Photobiomodulation using red and infrared spectrum light emitting-diode (LED) for the healing of diabetic foot ulcers: a controlled randomized clinical trial.

Assessing the responses to the application of photobiomodulation using red and infrared spectrum light-emitting diodes (LED) on diabetic foot ulcers. Diabetic volunteers, of both genders, aged between 30 and 65 years, with grade I or II ulcers, were randomized into the groups: red LED, infrared LED, LED associated, and control. Home-based interventions took place on a daily basis for 12 weeks. Assessments of sample characterization were performed on day 1 and 90, and the variables wound healing index, mean skin temperature, sensitivity and pain in the wound area were measured at the pre-intervention time on days 1, 30, 60 and 90, with subsequent follow-up 30 days after the end of treatment. For statistical analysis, the software SPSS, version 17.0, intention-to-treat analysis, data normality was tested, and the linear mixed effects model, with a significance level of 5%. Magnitudes of clinical effect by Cohen's d. At the pre vs post intervention time of 90 days, we found a large clinical effect of G-LED V (d=1.7) and G -LED IV (d=1.6) in relation to G-C, where these intervention groups showed a tendency for faster wound healing compared to G-C. We also observed small clinical effect of G-LED IV, which showed greater reduction in the area in relation to G-LED V (d=0.4) and G-LED A (d=0.3). Conclusion: The use of individually applied red and infrared LED phototherapy clinically tended to be more effective for the reduction of diabetic foot ulcer areas, and infrared LED was the most effective. Trial registration: NCT03250533 (clinicaltrials.gov).

Interaction Between Near-Infrared Radiation and Temozolomide in a Glioblastoma Multiform Cell Line: A Treatment Strategy?

Photodynamic therapy (PDT) is a potential therapeutic modality against cancer, resulting from the interaction of a photosensitizer (PS) and radiation that generates damage to tumor cells. The use of near-infrared radiation (IR-A) is relevant because presents recognized biological effects, such as antioxidant, neuroprotective and antitumor effects. Glioblastoma is the most aggressive central nervous system (CNS) neoplasm with high proliferation and tissue invasion capacity and is resistant to radio and chemotherapy. Here, we evaluated in vitro the possible interaction of temozolomide (TMZ) with IR-A in a glioblastoma cell line (C6) and in a human keratinocyte cell line (HaCat) how non-tumor cell model, in an attempt to search for a new treatment strategy. The effects of TMZ, IR-A and the interaction between TMZ and IR-A was evaluated by viability exclusion with trypan blue. To perform the interaction experiments, we have chosen 10 µM TMZ and 4.5 J/cm2 of IR-A. From this, we evaluated cytotoxicity, cell proliferation, intracellular reactive oxygen species levels (ROS), as well as the process of cell migration and the P-gp and MRP-1 activity. Cell death mainly due to apoptosis, followed by necrosis, decreased cell proliferation, increased ROS levels, decreased cell migration and decreased P-gp and MRP1 activity were observed only when there was interaction between TMZ and IR-A in the C6 cell line. The interaction between TMZ and IR-A was not able to affect cell proliferation in the HaCat non-tumor cell line. Our results suggest that this interaction could be a promising approach and that in the future may serve as an antitumor strategy for PDT application.

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.

Measurement of Physical Parameters and Development of a Light Emitting Diodes Device for Therapeutic Use.

INTRODUCTION: Effectiveness of light-emitting diode (LED) in biological tissue is due to the correct application of physical parameters. However, most studies found do not provide complete information on the physical characteristics of the diodes. It is necessary to carefully evaluate the diode parameters so that the results of research with this feature can be reproduced. The objective of this study was to develop a light-emitting device using LED, with proper measurements for application in clinical research. It was used 267 LEDs, powered with 12-V voltage and fixed on a plate of ethylene-vinyl acetate (25 × 42 cm), equidistant at 1.0 cm. For the calculation of red and infrared irradiation, a spectrometer was used, and the data were processed in routines implemented in the OriginPro 8.5.0 SR1 Software. The irradiance was determined by the integration of the spectral irradiation in the LED emission region. The red LED has a wavelength of 620 ± 10 nm, a power density of 52.86 mW/cm2, power of 6.6 mW, and total power of 1.76 W on the device. The infrared LED has a wavelength of 940 ± 10 nm, power density 33.7 mW/cm2, power of 6 mW, and total power of 1.6 W on the device. The LED characterization enables the generation and application of energy with greater precision and reproducibility. Besides, it is a light source, a device capable of framing large areas, reducing the time and cost of the application in different clinical conditions related to neuromuscular performance or rehabilitation.

Effects of Far-Infrared Emitting Ceramic Materials on Recovery During 2-Week Preseason of Elite Futsal Players.

Nunes, RFH, Cidral-Filho, FJ, Flores, LJF, Nakamura, FY, Rodriguez, HFM, Bobinski, F, De Sousa, A, Petronilho, F, Danielski, LG, Martins, MM, Martins, DF, and Guglielmo, LGA. Effects of far-infrared emitting ceramic materials on recovery during 2-week preseason of elite futsal players. J Strength Cond Res 34(1): 235-248, 2020-We investigated the effects of far-infrared emitting ceramic materials (cFIR) during overnight sleep on neuromuscular, biochemical and perceptual markers in futsal players. Twenty athletes performed a 2-week preseason training program and during sleep wore bioceramic (BIO; n = 10) or placebo pants (PL; n = 10). Performance (countermovement jump [CMJ]; squat jump [SJ]; sprints 5, 10, and 15-m) and biochemical markers (tumor necrosis factor alpha-TNF-α, interleukin 10-IL-10, thiobarbituric acid-reactive species [TBARS], carbonyl, superoxide dismutase [SOD], catalase [CAT]) were obtained at baseline and after the 1st and 2nd week of training. Delayed-onset muscle soreness (DOMS) and training strain were monitored throughout. Changes in ΔCMJ and ΔSJ were possibly (60/36/4 [week-1]) and likely (76/22/2 [week-2]) higher in BIO. Both groups were faster in 5-m sprint in week 2 compared with baseline (p = 0.015), furthermore, BIO was likely faster in 10-m sprint (3/25/72 [week 1]). Significant group × time interaction in %ΔTNF-α were observed (p = 0.024 [week-1]; p = 0.021 [week-2]) with values possibly (53/44/3 [week 1]) and likely (80/19/1 [week 2]) higher in BIO. The %ΔIL-10 decreased across weeks compared with baseline (p = 0.019 [week-1]; p = 0.026 [week-2]), showing values likely higher in BIO (81/16/3 [week-1]; 80/17/3 [week-2]). Significant weekly increases in %ΔTBARS (p = 0.001 [week-1]; p = 0.011 [week-2]) and %ΔCarbonyl (p = 0.002 [week-1]; p < 0.001 [week-2]) were observed compared with baseline, showing likely (91/5/4 [week-1]) and possibly (68/30/2 [week-2]) higher changes in BIO. Significant weekly decreases in %ΔSOD were observed compared with baseline (p = 0.046 [week 1]; p = 0.011 [week-2]), and between week 2 and week 1 (p = 0.021), in addition to significant decreases in %ΔCAT compared with baseline (p = 0.070 [week 1]; p = 0.012 [week 2]). Training strain (p = 0.021; very -likely [0/2/98]; week 1) and DOMS was lower in BIO (likely; 7 sessions) with differences over time (p = 0.001). The results suggest that the daily use of cFIR clothing could facilitate recovery, especially on perceptual markers during the early phases of an intensive training period.

Effects of red and near-infrared LED light therapy on full-thickness skin graft in rats.

The aim of the present study was to evaluate the in vivo response of different wavelengths (red and near-infrared) of light-emitting diode (LED) on full-thickness skin grafts (FTSG) in rats. Thirty rats were randomly allocated into three experimental groups: control group (C); red LED treated group (R); and near-infrared LED group (NIR). Skin grafts were irradiated daily for ten consecutive days, starting immediately after the surgery using a red (630 nm) or near-infrared (850 nm) LED. The results showed that the red wavelength LED significantly enhanced the skin graft score in relation to the NIR group and increased transforming growth factor beta (TGF-ß) protein expression and density of collagen fibers compared with the other experimental groups. These results suggest that the red wavelength LED was efficient to improve the dermo-epidermal junction and modulate the expression proteins related to tissue repair.

Effects of the use of bioceramic wraps in patients with lower limb venous ulcers: A randomized double-blind placebo-controlled trial.

BACKGROUND: Venous ulcer represents the most advanced stage of chronic venous insufficiency. It is an important public health problem and has a significant impact on patients' quality of life due to chronic pain, inability to work, need for hospitalization and frequent outpatient follow-up. OBJECTIVE: We investigated the treatment benefits of far-infrared ceramic (cFIR), in a 90-day study of lower limb venous ulcers and looked at ulcer healing scores, quality of life, serum bio-markers of oxidative stress and antioxidant defense enzymes. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a randomized double-blind placebo-controlled study conducted in the Vascular Surgery Service of a hospital located in the northwest region of the State of Rio Grande do Sul, Brazil. We included patients with lower limb venous ulcers who were randomized to use either a bioceramics wrap or a placebo wrap for 90 days. MAIN OUTCOME MEASURES: The following evaluations were conducted at baseline and after 15, 30, 60 and 90 days: ulcer healing score, quality of life, and serum markers of oxidative stress and antioxidant enzyme activity. RESULTS: Patients (n = 24) with lower limb venous ulcers were randomized into two treatment groups. cFIR decreased the ulcer size on day 30 (P = 0.042) and 90 (P = 0.034) and the total ulcer healing scale scores on day 30 (P = 0.049) and 90 (P = 0.02) of the treatment, when compared to baseline. Additionally, cFIR improved tissue type (epithelial tissue) on day 60 (P = 0.022) when compared to baseline evaluation. CONCLUSION: cFIR clinically improved ulcer healing in patients with lower limb venous ulcers. TRIAL REGISTRATION: RBR-8c7xzn on ReBEC.

Aquatic exercise and Far Infrared (FIR) modulates pain and blood cytokines in fibromyalgia patients: A double-blind, randomized, placebo-controlled pilot study.

Fibromyalgia (FM) has an inflammatory component, as elevated serum levels of inflammatory biomarkers are associated with its diagnosis. Treatments decreased pain, body temperature, improved quality of life and reduced serum levels of IL-6 in both groups; however, these beneficial effects were more pronounced in aquatic exercise (AE) + Far-Infrared (FIR) group. The findings of the present study suggest that the association of AE to FIR increases the benefits of aquatic exercise in patients with FM.

Photobiomodulation with simultaneous use of red and infrared light emitting diodes in the treatment of temporomandibular disorder: study protocol for a randomized, controlled and double-blind clinical trial.

INTRODUCTION: Temporomandibular disorder (TMD) is considered the main cause of orofacial pain of non-dental origin, and a public health problem. The symptomatology is muscular and/or articular pain, restriction of the mandibular range of motion, and changes in the mandibular movement pattern. Due to its complexity there are already treatments using various forms of therapy. Photobiomodulation using light sources, such as low-level laser or light emitting diodes (LED), with different wavelengths, in a single or combined form, allows one more therapeutic resource to be explored. The objective of this study is to evaluate the effects of photobiomodulation with the simultaneous use of red and infrared LEDs, on pain, range of mandibular movements, and on the electrical activity of masticatory muscles in individuals with TMD. METHODS: A randomized, controlled, double-blind clinical trial is proposed, which will involve 33 individuals (n = 11 per group) of both sexes, ages 18 to 45 years in 3 groups: LED group; placebo group; and control group, submitted to 6 non-consecutive sessions of photobiomodulation totaling 2 weeks of treatment. The Research Diagnostic Criteria for Temporomandibular Disorders-RDC/TMD will be used to assess and determine the participants' TMD. The pain will be assessed using the Visual Analog Scale - VAS, the mandibular range of motion will be determined with the aid of a digital caliper, and the electrical activity of the masticatory muscles will be verified by electromyography. A mixed plate of 18 red LEDs-660 nm and 18 infrared LEDs-850 nm with power of 3.5 mW per LED, 4.45 mW/cm, radiant exposure of 5.35 J/cm, will be used for photobiomodulation. The irradiated area will be 14.13 cm, and energy of 75.6 J, in the TMJ region and in the bilateral masseter and temporal muscles. Participants from all groups will be reassessed after the first therapeutic intervention, and at the end of treatment. DISCUSSION: We expect the use of photobiomodulation with LEDs, infra and red, to reduce pain, improve temporomandibular joint function in patients with TMD, and thus improve the general conditions of the patient.

Oxidative stress generated by irradiation of a zinc(II) phthalocyanine induces a dual apoptotic and necrotic response in melanoma cells.

Melanoma is an aggressive form of skin carcinoma, highly resistant to traditional therapies. Photodynamic therapy (PDT) is a non-invasive therapeutic procedure that can exert a selective cytotoxic activity toward malignant cells. In this work we evaluated the effect of a cationic zinc(II) phthalocyanine (Pc13) as photosensitizer on a panel of melanoma cells. Incubation with Pc13 and irradiation induced a concentration and light dose-dependent phototoxicity. In order to study the mechanism underlying Pc13-related cell death and to compare the effect of different doses of PDT, the most sensitive melanoma B16F0 cells were employed. By confocal imaging we showed that Pc13 targeted lysosomes and mitochondria. After irradiation, a marked increase in intracellular reactive oxygen species was observed and a complete protection from Pc13 phototoxicity was reached in the presence of the antioxidant trolox. Acridine orange/ethidium bromide staining showed morphological changes indicative of both apoptosis and necrosis. Biochemical hallmarks of apoptosis, including a significant decrease in the expression levels of Bcl-2, Bcl-xL and Bid and mitochondrial membrane permeabilization, were observed at short times post irradiation. The consequent release of cytochrome c to cytosol and caspase-3 activation led to PARP-1 cleavage and DNA fragmentation. Simultaneously, a dose dependent increase of lactate dehydrogenase in the extracellular compartment of treated cells revealed plasma membrane damage characteristic of necrosis. Taken together, these results indicate that a dual apoptotic and necrotic response is triggered by Pc13 PDT-induced oxidative stress, suggesting that combined mechanisms of cell death could result in a potent alternative for melanoma treatment.

Efeito da magnetoterapia e infravermelho na algesia e estresse de uma cadela paraplégica: um breve relato de caso

A dor e estresse são achados que podem ser visualizados nos animais e que levam a distúrbios homeostáticos que comprometem o seu bem-estar. Dessa forma, a magnetoterapia surge como uma alternativa terapêutica para amenizar a dor, o estresse e suas consequências para o animal. Objetivou-se relatar o efeito da magnetoterapia e infravermelho na algesia e estresse de uma cadela paraplégica. Acompanhou-se uma cadela de 10 anos com histórico de paraplegia. A mesma apresentava constantes recidivas de infecção urinária, quadro de insônia e dor. Diante do quadro, foi confeccionado um colchão o qual continha magneto e infravermelho longo. Após 06 meses de uso, verificou-se uma melhora significativa no quadro de dor e estresse do animal. Verificou-se também uma redução na frequência de recidivas de infecções do trato urinário. Conclui-se, nesse relato, que a utilização de magnetoterapia associada ao efeito do infravermelho longo parecem apresentar efeito analgésico e antiestressante em cadela paraplégica. Entretanto, são necessários maiores estudos.

Pain and stress are findings that can be seen in animals and lead to homeostatic disorders that compromise their well-being. In this way, magnetotherapy appears as a therapeutic alternative to relieve pain, stress and its consequences for the animal. The objective was to report the effect of magnetotherapy and infrared on the algesia and stress of a paraplegic bitch. We followed a 10-year-old female with a history of paraplegia. It had constant recurrences of urinary tract infection, insomnia and pain. Before the painting, a mattress was made which contained a magnet and a long infrared. After six months of use, there was a significant improvement in the pain and stress of the animal. There was also a reduction in the frequency of relapses of urinary tract infections. It is concluded, in this report, that the use of magnetotherapy associated to the effect of the long infrared seems to present analgesic and anti-stressant effect in a paraplegic bitch. However, further studies are needed.

Efeito da magnetoterapia e infravermelho na algesia e estresse de uma cadela paraplégica: um breve relato de caso

A dor e estresse são achados que podem ser visualizados nos animais e que levam a distúrbios homeostáticos que comprometem o seu bem-estar. Dessa forma, a magnetoterapia surge como uma alternativa terapêutica para amenizar a dor, o estresse e suas consequências para o animal. Objetivou-se relatar o efeito da magnetoterapia e infravermelho na algesia e estresse de uma cadela paraplégica. Acompanhou-se uma cadela de 10 anos com histórico de paraplegia. A mesma apresentava constantes recidivas de infecção urinária, quadro de insônia e dor. Diante do quadro, foi confeccionado um colchão o qual continha magneto e infravermelho longo. Após 06 meses de uso, verificou-se uma melhora significativa no quadro de dor e estresse do animal. Verificou-se também uma redução na frequência de recidivas de infecções do trato urinário. Conclui-se, nesse relato, que a utilização de magnetoterapia associada ao efeito do infravermelho longo parecem apresentar efeito analgésico e antiestressante em cadela paraplégica. Entretanto, são necessários maiores estudos.(AU)

Pain and stress are findings that can be seen in animals and lead to homeostatic disorders that compromise their well-being. In this way, magnetotherapy appears as a therapeutic alternative to relieve pain, stress and its consequences for the animal. The objective was to report the effect of magnetotherapy and infrared on the algesia and stress of a paraplegic bitch. We followed a 10-year-old female with a history of paraplegia. It had constant recurrences of urinary tract infection, insomnia and pain. Before the painting, a mattress was made which contained a magnet and a long infrared. After six months of use, there was a significant improvement in the pain and stress of the animal. There was also a reduction in the frequency of relapses of urinary tract infections. It is concluded, in this report, that the use of magnetotherapy associated to the effect of the long infrared seems to present analgesic and anti-stressant effect in a paraplegic bitch. However, further studies are needed.(AU)

Method for auxiliary use of thermography in diagnosing inflammation in the coxofemoral joint in dogs / Método para uso da termografia no diagnóstico auxiliar da inflamação na articulação coxofemoral em cães

Joint diseases are relatively common in domestic animals, such as dogs. The involved inflammation produces thermal emission, which can be imaged using specific sensors that allow capturing of infrared images. Given that there have been few reports on the use of thermography in the diagnosis of inflammation associated with diseases of the hip joint in dogs, we here propose a method for identification of inflammatory foci in dogs by using infrared thermometry. The present study aimed to find non-invasive and low-cost resources that could facilitate a clinical diagnosis in cases with inflammation in the coxofemoral joint of dogs. To this end, we developed a system in which the Flir Systems TG165 thermograph is coupled to a black PVC cannula with a 30-cm focus-to-animal distance. External effects of the environment on the temperature of the animals were compared with the body temperature as measured by a conventional thermometer. Thirty-one dogs with and without inflammation in the coxofemoral joint underwent clinical evaluation. We verified that the temperature registered by the thermograph in the animals with joint inflammation was significantly different from that in control animals without inflammation, in the lateral projection. The method showed a sensitivity of 80%, specificity of 87.5%, and accuracy of 83.87%. This standardized method of diagnosis of inflammatory foci in the coxofemoral articulation of dogs by way of thermography showed sensitivity, specificity, and satisfactory accuracy.(AU)

Tentando buscar recursos não invasivos e de baixo custo, para auxiliar o diagnóstico clínico em casos de inflamação na articulação coxofemoral de cães, idealizou-se o presente trabalho, que teve como objetivo propor um método de diagnóstico, em casos de inflamação na articulação coxofemoral de cães, desenvolvido a partir do registro do aumento da temperatura no local da inflamação, mediante o emprego de um termógrafo do tipo TG165 da Flir Systems acoplado a uma cânula de PVC, negra, com 30 cm de distância foco-animal para diminuir os efeitos externos que o ambiente exerce sobre a temperatura dos animais, e comparando-a com a temperatura corpórea, aferida por um termômetro convencional. Foram submetidos à avaliação clínica, 31 cães com e sem inflamação na articulação coxofemoral, onde verificou-se que a temperatura, registrada pelo termógrafo, dos animais pertencente ao grupo com inflamação na articulação apresentou diferença significativa na projeção lateral, em relação a temperatura dos animais do grupo sem doença articular, também aferida através do aparelho termográfico. O método apresentou sensibilidade de 80%, especificidade de 87,5% e precisão de 83,87%. Conclui-se que a padronização do método de diagnóstico de focos inflamatórios na articulação coxofemoral de cães pela termografia apresentou sensibilidade, especificidade e precisão satisfatória.(AU)

Photobiomodulation prevents DNA fragmentation of alveolar epithelial cells and alters the mRNA levels of caspase 3 and Bcl-2 genes in acute lung injury.

Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) are defined as pulmonary inflammation that could occur from sepsis and lead to pulmonary permeability and alveolar edema making them life-threatening diseases. Photobiomodulation (PBM) properties have been widely described in the literature in several inflammatory diseases; although the mechanisms of action are not always clear, this could be a possible treatment for ARDS/ALI. Thus, the aim of this study was to evaluate the mRNA levels from caspase-3 and BCL-2 genes and DNA fragmentation in lung tissue from Wistar rats affected by ALI and subjected to photobiomodulation by exposure to a low power infrared laser (808 nm; 100 mW; 3.571 W cm-2; four points per lung). Adult male Wistar rats were randomized into 6 groups (n = 5, for each group): control, PBM10 (10 J cm-2, 2 J and 2 seconds), PBM20 (20 J cm-2, 5 J and 5 seconds), ALI, ALI + PBM10 and ALI + PBM20. ALI was induced by intraperitoneal Escherichia coli lipopolysaccharide injection. Lung samples were collected and divided for mRNA expression of caspase-3 and Bcl-2 and DNA fragmentation quantifications. Data show that caspase-3 mRNA levels are reduced and Bcl-2 mRNA levels increased in ALI after low power infrared laser exposure when compared to the non-exposed ALI group. DNA fragmentation increased in inflammatory infiltrate cells and reduced in alveolar cells. Our research shows that photobiomodulation can alter relative mRNA levels in genes involved in the apoptotic process and DNA fragmentation in inflammatory and alveolar cells after lipopolysaccharide-induced acute lung injury. Also, inflammatory cell apoptosis is part of the photobiomodulation effects induced by exposure to a low power infrared laser.

Method for auxiliary use of thermography in diagnosing inflammation in the coxofemoral joint in dogs / Método para uso da termografia no diagnóstico auxiliar da inflamação na articulação coxofemoral em cães

Joint diseases are relatively common in domestic animals, such as dogs. The involved inflammation produces thermal emission, which can be imaged using specific sensors that allow capturing of infrared images. Given that there have been few reports on the use of thermography in the diagnosis of inflammation associated with diseases of the hip joint in dogs, we here propose a method for identification of inflammatory foci in dogs by using infrared thermometry. The present study aimed to find non-invasive and low-cost resources that could facilitate a clinical diagnosis in cases with inflammation in the coxofemoral joint of dogs. To this end, we developed a system in which the Flir Systems TG165 thermograph is coupled to a black PVC cannula with a 30-cm focus-to-animal distance. External effects of the environment on the temperature of the animals were compared with the body temperature as measured by a conventional thermometer. Thirty-one dogs with and without inflammation in the coxofemoral joint underwent clinical evaluation. We verified that the temperature registered by the thermograph in the animals with joint inflammation was significantly different from that in control animals without inflammation, in the lateral projection. The method showed a sensitivity of 80%, specificity of 87.5%, and accuracy of 83.87%. This standardized method of diagnosis of inflammatory foci in the coxofemoral articulation of dogs by way of thermography showed sensitivity, specificity, and satisfactory accuracy.

Tentando buscar recursos não invasivos e de baixo custo, para auxiliar o diagnóstico clínico em casos de inflamação na articulação coxofemoral de cães, idealizou-se o presente trabalho, que teve como objetivo propor um método de diagnóstico, em casos de inflamação na articulação coxofemoral de cães, desenvolvido a partir do registro do aumento da temperatura no local da inflamação, mediante o emprego de um termógrafo do tipo TG165 da Flir Systems acoplado a uma cânula de PVC, negra, com 30 cm de distância foco-animal para diminuir os efeitos externos que o ambiente exerce sobre a temperatura dos animais, e comparando-a com a temperatura corpórea, aferida por um termômetro convencional. Foram submetidos à avaliação clínica, 31 cães com e sem inflamação na articulação coxofemoral, onde verificou-se que a temperatura, registrada pelo termógrafo, dos animais pertencente ao grupo com inflamação na articulação apresentou diferença significativa na projeção lateral, em relação a temperatura dos animais do grupo sem doença articular, também aferida através do aparelho termográfico. O método apresentou sensibilidade de 80%, especificidade de 87,5% e precisão de 83,87%. Conclui-se que a padronização do método de diagnóstico de focos inflamatórios na articulação coxofemoral de cães pela termografia apresentou sensibilidade, especificidade e precisão satisfatória.

Ablación de las neoplasias intraepiteliales escamosas anales de alto grado, precursoras del cáncer anal, con coagulación infrarroja / Ablation of high-grade anal squamous intraepithelial neoplasms, anal cancer precursors, with infrared coagulation

Introducción: Las neoplasias intraepiteliales anales de alto grado (AIN-AG) sin tratamiento progresan a carcinoma anal escamoso invasor (CAE) en 8-13% de los casos. Esto disminuye al 1,2% con la ablación dirigida por anoscopía de alta resolución (AAR). El tratamiento ideal de la AIN-AG no está establecido. Goldstone, en 2005 introdujo el coagulador infrarrojo (CIR) para la ablación de estas lesiones y demostró que tiene tanta efectividad como la cirugía, aunque menor morbilidad y la ventaja de no requerir quirófano. No hemos encontrado publicaciones con esta técnica en nuestro medio. El objetivo de este trabajo es evaluar los resultados de la ablación de las AIN-AG con CIR, las complicaciones del método y la recurrencia temprana. Diseño: Observacional, retrospectivo, con base de datos prospectiva. Pacientes y Método: Se incluyeron individuos con AIN-AG en conducto anal y/o región perianal diagnosticadas en el Consultorio de Detección Temprana de Displasia Anal del Hospital Juan A. Fernández mediante biopsia dirigida por AAR y tratadas con CIR con el aparato Redfield®, entre marzo 2013-agosto 2014 previo consentimiento informado escrito. Tras infiltración con anestesia local las lesiones fueron coaguladas con repetidos pulsos de 1,5 segundos hasta visualizar los vasos de la submucosa. Se controló entre los 3 y 6 meses con AAR y biopsia de lesiones sospechosas. Resultados: Fueron 14 pacientes (10 hombres que tienen sexo con hombres, todos VIH-positivos y 4 mujeres, 2 VIH-positivas). Edad mediana: 37,5 (rango 20-59) años. La AIN-AG se localizaba en el conducto anal en 11 pacientes y en la región perianal en 3. En la AAR diagnóstica todos presentaban sólo un área de AIN-AG. El procedimiento fue bien tolerado. Una paciente VIH-positiva presentó secreción purulenta a los tres días de la ablación, que se trató con antibióticos. Esta paciente y otro más tuvieron dolor post-procedimiento manejado con anti-inflamatorios no esteroides. En la AAR de control se hallaron 2 (14,3%) recurrencias, una interpretada como persistencia por margen insuficiente de una lesión extendida y otra diagnosticada al momento de realizar CIR, que no había sido observada en la AAR realizada 1 mes antes. La eficacia por lesión individual tratada fue del 92,9%. Conclusiones: El tratamiento de las AIN-AG en el consultorio mediante CIR es bien tolerado, tiene mínimas complicaciones y resulta efectivo en el corto plazo. Es necesario un seguimiento más prolongado para evaluar la tasa de recidiva y la utilidad para prevenir la progresión al CAE. (AU)

Background: High-grade anal intraepithelial neoplasia (HGAIN) without treatment progresses to invasive squamous cell carcinoma (SCC) in 8-13% of cases, and that incidence decreases to 1,2% with ablation targeted with high resolution anoscopy (HRA). The ideal treatment for HGAIN is not established yet. Goldstone, in 2005 introduced the infrared coagulator (IRC) for the ablation of these lesions, and with great experience demonstrated that it is as effective as surgery but has less morbidity and the advantage of not requiring the operating room. To our knowledge there are not publications with this technique in our country. The aim of this study is to assess the results of HGAIN ablation with CIR, the method complications, and early recurrence. Design: Observational, retrospective study, with prospective database. Patients and Methods: Individuals with HGAIN in the anal canal or the perianal region, diagnosed with biopsy targeted with HRA and treated with the IRC in the Anal Dysplasia Clinic of the Hospital Juan A. Fernández, between March 2013 and August 2014, were included. After written informed consent, HRA was repeated in the outpatient clinic to localize the area to be treated with the IRC Redfield®. After local anesthesia the lesions were coagulated with repeated 1.5 seconds pulses until the submucosa vessels were visualized. Control with HRA and biopsy of suspicious lesions was performed between 3-6 months of the procedure. Results: Fourteen patients (10 men who have sex with men, all HIV-positive, and 4 women, 2 HIV-positive). Median age: 37.5 (range 20-59) years. The HGAIN was localized at the anal canal in 11 patients, and in the perianal region in 3. In the diagnostic HRA all patients presented only one area of HGAIN. The procedure was well tolerated. Only one HIV-positive woman presented purulent discharge 3 days after ablation, and was treated with antibiotics. The latter and another patient had post-procedure pain, managed with non-steroidal anti-inflammatory drugs. In the control HRA, 2 (14,3%) recurrences were found, 1 was interpreted as persistency due to insufficient margin of a extended lesion, and 1 diagnosed during the CIR of other lesion, that had went unaware at the initial HRA performed one month before. The efficacy for individual lesion treated was 92.9%. Conclusions: The treatment of HGAIN with IRC in the outpatient department is well tolerated, has minimal complications, and is effective in the short term. It is necessary a longer surveillance to assess the recurrence rate and the usefulness for preventing progression to SCC. (AU)

Effects of phototherapy plus physical training on metabolic profile and quality of life in postmenopausal women.

A cluster of metabolic abnormalities are markedly higher among postmenopausal women. The present study evaluated the effects of infrared light emitting diode (LED) during treadmill training on multiple metabolic markers, body fat, dietary habits and quality of life in postmenopausal women. Forty-five postmenopausal women aged 50-60 years were randomly assigned to one of three groups, and of these, 30 women successfully completed the full study. The three groups were as follows: (i) the LED group, which performed treadmill training associated with phototherapy (n = 10); (ii) the exercise group, which carried out treadmill training only (n = 10); and (iii) the sedentary group, which neither performed physical training nor underwent phototherapy (n = 10). Training was performed over a period of six months, twice a week for 45 min per session at 85-90% of maximal heart rate (HRmax), which was obtained during a progressive exercise testing. The average HR and velocity during treadmill training were 144 ± 9 bpm and 5.8 ± 1.3 km/h for both trained groups. The irradiation parameters were 100 mW, 39 mW/cm2 and 108 J/cm2 for 45 min. Anthropometric data, skinfolds thickness, biochemical exams (lipid profile, glucose and insulin levels), dietary habits and quality of life were evaluated. The sum of skinfolds significantly improved in the exercise and sedentary groups (p < 0.05). Additionally, there was an improvement in lipid profile, particularly, total cholesterol and low-density lipoprotein, which reduced significantly for all groups (p ˂ 0.05). However, intake of saturated fats was significantly reduced in the sedentary group only (p < 0.05). The quality of life improved in the LED group only, with a significant reduction in the total WHQ score (p < 0.05). Physical training with or without phototherapy may improve the metabolic profile. In addition, phototherapy together with treadmill training prevented an increase in subcutaneous fat and facilitated an improved quality of life in postmenopausal women.

Rapid microplate, green method for high-throughput evaluation of vinegar acidity using thermal infrared enthalpimetry.

Infrared thermal imaging was combined with disposable microplates to perform enthalpimetric analysis using an infrared camera to monitor temperature without contact. The proposed thermal infrared enthalpimetry (TIE) method was used to determine the total, fixed and volatile acidities of vinegars. Sample preparation and analysis were performed in the same vessel, avoiding excessive sample handling and reducing energy expenditure by more than ten times. The results agreed with those of the conventional method for different kinds of vinegars, with values of 1.7%, and 2.3% for repeatability and intermediate precision, respectively. A linear calibration curve was obtained from 0.040 to 1.30molL(-1). The proposed method provided rapid results (within 10s) for four samples simultaneously, a sample throughput of up to 480 samples per hour. In addition, the method complies with at least eight of twelve recommendations for green analytical chemistry, making TIE a promising tool for routine vinegar analysis.

Physiotherapeutic approach on the late phase of chikungunya: a case report / Abordagem fisioterapêutica na fase tardia da chikungunya: um relato de caso

Abstract Introduction: in April of 2016, the epidemiological bulletin reported 39,017 suspected cases of chikungunya fever in Brazil. The main symptoms of the disease in the acute phase are: high fever, polyarthralgia, back pain, headache and fatigue; while in the late phase present polyarthralgia or musculoskeletal pain which often has prolonged duration. Description: in the late phase, the patient presented complaints mainly of: severe pain on the ankle joints wrists, elbows and shoulders. The medical handling consisted of continuous ultrasound sessions with the frequency of 1 MHz. The infrared laser with a dosage of 4J and 3s per point; TENS-burst with a pulse width of 250 us and the frequency of 2Hz, carried out for 10 days. The physiotherapeutic treatment proposal was an innovation, however there are no medical literatures for completementary medication for the treatment which could reduce the use of analgesics and could cause prolonged comfort to the patient ratified by EVA and the SF-36. Discussion: the use of ultrasound and low intensity laser are performed on the signs of chronic articular treatment in order to reduce inflammation, pain and joint stiffness. Therefore, a remarkable reduction of the algic state and the improvement of the patient's life along the r ten consecutive sessions of a proposed protocol in this study, thus there is a need for further researches on this issue so it is possible to perform a medical handling based on evidences on the theme.

Resumo Introdução: o boletim epidemiológico de abril de 2016 informou 39.017 casos prováveis de febre de chikungunya no país. Na fase aguda da doença os principais sintomas são: febre alta, poliartralgia, dores nas costas, dor de cabeça e fadiga; enquanto que na fase tardia estão presentes a poliartralgia ou dores músculo-esqueléticas, que frequentemente apresentam-se com duração prolongada. Descrição: o paciente apresentava na fase tardia como principais queixas: dores severas nas articulações dos tornozelos, punhos, cotovelos e ombros. O manejo clínico foi constituído de sessões com ultrassom contínuo com frequência de 1 MHz, Laser infravermelho com dosagem de 4J e 3s por ponto; TENS-burst com largura de pulso de 250 us e Frequência de 2Hz, realizado por 10 dias. O tratamento fisioterapêutico proposto foi inovador, pois não há na literatura tratamentos complementares que possam diminuir o uso de analgésicos e causar conforto prolongado ao paciente ratificado pelo EVA e o SF-36. Discussão: o uso do ultrassom e do laser de baixa intensidade são utilizados no tratamento de manifestações reumáticas crônicas com o objetivo de reduzir a inflamação, dor e rigidez articular. Por conseguinte, foi notável a redução do quadro álgico e melhora da qualidade de vida da paciente ao longo de dez sessões consecutivas com o protocolo proposto no presente estudo, sendo assim surge à necessidade de novas pesquisas acerca do assunto para que seja possível fazer um manejo clínico baseado em evidências sobre o tema.