Application of Biotechniques for In Vitro Virus and Viroid Elimination in Pome Fruit Crops.

Sustainable production of pome fruit crops is dependent upon having virus-free planting materials. The production and distribution of plants derived from virus- and viroid-negative sources is necessary not only to control pome fruit viral diseases but also for sustainable breeding activities, as well as the safe movement of plant materials across borders. With variable success rates, different in vitro-based techniques, including shoot tip culture, micrografting, thermotherapy, chemotherapy, and shoot tip cryotherapy, have been employed to eliminate viruses from pome fruits. Higher pathogen eradication efficiencies have been achieved by combining two or more of these techniques. An accurate diagnosis that confirms complete viral elimination is crucial for developing effective management strategies. In recent years, considerable efforts have resulted in new reliable and efficient virus detection methods. This comprehensive review documents the development and recent advances in biotechnological methods that produce healthy pome fruit plants. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Fox eyes lift-A new protocol for eyebrow elevation with laser Fotona.

BACKGROUND: The eyelids play an important role in our appearance and are usually the first to show signs of age. The Fotona SP Spectro Systems consist of a range of noninvasive laser treatments that work together synergistically to tighten the collagen in four dimensions and provide long-lasting firmness to the face. The Fotona SP Spectro combines two wavelengths: Er:YAG (2940 nm) and Nd:YAG (1064 nm) with four distinct treatments: SmoothLiftingTM, FRAC3®, PIANO®, and SupErficialTM, allowing safe, painless, noninvasive, and no downtime rejuvenation. AIMS: To present a new protocol of treatment with Fotona SP Spectro for eyebrow elevation, which we call fox eyes lift (FEL), and compare it to the standard SmoothEye® (SE) protocol. METHODS: This is a prospective, interventional, split-face study. The sample consisted of 21 subjects (19 women) with a mean age of 50.1 ± 7.9 years who underwent two different protocols, that is, SE on one side and FEL on the other. The protocol used on each side was selected by drawing lots. Three sessions were held at 1-month intervals. Standardized photographic documentation was obtained before and 30 days after the end of treatment. Eyebrow position before and after complete treatment was quantified using ImageJ software. RESULTS: Statistical analysis by ANOVA showed a significant improvement in eyebrow position after treatment with both protocols, with a significantly greater effect of FEL (p = 0.0003 d = 0.95). CONCLUSION: Fox eyes lift is an efficient and safe technique providing significant improvement in the position of the eyebrow.

Comparison of bipolar radiofrequency thermotherapy and transurethral prostate resection in treatment of benign prostate hyperplasia.

OBJECTIVES: Lower urinary tract symptoms due to benign prostatic hyperplasia in men increase with aging. Risks related to anesthesia and surgery have led a search for alternative treatments. Bipolar radiofrequency (RF) thermotherapy is one of the methods adopted in patients with high surgical risks. The aim of this study is to compare the effect of bipolar RF thermotherapy and transurethral resection of the prostate (TURP) methods on voiding symptoms and on post-operative complication rates especially in patients carrying high surgical risks. METHODS: Pre-operative, post-operative 1st and 6th month International Prostate Symptom Score (IPSS), Qmax, quality of life, prostate volumes, and postoperative complications of the patients underwent TURP and RF for benign prostatic hyperplasia (BPH) were compared. RESULTS: In the RF group, the pre-operative median IPSS was 30, prostate volume 41.5 cc, post-void residual (PVR) 80 ml, and Qmax is 5.85 ml/s.; In the TURP group, these were 29, 40 cc, 85 ml, and 5.3 ml/sec, respectively. In the Bipolar RF group, post-operative 1st- and 6th-month median values were IPSS 18, 21; prostate volume 40, 40; PVR 40, 35; Qmax 10.9, 9.15 and in the TURP group IPSS 9, 8; prostate volume 20, 20; PVR 30, 10; Qmax 17.25, 19.1, respectively. CONCLUSION: Bipolar RF thermotherapy is an applicable treatment method for BPH patients with high surgical risks.

OBJETIVOS: La termoterapia bipolar por radiofrecuencia es uno de los métodos adoptados en pacientes con alto riesgo quirúrgico. El objetivo de este estudio es comparar el efecto de la termoterapia de radiofrecuencia bipolar y los métodos de RTUP en los síntomas de vaciado y en las tasas de complicaciones posoperatorias, especialmente en pacientes con alto riesgo quirúrgico. MÉTODOS: Se compararon el IPSS, el Qmax, la calidad de vida, los volúmenes de próstata y las complicaciones posoperatorias de los pacientes sometidos a RTUP y RF para la HBP preoperatorios, posoperatorios al primer y sexto mes. RESULTADOS: En el grupo de RF, la mediana preoperatoria del IPSS fue de 30, el volumen prostático de 41.5 cc, el PVR de 80 ml y el Qmax de 5.85 ml/seg.; En el grupo RTUP estos fueron 29, 40 cc, 85 ml y 5.3 ml/seg, respectivamente. En el grupo de RF bipolar, los valores medianos postoperatorios del primer y sexto mes fueron IPSS 18, 21; volumen de próstata 40, 40; PVR 40, 35; Qmax 10.9, 9.15 y en el grupo TURP IPSS 9, 8; volumen de próstata 20, 20; PVR 30, 10; Qmax 17.25, 19.1, respectivamente. CONCLUSIÓN: La termoterapia de RF bipolar es un método de tratamiento aplicable para pacientes con HPB con alto riesgo quirúrgico.

Paraffin-Peloid Formulations from Copahue: Processing, Characterization, and Application.

The Copahue Thermal Center, situated in Neuquén, Argentina, produces natural and matured peloids, which are employed in the prevention and treatment of various osteoarticular and dermatological disorders. The presence of sulfur as a constituent and its thermotherapeutic potential constitute the primary strengths of these peloids. Nevertheless, accessing Copahue is challenging due to its distance from densely populated centers and the snow cover during the winter months in the southern hemisphere. Therefore, in order to propose a material that can be utilized year-round in any location, a mudpack was obtained by combining medicinal paraffin with dehydrated Copahue peloids, with concentrations evaluated up to 10% w/w. This mudpack was analyzed through X-ray diffraction, which detected the presence of sulfur, the most important component of Copahue's peloids. Through IR spectroscopy, the signals that identify medicinal paraffin were clearly observed, and for concentrations of 6% and 10% peloid in the material, it was possible to detect the presence of mineral clay components associated with Si-O stretching vibrations at around 1041 cm-1. The low values of luminosity and grey tonality obtained for the mudpack contributed to patient acceptability and the absorption of electromagnetic radiation. The experimental cooling rate, calculated using the ratio of the temperature variation (∆T) with respect to the time variation (∆t) in each interval of the experimental curve, was determined to be 0.6 °C·min-1 for both paraffin and the mudpack. However, for peloids, higher values ranging from 0.6 to 4.8 °C·min-1 were obtained. This suggests that the mudpack mixtures have a slower heat release, which is a desirable property for their use as a thermotherapeutic agent. Considering the reusability of the mudpack, its stability was evaluated after 10 cycles of cooling and heating through XRD, DSC, and FTIR tests, resulting in a system that retains its properties. The formulation of the obtained mudpack is promising for the development of these materials on a larger scale.

Termoterapia associada com treinamento de flexibilidade não aprimora a amplitude de movimento de joelhos em adultos saudáveis: revisão sistemática de ensaios clínicos randomizados com meta-análise / Thermotherapy associated with flexibility training does not increase the knee range of movement of healthy adults: systematic review and meta-analysis of randomized clinical trials

The stretching with thermotherapies associated have been related in the literature as a way to increase the range of motion (ROM), but still are not consensus about this efficacy and costeffectiveness. The muscle stretching is a useful technique in rehabilitation and in physical activities programs, either to gain or maintain the flexibility, as a recovery of musculoskeletal and joint injuries. Objective: To determine the effects of thermotherapies associated to flexibility training in ROM of knee extension in healthy adults. Method: The search strategy was conducted in main databases, as Cochrane Library, LILACS, PEDro, PUBMED/ Medline, Scopus and Web of Science. The searches were done in 2016, and renewed in 2023, in order to achieve new publications along this time. Were selected only randomized clinical trials that have executed a training of hamstrings stretching, associated or not with one or more thermotherapies in healthy young adults, as long as the outcome was knee extension ROM. Only papers in Portuguese or English were assessed. To evaluate risk of bias was used the Cochrane Collaboration's Risk of Bias Tool, and the methodological quality assessment was rated following the PEDro Scale. Results: Eight articles were included, totalizing 260 participants. The papers showed low methodological quality, and uncertain risk of bias. Only chronic effect of local warming and cryotherapy plus stretching showed a statistically significant difference versus control group. However, the thermotherapy action associated with stretching is still unclear, once the results suggest that even without the thermotherapy there are ROM increases. Conclusion: The stretching is effective in knee extension ROM improvement in healthy adults, with or without thermotherapy. New studies with higher methodological rigor and standardized protocols are needed

Os alongamentos com termoterapias associadas têm sido relatados na literatura como forma de aumentar a amplitude de movimento (ADM), mas ainda não há consenso sobre sua eficácia e custo-efetividade. O alongamento muscular é uma técnica útil na reabilitação e em programas de atividades físicas, tanto para ganho ou manutenção da flexibilidade, quanto para recuperação de lesões musculoesqueléticas e articulares. Objetivo: Determinar os efeitos das termoterapias associadas ao treinamento de flexibilidade na ADM de extensão do joelho em adultos saudáveis. Método: A estratégia de busca foi realizada nas principais bases de dados, como Cochrane Library, LILACS, PEDro, PUBMED/ MedLine, Scopus e Web of Science. As buscas foram realizadas em 2016, e renovadas em 2023, a fim de alcançar novas publicações ao longo deste tempo. Foram selecionados apenas ensaios clínicos randomizados que tenham executado um treinamento de alongamento de isquiotibiais, associado ou não a uma ou mais termoterapias, em adultos jovens saudáveis, desde que o desfecho fosse ADM de extensão de joelho. Apenas artigos em português ou inglês foram avaliados. Para avaliar o risco de viés foi usado o Risk of Bias Tool da Cochrane Collaboration, e a avaliação da qualidade metodológica foi classificada de acordo com a Escala PEDro. Resultados: Foram incluídos oito artigos, totalizando 260 participantes. Os artigos apresentaram baixa qualidade metodológica e risco incerto de viés. Apenas o efeito crônico de aquecimento local e crioterapia associados ao alongamento mostrou uma diferença estatisticamente significativa em relação ao grupo controle. No entanto, a ação da termoterapia associada ao alongamento ainda não está clara, uma vez que os resultados sugerem que mesmo sem a termoterapia há aumento da ADM. Conclusão: O alongamento é eficaz na melhora da ADM de extensão do joelho em adultos saudáveis, com ou sem termoterapia. Novos estudos com maior rigor metodológico e protocolos padronizados são necessários

Regional moderate hyperthermia for mild-to-moderate COVID-19 (TherMoCoV study): a randomized controlled trial.

Background: To prevent COVID-19 progression, low-cost alternatives that are available to all patients are needed. Diverse forms of thermotherapy have been proposed to prevent progression to severe/critical COVID-19. Objective: The aim of this study is to evaluate the efficacy and safety of local thermotherapy to prevent disease progression in hospitalized adult patients with mild-to-moderate COVID-19. Methods: A multicenter, open-label, parallel-group, randomized, adaptive trial is used to evaluate the efficacy and safety of local thermotherapy to prevent disease progression in hospitalized adult patients with mild-to-moderate COVID-19. Eligible hospitalized adult patients with symptoms of COVID-19 with ≤5 days from symptom onset, meeting criteria for mild or moderate COVID-19, were randomly assigned to the intervention consisting of local thermotherapy via an electric heat pad in the thorax (target temperature range 39.5­42°C) continuously for 90 min, twice daily, for 5 days, or standard care. The main outcome was the proportion of patients who progressed to severe-to-critical COVID-19 or death. Patients were randomized in a 1:1 ratio through a centralized computer-generated sequence of minimization with a random component of 20%. Participants and medical staff were not blinded to the intervention. Results: One-hundred and five participants (thermotherapy n = 54, control n = 51) with a median age of 53 (IQR: 41­64) years were included for analysis after the early cessation of recruitment due to the closure of all temporal COVID-19 units (target sample size = 274). The primary outcome of disease progression occurred in 31.4% (16/51) of patients in the control group vs. 25.9% (14/54) of those receiving thermotherapy (risk difference = 5.5%; 95%CI: −11.8­22.7, p = 0.54). Thermotherapy was well tolerated with a median total duration of thermotherapy of 900 (IQR: 877.5­900) min. Seven (13.7%) patients in the control group and seven (12.9%) in the thermotherapy group had at least one AE (p = 0.9), none of which were causally attributed to the intervention. No statistically significant differences in serum cytokines (IL-1ß, IL-6, IL-8, IL-10, IL-17, and IFN-γ) were observed between day 5 and baseline among groups. Conclusion: Local thermotherapy was safe and well-tolerated. A non-statistically significant lower proportion of patients who experienced disease progression was found in the thermotherapy group compared to standard care. Local thermotherapy could be further studied as a strategy to prevent disease progression in ambulatory settings.Clinical Trial registration: www.clinicaltrials.gov, identifier: NCT04363541.

Effect of thermotherapy, Leifsonia xyli subsp. xyli titres, sugarcane genotype and diagnostic techniques on ratoon stunt control in Brazil.

AIMS: To examine the interaction of diagnostic techniques, initial titres of Leifsonia xyli subsp. xyli (Lxx), sugarcane genotype and thermotherapy on ratoon stunt (RSD) control. METHODS AND RESULTS: Single buds of RB867515, RB92579 and RB966928 were submitted to 50°C/2 h or 52°C/30 min under factorial block design and five replications; results were checked 9 months later by serological (DBI) and molecular (PCR) techniques. A 10,000 bootstrapping simulations were performed to infer the best plot size based on the experimental coefficient of variation. Analysis of variance showed significance only on initial Lxx titres and RSD control. Despite the absence of significance in the overall analysis, minor differences in control success with different methods and cultivars are predicted to have a major epidemiological impact on RSD, considering successive harvests and vegetative increase. According to an epidemiological interpretation, the 50°C/2 h treatment was more effective, cultivar RB966928 was the most susceptible and the PCR-based method was the most sensitive for pathogen detection. The minimum required plants per plot was 15, indicating high precision of our experiment CONCLUSIONS: Data interpretation considered both the statistical analysis and the epidemiology aspect of RSD in order to improve RSD management. The Brazilian sugarcane industry will benefit from this approach since it is not using it. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study that examined multiple factors that affect RSD control. Our work pinpointed the importance of the thermotherapy, its best combination as well as the diagnostic test. Also, the effect of the cultivar to respond to management strategies. Because the epidemiological aspect of RSD was taken into consideration, results of our work can have an impact on RSD control in the field.

Utilização da fisioterapia na reabilitação de bezerro com poliartrite e paresia neuromuscular: relato de caso / Use of physiotherapy in the rehabilitation of calves with polyarthritis and neuromuscular paresis: case report / Uso de la fisioterapia en la rehabilitación de un ternero con poliartritis y parisia neuromuscular: reporte de caso

A reabilitação animal na medicina veterinária é um campo recente, porém crescente a cada dia. Neste sentido, a fisioterapia veterinária atua trazendo inúmeros benefícios, como melhoria dos movimentos, redução da dor, edema e outras. Interfere ainda no tempo de recuperação, redução de custos para o proprietário, podendo ser hoje utilizada como um tratamento na recuperação pós-cirúrgica. Desta forma, objetivou-se relatar o uso da fisioterapia em uma bezerra com poliartrite e paresia neuromuscular. O animal apresentou um aumento de volume nas articulações cárpicas e társicas após histórico de onfalite, permanecendo em decúbito esternal por vários dias. O proprietário resolveu aplicar ferro dextrano na região glútea do animal, o que causou uma lesão de nervo isquiático. Foram instituídos protocolos medicamentosos e fisioterápicos, que culminaram no estímulo da marcha, propriocepção, além de hipertrofia muscular. Porém, em virtude de complicações resultantes de onfalite, o animal veio a óbito.(AU)

Animal rehabilitation in veterinary medicine is a recent field, but growing every day. In this sense, veterinary physiotherapy works bringing numerous benefits, such as improved movements, reduced pain, edema and others. Reducing the recovery time, reducing costs for the owner, and today it can be used as a treatment in post-surgical recovery. In this sense, the objective was to report the use of physiotherapy in a heifer with polyarthritis and neuromuscular paresis. The animal showed an increase in volume in the carpal and tarsal joints after a history of omphalitis, remaining in sternal decubitus for several days. The owner decided to apply iron dextran to the animal's gluteal region, which caused an injury to the sciatic nerve. Medicinal and physical therapy protocols were instituted, which culminated in the stimulation of gait, proprioception, in addition to muscle hypertrophy. However, due to complications resulting from omphalitis, the animal died.(AU)

La rehabilitación animal en medicina veterinaria es un campo reciente, pero en crecimiento cada día. En este sentido, la fisioterapia veterinaria actúa aportando numerosos beneficios, como mejora de los movimientos, reducción del dolor, edemas y otros. Disminución del tiempo de recuperación, reducción de costos para el propietario, pudiendo ser utilizado hoy en día como tratamiento en la recuperación posquirúrgica. En ese sentido, el objetivo fue reportar el uso de fisioterapia en una vaquilla con poliartritis y paresia neuromuscular. El animal presentó un aumento de volumen en las articulaciones del carpo y del tarso tras un antecedente de onfalitis, permaneciendo en decúbito esternal durante varios días. El propietario decidió aplicar hierro dextrano en la región glútea del animal, lo que provocó una lesión en el nervio ciático. Se instauraron protocolos farmacológicos y de fisioterapia, que culminaron con estimulación de la marcha, propiocepción, además de hipertrofia muscular. Sin embargo, debido a complicaciones derivadas de la onfalitis, el animal falleció.(AU)

Minimally invasive treatments for benign prostatic hyperplasia: a Cochrane network meta-analysis.

OBJECTIVE: To assess the comparative effectiveness and ranking of minimally invasive treatments (MITs) for lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We searched multiple databases up to 24 February 2021. We included randomized controlled trials assessing the following treatments: convective radiofrequency water vapour thermal therapy (WVTT; or Rezum); prostatic arterial embolization (PAE); prostatic urethral lift (PUL; or Urolift); temporary implantable nitinol device (TIND); and transurethral microwave thermotherapy (TUMT) compared to transurethral resection of the prostate (TURP) or sham surgery. We performed a frequentist network meta-analysis. RESULTS: We included 27 trials involving 3017 men. The overall certainty of the evidence of most outcomes according to GRADE was low to very low. Compared to TURP, we found that PUL and PAE may result in little to no difference in urological symptoms, while WVTT, TUMT and TIND may result in worse urological symptoms. MITs may result in little to no difference in quality of life, compared to TURP. MITs may result in a large reduction in major adverse events compared to TURP. We were uncertain about the effects of PAE and PUL on retreatment compared to TURP, however, TUMT may result in higher retreatment rates. We were very uncertain of the effects of MITs on erectile function and ejaculatory function. Among MITs, PUL and PAE had the highest likelihood of being the most efficacious for urinary symptoms and quality of life, TUMT for major adverse events, WVTT and TIND for erectile function and PUL for ejaculatory function. Excluding WVTT and TIND, for which there were only studies with short-term (3-month) follow-up, PUL had the highest likelihood of being the most efficacious for retreatment. CONCLUSIONS: Minimally invasive treatments may result in similar or worse effects concerning urinary symptoms and quality of life compared to TURP at short-term follow-up.

Exploring the rationale for thermotherapy in COVID-19.

Increased transmissibility of the pandemic severe acute respiratory coronavirus 2 (SARS-CoV-2) has been noted to occur at lower ambient temperatures. This is seemingly related to a better replication of most respiratory viruses, including SARS-CoV-2, at lower-than-core body temperatures (i.e., 33 °C vs 37 °C). Also, intrinsic characteristics of SARS-CoV-2 make it a heat-susceptible pathogen. Thermotherapy has successfully been used to combat viral infections in plants which could otherwise result in great economic losses; 90% of viruses causing infections in plants are positive-sense single-stranded ribonucleic acid (+ssRNA) viruses, a characteristic shared by SARS-CoV-2. Thus, it is possible to envision the use of heat-based interventions (thermotherapy or mild-temperature hyperthermia) in patients with COVID-19 for which moderate cycles (every 8-12 h) of mild-temperature hyperthermia (1-2 h) have been proposed. However, there are potential safety and mechanistic concerns which could limit the use of thermotherapy only to patients with mild-to-moderate COVID-19 to prevent disease progression rather than to treat patients who have already progressed to severe-to-critical COVID-19. Here, we review the characteristics of SARS-CoV-2 which make it a heat-susceptible virus, potential host mechanisms which could be enhanced at higher temperatures to aid viral clearance, and how thermotherapy could be investigated as a modality of treatment in patients with COVID-19 while taking into consideration potential risks.

Efeito agudo de diferentes métodos de termoterapia na amplitude de movimento articular / Acute effect of different thermotherapy methods on articular range of motion

Objetivo O objetivo deste estudo foi comparar quantitativamente o efeito agudo de diferentes técnicas de termoterapia no ganho da amplitude de movimento. Participaram da pesquisa voluntários (n=34) de ambos os sexos e média de idade de 22,3 anos (±3,3 anos). Métodos Os participantes foram divididos aleatoriamente em dois grupos: em um grupo, os indivíduos foram submetidos a aplicação da lâmpada infravermelha (calor superfi cial), enquanto no outro grupo utilizou-se o aparelho de ondas curtas (calor profundo) como técnica de termoterapia. Resultados Como resultado, observou-se que o grupo submetido ao calor profundo obteve melhora significante em relação a amplitude de movimento, tanto em comparação dentro do mesmo grupo, confrontando-se a amplitude de movimento pré- e pós-intervenção (aumento médio de 10,9+3,1º), quanto quando comparado ao grupo submetido ao calor superficial, que não apresentou melhora significativa (aumento médio de 3,1+2,5º). Conclusão Concluiu-se que, embora o efeito agudo da termoterapia seja benéfico no ganho de amplitude de movimento, o calor profundo parece ter um efeito mais pronunciado quando comparado às técnicas de calor superficial.

Objective The objective of this study was to quantitatively compare the acute effect of different thermotherapy techniques on the gain of range of motion. Methods Research volunteers (n=34) of both genders and mean age of 22.3 years (±3.3 years) were randomly divided into two groups: one group in which subjects were treated with infrared lamp (surface heat) while the other group was treated with the selected thermotherapy technique with the shortwave apparatus (deep heat). Results The deep heat group obtained a significant improvement in terms of range of motion, both within the same group, comparing the pre and post intervention range of motion (mean increase of 10.9±3.1º) when compared to the superficial heat group, which in turn did not show significant improvement (mean increase of 3.1+2.5º). Conclusion Although the acute effect of thermotherapy is beneficial in gain of range of motion, deep heat seems to have a more pronounced effect when compared to surface heat techniques

Comprehensive economic evaluation of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia.

BACKGROUND: Cutaneous leishmaniasis causes a high disease burden in Colombia, and available treatments present systemic toxicity, low patient compliance, contraindications, and high costs. The purpose of this study was to estimate the cost-effectiveness of thermotherapy versus Glucantime in patients with cutaneous leishmaniasis in Colombia. METHODS: Cost-effectiveness study from an institutional perspective in 8133 incident cases. Data on therapeutic efficacy and safety were included, calculating standard costs; the outcomes were disability adjusted life years (DALYs) and the number of patients cured. The information sources were the Colombian Public Health Surveillance System, disease burden studies, and one meta-analysis of controlled clinical trials. Incremental cost-effectiveness was determined, and uncertainty was evaluated with tornado diagrams and Monte Carlo simulations. RESULTS: Thermotherapy would generate costs of US$ 501,621; the handling of adverse effects, US$ 29,224; and therapeutic failures, US$ 300,053. For Glucantime, these costs would be US$ 2,731,276, US$ 58,254, and US$ 406,298, respectively. With thermotherapy, the cost would be US$ 2062 per DALY averted and US$ 69 per patient cured; with Glucantime, the cost would be US$ 4241 per DALY averted and US$ 85 per patient cured. In Monte Carlo simulations, thermotherapy was the dominant strategy for DALYs averted in 67.9% of cases and highly cost-effective for patients cured in 72%. CONCLUSION: In Colombia, thermotherapy can be included as a cost-effective strategy for the management of cutaneous leishmaniasis. Its incorporation into clinical practice guidelines could represent savings of approximately US$ 10,488 per DALY averted and costs of US$ 116 per additional patient cured, compared to the use of Glucantime. These findings show the relevance of the incorporation of this treatment in our country and others with similar parasitological, clinical, and epidemiological patterns.

Microwave diathermy and transcutaneous electrical nerve stimulation effects in primary dysmenorrhea: clinical trial protocol.

The aim of this study will be to analyze the effects of microwave diathermy (MWD) and transcutaneous electrical nerve stimulation (TENS) on primary dysmenorrhea. Eighty eight women, age range 18-44 years, with no previous pregnancy, no practice physical activities, a BMI of ≤29.9 kg/m2, a regular menstrual cycle and a diagnosis of primary dysmenorrhea, with menstrual pain ranging from mild to severe, will be selected. The participants will be randomized into four groups: MWD and TENS, MWD and placebo TENS, placebo MWD and TENS, and placebo MWD and placebo TENS. Pain will be measured using the visual numeric scale and the McGill Pain Questionnaire; the pressure pain threshold using a digital algometer and conditioned pain modulation using the cold pressor test. Brazilian Clinical Trials Registry (RBR-5QKCK4. Registered on 16 March 2016).

Cost-effectiveness analysis of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis.

OBJECTIVE: The treatment of cutaneous leishmaniasis is toxic, has contraindications, and a high cost. The objective of this study was to estimate the cost-effectiveness of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis. METHODS: Effectiveness was the proportion of healing and safety with the adverse effects; these parameters were estimated from a controlled clinical trial and a meta-analysis. A standard costing was conducted. Average and incremental cost-effectiveness ratios were estimated. The uncertainty regarding effectiveness, safety, and costs was determined through sensitivity analyses. RESULTS: The total costs were $66,807 with Glucantime and $14,079 with thermotherapy. The therapeutic effectiveness rates were 64.2% for thermotherapy and 85.1% for Glucantime. The average cost-effectiveness ratios ranged between $721 and $1275 for Glucantime and between $187 and $390 for thermotherapy. Based on the meta-analysis, thermotherapy may be a dominant strategy. CONCLUSION: The excellent cost-effectiveness ratio of thermotherapy shows the relevance of its inclusion in guidelines for the treatment.

Termoterapia para la espasticidad post accidente cerebro vascular: revisión sistem / Thermotherapy for spasticity post stroke: systematic review

Objective: Determine whether there is scientific evidence to support the effectiveness of thermotherapy in the management of spasticity in adult patients post stroke. Method: A systematic review of randomized trials were performed, the databases searched were Medline, Cinahl, Central, PEDro, SPORTDiscus and Lilacs. Results: 4 studies that metour eligibility criteria and selection were selected. Conclusion: There is controversial evidence that the US produces are duction in neural electrophysiological excitability compared to US placeboand IR; moderate evidence that US not produces clinical improvement in range of motion or level of spasticity, compared to US placebo, IR, TENS and botulinum toxin.

Objetivo: Determinar si existe evidencia científica que avale la efectividad de la termoterapia en el manejo de la espasticidad en pacientes adultos post accidente cerebro vascular. Método: Se realizó una revisión sistemática de estudios clínicos aleatorizados, las bases de datos consultadas fueron: Medline, Cinahl, Central, PEDro, SPORTDiscus y Lilacs. Resultados: Se seleccionaron 4 artículos que cumplían con nuestros criterios de elegibilidad y selección. Conclusión: Existe evidencia contradictoria que el US produce una reducción electrofisiológica de la excitabilidad neural comparado con US apagado e IR; existe moderada evidencia que el US no produce una mejoría clínica del rango de movimiento ni del nivel de espasticidad, comparado con US apagado, IR, TENS y toxina botulínica.

Effects of cryotherapy and microwave diathermy on the strength production capacity of elbow flexors in healthy men / Efeitos da crioterapia e da diatermia por micro-ondas sobre a capacidade de produção de força de flexores de cotovelo de homens saudáveis

Abstract Physiological effects of thermal changes in tissues might influence some physical properties of muscle fibers, such as strength. The aim of this study was to compare the effects of cryotherapy and microwave diathermy application on the strength production capacity of the elbow flexor muscles. Thirty male, healthy and sedentary subjects, with average age of 22.40 (±3.42) years, participated in this prospective study. Participants were submitted to assessment of isometric strength production capability by an adapted load cell. Half of volunteers received cryotherapy on the first day of application and microwave diathermy (MD) 48 hours later, whereas the other half was treated the other way around. Cryotherapy was applied up to the temperature of the biceps region reached 25ºC, and MD was applied up to 42ºC. Six peak strength reevaluations were made over 2 hours. There was significant increase in peak strength (PS) up to 15 minutes after cryotherapy, then there was a decrease in maximum isometric strength, however, statistically significant difference remained up to 1 hour and 30 minutes after cryotherapy. In MD, PS decreased significantly after application until 15 min. From this moment, PS returned close to the initial value, and in the last assessment, PS reduced again. Cryotherapy and MD differently interfered in isometric muscle strength production capacity of elbow flexors, while cooling generated increment, heating caused decline.

Resumo Os efeitos fisiológicos das mudanças térmicas nos tecidos podem influenciar propriedades físicas das fibras musculares, como a força. O objetivo deste estudo foi comparar os efeitos da aplicação da crioterapia e da diatermia por micro-ondas (DMO) sobre a capacidade de produção de força dos músculos flexores de cotovelo. Participaram deste estudo prospectivo 30 voluntários do sexo masculino, saudáveis, não praticantes de atividade física, com valor médio de 22,40 (±3,42) anos de idade. Foram submetidos à avaliação da capacidade de produção de força isométrica, por meio de uma célula de carga adaptada. Metade dos voluntários recebeu no primeiro dia aplicação da crioterapia e no outro dia (48 horas depois) a DMO, e a outra metade dos sujeitos o inverso. A crioterapia foi aplicada até que a temperatura na região bicipital atingisse 25ºC e a DMO foi aplicada até que atingisse 42ºC. Seis reavaliações do PF foram feitas ao longo de 2 horas. Houve incremento significativo no pico de força (PF) até 15 minutos após a aplicação da crioterapia, a partir desse momento houve decréscimo da força isométrica máxima, no entanto, a diferença estatisticamente significativa esteve presente até 90 minutos depois. Na DMO, o PF reduziu significativamente até 15 min após a aplicação do recurso. A partir deste momento, o PF foi retornando próximo ao valor inicial. Na última avaliação, o PF reduziu novamente. A crioterapia e a DMO interferiram de maneira diferente na capacidade de produção de força muscular isométrica de flexores de cotovelo, enquanto o resfriamento gerou incremento, o aquecimento causou declínio.

Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy.

[Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care.

Efectividad de los agentes físicos en el tratamiento del dolor en la artrosis de rodilla: una revisión sistemática / Physical agents’ effectiveness in the pain treatment in knee arthrosis: a systematic review

Objetivo: determinar si los agentes físicos son eficaces para disminuir el dolor y mejorar la calidad de vida en adultos con artrosis de rodilla, mediante la recopilación de los diferentes estudios científicos de alta calidad metodológica publicados a la fecha. Métodos: se realizó una revisión sistemática en las bases de datos: PEDro, Scielo y Medline. Fueron incluidos ensayos controlados aleatorios con pacientes diagnosticados de osteoartritis de rodilla. Se seleccionaron artículos publicados entre el 1 de enero de 2004 al 10 de octubre de 2014, tanto en lengua española como inglesa. La selección de estudios se realizó de manera independiente, no cegada por 2 revisores, y se llevó a cabo una clasificación de los estudios mediante la escala PEDro. Resultados: se encontraron 428 artículos que potencialmente podrían incluirse a este trabajo. Al determinar los criterios de inclusión y exclusión, solo se seleccionaron 28 artículos para su análisis. Conclusiones: se dispone de evidencia de buen nivel que sustenta la aplicación del láser, biomagnetismo y la electroestimulación nerviosa transcutánea, para disminuir el dolor y mejorar la calidad de vida en personas con artrosis de rodilla.

Aim: to determine if physical agents are efficient for pain decreasing and life quality improving in adults with knee arthrosis, compiling the different, methodologically high quality scientific studies published up to the date. Methods: a systematic review was carried out in the databases PEDro, Scielo and Medline. We included controlled, randomized trials with patients diagnosed of knee osteoarthritis. We chose articles published in the period from January 1st 2004 and October 10 2014, both in Spanish and in English. The studies compilation was performed in an independent way, not blinded by 2 reviewers, and the studies were classified using the PEDro scale. Outcomes: we found 428 articles that potentially might be included in this work. After applying the inclusion and exclusion criteria, only 28 articles were chosen for the analysis. Conclusions: we have good evidence supporting the usage of laser, biomagnetism and transcutaneous nervous electrostimulation to diminish pain and improve live quality in people with knee arthrosis.

Efeitos da crioterapia vs correntes diadinâmicas na redução do edema de pata em ratas / Effects of cryotherapy vs diadynamic currents on the reduction of the rats paw edema

O edema inflamatório agudo é considerado um problema para a reabilitação, pois acarreta perda da mobilidade e dor, comprometendo a funcionalidade do indivíduo, sendo importante sua diminuição pós-lesão. O presente estudo comparou os efeitos da crioterapia e das correntes diadinâmicas de Bernard (CDB) na redução de edema induzido experimentalmente. O experimento incluiu 15 ratas Wistar com 256,16 ± 15,48 g, divididas em três grupos constituídos de 5 animais cada, sendo G1, G2 e G3. Foi realizado a hidropletismografia da pata direita de cada animal, seguida da indução do edema em todos os animais com carragenina 1% e solução salina 0,9%. Os animais foram reavaliados após 60; 120 e 180 minutos da indução do edema e após o tratamento. Os animais do G1 foram tratados através da crioterapia via imersão por 10 minutos; G2, submetidos à aplicação das CDB utilizando as correntes difásica, monofásica e curtos períodos, por 9 minutos e G3 representou o grupo controle. Para G1, o volume deslocado inicialmente foi 1,68 ± 0,18 ml; após 180 minutos 2,8 ± 0,28; e após o tratamento com crioterapia 2,4 ± 0,28 ml. Para G2, os valores foram 1,76 ± 0,22; 2,72 ± 0,33; e posteriormente à aplicação das correntes, o valor foi 2,32 ± 0,33 ml. Para G3, os valores foram 1,6 ± 0; 3,04 ± 0,35; ao término do tratamento proposto para G1 e G2, o G3 apresentou 3,12 ± 0,33 ml. Os resultados demonstraram redução não significativa do edema comparando G1 e G2, porém apresentou diminuição significativa (p < 0,01), quando comparado G1 e G2 com o G3. As duas modalidades terapêuticas avaliadas foram eficazes na redução do edema induzido experimentalmente, no entanto não diferiram significativamente quando comparadas entre si.

Acute inflammatory edema is considered a problem for the rehabilitation; because it leads to mobility loss and pain endangering the individual functionality, being important its reduction at post-lesion phase. The present study compared the effects of cryotherapy and Bernard's Diadynamic Currents (BDC) on reduction of a pharmacologically induced edema. The trial included 15 Wistar female rats with 256.16 ± 15.48 g, divided into three groups: G1 under cryotherapy treatment through immersion for 10 minutes; G2 under BDC application using diphasic current, monophasic current and short periods for a nine minutes, and G3 as control group. The volume measurement of right paw of each animal followed by edema induction in all animals with 1% carragenin solution was carried out by hidropletismography. The animals were re-evaluated 60; 120; and 180 minutes after the edema induction and treatment. For animals of G1 group, initial dislocated volume was 1.68 ± 0.18 ml; after 180 minutes, 2.8 ± 0.28; and after cryotherapy treatment, 2.4 ± 0.28 ml. For G2, values were 1.76 ± 0.22; 2.72 ± 0.33; and after currents application, 2.32 ± 0.33 ml. For G3, values were 1.6 ± 0; 3.04 ± 0.35; at the end of treatment proposed to G1 and G2, G3 showed 3.12 ± 0.33 ml. The results showed non-significant reduction when comparing G1 and G2 groups; however, significant reduction (p < 0,01), was observed when comparing G1 and G2 with G3 group. Both therapeutic modalities were efficient in reducing the pharmacologically induced edema, although they did not significantly differ when compared each other.

Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia / Termoterapia efectiva y más segura que la miltefosina en el tratamiento de la leishmaniasis cutánea en Colombia

In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems), cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145) or a thermotherapy (Thermomed®) application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149). Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients) and 69% (85/145 patients), respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol) between the two treatments. ClinicalTrials.gov: NCT00471705.

En Colombia antimoniales pentavalentes y miltefosina son los medicamentos de primera elección para el tratamiento de la leishmaniosis cutánea; sin embargo, su toxicidad, duración (que lleva a problemas de adherencia), costo y la disminución de la sensibilidad de los parásitos a los mismos, hacen necesaria la búsqueda de nuevas alternativas de tratamiento para la leishmaniosis cutánea americana. A partir de resultados derivados de un ensayo clínico controlado abierto, aleatorizado, fase III, se comparó la eficacia y seguridad de la miltefosina con la de la termoterapia, para el tratamiento de la leishmaniosis cutánea en Colombia. Adultos pertenecientes al Ejército de Colombia participaron el estudio. Miltefosina, una cápsula de 50 mg tres veces día durante 28 días, vía oral (n = 145). Termoterapia (Thermomed®) aplicación de 50 °C/30" sobre la lesión y el área circundante (n = 149). Ambos grupos fueron comparables en características sociodemográficas, clínicas y parasitológicas. Eficacia de la miltefosina por protocolo 70% (85/122 pacientes) y 69% (85/145 pacientes) por intención a tratar. Termoterapia eficacia por protocolo 64% (86/134 pacientes) y 58% (86/149 pacientes) por intención a tratar. En miltefosina los eventos adversos fueron principalmente de tipo gastrointestinal y en termoterapia se encontró dolor en el sitio de la lesión luego del tratamiento. En el análisis de eficacia (intención a tratar y protocolo) no se encontró diferencia estadísticamente significativa entre los tratamientos evaluados. ClinicalTrials.gov: NCT00471705.