Monografias, Dissertações e Teses
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Item Avaliação e comparação de diferentes comprimentos de onda (660 e 808 nm) da terapia por fotobiomodulação a laser na atrofia muscular em modelo de imobilização em ratos(Universidade Brasil, 2021) Gonçalves, Silma Rodrigues; Garcia, Lívia Assis; Tim, Carla RobertaAtrophy of skeletal striated muscle tissue is a complex process caused by an imbalance between the degradation and synthesis of myofibrillar proteins, leading to a reduction in muscle strength and the quality of life individuals. Considerable efforts have been devoted to establish new treatments for an effective and safe clinical for treatment of muscle atrophy. Among the available therapeutic resources, photobiomodulation therapy (PBMT) has great potential, as it is often used as a promising therapeutic strategy for the rehabilitation of skeletal striated muscle tissue, however, there is no consensus on the best parameters in the treatment of muscle atrophy. Thus, the aim of the present study was to evaluate the in vivo response of PBMT to laser at red and infrared wavelengths in muscle atrophy in an immobilization model in rats. 32 male Wistar rats were used, divided into 4 groups (n = 8): control group (C); Immobilized group (ImC); Immobilized group submitted to PBMT laser at red wavelength (ImR); Immobilized group submitted to laser PBMT at the infrared wavelength (ImIR). The left hind limb was immobilized in extension for 5 days. For laser PBMT, equipment was used (λ = 660 and 808 nm; P = 30 mW; t = 47 s; D = 50 J/cm²) applied at two points in the gastrocnemius muscle (cranial and caudal). Treatments started immediately after removal of the immobilization, with 24-hour intervals, totaling 9 sessions. To evaluate and compare the treatments, histological analysis were performed, as well as the profile area, cell density and ATPase histochemistry. Histological results showed fibers of varied shape, infiltration of inflammatory cells, and thickening of the connective tissue, reduced profile and increased density of muscle fibers in all immobilized animals. Furthermore, it was possible to verify a modulation of the inflammatory process and a lesser thickening of the intramuscular connective tissue in both ImR and ImIR groups, however, these results were more pronounced in the ImIR group, associated with morphological findings of regenerating fibers and an increase in the number of fibers oxidative (type I fibers). Thus, we can conclude that laser PBMT at both wavelengths were effective in changing the morphology of the gastrocnemius muscle subjected to atrophy in an experimental immobilization model, reducing the inflammatory infiltrate and the formation of intramuscular connective tissue. However, RI promoted a more evident positive effect by increasing regenerating muscle fibers and the number of oxidative fibers, which may be a promising resource in the clinical treatment of muscle atrophy.Item Fotobiomodulação como coadjuvante no tratamento da lesão pulmonar aguda decorrente de sepse(Universidade Brasil, 2020) Dantas, Emanuelle; Garcia, Lívia Assis; Tim, Carla RobertaSepsis is a common condition associated with high mortality and, for many who survive, long-term morbidity. It is defined as infection with organ dysfunction, with the lung being one of Organs most affected organs. Acute lung injury (ALI) is a serious and serious disease, characterized by infiltrations of pulmonary inflammatory cells, diffuse alveolar damage, in addition to loss of the alveolar epithelium, together with edema and changes in gas exchange. During the rehabilitation period, there is a growing concern to modulate these processes in order to prevent complications and favor the patient's functional recovery. The therapeutic verification of the applications of photobiomodulation therapies (PBM) through lasers and LEDs) in the clinical treatment of inflammatory diseases is currently well known, however the mechanisms of action triggered by these resources and their use in clinical practice for the treatment of APL due to sepsis still remains incipient. Thus, this thesis aimed to provide an understanding of the current evidence on the importance of PBM in the treatment of respiratory disorders and its possible applicability in APL due to sepsis, as well as to evaluate and compare in vivo the PBM response through laser and LEDs on the LPA in rats. A qualitative, descriptive and exploratory narrative literature review was carried out and an experimental study using male Wistar rats, allocated in 3 (three) experimental groups: Sepsis control (CS); laser treatment (LASER); LED treatment (LED). Irradiations in the red wavelength (630 nm) were applied at three points (anterior region of the trachea and in the ventral regions of the chest, bilaterally) 1 and 24 hours after surgery. Based on all verified evidence and results observed in this study, it is inferred that PBM through laser and LED can be proposed as a support for conventional medical therapy in the treatment of APL arising from sepsis, due to the potential to mitigate the inflammatory condition, prevent the progression of the lung parenchyma lesion and, consequently, reduce the recovery time of the patient with ALI due to sepsis.Item Efeitos da Fotobiomodulação no processo de cicatrização da lesão por pressão(Universidade Brasil, 2022) Oliveira, Laricy Rodrigues de; Baptista, AlessandraCurrently, the prevention and treatment of Pressure Ulcer (PU) is the focus of multidisciplinary actions in different health care settings. Photobiomodulation is a form of phototherapy proposed in the treatment of PU, as it is able to modulate the quality and speed of the healing process. The objective of this study was to evaluate the quality of life (QoL) of the individual affected by PU, as well as to evaluate the modulation of the PU healing process, through photobiomodulation. This is a qualitative-quantitative clinical study, in which 10 volunteers with PU participated, treated at home. Participants were randomly divided into two groups, according to the therapeutic intervention: Control Group (n=5); treated with calcium and sodium alginate coating and Photobiomodulation Group (n=5); treated with photobiomodulation, where the PUs received punctual irradiation, 4J/point, on alternate days, with a low power laser emitting at 660 nm, with 100 mW of power, for 40 s. All volunteers in this study received treatment for 4 weeks. Participants QoL was analyzed using the WHOQOL-BREF questionnaire, before and after the interventions. The PU healing process was evaluated by the PUSH instrument, on the 1st, 15th and 29th days. The PUs were photographed in a standardized way, on the respective days, to compare the evolution of the repair process. For data analysis, the Shapiro Wilk normality test and the two way ANOVA test of variance were applied, and the means were compared using the Tukey test with a significance of 5%, being considered statistically different when p<0.05. The perception of QoL in the Photobiomodulation Group was regular in the initial phase of treatment, evolving to very good in the final phase, while the volunteers in the Control Group maintained a very good response from the beginning to the end of the treatment. The evaluation using the PUSH instrument showed a gradual temporal improvement in the PU repair process, regardless of the treated group. The comparison of photographic images revealed that there was a reduction in the staging of PUs in both groups. Therefore, we can conclude that photobiomodulation, in the parameters tested in this study, can be a good alternative in relation to QoL and modulation of the PU healing process.Item Influência da Terapia por Fotobiomodulação no tratamento de condições inflamatórias pulmonares e seu impacto sobre o Covid-19(Universidade Brasil, 2021) Macedo, Daniela Bezerra; Tim, Carla Roberta; Garcia, Lívia AssisToday we are facing a pandemic that continually causes high rates of deaths and catastrophic and countless economic and psychosocial consequences. Thus, this period requires a rapid search for viable procedures that can allow us to use safe and noninvasive clinical tools as prophylactic or even adjuvant methods in the treatment of COVID-19, thus constituting an important challenge to the medical clinic. Evidence shows that photobiomodulation therapy (PBMT) is shown to attenuate the inflammatory process and reduce respiratory disorders similar to acute lung injury (ALI), complications associated with infections, such as that caused by the new Coronavirus (SARS-CoV-2). Thus, the aim of this study was to evaluate the influence of laser PBMT on infrared length in the treatment of ALI, one of the main critical complications of COVID-19 infection, in an experimental model of rats. Twenty-four male Wistar rats were randomly allocated into three experimental groups (n = 8): Control (CG); LPA (LPA); LASER-treated LPA (LPAL). For the treatment, a laser equipment (808 nm; 30 mw; 1.8 J) was applied at three points (anterior region of the trachea and in the venereal regions of the thorax bilaterally) in the period of 1 and 24 hours after lpa induction. Descriptive histopathological analysis, lung injury score, analysis of the number of inflammatory cells, interleukin 1 β (IL-1β) and interleukin 10 levels (IL-10) were performed for treatment evaluation. In the results, it was possible to observe that the treatment reduced inflammatory infiltrates, there was thickening of the alveolar septum and the pulmonary injury score when compared to the LPA group. In addition, laser PBMT showed lower immunoexpression of IL-1β, however, it did not alter the levels of pulmonary IL-10. Thus, it can be concluded with this experimental study that infrared laser PBMT was efficient in attenuating ALI, one of the main complications of COVID-19, since it was able to reduce the inflammatory process, as well as increase the production of anti-inflammatory cytokines.Item Avaliação e comparação de diferentes comprimentos de onda (660 e 808 NM) da terapia por fotobiomodulação a laser na atrofia muscular em modelo de imobilização em ratos(Universidade Brasil, 2021) Gonçalves, Silma Rodrigues; Tim, Carla Roberta; Garcia, Lívia AssisAtrophy of skeletal striated muscle tissue is a complex process caused by an imbalance between the degradation and synthesis of myofibrillar proteins, leading to a reduction in muscle strength and the quality of life individuals. Considerable efforts have been devoted to establish new treatments for an effective and safe clinical for treatment of muscle atrophy. Among the available therapeutic resources, photobiomodulation therapy (PBMT) has great potential, as it is often used as a promising therapeutic strategy for the rehabilitation of skeletal striated muscle tissue, however, there is no consensus on the best parameters in the treatment of muscle atrophy. Thus, the aim of the present study was to evaluate the in vivo response of PBMT to laser at red and infrared wavelengths in muscle atrophy in an immobilization model in rats. 32 male Wistar rats were used, divided into 4 groups (n = 8): control group (C); Immobilized group (ImC); Immobilized group submitted to PBMT laser at red wavelength (ImR); Immobilized group submitted to laser PBMT at the infrared wavelength (ImIR). The left hind limb was immobilized in extension for 5 days. For laser PBMT, equipment was used (λ = 660 and 808 nm; P = 30 mW; t = 47 s; D = 50 J/cm²) applied at two points in the gastrocnemius muscle (cranial and caudal). Treatments started immediately after removal of the immobilization, with 24-hour intervals, totaling 9 sessions. To evaluate and compare the treatments, histological analysis were performed, as well as the profile area, cell density and ATPase histochemistry. Histological results showed fibers of varied shape, infiltration of inflammatory cells, and thickening of the connective tissue, reduced profile and increased density of muscle fibers in all immobilized animals. Furthermore, it was possible to verify a modulation of the inflammatory process and a lesser thickening of the intramuscular connective tissue in both ImR and ImIR groups, however, these results were more pronounced in the ImIR group, associated with morphological findings of regenerating fibers and an increase in the number of fibers oxidative (type I fibers). Thus, we can conclude that laser PBMT at both wavelengths were effective in changing the morphology of the gastrocnemius muscle subjected to atrophy in an experimental immobilization model, reducing the inflammatory infiltrate and the formation of intramuscular connective tissue. However, RI promoted a more evident positive effect by increasing regenerating muscle fibers and the number of oxidative fibers, which may be a promising resource in the clinical treatment of muscle atrophy.Item Fotobiomodulação no tratamento de lesões por pressão: revisão sistemática com metanálise(Universidade Brasil, 2021) Macedo, Suellen Pereira Rodrigues; Navarro, Ricardo ScarparoPressure sores (PS) are important causes of morbidity, especially in patients admitted to intensive care units. Besides having a high cost to the health system, it adds an additional risk for the patients because it imposes the loss of the skin constitutional barrier. Photobiomodulation (PBM) with low-level laser has been shown to be effective in the treatment of PS in different stages. There is no consensus on the protocols of irradiation parameters, wavelength, energy, dose, intervals between sessions. The objective of this study was to evaluate the effects of photobiomodulation in the treatment of pressure sores from a systematic review of literature and meta-analysis. This is a systematic review carried out according to the PRISMA guidelines, which included studies without restrictions on year and language of publication, published until January 2020. Randomized studies that compared the effects of low-level laser therapy with a control group in patients with pressure ulcers were included. The studies were analyzed, reported descriptively and combined in a meta-analysis, the heterogeneity of the studies was assessed and the combined Odds Ratio for total PS healing in the follow-up period and the combined mean percentage area reduction were calculated. Six randomized clinical trials were included in the qualitative analysis and five trials in the quantitative analysis. A total of 207 patients were randomized to either FBM or control. The studies reported PBM with low-level laser with different wavelengths within the therapeutic window, in the range of 600 nm (red), 800 nm and 900 nm (infrared). From these data, subgroup analysis was performed and the combined Odds Ratio for each band was calculated, and no statistically significant difference was found in the set of studies as a whole and in the subgroups (p> 0.05). Only two studies described the percentage of reduction of the PS area. Analysis of these combined data showed Odds Ratio values equal to 1.34 (95% CI 0.8 - 2.24; Z 1.11; p= 0.82) in favor of the PBM but without statistical significance (p> 0.05). Of the included studies, only PBM with low-level laser therapy using red laser (660 nm) promoted a significant difference in the reduction of PS (p< 0.05). It can be concluded that in the studies included, photobiomodulation with red low-level laser was effective in the healing process of pressure sores in stages 2 and 3. It is suggested to carry out other randomized clinical trials to analyze the parameters of photobiomodulation.