Effectiveness of intravesical ozone in interstitial cystitis by the O'Leary-Sant symptom index.

INTRODUCTION AND HYPOTHESIS: A prospective clinical, preliminary study was performed in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) who were nonresponders to conventional treatment and received intravesical ozone as a therapeutic alternative. METHODS: Sixteen patients received six applications of intravesical ozone at a concentration of 41 µg/mL. We evaluated therapeutic efficacy by the percentage reduction of Interstitial Cystitis Symptom and Problem Index scores (ICSI/ICPI-the O'Leary-Sant symptom index), recurrence rate, nonresponse, and side effects in scores collected on admission (pre-treatment), at the end of the therapeutic protocol (post-treatment), and 180 days (follow-up) after the last ozone application. RESULTS: The mean age of women was 52.9 years (SD: 15.5), and the duration of symptoms was 5.7 years (SD: 7.1). The median ICSI on admission was 17 (IQR: 14.25-19.5) and at follow-up was 0.5 (IQR: 0-2), with a reduction of 97.5% (CI: 85.7-100). The median ICSI/ICPI on admission was 31.5 (IQR: 29-35.2) and at follow-up was 2.0 (IQR: 0-3.75), with a reduction of 92.3% (CI: 88.8-100). The recurrence rate was only 6.25%, and no patients were nonresponders to the treatment. CONCLUSIONS: The application of intravesical ozone was effective in the treatment of patients with IC/BPS who were nonresponders to conventional therapy, showing a progressive and safe effect, at least in the short term.

Analysis of pain relief and functional recovery in patients with rotator cuff tendinopathy through therapeutic ultrasound and photobiomodulation therapy: a comparative study.

This study aimed to compare shoulder tendinopathy treatment with therapeutic ultrasound combined with LED photobiomodulation therapy using LED-infrared (850 nm) or LED-red (640 nm). The study assessed 75 patients, aged 45 to 70 years, distributed into five experimental groups (15 patients each): therapeutic ultrasound (US), infrared light irradiation (IR), visible red light irradiation (VR), infrared light and ultrasound combined (IR-US), and red light in conjunction with ultrasound (VR-US). The ultrasound parameters are 1 MHz, 0.5 W/cm2 (SATA), and 100 Hz repetition rate, applied for 4 min each session. LED irradiation protocols were as follows: 3 points, 7.5 J per point, IR-LED 750 mW, 10 s, VR-LED 250 mW, 30 s. LED irradiation is followed by ultrasound in the combined therapies. The efficiency of the five therapies was evaluated assessing 12 parameters: quality of life (Health Assessment Questionnaire, HAQ), pain intensity (Visual Analog Scale, VAS), articular amplitude of shoulder movement (flexion, extension, abduction, adduction, medial rotation, lateral rotation), muscle strength (abduction, lateral rotation), and electromyography (lateral rotation, abduction). Treatments comprised 12 sessions for 4 weeks. Intra-group analysis showed that the five therapies significantly improved the recovery of all parameters after treatment. Regarding the comparison of irradiated therapies and ultrasound, statistical analysis showed that IR-US was a better treatment than US for all 12 parameters. IR treatment exceeded US on 9 items, whereas that VR and VR-US therapies exceeded US in 7 and 10 parameters, respectively (p < 0.05). Because of that, IR-US shows to be the best treatment for rotator cuff tendinopathy. In conclusion, improvements in quality of life, pain intensity relief, shoulder amplitude motion, and muscle strength force obtained with ultrasound therapy are enhanced by adding infrared LED irradiation to ultrasound for patients suffering from rotator cuff tendinopathy. This study was registered with the Brazilian Registry of Clinical Trials (ReBEC) under Universal Trial Number (UTN) U1111-1219-3594 (2018/22/08).

Systemic Effects of Photobiomodulation on Blood Components in the Treatment of Community-Acquired Pneumonia.

Background: The analysis of the complete blood count (CBC) of patients with community-acquired pneumonia (CAP) is an essential practice both for diagnosing the disease and for evaluating the patient's clinical evolution. It is proposed in the present study to analyze the hematological alterations resulting from photobiostimulation using near-infrared light-emitting diodes (LEDs) in patients with CAP. Methods: This was a clinical, prospective, blinded, and descriptive longitudinal study that involved 21 patients undergoing CAP treatment who were divided into two groups: LED, 11 patients who were treated with infrared LED and conventional treatment; and CON (control), 10 patients who received only conventional treatment (antibiotic therapy and physiotherapy). Physiotherapy was applied before LED irradiation in the LED group. The patients' CBCs were obtained before and after treatment, and erythrocyte counts, hemoglobin and hematocrit concentrations, and leukocyte and platelet counts were assessed. The phototherapy was performed with a vest with an array of 300 LEDs (940 nm) mounted on an area of 36 × 58 cm and positioned in the patient's anterior thoracic and abdominal regions. The total power was 6 W, with 15 min of irradiation time. The patients were treated daily for seven consecutive days. Statistical analyses of the intra- and intergroups of CBC data were done using Student's t-test and one-way ANOVA (analysis of variance), respectively, both at the significance level of α = 0.05. Results: There was a statistically significant recovery difference after treatment in the LED group compared with the CON group for erythrocytes, hemoglobin, leukocytes, segmented and band neutrophils, lymphocytes, and monocytes (p < 0.05). The greatest differences between the LED and CON groups were lymphocyte count reduction (60% vs. 16%), erythrocyte increase (86% vs. 35%), and leukocyte reduction (28% vs. 15%). Conclusions: The hematologic components of CAP patients recovered their normal values faster with conventional treatment associated with infrared LED therapy, thus indicating greater treatment efficiency when compared with the conventional therapy. This study was registered with the Brazilian Registry of Clinical Trials (ReBeC) under Universal Trial Number (UTN) U1111-1229-1296 (2019/06/05).

Photobiomodulation: Shining Light on COVID-19.

Objective: To evaluate the hypothesis that light could reduce the lethality of COVID-19. Methods: Most models for projections of the spread and lethality of COVID-19 take into account the ambient temperature, neglecting light. Recent advances in understanding the mechanism of action of COVID-19 have shown that it causes a systemic infection that significantly affects the hematopoietic system and hemostasis, factors extremely dependent of light, mainly in the region of visible and infrared radiation. Results: In the COVID-19 patients hemoglobin is decreasing and protoporphyrin is increasing, generating an extremely harmful accumulation of iron ions in the bloodstream, which are able to induce an intense inflammatory process in the body with a consequent increase in C-reactive protein and albumin. Observing the unsaturation characteristics of the cyclic porphyrin ring allows it to absorb and emit radiation mainly in the visible region. This characteristic can represent an important differential to change this process in the event of an imbalance in this system, through the photobiomodulation to increase the production of adenosine triphosphate (ATP) using red and near-infrared radiation (R-NIR) and vitamin D using ultraviolet B (UVB) radiation. These two compounds have the primary role of activating the defense mechanisms of the immune system, enabling greater resistance of the individual against the attack by the virus. According to the theory of electron excitation in photosensitive molecules, similar to hemoglobin heme, after the photon absorption there would be an increase in the stability of the iron ion bond with the center of the pyrrole ring, preventing the losses of heme function oxygen transport (HbO2). The light is also absorbed by cytochrome c oxidase in the R-NIR region, with a consequent increase in electron transport, regulating enzyme activity and resulting in a significant increase of oxygen rate consumption by mitochondria, increasing ATP production. Conclusions: The most favorable range of optical radiation to operate in this system is between R-NIR region, in which cytochrome c oxidase and porphyrin present absorption peaks centered at 640 nm and HbO2 with absorption peak centered at 900 nm. Based on the mechanisms described earlier, our hypothesis is that light could reduce the lethality of COVID-19.

Diagnosing sickle cell disease and iron deficiency anemia in human blood by Raman spectroscopy.

This work proposed the diagnosis of iron deficiency anemia (IDA) and sickle cell disease (SCD) in human blood caused by iron deficiency and hemoglobin S (HbS), which are among the most common anemias, by means of Raman spectroscopy. Whole blood samples from patients diagnosed with IDA and HbS, as well as from normal subjects (HbA), were obtained and submitted to Raman spectroscopy (830 nm, 150 mW, 400-1800 cm-1 spectral range, 4 cm-1 resolution). Difference spectra of IDA-HbA showed spectral features of hemoglobin with less intensity in the IDA, whereas the difference spectra of SCD-HbA showed spectral features of deoxyhemoglobin increased and of oxyhemoglobin decreased in SCD. An exploratory analysis by principal components analysis (PCA) showed that the peaks referred to oxy- and deoxyhemoglobin markedly differentiated SCD and HbA, as well as the increased amount of hemoglobin features in the SCD group, suggesting increased erythropoiesis. The IDA group showed hemoglobin features with lower intensities as well as peaks referred to the iron bonding to the porphyrin ring with reduced intensities when compared to the HbA. Discriminant analysis based on partial least squares (PLS-DA) and PCA (PCA-DA) showed that the IDA and SCD anemias could be discriminated from the HbA spectra with 95.0% and 93.8% of accuracy, for the PLS and PCA respectively, with sensitivity/specificity of 93.8%/95.7% for the PLS-DA model. The iron depletion and the sickling of erythrocytes could be identified by Raman spectroscopy and a spectral model based on PLS accurately discriminated these IDA and SCD samples from the normal HbA.

Influence of neural mobilization in the sympathetic slump position on the behavior of the autonomic nervous system

Abstract Introduction The neural mobilization technique in the sympathetic slump position (NMSS) was based on the slump test, whose purpose was to directly influence the sympathetic trunk and thus provide greater analgesia by sympathetic activation and treat pain syndromes caused by peripheral sympathetic changes. Therefore, as the autonomic nervous system (ANS) is responsible for extrinsic regulation of the cardiovascular system through sympathetic and parasympathetic action, the aim of this study was to investigate the influence of the NMSS technique on the systolic and diastolic blood pressure and heart rate variability in athlete and non-athlete men. Methods Twenty-eight subjects performed the procedure that was divided into three phases: rest; intervention and recovery, lasting 4 minutes and 30 seconds each, totaling a 13-minute and 30 seconds collection time. Results The results showed that the NMSS technique significantly influences the action/activity of the ANS, as there was predominant sympathetic activation during the application of the technique, which was observed by the increase in systolic blood pressure, low frequency (LF), LF/HF ratio and decreased values of high frequency (HF). Conclusion It may be concluded that the neural mobilization technique on the sympathetic slump (NMSS) significantly influences the ANS action/activity. Among the groups there was no statistically significant difference in heart rate variability. It is worth noting that patients with cardiovascular disorders may be at risk if the NMSS technique is applied, since there was an increase in SBP and sympathetic activation during its application in both groups.

LED phototherapy in full-thickness burns induced by CO2 laser in rats skin.

Many studies have been conducted on the treatment of burns because they are important in morbidity and mortality. These studies are mainly focused on improving care and quality of life of patients. The aim of this study was evaluate the LED phototherapy effects in rats skin full-thickness burns induced by CO2 laser. The animals were divided in NT group that did not received any treatment and LED group that received LED irradiation at 685 nm, 220 mW, and 4.5 J/cm2 during 40 s by burned area. Biopsies were obtained after 7, 14, and 21 days of treatment and submitted to histological and immunohistochemical analysis. The LED phototherapy shows anti-inflammatory effects, improves angiogenesis, and stimulates the migration and proliferation of fibroblasts. The T CD8+ lymphocytes were more common in burned areas compared to T CD4+ lymphocytes since statistically significant differences were observed in the LED group compared to the NT group after 7 days of treatment. These results showed that LED phototherapy performs positive influence in full-thickness burns repair from the healing process modulated by cellular immune response. The obtained results allowed inferring that burns exhibit a characteristic cell immune response and this cannot be extrapolated to other wounds such as incision and wounds induced by punch, among others.

Detecting alterations of glucose and lipid components in human serum by near-infrared Raman spectroscopy

Introduction Raman spectroscopy may become a tool for the analysis of glucose and triglycerides in human serum in real time. This study aimed to detect spectral differences in lipid and glucose components of human serum, thus evaluating the feasibility of Raman spectroscopy for diagnostic purposes. Methods A total of 44 samples of blood serum were collected from volunteers and submitted for clinical blood biochemical analysis. The concentrations of glucose, cholesterol, triglycerides, and low-density and high-density lipoproteins (LDL and HDL) were obtained using standard biochemical assays. Serum samples were placed in Eppendorf tubes (200 µL), kept cooled (5 °C) and analyzed with near-infrared Raman spectroscopy (830 nm, 250 mW, 50 s accumulation). The mean spectra of serum with normal or altered concentrations of each parameter were compared to determine which Raman bands were related to the differences between these two groups. Results Differences in peak intensities of altered sera compared to normal ones depended on the parameter under analysis: for glucose, peaks were related to glucose; for lipid compounds the main changes occurred in the peaks related to cholesterol, lipids (mainly triolein) and proteins. Principal Components Analysis discriminated altered glucose, cholesterol and triglycerides from the normal serum based on the differences in the concentration of these compounds. Conclusion Differences in the peak intensities of selected Raman bands could be seen in normal and altered blood serum samples, and may be employed as a means of diagnosis in clinical analysis.

Raman spectroscopy for a rapid diagnosis of sickle cell disease in human blood samples: a preliminary study.

Raman spectroscopy has been proposed as a tool for diagnosis of human blood diseases aiming a quick and accurate diagnosis. Sickle cell disease arises in infancy and causes a severe anemia; thus, an early diagnosis may avoid pathological complications such as vasoocclusion, hemolytic anemia, retinopathy, cardiovascular disease, and infections. This work evaluated spectral differences between hemoglobin S (HbS) and hemoglobin A (HbA) to be used in a diagnostic model based on principal components analysis. Blood samples of patients with a previous diagnosis of sickle cell disease were hemolyzed with water, centrifuged, and the pellet was collected with a pipette. Near-infrared Raman spectra (830 nm, 200 mW) were obtained from these samples, and a model based on principal components analysis and Mahalanobis distance were used to discriminate HbA from HbS. Differences were found in the spectra of HbS and HbA, mainly in the 882 and 1,373 cm(-1) (valine, HbA) and 1,547 and 1,622 cm(-1) (glutamic acid, HbS). The spectral model could correctly discriminate 100% of the samples in the correspondent groups. Raman spectroscopy was able to detect the subtle changes in the polypeptide chain (valine and glutamic acid substitution) due to the sickle cell disease and could be used to discriminate blood samples with HbS from HbA with minimum sample preparations (hemolysis with water and centrifugation).

Vias de sinalização envolvidas na invasão celular por formas amastigotas extracelulares de Trypanosoma cruzi das duas principais linhagens filogenéticas / Signal transduction pathwais involved in host cell invasion by T. cruzi amastigotes of strains from the two major phylogenetic lineages

Na primeira parte desta tese examinamos o papel de GTPases monoméricas da família Rho (Rho, Rac e Cdc42) no processo de invasão de células MDCK transfectadas (que superexpressam essas proteínas) por formas amastigotas e tripomastigotas metacíclicas de Trypanosoma cruzi das duas principais linhagens filogenéticas deste parasita. De acordo com os resultados obtidos determinamos que amastigotas intracelulares das diferentes cepas apresentam baixa infectividade nos diferentes transfectantes de células MDCK. A super expressão de GTPases monoméricas em células MDCK não afetou a infectividade da forma TM de diferentes cepas. Além disso, observamos que amastigotas extracelulares da cepa G invadiram mais significativamente o transfectante Rac1 V12 (constitutiva mente ativo) que os demais. Além disso, o transfectante Rac1 N17 (dominante-negativo) foi menos suscetível à infecção por amastigotas extracelulares da cepa G do que as células usadas como controle. Estes dados indicam que as proteínas Rac parecem estar relacionadas com a invasão celular por formas amastigotas extracelulares da cepa G de T. cruzi. Na segunda etapa deste trabalho estudamos as vias de transdução de sinal que são ativadas durante o processo de invasão celular por formas amastigotas extracelulares de T. cruzi das cepas G e CL, através de compostos que interferem direta ou indiretamente nas diversas rotas de sinalização. Demonstramos que AE das cepas G e CL de T. cruzi induzem um aumento na concentração de Ca 2+ intracelular em células HeLa de maneira dose-dependente. O tratamento dos parasitas com drogas que interferem na mobilização de cálcio intracelular não alterou a infectividade destes. Porém, o tratamento das células reduziu a infectividade dos AE das cepas G e CL. A…(au)