Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 587
Filtrar
1.
Ann Biomed Eng ; 52(6): 1732-1743, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38530533

RESUMO

Raynaud's phenomenon (RP) is a condition that causes decreased blood flow to areas perfused by small blood vessels (e.g., fingers, toes). In severe cases, ulceration, gangrene, and loss of fingers may occur. Most treatments focus on inducing vasorelaxation in affected areas by the way of pharmaceuticals. Recently, animal studies have shown that vasorelaxation can be induced by non-coherent blue light (wavelength ~ 430-460 nm) through the actions of melanopsin, a photoreceptive opsin protein encoded by the OPN4 gene. To study this effect in humans, a reliable phototherapy device (PTD) is needed. We outline the construction of a PTD to be used in studying blue light effects on Raynaud's patients. Our design addresses user safety, calibration, electromagnetic compatibility/interference (EMC/EMI), and techniques for measuring physiological responses (temperature sensors, laser Doppler flow sensors, infrared thermal imaging of the hands). We tested our device to ensure (1) safe operating conditions, (2) predictable, user-controlled irradiance output levels, (3) an ability for measuring physiological responses, and (4) features necessary to enable a double-blinded crossover study for a clinical trial. We also include in the Methods an approved research protocol utilizing our device that may serve as a starting point for clinical study. We introduced a reliable PTD for studying the effects of blue light therapy for patients suffering from Raynaud's phenomenon and showed that our device is safe and reliable and includes the required measurement vectors for tracking treatment effects throughout the duration of a clinical study.


Assuntos
Fototerapia , Doença de Raynaud , Doença de Raynaud/terapia , Doença de Raynaud/fisiopatologia , Humanos , Fototerapia/instrumentação , Feminino , Masculino , Luz , Adulto , Luz Azul
2.
Lasers Surg Med ; 54(6): 841-850, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35419820

RESUMO

OBJECTIVES: Photothermal therapy (PTT) is a minimally invasive or noninvasive method by destructing cancer cells through selective thermal decomposition. However, a long period of laser irradiation to achieve coagulative necrosis often causes unfavorable thermal damage to the surrounding healthy tissue. The current study aims to evaluate the feasibility of temporal power modulation to improve the treatment efficacy of gold nanorods-assisted PTT against tumor tissue. MATERIALS AND METHODS: A total of 25 µg/ml of PEGylated gold nanorods (PEG-GNR) was used as an absorbing agent during 1064 nm laser irradiation for PTT. Temperature monitoring was conducted on the aqueous solution of PEG-GNR for dosimetry comparison. For in vivo tests, CT-26 tumor-bearing murine models with PEG-GNR injected were treated with three irradiation conditions: 3 W/cm2 for 90 s, 1.5 W/cm2 for 180 s, and 3 W/cm2 for 60 s followed by 1.5 W/cm2 for 60 s (modulated). Ten days after the treatments, histology analysis was performed to assess the extent of coagulation necrosis in the treated tissues. RESULTS: The temporal power modulation maintained the tissue temperature of around 50°C for a longer period during the irradiation. Histology analysis confirmed that the modulated group entailed a larger coagulative necrosis area with less thermal damage to the peripheral tissue, compared to the other irradiation conditions. CONCLUSION: Therefore, the power-modulated PTT could improve treatment efficacy with reduced injury by maintaining the constant tissue temperature. Further studies will examine the feasibility of the proposed technique in large animal models in terms of acute and chronic tissue responses and treatment margin for clinical translations.


Assuntos
Ouro , Nanotubos , Neoplasias/terapia , Fototerapia/métodos , Animais , Linhagem Celular Tumoral , Estudos de Viabilidade , Ouro/uso terapêutico , Lasers , Camundongos , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Necrose , Fototerapia/instrumentação
3.
Arq. ciências saúde UNIPAR ; 26(1): 65-73, Jan-Abr. 2022.
Artigo em Português | LILACS | ID: biblio-1362676

RESUMO

O objetivo do presente trabalho foi relatar a eficácia da fotobiomodulação laser na abordagem de úlceras venosas de membros inferiores e como se dá o papel da enfermagem nesse contexto. Tratou-se de uma revisão sistemática que utilizou as bases de dados eletrônicas PubMed, BVS, SCIELO e Lilacs, além da busca no repositório de teses e dissertações pelo cruzamento dos descritores livres e provenientes do DeCS através dos operadores booleanos AND e OR: "laserterapia", "fotobiomodulação laser" e "úlceras venosas". Os critérios de inclusão estabelecidos foram estudos prospectivos, teses e dissertações escritas nos idiomas inglês, português e espanhol, e publicações entre o período de 2010-2020. A revisão foi conduzida conforme metodologia PRISMA, utilizou-se os critérios de Jadad para avaliação da qualidade dos manuscritos. Dos 104 artigos encontrados, apenas 8 contemplavam os critérios de inclusão, tendo uma população total de 942 pacientes. Notou-se que a maioria dos estudos mostrou a eficácia do uso da laserterapia, principalmente quando associado ao uso da terapêutica comum, como a terapia compressiva, agentes tópicos e farmacoterapia. A fotobiomodulação laser demonstrou ser eficaz, porém ainda são necessários mais estudos com o objetivo de uniformizar os parâmetros de aplicação dessa modalidade terapêutica.


The objective of this work was to investigate the effectiveness of laser photo-biomodulation in lower limb venous ulcers and the role of nursing in this context. This is a systematic review, using the PubMed, BVS, SCIELO and Lilacs electronic databases in addition to searching the repository of thesis and dissertations by crossing the free descriptors coming from the DeCS through the Boolean operators AND and OR: "laser therapy", "laser photo-biomodulation" and "venous ulcers". The inclusion criteria were prospective studies, theses and dissertations written in English, Portuguese, or Spanish, and publications in the 2010-2020 period. From the 104 articles found, only 8 met the inclusion criteria, with a total population of 942 patients. It could be observed that most studies showed the effectiveness of using laser therapy, especially when associated with the use of common therapy, such as the compressive therapy, topical agents, and pharmacotherapy. The laser photo-biomodulation was also shown as being effective, but further studies are needed to standardize the application parameters for this therapeutic modality.


Assuntos
Úlcera Varicosa/terapia , Lasers , Fototerapia/instrumentação , Cicatrização , Ferimentos e Lesões/terapia , Enfermagem
4.
Opt Express ; 29(23): 38606-38614, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34808910

RESUMO

Alzheimer disease and related dementias affect 15-20% of elderly people, and 60-70% of these suffer from sleep disturbances. Studies suggest that lighting can improve sleep. The key challenge is how to deliver light effectively. We have designed a lighting system that adjusts spectrum and irradiance on a 24-hour timetable to provide spatially uniform, shadow-free white light with CRI>85 and up to 1000 Lux for day vision and amber light for night vision. To aid sleep, melanopic illuminance varies over 3 orders of magnitude to enable strong suppression of melatonin in the morning/early afternoon, moderate suppression in the evening, and no suppression at night.


Assuntos
Doença de Alzheimer/complicações , Luz , Iluminação/métodos , Fototerapia/métodos , Transtornos do Sono-Vigília/terapia , Visão Ocular/fisiologia , Idoso , Relógios Circadianos/fisiologia , Humanos , Iluminação/instrumentação , Melatonina/metabolismo , Fototerapia/instrumentação , Transtornos do Sono-Vigília/etiologia , Fatores de Tempo
5.
Biomed Res Int ; 2021: 9992095, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34423044

RESUMO

In this study, we designed a low-power visible ray (V) drive module based on a light-emitting diode (LED) to initiate fat reduction using light source irradiation. A chemical phantom of muscle and fat was fabricated, and the performance of the proposed LED drive module was tested using this chemical phantom. The LED light source could reduce fat by irradiating the skin 4-5 cm deep. The device exhibits a negative feedback and parallel amplification to maintain a stable circuit based on low-power consumption. Muscles have a high-water content and low impedance, whereas fats have a low water content and significant salt content. Therefore, fat exhibits high impedance. Chemical phantoms were fabricated according to these impedance values, and the fat reduction effect using the LED circuits was analyzed. When the fat phantom was irradiated by the light source, the fat impedance lowered, and we confirmed that fat reduction could be obtained. This study is expected to be applicable to family medicine and weight management health care.


Assuntos
Tecido Adiposo/efeitos da radiação , Dieta Hiperlipídica/efeitos adversos , Obesidade/terapia , Fototerapia/instrumentação , Animais , Modelos Animais de Doenças , Impedância Elétrica , Desenho de Equipamento , Humanos , Luz , Camundongos , Obesidade/induzido quimicamente , Imagens de Fantasmas , Pele/efeitos da radiação
6.
Photobiomodul Photomed Laser Surg ; 39(7): 437-438, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34264764

RESUMO

The numerous dermatology clinics have decreased or stopped phototherapy sessions due to the increased risk of getting COVID-19 during the current pandemic. In this context, poorly ventilated phototherapy units (PUs) should be redesigned in order to continue UV-based therapies and to protect our patients from getting COVID-19. Recently, it has been reported that ultraviolet C (UVC)-related dose and virus concentration may play a decisive role in the virucidal activity. Considering air changes per hour and viral inactivation time, 30 min of 30-W UVC radiation is able to inactivate poorly ventilated PUs of 3-4 m length, 5.5-7 m width, and 2.7-3 m height. Upper-air UVC radiation for 30 min between sessions would allow us to have more treatment options for numerous dermatological diseases in novel PUs during the COVID-19 pandemic and possible future pandemics.


Assuntos
COVID-19/prevenção & controle , Controle de Infecções/métodos , Fototerapia/instrumentação , SARS-CoV-2/efeitos da radiação , Inativação de Vírus/efeitos da radiação , Desenho de Equipamento , Humanos , Pandemias , Raios Ultravioleta , Ventilação
7.
Biomed Mater ; 16(2): 022007, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33470976

RESUMO

Being a carbon-based hybrid, graphene-semiconductor composites have attracted considerable attention in recent decades owing to their potential features such as high photosensitivity, extended light absorption, and effective separation of charge carriers, thus have been regarded as a promising platform for environmental and biomedical applications, respectively. In this mini-review, we first summarized the recent advancements in the development of graphene-based semiconductor nanocomposites via sol-gel, solution mixing, in situ growth, hydrothermal, and solvothermal approaches, and then comprehensively reviewed their potential light activated cancer phototherapeutic applications. Finally, we rationally analyze the current challenges and new perspectives for the future development of more effective phototherapeutic nanoagents. We hope to offer enriched information to harvest the utmost fascinating properties of graphene as a platform to construct efficient graphene/semiconductor hybrids for cancer phototherapy.


Assuntos
Carbono/química , Grafite/química , Nanocompostos/química , Nanomedicina/instrumentação , Nanomedicina/métodos , Neoplasias/terapia , Fototerapia/instrumentação , Fototerapia/métodos , Semicondutores , Animais , Humanos , Teste de Materiais , Camundongos
8.
Arch Dermatol Res ; 313(6): 461-471, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32785837

RESUMO

The objective of this meta-analysis was performed to compare the effects of tacrolimus plus phototherapy in the treatment of patients with vitiligo. Relevant studies were identified by searching PubMed, Embase, and Web of Science databases. The main outcomes of interest included excellent response (≥ 75% repigmentation), good response (50-75% repigmentation), moderate response (25%-50% repigmentation), and poor response (< 25% repigmentation). Risk ratio (RR) with 95% confidence intervals (95% CIs) was used to calculate the data. Eleven studies were included in this study. Compared with phototherapy alone, combination treatment of tacrolimus and phototherapy significantly improved excellent response rate (RR = 1.40, 95% CI 1.16, 1.69; P < 0.001) and reduced the poor response rate (RR = 0.37, 95% CI 0.22, 0.61; P = 0.001). However, the good response rate (RR = 1.00, 95% CI 0.59, 1.69, P = 1.000) and moderate response rate (RR = 0.91, 95% CI 0.60, 1.38; P = 0.653) were not significantly different between the two treatments. Subgroup analysis suggested that combination treatment had a higher excellent response rate than phototherapy alone for lesions located in the face and proximal limbs. Both NB-UVB and EL, when added to tacrolimus, resulted in a significantly higher excellent response rate than they were used alone. Meta-regression analysis showed that age was a predictive factor that influenced the effect of combination treatment on an excellent response, in which children had a high excellent response to the treatment. Other demographic and clinical variables, including gender, disease duration, family history, and type of vitiligo, did not have any impact on the treatment effect. Combination treatment with tacrolimus and phototherapy was more effective than phototherapy monotherapy for patients with vitiligo, especially in the lesions located in the face and proximal limbs. More large-scale, well-performed trials are needed to verify our findings.


Assuntos
Imunossupressores/administração & dosagem , Lasers de Excimer/uso terapêutico , Fototerapia/métodos , Tacrolimo/administração & dosagem , Vitiligo/terapia , Administração Cutânea , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Humanos , Fototerapia/instrumentação , Índice de Gravidade de Doença , Resultado do Tratamento , Vitiligo/diagnóstico , Vitiligo/imunologia
10.
IUBMB Life ; 73(3): 554-567, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33166061

RESUMO

Near-infrared light (IRL) has been evaluated as a therapeutic for a variety of pathological conditions, including ischemia/reperfusion injury of the brain, which can be caused by an ischemic stroke or cardiac arrest. Strategies have focused on modulating the activity of mitochondrial electron transport chain (ETC) enzyme cytochrome c oxidase (COX), which has copper centers that broadly absorb IRL between 700 and 1,000 nm. We have recently identified specific COX-inhibitory IRL wavelengths that are profoundly neuroprotective in rodent models of brain ischemia/reperfusion through the following mechanism: COX inhibition by IRL limits mitochondrial membrane potential hyperpolarization during reperfusion, which otherwise causes reactive oxygen species (ROS) production and cell death. Prior to clinical application of IRL on humans, IRL penetration must be tested, which may be wavelength dependent. In the present study, four fresh (unfixed) cadavers and isolated cadaver tissues were used to examine the transmission of infrared light through human biological tissues. We conclude that the transmission of 750 and 940 nm IRL through 4 cm of cadaver head supports the viability of IRL to treat human brain ischemia/reperfusion injury and is similar for skin with different skin pigmentation. We discuss experimental difficulties of working with fresh cadavers and strategies to overcome them as a guide for future studies.


Assuntos
Encéfalo , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Fototerapia/instrumentação , Fototerapia/métodos , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Cadáver , Complexo IV da Cadeia de Transporte de Elétrons/antagonistas & inibidores , Desenho de Equipamento , Feminino , Humanos , Raios Infravermelhos , Pessoa de Meia-Idade , Fibras Ópticas , Traumatismo por Reperfusão/terapia , Pele/química
11.
J Drugs Dermatol ; 19(11): 1076-1079, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33196757

RESUMO

BACKGROUND: Device-based therapeutic approaches have been developed to treat women’s genitourinary post-menopausal symptoms. Fractional carbon dioxide laser resurfacing (FxCO2) has been demonstrated to be safe and effective in the treatment of GSM symptoms, however the results begin to wane by 12-months post-treatment. OBJECTIVE: This study aims at assessing the application of an at-home transvaginal red and infrared light device as a maintenance treatment commencing 12 months following FxCO2 laser treatment for genitourinary syndrome of menopause (GSM). STUDY DESIGN: Subjects completing 12-month follow-up after three fractional CO2 laser vulvovaginal treatments received an at-home device and monitored for GSM symptoms with long-term follow-up to 12 months (2 years post-laser). METHODS: 10 post-menopausal subjects completing 12-months follow-up after three FxCO2 vulvovaginal treatments for GSM were treated with an at-home red and infrared LED device. Treatment consisted of intravaginal application three times per week, and subjects were followed to 1, 3, 6, and 12 months. Subjects completed the vaginal assessment scale subject satisfaction, and QUID to assess for vulvovaginal and stress urinary incontinence (SUI) symptoms. RESULTS: Vulvovaginal symptoms measured by VAS were mean 89% improved at 12-month follow-up after FxCO2 and maintained at 73% improved over baseline (2 years post-laser) following an additional 12 months of at-home transvaginal light therapy (P<0.05). VAS symptoms gradually increased over the 12 months maintenance period by a mean of 17% (P<0.05). Mean subject satisfaction was 0 at baseline, 1.86 at 1 year following FxCO2, and 1.00 after an additional 1 year of at-home light therapy. SUI symptoms as measured by QUID were mean 81% improved at 12-month follow-up after FxCO2and maintained at 38% improved over baseline (2 years post-laser) following an additional 12-months of at-home light therapy (P<0.05). SUI symptoms gradually increased by a mean of 43% over the 12-month maintenance period (P<0.05). CONCLUSIONS: At-home transvaginal red and near infrared light therapy commencing at 12 months post-FxCO2 vulvovaginal treatment in a post-menopausal population maintained statistically significant improvements in vulvovaginal and SUI symptoms over the additional12-month period (2 years post-laser); however, a gradual return of symptoms suggests that laser re-treatment or combination withhormone therapy may be necessary to maintain optimal outcomes.J Drugs Dermatol. 2020;19(11):1076-1079. doi:10.36849/JDD.2020.1012.


Assuntos
Doenças Urogenitais Femininas/terapia , Lasers de Gás/uso terapêutico , Fototerapia/instrumentação , Pós-Menopausa/fisiologia , Autocuidado/instrumentação , Adulto , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Feminino , Doenças Urogenitais Femininas/fisiopatologia , Seguimentos , Humanos , Raios Infravermelhos/uso terapêutico , Pessoa de Meia-Idade , Fototerapia/métodos , Autocuidado/métodos , Síndrome , Resultado do Tratamento , Bexiga Urinária/fisiopatologia , Bexiga Urinária/efeitos da radiação , Vagina/fisiopatologia , Vagina/efeitos da radiação , Vulva/fisiopatologia , Vulva/efeitos da radiação
12.
J Drugs Dermatol ; 19(9): 844-850, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026752

RESUMO

BACKGROUND: An intense pulsed light (IPL) narrowband "KTP/PDL-like" filter (525–585 nm) may combine the tolerability of the IPL with the precision of KTP and PDL lasers. This study evaluated the impact of IPL with a KTP/PDL-like filter on telangiectasias. METHODS: This was a single-center, prospective study of 17 subjects with facial telangiectasias and skin types I–III. Three monthly treatments were performed using this specific filter, with follow-up visits at 1, 3, and 6 months. Telangiectasia improvement was assessed by the investigator and subjects using a 5-point scale. Facial photographs and safety assessments were obtained at each visit. Subject discomfort was evaluated using a visual analog scale (VAS) immediately posttreatment, and subject downtime was recorded at each subsequent visit. RESULTS: All facial telangiectasias significantly improved. At 1-month follow-up, >50% lesion clearance was noted in 97.1% of facial (n=36) and 85.7% of non-facial (n=7) lesions, with 73% of subjects satisfied or very satisfied. An increase in mean social downtime (0, 2.3, and 3 days) and VAS scores (3.5, 4.5, and 4.8) with treatments 1, 2, and 3, respectively, mirrored a stepwise increase in fluence with subsequent sessions. CONCLUSIONS: The use of a novel IPL narrowband KTP/PDL-like filter can significantly improve facial and non-facial telangiectasias with minimal downtime. J Drugs Dermatol. 2020;19(9):844-850. doi:10.36849/JDD.2020.4834.


Assuntos
Dermatoses Faciais/terapia , Dor/diagnóstico , Fototerapia/instrumentação , Dermatopatias Vasculares/terapia , Telangiectasia/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dermatoses Faciais/diagnóstico , Feminino , Seguimentos , Humanos , Luz/efeitos adversos , Pessoa de Meia-Idade , Dor/etiologia , Medição da Dor , Satisfação do Paciente/estatística & dados numéricos , Fotografação , Fototerapia/efeitos adversos , Fototerapia/métodos , Estudos Prospectivos , Pele/irrigação sanguínea , Pele/diagnóstico por imagem , Pele/efeitos da radiação , Dermatopatias Vasculares/diagnóstico , Telangiectasia/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
13.
Int J Nanomedicine ; 15: 6827-6838, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32982235

RESUMO

The ultimate goal of phototherapy based on nanoparticles, such as photothermal therapy (PTT) which generates heat and photodynamic therapy (PDT) which not only generates reactive oxygen species (ROS) but also induces a variety of anti-tumor immunity, is to kill tumors. In addition, due to strong efficacy in clinical treatment with minimal invasion and negligible side effects, it has received extensive attention and research in recent years. In this paper, the generations of nanomaterials in PTT and PDT are described separately. In clinical application, according to the different combination pathway of nanoparticles, it can be used to treat different diseases such as tumors, melanoma, rheumatoid and so on. In this paper, the mechanism of pathological treatment is described in detail in terms of inducing apoptosis of cancer cells by ROS produced by PDT, immunogenic cell death to provoke the maturation of dendritic cells, which in turn activate production of CD4+ T cells, CD8+T cells and memory T cells, as well as inhibiting heat shock protein (HSPs), STAT3 signal pathway and so on.


Assuntos
Nanopartículas/uso terapêutico , Neoplasias/terapia , Fototerapia/métodos , Animais , Antineoplásicos/uso terapêutico , Apoptose/efeitos dos fármacos , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD8-Positivos/efeitos dos fármacos , Citocinas/metabolismo , Humanos , Hipertermia Induzida , Nanopartículas/administração & dosagem , Neoplasias/imunologia , Neoplasias/patologia , Fotoquimioterapia/instrumentação , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Fármacos Fotossensibilizantes/farmacologia , Fototerapia/instrumentação , Espécies Reativas de Oxigênio/metabolismo
14.
Small ; 16(39): e2003834, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32877017

RESUMO

Cell adhesion of nanosystems is significant for efficient cellular uptake and drug delivery in cancer therapy. Herein, a near-infrared (NIR) light-driven biomimetic nanomotor is reported to achieve the improved cell adhesion and cellular uptake for synergistic photothermal and chemotherapy of breast cancer. The nanomotor is composed of carbon@silica (C@SiO2 ) with semi-yolk@spiky-shell structure, loaded with the anticancer drug doxorubicin (DOX) and camouflaged with MCF-7 breast cancer cell membrane (i.e., mC@SiO2 @DOX). Such biomimetic mC@SiO2 @DOX nanomotors display efficient self-thermophoretic propulsion due to a thermal gradient generated by asymmetrically spatial distribution. Moreover, the MCF-7 cancer cell membrane coating can remarkably reduce the bioadhesion of nanomotors in biological medium and exhibit highly specific self-recognition of the source cell line. The combination of effective propulsion and homologous targeting dramatically improves cell adhesion and the resultant cellular uptake efficiency in vitro from 26.2% to 67.5%. Therefore, the biomimetic mC@SiO2 @DOX displays excellent synergistic photothermal and chemotherapy with over 91% MCF-7 cell growth inhibition rate. Such smart design of the fuel-free, NIR light-powered biomimetic nanomotor may pave the way for the application of self-propelled nanomotors in biomedicine.


Assuntos
Antineoplásicos , Neoplasias da Mama , Doxorrubicina , Tratamento Farmacológico , Nanoestruturas , Fototerapia , Antineoplásicos/uso terapêutico , Materiais Biomiméticos/química , Materiais Biomiméticos/uso terapêutico , Neoplasias da Mama/terapia , Carbono/química , Adesão Celular , Membrana Celular , Doxorrubicina/administração & dosagem , Tratamento Farmacológico/instrumentação , Feminino , Humanos , Células MCF-7 , Nanoestruturas/química , Fototerapia/instrumentação , Dióxido de Silício/química
16.
Can J Cardiol ; 36(12): 1977.e1-1977.e3, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32798700

RESUMO

Neuraxial modulation therapies, such as stellate ganglion block, thoracic epidural anaesthesia, and cardiac sympathetic denervation, are effective for ventricular arrhythmias. However, these treatments can increase the risk of bleeding and infection. In this case report, stellate ganglion phototherapy was safely and effectively performed for refractory ventricular tachycardias in a patient with a history of left ventricular assist device implantation. Stellate ganglion phototherapy may have the potential to treat refractory ventricular arrhythmias as an additive therapy or bridge therapy.


Assuntos
Bloqueio de Ramo , Lasers Semicondutores/uso terapêutico , Fototerapia , Gânglio Estrelado , Taquicardia Ventricular , Adulto , Anticoagulantes/uso terapêutico , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/etiologia , Terapia de Ressincronização Cardíaca/métodos , Cardiomiopatia Dilatada/complicações , Fármacos Cardiovasculares/uso terapêutico , Desfibriladores Implantáveis , Resistência a Medicamentos , Cardioversão Elétrica/métodos , Eletrocardiografia/métodos , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/terapia , Transplante de Coração , Coração Auxiliar , Humanos , Masculino , Fototerapia/instrumentação , Fototerapia/métodos , Período Pré-Operatório , Risco Ajustado/métodos , Gânglio Estrelado/fisiopatologia , Gânglio Estrelado/efeitos da radiação , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/etiologia , Taquicardia Ventricular/terapia , Resultado do Tratamento
17.
Mol Pharm ; 17(10): 3720-3729, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-32633977

RESUMO

The limited tumor tissue penetration of many nanoparticles remains a formidable challenge to their therapeutic efficacy. Although several photonanomedicines have been applied to improve tumor penetration, the first near-infrared window mediated by the low optical tissue penetration depth severely limits their anticancer effectiveness. To achieve deep optical tissue and drug delivery penetration, a near-infrared second window (NIR-II)-excited and pH-responsive ultrasmall drug delivery nanoplatform was fabricated based on BSA-stabilized CuS nanoparticles (BSA@CuS NPs). The BSA@CuS NPs effectively encapsulated doxorubicin (DOX) via strong electrostatic interactions to form multifunctional nanoparticles (BSA@CuS@DOX NPs). The BSA@CuS@DOX NPs had an ultrasmall size, which allowed them to achieve deeper tumor penetration. They also displayed stronger NIR II absorbance-mediated deep optical tissue penetration than that of the NIR I window. Moreover, the multifunctional nanoplatform preferentially accumulated in tumor sites, induced tumor hyperthermia, and generated remarkably high ROS levels in tumor sites upon NIR-II laser (1064 nm) irradiation. More importantly, our strategy achieved excellent synergistic effects of chemotherapy and phototherapy (chemophototherapy) under the guidance of photothermal imaging. The developed nanoparticles also showed good biocompatibility and bioclearance properties. Therefore, our work demonstrated a facile strategy for fabricating a multifunctional nanoplatform that is a promising candidate for deep tumor penetration as an effective antitumor therapy.


Assuntos
Doxorrubicina/administração & dosagem , Portadores de Fármacos/efeitos da radiação , Nanopartículas/efeitos da radiação , Neoplasias/tratamento farmacológico , Fototerapia/métodos , Animais , Linhagem Celular Tumoral/transplante , Sobrevivência Celular , Modelos Animais de Doenças , Doxorrubicina/farmacocinética , Portadores de Fármacos/química , Liberação Controlada de Fármacos/efeitos da radiação , Humanos , Concentração de Íons de Hidrogênio , Raios Infravermelhos , Lasers , Camundongos , Nanopartículas/química , Neoplasias/patologia , Fototerapia/instrumentação , Distribuição Tecidual
18.
Cochrane Database Syst Rev ; 7: CD012011, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32609375

RESUMO

BACKGROUND: Phototherapy is a well-established effective therapy for treating babies with significant neonatal jaundice. Studies have shown that increasing light intensity will increase its efficiency. A potentially inexpensive and easy way of increasing the intensity of light on the body of the infant may be to hang reflective materials from the sides of phototherapy units. OBJECTIVES: To assess the effects of reflective materials in combination with phototherapy compared with phototherapy alone for unconjugated hyperbilirubinaemia in neonates. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 11), in the Cochrane Library; Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R); and the Cumulative Index of Nursing and Allied Health Literature (CINAHL), on 1 November 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials if the participants, who were term or preterm infants, received phototherapy with curtains made of reflective materials of any type in the treatment arm, and if those in the comparison arm received similar phototherapy without curtains or other intensified phototherapy, such as a double bank of lights. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS: Of 15 studies identified, we included 12 (1288 babies) in the review - 11 comparing phototherapy with reflective materials and phototherapy alone, and one comparing a single phototherapy light bank with reflective materials with double phototherapy. All reflective materials consisted of curtains on three or four sides of the cot and were made of white plastic (five studies), white linen (two studies), or aluminium (three studies); materials were not specified in two studies. Only 11 studies (10 comparing reflective materials versus none and one comparing reflective curtains and a single bank of lights with a double (above and below) phototherapy unit) provided sufficient data to be included in the meta-analysis. Two excluded studies used the reflective materials in a way that did not meet our inclusion criteria, and we excluded one study because it compared four different phototherapy interventions not including reflective materials. The risk of bias of included studies was generally low, but all studies had high risk of performance bias due to lack of blinding of the intervention. Three studies (281 participants) reported a decline in serum bilirubin (SB) (µmol/L) at four to eight hours (mean difference (MD) -14.61, 95% confidence interval (CI) -19.80 to -9.42; I² = 57%; moderate-certainty evidence). Nine studies (893 participants) reported a decline in SB over 24 hours and showed a faster decline in SB in the intervention group, but heterogeneity (I² = 97%) was too substantial to permit a meaningful estimate of the actual effect size (very low-certainty evidence). Subgroup analysis by type of reflective material used did not explain the heterogeneity. Exchange transfusion was reported by two studies; both reported none in either group. Four studies (466 participants) reported the mean duration of phototherapy, and in each of these studies, it was reduced in the intervention group but there was substantial heterogeneity (I² = 88%), precluding meaningful meta-analysis of data. The only two studies that reported the mean duration of hospital stay in hours showed a meaningful reduction (MD -41.08, 95% CI -45.92 to -36.25; I² = 0; moderate-certainty evidence). No studies reported costs of the intervention, parental or medical staff satisfaction, breastfeeding outcomes, or neurodevelopmental follow-up. The only study that compared use of curtains with double phototherapy reported similar results for both groups. Studies that monitored adverse events did not report increased adverse events related to the use of curtains, including acute life-threatening events, but other rarer side effects could not be excluded. AUTHORS' CONCLUSIONS: Moderate-certainty evidence shows that the use of reflective curtains during phototherapy may result in greater decline in SB. Very low-certainty evidence suggests that the duration of phototherapy is reduced, and moderate-certainty evidence shows that the duration of hospital stay is also reduced. Available evidence does not show any increase in adverse events, but further studies are needed.


Assuntos
Alumínio , Roupas de Cama, Mesa e Banho , Hiperbilirrubinemia Neonatal/terapia , Fototerapia/métodos , Plásticos , Viés , Bilirrubina/sangue , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Icterícia Neonatal/terapia , Iluminação/instrumentação , Fototerapia/instrumentação , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Clin Transl Gastroenterol ; 11(3): e00119, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32352709

RESUMO

Current conventional endoscopes have restricted the accuracy of treatment delivery and monitoring. Over the past decade, there have been major developments in nanotechnology and light triggered therapy, potentially allowing a better detection of challenging lesions and targeted treatment of malignancies in the gastrointestinal tract. Theranostics is a developing form of personalized medicine because it combines diagnosis and targeted treatment delivered in one step using advances in nanotechnology. This review describes the light-triggered therapies (including photodynamic, photothermal, and photoimmunotherapies), nanotechnological advances with nanopowder, nanostent, nanogels, and nanoparticles, enhancements brought to endoscopic ultrasound, in addition to experimental endoscopic techniques, combining both enhanced diagnoses and therapies, including a developed prototype of a "smart" multifunctional endoscope for localized colorectal cancer, near-infrared laser endoscope targeting the gastrointestinal stromal tumors, the concept of endocapsule for obscure gastrointestinal bleed, and a proof-of-concept therapeutic capsule using ultrasound-mediated targeted drug delivery. Hence, the following term has been proposed encompassing these technologies: "Theranostic gastrointestinal endoscopy." Future efforts for integration of these technologies into clinical practice would be directed toward translational and clinical trials translating into a more personalized and interdisciplinary diagnosis and treatment, shorter procedural time, higher precision, higher cost-effectiveness, and less need for repetitive procedures.


Assuntos
Endoscopia Gastrointestinal/métodos , Gastroenteropatias/terapia , Nanoestruturas/administração & dosagem , Fototerapia/métodos , Nanomedicina Teranóstica/métodos , Análise Custo-Benefício , Endoscopia Gastrointestinal/economia , Endoscopia Gastrointestinal/instrumentação , Endossonografia/instrumentação , Endossonografia/métodos , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/efeitos da radiação , Gastroenteropatias/diagnóstico , Gastroenteropatias/economia , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/efeitos da radiação , Luz , Fototerapia/economia , Fototerapia/instrumentação , Nanomedicina Teranóstica/economia , Nanomedicina Teranóstica/instrumentação
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...