Rodrigo Marcel Valentim da Silva

Effect of Capacitive Radiofrequency on the Fibrosis of Patients with Cellulite

Background. Cellulite is a type of lipodystrophy that develops primarily from an alteration in blood circulation or of the lymphatic system that causes structural changes in subcutaneous adipose tissue, collagen, and adjacent proteoglycans. The radiofrequency devices used for cutaneous applications have shown different physiological treatment effects, but there is controversy about the suitable parameters for this type of treatment. Objectives. The aim of this study was to evaluate the effects of low-temperature radiofrequency to confirm the thinning of the collagen tissue and interlobular septa and consequent improvement of cellulite. Methods. A sample of eight women was used to collect ultrasonographic data with a 12 MHz probe that measured collagen fiber thickness. The Vip Electromedicina (Argentina) device, frequency of 0.55 MHz and active electrode 3.5 cm in diameter (area = 9.61 cm2), was applied to a 10 cm2 region of the gluteal region for 2 minutes per area of active electrode, during 10 biweekly sessions. Results. The Wilcoxon matched paired test was applied using GraphPad InStat 3.01 for Win95-NT software. Pre- and posttreatment mean collagen fiber thickness showed a 24.66% reduction from 1.01 to 0.67 mm. Statistical analysis using the Wilcoxon matched paired test obtained a significant two-tailed P value of 0.0391. Conclusion. It was concluded that the use of more comfortable temperatures favored a reduction in fibrous septum thickness and consequent cellulite improvement, evidenced by the lower degree of severity and decrease in interlobular septal thickness.

Efeitos da quiropraxia em pacientes com cervicalgia: revisão sistemática

BACKGROUND AND OBJECTIVES: Cervical pain is mostly caused by mechanical-postural changes. Among different therapeutic techniques used by physical therapists, chiropractic care is becoming common in Brazil. This study aimed at reviewing the literature, with secondary and tertiary sources, using Pubmed, Medline and PEdro databases. CONTENTS: Just 6 controlled randomized clinical trials investigating the effects of chiropractic care on cervical pain were found. In most studies, manipulation techniques have promoted pain relief in a faster and more prolonged way and pain was evaluated by Oswestrys Functional Index, by McGill Pain Questionnaire and by Pain Visual Analog Scale. CONCLUSION: A larger number of controlled randomized clinical trials involving chiropractic care is needed, as well as the use of more dependable evaluation methods, to prove its real effects in the treatment of cervical pain.

Effects of the extracorporeal shock wave therapy on the skin: an experimental study

Extracorporeal shock wave therapy (ESWT) has been extensively studied for its multiple biological properties, and although it is widely applied in esthetical procedures, little is known about its effects on the epidermis and dermis. In this study, a histological and immunohistochemical study of the effects of ESWT was performed on rat skin. Forty-five female rats were treated with one or two sessions of ESWT and sacrificed on days 1, 7, 14, and 21 after treatment. The samples were histologically processed and then morphometric analyses were performed to assess the epidermis, dermis, and subcutaneous fat tissue thickness. Immunohistochemical reactions were also performed against the antibodies: basic fibroblastic growth factor (FGF2), its receptor (FGFR1), and α-smooth muscle actin. Slides were scanned and digitally assessed, to determine the microvessel density (MVD) and digital scoring of the immunohistochemical staining. The results showed that ESWT produced a significantly higher collagen content, MVD, and epidermis and dermis thickness than the control, non-treated group. Both in epidermis and dermis, FGF2 was overexpressed in the ESWT-treated groups, whereas FGFR1 was increased only in the group treated with two ESWT sessions at 21-days post-treatment. The ESWT-treated groups have also shown diminished thickness of subcutaneous fat tissue. In conclusion, ESWT induces neocollagenesis and neoangiogenesis, and upregulates the FGF2 expression, particularly in the groups treated with two sessions. Furthermore, it was demonstrated that overexpression of FGF2 on skins treated with ESWT seems to be a key role on its mechanism of action.

Cryolipolysis: patient selection and special considerations

Cryolipolysis is considered a safe and effective procedure, with high patient satisfaction rates, especially when compared to other procedures for localized adiposity, such as high-intensity focused ultrasound and shock waves. Although this statement is present in the literature, the importance of the selection of suitable patients for this type of treatment is not well known. The objective of this study was to discuss the criteria to be considered in the selection of patients who are candidates for cryolipolysis and assess their profile regarding their anthropometric data, age, skin characteristics, cutaneous sensitivity, and risk pathologies for this type of treatment. Assessing the amount of localized adiposity requires safe and validated methods that are significant in measuring results. The aim is to achieve success in the process of reducing adiposity guaranteeing patient satisfaction and assurance of results.

Physiotherapy Practice postoperative blepharoplasty: experimental study

Introduction: Blepharoplasty word is of Greek origin (blepharos refers to the eyelids, and plasty is on the form, shape), used to call the eyelid rejuvenation surgery. The physical therapy can prevent or reduce many of the complications caused by blepharoplasty, such as swelling, bruising, hematoma, keloid, among others. Objective: This project aims to observe the physiotherapy performance in the post-blepharoplasty, assessing the general condition of the patient, as the possible complications of surgery. Methods: This study is characterized as a clinical trial and quasi-experimental. The survey sample contains 8 participants (n = 8). Inclusion criteria were patients who had undergone blepharoplasty surgery at the Institute of Vision, female, with a mean age of 60.1 years, menopausal and time availability in the morning and / or afternoon. Exclusion criteria were patients who missed 3 or more sessions, presence of eye diseases such as conjunctivitis, exacerbated pain in the surgery area, infection in the incision area and to provide dehiscence. They started treatment in the second postoperative day, being applied to pumping technique with the use of gauze on the upper eyelid region, manual lymphatic drainage (MLD) and kinesiotherapy in a 40 minute session, with the total of 10 sessions. Results: The level of education of patients and their professions was observed to changes in the postoperative period, the quality of life of patients and duration of the presence of complications. Conclusion: It is suggested that physical therapy in the daily early postoperative period of blepharoplasty may have contributed to avoid complications and that blepharoplasty does not affect the quality of life.

Effects of Cryolipolysis on Abdominal Adiposity

Cryolipolysis is a noninvasive technique of localized fat reduction. Controlled cold exposure is performed in the selective destruction of fat cells. The aim of this study was to investigate the effects of cryolipolysis on adipocytes elimination through histological and sonographic analyses. This study reports the case of a 46-year-old female patient, with complaint of localized abdominal fat and in the preoperative period of abdominoplasty. The patient was submitted to a single 60-minute application of cryolipolysis, temperature of −5°C, on the hypogastrium area, 5 cm below the umbilicus. To study the effects of this treatment, ultrasound images taken before the session and 7, 15, 30, and 45 days after the therapy were analysed. After the abdominoplasty, parts of the treated and the untreated withdrawn abdominal tissues were evaluated macro- and microscopically. In ultrasound images, as well as in macroscopic and histological analyses, significant adipocytes destruction was detected, with consequent fat layer reduction and integrity of areas that were adjacent to the treated tissue. The presence of fibrosis observed during therapy and acknowledged through performed analyses encourages further studies to clarify such finding.

Analysis of the complementary measurement of nasogenian wrinkles using Radiocef 2.0® software in the evaluation of facial chronoaging among women of different age groups

1 Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Programa de Pós-graduação em Fisioterapia. Natal, RN, Brasil. 2 Universidade Potiguar, Curso de Fisioterapia. Natal, RN, Brasil. 3 Universidade Potiguar, Programa de Pós-graduação em Fisioterapia Dermato-funcional. Natal, RN, Brasil. 4 Universidade Católica Nostra Señora de Assuncion, Programa de Pós-graduação em Fisioterapia. Assunção, Paraguai. 5 Universidade do Estado do Rio Grande do Norte, Departamento de Odontologia. Caicó, RN, Brasil.Objective : To evaluate the facial aging of women of different ages using a software program to assist in the classification of wrinkles and sagging in the nasogenian region. Method : A descriptive observational study of 100 female volunteers was performed. The women were aged between 20 and 70 years old and were sorted by age group into five groups of 20 volunteers each. The instruments used were the Facial Assessment Protocol, a cephalostat for the standardization of photos, a 14.1 megapixel Sony digital camera, and the Radiocef 2.0® software program. The Kolmogorov-Smirnov (KS) test was used for confirmation of normality and all data was statistically analyzed using ANOVA and Tukeys post hoc analysis. The Chi-squared and Pearsons correlation tests were also performed. A significance level of 5% and a p value of ≤0.05 were adopted. Results : It was observed that all age groups had wrinkles in the nasolabial fold region. There was an association between age and the Goglau, Lapiere and Pierard scale. This incidence increased progressively with aging. A moderate correlation (r=0.67) was observed between age and distance from the nasolabial folds, while angle represented only a weak correlation (r=0.3), with the most significant age group that with the shortest distance and the widest angle. Conclusion : The present study demonstrated the importance of the Radiocef 2.0® software program in providing a more detailed analysis of the nasolabial folds. It is therefore a complementary assessment to the Facial Assessment Protocol, representing a research protocol for identifying the effectiveness of treatments and improving the evaluative procedure.

Efeitos da fonoforese com gel de ativos lipolíticos na adiposidade abdominal

Abdominal obesity or android obesity, a known risk factor for diseases, constitutes also an aesthetic problem that prevents to eliminate localized fat in the abdomen. The objective of this study was to analyze the possible effects of phonophoresis lipolytic gel for treatment of localized adiposity. This study was characterized as a quasi-experimental research. The sample consisted of 30 female volunteers, suffering from abdominal fat, not making use of slimming drugs or some other therapy, not performing any type of physical activity, non pregnant, not bearers of neoplasia, not affected by acute infectious diseases. Volunteers were excluded if presenting allergy to some active principle, lack of attendance, presence of acute infectious diseases and / or fever during treatment. As assessment tools we used the Physiotherapy Assessment Protocol in adiposity located PAFAL, anthropometric assessment by measures of cutaneous folds, perimetry and ultrasound. We held 10 therapeutic ultrasound sessions (phonophoresis) with a 3 MHz frequency, 1.2 W / cm2 intensity, in continuous mode associated with a gel Lipolytics assets, lasting 12 minutes. The treated area was the umbilicus region of 168 cm2, using a printhead with 4 ERA’s (effective radiation area), each of which is equivalent to 3.5 cm2. Statistical analysis was performed using Microsoft Excel software using the paired t test, adopting a significance level of 95% (p < 0.05) .The weight of volunteers practically remained the same; in circumference and measures of cutaneous folds decreases were not significant; and there was an increase in ultrasound, which was significant. This study demonstrated that the use of phosphotidylcholine phonophoresis by using ultrasound did not reduce localized adiposity.

Investigação sobre a exposição solar em trabalhadores de praia - doi: 10.5020/18061230.2012.p103

Objective: To investigate the habits of photoexposition and photoprotection among beach workers in Natal-RN, Brazil. Methods: It is a descriptive observational epidemiological study of transverse type, with random sample consisting in 102 workers of Ponta Negra Beach, evaluated through a questionnaire of the Ministry of Health (DAS UV). Results: It was noted that 56% (n=57) of workers remain submitted to sun exposure for an average of 6 hours or more per day. It was found that approximately 24% (n=24) of respondents do not use sun protection. Workers showed a low educational level, since 55% (n=56) had only attended elementary school, whether graduated or not, and average monthly income was below two minimum wages for 69.96% of volunteers. Conclusion: This assessment revealed that workers of Ponta Negra Beach, Natal-RN, are highly exposed to ultraviolet radiation during their professional activities, without proper photoprotection of skin.