Engenharia Biomédica
URI permanente para esta coleçãohttps://repositorioacademico.universidadebrasil.edu.br/handle/123456789/915
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Resultados da Pesquisa
Item Ensaio clínico sobre o efeito da Fotobiomodulação e da Terapia Fotodinâmica na cicatrização de lesões crônicas(Universidade Brasil, 2021) Moreira, Isabel Cristina Cavalcante Carvalho; Nunez, Silvia CristinaIntroduction: Chronic wounds can be defined as those that do not advance in relation to the orderly tissue repair process and compromise anatomical integrity and tissue repair time. Neuropathic ulcers are chronic lesions and one of the most stigmatizing sequelae of diabetic foot and leprosy-associated wounds, their presence is quite impairing for the individual and can lead to deformation and/or amputation of the affected limb. For the treatment of these wounds, there are a variety of existing topical products, including hydrogel. Besides, treatment through the use of photobiomodulation therapy (PBM) and photodynamic therapy (PDT) has shown positive results in the repair process. Objective: To evaluate the effects of PBM and PDT with methylene blue, associated or not with urea, on the healing of chronic wounds caused by diabetes and leprosy. Methodology: This is a blind randomized clinical trial. There were 17 volunteers with chronic diabetes wounds that were divided into 4 groups: Group I hydrogel with alginate (n=3), Group II PBM with diode laser λ= 660 nm, power of 100 mW, with 4J applied every 1 cm (n=6), Group III PDT with methylene blue at 100 µM associated with red emission diode laser λ = 660 nm, power of 100 mW with 9 J every 1 cm (n=5), and Group IV methylene blue 100 µM PDT associated with 2M urea (n=4) and the same irradiation parameters as G III. And 13 volunteers with chronic leprosy lesions divided into 4 groups: Group I hydrogel with alginate (n=3); Group II PBM with diode laser λ= 660 nm, power of 100 mW, with 4J applied every 1 cm (n=4) ; Group III PDT with methylene blue at 100 µM associated with red emission diode laser λ = 660 nm, power of 100 mW with 9 J every 1 cm (n=3) and Group IV PDT with methylene blue at 100 µM associated with 2M urea and the same irradiation parameters as G III. For the intervention protocol, the volunteers underwent 8 sessions, comprising 2 sessions a week, on alternate days. Photographic records were used for the macroscopic evaluation throughout the sessions and the measurement of the wound was related to the greatest length versus the greatest width. For all groups, the Pressure Ulcer Scale for Healing (PUSH), was applied to assess the healing process. Results: This study found that diabetic individuals undergoing hydrogel therapy (G I) did not present a reduction in chronic wound size. As measured by the PUSH score, it was not statistically significant (p value = 0.317). However, it was observed that there was a significant reduction in the size of the 9 chronic lesion measured by the PUSH Score between days 1 and 8 in individuals with diabetes for groups G II (p<0.001), G III (p=0.004) and G IV (p=0.001). It was found that in individuals with leprosy undergoing hydrogel therapy, the reduction of chronic wound, measured by the PUSH score, was not statistically significant (p value = 0.096). However, it was observed that there was a significant reduction in the size of the chronic lesion measured by the PUSH score between days 1 and 5 in individuals with leprosy for G II (p value = 0.021), G III (p value = 0.005 ) and G IV PDT+AM 100 µM associated with 2M urea (p value = 0.034). Conclusion: The therapies with PBM and PDT with methylene blue, and PDT with methylene blue associated with urea reduce the size of the chronic wound in diabetic patients, requiring 3 applications. All light therapies evaluated in the study reduced the size of chronic wounds in leprosy patients after five applications.Item Inativação fotodinâmica dos fungos causadores de onicomicoses Trichophyton rubrum e Microsporum gypseum(Universidade Brasil, 2022) Rodrigues, Eliane Mendes; Rangel, Drauzio Eduardo NarettoOnychomycosis is one of the most common diseases in the field of dermatology and refers to a fungal infection of the nail plate with a high incidence in the general population. The available treatment options for onychomycosis have limited use due to side effects, drug interactions, and contraindications, which requires the application of an alternative treatment for onychomycosis. In the last years, the antimicrobial Photodynamic Therapy (aPDT) has been acknowledged as treatment options for several infectious diseases, including dermatological ones. However, the ideal parameters for a safe and effective therapy in the treatment of onychomycosis are still not fully elucidated. Therefore, this study aimed to evaluate the effectiveness of aPDT, in vitro, on the fungi Trichophyton rubrum (T. rubrum) and Microsporum gypseum (M. gypseum), the main causes of onychomycosis. In the in vitro tests, the fungi T. rubrum (ATCC 28188) and M. gypseum (ATCC 24102) were used, divided into 13 experimental groups: Group C (control - no treatment); group MB (treated with methylene blue); group R100 (treated with LED at a dose of 100 J/cm2) and groups T10, T20, T30, T40, T50, T60, T70, T80, T90 and T100, treated with luz at doses of 10 J/cm2 , 20 J/ cm2 , 30 J/cm2 , 40 J/cm2 , 50 J/cm2 , 60 J/cm2 , 70 J/cm2 , 80 J/cm2 , 90 J/cm2 , and 100 J/cm2 . For the treatment, a light-emitting diode (LED) equipment with a wavelength of 630 nm (100 mW; 2.93 cm2 ) associated with a photosensitizer was used, AM was used at a concentration of 100 μM, using 30’ of pre-irradiation. It was observed that aPDT reduced germination on T. rubrum germination with an energy density from 20 J/cm2, reaching achieving its eradication with an energy density of 100 J/cm2. In relation to M. gypseum, the influence on germination was proportional to the energy density, in the energy density of 100 J/cm². These results suggest that aPDT may be a possible and attractive alternative treatment for combating onychomycosis, although further investigation is needed to determine whether such efficacy could be achieved in vivo.Item Avaliação da atividade antimicrobiana da terapia fotodinâmica no tratamento da microbiota bucal(Universidade Brasil, 2022) Moreti, Lucieni Cristina Trovati; Tim, Carla Roberta; Assis, LíviaPhotodynamic Therapy (PDT) is based on the interaction of light with a photosensitizer capable of promoting microbial destruction. In the present work, the antimicrobial activity of aPDT was evaluated in vitro using two photosensitizers (phenothiazine and annatto) and different times of treatment of oral biofilm, as well as microorganisms were identified and bacterial resistance and sensitivity to certain antibiotics were evaluated. For this, antimicrobial samples of oral biofilm (tongue) were collected from patients without and with pneumonia admitted to the ICU, who were intubated for a period of at least 24 and at most 48 hours, using swabs soaked in saline solution (NaCl 0.5 %) and later cultivated in agarized media. Samples from patients without pneumonia were randomized into: non-pneumonia control group (NP - C): microorganisms without intervention; non-pneumonia chlorhexidine group (NP - CLX): used 0.12% chlorhexidine; non-pneumonia group red PDT (NP - PDTV): used aPDT using 630 nm LED and phenothiazine photosensitizer; non-pneumonia blue PDT group (NP - PDTA): used the use of aPDT using 450 nm LED and annatto photosensitizer, both using a single application. And control pneumonia group (P - C): microorganisms without intervention; group with chlorhexidine pneumonia (P ¬ CLX): used 0.12% chlorhexidine; group with red PDT pneumonia (P - PDTV): used the use of PDT using 630 nm LED and phenothiazine photosensitizer; group with blue PDT pneumonia (P - PDTA): used the use of PDT using 450 nm LED and annatto photosensitizer. They were irradiated with the following parameters: red LED (λ630 ± 10ηm) or blue LED (λ450 ± 10ηm), both at 100 mW power and treated for 150, 300 or 600 seconds. After 24 hours, colony forming units (CFU) and antibiogram were counted. The results showed that the NP – CLX and P – CLX groups promoted total CFU reduction. The PDT groups in oral biofilm without and with pneumonia showed that the CFU reduction was dependent on the treatment time, being better at 600 seconds of treatment. Through the genetic code, Gram-negative microorganisms such as Pseudomonas aeruginosa and Gram-positive microorganisms such as Bhargavaea sp., Desemzia incerta, Kocuria rosea, Micrococcus sp. ,Micrococcus luteus, Agrococcus carbonis, Microbacterium paraoxydans, Corynebacterium sp., Dietzia aurantiaca, Enterococcus faecalis and Staphylococcus saprophyticus.The antibiogram performed evaluated the multiple antimicrobial resistance index (IRMA) characterizing multiresistance to all. Conclusion: Despite being composed of multidrug-resistant microorganisms, aPDT showed potential for the treatment of oral biofilm in patients with and without pneumonia.