Effect of photobiomodulation associated with strengthening pelvic floor muscles in volunteers with urinary incontinence: a randomized, double-blinded, and placebo-controlled clinical trial.

The dysfunctions of the female pelvic floor have a great influence on the quality of life of women, in all areas, social, psychological, and sexual. Stress urinary incontinence is the clinical condition in which the woman involuntarily loses urine to efforts, such as coughing and sneezing, causing great embarrassment and affecting her quality of life. The physiotherapeutic treatments include muscle strengthening; however, muscle fatigue is present when performing the exercises. Here we investigate the effects of photobiomodulation to prevent muscle fatigue in the pelvic floor in the treatment of stress urinary incontinence, associated with a muscle strengthening exercise protocol. We used an infrared laser (808 nm, 100 mW) and 3 J/point and fluence of 107.1 J/cm2. The application was performed at 3 points on the vaginal introits and at another 3 points inside the vaginal canal cavity for the treatment of stress urinary incontinence associated with strengthening exercises with vaginal cones. Twenty-two volunteers participated in the study, divided into two groups: group 1 (laser therapy + strengthening) and group 2 (placebo laser + strengthening). In the group 1 quality of life score, the assessment (11.63 ± 4.33) was the highest score at 17 and in the reevaluation (7.81 ± 5.14) the lowest was 0 (p < 0.05). The muscular strength increased considerably (p < 0.05) for group 1, where the vast majority of patients gained more than twice the strength in the pelvic apparatus (8.36 ± 6.65 before X 13.81 ± 8.92 after). The volunteers acquired an increase in the contraction of the muscles of the pelvic apparatus (p < 0.05) (3.45 ± 1.07); after laser application, this number increased considerably (4.27 ± 0.61). Endurance had an increase of almost 50% compared to placebo, demonstrating the resistance gain in the perineal muscles (3.90 ± 2.35 X 5 ± 1.90). We concluded that photobiomodulation treatment showed significant efficacy in relation to muscle fatigue in the pelvic apparatus right after a strengthening program in women with stress urinary incontinence.

Infrared thermography as valuable tool for gynoid lipodystrophy (cellulite) diagnosis.

Cellulite is a morphological alteration of the tegument tissue, directly interfering in self-esteem with etiology and pathophysiology far from being a consensus. Although the visual diagnosis of cellulitis is well known, it does not represent the real pathological condition of the subcutaneous tissue. The aim of the study was to investigate the hypothesis that the more heterogeneous tissue pattern analyzed by infrared thermography, the more severe is the cellulite grade. Forty female participants were selected and 60 thighs were analyzed by clinical anamnesis and infrared thermography. Classical visual analysis was correlated to the tissue heterogeneity measured by thermography. R Spearman's correlation between visual evaluation and thermography was 0.92. Phototype presented a negative significant correlation of 0.67 with classical visual analysis. In the present study, we presented a simple method based on infrared thermography that can be adopted in any esthetics office with a correlation of 0.92 with the visual classic evaluation, but, besides, may be very helpful to the clinician to decide which treatment will be adopted, i.e., an aggressive and inflammatory approach such as the radiofrequency of shockwave therapy or an anti-inflammatory approach such as photobiomodulation, depending on the inflammatory status of cellulite.

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.

High doses of laser phototherapy can increase proliferation in melanoma stromal connective tissue

It is well established that laser phototherapy (LP) is contraindicated directly over cancer cells, due to its bio modulatory effects in cell and blood vessel proliferation. The aim of the present study was to analyze the influence of typical low-level laser therapy (LLLT) and high intensity laser therapy (HILT) and an in-between dose of 9 J on collagen fibers and blood vessels content in melanoma tumors (B16F10) implanted in mice. Melanoma tumor cells were injected in male Balb C mice which were distributed in four groups: control (no irradiated) or irradiated by 3, 9, or 21 J (150; 450, or 1050 J/cm2). LP was performed in daily sessions for 3 days with a InGaAlP—660 nm (mean output: 50 mW, spot size: 2 mm2). Tumor volume was analyzed using (1) picrosirius staining to quantify collagen fibers content and (2) Verhoeff’s method to quantify blood vessels content. Tumor growth outcome measured in the 3-J group was not significantly different from controls. Nine and 21-J groups, presented significant and dose-dependent increases in tumor volume. Quantitative analysis of the intensity of collagen fibers and their organization in stroma and peri-tumoral microenvironment showed significant differences between irradiated and control group. Blood vessels count of 21-J group outnumbered the other groups. High doses (= 9 J) of LP showed a dose-dependent tumor growth, different collagen fibers characteristics, and eventually blood vessel growth, while a typical LLLT dose (3 J) appeared harmless on melanoma cell activity

High doses of laser phototherapy can increase proliferation in melanoma stromal connective tissue

It is well established that laser phototherapy (LP) is contraindicated directly over cancer cells, due to its bio modulatory effects in cell and blood vessel proliferation. The aim of the present study was to analyze the influence of typical low-level laser therapy (LLLT) and high intensity laser therapy (HILT) and an in-between dose of 9 J on collagen fibers and blood vessels content in melanoma tumors (B16F10) implanted in mice. Melanoma tumor cells were injected in male Balb C mice which were distributed in four groups: control (no irradiated) or irradiated by 3, 9, or 21 J (150; 450, or 1050 J/cm2). LP was performed in daily sessions for 3 days with a InGaAlP—660 nm (mean output: 50 mW, spot size: 2 mm2). Tumor volume was analyzed using (1) picrosirius staining to quantify collagen fibers content and (2) Verhoeff’s method to quantify blood vessels content. Tumor growth outcome measured in the 3-J group was not significantly different from controls. Nine and 21-J groups, presented significant and dose-dependent increases in tumor volume. Quantitative analysis of the intensity of collagen fibers and their organization in stroma and peri-tumoral microenvironment showed significant differences between irradiated and control group. Blood vessels count of 21-J group outnumbered the other groups. High doses (= 9 J) of LP showed a dose-dependent tumor growth, different collagen fibers characteristics, and eventually blood vessel growth, while a typical LLLT dose (3 J) appeared harmless on melanoma cell activity

Low level laser therapy reduces acute lung inflammation in a model of pulmonary and extrapulmonary LPS-induced ARDS.

The present study aimed to investigate the effects low level laser therapy (LLLT) in a LPS-induced pulmonary and extrapulmonary acute respiratory distress syndrome (ARDS) in BALB/c mice. Laser (830nm laser, 9J/cm(2), 35mW, 80s per point, 3 points per application) was applied in direct contact with skin, 1h after LPS administration. Mice were distributed in control (n=6; PBS), ARDS IT (n=7; LPS orotracheally 10µg/mouse), ARDS IP (n=7; LPS intra-peritoneally 100µg/mouse), ARDS IT+Laser (n=9; LPS intra-tracheally 10µg/mouse), ARDS IP+Laser (n=9; LPS intra-peritoneally 100µg/mouse). Twenty-four hours after last LPS administration, mice were studied for pulmonary inflammation by total and differential cell count in bronchoalveolar lavage (BAL), cytokines (IL-1beta, IL-6, KC and TNF-alpha) levels in BAL fluid and also by quantitative analysis of neutrophils number in the lung parenchyma. LLLT significantly reduced pulmonary and extrapulmonary inflammation in LPS-induced ARDS, as demonstrated by reduced number of total cells (p<0.001) and neutrophils (p<0.001) in BAL, reduced levels of IL-1beta, IL-6, KC and TNF-alpha in BAL fluid and in serum (p<0.001), as well as the number of neutrophils in lung parenchyma (p<0.001). LLLT is effective to reduce pulmonary inflammation in both pulmonary and extrapulmonary model of LPS-induced ARDS.

An experimental study of low-level laser therapy in rat Achilles tendon injury.

The aim of this controlled animal study was to investigate the effect of low-level laser therapy (LLLT) administered 30 min after injury to the Achilles tendon. The study animals comprised 16 Sprague Dawley male rats divided in two groups. The right Achilles tendons were injured by blunt trauma using a mini guillotine, and were treated with LLLT or placebo LLLT 30 min later. The injury and LLLT procedures were then repeated 15 hours later on the same tendon. One group received active LLLT (λ = 904 nm, 60 mW mean output power, 0.158 W/cm(2) for 50 s, energy 3 J) and the other group received placebo LLLT 23 hours after LLLT. Ultrasonographic images were taken to measure the thickness of the right and left Achilles tendons. Animals were then killed, and all Achilles tendons were tested for ultimate tensile strength (UTS). All analyses were performed by blinded observers. There was a significant increase in tendon thickness in the active LLLT group when compared with the placebo group (p < 0.05) and there were no significant differences between the placebo and uninjured left tendons. There were no significant differences in UTS between laser-treated, placebo-treated and uninjured tendons. Laser irradiation of the Achilles tendon at 0.158 W/cm(2) for 50 s (3 J) administered within the first 30 min after blunt trauma, and repeated after 15 h, appears to lead to edema of the tendon measured 23 hours after LLLT. The guillotine blunt trauma model seems suitable for inflicting tendon injury and measuring the effects of treatment on edema by ultrasonography and UTS. More studies are needed to further refine this model.

Avaliação do efeito da clareação dentária fotoativada sobre a polpa dentária em modelo experimental de ratos / Evaluation of the photo-activated dental bleaching effect on dental pulp in an in vivo rat experimental model

A clareação dentária é um procedimento estético bastante procurado em Odontologia. A diversidade de técnicas tem gerado controvérsia e insegurança por parte dos cirurgiões-dentistas. Neste artigo investigamos os efeitos da clareação dentária fotoativada, utilizando gel de peróxido de hidrogênio, a respeito de aspectos bioquímicos e morfológicos da polpa dentária em modelos experimentais in vivo. Foram utilizados 30 ratos Wistar (150 - 200g) divididos, aleatoriamente, em 5 grupos de 6 animais. Foram utilizados dentes incisivos superiorse e inferiores e três diferentes formulações de gel (15%, 25% e 35%, DMC). A fotoativação consistiu de 3 séries de 1 min com luz e 1 min sem luz. O equipamento utilizado foi o Whitening Lase Light (DMC), que conta com a tecnologia de emissor híbrido de luz (led-laser de diodo infravermelho). Após 24 horas, os animais foram sacrificados e os dentes extraídos para análises. Dentes que receberam gel em diferentes concentrações de peróxido, com ou sem fotoativação, apresentaram sinais leves de inflamação. A análise qualitativa histológica não revelou diferenças significativas entre os grupos experimentais, com exceção dos grupos que receberam gel + led, onde houve sinais mais visíveis de inflamação. No grupo gel 15%, os animais que receberam led apresentaram aumento significativo da expressão de COX-2. Nos géis com 25 e 35% de peróxido, os grupos tratados somente com led apresentaram expressão de COX-2 menor que o grupo gel. A combinação led-laser apresentou inibição altamente significativa da expressão de COX-2 na polpa dentária. A clareação dentária fotoativada utilizando a combinação led-laser não apresentou sinais de inflamação da polpa dentária.

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 ...

Effect of low-level laser (Ga-Al-As 655 nm) on skeletal muscle fatigue induced by electrical stimulation in rats.

We investigated whether low-level laser therapy (LLLT) can reduce muscular fatigue during tetanic contractions in rats. Thirty-two male Wistar rats were divided into four groups receiving either one of three different LLLT doses (0.5, 1.0, and 2.5 J/cm2) or a no-treatment control group. Electrical stimulation was used to induce six tetanic muscle contractions in the tibial anterior muscle. Contractions were stopped when the muscle force fell to 50% of the initial value for each contraction (T50%). There was no significant difference between the 2.5 J/cm2 laser-irradiated group and the control group in mean T50% values. Laser-irradiated groups (0.5 and 1.0 J/cm2) had significantly longer T50% values than the control group. The relative peak force for the sixth contraction in the laser-irradiated groups were significantly higher at 92.2% (SD 12.6) for 0.5 J/cm2, 83.2% (SD 20.5) for 1.0 J/cm2, and 82.9% (SD 18.3) for 2.5 J/cm2 than for the control group [50% (SD 15)]. Laser groups receiving 0.5 and 1.0 J/cm2 showed significant increases in mean performed work compared with both the control group and their first contraction values. Muscle damage was indirectly measured by creatine kinase levels in plasma. A distinct dose-response pattern was found in which 1.0 and 2.5 J/cm2 LLLT groups had significantly lower creatine kinase levels than the 0.5 J/cm2 LLLT group and the control group. We conclude that LLLT doses of 0.5 and 1.0 J/cm2 can prevent development of muscular fatigue in rats during repeated tetanic contractions.

Avaliação do ácido láctico intramuscular através da espectroscopia Raman: novas perspectivas em medicina do esporte / Intramuscular lactic acid assessment through Raman spectrography: new perspectives in sports medicine

O uso da espectroscopia Raman no infravermelho pode vir a constituir uma nova técnica para avaliação física, permitindo medidas da concentração de ácido láctico em sangue e em músculo esquelético, por um método não invasivo. A espectroscopia Raman é uma técnica que oferece grande riqueza de detalhes provida pela vibração de moléculas em diferentes níveis de energia. Em estudos prévios, foram obtidos espectros Raman de ácido láctico em plasma humano e em sangue de rato, onde os picos característicos foram observados claramente na matriz biológica. No presente estudo a espectroscopia Raman foi usada para a identificação de ácido láctico em músculo tibial de rato. Foi usado um laser de Ti:safira sintonizado em 830nm, um espectrômetro Kaiser f/l.8 e um detector de CCD refrigerado. O espectro Raman do ácido láctico apresenta oito picos bem distintos, entre 700 e 1.500cm-1, correspondendo aos diferentes modos de vibração da molécula do ácido láctico. O pico principal em 830cm-1 foi usado para caracterizar a presença do ácido láctico no músculo tibial de rato. Foram analisados espectros Raman de músculos tibiais in vivo e in vitro. Além disso, também foi monitorada a difusão do ácido láctico através do músculo, in vitro. Pode-se concluir, a partir dos resultados obtidos, que a espectroscopia Raman no infravermelho próximo apresenta grande potencial para, no futuro, com o aperfeiçoamento da técnica, ser utilizada em avaliações físicas com o intuito de permitir medições das concentrações de ácido láctico no músculo esquelético, através de metodologia não invasiva.