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OBJECTIVE: The aim of this study was to evaluate the impact of High Voltage Pulsed Current (HVPC) on the integration of total skin grafts in rats submitted to nicotine action. MATERIALS AND METHODS: For this purpose, 60 adult Wistar rats randomly distributed in 6 groups of 10 animals were analyzed. The electrical stimulation (anodic and cathodic stimulation, motor level, 30 min at 10 Hz; minimum voltage 20 µs and 100 µs pulse interval) was applied for seven days, starting on the third day after surgery and after the dressing was removed from the graft. RESULTS: Anodic HVPC promoted greater graft integration, demonstrating a lower percentage of tissue contraction, a lower number of inflammatory infiltrates and a greater amount of vascular endothelial growth factor (VEGF), as well as a higher number of newly formed blood vessels. CONCLUSIONS: HVPC can positively influence the integration of skin grafts in nicotine-treated rats. anodic HVPC is shown to promote greater integration in relation to a lower percentage of tissue contraction, a lower number of inflammatory infiltrates and a greater amount of vascular endothelial growth factor and newformed blood vessels. Whereas, the cathodic polarity has presented smaller amount of tissue gap.

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Electrical stimulation is widely used for pelvic floor muscle dysfunctions (PFMDs), but studies are not always clear about the parameters used, jeopardizing their reproduction. As such, this study aimed to be a reference for researchers and clinicians when using electrical stimulation for PFMD. This report was designed by experts on electrophysical agents and PFMD who determined all basic parameters that should be described. The terms were selected from the Medical Subject Headings database of controlled vocabulary. An extensive process of systematic searching of databases was performed, after which experts met and discussed on the main findings, and a consensus was achieved. Electrical stimulation parameters were described, including the physiological meaning and clinical relevance of each parameter. Also, a description of patient and electrode positioning was added. A consensus-based guideline on how to report electrical stimulation parameters for PFMD treatment was developed to help both clinicians and researchers.

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OBJECTIVE: In recent years, a number of new somatic (non-pharmacological treatments) have been developed for the treatment of major depression and other neuropsychiatric disorders. Among these, one of the most promising is transcranial direct current stimulation. METHOD: For the present literature review we searched the PubMed between January 1985 and February 2009. To be included, articles should have been published in English and should address general principles of transcranial direct current stimulation and its use in major depression. DISCUSSION: Current protocols for the treatment of major depression with transcranial direct current stimulation usually involve the application of two sponge-electrodes in the scalp. In general, the positive electrode is applied in the region above the left dorsolateral prefrontal cortex (i.e., F3 region of the 10/20 International System for EEG) and the negative electrode is applied in the region above the right supra-orbital area. A direct electrical current of 1-2 mA is then applied between the electrodes for about 20 minutes, with sessions being daily performed for one to two weeks. Initial studies (including a randomized, double-blind, placebo-controlled clinical trial) showed that transcranial direct current stimulation is effective for the treatment of non-complicated major depression and that this technique, when used in depressed patients, is associated with improvement in cognitive performance (including working memory). Finally, transcranial direct current stimulation is safe and well tolerated. CONCLUSION: Recent studies show that transcranial direct current stimulation is an important neuromodulatory method that may be useful for the treatment of depressed patients. However, further studies are needed to better clarify its precise role in the management of depressive disorders.

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OBJETIVO: Nos últimos anos, uma série de novos tratamentos somáticos não-farmacológicos vem sendo desenvolvida para o tratamento da depressão maior e de outros transtornos neuropsiquiátricos. Dentre esses, um dos mais promissores é a estimulação transcraniana por corrente direta. MÉTODO: Para a presente revisão da literatura consultou-se o PubMed entre janeiro de 1985 e fevereiro de 2009. Os artigos deveriam ser publicados em língua inglesa e deveriam abordar princípios gerais da estimulação transcraniana por corrente direta e sua utilização na depressão maior. DISCUSSÃO: Os protocolos atuais de estimulação transcraniana por corrente direta para o tratamento da depressão maior envolvem a aplicação de dois eletrodos-esponja no escalpo. Em geral, o eletrodo positivo é aplicado na região sobrejacente ao córtex pré-frontal dorsolateral esquerdo (região F3 do Sistema Internacional 10/20 para eletroencefalograma) e o eletrodo negativo é aplicado na região sobrejacente à área supra-orbital direita. Uma corrente elétrica direta de 1-2 mA é então aplicada entre os dois eletrodos por cerca 20 minutos, sendo as sessões de estimulação transcraniana por corrente direta realizadas diariamente durante uma a duas semanas. Estudos iniciais (incluindo um ensaio clínico randomizado, duplo-cego e controlado por placebo) demonstraram que a estimulação transcraniana por corrente direta é efetiva no tratamento da depressão maior não-complicada e que essa técnica, quando utilizada em pacientes deprimidos, está associada com melhoras na performance cognitiva (incluindo na memória de trabalho). Por fim, a estimulação transcraniana por corrente direta é segura e bem tolerada. CONCLUSÃO: Investigações recentes demonstram que a estimulação transcraniana por corrente direta é um importante método neuromodulatório que pode ser útil no tratamento de pacientes deprimidos. Contudo, novos estudos são necessários para esclarecer seu real papel no manejo dos transtornos depressivos.

OBJECTIVE: In recent years, a number of new somatic (non-pharmacological treatments) have been developed for the treatment of major depression and other neuropsychiatric disorders. Among these, one of the most promising is transcranial direct current stimulation. Method: For the present literature review we searched the PubMed between January 1985 and February 2009. To be included, articles should have been published in English and should address general principles of transcranial direct current stimulation and its use in major depression. DISCUSSION: Current protocols for the treatment of major depression with transcranial direct current stimulation usually involve the application of two sponge-electrodes in the scalp. In general, the positive electrode is applied in the region above the left dorsolateral prefrontal cortex (i.e., F3 region of the 10/20 International System for EEG) and the negative electrode is applied in the region above the right supra-orbital area. A direct electrical current of 1-2 mA is then applied between the electrodes for about 20 minutes, with sessions being daily performed for one to two weeks. Initial studies (including a randomized, double-blind, placebo-controlled clinical trial) showed that transcranial direct current stimulation is effective for the treatment of non-complicated major depression and that this technique, when used in depressed patients, is associated with improvement in cognitive performance (including working memory). Finally, transcranial direct current stimulation is safe and well tolerated. CONCLUSION: Recent studies show that transcranial direct current stimulation is an important neuromodulatory method that may be useful for the treatment of depressed patients. However, further studies are needed to better clarify its precise role in the management of depressive disorders.

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A piezocirurgia possui características terapêuticas nas osteotomias, como cortes extremamente precisos, seletivos e milimétricos e campo cirúrgico claro. A piezoeletricidade utiliza frequências ultrassônicas que fazem vibrar pontas especialmente desenhadas para osteotomia. As pontas do instrumento oscilam, permitindo uma osteotomia efetiva, com mínima ou nenhuma injúria aos tecidos moles adjacentes, membranas e tecidos nervosos. Esse artigo apresenta as várias aplicações da piezeletricidade em cirurgia oral implantológica como: a remoção de osso autógeno; janela óssea durante a elevação da membrana sinusal e remoção de implantes fraturados. O efeito cavitacional promovido pela vibração da ponta e o spray de soro fisiológico, proporcionaram um campo livre de sangramento e de fácil visualização. O estudo mostrou que a cirurgia piezelétrica é um novo procedimento cirúrgico que apresenta vantagens para cortes ósseos em múltiplas situações em implantodontia, com grandes vantagens em comparação com instrumentações convencionais. O tempo operatório apresentou-se maior em relação às fresas convencionais.

Pizosurgery has therapeutic characteristics in osteotomies, such as extremely precise, selective and millimetric cuts and a clear operating. Piezoelectricity uses ultrasonic frequencies, which cause the points specially designed for osteotomy to vibrate. The points of the instrument oscillate, allowing effective osteotomy with minimal or no injury to the adjacent soft tissues, membranes and nerve tissues. This article presents the various applications of piezoelectricity in oral implant surgery such as: removal of autogenous bone; bone window during elevation of thesinus membrane and removal of fractured implants. The cavitational effect caused by the vibration of the point and the spray of physiological solution, provided a free of bleeding and easy to visualize. The study showed that the piezoelectric surgery is a new surgical procedure that presents advantages for bone cutting in many situations in implant dentistry, with great advantages in comparison with conventional instrumentation. Operating time is longer when compared with that of conventional cutters.

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PURPOSE: To compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence. PATIENTS AND METHODS: One hundred eighteen subjects were randomly selected to receive pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response. RESULTS: In the objective evaluation, we observed a statistically significant reduction in the pad test (p=0.003), in the number of stress urinary episodes (p<0.001), and a significant improvement in the quality of life (p<0.001) in subjects who used pelvic floor exercises, electrical stimulation, and vaginal cones compared to the control group. No significant difference was found between groups in the urodynamic parameters. In the subjective evaluation, 58%, 55%, and 54% of women who had used pelvic floor exercises, electrical stimulation, and vaginal cones, respectively, reported being satisfied after treatment. In the control group, only 21% patients were satisfied with the treatment. CONCLUSION: Based on this study, pelvic floor exercises, electrical stimulation, and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence.

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PURPOSE: To compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence. PATIENTS AND METHODS: One hundred eighteen subjects were randomly selected to recieve pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response. RESULTS: In the objective evaluation, we observed a statistically significant reduction in the pad test (p=0.003), in the number of stress urinary episodes (p<0.001), and a significant improvement in the quality of life (p<0.001) in subjects who used pelvic floor exercises, electrical stimulation, and vaginal cones compared to the control group. No significant difference was found between groups in the urodynamic parameters. In the subjective evaluation, 58 percent, 55 percent, and 54 percent of women who had used pelvic floor exercises, electrical stimulation, and vaginal cones, respectively, reported being satisfied after treatment. In the control group, only 21 percent patients were satisfied with the treatment. CONCLUSION: Based on this study, pelvic floor exercises, electrical stimulation, and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence.

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A ação de agentes físicos como o laser, o ultra-som pulsado e campos elétrico e eletromagnético (todos de baixa intensidade) no tecido ósseo tem sido muito estudada, revelando que estes são capazes de estimular a osteogênese, acelerar a consolidação de fraturas e aumentar a massa óssea. O uso destas modalidades terapêuticas foi primeiramente baseado na descoberta de que o tecido ósseo é um material piezoelétrico, isto é, que quando deformado torna-se capaz de gerar uma polarização e transformar energia mecânica em elétrica, o que ampliou as possibilidades terapêuticas sobre este tecido. O presente trabalho tem por objetivo apresentar as evidências dos efeitos fisiológicos e discorrer sobre os mecanismos de ação destes agentes físicos sobre o metabolismo ósseo, com base em artigos publicados na literatura científica internacional.

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The action of physical agents such as low level laser therapy, low-intensity pulsed ultrasound and electrical and electromagnetic fields on bone have been often studied, showing that they are able to promote osteogenesis, accelerate fracture consolidation and augment bone mass. The use of these therapeutic modalities was first based on the finding that bone is a piezoelectric material, that means it can generate polarization when deformed, transforming mechanical energy into electric energy, and this has widen therapeutic possibilities to bony tissue. The present work aims to present evidences of physiologic effects and mechanisms of action of these physical agents on bone metabolism, based on articles published in international scientific literature.

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Fueron estudiados cinco pacientes con disfunción diafragmática uni o bilateral, cuatro de ellos sometidos a cirugía cardíaca con circulación extracorpórea y uno con secuelas de poliomielitis. Se realizó un programa de trabajo durante cuarenta y ocho horas, utilizando EDET (Estimulación Diafragmática Eléctrica Transcutánea), con una duración no mayor de quince minutos por sesión terapeútica. Se corroboró la efectividad del mismo a través de la expresión numérica de los siguientes parámetros estudiados: FVC (Capacidad Vital Forzado), PIF (Presión Inspiratoria Forzada), MVV (Ventilación Voluntaria Máxima), TLC (Total Lung Capacity), FEV (Volumen Espiratorio Forzado en segundo), TV/f pre y posterapia respiratoria. Fueron medidos y expresados en porcentajes con relación al teórico de cada paciente con una P=0,05, obteniéndose resultados favorables en todos los parámetros estudiados: FVC> de 100 por ciento; MVV> de 103,36 por ciento; TLC > de 29,90 por ciento; FEV > de 53,45 por ciento. A su vez, el índice TV/f: 33) significativos al :Best-Side". Se concluye diciendo que la EDET es una técnica terapeútica de fácil realización, segura e indolora. Por otra parte, es un método reproducible para mejorar la contractilidad diafragmática y evitar la fatiga muscular común en las patologías estudiadas (AU)

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Fueron estudiados cinco pacientes con disfunción diafragmática uni o bilateral, cuatro de ellos sometidos a cirugía cardíaca con circulación extracorpórea y uno con secuelas de poliomielitis. Se realizó un programa de trabajo durante cuarenta y ocho horas, utilizando EDET (Estimulación Diafragmática Eléctrica Transcutánea), con una duración no mayor de quince minutos por sesión terapeútica. Se corroboró la efectividad del mismo a través de la expresión numérica de los siguientes parámetros estudiados: FVC (Capacidad Vital Forzado), PIF (Presión Inspiratoria Forzada), MVV (Ventilación Voluntaria Máxima), TLC (Total Lung Capacity), FEV (Volumen Espiratorio Forzado en segundo), TV/f pre y posterapia respiratoria. Fueron medidos y expresados en porcentajes con relación al teórico de cada paciente con una P=0,05, obteniéndose resultados favorables en todos los parámetros estudiados: FVC> de 100 por ciento; MVV> de 103,36 por ciento; TLC > de 29,90 por ciento; FEV > de 53,45 por ciento. A su vez, el índice TV/f: 33) significativos al :Best-Side". Se concluye diciendo que la EDET es una técnica terapeútica de fácil realización, segura e indolora. Por otra parte, es un método reproducible para mejorar la contractilidad diafragmática y evitar la fatiga muscular común en las patologías estudiadas

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