Low-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers / Terapia con láser de baja intensidad y Calendula officinalis en la reparación de úlcera en pie diabético / Terapia a laser de baixa intensidade e Calendula officinalis no reparo de úlcera em pé diabético

Abstract OBJECTIVE To evaluate the effects of low-level laser therapy isolated and associated with Calendula officinalis oil in treating diabetic foot ulcers. METHOD An experimental, randomized, controlled, prospective, interventional clinical case study using a quantitative approach. The sample consisted of 32 diabetic patients of both genders. Participants were randomly divided into four groups. Doppler Ultrasound evaluation of the Ankle-Brachial Index, brief pain inventory and analog pain scale were performed at baseline and after 30 days. RESULTS Reduced pain was observed in the Low-level laser therapy and Low-level laser therapy associated with Essential Fatty Acids groups (p<0.01). Regarding the Ankle-Brachial Index and Doppler Ultrasound, all groups remained stable. By analyzing lesion area reduction, Low-level laser therapy associated with Essential fatty acids group showed a significance of p=0.0032, and the Low-level laser therapy group showed p=0.0428. CONCLUSION Low-level laser therapy, performed alone or associated with the Calendula officinalis oil was effective in relieving pain and accelerating the tissue repair process of diabetic foot.

Resumen OBJETIVO Evaluar los efectos de la Terapia con Láser de Baja Intensidad aislada y asociada con el aceite de Calendula officinalis en la reparación de úlceras en pie diabético. MÉTODO Estudio de caso clínico, experimental, controlado, randomizado, prospectivo, intervencionista, de carácter cuantitativo. La muestra estuvo compuesta de 32 pacientes diabéticos, de ambos géneros. Los participantes fueron distribuidos aleatoriamente en cuatro grupos. Ecografía Doppler, evaluación del Índice Tobillo-Brazo, Inventario breve de dolor y escala visual analógica fueron realizados al inicio y después de 30 días. RESULTADOS Hubo reducción del dolor en los grupos Terapia con Láser de Baja Intensidad y Terapia con Láser de Baja intensidad asociada con los Ácidos Grasos Esenciales, con p<;0,01. En cuanto al Índice Tobillo-Brazo y la Ecografía Doppler, todos los grupos se mantuvieron estables. En el análisis de la reducción del área de la lesión, el grupo Terapia con Láser de Baja Intensidad asociada con los Ácidos Grasos Esenciales presentó una significación p=0,0032, y el grupo Terapia con Láser de Baja Intensidad, p=0,0428. CONCLUSIÓN La Terapia con Láser de Baja Intensidad, llevada a cabo tanto aisladamente como asociada con el aceite de Calendula officinalis, fue eficaz en el alivio del dolor y la aceleración del proceso de reparación de tejidos del pie diabético.

Resumo OBJETIVO Avaliar os efeitos da Terapia a Laser de Baixa Intensidade isolada e associada ao óleo de Calendula officinalis no reparo de úlceras em pé diabético. MÉTODO Estudo de caso clínico, experimental, controlado, randomizado, prospectivo, intervencional, de caráter quantitativo. A amostra foi composta de 32 pacientes diabéticos, de ambos os gêneros. Os participantes foram distribuídos aleatoriamente em quatro grupos. Ultrassom Doppler, avaliação do Índice Tornozelo-Braquial, Inventário breve de dor e escala de dor analógica foram realizados no início e após 30 dias. RESULTADOS Houve redução da dor nos grupos Terapia a Laser de Baixa Intensidade e Terapia a Laser de Baixa intensidade associada aos Ácidos Graxos Essenciais, com p<0,01. Quanto ao Índice Tornozelo-Braquial e Ultrassom Doppler, todos os grupos mantiveram-se estáveis. Na análise da redução de área da lesão, o grupo Terapia a Laser de Baixa Intensidade associada aos Ácidos Graxos Essenciais apresentou uma significância p=0,0032, e o grupo Terapia a Laser de Baixa Intensidade, p=0,0428. CONCLUSÃO A Terapia a Laser de Baixa Intensidade, realizada tanto isoladamente quanto associada ao óleo de Calendula officinalis, foi eficaz no alívio da dor e na aceleração do processo de reparo tecidual de pé diabético.

The low-level laser on acute myositis in rats

ABSTRACT PURPOSE: To analyze the effects of the low-level laser therapy in the acute myositis induced in rats. METHODS: Twelve rats were subjected to bilateral ovariectomy for inducing osteoporosis. After surgery, they were divided into two groups: Ovariectomy-control group (G1, n=6), receiving 0.5 ml distilled water by gavage for 30 days, and Ovariectomy plus mastruz group (G2, n=6), receiving 0.5 ml of the hydroalcoholic extract of mastruz at 10% concentration (50mg) daily, for the same period. Then, the blood of the animals was collected for further biochemical analysis (liver function) and tibia and liver were removed for histological and histomorphometric analyses. RESULTS: In the MT group there was a statistic significant decrease in the number of inflammatory cells, related to the MI group (p<0.05), increase in the fibroblastic proliferation, when compared to groups C and MI related to MT group (p<0.01) and statistic significant edema regression (p=0.0400) in the MT group CONCLUSION: The low-level laser therapy was efficient in the reduction of the inflammatory process, increase of the fibroblastic proliferation and the reduction of the edema.

Effects of the Low-Level Laser Therapy (LLLT) in the process of healing diabetic foot ulcers

ABSTRACT PURPOSE: To evaluate the effects of the low-level laser therapy applying Laser on the tissue repair in ulcer carriers due to diabetes. METHODS: Sixteen type II diabetic patients, ulcer carriers in the lower limbs, participated in the research from which eight were in the control group and eight were submitted to the low-level laser therapy with a pulsed wave form, visible ray, wave length of 632.8 nm, 30 mW peak power, (Laser - HTM). The application time was of 80 (4J/cm2) seconds. The application was punctual without contact (approximately 1mm of distance), the pen being held in a perpendicular position related to the wound, in equidistant points. There were 12 appointments, of which three were done weekly in alternated days. Photograph records and an application of the brief inventory of pain were done before and after 30 days of follow-up. RESULTS: There was a significant decrease in the size of the wound when compared to the control group (p<0.05). The pain was also reported as having an intense improvement in the treated group. CONCLUSION: The low-level laser treatment seems to be an efficient method, viable, painless and of low costs concerning the tissue repair ulcers in a diabetic foot.

O retalho pleural na perfuração do esôfago torácico / The pleural wrap in the thoracic esophageal perforation

The thoracic esophageal perforations frequently complicate with fistula when submitted to primary suture. The use of autogenous tissues, like pleura, to reinforce the primary suture has proved to be useful in reduce the incidence of fistulas or at least the severity of the leaks in case they occur. The mortality has reduced too, consequently. A case of an extensive esophageal perforation is presented, where the use of pleural wrap to reinforce the esophagorrafy was very important to contain the leak and to permit a good evolution of the patient.