RESUMEN

CONTEXT: Light transmission (LT) into deeper areas of the dentin root is limited. AIM: The aim of this study is to perform a quantitative investigation of the radial transmission of light (LT) through different fiber posts and its influence on the Knoop hardness number (KHN) and bond strength (BS) of a dual-cure self-adhesive resin cement at 3 different depths. MATERIALS AND METHODS: Four types of fiber posts (2 translucent and 2 conventional) were used. LT and KHN analyses were performed in a specially designed matrix, which allowed measurements at 3 different depths. LT was measured using a volt-ampere meter while KHN tests were performed in a microhardness tester. For BS analysis, endodontically treated bovine roots were divided into 4 groups, each group receiving one type of post. After cementation, cross sections of the root were tested for resistance to displacement using a universal testing machine. STATISTICAL ANALYSIS USED:: Statistical analysis was performed by using this ANOVA and Tukey's test. RESULTS: For LT, translucent posts showed significantly higher values at all depths compared to the conventional ones. For all posts, LT decreased at the deeper depths. The KHN results showed no statistical differences among the different posts, regardless of depth. For BS, a translucent post showed the highest values, and comparative analyses between the different depths of posts also showed statistically significant differences while comparisons among the different depths of the same post showed no differences. CONCLUSIONS: LT depended on the type of post and on depth. The type of post did not significantly influence the cement KHN. A translucent post showed higher BS in pooled data.

Asunto(s)

Resinas Compuestas/uso terapéutico , Recubrimiento Dental Adhesivo/métodos , Técnica de Perno Muñón , Análisis del Estrés Dental , Vidrio/química , Vidrio/efectos de la radiación , Dureza , Humanos , Luz , Técnica de Perno Muñón/instrumentación

RESUMEN

BACKGROUND: Robotic-assisted gait training, a viable and promising therapeutic option for neurological rehabilitation, is not widely adopted in developing countries because of its high cost. In this paper, we describe the concept and construction of a low-cost robot prototype to restore walking ability in children with neurological dysfunction. METHODS: The proposed robot consists of an orthosis, a treadmill, a body weight support system and two ankle guidance systems that move the ankles along a physiological kinematic trajectory. The spatiotemporal gait parameters of 60 children with typical development and children with cerebral palsy (aged 7-10 years) were obtained through clinical tests and compared with those provided by the robot. RESULTS: The robotic orthosis presents normative values for stride length, step length and cadence during the typical development of children's gait speed and allows speed adjustments according to the degree of neuromotor impairment. CONCLUSION: The results evidence the high feasibility of developing a low-complexity rehabilitation device compliant with the physiological trajectory of the ankle as well as with several other physiological gait parameters.

RESUMEN

The use of porcine or bovine pericardium biological cardiac valves has as its main disadvantage a relatively short lifespan, with failures due to calcification and fatigue. Increasing these valves' durability constitutes a great challenge. An understudied phenomenon is the effect of flutter, an oscillation of the leaflets that can cause regurgitation and accelerate calcification and fatigue. As a starting point to study how to reduce or prevent these oscillations, a method was developed to quantify the flutter frequencies occurring at the point of the valve's full opening. On a test bench that simulates the heart flow, the cusp behaviors of eight biological valves were filmed with a high speed camera at 2000 frames per second at different flow rates and motion capture software obtained the frequencies and amplitudes of the vibrations of each leaflet. Oscillations in the range of 200 Hz with average amplitudes of 0.4 mm were found; larger nominal diameter valves obtained lower values, and bovine pericardial valves had superior performance compared to porcine valves. A dimensionless analysis was performed to find a relationship between the geometric and mechanical properties of the valves with the critical speed of the onset of fluttering. This relationship inspired a method to predict whether flutter will occur in the bioprosthesis. This method is a new tool for the consideration of maximizing the life of prosthetic valves.

Asunto(s)

Bioprótesis/efectos adversos , Prótesis Valvulares Cardíacas/efectos adversos , Ensayo de Materiales/métodos , Diseño de Prótesis/métodos , Falla de Prótesis , Algoritmos , Animales , Fenómenos Biomecánicos , Bovinos , Porcinos , Factores de Tiempo , Vibración

RESUMEN

ABSTRACT Antimicrobial photodynamic therapy (aPDT) involves the association of a photosensitizing agent with a light source with the goal of causing apoptosis or microbial lysing. The use of compounds with natural active principles is gaining prominence throughout the world. Several studies from groups that are linked to the development of innovations in the pharmaceutical market have used natural dyes, such as curcumin, the efficacy of which has been demonstrated in aPDT trials. Difficulties related to physicochemical stability, solubility and cell penetration are some of the challenges associated with this field. The present work aimed to prepare, investigate the characteristics and improve the photodynamic activity of PLGA-based nanoparticles loaded with curcumin for use in aPDT therapy. Using the simple technique of emulsion during the evaporation of a solvent, the particles were built, characterized and tested against microorganisms with importance for medicine and dentistry. The results revealed that the particles were able to protect the curcumin against degradation and eliminate some microorganism species at nanomolar concentrations.

Asunto(s)

Curcumina/análisis , Nanopartículas/análisis , Fotoquimioterapia/efectos adversos , Composición de Medicamentos

RESUMEN

Paracoccidioidomycosis (PCM) is a public health concern in Latin America and South America that when not correctly treated can lead to patient death. In this study, the influence of melanin produced by Paracoccidioides spp. on the effects of treatment with antimicrobial photodynamic inhibition (aPI) and antifungal drugs was evaluated. aPI was performed using toluidine blue (TBO) as a photosensitizer and a 630-nm light-emitting diode (LED) light. The antifungals tested were itraconazole and amphotericin B. We evaluated the effects of each approach, aPI or antifungals, against nonmelanized and melanized yeast cells by performing susceptibility tests and by quantifying oxidative and nitrosative bursts during the experiments. aPI reduced nonmelanized cells by 3.0 log units and melanized cells by 1.3 log units. The results showed that melanization protects the fungal cell, probably by acting as a scavenger of nitric oxide and reactive oxygen species, but not of peroxynitrite. Melanin also increased the MICs of itraconazole and amphotericin B, and the drugs were fungicidal for nonmelanized and fungistatic for melanized yeast cells. Our study shows that melanin production by Paracoccidioides yeast cells serves a protective function during aPI and treatment with itraconazole and amphotericin B. The results suggest that melanin binds to the drugs, changing their antifungal activities, and also acts as a scavenger of reactive oxygen species and nitric oxide, but not of peroxynitrite, indicating that peroxynitrite is the main radical that is responsible for fungal death after aPI.

Asunto(s)

Antifúngicos/farmacología , Melaninas/farmacología , Paracoccidioides/efectos de los fármacos , Fotoquimioterapia , Anfotericina B/química , Anfotericina B/farmacología , Antifúngicos/química , Farmacorresistencia Fúngica/efectos de los fármacos , Depuradores de Radicales Libres/farmacología , Itraconazol/química , Itraconazol/farmacología , Lacasa/metabolismo , Levodopa/farmacología , Melaninas/química , Pruebas de Sensibilidad Microbiana , Óxido Nítrico/metabolismo , Ácido Peroxinitroso/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Estallido Respiratorio/efectos de los fármacos

RESUMEN

Introduction Thermography is a surface thermal radiation measurement technique whose application has been expanding in the healthcare field. The unhealed wound is a serious public health problem because it intervenes in the quality of life of patients and may cause emotional and psychological losses. The wound temperature can provide quantitative data that allow for the healing process to be monitored. The aim of this study was to verify whether thermography can be used as a method to evaluate the healing of pressure ulcers. Methods Eight participants with sacral pressure ulcers were recruited and randomly divided into two groups: A (control) and B (experimental). Both groups received standard treatment for a period of four weeks, which consisted of a daily cleaning of the pressure ulcers with physiological saline (sodium chloride 0.9%) followed by an alginate hydrogel dressing. The group B received light-emitting diode (LED) phototherapy in addition to standard treatment, three times a week, yielding a total of 12 sessions. Photographs and thermograms of each pressure ulcer were obtained in all sessions in both groups. Results Pressure ulcers treated with LED phototherapy were healed. The pressure ulcer area of group B decreased over the 12 treatment sessions, whereas the pressure ulcer area of group A increased. The ulcer temperature of group B was higher than that of group A during the treatment (temperature difference up to 7.6%). Discussion The present study suggests a relationship between the temperature and area of pressure ulcers and proposes thermography as an adjunctive method for the evaluation of healing processes.

RESUMEN

Biomechanical models are important tools in the study of human motion. This work proposes a computational model to analyse the dynamics of lower limb motion using a kinematic chain to represent the body segments and rotational joints linked by viscoelastic elements. The model uses anthropometric parameters, ground reaction forces and joint Cardan angles from subjects to analyse lower limb motion during the gait. The model allows evaluating these data in each body plane. Six healthy subjects walked on a treadmill to record the kinematic and kinetic data. In addition, anthropometric parameters were recorded to construct the model. The viscoelastic parameter values were fitted for the model joints (hip, knee and ankle). The proposed model demonstrated that manipulating the viscoelastic parameters between the body segments could fit the amplitudes and frequencies of motion. The data collected in this work have viscoelastic parameter values that follow a normal distribution, indicating that these values are directly related to the gait pattern. To validate the model, we used the values of the joint angles to perform a comparison between the model results and previously published data. The model results show a same pattern and range of values found in the literature for the human gait motion.

Asunto(s)

Marcha/fisiología , Articulaciones/fisiología , Extremidad Inferior/fisiología , Modelos Biológicos , Caminata/fisiología , Adulto , Fenómenos Biomecánicos , Simulación por Computador , Femenino , Humanos , Masculino , Adulto Joven

RESUMEN

Several studies demonstrate the benefits of low-power light therapy on wound healing. However, the use of LED as a therapeutic resource remains controversial. There are questions regarding the equality or not of biological effects promoted by LED and LASER. One objective of this review was to determine the biological effects that support the use of LED on wound healing. Another objective was to identify LED´s parameters for the treatment of wounds. The biological effects and parameters of LED will be compared to those of LASER. Literature was obtained from online databases such as Medline, PubMed, Science Direct and Scielo. The search was restricted to studies published in English and Portuguese from 1992 to 2012. Sixty-eight studies in vitro and in animals were analyzed. LED and LASER promote similar biological effects, such as decrease of inflammatory cells, increased fibroblast proliferation, stimulation of angiogenesis, granulation tissue formation and increased synthesis of collagen. The irradiation parameters are also similar between LED and LASER. The biological effects are dependent on irradiation parameters, mainly wavelength and dose. This review elucidates the importance of defining parameters for the use of light devices.

Asunto(s)

Láseres de Semiconductores/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Cicatrización de Heridas/efectos de la radiación , Relación Dosis-Respuesta en la Radiación , Humanos , Valores de Referencia , Piel/efectos de la radiación

RESUMEN

Several studies demonstrate the benefits of low-power light therapy on wound healing. However, the use of LED as a therapeutic resource remains controversial. There are questions regarding the equality or not of biological effects promoted by LED and LASER. One objective of this review was to determine the biological effects that support the use of LED on wound healing. Another objective was to identify LED´s parameters for the treatment of wounds. The biological effects and parameters of LED will be compared to those of LASER. Literature was obtained from online databases such as Medline, PubMed, Science Direct and Scielo. The search was restricted to studies published in English and Portuguese from 1992 to 2012. Sixty-eight studies in vitro and in animals were analyzed. LED and LASER promote similar biological effects, such as decrease of inflammatory cells, increased fibroblast proliferation, stimulation of angiogenesis, granulation tissue formation and increased synthesis of collagen. The irradiation parameters are also similar between LED and LASER. The biological effects are dependent on irradiation parameters, mainly wavelength and dose. This review elucidates the importance of defining parameters for the use of light devices.

Asunto(s)

Humanos , Terapia por Luz de Baja Intensidad/métodos , Láseres de Semiconductores/uso terapéutico , Cicatrización de Heridas/efectos de la radiación , Relación Dosis-Respuesta en la Radiación , Valores de Referencia , Piel/efectos de la radiación

RESUMEN

As mastites estão entre as principais causas de prejuízo para produtores de leite. Em casos graves de hiperqueratose, o canal do teto pode se tornar uma barreira mais fácil para que as bactérias penetrem na glândula mamária. Os objetivos deste estudo foram avaliar um dispositivo fotobiomodulador de LED para tratamento e prevenção de hiperqueratose de teto e prevenção da mastite subclínica em um rebanho de leite com alta prevalência de hiperqueratose (35,3 por cento de casos graves). Foram utilizadas 60 primíparas para o experimento de prevenção e 30 vacas com hiperqueratose para o experimento terapêutico. Em ambos os experimentos, metade dos animais foram tratados com o dispositivo fotobiomodulador três vezes por semana, durante 6 semanas. Os outros animais foram os controles. Imagens fotográficas digitalizadas foram realizadas na avaliação inicial e, semanalmente, por 6 semanas consecutivas. Nas primíparas, novas avaliações foram realizadas entre 6 e 7 meses de lactação. Para avaliação da mastite subclínica, contagem de células somáticas (CCS) foram feitas mensalmente. No experimento preventivo, o diâmetro externo das lesões permaneceu constante nos tetos do grupo tratado, enquanto houve aumento no grupo controle. No experimento terapêutico não foram observadas diferenças estatísticas entre as variáveis de hiperqueratose. Contudo, o grupo tratado apresentou menor incidência de mastites subclínicas (CCS < 250 células/mL) por lactação do que o grupo controle (P<0,05). Em conclusão, o tratamento não foi efetivo em prevenir o desenvolvimento ou reduzir lesões instaladas de hiperqueratose de teto. Contudo, o uso protótipo se mostrou útil e promissor como adjuvante na prevenção do aumento de tamanho das lesões de hiperqueratose de teto em primíparas e como forma de reduzir incidência de mastite subclínicas em vacas leiteiras já acometidas.

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Mastitis consistis one of the main problems of milk production, mainly due to the production losses and the rising cost of milk. In case of severe hyperkeratosis, the teat canal can become an easier barrier for the bacteria to penetrate. The objeSctive of this study was to assess a phototherapy device construct with LED light for prevention and treatment of teat hyperkeratosis in a dairy cattle herd with high prevalence (35.3 percent of severe cases). 60 primiparous cows were used in the preventive experiment and 30 cows with hyperkeratosis were used in the therapeutic experiment. In both experiments, half of the cows started to be treated in early lactation using the phototherapy device three times per week for 6 weeks. The other cows were the controls. Hyperkeratosis was assessed by scoring and by morphometric analyses of teat images that were taken at baseline and then weekly for 6 consecutive weeks. In the preventive experiment, more images were taken later, between 6 and 7 months of the first lactation. Somatic cell counts (SCC) were performed monthly. In the preventive experiment, the outer diameter of the teat lesions remained constant in the treated group, whereas cows of the control group showed a significant increase at the end of lactation. In the therapeutic groups, no statistical differences for teat hyperkeratosis variables were seen between groups. However, the incidence of subclinical mastitis (SCC > 250 cells/mL) during lactation was lower in the treated group (P<0.05). In conclusion the phototherapy protocol did not prevent the development in primiparous or ameliorate previous hyperkeratosis lesions in cows. However, the prototype was considered useful as an adjunct in preventing the increase in the size of teat hyperkeratosis lesions and also as a way to reduce subclinical mastitis incidence in affected dairy cows.

Asunto(s)

Animales , Femenino , Bovinos , Callosidades/veterinaria , Fototerapia/veterinaria , Mastitis Bovina/prevención & control , Mastitis Bovina/terapia , Queratinas/efectos adversos , Glándulas Mamarias Animales/patología , Lactancia , Mastitis Bovina/diagnóstico

RESUMEN

As mastites estão entre as principais causas de prejuízo para produtores de leite. Em casos graves de hiperqueratose, o canal do teto pode se tornar uma barreira mais fácil para que as bactérias penetrem na glândula mamária. Os objetivos deste estudo foram avaliar um dispositivo fotobiomodulador de LED para tratamento e prevenção de hiperqueratose de teto e prevenção da mastite subclínica em um rebanho de leite com alta prevalência de hiperqueratose (35,3 por cento de casos graves). Foram utilizadas 60 primíparas para o experimento de prevenção e 30 vacas com hiperqueratose para o experimento terapêutico. Em ambos os experimentos, metade dos animais foram tratados com o dispositivo fotobiomodulador três vezes por semana, durante 6 semanas. Os outros animais foram os controles. Imagens fotográficas digitalizadas foram realizadas na avaliação inicial e, semanalmente, por 6 semanas consecutivas. Nas primíparas, novas avaliações foram realizadas entre 6 e 7 meses de lactação. Para avaliação da mastite subclínica, contagem de células somáticas (CCS) foram feitas mensalmente. No experimento preventivo, o diâmetro externo das lesões permaneceu constante nos tetos do grupo tratado, enquanto houve aumento no grupo controle. No experimento terapêutico não foram observadas diferenças estatísticas entre as variáveis de hiperqueratose. Contudo, o grupo tratado apresentou menor incidência de mastites subclínicas (CCS < 250 células/mL) por lactação do que o grupo controle (P<0,05). Em conclusão, o tratamento não foi efetivo em prevenir o desenvolvimento ou reduzir lesões instaladas de hiperqueratose de teto. Contudo, o uso protótipo se mostrou útil e promissor como adjuvante na prevenção do aumento de tamanho das lesões de hiperqueratose de teto em primíparas e como forma de reduzir incidência de mastite subclínicas em vacas leiteiras já acometidas.(AU)

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Mastitis consistis one of the main problems of milk production, mainly due to the production losses and the rising cost of milk. In case of severe hyperkeratosis, the teat canal can become an easier barrier for the bacteria to penetrate. The objeSctive of this study was to assess a phototherapy device construct with LED light for prevention and treatment of teat hyperkeratosis in a dairy cattle herd with high prevalence (35.3 percent of severe cases). 60 primiparous cows were used in the preventive experiment and 30 cows with hyperkeratosis were used in the therapeutic experiment. In both experiments, half of the cows started to be treated in early lactation using the phototherapy device three times per week for 6 weeks. The other cows were the controls. Hyperkeratosis was assessed by scoring and by morphometric analyses of teat images that were taken at baseline and then weekly for 6 consecutive weeks. In the preventive experiment, more images were taken later, between 6 and 7 months of the first lactation. Somatic cell counts (SCC) were performed monthly. In the preventive experiment, the outer diameter of the teat lesions remained constant in the treated group, whereas cows of the control group showed a significant increase at the end of lactation. In the therapeutic groups, no statistical differences for teat hyperkeratosis variables were seen between groups. However, the incidence of subclinical mastitis (SCC > 250 cells/mL) during lactation was lower in the treated group (P<0.05). In conclusion the phototherapy protocol did not prevent the development in primiparous or ameliorate previous hyperkeratosis lesions in cows. However, the prototype was considered useful as an adjunct in preventing the increase in the size of teat hyperkeratosis lesions and also as a way to reduce subclinical mastitis incidence in affected dairy cows.(AU)

Asunto(s)

Animales , Femenino , Bovinos , Callosidades/veterinaria , Queratinas/efectos adversos , Mastitis Bovina/prevención & control , Mastitis Bovina/terapia , Fototerapia/veterinaria , Mastitis Bovina/diagnóstico , Glándulas Mamarias Animales/patología , Lactancia

RESUMEN

The goal of this study was to assess the use of a dynamic orthosis on upper extremity function in chronic stroke patients. A case series approach was utilized, with provision of a training program (3x/week, 50 minutes/session for 8 weeks) and employment of a dynamic orthosis. Six volunteers with persistent hemiparesis due to a single, unilateral stroke performed task-oriented movements with the aid of a dynamic orthosis. Tests were administered before and after training. Functional capacity was assessed using the TEMPA (Test d'Évaluation des Membres Supérieurs de Personnes Âgées) test. The Wilcoxon test was used for pre-training and post-training comparisons of TEMPA scores. The volunteers showed significant improvement of upper extremity function in the performance of a bilateral task (p = 0.01) and three unilateral tasks (p = 0.04). This pilot study suggests that the dynamic orthosis associated with the performance of functional tasks can have positive outcomes regarding the improvement of functional capacity of upper extremity.

Asunto(s)

Brazo/fisiología , Aparatos Ortopédicos , Rehabilitación/métodos , Rehabilitación de Accidente Cerebrovascular , Adulto , Anciano , Isquemia Encefálica/rehabilitación , Electromiografía , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Rango del Movimiento Articular , Resultado del Tratamiento

RESUMEN

OBJECTIVES: Antimicrobial photodynamic inhibition (aPI) is based on the use of a light source and a photosensitizer to kill pathogens. Little is known about aPI of dermatophytic fungi and its mechanism of action. We aimed to evaluate aPI of Trichophyton rubrum. METHODS: We performed tests using toluidine blue (TBO) as a photosensitizer and a 630 nm light-emitting diode (LED) as a source of light to target 12 T. rubrum isolates. Susceptibility testing with cyclopiroxolamine, time-kill curves and quantification of reactive oxygen species (ROS), peroxynitrite (ONOO·) and nitric oxide (NO·) were performed. RESULTS: The optimal conditions for in vitro aPI were 10 mg/L for TBO and 48 J/cm(2) for LED; these conditions were fungicidal or inhibited >98% of fungal growth depending on the strain tested. LED or TBO treatment alone did not inhibit growth. The MICs of cyclopiroxolamine were 2.0 mg/L for 90% of the strains. Analysis of time-kill curves revealed that pathogen death occurred 24 h post-treatment. Quantification of ROS, ONOO· and NO· revealed improvement after aPI. CONCLUSIONS: Photodynamic inhibition was more efficient in promoting cell death than the antifungal cyclopiroxolamine against T. rubrum. ROS, ONOO· and NO· were important in the fungicidal activity of aPI. A suggested mechanism for this activity is that TBO is excited by LED light (630 nm), reacts with biomolecules and increases the availability of transition electrons and substrates for nitric oxide synthase, thereby increasing the oxidative and nitrosative bursts in the fungal cell.

Asunto(s)

Antifúngicos/farmacología , Luz , Viabilidad Microbiana/efectos de los fármacos , Fármacos Fotosensibilizantes/farmacología , Trichophyton/efectos de los fármacos , Trichophyton/fisiología , Ciclopirox , Humanos , Pruebas de Sensibilidad Microbiana , Óxido Nítrico/análisis , Piridonas/farmacología , Especies Reactivas de Oxígeno/análisis , Cloruro de Tolonio/farmacología

Asunto(s)

Humanos , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Fotogrametría , Electromiografía , Torso , Vértebras Lumbares

RESUMEN

BACKGROUND: Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. OBJECTIVES: This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. METHODS: The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. RESULTS: A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. CONCLUSION: The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.

Asunto(s)

Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Cloruro de Tolonio/uso terapéutico , Trichophyton/efectos de la radiación , Relación Dosis-Respuesta en la Radiación

RESUMEN

BACKGROUND: Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. OBJECTIVES: This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. METHODS: The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. RESULTS: A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. CONCLUSION: The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.

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FUNDAMENTOS: Trichophyton rubrum é o agente mais comum das micoses superficiais de pele e unhas causando infecções de longa duração e altas taxas de recidiva. As desvantagens do tratamento atual envolvem medicações tópicas as quais não são capazes de alcançar o leito ungueal em concentrações terapêuticas, antifúngicos sistêmicos que não erradicam o fungo antes das unhas serem renovadas, efeitos colaterais graves e seleção de isolados fúngicos resistentes. A terapia fotodinâmica tem sido uma alternativa promissora aos tratamentos convencionais. OBJETIVOS: Este estudo avaliou a eficácia, in vitro, de azul de orto-toluidina irradiado por diodo emissor de luz na redução da viabilidade de T. rubrum. MÉTODOS: O inóculo fúngico foi preparado e exposto a diferentes concentrações de azul de orto-toluidina e densidades de energia do diodo emissor de luz, para avaliar a sensibilidade de T. rubrum e o efeito fungicida, após terapia fotodinâmica. Além disso, os perfis da área e volume das suspensões fúngicas irradiados também foram investigados. RESULTADOS: Uma pequena redução, in vitro, de células fúngicas foi observada após a exposição a 100 mM azul de orto-toluidina irradiados por diodo emissor de luz a 18 J/cm². Efeito fungicida ocorreu após irradiação 25 µM orto-toluidina por diodo emissor de luz com densidade de energia de 72 J/cm². A análise mostrou que a área e o volume irradiados pelo diodo emissor de luz foram 52,2 mm² e 413,70 mm³, respectivamente. CONCLUSÕES: Os resultados permitiram concluir que a terapia fotodinâmica com diodo emissor de luz, nas condições experimentais é uma abordagem alternativa para inibir, in vitro, T. rubrum e pode ser um tratamento promissor para as dermatofitoses causadas por este fungo.

Asunto(s)

Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Cloruro de Tolonio/uso terapéutico , Trichophyton/efectos de la radiación , Relación Dosis-Respuesta en la Radiación

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the clinical effectiveness of a LED phototherapy prototype apparatus in the healing of nipple trauma in breastfeeding women. BACKGROUND DATA: There is no scientific evidence of an effective treatment for nipple trauma. METHODS: The experimental group was treated with orientation on nipple care and adequate breastfeeding techniques in addition to active LED phototherapy. The control group was treated with orientation on nipple care and adequate breastfeeding techniques in addition to placebo LED phototherapy. Participants were treated twice a week, for a total of eight sessions. Healing of the nipple lesions was measured by a reduction in their area, and decrease in pain intensity was measured in accordance with an 11-point Pain Intensity Numerical Rating Scale and a standard 7-point patient global impression of change. RESULTS: Statistically significant reductions in measured nipple lesion area (p<0.001) were observed for both the experimental and control groups with an increase in the number of treatment sessions. A significant difference between the experimental and control groups was observed for the healing of nipple lesions (p<0.001). The pain intensity was significantly reduced only in the experimental group (p<0.001). CONCLUSIONS: Preliminary results demonstrated the prototype apparatus for LED phototherapy to be an effective tool in accelerating the healing of nipple trauma.

Asunto(s)

Enfermedades de la Mama/radioterapia , Lactancia Materna/efectos adversos , Dermatitis/radioterapia , Terapia por Luz de Baja Intensidad/métodos , Pezones/lesiones , Cicatrización de Heridas , Administración Tópica , Adulto , Enfermedades de la Mama/etiología , Enfermedades de la Mama/fisiopatología , Dermatitis/etiología , Dermatitis/fisiopatología , Fármacos Dermatológicos/uso terapéutico , Método Doble Ciego , Femenino , Humanos , Pezones/fisiopatología , Dimensión del Dolor , Proyectos Piloto , Medición de Riesgo , Índice de Severidad de la Enfermedad , Cuidados de la Piel/métodos , Estadísticas no Paramétricas , Cicatrización de Heridas/fisiología , Adulto Joven

RESUMEN

OBJECTIVES: To evaluate the use of an electromechanical device, comprising an exoskeleton, a static orthosis, and a glove, for functional rehabilitation of the elbow and hand in patients with hemiparesis, and to compare it with physical therapy rehabilitation. DESIGN: Pretest-posttest design. SETTING: Rehabilitation laboratory. PARTICIPANTS: Volunteer sample of persons (N=12) with persistent hemiparesis from a single, unilateral stroke within the past 3 to 36 months. INTERVENTIONS: The volunteers were randomly divided into 2 groups. One group was treated with a conventional program of physiotherapy, and another group participated in a training program in which an electromechanical orthosis was used. All volunteers received 24 sessions, held 3 times a week for 8 weeks. MAIN OUTCOME MEASURES: Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), and electromyogram (EMG) amplitude. RESULTS: No statistical difference was found in the initial and final values of the MAS. Both groups showed a significant increase for the total scores of the FMA. However, only the group treated with the orthosis showed an increase in FMA scores related to the wrist and hand joint. The EMG analysis showed increased EMG amplitudes for all muscles in the group treated with the orthosis, whereas the group treated with physiotherapy showed gains in electromyographic activity only in the extensor digitorum communis. Intergroup comparison showed that the initial FMA scores of the wrist/hand were higher in the group treated with physiotherapy. However, after training, the scores in the group that used the orthosis were equivalent to those of the physiotherapy group. CONCLUSIONS: The results suggest that this device can be an auxiliary tool to help the conventional rehabilitation program of motor function of the affected upper extremity.

Asunto(s)

Brazo , Aparatos Ortopédicos , Paresia/rehabilitación , Modalidades de Fisioterapia/instrumentación , Rehabilitación de Accidente Cerebrovascular , Adulto , Anciano , Enfermedad Crónica , Codo , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Paresia/etiología , Accidente Cerebrovascular/complicaciones , Muñeca

RESUMEN

Cryptococus gattii is an emergent primary human pathogen that causes meningismus, papilledema, high intracranial pressure and focal involvement of the central nervous system in immunocompetent hosts. Prolonged antifungal therapy is the conventional treatment, but it is highly toxic, selects for resistant strains, contributes to therapy failure and has a poor prognosis. Photodynamic inactivation (PDI) offers a promising possibility for the alternative treatment of cryptococcosis. The aim of this study was to test the effectiveness of toluidine blue O (TBO) and light-emitting diode (LED) against C. gattii strains with distinct susceptibility profile to antifungal drugs (amphotericin B: 0.015-1.0 µg mL(-1); itraconazole: 0.015-2 µg mL(-1); fluconazole: 4-64 µg mL(-1)). Using 25 µM (6.76 µg mL(-1)) TBO and LED energy density of 54 J cm(-2) these fungal isolates presented variable susceptibility to PDI. The production of reactive oxygen species (ROS)/peroxynitrite was determined, and the catalase and peroxidase activities were measured. After PDI, high amounts of ROS/peroxynitrite are produced and higher catalase and peroxidase activities could be correlated with a lower susceptibility of C. gattii isolates to PDI. These results indicate that PDI could be an alternative to C. gattii growth inhibition, even of isolates less susceptible to classical antifungal drugs, also pointing to mechanisms related to their variable susceptibility behavior.

Asunto(s)

Cryptococcus gattii/efectos de la radiación , Antifúngicos/uso terapéutico , Criptococosis/radioterapia , Humanos , Fotoquimioterapia , Trastornos por Fotosensibilidad , Cloruro de Tolonio/uso terapéutico

RESUMEN

Introdução: A síndrome da dor femoropatelar (SDFP) é caracterizada por uma dor difusa na região retopatelar. A SDFP tem maior prevalência em mulheres jovens e sua etiologia não é totalmente conhecida. Objetivo: O objetivo desse trabalho foi comparar a porcentagem de disparo inicial (PDI) dos músculos vasto medial oblíquo (VMO) e vasto lateral longo (VLL) de mulheres saudáveis com disfunção femoropatelar (SDFP) ao sentar e levantar de um banco, calçando sapatos de salto alto, tênis e descalças. Métodos: Vinte mulheres foram divididas em dois grupos: controle e SDFP. O início da atividade EMG dos músculos VMO e VLL foi registrada durante a realização das tarefas, executadas com diferentes calçados. Para a comparação das PDIs foi utilizado o teste Qui-quadrado com p<0,05. Resultados: Verificou-se que o uso do tênis e do salto alto proporcionaram aumento da PDI no grupo controle. No entanto, nenhuma diferença foi observada no grupo SDFP. Conclusão: Os resultados sugerem que os indivíduos com SDFP não apresentam respostas adaptativas ao uso de diferentes calçados.

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Introduction: Patellofemoral pain syndrome (PPS) is characterized by diffuse pain in the retropatellar region. The PPS has a higher prevalence in young women and its aetiology is not fully understood. Objective: The aim of this study was to compare the percentage of onset (%) of the vastus medialis oblique (VMO) and vastus lateralis longus (VLL) of healthy women and with patellofemoral pain syndrome (PPS) during sitting and standing tasks, wearing hig heeled shoes, tennis shoes and barefoot. Methods: Twenty women were divided into two groups: control group and PPS. The onset of EMG activity of VMO and VLL muscles was recorded during the tasks, using different shoes. To compare the percentage of onset was used chi-square test with p <0.05. Results: It was found that the use of high-heeled and tennis shoes promote increased the PDI in the control group. However, no difference was observed in the PPS group. Conclusion: The results suggest that individuals with PPS do not present adaptive responses to the use of different shoes.

Asunto(s)

Humanos , Femenino , Adolescente , Adulto , Adulto Joven , Zapatos , Síndrome de Dolor Patelofemoral/complicaciones , Electromiografía , Rodilla