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1.
Lasers Med Sci ; 39(1): 70, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38378954

RESUMO

Inflammatory bowel diseases (IBD) are chronic and multifactorial diseases characterized by dysfunction of the intestinal mucosa and impaired immune response. Data show an important relationship between intestine and respiratory tract. The treatments of IBD are limited. Photobiomodulation (PBM) is an effective anti-inflammatory therapy. Our objective was to evaluate the repercussion of IBD as well as its treatment with PBM on pulmonary homeostasis. Male Wistar rats were submitted to IBD induction by acetic acid and treated or not with PBM. Rats were irradiated with red LED on both right and left sides of the ventral surface and beside the external anal region during 3 consecutive days (wavelenght 660 nm, power 100 mw, total energy 15 J and time of irradiation 150 s per point). Our results showed that IBD altered pulmonary homeostasis, since we observed an increase in the histopathological score, in myeloperoxidase activity (MPO), in mast cell degranulation, and in the release and gene expression of cytokines. We also showed that PBM treatment reduced biomarkers of IBD and reverted all augmented parameters in the lung, restoring its homeostasis. Thus, we confirm experimentally the important gut-lung axis and the role of PBM as a promising therapy.


Assuntos
Doenças Inflamatórias Intestinais , Terapia com Luz de Baixa Intensidade , Ratos , Masculino , Animais , Ratos Wistar , Terapia com Luz de Baixa Intensidade/métodos , Doenças Inflamatórias Intestinais/radioterapia , Antioxidantes , Pulmão
2.
J Biophotonics ; 17(4): e202300412, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38253349

RESUMO

This study aimed to evaluate the clinical evolution of patients with diabetic foot ulcer treated with antimicrobial photodynamic therapy (aPDT) using the Bates-Jensen (BJ) scale. A total of 21 patients were monitored, with an average age of 58 years. Patients underwent the standard treatment protocol of the institution, supplemented with aPDT utilizing 0.01% methylene blue (MB) and laser irradiation (660 nm, 100 mW, 6 J per point). Following aPDT, the lesions were protected with hydrofiber dressings containing silver. The Bates-Jensen Scale was employed at pre-treatment and post-aPDT sessions to assess lesion progression. The results demonstrated a significant difference between pre- and post-treatment values in the overall BJ score. The use of MB in aPDT proved to be an effective, safe, well-tolerated treatment with high patient adherence and the potential for implementation in the care of diabetic foot conditions.


Assuntos
Anti-Infecciosos , Diabetes Mellitus , Pé Diabético , Fotoquimioterapia , Humanos , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Pé Diabético/tratamento farmacológico , Fotoquimioterapia/métodos , Resultado do Tratamento , Azul de Metileno/farmacologia , Azul de Metileno/uso terapêutico
3.
Artigo em Inglês | MEDLINE | ID: mdl-38189964

RESUMO

PURPOSE: Radiotherapy is one of the main strategies used in the treatment of cancer patients and it can cause early or late xerostomia and/or hyposalivation. Therapeutic management of xerostomia includes oral hygiene, sialogenic agents among others. METHODS: This study reviews the use of extra-oral salivary glands photobiomodulation in treating xerostomia and/or hyposalivation after radiotherapy and performs a meta-analysis of this data. RESULTS: After a broad search of the literature, eight clinical studies were selected. DISCUSSION: In a safe way, the studies found that extra-oral stimulation of the salivary glands has benefits in the hyposalivation and changes in salivary flow resulting from lesions by radiotherapy. A meta-analysis found significant values in pain comparing the pre- and post-treatment moments (MD - 3.02, I2 95%, IC - 5.56; - 0.48) and for stimulated salivary flow at 30 days after the end of radiotherapy (MD 2.90, I2 95%, IC 1.96; 3.84). CONCLUSION: The most promising parameters comprise wavelengths between 630 and 830 nm, radiant exposure from 2 to 10 J/cm2, two-to-three times a week, before the radiotherapy damage, and homogeneously in the glands. Therefore, Light-Emitting Diode (LED) stimulation of larger areas than the punctual stimulation of small millimeters of the Low-Level Laser Therapy (LLLT) appears to be promising.

4.
Lasers Med Sci ; 38(1): 271, 2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-37989885

RESUMO

Ulcerative colitis (UC) is an important chronic and multifactorial disease, which alters the colon mucosal with a significant impact on life quality affecting both men and women. The difference between genders causes changes in the inflammatory processes, modulating the development of several diseases. The available drugs to treat UC exhibit limited outcomes and side effects; thus, new therapies are needed. Photobiomodulation (PBM) emerges as potential treatment by modulating the inflammatory process without side effects and low costs. The aim of this study was to evaluate the effects of PBM in acetic acid-induced UC comparing the responses between male and females. For this purpose, male and female Wistar rats (36) were submitted to induction of UC by rectal administration of 10% acetic acid (colitis group) and treated or not with PBM (colitis-PBM group) (LED, 660 nm, 100 mW, 150 s) in three points: right side and left of the ventral surface and in the external anal region. Non-manipulated rats were used as control (basal group). We investigated the disease activity index (DAI score), myeloperoxidase enzyme activity (MPO) and release of cytokines in the intestine homogenates, and histological analysis. PBM reduces DAI score, MPO activity, and mast cell degranulation while increased mucous production in both females and males. Moreover, PBM reduced histopathological score as well as the levels of IL-6 and IL-4 in the bowel only in males. We also showed reduced levels of IL-1beta and TNF-alpha after PBM in both males and females, while the levels of IL-10 and IFN-gamma were increased. In conclusion, despite our study has shown some differences between males and females, PBM attenuated the biomarkers of UC in both genders constituting a potential combined treatment that is non-invasive and low cost.


Assuntos
Colite Ulcerativa , Colite , Humanos , Feminino , Ratos , Masculino , Animais , Ácido Acético , Ratos Wistar , Colite/tratamento farmacológico , Colite/patologia , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/radioterapia , Colite Ulcerativa/tratamento farmacológico , Citocinas , Colo/patologia , Antioxidantes
5.
Lasers Med Sci ; 38(1): 247, 2023 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-37897531

RESUMO

Ulcerative colitis (UC) is a chronic autoimmune disease that impacts the quality of life, but current pharmacological treatments are limited. Photobiomodulation (PBM) is a light-based treatment that can be applied either locally or systemically. Here, we compare the effects of local and vascular PBM (VPBM) in an experimental rat model of UC. Male Wistar rats were induced with UC by rectal instillation of acetic acid and treated with either local abdominal PBM or VPBM to the tail vein using a 660-nm LED. The findings indicated that local PBM but not VPBM reduced intestinal histological scores. Both local and VPBM increased mucus production, decreased mast cell degranulation, and modulated TNF-α and IL-1 ß levels in the intestines. Local PBM also affected the expression of the mRNAs for IL-6, TNF-α, and IFN-γ. In conclusion, we suggest that local PBM appears to be more promising than VPBM for treating UC. However, further research is needed to fully understand the mechanisms and to optimize the parameters of PBM for UC treatment.


Assuntos
Colite Ulcerativa , Ratos , Masculino , Animais , Colite Ulcerativa/radioterapia , Colite Ulcerativa/tratamento farmacológico , Fator de Necrose Tumoral alfa/metabolismo , Qualidade de Vida , Cauda/patologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Ratos Wistar
6.
Rev Assoc Med Bras (1992) ; 69(suppl 1): e2023S115, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37556634

RESUMO

Women and men can have the same illnesses, but with different prevalence and reactions to symptoms. OBJECTIVE: This study aimed to emphasize that distinct traits between men and women require a different approach for each of them. METHODS: PubMed and Google Scholar were searched using the following terms: Disability Evaluations, Women's health, Osteoporosis, Osteoarthritis, and Lymphedema, Pregnancy. RESULTS/CONCLUSION: Disease management can go beyond the symptoms, assessing the long-term consequences and possibly the disabilities they can generate, compromising the quality of life of the person, his/her family members, and eventually caregivers.


Assuntos
Pessoas com Deficiência , Qualidade de Vida , Humanos , Gravidez , Feminino , Masculino , Saúde da Mulher , Cuidadores
7.
Lasers Med Sci ; 38(1): 93, 2023 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-36964849

RESUMO

Intravascular laser irradiation of blood (ILIB) was developed to treat cardiovascular diseases due to its rheological effects. In its original form, ILIB was applied by an intravenous optical fiber, restricting its application. However, this technique was modified to non-invasive irradiation through the radial artery, now called vascular photobiomodulation (VPBM). Many studies have used both, ILIB and VPBM, to treat lung diseases. It is well established that lung diseases affect more than 300 million people worldwide with high morbidity and mortality rates. In this short critical review, we discuss the potential benefits of photobiomodulation to treat lung diseases using these two approaches. The search was performed in the electronic database of MEDLINE (Medical Literature Analysis and Retrieval System Online) via PubMed. The data search was carried out from 1991 to 2017. We selected a total of 10 clinical studies using either ILIB or VPBM, in addition to 2 experimental studies in animals. The respiratory diseases treated in these studies included bronchitis, asthma, pneumonia, and tuberculosis. The results showed overall beneficial effects on lung diseases, characterized by a reduction in the inflammatory cascade and antioxidant effects, improvement of hemodynamic parameters, the efficiency of gas exchange, and reduction of hospitalization periods. In conclusion, all studies showed promising effects of ILIB in both animal and human studies. The studies did not discuss any disadvantages or contraindications. However, further studies are needed in order to understand the dosimetry, and the literature is lacking in randomized, controlled clinical trials. Thus, this review highlights the need for additional studies using this approach.


Assuntos
Asma , Doenças Cardiovasculares , Terapia com Luz de Baixa Intensidade , Humanos , Terapia com Luz de Baixa Intensidade/métodos , Hemodinâmica , Lasers
8.
J Biophotonics ; 16(4): e202200306, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36560919

RESUMO

COVID-19 appeared in December 2019, needing efforts of science. Besides, a range of light therapies (photodynamic therapy, ultraviolet [UV], laser) has shown scientific alternatives to conventional decontamination therapies. Investigating the efficacy of light-based therapies for environment decontamination against SARS-CoV2, a PRISMA systematic review of Phototherapies against SARS-CoV or MERS-CoV species discussing changes in viral RT-PCR was done. After searching MEDLINE/PubMed, EMBASE, and Literatura Latino-Americana e do Caribe em Ciências da Saúde we have found studies about cell cultures irradiation (18), blood components irradiation (10), N95 masks decontamination (03), inanimate surface decontamination (03), aerosols decontamination (03), hospital rooms irradiation (01) with PDT, LED, and UV therapy. The best quality results showed an effective low time and dose UV irradiation for environments and inanimate surfaces without human persons as long as the devices have safety elements dependent on the surfaces, viral charge, humidity, radiant exposure. To interpersonal contamination in humans, PDT or LED therapy seems very promising and are encouraged.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/terapia , Descontaminação/métodos , RNA Viral , Fototerapia , Raios Ultravioleta
9.
Am J Kidney Dis ; 81(5): 528-536.e1, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36396084

RESUMO

RATIONALE & OBJECTIVE: Infections are an important cause of mortality among patients receiving maintenance hemodialysis. Staphylococcus aureus is a frequent etiological agent, and previous nasal colonization is a risk factor for infection. Repeated antimicrobial decolonization reduces infection in this population but can induce antibiotic resistance. We compared photodynamic therapy, a promising bactericidal treatment that does not induce resistance, to mupirocin treatment among nasal carriers of S aureus. STUDY DESIGN: Randomized controlled pilot study. SETTING & PARTICIPANTS: 34 patients receiving maintenance hemodialysis who had nasal carriage of S aureus. INTERVENTIONS: Patients were randomly assigned to decolonization with a single application of photodynamic therapy (wavelength of 660nm, 400mW/cm2, 300 seconds, methylene blue 0.01%) or with a topical mupirocin regimen (twice a day for 5 days). OUTCOME: Nasal swabs were collected at time 0 (when the carrier state was identified), directly after treatment completion, 1 month after treatment, and 3 months after treatment. Bacterial isolates were subjected to proteomic analysis to identify the species present, and antimicrobial susceptibility was characterized. RESULTS: All 17 participants randomized to photodynamic therapy and 13 of 17 (77%) randomized to mupirocin were adherent to treatment. Directly after treatment was completed, 12 participants receiving photodynamic therapy (71%) and 13 participants treated with mupirocin (77%) had cultures that were negative for S aureus (risk ratio, 0.92 [95% CI, 0.61-1.38]; P=0.9). Of the patients who had negative cultures directly after completion of photodynamic therapy, 67% were recolonized within 3 months. There were no adverse events in the photodynamic therapy group. LIMITATIONS: Testing was restricted to assessing nasal colonization; infectious complications were not assessed. CONCLUSIONS: Photodynamic therapy is a feasible approach to treating nasal carriage of S aureus. Future larger studies should be conducted to determine whether photodynamic therapy is equivalent to the standard of care with mupirocin. FUNDING: Government grant (National Council for Scientific and Technological Development process 3146682020-9). TRIAL REGISTRATION: Registered at ClinicalTrials.gov with study number NCT04047914.


Assuntos
Fotoquimioterapia , Infecções Estafilocócicas , Humanos , Mupirocina/uso terapêutico , Projetos Piloto , Proteômica , Antibacterianos/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Diálise Renal/efeitos adversos
10.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 69(supl.1): e2023S115, 2023.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1449119

RESUMO

SUMMARY Women and men can have the same illnesses, but with different prevalence and reactions to symptoms. OBJECTIVE: This study aimed to emphasize that distinct traits between men and women require a different approach for each of them. METHODS: PubMed and Google Scholar were searched using the following terms: Disability Evaluations, Women's health, Osteoporosis, Osteoarthritis, and Lymphedema, Pregnancy. RESULTS/CONCLUSION: Disease management can go beyond the symptoms, assessing the long-term consequences and possibly the disabilities they can generate, compromising the quality of life of the person, his/her family members, and eventually caregivers.

11.
Curr Phys Med Rehabil Rep ; 10(4): 339-344, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36466557

RESUMO

Purpose of Review: Our aim is to provide a historical review of the implementation of a cancer rehabilitation center in Brazil, active since 2008. We expect this data to support the implementation of other centers both in Brazil and worldwide. Recent Findings: Cancer rehabilitation delivery is fragmented and punctuated in most cases, and cancer rehabilitation centers are rare. Data on how to establish rehabilitation centers could facilitate the implementation of new centers. We provide data on what was our strategy for hiring, establishing treatment protocols, barriers, and facilitators. We also provide figures on the number of each rehabilitation specialist, as well as the general standard operating procedures of our rehabilitation center, among other features. Summary: Establishing cancer rehabilitation centers in a middle-income country is feasible. We expect that our experience may facilitate the establishment of new cancer rehabilitation services and the improvement of current ones.

12.
J Photochem Photobiol B ; 235: 112552, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36088836

RESUMO

The aim of the present study was to investigate the effects of PDT using the photosensitizer 5-aminoulevulinic acid (5-ALA) in oral squamous cell carcinoma (OSCC) behavior, mainly regarding its role on the cancer stem cell (CSC) phenotypes and in maintenance of the stem cell properties. Two OSCC cell lines were used and divided in the groups: Control, 5-ALA, LED 6 J/cm2 and PDT. MTT and Neutral red assays were used to access cellular viability, cell migration was evaluated by the wound healing assay. The stem cell phenotype was analyzed by flow cytometry to evaluate the CD44high/ESAhigh, CD44high/ESAlow and CD44low populations, by the clonogenic and tumor sphere formation assays as well as by RT-qPCR. The presence of Protoporphyrin IX in each CSC fraction was evaluated by flow cytometry. The OSCC cell lines showed a significant decrease in cell viability and migration after PDT. The percentage of CD44high/ESAhigh cells decreased after PDT, which was associated with an increase in the CD44low cells and with a functional decrease in the colony and sphere formation capacity. CD44high/ESAhigh cells showed increased PpIX, which contributed for their greater sensitivity to PDT. INV gene increased significantly after PDT, indicating cellular differentiation. Altogether, our results demonstrate that 5-ALA mediated PDT decreases not only the fraction of oral CSC but also their functional capabilities, inducing their differentiation.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Fotoquimioterapia , Ácido Aminolevulínico/farmacologia , Ácido Aminolevulínico/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Linhagem Celular Tumoral , Humanos , Neoplasias Bucais/tratamento farmacológico , Células-Tronco Neoplásicas/metabolismo , Vermelho Neutro/uso terapêutico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Protoporfirinas/metabolismo
14.
Med Acupunct ; 34(1): 58-65, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-35251438

RESUMO

Objective: Breast cancer is the most prevalent malignant neoplasm in women. Optimal treatment frequently includes a hormonal-blockage phase maintained for 5-10 years. Pharmacologic agents used for this blockage induce many climacteric-like symptoms, which often exact a heavy toll on patients' quality of life. Acupuncture has had promising results for treating climacteric-like symptoms induced by hormonal blockage, but there is no evidence of efficacy for controlling hot flashes. Materials and Methods: This trial used acupuncture to treat the climacteric-like symptoms of patients with breast cancer, focusing on the mental, physical, and genitourinary symptoms and sleep disturbances, to determine the influence of acupuncture treatment. The randomized placebo-controlled trial, at a university-based cancer center, with blinded data collectors, compared an Acupuncture group (A), a Sham-Acupuncture group (S), and a Wait-List Control group (C). The patients were receiving tamoxifen. Group A had 10 weekly sessions of manual Acupuncture; Group S had 10 weekly sessions of Sham Acupuncture; and Group C spent 10 weeks on a Wait-List. The main outcome measures were the Beck Depression Inventory-II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Menopause Rating Scale (MRS). Results: Primary analysis revealed differences among the groups' improvements in scores for the 3 questionnaires (P < 0.001), The A group had significant improvements on the BDI-II (P < 0.001), PSQI (P < 0.002), and MRS (P < 0.004) compared to the S group in a post hoc analysis. Conclusions: Acupuncture improved sleep, and mental and emotional distress symptoms induced by hormonal blockage in patients with breast cancer. Clinical Trial: This trial was registered at CAAE as trial #: 37758414.8.0000.0065.

15.
Antibiotics (Basel) ; 11(1)2022 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-35052948

RESUMO

BACKGROUND: To investigate the efficacy and safety of interventions for early stage pericoronitis. METHODS: We searched for randomized controlled trials (RCTs) in databases from inception to July 2020, without language restriction. RCTs assessing adolescents and adults were included. RESULTS: Seven RCT with clinical diversity were included, so, it was not possible to conduct meta-analyses. Individual study data showed an improvement in oral health quality of life in favor of topical benzydamine versus diclofenac capsule (Mean difference (MD) -1.10, 95% Confidence interval (CI) -1.85 to -0.35), and no difference between topical benzydamine and flurbiprofen capsule (MD -0.55 95% CI -1.18 to 0.0). There was no difference between diclofenac and flurbiprofen capsules (MD 0.55, 95% CI -0.29 to 1.39). An imprecise estimate of effects was found for all outcomes, considering (i) oral versus topic pharmacological treatment, (ii) different oral pharmacological treatments, (iii) pharmacological treatment associated with laser versus placebo laser, (iv) pharmacological treatment associated with different mouthwashes, and (v) conventional treatment associated to antimicrobial photodynamic therapy versus conventional treatment, with low to very low certainty of evidence. CONCLUSIONS: Until future well-designed studies can be conducted, the clinical decision for early stage pericoronitis should be guided by individual characteristics, settings and financial aspects.

16.
Lasers Med Sci ; 37(3): 1441-1470, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34855034

RESUMO

This narrative review aimed to evaluate the effectiveness of PDT in early or advanced squamous cell carcinoma of the head and neck (SCCHN). Scopus, MEDLINE/PubMed, and Embase were searched electronically following the PRISMA protocol. Quality assessment was performed according to JBI, NIH, and AMSTAR protocols. The main outcomes evaluated were treatment response, recurrence, survival, and adverse effects. A total of 49 articles met the search criteria: 43 case series, two cohort studies, two prospective before-after clinical trials, one systematic review, and one meta-analysis. Data from 2121 SCCHN patients were included. The response to PDT was variable according to the type of photosensitizer, tumor location, and tumor stage. In general, higher complete responses rated were observed in T1/T2 SCCHN, mainly with mTHPC-mediated PDT. With regard to T3/T4 or advanced SCCHN tumors, there is no compelling evidence suggesting the effectiveness of PDT. Any adverse effects reported were well tolerated by patients. The present review suggests that PDT is a promising treatment modality for early-stage SCCHN. Although there are limitations due to the low level of evidence of the included studies, we believe that the present review could help to design robust clinical trials to determine the efficacy of PDT in SCCHN.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Fotoquimioterapia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/etiologia
17.
BMJ Support Palliat Care ; 12(1): 64-72, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31256014

RESUMO

Chemotherapy-induced peripheral neuropathy (CIPN) can cause loss of independence and poor quality of life (QoL) due to severe disabilities, but in spite of its importance there is still a lack of data for the management of CIPN. Acupuncture has showed promising results and may be a cost-effective option for the treatment. OBJECTIVES: To evaluate the effect of acupuncture treatment on neurological symptoms of CIPN and QoL of oncological patients. METHODS: We performed a clinical, single-centre, randomised and controlled pilot study that involved 33 adult patients with cancer and CIPN randomised into two groups (control and acupuncture treated with 10 sessions, two times per week). Both groups were subjected to a complete physical examination and clinical assessment with National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Scale V.2.0, FIM Scale, European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) Scale and Visual Analogue Scale for pain before and 5 weeks after treatment. RESULTS: There were no adverse events, and we found statistical differences in groups in physical (p=0.03) and function (p=0.04) domains of EORTC QLQ-C30 when comparing control and acupuncture groups. About NCI CTCAE Scale and neuropathy sensory symptoms, we found better results in acupuncture group, comparing pretreatment and post-treatment analyses (p=0.01). In control group, we have no differences after 5 weeks (p=0.11). CONCLUSION: Although these results suggest an interesting effect of acupuncture on this patient population, the clinical significance has remained unclear. Given the tendency towards benefit and the lack of adverse effects, the authors recommend a follow-up acupuncture trial using higher follow-up time and better sample size. TRIAL REGISTRATION NUMBER: NCT02309164.


Assuntos
Terapia por Acupuntura , Antineoplásicos , Doenças do Sistema Nervoso Periférico , Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/métodos , Adulto , Antineoplásicos/efeitos adversos , Humanos , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/terapia , Projetos Piloto , Qualidade de Vida
18.
Acta fisiátrica ; 28(3): 173-183, set. 2021.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1348858

RESUMO

Laser therapies are noninvasive techniques with painless, safe, and low-cost therapeutic procedures for chronic pain. No systematic review has evaluated the effects of laser in the treatment of multi-site chronic pain. Objective: To evaluate the effects of laser in the treatment of generalized multi-site chronic pain. Methods: This pioneering study presents a PRISMA systematic review protocol designed to up-to-date the current literature on Laser Therapy in patients with chronic multi-site pain from all founded etiologies. This protocol was registered on the PROSPERO website before data extraction (registration no. CRD42019152345). Results: About 1391 articles met the inclusion criteria and 15 studies were selected for the data extraction. We found 12 studies in patients with fibromyalgia, 01 study about myofascial pain syndrome, 01 study about rheumatoid arthritis and 01 study about diabetic sensorimotor polyneuropathy. Homogeneity was not found in the Laser protocols, clinical conditions studied, the evaluation methods, or in the controlled groups but together studies suggested that Laser could have benefits in the treatment of pain severity, quality of life, fatigue, stiffness, depression, and anxiety compared to placebo and other therapies for fibromyalgia and for pain at Rheumatoid Arthritis and Diabetic Polyneuropathy. Conclusion: Laser therapy plus the standardized exercise or amitriptilyne provided no extra advantage in the relief of symptoms at fibromyalgia. For TMD myofascial pain no benefits were founded. Studies showed numerous different points and locations of light application but none of the selected studies used spinal stimulation as the Laser application site.


As terapias a laser são técnicas não invasivas, indolores, seguras e de baixo custo e de utilidade no tratamento da dor crônica. Nenhuma revisão sistemática avaliou os efeitos do laser no tratamento da dor crônica em múltiplos locais simultâneos. Objetivo: Avaliar os efeitos do laser no tratamento da dor crônica multifocal generalizada. Métodos: Revisão sistemática PRISMA sobre o uso do laser em pacientes com dor crônica multifocal de diversas etiologias. Este protocolo foi registrado no site PROSPERO antes da extração dos dados (registro nº. CRD42019152345). Resultados: 1.391 artigos atenderam aos critérios de inclusão e 15 estudos foram selecionados para a extração de dados, sendo 12 estudos em pacientes com fibromialgia, 01 estudo sobre síndrome dolorosa miofascial, 01 estudo sobre artrite reumatoide e 01 estudo sobre polineuropatia sensório-motora diabética. Não foi encontrada homogeneidade nos protocolos do laser, nos métodos de avaliação ou nos grupos controlados, mas em conjunto os estudos sugeriram que o laser poderia ter benefícios no tratamento da intensidade da dor, qualidade de vida, fadiga, rigidez, depressão e ansiedade em comparação com placebo e outras terapias para fibromialgia e para dor na artrite reumatóide e polineuropatia diabética. A terapia a laser mais o exercício padronizado ou amitriptilina não proporcionou nenhuma vantagem extra no alívio dos sintomas da fibromialgia. Para dor miofascial DTM, nenhum benefício foi encontrado. Conclusão: Os estudos mostraram vários pontos e locais diferentes de aplicação de luz, mas nenhum dos estudos selecionados usou a estimulação espinhal como local de aplicação do laser.

19.
Acta fisiátrica ; 26(3): 139-143, set. 2019.
Artigo em Português | LILACS | ID: biblio-1122756

RESUMO

Neuropatia periférica induzida por quimioterapia (NIPQ) é uma condição incapacitante resultante de tratamento quimioterápico para câncer. Dentre os fatores de risco destaca-se a presença de neuropatia prévia e baixo clearance de creatinina. Objetivo: Avaliar a ocorrência de NPIQ entre os pacientes portadores de câncer de mama submetidos ao uso do Paclitaxel (taxol) adjuvante e sua relação com obesidade. Métodos: Estudo observacional, retrospectivo, que avaliou os prontuários médicos de portadores de câncer de mama em tratamento adjuvante com uso do Paclitaxel no primeiro semestre de 2019, coletando dados referentes a CIPN, peso, altura e índice de massa corpórea (IMC). Resultados: Dentre os 70 pacientes avaliados, 44,3% apresentaram IMC entre 25,0 e 29,9 kg/m2, 15,7% entre 30,0 e 34,9 Kg/m2,, 8,6% entre 35,0 e 39,9 kg/m2, e 1,4% maior do que 40,0 kg/m2. A presença de neuropatia periférica foi documentada em 57,14 % dos pacientes. A média do IMC encontrado nos pacientes sem neuropatia foi de 25,05 e nos pacientes com neuropatia foi de 29,10 (p = 0,0005). A correlação de Spearman entre a presença de neuropatia e valores do IMC mostrou correlação positiva com r=0,40 e p=0,0006. O Risco Relativo RR para o surgimento de neuropatia em relação aos valores de IMC foi de 1.833 para o IMC acima de 25 (IC 95%). Conclusões: Há correlação positiva entre valores de IMC e o surgimento da NPIQ nesta amostra de pacientes, o que sugere que a obesidade pode ser um fator de risco para o surgimento da NPIQ.


Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling condition resulting from chemotherapy for cancer. Among the risk factors, the presence of previous neuropathy and low creatinine clearance stands out. Objective: To assess the occurrence of CIPN among breast cancer patients submitted to the use of adjuvant Paclitaxel (TAXOL) and its relationship with obesity. Methods: An observational, retrospective study that evaluated the medical records of breast cancer patients undergoing adjuvant treatment with the use of Paclitaxel in the first half of 2019, collecting data related to CIPN, weight, height and BMI. Results: Among the 70 patients evaluated, 44.3% had a BMI between 25.0 and 29.9 kg / m2, 15.7% between 30.0 and 34.9 kg / m2, 8.6% between 35, 0 and 39.9 Kg / m2, and 1.4% greater than 40.0 Kg / m2. The presence of peripheral neuropathy was documented in 57.14% of the patients. The mean BMI found in patients without neuropathy was 25.05 and in patients with neuropathy it was 29.10 (p = 0.0005). Spearman's correlation between the presence of neuropathy and BMI values ​​showed a positive correlation with r = 0.40 and p = 0.0006. The Relative Risk RR for the occurrence of neuropathy in relation to BMI values ​​was 1,833 for BMI above 25 (95% CI). Conclusion: There is a positive correlation between BMI values ​​and the ocurrence of CIPN in this sample of patients, which suggests that obesity may be a risk factor for the emergence of CIPN.


Assuntos
Reabilitação , Fatores de Risco , Doenças do Sistema Nervoso Periférico , Tratamento Farmacológico , Obesidade
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