rhBMP4, os grupos irradiados tanto com 3 J/cm2 quanto com 5 J/cm2 apresentaram deposição mineral precoce quando comparados aos grupos não irradiados. Ainda, após 21 dias de diferenciação odonto/osteogênica, DPSCs irradiadas produziram maior quantidade de nódulos mineralizados. A irradiação com 5 J/cm2 levou ao aumento significativo da expressão de genes envolvidos na diferenciação odonto/osteogênica, como colágeno tipo I (COL1A1), osteocalcina (OCN), proteína da matriz dentinária 1 (DMP1), sialofosfoproteina dentinária (DSPP) e proteína heat shock 27 kDa (HSPB1). A associação entre rhBMP4 e FTL promove proliferação e diferenciação odonto/osteogênica de DPSCs acelerando e aumentando notavelmente a formação de tecido mineralizado, em especial quando a densidade de energia de 5 J/cm2 é aplicada.


This study evaluated the influence of laser phototherapy (LPT) on dental pulp stem cells (DPSCs) proliferation and differentiation upon encapsulation in an injectable and thermo-responsive cell carrier (PL; Pluronic® F-127, Sigma-Aldrich, MO, USA) loaded with human recombinant bone morphogenetic protein 4 (rhBMP4)(PL/rhBMP4 system). The biomaterial was characterized according to its swelling and dissolution profiles, release of rhBMP4 and morphological structure. DPSCs were isolated, characterized and encapsulated in PL to confirm their viability and multilineage differentiation potential (adipo and osteogenic) in comparison to bone marrow mesenchymal stem cells (BMMSCs). When encapsulated in the PL/rhBMP4 system, DPSCs were irradiated with two different energy densities using a continuous-wave indium-gallium-aluminum-phosphide (InGaAlP) diode laser [660 nm, 0.028 cm2, 20 mW, 0.71 W/cm2, 3 J/cm2 (4 s) or 5 J/cm2 (7 s)] in punctual and contact modes. The PKH26 (Red Fluorescent Cell Linker), the CFU-F (Coloning Forming Units - Fibroblastic), and the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide] assays were used to assess differences in cell adhesion/proliferation, colony forming units formation ability, and cell viability of DPSCs (in this case under nutritional stress), respectively. Then, alizarin red and qRT-PCR analyzes were used to evaluate odonto/osteogenic differentiation. The biomaterial swelled and dissolved rapidly; dense tubular and reticular network morphology with well-interconnected pores was observed. DPSCs and BMMSCs presented high cell viability when encapsulated in PL. Both cell lineages successfully differentiated into bone or adipose tissues. According to PKH26,


DPSCs were able to adhere and proliferate in the PL/rhBMP4 system. Irradiated DPSCs encapsulated in either PL or PL/rhBMP4 system formed more CFU-F than non-irradiated controls. Under nutritional stress, DPSCs encapsulated in the hydrogels with no rhBMP4 and irradiated at 5 J/cm2 exhibited higher cell viability than the other groups. In the presence of rhBMP4, the groups irradiated both at 3 and 5 J/cm2 energy densities displayed earlier mineral deposition than the non-irradiated groups. Moreover, after 21 days of odonto/osteogenic differentiation, irradiated DPSCs produced greater nodule formation than the control groups. At the energy density of 5 J/cm2, there were significant upregulation of genes involved in odonto/osteoblast differentiation, such as type I collagen (COL1A1), osteocalcin (OCN), dentin matrix protein 1 (DMP1), dentin sialophosphoprotein (DSPP) and heat shock protein 27 kDa (HSPB1). The association between rhBMP4 and LPT promotes cell proliferation and odonto/osteogenic differentiation of DPSCs accelerating and increasing the formation of mineralized tissue, in particular when the energy density of 5 J/cm2 is applied.


Subject(s)
Stem Cells/cytology , Stem Cells/classification , Stem Cells/physiology , Stem Cells/pathology , Phototherapy/instrumentation , Phototherapy/methods , Phototherapy , Lasers
14.
Surg. cosmet. dermatol. (Impr.) ; 7(supl.1): s59-s62, Jul-Set.2015. ilus
Article in English, Portuguese | LILACS, SES-SP, CONASS, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP | ID: biblio-542

ABSTRACT

O líquen escleroso é patologia incomum acometendo tanto região genital quanto extragenital, constituindo apresentação atípica da doença. O uso de corticosteroides tópicos é considerado primeira linha para tratamento da doença genital. Lesões extragenitais são menos sensíveis a essa terapêutica. Relata-se caso de líquen escleroso em paciente do sexo feminino, de 82 anos, com envolvimento extragenital generalizado e tratamento bem-sucedido com fototerapia UVB de banda estreita. O líquen escleroso é dermatose inflamatória crônica, e as formas disseminadas da doença são raras e sem consenso em relação ao tratamento da forma extragenital. A opção pela terapia com UVB de banda estreita baseou-se nos relatos da literatura.


Lichen sclerosus is an uncommon condition affecting both the genital and extragenital region, the latter constituting an atypical occurrence of the disorder. The use of topical corticosteroids is considered the first-line treatment of this genital disease. Extragenital lesions are less sensitive to this therapy. The present study describes a case of lichen sclerosus in an 82-year-old female patient, with widespread extragenital involvement and successful treatment with narrow band UVB phototherapy. Lichen sclerosus is a chronic inflammatory dermatosis and disseminated forms of the condition are rare, with an absence of consensus on the treatment of the extragenital form. The choice for narrow band UVB therapy was based on the literature.


Subject(s)
Humans , Female , Aged, 80 and over , Lichen Sclerosus et Atrophicus/therapy , Phototherapy/methods , Atrophy
15.
Article in English | IMSEAR | ID: sea-163481

ABSTRACT

Ultraviolet light has a wide spectrum of effects on human skin depending on the wavelength. Ultraviolet light often used for therapy of psoriasis comprises of electromagnetic spectrum ranging from 200nm – 400nm. Phototherapy of psoriasis is frequently used in combination regimens to achieve higher clearance rates, longer disease-free intervals, and to reduce the patient`s cumulative radiation dose thereby lowering the carcinogenic risk. Phototherapy may be combined with topical or systemic agents. Topical agents most commonly used are anthralin, tar, vitamin D analogues and tazarotene. Among systemic agents, retinoids are the most widely used. Ultraviolet B wavelengths in the range of 300-313nm is more efficacious than conventional broad-band UV-B [Philips TL 40W/12 lamp] and causes greater remission of psoriatic lesions. 311nm narrow-band UV-B (TL-01) phototherapy is more effective and probably has no greater risk than conventional UV-B (TL-12) phototherapy in the treatment of psoriasis.


Subject(s)
Humans , Phototherapy/methods , Phototherapy/therapeutic use , Phototherapy/trends , Phototherapy/statistics & numerical data , Psoriasis/radiotherapy , Psoriasis/therapy , Retinoids/administration & dosage , Retinoids/therapeutic use
16.
Acta cir. bras ; 29(9): 588-595, 09/2014. graf
Article in English | LILACS | ID: lil-722130

ABSTRACT

PURPOSE: To compare the biomodulatory effects of LED and ultrasound combined with semipermeable dressing in the repair of cutaneous lesions. METHODS: Eighty-four Wistar rats were submitted to surgical injury (2.5 cm) and divided into four groups (n=21): Group I (control), Group II (LED therapy, LED), Group III (LED therapy + dressing, LED+D) and Group IV (ultrasound + dressing, US+D). At seven, 14 and 21 days, the animals were euthanized, and the specimens of interest removed for histological analysis. RESULTS: Histological and histomorphometric analysis revealed a greater percent wound regression in animals receiving the dressing (group III: 55.97; group IV: 53.06), as well as a greater reduction in the inflammatory infiltrate (group III: 29.14; group IV: 31.71) since day 7. A later effect, with progression of the tissue repair process only after 14 and 21 days, was observed in the LED group intense fibroblast proliferation and greater collagen fiber production and organization were seen in the LED+D and US+D groups compared to the other groups. CONCLUSION: LED combined with a dressing was more effective at accelerating in the repair of cutaneous lesions. .


Subject(s)
Animals , Male , Bandages , Phototherapy/methods , Skin/injuries , Ultrasonic Therapy/methods , Wound Healing/physiology , Cell Proliferation/radiation effects , Collagen/analysis , Collagen/radiation effects , Combined Modality Therapy/methods , Dermatitis/pathology , Dermatitis/therapy , Fibroblasts/radiation effects , Random Allocation , Rats, Wistar , Reproducibility of Results , Skin/pathology , Skin/radiation effects , Time Factors , Treatment Outcome
17.
An. bras. dermatol ; 89(5): 784-790, Sep-Oct/2014. tab, graf
Article in English | LILACS | ID: lil-720797

ABSTRACT

In an unprecedented effort in the field of vitiligo, a global consensus resulted on a suggested new classification protocol for the disease. The main histopathological finding in vitiligo is the total absence of functioning melanocytes in the lesions, while the inflammatory cells most commonly found on the edges of the lesions are CD4+ and CD8+ T lymphocytes. Physical and pharmacological treatment strategies aim to control the autoimmune damage and stimulate melanocyte migration from the unaffected edges of lesions and the outer hair follicle root sheath to the affected skin; moreover, surgical treatments can be combined with topical and physical treatments.


Subject(s)
Female , Humans , Male , Vitiligo/pathology , Vitiligo/therapy , Adrenal Cortex Hormones/therapeutic use , Calcineurin Inhibitors/therapeutic use , Melanocytes/pathology , Phototherapy/methods , Vitiligo/classification
19.
São Paulo; s.n; 2014. 80 p. ilus, tab. (BR).
Thesis in Portuguese | LILACS, BBO | ID: biblio-867206

ABSTRACT

A instalação imediata de implante dental na região de molares é crítica, devido a grande perda óssea e da discrepância entre a espessura da crista alveolar e a plataforma do implante. Laserfototerapia (LFT) auxilia na reparação óssea, portanto pode acelerar a instalação do implante. Vinte pacientes foram selecionados para o estudo. Dez pacientes foram submetidos à LFT com laser de diodo de GaAlAs (808nm) no transcirúrgico de exodontia de molares, imediatamente após, e em 24h, 48h, 72h, 96h, 7 e 15 dias. As irradiações foram aplicadas no modo contínuo, em contato e pontual (100mW, 0,04cm2, 075,0J/cm2, 30s por ponto, 3J por ponto, em 5 pontos). O grupo controle (n=10) recebeu o mesmo tratamento, no entanto, o equipamento estava desligado. Quarenta dias depois, espécimes do tecido formado no interior dos alvéolos foram coletados para posterior análise por microtomografia (microCT) e histomorfometria. Dados de ambos os grupos foram comparados pelo test t de Student, enquanto aqueles das diferentes avaliações microtomográficas foram comparados pelo teste de correlação de Pearson (p<0.05). O volume relativo do osso, bem como a área relativa do osso foram significativamente maiores (p<0.001) no grupo laser do que no controle. No grupo controle houve correlação negativa significativa entre número e espessura de trabéculas, e entre número e separação entre trabéculas (p<0.01); entre espessura e separação das trabéculas a correlação foi positiva (p<0.01). O grupo laser mostrou correlação negativa significante entre número e espessura de trabéculas (p<0.01). A Laserfototerapia acelerou o reparo ósseo. Baseado na correlação de Pearson foi possível inferir que o grupo laser apresentou uma distribuição trabecular mais homogênea, com trabéculas menos espessas e mais numerosas, o que pode propiciar a redução do tempo para a instalação do implante


The immediate dental implant placement in the molars region is critical, because of the high amount of bone loss and the discrepancy between the alveolar crest thickness and the dental implant platform. Laserphototherapy (LPT) improves bone repair thus could accelerate the implant placement. Twenty patients were selected for the study. Ten patients were submitted to LPT with GaAlAs diode laser (808nm) during molar extraction, immediately after, 24h, 48h, 72h, 96h, 7 and 15 days. The irradiations were applied in continuous wave, in contact and punctual mode (100mW, 0.04cm2, 075,0J/cm2, 30s per point, 3J per point, in 5 points). The control group (n=10) received the same treatment; however with the power of the laser off. Forty days later samples of the tissue formed inside the sockets were obtained for further microtomography (microCT) and histomorphometry analyses. Data of both groups were compared by the Student t test, whereas those from the different microCT parameters were compared by the Pearson correlation test (p<0.05). The relative bone volume, as well as the relative area were significantly higher (p<0.001) in the lased than the control group. In the control group there were negative correlations between number and thickness, and between number and separation of trabecula (p<0.01); between thickness and separation of trabecula the correlation was positive (p<0.01). The laser group showed significant negative correlation between the number and the thickness of trabecula (p<0.01). Laserphototherapy accelerated bone repair. By the Pearson correlation test it was possible to infer that the lased group presented a more homogeneous trabecula configuration, with thin and numerous trabecula, which would facilite the reduction of time for the installation of the implant


Subject(s)
Bone Regeneration , Phototherapy/methods , Dental Implantation/methods , X-Ray Microtomography , Bone Transplantation/methods
20.
Rev. chil. dermatol ; 30(2): 151-157, 2014. ilus, graf
Article in Spanish | LILACS | ID: biblio-835936

ABSTRACT

Diodos Emisores de la Luz- Light Emitting Diodes (LED) son fuentes de luz que están siendo introducidos en los tratamientos del envejecimiento. El objetivo del estudio fue evaluar los efectos del LED rojo en la dermis de ratones wistar. Se trata de un estudio experimental controlado y randomizado, fueron utilizados 20 ratones wistar divididos en cinco grupos. Los grupos fueron: G1 en donde se aplicó 10 sesiones de diez minutos de fototerapia por LED. El G2 con 20 sesiones de 10minutos, el G3 con 10 sesiones de 20 minutos, el G4 con 20 sesiones de 20 minutos y el G5 fue el grupo control. Después de las aplicaciones se recolectó el material biológico de la zona, siendo realizado el análisis histológico de las áreas que recibieron las aplicaciones, sometiéndolas a las coloraciones de HE, tricómico de Masson y Verhoeef. Fue observada la presencia de micro vasos dérmicos con resultados significativos entre el G2 y el G5. Con relación a la presencia de mastocitos hubo resultados significativos entre el G1 y el G3. El análisis de las fibras elásticas presentó resultados significativos en los grupos G1, G2, G3, G4 en comparación al grupo control (G5). La evaluación de los efectos del LED en las fibras colágenos, los grupos tratados comparados al grupo control no presentaron ninguna diferencia significativa.


The Light-Emitting Diodes Light Emitting Diodes (LED) are a source of light wich are being introduced into the treatment of aging process. This study evaluate the effect of application of red LED on the dermis of Wistar rats. Twenty Wistar rats were used in this randomized controlled experimental study. Those rats were divided randomly into five groups. The G1 group underwent ten sessions of phototherapy by LED lasting ten minutes each. The G-2, 20 sessions of 10 minutes, the G-3, 20 minutes, the fourth group, 20 sessions of 20 minutes and the G-5 group was the control group. After the application, the biological material was collected and the histological analysis of the areas that suffered application were done, being subjected to HE staining, and Masson trichrome & Verhoeff. It was observed the presence of dermal microvascular, with significant results among G2 and G5 groups. Regarding the presence of mast cells, significant results were observed among G1 and G3 groups, however, that was not the case with the G5. By analyzing the elastic fibers, significant results were observed among G1, G2, G3, G4 groups, but the same results weren’t observed in the fifth group. Regarding the assessment of the effects of LED on the collagen fibers, the treated groups, when compared to the control group, showed no significant difference.


Subject(s)
Animals , Rats , Phototherapy/methods , Radio Waves/therapeutic use , Skin/radiation effects , Dermis/radiation effects , Skin Aging/radiation effects , Physical Therapy Modalities , Rats, Wistar , Semiconductors , Connective Tissue/radiation effects , Elastic Tissue/radiation effects
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