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Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique that induces action potentials in the stimulated cortical area and has been approved by the Food and Drug Administration (FDA) for the treatment of major depressive disorder (MDD). The prevalence of MDD in Mexico almost tripled after the COVID-19 pandemic. In this study, we evaluated the safety and therapeutic effects of low-intensity TMS (Li-TMS) - characterized by inducing electric currents below the action potential threshold on the cerebral cortex - in 41 subjects diagnosed with treatment-resistant depression (TRD). A Li-TMS device dispensed repetitive magnetic pulses at 30 mT for 60 minutes during 20 sessions (once daily from Monday to Saturday) with the theta burst pattern. Our results suggest that Li-TMS is a safe therapy with antidepressant effects, demonstrated by the decrease in Beck Depression Inventory (BDI) scores and lessening of depressive symptoms.

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Second-degree burns require greater care, as the damage is more extensive and worrisome and the use of a biomaterial can help in the cell repair process, with better planning, low cost, and better accessibility. Arnica has anti-inflammatory and analgesic properties in skin lesions treatments and laser therapy is another therapeutic alternative for burns. Evaluate the effects of arnica incorporated into PVA associated or not with low intensity laser on burns in rats. PVA and PVA with arnica (PVA+A) were obtained and characterized physicochemically. Through in vivo studies, the effects of PVA and PVA+A with or without the application of laser on the lesions allowed histological and immunohistochemical analyzes. PVA+A was biocompatible and with sustained release of the active, being a promising pharmacological tool and confirmed that laser therapy was effective in accelerating the healing process, due to its potential biomodulator, improving inflammatory aspects, promoting rapid healing in skin lesions.

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ABSTRACT BACKGROUND AND OBJECTIVES: Low back pain is among the most disabling conditions worldwide, and among the epigenetic factors, methylation in CpG islands of gene promoter regions can modulate gene expression, potentially correlating with the development of the disease and providing insights into the choice of treatment. The objective of this study was to assess the efficacy of therapy using modified ILIB related to DNA methylation processes in low back pain. Secondary objectives of this study included investigating pain intensity, gender, sociodemographic data, and physical-functional profile. METHODS: This prospective study was conducted in a municipality in the southern region of Brazil. The sample consisted of 30 participants of both genders, with an average age of 41.77 years. The following aspects were analyzed: anthropometric characteristics, global methylation using the ELISA method, pain level, physical activity level, functional disabilities, and hesitancy level related to work and physical activity-related activities. RESULTS: A statistically significant association was observed between methylation levels before and after treatment application for the experimental and placebo groups (p < 0.005), demonstrating a mean responsiveness between methylation and treatment (d = 0.5). However, there were no other statistically significant associations correlated with the other work variables. CONCLUSION: The results obtained in this study suggest the need for further research related to the identification of specific genes in methylation, as well as the standardization of dosimetry used for transcutaneous ILIB laser application in the radial artery.

RESUMO JUSTIFICATIVA E OBJETIVOS: A lombalgia está entre as condições mais incapacitantes no mundo e; dentre os fatores epigenéticos, a metilação em ilhas CpG de regiões promotoras de genes pode modular a expressão gênica permitindo uma possível correlação ao desenvolvimento da doença, como também pode trazer esclarecimentos a respeito do tratamento a ser escolhido. O objetivo deste estudo foi verificar a eficácia da terapia através do uso do ILIB modificado relacionada ao processo de metilação de DNA na lombalgia. Os objetivos secundários deste estudo foram a investigação da intensidade da dor, sexo, dados sociodemográficos e perfil físico-funcional. MÉTODOS: Este estudo, desenvolvido em um município da região sul do Brasil, caracteriza-se como prospectivo. A amostra deste estudo foi composta por 30 participantes, de ambos os sexos, com idade média de 41,77 anos. Foram analisados os seguintes aspectos: características antropométricas, metilação global através do método ELISA, nível de dor, nível de atividade física, incapacidades funcionais e nível de hesitação para realizar atividades relacionada ao trabalho e atividade física. RESULTADOS: Observou-se associação estatisticamente significativa entre os níveis de metilação antes e a após aplicação do tratamento para grupo experimental e placebo (p<0,005) demostrando uma média responsividade entre as variáveis metilação e tratamento (d=0,5). No entanto, não houve nenhuma outra associação estatística correlacionada as demais variáreis do trabalho. CONCLUSÃO: Os resultados obtidos neste estudo sugerem que há necessidade mais estudos relacionados a identificação de genes específicos na metilação, além da necessidade de padronização de dosimetria utilizadas para aplicação do laser ILIB de forma transcutânea, em artéria radial.

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Introduction: Osteoradionecrosis (ORN) is a secondary complication from radiotherapy, which is difficult to manage and significantly reduces the life quality of the affected patients. Case Report: A 59-year-old female patient, diagnosed with infiltration by squamous cell carcinoma in the left cervical region, underwent adjuvant cervical-facial radiotherapy with a total dose of 66.6 Gy of radiation. Eight years after the diagnosis, the patient underwent multiple extractions and, subsequently, the installation of osseointegrated implants, evolving to extensive intraoral bone exposure associated with oral cutaneous fistula. The patient was initially exposed to photobiomodulation therapy (PBMT), with a low-power laser at wavelengths of 660 nm and 808 nm, and thereafter to antimicrobial photodynamic therapy (aPDT). After an improvement in the clinical condition and resolution of the oral cutaneous fistula, a surgical procedure with the Er: YAG laser was performed to remove the remaining necrotic bone. Once the ORN condition was completely treated, the patient's oral rehabilitation was implemented by the installation of an upper mucous-supported total prosthesis and a lower implant-supported prosthesis. Conclusion: The patient is in a clinical follow-up and has no signs of bone necrosis recurrence, suggesting that low and high-power laser treatment can be an effective therapeutic alternative to resolve this condition.

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The management of skin burns is still challenging. Among the therapeutic methods used, there are topical treatments with pharmacological and herbal agents, low-intensity therapeutic ultrasound, use of biomaterials, reconstructive techniques and photobiomodulation therapy. The aim of this study was to evaluate the effects of photobiomodulation with blue Light Emitting Diode (LED) on burn healing. Fifty Wistar rats were divided into control (CTRL) (n = 25) and blue LED (LED) (n = 25), with subgroups (n = 5) for each time of euthanasia (7, 14, 21, 28 and 32 days). Treated animals were daily irradiated (470 nm, 1W, 0.44 W/cm2, 50 J/cm2). Clinical evaluations were performed and the Wound Retraction Index (WRI) was determined. Histological sections were submitted to hematoxylin-eosin, toluidine blue and the immunohistochemical technique, with anti-α-SMA and anti-TGF-ß1 antibodies. All data were directly collected by previously calibrated evaluators in a blind manner. The values were included in a statistical program. For all statistical tests used, 5% significance level (p < 0.05) was considered. No statistically significant differences in WRI between groups were observed (p > 0.05). Re-epithelialization was higher using LED at 7 and 14 days (p < 0.05) and greater amount of inflammatory cells was observed at 7 days (p = 0.01). With LED at 21 and 32 days, greater number of mast cells were observed (p < 0.05), as well as smaller number of myofibroblasts at 14, 21, 28 and 32 days (p < 0.05) and lower percentage of TGF-ß1 positive cells in the conjunctiva at 7, 14 and 21 days (p < 0.05). Negative correlations were observed in LED between the percentage of TGF-ß1 in the epithelium and the mean number of inflammatory cells and number of myofibroblasts (p < 0.05). The results suggest that, depending on the period, blue LED can modulate the healing processes of third-degree skin burns, such as re-epithelialization, inflammatory response, mast cell concentration, myofibroblast differentiation and TGF-ß1 immunoexpression. Despite these effects, this therapy does not seem to have significant influence on the retraction of these wounds. Future studies, using different protocols, should be carried out to expand the knowledge about the photobiomodulatory mechanisms of this type of light in the healing process.

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Introdução: As úlceras de difícil cicatrização caracterizam-se como uma patologia que afeta cerca de 20 milhões de pessoas pelo mundo. A terapia fotodinâmica TFD é um método que atua nas fases da cicatrização, bioestimulando o tecido e promovendo a morte dos microorganismos Objetivo: O objetivo deste estudo foi avaliar a TFD como técnica de ação bactericida na cicatrização das úlceras de usuários de um serviço público de saúde acometidos por úlceras venosas UV. Métodos: Para avaliar a presença de bactérias nas úlceras, foi utilizado um swab stuart. Foi aplicado o medicamento à base de curcumina na úlcera e a mesma foi imediatamente ocluída com papel alumínio durante 20 minutos. Resultados: Durante todo período de coleta houve crescimento de bactérias nas úlceras. Os participantes obtiveram redução da área das úlceras, avaliadas pela quantificação do software Image J Conclusão: A TFD foi capaz de acelerar o tempo de cicatrização de úlceras venosas, ao efeito bactericida, a técnica carece ainda de mais estudos.

Introduction: Ulcers that are difficult to heal are characterized as a pathology that affects about 20 million people around the world. PDT photodynamic therapy is a method that acts in the healing phases, biostimulating the tissue and promoting the death of microorganisms affected by UV. Methods: To assess the presence of bacteria in the ulcers, a stuart swab was used. the medicine based on curcumin was applied to the ulcer and it was immediately occluded with aluminum foil for 20 minutes. Results: During the entire collection period, there was growth of bacteria in the ulcers. The participants obtained a reduction in the area of the ulcers, evaluated by the quantification of the Image J software. Conclusion: PDT was able to accelerate the healing time of venous ulcers, due to its bactericidal effect, the technique still needs further studies.

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During orthodontic treatment, diverse cytokines, enzymes, and osteolytic mediators produced within the teeth surrounding periodontal tissues determine the rate of alveolar bone remodeling and consequent teeth movement. In patients with teeth presenting reduced periodontal support, periodontal stability should be ensured during orthodontic treatment. Thus, therapies based on the application of low-intensity intermittent orthodontic forces are recommended. To determine if this kind of treatment is periodontally well tolerated, this study aimed to analyze the production of receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin (IL)-6, IL-17A, and matrix metalloproteinase (MMP)-8 in periodontal tissues of protruded anterior teeth with reduced periodontal support and undergoing orthodontic treatment. Patients with periodontitis-associated anterior teeth migration received non-surgical periodontal therapy and a specific orthodontic treatment involving controlled low-intensity intermittent orthodontic forces. Samples were collected before periodontitis treatment, after periodontitis treatment, and at 1 week to 24 months of the orthodontic treatment. During the 2 years of orthodontic treatment, no significant differences were detected in the probing depth, clinical attachment level, supragingival bacterial plaque, and bleeding on probing. In line with this, the gingival crevicular levels of RANKL, OPG, IL-6, IL-17A, and MMP-8 did not vary between the different evaluation time-points of the orthodontic treatment. When compared with the levels detected during the periodontitis, the RANKL/OPG ratio was significantly lower at all the analyzed time-points of the orthodontic treatment. In conclusion, the patient-specific orthodontic treatment based on intermittent orthodontic forces of low intensities was well tolerated by periodontally compromised teeth with pathological migration.

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Objective: This study aimed to evaluate red and amber light-emitting diode protocols for facial rejuvenation at the same light dose. Background: The demand for minimally invasive cosmetic procedures to address skin aging has grown throughout the world. In vitro red and amber photobiomodulation (PBM) has been shown to improve collagen synthesis. Meanwhile, red PBM has already been studied in clinical trials; however, a comparison of the use of different wavelengths at the same light dose to reduce periocular wrinkles has not yet been performed. Methods: This split-face, randomized clinical trial recruited 137 women (40-65 years old) presenting with skin phototypes II-IV and Glogau photoaging scale types II-IV. The individuals received 10 sessions for 4 weeks of red (660 nm) and amber (590 nm) PBM (3.8 J/cm2), one at each side of the face. The outcomes, measured before and after the treatments, were the periocular wrinkle volume measured by VisioFace® RD equipment; hydration measured by the Corneometer CM 825; skin elasticity measured by the Cutometer Dual MPA 580; and quality of life determined by adapted versions of validated questionnaires [Melasma Quality of Life Scale-Brazilian Portuguese (MelasQoL-BP) and Skindex-29]. Results: There was a significant reduction in wrinkle volume after red (31.6%) and amber (29.9%) PBM. None of the treatments improved skin hydration and viscoelasticity. Both questionnaires showed improvements in participants' quality of life. Conclusions: PBM, both at red and amber wavelengths, is an effective tool for rejuvenation, producing a 30% wrinkle volume reduction. The technique has strong potential in patients with diabetes or those presenting with keloids, conditions for which highly inflammatory rejuvenating procedures are not indicated. Clinical trial registration number: REBEC-6YFCBM.

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Fundamento entre las urgencias periodontales que requieren atención inmediata está la estomatitis aftosa recurrente, debido a las molestias o complicaciones que ocasiona al paciente. El empleo de la radiación láser de baja potencia puede resultar efectivo en el tratamiento de esta entidad. Objetivo determinar el efecto terapéutico del tratamiento con radiación láser de baja potencia en pacientes con diagnóstico de estomatitis aftosa recurrente. Métodos estudio descriptivo, transversal, realizado en el periodo mayo/2019-mayo/2021, en el servicio estomatológico del policlínico Dr. Enrique Barnet, del municipio de Lajas, provincia de Cienfuegos, que incluyó a 46 pacientes con diagnóstico de estomatitis aftosa recurrente. Se empleó el análisis de documentos, la observación y el cuestionario; además del examen bucal como método diagnóstico. Los pacientes recibieron tratamiento con radiación láser de baja potencia. Se aplicó el programa EPIDAT 3.1 para el procesamiento estadístico de los datos. Resultados predominó el sexo femenino, la edad entre 19-34 años, así como las úlceras aftosas menores. Las lesiones se localizaron principalmente en labio. El 97,83 % de los pacientes refirió remisión de la lesión al quinto día de tratamiento. Todos los pacientes tratados evolucionaron favorablemente hacia la cicatrización. Solo un paciente presentó reacciones adversas. Conclusiones los resultados permitieron constatar los beneficios terapéuticos de la terapia con láser de baja potencia en el tratamiento de la estomatitis aftosa recurrente.

Background among the periodontal emergencies that require immediate attention is the RAS, due to the inconvenience or complications that it causes to the patient. The use of low power laser radiation can be effective in the treatment of this entity. Objective to determine the therapeutic effect of treatment with low-power laser radiation in patients diagnosed with recurrent aphthous stomatitis. Methods descriptive, cross-sectional study, carried out from May/2019 to May/2021, in the Dr. Enrique Barnet polyclinic's dental service, in Lajas municipality, Cienfuegos province, which included 46 patients diagnosed with recurrent aphthous stomatitis. Document analysis, observation and questionnaire were used; in addition to the oral examination as a diagnostic method. Patients received treatment with low-power laser radiation. The EPIDAT 3.1 program was applied for the statistical data processing. Results the female sex predominated, the age between 19-34 years, as well as minor aphthous ulcers. The lesions were located mainly on the lip. 97.83% of the patients reported remission of the lesion on the fifth day of treatment. All treated patients evolved favorably towards healing. Only one patient presented adverse reactions. Conclusions the results allowed us to verify the therapeutic benefits of low power laser therapy in the treatment of recurrent aphthous stomatitis.

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Introdução: A doença periodontal, de origem infecciosa, constitui diferentes quadros clínicos de caráter multifatorial e inflamatório. A fotobiomodulação é uma técnica não invasiva que tem demonstrado ser capaz de diminuir a inflamação e proporcionar alívio da dor. Estudos também demonstraram que a adoção da fotobiomodulação adjuvante à raspagem e alisamento radicular tem sido capaz de reduzir a carga bacteriana proveniente da periodontite crônica. Objetivos: Analisar os efeitos da fotobiomodulação como terapia adjuvante à raspagem e ao alisamento radicular no tratamento da periodontite crônica publicados nos últimos cinco anos. Métodos: Trata-se de uma revisão integrativa da literatura, realizada no período de setembro a novembro de 2021, mediante a utilização dos seguintes descritores: "Periodontitis", "Photobiomodulation" e "Therapy, selecionando artigos publicados em inglês durante o período entre 2016 a 2021. Resultados: Foram identificados 47 trabalhos. Destes, foram excluídos 39 estudos que se dispersaram do tema e 2 que se encontravam indisponíveis para o acesso, resultando em 6 artigos que foram consultados integralmente. Foi consenso entre os artigos consultados que a prática da fotobiomodulação tornou-se um potencial agente terapêutico no tratamento da periodontite crônica contribuindo para a redução da contagem de periodontopatógenos e que atua de maneira coadjuvante às raspagens radiculares. Conclusão: A fotobiomodulação mostrou-se uma ferramenta promissora na área odontológica. Entretanto, a grande variedade nos parâmetros de tratamentos e protocolos utilizados na fotobiomodulação impossibilita uma comparação e uma análise mais crítica e rigorosa dos resultados obtidos nos trabalhos analisados.

Introduction: Periodontal disease, which has an infectious origin, constitutes a multifactorial and inflammatory different clinical condition of multifactorial, inflammatory, and infectious origin. Photobiomodulation is a non-invasive technique that has been shown to decrease inflammation and provide pain relief. Studies also have shown that the choosing of photobiomodulation as adjuvant therapy to scaling and root planing has been able to reduce the bacterial load from chronic periodontitis. Objectives: To analyze the effects of photobiomodulation as an adjuvant therapy to scaling and root planing in the treatment of chronic periodontitis in the studies published in the last five years. Methods: This is an integrative literature review, carried out from September to November 2021, using the following descriptors: "Periodontitis", "Photobiomodulation" and "Therapy, from selected articles published in English during the period between 2016 to 2021. Results: From the research and selection of studies to compose this integrative literature review, 47 studies were initially identified based on the descriptors. From those, 39 papers that were outside from the topic and 2 papers that were unavailable for access were excluded from the present review. Then remained, 6 articles that were fully consulted. The practice of photobiomodulation has become a potential therapeutic agent in the treatment of chronic periodontitis reducing the count of periodontopathogens and as an adjunct therapy to root scaling. Conclusion: Photobiomodulation therapy has become a promising tool in the dental field, however, the great variety in the treatment parameters and protocols used for photobiomodulation makes impossible to compare and perform a more critical and rigorous analysis of the results collected in the present work.

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O Neuroblastoma (NB) é uma neoplasia do sistema nervoso simpático, e o segundo tumor sólido maligno extracraniano mais comum da infância. Na terapia antineoplásica, complicações orais podem ser observadas, dentre elas a mucosite oral (MO). Trata-se de uma inflamação aguda da mucosa, proveniente da toxicidade dos quimioterápicos. Este relato de caso enfatiza o manejo da MO, bem como sua influência na condição sistêmica e qualidade de vida. Paciente do sexo feminino, nove anos, apresentou recidiva de NB metastático, após tratamento de primeira linha. Admitida na unidade hospitalar para tratamento oncológico na enfermaria de pediatria oncológica, queixando-se de dor intensa em cavidade bucal e orofaringe, associada a pancitopenia severa febril. Ao exame físico apresentava disfagia e déficit ponderal grave, que debilitava a deglutição da própria saliva. O exame intraoral revelou lesões de MO grau 3, segundo a Organização Mundial de Saúde (OMS), em lábios, gengiva anterior e orofaringe. O tratamento consistiu em remoção de debris local, higiene da cavidade bucal com clorexidina 0,12% e utilizando haste flexível de algodão estéril tipo "Swab", visando controle microbiano local, diariamente. Além disso, foi aplicado no leito eritematoso e hemorrágico fotobiomodulação (660 nm, 50 mW, 2 J/cm2, 90 segundos) pontualmente nas áreas do leito da lesão e em varredura na região de orofaringe (sessões intercaladas). Foi prescrito acetato de racealfatocoferol (vitamina E) para ação antioxidante e hidratação dos lábios. Concomitante a mucosite, a paciente apresentou pancitopenia febril severa, sendo necessário uso de cefepima 150 mg/kg/dia, com coleta prévia de hemoculturas, fator estimulador de colônias de granulócitos, Fluconazol, hidratação e suporte nutricional. As hemoculturas foram negativas. As consequências da mucosite contribuíram para desnutrição e piora da qualidade de vida. Conclui-se que a intervenção odontológica em interdisciplinaridade, possibilitou o restabelecimento físico e emocional, possibilitando melhor uma qualidade de vida da paciente (AU).

Neuroblastoma (NB) is a neoplasia of the sympathetic nervous system and the second most common extracranial malignant solid tumor in childhood. In antineoplastic therapy, oral complications can be observed in antineoplastic therapy, among them oral mucositis (OM). It is an acute mucosa inflammation resulting from the toxicity of chemotherapy drugs. This case report emphasizes the management of OM and its influence on the systemic condition and quality of life. A female patient, nine years old, presented a recurrence of metastatic NB after first-line treatment. She was admitted to the hospital unit for oncological therapy in the pediatric oncology ward, complaining of severe pain in the oral cavity and oropharynx associated with severe febrile pancytopenia. On physical examination, she presented dysphagia and severe weight deficit, which weakened the swallowing of her saliva. According to the World Health Organization (WHO), the intraoral exam revealed third-grade OM lesions on the lips, anterior gum, and oropharynx. Treatment consisted of removing local debris, cleaning the oral cavity with 0.12% chlorhexidine, and using a flexible, sterile cotton swab, aiming for daily local microbial control. In addition, photobiomodulation (660 nm, 50 mW, 2 J/cm2, 90 seconds) was applied to the erythematous and hemorrhagic bed, punctually in the areas of the lesion and sweeps in the oropharynx region (interspersed sessions). Racealphatocopherol acetate (vitamin E) was prescribed for antioxidant action and lip hydration. Concomitant with mucositis, the patient had severe febrile pancytopenia, requiring cefepime 150 mg/kg/day, with previous collection of blood cultures, granulocyte colony-stimulating factor, fluconazole, hydration, and nutritional support. Blood cultures were negative. The consequences of mucositis contributed to malnutrition and worsened quality of life. It is concluded that the interdisciplinary dental intervention enabled physical and emotional restoration, enabling a better quality of life for the patient (AU).

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El apiñamiento dental es una maloclusión frecuen-te y junto con los requerimientos de estética dental son una causa habitual de la solicitud de tratamien-to ortodóncico. El tiempo que demanda y las moles-tias que pudiera ocasionar el tratamiento produce inquietud en los pacientes y un esfuerzo de los or-todoncistas para optimizar el tiempo y prevenir los efectos adversos. Los tratamientos odontológicos multidisciplinarios permiten una mejor respuesta estética, funcional y de estabilidad post tratamiento. El tiempo de alineación dentaria y finalización, en los pacientes tratados con láser de baja intensidad po-dría mejorar tanto los índices gingivales como la res-puesta al dolor. Adicionalmente, las corticales óseas de los pacientes con ortodoncia tratados con láser, podrían verse menos afectadas en comparación con las de los pacientes no tratados. Se presenta un caso de fotobioestimulación con láser de baja intensidad aplicado en un paciente en fase de alineación, que forma parte de un estudio prospectivo aleatorizado que se desarrolla en la FOUBA y fue aprobado por el comité de Ética de la institución. El paciente aceptó y firmó el consentimiento informado. Finalizada la etapa de alineación, se evaluó la efectividad de la te-rapia con láser de baja intensidad actualmente de-nominada fotobiomodulación en incisivos superiores en la fase de alineación para acelerar el movimiento dentario, la respuesta gingival, el dolor, el estado de la cortical alveolar vestibular y la estética del perfil (AU)

Dental crowding, which is a frequent malocclusion, and dental aesthetic requirements are a common cause for requesting orthodontic treatment. The time that the treatment requires and the inconvenience that it could cause worries the patient and makes orthodontists strive to optimize time and prevent adverse effects. Multidisciplinary treatments would allow a better aesthetic, functional and post-treatment stability response. The dental alignment and completion time in patients treated with low-intensity laser could improve both gingival indices and response to pain. Additionally, the bone cortical of orthodontic patients treated with laser could be less affected compared to those of untreated patients. A case of low-intensity laser photobiostimulation applied to a patient in the alignment phase is presented, which is part of a prospective randomized study carried out at FOUBA and was approved by the institution's Ethics Committee. The patient accepted and signed the informed consent. After the alignment phase, the effectiveness of low-level laser therapy actually called photobiomodulation in upper incisors in the alignment phase is evaluated to accelerate tooth movement; the gingival response; the pain; the vestibular alveolar cortical and the aesthetics of the profile (AU)

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Se presenta el caso clínico de una paciente con alte-ración de la sensibilidad, consecuente a la extracción de un tercer molar inferior retenido bajo el contexto de urgencia, resultando en la injuria del nervio denta-rio inferior. La cirugía fue realizada en el Servicio de Urgencias Odontológicas y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), en respuesta a la sintomatolo-gía dolorosa que venía presentando la paciente desde hacía tiempo, motivo por el cual concurre a la consul-ta. En este trabajo se exponen los parámetros utiliza-dos, las etapas evolutivas y los resultados obtenidos luego de un tratamiento con láser de diodo de baja intensidad, efectuado con equipamiento Woodpecker LX 16 Plus, realizado en el área de Unidad Láser de la Cátedra de Endodoncia de la FOUBA. El tratamiento fue aceptado por la paciente quien firmó el consen-timiento informado correspondiente. Se observó una pronta y favorable recuperación ante las aplicacio-nes de fotobiomodulación láser. En la sexta sesión, se pudo determinar que la recuperación sensitiva había sido completa. Asimismo, en este trabajo se hace mención a ciertos factores preventivos prequirúr-gicos a tener en cuenta para minimizar los riesgos de lesión nerviosa ante situaciones similares, tales como forma y posición de la pieza dentaria en la man-díbula, la importancia de los estudios imagenológicos como la tomografía computarizada de haz cónico (CBCT) y la técnica quirúrgica (AU)

A clinic case of a patient with alteration of sensitivity is presented, following an emergency extraction of a retained lower third molar, which resulted in the injury of the lower dental nerve. The surgery was performed at the Dental Emergency and Patient Orientation Service of the Faculty of Dentistry, University of Buenos Aires (FOUBA), in response to the painful symptomatology that the patient had been presenting for some time, reason for which the patient arrived to the clinic. This report presents the parameters used, the evolutionary stages and the results obtained after a treatment with low intensity diode laser, performed with Woodpecker LX 16 Plus equipment, carried out in the Laser Unit area of the Chair of Endodontics, FOUBA. The treatment was performed with the permission of the patient, who signed the corresponding informed consent. A prompt and favorable recovery was observed after photobiomodulatory applications. Completion of sensory recovery was determined during the six sessions. Furthermore, this work describes certain pre-surgical preventive factors to take into account to minimize the risks of nerve injury in similar situations, such as the shape and position of the tooth in the jaw, the importance of imaging studies such as cone beam computed tomography (CBCT) and the surgical technique (AU)

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ABSTRACT Objective: The aim of this study was to evaluate the volumetric root resorption in maxillary incisors following clear aligner therapy (CAT) with low-intensity pulsed ultrasound (LIPUS), and compare the results to CAT alone. Material and Methods: This retrospective study evaluated pretreatment (T0) and post-treatment (T1) cone-beam computed tomography imaging of 42 adult patients. Twenty-one patients (14 females, 7 males, mean age= 38.1±12.96 years) were treated using CAT with LIPUS device, whereas the other twenty-one matching controls patients (15 females, 6 males, mean age= 35.6±11.7 years) were treated using CAT alone. Images were analyzed and a segmentation protocol was applied on the maxillary incisors. Each segmented tooth volume was exported as a surface mesh in the Visualization Toolkit (VTK) file format. The VTK files for all maxillary incisors were coded and corresponding teeth volumes from T0 and T1 were superimposed. Clipping the crown of each tooth was done, then measurements of root volumes and differences between groups were performed. Changes in root volumes were assessed (p<0.05). Results: Root loss was evident in all teeth in both groups, but was significantly increased in all maxillary incisors of the control group (p<0.001) and in upper left central incisor of LIPUS group (p=0.009). When both groups were compared, there was statistically significant minimal volumetric root loss in LIPUS group (3.50-7.32 mm3), when compared to control group (11.48-12.95 mm3) (p<0.05). Conclusion: LIPUS group showed less volumetric root resorption compared to control group during the studied treatment time using clear aligners.

RESUMO Objetivo: O objetivo deste estudo foi avaliar volumetricamente a reabsorção radicular em incisivos superiores após tratamento com alinhadores transparentes (CAT) com e sem uso adjuvante de ultrassom de baixa intensidade (LIPUS). Material e Métodos: Esse estudo retrospectivo avaliou imagens de tomografia computadorizada de feixe cônico pré-tratamento (T0) e pós-tratamento (T1) de 42 pacientes adultos: 21 pacientes (14 mulheres, 7 homens, idade média= 38,1±12,96 anos) foram tratados com CAT e LIPUS, enquanto os outros 21 pacientes controles correspondentes (15 mulheres, 6 homens, idade média= 35,6±11,7 anos) foram tratados apenas com CAT. As imagens foram analisadas e foi aplicado um protocolo de segmentação dos incisivos superiores. Os volumes de cada dente segmentado foram exportados como malhas de superfície, em arquivos no formato Visualization Toolkit (VTK). Os arquivos VTK de todos os incisivos superiores foram codificados e foram sobrepostos os volumes dos dentes correspondentes a T0 e T1. Foi realizada a clipagem da coroa de cada dente e, em seguida, foram realizadas medições dos volumes radiculares e comparadas as diferenças entre os grupos, avaliando-se as alterações nos volumes de raízes (p<0,05). Resultados: A perda radicular foi evidente em todos os dentes em ambos os grupos, mas foi significativamente maior em todos os incisivos superiores do grupo controle (p<0,001) e no incisivo central superior esquerdo do grupo LIPUS (p=0,009). Quando ambos os grupos foram comparados, houve perda volumétrica mínima estatisticamente significativa no grupo LIPUS (3,50-7,32 mm3), em comparação ao grupo controle (11,48-12,95 mm3) (p<0,05). Conclusão: O grupo LIPUS apresentou menor volume de reabsorção radicular, em comparação ao grupo controle, durante o tempo de tratamento estudado usando alinhadores transparentes.

RESUMO

Objetivo: Estudo quase experimental aprovado pelo Comitê de Ética em Pesquisas com Seres Humanos ­ COPEP da Universidade Estadual de Maringá, sob Parecer nº. 5.262.784, cujo objetivo foi avaliar a segurança e eficácia da laseracupuntura como uma abordagem terapêutica complementar no tratamento da fadiga e capacidade pulmonar em pacientes pós-COVID. Materiais e método: Nos meses de fevereiro e maço de 2023, no ambulatório de enfermagem da Universidade Estadual do Paraná, Campus de Paranavaí, foram recrutados 23 pacientes da comunidade acadêmica (discentes, docentes e agentes universitários) da própria universidade, com idade mediana de 24 anos (IQR = 22,0, 32,0), com diagnóstico prévio de COVID-19 e que apresentavam sintomas de fadiga e queixa de desconforto respiratório por pelo menos quatro semanas após a recuperação da fase aguda da doença. Dados demográficos, socioeconômicos e de estado de saúde geral e relacionados à COVID-19 foram coletados. Os pacientes foram tratados com duas sessões semanais de laseracupuntura por um período de cinco semanas. Para identificação da presença e intensidade da fadiga, foi aplicada a Escala de Fadiga de Piper Revisada com 23 itens e dividida em três dimensões, no início e final do tratamento e realizados testes de função pulmonar por espirometria para descrição do padrão ventilatório dos voluntários, em todas as sessões. Resultados: Participaram 23 voluntários com idade mediana de 24 anos (IQR, 22-32) e predominantemente do sexo feminino (N= 15 [65%]) e da cor branca (N = 13 [56,4%]). A maioria dos voluntários tinha sobrepeso ou obesidade (N = 16 [79,6%]). Após a fase aguda da COVID-19, os sintomas mais relatados foram ansiedade (65%), queda de cabelo (35%) e dor de cabeça (30%). Todos os participantes apresentaram fadiga intensa pós-COVID (6,36 [IQR = 6,00 ­ 7,73]). Os resultados do estudo mostraram que o tratamento com a laseracupuntura resultou em redução significativa nas pontuações da escala de fadiga quanto à Dimensão comportamental (Diferença média [DM] = -1,65; IC 95%; 0,56-2,75; p < 0,001) Dimensão afetiva (DM = -2,43; IC 95%; 1,33-3,52; p < 0,001) e Dimensão sensorial (DM= -2,85; IC 95%; 2,08-3,63; p < 0,001), além do total geral de fadiga (-2,44; IC 95%; 1,63-3,24; p < 0,001), mas não apresentou qualquer efeito nas medidas de função pulmonar como Capacidade Vital Forçada (DM = -0,87; IC 95%; -4,24, 5,98); p = 0,727), manobra básica avaliada em espirometria e relação entre Volume expiratório forçado em 1 segundo (VEF1) e Capacidade vital forçada (CVF), o VEF1/CVF (DM = -1,00; IC 95%; -10,38-8,39; p = 0,828). Nenhum efeito colateral foi relatado durante o tratamento. Conclusão: O protocolo de laseracupuntura foi seguro e bem tolerado pelos pacientes, sem efeitos colaterais relatados durante o tratamento, sugerindo que a laseracupuntura pode ser uma opção segura para o tratamento da fadiga pós-COVID-19. Apesar da intervenção não ter provocado efeito nos padrões respiratórios dos voluntários, estes verbalizaram melhora da expansibilidade e dor torácica, aumento do fôlego e disposição. Sugere-se novos estudos controlados para melhor compreensão do manejo dos sintomas pós-agudos da COVID-19.

Objective: Quasi-experimental study approved by the Ethics Committee for Research with Human Beings ­ COPEP of the State University of Maringá, Opinion nº. 5,262,784, whose objective was to evaluate the safety and efficacy of laser acupuncture as a complementary therapeutic approach in the treatment of fatigue and lung capacity in post-COVID patients. Materials and method: In February and March 2023, at the nursing clinic of the State University of Paraná, Campus Paranavaí, 23 patients were recruited from the academic community (students, professors and university agents) of the university itself, with a median age of 24 years old (IQR = 22.0, 32.0), with a previous diagnosis of COVID-19 and who had symptoms of fatigue and a complaint of respiratory distress for at least four weeks after recovery from the acute phase of the disease. Demographic, socioeconomic, and general health and COVID-19 related data were collected. The patients were treated with two laseracupuncture sessions per week for a period of five weeks. To identify the presence and intensity of fatigue, the Revised Piper Fatigue Scale was applied, with 23 items and divided into three dimensions, at the beginning and end of treatment, and pulmonary function tests were performed by spirometry to describe the ventilatory pattern of the volunteers, in all sessions. Results: Participants were 23 volunteers with a median age of 24 years (IQR, 22-32) and predominantly female (N = 15 [65%]) and Caucasian (N = 13 [56.4%]). Most volunteers were overweight or obese (N = 16 [79.6%]). After the acute phase of COVID-19, the most reported symptoms were anxiety (65%), hair loss (35%) and headache (30%). All participants experienced severe post-COVID fatigue (6.36 [IQR = 6.00 ­ 7.73]). The results of the study showed that treatment with laser acupuncture resulted in a significant reduction in scores on the fatigue scale for the Behavioral Dimension (Mean difference [MD] = -1.65; CI 95%; 0.56-2.75; p < 0.001) Affective dimension (DM = -2.43; CI 95%; 1.33-3.52; p < 0.001) and Sensory dimension (DM = -2.85; CI 95%; 2.08-3, 63; p <0.001), in addition to the fatigue grand total (-2.44; 95% CI; 1.63-3.24; p < 0.001), but had no effect on measures of lung function such as Forced Vital Capacity (MD = -0.87; 95% CI; -4.24, 5.98); p = 0.727), basic maneuver evaluated in spirometry and ratio between Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC), FEV1/FVC (DM = -1.00; CI 95%; -10.38 -8.39; p = 0.828). No side effects were reported during treatment. Conclusion: The laseracupuncture protocol was safe and well tolerated by patients, with no reported side effects during treatment, suggesting that laseracupuncture may be a safe option for treating post-COVID-19 fatigue. Although the intervention had no effect on the breathing patterns of the volunteers, they reported improvement in chest expansion and pain, increased breath and disposition. New controlled studies are suggested to better understand the management of post-acute symptoms of COVID-19.

Objetivo: Estudio casi experimental aprobado por el Comité de Ética en Investigación con Seres Humanos - COPEP de la Universidad Estatal de Maringá, con arreglo a la Opinión No. 5,262,784, cuyo objetivo fue evaluar la seguridad y eficacia de la laseracupuntura como enfoque terapéutico complementario en el tratamiento de la fatiga y la capacidad pulmonar en pacientes post-COVID. Materiales y método: En los meses de febrero y marzo de 2023, en la clínica de enfermería de la Universidad Estatal de Paraná, Campus de Paranavaí, se reclutaron 23 pacientes de la comunidad académica (estudiantes, profesores y agentes universitarios) de la propia universidad, con una edad media de 24 años (IQR = 22,0, 32,0), con diagnóstico COVID y que muestren síntomas de fatiga y una queja de molestias respiratorias durante al menos cuatro semanas después de la recuperación de la fase aguda de la enfermedad. Se han recopilado datos demográficos, socioeconómicos y de salud general relacionados con el programa COVID-19. Los pacientes fueron tratados con dos sesiones de laseracupuntura por semana durante cinco semanas. Para la identificación de la presencia y la intensidad de la fatiga, se revisó la escala de fatiga de los piper con 23 elementos y se dividió en tres dimensiones, al inicio y al final del tratamiento, y se realizaron pruebas de función pulmonar mediante espirometría para describir el patrón de ventilación de los voluntarios, en todas las sesiones. Resultados: participaron 23 voluntarios con una edad media de 24 años (RCI, 22-32) y predominantemente mujeres (N = 15 [65%]) y blancas (N = 13 [56,4%]). La mayoría de los voluntarios presentaron sobrepeso u obesidad (N = 16 [79,6%]). Después de la fase aguda de COVID-19, los síntomas notificados más frecuentemente fueron ansiedad (65%), pérdida de pelo (35%) y dolor de cabeza (30%). Todos los participantes presentaron fatiga grave post-COVID (6,36 [IQR = 6,00 - 7,73]). Los resultados del estudio mostraron que el tratamiento con laseracupuntura dio lugar a una reducción significativa de las puntuaciones de la escala de fatiga para la dimensión conductual (Diferencia media [DM] = -1,65; IC del 95%; IC del 0,56-2,75; p < 0,001) La dimensión afectiva (DM = -2,43; IC del 95%: 1; 33-3,52; p < 0,001) y dimensión sensorial (DM = -2,85; IC del 95% 2,08-3,63; p < 0,001), además de la fatiga general (-2,44; IC del 95%: 1,63-3,24; p < 0,0 01), pero no tuvo efecto sobre las medidas de función pulmonar como capacidad vital forzada (DM = -0,87; IC del 95%; -4,24,5,98); p = 0,727), maniobra basal evaluada en espirometría y relación entre el volumen respiratorio forzado 1 segundo (VEF1) y la capacidad viciosa forzada (CVF), EF1/CVF (DM = -1,00; IC del 95%; -10,38-8,39; p = 0,828). No se notificaron efectos adversos durante el tratamiento. Conclusión: El protocolo de laseracupuntura fue seguro y bien tolerado por los pacientes, sin efectos secundarios notificados durante el tratamiento, lo que sugiere que la laseracupuntura puede ser una opción segura para el tratamiento de la fatiga post-COVID-19. Aunque la intervención no tuvo efecto sobre los patrones respiratorios de los voluntarios, verbalizaron mejoría en la capacidad de expansión y dolor torácico, dificultad respiratoria y disposición. Se sugieren nuevos estudios controlados para entender mejor el manejo de los síntomas post-agudos de COVID-19.

RESUMO

A pandemia da COVID-19, provocou um grande impacto na saúde mental das pessoas, mesmo após a fase aguda da doença, resultando em altas taxas de ansiedade e depressão, tornando necessário o desenvolvimento e a avaliação de tratamentos, não farmacológicos, eficazes para aliviar esses sintomas. Este estudo quase-experimental, aberto, unicêntrico, realizado nos meses de fevereiro e março de 2023, no ambulatório de enfermagem da Universidade Estadual do Paraná, campus de Paranavaí, teve como objetivo avaliar a eficácia da Laseracupuntura, para o tratamento de ansiedade e depressão, na Síndrome Pós-COVID-19. O estudo foi aprovado pelo Comitê de Ética (Parecer nº. 5.262.784). Foram coletados dados demográficos, socioeconômicos e de estado de saúde. A presença e a intensidade de ansiedade e depressão foram verificadas no início e, ao final, do tratamento, por meio do Inventário de Ansiedade de Beck (21 itens) e Inventário de Depressão de Beck (21 itens). Ao todo, 23 voluntários receberam até 10 sessões, de um protocolo de Laseracupuntura, para tratar ansiedade e depressão pós-COVID-19. Os pontos P1, PC6, E36, E25, VC6, VC12, VC17 e Yintang, foram estimulados por luz de laser infravermelho sobre a pele. Os participantes eram predominantemente, mulheres, de raça/cor branca e tinham sobrepeso ou obesidade. Os sintomas pós-agudos da COVID-19, mais relatados, foram: ansiedade, queda de cabelo e dor de cabeça. A mediana inicial de pontuação das escalas de ansiedade e depressão foram de 23,00 (IQR, 13,50 ­ 27,50) e 22,00 (IQR, 11,50 ­ 26,50), respectivamente. A intervenção resultou em reduções significativas, nas pontuações de duas escalas: de ansiedade (DM = -9,74; IC 95%, 4,88 ­ 14,60; p < 0,001) e depressão (DM = -9,87; IC 95%; 5,53 ­ 14,21; p < 0,001). Nenhum efeito colateral foi relatado durante o tratamento. Os resultados obtidos neste estudo, sugerem que, a Laseracupuntura pode ser uma terapia eficaz e segura para tratar sintomas de ansiedade e depressão em pacientes pós-COVID-19. Além disso, o uso da laseracupuntura, tem a vantagem adicional de ser menos invasiva que a Acupuntura tradicional, tornando-a uma opção atraente para pessoas que buscam tratamentos integrativos para saúde mental, sem os riscos presentes em terapias medicamentosas tradicionais. Recomenda-se a realização de mais estudos ­ principalmente ensaios clínicos randomizados ­, para confirmar a eficácia da Laseracupuntura.

The COVID-19 pandemic has had a major impact on people's mental health even after the acute phase of the disease, resulting in high rates of anxiety and depression, making it necessary to develop and evaluate treatments, non- pharmacological, effective to alleviate these symptoms. This quasi-experimental, open- label, unicentric study, conducted in February and March 2023, at the nursing outpatient clinic at Paraná State University, Paranavaí campus, aimed to evaluate the effectiveness of Laseracupuncture, for the treatment of anxiety and depression, in Post-COVID-19 Syndrome. The study was approved by the Ethics Committee (Opinion No. 5 262 784). Demographic, socioeconomic and health status data were collected. The presence and intensity of anxiety and depression were verified at the beginning and at the end of the treatment, through the Beck Anxiety Inventory (21 items) and Beck Depression Inventory (21 items). In all, 23 volunteers received up to 10 sessions of a Laseracupuncture protocol to treat post-COVID-19 anxiety and depression. The points P1, PC6, E36, E25, VC6, VC12, VC17 and Yintang, were stimulated by infrared laser light on the skin. Participants were predominantly women of white race/color and were overweight or obese. The most reported post-acute symptoms of COVID-19 were: anxiety, hair loss, and headache. The median baseline scores for the anxiety and depression scales were 23.00 (IQR, 13.50 - 27.50) and 22.00 (IQR, 11.50 - 26.50), respectively. The intervention resulted in significant reductions in the scores of two scales: anxiety (DM = -9.74; 95% CI, 4.88 - 14.60; p < 0.001) and depression (DM = -9.87; 95% CI; 5.53 - 14.21; p < 0.001). No side effects were reported during treatment. Results obtained in this study suggest that Laseracupuncture may be an effective and safe therapy for treating symptoms of anxiety and depression in post-COVID-19 patients. In addition, the use of laseracupuncture has the additional advantage of being less invasive than traditional Acupuncture, making it an attractive option for people seeking integrative treatments for mental health, without the risks present in traditional drug therapies. Further studies - mainly randomized clinical trials - are recommended to confirm the efficacy of Laseracupuncture.

La pandemia COVID-19 ha tenido un gran impacto en la salud mental de las personas, incluso después de la fase aguda de la enfermedad, dando lugar a altas tasas de ansiedad y depresión, lo que hace necesario desarrollar y evaluar tratamientos no farmacológicos eficaces para el alivio de estos síntomas. Este estudio casi experimental, abierto y unicéntrico, realizado en los meses de febrero y marzo de 2023 en la clínica de enfermería de la Universidad Estatal de Paraná, campus Paranavaí, tuvo como objetivo evaluar la eficacia de la Laseracupuntura, para el tratamiento de la ansiedad y la depresión, en el Síndrome Post-COVID-19. El estudio fue aprobado por el Comité de Ética (Opinión No. 5 262 784) Se han reunido datos demográficos, socioeconómicos y de salud. La presencia y la intensidad de la ansiedad y la depresión se verificaron al principio y al final del tratamiento, mediante el Inventario de ansiedad Beck (21 artículos) y el Inventario de depresión Beck (21 artículos). En total, 23 voluntarios recibieron hasta 10 sesiones, de un protocolo de Laseracupuntura, para tratar la ansiedad y la depresión post- COVID-19. Los puntos P1, PC6, E36, E25, VC6, VC12, VC17 y Yintang fueron estimulados por luz láser infrarroja en la piel. Los participantes fueron predominantemente mujeres blancas/de raza y tenían sobrepeso u obesidad. Los síntomas post-agudos más frecuentemente notificados de COVID-19 fueron ansiedad, pérdida de pelo y dolor de cabeza. La mediana inicial de la puntuación de ansiedad y depresión osciló entre 23,00 (RPI, 13,50 - 27,50) y 22,00 (RI, 11,50 - 26,50), respectivamente. La intervención dio lugar a reducciones significativas en las puntuaciones de dos escalas: ansiedad (DM = -9,74; IC del 95%, 4,88 - 14,60; p < 0,001) y depresión (DM = -9,87; IC del 95%; IC del 5,53 al 14,21; p < 0,00 1. No se notificaron efectos adversos durante el tratamiento. Los resultados de este estudio sugieren que Laseracupuntura puede ser una terapia eficaz y segura para tratar los síntomas de ansiedad y depresión en pacientes post- COVID-19. Además, el uso de laseracupuntura tiene la ventaja adicional de ser menos invasiva que la acupuntura tradicional, lo que la convierte en una opción atractiva para las personas que buscan tratamiento integrador para la salud mental, sin los riesgos presentes en los medicamentos tradicionales. Se recomiendan otros estudios, principalmente ensayos clínicos aleatorizados, para confirmar la eficacia de Laseracupuntura.

RESUMO

Photobiomodulation (PBM) has ergogenic effects on aerobic and anaerobic efforts and may improve sports performance. As Brazilian jiu-jitsu (BJJ) fighting requires both aerobic and anaerobic metabolism, so PBM may be effective in increasing the physical performance of BJJ athletes. Thus, this study aimed to verify the effects of PBM with different energy doses (6 or 12 J per point) on high-intensity intermittent anaerobic performance in BJJ athletes. METHODS: Eleven male athletes performed three lower limb Wingate testing sessions. At the beginning of each session, in a randomized, crossover, double-blind fashion, the athletes received PBM with a dose of 6 J (4.5 J/cm2) or 12 J (9.1 J/cm2), or placebo (PLA) at 17 points in each lower limb. In each session, the squat jump (SJ) and three Wingate test series were performed, with a 3-minute interval between series. Heart rate (HR) was collected immediately before, after each Wingate test, and at 1, 3, and 5 minutes after the last test. The rate of perceived exertion (RPE) was reported after each Wingate test. Differences between Wingate tests and treatment sessions were set at p<0.05. RESULTS: No differences were observed between treatments in SJ height, Wingate performance, HR, and RPE (p>0.05; for all comparisons). The Wingate test session promoted a reduction in anaerobic capacity in the second and third sets in all conditions, indicating fatigue (p<0.05). CONCLUSION: Treatment with PBM did not produce a dose-dependent ergogenic response in high-intensity intermittent performance in BJJ athletes.

RESUMO

Objetivo: Relatar a experiência na elaboração e implantação do protocolo de extravasamento e infiltração de antineoplásicos em acesso venoso central. Método: estudo descritivo, tipo relato de experiência realizado de fevereiro a maio de 2021. Resultados: Após a busca de evidências na literatura, foi elaborado um fluxograma referente aos cuidados de enfermagem realizados durante e após o extravasamento/infiltração. Além das medidas iniciais padronizou-se o uso da hialuronidase tópica e da fotobiomodulação (1 a 3 joules, com potência de 100 miliwats). A área deveria ser demarcada e se possível fotografada. Após a validação do protocolo por um grupo de enfermeiros especialistas e pelo escritório de qualidade, foi implantado em um Ambulatório de Oncologia de Hospital Público do interior do Estado de São Paulo. Conclusão: Apesar de raro, o extravasamento em acesso central pode acontecer e a equipe precisa de um protocolo assistencial para padronizar a conduta e garantir o sucesso da terapêutica.(AU)

Objective: To report the experience in the elaboration and implementation of the protocol for extravasation and infiltration of anticancer drugs in central venous access. Method: descriptive study, experience report type carried out from February to May 2021. Results: After searching for evidence in the literature, a flowchart was created referring to the nursing care performed during and after the extravasation/infiltration. In addition to the initial measurements, the use of topical hyaluronidase and photobiomodulation (1 to 3 joules, with a potency of 100 milliwatts) was standardized. The area should be demarcated and, if possible, photographed. After validation of the protocol by a group of specialist nurses and by the quality office, it was implemented in an Oncology Outpatient Clinic of a Public Hospital in the interior of the State of São Paulo. Conclusion: Although rare, extravasation in central access can happen and the team needs a care protocol to standardize the conduct and ensure the success of the therapy.(AU)

Objetivo: Informar la experiencia en la elaboración e implementación del protocolo de extravasación e infiltración de fármacos antineoplásicos en acceso venoso central. Método: estudio descriptivo, tipo relato de experiencia realizado de febrero a mayo de 2021. Resultados: Después de la búsqueda de evidencias en la literatura, se elaboró un diagrama de flujo sobre los cuidados de enfermería realizados durante y después de la extravasación/infiltración. Además de las mediciones iniciales, se estandarizó el uso de hialuronidasa tópica y fotobiomodulación (1 a 3 julios, con una potencia de 100 milivatios). El área debe ser delimitada y, si es posible, fotografiada. Después de la validación del protocolo por un grupo de enfermeros especialistas y por la oficina de calidad, fue implantado en un Ambulatorio de Oncología de un Hospital Público del interior del Estado de São Paulo. Conclusión: aunque rara, la extravasación en el acceso central puede ocurrir y el equipo necesita un protocolo de atención para estandarizar la conducta y garantizar el éxito de la terapia.(AU)

Assuntos

RESUMO

Duchenne muscular dystrophy (DMD) is a muscle disease characterized by the absence of the protein dystrophin, which causes a loss of sarcolemma integrity, determining recurrent muscle injuries, decrease in muscle function, and progressive degeneration. Currently, there is a need for therapeutic treatments to improve the quality of life of DMD patients. Here, we investigated the effects of a low-intensity aerobic training (37 sessions) on satellite cells, peroxisome proliferator-activated receptor-gamma coactivator (PGC)-1α protein (PGC-1α), and different types of fibers of the psoas muscle from mdx mice (DMD experimental model). Wildtype and mdx mice were randomly divided into sedentary and trained groups (n = 24). Trained animals were subjected to 37 sessions of low-intensity running on a motorized treadmill. Subsequently, the psoas muscle was excised and analyzed by immunofluorescence for dystrophin, satellite cells, myosin heavy chain (MHC), and PGC-1α content. The minimal Feret's diameters of the fibers were measured, and light microscopy was applied to observe general morphological features of the muscles. The training (37 sessions) improved morphological features in muscles from mdx mice and caused an increase in the number of quiescent/activated satellite cells. It also increased the content of PGC-1α in the mdx group. We concluded that low-intensity aerobic exercise (37 sessions) was able to reverse deleterious changes determined by DMD.

Assuntos