Structural equation modelling provides insights to understand the construct of chronic pain in women with rheumatoid arthritis.

OBJECTIVES: We aimed to adopt a multidimensional approach and investigate the interconnections between biomarkers (cytokines, matrix metalloproteinases, and cortisol) and psychosocial aspects considering pain acceptance, the individual construct of pain perception in terms of blood inflammation biomarkers, anxiety, self-efficacy, and functional performance and to define the quality of life (QoL) in women with rheumatoid arthritis (RA). METHODS: An observational cross-sectional study with a total of 42-RA participants, with chronic pain and 42-women without rheumatic diseases or chronic pain were included. A structural equation model was used to investigate the association between independent variables. RESULTS: Women with RA presented high blood biomarker levels, representing an intense inflammatory process. The participants with RA reported moderate pain most of the time, a worsening QoL, functionality, engagement in activities, and a willingness to live with pain and self-efficacy. It was found that the higher the chronic pain, the greater the intensity of pain perceived by these women with RA, as well as, the worse the functionality, the higher the perceived pain. CONCLUSIONS: The exacerbation of pain perception leads to worsening of the experience of chronic pain. The new construct of pain experience should include functionality as a crucial factor in understanding the mechanisms underlying pain.

Perfil e capacidade funcional em sujeitos com Doença de Huntington / Profile and functional capacity in Huntington's disease subjects

Objetivo: traçar o perfil e a capacidade funcional de sujeitos com Doença de Huntington (DH) atendidos em um ambulatório de fisioterapia do Distrito Federal. Método: trata-se de um estudo transversal em que foram aplicados um questionário para coletar informações gerais para traçar o perfil, além do índice de Barthel, escala Lawton para medir grau de independência para as atividades de vida diária, força de preensão palmar por meio do dinamômetro JAMAR®, equilíbrio por meio da escala de equilíbrio de Berg, declínio cognitivo por meio da Montreal Cognitive Assessment (MoCA), e risco de disfagia utilizando a Eating assessment tool (EAT-10). Resultados: foram avaliados sete sujeitos, 58% homens e 42% mulheres com média de idade de 45,8±10,5 anos e tempo médio de diagnóstico de 7,5±4,2 anos. Todos apresentam redução da força de preensão palmar (21,1±7,3 Kg/F) e declínio cognitivo (13,1±4,2 pontos) no MoCA. Sobre o risco de cair, este se fez presente em todos os participantes com o risco de disfagia. Conclusão: os indivíduos com Doença de Huntington apresentaram déficit cognitivo, diminuição da força de preensão palmar e alterações de marcha; porém, ainda mantêm independência para as atividades básicas de vida diária , além de risco para a disfagia.

Objective: to outline the profile and functional capacity of subjects with Huntington's disease (HD) attended at a physiotherapy clinic in the Federal District. Methods: This is a cross-sectional study in which a questionnaire was used to collect general information to profile, besides Barthel index, Lawton scale to measure the degree of independence for the activities of daily life, palmar grip strength using the JAMAR® dynamometer, balance by means of Berg balance scale, cognitive decline by means of the Montreal Cognitive Assessment (MoCA), and risk of dysphagia using the Eating assessment tool (EAT-10). Results: Seven subjects were evaluated, 58% male and 42% female with mean age of 45.8 ± 10.5 years and mean diagnosis time of 7.5 ± 4.2 years. All presented reduced palmar grip strength (21.1 ± 7.3 Kg / F) and cognitive decline (13.1 ± 4.2 points) in MoCA. About the risk of falling this was present in all partcipants as well as the risk of dysphagia. Conclusion: The individuals with Huntington's disease presented cognitive deficit, decreased palmar grip strength and gait alterations, however still maintains independence for the basic activities of daily life, besides risk for dysphagia.

Systemic alterations in plasma biomarkers levels in patients with chronic pain / Alterações nos níveis plasmáticos de biomarcadores de pacientes com dor crônica

ABSTRACT BACKGROUND AND OBJECTIVES: To analyze the scientific evidence on the changes in plasma levels of interleukins, nitric oxide, extracellular matrix metalloproteinases, bradykinins, and cortisol in patients with chronic pain. CONTENTS: The studies were identified by searching the following electronic databases: Pubmed/Medline, Scopus, LILACS, and Web of Science, published from June of 2016 to December of 2016. The selected articles were presented in a flow chart based on their identification, selection, eligibility and inclusion and exclusion criteria. The content of the articles included in the study was analyzed to identify the biomarkers present in patients with chronic pain. Thirteen articles that addressed the plasma biomarkers levels in humans with chronic pain were selected. Most of the articles presented the cytokines levels, followed by cortisol. Only one article mentioned the nitric oxide, and none mentioned what plasma levels of extracellular matrix metalloproteinases and bradykinins were identified. CONCLUSION: Changes were observed in inflammatory and anti-inflammatory cytokine plasma levels, and that cortisol is related to anxiety and depression symptoms in patients with chronic pain. However, it was not possible to identify the changes in plasma levels of nitric oxide, bradykinin, and extracellular matrix metalloproteinases due to the absence of scientific evidence.

RESUMO JUSTIFICATIVA E OBJETIVOS: Analisar as evidências científicas sobre alterações nos níveis plasmáticos de interleucinas, óxido nítrico, metaloproteinases de matriz extracelular, bradicinina e cortisol em pacientes com dor crônica. CONTEÚDO: Os estudos foram identificados por meio das bases de dados eletrônicas: Pubmed/Medline, Scopus, LILACS e Web of Science, publicados no período de junho a dezembro de 2016. Os artigos selecionados foram classificados em ficha de identificação, seleção dos participantes, elegibilidade, critérios de inclusão e exclusão. Os artigos selecionados foram avaliados por meio de análise de conteúdo, buscando identificar os biomarcadores presentes nos pacientes com dor crônica. Foram selecionados 13 artigos que abordavam a dosagem plasmática de biomarcadores em humanos com dor crônica. A maior parte dos artigos apresentou a dose de citocinas, seguidos pelo cortisol. Apenas um artigo apresentou a dose de óxido nítrico e nenhum artigo identificou a dosagem de níveis plasmáticos de metaloproteinases de matriz extracelular e bradicinina. CONCLUSÃO: Pôde-se verificar modificações nos níveis plasmáticos de citocinas inflamatórias e anti-inflamatórias, e que os níveis plasmáticos de cortisol estão relacionados com os sintomas de ansiedade e depressão nos pacientes com dor crônica. No entanto, não foi possível verificar as alterações nos níveis de plasma do óxido nítrico, bradicinina e metaloproteinase de matriz extracelular devido à ausência de evidências científicas.

Efeitos agudos da crioterapia na transferência de peso em sujeitos com hemiparesia espástica crônica / Acute effects of cryotherapy on weight transfer in subjects with chronic spastic hemiparesis

Objetivo: Foi avaliar os efeitos agudos da crioterapia na transferência de peso de pacientes hemiparéticos crônicos. Métodos: Estudo transversal composto por 52 pacientes, sendo 24 pacientes hemiparéticos crônicos e 28 pacientes saudáveis como controles. Utilizou-se a versão brasileira do Questionário de Waterloo para avaliar a preferência podal (WFQ-Brasil) para o grupo de pacientes-controle. Foram utilizadas duas balanças calibradas nas quais foi calculada a razão de simetria (lado parético/lado não parético) em pacientes hemiparéticos crônicos. Para o grupo controle, foi calculada uma razão de simetria (lado não dominante/lado dominante). Foi realizada a imersão do membro inferior acometido dos pacientes hemiparéticos e o lado dominante dos pacientes-controle em um balde com capacidade de 60 litros, com gelo e água, a uma temperatura aproximada de até 5ºC, sendo feita a avaliação pré-intervenção e imediatamente após. Resultados: Pôde-se observar diferença significativa na transferência de peso em ambos os grupos após a crioimersão. Conclusão: Conclui-se que a crioimersão por um perí­odo de 30 segundos com temperatura de até 5ºC foi suficiente para gerar alterações na transferência de peso para o lado parético resultando em alterações na simetria de sujeitos hemiparéticos crônicos, e nos controles, o comportamento foi similar com alterações na transferência de peso para a perna não dominante. (AU)

Aim: This study aims to evaluate the acute effects of cryotherapy immersion on weight transfer in chronic hemiparetic patients. Methods: The cross-sectional study was performed with 52 patients, 24 chronic hemiparetic and 28 healthy controls. The Brazilian version of the Waterloo Footedness Questionnaire (WFQ-Brazil) was used to evaluate the foot preference of the control group. Two calibrated balance were used to calculated in chronic hemiparetic patients with which the symmetry ratio (paretic side/non-paretic side), for the control group, a ratio of symmetry (non-dominant side/dominant side) was calculated. Immersion of the affected lower limb of the hemiparetic patients and the dominant side of the control patients was performed in a 60-litre bucket, with ice and water, at an approximate temperature of up to 5ºC, and immediately after this the pre-intervention evaluation was performed. Results: We observed a significant difference in weight transfer in both groups after cryo immersion. Conclusion: We concluded that the cryo immersion for a period of 30 seconds at a temperature of up to 5ºC was enough to generate changes in weight transfer, resulting in changes in the symmetry of chronic hemiparetic and control patients. (AU)

Changes in occupational roles in women with chronic pain and Rheumatoid Arthritis compared to healthy women / Modificações dos papéis ocupacionais de mulheres com dor crônica e Artrite Reumatoide, comparada a mulheres saudáveis

Abstract The objective of this study was to understand the occupational roles of women with chronic pain caused by Rheumatoid Arthritis (RA) and to compare these performance standards with those of healthy subjects. It is a cross-sectional, exploratory and comparative study. Participants were divided into 2 groups. For the RA group, two validated questionnaires were applied: Visual Analog Scale and the Occupational Roles List, clinical and demographic data. In the control group, the personal information sheet and the Occupational Role List were applied. The control group was matched in age and sociodemographic level. A total of 164 women participated in the study, of which 82 were women with chronic pain and rheumatoid arthritis, with a mean age of 55.9 ± 11.2 years, and 82 healthy and matched women. In the RA group (GAR), 48% of the participants in the work activities were lost, but the roles of caregiver (68%), household chores (89%), friend (74%), family member (93%), and religious (60%), remained in the process of becoming ill. In the control group (CG), the maintenance of most occupational roles is observed. In the comparison between both groups, a statistically significant difference was found in student, worker, volunteer, friend and passer/amateur roles. The occupational roles of women with chronic pain caused by RA are modified by illness and pain. When compared to healthy women, it is observed that the student, worker, volunteer and hobby/amateur roles are no longer performed due to illness. This influence is not dependent on pain intensity since no difference was found between participants with RA and levels of severity other than pain.

Resumo O objetivo deste estudo foi compreender os papéis ocupacionais de mulheres com dor crônica causada pela Artrite Reumatoide (AR) e comparar estes padrões de desempenho com os de sujeitos saudáveis. Trata-se de um estudo transversal, exploratório e comparativo. Os participantes foram divididos em 2 grupos. Para o grupo AR, foram aplicados dois instrumentos validados: Escala Visual Analógica e as Lista de Papéis Ocupacionais, dados pessoais, clínicos e sociodemográficos. No grupo controle, foram aplicados a ficha de informações pessoais e a Lista de Papéis Ocupacionais. O grupo controle era pareado em idade e nível sociodemográfico. Participaram deste estudo 164 mulheres, sendo 82 mulheres com dor crônica e artrite reumatoide, com média de idade de 55,9 ± 11,2 anos, e 82 mulheres pareadas e sem dor crônica e sem AR. No grupo AR, 48% das participantes perderam as atividades laborais, porém os papéis de cuidador (68%), serviços domésticos (89%), amigo (74%), membro da família (93%) e religioso (60%), se mantiveram mesmo com o processo de adoecimento. Já no Grupo controle (GC), observa-se a manutenção da maioria dos papéis ocupacionais. Na comparação entre os grupos GAR e GC, encontrou-se diferença estatisticamente significante nos papéis de estudante, trabalhador, voluntário, amigo e passatempo/amador. Os papéis ocupacionais de mulheres com dor crônica causada pela AR são modificados pelo adoecimento e pela dor. Quando comparadas com mulheres saudáveis, observa-se que os papéis de estudante, trabalhador, voluntário e passatempo/amador, deixam de ser realizados devido ao adoecimento. Esta influência não é dependente da intensidade da dor, já que não foi encontrada diferença entre as participantes com AR e níveis de severidade diferentes da dor.

Low level laser therapy for reducing pain in rheumatoid arthritis and osteoarthritis: a systematic review / Terapia Laser de Baixa Intensidade para a redução da dor em artrite reumatoide e osteoatrite: uma revisão sistemática / Terapia con Láser de baja intensidad para reducir el dolor en la artritis reumatoide y la osteoartritis: una revisión sistemática

Abstract Introduction: Treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) can reduce, modulate inflammation, and reduce deformities. Low-Level Laser Therapy is a biomodulator and may aid in the clinical picture of these conditions. Objective: To analyze the parameters most frequently used to determine the responses of patients with RA and OA in controlled and uncontrolled clinical trials. Method: This is a systematic review with search of articles in English, Portuguese and Spanish in PUBMED, SCOPUS, LILACS and Web of SCIENCE, of articles published between 2006 and 2018. MeSH terms were used. Inclusion criteria: evaluation of LLLT in the evaluations, evaluation and evaluation of the period, controlled and uncontrolled clinical trials, full publications. The base date of the energy dosimetry and the analysis of mean, median and mode of energy per point and energy per treatment. Results: Three articles on RA and 16 on OA were included in this study. Regarding dosimetry, it was one of the most recent of the pain, being this one with a greater energy dose. In OA, most of the articles presented are of importance, with variability in the dosage applied. Conclusion: There are several reports for patient studies purposes, mainly with doses of 6 J per point and 48 J. In the joints affected with OA and AR, it would be important to publish more scientific articles with better methodological quality and description of dosimetry.

Resumo Introdução: Os tratamentos para artrite reumatoide (AR) e osteoartrite (OA) devem diminuir dor, modular inflamação e diminuir deformidades. O LLLT é um biomodulador e pode auxiliar no quadro clínico destas. Objetivo: Analisar os parâmetros mais comumente utilizados para a diminuição das respostas de dor em pacientes com AR e OA em ensaios clínicos controlados e não controlados. Método: Trata-se de uma revisão sistemática com busca de artigos em inglês, português e espanhol na: PUBMED, SCOPUS, LILACS e Web of SCIENCE, entre 2006 a 2018. Foram utilizados os descritores MESH. Critérios de inclusão: avaliação da eficácia do LLLT nestas populações, verificação da dor antes e depois do tratamento, ensaios clínicos controlados e não controlados, publicados integralmente. Foi realizado o cálculo da dosimetria do laser e análise de média, mediana e moda da energia por ponto e energia por tratamento. Resultados: Incluídos neste estudo 3 artigos de AR e 16 de OA. Em relação à dosimetria, apenas um AR apresentou redução da dor, sendo este com a maior dose de energia. Já na OA, a maioria dos artigos apresentou diminuição da dor, e com variabilidade na dosagem aplicada. Alguns tiveram poucos parâmetros apresentados, tornando impossível calcular a dosimetria. Conclusão: há evidências científicas para reduzir a dor relatada em pacientes com OA de joelho, principalmente com doses de 6 J por ponto e 48 J aplicadas no tratamento diário. Para as outras articulações afetadas com OA e AR, seria importante a publicação de mais artigos científicos com melhor qualidade metodológica e descrição da dosimetria.

Resumen Introducción: Los tratamientos para la artritis reumatoide (AR) y la osteoartritis (OA) pueden reducirse, modular, encender y disminuir las deformidades. El LLLT es un biomodulador y puede auxiliar en el cuadro clínico de éstas. Objetivo: Analizar los parámetros más frecuentemente utilizados para determinar las respuestas de pacientes con AR y OA en ensayos clínicos controlados y no controlados. Método: Se trata de una revisión sistemática y la búsqueda de artículos en Inglés, portugués y español en: PubMed, SCOPUS, se utilizaron LILACS y Web of Science, entre 2006 y 2018. Los descriptores de malla. Criterios de inclusión: evaluación de la LLLT en las evaluaciones, evaluación y evaluación del período, ensayos clínicos controlados y no controlados, íntegramente. La fecha base de la dosimetría de energía y el análisis de media, media y moda de la energía por punto y energía por tratamiento. Resultados: Incluido en este estudio 3 artículos de AR y 16 de OA. En cuanto a la dosimetría, fue uno de los más recientes del dolor, siendo éste con una dosis mayor de energía. En la OA, la mayoría de los artículos presentados son de importancia, con la variabilidad en la dosificación aplicada. Se han tenido pocos pocos parámetros parámetros parámetros presentados presentados. Conclusión: hay una serie de informes para fines de estudios con pacientes, principalmente con dosis de 6 J por punto y 48 J. Las articulaciones afectadas con OA y AR, sería importante la publicación de más artículos científicos con mejor calidad metodológica y descripción de dosimetría.

Biomechanical properties: effects of low-level laser therapy and Biosilicate® on tibial bone defects in osteopenic rats.

PURPOSE: The aim of this study was to investigate the effects of laser therapy and Biosilicate® on the biomechanical properties of bone callus in osteopenic rats. METHODS: Fifty female Wistar rats were equally divided into 5 groups (n=10/group): osteopenic rats with intact tibiae (SC); osteopenic rats with unfilled and untreated tibial bone defects (OC); osteopenic rats whose bone defects were treated with Biosilicate® (B); osteopenic rats whose bone defects were treated with 830-nm laser, at 120 J/cm2 (L120) and osteopenic rats whose bone defects were treated with Biosilicate® and 830-nm laser, at 120 J/cm2 (BL120). Ovariectomy (OVX) was used to induce osteopenia. A non-critical bone defect was created on the tibia of the osteopenic animals 8 weeks after OVX. In Biosilicate® groups, bone defects were completely filled with the biomaterial. For the laser therapy, an 830-nm laser, 120 J/cm2 was used. On day 14 postsurgery, rats were euthanized, and tibiae were removed for biomechanical analysis. RESULTS: Maximal load and energy absorption were higher in groups B and BL120, according to the indentation test. Animals submitted to low-level laser therapy (LLLT) did not show any significant biomechanical improvement, but the association between Biosilicate® and LLLT was shown to be efficient to enhance callus biomechanical properties. Conversely, no differences were found between study groups in the bending test. CONCLUSIONS: Biosilicate® alone or in association with low level laser therapy improves biomechanical properties of tibial bone callus in osteopenic rats.

Low level laser therapy increases angiogenesis in a model of ischemic skin flap in rats mediated by VEGF, HIF-1α and MMP-2.

It is known that low level laser therapy is able to improve skin flap viability by increasing angiogenesis. However, the mechanism for new blood vessel formation is not completely understood. Here, we investigated the effects of 660 nm and 780 nm lasers at fluences of 30 and 40 J/cm(2) on three important mediators activated during angiogenesis. Sixty male Wistar rats were used and randomly divided into five groups with twelve animals each. Groups were distributed as follows: skin flap surgery non-irradiated group as a control; skin flap surgery irradiated with 660 nm laser at a fluence of 30 or 40 J/cm(2) and skin flap surgery irradiated with 780 nm laser at a fluence of 30 or 40 J/cm(2). The random skin flap was performed measuring 10×4 cm, with a plastic sheet interposed between the flap and the donor site. Laser irradiation was performed on 24 points covering the flap and surrounding skin immediately after the surgery and for 7 consecutive days thereafter. Tissues were collected, and the number of vessels, angiogenesis markers (vascular endothelial growth factor, VEGF and hypoxia inducible factor, HIF-1α) and a tissue remodeling marker (matrix metalloproteinase, MMP-2) were analyzed. LLLT increased an angiogenesis, HIF-1α and VEGF expression and decrease MMP-2 activity. These phenomena were dependent on the fluences, and wavelengths used. In this study we showed that LLLT may improve the healing of skin flaps by enhancing the amount of new vessels formed in the tissue. Both 660 nm and 780 nm lasers were able to modulate VEGF secretion, MMP-2 activity and HIF-1α expression in a dose dependent manner.

Low level laser therapy (830nm) improves bone repair in osteoporotic rats: similar outcomes at two different dosages.

BACKGROUND AND OBJECTIVE: The goal of this study was to investigate the effects of low level laser therapy (LLLT) in osteoporotic rats by means of subjective histopathological analysis, deposition of collagen at the site of fracture, biomechanical properties and immunohistochemistry for COX-2, Cbfa-1 and VEGF. MATERIAL AND METHODS: A total of 30 female Wistar rats (12weeks-old, ±250g) were submitted to ovariectomy (OVX). Eight weeks after the OVX, a tibial bone defect was created in all animals and they were randomly divided into 3 groups (n=10): control bone defect group (CG): bone defects without any treatment; laser 60J/cm(2) group (L60): animals irradiated with LLLT, at 60J/cm(2) and laser 120J/cm(2) group (L120): animals irradiated with LLLT, at 120J/cm(2). RESULTS: In the laser treated groups, at both fluences, a higher amount of newly formed bone was evidenced as well as granulation tissue compared to control. Picrosirius analysis demonstrated that irradiated animals presented a higher deposition of collagen fibers and a better organization of these fibers when compared to other groups, mainly at 120J/cm(2). COX-2, Cbfa-1 or VEGF immunoreactivity was detected in a similar manner either 60J/cm(2) or 120J/cm(2) fluences. However, no differences were shown in the biomechanical analysis. CONCLUSION: Taken together, our results support the notion that LLLT improves bone repair in the tibia of osteoporotic rats as a result of stimulation of the newly formed bone, fibrovascularization and angiogenesis.

Low-level laser therapy, at 60 J/cm2 associated with a Biosilicate(®) increase in bone deposition and indentation biomechanical properties of callus in osteopenic rats.

We investigate the effects of a novel bioactive material (Biosilicate(®)) and low-level laser therapy (LLLT), at 60 J/cm(2), on bone-fracture consolidation in osteoporotic rats. Forty female Wistar rats are submitted to the ovariectomy, to induce osteopenia. Eight weeks after the ovariectomy, the animals are randomly divided into four groups, with 10 animals each: bone defect control group; bone defect filled with Biosilicate group; bone defect irradiated with laser at 60 J/cm(2) group; bone defect filled with Biosilicate and irradiated with LLLT, at 60 J/cm(2) group. Laser irradiation is initiated immediately after surgery and performed every 48 h for 14 days. Histopathological analysis points out that bone defects are predominantly filled with the biomaterial in specimens treated with Biosilicate. In the 60-J/cm(2) laser plus Biosilicate group, the biomaterial fills all bone defects, which also contained woven bone and granulation tissue. Also, the biomechanical properties are increased in the animals treated with Biosilicate associated to lasertherapy. Our results indicate that laser therapy improves bone repair process in contact with Biosilicate as a result of increasing bone formation as well as indentation biomechanical properties.

Biosilicate® and low-level laser therapy improve bone repair in osteoporotic rats.

The aim of this study was to investigate the effects of a novel bioactive material (Biosilicate®) and low-level laser therapy (LLLT) on bone fracture consolidation in osteoporotic rats. Forty female Wistar rats were submitted to ovariectomy (OVX) to induce osteopenia. Eight weeks after surgery, the animals were randomly divided into four groups of 10 animals each: a bone defect control group (CG); a bone defect filled with Biosilicate group (BG); a bone defect filled with Biosilicate and irradiated with LLLT at 60 J/cm(2) group (BG60); and a bone defect filled with Biosilicate and irradiated with LLLT at 120 J/cm(2) group (BG120). Bone defects were surgically performed on both tibias. The size of particle used for Biosilicate was 180-212 µm. Histopathological analysis showed that bone defects were predominantly filled with the biomaterial in specimens treated with Biosilicate. LLLT with either 60 or 120 J/cm(2) was able to increase collagen, Cbfa-1, VGEF and COX-2 expression in the circumjacent cells of the biomaterial. A morphometric analysis revealed that the Biosilicate + laser groups showed a higher amount of newly formed bone. Our results indicate that laser therapy improves bone repair process in contact with Biosilicate as a result of increasing bone formation, as well as COX-2 and Cbfa-1 immunoexpression, angiogenesis and collagen deposition in osteoporotic rats.

The effects of 660 nm and 780 nm laser irradiation on viability of random skin flap in rats.

BACKGROUND AND OBJECTIVE: Some studies have shown that laser phototherapy is able to increase skin flap viability by decreasing the necrotic area and increasing neoangiogenesis. However, the mechanism by which laser acts on cells is not fully understood. The present study investigated the effects of two different laser wavelengths at 30 and 40 J/cm(2) on the viability of skin flap in rats. MATERIAL AND METHODS: Sixty male animals were used in this study. They were distributed into the following groups (n = 12 each group): control group, group irradiated with 660 nm at 30 J/cm(2); group irradiated with 780 nm, at 30 J/cm(2), group irradiated with 660 nm at 40 J/cm(2); and group irradiated with 780 nm at 40 J/cm(2). The skin flap was performed on the back of all animals studied, with a plastic sheet interposed between the flap and the donor site. Laser irradiation was done immediately after the surgery and on days 1, 2, 3, and 4 post-surgery. The percentage of the necrotic area of the flap was calculated at day 7 post-surgery. RESULTS: Control group showed a necrotic area of 62.83%. Interestingly, no statistically significant differences were found among the treated groups and the control group. CONCLUSION: This present study showed that 660 nm and 780 nm lasers at doses of 30 and 40 J/cm(2) were not effective for decreasing the necrotic area of the skin flaps in rats.

Low-level laser therapy (670 nm) on viability of random skin flap in rats.

This study investigated the effects of 670 nm laser, at different fluences, on the viability of skin flap in rats. One hundred male animals were used. The animals were divided into control group; group treated with 3 J/cm(2); group treated with 6 J/cm(2); group treated with 12 J/cm(2) and group treated with 24 J/cm(2). The skin flap was made on the backs of all animals studied, with a plastic sheet interposed between the flap and the donor site. Laser irradiation was done immediately after the surgery and on days 1, 2, 3 and 4 after surgery. The percentage of necrosis of the flap was calculated at the 7th postoperative day. Additionally, a sample of each flap was collected to enable us to count the blood vessels. Treated animals showed a statistically significant smaller area of necrosis than did the control group. The necrosis in the treated groups was 41.82% (group 2), 36.51% (group 3), 29.45% (group 4) and 20.37% (group 5). We also demonstrated that laser irradiation at 670 nm, at all doses used, had a stimulatory effect on angiogenesis. Our study showed that the 670 nm laser was efficient to increase the viability of the skin flap, at all fluences used, with a tendency of reaching better results at higher doses.