Characterization of Skeletal Muscle Strain Lesion Induced by Stretching in Rats: Effects of Laser Photobiomodulation.

BACKGROUND: Unusual and exhaustive physical exercise can lead to muscle lesions depending on the type of contraction, intensity, duration, age, and level of conditioning. Different therapies have been proposed to prevent or reduce exercise-induced muscle damage. OBJECTIVE: In this study, we investigate the effects of low-level laser therapy on skeletal muscle strain in an experimental model in rats. MATERIALS AND METHODS: Male Wistar rats (200 g) were used. The animals were randomized into groups of six animals. We performed tibialis muscle elongation using a previously described protocol. The animals were anesthetized and submitted to passive stretching of the anterior tibial muscle attached to a weight corresponding to 150% of the body mass of the animal for 20 min, rested for 3 min, and received a second traction for 20 min. The cytokines, tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), IL-6, and IL-10, edema, and C-reactive protein (CRP) levels were determined in the tibialis anterior muscle. RESULTS: Plasma extravasation of groups treated with different doses of laser energy, lesion +1 J (2.61 ± 0.46), lesion +3 J (2.33 ± 0.13), lesion +6 J (2.92 ± 0.91), and lesion +9 J (2.80 ± 0.55), shows a significant reduction of extravasation when compared with the injury group (5.46 ± 1.09). Laser therapy was able to significantly reduce CRP and cytokine levels (TNF-α, IL-1ß, IL-6, and IL-10). CONCLUSIONS: Laser photobiomodulation reduced skeletal muscle edema as well as cytokines and CRP, leading to a significant reduction in inflammatory markers.

O Cuidado de Enfermagem no Atendimento de Emergências Oncológicas: uma revisão integrativa / The Nursing Care at Emergency Cancer Care: an integrative review

Este estudo versa sobre a assistência de enfermagem nas emergências oncológicas. Objetiva-se destacar o conhecimento sobre o cuidado de enfermagem no atendimento a pessoas que vivem com neoplasias e encontram-se em situação de emergência oncológica. Trata-se de uma revisão integrativa com a seguinte questão norteadora: como se dá o cuidado de enfermagem numa emergência oncológica, tendo em vista o aprimoramento da assistência? A busca das publicações foi realizada nas bases de dados LILACS, PUBMED e BVS. Como critério de inclusão, foram selecionados artigos publicados entre os anos de 2007 e 2016, utilizando-se os seguintes descritores: Enfermagem em Emergência, Cuidados de Enfermagem e Neoplasias. O conhecimento evidenciado nas publicações selecionadas mostrou-se reduzido. Todavia, entre os artigos de enfermagem relativos às emergências oncológicas, a maioria limitou-se a descrever as intervenções específicas para cada situação, tais como: observação do paciente, favorecimento do conforto físico, orientações ao paciente e seus familiares. Conclui-se a necessidade de um maior incentivo para estudos nesta temática, para que os enfermeiros estejam cada vez mais capacitados e embasados em princípios científicos, contribuindo para um melhor desempenho da prática profissional

This study deals with nursing care in oncologic emergencies. The aim is to highlight the knowledge about nursing care to people living with neoplasms and who are in an oncologic emergency situation. This is an integrative review with the following guiding question: how does nursing care take place in an oncologic emergency, bearing in mind the enhancement of care? The search of the publications was performed in the LILACS, PUBMED and BVS databases. Concerning the inclusion criteria, we selected papers published between 2007 and 2016, using the following descriptors: Emergency Nursing, Nursing Care and Neoplasms. The knowledge evidenced in the selected publications proved to be reduced. Nevertheless, among the nursing papers related to oncologic emergencies, most were limited to describing specific nursing interventions for each situation, such as observing the patient, favoring of the physical comfort, guidance to the patient and to their family members. In conclusion, there is a need for greater encouragement for this field of research, so that the nurses are increasingly trained and based on scientific principles, thus achieving a good performance in their function

Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation.

Arthritis of the knee is the most common type of joint inflammatory disorder and it is associated with pain and inflammation of the joint capsule. Few studies address the effects of the 810-nm laser in such conditions. Here we investigated the effects of low-level laser therapy (LLLT; infrared, 810-nm) in experimentally induced rat knee inflammation. Thirty male Wistar rats (230-250 g) were anesthetized and injected with carrageenan by an intra-articular route. After 6 and 12 h, all animals were killed by CO(2) inhalation and the articular cavity was washed for cellular and biochemical analysis. Articular tissue was carefully removed for real-time PCR analysis in order to evaluate COX-1 and COX-2 expression. LLLT was able to significantly inhibit the total number of leukocytes, as well as the myeloperoxidase activity with 1, 3, and 6 J (Joules) of energy. This result was corroborated by cell counting showing the reduction of polymorphonuclear cells at the inflammatory site. Vascular extravasation was significantly inhibited at the higher dose of energy of 10 J. Both COX-1 and 2 gene expression were significantly enhanced by laser irradiation while PGE(2) production was inhibited. Low-level laser therapy operating at 810 nm markedly reduced inflammatory signs of inflammation but increased COX-1 and 2 gene expression. Further studies are necessary to investigate the possible production of antiinflammatory mediators by COX enzymes induced by laser irradiation in knee inflammation.

Effect of low-level laser therapy (GaAs 904 nm) in skeletal muscle fatigue and biochemical markers of muscle damage in rats.

We wanted to test if pre-exercise muscle irradiation with 904 nm laser affects the development of fatigue, blood lactate levels and creatine kinase (CK) activity in a rat model with tetanic contractions. Thirty male Wistar rats were divided into five groups receiving either one of four different laser doses (0.1, 0.3, 1.0 and 3.0 J) or a no-treatment control group. Laser irradiation was performed immediately before the first contraction for treated groups. Electrical stimulation was used to induce six tetanic tibial anterior muscle contractions with 10 min intervals between them. Contractions were stopped when the muscle force fell to 50% of the peak value for each contraction; blood samples were taken before the first and immediately after the sixth contraction. The relative peak forces for the sixth contraction were significantly better (P < 0.05) in the two laser groups irradiated with highest doses [151.27% (SD +/- 18.82) for 1.0 J, 144.84% (SD +/- 34.47) for 3.0 J and 82.25% (SD +/- 11.69) for the control group]. Similar significant (P < 0.05) increases in mean performed work during the sixth contraction for the 1.0 and 3.0 J groups were also observed. Blood lactate levels were significantly lower (P < 0.05) than the control group in all irradiated groups. All irradiated groups except the 3.0 J group had significantly lower post-exercise CK activity than the control group. We conclude that pre-exercise irradiation with a laser dose of 1.0 J and 904 nm wavelength significantly delays muscle fatigue and decreases post-exercise blood lactate and CK in this rat model.

Effect of cluster multi-diode light emitting diode therapy (LEDT) on exercise-induced skeletal muscle fatigue and skeletal muscle recovery in humans.

BACKGROUND AND OBJECTIVES: There are some indications that low-level laser therapy (LLLT) may delay the development of skeletal muscle fatigue during high-intensity exercise. There have also been claims that LED cluster probes may be effective for this application however there are differences between LED and laser sources like spot size, spectral width, power output, etc. In this study we wanted to test if light emitting diode therapy (LEDT) can alter muscle performance, fatigue development and biochemical markers for skeletal muscle recovery in an experimental model of biceps humeri muscle contractions. STUDY DESIGN/MATERIALS AND METHODS: Ten male professional volleyball players (23.6 [SD +/-5.6] years old) entered a randomized double-blinded placebo-controlled crossover trial. Active cluster LEDT (69 LEDs with wavelengths 660/850 nm, 10/30 mW, 30 seconds total irradiation time, 41.7 J of total energy irradiated) or an identical placebo LEDT was delivered under double-blinded conditions to the middle of biceps humeri muscle immediately before exercise. All subjects performed voluntary biceps humeri contractions with a workload of 75% of their maximal voluntary contraction force (MVC) until exhaustion. RESULTS: Active LEDT increased the number of biceps humeri contractions by 12.9% (38.60 [SD +/-9.03] vs. 34.20 [SD +/-8.68], P = 0.021) and extended the elapsed time to perform contractions by 11.6% (P = 0.036) versus placebo. In addition, post-exercise levels of biochemical markers decreased significantly with active LEDT: Blood Lactate (P = 0.042), Creatine Kinase (P = 0.035), and C-Reative Protein levels (P = 0.030), when compared to placebo LEDT. CONCLUSION: We conclude that this particular procedure and dose of LEDT immediately before exhaustive biceps humeri contractions, causes a slight delay in the development of skeletal muscle fatigue, decreases post-exercise blood lactate levels and inhibits the release of Creatine Kinase and C-Reative Protein. Lasers Surg. Med. 41:572-577, 2009. (c) 2009 Wiley-Liss, Inc.

Effect of 830 nm low-level laser therapy applied before high-intensity exercises on skeletal muscle recovery in athletes.

Our aim was to investigate the immediate effects of bilateral, 830 nm, low-level laser therapy (LLLT) on high-intensity exercise and biochemical markers of skeletal muscle recovery, in a randomised, double-blind, placebo-controlled, crossover trial set in a sports physiotherapy clinic. Twenty male athletes (nine professional volleyball players and eleven adolescent soccer players) participated. Active LLLT (830 nm wavelength, 100 mW, spot size 0.0028 cm(2), 3-4 J per point) or an identical placebo LLLT was delivered to five points in the rectus femoris muscle (bilaterally). The main outcome measures were the work performed in the Wingate test: 30 s of maximum cycling with a load of 7.5% of body weight, and the measurement of blood lactate (BL) and creatine kinase (CK) levels before and after exercise. There was no significant difference in the work performed during the Wingate test (P > 0.05) between subjects given active LLLT and those given placebo LLLT. For volleyball athletes, the change in CK levels from before to after the exercise test was significantly lower (P = 0.0133) for those given active LLLT (2.52 U l(-1) +/- 7.04 U l(-1)) than for those given placebo LLLT (28.49 U l(-1) +/- 22.62 U l(-1)). For the soccer athletes, the change in blood lactate levels from before exercise to 15 min after exercise was significantly lower (P < 0.01) in the group subjected to active LLLT (8.55 mmol l(-1) +/- 2.14 mmol l(-1)) than in the group subjected to placebo LLLT (10.52 mmol l(-1) +/- 1.82 mmol l(-1)). LLLT irradiation before the Wingate test seemed to inhibit an expected post-exercise increase in CK level and to accelerate post-exercise lactate removal without affecting test performance. These findings suggest that LLLT may be of benefit in accelerating post-exercise recovery.

Efeito da administração oral de arginina sobre a pressão arterial e parâmetros cardíacos em ratos submetidos ao bloqueio crônico da síntese de óxido nítrico / Efecto de la administración oral de arginina sobre la presión arterial y los parámetros cardiacos en ratones sometidos al bloqueo crónico de síntesis de óxido nítrico / Effect of oral arginine administration over blood pressure and cardiac parameters in rats submitted to chronic inhibition of nitric oxide synthesis

Já está claramente estabelecido, que a inibição crônica da síntese de óxido nítrico resulta em hipertensão sustentada, remodelamento cardíaco e fibrose. Além disso, resultados de nosso grupo demonstraram que a suplementação oral com L-arginina foi capaz de aumentar a resistência da musculatura esquelética a fadiga muscular localizada em humanos. O tratamento experimental de ratos com L-NAME é um dos modelos mais comumente utilizados para se induzir hipertensão. A resposta compensatória esperada contra o aumento da resistência vascular sistêmica seria a hipertrofia ventricular esquerda; entretanto, isso tem sido um ponto bastante controverso na literatura. O objetivo do presente estudo foi verificar os efeitos da inibição do óxido nítrico pela administração oral de L-NAME sobre o tecido cardíaco de ratos e a possível reversão pela L-arginina. Foram utilizados 30 ratos Wistar machos (250-350g), mantidos em condições de temperatura, luz e umidade controlada, e com água e comida ad libitum. Ao final de quatro semanas, os animais foram sacrificados por inalação de CO2 e os corações foram removidos e imediatamente dissecados, sendo separados átrios e ventrículos, obtendo-se os pesos total e parcial. Os valores foram corrigidos em função do peso corporal obtido na última semana de tratamento e expressos como índice cardíaco. O L-NAME foi capaz de induzir hipertensão e aumento significativo do duplo produto, porém sem resultados significativos sobre os pesos cardíacos, não sendo observada hipertrofia do órgão. Os aumentos de pressão arterial e duplo produto foram revertidos pela administração concomitante de arginina, de maneira dependente da dose. Dados preliminares não publicados demonstraram a reversão da fibrose cardíaca induzida pelo L-NAME, nos animais que receberam tratamento com arginina. Podemos concluir que a arginina pode vir a ser uma ferramenta valiosa na prevenção da hipertensão e do remodelamento cardíaco, principalmente nos casos ...

It has been clearly established that chronic inhibition of nitric oxide synthesis results in a sustained increase in blood pressure, cardiac remodeling and fibrosis. It was also demonstrated by our group that arginine supplementation was able to increase the skeletal muscle resistance to fatigue, but its mechanism remains uncertain. The experimental treatment of rats with L-NAME is one of the most common models employed to induce hypertension. The expected compensatory response against increases in systemic vascular resistance would be ventricular hypertrophy. However, the presence of cardiac hypertrophy still controversial. The aim of the present study was to verify the effects of nitric oxide inhibition through oral L-NAME administration on the cardiac tissue of rats, and the possible reversion by L-arginine. Thirty male Wistar rats (250-350 g) were kept in controlled conditions of temperature, light, humidity, with water and food "ad libitum". At the end of 4 weeks or treatments the animals were sacrificed by CO2 inhalation and the hearts were removed. Soon after, the hearts were dissected, to separate atria and ventricules, obtaining the total heart weight. After the retreat of the right ventricule, the remaining part was weighed, to obtain the left ventricular weight (LVW, mg); the difference between the total heart weight and the LVW was considered the right ventricular weight (RVW, mg). These values were corrected in function of the corporal weight obtained in the last week of treatment. L-NAME was able to induced hypertension and increases in double product but without any heart hypertrophy. The increase arterial pressure and double product were reversed by L-arginine administration in a dose-dependent way. Preliminary findings demonstrated a reversion of heart fibroses induced by L-NAME, after arginine treatment. We concluded that arginine may constitute a valuable tool in preventing hypertension and cardiac remodeling mainly ...

Está claramente establecido que la inhibición crónica de la síntesis de óxido nítrico resulta en hipertensión sustentada, remodelación cardiaca y fibrosis. Además de esto, los resultados de nuestro grupo demostraron que el suplemento oral con L-arginina fue capaz de aumentar la resistencia de la musculatura esquelética a la fadiga muscular localizada en humanos. El tratamiento experimental de ratones con L-NAME, es uno de los modelos más utilizado para inducir hipertensión. La respuesta compensatoria esperada contra el aumento de la resistencia vascular sistémica sería la hipertrofia ventricular izquierda, sin embargo, esto ha sido un punto bastante controversial en la literatura. El objetivo del presente estudio ha sido el de verificar los efectos de la inhibición del óxido nítrico por la administración oral de L-NAME sobre el tejido cardiaco de ratones, y la posible reversión por la L-arginina. Fueron utilizados 30 ratones Wistar machos (250-350g), mantenidos en condiciones de temperatura, luz y humedad controlada, y con agua y comida "ad libitum". Al final de 4 semanas, los animales fueron sacrificados por inhalación de CO2 y los corazones fueron removidos e inmediatamente disecados, siendo separados atrios y ventrículos, obteniéndose los pesos total y parcial. Los valores fueron corregidos en función del peso corporal obtenido en la última semana de tratamiento y expresados como índice cardiaco. El L-NAME fue capaz de inducir hipertensión y aumento significativo del doble producto, pero sin resultados significativos sobre los pesos cardiacos, no siendo observada hipertrofia del órgano. Los aumentos de presión arterial y el doble producto fueron revertidos por la administración concomitante de arginina, de manera dependiente de la dosis. Datos preliminares no publicados demostraron la reversión de fibrosis cardiaca inducida por L-NAME, en los animales que recibieron tratamiento con arginina. Podemos entonces concluir que la arginina ...