Lais Mara Siqueira das Neves

Effect of Low-Level Laser Therapy on Malondialdehyde Concentration in Random Cutaneous Flap Viability

OBJECTIVE The aim of this study was to assess the effects of 830 and 670 nm laser on malondialdehyde (MDA) concentration in random skin-flap survival. BACKGROUND DATA Low-level laser therapy (LLLT) has been reported to be successful in stimulating the formation of new blood vessels and activating superoxide-dismutase delivery, thus helping the inhibition of free-radical action and consequently reducing necrosis. MATERIALS AND METHODS Thirty Wistar rats were used and divided into three groups, with 10 rats in each one. A random skin flap was raised on the dorsum of each animal. Group 1 was the control group; group 2 received 830 nm laser radiation; and group 3 was submitted to 670 nm laser radiation. The animals underwent laser therapy with 36 J/cm(2) energy density immediately after surgery and on the 4 days subsequent to surgery. The application site of the laser radiation was 1 point, 2.5 cm from the flaps cranial base. The percentage of the skin-flap necrosis area was calculated 7 days postoperative using the paper-template method, and a skin sample was collected immediately after as a way of determining the MDA concentration. RESULTS Statistically significant differences were found between the necrosis percentages, with higher values seen in group 1 compared with groups 2 and 3. Groups 2 and 3 did not present statistically significant differences (p > 0.05). Group 3 had a lower concentration of MDA values compared to the control group (p < 0.05). CONCLUSION LLLT was effective in increasing the random skin-flap viability in rats, and the 670 nm laser was efficient in reducing the MDA concentration.

Low-Level Laser Therapy on the Viability of Skin Flap in Rats Subjected to Deleterious Effect of Nicotine

OBJECTIVE The purpose of this study was to evaluate the effect of 830-nm laser in blocking the action of nicotine on the viability of skin flap. BACKGROUND DATA The authors have analyzed the deleterious effect of cigarette smoke or nicotine on the skin flap alone with evidence of increased skin necrosis in the flap. MATERIALS AND METHODS Twenty-four Wistar-albino rats were divided into three groups of eight animals each: Group 1 (control), subjected to a surgical technique to obtain a flap for cranial base, laser irradiation simulation, and a subcutaneous injection of saline; Group 2, similar to Group 1, with subcutaneous injection of nicotine (2  mg/kg/day) for a period of 1 week before and 1 week after surgery; and Group 3, similar to Group 2, with skin flaps subjected to a λ 830-nm laser irradiation. The laser parameters used were: power 30 mW, beam area 0.07 cm(2), irradiance 429 mW/cm(2), irradiation time 84  sec, total energy 2.52  J, and energy density 36 J/cm(2). The laser was used immediately after surgery and for 4 consecutive days, in one point at 2.5  cm of the flap cranial base. The areas of necrosis were examined by two macroscopic analyses: paper template and Mini-Mop(®). The pervious blood vessels were also counted. RESULTS The results were statistically analyzed by ANOVA and post-test contrast orthogonal method (multiple comparisons), showing that the laser decreased the area of necrosis in flaps subjected to nicotine, and consequently, increased the number of blood vessels (p < 0.05). CONCLUSIONS The laser proved to be an effective way to decrease the area of necrosis in rats subjected to nicotine, making them similar to the control group.

The influence of different non-articular proximal forearm orthoses (brace) widths in the wrist extensors muscle activity, range of motion and grip strength in healthy volunteers

PURPOSE The purpose this study was perform a biomechanical evaluation to compare the influence of commercial models of different non-articular proximal forearm orthoses widths (2.5 cm, 5.5 cm, 7.5 cm and 12.0 cm) in the extensor muscle activation, range of motion and grip strength in healthy subjects. METHODS Was analyzed data from extensor carpi radialis, extensor carpi ulnares and extensor digitorum comunis using surface electromyography, simultaneous with a wrist electrogoniometer MiotecTM and a hydraulic dynamometer JamarTM. The sequence of tests with all the commercial orthoses models was randomized. Statistics analyses were performed by linear model with mixed effects. RESULTS According to our findings the non-articular proximal forearm orthoses (2.5 cm - narrowest) positioned close to lateral epicondyle provided lesser muscle activation on extensor carpi radialis brevis/longus and extensor digitorum comunis, decreased wrist extension and grip strength during submaximal grip task (p< 0.01). CONCLUSIONS A narrow non-articular proximal forearm orthosis positioned close to the lateral epicondyle might decrease the extensor muscle activation and therefore could reduce mechanical stress on its insertion, based on this sample. Clinical studies must be conducted to confirm these findings.

Manual Lymphatic Drainage in Blood Circulation of Upper Limb With Lymphedema After Breast Cancer Surgery

Objective: The purpose of this study was to assess blood flow after manual lymphatic drainage (MLD) in women who had received surgery for breast cancer and had post–axillary lymphadenectomy lymphedema. Methods: Sixteen volunteers (mean age 64 ± 11.44 years) were divided into 2 groups. Those in group 1 received MLD without upper limb elevation, and those in group 2 received MLD with elevation of 30° of the upper limb. Blood flow velocity of the brachial vein and artery were measured using Doppler ultrasound before, immediately after, and 30 minutes after MLD, with and without 30° of upper limb elevation as defined by a random crossover design and an interval (washout) of 7 days. Comparison of data before and after MLD was evaluated by the Friedman test. Results: There was a significant increase of blood flow velocity in the brachial vein after the therapeutic procedure with upper limb elevation. However, after 30 minutes the data returned to the pretreatment value. Conclusion: This preliminary study indicated that MLD promoted increased brachial vein velocity flow in the short term.

Reduction in handgrip strength and electromyographic activity in women with breast cancer

BACKGROUND Breast cancer survivors have side effects from surgical treatment and adjuvant that may acutely or chronically compromise the musculoskeletal system, resulting in loss of muscle strength. OBJECTIVE Handgrip strength and electromyography of the upper limbs and its relationship with dominance in women submitted to surgery for breast cancer. METHODS Were evaluated 28 women. The handgrip strength was measured through dynamometer associated with electromyographic, in the muscles: descending trapezius, biceps brachial, triceps brachial, extensor carpi ulnaris, radial extensor carpi and superficial flexor of wrist and fingers. RESULTS Reduction in grip strength on the side affected by the surgery, that occurred when the surgery was performed on the non-dominant side. The electromyographic showed significant differences in affected side. This shows the need to consider the affected side by surgery and dominance. CONCLUSIONS Decreased grip strength and lower electromyographic activity of upper limb affected by surgery for breast cancer, when the side affected was not the dominant this loss was greater.

Effects of High-Voltage Electrical Stimulation in Improving the Viability of Musculocutaneous Flaps in Rats.

BackgroundThe musculocutaneous flap of the transverse rectus abdominis muscle is a technique used for breast reconstruction, and one of the complications of this procedure is tissue necrosis. The objective of the study is to determine the effect of high-voltage electrical stimulation (HVES) in the transverse rectus abdominis muscle flap in rats. MethodsFourteen rats underwent surgery for obtaining the flap. The rats were distributed into 2 homogeneous groups: group 1 underwent both surgery and the use of HVES, whereas group 2 underwent just the surgery (control). Electrical stimulation was applied immediately after surgery and for 2 consecutive days. The percentage of necrotic area was analyzed using the Image J software, and blood flow was assessed by infrared thermography in different regions of the flap, divided into 4 zones according to the proximity of the pedicle of the inferior epigastric artery. ResultsThe results were analyzed using a Student t test, where group 1 experienced a necrotic area of 26.2%, and group 2 had an area of 54.5%. Regarding the temperature, the 2 groups showed increase in the minimum and maximum temperature on the fourth postoperative day. ConclusionThe HVES appeared to have a positive influence on the viability of the flap.

ASCORBIC ACID IONTOPHORESIS FOR CHONDRAL GAIN IN RATS WITH ARTHRITIS

OBJECTIVES: To examine the cellularity and thickness of the articular cartilage of the femur in rats with arthritis after treatment with iontophoresis. METHODS: To evaluate these objectives, a histological analysis was performed on hematoxylin and eosin, where cellularity and cartilage thickness were observed and evaluated qualitatively and quantitatively by manual counting by 700.09µm² area. RESULTS: The group treated with IAA had normal cellularity (40.1 cells/μm2) and maintenance of non-calcified cartilage (75.5μm), suggesting normal thickness. The non-treated group C+, on the other hand, had a lower mean number of chondrocytes (13.0μm2) (P <0.05) and, when the cartilage thickness was compared, it showed higher average thickness of calcified cartilage (104.8 mm) and lower mean of non-calcified cartilage (53.3μm) CONCLUSION: The use of iontophoresis with L-ascorbic acid by continuous electric current contributed to a quantitative gain of chondrocytes and improved the thickness distribution of calcified and non-calcified cartilage. Level of Evidence III, Case Control Study.

Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina

Objective: To investigate the possible effects of laser diode 830nm counter to the action of nicotine on the viability of the skin flap in rats. Methods: 24 Wistar-albino rats were used, divided into 3 groups of 8: Group 1 - subject to the surgical technique to obtain the random skin flap in cranial base, subcutaneous injection of nicotine of 2mg/Kg/dia a week before and one week after surgery and simulation of laser. Group 2 - similar to group 1, the random skin flap in the cranial base were subjected to laser irradiation immediately after surgery and on thesubsequent 4 days. After euthanasia, areas of necrosis and viable tissue were examined by a manual method (weighing the Role of Feedback) and by the semi-automated method of analysis (Mini-Mop ® ). Results:The results were statistically analyzed by ANOVA. The values of the percentage of necrotic area by the method of analysis showed a decreased area of necrosis in group 2 where the laser was applied. Conclusion: The 830nm laser was effective in improving the viability of skin flaps in rats subjected to the action of nicotine. Level of evidence II: Therapeutic Studies - Investigating the results of treatment.